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

02 Dec 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 and here.

Long-term exposure to air pollution is associated with a higher risk of developing COVID-19 among those people who get infected, shows a study led by the Barcelona Institute of Global Health (ISGlobal).

A series of studies have indicated that regions with higher pre-pandemic levels of air pollution had a higher incidence of COVID-19 cases and deaths. However, the reasons for this association are not yet clear; air pollution could favour airborne transmission of the virus, or it could increase an individual’s susceptibility to infection or disease.

“The problem is that previous studies were based on reported cases, which had been diagnosed, but missed all the asymptomatic or undiagnosed cases,” said Manolis Kogevinas, ISGlobal researcher and first author of the study.

The research team combined technology for measuring a series of virus-specific antibodies in a cohort of adults living in Catalonia, with information on the long-term exposure of such individuals to air pollutants.

The study included 9,605 participants among which there were 481 confirmed cases (5%). In addition, blood samples from over 4,000 participants were taken to determine the presence and quantity of antibodies to five viral antigens. Of these, 18% had virus-specific antibodies, but no association was found between infection and exposure to air pollutants.

However, among those who got infected, an association was found between higher exposure to air pollution and higher levels of antibodies. There was also an association between higher exposure to air pollution and disease symptoms, particularly for severe cases that ended in the hospital or in intensive care.

“Our study provides the strongest evidence globally on the association of ambient air pollution and COVID-19,” said Kogevinas. “These results are in line with the association between air pollution and hospitalisation described for other respiratory diseases such as influenza or pneumonia.”

Air pollution could also contribute by promoting the development of cardiovascular, respiratory or other chronic conditions, which in turn increase the risk of severe COVID-19.

The European Medicines Agency has recommended approval of two monoclonal antibody drugs, Ronapreve and Regkirona for treating COVID-19.

The drugs can now be used in patients aged 12 years of age on older who do not require oxygen, but are at increased risk of their disease becoming severe.

Whilst conducting its review, EMA gave advice to member states on the use of the two therapies, which means they are already available in some countries.

The antibodies are designed to attach to the spike protein of SARS-CoV-2, via which the virus enters human cells. That preferential attachment blocks the virus’ route into cells in the respiratory tract.

EMA evaluated data from studies showing that treatment with Ronapreve or Regkirona significantly reduces hospitalisation and deaths in COVID-19 patients at risk of severe COVID-19.

Another study showed that Ronapreve reduces the chance of contracting COVID-19 if a household member is infected.

Overall 0.9% of patients treated with Ronapreve, 11 of 1,192 in the study, were hospitalised or died within 29 days of treatment. That compared with 3.4% of patients on placebo (40 out of 1,193 patients).

Ronapreve was also found to be effective at preventing symptoms in infected people. Amongst the people who tested positive for SARS-CoV-2 after contact, 29% of people (29 out of 100) who received Ronapreve developed symptoms compared with 42.3% of people (44 out of 104) who received a placebo.

A main study in patients with COVID-19 showed that Regkirona treatment led to fewer patients requiring hospitalisation or oxygen therapy or dying, when compared with placebo.

Among the patients at increased risk of their illness becoming severe, 3.1% of patients treated with Regkirona (14 out 446) were hospitalised, required supplemental oxygen or died within 28 days of treatment, compared with 11.1% of patients on placebo (48 out of 434).

The European Commission has agreed a contract for 55,000 courses of Ronapreve with its manufacturer, Swiss pharma Roche.

Pfizer and the UN-backed Medicines Patent Pool (MPP), announced the signing of a voluntary license agreement for Pfizer’s COVID-19 oral antiviral drug Paxlovid, which has been shown to cut the risk of hospitalisation or death by 89%.

The agreement will enable MPP to support additional production and distribution of the drug by granting sub-licenses to generic medicine manufacturers, with the goal of providing greater access for low and middle income countries.

Under the terms of the license agreement qualified generic medicine manufacturers worldwide that are granted sub-licenses will be able to supply Paxlovid to 95 countries, covering up to 53% of the world’s population.

This includes all low- and lower-middle-income countries and some upper-middle-income countries in sub-Saharan Africa. Pfizer will not receive royalties on sales in low-income countries and will waive royalties on sales in all countries covered by the agreement while COVID-19 remains classified as a public health emergency of international concern by the World Health Organisation.

“Pfizer remains committed to bringing forth scientific breakthroughs to help end this pandemic for all people. We believe oral antiviral treatments can play a vital role in reducing the severity of COVID-19 infections, decreasing the strain on our healthcare systems and saving lives,” said Albert Bourla, Pfizer CEO. “We must work to ensure that all people, regardless of where they live or their circumstances, have access to these breakthroughs, and we are pleased to be able to work with MPP to further our commitment to equity.”

Charles Gore, Executive Director of MPP said, “[Paxlovid] is to be taken together with ritonavir, an HIV medicine we know well, as we have had a license on it for many years, and we will be working with generic companies to ensure there is enough supply for both COVID-19 and HIV.”

The global health agency Unitaid created MPP ten years ago “for this exact purpose”, to secure licenses that enable and accelerate access to affordable quality treatments for people in resource-limited settings, said Philippe Duneton, Executive Director of Unitaid. “This agreement could help us to reach more people more quickly as soon as the medicine is approved and, when coupled with increased access to testing, bring benefits to millions.”

MPP is inviting expressions of interest from generics manufacturers based anywhere in the world for sublicences to manufacture and sell co-packs of Paxlovid and ritonavir.

Scientists at University College London say that by designing next generation vaccines for COVID-19 to activate immune memory T cells, it may be possible to eliminate SARS-CoV-2 at the very start of an infection, thereby helping stop its spread.

The suggestion is based on research published in Nature today, describing how intensive monitoring of healthcare workers in London from before the pandemic took hold in March 2020, showed that despite their high risk, 58 participants did not test positive for COVID-19 at any point.

Analysis of their blood showed they had increased levels of memory T cells that reacted against SARS-CoV-2. These T cells target infected cells expressing replication proteins which the virus needs to spread once it enters a human host cell.

The proteins are common to all coronaviruses and remain highly conserved. Unlike the spike protein targeted by first generation vaccines, these are unlikely to change or mutate.

Leo Swadling, Medical Research Foundation Research Fellow at UCL and lead author, said it was known that some individuals remain uninfected despite having likely exposure to the virus.

“What we didn’t know is whether these individuals really did manage to completely avoid the virus, or whether they naturally cleared the virus before it was detectable by routine tests,” Swadling said. “By intensively monitoring health care workers for signs of infection and immune responses, we identified a minority with this particular SARS-CoV-2 specific T cell response.”

A vaccine that can induce T cells to recognise and target infected cells expressing replication proteins would be more effective at eliminating early SARS-CoV-2, and may have the added benefit of being active against other coronaviruses.

The European Commission has approved its eighth COVID-19 vaccines contract, signing a deal for French biotech Valneva to supply 27 million doses in 2022, and a further 33 million in 2023.

The contract includes the intention to adapt the vaccine to new variant strains of SARS-CoV-2, should that be necessary. With the product yet to be approved by the European Medicines Agency, initial supplies are expected in April 2022.

The agreement is a huge boost for the company, after the UK government cancelled a $1.65 billion contract to buy the vaccine in mid-September.

The vaccine uses traditional technology, in which a whole virus is inactivated. It is hoped that this might persuade people who were reluctant to receive vaccines based on novel mRNA and viral vector platforms, to get vaccinated.

While it is based on the original strain of SARS-CoV-2 that emerged in in Wuhan, in the phase III trial in the UK, the vaccine was effective in preventing severe disease at a time when the Delta variant was dominant.

None of the trial participants who contracted the infection was so seriously ill that they had to be admitted to hospital.

President of the European Commission, Ursula von der Leyen, said, “The contract allows for the vaccine to be adapted to new variants. Our broad portfolio will help us to fight COVID and its variants in Europe and beyond. The pandemic is not over. Everyone who can, should get vaccinated.”

Thomas Lingelbach, CEO of Valneva, said, “Our phase III results confirmed the advantages often associated with inactivated vaccines and we continue to believe that our differentiated vaccine candidate could make an important contribution to the global fight against the COVID-19 pandemic.”

Antibiotic Research UK released new research on antibiotic prescribing in England during the first 12 months of the pandemic, showing there was a 17% reduction in the prescribing of antibiotics in general practice compared to the previous year.

Analysis of the data also reveals that the rise in antibiotic prescribing that occurs each winter, from December to February, compared to the summer, from June to August, was considerably lower at 4%, compared to the rise seen in the winter of 2019 to 2020, before the pandemic began, when it was 21%.  

This study highlights the potential of sustaining lower antibiotic prescribing rates in general practice, according to Colin Garner chief executive of Antibiotic Research UK, a charity which is working to address the rise of antimicrobial resistance.

“Although typical cough symptoms can take up to three weeks to resolve, we also know that antibiotics for most respiratory tract infections - your typical cough, sore throat, earache - do not speed up recovery times. Instead, they often give patients many side effects, and promote the development of resistant bacteria,” Garner said.

The dramatic fall in antibiotic prescribing during the COVID-19 pandemic could be due to many factors, including less infection transmission during lockdowns and fewer visits to GPs. More work is needed to understand the extent to which each of these factors has resulted in this drop in antibiotic prescribing.

But, Garner said, “The data does tell us that antibiotic prescribing can be reduced to help protect us all from the danger of the growing threat of antibiotic resistance.”

The European Medicines Agency (EMA) and the heads of Europe’s national drug regulators have agreed to expedite the review of Merck’s antiviral pill for treating COVID-19, after the UK approved the drug last week.

The context for speeding up the review of molnupiravir is the need for additional guidance on COVID-19 treatments in light of rising rates of infection and deaths due to COVID-19 across the EU. 

This will help national authorities in decisions on whether to use the antiviral prior to its authorisation. 

While the EMA’s more comprehensive rolling review is ongoing ahead of a possible application for marketing approval, this will provide EU-wide recommendations in the shortest possible timeframe.

Molnupiravir is an oral antiviral medicine that reduces the ability of SARS-CoV-2 to multiply in the body, by increasing the number of mutations in the virus in a way that impairs its ability to replicate. 

Emer Cooke, EMA executive director, requested the expedited review following discussions with EMA’s COVID-19 pandemic task force, which brings together experts from across the European medicines regulatory network.

A new study in the journal Veterinary Record shows that pets can be infected with the alpha variant of SARS-CoV-2, which was first detected in Kent, UK, last December.

The study describes the first identification of the SARS-CoV-2 alpha variant in domestic pets; two cats and one dog were positive on PCR testing, while two additional cats and one dog displayed antibodies two to six weeks after they developed signs of cardiac disease. Many owners of these pets had developed respiratory symptoms several weeks before their pets became ill and had also tested positive for COVID-19.  

All of these pets had an acute onset of cardiac disease, including severe myocarditis, an inflammation of the heart muscle.

“Our study reports the first cases of cats and dogs affected by the COVID-19 alpha variant and highlights, more than ever, the risk that companion animals can become infected with SARS-CoV-2,” said lead author Luca Ferasin, of the Ralph Veterinary Referral Centre, in the UK.

“We also reported the atypical clinical manifestations characterised by severe heart abnormalities, which is a well-recognised complication in people affected by COVID-19, but has never described in pets before. However, COVID-19 infection in pets remains a relatively rare condition and, based on our observations, it seems that the transmission occurs from humans to pets, rather than vice versa.”

Meanwhile, researchers in the US have shown that 40% of white deer from animals sampled across the country tested positive for SARS-CoV-2, and conclude the infection passed from humans to deer and is now being transmitted deer-to-deer.

Evidence of transmission of SARS-CoV-2 from human to animals and then spreading among animals is of concern because of the potential for an increased number of mutations promoting the development of more virulent variants.

The possibility exists that new animal reservoirs of SARS-CoV-2 could emerge, each with unique potential to maintain, disseminate, and drive novel evolution of the virus. Of particular concern are wildlife species that are both abundant and live in close association with humans

Birmingham University has signed a licensing agreement to commercialise a novel anti-viral nasal spray that protects against COVID-19.

COVID-19 is both contracted and transmitted by inhalation of droplets or aerosols containing the SARS-CoV-2 virus, and the nose is the major viral entry point into the body. The anti-viral spray is designed to work by encapsulating and deactivating the virus while it is still in the nose, preventing its wider uptake by the body.

It is formulated with two compounds that are already approved by regulatory bodies in the UK, Europe and the US, and widely used in drugs and food products.

The first is a polysaccharide gel which is retained on the mucous-coated epithelia in the nose where it coats and retains the virus, so the virus does not travel further down the respiratory tract. The second compound, carrageenan, is a potent antiviral agent.    

Researchers in Birmingham have confirmed the complete inhibition of SARS-CoV-2 activity by carrageenan and the ability of the formulation to prevent contraction and transmission in cell culture.

They also confirmed that the spray covers a surface area that is six times greater than when formulated without the gel.

The formulation, engineered by Liam Grover, from the university’s Healthcare Technologies Institute, has been licensed to the company Birmingham Biotech for commercialisation. “As COVID-19 restrictions around the world are gradually lifting, there is a real need for effective methods of viral protection. While existing measures like wearing masks and handwashing remain essential, this nasal spray provides an additional protective measure with the potential to reduce transmission,” Grover said.

Worldwide carbon emissions in 2021 are set to rebound to close to pre-COVID levels, according to the 16th edition of the Global Carbon Project.

COVID-19 lockdowns caused fossil carbon emissions to drop by 5.4% in 2020, but the new report projects an increase of 4.9% this year, to 36.4 billion tonnes.

Emissions from coal and gas will grow more in 2021 than they fell in 2020, but emissions from oil use remain below 2019 levels.

For major emitters, 2021 emissions appear to be returning to the pre-COVID trends of decreasing CO2 emissions for the US and EU, and increasing CO2 emissions for India. For China, the response to the COVID-19 pandemic has sparked further growth in CO2 emissions, pushed by the power and industry sectors.

The researchers say a further rise in emissions in 2022 cannot be ruled out if road transport and aviation return to pre-pandemic levels and coal use is stable.

"The rapid rebound in emissions as economies recover from the pandemic reinforces the need for immediate global action on climate change," said Pierre Friedlingstein of Exeter University’s Global Systems Institute, who led the study.

"The rebound in global fossil CO2 emissions in 2021 reflects a return towards the pre-COVID fossil-based economy. Investments in the green economy in post-pandemic recovery plans of some countries have been insufficient so far, on their own, to avoid a substantial return close to pre-COVID emissions," Friedlingstein said.

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