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Morning Rounds Elizabeth Cooney

2020's pandemic death toll, in more detail

(MMWR)

The pandemic death toll continues its relentless climb. New, provisional numbers from the CDC say Covid-19 boosted the age-adjusted death rate by 16% in 2020, the first such increase since 2017. April and December had both the highest number of deaths and Covid-19 deaths. Looked at another way, Covid-19 was the third leading cause of death last year among all Americans — it was the leading cause among Hispanic persons — and it replaced suicide as one of the top 10 leading causes of death. And like so much else in the pandemic, the burden was uneven. Overall death rates were highest among men, people over 85, non-Hispanic Black persons, and non-Hispanic American Indian or Alaska Native persons. Final data are expected later this year.

Increased rates of organ damage follow Covid patients after they leave the hospital

After Covid-19 patients leave the hospital, they experience organ damage at much higher rates than uninfected people, a new study says. While unexplained post-Covid symptoms are being studied in general, these researchers looked specifically for diagnoses of respiratory, cardiovascular, metabolic, kidney, and liver diseases. Among more than 47,000 Covid patients, nearly one-third were readmitted to the hospital and more than one-tenth died. Those rates were four and eight times greater, respectively, than in people in the comparison group over the previous 10 years. The differences were greater in people under 70 and in racial and ethnic minority groups. “Urgent research is needed to understand the risk factors for post-Covid syndrome so that treatment can be targeted better to demographically and clinically at-risk populations,” the authors write.

An Ebola patient's recovery, vaccination, and relapse 

An African man who recovered from Ebola and was later vaccinated against the virus had a relapse six months later, infecting 91 other people before he died. The new report from North Kivu in the Democratic Republic of Congo details the genomic testing and transmission tracing that confirm but don't explain this unusual case. The authors note this is the third relapse case in which patients received antibody treatments during their first illness. They also say that while the Ebola vaccine sometimes fails, perhaps the virus was hiding in in the body. “More data are needed to understand the mechanism and risk factors of [Ebola] relapse in order to prevent future transmission events and protect patients as well as their families and communities,” the authors write.

Inside STAT: At China’s genomics giant, the line between biotech and Beijing is increasingly blurry

(sam ward for the wire china)

In just a decade, BGI has gone from a scrappy startup working out of a shoe factory to a $7 billion biotech giant that boasts the world’s largest genetics research center. When the Covid-19 pandemic began, it built a field lab in Wuhan to collect and analyze Covid-19 samples, work it says helped reduce spread there by nearly 50%. BGI sought to offer a hand in the rest of the world, but in the West, BGI seemed less like a group of brilliant scientists and more like a shady behemoth in cahoots with the Chinese authorities. “It is this merger of company, academic institution, and government that blurs all the lines,” George Church, a renowned Harvard geneticist and longtime BGI adviser, told The Wire, an online magazine covering China's economic rise. Read more.

Teasing out genetic clues to the origin of type 1 diabetes

Predicting who will develop type 1 diabetes — and when — is challenging. The disease usually develops in childhood when the immune system targets and destroys the islet beta cells in the pancreas that produce insulin. (In type 2, people can’t make enough insulin to convert the glucose their bodies need for fuel, or they grow insensitive to the insulin they do make.) A new study of 400 children at risk for type 1 diabetes tracked genetic and environmental factors shaping type 1 diabetes and found extensive changes in the gene expression of natural killer cells that correlated with the progression of type 1 diabetes. In a model using samples from 356 other children, they could predict type 1 diabetes based on these genetic changes. The authors say it's possible that a viral trigger leads to altered natural killer cells that track with progressive damage to the pancreas.

Mice social distance, too

Social distancing entered our collective human repertoire about a year ago, but mice have been doing it all along, at least when it comes to mating. Mice can sense when another mouse is sick, responding to distinctive odors from sick animals that send a message to stay away. In a new paper, neuroscientists pinpoint a brain circuit that stops mice from mating with others that appear to be sick. They also connect that circuit to another neural pathway in the brain related to thyroid function, which when impaired is linked to depression and social withdrawal in humans. “Individuals must balance the cost of social interactions relative to the benefit, as deficits in the ability to select healthy mates may lead to the spread of disease,” the authors conclude.

Covid-19 cases in the U.S.

Cases yesterday: 66,146
Deaths yesterday
: 1,076

In this week's episode of STAT’s “First Opinion Podcast,” First Opinion editor Pat Skerrett speaks with Alzheimer’s expert Jason Karlawish and Richard Bartholomew, the husband and caretaker of one of his patients. Listen here.

What to read around the web today

  • Covid-19: Some Johnson & Johnson vaccine doses on hold in U.S. after factory mix-up. New York Times
  • Vaccine calculus is changing for new parents. The Atlantic
  • The U.S. government doesn’t have patent rights to Gilead’s remdesivir, despite investing millions in research. STAT+
  • Top adviser warned then-President Trump of virus supply shortage, then pursued his own deals. Washington Post
  • The ultimate incubator: The brave new world of bionic babies. IEEE Spectrum

Thanks for reading! More tomorrow,

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