The biology of coronavirus COVID-19 - including research and treatments

Besides the obvious immediate harm from doing something this foolish, this will also be a massive boon to the anti-vaccine movement. It's impossible to overstate how damaging to public perception of vaccines releasing a likely invalid, for lack of proper testing, vaccine will be.

This is very likely to be a done deal. If not this one it may be another one, politics are driving the issue and no one is willing and able to stop this, the personal risk is too high.

Thanks, Richard Horton, for having released this genie out into the wild. That he is still the editor of the Lancet is one of the most catastrophic errors of judgment I have seen from a supposedly serious institution.

 
I'm becoming very concerned by reports coming out of the USA that there is pressure to get a vaccine out by the beginning of November (remind me what the election date is, please, someone?) Here's an example:

http://www.msn.com/en-gb/news/us/cd...tion-running-by-nov-1/ar-BB18E2QN?ocid=ASUDHP

If the situation is as politicised as it appears to be becoming, then I find that absolutely appalling - public bodies shouldn't be partisan in such a case, in particular when lives are at stake. I hope no corners will be cut.
 
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Things are getting a bit confused. Lots of talk about heart damage, but from autopsies many have commented that although this looks like myocarditis at a distance, a closer look reveals a different picture, that this is not typical myocarditis, though clearly heart damage.



Topol is referring to this:

 
Post copied from the Possibility of ME or PVFS after COVID-19 thread

Last night on CNN Chris Como interviewed Dr. William Li who says it appears that COVID is a 'blood vessel disease' causing severe damage to the vascular system, which would explain why the virus seems to be affecting all organs.

Dr Li is an internal medicine physician and a research scientist—specifically a vascular biologist. He’s been actively involved in angiogenesis research and clinical analysis for more than two decades. Angiogenesis is the development of new blood vessels and Dr. Li is one of the world’s leading experts in this field.
 
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Broad and strong memory CD4+ and CD8+ T cells induced by SARS-CoV-2 in UK convalescent individuals following COVID-19
Abstract
The development of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines and therapeutics will depend on understanding viral immunity. We studied T cell memory in 42 patients following recovery from COVID-19 (28 with mild disease and 14 with severe disease) and 16 unexposed donors, using interferon-γ-based assays with peptides spanning SARS-CoV-2 except ORF1. The breadth and magnitude of T cell responses were significantly higher in severe as compared with mild cases. Total and spike-specific T cell responses correlated with spike-specific antibody responses. We identified 41 peptides containing CD4+ and/or CD8+ epitopes, including six immunodominant regions. Six optimized CD8+ epitopes were defined, with peptide–MHC pentamer-positive cells displaying the central and effector memory phenotype. In mild cases, higher proportions of SARS-CoV-2-specific CD8+ T cells were observed. The identification of T cell responses associated with milder disease will support an understanding of protective immunity and highlights the potential of including non-spike proteins within future COVID-19 vaccine design.
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https://www.nature.com/articles/s41590-020-0782-6

Notably:
IFN-γ-producing SARS-CoV-2-specific T cell responses were not observed in 16 healthy unexposed volunteers, in contrast with recently published reports by Grifoni et al.
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This contradicts the suggestion by Mateus et al. and Grifoni, A. et al. who suggested there was partial T-cell immunity acquired from prior coronavirus infections. I previously wondered whether this was merely naive T-Cell cross reactivity, or low-affinity reactivity and would not provide a robust immune response.

https://science.sciencemag.org/content/early/2020/08/04/science.abd3871
https://www.cell.com/cell/fulltext/S0092-8674(20)30610-3

Amw66 said:
Twitter thread which gives the gist of this
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Note that this was in a "brain organoid" (in-vitro) model. Thus, it is only suggestive of what could happen to real people and says nothing about how common this may be.
 
Coronavirus research updates: Powerful new evidence links steroid treatment to lower deaths

People severely ill with COVID-19 are less likely to die if they are given drugs called corticosteroids than people who are not, according to an analysis of hospital patients on five continents.

Earlier findings showed that the steroid dexamethasone cut deaths in people with COVID-19 on ventilators. To examine the effects of steroids in general, Jonathan Sterne at the University of Bristol, UK, and his colleagues did a meta-analysis that pooled data from seven clinical trials; each of the seven studied the use of steroids in people who were critically ill with COVID-19 (REACT Working Group J. Am. Med. Assoc. https://doi.org/d7z8; 2020). The trials included more than 1,700 people across 12 countries.
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https://www.nature.com/articles/d41586-020-00502-w
 
Coronavirus: Oxford University vaccine trial paused after participant falls ill
Final clinical trials for a coronavirus vaccine, developed by AstraZeneca and Oxford University, have been put on hold after a participant had a suspected adverse reaction in the UK.
AstraZeneca described it as a "routine" pause in the case of "an unexplained illness".
The outcome of vaccine trials is being closely watched around the world.
The AstraZeneca-Oxford University vaccine is seen as a strong contender among dozens being developed globally.
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https://www.bbc.co.uk/news/world-54082192

Amazing isn't it, one patient has a suspected adverse reaction of unknown cause and they pause the whole trial.
Yet people dropped out of the PACE study and they just carried on as if nothing had happened.
 
The adverse reaction has to be in the "serious" category for them to call a halt. It could be a coincidence, e.g. someone suffering from a stroke, or it could be a reaction that is probably associated with the vaccine (Guillain Barre Syndrome).

I'm not sure how many people they have enrolled so far, but if 10,000+, a coincidence might not be unheard of.

The Phase 2 trial had a high proportion of people suffering from headache, fever, so I still wonder about (rare) serious immunological reactions.

edit - I should have read the article, as it had a new report about the underlying condition that wasn't a part of previous news reports.
edit 2 - Is this a second case of transverse myelitis or is the earlier (July) case being cited incorrectly?
 
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Snow Leopard said:
The adverse reaction has to be in the "serious" category for them to call a halt.
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The New York Times is reporting a volunteer in the UK trial has been diagnosed with transverse myelitis, an inflammatory syndrome that affects the spinal cord and can be caused by viral infections.
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Transverse myelitis is an inflammation of both sides of one section of the spinal cord. This neurological disorder often damages the insulating material covering nerve cell fibers (myelin). Transverse myelitis interrupts the messages that the spinal cord nerves send throughout the body.
 
John Mac said:
Transverse myelitis is an inflammation of both sides of one section of the spinal cord. This neurological disorder often damages the insulating material covering nerve cell fibers (myelin). Transverse myelitis interrupts the messages that the spinal cord nerves send throughout the body.
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Ah, the news reports earlier today did not report the actual condition.

Transverse myelitis is similar to Guillain Barre Syndrome and sometimes GBS is misdiagnosed as Transverse myelitis or vice versa.

https://www.bioscience.org/2004/v9/af/1351/fulltext.php?bframe=tables.htm
https://www.nature.com/articles/cmi2017142

And sometimes they occur at the same time...

https://www.cureus.com/articles/370...myelitis-of-unknown-etiology-in-an-adolescent
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5177703/
https://adc.bmj.com/content/102/Suppl_1/A152.1.info
 
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Discovery of four COVID-19 risk groups helps guide treatment
People who are admitted to hospital with COVID-19 can be divided into four distinct groups, according to data from the world’s largest study of patients with the disease.

Researchers identified the groups using clinical information and tests carried out upon arrival at hospital to predict the patients’ risk of death – ranging from low to very high.

A COVID-19 risk identification tool – the most accurate to date – has been designed using the groupings to help clinical staff choose the best course of treatment for patients admitted to hospital.

The tool was built by the ISARIC Coronavirus Clinical Characterisation Consortium involving researchers from Universities of Edinburgh, Glasgow, Liverpool and Imperial College London using data from some 35,000 patients admitted to hospital between February and May 2020 who met the criteria for one of the four groups.

The tool was then tested and confirmed to be accurate using data from a further 22,000 patients hospitalised from the end of May to the end of June 2020.
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https://www.ukri.org/news/discovery-of-four-covid-19-risk-groups-helps-guide-treatment/

Discussion thread for study, Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol, 2020, Knight et al
 
Medscape: Unexpected Results in New COVID-19 'Cytokine Storm' Data

The immune system overactivation known as a "cytokine storm" does not play a major role in more severe COVID-19 outcomes, according to unexpected findings in new research. The findings stand in direct contrast to many previous reports.

"We were indeed surprised by the results of our study," senior study author Peter Pickkers, MD, PhD, told Medscape Medical News.

In a unique approach, Pickkers and colleagues compared cytokine levels in critically ill people with COVID-19 to those in patients with bacterial sepsis, trauma, and after cardiac arrest.


"For the first time, we measured the cytokines in different diseases using the same methods. Our results convincingly show that the circulating cytokine concentrations are not higher, but lower, compared to other diseases," said Pickkers, who is affiliated with the Department of Intensive Care Medicine at Radboud University Medical Center in Nijmegen, the Netherlands.

The team's research was published online on September 3 in a letter in JAMA
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