With input from Dr Monica Vasudev

1076:  Patients with COVID-19 and obesity [BMI > 30 kg/m²] have a higher viral load and the virus may persist for longer

In a large multicentre trial, those with a BMI <25 kg/m² and COVID-19 took around 14 days to recover completely, those with BMI 25-30 kg/m² took around 17 days, and those with a BMI > 30 kg/m² took nearly 19-20 days.

Dror Dicker, MD, from Hasharon Hospital, Petah Tikva, Israel, presented the preliminary results of the work at the opening plenary of the virtual European and International Congress on Obesity (ECOICO) 2020. 

While addressing if patients with obesity are more contagious than those without, the research revealed that the COVID-19 status of individuals with a BMI > 30 kg/m²  became negative 5 days later compared to those with a BMI < 25 kg/m² (considered a healthy weight).

Obese patients have a higher viral load, stated Dicker.

In adipose tissue, the ACE2 levels are higher.

[Source: Medscape]

1077: 85% of a Seattle fishing boat crew got infected on board with COVID-19 in May

The crew had tested negative for infection and had blood drawn before departure.

On return, the three people who had neutralizing antibodies prior to departure were not infected on the ship.

• How long are COVID-19 antibodies protective? It is based on the titers, or the concentration of antibodies, in a person’s blood.
• Individuals with more severe COVID-19 infection probably have more antibodies, which could possibly protect them from reinfection for a year or beyond. Milder infections lead to fewer antibodies and could possibly protect for up to 6 months.
• Nearly 10% of people dont exhibit a very strong immune response in mild infection. Those people would have a much higher risk for reinfection. Those reinfections are usually milder and the people are asymptomatic.
• Virus is always mutating. It undergoes two mutations a month. COVID-19 has been around for 10 months in people. Influenza, RSV, other respiratory viruses, and have been circulating in people for hundreds of years or in different animal hosts that can infect people.
• Across the whole antibody and clinical lab spectrum, there are two different antigens - the nucleocapsid, which wraps the genome, and the spike protein, which binds the cells.
• Most of the tests done in the United States are done against the nucleocapsid, as it is the most sensitive assay.
• We need antibody tests that show that spike, the outside glycoprotein from the virus that is associated with attachment and entry.
• But this is not what current labs are doing. The market is 75%-80% nucleocapsid, and only 20% spike.
• For the receptor-binding domain, we look at the outside of the spike, the part that binds the receptor.

[Source: Medscape] 

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA