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Vitamin D Helps Us Fight Covid-19, Major Study Finds

AHA Publisher — Sun, 02 Aug 2020 07:00:43 +0000

ISRAEL21c Staff via Israel21c – A low level of vitamin D in blood plasma appears to be an independent risk factor for Covid-19 infection and hospitalization, say scientists from Israeli HMO Leumit Health Services and the Azrieli Faculty of Medicine of Bar-Ilan University. The researchers came to their conclusion using real-world data and an Israeli cohort of 782 Covid-19 positive patients and 7,025 Covid-19 negative patients. “The main finding of our study was the significant association of low plasma vitamin D level with the likelihood of Covid-19 infection among patients who were tested for Covid-19, even after adjustment for age, gender, socio-economic status and chronic, mental and physical disorders,” said Dr. Eugene Merzon, head of Leumit’s Department of Managed Care. “Furthermore, low vitamin D level was associated with the risk of hospitalization due to Covid-19 infection, although this association wasn’t significant after adjustment for other factors,” he added. The scientists’ research follows a few worldwide studies that have shown the pronounced impact of vitamin D metabolites on the immune system response and on the development of Covid-19 infection by the novel SARS CoV-2 coronavirus. “Our finding is in agreement with the results of previous studies in the field. Reduced risk of acute respiratory tract infection following vitamin D supplementation has been reported,” said Dr. Ilan Green, head of Leumit’s Research Institute. As for the amount of vitamin D required, Merzon says it should be “personalized and take into account patients’ age, gender, race and ethnicity, nutritional status and health condition.” Their report on the study was published in The FEBS Journal and is expected to make a wide impact because of the study’s size and population-based structure. Fascinating Findings Dr. Milana Frenkel-Morgenstern, leader of the Azrieli Faculty of Medicine research group, added that the analysis showed people who were Covid-19 positive were older than non-infected people. “Interestingly, the two-peak distributions for age groups were demonstrated to confer increased risk for Covid-19: around ages 25 and 50 years old,” she said. “The first peak may be explained by high social gathering habits at the young age. The peak at age 50 years may be explained by continued social habits, in conjunction with various chronic diseases.” Leumit Chief Medical Officer Dr. Shlomo Vinker said he was surprised to discover that “chronic medical conditions, like dementia, cardiovascular disease and chronic lung disease that were considered to be very risky in previous studies, were not found as increasing the rate of infection in our study.” However, he added, “this finding is highly biased by the severe social contacts restrictions that were imposed on all the population during the Covid-19 outbreak. Therefore, we assume that following the Israeli Ministry of Health instructions, patients with chronic medical conditions significantly reduced their social contacts. This might indeed minimize the risk of Covid-19 infection in that group of patients.” Now this joint Israeli research team is planning to evaluate factors associated with Covid-19 mortality in Israel. “We are willing to find associations to the Covid-19 clinical outcomes — for example, pre-infection glycemic control of Covid-19 patients — to make the assessment of mortality risk due to Covid-19 infection in Israel,” said Merzon. To read the original article click here. For more articles from Israel21c click here.

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Does Blood Plasma from COVID-19 Survivors Help Patients Infected with Novel Coronavirus?

AHA Publisher — Sat, 11 Jul 2020 07:00:30 +0000

University of California San Diego Health via Newswise – A new clinical trial at UC San Diego Health will investigate whether an old therapy might effectively treat a modern-day scourge. There is only one approved, specific treatment for COVID-19, the illness caused by the novel coronavirus SARS-CoV-2, albeit with modest efficacy. Numerous experimental or repurposed drugs are under investigation, including the arthritis drug tocilizumab. And one treatment that is more than a century old. Researchers at University of California San Diego School of Medicine and UC San Diego Health have launched a clinical trial to assess the safety and efficacy of convalescent plasma (CP) to prevent COVID-19 after a known exposure to the virus. CP therapy involves infusing patients with antibodies extracted from the blood of donors who have successfully recovered from COVID-19, with the hope that the resulting boost to their immune systems will shorten the length and reduce the severity of the disease. The UC San Diego trial is part of a larger, national effort approved by the U.S. Food and Drug Administration. The goal is to create a network of hospitals and blood banks collecting, isolating, processing and testing whether plasma from COVID-19 survivors has therapeutic, preventive value. The national trial is being coordinated by Johns Hopkins University and sponsored by the National Insitute of Health through the Department of Defense. “With convalescent plasma therapy, we want to act prophylactically, using a product with known high-titers (concentrations) of neutralizing antibodies,” said Edward Cachay, MD, an infectious disease specialist at UC San Diego Health and professor of medicine at UC San Diego School of Medicine. “We want to learn how we can prevent sickness, how we can prevent COVID patients from needed mechanical ventilation, and how we can prevent them from dying from the disease.” Before the emergence of antibiotics, CP was used to prevent and treat a host of bacterial and viral infections, including diphtheria, scarlet fever and pertussis. It was used during the 1918 influenza pandemic with reported good effect. In general, CP treatment has proven safe, but its effectiveness has varied with disease and among individuals. Studies of CP therapies for Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and the 2009 H1N1 influenza showed measurable reductions of mortality (compared to placebo or no therapy), but efforts to treat Ebola virus infections during the 2014-16 outbreak in West Africa were inconclusive. Chinese researchers treating COVID-19 patients have reported some success using CP, albeit not in randomized, controlled studies — the gold standard in clinical research. On April 13, the Food and Drug Administration (FDA) issued research guidelines for assessing CP as a potential COVID-19 treatment and the American Red Cross is currently seeking blood plasma donors who have fully recovered from novel coronavirus infections. Plasma is the liquid portion of blood that carries blood components throughout the body, such as red and white blood cells, platelets, salts and enzymes. It also contains proteins and antibodies produced by the body’s immune system to fend off invasive pathogens, such as SARS-CoV-2. To qualify as a plasma donor for COVID-19 patients, donors must be at least 17 years old and weigh 110 pounds; be in good health; and have a prior, verified diagnosis of COVID-19 but are now symptom-free and fully recovered. The UC San Diego Health clinical trial will recruit a total of 487 qualifying participants for the study. Criteria to qualify for participation include a high-risk factor, such as age or an underlying condition, like cardiovascular disease, diabetes, existing pulmonary impairment or employment as a health care worker; known exposure to SARS-CoV-2; and a negative PCR diagnostic test to show no current infection. Testing will be conducted inside tents set up across from the emergency department at Jacobs Medical Center and the Altman Clinical and Translational Research Institute (ACTRI) on the La Jolla health campus. The UC Health Blood Bank is coordinating efforts with the San Diego Blood Bank. The ACTRI is providing personnel, infrastructure support and other resources for the CP trial and for other COVID-19-related clinical trials at UC San Diego. In addition, the ACTRI has created a COVID-19 Biobank to provide materials for research projects to diagnose or treat the disease. In cases of infection by the novel coronavirus, it appears the human immune system begins producing antibodies to the disease five to 10 days after the initial infection. The antibodies bind to the targeted coronavirus, stopping it from latching onto new cells and beginning the production of more viral particles. Over the course of two or so weeks, the body clears out the virus, but antibodies to it (or the blueprints for making them) remain. The depth and length of subsequent immunity have not been determined. Cachay said he thinks CP will likely be most effective in persons with early exposure to the novel coronavirus, before symptoms appear, but it will require a clinical trial to substantiate that thinking. “If we don’t do this, if we just gather anecdotal evidence that isn’t conclusive, then we won’t be any better off when the next wave hits.” To read the original article click here.

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The Most Promising Strategies for Defeating Coronavirus

AHA Publisher — Sat, 25 Apr 2020 07:00:22 +0000

Frontiers via EurekAlert – In an unprecedented effort, hundreds of thousands of researchers and clinicians worldwide are locked in a race against time to develop cures, vaccines, and better diagnostic tests for COVID-19, the illness caused by the virus SARS-CoV-2. Over 1,650 articles on COVID-19 are already listed in databases such as Google Scholar, while dozens more are added daily. The register ClinicalTrials.gov lists over 460 ongoing clinical trials on COVID-19, although the majority are still in the earliest stages. Given the diversity of experimental approaches among these studies, a systematic review of possible clinical strategies is timely and welcome. In a new study in Frontiers in Microbiology, aimed at the research community but also comprehensible for non-specialists, experts from the University of North Carolina at Chapel Hill review possible strategies against dangerous coronaviruses – not only SARS-CoV-2 and its relatives such as SARS-Cov (causing Severe Acute Respiratory Syndrome, SARS) and MERS-Cov (causing Middle East Respiratory Syndrome, MERS), but also as yet unknown strains which will inevitably emerge in the future. They propose that the most promising approaches for fast progress are selected antivirals such as remdesivir, and gene therapy. “Coronaviruses represent a true threat to human health and the global economy. We must first consider novel countermeasures to control the SARS-Cov-2 pandemic virus and then the vast array of high-threat zoonotic viruses that are poised for human emergence in the future,” says Dr Ralph Baric, William R. Kenan, Jr. Distinguished Professor in the Department of Epidemiology and Professor in the Department of Microbiology and Immunology at UNC Chapel Hill. “To help focus the global search for a treatment, we here aim to provide a comprehensive resource of possible lines of attack against SARS-Cov-2 and related coronaviruses, including the results from all preclinical and clinical trials so far on vaccines against SARS and MERS.” The authors discuss one-by-one the possible strategies against the coronavirus. First, and most effective are vaccines. In the present case, the most successful are likely to carry the Receptor Binding Domain (of the virus’s S-protein), which allows it to bind to and fuse with host cells. Besides the traditional live attenuated, inactivated, and subunit-based vaccines, modern types such as DNA/RNA-based and nanoparticle- or viral vector-borne vaccines should be considered. Because the amino acid sequence of the S-protein is very different across coronaviruses (e.g., 76-78% similarity between SARS-Cov and SARS-Cov-2), vaccines against one strain typically won’t work against another. But because the development and testing of new vaccines takes one to several years, other approaches are essential in the meantime. The second-most likely effective are broad-spectrum antivirals such as nucleoside analogs, which mimic the bases in the virus’s RNA genome and get mistakenly incorporated into nascent RNA chains, stalling the copy process. But because coronaviruses have a so-called “proofreading” enzyme which can cut such mismatches out, most nucleoside analogs don’t work well. Exceptions seem to be β-D-N4-hydroxycytidine and remdesivir, proposed by the authors as good candidates against SARS-Cov-2. Third, convalescent blood plasma from patients who recovered, with low levels of a range of antibodies against the virus; or preferably (but slower to develop), monoclonal antibodies, isolated and mass-produced through biotechnology. Such “passive immunization” can give short-term immunity. The authors discuss a range of options from fusion inhibitors, to inhibitors of human proteases, to immune modulators such as corticosteroid hormones, and others. Finally, and in the authors’ view the most attractive alternative until a vaccine is produced, is gene therapy delivered through the adeno-associated virus (AAV). This would entail the fast, targeted delivery of antibodies, immunoadhesins, antiviral peptides, and immunomodulators to the upper airways, to give short-term protection. Because the rapid turnover of cells here, risks of toxicity are minimal. They estimate that such tools can be developed, adapted, and tested within a month. “AAV-based passive immunization can be used as a quick alternative. It is straightforward and only contains two components, the viral vector and the antibody. Multiple AAV vectors have been proven to be safe and effective for human use,” says author Dr Long Ping Victor Tse. “In theory, a single dose could mount a protective response within a week and last for more than a year. The currently high price could be reduced when treating infectious diseases, which have a larger market. It may or may not already be too late to use AAV to treat SARS-CoV-2, but it is certainly not too late for future outbreaks.” To read the original article click here.

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