Covid-19
RCT | P2Y12 inhibitors don’t improve outcomes in critically ill COVID-19 patients
31 May, 2023 | 14:13h | UTCSee also: Visual Abstract
RCT | Rivaroxaban doesn’t reduce thrombotic events, hospitalization, or death in outpatients with COVID-19
15 May, 2023 | 13:19h | UTCSummary: The PREVENT-HD trial, a double-blind, placebo-controlled randomized study, was conducted to evaluate the effectiveness of prophylactic anticoagulation in reducing venous and arterial thrombosis, hospitalization, and death in nonhospitalized patients with symptomatic COVID-19 and at least one thrombosis risk factor. The trial took place between August 2020 and April 2022 across 14 US integrated healthcare delivery networks, with 1,284 patients enrolled and randomly assigned to receive either 10 mg of oral rivaroxaban or placebo daily for 35 days.
However, the study was terminated prematurely due to enrollment challenges and lower-than-expected event rates. The primary efficacy outcome, a composite of various hazardous events, occurred in 3.4% of the rivaroxaban group and 3.0% of the placebo group, with no significant difference between the two groups (hazard ratio, 1.16 [95% CI, 0.63–2.15]; P=0.63). No critical-site or fatal bleeding was observed, and only one patient in the rivaroxaban group experienced a major bleed.
In conclusion, rivaroxaban prescribed for 35 days in nonhospitalized patients with symptomatic COVID-19 at risk for thrombosis does not appear to reduce the composite end point of venous and arterial thrombotic events, hospitalization, and death. The study’s premature termination and lower-than-expected event rates may limit the generalizability of these findings.
Commentary on Twitter
#OriginalArticle: In this #RCT, Rivaroxaban did not appear to reduce a composite endpoint of venous and arterial thrombotic events, hospitalization, and death among non‐hospitalized patients with symptomatic COVID‐19 #AHAJournals https://t.co/PhdXnTJ0V9 pic.twitter.com/f04uYu2M5f
— Circulation (@CircAHA) May 10, 2023
RCT | Cognitive behavioral therapy proves effective for severe post-COVID-19 fatigue
15 May, 2023 | 13:16h | UTCNews Release: Cognitive behavioral therapy lessens post-viral fatigue after COVID-19 – Amsterdam UMC
Commentary on Twitter
Efficacy of Cognitive Behavioral Therapy Targeting Severe Fatigue Following COVID-19: Results of a Randomized Controlled Trial
✅ Just Accepted
🔓 Open Access@amsterdamUMChttps://t.co/P1jwLOcfvw— Clinical Infectious Diseases (@CIDJournal) May 13, 2023
M-A | Association of SARS-CoV-2 vaccination or infection with Bell palsy
10 May, 2023 | 16:03h | UTC
Review | Therapeutics for COVID-19
9 May, 2023 | 14:53h | UTCTherapeutics for COVID-19 – Nature Microbiology
Commentary on Twitter
📢New Perspective out now:
Therapeutics for COVID-19
By Sima Toussi, Jennifer Hammond, Brian Gerstenberger & Annaliesa Andersonhttps://t.co/WNJzkFMFuF
— Nature Microbiology (@NatureMicrobiol) May 5, 2023
Cohort Study | Limited evidence linking COVID-19 vaccines to menstrual disturbance or postmenopausal bleeding
9 May, 2023 | 14:52h | UTCNews Release: New study finds no increased risk of menstrual changes after covid-19 vaccination – BMJ Newsroom
Commentary: Large study shows no changes to menstrual cycles after COVID vaccination – CIDRAP
Related:
Editorial: Menstruation and Covid-19 vaccination.
Commentary on Twitter
The findings of this new study do not provide substantial support for a causal association between SARS-CoV-2 vaccination and healthcare contacts related to menstrual or bleeding disordershttps://t.co/Tsw2hjIiIz
— The BMJ (@bmj_latest) May 4, 2023
WHO declares end to COVID-19 global health emergency
8 May, 2023 | 13:26h | UTCWHO Declares End to COVID-19 Global Health Emergency – Health Policy Watch
RCT | BCG vaccine did not protect health care workers against Covid-19
4 May, 2023 | 13:56h | UTCCommentary: The BCG vaccine does not decrease the risk of COVID-19 in healthcare workers – News Medical
Commentary on Twitter
The bacille Calmette–Guérin vaccine may enhance generic antiviral immunity. In a randomized, controlled trial, health care workers received BCG vaccination or placebo. The BCG vaccine did not reduce Covid-19 risk. https://t.co/f2Uu4yhYZP
— NEJM (@NEJM) April 26, 2023
RCT | Higher dose corticosteroids increase mortality in hypoxic COVID-19 patients on simple oxygen
24 Apr, 2023 | 13:55h | UTCEditorial: Higher-dose dexamethasone for patients with COVID-19 and hypoxaemia? – The Lancet
Commentary: Higher-dose corticosteroids tied to 60% more deaths in low-oxygen COVID patients – CIDRAP
Commentary on Twitter (thread – click for more)
Low-dose corticosteroids have been shown to reduce mortality for patients with COVID-19 requiring oxygen or ventilatory support.
A new study evaluated the use of a higher dose of corticosteroids in this patient group. https://t.co/uJGSYSBQAO
— The Lancet (@TheLancet) April 13, 2023
RCT | Oral fluvoxamine plus inhaled budesonide reduced hospitalizations in high-risk patients with early-onset COVID-19
24 Apr, 2023 | 13:51h | UTC
Commentary on Twitter
Treatment w/ oral fluvoxamine + inhaled budesonide among high-risk outpatients w/ early #COVID19 reduced incidence of severe disease requiring advanced care. The combined effect seems to offer benefits over individual use of each drug: https://t.co/wM2da5a5MD pic.twitter.com/Sl1qFzTOjD
— Annals of Int Med (@AnnalsofIM) April 19, 2023
M-A | Glucocorticoids may increase mortality for hospitalized Covid-19 patients not receiving oxygen
19 Apr, 2023 | 13:24h | UTCMeta-Analysis of Glucocorticoids for Covid-19 Patients Not Receiving Oxygen – NEJM Evidence
Commentary on Twitter (thread – click for more)
4/
💡 IMPLICATIONS#Glucocorticoids are a two-edged sword in COVID-19 treatment 🗡️
👍 Life-saving for patients receiving #oxygen☠️ Harmful for patients not on oxygen
— San Raffaele Anesthesia and Intensive Care (@SRAnesthesiaICU) April 18, 2023
Opinion | Universal masking in health care settings: a pandemic strategy whose time has come and gone, for now
18 Apr, 2023 | 13:37h | UTC
Opinion | In-person schooling is essential even during periods of high transmission of COVID-19
18 Apr, 2023 | 13:36h | UTC
Review | Post-COVID syndrome
6 Apr, 2023 | 13:21h | UTCPost-COVID Syndrome – Deutsches Ärzteblatt International
Related:
Long COVID: major findings, mechanisms and recommendations – Nature Reviews Microbiology
Bivalent Booster | Observational data suggests no increased cardiovascular risks compared to monovalent vaccine
4 Apr, 2023 | 13:55h | UTCCommentary: Similarly Low Risk of CV Events With Bivalent and Monovalent mRNA Boosters – TCTMD
Commentary on Twitter
In this French study, the risk of cardiovascular events was similar among recipients of the bivalent Pfizer–BioNTech vaccine and the original monovalent vaccine 21 days after the booster dose. https://t.co/FUZbbsn82I pic.twitter.com/ki0FPeutNm
— NEJM (@NEJM) March 29, 2023
Contrary to prior studies, new research finds no heightened postoperative risk after a recent covid-19 infection
4 Apr, 2023 | 13:54h | UTCCommentaries:
COVID infection within 60 days not tied to adverse postsurgical outcomes – CIDRAP
Adverse Postoperative Outcomes Not Increased With Recent COVID-19 – HealthDay
Related:
ASA and APSF statement on perioperative testing for the COVID-19 virus.
Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery
BJS commission on surgery and perioperative care post-COVID-19.
ASA Guidance: Preoperative testing for COVID-19 is essential, regardless of vaccination.
Position statement: Perioperative management of post-COVID-19 surgical patients.
M-A | Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2
4 Apr, 2023 | 13:52h | UTCRelated:
Interpreting a lateral flow SARS-CoV-2 antigen test – The BMJ
Lateral flow devices maintain detection sensitivity across Alpha, Delta, and Omicron waves
3 Apr, 2023 | 13:53h | UTCSummary: The study assessed the performance of antigen lateral flow devices (LFDs) during the alpha, delta, and omicron waves of the SARS-CoV-2 pandemic in the UK. Researchers aimed to understand LFD performance concerning changes in variant infections, vaccination, viral load, and LFD use, as well as the devices’ ability to detect infectious individuals. Paired LFD and RT-PCR test results were collected from both asymptomatic and symptomatic participants between November 2020 and March 2022.
When compared to RT-PCR testing, the overall LFD sensitivity was 63.2%, and specificity was 99.71%. The sensitivity was higher in symptomatic participants (68.7%) than in asymptomatic participants (52.8%). The study found that increased viral load was independently associated with a higher likelihood of being LFD positive. There was no evidence of a significant difference in LFD sensitivity between the alpha and delta variants, but sensitivity increased during the omicron wave. Vaccination status did not show an independent association with LFD sensitivity.
The study concluded that LFDs can detect most SARS-CoV-2 infections across different viral variants and during vaccine roll-out, contributing to reduced transmission risk. However, LFD performance is lower in asymptomatic individuals, which should be taken into account when designing testing programs.
Invited Commentary: The performance of rapid antigen tests against SARS-CoV-2 variants – The Lancet Infectious Diseases
Related:
Interpreting a lateral flow SARS-CoV-2 antigen test – The BMJ
Updated WHO Guidelines | COVID-19 boosters no longer routinely recommended for low-risk groups
30 Mar, 2023 | 14:33h | UTCSummary: The WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) has revised its COVID-19 vaccination roadmap in light of the Omicron variant and widespread population immunity. The revised roadmap prioritizes protecting those at the highest risk of severe disease and death while maintaining resilient health systems. It introduces cost-effectiveness considerations for vaccinating lower-risk individuals, such as healthy children and adolescents, and presents revised booster dose recommendations.
Priority groups are categorized as high, medium, and low, based on factors like risk of severe disease and death. People in the high-priority group, consisting of older adults, individuals with significant comorbidities or immunocompromising conditions, pregnant persons, and frontline health workers, are advised to receive additional boosters 6 or 12 months after the last dose. The medium priority group, which includes healthy adults without comorbidities and children with comorbidities, is recommended to receive primary series and first booster doses. However, SAGE no longer routinely recommends additional boosters for this group due to limited public health gains.
For the low-priority group, encompassing healthy children and adolescents, vaccination decisions should take into account factors such as disease prevalence and cost-effectiveness. It is important to note that the public health benefits of vaccinating healthy children and adolescents are considerably lower compared to established essential vaccines for children, like rotavirus, measles, and pneumococcal conjugate vaccines.
News Release: SAGE updates COVID-19 vaccination guidance – World Health Organization
Commentaries:
No More COVID-19 Boosters for Healthy People, WHO Experts Recommend – Health Policy Watch
WHO vaccine advisers update COVID vaccine recommendations – CIDRAP
Study suggests no heightened death risk in young people with mRNA vaccines, but ChAdOx1 nCoV-19 vaccine linked to female cardiac deaths
30 Mar, 2023 | 14:28h | UTC
Commentary from the author on Twitter (thread – click for more)
Our latest @NatureComms research: Risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people in England. Led by @Vnafilyan @kamleshkhunti @IsobelLWard et al. https://t.co/oxNdgEAflQ (1/3)
— Prof Amitava Banerjee💙 (@amibanerjee1) March 28, 2023
Review | Cerebrovascular manifestations of SARS-CoV-2
29 Mar, 2023 | 13:29h | UTC
M-A | Risk factors associated with post−COVID-19 condition
28 Mar, 2023 | 15:07h | UTCCommentary:
Meta-analysis reveals risk, protective factors for long COVID – CIDRAP
Long Covid: University of East Anglia study finds women more likely affected – BBC
People who catch Omicron are less likely to get Long Covid
28 Mar, 2023 | 15:04h | UTCPeople who catch Omicron are less likely to get Long Covid – Science
Cohort Study | Outcomes in critically Ill HIV-infected patients between 1997 and 2020
22 Mar, 2023 | 13:22h | UTC
M-A | Comparison of mental health symptoms before and during the covid-19 pandemic
21 Mar, 2023 | 13:40h | UTCEditorial: Mental health and the covid-19 pandemic – The BMJ
News Release: Study suggests little deterioration in mental health linked to the pandemic – BMJ Newsroom
Commentaries:
A patient’s perspective on mental health and the pandemic – The BMJ
World’s most comprehensive study on COVID-19 mental health – McGill University