· The Immunization Action Coalition and the Vanderbilt School of Medicine discuss the progress of developing a COVID-19 vaccine, detailing the 11 vaccines in phase 1/2 clinical trials and the inclusion of multiple countries in the development of a Target Product Profile, a tool for quantifying critical vaccine characteristics. The authors emphasize the need for well-established infrastructure and logistical planning in order to distribute a potential COVID-19 vaccine safely and effectively to the world in a timely manner.
· Researchers in the United States and United Kingdom used Twitter data to predict human mobility in and out of China and estimate global spread of COVID-19 and found a high correlation between country-level Twitter user visits and reported COVID-19 cases. These findings highlight the utility of geolocated platforms for public health authorities to develop response protocols and assess impending risks of COVID-19.
Understanding the Pathology
· A systematic review and meta-analysis of 13 studies, including 1341 cases, investigated abnormal coagulation function markers to predict severity of COVID-19 infection. They found that decreased platelet counts, elevated d-dimer, and increased fibrinogen are correlated with disease severity, whereas prothrombin time and activated partial thromboplastin time have no significant correlation with disease severity.
· Based on literature of prostaglandins in SARS-CoV-1 and MERS-CoV, a group from the University of Edinburgh cite the potential roles of multiple prostaglandins (including PGD2, PGE2, PGI2) in the pathogenesis of COVID-19 and consider the possible benefits of NSAID usage in COVID-19 patients.
· A study found that among 59 patients with symptoms consistent with COVID-19, fibrinogen levels were markedly higher in patients who ultimately tested positive on RT-PCR compared to those who tested negative. Additionally, the neutrophil-to-lymphocyte ratio was increased in critically ill COVID-19 patients. These results suggest that fibrinogen may have value as a diagnostic marker in patients with suspected COVID-19 and that neutrophil to lymphocyte ratio may be useful as a prognostic marker indicative of COVID-19 disease severity.
Adjusting Practice During COVID-19
· A cross sectional study of 26 heart failure patients found a 16.2% decrease in daily step count on wearable accelerometers during the first 3 weeks of quarantine compared to regular activity suggesting that widespread COVID-19 quarantine mandates were detrimental to physical activity habits in these patients. These findings highlight the importance of physical activity during the pandemic in reducing deterioration in cardiovascular health.
R&D: Diagnosis and Treatments
· Investigators in China measured SARS-CoV-2-specific antibodies among moderate and severe COVID-19 patients as well as non-COVID-19 patients and found that IgA and IgG were higher among severe patients compared to moderate patients whereas no difference was observed between the groups in IgM. Based on their findings, the authors suggest that IgA-IgG serological diagnosis of COVID-19 may be more effective than the traditional detection of IgM-IgG combined antibodies.
· A group from Stanford University School of Medicine conducted a case-control study to assess for differences in inflammatory cytokine levels by comparing 15 hospitalized patients with severe COVID-19 to critically ill patients with ARDS or sepsis due to another cause. The authors found no differences in IL-1b, IL-1RA, IL-6, IL-8, IL-18, and TNFα levels between patients with COVID-19 and controls with ARDS or sepsis. The authors discuss how numerous phase 3 trials testing the broad use of immunosuppressants in ARDS and sepsis have failed previously and state that these therapies may be unnecessary in COVID-19 as well.