Healthcare associated infections have always been a serious problem public health, which has further exacerbated with the COVID-19 infection. A retrospective analysis (Kenneth E. Sands et al) was conducted from January 1, 2019 to March 31, 2022, in a series of US hospitals, which indicated, as of approximately 5 million admissions in 182 hospitals, the incidence of healthcare-associated infections (hospital infections) was elevated in the more than 300,000 patients hospitalized with COVID-19, compared with those hospitalized without. The conclusion reached by the authors of the research is that i patients with COVID-19 may be more susceptible to these types of infections and for this reason, greater prevention measures may be necessary for these patients.
In order to improve the protective response against COVID-19, a vaccine (BNT162b4) has been produced that contains component segments (antigens) of SARS-CoV-2: N, M, ORF1ab (Christina M. Arieta and others). This vaccine induces direct T lymphocyte responses in mice not against the spike (like the vaccines currently used) but still able to reduce the severity and duration of the disease in these animals, being less influenced by the presence of the variants present in the spike. This The vaccine approach could therefore represent a new opportunity to improve protection against COVID-19. A ferritin-based nanoparticle vaccine candidate, formulated with aluminum hydroxide as an adjuvant (Payton A.-B. Weidenbacher et al), is able to induce the appearance of neutralizing, effective and long-lasting antibodies in non-human primates , directed against several variants of SARS-CoV-2, including Omicron BQ.1, when used as a booster one year after primary immunisation. A cell line capable of producing thousands of doses of this type of vaccine was also generated which could be used as a booster, once a year or even more frequently, especially in the pediatric age and also in newborns. It has been observed, in a study conducted in China (Yubin Liu et al), that a broad spectrum of neutralizing antibodies can be induced in individuals immunized with an inactivated virus vaccine, suggesting a potential indication for this type of vaccine and the antibodies generated by this to prevent infections caused by the variants, the inactivated virus vaccine being less influenced by the presence of these.
The possibility of a new diagnosis of retinal vascular occlusion, following the mRNA vaccination against COVID-19, appears to be a very rare event and above all has a frequency rate equal to that observed with other types of vaccines, such as the anti-flu and the trivalent, anti-diphtheria, tetanus, acellular pertussis ( Ian Dorney and others). This research was also the subject of a careful critical review (Lee M. Jampol, Maureen G. Maguire) which underlined the various aspects related to this rare problem which should therefore not, at least in theory, represent an obstacle to vaccine prophylaxis . An interesting study (Guangdi Li and others) considered the therapeutic options available today for the treatment of COVID-19: antiviral drugs and monoclonal antibodies, these therapeutic approaches that require early treatment, within 10 days of onset and immunomodulatory drugs (cytokine antagonists, steroids) to be used in hospitalized patients with severe or critical COVID-19 to control the cytokine storm, which is associated with a state of hyper-inflammation. A randomized studyREMAP-CAP (Writing Committee for the REMAP-CAP Investigators) involving 779 patients involved the use of both an ACE2 enzyme inhibitor and an angiotensin receptor blocker, to see if these could improve prognosis of seriously ill hospitalized patients, in terms of reducing the need for assisted ventilation support. The results of this research showed that the use of both these drugs in critically ill patients, not only did it not improve the clinical outcome, but in some cases it even worsened it. This REMAP-CAP study was also the subject of a critical review (Matthew MY Lee and others) which appeared in the same journal, in which the critical issues that emerged in the conduct of the study are analyzed in detail and some hypotheses are formulated to explain the results , apparently conflicting, that have been obtained. A cohort study (Alaleh Azhir et al) conducted in Massachusetts from July 2021 to December 2022, indicated that the severity of COVID-19 has been declining over time.
This result is certainly attributable in the first reading to vaccination which has led to a decrease in the risk of serious forms. It is also important to remember that the emergence of the sub-variants of Omicron, which occurred in conjunction with the presence of a high percentage of vaccinated people, has certainly led to milder forms of disease (less pulmonary involvement) than the previous variants. Strains of SARS-CoV-2 resistant to nirmatrelvir (paxlovid), are transmitted effectively in the Syrian hamster, even if they maintain a certain susceptibility to the drug, especially if this is administered at a higher dose (Rana Abdelnabi and others). The results of this research are important because they demonstrate how drug-resistant viruses can be transmitted effectively, which underlines the need to promote studies that make new antiviral molecules available as soon as possible. A Dutch study (Felix Patience Chilunga and others) conducted in 1886 patients, 483 of whom with long COVID, demonstrated that there are significant differences in the incidence, nature and duration of symptoms of this morbid condition within the Dutch population, compared to the migrated one. For this reason it is important to prepare suitable measures to promote and expand access to post-COVID health care to a large number of patients, so as to plan appropriate and targeted health interventions.
Between 15 December 2021 and 23 May 2022, 21 patients with long COVID were treated in a phase 2 study with an endogenous metabolic modulator (AXA A 1125) and compared with a control group of 20 untreated patients (Lucy EM Finnigan et al). In this research, numerous parameters were considered to evaluate the symptoms linked above all to “fatigue”. Treatment with the drug in question did not improve cellular respirationwhich was the main focus of the research, but was still able to improve some fatigue-related symptoms in patients with long COVID for a duration of approximately 4 weeks.