Myocarditis in 30 patients after mRNA vaccines
Myocarditis detailed in 30 patients after mRNA COVID vaccines
[Media report.] Two recent reports in JAMA Cardiology describe 30 patients with myocarditis, or inflamed heart muscles, less than a week after receiving either a Pfizer/BioNTech or Moderna mRNA COVID-19 vaccine. While these events may indicate a higher prevalence of myocarditis than expected, both reports note their rarity.
mRNA vaccines ease breakthrough COVID; Novavax helps block variant
[Media report.] The few adults who receive a COVID-19 mRNA vaccine but still become infected have a milder, shorter illness and lower viral RNA loads than their unvaccinated peers, finds a real-world US study yesterday in the New England Journal of Medicine. The journal also features a UK study confirming that the Novavax vaccine offers 90% overall effectiveness and protects against the highly transmissible and potentially more deadly Alpha (B117) SARS-CoV-2 variant.
Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications
The systematic review encompassed 113 studies, of which 27 studies (covering 34 geographical locations) satisfied the inclusion criteria and were included in the meta-analysis. Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Consequently, public health measures to mitigate infections in older adults could substantially decrease total deaths.
Ivermectin for COVID-19: real-time meta analysis of 62 studies
[Preprint.] The probability that an ineffective treatment generated results as positive as the 62 studies to date is estimated to be 1 in 652 billion (p = 0.0000000000015). Meta analysis using the most serious outcome reported shows 74% and 85% improvement for early treatment and prophylaxis (RR 0.26 [0.16-0.43] and 0.15 [0.09-0.25]), with similar results after exclusion based sensitivity analysis, restriction to peer-reviewed studies, and restriction to Randomized Controlled Trials. Heterogeneity arises from many factors including treatment delay, population, effect measured, variants, and regimens. While many treatments have some level of efficacy, they do not replace vaccines and other measures to avoid infection. Only 27% of ivermectin studies show zero events in the treatment arm. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. All practical, effective, and safe means should be used.
Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines
Twenty-four randomized controlled trials involving 3406 participants met review inclusion. Meta-analysis of 15 trials found that ivermectin reduced risk of death compared with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19–0.73; n = 2438; I2 = 49%; moderate-certainty evidence). Low-certainty evidence found that ivermectin prophylaxis reduced COVID-19 infection by an average 86% (95% confidence interval 79%–91%). Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.