Chest Medicine (all articles) | Page 48 of 169 | Links Medicus Content Curation & Alerts in Medicine

[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

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

Remember Novavax's #COVID vaccine?

Recent data looks really good.

~30K participants enrolled in a prospective clinical trial.

The vaccine appeared to be safe & effective (>90%).

Unclear why approval is taking so long.

Preprint ? https://t.co/MQkJXdgJyR pic.twitter.com/217Erw2stC

— Isaac Bogoch (@BogochIsaac) October 12, 2021

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

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

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

When exposed to #SARSCoV2 why does one person have no illness, while another is soon in ICU?
Dose.
Controlled study in monkeys shows the dose of viruses inhaled is a key factor determining the severity of the disease.
Seems obvious, yet this is new.https://t.co/zdfCnR40bR pic.twitter.com/HH8kxMM2xm

— Laurie Garrett (@Laurie_Garrett) October 11, 2021

In summer of 2020, our group had proposed a hypothesis that SARS-CoV-2 viral dose or "inoculum" was associated with severity of symptoms in COVID (and proposed NPIs reduced the dose). There is now an experimental model showing this in cynomolgus monkeys:https://t.co/dXGDPyPBFZ

— Monica Gandhi MD, MPH (@MonicaGandhi9) October 12, 2021

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

Data do not support the use of aspirin or apixaban in the outpatient setting to reduce the major adverse cardiovascular or pulmonary consequences associated with symptomatic but clinically stable #SARSCoV2 infection https://t.co/SH6OefXOCj #COVID19

— JAMA (@JAMA_current) October 11, 2021

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

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

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.

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

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

Thromboprophylaxis w therapeutic-dose LMWH reduced major thromboembolism and death by 32% compared with institutional standard heparin without increased major bleeding among #COVID19 inpatients with elevated D-dimers. The effect wasn't seen in ICU patients https://t.co/Wrgj2Ho5lv

— JAMA Internal Medicine (@JAMAInternalMed) October 7, 2021

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.

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

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)

Testing remains a critical component to the strategy to end the #COVID19 pandemic, and testing needs to be reliable, accessible, affordable, fast and linked to public health action.

So many around ? have worked hard to increase testing capacities @WHO https://t.co/VDPdU0VK4g

— Maria Van Kerkhove (@mvankerkhove) October 7, 2021

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

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)

? WHO clinical case definition for post #COVID19 condition, also called 'long COVID' https://t.co/WoiLcwsgJX pic.twitter.com/Z0olrHlWPC

— World Health Organization (WHO) (@WHO) October 7, 2021

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

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.

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

As more & more countries consider adding a 3rd #COVID19 vaccine dose into their national immunisation programmes, vaccine reactogenicity will become important, especially if 3rd dose is different to first 2 doses. We need more mix-n-match booster studies ?https://t.co/G57i9Ej7Nd

— Shamez Ladhani (@ShamezLadhani) October 7, 2021

Ivermectin: How false science created a Covid ‘miracle’ drug.

8 Oct, 2021 | 10:24h | UTC

Ivermectin: How false science created a Covid ‘miracle’ drug – BBC

Commentary on Twitter

Scientists evaluating ivermectin data for #COVID19
"had not found 'a single clinical trial' claiming to show that ivermectin prevented Covid deaths that did not contain 'either obvious signs of fabrication or errors so critical they invalidate the study'." https://t.co/Xndr6Q5LaS

— Isaac Bogoch (@BogochIsaac) October 7, 2021

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.

7 Oct, 2021 | 10:55h | UTC

Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar – New England Journal of Medicine

Commentary on Twitter

In this 900,000-participant study in Qatar, vaccine effectiveness peaked at 77.5% in the first month after the second dose. The effectiveness fell to as low as 20% in months 5 through 7 after vaccination. #Covid19vaccine #IDTwttier https://t.co/TeDcLLftIH pic.twitter.com/pEBoxs6Hmr

— NEJM (@NEJM) October 6, 2021

Opinion | Why Are Americans Still—Still!—Wearing Cloth Masks?

6 Oct, 2021 | 10:04h | UTC

Why Are Americans Still—Still!—Wearing Cloth Masks? – The Atlantic

Evidence shows that, yes, masks prevent COVID-19 – and surgical masks are the way to go.

Face masks for COVID pass their largest test yet – “A rigorous study finds that surgical masks are highly protective, but cloth masks fall short”.

[Preprint] Largest study of masks yet details their importance in fighting Covid-19.

Commentary on Twitter

Any mask is better than no mask, especially indoors. But for those who are at higher risk of severe disease or around lots of unvaccinated people, consider upgrading to an N95 (or equivalent) mask, which are more protective. https://t.co/vhNPadTP8O

— Dr. Tom Frieden (@DrTomFrieden) October 5, 2021

EMA recommendations on extra doses and boosters of BioNTech/Pfizer and Moderna mRNA vaccines.

6 Oct, 2021 | 10:15h | UTC

Comirnaty and Spikevax: EMA recommendations on extra doses and boosters – European Medicines Agency

Commentary on Twitter

EMA recommended additional doses and boosters for #Comirnaty and #Spikevax. https://t.co/qefPg2kMMO

In this context, see below what the difference between an additional dose and a #boosterdose is. pic.twitter.com/HeyOACbWXm

— EU Medicines Agency (@EMA_News) October 5, 2021

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

6 Oct, 2021 | 10:07h | UTC

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

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

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

RCT: An active strategy for diagnosing pulmonary embolism did not improve outcomes in patients hospitalized for COPD exacerbation.

6 Oct, 2021 | 09:52h | UTC

Effect of a Pulmonary Embolism Diagnostic Strategy on Clinical Outcomes in Patients Hospitalized for COPD Exacerbation: A Randomized Clinical Trial – JAMA (free for a limited period)

Commentary on Twitter

Among patients hospitalized for an exacerbation of #COPD, addition of an active diagnostic strategy for pulmonary embolism to usual care compared with usual care alone did not improve a composite set of health outcomes https://t.co/7mOi5lOBD8

— JAMA (@JAMA_current) October 5, 2021

Systematic review: Pretomanid for tuberculosis.

6 Oct, 2021 | 08:51h | UTC

Pretomanid for tuberculosis: a systematic review – Clinical Microbiology and Infection

Summary | WHO recommendations on the treatment of drug-resistant tuberculosis, 2020 update.

WHO announces updates on new molecular assays for the diagnosis of tuberculosis (TB) and drug resistance

WHO announces updated definitions of extensively drug-resistant tuberculosis

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.

5 Oct, 2021 | 10:09h | UTC

Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study – The Lancet

Commentary: Expert reaction to study on Pfizer-BioNTech vaccine effectiveness up to 6 months – Science Media Centre

Commentary on Twitter

Study of 3.4 million people @aboutKP @TheLancet

Vaccine efficacy against infections:
– First month post: 88%
– 5 months post: 47%

But vaccine efficacy against hospitalization (Figure):
– First month post: 87%
– 5 months post: 88 %https://t.co/1Gse0FKpoI pic.twitter.com/p9wyiaWGeg

— Vincent Rajkumar (@VincentRK) October 4, 2021