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COVID-19 again? Reinfection cases raise concerns over immunity

By Kate Kelland

LONDON (Reuters) – The case of a man in the United States infected twice with COVID-19 shows there is much yet to learn about immune responses and also raises questions over vaccination, scientists said on Tuesday.

The 25-year-old from Reno, Nevada, tested positive in April after showing mild symptoms, then got sick again in late May with a more serious bout, according to a case report in the Lancet Infectious Diseases medical journal.

The report was published just hours after U.S. President Donald Trump, who was infected with COVID-19 and hospitalised earlier this month, said he believes he now has immunity and felt “so powerful”.

Scientists said that while known incidences of reinfection appear rare – and the Nevada man has now recovered – cases like his were worrying. Other isolated cases of reinfection have been reported around the world, including in Asia and Europe.

In the Netherlands, the National Institute for Public Health confirmed on Tuesday that an 89-year-old Dutch woman, also sick with a rare form of bone marrow cancer, had recently died after contracting COVID-19 for a second time.

Dutch media said this was the first known case worldwide of a death after SARS-CoV-2 coronavirus reinfection.

‘IMPLICATIONS FOR VACCINATION’

“It is becoming increasingly clear that reinfections are possible, but we can’t yet know how common this will be,” said Simon Clarke, a microbiology expert at Britain’s Reading University.

“If people can be reinfected easily, it could also have implications for vaccination programmes as well as our understanding of when and how the pandemic will end.”

The Nevada patient’s doctors, who first reported the case in a non peer-reviewed paper in August, said sophisticated testing showed that the virus strains associated with each bout of infection were genetically different.

“These findings reinforce the point that we still do not know enough about the immune response to this infection,” said Paul Hunter, a professor in medicine at Britain’s University of East Anglia.

Brendan Wren, a professor of vaccinology at the London School of Hygiene & Tropical Medicine, said the Nevada case was the fifth confirmed example of reinfection worldwide. 

“The demonstration that it is possible to be reinfected by SARS-CoV-2 may suggest that a COVID-19 vaccine may not be totally protective,” he said. “However, given the (more than) 40 million cases worldwide, these small examples of reinfection are tiny and should not deter efforts to develop vaccines.”

World Health Organization spokesman Tarik Jasarevic concurred that the U.S. case underlined what was unknown about immunity. “And this also really is an argument against what some have been advocating, and that’s building naturally what is called herd immunity. Because we don’t know,” he told a briefing.

(Reporting by Kate Kelland; Additional reporting by Anthony Deutsch in Amsterdam, Stephanie Nebehay in Geneva; Editing by Andrew Cawthorne)

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The Wanted’s Tom Parker aims to raise awareness following diagnosis

Tom Parker has been diagnosed with an inoperable brain tumour, pictured in May 2013. (Getty Images)
Tom Parker has been diagnosed with an inoperable brain tumour, pictured in May 2013. (Getty Images)

The Wanted’s Tom Parker has been diagnosed with an inoperable brain tumour.

The boy band singer, 32, said he was “still in shock” after being told six weeks ago that he had a type of tumour called a stage 4 glioblastoma

He received the diagnosis shortly before he is due to become a dad for the second time.

“There’s no easy way to say this but I’ve sadly been diagnosed with a Brain Tumour and I’m already undergoing treatment,” he wrote on Instagram, alongside a picture of himself and his wife, Kelsey Hardwick and their 16-month-old daughter, Aurelia.

Parker went on to say he hopes to remain positive, despite being told the cancer diagnosis is terminal.

“We are all absolutely devastated but we are gonna fight this all the way,” his post continues. “We don’t want your sadness, we just want love and positivity and together we will raise awareness of this terrible disease and look for all available treatment options.

“It’s gonna be a tough battle but with everyone’s love and support we are going to beat this.”

Read more: Brain cancer patient, 32, given six weeks to live ‘still fighting’ two years later

In an interview with OK! magazine, Parker revealed he suffered a seizure in July and was put on a waiting list for an MRI scan.

Six weeks later he had another, more serious seizure during a family trip to Norwich and was rushed to hospital.

After three days of tests, he was given the diagnosis that he was suffering from grade four glioblastoma.

What are the symptoms of a brain tumour?

The symptoms of a brain tumour will depend upon which part of the brain is affected, according to Brain Tumour Research.

The most common symptoms are caused by an increase in pressure in the skull caused by the growth of a tumour in the brain.

Other common symptoms, which may initially come and go, can include one or more of the following:

  • Headaches

  • Eye and vision-related problems (such as squinting and double-vision)

  • Continuing nausea, vomiting 

  • Extreme or sudden drowsiness

  • Tinnitus (ringing in the ears) or hearing loss 

  • Unexplained twitches of the face or limbs

  • Seizures (fits or faints)

  • Appearing to be lost in a deep daydream for a short while

  • Confusion

  • Loss of balance

  • Numbness or weakness in the arms or legs, especially if progressive and leading to paralysis

  • Numbness or weakness in a part of the face, so that the muscles drop slightly

  • Numbness or weakness on one side of the body, resulting in stumbling or lack of co-ordination

  • Changes in personality or behaviour

  • Impaired memory or mental ability, which may be very subtle to begin with

  • Changes in senses, including smell

  • Problems with speech, writing or drawing

  • Loss of concentration or difficulty in concentrating

  • Changes in sleep patterns

Read more: Sarah Harding is undergoing treatment for breast cancer

“Depending on which part of the

COVID-19 Antibodies Raise Unanswered Clinical Questions

While monoclonal antibody treatment may hold promise for COVID-19, its clinical benefit has yet to be proven, said experts from the Infectious Diseases Society of America (IDSA).

In a media briefing, IDSA experts discussed that while manufacturers of monoclonal antibody treatment, Regeneron and Eli Lilly, both applied for emergency use authorization (EUA) from the FDA to treat COVID-19, the data on both so far have yet to demonstrate any impact on patient care.

Reviewing the data, Adarsh Bhimraj, MD, co-chair of the IDSA COVID-19 Treatment and Management Guidelines Expert panel, noted how the endpoints of both trials examined decreases in viral load for patients. He characterized these as surrogate endpoints, or “disease-oriented endpoints,” which are only meaningful if they translate into patient-oriented outcomes, such as preventing death or disability.

“Curing the virus is not the same thing as curing the patient and making them better,” he said.

Bhimraj even compared these antibody therapies to the saga of hydroxychloroquine, which was also shown to have “a very fast reduction in viral load” in early studies, “but randomized controlled trials did not translate into patients getting better or not dying.”

Helen Boucher, MD, member of the IDSA Board of Directors, said she wanted to support the FDA in their efforts to make evidence-based decisions about EUAs, saying they wanted to keep “everyone assured when we make recommendations, they’re believable and everyone can feel good about them.”

Bhimraj pointed to the situation with convalescent plasma, which received an EUA outside the context of a randomized clinical trial.

“We don’t have clinical trial data and it’s been used in thousands and thousands of people,” he said. “An EUA is important, but … what are the consequences … of an EUA and what are the collateral effects, especially when other therapies exist?”

He emphasized how important it was to “let science and let objectivity … determine the decision-making rather than any kind of political pressure.”

Boucher noted that the difference between having enough data for an EUA application was different than having enough data for a decision to be made. She suggested if the FDA wanted more data, it could convene an advisory committee to help in the decision-making process, “but it’s not a requirement, as far as I know.”

She added that even if an EUA is issued, that’s only half the battle, given how much manufacturers would need to scale up to meet demand.

“Any kind of authorization or approval doesn’t necessarily mean the drug is available to anyone who needs it,” Boucher said.

Using the example of 50,000 people who may be infected with COVID-19 on any particular day, even 20% of those patients ending up in the hospital would require more product than the companies are prepared to produce right now. Boucher said it would take “months” to manufacture enough to treat everyone in this country who needs it.

Cost is potentially another issue, with the other existing COVID-19 treatments potentially being much less expensive. Boucher said the steroid, dexamethasone, costs

Money Worries Raise Suicide Risk in People With ADHD: Study | Health News

By Robert Preidt, HealthDay Reporter

(HealthDay)

MONDAY, Oct. 5, 2020 (HealthDay News) — There’s a link between attention-deficit hyperactivity disorder (ADHD), financial stress and suicide risk, a new study suggests.

Researchers analyzed data on ADHD and suicide in Sweden from 2002 to 2015, as well as credit and default data from a random sample of more than 189,000 Swedish adults for the same period.

Before age 30, people with ADHD had only a slightly higher demand for credit than others. But demand among people with ADHD continued to grow with age, while demand for credit fell among others.

“Because they are in financial distress, those with ADHD keep asking for more credit and not getting it,” said study co-author Itzhak Ben-David, a professor of finance at Ohio State University.

“The result is that their financial problems just keep getting worse and worse through adulthood,” he said in a university news release.

Adults with ADHD were more than four times more likely than the general population to have bank overdrafts, impounded property and unpaid alimony, educational support or road taxes. By age 40, their default risk peaked at more than six times that of the general population.

As in previous research, this study found that people with ADHD were more likely than others to die by suicide.

But it also found that adults with ADHD who were at the highest risk of default were about four times more likely to die of suicide than those with ADHD who were at low risk of default and people without ADHD who had poor credit.

Among men with ADHD, the frequency of unpaid debts increased significantly in the three years prior to suicide, according to findings published Sept. 30 in the journal Science Advances.

“There is more financial chaos in the lives of men with ADHD in the years immediately preceding suicide,” said study co-author Marieke Bos, deputy director of the Swedish House of Finance at the Stockholm School of Economics.

The findings highlight the significant role that financial problems play in suicide risk among people with ADHD, according to the researchers.

“Our modern life is built on paying bills on time and making rent and mortgage payments. These tasks are more difficult for people with ADHD and it takes a toll,” Ben-David said.

Co-author Theodore Beauchine, a professor of psychology at Ohio State, said more attention should be given to financial difficulties facing people with ADHD.

“The impulsivity found in ADHD is predisposing to suicide. And if you have a lifetime of financial problems, that can lead to a sense of hopelessness,” he said in the release. “Hopelessness combined with impulsivity is a really bad combination and may increase the risk of suicide.”

The U.S. National Institute of Mental Health has more on ADHD.

Copyright © 2020 HealthDay. All rights reserved.

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