3- Wednesday Research News – 17th November

 1 – Clinical Features of Vaccine-Induced Immune Thrombocytopenia and Thrombosis

• Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is a new syndrome associated with the ChAdOx1 nCoV-19 adenoviral vector vaccine against severe acute respiratory syndrome coronavirus 2.
• Data are lacking on the clinical features of and the prognostic criteria for this disorder.
• They conducted a prospective cohort study involving patients with suspected VITT who presented to hospitals in the United Kingdom between March 22 and June 6, 2021.
• Data were collected with the use of an anonymized electronic form, and cases were identified as definite or probable VITT according to prespecified criteria.
• The high mortality associated with VITT was highest among patients with a low platelet count and intracranial hemorrhage.
• Treatment remains uncertain, but identification of prognostic markers may help guide effective management.

Source: NEJM

2- Efficacy of the mRNA-1273 SARS-CoV-2 Vaccine at Completion of Blinded Phase

• At interim analysis in a phase 3, observer-blinded, placebo-controlled clinical trial, the mRNA-1273 vaccine showed 94.1% efficacy in preventing coronavirus disease 2019 (Covid-19).
• After emergency use of the vaccine was authorized, the protocol was amended to include an open-label phase.
• Final analyses of efficacy and safety data from the blinded phase of the trial are reported.
• The mRNA-1273 vaccine continued to be efficacious in preventing Covid-19 illness and severe disease at more than 5 months, with an acceptable safety profile, and protection against asymptomatic infection was observed.

Source: NEJM

3- Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine through 6 Months

• BNT162b2 is a lipid nanoparticle–formulated, nucleoside-modified RNA vaccine encoding a prefusion-stabilized, membrane-anchored severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) full-length spike protein.
• BNT162b2 is highly efficacious against coronavirus disease 2019 (Covid-19) and is currently approved, conditionally approved, or authorized for emergency use worldwide.
• At the time of initial authorization, data beyond 2 months after vaccination were unavailable.
• Through 6 months of follow-up and despite a gradual decline in vaccine efficacy, BNT162b2 had a favorable safety profile and was highly efficacious in preventing Covid-19.

Source: NEJM

4- The COVID19 pandemic has changed women’s experiences of pregnancy in the UK

• During the SARS-CoV-2 pandemic, maternity care has been substantially altered to reduce transmission of the SARS-CoV-2 virus.
• Many antenatal services are now restricted or delivered online, and visiting has been restricted during labour and in the postnatal period.
• Maternity services in the UK have been significantly restructured to prevent transmission of the SARS-CoV-2 virus, including restrictions to in-person antenatal care, and perinatal visiting.
• It is not fully known how these changes are perceived by pregnant and breastfeeding women.
• Reactions to changes in antenatal care are mixed, including whether restrictions were too lenient or too strict.
• Most women underwent online antenatal care in addition in-person visits.
• Some received no information about COVID-19, and a significant proportion of women would have liked more information, particularly regarding antibody transfer and benefits of breastfeeding during the pandemic.

Source: MedRxiv

5- Impact of SARS-CoV-2 infection on vaccine-induced immune responses over time.

• People with previous SARS-CoV-2 infection mount potent immune responses to COVID-19 vaccination, but long-term effects of prior infection on these immune responses are unknown.
• They investigated the long-term impact of prior SARS-CoV-2 infection on humoral and cellular immune responses in healthcare workers receiving the mRNA BNT162b2 or the adenovirus vectored ChAdOx1 nCoV-19 vaccine.
• Vaccination with both vaccine platforms resulted in substantially enhanced T cell immune responses, antibody responses to spike and neutralizing antibodies effective against ten SARS-CoV-2 variants following SARS-CoV-2 infection, compared to in naive individuals.
• The enhanced immune responses sustained over seven months following vaccination.
• These findings imply that prior infection should be taken into consideration when planning booster doses and design of current and future COVID-19 vaccine programs.

Source: MedRxiv

6- Virtual reality exercise to help COVID patients with refractory breathlessness

• Immersive virtual reality (iVR)-based digital therapeutics (DTx) are gaining clinical attention in the field of pain management. Based on known analogy between chronic pain and dyspnea, we investigated the effects of visual respiratory feedback in iVR, on refractory breathlessness in patients recovering from severe COVID-19 pneumonia.
• We performed a controlled, randomized, single-blind, cross-over clinical study to evaluate an iVR-based intervention to alleviate refractory breathlessness in patients recovering from COVID-19 pneumonia.
• Participants received synchronous (intervention) or asynchronous (control) feedback of their breathing, embodied via a gender-matched avatar in iVR.
• Prior to the first exposure and following both experimental conditions, patients completed questionnaires.
• Breathing patterns were captured continuously.
• Of all patients, 91.2% were satisfied with the intervention and 66.7% perceived it as beneficial for their breathing

Source: MedRxiv

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