A mask lies on the ground at John F. Kennedy International Airport in New York City on April 19. Spencer Platt/Getty Images hide caption
A mask lies on the ground at John F. Kennedy International Airport in New York City on April 19.
If it feels like everyone you know has COVID-19 right now, you're not alone. In many parts of the U.S., case numbers are going up, and much of that increase is being driven by subvariants of the omicron variant of the coronavirus.
And this new wave of cases might be a glimpse into what the endemic stage of COVID-19 will look like, according to Andy Slavitt, a former senior adviser to President Biden on COVID-19 and a former head of Medicare and Medicaid in the Obama administration.
The U.S. is not in an endemic phase just yet, Slavitt said, and the country likely won't know until after it's in it because, as he put it, "the best definition of endemic that I've heard is just when the surprises are gone and it becomes predictable."
"Endemic doesn't necessarily mean everybody's safe, and endemic doesn't necessarily mean people are no longer losing their lives. It just means it's following a predictable pattern. And what we don't know, but we may be witnessing, are some clues as to what a predictable pattern will look like when we settle into one."
Slavitt outlines the tools the U.S. has to handle COVID-19 going forward, the factors that could change his assessment and the shift vs. drift calculation.
This interview has been edited for length and clarity.
On the tools that the U.S. has that can help people live as normal a life as possible
The best news of all is that we have incredible scientific tools, vaccines, boosters, oral therapeutics. And while none of them are perfect, down the road when you combine them with what our own immune system does and the continued kind of improvement of these tools, the layered immunity we have, COVID should become less and less fatal.
It will still be dangerous and still dangerous for people who are frail, people who are immunocompromised. But even in those situations, the tools are better and better. So what we really want to know is, is it going to get any more severe? And is it going to get any more frequent? And are the vaccines and tools we have going to continue to work? And if we are in a situation where we need to update our vaccines once or twice a year, we need to be prepared to do that.
On the unknowns that could change his assessment of how close the U.S. is getting to an endemic phase of COVID-19
So scientists talk about this notion of drift versus shift, and what they mean by that is a drift virus would indicate that we will just continue to see more progressions, almost laddering up of new omicron, with 1.1, 1.2, 1.3, 1.4. And a drift is a better scenario than a shift. A shift is where we would get an entirely new Greek letter in this case, with completely different mutations and characteristics.
What's better about a drift is that our body is, generally speaking, forming better immunity in prior versions that protect us against newer versions. And our vaccines will, generally speaking, be more aligned to what we see next than they would be if we were to see a shift.
So the big question is, are we going to be in drift mode? And for how long will we be in drift mode? Or are we going to go back to shift mode where we'll see a delta and omicron, et cetera? No one knows the answer, but there are a number of scientists who say that the number of times we'll see a major shift could be pretty rare could be as infrequently as once a decade.
On whether reaching the endemic phase of COVID-19 will discourage other precautions, including masks and vaccines
Well, predictability will be a good thing. You know, if we knew that we were going to see COVID-19 every June and every December, we might not like that, but at least it would tell us that we can take the kinds of precautions that we need to take then, and we don't need to take them in other parts of the year. What bothers people is feeling like they're taking precautions in periods of time when it doesn't matter. So, you know, we don't give people flu shots in April, May and June because the risk of the flu is quite low then.
So if we understand this well enough and it becomes predictable enough, I think you can then create targeted campaigns to say, "Hey, every time that this happens, these are the precautions we have to take. We have to wear masks. We have to stay away from these types of crowds and these types of situations if we're immunocompromised. But other times of the year, go on, live your life, things will be more or less safer."
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What COVID might look like in the U.S. once we reach the endemic phase - NPR
Kristen Hare | Poynter
In many places, it started with a cut in print days. Furloughs. Layoffs. Just to get through the crisis, newsroom leaders told readers.
In some places, none of it was enough.
Now, small newsrooms around the country, often more than 100 years old, often the only news source in those places, are closing under the weight of the coronavirus. Some report theyre merging with nearby publications. But that merger means the end of news dedicated to those communities, the evaporation of institutional knowledge and the loss of local jobs.
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More than 100 local newsrooms closed during the coronavirus pandemic - Editor And Publisher Magazine
CNN
The United States might need to update its Covid-19 vaccines each year, according to a trio of top US Food and Drug Administration officials, and a new normal may include an annual Covid-19 vaccine alongside a seasonal flu shot.
Widespread vaccine- and infection-induced immunity, combined with the availability of effective therapeutics, could blunt the effects of future outbreaks. Nonetheless, it is time to accept that the presence of SARS-CoV-2, the virus that causes COVID-19, is the new normal. It will likely circulate globally for the foreseeable future, taking its place alongside other common respiratory viruses such as influenza. And it likely will require similar annual consideration for vaccine composition updates, Dr. Peter Marks, director of the FDAs Center for Biologics Evaluation and Research; Principal Deputy Commissioner Dr. Janet Woodcock; and new FDA Commissioner Dr. Robert Califf wrote in a paper published in the medical journal JAMA on Monday.
During the 2022-2023 COVID-19 vaccine planning and selection process, it is important to recognize that the fall season will present a major opportunity to improve COVID-19 vaccination coverage with the goal of minimizing future societal disruption and saving lives, they wrote. With the plan for implementation of this years vaccine selection process, society is moving toward a new normal that may well include annual COVID-19 vaccination alongside seasonal influenza vaccination.
June could be when FDA officials make a decision on the composition of Covid-19 vaccines for the fall and winter seasons and what the vaccination plans might be.
By this summer, decisions will need to be made on who should be eligible for additional Covid-19 shots in the fall, and by June, the composition of the vaccines will need to be determined, Marks, Woodcock and Califf wrote.
Last week, the FDA announced plans to convene its Vaccines and Related Biological Products Advisory Committee on June 28 to discuss whether the composition of current Covid-19 vaccines should be modified, and if so, what updates should be selected for the fall.
In terms of practical considerations, at the recent meeting of the VRBPAC, there was relatively uniform agreement that a single vaccine composition used by all manufacturers was desirable and that data would be needed to inform and drive the selection of a monovalent, bivalent, or multivalent COVID-19 vaccine, Marks, Woodcock and Califf wrote. There was also general agreement that, should a new vaccine composition be recommended based on the totality of the available clinical and epidemiologic evidence, optimally it could be used for both primary vaccination as well as booster administration.
VRBPAC members met in April to discuss how the composition of Covid-19 vaccines could change to target any new and emerging coronavirus variants. The committee agreed that there needs to be a framework for how and when such changes take place. The advisers plan to continue their conversation in the coming months.
By summer, decisions will need to be made for the 2022-2023 season about who should be eligible for vaccination with additional boosters and regarding vaccine composition. Administering additional COVID-19 vaccine doses to appropriate individuals this fall around the time of the usual influenza vaccine campaign has the potential to protect susceptible individuals against hospitalization and death, and therefore will be a topic for FDA consideration, Marks, Woodcock and Califf wrote.
Certain immunocompromised people and adults 50 and older are eligible for additional booster doses of Covid-19 vaccine in the United States. The FDA officials added that for those who have yet to get vaccinated or boosted, getting a vaccine dose now will not have adverse effects that preempt getting an additional dose in the fall.
The composition of the current vaccines could be updated to target circulating coronavirus variants. Marks, Woodcock and Califf wrote that this coming fall and winter, three factors may come together to place the nation at additional risk of Covid-19: waning immunity, seasonal waves of more coronavirus spread, and the further evolution of the coronavirus, leading to new variants.
The timeframe to determine the composition of the COVID-19 vaccine for the 2022-2023 season, to use alongside the seasonal influenza vaccine for administration in the Northern Hemisphere beginning in about October, is compressed because of the time required for manufacturing the necessary doses, the officials wrote. A decision on composition will need to be made in the US by June 2022.
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A team of University of Texas at Austin researchers has resumed testing Austins wastewater for signals of COVID-19 after the Texas Division of Emergency Management gave new funding for the project.
Although Austins risk-based COVID-19 guidelines have now been eliminated, Mary Jo Kirisits of the Cockrell School of Engineering said that continuing to monitor the wastewater will give the city advance knowledge of any spikes in cases, which is beneficial as fewer people are getting tested or reporting positive results.
People are going to get complacent and let their guard down, said Kirisits, a professor in the Department of Civil, Architectural and Environmental Engineering. Testing wastewater as a normal course of action will give the city lead time in making important decisions like when to provide more resources such as testing sites and vaccine hubs.
The coronavirus SARS-CoV-2 is a fecal-shed virus. Knowing that, Kirisits and a team of researchers began taking samples from the citys two largest wastewater treatment plants starting in summer 2020 with the goal of being able to track spikes of cases in Austin before they showed up in diagnostic testing.
Although wastewater monitoring generally indicated spikes in clinical cases a few days before they occurred, the testing did not give the two-week lead time desired. This might change as cases wane and fewer COVID-19 tests are administered.
The only way to get that two-week advance notice is when the cases are so low you can spot a difference, said Kerry Kinney, a professor in the Department of Civil, Architectural and Environmental Engineering. It will be interesting doing monitoring going forward to see when cases rise. At this point, we havent gotten out of the pandemic to monitor for its resurgence.
Initial funding for the project was provided by the Cockrell School and two research grand challenges at UT Austin Planet Texas 2050 and Whole CommunitiesWhole Health. However, when that money ran out in the fall of 2021, further testing was put on hold.
Despite this, Kirisits still went out to the treatment plants most days during the winter, collecting samples to be sure that when they did receive additional funding, they would be able to record the surge in omicron cases that happened around the holidays.
The Texas Division of Emergency Management has awarded the team a $150,000 grant to resume its work.
Sampling is currently ongoing at the Walnut Creek and South Austin Regional wastewater treatment plants. The specimens will be sent to Biota Technology for sequencing and variant calling, which means that the percentage of SARS-CoV-2 in each variant class will be determined. Since the variants have some differences in associated symptoms and some variants are more contagious than others, this will allow residents and health care providers to know what to look for and when to test.
The research team also plans to deploy 3D-printed sampling devices at several sites on the UT Austin campus to be able to tell whether specific buildings or residence halls are seeing spikes. These devices can be dropped into maintenance holes for sampling over a specific period to monitor for the virus in certain locations. These devices are inexpensive to make and do not require a power source during deployment, which makes them convenient for sampling.
Kirisits said wastewater is also useful for tracking other pathogens and disease markers, including for diabetes, so ongoing research is a crucial tool for public health.
There are so many things we can track in wastewater, and we should be doing that, she said. Once you have those samples, you might as well interrogate for multiple markers associated with human disease.
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Wastewater Testing for COVID-19 Resumes in Austin - UT News - University of Texas
In a recent study posted to the bioRxiv* preprint server, researchers analyzed the inhibition of stress granules (SG) formation in cells infected by the human common cold coronavirus HCOV-OC43 (HCoV-HCOV-OC43) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Host cells possess several mechanisms to detect viral infections and trigger immune defense reactions for suppressing viral replication and transmission. One such antiviral mechanism is the formation of SGs in response to viral infections.
SGs are condensates of ribonucleic acid (RNA) and proteins that cause sequestration of cellular factors and viral components essential for viral replication. However, viruses have evolved mechanisms to prevent the formation of SGs in the host. Despite the increasing interest in deciphering the role of SGs in viral replication, SG inhibition mechanisms for host protection are unclear.
In the present study, researchers investigated the ability of HCoV-HCOV-OC43 and SARS-CoV-2 to inhibit SG formation.
To assess SG dynamics during CoV infections, human embryonic kidney 158 (HEK)293A cells were infected with HCOV-OC43 and examined for the formation of SGs by immunofluorescence staining for T-cell internal antigen-related (TIAR) protein. After one to two days of infection, negligible SG formation was detected.
Thus, the team analyzed if HCOV-OC43 inhibited the formation of SGs, for which mock-infected and virus-infected cells were treated with sodium arsenite after a day of infection. Arsenite was used due to its ability to induce SG formation and eIF2 (eukaryotic translation initiation factor 2) phosphorylation. While SG induction was observed in all the mock-infected cells, <50% of the cells infected by HCOV-OC43 demonstrated SG formation. Next, the magnitude of eIF2 phosphorylation in the HCOV-OC43-infected cells was assessed, and HCOV-OC43 efficiently inhibited eIF2 phosphorylation at 12 hours per infection (hpi) and 48 hpi.
To verify the applicability to other cell lines, the analyses were repeated in human colon cancer (HCT-8) and the bronchial epithelial (BEAS-2B) cell lines. SG formation and eIF2 phosphorylation were suppressed among the HCT-8 cells after two days of infection, reflecting slower viral replication in the cells in comparison to 293A. After one day of infection, substantially low levels of HCOV-OC43 nucleocapsid (N) protein were found in the HCT-8 cells. As observed in the 293A cells, the infected BEAS-2B cells demonstrated inhibition of SG formation and eIF2 phosphorylation within a day of infection. This indicated that the phenotypes were not restricted to entirely transformed cells and that the 293A model was appropriate for analyzing the inhibition of SG formation.
Nucleating proteins such as the Ras-GTPase-activating protein SH3-domain-binding protein 1 (G3BP1), G3BP2, T-cell internal antigen 1 (TIA-1), and (TIAR) drive condensation of SG. To assess the significance of G3BP1 in CoV replication, cells that overexpressed the enhanced green fluorescent protein (EGFP)-tagged G3BP1 were infected by HCoV-HCOV-OC43. In the study, ribopuromycylation assays and western blot analysis were also performed.
In the study, SG formation was not observed in the HCoV-HCOV-OC43- and SARS-CoV-2-infected cells. Both viruses inhibited the formation of SGs induced by exogenous stress, such as treatment with sodium arsenite and eIF2 phosphorylation.
Further, in SARS-CoV-2-infected cells, a steep decline in G3BP1 levels was observed. Ectopic overexpression of N and non-structural protein 1 (Nsp1) by both viruses inhibited the formation of SGs and arsenite-induced eIF2 phosphorylation. Of note, Nsp1 of the highly pathogenic SARS-CoV-2 alone was adequate to reduce G3BP1 levels. This reduction depended on the depletion of messenger RNA (mRNA) in the cytoplasm, mediated by Nsp1 and TIAR. In the immunostaining analysis, a substantial reduction in the EGFP-expressing infected cells compared to controls was observed.
The study findings showed that both the viruses depend on the Nsp1 and N proteins for suppressing SG formation. Both HCOV-OC43 and SARS-CoV-2 dedicate >1 gene product each for SG inhibition. This indicates that viral disarming of SG responses is vital to generating a productive CoV infection.
While N proteins of SARS-CoV-2 and HCOV-OC43 act independently from eIF2 phosphorylation and downstream of translation arrest, Nsp1 proteins inhibit SG formation by suppressing eIF2 phosphorylation upstream of SG nucleation. Additionally, SARS-CoV-2 and not HCOV-OC43 infection depletes G3BP1 and disrupts the TIAR-mediated nucleocytoplasmic shuttling, contributing to SG inhibition with higher potency. Therefore, SARS-CoV-2 Nsp1-mediated host shutoff contributes, at least partially, to G3BP1 depletion and TIAR nuclear accumulation. G3BP1 overexpression significantly reduced HCOV-OC43 infection, indicative of the antiviral property of G3BP1 in CoV infections.
Overall, the study findings showed that HCoV-HCOV-OC43 and SARS-CoV-2 each contribute >1 gene product for the inhibition of SG formation, underpinning the importance of viral disarming of SG responses for generating productive infections. Both viruses efficiently inhibited SG formation, and the inhibition was mediated by Nsp1 and N proteins.
The findings highlight the antiviral property of G3BP1 and the presence of several mechanisms for SG suppression that are conserved between HCoV-HCOV-OC43 and SARS-CoV-2. SG formation may be an essential antiviral mechanism for host defense targeted by CoVs for efficient viral replication. Therefore, elucidating the SG inhibition mechanisms could reveal probable targets for anti-CoV therapies to inhibit viral replication by SG inhibition.
bioRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread worldwide,causing the coronavirus disease 2019 (COVID-19) pandemic, with over 512million cases and over 6.2 million deaths so far.
The often-unpredictable severity of the illness has defied attempts to predict COVID-19 outcomes, driving much research to identify factors that can mitigate the clinical manifestations of the infection.
A new study discusses the role of dietary factors in this area, concluding,
Optimal nutrition status remains an effective strategy for supporting and preserving a strong immune response that is ready to protect against infections.
Infection with this novel coronavirus leads to an intense immune response in a subset of people, who rapidly show evidence of hyper-inflammation on a systemic scale, causing rapid deterioration of the clinical condition. This is mediated by the detection of COVID-19 by macrophages and dendritic antigen-presenting cells that present the viral antigen peptides to CD4 T cells. This results in their switching to Th1 or Th2 cells, secreting antiviral gamma-interferons (IFN-) or eliciting an adaptive humoral response, respectively.
The Th1/Th2 balance is essential to viral clearance and clinical resolution, as well as the return of the body systems to normal. Dysregulation of this immune response can cause exhaustion of the T cells and heightened inflammatory cascades (the so-called cytokine storm), causing severe disease. The mechanism of such critical disease is vascular damage because of the immune response, causing acute respiratory distress syndrome (ARDS) and a high incidence of death.
The role of nutrition has been suggested by many earlier studies, and is relevant in the light of the reduced access to some foods because of case isolation, contact quarantine and lockdown restrictions. The current paper, published online in the journal Nutrients, reviews the state of current knowledge in this area.
The consumption of fresh fruits and vegetables, that are rich in anti-oxidants in the form of plant polyphenols, promotes the suppression of inflammatory reactions and oxidative stress. Fish is another source of antioxidants in the shape of vitamins and omega-3 fatty acids, which reduce cell membrane lipid oxidation and proinflammatory mediator concentrations.
The Mediterranean diet is thus associated with an adiponectin-mediated increase in insulin sensitivity and decrease in systemic inflammation, reduced blood pressure and better arterial compliance, with lower levels of blood glucose, cholesterol and other dangerous lipids. Inflammatory biomarkers such as C-reactive protein (CRP), interleukin-6 and interleukin-8 are also reduced.
Even more significantly, a Mediterranean diet reduced the risk of rhinitis, asthma and respiratory impairment, even producing an anti-oxidant effect in children with asthma who were exposed to atmospheric pollution. Studies have shown that this diet was associated with fewer deaths from COVID-19 in a dose-dependent manner, after compensating for factors like the socioeconomic status, housing and life satisfaction.
In contrast, the Western diet is high in refined sugar and saturated fats, and is associated with systemic inflammation. This is probably because of the activation of innate immune cells via the Toll-like receptor 4 (TLR4) which eventually dampens the innate and adaptive immune response via chronic inflammation and oxidative stress. The outcome is an immunocompromised state that makes the individual more prone to infections, as well as damage to multiple organs over time.
In fact, the Western diet is linked to higher numbers of macrophages in the lungs and increased airway inflammation, which acts with the impaired immune response to predispose to COVID-19 and other viral infections.
Several dietary constituents and supplements are found to be useful in improving COVID-19 outcomes. For instance, vitamin A levels are higher in those who recover from the infection. Vitamin D is an immunomodulator, strengthening the innate immune response while preventing dysregulated T cell responses. High levels of this vitamin may lead to improved physical fitness.
Regular supplementation of vitamin D has been linked to better outcomes from COVID-19, though the evidence is weak overall. Seasonal efficacy also appears to be a possibility, and further research will be needed.
Antioxidant activity exerted by vitamins C and E could protect against cardiovascular damage by free radicals and reactive oxygen species while reducing systemic inflammation via its suppressive effect on pro-inflammatory cytokines. This could not just modulate the immune response but also fortify the lung epithelium against injury. While these have been shown to be safe and well-tolerated, more evidence will be needed to support their routine supplementation in COVID-19 patients.
Glutathione is the primary antioxidant defense mechanism in cells, inhibiting inflammatory signaling mediated by NF-B activation. This molecule is found at high levels in the lung fluid, protecting the epithelium against oxidative damage. Its deficiency is linked to a higher incidence of viral infections with more severe symptoms and worse outcomes.
Here again, promising early results need to be supported by larger studies before the therapeutic dosage can be arrived at.
Zinc and other trace elements are also linked to improved innate and acquired immune responses. For instance, zinc may strengthen the airway epithelial barrier, while its deficiency may predispose to viral infection by damaging the barrier. Zinc also promotes immune cell growth, maturation, and activation, while its immunomodulatory effects are valuable in preventing hyperinflammation.
In addition, zinc has antiviral effects, preventing viral replication as an anti-fusion factor and inhibiting important viral lifecycle functions. Zinc levels have been associated with a potential improvement in COVID-19 outcomes, though its existence as a part of the diet may make it difficult to determine therapeutic levels. Other studies have shown the potential efficacy of omega-3 fatty acids in this condition.
Traditional Chinese medicine (TCM) makes use of herbal therapies and has been used to treat illnesses and infectious outbreaks. This is attributable to its antiviral, antibacterial and anti-inflammatory activities. Multiple preparations are available, some of which have been adapted to treat COVID-19.
Probiotics are live microbes that form part of the diet, regulating the immune response by acting on interleukins and natural killer cells, as well as the differentiation of T cells. The interconnection between the gut and the lungs makes it important to understand how these microbes affect the immune response.
At present, there is some evidence that probiotics are useful in upper respiratory infections, but more research is required to validate their efficacy and safety in immunocompromised patients.
The findings of this review paper indicate the role of nutrients in preventing and managing COVID-19. The superior health profile of the Mediterranean dietand the powerful benefits of multiple dietary supplements such as antioxidants, vitamin D, and probiotics, in terms of their immunomodulatory and anti-inflammatory effects, make it important to understand how supplementation with these molecules can help improve COVID-19 outcomes.
Further research in this field is necessary, along with a better insight into the action of TCM, to take advantage of these nutrients in developing a nutritional program that can help build up a strong immune responseto prevent and clear infectious agents rapidly and effectively.
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Efficacy and Safety of the RBD-DimerBased Covid-19 Vaccine ZF2001 in Adults | NEJM nejm.org
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Efficacy and Safety of the RBD-DimerBased Covid-19 Vaccine ZF2001 in Adults | NEJM - nejm.org
In a recent study posted to the medRxiv* preprint server, researchers investigated the outcomes of coronavirus disease 2019 (COVID-19) treatment with paxlovid.
Treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in its early phases is currently achieved by administering convalescent plasma and biclonal or monoclonal antibodies intravenously. However, there is no orally available treatment method present to prevent disease severity in high-risk patients.
In the present study, the team assessed the impact of paxlovid treatment on SARS-CoV-2 disease outcomes and healthcare resource utilization (HCRU).
The team used retrospective and observational data from the Maccabi healthcare services (MHS) database to identify SARS-CoV-2 patients between 1 June 2021 and 28 February 2022. The data obtained from the MHS database included information regarding the patients demographics, comorbidities based on ICD-9 codes, the status of immunocompromise, dates of SARS-CoV-2 polymerase chain reaction (PCR), and formal antigen tests, medications, history of hospitalization, and death. Information regarding COVID-19 symptoms was collected via a questionnaire provided to the participants.
The study involved patients who had at least one SARS-CoV-2-positive reverse transcription PCR (RT-PCR) test or a positive rapid antigen test during the period of identification. These eligible patients were divided into the following cohorts: (1) pre-paxlovid period: patients who tested positive between 1 June 2021 and 30 November 2021 when the dominant variant in Israel was SARS-CoV-2 Delta and paxlovid was not available for treatment and (2) paxlovid period: patients who tested SARS-CoV-2 positive between 2 January and 28 February 2022 when paxlovid was available for treatment in Israel. This category was further sub-classified into (a) paxlovid-treated: SARS-CoV-2 patients who received paxlovid treatment and (b) paxlovid-untreated: SARS-CoV-2 patients who were offered paxlovid treatment but declined. A total of 20,284 patients from the pre-paxlovid period and 10,030 from the paxlovid period were eligible for paxlovid treatment
The index date for patients from the paxlovid treated group was the date when paxlovid was first dispensed, while that for the paxlovid untreated patients was the date the paxlovid treatment was declined. For patients belonging to the pre-paxlovid period, the index date was the average number of days from the date of the first COVID-19 positive test to the date of the paxlovid administration. The resulting number of days was added to the date of the first positive SARS-CoV-2 RT-PCR test or the formal antigen test of the patients from the pre-paxlovid period.
Patients eligible for paxlovid treatment were either aged 70 years and above irrespective of their risk score, aged between 50 to 69 years and had a risk score of two points or more, or aged between 12 to 49 years and had a risk score of four points or more. The COVID-19 risk score point system combined the age and disease characteristics to yield a numerical score ranging from zero to four, where four represented the highest risk of disease progression to severe COVID-19.
Almost 10% of the paxlovid-treated, 25.9% of the paxlovid untreated, and 22.9% of the pre-paxlovid period patients were unvaccinated, while most of the participants had no history of SARS-CoV-2 infection. The mean time duration from the first SARS-CoV-2-positive test to paxlovid treatment was 1.8 days.
A COVID-19 hospital risk score of four was observed in 87.2% of the untreated group, 69% of the paxlovid-treated group, and 64.7% of the pre-paxlovid period group. Additionally, a minimum of one COVID-19 symptom was reported by 74% of the treated, 64% of the untreated, and 81% of the pre-paxlovid period cohorts. Notably, fever and cough were observed in 27.7% and 45% of the paxlovid untreated group, 35.5% and 56.4% of the paxlovid treated group, and 80.6% and 45% of the pre-paxlovid period group, respectively. Moreover, anosmia was reported by 17.8% of the pre-paxlovid, 3% of the paxlovid-treated, and 2.7% of the paxlovid untreated groups.
Notably, the patients from the paxlovid period were more likely to be older than those in the pre-paxlovid period. The number of patients aged 70 years and above was higher in the paxlovid-treated and the paxlovid-untreated groups than those in the pre-paxlovid period group.
Overall, the study findings showed that paxlovid sufficiently lowered the risk of COVID-19 disease severity. The study also highlighted the potential comparability among patients who tested positive for SARS-CoV-2 and supported further analyses by recognizing key aspects for future comparative studies.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
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Outcomes of COVID-19 treatment with Paxlovid - News-Medical.Net
