COVID-19

The authors screened a library of 1900 drugs for activity against common cold coronaviruses and SARS-CoV-2. The most potent was masitinib, an orally bioavailable tyrosine kinase inhibitor. Mice infected with SARS-CoV-2 and then treated with masitinib showed >200-fold reduction in viral titers in the lungs and nose, as well as reduced lung inflammation. Masitinib was also effective in vitro against all tested variants of concern (B.1.1.7, B.1.351 and P.1).

UK investigators find a field effectiveness of 2 doses of the BNT162b2 mRNA vaccine (Pfizer) of 88% against the delta variant (compared with 94% against the alpha variant). Effectiveness after one dose of vaccine was only 36%. Effectiveness of 2 doses of the AZ vaccine (ChAdOx) was 74%.

Investigators estimate the real-world effectiveness of 2 doses of the mRNA-1273 vaccine (Moderna) against the alpha (B.1.1.7 [British]) and beta (B.1.351;[South african] variants to be 100% and 96.4% respectively.

Sera from patients recovering from COVID-19 as well as those from individuals immunized with a mRNA vaccine showed significantly lower but still detectable protective antibody titers against to two emerging Indian variants (B.1.617.1 [kappa] and B.1.671.2 [delta)] in all 96% of cases tested

US military physicians report the occurrence of 20 cases of acute myocarditis 12-96 hours after dose 2 of a mRNA vaccine and 3 cases after dose 1 in patients with previous COVID-19 infection. The clinical pattern was uniform with chest pain, elevated troponin, ECG findings and cMRI (8 patients) findings consistent with myocarditis and no evidence of alternative etiology. The 30-day incidence post dose 2 was 22 cases per 100’000 (expected: 1-10 cases per 100’000)

This review summarises the role of chest x-ray and CT in the diagnosis and management of COVID-19 and includes a description of approach to CT in patients suspected of having COVID-19 at Inselspital.

Israeli authors observe a high level of protection against SARS-CoV-2 in the unvaccinated < 16 year-old. They calculate that for each 20 percent point of vaccinated individuals > 16 years, the SARS-CoV-2 test positivity in the < 16 year-old dropped by twofold.

This intermediate term outcome study of PIMS-TS (MIS-C) in 46 UK children identifies reduced functional exercise capacity (6-minute-walking test below 3rd percentile in 45%) and severe emotional difficulties (20%) as the most important 6-month-sequelae, while 44/46 patients had fully restored cardiac function and 45/46 were back to full-time education.

In a US multicenter, investigator-blinded, 1:1 placebo-controlled trial including 2260 adolescents 12-15 years of age, the Pfizer/Biontech COVID-19 mRNA vaccine BNT162b2 demonstrated superior immunogenicity and comparable reactogenicity in comparison with the 16-25 year age group investigated in the first BNT162b2 study. Efficacy was 100% (95% CI, 75.3 to 100).

Case-Control study of COVID-Vaccine Response in 609 transplant recipients treated with standard-immunosuppression or Belatacept (CTLA4-IgG). 14% among standard-treated patients compared to 5% among Belatacept-treated Patients achieved detectable anti-COVID IgG after two doses of vaccine. Belatacept use was associated with 16.7-fold lower odds of having a positive post-D2 titer result.