With inputs from Dr Monica Vasudev

Tokyo Olympics to be held sans spectators due to surge in delta variant cases

The Tokyo Olympics will be held as scheduled. However, the Games will take place without spectators, according to the organisers, following declaration of a state of emergency in the city in the wake of the rapidly spreading delta variant of Covid-19, which will continue throughout the Games. People will also be asked not to gather for events on public roads, such as the triathlon, though officials said some venues outside the greater Tokyo metropolitan area would allow small numbers of spectators. The Games are due to start on July 23 and will end on August 8 (Source: Medscape).

Fitbit and other wearable devices can assess prolonged physiological changes post-Covid-19

Fitbit detected lasting physiologic effects in Covid-19 patients following their recovery from the infection, according to early data from the ongoing DETECT (Digital Engagement and Tracking for Early Control and Treatment) study that is evaluating the use of Fitbit and other wearable devices to assess prolonged physiological and behavioral changes associated with Covid-19. The study was published online July 7 in JAMA Network Open. The study found “a prolonged physiological impact of COVID-19 infection, lasting approximately 2 to 3 months, on average, but with substantial intraindividual variability, which may reflect various levels of autonomic nervous system dysfunction or potentially ongoing inflammation”.

Individuals with COVID-19 took longer to return to their resting heart rate (RHR), sleep and activity baselines vs symptomatic individuals who were Covid-19 negative. This difference was most marked for RHR, with COVID-19–positive individuals initially experiencing a transient bradycardia followed by a prolonged relative tachycardia that did not return to baseline, on average, until 79 days after symptom onset. Step count and sleep quantity returned to baseline sooner than RHR at 32 and 24 days, respectively (Source: Fitbit stats show lingering physiologic hit after COVID-19 - Medscape - Jul 08, 2021; JAMA Netw Open. 2021;4(7):e2115959)

IL-6 inhibitors reduce mortality in patients with severe or critical Covid-19

Findings from a prospective meta-analysis of 27 randomized trials included almost 11,000 patients show that administration of IL-6 antagonists, compared with usual care or placebo, was associated with lower 28-day all-cause mortality in patients hospitalized for COVID-19. According to the WHO analysis, the risk of dying within 28 days for patients getting one of the arthritis drugs with corticosteroids such as dexamethasone is 21%, compared with an assumed 25% risk among those who got standard care. For every 100 such patients, four more will survive, the WHO said. Moreover, the risk of progressing to mechanical ventilation or death was 26% for those getting the drugs and corticosteroids, compared with 33% in those getting standard care.

On Tuesday (July 6), the WHO has made a strong recommendation to use IL-6 receptor blockers (tocilizumab or sarilumab) in patients with severe or critical COVID-19.

Asymptomatic or mild Covid-19 generate effective and durable neutralising antibody response in children and adolescents

Children and adolescents with asymptomatic or mild symptomatic SARS‑CoV‑2 infection mount “broad, effective, and durable” antibody responses that exhibit “robust” viral neutralising activity for at least 4 months after acute infection. The study published in JCI Insight evaluated humoral immune responses in 69 children and adolescents with asymptomatic or mild symptomatic SARS-CoV-2 infection.

• These antibody responses were associated with virus neutralizing activity that was still detectable 4 months after acute infection in 94% of children.
• Antibody responses and neutralizing activity in sera from children and adolescents were comparable or superior to those observed in sera from 24 adults with mild symptomatic infection

“Our findings suggest that children and adolescents develop effective humoral immune responses irrespective of illness severity that are likely to contribute to protection against reinfection, thereby contributing to the establishment of herd immunity,” said the authors (DG Alerts, July 7, 2021).