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Chest Medicine (all articles)

NICE COVID-19 rapid guideline: vaccine-induced immune thrombocytopenia and thrombosis.

30 Jul, 2021 | 12:14h | UTC

COVID-19 rapid guideline: vaccine-induced immune thrombocytopenia and thrombosis – National Institute for Health and Care Excellence

News release: NICE publishes new rapid guideline to diagnose and treat rare blood clotting condition associated with COVID-19 vaccination – National Institute for Health and Care Excellence

Related: Very rare cases of thrombosis with thrombocytopenia syndrome (TTS) after AstraZeneca vaccine: a global safety database analysis – the estimated rate of TTS after the first dose was 8.1 per million vaccinees; after the second dose, the estimated rate was 2.3 per million vaccinees. (several articles and resources on the subject)

 

Vaccine-induced immune thrombotic thrombocytopenia: what we know and do not know.

30 Jul, 2021 | 12:12h | UTC

Vaccine-induced immune thrombotic thrombocytopenia: what we know and do not know – Blood

Related: Very rare cases of thrombosis with thrombocytopenia syndrome (TTS) after AstraZeneca vaccine: a global safety database analysis – the estimated rate of TTS after the first dose was 8.1 per million vaccinees; after the second dose, the estimated rate was 2.3 per million vaccinees. (several articles and resources on the subject)

 

Study: Patients who have recovered from COVID-19 may have persistent cognitive symptoms.

30 Jul, 2021 | 12:03h | UTC

Cognitive deficits in people who have recovered from COVID-19 – EClinicalMedicine

 

Commentary on Twitter (thread – click for more)

 

Risk of acute myocardial infarction and ischemic stroke following COVID-19 in Sweden – “the true risk is increased by between three and eight times for acute myocardial infarction and by between three and seven times for ischaemic stroke following COVID-19.”

30 Jul, 2021 | 12:06h | UTC

Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study – The Lancet

Invited commentary: What is the association of COVID-19 with heart attacks and strokes? – The Lancet

 

Commentary on Twitter

 

Self-reported memory problems 8 months after COVID-19 infection.

30 Jul, 2021 | 12:02h | UTC

Self-reported Memory Problems 8 Months After COVID-19 Infection – JAMA Network Open

Commentary: Post-acute Sequelae of SARS-CoV-2 Infection and Subjective Memory Problems – JAMA Network Open

 

Commentary on Twitter (thread – click for more)

 

Israel to offer 3rd COVID booster shot to older citizens.

30 Jul, 2021 | 11:57h | UTC

Israel to offer 3rd COVID booster shot to older citizens – Associated Press

 

Study: Recommended approaches to minimize aerosol dispersion of SARS-CoV-2 during noninvasive ventilatory support can cause ventilator performance deterioration.

30 Jul, 2021 | 11:59h | UTC

Study Recommended Approaches to Minimize Aerosol Dispersion of SARS-CoV-2 During Noninvasive Ventilatory Support Can Cause Ventilator Performance Deterioration: A Benchmark Comparative Study – CHEST

Editorial: Circuit Set-ups to Reduce Virus Aerosolization During Noninvasive Positive Pressure Ventilation: Dancing in the Dark

 

Systematic review: no evidence to support the use of Ivermectin for treating or preventing COVID-19.

29 Jul, 2021 | 11:38h | UTC

Ivermectin for preventing and treating COVID‐19 – Cochrane Library

Summary: Ivermectin for preventing and treating COVID-19 – Cochrane Library

Commentary: Ivermectin treatment in humans for COVID-19 – Liverpool School of Tropical Medicine

Related:

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

RCT: Ivermectin does not prevent hospitalizations in patients with COVID-19.

Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials – “IVM did not reduce all-cause mortality, length of stay or viral clearance in RCTs in COVID-19 patients with mostly mild disease”.

Ivermectin is the new hydroxychloroquine, take 2 – “Ivermectin shouldn’t be used to treat COVID-19 outside of the context of a well-designed clinical trial”.

Therapeutics and COVID-19 | WHO guideline update advises Ivermectin should only be used to treat COVID-19 within clinical trials

RCT: Ivermectin does not improve time to resolution of symptoms among adults with mild COVID-19

 

PRINCIPLE RCT: Doxycycline does not improve outcomes in outpatients with suspected COVID-19 at high risk for adverse outcomes.

29 Jul, 2021 | 11:36h | UTC

Doxycycline for community treatment of suspected COVID-19 in people at high risk of adverse outcomes in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial – The Lancet Respiratory Medicine

Commentary: PRINCIPLE: a community-based COVID-19 platform trial – The Lancet Respiratory Medicine

 

Commentary on Twitter

 

What is a breakthrough infection? 6 questions answered about catching COVID-19 after vaccination.

29 Jul, 2021 | 11:28h | UTC

What is a breakthrough infection? 6 questions answered about catching COVID-19 after vaccination – The Conversation

 

Efficacy of Pfizer/BioNTech Covid vaccine slips to 84% after six months, data show.

29 Jul, 2021 | 11:19h | UTC

Efficacy of Pfizer/BioNTech Covid vaccine slips to 84% after six months, data show – STAT

Original study (preprint): Six Month Safety and Efficacy of the BNT162b2 mRNA COVID-19 Vaccine – medRxiv

 

Commentary on Twitter (thread – click for more)

 

Cohort study: Postdiagnosis smoking cessation linked to reduced risk for lung cancer progression and mortality.

29 Jul, 2021 | 11:12h | UTC

Postdiagnosis Smoking Cessation and Reduced Risk for Lung Cancer Progression and Mortality: A Prospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentary: Never too late: Cancer centers push patients to quit smoking – STAT

Summary for Patients: Postdiagnosis Smoking Cessation and Reduced Risk for Lung Cancer Progression and Death

 

Commentary on Twitter

 

Very rare cases of thrombosis with thrombocytopenia syndrome (TTS) after AstraZeneca vaccine: a global safety database analysis – the estimated rate of TTS after the first dose was 8.1 per million vaccinees; after the second dose, the estimated rate was 2.3 per million vaccinees.

28 Jul, 2021 | 10:19h | UTC

Very rare thrombosis with thrombocytopenia after second AZD1222 dose: a global safety database analysis – The Lancet

Related:

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

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.”

ISTH Interim Guidance for the Diagnosis and Treatment on Vaccine Induced Immune Thrombotic Thrombocytopenia

Case series: therapeutic plasma exchange in 3 patients with vaccine-induced immune thrombotic thrombocytopenia.

Vaccine-induced immune thrombotic thrombocytopenia (VITT) – a novel clinico-pathological entity with heterogeneous clinical presentations.

Case report: Thrombosis with Thrombocytopenia After the Messenger RNA–1273 Vaccine.

Laboratory testing for suspected COVID-19 vaccine–induced (immune) thrombotic thrombocytopenia.

Concerned about the latest AstraZeneca news? These 3 graphics help you make sense of the risk – “Two people in Australia have died from thrombosis with thrombocytopenia after 3.8 million doses of the AstraZeneca vaccine delivered”.

Case series: Adjunct immune globulin for vaccine-induced thrombotic thrombocytopenia.

Case report: Successful treatment of vaccine-induced prothrombotic immune thrombocytopenia (VIPIT).

[Preprint] Meta-analysis of risk of vaccine-induced immune thrombotic thrombocytopenia following ChAdOx1-S recombinant vaccine – Overall risk is 1 in 139,000; for age 65 and over, about 1 in 1,000,000; for age under 55, between 1 in 20,000 to 60,000.

Cohort study: Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S. 11 excess venous thromboembolic events per 100 000 vaccinations; 2.5 excess cerebral venous thrombosis per 100 000 vaccinations.

Case series of 12 patients with cerebral venous sinus thrombosis with thrombocytopenia after Ad26.COV2.S vaccination – all women younger than 60 years, with symptoms from 6 to 15 days after vaccination

Vaccine-induced Immune Thrombotic Thrombocytopenia: Frequently Asked Questions

Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination

Editorial: SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia – “The very low prevalence of this complication of vaccination, however severe, relative to the benefits of preventing Covid-19 must be emphasized”

Case Report: Thrombotic Thrombocytopenia after Johnson & Johnson Vaccine

Papers Confirm Rare Thrombocytopenia Link to AstraZeneca Vaccine

Guidance on syndrome of Thrombosis and Thrombocytopenia occurring after coronavirus Vaccination

 

Commentary on Twitter

 

Household transmission of SARS-CoV-2 from children and adolescents.

28 Jul, 2021 | 10:08h | UTC

Household Transmission of SARS-CoV-2 from Children and Adolescents – New England Journal of Medicine

Related:

Effect of Vaccination on Household Transmission of SARS-CoV-2 in England – “the likelihood of household transmission was approximately 40 to 50% lower in households of index patients who had been vaccinated 21 days or more before testing positive than in households of unvaccinated index patients”.

Covid-19 vaccination prevents transmission from vaccinated to unvaccinated household members.

Study in England showed one dose of COVID-19 vaccine can cut household transmission by up to half – This protection is on top of the reduced risk of a vaccinated person developing symptomatic infection, which is around 60 to 65% after the first dose

Study: Household transmission of SARS-CoV-2 and risk factors for susceptibility and infectivity

A meta-analysis on the role of children in SARS-CoV-2 in household transmission clusters

Report: SARS-CoV-2 setting-specific transmission rates. Households showed the highest transmission rates (21.1%). Asymptomatic infections do occur but much less efficiently than symptomatic infection.

CDC Report: Transmission of SARS-COV-2 infections in households

The household secondary attack rate of SARS-CoV-2: A rapid review

 

Commentary on Twitter

 

COVID-19 and mucormycosis superinfection: the perfect storm.

28 Jul, 2021 | 10:09h | UTC

COVID-19 and mucormycosis superinfection: the perfect storm – Infection

Related:

ECMM/ISHAM recommendations for clinical management of COVID -19 associated mucormycosis in low- and middle-income countries.

The “Black Fungus” in India: The Emerging Syndemic of COVID-19–Associated Mucormycosis – careful use of antibiotics and corticosteroids and closely monitoring blood glucose levels are some of the strategies suggested by the authors.

Multicenter Epidemiologic Study of Coronavirus Disease–Associated Mucormycosis, India – Uncontrolled diabetes mellitus was the most common underlying disease; improper glucocorticoid use was independently associated with the disease.

Opinion | “Doctors have been blamed for the rise in black fungus in India, but the COVID treatment guidelines could be contributing” – improper use of antibiotics and higher than usual doses of corticosteroids may be contributing to the emergence of mucormycosis and other fungal co-infections.

What is mucormycosis, the fungal infection affecting COVID patients in India?

[Preprint] The Emergence of COVID-19 Associated Mucormycosis: Analysis of Cases From 18 Countries.

Mucormycosis: The ‘black fungus’ maiming Covid patients in India

Global Guideline for the Diagnosis and Management of Mucormycosis

 

WHO reports progress in the fight against tobacco epidemic – Highlights threats posed by new nicotine and tobacco products.

28 Jul, 2021 | 10:01h | UTC

News release: WHO reports progress in the fight against tobacco epidemic – World Health Organization

Report: WHO report on the global tobacco epidemic 2021: New and Emerging Products – World Health Organization

Commentary: While Global Tobacco Control Measures Improve, Electronic Cigarettes Evade Regulation in Many Countries – Health Policy Watch

 

Commentary on Twitter (thread – click for more)

 

Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management.

28 Jul, 2021 | 09:44h | UTC

Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management – European Respiratory Review

 

Review: Long covid—mechanisms, risk factors, and management.

27 Jul, 2021 | 03:52h | UTC

Long covid—mechanisms, risk factors, and management – The BMJ

 

Commentary on Twitter

 

M-A of randomized trials: Conservative oxygen therapy for critically ill patients.

28 Jul, 2021 | 09:41h | UTC

Conservative oxygen therapy for critically ill patients: a meta-analysis of randomized controlled trials – Journal of Intensive Care

 

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

27 Jul, 2021 | 03:48h | UTC

Immunogenicity and reactogenicity of heterologous ChAdOx1 nCoV-19/mRNA vaccination – Nature Medicine

Commentary: A ‘mix and match’ approach to SARS-CoV-2 vaccination – Nature Medicine

Related:

WHO warns against mixing and matching COVID vaccines.

Germany issues world’s strongest recommendation for mixing Covid-19 vaccines.

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”.

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

 

Commentary on Twitter

 

[Preprint] Covid-19: Longer interval between Covid-19 Pfizer vaccine doses boosts immunity.

27 Jul, 2021 | 03:50h | UTC

News release: Longer interval between Covid-19 Pfizer vaccine doses boosts immunity – Newcastle University

Original Study (preprint): Sustained T cell immunity, protection and boosting using extended dosing intervals of BNT162b2 mRNA vaccine

Commentaries:

Commentary: Covid-19: Longer interval between Pfizer doses results in higher antibody levels, research finds – BMJ

Expert reaction to preprint from PITCH study looking at interval between two Pfizer vaccine doses, and antibody and T-cell responses – Science Media Centre

Related:

Debate: Should we delay second vaccine doses to give one dose of the Covid-19 vaccine to more people? (several texts on the subject)

 

Safety evaluation of the second dose of mRNA COVID-19 vaccines in patients with immediate reactions to the first dose.

27 Jul, 2021 | 03:42h | UTC

Safety Evaluation of the Second Dose of Messenger RNA COVID-19 Vaccines in Patients With Immediate Reactions to the First Dose – JAMA Internal Medicine

Commentaries:

Second COVID-19 mRNA vaccine dose found safe following allergic reactions to first dose – Massachusetts General Hospital

No anaphylaxis after second dose of mRNA COVID vaccine, study finds – CIDRAP

 

Commentary on Twitter

 

[Preprint] Test-negative case-control study: Effectiveness of Oxford-AstraZeneca vaccine in older people during SARS-CoV-2 Gamma variant transmission in Brazil – Adjusted effectiveness was 77.9% for symptomatic Covid-19, 87.6% against hospitalization, and 93.6% against death.

27 Jul, 2021 | 03:41h | UTC

Effectiveness of the ChAdOx1 vaccine in the elderly during SARS-CoV-2 Gamma variant transmission in Brazil – medRxiv

 

Commentary on Twitter (thread – click for more)

 

[Preprint] Test-negative case-control study: Effectiveness of CoronaVac vaccine in older people during SARS-CoV-2 Gamma variant transmission in Brazil – Adjusted vaccine effectiveness was 41.6% for symptomatic Covid-19, 59.0% against hospitalizations and 71.4% against deaths.

27 Jul, 2021 | 03:39h | UTC

Effectiveness of the CoronaVac vaccine in the elderly population during a Gamma variant-associated epidemic of COVID-19 in Brazil: A test-negative case-control study – medRxiv

 

Commentary on Twitter (thread – click for more)

 

CoronaVac vaccine: its results are patchy, but the world can’t ignore its usefulness.

27 Jul, 2021 | 03:38h | UTC

CoronaVac vaccine: its results are patchy, but the world can’t ignore its usefulness – The Conversation

Related:

RCT: CoronaVac showed efficacy of 83.5% for preventing symptomatic SARS-CoV-2 infection.

Prospective national cohort in Chile showed CoronaVac effectiveness was 65.9% for symptomatic Covid-19, 87.5% for hospitalization, 90.3% for ICU admission, and 86.3% for death.

Phase 1/2 RCT: CoronaVac is well tolerated and safe and induces strong humoral responses in children and adolescents aged 3–17 years.

Perspective | Are Chinese COVID vaccines underperforming? a dearth of real-life studies leaves unanswered questions.

WHO approval of Chinese CoronaVac COVID vaccine will be crucial to curbing pandemic.

Brazilian town experiment shows mass vaccination can wipe out COVID-19.

WHO validates Sinovac-CoronaVac COVID-19 vaccine for emergency use and issues interim policy recommendations.

[Press release – not published yet] The city of Serrana in Brazil has seen a 95% drop in Covid-19 deaths after almost all adults were vaccinated with Chinese CoronaVac – The findings suggest the pandemic can be controlled after 75% of people are fully vaccinated.

[Not published yet] Observational study in Uruguay found CoronaVac reduced mortality by 97 percent – “In people who had received two doses, it reduced infection with the coronavirus by 57 percent and intensive care admissions by 95 percent”.

 

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