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Six-country African study shows COVID-19 can be dangerous in pregnancy

A new study involving hospitalized women in six African countries from the University of Maryland School of Medicine’s (UMSOM) Institute of Human Virology…

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A new study involving hospitalized women in six African countries from the University of Maryland School of Medicine’s (UMSOM) Institute of Human Virology (IHV) showed that pregnant women with SARS-CoV-2, the virus that causes COVID-19, had double the risk of being admitted to the intensive care unit (ICU) and four-times the risk of dying in-hospital than pregnant women who did not have COVID-19.

Credit: University of Maryland School of Medicine

A new study involving hospitalized women in six African countries from the University of Maryland School of Medicine’s (UMSOM) Institute of Human Virology (IHV) showed that pregnant women with SARS-CoV-2, the virus that causes COVID-19, had double the risk of being admitted to the intensive care unit (ICU) and four-times the risk of dying in-hospital than pregnant women who did not have COVID-19.

The researchers stated that their findings suggest that women who are pregnant or may become pregnant should avoid getting COVID-19 and protect themselves as best as they can with available vaccines.

The findings were published on June 8, 2022, in the Clinical Infectious Diseases journal, along with an accompanying viewpoint.

“If the mother does not do well, then the baby does not do well either. As we do not yet have vaccines for babies less than six months old, pregnant women should get the vaccine to protect their unborn children and newborns,” said Nadia Sam-Agudu, MD, Associate Professor of Pediatrics at UMSOM, Senior Technical Advisor for Pediatric and Adolescent HIV at the UMSOM’s Institute of Human Virology, and International Senior Technical Advisor of Pediatric and Adolescent HIV at the Institute of Human Virology Nigeria.

Dr. Sam-Agudu added that currently available evidence shows that COVID-19 vaccines indicated for use in pregnancy are safe, and emerging data show that they provide protection for newborns as well as mothers.

The new study was conducted by the African Forum for Research and Education in Health (AFREhealth) Research Collaboration on COVID-19 and Pregnancy. The study examined data on 1,315 women hospitalized in Ghana, Nigeria, Democratic Republic of the Congo, Uganda, Kenya, and South Africa, including 510 pregnant women with COVID-19, 403 non-pregnant women with COVID-19, and 402 pregnant women without COVID-19.

Women with other risk factors such as diabetes, HIV, history of tuberculosis, or sickle cell disease were at greater risk for severe COVID-19. About 32% of pregnant women with COVID-19 needed in-hospital oxygen therapy compared to 16% of pregnant women without COVID-19. Some 19% of pregnant women with COVID-19 were admitted to the ICU, compared to 6% of pregnant women who did not have COVID-19. Among the women hospitalized with COVID-19, 10% of those who were pregnant died compared to the 5% that were not pregnant.

“I would like to appeal to healthcare providers to consider the data with respect to vaccine safety for pregnant women, and to counsel women to help them consider the vaccine in light of the consequences of COVID-19,” said Dr. Sam-Agudu. “Knowing that we have tools to prevent this disease from progressing, we should be more intentional, educational, and supportive about vaccination in pregnancy, so that pregnant women or women who plan to become pregnant can access and receive vaccines.”

Overall, COVID-19 vaccination rates remain much lower in Africa compared to much of the rest of the world. As of today, with the exception of a few, full vaccination rates in African countries do not top 40%. According to the researchers, COVID-19 vaccination rates are likely to be much lower among pregnant women in these settings.

African countries still contend with low and inconsistent COVID-19 vaccine supplies, largely due to persistent inequity in access to global vaccine supply and manufacturing. Experts remain concerned that vaccine demand and acceptance may wane, and vaccine apathy may set in, as inconsistent access and supply persist.

“This study furthers confirms that pregnant women face special risks and potential complications from COVID-19,” said Man Charurat, PhD, MHS, Professor of Medicine at UMSOM and the Division Director of Epidemiology & Prevention at UMSOM’s Institute of Human Virology. “Public health experts and physicians need to make more effort to solve the problem of vaccine inequity in Africa.”

E. Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, University of Maryland Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, UMSOM, said, “We need to make every effort to ensure that all countries or regions have available access to resources such as COVID-19 vaccines to prevent any unnecessary suffering. It is imperative that we encourage pregnant women to use the tools we now have developed to prevent their own disability and promote healthy births.” 

This work was supported by the U.S. National Institutes of Health (NIH) Fogarty International Center (1R25TW011217-01) to AFREhealth.

Study author John Mellors, MD, of the University of Pittsburgh receives funding from Gilead Sciences, Inc; and Janssen Pharmaceuticals, and consults for Gilead Sciences, Inc (Scientific Advisory Board), Accelevir Diagnostics, Merck, and Xi’an Yufan Biotechnologies. He owns shares from Abound Bio, Inc, Co-Crystal Pharma, Inc, and Infectious Diseases Connect.

About the Institute of Human Virology

Formed in 1996 as a partnership between the State of Maryland, the City of Baltimore, the University System of Maryland, and the University of Maryland Medical System, the IHV is an institute of the University of Maryland School of Medicine and is home to some of the most globally-recognized and world-renowned experts in all of virology. The IHV combines the disciplines of basic research, epidemiology, and clinical research in a concerted effort to speed the discovery of diagnostics and therapeutics for a wide variety of chronic and deadly viral and immune disorders, most notably HIV, the virus that causes AIDS. For more information, visit ihv.org and follow us on Twitter @IHVmaryland.

About the University of Maryland School of Medicine

Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world — with 46 academic departments, centers, institutes, and programs, and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished two-time winner of the Albert E. Lasker Award in Medical Research. With an operating budget of more than $1.3 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic, and clinically based care for nearly 2 million patients each year. The School of Medicine has nearly $600 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total population of nearly 9,000 faculty and staff, including 2,500 students, trainees, residents, and fellows. The combined School of Medicine and Medical System (“University of Maryland Medicine”) has an annual budget of over $6 billion and an economic impact of nearly $20 billion on the state and local community. The School of Medicine, which ranks as the 8th highest among public medical schools in research productivity (according to the Association of American Medical Colleges profile) is an innovator in translational medicine, with 606 active patents and 52 start-up companies. In the latest U.S. News & World Report ranking of the Best Medical Schools, published in 2021, the UM School of Medicine is ranked #9 among the 92 public medical schools in the U.S., and in the top 15 percent (#27) of all 192 public and private U.S. medical schools. The School of Medicine works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu

 

Journal

Clinical Infectious Diseases

DOI

10.1093/cid/ciac294

Method of Research

Observational study

Subject of Research

People

Article Title

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis

Article Publication Date

8-Jun-2022

COI Statement

Study author John Mellors, MD, of the University of Pittsburgh receives funding from Gilead Sciences, Inc; and Janssen Pharmaceuticals, and consults for Gilead Sciences, Inc (Scientific Advisory Board), Accelevir Diagnostics, Merck, and Xi’an Yufan Biotechnologies. He owns shares from Abound Bio, Inc, Co-Crystal Pharma, Inc, and Infectious Diseases Connect.

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Call for Papers: JMIR Neurotechnology

JMIR Neurotechnology, published by JMIR Publications, welcomes submissions from researchers, clinicians, caregivers, and technologists that explore novel…

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October 27, 2023

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JMIR Neurotechnology, published by JMIR Publications, welcomes submissions from researchers, clinicians, caregivers, and technologists that explore novel diagnostic and treatment tools for neurological disorders, particularly those leveraging the potential of neurotechnology.

Credit: JMIR Publications

JMIR Neurotechnology, published by JMIR Publications, welcomes submissions from researchers, clinicians, caregivers, and technologists that explore novel diagnostic and treatment tools for neurological disorders, particularly those leveraging the potential of neurotechnology.

The scope of the journal includes but is not limited to:

  • Neuroradiology
  • Advancements in neurosurgery
  • Innovative diagnostic tools and techniques
  • Cutting-edge neurotechnology for therapeutics
  • Data sharing and open science in neurotechnology
  • Code transparency and reproducibility
  • Neurorehabilitation
  • Cognitive enhancement
  • Challenges and ethical considerations
  • Neuroimaging and brain-machine interfaces
  • Neurotechnology and artificial intelligence (AI).

For a limited time only, JMIR Neurotechnology is offering a 50% APF discount on all manuscripts accepted for publication with the use of an active promo code. For more information, please visit https://neuro.jmir.org/about-journal/article-processing-fees.

Please visit our website for more information on submission guidelines and the peer-review process.
 

###

 

About JMIR Publications

JMIR Publications is a leading, born-digital, open access publisher of 35+ academic journals and other innovative scientific communication products that focus on the intersection of health, and technology. Its flagship journal, the Journal of Medical Internet Research, is the leading digital health journal globally in content breadth and visibility, and is the largest journal in the medical informatics field.

To learn more about JMIR Publications, please visit jmirpublications.com or connect with us via Twitter, LinkedIn, YouTube, Facebook, and Instagram.

Head office: 130 Queens Quay East, Unit 1100, Toronto, ON, M5A 0P6 Canada

Media contact: communications@jmir.org

 

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fMRI study finds correlated shifts in brain connectivity associated with overthinking in adolescents

COLUMBUS, Ohio – A new study from The Ohio State University Wexner Medical Center and College of Medicine, University of Utah and University of Exeter…

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October 27, 2023

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COLUMBUS, Ohio – A new study from The Ohio State University Wexner Medical Center and College of Medicine, University of Utah and University of Exeter (UK) substantiates previous groundbreaking research that rumination (overthinking) can be reduced through an intervention called Rumination-focused Cognitive Behavioral Therapy (RF-CBT). In addition, the use of fMRI technology allowed researchers to observe correlated shifts in the brain connectivity associated with overthinking.

Credit: The Ohio State University Wexner Medical Center

COLUMBUS, Ohio – A new study from The Ohio State University Wexner Medical Center and College of Medicine, University of Utah and University of Exeter (UK) substantiates previous groundbreaking research that rumination (overthinking) can be reduced through an intervention called Rumination-focused Cognitive Behavioral Therapy (RF-CBT). In addition, the use of fMRI technology allowed researchers to observe correlated shifts in the brain connectivity associated with overthinking.

Study findings are published online in the journal Biological Psychiatry Global Open Science.

“We know adolescent development is pivotal. Their brains are maturing, and habits are forming. Interventions like RF-CBT can be game-changers, steering them towards a mentally healthy adulthood. We were particularly excited that the treatment seemed developmentally appropriate and was acceptable and accessible via telehealth during the early pandemic,” said corresponding author Scott Langenecker, PhD, vice chair of research in the Department of Psychiatry and Behavioral Health at Ohio State, who started this project while at the University of Utah.

RF-CBT is a promising approach pioneered by Ed Watkins, PhD, professor of experimental and applied Clinical Psychology at the University of Exeter. It has been shown to be effective among adults with recurrent depression.

“We wanted to see if we could adapt it for a younger population to prevent the ongoing burden of depressive relapse,” said Rachel Jacobs, PhD, adjunct assistant professor of psychiatry and behavioral sciences at Northwestern University who conducted the pilot study in 2016.

“As a clinician, I continued to observe that standard CBT tools such as cognitive restructuring didn’t give young people the tools to break out of the painful mental loops that contribute to experiencing depression again. If we could find a way to do that, maybe we could help young people stay well as they transition to adulthood, which has become even more important since we’ve observed the mental health impact of COVID-19,” Jacobs said.

In the just published trial, 76 teenagers, ages 14-17, with a history of depression were randomly assigned to 10-14 sessions of RF-CBT, while controls were allowed and encouraged to receive any standard treatment. Teens reported ruminating significantly less if they received RF-CBT. Even more intriguing, fMRI illustrated shifts in brain connectivity, marking a change at the neural level.

Specifically, there was a reduction in the connection between the left posterior cingulate cortex and two other regions; the right inferior frontal gyrus and right inferior temporal gyrus. These zones, involved in self-referential thinking and emotional stimuli processing, respectively, suggest RF-CBT can enhance the brain’s ability to shift out of the rumination habit. Notably, this work is a pre-registered replication; it demonstrates the same brain and clinical effects in the Utah sample in 2023 that was first reported in the Chicago sample in 2016.

“For the first time, this paper shows that the version of rumination-focused CBT we have developed at the University of Exeter leads to changes in connectivity in brain regions in adolescents with a history of depression relative to treatment as usual. This is exciting, as it suggests the CBT either helps patients to gain more effortless control over rumination or makes it less habitual. We urgently need new ways to reduce rumination in this group in order to improve the mental health of our young people,” Watkins said.

Next, the researchers will focus on demonstrating the efficacy of RF-CBT in a larger sample with an active treatment control, including continued work at Ohio State, Nationwide Children’s Hospital, University of Exeter, University of Utah and the Utah Center for Evidence Based Treatment. Future directions include bolstering access to teens in clinical settings and enhancing the ways we can learn about how this treatment helps youth with similar conditions.

“Our paper suggests a science-backed method to break the rumination cycle and reinforces the idea that it’s never too late or too early to foster healthier mental habits. Our research team thanks the youths and families who participated in this study for their commitment and dedication to reducing the burden of depression through science and treatment, particularly during the challenges of a global pandemic,” Langenecker said.

This work was supported by the National Institutes of Mental Health and funds from the Huntsman Mental Health Institute and is dedicated to researcher Kortni K. Meyers and others who have lost their lives to depression.

 

# # #

Journal

Biological Psychiatry Global Open Science

DOI

10.1016/j.bpsgos.2023.08.012

Method of Research

Randomized controlled/clinical trial

Subject of Research

People

Article Title

Rumination-Focused Cognitive Behavioral Therapy Reduces Rumination and Targeted Cross-network Connectivity in Youth With a History of Depression: Replication in a Preregistered Randomized Clinical Trial

Article Publication Date

27-Oct-2023

COI Statement

Edward R. Watkins reports royalties from a treatment manual for RF-CBT published by Guilford Press and licensing of RF-CBT for Internet treatment packages. Sheila E. Crowell is a co-owner of the Utah Center for Evidence Based Treatment, an outpatient psychotherapy practice that is unrelated to this work. Scott A. Langenecker reports
consultant payments from Stony Brook University, Penn State University, and Johns Hopkins University (unrelated to this work) and payments from the Center for Scientific Review (unrelated to this work) and part ownership of Secondary Triad, Inc. (unrelated to this work). All other authors report no biomedical financial interests or potential conflicts of interest.

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Why Big Oil Isn’t To Blame For Rising Gas Prices

Why Big Oil Isn’t To Blame For Rising Gas Prices

Authored by Robert Rapier via OilPrice.com,

Republicans and Democrats both have misconceptions…

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October 27, 2023

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Why Big Oil Isn't To Blame For Rising Gas Prices

Authored by Robert Rapier via OilPrice.com,

  • Republicans and Democrats both have misconceptions about the energy sector, with the former often downplaying climate change and the latter misunderstanding oil industry operations.

  • Oil prices are determined by global supply and demand, not by individual oil companies; thus, claims of oil companies causing inflation or gouging prices are misplaced.

  • Implementing policies like windfall profits taxes on oil companies doesn't address the root issues of supply and demand, and it's essential for policymakers to have a comprehensive understanding of the energy sector for effective governance.

Good energy policy starts with a good understanding of energy issues. But both major political parties have glaring blind spots when it comes to understanding the energy sector.

Let me preface this column by noting that I am a registered Independent. I have major disagreements with both political parties, and I strive to approach issues from a completely objective viewpoint.

I think Republicans get it mostly wrong when it comes to climate change, and the importance of transitioning to alternative energy. But they seem to understand the current critical role of fossil fuels in the economy, and they mostly get it right when it comes to supporting nuclear power.

Democrats never seem to understand how the oil industry works. For example, look at the list of Democrats who signed onto the “Big Oil Windfall Profits Tax” introduced last year by Senator Sheldon Whitehouse (D-RI). In announcing the bill, Senator Whitehouse said it would “curb profiteering by oil companies and provide Americans relief at the gas pump.”

The bill was cosponsored by Senators Jeff Merkley (D-OR), Elizabeth Warren (D-MA), Bernie Sanders (I-VT), Richard Blumenthal (D-CT), Tammy Baldwin (D-WI), Sherrod Brown (D-OH), Jack Reed (D-RI), Ed Markey (D-MA), Cory Booker (D-NJ), Michael Bennet (D-CO), and Bob Casey (D-PA). Congressman Ro Khanna (D-CA-17) introduced the legislation in the U.S. House of Representatives.

In addition to claims of price gouging, this same cast of characters has sometimes blamed oil company profits for inflation.

Here’s Senator Bernie Sanders doing that.

These politicians do not seem to understand that oil companies don’t control prices. Oil is the world’s most valuable commodity. Oil prices are set by buyers and sellers in global markets, based on supply and demand expectations.

Firms like ExxonMobil produce such a small share of the world’s oil they couldn’t move prices much if they wanted to. They benefit from high prices, but don’t set those prices. If they did, prices would never fall.

Saying profits cause inflation confuses cause and effect. It’s like saying hospitalizations cause car crashes. It is true that a car crash can result in hospitalization, but hospitalizations do not cause car crashes. If you believe the latter — and you try to address the problem by focusing on the hospital — you are working on the wrong problem.

Likewise, high profits in the oil industry and inflation are both caused by high oil prices. But high oil prices are caused by supply and demand factors.

Outside of rare circumstances, it’s impossible for oil companies to gouge you, because they don’t set the price. An example of true price gouging would be if a local gas station that sets its own prices doubled them when supply is ample. But Chevron earning more from high global prices set by markets is normal capitalism. That’s how the entire global commodity markets work.

I can only imagine that in the minds of some politicians, executives of Big Oil are meeting in smoke-filled boardrooms, rubbing their greedy hands together, and deciding to raise prices because Russia invaded Ukraine. But that’s not how any of this works.

If politicians want to address oil prices, they need to address the supply side and the demand side. When politicians propose windfall profits taxes on oil companies, intending to give rebates to consumers, it might sound good, but it doesn’t address the core issue.

High prices should signal consumers to use less energy, but rebates would diminish the price signal — which wouldn’t alleviate pressure on demand. On the supply side, punitive taxes on oil companies might sound appealing, but that’s less money that can be allocated to projects, which affects future supplies. Former Venezuelan president Hugo Chávez learned this lesson the hard way, and Venezuela is still paying the price.

Some have expressed outrage that oil companies are using record profits to buy back shares or pay special dividends to shareholders. But it’s common for companies, not just in the oil industry, to buy back shares or pay dividends when profits are high. It’s a part of how our capitalist system works. If companies can issue shares, they should be able to buy them back.

For consumers worried about high oil prices, there are options. You can invest in an oil company. Thus, when oil prices rise, so do your shares. Or consider switching to an electric vehicle to reduce your reliance on fossil fuels.

In conclusion, understanding energy issues is crucial for effective policymaking, yet both major political parties often exhibit significant misunderstandings of the energy sector. By understanding the complexities of the energy sector, policymakers and consumers alike can make informed decisions that contribute to a more sustainable and economically sound future.

Tyler Durden Fri, 10/27/2023 - 12:45

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