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

02 Jun 2022 | 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.

The results of a new randomised clinical trial, published in The Lancet Global Health, have demonstrated that using the depression treatment fluvoxamine to treat high-risk outpatients with early-diagnosed COVID-19 reduces the need for prolonged observation in an emergency setting or hospitalisation, compared to a control group who received a placebo.

The results represent an important step in understanding the role of fluvoxamine for outpatients with early diagnosed, symptomatic COVID-19 and reinforce the concept that it is possible to generate rapid and high-quality evidence during the pandemic.

“Recent vaccination developments and campaigns have proved to be effective and important in reducing the number of new symptomatic cases, hospitalisations, and deaths due to COVID-19. However, COVID-19 still poses a risk to individuals in countries with low resources and limited access to vaccinations,” said Edward Mills of McMaster University, Canada, co-principal investigator on the trial.

“Identifying inexpensive, widely available, and effective therapies against COVID-19 is therefore of great importance, and repurposing existing medications that are widely available and have well-understood safety profiles is of particular interest.” Mills said.

Fluvoxamine is a selective serotonin reuptake inhibitor used to treat mental health conditions such as depression and obsessive-compulsive disorders. It was chosen for study as a potential treatment for COVID-19 due to its anti-inflammatory properties.

The trial began in June 2020 with the fluvoxamine arm beginning in January 2021, recruiting a cohort of Brazilian adults who were symptomatic, had tested positive for COVID-19, were unvaccinated, and had at least one additional criterion for high risk.

A total of 741 participants were given 100mg of fluvoxamine twice daily for ten days and 756 participants received a placebo. The trial participants were observed for 28 days post-treatment, with the main outcome of the trial being patients spending more than six hours receiving physician treatment at a specialised COVID-19 emergency setting, or hospitalisation.

Of the 741 participants who received fluvoxamine, 79 (10.6%) required an extended stay for more than six hours in an emergency setting or hospitalisation, compared to 119 (15.7%) of participants who received the placebo. These results demonstrated an absolute reduction in the risk of prolonged hospitalisation/prolonged emergency care of 5% with a relative risk reduction of 32%.

An Anglo-German team of researchers has identified a potential new treatment that suppresses the replication of SARS-CoV-2, after showing that cells infected with virus can only generate more viruses when a particular metabolic pathway is activated.

A synthetic version of vitamin B1, which is a known inhibitor of this pentose phosphate pathway, blocked SARS-CoV-2 replication and the virus could not replicate in infected cells.

The research, by scientists at the University of Kent and Goethe-University Frankfurt, found synthetic vitamin B1 also increased the antiviral activity of another drug. This shows that pentose phosphate pathway inhibitors are a potential new treatment option for COVID-19, both on their own and in combination with other treatments.

In addition, the mechanism differs from that of other antiviral COVID-19 drugs, and viruses resistant to these may be sensitive synthetic vitamin B1.

Martin Michaelis, professor of molecular medicine at Kent University said, “This is a breakthrough in the research of COVID-19 treatments. Since resistance development is a big problem in the treatment of viral diseases, having therapies that use different targets is very important and provides further hope for developing the most effective treatments for COVID-19.”

Co-researcher, Jindrich Cinatl of the Institute for Medical Virology at Goethe-University Frankfurt, said, “Targeting virus-induced changes in the host cell metabolism is an attractive way to interfere specifically with the virus replication process.”

A large-scale government subsidy aimed at encouraging people to eat out in restaurants in the wake of the first 2020 COVID-19 wave in the UK, accelerated a second COVID-19 wave, according to new research.

The COVID-19 pandemic hurt economies around the world, with the hospitality sector particularly vulnerable, due to the decline in tourism and leisure activities.

This rippled across economies, as hospitality workers then reduce their spending and had trouble meeting basic expenses. Some governments used fiscal policy to help the hospitality sector by stimulating demand. One example is the UK Eat-Out-To-Help-Out scheme, which had the inadvertent effect of promoting COVID-19 infections, according to research by Thiemo Fetzer of the Department of Economics at Warwick University.

The scheme, designed to encourage demand for hospitality and restaurants, directly subsidised the cost of meals and non-alcoholic drinks by up to 50% in participating restaurants across the UK for meals served on all Mondays to Wednesdays from 3 August to 31 August 2020.

The discount was capped at a maximum of £10 per person, but there was no limit on how often people could benefit. Aggregate data suggest that the government subsidised 160 million meals, costing the taxpayer £849 million. Restaurant visits increased dramatically on Monday to Wednesday. Official government statistics released at the end of January 2021 suggest that at least 59,981 businesses registered for the scheme.

Areas with higher participation in the Eat-Out-To-Help-Out scheme saw both a notable increase in new COVID-19 infection clusters within a week of the scheme starting, and a deceleration in infections within two weeks of the scheme ending.

Areas that had notable rainfall during the prime lunch and dinner hours on days the scheme was active, making customers less likely to visit restaurants to take advantage of the subsidised meals, had a lower infection rate.

The empirical estimates suggest that the scheme may have been responsible for around 11% of all new detected COVID-19 clusters emerging during August and into early September in the UK.

A key question about SARS-CoV-2 is whether it is behaving, or will behave, as a seasonal virus like influenza, or whether it will be equally transmitted during any time of the year.

Now, a new study led by the Barcelona Institute for Global Health (ISGlobal), has provided evidence that COVID-19 is a seasonal infection linked to low temperatures and humidity, much like flu.

The results, published in Nature Computational Science, also highlight the considerable contribution of airborne SARS-CoV-2 transmission to the spread of infection and the need to promote air hygiene measures.

“The question of whether COVID-19 is a genuine seasonal disease becomes increasingly central, with implications for determining effective intervention measures,” said Xavier Rodó, director of the Climate and Health programme at ISGlobal and coordinator of the study.

Rodó and colleagues first analysed the association of temperature and humidity in the initial phase of SARS-CoV-2 spread in 162 countries across five continents, before changes in human behaviour and public health policies were put into place. The results show a negative relationship between the transmission rate (R0) and both temperature and humidity at the global scale: higher transmission rates were associated with lower temperatures and humidity.

The researchers then analysed how this association between climate and disease evolved over time, and whether it was consistent at different geographical scales, using a statistical method that was specifically developed to identify similar patterns of variation at different windows of time.

Again, they found a strong negative association for short time windows between disease, in terms of number of cases and climate, with reference to temperature and humidity. There were consistent patterns during the first, second and third waves of the pandemic at different spatial scales: worldwide, at country level, down to individual regions within highly affected countries, where they looked at Lombardy, Thüringen and Catalonia, and even to the city level in the case of Barcelona.

The first epidemic waves waned as temperature and humidity rose, and the second wave rose as temperatures and humidity fell. However, this pattern was broken during summertime in all continents. “This could be explained by several factors, including mass gatherings of young people, tourism, and air conditioning, among others,” said Alejandro Fontal, first author of the study.

Applying the model in the southern hemisphere, where the virus arrived later, the same negative correlation was observed.

Finally, using an epidemiological model, the researchers showed that incorporating temperature into the transmission rate works better for predicting the rise and fall of the different waves, particularly the first and third ones in Europe. “Altogether, our findings support the view of COVID-19 as a true seasonal low-temperature infection, similar to influenza and to the more benign circulating coronaviruses,” said Rodó.

The research also highlights the need to include meteorological parameters in the evaluation and planning of control measures. 

EMA’s human medicines committee has said a booster dose of Moderna’s COVID-19 vaccine Spikevax may be considered in people aged 18 years and above, after reviewing data showing a third dose given 6 to 8 months after the second dose led to a rise in antibody levels in adults whose antibody levels were waning.

The booster dose consists of half the dose used for the primary vaccination schedule.

Current data indicate the pattern of side effects after the booster is similar to what occurs after the second dose. The risk of inflammatory heart conditions or other very rare side effects after a booster is being carefully monitored, EMA said.

EMA does not dictate vaccines policy at a national level, but its approval means public health bodies may issue official recommendations on the use of booster doses, taking into account the local epidemiological situation, as well as new effectiveness data and the fact there is limited safety data for the booster dose.

Earlier in October EMA concluded that a booster dose of Pfizer/BioNTech’s vaccine may be considered at least six months after the second dose for people aged 18 years and older.

The Commission has established a portfolio of ten potential COVID-19 treatments and says it will expedite access to the drugs across Europe, once they are approved.

The list includes possible treatments for COVID-19 that are in the process of being authorised and which should therefore soon be available on the European market.

While vaccination against COVID-19 offers the best protection against infection, the Commission says at the same time it is ensuring that the appropriate treatments are available for those who are infected.

“We have already signed four joint procurement contracts for different treatments related to COVID-19 and we are ready to negotiate more. Our aim is to allow at least three treatments in the coming weeks, and possibly two more by the end of the year, and to help member states to access them as soon as possible,” said Stella Kyriakides, health commissioner.

The list was drawn up by a group of independent scientific experts who examined 82 drugs at an advanced stage of clinical development, taking into account the different types of product needed for different patient populations and at varying stages, and degrees of severity of the disease.

This list of ten treatments includes three categories and will continue to evolve as new scientific data becomes available:

 

1. Antiviral monoclonal antibodies, most effective in the early stages of infection:

Ronapreve, a combination of two monoclonal antibodies casirivimab and imdevimab, from Regeneron Pharmaceuticals and Roche

Xevudy (sotrovimab), from Vir Biotechnology and GlaxoSmithKline

Evusheld, a combination of the two monoclonal antibodies tixagevimab and cilgavimab, from AstraZeneca

 

2. Oral antivirals to be used as soon as possible after infection:

Molnupiravir, from Ridgeback Biotherapeutics and Merck Sharp Dome

PF-07321332, from Pfizer

AT-527 from Atea Pharmaceuticals and Roche

 

3. Immunomodulators for the treatment of hospital patients:

Actemra (tocilizumab), by Roche

Kineret (anakinra) by Swedish Orphan Biovitrum

Olumiant (baricitinib), Eli Lilly

Lenzilumab, by Humanigen

The COVID-19 pandemic made visible the poor state of health data research in Germany. While urgent issues regarding the transmission dynamics of the virus, interaction with other health conditions, and recording and assessment of reactions to vaccines, were being intensively studied and answers being found in other European countries, in Germany this is only happening with delays, requires great effort - or is even entirely impossible.

Against this backdrop, the Interdisciplinary Commission for Pandemic Research of the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) has now issued a statement, in which it calls for data for health-related research to be made more accessible and more linkable.

The Commission points out that research in Germany is not only suffering from a lack of data and methodological underpinnings, but that much needed progress in health-related research is blocked, as access to existing data is often inadequate and that linking such data is associated with significant organisational and legal obstacles.

In its statement, the Commission highlights five fields of action that are interconnected factually and temporally, and should be addressed jointly.

Development of a system of consent for legally compliant and trust-based use of data is required as a first step. In addition, electronic patient records should be developed further to feature an opt-out approach for consent to data collection. National disease registers or epidemiological registers should be established and expanded to avoid incomplete data analysis and duplicates, detect gaps and harness linkage potential. It must also be ensured that these registers are searchable and can be linked to other data sources.

The Commission also says that data should be consolidated and that a sustainably funded central data integration body should be established. This body should function as a trust agency that is legally and organisationally able to grant access to data and to link different sets of data.

The onset of pandemic may have amplified existing gender inequalities in academia, according to an analysis of data on over five million academic authors by Flaminio Squazzoni and colleagues at the University of Milan.

The study of 2,329 academic journals found that during the first wave of the COVID-19 pandemic fewer manuscripts were submitted by women than men, and that this gender gap was especially prominent in the medical research and for women in earlier stages of their careers.

While the onset of the COVID-19 pandemic prompted unusually high numbers of submissions of academic articles, lockdown policies forced academics to handle new family responsibilities, potentially exacerbating known family-related challenges for women in academia. Previous studies have examined this possibility, but the findings have been inconsistent.

Squazzoni and colleagues applied statistical analyses to submission data from 2,329 journals published by Elsevier. They also examined data on academics who were invited to review submissions as part of the peer-review process. In total, data on over five million authors working between February 2018 and May 2020 was analysed.

Between February and May of 2020, submissions to Elsevier journals increased by 30% compared to the same period in 2019. However, women submitted fewer manuscripts than men across academic fields including medicine, life sciences, physical sciences, and social sciences. This gender gap was especially strong in health and medicine, the field that is most directly related to COVID-19, and for women towards the beginning of their careers.

Meanwhile, for most academic fields, similar proportions of women and men accepted invitations to review manuscripts. However, this was not the case for health and medicine, in which women were less involved.

Overall, these findings suggest that the onset of the pandemic may have fostered an environment that was relatively advantageous for men in academia. Given the importance of publishing for academic career success, the gender deficits observed in this study could potentially have long-term effects that deepen gender inequality in academia.

Scientists at Southampton University have developed a new method to safely clean and reuse facemask respirators using low-temperature plasma technology.

They say the method could help in future pandemics by providing contingency options should a shortage of personal protective equipment (PPE) for frontline healthcare staff occur again.

The study showed that the technology can remove 99.99% of coronavirus from contaminated facemasks, while maintaining their ability to filter out harmful airborne droplets.

The technique could reduce by approximately 70% the plastic waste caused by facemasks.

Min Kwan Kim, lecturer in astronautics , who led the research said, “Although most of the masks are considered one-time use, the reuse of masks may need to be considered as a crisis capacity strategy.”

Other techniques to decontaminate PPE have been trialled, including hydrogen peroxide, ultraviolet irradiation, and moist heat. However, these can negatively affect mask performance, either by damaging the filters or leaving residues that are harmful to skin.

The research team applied microdroplets containing SARS-CoV-2 to FFP2 and FFP3 facemasks, the most commonly used by frontline healthcare staff. A prototype decontamination system was then used to apply cold plasma to the samples for two, five and ten minutes. They then tested the samples for the presence of residual SARS-CoV-2 and transmitted aerosols of sodium chloride through the samples to monitor filter performance.

The results showed that the samples that were treated for ten minutes had been successfully decontaminated and the researchers found no significant impact on the filters for both the FFP2 and FFP3 masks.

Pfizer and its partner BioNTech announced topline results from a phase III trial evaluating the efficacy and safety of a booster dose of their COVID-19 vaccine in more than 10,000 individuals 16 years of age and older.

In the trial, a booster dose administered to individuals who previously received the primary two doses restored protection against COVID-19 to the high levels achieved after the second dose, showing a relative vaccine efficacy of 95.6% when compared to those who did not receive a booster. These are the first efficacy results from any randomised, controlled COVID-19 vaccine booster trial.

“We look forward to sharing these data with health authorities and working together to determine how they can be used to support the rollout of booster doses around the world,” said Albert Bourla, CEO of Pfizer.

During the study, there were five cases of COVID-19 in the booster group, and 109 cases in the non-booster group. The adverse event profile was generally consistent with other clinical safety data for the vaccine, with no safety concerns identified.

The companies said they plan to share these data with the US Food and Drug Administration, European Medicines Agency, and other regulatory agencies as soon as possible.

In the US a booster dose is authorised for emergency use in people 65 years of age and older. Booster doses of the vaccine are approved in the EU, with recommendations for population subgroups varying based on local health authority guidance.

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