Monday, May 16, 2022

Resolving the subtypes of COVID-19 in the elderly

SARS-Cov-2 is one of the most complex viruses known to medical science. Patients with COVID-19 present a broad spectrum of clinical manifestations, ranging from asymptomatic infection to lethal outcome. Both the young and the old may have very different clusters of symptoms and responses to medications, including the COVID-19 vaccines.  Each type is associated with how severe of an illness a patient might experience, ranging from asymptomatic to lethal. 


Precision medicine approaches such as whole-exome sequencing can provide insight into the phenotypes, endotypes and underlying mechanisms of the disease. The high cost of cutting-edge approaches, however, keeps these tools out of reach for many research teams. 

In this age of big data and large clinical studies, we should not forget about the value of individual cases. A good case report tells a detailed story. It describes a unique phenotype and offers unique clues to its resolution into an endotype. 

A new systematic review of case reports aims to answer questions about COVID-19 subtypes in octogenarians, nonagenarians, and centenarians and offer possible solutions to organize the knowledge and identify the gaps. 


REFERENCE

Irene S. Gabashvili. The outcomes of COVID-19 vaccination and SARS-CoV-2 infection in octogenarians, nonagenarians, and centenarians. PROSPERO 2022 CRD42022332621 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022332621

Irene S. Gabashvili (2022), “COVID-19 vaccine and SARS-CoV-2 in the oldest old: rapid literature review”, Mendeley Data, v1 http://dx.doi.org/10.17632/6sk33d9z7s.1 https://data.mendeley.com/datasets/6sk33d9z7s/1


Thursday, March 3, 2022

Getting Out of Echo Chambers

Web search is hyper personalized and social media creates echo chambers. 

Nothing new, really. "The Facebook effect" was coined over 10 years ago, and the echo chamber effect of the Internet was known long before that.  Echo chambers existed even in the early blogosphere. But the isolation from a diversity of views and opinions may be reaching the tipping point. 

A study published last month in PLOS One, analyzed and visualized 60 billion tweets demonstrating how highly the vaccine debate is polarized. 

Users with similar stances interacted preferentially with one another. Interactions between individuals with different views were rare and not productive.  Extending this insight, the authors provide evidence of an epistemic echo chamber effect, where users are exposed to highly dissimilar sources of information, depending on the stance of their contacts. 

But does it make sense to call an article or a blog post provaxx or antivaxx based on pro- or anti-vaccine sentiment?

Why can't we discuss pros and cons of vaccines objectively and admit that medicine should be personalized? Majority of population benefits from vaccines, but there are those that don't. Should not we try to understand why?

The only way to overcome hyperpolarization is to increase our collective cultural intelligence, improve critical thinking skills, recognize the legitimacy and ongoing necessity of opposing viewpoints.

The new.aurametrix.com site is a collection of scientific papers about the less discussed medical cases. We all know that vaccines work. We dare you to understand why there are cases when they don't. 



REFERENCES

Less Discussed Medical Case Reports

Mønsted B, Lehmann S. Characterizing polarization in online vaccine discourse—A large-scale study. PloS one. 2022 Feb 9;17(2):e0263746.

Ries M. The COVID-19 Infodemic: Mechanism, Impact, and Counter-Measures—A Review of Reviews. Sustainability. 2022 Jan;14(5):2605.

Gorman, J. M., & Scales, D. A. (2022). Leveraging infodemiologists to counteract online misinformation: Experience with COVID-19 vaccines. Harvard Kennedy School (HKS) Misinformation Review. https://doi.org/10.37016/mr-2020-92

Saturday, December 25, 2021

Myocarditis and COVID-19: for some people the risk may be higher following vaccination than infection

COVID-19 is a known cause of cardiac complications such as myocarditis and systolic dysfunction. Vaccine associated myocarditis was described following smallpox vaccination, streptococcal pneumonia and influenza vaccine. In some cases, autoimmune/inflammatory syndrome induced by adjuvants used in the vaccine have been also implicated. 

Associations of COVID-19 vaccination and myocarditis have been proposed in multiple publications, but the consensus was that the benefits of vaccine are worth the increased risk even though more personalized approach seems warranted by the evidence

A new study presents data about the risk of myocarditis increasing with each subsequent dose of mRNA vaccines, especially mRNA-1273. Moreover, in younger males the risk of myocarditis was higher following vaccination than infection. Another study presents a case of fatal breakthrough infection in an older male who experienced myocarditis-like symptoms after his COVID-19 vaccine. 

REFERENCES

Martina Patone, Winnie Xue Mei, Lahiru Handunnetthi, Sharon Dixon, Francesco Zaccardi, Manu Shankar-Hari, Peter Watkinson, Kamlesh Khunti, Anthony Harnden, Carol AC Coupland, Keith M. Channon, Nicholas L Mills, Aziz Sheikh, Julia Hippisley-Cox Risk of myocarditis following sequential COVID-19 vaccinations by age and sex  medRxiv 2021.12.23.21268276; doi: https://doi.org/10.1101/2021.12.23.21268276

Kim HW, Jenista ER, Wendell DC, Azevedo CF, Campbell MJ, Darty SN, Parker MA, Kim RJ. Patients with acute myocarditis following mRNA COVID-19 vaccination. JAMA cardiology. 2021 Oct 1;6(10):1196-201.

Lazaros G, Anastassopoulou C, Hatziantoniou S, Kalos T, Soulaidopoulos S, Lazarou E, Vlachopoulos C, Vassilopoulos D, Tsakris A, Tsioufis C. A case series of acute pericarditis following COVID-19 vaccination in the context of recent reports from Europe and the United States. Vaccine. 2021 Oct 29;39(45):6585-90.

Hendren NS, Carter S, Grodin JL. Severe COVID-19 vaccine associated myocarditis: Zebra or unicorn?. International journal of cardiology. 2021 Nov 15;343:197-8.

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Athletes with issues after vaccination: 

 Dembele, 29, Atletico Madrid striker collapses in training, requires medical attention https://www.youtube.com/watch?v=-R2_5LMobXc

Alex Apolinario, 24, Brazilian soccer player dies after collapsing on pitch during match: https://www.cbssports.com/soccer/news/brazilian-soccer-player-alex-apolinario-dies-after-collapsing-on-pitch-during-match-in-portugal/

Britain’s Jack Draper, 19, collapses at Miami Open: https://www.youtube.com/watch?v=VDuOP0V1nUw

Mirko Kido, 36, Olympic gold medalist dies of heart attack during game: https://www.reuters.com/lifestyle/sports/indonesian-doubles-star-kido-dies-heart-attack-36-2021-06-14/

Ghanaian referee collapses during AFCON Match: https://www.youtube.com/watch?v=cvPQO44NzN4

Referee Bert Smith collapses on court due to blood clot during Gonzaga-USC men’s Elite Eight game: https://www.espn.com/mens-college-basketball/story/_/id/31222546/referee-bert-smith-says-blood-clot-lung-caused-fall-ncaa-tourney

Josh Downie, 24, cricketer dies after heart attack at practice: https://www.bbc.co.uk/news/uk-england-nottinghamshire-57058626

Giuseppe Perrino, 29, ex-Parma footballer dies at memorial match after collapsing https://www.thesun.co.uk/sport/football/15151824/giuseppe-perrino-dead-29-parma-brother/

Raymond van Barneveld collapses and receives paramedic attention during PDC Championship: https://www.dailystar.co.uk/sport/darts/pdc-players-championship-8-suspended-23759939

Devaraj Anchan, 33, volleyball player collapses during game, dies: https://www.thehindu.com/news/cities/Mangalore/volleyball-player-collapses-during-game-dies/article34185430.ece

Garissone Innocent, 20, fell unconscious due to abnormal electrical impulse in heart during game: https://www.thesun.co.uk/sport/football/13901939/goalkeepers-rushed-hospital-collapsing/

Ethan Jovani Trejo, 16-year-old soccer player, collapsed on the field during training: https://eu.cincinnati.com/story/news/2021/06/25/teen-dies-after-medical-incident-princeton-high-school-field/5344293001/

Samuel Kalu, 24, Bordeaux star collapses minutes into football game: https://www.bbc.com/sport/football/58228778

Roy Butler, 23, Irish footballer Watford FC dies after Jansen: https://twitter.com/NewsForAllIre/status/1428301909715296263?s=20

Dylan Rich, 19, FA Youth Cup – player suffered sudden cardiac arrest on the field, passes away: https://www.bbc.com/news/uk-england-nottinghamshire-58496077

Vinny Curry, 33, out for season due to blood clots: https://nypost.com/2021/08/25/jets-vinny-curry-out-after-rare-blood-disorder-diagnosis/

Cameron Dale, 29, Australian sailor dies after catastrophic stroke: https://7news.com.au/sport/sailing/australian-sailor-jessica-watson-reveals-sudden-death-of-partner-cameron-dale-c-3845979

Two young Columbia High school footballers die: https://www.wistv.com/2021/09/04/he-would-love-it-donadrian-robinsons-family-reacts-tribute-wj-keenan-high-school/?outputType=apps

Bollywood’s star, 40, dies following heart attack https://www.dailymail.co.uk/news/article-9950385/Indian-TV-film-star-Siddharth-Shukla-40-dies-heart-attack.html#reader-comments

Tom Felton, 34, collapses during golf game: https://bbc.in/3i4YpI5?fbclid=IwAR0aZBaXpiX9ky34g3eLiG3pcMs5r2udih4kRGUIi7GOBK3iciefX1-qoXk

Francis Perron, 25, Ottawa footballer dies after game: https://www.cbc.ca/news/canada/ottawa/usports-ottawa-gee-gees-francis-perron-dies-1.6182332

Parys Haralson, 37, former Saints line backer dies: https://www.usatoday.com/story/sports/nfl/2021/09/13/parys-haralson-former-49-ers-and-saints-lb-dies-37/8328669002/

Jimmy Hayes, 31, former Bruins player unexpectedly dies: https://www.bostonglobe.com/2021/08/23/sports/jimmy-hayes-former-bruin-boston-college-hockey-champ-dies-31/

Kjeld Nuis, 31, Dutch professional skater admitted to hospital with inflamed heart: https://www.rtlboulevard.nl/entertainment/news/artikel/5243606/kjeld-nuis-vaccinatie-ziek-update

John Stokes, 21, athlete at Tennessee Uni hospitalized with heart inflammation: https://www.yahoo.com/lifestyle/student-athlete-john-stokes-myocarditis-covid-vaccine-002451374.html?guccounter=1

Jake Ehlinger, 20, found dead – cause unknown: https://usdaynews.com/celebrities/celebrity-death/sam-ehlinger-brother-death-cause/

Jeremy Chardy, 34, tennis pro cannot train or play after vaccine: https://www.tennisworldusa.org/tennis/news/Tennis_Interviews/102836/jeremy-chardy-i-regret-getting-vaccinated-i-have-series-of-problems-now/

Francesca Marcon, 38, volleybal professional can’t play, has pericarditis post vaccine: https://www.lapressa.it/notiziario/sport/la-campionessa-di-volley-ho-una-pericardite-post-vaccino

Yusuke Kinoshita, 27, baseball pro dies 7 weeks post vaccine: https://thecovidworld.com/yusuke-kinoshita-27-year-old-japanese-professional-baseball-player-dies-7-weeks-after-covid-19-vaccine/

Alex Stalock, 34, NHL Oilers goalie out for the season due to heart condition: https://ca.sports.yahoo.com/news/nhl-oilers-goalie-alex-stalock-miss-entire-season-with-heart-condition-covid-19-related-191817673.html

Ceylin Alvarado, 23, pro cyclists out for season due to blood complications: https://www.nu.nl/sport-overig/6160296/veldrijdster-alvarado-voorlopig-niet-in-actie-door-verstoord-bloedbeeld.html

Greg van Aevermat, 36, pro cyclist, loss of form since vaccine: https://www.indeleiderstrui.nl/wielrennen/van-avermaet-wijst-naar-vaccin-als-oorzaak-vormdip-op-deze-manier-heeft-wk-geen-zin/amp?__twitter_impression=true

Three young Belgian cyclists suffer heart issues following race: https://rtv.be/artikels/jonge-kempense-wielrenners-krijgen-hartklachten-na-vaccinatie-a102612

Kamila Label-Farrel, 19, Uni Basketball Star died unexpectedly: https://www.baytoday.ca/obituaries/lebel-farrell-kamila-3884874

Jacob Downey, 19, Queens Uni Hockey player passes away after medical emergency: https://www.kawartha411.ca/2021/10/01/local-teen-queens-university-student-passed-away-suddenly-after-medical-emergency/

Christian Eriksen, 29, Collapses at Euros due to heart issue https://youtu.be/s0B03LSzXvo

Josh Archibald, 28, Oilers hockey forward out indefinitely due to myocarditis: https://www.si.com/hockey/.amp/news/oilers-forward-josh-archibald-out-indefinitely-with-myocarditis

Jen Gouveia, 38, suffered cardiac arrest during a run: https://toronto.ctvnews.ca/husband-of-toronto-mother-who-died-suddenly-on-run-says-he-lost-his-everything-1.5501767

Kyle Warner, pro BMX cyclist has pericarditis post vaccine: https://youtu.be/aebtcTi7EaA

16 year old youth suffered cardiac arrest after weightlifting: https://www.straitstimes.com/singapore/health/16-year-old-suffers-cardiac-arrest-following-strenuous-weightlifting-session-six

Brandon Goodwin, 26, Atlanta Hawks star, career over due to blood clots: https://www.peachtreehoops.com/2021/10/3/22706769/former-atlanta-hawks-guard-brandon-goodwin-claims-covid-19-vaccine-ended-his-season

Ewan Fraser, 30, Glasgow hockey player suffered cardiac arrest, passes away: https://www.thescottishsun.co.uk/news/7832060/glasgow-hockey-player-died-collapse-life/amp/?__twitter_impression=true

David Jenkins, 31, Olympic silver medalist diver unexpectedly passes away: https://metro.co.uk/2021/10/12/david-jenkins-dead-at-31-tributes-pour-in-for-team-gb-olympic-diving-coach-15404658/amp/?__twitter_impression=true

Paul Zisper, 27, Munich basketball pro, has emergency surgery after brain hemorrhage related to J and J: https://www.fr.de/sport/drama-um-zipser-90801217.html

Filip Ingebrigsten, 28, Norwegian runner suffers loss of form post vaccine: https://norwaytoday.info/sport/filip-ingebrigtsen-is-back-in-training-after-experiencing-long-corona-vaccination-side-effects/

Avi Barot, 29, Saurashtra cricketer suffers cardiac arrest, passes away: https://www.thehindu.com/sport/cricket/young-saurashtra-cricket-player-avi-barot-dies-after-suffering-cardiac-arrest/article37015873.ece

Abou Ali, 22, professional footballer collapses on pitch during game: https://www.thesun.co.uk/sport/football/16118079/footballer-wessam-abou-ali-awake-hospital-collapse/

Fabrice NSakala, 31, Besiktas defender collapses on pitch during game: https://www.theguardian.com/football/2021/aug/22/fabrice-nsakala-besiktas-collapse

Jens De Smet, 27, footballer collapses on field, passes away of heart attack: https://newswep.com/jens-27-collapses-on-the-football-field-and-dies-this-is-not-maldegem/

Jente van Genechten, 25, footballer collapses on field due to heart attack: https://www.sudinfo.be/id411745/article/2021-08-18/25-ans-un-joueur-belge-de-football-fait-un-arret-cardiaque-sur-le-terrain-avant

Frederic Lartillot, French footballer collapses in changing room, passes away due to heart attack after game: https://www.leprogres.fr/culture-loisirs/2021/09/11/deces-d-un-joueur-de-foot-apres-un-match-ses-coequipiers-ont-tout-tente-pour-le-sauver

Benjamin Taft, 31, German footballer collapses after game, passes away due to heart attack: https://www.anpfiff.info/mobile/sites/cms/artikel.aspx?SK=2&Btr=96044&Rub=390

Rune Coghe, 18, Belgian footballer suffers cardiac arrest on pitch: https://www.sudinfo.be/id409738/article/2021-08-07/rune-jeune-joueur-de-18-ans-secroule-sur-le-terrain-du-rds-plus-le-temps-passe

Helen Edwards, referee taken off court during World Cup qualifier due to heart issues: https://www.rtl.de/cms/dfb-spiel-unterbrochen-linienrichterin-vom-platz-getragen-4834888.html

Dimitri Lienard, 33, FC Strasbourg midfielder collapses during game: https://madeinfoot.ouest-france.fr/infos/article-rc-strasbourg-dimitri-lienard-a-ete-victime-d-un-malaise-354221.html

Sergio Aguero, 33, Barecelona star striker admitted to hospital for cardiac exam after match: https://www.cnn.com/2021/10/31/football/sergio-aguero-barcelona-chest-pain-spt-intl/index.html

Emil Palsson, 28, Sognal midfielder collapses due to cardiac arrest during game: https://www.independent.co.uk/sport/football/norway-footballer-emil-palsson-cardiac-arrest-b1949583.html

Antoine Méchin, 31, French triathlete suffers pulmonary embolism following Moderna: https://www.sudouest.fr/sport/course-pedestre/triathlon/le-triathlete-saintais-antoine-mechin-met-un-terme-a-sa-saison-et-ne-se-referait-pas-vacciner-si-c-etait-a-refaire-6234090.php

Luis Ojeda, 20, Argentine football player unexpectedly passes away: https://www.antena3.com/noticias/deportes/futbol/emotiva-carta-lola-ortiz-muerte-novio-futbolista-luis-ojeda-soporto-idea-volver-ver-verte-nunca-mas_20210426608696616e5d5b0001eb20e9.html

Greg Luyssen, 22, Belgian pro cyclist ends career due to heart issues: https://kw.be/sport/wielrennen/wielerbelofte-greg-luyssen-22-uit-de-panne-over-gedwongen-afscheid-door-hartprobleem-dat-akelig-gevoel-wil-ik-nooit-meer/

Pedro Obiang, 29, ex-West Ham star suffers myocarditis post vaccine: https://thecovidworld.com/pedro-obiang-29-year-old-professional-footballer-suffers-myocarditis-after-covid-19-vaccine/

Cienna Knowles, 19, equestrian star hospitalized due to blood clots: https://www.news.com.au/lifestyle/health/health-problems/teen-equestrian-star-cienna-knowles-hospitalised-with-blood-clots-after-pfizer-vaccine/news-story/286e7cd42e896b091e4b257322296a05

Boise pro mountain biker Kyle Warner tells about his vaccine journey: Big Health Update / Checking In - YouTube

Boris Sadecky, 24, Slovak hockey player dies of heart attack during hockey game: https://www.rt.com/sport/539312-bruno-sadecki-hockey-player-khl-death/

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