geoffrey modest medical blogs

Just when you thought that Covid was over (and blogs on covid would stop):   Older adults with a prior Omicron infection may have an increased likelihood of reinfection, more than those without a prior infection (see covid omicron infection in elderly assoc with inc risk of reinfection Lancet2023 in dropbox, or https://doi.org/10.1016/j.eclinm.2023.102148   Details: -- 750 vaccinated residents of long-term care and retirement homes in the observational cohort COVID In Longer-Term Care Study in Ontario, Canada. The observation period for this study was from July to September 2022     -- patients were in 27 long-term care and retirement homes in Ontario -- median age 87, 64% female, 57% in long-term care residence -- all received 4 mRNA monovalent vaccines (36% had only mRNA-1273, 18% had only BNT162b2, and 46% a mixture), none received a bivalent vaccine; time since 4th vaccination was mean of 138 days, 60% living in residence with <6 outbreaks, clinical frailty sc...

  Two articles of note: one assessing the association between three doses of an mRNA vaccine in preventing symptomatic infection caused by the omicron and delta variants; the other found that in animals the development of an omicron-specific mRNA vaccine did not provide additional protection in the short term. ---------------------------------------------------------- this first article was a large data assessment in the US finding protection from the booster dose, in a CDC study (see  covid booster vaccine delta and omicron jama2022  in dropbox, or doi:10.1001/jama.2022.0470) Details: -- cases were identified in a national pharmacy-based testing program, from 4666 Covid testing sites across 49 states. This was a subset of the national Increasing Community Access to Testing (ICATT)  platform -- this was a test- negative  control analysis in adults with Covid-like illness from December 10, 2021 to January 1, 2022 (ie, all were sick) -- the omicron varia...

  This blog has three parts:   1. Anna Wald (who is head of the Allergy and Infectious Diseases division at the University of Washington) sent me this reference after seeing the blog yesterday: a recent pre-print, pre-peer reviewed study suggested that remdesivir, molnupiravir  and nirmatrelvir remain active against the omicron variant of SARS-CoV-2 and other variants of concern (see  covid outpt treatments for omicron biorxiv2021  in dropbox, or    https://www.biorxiv.org/content/10.1101/2021.12.27.474275v1 .     details in brief: -- this  in vitro  Belgian study assessed the effects of these three medications against various variants of concern (VOCs), by pretreating cells overnight with serial dilutions of these medications, then later infecting the cells with the VOCs (all isolated from patients in Belgium)      -- nirmatrevir (Pfizer pills): good susceptibility for alpha, beta, gamma, delta, and om...