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New Delhi: The coronavirus pandemic continues to take thousands of lives across the world every day, even as scientists make new revelations about the SARS-CoV-2.
Here are some of the latest research findings on Covid-19.
Blood test can determine who will benefit from dexamethasone
A common blood test — that looks for inflammatory proteins — can help doctors decide which Covid-19 patients are most likely to benefit from treatment with the steroid dexamethasone.
The UK RECOVERY trial, involving more than 6,000 people with Covid-19, has shown that dexamethasone reduced deaths by about one third in patients on ventilator and by about one fifth among those who needed oxygen.
A study led by Albert Einstein College of Medicine and Montefiore Health System has confirmed these findings, and answered several other questions such as which patients are most likely to benefit from steroid therapy and who may be harmed by it.
The research, published in the Journal of Hospital Medicine, also shows that steroid formulations such as prednisone and methylprednisolone can give same life-saving benefits.
Nearly all patients initially had a blood test to measure their levels of C-reactive protein (CRP), which the liver produces in response to inflammation. The higher the CRP level in the blood, the greater is the amount of inflammation.
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A normal CRP level reported in the study is below 0.8 milligrams per deciliter of blood. Researchers found that in patients with CRP level greater than 20, steroids were associated with a 75 per cent reduction in the risk of going under mechanical ventilation or dying.
However, in patients with CRP levels less than 10, steroid use was associated with an almost 200 per cent increased risk of going on mechanical ventilation or death.
Also read: Immunotherapy could be safe for cancer patients with Covid, early data indicates
Cancer patients may not benefit from dexamethasone
Another study has shown that dexamethasone is associated with increased mortality in cancer patients who are diagnosed with Covid-19.
The data, published in Cancer Discovery, is part of a cancer-specific observational study of treatments purported to improve Covid-19 outcomes.
In the study, patients receiving high-dose corticosteroids with any other potential Covid-19 treatment were more than twice as likely to die, as compared to patients treated with other medications or those not requiring any treatment.
There was a very small number of patients treated just with steroids, researchers said, making analysis of steroids in isolation difficult.
Cancer patients are already immunocompromised and steroids could potentially make things worse, the researchers said. However, further trials are required to confirm these findings, the team noted.
Hypertension drugs may not increase Covid-19 risk
A new study on mice has found that some widely-used class of drugs to treat hypertension, heart and kidney diseases does not increase the risk of developing a severe and potentially fatal Covid-19 infection, as was previously feared.
Concerns were raised by the medical community earlier that these drugs, which are ACE inhibitors and angiotensin receptor blockers (ARB), may cause an increase of ACE2 — a protein that helps the SARS-CoV-2 latch on to host cells. Such a scenario could possibly increase the risks of Covid-19 infection and its severity.
However, new findings have shown a decrease in ACE2 in mice kidney membranes and no change in lung membranes. The study supports the safety of these drugs in the face of the Covid-19 pandemic.
Autopsies show damage to hearts in Covid-19 patients
A series of autopsies have shown the damage caused to hearts in Covid-19 patients. A unique pattern of cell death in scattered individual heart muscle cells, rather than the typical inflammation of the heart muscle, has been observed.
The findings, published in the journal Circulation, identifies microscopic changes which challenge the notion that typical myocarditis — heart muscle inflammation usually caused by a viral infection — is present in severe SARS-CoV-2 infection.
While the mechanism of cardiac injury in Covid-19 is not well understood, the researchers have proposed several theories that need further investigation.
The autopsies were conducted on 22 patients who died of Covid-19 in the US, a majority of whom were African American.
The team also found viral infection of some of the cells in the lining of the smaller blood vessels. At low levels, it may be enough to cause dysfunction leading to individual cell death. The effects of ‘cytokine storm’ — overreaction of the immune system cells while fighting infection — associated with Covid-19 may also play a role.
Nitric oxide may help improve outcome in Covid-19 patients
A review of research published since 1993 has shown that inhaled nitric oxide can improve clinical outcomes for Covid-19 patients.
Nitric oxide is an antimicrobial and anti-inflammatory molecule with key roles in pulmonary vascular function, in the context of viral infections and other pulmonary diseases.
According to the study, in SARS-CoV-1 infection, which led to the outbreak of SARS in 2003, nitric oxide helped inhibit viral replication. It is one of several potential Covid-19 treatments included in the US FDA’s emergency expanded access program.
Nitric oxide plays key roles in maintaining normal vascular function and regulating inflammatory cascades that contribute to acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), the researchers said.
As researchers continue to work with nitric oxide, the team recommends that dosing and protocol variations should be examined while evaluating studies.
Also read: India’s R value for Covid climbs a second time this month, at 1.17 now from 1.11 last week
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