COVID-19: News & Updates from June 2021
COVID-19: News & Updates
As a response to the Coronavirus/Covid-19 outbreak, many medical associations and organizations have released statements specifically related to treatment for cardiovascular patients.
These resources provide credible and trustworthy information. Many if not most, speak to the need for more detailed research and data, to help guide us as we develop new standards of practice to ensure optimal care based on clinical practice rather than speculation.
- Wear a mask in public places
- Social distancing - stay at least 6 feet away from other people
- Wash your hands frequently - with warm soapy water for at least 30 seconds
- Avoid crowds, confined and poorly ventilated spaces.
Eagle's Eye View: COVID-19 Tip of the Week
16 June, 2021 - ACC Eagle's Eye View: COVID-19 Tip of the Week
Dr. Kim Eagle provides a weekly tip for clinicians on the front lines of the COVID-19 pandemic. This week's tip focuses on the use of frequency with which patients hospitalized with COVID-19 are treated with anticoagulants https://www.acc.org/latest-in-cardiology, and the association of anticoagulation with in-hospital and 60-day mortality.
Please visit the ACC COVID-19 Hub for additional resources and information...
Scottish Study on Covid-19 Delta Variant Published in The Lancet
EXCERPT:
The Delta variant of COVID-19 is associated with approximately double the risk of hospitalisation compared with the Alpha variant, according to a new nationwide study published as a research letter in The Lancet.
Two vaccine doses still provide strong protection against the Delta variant but it may be at a lower level compared with the Alpha variant, the early evidence suggests.
The research team from Universities of Edinburgh and Strathclyde, and Public Health Scotland, analysed a dataset as part of the EAVE II project, which uses anonymised linked patient data to track the pandemic and the vaccine roll-out in real time.
Based on data analysed from 5.4 million people in Scotland, the Delta variant is now the dominant form of COVID-19 cases in the country, overtaking the Alpha variant, which was first identified in Kent.
During the period studied 1 April to 6 June 2021, there were 19,543 community cases and 377 hospitalisations where a specific variant of COVID-19 was confirmed. Of these totals, 7723 cases and 134 hospitalisations were found to have the Delta variant. People with underlying conditions were more at risk of being hospitalised, researchers said.
Vaccines were found to reduce the risk of being admitted to hospital, but strong protective effects against the Delta variant were not seen until at least 28 days after the first vaccine dose.
In community cases at least 2 weeks after the second dose, the Pfizer/BioNTech vaccine was found to provide 79% protection against infection from the Delta variant, compared with 92% against the Alpha variant.
For the same scenario, the Oxford/AstraZeneca vaccine offered 60% protection against infection with the Delta variant compared with 73% for the Alpha variant. This lower vaccine effect may reflect that is takes longer to develop immunity with Oxford/AstraZeneca, experts say.
The team caution that because of the observational nature of the study, data about vaccine effectiveness should be interpreted with caution and it is not possible to make a direct comparison between both vaccines.
COVID-19-induced Vascular Inflammation Behind Mortality Risk
COVID-19 infection is associated with a unique vascular inflammation 'signature' that, when present in at-risk individuals, increases the risk of in-hospital mortality around three-fold, shows an innovative data analysis of thousands of UK angiography patients.
The results, presented at the British Cardiovascular Society 2021 Annual Conference on June 10, may also explain why the cheap and widely-used steroid dexamethasone is able to reduce mortality rates in COVID-19 patients.
Dr Charalambos Antoniades, Radcliffe Department of Medicine, University of Oxford, and colleagues were already conducting a large-scale, artificial intelligence (AI)-led analysis of patients undergoing computed tomography (CT) angiograms of their heart when the pandemic struck.
They quickly repurposed their study to examine whether feature extraction of the CT scans could be combined with RNA sequencing to identify a profile of vascular inflammation induced by COVID-19 infection.
One Extra Step
The study, which was co-funded by the British Heart Foundation (BFH), showed that not only was an inflammation signature identifiable but also that it could be used to predict in-hospital mortality, particularly in those not given dexamethasone therapy.
"By simply adding in one extra step to the routine care of people admitted to hospital with COVID-19 who already have a CT scan, we can now detect patients at high risk of life-threatening complications and could potentially tailor their treatment to aid long-term recovery," Dr Antoniades said in a press release.
"This research clearly demonstrates that COVID-19 is a powerful virus that can wreak havoc on our circulatory system, and that different variants are associated with different levels of risk," commented Professor James Leiper, Institute of Cardiovascular and Medical Sciences, University of Glasgow, and Associate Medical Director at the BFH.
"There are still a lot of unknowns relating to how the virus can impact our health in the long-term, but this AI tool could ultimately help to save lives."
Dr Antoniades said that the benefits of the tool "don't stop there", however.
"We know that this exaggerated immune response to the virus can also cause abnormal blood clotting, and so we are developing this AI platform to specifically identify COVID-19 patients who are most at risk of having a future heart attack or stroke.
"We can also pivot our platform with ease to develop a new scanning 'signature' to better understand future viruses and diseases that take hold of our population."
Cardiovascular Risk Prediction Consortium
The UK C19 CT Cardiovascular Risk Prediction Consortium (CRT) study was originally designed to be the world's largest registry of cardiovascular CT scans, linked to life-long outcome data and biological factors, with the aim of developing and validating novel biomarkers.
Sixteen sites in the UK and 14 international centres are enrolled in the study, and it incorporates the Oxford Risk Factors And Non-invasive imaging study (ORFAN), for which 10,000 patients undergoing coronary computed tomography angiography (CCTA) in the UK have been prospectively recruited.
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