Pandemic tied to spike in diabetes in children; type of immune response lasts months after Pfizer/BioNTech vaccine
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By Nancy Lapid
(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.
Pandemic tied to sharp rise in type 2 diabetes in kids
Hospitalization rates for children with newly diagnosed type 2 diabetes more than doubled during the pandemic, two hospitals reported at the American Diabetes Association Scientific Sessions, held virtually this year. At Our Lady of the Lake Children’s Hospital in Baton Rouge, Louisiana, children with newly diagnosed type 2 diabetes accounted for 0.62% of inpatients from March through December 2020, up from 0.27% the year before. Those numbers are low, “but just the fact that this rate has more than doubled over the past year is … significant,” said Dr. Daniel Hsia of Pennington Biomedical Research Center in Baton Rouge. Children hospitalized in 2020 had more severe diabetes, with higher blood sugar and more dehydration, than children admitted in the prior year, he said. At Children’s National Hospital in Washington, DC, cases of new-onset type 2 diabetes in children increased 233% from 2019 to 2020 – and the children were sicker than in previous years, a separate team reported. Most of these children at both hospitals had not previously had COVID-19. Social distancing measures may have kept children from having regular physical activity and contributed to weight gain, and also kept parents from taking them for routine medical care, all of which may have contributed to more severe illness, researchers speculated. “Our study reinforces the importance of maintaining a healthy lifestyle for children even under such difficult circumstances” Hsia said in a statement. (https://bit.ly/2T4HsV6)
Immune cell “factories” work longer after mRNA vaccines
The tiny “factories” in lymph nodes that churn out antibody-producing B cells to fight infections, called germinal centers, were still functioning to hold COVID-19 at bay for months after people received the mRNA vaccine from BioNTech and Pfizer, according to a new study. After most vaccines, germinal centers last only a few weeks. “Germinal centers are the key to a persistent, protective immune response,” said Ali Ellebedy of Washington University School of Medicine in St. Louis, who coauthored a report on Monday in Nature. “Germinal centers are where our immune memories are formed. And the longer we have a germinal center, the stronger and more durable our immunity will be because there’s a fierce selection process happening there, and only the best immune cells survive.” Researchers studied cells from germinal centers in armpit lymph nodes of 14 recipients of the Pfizer/BioNTech vaccine. Three weeks after the first dose, all 14 had germinal centers that were still generating B cells. B-cell production “expanded greatly” after the second shot and stayed high, they reported. Eight of 10 people biopsied 15 weeks after the first dose, still had functioning germinal centers. “We’re still monitoring the germinal centers, and … in some people, they’re still ongoing,” Ellebedy said. “This is truly remarkable.” The same effect is likely also true for Moderna’sO> mRNA vaccine, the researchers believe. Ultimately, immune cells called T cells are what sustains the germinal centers’ work after they disappear. The researchers plan next to investigate the magnitude and durability of T cell responses after mRNA COVID-19 vaccines. (https://go.nature.com/3jr3WtZ)
Following AstraZeneca with Pfizer shot boosts antibody response
Giving a dose of the Pfizer/BioNTech COVID-19 vaccine four weeks after an AstraZeneca shot produces better immune responses than a second dose of AstraZeneca’s, Oxford University researchers said on Monday. In a study of 830 older adults, mixed two-dose schedules of AstraZeneca and Pfizer vaccines produced higher concentrations of antibodies against the coronavirus that a full schedule of the AstraZeneca shot. The most effective approach – two doses of Pfizer/BioNTech mRNA vaccine – produced levels of antibodies about 10 times higher than two doses of the AstraZeneca vaccine, the researchers reported on Friday in a Lancet preprint. However, the AstraZeneca shot followed by a Pfizer jab induced antibody levels about as high as two Pfizer/BioNTech doses. Giving the Pfizer shot first, followed by AstraZeneca’s, was not as successful. That combination yielded antibody levels higher than two AstraZeneca shots but lower than two doses of the Pfizer vaccine. There were no new safety issues uncovered in the study. Matthew Snape, the Oxford professor behind the trial, said the findings could be used to give flexibility to vaccine rollouts but were not significant enough to recommend a broad shift away from clinically approved schedules. (https://bit.ly/3xXX37B)
COVID-19, not Pfizer’s vaccine, tied to Bell’s palsy
The Pfizer/BioNTech vaccine has not been linked with a higher risk for the facial nerve paralysis known as Bell’s palsy, but COVID-19 itself does increase the risk, suggest two separate studies published on Thursday in JAMA Otolaryngology-Head and Neck Surgery. One study involved 110 people in Israel who received the Pfizer vaccine, including 37 in whom the characteristic facial droop developed on average nine days after the first dose or 14 days after the second. After accounting for underlying risk factors for Bell’s palsy, the researchers concluded the vaccine itself did not increase the risk. Furthermore, they found, rates of Bell’s palsy had not gone up during the vaccine rollout. In the second study, researchers compared Bell’s palsy rates among roughly 348,000 patients with COVID-19 and roughly 63,500 people who had been vaccinated against the coronavirus. The Bell’s palsy risk was nearly seven times higher in those with COVID-19, they found. “Our data suggest that rates of facial nerve palsy are higher in patients who are positive for COVID-19, and this incidence exceeds the reported incidence of Bell’s Palsy with the COVID-19 vaccine,” said Dr. Akina Tamaki of University Hospitals Cleveland Medical Center, who coauthored that study. “Taken together, it supports that the vaccine is safe from a facial nerve paralysis standpoint.” (https://bit.ly/2Tiw6wx, https://bit.ly/3hgiEBu, and https://bit.ly/3y3mi8A)
Open https://tmsnrt.rs/3c7R3Bl in an external browser for a Reuters graphic on vaccines in development.
(Reporting by Nancy Lapid, Megan Brooks, Marilynn Larkin and Alistair Smout; Editing by Bill Berkrot)