Human challenge trials with live coronavirus aren’t the answer to a Covid-19 vaccine

‘With vaccines already a target of widespread misinformation campaigns, the death of a single volunteer would likely cause even greater damage. From a public health perspective, it would be especially disastrous if it both slowed the race to develop a coronavirus vaccine and fueled the anti-vaccination movement. There are other ethical considerations. An important principle in human challenge studies is that subjects must give their informed consent in order to take part. That means they should be provided with all the relevant information about the risk they are considering. But that is impossible for such a new disease.’

Read here (STAT News, June 23, 2020)

To date (July 19, 2020), the 1DaySooner campaign has attracted nearly 33,000 volunteers from 140 countries. Read here

The long-term effects of Covid-19 infection

‘Some scientists suspect that Covid-19 causes respiratory failure and death not through damage to the lungs, but the brain – and other symptoms include headaches, strokes and seizures... For Julie Helms, it started with a handful of patients admitted to her intensive care unit at Strasbourg University Hospital in northeast France in early March 2020. Within days, every single patient in the ICU had Covid-19 – and it was not just their breathing difficulties that alarmed her. “They were extremely agitated, and many had neurological problems – mainly confusion and delirium,” she says. “We are used to having some patients in the ICU who are agitated and require sedation, but this was completely abnormal. It has been very scary, especially because many of the people we treated were very young – many in their 30s and 40s, even an 18-year-old.”

‘Helms and her colleagues published a small study in the New England Journal of Medicine documenting the neurological symptoms in their Covid-19 patients, ranging from cognitive difficulties to confusion. All are signs of “encephalopathy” (the general term for damage to the brain) – a trend that researchers in Wuhan had noticed in coronavirus patients there in February.’

Read here (BBC, June 23, 2020)

Immunity to the coronavirus remains a mystery. Scientists are trying to crack the case

‘With Covid-19, immunity — whether from an infection or a vaccine — is expected to wane over perhaps a few years; that is what happens with the four human coronaviruses that cause colds. If that pattern extends to this virus, people will gradually become more susceptible to the virus after some amount of time (though they may be less likely to get a severe case). Tracking the levels of the different correlates could provide clues to how long immunity lasts, and when a person becomes vulnerable again. It could also indicate when people might need another dose of the vaccine.’

Read here (STAT News, June 11, 2020)

50% asymptomatic carriers. They have lung tissue damage typical of Covid-19 too

‘Another concern, says Topol, is that the virus may be damaging the bodies of asymptomatic in other, silent ways. Among the 331 passengers on the Diamond Princess cruise ship who tested positive but did not have symptoms, 76 people had CT scans of their lungs and nearly half showed signs of lung tissue damage typical of coronavirus infection. “People who are getting infection without symptoms are actually doing a lot of damage to their bodies and they don’t know it,” says Topol. Another small study in South Korea that studied 10 asymptomatic people from a group of 139 COVID-19 patients supports these findings.’

Read here (Time Magazine, June 5, 2020)

What are the long-term health implications of Covid-19?

‘Six months into the Covid-19 pandemic, and with more than 380,000 people dead, the picture we have of Sars-CoV-2 remains opaque and unclear. Thousands of papers and reports have flooded the academic sphere during this period, as scientists have rushed to understand the virus, which, according to the journal Science, “acts like no pathogen humanity has ever seen”...

‘What initially appeared to be a predictable respiratory infection, similar to Sars or Avian flu, Sars-CoV-2 is now known to affect the lungs, brain, eyes, nose, heart, blood vessels, livers, kidneys and intestines — virtually every organ in the human body.’

Read here (The Independent, June 4, 2020)

Covid-19 can last for several months

I interviewed nine of them [“long-termers” or “long-haulers” who have suffered symptoms for months] for this story, all of whom share commonalities. Most have never been admitted to an ICU or gone on a ventilator, so their cases technically count as “mild.” But their lives have nonetheless been flattened by relentless and rolling waves of symptoms that make it hard to concentrate, exercise, or perform simple physical tasks. Most are young. Most were previously fit and healthy. “It is mild relative to dying in a hospital, but this virus has ruined my life,” LeClerc said. “Even reading a book is challenging and exhausting. What small joys other people are experiencing in lockdown—yoga, bread baking—are beyond the realms of possibility for me.”

Read here (The Atlantic, June 4, 2020)

Genes may leave some people more vulnerable to severe Covid-19

‘Variations at two spots in the human genome are associated with an increased risk of respiratory failure in patients with Covid-19, the researchers found. One of these spots includes the gene that determines blood types. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study...

‘The coronavirus triggers an overreaction of the immune system in some people, leading to massive inflammation and lung damage — the so-called cytokine storm. It is theoretically possible that genetic variations influence that response.’

Read here (New York Times, June 3, 2020)

What does recovery from Covid-19 look like?

“Eighty to 85% of our patients who are infected do not need to be hospitalized, but they do require monitoring and medical care, most of which is now taking place with telehealth,” Dr. Ellman says. He says it’s typical for these patients to have a telehealth appointment, either on phone or video, at least every other day for 10 to 14 days from the onset of symptoms...

“Generally speaking, most patients can be managed outside of the hospital,” Dr. Sofair says. “But if you start to get sicker, early treatment can prevent complications. If you do need to be admitted to the hospital, that does not mean you will get really sick. Only a minority of patients end up in the ICU. We have had many good outcomes, and our doctors and nurses now have experience treating this.”

Read here (Yale Medicine, May 18, 2020)