In the study led by doctors at Cedars-Sinai Medical Centre in Los Angeles, researchers looked at 912 people who tested positive for Covid after receiving at least three doses of Pfizer or Moderna.A total of 145 people were hospitalised, 125 of whom had high blood pressure (hypertension).The risk for hospitalisation included hypertension, older age, chronic kidney disease, heart attack or heart failure, and a longer interval between the last vaccine dose and infection.Hypertension, which carried a 2.6-fold increased risk, superseded all other risk factors in importance — even after excluding patients with heart failure and chronic kidney disease. Other previously identified risk factors for severe Covid-19, such as obesity and diabetes, weren‘t as strongly linked to hospitalisation amid Omicron.“We were surprised to learn that many people who were hospitalised with Covid-19 had hypertension and no other risk factors,” lead researcher Dr Susan Cheng said in a statement. “This is concerning when you consider that almost half of American adults have high blood pressure.”Cardiologist and clinician-scientist at Cedars-Sinai, Joseph Ebinger, said the study showed how three Covid vaccine doses may not be enough to prevent severe infection in everyone, particularly those with hypertension. “Breakthrough Omicron infection severe enough to cause hospitalisation can happen to an adult of any age, especially if a person has high blood pressure, even if they have no other major chronic disease,” Mr Ebinger said.“The people who are most at risk are not necessarily who we think they are. They are not the sickest of the sick, and this was a surprising finding.”EXPERTS URGE CAUTION IN DEFINING ‘LONG COVID’Figuring out the exact number of people across the world, and in Australia, with long Covid is difficult as there is no official tally, nor is there a universal definition of it.But experts say that may not be a bad thing.The Australian government defines long Covid as symptoms that persist for more than four weeks after an initial Covid-19 infection, which cannot be explained by other factors.Meanwhile, the World Health Organisation defines long Covid as symptoms that occur “usually within three months from the onset of Covid-19, with symptoms and effects that last for at least two months.”However, medical societies have taken a more clinical swing at defining long Covid in an effort to improve patient care. The American Academy of Physical Medicine and Rehabilitation has listed 50 different symptoms that could be related to long Covid.Still, researchers and clinicians working to understand long Covid are no closer to identifying clear definitions for diagnosing or treating the condition. And while it may be frustrating for sufferers and clinicians, experts have agreed that rushing to define long Covid could present a slew of new challenges.“If we defined it a certain way and we missed something in that initial definition, then there will be silence on that until someone comes around and does a post-mortem on our analysis,” Dr. Lawrence Kleinman, from Rutgers Robert Wood Johnson Medical School in New Jersey, told MedPage Today. “We want to avoid that to the extent that‘s possible.”Dr Kleinman said more research and data collection are needed before the work of defining long Covid is possible in a clinically meaningful way.He said at the moment there aren‘t even clear criteria for where to start.adellatips
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