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Mix-and-match COVID vaccines: the case is growing, but questions remain


01 Jul 2021

A slew of studies suggests that mixing vaccines provokes potent immune responses, but scientists still want answers on real-world efficacy and rare side effects.


NIH Director's Blog: How Immunity Generated from COVID-19 Vaccines Differs from an Infection


22 Jun 2021

A key issue as we move closer to ending the pandemic is determining more precisely how long people exposed to SARS-CoV-2, the COVID-19 virus, will make neutralizing antibodies against this dangerous coronavirus. Finding the answer is also potentially complicated with new SARS-CoV-2 “variants of concern” appearing around the world that could find ways to evade acquired immunity, increasing the chances of new outbreaks.


Antibody-laden nasal spray could provide COVID protection — and treatment


04 Jun 2021

A nasal spritz of a designer antibody offers strong protection against variants of the coronavirus SARS-CoV-2 — at least in mice1. Since the early days of the pandemic, scientists have been developing antibodies as treatments for COVID-19. Today, several such antibodies are in late-stage clinical trials, and a handful have been approved for emergency use by regulatory agencies in the United States and elsewhere. Among doctors, however, antibody treatments have not been very popular, says Zhiqiang An, an antibody engineer at the University of Texas Health Science Center at Houston. That’s partly because those available are delivered through intravenous infusions rather than directly to the respiratory tract, where the virus is mainly found — so it takes high doses for them to be effective. Another challenge is the emergence of SARS-CoV-2 variants that seem to be resistant to some existing antibodies. An and his colleagues set out to engineer an antibody that could be delivered directly into the nose. They scanned a library of antibodies from healthy humans and zeroed in on those that were able to recognize a component of SARS-CoV-2 that the virus uses to latch on to and enter cells2. Among the promising candidates were IgG antibodies, which are relatively slow to appear after an infection but are precisely tailored to the invading pathogen. The team stitched IgG fragments targeting SARS-CoV-2 to a different type of molecule: IgM antibodies, which act as speedy first-responders to a broad range of infection. The engineered IgMs had a much stronger ‘neutralizing’ effect against more than 20 variants of SARS-CoV-2 than did the IgGs alone. When squirted into the noses of mice either six hours before or six hours after infection, the engineered IgMs sharply reduced the amount of virus in the rodents’ lungs two days after infection, the team reports in Nature1. This work is a “big feat of engineering”, says Guy Gorochov, an immunologist at Sorbonne University in Paris. But he adds that there are open questions, such as how long these antibodies will linger in humans. An envisions these antibodies as a kind of chemical mask that could be used by anyone who has been exposed to SARS-CoV-2, and as an extra line of defence for people who might not be fully protected by vaccines. Because IgM molecules are relatively stable, it might be feasible to formulate them into a nasal spray to be bought at a pharmacy and kept for emergency use, An adds. IGM Biosciences, a biotechnology company in Mountain View, California, that collaborated in An’s study, will test this antibody in clinical trials.


Moderna applies for full F.D.A. approval for its Covid vaccine.


02 Jun 2021

Moderna on Tuesday became the latest pharmaceutical company to apply to the U.S. Food and Drug Administration for full approval for its Covid-19 vaccine for use in people 18 and older. F.D.A. approval would allow the company to market the shot directly to consumers, and could also help raise public confidence in the vaccine.


Seven European countries begin issuing a digital Covid certificate for travel.


02 Jun 2021

A digital Covid certificate system intended to ease travel within the European Union became operational in seven countries on Tuesday — ahead of schedule — offering a preview of what could become a standard for post-pandemic global mobility.




Articles


Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection


25 May 2023

Key Points Question What symptoms are differentially present in SARS-CoV-2–infected individuals 6 months or more after infection compared with uninfected individuals, and what symptom-based criteria can be used to identify postacute sequelae of SARS-CoV-2 infection (PASC) cases? Findings In this analysis of data from 9764 participants in the RECOVER adult cohort, a prospective longitudinal cohort study, 37 symptoms across multiple pathophysiological domains were identified as present more often in SARS-CoV-2–infected participants at 6 months or more after infection compared with uninfected participants. A preliminary rule for identifying PASC was derived based on a composite symptom score. Meaning A framework for identifying PASC cases based on symptoms is a first step to defining PASC as a new condition. These findings require iterative refinement that further incorporates clinical features to arrive at actionable definitions of PASC.




11 clinical trials that will shape medicine in 2023


23 Dec 2022

2022 has been a rollercoaster year for biopharma, as it has faced an industry-wide slowdown and late-stage clinical trial failures, as well as breakthroughs and regulatory approvals. COVID-19 has continued to disrupt nearly all aspects of clinical trial infrastructure, from patient recruitment to supply chains, but despite this, 2023 promises to bring many new readouts from different branches of medicine (Table 1). Nature Medicine asked 11 leading experts for their top clinical trials to watch in the coming year




Association of Baseline Adherence to Antihypertensive Medications With Adherence After Shelter-in-Place Guidance for COVID-19 Among US Adults


20 Dec 2022

Question: Does baseline antihypertensive medication adherence identify individuals at risk for poor adherence during sheltering for COVID-19? Findings This cohort study assessed antihypertensive medication adherence as the proportion of days covered (PDC) from filled prescriptions claims for 6 months before and after COVID-19 sheltering guidance in a random sample of 27 318 US adults. Poor adherence (PDC < 50) during sheltering occurred in 73% with poor baseline adherence, 32% with fair baseline adherence (PDC 50-79), and 10% with good baseline adherence (PDC ≥ 80). These findings suggest that adherence-promoting interventions may be helpful irrespective of sheltering for poor baseline adherence and during sheltering for fair baseline adherence.




Changes in the Relationship Between Income and Life Expectancy Before and During the COVID-19 Pandemic, California, 2015-2021


07 Jul 2022

Key Points Question How did the first 2 years of the COVID-19 pandemic affect life expectancy in California and the relationship between census tract income and life expectancy relative to prepandemic years? Findings In this retrospective analysis of 1 988 606 deaths in California during 2015 to 2021, life expectancy declined from 81.40 years in 2019 to 79.20 years in 2020 and 78.37 years in 2021. Life expectancy differences between the census tracts in the highest and lowest income percentiles increased from 11.52 years in 2019 to 14.67 years in 2020 and 15.51 years in 2021. Meaning This ecological study of deaths in the state of California demonstrated that life expectancy declines in 2020 increased in 2021 and that the life expectancy gap by income level increased during the first 2 years of the COVID-19 pandemic relative to the pre-pandemic period.




Four Vaccine Doses Prevented Severe Omicron COVID-19 Better Than 3


10 May 2022

Older patients in Israel who received a fourth dose of the BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine were more than 3 times less likely to develop severe COVID-19 than those who received only 3 doses. But while protection against severe disease did not wane during the testing period, protection against confirmed infection appeared short-lived.




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