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Infectious Diseases

27 September 2020

Coronavirus science | Week in review: Post-recovery fatigue, latest on masks and Covid in kids

Recap of the latest coronavirus research: Fatigue is common in people who recover, regardless of severity; latest science on masks, and Covid-19 in children.

LATEST SCIENCE AND RESEARCH

READ | Fatigue is common in people who recover from Covid-19, regardless of severity

As the Covid-19 outbreak continues, we have learnt that people experience the disease differently. Some require hospitalisation where the outcome may be fatal, while others are able to recover at home.

But according to new research presented at a conference on Covid-19 hosted by the European Society of Clinical Microbiology and Infectious Diseases, there is one key factor that many Covid-19 patients, mild and severe alike, experience – persistent fatigue.

As more people recover from Covid-19, some are experiencing post-infection problems, the researchers stated.

"Fatigue is a common symptom in those presenting with symptomatic Covid-19 infection. Whilst the presenting features of SARS-CoV-2 infection have been well-characterised, the medium and long-term consequences of infection remain unexplored,” explained Dr Liam Townsend, lead study author from St James's Hospital and Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland.

"In particular, concern has been raised that SARS-CoV-2 has the potential to cause persistent fatigue, even after those infected have recovered from Covid-19. In our study, we investigated whether patients recovering from SARS-CoV-2 infection remained fatigued after their physical recovery, and to see whether there was a relationship between severe fatigue and a variety of clinical parameters. We also examined persistence of markers of disease beyond clinical resolution of infection,” Dr Townsend stated.

The researchers used a scale called the Chalder Fatigue Score to investigate fatigue in 128 recovered Covid-19 patients and found that more than half of the patients reported persistent fatigue after their recovery.

READ | Children’s immune systems respond differently to Covid-19 than those of adults, research suggests 

Early in the Covid-19 outbreak, evidence showed that children are likely to experience milder Covid-19 symptoms than adults.

A study published in Science Translational Medicine is the first to compare the immune responses of children and adults. This new research detected some key differences to explain the phenomenon.

For the research, scientists from the Albert Einstein College of Medicine, Children’s Hospital at Montefiore and Yale University investigated cases of 60 adult Covid-19 patients and 65 child patients (all younger than 24 years) between 13 March and 17 May 2020.

The scientists tested the patients’ blood for several types of immune cells, antibody responses and cytokines produced by immune cells.

The children’s immune responses looked significantly better than those of the adults. Twenty-two adults needed ventilation, in comparison with only five children, and 17 adults died compared to just two of the paediatric patients.

"Our findings suggest that children with Covid-19 do better than adults because their stronger innate immunity protects them against SARS-CoV-2, the novel coronavirus that causes the disease," said co-senior author Dr Betsy Herold, chief of infectious diseases and vice chair for research in the department of paediatrics at Einstein and CHAM.

READ | To what extent is Covid-19 damaging the brain? 

Maybe it's a bad trip, or maybe it's the "rona". For one woman – hallucinating about lions and monkeys in her home and convinced her husband was someone else – it turned out to be the latter.

And she's not the only one.

Scientists are struggling to understand Covid-19's effect on the brain as more patients present with neurological symptoms. In the beginning of the pandemic, these symptoms were often missed as healthcare workers were more concerned about keeping patients breathing than noticing whether they were "seeing things".

Scientists have, however, slowly started taking note of neurological disorders in Covid-19 patients. In July, a UK study detailed more than 40 cases of patients presenting with brain dysfunctions like encephalopathy, ischaemic stroke and Guillain-Barré Syndrome, all of which can cause haemorrhaging and inflammation.

These symptoms were even present in patients with mild Covid-19.

Another study also showed how mini-brains grown in a lab proved that viral replication could take place in their cells, signalling potential long-term brain damage, although how the virus would get into the brain remains an unanswered question.

A research paper explained that an infection of the brain could happen in three stages: loss of taste and smell as it infects the nose's epithelial cells; blood clots in the system that could lead to strokes; and damage to the blood-brain barrier by the ensuing cytokine storm, making our most important organ vulnerable to further infection.

PICS | Striking images show exactly how Covid-19 virus infects lungs 

The lungs are the organs most commonly affected by Covid-19, the disease caused by SARS-CoV-2, and researchers from the UNC School of Medicine have published striking images of cells infected by the virus.

The high-powered microscopic images generated by Dr Camille Ehre from UNC (done in collaboration with two other researchers), show high SARS-CoV-2 viral loads on human respiratory surfaces, ready to spread infection in infected individuals and transmit infection to others.

The images were published in the New England Journal of Medicine.

In a laboratory setting, the researchers inoculated the SARS-CoV-2 virus into human bronchial epithelial cells. Using scanning electron microscopy, they examined the cells 96 hours later.

The images below were re-colourised by UNC medical student Cameron Morrison and indicate the following: the infected ciliated cells with strands of mucus (yellow), attached to cilia tips (blue).

In their published paper, the authors explain that cilia are hair-like structures on the surface of airway epithelial cells that transport mucus (and trapped viruses) from the lungs. The airway epithelium’s job is to moisten and protect the airways.

READ | Want a breathable, yet effective homemade mask? Use silk, study suggests 

As masks are becoming mandatory all over the world, authorities have asked people to use homemade cloth masks instead of single-use surgical and N95 masks that are needed by medical staff.

Face coverings from all materials and shapes are being used. And while all face coverings offer a measure of protection against large and small respiratory droplets, a team of researchers from the University of Cincinnati wanted to examine the efficacy of different household fabrics.

The study, which was recently published in the journal PLOS ONE, wanted to determine what practices would be most effective in practice. The researchers examined cotton, polyester and silk by their resistance to the penetration of small and aerosolised water drops.

They also investigated the breathability of the fabrics, and how they would fare if they were washed repeatedly. In the laboratory, they used the materials as an overlaying barrier for respirators, as well as face coverings. The team then looked at the penetration and absorption of droplets – and observed that silk faired the best, both as a barrier and in terms of breathability.

"Cotton traps moisture like a sponge. But silk is breathable. It's thinner than cotton and dries really fast," said Patrick Guerra, an assistant professor of biology at UC’s College of Arts and Sciences.

It’s not only the fact that silk is dense and breathable that made the researchers take note.

CORONAVIRUS CASES LATEST

SA cases update: 

The latest number of confirmed cases is 669 498.

According to the latest update, 16 376 deaths have been recorded in the country.

There have been 601 818 recoveries.

So far, more than 4.12 million tests have been conducted, with 11 359 new tests reported.

Global cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Late on Saturday night, positive cases worldwide were almost 32.71 million, while deaths were more than 991 000.

The United States had the most cases in the world - more than 7.07 million, as well as the most deaths - more than 204 000.

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

Image credit: Getty Images