COVID-19 Update: Immune Responses Explained, What Autopsies Reveal

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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: 

Immune Responses Explained

Although reports of weak or short-lived antibody responses in patients with COVID-19 have raised concerns that vaccines won’t be protective against the virus, Akiko Iwasaki, PhD, says the pattern is exactly as expected. 

“That is not a cause for alarm,” the Yale immunobiologist said. Other parts of a patient’s immune system still remember the virus and will likely mount a robust and protective response if reexposed. 

In an interview with Medscape’s editor-in-chief Eric Topol, MD, and Stanford’s Abraham Verghese, MD, Iwasaki explains numerous aspects of the interplay between the immune system and the virus, including how interferon might work as a very early treatment or postexposure prophylaxis, how the virus appears to confuse the immune system causing cytokine storms — which might be better called tornadoes or hurricanes — and why men may be more susceptible than women to severe disease. 

She also talks about how her lab has been able to continue working during the pandemic with some extra procedures in place, and whether she’ll be letting her kids go back to school in a few weeks. 

What Autopsies Reveal

Many hospitals and pathologists, for fear of infection and insufficient equipment, initially avoided conducting autopsies on those who had died from COVID-19. That logjam has been broken and reports on how the SARS-CoV-2 virus affects the body have yielded both expected and unexpected findings. 

“I was surprised at how bad it was,” Amy Rapkiewicz, MD, chair of the department of pathology at NYU Langone Health’s Winthrop Hospital in Mineola, New York, told Medscape Medical News . “The degree of respiratory disease was some of the worst I’ve ever seen,” she said. “It’s a terrible, terrible disease. Every organ in the body is pretty much affected.”

More Than 2000 Healthcare Workers Memorialized

Just as the global death toll from COVID-19 climbs to staggering new highs — now more than 794,000, according to the Johns Hopkins University COVID-19 tracker — so grows the number of those lost on the front lines trying to help those infected.

Medscape has been compiling a list in memoriam of fallen healthcare workers worldwide with information from friends, colleagues, and families who have shared details about those who have died. (You can submit information through this form.) 

The list memorializes physicians, nurses, first responders, therapists, pharmacists, medical examiners, technicians, staff, and practitioners of all kinds. 

As of August 18, the list, while incomplete, included more than 2000 names, 386 from the United States. The list includes workers from 74 countries. The youngest is 21, the eldest, 99.

CDC: Influenza Vaccination Critical During Pandemic

The Centers for Disease Control and Prevention (CDC) is urging all individuals who are without contraindications to receive the influenza vaccine for the 2020-2021 influenza season. Reducing the prevalence of influenza through vaccination will reduce symptoms that could be confused with COVID-19, CDC experts write, as well as reduce stress on the US healthcare system from hospitalizations and intensive care unit admissions. 

Hospitalists’ Experience as Working Parents During Pandemic

The week of March 13, Heather Nye, MD, PhD, SFHM, professor of medicine at the University of California, San Francisco, got word that schools were closing because of COVID-19.

“My first thought was, ‘You’re kidding, right?,’ ” she said. That was the start of a series of reactions that included denial and bargaining and, finally, some semblance of acceptance.

In a session at HM20 Virtual, hosted by the Society of Hospital Medicine, she and David J. Alfandre, MD, MPH, associate professor of medicine at New York University Langone, described the complicated logistics and emotional and psychological strain that has come from working during a time of such great healthcare need while balancing home responsibilities and parenting.

Supporting Survivors of Intimate-Partner Violence 

Domestic violence concerns have increased during the pandemic, and healthcare providers can offer several avenues of support, a group of women’s and adolescent-health doctors write in the journal Pediatrics .

Typically, those who experience intimate-partner violence may seek escape through their workplace, activities outside of the home, or trusted family and friends, but those options have been limited during the pandemic. Doctors can check for privacy during telehealth visits, validate their patients’ concerns, and share resource lists. 

The Week That Wasn’t

This week in COVID-19 news, scientists said they confirmed a link between humidity and SARS-CoV-2 transmission, and the use of face shields seemed to eliminate infections among community health workers in India. But you didn’t see these headlines on Medscape. Here’s why.

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 ekincaid@medscape.net or on Twitter @ellie_kincaid.

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