This data from NY Times shows that deaths due to COVID-19 are following a familiar pattern and spiking about 3 weeks after a spike in cases; this time the spike is being driven by omicron cases. However, this wave may in fact have lower severity per case; with this current wave, the number of reported cases is probably undercounted by a greater degree than in previous spikes due to widespread availability of home testing and the likelihood of more asymptomatic cases. Thus, it could be that the death rate per case would/will be significantly lower if/when all cases are accounted for.
My take: Cardiac complications related to COVID-19 appear to be much more likely than adverse cardiac events due to vaccination.
I am happy to say that this is the last nightcall that I will have this year!
Today, I’ve compiled some of my favorite posts from the past year. I started this blog a little more than 10 years ago. I am grateful for the encouragement/suggestions from many people to help make this blog better. Also, I want to wish everyone a Happy New Year.
- Must-Read: How to Handle Post-Procedure Fevers
- Pictographic Constipation Action Plans
- Carlo DiLorenzo: Lessons Learnt Over 30 Years
- Why Observational Studies Are Misleading and PPI Association with Kidney Stones
- Does It Makes Sense to Look for Celiac Disease in Children with Constipation?
- Secondary Prophylaxis of Clostridiodes difficile Infection
- Pelvic AnoRectal Care Program (PARC)
- Expert Consensus: New Recommendations for Therapeutic Drug Monitoring
- Unpacking the Pivotal Ozanimod (True North) Trial
- The Really Simplified Endoscopy Scoring
- Algorithm for Neonatal Acute Liver Failure
- NASPGHAN Alagille Syndrome Webinar
- Aspen Webinar 2021 Part 8 -Neonatal Cholestasis
- Aspen Webinar 2021 Part 2 -Nonalcoholic Steatohepatitis
- Aspen Webinar 2021 Part 1-COVID-19 and the Liver
- Oral Pan-Genotypic HCV Drugs Approved For Children Starting at Age 3 Years
M Levy et al. JAMA. Published online December 20, 2021. doi:10.1001/jama.2021.23262. Open Access: Multisystem Inflammatory Syndrome in Children by COVID-19 Vaccination Status of Adolescents in France
- From September 1, 2021, to October 31, 2021, a total of 107 children with MIS-C were hospitalized in France…33 (31%) were adolescents eligible for vaccination
- Among those with MIS-C, 0 had been fully vaccinated, 7 had received 1 dose with a median (IQR) time between vaccine injection and MIS-C onset of 25 (17-37) days, and 26 had not been vaccinated. The HR for MIS-C was 0.09 (95% CI, 0.04-0.21; P < .001) after the first vaccine dose compared with unvaccinated adolescent. Because there were no MIS-C cases in those who were vaccinated, an HR cannot be calculated in this group.
- The study had limitations, including the low number of patients, use of national data to calculate HR without considering regional variations, and inability to control for individual risks of MIS-C, such as sex, race and ethnicity, and comorbidities
My take: This study indicates that COCID-19 vaccination likely results in a marked decrease in the risk of MISC-C. This finding provides an additional reason favoring vaccination in adolescents in terms of risk-benefit calculation for immunization.
- Healthcare workers with COVID-19 who are asymptomatic can return to work after 7 days with a negative test, and that isolation time can be cut further if there are staffing shortages.
- Healthcare workers who have received all recommended COVID-19 vaccine doses, including a booster, do not need to quarantine at home following high-risk exposures.
And this, from NBC News:
This article shows that the booster shot lowers the risk of death by 90% compared to those who did not receive the booster shot in those 50 years of age or older. R Arbel et al. NEJM 2021; DOI: 10.1056/NEJMoa2115624. Open Access: BNT162b2 Vaccine Booster and Mortality Due to Covid-19
- A total of 843,208 participants (50 years and older) met the eligibility criteria, of whom 758,118 (90%) received the booster during the 54-day study period. Death due to Covid-19 occurred in 65 participants in the booster group (0.16 per 100,000 persons per day) and in 137 participants in the nonbooster group (2.98 per 100,000 persons per day). The adjusted hazard ratio for death due to Covid-19 in the booster group, as compared with the nonbooster group, was 0.10 (95% confidence interval, 0.07 to 0.14; P<0.001).
This twitter thread from Ashish Jha provides insight into the current understanding of the Omicron variant.
Link: The Coronavirus Attacks Fat Tissue, Scientists Find (Study has not been published or peer-reviewed yet)
J Ge et al. Gastroenterol 2021; 161: 1487-1501. Full text-open access: Outcomes of SARS-CoV-2 Infection in Patients With Chronic Liver Disease and Cirrhosis: A National COVID Cohort Collaborative Study
“In this study of approximately 221,000 nationally representative, diverse, and sex-balanced patients with CLD; we found SARS-CoV-2 infection in patients with cirrhosis was associated with 2.38 times mortality hazard, and the presence of cirrhosis among patients with CLD infected with SARS-CoV-2 was associated with 3.31 times mortality hazard”
Related blog post: Aspen Webinar 2021 Part 1 COVID-19 and the Liver
The Minnesota Health Department Stats are easy to review -here is a link: COVID-19 Vaccine Breakthrough Weekly Update
Here are some recent stats -showing that vaccines reduce the risk of hospitalization and death in all age groups:
- To protect children from serious illness, long-term sequelae, hospitalization and death. USA Today recently estimated that less than 700 children have died from COVID-19 -which is still a lot of vaccine-preventable illness (yearly flu deaths in children are closer to about 100 per year). Link (10/8/21) How bad is COVID-19 in kids? See the latest data and charts on kids cases; hospitalizations; deaths
- To protect everyone else (from Eric Topol twitter feed):