Alcohol Use Linked To Over 740000 Cancer Cases Last Year, New Study Says

Health

NPR 17 July, 2021 - 09:59am 54 views

The link between smoking and cancer is well-documented and widely known. But alcohol?

"Fewer than one in three Americans recognize alcohol as a cause of cancer," says Harriet Rumgay, researcher at the International Agency for Research on Cancer, the specialized cancer agency of the World Health Organization. "That's similar in other high-income countries, and it's probably even lower in other parts of the world."

A new study shows just how much of a risk drinking can be. At least 4% of the world's newly diagnosed cases of esophageal, mouth, larynx, colon, rectum, liver and breast cancers in 2020, or 741,300 people, can be attributed to drinking alcohol, according to a study in the July 13 edition of Lancet Oncology. Men accounted for three-quarters of alcohol-related cancers. Of the 172,600 alcohol-related cancer cases diagnosed in women, the vast majority, or 98,300 cases, were breast cancer.

There are a few biological pathways that lead from alcohol consumption to a cancer diagnosis, according to the study. Ethanol, the form of alcohol present in beer, wine and liquor, breaks down to form a known carcinogen called acetaldehyde, which damages DNA and interferes with cells' ability to repair the damage.

Alcohol can also increase levels of hormones, including estrogen. Hormones signal cells to grow and divide. With more cell division, there are more opportunities for cancer to develop. Alcohol also reduces the body's ability to absorb certain cancer-protective nutrients, including vitamins A, C, D, E and folate.

What's more, the combination of drinking and smoking might indirectly increase the risk of cancer, with alcohol acting as a kind of solvent for the carcinogenic chemicals in tobacco.

The more a person drinks, the greater the likelihood of biological damage.

To come up with their statistical estimate, researchers crunched three sets of data: estimated global alcohol consumption estimates, specific cancer risks from alcohol, and estimates of the global incidence of those cancers in 2020.

They found that the more alcohol people drink, the higher their risk of an alcohol-related cancer. Drinking at least two and as many as more than six drinks a day, defined as risky to heavy drinking, posed the greatest risk of a future cancer. Even moderate drinking, two or fewer drinks a day, accounted for an estimated 14%, or 103,000 cases, of alcohol-related cancers, according to the study.

The study's authors suggest that the numbers of alcohol-related cancers are probably even higher than these estimates. "That's because we didn't include former drinkers in our main analysis, even though they may have an increased risk of cancer," says Rumgay. Instead, they looked at countrywide estimates of current drinkers. They also looked only at cancers where the risk factor has been scientifically shown to increase with alcohol use. They didn't include cancers for which emerging evidence suggests are likely linked to alcohol, such as pancreatic and stomach cancers.

When they further analyzed their data incorporating former drinkers and including the two cancers possibly linked to alcohol, the numbers went up significantly. "When we did the analysis and included former drinking, pancreatic and stomach cancers, the numbers increased to 925,000 alcohol-related cancers," she said. That's an additional 185,000 possible alcohol-related cancers, or 5% of all the world's cancers.

Some of the highest proportions of alcohol-related cancers were found in Moldova and Romania, she said. But recent changes in taxing policy, which has increased the cost of alcohol in those countries, have caused a drop in alcohol sales. And that could foreshadow a future reduction in related cancers, she said.

On the other hand, economic growth in places like China, India and Vietnam might lead to increased alcohol use and related cancers down the road. The lowest rates of alcohol-related cancers in the world were found in Saudi Arabia and Kuwait, where religious-based policies ensure low rates of drinking.

Drinking rates are relatively low in parts of Africa, but that seems to be changing. "Drinking trends show that alcohol use is increasing in countries in sub-Saharan Africa. We predict that the number of cases of cancer in Southern Africa will increase by two-thirds over the next 20 years, and in Eastern Africa, cases will double," says Rumgay.

Those strategies could include increasing taxes on alcohol and adding cancer warning labels to alcohol similar to warnings now on cigarette packages.

While such public policies are effective and necessary, says Dr. Amy Justice, professor of medicine and public health at Yale University, we need to go further. Justice wrote a commentary in Lancet Oncology accompanying the alcohol-related cancer study. She agrees with the authors that the results are, if anything, an understatement of the impact of alcohol on cancer cases. And she has suggestions to reduce the burden of alcohol-related cancers that go beyond governmental action.

"I'm a doctor," she says. And as a physician, she thinks about the things she can say individually to a patient, one on one, to encourage them to reduce their drinking. "There's pretty good data that you can get people to decrease their alcohol consumption with brief motivational information," she said.

That might mean teaching doctors around the world to talk about alcohol use as a possible cause when a patient complains of sleep or memory problems or when they have the beginning signs of liver disease. "You tailor the information to the personal concerns of the patient in front of you," says Justice.

Read full article at NPR

COVID gets more mysterious! What do we do then?

NEWS9 live 16 July, 2021 - 05:00pm

Cholesterol Lowering Statins can cut Death Risk in COVID-19 Patients | The Weather Channel - Articles from The Weather Channel | weather.com

The Weather Channel 16 July, 2021 - 05:00pm

Statins block liver enzymes responsible for making cholesterol. The US Centers for Disease Control and Prevention estimates that 93 per cent of patients who use a cholesterol-lowering drug use a statin.

The use of statins or an anti-hypertension medication was associated with a 32 per cent lower risk of death among COVID-19 inpatients with a history of cardiovascular disease or hypertension.

This is because statins and anti-hypertension medications stabilise the underlying diseases for which they are prescribed, making patients more likely to recover from COVID-19, according to researchers from the University of California San Diego.

In the study, published in the journal PLOS ONE, the research team analysed anonymised medical records of 10,541 patients admitted for COVID-19 over a nine-month period, January through September 2020, at 104 different hospitals in the US.

"From this data, we performed more advanced analyses as we attempted to control for coexisting medical conditions, socioeconomic status and hospital factors," said lead author Lori Daniels, Professor and director of the Cardiovascular Intensive Care Unit at the varsity's School of Medicine.

"In doing so, we confirmed our prior findings that statins are associated with a reduced risk of death from COVID-19 among patients hospitalised for COVID-19," Daniels added.

The ACE2 receptor -- the regulatory target of statins -- helps control blood pressure. In 2020, it was discovered that SARS-CoV-2 virus primarily uses the same receptor to enter lung cells.

"As with any observational study, we cannot say for certain that the associations we describe between statin use and reduced severity of COVID-19 infection are definitely due to the statins themselves; however, we can now say with very strong evidence that they may play a role in substantially lowering a patient's risk of death from COVID-19," said Daniels.

"We hope that our research findings are an incentive for patients to continue with their medication."

Statins may cut the risk of dying from Covid-19, study finds

Daily Mail 16 July, 2021 - 10:55am

By Jonathan Chadwick For Mailonline

Cholesterol-lowering drugs called statins have proven controversial in the past, but they may cut your risk of dying from Covid-19, a new study suggests.  

Researchers in San Diego analysed anonymised medical records from a national American registry during the pandemic.

The sample consisted of people who either had or hadn't taken statins prior to contracting Covid-19 and being admitted to hospital.

Researchers found that the drug – which is taken as a pill and can be bought over the counter in some areas – slashes the risk of dying in hospital from Covid-19 by 41 per cent.   

Statins are a class of drugs that lower levels of 'bad' low-density lipoprotein (LDL) cholesterol, which can lead to lead to a hardening and narrowing of the arteries and therefore heart attacks and strokes. 

Cutting LDL cholesterol by taking statins may have anti-inflammatory effects, because LDL itself strongly promotes inflammation, thereby possibly making patients more likely to survive the inflammatory symptoms of Covid. 

Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood 

The study has been led by Lori Daniels, professor and director of the Cardiovascular Intensive Care Unit at UC San Diego Health.

ACE2 is an enzyme attached to the cell membranes of cells located in the arteries and lungs. 

ACE2 also serves as the entry point into cells for some coronaviruses.  

SARS-CoV-2, the coronavirus that causes Covid-19, attaches to ACE2 in order to infect our healthy cells. 

It’s thought that the more of these receptors you have, the more entry points there are for the virus. 

Covid-fighting properties of statins could also be related to angiotensin-converting enzyme 2 (ACE2), the researchers claim.  

ACE2 – an enzyme attached to the cell membranes of cells located in the arteries and lungs – is already known to be the 'gateway' for coronavirus infection.  

Once the spike has opened the door for the virus to enter the cell, the genetic material of SARS-CoV-2, its RNA, binds to myriad proteins and begins replicating.    

'When faced with this virus at the beginning of the pandemic, there was a lot of speculation surrounding certain medications that affect the body's ACE2 receptor, including statins, and whether they may influence Covid-19 risk,' said Professor Daniels.

'At the time, we thought that statins may inhibit SARS-CoV-2 infection through their known anti-inflammatory effects and binding capabilities, which could potentially stop progression of the virus.'

Illustration of SARS-CoV-2 virus binding to ACE2 receptors on a human cell, the initial stage of Covid infection

For their study, the experts used data from the American Heart Association's Covid-19 Cardiovascular Disease Registry.

This database contains de-identified health data on patients treated for Covid at more than 140 participating hospitals across the country. 

As of July 2021, data from more than 49,000 patient records had been contributed into the platform.   

The research team analysed anonymised medical records of 10,541 patients in the registry who were admitted for Covid over a nine-month period, January through September 2020, at 104 different US hospitals.

'From this data, we performed more advanced analyses as we attempted to control for coexisting medical conditions, socioeconomic status and hospital factors,' said Professor Daniels. 

'In doing so, we confirmed our prior findings that statins are associated with a reduced risk of death from Covid-19 among patients hospitalised for Covid-19.'  

Those who benefitted the most seemed to have good medical reasons to be taking statins, such as a history of cardiovascular disease or high blood pressure. 

Hypertension is otherwise known as high blood pressure. 

Blood pressure is a measure of the force that the heart uses to pump blood around the body, and it rises and falls in a cycle with each pulse.

It is measured in units of millimetres of mercury (mmHg), and the reading is always given as two numbers – systolic pressure (the pressure when the heart pushes blood out) and diastolic pressure (the pressure when the heart rests between beats).

The systolic reading represents the maximum blood pressure and the diastolic reading is the minimum blood pressure.

A high systolic blood pressure in one arm alone indicates hypertension. 

According to the research team, the use of statins or an anti-hypertension medication was associated with a 32 per cent lower risk of death among Covid inpatients with a history of cardiovascular disease or hypertension.

This can also be attributed to the ACE2 receptor, which helps control blood pressure. 

Patients with any statin use (alone or in combination with anti-hypertension medication) had a 41 per cent lower odds of death.

Compared to those taking neither class of medication, patients taking a statin alone had a 46 per cent lower odds of death, while those on both statin and anti-hypertension medication had a 40 per cent lower odds.  

Statistical matching techniques were used to compare outcomes for patients who used statins or anti-hypertension medication with similar patients who did not. 

'We matched each patient to one or more similar patients, using hospital site, month of admission, age, race, ethnicity, gender, and a list of pre-existing conditions, in order to make the two groups as comparable as possible' said co-author Professor Karen Messer.  

But the study did not confirm that statins were definitely the cause of survival. 

'As with any observational study, we cannot say for certain that the associations we describe between statin use and reduced severity of Covid-19 infection are definitely due to the statins themselves,' said Professor Daniels. 

'However, we can now say with very strong evidence that they may play a role in substantially lowering a patient's risk of death from Covid-19. 

'We hope that our research findings are an incentive for patients to continue with their medication.'

This new study builds on research published by UC San Diego Health last year that only included 170 anonymised medical records from patients specifically receiving care at UC San Diego Health.

Hypertension - high blood pressure - is one of the main risk factors of cardiovascular diseases

At the time, researchers found that statin use prior to hospital admission for Covid resulted in a more than 50 per cent reduction in risk of developing severe infection.       

Statins are widely prescribed – the Centers for Disease Control estimates that 93 per cent of patients who use a cholesterol-lowering drug use them. 

While statins are generally well tolerated, many people report aches and pains as a side effect, which may lead some to stop taking the drug. 

They cause some minor side effects, such as diarrhoea, headaches and nausea, according to the NHS, but they can prevent serious health problems. 

The new study, which has been published in the journal PLOS One, follows plenty of research into their various benefits. 

Last year, experts at VA Boston Health Care System, a branch of hospitals in Massachusetts, found deaths from any cause were 25 per cent lower for those who took statins, from a sample of 300,000 veterans aged 75 years or more. 

In 2019, another study found that up to 8,000 deaths could be avoided saved annually in the UK if everyone over the age of 75 received statins. 

Men who are on statins have a 24 per cent lower risk of a deadly form of prostate cancer, a study in 2019 also revealed.   

And in 2017, a 20-year review by British researchers found the pills slashed the risk of an early death by 28 per cent. 

Despite this, there has long been controversy over whether statins should be taken routinely by elderly people.   

'This topic has been controversial with several mixed results in the past, showing either no benefit or little benefit of statins in this age group,' said Dr Riyaz Patel, associate professor of cardiology at University College London.

'This in turn has led to uncertainty whether statins should be started or even stopped in older people.'    

Statins are the most commonly prescribed drug in the world and an estimated 30 per cent of all adults over the age of 40 are eligible to take them.

The cholesterol-lowering drugs are given to people believed to have a 10 per cent or higher risk of developing cardiovascular disease or having a heart attack or stroke within the next 10 years.

They are proven to help people who have suffered heart problems in the past, but experts say the thresholds may be too high, meaning benefits are outweighed by side effects for many people.

Nearly all men exceed the 10 per cent threshold by age 65, and all women do so by age 70 – regardless of their health.

Commonly reported side effects include headache, muscle pain and nausea, and statins can also increase the risk of developing type 2 diabetes, hepatitis, pancreatitis and vision problems or memory loss.

Research published in the Pharmaceutical Journal last year found taking a daily statin for five years after a heart attack extends your life by just four days, new research reveals.

And Dr Rita Redberg, professor at the University of California, San Francisco told CNN in January that of 100 people taking statins for five years without having had a heart attack or stroke, 'the best estimates are that one or two people will avoid a heart attack, and none will live longer, by taking statins.

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Warning to under 30s as quarter hospitalised from Covid suffering serious complications

Glasgow Times 16 July, 2021 - 05:00am

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HALF of patients hospitalised with Covid develop at least one complication, with large numbers of "young, previously healthy" individuals among those affected.

As reported in our sister title, The Herald, a study of more than 73,000 patients admitted to 302 hospitals across the UK was carried out between January and August last year, before the vaccine rollout and prior to the emergence of the Alpha (Kent) variant and the Delta strain from India.

It found that 27 per cent of 19-29 year olds and 37% of 30-39 year olds suffered a complication which had both short and long-term health impacts.

The most common were kidney and respiratory problems, but cardiovascular, neurological, gastrointestinal, and liver complications were also reported, and 13% of 19-29 year olds were unable to look after themselves - at least temporarily - once discharged from hospital.

This rose to 17% among 30 to 39-year olds.

Chief investigator Professor Calum Semple, of Liverpool University, said the findings should "dispel" narratives that Covid "is only dangerous in people with existing co-morbidities and the elderly".

The research, published today in the Lancet, comes at a time when young people are making up a larger share of Covid patients in hospital while older Scots benefit from vaccine protection.

Of the 475 Covid admissions in Scotland in the week ending July 6, 135 (28%) were aged 20 to 39. Previously, this age group made up less than 10% of admissions.

Of the 73,197 patients included in the Lancet study, just over 23,000 died. Of those who survived, 44% experienced complications.

The incidence of complications rose with age, from 27%in the 19 to 29 age group to roughly 50% in patients aged 60-plus.

They were more common in men than women, and most frequent in Black patients than other ethnicities.

The authors warn that policymakers should consider the health impact for Covid survivors, not just mortality, when making decisions around easing restrictions.

Joint senior author Professor Ewen Harrison, of Edinburgh University, said: “Those with complications had poorer health on discharge from hospital, and some will have long-term consequences.

"We now have a more detailed understanding of Covid-19 and the risks posed, even to younger otherwise healthy people...Our results can also inform public health messaging on the risk Covid-19 poses to younger otherwise healthy people at a population level, particularly in terms of the importance of vaccination for this group.”

Aya Riad, joint co-author, also from Edinburgh University, added: “Just focusing on death from Covid-19 is likely to underestimate the true impact, particularly in younger people who are more likely to survive severe Covid-19.”

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Younger adults suffering with coronavirus still at risk of serious organ damage, study finds

Yahoo News UK 16 July, 2021 - 12:42am

Four in 10 people aged between 19 and 49 developed problems with their kidneys, lungs or other organs while treated, the research found.

The study examined 73,197 adults of all ages across 302 UK hospitals during the first wave of the pandemic last year.

The study looked at the number of "complications" in those needing hospital treatment for Covid-19, defined as an organ-specific medical diagnosis.

Overall, about half of all adult patients suffered a least one complication during their hospital stay. The most common was a kidney injury, followed by lung and heart damage.

The highest rates were in those over 50 years old, with 51per cent experiencing at least one problem.

However, they were also "very common" in younger age groups.

Some 37 per cent of 30 to 39 year olds and 44 per cent of 40 to 49 year olds had at least one complication recorded by experts involved in the study.

"The message is that this is not just a disease of the elderly and frail," said Prof Calum Semple, who led the work.

"The data reinforces the fact that Covid is not flu and we are seeing even young adults coming into hospital suffering significant complications, some of which will require furthering monitoring and potentially further treatment in the future."

Doctors are not yet certain how a severe Covid illness can cause organ damage, but it is thought the body's own immune system can in some cases spark an inflammatory response.

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Complications Common Even in Younger COVID-19 Patients

Medscape 16 July, 2021 - 12:00am

Almost half of patients, regardless of age, admitted to hospital with COVID-19 develop at least one complication, which can have a significant impact on their ability to look after themselves after they are discharged, suggests a large UK prospective study.

With complications and poor outcomes common even among younger patients, the researchers say the results underline the importance of vaccination and appropriate healthcare planning.

The research was published by The Lancet on July 17.

The team studied more than 73,000 UK patients admitted to hospital with COVID-19 between January and August 2020, of whom almost 50% developed at least one complication, ranging from 39% in those aged 19–49 years to 51% in older patients.

The most common complications were renal, complex respiratory and systemic, and they had an ongoing impact on patient health, leaving 27% less able to take care of themselves after discharge, including 13% of those aged 19–29 years.

"This work contradicts current narratives that COVID-19 is only dangerous in people with existing comorbidities and the elderly," commented joint chief investigator Calum Semple, professor of child health and outbreak medicine, University of Liverpool, in a news release.

"Dispelling and contributing to the scientific debate around such narratives has become increasingly important," he continued. "Disease severity at admission is a predictor of complications even in younger adults, so prevention of complications requires a primary prevention strategy, meaning vaccination."

Joint senior author Professor Ewen Harrison, from the Centre for Medical Informatics, Usher Institute, University of Edinburgh, agreed that their work underlines the importance of COVID-19 vaccination.

"The results can also inform public health messaging on the risk COVID-19 poses to younger otherwise healthy people at a population level, particularly in terms of the importance of vaccination for this group."

Moreover, the results highlight "some insightful patterns and trends that can inform healthcare systems and policy maker responses to the impacts of COVID-19".

Co-author Dr Thomas Drake, Centre for Medical Informatics, Usher Institute, University of Edinburgh, emphasised that the study also shows the importance of considering "not just death from COVID-19, but other complications as well".

He added: "We are still studying the participants in our study to understand what the long-term effects of COVID-19 on their health.

"The results from these ongoing studies will be particularly useful, as we found many people who survive COVID-19 and develop complications are from economically active age groups."

Aya Riad, a medical student at the University of Edinburgh, and co-author of the study, said understanding this is crucial when "making decisions on how best to tackle the pandemic".

"Just focussing on death from COVID-19 is likely to underestimate the true impact, particularly in younger people who are more likely to survive severe COVID-19."

Previous studies of patients hospitalised with COVID-19 have indicated that they have mortality rates of approximately 26%, and up to 17% require ventilatory support and critical care.

The researchers note that a "substantial proportion of patients with COVID-19 go on to develop critical illness and require organ support", leading to "substantial" additional physical and mental health morbidity.

However, the wide use of mortality as an outcome in epidemiological studies has failed to capture "the immediate short-term health issues faced by survivors, including in-hospital complications and functional outcomes".

To investigate further, the team conducted a prospective, multi-centre cohort study of patients aged 19 years or over with confirmed or highly suspected COVID-19 at 302 healthcare facilities in the UK.

Nurses and medical students collected baseline demographic and health-related data, including the presence of comorbidities such as chronic cardiac, haematological, kidney, neurological or pulmonary disease, asthma, HIV/AIDS, cancer, liver disease, obesity, and rheumatological disorders.

They also collected data on the respiratory, neurological, cardiovascular, renal, gastrointestinal and systemic complications participants experienced while in hospital, and the ability of patients to look after themselves when they were discharged.

Between 17 January and 4 August, 2020, 75,276 eligible patients aged 19 years or over were included. Among those, 73,197 (97.2%) had complication data available for analysis.

The mean age of the patients was 71.1 years, 56.0% were male and 81.0% had at least one comorbidity. Chronic cardiac disease was the most common (30.8%), followed by diabetes (24.2%), chronic pulmonary disease (16.7%) and chronic kidney disease (16.6%).

The overall mortality rate in the cohort was 31.5%, and 49.7% of patients had at least one complication. Among patients who survived, 43.5% had at least one complication.

Having any complication was found to be significantly associated with critical care admission, at an odds ratio of 7.25 (p<0.0001), and with mortality, at a hazard ratio of 1.74 (p<0.0001).

Men were more likely to have at least one complication than women, as were patients aged 60 years and over.

Among patients aged over 60 years, the complication rate was 54.5% in men versus 48.2% in women, while in those aged less than 60 years the complication rate was 48.8% in men and 36.6% in women.

The incidence rose with increasing age, from 27% among 19–29 year olds hospitalised with COVID-19 to 37% in 30–39 year olds, 43% among 40–49 year olds and 51% of people aged 50 years and over.

Black patients were also more likely to experience complications than White people, at 58% versus 49%.

The most common complications were renal, which were seen in 24.3% of patients, followed by complex respiratory (18.4%) and systemic (16.3%) complications.

Cardiovascular complications were recorded in 12.3% of patients, while gastrointestinal and liver complications were seen in 10.8%, and neurological complications in 4.3%.

The most common individual complications were acute kidney injury, probable acute respiratory distress syndrome, liver injury, anaemia, and cardiac arrhythmia.

Following hospitalisation, 27% of patients were less able to take care of themselves than they had been before they had COVID-19, an outcome that was associated with older age, being male, and receipt of critical care.

The team calculates that having any complication was associated with a significantly worse ability to self-care following discharge, at an odds ratio of 2.42 (p<0.0001).

In an accompanying comment, Dr Xiaoying Gu and Professor Bin Cao, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, say the study provides "inspiring ideas" for further study.

"One of the most notable findings…is that the relative risk of death is much higher in younger patients with complications when compared with those of the same age who did not suffer a complication, whereas in older patients, the relative impact of complications on mortality appears to be lower," they say

This "indicates that attention should also be paid to younger patients who are less likely to die during the acute phase but more likely to live longer with complications in the days after acute or subacute COVID-19", they write.

The long-term consequences of in-hospital COVID-19 complications need to be examined, they say, as well as the impact of ethnicity and socioeconomic factors.

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Warning to under 30s as quarter hospitalised from Covid suffering serious complications

HeraldScotland 16 July, 2021 - 12:00am

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HALF of patients hospitalised with Covid develop at least one complication, with large numbers of "young, previously healthy" individuals among those affected.

A study of more than 73,000 patients admitted to 302 hospitals across the UK was carried out between January and August last year, before the vaccine rollout and prior to the emergence of the Alpha (Kent) variant and the Delta strain from India.

It found that 27 per cent of 19-29 year olds and 37% of 30-39 year olds suffered a complication which had both short and long-term health impacts.

The most common were kidney and respiratory problems, but cardiovascular, neurological, gastrointestinal, and liver complications were also reported, and 13% of 19-29 year olds were unable to look after themselves - at least temporarily - once discharged from hospital.

This rose to 17% among 30 to 39-year olds.

Chief investigator Professor Calum Semple, of Liverpool University, said the findings should "dispel" narratives that Covid "is only dangerous in people with existing co-morbidities and the elderly".

The research, published today in the Lancet, comes at a time when young people are making up a larger share of Covid patients in hospital while older Scots benefit from vaccine protection.

Of the 475 Covid admissions in Scotland in the week ending July 6, 135 (28%) were aged 20 to 39. Previously, this age group made up less than 10% of admissions.

Of the 73,197 patients included in the Lancet study, just over 23,000 died. Of those who survived, 44% experienced complications.

The incidence of complications rose with age, from 27%in the 19 to 29 age group to roughly 50% in patients aged 60-plus.

They were more common in men than women, and most frequent in Black patients than other ethnicities.

The authors warn that policymakers should consider the health impact for Covid survivors, not just mortality, when making decisions around easing restrictions.

Joint senior author Professor Ewen Harrison, of Edinburgh University, said: “Those with complications had poorer health on discharge from hospital, and some will have long-term consequences.

"We now have a more detailed understanding of Covid-19 and the risks posed, even to younger otherwise healthy people...Our results can also inform public health messaging on the risk Covid-19 poses to younger otherwise healthy people at a population level, particularly in terms of the importance of vaccination for this group.”

Aya Riad, joint co-author, also from Edinburgh University, added: “Just focusing on death from Covid-19 is likely to underestimate the true impact, particularly in younger people who are more likely to survive severe Covid-19.”

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Covid: Younger adults still at risk of serious organ damage - study

BBC News 15 July, 2021 - 06:01pm

Four in 10 of those between 19 and 49 developed problems with their kidneys, lungs or other organs while treated.

The research looked at 73,197 adults of all ages across 302 UK hospitals in the first wave of Covid in 2020.

"The message is that this is not just a disease of the elderly and frail," said Prof Calum Semple, who led the work.

"The data reinforces the fact that Covid is not flu and we are seeing even young adults coming into hospital suffering significant complications, some of which will require furthering monitoring and potentially further treatment in the future."

The study, conducted by researchers at seven UK universities, the Department of Health and Social Care and Public Health England, looked at the number of "complications" in those needing hospital treatment for Covid-19, defined as an organ-specific medical diagnosis.

Overall, around half of all adult patients suffered a least one complication during their hospital stay. The most common was a kidney injury, followed by lung and heart damage.

The highest rates were in those over 50 years old, with 51% reporting at least one problem. But they were also "very common" in younger age groups. Some 37% of 30 to 39 year olds and 44% of 40 to 49 year olds had at least one complication recorded by nurses and medical students involved in the study.

Doctors are not yet certain how a severe Covid illness can cause organ damage, but it is thought in some cases the body's own immune system can spark an inflammatory response and injure healthy tissue.

Paul Godfrey, from Frinton in Essex, developed Covid in March 2020 after suffering what he thought was a chest infection.

Paul, who was 31 at the time of diagnosis and has the lung condition bronchiectasis, said: "There's no doubt about it - the NHS staff who cared for me saved my life. I would not be here today if it wasn't for them."

The study, published in the medical journal the Lancet, found that those with pre-existing conditions were more likely to report complications but the risk was high even in young, previously healthy individuals.

Paul was diagnosed with pneumonia in Colchester hospital and was told the bottom half of both his lungs had collapsed. He narrowly avoided being placed in an induced coma and spent two weeks on a Covid ward before he was allowed home in a wheelchair.

The research showed that 13% of 19 to 29 year olds and 17% of 30 to 39 year olds hospitalised with Covid were unable to look after themselves at discharge and had to rely on friends and family.

"It was the worst experience of my life and I am still dealing with it 18 months later," said Paul, who continues to suffer from extreme fatigue and breathlessness caused by his illness.

"I don't really know what the damage is to my body so I am just praying I get back to what I was."

Age is the single largest factor in determining a severe Covid infection.

Of the 406,687 people taken to hospital with the disease in England since the start of the pandemic, 62% were over the age of 65.

That leaves another 155,866 under the age of 65 who have needed hospital treatment since February 2020.

Higher vaccination rates in the elderly and vulnerable population mean that the average age of those hospitalised with the disease has been falling.

In the week ending 4 July, there were just 17 people over 85 years old admitted to hospital with Covid in England, compared with 478 aged between 25 and 44.

The research was conducted in the first wave of the pandemic between 17 January and 4 August 2020 - before vaccines were available and new variants of the virus had been detected.

The authors said the data suggested those with more severe Covid symptoms at admission to hospital were more likely to suffer serious health problems, showing the importance of vaccines in reducing the severity of the disease in this latest wave.

The study was only designed to look at short-term complications during a hospital stay but there is evidence some organ damage can persist, becoming a form of what is known as long Covid.

"We do know from other infectious diseases that these sorts of problems with your kidneys or heart can develop into longer-term complications," said Dr Annemarie Docherty, senior clinical lecturer at the University of Edinburgh and a consultant in intensive care medicine.

"I think it's reasonable to expect that this may be the same with Covid-19."

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Complications in Hospitalized COVID-19 Patients More Common, Affect Younger Population

Contagionlive.com 15 July, 2021 - 05:30pm

In a large observational study from the United Kingdom, investigators reported that 1 out of every 2 hospitalized patients developed one or more health complications. In their findings, 36,367 of 73,197 saw complications during their hospitalization. In addition, patients between 19-39 years of age made up 64% of the complications. Specifically, 27% of patients aged 19-29 year old, and 37% of patients aged 30-39 experienced a complication.

This age-related discovery offers a contrarian view of the public perception that COVID-19 mostly impacts seniors and those with underlying conditions.  

“This work contradicts current narratives that COVID-19 is only dangerous in people with existing comorbidities and the elderly,” Chief Investigator and joint senior author of the study, Professor Calum Semple, University of Liverpool, UK, said. “Dispelling and contributing to the scientific debate around such narratives has become increasingly important. Disease severity at admission is a predictor of complications even in younger adults, so prevention of complications requires a primary prevention strategy, meaning vaccination.”

And with the majority of patients being admitted to hospitals being people who are unvaccinated, and the Delta variant proving to be highly transmissible, younger people who have chosen not to get the vaccine, should be aware of these findings.

The findings were published today in The Lancet.

The authors reported the most common complications included renal, complex respiratory, and systemic complications; however it is important to note patients did experience others related to cardiovascular, neurological, gastrointestinal and liver health conditions.

Following hospitalization, 27% (13,309 of 50,105) of patients were less able to look after themselves than before COVID-19, and this was more common with older age, being male, and in people who received critical care. The association between having a complication and worse ability for self-care remained irrespective of age, sex, socioeconomic status, and which hospital someone received treatment in. Neurological complications were associated with the biggest impact on ability for self-care.

The most common complications were renal (affecting almost one in four people, 24%, 17,752), respiratory (affecting around one in five people, 18%, 13,486), and systemic (affecting one in six, 16%, 11,895). However, cardiovascular complications were reported in around one in eight participants (12%, 8,973), and neurological (less than one in 20, 4%, 3,115), and gastrointestinal or liver (less than 1%, 7,901) complications were also reported. Specifically, acute kidney injury, probable acute respiratory distress syndrome, liver injury, anemia, and cardiac arrhythmia were the most common complications.

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