COVID-19

COVID-19 Roundup: Convalescent Plasma, Confirmed Reinfection

Convalescent Plasma

The FDA has issued an emergency use authorization for investigational convalescent plasma for the treatment of COVID-19 in patients hospitalized with the infection.

The decision is based upon data from an expanded access program designed to “fill an urgent need to provide patient access to a medical product of possible benefit.” Overall, a 37% relative risk reduction in mortality at 7 days was observed in patients in the high titer (≥1:320) group compared with the low titer (≤1:160) group (P=.03).

The program was not designed to assess the efficacy of convalescent plasma, and the mortality benefit versus standard of care is not currently known. “The emergency use authorization is not intended to replace randomized clinical trials and facilitating the enrollment of patients into any of the ongoing randomized clinical trials is critically important for the definitive demonstration of safety and efficacy of COVID-19 convalescent plasma,” the FDA stressed.

Antihypertensives

In a new analysis, researchers found that treatment with Angiotensin-Converting Enzyme inhibitors (ACEi) or Angiotensin Receptor Blockers (ARB) was associated with a reduction in mortality and the risk of severe COVID-19 among patients with hypertension.

They examined data from 19 studies involving 28,872 patients. Overall, they found that while use of any renin-angiotensin-aldosterone system inhibitors for any condition was associated with a trend to lower risk of death and critical events, a significantly lower risk was observed among the hypertension cohort. 

“This is the largest meta-analysis including critical events and mortality data on patients prescribed ACEi/ARB and found evidence of beneficial effects of chronic ACEi/ARB use especially in hypertensive cohort with COVID-19. As such we would strongly encourage patients to continue with RAAS inhibitor pharmacotherapy during the COVID-19 pandemic,” they wrote.

Reinfection

The first documented case of COVID-19 reinfection has been reported, according to researchers at the University of Hong Kong.

The patient, a 33-year-old man, originally contracted the infection in April, and now, more than 4 months later, has tested positive for the infection a second time. Notably, the strain of SARS-CoV-2 identified was different from the strain originally identified when he first contracted the disease.

COVID-19 Updates from CDC

As of August 21, 2020, the CDC has received reports of a total of 40,713,070 specimens tested for SARS-CoV-2, of which, 3,692,858 (9.1%) were positive.

Levels of influenza-like illness (ILI) are low, but high for the time of year. Levels of COVID-19-like illness have decreased since the previous week, with 9 of 10 regions showing decreases or stable levels.

Overall, the cumulative COVID-19-associated hospitalization rate is 151.7 per 100,000, with the highest rates in individuals aged 65 years and older (412.9 per 100,000) and 50-64 years (228.1 per 100,000).

Percentages of deaths attributed to pneumonia, influenza, or COVID-19 is 7.8% for week 33, which is lower than the 12.6% seen the week before.

 

—Michael Potts

 

References:

  1. FDA issues emergency use authorization for convalescent plasma as potential promising COVID–19 treatment, another achievement in administration’s fight against pandemic. News release. Silver Spring, MD: US Food and Drug Administration; August 23, 2020. https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-convalescent-plasma-potential-promising-covid-19-treatment
  2. Baral R, White M, Vassiliou V. Effect of renin-angiotensin-aldosterone system inhibitors in patients with covid-19: a systematic review and meta-analysis of 28,872 patients. Published online August 24, 2020. Curr Atheroscler Rep. doi: 10.1007/s11883-020-00880-6
  3. Hong Kong researchers report first documented coronavirus re-infection. News release. Hong Kong: Reuters; August 24, 2020. https://www.reuters.com/article/us-health-coronavirus-hongkong-reinfecti/hong-kong-researchers-report-first-documented-coronavirus-re-infection-idUSKBN25K1PQ
  4. COVIDView: a weekly surveillance summary of US COVID-19 Activity. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html. Updated August 7, 2020. Accessed August 10, 2020.