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Topic: Testing and Treatment
June 18, 2020
GLUCOCOVID A Controlled Trial of Methylprednisolone in Adults Hospitalized with COVID-19 Pneumonia
[pre-print, not peer reviewed] In a partially randomized open-label trial among patients hospitalized with COVID-19 pneumonia (n=85), methylprednisolone was associated with a reduced risk of death, ICU admission, or non-invasive ventilation (RR =0.55, 95% CI: 0.33-0.91). Corral et al. (June 18, 2020). GLUCOCOVID A Controlled Trial of Methylprednisolone in Adults Hospitalized with COVID-19 Pneumonia. Pre-print downloaded June 18 from https://doi.org/10.1101/2020.06.17.20133579
June 17, 2020
A Combined Oropharyngeal/Nares Swab Is a Suitable Alternative to Nasopharyngeal Swabs for the Detection of SARS-CoV-2
Paired oropharyngeal/nares (OP/Na) and nasopharyngeal (NP) samples were collected from 190 individuals with suspected COVID-19, of whom 36 were positive by at least one molecular method. There was high concordance of results between OP/Na and NP samples, with the greatest discordance observed in those individuals with low viral concentrations. LeBlanc et al. (July 2020). A Combined Oropharyngeal/Nares Swab Is a Suitable Alternative…
Potent Neutralizing Antibodies from COVID-19 Patients Define Multiple Targets of Vulnerability
Antibodies isolated from three convalescent COVID-19 patients were found to have strong neutralizing activity against SARS-CoV-2. Further analysis revealed several sites on the SARS-CoV-2 spike protein that could be targeted for vaccine development. Brouwer et al. (June 2020). Potent Neutralizing Antibodies from COVID-19 Patients Define Multiple Targets of Vulnerability. Science. https://doi.org/10.1126/science.abc5902
June 16, 2020
Severe Acute Respiratory Syndrome Coronavirus 2-Specific Antibody Responses in Coronavirus Disease 2019 Patients
Okba et al. validated two ELISA serologic assays for detection of SARS-CoV-2 antibodies. Among 3 PCR-confirmed SARS-CoV-2-cases with serial sample collection, they found that most seroconverted within 2 weeks of disease onset. They found that commercial spike protein subunit 1 IgG or IgA ELISAs had low specificity and sensitivity varied between the 2 assays (the IgA ELISA showed higher sensitivity). These results…
Severe Acute Respiratory Syndrome Coronavirus 2 Infection among Returnees to Japan from Wuhan, China, 2020
In January 2020, 566 Japanese nationals were repatriated from Wuhan, China and were monitored for 14 days following their return. Universal RT-PCR testing identified 12 cases of SARS-CoV-2 infection over this period. Entry screening only detected 7/12 cases, 2 of whom were symptomatic and 5 of whom were asymptomatic. Subsequent testing identified 5 additional cases among individuals…
Coronavirus breakthrough: dexamethasone is first drug shown to save lives
Researchers leading the RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial at Oxford University released a statement today distributed widely by media outlets indicating that their trial found that the steroid dexamethasone reduced deaths in ventilated patients (RR=0.65; 95% CI: 0.48, 0.88) and in other patients receiving oxygen only (RR=0.80; 95% CI: 0.67, 0.96). The trial has not been published, but was featured in a news article by the journal Nature cited…
June 15, 2020
First Clinical Use of Lenzilumab to Neutralize GM-CSF in Patients with Severe and Critical COVID-19 Pneumonia
[pre-print, not peer reviewed] Temesgen et al. reported the use of lenzilumab, an anti- GM-CSF monoclonal antibody, in 12 patients with severe COVID-19 pneumonia. Of the 12 treated patients, 11 (92%) patients had significantly improved clinical outcomes. There were no treatment-related adverse events and no deaths. Temesgen et al. (June 12, 2020). First Clinical Use of Lenzilumab to Neutralize GM-CSF in Patients with Severe…
Multiple Assays in a Real-Time RT-PCR SARS-CoV-2 Panel Can Mitigate the Risk of Loss of Sensitivity by New Genomic Variants during the COVID-19 Outbreak
Penarrubia et al. assessed the effect of accumulated genetic variability of SARS-CoV-2 on sensitivity of five SARS-CoV-2 PCR assays. A total of 11,627 (34%) genomes included single mutations that affected annealing of a PCR assay. Variations in 8,773 (26%) genomes were considered high risk, whereas an additional 2,854 (8.43%) genomes had single mutations that were not predicted affect sensitivity. Targeting more than one region in the viral genome…
Persistent Viral RNA Shedding after COVID‐19 Symptom Resolution in Older Convalescent Plasma Donors
Hartman et al. re-tested 86 patients within 28 days after self-reported symptom resolution to investigate SARS-CoV-2 clearance. They found persistent viral shedding in 11/86 (13%) participants at a median of 19 days (range 12-24 days) after symptom resolution. Participants with persistent shedding were significantly older (mean age 54 years vs. 42 years) and older people were more likely to have higher viral concentrations. These results may have…
Nasal-Swab Testing Misses Patients with Low SARS-CoV-2 Viral Loads
[pre-print, not peer reviewed] Callahan et al. compared results of nasal specimens under 3 transport conditions, traditional viral transport media (VTM), GITC transport medium, and dry swabs, to those of standard nasopharynx swabs collected at the same time among 308 individuals. They observed high concordance (Cohen’s kappa >0.8) only for patients with viral loads (VL) from the nasal samples >1000 copies/mL. There…
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