The Perfect Enemy | News Scan for Nov 04, 2022
December 6, 2022

News Scan for Nov 04, 2022

Quality of life with long COVID
Zinc for treating COVID-19
More Ebola in Uganda
H5N1 avian flu in Spanish poultry workers
New Mexico H3N2v flu case
Polio in 4 countries
Read Time:7 Minute

Study shows moderate, severe COVID diminishes quality of life 1 year later

In a new study in BMC Medicine, Dutch researchers report that, 12 months after illness onset, people with initially moderate to severe COVID-19 still had impaired health-related quality of life (HRQL), but the same was not true for mild COVID-19.

The study is part of the RECoVERED trial, a prospective cohort study in Amsterdam that looks at adult health following a confirmed COVID-19 diagnosis. HRQL was assessed with the Medical Outcomes Study Short Form 36-item health survey (SF-36), which was completed by 269 adults by December of 2021.

The 36 items assessed the respondent’s HRQL: ability to perform usual and vigorous activities (physical functioning), ability to participate in social and occupational activities (social functioning, physical role functioning, and emotional role functioning), mood (mental health dimension), amount of energy and pain (vitality/fatigue and pain dimensions) and perceived current health (general health perceptions). Scores were 0 to 100, with higher scores showing higher quality of life.

One month after diagnosis, all adult participants with COVID scored lower on HRQL when compare to population controls, but by 12 months, only those who had moderate or severe/critical COVID-19 had HRQL below population norms on more than half of the SF-36 domains.

People with three or more COVID-19 high-risk comorbidities had significantly worse HRQL at both the 1- and 12-month mark. At 12 months, those with worse initial infection still had significantly lower HRQL on five out of eight categories.

“At month 12, participants with initial moderate or severe COVID-12 still had impaired HRQL on the dimensions physical, social and role emotional functioning, vitality and general health with moderate to large deviations from general population norms,” the authors concluded.
Nov 2 BMC Med

Oral zinc cuts risk of death, ICU stay nearly 40% in COVID-19 patients

Tunisian COVID-19 patients given oral zinc twice daily had a nearly 40% lower rate of death and intensive care unit (ICU) admission, as well as shorter hospital stays and time to symptom resolution, concludes a randomized controlled trial published today in Clinical Infectious Diseases.

The double-blind, multicenter trial involved 190 adult COVID-19 outpatients and 280 hospitalized patients randomly assigned to receive oral zinc (231 patients) or a placebo (239) for 15 days, from Feb 15 to May 4, 2022.

Average duration of symptoms before enrollment was 4.6 days, and average age was 54.2 years. Roughly 20% had received two doses of COVID-19 vaccine, and 23% had at least one dose. Thirty-seven patients died, 81.1% of them in the ICU.

The 30-day death rate was 6.5% among zinc recipients and 9.2% in the placebo group (odds ratio [OR], 0.70; 95% confidence interval [CI], 0.37 to 1.32), and 5.2% and 11.3%, respectively, were admitted to an ICU (OR, 0.46; 95% CI, 0.23 to 0.88). The need for hospitalization was similar in the two groups (1.2% vs 3.8%, respectively; OR, 0.30; 95% CI, 0.03 to 2.8).

The zinc group was also less likely to experience the combined outcome of death or ICU admission (OR, 0.62; 95% CI, 0.38 to 0.99). Hospital stays were shorter among zinc recipients than among those given placebo (difference, 3.5 days; 95% CI, 2.76 to 4.23), as was duration of symptoms among outpatients (difference, 1.9 days; 95% CI, 0.62 to 2.6).

The results were similar in patients older than 65 years and those with underlying medical conditions or the need for supplemental oxygen at baseline. No severe adverse events were reported; minor events occurred in 3.9% of the zinc group and 7.1% of placebo recipients (OR, 0.52; 95% CI, 0.23 to 1.12).

Zinc has a key role in regulating the immune system, the authors noted. “Zinc should be considered for the treatment of patients with COVID-19,” they wrote.
Nov 4 Clin Infect Dis study

Ebola sickens 1 more in Uganda, kills 5 more

Over the past 2 days, Uganda reported one more Ebola case and five deaths, according to updates from the World Health Organization (WHO) Uganda office.

The new infection was reported from Kampala in a patient who is a known contact of an earlier patient. Of the five deaths, four were in Mubende, the outbreak’s main hot spot, and one was in the Ebola treatment center in Entebbe. The developments lift the overall outbreak to 131 confirmed cases, 48 of them fatal. In addition, the country has reported 21 suspected cases, all fatal. The case-fatality rate among confirmed cases is 37%.

The number of districts reporting cases stands at seven, and outbreak responders are monitoring 1,604 contacts across eight districts, with a follow-up rate of 93%.

The outbreak, which involves the less common Sudan Ebola strain, began in September, marking Uganda’s first outbreak involving the strain since 2012.
Nov 3 WHO Uganda office situation report
Nov 4 WHO Uganda office situation report

Spain reports H5N1 avian flu in 2 poultry workers

Spanish public health officials have identified H5N1 avian influenza in two male poultry workers who underwent nasopharyngeal swabbing in the wake of an avian flu outbreak in September at a poultry farm on which they both worked.

The WHO said the detections were probably due to their exposure to infected poultry and that no evidence of human-to-human transmission has been found. Neither man had symptoms.

In a statement that detailed the findings, the WHO said nasopharyngeal samples were collected from all 12 of workers on the farm in Guadalajara province on Sep 23, which was 3 days after the poultry outbreak began. H5N1 was detected in a sample from a 19-year-old man. Samples from his contacts were negative.

The workers were tested again on Oct 12 after response measures were taken at the farm. A 27-year-old man who had been involved in cleaning and disinfection while wearing personal protective equipment tested positive. Two of his close contacts tested negative.

The WHO said it has now received reports of four such cases. The other was reported from the United Kingdom in 2021 in a man who had prolonged close contact with poultry. In the United States, Colorado officials in April reported an H5 infection in a 40-year-old man who, as a prison inmate, was exposed to poultry outbreak response as part of a prerelease employment program. His only symptoms were mild fatigue.
Nov 3 WHO statement
Apr 29 CIDRAP News story


New Mexico reports H3N2v flu case

New Mexico’s health department has reported a variant H3N2 (H3N2v) case, the nation’s tenth variant flu infection of the year, the US Centers for Disease Control and Prevention (CDC) said its regular weekly flu update today.

The patient is a child who is recovering. An investigation revealed that he or she had been exposed to pigs before symptoms began. No other related H3N2v infections have been found, but the investigation is still under way.

Of the 10 variant flu infections reported so far this year, 5 were H3N2v and 5 were H1N2v.

The CDC said variant flu cases commonly involve exposure to swine, but human-to-human illnesses have been reported. It added that although the viruses don’t spread easily among people, early identification is essential to gauge the risk and guide public health measures.
Nov 4 CDC FluView update


Four African nations report more polio cases

Four countries reported more polio cases this week, including Mozambique, which reported another wild poliovirus type 1 (WPV1) case, the Global Polio Eradication Initiative (GPEI) said in its latest weekly update.

Mozambique has now reported eight WPV1 cases. Its latest infection was in Tete province. GPEI said reporting of multiple cases in such a short time span shows that intensified surveillance efforts are working. Also, the country reported 5 more circulating vaccine-derived poliovirus type 1 (cVDPV1) cases, all in Zambezia, raising the total for the year to 13.

The Democratic Republic of the Congo (DRC) reported 7 more cVDPV1 cases as well as 3 more involving circulating vaccine-derived poliovirus type 2 (cVDPV2). All of the cVDPV1 cases were in Haut Lomami province and raise the country’s 2022 total to 36. The cVDPV2 cases were in three provinces, putting the total for the year at 163, up sharply from the 28 cases the DRC reported in 2021.

Elsewhere, Madagascar reported 2 more cVDPV1 cases, 1 each in Androy and Sava, bringing the total for 2022 to 10. And Nigeria reported 1 more cVDPV2 case, which was in Oyo, lifting the nation’s number for the year to 38, compared with 415 in 2021.
Nov 3 GPEI update