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Analysis suggests high efficacy for single dose of Pfizer-BioNTech vaccine
Analysis by Canadian researchers suggests that a single dose of the Pfizer-BioNTech COVID-19 vaccine is highly effective, according to a letter published yesterday in the New England Journal of Medicine (NEJM).
Results from the Pfizer-BioNTech vaccine phase 3 trial, published in NEJM on December 31, 2020, suggest that the efficacy after the first dose of the two-dose vaccine was 52.4%, based on the data collected in the first 2 weeks after the first stroke before the second stroke. The overall efficacy after two doses was 94.8%.
But in their analysis of test data submitted to the U.S. Food and Drug Administration by Pfizer and BioNTech, researchers at the British Columbia Center for Disease Control and the Quebec National Institute of Public Health found that the data collected from 2 weeks after the first before the second injection, the effectiveness of the first dose was 92.6%. The researchers suggest that the initial efficacy analysis was weaker because immunity was still building up in those vaccinated during the first 2 weeks after the first shot.
“With such a highly protective first dose, the benefits from a limited vaccine supply could be maximized by postponing the second doses until all members of the priority group are offered at least one dose,” the wrote. authors.
In a response, trial researchers said that alternative dosing regimens for the Pfizer-BioNTech vaccine have not been evaluated and that the decision to implement alternative regimens rests with health authorities.
Feb 17 N Engl J Med letter
Study finds heart damage 1 month after severe COVID-19
More than half of patients with severe COVID-19 and elevated levels of a key marker of heart muscle damage after discharge from hospital showed signs of heart damage a month later, a study conducted today hui in the European Heart Journal find.
Led by researchers at University College London, the study involved cardiac magnetic resonance imaging (MRI) of 148 COVID-19 patients who had high levels of troponin, indicating heart damage, and who needed treatment. ‘ventilatory assistance before being released from one of the six hospitals in London at least a month before. One in three people needed mechanical ventilation.
Imaging showed inflammation of the heart muscle (26% of patients), scarring or dead heart tissue (54%), restricted blood supply to the heart (22%), or both inflammation and ischemia (6 %). Eight percent showed signs of continued heart inflammation.
Co-author Marianna Fontana, MD, PhD, of University College London said in a press release from the European Society of Cardiology that elevated troponin levels are linked to worse outcomes from COVID-19 and that patients with severe infections often have other heart conditions such as diabetes, high blood pressure and obesity.
“During a severe infection with COVID-19, however, the heart can also be directly affected,” Fontana said. “Finding out how the heart may be damaged is difficult, but MRI scans of the heart can identify different types of injury, which can allow us to make more precise diagnoses and target treatments more effectively.”
The researchers noted that the heart lesions seen on imaging may have preceded COVID-19 or occur as a result of infection. “Although we detected only a small amount of ongoing injuries, we saw injuries to the heart that were present even when the pumping function of the heart was not impaired and might not have been detected by other techniques. ”Fontana said. “In the most severe cases, there are concerns that this injury may increase the risk of heart failure in the future, but more work is needed to investigate this further.”
The authors said the findings may also help researchers find ways to prevent heart damage in critically ill COVID-19 patients and to detect and treat blood clots associated with the virus.
Feb 18 Heart Eur J to study
February 17 European Society of Cardiology Press release
High mortality found in hospitalized diabetic patients with COVID-19
Updated results of a study of hospitalized diabetic patients with COVID-19 show that one in 5 died within 28 days of hospitalization, French researchers reported yesterday Diabetology.
The updated results of the CORONADO study (Coronavirus SARS-CoV-2 and Diabetes Outcomes), which evaluated the results in French diabetic patients hospitalized for COVID-19 from March 10 to April 10, 2020, show that among 2,796 patients, 577 ( 20.6%; 95% confidence interval [CI], 19.2% to 22.2%) died within 28 days of hospitalization and 1404 (50.2%; 95% CI, 48.3% to 52.1%) were discharged from the hospital . Results presented in May 2020 showed that 10% of patients with diabetes and COVID-19 died within 7 days of hospitalization.
The patients were predominantly male (63.7%), with an average age of 69.7 years, and the vast majority had type 2 diabetes (88.2%). Microvascular and macrovascular diabetic complications were found in 44.2% and 38.6% of patients, respectively.
In multivariable models, younger age, routine metformin treatment, and longer duration of symptoms were positively associated with hospital discharge, while a history of microvascular complications, routine anticoagulant therapy, shortness of breath on admission, abnormal liver enzyme levels, and increased white blood cell count and C-reactive protein levels were associated with a lower risk of discharge and a higher risk of death. Patients receiving routine treatment with insulin and statins also had a higher risk of death.
The study authors said that establishing prognostic factors for hospital discharge and death in COVID-19 diabetic patients could help clinicians better manage this population and use hospital resources accordingly.
Feb 7 Diabetology to study
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