🦘Cacatman's Personal Coronavirus COVID-19 Update Thread

[cacatman]

New British (Kent) Strain could be up to 33% more lethal
Newer researches and preliminary findings from the London School of Hygiene and Tropical Medicine (LSHTM) have also identified that the SARS-COV-2 variant may also increase the risk of dying from the disease by a whopping 33%.

Coronavirus new strain: Can the new COVID-19 strain cause mortality? Who has a higher risk?

It may only have been weeks since the new coronavirus strains have been discovered, namely the Kent variant (B.1.1.7) and the South African strain, (B.1.351), but it has become evidently clear that the cases are quickly spreading across the world, and wreaking havoc.While scientists are trying...

timesofindia.indiatimes.com

It is 50-74% more infective

https://cmmid.github.io/topics/covid19/reports/uk-novel-variant/2020_12_23_Transmissibility_and_severity_of_VOC_202012_01_in_England.pdf

 

[Carrera1963]

New British (Kent) Strain could be up to 33% more lethal
Newer researches and preliminary findings from the London School of Hygiene and Tropical Medicine (LSHTM) have also identified that the SARS-COV-2 variant may also increase the risk of dying from the disease by a whopping 33%.

Coronavirus new strain: Can the new COVID-19 strain cause mortality? Who has a higher risk?

It may only have been weeks since the new coronavirus strains have been discovered, namely the Kent variant (B.1.1.7) and the South African strain, (B.1.351), but it has become evidently clear that the cases are quickly spreading across the world, and wreaking havoc.While scientists are trying...

timesofindia.indiatimes.com

It is 50-74% more infective

https://cmmid.github.io/topics/covid19/reports/uk-novel-variant/2020_12_23_Transmissibility_and_severity_of_VOC_202012_01_in_England.pdf

The mortality rate increased from 1% to 1.3-1.4% so “a whopping 33%” needs to be taken in context. The initial study was also not clear as to whether all the variables had been sufficiently isolated to ascribe the increase wholly to the Kent variant.

 

[cacatman]

The mortality rate increased from 1% to 1.3-1.4% so “a whopping 33%” needs to be taken in context. The initial study was also not clear as to whether all the variables had been sufficiently isolated to ascribe the increase wholly to the Kent variant.

I agree that there will always be confounding factors, at least in the early observations. It remains to be seen exactly how much higher the mortality rate from the new variant (and the others that follow) will be. I'm sure in due course, time will tell. Ultimately, I don't doubt that COVID-19 will burn itself out, as did the black death and others before and after it. Nevertheless, that knowledge is still cold comfort to the families and loved ones who suffered loss.

 

[cacatman]

Sinopharm not recommended for > 60 yo
Islamabad: Pakistan on Thursday said that China's Sinopharm vaccine is not effective for people over 60 years of age, a day after it began its countrywide coronavirus vaccination programme with the Chinese jabs.

Pakistan says China's Sinopharm vaccine not effective for people over 60 years

China donated half a million doses of Sinopharm vaccines to Pakistan which sent a special plane to airlift the jabs on Monday

www.livemint.com

 

[cacatman]

Big increases in antibodies after 1st mRNA vaccination if you've had COVID before!
The antibody titers of vaccinees with preexisting immunity were 10 to 45 times as high as those of vaccinees without preexisting immunity at the same time points after the first vaccine dose

https://www.nejm.org/doi/full/10.1056/NEJMc2101667?query=featured_home

 

[cacatman]

Outcomes of Rheumatological Patients
Overall, the risk profile is favourable for patients with rheumatic diseases who are taking many commonly used medicines, including non-steroidal anti-inflammatory drugs, hydroxychloroquine, methotrexate, and most biologics. However, moderate-dose and high-dose glucocorticoids, rituximab, sulphasalazine, and transplantation-like immunosuppressants are associated with poor outcomes.

Patients with gout have a high absolute risk of poor COVID-19 outcomes.

Patients with gout: an under-recognised group at high risk of COVID-19

Since the first reports of COVID-19 in late 2019, there has been a rapid acceleration in the understanding of predictors of poor outcomes of SARS-CoV-2 infection, such as death or severe illness requiring hospitalisation. Concern among rheumatologists has primarily focused on the risk of these...

www.thelancet.com

 

[cacatman]

What Can Vaccinated People Be Permitted to Do?
Current data demonstrate that the authorized COVID-19 vaccines are efficacious among adults of different ages, races, and ethnicities, and among those with underlying medical conditions.3 Even if fully vaccinated people do become infected, they are much less likely to develop severe disease, be hospitalized, or die.3

In addition, preliminary but rapidly increasing evidence suggests that fully vaccinated people likely pose little risk of transmission to unvaccinated people. Studies from the US, UK, and Israel found that 2 doses of Pfizer-BioNTech or Moderna vaccines were 86% to 92% effective against asymptomatic and symptomatic SARS-CoV-2 infection.3 More specifically, studies from Israel demonstrated that the Pfizer-BioNTech COVID-19 vaccine was 90% effective against asymptomatic infection, and vaccinated people who developed COVID-19 had a substantially lower viral load than unvaccinated people.3 Viral load has been identified as a key driver of transmission and this observation may indicate reduced transmissibility. Collectively, these findings demonstrate that vaccination has the potential to substantially reduce the COVID-19 disease burden in the US.

Despite these unknowns, fully vaccinated people can resume several activities now, at low risk to themselves, while being mindful of the potential risk of becoming infected and transmitting the virus to other people. With the new CDC recommendations (Box), fully vaccinated people can share a meal or movie night in their private residence, without masks or physical distancing. Fully vaccinated people can also do these things with unvaccinated family and friends; however, prevention measures (such as wearing masks and physical distancing) should be maintained if any unvaccinated people are at risk of severe COVID-19 or if multiple households of unvaccinated people are mixing together.

CDC Interim Recommendations for People Fully Vaccinated Against Coronavirus

This Viewpoint summarizes CDC activity recommendations for individuals fully vaccinated against SARS-CoV-2 infection, including resumption of low-risk gatherings among vaccinated people and maintenance of public health measures in activities involving unvaccinated people.

jamanetwork.com

 

[cacatman]

Benefits of Aspirin
Aspirin use may be associated with improved outcomes in hospitalized COVID-19 patients. However, a sufficiently powered randomized controlled trial is needed to assess whether a causal relationship exists between aspirin use and reduced lung injury and mortality in COVID-19 patients.

People taking aspirin were 44 percent less likely to be put on a ventilator and 43 percent less likely to be admitted to the intensive care unit (ICU).

The researchers also reported that those who took aspirin had a 47 percent decrease in risk of dying from COVID-19 when compared with those studied who were not taking a daily dose of aspirin.

Some studies suggest between 30 percent and 70 percent of people with COVID-19 in the ICU will develop blood clots in the legs or lungs.

Aspirin Use Is Associated With Decreased Mechanical... : Anesthesia & Analgesia

dmission, and in-hospital mortality. METHODS: A retrospective, observational cohort study of adult patients admitted with COVID-19 to multiple hospitals in the United States between March 2020 and July 2020 was performed. The primary outcome was the need for mechanical ventilation. Secondary...

journals.lww.com

Suggested possibly for 40-60 yo

https://www.emiia.org/writable/files/rethinking_the_baby_aspirin_in_the_time_of_covid_2_4-29-20.pdf

In this study, aspirin medication among patients with COVID-19 was associated with low risk of mortality compared with those who did not.

Effect of low-dose aspirin on mortality and viral duration... : Medicine

in the aspirin group were significantly lower than that in the non-aspirin group (P = .021 and P = .030, respectively). The viral duration time between the 2 groups was not significantly different (P = .942). Among adults (with hypertension, cardiovascular diseases) infected with SARS-Cov-2...

journals.lww.com

A total of 3,627 (84.4%) patients received prophylactic anticoagulation within 24 hours of admission and there were 622 deaths (14.5%) within 30 days.

Death at 30 days was 14.3% among those who received prophylactic anticoagulation compared with 18.7% among those who did not -- a relative risk reduction as high as 34% and an absolute risk reduction of 4.4%.

Findings In this randomized clinical trial that included 562 patients with COVID-19 admitted to the ICU, the primary outcome (a composite of adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days) occurred in 45.7% of patients in the intermediate-dose prophylactic anticoagulation group and 44.1% of patients in the standard-dose prophylactic anticoagulation group, a difference that was not statistically significant (odds ratio, 1.06).

Meaning The results do not support routine empirical use of intermediate-dose prophylactic anticoagulation in unselected patients with COVID-19 admitted to the ICU.

Effect of Intermediate- vs Standard-Dose Anticoagulation on Outcomes of Patients With COVID-19

This randomized trial compares the effect of intermediate-dose vs standard prophylactic enoxaparin on a composite outcome of acute venous thromboembolism (VTE), arterial thrombosis, need for extracorporeal membrane oxygenation (ECMO), and all-cause mortality within 30 days among patients with...

jamanetwork.com

This benefit seemed to be greater among patients not admitted to the intensive care unit (ICU) within 24 hours of hospital admission.

Study: Anti-clotting therapy may prevent death in Covid-19 patients

A clinical study circulated by the British Medical Journal (BMJ) claims strong evidence that prompt preventive blood-thinning drugs may reduce the risk of death in COVID-19 patients.

health.economictimes.indiatimes.com

George Washington University researchers found low dose aspirin may reduce the need for mechanical ventilation, ICU admission and in-hospital mortality in hospitalized COVID-19 patients. Final results indicating the lung protective effects of aspirin were published today in Anesthesia & Analgesia.

Aspirin use may decrease ventilation, ICU admission and death in COVID-19 patients

George Washington University researchers found low dose aspirin may reduce the need for mechanical ventilation, ICU admission and in-hospital mortality in hospitalized COVID-19 patients. Final results indicating the lung protective effects of aspirin were published today in Anesthesia & Analgesia.

www.eurekalert.org

The cheap and widely available pills also keep patients out of ICUs and can reduce the risk of death, probably by preventing tiny blood clots, a team at George Washington University reported in a study published in the journal Anesthesia & Analgesia.

Aspirin use was associated with a 44% reduction in mechanical ventilation, a 43% reduction in ICU admission, and a 47% reduction for in-hospital mortality, the researchers found.

Aspirin Use Is Associated With Decreased Mechanical... : Anesthesia & Analgesia

dmission, and in-hospital mortality. METHODS: A retrospective, observational cohort study of adult patients admitted with COVID-19 to multiple hospitals in the United States between March 2020 and July 2020 was performed. The primary outcome was the need for mechanical ventilation. Secondary...

journals.lww.com

Use in pre-ICU Patients
Overall, the authors found no survival benefit from early anticoagulation therapy for the group as a whole nor for any subgroup. The authors suggested that therapeutic anticoagulation may reduce the risk of VTE but increase the risk for major bleeding. Patients with major bleeding were found to have higher mortality rates.

No Survival Benefit from Anticoagulation for COVID-19 Patients - Infectious Disease Advisor

Although hypercoagulability in COVID-19 is a leading cause of mortality from the disease, anticoagulation therapy does not provide benefit.

www.infectiousdiseaseadvisor.com

Among hospitalized patients with COVID-19, the overall estimated pooled incidence of VTE was 17.0%, with higher rates with routine screening, inclusion of distal DVT, and subsegmental PE, in critically ill patients and in prospective studies. Bleeding events were observed in 7.8% of patients and were sensitive to use of escalated doses of anticoagulants and nature of data collection. Additional studies are required to ascertain the significance of various thrombotic events and to identify strategies to improve patient outcomes.

DEFINE_ME

Healthy people who use aspirin regularly to prevent cardiovascular disease are less likely to get infected with COVID-19 than those who do not use aspirin.

The researchers analyzed data of 10,477 people who were tested for COVID-19 from February 1, 2020 to June 30, 2020 — 662 of which tested positive for COVID-19. Of those who tested positive, 11 percent were aspirin users. Patients who used aspirin use for “secondary prevention” (say, individuals who had already been diagnosed with coronary artery disease) or for other conditions were not observed for the study.

The researchers found that people who regularly used aspirin to prevent heart disease had a 29 percent lower chance of getting infected with COVID-19 than people who did not. And for the aspirin users who did get COVID-19, their disease duration was two to three days shorter than non-aspirin users who lacked pre-existing conditions that extended the disease duration, like diabetes.

She adds that this study showed that “aspirin reduces the likelihood of COVID-19 infection, reduces the disease duration, and reduces chances of long COVID-19.

FEBS Press

febs.onlinelibrary.wiley.com

 

[cacatman]

Head to head Pfizer, Moderna Johnson & Johnson Vaccine

 

[cacatman]

Novavax Confirms High Levels of Efficacy Against Original and Variant COVID-19 Strains in UK/SA trials

• 100% protection against severe disease
• Final analysis in U.K. trial confirms 96% efficacy against original strain of COVID-19
• Efficacy against variants confirmed in U.K. and South Africa

United Kingdom Phase 3 Trial​

The study enrolled more than 15,000 participants between 18-84 years of age, including 27% over the age of 65. The primary endpoint of the U.K. Phase 3 clinical trial is based on the first occurrence of PCR-confirmed symptomatic (mild, moderate or severe) COVID-19 with onset at least 7 days after the second study vaccination in serologically negative (to SARS-CoV-2) adult participants at baseline.

Efficacy was 96.4% (95% CI: 73.8, 99.5) against the original virus strain and 86.3% (95% CI: 71.3, 93.5) against the B.1.1.7/501Y.V1 variant circulating in the U.K (post hoc). The primary efficacy endpoint demonstrated an overall vaccine efficacy of 89.7% (95% CI: 80.2, 94.6). 106 cases were observed, with 10 in the vaccine group and 96 in the placebo group. NVX-CoV2373 was effective against severe disease: five severe[1] cases were observed in the study, and all occurred in the placebo group. Four of the five severe cases were attributed to the B.1.1.7/501Y.V1 variant. Fourteen days after dose 1, vaccine efficacy was 83.4% (95% CI: 73.6, 89.5).

South Africa Phase 2b Trial​

The South Africa trial was a randomized, observer-blinded, placebo-controlled Phase 2b clinical trial of NVX-CoV2373. One cohort evaluated efficacy, safety and immunogenicity in approximately 2,665 healthy adults. The second cohort evaluated safety and immunogenicity in approximately 240 medically stable, HIV-positive adults.

A complete analysis of vaccine efficacy among 147 PCR-positive cases (51 cases in the vaccine group and 96 in the placebo group) demonstrated an overall efficacy of 48.6% against predominantly variant strains (95% CI: 28.4, 63.1). The vast majority of cases circulating during the efficacy analysis were due to the B.1.351/501Y.V2 variant circulating in South Africa. All five cases of severe disease observed in the trial occurred in the placebo group. Among HIV-negative participants, 55.4% efficacy was observed (95% CI: 35.9, 68.9). The complete analysis shows that vaccine-induced protection began 14 days after dose 1 (42.7% 95% CI: 25.0, 56.3), although increased efficacy was observed 7 days after dose 2, the primary endpoint for the study.

Novavax Investor Relations - Press Releases & Statements

ir.novavax.com