6/16
I don’t have time right now to look up the actual study, but a cheap steroid, dexamethasone, has been found to reduce the risk of death in patients who are on oxygen or ventilators.
6/16
That’s not super-exciting news, though, because corticosteroids have been widely used outside the UK to treat inflammation in covid patients for a while. For instance
https://emcrit.org/ibcc/covid19/#steroid_for_severe_hypoxemic_respiratory_failure
Notice the dates of those studies. (bolding added)
still, there are a lot of guidelines out there advising against using steroids, which apparently didn’t appear to help for SARS1.
This article is graphics-heavy, so I won’t post any of it, but it gives a good explanation of the timing issues around using steroids to treat covid.
https://emcrit.org/pulmcrit/steroid-covid/
That’s what I scraped from the old AO. I guess it’s time to add new stuff about vaccine trials, etc.
Oh, here’s something I saw yesterday – more promising news re vitamin D
The Journal of Steroid Biochemistry and Molecular Biology
Volume 203, October 2020, 105751
https://www.sciencedirect.com/science/article/pii/S0960076020302764
“Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study”
Basically, a prospective, randomized (but not blinded) study looked at 76 people hospitalized for covid-19. 50 of them were treated with a vitamin D metabolite that is more rapidly absorbed than vitamin D, and the others weren’t. They were all also treated with the then-best-available treatment. Of the 50 given vitamin D, 1 ended up in the ICU, and all 50 recovered. Of the 26 controls, 13 ended up in the ICO and 2 died.
They controlled for what they understood to be major risk factors at the time, but did not record BMI, which has since been found to be highly predictive of covid 19 outcomes.
I have seen it – it was even posted on the ao, but in a much longer thread. Thanks for bringing it here.
Yes – if that proves to be true, there are apparently several widely available drugs that can help regulate bradykinins, and which might become useful treatments.
likely not much impact. If it’s a peer-reviewed journal, then the “changes” are likely some edits to help clarify things or to add some additional info that is believed to be helpful to a reader.
So anyway, Pfizer is reporting 90%+ early results in their Phase 3 study, which, caveats aside, is terrific news. Public health officials were expecting a vaccine with around 60% effective. Which is good enough if you have a very high vaccination rate, but indications are that it won’t be that high at all. But with 90% effective rate, you can have a vaccination rate of 60-70% and still suppress the virus.
Today’s lecture (which will be posted in a couple days)
was about the development of the Moderna vaccine, which is extremely similar to the Pfizer vaccine, and which is expected to release preliminary results later this month. She showed all sorts of very promising data about that vaccine (which may be stable at -4C, a temp that most commercial freezers can manage) but she said that she cried when she saw the 90% preliminary effectiveness of the Pfizer vaccine. That’s about the best news we could have hoped for.
Also, today’s lecture was very accessible, and I think a lot of people here would find it interesting.
So I definitely no expert. But it’s my understanding that both the Pfizer and the Moderna vaccine target the “spike protein” which completely new type of vaccine.
What I’m wondering is this… does that mean if the virus mutates, the vaccine will remain effective as long as the virus maintains the spike protein? And, if it loses that protein, it’ll be a much less dangerous virus so it doesn’t matter if the vaccine doesn’t work anymore? Is that the correct way to look at it?
IANAD but my understanding is the spike protein is what allows the coronavirus to infect human cells. So if it didn’t exist then it wouldn’t infect us
Unfortunately, mutations to the spike protein won’t necessarily make the virus less dangerous. They could make the vaccine less effective, though. That’s why Denmark was considering killing every mink in the country (they seem to have pulled back on that though).
Basically a variant of COVID-19 has emerged among minks in Denmark that has (among other changes) altered the spike protein; as a result it appears that antibodies for main-strain COVID-19 are less effective. (Minks are susceptible to COVID-19, and apparently unlike most animals can transmit that infection back to humans.)
Huh. I feel like every time there is a little bit of good news with this virus, a Danish mink takes a big shit all over it.
I think it’s more like the flu vaccine . . . but once we have something in place for the current strain, ongoing research for what the “next” vaccine will need to be and then mass produce it.
I agree. The original estimates for the first round vaccine was around 60% effective. That’s flu vaccine territory. But, 90%? We could crush this virus if that plays out.
I doubt that we’ll see the 90% once it hits the general population. I agree that it’s promising, but I’m guessing that the number will be closer to 70% since the current test population is unlikely to account for ALL possible people that will have different responses to the vaccine.
No, the flu mutates much faster than most viruses, and preliminary information suggests the covid-19 mutates fairly slowly. We need a new flu vaccine every year because the flu changes every year, not because our immunity to it wanes. (and the woman who spoke at that MIT course on Tuesday is also working on a universal flu vaccine, which maybe we are close to getting.) In contrast, our immunity to coronaviruses wanes over time. We need a different flu vaccine every year, but if we need boosters for covid, it could be the exact same vaccine.
fwiw, our immunity to tetanus and pertussis also wanes with time, and getting the same immunization we got 10 years previously does the trick to boost our immunity.
Yes, the mink thing shows that it CAN mutate enough to matter. And that will remain a risk. The WHO article says the mutation makes the virus slightly less susceptible to neutralizing antibodies, which is bad, but probably not terrible.
They aren’t testing the vaccines on babies or the frail elderly, but I’ve looked at some of the calls for volunteers, and they are looking for people up to age 85, and for a wide racial diversity in the phase III trials.
And this is why I don’t think that we’ll see the 90% rate when it rolls out to the general public; potential sample bias.