Inside Medicine. What Are You Seeing? [COVID-19 medical news]

About the diagnosis of second infection: my mother had COVID for the month of January, and when a hospice aide tested positive a little more than 3 months later, my mother also tested positive. The facility had a test done to determine the strain and since it was identical to her original strain, they took her off quarantine. They told me that the very elderly take longer to get a negative test. She was fully vaccinated at that time.

ps My vaccine was delayed by all this because I was told to get a test, by the facility, and the test meant I had to wait 14 days for a vaccine! Even though it was a false positive for my mother.

I know two people who were I, V, I, one being my son. It probably won’t be long before we know if he gets infected again, as he and his wife are both in the healthcare field and their toddler is in daycare. He had the vaccine about a month ago and is just getting over his second bout. It was bad enough to keep a 30 yr. old, healthy, fit guy in bed for a day.

if this is in response to my original question - please do not assume why i asked that.

I have a 6 month vaxxed kid sick right now with some very rare reactions. (google skin rash from covid and you’ll understand why i’m asking this.) I’m wanting to know if kid should be getting a booster or if immunity from this case will prevent another case in 6 months.

You/your kid should talk with your doctor.

Are u saying your kid has covid now and was vaxxed 6 months ago? If so, they will probably say wait 90 days after this case to get a booster. Regardless, still ask your doctor, and get a second opinion if needed. Have you asked about the Merck antibody treatment (if your kid is 18+)? FWIW I don’t think covid skin reactions are rare. Hope your kid gets better soon.

4 Likes

One of my co-workers friends is involved ( at a low level) with the Pfizer pill. His friend called him today when the early results were announced and said he burst into tears when he got the communication about just how effective it is. The friend’s wife thought someone must have died! The friend said it surpassed his wildest dreams ( and everyone there felt the same)!

16 Likes

I just read about it, and it sounds fantastic. And there seems to be few side effects, in fact side effects were lower with the drug than placebo. So more effective and less of a concern about DNA mutation with this anti-viral than molnupiravir. Hopefully…

1 Like

The drug appears to be more effective than a similar offering from Merck, which is awaiting federal authorization. Pfizer’s pill, which will be sold under the brand name Paxlovid, cut the risk of hospitalization or death by 89 percent when given within three days after the start of symptoms.

Pfizer said an independent board of experts monitoring its clinical trial recommended that the study be stopped early because the drug’s benefit to patients had proved so convincing. The company said it planned to submit the data as soon as possible to the Food and Drug Administration to seek authorization for the pill to be used in the United States.

“The results are really beyond our wildest dreams,” said Annaliesa Anderson, a Pfizer executive who led the drug’s development. She expressed hope that Paxlovid “can have a big impact on helping all our lives go back to normal again and seeing the end of the pandemic.”

The arrival of a new class of easy-to-use pills that dramatically reduce hospitalizations could help bring the curtain down on the most severe phase of the pandemic, at least in wealthy countries where most adults have been vaccinated.

Listening to the Pfizer CEO about their new COVID pill. Sounds amazing. Highly at risk unvaccinated people…89% were kept out of the hospital. Treatment started at 3 days after diagnosis. Even 5 days after diagnosis, 85% kept out of the hospital.

4 Likes

Non-paywall article:

The drug is a type of protease inhibitor, like some drugs used against HIV and hepatitis C.

Description of the drug, known as PF-07321332 or Paxlovid, and is used with ritonovir, an existing drug:
https://www.science.org/doi/10.1126/science.abl4784

5 Likes

That seems encouraging because I know HIV mutates very frequently so maybe these drugs can effectively deal with mutations?

1 Like

Ritonavir (an old HIV drug) is apparently used in sub-therapeutic concentrations in combination with other protease inhibitor drugs to inhibit an enzyme that would rapidly inactivate that protease inhibitor before that protease inhibitor reaches its target (which is what it does here in combo with the Pfizer drug).

(I’m almost sure there will be an avalanche of Facebook posts from idiots who would tell people to rush to their docs to ask for a prescription of generic ritonavir. Ugh.)

ETA: adding a reference to support my above statement about mechanism of action:

1 Like

Were aborted fetal cells used in the development of this medication?

From the Pfizer paper:

“ The in vitro antiviral activity of PF-07321332 was also evaluated in two physiologically relevant cellular systems; human adenocarcinoma-derived alveolar basal epithelial (A549) cells constitutively expressing ACE2 (19) and differentiated normal human bronchial epithelial (dNHBE) cells (31).”

These are not fetal cell lines.

The Vero cell line also mentioned in the paper is derived from a monkey.

2 Likes

The problem is, as with monoclonal antibiodies, anti-vaxxers now have more reason to refuse vaccines. Will this pill help those who are immunocompromised and/or have inadequate responses to vaccines?

1 Like

They might be in for a shock when they see the price of new under-patent drugs…

3 Likes

Good to hear. Otherwise some of the folks refusing the vaccine on religious/ethical grounds would have no recourse if they were truly refusing because of the fetal cell line objection.

Study of 780,225 US veterans and vaccinations:
https://www.science.org/doi/10.1126/science.abm0620

When Delta came, both vaccinated and unvaccinated veterans had a more difficult time escaping infection:


“Kaplan-Meier curves illustrating cumulative risk of SARS-CoV-2 infection by vaccination status and age. (A) All ages. (B) Age <50 years. (C) Age 50-64 years. (D) Age ≥65 years. The survival function estimates time to infection detected by most recent RT-PCR assay.”

However, vaccinated veterans were much less likely to die:


“Kaplan-Meier curves illustrating cumulative risk of death due to any cause by vaccination status and RT-PCR assay. (A) Age <65 years. (B) Age ≥65 years. (C) Charlson Comorbidity Index score <3. (D) Charlson Comorbidity Index score ≥3.”

Page about why rapid tests are scarce and expensive in the US, so most people who want to know if they have COVID-19 use PCR tests which come with delays in getting the results, resulting in either unnecessary quarantine while waiting for the result if the result is negative, or what should have been avoidable spreading if not quarantining before the result if the result is positive. (Or they don’t get tested at all.)

2 Likes

More FDA disappointment. They’ve really screwed up time and again. And people wonder why many are skeptical. Why was the choice supporting either the vaccine or cheap rapid testing instead of supporting both?

My health care system did PCR’s that came back in 3 hours.

2 Likes

I would never defend everything they’ve done. I’ve been a proponent of cheap, frequent, semi-reliable testing for some time, knowing that the frequency would cover for the reliability. That said, where we are, mistakes and all, is actually quite amazing.

We are not 2 years in from first symptoms being reported in Wuhan, let alone a sequence being identified. We have VERY effective vaccines, not one, but many, AND effective therapeutics on the near horizon. If we were on the timeline of the previous record setting commercially available vaccine (Mumps), we’d still have over two years to go. So be indignant about the failures of the FDA if you must, but don’t lose sight of the remarkable progress we’ve made over the last two administrations.

11 Likes