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Virus in Heart Cells, ‘Long COVID’ Link


Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Here are the coronavirus stories Medscape’s editors around the globe think you need to know about today:

Virus in Heart Cells

SARS-CoV-2 has been found in cardiac tissue of a child from Brazil with multisystem inflammatory syndrome related to COVID-19. The child presented with myocarditis and died of heart failure

It’s believed to be the first evidence of direct infection of heart muscle cells by the virus; viral particles were identified in different cell lineages of the heart, including cardiomyocytes, endothelial cells, mesenchymal cells, and inflammatory cells.

“The presence of the virus in various cell types of cardiac tissue, as evidenced by electron microscopy, shows that myocarditis in this case is likely a direct inflammatory response to the virus infection in the heart,” first author Marisa Dolhnikoff, MD, Department of Pathology, University of Sao Paulo, Brazil, told Medscape Medical News.

“Long COVID” Link with ME/CFS?

The persistence of long-term symptoms in some individuals with COVID-19 has opened up a new line of research into the mechanisms underlying myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). 

In recent studies, “chronic fatigue” was listed as the top symptom among individuals still feeling unwell beyond 2 weeks after COVID-19 onset. Other persistent symptoms overlap with the diagnostic criteria for ME/CFS, which commonly arises after a viral illness. 

“It offers a lot of opportunities for us to study potentially early ME/CFS and how it develops, but in addition, a lot of the research that has been done on ME/CFS may also provide answers for COVID-19,” said a leader of the International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.

First Documented Coronavirus Reinfection 

A Hong Kong man who recovered from COVID-19 in April was infected again four-and-a-half months later in the first documented instance of human reinfection, researchers at the University of Hong Kong said today.

Through genetic sequencing, researchers found that the man had contracted a different coronavirus strain from the one he had previously contracted. He remained asymptomatic for the second infection. The findings are described in a paper accepted by Clinical Infectious Diseases but not yet available online.

“The finding does not mean taking vaccines will be useless,” Kai-Wang To, MD, a coauthor of the paper, told Reuters. “Immunity induced by vaccination can be different from those induced by natural infection,” To said.

T Cells a More Precise Immune Indicator?

Immune system memory T-cell levels accurately corresponded with COVID-19 severity in the first study to evaluate a wide range of responses to SARS-CoV-2 infection, from persons who were healthy to those who were severely ill. 

T-cell response persisted in convalescent COVID-19 patients, suggesting that such responses offer a more precise measure of potential long-term immune protection compared with antibody assays.

Measuring memory T-cells could help to identify people with asymptomatic or mild COVID-19 illness “who likely act inadvertently as the major transmitters,” the researchers propose.

Daycare Centers Don’t Have to be Infection Hotbeds 

Rhode Island, a state that has kept its COVID-19 outbreak under relatively good control, saw little new viral transmission when the state reopened daycare centers earlier this summer, according to a new study released by the US Centers for Disease Control and Prevention and the Rhode Island Department of Health.

The percentage of COVID-19 tests that come back positive in Rhode Island — which is an indication of how widespread the infection is in a community — has been significantly below the national average, hovering around 2%.

It’s not clear, however, that cities and states struggling with higher rates of community transmission would get the same reassuring results. Most of the cases (75%) recorded in the Rhode Island daycare study occurred from mid- to late July, when cases began to climb in the state.

FDA Under Pressure?

The US Food and Drug Administration (FDA) on Sunday said it authorized the use of blood plasma from patients who have recovered from COVID-19 as a treatment for the disease, a day after President Donald Trump blamed the agency for impeding the rollout of coronavirus vaccines and therapeutics for political reasons.

On Thursday, Reuters reported that Peter Marks, MD, director of the FDA’s Center for Biologics Evaluation and Research and a top regulator who will help decide the fate of a coronavirus vaccine, had vowed to resign if the Trump administration approves a vaccine before it is shown to be safe and effective. 

Marks told Reuters he has not faced any political pressure and that the FDA would be guided by science alone. Should that change, “I could not stand by and see something that was unsafe or ineffective that was being put through,” Marks said.

Clinical Trials for Cannabinoid Drug OK’d

The FDA will allow phase 1 clinical trials to proceed for a synthetic cannabinoid drug designed to treat acute respiratory distress syndrome (ARDS) that develops in severe cases of COVID-19, according to the company developing the experimental drug.

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk of infection. Thousands throughout the world have died.

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form. If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Ellie Kincaid is Medscape’s associate managing editor. She has previously written about healthcare for Forbes, the Wall Street Journal, and Nature Medicine. She can be reached at [email protected] or on Twitter @ellie_kincaid .

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube, and follow Ellie Kincaid on Twitter @ellie_kincaid.

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