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KHUSAB, PUNJAB – A police superintendent has died almost immediately after receiving the COVID-19 vaccine. Malik Imtiaz who was a police superintendent for the city of Khushab received the shot on June 13th and collapsed several minutes later during an event with colleagues. An investigation into his death showed that he died due to a sudden heart attack.
The sudden collapse of the superintendent took his colleagues by surprise as they are seen rushing towards him:
Recently, the World Health Organization (WHO) revealed that in 2020, countries dealing with the onchocerciasis endemic continued to make progress in interrupting transmission of the disease, despite disruptions caused by the COVID-19 pandemic. Many countries were able to implement large-scale treatment campaigns by observing robust COVID-19 risk mitigation measures. Ivermectin continues to produce tremendous results in this fight against river blindness.
“Despite pandemic challenges, health workers managed to deliver ivermectin treatment to more than 112 million people,” said Dr. Daniel Argaw Dagne, Unit head, Prevention, Treatment and Care, WHO Department of Control of Neglected Tropical Diseases. “In current circumstances, this is a remarkable achievement.”
To support the transition from control to elimination and to improve national entomological capacity, WHO is preparing a manual with new techniques and strategies on how to standardize entomological surveys. This will be complemented by research in new diagnostic tools, as diagnosis of onchocerciasis remains a challenge for many national programs.
The integrated approaches advocated in the road map for neglected tropical diseases 2021–2030, supported by activities and messaging for the “Stamp Out Oncho” campaign (launched in 2018), are bound to accelerate onchocerciasis elimination.
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Onchocerciasis is a parasitic infection caused by infection with the filarial nematode Onchocerca volvulus. Infection is transmitted through the bites of black flies of the genus Simulium that breed in rivers and streams. More than 99% of all onchocerciasis cases are in sub-Saharan Africa, but some small foci exist in the Americas and in Yemen.
The risk of onchocerciasis-related blindness or skin disease has been reduced as a result of continued mass drug administration with ivermectin.
Researchers from the North Bristol NHS Trust, Academic Respiratory Unit in Bristol, UK, recently uploaded study results to the medRxiv preprint server. The study team sought to identify if the corticosteroid dexamethasone, proven to reduce COVID-19 mortality in certain hospitalized acute COVID-19 pneumonia scenarios thanks to the RECOVERY trial, could help reduce symptoms associated with long-COVID.
The RECOVERY trial led to a material change in how acute COVD-19 was managed and, according to the study authors, saved approximately 1 million lives worldwide.
Importantly, however, steroids have a downside even if administered on a short-term basis. In the case of the RECOVERY trial, the benefits were constrained to patients requiring oxygen or already on a ventilator as compared to patients less severely affected—the latter could actually be harmed by the regimen.
Long-COVID, also known as post-COVID-19 syndrome, post-acute sequelae of COVID-19 (PASC) or chronic COVID syndrome (CSS) is characterized by long-term sequelae appearing or persisting well after the preliminary infection period associated with SARS-CoV-2. This condition may impact every organ system with sequelae including respiratory disorder, nervous system and neurocognitive disorders, mental health issues, metabolic disorders, and more.
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A recent study covered by TrialSite suggests vaccination doesn’t help stave this condition off if the individual experiences a breakthrough infection. Presently there are no treatments. The total number of COVID-19 patients that end up experiencing long COVID ranges from a range of 10% to 30%. However, one study led by the University of Oxford study revealed about 37% of 273,618 COVID survivors experience the condition.
It turns out that many survivors of acute COVID-19 are afflicted by long COVID.
Conducted at UK hospitals, the study team was able to enroll 198 patients who happened to be admitted with COVID-19 pneumonia all from one particular UK hospital during the period of April 2020 to August 2020. The study authors sought to answer what is the quality of life of those people eight months after COVID-19 hospitalization. Would the use of the corticosteroid reduce or mitigate long COVID symptoms?
Participants were tested positive during polymerase chain reaction (PCR) testing for SARS-CoV-2 or a clinical-radiological test for the novel coronavirus. The exclusion criteria applied to any patients who were either A) already receiving dexamethasone a couple of weeks prior to admission or B) any subjects needing a long-term steroid prescription.
The study subjects, segmented into two cohorts, received six milligrams (mg) of oral dexamethasone one time daily in addition to a control group. The study investigators ensured that both cohorts were balanced in terms of demographics (e.g., age, gender, etc.) in addition to other attributes such as comorbidities and need for ventilation as an example. The authors note that they included more marks in the control group.
For those COVID-19 survivors that endured acute pneumonia, a striking 68% were disclosed to have at least one ongoing problematic symptom eight months after the initial SARS-CoV-2 condition. The study team analyzed results based on the symptoms reported below.
Symptoms at 8-month follow-up comparing dexamethasone group (orange) to no dexamethasone group (green).
The UK-based authors note:
“There are several hypotheses on the pathophysiology of Long Covid including persistence of virus, development of auto-immune disease or a product of organ damage during the acute phase. All might be theoretically affected by steroid use in either positive or negative direction. Reassuringly, this case-control study suggests that dexamethasone given in the acute phase of COVID-19 is associated with reduced long-term symptoms.”
The authors delineate a series of possible explanations for this observation including:
∙ Confounding by indication (those who receive steroids face greater probability to recover regardless of the steroid prescription
∙ Reduce symptomatology may be associated with general improvements in care occurring during the pandemic leading to lower levels of long-term symptoms—but the counterargument here is that there is little evidence to support a reduction in long term symptoms of SARS-CoV-2 infection during the pandemic
∙ Those patients with more severe disease passed away and thus were not available for follow up
∙ This just may be a causal association
There are a number of limitations associated with this study. TrialSite notes the results are not yet peer-reviewed and, thus, it’s not a good practice to cite as evidence.
∙ Small sample size
∙ Analysis limited to patients who needed oxygen during inpatient stay and therefore materially compromised
∙ The authors remind that in RECOVERY dexamethasone “shows a trend toward harm in hospitalized patients not requiring oxygen” thus this analysis should not be a basis to over prescribe dexamethasone.
This case-control study demonstrates that study patients who received oral dexamethasone while hospitalized due to their SARS-CoV-2 infection were less likely to experience persistent symptoms at month 8 of a follow-up.
Part of the British public health system, this health system employs over 8,000 staff delivering healthcare across Southmead Hospital Bristol, Crossham Hospital and the Bristol Centre for Enablement. The health system provides community healthcare and hospital services to Bristol, South Gloucestershire and North Somerset, England. The facility includes an academic medical center as well as clinical trials.
∙ Alice Milne, North Bristol NHS Trust, Academic Respiratory Unit
∙ S. Maskell, North Bristol NHS Trust, Academic Respiratory Unit
∙ Fergus Hamilton, North Bristol NHS Trust, Academic Respiratory Unit
∙ David Arnold, North Bristol NHS Trust, Academic Respiratory Unit
∙ C Sharp, Gloucester Royal Hospital
PAPHOS, CYPRUS – Stephanie Dubois, a British fashion model based in Cyprus, has died 16 days after receiving the AstraZeneca COVID-19 vaccine. Dubois got her shot on May 6th and was hospitalized with breathing difficulties 8 days later. Her health quickly deteriorated and she slipped into a coma before passing away on Saturday, May 22nd.
Stephanie had no underlying health conditions according to health officials at the hospital in Nicosia where she was until her death.
Dubois made a post on Facebook announcing that she was going to receive her first COVID-19 shot on Thursday, May 6th:
She felt “horrendous” hours after the shot:
Her final was post on May 18th where she wrote that she had to undergo a “couple more tests”:
A health service spokesperson for the Cypriot government said that an investigation into her death was launched by the European Medicines Agency (EMA).
LAGUINDINGAN, PHILIPPINES – Four members of the same family have died within a 2 week period after receiving a single dose of the Johnson & Johnson COVID-19 vaccine. The family, whose name is not released, all died in the first ten days of August. The daughter and husband/son-in-law were both vaccinated on July 26th while the parents of the 35-year-old daughter got vaccinated on July 27th.
The 35-year-old daughter died on August 1st while her 37-year-old husband died five days later on August 6th. One of her parents died in hospital three days after admission on August 8th. The other parent died two days later on August 10th.
The two couples lived in separate houses in a compound in the municipality of Laguindingan.
The Philippines Department of Health (DoH) announced that they have launched an investigation into the sudden deaths of the four family members.
KHUSAB, PUNJAB – A police superintendent has died almost immediately after receiving the COVID-19 vaccine. Malik Imtiaz who was a police superintendent for the city of Khushab received the shot on June 13th and collapsed several minutes later during an event with colleagues. An investigation into his death showed that he died due to a sudden heart attack.
CALGARY, CANADA – A 40-year-old man has been diagnosed with Guillain-Barre syndrome just 11 days after receiving the AstraZeneca COVID-19 vaccine. Matthew Dawe received his shot on April 23rd and was hospitalized 10 days later with severe numbness and tingling in his body. A day later, a neurologist at the hospital diagnosed him with GBS.
Dawe was walking his dog about ten days after receiving the AstraZeneca vaccine when his feet went numb. Within hours, he was in the ER, slowly losing function in different parts of his body.
“My life is going to be invariably changed because of the decision to try and support the greater health of the community. And the relatively low probability of getting this, messes with your head a bit, right?
You don’t know where it’s going to stop.”
