Covid-19
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
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.
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
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
COVID-19-associated mucormycosis | A systematic review and meta-analysis of 958 cases
20 Mar, 2023 | 13:43h | UTC
Cohort Study | COVID-19 outpatients mostly at low risk for VTE, but age, being male, and obesity are risk factors
17 Mar, 2023 | 13:11h | UTCSummary: The article discusses a cohort study that aimed to assess the risk of venous thromboembolism (VTE) among outpatients with COVID-19 and identify independent predictors of VTE.
The study used data from two integrated healthcare delivery systems in California and included 398.530 nonhospitalized adults aged 18 years or older with COVID-19 diagnosed between January 1, 2020, and January 31, 2021, with follow-up through February 28, 2021.
The results showed that the overall risk of VTE among outpatients with COVID-19 is low, but higher in the first 30 days after diagnosis. Factors associated with a higher risk of VTE in COVID-19 outpatients included:
- Age 55 years or older.
- Being male.
- history of VTE or thrombophilia.
- Body mass index greater than or equal to 30.0.
The study’s results could inform future randomized trials to explore targeted VTE preventive strategies and more intensive short-term surveillance for patients with COVID-19 who are at a higher risk of developing VTE.
Commentary: Venous blood clots rare among COVID-19 outpatients, study finds – CIDRAP
Commentary on Twitter
The rate of VTE was low in outpatients with #COVID19 in the first 30 days, and even lower >30 days. Factors associated with a higher risk of VTE in included age ≥55, male, prior VTE/thrombophilia, and BMI ≥30. https://t.co/3hwfDW88k4
— JAMA Network Open (@JAMANetworkOpen) March 13, 2023
Review | Orthostatic tachycardia after covid-19
14 Mar, 2023 | 13:48h | UTCOrthostatic tachycardia after covid-19 – The BMJ
Commentary: Key steps for diagnosis and management of orthostatic tachycardia after COVID-19 – News Medical
Perspective | How to not be completely wrong about masks
8 Mar, 2023 | 14:25h | UTCHow to not be completely wrong about masks – The Munro Report
Related:
SR | Physical interventions to interrupt or reduce the spread of respiratory viruses
Hospital masking should be optional – Sensible Medicine
RCT | Medical masks vs. N95 respirators for preventing COVID-19 among health care workers.
Commentary on Twitter
Excellent and sensible interpretation of the data, on both ends of the spectrum, and everything in between.
(Will forgive the split infinitive in the title. ?)
How to not be completely wrong about masks, by @apsmunro https://t.co/85Ot6oUOZF
— Paul Sax (@PaulSaxMD) March 2, 2023
Myocarditis or pericarditis events after BNT162b2 vaccination in individuals aged 12 to 17 years in Ontario, Canada
7 Mar, 2023 | 13:13h | UTCSummary:
A population-based cohort study was conducted to estimate the incidence of reported myocarditis or pericarditis after BNT162b2 vaccination in adolescents aged 12 to 17 years in Ontario, Canada, and to describe the clinical information associated with these events. The study analyzed data from 1.65 million doses of BNT162b2 vaccinations administered between December 14, 2020, and November 21, 2021.
According to the study, 77 adolescents were reported to have developed myocarditis or pericarditis after receiving the vaccine, and there was a greater occurrence of these events among those aged 16 to 17 years compared to those aged 12 to 15 years. Additionally, adolescents with shorter intervals between vaccine doses had a higher incidence of myocarditis or pericarditis.
Most cases of myocarditis and pericarditis were mild, and the adolescents required either no treatment or were treated conservatively with nonsteroidal anti-inflammatory drugs.
M-A | COVID-19 convalescent plasma outpatient therapy may prevent hospitalizations
23 Feb, 2023 | 13:37h | UTC
M-A | Past SARS-CoV-2 infection provides long-lasting protection against severe disease caused by all variants
22 Feb, 2023 | 12:48h | UTCSummary: The article describes a systematic review and meta-analysis of studies assessing protection from past SARS-CoV-2 infection against subsequent re-infection, symptomatic COVID-19 disease, and severe disease. The researchers identified 65 studies from 19 different countries and found that protection from past infection against re-infection from pre-omicron variants was high and remained so even after 40 weeks. However, protection was substantially lower for the omicron BA.1 variant and declined more rapidly over time than protection against previous variants. Protection from severe disease was high for all variants, estimated at 90·2% for ancestral, alpha, and delta variants, and 88·9% for omicron BA.1 at 40 weeks. The study highlights the importance of considering past infection in assessing future disease burden from COVID-19, providing guidance on when individuals should be vaccinated, and designing policies that mandate vaccination for workers or restrict access. The findings also suggest that individuals with a documented infection should be treated similarly to those who have been fully vaccinated with high-quality vaccines.
Commentaries:
Previous COVID-19 may slash severe illness at reinfection by 89% – CIDRAP
RCT | Another study shows Ivermectin does not benefit patients with Covid-19
22 Feb, 2023 | 12:45h | UTCSummary: The study aimed to evaluate whether Ivermectin, at a maximum dose of 600 μg/kg daily for 6 days, shortened symptom duration or prevented hospitalization among outpatients with mild to moderate COVID-19. A total of 1206 US adults were enrolled in the double-blind, randomized, placebo-controlled platform trial, with follow-up data through November 10, 2022. The study found that the median time to sustained recovery was 11 days in both the ivermectin and placebo groups. Among those receiving Ivermectin, 5.7% were hospitalized, died, or had urgent or emergency care visits compared with 6.0% receiving placebo. These findings, along with all the previous studies to date, do not support using Ivermectin in patients with mild to moderate COVID-19.
Editorials:
At a Higher Dose and Longer Duration, Ivermectin Still Not Effective Against COVID-19 – JAMA
The Ethics of Clinical Research: Managing Persistent Uncertainty – JAMA
Related:
RCT | Ivermectin does not improve time to recovery in outpatients with mild to moderate COVID-19.
RCT | Metformin, Ivermectin, and Fluvoxamine are not beneficial for obese outpatients with Covid-19.
Ivermectin for COVID-19 Cochrane review update: 11 trials and no evidence of benefit shown.
RCT: Early treatment with ivermectin does not improve outcomes in patients with Covid-19.
Case Series: Toxic effects from ivermectin use associated with prevention and treatment of Covid-19.
Long-term consequences of the misuse of ivermectin data.
Ivermectin: How false science created a Covid ‘miracle’ drug.
Fraudulent ivermectin studies open up new battleground between science and misinformation.
The lesson of ivermectin: meta-analyses based on summary data alone are inherently unreliable.
Ivermectin: Cochrane’s most talked about review so far, ever. Why?
Flawed ivermectin preprint highlights challenges of COVID drug studies.
Systematic review: no evidence to support the use of Ivermectin for treating or preventing COVID-19.
Why was a major study on ivermectin for covid-19 just retracted?
RCT: Ivermectin does not prevent hospitalizations in patients with COVID-19.
RCT: Ivermectin does not improve time to resolution of symptoms among adults with mild COVID-19
Review | Comorbidities, multimorbidity and COVID-19
22 Feb, 2023 | 12:39h | UTCComorbidities, multimorbidity and COVID-19 – Nature Medicine
Cohort Study | One third of patients hospitalized with Covid-19 persist with lung abnormalities after 2 years
21 Feb, 2023 | 11:47h | UTCSummary: The study aimed to assess changes in chest CT abnormalities and pulmonary function in patients two years after recovery from SARS-CoV-2 infection. The prospective study followed 144 participants discharged from the hospital after SARS-CoV-2 infection between January 15 and March 10, 2020. The participants underwent serial chest CT scans and pulmonary function tests at 6 months, 12 months, and 2 years after symptom onset. The study found that 39% of participants had persistent interstitial lung abnormalities at 2 years, and this was associated with respiratory symptoms and decreased diffusion pulmonary function.
Editorial: Radiologic Findings after COVID-19 and the Correlation with Lung Function – Radiology
Commentaries:
Post-COVID-19 CT scans show lung abnormalities persist two years later – News Medical
COVID’s aftermath: Persistent organ damage at 1 year, lung abnormalities at 2 – CIDRAP
RCT | Evaluation of BNT162b2 Covid-19 vaccine in children younger than 5 years of age
17 Feb, 2023 | 13:27h | UTCSummary: The study was a combined phase 2-3 clinical trial that aimed to determine whether the BNT162b2 vaccine was safe, could elicit an immune response and was effective in preventing COVID-19 in healthy children. The trial was conducted on children aged 6 months to 11 years, with the findings presented for the 6 months to 4 years age group. The results indicated that the vaccine was safe, immunogenic, and effective in reducing the risk of symptomatic COVID-19 by 73.2% in children aged 6 months to 4 years. The vaccine was well-tolerated, and the side effects were mainly mild to moderate. The incidence of fever was similar among those who received the vaccine or a placebo.*
Article: Evaluation of BNT162b2 Covid-19 Vaccine in Children Younger than 5 Years of Age – New England Journal of Medicine (link to abstract – $ for full-text)
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.