COVID-19 Scan for May 05, 2022

News brief

Two doses of J&J, Pfizer vaccines effective against Omicron variant

A study of more than 160,000 COVID-19 tests of South African healthcare workers concludes that two doses of the Johnson & Johnson (J&J) and Pfizer/BioNTech vaccines are about 71% effective against hospitalization caused by Omicron 1 to 2 months after the second dose, with little waning at 5 months or longer.

Investigators from the South African Medical Research Council led the study, published yesterday in the New England Journal of Medicine (NEJM). They used a test-negative design to estimate the effectiveness of two doses of the J&J or Pfizer vaccine against hospitalization or intensive care unit (ICU) admission with an Omicron variant infection from Nov 15, 2021, to Jan 14, 2022.

The team analyzed the results of 162,637 polymerase chain reaction (PCR) COVID-19 tests, of which 93,854 (57.7%) were from participants given two doses of either the Pfizer vaccine at least 42 days apart or J&J vaccine 4 to 6 months apart.

Test positivity was 34%, with 1.6% of patients hospitalized and 0.5% admitted to an ICU. Among J&J recipients, estimated vaccine effectiveness (VE) against COVID-19 hospitalization was 55% (95% confidence interval [CI], 22% to 74%) by 13 days after the second dose, 74% (95% CI, 57% to 84%) at 14 to 27 days, and 72% (95% CI, 59% to 81%) at 1 or 2 months.

Of Pfizer vaccinees, VE was 81% (95% CI, 41% to 94%) by 13 days after the second dose, 88% (95% CI, 62% to 96%) at 14 to 27 days, 70% (95% CI, 64% to 76%) at 1 or 2 months, 71% (95% CI, 68% to 74%) at 3 or 4 months, and 67% (95% CI, 63% to 71%) at 5 or more months.

VE against ICU admission in J&J vaccinees was 69% (95% CI, 26% to 87%) at 14 to 27 days and 82% (95% CI, 57% to 93%) at 1 or 2 months after the second dose. Among Pfizer vaccinees, VE against ICU admission was 70% (95% CI, 56% to 79%) at 1 or 2 months, 73% (95% CI, 67% to 77%) at 3 or 4 months, and 71% (95% CI, 65% to 76%) at 5 or more months.

"These data provide reassurance about the continued value of the national Covid-19 vaccine program during a surge in the omicron variant," the authors wrote.
May 4 NEJM research letter

Recent cancer, active treatment tied to higher risk of worse COVID-19

Patients diagnosed as having cancer within 1 year after testing positive for COVID-19 and those undergoing treatment are at a 10% higher risk for infection-related hospitalization and 17% higher risk of death than other patients, suggests a study published yesterday in PLOS One.

University of Texas researchers led the study, which involved mining the electronic health records of 271,639 adults who tested positive for COVID-19 at more than 700 hospitals and 7,000 clinics in the United States from Jun 1 to Dec 31, 2020. Of these patients, 18,460 had one or more cancer diagnoses, 8,034 had a history of cancer, and 10,426 were newly diagnosed with cancer within 1 year of COVID-19 diagnosis. Relative to other patients, those with cancer were older and more likely to be male, to be White Medicare enrollees, and to have more underlying conditions.

Compared with other patients, those with cancer were at higher risk for COVID-19 death by 30 days (relative risk [RR], 1.07; 95% confidence interval [CI], 1.01 to 1.14) and hospitalization (RR, 1.04; 95% CI, 1.01 to 1.07). But the two groups didn't differ significantly in terms of ICU admission or ventilator use.

Recent cancer diagnoses were tied to a higher risk of worse COVID-19 outcomes (RR for death, 1.17 [95% CI, 1.08 to 1.25]; RR for hospitalization, 1.10 [95% CI, 1.06 to 1.14]), especially in those with metastatic disease and blood, liver, and lung cancers.

Death among COVID-19 patients with recent cancer diagnoses was linked to receipt of chemotherapy or radiation therapy within 3 months before infection. Other risk factors for death were older age, Black race, Medicare enrollment, residence in southern states, diabetes, and cardiovascular, liver, and kidney diseases.

In a University of Texas news release, senior author Guo-Qiang Zhang, PhD, said the results confirm that cancer patients generally have poorer COVID-19 outcomes but also identified subgroups of cancer patients not at elevated risk. "This is an important finding for the health care system as they intervene based on the appropriate risk assessment and for cancer survivors to understand their specific risks associated with COVID-19," he said.
May 4 PLOS One study
May 4 University of Texas news release

News Scan for May 05, 2022

News brief

DRC announces third Ebola case in Equateur province outbreak

The Democratic Republic of the Congo (DRC) has reported one more Ebola case in its latest outbreak in Equateur province in the country's northwest, raising the total to three, according to the World Health Organization (WHO) African regional office.

The patient is a 48-year-old man who is considered a high-risk contact of the index patient. So far, health officials are monitoring 444 contacts.

To date, outbreak responders have vaccinated 353 people, including 253 contacts, in the Mbandaka outbreak area where the three cases were detected. The first two patients died from their infections. They include the index case, a 31-year-old man, and a 25-year-old woman who was his sister-in-law.

Early genetic analysis suggests that the outbreak likely resulted from another animal spillover, rather than persistent virus from a survivor. The outbreak is the DRC's 18th, marking the third outbreak since 2018 in Equateur province.
May 5 WHO African regional office tweet
May 5 WHO African regional office situation update tweet

Nanoparticle drug for MRSA receives FDA go-ahead for human trial

Biotechnology startup Cellics Therapeutics announced yesterday that the Food and Drug Administration has allowed the investigational new drug (IND) application for CTI-005, an experimental blood cell membrane drug that targets methicillin-resistant and methicillin-susceptible Staphylococcus aureus (MRSA and MSSA).

The IND authorization will allow Cellics to start a multicenter, randomized phase 1b/2a trial investigating the safety and efficacy of CTI-005 in MRSA and MSSA pneumonia patients. CTI-005 consists of red blood cell membrane nanoparticles, or "nanosponges," that neutralize toxins emitted by MRSA and MSSA, enabling the immune system to kill the bacteria. MRSA and MSSA pneumonia is traditionally treated with the antibiotics vancomycin and linezolid.

CTI-005 is one of several drugs Cellics is developing through its Cellular Nanoparticle (CNP) technology.

"This IND allowance is an important milestone for Cellics Therapeutics and also for the CNP Technology," Cellics founder Liangfang Zhang, PhD, said in a company press release. "The CNP Technology creates a new therapeutic modality, Cellular Nanosponge, which uses human cell membranes as drug substance to treat infectious diseases and inflammatory diseases."
May 3 Cellics Therapeutics press release

Avian flu detected in dozens more wild birds in US, mainly in Midwest

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) reported 57 more highly pathogenic H5N1 avian flu virus detections in wild birds, mostly from Midwestern states, raising the total since January to 956.

Most of the new detections, part of ongoing surveillance for the virus, are from Minnesota, North Dakota, Wisconsin, and Michigan. Some were birds harvested for testing, but many others were found dead, ranging from gulls in North Dakota to American white pelicans in Minnesota and Wisconsin. Wild ducks, wild geese, and raptors were also among birds that tested positive.

Outside of the Midwest, there was a detection in a wild duck in Colorado, a wild goose in Vermont, black vultures in Florida, and wild geese and a vulture in Wyoming.

Separately, Texas Parks and Wildlife Department (TPWD) yesterday reported the state's first highly pathogenic avian flu detection in a wild bird, which involves a great horned owl that was at a rehabilitation facility in Wichita County. In early April, Texas reported its first outbreak at a commercial farm, a facility that housed pheasants in Erath County.
USDA APHIS wild bird detection page
May 4 TPWD press release

In global developments, Iceland reported a new H5N1 event in poultry, which occurred in a backyard flock of 10 birds in Reykir in the north. The outbreak began on Apr 15, killing 1 of the 10 birds and sickening 4 more. The rest were culled.
May 4 OIE report on H5N1 in Iceland

Global flu levels decline but persist in North America, parts of Europe

Except for North America, flu activity declined in most of the world or remained sporadic or at low levels, the WHO said this week in its latest global flu update, which roughly covers the first half of April.

Though North America's flu activity—mostly caused by the H3N2 strain— continues to rise, it is still at lower levels than the most recent prepandemic seasons. Europe's flu activity appeared to decline, though some countries continue to report test positivity over 30%.

In East Asia, influenza B activity continues to fall in China. In Western Asia, Georgia reported a rise in H3N2 detections. East Africa continues to report circulation, mainly from influenza B.

In temperate countries of the Southern Hemisphere, flu activity remained low, with continued detections, mainly from H3N2.

Globally, of respiratory samples that were positive for flu at national flu labs in the first half of April, 98.4% were influenza A. Of the subtyped influenza A samples, 90.5% were H3N2.

The WHO urged caution in interpreting flu patterns, owing to the cocirulation of other respiratory viruses, including SARS-CoV-2. It also recommended that countries integrate their flu and COVID-19 surveillance systems, since both viruses are circulating at the same time. In its flu report, it wove in data from countries that are doing sentinel specimen testing for COVID-19.
May 2 WHO global flu update

Connecticut confirms its first tick-borne Powassan case of 2022

Yesterday the Connecticut Department of Public Health (CDPH) confirmed the state's first Powassan virus infection of the year, in a man in his 50s from Windham. The state logged three cases of the sometimes-deadly tick-borne disease last year.

The man became ill on Mar 4 and was hospitalized for symptoms of central nervous system involvement after a tick bite, the CDPH said in a news release. Tests by the Centers for Disease Control and Prevention (CDC) confirmed the presence of Powassan virus. The man is now recovering at home.

"The identification of a Connecticut resident with Powassan virus associated illness emphasizes the need to take actions to prevent tick bites from now through the late fall," said CDPH Commissioner Manisha Juthani, MD. "Using insect repellent, avoiding areas where ticks are likely, and checking carefully for ticks after being outside can reduce the chance of you or your children being infected with this virus."

The disease is primarily spread via the blacklegged, or deer, tick, the same principal vector of Lyme disease.

According to CDC statistics, states reported 178 Powassan cases involving neuroinvasive disease from 2011 through 2020, primarily in the Northeast and Great Lakes states, with a general increase in recent years. 2019 saw the most infections, 39, while 20 were confirmed in 2020. In that span, Massachusetts had the most infections, 37, followed by Minnesota (35), Wisconsin (30), and New York (21). Connecticut had 10 cases in that decade.

Of the 178 US cases, 22 (12%) were fatal.
May 4 CDPH news release
CDC Powassan virus statistics page