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Asthma linked to increased risk of COVID-19

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A recent forward about a young doctor, who was a known asthmatic, succumbing to COVID-19 after being on the ventilator for a long time, has again highlighted the issue of asthma being a risk factor for COVID-19 patients. Do these patients need to be more careful? Theoretically, asthmatic patients would have increased susceptibility and severity for COVID-19 due to a deficient antiviral immune response and the tendency for exacerbation elicited by common respiratory viruses.1

According to a recent study2 published in The Journal of Allergy and Clinical Immunology, adults with asthma who were COVID-19 positive, were at higher risk of complications, compared to patients who were not asthmatic. Having non-allergic asthma increased the risk of severe COVID-19 by as much as 48%. They also found that the risk of severe COVID-19 increased by as much as 82% among people with asthma and chronic obstructive pulmonary disease.Additionally, however, the study also found that allergic asthma did not significantly increase this risk, andon the same lines, a vast majority of similar studies3conducted over the past few weeks, summarized by the American Academy of Allergy, Asthma and Immunology, have found no increased risk of COVID-19 disease severity in those with asthma. 

These studies3 have suggested that non-allergic asthma may be associated with more severe COVID-19 disease, although it is not clear in these studies if the tested subjects had diseases such as COPD, which is a well-established risk for severe COVID-19. Some of these studies have also suggested a higher rate of intubation in asthma patients hospitalized with COVID-19, but other studies have not replicated these findings.Therefore, collating all published evidence, the American Academy of Allergy, Asthma and Immunology concluded, that it appears there is either no risk or at most a very slight risk for more severe COVID-19 disease in non-allergic asthma patients. This is in contrast to other risk factors like COPD, obesity, etc., that have consistently been linked to more severe COVID-19 disease.

Source:
1. Clin Rev Allergy Immunol 2020;59(1):78-88.
2. J Allergy Clin Immunol2020;146(2):327-329.e4.
3. https://education.aaaai.org/resources-for-a-i-clinicians/summary-asthma_COVID-19

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Coronavirus

UV Germicidal lamp is useful for Covid-19

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In the fight against the coronavirus disease 2019 (COVID-19) pandemic, an old weapon has re-emerged.1 Ultraviolet C (UVC) radiation is a known disinfectant for air, water, and nonporous surfaces and has effectively been used for decades to reduce the spread of bacteria, such as tuberculosis. For this reason, UVC lamps are often called “germicidal” lamps.2 In the current pandemic, with disinfection and sanitization being the primary modes of prevention against the Coronaviruses, UV lamps have generated newfound interest for all of us. However, the reports are still not confirmatory as to whether it can be assumed that UV germicidal lamps are useful for COVID-19 or not.

According to a recent FDA report, UVC radiation has been shown to destroy the outer protein coating of the SARS-CoV-1 Coronavirus, which is a different virus from the current SARS-CoV-2 virus. Destruction of this outer protein coating inactivates the virus. Therefore, it is being assumed that UVC radiation may also be effective in inactivating the SARS-CoV-2 virus. However, currently there is limited published data about the wavelength, dose, and duration of UVC radiation required to inactivate the SARS-CoV-2 virus.

Theoretically, UVB and UVA radiations are expected to be less effective than UVC radiation at inactivating the SARS-CoV-2 coronavirus. But, in an August 2020 report, the FDA has elaborated upon the possibility of UVB and UVA in the inactivation of the SARS viruses.2

“UVB: There is some evidence that UVB radiation is effective at inactivating other SARS viruses (not SARS-CoV-2). However, it is less effective than UVC at doing so and is more hazardous to humans than UVC radiation because UVB radiation can penetrate deeper into the skin and eye. UVB is known to cause DNA damage and is a risk factor in developing skin cancer and cataracts.

UVA: UVA radiation is less hazardous than UVB radiation but is also significantly (approximately 1000 times) less effective than either UVB or UVC radiation at inactivating other SARS viruses. UVA is also implicated in skin aging and risk of skin cancer.”

The airborne antimicrobial potential of UVC ultraviolet light has long been established; but its widespread use in public settings is limited as conventional UVC light sources are a health hazard being both carcinogenic and cataractogenic.4

By contrast, we have previously shown that far-UVC light (207–222 nm) efficiently inactivates bacteria without harm to exposed mammalian skin. This is because, due to its strong absorbance in biological materials, far-UVC light cannot penetrate even the outer (nonliving) layers of human skin or eye; however, because bacteria and viruses are of micrometer or smaller dimensions, far-UVC can penetrate and inactivate them.4

Disinfection with far-UVC lamps remains largely experimental but could have an intrinsic advantage. Initial evidence suggests that far-UVC light does not penetrate beyond the outer dead layer of skin cells or the liquid film on eyes in healthy people.3,4 Thus, it cannot cause skin cancer or cataracts, like UVA and UVB. It also seems not to cause temporary skin burns and eye damage (“welder’s flash”) like standard UVC. This presumably depends on the intensity of exposure; whether intense exposure to destroy pathogens on the hands, for example, would be safe is unknown.

However, doctors may need some convincing to accept that some kinds of UV light may be safe to human eyes. “I would like to see more research on longer term exposure before I am convinced,” said Karl Linden, a professor of environmental engineering at the University of Colorado in Boulder, CO, USA. If it can be proven safe at the incidental exposure involved, far-UVC light might prove ideal for disinfecting spaces that always have people in them, like a 24-hour market; they could perhaps also be used to provide constant disinfection in hospitals.1 UV light is also being used to disinfect and re-use hospital face masks.5 In conclusion, the effectiveness of UVC lamps in inactivating the SARS-CoV-2 virus is unknown because there is limited published data about the wavelength, dose, and duration of UVC radiation required to inactivate the SARS-CoV-2 virus. It is important to recognize that, generally, UVC cannot inactivate a virus or bacterium if it is not directly exposed to UVC. In other words, the virus or bacterium will not be inactivated if it is covered by dust or soil, embedded in porous surface or on the underside of a surface. Therefore, until further reports emerge on the efficacy of UV lamps against the Coronaviruses, standard precautions should be taken including wearing masks, social distancing, cleaning and disinfection of all surfaces in contact.

Source:

1.Engineering (Beijing). 2020; 6(8): 851–53.
2.https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/uv-lights-and-lamps-ultraviolet-c-radiation-disinfection-and-coronavirus
3.Radiat Res. 2017;187:493–501.
4.Sci Rep. 2018;8:2752.
5.Engineering 2020;6(6):593–6.

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Coronavirus

Is loss of taste and smell permanent post COVID-19?

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Expert: Dr. Narottam Puri, MD ENT Specialist, Chairman Fortis Medical Council, Advisor- FICCI

It is well known that the key symptoms that may suggest coronavirus infection include cough, shortness of breath or difficulty breathing, fever, chills, muscle pain, sore throat, and new loss of smell or taste. There is increasing evidence that loss olfactory dysfunction can present in COVID-19 patients and loss of smell forms one of the prominent signs of Coronavirus infection.1 For example, in a study from Iran, 59 of 60 patients hospitalized with COVID-19 were found to have an impaired sense of smell according to psychophysical olfactory testing.2 Olfactory dysfunction defined as the reduced or distorted ability to smell during sniffing or eating, is often reported in mild or even asymptomatic cases; in a study from Italy, 64% of 202 mildly symptomatic patients reported impaired olfaction.3

Another recent study published in the journal Science Advances4 reveals that the olfactory sensory neurons do not have the genetic mechanism to encode the ACE2 receptor protein. This means that the virus cannot grab onto something and permanently damage it, which means when a COVID-19 patient loses sense of smell and taste, the senses will come back once the patient recovers. The loss of smell and taste will not be permanent. This however is published in only a peer-reviewed journal and needs further clarity on the data.

A September 2020 study5 has highlighted the observation that these symptoms may persist in patients even after recovering from COVID-19. The investigators of this study applied the Sniffin` Sticks battery, a comprehensive standardized and validated smelling test battery in 50 patients after recovering from COVID-19 and found that 7 weeks after the start of COVID-19, 50% of patients still suffered from an olfactory dysfunction despite reporting full recovery. Subtests analysis showed that not only indicators of peripheral, but also indicators of central olfactory function remained impaired. Clinicians and patients should therefore be aware that olfactory dysfunction may persist in patients after recovering from COVID-19.

Source:

1. Am J Otolaryngol. 2020; 41(5): 102581.
2. Int Forum Allergy Rhinol. Published online April 17, 2020. doi:10.1002/alr.22587
3. JAMA. Published online April 22, 2020. doi:10.1001/jama.2020.6771
3. Sci Advances 2020;6(31):eabc5801
4 J Infect. 2020; 81(3): e58.

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Fact Check

Side-effects of too much turmeric, methi and Vitamin D

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  • SARS-CoV-2 infection associated respiratory disease- COVID-19 has evolved into a pandemic but, being a new form of virus, pathogenesis of disease causation is not fully understood and drugs and vaccines against this virus are still being tested so that no effective drugs or vaccines have been advised by regulatory authority.
  • Turmeric has anti-inflammatory properties, while honey is super healthy for your immune system and relieve symptoms of a bad cough or cold. However, as is understandable, excess of anything is not good. For e.g. fenugreek (methi) is known to interact with warfarin to cause bleeding; therefore, caution should be used in giving high dosages to women with diabetes mellitus or those taking warfarin.
  • The only thing that works? Rest, sanitary hygiene, quarantine, wearing a mask and most of all, practicing social distancing.

Source:
In: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006–.2020 Jul 20.

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Fact Check

Neem leaves can cure Coronavirus

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  • Clinical symptom-based Indian traditional medicinal practices like Ayurveda and Siddha could be beneficial to treat and prevent the infection. Indian origin traditional medicinal plant Neem (Azadirachta indica) has been reported to have antiviral potential against bovine herpes virus type-1, poliovirus type 1, duck plague virus, dengue virus type-2, Newcastle disease virus, infectious bursal disease virus, avian influenza virus, and group B coxsackievirus.
  • Neem is widely used as Ayurvedic medicine to treat fever, cough, asthma, and diarrhoea, which are also reported as the common clinical symptoms of COVID-19.
  • Neem is reported to enhance both humoral and cell-mediated immune response during any viral infection.
  • Multidimensional antiviral therapeutic potentials of Neem insist on hypothesizing its probable application to control COVID-19 along with modern medicinal practices.
  • Bitter and astringent leaves; they all have antiviral and antibacterial actions
  • Neem leaves are bitter and astringent with antiviral and antibacterial actions, so it is worth studying as an anti-viral COVID-19. Until further studies are there, Neem can be an adjunct in the treatment of COVID-19 but no direct studies have done on COVID-19

Result: IN PROGRESS

Source
Int. J. Res. Pharm. Sci.2020;Special Issue 1(11):122-25.

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Fact Check

Homeopathic drug ‘Arsenicum album 30’ has been approved for prevention of Coronavirus infection

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  • This was after the Ministry of AYUSH listed the drug among “preventive and prophylactic simple remedies” against COVID-191.
  • There is no scientific evidence that the drug works against COVID-19, a fact stressed not only by medical scientists but also by some homoeopathic practitioners themselves. The ICMR has also said that there are no guidelines issued in this regard. With no clinical trial or large-scale study having been undertaken anywhere to scientifically validate the use of Arsenicum album 30 as a preventive medication, it is premature to say it prevents COVID-19.

Result: IN PROGRESS

Source:
AYUSH Ministry of Health Corona Advisory – D.O. No. S. 16030/18/2019 – NAM;
Dated: 06th March, 2020
https://indianexpress.com/article/explained/debate-over-a-homoeo-drug-arsenicum-album-coronavirus-vaccine-6439697/

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