I notice that TN Dept of Health hasn't updated the covid-19 dashboard or the downloadable datasets since September 8. Anyone know what the schedule is now?

Most of the information that I see about the new bivalent boosters says that Tennessee residents can get the bivalent shot now. What if I’m not a resident of Tennessee?

Since in the last months the new variant that has spread the most has been Omicron Ba.5 I wanted to make a poll to know about the symptoms you experienced with it if you have caught Covid in the last months ( Late June, July, August until now) to understand its features. Thanks if you wanted to participate😀👍🏼

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Im traveling out of the country in two weeks and want to ensure im protected so i dont get sick in a foreign country, and so i dont spread it back to my family.

I had the Pfizer dose, so 2 initial shots and ive had one booster back in November.

I have a weak immune system due to anemia, endometriosis, constant inflammation, and other issues. My doctor basically told me to mark yes on the immune issue question mark.

My question is, would you guys get another booster if you were in my situation? According to the cdc im fully vaxxed, but im nervous about this trip.

We just stopped wearing masks when out at church two weeks ago. Monday my daughter tested positive for c diff. Her symptoms were vomiting and diarrhea. She didn’t have a fever on Monday but they said if she got a fever to bring her to the er if it reached over 103 with meds. Yesterday it did. They did a covid test at the er and it came back positive. Anybody ever had covid with c diff? Any advice on what to expect the next few days with symptoms? We’ve never had either before. So far her only symptoms have been on day 1 : vomiting and diarrhea, day 2: fevers without vomiting and diarrhea. Day 3: no fevers, no vomiting and one time loose watery stool. No sniffles, coughing, or sneezing at all.

Is this BA 5?

Favorite food

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Hello, so it finally happened, I got COVID for the first time since this whole thing started. I reached out to a new Doctor that I started seeing earlier this year. They are recommending hydroxychloroquine and ivermectin. Last I checked, this is not approved for treatment. Are there other options? Did I miss something?

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I am fully vaxxed with a booster (oct '21).

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Any insight would be appreciated.

Just a reminder to you folks in Tennessee that there’s a website where you can locate supplies of the 4 drugs the US government is shipping to states for Covid:

Preventive drug

Evusheld (This is for people whose immune systems are not working right, so that they cannot make antibodies when they are vaccinated. It basically gives the person a supply of the antibodies their body cannot make.)

Treatment drugs (These help fight the virus if you are already infected.)

Paxlovid

Molnupiravir

Bebtelovimab

This is the site for Tennessee. It searches for Evusheld, but you can use the menu in the upper left to search for one of the other drugs. The site does not ask you to register and does not charge a fee. It was put up as a public service by a Microsoft engineer whose wife needed Evusheld after cancer treatment.

Anyone?

.......?

I've heard about this and Guillian-Barre in relation to the vaccine. How likely is this to effect me? I have severe anxiety and OCD, so this has been a struggle for me. (I'm a 21 year old male)

I'm convinced some people want to get infected

Cardiac Function Normalizes by 3 Months
in MIS-C in Study

Bianca Nogrady

January 19, 2022

Most children with multisystem inflammatory syndrome related to COVID-19 infection show recovery of cardiac function by 3 months, but longer term follow-up is still needed, suggests a new retrospective longitudinal cohort study.

While 80%-85% of children with multisystem inflammatory syndrome have cardiovascular involvement, "lack of knowledge about the short-term consequences of MIS-C has led to uncertainty among physicians in making recommendations about follow-up," Daisuke Matsubara, MD, PhD, and colleagues wrote in their paper, which was published in the Journal of the American Heart Association.

Matsubara, of the department of pediatrics at the Children's Hospital of Philadelphia, and colleagues examined cardiac outcomes among 60 patients aged 18 years or under admitted to two Philadelphia hospitals with MIS-C between April 2020 and January 2021. They compared those with outcomes in 60 age-matched healthy children who had undergone echocardiography for a range of non–COVID-related conditions such as chest pain or syncope.

The study used echocardiography, MRI, biochemistry, and functional and clinical parameters to assess the degree of change and damage to the heart at 3 months after admission.

When the patients first presented to a hospital, 42 had biochemical signs of myocardial injury, such as elevated brain-type natriuretic peptide and troponin levels. However, most patients' symptoms were no longer present by the time they were discharged from hospital.

The researchers found that 81% of patients who presented with myocardial injury had lost the left atrial contraction phase. This dropped to 51% during the subacute phase, then 30% at 1 month. By 3-4 months, all patients achieved normal left atrial contraction phase.

At 1 month after admission, all MIS-C patients had significant signs of cardiac strain, compared with controls, including changes to global longitudinal strain, global circumferential strain, circumferential early diastolic strain rate, and right ventricular free wall longitudinal strain.

Parameters of Strain Normalized by 3 Months

All parameters of strain had normalized, compared with controls, by 3 months. In the case of global longitudinal strain and left atrial strain, the median time to normalization was 6 days. For left ventricular ejection fraction the median time to normalization was 8 days and for right ventricular free wall longitudinal strain it was 9 days.

A small difference persisted with global longitudinal strain, but the authors said the difference was within the range of normal published values and not clinically relevant. The dysfunction appeared to be spread evenly across the heart rather than varying between segments, they noted.

"Deformation analysis could detect subtle myocardial changes; therefore, our study suggests the absence of persistent subclinical myocardial dysfunction after 3-4 months," Matsubara said in an interview.

Four patients experienced small coronary aneurysms during the acute phase of MIS-C, but all had resolved within 2 months and none experienced any further lesions.

Among the 14 patients who underwent cardiac MRI at presentation, 2 had evidence of myocardial edema and fibrosis during the subacute phase of illness, despite having normal left ventricular systolic function and conventional echocardiography.

At follow-up, only one patient had residual edema; this individual had no evidence of fibrosis and had normal systolic function.

Study Provides Reassurance, but Longer Follow-Up Needed

Commenting on the study, pediatric cardiologist Devyani Chowdhury, MD, director of Cardiology Care for Children in Lancaster, Pa., said that overall it provided reassurance that most children do recover from MIS-C — and fits with her own clinical experience of the condition — but cautioned that longer-term follow-up was still needed.

"Three months is really not long term for a child," Chowdhury said in an interview. "I've had a couple of patients whose MRIs have not normalized even after 1 year."

Chowdhury also noted that it was a relatively small sample size, and it was also not yet possible to work out what host factors might play a role in increasing the risk of longer-term effects of MIS-C.

"I think it is a disease in evolution and we have to give it time, but in the very short term at least these kids are not dying, they are recovering, going home, and returning to activity and the heart is getting better," she said.

The study authors suggested their findings could provide an evidence base for recommendations on when children with MIS-C can return to sports and physical activity, given that current consensus statements on the issue treat MIS-C as being equivalent to myocarditis in adults.

Matsubara noted that the cardiac outcomes of MIS-C were very different from those in COVID-19–affected adults, where echocardiography and MRI show longer-term evidence of myocardial impairments.

"This finding is also different from that of adult COVID-19, where the high troponin is reported to be the prognostic factor," he said, suggesting this could explain different mechanisms of myocardial injury between MIS-C and COVID-19 myocarditis.

One author was supported by the National Institutes of Health. No conflicts of interest were declared.

This article originally appeared on MDedge.com, part of the Medscape Professional Network.

Credits:

Lead Image: Dreamstime

Medscape Medical News © 2022 WebMD, LLC

Cite this: Cardiac Function Normalizes by 3 Monthsin MIS-C in Study - Medscape - Jan 19, 2022.