NIH tests therapies to help cut hospital stays for COVID-19 patients

(Reuters) – The U.S. National Institutes of Health (NIH) has started a late-stage trial to evaluate if immune-modulating therapies from three drugmakers can help reduce the need for ventilators for COVID-19 patients and shorten their hospital stay.

The NIH said on Friday it has selected three agents for the study – Johnson & Johnson unit Janssen Research’s Remicade, Bristol Myers Squibb’s Orencia and Abbvie Inc’s experimental drug cenicriviroc.

The study will enroll up to 2,100 hospitalized adults with moderate to severe COVID-19 symptoms in the United States and Latin America.

Immune-modulating therapies are medications that alter the way the immune system works. Severe infections are believed to be triggered by an over-reaction of the immune system, known as a “cytokine storm,” and drugs that suppress certain elements of the immune system can play a role in arresting a rapid escalation of symptoms.

This can lead to acute respiratory distress syndrome and multiple organ failure, among other life-threatening complications.

The NIH said its clinical trial – ACTIV-1 Immune Modulators (IM) – will last six months, and the agency will study if the therapeutics can restore balance by modulating that immune response.

All patients will be given Gilead Sciences Inc’s antiviral drug remdesivir – the current standard of care – and also be randomly assigned to receive a placebo or one of the immune modulators as an add-on treatment, the NIH said in a statement.

Remdesivir was one of the drugs used to treat U.S. President Donald Trump’s coronavirus infection, and has been shown in previous studies to have cut time to recovery, though the European Union is investigating it for possible kidney injury.

(Reporting by Vishwadha Chander in Bengaluru, Editing by Sherry Jacob-Phillips)

Convalescent plasma lowers COVID-19 death risk; exposure to common cold may limit disease severity

By Nancy Lapid

(Reuters) – The following is a brief roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Convalescent plasma lowers COVID-19 death risk

Infusions of antibody-rich blood plasma from people who have recovered from the new coronavirus, known as convalescent plasma, can lower the risk of death for hospitalized COVID-19 patients, according to a pooled analysis of data from eight earlier studies of more than 700 hospitalized patients around the world. Researchers found that mortality rates were roughly 13% in patients who received convalescent plasma versus about 25% for those who did not get the treatment. Convalescent plasma was shown to be safe in an earlier study of 5,000 hospitalized adults with severe or life-threatening COVID-19. In that study, fewer than 1% of patients had any serious adverse effects in the first four hours after transfusion. The current study could not account for differences in factors such as how sick patients were, how much plasma they received, how long they were sick before the received it, and how long doctors followed them afterward. “Given the safety of plasma administration in COVID-19 patients, the results … provide encouragement for its continued used as a therapy,” the researchers write in a report published ahead of peer review.

Exposure to common colds may impact COVID-19 severity

In patients with COVID-19, the immune system’s T cells learn to recognize and target the new coronavirus. But some people who were never infected with the virus nonetheless have T cells that also recognize it. Researchers had suspected that in these individuals, past exposure to other corona viruses, such as those that cause the common cold, had somehow primed their T cells to recognize and attack this new coronavirus (SARS-CoV-2), and new research appears to confirm that. In studies of human blood samples collected well before the new coronavirus was discovered, researchers found T cells that were equally reactive against the new virus and four types of common cold corona viruses. The strongest T cell responses to the new coronavirus were associated with the spike protein the virus uses to enter human cells. “We knew there was pre-existing reactivity, and this study provides very strong direct molecular evidence that memory T cells can ‘see’ sequences that are very similar between common cold corona viruses and SARS-CoV-2,” coauthor Alessandro Sette of the La Jolla Institute for Immunology said in a statement. It is plausible to think that previous exposure to common cold viruses might contribute to variations in COVID-19 severity, researchers said on Tuesday in the journal Science.

Severe COVID-19 may be less deadly in children

Children with COVID-19 rarely become critically ill, and when they do, they tend to have better outcomes than adults, based on early data from an ongoing study. The Critical Coronavirus and Kids Epidemiology (CAKE) study involves 65 pediatric intensive care units in 18 countries. In a paper published on Wednesday in the journal Pediatrics, the study team reported on the first 17 children with severe COVID-19 from 10 hospitals in Chile, Colombia, Italy, Spain and the United States. Most required respiratory support, with nearly half needing to be put on ventilators. Symptoms were varied, with fever, cough and gastrointestinal issues common. Overall, one child died, four developed inflammation of the heart and three remain hospitalized. The investigators hope to have more data soon that will provide additional information on the care and outcomes of these patients, which may become more important as schools reopen around the world. As of now, CAKE has enrolled almost 100 critically ill children “and we are projecting perhaps 100 more by the end of 2020,” Dr. Sebastian Gonzalez-Dambrauskas, with the Latin American Pediatric Collaborative Network, told Reuters.

(Reporting by Nancy Lapid and Megan Brooks; Editing by Bill Berkrot)

Fasting For Two Days Can Boost Immune System

A new study from the University of Southern California shows fasting for as little as two days can regenerate the body’s immune system.

The study showed that fasting worked not only for normal, “healthy” people but also the elderly and people whose immune systems have been compromised because of chemotherapy treatments.

The periods without eating would lower the amount of white blood cells in the body, which would trigger stem cells to begin regeneration of the white blood cells, rushing them into the body.  However, the scientists also found that the rush of white blood cells also repaired damage.

“[Fasting] gives the OK for stem cells to go ahead and being proliferating and rebuild the entire system,” Professor Valter Longo said.  “And the good news is that the body got rid of the parts of the system that might be damaged or old, the inefficient parts, during the fasting.”

A pilot clinical trial found that fasting for 72 hours prior to chemotherapy protected the patients against toxicity.