The world is currently in the grips of the coronavirus disease (COVID-19) pandemic, caused by the SARS-CoV-2 virus, which has mutated to allow human-to-human spread. Infection can cause fever, dry cough, fatigue, severe pneumonia, respiratory distress syndrome and in some instances death. COVID-19 affects the immune system by producing a systemic inflammatory response, or cytokine release syndrome. Patients with COVID-19 have shown a high level of pro-inflammatory cytokines and chemokines. There are currently no effective anti-SARS-CoV-2 viral drugs or vaccines. COVID-19 disproportionately affects the elderly, both directly, and through a number of significant age-related comorbidities. Undoubtedly, nutrition is a key determinant of maintaining good health. Key dietary components such as vitamins C, D, E, zinc, selenium and the omega 3 fatty acids have well-established immunomodulatory effects, with benefits in infectious disease. Some of these nutrients have also been shown to have a potential role in the management of COVID-19. In this paper, evidence surrounding the role of these dietary components in immunity as well as their specific effect in COVID-19 patients are discussed. In addition, how supplementation of these nutrients may be used as therapeutic modalities potentially to decrease the morbidity and mortality rates of patients with COVID-19 is discussed.
Background: An ongoing outbreak of coronavirus disease 2019 (COVID-19) has spread around the world. It is debatable whether asymptomatic COVID-19 virus carriers are contagious. We report here a case of the asymptomatic patient and present clinical characteristics of 455 contacts, which aims to study the infectivity of asymptomatic carriers.
Material and methods: 455 contacts who were exposed to the asymptomatic COVID-19 virus carrier became the subjects of our research. They were divided into three groups: 35 patients, 196 family members and 224 hospital staffs. We extracted their epidemiological information, clinical records, auxiliary examination results and therapeutic schedules.
Results: The median contact time for patients was four days and that for family members was five days. Cardiovascular disease accounted for 25% among original diseases of patients. Apart from hospital staffs, both patients and family members were isolated medically. During the quarantine, seven patients plus one family member appeared new respiratory symptoms, where fever was the most common one. The blood counts in most contacts were within a normal range. All CT images showed no sign of COVID-19 infection. No severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections was detected in 455 contacts by nucleic acid test.
Conclusion: In summary, all the 455 contacts were excluded from SARS-CoV-2 infection and we conclude that the infectivity of some asymptomatic SARS-CoV-2 carriers might be weak.
A new monoclonal antibody treatment has been found to protect chronically ill adults from developing COVID-19. The Phase 3 trial results suggest the novel antibody cocktail, delivered by intramuscular injection, could offer up to 12 months protection.
Antibodies are like our immune system’s front-line soldiers. They constantly circulate around the body, on the hunt for whatever specific pathogen they have been trained to target.
In early 2020 researchers at Vanderbilt University Medical Center homed in on a handful of particularly potent antibodies, isolated from some of the earliest detected COVID-19 patients. The antibodies were subsequently licensed by pharma company AstraZeneca and turned into monoclonal antibody treatments designed to prevent symptomatic COVID-19 infections.
The new treatment has been dubbed AZD7442 and the latest clinical trial results announced by AstraZeneca indicate it could play an important role in helping protect the most vulnerable from severe COVID-19.
The company’s recent announcement details results from a trial called Provent, which commenced in late 2020. The trial enrolled over 5,000 subjects, focusing on those most at risk of severe COVID-19 either due to chronic pre-existing illness or at risk of a weak response to vaccination due to being immunocompromised.
The newly announced results come from a primary analysis of the recently completed trial and are yet to be peer-reviewed or published in a journal. Over the course of a six-month follow-up period the trial saw no cases of severe COVID-19 or death in those patients receiving AZD7442. This compares to the placebo group that saw three severe COVID-19 cases, two of which led to death.
Overall, AstraZeneca indicates there were 25 symptomatic COVID-19 cases detected in the total trial cohort. AZD7442 was found to reduce a chronically ill person’s risk of symptomatic COVID-19 by 77 percent.
Provent is not the only clinical trial testing AZD7442, but it is the first to deliver promisingly positive data. Another trial, dubbed Storm Chaser, recently failed to meet its primary endpoint.
Storm Chaser was testing the same antibody cocktail as a post-exposure tool in those who had potentially been recently exposed to SARS-CoV-2 but had yet to test positive to the virus. After enrolling over 1,000 subjects in the Storm Chaser trial, AstraZeneca announced in June it had found no statistically significant difference in COVID-19 cases between placebo and AZD7442 groups.
Penny Ward, a researcher from King’s College London who did not work on these AstraZeneca trials, hypothesizes the different results between the two trials could be due to the fact AZD7442 is administered by intramuscular (IM) injection, which may be slower to take effect than if the treatment were delivered by intravenous infusion.
“What the Storm Chaser trial tells us is that IM injection does not provide an immediate level of antibody sufficient to cut off viral replication and prevent disease among individuals exposed to the virus who are already infected,” says Ward. “It would be interesting to see if earlier administration using an IV infusion would be more successful than IM injection in this setting.”
The simplicity of delivering this treatment by intramuscular injection is one of the factors that sets it apart from other recent monoclonal antibody treatments under investigation for COVID-19. Another novel feature of this monoclonal antibody treatment is its potential long-term efficacy.
AstraZeneca worked to optimize the half-life of these monoclonal antibodies and initial studies indicate a single treatment may produce effective protection for up to 12 months. This preliminary data analysis for the Provent trial covers six months of follow-up, with another nine months of observation to follow.
James Crowe Jr., from the Vanderbilt Vaccine Center, says this new treatment may be a game-changer for vulnerable subjects who don’t respond well to vaccines. Crowe Jr. was part of the Vanderbilt team working on the isolation of these potent antibodies in early 2020.
“It’s deeply gratifying to see the antibodies we isolated under challenging circumstances, in the middle of the international lockdown last spring, protecting the most vulnerable amongst us,” says Crowe Jr. “This single-shot prevention is likely to be a game changer for at-risk patients.”
Although the Provent trial took place prior to the emergence of the Delta variant, preliminary preclinical research indicates these monoclonal antibodies should still be effective at neutralizing current SARS-CoV-2 variants. AstraZeneca says it is preparing submissions to regulatory bodies for emergency use authorization of AZD7442.
Ward points out that until the full trial data is peer-reviewed and published the optimal method of administration for this novel monoclonal antibody in clinical practice is unclear. However, she does stress these findings are good news for those vulnerable patients worried their vaccination has not been completely effective.
“This could be very important as an option for patients at high risk from COVID infection who have responded poorly to vaccination or who must take immune-suppressing treatment for other disease (cancer, post-transplant, autoimmune disease etc),” says Ward. “Indeed it could potentially be game changing for these individuals, who are currently being advised to continue to shield despite being fully vaccinated.”
Dr. Pierre Kory testifies to US Senate Committee about Ivermectin, Dec. 8, 2020 (Update: The Youtube video was apparently censored and removed. Please visit the link below or scroll right to the bottom for the Vimeo Video-apparently censored also.)
Appearing as a witness Tuesday morning before the Senate Committee on Homeland Security and Governmental Affairs—which held a hearing on “Early Outpatient Treatment: An Essential Part of a COVID-19 Solution”— Dr. Pierre Kory, President of the Frontline COVID-19 Critical Care Alliance (FLCCC), called for the government to swiftly review the already expansive and still rapidly emerging medical evidence on Ivermectin.
The data shows the ability of the drug Ivermectin to prevent COVID-19, to keep those with early symptoms from progressing to the hyper-inflammatory phase of the disease, and even to help critically ill patients recover.
Dr. Kory testified that Ivermectin is effectively a “miracle drug” against COVID-19 and called upon the government’s medical authorities—the NIH, CDC, and FDA—to urgently review the latest data and then issue guidelines for physicians, nurse-practitioners, and physician assistants to prescribe Ivermectin for COVID-19.
In view of the current realities and rules/regulations imposed on everyone to have social distancing and the need to stay away from crowded areas as much as possible, we feel it is vital to have a balanced perspective on certain matters pertaining to public health. Should you stay home all the time, thereby depriving yourself of Sunlight or Vitamin D(aka Sunshine Vitamin). How about coming into contact with surfaces that do have the Coronavirus? Will sunlight kill the Coronavirus? We did some research and found something interesting. Please read the brief extract below on how sunlight may affect the Coronavirus that we are facing right now.
Previous studies have demonstrated that SARS-CoV-2 is stable on surfaces for extended periods under indoor conditions. In the present study, simulated sunlight rapidly inactivated SARS-CoV-2 suspended in either simulated saliva or culture media and dried on stainless steel coupons. Ninety percent of infectious virus was inactivated every 6.8 minutes in simulated saliva and every 14.3 minutes in culture media when exposed to simulated sunlight representative of the summer solstice at 40°N latitude at sea level on a clear day. Significant inactivation also occurred, albeit at a slower rate, under lower simulated sunlight levels. The present study provides the first evidence that sunlight may rapidly inactivate SARS-CoV-2 on surfaces, suggesting that persistence, and subsequently exposure risk, may vary significantly between indoor and outdoor environments. Additionally, these data indicate that natural sunlight may be effective as a disinfectant for contaminated nonporous materials. The full article can be found here at: https://academic.oup.com/jid/article/222/2/214/5841129
Incidentally, while we were researching the above, we came across another interesting article that mentioned that sunlight exposure increased Covid-19 recovery rates. This study was done in Jakarta, Indonesia. Please read the brief extract below.
This study aims to present the correlation between sunlight exposure and Covid-19 statuses in Jakarta, Indonesia. The secondary data analysis was derived from surveillance data for Covid-19 from government authorities, including the Ministry of Health, the Meteorological, Climatological, and Geophysical Agency, and the local government of Jakarta. Three statuses related to Covid-19 were examined in the study: incidence, death, and recovered. Meanwhile, sunlight exposure was presented as daily duration of it. Only the number of recovered patients correlated significantly with sunlight exposure (p-value = .025; r = 0.350). This study’s findings showed that sunlight exposure was associated with recovery from Covid-19. The full article can be found here at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184988/