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Thursday, March 23, 2023

Hello Health Rounds readers! Briefly taking an inexpensive diabetes pill after the onset of COVID-19 can significantly reduce the risk of long COVID, a finding that one expert hailed as a “breakthrough.” We also highlight the latest data on serious eye infections linked to over-the-counter eye drops, and more evidence that Black women giving birth are at risk for substandard care.

In breaking news, see these stories from our Reuters journalists: Dupixent from Regeneron and Sanofi improves chronic lung disease in smokers; Roche and Eli Lilly join forces to develop a blood test for Alzheimer’s disease; and Moderna expands beyond COVID shots.

An outbreak of serious eye infections linked with over-the-counter artificial tears has ophthalmologists and public health officials worried. REUTERS/Yuriko Nakao.

Two weeks of treatment with the oral diabetes drug metformin significantly lowered the risk of long COVID in high-risk adults, according to data from a clinical trial.

Participants were all overweight or obese, conditions known to be linked with higher risk for long COVID, and started treatment within 6 days of COVID-19 symptom onset.

Over the next 9 months, a long COVID diagnosis was reported by 6.3% of the 564 patients randomly assigned to receive metformin versus 10.6% of the 561 who received a placebo, the researchers reported in a paper that has not yet undergone peer-review.

After accounting for participants’ other risk factors, including whether they had been vaccinated against the coronavirus, long COVID was 42% less likely in patients who received metformin, the researchers said. When metformin was started within 3 days of symptom onset, patients were 63% less likely to develop long COVID compared to those in the placebo group.

The effect of metformin – an inexpensive generic drug – for preventing long COVID was consistent across viral variants, researchers said.

Commenting in a Substack, Dr. Eric Topol of the Scripps Research Institute in La Jolla, California called the study results an exciting breakthrough.

“I don’t use the term ‘breakthrough’ lightly,” he said. “But to see such a pronounced benefit in the current randomized trial of metformin, in the context of it being so safe and low cost, I’d give it a breakthrough categorization,” he said.

“Unless or until there are data to the contrary, if I got COVID, I’d take metformin for 2 weeks at the doses used in this trial.”

Read more about long COVID on Reuters.com

• Top scientists join forces to study leading theory behind long COVID.
• Long COVID at 12 months persists at 18 months.
• Infected in the first wave, they navigated long COVID without a roadmap.

An outbreak of serious eye infections linked with an over-the-counter brand of artificial tears reported in 16 U.S. states has ophthalmologists and public health officials worried, according to reports that include updated information on affected individuals published this week.

As of March 14, three people have died, 8 have had vision loss, and 4 required surgical removal of an eyeball, the U.S. Centers for Disease Control and Prevention (CDC) reported on Tuesday.

The outbreak involves a strain of Pseudomonas aeruginosa bacteria – first seen in the United States in May 2022 – that is highly resistant to treatment with antibiotics. So far, 68 people have been infected, with many cases linked to use of EzriCare Artificial Tears, the CDC said.

The CDC and the U.S. Food and Drug Administration have advised patients to stop using artificial tears from EzriCare or from Delsam Pharma, which uses the same manufacturer.

The bacteria can also cause infections elsewhere in the body, the CDC said.

In a commentary published on Wednesday in JAMA Opthalmology alongside reports describing infected patients in Florida and Ohio, Dr. Christina Prescott and Dr. Kathryn Colby of NYU Langone Medical Center in New York City note that the eye drops involved in the outbreak are free of preservatives and provided in multiple-dose bottles.

“Traditionally, preservative-free eye drops are dispensed in single-use vials, which ensures sterility but increases both cost and waste,” they wrote. “Recently, companies have developed various proprietary bottle designs that claim to ensure sterility of the preservative-free contents despite being multi-use. Unfortunately, as the current outbreak demonstrates, these designs may not always be effective.”

Black women delivering babies by Cesarean section in the UK are more likely than white women to receive general anesthesia instead of epidural nerve blocks, a new study found.

Previous studies have shown a similar racial disparity in C-section anesthesia in U.S. women, the researchers said.

Overall in the UK, more than 95% of patients delivering by C-section receive epidural anesthesia and about 2% receive general anesthesia, according to a report of the study published in Anesthesia. General anesthesia comes with higher risks of anesthesia-related complications, surgical site infection, and blood clots and longer recovery periods, the authors note.

Data on roughly 1.7 million births via C-section at National Health Service hospitals between 2011 and 2021 showed that general anesthesia use was infrequent, with rates of 1.1% during non-emergency C-sections and 3.8% during emergency cases.

But compared to white patients, Black patients of Caribbean descent were 58% more likely to receive general anesthesia for non-emergency C-sections, while Black patients of African descent were 35% more likely, the researchers found.

Black Caribbean patients were also 10% more likely than white patients to receive general anesthesia for emergency C-sections.

The study was not designed to identify reasons for the disparities. It’s possible, the researchers say, that they reflect women’s preferences and choices, but before attributing the differences to personal or cultural preferences it is essential to ensure they are not due to inequities in quality of care.

Read more about health disparities on Reuters.com

• Kidney dialysis-related infection rates higher in U.S. minorities.
• Predictive value of ‘good’ cholesterol level varies by race.
• Pulse oximeters are less accurate in non-white patients.

This newsletter was edited by Bill Berkrot. Additional reporting by Shawana Alleyne-Morris.

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