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CMAAO Coronavirus Facts and Myth Buster – COVID Update

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Dr KK Aggarwal    04 April 2021

With input from Dr Monica Vasudev

 

1530: Most adults with congenital heart disease (CHD) do not appear to have an increased risk of COVID-19 mortality; however, certain subgroups may have a high risk, reports an international study. Fever, dry cough, and malaise seem to be the most common presenting symptoms. Sixty patients had no presenting symptoms but underwent testing on the basis of known exposure or an upcoming procedure. A total of 179 patients (17%) were hospitalized and 67 patients (6.4%) needed ICU admission, 36 of whom had to be intubated.

 

There were 24 COVID-19 related deaths, with a case/fatality rate of 2.3% (95% CI, 1.4% - 3.2%). This is in line with a reported cumulative world fatality rate of 2.2%. Mortality rates and severe course varied by CHD diagnosis and were found to be the highest in patients with Eisenmenger physiology (13%), cyanosis (12%), and pulmonary arterial hypertension (10%). The findings are published in the Journal of the American College of Cardiology. (Medscape)

 

1531: Around two-thirds of epidemiologists from across the globe state that we will need new or modified vaccines for COVID-19 within a year. A survey of 77 epidemiologists from 28 countries by the Peoples Vaccine Alliance, reported that about 66.2% predicted that the world has a year or even less before the available vaccines become ineffective against the variants. 

Around one-third (32.5%) of the surveyed epidemiologists said that ineffectiveness would be seen in 9 months or less while 18.2% said it will be seen within 6 months or less. Around 88% of those surveyed said that persistently low vaccine coverage in many countries would increase the likelihood of emergence of vaccine-resistant mutations. (Medscape)

1532: When variants of SARS-CoV-2 started surfacing in late 2020, there were concerns that they might elude the immune responses generated by previous infection or vaccination, thus making re-infection more likely or vaccination less effective.

National Institute of Allergy and Infectious Diseases (NIAID) researchers evaluated blood cell samples from 30 people who had recovered from COVID-19 before the virus variants emerged. It was noted that CD8+ T cell continued to remain active against the virus.

The investigators explored if CD8+ T cells in the blood of recovered COVID-19 patients, who had been infected with the initial virus, could recognize the three key variants: B.1.1.7, B.1.351, and B.1.1.248.

Investigators noted that the SARS-CoV-2-specific CD8+ T-cell responses were largely intact and recognized virtually all mutations in the variants that were studied.

The T cell response in convalescent individuals, and in individuals who have been vaccinated, do not seem to be affected by the mutations in these three variants, and should protect against emerging variants.    

Optimal immunity to the virus needs strong multivalent T-cell responses besides neutralizing antibodies and other responses to protect against current SARS-CoV-2 strains as well as the emerging variants. [Medscape]

1533: Measles vaccine is among the safest and most effective vaccines. The vaccine has been shown to be safe in both children and adults, and provides long-term protection against the measles virus. It uses a live, weakened strain of the measles virus.

Researchers have used it to develop an experimental vaccine against SARS-CoV-2. They created and evaluated a series of measles-based vaccine candidates. The vaccines were developed by inserting genes for different forms of the coronavirus spike protein into the measles vaccine genome.

The modified measles virus serves as a vehicle and carries the gene for the spike protein into the body. The cells are instructed to produce the coronavirus spike protein, thus prompting the immune system to produce antibodies. This guides the immune system to neutralize the virus when encountered.

The study findings have been published in the Proceedings of the National Academy of Sciences.

Researchers found the most promising vaccine candidate, which produced the highest levels of neutralizing antibodies against SARS-CoV-2 in rodents. The vaccine carried the gene for the stabilized prefusion version of the spike protein, which forms the basis for the available vaccines.

The new vaccine, named rMeV-preS, yielded neutralizing antibody levels in rodents higher than those seen in patients who have recovered from COVID-19. The vaccine also evoked a robust T cell response.

Researchers also assessed if the vaccine would protect against SARS-CoV-2 infection. Using golden Syrian hamsters, they noted that the vaccine protected them from infection and also prevented viral replication in the lungs and nasal passages.

This new candidate may offer several advantages. The measles vaccine is known to be safe, effective, and long-lasting. Several experimental measles-based vaccines against other viruses are also being evaluated in clinical trials. The new vaccine could protect against both COVID-19 and measles. (NIH)

 

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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