Molnupiravir reduces COVID-19 symptoms, virus by day 3, data show
Three new studies to be presented at the upcoming European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) conference at the end of the month demonstrate benefits of the antiviral molnupiravir against COVID-19 infections, including evidence that Merck's pill reduces symptoms of the SARS-CoV-2 virus by day 3 of administration.
All three studies are based on results seen in the MOVe-OUT study, which was conducted throughout 2021 to determine the drug's efficacy against COVID-19 infections.
In the first study, participants were randomized and given molnupiravir or placebo within 5 days of symptom onset. Participants in the study kept a daily record of COVID-19 symptoms for 1 month. Those who took molnupiravir saw significant reduction of symptoms by day 3 and 5, including shortness of breath or difficulty breathing, cough, fatigue, loss of smell, and loss of taste.
In a second study, the antiviral pill was able to clear active SARS-CoV-2 virus equally well in immunocompromised patients, as well as those who were deemed immunocompetent. Of the 1,433 participants in MOVe-OUT, 57 (4%) were identified as immunocompromised. Of those participants, only 2 of 25 (8%) given molnupiravir were hospitalized or died from COVID-19, compared to 8 of 32 (25%) of immunocompromised patients given a placebo.
In a final study, PCR testing was used to determine viral loads from nasopharyngeal swabs collected on days 1 (baseline), 3, 5 (end-of-treatment visit), 10, 15, and 29. By day 3 of treatment, among patients with infectious virus at baseline, infectious SARS-CoV-2 was detected in none of the 92 patients who received molnupiravir, compared with 20 (20.8%) of 96 patients who received a placebo. By day 5, virus was detected in 0.0% in the molnupiravir arm of the study compared with 2.2% in the placebo arm.
"This study provides additional evidence that molnupiravir helps those infected clear SARS-CoV-2 faster than placebo, and supports MOVe-OUT's primary finding that molnupiravir can lower the risk of progression to serious illness in this high-risk cohort," said Julie Strizki, PhD, a researcher at Merck.
Mar 31 ECCMID symptoms press release
Mar 31 ECCMID immunocompromised press release
Mar 31 ECCMID infectiousness press release
CWD confirmed in North Carolina for first time
Chronic wasting disease (CWD) has been detected in North Carolina for the first time, in a white-tailed deer, the North Carolina Wildlife Resources Commission (NCWRC) said yesterday in a news release, bringing the number of CWD-affected US states to 30.
The deer was harvested by a hunter in Yadkin County in north central North Carolina in December 2021, and the sample was sent in by a taxidermist through a program established by the NCWRC. It is 1 of 7,200 samples collected by the agency after the discovery of a CWD-positive deer 33 miles away from the North Carolina border last year in Montgomery County, Virginia.
The NCWRC has received test results from 4,287 samples submitted, including 626 from a focal area that includes Alleghany, Surry, Stokes, and Rockingham counties. CWD is a prion disease that is always fatal to the members of the deer family (cervids) that it infects. A human case has yet to be detected, but the Centers for Disease Control and Preventions warns people not to eat meat from CWD-infected animals.
"We are appreciative of all the cooperating taxidermists, meat processors and hunters that have helped us with our CWD surveillance," said Brad Howard, chief of the NCWRC's Wildlife Management Division. "Now that we know the disease is in North Carolina, we will implement our CWD Response Plan to help slow the spread of CWD while preserving our deer herd and deer hunting tradition."
He added, "We've been in contact with wildlife professionals in other states that are already CWD-positive to learn from their experiences."
The disease is spread among cervids through direct contact and from infected saliva, urine, and feces of live animals or carcasses and body parts.
Mar 31 NCWRC news release
Study finds high rates of resistant E coli in young Kenyan children
A study of Escherichia coli isolates from young hospitalized children in western Kenya found high levels of antimicrobial resistance (AMR), researchers reported yesterday in PLOS Neglected Tropical Diseases.
For the cross-sectional study, researchers with the Kenya Medical Research Institute and the University of Washington cultured and analyzed E coli fecal samples collected at the time of hospital discharge from 406 children ages 1 to 59 months. Most of the children (87.2%) had received antibiotics in the hospital, and the most frequent diagnoses at admission and discharge were pneumonia, diarrhea, anemia, and malaria.
The researchers performed antimicrobial susceptibility testing on the isolates and tested for extended-spectrum beta-lactamase (ESBL) production, and they used multivariate regression models to identify risk factors for the presence of ESBL-producing E coli.
All 406 children had reduced susceptibility to at least 1 of the 12 antibiotics tested; 92.6% had E coli that lacked susceptibility to ampicillin, 46.1% harbored isolates that were non-susceptible to ceftriaxone, and 43.8% had isolates resistant to gentamicin. ESBL-producing E coli was found in 44.3% of children.
Multivariate analysis showed that receipt of antibiotics during the hospitalization was associated with the presence of ESBL-producing E coli (adjusted prevalence ratio [aPR], 2.23; 95% confidence interval [CI], 1.29 to 3.83), as was being hospitalized within the prior year (aPR, 1.32; 95% CI, 1.07 to 1.69). Defecating in the open (aPR, 2.02; 95% CI, 1.39 to 2.94), having a toilet shared with other households (aPR, 1.49; 95% CI, 1.17 to 1.89), and being female (aPR, 1.42; 95% CI, 1.15 to 1.76) were also associated with carriage of ESBL E coli.
The authors say the high rates of AMR carriage observed in the study may be particularly problematic during the post-discharge period, when children are at high risk of subsequent illness, and has potential implications for the broader population, given that resistant organisms and genetic elements can be spread to others in households and communities.
"AMR is increasing globally, and the public health relevance of these findings is likely significant, both for individual children and for communities," they wrote. "Health care exposure appears to be a major driver of AMR, and interventions to prevent and reduce AMR transmission and acquisition in the health care setting are urgently needed."
Mar 31 PLOS Negl Trop Dis study
Four countries report more vaccine-derived polio detections
The Democratic Republic of the Congo (DRC), Nigeria, and Yemen reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases this week, and Israel reported more detections of cVDPV3, according to the latest official reports.
The Global Polio Eradication Initiative detailed the cVDPV2 cases in its latest weekly update. In Africa, the DRC reported six cases, all in Maniema province, bringing its number this year to nine. Nigeria reported three more cases, two in Bauchi state and one in Gombe state, raising its 2022 total to eight.
In the Middle East, Yemen reported 16 more cVDPV2 cases from 8 different governorates, which are added to its 2021 total, which now stands at 32.
In another polio development, Israeli officials reported four more cVDPV3 positives in asymptomatic children, raising the total in asymptomatic kids to six, the European Centre for Disease Prevention and Control (ECDC) said in its weekly communicable disease update.
Testing is under way as part of the investigation into a case of acute flaccid myelitis that was diagnosed in a child on Mar 6. All children who have tested positive so far are unvaccinated.
Mar 31 GPEI update
Apr 1 ECDC weekly communicable disease threat report