Publisher Health

Moderate alcohol intake — defined as no more than one alcoholic drink for women and two for men per day — has been associated with a lower risk of dying from cardiovascular disease when compared with individuals who abstain from drinking or partake in excessive drinking, according to a new study being presented at the American College of Cardiology’s 70th Annual Scientific Session. It’s also the first study to show that drinking moderate amounts of alcohol may be heart protective, in part, by reducing stress-related brain signals based on a subset of patients who underwent brain imaging.
“We found that stress-related activity in the brain was higher in non-drinkers when compared with people who drank moderately, while people who drank excessively (more than 14 drinks per week) had the highest level of stress-related brain activity,” said Kenechukwu Mezue, MD, a fellow in nuclear cardiology at Massachusetts General Hospital and the study’s lead author. “The thought is that moderate amounts of alcohol may have effects on the brain that can help you relax, reduce stress levels and, perhaps through these mechanisms, lower the incidence of cardiovascular disease.”
While Mezue was quick to caution that these findings should not encourage alcohol use, he said they could open doors to new therapeutics or prescribing stress-relieving activities like exercise or yoga to help minimize stress signals in the brain.
“The current study suggests that moderate alcohol intake beneficially impacts the brain-heart connection. However, alcohol has several important side effects, including an increased risk of cancer, liver damage and dependence, so other interventions with better side effect profiles that beneficially impact brain-heart pathways are needed,” Mezue said.
In a related study by the same research team (which is also being presented at ACC.21), exercise was found to have a similar effect on brain activity as well as on the incidence of cardiovascular disease and events. The authors said exercise is associated with decreased stress-associated brain activity in a dose-dependent manner. While the connection between stress and heart disease is widely accepted, the authors said relatively little research has been done on how modifying stress may help protect heart health.
Data were obtained from the Mass General Brigham Biobank health care survey of 53,064 participants, of which 59.9% were women and the average age was 57.2 years. Alcohol intake was based on self-report and was classified as low (14 drinks/week). Major adverse cardiovascular events, including heart attack, stroke or related hospitalizations, were determined using diagnostic (ICD) codes.
Of the patients included, 752 underwent 18F-fluorodeoxyglucose positron emission tomography, or PET imaging, which is often used as part of cancer screening but can also show areas in the brain that have increased activity. The scans allowed researchers to objectively measure activity in regions of the brain known to be associated with stress. Researchers assessed stress-related brain activity by measuring the activity of the amygdala (the part of the brain associated with fear and stress) and dividing it by activity in the frontal cortex (the part of the brain involved in executive functions). They then grouped patients based on the extent of brain stress activity.
Of the 53,064 participants, 7,905 (15%) experienced a major adverse cardiovascular event: 17% in the low alcohol intake group and 13% in the moderate alcohol intake group. People who reported moderate alcohol intake were found to have a 20% lower chance of having a major event compared to low alcohol intake (in adjusted analysis), and also had lower stress-related brain activity. This remained significant even after controlling for demographic variables, cardiovascular risk factors, socioeconomic variables and psychological factors.
“Previous studies by our group and others have shown a robust association between heightened amygdalar activity and a higher risk of major adverse cardiovascular outcomes, such as heart attack, stroke or death. In the current study, path analyses showed that the link between moderate alcohol intake and lowered cardiovascular event risk is significantly mediated though reductions in amygdalar activity,” Mezue said.
The study is limited due to the self-reporting of alcohol intake based on the average consumption of drinks per week. The data is also from a single center, and each participant in the imaging sub-study only received a single brain scan. Further study would be needed to show that the observed reductions in brain activity are the direct result of moderate alcohol intake through repeated brain scans and more detailed alcohol intake assessments over time.
Story Source:
Materials provided by American College of Cardiology. Note: Content may be edited for style and length.

Nearly 1 in 5 adults with high blood pressure, a leading risk factor for heart disease and stroke, also take a medicine that could be elevating their blood pressure, according to new research presented at the American College of Cardiology’s 70th Annual Scientific Session. The results underscore the need for patients to routinely review all of the medications they take with their care team, including those available over the counter, to make sure none could be interfering with blood pressure lowering efforts.
Which are the most likely culprits? Based on the study findings, the three most common classes of medications were antidepressants; nonsteroidal anti-inflammatory drugs (NSAIDs) that include ibuprofen and naproxen; and oral steroids used to treat conditions such as gout, lupus, rheumatoid arthritis or after an organ transplant. These medications were reported by 9%, 7% and 2% of participants, respectively. Other medications associated with blood pressure elevation were also reported, including antipsychotics, certain oral contraceptives and popular decongestants.
Researchers said these findings raise concerns, especially as nearly half of Americans diagnosed with high blood pressure do not have it sufficiently controlled. Dr. Vitarello explained the goal blood pressure for hypertension patients is a reading of less than 130 mmHg over 80 mmHg, based on the 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.
“These are medications that we commonly take — both over-the-counter and prescribed medications — that may have the unintended side effect of raising blood pressure and could have adverse effects on our heart health,” said John Vitarello, MD, an internal medicine resident at Beth Israel Deaconess Medical Center in Boston and the study’s lead author. “We know that high blood pressure leads to cardiovascular disease, stroke and death and even small increases in blood pressure can have meaningful impacts on cardiovascular disease. Based on our findings, we need to be more aware of polypharmacy (the use of multiple medications by a single patient) in older adults who also have the highest burden of high blood pressure.”
The study examined data from 27,599 participants in the National Health and Nutrition Examination Survey (NHANES) between 2009 and 2018. Of these, about half (49%) had hypertension (average age 55 years, 48% female), which was defined in the study as having a blood pressure reading of ?130 mmHg (systolic, the top number) or ?80 mmHg (diastolic, the bottom number) or ever having been told they have high blood pressure. Researchers identified medications associated with blood pressure elevation based on those listed in the ACC/AHA guideline and examined use of these medications by adults with hypertension above and below recommended blood pressure goals.
Among participants with high blood pressure, 19% reported using one or more blood pressure raising medications and 4% reported using multiple. Nearly one-quarter (24%) of women with high blood pressure reported using a blood pressure raising medication compared with 14% of men. Older adults were more likely to be using blood pressure raising medications than younger adults (19% of participants over age 65 vs. 18% of participants under age 65).
Vitarello said the findings suggest that, in some cases, rather than treating high blood pressure with more medications, there may be opportunities to lower blood pressure by deprescribing or substituting safer medications. For example, there may be other classes of medications to treat the same condition that have less impact on blood pressure. Nevertheless, there are some patients who may not have another medication option, so it’s advisable to keep a closer eye on their blood pressure and talk with their care team before stopping or starting medications.
Additionally, the study authors estimate that if half of U.S. adults with hypertension who are taking blood pressure raising medications were to discontinue one of these medications, 560,000 to 2.2 million patients could be able to achieve their blood pressure goals without additional medications. But Vitarello said this analysis is only preliminary and individual responses to stopping blood pressure medications are likely to vary, thus the real-world benefit and tradeoffs of stopping these medications need to be further studied.
The study is limited in that it relies on participants’ self-report of having high blood pressure and an accurate accounting of all the medications they take. The study was funded by the National Institute on Aging and an ACC Fellows Career Development Award.
Story Source:
Materials provided by American College of Cardiology. Note: Content may be edited for style and length.

New research from the University of Virginia School of Medicine reveals why sleep can put people with epilepsy at increased risk of sudden death.
Both sleep and seizures work together to slow the heart rate, the researchers found. Seizures also disrupt the body’s natural regulation of sleep-related changes. Together, in some instances, this can prove deadly, causing Sudden Unexpected Death in Epilepsy, or SUDEP.
“We have been trying to better understand the cardiac changes around the time of a seizure in patients with epilepsy. When we looked at the heart rates for patients with epilepsy admitted to the hospital, many of them develop tachycardia [a fast heart rate] following a seizure, but a subset of patients have a decreased heart rate. This decline was more pronounced when the patients were asleep,” said Andrew Schomer, MD, of UVA’s Department of Neurology and the UVA Brain Institute. “The mechanism of SUDEP, or Sudden Unexpected Death in Epilepsy, is still not fully understood. We know there is an increased risk during sleep and if seizures are poorly controlled. Hopefully with further study we can try to identify individuals who are at an increased risk and work to prevent this devastating outcome.”
Understanding SUDEP in Sleep
Doctors have been unsure how seizures in sleep can cause death, such as was the case with young Disney Channel star Cameron Boyce in 2019. He died of SUDEP while sleeping at age 20. (While SUDEP can occur when patients with epilepsy are awake, the majority of cases occur during sleep.)
To better understand the effect of sleep seizures, UVA researchers led by Schomer and Mark Quigg, MD, MSc, monitored the brain and heart activity of people with epilepsy as they slept. The patients were admitted to the UVA Epilepsy Monitoring Unit between February 2018 and August 2019, and all were 17 or older.
In total, the researchers evaluated 101 sleep seizures in 41 patients, with a median age of 40.5. The participants were, on average, diagnosed more than 20 years previously.
The researchers monitored how deeply the patients were sleeping when the seizures occurred. Some seizures caused heart rates to increase. But the greater sleep depth prior to a seizure, the slower the patient’s heart rate was likely to become, the scientists found.
The results suggest that seizures during sleep are more likely to lead to dangerously slow heart rate. The effect of the seizure is secondary to the natural slowing of the heart rate during sleep, the researchers believe, but the two together can, in some instances, prove deadly.
More study is needed to better understand the variables involved and to better determine what is occurring in individual patients, the researchers say. But the findings represent an important advance in the effort to prevent SUDEP during sleep.
“People with poorly controlled seizures have the greatest risk of SUDEP, and seizures during sleep may hold the higher risk,” said Quigg, of UVA’s Department of Neurology and the UVA Brain Institute. “Our findings can direct further research to determine how the heart’s and lung’s control systems fail during sleep-related seizures in order to help prevent SUDEP.”

Researchers at the University of Eastern Finland have discovered previously unknown non-coding RNAs (ncRNAs) involved in regulating the gene expression of vascular endothelial growth factors (VEGF), the master regulators of angiogenesis. The study, conducted by the research groups of Associate Professor Minna Kaikkonen-Määttä and Academy Professor Seppo Ylä-Herttuala, provides a better understanding of the complex interplay of ncRNAs with gene regulation, which might open up novel therapeutic approaches in the future. The results were published in the Molecular and Cellular Biology Journal.
Over the past years, the development of next generation sequencing techniques has revealed that around 97% of the human transcriptome is transcribed as non-coding RNAs, and although the role of the vast majority remains uncharacterized, many functions such as gene regulation have been proven.
On the other hand, endothelial growth factors VEGF-A and VEGF-C are the main regulator of angiogenesis, i.e., new blood vessel formation. Due to their important role in vasculature development, they constitute a potential target for the treatment of several diseases, such as atherosclerosis. Therapeutic angiogenesis has been developed as a promising strategy to rescue ischemic tissues by induction of new blood vessels sprouting from existing vasculature but so far, very few results with clinical significance have been achieved. Therefore, a deeper understanding of the regulatory mechanisms underlying the expression of these key angiogenic factors is needed for the future therapeutic avenues.
In this study, researchers performed in-depth characterization of the genomic loci around the VEGFA and VEGFC genes and identified novel non-coding RNAs, in particular enhancer RNAs (eRNAs) and long non-coding RNAs (lncRNAs). While the enhancers clearly upregulated gene expression, lncRNAs demonstrated various functions. Interestingly, lncRNAs were also regulating other targets including factors related to endothelial functions, such as angiogenesis and cell proliferation.
Story Source:
Materials provided by University of Eastern Finland. Note: Content may be edited for style and length.

Determining safe yet effective drug dosages for children is an ongoing challenge for pharmaceutical companies and medical doctors alike. A new drug is usually first tested on adults, and results from these trials are used to select doses for pediatric trials. The underlying assumption is typically that children are like adults, just smaller, which often holds true, but may also overlook differences that arise from the fact that children’s organs are still developing.
Compounding the problem, pediatric trials don’t always shed light on other differences that can affect recommendations for drug doses. There are many factors that limit children’s participation in drug trials — for instance, some diseases simply are rarer in children — and consequently, the generated datasets tend to be very sparse.
To make drugs and their development safer for children, researchers at Aalto University and the pharmaceutical company Novartis have developed a method that makes better use of available data.
‘This is a method that could help determine safe drug doses more quickly and with less observations than before,’ says co-author Aki Vehtari, an associate professor of computer science at Aalto University and the Finnish Center for Artificial Intelligence FCAI.
In their study, the research team created a model that improves our understanding of how organs develop.
‘The size of an organ is not necessarily the only thing that affects its performance. Kids’ organs are simply not as efficient as those of adults. In drug modeling, if we assume that size is the only thing that matters, we might end up giving too large of doses,’ explains Eero Siivola, first author of the study and doctoral student at Aalto University.
Whereas the standard approach of assessing pediatric data relies on subjective evaluations of model diagnostics, the new approach, based on Gaussian process regression, is more data-driven and consequently less prone to bias. It is also better at handling small sample sizes as uncertainties are accounted for.
The research comes out of FCAI’s research programme on Agile and probabilistic AI, offering a great example of a method that makes the best out of even very scarce datasets.
In the study, the researchers demonstrate their approach by re-analyzing a pediatric trial investigating Everolimus, a drug used to prevent the rejection of organ transplants. But the possible benefits of their method are far reaching.
‘It works for any drug whose concentration we want to examine,’ Vehtari says, like allergy and pain medication.
The approach could be particularly useful for situations where a new drug is tested on a completely new group — of children or adults — which is small in size, potentially making the trial phase much more efficient than it currently is. Another promising application relates to extending use of an existing drug to other symptoms or diseases; the method could support this process more effectively than current practices.
Story Source:
Materials provided by Aalto University. Note: Content may be edited for style and length.

In Alzheimer’s disease, neurons in the brain die. Largely responsible for the death of neurons are certain protein deposits in the brains of affected individuals: So-called beta-amyloid proteins, which form clumps (plaques) between neurons, and tau proteins, which stick together the inside of neurons. The causes of these deposits are as yet unclear. In addition, a rapidly progressive atrophy, i.e. a shrinking of the brain volume, can be observed in affected persons. Alzheimer’s symptoms such as memory loss, disorientation, agitation and challenging behavior are the consequences.
Scientists at the DZNE led by Prof. Michael Wagner, head of a research group at the DZNE and senior psychologist at the memory clinic of the University Hospital Bonn, have now found in a study that a regular Mediterranean-like dietary pattern with relatively more intake of vegetables, legumes, fruit, cereals, fish and monounsaturated fatty acids, such as from olive oil, may protect against protein deposits in the brain and brain atrophy. This diet has a low intake of dairy products, red meat and saturated fatty acids.
A total of 512 subjects with an average age of around seventy years took part in the study. 169 of them were cognitively healthy, while 343 were identified as having a higher risk of developing Alzheimer’s disease — due to subjective memory impairment, mild cognitive impairment that is the precursor to dementia, or first-degree relationship with patients diagnosed with Alzheimer’s disease. The nutrition study was funded by the Diet-Body-Brain competence cluster of the German Federal Ministry of Education and Research (BMBF) and took place as part of the so-called DELCODE study of the DZNE, which does nationwide research on the early phase of Alzheimer’s disease — that period before pronounced symptoms appear.
“People in the second half of life have constant eating habits. We analyzed whether the study participants regularly eat a Mediterranean diet — and whether this might have an impact on brain health ,” said Prof. Michael Wagner. The participants first filled out a questionnaire in which they indicated which portions of 148 different foods they had eaten in the past months. Those who frequently ate healthy foods typical of the Mediterranean diet, such as fish, vegetables and fruit, and only occasionally consumed foods such as red meat, scored highly on a scale.
An extensive test series
The scientists then investigated brain atrophy: they performed brain scans with magnetic resonance imaging (MRI) scanners to determine brain volume. In addition, all subjects underwent various neuropsychological tests in which cognitive abilities such as memory functions were examined. The research team also looked at biomarker levels (measured values) for amyloid beta proteins and tau proteins in the so-called cerebrospinal fluid (CSF) of 226 subjects.
The researchers, led by Michael Wagner, found that those who ate an unhealthy diet had more pathological levels of these biomarkers in the cerebrospinal fluid than those who regularly ate a Mediterranean-like diet. In the memory tests, the participants who did not adhere to the Mediterranean diet also performed worse than those who regularly ate fish and vegetables. “There was also a significant positive correlation between a closer adherence to a Mediterranean-like diet and a higher volume of the hippocampus. The hippocampus is an area of the brain that is considered the control center of memory. It shrinks early and severely in Alzheimer’s disease,” explained Tommaso Ballarini, PhD, postdoctoral fellow in Michael Wagner’s research group and lead author of the study.
Continuation of nutrition study is planned
“It is possible that the Mediterranean diet protects the brain from protein deposits and brain atrophy that can cause memory loss and dementia. Our study hints at this,” Ballarini said. “But the biological mechanism underlying this will have to be clarified in future studies.” As a next step, Ballarini and Wagner now plan to re-examine the same study participants in four to five years to explore how their nutrition — Mediterranean-like or unhealthy — affects brain aging over time.
Story Source:
Materials provided by DZNE – German Center for Neurodegenerative Diseases. Note: Content may be edited for style and length.

Through a unique combination of computer simulations and laboratory experiments, researchers at the Paul Scherrer Institute PSI have discovered new binding sites for active agents — against cancer, for example — on a vital protein of the cell cytoskeleton. Eleven of the sites hadn’t been known before. The study appears today in the journal Angewandte Chemie International Edition.
The protein tubulin is an essential building block of the so-called cell cytoskeleton. In cells, tubulin molecules arrange themselves into tube-like structures, the microtubule filaments. These give cells their shape, aid in transporting proteins and larger cellular components, and play a crucial role in cell division.
Thus tubulin performs diverse functions in the cell and in doing so interacts with numerous other substances. “Tubulin can bind an astonishing number of different proteins and small molecules, several hundred for sure,” says Tobias Mühlethaler, a doctoral candidate in the PSI Laboratory of Biomolecular Research and first author of the study. The functions of the protein are guided by means of such bonds. Also, many drugs dock on tubulin and take effect, for example, by preventing cell division in tumours.
“In this project, we addressed the fundamental question of how many binding sites in total exist on this vital protein,” Mühlethaler explains. “If we discover new ones, these could possibly be used therapeutically.”
From the virtual to the laboratory
In computer simulations conducted in collaboration with the Italian Institute of Technology in Genoa, the researchers combed through the structure of the protein: They identified places where other molecules could dock particularly well to tubulin. These are the so-called binding pockets. Subsequently, in an actual laboratory experiment, the researchers sought to verify such sites. For this, they used a method called fragment screening: Starting with hundreds of crystals of tubulin, the researchers added individual solutions containing fragments of molecules that are typical precursors for promising active agents. Within an hour, the tubulin crystals were able to soak up as much of the fragment solution as they could hold. Finally the crystals were fished out of the liquid and exposed to synchrotron X-ray radiation. On the basis of the resulting diffraction pattern, the researchers are able to infer the structure of the crystal. Thus it could be determined if and where the molecule fragments have bound to the protein.
“Both methods, computer simulations and fragment screening, have their respective strengths and weaknesses,” says Michel Steinmetz, head of the Laboratory of Biomolecular Research. “By combining them, we ensure that no binding site on the protein escapes our search.”
Eleven new ones
Overall, the researchers found 27 binding sites on tubulin where molecules or other proteins can dock. “Eleven of them had never been described before,” says Mühlethaler. In addition, the researchers identified 56 fragments that bind to tubulin and might be suitable for developing new active agents.
As the researchers stress, their approach is also transferable to other proteins. “Here we have developed a method for early discovery of so-called lead molecules and, with that, new starting points for the development of active agents,” says Michel Steinmetz. It should be possible to apply this method successfully to all proteins for which high quality crystals can be obtained.
“The search for potential new lead molecules is a focus of the Swiss Light Source SLS,” Steinmetz adds. “This will gain increasing significance after the upgrade to SLS 2.0, planned for the coming years, has taken place.”
Story Source:
Materials provided by Paul Scherrer Institute. Original written by Brigitte Osterath. Note: Content may be edited for style and length.

Epithelial cells form the covering of most internal and external surfaces of the human body. This protective layer acts as a defense against invaders — including bacteria, viruses, environmental toxins, pollutants and allergens. If the skin and mucosal barriers are damaged or leaky, foreign agents such as bacteria can enter into the tissue and cause local, often chronic inflammation. This has both direct and indirect consequences.
Chronic diseases due to defective epithelial barriers
Cezmi Akdis, Director of the Swiss Institute of Allergy and Asthma Research (SIAF), which is associated with the University of Zurich (UZH), has now published a comprehensive summary of the research on epithelial barrier damage in Nature Reviews Immunology. “The epithelial barrier hypothesis proposes that damages to the epithelial barrier are responsible for up to two billion chronic, non-infectious diseases,” Professor Akdis says. In the past 20 years, researchers at the SIAF alone published more than 60 articles on how various substances damage the epithelial cells of a number of organs.
Rise in allergic and autoimmune conditions
The epithelial barrier hypothesis provides an explanation as to why allergies and autoimmune diseases have been increasing for decades — they are linked to industrialization, urbanization and westernized lifestyle. Today many people are exposed to a wide range of toxins, such as ozone, nanoparticles, microplastics, household cleaning agents, pesticides, enzymes, emulsifiers, fine dust, exhaust fumes, cigarette smoke and countless chemicals in the air, food and water. “Next to global warming and viral pandemics such as COVID-19, these harmful substances represent one of the greatest threats to humankind,” emphasizes Akdis.
Asthma, Alzheimer’s and more
Local epithelial damage to the skin and mucosal barriers lead to allergic conditions, inflammatory bowel disorders and celiac disease. But disruptions to the epithelial barrier can also be linked to many other diseases that are characterized by changes in the microbiome. Either the immune system erroneously attacks “good” bacteria in healthy bodies or it targets pathogenic — i.e. “bad” — invaders. In the gut, leaky epithelial barriers and microbial imbalance contribute to the onset or development of chronic autoimmune and metabolic diseases such as diabetes, obesity, rheumatoid arthritis, multiple sclerosis or ankylosing spondylitis. Moreover, defective epithelial barriers have also been linked to neurodegenerative and psychiatric diseases such as Parkinson’s disease, Alzheimer’s disease, autism spectrum disorders and chronic depression, which may be triggered or aggravated by distant inflammatory responses and changes in the gut’s microbiome.
Prevention, intervention — and more research
“There is a great need to continue research into the epithelial barrier to advance our understanding of molecular mechanisms and develop new approaches for prevention, early intervention and therapy,” says Akdis. Novel therapeutic approaches could focus on strengthening tissue-specific barriers, blocking bacteria or avoiding colonization by pathogens. Other strategies to reduce diseases may involve the microbiome, for example through targeted dietary measures. Last but not least, the focus must also be on avoiding and reducing exposure to harmful substances and developing fewer toxic products.
Story Source:
Materials provided by University of Zurich. Note: Content may be edited for style and length.

Half of the Danish population have overweight, while 17 percent live with obesity. Worldwide, almost 40 procent have overweight and 13 procent live with obesity.
The condition is associated with increased risk for early death, as well as sequelae such as Type 2 diabetes, cardiovascular diseases, cancer, and infertility.
Weight regain after an initial successful weight loss in people with obesity, constitutes an important and unsolved problem. Until now, no well-documented study on which treatment method is best for maintaining a healthy weight loss has been available.
Researchers at University of Copenhagen and Hvidovre Hospital have completed a new, sensational study, which is being published in the world’s most quoted medical journal, The New England Journal of Medicine. By testing four different types of treatment following a diet-induced weight loss, the researchers demonstrate for the first time how it is possible for people with obesity to maintain long-term weight loss, says Professor Signe Torekov at the Department of Biomedical Sciences.
In a randomized clinical trial, the group of researchers has demonstrated a highly effective treatment after a diet-induced weight loss, by combining moderate to vigorous-intensive exercise with appetite-inhibiting obesity medication, an analogue to the appetite-inhibiting hormone GLP-1.
“This is new knowledge for doctors, dietitians and physical therapists to use in practice. This is evidence that we have been missing,” explains Signe Torekov, who has been heading the study.

A new study has shown that most patients discharged from hospital after experiencing severe COVID-19 infection appear to return to full health, although up to a third do still have evidence of effects upon the lungs one year on.
COVID-19 has infected millions of people worldwide. People are most commonly hospitalised for COVID-19 infection when it affects the lungs — termed COVID-19 pneumonia. Whilst significant progress has been made in understanding and treating acute COVID-19 pneumonia, very little is understood about how long it takes for patients to fully recover and whether changes within the lungs persist.
In this new study, published in The Lancet Respiratory Medicine, researchers from the University of Southampton worked with collaborators in Wuhan, China, to investigate the natural history of recovery from severe COVID-19 pneumonia up to one year after hospitalisation.
83 patients were recruited after they were discharged from hospital following severe COVID-19 pneumonia and were followed up after three, six, nine and twelve months. At each time point they underwent clinical assessment as well as measures of how well the lungs function, a CT scan of their chest to take a picture of the lungs, and a walking test.
Over 12 months in most patients there was an improvement in symptoms, exercise capacity, and COVID-19 related CT changes. By 12 months the majority of patients appeared to have fully recovered although about 5% of patients still reported breathlessness. A third of patients’ measures of lung function were still reduced — in particular how efficiently oxygen is transferred in the lungs into the blood — and this was more frequently found in women than in men. In around a quarter of patients CT scans showed there were still small areas of change in the lungs, and this was more common in patients with more severe lung changes at time of hospitalisation.
Dr Mark Jones, Associate Professor in Respiratory Medicine at the University of Southampton and NIHR Southampton Biomedical Research Centre who co-led the study said, “the majority of patients with severe COVID-19 pneumonia appeared to fully recover, although for some patients this took many months. Women were more likely to have persistent reductions in lung function tests and further investigation is needed to understand if there is a sex specific difference in how patient’s recover. We also don’t yet know what happens beyond 12 months and this will need ongoing study.”
The researchers acknowledged that this study only involved a small number of patients and the findings will require confirmation in additional studies, however they have identified a number of important implications.
Dr Yihua Wang, Lecturer in Biomedical Sciences at the University of Southampton and NIHR Southampton Biomedical Research Centre who co-led the study explained, “firstly, our research provides evidence that routine respiratory follow-up of patients hospitalised with COVID-19-pneumonia is required. Secondly, given the length of time it takes for some patients to recover it suggests that research into whether exercise programmes help patients recover more quickly is required. Finally, it highlights the need for treatment strategies to prevent the development of long term COVID-19 related lung changes.”
Story Source:
Materials provided by University of Southampton. Note: Content may be edited for style and length.