geoffrey modest medical blogs

  A new T-cell vaccine is in the early stages of development but might be a big leap forward in really dealing with our covid-19 scourge (see   covid Tcell vaccine nature2022  in dropbox, or   doi.org/10.1038/s41586-021-04232-5)    Details:  --36 participants received CoVac-1, a peptide-based vaccine composed of SARS-CoV-2 T cell epitopes from various SARS-CoV-2 proteins (spike, nucleocapsid, membrane, envelope, open reading frame 8), combined with the Toll-like receptor 1/2 agonist XS15, which has been shown to elicit profound T-cell immunity against SARS-CoV-2  -- divided into 2 groups: age 18-55yo and 56-80yo  -- median age 60, 44% female, 100% white, BMI 24  --pre-existing conditions: hypertension 17%, previous malignancy and mild psoriasis 3% (1 person for each)  --none had pre-existing SARS-CoV-2 T-cell responses  --open-label phase 1 trial:       -- primary outcome: safety from day 28 (from diary...

An intriguing Chinese study suggested benefit by infusing convalescent plasma from a prior infected Covid-19 patient into 5 critically ill patients (see  covid Rx convalescent serum jama2020  in dropbox or doi:10.1001/jama.2020.4783 ). Details: -- 5 critically ill patients with laboratory confirmed Covid-19, ARDS, severe pneumonia with rapid progression, and continuously high viral load despite antiviral treatment; PaO 2 /FIO 2  <300; and on mechanical ventilation -- all were treated with convalescent plasma transfusion from donors who recovered from Covid-19 infection, were subsequently negative for SARS-CoV-2, and had serum SARS-CoV-2 specific ELISA antibody titer >1:1000 and a neutralizing antibody titer >40 Cases: --1: 70+ yo male  admitted 2 days after symptom onset,  with no coexisting chronic diseases, in critical condition with bacterial pneumonia, severe ARDS, multi-organ dysfunction syndrome. On methylprednisolone and lopinavir...