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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)

https://twitter.com/hildabast/status/1420481872212070404

 

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)

https://twitter.com/MHitchingsEpi/status/1418599162795360260

 

[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)

https://twitter.com/MHitchingsEpi/status/1418599162795360260

 

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”.

 

[Preprint] RCT: In patients with COVID-19 and severe hypoxia, dexamethasone 12 mg did NOT result in statistically significant improved outcomes compared to dexamethasone 6 mg – “Mortality at 28 days was 27.1% and 32.3% in patients assigned to 12 mg and 6 mg, respectively (adjusted relative risk 0.86, 99% CI, 0.68-1.08)”.

26 Jul, 2021 | 03:01h | UTC

Dexamethasone 12 mg versus 6 mg for patients with COVID-19 and severe hypoxia: an international, randomized, blinded trial – medRxiv

 

Large cohort study finds one in two hospitalized COVID-19 patients develop a complication.

26 Jul, 2021 | 03:00h | UTC

Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study – The Lancet

Commentaries:

Landmark study finds one in two hospitalised COVID-19 patients develop a complication – National Institute for Health Research

In-hospital complications associated with COVID-19 – The Lancet

CV Complications Common in Hospitalized COVID-19 Patients – TCTMD

Almost Half of Patients Admitted With COVID-19 Have Complications – HealthDay

 

Commentary on Twitter (thread – click for more)

 

Study: Lateral flow antigen testing can rapidly and accurately detect early COVID-19 among patients presenting with flu-like illness and can be a plausible alternative to RT-PCR.

26 Jul, 2021 | 02:56h | UTC

Comparing the diagnostic accuracy of point-of-care lateral flow antigen testing for SARS-CoV-2 with RT-PCR in primary care (REAP-2) – EClinicalMedicine

News release: Lateral flow tests are 95% effective at detecting Covid-19 when used at the onset of symptoms – University of Oxford

Related:

Interactive Infographic | Interpreting a lateral flow SARS-CoV-2 antigen test – “This calculator demonstrates how interpreting a covid-19 lateral flow device (LFD) result varies according to the pre-test probability, and the sensitivity and specificity of the LFD used”.

Rapid point-of-care tests for diagnosing COVID-19 infection: the latest Cochrane evidence

 

Commentary on Twitter (thread – click for more)

 

M-A: Psychiatric patients at increased risk of COVID-19 hospitalization and mortality.

26 Jul, 2021 | 02:57h | UTC

News release: Psychiatric patients at increased risk of COVID-19 hospitalization and mortality – European College of Neuropsychopharmacology

Original article: Mental disorders and risk of COVID-19-related mortality, hospitalisation, and intensive care unit admission: a systematic review and meta-analysis – The Lancet Psychiatry

 

Study: Among kidney transplant recipients who did not respond after 2 doses, a third dose of an mRNA-1273 vaccine induced a serologic response in 49% of patients.

26 Jul, 2021 | 02:54h | UTC

Antibody Response After a Third Dose of the mRNA-1273 SARS-CoV-2 Vaccine in Kidney Transplant Recipients With Minimal Serologic Response to 2 Doses – JAMA

Commentary: Case Mounts for COVID Vaccine Boosters in Kidney Transplant Recipients – MedPage Today (free registration required)

Related:

Case series: Safety and immunogenicity of a third dose of SARS-CoV-2 vaccine in solid organ transplant recipients.

[Preprint] 3rd AstraZeneca shot gives strong immunity.

 

Commentary on Twitter

 

Case report: Kawasaki-like multisystem inflammatory syndrome associated with SARS-CoV-2 infection in an adult.

26 Jul, 2021 | 02:52h | UTC

Kawasaki-like multisystem inflammatory syndrome associated with SARS-CoV-2 infection in an adult – BMJ Case Reports

Related:

Case report: Multisystem inflammatory syndrome in an adult after SARS-CoV-2 infection.

Characteristics associated with Multisystem Inflammatory Syndrome among adults with SARS-CoV-2 infection

Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection

Case Reports: 2 Adults with Kawasaki-like Multisystem Inflammatory Syndrome Associated with COVID-19

 

Position paper: Advancing precision medicine for acute respiratory distress syndrome.

26 Jul, 2021 | 02:28h | UTC

Advancing precision medicine for acute respiratory distress syndrome – The Lancet Respiratory Medicine

Related:

Review: Personalized mechanical ventilation in acute respiratory distress syndrome.

Seminar | Acute respiratory distress syndrome.

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.

M-A: High versus low PEEP levels for mechanically ventilated adult patients with acute lung injury and ARDS

M-A: Decreased mortality in acute respiratory distress syndrome patients treated with corticosteroids

ARDS: Contemporary management and novel approaches during COVID-19

Systematic review: Evidence-based practices for acute respiratory failure and Acute Respiratory Distress Syndrome

Current and evolving standards of care for patients with acute respiratory distress syndrome (ARDS). Definition, ventilatory support, fluid management, use of corticosteroids, indications of prone positioning and ECMO, and more.

 

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”.

 

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.

 

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.

 

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