Medical Minutes
COVID-19 infection rates low among older adults with rheumatic diseases
Texas researchers are happy to report some reassuring news for older adults living with rheumatic diseases. A new study is showing that the COVID-19 infection incidence has been low among adults with rheumatic diseases, and most of those infected only have a mild course of illness. Additionally, deaths have been low among rheumatic disease patients infected with COVID-19.
As the COVID-19 pandemic continues to surge worldwide, the risk of serious infection, complications or fatality was unknown for adults with a rheumatic disease. Many older adults with a rheumatic disease are treated with immunosuppressant medications that leave them more susceptible to infection.
“When the pandemic started, there was concern on whether to continue or hold immune therapies among patients with rheumatic diseases because they are at increased risk for infection,” said study co-author, Dr. Akhil Sood, who is with the University of Texas Medical Branch in Galveston. “We were interested to see if these patients are at an increased risk for COVID-19 infection. If they were to become infected, we wanted to know the severity of their clinical course. This can help us to determine whether it is safe to continue or hold immune therapies in settings of COVID-19 infection.”
The researchers systematically searched PubMed/Medline and Scopus to identify relevant studies from January to June 2020 that reported the outcomes of COVID-19 among individuals with a rheumatic disease. They examined patients’ use of certain medications, including biologics and targeted therapy with Janus kinase (JAK) inhibitors.
The final review included 6,095 patients with rheumatic diseases, with 28% having rheumatoid arthritis and 7% having psoriatic arthritis. Of the 6,095 patients, only 123, or 2%, were positive or highly suspicious for COVID-19. Across all the studies used for the review, 68% of COVID-19 patients were taking biologics, with 31% taking anti-TNF drugs and 6% taking JAK inhibitors. Among those patients who were infected with the coronavirus, 91, or 73%, were never hospitalized. Thirteen patients who were hospitalized required admission to an ICU and four patients died.
Wearable fitness devices to combat COVID-19
A new study is showing that smart phones and wearables may be helpful in the war on COVID-19. The DETECT study, launched on March 25, uses a mobile app to collect smartwatch and activity tracker data from consenting participants. It also gathers their self-reported symptoms and diagnostic test results. Any adult living in the United States is eligible to participate in the study by downloading the research app MyDataHelps.
In a study published in “Nature Medicine”, investigators reported that wearable devices like Fitbit are capable of identifying cases of COVID-19 by evaluating changes in heart rate, sleep and activity levels, along with self-reported symptom data.
“What’s exciting here is that we now have a validated digital signal for COVID-19. The next step is to use this to prevent emerging outbreaks from spreading,” said Dr. Eric Topol, who is the director and founder of the Scripps Research Translational Institute, La Jolla, Calif. “Roughly 100 million Americans already have a wearable tracker or smartwatch and can help us. All we need is a tiny fraction of them, just 1% or 2% to use the app.”
With data from the app, researchers can see when participants fall out of their normal range for sleep, activity level, or resting heart rate. Deviations from individual norms are a sign of viral illness or infection. The predictive model under development in DETECT might help public health officials spot coronavirus hotspots early. It also may encourage people who are potentially infected to immediately seek diagnostic testing and, if necessary, quarantine themselves to avoid spreading the virus.
Virus-deactivating face masks
Researchers have developed a face mask with an embedded antiviral layer that sanitizes the wearer’s respiratory droplets to make them less infectious to others. A team of Northwestern University researchers have developed a new concept for a mask that aims to make the wearer less infectious. The central idea is to modify mask fabrics with anti-viral chemicals that can sanitize exhaled, escaped respiratory droplets.
By simulating inhalation, exhalation, coughs and sneezes in the laboratory, the researchers found that non-woven fabrics used in most masks work well to demonstrate the concept. A lint-free wipe with just 19% fiber density, for example, sanitized up to 82% of escaped respiratory droplets. Such fabrics do not make breathing more difficult, and the on-mask chemicals did not detach during simulated inhalation experiments.
“Masks are perhaps the most important component of the personal protective equipment (PPE) needed to fight a pandemic,” said lead study investigator Jiaxing Huang, who is with Northwestern University in Chicago, Illinois. “We quickly realized that a mask not only protects the person wearing it, but much more importantly, it protects others from being exposed to the droplets (and germs) released by the wearer.”
Although masks can block or reroute exhaled respiratory droplets, many droplets (and their embedded viruses) still escape. From there, virus-laden droplets can infect another person directly or land on surfaces to indirectly infect others. Huang’s team aimed to chemically alter the escape droplets to make the viruses inactivate more quickly.
After performing multiple experiments, Huang’s team grew a layer of a conducting polymer polyaniline on the surface of the mask fabric fibers. The material adheres strongly to the fibers, acting as reservoirs for acid and copper salts. Huang hopes the current work provides a scientific foundation for other researchers, particularly in other parts of the world, to develop their own versions of this chemical modulation strategy.
John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.
John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.
