COVID-19 January 2022 Column

A-       Recently, an American flight left Miami International Airport and headed to London and the stewardesses were confronted to a passenger refusing to wear her mask in the plane. The flight AA L38 returned to Miami and police officers escorted out a woman off the plane and she was placed on a no-fly-list. Her disruptive behavior was reported by ASA today. Many incidents (92) with face masks were observed causing friction on flights. The FAA has no authorities to to prosecute criminal cases but they can impose fines up to 37,000 dollars to the unruly passengers.

B-        A COVID-19Treatment guideline Panel has published version on the therapies offered to the high-risk non-hospitalized patient with mild to moderate COVID-19. The update addresses the fact that the Omicron (B.1.1.529) variant is now the dominant SARS-CoV-2 variant in the United States because apparently the monoclonal antibodies are predicted to have markedly reduced activities against the strain.

C-        Researchers at the University of California found abnormalities in the cerebrospinal fluid of at least 10 of 13 people infected with the virus and who presented with problems in thinking. It was called “brain fog” because of their mental confusion reported in the study. Of the 32 who did not require admission 13 were found to have cognitive symptoms. This study was reported in the Annals of Clinical and Translational Neurology. All participants underwent a series of cognitive tests. The one with brain fog had problems in remembering recent events or names or words and the cerebrospinal fluid was abnormal for all the 13 suffering with the symptoms. Elevated protein was constant perhaps signifying an inflammation and the presence of unexpected antibodies. Possibly attacking the immune system, once stimulated by the virus. Cognitive problems have been found in people infected by other virus like HIV, MERS, SARS, Hepatitis C, Epson-Barr virus. Such people were also found to be prone to High Blood Pressure, Diabetes, Vascular Dementia and even ADHD (attention deficit hyperactivity disorder). Brain Fog appears to be reported more frequently as reported in a post COVID study done in NY where 67% of 156 patients had the thinking problems.

D-       The Omicron variant appears to cause less damage to the lungs as compared to the other strains like Delta. This was confirmed on mice and hamsters. The virus appears to be limited to the upper airway (nose, throat, trachea etc.). When it emerged in November, it was noted that hospitalizations have not much increased and has produced less lung damages and appears to cause a less severe disease than the previous strains.

E-         Pfizer and Merck received authorization from the US Food and Drugs Administration on the use of Paxlovid and Molnupiravar. They are antiviral drugs (pill) for oral use in te treatment of mild to moderate COVID-19 in individuals ages 12 and older who are found to have a COVID-19 test positive and are found to be at high risk for progression to severe illness requiring hospitalization or at risk for death. They need to be treated within 5 days of the increase of symptoms or may have not received any monoclonal antibody therapy. 3 tablets a day for a total of 5 days for Paxlovid while for the Molnupiravir is given to the 18-year-old and older as one tablet orally every 12 hours for a period of seven days. Molnupiravir reduce the population of patients in need of a hospitalization. Not all pharmacies will carry the “per os” medications.

F-         20% of the US population has been infected by the SARS-CoV-2 virus. 71.4 million cases have been reported in the country while more than 867,000 COVID-19 related deaths are recorded since the discovery of the first COVID case in the US on Jan 21, 2020 in a man who returned from a trip to Wuhan, China. Washington State. The USA has the most cases and deaths, followed by India 30.5 million and Brazil 623,000.

G-       Two new studies came out on pregnant women and their newborn infants. A study from Scotland showed that the unvaccinated pregnant women who get COVID were much likely to have a stillborn or a baby that will die in the first 28 days of life. Also, Pregnant women infected with COVID were at risk for dyeing or needing hospitalization at a much higher rate than the vaccinated. Of the 2364 babies born in that study from mother unvaccinated, infected with COVID, 11 children from 2.353 life birth were stillborn and more, eight more babies died within the 28 days of life. More 241 were born premature. A low vaccination rate of 32% was also found in the women giving birth during that period of Oct 2021. Most of the birth problems occurred in the first and second trimester infections, even if the mother di not have respiratory complications.

H-       The CDC (Center for Disease Control and Prevention) announced that loosely woven masks offer the least protection against COVID-10, they encourage the use of N-95 masks. The industry recommends ditching cloth masks for N95 respirators or 3-plysurgical masks. A single-cloth-mask is not sufficient to stop the virus. Children below the age of 2 does not need to wear on but children and staff in all K-12 schools should wear one…

I-            The average number of COVID-1099 cases is falling nationwide in the US. The hospitalizations may be at a peak especially for the unvaccinated and the one with co-morbidities. The deaths rate still rising with 2500 deaths each day. Cases are at record levels in states like Alabama, Alaska, Kansas, North Dakota. The Omicron variant makes now up to 99.9% of the cases. Soon we sill reach a million of deaths because we have already reached 889,000 during this pandemic.

Maxime Coles MD

Boca Raton FL


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