Dangers Of Investigating Big Pharma

 by Jeffrey A. Tucker via The Epoch Times (emphasis ours),

My family is from Texas (since 1830), so I have a focused interest in the well-being of that state. But I quickly got lost in the strange thicket of confusion when Attorney General Ken Paxton was impeached by the Texas House.

In a series of wild allegations, they accused him of misconduct, including bribery, obstruction of justice, and misappropriation of public resources.

In an instant and with no warning about what was coming, Paxton had to pack up his things, was blocked from doing his duties, and was forced to step aside from the office that the people had three times elected him to hold.

Last week, he was exonerated of all charges and his name was fully cleared. Hardly anyone can even explain what the charges were. From a distance, it sure looked like a big political takedown attempt, but why?

Paxton just sat for an extended interview with Tucker Carlson, who now runs the planet’s most-watched show, which appears on X, formerly Twitter, and has no advertisers at all. In one portion of the interview, Mr. Paxton explained that three weeks before the impeachment, he had initiated an investigation against the COVID-19 vaccine makers for engaging in deceptive trade practices under the laws of Texas.

I recall being very excited about this at the time as a hugely important step. At the national level, the vaccine manufacturers are completely indemnified against liability from harms, which are plenty and also well-documented. Millions were forced to have this product injected into their bodies, and when something goes wrong, there's no one to sue. It isn't the way we are supposed to do business in America.

Paxton was all over the case and ready to start a serious inquiry.

“As soon as I did that,” he told Mr. Carlson, “that blew up my world. I became a target of Big Pharma, Big Tech, and obviously the Biden administration.”

Mr. Carlson then asked him why that would be the case.

“Big Pharma gives a lot of money. ... I was doing it because the federal government has this immunity for them. This is wrong," Paxton said. "They didn’t test this thing. They didn’t tell us about the side effects. They had an obligation to test it, even if they weren’t liable.

"They had an obligation to tell my people there are some risks here. You should decide but here are the risks. Instead, they said everything is good, it prevents it, you won’t spread it. None of that was true. That’s a deceptive trade practice. If they did that ...”

Mr. Carlson interrupts and says, “It seems like they did that.”

Then. Mr. Paxton says he will know more in the coming weeks and months, because he's picking up the case again. He should watch his back.

We need to be clear on what might be going on here. A state attorney general merely decided to apply existing law to the vaccine makers who provide most of the revenue to the drug approval side of the Food and Drug Administration. They fund 75 percent of television advertising and have moles embedded at all the commanding heights.

They are so powerful that they manage to get Congress and the president to grant them full freedom from liability for any of the effects of a vaccine. That only incentivized the firms to call gene therapy a vaccine even though it didn’t work like any vaccine in history.

How can it be possible that such tax-funded corporate agents, which own the patents to their drugs, and can even force their product on unwilling customers, can unseat a duly elected official in a state? It’s amazing ... and terrifying.

But that might be only the start of it. Mr. Carlson’s show on Fox was canceled just after he started asking hard questions about the vaccine, while Russell Brand was smeared the world over as he started to raise questions. It’s happened to many public figures.

Look at the unseating of the founder of Project Veritas’s James O’Keefe, which occurred after he exposed a Pfizer employee bragging about how much money the company would make by creating new strains of viruses against which they can vaccinate. It was easily the most spectacular exposé of the institution’s history—and then, boom, he was fired.

Now, Mr. O’Keefe runs his own outfit that continues to chase down pharma executives.

As for Project Veritas, it just pulled the plug and fired all but a few employees. It has ceased operations, which isn't surprising. When you get rid of the highest-performing person, the fumes you are left with don’t last long.

Think about it: This awesome operation was wrecked because some powerful people got squeamish about exposing the vaccine makers.

Robert F. Kennedy Jr., the biggest and most learned critic of Big Pharma on the planet, faced what might have been an assassination attempt last week. It didn’t even make the newspapers (The Epoch Times excepted). Meanwhile, he's still being denied Secret Service protection even though he's a serious candidate and faces non-stop threats on his life.

As president of Brownstone Institute, I see examples several times a day of what happens to doctors, professors, statisticians, or anyone who asks questions about this industry, which somehow has emerged as among the most powerful in U.S. politics. The dirty dealings of the industry in canceling critics are legion. Any study that questions the effectiveness, safety, or necessity of their products is nearly always rejected by the mainstream journals. Even letters to the editor that expose statistical errors end up in the dustbin.

As for Big Tech, they too are fully beholden. We have ironclad proof that Facebook and Twitter blocked any posts critical of vaccines. They went so far as to block “true information” about vaccine side effects that might contribute to an environment of “vaccine hesitancy.”

We must ask again: How did Big Pharma buy control of so many governments?

At this point, this problem has become a genuine threat to democracy and freedom. No industry has greater power to extract tax funding of its operations, retain intellectual property control over the results, enjoy indemnity from harms, and then even force its products on consumers. This is indefensible.

Any warrior who dares stand up to this deserves the support of everyone who believes in what was the American system.

https://www.zerohedge.com/political/dangers-investigating-big-pharma

The more people exercise, the lazier they are throughout the rest of the day, study suggests

 The more time you spend engaging in a structured exercise routine, such as going to the gym or running, the more likely you are to cut back on other physical daily activities, according to a recent study. 

This decline in physical activities could affect people's ability to lose weight successfully even if they participate in a routine exercise program, according to the study, which was published in the journal Current Nutrition Reports.

"If people are seeking weight loss, they should be aware of their non-exercise physical activity (NEPA) — activities such as walking the dog, riding a bike to work or standing at the desk at work," study author Julie Marvel Mansfeldt, a graduate student at the University of Copenhagen’s Department of Nutrition, Exercise and Sports (NEXS), told Fox News Digital.

"If these activities are suddenly stopped, the total daily energy expenditure is less than expected — and thus the weight loss will be less than expected," she added.

"Compensation of NEPA can thus be a barrier to weight loss."

Mansfeldt, under the supervision of Professor Faidon Magkos of NEXS at the University of Copenhagen, conducted a systemic review of 24 research studies that looked at people’s levels of daily physical activities before and while participating in different types of structured exercise regimens. 

The team found that a person who is more engaged in a routine exercise program is more prone to "lounge around" and avoid other, non-structured physical daily activities, like taking the stairs. 

In a prior research study, this decline in daily physical activity resulted in subjects losing 22% less weight than expected from their exercise training program, according to a news release from the university.

"Sixty-seven percent of studies reported less-than-expected weight loss, which was not explained by the change in energy intake, but likely NEPA," Mansfeldt told Fox News Digital.

In theory, exercise should result in an energy deficit — which should result in weight loss, the release noted. 

"But in practice, we see that the two things are seldom linked, and that weight loss from exercise is often less than expected," Mansfeldt pointed out, suggesting that a "compensatory mechanism" must occur.

Cutting back on daily physical activity may be a type of physical compensation for the person who is engaging in more training, the study stated.  

After exercising, people may be more tired, leading them to lounge more and avoid other physical daily activities — or it could be a reward for working out.

The study also noted that dietary compensation might occur with increased structured exercise, where people eat more after completing a workout — which then increases their energy (calorie) intake, though this compensation was less common.

"Surprisingly and contrary to what many people think, we do not typically increase the amount of food we eat upon starting exercise training," Mansfeldt said in the news release. 

"This then suggests that we must be decreasing non-exercise physical activity, which refers to all the physical activities we do in our daily lives aside from the structured exercise."

Those who enjoyed their exercise regimen were less likely to partake in these compensatory motions, the study noted, and also achieved greater weight loss than those who had a negative view of their program, according to the study.

"Depending on the feelings associated with the physical activity, people change their energy intake," Mansfeldt told Fox News Digital. 

"For example, if they did not enjoy running, they increased their energy intake afterward, which is an example of dietary compensation — and this is potentially also true for non-exercise physical activities."

Reduced non-exercise physical activity was common in both men and women across all weight ranges, the study found.

https://www.foxnews.com/health/more-people-exercise-lazier-they-are-throughout-day-study-suggests

Straightforward Policy Solution to Drug Shortages

 The FDA maintains a current list of drugs that are currently in shortage. As of September 29, 145 drugs were on it, including two (amoxicillin and Adderall) mentioned by Dr. Greenhouse. The list includes much of the contents of the medicine cabinet of a hospital ICU or emergency room and many drugs used by paramedics. 

Hospitals are scrambling to ensure adequate supplies of drugs that are in shortage or to find substitutes for them. In the University of Chicago study, one-third of hospitals had to ration medications at least once. That means that some patients, like those of Dr. Greenhouse, got the second or third choice of drug treatment, increasing the likelihood that the drug will be ineffective, suboptimally effective, or have unwanted side effects.

Based on questions posed to 29 of its 33 member hospitals, the National Comprehensive Cancer Network reported today (October 5) that 86% of those cancer centers are experiencing a shortage of at least one type of generic chemotherapy drug.  The survey focused mainly on two platinum-containing drugs, carboplatin and cisplatin, that are used to treat multiple cancer types, including lung, breast, prostate, and gynecologic cancers, as well as many leukemias and lymphomas.

Much of this is preventable. In order to ameliorate drug shortages, we need a policy change that would enable overseas manufacturers to sell products in the U.S. that already have received marketing approval from certain foreign governments with standards comparable to those of the U.S. FDA, and vice versa. In other words, reciprocity: An approval in one country on the list would be reciprocated automatically by the others (subject to the creation of approved labeling in the appropriate format, language, and other formalities). That would afford drugmakers in those countries rapid access to the U.S. market, helping to alleviate our shortages and preventing future ones.

Reciprocity would ameliorate other problems as well, such as the FDA dragging its feet on the approval of important drugs and vaccines that have been given the green light elsewhere. For example, Bexsero, a vaccine to prevent meningitis B, was approved in 2013 by the European Union, Australia, and Canada but not by the FDA until 2015.

Another example was the long delay before the FDA’s 2015 approval of Fluad, a flu vaccine containing an adjuvant that boosts the immune response. It is used primarily in the elderly, whose immune response to flu vaccines typically is poor. Fluad has been used in Italy since 1997 and approved in more than three dozen countries. The 18‐year delay in availability in the United States undoubtedly caused many avoidable hospitalizations and deaths. 

There is another unobvious problem that reciprocity could help. There have been attempts by senior FDA officials to invent new standards for drug approval in addition to the statutory requirements of safety and efficacy. For example, the Agency denied approval of a drug, Arcoxia (etoricoxib, a cyclooxygenase (COX)-2 inhibitor for the relief of arthritis pain), because, they said, it needed to be shown to be superior to existing drugs to obtain approval. Such wandering off the reservation would be neutralized by reciprocity of approvals.

The stage is set for such an advance. The United States has been a leader in the deliberations of the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use, which has led to harmonized standards among the FDA and its foreign counterparts. These countries now have a standardized dossier for seeking approval of new drugs, the U.S. accepts research conducted in other countries to support applications for the approval of new drugs and medical devices, and the FDA has established Current Good Manufacturing Practices for foreign production facilities. Thus, we’re already part of the way there.

Although reciprocity of regulatory approvals of drugs would be a significant advance, it would create some dilemmas. For example, what happens to trials underway that were intended to obtain FDA approval if they were preempted by approval in a "reciprocating country?" Would the sponsor stop them? Similarly, what happens to a pending New Drug Application submitted to the FDA if a reciprocating country approves the drug? (On average, the FDA review takes more than two years.)

Finally, would drug companies stop filing applications for approval in the U.S. entirely and simply go to regulators in one or two of the reciprocating countries considered "easier” or faster? And if so, would that be good or bad for American consumers?

Admittedly, not all drug shortages would be addressed by reciprocity of approvals. The Senate report found that part of the problem is that 90% to 95% of generic sterile injectable drugs, heavily represented on the FDA’s shortage list, depend on starting materials from China and India. When he introduced the Senate report in March, Senator Peters warned that the U.S.'s over-reliance on foreign suppliers, especially those in China, "remains an unacceptable national security risk."  Still, reciprocity would help in the short term. As FDA Commissioner Dr. Frank Young, my old boss, used to say, “Walking on water wasn’t built in a day.”  (He was fond of mixing his metaphors.)

Americans must be assured of the availability of approved drugs and medical devices in the marketplace so that healthcare providers have more reliable inventory, experience fewer shortages, and more choices when shortages arise. Reciprocity of regulatory decisions would help to achieve that, and the White House and Congress should make it happen without delay. FDA Commissioner Califf should be urging them on.

Henry I. Miller, MS, MD, is the Glenn Swogger Distinguished Fellow at the American Council on Science and Health. His research focuses on public policy toward science, technology, and medicine, encompassing a number of areas, including pharmaceutical development, genetic engineering, models for regulatory reform, precision medicine, and the emergence of new viral diseases. Dr. Miller served for fifteen years at the US Food and Drug Administration (FDA) in a number of posts, including as the founding director of the Office of Biotechnology.

https://www.acsh.org/news/2023/10/05/drug-shn-17288ortages-plague-doctors-and-patients-there%E2%80%99s-straightforward-policy-solutio

Investors are hiding out in cash, putting 20.4% aside, as volatility erupts, State Street says

 Forget 60/40 -- for now

Long-term institutional investors kept more of their portfolios in cash in September as volatility struck the roughly $25 trillion Treasury market, spurring a sharp selloff in stocks and bonds, according to State Street Global Markets.

Instead of the traditional 60/40 portfolio construction, which dedicates a bigger share to stocks and a smaller portion to bonds, investors increasingly were keeping a significant pot of cash at the ready, according to a new State Street report.

It showed cash allocations rose 0.3% to 20.4% in September, while the slice for fixed-income rose 0.2% to 28.5% and equities dropped 0.5% to 51.1%.

"Investors are hiding in cash once again in the face of combined equity and fixed income market weakness," said Michael Metcalfe, head of macro strategy at State Street. "While cash holdings are now above average, we would caution they remain a few percentage points below their normal crises peaks."

State Street's holdings report is based on the share of investor portfolios allocated toward equity, fixed income and cash going back to 1998.

The 10-year Treasury yield BX:TMUBMUSD10Y jumped 7 basis points on Friday to 4.78%, while the 30-year Treasury yield BX:TMUBMUSD30Y advanced 5 basis points to 4.94%.

The surge in short-term Treasury yields since the Federal Reserve began ratcheting up its policy rate to a 22-year high has given ordinary investors in Treasury bills, or T-bills, a shot at 5% yields for the first time in more than a decade.

Until recently, however, longer-dated Treasury yields used to finance much of the economy, namely the 10-year and 30-year rate, were slower to approach the 5% level. The sharp recent repricing creates price pressures on older bonds issued at lower coupons.

Until Friday, it also had been hurting stocks. The Dow Jones Industrial Average DJIA was up about 400 points Friday, or 1.2%, while the S&P 500 index SPX was 1.5% higher and the Nasdaq Composite Index COMP was up 1.8%, according to FactSet.

https://www.morningstar.com/news/marketwatch/20231006458/investors-are-hiding-out-in-cash-putting-204-aside-as-volatility-erupts-state-street-says

'Virtual Nursing Offers a New Career for Burned-Out Nurses'

 More than a year into the pandemic, as new COVID variants surged in the United States, Nicole McQueen sought a change from her high-stress career in the operating room. After 14 years as a registered nurse in the OR, she switched to virtual nursing. Three years later, she has no regrets. "I wanted to reinvigorate my skills. It piqued my curiosity, and it was something new," she said. "It was also physically less demanding."

These days, McQueen handles admissions and patient discharges from her Indiana home for 8 to 10 nursing units in three hospitals in Maine. They are time-consuming tasks for bedside nurses that can easily be handled off site, McQueen told Medscape Medical News. "I am able to spend so much more time with the patients than the bedside nurse."

She added that her duties include providing patient education, such as detailed discharge instructions often shortchanged by busy bedside nurses.

McQueen is part of a growing cadre of virtual nurses who are using their skills for hospital-based telemedicine, potentially working a more flexible schedule without having to be on their feet all day.

Hospitals using the hybrid nursing model say it gained attention in recent years as an outgrowth of telehealth services and a way to lighten the workload of strained healthcare workers. Virtual nursing helps fill some of the gaps of bedside nurses, administrative and minor tasks that require professional expertise but not the physical presence of a nurse. While there is no national certification or industry standard, hospital leaders are starting to notice improvement in staff morale and turnover.

Rise of Telehealth

Virtual nursing is a subset of telehealth, a broad category for digital information and communication technologies that provide health care services remotely.

The hybrid nursing model differs from telehealth, which took off during the pandemic as a way to link patients with clinicians, generally in an outpatient setting, according to Tom Bobich, MBA, vice president of marketing at Hicuity Health. The company provides telemedicine services to more than 140 hospitals in 34 states.

More recently, telemedicine expanded into patient care, such as remote monitoring and tele-triage, Bobich said. "And now hospitals are trying to figure out what workloads can be handled remotely. And except for tasks that require hands-on care, much can be done offsite."

Virtual nurses can help with admissions, conduct initial patient interviews, handle discharges, and offer confirmation on medications that require two nurse signatures, he said.

McQueen, who works for Hicuity, said that as a virtual nurse, she reviews charts to make sure they are complete. "At my previous virtual job, we also provided support for newer nurses," she said. "For instance, I could answer questions that they may have about the patient or a procedure or a medication."

As with other nursing jobs, salaries for telehealth nurses vary considerably by factors such as level of education and training, specialty, geographic location, and specific employer.

Telehealth nurses earned an average annual salary last year of nearly $63,000, or about $31 an hour, according to Payscale. Meanwhile, RNs nationwide earned an average of $89,000 annually, or about $43 an hour last year, the US Bureau of Labor Statistics reported.

Potential Downsides

While it continues to evolve, virtual nursing lacks formal structure and regulation. At this point, becoming a virtual nurse doesn't require any specific training or certification, except what the healthcare facility may request, such as learning how to use its electronic health records and virtual platform.

The American Nurses Credentialing Center said it is not considering a virtual nursing certification. Earlier this year, however, the Medical-Surgical Nursing Certification Board announced a new virtual acute care nursing certification. It will include patient education, staff mentoring, patient monitoring, physician rounding, ongoing risk assessment, and support activities during admission and discharge.

At least one nurses' union urged caution in hiring virtual nurses. The California Nurses Association (CNA), which is affiliated with National Nurses United, was concerned about other types of telehealth programs, including advanced home care that replaces hospital nursing care with technology.

Instead of hiring virtual nurses to handle admissions and discharges, hospitals should try to improve working conditions so that bedside nurses return to work, said Rochelle Pardue-Okimoto, RN, a CNA nursing practice representative.

"There has to be some other motivation to doing it virtually as opposed to hiring someone who is physically going to be right there at the bedside," she told Medscape Medical News.

"We don't believe that you can give optimal care in this model," she said of virtual nursing. "We believe that this is something that is ultimately trying to change the scope of practice of registered nurses and decrease the number of registered nurses at the bedside. And this is the exact opposite of the goal of increasing staffing and improving workplace conditions."

To date, hospitals have only used virtual nurses in acute settings in a limited way, Pardue-Okimoto said, adding that there's non-patient paperwork they can easily handle. "We can see how it can also be appealing for nurses and give them different career options."

Addressing Burnout

AdventHealth Fish Memorial in Orange City, Florida, recently started a virtual nursing pilot program to deal with burnout and workforce shortages, according to Michele Johnson, RN, chief nursing officer. "We were looking at from the perspective of reducing workload intensity and not from increasing ratios," she said.

The pilot program began in two nursing units and the emergency department. The hospital maintains a 1:14 virtual nurse-to-patient ratio. The virtual nurses assist the primary staff, handling admissions, enhancing patient education, providing virtual observation, and helping new nurses, Johnson said.

When a virtual nurse provides around-the-clock observation, patients understand that there is "always someone there" behind the screen. But they always knock or ring the doorbell of a patient's room before entering the first time. "This is so the patient doesn't feel like someone is always watching them," Johnson explained. "There have only been a handful that have refused care from a virtual nurse."

Staff retention and job satisfaction is one of the biggest rewards of the virtual nurse program, Johnson said. Turnover at the hospital declined from 30% to 9% with the pilot virtual nurses, she said. The pilot program also contributed to a low job vacancy rate and eliminated the need for travel nurses. "We realized that we just can't keep doing things the same way."

Division of Duties

At Saint Luke's Health System Kansas City in Missouri, patients who have a quick question about their care — or perhaps just can't work their TV remote — can call for a virtual nurse through a computer screen for immediate attention.

St Luke's started using virtual nursing in 2019 to address staffing issues.

"We identified areas where innovation and technology could truly transform the way we provide care — and even help us extend and expand nursing careers," said Susie Krug, RN, chief nursing officer at Saint Luke's East Hospital in Lee's Summit, Missouri. It's one of the health system's 16 area hospitals and campuses.

Krug explained that virtual nursing is now an option for nurses who may have wanted to leave bedside nursing for any number of reasons but didn't really want to give up patient care.

"We brought together our own multidisciplinary team and mapped out what our program would look like at Saint Luke's," she said. This included how to divide services between bedside and virtual nursing teams to be the most efficient and effective.

St. Luke's hires virtual nurses as staff, whether they are a full-time employee in a tech center or work both at the bedside and as a virtual nurse.

At other health systems, virtual nurses may work in a room with a computer and camera, or remote nurses may work from a command center, managing operations across several campuses. In addition, some hospitals contract with a third-party clinical service, such as Hicuity, to manage the technology and provide virtual nurses.

Hospitals decide how many virtual nurses they need based on patient-to-staff ratios and tasks to assign to the nurses. In some cases, a virtual nurse performs physical assessments using sensors or with help from a technician assistant.

Virtual nurses at St Luke's handle admissions, including medications that patients need before receiving further care; provide a second confirmation when needed for medication sign off; or conduct a skin assessment and discharge education, Krug said. The health system has only used virtual nursing in the acute setting so far, but will consider expanding to other areas, she said.

https://www.medscape.com/viewarticle/997110

Home-Based Exercise Benefits Patients With PAD

Compared with supervised treadmill workouts at a gym, which is considered first-line therapy for walking impairment in lower extremity peripheral artery disease (PAD), exercising at home significantly improves 6-minute walking (6MW) distance, but not maximal treadmill walking distance, results of a new meta-analysis show.

METHODOLOGY:

• The analysis included five randomized clinical trials with a total of 719 participants, mean age 68.6 years, all led by researchers at Northwestern University in Chicago, that compared either supervised treadmill or home-based walking exercise with a non-exercise control group in people with PAD (defined as Ankle Brachial Index ≤ 0.90).

• All trials measured 6-minute walk (6MW) distance (walking as far as possible in 6 minutes), treadmill walking performance, and outcomes from the Walking Impairment Questionnaire (WIQ), which includes distance, walking speed, and stair-climbing domains, at baseline and at 6 months.

• Supervised treadmill exercise interventions included three individualized exercise sessions per week with an exercise physiologist at an exercise center, and home-based exercises involved walking near home 5 days per week, both for up to 50 minutes per session.

TAKEAWAY:

• After adjusting for study, age, sex, race, smoking, history of myocardial infarction, heart failure, and baseline 6MW distance, the study found both exercise interventions were better than non-exercise controls for 6MW distance.

• Compared with supervised treadmill exercise, home-based walking was associated with significantly improved mean 6MW distance (31.8 m vs 55.6 m; adjusted between-group difference: −23.8 m, 95% CI, −44.0 to −3.6; P = .021), and significantly improved WIQ walking speed score.

• However, home-based walking was associated with significantly less improvement in maximal treadmill walking distance compared with supervised treadmill exercise (adjusted between-group difference: 132.5 m; 95% CI, 72.1 - 192.9; P < .001).

IN PRACTICE:

Home-based walking exercise "circumvents" barriers to accessing supervised exercise such as having to travel to a facility, said the authors, who noted the new data "demonstrated a large and consistent effect of home-based walking exercise on improved 6MW distance and also significantly improved the WIQ walking speed score compared with supervised treadmill exercise."

SOURCE:

The study was conducted by Neela D. Thangada, MD, Feinberg School of Medicine, Northwestern University, Chicago, and colleagues. It was published online September 21 in JAMA Network Open.

LIMITATIONS:

Data were combined from different randomized clinical trials that were led by one investigative team, and reported comparisons were not prespecified. Comparisons between supervised and home-based exercise lacked statistical power for the WIQ distance and stair-climbing measures.

DISCLOSURES:

The study was sponsored by the National Center for Research Resources and the National Heart, Lung, and Blood Institute of the National Institutes of Health. Thangada reports no relevant financial relationships. Disclosures for study co-authors can be found with the original article.

https://www.medscape.com/viewarticle/997166

'COVID-19 Tied to Autoimmune Disease Risk'

 Research from Korea provides additional evidence for the connection between COVID-19 and an increased risk for autoimmune conditions post-infection.

METHODOLOGY:

• In this retrospective study, researchers identified 354,527 individuals diagnosed with COVID-19 via polymerase chain reaction (PCR) testing from October 8, 2020 to December 31, 2021.

• Researchers compared the COVID-19 group to 6,134,940 healthy individuals who had no evidence of COVID-19 to quantify the risk for autoimmune and autoinflammatory connective tissue disorders.

• Patients were followed until diagnosis, death, or end of study period (December 31, 2021).

TAKEAWAY:

• Risks for alopecia areata, alopecia totalis, antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis, Crohn's disease, and sarcoidosis were higher in the COVID-19 group.

• Patients with more severe COVID-19 (admitted to the ICU) were at greater risk for many autoimmune conditions, including alopecia totalis, psoriasis, vitiligo, and vasculitis.

IN PRACTICE:

"Our results emphasize the need to focus on managing not only the acute stages of COVID-19 itself but also autoimmune diseases as complications of COVID-19," the authors write.

SOURCE:

Sung Ha Lim, MD, of the Yonsei University Wonju College of Medicine in Wonju, Korea, was the first author of the study, published in JAMA Network Open on October 6.

LIMITATIONS:

The study was retrospective and was comprised almost exclusively of individuals from a single ethnicity. The study could have included individuals with COVID-19 in the control group who did not undergo PCR testing. The analysis did not include detailed information on each patient, including genetic information, that could have contributed to autoimmune disease risk.

DISCLOSURES:

The study was supported by a fund from the research program of the Korea Medical Institute and by grants from the Korea Health Industry Development Institute, the Korean Ministry of Health & Welfare, and the National Research Foundation of Korea. The authors disclosed no relevant financial relationships.

https://www.medscape.com/viewarticle/997134