With inputs from Dr Monica Vasudev

1035: An analysis of primary human lung cells that were infected in the lab with SARS-CoV-2 revealed how the cells accumulated large amounts of lipid droplets. Following infection, the lung proteins downregulate the ability of lung cells to burn carbohydrates and fatty acids. Lung cells cannot hold fat. This could possibly explain some of the severe damage that is done to the lungs of patients with COVID-19. The virus depends on glucose uptake, cholesterol production, and fatty acid oxidation. Additional research is needed on the cholesterol drug fenofibrate before clinical trials can start.

1036: The antihistamine cloperastine, mostly sold in Japan, tends to block glucose uptake in lung cells and has shown some effect in fighting COVID-19.

1037: Moderna’s experimental COVID-19 vaccine led to a strong immune response and provided protection against infection in monkey study. The vaccine, MRNA-1273, when given to non-human primates provided protection against infection in the lungs and nose, and prevented pulmonary disease. Results of the study were published in the New England Journal of Medicine.

It appears to be an improvement over the results of AstraZenecas COVID-19 vaccine in a similar study. This study included 24 monkeys, where Moderna tested 10 micrograms or 100 micrograms of the vaccine against no treatment.

Both doses were found to be effective in protecting against viral replication in the lungs and lung inflammation. The larger dose also protected against viral replication in the nose of the animals.

1038: A vaccine being developed by AstraZeneca and Oxford University is among the most advanced in human trials. In a similar animal study, this vaccine also appeared to prevent damage to the lungs and prevent the virus from replicating. However, the virus actively replicated in the nose.

1039: A cohort of 145 patients below 1 month to 65 years separated by age noted that the youngest children had significantly lower median cycle threshold (CT) values compared to older children or adults. This indicated that they had equivalent or more viral nucleic acid in their upper respiratory tract than other age groups. These differences amounted to a 10- to 100-fold greater amount of SARS-CoV-2 in the nasopharynx of young children, noted the authors in a research letter in JAMA Pediatrics. However, these findings were limited to detection of viral nucleic acid and not infectious virus.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA