Research: 30% of COVID sufferers had rebound after 2 days with out signs
Almost one third of 158 untreated COVID-19 sufferers skilled symptom rebound after being symptom-free for not less than 2 consecutive days, finds a examine of US adults printed yesterday in JAMA Community Open.
A staff led by researchers from the College of California at San Diego and Harvard College investigated whether or not the symptom rebound typically attributed to therapy with the antiviral drug nirmatrelvir-ritonavir (Paxlovid) is solely a part of the pure course of some COVID-19 circumstances.
The researchers mentioned that the organic underpinning of COVID-19 rebound after Paxlovid therapy is unclear however could embrace speedy clearance of nirmatrelvir, delayed immune responses, or the event of drug resistance. Research individuals accomplished a day by day diary of 13 signs for 28 days in 2020. Median affected person age was 47 years, and median time from symptom onset to enrollment was 6 days.
Throughout follow-up, 68% of sufferers reported symptom decision, of which 44% (30% of all individuals) later reported recurrence of not less than 1 of the 13 signs. Eighty-five % mentioned their signs have been gentle, and 15% reported not less than one reasonable symptom.
The commonest rebound signs have been cough (44%), fatigue (35%), and headache (35%), much like these reported at enrollment (besides that ache and aches have been reported extra typically at enrollment), and to these of sufferers who nonetheless had signs on the finish of the examine. Eight sufferers (5%) have been hospitalized, however none died.
The researchers cautioned that the examine was performed earlier than COVID-19 vaccines grew to become obtainable and during times dominated by wild-type SARS-CoV-2 and the Alpha variant and thus is probably not generalizable to present situations.
“We discovered the pure historical past of untreated COVID-19 was variable and undulating,” the authors wrote, including that rebound signs should not predictive of extreme illness. “Our noticed variation could clarify among the rebound of signs after therapy for COVID-19, like in circumstances of what has been described as Paxlovid rebound.”
Oct 27 JAMA Netw Open research letter
COVID-19 vaccines linked to decrease ICU admissions for pneumonia
A brand new examine in JAMA Community Open based mostly on Italian intensive care unit (ICU) admissions exhibits that COVID-19 vaccination was tied to decrease charges of ICU admissions as a result of pneumonia however was not related to a discount in hospital mortality.
The cohort examine was based mostly on vaccine data of 10 million residents of the Lombardy area of Italy from Aug 1 to Dec 15, 2021. The median age was 48, and 51% of residents have been feminine. As of Jan 31, 2022, a complete of seven,863,417 residents have been vaccinated; 79.5%; obtained an mRNA vaccine, 7.0%; obtained an adenoviral vector vaccine (AdV), 13.5% obtained a mixture of vaccines, and 57.2% have been boosted.
There have been 553 sufferers admitted to an ICU for COVID-19 pneumonia in the course of the examine interval, of whom 139 (25.1%) have been vaccinated and 414 (74.9%) have been unvaccinated. Adjusting for age, intercourse, time from the final administered dose, and vaccine kind, the danger of ICU admission remained decrease in vaccinated people in contrast with these unvaccinated, the authors mentioned.
The bottom incident charge ratios (IRRs) (0.03; 95% confidence interval [CI], 0.03 to 0.04; P < .001) have been amongst people who had obtained an mRNA vaccine inside 120 days and translate to 97% safety from ICU sickness. The very best IRR (0.21; 95% CI, 0.19 to 0.24; P < .001), or 79% safety, was amongst people who had a time from the final administered dose of an AdV vaccine of greater than 120 days.
“Even 4 months after vaccine administration, vaccinated people nonetheless had a 4.5-times decrease danger of ICU admission in contrast with unvaccinated people. Moreover, mRNA vaccines maintained a larger and extra extended effectiveness in stopping ICU admission in contrast with AdV,” the authors wrote.
Hospital mortality charges weren’t, nevertheless, considerably affected by vaccination standing, with crude mortality charges starting from 23% to 33% for vaccinated sufferers and 22% and 29% for unvaccinated affected person. The authors mentioned this was possible as a result of superior affected person age and comorbidities.
Oct 27 JAMA Netw Open study
CDC experiences extra flu rises, first pediatric dying of the season
US flu exercise continued its early rise final week, with the primary pediatric flu dying of the brand new season reported and hospitalization charges already rising, the Facilities for Illness Management and Prevention (CDC) mentioned at the moment in its weekly replace.
The pediatric flu dying concerned an H3N2 virus and occurred in the course of the week that ended on Oct 8. The CDC mentioned the cumulative hospitalization charge for flu final week was 1.5 per 100,000 inhabitants, which is on the highest degree for this level of the season since 2010-11. Greater than 94% of flu hospitalizations concerned influenza A, and of subtyped samples, 72.9% have been the H3N2 pressure. Charges have been highest in seniors and in kids as much as age 4 years.
Different markers that the CDC makes use of to trace flu exercise additionally rose, together with the proportion of outpatient visits for flu, a measure that may additionally mirror exercise from different respiratory viruses which have related signs.
The southeast and south-central areas are nonetheless reporting the very best flu ranges. The share of respiratory samples that examined constructive for flu elevated final week in most elements of the nation, to six.2% total.
The CDC recommends that everybody age 6 months and older obtain a flu vaccine, which it says is the easiest way to guard towards flu and severe outcomes in individuals with are vaccinated however nonetheless get sick. This yr, federal well being officers have urged the general public to get vaccinated towards flu on the similar time they obtain up to date COVID-19 boosters.
Oct 28 CDC FluView update
Three nations report new polio circumstances
Three nations have new polio circumstances this week, all vaccine-derived sorts. The Democratic Republic of the Congo (DRC), Niger, and Nigeria all recorded new circumstances, in response to the weekly report printed by the World Polio Eradication Initiative (GPEI).
Niger and Nigeria every reported a single case of circulating vaccine-derived poliovirus kind 2 (cVDPV2). In Niger the case was reported in Maradi. There are actually 11 circumstances in 2022, and 18 have been reported in 2021.
Nigeria’s case was recorded in Borno, elevating the yearly whole to 37 circumstances. There have been 415 circumstances reported in 2021.
The DRC is intensifying its outbreak response as one case of circulating vaccine-derived poliovirus kind 1 (cVDPV1) was reported in Haut Lomami. There are actually 29 circumstances reported in 2022. Six new circumstances of cVDPV2 have been reported, bringing the variety of such circumstances reported in 2022 to 160. The nation had 28 cVDPV2 circumstances in 2021.
Oct 28 GPEI report