Wastewater research technology finds virus variants faster; many patients are taking drugs affected by Paxlovid

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Below is a summary of some recent studies of COVID-19. They include research that warrants further study to confirm the findings and has yet to be certified by peer review.

New technology for wastewater research finds variants earlier

Using just a very small amount of raw sewage and a new analysis technique, researchers can determine the genetic mixture of SARS-CoV-2 variants in the community and detect new variants up to 14 days before they appear on patients’ nasal swabs, according to a new report.

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Until recently, levels of SARS-CoV-2 genetic material in wastewater could help monitor the spread and transmission of infections, but provided no information on individual variants. Tests of a new genomic monitoring method for wastewater on the campus of the University of California, San Diego, from November 2020 to September 2021, have detected the Epsilon, Alpha and Delta variants “earlier and more consistently than clinical samples” and Several cases of virus spread identified that were not detected with traditional monitoring, researchers reported Thursday in Nature https://www.nature.com/articles/s41586-022-05049-6 . “Further sampling of wastewater in San Diego from September 2021 to February 2022 detected the presence of the Omicron variant more than 10 days before the city’s first clinical detection,” they said.

Monitoring wastewater from individual buildings or places such as schools and airports could potentially “be used to better direct public health interventions…in real time,” the researchers suggest. “In many places, standard clinical surveillance for new variants of care is not only slow, but also extremely cost-effective,” study co-author Kristian Andersen of Scripps Research in La Jolla, Calif., said in a statement. “But with this new tool, you can take one wastewater sample and profile the entire city.”

Patients taking drugs that interact with Paxlovid

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A significant proportion of elderly patients may be taking medications that interact with Paxlovid, Pfizer Inc’s antiviral treatment for COVID-19, according to a new report.

Paxlovid is approved for early outpatient treatment of COVID-19 to prevent serious illness. Using national databases in Denmark, researchers estimate the proportion of Danish people over 65 who are at risk for significant drug interactions when taking Paxlovid. Blood thinners that should not be taken with Paxlovid were used by 20% of people over 65 and by 30% of people over 80, they reported Tuesday in the International Journal of Infectious Diseases https://linkinghub.elsevier.com/pickup /pii/S1201971222003915. Cholesterol-lowering statins that should not be taken with Paxlovid were used by up to 18% of people over the age of 65, and more than 20% were taking medications such as pain relievers or heart medications that may require dose adjustments. Before prescribing Paxlovid, “the patient’s complete medical history, including herbal, over-the-counter, and recreational drugs, should be known and the concomitant treatment should be carefully managed by the treating physician or a specialist to avoid adverse effects,” the researchers concluded.

On Wednesday, the US Food and Drug Administration ruled https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-pharmacists-prescribe-paxlovid-certain-limitations that pharmacists can Prescribing Paxlov. In response, the president of the American Medical Association, Dr. Jack Resnick Jr. that “whenever possible, prescribing decisions should be made by a physician with knowledge of a patient’s medical history and the ability to follow up.”

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Second booster yields higher marginal benefit in the elderly

Vulnerable elderly people may receive more protection against COVID-19 from a fourth dose of a Pfizer/BioNTech or Moderna mRNA vaccine than from their third dose, new findings suggest.

Researchers studied 61,344 residents of Ontario long-term care facilities after Omicron became the dominant coronavirus variant. More than 13,650 residents tested positive during the study. For those whose most recent injection was a third dose at least 12 weeks earlier, a fourth dose of an mRNA vaccine was 19% more effective against infection, 31% more effective against symptomatic infection, and 40% more effective against severe disease from the virus. researchers reported Wednesday in The BMJ https://www.bmj.com/content/378/bmj-2022-071502.

The additional protection of the fourth dose against all outcomes was lower when the third dose was received less than three months earlier, although the optimal dosing interval and duration of protection remain unknown, the researchers said.

Click for an image from Reuters https://tmsnrt.rs/3c7R3Bl on vaccines in development.

(Reporting by Nancy Lapid; editing by Bill Berkrot)

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