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The study details tracheal injury in long-ventilated COVID patients

Yesterday’s study found that 47% of COVID-19 patients who required long-term mechanical ventilation developed potentially life-threatening tracheal (airway) complications.

The· JAMA Otolaryngology Head and Neck Surgery Studies show that patients with COVID-19 can suffer from full-thickness tracheal lesions (FTTL) (tear that penetrates the tracheal muscle wall) and tracheoesophageal fistula (TEF) (abnormal connection between the patient’s airways and esophagus). It turned out that the sex was significantly higher. A tube that connects to the stomach.

Serious tracheal complications from long-term mechanical ventilation are usually rare (0.3% to 3%), but caregivers have observed an unprecedented increase in COVID-19 patients, the study authors say.

In a retrospective study, 98 COVID-19 patients admitted to Pisa, Italy, with severe respiratory failure from March 1, 2020 to May 31, 2020, from March 1, 2019 to May 31, 2019. It was compared to a control group of 45 non-COVID-19 patients. The mean age of patients in the COVID-19 group was similar to that in the control group (68.8 and 68.5 years, respectively).

In the COVID-19 group, 14 patients (47%) developed FTTL or TEF as a result of intubation and long-term ventilation, whereas only one patient (2.2%) in the control group had FTTL (odds ratio). I got sick. [OR], 38.4; 95% confidence interval [CI]4.7 to 316.9).

Researchers have found that early circumflex surgery (putting the patient in the stomach to facilitate ventilation) and the resulting increase in ventilation cuff pressure on the tracheal wall, COVID blood coagulation complications, and much more. Mechanism suggests that it may explain the occurrence of tracheal injury. 19 patients, viral weakness of tracheal tissue, steroid use, and caregiver fatigue causing accidents and mistakes.

The authors advocate weekly bronchoscopy to detect tracheal lesions, careful use of high-dose steroids, and careful monitoring of cuff pressure to prevent tracheal damage in ventilated COVID-19 patients. ..
November 19th PIT Otolaryngol head neck surge Survey

MMR vaccine may help prevent COVID-19

Today’s small study mBio Researchers have found that mumps immunoglobulin (Ig) G antibody levels are inversely associated with COVID-19 severity in MMR vaccinated patients, so mumps, rubella (MMR) vaccine is COVID- Indicates that it may be protected from 19.

Epidemiology data It has been pointed out that COVID-19 mortality is low in populations with high MMR vaccination rates, but the mechanism of protection remains unclear. In this study, 50 COVID-19 patients who received MMR vaccination and 30 COVID-who had no record of MMR vaccination and whose antibodies were mainly derived from previous measles, mumps, and rubella diseases- A control group of 19 patients was compared.

Researchers found a significant inverse correlation (-0.71, P <0.001) Between the level of mumps antibody and COVID-19 severity in the MMR group. All asymptomatic and functionally immune patients had a mumps cold titer (antibody level) of 134 to 300 arbitrary units / milliliter (AU / ml). All 17 patients with mild COVID-19 symptoms showed titers of less than 134 AU / ml, and 11 patients with moderate symptoms showed titers of less than 75 AU / ml. All five inpatients who needed oxygen had a titer of less than 32 AU / ml. No significant correlation was found between the mumps titer and the severity of COVID-19 in the control group, or between the severity of the disease in either group and the measles or rubella titer.

“This adds to other associations that show that the MMR vaccine may be defensive against COVID-19,” said Jeffrey E. Gold, President of the World Organization and Principal Research Author. Today, we announced in a news release from the American Society for Microbiology (ASM). mBio..

Elderly people, including virtually all people born before 1957, are more likely to have MMR antibodies from natural infections, but these antibodies may have declined by as much as 73% over time. The authors suggest. In addition, researchers found that the mumps titer was the only MMR titer that steadily declined over time (average annual decay rate of 9.2%), with an average titer of 142 AU 9 years after vaccination. I found it to be / ml.

“Based on our study, it is wise to vaccinate people over the age of 40, whether or not their serum MMR titers are already high,” said co-author Dr. David J. Hurley.
November 20 mBio Survey
November 20th ASM news release

Expert: Distribution of COVID-19 vaccine requires collaboration and transparency

For fair distribution of the COVID-19 vaccine, the United States needs diverse clinical trial populations, data transparency (especially with regard to emergency licenses), universal accessibility, and collaboration. Health problems yesterday.

Vaccine experts need to be transparent, timely, and consistent with their communications and guidelines, given that the federal government sets basic policies and determines state grants. I add.

The author emphasizes partnership and coordination throughout the recommendations. Groups such as the Professional Medical Association, AARP, and NAACP help ensure that diverse populations are included in the trial, they say. The Immunization Implementation Advisory Board needs continued support from the National Academy of Science and Technology Medicine and the National Association. Of medicine when it formulates a distribution plan.

Federal agencies and departments may be working with McKesson, but state and local organizations are needed to deliver the vaccine to people. This article introduces the unique vaccination sites and partners used in the distribution of the H1N1 pandemic influenza vaccine in 2009 and 2010 to prevent pregnant women, high-risk adults and children from slipping in the traditional supply chain. It points out as an example of how it has changed. Through the crack.

According to the authors, an estimated 20% of the US population can be completely uninsured, so we recommend that you provide more funding to reach these populations.

To help track coverage, the Immunization Information Systems (IIS) has an opt-out policy that requires data to be shared across state boundaries, experts say. They add that all vaccine managers need to help with this, including school nurses, health insurance providers, and Medicaid providers. Currently, according to the author, children and teens make up 95% and 80% of IIS, respectively, but only about 56% of adults are documented in the system.
November 19th Health problems Survey
November 19 Philadelphia Children’s Hospital Press release

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