Roundup: Death Rate from Heart Disease has Surprisingly Risen, New Data Says; FDA Warns of Cough Medicine Misuse Among Kids; and Risks of Repeat COVID Infections

COVID Pandemic Reversed Decade of Progress in Lowering Heart-Disease Death Rate in U.S., Says CDC Preliminary Data

Before 2020, death rates from heart disease had been declining for decades. But the first year of the COVID-19 pandemic put a sudden halt to that progress, according to preliminary research from the U.S. Centers for Disease Control and Prevention (CDC) released this month by the American Heart Association (AHA).

“The increases in death rates from heart disease in 2020 represented about five years of lost progress among adults nationwide and about 10 years of lost progress among younger adults and non-Hispanic Black adults,” said lead researcher and CDC epidemiologist Rebecca C. Woodruff in a news release.

Researchers used the CDC’s “Wide-Ranging ONLine Data for Epidemiologic Research (WONDER)” database to review aggregated death certificate data from 2010 to 2020. The analysis found that the U.S. heart disease death rate fell by 9.8% percent from 2010 to 2019, then rose by 4.1 percent in 2020, returning to roughly the level in 2015.

The increased heart disease death rate was particularly high among younger adults, signifying about 10 years of lost progress for this group. From 2010 to 2019, the death rate fell by 5.5 percent for adults 35 to 54. But in 2020, it jumped 12 percent – “not only erasing prior progress but exceeding levels from a decade earlier,” states the AHA. For adults 55 to 74, the death rate initially fell by 2.3 percent between 2010 and 2019, then increased 7.8 percent in 2020.

What were the contributing factors? March 2020 marked the beginning of stay-at-home orders, which limited access to healthcare for many, researchers said.  Moreover, there are some indications that COVID itself put some people at higher risk for new or worsening cardiovascular disease. Other pandemic-related factors – such as decreases in physical activity and increases in smoking and alcohol use – also may have fueled the reversal, said AHA President Michelle A. Albert, M.D., in a news release.  

The CDC’s findings were presented at the American Heart Association’s Scientific Sessions conference in Chicago this month. The data are considered preliminary until full results are published in a peer-reviewed journal.

FDA: Unintentional Ingestions, Misuse of Cough Suppressant, Benzonatate, Rising Among Children

Cases reported to poison control centers of children overdosing on the cough suppressant benzonatate have been increasing in recent years, according to research published this week by the U.S. Food and Drug Administration.

About 77 percent of benzonatate exposures reported to poison control were unintentional, according to the study published by the American Academy of Pediatrics, as part of a reminder to keep prescriptions out of the reach of children.

An overdose of benzonatate can cause choking, airway compromise, depression of the central nervous system and death. Researchers also found that pediatric prescriptions for benzonatate increased 62 percent from 2012 to 2019

“Accessibility to medical products at home presents a risk for unintentional ingestion in young children as oral exploration is a normal part of development in infants, and young children may be enticed to consume objects that resemble candy,” authors from the FDA wrote in “Benzonatate Exposure Trends and Adverse Events.”

There were 4,689 cases reported from 2010 to 2018 to poison control centers. Cases rose each year from 308 in 2010 to 799 in 2018, a 159 percent increase. About 75 percent had no effect, 20 percent had a minor effect, 4 percent had a moderate effect and 1 percent had major outcomes. There were six deaths.

Intentional exposures reported to poison control increased from 49 in 2010 to 210 in 2018. “Just over half of intentional misuse/abuse and nearly all suspected suicide attempts were among children ages 10-16 years,” researchers stated.

Researchers emphasized that exposures and deaths reported in the study “likely are an undercount, and they could not discern how benzonatate exposure severity compared to other cough medication.”

Repeat COVID-19 Infections can Carry Risks of Severe Illness or Death as High as Initial Infection, New Research Finds

How much protection does natural immunity provide if you’re re-infected with COVID-19 within a certain period of time? Not much, if at all, indicates the findings of a new study from the U.S. Department of Veterans Affairs of nearly 41,000 people who were reinfected.

Researchers found that reinfected patients were likely to develop more complications during their initial infection and subsequent bouts with COVID. Compared to those who were not re-infected, those infected more than once were more likely to be diagnosed with “long COVID,” the term given for those who suffer lingering symptoms for several months or longer.  The findings applied even to those who were vaccinated against COVID.

“The risks were evident in those who were unvaccinated and had one vaccination or two or more vaccinations before reinfection,” the study states. “The risks were most pronounced in the acute phase (first infection), but persisted in the post-acute phase at 6 months. Compared to noninfected controls (study participants), cumulative risks and burdens of repeat infection increased according to the number of infections.”

The paper, published in the journal Nature Medicine, is based on an analysis of electronic medical records in the VA’s national healthcare database. Researchers evaluated medical records of 5.8 million patients, with 443,588 of them having been infected once, and 40,947 who had been infected two or more times. The median time between the first and second infection was 191 days.

Compared with those who suffered just one infection, those who were reinfected had a two-fold increased risk of death; three-fold increased risk of hospitalization; two-fold increased risk of long COVID; three-fold increased risk of heart issues and blood clotting disorders, and two-fold increased risk of fatigue.