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Myocarditis: COVID-19 Is A Much Bigger Risk To The Heart Than Vaccination

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Myocarditis: COVID-19 Is A Much Bigger Risk To The Heart Than Vaccination


The heart has played a central role in COVID-19 since the beginning. Cardiovascular conditions are among the highest risk factors for hospitalization. A significant number of patients hospitalized with SARS-CoV-2 infections have signs of heart damage, and many recover from infection with lasting cardiovascular injury.

 

It’s not surprising that debates over COVID-19 vaccines frequently centre around issues involving cardiovascular health. The high-profile collapse of Danish soccer player Christian Eriksen in June initiated a myth about the link between sudden cardiac death and vaccination among athletes that persists several months later.

Perhaps the most common point of conflict concerning COVID-19 vaccines is the risk of myocarditis following immunization, particularly among young people.

What do the numbers tell us about COVID-19, vaccines and myocarditis?

What is myocarditis?

Myocarditis is an inflammation of the heart muscle most commonly caused by a virus like influenza, coxsackie, hepatitis or herpes. Other causes include bacteria, fungi, toxins, chemotherapy and autoimmune conditions.

Some viruses infect heart muscle and cause direct injury to the heart, while others cause heart damage indirectly through the immune system. Activation of the immune system in response to an infection triggers the release of chemicals in the body called cytokines, which help clear infections. In some cases, the levels of cytokines rise to unusually high levels to produce a “cytokine storm” that causes damage to heart muscle.

Myocarditis by the numbers

Before COVID-19 the incidence of myocarditis was between one and 10 cases per 100,000 people per year. Rates are highest in males between 18 and 30 years old. Interestingly, most cases of myocarditis in the highest risk group are in otherwise healthy and active people.

According to the U.S. Centers for Disease Control and Prevention, the risk of myocarditis after infection with COVID-19 is much higher, at 146 cases per 100,000. The risk is higher for males, older adults (ages 50+) and children under 16 years old. Soccer player Alphonso Davies, 21, of Canada’s national men’s team, was sidelined by heart inflammation after having COVID-19.

Post-vaccination myocarditis

Myocarditis following COVID-19 vaccination is rare and the risk is much smaller than the risks of cardiac injury linked to COVID-19 itself.

Based on a study out of Israel, the risk of post-vaccine myocarditis is 2.13 cases per 100,000 vaccinated, which is within the range usually seen in the general population. This study is consistent with others in the United States and Israel which put the overall incidence of post-vaccine myocarditis between 0.3 and five cases per 100,000 people.

The kids are alright

The highest incidence of myocarditis after vaccination with mRNA vaccines has occurred within three to four days after the second vaccination in males who are under age 30. In pediatric data, the median age is 15.8 years, with most patients being male (90.6 per cent) and white (66.2 per cent) or Hispanic (20.9 per cent). Reliable data on booster shots in this age group is not yet available.

Most studies show a clear benefit of COVID-19 mRNA vaccination with respect to myocarditis. Only one study by Martina Patone, from the University of Oxford, and colleagues found more ambiguous results for those under 40 years of age based on myocarditis rates alone. However, if considering the other ill effects of infection with SARS-CoV-2 — both cardiac and not — there was still a strong benefit in immunizing younger people with COVID-19 vaccines other than Moderna, which research suggests has a higher risk for myocarditis than Pfizer’s vaccine.

Repairing the damage

The treatment for myocarditis varies depending on its severity. Adults with mild forms of myocarditis typically need only rest and non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen. More severe cases require medications or even mechanical circulatory supports like left ventricular assist devices to support heart function. In some cases when treatment is no longer effective, a heart transplant is required.

In a multicentre series of patients under 21 years old, those with mild symptoms received only NSAIDs or no anti-inflammatory therapy at all. Patients with more severe symptoms can receive stronger therapies including intravenous immunoglobulin, glucocorticoids or colchicine in addition to NSAIDs.

How serious is it?

Over 80 per cent of myocarditis cases not related to COVID-19 or COVID-19 vaccination resolve spontaneously, while five per cent of patients die or require a heart transplant within one year of diagnosis.

Adults who develop myocarditis from COVID-19 have poorer outcomes than non-COVID-19 cases, including a higher risk of death. It should be noted that myocarditis associated with SARS-CoV-2 infection is just one of several heart conditions linked to COVID-19 with outcomes that are worse than non-COVID-19 cases.

In cases of myocarditis following COVID-19 vaccination, the vast majority of cases are mild and resolve quickly. In adults, 95 per cent of cases were deemed to be mild. Similarly, in children, 98.6 per cent are mild, and there has not been any reported need for mechanical heart support (extracorporeal membrane oxygenation, when blood is pumped outside the body to a heart-lung machine) or deaths. All children who had heart weakness had complete normalization of their heart function on followup.

Take-home message

The dynamic changes in the global pandemic, combined with rapid developments in research, make it challenging for the public to take in all the information about the risks and benefits of COVID-19 vaccines. In cases like this it is useful to turn to the guidance of medical organizations whose mandates are to protect the health and welfare of society.

Considering all of the available research, organizations including the American Heart Association, Canadian Cardiovascular Society, Heart and Stroke Foundation of Canada, Canadian Paediatric Society and the American Academy of Pediatrics encourage all who are eligible to be vaccinated against COVID-19.

That’s a message we should all take to heart.

Glen Pyle, Professor, Laboratory of Molecular Cardiology, University of Guelph and Jennifer H Huang, Associate Professor of Pediatric Cardiology, Oregon Health & Science University

This article is republished from The Conversation under a Creative Commons license. Read the original article.





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Feeling Tired All The Time? Possible Causes And Solutions

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Long days of work, lack of sleep, and stress at the office can be the most common factors that make you feel tired. However, feeling “tired all the time” (TATT) without known reasons can be an indication of an underlying health issue that needs immediate attention.

Finding the exact cause of the lingering tiredness can be the first step toward solving the symptom.

Health conditions that cause fatigue:

1. Anemia – Anemia is one of the most common causes of fatigue. A person who has anemia does not have enough red blood cells in the body, causing symptoms such as tiredness, dizziness, feeling cold and crankiness.

Most often, anemia is caused by iron deficiency. Hence, the condition can be best resolved by including iron-rich foods in the diet and use of iron supplements.

2. Sleep Apnea – It causes the body to stop breathing momentarily during sleep. The condition can affect the quality of sleep and hence make you feel fatigued.

For milder cases of sleep apnea, lifestyle changes such as losing weight or quitting smoking can help solve the sleep disorder. In more severe cases where there is an obstruction in breathing, surgeries and therapies can help.

3. Diabetes – A person who has diabetes has changes in blood sugar level, which can cause fatigue. A patient who is already on diabetic medication can also experience tiredness as a side effect of the medication.

Early identification and taking the correct treatment is the key to managing diabetes. Losing extra weight and having a healthy diet also help in the treatment.

4. Thyroid – Thyroid diseases can be due to an overactive or an underactive thyroid gland. In people who have an underactive thyroid (hypothyroidism), the metabolism slows down leading to symptoms such as lethargy and fatigue. In people with an overactive thyroid (hyperthyroidism), the metabolism speeds up leading to fatigue and difficulty sleeping.

Right diet and lifestyle choices, along with medications, can help in thyroid management.

5. Infections – A person can show symptoms of fatigue when the body is fighting a viral or bacterial infection. Infections ranging from the flu to HIV can cause tiredness.

Along with fatigue, other symptoms such as fever, headache, body aches, shortness of breath and appetite loss can also accompany the infection. Treating the symptoms and taking adequate rest helps in faster recovery.

6. Food allergies – Fatigue may be an early warning sign of hidden food allergies and autoimmune disorders such as celiac disease. Identifying the allergen using a food allergy test or through an elimination diet can help in allergy treatment.

7. Heart disease – If you feel exhausted from an activity that used to be easy, then it is good to check your heart health, as fatigue can be an indication of underlying heart disease.

8. Depression/ anxiety – Fatigue can also be an indicator of a mental health disorder such as depression or anxiety. A combination of medication and psychotherapy can help relieve symptoms.

Lifestyle causes

Apart from serious health conditions, certain lifestyle habits such as dehydration, poor diet, stress and insufficient sleep can cause exhaustion. Having a well-balanced diet, regular exercise and routine sleep can help solve fatigue caused by lifestyle habits.

Published by Medicaldaily.com



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How To Overcome Your Sleep Debt And Reclaim Energy

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Picture this: you’re burning the midnight oil, studying or binge-watching your favorite shows, all at the expense of a good night’s sleep. Have you ever stopped to think about the toll it takes on your body and mind? The consequences can be more serious than you might realize.

Not getting enough sleep can translate into a multitude of issues, including weight gain, lack of focus, tiredness, a haze of confusion, and even depression. If you too are encountering similar issues lately then chances are you have a sleep debt.

Wondering what is sleep debt?

People from 13-18 years of age need 8 hours of sleep, whilst adults beyond that age will require at least 7 hours of snooze.

Sleep debt is a collection of the total hours you haven’t slept or traded your sleep for something else. Sleep debt keeps piling up as a person falls short of the total hours of sleep recommended for an adult, according to the Centers for Disease Control and Prevention.

And when you keep letting go of your sleep for other activities, the body adapts to the new normal and effects start to reflect on the energy levels, which deplete.

“However, like every other debt out there, this too has a repayment option,” Dr. Kunal Kumar, medical director of the Sleep Center at Einstein Medical Center in Philadelphia, told Livestrong.

Below are some expert-vetted ways you can pay back the sleep debt. (Courtesy: Livestrong and Sleepfoundation)

Just like financial debt, imagine sleep debt as a debt you owe to your body. It needs to be repaid. The good news is that catching up on sleep is indeed possible.

  • Maintain a set sleep schedule: Overhauling the sleep schedule is a pretty difficult task to achieve, and it’s best to do that gradually. Create a set sleep schedule by making some small changes to your routine. Instead of making abrupt shifts in your bedtime or wake-up time, adjust them gradually by 15 to 30-minute increments.
  • Minimize your gadget usage: Wind down activities and minimize electronic usage before bed to promote better sleep. Relax and prepare for quality sleep by dimming the lights and setting an alarm for 30 minutes to an hour before bed.
  • Reshuffle your sleeping arrangements: Are you finding it hard to get a good night’s sleep due to excessive sweating? Well, here’s a handy solution: consider upgrading to a cooling mattress or opting for cooling sheets. These innovative sleep essentials can help regulate your body temperature, and keep you comfortably cool throughout the night, ensuring a more blissful slumber. Memory foam pillows can work wonders in relieving neck and back discomfort in case you are struggling with backache.
  • Improve the bedroom environment: Create a sleep-friendly bedroom environment by adjusting the temperature for comfort, and blocking out disruptive lights, or noises that might disturb your restful slumber. And if your mattress, pillow, or sheets are worn out or no longer providing the support you need, consider treating yourself to new ones.

Published by Medicaldaily.com



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Omega-3 Fatty Acids Slow The Progression Of Amyotrophic Lateral Sclerosis: Study

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Omega-3 fatty acids are known for a range of health benefits, from promoting brain and heart health to reducing inflammation and protection against several chronic conditions.

In a new study, researchers found that omega-3 acids, especially the type found in foods like flaxseeds, walnuts, chia seeds, canola oil and soybean oil, can slow down the progression of amyotrophic lateral sclerosis (ALS).

It is a debilitating nervous system disease that gradually worsens over time and can be fatal. The condition results in a loss of muscle control and affects the nerve cells in the brain and spinal cord. It is also known as Lou Gehrig’s disease after the baseball player who was diagnosed with it.

The initial symptoms of the disease include muscle weakness, difficulty in walking and hand movements. The symptoms can slowly progress to difficulties with chewing, swallowing, speaking and breathing.

The exact cause of ALS is not known. However, around 10% of people get it from a risk gene passed down from a family member. It is estimated that more than 32,000 people in the U.S. live with the condition.

In the latest study, researchers from Harvard T.H. Chan School of Public Health in Massachusetts evaluated 449 people living with ALS in a clinical trial. The team assessed the severity of their symptoms, the progression of their disease, along with the levels of omega-3 fatty acids in their blood, for 18 months.

The study suggested that alpha-linolenic acid (ALA), a type of omega-3 found in plants, is particularly beneficial in slowing the progression of ALS. The participants with the highest levels of ALA had a 50% reduced risk of death during the study period compared to those with the lowest levels of ALA.

Researchers also found a reduction in death risk in participants who had eicosapentaenoic acid, the type of omega-3 fatty acid found in fatty fish and fish oil, and linoleic acid found in vegetable oils, nuts and seeds.

A previous study conducted by the same team suggested that a diet high in ALA and higher blood levels of the nutrient could reduce the risk of developing the condition.

“In this study, we found that among people living with ALS, higher blood levels of ALA were also associated with a slower disease progression and a lower risk of death within the study period. These findings, along with our previous research suggest that this fatty acid may have neuroprotective effects that could benefit people with ALS,” said Kjetil Bjornevik, the lead author of the study.

Published by Medicaldaily.com



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