Venous thromboembolism in critically Ill patients with COVID-19: Results of a screening study for deep vein thrombosis.

The rapid spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and coronavirus disease 2019 (COVID-19), has caused more than 3.9 million cases worldwide. Currently, there is great interest to assess venous thrombosis prevalence, diagnosis, prevention, and management in patients with COVID-19. To determine the prevalence of venous thromboembolism (VTE) in critically ill patients with COVID-19, using lower limbs venous ultrasonography screening. Beginning March 8, we enrolled 25 patients who were admitted to the intensive care unit (ICU) with confirmed SARS-CoV-2 infections. The presence of lower extremity deep vein thrombosis (DVT) was systematically assessed by ultrasonography between day 5 and 10 after admission. The data reported here are those available up to May 9, 2020. The mean (± standard deviation) age of the patients was 68 ± 11 years, and 64% were men. No patients had a history of VTE. During the ICU stay, 8 patients (32%) had a VTE; 6 (24%) a proximal DVT, and 5 (20%) a pulmonary embolism. The rate of symptomatic VTE was 24%, while 8% of patients had screen-detected DVT. Only those patients with a documented VTE received a therapeutic anticoagulant regimen. As of May 9, 2020, 5 patients had died (20%), 2 remained in the ICU (8%), and 18 were discharged (72%). In critically ill patients with SARS-CoV-2 infections, DVT screening at days 5-10 of admission yielded a 32% prevalence of VTE. Seventy-five percent of events occurred before screening. Earlier screening might be effective in optimizing care in ICU patients with COVID-19

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Land/sea level changes in southern Finland during the formation of the Salpausselkä endmoraines

The altitudes of delta plains of the Salpausselkä endmoraines and of eskers, as well as some determinations of the highest beach level, were used in the study of land/sea level changes. An area south of Hämeenlinna in southern Finland was studied in more detail and compared with Salpausselkä I at Lahti and Utti. It was found that there is a zone in the Salpausselkä belt, partly including Salpausselkä I, and reaching to a line inside Salpausselkä II, in which the outwash features were formed during a high position of the water level, when the Baltic Ice Lake was dammed and its level higher than the sea level. The transgression began 8 600–8 700 B.C. and ended with the drainage of the Baltic Ice Lake at Billingen in Central Sweden in 8 213 B.C., when the water level dropped to the Yoldia level, Y I. Before the transgression the deltas, which mostly belong to Salpausselkä I, were formed at a low position of sea level, the g level. A curve of the land/sea level changes covering the last 11 000 years was constructed on the basis of the results from the present study and earlier investigations in the same area

Errors in the radiocarbon dating of deposits in Finland from the time of deglaciation

Some radiocarbon dates of sediments from the area of the Salpausselkä moraines, and north of them in the area deglaciated after c. 10200 B.P., are too old and at variance with a number of radiocarbon dates for the regional pollen assemblage zones. Redeposited organic material is mainly responsible for the dates being too old, but an influence of the hard-water effect and of graphite can also be demonstrated. The age of the deglaciation is therefore likely to be in agreement with that suggested by the varve chronology and supported by most radiocarbon dates from organic deposits

Some ventifacts found near recent and fossil coastal dunes in Finland

During the Holocene relative uplift of land in Finland coastal dunes were formed at various altitudes in areas earlier submerged. Some ventifacts found near these dunes, the oldest being about 4000 years old, are described from the Hanko (Hangö) peninsula and from Kalajoki in Ostrobothnia. The hard rock ventifacts have a shiny upper surface with no facets developed

Redeposited Eemian marine clay in Somero, south-western Finland

Samples from a 33.3 m deep borehole of early Flandrian clay in Somero, south-western Finland, were studied. The thick clay, although similar in origin to the varved clays in the area, is here without clearly developed varves. Pollen analysis showed that most or all pollen was redeposited Eemian pollen, also representing the Eemian climatic optimum, and the diatoms confirmed the marine origin of the redeposited clay. The Somero clay, together with earlier finds of marine Eemian clay in the south-eastern parts of Fennoscandia, as in Rouhiala, Karelia, prove that southern Finland was more submerged during the climatic optimum of the Eemian interglacial than during the Litorina Sea period of the Flandrian