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Mechanism behind deadly fungal infection on top of influenza or Covid-19 deciphered

Over 15 per cent of all critically ill patients who end up in intensive care with severe influenza or Covid-19 additionally develop aspergillosis, a pulmonary…

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Over 15 per cent of all critically ill patients who end up in intensive care with severe influenza or Covid-19 additionally develop aspergillosis, a pulmonary fungal infection. This doubles their mortality rate. A UZ Leuven and KU Leuven trial with international partners has revealed that multiple dysfunctions of the immune response lie at the basis of higher susceptibility to fungal infections. These insights were published in The Lancet Respiratory Medicine and constitute an important first step towards increasing the survival rate of patients with these severe lung infections.

Credit: UZ Leuven

Over 15 per cent of all critically ill patients who end up in intensive care with severe influenza or Covid-19 additionally develop aspergillosis, a pulmonary fungal infection. This doubles their mortality rate. A UZ Leuven and KU Leuven trial with international partners has revealed that multiple dysfunctions of the immune response lie at the basis of higher susceptibility to fungal infections. These insights were published in The Lancet Respiratory Medicine and constitute an important first step towards increasing the survival rate of patients with these severe lung infections.

Every year, hundreds of thousands of people worldwide end up in intensive care with influenza or Covid-19. About 15 per cent of them develop an additional lung infection with the common fungus Aspergillus (aspergillosis). In healthy people, this infection hardly ever leads to illness. For critically ill patients with an underlying influenza or Covid-19 infection, however, aspergillosis can be deadly: the fungus can start to grow in the tissue of their respiratory tract and lungs and cause irreversible damage. The mortality rate of these patients becomes 40%-50%, about twice as high as that of ICU patients who only have severe influenza or Covid-19.

Compromised immune system

To find out why some patients with severe influenza or Covid-19 also develop aspergillosis and what to do about it, UZ Leuven and KU Leuven researchers set up an observational study, together with international colleagues. The study uncovered part of the mechanism that opens the door to an additional fungal infection in patients with an influenza or coronavirus infection.

Prof. dr. Joost Wauters (UZ Leuven/KU Leuven), intensivist at UZ Leuven and the principal investigator of the study, explained: “We discovered that, in patients with serious influenza or Covid-19 who develop this type of fungal infection, the innate immune system had been affected in various areas. Their immune cells, which in healthy people are responsible for eliminating fungal spores in the lungs, were compromised. Furthermore, the white blood cells that would normally clean up fungal hyphae did not seem to function properly in those influenza or Covid-19 patients. It was surprising to see that partly similar deviating immune processes come into play in both Covid-19 and influenza.”

Dr. Simon Feys, internist in training at UZ Leuven and doctoral researcher at KU Leuven, added: “In tissue stainings, we also saw that the corona or influenza virus affects the epithelium of the lungs. This is the layer of cells that lines the respiratory tract and lung tissue, which forms the first barrier against infections. For Covid-19, we were able to show that specifically in the locations where the virus affects the epithelium, the fungus also penetrates the tissue.”

Therapeutic target

Johan Van Weyenbergh (KU Leuven Rega Institute), PhD, who is the co-lead of the study, said: “With this information, we can develop biomarkers that help to predict which patients are more susceptible to a fungal infection and therefore need close follow-up.”

Professor Agostinho Carvalho (University of Braga, Portugal), who also co-led the study, added:  “Our results also lead the way for further research into medication that can repair the affected processes of the immune system and, as a result, suppress the fungal infection.”

More about the study

The study was performed using lung samples of 169 patients with influenza or Covid-19, with or without aspergillosis. Most of the samples were collected over the last couple of years via bronchoalveolar lavage, a classical diagnostic technique for suspected lung infections, and stored in the Leuven biobank.

In 2018, Professor Joost Wauters and his team were the first to report the dangerous combination of aspergillosis and influenza, which led to worldwide vigilance in intensive care units. The current follow-up study now uncovers the mechanism, which will pave the way for the development of biomarkers and modified treatments for patients with this double infection. The corona pandemic made it interesting to include the samples of patients with Covid-19 as well as samples of patients with influenza.

The study was performed in collaboration with various research groups of KU Leuven and UZ Leuven, as well as researchers from ZNA (Belgium), the University of Braga (Portugal), the Max Planck Research Unit for Neurogenetics in Frankfurt (Germany), CHU Amiens-Picardie (France) and the Radboud Universiteit in Nijmegen (The Netherlands). The study was part of the Horizon 2020 HDM-FUN project. 

Journal

The Lancet Respiratory Medicine

DOI

10.1016/S2213-2600(22)00259-4

Method of Research

Observational study

Subject of Research

People

Article Title

Lung epithelial and myeloid innate immunity in influenza associated or COVID-19-associated pulmonary aspergillosis: an observational study

Article Publication Date

24-Aug-2022

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Raining cats and dogs: research finds global precipitation patterns a driver for animal diversity

Since the HMS Beagle arrived in the Galapagos with Charles Darwin to meet a fateful family of finches, ecologists have struggled to understand a particularly…

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October 24, 2023

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Since the HMS Beagle arrived in the Galapagos with Charles Darwin to meet a fateful family of finches, ecologists have struggled to understand a particularly perplexing question: Why is there a ridiculous abundance of species some places on earth and a scarcity in others? What factors, exactly, drive animal diversity?

Credit: Wikimedia

Since the HMS Beagle arrived in the Galapagos with Charles Darwin to meet a fateful family of finches, ecologists have struggled to understand a particularly perplexing question: Why is there a ridiculous abundance of species some places on earth and a scarcity in others? What factors, exactly, drive animal diversity?

With access to a mammoth set of global-scale climate data and a novel strategy, a team from the Department of Watershed Sciences in Quinney College of Natural Resources and the Ecology Center identified several factors to help answer this fundamental ecological question. They discovered that what an animal eats (and how that interacts with climate) shapes Earth’s diversity.

The work was recently published in the high-impact journal Ecology Letters.

“Historically studies looking at the distribution of species across Earth’s latitudinal gradient have overlooked the role of trophic ecology — how what animals eat impacts where they are found,” said Trisha Atwood, author on the study from the Department of Watershed Sciences and the Ecology Center. “This new work shows that predators, omnivores and herbivores are not randomly scattered across the globe. There are patterns to where we find these groups of animals.”

Certain locations have an unexpected abundance of meat-eating predators — parts of Africa, Europe and Greenland. Herbivores are common in cooler areas, and omnivores tend to be more dominant in warm places. Two key factors emerged as crucial in shaping these patterns: precipitation and plant growth.

Precipitation patterns across time play a big role in determining where different groups of mammals thrive, Atwood said. Geographical areas where precipitation varies by season, without being too extreme, had the highest levels of mammal diversity.

“Keep in mind that we aren’t talking about the total amount of rain,” said Jaron Adkins, lead author on the research. “If you imagine ecosystems around the world on a scale of precipitation and season, certain places in Utah and the Amazon rainforest fall on one end with low variability — they have steady levels of precipitation throughout the year. Other regions, like southern California, have really high variability, getting about 75 percent of the annual precipitation between December and March.”

But the sweet spot for predators and herbivores fell in a middle zone between the two extremes, he said. Places like Madagascar, where precipitation patterns had an equal split between a wet season and a dry one (six months each), had the ideal ecological cocktail for promoting conditions for these two groups. Omnivore diversity tends to thrive in places with very stable climates.

The second important factor connected with mammal diversity the work uncovered was a measure of the amount of plant growth in an area, measured as “gross primary productivity.”

“It makes intuitive sense for plant-eating animals to benefit from plant growth,” Adkins said.

But this measure actually impacted carnivores most, according to the research. The strong relationship between predators and plant growth highlights the importance of an abundance of plants on an entire food chain’s structural integrity.

“It was surprising that this factor was more important for predators than omnivores and herbivores,” Atwood said. “Why this is remains a mystery.”

Although evolutionary processes are ultimately responsible for spurring differences in species, climate conditions can impact related factors — rates of evolutionary change, extinction and animal dispersal — influencing species and trait-based richness, according to the research.

Animal diversity is rapidly declining in many ecosystems around the world through habitat loss and climate change. This has negative consequences for ecosystems. Forecasting how climate change will disrupt animal systems going forward is extremely important, Atwood said, and this research is a first step in better managing future conditions for animals around the world.

“Animal diversity can act as an alarm system for the stability of ecosystems,” Atwood said. “Identifying the ecological mechanisms that help drive richness patterns provides insight for better managing and predicting how diversity could change under future climates.”

In addition to Adkins and Atwood, the research included seven authors currently or previously associated with the Department of Watershed Sciences and the Ecology Center: Edd Hammill, Umarfarooq Abdulwahab, John Draper, Marshall Wolf, Catherine McClure, Adrián González Ortiz and Emily Chavez.

 

Journal

Ecology Letters

DOI

10.1111/ele.14306

Method of Research

Meta-analysis

Subject of Research

Not applicable

Article Title

Environmental variables drive spatial patterns of trophic diversity in mammals

Article Publication Date

23-Aug-2023

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U.S. National Pension System Ranks 22nd Out Of 47 Countries; Canada Ranks 12th

The three highest-ranking countries on the list for retirees are the Netherlands (85.0), Iceland (83.5) and Denmark (81.3). Australia came in fifth (77.3),…

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October 24, 2023

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The U.S. may be the richest country in the world, but its retirement system sure doesn’t show it. Once again, the United States earns an embarrassingly low overall score (63.0), ranking No. 22 out of 47 national pension systems, covering 64% of the world’s population according to Mercer’s retirement research. The three highest-ranking countries on the list for retirees are the Netherlands (85.0), Iceland (83.5) and Denmark (81.3). Australia came in fifth (77.3), the UK 10th (73.0) and Canada 12th (70.2). Argentina had the lowest index value (42.3). The information for this original article by Lorimer Wilson, Managing Editor of munKNEE.com – Your KEY To Making Money! – was sourced from an article by Pete Grieve and Julia Glum. The United States now lands outside the top 20 countries in a new ranking of 47 national pension systems in the 2023 edition of the Mercer CFA Institute Global Pension Index, which analyzes countries based on more than 50 indicators in three categories: adequacy, sustainability and integrity.

The U.S. scored its highest rank (16th) in the sustainability category, which measures the likelihood of a country’s pension system being able to provide strong benefits in the future. This sub-index includes contribution rates, coverage of the private pension system and government debt, among other factors. The U.S. ranked 24th in the adequacy category which judges the extent to which pension systems provide sufficient retirement income. This category includes taxation incentives and vesting rules for retirement income programs. The integrity sub-index is about the regulation of retirement income programs, especially private-sector pensions and the laws that govern them and the U.S. ranks 41st here. The report provides several recommendations it says could help the U.S. increase its scores, including improving retirement income for lower-income people and limiting access to funds before retirement.

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Revenge travel is coming to an end, says industry CEO — a recession will replace it

The CEO of Intercontinental Hotels Group says that the world has moved beyond revenge travel–even China.

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2 hours ago

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October 24, 2023

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Maybe revenge isn't so sweet anymore. Not so long ago the term "revenge travel" was making the rounds. The idea was that people were so fed up with the covid-19 pandemic lockdown that they packed their bags and took off for just about anywhere once travel restrictions started to ease.

Related: Delta adds a route U.S. tourists have been begging for

Last year, travel insurance company Allianz Partners projected that travel to Europe would soar 600% over 2021. “The pandemic made people realize you can't take travel for granted and many Americans are eager to visit Europe this summer,” Daniel Durazo, director of external communications at Allianz Partners USA, said in an April 2022 statement.

'Last stage of pent-up demand'

The Summer of '23 was also pretty strong, according to a survey by the Federal Reserve Bank of New York, which found that almost a third, or 32.8%, of all U.S. households took a vacation between May and August, up from 28.5% in August 2022 and a record high in data going back to 2015. However, it looks like the revenge travel upswing is coming to an end. The Federal Reserve's Beige Book said in September that consumer spending on tourism was stronger than expected, "surging during what most contacts considered the last stage of pent-up demand for leisure travel from the pandemic era." Elie Maalouf also thinks that the revenge travel dish has gone cold. The CEO of Intercontinental Hotels Group  (IHG) - Get Free Report said in an interview with CNBC that he believes pent-up demand is over. "People started traveling really by the end of 2020 as restrictions started to lift,” he said. “So we’re really past revenge travel — even in China.” Intercontinental Hotel Group operates hotels under several brand names, including Regent, Crowne Plaza, Holiday Inn Club Vacations, and Candlewood Suites. The company’s latest quarterly update showed travel demand remained strong during the close of the summer travel season. “We think we’re in a sustainable place,” Maalouf said. “Our bookings for groups and meetings going into 2024 and beyond are the strongest we’ve seen in a very long time.”

Average room rates increase

IHG’s third quarter trading update showed the company’s revenue per available room — or “revpar” — was up 10.5% compared to third quarter 2022, and nearly 13% higher compared with the third quarter of 2019, which was before the pandemic. This is despite a 3% drop in revpar, compared to 2019, in large cities in Greater China, which are more dependent on international travelers. Maalouf said that lack of “airlift,” or flight capacity, into China is below 50% of prepandemic levels, which is affecting travel recovery in cities like Beijing, Shanghai, Guangzhou and Shenzhen. “But if you look at the country as a whole, travel — which is mostly domestic in China — it’s recovered well above 2019,” he said, adding that more than 80% of IHG’s business in China is in mid-sized to smaller cities. Occupancy levels in the third quarter at IHG hotels was 72% — just 1% shy of pre-pandemic levels, according to the quarterly update. But average room rates have jumped well above 2019 levels — up nearly 6% in Greater China, 15% in the Americas, and 24% in Europe, Middle East, and Africa (EMEA) and Asia. But rising rates are barely keeping up with inflation, said Maalouf. “Room rates have not really exceeded inflation in any of our markets,” he said. “I think people’s willingness to travel is exhibited by the fact they’re willing to pay.” Get investment guidance from trusted portfolio managers without the management fees. Sign up for Action Alerts PLUS now.

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