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The most important news in healthcare: Friday, July 31st.
Good morning. Today we’re discussing how COVID-19 is shaking up transplant surgery, and how new research on Alzheimer’s hopes to bring cheaper, more reliable diagnoses to millions of patients worldwide.
First COVID-19 double lung transplant patient discharged home
The pulse
On Wednesday, the first COVID-19 patient to receive a double lung transplant was discharged from the hospital. She likely won’t be the last person to need the life-saving operation.
Who is this patient?
Mayra Ramirez is a 28-year-old paralegal who started feeling ill towards the end of April. Ms. Ramirez suffers from an autoimmune condition requiring immunosuppressive therapy that likely weakened her body’s response to COVID-19. Within weeks, she became too ill to walk unassisted, and eventually even to breathe on her own. By the end of May, doctors were forced to consider their absolute last resort option – a lung transplant.
Why are lung transplants a last resort?
There are the more obvious factors to consider, such as the fact that most people have to wait years to receive an organ transplant due to a long waiting list, and that transplants require life-long immunosuppression (which is likely what had made Ms. Ramirez more susceptible to COVID-19 in the first place). Even then, the patient’s body may reject the donor’s organ. Importantly, a lung transplant is by no means a guarantee of a restored life expectancy. In fact, the five-year survival rate for lung transplant recipients is only about 50%.
Will more COVID-19 patients get lung transplants?
Since Ms. Ramirez’s June 5th operation, two other patients have received lung transplants following COVID-19 infections and two more patients are awaiting their operations. This represents a major paradigm shift in healthcare– lung transplants have not previously been considered a treatment option for infectious diseases, even for serious diseases such as tuberculosis. However, in the case of severe COVID-19 infection, the degree of inflammation and scarring in the lungs may leave transplantation as the only viable option for some patients.
Bottom line it for me:
COVID-19 is radically altering the field of lung transplantation, forcing doctors to consider transplants in young patients who might otherwise succumb to infection.
Source: AARP
New Alzheimer’s Blood Test Promises Faster, Cheaper Diagnosis
The pulse:
On Tuesday, scientists reported that a new blood test can diagnose Alzheimer’s disease more accurately than expensive imaging technologies, creating the potential for cheap, widely-available diagnoses.
How is Alzheimer’s diagnosed today?
Alzheimer’s, the devastating memory-loss disorder that affects six million people in the U.S., is usually diagnosed through clinical assessments of memory and cognition, coupled with family member interviews. If that sounds qualitative or archaic, that’s because it is - diagnoses are often inaccurate, and doctors will sometimes mistake Alzheimer’s for other neurodegenerative conditions (and vice versa).
Brain imaging technologies — like PET scans and MRI — allow for a more accurate interpretation of whether a patient has Alzheimer’s, but cost thousands of dollars and are inaccessible to much of the population.
How does the blood test work? How good is it?
The new blood test measures the levels of distinctive plaques and proteins (amyloid and tau) that form in Alzheimer’s patients. It’s able to distinguish Alzheimer’s from other dementias with 96% accuracy, which is comparable to PET scans, and surpasses MRI.
The new test also has the potential to detect disease well before symptoms start. In over 600 members of the world’s largest family with genetic early-onset disease, the test identified who would develop Alzheimer’s 20 years before dementia would begin.
If all goes well with development, this test could reach the market within three years.
What are the implications of having a really good Alzheimer’s test?
For patients with a genetic history of disease in their family, this test could quickly confirm or deny whether or not they also have Alzheimer’s. Unfortunately, the benefits stop there. As there is no cure for Alzheimer’s, there is no pre-emptive medical action that can be taken to prevent the disease.
The value of a cheap diagnostic will improve tremendously as Alzheimer’s therapies reach the market.
Bottom line it for me.
Cheap, novel diagnostics like this new Alzheimer’s blood test are important -- but a lot of people might not actually want to know whether they have the disease if there’s no treatment available for it.
Rapidfire
Kodak (yes, the photo company) is receiving a $765 million loan from the Trump administration to develop film chemicals. Kodak claims these ingredients are similar to those used to make drugs. Or are they just trying to make this a Kodak moment?
Former presidential candidate Herman Cain has died after being infected with the coronavirus. The New York Times memorializes him here.
A large study from South Korea found that children aged 10 - 19 spread the coronavirus at least as well as adults do. The study raises red flags as the administration pushes for public schools to reopen in the fall.
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