Study: Painless organ damage seen in COVID-19 ‘long hauler’

A healthcare worker treats a patient inside a negative pressure room in the COVID-19 intensive care unit at Freeman Hospital West in Joplin, Missouri. (BLOOMBERG)

NEW YORK / HELSINKI / TUNISIA / RABAT / BERLIN / LONDON / JOHANNESBURG / ADDIS ABABA / DAR ES SALAAM / DUBLIN / CAIRO / ABUJA / GENEVA / RIO DE JANEIRO / MEXICO CITY / CHICAGO / SAO PAULO / LUANDA – Kidney damage is painless and silent, and it’s the latest ailment to be identified afflicting a large swath of COVID-19 survivors.

Injury to the blood-filtering organ can occur among people who recover from the coronavirus at home, and escalates with the severity of COVID, a study found. Even non-hospitalized patients with no renal problems have almost a twofold higher risk of developing end-stage kidney disease, compared with someone who never had COVID-19. 

The findings, reported Wednesday in the Journal of the American Society of Nephrology, highlight yet another pernicious burden of the pandemic that’s sickened more than 200 million people globally.

The study found non-hospitalized COVID-19 patients have a 23 percent increased risk of suffering acute kidney injury within six months — a condition that impedes the removal of waste and toxins from the blood. 

Doctors caring for virus survivors must also be alert for a broad spectrum of kidney disease among these patients, according to Ziyad Al-Aly, director of the clinical epidemiology center at the Veterans Affairs St. Louis Health Care System in Missouri.

Long COVID

As many as 1 in 7 children may have symptoms linked to the coronavirus months after testing positive for COVID-19, the authors of an English study on long COVID in adolescents said on Wednesday.

Children rarely become severely ill with COVID-19 but they can suffer lingering symptoms, and the study is one of the largest of its kind on how common so-called long COVID is in the age group.

The study, led by University College London and Public Health England, found that 11- to 17-year-olds who tested positive for the virus were twice as likely to report three or more symptoms 15 weeks later than those who had tested negative.

Researchers surveyed 3,065 11- to 17-year-olds in England who had positive results in a PCR test between January and March, and a control group of 3,739 11- to 17-year-olds who tested negative over the same period.

Among those who tested positive, 14 percent reported three or more symptoms such as unusual tiredness or headaches 15 weeks later, compared with 7 percent reporting symptoms by that time among the control group.

The researchers said that while the findings suggested as many as 32,000 teenagers might have had multiple symptoms linked to COVID-19 after 15 weeks, the prevalence of long COVID in the age group was lower than some had feared last year.

"Overall, it's better than people would've guessed back in December," Professor Terence Stephenson of the UCL Great Ormond Street Institute of Child Health, told reporters.

This photo shows a view of vials of Moderna COVID-19 vaccine, at the Assad Iben El Fourat school in Oued Ellil, outside Tunis on Aug 15, 2021. (HASSENE DRIDI / AP)

Moderna

Moderna Inc.’s COVID-19 vaccine generated more than double the antibodies of a similar shot made by Pfizer Inc. and BioNTech SE in research that compared immune responses evoked by the two inoculations. 

The study is one of the first to compare levels of antibodies produced by the two vaccines, which are thought to be one of the important components of the immune response. It didn’t examine whether the antibody differences led to a difference in efficacy over time between the two shots, which both were more than 90 percent effective in final-stage clinical trials.

The research looked at antibody levels against the coronavirus spike protein in about 1,600 workers at a major Belgium hospital system whose blood samples were analyzed 6 to 10 weeks after vaccination. The participants hadn’t been infected with the coronavirus before getting vaccinated. Levels among those who got two doses of the Moderna vaccine averaged 2,881 units per milliliter, compared with 1,108 units per milliliter among those who received two Pfizer doses. 

The results, published Monday in a letter to the Journal of the American Medical Association, suggested the differences might be explained by the higher amount of active ingredient in the Moderna vaccine — 100 micrograms, versus 30 micrograms in Pfizer-BioNTech — or the slightly longer interval between doses of the Moderna vaccine — four weeks, versus three weeks for Pfizer-BioNTech.  

Pfizer said in a statement that its vaccine “continues to be highly efficacious” in preventing COVID-19, including against severe cases and hospitalization. A continuing analysis of its final-stage study has shown a decline of efficacy against symptomatic infection over time, the drugmaker said, but initial trial data also show that a third dose of the existing vaccine at least six months after the first two significantly raises neutralizing antibody levels.

Global tally

Coronavirus cases worldwide have exceeded 217.7 million while the global death toll topped 4.5 million, according to data compiled by Johns Hopkins University.

WHO

The World Health Organization opened a new hub for pandemic and epidemic intelligence in Berlin, saying the center will help give countries the fast analysis they need to respond more quickly to public-health emergencies.

The German government is providing US$100 million in initial funding for the project, which will seek to combine case and lab data with other information sources, including economic factors, cultural beliefs and human-animal interactions.

Meanwhile, the WHO said a new coronavirus variant that was first detected in South Africa in May does not appear to be spreading, adding it was monitoring the variant as the virus evolves.

"It does not appear to be increasing in circulation," WHO spokesperson Margaret Harris said at a UN briefing, adding the variant labeled C.1.2. was not currently classified as a "variant of concern" by the UN health agency.

ALSO READ: New virus variant found in S. Africa has concerning mutations

Africa

The number of confirmed COVID-19 cases in Africa reached 7,767,332 as of Tuesday afternoon, the Africa Centers for Disease Control and Prevention (Africa CDC) said.

The death toll from the pandemic stood at 195,544 while the number of recoveries reached 6,917,240, the Africa CDC said.

Mauritius

Mauritius vaccinated 60 percent of its population a month ahead of target and now plans to halve the number of days tourists will need to isolate on the island nation after arrival.

The “milestone comes ahead of two major steps to reduce restrictions on inbound international travel,” the Mauritius Tourism Promotion Authority said in an emailed statement Tuesday. 

Inoculated tourists will have to spend seven days in a a so-called resort bubble hotel from Wednesday, down from 14 days now, before they can travel freely. From Oct 1, they will be free to explore the Indian Ocean Island nation without restrictions. That’s provided they submit a negative PCR test taken within 72 hours before arrival, the agency said.

Arrivals in the tourism-dependent nation are forecast to reach about 325,000 in 2021, according to Statistics Mauritius. The bulk are expected in the final quarter of this year, during the start of the nation’s high season.

Before the COVID-19 pandemic struck, as many as 1.4 million tourists per year descended on the country’s pristine beaches, accounting for 10 percent of gross domestic product. 

Italy 

Italy’s introduction of a third vacccine dose is “very likely,” Health Minister Roberto Speranza said.

The government is also evaluating making use of the so-called “green pass” compulsory among workers in the public sector, according to Sole24Ore daily.

As of Sept 1, Italy requires travelers on planes, ferries, and long-distance trains and coaches to show proof of vaccination or of a recent negative COVID-19 test. 

The so-called green pass, a digital certificate also given to those who have recovered from COVID-19, will also be required for school and university personnel. University students attending in-person lessons will also be asked to show proof of vaccination.

The long-announced measures have been criticized by anti-vaccine activists, who are organizing protests to block the country’s main railway station on Wednesday. Doctors and journalists have also been targets of online intimidation and hate campaigns.

More than 70 percent of Italians are fully vaccinated, Speranza said on Wednesday.

Ireland

Ireland, which had one of Europe's longest COVID-19 lockdowns, will drop almost all pandemic restrictions in October after one of the continent's most successful vaccine rollouts, Prime Minister Micheal Martin said on Tuesday.

From Oct 22, the requirement for vaccine certificates in bars and restaurants will be dropped, as will all restrictions on the numbers attending indoor and outdoor events.

As part of a phased easing of restrictions, the government is recommending the reopening of theatres and cinemas at 60% capacity next week and a return of non-essential workers to offices from Sept. 20.

"Because of the effort of our vaccination team and because you have stepped up to the mark and taken the vaccine when it was offered, we are now entering a whole new phase of the pandemic," Martin said in a televised address.

Almost 9 percent of adults in Ireland are fully vaccinated as are 80 percent of over those over 12 years old.

Martin struck a note of caution, however, warning of an increase in case numbers in the coming weeks before an expected decline.

Children wait to get tested for COVID-19 in North Miami, Florida, Aug 31, 2021. (MARTA LAVANDIER / AP)

US

The United States continues to see more people, including children, hospitalized, fueled by the Delta variant of COVID-19.

Five states, namely Alabama, Georgia, Texas, Florida and Arkansas, are nearly out of ICU beds, having less than 10 percent left of their ICU bed capacity, reported CNN on Tuesday.

"Hospitals around the country have been stretched as cases have picked back up, but the South, where vaccinations have been lagging, has been particularly hit. Many hospitals have been reporting oxygen shortages," reads the report, citing data from the Department of Health and Human Services.

On Monday, data presented by a vaccine adviser from the US Centers for Disease Control and Prevention (CDC) showed a hospitalization rate 16 times greater in the unvaccinated population than in those vaccinated, it added.

Children account for the fastest rate of new COVID-19 infections in Colorado, a health official said Tuesday. Other western states reported hospitals under stress and called up the National Guard.

Colorado has “significant” hospital capacity for children and adults, said Scott Bookman, the state’s COVID-19 incident commander, who called vaccines “the ticket out of this pandemic”.

Just this month in Brevard County, Florida, 1,623 children were infected and more than 8,000 students were quarantined. In the Atlanta area, thousands of positive cases were confirmed in schools with 23,000 students and staff have been quarantined.

ALSO READ: COVID-19: US adds Canada to its 'do not travel' advisory list

The pandemic has also forced the cancellations of college enrollments and social events, in addition to disrupting Americans' daily life and eroding their long-term welfare.

This year's Wonderfront Music & Arts Festival, a major music, culinary and arts event first held in 2019 upon the stunning waterfront of downtown San Diego, has been postponed until Nov 18 to 20, 2022, due to the surge in COVID-19 cases caused by the Delta variant.

Xavier University is unenrolling students who have not received the COVID-19 vaccine, reported Black Enterprise, the No. 1 Black digital media brand in the United States, on Monday. The private Catholic and historically Black college in Louisiana will begin the process at the end of this week.

Around 14 million people in the US received their first dose of a COVID-19 vaccine in August, about 4 million more than in July, officials said on Tuesday as the government pushes inoculation as infections rise.

The United States' vaccination rate still lags other developed countries. Only around 52 percent of US residents are fully vaccinated, including about 63 percent of adults, according to federal data.

Two women in New York have been charged with selling forged COVID-19 vaccination cards through an Instagram account and to enter the names of customers into the state's immunization database, prosecutors said on Tuesday.

Finland

As of Sept 1, Finland will no longer require visitors arriving from "non-high-risk" countries and areas to present a negative COVID-19 test or a COVID-19 vaccination certificate, the Finnish government said in a press release issued on Tuesday.

According to the release, in "non-high-risk" countries and areas the risk of contracting COVID-19 is low. These include the Chinese mainland, the Hong Kong SAR, Macao SAR, Taiwan, Malta, Hungary, New Zealand, Poland and the Vatican, as well as some municipalities of Norway and Sweden.

Visitors arriving in Finland from other countries and areas will still be required to present a reliable certificate of recovery from COVID-19 within the past six months, proof of full vaccination or a negative COVID-19 test taken before arrival.

The new decree will remain in force until Oct 15, 2021. The list of countries and areas and the overall epidemiological situation will be reviewed every two weeks, the government said.

Egypt

Egypt is ramping up production of the Sinovac coronavirus vaccine as it aims to become a hub for vaccine exports to Africa and protect its own population of more than 100 million from a fourth wave of infections.

The government is preparing new facilities that it says could produce several million vaccine doses daily, and is also in talks with an unspecified European vaccine producer.

Dr Heba Wali, president of the state-run Holding Company for Biological Products and Vaccines (VACSERA), said one million doses of the VACSERA-Sinovac jab had already been distributed within Egypt.

A new VACSERA facility outside Cairo aims to begin production in November and have a capacity of 1 billion vaccines per year.

In recent months, Egypt has also received shipments of vaccines made by Sinopharm, AstraZeneca, Sputnik, Sinovac and Johnson & Johnson.

Nearly 7.5 million people in Egypt had received at least one dose of a vaccine, Health Minister Hala Zayed said last week as she announced a push to accelerate jabs.

A fourth wave of COVID-19 infections is expected to peak in late September after a lull in infections, according to Zayed.

On Tuesday, Egypt reported 263 new cases, bringing its total to 288,162, including 16,727 deaths. 

A health worker takes a sample for a coronavirus test at the Ajusco Medio General Hospital, which is designated for COVID-19 cases only, in Mexico City, Aug 31, 2021. (MARCO UGARTE / AP)

Mexico

Mexico on Tuesday reported 11,146 newly confirmed cases of COVID-19 as well as 835 more deaths, bringing the total number of infections in the country to 3,352,410 and the death toll to 259,326, according to health ministry data. 

Portugal

Portugal said it would allow entry for tourists from Brazil, nearly 18 months after it imposed a ban on non-essential travel from the Portuguese-speaking South American nation to stem the spread of coronavirus.

Although Brazilians, who make up Portugal's biggest expatriate community, were allowed access for reasons such as work, family or health, the lifting of the tourism ban has been long-awaited.

Portugal is now open to tourists from the European Union who present the bloc's digital COVID-19 certificate, as well as the United States, from where visitors must show a negative test result on arrival.

Nigeria

Two southern Nigerian state governments instructed their populations to get inoculated against the coronavirus or be banned from religious services and public places, while federal authorities suggested they’re considering restrictions to tackle vaccine hesitancy.

Large gatherings, places of worship and banks will only be accessible to those with proof that they’ve received at least one COVID-19 shot from mid-September, Edo state governor Godwin Obaseki said last week. On Aug 30, the leaders of neighboring Ondo declared that only the vaccinated can enter churches, mosques, hospitals, government offices and other public places after a two-week grace period. Nigeria comprises 36 states and the capital, Abuja. 

Just 150,000 of the approximately 10 million residents of Edo and Ondo have had a vaccine so far, although the inoculation rate has recently picked up, with more than 60,000 shots issued on Aug. 30

Nigeria is prioritizing the AstraZeneca, Pfizer, Moderna and Johnson & Johnson vaccines, the official heading Nigeria's COVID-19 vaccination campaign said on Tuesday.

So far, 2.9 million people in Nigeria have received one dose of a COVID-19 vaccine, while 1.4 million people have received two doses. Nigeria's population is estimated at 200 million.

The main constraints are a lack of supply and high levels of vaccine hesitancy among parts of the population.

Shuaib said Nigeria had taken delivery last week of close to 600,000 doses of the AstraZeneca vaccine supplied by Britain through the COVAX scheme, the latest out of a series of donations from developed countries.

Nigeria is also expecting deliveries over coming months of tens of millions of doses of the Johnson & Johnson vaccine which it has purchased through an African Union program.

Tunisia

Tunisia’s Ministry of Health announced on Tuesday that the death toll from COVID-19 rose by seven to 23,451.

The ministry reported 1,282 new COVID-19 cases, raising the tally in the North African country to 664,034, while the total number of recoveries reached 614,150.

The number of hospitalized COVID-19 patients in Tunisia stood at 2,701, including 513 in intensive care units and 117 mechanically ventilated, it added.

A total of 2,155,652 Tunisians have been fully vaccinated against COVID-19.

Morocco

Morocco begun on Tuesday vaccinating teenagers aged between 12 and 17 years old against COVID-19.

The Moroccan COVID-19 Scientific Committee has adopted Chinese Sinopharm and Pfizer-BioNTech vaccines for this campaign, as the two vaccines demonstrated effectiveness in this age group, according to a joint statement issued by the ministries of health and education.

On the same day, the country reported 4,899 new cases and 109 more fatalities, bringing the tally to 860,948 and the toll to 12,649.

More than 51 percent of Morocco’s population over 12 years old have been fully vaccinated.

A girl holds her mother's hand while receiving her COVID-19 vaccine as Morocco launches a campaign to vaccinate 12-17 year olds before the start of the school year, in Rabat, Morocco, Aug 31, 2021. (MOSA'AB ELSHAMY / AP)

Germany

For the first time since early July, the seven-day COVID-19 incidence rate in Germany fell from 75.8 cases per 100,000 residents on Monday to 74.8 cases on Tuesday, the Robert Koch Institute (RKI) for infectious diseases said.

Since sinking to its recent low of 4.9 cases around two months ago, the figure has been increasing steadily as Germany braces for the fourth wave of the pandemic. A week ago, the incidence rate stood at 58.0, the RKI said.

The number of daily infections has been steady in recent days with 5,750 new cases registered on Tuesday, only three more than seven days ago, according to the RKI.

A regulation could soon come into effect in Germany that would allow employers to ask for employees' vaccination status in order to protect the workforce.

As of Tuesday, almost 50.3 million people in Germany have been fully vaccinated, bringing the country's vaccination rate to 60.5 percent, according to the RKI. More than 54 million people in the country have received at least one vaccine dose.  

ALSO READ: S'pore trying to 'live with virus' with world's highest vaccination rate

UK

The UK on Tuesday recorded 32,181 new cases COVID-19, up from 26,476 the previous day following a long holiday weekend, official government figures showed.

Another 50 deaths within 28 days of a positive coronavirus test were also reported, compared to the 48 recorded on Monday.

In total, the UK has posted 6,789,581 confirmed cases and 132,535 deaths.

South Africa

South Africa may limit the use of public amenities to the people who have been vaccinated against COVID-19, the country’s health minister said. 

While a decision hasn’t been taken it is being discussed by the government, Joe Phaahla said in the National Council of Provinces on Tuesday. The Department of Labour and Employment has already given directives allowing employers to make the decision on whether to make vaccination a requirement, he said. 

“The opinion we are getting from legal people, that once there is sufficient coverage we should be able to arrive at the stage where we can actually make demands even at public amenities,” he said. “You can’t have your cake and eat it. You have the right to not have a vaccination, but you have no right to endanger the lives of other people.”

So far about 6 million of the country’s about 40 million adults have been fully vaccinated.

The highly infectious Delta variant continues to be the "dominant variant" in South Africa and the driver of the third wave, as the newly detected C.1.2 variant is present at very low levels, scientists said.

"The Delta variant was still the most dominant variant with the new variant C.1.2 being detected at low frequency," said Dr Jinal Bhiman, Principal Medical Scientist at National Institute for Communicable Diseases (NICD) at a new conference on Monday night.

The new C.1.2 variant was detected in May and has been detected in all nine provinces at less than 3 percent frequency. However, scientists said it was still being "assessed" at various laboratories.

"It has been increasing in frequency but it remains low in frequency," Bhiman said.

NICD's acting executive director Prof Adrian Puren said the vaccines being rolled out in South Africa would protect people against the variant even though more research was still being conducted.

Switzerland

Switzerland will not tighten curbs on public life for now despite rising coronavirus cases, the government said on Wednesday, reserving the right to make people show a COVID-status certificate to access many indoor spaces.

The government had signaled such a move last week when it ordered millions of more doses of COVID-19 vaccine for possible use as booster shots, amid concerns that a rising number of serious cases could soon overwhelm hospitals.

The number of new infections in Switzerland and tiny neighbour Liechtenstein has picked up again to surpass 780,000 since the pandemic began. The death toll has exceeded 10,500.

Tanzania

The Tanzanian parliament on Tuesday announced measures aimed at curbing the spread of COVID-19 among lawmakers as they gathered for meetings.

The measures included a reduction in the duration  of its two-week sessions from seven hours to five hours a day.

Speaker of Parliament Job Ndugai said that all members of parliament (MPs) will also be required to wear face masks during the sessions.

"Only MPs with special needs approved by medical personnel will be allowed to attend the sessions without wearing the face masks," Ndugai told the House.

Tanzanian health authorities last released COVID-19 statistics on July 23, saying there were 29 deaths related to the pandemic and 858 patients recorded in the third wave COVID-19 pandemic in the east African nation. 

More than 200,000 Tanzanians across the country have been vaccinated against the pandemic since President Samia Suluhu Hassan launched a mass vaccination campaign on July 28.  

Brazil

Brazil recorded 24,589 new confirmed cases of the coronavirus in the past 24 hours, along with 839 deaths from COVID-19, the Health Ministry said on Tuesday.

Brazil has registered more than 20 million cases since the pandemic began, while the official death toll has risen to 580,413, according to ministry data.

US study

COVID-19 vaccination elicited antibody responses in nearly nine out of 10 people with weakened immune systems, although their responses were only about one-third as strong as those mounted by healthy people, according to a study by researchers at Washington University School of Medicine in St. Louis.

To determine how well people taking immunosuppressive drugs respond to COVID-19 vaccination, the researchers pulled together a participant group comprising 133 patients and 53 healthy people for comparison. Each patient took at least one immune-suppressing medication for illnesses such as inflammatory bowel disease, rheumatoid arthritis, spondyloarthritis, lupus and multiple sclerosis.

Participants provided blood samples within two weeks before receiving the first dose of the Pfizer or Moderna vaccine and within three weeks after receiving the second dose. The researchers measured each participant’s antibody levels and counted the number of antibody-producing cells in their blood samples. During the period, all patients stayed on their prescribed drug regimens, except for three whose medications were paused within one week of immunization.

The researchers found that all healthy participants and 88.7 percent of the immunosuppressed participants produced antibodies against SARS-CoV-2, the virus that causes COVID-19. However, antibody levels and the number of antibody-producing cells in the immunosuppressed group were one-third as high as those in the healthy group.

Two classes of drugs led to particularly weak immune responses. Only 65 percent of people taking glucocorticoids and 60 percent of people taking B cell-depleting therapies developed detectable antibody responses. People taking antimetabolites such as methotrexate, TNF inhibitors or JAK inhibitors, on the other hand, did not generate significantly weaker immune responses than people not taking those drugs.

The study was published Monday in the Annals of Internal Medicine.  

Brazilian study

Brazilian researchers have found that a molecule in the venom of a type of snake inhibited coronavirus reproduction in monkey cells, a possible first step toward a drug to combat the virus causing COVID-19.

A study published in the scientific journal Molecules this month found that the molecule produced by the jararacussu pit viper inhibited the virus's ability to multiply in monkey cells by 75 percent.

"We were able to show this component of snake venom was able to inhibit a very important protein from the virus," said Rafael Guido, a University of Sao Paulo professor and an author of the study.

The molecule is a peptide, or chain of amino acids, that can connect to an enzyme of the coronavirus called PLPro, which is vital to reproduction of the virus, without hurting other cells.

Already known for its antibacterial qualities, the peptide can be synthesized in the laboratory, Guido said in an interview, making the capture or raising of the snakes unnecessary.

Ethiopia

Ethiopia registered 1,324 new COVID-19 cases in the past 24 hours, taking the tally to 308,134 as of Tuesday evening, the country's Ministry of Health said.

The ministry reported 15 more deaths related to COVID-19 and 764 new recoveries during the same period, taking the total counts to 4,675 and 276,842, respectively.

According to the ministry, Ethiopia now has 26,615 active COVID-19 cases, 630 of whom are in severe health conditions.

The country has so far administered a total of 2,451,950 COVID-19 vaccine doses.

Angola

Angola's capital Luanda will no longer be under a sanitary lockdown as of Wednesday, officials announced Tuesday.

The measure was included in a new national decree on COVID-19, said Francisco Pereira Furtado, Angola's minister of state and head of the presidency's security affairs.

He also called on Angolans to exercise a high level of consciousness, comply with bio-security rules and avoid gatherings.

According to the decree, economic activities severely affected by the pandemic are expected to gradually return to normal. 

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