“Fighting COVID-19: Knowledge and Experience Sharing” – Sanofi

In light of the COVID-19 outbreak, and in its aim to raise the necessary awareness on this pandemic, Sanofi launched its online webinar titled “Fighting COVID-19: Knowledge and Experience Sharing”. Targeted towards members of the media in Lebanon and Jordan, this informative and educational webinar was organized in collaboration with renowned expert physicians from the region who shared their knowledge and experience about the impact of COVID-19 on people with underlying health conditions such as diabetes, cardiovascular diseases, multiple sclerosis and cancer.

COVID-19 is a highly transmissible viral illness caused by SARS-CoV-2 of the coronavirus family that was declared a global pandemic by WHO on March 11, 2020. The virus is primarily transmitted from symptomatic people to others through respiratory droplets, or by contact with contaminated objects and surfaces. COVID-19 has a 2-14 days incubation period and most cases have reported mild to moderate symptoms of fever, myalgia, dry cough, fatigue, some intestinal symptoms and anosmia (loss of smell) and in some cases the loss of taste. In severe cases, acute respiratory distress syndrome (ARDS) is the leading cause of mortality.

Taking it a step further to shed light onto the effects of COVID-19 on people with other health issues, the webinar was kicked-off with a talk on the necessity of immunization during this pandemic. Prof. Wail Hayajneh, M.D, Chairman National Immunization Technical Advisory Group (NITAG) and Chairman Infectious Diseases Committee JFDA, stressed that “COVID-19 does not visit without invitation.” He added “WHO stated that ‘the disruption of immunization services, even for brief periods, will result in increased numbers of susceptible individuals and raise the likelihood of outbreak-prone vaccine preventable diseases (VPDs) such as measles. And in order to avoid new outbreaks during the COVID-19 pandemic, it is important as per WHO recommendations ‘to prioritize pneumococcal and seasonal influenza vaccines for the vulnerable population groups such as health workers, older adults and pregnant women and encourage to track Vaccine Coverage Rate in the context of COVID-19’”.

The second topic brought to the table was diabetes. When it comes to diabetes patients, they are not affected by COVID-19 more frequently than people without diabetes. High blood sugar poses a risk on diabetic patients by causing complications that lead to cerebrovascular accidents and arteriosclerosis, and it is the most common factor for chronic kidney failure that results in chronic dialysis and impairing of the functioning of blood cells, especially the ones that defend the body against viral and bacterial infections.

According to Prof. Fares Haddad, M.D, FRCP (EDIN), FACE, Clinical Associate Professor and Senior Consultant Endocrine and Diabetes, “Although diabetic patients are not more susceptible to COVID-19 infection, the virus exposes them to more complications and to an increased death rate ranging between 7-9% as per the studies and observations. Additionally, these complications are more serious if diabetes is accompanied by other chronic diseases, especially obesity. Therefore, patients with Diabetes must maintain several essential things in light of the COVID-19 pandemic:

• Take the treatment regularly without stopping it, especially insulin in case of illness and infections. Stick to the treatment prescribed by the physician.Ensure control of the standards set by the physician.Ensure supply of the medications for a month or more to avoid any discontinuation of the treatment.

In the context of the COVID-19 global pandemic, serious heart conditions, including heart failure, coronary artery disease, congenital heart disease, cardiomyopathies, and pulmonary hypertension, may put people at higher risk for severe illness from COVID-19. Based on early reports, 40% of hospitalized COVID-19 patients had cardiovascular diseases or cerebrovascular diseases (which refers to blood flow in the brain, such as stroke).

“The case fatality rate for those with CVDs is higher than the average population at 10.5% as per the American College of Cardiology. Age matters here as the case fatality rate rises to 8.0% among CVD patients aged 70-79 and 14.8% in patients over 80” stated Prof. Antoine Sarkis, M.D, FESC, FACC, Professor of Cardiology, Hôtel Dieu Hospital, St. Joseph University. He continued by recommending a set of actions to be taken by CVD patients as precautionary measures in the face of COVID-19:

• “Take your medication exactly as prescribed and keep contact with your Doctor.Continue your anti- hypertensive medication including angiotensin converting enzyme inhibitors (ACE-I) or angiotensin-II receptor blockers (ARB) as prescribed by your healthcare provider.Make sure that you have at least a two-week supply of your heart disease medications.Continue to manage and control your blood pressure and take your medication as directed.Adhere to barrier rules: social distancing, wearing face masks, hands hygiene.”

Multiple Sclerosis is a chronic disease of the central nervous system that affects persons differently, and is caused by the body’s immune system by attacking the central nervous system, damaging the myelin sheath. Numerous studies have shown that MS exacerbations can be triggered by infections (both viral and bacterial). MS therapies with immunosuppressants may leave patients with weakened immune systems, and therefore more susceptible to opportunistic infections.

Weighing in on this subject is Prof. Bassem Yamout, Professor of Clinical Neurology, President of MENACTRIMS and Director of Multiple Sclerosis Center Clinical Research, American University of Beirut Medical Center, who confirmed that “MS itself does not increase the risk of getting COVID-19. However, certain factors associated with MS may increase the risk for complications such as:

• Chronic medical conditions, such as lung disease, heart disease, diabetes, cancer, smoking and asthmaSignificantly restricted mobility, such as needing to spend most of your day seated or in bedAge 65 or olderPossibly taking certain disease modifying therapies that deplete immune system cellsSevere obesity or BMI higher than 40Living in a long-term care facility

He concluded, “sometimes, as with any infection, COVID-19 may cause temporary worsening of MS symptoms. Typically, these symptoms settle down once the infection clears up. According to the MS International Federation recommendations, people with MS should continue their treatment and discuss specific risks with their MS healthcare provider regarding the need to alter or stop their  treatment”.

Tackling Cancer patients, the risk of hospitalization is 4 times higher, and the risk of death is also higher by 10 times compared to the general population, especially in patients with hematologic malignancy or receiving many lines of chemotherapy or presenting neutropenia and lymphopenia.

“The LSMO issued guidelines to help Oncologists, Oncology staff, patients and their relatives to cope and deliver the most optimal care while reducing their chances of contracting and transmitting COVID-19 during the present outbreak that is predicted to last for a while. There could be a higher prevalence of cancer patients with COVID-19 infections compared with the overall population (1 vs 0.29%) but cancer patients had a higher incidence of severe events; the risk of hospitalization for cancer patients were higher compared to the general population and severe events were reported in 48–54% of cases versus 16% in the overall population, notably among patients receiving anticancer treatment within the previous 2 weeks” said Prof. Joseph Kattan, Professor in Hematology and Oncology and Head of Hematology and Oncology department at HDF University hospital. He ended his talk by sharing the two principles of daily practice recommendations to follow for cancer patients:

1) “Sanctuarization” of Oncology Department:

• “Prevention of Contamination: Screening of patients and visitors from travel history and symptoms. Wearing and adopting personal precautions.
• Avoid overcrowded clinics and chemotherapy units by decreasing the number of patients, limiting the number of accompanying persons, reducing waiting time etc.

 2) Prioritization of Oncology patients:

• Postpone palliative and supportive treatments.
• Convert IV therapy to oral, avoid weekly schedule.
• Use growth factors.
• Delay routine follow-up visits or imaging.

All experts reminded attendees that precaution and safety measures remain essential steps to follow in order to contain the spreading of COVID-19 and protect those who are most vulnerable in the face of the virus:

• Avoid crowded places
  • Wash hands thoroughly according to WHO guidelines
    • Use sanitizers and gloves/wear masks properly when going to a clinic/hospital
      • Do not have contact with family/friends with COVID-19 symptoms/possible exposure
      • Practice social distancing with all people to protect yourself and others
      • Keep in contact with medical team and report new symptoms by telephone 1st (particularly fever/cough/shortness of breath)