Thursday, April 2, 2020
COVID-19: Case fatality rate in Italy
Hello everyone, this post explains the factors behind the higher case fatality rate in Italy compared to the other COVID-19 infected countries.
As of today, there are 937,941 coronavirus cases in the world with 47,273 deaths; that comes down to a mortality rate of around 5%. On the other hand, China, the former epicenter of the disease has a COVID-19 case fatality rate of approximately 4%; while Italy has a much higher rate of 11.897%.
As of today, there are 937,941 coronavirus cases in the world with 47,273 deaths; that comes down to a mortality rate of around 5%. On the other hand, China, the former epicenter of the disease has a COVID-19 case fatality rate of approximately 4%; while Italy has a much higher rate of 11.897%.
Wednesday, April 1, 2020
COVID-19: Vaccines under development
COVID-19 pandemic has led researchers around the world to work on developing a safe and effective vaccine. At present, there are 5 agents which are being extensively tested as potential vaccines. Here is some information about them.
1. mRNA- 1273
Trial: Safety and Immunogenicity Study of 2019-nCoV Vaccine (mRNA-1273) for Prophylaxis SARS CoV-2 Infection
- novel lipid nanoparticle encapsulated mRNA based vaccine that encodes for spike protein of SARS-CoV-2
- an open-label phase I dose-ranging clinical trial in the United States
- Study Population: 45 healthy people, males and non-pregnant women aged 18-55
- enrolled in one of three cohorts - 25mcg, 100mcg, 250mcg
- IM injection of the vaccine on Day 1 and 29 in deltoid
- Follow up: 1,2,4 weeks post each vaccination, 3,6,12 months post second vaccine
- Objective
- To evaluate the safety and reactogenicity of a 2-dose vaccination schedule of mRNA-1273, given 28 days apart, across 3 dosages in healthy adults
- To evaluate the immunogenicity as measured by Immunoglobulin G (IgG) enzyme-linked immunosorbent assay ELISA to the SARS-CoV-2 S (spike) protein following a 2-dose vaccination schedule of mRNA-1273 at Day 57
2. BCG Vaccine
BCG vaccine — developed for Tuberculosis. It has favorable in vitro or in vivo effect against RSV, Yellow fever, HSV, HPV. The hypothesis is that it may induce partial protection against the susceptibility to and/or severity of SARS-CoV-2 infection
Trial 1: BCG-CORONA reducing health care workers absenteeism in SARS-CoV-2 pandemic through Bacillus Calmette-Guérin vaccination, a randomized controlled trial (BCG-CORONA)
- RCT in the Netherlands
- Study population: 1000 Health care workers with direct COVID-infected patient
contact
- Study duration: 6 months
- Objective:
- To reduce absenteeism among HCW with direct patient contacts during the epidemic phase of COVID19
- To reduce hospital admission, ICU admission or death in HCW with direct patient contacts during the epidemic phase of COVID19
Trial 2: BRACE - BCG Vaccination to Reduce the Impact of COVID-19 in Australian Healthcare Workers Following Coronavirus Exposure (BRACE) Trial
- Open-label two group phase III RCT in Australia
- Study population: 4170 Healthcare workers
- Study duration: 12 months
- Objective:
- COVID 19 disease incidence over 6 months, by 12 months
- severe COVID 19 disease incidence over 6 months, by 12 months
3. Synthetic Minigene Vaccine
Artificial antigen-presenting cell Vaccine - a synthetic minigene that has been engineered based on conserved domains of the viral structural proteins and a polyprotein protease. The vaccine will be produced using a vector system to express viral proteins and immune modulators genes to modify artificial antigen-presenting cells (APC) and to activate T cells
Trial 1: Safety and Immunity of COVID-19 aAPC Vaccine
- Open-label phase I study in China
- Study population: 100 participants aged 6months to 80 years
- Objective:
- Injection of COVID-19/aAPC vaccine to volunteers to evaluate the safety
- To evaluate the anti- COVID-19 reactivity of the COVID-19/aAPC vaccine
Trial 2: Phase I/II Multicenter Trial of Lentiviral Minigene Vaccine (LV-SMENP) of COVID-19 Coronavirus
- Open-label Phase I/II study in China
-Study population: 100 participants aged 6months to 80 years
- Objective:
- Injection and infusion of LV-SMENP DC and antigen-specific cytotoxic T cell vaccines to
healthy volunteers and COVID-19 infected patients to evaluate the safety
- To evaluate the anti- COVID-19 efficacy of the LV-SMENP DC and antigen-specific
cytotoxic T cell vaccines
4. ChAdOx1 nCoV-19 Vaccine
Trial: A Phase I/II Study to Determine Efficacy, Safety, and Immunogenicity of the Candidate Coronavirus Disease (COVID-19) Vaccine ChAdOx1 nCoV-19 in UK Healthy Adult Volunteers
- Single-blinded, Randomized Phase I/II study in UK
-Study population: 510 participants aged 18 to 55 years
- Objective:
- To assess efficacy of the candidate ChAdOx1 nCoV-19 against COVID-19
- To assess safety of the candidate ChAdOx1 nCoV
5. Recombinant Novel Coronavirus Vaccine (Adenovirus Type 5 Vector)
Trial: A Single-center,Open-label，Dose-escalating Phase I Clinical Trial to Evaluate Recombinant Novel Coronavirus Vaccine (Adenovirus Type 5 Vector) in Healthy Adults Aged 18-60 Years Old
- Open label, dose-escalating Phase I study in China
-Study population: 108 participants aged 18 to 60 years
- Objective:
- To evaluate the safety, reactogenicity and immunogenicity of Recombinant Novel Coronavirus Vaccine (Adenovirus Type 5 Vector)
Written by Devi Bavishi
Reference: clincialtrials.gov
COVID-19: App based clinical trials
Let’s see how scientists are using app technology to generate data for research on COVID-19.
COVID-19: Lessons from coronavirus outbreak in China and formulating a strategy
Hello awesomites!
The following information is regarding the situation of COVID19 in China and how did China manage to reduce the incidence of new cases.
The following information is regarding the situation of COVID19 in China and how did China manage to reduce the incidence of new cases.
 |
| Image by Nakeya. Medicowesome 2020 |
Tuesday, March 31, 2020
COVID-19: Was SARS-CoV-2 genetically engineered for biological warfare?
An article published in Nature Medicine noted that it is improbable that SARS-CoV-2 emerged through laboratory manipulation of a related SARS-CoV-like coronavirus. This article disproves most conspiracy theories about the artificial origin of the SARS-CoV-2 virus.
I am going to try to explain what the article says in simplified terms but you need to have some background in biochemistry to understand what it says. Let's begin!
I am going to try to explain what the article says in simplified terms but you need to have some background in biochemistry to understand what it says. Let's begin!
COVID-19: Structure of the novel coronavirus (SARS-CoV-2)
Okay, let's start right away.
 |
| Molecular structure of SARS-CoV-2 |
Acute Liver Failure in a nutshell.
Acute Liver Failure is defined as the acute onset of severe liver injury with encephalopathy and ↓ synthetic function (INR ≥ 1.5 ) in a patient without cirrhosis or underlying known liver disease.
 |
| Acute Liver Failure. |
COVID-19: Summary of drugs that are under investigation for use as potential treatment options
SARS -CoV-2 that causes the famous disease, COVID-19, has no FDA approved treatment yet. Researchers around the world are using drugs that have previously demonstrated efficacy against similar virus types clinically or based on their in-vitro activity. Many clinical trials are also underway to demonstrate the most efficacious drug which can be used against this disease. Let's go through them today.
 |
| COVID-19: Summary of drugs that are under investigation for use as potential treatment options |
Monday, March 30, 2020
Rickettsia mnemonic
Hi!
Do you want to learn about Rickettsia today?
Do you want to learn about Rickettsia today?
 |
| Rickettsia mnemonic (Rickettsia typhi, flea vector) |
COVID-19: Convalescent plasma as a treatment option
As the pandemic of COVID-19 continues, researchers have been looking at treatment options, most recently the use of convalescent plasma has generated a great deal of interest.
So let's dive in and understand convalescent plasma therapy and its scope:
Convalescent plasma therapy is based on the theory that a patient in the convalescence phase develops antibodies for that disease in their serum, which can be used to treat other patients, after ensuring that safe blood banking practices are being followed.
Historically, convalescent plasma was used as a prophylactic agent against measles. [1] But with the advent of vaccine development and monoclonal antibodies, the use of convalescent plasma went out of practice. It has also been used for scarlet fever [2] and poliomyelitis [3]. The use of convalescent plasma was recommended as an empirical treatment during outbreaks of the Ebola virus in 2014 [4], and a protocol for the treatment of Middle East respiratory syndrome coronavirus with convalescent plasma was established in 2015 [5].
A case series of 5 critically ill patients with laboratory-confirmed COVID-19 and ARDS was done in Shenzhen, China from January 20, 2020, to March 25, 2020. [6] In this study, 5 patients with severe pneumonia (rapid progression and high viral load requiring mechanical ventilation) received SARS-CoV-2 specific antibody (via convalescent plasma), with a binding titer>1:1000 and neutralization titer>40 along with interferon, lopinavir/ritonavir, and methylprednisolone. On 28th March 2020, the FDA gave approval of IND, i.e. Investigatory new drug application to use of convalescent plasma (after approval) to treat critically ill patients. [7]
So let's dive in and understand convalescent plasma therapy and its scope:
Convalescent plasma therapy is based on the theory that a patient in the convalescence phase develops antibodies for that disease in their serum, which can be used to treat other patients, after ensuring that safe blood banking practices are being followed.
Historically, convalescent plasma was used as a prophylactic agent against measles. [1] But with the advent of vaccine development and monoclonal antibodies, the use of convalescent plasma went out of practice. It has also been used for scarlet fever [2] and poliomyelitis [3]. The use of convalescent plasma was recommended as an empirical treatment during outbreaks of the Ebola virus in 2014 [4], and a protocol for the treatment of Middle East respiratory syndrome coronavirus with convalescent plasma was established in 2015 [5].
A case series of 5 critically ill patients with laboratory-confirmed COVID-19 and ARDS was done in Shenzhen, China from January 20, 2020, to March 25, 2020. [6] In this study, 5 patients with severe pneumonia (rapid progression and high viral load requiring mechanical ventilation) received SARS-CoV-2 specific antibody (via convalescent plasma), with a binding titer>1:1000 and neutralization titer>40 along with interferon, lopinavir/ritonavir, and methylprednisolone. On 28th March 2020, the FDA gave approval of IND, i.e. Investigatory new drug application to use of convalescent plasma (after approval) to treat critically ill patients. [7]
Sunday, March 29, 2020
COVID-19: ACE-inhibitors and SARS-Co-V2
Nowadays, many are aware of the pandemic spreading all around the world and causing victims on a daily basis. This infection which appears for the first time at Wuhan in China represents a great concern. Today, let us explore some questions relating to the disease.
1) ACE-inhibitors and SARS-Co-V2, what is the link existing between them?
The angiotensin-converting-enzyme is secreted by pneumocytes 2 of the lungs and allows the conversion of angiotensin 1 to angiotensin 2, a powerful vasoconstrictor. The receptors for this enzyme are found in various places, including the heart and lungs. Normally, the inhibitor of this enzyme is used in case of high blood pressure, coronary heart disease and also diabetes thanks to its protective effect for the kidneys. However, in the context of COVID19 infection, the virus (SARS-Cov2) uses the converting enzyme receptors to enter the lungs. Given the increase in the number of these receptors in the event of therapy based on ACE inhibitors, the maintenance of this drug in patients infected with SARS-Cov2 is controversial.
1) ACE-inhibitors and SARS-Co-V2, what is the link existing between them?
The angiotensin-converting-enzyme is secreted by pneumocytes 2 of the lungs and allows the conversion of angiotensin 1 to angiotensin 2, a powerful vasoconstrictor. The receptors for this enzyme are found in various places, including the heart and lungs. Normally, the inhibitor of this enzyme is used in case of high blood pressure, coronary heart disease and also diabetes thanks to its protective effect for the kidneys. However, in the context of COVID19 infection, the virus (SARS-Cov2) uses the converting enzyme receptors to enter the lungs. Given the increase in the number of these receptors in the event of therapy based on ACE inhibitors, the maintenance of this drug in patients infected with SARS-Cov2 is controversial.
Subscribe to:
Posts (Atom)