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Placenta may have mechanism that protects fetus from COVID; vaccines safe with rheumatic diseases

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The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

Placenta may shed proteins to keep virus out

The placenta may have a way to protect itself and the fetus from infection with the coronavirus, a small study suggests.

Researchers studied 24 women who gave birth between July 2020 and April 2021. Eight had symptomatic COVID-19 in the second trimester, eight were sick from the virus in the third trimester, and eight were not infected during pregnancy. When COVID-19 occurred in pregnancy, particularly during the third trimester, placenta cells appeared to “shed” a surface protein called ACE2 that the virus uses to break into cells and infect them, leaving fewer gateways for entry. Women who had COVID-19 in the third trimester had high levels of an enzyme called ADAM17 that is known to help ACE2 release itself from the cell surface, the researchers reported in The American Journal of Pathology.

The placenta may be sensing the maternal COVID-19 infection “and possibly putting in place this mechanism to help shed off ACE2, prevent SARS-CoV-2 from invading the placenta and passing on to the fetus,” said Elizabeth Taglauer of Boston Medical Center. Earlier studies have shown that placental cells become infected in only about 7% to 20% of pregnancies where the mother has COVID-19, Taglauer said. When the virus does somehow get into the placenta, it rarely reaches the fetus, she added. Her team plans further studies of “protection pathways” that may be keeping the virus out of placental cells and away from fetal blood vessels.

COVID vaccines safe in rheumatic, musculoskeletal diseases

COVID-19 vaccines appear to be safe for people with rheumatic and musculoskeletal diseases and are likely to trigger flares – a sudden worsening of symptoms – in less than 5% of cases, researchers have found.

The findings were based on data from 5,121 patients in 30 countries. Severe flares occurred in fewer than 1% of patients after vaccination, they found. Overall, flares were more likely to occur in patients with active disease, according to a report published in Annals of the Rheumatic Diseases. “However, it is important to note that flares can occur as part of the … disease, and the observed percentages of flare would be compatible with the natural history of the disease rather than necessarily caused by vaccines against SARS-CoV-2,” said Dr. Pedro Machado of University College London. The average study participant was 72 years old, and most were women. Many had inflammatory joint diseases, connective tissue diseases or vasculitis and were receiving various combinations of disease-modifying antirheumatic drugs, immunosuppressants, and other medications.

Most had received the Pfizer/BioNTech vaccine (70%), followed by shots from AstraZeneca (17%) and Moderna (8%). “Our findings should provide reassurance to rheumatologists, other health professionals and vaccine recipients, and promote confidence in the safety of COVID-19 vaccination in people with inflammatory rheumatic diseases,” Dr. Machado said.

Peer-review does not lead to major changes in “preprints”

Two studies published on Tuesday in PLoS Biology suggest that papers posted on so-called preprint servers before undergoing formal peer review do not change significantly before publication in medical journals.

One study compared more than 180 reports posted during the first four months of the pandemic on the preprint servers medRxiv and bioRxiv to the versions eventually published in peer-reviewed journals. Roughly 83% of COVID-related papers and 93% of non-COVID-related papers did not change from their preprint to final published versions, they found. When the researchers did identify changes, in the majority of cases those changes did not qualitatively change the conclusions of the paper, they said.

The other study used machine learning to analyze the relationships between nearly 18,000 preprints on the bioRxiv server and their published versions. Most manuscripts had only modest changes in wording during the peer-review and publication process, the researchers found.

Click for a Reuters graphic on vaccines in development.

 

(Reporting by Nancy Lapid; Additional reporting by Marilynn Larkin; Editing by Bill Berkrot)

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Westmount Mall to open COVID-19 vaccination clinic for month of July – CTV News London

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A new COVID-19 vaccination clinic may soon open in a mall near you.

According to a press release issued by the Middlesex-London Health Unit (MLHU) on Tuesday, the latest mall-based COVID-19 vaccination clinic is set to open in southwest London in early July.

Westmount Shopping Centre will be the home of the newest vaccination clinic and is slated to open on July 7.

In the press release, the MLHU said due to the previous success of the clinics at CF Masonville Place and White Oaks Mall, “The opening of this latest COVID-19 vaccination clinic continues the Health Unit’s strategy of creating easy and convenient ways for area residents to have optimal protection against the virus.”

The clinic will operate out of a space beside the Bulk Barrel located near the mall’s entrance one location, off Viscount Road.

It will be open Thursdays, Fridays and Saturdays from 11:30 a.m. to 5:30 p.m. throughout the month of July. It will operate on a walk-in basis, and individuals can receive any dose they are currently eligible for.

Dr. Alex Summers, MLHU medical officer of health said that due to the summer weather and more people spending time outdoors, Londoners might not be thinking about COVID-19. But, he hopes the new clinic will change that for the better.

“Our clinic at Westmount Shopping Centre will allow people who have not received all the doses they are eligible for to get vaccinated. This will provide additional protection against the COVID-19 virus that continues to circulate in our community.”

Likewise, Amanda Smith, property administrator at Westmount Shopping Centre is optimistic at the upcoming partnership with the MLHU.

“Westmount Shopping Centre Management is pleased to be collaborating with the Middlesex-London Health Unit, as they offer these vaccination services to our Centre and our community,” she said.

A list of the MLHU’s COVID-19 vaccination clinics can be found on the health unit’s website

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Vitamin D supplement 'overdosing' is possible and harmful, warn doctors – Medical Xpress

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Credit: Pixabay/CC0 Public Domain

‘Overdosing’ on vitamin D supplements is both possible and harmful, warn doctors in the journal BMJ Case Reports after they treated a man who needed hospital admission for his excessive vitamin D intake.

‘Hypervitaminosis D’, as the condition is formerly known, is on the rise and linked to a wide range of potentially serious health issues, they highlight.

The case concerns a middle-aged man who was referred to hospital by his family doctor after complaining of recurrent vomiting, nausea, , leg cramps, tinnitus (ringing in the ear), dry mouth, increased thirst, diarrhea, and weight loss (28 lbs or 12.7 kg).

These symptoms had been going on for nearly 3 months, and had started around 1 month after he began an intensive vitamin supplement regimen on the advice of a nutritional therapist.

The man had had various health issues, including tuberculosis, an inner ear tumor (left vestibular schwannoma), which had resulted in deafness in that ear, a build-up of fluid in the brain (hydrocephalus), bacterial meningitis, and chronic sinusitis.

He had been taking high doses of more than 20 over the counter supplements every day containing: vitamin D 50000 mg—the daily requirement is 600 mg or 400 IU; vitamin K2 100 mg (daily requirement 100–300 μg); vitamin C, vitamin B9 (folate) 1000 mg (daily requirement 400 μg); vitamin B2 (riboflavin), vitamin B6, omega-3 2000 mg twice daily (daily requirement 200–500 mg), plus several other vitamin, mineral, nutrient, and probiotic supplements.

Once symptoms developed, he stopped taking his daily cocktail, but his symptoms didn’t go away.

The results of blood tests ordered by his revealed that he had very high levels of calcium and slightly raised levels of magnesium. And his vitamin D level was 7 times over the level required for sufficiency.

The tests also indicated that his kidneys weren’t working properly (acute kidney injury). The results of various X-rays and scans to check for cancer were normal.

The man stayed in hospital for 8 days, during which time he was given intravenous fluids to flush out his system and treated with bisphosphonates—drugs that are normally used to strengthen bones or lower excessive levels of calcium in the blood.

Two months after discharge from hospital, his calcium level had returned to normal, but his vitamin D level was still abnormally high.

“Globally, there is a growing trend of hypervitaminosis D, a clinical condition characterized by elevated serum vitamin D3 levels,” with women, children and surgical patients most likely to be affected, write the authors.

Recommended vitamin D levels can be obtained from the diet (eg wild mushrooms, oily fish), from exposure to sunlight, and supplements.

“Given its slow turnover (half-life of approximately 2 months), during which vitamin D toxicity develops, symptoms can last for several weeks,” warn the authors.

The symptoms of hypervitaminosis D are many and varied, they point out, and are mostly caused by excess calcium in the blood. They include drowsiness, confusion, apathy, psychosis, depression, stupor, coma, anorexia, abdominal pain, vomiting, constipation, peptic ulcers, pancreatitis, , abnormal heart rhythm, and kidney abnormalities, including renal failure.

Other associated features, such as keratopathy (inflammatory eye disease), joint stiffness (arthralgia), and hearing loss or deafness, have also been reported, they add.

This is just one case, and while hypervitaminosis D is on the rise, it is still relatively uncommon, caution the authors.

Nevertheless, complementary therapy, including the use of dietary supplements, is popular, and people may not realize that it’s possible to overdose on D, or the potential consequences of doing so, they say.

“This case report further highlights the potential toxicity of supplements that are largely considered safe until taken in unsafe amounts or in unsafe combinations,” they conclude.


Explore further

Vitamin D supplements may offset bone loss caused by diabetes drug


More information:
Vitamin D intoxication and severe hypercalcaemia complicating nutritional supplements misuse, BMJ Case Reports (2022). DOI: 10.1136/bcr-2022-250553

Citation:
Vitamin D supplement ‘overdosing’ is possible and harmful, warn doctors (2022, July 5)
retrieved 6 July 2022
from https://medicalxpress.com/news/2022-07-vitamin-d-supplement-overdosing-doctors.html

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.

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Pharmacists in London, Ont., hope medication shortage is resolved before cold and flu season – CBC.ca

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An Ontario-wide shortage of cold and flu medication has led to partially empty shelves in pharmacies in London. 

The Ontario Pharmacists Association told CBC News in April that drug stores were seeing an increase in people looking to treat symptoms of upper respiratory tract infections, due to COVID-19, influenza or the common cold, after mask mandates were lifted on March 21. 

Months later, pharmacists in London say the shortage has been further exacerbated by allergy season and ongoing supply chain issues.

“Demand is the same, but we hear patients are going from one pharmacy to the other looking for the product,” said Gamal Awad, owner of Guardian Wonderland Pharmacy. 

For the past month, wholesalers of over-the-counter medications for cold and flu have been unable to make their delivery dates. Pharmacies have lost out on sales, said Awad, while customers are scrambling for back-ordered items like cough syrup, Tylenol or Advil. 

At Guardian Wonderland Pharmacy in London, Ont., what little stock owner Gamal Awad has is pushed to the front of shelves. (Angela McInnes/CBC)

“The only thing we can ask our patients is to wait as we look back on our supplier website to see when those medications are going to be back online or when we can order them,” said Fadi Shatara, a pharmacist at Chapman’s Pharmacy.   

The shortage includes medication for children, said Shatara. He advises parents to refer to their doctors for alternatives if they’re unable to find what they need. 

Risk of transmission is low, for now

London’s medical officer of health, Dr. Alex Summers, said outdoor movement in summer generally brings a lower risk of respiratory illness transmission, even as COVID-19 restrictions have been lifted. 

However, the absence of those measures and return to indoor activity mean risk for cold, flu and COVID-19 will rise in the fall and winter months. 

“The more people gather indoors, the greater the risk of transmission. The less people are wearing masks, the greater the risk of transmission, the less people are vaccinated, the greater the risk of transmission,” he said. 

That leaves pharmacists like Shatara bracing for the changing seasons and hoping the medication shortage is resolved by then. 

“If it happens again, that’s going to be devastating, especially with the lack of medications,” he said. “Now, if that lasts until winter or fall, it’s going to have a huge impact on everyone.” 

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