COVID-19 Scan for May 18, 2021

News brief

Bamlanivimab cuts hospitalization, deaths in high-risk COVID outpatients

Fewer high-risk outpatients with mild or moderate COVID-19 needed hospitalization or died within 28 days when given bamlanivimab soon after infection compared with their matched peers, finds an observational study yesterday in Open Forum Infectious Diseases.

University of Pittsburgh researchers compared the outcomes of 232 COVID-19 outpatients given the monoclonal antibody (mAb) from Dec 9, 2020, to Mar 3, 2021, with those of 1,160 coronavirus patients of similar age and health status who didn't receive the drug.

Bamlanivimab reduced the risk of hospitalization and death by 60% and  was associated with a significantly lower risk-adjusted likelihood of hospitalization or death by 28 days (odds ratio [OR], 0.40). Data also showed lower odds of hospitalization or an emergency department (ED) visit without hospitalization in treated patients (OR, 0.54).

Patients 65 years and older appeared to benefit the most from bamlanivimab; they were nearly three times less likely to be admitted to a hospital or die than their untreated matches. Likewise, those who received the drug soon after infection also appeared to benefit more than those who received it later in the course of their disease.

Few patients had adverse reactions to the infusion, and all were mild. Mean patient age was 67 years, 56% were female, and 14% were hospitalized or died.

"These data support health systems' investment of resources in developing infrastructure for mAb infusions," the authors wrote. "Additionally, the potential benefits of mAb could be explored in patients cared for in the ED and those early in hospital admission without severe disease."

The US Food and Drug Administration granted emergency use authorization for bamlanivimab given in combination with another monoclonal antibody within 10 days of symptom onset in patients 65 years and older with mild or moderate COVID-19 or in patients with a higher risk for severe infection, such as those with a body mass index of at least 40 kg/m2 or an underlying illness.

"If there's one key take-away that we're seeing in our data, it's this: If you get COVID-19 and are at higher risk for severe illness, ask your doctor about monoclonal antibodies," senior study author Graham Snyder, MD, said in a University of Pittsburgh news release. "Don't hesitate. Early treatment, while your symptoms are still mild, may be essential."
May 17 Open Forum Infect Dis study
May 17 University of Pittsburgh news release


Interest in home births appears to rise with pandemic

The proportional volume of weekly Google searches relating to home births rose 239% in the United States and 53% in the United Kingdom since the COVID-19 pandemic began, according to a research letter yesterday in JAMA Network Open.

The researchers used Google Trends to measure weekly relative search volumes (RSVs) from Mar 3, 2019, to Nov 1, 2020. RSVs show how much a search term was logged in relation to the total number of queries on a scale of 0 to 100 (with 100 being the highest). In the United States and the United Kingdom, the average RSV scores were 53.5 and 39.0, respectively, compared with 40.6 and 31.2 before the COVID-19 pandemic. The trend may have been smaller in the United Kingdom because the nation has a higher baseline of home births and a more integrated home birth system, the researchers note.

Data showed higher RSVs in the earlier months of the pandemic, with 8 of 9 of the highest US RSVs and 6 of 9 of the highest UK RSVs falling between March and May 2020. Even after the spike, though, RSVs have maintained a greater level than pre-pandemic trends, according to the researchers.

"This increased information-seeking parallels media coverage and anecdotal reports from home birth practitioners, who have noted heightened demand for home birth services," the researchers write. "As individuals increasingly rely on digital sources of health-related information, tools like the one used in this study are important for understanding information-seeking behaviors."
May 17 JAMA Netw Open study

News Scan for May 18, 2021

News brief

CARB-X to fund development of novel antibiotic for CRE infections

CARB-X announced today that it is awarding up to $4.1 million to Summit Therapeutics of Cambridge, Massachusetts, to develop a first-in-class antibiotic to treat multidrug-resistant bacterial infections.

The money will help fund development of SMT-738, the first candidate from a novel class of antibiotics that target carbapenem-resistant Enterobacteriaceae (CRE) via the LoICDE complex, an essential lipid transport system in gram-negative bacteria. The company says SMT-738 has shown potent in vitro activity against CRE isolates, including strains carrying the New Delhi Metallo-beta-lactamase (NDM) enzyme, and that it hopes to begin phase 1 clinical trials in 2023.

Under the award from CARB-X (the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator), Summit could receive an additional $3.7 million if certain project milestones are achieved.

"SMT-738 has the potential to save the lives of patients, as yet with untreatable infections through a novel drug class with a low propensity for resistance development," Summit Chairman and Chief Executive Officer Robert Duggan said in a CARB-X press release. "We are excited and optimistic to take on the real challenge of antibiotic resistance and are grateful to CARB-X for partnering with us in support of this important mission."

The Centers for Disease Control and Prevention (CDC) estimates that infections caused by CRE, dubbed "nightmare bacteria," kill an estimated 1,100 hospital patients a year. 

CARB-X is now funding 58 active projects focused exclusively on drug-resistant bacteria.
May 18 CARB-X press release


Chronic wasting disease found for first time in 2 Texas counties

Two instances of chronic wasting disease (CWD) have been confirmed in deer-breeding facilities in Matagorda and Mason counties, Texas, marking the first cases in these counties, according to the Texas Parks and Wildlife Department (TPWD) late last week.

Besides securing the deer at these sites for further investigation, any facility that has given deer to or from these locations in the past 5 years has been contacted and told not to transfer any deer.

CWD is a fatal prion disease affecting the cervid family, including deer, elk, and moose. It can be spread through contact with infected fluids, antler velvet, and prions shed onto the environment, and prions can take years to incubate in their hosts before presenting symptoms.

Both deer-breeding facilities received deer from Uvalde County, which had flagged CWD cases on Mar 29 during an epidemiological investigation. On Mar 31, TPWD and the Texas Animal Health Commission (TAHC) confirmed CWD at both that site and at a Hunt County breeding facility. (While Uvalde County is 100 miles west of San Antonio, Matagorda County is on the coast of the Gulf of Mexico, Mason County is 118 miles northwest of Austin, and Hunt County is in Texas' northeast corner.)

"Regrettably, the gravity of this situation continues to mount with these new CWD positive discoveries, as well as with the full understanding of just how many other facilities and release sites across Texas were connected to the CWD positive sites in Uvalde and Hunt Counties,” said Carter Smith, TPWD executive director, in a TPWD press release.

"Along with our partners at the Texas Animal Health Commission, we will continue to exercise great diligence and urgency with this ongoing investigation. Accelerating the testing at other exposed facilities will be critical in ensuring we are doing all we can to arrest the further spread of this disease, which poses great risks to our native deer populations, both captive and free-ranging alike."

CWD spread was identified in Texas in 2012, more than 50 years after the disease was first discovered. Now, TPWD reports, 228 cases have been confirmed in 13 counties.
May 14 TPWD press release

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