Sleep-related hypoxia and COVID-19 outcomes

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Key clinical point: Sleep-related hypoxia is associated with worse outcomes in patients with COVID-19.

Major finding: Sleep-related hypoxia was associated with an increased risk for COVID-19-related hospitalization and mortality (adjusted hazard ratio, 1.31; 95% CI, 1.08-1.57; P = .005).

Study details: The data come from a case-control study involving 5,402 individuals who had previously participated in a sleep study, of whom 1,935 tested positive for SARS-CoV-2.

Disclosures: The study was supported by the Neuroscience Transformative Research Resource Development Award (R Mehra). A Milinovich reported ties with various pharmaceutical companies and research organizations. L Aboussouan, L Jehi, R Mehra, and C Pena Orbea reported ties with research organizations and/or publishing companies. The remaining authors declared no competing interests.

Source: Pena Orbea C et al. JAMA Netw Open. 2021 Nov 10. doi: 10.1001/jamanetworkopen.2021.34241.

 

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Key clinical point: Sleep-related hypoxia is associated with worse outcomes in patients with COVID-19.

Major finding: Sleep-related hypoxia was associated with an increased risk for COVID-19-related hospitalization and mortality (adjusted hazard ratio, 1.31; 95% CI, 1.08-1.57; P = .005).

Study details: The data come from a case-control study involving 5,402 individuals who had previously participated in a sleep study, of whom 1,935 tested positive for SARS-CoV-2.

Disclosures: The study was supported by the Neuroscience Transformative Research Resource Development Award (R Mehra). A Milinovich reported ties with various pharmaceutical companies and research organizations. L Aboussouan, L Jehi, R Mehra, and C Pena Orbea reported ties with research organizations and/or publishing companies. The remaining authors declared no competing interests.

Source: Pena Orbea C et al. JAMA Netw Open. 2021 Nov 10. doi: 10.1001/jamanetworkopen.2021.34241.

 

Key clinical point: Sleep-related hypoxia is associated with worse outcomes in patients with COVID-19.

Major finding: Sleep-related hypoxia was associated with an increased risk for COVID-19-related hospitalization and mortality (adjusted hazard ratio, 1.31; 95% CI, 1.08-1.57; P = .005).

Study details: The data come from a case-control study involving 5,402 individuals who had previously participated in a sleep study, of whom 1,935 tested positive for SARS-CoV-2.

Disclosures: The study was supported by the Neuroscience Transformative Research Resource Development Award (R Mehra). A Milinovich reported ties with various pharmaceutical companies and research organizations. L Aboussouan, L Jehi, R Mehra, and C Pena Orbea reported ties with research organizations and/or publishing companies. The remaining authors declared no competing interests.

Source: Pena Orbea C et al. JAMA Netw Open. 2021 Nov 10. doi: 10.1001/jamanetworkopen.2021.34241.

 

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COVID Vaccine [ 5979 ]

Real-world effectiveness of J&J's COVID-19 vaccine

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Key clinical point: Johnson & Johnson's (J&J) adenoviral vector COVID-19 vaccine (Ad26.COV) was effective in preventing COVID-19 and severe outcomes in a real-world setting.

Major finding: The incidence rate ratio of COVID-19 in the Ad26.COV-vaccinated vs unvaccinated cohort was 0.26 (95% CI, 0.20-0.34), corresponding to an effectiveness of 73.6% (95% CI, 65.9%-79.9%). Ad26.COV recipients also had a lower risk for hospitalization (odds ratio [OR], 0.32; P = .00028) and ICU admissions (OR, 0.00; P = .001) compared with unvaccinated individuals.

Study details: The data come from an analysis of 8,889 individuals vaccinated with Ad26.COV and 88,898 unvaccinated matched controls.

Disclosures: No information on funding was available. J Corchado-Garcia, D Zemmour, T Hughes, P Lenehan, C Pawlowski, JC O’Horo, AD Badley, MD Swift, T Wagner, and V Soundararajan reported relationships with various pharmaceutical companies. The remaining authors declared no conflict of interests.

Source: Corchado-Garcia J et al. JAMA Netw Open. 2021 Nov 2. doi: 10.1001/jamanetworkopen.2021.32540.

 

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Key clinical point: Johnson & Johnson's (J&J) adenoviral vector COVID-19 vaccine (Ad26.COV) was effective in preventing COVID-19 and severe outcomes in a real-world setting.

Major finding: The incidence rate ratio of COVID-19 in the Ad26.COV-vaccinated vs unvaccinated cohort was 0.26 (95% CI, 0.20-0.34), corresponding to an effectiveness of 73.6% (95% CI, 65.9%-79.9%). Ad26.COV recipients also had a lower risk for hospitalization (odds ratio [OR], 0.32; P = .00028) and ICU admissions (OR, 0.00; P = .001) compared with unvaccinated individuals.

Study details: The data come from an analysis of 8,889 individuals vaccinated with Ad26.COV and 88,898 unvaccinated matched controls.

Disclosures: No information on funding was available. J Corchado-Garcia, D Zemmour, T Hughes, P Lenehan, C Pawlowski, JC O’Horo, AD Badley, MD Swift, T Wagner, and V Soundararajan reported relationships with various pharmaceutical companies. The remaining authors declared no conflict of interests.

Source: Corchado-Garcia J et al. JAMA Netw Open. 2021 Nov 2. doi: 10.1001/jamanetworkopen.2021.32540.

 

Key clinical point: Johnson & Johnson's (J&J) adenoviral vector COVID-19 vaccine (Ad26.COV) was effective in preventing COVID-19 and severe outcomes in a real-world setting.

Major finding: The incidence rate ratio of COVID-19 in the Ad26.COV-vaccinated vs unvaccinated cohort was 0.26 (95% CI, 0.20-0.34), corresponding to an effectiveness of 73.6% (95% CI, 65.9%-79.9%). Ad26.COV recipients also had a lower risk for hospitalization (odds ratio [OR], 0.32; P = .00028) and ICU admissions (OR, 0.00; P = .001) compared with unvaccinated individuals.

Study details: The data come from an analysis of 8,889 individuals vaccinated with Ad26.COV and 88,898 unvaccinated matched controls.

Disclosures: No information on funding was available. J Corchado-Garcia, D Zemmour, T Hughes, P Lenehan, C Pawlowski, JC O’Horo, AD Badley, MD Swift, T Wagner, and V Soundararajan reported relationships with various pharmaceutical companies. The remaining authors declared no conflict of interests.

Source: Corchado-Garcia J et al. JAMA Netw Open. 2021 Nov 2. doi: 10.1001/jamanetworkopen.2021.32540.

 

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Single-dose levilimab safe and effective in severe COVID-19

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Key clinical point: A single subcutaneous dose of levilimab (LVL) was safe and effective in severely ill patients with COVID-19 not requiring mechanical ventilation.

Major finding: 63.1% of patients in the LVL group vs 42.7% in the placebo group achieved sustained clinical improvement on day 14 (P = .0017). Adverse event frequency was comparable between the groups.

Study details: In the phase 3 CORONA trial, 206 patients were randomly assigned (1:1) to receive either LVL+standard of care (SOC) vs placebo+SOC.

Disclosures: This study was funded by JSC BIOCAD. MY Gilyarov reported ties with various pharmaceutical companies. AI Seleznev, YN Linkova, EA Dokukina, PS Pukhtinskaia, AV Eremeeva, MA Morozova, AV Zinkina-Orikhan, and AA Lutckii are employees of JSC BIOCAD.

Source: Lomakin NV et al. Inflamm Res. 2021 Sep 29. doi: 10.1007/s00011-021-01507-5.

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Key clinical point: A single subcutaneous dose of levilimab (LVL) was safe and effective in severely ill patients with COVID-19 not requiring mechanical ventilation.

Major finding: 63.1% of patients in the LVL group vs 42.7% in the placebo group achieved sustained clinical improvement on day 14 (P = .0017). Adverse event frequency was comparable between the groups.

Study details: In the phase 3 CORONA trial, 206 patients were randomly assigned (1:1) to receive either LVL+standard of care (SOC) vs placebo+SOC.

Disclosures: This study was funded by JSC BIOCAD. MY Gilyarov reported ties with various pharmaceutical companies. AI Seleznev, YN Linkova, EA Dokukina, PS Pukhtinskaia, AV Eremeeva, MA Morozova, AV Zinkina-Orikhan, and AA Lutckii are employees of JSC BIOCAD.

Source: Lomakin NV et al. Inflamm Res. 2021 Sep 29. doi: 10.1007/s00011-021-01507-5.

Key clinical point: A single subcutaneous dose of levilimab (LVL) was safe and effective in severely ill patients with COVID-19 not requiring mechanical ventilation.

Major finding: 63.1% of patients in the LVL group vs 42.7% in the placebo group achieved sustained clinical improvement on day 14 (P = .0017). Adverse event frequency was comparable between the groups.

Study details: In the phase 3 CORONA trial, 206 patients were randomly assigned (1:1) to receive either LVL+standard of care (SOC) vs placebo+SOC.

Disclosures: This study was funded by JSC BIOCAD. MY Gilyarov reported ties with various pharmaceutical companies. AI Seleznev, YN Linkova, EA Dokukina, PS Pukhtinskaia, AV Eremeeva, MA Morozova, AV Zinkina-Orikhan, and AA Lutckii are employees of JSC BIOCAD.

Source: Lomakin NV et al. Inflamm Res. 2021 Sep 29. doi: 10.1007/s00011-021-01507-5.

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Higher risk for COVID-19-related hospitalization, death in HIV-positive individuals

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Key clinical point: HIV-positive individuals are more likely to be hospitalized for or die from COVID-19 compared with non-HIV individuals.

Major finding: The HIV-positive vs non-HIV group had a higher risk for COVID-19-related hospitalization (adjusted odds ratio [aOR], 1.20; 95% CI, 1.15-1.26) and mortality (aOR, 1.29; 95% CI, 1.16-1.44). The risk was pronounced for older patients, male sex, and Black race.

Study details: The data come from a US population-based surveillance study involving 1,436,622 COVID-19 cases, of which 13,170 were HIV positive.

Disclosures: The study was funded by National Center for Advancing Translational Sciences, National Institute of Allergy and Infectious Diseases, and National Institutes of Health, USA. The authors declared no competing interests.

Source: Yang X et al. Lancet HIV. 2021 Oct 13. doi: 10.1016/S2352-3018(21)00239-3.

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Key clinical point: HIV-positive individuals are more likely to be hospitalized for or die from COVID-19 compared with non-HIV individuals.

Major finding: The HIV-positive vs non-HIV group had a higher risk for COVID-19-related hospitalization (adjusted odds ratio [aOR], 1.20; 95% CI, 1.15-1.26) and mortality (aOR, 1.29; 95% CI, 1.16-1.44). The risk was pronounced for older patients, male sex, and Black race.

Study details: The data come from a US population-based surveillance study involving 1,436,622 COVID-19 cases, of which 13,170 were HIV positive.

Disclosures: The study was funded by National Center for Advancing Translational Sciences, National Institute of Allergy and Infectious Diseases, and National Institutes of Health, USA. The authors declared no competing interests.

Source: Yang X et al. Lancet HIV. 2021 Oct 13. doi: 10.1016/S2352-3018(21)00239-3.

Key clinical point: HIV-positive individuals are more likely to be hospitalized for or die from COVID-19 compared with non-HIV individuals.

Major finding: The HIV-positive vs non-HIV group had a higher risk for COVID-19-related hospitalization (adjusted odds ratio [aOR], 1.20; 95% CI, 1.15-1.26) and mortality (aOR, 1.29; 95% CI, 1.16-1.44). The risk was pronounced for older patients, male sex, and Black race.

Study details: The data come from a US population-based surveillance study involving 1,436,622 COVID-19 cases, of which 13,170 were HIV positive.

Disclosures: The study was funded by National Center for Advancing Translational Sciences, National Institute of Allergy and Infectious Diseases, and National Institutes of Health, USA. The authors declared no competing interests.

Source: Yang X et al. Lancet HIV. 2021 Oct 13. doi: 10.1016/S2352-3018(21)00239-3.

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Heart rate variability predicts COVID-19 outcomes

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Key clinical point: Heart rate variability (HRV) is a predictor of survival and intensive care unit (ICU) admission in older adults hospitalized with COVID-19.

Major finding: After adjusting for age and chronic heart disease, HRV was a significant predictor of survival (adjusted hazard ratio [aHR] with low vs high HRV, 0.51; 95% CI, 0.27-0.97). This association was primarily driven by patients aged 70 years (aHR with low vs high HRV, 0.28; 95% CI, 0.12-0.66). HRV also predicted ICU admission within the first week of hospitalization (adjusted HR, 0.51; 95% CI, 0.29-0.90), independent of age and chronic heart disease.

Study details: The data come from a retrospective cohort study involving 271 consecutive adults hospitalized with COVID-19 between March 2020 and May 2020.

Disclosures: The study did not receive any specific funding. The authors declared no competing interests.

Source: Mol MBA et al. PLoS One. 2021 Oct 28. doi: 10.1371/journal.pone.0258841.

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Key clinical point: Heart rate variability (HRV) is a predictor of survival and intensive care unit (ICU) admission in older adults hospitalized with COVID-19.

Major finding: After adjusting for age and chronic heart disease, HRV was a significant predictor of survival (adjusted hazard ratio [aHR] with low vs high HRV, 0.51; 95% CI, 0.27-0.97). This association was primarily driven by patients aged 70 years (aHR with low vs high HRV, 0.28; 95% CI, 0.12-0.66). HRV also predicted ICU admission within the first week of hospitalization (adjusted HR, 0.51; 95% CI, 0.29-0.90), independent of age and chronic heart disease.

Study details: The data come from a retrospective cohort study involving 271 consecutive adults hospitalized with COVID-19 between March 2020 and May 2020.

Disclosures: The study did not receive any specific funding. The authors declared no competing interests.

Source: Mol MBA et al. PLoS One. 2021 Oct 28. doi: 10.1371/journal.pone.0258841.

Key clinical point: Heart rate variability (HRV) is a predictor of survival and intensive care unit (ICU) admission in older adults hospitalized with COVID-19.

Major finding: After adjusting for age and chronic heart disease, HRV was a significant predictor of survival (adjusted hazard ratio [aHR] with low vs high HRV, 0.51; 95% CI, 0.27-0.97). This association was primarily driven by patients aged 70 years (aHR with low vs high HRV, 0.28; 95% CI, 0.12-0.66). HRV also predicted ICU admission within the first week of hospitalization (adjusted HR, 0.51; 95% CI, 0.29-0.90), independent of age and chronic heart disease.

Study details: The data come from a retrospective cohort study involving 271 consecutive adults hospitalized with COVID-19 between March 2020 and May 2020.

Disclosures: The study did not receive any specific funding. The authors declared no competing interests.

Source: Mol MBA et al. PLoS One. 2021 Oct 28. doi: 10.1371/journal.pone.0258841.

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COVID-19: Sotrovimab may prevent disease progression

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Key clinical point: Sotrovimab significantly reduced the risk for complications, hospitalization, or mortality in patients with mild-to-moderate COVID-19.

Major finding: 1% of patients in the sotrovimab group vs 7% in the placebo group experienced disease progression leading to hospitalization (relative risk reduction, 85%; P = .002). Grade 3/4 adverse events were reported in 2% of patients in the sotrovimab group vs 6% of patients in the placebo group.

Study details: The data come from a prespecified, interim analysis of the ongoing, double-blind, placebo-controlled phase 3 COMET-ICE trial assessing the efficacy and safety of sotrovimab in patients with high-risk, ambulatory, mild-to-moderate COVID-19.

Disclosures: The COMET-ICE trial was funded by Vir Biotechnology and GlaxoSmithKline. The COMET-ICE Investigators reported relationships with Vir Biotechnology and GlaxoSmithKline.

Source: Gupta A et al. N Engl J Med. 2021 Oct 27. doi: 10.1056/NEJMoa2107934.

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Key clinical point: Sotrovimab significantly reduced the risk for complications, hospitalization, or mortality in patients with mild-to-moderate COVID-19.

Major finding: 1% of patients in the sotrovimab group vs 7% in the placebo group experienced disease progression leading to hospitalization (relative risk reduction, 85%; P = .002). Grade 3/4 adverse events were reported in 2% of patients in the sotrovimab group vs 6% of patients in the placebo group.

Study details: The data come from a prespecified, interim analysis of the ongoing, double-blind, placebo-controlled phase 3 COMET-ICE trial assessing the efficacy and safety of sotrovimab in patients with high-risk, ambulatory, mild-to-moderate COVID-19.

Disclosures: The COMET-ICE trial was funded by Vir Biotechnology and GlaxoSmithKline. The COMET-ICE Investigators reported relationships with Vir Biotechnology and GlaxoSmithKline.

Source: Gupta A et al. N Engl J Med. 2021 Oct 27. doi: 10.1056/NEJMoa2107934.

Key clinical point: Sotrovimab significantly reduced the risk for complications, hospitalization, or mortality in patients with mild-to-moderate COVID-19.

Major finding: 1% of patients in the sotrovimab group vs 7% in the placebo group experienced disease progression leading to hospitalization (relative risk reduction, 85%; P = .002). Grade 3/4 adverse events were reported in 2% of patients in the sotrovimab group vs 6% of patients in the placebo group.

Study details: The data come from a prespecified, interim analysis of the ongoing, double-blind, placebo-controlled phase 3 COMET-ICE trial assessing the efficacy and safety of sotrovimab in patients with high-risk, ambulatory, mild-to-moderate COVID-19.

Disclosures: The COMET-ICE trial was funded by Vir Biotechnology and GlaxoSmithKline. The COMET-ICE Investigators reported relationships with Vir Biotechnology and GlaxoSmithKline.

Source: Gupta A et al. N Engl J Med. 2021 Oct 27. doi: 10.1056/NEJMoa2107934.

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History of diphtheria or tetanus vaccination linked to lower risk for severe COVID-19

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Key clinical point: Individuals who had received diphtheria or tetanus vaccinations in the last 10 years were less likely to develop severe COVID-19 compared with those who had not received them.

Major finding: The study included 103,049 participants (mean age, 71.5 years; 54.2% women) with vaccination records for the past 10 years and data on COVID-19 testing.

Study details: Individuals who had been vaccinated against diphtheria (odds ratio [OR], 0.47; 95% CI, 0.33-0.68; P = .000053) and tetanus (OR, 0.52; 95% CI, 0.37-0.72; P = .00012) in the last 10 years had a lower likelihood of developing severe COVID-19 symptoms compared with those who had not received them.

Disclosures: The study was funded by the Research Council of Norway, the South-Eastern Norway Regional Health Authority, Stiftelsen Kristian Gerhard Jebsen, The European Research Council under the European Union’s Horizon 2020 research and innovation programme, and National Institutes of Health. O Andreassen and J Pinzón-Espinosa reported relationships with various pharmaceutical companies. The remaining authors declared no conflict of interests.

Source: Monereo-Sánchez J et al. Front Immunol. 2021 Oct 7. doi: 10.3389/fimmu.2021.749264.

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Key clinical point: Individuals who had received diphtheria or tetanus vaccinations in the last 10 years were less likely to develop severe COVID-19 compared with those who had not received them.

Major finding: The study included 103,049 participants (mean age, 71.5 years; 54.2% women) with vaccination records for the past 10 years and data on COVID-19 testing.

Study details: Individuals who had been vaccinated against diphtheria (odds ratio [OR], 0.47; 95% CI, 0.33-0.68; P = .000053) and tetanus (OR, 0.52; 95% CI, 0.37-0.72; P = .00012) in the last 10 years had a lower likelihood of developing severe COVID-19 symptoms compared with those who had not received them.

Disclosures: The study was funded by the Research Council of Norway, the South-Eastern Norway Regional Health Authority, Stiftelsen Kristian Gerhard Jebsen, The European Research Council under the European Union’s Horizon 2020 research and innovation programme, and National Institutes of Health. O Andreassen and J Pinzón-Espinosa reported relationships with various pharmaceutical companies. The remaining authors declared no conflict of interests.

Source: Monereo-Sánchez J et al. Front Immunol. 2021 Oct 7. doi: 10.3389/fimmu.2021.749264.

Key clinical point: Individuals who had received diphtheria or tetanus vaccinations in the last 10 years were less likely to develop severe COVID-19 compared with those who had not received them.

Major finding: The study included 103,049 participants (mean age, 71.5 years; 54.2% women) with vaccination records for the past 10 years and data on COVID-19 testing.

Study details: Individuals who had been vaccinated against diphtheria (odds ratio [OR], 0.47; 95% CI, 0.33-0.68; P = .000053) and tetanus (OR, 0.52; 95% CI, 0.37-0.72; P = .00012) in the last 10 years had a lower likelihood of developing severe COVID-19 symptoms compared with those who had not received them.

Disclosures: The study was funded by the Research Council of Norway, the South-Eastern Norway Regional Health Authority, Stiftelsen Kristian Gerhard Jebsen, The European Research Council under the European Union’s Horizon 2020 research and innovation programme, and National Institutes of Health. O Andreassen and J Pinzón-Espinosa reported relationships with various pharmaceutical companies. The remaining authors declared no conflict of interests.

Source: Monereo-Sánchez J et al. Front Immunol. 2021 Oct 7. doi: 10.3389/fimmu.2021.749264.

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Colchicine not beneficial in hospitalized COVID-19 patients

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Key clinical point: Addition of colchicine to standard of care (SOC) had no significant benefit in hospitalized COVID-19 patients.

Major finding: There were no significant differences between SOC alone and SOC plus colchicine groups in all-cause mortality (rate ratio [RR], 1.01; P = .77), probability of being discharged alive within 28 days (RR, 0.98; P = .44), and the risk of progressing to invasive mechanical ventilation or death (RR, 1.02; P = .47).

Study details: In the RECOVERY trial, 11,340 hospitalized COVID-19 patients were randomly assigned to receive SOC with (n=5,610) or without (n=5,730) colchicine.

Disclosures: The RECOVERY trial was funded by the UK Research and Innovation (Medical Research Council), National Institute for Health Research, and Wellcome Trust. The authors declared no competing interests.

Source: RECOVERY Collaborative Group. Lancet Respir Med. 2021 Oct 18. doi: 10.1016/ S2213-2600(21)00435-5.

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Key clinical point: Addition of colchicine to standard of care (SOC) had no significant benefit in hospitalized COVID-19 patients.

Major finding: There were no significant differences between SOC alone and SOC plus colchicine groups in all-cause mortality (rate ratio [RR], 1.01; P = .77), probability of being discharged alive within 28 days (RR, 0.98; P = .44), and the risk of progressing to invasive mechanical ventilation or death (RR, 1.02; P = .47).

Study details: In the RECOVERY trial, 11,340 hospitalized COVID-19 patients were randomly assigned to receive SOC with (n=5,610) or without (n=5,730) colchicine.

Disclosures: The RECOVERY trial was funded by the UK Research and Innovation (Medical Research Council), National Institute for Health Research, and Wellcome Trust. The authors declared no competing interests.

Source: RECOVERY Collaborative Group. Lancet Respir Med. 2021 Oct 18. doi: 10.1016/ S2213-2600(21)00435-5.

Key clinical point: Addition of colchicine to standard of care (SOC) had no significant benefit in hospitalized COVID-19 patients.

Major finding: There were no significant differences between SOC alone and SOC plus colchicine groups in all-cause mortality (rate ratio [RR], 1.01; P = .77), probability of being discharged alive within 28 days (RR, 0.98; P = .44), and the risk of progressing to invasive mechanical ventilation or death (RR, 1.02; P = .47).

Study details: In the RECOVERY trial, 11,340 hospitalized COVID-19 patients were randomly assigned to receive SOC with (n=5,610) or without (n=5,730) colchicine.

Disclosures: The RECOVERY trial was funded by the UK Research and Innovation (Medical Research Council), National Institute for Health Research, and Wellcome Trust. The authors declared no competing interests.

Source: RECOVERY Collaborative Group. Lancet Respir Med. 2021 Oct 18. doi: 10.1016/ S2213-2600(21)00435-5.

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Anticoagulant type and COVID-19 outcomes in patients with AF

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Fri, 12/03/2021 - 13:16

Key clinical point: In patients with nonvalvular atrial fibrillation (AF), warfarin use was linked to a lower risk of SARS-CoV-2 infection and adverse COVID-19 outcomes compared with the use of direct oral anticoagulants (DOACs).

Major finding: Warfarin vs DOAC use was associated with a lower risk for testing positive for SARS-CoV-2 (adjusted hazard ratio [aHR]; 0.73; 95% CI, 0.68-0.79), COVID-19-related hospitalization (aHR, 0.75; 95% CI, 0.68-0.83), and COVID-19-related mortality (aHR, 0.74; 95% CI, 0.66-0.83).

Study details: The details come from a population-based cohort study involving 92,339 warfarin users and 280,407 DOAC users. The OpenSAFELY platform was used for data analysis.

Disclosures: The OpenSAFELY data science platform was funded by the Wellcome Trust. OpenSAFELY work was jointly funded by UKRI, NIHR, Asthma UK-BLF, and the Longitudinal Health and Wellbeing strand of the National Core Studies programme. Principal investigator B Goldacre reported relationships with various research organizations. The co-principal investigator IJ Douglas reported ties with GSK.

Source: OpenSAFELY Collaborative et al. J Hematol Oncol. 2021 Oct 19. doi: 10.1186/s13045-021-01185-0.

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Key clinical point: In patients with nonvalvular atrial fibrillation (AF), warfarin use was linked to a lower risk of SARS-CoV-2 infection and adverse COVID-19 outcomes compared with the use of direct oral anticoagulants (DOACs).

Major finding: Warfarin vs DOAC use was associated with a lower risk for testing positive for SARS-CoV-2 (adjusted hazard ratio [aHR]; 0.73; 95% CI, 0.68-0.79), COVID-19-related hospitalization (aHR, 0.75; 95% CI, 0.68-0.83), and COVID-19-related mortality (aHR, 0.74; 95% CI, 0.66-0.83).

Study details: The details come from a population-based cohort study involving 92,339 warfarin users and 280,407 DOAC users. The OpenSAFELY platform was used for data analysis.

Disclosures: The OpenSAFELY data science platform was funded by the Wellcome Trust. OpenSAFELY work was jointly funded by UKRI, NIHR, Asthma UK-BLF, and the Longitudinal Health and Wellbeing strand of the National Core Studies programme. Principal investigator B Goldacre reported relationships with various research organizations. The co-principal investigator IJ Douglas reported ties with GSK.

Source: OpenSAFELY Collaborative et al. J Hematol Oncol. 2021 Oct 19. doi: 10.1186/s13045-021-01185-0.

Key clinical point: In patients with nonvalvular atrial fibrillation (AF), warfarin use was linked to a lower risk of SARS-CoV-2 infection and adverse COVID-19 outcomes compared with the use of direct oral anticoagulants (DOACs).

Major finding: Warfarin vs DOAC use was associated with a lower risk for testing positive for SARS-CoV-2 (adjusted hazard ratio [aHR]; 0.73; 95% CI, 0.68-0.79), COVID-19-related hospitalization (aHR, 0.75; 95% CI, 0.68-0.83), and COVID-19-related mortality (aHR, 0.74; 95% CI, 0.66-0.83).

Study details: The details come from a population-based cohort study involving 92,339 warfarin users and 280,407 DOAC users. The OpenSAFELY platform was used for data analysis.

Disclosures: The OpenSAFELY data science platform was funded by the Wellcome Trust. OpenSAFELY work was jointly funded by UKRI, NIHR, Asthma UK-BLF, and the Longitudinal Health and Wellbeing strand of the National Core Studies programme. Principal investigator B Goldacre reported relationships with various research organizations. The co-principal investigator IJ Douglas reported ties with GSK.

Source: OpenSAFELY Collaborative et al. J Hematol Oncol. 2021 Oct 19. doi: 10.1186/s13045-021-01185-0.

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Risk of neurological sequalae after COVID-19 and COVID-19 vaccination

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Key clinical point: There is an increased risk of neurological complications following COVID-19 vaccination; however, this risk is substantially higher following SARS-CoV-2 infection.

Major finding: There was an increased risk for Guillain-Barré syndrome and Bell’s palsy following vaccination with ChAdOx1nCoV-19 (incidence rate ratio [IRR], 2.90 [95% CI, 2.15-3.92] and 1.29 [95% CI, 1.08-1.56], respectively) and for hemorrhagic stroke following vaccination with BNT162b2 (IRR, 1.38; 95% CI, 1.12-1.71). The risk for all neurological complications was significantly higher within 28 days of a positive SARS-CoV-2 test, including Guillain-Barré syndrome (IRR, 5.25; 95% CI, 3.00-9.18).

Study details: The data come from an analysis of 20,417,752 individuals who received ChAdOx1nCoV-19 (AstraZeneca) COVID-19 vaccine, 12,134,782 who received BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine, and 2,005,280 who tested positive for COVID-19.

Disclosures: No specific funding information was available. A Sheikh, D Hunt, K Khunti, C Robertson, and J Hippisley-Cox reported ties with various research organizations and/or advisory groups. The remaining authors declared no conflict of interests.

Source: Patone M et al. Nat Med. 2021 Oct 25. doi: 10.1038/s41591-021-01556-7.

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Key clinical point: There is an increased risk of neurological complications following COVID-19 vaccination; however, this risk is substantially higher following SARS-CoV-2 infection.

Major finding: There was an increased risk for Guillain-Barré syndrome and Bell’s palsy following vaccination with ChAdOx1nCoV-19 (incidence rate ratio [IRR], 2.90 [95% CI, 2.15-3.92] and 1.29 [95% CI, 1.08-1.56], respectively) and for hemorrhagic stroke following vaccination with BNT162b2 (IRR, 1.38; 95% CI, 1.12-1.71). The risk for all neurological complications was significantly higher within 28 days of a positive SARS-CoV-2 test, including Guillain-Barré syndrome (IRR, 5.25; 95% CI, 3.00-9.18).

Study details: The data come from an analysis of 20,417,752 individuals who received ChAdOx1nCoV-19 (AstraZeneca) COVID-19 vaccine, 12,134,782 who received BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine, and 2,005,280 who tested positive for COVID-19.

Disclosures: No specific funding information was available. A Sheikh, D Hunt, K Khunti, C Robertson, and J Hippisley-Cox reported ties with various research organizations and/or advisory groups. The remaining authors declared no conflict of interests.

Source: Patone M et al. Nat Med. 2021 Oct 25. doi: 10.1038/s41591-021-01556-7.

Key clinical point: There is an increased risk of neurological complications following COVID-19 vaccination; however, this risk is substantially higher following SARS-CoV-2 infection.

Major finding: There was an increased risk for Guillain-Barré syndrome and Bell’s palsy following vaccination with ChAdOx1nCoV-19 (incidence rate ratio [IRR], 2.90 [95% CI, 2.15-3.92] and 1.29 [95% CI, 1.08-1.56], respectively) and for hemorrhagic stroke following vaccination with BNT162b2 (IRR, 1.38; 95% CI, 1.12-1.71). The risk for all neurological complications was significantly higher within 28 days of a positive SARS-CoV-2 test, including Guillain-Barré syndrome (IRR, 5.25; 95% CI, 3.00-9.18).

Study details: The data come from an analysis of 20,417,752 individuals who received ChAdOx1nCoV-19 (AstraZeneca) COVID-19 vaccine, 12,134,782 who received BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine, and 2,005,280 who tested positive for COVID-19.

Disclosures: No specific funding information was available. A Sheikh, D Hunt, K Khunti, C Robertson, and J Hippisley-Cox reported ties with various research organizations and/or advisory groups. The remaining authors declared no conflict of interests.

Source: Patone M et al. Nat Med. 2021 Oct 25. doi: 10.1038/s41591-021-01556-7.

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