COVID-19 Roundup: Bivalent Vaccines Include Infants, NIH Recommends Against Bebtelovimab, COVID’s Impact on Short-Term Memory, and More
FDA Amends Bivalent COVID-19 Vaccines to Include Children Aged 6 Months1
The FDA modified their emergency use authorization of the updated Moderna and Pfizer-BioNTech COVID-19 bivalent vaccines—targeting both the original strain of COVID-19 and the omicron strain of the virus—to include their use in children aged 6 months.
Children aged 6 months through 5 years who received the original Moderna COVID-19 vaccine are now eligible to receive a single booster of the updated Moderna vaccine two months after completing the primary series.
For children aged 6 months through 4 years who have yet to begin their three-dose Pfizer-BioNTech COVID-19 vaccine series, they will now receive the updated bivalent Pfizer-BioNTech vaccine as the third dose in the series. The third dose will follow two doses of the original Pfizer-BioNTech vaccine. Further, children who have already completed their three-dose primary series with the original vaccine will not be eligible for a booster dose of an updated bivalent vaccine at this time.
“More children now have the opportunity to update their protection against COVID-19 with a bivalent COVID-19 vaccine, and we encourage parents and caregivers of those eligible to consider doing so – especially as we head into the holidays and winter months where more time will be spent indoors,” said FDA Commissioner Robert M. Califf, MD in a press release.
NIH Recommends Against the Use of Bebtelovimab in Treatment2
According to the NIH, the prevalence of omicron subvariants that are anticipated to be resistant to bebtelovimab (BQ.1, BQ.1.1, XBB) has been rapidly increasing. In the United States, the estimated combined prevalence of these subvariants is over 68% (as of December 2, 2022).
Like the FDA, the NIH COVID-19 Treatment Guidelines Panel issued a response to the increased prevalence of these resistant strains, revising their emergency authorization for bebtelovimab as deeming it unauthorized for the treatment of COVID-19 in the United States.
The Panel noted the antiviral drugs ritonavir-boosted nirmatrelvir, remdesivir, and molnupiravir are still active to use against the omicron subvariants. Ritonavir-boosted nirmatrelvir and remdesivir are preferred treatments for mild to moderate COVID-19 cases, and molnupiravir is recommended as an alternative therapy when the first two options aren’t available, feasible to use, or clinically appropriate.
Monoclonal antibodies are no longer recommended for the treatment of patients with COVID-19 infection.
COVID-19 Virus Negatively Impacts Short-Term Memory3
According to a new study, COVID-19 negatively affects working memory function in adults 25 years of age and older.
The research team developed an online anonymous survey featuring a memory quiz for participants to take. A total of 5428 participants completed the survey and memory quiz (68.6% non-COVID-19 and 31.4% COVID-19). The factors that significantly affected memory scores, according to the researchers, were COVID-19 status, age, time post-COVID, and ongoing symptoms.
When compared to people without COVID-19, memory scores for COVID-19 participants were significantly reduced. Further, people with ongoing symptoms continued to show a reduction in memory scores. Over a period of 17 months post-COVID, memory scores gradually increased.
It should be noted that one limitation of the study was that the survey and quiz were not conducted under laboratory conditions, which could affect the survey and quiz results. Additionally, the authors noted: “While our study provides evidence that working memory is negatively impacted by COVID-19, the underlying mechanisms for this are unknown.”
Still, the authors believe that the reduction in memory quiz scores in the COVID group compared to the non-COVID group was a “key discovery.”
“Our results suggest that working memory deficits with COVID-19 can recover over time, although impairments may persist in those with ongoing symptoms,” the researchers concluded.
The Risk of Seizures, Epilepsy High After COVID-19 Infection4
The risk of a new diagnosis of seizures or epilepsy in the 6 months after COVID-19 infection was higher than in patients with influenza, according to a new study.
The researchers analyzed data of 860,934 patients, yielding two cohorts with the same number of patients (n = 152,754). From their analysis, the researchers found that COVID-19 was associated with an increased risk of seizures and epilepsy. Within 6 months of COVID-19, the incidence of seizures was 0.81%, and the incidence of epilepsy was 0.30%.
Further, the hazard ratio of epilepsy after COVID-19 compared to influenza was greater in people who were not hospitalized for the virus and individuals aged 16 years and younger. But as the authors note: “An increasing HR over time only implies that the incidence in one group increases relative to the other group.” Put in this context, the authors advise cautious interpretation of the study results.
Still, the study results were noteworthy.
“This difference was more marked in people who were not hospitalized, highlighting the risk of epilepsy and seizures even in those with less severe infection,” the researchers concluded. “Children appear at particular risk of seizures and epilepsy after COVID-19 providing another motivation to prevent COVID-19 infection in pediatric populations.”
- Coronavirus (COVID-19) update: FDA authorizes updated (bivalent) COVID-19 vaccines for children down to 6 months of age. News release. US Food and Drug Administration; December 8, 2022. Accessed December 20, 2022. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-updated-bivalent-covid-19-vaccines-children-down-6-months
- The COVID-19 treatment guidelines panel’s update on bebtelovimab. News release. The National Institutes on Health; December 6, 2022. Accessed December 20, 2022. https://www.covid19treatmentguidelines.nih.gov/therapies/update-on-bebtelovimab/
- Baseler HA, Aksoy M, Salawu A, Green A, Asghar AUR. The negative impact of COVID-19 on working memory revealed using rapid online quiz. PLoS One. Published online November 14, 2022. doi:10.1371/journal.pone.0269353
- Taquet M, Devinsky O, Cross JH, Harrison PJ, Sen A. Incidence of epilepsy and seizures over the first 6 months after a COVID-19 diagnosis: a retrospective cohort study. Neurology. Published online November 16, 2022. doi:10.1212/WNL. 0000000000201595