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NEWS TRENDS ANALYSIS :: THE OBSERVATORY


Neurology and Director of the Divi- sion of Neuroradiology/Head & Neck Imaging at Thomas Jefferson University in Philadelphia. To derive a more complete picture,


Faro and his colleagues analyzed nearly 40,000 cases of hospitalized COVID-19 positive patients from seven U.S. and four western European university hos- pitals. The patients had been admitted between September 2019 and June 2020. Their average age was 66 years old, and there were twice as many men as women. The most common cause of admis-


sion was confusion and altered mental status, followed by fever. Many of the patients had comorbidities like hyper- tension, cardiac disease, and diabetes. There were 442 acute neuroimaging findings that were most likely associ- ated with the viral infection. The overall incidence of central nervous system complications in this large patient group was 1.2%. The most common complication was


ischemic stroke, with an incidence of 6.2%, followed by intracranial hemor- rhage (3.72%) and encephalitis (0.47%), an inflammation of the brain. The researchers also discovered a small percentage of unusual findings, such as acute disseminating encepha- lomyelitis, an inflammation of the brain and spinal cord, and posterior reversible encephalopathy syndrome, a syndrome that mimics many of the symptoms of a stroke.


Diverse genome sequences provide a tool for studying heart disease risk In a large-scale study of people from diverse ancestries, researchers nar- rowed down the number of genomic variants that are strongly associated with blood lipid levels and generated a polygenic risk score to predict elevated low-density lipoprotein cholesterol lev- els, a major risk factor for heart disease, according to a news release from the National Institutes of Health (NIH). The study, published in the journal


Nature, was led by the Global Lipids Genetics Consortium. The authors include researchers at the National Human Genome Research Institute (NHGRI), part of NIH. Lipids are fat-like substances that can be found in blood and body tis- sues. They come in two major forms - cholesterol and triglycerides. Humans need a certain amount of lipids in the body for normal function, but elevated lipid levels may increase the risk of de- veloping a heart condition. Polygenic risk scores provide an estimate of an individual’s risk for specific diseases, based on their DNA changes related to those diseases.


“Finding the set of genomic variants that are important for this trait is key for us to understand the biology and identify new drug targets,” said Cristen Willer, PhD, Professor of Human Ge- netics at the University of Michigan. “These genomic variants then inform


how well polygenic risk scores work to determine risk for such diseases.” Since the field’s inception, the ge- nomics community has performed over 6,000 studies looking at the associa- tion of specific genomic variants and cardiovascular disease. However, the design of these studies overwhelmingly included individuals from European ancestral populations. To address this issue, researchers


accumulated data from 201 previous genome-wide association studies, in- cluding about 1.65 million individuals from five ancestral groups: African, East Asian, European, Hispanic, and South Asian. About 1.32 million of those studies were from European ancestry, and the remaining 350,000 were non- European. The studies contained data on blood levels of the different classes of cholesterol and triglycerides. The research group calculated the


polygenic risk scores using data from each of the different ancestral groups, either separately or all together. Then, they tested the risk scores in a diverse set of studies, including Africans en- rolled from Ghana, Kenya, and Nigeria as part of the Africa America Diabetes Mellitus study. The results showed a polygenic risk score that includes diverse ge- nomic data is much more predictive of whether a person of any ancestry will have elevated low-density lipoprotein cholesterol levels than a score that only includes European genomic data.


Pathologists find evidence of pre-existing chronic lung disease in people with long COVID


Researchers at University of Michigan Health, part of Michigan Medicine, are examining lung biopsies from patients living with persistent respi- ratory symptoms, such as shortness of breath, to help better define the pattern of damage associated with COVID-19. Their work has led to a surprising finding: some patients’ symptoms could be due to damage that existed before getting COVID-19, according to a news release from the academic medical center. Jeffrey Myers, MD, Professor of Anatomic Pathology, along with Kristine E. Konopka, MD, Associate Professor of Thoracic Pathology, and their Department of Pathology team, examined lung biopsies from


18 living patients who had ongoing respiratory symptoms or abnormal CT scans after recovering from COVID-19. Five patients were reported to have lung disease prior to their COVID-19 diagnosis. Fourteen patients had what is known as ground glass opacities on radiological scans, areas of the lungs that appear as a cloudy gray color as opposed to the dark color of normal air-filled lungs, on a chest X-ray or CT scan. The most common finding in this set of patients was a condition known to pathologists as usual interstitial pneu- monia, or UIP, also known clinically as idiopathic pulmonary fibrosis, or IPF, a well-studied chronic lung disease. IPF is the most common type of pulmonary


fibrosis and causes scarring and stiffen- ing of the lungs. UIP/IPF is a progressive disease that gets worse with time and an infection, such as with SARS-CoV-2, can lead to accelerated illness or even death, what is known as an acute exacerbation of IPF, explained Myers. “SARS-CoV-2 comes along and does to the lung, from a pathology perspective, exactly what happens with an acute exacerbation.” Biopsies from these patients show evidence of the underlying pre- existing lung scarring with, layered on top, evidence of diffuse alveolar damage, a pattern of lung tissue dam- age commonly seen in patients with acute respiratory distress syndrome of any cause.


MLO-ONLINE.COM JANUARY 2022 7


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