Covid19-Sources

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Effectiveness of CoronaVac, ChAdOx1 nCoV-19, BNT162b2, and Ad26.COV2.S among individuals with previous SARS-CoV-2 infection in Brazil: a test-negative, case-control study
Effectiveness of CoronaVac, ChAdOx1 nCoV-19, BNT162b2, and Ad26.COV2.S among individuals with previous SARS-CoV-2 infection in Brazil: a test-negative, case-control study
COVID-19 vaccines have proven highly effective among individuals without a previous SARS-CoV-2 infection, but their effectiveness in preventing sympto…
·sciencedirect.com·
Effectiveness of CoronaVac, ChAdOx1 nCoV-19, BNT162b2, and Ad26.COV2.S among individuals with previous SARS-CoV-2 infection in Brazil: a test-negative, case-control study
A living WHO guideline on drugs for covid-19
A living WHO guideline on drugs for covid-19
Updates This is the twelfth version (eleventh update) of the living guideline, replacing earlier versions (available as data supplements). New recommendations will be published as updates to this guideline. Clinical question What is the role of drugs in the treatment of patients with covid-19? Context The evidence base for therapeutics for covid-19 is evolving with numerous randomised controlled trials (RCTs) recently completed and under way. The emerging SARS-CoV-2 variants (such as omicron) and subvariants are also changing the role of therapeutics. This update provides updated recommendations for remdesivir, addresses the use of combination therapy with corticosteroids, interleukin-6 (IL-6) receptor blockers, and janus kinase (JAK) inhibitors in patients with severe or critical covid-19, and modifies previous recommendations for the neutralising monoclonal antibodies sotrovimab and casirivimab-imdevimab in patients with non-severe covid-19. New or updated recommendations • Remdesivir: a conditional recommendation for its use in patients with severe covid-19; and a conditional recommendation against its use in patients with critical covid-19. • Concomitant use of IL-6 receptor blockers (tocilizumab or sarilumab) and the JAK inhibitor baricitinib: these drugs may now be combined, in addition to corticosteroids, in patients with severe or critical covid-19. • Sotrovimab and casirivimab-imdevimab: strong recommendations against their use in patients with covid-19, replacing the previous conditional recommendations for their use. Understanding the new recommendations When moving from new evidence to updated recommendations, the Guideline Development Group (GDG) considered a combination of evidence assessing relative benefits and harms, values and preferences, and feasibility issues. For remdesivir, new trial data were added to a previous subgroup analysis and provided sufficiently trustworthy evidence to demonstrate benefits in patients with severe covid-19, but not critical covid-19. The GDG considered benefits of remdesivir to be modest and of moderate certainty for key outcomes such as mortality and mechanical ventilation, resulting in a conditional recommendation. For baricitinib, the GDG considered clinical trial evidence (RECOVERY) demonstrating reduced risk of death in patients already receiving corticosteroids and IL-6 receptor blockers. The GDG acknowledged that the clinical trials were not representative of the world population and that the risk-benefit balance may be less advantageous, particularly in patients who are immunosuppressed at higher risk of opportunistic infections (such as serious fungal, viral, or bacteria), those already deteriorating where less aggressive or stepwise addition of immunosuppressive medications may be preferred, and in areas where certain pathogens such as HIV or tuberculosis, are of concern. The panel anticipated that there would be situations where clinicians may opt for less aggressive immunosuppressive therapy or to combine medications in a stepwise fashion in patients who are deteriorating. The decision to combine the medications will depend on their availability, and the treating clinician's perception of the risk-benefit balance associated with combination immunosuppressive therapy, particularly in patient populations at risk of opportunistic infections who may have been under-represented in clinical trials. When making a strong recommendation against the use of monoclonal antibodies for patients with covid-19, the GDG considered in vitro neutralisation data demonstrating that sotrovimab and casirivimab-imdevimab evaluated in clinical trials have meaningfully reduced neutralisation activity of the currently circulating variants of SARS-CoV-2 and their subvariants. There was consensus among the panel that the absence of in vitro neutralisation activity strongly suggests absence of clinical effectiveness of these monoclonal antibodies. However, there was also consensus regarding the need for clinical trial evidence in order to confirm clinical efficacy of new monoclonal antibodies that reliably neutralise the circulating strains in vitro. Whether emerging new variants and subvariants might be susceptible to sotrovimab, casirivimab-imdevimab, or other anti-SARS-CoV-2 monoclonal antibodies cannot be predicted. Prior recommendations • Recommended for patients with severe or critical covid-19—strong recommendations for systemic corticosteroids; IL-6 receptor blockers (tocilizumab or sarilumab) in combination with corticosteroids; and baricitinib as an alternative to IL-6 receptor blockers, in combination with corticosteroids. • Recommended for patients with non-severe covid-19 at highest risk of hospitalisation—a strong recommendation for nirmatrelvir/ritonavir; conditional recommendations for molnupiravir and remdesivir. • Not recommended for patients with non-severe covid-19—a conditional recommendation against systemic corticosteroids; a strong recommendation against convalescent plasma; a recommendation against fluvoxamine, except in the context of a clinical trial; and a strong recommendation against colchicine. • Not recommended for patients with non-severe covid-19 at low risk of hospitalisation—a conditional recommendation against nirmatrelvir/ritonavir. • Not recommended for patients with severe or critical covid-19—a recommendation against convalescent plasma except in the context of a clinical trial; and a conditional recommendation against the JAK inhibitors ruxolitinib and tofacitinib. • Not recommended, regardless of covid-19 disease severity—a strong recommendations against hydroxychloroquine and against lopinavir/ritonavir; and a recommendation against ivermectin except in the context of a clinical trial. About this guideline This living guideline from the World Health Organization (WHO) incorporates new evidence to dynamically update recommendations for covid-19 therapeutics. The GDG typically evaluates a therapy when the WHO judges sufficient evidence is available to make a recommendation. While the GDG takes an individual patient perspective in making recommendations, it also considers resource implications, acceptability, feasibility, equity, and human rights. This guideline was developed according to standards and methods for trustworthy guidelines, making use of an innovative process to achieve efficiency in dynamic updating of recommendations. The methods are aligned with the WHO Handbook for Guideline Development and according to a pre-approved protocol (planning proposal) by the Guideline Review Committee (GRC). A box at the end of the article outlines key methodological aspects of the guideline process. MAGIC Evidence Ecosystem Foundation provides methodological support, including the coordination of living systematic reviews with network meta-analyses to inform the recommendations. The full version of the guideline is available online in MAGICapp and in PDF, with a summary version here in The BMJ . These formats should facilitate adaptation, which is strongly encouraged by WHO to contextualise recommendations in a healthcare system to maximise impact. Future recommendations Recommendations on anticoagulation are planned for the next update to this guideline.
·bmj.com·
A living WHO guideline on drugs for covid-19
Cytokine Storm
Cytokine Storm
he severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has reminded us of the critical role of an effective host immune response and the devastating effect of immune dysregulation. This year marks 10 years since the first description of a cytokine storm that developed after chimeric antigen receptor (CAR) T-cell therapy1 and 27 years since the term was first used in the literature to describe the engraftment syndrome of acute graft- versus-host disease after allogeneic hematopoietic stem-cell transplantation.2 The term “cytokine release syndrome” was coined to describe a similar syndrome after infusion of muromonab-CD3 (OKT3).3 Cytokine storm and cytokine release syn- drome are life-threatening systemic inflammatory syndromes involving elevated levels of circulating cytokines and immune-cell hyperactivation that can be trig- gered by various therapies, pathogens, cancers, autoimmune conditions, and monogenic disorders. From a historical perspective, cytokine storm was previously referred to as an influenza-like syndrome that occurred after systemic infections such as sepsis and after immunotherapies such as Coley’s toxins.4 Yersinia pestis infection (i.e., the plague) has led to major pandemics (e.g., the Black Death) and triggers alveolar macrophages to produce excessive amounts of cytokines, resulting in cytokine storm.5 An exaggerated immune response was suspected to contribute to the lethal- ity of the 1918–1919 influenza pandemic. In fact, a reconstructed H1N1 virus isolated from the 1918 pandemic, as compared with common reference strains of the virus that causes influenza A, triggered marked pulmonary inflammation in mice.6 Recognition that the immune response to the pathogen, but not the patho- gen itself, can contribute to multiorgan dysfunction and that similar cytokine storm syndromes could occur with no obvious infection led to the investigation of immunomodulators and cytokine-directed therapies. One of the earliest targeted therapies for abrogation of a cytokine storm was the anti–interleukin-6 receptor monoclonal antibody tocilizumab, which was developed for the treatment of idio- pathic multicentric Castleman’s disease in the 1990s. A host of other disorders have been described as causes of cytokine storm and targeted with immune-di- rected therapies, such as sepsis, primary and secondary hemophagocytic lympho- histiocytosis (HLH), autoinflammatory disorders, and coronavirus disease 2019 (Covid-19).
·nejm.org·
Cytokine Storm
Role of air temperature and humidity in the transmission of SARS-CoV-2 in the United States
Role of air temperature and humidity in the transmission of SARS-CoV-2 in the United States
Improved understanding of the effects of meteorological conditions on the transmission of SARS-CoV-2, the causative agent for COVID-19 disease, is urgently needed to inform mitigation efforts. Here, we estimated the relationship between air temperature or specific humidity (SH) and SARS-CoV-2 transmission in 913 U.S. counties with abundant reported infections from March 15 to August 31, 2020. Specifically, we quantified the associations of daily mean temperature and SH with daily estimates of the SARS-CoV-2 reproduction number ( Rt ) and calculated the fraction of Rt attributable to these meteorological conditions. Both lower temperature and lower SH were significantly associated with increased Rt . The fraction of Rt attributable to temperature was 5.10% (95% eCI: 5.00 - 5.18%), and the fraction of Rt attributable to SH was 14.47% (95% eCI: 14.37 - 14.54%). These fractions generally were higher in northern counties than in southern counties. Our findings indicate that cold and dry weather are moderately associated with increased SARS-CoV-2 transmissibility, with humidity playing a larger role than temperature. ### Competing Interest Statement J.S. and Columbia University disclose partial ownership of SK Analytics. J.S. discloses consulting for BNI. All other authors declare no competing interests. ### Funding Statement Y.M. received funding from the China Scholarship Council (201906320022). S.P. and J.S. acknowledged funding from the National Institutes of Health (GM110748) and the National Science Foundation (DMS-2027369), as well as a gift from the Morris-Singer Foundation. R.D. received funding from the High Tide Foundation. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Not Human Subject Research. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Estimates of county-level reproduction number are available at https://github.com/shaman-lab/Counterfactual The data sets used in the study are publicly available from the following locations: Hourly air temperature and specific humidity data: https://disc.gsfc.nasa.gov/datasets/NLDAS\_FORA0125\_H\_002/summary?keywords=NLDAS Population density, median household income, percent of people older than 60 years, percent black residents, percent Hispanic residents, percent owner-occupied housing, and percent residents aged 25 years and over without a high school diploma: https://www.census.gov/data/tables.html U.S. county boundary: https://www.census.gov/geographies/mapping-files/time-series/geo/cartographic-boundary.html Prevalence of smoking and obesity among adults in each county: https://www.countyhealthrankings.org/explore-health-rankings/rankings-data-documentation Total ICU beds in each county: https://khn.org/news/as-coronavirus-spreads-widely-millions-of-older-americans-live-in-counties-with-no-icu-beds/ Annual PM2.5 concentrations in the U.S. from 2014 to 2018: http://fizz.phys.dal.ca/~atmos/martin/?page\_id=140 Short-term daily mean PM2.5 and daily maximum 8-hour O3: https://www.epa.gov/outdoor-air-quality-data/download-daily-data Daily downward UV radiation at the surface: https://cds.climate.copernicus.eu/cdsapp#!/dataset/reanalysis-era5-single-levels?tab=overview
·medrxiv.org·
Role of air temperature and humidity in the transmission of SARS-CoV-2 in the United States
Associations between indoor relative humidity and global COVID-19 outcomes | Journal of The Royal Society Interface
Associations between indoor relative humidity and global COVID-19 outcomes | Journal of The Royal Society Interface
Globally, the spread and severity of COVID-19 have been distinctly non-uniform. Seasonality was suggested as a contributor to regional variability, but the relationship between weather and COVID-19 remains unclear and the focus of attention has been on ...
·royalsocietypublishing.org·
Associations between indoor relative humidity and global COVID-19 outcomes | Journal of The Royal Society Interface
Resurgence of Respiratory Syncytial Virus Infection During COVID-19 Pandemic Among Children in Shanghai, China
Resurgence of Respiratory Syncytial Virus Infection During COVID-19 Pandemic Among Children in Shanghai, China
Respiratory syncytial virus (RSV) is the most common pathogen causing acute lower respiratory tract infection (LRTI) in children. RSV usually peaks in winter and declines by early spring in China. The outbreak of coronavirus disease 2019 (COVID-19) was reported to bring changes to the transmission pattern of respiratory pathogens including RSV. Here in this paper, we analyzed RSV-positive nasopharyngeal aspirates from inpatients in the Children’s Hospital of Fudan University from October 2019 to October 2021 and compared the clinical features of the RSV-positive patients before and during COVID-19. We found an atypical upsurge of RSV infection in the late summer of 2021 after a major suppression in 2020. RSV B was the main subtype spreading among children throughout the study. Phylogenetic analysis revealed that all RSV A strains belonged to ON1 genotype and all RSV B strains were BA9 genotype. Deduced amino acid analysis displayed different substitutions in the RSV strains observed before and during COVID-19. Demographic analysis suggested that males and infants aged under 5 months were the main populations infected with RSV by gender and age, respectively. Less severe clinical outcomes were observed in patients during COVID-19 than before the pandemic, especially in RSV B-positive patients. Our findings described the epidemiological changes in RSV infection brought by COVID-19, which further underscored the importance of continuous surveillance of RSV in the shadow of CO...
·frontiersin.org·
Resurgence of Respiratory Syncytial Virus Infection During COVID-19 Pandemic Among Children in Shanghai, China
Single-cell multiomics revealed the dynamics of antigen presentation, immune response and T cell activation in the COVID-19 positive and recovered individuals
Single-cell multiomics revealed the dynamics of antigen presentation, immune response and T cell activation in the COVID-19 positive and recovered individuals
IntroductionDespite numerous efforts to describe COVID-19's immunological landscape, there is still a gap in our understanding of the virus's infections after-effects, especially in the recovered patients. This would be important to understand as we now have huge number of global populations infected by the SARS-CoV-2 as well as variables inclusive of VOCs, reinfections, and vaccination breakthroughs. Furthermore, single-cell transcriptome alone is often insufficient to understand the complex human host immune landscape underlying differential disease severity and clinical outcome.MethodsBy combining single-cell multi-omics (Whole Transcriptome Analysis plus Antibody-seq) and machine learning-based analysis, we aim to better understand the functional aspects of cellular and immunological heterogeneity in the COVID-19 positive, recovered and the healthy individuals.ResultsBased on single-cell transcriptome and surface marker study of 163,197 cells (124,726 cells after data QC) from the 33 individuals (healthy=4, COVID-19 positive=16, and COVID-19 recovered=13), we observed a reduced MHC Class-I-mediated antigen presentation and dysregulated MHC Class-II-mediated antigen presentation in the COVID-19 patients, with restoration of the process in the recovered individuals. B-cell maturation process was also impaired in the positive and the recovered individuals. Importantly, we discovered that a subset of the naive T-cells from the healthy individuals were absent from the recov...
·frontiersin.org·
Single-cell multiomics revealed the dynamics of antigen presentation, immune response and T cell activation in the COVID-19 positive and recovered individuals
Decline of RSV-specific antibodies during the COVID-19 pandemic
Decline of RSV-specific antibodies during the COVID-19 pandemic
Hospitalisations due to respiratory syncytial virus (RSV) infections largely decreased after social distancing measures were introduced to control the COVID-19 pandemic. Lifting these measures resulted in out-of-season RSV activity, sometimes exceeding the incidence of hospitalisations observed in regular seasons.1–3 Declining immunity due to reduced exposure to the virus may contribute to this altered epidemiology.1,4,5 Bardsley and colleagues1 showed that the combination of laboratory, clinical, and syndromic data capture the impact of RSV activity, yet did not provide insight into the proposed decline in immunity.
·thelancet.com·
Decline of RSV-specific antibodies during the COVID-19 pandemic
Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants
Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants
The SARS-CoV-2 Omicron variant continues to evolve, with new BQ and XBB subvariants now rapidly expanding in Europe/US and Asia, respectively. As these new subvariants have additional spike mutations, they may possess altered antibody evasion properties. Here, we report that neutralization of BQ.1, BQ.1.1, XBB, and XBB.1 by sera from vaccinees and infected persons was markedly impaired, including sera from individuals who were boosted with a WA1/BA.5 bivalent mRNA vaccine. Compared to the ancestral strain D614G, serum neutralizing titers against BQ and XBB subvariants were lower by 13-81-fold and 66-155-fold, respectively, far beyond what had been observed to date. A panel of monoclonal antibodies capable of neutralizing the original Omicron variant, including those with Emergency Use Authorization, were largely inactive against these new subvariants. The spike mutations that conferred antibody resistance were individually studied and structurally explained. Finally, the ACE2-binding affinities of the spike proteins of these novel subvariants were found to be similar to those of their predecessors. Taken together, our findings indicate that BQ and XBB subvariants present serious threats to the efficacy of current COVID-19 vaccines, render inactive all authorized monoclonal antibodies, and may have gained dominance in the population because of their advantage in evading antibodies. ### Competing Interest Statement S.I, J.Y., L.L., and D.D.H. are inventors on patent applications (WO2021236998) or provisional patent applications (63/271,627) filed by Columbia University for a number of SARS-CoV-2 neutralizing antibodies described in this manuscript. Both sets of applications are under review. D.D.H. is a co-founder of TaiMed Biologics and RenBio, consultant to WuXi Biologics and Brii Biosciences, and board director for Vicarious Surgical. Aubree Gordon serves on a scientific advisory board for Janssen Pharmaceuticals. Other authors declare no competing interests.
·biorxiv.org·
Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants
Immune amnesia induced by measles and its effects on concurrent epidemics - PubMed
Immune amnesia induced by measles and its effects on concurrent epidemics - PubMed
It has been recently discovered that the measles virus can damage pre-existing immunological memory, destroying B lymphocytes and reducing the diversity of non-specific B cells of the infected host. In particular, this implies that previously acquired immunization from vaccination or direct expositi …
·pubmed.ncbi.nlm.nih.gov·
Immune amnesia induced by measles and its effects on concurrent epidemics - PubMed
Watching viruses fail to pass through face masks
Watching viruses fail to pass through face masks
Using a new analytical method, Empa researchers have tracked viruses as they pass through face masks and compared their failure on the filter layers of different types of masks. The new method should ...
·medicalxpress.com·
Watching viruses fail to pass through face masks
Effect of Zinc and Ascorbic Acid on Symptom Length Among Patients With SARS-CoV-2
Effect of Zinc and Ascorbic Acid on Symptom Length Among Patients With SARS-CoV-2
This randomized clinical trial examines whether high-dose zinc and/or high-dose ascorbic acid reduces the severity or duration of symptoms compared with usual care among ambulatory patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
·jamanetwork.com·
Effect of Zinc and Ascorbic Acid on Symptom Length Among Patients With SARS-CoV-2
Bert Weingarten on Twitter
Bert Weingarten on Twitter
Realitätslevel US-Daten zu Masken und zur Maskenpflicht an Schulen belegen einen positiven und imposanten Effekt auf das Infektionsgeschehen.Wann korrigieren@hendrikstreeck@stohr_klaus@ChanasitJonas ihre Empfehlung - pro 😷#Maske und #Maskenpflicht? https://t.co/4i0jJbedxl— Bert Weingarten (@WeingartenDE) November 10, 2022
·twitter.com·
Bert Weingarten on Twitter
SARS-CoV-2 evolution, post-Omicron
SARS-CoV-2 evolution, post-Omicron
SARS-CoV-2 evolution, post-Omicron Cornelius Roemer1, Ryan Hisner2, Nicholas Frohberg2, Hitoshi Sakaguchi3, Federico Gueli4, Thomas P. Peacock5 1Biozentrum, University of Basel, Basel, Switzerland; Swiss Institute of Bioinformatics 2Independent Researcher, USA 3Retired, Japan 4Independent Researcher, Italy 5Department of Infectious Disease, Imperial College London, UK *corresponding author: tpp09@ic.ac.uk Summary Following the emergence and global spread of Omicron lineage BA.5, there h...
·virological.org·
SARS-CoV-2 evolution, post-Omicron
Dr. Jeff Gilchrist on Twitter
Dr. Jeff Gilchrist on Twitter
Children dying from Strep throat and other immune consequencesThis virus season has been like no other with high hospitalization rates from RSV, Influenza and now more children are dying from Strep A bacterial infections. This long thread looks at what might be going on.🧵1/ pic.twitter.com/r8mcrtBA7d— Dr. Jeff Gilchrist (@jeffgilchrist) December 5, 2022
·twitter.com·
Dr. Jeff Gilchrist on Twitter