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RCT supports the use of therapeutic heparin in moderately ill patients admitted to the hospital with Covid-19.

17 Oct, 2021 | 21:35h | UTC

Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial – The BMJ

Commentary: High-dose of readily available blood thinner reduces risk of death for moderately ill COVID-19 patients – St. Michael’s Hospital

Related studies (some conflicting results)

RCT: Therapeutic-dose heparin superior to standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19.

Another meta-analysis suggests standard-dose prophylactic anticoagulation is the best option for patients hospitalized with Covid-19.

M-A: Safety and efficacy of different prophylactic anticoagulation dosing regimens in critically and non-critically ill patients with COVID-19 – According to this analysis, standard-dose prophylactic anticoagulation should be the standard of care for hospitalized patients with COVID-19 who do not have an indication for therapeutic anticoagulation, irrespective of disease severity.

RCT: In noncritically ill patients hospitalized with Covid-19, therapeutic-dose anticoagulation with heparin increased the probability of survival to hospital discharge compared with usual-care thromboprophylaxis.

RCT: In critically ill patients with Covid-19, therapeutic anticoagulation with heparin did not result in improved outcomes compared to usual-care pharmacologic thromboprophylaxis.

RCT: In patients hospitalized with Covid-19 with elevated D-Dimer, a full-dose anticoagulation strategy based on rivaroxaban (full-dose heparins in unstable patients) + rivaroxaban to day 30 was not better than prophylactic anticoagulation and increased bleeding risk.

 

Commentary on Twitter

 


J&J COVID-19 Vaccine: FDA recommends booster shot for all adults aged 18 and older at least two months following initial vaccination with the single-shot vaccine.

17 Oct, 2021 | 21:32h | UTC

News release: Johnson & Johnson COVID-19 Vaccine Booster Shot Unanimously Recommended for Emergency Use Authorization by U.S. FDA Advisory Committee

Commentaries:

FDA panel endorses booster shot for J&J COVID-19 vaccine – Associated Press

The Johnson & Johnson one-dose vaccine offers good protection now. A booster shot will maximize that, experts say – CNN

FDA advisers recommend J&J Covid-19 vaccine boosters, talk mix and match boosters – CNN

Related: [Press release – not published yet] J&J says booster shot at two months provided 75% protection against moderate to severe COVID-19 globally and 94% of such cases in the U.S.

 


[Preprint] Breakthrough SARS-CoV-2 infections in 620,000 U.S. Veterans, February 1, 2021 to August 13, 2021 – “Vaccine protection declined by mid-August 2021, decreasing from 91.9% in March to 53.9%”.

17 Oct, 2021 | 21:29h | UTC

Breakthrough SARS-CoV-2 infections in 620,000 U.S. Veterans, February 1, 2021 to August 13, 2021 – medRxiv

Related:

Observational study in Qatar showed the effectiveness of Pfizer vaccine against any SARS-CoV-2 infection dropped to 20% in months 5 through 7 after the second dose, but effectiveness against severe Covid-19 remained high.

Cohort study: Pfizer vaccine effectiveness against any infections declined from 88% during the first month after full vaccination to 47% after 5 months. Vaccine effectiveness against hospital admissions remained high; 87% within 1 month, and 88% at 5 months after full vaccination, with no significant waning.

Editorial | Covid-19 vaccination: evidence of waning immunity is overstated.

COVID vaccine immunity is waning — how much does that matter? – “As debates about booster shots heat up, what’s known about the duration of vaccine-based immunity is still evolving”.

COVID vaccine effects wane over time but still prevent death and severe illness.

Perspective | What we actually know about waning immunity.

Another study shows Pfizer mRNA vaccine immunity is reduced over time.

[Press release – not published yet] Study shows vaccine protection wanes over time, but vaccines still offer good protection against severe disease.

Studies: COVID vaccine protection waning against infection but not hospitalization.

 

Commentary on Twitter

 


What can masks do? Part 2: What makes for a good mask study — and why most fail.

17 Oct, 2021 | 21:25h | UTC

COMMENTARY: What can masks do? Part 2: What makes for a good mask study — and why most fail – CIDRAP

See also: COMMENTARY: What can masks do? Part 1: The science behind COVID-19 protection – CIDRAP

 


Study evaluated several heterologous SARS-CoV-2 vaccine regimens; no efficacy data but there was increased antibody production on study days 15 and 29 after booster shots from Moderna and Pfizer.

15 Oct, 2021 | 02:49h | UTC

Heterologous SARS-CoV-2 Booster Vaccinations: Preliminary Report – medRxiv

Commentary: Study: Mixing and Matching COVID-19 Booster Shots Is Effective, Safe – U.S. News

 

Commentary on Twitter

 


Statins linked to reduced risk of death from COVID-19 in major population study – “Randomized studies will be needed to ascertain whether there is a causal relationship, note the researchers”.

15 Oct, 2021 | 02:47h | UTC

News release: Statins linked to reduced risk of death from COVID-19 in major population study – Karolinska Institutet

Original study: HMG-CoA reductase inhibitors and COVID-19 mortality in Stockholm, Sweden: A registry-based cohort study – PLOS Medicine

Commentaries:

Expert reaction to study looking at statins and risk of death from COVID-19 – Science Media Centre

People taking statins less likely to die from Covid, study suggests – The Guardian

 


Perspective | Trying to Block SARS-CoV-2 Transmission With Intranasal Vaccines.

15 Oct, 2021 | 02:44h | UTC

Trying to Block SARS-CoV-2 Transmission With Intranasal Vaccines – JAMA

 


Cohort study: Vaccinated pregnant patients had 90% lower risk of severe or critical Covid-19 compared with unvaccinated pregnant patients.

15 Oct, 2021 | 02:38h | UTC

Maternal Outcomes After Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Vaccinated Compared With Unvaccinated Pregnant Patients – Obstetrics & Gynecology

Related:

Two observational studies suggest spontaneous abortion is not increased following COVID-19 mRNA vaccination during pregnancy.

Study shows high effectiveness of the Pfizer mRNA COVID-19 vaccine in pregnancy.

5 Crucial Things to Know About COVID-19 Vaccines and Pregnancy.

CDC Guidance: Pregnant people should be vaccinated against COVID-19.

ACOG and SMFM Recommend COVID-19 Vaccination for Pregnant Individuals – “ACOG encourages its members to enthusiastically recommend vaccination to their patients.”

Cohort study: Pfizer/BioNTech COVID vaccine associated with 78% lower risk of Covid-19 in pregnancy.

 

Commentary on Twitter (thread – click for more)

 


WHO Report: Tuberculosis deaths rise for the first time in more than a decade due to the COVID-19 pandemic.

15 Oct, 2021 | 02:30h | UTC

Tuberculosis deaths rise for the first time in more than a decade due to the COVID-19 pandemic – World Health Organization

Report: Global tuberculosis report 2021

Commentary: Tuberculosis deaths rise for 1st time in years, due to COVID – Associated Press

 

Commentary on Twitter (thread – click for more)

 


[Preprint] In RCT with 29,949 participants, the Novavax vaccine demonstrated high overall efficacy (>90%) for the prevention of Covid-19, and all moderate-to-severe cases occurred in placebo recipients.

14 Oct, 2021 | 10:17h | UTC

Efficacy and Safety of NVX-CoV2373 in Adults in the United States and Mexico – medRxiv

Commentary: Novel vaccine demonstrates high efficacy for prevention of COVID-19 – News Medical

Related:

RCT: Novavax vaccine conferred 89.7% protection against symptomatic SARS-CoV-2 infection and 100% protection against hospitalizations or deaths.

Opinion | The mRNA vaccines are extraordinary, but Novavax is even better.

(Press release – not published yet) Novavax COVID-19 vaccine demonstrates 90% overall efficacy and 100% protection against moderate and severe disease.

RCT: Novavax vaccine is 49.4% effective against B.1.351 SARS-CoV-2 variant.

[Press release – not published yet] Novavax reports 96% efficacy against original strain of COVID-19, 86% efficacy against B.1.1.7 variant, and 55% efficacy against B1.351 variant

New COVID-19 vaccines: here’s how the promising Novavax and Johnson & Johnson jabs work

Covid-19: Novavax vaccine efficacy is 86% against UK variant and 60% against South African variant

 

Commentary on Twitter

 


Systematic Review: Short-term and long-term rates of postacute sequelae of SARS-CoV-2 infection.

14 Oct, 2021 | 10:15h | UTC

Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review – JAMA Network Open

Commentaries:

Most COVID-19 survivors have symptoms 6 months on, review finds – CIDRAP

Expert reaction to systematic review on rates of postacute sequelae of SARS-CoV-2 infection (PASC) – Science Media Centre

How many people get ‘long COVID’? More than half, researchers find – Penn State

Related:

WHO Consensus: A clinical case definition of post COVID-19 condition (Long Covid).

Characterizing long COVID: a living systematic review.

Long Covid – The illness narratives.

New guidelines to help doctors manage long COVID patients published.

M-A: More than 50 long-term effects of COVID-19. (several articles on the subject)

 

Commentary on Twitter

 


WHO advisers recommend 3rd COVID vaccine dose for highest-risk groups.

13 Oct, 2021 | 01:48h | UTC

WHO advisers recommend 3rd COVID vaccine dose for highest-risk groups – CIDRAP

See also: WHO advises additional COVID shot for immunocompromised people – Reuters

 


A primer on what we know about mixing and matching Covid vaccines.

13 Oct, 2021 | 01:44h | UTC

A primer on what we know about mixing and matching Covid vaccines – STAT

Related:

Real-world data shows increased reactogenicity in adults after heterologous compared to homologous prime-boost COVID-19 vaccination.

RCT: Safety and immunogenicity of heterologous vs. homologous prime-boost schedules with an adenoviral vectored and mRNA COVID-19 vaccine.

Another study shows increased immune response with heterologous Oxford-AstraZeneca/mRNA vaccination.

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

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

[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”.

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”.

Lab study shows heterologous AstraZeneca/Pfizer vaccination produces strong immune response against SARS-CoV-2 Delta variant.

Lab study shows a heterologous AstraZeneca + Pfizer immunization strategy provides stronger immunogenicity against Covid compared to homologous AZ + AZ or Pfizer + Pfizer strategies.

RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects.

 


Seroconversion and fever are dose-dependent in a nonhuman primate model of inhalational COVID-19.

13 Oct, 2021 | 01:41h | UTC

Seroconversion and fever are dose-dependent in a nonhuman primate model of inhalational COVID-19 – PLOS Pathogens

Commentary: Dose-dependent COVID-19 symptoms – Nature Reviews Microbiology

 

Commentaries on Twitter

 


RCT: No benefit from antithrombotic therapy (aspirin or apixaban) in outpatients with clinically stable symptomatic COVID-19.

12 Oct, 2021 | 00:28h | UTC

Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial – JAMA

Editorial: Antithrombotic Therapy for Outpatients With COVID-19: Implications for Clinical Practice and Future Research – JAMA

 

Commentary on Twitter

 


D-Dimer testing for the exclusion of pulmonary embolism has limited clinical utility among hospitalized patients with COVID-19 – most patients with or without pulmonary embolism have increased levels.

12 Oct, 2021 | 00:26h | UTC

D-Dimer Testing for the Exclusion of Pulmonary Embolism Among Hospitalized Patients With COVID-19 – JAMA Network Open

Commentary: D-Dimer Level Not Useful for Ruling Out PE in COVID-19 Patients – HealthDay

 


Why easing COVID restrictions could prompt a fierce flu rebound – “As pandemic restrictions ease, other respiratory viruses are returning in unexpected ways”.

12 Oct, 2021 | 00:19h | UTC

Why easing COVID restrictions could prompt a fierce flu rebound – Nature

 


How antiviral pill Molnupiravir shot ahead in the COVID drug hunt.

12 Oct, 2021 | 00:18h | UTC

How antiviral pill molnupiravir shot ahead in the COVID drug hunt – Nature

Related:

What we know — and don’t know — about Merck’s new Covid-19 pill.

[Press release – not published yet] Merck announces oral antiviral Molnupiravir reduced the risk of hospitalization or death by approximately 50 Percent compared to placebo for patients with mild or moderate COVID-19.

Merck’s Covid-19 pill is great news but may not be a game-changer.

Video | A Pill For COVID? A Doctor Explains Molnupiravir.

 


Cluster RCT: An antimicrobial stewardship intervention safely reduced the use of broad-spectrum antibiotics among patients hospitalized with moderately severe community-acquired pneumonia.

11 Oct, 2021 | 23:55h | UTC

Narrow-spectrum antibiotics for community-acquired pneumonia in Dutch adults (CAP-PACT): a cross-sectional, stepped-wedge, cluster-randomised, non-inferiority, antimicrobial stewardship intervention trial – The Lancet Infectious Diseases (link to abstract – $ for full-text)

 


RCT: Therapeutic-dose heparin superior to standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19.

10 Oct, 2021 | 21:53h | UTC

Efficacy and Safety of Therapeutic-Dose Heparin vs Standard Prophylactic or Intermediate-Dose Heparins for Thromboprophylaxis in High-risk Hospitalized Patients With COVID-19: The HEP-COVID Randomized Clinical Trial – JAMA Internal Medicine

Invited commentary: Anticoagulant Therapy in Patients Hospitalized With COVID-19 – JAMA Internal Medicine

Related studies (some conflicting results)

Another meta-analysis suggests standard-dose prophylactic anticoagulation is the best option for patients hospitalized with Covid-19.

M-A: Safety and efficacy of different prophylactic anticoagulation dosing regimens in critically and non-critically ill patients with COVID-19 – According to this analysis, standard-dose prophylactic anticoagulation should be the standard of care for hospitalized patients with COVID-19 who do not have an indication for therapeutic anticoagulation, irrespective of disease severity.

RCT: In noncritically ill patients hospitalized with Covid-19, therapeutic-dose anticoagulation with heparin increased the probability of survival to hospital discharge compared with usual-care thromboprophylaxis.

RCT: In critically ill patients with Covid-19, therapeutic anticoagulation with heparin did not result in improved outcomes compared to usual-care pharmacologic thromboprophylaxis.

RCT: In patients hospitalized with Covid-19 with elevated D-Dimer, a full-dose anticoagulation strategy based on rivaroxaban (full-dose heparins in unstable patients) + rivaroxaban to day 30 was not better than prophylactic anticoagulation and increased bleeding risk.

 

Commentary on Twitter

 


Bioethics | The Trolley Problem and Vaccinating Young People Against COVID-19.

10 Oct, 2021 | 21:50h | UTC

The Trolley Problem and Vaccinating Young People Against COVID-19 – Science-Based Medicine

 


Heart-inflammation risk from Pfizer COVID vaccine is very low.

10 Oct, 2021 | 21:42h | UTC

Heart-inflammation risk from Pfizer COVID vaccine is very low – Nature

Original studies:

Large cohort study with over 2.5 million individuals showed the incidence of myocarditis after the Pfizer vaccine was 2.13 cases per 100,000 persons.

Study with over 5.1 million vaccinated individuals showed the incidence of myocarditis after the receipt of the Pfizer vaccine was low and more common after the second dose in young male recipients.

 


WHO Guidance: Antigen-detection in the diagnosis of SARS-CoV-2 infection.

8 Oct, 2021 | 10:47h | UTC

Antigen-detection in the diagnosis of SARS-CoV-2 infection – World Health Organization

Related infographics:

Use of antigen detection rapid diagnostic testing – World Health Organization

Diagnostic testing for SARS-CoV-2 infection – World Health Organization

 

Commentary on Twitter (thread – click for more)

 


WHO Consensus: A clinical case definition of post COVID-19 condition (Long Covid).

8 Oct, 2021 | 10:45h | UTC

A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021 – World Health Organization

Related:

Characterizing long COVID: a living systematic review.

Long Covid – The illness narratives.

New guidelines to help doctors manage long COVID patients published.

M-A: More than 50 long-term effects of COVID-19. (several articles on the subject)

 

Commentary on Twitter (thread – click for more)

 


Real-world data shows increased reactogenicity in adults after heterologous compared to homologous prime-boost COVID-19 vaccination.

8 Oct, 2021 | 10:29h | UTC

Real-world data shows increased reactogenicity in adults after heterologous compared to homologous prime-boost COVID-19 vaccination, March−June 2021, England – Eurosurveillance

Related:

RCT: Safety and immunogenicity of heterologous vs. homologous prime-boost schedules with an adenoviral vectored and mRNA COVID-19 vaccine.

Another study shows increased immune response with heterologous Oxford-AstraZeneca/mRNA vaccination.

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

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

[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”.

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”.

Lab study shows heterologous AstraZeneca/Pfizer vaccination produces strong immune response against SARS-CoV-2 Delta variant.

Lab study shows a heterologous AstraZeneca + Pfizer immunization strategy provides stronger immunogenicity against Covid compared to homologous AZ + AZ or Pfizer + Pfizer strategies.

RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects.

 

Commentary on Twitter

 


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