A 28 year old male, type 1 diabetic usually requires an average of 110 units of insulin daily. However, since getting COVID-19 infection three months ago, his requirements have gone up to nearly double. Hba1c is also slightly increased. Fortunately, he has never suffered from complications of hyperglycaemia as he is very well educated and understands how to control his blood glucose quite well. This is not his first COVID-19 infection, he has had two previous infections and both times his insulin requirements went back to normal within 2-3 weeks. Is there anything that can be done to help his control?

"The Transposon Theory of Aging and SARS-CoV-2

Even mild COVID infection accelerates aging by activating Transposable Elements"

https://wmcresearch.substack.com/p/the-transposon-theory-of-aging-and

Worth reading to help one get a grasp on just how diabolical the bioweapons know as SARS-COV2 and the COVID-19 mRNA gene therapies really are...

It is hard for moral Humans to understand the depth of pure EVIL behind this war on us all. Those complicit in the on-going attack on Humankind deserve the worst punishments that can be bestowed upon them. 

This entire affair was not only unnecessary, but avoidable had the medical profession stood its ground in defense of our patients. It failed horribly..

https://salemyoussefmohamed.blogspot.com/2024/04/prognostic-value-of-andc-score-and-crp.html

Shimaa Abdelmoneem a, Rasha E. Omar b, Nabila Hassan Ahmed c, Sara Refaee Abdo Mohamed c, Mohammad Walaa d, Ahmad Abbas d, Eman M. Abdel-Sattar e, Abdullah Mohammad Abdel-hameed f, Lobna A. El-Korashi g, Salem Youssef Mohamed h, Tse-Wei Chen i, Reem M. Aljowaie j, Saeedah Musaed Almutairi j, Ahmed Embaby a

aClinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptbInternal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptcTropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptdChest Department, Faculty of Medicine, Zagazig University, Zagazig, EgypteFamily Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptfClinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptgMedical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, EgypthGastroenterology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, EgyptiDepartment of Materials, Imperial College London, London, SW7 2AZ, United KingdomjDepartment of Botany and Microbiology, College of Science, King Saud University, Saudi Arabia

SARS-CoV-2 has been a causative agent of severe acute respiratory syndrome since 2019. Early diagnosis of severe cases is crucial to decrease a patient's hospital stay and death risk. Severity and prognosis

This retrospective study included COVID-19 patients who underwent chest computed tomography scan and a battery of laboratory tests, including measurements of leukocytes, neutrophils, lymphocytes, lactic dehydrogenase, creatinine level, ferritin, D-dimer, albumin, and C-reactive protein. In addition, the CRP to lymphocyte ratio (CLR), CRP to albumin ratio (CAR), CRP to platelet ratio (CPR), and the ANDC score. Patients' clinical outcomes were recorded, including length of hospital stays (LOS) and mortality.

Out of 98 patients, 51 patients had passed away. There was a statistically significant difference between survivors and non-survivors regarding age, TLC, ANC, NLR, D-Dimer, and albumin. Moreover, a highly statistically significant difference regarding CRP levels, CAR, CPR, CLR, and ANDC was noted. Serum CRP level > 123 ng/ml, CAR > 36.77, CPR level > 462, and CLR > 84 had sensitivity (64.71 %, 66.6 %, 72.5 %, and 76.4 %, respectively) and specificity (85.1 %, 78.7 %, 72.3 %, and 72.3 % respectively) in mortality prediction. Meanwhile, the ANDC score was the most sensitive indicator (88.2 %) for mortality outcomes. Multivariable regression analysis revealed that aging, CPR, and ANDC level were independently associated with mortality with H.R. [1.025 (1.002–1.050); 2.338 (1.189–4.599) and 2.896 (1.191–7.044)]

The value of the ANDC score and CRP-derived inflammatory indicators correlate with the likelihood of mortality, so the efficacy of these metrics might assist in urgent early dialogues about treatment escalation.

THURSDAY, April 25, 2024 (HealthDay News) -- There is significant global variation in COVID-19 treatment recommendations and disease severity stratifications, according to a study published online April 22 in BMJ Global Health.

Mia Cokljat, M.B.Ch.B., from the University of Oxford in the United Kingdom, and colleagues compared the COVID-19 treatment guidelines of each World Health Organization (WHO) member state to the WHO COVID-19 therapeutic guidelines. The analysis included COVID-19 therapeutic national guidelines for 109 of the 194 WHO member states.

The researchers found considerable variation in guidelines and in disease severity stratifications. There were also substantial differences in therapeutic recommendations in many national guidelines versus the WHO guidelines. In late 2022, 93 percent of national guidelines were recommending at least one treatment that had been proven to be ineffective in large, randomized trials and was not recommended by WHO. For example, corticosteroids were not recommended in severe disease in nearly 10 percent of national guidelines, despite overwhelming evidence of their benefit. For countries categorized as low-resource settings, national guidelines showed the greatest divergence.

"The formalization of processes in the development of national guidelines for COVID-19 and other infectious diseases is essential for ensuring that these guidelines are grounded in the best available evidence," the authors write. "A systematic and structured approach would not only enhance the credibility of the guidelines but could also contribute to their effectiveness in guiding public health interventions, especially in a pandemic setting."

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MONDAY, April 22, 2024 (HealthDay News) -- Modest changes were seen in early childhood development milestone achievement during the COVID-19 pandemic, according to a study published online April 22 in JAMA Pediatrics.

Sara B. Johnson, Ph.D., M.P.H., from the Johns Hopkins School of Medicine in Baltimore, and colleagues conducted a cohort study using an interrupted time-series analysis comparing prepandemic (March 1, 2018, to Feb. 29, 2020), interruption (March 1 to May 31, 2020), and intrapandemic (June 1, 2020, to May 30, 2022) periods among 50,205 children aged 0 to 5 years. Data were included from 134,342 Age-standardized Ages and Stages Questionnaire, Third Edition (ASQ) observations.

The researchers found that from prepandemic to intrapandemic, significant age-specific mean score decreases were observed in communication, problem-solving, and personal-social domains (−0.029, −0.018, and −0.016, respectively) in adjusted models. From prepandemic to intrapandemic, no changes were seen in fine or gross motor domains. Similar effect sizes were seen for infants aged 0 to 12 months for communication and problem-solving domains (−0.027 and −0.018, respectively). Compared with the prepandemic period, in the intrapandemic period, caregiver worries about the child increased slightly after accounting for age-standardized ASQ scores (rate ratio, 1.088); no changes were seen in caregiver concerns about the child's behavior. Modest changes in developmental screening scores were seen (2 to 3 percent), but this could translate to more than 1,500 additional recommended developmental referrals over baseline each month nationwide.

"Our findings provide reason for cautious optimism about the development of a generation of children exposed to the pandemic," the authors write.

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THURSDAY, April 18, 2024 (HealthDay News) -- There was a substantial increase in pediatric prescription-opioid overdose emergency department visits from 2019 to 2020 in the United States, according to a study published online April 17 in PLOS ONE.

Audrey Lu, from Nationwide Children’s Hospital in Columbus, Ohio, and colleagues examined trends in pediatric (ages 0 to 17 years) prescription-opioid overdose emergency department visits. The analysis included data from the U.S. Nationwide Emergency Department Sample (2008 to 2020).

The researchers found that prescription-opioid overdose emergency department visits decreased by 22 percent from 2008 to 2019 and then increased by 12 percent in 2020. While most patients were discharged to home following their emergency department visit, there was a 42 percent increase in pediatric patients admitted from 2019 to 2020. The prescription-opioid overdose rate was highest in the 0- to 1-year-old and 12- to 17-year-old age groups, with the 12- to 17-year-old age group increasing by 27 percent in 2020. From 2019 to 2020, prescription-opioid emergency department visits in the West and Midwest increased by 58 and 20 percent, respectively.

"Future studies could investigate the impact of the COVID-19 pandemic on the opioid epidemic once nationwide data on opioid overdose is made available for later years of the pandemic," the authors write.

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