Category: Treatment
Preprint: 75% of Covid ICU patients report symptoms after one year
Of 246 patients who were alive 1 year following ICU treatment for COVID-19, 74.3% reported physical symptoms, 26.2% reported mental symptoms, and 16.2% reported cognitive symptoms.
Physical, mental, and cognitive symptoms were frequent 1 year after ICU treatment for COVID-19.
Jama Network Preprint: Clinical Outcomes Among Patients With 1-Year Survival Following Intensive Care Unit Treatment for COVID-19
Image by Okan Caliskan from Pixabay
Research: Probiotic improves symptomatic and viral clearance in Covid19 outpatients
Primary outcome of complete remission on day 30 was achieved by 78 (53.1%) in the probiotic group compared to 41 (28.1%) in placebo.
Patients in probiotic group reported significantly less days of fever, cough, headache, body aches (myalgia), shortness of breath (dyspnea), nausea, diarrhea and abdominal pain.
Research paper: Probiotic improves symptomatic and viral clearance in Covid19 outpatients: a randomized, quadruple-blinded, placebo-controlled trial
Image by RENE RAUSCHENBERGER from Pixabay
It’s the largest global Covid wave EVER
Driven by the new Omicron variant, the world is now being overwhelmed by the largest global Sars-CoV-2 wave EVER. The current winter wave is now larger than the Indian wave in spring 2021, and has also easily exceeded last winter’s global wave by some margin.
The word’s largest ever Covid wave is being driven by new cases in North America and Europe, just as the last winter wave of 2020-2021 was.
Unfortunately, just as the global media celebrates the new “milder” Omicron variant, the likely consequences of the emergence of the variant are being completely overlooked.
A simple extrapolation of the events of the last two years would suggest that the next Covid release could be the first ever Variant of High Consequence or VOHC.
A VOHC would be far more transmissible than Omicron, far more deadly than Delta, and it could be in circulation within weeks.
It is patently obvious that, even after two years of this pandemic, the world is COMPLETELY unprepared for what is coming.
Omicron overpowers monoclonal antibody treatments in early tests
Preliminary experiments suggest that most of the monoclonal antibody treatments for Covid-19 are powerless against Omicron.
A slew of publications posted on preprint servers report laboratory evidence that Omicron is totally or partially resistant to all currently available treatments based on these monoclonal antibodies. The publications have not yet been peer reviewed, but some of the companies that manufacture antibody therapies already concede that their products have lower potency against Omicron than against other variants
Nature article: Omicron overpowers key COVID antibody treatments in early tests
Image by Mufid Majnun from Pixabay
UK GP: Omicron kills in the same way as classic covid in the elderly
“Omicron spreads like wildfire. Omicron went from one patient in a ward, to 8 patients and 4 staff infected overnight, to 5 wards full (mostly hospital acquired) 4 days later. Monday was horrible, Tuesday worse.”
"Omicron kills in the same way as 'classic covid' in the elderly – exponential oxygen or a more gentle oxygen demand and then death. Lots of back pain and diarrhoea as a feature as well as sore throat. Most of the old who are dying are double vaxed with AZ"
This is terrifying— Susan Bowie #keepwearingyourmasks (@docsuzy) December 16, 2021
UKHSA risk assessment for Omicron variant
UK risk assessment for Omicron variant B.1.1.529, dated 3rd December 2021
Transmissibility between humans: Amber – At least as transmissible as currently circulating variants
Omicron is transmitting rapidly and successfully. Increased transmissibility compared to Delta is
biologically plausible with the presence of furin cleavage site and nucleocapsid changes
associated in vitro with advantages for replication, as well as extensive changes to the RBD.
Structural modelling suggests that the mutations present may increase human ACE2 binding
affinity to a much greater extent than that seen for any other variant.
Phylogeny suggests a recent emergence. Data from South Africa suggests that Omicron has a
pronounced growth advantage there. However, this may be due to transmissibility or immune
escape related, or both.
Naturally acquired immunity: Red – Mutations suggestive of reduced protection from natural immunity and limited supporting epidemiological evidence
Based on experience with other variants, laboratory data on individual mutations, and structural
modelling, the mutations present are very likely to reduce antibody binding and include changes
in all 4 neutralising antibody binding sites in the RBD and also in antigenic sites in the S NTD. T
cell epitope data is awaited. Analysis from South Africa suggests a reduction in protection from
previous infection, including from recent Delta infection. There is no convalescent sera
neutralisation data and no relative risk of reinfection analyses as yet.
Vaccine-derived immunity: Red – Mutations suggestive of reduced protection from vaccine derived immunity, no supporting evidence
The mutations present are likely to reduce antibody binding and include changes in all 4 RBD
neutralising antibody binding sites. T cell epitope data is awaited. There is no vaccinee sera
neutralisation data and no epidemiological data on vaccine effectiveness.
Therapeutics: Red – Mutations suggestive of reduced effectiveness of a treatment in UK clinical use
The mutations present are likely to reduce the binding of most available therapeutic monoclonal
antibodies, based on structural modelling. On the same basis, they are unlikely to affect current
small molecule antivirals. However, there is no laboratory or clinical data to support these
predictions at present.
UK: All travellers will require a PCR test and quarantine until negative to prevent spread of Omicron
At a press conference today, 10 Downing Street announced new measures to combat the potential spread of the Omicron variant in the UK.
The new variant of concern, which has already been found in the UK, Belgium, Hong Kong, Germany, the Netherlands and possibly also in Australia, will clearly require stricter measures to prevent it seeding across the country.
The press conference, which was, in some ways, two years too late, did nevertheless show that the UK has at least learned some lessons from the pandemic. The speed with which the red list for travel was updated is a promising sign that the UK is finally taking Sars-CoV-2 seriously.
Unfortunately, however, the drumbeat from the UK government was still about putting all their eggs in the single basket of vaccination rather than promoting a multi-layered approach of defences in depth which is what is really required. Even the World Health Organisation has recently criticised the ‘false sense of security’ given by over-selling of the benefits of the vaccines.
Although facemasks are to be reintroduced in retail and travel settings, these measures clearly won’t be enough to stop a more transmissible variant with strong vaccine escape capabilities becoming dominant in the UK within a month of arrival.
After two years of the UK aimlessly thrashing around for solutions to the pandemic, it seems that are plenty of lessons still to be learned.
Key measures announced by the UK today:
- All travellers to the UK will have to take a PCR test by the end of day 2 of their arrival; travellers must self-isolate until they receive a negative test result
- All contacts of suspected Omicron cases must self-isolate for 10 days, regardless of their vaccination status. They will be contacted by NHS Test and Trace
- Face coverings will become compulsory on public transport and in shops – not including hospitality
- The JCVI (Joint Committee on Vaccination and Immunisation) will consider giving boosters to a wider age group, as well as reducing the gap between the second dose and booster.
UK: Third Omicron case confirmed, was last seen in Westminster
Merck’s Covid-19 pill Molnupiravir only 30% effective in final analysis
The pharmaceutical company Merck said on Friday that in a final analysis of a clinical trial, its antiviral pill molnupiravir reduced the risk of hospitalization and death among high-risk Covid patients by 30 percent, down from an earlier estimate of 50 percent.
The lower efficacy is a disappointment for the drug, known as molnupiravir, which health officials around the world are counting on as a critical tool to save lives and reduce the burden on hospitals. It increases the importance of a similar, apparently more effective, offering from Pfizer that is also under review by the Food and Drug Administration.
Image by Mahmoud Ahmed from Pixabay
Prostacyclin could help the most severely affected Covid-19 patients in ICU
A research team headed by Prof. Pär Johansson from the Department of Clinical Immunology at Rigshospitalet has investigated whether treatment with prostacyclin can help patients by reducing damage to the endothelial cells, which lines the inside of all blood vessels.
A total of 80 patients in intensive-care departments in the Capital Region of Denmark were included in the trial: half received the medicine, while the other half – the control group – received normal saline.
Patients who received three days’ treatment with prostacyclin had overall significantly less damage to their vital organs during their stay in the intensive-care department. Furthermore, mortality was halved from 44% for the control group to 22% for the group receiving prostacyclin. The results for mortality are not, however, statistically significant, as this was a study of limited size.
“We found that the patients who had received prostacyclin overall had better organ function and better chances of survival. There are still many Covid-19 patients at intensive care departments around the world and we are very pleased that now it seems there’s possibly a better treatment option,” said Pär Johansson.
Rigshospitalet.dk press release (in English)
Image by Parentingupstream from Pixabay
USA: Hyenas test positive for Sars-Cov-2 in Colorado zoo
Two hyenas at the Denver Zoo have tested positive for the coronavirus, the first confirmed cases among the animals worldwide. In addition to the two hyenas, 11 lions and two tigers at the zoo also tested positive for the virus.
Zoo officials said the hyenas — 22-year-old Ngozi and 23-year-old Kibo — are experiencing mild symptoms, including slight lethargy, some nasal discharge and an occasional cough.
UK approves oral Covid drug Molnupiravir for use
UK Health and Social Care Secretary Sajid Javid said “Today is a historic day for our country, as the UK is now the first country in the world to approve an antiviral that can be taken at home for COVID-19. This will be a game changer for the most vulnerable and the immunosuppressed, who will soon be able to receive the ground-breaking treatment.”
Image by Emilian Danaila from Pixabay
The dangers of new oral Covid drug Molnupiravir
“The FDA needs to tread very carefully with molnupiravir, the antiviral currently before them for approval. My misgivings are founded on two key concerns. The first is the drug’s potential mutagenicity, and the possibility that its use could lead to birth defects or cancerous tumors. The second is a danger that is far greater and potentially far deadlier: the drug’s potential to supercharge SARS-CoV-2 mutations and unleash a more virulent variant upon the world.”
William Haseltine at Forbes.com
1918 pandemic caused Long Covid like symptoms in survivors
“The influenza pandemic of 1918 was followed by another epidemic. The disease was encephalitis lethargica, or the sleepy sickness, and like influenza it spread through most of the world. Its symptoms were extraordinarily varied — most commonly there was lethargy, but sometimes there was insomnia, and even frenzy; sometimes there were paralyses, sometimes mental disorders.”
Of the million or so people who came down with encephalitis lethargica during this period, half a million died in the acute stages of the illness; most of the survivors, people who appeared to have recovered, went on to develop, sometimes decades later, a variety of neurological problems, including a crippling form of parkinsonism.”
Oliver Sacks, New York Times, November 2005
Awakenings is a 1990 American drama film based on Oliver Sacks’s 1973 memoir of the same name. It tells the story of a fictional character, neurologist Dr. Malcolm Sayer, who is based on Sacks and played by Robin Williams. In 1969, he discovered beneficial effects of the drug L-Dopa. He administers it to catatonic patients who survived the 1917–1928 epidemic of encephalitis lethargica.
Wikipedia entry on the Film “Awakenings”
UK ONS: Natural infection by Covid provides a similar level of protection to two vaccine doses
UK Office of National Statistics: “Two vaccination doses provided a similar level of protection to previous natural infection during the Delta-dominant period”
Modelled risk ratios of testing positive for COVID-19 by COVID-19 vaccine exposure, when the Delta variant was dominant, UK, 17 May to 14 August 2021
- there was no evidence that the reduction in risk of infection from two doses of either vaccine differed from that of previous natural infection
- two doses (14 days or more previously) of Pfizer-BioNTech reduced the risk of testing positive by 73% (95% confidence interval: 70% to 76%) in the Delta period, compared with 80% (95% confidence interval: 74% to 85%) in the Alpha period
- two doses (14 days or more previously) of Oxford-AstraZeneca reduced the risk of testing positive by 62% (95% confidence interval: 58% to 66%) in the Delta period, compared with 76% (95% confidence interval: 62% to 85%) in the Alpha period
- the reduction in risk 14 days or more after second dose was significantly higher with Pfizer-BioNTech compared with Oxford-AstraZeneca
- the risk reduction from two doses of either vaccine was greater than from one dose (21 days or more previously)
UK ONS report: Coronavirus (COVID-19) Infection Survey Technical Article: Impact of vaccination on testing positive in the UK: October 2021