COVID-19

MONDAY, March 25, 2024 (HealthDay News) -- Time spent on social media and use of photo-editing applications contribute to the desire to undergo a cosmetic procedure, according to a study recently published in the Journal of Clinical and Aesthetic Dermatology.Iman F. Khan, M.D., M.P.H., from Boston University, and colleagues surveyed 175 adults visiting an outpatient dermatology clinic about social media usage, perceptions of cosmetic procedures, and desire to have a cosmetic procedure.The researchers found that factors significantly resulting in differences in desire to have a cosmetic procedure included using photo-editing applications, following celebrities and influencers on social media, and following social media accounts showing cosmetic results. During the pandemic, there was a statistically significant change seen in the number of participants who followed social media accounts showing results of cosmetic procedures (pre-COVID, 31.9 percent; post-COVID, 50.6 percent); who thought about having a cosmetic procedure done (pre-COVID, 63.8 percent; post-COVID, 86.4 percent); who discussed cosmetic procedures with a physician, dermatologist, or other professional (pre-COVID, 43.6 percent; post-COVID, 67.9 percent); and who believed that a cosmetic procedure would help their self-esteem (pre-COVID, 47.9 percent; post-COVID, 77.8 percent)."We advise that cosmetic practitioners discuss social media and video platform usage with their patients to understand their desire for a cosmetic procedure as well as their anticipated results," the authors write.<a target="_blank" rel="noopener noreferrer" href="https://jcadonline.com/covid-19-social-media-cosmetic-procedures/">Abstract/Full Text</a>

Increases seen in social media use and cosmetic consultations during the COVID-19 pandemic

Social Media + Photo-Editing Apps Tied to Higher Interest in Cosmetic Procedures

TUESDAY, Feb. 27, 2024 (HealthDay News) -- Delays in melanoma diagnoses due to COVID-19 pandemic lockdowns were associated with a significant burden, including years of life lost and costs, according to a study published online Feb. 16 in JAMA Network Open.Lara V. Maul, M.D., from University Hospital of Basel in Switzerland, and colleagues examined the consequences associated with delays in melanoma screenings during pandemic-related lockdowns. The analysis included data from 50,072 adults with invasive primary cutaneous melanomas stages I to IV from Switzerland (January 2017 to December 2021) and Hungary (January 2019 to December 2021).The researchers found an estimated 111,464 years of life lost (YLL) due to pandemic-associated delay in melanoma diagnosis in Europe, with estimated total additional costs of $7.65 billion. The main cost driver was indirect treatment costs, accounting for 94.5 percent of total costs. There were 15,360 years lost due to disability (YLD) for the 17 percent upstaging model. The overall disease burden (YLL plus YLD) was 126,824 disability-adjusted life-years for the real-world 17 percent scenario."This economic analysis emphasizes the importance of continuing secondary skin cancer prevention measures during pandemics," the authors write. "Beyond the personal outcomes of a delayed melanoma diagnosis, the additional economic and public health consequences are underscored, emphasizing the need to include indirect economic costs in future decision-making processes."Several authors disclosed ties to the pharmaceutical industry.<a target="_blank" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815226">Abstract/Full Text</a>

Delayed diagnoses due to pandemic lockdowns tied to years of life lost

Delayed Melanoma Care During Pandemic Proved Costly

WEDNESDAY, Jan. 10, 2024 -- The incidence and prevalence of alopecia areata (AA) are increased after COVID-19 infection, according to a research letter published online Jan. 10 in JAMA Dermatology.Jong-Seung Kim, M.D., Ph.D., from the Jeonbuk National University Medical School in Jeonju, South Korea, and colleagues conducted a propensity score-matched, nationwide, population-based cohort study to examine the association between COVID-19 and AA. The cohort included 259,369 patients with COVID-19 and 259,369 uninfected controls.The researchers found that the cohort with COVID-19 had an increased risk for telogen effluvium (positive control) compared with the uninfected cohort (adjusted hazard ratio, 6.40); the incidence of negative control outcomes was not different between the groups. Patients with COVID-19 had a significantly higher incidence of AA than controls (43.19 versus 23.61 per 10,000 person-years [PY]), regardless of clinical subtype (adjusted hazard ratio, 1.82). A higher incidence of patchy AA and alopecia totalis and alopecia universalis (AT/AU) was seen for patients with COVID-19 (35.94 and 7.24 per 10,000 PY, respectively) than controls (19.43 and 4.18 per 10,000 PY, respectively). In all groups older than 20 years, the incidence of AA after COVID-19 was significantly increased, with higher risk seen for both male and female patients. The prevalence of AA and AT/AU was significantly higher for patients with COVID-19 (70.53 and 12.39 per 10,000 PY, respectively) than controls (52.37 and 8.97 per 10,000 PY, respectively)."This study suggested an epidemiologic association between COVID-19 and AA," the authors write. "Further studies are necessary to validate the association between different populations and elucidate the causal relationship between the two conditions."

Patients with COVID-19 have a significantly higher incidence of AA than controls, irrespective of clinical subtype

Does COVID-19 Infection Raise the Odds of Alopecia Areata?

For hospitalized patients with COVID-19 requiring supplemental oxygen, baricitinib plus remdesivir and dexamethasone plus remdesivir result in similar mechanical ventilation-free survival by day 29, but adverse events occur more frequently with dexamethasone, according to a study published online May 23 in
 
 The Lancet Respiratory Medicine.
 




 Cameron R. Wolfe, M.B.B.S., from Duke University in Durham, North Carolina, and colleagues conducted a randomized study enrolling 1,010 hospitalized adults with COVID-19 who required supplemental oxygen by low-flow, high-flow, or noninvasive mechanical ventilation modalities. Participants were randomly assigned to receive either baricitinib plus remdesivir plus placebo (516 patients) or dexamethasone plus remdesivir plus placebo (494 patients).




 The researchers found that mechanical ventilation-free survival by day 29 was similar between the groups (87.0 percent in the baricitinib group and 87.6 percent in the dexamethasone group). The odds ratio for improved status in the dexamethasone group versus baricitinib group was 1.01 (95 percent confidence interval, 0.80 to 1.27). At least one adverse event occurred in 30 and 37 percent of patients in the baricitinib and dexamethasone groups, respectively. Overall, 4 and 10 percent of patients in the baricitinib and dexamethasone groups, respectively, had at least one treatment-related adverse event.




 "Dexamethasone was associated with significantly more adverse events, treatment-related adverse events, and severe or life-threatening adverse events," a coauthor said in a statement. "A more individually tailored choice of immunomodulation now appears possible, where side-effect profile, ease of administration, cost, and patient comorbidities can all be considered."




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Baricitinib plus remdesivir shows similar efficacy but better safety profile than dexamethasone plus remdesivir in hospitalized adults

Study Compares Baricitinib to Dexamethasone for COVID-19

Dengue incidence was low in 2020, which was attributable to COVID-19-related disruption, according to a study published online March 2 in
 
 The Lancet Infectious Diseases
 
 .




 Yuyang Chen, Ph.D., from the College of Global Change and Earth System in Beijing, and colleagues collected data on monthly dengue incidence from World Health Organization weekly reports, climatic data, and population variables for 23 countries between January 2014 and December 2019 in order to predict seasonal and multi-year dengue cycles. Model predictions were compared with reported dengue data from January to December 2020.




 The researchers found that across many dengue-endemic regions, there was a consistent, prolonged decline in dengue incidence, which began in March 2020 (2.28 million cases in 2020 versus 4.08 million in 2019; 44.1 percent decrease). There was a strong association observed for COVID-19-related disruption and reduced risk of dengue, even after accounting for other drivers of dengue cycles (relative risk, 0.01 to 0.17). The strongest evidence of association with reduced dengue risk was seen for measures related to closure of schools and reduced time spent in nonresidential areas; however, there was high collinearity between covariables. In 2020, an estimated 0.72 million fewer dengue cases occurred that were potentially attributable to COVID-19-related disruption.




 "Although it remains unknown what effect these restrictions will have on dengue dynamics in the long term, the unique circumstances of the COVID-19 pandemic might give new insights into the development and targeting of new and existing interventions for dengue," the authors write.




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Strongest evidence of association with reduced risk for measures related to school closures, reduced time spent in nonresidential areas

Low Dengue Incidence in 2020 Due to COVID-19-Related Disruption

For critically ill hospitalized patients with COVID-19 receiving invasive mechanical ventilation or extracorporeal membrane oxygenation, baricitinib plus standard of care is associated with reduced mortality, according to a study published online Feb. 3 in
 
 The Lancet Respiratory Medicine
 
 .




 E. Wesley Ely, M.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues conducted a trial in 18 hospitals to examine the efficacy and safety of baricitinib plus standard of care for critically ill hospitalized adults with COVID-19 receiving invasive mechanical ventilation or extracorporeal membrane oxygenation. A total of 101 patients were enrolled and randomly assigned to either baricitinib or placebo plus standard of care (51 and 50 patients, respectively).




 The researchers observed a significant reduction in 28-day all-cause mortality with baricitinib treatment versus placebo (39 versus 58 percent; hazard ratio, 0.54). There was also a significant reduction seen in 60-day mortality in the baricitinib group versus the placebo group (45 versus 62 percent; hazard ratio, 0.56). At days 28 and 60, one additional death was prevented for every six baricitinib-treated patients versus placebo-treated patients. No significant difference was seen between the groups in the number of ventilator-free days. The mean duration of hospitalization did not differ significantly for baricitinib- and placebo-treated patients.




 "These results are consistent with the reduction in mortality observed in the less severely ill hospitalized patients in the primary COV-BARRIER study population and further support the use of baricitinib in hospitalized adults with COVID-19," the authors write.




 Several authors disclosed financial ties to pharmaceutical companies, including Eli Lilly, which manufactures baricitinib and funded the study.




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Reduction in death seen at 28, 60 days for patients receiving invasive mechanical ventilation, extracorporeal membrane oxygenation

Baricitinib Reduces Mortality in Critically Ill Adults With COVID-19

Pfizer Inc. said Tuesday that a COVID-19 vaccine that specifically targets the omicron variant will be ready by March.




 The company has already started making the new version of the vaccine, Pfizer CEO Albert Bourla told
 
 CNBC
 
 's "Squawk Box,"
 
 CBS News
 
 reported.




 Pfizer is also working to improve its current COVID-19 vaccine "to address any future variant of potential concern, if needed," a company spokesperson said in a statement to
 
 CBS MoneyWatch
 
 . "In the event that a third dose with the current vaccine is not found to protect against the omicron variant or other future variants, Pfizer expects to be able to develop and produce a tailor-made vaccine against that variant in approximately 100 days, subject to regulatory approval," the spokesperson added.




 Also on Monday, Moderna said in a
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 that it is also developing an omicron-specific vaccine,
 
 CBS News
 
 reported. "Given the long-term threat demonstrated by omicron's immune escape, Moderna will continue to develop an omicron-specific variant vaccine that it expects to advance into clinical trials in early 2022," the company stated.




 In the meantime, booster shots remain the best defense against omicron, experts said. A recent
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 from the U.K. Health Security Agency revealed that booster shots are up to 75 percent effective at preventing symptomatic COVID-19 infection caused by omicron.




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Pfizer also working to improve its current COVID-19 vaccine 'to address any future variant of potential concern, if needed'

Pfizer Says Omicron-Specific Vaccine Ready by March

Severe COVID-19 outcomes are rare after primary vaccination, but those who are 65 years or older, are immunosuppressed, or have underlying conditions may be at increased risk, according to research published in the Jan. 7 issue of the U.S. Centers for Disease Control and Prevention
 
 Morbidity and Mortality Weekly Report
 
 .




 Christina Yek, M.D., from the National Institutes of Health Clinical Center in Bethesda, Maryland, and colleagues used data from 465 facilities in a large U.S. health care database to examine the frequency of and risk factors for developing a severe COVID-19 outcome after completion of a primary COVID-19 vaccination series (receipt of two doses of BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna] or a single dose of JNJ-78436735 [Janssen]).




 The researchers found that 2,246 of the 1,228,664 persons who completed primary vaccination during December 2020 to October 2021 developed COVID-19 (18.0 per 10,000 vaccinated persons) and 189 had a severe outcome (1.5 per 10,000), 36 of whom died (0.3 per 10,000). Persons who were aged 65 years or older, were immunosuppressed, or had at least one of six other underlying conditions had a higher risk for severe outcomes. All persons with severe outcomes had one or more of these risk factors; of those who died, 77.8 percent had four or more risk factors.




 "Even when vaccinated, persons with identifiable risk factors should receive interventions including chronic disease management, precautions to reduce exposure, additional primary and booster vaccine doses, and effective pharmaceutical therapy as indicated to reduce risk for severe COVID-19-associated outcomes," the authors write.




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Risk higher for people who were aged 65 years or older, immunosuppressed, or had at least one of six underlying conditions

Severe COVID-19 Outcomes Rare After Primary Vaccination

As concerns about the new omicron variant grow, vaccine makers say they are already working on ways to protect people against the potential new threat.




 Pfizer said it and its partner BioNTech could develop and produce a "tailor-made vaccine" in about 100 days if a "vaccine-escape" variant emerges,
 
 NBC News
 
 reported.




 Meanwhile, Moderna said it was employing a three-pronged strategy against the omicron variant. "From the beginning, we have said that as we seek to defeat the pandemic, it is imperative that we are proactive as the virus evolves. The mutations in the omicron variant are concerning and for several days, we have been moving as fast as possible to execute our strategy to address this variant," Moderna CEO Stéphane Bancel said in a
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 "We have three lines of defense that we are advancing in parallel: we have already evaluated a higher dose booster of mRNA-1273 [100 µg], second, we are already studying two multi-valent booster candidates in the clinic that were designed to anticipate mutations such as those that have emerged in the omicron variant and data is expected in the coming weeks, and third, we are rapidly advancing a omicron-specific booster candidate [mRNA-1273.529]," Bancel added.




 So far, existing vaccines have proven effective against prior coronavirus variants, including the delta variant, but it is wise to be preparing for updated vaccines, said Deepti Gurdasani, M.D., clinical epidemiologist at Queen Mary University of London. It is also important to try to contain the new variant's spread.




 "It’s possible that Pfizer might come up with this vaccine in three or four months' time and by the time it becomes available, there's a new globally dominant variant," Gurdasani told
 
 NBC News
 
 . "So, vaccine development and re-engineering has to go hand in hand with efforts to contain transmission, which is the only way that we’re going to be able to get on top of the virus adaptation."




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So far, existing vaccines have proven effective against prior coronavirus variants, including the delta variant

Vaccine Makers Already Testing Their Shots Against Omicron Variant

The impact of human papillomavirus (HPV) vaccination is increasing in the United States, with evidence of herd protection, according to a study published online May 17 in the
 
 Annals of Internal Medicine
 
 .




 Hannah G. Rosenblum, M.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues estimated vaccine impact and effectiveness against quadrivalent HPV vaccine (4vHPV)-type prevalent infection among sexually experienced U.S. females and vaccine effectiveness among sexually experienced U.S. males using data from the National Health and Nutrition Examination Survey conducted in 2003 to 2006 (prevaccine era) and in 2007 to 2010, 2011 to 2014, and 2015 to 2018 (vaccine eras). Cervicovaginal and penile specimens were tested for HPV DNA; the prevalence rates of 4vHPV and non-4vHPV types were estimated for females in each era and for males in 2013 to 2016.




 The researchers found that the impact on 4vHPV-type prevalence in 2015 to 2018 was 85 percent overall among sexually experienced females aged 14 to 24 years, and the impact was 90 and 74 percent among vaccinated and unvaccinated females, respectively. There were no significant decreases seen in non-4vHPV-type prevalence. During the vaccine eras, vaccine effectiveness varied from 60 to 84 percent for females and was 51 percent for males during 2013 to 2016.




 "The COVID-19 pandemic disrupted immunization programs worldwide," the authors write. "Data from the United States indicate that the pandemic may reverse trends of increasing HPV vaccination coverage."




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Impact on 4vHPV-type prevalence in 2015 to 2018 for 14- to 24-year-old females 90 percent among vaccinated, 74 percent among unvaccinated

Increasing Impact of HPV Vaccination Seen in the United States

If a patient develops a COVID-19 infection, should I stop my biologic?

You. If a patient develops Covid-19 you should stop your biologic and only restart it once they are past, you know, the CDC guidelines of the number of days to quarantine, and as long as they don't have any residual Covid-19 symptoms. So it's really a case by case basis to sort of decide when to restart the biologic. But certainly if a patient has Covid-19 while on a biologic, the biologic should be stopped.

What level of impact is teledermatology having on dermatology and will it persist?

You. I would say telermatology is an amazing tool if used in the right way. I have lectured and like to use it as a triage tool to really be able to tell patients, hey, you need to come in immediately or be seen later. I think we will see it used more just because people have perhaps moved out of some larger cities and want to still maintain that relationship with their dermatologist, or are going to be doing more remote work and don't want to have to leave their home and come to a practice. I would say long term, the challenges are that there are certain things you can't assess as well, biotelermatology. So my opinion is really that it's a great tool if used in the right way, and I think we'll continue to see it. Likely not as much as we saw it during the height of the pandemic, but we will continue to see it in some form.

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