Killian Meara

Investigators from the University of Cambridge and the Wellcome Sanger Institute have discovered the impact that 

 has had on care homes and how the virus spreads in these types of settings. Results from the recent study were published in the journal 

Care homes have been known to be high risk environments for the transmission of COVID-19 and outbreaks of the disease. Older populations are affected by the virus more compared to younger individuals, making care homes especially vulnerable places.

"Older people, particularly those in care homes who may be frail, are at particular risk from COVID-19, so it's essential we do all that we can to protect them," Estée Török, an Honorary Consultant at Addenbrooke's Hospital, Cambridge University Hospitals (CUH), and an Honorary Senior Visiting Fellow at the University of Cambridge said. "Preventing the introduction of new infections into care homes should be a key priority to limit outbreaks, alongside infection control efforts to limit transmission within care homes, including once an outbreak has been identified."

The investigators behind the study made use of both genome sequencing and detailed epidemiological information to examine how COVID-19 has impacted care homes. The team analyzed samples that were taken from 6,600 patients who tested positive for a SARS-CoV-2 infection. Of those, 1,167 were care home resident from 337 care homes in the east of England. The median age of the participants was 86 years old.

Findings from the study showed that nursing homes had more cases per home than residential homes. Although the median number of cases per care home was 2, 10 of the care homes in the study accounted for 164 of the cases. Less of the care home patients were admitted to the ICU but were more likely to die.

Additionally, 68% of the care home residents were admitted to the hospital throughout the course of the study, with 57% being due to an infection with COVID-19 and 6% of these acquiring the disease in the hospital. Several of the cases from the care homes clustered closely together on the phylogenetic tree with identical genomes or ones that were off by 1 base pair difference.

"Our data suggest that care home transmission was more resistant to lockdown measures than non-care home settings,” Gerry Tonkin-Hill from the Wellcome Sanger Institute said. “This may reflect the underlying vulnerability of the care home population, and the infection control challenges of nursing multiple residents who may also share communal living spaces.”

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By integrating genomic and temporal data, 409 viral clusters within 292 care homes were identified.

Genomics Identifies Routes of COVID-19 Transmission in Care Homes

A recent research review conducted by investigators from Oxford Brookes University has discovered that a large proportion of survivors from 

 will be impacted by both cognitive and neuropsychiatric complications. The results were published in the journal 

A team of psychologists and psychiatrists evaluated published research so that they could gain a more thorough understanding of the potential impacts that COVID-19 has on the brain and what individuals can expect both in long and short term mental health issues.

"Understanding the neuropsychiatric and cognitive consequences of COVID-19 is important as millions of people have been affected by the virus, and many cases go undetected,” Sanjay Kumar, Senior Lecturer in Psychology at Oxford Brookes University said. “These conditions affect people's capacity to work effectively, drive, manage finances, make informed decisions and participate in daily family activities.”

Findings from the review discovered that people may experience a wide range of neuropsychiatric issues in the short term. A study that evaluated stable COVID-19 patients showed that 95% had post-traumatic stress disorder, with other studies finding that between 17% and 42% experienced affective disorders like depression. The highest reported short-term issue was impaired attention and memory, with between 13% and 28% experiencing them.

For the long-term, it was found that 44% of patients reported fatigue and impaired attention. Between 28% and 50% of patients also reported long-term memory impairment. The investigators said that there would most likely be an increase in patients with these issues who were otherwise healthy before the COVID-19 infection.

"We are already seeing an impact of COVID -19 on mental health. Patients are presenting with Long COVID syndrome which includes fatigue, cognitive problems and a range of psychiatric problems,” Tina Malhotra, a Consultant Psychiatrist working in Oxford Health NHS Foundation Trust said. "It is estimated that these problems are experienced by 1 in 5 people who have had COVID. Management of such patients in long-covid clinics should involve a multidisciplinary team including psychiatrists.”

Neurotropic capacities of SARS-CoV-2 makes it a potent factor to cause acute and late neurological effects.

Many Survivors of COVID-19 Will Experience Cognitive Complications

Because it is difficult to predict which patients will develop a more severe case of 

 when they first arrive in the hospital, any way to assess who may become critically ill and require intensive care would be a significant advantage to physicians on the front lines.

A recent study conducted by investigators from Yale University suggests that a series of biological signals that are associated with white blood cell activation and obesity are able to predict more severe outcomes of those who are infected with COVID-19. Results from the study were published in the journal 

"This is one of the first demonstrations that a set of biomarkers in the blood of COVID patients can predict eventual ICU admission, even before such patients become critically ill," Alfred Lee, associate professor of medicine in hematology, director of the Yale Medical Oncology-Hematology Fellowship Program, and a member of the Yale Cancer Center said.

The investigators behind the study employed proteomic profiling, which is a way to screen for multiple proteins within the blood, and analyzed samples that were taken from 100 patients on the first day of hospital admission who were infected with COVID-19. They also looked at data from an additional 3,000 patients in the Yale New Haven Hospital system.

Findings showed that 5 proteins (resistin, lipocalin-2, HGF, IL-8, and G-CSF) that are associated with a of a type of white blood cell called neutrophils, were elevated in patients who eventually became severely ill. The biomarkers were seen before the patients ever experienced serious symptoms and those who never developed severe symptoms had lower levels of the neutrophils.

The investigators plan on future studies that will continue their research into biomarkers and COVID-19, with the hopes of analyzing patients who have recovered from the disease.

"Patients with high levels of these markers were much more like to require care in the intensive care unit, require ventilation, or die due to their COVID-19," said Dr. Hyung Chun, the lead author on the study said. "We are hoping these findings motivate other groups to look at their own patient populations.”

The findings underscore the connection between COVID-19 and the increased risk from obesity.

Biomarkers Can Give Early Indication of Severe COVID-19

 has suggested that T cells are a key component in clearing the 

 virus without developing any symptoms. An efficient response can produce a careful balance of pro and anti-inflammatory molecules. The study was conducted by the Saw Swee Hock School of Public Health in Singapore, in collaboration with the National University of Singapore and the National Research Foundation of Singapore.

An infection with SARS-CoV-2 triggers an immune response by antibodies and T cells that recognize the virus and attempt to clear it from the body. However, this response sometimes causes an excessive amount of inflammation that can damage tissue and worsen symptoms.

It is still unknown what determines someone who is infected from showing symptoms, though some studies have suggested those who are symptomatic produce fewer anti-SARS-CoV-2 antibodies than those with symptoms.

"Asymptomatic individuals constitute a variable but often large proportion of infected individuals, and they should hold the key to understanding the immune response capable of controlling the virus without triggering pathological processes," Antonio Bertoletti, a professor at the Duke-NUS Medical School in Singapore said.

Investigators behind the study analyzed a group of migrant workers who were exposed to COVID-19 over the course of 6 weeks/ They took blood samples from 85 who became infected and were asymptomatic and compared them to 75 who were hospitalized with a mild to moderate case of the disease.

Findings showed that shortly after the infection, the frequency with which the T cells recognized the virus was similar in both groups. However, the T cells of the asymptomatic group produced a greater amount of two types of proteins called IFN-γ and IL-2. The 2 proteins help coordinate the response of the immune system when there is a virus or pathogen present. Additionally, the asymptomatic group showed a balanced, well-proportioned mix of pro and anti-inflammatory molecules, while the other group had a disproportionate amount of proinflammatory molecules.

"Overall, our study suggests that asymptomatic SARS-CoV-2-infected individuals are not characterized by a weak antiviral immunity; on the contrary, they mount a highly efficient and balanced anti-viral cellular response that protects the host without causing any apparent pathology," the investigators said.

Cells reactive to SARS-CoV-2 peptide pools were found in all anti-NP IgG–positive individuals.