LeoPatrizi/Getty Images

In a living systematic review and meta-analysis in The BMJ, scientists from the United Kingdom, along with international collaborators, continue to collate and analyze emerging evidence of how COVID-19 affects women and their babies during and shortly after pregnancy.

In the latest update, the team confirms that pregnant women attending or admitted to the hospital from whatever cause continue to be at a greater risk of severe COVID-19 than nonpregnant women of similar ages.

Preexisting diabetes, chronic hypertension, asthma, smoking, gestational diabetes, preeclampsia, being aged 35 years or over, and having a body mass index (BMI) of 30 or above were all associated with greater odds of severe COVID-19 and requiring admission to the intensive care unit (ICU).

Nonwhite ethnicity was linked with a greater likelihood of ICU admission, but not necessarily with severe COVID-19.

Meanwhile, babies of mothers with COVID-19 were more likely to require admission to the neonatal intensive care unit (NICU). The authors note that this could be due to hospital policies for observation and quarantine of babies in contact with COVID-19.

Dr. John Allotey, the study’s first author and a lecturer in epidemiology and women’s health at the World Health Organization (WHO) Collaborating Centre for Global Women’s Health at the University of Birmingham in the U.K., comments: “Pregnant women should be considered a high risk group, particularly those identified to have risk factors, for severe COVID-19 based on our findings.”

“Mothers should also be reassured that the risks to their babies are very low,” he continues.

Reviewing the evidence

The research team started work on the review in April 2020. For its first iteration, they collated data from available publications between December 2019 and June 2020.

Each week, the researchers looked for newly published data, which they aimed to review every 2–4 months. For the recent update, they added new studies published up until October 2020.

The review now includes data from 192 studies and 29 different countries. Of these studies, 115 were new editions to the latest update.

Overall, the data show that 10% of pregnant women who are either admitted to the hospital or visiting the hospital receive a positive SARS-CoV-2 test.

Pregnant women are more likely than nonpregnant women to have an asymptomatic SARS-CoV-2 infection.

However, the reason for this may lie in the strategy for testing.

Pregnant people routinely undergo COVID-19 testing when they attend hospital appointments, while nonpregnant individuals most likely have a test when they experience symptoms.

“[The] true prevalence of [COVID-19] in pregnancy is likely to be lower than the current estimate if all pregnant women, including those not attending the hospital, are included,” the authors comment in the paper.

While the risk of severe COVID-19 was greater for pregnant women than for nonpregnant women overall, there were specific risk factors that the team identified.

These include age, BMI, preexisting conditions, as well as conditions developed during pregnancy.

The researchers found that pregnant women or those who had recently given birth were more likely to die if they had COVID-19 than those who were the same age but not pregnant. In addition, the rates of premature birth and stillbirth were higher for women with the disease.

However, the team caveat that the premature births are likely to be the result of medical decisions to induce early delivery in those with COVID-19 as the number of spontaneous preterm births was the same as baseline levels. The number of stillbirths across all of the studies included in the review was very small (9 out of 5,794 women with COVID-19).

More data needed

One further issue that this review found is that women who were of nonwhite ethnicity were more likely to require admission to the ICU for COVID-19 treatment.

There was a link between nonwhite ethnicity and a greater likelihood of ICU admission, based on four studies covering 31,456 individuals. Four smaller studies covering 2,263 women suggested that nonwhite ethnicity may result in having a 6% lower chance of severe disease. However, this figure could vary between 43% less likely and 57% more likely.

Other studies have previously found disparities in maternal outcomes between people of different ethnicities.

“The observed disparity could be attributed to associated comorbidities, socioeconomic characteristics, and factors related to access to and quality of care in the preconception, pregnancy, and postpartum periods,” the review’s authors write in their discussion. “The multifaceted contributors to ethnic disparities need to be investigated to reduce mortality and morbidity related to both [COVID-19] and pregnancy.”

The team highlights several limitations of their review, including the fact that the studies included in the analysis did not use the same methods to collect and gather data. This is an issue that all systematic reviews face.

Senior study author Professor Shakila Thangaratinam, who is the Co-Director of the WHO Collaborating Centre for Global Women’s Health, comments on the team’s finding:

“In the current situation, where evidence is rapidly produced, our living systematic review — underpinned by robust methods and continually updated at regular intervals — is crucial to address important research questions and to shape healthcare policy and clinical decision-making.”

“Pregnant women and healthcare professionals will need to take into account the additional risks faced by pregnant women with COVID-19 in making decisions, such as taking-up of vaccines if offered to prevent COVID-19 and plan management in pregnancy.” – Prof. Shakila Thangaratinam

The Centers for Disease Control and Prevention (CDC) additionally state that “[a]lthough the overall risk of severe illness is low, pregnant people are at an increased risk for severe illness from COVID-19 when compared to nonpregnant people.”

They advise nonpharmaceutical interventions, such as mask wearing, physical distancing, avoiding crowds, and limiting contact with people who may have been exposed to the SARS-CoV-2 virus to reduce the risk of developing COVID-19.

The CDC also suggest having a COVID-19 vaccine when it is available to pregnant people and speaking with a healthcare professional about any questions or concerns.

krisanapong detraphiphat/Getty Images

In laboratory tests, a team of researchers has analyzed the efficacy of a range of COVID-19 antibody-based therapeutics against the latest variants of SARS-CoV-2.

The researchers noted that some combinations of monoclonal antibody therapeutics were less effective against these new variants.

However, they also found that other updated combinations, or cocktails, of monoclonal antibodies — which target areas of the virus that change less frequently — showed promise in neutralizing the latest virus variants.

The research, published in the journal Nature Medicine, suggests directions for the development of future therapeutics that may be more resistant to mutations of SARS-CoV-2.

Researching SARS-CoV-2 therapeutics

A central focus of scientific research in response to the COVID-19 pandemic has been the development of vaccines.

However, scientists have also been looking at other therapeutics that may be effective in reducing transmission of the virus or decreasing the severity of its symptoms.

One such technology is monoclonal antibodies. According to the Food and Drug Administration (FDA), monoclonal antibodies are developed in a laboratory and designed to copy the function of a person’s antibodies that they produce in response to an infection, which in this case is SARS-CoV-2.

In the development of therapeutics, scientists have also used antibodies taken from people who have contracted the virus.

However, many of these technologies are based around early variants of SARS-CoV-2. As the virus has been spreading, it has developed mutations, which in some cases can make the virus more infectious.

Laboratory tests

In the present study, the researchers wanted to see the effectiveness of COVID-19 therapeutics on the variants of SARS-CoV-2 that have become more infectious after developing mutations.

They tested these new variants in a laboratory context to see how effective different therapeutics are at neutralizing the virus.

SARS-CoV-2 makes use of a spike protein to infect the cells of a host organism. In many of the monoclonal antibody therapeutics that researchers have developed, they have selected the spike protein as a good target.

However, it is also this spike protein that has been the site of mutations in the most transmissible new variants of the virus.

Developing an antibody cocktail

The researchers found that many of the therapeutics that have been developed in response to SARS-CoV-2 showed “moderate to substantially diminished neutralizing potency.”

However, they also found that two highly neutralizing monoclonal antibody cocktails showed only slightly reduced effectiveness against the variants.

Researchers at Vanderbilt University Medical Center in Nashville, TN, in collaboration with the University of Texas, the Washington University School of Medicine in St. Louis, MO, and the Swiss firm Vir Biotechnology developed the cocktails.

According to Prof. James Crowe, Jr., director of the Vanderbilt Vaccine Center (VVC), Ann Scott Carell Professor in the Departments of Pediatrics and Pathology, Microbiology, and Immunology at Vanderbilt, and co-author of the paper, “this study highlights the importance of rationally designed antibody cocktails like those we developed.”

Prof. Crowe said: “We chose two antibodies to create a mixture that specifically would resist escape by SARS-CoV-2. Fortunately, this work and several other papers recently published show that the protection mediated by the antibodies we discovered that are now in six different phase 3 clinical trials should extend to all current variants of concern.”

For Dr. Robert Carnahan, associate VVC director and associate professor of pediatrics, “these findings, that the antibodies we are developing inhibit the new SARS-CoV-2 variants well, are made even more important by the fact that some previously approved monoclonal antibody treatments look very unlikely to protect against these variants.”

“Using our variant-resistant antibody cocktails likely will provide an important new tool for controlling the COVID-19 pandemic.”

Sara Johansen/Offset

Humans first drank caffeinated tea more than 4,000 years ago in China. Since then, it has become one of the most popular drinks worldwide, second only to water.

Both green and black teas are brewed from the leaves of the same shrub, Camellia sinensis, but green tea, which is made from unfermented leaves, contains more antioxidants.

Oxidation during the fermentation process of black tea reduces its antioxidant levels.

Several studies have found that green tea inhibits the formation of cancers, lowers high blood pressure, and reduces the risk of heart disease.

However, the molecular mechanism responsible for the effect on blood pressure has been unclear until now.

Scientists at the University of California, Irvine (UCI) and the University of Copenhagen, in Denmark, have found that antioxidants in tea open ion channels and can relax the muscles that line blood vessels.

They report their findings in the journal Cellular Physiology & Biochemistry.

Preventable risk factor

The discovery could guide the design of more effective antihypertensive drugs, which could potentially improve the health of millions of people around the world.

According to the National Heart, Lung, and Blood Institute, controlling or lowering high blood pressure can help prevent chronic kidney disease, heart attacks, heart failure, and possibly dementia.

The Centers for Disease Control and Prevention (CDC) report that almost half of all adults in the United States have hypertension. It estimates that in 2018, the condition played a role in the deaths of nearly half a million people in the country.

The World Health Organization (WHO), meanwhile, estimate that more than 1 billion people worldwide have hypertension.

The new study first shows that two antioxidants in tea, known as catechins, open a protein channel in the membranes of the smooth muscle cells that line blood vessels. This allows positively charged potassium ions to leave the cells.

Channels in nerve and muscle cells maintain voltages across their membranes by allowing negative and positive ions to pass in and out in a controlled way. They are “voltage-gated,” which means that they respond to changes in this voltage by opening or closing.

The researchers found that the catechins in green tea activate a particular type of potassium ion channel, called KCNQ5.

Previous work by some of the same scientists suggests that this protein channel may underlie the antihypertensive effects of several plants used as folk medicines for millennia.

Voltage sensor

For the new study, the researchers used computer modeling and mutated versions of the channel protein to show that the two catechins bind to a section that senses voltage changes.

“This binding allows the channel to open much more easily and earlier in the cellular excitation process,” explains senior study author Prof. Geoffrey Abbott, of the Department of Physiology & Biophysics at the UCI School of Medicine.

In theory, this should make the muscle cells less “excitable” and therefore less likely to contract. They should instead relax, dilating the blood vessel and reducing blood pressure.

To test this theory, Prof. Abbott’s co-authors at the University of Copenhagen measured changes in tension in the walls of arteries from rats. Their findings confirmed that the two catechins from tea relax and dilate arteries by activating the KCNQ5 ion channel.

Milky tea

The authors are confident that adding a dash of milk to black tea does not reduce its antihypertensive effects.

Milky tea, applied directly to cells in the lab, failed to activate their KCNQ5 channels. But this is likely not the case when a person drinks it.

Prof. Abbott explains:

“We don’t believe this means one needs to avoid milk when drinking tea to take advantage of the beneficial properties of tea. We are confident that the environment in the human stomach will separate the catechins from the proteins and other molecules in milk that would otherwise block [the] catechins’ beneficial effects.”

The scientists also discovered that warming green tea to 35°C increased the activation of KCNQ5.

However, lovers of iced tea need not be concerned.

“Regardless of whether tea is consumed iced or hot, this temperature is achieved after tea is drunk, as human body temperature is about 37°C,” says Prof. Abbott. “Thus, simply by drinking tea, we activate its beneficial, antihypertensive properties.”

Electrical activity in the brain

KCNQ5 also exists in the membranes of nerves in the brain, where it helps regulate electrical activity and signal transmission.

People with a disorder called epileptic encephalopathy have a version of the channel protein that does not respond effectively to voltage changes, which leads to frequent seizures.

The study authors point out that catechins can cross the blood-brain barrier, which prevents larger molecules, including some drugs, from entering the brain.

In theory, drugs modeled on catechin molecules could, therefore, help correct the cause of epileptic encephalopathy.

“Discovery of their ability to activate KCNQ5 may suggest a future mechanism to fix broken KCNQ5 channels to ameliorate brain excitability disorders stemming from their dysfunction,” the researchers conclude.

Anna Larson/Offset

For many decades, nutritionists have recommended a balanced diet to provide the body with the proper nutrients to stay healthy. The core components of this diet include vegetables, fruits, grains, proteins, and dairy.

A recent study by researchers at the Harvard T. H. Chan School of Public Health in Boston, MA, provides further evidence for current dietary guidelines and expands on them, finding that consuming at least 2 fruit and 3 vegetable servings on a daily basis may lower the risk of both disease-related death and death from all causes.

The study appears in Circulation, a scientific journal of the American Heart Association (AHA).

Current dietary guidelines

“While groups like the American Heart Association recommend 4–5 servings each of fruits and vegetables daily, consumers likely get inconsistent messages about […] the recommended amount and which foods to include and avoid,” says Dr. Dong D. Wang, M.D., Sc.D., an epidemiologist and nutritionist at Harvard Medical School and lead author of the study.

The Department of Health and Human Services and the Department of Agriculture published their recommendations in the form of the 2020–2025 Dietary Guidelines for Americans.

According to this set of guidelines, half of the plate for every meal should contain fruits and vegetables.

However, the guidelines also note that more than 80% of people in the United States do not meet this recommendation and should aim to increase their consumption of nutrient-dense foods.

Participant dietary information

The researchers collected self-reported dietary information from two large cohort studies: the Nurses’ Health Study (NHS) and the Health Professionals’ Follow-up Study (HPFS).

The NHS cohort included registered female nurses between the ages of 30 and 55 years, while the HPFS cohort included males aged 40–75 years with occupations in the health profession. These studies included follow-ups with the participants every 2–4 years to accumulate dietary information over a span of approximately 30 years.

The researchers excluded participants with baseline heart disease, cancer, or diabetes, leaving them with data from 66,719 females and 42,016 males.

They also incorporated data from an additional 26 studies involving a total of 1.9 million participants, which examined the relationship between fruit and vegetable intake and death rates.

The high participant numbers and continuous longitudinal assessments provided the team with an extensive collection of data for analysis.

However, it is important to note that the criteria of the two cohorts — occupation and corresponding education — suggest a similar socioeconomic status across the participants, who may have been more likely than other members of the population to have access to a healthy diet. The study does not address the realities and effects of food insecurity.

Nutritional values of fruits and vegetables lower risk of death

The study outcomes showed that an increased intake of fruits and vegetables is associated with a lower risk of death, including death due to cancer, heart disease, or respiratory disease.

Additionally, the researchers saw the lowest risk of death at a threshold of a combined 5 servings, beyond which there was no apparent benefit on risk.

These results point to the nutritional value of these foods. For example, higher consumption of fruits and vegetables increases the intake of potassium and antioxidant activity, which link to lower blood pressure and improved lung function, respectively.

As the data are fully self-reported, there may be discrepancies between the actual and reported intakes. Participants with higher intake, in particular, may have tended to overestimate how many servings they consumed.

This margin of error may blur the defined threshold of 5 servings, so the study authors acknowledge that slightly higher servings (up to 10) could also lead to lowered risk.

This study also expands beyond current guidelines by differentiating among specific groups of fruits and vegetables.

The researchers observed trends with a lowered risk of death for leafy greens and foods rich in vitamin C and beta carotene. Fruits and vegetables that fall into these categories include spinach, kale, carrots, and citrus fruits.

Conversely, they did not identify any trends for fruit juices or starchy vegetables, such as potatoes and peas. One possible reason for the latter is the prominence of canned foods. The canning process may deprive starchy vegetables of their antioxidant properties.

Compared with whole fruits, the fluid form of juices may cause a more rapid elevation of blood glucose and insulin levels, which can increase the risk of disease.

In contrast to the existing guidelines, which include canned foods and juices among the recommended foods and drinks, this study calls for further research on the effects of these items on health.

Continued support for ‘5-a-day’ serving recommendation

Rather than being an interventional study, in which researchers directly implement variables and analyze the effects, this study was observational. As a result, it is not possible to conclude that the trends present in this study indicate a causal relationship.

Regardless, there is plentiful evidence that highlights the benefits of a balanced diet containing plenty of fruits and vegetables. The present conclusions also correspond to findings from similar observational studies on the associations between fruit and vegetable intake and disease.

The findings of this study conform to the overall current dietary guidelines to eat at least 5 servings of fruits and vegetables a day. Additionally, it provides further insight into the specificities and benefits of fruit and vegetable intake.

© Santiago Urquijo/Getty Images

Around 1 million people in the United States and 10 million people worldwide have Parkinson’s. It is the second most common neurodegenerative disorder after Alzheimer’s disease.

Parkinson’s disease is a progressive brain disorder that affects dopamine-producing neurons. It causes tremors, muscular stiffness or rigidity, and slowness of movement, among other symptoms.

Loss and degeneration of dopamine-producing neurons in a specific region of the brain called the substantia nigra causes the movement-related, or “motor,” symptoms that can characterize Parkinson’s.

There is no cure for Parkinson’s disease, though several drug treatments can help alleviate the symptoms. The most commonly prescribed medication for this purpose is levodopa (Sinemet), which replenishes dopamine levels.

“Currently, there is no preventive medicine for Parkinson’s disease,” notes Dr. Akiko Kojima-Yuasa, an associate professor at the Graduate School of Human Life Science at Osaka City University, in Japan, “we only have coping treatments.”

One cause of cell loss in the substantia nigra is oxidative stress. This led Dr. Kojima-Yuasa and colleagues to investigate whether sesaminol, a powerful antioxidant, could prevent nerve cell death in a model of Parkinson’s.

Sesaminol is found in abundance in sesame seed husks, which are a waste product from the industrial extraction of sesame oil.

Oxidative damage

The researchers used a toxic chemical called 6-hydroxydopamine to model the oxidative damage that occurs in Parkinson’s.

When they applied the chemical to human nerve cells growing in lab cultures, the concentration of damaging reactive oxygen species increased, and the cells began to die off.

Adding sesaminol to the cultures significantly reduced the concentration of reactive oxygen species and prevented cell death. Sesaminol appeared to shield the cells from oxidative damage by increasing their production of two protective proteins: Nrf2 and NQO1.

Next, the researchers turned to a standard animal model of Parkinson’s disease, which involves dosing mice with the neurotoxin rotenone.

The toxin reduces dopamine production in the animals’ brains. This impairs their motor abilities and reduces their gut motility, which are both classic symptoms of Parkinson’s in humans. In fact, people with the disease might experience constipation decades before difficulties with movement become apparent.

Mice that ate a diet containing sesaminol for 36 days had higher dopamine levels and performed better on a standard test of motor abilities than control-group mice that ate a normal diet. The gut motility of the mice in the test group was also normal.

In addition, the mice that ate sesaminol had lower levels of alpha-synuclein in their substantia nigras. Alpha-synuclein is a protein that clumps together to form larger structures called Lewy bodies, which are a characteristic feature of neurodegeneration in Parkinson’s.

The research has been published in the journal Heliyon.

Preventive treatment?

In their paper, the scientists conclude:

“Notably, the protective effect was observed with the feeding of a small amount of sesaminol. These results show that sesaminol is very suitable for use as a preventive treatment of [Parkinson’s disease]. Further detailed elucidation of the mechanism of action will be necessary for practical application.” Dr. Kojima-Yuasa and her team are keen to start clinical trials of the extract.

The authors suggest that sesaminol may be able to cross the blood-brain barrier in humans. This barrier prevents pathogens and large molecules from entering the brain. Further investigation, however, is needed to support the findings.

Overall, it is worth keeping in mind that results of studies in cell cultures and animal models do not always reflect what happens in the human body.

GEORGE FREY/AFP via Getty Images

Research is currently underway to determine whether it is possible to repurpose existing medications to prevent or treat COVID-19.

To guide healthcare professionals through this ever-evolving wave of new evidence, the World Health Organization (WHO) is creating a ‘living’ guideline outlining the most complete, accurate, up-to-date information on COVID-19 management.

This guideline also offers patients the chance to consider their best treatment options. The WHO have called it a ‘living’ guideline because they will continuously update it to reflect new knowledge.

To create this living guideline, experts, doctors, patients, and methodologists from around the world are assessing existing studies to produce a set of universal recommendations.

On March 1, 2020, the panel released the first installment of the living WHO guideline on drugs to prevent COVID-19 in the British Medical Journal.

In this first installment, the panel evaluates whether hydroxychloroquine can help prevent COVID-19.

These findings could focus research efforts on more effective, safer treatment and prevention options for COVID-19. It could also discourage doctors and patients from using a medication that is likely to do more harm than good.

Why focus on hydroxychloroquine?

Scientists developed hydroxychloroquine in 1946 to reduce the risk of getting malaria and help treat it. Today, doctors use the drug to treat several autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus.

Some early in vitro studies suggested that hydroxychloroquine may help reduce the risk of developing COVID-19 in several ways.

Hydroxychloroquine raises the pH inside of endosomes, a group of organelles inside cells that regulate the exchange of proteins and lipids. This may make it difficult for SARS-CoV-2 to fuse with cell membranes.

Some studies have also shown that hydroxychloroquine appears to block the release of SARS-CoV-2 viral particles from infected cells.

Once viruses enter cells, they take over the cell’s machinery to reproduce its own genetic material, ribonucleic acid (RNA). The cell typically releases these new viral particles with help from late-stage or mature endosomes.

Hydroxychloroquine appears to prevent the transport of new viral particles into these special endosomes, preventing their release.

But scientists have not confirmed most of these findings in humans, only in cells from organisms.

In one study, hydroxychloroquine had some antiviral effect in African green monkey kidney cells, but not in cell models from the lining of human airways.

Another study using macaque monkeys also concluded that hydroxychloroquine was not effective in preventing infection with SARS-CoV-2.

A few early studies, including small human studies without a control group, suggested that hydroxychloroquine could treat patients with COVID-19.

The FDA issued an emergency use authorization in March 2020 that allowed healthcare professionals to use hydroxychloroquine in teens and adults hospitalized for COVID-19 who weigh more than 110 pounds.

And doctors in many hospitals starting using hydroxychloroquine routinely in COVID-19 patients.

But even at the time of its issuing, the FDA noted that a person should only use the drug when a healthcare professional feels the possible benefits outweigh the risks.

That is because hydroxychloroquine carries substantial health risks, including:

  • serious heart rhythm problems
  • anemia
  • low blood sugar
  • damage to the tissues in the inner eye that may cause a vision problem
  • worsening of neurological problems or seizures
  • drug interactions, such as with some beta-blockers, antidepressants, antipsychotics, and methadone

Dangers outweigh potential health benefits

By mid-June, the FDA formally revoked this emergency issue, claiming the potential benefits of the drug in cases of COVID-19 did not outweigh existing and potential health risks.

There were reports of serious cardiac side effects and other adverse effects at the doses doctors used for treating people hospitalized with Covid-19.

Hydroxychloroquine typically has few severe side effects when used to treat conditions such as rheumatoid arthritis and systemic lupus erythematosus.

Possible reasons why the drug is more toxic in people with COVID-19 include:

  • people hospitalized with COVID-19 received higher doses of the drug
  • the cardiac inflammation caused by COVID-19 may have increased the cardiac side effects of the drug
  • interaction with other medications, such as azithromycin, exacerbated the risk of potentially lethal cardiac rhythm abnormalities

A few days later, the National Institute of Health (NIH) halted its clinical trial evaluating the efficacy and safety of using hydroxychloroquine in adults hospitalized for COVID-19.

Creating a ‘living guideline’

To create the living WHO guideline, collaborators from the MAGIC Evidence Ecosystem Foundation first analyzed six randomized, controlled trials. The six trials included 6,059 participants with or without exposure to COVID-19.

Making GRADE the Irresistible Choice (MAGIC) is a non-profit foundation that creates reliable, evidence-based digital tools to share guidelines with healthcare professionals and patients.

The acronym GRADE stands for Grading of Recommendations, Assessment, Development and Evaluations. It describes a popular framework for assessing and sharing summaries of scientific evidence that help guide clinical recommendations.

The WHO panel reviewed the MAGIC team’s findings to determine the accuracy of the findings and form their recommendations for the guideline.

Researchers often describe how confident they are in study findings by defining the level of certainty of the evidence supporting it. Typically, the more positive research to support an idea, the higher the certainty of the evidence and the more likely it is to be true in the real world.

In the new review of trials testing hydroxychloroquine for preventing COVID-19, the team found high certainty evidence indicating hydroxychloroquine has no significant impact on the risk of COVID-19 death or hospital admission.

The WHO panel also found moderate certainty evidence that the drug does not significantly impact the risk of developing COVID-19.

The panel concludes that using hydroxychloroquine may increase the risk of experiencing side effects severe enough to stop taking the drug when compared with a placebo.

People in the trials taking hydroxychloroquine had many more minor side effects, such as diarrhea and headaches, than those in the placebo group (56% vs. 6%). However, only marginally more people had side effects serious enough to stop taking the drug compared with a placebo.

Reconsidering priorities and resources

Based on these findings, the panel recommends that researchers shift their priority and resources to explore other medications.

This new guideline could help uncover more effective COVID-19 therapies by focusing research efforts and funding on prevention and treatment options with more promising results.

It may also bust the widespread myths and misconceptions that led to some people accessing or taking hydroxychloroquine to prevent or treat COVID-19 without medical advice.

And this is good news given the long-list of adverse side effects associated with taking hydroxychloroquine unnecessarily.

It could also be very good news for people with autoimmune diseases, such as lupus, who need the medication to stay healthy and who have been facing drug shortages.

The panel encourages researchers, doctors, and patients to check back for more information as they include new recommendations within the existing published document.

This review is a good reminder that drugs showing promise in the laboratory and in initial observational, non-randomized human studies may not deliver the hoped-for results in well-conducted randomized trials.

Westend61/Getty Images

Mental health conditions can cause changes in thinking, emotions, behavior, or all of these, impairing interpersonal relationships and daily functioning. They can be temporary or chronic.

Approximately 26% of adults in the United States will experience a mental health condition within a given year, with close to 9.5% having a serious condition, such as major depression or bipolar disorder.

Although pharmacologic and psychosocial treatment options for psychiatric illnesses can be safe and effective, there are cases in which the treatments may cause significant adverse effects in some individuals, potentially leading to discontinuation. In addition, some illnesses are treatment-resistant.

One possible reason why current standard-of-care treatments have varying efficacy is that they do not target the disruption to neural circuits that researchers have associated with mental illness.

Researchers can use functional MRI (fMRI), a noninvasive neuroimaging tool that measures brain activity through changes in cerebral blood flow, to comprehend the neurobiological changes accompanying psychiatric illness.

In the new study, the researchers used rtfMRI-NF, which incorporates biofeedback, to teach the participants how to control their own brain neural activity instantaneously while in a scanner. Biofeedback is a treatment that healthcare professionals sometimes use to control involuntary bodily processes.

Novel treatment method

Although some studies using rtfMRI-NF experimentally to treat a wide range of mental illnesses have demonstrated benefits, rtfMRI-NF is costly, and it requires extensive setup for real-time analysis.

Researchers at the University of Rochester Medical Center in New York conducted a meta-analysis of 17 relevant studies to determine the effectiveness of rtfMRI-NF in modulating brain activity and behavioral outcomes.

They have published their findings in Neuroscience & Biobehavioral Reviews.

Study co-author Dr. David Dodell-Feder, an assistant professor at both the Department of Psychology in the School of Arts and Sciences at the University of Rochester and the Department of Neuroscience at the University’s Medical Center, comments on the objectives of the review:

“Ultimately, we want people to be able to take what they learn in the scanner during the training sessions to use in their day-to-day life. If they can do that, it shows that the neurofeedback is meaningful, that they are taking something away from it, and that they can now apply that experience — even without neurofeedback.”

The meta-analysis evaluated whether rtfMRI-NF led to voluntary control of brain activity during training, whether the effects persisted after training (in the absence of neurofeedback), and whether treatment resulted in improved outcomes.

The studies that the team analyzed included 410 participants, of whom 234 received rtfMRI-NF. The study participants were 34 years old, on average, and there were almost equal numbers of males and females. About 53% of the participants took psychotropic medications.

The studies included participants with diagnoses such as:

  • depressive disorders
  • schizophrenia and other psychotic disorders
  • neurodevelopmental disorders
  • substance-related and addictive disorders
  • trauma and stressor-related disorders
  • anxiety disorders

The study participants completed an average of two sessions with a total regulation time of about 24 minutes across sessions. Most studies compared active neurofeedback with a sham feedback control group.

The area of the brain targeted most often as the source of the neurofeedback signal was the amygdala. The amygdala is part of the brain’s limbic system, and it is responsible for processing strong emotions, such as fear and pleasure.

Additionally, most studies provided explicit instructions for regulating the neural signal, measured the percent signal-change that a task triggered, provided continuous neurofeedback, and included a transfer task to measure whether the participant could perform the previously learned regulation during the period of no neurofeedback.

Some positive results

The meta-analysis found that rtfMRI-NF produced a moderate effect on the brain activity of targeted regions during training and a large effect after training in the absence of neurofeedback.

However, rtfMRI-NF demonstrated only a small effect on symptoms and cognitive impairment.

Emily Dudek, lead author and a clinical research coordinator at the Brain Injury Research Center of Mount Sinai in New York City, comments on the results:

“We believe this provides relatively strong evidence that volitional control over neural processes that are specifically targeted during training is possible. This volitional control was also present in contexts in which no feedback was provided,” she notes.

The possibility of publication bias — the influence of nonpublished studies that failed to find an effect — that the team detected during analyses may further decrease the measured effect of rtfMRI-NF on symptoms.

Limitations of the meta-analysis include small study sample sizes leading to potential underpowering and decreased validity of results.

Further research involving adequately powered, high quality studies is necessary to elucidate specifically how and for whom rtfMRI-NF demonstrates effectiveness to optimize potential clinical benefits. Future studies may be crucial to proving the clinical utility of rtfMRI-NF outside a research setting.

Prof. Dodell-Feder, Dr. J. Steven Lamberti, from the Department of Psychiatry at the University of Rochester Medical Center, and a graduate student team have set out to conduct a rtfMRI-NF research study aiming to teach people with schizophrenia to self-regulate areas of the brain responsible for social information processing.

The trial is ongoing, and, hopefully, the results of the study will provide some much-needed answers.

ferrantraite/Getty Images

Researchers have found that aerobic exercise may reduce cognitive decline in people with Alzheimer’s disease.

The research, published as a pilot study in the Journal of Alzheimer’s Disease, supports aerobic exercise as an intervention for people with this condition and lays the ground for future, larger studies to corroborate the initial findings.

Alzheimer’s treatments

According to the National Institute on Aging (NIA), Alzheimer’s disease is an irreversible and progressive neurological disorder.

At its mildest, it can affect a person’s ability to think or remember things. Moderate forms of the condition can affect a person’s brain areas and impair language, reasoning, sensory processing, and conscious thought.

When the disease progresses to become severe, it can stop a person from performing basic, everyday tasks and recognizing or communicating with friends or family.

According to the NIA, researchers estimate Alzheimer’s disease affects over 5.5 million people in the United States. It typically first appears in people in their mid-60s.

The Alzheimer’s Association highlight that there is no known cure for the condition, with treatments instead focusing on easing the symptoms of the disease or slowing its progression.

While various drugs are available in the treatment of Alzheimer’s disease, there is an emerging body of evidence suggesting that aerobic exercise may also be effective in reducing the progression of the disease.

However, as the authors of the present study note, randomized controlled trials that have put this to the test have produced inconsistent findings.

To begin to resolve this problem in existing research, the present authors devised a randomized controlled trial to act as a pilot study.

This study examined whether a group of older adults with Alzheimer’s disease would have less cognitive decline following 6 months of aerobic exercise compared with the expected level of cognitive decline they would experience if the disease progressed naturally.

Pilot study

The study involved 96 participants aged 66 years or older with Alzheimer’s disease.

Researchers randomly split these participants into two groups. One group of 64 people took part in supervised cycling exercise classes three times a week for 6 months.

The remaining 32 participants took part in supervised stretching and range of motion exercise classes, which the scientists matched to the cycling group in terms of the regularity of the classes and their length of time, but at low intensity. This latter group also acted as a control.

Researchers continually monitored participants’ heart rates in both groups. The team also supported the cycling group to achieve 50–75% heart rate reserve while helping the control group maintain less than 20% heart rate reserve.

In addition, the scientists measured participants’ cognition at the beginning of the intervention, as well as at months 3, 6, 9, and 12.

Exercise reduced cognitive decline

The researchers found that both the cycling group and the stretching or range of motion group scored significantly better than would have been predicted if they had continued with treatment as normal.

The researchers used the Alzheimer’s Disease Assessment Scale-Cognitive Subscale, a scaling system where a greater number reflects worse cognition.

According to this scale, after 6 months, the cycling group scored 1.0±4.6, and the control group 0.1±4.1. This compares with a score of 3.2±6.3, which would be in line with expectations given the natural progression of Alzheimer’s disease.

According to Prof. Fang Yu, Edson Chair in Dementia Translational Nursing Science at the Arizona State University Edson College of Nursing and Health Innovation, and corresponding author of the study, “our primary finding indicates that a 6-month aerobic exercise intervention significantly reduced cognitive decline in comparison to the natural course of changes for Alzheimer’s dementia.”

“However, we did not find a superior effect of aerobic exercise to stretching, which is likely due to the pilot nature of our trial. We do not have the statistical power to detect between-group differences, there was a substantial social interaction effect in the stretching group, and many stretching participants did aerobic exercise on their own.”

As a consequence, scientists need to conduct further research to corroborate these initial encouraging findings.

80284602 Noel Hendrickson/Getty Images.

The research found small but significant decreases in the risk of SARS-CoV-2 infection among females — but not males — who took multivitamins, vitamin D, omega-3 fatty acids, or probiotics.

Researchers at King’s College London, in the United Kingdom, analyzed data from 1.4 million users of the COVID Symptom Study app in the U.K., the United States, and Sweden. The participants answered questions about their regular use of dietary supplements.

The app users also reported results from COVID-19 tests and whether they had experienced symptoms of the illness.

“Our research is an observational study and not a clinical trial, so we can’t make strong recommendations based on the data we have,” cautions senior researcher Dr. Cristina Menni, of the School of Life Course Sciences, at King’s.

“Until we have further evidence about the role of supplements from randomized controlled trials, we recommend following the [National Health Service] guidelines on vitamin usage as part of a healthy, balanced diet,” she adds.

The study, which has not yet been peer-reviewed, has been uploaded to the preprint server MedRxiv.

Female immune defenses

The researchers were surprised to find that only females appeared to benefit from taking the four supplements in question.

They cite, however, several studies that have found that females have more robust immune systems, which may mean that their immune defenses get more of a boost from supplements.

Alternately, females may be more likely to wear masks or wash their hands than males, which could increase the apparent protective effects of taking supplements.

“These are interesting results, but due to the way the study has been conducted, these data absolutely cannot tell us that taking such supplements ‘protects’ against infection [resulting in] COVID-19,” says Naveed Sattar, a professor of metabolic medicine at the University of Glasgow, in the U.K., who was not involved in the research.

“It may be that by being more health-conscious, some women are less likely to become infected, so that it’s the behaviors that explain these results, not the supplements,” he hypothesizes.

Seif Shaheen, a professor of respiratory epidemiology at Queen Mary University of London, adds that the researchers had not accounted for factors such as income and educational attainment in their analysis.

“A major concern is that these findings may be confounded by socioeconomic status, given that individuals of higher status are more likely to take supplements and are also less likely to become infected with SARS-CoV-2,” he cautions.

The results in detail

Out of 327,720 users of the app in the U.K. who had each had a polymerase chain reaction or serology test for SARS-CoV-2, 175,652 reported having used supplements regularly since the beginning of the pandemic. The study sample was predominantly female, at 66.8%.

In total, 10,508, or 6.0%, of the supplement users had tested positive for the novel coronavirus, while 13,013, or 6.6%, of the nonusers had received positive results.

After the researchers had adjusted for other factors that could contribute to COVID-19 risk, they found that four supplements were associated with reduced risk.

Taking probiotics, multivitamins, omega-3 fatty acids, or vitamin D was associated with a 14%, 13%, 12%, and 9% lower risk of COVID-19.

Taking vitamin C, zinc, or garlic supplements was not associated with any reduced risk.

When the researchers broke down the numbers by sex, they found reduced risk associated with probiotics, multivitamins, omega-3 fatty acids, and vitamin D in females only.

After analyzing data from app users in the U.S. and Sweden, the researchers found similar associations between supplement use and confirmed SARS-CoV-2 infections.

Among the 993,365 regular users of the app worldwide who had not undergone testing, 126,556 had reported a loss of smell or taste. This suggests that they likely had COVID-19.

When the researchers analyzed data from these individuals, they found a small but significant reduction in risk among both males and females who regularly took omega-3 fatty acids, multivitamins, vitamin D, or probiotics.

Vitamin D uncertainties

During the ongoing pandemic, vitamin D has attracted a lot of media attention following the publication of studies suggesting that it may have a protective effect. The evidence to date has been mixed and inconclusive, however.

Two clinical trials underway may provide more clarity — one run by the Queen Mary University of London and the other by the Angers University Hospital, in France.

Meanwhile, the researchers behind the present study acknowledge several limitations. For example, all the participants were “self-selected.” They chose to download and use the app and so may not be representative of the general population.

In addition, the information that they provided may be inaccurate. For example, they may have started taking supplements after developing symptoms.

The authors emphasize that, as an observational study, their research cannot provide definitive proof that taking any supplement reduces the risk of COVID-19.

They conclude:

“Large randomized controlled trials of selected supplements testing their protective effects and also possible adverse effects on disease severity are required before any evidence-based recommendations can be made. We eagerly await the result of ongoing trials, including [those investigating] vitamin D and COVID risk.”

Researchers have raised alarm over rising cases of hypertension among teenagers and adolescents especially those in secondary schools across the nation.

In fact, several studies concluded that the prevalence of hypertension in Nigerian children is high and appears to be increasing and there is need for routine Blood Pressure (BP) and urinalysis check for all children in especially those in clinics and wards.

Indeed, studies suggest a high prevalence of elevated blood pressure among children and adolescents in Africa, with overweight and obesity being an important risk factor. They say efforts to address this burden of elevated blood pressure in children and adolescents should mainly focus on primary prevention at the community level, by promoting healthy lifestyles and avoiding other cardiovascular risk factors, especially overweight and obesity.

According to a study published in the journal The Lancet Public Health and titled “Prevalence of elevated blood pressure in children and adolescents in Africa: a systematic review and meta-analysis”, hypertension in children and adolescents is becoming a major concern, not only because of its rising prevalence, but also because of evidence suggesting that hypertension tracks from childhood to adulthood. Almost half of adults with hypertension had elevated blood pressure values during childhood.x

Furthermore, several studies have suggested that elevated blood pressure in childhood correlates with carotid intima-media thickness, atherosclerosis, left ventricular hypertrophy, and kidney failure in adulthood. Consequently, the study recommended early diagnosis and control of hypertension in childhood are likely to have an important effect on long-term outcomes of hypertension-related cardiovascular complications.

A recent study published in European Journal of Medical and Health Sciences concluded: “There is a noteworthy prevalence of hypertension among adolescent public secondary school students in Nnewi. This was significantly higher among the female gender, lower socioeconomic level and students with minimal physical activity. Waist circumference in the obese/overweight category very likely predicts hypertension.”

The study titled “Blood Pressure Profiles And Determinants Of Hypertension Among Public Secondary School Students In Nnewi, Southeast Nigeria” was conducted by Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State.

According to the researchers, hypertension and associated factors among adolescents have not been given the deserved attention in health care, more so as hypertensive children end up as hypertensive adults with serious co-morbidities. This is even more expedient among public school students, who in our environment are generally of lower socioeconomic status than those in private schools.

The researchers set out to determine the Blood Pressure (BP) profiles and association of obesity indicators, socioeconomic level and physical activity with hypertension among public secondary school students.

A cross-sectional school-based assessment of blood pressure (BP), body mass index (BMI), weight to height ratio (WHR), waist circumference (WC), physical activity and socioeconomic level among 593 students aged 10 – 17 years in public schools in Nnewi, Southeast Nigeria was carried out.

The results of the study showed the mean systolic BP increased with age and was higher for girls than for boys.x

“The prevalence of systolic hypertension and prehypertension were 8.4 per cent and 6.6 per cent respectively, while that of diastolic hypertension and prehypertension were 5.7 per cent and 11.8 per cent respectively. Both systolic and diastolic hypertension occurred in 2.4 per cent of students. Girls had a higher prevalence of hypertension – both systolic and diastolic. There was no significant gender difference in the prevalence of systolic hypertension and prehypertension between early and late adolescents.

Early adolescent males were more likely to have diastolic hypertension and prehypertension compared to late adolescent males, while no difference in prevalence was noted among the females. Systolic hypertension was more evident in the lower socioeconomic level, those with minimal physical activity, and those in the obese/overweight categories of BMI, WC, and WHR,” the researchers noted.

Blood pressure is recorded as two numbers: Systolic blood pressure (the first number) – indicates how much pressure your blood is exerting against your artery walls when the heart beats.

Diastolic blood pressure (the second number) – indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

Which number is more important? According to studies, typically, more attention is given to systolic blood pressure (the first number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term buildup of plaque and an increased incidence of cardiac and vascular disease.

However, either an elevated systolic or an elevated diastolic blood pressure reading may be used to make a diagnosis of high blood pressure. According to recent studies, the risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.

The abbreviation mm Hg means millimeters of mercury. Mercury was used in the first accurate pressure gauges and is still used in medicine today as the standard unit of measurement for pressure.x

Another study titled “Hypertension and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria” and published in Italian Journal of Pediatrics concluded: “Our study revealed a relatively high prevalence rate of hypertension and prehypertension among adolescents studied and these were more common among female subjects.

“It is therefore recommended that periodic screening and monitoring of blood pressure of adolescents should be incorporated into the school health programme, while general public health education on hypertension and its associated risk factors should be strengthened.”

The researchers are from University of Nigeria Teaching Hospital (UNTH) Enugu.

According to the researchers, hypertension is a prevalent cardiovascular disease risk factor among blacks and adolescent hypertension can progress into adulthood.

To determine the prevalence of hypertension and prehypertension among secondary school adolescents in Enugu State, a study of 2,694 adolescents aged 10-18 years in Enugu metropolis was carried out. Socio-demographic profile anthropometric and blood pressure readings were obtained. Derived measurements such as prehypertension, hypertension and BMI were obtained.x

The results showed that the mean systolic blood pressure and diastolic blood pressure for males were 106.66+ 11.80 mmHg and 70.25 + 7.34 mmHg respectively. The mean SBP and DBP for females were 109.83+ 11.66 mmHg and 72.23 + 8.26 mmHg respectively (p < 0.01). Blood pressure was found to increase with age. Prevalence of hypertension and prehypertension was 5.4 per cent and 17.3 per cent respectively with a higher rate in females (6.9 per cent) than males (3.8 per cent). Prevalence of prehypertension among males and females were 14.3 per cent and 20.1 per cent respectively. The prevalence of obesity was 1.9 per cent. Modifiable risk factors exist among adolescents. Early lifestyle modification and a strengthened school health are recommended.

Meanwhile, hypertension has been defined by levels of BP above, which lowering BP will reduce the cardiovascular risk associated with elevated BP and this level has been classically documented at 140/90 mmHg in adults. The new 2017 American College of Cardiology/American Heart Association guideline set hypertension stage 1 at greater than 130/80 mmHg rather than 140/90 mmHg as in the European guidelines.

According to a study titled “Hypertension in children: Could the prevalence be on the increase?” and published in the Nigerian Medical Journal, factors such as age, height, and gender are important factors in interpreting BP values in children. The most widely used definition of hypertension in children is delineated as BP greater than 95 per cent of expected BP for age, gender, and height.

The researchers from the Departments of Paediatrics, College of Medicine, Enugu State University of Technology and College of Medicine, University of Nigeria, Nsukka, Nigeria; and Child Survival Unit, Medical Research Council, Fajara, The Gambia, said unlike in adults where essential hypertension is very common, both secondary and essential (primary) hypertension are seen in children– primary hypertension being influenced by factors such as birth weight, maturity during birth, heredity, and diet while secondary is influenced by renal abnormalities, coarctation of the aorta, medications, neoplasm, etc.

Worldwide, the prevalence of hypertension in children ranges between one per cent and five per cent, with a significant proportion of them under-diagnosed. The prevalence of hypertension in children and adolescents in the United States of America is 3.3 per cent, whereas in Europe, prevalence ranging from 2.2 per cent to 22 per cent has been documented. Across Africa, the prevalence also varies between 0.2 per cent and 24.8 per cent, with a pooled figure of 5.5 per cent.

In Nigeria, various studies have also demonstrated similar prevalence rates in the neighborhood of 3.5 per cent and six per cent. In 2013, in Enugu, southeast Nigeria, Ujunwa et al. reported a prevalence of 5.4 per cent. A similar study in 2014 on pre-school children in Enugu, Nigeria, noted a comparatively low prevalence rate of elevated BP prevalence of 1.9 per cent.x

The authors opined that the prevalence of hypertension in children mighy still be on the increase. A higher prevalence value, however, may be expected when other groups of children are considered since BP increases with growth and development and results in hypertension during the first two decades of life. Although the pathogenesis of raised BP in obese children is not widely understood, evidence abounds on other comorbid conditions, which further accentuate the risk of hypertension. Aside from the risks associated with it, childhood hypertension is a major killer and one of the most common health concerns in children worldwide.

There is also substantive evidence linking it with long-term cardiovascular risk in adulthood. Therefore, it is of public health importance.

The researchers noted: “BP measurement is usually done for adults and has proven to be crucial in the assessment of cardiovascular health. This important measurement is not usually done routinely for children, although childhood hypertension detection is a measurement identifying potential future morbidity (essential hypertension) or existing underlying disease (secondary hypertension). In general, screening of children for hypertension is focused on essential hypertension since this is usually asymptomatic in children and may go unnoticed, but later becomes a risk in adulthood. Secondary hypertension comes to the fore with the presentation of the underlying disease. Consequently, childhood essential hypertension has been termed a strong predictor of hypertension in the adult population.

“Interestingly, identifying children with elevated BP and successfully treating them will have an impact on long-term outcomes of cardiovascular disease as well as a sizeable effect on hypertension-related morbidity and mortality. The cost implication of treating adults with raised BP will be addressed when attention is paid to childhood primary hypertension. To further understand the degree of attention that should be given to hypertension in childhood, knowledge of its prevalence and factors associated with it need to be continuously emphasized. It can also inform the need for routine BP check in children and adolescents in the routine children’s clinic.”

Meanwhile, as part of efforts to curb non communicable diseases including hypertension, the World Health Organisation (WHO) on Tuesday, launched a year-long global campaign for World No Tobacco Day 2021 – “Commit to Quit.” The new WHO Quit Challenge on WhatsApp and publication “More than 100 reasons to quit tobacco” are being released today to mark the start of the campaign.

The COVID-19 pandemic has led to millions of tobacco users saying they want to quit. The campaign will support at least 100 million people as they try to give up tobacco through communities of quitters.

“Commit to Quit” will help create healthier environments that are conducive to quitting tobacco by advocating for strong tobacco cessation policies; increasing access to cessation services; raising awareness of tobacco industry tactics, and empowering tobacco users to make successful quit attempts through “quit & win” initiatives.

WHO, together with partners, will create and build-up digital communities where people can find the social support they need to quit. The focus will be on high burden countries* where the majority of the world’s tobacco users live.

WHO welcomes new contributions from partners, including private sector companies that have offered support, including Allen Carr’s Easyway, Amazon Web Services, Cipla, Facebook and WhatsApp, Google, Johnson & Johnson, Praekelt, and Soul Machines.x

Quitting tobacco is challenging, especially with the added social and economic stresses that have come as a result of the pandemic. Worldwide around 780 million people say they want to quit, but only 30 per cent of them have access to the tools that can help them do so. Together with partners, WHO will provide people with the tools and resources they need to make a successful quit attempt.

“Smoking kills eight million people a year, but if users need more motivation to kick the habit, the pandemic provides the right incentive,” said WHO Director-General, Dr. Tedros Adhanom Ghebreyesus.

WHO released a scientific brief earlier this year showing that smokers are at higher risk of developing severe disease and death from COVID-19. Tobacco is also a major risk factor for noncommunicable diseases like cardiovascular disease, cancer, respiratory disease and diabetes. Moreover, people living with these conditions are more vulnerable to severe COVID-19.

Both global and regional cessation tools will be rolled out as part of the campaign. WHO’s 24/7 digital health worker to help people quit tobacco is available in English and will soon be released to support people in Arabic, Chinese, French, Russian, and Spanish.

“Millions of people worldwide want to quit tobacco – we must seize this opportunity and invest in services to help them be successful, while we urge everyone to divest from the tobacco industry and their interests,” said Dr. Ruediger Krech, Director of Health Promotion.

To create environments conducive to quitting tobacco, WHO has worked with partners and countries around the globe to implement tobacco control measures that effectively reduce the demand for tobacco.

WHO calls on all governments to ensure their citizens have access to brief advice, toll-free quit lines, mobile and digital cessation services, nicotine replacement therapies and other tools that are proven to help people quit. Strong cessation services improve health, save lives and save money.

Nigeria is one of the 22 campaign focus countries.