Since the COVID-19 pandemic, there has been a decline in U.S. vaccine uptake, while widespread misinformation and distrust make it challenging to craft effective public health responses. In a new paper, University of Illinois Urbana-Champaign researchers discuss three case studies exemplifying different vaccine attitudes and behaviors. Their findings underscore the need for flexible approaches to reach diverse audiences with disease prevention strategies. 

Cannabidiol – which lacks the psychotropic effects of cannabis – has been shown to have beneficial effects on inflammation in myocarditis and pericarditis models. 

A prospective placebo-controlled trial was conducted with an oral pharmaceutically manufactured (GMP) cannabidiol formulation in patients at high risk of cardiovascular events who were hospitalised for non-critical COVID-19 infection.  

GMP-cannabidiol formulation was well tolerated with a similar low rate of overall and cardiac side effects as placebo, supporting its study in further trials.  

Researchers surveyed 4,177 adult American citizens in the United States. Participants provided opinions about four scenarios that featured individuals with distinct life circumstances and names that were racially/ethnically identifiable. The individual in the first scenario had “a genetic condition that destroyed his kidneys” and necessitated a kidney transplant. The second had “worked in a coal mine all his life” and needed a lung transplant because of black lung disease. The third was “very ill with COVID-19,” had not been vaccinated against COVID-19 and needed a lung transplant. And the fourth had alcohol use disorder and needed a liver transplant.

New Haven, Conn. — Most vaccines — and boosters — are injected directly into muscle tissue, usually in the upper arm, to kickstart the body’s immune system in the fight against disease. But for respiratory diseases like COVID-19, it can be important to have protection right where the virus enters: the respiratory tract. 

In a new study, Yale researchers found that nasal vaccine boosters can trigger strong immune defenses in the respiratory tract, even without the help of immune-boosting ingredients known as adjuvants. The findings, researchers suggest, may offer critical insights into developing safer, more effective nasal vaccines in the future.   

Background: Although coronavirus disease 2019 (COVID-19) is no longer classified as a Public Health Emergency of International Concern by World Health Organization, its global impact persists. Data on its impact in lung transplant recipients (LTRs) from China remain limited. This study aims to share clinical experiences and provide insights into managing LTRs with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Methods: We conducted a study on LTRs with COVID-19 caused by the Omicron variant from November 17, 2022, to May 1, 2023. Clinical information was gathered retrospectively through electronic medical records, questionnaires, or follow-up telephone calls.

Results: A total of 227 LTRs were reviewed for infection with Omicron variant. After excluding 49 cases without confirmed SARS-CoV-2 infection, this left a final cohort of 178 infected LTRs, accounting for an infection rate of 78.4% (178/227). Of the patients, 50% (89/178) required hospitalization, with an average hospital stay of 16 days [interquartile range (IQR): 9.5–25.5 days]. Of the 89 hospitalized patients, 41.6% (37/89) eventually progressed to severe or critical disease, forming the severe/critical group (S/C group), while the remaining 58.4% (52/89) had mild or moderate disease (M/M group). In comparison to the M/M group, the S/C group had higher C-reactive protein (CRP) (59.6 vs. 16.8 mg/L, P<0.001), Erythrocyte sedimentation rate (45.5 vs. 22.5 mm/h, P=0.005) and D-dimer level (1.09 vs. 0.65 mg/L, P=0.01), but lower CD4⁺ T lymphocytes count (217 vs. 427 cells/µL, P=0.004). The S/C group had significantly higher rates of combined pulmonary bacterial infection (67.6% vs. 38.5%, P=0.006) and pulmonary fungal infection (73.0% vs. 38.5%, P=0.001) during the course of COVID-19, nearly double that of the M/M group. In a multivariate logistic analysis, elevated CRP (>41.8 mg/L), combined pulmonary fungal infection, and interstitial lung disease (ILD) as primary disease emerged as high-risk factors for developing the severe disease phenotype following Omicron variant infection in LTRs, with respective odds ORs values of 4.23 [95% confidence interval (CI): 1.68–11.23], 4.76 (95% CI: 1.59–15.64), and 5.13 (95% CI: 1.19–29.17). Receiver operating characteristic (ROC) curve analysis showed that CD4⁺ T lymphocyte count may be a strong marker for predicting death. At a cutoff of 404 cells/µL, sensitivity was 0.509, specificity 0.999, and area under the curve (AUC) was 0.806 (95% CI: 0.678–0.934). Ultimately, 13 recipients succumbed to COVID-19 related respiratory failure or secondary multiple organ dysfunction, resulting in an overall mortality rate of 7.3% (13/178).

Conclusions: LTRs are at high risk of secondary lung infections after Omicron. Key risk factors for severe disease include CRP >41.8 mg/L, ILD as primary disease, and pulmonary fungal infection. CD4+ T lymphocyte count may predict mortality risk in LTRs with COVID-19.

Keywords: Lung transplantation; Omicron; coronavirus disease 2019 (COVID-19); coronavirus; risk factor

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