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<title>29 August, 2021</title>
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<title>Covid-19 Sentry</title><meta content="width=device-width, initial-scale=1.0" name="viewport"/><link href="styles/simple.css" rel="stylesheet"/><link href="../styles/simple.css" rel="stylesheet"/><link href="https://unpkg.com/aos@2.3.1/dist/aos.css" rel="stylesheet"/><script src="https://unpkg.com/aos@2.3.1/dist/aos.js"></script></head>
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<h1 data-aos="fade-down" id="covid-19-sentry">Covid-19 Sentry</h1>
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<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
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<li><a href="#from-preprints">From Preprints</a></li>
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<li><a href="#from-clinical-trials">From Clinical Trials</a></li>
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<li><a href="#from-pubmed">From PubMed</a></li>
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<li><a href="#from-patent-search">From Patent Search</a></li>
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<h1 data-aos="fade-right" id="from-preprints">From Preprints</h1>
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<li><strong>Early immune responses have long-term associations with clinical, virologic, and immunologic outcomes in patients with COVID-19</strong> -
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The great majority of SARS-CoV-2 infections are mild and uncomplicated, but some individuals with initially mild COVID-19 progressively develop more severe symptoms. Furthermore, mild to moderate infections are an important contributor to ongoing transmission. There remains a critical need to identify host immune biomarkers predictive of clinical and virologic outcomes in SARS-CoV-2-infected patients. Leveraging longitudinal samples and data from a clinical trial of Peginterferon Lambda for treatment of SARS-CoV-2 infected outpatients, we used host proteomics and transcriptomics to characterize the trajectory of the immune response in COVID-19 patients within the first 2 weeks of symptom onset. We define early immune signatures, including plasma levels of RIG-I and the CCR2 ligands (MCP1, MCP2 and MCP3), associated with control of oropharyngeal viral load, the degree of symptom severity, and immune memory (including SARS-CoV-2-specific T cell responses and spike (S) protein-binding IgG levels). We found that individuals receiving BNT162b2 (Pfizer-BioNTech) vaccine had similar early immune trajectories to those observed in this natural infection cohort, including the induction of both inflammatory cytokines (e.g. MCP1) and negative immune regulators (e.g. TWEAK). Finally, we demonstrate that machine learning models using 8-10 plasma protein markers measured early within the course of infection are able to accurately predict symptom severity, T cell memory, and the antibody response post- infection.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.27.21262687v1" target="_blank">Early immune responses have long- term associations with clinical, virologic, and immunologic outcomes in patients with COVID-19</a>
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<li><strong>Child and caregiver mental health during COVID-19</strong> -
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There are urgent calls for research into the mental health consequences of living through the COVID-19 pandemic. We describe caregiver and child mental health over 12 months using Australia9s only nationally representative, repeated cross-sectional survey of caregivers with children (0-17 years). N=2020 caregivers in June 2020, N=1434 in September 2020, and N=2508 in July 2021 provided data. Caregivers rated their mental health (Kessler-6), and impacts of the pandemic on their own and their children9s mental health. Data were weighted using national distribution of age, gender, number of children, state/territory and neighbourhood-level disadvantage. Mental health measures worsened over time. There was an unequal distribution of impacts based on caregiver gender, child age and family socioeconomic characteristics. Negative impacts were more common with current or cumulative lockdown. The indirect impacts of COVID-19 are real and concerning. Mental health must be central to the immediate and ongoing pandemic responses for families and children.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.26.21262708v1" target="_blank">Child and caregiver mental health during COVID-19</a>
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<li><strong>Previous Infection Combined with Vaccination Produces Neutralizing Antibodies With Potency Against SARS-CoV-2 Variants</strong> -
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SARS-CoV-2 continues to evolve in humans. Spike protein mutations increase transmission and potentially evade antibodies raised against the original sequence used in current vaccines. Our evaluation of serum neutralizing activity in both persons soon after SARS-CoV-2 infection (in April 2020 or earlier) or vaccination without prior infection confirmed that common spike mutations can reduce antibody antiviral activity. However, when the persons with prior infection were subsequently vaccinated, their antibodies attained an apparent biologic ceiling of neutralizing potency against all tested variants, equivalent to the original spike sequence. These findings indicate that additional antigenic exposure further improves antibody efficacy against variants.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.27.21262744v1" target="_blank">Previous Infection Combined with Vaccination Produces Neutralizing Antibodies With Potency Against SARS-CoV-2 Variants</a>
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<li><strong>Highly valued despite burdens: qualitative implementation research on rapid tests for hospital-based SARS-CoV-2 screening</strong> -
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Antigen-based rapid diagnostic tests (RDTs) for SARS-CoV-2 have good reliability and have been repeatedly implemented as part of pandemic response policies, especially for screening in high-risk settings (e.g., hospitals and care homes) where fast recognition of an infection is essential, but evidence from actual implementation efforts is lacking. We conducted a prospective qualitative study at a large tertiary care hospital in Germany where RDTs are used to screen incoming patients. We relied on semi-structured observations of the screening situation, as well as on 30 in- depth interviews with hospital staff (members of the regulatory body, department heads, staff working on the wards, staff training providers on how to perform RDTs, and providers performing RDTs as part of the screening) and patients being screened with RDTs. Despite some initial reservations, RDTs were rapidly accepted and adopted as the best available tool for accessible and reliable screening. Decentralized implementation efforts resulted in different procedures being operationalized across departments. Procedures were continuously refined based on initial experiences (e.g., infrastructural or scheduling constraints), pandemic dynamics (growing infection rates), and changing regulations (e.g., screening of all external personnel). To reduce interdepartmental tension, stakeholders recommended high-level, consistently communicated and enforced regulations. Despite challenges, RDT-based screening for all incoming patients was observed to be feasible and acceptable among implementers and patients, and merits continued consideration in the context of rising infections and stagnating vaccination rates.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.27.21262660v1" target="_blank">Highly valued despite burdens: qualitative implementation research on rapid tests for hospital-based SARS-CoV-2 screening</a>
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<li><strong>COVID-19 infection among health care workers: Experience in Base Hospital Wathupitiwala,Sri Lanka.</strong> -
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Abstract: Coronavirus disease 2019 (COVID-19) is a serious global health pandemic resulting in high mortality and morbidity. Frontline health care workers (HCWs) are at an increased risk of the acquisition of severe acute respiratory syndrome coronavirus-2 infection (SARS CoV-2) due to their close interaction with infected patients (1, 2). Also, HCWs can serve as reservoirs of SARS CoV-2 cross-transmission both in community and hospital settings (1). However, the extent of COVID-19 infection among HCWs in Sri Lanka is understudied. Objectives: This study determined the incidence, demographic characteristics, and risk exposure behavior of HCWs who tested positive for SARS CoV-2 at Base Hospital Wathupitiwala. Furthermore, the rate of acquisition of SARS CoV-2 following COVISHIELD/ChAdOx1 nCoV-19 and Sinopharm /BBIBP-CorV vaccines in HCWs were studied. Methods: A retrospective cross-sectional descriptive analysis was conducted from May 2021 to August 2021 for a total of 818 HCWs. Results: Hundred and twenty-four HCWs (15.16%) were tested positive for COVID-19. The mean age of infected HCWs was 46.27 years and the majority were females (74.19%). Among all infected persons, 54 (43.55%) were nurses/midwives, 39 (31.45%) were clinical supportive staff and 12(9.68%) were medical officers. The number of infected HCWs rapidly escalated and a total of 64(51.61%) HCWs got an infection during August/2021. No source was identified in most of them (34.68%) followed by community acquisition (33.87%). Thirty-five HCWs (28.23%) had acquired infection during a hospital setting or had a high-risk exposure in recent history. Among hospital-related infections, 37.91% of HCWs had shared meals or shared sleeping rooms with an infected workmate. The majority of the HCWs were tested by the infection control unit as symptomatic screening (70.16%) followed by contact tracing (20.16%). Fifty-six (45.16%) HCWs had a history of single or multiple comorbidities. The vast majority of HCWs (95.97%) presented as mild to asymptomatic disease that followed an uneventful recovery. Body aches, headache, fever, and sore throat were the most commonly reported symptoms among them. Among the five HCWs required therapeutic oxygen supplementation, two unvaccinated HCWs succumbed to the infection. The rate of breakthrough infection among HCWs was 8.93%. The acquisition of disease was significantly higher among unvaccinated HCWs than partially (p<0.0001) or fully vaccinated (p<0.0001) HCWs with either type of vaccine. Conclusions: Protecting HCWs remains a challenge in resource-poor settings. The risk of infection fueled by very contagious circulating variants is continuously high even though vaccination has shown clear benefits in preventing mortality and severe infection. Therefore, all healthcare workers should be vaccinated while ensuring continuous infection control measures in the hospital setting.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.28.21262733v1" target="_blank">COVID-19 infection among health care workers: Experience in Base Hospital Wathupitiwala,Sri Lanka.</a>
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<li><strong>Direct Comparison of Antibody Responses to Four SARS-CoV-2 Vaccines in Mongolia</strong> -
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Different vaccines for SARS-CoV-2 are approved in various countries, but few direct comparisons of the antibody responses they stimulate have been reported. We collected plasma specimens in July 2021 from 196 Mongolian participants fully vaccinated with one of four Covid vaccines: Pfizer/BioNTech, AstraZeneca, Sputnik V and Sinopharm. Functional antibody testing with a panel of nine SARS-CoV-2 viral variant RBD proteins reveal marked differences in the vaccine responses, with low antibody levels and RBD-ACE2 blocking activity stimulated by the Sinopharm and Sputnik V vaccines in comparison to the AstraZeneca or Pfizer/BioNTech vaccines. The Alpha variant caused 97% of infections in Mongolia in June and early July 2021. Individuals who recover from SARS-CoV-2 infection after vaccination achieve high antibody titers in most cases. These data suggest that public health interventions such as vaccine boosting, potentially with more potent vaccine types, may be needed to control the COVID-19 pandemic in Mongolia and worldwide.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.22.21262161v1" target="_blank">Direct Comparison of Antibody Responses to Four SARS-CoV-2 Vaccines in Mongolia</a>
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<li><strong>Behavioural barriers to COVID-19 testing in Australia: Two national surveys to identify barriers and estimate prevalence by health literacy level</strong> -
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Background: COVID-19 testing and contact tracing has been crucial in Australia9s prevention strategy. However, testing for COVID-19 is far from optimal, and behavioural barriers are unknown. Study 1 aimed to identify the range of barriers to testing. Study 2 aimed to estimate prevalence in a nationally relevant sample to target interventions. Methods: Study 1: National longitudinal COVID-19 survey from April-November 2020. Testing barriers were included in the June survey (n=1369). Open responses were coded using the COM-B framework (capability-opportunity-motivation). Study 2: Barriers from Study 1 were presented to a new nationally representative sample in November to estimate prevalence (n=2869). Barrier prevalence was analysed by health literacy level using Chi square tests. Results: Study 1: 49% strongly agreed to get tested for symptoms, and 69% would self-isolate. Concern about pain was the top barrier from a provided list (11%), but 32 additional barriers were identified from open responses and coded to the COM-B framework. Study 2: The most prevalent barriers were motivation issues (e.g. don9t believe symptoms are COVID-19: 28%, few local cases: 18%). Capability issues were also common (e.g. not sure symptoms are bad enough: 19%, not sure whether symptoms need testing: 15%). Many barriers were more prevalent amongst people with low compared to high health literacy, including motivation (preference to self isolate: 21% vs 12%, pain: 15% vs 9%) and capability (not sure symptom needs testing: 12% vs 8%, not sure how to test:11% vs 4%). Conclusion: Even in a health system with free and widespread access to COVID-19 testing, motivation and capability barriers were prevalent issues, particularly for people with lower health literacy. This study highlights the important of diagnosing behaviour barriers to target public health interventions for COVID-19 and future pandemics.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.26.21262649v1" target="_blank">Behavioural barriers to COVID-19 testing in Australia: Two national surveys to identify barriers and estimate prevalence by health literacy level</a>
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<li><strong>LESSONS FROM THE COVID-19 THIRD WAVE IN CANADA: THE IMPACT OF VARIANTS OF CONCERN AND SHIFTING DEMOGRAPHICS</strong> -
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Importance: With the emergence of more transmissible SARSCoV2 variants of concern (VOC), there is an urgent need for evidence about disease severity and the health care impacts of VOC in North America, particularly since a substantial proportion of the population have declined vaccination thus far. Objective: To examine 30day outcomes in Canadians infected with SARSCoV2 in the first year of the pandemic and to compare event rates in those with VOC versus wild type infection. Design: Retrospective cohort study using linked healthcare administrative datasets. Setting: Alberta and Ontario, the two Canadian provinces that experienced the largest third wave in the spring of 2021. Participants: All individuals with a positive SARSCoV2 reverse transcriptase polymerase chain reaction swab from March 1, 2020 until March 31, 2021, with genomic confirmation of VOC screen positive tests during February and March 2021 (wave 3). Exposure of Interest: VOC versus wild type SARSCoV2 Main Outcomes and Measures: All-cause hospitalizations or death within 30 days after a positive SARSCoV2 swab. Results: Compared to the 372,741 individuals with SARSCoV2 infection between March 2020 and January 2021 (waves 1 and 2 in Canada), there was a shift in transmission towards younger patients in the 104,232 COVID19 cases identified in wave 3. As a result, although third wave patients were more likely to be hospitalized (aOR 1.34 [1.29 to 1.39] in Ontario and aOR 1.53 [95%CI 1.41 to 1.65] in Alberta), they had shorter lengths of stay (median 5 vs. 7 days, p<0.001) and were less likely to die within 30 days (aOR 0.66 [0.60 to 0.71] in Ontario and aOR 0.74 [0.62 to 0.89] in Alberta). However, within the third wave, patients infected with VOC (91% Alpha) exhibited higher risks of death (aOR 1.52 [1.27 to 1.81] in Ontario and aOR 1.67 [1.13 to 2.48] in Alberta) and hospitalization (aOR 1.57 [1.47 to 1.69] in Ontario and aOR 1.88 [1.74 to 2.02] in Alberta) than those with wild- type SARSCoV2 infections during the same timeframe. Conclusions and Relevance: On a population basis, the shift towards younger age groups as the COVID19 pandemic has evolved translates into more hospitalizations but shorter lengths of stay and lower mortality risk than seen in the first 10 months of the pandemic in Canada. However, on an individual basis, infection with a VOC is associated with a higher risk of hospitalization or death than the original wild type SARSCoV2; this is important information to address vaccine hesitancy given the increasing frequency of VOC infections now.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.27.21261857v1" target="_blank">LESSONS FROM THE COVID-19 THIRD WAVE IN CANADA: THE IMPACT OF VARIANTS OF CONCERN AND SHIFTING DEMOGRAPHICS</a>
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<li><strong>COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. PUBLISHED VERSION: https://doi.org/10.1186/s12879-021-06357-4</strong> -
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Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk (“Emmentaler cheese model”), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.
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🖺 Full Text HTML: <a href="https://osf.io/k2d84/" target="_blank">COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. PUBLISHED VERSION: https://doi.org/10.1186/s12879-021-06357-4</a>
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<li><strong>Implementation of a Web-Based Symptom Checker to Manage the Quarantine of the USS Theodore Roosevelt Crew Following a Shipboard Outbreak of SARS-CoV-2</strong> -
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Introduction: In late March 2020, the USS Theodore Roosevelt (TR), a nuclear-powered aircraft carrier, pulled into port in the US territory of Guam to assess the severity of a developing outbreak of COVID-19 aboard the ship. A small staff contingent of 60 personnel from US Naval Hospital (USNH) Guam was tasked with the medical care of 4,079 sailors who were placed in single room quarantine amongst 11 hotels across the island of Guam. With the assistance of the Defense Digital Service, the USNH Guam staff implemented a web-based symptom checker, which allowed for monitoring of developing COVID symptoms, and selective testing of symptomatic individuals. Materials and Methods: Sailors from the TR were placed in quarantine or isolation cohorts upon debarking the ship. Sailors not positive for COVID-19 were quarantined amongst 11 hotels on Guam. Sailors positive for COVID-19 were isolated aboard Naval Base Guam (NBG). A retrospective cohort analysis and subgroup analyses were performed on symptom data obtained from sailors in quarantine. The sailors recorded their symptoms and temperature in a web-based symptom checker that assigned a symptom severity score (SSS). Sailors with a SSS >50 were evaluated by a medical provider and re-tested. Data were collected from 4 April 2020 to 1 May 2020. Sailors required two negative tests to exit quarantine and re-embark the ship. The time course, and most common cluster of symptoms associated with a positive COVID-19 PCR test were determined retrospectively after data collection. Results: The web-based symptom checker was successful in establishing daily positive contact and symptom monitoring of susceptible individuals in quarantine. 4,079 sailors in quarantine maintained positive contact with medical staff via the symptom checker, with at least 81% of the sailors recording their symptoms on a daily basis. Individuals with high symptom scores were quickly identified and underwent further evaluation and repeat COVID-19 testing. A cohort of 331 sailors tested positive for COVID-19 while in quarantine and recorded symptoms in the symptom checker before and after a positive COVID-19 test. In this cohort, the most frequent symptoms reported prior to a positive test were headache, anosmia, followed by cough. The symptom of anosmia was reported more frequently in sailors positive for COVID-19, compared to a cohort of matched controls. A small medical staff was able to monitor developing symptoms in a large quarantined population, while efficiently allocating resources, preserving personal protective equipment (PPE), and maintaining isolation and social distancing protocols. Conclusions and Relevance: The application provided a tool for broad health surveillance over a large population while maintaining strict quarantine and social distancing protocols. Highly symptomatic sailors were quickly identified, triaged, and transferred to a higher level of care if indicated. The symptom checker and predictive model generated from the data can be utilized by military and civilian public health officials to triage large populations and make rapid decisions on isolation measures, resource allocation, selective testing.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.25.21254738v1" target="_blank">Implementation of a Web-Based Symptom Checker to Manage the Quarantine of the USS Theodore Roosevelt Crew Following a Shipboard Outbreak of SARS- CoV-2</a>
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<li><strong>Effectiveness of vaccination against symptomatic and asymptomatic SARS-CoV-2 infection: a systematic review and meta-analysis</strong> -
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OBJECTIVE: To assess the effectiveness of SARS-CoV-2 vaccines in terms of prevention of disease and transmission. The evaluation was narrowed to two mRNA vaccines and two modified adenovirus vectored vaccines. METHODS: A frequentist random effects meta-analysis was carried out after data extraction. Risk of bias of the included studies was assessed using New-Castle-Ottawa Scale. The overall risk of SARS-CoV-2 infection confirmed by real time Polymerase Chain Reaction (PCR) was estimated in partially and fully vaccinated individuals. The effect size was expressed as Relative Risk (RR) and RRR (RR reduction) of SARS-CoV-2 infection after vaccination. Potential sources of heterogeneity were investigated through between-study heterogeneity analysis and subgroup meta-analysis. RESULTS: The systematic review identified 27 studies eligible for the quantitative synthesis. Partially vaccinated individuals presented a RRR=73% (95%CI=59%-83%) for any positive SARS-CoV-2 PCR (RR=0.27) and a RRR=79% (95%CI=30%-93%) for symptomatic SARS-CoV-2 PCR (RR=0.21). Fully vaccinated individuals showed a RRR=94% (95%CI=88%-98%) for any SARS-CoV-2 positive PCR (RR=0.06) compared to unvaccinated. According to the subgroup meta-analysis, full BNT162b2 vaccination protocol achieved a RRR=84%-94% against any SARS-CoV-2 positive PCR and a RRR=68%-84% against symptomatic positive PCR. The RR for any SARS-CoV-2 positive PCR remained higher within elderly groups aged ≥69 years (RR=0.12-0.15) compared to younger individuals (RR=0.05-0.12). The RR against B.1.351 infection approached 0.40 for any positive PCR and 0.36 for symptomatic SARS-COV-2 while the RR of any B.1.1.7 infection was 0.14. CONCLUSION: The current licensed vaccines may be transmission blocking, especially after full vaccination protocol. Given the substantial heterogeneity, results should be interpreted with caution. Subgroups meta-analyses suggested that the risk of any SARS-CoV-2 infection may be higher for non-B.1.1.7 variants and individuals aged ≥69 years. Further data and longer follow-up are required to investigate additional sources of heterogeneity and the effectiveness of SARS-CoV-2 vaccination within population subgroups.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.25.21262529v1" target="_blank">Effectiveness of vaccination against symptomatic and asymptomatic SARS-CoV-2 infection: a systematic review and meta-analysis</a>
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</div></li>
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<li><strong>Socioeconomic and comorbid factors affecting mortality and length of stay in COVID-19</strong> -
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Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic exposed and exacerbated health disparities between socioeconomic groups. Our purpose was to determine which disparities are most prevalent and their impact on length of stay (LoS) and in hospital mortality in patients diagnosed with Covid-19. Methods De- Identified data for patients who tested positive for COVID-19 was abstracted from the HCA enterprise database. Data was binned into summary tables. A negative binomial regression with LoS as the dependent variable and a logistic regression of in-hospital mortality data, using age, insurance status, sex, comorbidities as the dependent variables, were performed. Results From March 1, 2020 to August 23, 2020, of 111,849 covid testing patient records, excluding those with missing data (n=7), without confirmed COVID-19 (n=27,225), and those from a carceral environment (n=1,861), left 84,624 eligible patients. Compared to the US population, the covid cohort had more black patients (23.17% vs 13.4%). Compared to the white cohort, the black cohort had higher private insurance rates (28.52% vs. 23.68%), shorter LoS (IRR=0.97 CI=0.95-0.99, P<0.01) and lower adjusted mortality (OR 0.81, 95% CI 0.75-0.97). Increasing age was associated with increased mortality and LoS. Patients with Medicare or Medicaid had longer LoS (IRR=1.07, 95% CI=1.04-1.09) and higher adjusted mortality rates (OR=1.11, 95% CI=1-1.23) than those with private insurance Conclusion Conclusions We found that when blacks have higher rates of private insurance, they have shorter hospitalizations and lower mortality than whites, when diagnosed with Covid-19. Some other psychiatric and medical conditions also significantly impacted outcomes in patients with Covid-19.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.26.21262693v1" target="_blank">Socioeconomic and comorbid factors affecting mortality and length of stay in COVID-19</a>
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</div></li>
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<li><strong>Association between tocilizumab, sarilumab and all-cause mortality at 28 days in hospitalized patients with COVID-19: A network meta-analysis</strong> -
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Objective: To estimate pairwise associations between administration of tocilizumab, sarilumab and usual care or placebo with 28-day mortality, in COVID-19 patients receiving concomitant corticosteroids and non-invasive or mechanical ventilation, based on all available direct and indirect evidence. Methods: Eligible trials randomized hospitalized patients with COVID-19 that compared either interleukin-6 receptor antagonist with usual care or placebo in a recent prospective meta-analysis (27 trials, 10930 patients) or that directly compared tocilizumab with sarilumab. Data were restricted to patients receiving corticosteroids and either non-invasive or invasive ventilation at randomization. Pairwise associations between tocilizumab, sarilumab and usual care or placebo for all-cause mortality 28 days after randomization were estimated using a frequentist contrast-based network meta-analysis of odds ratios (ORs), implementing multivariate fixed-effects models that assume consistency between the direct and indirect evidence. Results: One trial (REMAP-CAP) was identified that directly compared tocilizumab with sarilumab and supplied results on all-cause mortality at 28-days. This network meta-analysis was based on 898 eligible patients (278 deaths) from REMAP-CAP and 3710 eligible patients from 18 trials (1278 deaths) from the prospective meta-analysis. Summary ORs were similar for tocilizumab [0.82 [0.71-0.95, P=0.008]] and sarilumab [0.80 [0.61-1.04, P=0.09]] compared with usual care or placebo. The summary OR for 28-day mortality comparing tocilizumab with sarilumab was 1.03 [95%CI 0.81-1.32, P=0.80]. The P value for the global test for inconsistency was 0.28. Conclusion: Administration of either tocilizumab or sarilumab was associated with lower 28-day all-cause mortality compared with usual care or placebo. The association is not dependent on the choice of interleukin-6 receptor antagonist.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.26.21262523v1" target="_blank">Association between tocilizumab, sarilumab and all-cause mortality at 28 days in hospitalized patients with COVID-19: A network meta- analysis</a>
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</div></li>
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<li><strong>Profile of Mucormycosis Cases from a Network of Hospitals in North India Amidst COVID-19 Pandemic</strong> -
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Incidence of mucormycosis suddenly surged in India after the second wave of COVID-19. This is a crippling disease and needs to be studied in detail to understand the disease, its course, and the outcomes. Between 1st March and 15th July 2021, our network of hospitals in North India received a total of 155 cases of COVID-associated mucormycosis cases as all of them reported affliction by COVID-19 earlier or concurrent. Their records were retrieved from the Electronic Health Records system of the hospitals and their demographics, clinical features, treatments, and outcomes were studied. More than 80% (125 cases) had proven disease and the remaining 30 were categorized as possible mucormycosis as per the EORTC criteria. More than two-thirds (69.0%) of the cases were males and the mean age was 53 years for either sex. Nearly two-thirds (64.5%) had symptoms of nose and jaws and 42.6% had eye involvement. Some had multiple symptoms. As many as 78.7% had diabetes and 91.6% gave history of use of steroids during COVID-19 treatment. The primary surgery was functional endoscopic sinus surgery (FESS) (83.9%). Overall mortality was 16.8%, which is one- and-a-half times the mortality in hospitalized COVID-19 patients in the corresponding population. Occurrence of mucormycosis was associated with diabetes and use of steroids, but mortality was not associated with either of them. Cases undergoing surgery and on antifungal had steeply lower mortality (11.9% vs. 50.0%, P < 0.001) than those who were exclusively on antifungal drugs. Treatment by different drugs did not make much of a difference in mortality.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.25.21262404v1" target="_blank">Profile of Mucormycosis Cases from a Network of Hospitals in North India Amidst COVID-19 Pandemic</a>
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</div></li>
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<li><strong>Clinical Evaluation of the Novel Rapid Nucleic Acid Amplification Point-of-Care Test (Smart Gene SARS-CoV-2) in the analysis of Nasopharyngeal and Anterior Nasal samples.</strong> -
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Introduction Smart Gene is a point-of-care (POC)-type automated molecular testing platform that can be performed with 1 minute of hands-on-time. Smart Gene SARS-CoV-2 is a newly developed Smart Gene molecular assay for the detection of SARS-CoV-2. The analytical and clinical performance of Smart Gene SARS-CoV-2 has not been evaluated. Methods Nasopharyngeal and anterior nasal samples were prospectively collected from subjects referred to the local PCR center from March 25 to July 5, 2021. Two swabs were simultaneously obtained for the Smart Gene SARS-CoV-2 assay and the reference real-time RT-PCR assay, and the results of Smart Gene SARS-CoV-2 were compared to the reference real-time RT- PCR assay. Results Among a total of 1150 samples, 68 of 791 nasopharyngeal samples and 51 of 359 anterior nasal samples were positive for SARS-CoV-2 in the reference real-time RT-PCR assay. In the testing of nasopharyngeal samples, Smart Gene SARS-CoV-2 showed the total, positive and negative concordance of 99.2% (95% confidence interval [CI]: 98.4–99.7%), 94.1% (95% CI: 85.6–98.4%) and 99.7% (95% CI: 99.0–100%), respectively. For anterior nasal samples, Smart Gene SARS- CoV-2 showed the total, positive and negative concordance of 98.9% (95% CI: 97.2–99.7%), 98.0% (95% CI: 89.6–100%) and 99.0% (95% CI: 97.2–99.8%), respectively. In total, 5 samples were positive in the reference real-time RT-PCR and negative in Smart Gene SARS-CoV-2, whereas 5 samples were negative in the reference real-time RT-PCR and positive in Smart Gene SARS-CoV-2. Conclusion Smart Gene SARS-CoV-2 showed sufficient analytical performance for the detection of SARS-CoV-2 in nasopharyngeal and anterior nasal samples.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2021.08.25.21262583v1" target="_blank">Clinical Evaluation of the Novel Rapid Nucleic Acid Amplification Point-of-Care Test (Smart Gene SARS-CoV-2) in the analysis of Nasopharyngeal and Anterior Nasal samples.</a>
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</div></li>
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<h1 data-aos="fade-right" id="from-clinical-trials">From Clinical Trials</h1>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Phase III Study to Evaluate the Efficacy and Safety of Proxalutamide (GT0918) in Hospitalized Subjects With COVID-19</strong> - <b>Condition</b>: Covid19<br/><b>Interventions</b>: Drug: GT0918; Drug: Standard of care; Drug: Matching placebo<br/><b>Sponsor</b>: Suzhou Kintor Pharmaceutical Inc,<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Study of PF-07321332/Ritonavir in Non-hospitalized Low-Risk Adult Participants With COVID-19</strong> - <b>Condition</b>: COVID-19<br/><b>Interventions</b>: Drug: PF-07321332; Drug: Ritonavir; Drug: Placebo<br/><b>Sponsor</b>: Pfizer<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Targeting de Novo Pyrimidine Biosynthesis by Leflunomide for the Treatment of COVID-19 Virus Disease</strong> - <b>Condition</b>: COVID-19<br/><b>Intervention</b>: Drug: leflunomide<br/><b>Sponsor</b>: <br/>
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Ashford and St. Peter’s Hospitals NHS Trust<br/><b>Active, not recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Andrographis Paniculata vs Boesenbergia Rotunda vs Control in Asymptomatic COVID-19</strong> - <b>Condition</b>: Covid19<br/><b>Interventions</b>: Drug: Andrographis Paniculata; Drug: Boesenbergia; Other: Standard supportive treatment<br/><b>Sponsors</b>: Mahidol University; Ministry of Health, Thailand<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Efficacy of PJS-539 for Adult Patients With COVID-19.</strong> - <b>Conditions</b>: Covid19; COVID-19 Pneumonia<br/><b>Interventions</b>: Drug: PJS-539 Dose 1; Drug: PJS-539 Dose 2; Drug: Placebo<br/><b>Sponsors</b>: Hospital do Coracao; Covicept<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Enhancing COVID Rehabilitation With Technology</strong> - <b>Condition</b>: Covid19<br/><b>Interventions</b>: Behavioral: NexJ Connected Wellness; Other: Usual Care<br/><b>Sponsors</b>: University of Ottawa; Canadian Institutes of Health Research (CIHR); Ottawa Hospital Research Institute<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Phase I/II Clinical Trial of Recombinant COVID-19 Vaccine (Sf9 Cells) in Children and Adolescents</strong> - <b>Condition</b>: COVID-19<br/><b>Interventions</b>: Biological: Recombinant COVID-19 vaccine (Sf9 cells); Other: Placebo control<br/><b>Sponsors</b>: WestVac Biopharma Co., Ltd.; West China Hospital<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Treatment of Covid-19 With a Herbal Compound, Xagrotin</strong> - <b>Condition</b>: Covid19<br/><b>Intervention</b>: Combination Product: Xagrotin<br/><b>Sponsors</b>: <br/>
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Biomad AS; Directorate of health of Sulaimani, Iraq -KRG<br/><b>Completed</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Philippine Trial to Determine Efficacy and Safety of Favipiravir for COVID-19</strong> - <b>Condition</b>: Covid19<br/><b>Interventions</b>: Combination Product: Favipiravir + Standard of Care; Procedure: Standard of Care<br/><b>Sponsors</b>: University of the Philippines; Department of Health, Philippines<br/><b>Recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of the Effects of Bradykinin Antagonists on Pulmonary Manifestations of COVID-19 Infections (AntagoBrad- Cov Study).</strong> - <b>Condition</b>: Covid19<br/><b>Interventions</b>: Drug: C1 Inhibitor Human; Drug: Icatibant Injection; Other: Placebo<br/><b>Sponsor</b>: GCS Ramsay Santé pour l’Enseignement et la Recherche<br/><b>Completed</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Combination of Dietary Supplements Curcumin, Quercetin and Vitamin D for Early Symptoms of COVID-19</strong> - <b>Condition</b>: Covid19<br/><b>Interventions</b>: Drug: Standard of care; Dietary Supplement: combination of curcumin, quercetin and Vitamin D<br/><b>Sponsor</b>: Ayub Teaching Hospital<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of Safety and Immunogenicity of a Novel Vaccine for Prevention of Covid-19 in Adults Previously Immunized</strong> - <b>Condition</b>: Covid19<br/><b>Intervention</b>: Biological: A vaccine composed of a recombinant S1 antigen<br/><b>Sponsors</b>: Hospital do Coracao; Farmacore Biotecnologia Ltda<br/><b>Withdrawn</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Preventive Dendritic Cell Vaccine, AV-COVID-19, in Subjects Not Actively Infected With COVID-19</strong> - <b>Condition</b>: COVID-19<br/><b>Intervention</b>: Biological: AV-COVID-19<br/><b>Sponsors</b>: <br/>
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Aivita Biomedical, Inc.; PT AIVITA Biomedika Indonesia; Kariadi Hospital; Central Army Hospital RSPAD Gatot Soebroto<br/><b>Completed</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Phase 3 Clinical Study Evaluating Nitric Oxide Nasal Spray (NONS) Efficacy To Treat and Prevent the Exacerbation of Infection in Individuals With Documented Asymptomatic or Mild COVID-19</strong> - <b>Condition</b>: Covid19<br/><b>Intervention</b>: Drug: to be given as a treatment<br/><b>Sponsor</b>: <br/>
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Salmaniya Medical Complex<br/><b>Recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Phase I Study to Determine Safety and Immunogenicity of the Candidate COVID-19 Vaccine AZD1222 Delivered by Aerosol in Healthy Adult Volunteers</strong> - <b>Conditions</b>: Covid19; SARS-CoV-2 Infection<br/><b>Interventions</b>: Biological: 1x10^9 vp AZD1222; Biological: 5x10^9 vp AZD1222; Biological: 1x10^10 vp AZD1222<br/><b>Sponsors</b>: Imperial College London; University of Oxford; AstraZeneca<br/><b>Not yet recruiting</b></p></li>
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</ul>
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<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
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<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
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<ul>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Anti-Sars-Cov-2 Neutralizing Antibodies</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU333857732">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Expression Vector for Anti-Sars-Cov-2 Neutralizing Antibodies</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU333857737">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>DEVELOPMENT OF CNN SCHEME FOR COVID-19 DISEASE DETECTION USING CHEST RADIOGRAPH</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU333857177">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>SARS-COV-2 BINDING PROTEINS</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU333402004">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A PROCESS FOR PREPARING MONTELUKAST SODIUM FOR TREATING COVID 19 PATIENTS</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU333857132">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>IDENTIFICATION OF ANTI-COVID 19 AGENT SOMNIFERINE AS INHIBITOR OF MPRO & ACE2-RBD INTERACTION</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU333857079">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Deep Learning Based System For Detection of Covid-19 Disease of Patient At Infection Risk.</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU333857030">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>자외선살균등</strong> - 본 발명은 사람의 의복이나 사용한 마스크 등에 부착하여 있다 호흡기로 유입되어 감염을 유발할 수 있는 COVID-19와 같은 유해균류를 간편하게 살균하기 위한 휴대용 자와선살균등에 관한 것이다. 반감기가 길고 인체에 유해한 오존을 발생하지 않으면서 탁월한 살균능력이 있는 250~265nm(최적은 253.7nm) 파장의 자외선을 발광하는 자외선램프를 본 발명의 막대형의 자외선살균등 광원으로 사용하고 비광원부를 손으로 잡고 의복이나 사용한 마스크 등 유해균류가 부착되었을 것으로 의심되는 곳에 자외선을 조사하여 간편하게 유해균류를 살균하므로써 감염을 예방하기 위한 휴대용 자외선살균등에 관함 것이다. - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=KR332958765">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Protein chip and kit for detecting the SARS-CoV-2 S antigen</strong> - - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=AU333400883">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>桑黄和百蕊草复方作为新型冠状病毒治疗药物或抗病毒制剂的用途</strong> - 本发明公开了桑黄和百蕊草复方作为新型冠状病毒治疗药物或抗病毒制剂的用途。本发明提供了桑黄和百蕊草的应用：在制备治疗新型冠状病毒所致疾病的药物中的应用；在制备治疗新型冠状病毒感染的药物中的应用；在制备预防新型冠状病毒所致疾病的药物中的应用；在制备预防新型冠状病毒感染的药物中的应用；在制备新型冠状病毒抑制剂中的应用。发明人在前期研究发现桑黄和百蕊草具有抗新冠病毒的作用效果。进一步的，将百蕊草提取物与桑黄提取物组合使用，组合药物的毒性并没有增加，同时百蕊草有很强的抗炎作用，桑黄具有调节人体免疫力作用，这种组合药物对于治疗新冠肺炎病人是理想的选择药物。 - <a href="https://patentscope.wipo.int/search/en/detail.jsf?docId=CN333965968">link</a></p></li>
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