Author Interviews, COVID -19 Coronavirus, Pulmonary Disease / 12.01.2021

MedicalResearch.com Interview with: [caption id="attachment_56399" align="alignleft" width="200"]MedicalResearch.com Interview with: Dr. Townsend Department of Infectious Diseases St. James's Hospital and Department of Clinical Medicine Trinity Translational Medicine Institute Trinity College, Dublin, Ireland MedicalResearch.com: What is the background for this study? Response: Much is known about the clinical characteristics and pathological features of acute SARS-CoV-2 infection, but there is relatively little known about post-COVID recovery. This has come under increasing scrutiny in light of reports that patients suffer persistent symptoms beyond resolution of initial infection, known as long COVID. We set out to assess patients in our post-COVID clinic for ongoing ill-health, with particular focus on fatigue and breathlessness. Given that COVID-19 primarily affects the respiratory system, we also evaluated respiratory recovery. Patients underwent chest radiography and six-minute-walk testing, as well as routine blood tests including inflammatory markers and D-dimers. We included both patients who were admitted during their acute infection as well as those managed in the community in order to capture the full spectrum of disease. MedicalResearch.com: What are the main findings? Are there any markers that suggest a higher risk of persistent post-Covid symptoms? Response: We assessed 153 patients, of whom 74 had required admission during initial infection, at a median of 75 days post-infection. We found persistent ill-health was common in those attending our clinic, with 62% reporting that they did not feel back to full health. Almost half (47%) met the case definition for fatigue, as assessed by the Chalder Fatigue Scale. Patients also reported moderate breathlessness on six-minute-walk-test, with a median modified Borg score of 3. Reassuringly, we saw persistent abnormal chest x-rays in only 4% of patients, and the median distance covered during walk test was 460m, which approaches the normal range for healthy populations. Furthermore, there were only two patients that experienced oxygen desaturation to less than 90% during walk test. We investigated the potential predictors and associations of breathless, distance covered and abnormal chest x-ray using a multivariate regression analysis model. Interestingly, we found that severity of initial infection, as defined by requirement for admission to hospital, peak CRP and peak oxygen requirement, was not associated with severity of self-reported symptoms. Thus, there were no features from initial infection identified that could predict persistence of symptoms beyond initial infection. MedicalResearch.com: What should readers take away from your report? Response: This study highlights several important points: 1. Ill-health, fatigue and breathlessness are common in the aftermath of SARS-CoV-2 infection 2. These appear unrelated to initial severity of infection. This has implications for the potential number of patients who may be affected, as well as increased burden on the healthcare system 3. We show reassuringly low rates of abnormal chest x-rays as well as reassuring objective six-minute-walk test results, suggesting that clinically significant pulmonary damage is uncommon. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: We would suggest that future studies on the aftermath of COVID-19 include patients across the spectrum of disease severity, rather than focusing only on those who required hospitalization. The range and frequency of post-COVID symptoms are being emerging in the literature, and there is a need for mechanistic studies to understand the underlying pathology. We have no disclosures to declare. Citation: Liam Townsend, Joanne Dowds, Kate O'Brien, Grainne Sheill, Adam H Dyer, Brendan O'Kelly, John P. Hynes, Aoife Mooney, Jean Dunne, Cliona Ni Cheallaigh, Cliona O'Farrelly, Nollaig M Bourke, Niall Conlon, Ignacio Martin-Loeches, Colm Bergin, Parthiban Nadarajan, Ciaran Bannan. Persistent Poor Health Post-COVID-19 Is Not Associated with Respiratory Complications or Initial Disease Severity. Annals of the American Thoracic Society, 2021; DOI: 10.1513/AnnalsATS.202009-1175OC MedicalResearch.com is not a forum for the exchange of personal medical information, advice or the promotion of self-destructive behavior (e.g., eating disorders, suicide). While you may freely discuss your troubles, you should not look to the Website for information or advice on such topics. Instead, we recommend that you talk in person with a trusted medical professional. The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. Dr. Townsend[/caption] Dr. Liam Townsend, PhD Department of Infectious Diseases St. James's Hospital and Department of Clinical Medicine Trinity Translational Medicine Institute Trinity College, Dublin, Ireland  MedicalResearch.com: What is the background for this study? Response: Much is known about the clinical characteristics and pathological features of acute SARS-CoV-2 infection, but there is relatively little known about post-COVID recovery. This has come under increasing scrutiny in light of reports that patients suffer persistent symptoms beyond resolution of initial infection, known as long COVID. We set out to assess patients in our post-COVID clinic for ongoing ill-health, with particular focus on fatigue and breathlessness. Given that COVID-19 primarily affects the respiratory system, we also evaluated respiratory recovery. Patients underwent chest radiography and six-minute-walk testing, as well as routine blood tests including inflammatory markers and D-dimers. We included both patients who were admitted during their acute infection as well as those managed in the community in order to capture the full spectrum of disease.
Author Interviews / 01.12.2020

MedicalResearch.com Interview with: Daniel Maloney, Ph.D Farrar Lab Smurfit Institute of Genetics Trinity College Dublin MedicalResearch.com: What is the background for this study? Would you briefly describe the condition of Dominant optic atrophy? Response: Dominant Optic Atrophy (DOA) is a progressive blinding disorder that affects roughly 1:10,000 to 1:30,000 people. It is primarily caused by mutations in the OPA1 gene, which plays a pivotal role in the maintenance of the mitochondrial network. There is currently no way to prevent or cure DOA. We sought to build upon previous work to test if OPA1 could be delivered as a potential gene therapy intervention. 
Author Interviews, Environmental Risks, Nature, Pediatrics / 23.10.2020

MedicalResearch.com Interview with: Prof. John Boland AMBER The SFI Research Centre for Advanced Materials and BioEngineering Research, CRANN, and Trinity’s School of Chemistry Prof. Liwen Xiao at TrinityHaus and Trinity’s School of Engineering Trinity College Dublin baby-bottle-infant-plasticsMedicalResearch.com: What is the background for this study? Response: There is growing evidence to suggest that micro and nano plastics are released into our food and water sources through the chemical and physical degradation of larger plastic items. Some studies have demonstrated the potential transfer of micro and nano plastics from oceans to humans via the food chain but little is known about the direct release of microplastics (MPs) from plastic products through everyday use – and this is what we wanted to investigate.  Polypropylene (PP) is one of the most commonly produced plastics in the world for food preparation and storage. It is used to make everyday items such as lunch boxes, kettles and infant-feeding bottles (IFBs). Despite its widespread use the capacity of PP to release microplastics was not appreciated until now. We analysed the potential for release of MPs from polypropylene infant-feeding bottles (PP-IFBs) during formula preparation by following international guidelines. We also estimated the exposure of 12-month-old infants to MPs in 48 countries and regions. 
Asthma, Author Interviews, Genetic Research, Nature / 28.02.2020

MedicalResearch.com Interview with: [caption id="attachment_53322" align="alignleft" width="92"]Zbigniew Zasłona PhD Luke A. J. O’Neill PhD Professor (Chair of Biochemistry) School of Biochemistry and Immunology Trinity Biomedical Sciences Institute Trinity College Dublin, Dublin, Ireland Dr. Zasłona and Dr. ONeill[/caption] Zbigniew Zasłona PhD Luke A. J. O’Neill PhD Professor (Chair of Biochemistry) School of Biochemistry and Immunology Trinity Biomedical Sciences Institute Trinity College Dublin, Dublin, Ireland  MedicalResearch.com: What is the background for this study? Response: Asthma is the most common disease in childhood and the most common respiratory condition in Ireland. It is a disease of environmental and genetic components. It is important to point out that although Ireland has very good air quality, asthma prevalence is very high (the second highest in Europe), and although asthma is not a single gene disease (such as cystic fibrosis) it is very important to study genetic variations in Irish population. Therefore in this study we put emphasis on the genetic component of asthma, rather than environmental factors, especially given that asthma heritability has been estimated as high as 60%. Prevention of asthma by reducing exposure to common risk factors, such as air pollution, will not stop the asthma epidemic in Ireland, as inferior air quality is not an issue.
Author Interviews, Macular Degeneration, Ophthalmology / 08.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50631" align="alignleft" width="165"]Matthew Campbell, PhD Smurfit Institute of Genetics Trinity College Dublin Dublin Dr. Campbell[/caption] Matthew Campbell, PhD Smurfit Institute of Genetics Trinity College Dublin Dublin MedicalResearch.com: What is the background for this study? What are the main findings? Response: Age related macular degeneration (AMD) is the most common form of central retinal blindness in the world. However the underlying causes and initiating factors for disease progression are still not clear. It is classically a disease of the outer retina, where cells called retinal pigment epithelial (RPE) cells degenerate. However, our findings suggest that some of the early initiating events that promote AMD progression are actually coming from the inner retina and more specifically the microvasculature of the inner retina. We discovered that a gene called claudin-5 appears to be regulated by a circadian rhythm that in turn can regulate what gets into and out of the retina on a daily basis. Dysregulating the levels of this component made the inner retinal blood vessels marginally leaky and promoted a pathology that was AMD-like in animal models.  We also showed that the blood vessels of the retina appear to be highly dynamic in human subjects and can appear leakier at different times of the day, likely a mechanism that allows for clearance and replenishment of material into and out of the retina.  It is this process we believe breaks down in early AMD.