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Opinion | Tocilizumab in COVID-19 therapy: who benefits, and how? – the researchers suggest that maybe IL-6 inhibitors should be given only to patients with high IL-6.

23 Jul, 2021 | 10:51h | UTC

Tocilizumab in COVID-19 therapy: who benefits, and how? – The Lancet

Related: A living WHO guideline on drugs for covid-19 – interleukin-6 receptor blockers are now recommended for patients with severe or critical covid-19. AND M-A: Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19 – “The 4% absolute risk reduction in mortality from 25% to 21% with IL-6 inhibition added to glucocorticoids may not translate to patients with a lower baseline mortality risk and likely do not justify the additional expense and risk for toxicities for patients hospitalized with modest oxygen requirements and a stable clinical course (from editorial)”. AND RECOVERY trial: In hospitalized COVID-19 patients with hypoxia and systemic inflammation (C-reactive protein ≥75 mg/L), tocilizumab improved survival and other clinical outcomes AND Secondary analysis of RCT finds Tocilizumab was beneficial to patients hospitalized with Covid-19 if CRP levels were greater than 15.0 mg/dL, but not if CRP levels were 15.0 mg/dL or less. AND M-A: Tocilizumab in COVID-19 – “For hospitalized COVID-19 patients, there is some evidence that tocilizumab use may be associated with a short-term mortality benefit, but further high-quality data are required”.

 


How the Delta variant achieves its ultrafast spread – “Viral load is roughly 1,000 times higher in people infected with the Delta variant than those infected with the original coronavirus strain, according to a study in China”.

23 Jul, 2021 | 10:46h | UTC

How the Delta variant achieves its ultrafast spread – Nature

Original study: Study shows the viral loads in the Delta infections are ~1000 times higher than those in the earlier strain infections on the day when viruses are firstly detected.

 


What are the Delta, Gamma, Beta and Alpha Covid variants?

23 Jul, 2021 | 10:45h | UTC

What are the Delta, Gamma, Beta and Alpha Covid variants? – BBC

Related: Increased transmissibility and global spread of SARS-CoV-2 variants of concern – “Estimated transmissibility increases of alpha 29% (95% CI: 24–33), beta 25% (95% CI: 20–30), gamma 38% (95% CI: 29–48) & delta 97% (95% CI: 76–117)”. AND WHO renames COVID-19 variants with the Greek alphabet (i.e., Alpha, Beta, Gamma, etc), making them simple, easy to say and remember. The naming system aims to prevent calling COVID-19 variants by the places where they are detected, which is stigmatizing & discriminatory.

 


Review: Ethics in extracorporeal life support.

23 Jul, 2021 | 10:29h | UTC

Ethics in extracorporeal life support: a narrative review – Critical Care

 


Study shows AstraZeneca and Pfizer vaccines are effective against Delta variant, but both doses are needed.

22 Jul, 2021 | 11:16h | UTC

Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant – New England Journal of Medicine

Commentaries: Study Finds Pfizer And AstraZeneca Vaccines Effective Against The Delta Variant — As Long As You Get Both Doses – Forbes AND Pfizer’s COVID-19 vaccine works very well against the Delta variant — but only after 2 doses – Insider

Related: [Preprint] 2 doses of Covid vaccines (Pfizer-BioNTech or Oxford-AstraZeneca) highly effective against hospitalization from Delta variant. AND Reduced sensitivity of SARS-CoV-2 variant Delta to antibody neutralization. AND Should I get my second AstraZeneca dose? Yes, it almost doubles your protection against Delta.

 

Commentary on Twitter

 


COVID-19 antibodies persist at least nine months after infection – “98.8 percent of people infected in February/March showed detectable levels of antibodies in November”.

22 Jul, 2021 | 11:14h | UTC

News release: COVID-19 antibodies persist at least nine months after infection – Imperial College London

Original study: SARS-CoV-2 antibody dynamics and transmission from community-wide serological testing in the Italian municipality of Vo’ – Nature Communications

 


RCT: Dapagliflozin in patients with cardiometabolic risk factors hospitalized with COVID-19 – safe, but no statistically significant risk reduction in organ dysfunction or death.

22 Jul, 2021 | 11:08h | UTC

Dapagliflozin in patients with cardiometabolic risk factors hospitalised with COVID-19 (DARE-19): a randomised, double-blind, placebo-controlled, phase 3 trial – The Lancet Diabetes & Endocrinology

Commentary: Dapagliflozin in patients with COVID-19: truth or dare – The Lancet Diabetes & Endocrinology

 


Review: Personalized mechanical ventilation in acute respiratory distress syndrome.

22 Jul, 2021 | 10:40h | UTC

Personalized mechanical ventilation in acute respiratory distress syndrome – Critical Care

Related: M-A of randomized trials: In patients with acute respiratory distress syndrome, there was no difference in mortality between higher vs. lower positive end-expiratory pressure strategies. AND Seminar | Acute respiratory distress syndrome. AND Short review: Diagnosis and management of acute respiratory distress syndrome

 


WHO Guidance for clinical case management of thrombosis with thrombocytopenia syndrome (TTS) following vaccination to prevent coronavirus disease (COVID-19).

20 Jul, 2021 | 10:29h | UTC

Guidance for clinical case management of thrombosis with thrombocytopenia syndrome (TTS) following vaccination to prevent coronavirus disease (COVID-19) – World Health Organization

Related Guidance: AHA/ASA Guidance: Diagnosis and Management of Cerebral Venous Sinus Thrombosis with Vaccine-Induced Thrombotic Thrombocytopenia – “No heparin products in any dose should be given.” AND ISTH Interim Guidance for the Diagnosis and Treatment on Vaccine Induced Immune Thrombotic Thrombocytopenia

 


WHO warns that HIV infection increases risk of severe and critical COVID-19.

20 Jul, 2021 | 10:24h | UTC

News release: WHO warns that HIV infection increases risk of severe and critical COVID-19 – World Health Organization

Report: WHO report on clinical features and prognostic factors of COVID-19 in people living with HIV hospitalized with SARS-CoV-2 infection

Related: M-A: Epidemiology and outcomes of COVID-19 in HIV-infected individuals – HIV is a significant risk factor for acquiring SARS-CoV-2 infection and is associated with a higher risk of mortality.

 

Commentary on Twitter (thread – click for more)

 


What vaccinated people should know about Covid-19 exposure, tests and more.

20 Jul, 2021 | 10:17h | UTC

What vaccinated people should know about Covid-19 exposure, tests and more – CNN

 


ALA/ATS Response to Philip Morris International’s (PMI) Purchase of British Producer of Respiratory Treatments – “The announcement that PMI wants to acquire an inhaled medicine company is the latest reprehensible choice from a company that has profited from addicting users to its deadly products”.

20 Jul, 2021 | 10:12h | UTC

American Lung Association and the American Thoracic Society Response to Philip Morris International’s Purchase of British Producer of Respiratory Treatments – American Thoracic Society

 


RCT: more data showing Azithromycin is not better than placebo in patients with Covid-19.

18 Jul, 2021 | 23:54h | UTC

Effect of Oral Azithromycin vs Placebo on COVID-19 Symptoms in Outpatients With SARS-CoV-2 Infection: A Randomized Clinical Trial – JAMA

Commentary: Common antibiotic no more effective than placebo in preventing COVID-19 symptoms among non-hospitalized – University of California – San Francisco

Related: RCT: Another study shows Azithromycin does not improve outcomes in patients with Covid-19. (several articles on the subject)

 

Commentary on Twitter

 


Position Paper: Recommendations for the use of topical inhalant budesonide in COVID-19.

18 Jul, 2021 | 23:53h | UTC

Recommendations for use of topical inhalant budesonide in COVID-19 – HNO

Related: RCT: Inhaled budesonide shortens recovery time in non-hospitalized patients with COVID-19 AND Phase 2 RCT: Inhaled budesonide shows promise for the treatment of early COVID-19

 


Review: Symptoms, complications and management of long COVID.

18 Jul, 2021 | 23:46h | UTC

Symptoms, complications and management of long COVID: a review – Journal of the Royal Society of Medicine

Commentary: Long COVID: More likely in patients with 5+ symptoms in first week of infection – SAGE Publications

 

Commentary on Twitter

 


Long Covid: fatigue, post-exertional malaise, and cognitive dysfunction are the most common symptoms, according to an international survey.

18 Jul, 2021 | 23:44h | UTC

Characterizing long COVID in an international cohort: 7 months of symptoms and their impact – EClinicalMedicine

Commentaries: Identification of over 200 long COVID symptoms prompts call for UK screening programme – University College London AND A survey of long-haulers found 66 symptoms that lasted more than 6 months. Tiredness and brain fog were most common. – Insider AND Long Covid has more than 200 symptoms, study finds – The Guardian

 


Studies elucidate poorly understood long COVID.

18 Jul, 2021 | 23:42h | UTC

Studies elucidate poorly understood long COVID – CIDRAP

 


CDC warns Covid-19 vaccines might not protect people who are immunocompromised – “CDC is looking into ongoing research exploring the possibility that immunocompromised could benefit from an additional dose”.

18 Jul, 2021 | 23:38h | UTC

CDC warns Covid-19 vaccines might not protect people who are immunocompromised – CNN

 


Study: Pooled saliva analysis is a low-cost and effective strategy for surveillance of Covid-19 in schools and universities and allows to rapidly assess transmission and adjust prevention protocols.

18 Jul, 2021 | 23:37h | UTC

Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universities – EClinicalMedicine

Related: Pooling of Samples for Testing for SARS-CoV-2 in Asymptomatic People AND Implementation of a Pooled Surveillance Testing Program for Asymptomatic SARS-CoV-2 Infections on a College Campus — Duke University, Durham, North Carolina, August 2–October 11, 2020 – CDC Morbidity and Mortality Weekly Report

 


Why was a major study on ivermectin for covid-19 just retracted?

16 Jul, 2021 | 11:11h | UTC

Why Was a Major Study on Ivermectin for COVID-19 Just Retracted? – Grifter Analysis and Review

See also: Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns – The Guardian AND Some problems in the dataset of a large study of Ivermectin for the treatment of Covid-19 – Nick Brown’s Blog AND Is Ivermectin for Covid-19 Based on Fraudulent Research? – Gideon M-K; Health Nerd

 

Commentary on Twitter (thread – click for more)

 


Heterologous Oxford–AstraZeneca and Moderna Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.

16 Jul, 2021 | 11:02h | UTC

Heterologous ChAdOx1 nCoV-19 and mRNA-1273 Vaccination – New England Journal of Medicine

Related: [Preprint] Mixing Covid jabs has good immune response, study finds – “The Com-Cov trial looked at the efficacy of either two doses of Pfizer, two of AstraZeneca, or one of them followed by the other. All combinations worked well, priming the immune system”. AND Phase 2 RCT: Immunogenicity and reactogenicity of a Pfizer-BioNTech booster in patients that have received a single dose of AstraZeneca vaccine – “BNT162b2 (Pfizer) given as a second dose in individuals prime vaccinated with ChAdOx1-S (AstraZeneca) induced a robust immune response, with an acceptable and manageable reactogenicity profile”. AND RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects.

 

Commentary on Twitter

 


Heterologous Oxford–AstraZeneca and BioNTech/Pfizer Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.

16 Jul, 2021 | 11:00h | UTC

Immune responses against SARS-CoV-2 variants after heterologous and homologous ChAdOx1 nCoV-19/BNT162b2 vaccination – Nature Medicine

Heterologous ChAdOx1 nCoV-19 and mRNA-1273 Vaccination – New England Journal of Medicine

Related: [Preprint] Mixing Covid jabs has good immune response, study finds – “The Com-Cov trial looked at the efficacy of either two doses of Pfizer, two of AstraZeneca, or one of them followed by the other. All combinations worked well, priming the immune system”. AND Phase 2 RCT: Immunogenicity and reactogenicity of a Pfizer-BioNTech booster in patients that have received a single dose of AstraZeneca vaccine – “BNT162b2 (Pfizer) given as a second dose in individuals prime vaccinated with ChAdOx1-S (AstraZeneca) induced a robust immune response, with an acceptable and manageable reactogenicity profile”. AND RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects.

 

Commentary on Twitter

 


AAFP Guideline: Pharmacologic Management of COPD Exacerbations.

16 Jul, 2021 | 10:51h | UTC

Pharmacologic Management of COPD Exacerbations: A Clinical Practice Guideline from the AAFP – American Family Physician

 


M-A of randomized trials: In patients with acute respiratory distress syndrome, there was no difference in mortality between higher vs. lower positive end-expiratory pressure strategies.

16 Jul, 2021 | 10:43h | UTC

Higher versus lower positive end-expiratory pressure in patients without acute respiratory distress syndrome: a meta-analysis of randomized controlled trials – Critical Care

 


RCT: Bamlanivimab plus Etesevimab reduce mortality and hospitalization in ambulatory patients with early Covid-19 (within 3 days of a positive test) who are at risk for clinical deterioration (i.e., older people, obese, diabetics, immunocompromised, with CV disease).

15 Jul, 2021 | 09:26h | UTC

Bamlanivimab plus Etesevimab in Mild or Moderate Covid-19 – New England Journal of Medicine

 


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