3- Wednesday Research News – 14th July

1 – Spread of delta variant prompts new restrictions worldwide

• The rapid spread of the delta coronavirus variant has forced a growing number of countries to reimpose lockdowns and other public health restrictions, raising fears that the more contagious variant was hampering global efforts to contain the pandemic.
• The new curbs on travel and daily life stretched from Australia and Bangladesh to South Africa and Germany , where authorities over the weekend set new limits on travelers from “virus-variant zones” such as Portugal and Russia.

Source: Washington Post

2- Effective post-exposure prophylaxis of Covid-19 associated with hydroxychloroquine: Prospective dataset re-analysis incorporating novel, missing data

• A key trial of post-exposure prophylaxis found hydroxychloroquine-associated (HCQ) reductions of Covid-19 by 17% overall and 31% to 49% in subgroups.
• To understand these trends, they re-analyzed the dataset.
• After re-analysis, they found reduced HCQ-associated incidence of Covid-19 with Early (up to 3 days post-exposure) but not Late prophylaxis.
• They found a significant HCQ-associated Covid-19 reduction in subjects 18 to 45 years old with Early but not Late prophylaxis, attenuated in older subjects and by co-morbidities.

Source: MedRxiv

3- Efficacy and safety of cyclosporine in the management of coronavirus disease 2019: A protocol for systematic review and meta-analysis

• Cyclosporine may improve the clinical course and outcomes of Coronavirus disease 2019 (COVID-19) due to its antiviral and anti-cytokine effects as shown in vitro.
• A few ongoing trials are exploring the benefit of adding it to the standard of care (SOC) of COVID-19 patients.
• The primary objective is to evaluate the severity of COVID-19, determined by oxygen saturation, intensive care unit (ICU) admission, or the World Health Organization COVID-19 clinical severity scale in patients treated with oral or intravenous cyclosporine added to SOC compared SOC alone or placebo.

Source: MedRxiv

4- Safety and Efficacy of NVX-CoV2373 Covid-19 Vaccine

• Early clinical data from studies of the NVX-CoV2373 vaccine (Novavax), a recombinant nanoparticle vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that contains the full-length spike glycoprotein of the prototype strain plus Matrix-M adjuvant, showed that the vaccine was safe and associated with a robust immune response in healthy adult participants.
• Additional data were needed regarding the efficacy, immunogenicity, and safety of this vaccine in a larger population.
• A two-dose regimen of the NVX-CoV2373 vaccine administered to adult participants conferred 89.7% protection against SARS-CoV-2 infection and showed high efficacy against the B.1.1.7 variant.

Source: NEJM

5- Prevention and Attenuation of Covid-19 with the BNT162b2 and mRNA-1273 Vaccines

• Information is limited regarding the effectiveness of the two-dose messenger RNA (mRNA) vaccines BNT162b2 (Pfizer–BioNTech) and mRNA-1273 (Moderna) in preventing infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and in attenuating coronavirus disease 2019 (Covid-19) when administered in real-world conditions.
• They conducted a prospective cohort study involving 3975 health care personnel, first responders, and other essential and frontline workers.
• Authorized mRNA vaccines were highly effective among working-age adults in preventing SARS-CoV-2 infection when administered in real-world conditions, and the vaccines attenuated the viral RNA load, risk of febrile symptoms, and duration of illness among those who had breakthrough infection despite vaccination.

Source: NEJM

6- Therapeutic Doses of Anticoagulation Did Not Benefit Patients with COVID-19 and Elevated D-Dimer Levels

• Compared with other respiratory infections, COVID-19 is associated with higher incidence of thromboembolic events — moreover, these complications are thought to be more likely in patients with elevated D-dimer concentrations.
• Observational studies have suggested that both therapeutic and prophylactic doses of anticoagulation may reduce risk for in-hospital death in such patients, but controlled studies are lacking.
• In an open-label trial involving hospitalized patients, therapeutic anticoagulation dosing did not improve overall outcomes and was associated with more bleeding than prophylactic anticoagulation.

Source: NEJM

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