Nepal | January 23, 2021

Gut bacteria tied to disease severity, immune response; high mental health toll seen in ICUs

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The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Gut bacteria tied to COVID-19 severity, immune response

The microscopic organisms living in our intestines may influence the severity of COVID-19 and the body’s immune response to it, and could account for lingering symptoms, researchers reported on Monday in the journal Gut. They found that the gut microorganisms in COVID-19 patients were very different from those in uninfected individuals. “COVID patients lack certain good bacteria known to regulate our immune system,” said Dr. Siew Ng of The Chinese University of Hong Kong. The presence of an abnormal assortment of gut bacteria, or “dysbiosis,” persists after the virus is gone and could play a role in the long-lasting symptoms that plague some patients, she said. Her team has developed an oral formula of live bacteria known as probiotics and a special capsule to protect the organisms until they reach the gut. “Compared with patients on standard care, our pilot clinical study showed that more COVID patients who received our microbiome immunity formula achieved complete symptom resolution,” Ng said, adding that those who got it had significantly reduced markers for inflammation in their blood, increased favorable bacteria in their stool and they developed neutralizing antibodies to the virus.

Pandemic takes toll on ICU workers’ mental health

Nearly half of staff working in intensive care units (ICU) in England have severe anxiety, depression or post-traumatic stress disorder, with some feeling they would be better off dead, researchers reported on Wednesday in Occupational Medicine. The study was conducted in June and July – before Britain began experiencing its latest surge in hospitalizations. Among more than 700 healthcare workers in nine ICUs, 45% met the threshold for probable clinical significance for at least one of four serious mental health disorders: severe depression (6%), PTSD (40%), severe anxiety (11%) or problem drinking (7%). More than one in eight reported frequent self-harming or suicidal thoughts in the previous two weeks. Poor mental health among ICU staff caring for critically ill and dying COVID-19 patients not only harms their quality of life but also likely impairs their ability to work effectively, the researchers said. The findings show an urgent need for mental health services to be promptly accessible for all healthcare workers.

Cooling vests help COVID-19 nurses tolerate PPE

Nurses in COVID-19 wards who wear cooling vests under their personal protective equipment (PPE) feel less burdened by heat during their shifts, a small study suggests. Seventeen nurses wore a light-weight cooling vest under their PPE on one day, and PPE only on another day. On both days, participants swallowed an electronic capsule that provides a continuous reading of core body temperature. The vests led to a slight improvement in body temperature but a much bigger improvement in the sensation of being too hot, researchers reported in the journal Temperature. Only 18% of nurses reported thermal discomfort and 35% a slightly warm thermal sensation at the end of the day with the vest. That compared to 81% and 94%, respectively, on the day without the vest. “PPE is known to induce heat stress, which increases fatigue and sensory displeasure, and is known to impair effective decision making,” said study coauthor Thijs Eijsvogels of Radboud University Medical Center in the Netherlands. The CoolOver vests made by Dutch company Inuteq are easy to disinfect and re-activate in a refrigerator, he said, and may extend work tolerance time and improve recovery of clinicians involved in COVID-19 care.

Diabetes adds to COVID-19 risks for Black patients

Black patients with Type 1 diabetes (T1D) who become infected with the new coronavirus face a particularly high risk of a life-threatening diabetes complication known as ketoacidosis, new data show. T1D usually develops in children or young adults and requires daily insulin to survive. Researchers studied 180 patients from across the United States with T1D and COVID-19, including 31% who were Black and 26% who were Hispanic. Black patients had nearly four times the odds of developing diabetic ketoacidosis (DKA) compared with white patients, the researchers reported in The Journal of Clinical Endocrinology and Metabolism. Hispanics had a slightly higher risk than white patients. Blacks and Hispanics were significantly less likely to be using new diabetes technology like continuous glucose monitoring and insulin pumps, and had significantly worse blood sugar control compared with white patients. That suggested that the higher risk was likely driven by structural and systemic inequality, coauthor Dr. Osagie Ebekozien of the nonprofit T1D Exchange in Boston told Reuters. Particularly during the pandemic, healthcare providers need to screen patients with T1D for socio-economic factors that increase their risk of DKA like food insecurity, insulin affordability, and access to diabetes supplies, the researchers said.

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