‘We were frustrated and afraid’: Some COVID-19 patients suffer lung and heart damage, but there’s encouraging news for these ‘long haulers’ - MarketWatch | Canada News Media
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‘We were frustrated and afraid’: Some COVID-19 patients suffer lung and heart damage, but there’s encouraging news for these ‘long haulers’ – MarketWatch

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Up until she fell ill with COVID-19, Yvonne Cassidy, a New York-based novelist, said she thought there were only three types of COVID: “The mild version, the version that put you in hospital and the version that killed you. I didn’t know there were others like me, stuck on a post-COVID plateau, not sick anymore, but not better either.”

Two months after being diagnosed with coronavirus, she found it difficult to even walk one block. “It turned out we were a group who had a name: We were COVID long-haulers. The Mayo Clinic and medical journals had published pieces about us,” she said. “We had support groups on social media. We even had a hashtag. We were frustrated and afraid.”

“With my doctor’s guidance I introduced a very slow five-minute jog into my already slow walking schedule. The first time I did it, my chest burned and I doubled over, hands on knees, gasping for breath,” Cassidy, who had toyed with training for a marathon, wrote in an essay for MarketWatch. And today? “The goal isn’t 26 miles. Today’s goal was 30 minutes.”

Cassidy was fortunate. Some younger COVID-19 patients who were otherwise healthy have had blood clots and strokes. Many “long-haulers” — COVID-19 patients who have continued showing symptoms for months after the initial infection — report neurological problems including confusion, difficulty concentrating, heart and lung issues, fatigue, insomnia, plus loss of taste and/or smell.

“There is evidence now that the virus can directly attack heart muscle cells, and there’s also evidence that the cytokine storm that the virus triggers in the body not only damages the lungs, but can damage the heart,” according to John Swartzberg, a clinical professor emeritus of infectious diseases and vaccinology in the the UC Berkeley-UCSF Joint Medical Program.

“One thing we didn’t anticipate was that the virus seems to accelerate a great deal of scarring in the lungs,” he said in an interview with the university. “What we really fear is long-term shortness of breath that could extend anywhere from being very mild to severely limiting.” He found it “disturbing” that one report of CT scans of asymptomatic patients were left with some scar tissue.

Some of these symptoms can persist for months, according to the Mayo Clinic. “The virus can damage the lungs, heart and brain, which increases the risk of long-term health problems.” Most people recover completely within a few weeks, “but some people — even those who had mild versions of the disease — continue to experience symptoms after their initial recovery,” it added.

“Older people and people with many serious medical conditions are the most likely to experience lingering COVID-19 symptoms,” the clinic added. “Although COVID-19 is seen as a disease that primarily affects the lungs, it can damage many other organs as well. This organ damage may increase the risk of long-term health problems.”

Also see:Johns Hopkins scientists examining weird side effects of COVID-19 suggest one way coronavirus ‘gains a foothold in the body’

Yvonne Cassidy: ‘My chest burned and I doubled over, hands on knees, gasping for breath.’

Although COVID-19 patients can suffer long-term lung and heart damage, there is some good news for these long haulers. There’s more evidence that such aftereffects improve over time, according to a paper by a team of researchers presented at the European Respiratory Society International Congress, which studied patients in a COVID-19 “hot spot” in the Tyrolean region of Austria.

Some 86 patients out of a sample of 150 people were scheduled to return for evaluation 6, 12 and 24 weeks after their discharge from hospital. During these visits, clinical examinations, laboratory tests, arterial blood analysis of oxygen and carbon dioxide, lung function tests, computed tomography scans and echocardiograms (on the heart’s chambers and valves) were carried out.

At the time of their first visit, more than half of the patients had at least one persistent symptom, predominantly breathlessness and coughing, and computer tomography or CT scans showed lung damage in 88% of patients. However, by week 12 after discharge, symptoms improved and lung damage was reduced to 56%.


‘The good news is that the impairment tends to ameliorate over time, which suggests the lungs have a mechanism for repairing themselves.’


— Sabina Sahanic, a clinical Ph.D student at the University Clinic in Innsbruck, Austria

“The bad news is that people show lung impairment from COVID-19 weeks after discharge; the good news is that the impairment tends to ameliorate over time, which suggests the lungs have a mechanism for repairing themselves,” said Sabina Sahanic, a clinical Ph.D student at the University Clinic in Innsbruck and part of the team that carried out the study.

The average age of the 86 patients was 61 and 65% of them were male. Unlike Cassidy, nearly half of them were current or former smokers and 65% of hospitalized COVID-19 patients were overweight or obese. Eighteen (21%) had been in an intensive care unit, 16 (19%) underwent invasive mechanical ventilation, and the average length of stay in hospital was 13 days.

The CT scans indicated that overall lung damage decreased from week 6 to week 12. Damage from inflammation and fluid in the lungs caused by COVID-19 was present in 74 patients (88%) at 6 weeks and 48 patients (56%) at 12 weeks. “We did not observe any severe coronavirus-associated heart dysfunction in the post-acute phase,” Sahanic said.

“The findings from this study show the importance of implementing structured follow-up care for patients with severe COVID-19 infection,” she added. “Importantly, CT unveiled lung damage in this patient group that was not identified by lung function tests. Knowing how patients have been affected long-term by the coronavirus might enable symptoms and lung damage to be treated much earlier.”

COVID-19 patients can suffer long-term lung and heart damage but, but there is some good news for these long haulers. (Photo: Getty Images)

This study is also supported by an article for primary-care physicians that was published last month in the British Medical Journal. It said that around 10% of patients who have tested positive for SARS-CoV-2 remain unwell beyond three weeks, and a smaller proportion for months. This was based on a study in which people log their ongoing symptoms on a smartphone app.

This percentage, however, is lower than that cited in many published observational studies. A recent U.S. study found that only 65% of people had returned to their previous level of health 14 to 21 days after a positive test, which has been the case with people who like Yvonne Cassidy who no longer have the virus, but have the antibodies.

Dr. Dixie Harris, a pulmonologist at the Intermountain Healthcare hospital system in Utah, told MarketWatch that coronavirus long haulers suffer shortness of breath, fatigue, memory issues, and even depression, but she too said there is “improvement over time.” She added, “Things such as prolonged symptoms — fatigue, that kind of thing — [have] been reported in MERS and SARS.”

In a second presentation to the European Respiratory Society International Congress on Monday, Yara Al Chikhanie, a Ph.D student at the Dieulefit Santé clinic for pulmonary rehabilitation and the Hp2 Lab at the Grenoble Alps University, France, said that the sooner COVID-19 patients started a pulmonary rehabilitation program after coming off ventilators, the better and faster their recovery.

She studied 19 patients who had spent an average of 3 weeks in intensive care and 2 weeks in a pulmonary ward before being transferred to the Dieulefit Santé clinic. The lack of physical movement in addition to severe infection and inflammation, lead to severe muscle loss, she said. The muscles for breathing are also affected. Most were unable to walk when they arrived at the clinic.

They underwent a test to see how far they could walk in six minutes. At the beginning, they were only able to walk barely a fifth of that distance on average, but after three weeks of pulmonary rehabilitation, this increased to an average of 43%. That is obviously still far from normal, but supervised rehabilitation helped to increase their lung capacity.


‘The sooner rehabilitation started and the longer it lasted, the faster and better was the improvement in patients’ walking and breathing capacities and muscle gain.’


— Yara Al Chikhanie, Ph.D student at Dieulefit Santé, a clinic for pulmonary rehabilitation

“The sooner rehabilitation started and the longer it lasted, the faster and better was the improvement in patients’ walking and breathing capacities and muscle gain,” Al Chikhanie said. “Patients who started rehabilitation in the week after coming off their ventilators progressed faster than those who were admitted after 2 weeks.”

COVID-19 has now killed at least 892,880 people worldwide, and 189,215 in the U.S., Johns Hopkins University says. As of Tuesday, the U.S. still has the world’s highest number of COVID-19 cases (6,301,320). Worldwide, there have been at least 27,351,624 confirmed cases, which mostly does not account for asymptomatic cases.

The Dow Jones Industrial Index
DJIA,
-2.24%
,
the S&P 500
SPX,
-2.77%

and the Nasdaq Composite
COMP,
-4.11%

ended lower Friday. Doubts about traction for further fiscal stimulus from Washington may be one factor discouraging investors who have been betting on Republicans and Democrats striking a deal to offer additional relief to consumers and businesses.

India has reported 4,280,422 COVID-19 cases, surpassing Brazil (with 4,147,794) as the country with the second highest number of coronavirus cases in the world behind the U.S. India has a rate of COVID-related death per 100,000 people of 5.3 and a case-fatality rate of 1.7%. In contrast, the U.S. has a fatality rate of 57.7 per 100,000 people and a case-fatality rate of 3%.

‘The sooner rehabilitation started and the longer it lasted, the faster and better was the improvement in patients’ walking and breathing capacities and muscle gain.’ (Photo: AFP via Getty Images)


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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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