16-11-2020 The Asian Independent

14 16-11-2020 to 30-11-2020 HEALTH
www.theasianindependent.co.uk
How Covid-19 may severely affect our offsprings
Exposure to virus could pose risk to the health and ageing of individuals who aren’t even born yet, reveals study
New York : Scientists have claimed
that by the end of 2020, approximately
3,00,000 infants could be born to mothers
infected by SARS-CoV-2, the virus
that causes Covid-19.
The study, published in the Journal
of Developmental Origins of Health and
Diseases, revealed that exposure to
Covid-19 could pose a risk to the health
and ageing of individuals who aren’t
even born yet. “Millions more will be
born into families who have experienced
tremendous stress and upheaval
due to the pandemic even if they haven’t
been infected themselves,” said the
study authors from University of
Southern California (USC) in the US.
While the longer-term effects of
Covid-19 on infants is yet to be seen,
researchers can find some insight from
the past, including the 1918 flu pandemic
and previous coronavirus illnesses
such as SARS in 2002 and MERS in
2012. “The 1918 influenza pandemic
had long-term impacts on the cohort
exposed in utero, which experienced
earlier adult mortality and more diabetes,
ischemic heart disease and
depression after age 50,” said study
author Caleb Finch from USC.
“It is possible that the Covid-19 pandemic
will also have long-term impacts
on the cohort that was in utero during
the pandemic, from exposure to maternal
infection and/or the stress of the
pandemic environment,” Finch added
Maternal viral infections can affect
fetuses through multiple pathways,
from direct transmission through the
placenta to inflammatory responses that
disturb in-utero metabolism and negatively
affect growth.
While direct maternal-fetal transmission
of the virus and severe birth defects
appear to have been rare during previous
coronavirus outbreaks, there were
increases in preterm delivery and low
birth weight during both the 2002 SARS
and 2009 H1N1 influenza outbreaks,
which are possible consequences of
increased inflammation.
While studies on Covid-19 and pregnancy
are still in their early stages, there
have already been some concerning
results that merit a closer look in ongoing
studies, the authors wrote.
Increased rates of preterm birth may
be linked to maternal SARS-CoV-2
infections, and other studies indicate
that severe illness is correlated with a
higher risk of stillbirth.
Other potential dangers, including
the increased risk of blood clots presented
by both pregnancy and severe
Covid-19, also need further study.
“We suggest that to capture the consequences
of viral exposure in utero for
childhood development and adult
health, Covid-19 birth cohort studies
consider the immediate collection of
data from the mother, fetus, neonate,
and placenta,” the team noted.
World's top intensive care body
advises against fremdesiviror
sickest COVID PATIENTS
* Advice on remdesivir follows WHO trial results *
Dexamethasone recommended for COVID patients, not plasma
Brussels : Antiviral remdesivir
should not be used as a routine
treatment for COVID-19 patients
in critical care wards, the head of
one of the world's top bodies representing
intensive care doctors
said, in a blow to the drug developed
by U.S. firm Gilead.
Remdesivir, also known as
Veklury, and steroid dexamethasone
are the only drugs authorised
to treat COVID-19 patients across
the world. But the largest study on
remdesivir's efficacy, run by the
World Health Organization
(WHO), showed on Oct. 15 it had
little or no impact, contradicting
previous trials. In light of the new interim
data from the WHO's Solidarity trial "remdesivir
is now classified as a drug you should
not use routinely in COVID-19 patients," the
President of the European Society of
Intensive Care Medicine (ESICM), Jozef
Kesecioglu, said in an interview with
Reuters. Kesecioglu said the recommendation
would be discussed in a scientific paper
on COVID therapies that ESICM is preparing
with the Society of Critical Care
Medicine, another intensive care body,
expected to be published by January. The
first version of the paper, released in March,
said there was not enough information to recommend
the use of remdesivir and other
antivirals in critically ill COVID-19 patients.
Gilead, which has questioned the WHO's
findings, said in an emailed statement: "We
are confident that doctors on the front lines
recognise the clinical benefit of Veklury
based on robust evidence from multiple randomized,
controlled studies." ESICM represents
thousands of anaesthesiologists, respiratory
physicians, nurses and other critical
care professionals in more than 120 countries.
While doctors and hospitals are not
obliged to follow its advice, its recommendation
could curb the use of remdesivir.
At the end of October, Gilead cut its 2020
revenue forecast, citing lower-than-expected
demand and difficulty in predicting sales of
remdesivir.
WIDELY USED : The drug remains,
however, widely used in hospitals. It is
authorised or approved for use in more than
50 countries and was one of the medicines
administered to U.S. President Donald
Trump when he tested positive for coronavirus
in October.
The European Union signed a 1-billioneuro
($1.2 billion)deal with Gilead for
500,000 courses of remdesivir at 2,070 euros
each, days before the Solidarity results. The
deal does not oblige European countries to
buy remdesivir, but governments decided to
place large orders even after the Solidarity
results, with Germany buying a big stock in
November, saying the drug was useful, especially
early in the course of the disease.
Kesecioglu said there was not enough data
available about when remdesivir might be
effective or for which patients,
leading to the decision to discourage
its routine use in intensive
care. This means doctors should
use remdesivir only occasionally,
and not as a standard treatment for
COVID-19 patients.
Because of remdesivir's unclear
benefits, the critical care department
at the University Medical
Center of Utrecht in the
Netherlands, where Kesecioglu
works, has not used it to treat
COVID-19 patients, he said.
SIDE-EFFECTS
Ten months into the pandemic,
a debate continues to rage in the
medical industry about which drugs are best
to treat hospitalised COVID-19 patients.
Remdesivir has potential side-effects on
the kidneys, according to data shared by
Gilead with the European Medicines
Agency, which is assessing its possible toxicity
Arnaud Hot, head of medicine at Edouard
Herriot hospital in Lyon, France, told
Reuters that some patients at his hospital had
experienced kidney injury and so it was no
longer using remdesivir, except in rare cases.
Kesecioglu said convalescent plasma,
which is also experimentally administered to
some COVID-19 patients despite not having
been approved, was also not recommended
by ESICM for routine intensive care use, as
its benefits were unclear.
He added the potential side-effects of
convalescent plasma - the liquid part of
blood extracted from COVID-19 patients -
were also not clear
In contrast, Kesecioglu said dexamethasone
was recommended for use in hospitalised
patients because there was sufficient
information on its efficacy.
Air pollution may up chronic
lung disease in young adulthood
London : Amid the spike in air pollution in Delhi-NCR, a new
study has found that early-life events, such as the exposure to air pollutants,
increase the risk of chronic lung disease in young adulthood.
The findings, published in the European Respiratory Journal, add
to the growing evidence that chronic lung disease in adulthood can be
traced back to childhood. Chronic bronchitis and chronic obstructive
pulmonary disease (COPD), with the hallmark features phlegm and
irreversible airflow limitation, respectively, are lung diseases known
to affect adults with a history of long-term smoking.
"We found the prevalence of chronic bronchitis and irreversible
airflow limitation to be rather high considering the young age of the
study participants." said study senior author Erik Melen from
Karolinska Institutet in Sweden.
"Those diseases are usually diagnosed in patients older than 50
years of age," the researchers wrote.
In the present studies, the researchers used data from birth up to
age 24 years from the follow-up of the Swedish population-based
birth cohort 'BAMSE', which includes 4,089 participants from the
Stockholm area recruited 1994-96.
Analyses performed by the research team showed that smoking,
as well as early-life air pollution exposures and childhood asthma,
are risk factors for chronic bronchitis, whereas breastfeeding was
identified as a protective factor.
In addition, the early-life risk factors for the development of irreversible
airflow limitation were recurrent lung infections, asthma,
and exposure to air pollution.
"The levels of air pollutants in the current study mainly reflect
local emissions from road traffic, which implies that this preventable
risk factor may play an important role in the development of chronic
lung disease in young adults," the authors wrote.
Given that air pollution levels in Stockholm are comparatively
low by international standards, this makes the current findings very
important in a global context.
And despite the young participants' age, active smoking was
linked to chronic bronchitis, which underlines the negative health
effects from even a limited period of exposure to tobacco smoke.
"In conclusion, our two novel studies demonstrate that chronic
bronchitis and irreversible airflow limitation do exist in young adults
and emphasize the importance of early-life events for maintaining
lung health during adulthood," the study authors noted.