I hope everyone is surviving this weekend's storm. I really knew this weather event was a little different when my Sunday morning paper was delivered Saturday at 10 PM. I've adopted the Washington Post's move by trying to get this post published earlier this morning, before the snow/ice severs my electrical and wifi access.
A couple of friends, maybe the only 2 readers of this blog beyond my immediate family, told me independently they didn't see anything different about last week's website. Obviously, I needed to point that out more clearly.
The main difference is the presence of multiple tabs. Here's what it looks like on the LSW's (Long Suffering Wife's) PC:
The area of interest is just above the culture plate photo. Two of the tabs represent new content: Bud's "Laws" and Epidemiology Links. Please click on the tabs to explore what's new.
Not visible to most of you are the changes I've made in the site to optimize search engine spying and to set up accommodations for readers who may have visual impairment. The latter requires me to take a little bit of extra time to include verbal descriptions of any photos, graphs, etc., that will be visible to those who activate disability tools on their devices.
Updates From the RECOVER Studies
I'm usually annoyed by complicated titles invented just to make a catchy acronym, but I'll put my feelings aside because the Researching COVID to Enhance Recovery group is very important to our understanding of long-term consequences of SARS-CoV-2 infection. Two new reports in the Journal of Pediatrics appeared online last week.
The first report concerns the RECOVER pregnancy cohort, comparing 18-month neurodevelopmental outcomes of infants exposed and unexposed to intrauterine SARS-CoV-2 infection. Adults were enrolled in 23 US sites between January 2020 and December 2023, and their infants were evaluated at 12 and 18 months of age with 2 neurodevelopmental tools. They ended up with 1179 participants, 1008 of whom were infected during pregnancy. Eighty percent of the enrollees were infected during the omicron period. Most of the infections occurred during the 2nd or 3rd trimesters. The bottom line news was very good - no differences between exposed and unexposed infants in their neurodevelopmental testing scores.
Here's what some of the 12-month evaluation scores looked like:
The second report looked at post-acute dyslipidemia and abnormal BMI in children and adolescents in a retrospective cohort study using electronic medical record data from 25 US children's hospitals covering the time period September 2020 to March 2023. It was a large group, with over 384,000 COVID-positive subjects for lipid studies and over 285,000 for BMI analysis. The covid-negative group numbered over a million and over 800,000, respectively. Infection was defined in multiple ways. The infected group showed higher rates of new-onset dyslipidemia and abnormal BMI
Figure 2. Adjusted relative risks of post-acute dyslipidemia and abnormal BMI outcomes in COVID-19-positive versus COVID-19-negative cohorts. Forest plot displaying adjusted relative risks (aRRs) and 95% confidence intervals for incident post-acute
dyslipidemia outcomes and abnormal BMI. Estimates were obtained using modified Poisson regression models adjusted for demographic and clinical covariates. †Definitions and abbreviations: Abnormal HDL Cholesterol: high-density lipoprotein (HDL) cholesterol: < 40 mg/dL; Abnormal LDL Cholesterol: lowdensity lipoprotein (LDL) cholesterol: ≥ 130 mg/dL; Abnormal Non-HDL Cholesterol: non-HDL cholesterol: ≥ 145 mg/dL; Abnormal TC: total cholesterol (TC): ≥ 200 mg/dL; Abnormal TG: triglycerides (TG) ≥ 100 mg/dL for ages 0-9 years, ≥ 130 mg/dL for ages 10-19 years, ≥ 150 mg/dL for ages 20-21 years. Any abnormal lipid lab results: the first occurrence of any of the above thresholds during the study period; Abnormal BMI: BMI z-score≥ 95th percentile for ages 2-18 years, BMI ≥ 30 kg/m2 for ages 19-21 years; aRR: adjust Relative Risk.
Measles
South Carolina looks primed to top the West Texas case numbers from 2025, now at 700 cases compared to 762 from the Texas outbreak that ended last August. CDC numbers for 2026 are at 416 cases country-wide, not even a full month into the year. The updated count for 2025 is 2255 cases. Here's the Johns Hopkins map for the last 2 weeks, remember that the numbers are slightly different from CDC's because they use state and other jurisdiction reports that aren't yet confirmed by CDC.
WRIS
RSV hospitalization rates for children under 5 might have bumped up a little (see black dotted line), hard to know if that suggests any new trend.
Influenza hospitalizations are still trending downward (red line), though I'm holding my breath in anticipation of a rebound.
Covid hospitalizations also are dropping, seen in the black dotted line.
On Aphorisms
A special shout-out to Dr. Jim Stockman, whose Question of the Week for the American Board of Pediatrics last week included his usual rabbit-hole dive into medical history and trivia; this time I learned that Hippocrates created a list of 54 medical aphorisms. You readers will only know why I'm mentioning this if you explored the new Bud's Laws tab on the website. I thought I was relatively unique in using aphorisms in medical education, but Hippocrates had me beat by a long shot. He had more, 54 versus 10, and most of his are self-explanatory whereas mine are very cryptic. His aphorisms don't appear too helpful in today's world, ranging from the obvious to the silly to the just plain incomprehensible. For example, #10: "Bodies not properly cleansed, the more you nourish the more you injure."
I wonder how my aphorisms will fare over the next 2400 years.
I'm reminded of Robert Frost's short, simple, and stately poem, especially these lines.
"The only other sound’s the sweep
Of easy wind and downy flake."