Can touching a barbell in the gym get you sick with the coronavirus?

[Michael Scally MD]

Male Predisposition to Severe COVID-19

Highlights

Effect of sex hormones on COVID-19 outcome bias in males and females.
Effect of immunological factors on COVID-19 outcome bias in males and females.
Angiotensin-converting enzyme-2 (ACE2) system and COVID-19 outcome in males and females.
Correlation between smoking and COVID-19 incidence in males and females.
Possible therapeutic options for COVID-19.

The severe form of COVID-19 has significant sex disparities, with high fatalities commonly reported among males than females. The incidence of COVID-19 has also been higher in males compared with their female counterparts.

This trend could be attributed to a better responsive and robust immune system in females. Cytokine storm is one of the pathophysiological features of severe COVID-19, and it occurs as a result of over-activation of immune cells leading to severe inflammation and tissue damage. Nevertheless, it is well modulated in females compared to their male counterparts.

Severe inflammation in males is reported to facilitate progression of mild to severe COVID-19. The sex hormones, estrogens and androgens which exist in varying functional levels respectively in females and males are cited as the underlying cause for the differential immune response to COVID-19.

Evidence abounds that estrogen modulate the immune system to protect females from severe inflammation and for that matter severe COVID-19. On the contrary, androgen has been implicated in over-activation of immune cells, cytokine storm and the attendant severe inflammation, which perhaps predispose males to severe COVID-19.

In this review efforts are made to expand understanding and explain the possible roles of the immune system, the sex hormones and the angiotensin-converting enzyme (ACE) systems in male bias to severe COVID-19.

Also, this review explores possible therapeutic avenues including androgen deprivation therapy (ADT), estrogen-based therapy, and ACE inhibitors for consideration in the fight against COVID-19.

Acheampong DO, Barffour IK, Boye A, Aninagyei E, Ocansey S, Morna MT. Male predisposition to severe COVID-19: Review of evidence and potential therapeutic prospects. Biomed Pharmacother. 2020 Nov;131:110748. doi: 10.1016/j.biopha.2020.110748. Epub 2020 Sep 9. PMID: 33152916. Male predisposition to severe COVID-19: Review of evidence and potential therapeutic prospects

 

[Michael Scally MD]

Romantic Relationship Conflict Due to the COVID-19 Pandemic and Changes in Intimate and Sexual Behaviors

In early 2020, the novel coronavirus 2019 (COVID-19) spread across the United States and mitigation measures drastically affected the daily lives of Americans. In this study, we assessed the association between COVID-related relationship conflict and changes in intimate and sexual behaviors and experiences.

Using data from an online nationally representative probability survey of 1,010 American adults in April 2020, we estimated the impact of coronavirus-related relationship conflict on changes in intimate and sexual behaviors among those in any type of romantic or sexual relationship (Nweighted=742). Further, we assessed the association between conflict and experience of orgasm and feeling emotionally close to partner.

Among individuals in relationships, 34% reported some degree of conflict with their romantic partners due to the spread of COVID-19 and its related restrictions. Those experiencing frequent coronavirus-related conflict with their partner were significantly more likely to report decreased frequency of several solo and partnered intimate and sexual behaviors compared to those not experiencing any such conflict, exhibiting a dose-response trend among partnered sexual behaviors.

Since the spread of coronavirus and associated social distancing measures in the United States, Americans have experienced escalations in conflict in their romantic partnerships, which was associated with changes to their intimate and sexual lives.

Luetke M, Hensel D, Herbenick D, Rosenberg M. Romantic Relationship Conflict Due to the COVID-19 Pandemic and Changes in Intimate and Sexual Behaviors in a Nationally Representative Sample of American Adults. J Sex Marital Ther. 2020;46(8):747-762. doi: 10.1080/0092623X.2020.1810185. Epub 2020 Sep 3. PMID: 32878584. https://www.tandfonline.com/doi/full/10.1080/0092623X.2020.1810185

 

[Michael Scally MD]

Assessing the Risks of ‘Infodemics’ in Response to COVID-19 Epidemics

During COVID-19, governments and the public are fighting not only a pandemic but also a co-evolving infodemic—the rapid and far-reaching spread of information of questionable quality. We analysed more than 100 million Twitter messages posted worldwide during the early stages of epidemic spread across countries (from 22 January to 10 March 2020) and classified the reliability of the news being circulated.

We developed an Infodemic Risk Index to capture the magnitude of exposure to unreliable news across countries. We found that measurable waves of potentially unreliable information preceded the rise of COVID-19 infections, exposing entire countries to falsehoods that pose a serious threat to public health.

As infections started to rise, reliable information quickly became more dominant, and Twitter content shifted towards more credible informational sources. Infodemic early-warning signals provide important cues for misinformation mitigation by means of adequate communication strategies.

Gallotti, R., Valle, F., Castaldo, N. et al. Assessing the risks of ‘infodemics’ in response to COVID-19 epidemics. Nat Hum Behav (2020). https://doi.org/10.1038/s41562-020-00994-6

 

[Michael Scally MD]

[OA] Differential Effects of Intervention Timing on COVID-19 Spread in The United States

Assessing the effects of early non-pharmaceutical interventions on COVID-19 spread is crucial for understanding and planning future control measures to combat the pandemic. We use observations of reported infections and deaths, human mobility data, and a metapopulation transmission model to quantify changes in disease transmission rates in US counties from March 15 to May 3, 2020.

We find that marked, asynchronous reductions of the basic reproductive number occurred throughout the US in association with social distancing and other control measures.

Counterfactual simulations indicate that, had these same measures been implemented 1-2 weeks earlier, substantial cases and deaths could have been averted, and that delayed responses to future increased incidence will facilitate a stronger rebound of infections and death.

Our findings underscore the importance of early intervention and aggressive control in combatting the COVID-19 pandemic.

Pei S, Kandula S, Shaman J. Differential effects of intervention timing on COVID-19 spread in the United States. Science Advances 2020:eabd6370. http://advances.sciencemag.org/content/early/2020/11/05/sciadv.abd6370.abstract

 

[Michael Scally MD]

[OA] Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections on Testis

Purpose - To evaluate the presence and analyze the pathological changes within the testes of patients who died or recovered from severe acute respiratory syndrome coronavirus 2 (COVID-19) complications.

Materials and Methods - Testis tissue was collected from autopsies of COVID-19 positive (n=6) and negative men (n=3). Formalin-fixed paraffin-embedded tissues were stained with hematoxylin and eosin (H&E) and subjected to immunofluorescence for angiotensin-converting enzyme 2 (ACE-2) expression.

Fluorescent-labeled tissue slides were imaged on a quantitative pathology scope with various zoom levels allowing for qualitative and quantitative interpretation. Tissue from four COVID-19 positive autopsy cases and a live seroconverted patient was imaged with transmission electron microscopy (TEM).

Results - H&E histomorphology showed three of the six COVID-19 biopsies had normal spermatogenesis while the remaining three had impaired spermatogenesis. TEM showed the COVID-19 virus in testis tissue of one COVID-19 positive autopsy case and the live biopsy, H&E stain on the same autopsy case demonstrated interstitial macrophage and leukocyte infiltration. Immunofluorescent stained slides from six COVID-19 positive men demonstrated a direct association between increased quantitative ACE-2 levels and impairment of spermatogenesis.

Conclusions - The novel COVID-19 has an affinity for ACE-2 receptors. Since ACE-2 receptor expression is high in the testes, we hypothesized that COVID-19 is prevalent in testes tissue of infected patients. This study suggests the male reproductive tract, specifically the testes, may be targets of COVID-19 infection. We found an inverse association between ACE-2 receptor levels and spermatogenesis, suggesting a possible mechanism of how COVID-19 can cause infertility.

Achua JK, Chu KY, Ibrahim E, Khodamoradi K, Delma KS, Iakymenko OA, Kryvenko ON, Arora H, Ramasamy R. Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections on Testis. World J Mens Health. 2020;38:e56. Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections on Testis

 

[Michael Scally MD]

 

[MisterSuperGod]

Probably from all those sickly voters that were told it was okay for them to break quarantine to vote.

Seems to be the most logical possibility, i mean, there were no recent Trump rallies or gatherings of motorcycle riders to point the finger at this time.

 

[Millard]

Probably from all those sickly voters that were told it was okay for them to break quarantine to vote.

Seems to be the most logical possibility, i mean, there were no recent Trump rallies or gatherings of motorcycle riders to point the finger at this time.

Maybe someone should have told them to mail in their ballots.

 

[MisterSuperGod]

Maybe someone should have told them to mail in their ballots.

And tell a sick American that he can't leave his home and potentially infect others? Surely you jest. (Smiley face emoji)

 

[Michael Scally MD]

 

[Joe Morgan]

Maybe someone should have told them to mail in their ballots.

tell that to Dr. Fauci. he told voters it’s OK to go vote in person.

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

PFIZER AND BIONTECH ANNOUNCE VACCINE CANDIDATE AGAINST COVID-19 ACHIEVED SUCCESS IN FIRST INTERIM ANALYSIS FROM PHASE 3 STUDY
https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-announce-vaccine-candidate-against


Vaccine candidate was found to be more than 90% effective in preventing COVID-19 in participants without evidence of prior SARS-CoV-2 infection in the first interim efficacy analysis

Analysis evaluated 94 confirmed cases of COVID-19 in trial participants

Study enrolled 43,538 participants, with 42% having diverse backgrounds, and no serious safety concerns have been observed; Safety and additional efficacy data continue to be collected

Submission for Emergency Use Authorization (EUA) to the U.S. Food and Drug Administration (FDA) planned for soon after the required safety milestone is achieved, which is currently expected to occur in the third week of November

Clinical trial to continue through to final analysis at 164 confirmed cases in order to collect further data and characterize the vaccine candidate’s performance against other study endpoints

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]