Healing America
By Terrain Health
Healing AmericaApr 27, 2020
Doctors That Listen
Good News, Bad News in the COVID-19 Wars
Dr. Robin Rose and Aaron Cohen break down the week in SARS-COV-2 with a story about an extraordinary new wearable medical device created at Northwestern University and the emergence of Pediatric Multi-System Inflammatory Syndrome -- the first Covid-19 complication associated exclusively with children.
Articles to read: Wearable Device from Northwestern.
Do COVID-19 Antibody Tests Even Work?
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Show Notes:
1. If you have antibodies how long does that immunity last for
2. Tests are inaccurate- low sensitivity and specificity: False positives- some over 3% (upwards of 14%), while only 3-5% of the country have only likely been infected- giving people the false sense that they had the virus and or have immunity
3. Giving people a false sense of security- because they don’t tell you what type of antibodies you have? The ones that are neutralizing vs non-neutralizing- you need the neutralizing type to confer immunity.
4. Percentage of population not even mounting an immune response- talk about moy SIL and nephew
5. How robust is the immune response?
6. Are these antibodies able to distinguish between COVID and other coronaviruses
7. Antibody tests will help epideimiologists but aren’t as useful for individuals
Why Your Weight Matters Now More Than Ever
In this episode, we examine several studies at the intersection of COVID-19 and obesity. Here are the detailed show notes that we used during the conversation:
First Study:
A recent study published in JAMA of 5700 patients hospitalized with confirmed COVID-19 in New York revealed a 21% mortality rate among the 2634 patients whose outcomes were known at study end.
The most common comorbidities among all 5700 patients were hypertension (57%), obesity (41%), and diabetes (34%). As has been seen in other patient series, male sex and increasing age were associated with a higher risk for death.
Of patients receiving mechanical ventilation and whose outcomes (discharge or death) were known, 88.1% died. When stratified by age, the mortality rates for ventilated patients were 76.4% for those aged 18 to 65 years and 97.2% for those older than 65 years.
Among those who did not require mechanical ventilation and whose outcomes (discharge or death) were known, 19.8% of patients aged 18 to 65 years died, as did 26.6% of those older than 65 years. No patient under 18 years died during the study period.
Two new studies from NYU Langone Health
The second study found that of the 3,615 individuals who tested positive for COVID-19 in their series, 775 (21%) had a BMI of 30-34, and 595 (16%) had a BMI of at least 35. Obesity was NOT a predictor of admission to the hospital or the ICU in those over the age of 60 years, but in those younger than 60 years, it was.
Obesity in under patients under 60 y/o at least doubles risk of hospital admission in U.S.:
Those under age 60 with a BMI of 30-34 were twice as likely to be admitted to hospital (hazard ratio, 2.0; P < .0001) and critical care (HR, 1.8; P = .006), compared with those under age 60 with a BMI less than 30. Likewise, those under age 60 with a BMI of at least 35 were 2.2 (P < .0001) and 3.6 (P < .0001) times more likely to be admitted to acute and critical care, respectively.
The CDC defines an adult (a person aged 20 years or greater) with a body mass index (BMI) of 30 or greater as obese, and an adult with a BMI of 25.0 to 29.9 as overweight. Obesity in adults is divided into three categories. Adults with a BMI of 30 to 34.9 have class 1 obesity; adults with a BMI of 35 to 39.9 have class 2 obesity; adults with a BMI of 40 or greater have class 3 obesity, which is also known as extreme or severe obesity.