Medical Case Reports

While the current SARS-COV-2 viral activity levels may seem reassuring ( back to the levels seen in October-November 2023 ), the evolving world of JN.1 offshoots, where the next generation of variants is taking shape, presents a compelling case for anticipating the potential challenges that lie ahead.  From the widespread presence of JN.1.16 across continents to the emerging dominance of JN.1.13 in the U.S., the current variant landscape is rapidly shifting, although the potential implications for the future are not quite clear.  The roots of the pandemic can be traced back to lineage A, with many initial sequences originating from China and subsequently spreading globally, including to regions such as South East Asia, Japan, South Korea, Australia, the USA, and Europe. Lineage B followed as the second major haplotype, with subsequent evolutions leading to the emergence of various sublineages. In 2020, we witnessed the emergence of variants such as Alpha (B.1.1.7) and Delta (...

On October 13, 2023, the golfing world lost an eleven-time PGA Tour winner Andy Bean. He was 70. His demise came six weeks after undergoing a double-lung transplant to address severe lung damage caused by a battle with COVID-19.  Born on March 13, 1953, Thomas Andrew Bean spent his formative years on the picturesque Jekyll Island, Georgia, before his family relocated to Lakeland, Florida. The move was inspired by his father Tommy's passion for golf, which led to the development of a golf course in Lakeland. Andy Bean's connection to the sport grew stronger as he went on to attend the University of Florida, where he played alongside teammates Gary Koch, Woody Blackburn, and Phil Hancock, helping the Gators secure the 1973 NCAA Championship.  Bean turned professional in 1975, embarking on a journey that would establish him as one of the PGA Tour's most consistent performers. Standing at an impressive 6-foot-4, Bean even gained notoriety for an incident where he "wrestled...

SARS-CoV-2, the virus responsible for COVID-19, is showing no signs of disappearing. In fact, the scientific community is in broad agreement that it is likely to remain a persistent part of our global health landscape for the foreseeable future. Just yesterday, U.S. Senator Dick Durbin tested positive for COVID-19 , a third time in the last 12 months. While new COVID-19 hospital admissions are at their lowest levels  - with fewer than two people per 100,000 being admitted - and continue to decrease, SARS-CoV-2 continues to spread. Unfortunately, as hospitalizations decrease, test positivity rates have begun to rise, indicating continued community transmission (see orange curve in the plot below). Historically, coronaviruses were relegated to the sidelines of viral research throughout the '80s and '90s. They were viewed as minor players because the common colds they caused seemed relatively insignificant on the grand scale of human health. However, in 2020, with the emergence of...

Decreased Case Fatality Rate (CRD) in the Omicron era  was largely a result of the decreased pathogenicity of Omicron .  In one study of 101 470 patients , mortality rates were 0.7% for Delta (B.1.617.2), 0.4% for Omicron (B.1.1.529), and 0.3% for Omicron (BA.2) subvariants. Yet,  people keep dying from COVID even in the BA.5/BA4.6 variants era, since the severity of symptoms is affected by age and other health conditions.  One of the most recent October 2022 COVID-19 fatalities was a 62-year-old veteran competitive bodybuilder . He completed his primary vaccination series in April 2021. A 67-year old theoretical physicist  died on October 19th from complications of COVID-19 he had in September. A 63-year-old person with Navajo ancestry died after her 10-month battle with the original strain of Omicron.  By May 2022, more vaccinated individuals  aged 90 or more  died from COVID-19 than unvaccinated elderly of the same age. By mid-October 202...

75-year old man who thought to be the longest-serving inmate in solitary confinement, having survived 43 years in a 6ft x 9ft cell in one of America's most brutal prisons, has died aged 75 from complications caused by Covid-19.   He was released in 2016 on his 69th birthday and went on with his life, wrote a remarkable memoir, won an American book award and was a finalist for the Pulitzer price.  Early July 2022, despite being vaccinated and boosted, he contracted COVID-19. He got better, but started to experience shortness of breath in the end of July and was taken to the hospital. He got fluid in his lungs. It cleared up with medicine, but that aggravated his heart. Once his heart seemed better, his kidney function dwindled. Scans showed that he had developed blood clots and had begun suffering strokes.  Doctors thought he would pull through, but he was intubated and never regained consciousness. REFERENCES https://lailluminator.com/2022/08/04/albert-woodfox-angola-3-...

Previously healthy and fit (bicycling, scuba diving) 70-year-old man became ill with COVID-19 in December 2021. He was fully vaccinated and boosted. When his breathing became labored, he was admitted to the emergency room at George Washington University Hospital. His treatment included a monoclonal antibody.  But despite his robust good health and fitness level, he never left the hospital. He died after spending a month in the hospital. One of his last acts of generosity occurred as he was dying. Some of his blood was drawn for COVID-19 research that will hopefully save lives.  REFERENCES https://www.washingtonpost.com/health/2022/04/29/covid-deaths-unvaccinated-boosters/ https://dc.eater.com/2022/1/18/22881891/scott-bennett-amsterdam-falafelshop-adams-morgan-death https://www.nbcwashington.com/news/coronavirus/founder-of-amsterdam-falafel-shop-dies-of-covid-after-month-in-hospital/2937497/ https://www.gofundme.com/f/to-be-continued-the-scott-bennett-memorial-fund

A sixth wave of COVID-19 is sweeping across  Ontario , and it's being driven by the highly transmissible  BA .2 subvariant of Omicron,  "extremely mild" for most, deadly to some. The 79-year-old Belleville resident was having cancer therapy and was aware that the epidemic put her at risk. She was triple-vaccinated, wore a mask whenever she left the house and stayed in her tight family bubble. Nonetheless, the virus found her. She died on March 22 2022 in a hospital intensive care unit, little than a week after testing positive, her body unable to recover from the COVID that had ravaged her lungs.  REFERENCES https://www.thestar.com/news/gta/2022/03/28/my-mom-is-not-the-only-person-covid-has-killed-this-week-who-is-still-dying-from-the-virus-in-ontario.html https://death-obituary.com/muriel-thompson-death-muriel-thompson-died-from-covid-19-complication/

Second omicron variant – called BA.2 and nicknamed the stealth variant -- appears to be more transmissible, but not necessarily deadlier. Yet, deaths continue to rise.  A 40-year-old woman who had been vaccinated twice and also received her booster tested positive for SARS-CoV-2 during the BA.2 wave.    Her preexisting conditions included  asthma and difficulty with breathing. Two weeks after testing positive for the virus she was coughing up blood and on the same day she noticed the blood she had a fatal heart attack at home which is understood to have been triggered by the virus. GoFundMe campaign by her sisters.  REFERENCES https://www.mylondon.news/news/health/triple-vaccinated-mum-40-dies-23464762 https://www.msn.com/en-gb/health/familyhealth/triple-vaccinated-mum-40-dies-of-covid-with-friends-and-family-left-to-support-young-children/ar-AAVnnJj

A Bay Area News Group analysis of state COVID-19 deaths found that from Aug. 25 to Sept. 21, the deadliest four weeks of the delta surge when the variant accounted for 98% or more of genetically sequenced cases, 2,917 unvaccinated and 533 vaccinated people died. From Jan. 14 to Feb. 10, the deadliest period of the omicron surge when the variant was 98% or more of sequenced cases, 2,999 unvaccinated and 1,767 vaccinated people died, including 436 who’d received booster shots to shore up waning vaccine protection.  State figures have consistently shown the coronavirus is deadlier with age. Of the nearly 85,000 Californians who’ve died of COVID-19, 71% were age 65 or older and 92% at were least 50. In Santa Cruz,  10 patients lost their lives to COVID-19 in the end of January and beginning of February 2022. All but one were vaccinated, and five had received booster shots. O ff the vaccinated patients who died, one was in his early 100s, three were in their 90s, two were in their ...

A 67-year-old fully vaccinated and boosted man with Down syndrome (DS) died early February 2022 after he contracted COVID-19. The man spent 12 says in the hospital  and an intensive care unit due to his underlying health  conditions but was brought home and was cared by his family for the last 6 days preceding his death. The  man suffered a stroke 17 years ago.  Individuals with Down syndrome are presumed to be at high risk of severe CoVID-19, due to immune dysregulation and often compromised cardiopulmonary function. DS is caused by the presence of full or partial extra copy of chromosome 21 ( HSA21 ). REFERENCES The Austin American-Statesman, the major daily newspaper for Austin, the capital city of Texas: https://www.statesman.com/story/news/2021/12/21/donor-pays-off-loan-statesman-season-caring-austin-palliative-care-family/8962545002/ https://www.statesman.com/in-depth/news/2021/11/24/austins-judy-silva-brother-down-syndrome-season-for-caring/625450800...

The clinical course of COVID-19 depends on the complex interaction between genetic and environmental factors which might result in immune hyperactivation or dysregulation. Risk factors for severe outcomes include  cardiovascular and renal diseases, hypertension and diabetes, old age and host genetics.   Several genome-wide association studies  identified candidate genes and non-coding regions associated with the severity of COVID-19 and post-COVID sequelae.   Vaccine effectiveness may fail for individuals with particular genetics and we need more studies and more medical case reports to develop personalized preventative and curative approaches. Until then we can read the news. Valentina Boscardin , an 18 year old Brazilian model  (represented by Ford Models agency) died due to COVID complications despite being fully vaccinated against COVID. She was healthy before falling ill with the virus. Valentina Boscardin Mendes suffered a fatal thrombosis on Sun...

As Coronavirus is evolving breakthrough infections are not breakthroughs anymore.  The first Israeli who died from Omicron was a fully vaccinated and boosted woman . The first Australian was a fully vaccinated man in his 80s with an underlying health condition. The first US case was a reinfection in an unvaccinated man in his 50s . The first India death  from Omicron was a fully vaccinated 74-year-old man with diabetes. The first Brazilian was a triple-vaccinated 68-year-old man with chronic obstructive pulmonary disease and arterial hypertension. According to  today's technical briefing  from UK Health Security Agency, a total of 57 people has been reported to have died within 28 days of an Omicron COVID-19 diagnosis up to 29 December 2021. The median time from Omicron specimen date to death was 5 days (range 0 to 14). The age of those dying ranged from 41 to 99 years. 23% of Omicron cases were vaccinated with 3 doses, over 50% with two doses, while 25% where...