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March 10 | Daily COVID-19 LST Report


Epidemiology

· Can we open schools safely and limit the spread of SARS-CoV-2 infection? In a viewpoint article by the researchers of CDC, they present data that illustrates that in-person school attendance is not related to increased transmission or outbreaks in communities, with the significant exception to this being high school athletics. They state that overall, especially when proper prevention guidelines (facemasks, hand hygiene, postponing indoor and contact sports) is implemented, in-person school is safe for communities.

Transmission & Prevention

· Delayed large local reactions may occur with the mRNA-1273. In a letter to the editor of the New England Journal of Medicine, physicians describe a short 12-patient case series of delayed large local cutaneous reactions to the mRNA-1273 COVID-19 vaccination. The authors found that median time of onset of the reactions was on day 8 post-first dose, that all of the reactions appeared near the injection site, and resolution of symptoms occurred in a median of 6 days. The implication being that as more vaccinations occur en masse, clinicians need to have more information about these reactions to better help address patient concerns and management options when confronted with them.

· SARS-CoV-2 501Y.V2 variant escapes neutralization by South African COVID-19 donor plasma. A study conducted by researchers from South Africa investigated a SARS-CoV-2 pseudovirus expressing the South African variant lineage 501Y.V2 (B.1.351) and found it was able to effectively evade two major classes of neutralizing antibodies with dependence on the K417 residue. Samples of polyclonal plasma/sera from PCR-confirmed severe SARS-CoV-2 infection contained higher neutralizing antibody titers, however when assessed with the 501Y.V2 pseudovirus, 21/44 (48%) showed no detectable neutralization activity, signifying individuals with previous SARS-CoV-2 infection may have reduced antibody efficacy against the 501Y.V2 variant compared to previously identified variants. These findings suggest the need for rapidly adaptable vaccine design platforms and viral targets less susceptible to mutation for future immunogenicity.

R&D: Diagnosis & Treatments

· Early versus deferred timing of anti-SARS-CoV-2 convalescent plasma does not appear to differ in clinical impacts on COVID-19 patients. This controlled, open label phase II randomized clinical trial conducted by investigators at School of Medicine and Chilean Academic medical center in observed the outcomes of receiving early versus deferred convalescent plasma in 58 patients (1 patient withdrew consent) hospitalized with COVID-19 confirmed by RT-PCR. 28 participants received plasma on the day of enrollment and 30 patients received plasma between 3 days or greater than 7 days after enrollment based on development of respiratory failure or persistence of COVID-19 symptoms after 7 days of enrollment. There was no statistically different outcome between patients who received early or deferred convalescent plasma, suggesting clinical outcomes are not impacted by the timing of plasma initiation.



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