COVID Booster: HIV, variants and asthma

Address HIV to lower the risk of variants

The science on the Omicron variant of COVID-19 is not going to be well understood for a few weeks at least, but a perspective in Nature makes one thing clear: even if this variant didn’t emerge in an HIV-positive person, the HIV/AIDS epidemic is the perfect breeding ground for new variants of COVID-19.

Tackling the HIV crisis and COVID-19 in sub-Saharan Africa concurrently is the best way to prevent new variants, the authors argue.

“It is plausible that a prolonged COVID-19 infection in someone who is immunocompromised could lead to the emergence of a variant that is more transmissible even than the Delta variant, or that renders current COVID-19 vaccines less effective,” write the authors, who are based at the University of KwaZulu-Natal, South Africa.

They stress that sub-Saharan Africa needs support from richer nations in both the form of HIV-treating drugs, COVID-19 vaccines and a reduction in HIV-related stigma.

“Australia and New Zealand still refuse to give citizenship to people with HIV, even though effective antiretroviral treatments are now available,” the authors point out.

Poorly controlled asthma places children at higher risk of COVID-19 hospitalisation

A study that examined hospital records for all Scottish residents aged 5–17 (a total of around 752,867) has found that children with “poorly controlled asthma” are at higher risk of being hospitalised once diagnosed with COVID-19.

The study, published in The Lancet, also found that 548 per 100,000 children with poorly controlled asthma were admitted to hospital with COVID-19, compared to 94 per 100,000 children with well-controlled asthma and 55 per 100,000 children without asthma.

“Understanding which children with asthma are at increased risk of serious COVID-19 outcomes is critical to ongoing policy deliberations on vaccine prioritisation”, says lead author Professor Aziz Sheikh, from the University of Edinburgh, Scotland.

“The key takeaway from this study is that keeping children’s asthma under control is critical as this greatly reduces the risk of COVID-19 hospitalisation. Vaccinating those with poorly controlled asthma offers an additional important layer of protection from serious COVID-19 outcomes.”

But… asthma lowers your chances of getting COVID-19?

Science in action, folks – on the very same day, another study found that adults in the UK with allergic conditions like hay fever, rhinitis and eczema are less likely to get COVID-19, especially if they have asthma.

The study, published in Thorax, tracked 14,348 UK adults between May 2020 and February 2021. All participants volunteered for the study, and filled out regular questionnaires on their demographics, health, lifestyle, and COVID-19 infection status over the study period.

Those with allergies and asthma were less likely to test positive to COVID-19 over the study period.

The authors point out that they can’t establish causation – it’s possible that those with these conditions were taking more care to isolate and prevent infection than everyone else, for instance. It’s also a self-selecting sample, and not demographically representative of the UK’s overall population.

So these two headlines are not, in fact, contradictory: the Lancet paper indicates that asthma may make COVID more severe once a child is infected, while the Thorax research suggests that adults with asthma are less likely to get COVID-19 in the first place. Both of these findings can be true.

But even if they did find completely contradictory results, that’s not necessarily a bad thing – the next step would then be to repeat these studies and find out which results were more reproducible.

Survivors of severe COVID-19 more likely to die within a year

People who have survived a severe COVID-19 infection are more than twice as likely to die within a year, as compared to people who had a mild infection or didn’t catch it all.

A new study, published in Frontiers in Medicine, looked at the health records of more than 13,000 patients who had COVID-19. One hundred and seventy eight had a severe infection, 246 had a mild or moderate infection, and the rest had tested negative. The research team then tracked all the patients over the next 12 months.

“We conducted a previous study that showed that patients with severe COVID-19 who recovered were at significantly greater risk of being hospitalised in the subsequent six months,” says lead author Arch Mainous, of the University of Florida. “This new study extended that to investigate mortality risk over the next 12 months.”

It found that patients who had severe COVID-19 had a significantly increased chance of death, especially in patients under 65 years of age.

Only 20% of those patients died from typical COVID-19 complications like respiratory failure or clotting. The other causes of death were wide ranging, which suggests that a severe infection damages a person’s overall long-term health.

“Our recommendation at this point is to use preventive measures, such as vaccination, to prevent severe episodes of COVID-19,” Mainous says.

Link found between long COVID and chronic fatigue

A small US study has found that chronic fatigue syndrome may be more common in people living with long COVID, with almost half of the patients studied meeting the criteria for chronic fatigue.

This medical condition, also known as encephalomyelitis, can cause fever, aching, prolonged tiredness and depression.

Long COVID, on the other hand, is known to cause symptoms such as severe fatigue, cognitive difficulty, unrefreshing sleep and myalgia (muscle aches and pains).

The researchers from the Icahn School of Medicine, US, looked at 41 patients (23 women, 18 men) between 23 and 69 years old, who previously had COVID-19 and were still experiencing shortness of breath three to 15 months later. They were first interviewed about fatigue symptoms, which showed that 46% met the criteria for chronic fatigue syndrome.

The patients then underwent a cardiopulmonary exercise test (CPET) to find that 88% had dysfunctional breathing and 58% had circulation problems.

But the researchers caution that this is a small study, so further research is needed to draw a stronger link.