No, Mouthwash and Nasal Rinses Aren’t Cures for COVID-19

 New research examined if mouthwashes, antiseptics, and a nasal rinse were effective ways to kill a virus very similar to COVID-19.

• The study found that some of these products can be effective against a type of human coronavirus under lab-controlled conditions.
• However, experts say human trials with people with COVID-19 are needed to confirm how effective they would be at reducing the spread of the virus between people.
• Experts also say that mouthwash or nasal rinses are no substitute for using a mask to prevent the spread of COVID-19.

A new study from Penn State University suggests that commonly available oral antiseptics, mouthwashes, and nasal rinses might inactivate human coronaviruses, reducing risk of transmission.

“We were looking for a simple over-the-counter (OTC) procedure to lower the transmission of coronavirus,” study author Craig Meyers, PhD, and a professor at Penn State University told Healthline. “A procedure that did not differ from the standard use.”

The findings indicate that some OTC products may be effective at reducing the amount of coronavirus present in people’s mouths — potentially reducing spread of the virus that causes COVID-19.

The study was published in the Journal of Medical Virology.

According to Meyers, the results were surprising on two counts, “The first was how well certain products inactivated the virus. Second, how some products, those containing 1.5 percent hydrogen peroxide, had no effect.”

“It definitely is an eye-opener,” agreed Dr. Nikhil Bhayani, an infectious disease physician with Texas Health Resources.

What’s important to know about this study

While the nasal and oral cavities are major points of entry and transmission for coronaviruses, Meyers and team used a test to replicate how the virus interacted with rinses and mouthwashes.

The virus analyzed was human coronavirus 229e (HCoV-229e) and not the novel coronavirus SARS-CoV-2 that causes COVID-19. There were also no human participants involved in this research.

This study consisted of treating solutions that contained HCoV-229e, which was readily available and genetically similar to SARS-CoV-2.

Researchers introduced different hydrogen peroxide antiseptic rinses and various brands of mouthwash into the coronavirus solution and allowed them to interact with the virus for 30 seconds, 1 minute, and 2 minutes, before they diluted the solution to prevent any further virus deactivation.

Not the first study of mouthwash and coronavirus

Meyers’ findings add to previous research looking at how effective oral rinses can be to inactivate human coronavirus.

Although that study, published in The Journal of Infectious Diseases, also relied on lab-controlled conditions and didn’t specifically investigate SARS-CoV-2.

However, Meyers and team used longer contact times and OTC nasal and oral rinses not evaluated before, and he considers human trials on COVID-19-positive patients essential to confirm the findings.

“With this said, human clinical trials are still needed,” said Meyers. “But again the data suggests that we do something we already should probably [be] doing that is simple and safe.”

Those clinical trials are currently underway.

According to Bhayani, while he thinks the findings are plausible, there are important questions that need to be answered, such as: At what stage of infection would oral or nasal rinses reduce the risk of transmission?

A baby shampoo nasal rinse

Strangely, a baby shampoo-based nasal rinse showed significant virus-killing ability.

“A 1% baby shampoo nasal rinse solution inactivated HCoV greater than 99.9% with a 2‐min contact time,” the study authors wrote.

The OTC mouthwash/gargle products investigated included Listerine and Listerine-like products which were “highly effective at inactivating infectious virus with greater than 99.9% even with a 30‐s [second] contact time.

The Penn State researchers also pointed to studiesTrusted Source showing that baby shampoo has been found to be safe and effective to treat chronic rhinosinusitis (an inflammation of the nasal tissues).

When asked if antiseptics that kill coronaviruses in the mouth, throat, and nasal cavity could help delay or even prevent infection by SARS-CoV-2, Bhayani agreed that it might help “reduce the viral burden lowering the risk of transmission.”

Source: Healthline

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Newborns: improving survival and well-being

 Key facts

• Although the global number of newborns deaths declined from 5 million in 1990 to 2.4 million in 2019, children face the greatest risk of death in their first 28 days.
• In 2019, 47% of all under-5 deaths occurred in the newborn period with about one third dying on the day of birth and close to three quarters dying within the first week of life.
• Children who die within the first 28 days of birth suffer from conditions and diseases associated with lack of quality care at birth or skilled care and treatment immediately after birth and in the first days of life.
• Preterm birth, intrapartum-related complications (birth asphyxia or lack of breathing at birth), infections and birth defects cause most neonatal deaths.
• Women who receive midwife-led continuity of care (MLCC) provided by professional midwives, educated and regulated to internationals standards, are 16% less likely to lose their baby and 24% less likely to experience pre-term birth.

Who is most at risk?

Globally 2.4 million children died in the first month of life in 2019. There are approximately 7 000 newborn deaths every day, amounting to 47% of all child deaths under the age of 5-years, up from 40% in 1990.

The world has made substantial progress in child survival since 1990. Globally, the number of neonatal deaths declined from 5.0 million in 1990 to 2.4 million in 2019. However, the decline in neonatal mortality from 1990 to 2019 has been slower than that of post-neonatal under-5 mortality The share of neonatal deaths among under-five deaths is still relatively low in sub-Saharan Africa (36 per cent), which remains the region with the highest under-five mortality rates. In Europe and Northern America, which has one of the lowest under-five mortality rates among SDG regions, 54 per cent of all under-five deaths occur during the neonatal period. An exception is Southern Asia, where the proportion of neonatal deaths is among the highest (62 per cent) despite a relatively high under-five mortality rate.

Sub-Saharan Africa had the highest neonatal mortality rate in 2019 at 27 deaths per 1,000 live births, followed by Central and Southern Asia with 24 deaths per 1,000 live births. A child born in sub-Saharan Africa or in Southern Asia is 10 times more likely to die in the first month than a child born in a high-income country.

Causes

The majority of all neonatal deaths (75%) occurs during the first week of life, and about 1 million newborns die within the first 24 hours. Preterm birth, intrapartum-related complications (birth asphyxia or lack of breathing at birth), infections and birth defects cause most neonatal deaths in 2017. From the end of the neonatal period and through the first 5 years of life, the main causes of death are pneumonia, diarrhoea, birth defects and malaria. Malnutrition is the underlying contributing factor, making children more vulnerable to severe diseases.

Priority Strategies

The vast majority of newborn deaths take place in low and middle-income countries. It is possible to improve survival and health of newborns and end preventable stillbirths by reaching high coverage of quality antenatal care, skilled care at birth, postnatal care for mother and baby, and care of small and sick newborns. In settings with well-functioning midwife programmes the provision of midwife-led continuity of care  (MLCC) can reduce preterm births by up to 24%. MLCC is a model of care in which a midwife or a team of midwives provide care to the same woman throughout her pregnancy, childbirth and the postnatal period, calling upon medical support if necessary. With the increase in facility births (almost 80% globally), there is a great opportunity for providing essential newborn care and identifying and managing high risk newborns.  However, few women and newborns stay in the facility for the recommended 24 hours after birth, which is the most critical time when complications can present. In addition, too many newborns die at home because of early discharge from the hospital, barriers to access and delays in seeking care. The four recommended postnatal care contacts delivered at health facility or through home visits play a key role to reach these newborns and their families.

Accelerated progress for neonatal survival and promotion of health and wellbeing requires strengthening quality of care as well as ensuring availability of quality health services or the small and sick newborn.

 Source: World Health Organization

Steroids boost survival of preterm babies in low-resource settings, new study finds

 Accurate pregnancy dating and quality care combined with the steroids are key to survival

The results of a new clinical trial, published today in the New England Journal of Medicine, show that dexamethasone—a glucocorticoid used to treat many conditions, including rheumatic problems and severe COVID-19— can boost survival of premature babies when given to pregnant women at risk of preterm birth in low-resource settings.

The WHO ACTION-I trial resolves an ongoing controversy about the efficacy of antenatal steroids for improving preterm newborn survival in low-income countries. Dexamethasone and similar drugs have long shown to be effective in saving preterm babies lives in high-income countries, where high-quality newborn care is more accessible. This is the first time a clinical trial has proven that the drugs are also effective in low-income settings.

The impact is significant: for every 25 pregnant women treated with dexamethasone, one premature baby’s life was saved. When administered to mothers at risk of preterm birth, dexamethasone crosses the placenta and accelerates lung development, making it less likely for preterm babies to have respiratory problems at birth.

“Dexamethasone is now a proven drug to save babies born too soon in low-income settings,” says Dr Olufemi Oladapo, head of maternal and perinatal health unit at WHO and HRP, and one of the coordinators of the study. “But it is only effective when administered by health-care providers who can make timely and accurate decisions, and provide a minimum package of high-quality care for both pregnant women and their babies.”

Globally, prematurity is the leading cause of death in children under the age of 5. Every year, an estimated 15 million babies are born too early, and 1 million die due to complications resulting from their early birth. In low-income settings, half of the babies born at or below 32 weeks die due to a lack of feasible, cost-effective care.

The study notes, healthcare providers must have the means to select the women most likely to benefit from the drug and to correctly initiate the treatment at the right time – ideally 48 hours before giving birth to give enough time to complete steroid injections for maximal effect. Women who are in weeks 26-34 of their pregnancy are most likely to benefit from the steroid, so healthcare providers must also have access to ultrasound to accurately date their pregnancies. In addition, babies must receive sufficiently good-quality care when they are born.

“When a minimal package of care for newborn babies – including management of infection, feeding support, thermal care and access to a CPAP machine to support respiration – is in place in low-income countries, antenatal steroids such as dexamethasone can help to save preterm babies’ lives,” says Dr Rajiv Bahl, head of the newborn health unit at WHO and one of the study coordinators.

Conducted from December 2017–November 2019, the randomized trial recruited 2852 women and their 3070 babies from 29 secondary and tertiary level hospitals in Bangladesh, India, Kenya, Nigeria, and Pakistan. Beyond finding a significantly lower risk of neonatal death and stillbirth, the study also found there was no increase in possible maternal bacterial infections when treating pregnant women with dexamethasone in low-resource settings.

Source: World Health Organization

 

New coronavirus vs. flu

COVID-19 and the flu can cause similar symptoms. However, there are several differences between them.

The novel strain of coronavirus (SARS-CoV-2) causes coronavirus disease 19 (COVID-19).

Both COVID-19 and the flu are respiratory illnesses that spread from person to person. This article will discuss the differences between COVID-19 and the flu.

Symptoms

The symptoms of the flu and COVID-19 have some differences.

People who have the flu will typically experience symptoms within 1–4 days. The symptoms for COVID-19 can develop between 1–14 days. However, according to 2020 research, the median incubation period for COVID-19 is 5.1 days.

As a point of comparison, the incubation period for a cold is 1–3 days.

The symptoms of COVID-19 are similar in both children and adults. However, according to the Centers for Disease Control and Prevention (CDC), children typically present with fever and mild, cold-like symptoms, such as a runny nose and a cough.

The following table outlines the symptoms of COVID-19, the flu, and a cold.t

Severity and mortality

The symptoms of COVID-19 and flu can range from mild to severe. Both can also cause pneumonia.

It is important to note that the World Health Organization (WHO) have classified mild symptoms of COVID-19 to mean that a person will not require hospitalization. The WHO classify mild cases to consist of symptoms including:

• fever
• cough
• fatigue
• loss of appetite
• sore throat
• headache

The CDC also lists the following as potential symptoms:

• breathlessness
• muscle pain
• chills
• new loss of taste or smell

According to the WHO, around 15% of COVID-19 cases are severe, and 5% are critical. Those in a critical state require a ventilator to breathe. The chance of severe and critical infection is higher with COVID-19 than the flu.

COVID-19 is also more deadly. According to the WHO, the mortality rate for COVID-19 appears to be higher than that of the flu.

Compared with the flu, research on COVID-19 is still in its early stages. These estimates may change over time.

Transmission

Both SARS-CoV-2 and the flu virus can spread through person to person contact.

Tiny droplets containing the viruses can pass from someone with the infection to someone else, typically through the nose and mouth through coughing and sneezing.

The virus can also live on surfaces. The WHO is not sure exactly how long the virus can survive, but it could be days.

According to the CDC, people can transmit the flu virus to people who are 6 feet (ft) away. According to the WHO, people should stay at least 6 ft away from anyone coughing or sneezing to help prevent the transmission of the SARS-CoV-2 infection.

According to the WHO, the speed of transmission differs between the two viruses. The symptoms of flu appear sooner, and it can spread faster than the SARS-CoV-2 virus.

The organization also indicate that people with flu can pass the virus on before they show any symptoms. A person can also pass on the SARS-CoV-2 infection even if they have no symptoms.

There are also differences in transmission between children and adults.

According to the WHO, the transmission of the flu from children to adults is common. However, based on early data it appears that it is more common for adults to pass the SARS-CoV-2 infection onto children. Children are less likely to develop symptoms.

Source: Medical News Today

How does coronavirus affect the body?

 

Coronaviruses typically affect the respiratory system, causing symptoms such as coughing and shortness of breath. Some people, including older adults, are at risk of severe illness from these viruses.

Coronaviruses are present in many species of animals, such as camels and bats. Mutations of the virus can infect humans.

Previous outbreaks of diseases that coronaviruses have caused in humans have been severe. They typically spread rapidly and can cause death in some people.

One example is severe acute respiratory syndrome (SARS), which caused a pandemic in 2002. There were around 8,439 cases and 812 deaths as a result of the virus.

The outbreak of the disease known as COVID-19 is the result of the novel coronavirus, now renamed SARS-CoV-2, that has spread rapidly across many parts of the world.

As of March 25, 2020, there were around 424,048 cases of COVID-19 and 18,946 deaths.

This article will discuss how coronaviruses affect the body, possible complications, and treatments.

Effects on the body

Viruses work by hijacking cells in the body. They enter host cells and reproduce. They can then spread to new cells around the body.

Coronaviruses mostly affect the respiratory system, which is a group of organs and tissues that allow the body to breathe.

Respiratory illnesses affect different parts of this respiratory system, such as the lungs. A coronavirus typically infects the lining of the throat, airways, and lungs.

Early symptoms of coronavirus may include coughing or shortness of breath. In some cases, it can cause severe damage to the lungs.

For example, some people might develop acute respiratory distress syndrome, leading to severe breathing difficulties.

Usually, the immune system will identify and respond to coronavirus early by sending special proteins, or antibodies, to fight the infection.

The immune response to infection has side effects for the body, including fever. During an infection, white blood cells release pyrogens, a substance that causes fever.

A temperature of greater than 100.4°F from an oral thermometer indicates a fever.

Sometimes other symptoms will occur alongside a fever, including:

• breathlessness
• a cough
• muscle pain
• a sore throat
• a headache
• chills
• new loss of taste or smell

These symptoms will usually last until the body fights off the coronavirus.

Symptoms might not show up straightaway. For example, people with COVID-19 may get symptoms 2 to 14 days after infection.

Risks and complications

Coronavirus can have severe complications, such as pneumonia.

Pneumonia occurs if the virus causes infection of one or both lungs. The tiny air sacs inside the lungs can fill with fluid or pus, making it harder to breathe.

Coronavirus can also damage the heart, liver, or kidneys. In some people, it will affect the blood and immune system. For example, COVID-19 can cause heart, renal, or multiple organ failure, resulting in death.

Some people are more at risk of severe complications than others. The risk can increase for those with an underlying health condition, such as:

• serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
• kidney disease
• chronic obstructive pulmonary disease (COPD)
• obesity, which occurs in people with a body mass index (BMI) of 30 or higher
• sickle cell disease
• a weakened immune system from a solid organ transplant
• type 2 diabetes

Older adults are also at risk of severe illness from coronavirus. Other groups at risk include:

• people with HIV
• pregnant women
• people with asthma

Treatment

Antiviral drugs are a common method of treating viruses. These drugs kill or prevent the spread of viruses through cells in the body. However, there are currently no antiviral drugs for treating coronavirus.

Due to the COVID-19 pandemic, researchers around the world are now working on new treatments and vaccines for coronavirus.

Treatment is not always necessary if symptoms are mild. If a person has no risk factors that affect the respiratory or immune systems, their body may successfully fight the infection without medication or intervention.

For mild cases, doctors may suggest using various over-the-counter medications to treat symptoms. For example, acetaminophen, also known as paracetamol, might be helpful for some people.

In more severe cases, treatment in hospitals could include ventilators to support breathing. Antibiotics might help reduce the risk of bacterial pneumonia.

Outlook

Coronavirus effects on the body include respiratory symptoms and signs of infection, such as coughing, fever, and fatigue.

In some people, coronaviruses can cause severe illness. Factors that affect the risk include:

• older age
• underlying health conditions, such as diabetes
• HIV
• asthma
• pregnancy

People at risk of severe illness should seek immediate medical attention for signs of COVID-19. These include:

• sudden cough
• high temperature
• shortness of breath

Source: Medical News Today

Study identifies 3 existing drugs that may help treat COVID-19

 

A team of researchers has identified three repurposed drugs that may be effective in treating COVID-19.

In a new study, scientists have found three previously-available drugs that may be effective at treating COVID-19 in its early stages.

The research, which appears in the journal ACS Pharmacology & Translational Science, is valuable in helping researchers identify treatment candidates for clinical trials.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

COVID-19 treatments

SARS-CoV-2 and its associated disease, COVID-19, have had a profoundly negative effect on global economies, culture, people’s everyday lives, and above all, on people’s health.

To date, there have been more than 1,150,000 recorded deaths from the disease. There is also mounting anecdotal evidence of the long-term negative health effects it can have on people who recover from the initial illness.

Due to COVID-19’s lethality, and the fact that the disease is highly contagious, scientists are rushing to develop a vaccine. However, producing vaccines that are also safe and effective takes a considerable amount of time.

According to a report in The Lancet, on average, vaccines take 10 years to develop. Even with experts greatly accelerating research due to the urgency of the global pandemic, the report notes that an initial vaccine may take more than 18 months to be developed, manufactured, and distributed to people around the world.

Consequently, scientists have been researching vaccines and potential treatments that may ultimately reduce the chance of a person dying if they develop the disease.

This typically involves repurposing previously available drugs that may also be effective in treating COVID-19. This is important as, much like developing a working vaccine, finding new drugs that can treat COVID-19 may take a long time.

To date, the only repurposed drug that has shown signs of being effective is remdesivir, originally developed to treat Ebola in 2014.

However, a recent major World Health Organization (WHO) study has found that remdesivir has no significant effect on COVID-19 mortality.

As a consequence, identifying effective drugs that experts can repurpose to treat COVID-19 is particularly pressing.

Alternative approach

In this context, scientists behind the present study took a different approach in the search for potentially effective drugs to repurpose.

Typically, when scientists source drugs to repurpose, they use a technique called high throughput screening (HTS). This involves automating the testing of many different medications, allowing for a much more rapid process than using human teams. Researchers then analyze the results with a computer.

However, according to the current study team, there may be issues with HTS’s reliability and accuracy. Drawing on an article in the journal Patterns, they note that there has been little overlap in the potentially effective drugs identified in HTS studies.

Instead, in their study, the scientists used a ligand-based virtual screening (LBVS) protocol to identify drugs that may act similarly to the drug hydroxychloroquine.

Studies show hydroxychloroquine is effective against SARS-CoV-2 in test-tube experiments, even if it is unlikely to be effective in real life.

Importantly, the scientists verified their findings in test-tube experiments and then had their results independently tested to ensure their findings were accurate.

Source: Medical News Today

 

Researchers get to the roots of chronic stress and depression

 

A study in mice provides clues about the common molecular origins of chronic stress and depression. The discovery could inform new treatments for mood disorders.

Millions of years ago, our ancestors evolved the physiological responses needed to survive in the face of sudden threats from rivals and predators.

The release of hormones, including epinephrine (adrenaline), noradrenaline (nor epinephrine), and the steroid hormone cortisol, trigger these “fight-or-flight” stress responses.

However, sustained or chronic stress that does not resolve when the immediate threat passes is a major risk factor for the development of mood disorders such as anxiety and depression.

Traumatic experiences, for example, in military combat, can also damage the body’s ability to regulate its stress responses, causing post-traumatic stress disorder.

People with these mood disorders have abnormally high and sustained stress hormone levels, which puts them at an increased risk of developing cardiovascular disease.

Researchers at the Karolinska Institutet in Stockholm, Sweden, suspected that a protein called p11 plays a pivotal role in damping down stress responses in healthy brains after an acute threat has passed.

 

Serotonin signal boost

Their previous research found that p11 enhances the effect of the hormone serotonin, which regulates mood and has a calming effect.

Unusually low levels of p11 have been found in the brains of people with depression and in individuals who died by suicide.

Mice with reduced p11 levels also show depression and anxiety-like behaviors. In addition, three different classes of antidepressants that are effective in humans increase levels of this protein in the animals’ brains.

Now the Karolinska researchers have discovered that reduced p11 levels in the brains of mice make the animals more sensitive to stressful experiences.

The scientists also demonstrated that the protein controls activity in two distinct stress signaling pathways in the brain. It reduces not only the release of cortisol via one pathway but also adrenaline and noradrenaline via the other.

“We know that an abnormal stress response can precipitate or worsen depression and cause anxiety disorder and cardiovascular disease,” says first author Vasco Sousa. “Therefore, it is important to find out whether the link between p11 deficiency and stress response that we see in mice can also be seen in patients.”

The study, which appears in the journal Molecular Psychiatry, was a collaboration between the Karolinska Institutet and researchers at VU University in Amsterdam, The Netherlands.

 

Knockout mice

To investigate the role of p11 in stress responses, the scientists bred “knockout” mice that lack the gene that makes this protein.

They compared their behavior with normal mice using a variety of standard tests. These suggested that those without p11 experienced heightened stress and anxiety.

For example, in one test, mice pups were separated from their mothers for 3 hours a day. The researchers found that pups lacking p11 produced more high-pitched distress calls, known as ultrasonic vocalizations, compared with normal pups.

In another test of anxiety-like behavior, the team gave the adult mice a choice of spending time in a brightly lit area or a dark space. Mice that were deficient in p11 chose to spend less time in the brightly lit area compared with normal mice.

In addition, their heart rates took longer to return to normal after a stress-provoking stimulus.

The scientists also monitored stress hormone levels in the animals, revealing hyperactivity in two distinct stress pathways in the mice that lacked p11.

One such pathway, called the sympathetic-adrenal-medullary (SAM) axis, is responsible for the immediate surge in adrenaline and noradrenaline that occurs in frightening situations, triggering physiological changes such as increased heart rate.

The other pathway, known as the hypothalamus-pituitary-adrenocortical (HPA) axis, responds slightly less quickly and leads to the release of cortisol. This stress hormone raises blood sugar levels, among other metabolic changes, and suppresses functions that the body does not need for the fight-or-flight response.

Source: Medical News Today

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