LIVE BLOG: R&D response to COVID-19 pandemic

27 Jul 2021 | Live Blog
Covid 19 blog

The coronavirus pandemic is disrupting universities and research institutes across the world. But the same institutions are also working very hard to find out how the disease can be stopped and its effects mitigated.

Follow this live blog for the latest updates on how the crisis is impacting research and innovation, and what governments, funders, companies, universities, associations and scientists are doing to stop or cope with the pandemic.

You can read the full archive of this blog here.

MeMed Ltd has received the CE Mark in Europe for its new diagnostic MeMed COVID-19 Severity, a 15 minute test to assess which patients arriving in accident and emergency with COVID-19 infections are likely to progress to severe disease.

The test measures multiple proteins from a blood sample and applies machine learning to stratify the risk that a patient with COVID-19 disease is likely to experience severe outcomes.

The test is designed to identify patients who will need escalated care and those who may be safely discharged from the hospital and instructed to self-isolate at home.

With the CE mark, Haifa, Israel-based MeMed can now commercialize the test to help identify COVID-19 patients at risk of severe outcomes, and enable clinicians to manage what is increasingly likely to become an endemic situation, said Eran Eden, MeMed’s co-founder and CEO. MeMed COVID-19 Severity is also relevant for authorities looking at preparedness for future pandemics.

“It is another exciting step in the company’s long-term vision of harnessing the power of the host-immune response in order to transform the way infections are detected and managed,” Eran said.

Helping it to reach this point, in 2015 MeMed was awarded a Horizon Europe grant of €3 million.

The company recently published the results from a multinational clinical study, demonstrating the ability of its test to accurately predict severe COVID-19 respiratory failure. MeMed has also completed an additional independent multinational validation study, with the results due to be published in the coming months.

“Highly sensitive and accurate diagnostic and prognostic tests are key tools for clinicians, said Sergey Motov, professor of Emergency Medicine at Maimonides Medical Centre in New York “As an ER doctor myself, I am fascinated by the potential for host immune response technologies to help predict patient outcomes.” With tools like MeMed COVID-19 Severity doctors can assess the likelihood of patients suffering from severe complications, enabling tailored treatments or discharge if the risk of deteriorating is low, Motov said.

Researchers at Birmingham University have published an article demonstrating a new spike antibody lateral flow device is able to monitor antibody response following vaccination or natural infection with SARS-CoV-2 over time.

The paper shows differences in strength of antibody response with the Pfizer and AstraZeneca vaccines, and in the natural antibody responses to the original variant of the virus, first identified in Wuhan, China, around which the vaccines are designed.

The research also shows that these antibodies cross-react to the spike protein of different variants, such as the Delta variant that originated in India and which is now responsible for most infections in Europe.

The study was conducted using a lateral flow device called AbC-19TM LFD, developed by UK diagnostics specialist Abingdon Health. Unlike many of the lateral flow tests on the market, the test is designed to identify responses to different COVID-19 variants. 

With the successful roll-out of vaccinations, it is now imperative to monitor the neutralising antibody levels in the worldwide population, to maintain the safety of the public and instil confidence in people as they return to normal life, said Chris Yates, CEO of Abingdon Health

“This study demonstrates how AbC-19TM can be used to monitor antibody response alongside vaccines, as well as the neutralising antibody response following natural infection. The AbC-19TM test will allow individuals to know their own status, which is becoming a growing concern, and allow healthcare agencies and healthcare professionals worldwide to manage the continued vaccination roll-out and to develop effective and targeted booster vaccination programmes,” Yates said.

In addition, the study also shows the ability of the company to change the format of the test if other variants of concern emerge that generate a different antibody response.

Next month, Abingdon intends to make a supplementary product available, initially for research use only, which provides a semi-quantitative result, indicating the strength of antibody response and possibly immunity.

The European Medicines Agency has started a rolling review of Sanofi Pasteur’s COVID-19 vaccine Vidprevtyn.

The decision to start the rolling review is based on preliminary results from laboratory studies and early clinical studies in adults, which suggest that the vaccine triggers the production of antibodies against the SARS-CoV-2 virus that causes COVID-19, and may help protect against the disease.

EMA says it will evaluate data as they become available, with the rolling review continuing until enough evidence is available for a formal marketing authorisation application.

The agency said it cannot predict the overall timelines, but should take less time than normal to evaluate an eventual application because of the work done during the rolling review.

Vidprevtyn is a protein-based vaccine that contains a laboratory-grown version of the spike protein found on the surface of SARS-CoV-2. It also contains an adjuvant to help strengthen the immune response to the vaccine.

The World Trade Organisation published a list of trade related problems it says are to blame for limited access to COVID-19 vaccines in poorer countries, as it sat down with the World Health Organisation to discuss how to address the problem.

The private discussion, aimed to identify obstacles and propose solutions for increasing vaccine rates and bridging the wide gap in vaccination rates between rich and poor countries.

Participants described current and projected production volumes as well as plans for new investments in production capacity. They shared experiences about specific supply chain bottlenecks they were encountering, from export restrictions and raw material shortages and onerous regulatory processes, and exchanged ideas on how these might be addressed.

They also discussed issues around the transfer of know-how and technology, as well as factors influencing decisions on licensing intellectual property.

While there was broad agreement on the importance of keeping supply chains open and predictable, different perspectives were expressed on the proposed waiver of the WTO's Trade-Related Intellectual Property Rights Agreement in relation to vaccines and other products needed to combat COVID-19.

Low-income countries would add $38 billion to their GDP forecast for 2021 if they had the same COVID-19 vaccination rates as high-income countries, according to new data released today by the United Nations Development Programme, the World Health Organisation (WHO) and Oxford University.

As a result, global economic recovery is at risk if vaccines are not equitably manufactured, scaled up and distributed, with COVID-19 vaccine inequity having a lasting impact on socio-economic recovery in poorer countries.

The new COVID-19 Vaccine Equity Dashboard, combines the latest information on COVID-19 vaccination with the most recent socio-economic data, to illustrate why accelerating vaccine equity is not only critical to saving lives but also to driving a faster and fairer recovery with benefits for all.

“In some low- and middle-income countries, less than 1% of the population is vaccinated – this is contributing to a two-track recovery from the COVID-19 pandemic”, said Achim Steiner of the UN development programme.

“Vaccine inequity is the world’s biggest obstacle to ending this pandemic and recovering from COVID-19,” said Tedros Adhanom Ghebreyesus, director general of the World Health Organisation.

The Global Dashboard breaks down the impact of accessibility against a target for countries to vaccinate their at-risk populations, first to reduce mortality and protect the health system, and then move on to vaccinating larger shares of the population to reduce disease burden and re-open socio-economic activity.

Since the beginning of the pandemic, several reports have indicated that SARS-CoV-2 has been transmitted from humans to animals, as evidenced by the transmission of the virus between keepers and tigers and lions in the Bronx Zoo in New York.

However, to date the full range of animal species that are susceptible to the viral infection remains unclear. Conventionally, that would be assessed experimentally by infecting a large variety of animal species with SARS-CoV-2, but researchers at the University of Bern have used their knowledge of in vitro cell culture models of the human respiratory tract to create a large collection of cell models from various domesticated and wild animals.

This will be an important resource in controlling the pandemic. "This will benefit the general public since it will help prevent new SARS-CoV-2 variants from developing in animal reservoirs and potentially being reintroduced into the human population, to which the current vaccines may not be protective," said Ronald Dijkman, from the Institute for Infectious Diseases at the University of Bern.

Currently, Swiss research funding from the EU is under threat. The work on the test tube zoo was supported by the European Commission’s Marie Sklodowska-Curie Innovative Training Network, with the Swiss National Science Foundation, the German Federal Ministry of Education and Research, and the Swiss Federal Food Safety and Veterinary Office.

The team isolated airway epithelial cells from tissue from deceased animals and created a cell biobank from different animal species that can be used to determine whether these animals can be infected with SARS-CoV-2.

No live animal experiments were involved. To date, the cell biobank contains primary cells from a rhesus macaque, cat, ferret, dog, rabbit, pig, cattle, goat, llama, camel, and two bat species.

"Our collection is unique, and thus far we are the first that have used such a large collection of advanced in vitro cell culture models from various domesticated and wildlife animal species to assess their susceptibility to SARS-CoV-2 infection,” Dijkman said.

The researchers found their in vitro results agree well with previously published studies using live animals to assess susceptibility to SARS-CoV-2 infection. For example, the researchers observed that SARS-CoV-2 replicated in the cell models of monkey and cats, without the need for the virus to adapt.

"Our findings, together with the reports from previously documented spillover events, indicate that close surveillance of these animals and other close relatives, whether they live in the wild, captivity or households, is necessary,” said Dijkman.

Testing of an entire Italian town shows antibody levels remain high nine months after SARS-CoV-2 infection, whether symptomatic or asymptomatic, according to researchers from the University of Padua and Imperial College London.

They tested more than 85% of the 3,000 residents of Vo', Italy, in February - March 2020 for infection with SARS-CoV-2, the virus that causes COVID-19, and then tested them again in May and November 2020 for antibodies against the virus.

The team found that 98.8% of people infected in February - March showed detectable levels of antibodies in November. There was no difference between people who had suffered symptoms of COVID-19 and those that had been symptom-free. The results are published in the journal Nature Communications.

Antibody levels were tracked using three assays that each detected different antibodies generated in response to different parts of the virus. While all antibody types showed some decline between May and November, the rate of decay differed.

The team also found cases of antibody levels increasing in some people, suggesting potential re-infections with the virus, providing a boost to the immune system.

Ilaria Dorigatti, from the MRC Centre for Global Infectious Disease Analysis at Imperial College, said, "We found no evidence that antibody levels between symptomatic and asymptomatic infections differ significantly, suggesting that the strength of the immune response does not depend on the symptoms and the severity of the infection.”

However, the study does shows that antibody levels vary. This means that caution is needed when comparing estimates of infection levels in a population obtained in different parts of the world with different tests and at different times.

Testing in May showed 3.5% of the Vo' population had been exposed to the virus, even though not all of these subjects were aware of their exposure, given the large fraction of asymptomatic infections.

The team also investigated the infection status of household members, to estimate how likely an infected member is to pass on the infection within the household. Their modelling suggests that there was a probability of about 1 in 4 that a person infected with SARS-CoV-2 passes the infection to a family member and that 79% of transmission is caused by 20% of infections.

This confirms that there are large differences in the number of secondary cases generated by infected people. The large differences in how one infected person may infect others in the population suggest that behavioural factors are key for epidemic control. Physical distancing, as well as limiting the number of contacts and mask wearing, continue to be important to reduce the risk of transmitting the disease, even in highly vaccinated populations.

Teasing apart the impact of various control measures, the researchers showed that, in the absence of case isolation and short lockdowns, manual contact tracing alone would not have been enough to suppress the epidemic.

Spanish researchers have shown a blood test that quantifies ACE2, the cellular protein which allows the SARS-CoV-2 virus to enter human cells, and ACE2 fragments produced as a result of interaction with the virus, could be an effective method for monitoring SARS-CoV-2 infection.

In a study carried out during the first wave of the pandemic, patients with COVID-19 who were in the acute phase of infection had significantly reduced blood levels of the full-length ACE2 protein, while levels of an ACE2 fragment, generated as a result of interaction with the virus, increased.

The abnormal levels of ACE2 and truncated ACE2 returned to normal after the patients recovered, suggesting these two forms of ACE2 could be used as a biomarker of the evolution of coronavirus infection. In addition, truncated ACE2 levels made it possible to distinguish between patients infected with SARS-CoV-2 and those with flu, the researchers say.

The latest assessment of the COVID-19 situation in the EU by the European Medicines Agency (EMA) and the European Centres for Disease Control (ECDC) shows the Delta variant (B.1.617.2), first identified in India, is spreading fast in Europe and may “seriously hamper” efforts to control the pandemic.

The evidence suggests Delta is 40% to 60% more transmissible than the earlier Alpha (Β.1.1.7) variant first identified in Kent, which drove the second wave of infection from December to May, and which was the first major variant of concern in the EU.

In addition, the Delta variant may be associated with higher risk of hospital admission, EMA and ECDC said in a joint update.

ECDC estimates that by the end of August the Delta variant will represent 90% of all SARS-CoV-2 viruses circulating in the EU.

Taken together, this makes it essential for countries to speed up vaccination programmes, including second doses, to prevent new infections and reduce the possibility of the further emergence of variants, the update says.

The risk of severe disease and mortality caused by COVID-19 is greater for older age groups and those with other underlying conditions. However, there are still 10 EU/EEA countries where nearly 30% or more of individuals older than 80 years have not yet completed the recommended vaccination course, according to ECDC’s Vaccine Tracker.

Further effort is also needed in some countries to increase vaccine uptake among health and social care workers.

The use of two different vaccines may allow populations to be protected more quickly and make better use of available vaccine supplies, but currently EMA and ECDC say they are not in a position to make any definitive recommendations on use of different COVID-19 vaccines for the two doses.

It’s also too early to confirm if and when a booster dose for COVID-19 vaccines will be needed.

Other measures such as mask wearing and social distancing will need to be maintained at a level sufficient to contain community transmission of the Delta variant until more of the populations are fully vaccinated, EMA and ECDC say.

ReiThera has published preliminary safety and immunogenicity data from the phase II clinical of GAd-COV2, its novel COVID-19 vaccine, showing it was well tolerated after the first, and even better after the second dose.

Antibody responses against the SARS-CoV-2 spike protein were achieved in over 93% of the volunteers at three weeks after the first dose, reaching 99% after the second dose. Five weeks after the first vaccination, levels of spike-binding and SARS-CoV-2 neutralising antibodies were comparable to that measured in a reference group of patients recovering from COVID-19 infection.

The study, conducted in 24 clinical centres in Italy, enrolled 917 volunteers over the age of 18, of whom 25% were over the age of 65 and/or had conditions associated with an increased risk of severe disease in case of SARS-CoV-2 infection. Volunteers were randomised to receive either a single vaccine dose followed by a placebo dose, or two vaccine doses, or two doses of placebo, with a three week interval between the two administrations.

“We are very excited about the preliminary phase II data,” said Roberto Camerini, Reithera’s medical director. “Our vaccine candidate confirmed its excellent safety and good immunogenicity profile in a large cohort.”

The phase III programme has approval from the European Medicines Agency and other regulatory agencies, and will start as soon as possible, Camerini said. 

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