Virus World

GETTING a cough, fever or sore throat at this time of year could be down to any number of things, from a common cold to Covid-19. With a new strain of swine flu being detected in the UK

The London Medical Laboratory said its test can be taken at 95 selected pharmacies, drop-in clinics and health stores nationwide. You can find a full list of the places they're sold here. Otherwise, you can also order the test online to be delivered to your home. Dr Narayanan said: "The current strains of flu that are circulating may produce only mild illness in one person but may cause severe symptoms and even prove fatal to others. "This is particularly important in people with pre-existing health conditions and long-term diseases. Similarly, while the RSV virus may only produce chesty cold symptoms in some people, it can severely affect elderly people and children. "All of these viruses, including swine flu, display very similar initial symptoms to the common cold, but these symptoms may quickly escalate."

Taking a test to identify which virus is causing your symptoms could bring "peace of mind" to some or ensure "they are not endangering anyone in their family this festive season", the clinical lead claimed. The fact that the UKHSA is still working to ascertain the source of the H1N2 strain spotted in the North Yorkshire resident is another reason people might want to get tested, Dr Narayanan added.

Where else can I get these test?

The 95 pharmacies and clinics aren't the only place you can take a test telling the difference between the viruses. Online pharmacy Chemist Connect sells a kit by the brand CordX that claims to test for Covid, influenza A and B and RSV. It carries a much lower price tag too - £37.95, along with a delivery charge. Granted, that's still a fair amount pay for a test. Alternatively, you can nab Flowflex Flu Test and Covid Test Bundle at your local Boots. It won't be able to test for RSV - but you'll only have to shell out £4 for the two kits that come in the bundle. You can buy a five-pack of Influenza A/B Rapid Test at Tesco for £12. You can't get a free Covid-19 PCR test any more and rapid lateral flow tests are no longer free for most people. But according to NHS guidance, you might be eligible to get them for free if:

• You have a health condition which means you're at high risk of getting seriously ill from Covid
• You work in healthcare settings or in a hospice

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is associated with a range of persistent symptoms impacting everyday functioning, known as post-COVID-19 condition or long COVID. We undertook a retrospective matched cohort study using a UK-based primary care database, Clinical Practice Research Datalink Aurum, to determine symptoms that are associated with confirmed SARS-CoV-2 infection beyond 12 weeks in non-hospitalized adults and the risk factors associated with developing persistent symptoms. We selected 486,149 adults with confirmed SARS-CoV-2 infection and 1,944,580 propensity score-matched adults with no recorded evidence of SARS-CoV-2 infection. Outcomes included 115 individual symptoms, as well as long COVID, defined as a composite outcome of 33 symptoms by the World Health Organization clinical case definition. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for the outcomes.

A total of 62 symptoms were significantly associated with SARS-CoV-2 infection after 12 weeks. The largest aHRs were for anosmia (aHR 6.49, 95% CI 5.02–8.39), hair loss (3.99, 3.63–4.39), sneezing (2.77, 1.40–5.50), ejaculation difficulty (2.63, 1.61–4.28) and reduced libido (2.36, 1.61–3.47). Among the cohort of patients infected with SARS-CoV-2, risk factors for long COVID included female sex, belonging to an ethnic minority, socioeconomic deprivation, smoking, obesity and a wide range of comorbidities. The risk of developing long COVID was also found to be increased along a gradient of decreasing age. SARS-CoV-2 infection is associated with a plethora of symptoms that are associated with a range of sociodemographic and clinical risk factors. A retrospective analysis of primary care records in the United Kingdom reveals individual symptoms associated with SARS-CoV-2 infections, which persisted for 12 weeks or more after infection, as well as risk factors associated with developing long COVID.

Published in Nature Medicine (July 25, 2022):

https://doi.org/10.1038/s41591-022-01909-w 

Health officials say parents should ensure their children have been vaccinated against the disease.  The virus that causes polio has been detected in a concerning number of sewage samples in London, health officials have said. The disease was common in the UK in the 1950s but was eliminated by 2003. The UK Health Security Agency (UKHSA) says it was probably imported to London by someone who was recently vaccinated overseas with a live form of the virus. It says the risk is low, but parents should ensure their children have been fully immunised against the disease. "Most of the UK population will be protected from vaccination in childhood, but in some communities with low vaccine coverage, individuals may remain at risk," said Dr Vanessa Saliba, consultant epidemiologist at UKHSA. An inactivated polio vaccine is used in the UK as part of the routine childhood programme. It is given to children three times before the age of one, and then again at three and 14 years of age.  Take-up of the first three doses is about 86% in London, well below target levels, with the rest of the UK over 92%. Health authorities have now declared a national incident and informed the World Health Organization (WHO) of the situation.

This briefing is produced to share data useful to other public health investigators and academic partners undertaking related work. Although a detailed clinical case review is also taking place, that data is not shared here as, given the small number of cases, there are some risks to confidentiality.

Cases

As of 3 May 2022, there have been 163 cases of acute non-A-E hepatitis with serum transaminases greater than 500 IU/l identified in children aged under 16 years old in the UK since 1 January 2022. This is the result of an active case finding investigation commencing in April which identified retrospective as well as prospective cases. Eleven cases have received a liver transplant. No cases resident in the UK have died. New cases continue to be identified. Whilst there is some apparent reduction in confirmed cases in the past 2 weeks overall in the UK, there are continued new case reports in Scotland, the number of cases pending classification in England is substantial and the likely reporting lags mean that we cannot yet say there is a decrease in new cases. Cases pending classification are usually those in which laboratory testing to rule out known causes of hepatitis has not been completed.

Working hypotheses

The working hypotheses have been refined. The leading hypotheses remain those which involve adenovirus. However, we continue to investigate the potential role of SARS-CoV-2 and to work on ruling out any toxicological component.

Associated pathogens

Adenovirus remains the most frequently detected potential pathogen. Amongst 163 UK cases, 126 have been tested for adenovirus of which 91 had adenovirus detected (72%). Amongst cases the adenovirus has primarily been detected in blood. On review of some of the adenovirus negative cases it was notable that some had only been tested on respiratory or faecal samples, and some had been tested on serum or plasma rather than whole blood (whole blood being the optimal sample). It is therefore not possible to definitively rule out adenovirus in these cases. SARS-CoV-2 has been detected in 24 cases of 132 with available results (18%). SARS-CoV-2 serological testing is in process. A range of other possible pathogens have been detected in a low proportion of cases and are of uncertain significance, although the inclusive nature of the UKHSA case definition intentionally will pick up some cases of non-A-E hepatitis with recognised causes.

Adenovirus characterisation

Typing by partial hexon gene sequencing consistently shows that the adenovirus present in blood is type 41F (18 of 18 cases with an available result). Whole genome sequencing (WGS) has been attempted on multiple samples from cases but the low viral load in blood samples, and limited clinical material from historic cases, mean that it has not been possible to get a good quality full adenovirus genome from a case as yet.

Metagenomics

Metagenomics undertaken on blood and liver tissue has detected primarily adeno-associated virus 2 (AAV-2) in high quantities. Whilst contamination was originally suspected, AAV-2 is now detected in multiple samples from different hospital sources and tested in more than one sequencing laboratory. This finding is of uncertain significance and may represent a normal reactivation of AAV-2 during an acute viral infection (for example, adenovirus) or during liver injury of another cause. It is not unusual to detect bystander, reactivating or other incidental species during metagenomic sequencing. However, given the presence of AAV-2 in a number of cases, the significance will be further explored through testing of additional sets of controls.

Toxicology

Toxicological investigations continue with no positive findings to date. Detection of paracetamol is likely to be related to appropriate therapeutic use (also noted in the trawling questionnaires) which would not be a concern, however verification work is being undertaken to confirm this.

Host investigations

Host (for example, immunological) investigations require full research consent and are undertaken under the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Clinical Characterisation Protocol. Thirty-seven cases have been recruited to the ISARIC clinical characterisation protocol to date and retrospective and prospective recruitment continues...

Update 2 (May 6, 2022):

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1073704/acute-hepatitis-technical-briefing-2.pdf 

Scientists are studying it to better understand how much of a threat it may pose.  Delta is the UK's dominant variant, but latest official data suggests 6% of Covid cases that have been genetically sequenced are of a new type. AY.4.2, which some are calling "Delta Plus", contains mutations that might give the virus survival advantages. Tests are under way to understand how much of a threat it may pose. Experts say it is unlikely to take off in a big way or escape current vaccines. It is not yet considered a variant of concern, or a variant under investigation - the categories assigned to variants and the level of risk associated with them.

Large study of UK health-care workers suggests that most people are immune for months after catching COVID-19 for the first time. Most people who catch and recover from COVID-19 are likely to be immune for several months afterwards, a study of more than 20,000 health-care workers in the United Kingdom has found.  The study — called SARS-CoV-2 Immunity and Reinfection Evaluation (SIREN) and published on the preprint server medRxiv on 15 January1 — concluded that immune responses from past infection reduce the risk of catching the virus again by 83% for at least 5 months. Over the course of the past year, reports of repeat infections with SARS-CoV-2 have shaken confidence in the immune system’s ability to sustain its defences against the virus. The interim results from the study assuage some of those fears, said SIREN lead investigator Susan Hopkins, a senior medical adviser at Public Health England in London, at a press briefing. The data suggest that natural immunity might be as effective as vaccination, she added, at least over the five-month period the study has covered so far.  The data suggest that repeat infections are rare — they occurred in fewer than 1% of about 6,600 participants who had already been ill with COVID-19. But the researchers also found that people who become reinfected can carry high levels of the virus in their nose and throat, even when they do not show symptoms. Such viral loads have been associated with a high risk of transmitting the virus to others, said Hopkins. “Reinfection is pretty unusual, so that’s good news,” says immunologist John Wherry at the University of Pennsylvania in Philadelphia. “But you’re not free to run around without a mask.”

Regular screening

SIREN is the largest study of coronavirus reinfection that systematically screens for asymptomatic infections, said Hopkins. Every two to four weeks, participants undergo blood tests for SARS-CoV-2 antibodies as well as PCR tests to detect the virus itself. Over the 5 months, the team found 44 possible reinfections. In the group of 14,000 participants who had not been previously infected, 318 people tested positive for the virus. Some of the reinfections are still being evaluated, Hopkins said. All 44 are considered ‘possible’ reinfections, and were classified on the basis of PCR tests combined with screening measures to reduce the risk of re-detecting virus from the initial infection. So far, only 2 of these 44 cases have passed more stringent tests to be classified as ‘probable’. The study did not assess whether symptoms were better or worse during the second infection than during the first, but Hopkins notes that only about 30% of the people with possible reinfections reported any symptoms, compared with 78% of participants with first-time infections.  At the moment, the team does not have enough data to tease out who might be most at risk of reinfection. And immunologist George Kassiotis at the Francis Crick Institute in London notes that participants in the study were mainly women, and mostly under the age of 60. “This group is unlikely to experience the most severe form of COVID-19,” he says, “and may not be representative of the population as a whole.” Investigators are still collecting data; they hope to get a sense of how long immunity lasts and to investigate the effects of a SARS-CoV-2 variant called B.1.1.7 that emerged in 2020 and has rapidly spread across the country. Although there are many reasons to suspect that existing protection should cover new variants, it is possible that immune responses raised against one variant will be less effective against another, says Kassiotis. “It is still an open question.”

Preprint available in medRxiv (Jan. 15, 2021):

https://doi.org/10.1101/2021.01.13.21249642 

European countries impose travel bans as scientists probe whether new strain spreads faster or causes more severe COVID-19.  On 8 December, during a regular Tuesday meeting about the spread of the pandemic coronavirus in the United Kingdom, scientists and public health experts saw a diagram that made them sit up straight. Kent, in the southeast of England, was experiencing a surge in cases, and a phylogenetic tree showing viral sequences from the county looked very strange, says Nick Loman, a microbial genomicist at the University of Birmingham. Not only were half the cases caused by one specific variant of SARS-CoV-2, but that variant was sitting on a branch of the tree that literally stuck out from the rest of the data. “I've not seen a part of the tree that looks like this before,” Loman says. Less than 2 weeks later, that variant is causing mayhem in the United Kingdom and elsewhere in Europe. Yesterday, U.K. Prime Minister Boris Johnson announced stricter lockdown measures, saying the strain, which goes by the name B.1.1.7, appears to be better at spreading between people. The news led many Londoners to leave the city today, before the new rules take effect, causing overcrowded railway stations. The Netherlands, Belgium, and Italy announced they were temporarily halting passenger flights from the United Kingdom. The Eurostar train between Brussels and London will stop running tonight at midnight, for at least 24 hours. Scientists, meanwhile, are hard at work trying to figure out whether B.1.1.7 is really more adept at human-to-human transmission—not everyone is convinced yet—and if so, why. They’re also wondering how it evolved so fast. B.1.1.7 has acquired 17 mutations all at once, a feat never seen before. “There's now a frantic push to try and characterize some of these mutations in the lab,” says Andrew Rambaut, a molecular evolutionary biologist at the University of Edinburgh.

Too many unknowns

Researchers have watched SARS-CoV-2 evolve in real time more closely than any other virus in history. So far, it has accumulated mutations at a rate of about one to two changes per month. That means many of the genomes sequenced today differ at about 20 points from the earliest genomes sequenced in China in January, but many variants with fewer changes are also circulating. “Because we have very dense surveillance of genomes, you can almost see every step,” Loman says. But scientists have never seen the virus acquire more than a dozen mutations seemingly at once. They think it happened during a long infection of a single patient that allowed SARS-CoV-2 to go through an extended period of fast evolution, with multiple variants competing for advantage.  One reason to be concerned, Rambaut says, is that among the 17  utations are eight in the gene that encodes the spike protein on the viral surface, two of which are particularly worrisome. One, called N501Y, has previously been shown to increase how tightly the protein binds to the angiotensin-converting enzyme 2 receptor, its entry point into human cells. The other, named 69-70del, leads to the loss of two amino acids in the spike protein and has been found in viruses that eluded the immune response in some immunocompromised patients.  A fortunate coincidence helped show that B.1.1.7 (also called VUI-202012/01, for the first “variant under investigation” in December 2020), appears to be spreading faster than other variants in the United Kingdom. One of the polymerase chain reaction (PCR) tests used widely in the country, called TaqPath, normally detects pieces of three genes. But viruses with 69-70del lead to a negative signal for the gene encoding the spike gene; instead only two genes show up. That means PCR tests, which the United Kingdom conducts by the hundreds of thousands daily and which are far quicker and cheaper than sequencing the entire virus, can help keep track of B.1.1.7.

In a press conference on Saturday, chief science adviser Patrick Vallance said that B.1.1.7, which first appeared in a virus isolated on 20 September, accounted for about 26% of cases in mid-November. “By the week commencing the ninth of December, these figures were much higher,” he said. “So, in London, over 60% of all the cases were the new variant.” Johnson added that the slew of mutations may have increased the virus’s transmissibility by 70%.  Christian Drosten, a virologist at Charité University Hospital in Berlin, says that was premature. “There are too many unknowns to say something like that,” he says. For one thing, the rapid spread of B.1.1.7 might be down to chance. Scientists previously worried that a variant that spread rapidly from Spain to the rest of Europe—confusingly called B.1.177—might be more transmissible, but today they think it is not; it just happened to be carried all over Europe by travelers who spent their holidays in Spain. Something similar might be happening with B.1.1.7, says Angela Rasmussen, a virologist at Georgetown University. Drosten notes that the new mutant also carries a deletion in another viral gene, ORF8, that previous studies suggest might reduce the virus’ ability to spread. But further reason for concern comes from South Africa, where scientists have sequenced genomes in three provinces where cases are soaring: Eastern Cape, Western Cape, and KwaZulu Natal. They identified a lineage separate from the U.K. variant that also has a N501Y mutation in the spike gene. “We found that this lineage seems to be spreading much faster,” says Tulio de Oliveira, a virologist at the University of KwaZulu-Natal whose work first alerted U.K. scientists to the importance of N501Y. (A preprint of their results on the strain, which they are calling 501Y.V2, will be released on Monday, de Oliveira says.) Another worry is B.1.1.7 could cause more severe disease. There is anecdotal evidence that the South African variant may be doing that in young people and those who are otherwise healthy, says John Nkengasong, director of the Africa Centres for Disease Control and Prevention. “It’s concerning, but we really need more data to be sure.” The African Task Force for Coronavirus will convene an emergency meeting to discuss the issue on Monday, Nkengasong says....

Preliminary characterization of the new variant available in Virological (Dec. 18, 2020): https://virological.org/t/preliminary-genomic-characterisation-of-an-emergent-sars-cov-2-lineage-in-the-uk-defined-by-a-novel-set-of-spike-mutations/563

See also ICOG Report (Dec.19, 2020): https://www.cogconsortium.uk/wp-content/uploads/2020/12/Report-1_COG-UK_19-December-2020_SARS-CoV-2-Mutations.pdf

CDC Comments on UK's variant (Dec. 22, 2020):

https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-emerging-variant.html

Though people may be emitting less virus in the earlier stage of infection, when they have very mild or no discernible symptoms, they may at that time be more likely to have contact that could lead to transmission. A new British study suggests people who are infected with monkeypox may be able to transmit the virus to others before they develop noticeable symptoms of the disease — and that this type of transmission could account for a sizable portion of infections in the current international outbreak.  Experts who reviewed the new analysis, published Wednesday in the journal BMJ, praised the rigor of the work, but warned that it cannot be considered the final answer on whether pre-symptomatic transmission occurs and if it does, to what degree it happens. More and different types of studies are needed to flesh out this question, they said. “There is still more work needed to understand pre-symptomatic and asymptomatic infections and what that might mean for future policies and management of the monkeypox outbreak,” Nachi Arunachalam, the monkeypox incident director at the United Kingdom’s Health Security Agency, said in a statement.  The lead author of the paper, Tom Ward, is the UKHSA’s head of infectious diseases modeling; the other authors are also staff of the agency. Arunachalam is not an author on the paper.

The researchers used data from 2,746 people infected with monkeypox in the U.K. from May 6 to Aug. 1 to try to come up with estimates of the incubation period and the serial interval for the current outbreak.  The incubation period is the time from infection to the development of symptoms; the serial interval is the average time from one person’s symptom onset to when the next person infected begins to show illness. The former was estimated to be, on average, 7.6 days while the latter was estimated to be eight days — though both estimates had ranges that overlapped. Using this information, the researchers looked at the question of whether some transmission could be happening before symptom onset occurred. It has been widely assumed that some transmission has occurred from people who were not exhibiting symptoms, based on anecdotal reports. But in this study, the authors concluded as many as 53% of transmission events could have occurred before the person transmitting the virus developed symptoms. “The median serial interval was estimated to be shorter than the incubation period, which indicates considerably greater pre-symptomatic transmission than previously thought,” they wrote. There is already evidence of pushback on the 53% figure.

“It’s an important piece of the transmission jigsaw, but personally I want to see it joined up with other pieces from other types of studies before we say asymptomatic or pre-symptomatic transmission is known to account for a substantial proportion of transmission in the … outbreak affecting mostly gay, bisexual and men who have sex with men (GBMSM) in the UK,” Jake Dunning, a senior research fellow in emerging and high consequence infectious diseases at the University of Oxford’s Pandemic Sciences Institute, said in a statement. Caitlin Rivers, an infectious diseases epidemiologist at Johns Hopkins Bloomberg School of Public Health, said it’s known that people with monkeypox are most infectious when they have the telltale lesions. But at that point, they may be less likely to have sex or other types of physical contact with others. Paradoxically, though people may be emitting less virus in the earlier stage of their infection, when they have very mild or no discernible symptoms — a time called the prodrome — they may at that time be more likely to have contact that could lead to transmission, Rivers said. “That could explain maybe a surprisingly high proportion of transmission happening during the prodromal period,” she said.  Esther Freeman, lead author of an editorial on the study, cautioned that it can be extremely difficult to get a clear picture of when symptom onset occurred. A person could feel tired but put it down to a bad night’s sleep, only realizing a day or two later when a rash develops that he or she had been incubating the virus.

“Anytime there’s self-reported symptom data it requires the person to have noticed the symptoms,” Freeman, director of global health dermatology at Massachusetts General Hospital and Harvard Medical School, told STAT in an interview. “When you think about what pre-symptomatic transmission is, that’s not the same for person A as it is for person B.” Rivers agreed, saying with self-reported data “there’s always a bit of squishiness there.” Freeman said whether pre-symptomatic transmission accounts for 53% or some smaller portion of onward spread, the fact that it likely occurs points to a need for vaccination policies to focus on protecting people before they have been exposed. “Specifically, post-exposure or ‘ring’ vaccination of contacts identified only through individuals with symptoms, could be inadequate,” she and her co-authors wrote. Freeman said the finding underscores the need for international discussions about vaccine equity. “If you look at the big picture of where this virus traditionally has been endemic, there is still zero access to vaccine,” Freeman said. “We know that there could be some pre-symptomatic or pre-people-noticing-their-symptoms transmission, and really the way to handle this is to not wait till people know they’ve been exposed to be vaccinated but to have pre-exposure vaccination.”

Research cited published in BMJ (Nov. 2, 2022):

https://doi.org/10.1136/bmj-2022-073153 

The likelihood of self-reported long COVID after a first coronavirus (COVID-19) infection compatible with the Omicron BA.1 or BA.2 variants, compared with the Delta variant, using data from the COVID-19 Infection Survey.

• Of triple-vaccinated adults, 4.5%, 4.2% and 5.0% self-reported having long COVID 12 to 16 weeks after a first laboratory-confirmed coronavirus (COVID-19) infection compatible with the Omicron BA.1, Omicron BA.2 or Delta variants, respectively, using data to 27 May 2022.

• There was no statistical evidence of differences in the odds of reporting long COVID between infections compatible with the Omicron BA.1, Omicron BA.2 and Delta variants among adults who were triple vaccinated when infected; this was after statistically adjusting for socio-demographic characteristics for all comparisons, and for time since last vaccine dose when comparing Omicron BA.1 and BA.2.

• Of double-vaccinated adults, 4.0% self-reported long COVID 12 to 16 weeks after a first infection compatible with the Omicron BA.1 variant, compared with 9.2% for those compatible with the Delta variant.

• The odds of reporting long COVID were 48.2% lower for first COVID-19 infections compatible with the Omicron BA.1 variant than those compatible with the Delta variant among adults who were double vaccinated when infected; this was after statistically adjusting for socio-demographic characteristics.

If you are worried about new or ongoing symptoms four or more weeks after having COVID-19, there are resources available to help. See Long-term effects of coronavirus (NHS) and Your COVID Recovery (NHS), which can help you to understand what has happened and what you might expect as part of your recovery. The time it takes to recover from COVID-19 is different for everyone, and the length of your recovery is not necessarily related to the severity of your initial illness or whether you were in hospital.

Characteristics of people testing positive for COVID-19 from the Coronavirus (COVID-19) Infection Survey. 

The most recent update (May 25, 2022) by the UK Health Security agency shows an increasingly alarming rate of re-infections in the U.K. As compared to the pre-Omicron period, re-infection rates were nearly 8-fold greater in the period from December 20 2021 onwards. A total of 4729 reinfections were reported during the Omicron period, with 75% of the re-infections showing cycle threshold values (Ct) below 30, suggesting high viral loads. People with asymptomatic infections, or with prior infections with lower viral loads (Ct above 30) were more likely to be re-infected. Vaccinated individuals, or older people, were less likely to suffer re-infections. The findings highlight the ability of Omicron, and the newest Omicron sub-lineages, to escape immunity elicited by prior infections.

The study involving more than 2,300 people also found that women were 33% less likely to fully recover than men.  Not even 1 in 4 people have completely recovered from the coronavirus a full year after being hospitalized with the disease, a U.K. study indicated Sunday, warning that long COVID-19 could become a common condition. The study involving more than 2,300 people also found that women were 33% less likely to fully recover than men. It also found that obese people were half as likely to fully recover, while those who needed mechanical ventilation were 58% less likely. The study looked at the health of people who were discharged from 39 British hospitals with COVID-19 between March 2020 and April 2021, then assessed the recovery of 807 of them five months and one year later. Just 26% reported a full recovery after five months, and that number rose only slightly to 28.9% after a year, according to the study published in the Lancet Respiratory Medicine journal.

“The limited recovery from five months to one year after hospitalization in our study across symptoms, mental health, exercise capacity, organ impairment and quality-of-life is striking,” said study co-leader Rachel Evans of the National Institute for Health and Care Research. The most common long-COVID-19 symptoms were fatigue, muscle pain, poor sleep, slowing down physically and breathlessness. “Without effective treatments, long-COVID could become a highly prevalent new long-term condition,” said study co-lead Christopher Brightling of the University of Leicester. The study, which will be presented at the European Congress of Clinical Microbiology and Infectious Diseases, is ongoing and will continue to monitor the patients’ health.

Published in The Lancet Respiratory Medicine (April 23, 2022):

https://doi.org/10.1016/S2213-2600(22)00127-8 

medRxiv - The PrexThe new SARS-CoV-2 variant B.1.1.7 was identified in December 2020 in the South-East of England, and rapidly increased in frequency and geographic spread. While there is some evidence for increased transmissibility of this variant, it is not known if the new variant presents with variation in symptoms or disease course, or if previously infected individuals may become reinfected with the new variant. Using longitudinal symptom and test reports of 36,920 users of the Covid Symptom Study app testing positive for COVID-19 between 28 September and 27 December 2020, we examined the association between the regional proportion of B.1.1.7 and reported symptoms, disease course, rates of reinfection, and transmissibility. We found no evidence for changes in reported symptoms, disease severity and disease duration associated with B.1.1.7. We found a likely reinfection rate of around 0.7% (95% CI 0.6-0.8), but no evidence that this was higher compared to older strains. We found an increase in R(t) by a factor of 1.35 (95% CI 1.02-1.69). Despite this, we found that regional and national lockdowns have reduced R(t) below 1 in regions with very high proportions of B.1.1.7.

Available in medRxiv (Jan. 29, 2021):

 https://doi.org/10.1101/2021.01.28.21250680 

At the heart of each coronavirus is its genome, a twisted strand of nearly 30,000 “letters” of RNA. These genetic instructions force infected human cells to assemble up to 29 kinds of proteins that help the coronavirus multiply and spread.  As viruses replicate, small copying errors known as mutations naturally arise in their genomes. A lineage of coronaviruses will typically accumulate one or two random mutations each month. Some mutations have no effect on the coronavirus proteins made by the infected cell. Other mutations might alter a protein’s shape by changing or deleting one of its amino acids, the building blocks that link together to form the protein. Through the process of natural selection, neutral or slightly beneficial mutations may be passed down from generation to generation, while harmful mutations are more likely to die out....

The new strain may be growing faster in some parts of the country, Health Secretary tells MPs. Health Secretary Matt Hancock said at least 60 different local authorities had recorded Covid infections caused by the new variant. He said the World Health Organization had been notified and UK scientists were doing detailed studies. He said there was "nothing to suggest" it caused worse disease or that vaccines would no longer work. He told MPs in the House of Commons that over the last week, there had been sharp, exponential rises in coronavirus infections across London, Kent, parts of Essex and Hertfordshire. "We've currently identified over 1,000 cases with this variant predominantly in the South of England although cases have been identified in nearly 60 different local authority areas. "We do not know the extent to which this is because of the new variant but no matter its cause we have to take swift and decisive action which unfortunately is absolutely essential to control this deadly disease while the vaccine is rolled out."