geoffrey modest medical blogs

  Another type of vaccine has found very positive results, with high levels of neutralizing antibody to SARS-CoV-2, in a drug company sponsored trial (see  covid vaccine nanoparticle NEJM2020     in dropbox, or  DOI: 10.1056/NEJMoa2026920 )       Details:  -- the vaccine (NVX-CoV2373) is a recombinant nanoparticle vaccine composed of trimeric full-length wild type SARS-CoV-2 spike glycoproteins (including the transmembrane domain) and Matrix-M1 adjuvant  -- 131 healthy adults were randomized to 2 different doses of the vaccine (5 µg and 25 µg), with and without the Matrix-M1 adjuvant, in May 2020       -- 83 received the vaccine with adjuvant, 25 without, and 23 placebo       -- all were healthy adults <60 years old       -- median age 30, 50% female, 79% white, BMI 25  -- phase 1 trial included 2 injections 21 days apart  -- primary outcomes were rea...

The NIH just released their Covid-19 treatment guidelines (see  https://covid19treatmentguidelines.nih.gov/introduction/ ). This blog will not go into details on the inpatient management. I have embedded my comments in the text in brackets Overall rating system: A=strong recommendation B=moderate  recommendation C= optional Modifiers: I: 1 or more RCTs with clinical outcomes and/or validated lab endpoints II: 1 or more well-designed, nonrandomized trials or observational cohort studies III: expert opinion Details (overall): -- the treatment panel does not recommend the use of any agents for preexposure prophylaxis or postexposure prophylaxis against SARS-CoV-2, outside of a clinical trial (level AIII recommendations for both) -- there is no additional lab testing or specific treatment for those with asymptomatic or presymptomatic SARS-CoV-2 infection (AIII) -- at present no drug is proven to be safe and effective for treating Covid-19. There are ...