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Could genetics explain the confusing array of SARS-CoV-2 symptoms? - Ars Technica
An extremely preliminary study highlights the range and variety of symptoms.
Enlarge/ A drive-through coronavirus testing station. 44 with 28 posters participating A dry cough. Loss of smell. Diarrhea. Fever. All of these have been considered possible symptoms associated with SARS-CoV-2 infection, along with the complete absence of symptoms at all. In the absence of a sufficient testing capacity, many areas in the United States are being compelled to allocate their limited tests to only those who seem to have COVID-19 symptoms. But, given the difficulty of determining which symptoms actually indicate a likely infection, those are difficult decisions to make. The bewildering array of symptoms also raises questions about why people respond so differently to the same virus. Figuring out what's going on in the midst of a pandemic is an incredible challenge. We're going to take a look at some preliminary reports about one way of doing sonot because the results are likely to hold up as more research comes in, but because it reveals some of the ways that researchers are using to try to understand the virus's infection. Symptom or coincidence? Currently, the CDC website lists a variety of symptoms associated with COVID-19. Some of these are what you'd expect for a viral infection of the lungs: fever and chills, cough, shortness of breath, and a sore throat. But there are also some less obvious ones, like headaches, muscle pain, and loss of the sense of smell. Lists like these are typically prepared by aggregating medical reports, as doctors take and update a person's symptoms as they're admitted and treated. But the lack of testing poses significant problems for this effort. For one, we're struggling to understand how many people have been infected without requiring medical care. The arrival of the pandemic was also coincident with flu season and the onset of seasonal allergies, which can produce an overlapping set of symptoms. Finally, the list of symptoms is generally a product of the patient's own memory as they're asked to describe the onset of the problems. Memories can be problematic, as the need for medical care itself can enhance recall of symptoms that might otherwise be ignored. The wide awareness of lists of symptoms like the CDC's can serve the same purpose. Complicating matters further, some problems seem to strike a relatively small subset of infected people. Various reports have implicated SARS-CoV-2 in blood-clot formation, possibly through its infection of the lining of blood vessels. Similar things are true for the gastrointestinal symptoms. And the receptor that the virus uses to enter cells is also found in the kidneys, which could potentially explain why a number of hospitalized patients have needed dialysis. Why some patients appear vulnerable to severe symptoms yet others have an asymptomatic infection remains unclear. Figuring out what's going on with some of this will ultimately require a lot of lab workwe'll need to find out if the virus can reproduce in kidney cells and explore the nature of any kidney damage, for example. But another group of researchers has been looking for ways to understand the onset of COVID-19 symptoms in real time. What happens when? Two recent draft papers have described the early results of a collaboration between health researchers at Harvard and King's College London. They've worked with an application development company to put together a simple application for mobile devices called COVID Symptom Tracker that asks its users a series of questions daily. These are focused on known symptoms of COVID-19 (and can be updated as that lists expands), as well as any test results and treatments received. This approach has some downsides. Its users are self-selected and have smartphones, which probably means a younger population. And the app only asks about the symptoms that the developers have enabled. But the approach trades these limitations for some significant advantages. The first is simply scale. Between the US and UK, the app already had 2.2 million users before the end of March. The second is that it doesn't suffer from recall biaspeople enter their symptoms as they arise, before they know they're associated with a positive diagnosis. Later, the early symptoms and even treatments can potentially be correlated with patient outcomes. How's it working out? A draft describing the application presents some initial analysis of its users. It found that people typically got tested after reporting coughing and/or fatigue, but these weren't actually strongly linked to the test coming back positive. The same was true if someone had diarrhea but no other symptoms. Instead, positive diagnoses went up if cough and/or fatigue was associated with diarrhea or the loss of smell. In fact, the results suggested, loss of smell was more common than fever among those who would eventually test positive for the virus. Last week, the team posted a follow-up draft that starts looking at the features associated with these symptoms. It does so by looking at a population of twins in the UK who have volunteered to take part in health research. A number of them (a bit over 2,500) have been using the application, and the researchers have used that to try to tease out whether genetics might influence the symptoms that people experience. Limitations The problem here is that not enough of them have received a diagnosis to do any sort of analysis. So the researchers weren't correlating anything to actual SARS-CoV-2 infections; instead, they correlated it to a prediction of a positive diagnosis, as determined in their earlier draft manuscript. That's clearly the biggest single weakness of this work. The second is that it covered an extremely short period: March 25 through April 3. Given those cautions, you should take the results with an entire salt flat. But there are some interesting potential results that seem worth following up on with longer-term tracking. They suggest that there's a significant genetic component to who is likely to end up with a COVID-19 diagnosis, with a likely value of 50-percent genetic (though the error range was from 30 to 80 percent). In addition, many symptoms also seemed to be linked by genetics, including fever, fatigue, loss of smell, and diarrhea. Others, like coughs, chest pains, and abdominal pains, were not. While this study isn't going to change our understanding in its current form, it does provide an interesting model for how a higher-quality study would workthat's a potential reason for posting a draft publicly in the first place. And it's clear that this study could eventually be what we're looking for, as there's no reason we couldn't eventually test every single participant and get a clearer picture of what's going on. Longer-term, rather than relying on twins, we might want to also do genome-wide studies with unrelated individuals, which could greatly expand the study population. Although this study shouldn't be viewed as much more than a hint of what's possible, something is clearly influencing the body's response to this virus in different individuals. Genetics is a reasonable candidate for one of the influences there.
Here are 10 alternative ideas for what NASA could do with its Moon budget - Ars Technica
For this kind of money in space, there's a universe of things we might do instead.
Enlarge/ Lake Bosumtwi, located in Ghana, is situated inside a meteorite impact crater. Perhaps we should protect ourselves? (Photo by USGS/ NASA Landsat/Orbital Horizon/Gallo Images/Getty Images) 17 with 16 posters participating One year ago, NASA embarked upon a journey to send humans back to the Moon for the first time since the Apollo Program. At the direction of the White House, NASA seeks to land astronauts at the South Pole of the Moon by 2024. Only recently, in February, did the space agency put a price on this Artemis Moon plan$35 billion over the next five years above its existing budget. Since then, of course, the world has turned upside down. In the weeks after NASA released this cost estimate, the threat posed by COVID-19 has swamped space budget debates or policy concerns. Moreover, most of the space agency's major hardware development programs for the Moon landing are temporarily shuttered. And truth be told, no one knows what kind of economy or federal budget will emerge on the other side of this pandemic. So during this pause in government spaceflight activity perhaps it is worth asking, is the Moon worth it? Certainly for much of the human spaceflight community, the Moon is the next logical step. It offers a nearby place to test our ability to fly humans beyond low-Earth orbit and the next frontier for human economic activity in space. On the other hand, $35 billion over five years is a lot of money. Instead of accelerating a human landing on the Moon by a few yearsand there is no guarantee that Artemis will succeedNASA could accomplish other interesting and useful things. To help find out just what we might do in space instead, I reached out to followers on Twitter and received hundreds of suggestions. From this, I broke these myriad proposals into 10 different "big ideas" that represent alternative approaches to exploration from NASA's mostly traditional Artemis Program. Under each category, for additional context, I've included links to individual suggestions that fall broadly into that area for additional context. Find asteroids, then deflect or mine them In survey after survey, protecting planet Earth from killer asteroids consistently ranks highest among public priorities for NASA. However, in recent years NASA has spent less than 1 percent of its budget tracking and characterizing hazardous objects in space, or about $150 million a year. Recently, the space agency proposed building a $600 million space-based NEO-Surveillance Mission to detect 65 percent of the undiscovered asteroids 140 meters or larger near Earth within five years, and 90 percent of them within 10 years. With more funding, NASA could build a second space-based telescope and supplement it with ground-based observatories. At the same time, the space agency could also do more missions like its Double Asteroid Redirection Test to study the deflection of potentially threatening asteroids. Finding and deflecting hazardous asteroids for the next century would cost substantially less than $35 billion. With the extra money, NASA could fund more missions to see about extracting rare metals and other precious commodities from them, which it is already doing in a limited fashion with the OSIRIS-REx, Psyche, and Lucy planetary science missions. The rare metals on asteroids are valued in the trillions of dollars. By better characterizing asteroids and conducting missions to test working on them, NASA could lay the groundwork for commercial development of asteroids and for building off-world mining industries. In doing so, the space agency could save Earth from strip mining and other activities harmful to the environmentin addition to averting a globally catastrophic impact. (suggested by Gabriel Arisi, Bryan Veersteg, What About It?!, Kurt, Kevin DuPriest, Maurice Brown, jules) Explore the Solar System In recent decades, NASA has arguably gotten the biggest bang for its buck from a succession of planetary missions that have explored all of the planets in the Solar System and many of their Moons. Thanks to the Voyagers, Galileo, Cassini, New Horizons, half a dozen landers on Mars, and a fleet of other spacecraft, we have learned so much about the worlds around us. Perhaps, then, NASA should double-down on these efforts to answer fundamental questions, such as whether life exists elsewhere in our Solar System today or whether it ever did in the past. With $35 billion, NASA could launch flagship missions to the planets Uranus, Neptune, Pluto, and Venus, as well as intriguing moons in the outer Solar System, such as Triton, Titan, Enceladus, Europa, and more.
- The Voyagers revealed many worlds in our Solar System begging for more in-depth exploration.
- This image of the crescent moon of Europa led scientists to believe a large ocean exists beneath the ice.
- And here's another one of the four big Jovian satellites, Ganymede.
- Voyager 1 looked back at Saturn on November 16, 1980, four days after the spacecraft flew past the planet, and observed the appearance of Saturn and its rings from this unique perspective.
- Titan's thick haze layer is shown in this enhanced Voyager 1 image taken November 12, 1980, at a distance of 435,000 kilometers.
- Saturn's moon Dione as seen by NASA's Voyager 1 spacecraft.
- This is an image of the planet Uranus taken by the spacecraft Voyager 2 in January 1986.
- This picture of Neptune was produced from the last whole planet images taken through the green and orange filters on the Voyager 2 narrow-angle camera.
- This Voyager 2 high resolution color image, taken two hours before closest approach, provides obvious evidence of vertical relief in Neptune's bright cloud streaks.
- A color mosaic of Triton, Neptune's largest moon. It is likely to have geysers.
- The cameras of Voyager 1 on February 14, 1990, pointed back toward the Sun and took a series of pictures of the Sun and the planets, making the first ever "portrait" of our solar system as seen from the outside.
- This narrow-angle color image of the Earth, dubbed "Pale Blue Dot," is a part of the first-ever "portrait" of the Solar System taken by Voyager 1.