Med (New York, N.y.)最新文献

{"title":"The Global Response to the COVID-19 Pandemic.","authors":"John Nkengasong,&nbsp;Akiko Iwasaki,&nbsp;Cesar Victora,&nbsp;Juhwan Oh,&nbsp;George F Gao,&nbsp;Anurag Agrawal,&nbsp;Christian Drosten,&nbsp;Cecilia Söderberg-Naucler,&nbsp;Eduardo López-Collazo,&nbsp;Allyson M Pollock,&nbsp;Antonella Viola,&nbsp;Michael Baker","doi":"10.1016/j.medj.2020.12.003","DOIUrl":"https://doi.org/10.1016/j.medj.2020.12.003","url":null,"abstract":"<p><p>Global approaches towards pandemic control range from strict lockdowns to minimal restrictions. We asked experts worldwide about the lessons learned from their countries' response. Their voices converge on the importance of scientifically guided interventions to limit the spread of SARS-CoV-2 and its impact on human health.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"3-8"},"PeriodicalIF":17.0,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38750867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pandemic Vaccines: How Are We Going to Be Better Prepared Next Time?","authors":"Florian Krammer","doi":"10.1016/j.medj.2020.11.004","DOIUrl":"https://doi.org/10.1016/j.medj.2020.11.004","url":null,"abstract":"<p><p>In response to the SARS-CoV-2 pandemic, we are currently witnessing the fastest vaccine development in history. While these vaccines will now make a significant impact on ending the pandemic, they were needed much earlier. Here I discuss how to ensure that vaccines will become available within 3-4 months after a new outbreak.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"28-32"},"PeriodicalIF":17.0,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2020.11.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25316701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Hydroxychloroquine Usage in United States Veterans Hospitalized with COVID-19.","authors":"Joseph Magagnoli,&nbsp;Siddharth Narendran,&nbsp;Felipe Pereira,&nbsp;Tammy H Cummings,&nbsp;James W Hardin,&nbsp;S Scott Sutton,&nbsp;Jayakrishna Ambati","doi":"10.1016/j.medj.2020.06.001","DOIUrl":"https://doi.org/10.1016/j.medj.2020.06.001","url":null,"abstract":"<p><strong>Background: </strong>Despite limited and conflicting evidence, hydroxychloroquine, alone or in combination with azithromycin, is widely used in COVID-19 therapy.</p><p><strong>Methods: </strong>We performed a retrospective study of electronic health records of patients hospitalized with confirmed SARS-CoV-2 infection in US Veterans Health Administration medical centers between March 9, 2020 and April 29, 2020. Patients hospitalized within 24 h of diagnosis were classified based on their exposure to hydroxychloroquine alone (HC) or with azithromycin (HC+AZ) or no HC as treatments. The primary outcomes were mortality and use of mechanical ventilation.</p><p><strong>Findings: </strong>A total of 807 patients were evaluated. Compared to the no HC group, after propensity score adjustment for clinical characteristics, the risk of death from any cause was higher in the HC group (adjusted hazard ratio [aHR], 1.83; 95% confidence interval [CI], 1.16-2.89; p = 0.009), but not in the HC+AZ group (aHR, 1.31; 95% CI, 0.80-2.15; p = 0.28). Both the propensity-score-adjusted risks of mechanical ventilation and death after mechanical ventilation were not significantly different in the HC group (aHR, 1.19; 95% CI, 0.78-1.82; p = 0.42 and aHR, 2.11; 95% CI, 0.96-4.62; p = 0.06, respectively) or in the HC+AZ group (aHR, 1.09; 95% CI, 0.72-1.66; p = 0.69 and aHR, 1.25; 95% CI, 0.59-2.68; p = 0.56, respectively) compared to the no HC group.</p><p><strong>Conclusions: </strong>Among patients hospitalized with COVID-19, this retrospective study did not identify any significant reduction in mortality or in the need for mechanical ventilation with hydroxychloroquine treatment with or without azithromycin.</p><p><strong>Funding: </strong>University of Virginia Strategic Investment Fund.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"114-127.e3"},"PeriodicalIF":17.0,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2020.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38399549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Lopinavir/Ritonavir or Arbidol in Adult Patients with Mild/Moderate COVID-19: An Exploratory Randomized Controlled Trial.","authors":"Yueping Li,&nbsp;Zhiwei Xie,&nbsp;Weiyin Lin,&nbsp;Weiping Cai,&nbsp;Chunyan Wen,&nbsp;Yujuan Guan,&nbsp;Xiaoneng Mo,&nbsp;Jian Wang,&nbsp;Yaping Wang,&nbsp;Ping Peng,&nbsp;Xudan Chen,&nbsp;Wenxin Hong,&nbsp;Guangming Xiao,&nbsp;Jinxin Liu,&nbsp;Lieguang Zhang,&nbsp;Fengyu Hu,&nbsp;Feng Li,&nbsp;Fuchun Zhang,&nbsp;Xilong Deng,&nbsp;Linghua Li","doi":"10.1016/j.medj.2020.04.001","DOIUrl":"https://doi.org/10.1016/j.medj.2020.04.001","url":null,"abstract":"<p><strong>Background: </strong>Antiviral therapies against the novel coronavirus SARS-CoV-2, which has caused a global pandemic of respiratory illness called COVID-19, are still lacking.</p><p><strong>Methods: </strong>Our study (ClinicalTrials.gov: NCT04252885, named ELACOI), was an exploratory randomized (2:2:1) controlled trial assessing the efficacy and safety of lopinavir/ritonavir (LPV/r) or arbidol monotherapy for treating patients with mild/moderate COVID-19.</p><p><strong>Findings: </strong>This study successfully enrolled 86 patients with mild/moderate COVID-19, with 34 randomly assigned to receive LPV/r, 35 to arbidol, and 17 with no antiviral medication as control. Baseline characteristics of the three groups were comparable. The primary endpoint, the rate of positive-to-negative conversion of SARS-CoV-2 nucleic acid, was similar between groups (all p > 0.05). There were no differences between groups in the secondary endpoints, the rates of antipyresis, cough alleviation, or improvement of chest computed tomography (CT) at days 7 or 14 (all p > 0.05). At day 7, 8 (23.5%) patients in the LPV/r group, 3 (8.6%) in the arbidol group, and 2 (11.8%) in the control group showed a deterioration in clinical status from moderate to severe/critical (p = 0.206). Overall, 12 (35.3%) patients in the LPV/r group and 5 (14.3%) in the arbidol group experienced adverse events during the follow-up period. No apparent adverse event occurred in the control group.</p><p><strong>Conclusions: </strong>LPV/r or arbidol monotherapy present little benefit for improving the clinical outcome of patients hospitalized with mild/moderate COVID-19 over supportive care.</p><p><strong>Funding: </strong>This study was supported by project 2018ZX10302103-002, 2017ZX10202102-003-004, and Infectious Disease Specialty of Guangzhou High-level Clinical Key Specialty (2019-2021).</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"105-113.e4"},"PeriodicalIF":17.0,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2020.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38399547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 Re-infections: Lessons from Other Coronaviruses.","authors":"Lia van der Hoek","doi":"10.1016/j.medj.2020.12.005","DOIUrl":"https://doi.org/10.1016/j.medj.2020.12.005","url":null,"abstract":"<p><p>Animal and human endemic coronaviruses have been known for decades, as has their capacity to re-infect. In the COVID-19 pandemic, it is key to reveal the factors that influence reinfection susceptibility. In this commentary, I provide a view on endemic animal and human coronaviruses and the correlates of protection to reinfection.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"23-28"},"PeriodicalIF":17.0,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25316700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deficiencies in the Designs and Interventions of COVID-19 Clinical Trials.","authors":"David Hsiehchen,&nbsp;Magdalena Espinoza,&nbsp;Antony Hsieh","doi":"10.1016/j.medj.2020.06.007","DOIUrl":"https://doi.org/10.1016/j.medj.2020.06.007","url":null,"abstract":"","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"103-104"},"PeriodicalIF":17.0,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2020.06.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38303334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A booster dose enhances immunogenicity of the COVID-19 vaccine candidate ChAdOx1 nCoV-19 in aged mice","authors":"Alyssa Silva-Cayetano, W. Foster, S. Innocentin, Sandra Belij-Rammerstorfer, Alexandra J. Spencer, O. Burton, Sigrid Fra-Bido, Jia Le Lee, N. Thakur, Carina Conceicao, D. Wright, J. Barrett, Nicola Evans-Bailey, Carly Noble, D. Bailey, A. Liston, S. Gilbert, T. Lambe, M. Linterman","doi":"10.1101/2020.10.27.357426","DOIUrl":"https://doi.org/10.1101/2020.10.27.357426","url":null,"abstract":"The spread of SARS-CoV-2 has caused a global pandemic that has affected almost every aspect of human life. The development of an effective COVID-19 vaccine could limit the morbidity and mortality caused by infection, and may enable the relaxation of social distancing measures. Age is one of the most significant risk factors for poor health outcomes after SARS-CoV-2 infection, therefore it is desirable that any new vaccine candidates should elicit a robust immune response in older adults. Here, we test the immunogenicity of the adenoviral vectored vaccine ChAdOx1 nCoV-19 (AZD-1222) in aged mice. We find that a single dose of this vaccine induces cellular and humoral immunity in aged mice, but at a reduced magnitude than in younger adult mice. Furthermore, we report that a second dose enhances the immune response to this vaccine in aged mice, indicating that a primeboost strategy may be a rational approach to enhance immunogenicity in older persons.","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134107020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}