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Antibodies in children last at least 6 mos after COVID; SK Bioscience vaccine shows promise vs Omicron

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The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

Antibodies in kids after COVID last 6 months or more

Most children and adolescents with COVID-19 antibodies after SARS-CoV-2 infection usually still have the antibodies in their blood more than half a year later, new data shows.

Starting in October 2020, researchers in Texas recruited 218 subjects between the ages of 5 and 19. Each provided three blood samples, at three-month intervals. More than 90% were unvaccinated when they enrolled in the study. The first blood test showed infection-related antibodies indicating recovery from COVID-19 in one-third of the children, the researchers reported online Friday in Pediatrics https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2021-055505/185412/Durability-of-SARS-CoV-2-Antibodies-From-Natural. Six months later, 96% of those with the antibodies still had them. The study was designed to detect the presence of antibodies, which are only one component of the immune system’s defenses, not the amount of antibodies. The level of protection even in those with antibodies is unclear. Researchers found no differences based on whether a child was asymptomatic, severity of symptoms, when they had the virus or due to weight or gender.

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“It was the same for everyone,” Sarah Messiah of UTHealth School of Public Health Dallas, said in a statement. “Some parents… think just because their child has had COVID-19, they are now protected and don’t need to get the vaccine,” Messiah said. “We have a great tool available to give children additional protection by getting their vaccine.”

A small study published earlier this month in JAMA Network Open https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789845 suggested that most children infected with the coronavirus do not have antibodies in their blood afterward. Only 37% of children appeared to develop antibodies, compared to 76% of adults, even though viral loads were similar in the two groups, those researchers found.

Experimental SK vaccine shows promise against Omicron

A booster shot of an experimental vaccine being developed by SK Bioscience Co has shown “durable protection” against the Omicron variant in Rhesus macaques, according to new data.

The monkeys had received two initial doses of the vaccine plus a booster 6 or 12 months later. Blood samples from the boosted primates showed “remarkably high” levels of antibodies that could neutralize both the original strain of the virus and the Omicron variant that caused infections to soar, the researchers reported on Sunday on bioRxiv https://www.biorxiv.org/content/10.1101/2022.03.18.484950v1 ahead of peer review. The animals’ second-line immune defenses were also “substantial and persistent,” they said. The vaccine, called GBP510, triggers responses from the immune system by delivering copies of a key part of the spike protein from the surface of the coronavirus. The protein “subunits” are studded onto nanoparticles to resemble the virus itself. These components are supplemented with an adjuvant from GSK that boosts the immune system’s responses, explained Bali Pulendran of Stanford University in California.

“Vaccination with two doses… followed a year later by a booster shot… plus adjuvant, led to highly durable antibody responses and protection against Omicron infection, even six months later,” Pulendran said. Large late-stage trials of GBP510 in humans are underway.

AstraZeneca drug less protective vs Omicron in transplant patients

The AstraZeneca antibody shots given to prevent COVID-19 in high-risk children and adults with weakened immune systems do not adequately protect organ transplant recipients from the Omicron variant, researchers found.

The drug, Evusheld, did protect against the Delta variant in kidney transplant recipients, and lab test results released on Monday show Evusheld can neutralize Omicron in mice, including the highly contagious BA.2 version. But among 416 kidney recipients treated with Evusheld after Omicron became the predominant variant, 9.4% developed symptomatic breakthrough infections, with one-in-three of those patients requiring hospitalization, researchers reported on Saturday on medRxiv https://www.medrxiv.org/content/10.1101/2022.03.19.22272575v1 ahead of peer review. Two patients died of COVID-19. In lab experiments, the researchers exposed the BA.1 version of Omicron that caused the massive winter surge to blood samples from 15 Evusheld-treated patients. None of the samples could neutralize the virus.

The U.S. Food and Drug Administration recently advised https://www.fda.gov/drugs/drug-safety-and-availability/fda-authorizes-revisions-evusheld-dosing that higher doses of Evusheld are likely needed to prevent Omicron infections, and that patients who received the originally approved shots should receive booster doses. The researchers said kidney transplant recipients “should be advised to maintain sanitary protection measures and undergo vaccine boosters.”

Click for a Reuters graphic https://tmsnrt.rs/3c7R3Bl on vaccines in development.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

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Deadly fungal infections a concern in patients post-COVID-19, flu | CTV News – CTV News Calgary

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While fungi are not about to start turning the human race into zombies, like in the HBO blockbuster series The Last of Us, the World Health Organization (WHO) says invasive fungal infections are an increasing threat to human health.

Aspergillosis is one fungal infection common in our environment but, in some circumstances, it can turn deadly. In an average day, most of us will inhale hundreds to thousands of Aspergillus spores with no adverse effects, but for people with weakened immune systems it can cause deadly infections. That includes people undergoing cancer treatments, or bone marrow transplants, but it is now recognized that some viral infections, like influenza (flu) and SARS-CoV-2 (COVID-19) increase the risk of deadly fungal infection even in otherwise healthy people.

“When these kinds of things happen in the ICU, it can be devastating because even advanced medicines still can’t treat these infections,” said Dr. Bryan Yipp, an intensive care physician and researcher at the University of Calgary.

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“Once many of these infections really get ingrained and take over, clearing them with medications alone, antifungal or anti microbials, can be very difficult.”

Dr.Yipp began studying Aspergillus — a type of fungus that is a common mould — and its connection to viral infections in 2019, following three deaths in intensive care units of patients initially admitted for influenza, but who subsequently died of the fungal infection.

“It was very much a surprise when people first started identifying the fungus in the lung.  There was a lot of discussion around the table of ICU doctors, infectious disease doctors, asking ‘Was Aspergillosis really the cause of death, or was this just a secondary finding?'” said Yipp. “The pathologists who looked at the samples and the autopsies, were convinced that it was Aspergillosis that was the main problem.”

UCalgary researchers have determined exposure to Aspergillus, a common fungal mould, can lead to a potentially dangerous Aspergillosis infection in people with weakened immune systems.

Working in Yipp’s lab, lead researcher Nicole Sarden, a PhD candidate, isolated the mechanism by which the immune system starts failing to prevent fungal infections.

“In healthy humans. specific immune cells, called B cells, produce molecules (antibodies) that basically tag invaders so that other cells in the immune system, called neutrophils, can recognize them, eat them, and clear the infection,” said Sarden

“But when you have infections with viruses, such as influenza, or if you get COVID, these molecules are no longer present, which means that the immune systems that are trying to eat, and clear the fungi cannot do it because they cannot see it.”

Working with both mice and human blood and tissue samples, the researchers discovered that following a viral infection, neutrophils could identify a fungal infection and surround it but did nothing to destroy it.  

“The virus kills the B cells, no messenger molecules exist, so the neutrophils that would normally attack, the fungus, are blinded. They sit there and don’t know what to do,” said Sarden.

The research team also discovered that reintroducing Aspergillosis reactive antibodies can protect infected mice, leading to hopes a similar treatment will be available in the near future for humans with Aspergillosis infections.

While Yipp and Sarden focused on Aspergillus, it is not the only fungus that can cause serious, or fatal infections. It is estimated fungal infections kill an estimated 1.5 million people worldwide every year. Most of those are due to four different fungi; Cryptococcus, Candida, Aspergillus, and Pneumocystis.  Since the advent of COVID, a previously rare infection of the fungus Mucormycosis has been increasing rapidly in India. It affects the sinuses, brains and lungs of its victims. The rise in Mucormycosis has also been seen in patients who are recovering or have recently recovered from COVID.

Yipp is hopeful the research being conducted at Calgary’s Cumming School of Medicine could lead to treatments for these infections as well.

“We have some hunches that that could be a similar mechanism to what we see here with what we have found.” said Yipp. “So we think that this could be applied to multiple different types of fungi around the world.”

The research team, led by Sarden, published their findings in the journal Science Translational Medicine.

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Barrie hospital declares COVID outbreak in transitional care unit – BarrieToday

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Royal Victoria Regional Health Centre (RVH), in collaboration with the Simcoe Muskoka District Health Unit, declared a COVID-19 outbreak in the Barrie hospital’s transitional care unit on Friday, Jan. 27.

According to RVH, eight patients have tested positive for COVID-19 and have been isolated.

“Enhanced cleaning measures are underway, as well as swabbing of patients and staff,” RVH said in a news release Monday afternoon. 

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Admissions to the unit are on hold at this time, and visitors are not permitted. However, RVH says some exceptions may apply.

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Guidance for diagnosing and managing migraine – News-Medical.Net

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Migraine is a major cause of disability, affecting about 12% of people. A 2-part series published in CMAJ (Canadian Medical Association Journal) on diagnosing and managing the condition with both acute and preventive therapy provides guidance for clinicians. https://www.cmaj.ca/lookup/doi/10.1503/cmaj.211969.

“The goal of treatment of migraine attacks is to provide rapid relief from pain and other migraine-related symptoms, to restore patient function and to prevent recurrence,” writes Dr. Tommy Chan, Department of Clinical Neurological Sciences, Western University, London, Ontario, with coauthors.

“A stratified approach to treatment that empowers patients to choose from different options, depending on attack symptoms and severity, and encourages them to combine medications from different classes (e.g., nonsteroidal anti-inflammatory drugs and triptans) for severe or prolonged attacks, is preferred.”

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Part 2 of the review, which will be published February 6, focuses on preventive treatment to reduce the frequency and severity of migraine attacks.

Journal reference:

Tzankova, V., et al. (2023) Diagnosis and acute management of migraine. Canadian Medical Association Journal. doi.org/10.1503/cmaj.211969.

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