Dr. Kevin Most of Northwestern Medicine joins the Steve Cochran Show with his weekly rundown of the latest medical news, including the way your eyes may be the gateway to early signs of Alzheimer’s, the best time to schedule your colonoscopy, and the possible effects of ‘long COVID’.

Read all of Dr. Most’s notes below and catch up with new medical news every Tuesday morning.

Booster shots

1. Lots of questions on Covid boosters. In the UK, Canada and a handful of other countries, if you are 6 months since your last Booster and are at high risk, you will be eligible for a spring booster for Covid.
2. This is interesting where in the UK over 85% of patients over the age of  75 received the bivalent booster in the fall, well above the US rate of 42%
3. The UK has seen a uptick of severe cases in the elderly, thus the call for booster
4. In the US, The FDA has been on radio silence. They have been considering it, but no response or guidance has been delivered
5. The other concern is that the bivalent Covid booster has not been licensed and are still being used and distributed  under the FDA Emergency Use Authorization, will this change in May
6. Some physicians are looking for guidance to give a booster to the high risk patients in their practice, looking for a simple statement that those over the age of 75 or immunocompromised may get a booster if desired.
7. Many physician feel we will need another booster prior to the fall, as Covid has peaked in mid to late summer in the past

Long Covid- is it becoming less common?

1. It appears that the incidence of long covid is decreasing, with the omicron variant when compared to the initial strain of Covid.
2. With the original strain of Covid, we noted Long Covid Symptoms in 8 % of those infected
3. With the Omicron strain we note Long Covid in only 6% of those infected
4. Why this is occurring is still up for discussion as this was from a very large study of close to 5 million Covid patients.
5. This study also noted that those who had preexisting conditions or severe Covid had higher incidence of  long covid,
6. The preexisting conditions noted include obesity, lung disease, kidney disease, diabetes and high blood pressure
7. Causes of long covid are still unclear but some theories feel the new virus attacks different cells in the resp tract, with omicron staying in upper and original covid going deep in the lungs
8. for the 14 million people suffering from long covid symptoms
9. The information was mined anonymously from Epic, the nations largest electronic medical record
10. Skeptics are looking at the younger age of patients impacted during the Omicron phase versus the original phase

Outpatient Treatment of  Covid- Omicron Variant and the development of Long Covid

1. Results of a study on the treatment of Long Covid for 1,125 patients, came out recently
2. In this study, which was completed across the US, had patients placed in one of 4 groups, each receiving a different medication or placebo
3. The drugs included metformin, ivermectin, fluvoxamine or placebo
4. Patients were entered in the study as soon as they got Covid, within a few days of symptoms
5. Patients were mainly middle aged and overweight, with age range of 30-85 yrs. old
6. The results showed that those who took Metformin had a 42% relative reduction in long covid
7. It is unclear what the precise reason was that prevented Long Covid from occurring.
8. Ivermectin, a drug once highly touted to treat Covid had no impact to preventing Long Covid
9. Women on Metformin did even better than men, as did those who were overweight
10. The study also showed that those vaccinated had a much lower incidence of Long Covid, 50% lower chance, very significant
11. The concern is that the diagnosis in some cases was made at day 30, when in fact some of these cases

Dangerous Strep Throat cases in Illinois, associate with 5 pediatric deaths

1. Strep throat is caused by the Strep bacteria and there are 2 main groups, A and B
2. Recently in Illinois, there have been a few cases of a bacteria called invasive Group A Strep.
3. There have been more cases in 2023 than in any of the past five years
4. Group A Strep often causes common and generally mild illnesses
5. This strain of Strep has the bacteria spreading to muscles, joints and lungs, causing severe illness.
6. Early detection is key as it can be treated with antibiotics before it spreads
7. Symptoms to look for, sudden onset of sore throat, pain with swallowing, some will also get a scarlet fever rash, red skin with sandpaper feel and fever is common. Although this can be caused by other bacteria and viruses, it is important to be tested to see if treatment is needed.
8. Concern is that people can have the bacteria, have no symptoms and be contagious, those who have symptoms are much more contagious
9. Couple this with a shortage of the antibiotic Amoxicillin, which is most commonly used to treat Group A Strep and you can understand why the concern is here.
10. It is unclear why we are seeing this spike in pediatric cases, however This bacteria has caused the death of five children