Updated: Apr 23, 2020
Below, I have copied a number of abstracts from medical publications that are related to the virus studies, of which there have been many of late. Doctors and researchers are making substantial progress on a number of important fronts. The more you read, the more questions you can ask if and when, god forbid, you become a patient. I am not a doctor. Any information that you obtain from this list if you feel is relevant to you should always be discussed with your doctor.
I have moved the more recent reports to the front of the post. 32
Thursday, April 23, 2020
32) Researchers identify cells likely targeted by COVID-19 virus
Study finds specific cells in the lungs, nasal passages, and intestines that are more susceptible to infection. My opinion: This is a key development, since it identifies specific cells that open the doors for the infection. Now, need to determine best way to close the doors.
Date:April 22, 2020
Source:Massachusetts Institute of Technology
Summary: Researchers have identified specific types of cells that appear to be the targets of the SARS-Cov-2 coronavirus that is causing the Covid-19 pandemic.
Researchers at MIT; the Ragon Institute of MGH, MIT, and Harvard; and the Broad Institute of MIT and Harvard; along with colleagues from around the world have identified specific types of cells that appear to be targets of the coronavirus that is causing the Covid-19 pandemic.
Using existing data on the RNA found in different types of cells, the researchers were able to search for cells that express the two proteins that help the SARS-CoV-2 virus enter human cells. They found subsets of cells in the lung, the nasal passages, and the intestine that express RNA for both of these proteins much more than other cells.
The researchers hope that their findings will help guide scientists who are working on developing new drug treatments or testing existing drugs that could be repurposed for treating Covid-19.
"Our goal is to get information out to the community and to share data as soon as is humanly possible, so that we can help accelerate ongoing efforts in the scientific and medical communities," says Alex K. Shalek, the Pfizer-Laubach Career Development Associate Professor of Chemistry, a core member of MIT's Institute for Medical Engineering and Science (IMES), an extramural member of the Koch Institute for Integrative Cancer Research, an associate member of the Ragon Institute, and an institute member at the Broad Institute. Shalek and Jose Ordovas-Montanes, a former MIT postdoc who now runs his own lab at Boston Children's Hospital, are the senior authors of the study, which appears today in Cell. The paper's lead authors are MIT graduate students Carly Ziegler, Samuel Allon, and Sarah Nyquist; and Ian Mbano, a researcher at the Africa Health Research Institute in Durban, South Africa.
Digging into data
Not long after the SARS-CoV-2 outbreak began, scientists discovered that the viral "spike" protein binds to a receptor on human cells known as angiotensin-converting enzyme 2 (ACE2). Another human protein, an enzyme called TMPRSS2, helps to activate the coronavirus spike protein, to allow for cell entry. The combined binding and activation allows the virus to get into host cells.
"As soon as we realized that the role of these proteins had been biochemically confirmed, we started looking to see where those genes were in our existing datasets," Ordovas-Montanes says. "We were really in a good position to start to investigate which are the cells that this virus might actually target."
Shalek's lab, and many other labs around the world, have performed large-scale studies of tens of thousands of human, nonhuman primate, and mouse cells, in which they use single-cell RNA sequencing technology to determine which genes are turned on in a given cell type. Since last year, Nyquist has been building a database with partners at the Broad Institute to store a huge collection of these datasets in one place, allowing researchers to study potential roles for particular cells in a variety of infectious diseases.
Much of the data came from labs that belong to the Human Cell Atlas project, whose goal is to catalog the distinctive patterns of gene activity for every cell type in the human body. The datasets that the MIT team used for this study included hundreds of cell types from the lungs, nasal passages, and intestine. The researchers chose those organs for the Covid-19 study because previous evidence had indicated that the virus can infect each of them. They then compared their results to cell types from unaffected organs. "Because we have this incredible repository of information, we were able to begin to look at what would be likely target cells for infection," Shalek says. "Even though these datasets weren't designed specifically to study Covid, it's hopefully given us a jump start on identifying some of the things that might be relevant there."
In the nasal passages, the researchers found that goblet secretory cells, which produce mucus, express RNAs for both of the proteins that SARS-CoV-2 uses to infect cells. In the lungs, they found the RNAs for these proteins mainly in cells called type II pneumocytes. These cells line the alveoli (air sacs) of the lungs and are responsible for keeping them open. In the intestine, they found that cells called absorptive enterocytes, which are responsible for the absorption of some nutrients, express the RNAs for these two proteins more than any other intestinal cell type.
"This may not be the full story, but it definitely paints a much more precise picture than where the field stood before," Ordovas-Montanes says. "Now we can say with some level of confidence that these receptors are expressed on these specific cells in these tissues."
In their data, the researchers also saw a surprising phenomenon -- expression of the ACE2 gene appeared to be correlated with activation of genes that are known to be turned on by interferon, a protein that the body produces in response to viral infection. To explore this further, the researchers performed new experiments in which they treated cells that line the airway with interferon, and they discovered that the treatment did indeed turn on the ACE2 gene.
Interferon helps to fight off infection by interfering with viral replication and helping to activate immune cells. It also turns on a distinctive set of genes that help cells fight off infection. Previous studies have suggested that ACE2 plays a role in helping lung cells to tolerate damage, but this is the first time that ACE2 has been connected with the interferon response.
The finding suggests that coronaviruses may have evolved to take advantage of host cells' natural defenses, hijacking some proteins for their own use.
"This isn't the only example of that," Ordovas-Montanes says. "There are other examples of coronaviruses and other viruses that actually target interferon-stimulated genes as ways of getting into cells. In a way, it's the most reliable response of the host."
Because interferon has so many beneficial effects against viral infection, it is sometimes used to treat infections such as hepatitis B and hepatitis C. The findings of the MIT team suggest that interferon's potential role in fighting Covid-19 may be complex. On one hand, it can stimulate genes that fight off infection or help cells survive damage, but on the other hand, it may provide extra targets that help the virus infect more cells.
"It's hard to make any broad conclusions about the role of interferon against this virus. The only way we'll begin to understand that is through carefully controlled clinical trials," Shalek says. "What we are trying to do is put information out there, because there are so many rapid clinical responses that people are making. We're trying to make them aware of things that might be relevant."
Shalek now hopes to work with collaborators to profile tissue models that incorporate the cells identified in this study. Such models could be used to test existing antiviral drugs and predict how they might affect SARS-CoV-2 infection.
The MIT team and their collaborators have made all the data they used in this study available to other labs who want to use it. Much of the data used in this study was generated in collaboration with researchers around the world, who were very willing to share it, Shalek says.
"There's been an incredible outpouring of information from the scientific community with a number of different parties interested in contributing to the battle against Covid in any way possible," he says. "It's been incredible to see a large number of labs from around the world come together to try and collaboratively tackle this."
The research was funded by the Searle Scholars Program, the Beckman Young Investigator Program, the Pew-Stewart Scholars Program for Cancer Research, a Sloan Fellowship in Chemistry, the National Institutes of Health, the Aeras Foundation, the Bill and Melinda Gates Foundation, the Richard and Susan Smith Family Foundation, the National Institute of General Medical Sciences, the UMass Center for Clinical and Translational Science Project Pilot Program, and the Office of the Assistant Secretary of Defense for Health Affairs.
Ziegler et al. SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues. Cell, April 22, 2020; DOI: 10.1016/j.cell.2020.04.035
Cite This Page:
Massachusetts Institute of Technology. "Researchers identify cells likely targeted by COVID-19 virus: Study finds specific cells in the lungs, nasal passages, and intestines that are more susceptible to infection." ScienceDaily. ScienceDaily, 22 April 2020. <www.sciencedaily.com/releases/2020/04/200422132556.htm>.
33) Scientists explore using 'own' immune cells to target infectious diseases including COVID-19
Date:April 21, 2020
Source:Duke-NUS Medical School
Summary:The engineering of specific virus-targeting receptors onto a patient's own immune cells is now being explored by scientists as a potential therapy for controlling infectious diseases, including the COVID-19-causing virus, SARS-CoV-2.Share:
FULL STORY The engineering of specific virus-targeting receptors onto a patient's own immune cells is now being explored by scientists from Duke-NUS Medical School (Duke-NUS), as a potential therapy for controlling infectious diseases, including the COVID-19-causing virus, SARS-CoV-2. This therapy that has revolutionized the treatment of patients with cancer has also been used in the treatment of other infectious diseases such as Hepatitis B virus (HBV), as discussed by the School's researchers in a commentary published in the Journal of Experimental Medicine.
This therapy involves extracting immune cells, called T lymphocytes, from a patient's blood stream and engineering one of two types of receptors onto them: chimeric antigen receptors (CAR) or T cell receptors (TCR). TCRs are naturally found on the surfaces of T lymphocytes while CARs are artificial T cell receptors that are generated in the laboratory. These receptors allow the engineered T lymphocytes to recognize cancerous or virus infected cells. "This therapy is classically used in cancer treatment, where the lymphocytes of the patients are redirected to find and kill the cancer cells. However, its potential against infectious diseases and specific viruses has not been explored. We argue that some infections, such as HIV and HBV, can be a perfect target for this therapy, especially if lymphocytes are engineered using an approach that keeps them active for a limited amount of time to minimise potential side effects," said Dr Anthony Tanoto Tan, Senior Research Fellow at the Duke-NUS' Emerging Infectious Diseases (EID) programme and the lead author of this commentary. This type of immunotherapy requires specialized personnel and equipment, and it needs to be administered indefinitely. This makes it cost-prohibitive for treating most types of viral infections. However, in the case of HBV infections, for example, current anti-viral treatments merely suppress viral replication and cure less than 5% of patients. Treating these patients with a combination of anti-virals and CAR/TCR T cells could be a viable option. The team's approach using mRNA electroporation to engineer CAR/TCR T cells limits their functional activity to a short period of time, and hence provides enhanced safety features suited for its deployment in patients with chronic viral diseases.
"We demonstrated that T cells can be redirected to target the coronavirus responsible for SARS. Our team has now begun exploring the potential of CAR/TCR T cell immunotherapy for controlling the COVID-19-causing virus, SARS-CoV-2, and protecting patients from its symptomatic effects," said Professor Antonio Bertoletti from the Duke-NUS' EID programme, who is the senior author of this commentary.
"Infectious diseases remain a leading cause of morbidity and mortality worldwide, necessitating the development of novel and innovative therapeutics. Although immunotherapy is most commonly associated with the treatment of cancer or inflammatory diseases such as arthritis, this commentary accentuates the evolving role of this specialised treatment strategy for various infectious diseases," said Professor Patrick Casey, Senior Vice Dean for Research at Duke-NUS.
34) Low-cost, easy-to-build ventilator performs similarly to high-quality commercial device
Ventilator could support coronavirus treatment in low-income regions or where supplies are limited
Date:April 20, 2020
Source:European Lung Foundation
Summary: A low-cost, easy-to-build non-invasive ventilator aimed at supporting the breathing of patients with respiratory failure performs similarly to conventional commercial devices. Researchers say the prototype ventilator could support treatment of coronavirus and other severe respiratory diseases in low income regions or where ventilator supplies are limited. The research paper provides a free to replicate, open source description for how to build the ventilator.
35) Diagnostic biosensor quickly detects SARS-CoV-2 from nasopharyngeal swabs
Date:April 20, 2020
Source: American Chemical Society
Summary: Researchers have developed a field-effect transistor-based biosensor that detects SARS-CoV-2 in nasopharyngeal swabs from patients with COVID-19, in less than one minute.
Share: According to many experts, early diagnosis and management are critical for slowing the spread of SARS-CoV-2, the new coronavirus that causes COVID-19. Therefore, the race is on to develop diagnostic tests for the virus that are faster, easier and more accurate than existing ones. Now, researchers reporting in ACS Nano have developed a field-effect transistor-based biosensor that detects SARS-CoV-2 in nasopharyngeal swabs from patients with COVID-19, in less than one minute.
36) Rapid COVID-19 test based on new biolabeling technology called plasmonic-fluor
Date: April 20, 2020
Source: Washington University in St. Louis
Summary: Engineers have received federal funding for a rapid COVID-19 test using a newly developed technology called plasmonic-fluor.
Tuesday April 14
27) Study finds remdesivir effective against a key enzyme of coronavirus that causes COVID-19
Remdesivir already in human trials in search for treatment of deadly disease
Date:April 13, 2020
Source: University of Alberta Faculty of Medicine & Dentistry
Summary:Scientists have shown that the drug remdesivir is highly effective in stopping the replication mechanism of the coronavirus that causes COVID-19. The finding follows closely on research demonstrating how the drug worked against the Middle East Respiratory Syndrome (MERS) virus, a related coronavirus.Share:
FULL STORY Scientists at the University of Alberta have shown that the drug remdesivir is highly effective in stopping the replication mechanism of the coronavirus that causes COVID-19, according to new research published today in the Journal of Biological Chemistry. The paper follows closely on research published by the same lab in late February that demonstrated how the drug worked against the Middle East Respiratory Syndrome (MERS) virus, a related coronavirus.
"We were optimistic that we would see the same results against the SARS-CoV-2 virus," said Matthias Götte, chair of medical microbiology and immunology at U of A. "We obtained almost identical results as we reported previously with MERS, so we see that remdesivir is a very potent inhibitor for coronavirus polymerases." advertisement Physicians: ADHD and Adults - Adult ADHD Treatment Option Discover an ADHD Treatment For Adults & Get Prescribing Info Here. Prescription treatment website Götte's new paper demonstrates how remdesivir, developed in 2014 to fight the Ebola epidemic, works in detail. He likens the polymerase to the engine of the virus, responsible for synthesizing the virus' genome.
"If you target the polymerase, the virus cannot spread, so it's a very logical target for treatment," Götte said.
The lab's work shows how remdesivir tricks the virus by mimicking its building blocks. "These coronavirus polymerases are sloppy and they get fooled, so the inhibitor gets incorporated many times and the virus can no longer replicate," Götte explained. He said the evidence from his group, along with previously published studies in animal and cell culture models, means that remdesivir can be classified as a "direct-acting antiviral" against SARS-CoV-2, a term first used to describe newer classes of antivirals that interfere with specific steps of the hepatitis C virus (HCV) life cycle.
He said the discovery of that direct action reinforces the promise of clinical trials for remdesivir in COVID-19 patients, which are already underway around the world. While Götte said the evidence justifies clinical trials, he cautioned that the results obtained in the lab cannot be used to predict how the drug will work with people.
"We've got to be patient and wait for the results of the randomized clinical trials," said Götte, whose research was funded by the Canadian Institutes of Health Research, Alberta's Major Innovation Fund and Gilead Sciences, which manufactures remdesivir.
The Götte lab previously worked on human immunodeficiency virus (HIV) and HCV, but a couple of years ago switched to focus on viruses with the highest epidemic potential. The World Health Organization (WHO) issued its list of the top pathogens likely to cause severe outbreaks, including Ebola, Lassa and coronaviruses, in 2015.
"In that sense we were prepared because my lab specializes in viral polymerases," said Götte, adding that his next step will be to use his lab's tools to evaluate other promising antivirals.
He is optimistic that the unprecedented amount of research going on worldwide and the high level of co-operation between researchers will lead to the discovery of one or more effective treatments for COVID-19.
"We are desperate, but we still have to keep the bar high for anything that we put into clinical trials," he said.
Remdesivir is one of several drugs being fast-tracked into trials by the World Health Organization, comparing potential treatments in hospitalized COVID-19 patients in a dozen countries, including Canada. Götte said we can expect results from important clinical trials as early as April or May.
Götte said it is disappointing that antivirals discovered at the time of the severe acute respiratory syndrome (SARS) outbreak of 2003 -- which might have been effective against COVID-19 too -- were never translated into widely available treatments, largely because of the huge cost involved in developing new drugs.
"This time around it's obvious that we have to cross the finish line," he said. "Ten billion dollars, it seems a lot, a huge amount," Götte said. "But in the context of this pandemic and the costs associated with this pandemic, it's nothing."
28) Super-charging drug development for COVID-19
Cell-free production method scales up yield by 5,000 times
Date:April 13, 2020
Summary:Researchers are using cell-free manufacturing to ramp up production of valinomycin, a promising drug that has proven effective in obliterating SARS-CoV in cellular cultures.Share:
FULL STORY Researchers are ramping up production of a promising drug that has proven effective in obliterating SARS-CoV in cellular cultures. The team hopes that the drug might also be effective in the fight against SARS's close genetic cousin, the novel coronavirus (COVID-19). Led by Northwestern University and ShanghaiTech University, the team has produced the promising molecule, called valinomycin, in a cell-free system. With this approach, they increased production yields more than 5,000 times in just a few rapid design cycles, achieving higher concentrations of the molecule than achieved previously in cells. "Because we use cell-free systems, we can optimize production faster than in cells to further increase yields," said Northwestern's Michael Jewett, who co-led the study. "For example, pathway optimization cycles take days rather than weeks or months, and this speed could be ever so important when dealing with a pandemic like the coronavirus COVID-19 outbreak." The research was published online recently in the journal Metabolic Engineering and will appear in the July 2020 print issue. Jewett is the Walter P. Murphy Professor of Chemical and Biological Engineering in the McCormick School of Engineering and director of Northwestern's Center for Synthetic Biology. He co-led the work with Jian Li, an assistant professor in the School of Physical Science and Technology at ShanghaiTech.
Jewett leads multiple projects that use cell-free biotechnology to accelerate COVID-19 therapeutics. His group takes the molecular machinery out of cells, and then uses that machinery to make a product, such as therapeutics, in a safe, inexpensive and rapid manner. The idea is akin to opening the hood of a car and removing the engine, which allows researchers to use the engine for different purposes, free from the constraints of the car. A naturally occurring peptide, valinomycin has recently emerged as a potential antiviral to treat SARS. Jewett imagines using cell-free synthetic biology to find similar molecules or to modify valinomycin to make it safer and more potent.
Jewett is a member of Northwestern's Chemistry of Life Processes Institute and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.
The research, "Total in vitro biosynthesis of the nonribosomal macrolactone peptide valinomycin," was supported by the National Institutes of Health (award number 1U19AI142780-01), the David and Lucile Packard Foundation, the Camille Dreyfus Teacher-Scholar Program, the National Natural Science Foundation of China (award numbers 31971348 and 31800720), the National Natural Science Foundation of Shanghai (award number 19ZR1477200), and the Shanghai Pujiang Program (award number 18PJ1408000).
29) Loss of smell and taste validated as COVID-19 symptoms in patients with high recovery rate
Study suggests clinicians should include sensory impairment as standard screening measure
Date:April 13, 2020
Source:University of California - San Diego
Summary:Researchers have published the first empirical findings that strongly associate sensory loss and COVID-19, the respiratory disease caused by the novel coronavirus.
30) Guidance for patients with IBD during the COVID-19 pandemic
Many patients with IBD who develop COVID-19 should stop their medication
Date:April 12, 2020
Source:American Gastroenterological Association
Summary:Today, the American Gastroenterological Association (AGA) published new COVID-19 guidance for gastroenterologists treating patients with inflammatory bowel disease (IBD).Share:
FULL STORY Today, the American Gastroenterological Association (AGA) published new COVID-19 guidance for gastroenterologists treating patients with inflammatory bowel disease (IBD): AGA Clinical Practice Update on Management of Inflammatory Bowel Disease During the COVID-19 Pandemic: Expert Commentary. While the COVID-19 pandemic is a global health emergency, patients with IBD have particular concerns for their risk for infection and management of their medical therapies. This clinical practice update incorporates the emerging understanding of COVID-19 and summarizes available guidance for patients with IBD and the providers who take care of them. Recommendations for gastroenterologists & their patients who have IBD: 1. During this pandemic, patients with IBD should continue IBD therapies including scheduled infusions.
2. Having IBD does not appear to increase the risk of SARS-CoV-2 infection or the development of COVID-19.
3. Instructions for patients with IBD who develop COVID-19 (fever, respiratory symptoms, digestive symptoms, etc.):
a. Stop thiopurines, methotrexate, tofacitinib.
b. Stop biological therapies (including anti-TNF, ustekinumab, vedolizumab).
c. Can restart therapies after complete resolution of COVID-19 symptoms. Patients should
always speak with their health care team before stopping any medication.
4. Doctors should submit cases of IBD and confirmed COVID-19 to the SECURE-IBD registry at COVIDIBD.org.ABOUT IBD
Inflammatory bowel disease (IBD) is a group of chronic immune disorders, including Crohn's disease and ulcerative colitis. These conditions can cause abdominal pain, diarrhea and weight loss. Symptoms and progression of the disease can often be controlled by medication, but sometimes surgery is needed, as well. In the U.S., 3.1 million people have IBD.
31) COVID-19 and the built environment
Examining how building design can influence disease transmission
Date: April 10, 2020
Source:University of California - Davis
Summary:Social distancing has Americans mostly out of the places they usually gather and in their homes as we try to reduce the spread of COVID-19. But some buildings, such as hospitals and grocery stores, have to remain open, and at some point, most of us will go back to the office or workplace. What is the role of building design in disease transmission, and can we change how we design the built environment to make it healthier?Share:
FULL STORY Social distancing has Americans mostly out of the places they usually gather and in their homes as we try to reduce the spread of COVID-19. But some buildings, such as hospitals and grocery stores, have to remain open, and at some point, most of us will go back to the office or workplace. What is the role of building design in disease transmission, and can we change how we design the built environment to make it healthier? Those questions are addressed in a review just published in the journal mSystems by David Coil, project scientist, and Professor Jonathan Eisen at the UC Davis Genome Center and School of Medicine; and colleagues at the Biology and the Built Environment Center, University of Oregon. Among the simplest suggestions for healthier buildings: opening windows to improve air circulation and opening blinds to admit natural daylight. While more research needs to be done on the effect of sunlight on SARS-CoV-2 indoors, "Daylight exists as a free, widely available resource to building occupants with little downside to its use and many documented positive human health benefits," the authors write. We spend almost all of our daily lives inside human-built environments whether homes, vehicles or workplaces. Built environments provide lots of opportunities for people to come into contact with viruses and bacteria -- through air flow, from surfaces and also from the way buildings make us interact with each other. So far, the only documented route of transmission of SARS-CoV-2 is directly from person to person. But viruses also settle on surfaces, which can become heavily contaminated quite quickly. How long SARS-CoV-2 survives on surfaces is still up for debate. Estimates range from a couple of hours to a few days, depending on the material and conditions. Regularly cleaning surfaces and thorough handwashing are important.
Air flow and humidity Viral particles are too small to be blocked by HEPA and MERV air filters, but ventilation strategies can still play a role in reducing disease transmission, the authors write. Increasing the amount of air flowing in from outside and the rate of air exchange can dilute virus particles indoors. This can include "perimeter ventilation" -- opening a window, when outdoor temperatures allow it. However, high air flow could also stir up settled particles and put them back in the air -- and it also uses more energy.
Virus particles like drier air, so maintaining a high relative humidity can help. Virus-bearing droplets get bigger in humid air, meaning they settle out more quickly and don't travel as far. Humidity also seems to interfere with the lipid envelope around viruses such as SARS-CoV-2. Too much humidity, however, can promote mold growth.
Modern buildings are generally designed to promote social mixing -- from open plan living areas in homes to open offices where many workers share space. By promoting interaction and chance encounters, these layouts are thought to generate more creativity and teamwork. At the same time, they are probably also really great for spreading viruses around. It may not be practical in the short term to make big changes in office layout. But understanding how layout and the ways people use shared spaces affect disease transmission could help in developing effective social distancing measures and making decisions about when people can go back to work.
Eisen holds appointments in the Department of Evolution and Ecology, College of Biological Sciences, and the Department of Microbiology and Immunology, School of Medicine, at the University of California, Davis. Co-authors on the review are Leslie Dietz, Patrick Horve, Mark Fretz and Kevin Van Den Wymelenberg at the Biology and the Built Environment Center, University of Oregon.
19) False-negative COVID-19 test results may lead to false sense of security
Date:April 9, 2020
Source: Mayo ClinicSummary: A new article calls attention to the risk posed by overreliance on COVID-19 testing to make clinical and public health decisions. The sensitivity of reverse transcriptase-polymerase chain reaction (RT-PCR) testing and overall test performance characteristics have not been reported clearly or consistently in medical literature, the article says.Share:
FULL STORY As COVID-19 testing becomes more widely available, it's vital that health care providers and public health officials understand its limits and the impact false results can have on efforts to curb the pandemic.
A special article published in Mayo Clinic Proceedings calls attention to the risk posed by over reliance on COVID-19 testing to make clinical and public health decisions. The sensitivity of reverse transcriptase-polymerase chain reaction (RT-PCR) testing and overall test performance characteristics have not been reported clearly or consistently in medical literature, the article says. As a result, health care officials should expect a "less visible second wave of infection from people with false-negative test results," says Priya Sampathkumar, M.D., an infectious diseases specialist at Mayo Clinic and a study co-author.
"RT-PCR testing is most useful when it is positive," says Dr. Sampathkumar. "It is less useful in ruling out COVID-19. A negative test often does not mean the person does not have the disease, and test results need to be considered in the context of patient characteristics and exposure."
Even with test sensitivity values as high as 90%, the magnitude of risk from false test results will be substantial as the number of people tested grows. "In California, estimates say the rate of COVID-19 infection may exceed 50% by mid-May 2020," she says. "With a population of 40 million people, 2 million false-negative results would be expected in California with comprehensive testing. Even if only 1% of the population was tested, 20,000 false-negative results would be expected."
The authors also cite the effects on health care personnel. If the COVID-19 infection rate among the more than 4 million people providing direct patient care in the U.S. were 10% -- far below most predictions ¬¬ -- more than 40,000 false-negative results would be expected if every provider were tested.
This poses risks for the health care system at a critical time. "Currently, CDC (Centers for Disease Control and Prevention) guidelines for asymptomatic health care workers with negative testing could lead to their immediate return to work in routine clinical care, which risks spreading disease," says Colin West, M.D., Ph.D., a Mayo Clinic physician and the study's first author. Victor Montori, M.D., a Mayo Clinic endocrinologist, also is a co-author. While dealing with the enormity of the growing COVID-19 pandemic, it's important for public health officials to stick to principles of evidence-based reasoning regarding diagnostic test results and false-negatives. Four recommendations are outlined in the Mayo Clinic article:
Continued strict adherence to physical distancing, hand-washing, surface disinfection and other preventive measures, regardless of risk level, symptoms or COVID-19 test results. Universal masking of both health care workers and patients may be necessary.
Development of highly sensitive tests or combinations of tests is needed urgently to minimize the risk of false-negative results. Improved RT-PCR testing and serological assays -- blood tests that identify antibodies or proteins present when the body is responding to infections such as COVID-19 -- are needed.
Risk levels must be carefully assessed prior to testing, and negative test results should be viewed cautiously, especially for people in higher-risk groups and in areas where widespread COVID-19 infection has been confirmed.
Risk-stratified protocols to manage negative COVID-19 test results are needed, and they must evolve as more statistics become available.
"For truly low-risk individuals, negative test results may be sufficiently reassuring," says Dr. West. "For higher-risk individuals, even those without symptoms, the risk of false-negative test results requires additional measures to protect against the spread of disease, such as extended self-isolation."
At Mayo Clinic, RT-PCR testing is "one of many factors we take into account in deciding whether the patient meets criteria for COVID-19," Dr. Sampathkumar says. If the RT-PCR test is negative but chest X-ray or CT scan results are abnormal, or there has been close contact with a person who has confirmed COVID-19, the recommendation is to continue caring for the patient as if he or she has COVID-19.
"We need to continue to refine protocols for asymptomatic patients and exposed health care workers," says Dr. Sampathkumar. make a difference: sponsored opportunity Story Source: Materials provided by Mayo Clinic. Original written by Jay Furst. Note: Content may be edited for style and length. Journal Reference:
Colin P. West, Victor M. Montori, Priya Sampathkuma. COVID-19 Testing: The Threat of False-Negative Results. Mayo Clinic Proceedings, April 9, 2020; [link]
Cite This Page:
Mayo Clinic. "False-negative COVID-19 test results may lead to false sense of security." ScienceDaily. ScienceDaily, 9 April 2020. <www.sciencedaily.com/releases/2020/04/200409144805.htm>.
20) Guidance on treating COVID-19 patients with signs of acute heart attack
Date:April 9, 2020
Source: Mayo Clinic
Summary: Much remains unknown about COVID-19, but many studies already have indicated that people with cardiovascular disease are at greater risk of COVID-19. There also have been reports of ST-segment elevation (STE), a signal of obstructive coronary artery disease, in patients with COVID-19 who after invasive coronary angiography show no sign of the disease.
21) Scientists discover six new coronaviruses in bats --
No evidence novel coronaviruses pose a risk to human health
Date:April 9, 2020
Source: Smithsonian's National Zoo and Conservation Biology Institute
Summary: Researchers have discovered six new coronaviruses in bats in Myanmar -- the first time these viruses have been detected anywhere in the world. Future studies will evaluate the potential for transmission across species to better understand the risks to human health.
22) Global trial fast tracks testing of hydroxychloroquine, other COVID-19 therapies
Date: April 9, 2020
Source:UPMC / University of Pittsburgh School of Medicine
Summary:A novel 'learning while doing' clinical trial approach called REMAP helps doctors find the optimal trade-off between quickly adopting new therapies during a pandemic, such as the anti-malarial drug hydroxychloroquine, and waiting until they are tested in longer clinical trials. The trial learns from similar trials enrolling around the world and uses artificial intelligence to quickly arrive at answers.Share:
FULL STORY (Part of the full story) A novel clinical trial developed by researchers at the University of Pittsburgh School of Medicine launched today at UPMC to address one of the most important debates during the COVID-19 pandemic: How should doctors decide between quickly adopting new therapies, such as the anti-malarial drug hydroxychloroquine, and waiting until they are tested in longer clinical trials?
"The solution is to find an optimal tradeoff between doing something now, such as prescribing a drug off-label, or waiting until traditional clinical trials are complete," said Derek Angus, M.D., M.P.H., professor and chair, Department of Critical Care Medicine at Pitt and UPMC. "We've developed a way to do that with an adaptive clinical trial model that relies on a type of artificial intelligence known as reinforcement learning to identify the best, evidence-backed therapy for COVID-19 much faster than using the traditional scientific approach."
23) Social media can forecast economic impact of disasters including COVID-19 pandemic
Date: April 9, 2020
Source:University of Bristol
Summary: Social media should be used to chart the economic impact and recovery of businesses in countries affected by the COVID-19 pandemic, according to new research. Scientists describe a 'real time' method accurately trialled across three global natural disasters which could be used to reliably forecast the financial impact of the current global health crisis.
24) COVID-19 drug lead treatments identified
Date: April 9, 2020
Source: University of Queensland
Summary:An international team of researchers has tested more than 10,000 compounds to identify six drug candidates that may help treat COVID-19. The research tested the efficacy of approved drugs, drug candidates in clinical trials and other compounds.Share:
FULL STORY An international team of researchers has tested more than 10,000 compounds to identify six drug candidates that may help treat COVID-19. The research, involving University of Queensland scientist Professor Luke Guddat, tested the efficacy of approved drugs, drug candidates in clinical trials and other compounds. "Currently there are no targeted therapeutics or effective treatment options for COVID-19," Professor Guddat said. "In order to rapidly discover lead compounds for clinical use, we initiated a program of high-throughput drug screening, both in laboratories and also using the latest computer software to predict how different drugs bind to the virus. Professor Guddat said the project targeted the main COVID-19 virus enzyme, known as the main protease or Mpro, which plays a pivotal role in mediating viral replication. advertisement ADHD Med-Physician Site - Adult ADHD Treatment Option Discover an ADHD Treatment For Adults & Get Prescribing Info Here. Prescription treatment website "This makes it an attractive drug target for this virus, and as people don't naturally have this enzyme, compounds that target it are likely to have low toxicity. "We add the drugs directly to the enzyme or to cell cultures growing the virus and assess how much of each compound is required to stop the enzyme from working or to kill the virus. "If the amount is small, then we have a promising compound for further studies." After assaying thousands of drugs, researchers found of the six that appear to be effective in inhibiting the enzyme, one is of particular interest. "We're particularly looking at several leads that have been subjected to clinical trials including for the prevention and treatment of various disorders such as cardiovascular diseases, arthritis, stroke, atherosclerosis and cancer," Professor Guddat said. "Compounds that are already along the pipeline to drug discovery are preferred, as they can be further tested as antivirals at an accelerated rate compared to new drug leads that would have to go through this process from scratch." After the enzyme's structure was made public, the team received more than 300 requests for more information, even before the paper was published. "To provide an analogy, we've provided scientists with a fishing pole, the line and the exact bait, and have in only one month caught some fish," Professor Guddat said. "Now it's up to us and the other fisherman -- our fellow scientists globally -- to take full advantage of this breakthrough."
25) COVID-19: Genetic network analysis provides 'snapshot' of pandemic origins
Date:April 9, 2020
Source: University of Cambridge
Summary: The first use of phylogenetic techniques shows the 'ancestral' virus genome closest to those in bats was not Wuhan's predominant virus type. The study charts the 'incipient supernova' of COVID-19 through genetic mutations as it spread from China and Asia to Australia, Europe and North America. Researchers say their methods could be used to help identify undocumented infection sources.Share:
FULL STORY Researchers from Cambridge, UK, and Germany have reconstructed the early "evolutionary paths" of COVID-19 in humans -- as infection spread from Wuhan out to Europe and North America -- using genetic network techniques.
26) Modeling study estimates impact of relaxing control measures on possible second wave of COVID-19 in China
Date: April 8, 2020
Source: The Lancet
Summary: Use of real-time monitoring of COVID-19 transmissibility and severity to fine-tune control strategies offers the best chance to minimize second wave of infection in mainland China, outside Hubei province, researchers say in a new study.Share:
FULL STORY New modelling research, published in The Lancet journal, suggests that China's aggressive control measures appear to have halted the first wave of COVID-19 in areas outside Hubei province, the epicentre of the epidemic. However, given the substantial risk of the virus being reintroduced from abroad, and with economic activity increasing, real-time monitoring of COVID-19 transmissibility and severity is needed to protect against a possible second wave of infection, researchers say.
The study estimates that in regions outside Hubei, the instantaneous reproductive number of COVID-19 -- the average number of cases generated by a single infected individual during the outbreak -- fell substantially after lock down measures were introduced on January 23, 2020, and has remained below 1 since then -- suggesting that the epidemic has shifted from one that is expanding rapidly to one that is slowly shrinking. (The higher the reproductive number, the more transmissible the virus is and the higher the risk for rapid spread. When the reproductive number falls below one, the epidemic is likely to die out.) However, mathematical modelling to simulate the impact of relaxing current control measures, suggests that premature lifting of these interventions will likely lead to transmissibility exceeding 1 again, resulting in a second wave of infection. The findings are critical to countries globally that are in the early phases of lock down because they warn against premature relaxation of strict control measures, researchers say. However, the study did not specifically examine the effect of each intervention, or which one was most effective in containing the spread of the virus. "While these control measures appear to have reduced the number of infections to very low levels, without herd immunity against COVID-19, cases could easily resurge as businesses, factory operations, and schools gradually resume and increase social mixing, particularly given the increasing risk of imported cases from overseas as COVID-19 continues to spread globally," says Professor Joseph T Wu from the University of Hong Kong who co-led the research. He continues, "Although control policies such as physical distancing and behavioural change are likely to be maintained for some time, proactively striking a balance between resuming economic activities and keeping the reproductive number below one is likely to be the best strategy until effective vaccines become widely available. Further analysis suggests that the confirmed case fatality risk (the probability of dying among confirmed cases of COVID-19 as officially reported) outside Hubei was 0.98% -- which is almost six times lower than in Hubei (5.91%) -- and varied substantially among different provinces, based on economic development and availability of health-care resources. Among the ten provinces with the largest number of confirmed cases, case fatality ranged from 0% in prosperous regions like Jiangsu to 1.76% in less developed provinces such as Henan. "Even in the most prosperous and well-resourced megacities like Beijing and Shanghai, health-care resources are finite, and services will struggle with a sudden increase in demand," says senior author Professor Gabriel M Leung from the University of Hong Kong. "Our findings highlight the importance of ensuring that local health-care systems have adequate staffing and resources to minimise COVID-related deaths."
In December 2019, a novel coronavirus (SARS-CoV-2) emerged in Wuhan city and spread across China. Stringent restrictions on the movement of people and goods were introduced nationwide on January 23. These measures have impacted on people's livelihood and personal liberties, as well as lost economic opportunity. Since February 17, restrictions have been progressively relaxed in several provinces, and factories and offices are gradually reopening.
In the study, researchers analysed local Health Commission data of confirmed COVID-19 cases between mid-January and 29 February, 2020, to estimate the transmissibility and severity of COVID-19 in four major cities -- Beijing, Shanghai, Shenzhen, Wenzhou -- and ten provinces outside Hubei with the highest number of confirmed COVID-19 cases. The number of new daily imported and local cases were used to construct epidemic curves for each location by date of symptom onset, and reporting delays -- time lags between the onset of a disease and the reporting of cases -- were incorporated in the modelling to calculate weekly reproduction numbers. The researchers also modelled the potential impact of relaxing control measures after the first wave of infection for different scenarios with rising reproduction numbers.
The analyses suggest that in regions outside Hubei, control measures should be lifted gradually so that the resulting reproductive number does not exceed 1, or the number of cases will progressively rise over the relaxation period. Moreover, the estimates suggest that once elevated, simply tightening control interventions again would not reduce the burden back to its original level, and would require extra effort to drive the reproductive number below 1 in order to revert to the pre-relaxation level -- likely resulting in both higher health and economic loss.
"We are acutely aware that as economic activity increases across China in the coming weeks, local or imported infection could lead to a resurgence of transmission," says co-lead author Dr Kathy Leung from the University of Hong Kong. "Real-time monitoring of the effect of increased mobility and social mixing on COVID-19 transmissibility could allow policymakers to fine tune control measures to interrupt transmission and minimise the impact of a possible second wave of infections."
Despite these important findings, the study has some limitations, including that the estimated reproductive numbers were based on the reported number of confirmed cases, and the time and dates of symptom onset were unavailable for some provinces and relied on data derived from Shenzhen. Finally, a limited number of simulations for relaxing control measures were done, and did not specify which interventions or public responses to the epidemic might correspond to each of these scenarios.
Writing in a linked Comment, lead author Dr Shunqing Xu (who was not involved in the study) from Huazhong University of Science and Technology in China says: "Case fatality rate (CFR) is one of the important unknowns of COVID-19...Leung and colleagues found the confirmed CFR was correlated with provincial per capita gross domestic product and the availability of hospital beds per 10,000. In Wuhan, the CFR was up to 5.08% by March 28, 2020. The remarkable difference in the CFR between these locations and Wuhan might be attributed to the difference in the degrees of health-care capacity. Therefore, consideration should be given to the variations in health-care capacity when implementing interventions."
1) Guidelines on caring for ICU patients with COVID-19
Date:April 1, 2020Source:McMaster UniversitySummary:An international team has come together to issue guidelines for health-care workers treating intensive care unit (ICU) patients with COVID-19.
An international team including McMaster University researchers has come together to issue guidelines for health-care workers treating intensive care unit (ICU) patients with COVID-19.
The Surviving Sepsis Campaign COVID-19 panel has released 54 recommendations on such topics as infection control, laboratory diagnosis and specimens, the dynamics of blood flow support, ventilation support, and COVID-19 therapy.
The panel of 36 experts, with six from McMaster, telescoped what would have been more than a year of work into less than three weeks. The guidelines were co-published in the journals Critical Care Medicine and Intensive Care Medicine.
"Previously there was limited guidance on acute management of critically ill patients with COVID-19, although the World Health Organization and the United States Centers for Disease Control and Prevention have issued preliminary guidance on infection control, screening and diagnosis in the general population," said first author Waleed Alhazzani, assistant professor of medicine at McMaster. He is also an intensive care physician at St. Joseph's Healthcare Hamilton.
"Usually, it takes a year or two to develop large clinical practice guidelines such as these ones. Given the urgency and the huge need for these guidelines, we assembled the team, searched the literature, summarized the evidence, and formulated recommendations within 18 days. Everyone worked hard to make this guideline available to the end user rapidly while maintaining methodological rigour."
Alhazzani added that the guidelines will be used by frontline clinicians, allied health professionals and policy makers involved in the care of patients with COVID-19. The Surviving Sepsis Campaign COVID-19 panel included experts in guideline development, infection control, infectious diseases and microbiology, critical care, emergency medicine, nursing, and public health. The corresponding author of the guidelines is Andrew Rhodes of St. George's Healthcare NHS Trust in the United Kingdom.
Members of the panel came from Australia, Canada, China, Denmark, Italy, Korea, the Netherlands, United Arab Emirates, United Kingdom, United States and Saudi Arabia. The panel started off by proposing 53 questions they considered to be relevant to the management of COVID-19 in the intensive care unit (ICU). The team then searched the literature for direct and indirect evidence on the management of COVID-19 in the ICU. They found relevant and recent systematic reviews on most questions relating to supportive care. The group then assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, which itself was developed at McMaster. GRADE is a way to assess previous work, a transparent framework for developing and presenting summaries of evidence and provides a systematic approach for making clinical practice recommendations for health-care professionals. The resulting 54 recommendations include four best practice statements, nine strong recommendations, and 35 weak recommendations. No recommendation was provided for six questions. The four best practice statements based on high-quality evidence include:
Health-care workers performing aerosol-generating procedures, such as intubation, bronchoscopy, open suctioning, on patients with COVID-19 should wear fitted respirator masks, such as N95, FFP2 or equivalent -- instead of surgical masks -- in addition to other personal protective equipment, such as gloves, gown and eye protection.
Aerosol-generating procedures should be performed on ICU patients with COVID-19 in a negative pressure room, if available. Negative pressure rooms are engineered to prevent the spread of contagious pathogens from room to room.
Endotracheal intubation of patients with COVID-19 should be performed by health-care workers with experience in airway management to minimize the number of attempts and risk of transmission.
Adults with COVID-19 who are being treated with non-invasive positive pressure ventilation or a high flow nasal cannula should be closely monitored for worsening respiratory status and intubated early if needed.
The Surviving Sepsis Campaign COVID-19 panel said it plans to issue further guidelines in order to update the recommendations, if needed, or formulate new ones.
Waleed Alhazzani, Morten Hylander Møller, Yaseen M. Arabi, Mark Loeb, Michelle Ng Gong, Eddy Fan, Simon Oczkowski, Mitchell M. Levy, Lennie Derde, Amy Dzierba, Bin Du, Michael Aboodi, Hannah Wunsch, Maurizio Cecconi, Younsuck Koh, Daniel S. Chertow, Kathryn Maitland, Fayez Alshamsi, Emilie Belley-Cote, Massimiliano Greco, Matthew Laundy, Jill S. Morgan, Jozef Kesecioglu, Allison McGeer, Leonard Mermel, Manoj J. Mammen, Paul E. Alexander, Amy Arrington, John E. Centofanti, Giuseppe Citerio, Bandar Baw, Ziad A. Memish, Naomi Hammond, Frederick G. Hayden, Laura Evans, Andrew Rhodes. Surviving Sepsis Campaign. Critical Care Medicine, 2020; 1 DOI: 10.1097/CCM.0000000000004363
2) US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
Study estimates 1 in 7 frontline medical workers may miss work to care for their children when US schools are closed to reduce the spread of COVID-19
Date:April 4, 2020Source:The Lancet
Summary:US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research.
3) Possible coronavirus drug identified
Ivermectin stops SARS-CoV-2 virus growing in cell culture
Date:April 3, 2020
Summary: A new study has shown that an anti-parasitic drug already available around the world can kill the virus within 48 hours. Scientists found that a single dose of the drug, Ivermectin, could stop the SARS-CoV-2 virus growing in cell culture. The next steps are to determine the correct human dosage -- ensuring the doses shown to effectively treat the virus in vitro are safe for humans.
4) Rapid infectious disease shifts in Chinese children and adolescents prior to COVID-19
Date:April 3, 2020
Source:Murdoch Childrens' Research Institute
Summary:Deaths of children and adolescents in China due to infectious diseases were becoming rare prior to the covid-19 pandemic, according to a new study.
5) Vaccine candidate against SARS-CoV-2 being tested
Date:April 3, 2020
Summary:South Australian researchers working with Oracle Cloud technology and vaccine technology developed by local company Vaxine Pty Ltd are testing a vaccine candidate against the SARS-CoV-2 coronavirus responsible for the COVID-19 pandemic.
6) Two COVID-19 Articles: Model of Spread as well as CT scans and mortality
Date:March 31, 2020
Summary:Two studies of the coronavirus COVID-19 outbreak recently published. One recent study use SIRD model to forecast COVID-19 spread and other examined patient CT scans to correlate clinical features with mortality.
7) Surgical masks likely good for most COVID-19 treatment
Date:April 6, 2020
Summary:A systematic review of four randomized controlled trials on masks done between 1990 and last month shows the use of medical masks did not increase viral respiratory infection or clinical respiratory illness.
8) COVID-19: On average only 6% of actual SARS-CoV-2 infections detected worldwide
-- Actual number of infections may already have reached several tens of millions
Date:April 6, 2020
Source:University of Göttingen
Summary:The number of confirmed cases of coronavirus disease officially issued by countries dramatically understates the true number of infections, a report suggests. Researchers used estimates of COVID-19 mortality and time until death from a recent study to test the quality of records. This shows that countries have only discovered on average about 6% of infections. The number of infections worldwide may already have reached several tens of millions.
9) Positives in first published clinical trial of COVID-19 treatment
Date:April 6, 2020
Summary:A statistician who worked on the first published large randomized clinical trial for a potential treatment for the COVID-19 virus said the study produced positive results.
10) Researchers hope to improve future epidemic predictions
New mathematical model uses information theory to improve epidemiological predictions
Date:April 6, 2020
Source:U.S. Army Research Laboratory
Summary:As the world grapples with the COVID-19 pandemic, a new mathematical model could offer insights on how to improve future epidemic predictions based on how information mutates as it is transmitted from person to person and group to group.
11) Link between air pollution and coronavirus mortality in Italy could be possible
Date:April 6, 2020
Summary:A group of scientists has found another small piece in the puzzle of understanding COVID-19. Looking for reasons why the mortality rate is up to 12% in the northern part of Italy and only approx. 4.5% in the rest of the country, they found a probable correlation between air pollution and mortality in two of the worst affected regions in northern Italy.
April 8 2020
12) Common coronaviruses are highly seasonal, with most cases peaking in winter months
Date:April 7, 2020
Source:University of Michigan
Summary:Of the seven coronaviruses known to infect people, four cause common respiratory infections that are sharply seasonal and appear to transmit similarly to influenza, according to a new study.
13) Statement on chest imaging and COVID-19
Date:April 7, 2020
Source:Radiological Society of North America
Summary:A multinational consensus statement on the role of chest imaging in the management of patients with COVID-19 has just been published.
14) Researchers suggest a special diet against asthma
Date:April 7, 2020
Source:University of Bonn
Summary:Can a special diet help in certain cases of asthma? A new study at least points to this conclusion. According to the study, mice that were switched to a so-called ketogenic diet showed significantly reduced inflammation of the respiratory tract.
Although not mentioned in the article, diet can affect the gut flora, which can affect systemic inflammation. If would have been interesting to see them do fecal samples and correlate any changes in the gut bacteria with blood inflammation factors and weight along with changes in the bronchial condition. My opinion.
15) What type of cells does the novel coronavirus attack?
Date:April 7, 2020
Source:Berliner Institut für Gesundheitsforschung / Berlin Institute of Health
Summary:Scientists have examined samples from non-virus infected patients to determine which cells of the lungs and bronchi are targets for novel coronavirus (SARS-CoV-2) infection.
16) Engineered virus might be able to block coronavirus infections, mouse study shows
Date:April 7, 2020
Source:American Society for Microbiology
Summary:No vaccines exist that protect people against infections by coronaviruses, including SARS-CoV-2, which causes COVID-19, or the ones that cause SARS and MERS. As COVID-19 continues to wreak havoc, many labs around the world have developed a laser-like focus on understanding the virus and finding the best strategy for stopping it. Researchers now suggest that the approach they took for a MERS virus vaccine may also work against SARS-CoV-2.
17) Chemists working on drugs to treat COVID-19
Date:April 6, 2020
Source:Texas A&M University
Summary:In the wake of the novel coronavirus pandemic, chemists have focused on searching for drugs to treat COVID-19. One group identified the antiviral drug remdesivir as a viable medicine to treat COVID-19 in a research study published in late January. The drug was originally developed in response to the 2014 Ebola pandemic.Share:
FULL STORY In the wake of the novel coronavirus pandemic, Texas A&M University chemist Wenshe Ray Liu and his research team have focused their lab solely on searching for drugs to treat COVID-19.
The Liu group was the first to identify the antiviral drug remdesivir as a viable medicine to treat COVID-19 in a research study published in late January. The drug was originally developed in response to the 2014 Ebola pandemic. As a chemical biologist specializing in medicinal chemistry, Liu's primary research target is cancer. But the lockdown of Wuhan and the first two diagnosed cases in the U.S. prompted him to refocus his lab on coronavirus.
"The motivation that drove us was the rush against time to find alternative medicines that might be put in use to fight against the virus when it spread to the U.S," Liu said. advertisement Physician Site: Vyvanse® - Full Prescribing Information Vyvanse® (lisdexamfetamine dimesylate) CII. See Package Insert & Abuse Warning. See more at www.vyvansepro.com The researchers are working to develop drugs that can prevent SARS-CoV-2 -- the virus that causes COVID-19 -- and other coronaviruses from replicating once inside human cells. They're also exploring how to counteract the effect of the viruses in human plasma. Liu said his group has made significant progress in a very short time toward their ultimate goal: to push a COVID-19 drug candidate to preclinical trials and clinical testing before the pandemic subsides.
"There is sufficient scientific knowledge for this group of viruses, and we will be able to find cures," he said.
Remdesivir is being tested in at least five large-scale clinical trials around the world and also has been delivered to some patients, including the first known U.S. case confirmed Jan. 21 in Washington. That patient recovered after compassionate use of remdesivir.
While Liu said he remains convinced it's the right treatment, he cautioned that success shouldn't be viewed as a one-shot approach, given such a swift-moving target as COVID-19. "Remdesivir is still the best and probably the only option to target the virus directly in patients," he said.
With the U.S. clinical trial set to finish this week, Liu is optimistic that the final results released next week will speak for themselves. However, with remdesivir poised to be the only approved drug to treat COVID-19, its large-scale use will occur, and some drug-resistant virus strains will evolve.
"At this stage, the scientific community needs to prepare for the worst and work to bring other treatment options to the forefront," he said, adding that while there have been positive results from tests of hydroxychloroquinine, additional options are needed.
When it comes to viral mutations and reports that multiple strains of the virus exist, Liu deferred to clinicians, but acknowledged that it has become more virulent. "The infectivity of the original strain shown in Wuhan was not as high as what we have observed for the current strain in the U.S.," he said.
Liu is joined in his work by several additional collaborators in the Department of Chemistry and across the Texas A&M campus, including Distinguished Professor of Chemistry and 2017 National Academy of Sciences member Marcetta Y. Darensbourg, Texas A&M Provost and Executive Vice President Carol A. Fierke, who is an X-ray crystallography expert, and noted Texas A&M biochemist Thomas Meek.
Their research is supported by Liu's Texas A&M Presidential Impact Fellow funds through the Texas A&M Drug Discovery Laboratory, as well as indirectly through the National Institutes of Health, Cancer Prevention and Research Institute of Texas, and Welch Foundation funding initially provided for his group's underlying cancer-related research. Alongside Liu and his faculty colleagues are dozens of students and postdoctoral researchers who are fully engaged in the effort, including Tyler Lalonde, Trae Hampton, Xinyu Ma, Yuying Ma, Erol Vatansever, Jared Morse, Shiqing Xu, Chia-Chuan Cho, Peng-Hsun Chen, Yugendar Reddy and Kaci Kratch. make a difference: sponsored opportunity Story Source: Materials provided by Texas A&M University. Original written by Shana K. Hutchins. Note: Content may be edited for style and length. Journal Reference:
Jared S. Morse, Tyler Lalonde, Shiqing Xu, Wenshe Ray Liu. Learning from the Past: Possible Urgent Prevention and Treatment Options for Severe Acute Respiratory Infections Caused by 2019‐nCoV. ChemBioChem, 2020; 21 (5): 730 DOI: 10.1002/cbic.202000047
18) Clinical trial to assess potential treatment for COVID-19-related respiratory failure -- If positive, findings could alleviate expected shortage of ventilators for patients with severe COVID-19 infections
Date:April 6, 2020
Source:Beth Israel Deaconess Medical Center
Summary:A team of physician-scientists are now enrolling patients in a clinical trial to evaluate a common anti-clotting drug for the treatment of COVID-19-positive patients with ARDS. The newly launched trial follows a special report the team published that suggested the use of a drug called tPA could reduce deaths among patients with ARDS as a complication of COVID-19.