COVID-19 Update #75 for 3/30/2021

COVID-19 Vaccines
 
In a retrospective review of 39,156 asymptomatic patients, in the Mayo Clinic Health System, who were tested for COVID-19 for an upcoming procedure, 1.4% of vaccinated patients tested positive compared to 3.2% of unvaccinated patients for an 80% reduction in the development of asymptomatic COVID-19 with the vaccine.
 
CDC researchers analyzed results of COVID-19 tests from 3,950 health care workers and first responders to estimate real-world effectiveness of the COVID-19 mRNA vaccines. Vaccine effectiveness was found to be 80% after one immunization and 90% in fully vaccinated individuals.
 
COVID-19 Antibodies
 
Lilly, Vir and GSK announced that in the seven-day, Phase II, BLAZE-4 trial (NCT04634409), treatment with bamlanivimab plus VIR-7831 reduced viral load compared to placebo in low-risk adult patients with mild to moderate COVID-19.
 
COVID-19 Anti-Inflammatories
 
Humanigen announced that in a 28-day, 520 patient, Phase III trial (NCT04351152), 15.6% of patients treated with lenzilumab died or required a ventilator compared to 22.1% with placebo in hospitalized hypoxic COVID-19 patients not requiring invasive mechanical ventilation. In the trial, 88% of patients received a corticosteroid, 62% received remdesivir, and 57% received both.
 
Fluvoxamine, a selective serotonin reuptake inhibitor and sigma-1 receptor (S1R) agonist, approved for the treatment of obsessive-compulsive disorder, is being evaluated for the treatment of COVID-19. Inhibiting S1R decreases cytokine production through its interaction with the endoplasmic reticulum stress sensor inositol-requiring enzyme 1alpha (IRE1). The decrease in cytokines reduces the inflammatory response, which diminishes progression of COVID-19.

• In a 15-day, 152 patient, Phase II trial (NCT04342663), no patient treated with fluvoxamine experienced clinical deterioration (shortness of breath or oxygen saturation of 92% or less) compared to 8.7% with placebo in nonhospitalized patients with severe acute respiratory syndrome from COVID-19. Patients were mostly white and over half were female with a median age of 45 to 46.
• In a 14-day, 113 patient, non-randomized, Phase III trial (NCT04668950), no patient treated with fluvoxamine required hospitalization compared to 12.5% of observation patients with COVID-19. At day 14, no fluvoxamine patient continued to have symptoms compared to 60% of observation patients. The patient population was mostly male Latinos with a median age of 42 recruited from an occupational setting with congregate living at a horse racing track in California. Fewer patients that chose to receive fluvoxamine were asymptomatic (38% vs 58%) at the beginning of the study.