Medical Bulletin 18 /December/2023

Here are the top medical news of the day:

Immune cells shape lung before birth and provide new avenues for treating respiratory diseases

Immune cells play an active and intimate role in directing the growth of human lung tissue during development, researchers find, revolutionising our understanding of early lung development and the role of immune cells outside of immunity.

The research offers new insights for understanding and treating respiratory conditions, such as chronic obstructive pulmonary disease (COPD). Respiratory conditions account for almost 20 per cent of all deaths in children under five years worldwide1.

The work reveals a surprising coordination between the immune and respiratory systems, much earlier in development than previously thought. This discovery raises questions about the potential role of immune cells in other developing organs across the body.

This study has created a first-of-its-kind immune cell atlas of the developing lung2. It is part of the international Human Cell Atlas3 initiative, which is mapping every cell type in the human body, to transform our understanding of health, infection and disease.

The findings, published today (15 December) in Science Immunology, will help shed light on the mechanisms behind childhood lung diseases.

They identified key regulators of lung development, including signalling molecule IL-1β and IL-13 that facilitate the coordination of lung stem cells differentiating into specialised mature cell types.

These new insights into mechanisms in early lung formation will also contribute to the development of new therapeutic approaches for regenerating damaged lung tissue and restoring lung function.

Reference: Immune cells shape lung before birth and provide new avenues for treating respiratory diseases; Science Immunology, DOI:10.1126/sciimmunol.adf9988

‘Long flu’ has emerged as a consequence similar to long COVID

Since the COVID-19 pandemic began, extensive research has emerged detailing the virus’s ability to attack multiple organ systems, potentially resulting in a set of enduring and often disabling health problems known as long COVID. Now, new research from Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care System indicates that people hospitalized with seasonal influenza also can suffer long-term, negative health effects, especially involving their lungs and airways.

The new study comparing the viruses that cause COVID-19 and the flu also revealed that in the 18 months after infection, patients hospitalized for either COVID-19 or seasonal influenza faced an increased risk of death, hospital readmission, and health problems in many organ systems. Further, the time of highest risk was 30 days or later after initial infection. The findings are published Dec. 14 in The Lancet Infectious Diseases.

Regarding both viruses, patient vaccination status did not affect results. Those in the COVID-19 cohort were hospitalized during the pre-delta, delta and omicron eras.

During the overall 18-month study period, patients who had COVID-19 faced a 50% higher risk of death than those with seasonal influenza. This corresponded to about eight more deaths per 100 persons in the COVID-19 group than among those with the flu.

Although COVID-19 showed a greater risk of health loss than seasonal influenza, infection with either virus carried significant risk of disability and disease. The researchers found COVID-19 exhibited increased risk of 68% of health conditions examined across all organ systems (64 of the 94 adverse health outcomes studied), while the flu was associated with elevated risk of 6% of health conditions (six of the 94) – mostly in the respiratory system.

Also, over 18 months, COVID-19 patients experienced an increased risk of hospital readmission as well as admission to an intensive care unit (ICU). For every 100 persons in each group, there were 20 more hospital admissions and nine more ICU admissions in COVID-19 than flu.

Reference: ‘Long flu’ has emerged as a consequence similar to long COVID; The Lancet Infectious Diseases, DOI: 10.1016/S1473-3099(23)00684-9

Holidays are not happy time for everyone, finds study

Holidays are the favourite part of the year, people meet and spend time together. This happy time might not be the same for everyone, some of them find it distressing and difficult to spend time with people or go out to social gatherings.

A survey by the American Psychological Association (APA; 2023) found that 89% of U.S. adults said they felt stressed at the holidays and 41% said their stress increased during this time compared with other points in the year. The National Alliance on Mental Health (2023) reported that 64% of people living with a mental illness felt that their conditions worsened around the holidays. For women and those with lower income, the holidays can be particularly stressful.

Holiday stress is caused by 4 major feelings: Overwhelm, Social isolation and Loneliness, Depression, Grief.

The survey was conducted among 2,061 adults by The Harris Poll between Nov. 14 and 16, 2023.

This survey was conducted online within the United States by The Harris Poll on behalf of APA from Nov. 14–16, 2023, among 2,061 adults ages 18 and older. The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data is accurate to within + 2.7 percentage points using a 95% confidence level.

Financial concerns were most often cited as a cause of stress during the holidays, with 58% of U.S. adults saying that spending too much or not having enough money to spend causes them stress. This was followed by finding the right gifts (40%) and the stress of missing family or loved ones during the holidays (38%). Households earning under $50K annually especially feel under pressure at this time of year and were more likely to rate their stress levels as high compared with households earning more than $100K annually (24% vs. 18%, respectively).

Reference: Reference: Even a joyous holiday season can cause stress for most Americans; American Psychological Association, Press Release Nov 2023.