COVID Transmissions for 6-14-2021

Myocarditis due to Pfizer vaccine?

Greetings from an undisclosed location in my apartment. Welcome to COVID Transmissions.

It has been 574 days since the first documented human case of COVID-19. In 574 there was a major volcanic eruption in the Antarctic.

While that is very cool, I don’t really have a good way to tie it in with COVID, so let’s just appreciate it.

Anyway, today we have three stories to discuss, the first being related to heart inflammation potentially associated with vaccines. The next is a continuation of discussion on trends in COVID-19 hospitalization, and the last is a discussion of how to treat a particularly dangerous outcome of COVID-19: serious blood clots.

Mostly, what I have to tell you about today is good news. Have a great week!

Note: if you’re seeing this twice, my apologies—there was a settings error and the original message did not go to the full list.

Bolded terms are linked to the running newsletter glossary.

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Now, let’s talk COVID.

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Myocarditis in young people following Pfizer vaccine administration

There has been a new development in a story we’ve followed for a little while now: the rare cases where children given the Pfizer vaccine have developed transient heart inflammation, myocarditis. 226 potential cases have been identified in vaccinees under the age of 30. Now, the CDC is planning to hold a meeting to discuss this adverse event. https://abcnews.go.com/Politics/cdc-panel-discuss-myocarditis-reports-young-people-covid/story?id=78222009

It’s worth pointing out here that there have been many millions of doses administered in the US. Specifically, 173,000,000 people have received at least one dose and 143,000,000 people have received two doses. 226 total cases of this have been observed. I am not sure how the numbers look exactly in patients under 30, but it’s definitely in the millions. 226 cases represents a very rare event, and not all of these cases are even confirmed.

Still, heart inflammation is certainly undesirable. However, it is not necessarily harmful in the long run, as we’ve discussed before. I suspect that here, the attention of the CDC is being paid in order to provide an assessment as to whether this rare event is genuinely vaccine-emergent, and if it is, to provide some guidance as to management. These cases do tend to resolve over a couple of weeks, so I think ultimately the guidance will involve monitoring the situation and potentially some administration of anti-inflammatory medications. All in all, I am glad that the CDC is paying attention to this but not overly concerned about it. COVID-19 remains substantially more dangerous than this rare potential effect, even in the younger demographics.

Anecdotal reports from around the country reinforce trend that unvaccinated people in the US are now the main victims of serious COVID-19

I saw this story over the weekend about how most people hospitalized for COVID-19 in the US right now are unvaccinated, similar to a story I shared last week: https://www.nbcnews.com/health/health-news/virtually-all-hospitalized-covid-patients-have-one-thing-common-they-n1270482

I didn’t share this just to repeat news; I think the quote in the kicker of this article makes a really good point. The person quoted has seen patients who didn’t get vaccinated because they got sick earlier in the pandemic and thought it must have been COVID-19. They assumed themselves protected and so skipped the vaccine. Don’t do this. Even if you’ve had COVID-19, it is worthwhile to seek out vaccination. I will leave it to the healthcare practitioners involved to decide whether or not it’s appropriate for you after you ask.

Prophylactic anticoagulation associated with reduced 60-day death rate in COVID-19 patients

A new study in JAMA Network Open explores the effects of anticoagulation therapy in patients with COVID-19: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780927

Anticoagulation was used here in two “modes,” either the therapeutic mode, where the drug is being used to treat active clotting processes, or the prophylactic mode, where it is being used to prevent clots from developing.

The study includes various results for both modes, but the headline here is that prophylactic anti-coagulation significantly reduced the 60-day risk of death for patients recovering from COVID-19.

Clotting risks with COVID-19 have been an unusual feature of the disease that have driven much speculation, and I’m sure that scientists will continue to investigate how this arises. In the meantime, however, we need to evaluate good ways to prevent deadly clotting in patients recovering from COVID-19.

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What am I doing to cope with the pandemic? This:

Reverse-searing steak

You’ve heard of searing steak, but have you heard of “reverse-searing” it? No, this is not the concept of un-cooking a steak. Instead, reverse-searing is a process by which the steak is raised close to its desired final internal temperature, in an oven set low, before the outside of it is seared. It is then finished in a “screaming hot” pan to sear the outside.

This method helps the steak to retain juices that would otherwise run off in the more typical cooking process. I’ve been playing around with it to varying degrees of success and might share some of my results soon.

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You might have some questions or comments! Send them in. As several folks have figured out, you can also email me if you have a comment that you don’t want to share with the whole group.

Join the conversation, and what you say will impact what I talk about in the next issue.

Also, let me know any other thoughts you might have about the newsletter. I’d like to make sure you’re getting what you want out of this.

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Part of science is identifying and correcting errors. If you find a mistake, please tell me about it.

Though I can’t correct the emailed version after it has been sent, I do update the online post of the newsletter every time a mistake is brought to my attention.

Correction: due to a typo, one sentence in last issue read “"There was also no sense of the magnitude of that protection—how many ashes can be prevented among the unvaccinated ..." The word “ashes” here should have been “cases.” Thank you to Carl Fink for catching this error, which was soon corrected in the online edition.

See you all next time. And don’t forget to share the newsletter if you liked it.

Always,

JS