The CDC released 70K+ more doses of the #RSV vaccines for babies. Get those shots! 💉
The anti-vaccine movement is starting to show in measles cases. Increase of 18% in cases and 43% increase in deaths worldwide from 2021 to 2022. Most of the #measles deaths are in young kids. 😔
A VA study found that people taking immunosuppressive drugs (so, #immunocompromised) for organ transplants, rheumatoid arthritis, inflammatory bowel disease (IBD), or psoriasis are still somewhat likely develop severe COVID-19 even if they’ve been vaccinated. 22.7% of organ transplant recipients are likely to get severe #COVID, 12.8% of rheumatoid arthritis patients, 6.9% of IBD patients, and 7.3% of psoriasis patients. And Paxlovid helped a lot.
And another Paxlovid “rebound” study, comparing #COVID patients of similar health histories that were treated or untreated with #Paxlovid. To start, they really broaden the definition of “rebound” so that 20% of the untreated group would qualify as having “rebound.” Many people in both treated and untreated groups still report having at least 1 COVID symptom even after day 15 (70%). Also, only about 20% of people in both groups were testing negative on PCR tests by day 10…
…Both Drs. Griffin and Racaniello point out how “odd” this is, and question how you’re going to measure “rebound” if nobody goes to zero to rebound from? The study did find that people who took #Paxlovid have fewer symptoms and lower viral load than untreated, so it should still help with transmission. And observe that symptom rebound is a separate thing from viral rebound. So Paxlovid should really be prescribed for everyone with #COVID who is high risk.
The middling results of using COVID convalescent plasma (given to #immunocompromised ppl who can’t take anything else) may be down to timing - if you give it late, it doesn’t have much of an effect. Also, the vast majority given plasma were also on steroid drugs at the time, which may have affected the plasma’s impact. (You take steroids to reduce inflammation from hyperactive immune response.) It emphasizes the importance of giving COVID convalescent plasma in first week.
Taking 100mg of fluvoxamine 2x a day (an SSRI mostly used for OCD treatment) does not help people recover faster from mild to moderate #COVID. Apparently a bunch of people really thought this would work, because it was a thing that people told each other to take for COVID recovery. Sorry, it doesn’t work!
Another thing that doesn’t help with #COVID disease progression - Conestat A (ConA) a recombinant human C1 inhibitor, which generally affects inflammation. They even stopped the study early because of how useless it was.
A small study showed that people with #LongCOVID do not have reactivated Epstein-Barr virus in their blood. Dr. Griffin wants to reframe this, since some of his long COVID patients do have reactivated EBV, but some do not. It’s certainly true it’s not causative, but it also highlights the fact that a blood test for long COVID is still a ways off.
Still behind with #TWiVTLDR but I need to knit a Christmas gift and I think this is good background noise for that, so I may be catching up soon! 🤞🏻 This Week in Virology from November 9: https://www.microbe.tv/twiv/twiv-1060/
Dr. Griffin says we’re still seeing about 200 deaths a day from #COVID, and hospitalizations are starting to tick up.
Did you know that the CDC has voluntary nasal swab stations for people flying in from overseas? (At some airports, they also sample airplane wastewater.) They now do #flu, RSV, #COVID, and “other respiratory viruses” at 7 airports, and if they get a positive sample, they sequence it and upload it to public databases (deidentified obv) for scientists and policy makers to use. The participating airports are LAX, EWR, SEA, IAD, BOS, SFO, JFK.
Cases of syphilis in newborns (from birth parent) has increased 755% in last 10 years. If baby survives until delivery, they might develop blindness, deafness, developmental delays, or skeletal abnormalities if not treated properly. There is lack of testing and lack of treatment for pregnant people. Dr. Griffin describes both denial of a positive #syphilis test but also a shortage of common treatments. It’s important to start treating right when a pregnant person tests positive.
Looking at #COVID hospitalizations in Hong Kong over 2 years (6 epidemic waves) shows #omicron is “comparable” in severity to the ancestral strain in unvaccinated, uninfected population. (Omicron is actually a little more severe than ancestral, the figure shows, but it's not statistically significant.) Any perceived change in severity is due to the population being vaccinated. “The virus hasn’t gotten milder. #Vaccines work!”
Vaccinated people hospitalized with delta or omicron who die or were admitted to the ICU within 28 days have lower T-cell response markers to #COVID. 87% had antibody response, but only 50.8% had a detectable T-cell response. Hospitalized people who had both antibody and T-cell response were 84% less likely of dying and 62% less likely of being admitted to the ICU. “T-cells save your life!”
An article about masks that they say everybody should read! Masking (even badly) resulted in less incidences of #COVID. Dr. Griffin also goes into a history lecture about #masks and how they were used successfully, and subsequently derided, even in past centuries. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811136
#COVID convalescent plasma (for #immunocompromised people who can’t take anything else) given to ventilated patients had the greatest effect if given within 48 hours. Waiting to see how people do is not useful.
Blergh, this #TWiVTLDR is from July 8 but I feel like I can’t skip episodes - there’s interesting science! But I'll skip XBB booster talk until September. 😜 https://www.microbe.tv/twiv/twiv-1022/
Study re: leprosy in US! 6 cases in CA, all older men. LONG incubation - one reported contact w/ armadillo 50+ yrs ago. Early symptoms include tingling in fingers with bumpy scarring in the nerves there and spots on the skin where the person can’t feel anything. It’s curable with months-long regimens with pills.
A study tested #COVID patients with both rapid antigen tests (RAT) and rtPCR every 48 hours for 15 days. RAT sensitivity over time was 93% for people w/ symptoms, but 62.7% for asymptomatic ppl. The sensitivity went up for asymptomatic people to 79% after 3 tests, 48 hours in between.
The study matched rtPCR cycle threshold for positive RATs - basically, if the CT value was 20 or less, the RATs would always be positive (aka if the person was “teeming with #COVID virus”). Once you get to 25-30 cycles, the sensitivity starts to go down for RATs. But note that even at 30 cycles, the RATs are still 80% sensitive if the person has symptoms.
The “effectiveness” of the bivalent booster was examined in healthcare workers at the Cleveland Clinic, who were the first to get it. 8.7% of them got #COVID, meaning the vaccine was 29.3% effective for BA.4/5, 20% for BQ, and no difference for XBB. Dr. Griffin again emphasizes that long-term immunity still persists with the primary series, and that if you’re at risk, Paxlovid is still most important for you.
A retrospective cohort study found that vaccinated adults 18-59 with health conditions who took Paxlovid after testing positive were about 30% less likely to go to the ER, be hospitalized, or die. Dr. Griffin would love to see long #COVID outcomes from this too, but the data shows that Paxlovid is not necessarily something you need to give everyone.
(For context, Paxlovid shows ~80% reduction in hospitalizations and death for people over 65.)
Scientists have been looking into genome-wide associations with #LongCOVID, and the first one they’ve found is FoxP4 locus. FoxP4 is also associated with #COVID severity, lung function, and some cancers. They’re thinking in some people, FoxP4 is expressed/regulated differently in the lungs, in both aveolar and immune cells. The same genome family also generally expressed in other mucus-secreting cells like the intestines.
Vaccinated ppl who got #COVID had ⬆️ levels of antigen-presenting monocytes, mature monocytes, functionally-component T-cells, and mature neutrophils, and ⬇️ levels of activated T-cells, activated neutrophils, and immature B-cells. Apparently this mix of types protects against #LongCOVID, because the differences are starker for people with more severe COVID and unvaxxed people. Dr. Griffin says he likes to think vaccination “corrects” your immune response, rather than “boosting” it.
Polio cases now circulating worldwide, so the CDC moved to “level 2: practice enhanced precautions” if traveling to these countries: https://wwwnc.cdc.gov/travel/notices/level2/global-polio (Note Canada and the UK are on this list…and Dr. Racaniello points out the US also has circulating #polio. 😜)
Basically, get the polio #vaccine if you haven’t, and get a booster if you have had the initial dose but it’s been a while.