SECOND BOOSTER FOR COVID-19 VACCINATION: EARLY RESULTS
The U.S. CDC recently authorized a second mRNA COVID-19 vaccine booster (i.e., a fourth dose overall) for middle-aged and older adults (age, ≥50). The fourth dose began to show protection against confirmed SARS-CoV-2 infection during the second week after vaccination; the peak effect occurred at roughly 4 weeks (a roughly 50% reduction in infection, compared with infections in 3-dose recipients), but the effect had disappeared by 8 weeks. Protection against a global category of severe COVID-19 also was noted by the second week after the fourth dose. Between days 7 and 30 after the fourth dose, relative reductions in COVID-19–related hospitalization and death were both roughly 70%.
Full Access: NEJM
OBSERVATIONS FROM ID AND BEYOND: YES, RELAPSES AFTER PAXLOVID HAPPEN — NOW WHAT?
The investigators from Pfizer observed (in their clinical trial EPIC-HR) relapses do occur after treatment with Paxlovid. Not surprisingly, as use of Paxlovid increases along with the supply, the anecdotal reports of these relapses increase in parallel. Given all these unknowns, it would be enormously helpful for Pfizer to release further data on their relapsing cases. Not just how often they happened, but also how they did clinically.
Full Access: NEJM
EXCESS RISK FOR VENOUS THROMBOEMBOLISM PERSISTS FOR MONTHS AFTER COVID-19
People with severe COVID-19 are at excess risk for venous thromboembolism (VTE), but whether risk also rises among patients with mild disease is unclear. Using Swedish national health databases, researchers identified the incidence of first deep venous thrombosis (DVT), pulmonary embolism (PE), and bleeding. After adjustment, risks for DVT, PE, and bleeding were significantly higher in the 30 days after diagnosis of COVID-19 compared with no COVID-19 diagnosis and these risks remained significantly elevated for 3, 6, and 2 months, respectively.
Full Access: NEJM
COULD A COMMON COLD VIRUS BE CAUSING SEVERE HEPATITIS IN KIDS?
Late last week, the CDC released a Health Alert Network advisory regarding a cluster of nine cases of acute hepatitis in children in Alabama over a 5-month period. Standard workup was negative for the common causative agents — hepatitis A, B, and C — and no toxic exposures were identified. But there was one common thread among all these kids: They all tested positive for adenovirus. Of the 169 cases reported worldwide, 74 had evidence of adenovirus infection. On molecular testing, 18 of those were adenovirus 41. The WHO reports that of the 169 identified cases so far, 20 had active COVID infection.
Full Access: Medscape
