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Tuesday, May 7, 2024
Coronavirus

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US biotech firm Moderna on Monday announced its experimental vaccine against Covid-19 was 94.5 per cent effective, marking a second major breakthrough in the vaccine hunt.

Moderna released early results from a clinical trial with more than 30,000 participants, after US pharmaceutical company Pfizer and its German partner BioNTech last week said their vaccine was 90 per cent effective.

Both vaccine frontrunners are based on a new platform called messenger RNA, which is faster to produce than traditional vaccines and effectively turn human cells into vaccine factories.

“This positive interim analysis from our Phase 3 study has given us the first clinical validation that our vaccine can prevent COVID-19 disease, including severe disease,” said Stephane Bancel, Moderna’s CEO.

The company plans to submit applications for emergency approval in the US and around the world within weeks and says it expects to have approximately 20 million doses ready to ship in the US by the end of the year.

Global infections from Covid-19 have soared past 54 million with more than 1.3 million deaths since the virus emerged in China late last year.

The Moderna vaccine, which was co-developed by the US National Institutes of Health, is given in two doses 28 days apart, and the preliminary results are based on 95 volunteers of the 30,000 who fell ill with Covid-19.

Of the 95, 90 had been in the trial’s placebo group, and five in the group that received the drug called mRNA-1273.

‘Tremendously exciting’
There were 11 people who fell severely ill, all of whom were in the placebo group.

The vaccine was well tolerated, with the majority of side-effects classed as mild or moderate.

After the first dose, about three per cent of people had injection site pain classed as severe.

Among side-effects classed as severe after the second dose, about 10 per cent had fatigue, nine per cent had muscle pain, five per cent had joint pain or headaches, four per cent had other pain and two per cent had redness at the injection site.

These adverse events were “short-lived,” according to a statement.

“This news from Moderna is tremendously exciting and considerably boosts optimism that we will have a choice of good vaccines in the next few months,” said Peter Openshaw, a professor of experimental medicine at Imperial College London.

Crucially, Moderna also announced that its vaccine can remain stable at standard refrigerator temperatures of 2 degrees Celsius to 8 degrees Celsius (36 degrees Fahrenheit to 46 degrees Fahrenheit) for 30 days.

The company added it could be kept in long-term storage at standard freezer temperatures of -20 degrees Celsius (-4 degrees Fahrenheit) for up to six months.

Pfizer’s vaccine, on the other hand, needs to be stored in deep-freezer conditions which could complicate supply chain logistics, particularly in less developed countries.

It is not yet clear how long-lasting the protection will be from either the Moderna or Pfizer vaccines, nor how well they work for the elderly, the age-group at highest risk from Covid-19.

AFP

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Scientists have discovered antibodies that react to the new coronavirus in blood samples donated prior to the start of the pandemic. They suggest that some people may have at least a degree of preexisting immunity to the new virus.

The number of new COVID-19 cases is on the rise in many regions across the globe. But not everyone who comes into contact with SARS-CoV-2, the new coronavirus, develops COVID-19.

A group of scientists from the Francis Crick Institute, in London, along with colleagues at University College London, both in the United Kingdom, may have found a clue as to why some people can fight off a SARS-CoV-2 infection better than others.

Their work recently appeared in the journal Science.

Surprise discovery

The research team originally set out to develop a high-sensitivity test to detect antibodies to the SARS-CoV-2 virus.

Scientists can use this type of test to establish whether a person has antibodies after they had COVID-19, which is a key piece of information for those trying to establish how long immunity may last after SARS-CoV-2 infection.

As part of their work, the scientists used serum samples provided by people who did not have COVID-19. To their surprise, they found antibodies that reacted to SARS-CoV-2 in some of the samples.

In their paper, the researchers describe a scientific theory that exposure to any of the common human coronaviruses, which can cause the common cold, may lead to immunity against the other common human coronaviruses. They refer to this as immune cross-reactivity.

There are four seasonal common human coronaviruses, all of which mostly cause mild disease. The vast majority of people have an infection with at least one of these viruses at some point.

Scientists already know that our bodies do not build up long-lasting immunity to these viruses, which is why a person can contract an infection with a common human coronavirus more than once in their lifetime.

But can a previous exposure to a common human coronavirus provide at least temporary protection against SARS-CoV-2?

Finding cross-reacting antibodies

Coronaviruses use a protein called the spike protein to attach to and infect host cells.

Prof. George Kassiotis, a senior author of the new study and the group leader of the Retroviral Immunology Laboratory at the Francis Crick Institute, explains how antibodies that recognize a part of the spike protein may provide immune cross-reactivity.

“The spike of this coronavirus is made of two parts, or subunits, performing different jobs. The S1 subunit allows the virus to latch onto cells and is relatively diverse among coronaviruses, whereas the S2 subunit lets the virus into cells and is more similar among these viruses,” he says. “Our work shows that the S2 subunit is sufficiently similar between common cold coronaviruses and SARS-CoV-2 for some antibodies to work against both.”

In their study, Prof. Kassiotis and colleagues determined the levels of cross-reacting antibodies in several collections of samples, most of which had been donated prior to the emergence of the SARS-CoV-2 virus.

In a group of 50 blood samples from pregnant people from May 2018, the team found that 10% had cross-reacting antibodies. In a separate cohort of 101 samples from May 2019, three had these antibodies.

In a further experiment, the team analyzed 13 additional samples from adults who had recently had an infection with a common cold coronavirus. Of these, only 1 sample had cross-reacting antibodies.

Overall, the authors report, 16 of 302 samples, or 5.29%, had SARS-CoV-2 cross-reacting antibodies. The median age of the donors was 51 years.

But why did relatively few people have cross-reacting antibodies, given that infections with common human coronaviruses happen frequently?

“This suggested that their emergence was not simply a common transient event following each [common human coronavirus] infection in this age group,” the authors comment. “Instead, given that [common human coronavirus]-reactive antibodies are present in virtually all adults, the rarity of SARS-CoV-2’s cross-reactivity […] indicates additional requirements.”

One such requirement, they suggest, may involve how often a person has an infection with a common human coronavirus. The frequency is highest in children and adolescents.

Children ‘more regularly exposed to other coronaviruses’ 

To look for a link between age and SARS-CoV-2 cross-reacting antibodies, the team analyzed 48 blood samples from children and adolescents aged 1–16 years. All of the samples stemmed from before the pandemic.

Here, they found that 21 of the samples had cross-reacting antibodies, while in a separate cohort of samples from people aged 17–25 years, these were only present in one sample.

“Our results show that children are much more likely to have these cross-reactive antibodies than adults. More research is needed to understand why this is, but it could be down to children being more regularly exposed to other coronaviruses,” comments Kevin Ng, one of the lead study authors and a post-graduate student in Prof. Kassiotis’ lab.

“These higher levels we observed in children could also help explain why they are less likely to become severely ill with COVID-19. There is no evidence yet, however, that these antibodies prevent SARS-CoV-2 infection or spread.” – co-lead study author Kevin Ng

Professor Kassiotis also weighs in: “It is important to stress that there are still many unknowns which require further research. For example, exactly how is immunity to one coronavirus modified by exposure to another?”

“Or, why does this activity decline with age? It is not the case that people who have recently had a cold should think they are immune to COVID-19,” he adds.

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A new study has highlighted the prevalence of gastrointestinal symptoms in people with COVID-19 and what signs abdominal radiologists should look out for.

In a new study, researchers have synthesized evidence from 36 scientific articles to highlight the prevalence of gastrointestinal symptoms in people with COVID-19.

The study, appearing in the journal Abdominal Radiology, also identifies some of the signs abdominal radiologists should look out for when imaging people.

COVID-19 unknowns

One of the challenges of the COVID-19 pandemic has been the fact that SARS-CoV-2 is a novel coronavirus. While sharing some similarities with the previous severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2 also has many differences.

As time progresses, scientists can conduct research on the virus to discover some of these unknowns and therefore help inform effective policy decisions and clinical practices. This has been the case with the symptoms of COVID-19.

While scientists have been aware of the most common symptoms — fever, coughing, loss of smell or taste, and shortness of breath — for some time, they have only recently identified other less common but significant symptoms.

As Dr. Mitch Wilson, a radiologist and clinical lecturer at the University of Alberta’s Faculty of Medicine & Dentistry and co-author of the study points out, “[t]here’s a growing amount of literature showing that abdominal symptomatology is a common presentation for COVID-19.”

The study

In the present article, a team of researchers focused on the growing evidence of people presenting with gastrointestinal issues linked to COVID-19.

To do this, the researchers conducted a study to highlight trends, issues, or areas that require more research.

The team searched through popular scientific databases using variations of the keywords “COVID-19,” “gastrointestinal,” and “imaging.” This resulted in 614 potentially relevant articles. The team identified a further 21 articles from other sources.

The researchers then removed duplicate articles and began screening the articles’ abstracts and titles for relevance, identifying 137 articles.

The researchers then conducted a full-text screening, limiting the studies to those that included findings related to abdominal imaging in people who had received a diagnosis of COVID-19.

The team included 36 articles in their study.

Gastrointestinal COVID-19 signs

After synthesizing the evidence from these 36 studies, the researchers identified two key findings.

First, gastrointestinal symptoms are a significant aspect of COVID-19 and may be present in the absence of other more well-known symptoms.

The researchers highlighted a meta-analysis covering more than 4,200 people that found 17.6% had gastrointestinal symptoms. In another study of 1,141 people, 16% presented with only gastrointestinal symptoms.

Second, the researchers identified a series of signs that an abdominal radiologist should look out for when imaging people — particularly because doctors have reported the incidental identification of COVID-19 in a substantial proportion of individuals with gastrointestinal symptoms.

The signs that the researchers suggest abdominal radiologists should look out for include:

  • bowel inflammation,
  • air within the bowel wall,
  • bowel perforation.

However, these signs are relatively rare in people with COVID-19. As Dr. Wilson points out, “[s]eeing these things is not necessarily telling us a patient has COVID-19. It could be from a variety of potential causes.”

“But one of those potential causes is infection from the virus, and in an environment where COVID-19 is very prevalent, it’s something to consider and potentially raise as a possibility to the referring physician.”

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With 47 COVID-19 vaccine candidates in testing, it is no wonder that there are myths and misconceptions about when a vaccine will actually be available to the public, and how safe it will be. Pan American Health Organization (PAHO) experts have recently addressed the media to clarify some of these issues.

The latest data from the World Health Organization (WHO) indicate that, as of November 3, 2020, there are 47 COVID-19 vaccine candidates in clinical trial phases around the world. There are also as many as 155 in preclinical testing.

Given the sheer number of vaccine candidates that researchers have developed within months of the start of the pandemic, it is only natural that questions and doubts have arisen about this process.

Traditionally, it can take years for a vaccine candidate to undergo testing for safety and efficacy and to gain official approval for distribution to the public.

However, scientists have been ramping up their efforts with the aim of bringing a COVID-19 vaccine to the public in record time.

At this year’s WIRED Health:Tech conference, Prof. Uğur Şahin, the co-developer of one of the most promising vaccine candidates so far — the “Pfizer vaccine” — explained that speeding up does not mean that scientists are rushing the process.

Rather, researchers have been optimizing the vaccine development process by sharing more data across research teams and conducting some of the tests in parallel, rather than consecutively, Prof. Şahin explained.

Still, many people continue to have questions and doubts regarding the safety and efficacy of future COVID-19 vaccines, as well as the development process for vaccine candidates.

To address some of these questions, specialists affiliated with or collaborating with the PAHO held a dedicated webinar on October 23, 2020.

The speakers included:

  • Dr. Cuahtémoc Ruiz-Matuz, chief of the Comprehensive Family Immunization unit at the PAHO
  • Dr. Jarbas Barbosa, PAHO assistant director
  • Dr. Alba María Ropero Álvarez, PAHO regional advisor on immunization
  • Dr. Lucia Helena de Oliveira, PAHO regional advisor on new vaccines

The context of immunization

During the webinar, Dr. Ruiz-Matuz suggested that the issues regarding an upcoming COVID-19 vaccine did not emerge in a vacuum.

For decades, healthcare policymakers have striven to make immunization against common pathogens available worldwide, particularly to prevent potentially dangerous childhood diseases.

Dr. Ruiz-Matuz spoke of the recent situation of worldwide immunization programs, noting that global coverage of vaccines for 1-year-olds is increasing, leading to a lower number of deaths due to preventable illness in infancy.

In the Americas, he said, cases of childhood diseases that countries have been vaccinating against over the past few decades have lowered drastically. This is the case with rubella, diphtheria, pertussis, neonatal tetanus, and measles.

Some diseases, he added, have disappeared altogether — as is the case with polio and congenital rubella syndrome.

However, data from last year indicate that childhood immunization programs may be losing ground. “Of 25 children, three are completely left behind, while one starts the three-dose scheme and does not finish it,” Dr. Ruiz-Matuz pointed out.

Measles, mumps, and rubella vaccinations, in particular, have been on the decline in the past year. According to the PAHO specialist, “This is obviously the impact of the pandemic.”

Dr. Ruiz-Matuz also argued that, sometimes, the challenges that experts face at a local and global level when it comes to immunization are not intrinsic to health services.

Urbanization trends, natural disasters, local political contexts, the lack of social equity, the movement of populations between regions and countries, and country-wide financial crises are all added obstacles standing in the way of adequate vaccination.

Challenges for COVID-19 immunization

Dr. Barbosa noted that once a COVID-19 vaccine is finally available to the public, there will still be many challenges when it comes to distributing it across different populations.

According to him, these challenges include:

  • “ensuring equitable, timely, and sufficient access to the vaccine”
  • “addressing technical and logistic aspects” regarding vaccine development and production
  • “defining the priority groups to receive the first vaccine doses”
  • “determining the appropriate number of doses for adequate protection”

Widespread misinformation may further affect people’s trust in the COVID-19 vaccine and prevent them from getting inoculated against the new coronavirus, Dr. Barbosa also warned.

Mistrust in vaccines could also render the population more vulnerable to other preventable diseases, such as pertussis or measles.

Dr. Barbosa urged media representatives to provide information to the public based on hard scientific evidence, and to present it in a very transparent way, in order to fight current trends of misinformation.

Fighting vaccine hesitancy

Dr. de Oliveira spoke of the dangers of vaccine hesitancy, which, she argued, it is possible to reduce by increasing the public’s understanding of what vaccines are and how they work.

“Vaccines prevent diseases that can be dangerous, or even deadly. They greatly reduce the risk of infection by working with the body’s natural defenses to safely develop immunity to disease,” she explained.

“A vaccine is a part of a germ that is exposed to your immune system in a safe way, so that [the immune system] can learn how to fight off that harmful pathogen and protect your body from it in the future when this pathogen enters [the] body.” – Dr. Lucia Helena de Oliveira

The expert went on to cite WHO data that indicate that vaccines prevented at least 10 million deaths in 2010–2015.

She also noted that many fears around vaccines originate from the belief that, in some cases, they may cause rather than prevent infection. This is not true, she emphasized — but to understand why it is not true, it is necessary to have a clear understanding of how vaccines work.

“Vaccines help develop immunity by imitating an infection,” explained Dr. de Oliveira. “Once the imitation infection goes away, the body is left with a supply memory, and this memory will be activated when the germ — the virus or the bacteria, for example — enters […] your body.”

The imitation infection the vaccine triggers may cause minor symptoms similar to those a person might experience during illness, such as a fever. This is normal, the expert noted. It is a sign that the body is working and learning how to fight the pathogen. This is not the illness itself.

However, following vaccination, “it takes a few weeks for the body to produce antibodies” that can identify and help fight the pathogen.

In the meantime, she cautioned, exposure to an active virus just before or just after vaccination may still lead to disease, given that the vaccine has not yet had a chance to do its work.

Developing a COVID-19 vaccine

Vaccine development “is [a] very large and complex [process], often lasting 10–15 years,” Dr. de Oliveira added.

So, what about the fast work on the COVID-19 vaccine? Will it mean that the end result will not be as safe and effective as other vaccines? Not so, said the PAHO expert.

“It doesn’t mean that the vaccine is not going to be safe and [effective], because there are a lot of protocols [at] this moment — protocols from WHO, protocols from FDA [the Food and Drug Administration], protocols from EMA [the European Medicines Agency] — that [have] established rules for this vaccine, which is going to be produced in a much shorter time.”– Dr. Lucia Helena de Oliveira

Finding a safe and effective COVID-19 vaccine will also be possible because many research teams around the globe are looking at both old and new vaccine platforms. These include:

  • vaccines using a live virus with reduced infectivity
  • vaccines using an inactivated virus
  • vaccines using genetic information
  • viral vector vaccines
  • protein-based vaccines

Moreover, for a vaccine to become licensed for public distribution, it has to successfully pass through three clinical trial phases, Dr. de Oliveira explained.

Phase 1 is a small-scale safety study, phase 2 is an extended safety trial in hundreds of volunteers, and phase 3 is a large-scale trial in thousands of volunteers.

Phase 3 trials test for safety, dosage, and efficacy, as well as possible side effects across various demographics, she noted.

If phase 3 trials are successful, national healthcare decision makers will likely approve the vaccine’s release to the public.

However, the work does not stop there. Dr. de Oliveira said that there is also a phase 4, during which experts distribute the vaccine through immunization programs and the researchers continue to monitor its safety and effectiveness.

Challenges when a vaccine is ready

There are some real challenges ahead once a vaccine is ready and declared safe and effective. The PAHO experts noted that people should not forget these challenges or take them lightly; rather, they should try to understand them for what they are.

Dr. Ropero Álvarez said that the current working scenario is that there will be limited doses of the COVID-19 vaccine available for distribution, meaning that decision makers will have to prioritize their distribution to specific groups.

The WHO co-lead COVAX, which is an international program wherein experts and institutions from 172 countries are collaborating to ensure that a safe, effective COVID-19 vaccine will be available to all.

Dr. Ropero Álvarez cites data that indicate that, to begin with, countries participating in the COVAX program will receive doses that will likely be enough to cover 20% of their population.

Around 3% of doses will likely go to health and social care workers, and around 17% will likely go to high risk adults, such as those with chronic conditions and older adults. It is also possible that some doses may go to additional high priority groups, depending on each country’s situation.

Participating countries will have to conduct very clear communication campaigns, explaining why these groups will take priority in COVID-19 immunization programs, the PAHO expert noted.

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As some scientists work on potential COVID-19 vaccines, others are looking to existing products to slow the rate of coronavirus infection, including mouthwashes and oral rinses.

Alcohol-based hand sanitizers and wipes play an important part in reducing infection rates. However, other products might also have a role to play. Scientists at the Penn State College of Medicine in Hershey, PA, are looking at oral rinses and mouthwashes.

In a recent study, which appears in the Journal of Medical Virology, researchers determined that several oral and nasal solutions might lower the risk of viral transmission when used by those with a coronavirus infection.

Craig Meyers, professor of microbiology and immunology and obstetrics and gynecology, led the study. “While we wait for a vaccine to be developed, methods to reduce transmission are needed,” Meyers says. “The products we tested are readily available and often already part of people’s daily routines.”

Testing existing products

To investigate, Meyers and his team used a human respiratory virus called HCoV-229E, which is in the same virus family as SARS-CoV-2. In a laboratory, they introduced various products to the virus to assess whether they could successfully reduce viral activity.

The selected nasal products included a diluted Johnson’s Baby Shampoo nasal rinse and a CVS Health Neti Pot. The mouthwash gargling products tested were CVS Health Peroxide Sore Mouth Cleanser, 1.5% Hydrogen Peroxide solution (Cumberland Swan Inc.), Orajel Antiseptic Rinse (Church & Dwight Co. Inc.), Betadine 5% (Alcon Laboratories Inc.), Crest Pro-Health (Procter & Gamble), Listerine Antiseptic (Johnson & Johnson Consumer Inc.), Listerine Ultra (Johnson & Johnson Consumer Inc.), Equate (Walmart), and Antiseptic Mouthwash (CVS Health).

Researchers exposed the human coronaviruses to each solution in three separate tests lasting 30 seconds, 1 minute, and up to 2 minutes. While most of the selected products showed some level of impact, the neti pot had no measurable effect across any of the tests.

The Johnson’s Baby Shampoo nasal rinse solution killed 99% of the coronaviruses within 1 minute and 99.9% within 2 minutes. Crest Pro-Health reduced the coronaviruses from 99.9% to greater than 99.99%.

The most impactful product was Listerine Antiseptic, which managed to reduce the virus by greater than 99.99% after 2 minutes. Overall, the Listerine and Listerine-like mouthwashes produced the best results.

The findings further validated similar results published in the Journal of Infectious Diseases in July 2020. In this earlier study, the authors determined that routine oral rinsing by those with a coronavirus infection might reduce the viral load in their mouths, throat, and nose. This could potentially reduce the amount they could transmit to others with a cough or sneeze.

Additionally, the research team found it interesting that the three products with hydrogen peroxide as the main ingredient inactivated the virus at a rate between 90 and 99%. This result supports previous research that also found hydrogen peroxide solutions to be effective against SARS-CoV-2.

Taken together, there is enough research available to strongly suggest that these products could help reduce the transmission of SARS-CoV-2 between someone with an infection and someone without an infection.

Meyers explains: “People who test positive for COVID-19 and return home to quarantine may possibly transmit the virus to those they live with. Certain professions, including dentists and other healthcare workers, are at a constant risk of exposure.”

Study limitations

Use of these over-the-counter solutions, when combined with other preventive methods, could offer an even greater level of protection among the general public.

That said, there are some important aspects of the study to consider that might impact the overall accuracy of the outcome expected against SARS-CoV-2.

For instance, as the authors explain, “We did not use SARS-CoV-2 in this study as the virus, as it was more expensive, less available, and would have required biosafety level-3 laboratory conditions.”

Also, the tests were conducted in laboratory conditions rather than in human participants. As the authors explain, “[T]his does not represent the true nature of the nasopharyngeal endothelial ecosystem.”

Meyers and his team strongly advocate for future trials. With more accurate testing, it might be possible to eventually create a comprehensive prevention strategy that is easy, widely available, and affordable.

It is also important to note that, even if further research confirms the antiviral benefits of mouthwash use, these products cannot replace face coverings, social distancing, and other methods. They will be an additional tool.

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Doctors have warned that people in the United States may be drinking excessively as a way to cope with the COVID-19 pandemic.

In a new viewpoint article, two doctors have warned that more people in the U.S. may be turning to alcohol as a way of coping with the “myriad stressors” of the COVID-19 pandemic.

The article, published in the Journal of General Internal Medicine, proposes a series of interventions to try to minimize this behavior and better support people with alcohol use disorder.

Coping strategy

It is well documented that drinking alcohol is one way that people cope with stressful situations. For example, research has shown that in the U.S., people tend to drink more alcohol following terrorist attacks.

Furthermore, if a person has alcohol use disorder, they are more likely to use alcohol to cope with the stress of a traumatic event.

In this context, the current COVID-19 pandemic is a particular cause for concern. The authors of the current article point out that rather than being a single event, the effects of the COVID-19 pandemic are prolonged over time, potentially exposing people to ongoing trauma.

Further, the pandemic has caused various potential stressors that a person may cope with by drinking alcohol.

As well as the catastrophic effect on people’s health and the loss and grief experienced by many, the pandemic has also disrupted economies and social and cultural life, threatening people’s jobs, disrupting their interpersonal support structures, increasing barriers to health care, and forcing many people into isolation.

Before the pandemic, researchers had noted that people in the U.S. were tending to drink more. This was particularly the case for females.

Recent research suggests that people in the U.S. increased their alcohol consumption in the early phase of the pandemic. This is in line with similar findings from studies in the United Kingdom and Australia.

Alcohol health effects

This matters because well-documented links exist between increased alcohol consumption and adverse health outcomes.

As the National Institute on Alcohol Abuse and Alcoholism point out, alcohol consumption can change mood and behavior, damage a person’s heart, liver, and pancreas, increase the risk of several types of cancer, and weaken a person’s immune system.

Research has also linked excessive alcohol consumption to mental health disorders, such as anxiety and depression, which may worsen during the pandemic.

Consequently, it is important to encourage people to find alternative coping strategies in response to the stressors of the pandemic. Effective support should also be available for people experiencing the effects of increased alcohol consumption or people with alcohol use disorder.

Interventions

The authors of the present study offer various suggestions for interventions that may help reduce people’s dependence on alcohol during the pandemic. Other suggestions focus on better preparing clinical services to support people with substance abuse issues.

According to Dr. Shelly F. Greenfield, director of the Alcohol, Drug, and Addiction Clinical and Health Services Research Program at McLean Hospital in Belmont, MA, “[i]ncreasing identification of harmful alcohol use in patients and intervening early are key components of addressing this problem.”

“In addition, recognition of the problem from policymakers could lead to changes in federal regulations — such as we have seen with telehealth — and improvements in access to healthcare,” she notes.

The authors suggest that public health messaging should raise awareness of the potential for increased drinking during the pandemic, as well as giving advice on alternative coping strategies for the stressors of the pandemic.

They also suggest that primary care practitioners should offer increased screening for alcohol use disorder when people contact primary care services.

Technologies, such as telehealth — that enable clinical information to pass between doctors and individuals at a distance — may also be valuable for people who are isolating or where the pandemic has forced a reduction in the enrolment for some face-to-face clinical services.

Finally, the authors highlight that ensuring people have access to health insurance to cover medical treatment costs is crucial. This is particularly important given the number of people who depend on work-place health insurance and the significant number of people who have lost their jobs during the pandemic.

Co-author Dr. Dawn E. Sugarman, a research psychologist in the Center of Excellence in Alcohol, Drugs, and Addiction at McLean Hospital, notes that:

“We hope this article will call attention to the pandemic’s effects on alcohol use and offer mitigating approaches to this under-recognized public health concern.”

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Nerve damage from neurodegenerative conditions, traumatic injuries, and certain eye conditions leads to disability and death for millions of people in the United States. Currently, doctors consider such damage irreversible.

However, researchers at The Ohio State University Wexner Medical Center have discovered a new type of human immune cell that appears to prevent and reverse nerve damage in the optic nerve and spinal cord.

This finding could allow researchers to create more advanced neurodegenerative immunotherapies.

These therapies might offer fresh hope to people with currently incurable neurological conditions, including Alzheimer’s disease, multiple sclerosis, stroke, and Parkinson’s disease. They might also help treat central nervous system (CNS) damage from injury or infection.

“I treat patients who have permanent neurological deficits, and they have to deal with debilitating symptoms every day, “says Dr. Benjamin Segal, professor and chair of the Department of Neurology at The Ohio State College of Medicine and co-director of the Ohio State Wexner Medical Center’s Neurological Institute.

“So the idea of being able to restore neurological function and take that burden away from my patients is really amazing.”

Funded by the National Eye Institute (NEI), the National Institutes of Health (NIH), the Wings of Life Foundation (C.Y.), and the Dr. Miriam and Sheldon G. Adelson Research Foundation, the study appears in the journal Nature Immunology.

The emerging field of immunotherapy

Immunotherapy therapies alter the immune response by stimulating it or using the body’s own immune cells to treat disease. Over the past few decades, scientists have begun developing them to tackle a wide range of medical conditions.

Doctors already use immunotherapies to treat certain types of cancer. They help the immune system to recognize and destroy cancer cells.

Other researchers are investigating whether immunotherapy could help prevent or treat neurological disease.

Researchers have been extensively testing immunotherapies that increase the clearance rate of certain proteins whose accumulation has links with neurological diseases, such as Alzheimer’s disease, Parkinson’s disease, frontotemporal dementia, and dementia with Lewy bodies.

Scientists have already created T-cell mediated immunotherapy approaches that target proteins linked with these neurological diseases, such as amyloid-beta, tau, and alpha-synuclein proteins.

Immunotherapy may also present opportunities to prevent and treat nerve damage by activating alternative immune pathways in response to CNS damage.

A 2014 study found that anti-inflammatory or immunoregulating (M2) macrophages are critical for remyelination, which is a form of nerve repair.

The study

The researchers examined immune cells in fluids and spinal cord tissues collected from mice with optic and spinal nerve damage.

Within these fluids and tissues, the team found a unique type of granulocyte. Granulocytes are a category of white blood cells. Neutrophils are the most common kind of granulocytes.

Neutrophils are scavengers that help destroy pathogens or other unwanted particles in the body. The new type of granulocyte that the scientists identified behaved like an immature neutrophil.

This newly discovered granulocyte helped protect neural cells and tissues from damage in the mice. It also encouraged nerve cell regeneration by secreting a mix of beneficial growth compounds. The team also found a human cell line with similar neuroprotective properties.

“This type of cell actually secretes growth factors to rescue dying nerve cells. It can also stimulate the surviving nerve cells to grow new fibers once they’re severed or damaged in the [CNS], which is really unprecedented,” says Dr. Segal. “This can potentially lead to therapeutic breakthroughs for a wide range of conditions by repairing these nerve pathways.”

However, researchers have a long way to go before doctors can use immune cells, such as this newly discovered granulocyte, to treat humans.

The team’s first major hurdle will be figuring out how to harness the power of this new immune cell and enhance its natural healing effects by growing it in a laboratory setting. Next, they’ll have to prove their newly proposed therapy is both effective and safe in humans.

In the future, the team hopes that doctors can inject these novel cells into people with chronic cognitive deficits to slow down or halt degenerative decline.

Dr. Segal concludes that they have got a lot of work left to do to make their laboratory findings relevant in a clinical setting, but says he is optimistic about the road ahead:

“There’s so much that we’re learning at the bench that has yet to be translated to the clinic, but I think there’s huge potential for the future.”

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A small observational study has found no evidence that osteoporosis drugs increase the risk of getting COVID-19. The research hints that some of the drugs may even reduce the risk.

In people with osteoporosis, progressive reductions in bone density increase the risk of fractures. The condition tends to affect older people, and its incidence among females increases following menopause.

Researchers have yet to directly test the possible effect of drug treatments for osteoporosis on a person’s risk of developing COVID-19. Influential health organizations, such as the American College of Rheumatology, recommend that people continue taking their medications as usual.

Now, researchers led by a team from the Hospital del Mar Medical Research Institute, in Barcelona, Spain, have analyzed data from 2,102 patients who received treatments for osteoporosis, osteoarthritis, and fibromyalgia at the hospital.

The mean age of the patients was 66.4 years, and 80.5% were female. Around 64% had osteoarthritis, 44% had osteoporosis, and 27% had fibromyalgia.

The researchers compared the incidence of COVID-19 in these patients between March 1 and May 3, 2020, with the incidence in Barcelona as a whole over the same period, during the first wave of infections in Spain.

The age-adjusted incidence rate for COVID-19 was 3.7% in the general population of Barcelona, compared with 4.7% for this group of patients. However, when the researchers focused on the subset of 914 patients with osteoporosis, they found a lower rate of infection: around 3%.

The data appeared to show that some drugs increased COVID-19 risk, some decreased it, and others had no effect. However, this was an observational study, rather than a clinical trial, and the group sizes were too small to draw any definitive conclusions.

The researchers report their findings in the journal Aging.

Statistical models

The physicians and scientists used a statistical modeling technique called Poisson regression to estimate the relative risk of COVID-19 associated with particular treatments.

After adjusting for factors already known to affect the risk, including age, sex, and health conditions such as diabetes and cardiovascular disease, their models suggested that most of the treatments had no influence on the incidence of infection.

These included drugs that directly target osteoporosis, such as oral bisphosphonates or vitamin D, as well as nonsteroidal anti-inflammatory drugs that target chronic pain caused either by fractures from weakened bones or coexisting musculoskeletal conditions.

Antihypertensive drugs, used to treat the common comorbidity of high blood pressure, also showed no influence on COVID-19 infection rates.

According to the models, three osteoporosis treatments were potentially associated with a reduced risk of COVID-19.

Denosumab, a monoclonal antibody treatment, was associated with a 42% reduced risk. There was a considerable degree of uncertainty about this value — it could range from a 72% reduced risk to a 22% increased risk.

Intravenous zoledronate was associated with a 38% reduced risk, with a range of 73% reduction to 41% increase. Meanwhile, calcium showed a 36% reduced risk, with a range of 63% reduction to 12% increase.

“The study suggests that some of these treatments may protect patients against infection by [SARS-CoV-2, the virus that causes] COVID-19, although further studies still need to be conducted on more patients to prove it,” says the study’s first author, Dr. Josep Blanch-Rubió.

Both denosumab and zoledronate are known to modify the immune system, and they do so in different ways.

Denosumab decreases the activity of immune signalling molecules called cytokines, which are involved in the excessive immune reaction that characterizes severe COVID-19.

The authors speculate that zoledronate, meanwhile, may protect the lungs from the infection by stimulating T cells and natural killer cells.

Musculoskeletal conditions such as osteoarthritis and fibromyalgia can cause chronic pain, and fractures resulting from osteoporosis can also be painful. Some pain medications commonly prescribed to people with these health issues appeared to increase the risk of COVID-19.

This was particularly true for pregabalin, which was associated with a 55% increased risk of COVID-19, with a range of estimates of 14% reduced pain to 280% increased pain.

People with these conditions also frequently experience mood disorders, such as depression. Most of the antidepressants in the analysis were associated with an increased risk, apart from duloxetine, which was associated with a 32% reduced risk, with a range of 66% decrease to 34% increase.

Dr. Alba Gurt, a study author and primary care physician at the Pere Virgili Hospital Center, in Barcelona, concludes:

“The data from the study would indicate that the [osteoporosis] treatments and duloxetine administered to our primary care patients are safe against infection by [the virus that causes] COVID-19 and could even reduce its incidence. However, studies with a higher number of patients are required to verify this.”

Important limitations

The analysis had some important limitations that are common to all observational studies. The associations identified may result from hidden “confounders” — other influences on the risk of developing COVID-19 that the researchers did not take into account.

The statistical power of the study was limited due to the relatively small numbers of patients with osteoporosis taking each medication and the possibility of complex drug interactions.

Also, the estimates of relative risk have wide confidence intervals — a term that describes the level of certainty about the risk. As a result, it is possible that denosumab, zoledronate, and calcium could all increase the risk of COVID-19, though the estimates veered more toward the drugs having a protective effect.

Overall, the actual risks or benefits of these osteoporosis treatments with regard to COVID-19 may be very different from what the team has found.

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An infusion of immune cells from people who have recovered from COVID-19 could shield those with compromised immune systems from the infection responsible for the disease, a lab-based study of cellular cultures suggests.

People who have recently received a bone marrow or organ transplant or are undergoing cancer treatment have reduced immunity. This makes them especially vulnerable to infections with viruses such as SARS-CoV-2, which causes COVID-19.

The Cellular Therapy Program at Children’s National, a hospital in Washington, D.C., uses a technique called “adoptive immunotherapy” to protect those with weakened immune systems from viruses including cytomegalovirus and the Epstein-Barr virus.

The technique involves isolating T cells that target the virus from the blood of someone recovering from the infection. After the cells have been cultured in a lab, healthcare providers inject them into people with weakened immunity, protecting them from the infection.

A team from Children’s National has now investigated the potential of adoptive immunotherapy to protect against COVID-19.

This preclinical research involved testing the immune capabilities of T cells from individuals recovering from the illness.

“We found that many people who recover from COVID-19 have T cells that recognize and target viral proteins of SARS-CoV-2, giving them immunity from the virus because those T cells are primed to fight it,” says Dr. Michael Keller, a pediatric immunology specialist who led the study.

“This suggests that adoptive immunotherapy using convalescent T cells to target these regions of the virus may be an effective way to protect vulnerable people, especially those with compromised immune systems due to cancer therapy or transplantation.”

These individuals’ vulnerability to infection can prevent or delay the treatments they need.

“This approach could serve as a viable option to protect or treat them, especially since their underlying conditions may make vaccines for SARS-CoV-2 unsafe or ineffective,” says Dr. Catherine Bollard, director of the hospital’s Center for Cancer and Immunology Research.

Dr. Bollard is also the senior author of the new study, which has been published in the journal Blood.

Immune targets

For the research, 46 individuals recovering from COVID-19 donated blood. Most had experienced only mild symptoms, and the researchers analyzed the samples around 36 days after the onset of the symptoms.

They identified T cells that recognized parts of proteins in the virus’s membrane, spike, and nucleocapsid, the shell surrounding its genetic material.

The researchers expanded these immune cells in the lab and found that they responded to the viral proteins by producing interferon gamma, a signaling molecule that orchestrates the immune system’s assault on viruses.

Many of the cells targeted a part of the membrane that is highly conserved, meaning that it changes little, if at all, as the virus evolves. This suggests that the virus may not be able to evolve ways to evade this part of the human immune system.

Vaccines currently in development target key parts of the spike proteins that give coronaviruses their characteristic crown-like appearance.

The authors propose that the highly conserved part of the membrane that they have identified might be another worthwhile target. A vaccine that trained T cells to recognize this part of the virus could provide long-lasting protection against the infection.

The study adds to evidence that even if the number of circulating antibodies declines steeply in the months after SARS-CoV-2 infection, as a recently published preprint of one study suggests, T cells may continue to protect against reinfection.

The authors also note that T cell immunity to two closely related coronaviruses — which cause severe acute respiratory syndrome, or SARS, and Middle East respiratory syndrome, or MERS — appears to persist for years.

Unanswered questions

One important drawback of this study is that it did not directly test the ability of donors’ T cells to inactivate the virus, either in the lab or in humans.

As the researchers acknowledge, future studies will have to evaluate whether adoptive T cell immunotherapy is safe and effective for people at high risk of severe COVID-19.

In addition, they highlight that their sample size was relatively small and that many of the donors had only experienced mild symptoms of the illness. Moreover, not every participant had laboratory-confirmed COVID-19 or a positive antibody test.

Finally, the authors address the possibility that T cell therapy could provoke excessive inflammation that results from a massive release of immune signaling molecules known as cytokines. They note, however, that this “cytokine release syndrome” is associated with cytokines other than interferon gamma in people with COVID-19.

They conclude:

“As other inflammatory complications, such as cytokine release syndrome, are very rare after virus-specific T cell therapy, the risk of inflammatory complications after adoptive T cell therapy for COVID-19, particularly when utilized early and derived from donors who themselves did not have inflammatory disease, are likely low.”

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A preclinical study has tested a new vaccine for Alzheimer’s disease. The researchers found that the vaccine, which targets the beta-amyloid protein, was safe and effective in mice.

Alzheimer’s disease is a progressive neurological condition and the most common cause of dementia.

According to the latest estimates from the Alzheimer’s Association, 1 in 10 people over the age of 65 years in the U.S. have Alzheimer’s disease, and experts expect the number of people with the condition to increase as the population ages. By 2050, projections show that 13.8 million people aged 65 years and over will have Alzheimer’s disease in the U.S.

While groups around the world are working to find an effective treatment for the condition, an alternative approach is to develop a vaccine. Although they are more commonly associated with infectious diseases, vaccines can also prime the body to defend itself against other, noninfectious molecules.

In Alzheimer’s disease, scientists believe that two processes drive the progression of the disease: the buildup of plaques comprising beta-amyloid proteins between neurons in the brain and tangled knots of the tau protein within neurons.

Since the general understanding is that beta-amyloid initiates the disease process, scientists have tried to develop a vaccine against it. The hope is that the immune system recognizes and destroys the beta-amyloid before it can aggravate the cell damage that the tau protein causes.

Although scientists have developed several vaccines, translating the findings from murine models into humans while ensuring safety is notoriously challenging, and the authorities have not yet approved any vaccines for use.

Researchers need to overcome the fact that as people age, their immune system becomes less responsive. As a result, without help, they will have a lower response to a vaccine.

Scientists usually overcome this problem by adding adjuvants that kickstart and enhance the immune response. However, a potential problem is that the adjuvants overstimulate the immune system, leading to inflammation.

A new study that the University of South Florida Health (USF Health) led describes a novel therapeutic vaccine for Alzheimer’s disease, which uses the body’s own immune cells to target beta-amyloid. The study found that this approach avoided the overstimulation of the immune system that can occur due to chemical adjuvants.

The study showed effective antibody production and memory improvements in vaccinated mice, and the findings appear in the Journal of Alzheimer’s Disease.

Harnessing dendritic cells

The new vaccine uses dendritic cells, which communicate with other immune cells, such as B cells and T cells, to guide the immune response.

“This therapeutic vaccine uses the body’s own immune cells to target the toxic [beta-amyloid] molecules that accumulate harmfully in the brain,” explains the senior author of the paper, Dr. Chuanhai Cao.

The dendritic cells are loaded with a modified version of beta-amyloid so that the body can detect and destroy the real thing.

“Because we use dendritic cells to generate antibodies, this vaccine can coordinate both innate and acquired immunity to potentially overcome age-related impairments of the immune system,” adds Dr. Cao.

In the new study, the researchers tested the vaccine in mouse models of Alzheimer’s disease. The mice were genetically modified to produce high levels of beta-amyloid and show cognitive difficulties similar to those that occur in humans with Alzheimer’s disease.

Memory improvements

The team gave some of the mice the vaccine, while others received the dendritic cells only (containing no beta-amyloid).

The mice that received the vaccine produced antibodies against beta-amyloid in their brains and blood. They also showed symptom improvements — for example, in memory tests, the vaccinated mice performed similarly to healthy mice.

The vaccinated mice also showed significantly improved working memory compared with mice that received only the dendritic cells. Working memory involves holding and manipulating information for a short time, and deficits in this form of memory are a common feature of Alzheimer’s disease.

Importantly, the vaccine did not cause an inflammatory response in the mice — a major concern when developing a vaccine and the main reason why researchers had to stop using a previous vaccine.

“Inflammation is a primary symptom of Alzheimer’s disease, so any possible treatment with neural inflammation as a side effect essentially pours gas on the fire,” explains Dr. Cao.

This study found no evidence of an inflammatory reaction. There were no significant differences in the amounts of inflammatory molecules called cytokines in the vaccinated mice compared with the nonvaccinated mice.

What next?

The strength of the new vaccine lies in its specificity, says Dr. Cao. The antigen on the vaccine stimulates a very specific response from T cells, which enables the destruction of beta-amyloid but prevents activity that could cause autoimmunity. “[…] it provides strong immunomodulatory effects without inducing an unwanted, vaccine-associated autoimmune reaction in the aging mice,” he says.

Going forward, the team hopes that the vaccine could serve to stop the progression of Alzheimer’s disease in humans, although further studies will be necessary to confirm that the vaccine can produce long lasting antibodies and is safe to use in people.

It is important to note that this study used a mouse model of Alzheimer’s disease. There is a sharp fall-off in translation from animal models to human treatments from many promising preclinical studies, ranging from 0% to 100% failure.

Also, there has been some debate about the effectiveness of targeting beta-amyloid rather than either focusing on the tau protein, launching a combined attack on both proteins, or dampening the inflammation that results in cellular damage.

Beyond Alzheimer’s disease, the researchers suggest that the vaccine type could help improve the immune system of people with other age-related disorders. The vaccine may “lay the foundation for future immunotherapies for aging-related disorders,” the authors conclude.

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