SARS-CoV-2 infection triggers pro-atherogenic inflammatory responses in human coronary vessels
Patients with coronavirus disease 2019 (COVID-19) present increased risk for ischemic cardiovascular complications up to 1 year after infection. Although the systemic inflammatory response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection likely contributes to this increased cardiovascular risk, whether SARS-CoV-2 directly infects the coronary vasculature and attendant atherosclerotic plaques remains unknown. Here we report that SARS-CoV-2 viral RNA is detectable and replicates in coronary lesions taken at autopsy from severe COVID-19 cases. SARS-CoV-2 targeted plaque macrophages and exhibited a stronger tropism for arterial lesions than adjacent perivascular fat, correlating with macrophage infiltration levels. SARS-CoV-2 entry was increased in cholesterol-loaded primary macrophages and dependent, in part, on neuropilin-1. SARS-CoV-2 induced a robust inflammatory response in cultured macrophages and human atherosclerotic vascular explants with secretion of cytokines known to trigger cardiovascular events. Our data establish that SARS-CoV-2 infects coronary vessels, inducing plaque inflammation that could trigger acute cardiovascular complications and increase long-term cardiovascular risk.
Long-Term Dysfunction of Taste Papillae in SARS-CoV-2
Abstract BACKGROUND We sought to determine whether ongoing taste disturbance in the post-acute sequelae of coronavirus disease 2019 is associated with the persistent virus in primary taste tissue. CONCLUSIONS Our data show a temporal association in patients between functional taste, taste papillae morphology, and the presence of SARS-CoV-2 and its associated immunological changes. (Funded by Intramural Research Program/National Institute on Aging/National Institute of Allergy and Infectious Diseases/National Institutes of Health; ClinicalTrials.gov numbers NCT03366168 and NCT04565067.)
Uninsured and Not Immune — Closing the Vaccine-Coverage Gap for Adults
The U.S. Covid-19 vaccination strategy was simple: get safe and effective vaccines into arms as quickly as possible by making them free and accessible. This strategy worked: more than 670 million Covid-19 vaccine doses had been administered to more than 270 million Americans by the end of the national public health emergency.
Strategic Masking to Protect Patients from All Respiratory Viral Infections
The end of the public health emergency in the United States is a richly symbolic milestone in the course of the SARSCoV-2 pandemic. During the height of the pandemic, the virus killed millions of people worldwide, upended lives, and radically altered health care. One of the most visible changes in health care was the introduction of universal masking, a measure designed to reduce SARS-CoV-2 transmission in health care facilities by applying source control and exposure protection to everyone in the facility. With the end of the public health emergency, however, many health care centers in the United States are now stopping universal masking and reverting to requiring masking in only limited circumstances (e.g., when health care workers are caring for patients with potentially contagious respiratory infections).
Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection
Key Points Question What symptoms are differentially present in SARS-CoV-2–infected individuals 6 months or more after infection compared with uninfected individuals, and what symptom-based criteria can be used to identify postacute sequelae of SARS-CoV-2 infection (PASC) cases? Findings In this analysis of data from 9764 participants in the RECOVER adult cohort, a prospective longitudinal cohort study, 37 symptoms across multiple pathophysiological domains were identified as present more often in SARS-CoV-2–infected participants at 6 months or more after infection compared with uninfected participants. A preliminary rule for identifying PASC was derived based on a composite symptom score. Meaning A framework for identifying PASC cases based on symptoms is a first step to defining PASC as a new condition. These findings require iterative refinement that further incorporates clinical features to arrive at actionable definitions of PASC.