The increase in risk was not confined to the elderly and was not uniform across ethnic groups, prompting the researchers to suggest that the long-term burden of covid-19-related illness on hospitals and broader healthcare systems is likely to be substantial.

Although covid-19 is most well known for causing serious respiratory problems, it can affect other organs and systems within the body, including the heart, kidneys, and liver.

Several unexplained symptoms that continue for more than 12 weeks after covid-19 are said to be part of post-covid syndrome (also known as “long covid”), but the long term pattern of organ damage after infection is still unclear.

To investigate this, a team of UK researchers from the Office for National Statistics, University College London and University of Leicester set out to compare rates of organ dysfunction in individuals with covid-19 several months after discharge from hospital with a matched control group from the general population.

Their findings are based on 47,780 individuals (average age 65, 55% men) in hospital in England with covid-19 who were discharged alive by 31 August 2020.

Participants were matched with controls, based on personal characteristics and medical history. Health records were then used to track rates of hospital readmission (or any admission for controls), death from any cause, and diagnoses of respiratory, cardiovascular, metabolic, kidney, and liver diseases until 30 September 2020.

Over an average follow-up of 140 days, nearly a third of individuals who were discharged from hospital after acute covid-19 were readmitted (14,060 of 47,780) and more than 1 in 10 (5,875) died after discharge.

These events occurred at rates of 766 readmissions and 320 deaths per 1,000 person years, which were four and eight times greater, respectively, than those in matched controls.

Rates of respiratory disease, cardiovascular disease, and diabetes were also significantly raised in patients with covid-19, with 539, 66, and 29 new onset diagnoses per 1,000 person years, respectively (equivalent to 27, three, and 1.5 times greater than in matched controls).

Differences in rates of multiorgan dysfunction between patients with covid-19 and matched controls were greater for individuals aged less than 70 than for those aged 70 or older, and in ethnic minority groups compared with the white population, with the largest differences seen for respiratory disease.

Differences in disease rates between men and women were generally small.

This was a large, well-designed study using 10 years of historical clinical records to exactly match individuals with covid-19 to controls. However, the findings are observational, and the authors cannot rule out the possibility that rates of diagnoses in general might have decreased indirectly because of the pandemic, particularly in people not admitted to hospital with covid-19.

“Our findings suggest that the diagnosis, treatment, and prevention of post-covid syndrome requires integrated rather than organ or disease specific approaches,” they write.

And they say 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.”

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Materials provided by BMJ. Note: Content may be edited for style and length.

“This is a virus detection and surveillance method that doesn’t require an expensive infrastructure like other approaches,” says Juan Carlos Izpisua Belmonte, co-corresponding author and a professor in Salk’s Gene Expression Laboratory. “We can accomplish with one portable test the same thing that others are using two or three different tests, with different machines, to do.”

Around the world, more than 100 million people have been infected with SARS-CoV-2, the virus that causes COVID-19. A staggering 500,000 Americans have died from COVID-19 to date. Testing the population is key to stopping the spread of the virus. In addition, tracking the spread of new SARS-CoV-2 variants — some of which could respond differently to treatments or vaccines — is critical.

Today, the standard approach to determining whether a nasal swab is positive for COVID-19 is to run a polymerase chain reaction (PCR) test to detect genetic material from the SARS-CoV-2 virus. If the sample is negative, however, patients and clinicians don’t get any information on what might be causing the coronavirus-like symptoms — unless they run separate PCR tests, using different swab samples, for other viruses. And if the sample is positive for SARS-CoV-2, they don’t learn which COVID-19 variant a patient is infected with unless another set of tests is run; those require a large and expensive next-generation gene-sequencing machine.

Last summer, Mo Li, an assistant professor of bioscience at King Abdullah University of Science and Technology in Saudi Arabia, was pondering ways he could lend his expertise in genetic engineering and nanopore sequencing to combatting the COVID-19 pandemic. Li, who previously spent six years as a Salk postdoctoral researcher in the Izpisua Belmonte lab, wondered whether a gene-detection approach called isothermal recombinase polymerase amplification (RPA) coupled with real-time nanopore sequencing might be more useful — and faster, cheaper and more portable — than the current COVID-19 testing approach. He teamed up with Izpisua Belmonte to find out.

Unlike PCR, which cycles through lower and higher temperatures to separate DNA strands and copy them, RPA uses proteins — rather than temperature changes — to accomplish the same thing in only 20 minutes. The technology lets researchers copy longer stretches of DNA, and probe for multiple genes at the same time.

“We quickly realized that we could use this technique to not only detect SARS-CoV-2, but other viruses at the same time,” says Li.

In the new paper, Li and Izpisua Belmonte describe a small, portable device that can screen 96 samples at the same time using the RPA assay. They call the method NIRVANA, for “nanopore sequencing of isothermal rapid viral amplification for near real-time analysis.”

The scientists designed NIRVANA to simultaneously test samples for COVID-19, influenza A, human adenovirus, and non-SARS-CoV-2 human coronavirus. In just 15 minutes, the researchers report, the device begins to report positive and negative results. And within three hours, the device finalizes results on all 96 samples — including the sequences of five regions of SARS-CoV-2 that are particularly prone to accumulate mutations leading to new variants such as the B.1.1.7 variant identified in the UK.

Li and Izpisua Belmonte tested NIRVANA on 10 samples known to be positive for SARS-CoV-2, 60 samples of unknown SARS-CoV-2 status, as well as samples of municipal wastewater harboring the SARS-COV-2 virus and others. In all cases, the assay was able to correctly identify which viruses were present. The sequencing data also allowed them to narrow down the origin of SARS-CoV-2 in positive samples; differentiating strains from China and Europe, for instance.

“The design of this assay is really flexible, so it’s not just limited to the examples we’ve shown,” says Li. “We can easily adapt it to tackle another pathogen, even something new and emergent.”

With the small size and portability of the NIRVANA workflow, it could be used for fast virus detection at schools, airports or ports, the researchers say. It also could be used to monitor wastewater or streams for the presence of new viruses.

“The pandemic has provided two important lessons: first, test widely and quickly, and second, know your variants. Our NIRVANA method provides a promising solution to these two challenges not only for the current pandemic but also for possible future ones,” says Izpisua Belmonte, who holds the Roger Guillemin Chair at Salk. Market analysis would be required to determine whether the initial cost of commercialization — and the constant tweaks to the test needed to make sure it detected new variants or new viruses of interest — are worth it, Belmonte adds.

In addition to Izpisua Belmonte and Li, other authors on the study were Concepcion Rodriguez Esteban of Salk; Chongwei Bi, Gerargo Ramos-Mandujano, Sharis Hala, Jinna Xu, Sara Mfarrej, Yeteng Tian and Arnab Pain of King Abdullah University of Science and Technology (KAUST); Estrella Nunez Delicado of UCAM Universidad Católica San Antonio de Murcia; Fadwa Alofi of King Fahad Hospital; Asim Khogeer of Saudi Arabia’s Ministry of Health; Anwar Hashem of King Abdulaziz University; and Naif Almontashiri of Taibah University.

The work described in the current paper was supported by a competitive research grant from the King Abdullah University of Science and Technology.

Researchers analyzed antibody tests conducted on more than 500 subjects in patient care settings. They found that people who had COVID, including those with mild symptoms, produced antibodies.

“For a long time, people were very worried that people with mild COVID did not make immune responses,” says Charles Schuler, M.D., a clinical assistant professor of allergy and immunology at Michigan Medicine. “This should give people confidence that the tests that are available to them aren’t just random number generators. They’re actually giving them something useful.”

The findings also indicate that rapid screens can predict infection with nearly the same precision as antibody tests conducted in a lab. Schuler, who led the research team, says the results could prove very useful for providers.

“I was actually surprised at how well some of these tests did because it’s a very different experiment,” Schuler says. “[If you have] a patient at a clinic that does not have a lab on site, we can find out if you had COVID before and we can do it now and we can do it at low cost.”

The team examined lateral flow assays, which Schuler describes as modern litmus tests: A drop of blood or serum is placed on filter paper that changes color to indicate whether antibodies are present.

Researchers then compared three rapid screens taken by finger pricks or blood draws in point-of-care settings to serology tests assessed in a lab. They examined data from 512 patients, of which 104 had a history of COVID-19 and a positive PCR test.

Despite some false positives, two rapid tests agreed with positive lab results between 93 and 97 percent of the time. Both tests outperformed the third brand, which lost its FDA emergency use authorization during the trial.

“I think the FDA has done a nice job regulating bad tests out of the market,” Schuler says. “These are still accurate in a point-of-care setting…[so], you’ve got a test that can be taken to different parts of the world and can be done without the need for a higher-complexity lab setting.”

American vaccination is quickly ramping up — nearly 30 percent of the population received at least one dose as of March 30, according to the Centers for Disease Control and Prevention. But in places where immunization lags, Schuler says these point-of-care antibody tests could help determine who is prioritized.

“It’s important to vaccinate everyone,” he says. “But, if you can direct vaccines to people, in particular, who may be totally unprotected, something like this would be useful. I do think more data is needed to say that from a policy perspective.”

The study population is limited, raising some questions about how the data can be generalized. Almost 90 percent of test subjects are health care workers, many providing direct care for COVID-19 patients.

However, Schuler’s team will continue evaluating the subjects with a new focus. Some recent studies indicate antibodies may persist and offer protection for several months. Schuler hopes to make that answer more concrete.

“This is a down payment on, hopefully, a lot of great future data” he says. “While antibodies may or may not tell you how immunity happens, they might tell you about reinfection risk. That is the functional clinical significance that we need to know as soon as possible.”

Disclosures: The study was partially funded through two companies, Healgen Scientific and Access Bio Inc. Tests, which are normally sold, were provided at no cost by both companies, as well as Autobio Diagnostics Co. Ltd. Schuler, along with two other U-M physicians, received salary support from an institutional COVID-19 grant.

Named for their six-sided crystal structure, hexagonal diamonds have been found at some meteorite impact sites, and others have been made briefly in labs, but these were either too small or had too short of an existence to be measured.

Now scientists at Washington State University’s Institute for Shock Physics created hexagonal diamonds large enough to measure their stiffness using sound waves. Their findings are detailed in a recent paper in Physical Review B.

“Diamond is a very unique material,” said Yogendra Gupta, director of the Institute for Shock Physics and corresponding author on the study. “It is not only the strongest — it has beautiful optical properties and a very high thermal conductivity. Now we have made the hexagonal form of diamond, produced under shock compression experiments, that is significantly stiffer and stronger than regular gem diamonds.”

Researchers have long wanted to create a material stronger than natural diamonds, which could have a variety of uses in industry. While many theorized that hexagonal diamonds would be stronger, the WSU study provides the first experimental evidence that they are.

Lead author Travis Volz, now a post-doctoral researcher at Lawrence Livermore National Laboratory, focused his dissertation work at WSU on the creation of hexagonal diamonds from graphite. For this study, Volz and Gupta used gunpowder and compressed gas to propel small graphite disks about the size of a dime at a speed of around 15,000 miles per hour onto a transparent material. The impact produced shockwaves in the disks that very rapidly transformed them into hexagonal diamonds.

Immediately after impact the researchers produced a small sound wave and used lasers to measure its movement through the diamond. Sound moves faster through stiffer material. Previously sound moved fastest through cubic diamond; in the lab-created hexagonal diamonds it moved faster.

Each process happened in several billionths of a second, or nanoseconds, but the researchers were able to make the stiffness measurements before the high velocity impact destroyed the diamond.

Stiffness is the ability of a material to resist deformation under a force or pressure — for instance, a rock is stiffer than rubber as rubber will bend when pressed. Hardness is the resistance to scratching or other surface deformations.

Generally stiffer materials are also harder, said Volz. While the researchers weren’t able to scratch the diamonds to test hardness directly, by measuring the diamonds’ stiffness, they can make inferences about their hardness.

If the science advances to the point where lab-made hexagonal diamonds can be created and recovered, they could have a range of uses.

“Hard materials are useful for machining capabilities,” said Volz. “Diamond has been used for a long time in drill bits, for example. Since we found that the hexagonal diamond is likely harder than the cubic diamond, it could be a superior alternative for machining, drilling or any type of application where the cubic diamond is used.”

While the industrial advantages are clear, Gupta said it is still possible hexagonal diamonds could one day be used on engagement rings. Currently lab-made cubic diamonds have less value compared to their natural peers, but hexagonal diamonds would likely be more novel.

“If someday we can produce them and polish them, I think they’d be more in-demand than cubic diamonds,” said Gupta. “If somebody said to you, ‘look, I’m going to give you the choice of two diamonds: one is lot more rare than the other one.’ Which one would you pick?”

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Materials provided by Washington State University. Original written by Sara Zaske. Note: Content may be edited for style and length.

Cardiometabolic health risk factors include the metabolic syndrome, a cluster of disorders such as excess fat around the waist, insulin resistance and high blood pressure. Presence of the metabolic syndrome may increase the risk of developing heart disease, stroke and Type 2 diabetes.

Researchers noted it has been unclear whether adherence to both the U.S. Department of Health and Human Services’ 2018 Physical Activity Guidelines for Americans and their 2015-2020 Dietary Guidelines for Americans — as opposed to only one of the two — in midlife confers the most favorable cardiometabolic health outcomes later in life. The physical activity guidelines recommend that adults achieve at least 150 minutes of moderate or 75 minutes of vigorous physical activity per week, such as walking or swimming. The dietary guidelines, which were updated in January 2021, offer suggestions for healthy eating patterns, nutritional targets and dietary limits.

In an analysis of data from participants of the Framingham Heart Study, which began more than 70 years ago in Framingham, Massachusetts, investigators examined data from 2,379 adults ages 18 and older and their adherence to the two guidelines. They observed that meeting a combination of the two recommendations during midlife was associated with lower odds of metabolic syndrome and developing serious health conditions as participants aged in their senior years in 2016-2019 examinations.

“Health care professionals could use these findings to further promote and emphasize to their patients the benefits of a healthy diet and a regular exercise schedule to avoid the development of numerous chronic health conditions in the present and in later life,” said corresponding author Vanessa Xanthakis, Ph.D., FAHA, assistant professor of medicine and biostatistics in the Section of Preventive Medicine and Epidemiology at Boston University School of Medicine in Boston. “The earlier people make these lifestyle changes, the more likely they will be to lower their risk of cardiovascular-associated diseases later in life.”

Study participants were selected from the third generation of the Framingham Heart Study. Participants (average age 47, 54% women) were examined between 2008 and 2011. Researchers evaluated physical activity using a specialized device known as an omnidirectional accelerometer. The device, which tracks sedentary and physical activity, was worn on the participant’s hip for eight days. Researchers also collected dietary information from food frequency questionnaires to measure the kinds and levels of food and nutrients consumed.

In this investigation, researchers observed that among all participants, 28% met recommendations of both the physical activity and dietary guidelines, while 47% achieved the recommendations in only one of the guidelines. Researchers also observed that:

• participants who followed the physical activity recommendations alone had 51% lower odds of metabolic syndrome;
• participants who adhered to the dietary guidelines alone had 33% lower odds; and
• participants who followed both guidelines had 65% lower odds of developing metabolic syndrome.

“It is noteworthy that we observed a dose-response association of adherence to diet and physical activity guidelines with risk of cardiometabolic disease later in life,” Xanthakis said. “Participants who met the physical activity guidelines had progressively lower risk of cardiometabolic disease as they increased adherence to the dietary guidelines.”

All study participants were white adults, therefore, the findings cannot be generalized to people in other racial or ethnic groups. Additional studies with a multiethnic participant sample are needed, researchers said.

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Materials provided by American Heart Association. Note: Content may be edited for style and length.