Covid-19: Sore throat, fatigue, and myalgia are more common with new UK variant
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n288 (Published 29 January 2021) Cite this as: BMJ 2021;372:n288Read our latest coverage of the coronavirus outbreak
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Dear Editor,
1971 my studies of medicine in Göttingen started.
Prof. Dr. Arnold Hasselblatt taught the treatment of Group A Streptococci with Penicillin.
Prof. Dr. Wolfgang Poser asked for highly specific antibiotics, narrow spectrum.
1991 the US-Army described the resurgence of massive infections due to Group A Streptococci. (1)
2002 the US-Army observed not only upper respiratory tract infections but also many interstitial pneumonias during an outbreak of Group A Streptococci. Penicillin stopped this spike. (2)
2019 China and the UK showed peaks of scarlet fever, caused by different subgroups. (3)
2020 worldwide interstitial pneumonias.
Countries with high rates of penicillin use show the lowest excess-death-rates, Norway, Denmark, Germany.
Places like Manaus, Brazil, suffering from ever and ever recurrent Group A Streptococcal infections, not treated with oral penicillin V, see the worst wave of infection. (4)
1. G. C. Gray, J. Escamilla, K. C. Hyams, J. P. Struewing, E. L . Kaplan, A. K. Tupponce:
Hyperendemic Streptococcus pyogenes infection despite prophylaxis with penicillin G benzathine.
N Engl J Med 1991;325:92-97
2. N. F. Crum, K. L. Russell, E. L. Kaplan, M. R. Wallace, J. Wu, P. Ashtari, D. J. Morris, B. R. Hale:
Pneumonia Outbreak Associated with Group A Streptococcus Species at a Military Training Facility.
CID 2005;40:511-18
3. M. Chen, J. Cai, M. R. Davies, Y. Li, C. Zhang, W. Yao, D. Kong, H. Pan, X. Zhang, M. Zeng, M. Chen:
Increase of emm 1 isolates among group A Streptococcus strains causing scarlet fever in Shanghai, CHina.
International Jorunal of Infectious Diseases 2020;98:305-314
4. E. C. Sabino, L. F. Buss, M. P. Carvalho, C. A. Prete Jr., M. A. A. Crispim, N. A. Fraiji, R. H. M. Pereira, K. V. Parag, P. da Silva Peixoto, M. U. G. Kraemer, M. K. Oikawa, T. Salomon, Z. M. Cucunuba, M. C. Castro, A. Aruska de Souza Santos, V. H. Nascimento, H. S. Pereira, N. M. Ferguson, O. G. Pybus, A. Kucharski, M. P. Busch, C. Dye, N. R. Faria:
Resurgence of COVID-19 in Manaus, Brazil, despite high seroprevalence.
www.thelancet.com Published online January 27, 2021
Competing interests: No competing interests
Dear Editor
Thank you so much for drawing changes in the epidemic to attention, especially the new varient and its' symptoms. If we are to act as a responsible medical community it would help to engage with named DHSC spokespeople as well as knowing the membership of their "expert and independent scientific group" that "...keeps the list of symptoms of covid-19 under constant review...". The rationale for UK exceptionalism in not using WHO definitions is unclear. What data supports the claim that "the symptoms included on that list capture patients most likely to have covid-19..." given GPs are reporting that the "classic symptoms" alone are not good enough to contain community transmission https://www.bmj.com/content/372/bmj.n283. When the UK has many of the worst pandemic figures, despite continuing lockdowns, is it time to consider changing strategy? Rather than just capturing people with definite symptoms most likely to be covid-19, do we not need to keep those with any potential symptoms 'out of circulation' for those vital first five days when most likely to be infectious? At least by informing the general public they can use that knowledge wisely in their own, and others', best interest. Collectively, we have to accept that 'anyone could have the virus' so we can act accordingly. The problem remains for those millions who do have to go to work in crowded environments and who can't 'act accordingly' except by being terrified.
Competing interests: No competing interests
Ampicillin, non-invasive-ventilation and sufficient anticoagulation as new treatment
Dear Editor,
On February 3, 2021 the Frankfurter Allgemeine Zeitung discussed the landmark-article of Voshaar et al. (1).
Voshaar treated 280 COVID-19-patiens with non-invasive-ventilation, ampicillin and heparin.
Only 8% died. (2)
This is the way of the future. (3)
1. N von Lutteroti: Genug Sauerstoff. Künstliche Beatmung bei Covid-19 im Visier. FAZ 3. 2. 2021:N1
2. T. Voshaar, P. Stais, D. Köhler, D. Dellweg: Conservative management of Covid 19 associated hypoxemia. ERJ Open Res 2021; in press
(https://doi.org/10.1183/23120541.00026-2021).
3. M. J. Tobin, A. Jubran, F. Laghi: Noninvasive strategies in COVID-19: epistemology, randomised trials, guidelines, physiology. Eur Respir J 2020; in press
(https://doi.org/10.1183/13993003.04247-2020).
Competing interests: No competing interests