Dr. Irene Hamrick's Updates: June 2
Todd Winking June 2, 2022

COVID & Booster Dose For Children:

 

· The FDA provided EUA to expand eligibility for Pfizer-BioNTech COVID-19 Vaccine Booster Dose to Children 5 through 11 years.

· Pfizer reports that the 3rd dose of the 3 mcg dose of its vaccine for <5 year olds did the trick. In 1600 children protection from symptomatic infection was 80.3%. Moderna’s dose is 25 mcg for each of the 2 vaccines.

 

Guillain-Barré Syndrome (GBS) After COVID:

 

· Adenovirus vaccines have been shown to cause higher rates of Guillain-Barré Syndrome (GBS) than mRNA vaccines with a rate of 32.4 vs. 1.3 per 100,000. The rate for mRNA vaccine is the same as the background population rate. The rate of GBS after COVID-19 infection was 15 per 100,000. The FDA restricted the Janssen vaccine on the basis of the risk of thrombosis with thrombocytopenia syndrome and did not mention GBS.

· On the other hand, FDA declined to give EUA for fluvoxamine in the treatment of COVID. The Brazilian TOGETHER trial showed a 30% reduction in >6 hour ED visits or transfer to tertiary care centers. The FDA argues that it did not meet the standard criteria of hospitalizations of 24 hours or hospitalizations and deaths. The larger COVID-OUT and Stop Covid 2 trials were stopped for futility when it they did not meet end points in winter of 2022.

 

COVID & Pulmonary Embolism or Respiratory Conditions:

· COVID-19 survivors have twice the risk for developing pulmonary embolism or respiratory and other conditions; one in five COVID-19 survivors aged 18–64 years and one in four survivors aged ≥65 years experienced at least one incident condition.

 

Short & Long COVID Study - Taste & Smell:

· Before vaccination, the odds of experiencing long COVID was 24% and changed little over time. A first vaccine dose was associated with a 13% decrease in the odds of long COVID, and a second vaccine dose was associated with a further 9% decrease in the odds of long COVID. This improvement was sustained at least over an average follow-up of 9 weeks.

· This study reports that later variants are less likely to affect taste and smell. I wonder if this finding, along with later variants causing less severe disease, is more of a result of immunity from vaccines and infections protecting our brains (smell and taste) and bodies from more severe disease?

 

COVID & Pregnancy Study:

· Thank you Dr. Rosenthal for sharing this Canadian study of 6,012 women who were infected with COVID during pregnancy. Risk of hospitalization was 2.65 and risk of ICU admission 5.46 fold compared to uninfected women. The discussion takes a broader view of pregnancy outcomes with other studies and is worth a read for OB providers.

 

Paxlovid - Recurrent Positivity & Symptoms:

 

· We hear more and more about recurrent positivity and symptoms after Paxlovid. The CDC said that recurrence results in mild symptoms, and there have been no reports of severe disease, so far. CDC continues to recommend the oral antiviral drug as a treatment, despite the possibility of recurrences, but patients should continue to isolate to prevent spread.

· These tables list medications safe to take with Paxlovid and those to be avoided.

 

More free COVID tests are available at COVIDTests.gov.

 

Monkeypox News:

· Monkeypox is a virus infection transmitted by close contact with infected persons, usually contact and droplet. While case fatality rates are 3-6%, slightly higher than COVID, transmission occurs only during symptomatic disease. This excellent CDC webinar compares the rash with similar appearing rashes and how to differentiate them. It is a centripetal rash including the palms and soles, unlike the chickenpox rash that is more central on the trunk.

 

At 29 min it covers vaccine prevention and treatments. CDC contact info: cdcinfo@cdc.gov Tel: 1-800 CDC-info (232-4636) Operations Center: 770-488-7100.

 

Geriatric News:

· America’s Senior Health Report 2022 is published and showed: improvement in health status, vaccine uptake and longevity until the pandemic hit. Worse rates for drug deaths, early death due to COVID and disparities.

 

· A poll of 1,149 older adults found that 32% of are keen to continue using telehealth visits, with women and non-Hispanic Blacks the groups most likely to express a keen interest.

 

· The FDA permitted marketing for the first in vitro diagnostic test for early detection of amyloid plaques associated with Alzheimer’s disease, Lumipulse G β-Amyloid Ratio (1-42/1-40) test. It is for patients, >55 years with cognitive impairment to differentiate Alzheimer’s disease from other causes of cognitive decline. It is faster, with less radiation, and cheaper than a PET scan, $1250 vs. $3000 but neither are covered by insurance.

 

· From the LGBT Community Forum webinar I learned that caregivers are more often similar age supports. Here is a LGBTQ community resource page for dementia on the Alzheimer's Association website.

 

· Also, in follow up of last update, the National Academies Report on Nursing Homes is summarized in a 1 hour webinar, if you have not had time to read the report and want to listen while going for a run, walk or on your commute.

 

Cycling & Safety News:

 

· Cycling accounts for more than 25% of daily travel in the Netherlands and they use the “Dutch Reach,” a move to use their right hands when opening their doors, even though their left hands are closer. This forces individuals to fully turn their upper bodies toward their exit, increasing the probability that they will spot anyone approaching in a bike lane. Some local drivers even tie ribbons to their door handles as reminders, and the Dutch Reach Project employs the slogan, “Reach, Swivel, Look, Open” — good safety advice regardless of your seat placement.

 

 

Dr. Irene Hamrick is a professor at the University of Cincinnati College of Medicine. She is the Chief of Geriatrics Division, Dept Family and Community Medicine and Martha Betty Semmons Endowed Chair in Geriatric Medicine Education. 


 

 

About BASE10 Genetics

Located in Chicago, BASE10 is a healthcare software technology company whose platform creates turnkey disease management programs that can be deployed at scale for nursing home operators, pharmacies, payors, and self-funded employers. 

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