Category: Health

Excessive Hygiene from Masking, Distancing, and Deep-Cleaning, Can Increase Allergies and Auto-Immune Diseases

(p. A17) The idea that exposure to some infectious agents is protective against immune-related disorders isn’t new and comes with significant scientific heft. The so-called hygiene hypothesis is constructed from epidemiologic evidence, laboratory studies and clinical trials that, put together, support the notion that an excessive emphasis on antisepsis is implicated in misalignments of the immune system that risk disease.

Allergic and autoimmune diseases are far less common in communities with less hygiene, and autoimmune disorders increase in children who migrate from areas with less emphasis on hygiene to areas with more emphasis. They are less common in agricultural communities, where exposure to dirt and animals is common, compared with neighboring communities with shared genetics but little farming. Children who attend daycare early in life—runny noses, colds and all—have less asthma and fewer allergies. Animal studies, laboratory experiments and small trials in humans all point in a similar direction: Avoiding exposure to some microbes prevents the immune system from training well and predisposes to autoimmune diseases.

. . .

This isn’t a paean to infections and poor hygiene but a reminder of the importance of balance. When I prescribe antibiotics, they have to be strong enough to treat my patient’s infection. But if I overtreat, I run the risk of giving the patient colitis (inflammation of the colon) without additional benefits. Current hygiene policies and practices need rebalancing.

. . .

The extreme concern for hygiene at the onset of Covid-19 was intuitive and understandable. The virus was spreading fast, information on routes of transmission was limited, and we as a society tried to protect one another from infection. But policies that were easy to support two years ago need re-evaluation. Distancing, deep-cleaning and masking aren’t “more is better” kinds of goods.

On the other side of the balance, health risks from extended intensive hygiene are credible. As Omicron recedes and we internalize the paucity of Covid-19 benefits from some hygiene practices, we should balance those against the benefits we lose by shielding our immune systems from normal exposures—and the ones we withhold from children by preventing the exchange of microbes through play and smiles.

For the full commentary, see:

Eran Bendavid. “Covid and the ‘Hygiene Hypothesis’.” The Wall Street Journal (Wednesday, February 2, 2022): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date February 1, 2022, and has the same title as the print version.)

Natural Immunity Is Stronger and Lasts Longer Than Immunity from Covid Vaccines

(p. A17) Public-health officials ruined many lives by insisting that workers with natural immunity to Covid-19 be fired if they weren’t fully vaccinated. But after two years of accruing data, the superiority of natural immunity over vaccinated immunity is clear. By firing staff with natural immunity, employers got rid of those least likely to infect others. It’s time to reinstate those employees with an apology.

For most of last year, many of us called for the Centers for Disease Control and Prevention to release its data on reinfection rates, but the agency refused. Finally last week, the CDC released data from New York and California, which demonstrated natural immunity was 2.8 times as effective in preventing hospitalization and 3.3 to 4.7 times as effective in preventing Covid infection compared with vaccination.

Yet the CDC spun the report to fit its narrative, bannering the conclusion “vaccination remains the safest strategy.” It based this conclusion on the finding that hybrid immunity—the combination of prior infection and vaccination—was associated with a slightly lower risk of testing positive for Covid. But those with hybrid immunity had a similar low rate of hospitalization (3 per 10,000) to those with natural immunity alone. In other words, vaccinating people who had already had Covid didn’t significantly reduce the risk of hospitalization.

Similarly, the National Institutes of Health repeatedly has dismissed natural immunity by arguing that its duration is unknown—then failing to conduct studies to answer the question. Because of the NIH’s inaction, my Johns Hopkins colleagues and I conducted the study. We found that among 295 unvaccinated people who previously had Covid, antibodies were present in 99% of them up to nearly two years after infection. We also found that natural immunity developed from prior variants reduced the risk of infection with the Omicron variant. Meanwhile, the effectiveness of the two-dose Moderna vaccine against infection (not severe disease) declines to 61% against Delta and 16% against Omicron at six months, according to a recent Kaiser Southern California study. In general, Pfizer’s Covid vaccines have been less effective than Moderna’s.

The CDC study and ours confirm what more than 100 other studies on natural immunity have found: The immune system works. The largest of these studies, from Israel, found that natural immunity was 27 times as effective as vaccinated immunity in preventing symptomatic illness.

None of this should surprise us. For years, studies have shown that infection with the other coronaviruses that cause severe illness, SARS and MERS, confers lasting immunity.

For the full commentary, see:

Marty Makary. “The High Cost of Disparaging Natural Immunity.” The Wall Street Journal (Thursday, January 27, 2022): A17.

(Note: the online version of the commentary has the date January 26, 2022, and has the title “The High Cost of Disparaging Natural Immunity to Covid.”)

The Israeli preprint study mentioned above is:

Gazit, Sivan, Roei Shlezinger, Galit Perez, Roni Lotan, Asaf Peretz, Amir Ben-Tov, Dani Cohen, Khitam Muhsen, Gabriel Chodick, and Tal Patalon. “Comparing Sars-Cov-2 Natural Immunity to Vaccine-Induced Immunity: Reinfections Versus Breakthrough Infections.” medRxiv (2021): doi: https://doi.org/10.1101/2021.08.24.21262415.

Democrat-Praised “Whistleblower” Rick Bright, Not Trump Admin, Delayed Molnupiravir by Months at Peak of Pandemic

(p. A17) When Merck and Ridgeback Biotherapeutics announced on Oct. 1 [2021]that their new antiviral pill reduced Covid hospitalizations by roughly half, some in the media blamed Donald Trump. An Axios headline: “Before Merck backed COVID antiviral, Trump admin turned it down.” In fact, Trump officials pushed for government funding to accelerate the development of the drug, molnupiravir. They were opposed by a career official, Rick Bright, whom Democrats praised as a “whistleblower.”

Mr. Bright joined the Biomedical Advanced Research and Development Authority in 2010 and became Barda’s director in 2016.

. . .

Emory had licensed molnupiravir to Ridgeback, which in April 2020 requested $100 million from the government to fast-track studies in humans. Mr. Bright says Trump officials ordered Barda officials “to fund the Ridgeback proposal as quickly as possible, and preferably within 24 hours.” But he said “Ridgeback had not followed the proper procedure for receiving BARDA funding.” Barda declined the request, and Ridgeback collaborated with Merck, which put its own capital at risk.

After Mr. Bright’s reassignment, Barda funding for trials, manufacturing and advance purchases of monoclonal antibodies proved critical in accelerating their development. Molnupiravir would likely have been available much sooner had Barda provided funding as Trump officials urged last spring.

For the full commentary, see:

Allysia Finley. “Who Slowed Merck’s Covid Remedy?” The Wall Street Journal (Monday, October 11, 2021): A17.

(Note: ellipsis, an bracketed year, added.)

(Note: the online version of the commentary has the date October 10, 2021, and has the same title as the print version.)

The Elite Experts Who Have Failed, Tend to Censor the Heterodox Outsiders Who They Fear

(p. 8) When you have a chronic illness and struggle to get better, you try to maintain a certain equilibrium by distinguishing yourself from all those other sick people, the ones who are trying truly crazy things while you are proceeding sensibly and moderately along the path to health.

. . .

These exotic treatments, from acupuncture to IV vitamin C to magnet therapy and more, weren’t the core of what helped me eventually gain ground and improve — strong and various doses of antibiotics played the central role. But they were the most educational part of my slow, still-continuing recovery, in the sense of what they revealed about the complexity and strangeness of the world.

The strangest of them all was the Rife machine.

. . .

Naturally, it worked.

What does “worked” mean, you may reasonably ask? Just this: By this point in my treatment, there was a familiar feeling whenever I was symptomatic and took a strong dose of antibiotics — a temporary flare of pain and discomfort, a desire to move or rub the symptomatic areas of my body, a sweating or itching feeling, followed by a wave of exhaustion and then a mild relief. I didn’t get this kind of reaction with every alternative treatment I tried. But with the Rife machine I got it instantly: It was like having a high dose of antibiotics hit the body all at once.

Of course, this was obviously insane, so to the extent that I was able I conducted experiments, trying frequencies for random illnesses to see if they elicited the same effect (they did not), setting up blind experiments where I ran frequencies without knowing if they were for Lyme disease or not (I could always tell).

. . .

When I set out to write about the entire chronic-illness experience, I hesitated over whether to tell this kind of story. After all, if you’re trying to convince skeptical readers to take chronic sickness seriously, and to make the case for the medical-outsider view of how to treat Lyme disease, reporting that you’ve been dabbling in pseudoscience and that it works is a good way to confirm every stereotype about chronic ailments and their treatment: It’s psychosomatic … it’s all the power of suggestion … it’s a classic placebo effect … poor Ross, taken in by the quacks … he’ll be ‘doing his own research’ on vaccination next

    .

    But there are two good reasons to share this sort of story. The first is that it’s true, it really happened, and any testimony about what it’s like to fight for your health for years would be dishonest if it left the weird stuff out.

    The second is that this kind of experience — not the Rife machine specifically, but the experience of falling through the solid floor of establishment consensus and discovering something bizarre and surprising underneath — is extremely commonplace. And the interaction between the beliefs instilled by these experiences and the skepticism they generate (understandably) from people who haven’t had them, for whom the floor has been solid all their lives, is crucial to understanding cultural polarization in our time.

    On both sides of our national divides, insider and outsider, establishment and populist, something in human psychology makes us seek coherence and simplicity in our understanding of the world. So people who have a terrible experience with official consensus, and discover that some weird idea that the establishment derides actually seems to work, tend to embrace a new rule to replace the old one: that official knowledge is always wrong, that outsiders are always more trustworthy than insiders, that if Dr. Anthony Fauci or the Food and Drug Administration get some critical things wrong, you can’t trust them to get anything right.

    This impulse explains why fringe theories tend to cluster together, the world of outsider knowledge creating its own form of consensus and self-reinforcement. But it also explains the groupthink that the establishment often embraces in response, its fear that pure craziness automatically abounds wherever official knowledge fails, and its commitment to its own authority as the only thing standing between society and the abyss.

    This is a key dynamic in political as well as biomedical debates. The conspicuous elite failures in the last 20 years have driven many voters to outsider narratives, which blend plausible critiques of the system with outlandish paranoia. But the insiders only see the paranoia, the QAnon shaman and his allies at the gates. So instead of reckoning with their own failures, they pull up the epistemic drawbridge and assign fact checkers to patrol the walls. Which in turn confirms for outsiders their belief that the establishment has essentially blinded itself and only they have eyes to see.

    What we need, I’m convinced, are more people and institutions that sustain a position somewhere in between.

For the full commentary, see:

Ross Douthat. “How I Became Extremely Open-Minded.” The New York Times, SundayReview Section (Sunday, November 7, 2021): 8.

(Note: ellipses added.)

(Note: the online version of the commentary has the date November 6, 2021, and has the same title as the print version. The passages that are underlined above, were in italics in the original. In the underlined passages I use a hyphen were the original had ellipses.)

The passages quoted above are from a commentary adapted from Douthat’s book:

Douthat, Ross. The Deep Places: A Memoir of Illness and Discovery. New York: Convergent Books, 2021.

Less-Ventilated Energy-Efficient Buildings Reduce Indoor Air Quality, Harming Cognitive Performance

(p. D6) A new study shows that poor indoor air quality is associated with subtle impairments in a number of cognitive functions, including our ability to concentrate and process information. The study tracked 302 office workers in commercial buildings in six countries — the United States, Britain, China, India, Mexico and Thailand — for 12 months.

The scientists used monitors to measure ventilation and indoor air quality in the buildings, including levels of fine particulate matter, which includes dust and minuscule particles from smoking, cleaning products and outdoor air pollution that seeps into the building. The workers were asked to use an app to take regular cognitive tests during the workday. The tests included simple math problems, as well as a tricky color and word brain teaser called the Stroop test, in which a word like “blue” or “purple” is printed in green or red ink.  . . .

The study found that the office workers in buildings with the poorest indoor air quality tended to perform worse on the brain teasers. While the effect wasn’t dramatic, the findings add to a growing body of evidence suggesting that the air we breathe affects brain health.

. . .

“This study looked at how several factors in the indoor environment have an immediate impact on our cognitive function and performance,” said Joseph G. Allen, the director of the Harvard Healthy Buildings program and the study’s senior author. “This study shows that the air you’re breathing at your desk at that moment has an impact on how well you think.”

In the past, air quality control in buildings has been mostly focused on energy efficiency and comfort, with little consideration given to infection control or overall worker health.

. . .

Dr. Allen is the co-author of a new book, “Healthy Buildings: How Indoor Spaces Drive Performance and Productivity.” He said he’s been encouraged to see more businesses and individuals taking indoor air quality more seriously as a result of the pandemic. Recently he saw a job posting at a major company advertising for a “head of healthy buildings” in the company’s global real estate division.

“It tells you that serious companies are changing how they approach their buildings, and they’re not thinking about this as a one-off during Covid,” said Dr. Allen.

. . .

“The pressure is coming from employees, parents of kids in school, teachers — there’s a heightened level of awareness and expertise,” said Dr. Allen. “How many people were talking about MERV 13 filters prior to the pandemic? This knowledge that our indoor spaces have been underperforming is not going away. I think people are rightly frustrated and fed up with it.”

For the full story, see:

Tara Parker-Pope. “What Bad Indoor Air Could Do to Your Brain.” The New York Times (Tuesday, September 28, 2021): D6.

(Note: ellipses added.)

(Note: the online version of the story was updated Sept. 28, 2021, and has the title “Is Bad Indoor Air Dulling Your Brain?”)

The book co-authored by Allen, and mentioned above, is:

Allen, Joseph G., and John D. Macomber. Healthy Buildings: How Indoor Spaces Drive Performance and Productivity. Cambridge, MA: Harvard University Press, 2020.

Biden’s Cancer “Moonshot Is 100 Percent Hype”

(p. A17) WASHINGTON — President Biden unveiled a plan on Wednesday to reduce the death rate from cancer by at least 50 percent over the next 25 years — an ambitious new goal, he said, to “supercharge” the cancer “moonshot” program he initiated and presided over five years ago as vice president.

Mr. Biden, joined by his wife, Jill Biden, and Vice President Kamala Harris, also announced a campaign to urge Americans to undergo screenings that were missed during the coronavirus pandemic.

. . .

More screenings are not the answer — the only cancers for which screening has indisputably lowered the death rate are colon and cervical. Death rates for other cancers, like breast, have fallen, but a large part of the drop, if not all of it, is because of improved treatment, said Donald A. Berry, a biostatistician at the University of Texas M.D. Anderson Cancer Center who has spent decades studying these issues.

“Everybody loves early detection, but it comes with harms,” he said — principally, the harm of finding and treating tumors that do not need to be treated because they are innocuous. “The harms we know, but the benefits of screening are very uncertain,” he said.

If the age-adjusted cancer death rate were to plunge by 50 percent, it would have to be because cancers were being cured. Some treatments, like a drug that treats chronic myelogenous leukemia, have slashed death rates for that disease, but such marked effects in cancer are few and far between.

. . .

The White House billed the event as a fresh push by the president to “reignite” the moonshot program and “end cancer as we know it.”

. . .

Yet one Wall Street analyst who specializes in biotechnology and pharmaceuticals said that the time, money and effort might be better spent on initiatives to prevent cancer, like reducing smoking and rates of obesity. The Centers for Disease Control and Prevention says being obese increases a person’s risk of cancer. And reducing smoking is a proven way to cut the cancer death rate.

“This moonshot is 100 percent hype; this is the absolute wrong way to do this,” said the analyst, Stephen Brozak, the president of WBB Securities.

Presidents since Richard M. Nixon have sought to tackle cancer, of which there are more than 100 types of disease that can vary in how they grow, spread and respond to treatment. The cancer institute estimates that nearly 40 percent of men and women will be diagnosed with some type of cancer at some point during their lifetimes. The American Cancer Society estimates there will be 1.9 million new cases of cancer in the United States this year, and more than 609,000 cancer deaths.

For the full story, see:

Sheryl Gay Stolberg and Gina Kolata. “President Aims to Cut The Cancer Death Rate In Half Over 25 Years.” The New York Times (Thursday, February 3, 2022): A17.

(Note: ellipses added.)

(Note: the online version of the story has the date Feb. 2, 2022, and has the title “Biden Presents Ambitious Plan to Cut Cancer Death Rate in Half.”)

Centenarians Can Be “Cognitive Super-Agers”

(p. D7) Fewer than 1 percent of Americans reach the age of 100, and new data from the Netherlands indicate that those who achieve that milestone with their mental faculties still intact are likely to remain so for their remaining years, even if their brains are riddled with the plaques and tangles that are the hallmarks of Alzheimer’s disease.

Findings from the Dutch study may eventually pave a path for many more of us to become “cognitive super-agers,” as researchers call people who approach the end of the human life span with brains that function as if they were 30 years younger.

One day everyone who is physically able to reach 100 may also be able to remain mentally healthy. By studying centenarians, researchers hope to identify reliable characteristics and develop treatments that would result in healthy cognitive aging for most of us. Meanwhile, there is much we can do now to keep our brains in tiptop condition, even if reaching 100 is neither a goal nor a possibility.

These hopeful prospects stem from the study of 340 Dutch centenarians living independently who were tested and shown to be cognitively healthy when they enrolled. The 79 participants who neither died nor dropped out of the study returned for repeated cognitive testing, over an average follow-up of 19 months.

The research team, directed by Henne Holstege at Vrije University in Amsterdam, reported in JAMA Network Open in January that these participants experienced no decline in major cognitive measures, except for a slight loss in memory function. Basically, the participants performed as if they were 30 years younger in overall cognition; ability to make decisions and plans and execute them; recreate by drawing a figure they had looked at; list animals or objects that began with a certain letter; and not becoming easily distracted when performing a task or getting lost when they left home.

Even those with genes linked to an elevated risk of developing Alzheimer’s disease were able to perform well on the tests.

Nearly a third of the participants agreed to donate their brains after death. Brain autopsies of 44 of the original centenarians revealed that many had substantial neuropathology common to people with Alzheimer’s disease although they had remained cognitively healthy for up to four years beyond 100.

For the full commentary, see:

Jane E. Brody. “Living to 100 and Staying Sharp.” The New York Times (Saturday, June 22, 2021): D7.

(Note: ellipsis, and bracketed year, added.)

(Note: the online version of the commentary has the date June 21, 2021, and has the title “The Secrets of ‘Cognitive Super-Agers’.”)

Expert Medical Advice Often Flip-Flops

(p. D6) A History of Medical Flip-Flops

Shifting medical advice is surprisingly common, and it tends to fall into three categories: emerging guidance, replacement advice and reversals.

Emerging guidance comes during times of crisis — like pandemics — and is destined to change quickly. In the past several months, guidance about the best way to treat Covid patients, masks to prevent transmission and the limits of vaccine protection have all shifted as knowledge of the coronavirus and its variants has evolved.

Sometimes it’s hard to tell the difference between replacement advice, which is issued when research improves on advice that came before it, and a full reversal, which comes about because a common medical practice got ahead of the science and never actually worked or even caused harm. Here are some examples of true medical flip-flops in recent years.

MENOPAUSE HORMONES TO PROTECT THE HEART: In 2002, decades of advice about the heart benefits of menopause hormones seemed to change overnight when a major study called the Women’s Health Initiative was halted after researchers detected more heart attacks in the women taking hormones. In hindsight, doctors had misinterpreted data from observational research. The current advice: Hormones can relieve menopause symptoms but shouldn’t be used for chronic disease prevention.

VIOXX AS A LOWER-RISK ARTHRITIS TREATMENT: In 1999, the Food and Drug Administration approved Vioxx as a breakthrough pain reliever because it lowered the risk of gastrointestinal problems. But by 2004, Merck had withdrawn the drug because studies showed it significantly raised the risk of heart attack.

ARTHROSCOPIC SURGERY ON AGING KNEES: For years, the partial removal of torn meniscus tissue was the most common orthopedic procedure in the United States, with about 700,000 performed a year. In 2013, a researcher in Finland compared the operation to a “sham” procedure and found there was no benefit. Most doctors now recommend physical therapy instead.

VITAMIN MEGADOSES TO LOWER CANCER AND HEART RISK: For years, doctors believed various vitamins could lower risk for cancer and heart disease, but a number of studies showed just the opposite. A study of beta carotene and vitamin A found that the supplements actually increased the risk of lung cancer in male smokers. A study of vitamin E and selenium, thought to protect against prostate cancer, increased risk for the disease.

STENTS FOR STABLE HEART DISEASE: Doctors used to insert stents — tiny wire mesh tubes that prop open arteries — in millions of otherwise stable patients with heart disease. A study found that the surgical procedure was no better than drug therapy for preventing heart attacks.

Dr. Vinay Prasad, associate professor at the University of California San Francisco, and Dr. Adam S. Cifu, a professor of medicine at the University of Chicago Department of Medicine, coined the term “medical reversal” and concluded that about 40 percent of common medical practices that they reviewed turned out to be useless or harmful. In their book, “Ending Medical Reversal: Improving Outcomes, Saving Lives,” they noted that most of these failed treatments were initially embraced because they were based on logical reasoning.

“The thing that’s often behind reversal: All of these things have a good story, they have good pathophysiological rationale,” Dr. Cifu said. “They should work. But things only work if they’ve been shown in people to work, and people are so complicated.”

For the full story, see:

Tara Parker-Pope. “Shifting Medical Advice Is a Feature, Not a Bug.” The New York Times (Tuesday, November 2, 2021): D6.

(Note: the online version of the story was updated Oct. 24, 2021, and has the title “Is the New Aspirin Advice a Medical Flip-Flop, or Just Science?” The paragraphs on menopause hormones to protect the heart and on vitamin megadoses to lower cancer and heart risk appear in the online version, but not in the print version.)

The book co-authored by Prasad and mentioned above is:

Prasad, Vinayak K., and Adam S. Cifu. Ending Medical Reversal: Improving Outcomes, Saving Lives. Baltimore: Johns Hopkins University Press, 2015.

The Internet of Things Enables Better Indoor Air Measurement and Customization

(p. A1) “Indoor air quality is not a nice-to-have anymore—people have realized it’s essential,” says Arjun Kaicker, an architect at Zaha Hadid Architects, a London-based firm that has designed buildings around the world.

Many of the technologies bringing about this transformation are part of the oft-touted “Internet of Things.” It’s a combination of wireless, internet-connected sensors and automation, tied together by the cloud and millions of lines of code and sold as a service to solve a particular problem—in this case, the spread of communicable diseases and other air pollutants indoors.

As with other applications of the Internet of Things, such as in factories, much of the technology involved is about tying together existing systems so they can respond more dynamically to information their sensors are gathering, says Bobby George, chief digital officer of Carrier, which manufactures heating, ventilation and air-conditioning systems.

The goal is relatively simple: In more than 95% of buildings, air-conditioning systems are set on a schedule that remains largely untouched. Smart-building systems can pump more clean air into parts of an office as occupancy or other factors change throughout the day, adds Mr. George.

Wireless, battery-powered air-quality and occupancy sensors that can handle continuous monitoring are rapidly falling in price. They can be peppered throughout a building and don’t require opening up walls to connect to data and power.

. . .

In a May [2021] letter in the journal Science, 39 researchers and experts in public health, indoor air quality and engineering asserted that our understanding of transmission of respiratory infections, especially Covid-19, has progressed so rapidly that it should spur a “paradigm shift” for those responsible for the health and safety of office workers.

No longer, they continued, should people accept the idea that there is little we can do to prevent the spread of airborne infections at work. Just as we take pains to eliminate the spread of waterborne and foodborne disease, we now have the knowledge and tools to reduce the spread of germs in the air. And we should start demanding employers do something about it, they said.

To make that happen, businesses and schools should follow guidelines like those offered by the American Society of Heating, Refrigerating and Air-Conditioning Engineers, says William Bahnfleth, a professor of architectural engineering at Pennsylvania State University and the head of the committee that created these standards. Those guidelines include ensuring the right mix of fresh outdoor air and filtered indoor air, and using air filters that meet a higher standard of effectiveness.

Employees can use these types of published guidelines to inform their questions when talking to employers about returning to the office, Dr. Bahnfleth says. Similar guidelines are offered by the American Industrial Hygiene Association and the U.S. Centers for Disease Control and Prevention.

For the full story, see:

Christopher Mims. “KEYWORDS; Breath of Fresh Air.” The Wall Street Journal (Saturday, September 4, 2021): B2.

(Note: ellipsis, and bracketed year, added.)

(Note: the online version of the story has the same date as the print version, and has the title “KEYWORDS; The Pandemic Could Help Us Breathe Easier at the Office.”)

High Viral Load Increases Odds of Long Covid

(p. 18) It is one of many mysteries about long Covid: Who is more prone to developing it? Are some people more likely than others to experience physical, neurological or cognitive symptoms that can emerge, or linger for, months after their coronavirus infections have cleared?

Now, a team of researchers who followed more than 200 patients for two to three months after their Covid diagnoses report that they have identified biological factors that might help predict if a person will develop long Covid.

The study, published Tuesday [January 25, 2022] by the journal Cell, found four factors that could be identified early in a person’s coronavirus infection that appeared to correlate with increased risk of having lasting symptoms weeks later.

. . .

One of the four factors researchers identified is the level of coronavirus RNA in the blood early in the infection, an indicator of viral load. Another is the presence of certain autoantibodies — antibodies that mistakenly attack tissues in the body as they do in conditions like lupus and rheumatoid arthritis. A third factor is the reactivation of Epstein-Barr virus, a virus that infects most people, often when they are young, and then usually becomes dormant.

The final factor is having Type 2 diabetes, although the researchers and other experts said that in studies involving larger numbers of patients, it might turn out that diabetes is only one of several medical conditions that increase the risk of long Covid.

. . .

One persuasive conclusion, several experts said, was the suggestion that because patients with high viral loads early on often developed long Covid, giving people antivirals soon after diagnosis might help prevent long-term symptoms.

“The quicker one can eliminate the virus, the less likelihood of developing persistent virus or autoimmunity, which may drive long Covid,” Dr. Iwasaki said.

For the full story, see:

Pam Belluck. “New Research Hints at 4 Factors That May Increase Chances of Long Covid.” The New York Times, First Section (Sunday, January 30, 2022): 18.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date Jan. 25, 2022, and has the same title as the print version.)