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Topic: Testing and Treatment
March 19, 2021
Interleukin-6 blocking agents for treating COVID-19: a living systematic review
A systematic review (10 randomized trials among 6896 people with COVID-19) found that treatment of COVID-19 patients with the IL-6 blocker tocilizumab reduces the risk of all-cause mortality over 28 days, compared standard of care (with or without placebo). On average, tocilizumab reduced the risk of death by 32 deaths per 1000 compared to standard…
Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit
Intermediate-dose prophylactic anticoagulation treatment did not improve clinical outcomes among patients admitted to the ICU with COVID-19 compared with standard prophylactic anticoagulation, according to a randomized clinical trial (n=562). There was no difference in the primary composite outcome (an adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days) between…
March 18, 2021
Mavrilimumab in Patients with Severe COVID-19 Pneumonia and Systemic Hyperinflammation (MASH-COVID): An Investigator Initiated, Multicentre, Double-Blind, Randomised, Placebo-Controlled Trial
The monoclonal antibody treatment mavrilimumab did not significantly lower the proportion of patients with severe COVID-19 who were alive and off oxygen therapy at day 14 compared to placebo (52% vs 47%, OR = 1.48, 95% CI: 0.43-5.16) in a multicenter, double-blind placebo-controlled randomized trial (n=40). Patients were included in the study if they were…
March 17, 2021
Real-World Experience of SARS-CoV-2 Antibody Assays in UK Healthcare Workers
Among health care workers in the UK, Abbott and Roche antibody assays showed low sensitivity for detecting individuals with previous PCR-confirmed infection. In a cohort study conducted at 2 medical centers in the UK, the Abbott antibody assay had a sensitivity (proportion with a positive antibody test result in those with previous PCR-confirmed infection) of…
Nasopharyngeal Panbio COVID-19 Antigen Performed at Point-of-Care Has a High Sensitivity in Symptomatic and Asymptomatic Patients With Higher Risk for Transmission and Older Age
Performance of the nasopharyngeal Panbio COVID-19 antigen (Ag) test was highly dependent on the cycle threshold (Ct) value. The Panbio test showed high sensitivity among older, symptomatic patients with a cycle threshold (Ct) value below 30 (indicating higher viral load). The positive percent agreement (PPA) relative to RT-PCR of 94% for Ct at ≤25 and…
Clinical Evaluation of Roche SD Biosensor Rapid Antigen Test for SARS-CoV-2 in Municipal Health Service Testing Site, the Netherlands
Evaluation of the Roche SD Biosensor rapid antigen test for SARS-CoV-2 among asymptomatic outpatients demonstrated that test sensitivity was 84.9% and specificity was 99.5%. Around 98% of samples with a cycle threshold (Ct) below 30 (indicating higher viral load) were detected. Test sensitivity was higher (95.8%) among people who sought care within 7 days of…
March 15, 2021
Specific Allelic Discrimination of N501Y and Other SARS-CoV-2 Mutations by DdPCR Detects B.1.1.7 Lineage in Washington State
[Pre-print, not peer-reviewed] A research team in Washington State described detection of the first cases of the B.1.1.7 SARS-CoV-2 variant in the state using a novel droplet reverse transcriptase digital-PCR (RT-ddPCR) assay that detects four mutations associated with the B.1.1.7 lineage. All four targets were detected in two specimens, and follow-up sequencing revealed 10 mutations…
March 11, 2021
Convalescent Plasma in Patients Admitted to Hospital with COVID-19 (RECOVERY) a Randomised Controlled Open-Label Platform Trial
[Pre-print, not peer-reviewed] Convalescent plasma (CP) was not associated with improved 28-day survival compared to usual care (RR=1.00, 95% CI: 0.93-1.07) ] in a randomized controlled trial of hospitalized patients (RECOVERY TRIAL). The open-label platform trial (RECOVERY Trial) was conducted between May 2020 to January 2021 in the UK. The mortality risk was similar in…
Follow-up Testing of Borderline SARS-CoV-2 Patients by RRT-PCR Allows Early Diagnosis of COVID-19
Follow-up testing of “borderline” PCR test results within 96 hours occasionally identified additional positive results, according to a retrospective analysis of over 30,000 SARS-CoV-2 PCR test results (1,092 positive). Of the 204 borderline results, which had viral amplification just below the positivity threshold (>25 viral copies/mL), 107 were re-tested and 10 were found positive, representing…
March 10, 2021
Extremely Potent Human Monoclonal Antibodies from COVID-19 Convalescent Patients
A study that identified highly potent human monoclonal antibodies (mAbs) found that the most potent mAbs recognized the SARS-CoV-2 spike protein receptor-binding domain, followed by those that recognized the S1 domain, the spike protein trimer, and the S2 subunit. Only 1.4% neutralized the virus with a potency of 1–10 ng/mL. The authors also engineered the most…
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