COVID-19 Scan for Feb 18, 2021

Analysis suggests excessive efficacy for single dose of Pfizer-BioNTech vaccine

An evaluation by Canadian researchers suggests {that a} single dose of the Pfizer-BioNTech COVID-19 vaccine is very efficacious, in response to a letter printed yesterday within the New England Journal of Medicine (NEJM).

Results from the section 3 trial of the Pfizer-BioNTech vaccine, printed in NEJM on Dec 31, 2020, advised the efficacy after the primary dose of the two-dose vaccine was 52.4%, primarily based on information collected in the course of the first 2 weeks after the primary shot to earlier than the second shot. The total efficacy after two doses was 94.8%.

But of their evaluation of trial information submitted to the US Food and Drug Administration by Pfizer and BioNTech, researchers with the British Columbia Centre for Disease Control and the Institut National de Santé Publique du Québec discovered that information collected beginning 2 weeks after the primary shot to earlier than the second shot point out the efficacy of the primary dose was 92.6%. The researchers recommend the preliminary efficacy evaluation was decrease as a result of immunity was nonetheless mounting in vaccine recipients in the course of the first 2 weeks after the primary shot.

“With such a highly protective first dose, the benefits derived from a scarce supply of vaccine could be maximized by deferring second doses until all priority group members are offered at least one dose,” the authors wrote.

In a response, trial investigators stated that different dosing regimens of the Pfizer-BioNTech vaccine haven’t been evaluated, and that the choice to implement different regimens lies with well being authorities.
Feb 17 N Engl J Med letter


Study highlights coronary heart harm 1 month after extreme COVID-19

More than half of sufferers with extreme COVID-19 and elevated ranges of a key marker of coronary heart muscle harm after hospital launch confirmed indicators of harm to the guts a month later, a research at the moment within the European Heart Journal finds.

Led by researchers from University College London, the research concerned cardiac magnetic resonance imaging (MRI) of 148 COVID-19 sufferers who had elevated troponin ranges, indicating coronary heart harm, and who had required ventilatory assist earlier than being launched from certainly one of six London hospitals a minimum of a month earlier than. One in three had required mechanical air flow.

Imaging confirmed irritation of the guts muscle (26% of sufferers), scarring or useless coronary heart tissue (54%), restricted blood provide to the guts (22%), or each irritation and ischemia (6%). Eight % confirmed indicators of ongoing coronary heart irritation.

Co-author Marianna Fontana, MD, PhD, of University College London stated in a European Society of Cardiology press launch that elevated troponin ranges are linked to worse COVID-19 outcomes and that sufferers with extreme infections typically produce other heart-related medical situations corresponding to diabetes, hypertension, and weight problems.

“During severe COVID-19 infection, however, the heart may also be directly affected,” Fontana stated. “Unpicking how the heart can become damaged is difficult, but MRI scans of the heart can identify different patterns of injury, which may enable us to make more accurate diagnoses and to target treatments more effectively.”

The researchers famous that the guts harm seen on imaging could have preceded COVID-19 or have occurred because of an infection. “While we detected only a small amount of ongoing injury, we saw injury to the heart that was present even when the heart’s pumping function was not impaired and might not have been picked up by other techniques,” Fontana stated. “In the most severe cases, there are concerns that this injury may increase the risks of heart failure in the future, but more work is needed to investigate this further.”

The authors stated that the findings may assist researchers discover methods of stopping coronary heart damage in severely unwell COVID-19 sufferers and detecting and treating blood clots related to the virus.
Feb 18 Eur Heart J study
Feb 17 European Society of Cardiology
press release


High mortality present in hospitalized COVID-19 sufferers with diabetes

Updated outcomes from a research of hospitalized COVID-19 sufferers with diabetes reveals 1 in 5 died inside 28 days of hospitalization, French researchers reported yesterday in Diabetologia.

The up to date outcomes from the CORONADO (Coronavirus SARS-CoV-2 and Diabetes Outcomes) research, which evaluated outcomes in diabetic French sufferers hospitalized for COVID-19 from Mar 10 by way of Apr 10, 2020, present that amongst 2,796 sufferers, 577 (20.6%; 95% confidence interval [CI], 19.2% to 22.2%) died inside 28 days of hospitalization and 1,404 (50.2%; 95% CI, 48.3% to 52.1%) have been discharged from the hospital. Results offered in May 2020 confirmed that 10% of sufferers who had diabetes and COVID-19 died inside 7 days of hospitalization.

The sufferers have been principally male (63.7%), with a imply age of 69.7 years, and the overwhelming majority had kind 2 diabetes (88.2%). Microvascular and macrovascular diabetic issues have been present in 44.2% and 38.6% of sufferers, respectively.

In multivariable fashions, youthful age, routine metformin remedy, and longer symptom length have been positively related to hospital discharge, whereas historical past of microvascular issues, anticoagulant routine remedy, shortness of breath on admission, irregular ranges of liver enzymes, and better white blood cell counts and C-reactive protein ranges have been related to a decrease probability of discharge and a better threat of dying. Patients receiving routine therapy with insulin and statins additionally had a better threat of dying.

The research authors stated establishing prognostic components for hospital discharge and dying in diabetic COVID-19 sufferers may assist clinicians higher handle this inhabitants and use hospital assets accordingly.
Feb 7 Diabetologia study

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