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Topic: Testing and Treatment
September 24, 2020
Double-Blind, Randomized, Placebo-Controlled Trial with N-Acetylcysteine for Treatment of Severe Acute Respiratory Syndrome Caused by COVID-19
In a randomized, placebo-controlled trial of N-acetylcysteine (NAC) in Brazil among people with severe COVID-19, the frequency of intubation was similar in the NAC (20.6%) vs. placebo (23.9%) groups (p=0.68). No differences in secondary endpoints (ICU admission, time in ICU, and mortality) were observed. de Alencar et al. (Sept 23, 2020). Double-Blind, Randomized, Placebo-Controlled Trial…
Performance Characteristics of Five Immunoassays for SARS-CoV-2: A Head-to-Head Benchmark Comparison
Four commercial and widely available SARS-CoV-2 IgG assays (Abott, DiaSorine, Roche, and Siemens), and a novel immunoassay (Oxford) were evaluated for performance using identical sample sets. All assays achieved a sensitivity ≥98% and specificity≥98% on samples taken 30 days or more post-symptom onset, based on 976 pre-pandemic blood samples collected in 2014-2016 and 536 blood…
September 23, 2020
Evaluation of Pooled Sample Analysis Strategy in Expediting Case Detection in Areas with Emerging Outbreaks of COVID-19: A Pilot Study
Pooling 5 nasopharyngeal or oropharyngeal samples during PCR testing would offer a reduction of laboratory turn-around time by 66% and the cost of diagnosis by 68%. However, the sensitivity was compromised, with 5 of the 109 pools showing discordant results when compared with individual results. Single samples with Ct value ³34 were likely to be…
Second Week Methyl-Prednisolone Pulses Improve Prognosis in Patients with Severe Coronavirus Disease 2019 Pneumonia: An Observational Comparative Study Using Routine Care Data
Receiving methyl-prednisolone pulses (MP) during the second week of COVID-19 disease was associated with lower risk of death or intubation in a study among 242 patient with severe COVID-19 pneumonia admitted at a university hospital in Spain (aHR=0.34, 95%CI 0.1-0.8). Ruiz-Irastorza et al. (Sept 22, 2020). Second Week Methyl-Prednisolone Pulses Improve Prognosis in Patients with…
September 22, 2020
Glucocorticoid Therapy Does Not Delay Viral Clearance in COVID-19 Patients
Glucocorticoid therapy did not change viral clearance or peripheral lymphocyte counts in patients with SARS-CoV-2 infection in a cohort study from two hospitals in China. Time to viral clearance among participants with severe or critical COVID-19 was 26 days in participants who received glucocorticoids (n=72) versus 25.5 days in participants who did not (n=108). In…
Kinetics of SARS-CoV-2 Specific Antibodies (IgM, IgA, IgG) in Non-Hospitalized Patients Four Months Following Infection
Levels of antibodies against SARS-CoV-2 were found to decline over an 18-week period following symptom onset, although antibodies remained detectable. Data from longitudinal profiles of different antibody immunoglobulin classes using tests with different antigens and neutralizing titers showed that receptor-binding-domain-specific (RBD) and nucleocapsid protein-specific (NCP) IgM as well as S1-specific IgA levels significantly decreased within…
A Prospective, Randomized, Open-Label Trial of Early versus Late Favipiravir in Hospitalized Patients with COVID-19
There was no significant difference in the rate of SARS-CoV-2 viral clearance between patients receiving early treatment with the anti-viral agent favipiravir and those receiving late treatment in a prospective, randomized, open-label, multicenter trial at 25 hospitals across Japan (aHR=1.42; 95%CI 0.76–2.62). Favipiravir did not significantly improve viral clearance as measured by RT-PCR by day…
Hydroxychloroquine as Pre-Exposure Prophylaxis for COVID-19 in Healthcare Workers a Randomized Trial
Pre-exposure prophylaxis with hydroxychloroquine once or twice weekly did not significantly reduce laboratory-confirmed COVID-19 or COVID-19-compatible illness among healthcare workers in a randomized, double-blind, placebo-controlled clinical trial. For once weekly hydroxychloroquine prophylaxis, the hazard ratio was 0.72 (95%CI 0.44 to 1.16) and for twice weekly it was 0.74 (95%CI 0.46 to 1.19), as compared with…
September 21, 2020
Value of Swab Types and Collection Time on SARS-COV-2 Detection Using RT-PCR Assay
Samples collected on swabs before washing in the morning had higher detection rates of SARS-CoV-2 than samples collected during afternoon on the same day in a study (n=48) completed in Hubei, China. Nasopharyngeal swab detection was 65% in the morning vs. 43% in afternoon, and oropharyngeal swab detection was 23% in morning vs. 8% in…
Factors Associated with Good Patient Outcomes Following Convalescent Plasma in COVID-19: A Prospective Phase II Clinical Trial
Of 38 hospitalized COVID-19 patients who received convalescent plasma in Connecticut and Massachusetts, 24 (63%) recovered and were discharged, and 14 (37%) died. Sixteen patients (42%) with severe illness who received plasma early in disease progression had lower mortality (13% vs. 55%, p<0.02) and shorter mean hospital length of stay (15.4 vs. 33 days, p<0.01)…
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