Chest Medicine (all articles)
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 | UTCRelated: 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 | UTCWhy 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See also: Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns – The Guardian AND Some problems in the dataset of a large study of Ivermectin for the treatment of Covid-19 – Nick Brown’s Blog AND Is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)
So, one of the biggest studies to date on ivermectin for COVID-19 has issues significant enough that, if not fraud, are so serious that it invalidates the study without further explanation
I promised a thread
Here we go 1/n https://t.co/L9QOChmGtA
— Health Nerd (@GidMK) July 16, 2021
Heterologous Oxford–AstraZeneca and Moderna Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.
16 Jul, 2021 | 11:02h | UTCHeterologous 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
Health care workers who had received a dose of ChAdOx1 nCoV-19 were offered either ChAdOx1 nCoV-19 or mRNA-1273 9 to 12 weeks later. Levels of S-specific and RBD-specific IgG increased by a factor of 5 after ChAdOx1 nCoV-19 and by a factor of 115 to 125 after mRNA-1273.
— NEJM (@NEJM) July 14, 2021
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 | UTCHeterologous 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
Mix and match vaccines?
2 doses AZ vs AZ and then Pfizer:
"BNT162b2 induced significantly higher frequencies of spike-specific CD4+ and CD8+ T cells and, in particular, high titers of neutralizing antibodies against the B.1.1.7, B.1.351 and P.1 variants" https://t.co/53J2erWVMy pic.twitter.com/aEmqMlhEar— Eric Topol (@EricTopol) July 14, 2021
AAFP Guideline: Pharmacologic Management of COPD Exacerbations.
16 Jul, 2021 | 10:51h | UTC
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
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 | UTCBamlanivimab plus Etesevimab in Mild or Moderate Covid-19 – New England Journal of Medicine
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.
15 Jul, 2021 | 09:20h | UTCCommentary: The Delta Variant Isn’t Just Hyper-Contagious. It Also Grows More Rapidly Inside You – NPR
Related: WHO: Delta variant is ‘most transmissible’ identified so far. AND 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)”.
Commentary on Twitter
Part of the challenge that Delta presents may be tied to this finding
The variant's viral load ~1,000X higher than previous strains (reflected by low CTs), more infectious in the early stages of the illnesshttps://t.co/09CDQFwCSV pic.twitter.com/mjIfcNTYlO— Eric Topol (@EricTopol) July 9, 2021
Sarcoidosis: A clinical overview from symptoms to diagnosis.
15 Jul, 2021 | 08:58h | UTCSarcoidosis: A Clinical Overview from Symptoms to Diagnosis – Cells
RCT: Lopinavir-ritonavir and hydroxychloroquine worsened outcomes in critically ill patients with COVID-19.
14 Jul, 2021 | 11:25h | UTC
Commentary on Twitter (thread – click for more)
Results of @remap_cap #Covid_19 #Antiviral Domain released Online First @yourICM: Among critically ill patients with COVID-19, #lopinavir-ritonavir, #HydroxyChloroquine, or combination therapy worsened outcomes compared to no antiviral therapy
— remap-cap (@remap_cap) July 13, 2021
Opinion | The case for mandating COVID-19 vaccines for health care workers.
14 Jul, 2021 | 11:22h | UTCThe Case for Mandating COVID-19 Vaccines for Health Care Workers – Annals of Internal Medicine
News release: Case is strong for mandating COVID-19 vaccination for health care workers – American College of Physicians
Commentary on Twitter
The Case for Mandating COVID-19 Vaccines for Health Care Workers https://t.co/pdaBRZdkfG via @AnnalsofIM "The case for mandating SARS-CoV-2 vaccines for health care workers is substantially stronger than the case was for mandating influenza vaccines." I fully agree.
— Kenny Lin, MD, MPH (@kennylinafp) July 12, 2021
RCT: Neither Remdesivir nor Hydroxychloroquine affect viral clearance in hospitalized patients with COVID-19.
14 Jul, 2021 | 11:23h | UTCNews release: Neither remdesivir nor HCQ affect viral clearance in hospitalized patients with COVID-19 – American College of Physicians
Original Study: Evaluation of the Effects of Remdesivir and Hydroxychloroquine on Viral Clearance in COVID-19 – Annals of Internal Medicine
Commentary on Twitter
Newly published research in Annals concludes neither remdesivir nor #hydroxychloroquine affected viral clearance in hospitalized patients with #COVID19 https://t.co/K3qWLUW8uY. pic.twitter.com/ugbjJJ3qI5
— Annals of Int Med (@AnnalsofIM) July 12, 2021
Cohort study: Pfizer/BioNTech COVID vaccine associated with 78% lower risk of Covid-19 in pregnancy.
14 Jul, 2021 | 11:20h | UTCBetween BNT162b2 Vaccination and Incidence of SARS-CoV-2 Infection in Pregnant Women – JAMA
Commentary: Pfizer COVID vaccine shows 78% efficacy in pregnancy – CIDRAP
Real-World Evidence: The low validity of temperature screening for COVID-19 triage.
14 Jul, 2021 | 11:11h | UTC
Commentary on Twitter
Temperature screening with infrared thermometers has a sensitivity of 9.43% for PCR+ COVID. https://t.co/GjaKpkUqwU
— Carlos del Rio (@CarlosdelRio7) July 7, 2021
One COVID vaccine dose yields good protection in elderly, 2 studies find.
14 Jul, 2021 | 11:15h | UTCOne COVID vaccine dose yields good protection in elderly, 2 studies find – CIDRAP
Commentary on Twitter (thread – click for more)
2 research Articles on #COVID19 vaccine effectiveness in older people:
1) Effectiveness of BNT162b2 and ChAdOx1 nCoV-19 COVID-19 vaccination at preventing hospitalisations in people aged at least 80 years: a test-negative, case-control study https://t.co/ELvMCPwSHF— The Lancet Infectious Diseases (@TheLancetInfDis) June 24, 2021
German national treatment guidance for hospitalized COVID-19 patients.
13 Jul, 2021 | 10:02h | UTC
Long Covid: 39% of patients report persistent symptoms more than seven months after diagnosis of COVID-19 in an outpatient setting.
13 Jul, 2021 | 09:57h | UTCCommentaries: Long COVID symptoms in a third of people with COVID-19 – American College of Physicians AND Covid-19: 1-in-3 Patients Reported Long-Hauler Symptoms – Physician’s Weekly
Commentary on Twitter
A new prospective cohort study of >400 people with mild to moderate (outpatient) covid at 7-9 months: nearly 1 of 3 had persistent symptoms #LongCovid @AnnalsofIM
https://t.co/ix1Hhsm0iZ
by @mayssamnehme and colleagues pic.twitter.com/Uc4UEclDvA— Eric Topol (@EricTopol) July 5, 2021
WHO warns against mixing and matching COVID vaccines.
13 Jul, 2021 | 09:53h | UTCWHO warns against mixing and matching COVID vaccines – Reuters
Commentary: WHO cautions data still limited on mixing COVID-19 vaccines, but Canadian officials say it’s OK – CTV News
Related: Germany issues world’s strongest recommendation for mixing Covid-19 vaccines. AND [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 Perspective | Can I get AstraZeneca now and Pfizer later? Why mixing and matching COVID vaccines could help solve many rollout problems. AND RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects. AND Should you mix and match COVID-19 vaccines? Scientists are seeking answers
Commentary on Twitter
The World Health Organization's chief scientist on Monday advised against people mixing and matching COVID-19 vaccines from different manufacturers, calling it a "dangerous trend" since there was little data available about the health impact. https://t.co/Oog6fWDSMz
— Reuters Health (@Reuters_Health) July 13, 2021
[Preprint] Long Covid: Persistent symptoms following SARS-CoV-2 infection in a random community sample of 508,707 people.
13 Jul, 2021 | 09:55h | UTCCommentary: Study explores the prevalence of long COVID in England – News Medical
M-A: Similar mortality with Fluoroquinolones or Macrolides for the treatment of Legionella Pneumonia.
13 Jul, 2021 | 09:18h | UTCAre Fluoroquinolones or Macrolides Better for Treating Legionella Pneumonia? A Systematic Review and Meta-analysis – Clinical Infectious Diseases (link to abstract – $ for full-text)
[Preprint] Heparin for Moderately Ill Patients with Covid-19 – “In moderately ill ward patients with Covid-19 and elevated D-dimer level, therapeutic heparin did not significantly reduce the primary outcome but decreased the odds of death at 28 days”.
12 Jul, 2021 | 03:14h | UTCHeparin for Moderately Ill Patients with Covid-19 – medRxiv
Related: 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. AND [Preprint] Practice Changing RCT: Therapeutic-dose anticoagulation with heparin (LMWH or unfractionated heparin) improves outcomes in non-critically ill patients with Covid-19 – the superiority of therapeutic-dose anticoagulation was seen in both high and low D-dimer groups. AND [Preprint] RCT: Full-dose/therapeutic anticoagulation provides no benefit in critically ill patients with Covid-19
Commentary on Twitter (thread – click for more)
?Final results of the RAPID trial now pub'd @medrxivpreprint ? RAPID was an open-label trial that randomly assigned hospitalized ward patients with COVID-19 and elevated D-dimer levels to therapeutic or prophylactic heparin. ? 1/10 https://t.co/oxiyXQAPeK pic.twitter.com/V2GtruEyM2
— Michelle Sholzberg (@sholzberg) July 9, 2021
RCT: Another study shows Azithromycin does not improve outcomes in patients with Covid-19.
12 Jul, 2021 | 03:09h | UTCCommentaries: Trial shows that the antibiotic azithromycin does not prevent mild COVID cases progressing to hospitalization, death – European Society of Clinical Microbiology and Infectious Diseases AND Azithromycin: can its benefit be ruled out in mild COVID-19? – The Lancet Respiratory Medicine
Related: M-A: Azithromycin does not reduce the need for invasive mechanical ventilation or mortality in patients with Covid-19. AND RCT: Azithromycin provides no benefit for community treatment of patients with suspected COVID-19 AND RECOVERY trial: Azithromycin not beneficial for patients admitted to hospital with COVID-19 AND [Press release – not published yet] Azithromycin and doxycycline are not generally effective against COVID-19 in patients treated at home, shows PRINCIPLE trial AND Coalition Covid-19 Brazil – Randomized trial: Azithromycin not beneficial for patients admitted to the hospital with severe Covid-19 AND Coalition Covid-19 Brazil – Randomized trial: hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19
Commentary on Twitter
In patients with mild-to-mod #COVID19 managed without hospital admission, azithromycin + SOC did not reduce the risk of subsequent hospital admission or death
Read the ATOMIC2 trial here https://t.co/QXJ7T08JZS, being presented at #ECCMID2021 by lead author Tim Hinks @HinksLab pic.twitter.com/ZDiPhuQqFB
— The Lancet Respiratory Medicine (@LancetRespirMed) July 9, 2021
A correlate of protection for SARS-CoV-2 vaccines is urgently needed – “Recent studies suggest that neutralizing antibodies could serve as a correlate of protection for vaccines against SARS-CoV-2 in humans”.
12 Jul, 2021 | 03:03h | UTCA correlate of protection for SARS-CoV-2 vaccines is urgently needed – Nature Medicine
Pfizer says it’s time for a Covid booster; FDA and CDC say not so fast.
12 Jul, 2021 | 03:08h | UTCPfizer says it’s time for a Covid booster; FDA and CDC say not so fast – CNN
See also: CDC, FDA contradict Pfizer on COVID-19 vaccine booster – CIDRAP AND Do I need a COVID-19 booster shot? 6 questions answered on how to stay protected – The Conversation AND Pfizer suggests booster shots will be needed this year, but government officials say science will dictate the timing – The Washington Post AND Pfizer to seek OK for 3rd vaccine dose; shots still protect – Associated Press AND Citing the Delta Variant, Pfizer Will Pursue Booster Shots and a New Vaccine – The New York Times (a few articles per month are free) AND Question open on need for COVID booster shot, data awaited, WHO says – Reuters
Understanding the Host in the Management of Pneumonia. An Official American Thoracic Society Workshop Report.
12 Jul, 2021 | 01:41h | UTC