A divided visual field

Hummingbird hawkmoths are small insects that hover in the air like hummingbirds when drinking nectar from flowers. Dr. Anna Stöckl from the Biocentre of the Julius-Maximilians-Universität (JMU) Würzburg in Bavaria, Germany, is studying the visual performance of these insects. Dr. Stöckl and her doctoral student Ronja Bigge now present their latest findings in the journal Current Biology.
“To control their flight, hummingbird hawkmoths rely on optic flow in the lower half of their visual field,” Ronja Bigge explains. Optic flow is the relative motion that the surrounding image casts on the animals’ retinas when they fly. We experience this phenomenon ourselves when travelling by train — the landscape passing by the train windows allows us to estimate our speed, for example.
For hawkmoths, the optic flow also provides information about their own movement. It helps them to control the straightness and speed of their flight. The JMU researchers have now shown with outdoor measurements that the optic flow components parallel to the direction of flight are always strongest below the hawkmoths’ body. This is where the insects see meadows, gardens and streets that provide a varied texture. For flight control, what happens in the lower visual field is therefore the most reliable parameter.
Previously unknown behaviour discovered
“Surprisingly, we were able to show that the hawkmoths displayed a completely different and novel behaviour when we presented them with visual textures in the upper half of their visual field,” says Anna Stöckl.
The animals then oriented themselves along prominent contours in the patterns. Thus, they did not use the visual information for flight control, but for orientation — although the visual patterns were exactly the same as the ones that were previously presented in the lower half of their visual field.
“Our optical measurements in natural habitats showed a comparable relationship: high-contrast structures that can be used for orientation occur primarily in the upper half of the visual field,” says the JMU researcher. These are, for example, the silhouettes of treetops or bushes that form a strong contrast with the sky.
Visual field is divided in two
The conclusion of the Würzburg biologists: “The flight control system and the orientation system of the hummingbird hawkmoth divide the visual field among themselves and focus on the respective area that provides the most reliable information in their natural habitats.”
In other words, it is not only important what the animals see, but also where they see it.
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Materials provided by University of Würzburg. Original written by Robert Emmerich. Note: Content may be edited for style and length.

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How UK, South Africa coronavirus variants escape immunity

All viruses mutate as they make copies of themselves to spread and thrive. SARS-CoV-2, the virus the causes COVID-19, is proving to be no different. There are currently more than 4,000 variants of COVID-19, which has already killed more than 2.7 million people worldwide during the pandemic.
The UK variant, also known as B.1.1.7, was first detected in September 2020, and is now causing 98 percent of all COVID-19 cases in the United Kingdom. And it appears to be gaining a firm grip in about 100 other countries it has spread to in the past several months, including France, Denmark, and the United States.
The World Health Organization says B.1.1.7 is one of several variants of concern along with others that have emerged in South Africa and Brazil.
“The UK, South Africa, and Brazil variants are more contagious and escape immunity easier than the original virus,” said Victor Padilla-Sanchez, a research scientist at The Catholic University of America. “We need to understand why they are more infectious and, in many cases, more deadly.”
All three variants have undergone changes to their spike protein — the part of the virus which attaches to human cells. As a result, they are better at infecting cells and spreading.
In a research paper published in January 2021 in Research Ideas and Outcomes, Padilla-Sanchez discusses the UK and South African variants in detail. He presents a computational analysis of the structure of the spike glycoprotein bound to the ACE2 receptor where the mutations have been introduced. His paper outlines the reason why these variants bind better to human cells.

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Telehealth consults increased more than 50-fold among privately insured working-age patients during first phase of the pandemic

A study co-authored by researchers at the Johns Hopkins Bloomberg School of Public Health found that telehealth consults among privately insured working-age patients accounted for almost 24 percent of outpatient consults with health care providers during the early phase of the pandemic, March to June 2020, up from less than 0.3 percent during the same period in 2019.
The dramatic shift occurred as many medical practices halted or curtailed in-person office hours and patients stayed away from doctor’s offices out of fear of transmission during the early months of the pandemic. At the same time, insurance companies and the federal government relaxed policies around telehealth to meet demand for remote medical consults via internet video or telephone.
The study was published online March 23 in JAMA Network Open.
For their study, researchers from Johns Hopkins Bloomberg School of Public Health and Blue Health Intelligence®, an independent licensee of the Blue Cross Blue Shield Association, analyzed anonymized claims data drawn from 36.6 million private insurance plan members who were of working age and continuously enrolled during the study period. The claims data for the study were provided by Blue Health Intelligence.
A total of 15 million telehealth claims were submitted during the March to June 2020 study period, with nearly three-quarters involving video support (74.4 percent) and fewer than one in ten occurring via phone (9.2 percent). Just over 3 percent (3.3 percent) were conducted either by email or chat while 13.1 percent were unspecified.
Mental health consults were far more likely to take place virtually — with 46.1 percent taking place via telehealth. By comparison, 22.1 percent of medical consults were virtual. In COVID-19 “hot spot” states — those with a COVID-19 prevalence at least 1.5 times the national average — 36 percent of all consults were telehealth versus 21.6 percent in areas with lower COVID-19 prevalence. The study also found that the greater the COVID-19 prevalence in a specific ZIP code, the higher the use of telehealth.

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New strategy for fighting brain cancer

Most people relate cholesterol to heart health, but it is also a critical component in the growth and spread of brain cancer. VCU Massey Cancer Center researcher Suyun Huang, Ph.D., recently discovered how cholesterol becomes dysregulated in brain cancer cells and showed that the gene responsible for it could be a target for future drugs.
The mean survival of patients with the most common and aggressive type of brain cancer, glioblastoma multiforme (GBM), is 14 months. The need to find new, effective treatments is urgent and has driven Huang, a member of the Cancer Biology research program at Massey, to detail the workings of numerous genes, proteins, enzymes and other cellular components that contribute to brain cancer growth. Her studies are revealing a biological “roadmap” showing previously unknown functions of genes.
Huang’s most recent study, published in the journal Nature Communications, pinpoints a gene called YTHDF2 as a crucial link in a chain leading to the development and growth of GBM. It works through a process set in motion by another gene with a well-established reputation for driving cancer progression, EGFR.
“These findings are exciting because we can potentially target YTHDF2 expression by using YTHDF2 small molecule inhibitors to control glioblastoma tumor growth and spread,” says Huang, who is also a professor in the Department of Human and Molecular Genetics at VCU School of Medicine. “Our experiments also showed that we can stop the formation and growth of brain cancer cells by blocking YTHDF2 expression, so it could also be a powerful target for drug development.”
EGFR is frequently overactivated in many aggressive cancers, including GBM. Huang’s team found that EGFR drives the overexpression of TYHDF2, which then sustains increased cholesterol levels for the invasive growth and development of GBM cells through a process that degrades the LXR? and HIVEP2 genes. LXR? is known to regulate cholesterol levels within cells and HIVEP2 is involved in the development of brain tissue.
Huang’s study is the first to describe this cell signaling cascade, and it helps fill in important parts of the “roadmap” leading to GBM. It is also the first study to show that N6-methyladenosine (m6A), a DNA modification found in nearly all cell-based life forms, plays a role in brain tumor growth and cholesterol metabolism. Huang’s team found that the increase in YTHDF2 expression caused m6A modifications in the mRNA of LXR? and HIVEP2, which inhibited their functions.
Next, Huang and her collaborators plan to evaluate different YTHDF2 inhibitors and establish their effects in lab and animal models.
“EGFR inhibition and cholesterol regulation are both promising strategies for GBM treatment,” says Huang. “Our study offers an exciting new approach that could potentially work hand-in-hand with these strategies to regulate and treat GBM.”
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Materials provided by Virginia Commonwealth University. Original written by John Wallace. Note: Content may be edited for style and length.

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Vaccinated People Can Get Covid, but It’s Most Likely Very Rare

“Breakthrough” cases, though quite uncommon, are a sharp reminder that vaccinated people should wear masks while the virus is circulating widely.More than two months after he was fully vaccinated against Covid, a doctor in New York woke up with a headache and a dull, heavy feeling of fatigue. A fever and chills soon followed, and his senses of taste and smell began to fade.This, he thought, could not be happening. But it was: He tested positive for the coronavirus.“It was a huge shock,” he said. He knew that no vaccine was perfect and that the Pfizer-BioNTech shots he received had been found 95 percent effective in a large clinical trial. “But somehow in my mind, it was 100 percent,” he said.The doctor, who requested anonymity to protect his privacy, is among the few reported cases of people who have been infected after being partly or even fully vaccinated. Nearly 83 million Americans have received at least one dose of a Covid vaccine, and it’s unclear just how many of them will have a “breakthrough” infection, though two new reports suggest the number is very small.One study found that just four out of 8,121 fully vaccinated employees at the Southwestern Medical Center in Dallas became infected. The other found that only seven out of 14,990 workers at UC San Diego Health and the David Geffen School of Medicine at the University of California, Los Angeles tested positive two or more weeks after receiving a second dose of either the Pfizer-BioNTech or Moderna vaccines. Both reports, published on Tuesday in the New England Journal of Medicine, show how well the vaccines work in the real world, and during a period of intense transmission.But these breakthrough cases, though quite rare, are a sharp reminder that vaccinated people are not invincible, especially when the virus continues to circulate widely.“We felt really strongly that this data should not lead people to say, ‘Let’s all get vaccinated and then we can all stop wearing masks,’” said Dr. Francesca J. Torriani, an infectious disease specialist at UC San Diego Health who led the California study. “These measures have to continue until a larger segment of the population is vaccinated.”Only some of the Covid-positive health workers in the California study showed symptoms, she said, and they tended to be mild, suggesting that the vaccines were protective. That echoes data from the vaccine trials indicating that breakthrough infections were mild and did not require hospitalizations. Some people had no symptoms at all, and were discovered only through testing in studies or as part of their medical care.For example, doctors at the University of North Carolina found a few asymptomatic cases in vaccinated patients who were tested for the coronavirus ahead of surgery or other medical procedures, according to Dr. David Wohl, the medical director of that center’s vaccine clinic.He said the absence of symptoms may have meant that the vaccine was doing exactly what it is supposed to do: prevent people from getting sick, even if it does not fully block the virus from infecting them.The Centers for Disease Control and Prevention has a small team studying breakthrough cases, said an agency spokeswoman, Kristen Nordlund. One question the researchers are considering is whether particular variants of the coronavirus might play a role in breakthrough cases.“Currently, there is no evidence that Covid-19 after vaccination is occurring because of changes in the virus,” Ms. Nordlund said.In the next few months, Pfizer and Moderna are expected to release data that should indicate how often vaccinated people become infected by the virus, even if they have no symptoms. The companies have been testing participants in their vaccine trials for antibodies to a protein called N that is part of the coronavirus but not part of the vaccine. Finding those antibodies means that a vaccinated person has been infected by the virus. Some volunteers from the studies are also having their noses swabbed regularly to test for an active viral infection.Another question is how effective the vaccines are in people whose immune systems have been weakened by illness or medications, said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. Breakthrough cases might occur in those people because their bodies cannot produce a robust reaction to a vaccine.“And it is amazing how pervasive immunocompromise is,” Dr. Schaffner said. He called the condition “a testament to modern medicine,” because many patients with it are being treated successfully for conditions that not so long ago would have killed them.The doctor who became ill in New York despite full vaccination stayed in isolation at home for nearly two weeks. He described his illness as relatively mild, and said he was treated with monoclonal antibodies to fight the virus. “If the worst flu is a 10, this was a four,” he said.Without the vaccine, he said, he believes he would have been sicker.“I would have been in fear for my mortality,” he said. “But I didn’t have a moment’s anxiety. I did not think I was going to die. Thinking you’re not going to die — that’s a pretty big thing.”Apoorva Mandavilli contributed reporting.

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AstraZeneca’s Latest Stumble Again Clouds European Vaccinations

The company defended its claims of 79 percent efficacy for its coronavirus shot and said it would release more up-to-date trial results within 48 hours.LONDON — The announcement this week that the AstraZeneca shot, the workhorse of global vaccine rollouts, had achieved nearly 80 percent efficacy in a gold-standard American trial was met with relief by the many countries relying on it.“When you get the call, get the jab,” the British health secretary, Matt Hancock, urged, part of a campaign by European lawmakers to calm people’s nerves after a recent safety scare with the shot.But by Tuesday, that campaign had, once again, been thrown off course, at least for the moment. For AstraZeneca, it was seemingly another episode of public relations whiplash, part of a series of recent miscues and communication blunders by the company that scientists said had undercut the effort to sell one of the most potent and indispensable vaccines against the coronavirus.In a highly unusual move, American health officials said on Tuesday that the company’s account of its U.S. trial findings had not been entirely accurate, suggesting that AstraZeneca had used only the most favorable data to generate apparently spectacular efficacy results.Those comments created new friction between AstraZeneca and American officials even as the company vies for a coveted authorization from the Food and Drug Administration. But more urgently, they threw a wrench into the efforts of elected leaders around the world to rebuild trust in a shot whose low price and easy storage requirements have made it the backbone of many countries’ campaigns to end the pandemic.“It’s eroding confidence,” said Simon Clarke, an associate professor in cellular microbiology at the University of Reading. “When you pump things up, and then people not unreasonably question it, then that erodes confidence.”A vaccination center in Belgrade, Serbia, this month. Despite troubling news reports about the AstraZeneca vaccine, European and global regulators have deemed the shots safe and effective.Laura Boushnak for The New York TimesFaith in the vaccine had already plunged across Europe after recent reports that a very small number of recipients had developed unusual blood clots. In France, Germany, Italy and Spain, more people now believe that the vaccine is unsafe than that it is safe, polling has shown, a blow to a shot that remains the continent’s best hope for saving people’s lives during a mounting surge of new infections.Despite the drumbeat of troubling news reports about the vaccine, European and global regulators have deemed it safe and effective. More than 11 million doses have been administered in Britain alone, almost all of them without serious side effects, driving down hospitalizations and helping the country to emerge from a dreadful wintertime wave of infections.Nevertheless, AstraZeneca’s U.S. trial was hotly anticipated. The largest of its kind for the shot, it had been expected to provide the cleanest, most complete picture of the vaccine’s efficacy. American officials saw it as an incontrovertible test of the vaccine’s performance.And health officials around the world were looking to it as a crucial guide to their own rollouts: It would supply crucial data on older people, who had not been as well represented in earlier trials, and a more precise read on the vaccine’s overall efficacy, which had appeared from earlier trials to be lower than that of other leading shots.As soon as AstraZeneca announced its results on Monday, saying that the vaccine had 79 percent efficacy in preventing symptomatic Covid-19, lawmakers began citing it as part of their fledgling efforts to shore up public confidence in the vaccine.Prime Minister Boris Johnson of Britain received an AstraZeneca shot on Friday. “I literally did not feel a thing,” he later said. “I cannot recommend it too highly.”Pool photo by Frank AugsteinBy Tuesday, scientists said, it seemed as though AstraZeneca had punched a hole in those efforts. Rather than sewing up questions about the shot, it had called to mind communications problems that have dogged the company since last year, delaying the regulatory process in some regions and creating hesitation among some recipients.Scientists said that such a public dust-up between the American medical experts overseeing a trial and the company sponsoring it was extremely unusual.“It is usually done in private,” Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said of disagreements between a data and safety monitoring board — the experts overseeing the trial — and a vaccine maker. “So this is unprecedented, in my opinion.”In its first public comments, AstraZeneca said that the results published on Monday reflected its U.S. trial data up to Feb. 17. It said that its preliminary assessment of more complete trial data showed that “the results were consistent with the interim analysis,” but said that it would share more up-to-date efficacy results within 48 hours.Scientists said that the problem could yet turn out to be a technical matter that did not change their assessment of the vaccine. American officials did not suggest that any safety issues had been withheld, a subject of intense interest in the wake of the concerns in Europe.AstraZeneca said that the results published on Monday reflected its U.S. trial data up to Feb. 17.  American officials did not suggest that any safety issues had been withheld.Alessandro Grassani for The New York TimesNevertheless, it quickly took the wind out of the sails of European lawmakers’ public campaign to restore confidence in the shot. In recent days, a number of political leaders, including Prime Minister Boris Johnson of Britain and Prime Minister Jean Castex of France, have received the vaccine themselves in a bid to show people that it was safe.“I literally did not feel a thing,” Mr. Johnson told reporters. “I cannot recommend it too highly.”The stumble on Tuesday was the latest in a series of miscues that have made for a prickly relationship between AstraZeneca and American and European regulators — and, scientists said, created unnecessary public confusion about a vaccine that appears to be highly effective.In early September, the company quietly halted its global trials after a participant in Britain fell ill. But American regulators did not find out until the story broke publicly. Subsequently, the company’s slowness to provide the F.D.A. with evidence that its vaccine was not linked to any illnesses kept it grounded for nearly seven weeks. AstraZeneca has said it shared data in a timely manner.By late November, the company was again riding high: It released results from early clinical trials, including in Britain, showing that the vaccine was up to 90 percent effective.But those results, too, were quickly clouded by uncertainty. AstraZeneca later acknowledged that there had initially been confusion over the vaccine dosage received by some study participants, making it more difficult to interpret the findings.Britain, which has long championed the homegrown vaccine, authorized the shot in late December, relying on the earlier clinical trial results. The European Union’s medicine regulator did the same, but a month later.E.U. officials said that the delay had partly resulted from a back-and-forth between the regulators and AstraZeneca over the quality of the data.Waiting outside a vaccination center in Munich, Germany, on Sunday. Europe has seen a mounting surge of new infections recently.Laetitia Vancon for The New York TimesAnd even after the vaccine was authorized, a number of European countries initially restricted it to younger people, citing a lack of sufficient data about its efficacy in older people. That problem was supposed to be resolved by the American trial, in which older people were better represented.Neither European nor British regulators gave any indication on Tuesday that the problems with AstraZeneca’s American data would have any impact on rollouts there. Those agencies relied on a separate set of data from non-American trials to authorize the vaccine.“We are in contact with the company regarding this further information,” the European Medicines Agency said in a statement on Tuesday, “and E.M.A. will assess the data concerned as soon as the company submits it to us.”Matina Stevis-Gridneff contributed reporting from Brussels.

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How Much Weight Did We Gain During Lockdowns? 2 Pounds a Month, Study Hints

Many Americans know they’ve put on weight during the pandemic, but it’s been difficult for experts to detail the scope of the problem.Soon after the pandemic started over a year ago, Americans started joking about the dreaded “quarantine 15,” worried they might gain weight while shut in homes with stockpiles of food, glued to computer screens and binge-watching Netflix.The concern is real, but assessing the problem’s scope has been a challenge. Surveys that simply ask people about their weight are notoriously unreliable, and many medical visits have been virtual.Now a very small study using objective measures — weight measurements from Bluetooth-connected smart scales — suggests that adults under shelter-in-place orders gained more than half a pound every 10 days.That translates to nearly two pounds a month, said Dr. Gregory M. Marcus, senior author of the research letter, published on Monday in the peer-reviewed JAMA Network Open. Americans who kept up their lockdown habits could easily have gained 20 pounds over the course of a year, he added.“We know that weight gain is a public health problem in the U.S. already, so anything making it worse is definitely concerning, and shelter-in-place orders are so ubiquitous that the sheer number of people affected by this makes it extremely relevant,” said Dr. Marcus, a cardiologist and professor of medicine at University of California, San Francisco.While it is almost impossible to make generalizations based on the study — which included fewer than 300 people scattered across the United States — all participants were tracking their weight regularly.Many of these people were losing weight before shelter-in-place orders were issued in their states, Dr. Marcus noted. “It’s reasonable to assume these individuals are more engaged with their health in general, and more disciplined and on top of things,” he said. “That suggests we could be underestimating — that this is the tip of the iceberg.”Excess weight has been linked to a greater risk of developing more severe Covid-19 disease, and the United States already has among the highest rates of overweight and obesity in the world. Some 42 percent of American adults over age 20 have obesity, as defined by body mass index, while another 32 percent of Americans are simply overweight.The risk of severe illness has been documented among young adults who are overweight or have obesity, as well. Many states are prioritizing Americans with obesity for vaccination, along with those who have other chronic conditions like diabetes or hypertension.The new study analyzed data obtained from 269 participants who were involved in an ongoing cardiology study, the Health eHeart Study. They volunteered to report weight measurements from Bluetooth-connected smart scales and weighed themselves regularly; the researchers gathered 7,444 weight measurements over a four-month period, an average of 28 weight measurements from each participant.The group was not nationally representative, by any means, so the results are not generalizable: About three-quarters were white, and just 3.5 percent identified as Black or African-American; about 3 percent identified as Asian-American. The average age was 51, and they were split almost evenly among men and women.The participants were from 37 states and the District of Columbia. The researchers analyzed weight measurements taken between Feb. 1, 2020, and June 1, 2020, in order to look at weight changes both before and after shelter-in-place orders were issued for each state.While the participants mostly had been losing pounds before the orders were issued, their weights rose steadily at a rate of about six-tenths of a pound every 10 days after the orders were issued, regardless of where they were in the country and regardless of chronic medical conditions.The lockdowns have certainly had an effect on dietary patterns, on what people eat and how often they eat. But the restrictions also curtailed the humdrum physical activity that is part and parcel of daily living, the researchers said.“If you think about people commuting, even running to the subway or bus stop, or stepping in at the post office to mail a letter, or stopping at the store — we burn a lot of calories in non-exercise activities of daily living,” said Leanne Redman, a professor of clinical physiology at the Pennington Biomedical Research Center, part of Louisiana State University.Her research had found that people were eating a healthier diet during the initial days of the shutdown but were more sedentary.An earlier study by U.C.S.F. researchers looked at daily step counts, as tracked by smartphones, among nearly half a million people in nearly 200 countries. The number of steps people took declined by 27 percent a month after the World Health Organization declared the pandemic.The concern about exercise also extends to children, who are known to pack on unhealthy pounds during the summer recess months when they are not in school. The risk is even greater for Hispanic and Black children than for white children, said Andrew G. Rundle, an associate professor of epidemiology at Columbia University’s Mailman School of Public Health, author of a recent paper that expressed concern that school closings would exacerbate existing racial health disparities.“We argued that being out of school, which we thought would go on for six months and has gone on longer, was going to be like the summer recess but even worse, because everyone would be loading up on shelf-stable calorie-laden food, and staying indoors and not going out,” he said. “Everything that makes the summer dangerous for kids would be magnified by the lockdown.”

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Prolonged immune response may contribute to post-COVID-19 blood clots

Serious complications due to blood clots, such as heart attacks and strokes, that are experienced by some COVID-19 survivors may be caused by a lingering immune response in the blood vessels after recovery, suggests a study published today in eLife.
The findings may help explain why some COVID-19 survivors, so-called ‘long-haulers’, report lasting COVID-19 symptoms or why some experience strokes or heart attacks weeks or months after recovery. They may also suggest potential strategies to help prevent these complications.
“During the initial stages of infection, SARS-CoV-2, the virus that causes COVID-19, may attack the lining of the blood vessels which can trigger inflammation and an immune response. This can result in blood vessel damage in the short term,” explains first author Florence Chioh, Research Assistant at the Lee Kong Chian School of Medicine (LKCMedicine), Nanyang Technological University, Singapore. “For our study, we wanted to investigate what happens in the blood vessels of COVID-19 survivors over the longer term.”
Chioh and colleagues collected blood samples from COVID-19 survivors within a month of their recovery and discharge from the hospital. They found that, in comparison with healthy individuals, COVID-19 survivors have twice as many damaged blood vessel cells, called circulating endothelial cells, floating in their blood. Even more of these damaged blood vessel cells were found in survivors who had conditions such as hypertension or diabetes that can also damage the blood vessels.
In addition to signs of blood vessel damage, the team found that survivors had an abundance of inflammatory proteins called cytokines that are produced by immune cells. They also found unusually high numbers of immune cells called T cells, which help destroy viruses, despite the fact that the virus was already gone.
“We show that an overactive immune system is the likely cause of blood vessel damage seen in some COVID-19 survivors,” Chioh says. “This may cause ‘leakiness’ in the blood vessels that increases the risk of blood clots.”
“Our work suggests that COVID-19 patients, especially those with underlying chronic conditions, may benefit from close post-recovery monitoring,” adds senior author Christine Cheung, Assistant Professor and Provost’s Chair in Medicine at LKCMedicine. “This would help identify high-risk individuals who may need blood thinners or preventative therapy to protect them from debilitating blood-clotting complications.”
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Materials provided by eLife. Note: Content may be edited for style and length.

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Variances in critical protein may guide fate of those infected with SARS CoV-2

Of the many perplexing questions surrounding SARS CoV-2, a mysterious new pathogen that has killed an estimated 2.6 million people worldwide, perhaps the most insistent is this: why does the illness seem to strike in such a haphazard way, sometimes sparing the 100 year old grandmother, while killing healthy young men and women in the prime of life?
A new study by Karen Anderson, Abhishek Singharoy and their colleagues at the Biodesign Institute at Arizona State University, may offer some tentative clues. Their research explores MHC-I, a critical protein component of the human adaptive immune system.
The research suggests that certain variant forms of MHC-I can help protect the body, by stimulating a strong immune response, while others may leave an individual susceptible to viral assault, severe illness and possibly, death.
“The implication of our findings is that the capacity to mount a strong and diverse T cell response to SARS-CoV-2 may be important to limit disease severity,” Anderson says. “The key to this work is using protein structure to predict individual MHC-I peptide binding capacity.”
Anderson is researchers at the Biodesign Virginia G. Piper Center for Personalized Diagnostics and professor at ASU’s School of Life Sciences. Singharoy is a researcher in the Biodesign Center for Applied Structural Discovery and assistant professor at ASU’s School of Molecular Sciences.
Cellular police
Humans, like all vertebrates, carry MHC-I molecules in all nucleated cells. A central role of MHC-I is to help the body clear infections from viruses and other pathogens. It does this by gathering fragments of the virus, ferrying them to the cell surface and presenting them to immune agents known as CD8+ T cells, which ceaselessly patrol the body.

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Predicting ‘Long COVID Syndrome’ with Help of a Smartphone App

Credit: Zoe Global

As devastating as this pandemic has been, it’s truly inspiring to see the many innovative ways in which researchers around the world have enlisted the help of everyday citizens to beat COVID-19. An intriguing example is the COVID Symptom Study’s smartphone-based app, which already has been downloaded millions of times, mostly in the United States and United Kingdom. Analyzing data from 2.6 million app users, researchers published a paper last summer showing that self-reported symptoms can help to predict infection with SARS-CoV-2, the coronavirus that causes COVID-19 [1].

New work from the COVID Symptom Study now takes advantage of the smartphone app to shed more light on Long COVID Syndrome [2], in which people experience a constellation of symptoms long past the time that they’ve recovered from the initial stages of COVID-19 illness. Such symptoms, which can include fatigue, shortness of breath, “brain fog,” sleep disorders, fevers, gastrointestinal symptoms, anxiety, and depression, can persist for months and can range from mild to incapacitating

This latest findings, published in the journal Nature Medicine, come from a team led by Claire Steves and Tim Spector, King’s College London, and their colleagues, and that includes NIH grantee Andrew Chan, Massachusetts General Hospital, Boston, and others supported by the Massachusetts Consortium on Pathogen Readiness. The team began by looking at data recorded between March 24-Sept. 2, 2020 from about 4.2 million app users with an average age of 45, about 90 percent of whom lived in the U.K., with smaller numbers from the U.S. and Sweden.

For this particular study, the researchers decided to focused on 4,182 app users, all with confirmed COVID-19, who had consistently logged in their symptoms. Because these individuals also started using the app when they still felt physically well, the researchers could assess their COVID-19-associated symptoms over the course of the illness.

While most people who developed COVID-19 were back to normal in less than two weeks, the data suggest that one in 20 people with COVID-19 are likely to suffer symptoms of Long COVID that persist for eight weeks or more. About one in 50 people continued to have symptoms for 12 weeks or more. That suggests Long COVID could potentially affect many hundreds of thousands of people in the U.K. alone and millions more worldwide.

The team found that the individuals most likely to develop Long COVID were older people, women, and especially those who experienced five or more symptoms. The nature and order of symptoms, which included fatigue, headache, shortness of breath, and loss of smell, didn’t matter. People with asthma also were more likely to develop long-lasting symptoms, although the study found no clear links to any other pre-existing health conditions.

Using this information, the researchers developed a model to predict which individuals were most likely to develop Long COVID. Remarkably, this simple algorithm—based on age, gender, and number of early symptoms–accurately predicted almost 70 percent of cases of Long COVID. It was also about 70 percent effective in avoiding false alarms.

The team also validated the algorithm’s predictive ability in data from an independent group of 2,472 people with confirmed COVID-19 and a range of symptoms. In this group, having more than five symptoms within the first week also proved to be the strongest predictor of Long COVID. And, again, the model worked quite well in identifying those most likely to develop Long COVID.

These findings come as yet another important reminder of the profound impact of the COVID-19 pandemic on public health. This includes not only people who are hospitalized with severe COVID-19 but, all too often, those who get through the initial period of infection relatively unscathed.

Recently, NIH announced a $1.15 billion investment to identify the causes of Long COVID, to develop ways of treating individuals who don’t fully recover, and, ultimately, to prevent the disorder. We’ve been working diligently in recent weeks to identify the most pressing questions and areas of greatest opportunity to address this growing public health threat. As a first step, NIH is funding an effort to track the recovery paths of at least 40,000 adults and children infected with SARS-CoV-2, to learn more about who develops long-term effects and who doesn’t. If you’d like to find a way to pitch in and help, getting involved in the COVID Symptom Study is as easy as downloading the app.

References:

[1] Real-time tracking of self-reported symptoms to predict potential COVID-19. Menni C, Valdes AM, Freidin MB, Sudre CH, Nguyen LH, Drew DA, Ganesh S, Varsavsky T, Cardoso MJ, El-Sayed Moustafa JS, Visconti A, Hysi P, Bowyer RCE, Mangino M, Falchi M, Wolf J, Ourselin S, Chan AT, Steves CJ, Spector TD. Nat Med. 2020 Jul;26(7):1037-1040. doi: 10.1038/s41591-020-0916-2. Epub 2020 May 11.[2] Attributes and predictors of long COVID. Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, Pujol JC, Klaser K, Antonelli M, Canas LS, Molteni E, Modat M, Jorge Cardoso M, May A, Ganesh S, Davies R, Nguyen LH, Drew DA, Astley CM, Joshi AD, Merino J, Tsereteli N, Fall T, Gomez MF, Duncan EL, Menni C, Williams FMK, Franks PW, Chan AT, Wolf J, Ourselin S, Spector T, Steves CJ. Nat Med. 2021 Mar 10.

Links:

NIH launches new initiative to study to “Long COVID”. 2021 Feb 23. (NIH)

COVID-19 Research (NIH)

Massachusetts Consortium on Pathogen Readiness (Boston)

COVID Symptom StudyClaire Steves (King’s College London, United Kingdom)

Tim Spector (King’s College London)

Andrew Chan (Massachusetts General Hospital, Boston)

NIH Support: National Institute of Diabetes and Digestive and Kidney Diseases

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