With input from Dr Monica Vasudev

1402: All that is known about the coronavirus variant spreading in New York City

1.           A new variant of the coronavirus is spreading fast in New York City.

2.           Research from Caltech and Columbia, not yet peer-reviewed, has revealed that the variant - B.1.526 - could possibly weaken the effectiveness of some of the vaccine candidates being used currently.

3.           The variant started being detected in samples collected in New York City in November.

4.           By mid-February, the research team at Caltech noted that B.1.526 cases accounted for 27% of viral sequences in the database.

5.          Researchers at Columbia sequenced 1,142 samples and noted that 12% of the samples had E484K, one of the two mutations that constitute B.1.526.

6.           The strains found in New York had mutations on the virus’s spike protein, enabling it to enter the host cells and cause infections more effectively. B.1.526 is two variants, with a pair of common mutations known as E484K and S477N. 

7.           A study from Columbia published in January had revealed that monoclonal antibodies to treat COVID-19 had no effect against the South African strain, which also has the E484K mutation. Other studies have also noted that variants with the E484K mutation have reduced susceptibility to vaccines than the strain of the virus on which they were initially developed.

8.           The coronavirus is changing in similar ways on different continents. The New York, Brazilian, South African, and British variants, all carry the E484K mutation. This indicates that the mutations have led to more effective spread. There are similar mutations at several places.

[Source: https://nymag.com/intelligencer/2021/02/new-york-city-coronavirus-variant-b-1-526-what-we-know.html]

1403: Johnson & Johnson’s single dose vaccine provides robust protection against severe disease and death from COVID-19, and may reduce the spread of the virus by those who have received the vaccine, suggest new analyses by the U.S. Food and Drug Administration. [Source: NY Times]

1404: Women have reported axillary adenopathy after receiving the Pfizer-BioNTech and Moderna COVID-19 vaccines. However, this is also a common symptom of breast cancer. 

Clinicians should, therefore, consider recent COVID-19 vaccination in the differential diagnosis of patients coming with unilateral axillary adenopathy.

Swollen lymph nodes on one side are relatively uncommon and not usually seen on screening mammography. They are evident only 0.02% to 0.04% of the time. This alerts a radiologist to rule out the presence of breast malignancy on that side. 

An article published in Clinical Imaging reports on four cases involving women who received a COVID-19 vaccine and then sought breast screening.

Adenopathy has also been reported with other vaccines, such as the Bacille Calmette-Guérin vaccine, influenza vaccines, and the human papillomavirus vaccine. [Source: Medscape]

1405: A large number of hospitalizations related to COVID-19 in the United States can be attributed to four preexisting cardiometabolic conditions, suggests a new study published online on February 25 in the Journal of the American Heart Association.

Out of 906,849 COVID-19 hospitalizations among US adults as of November 2020, authors estimated that 30% could be attributed to obesity, 26% to hypertension, 21% to diabetes, and 12% to heart failure.

These cardiometabolic conditions accounted for nearly 63.5% of the hospitalizations. the authors stated that these hospitalizations would have been preventable if these conditions were not present.

The authors further estimated that a 10% decline in these four cardiometabolic conditions would have prevented 11.1% of the hospitalizations due to COVID-19.

[Source: Medscape]

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA