in a press release on Tuesday (June 16), researchers from a large, randomized controlled trial for COVID-19 treatments announced that they’d seen an improvement in survival at 28 days after entry into the trial for the sickest patients who received the drug dexamethasone. In ventilated patients in particular, giving the steroid reduced deaths by one-third in the RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial. And patients on supplemental oxygen who received dexamethasone had a 20 percent lower mortality rate than those who did not. In contrast, the press release reported no benefit of the medication in subjects who were not in need of respiratory support.
June 10, 2020 -- With more than 160 potential vaccines for COVID-19 under study, optimistic experts hope that a viable vaccine may be ready by the end of 2020.
he U.S. said it would fund and conduct the phase III trials -- the final step to determine how well the vaccine works and if it’s safe -- of three candidates: Moderna Inc., AstraZeneca, and Johnson & Johnson. The Moderna and AstraZeneca vaccines are already being tested in people, while J&J announced Wednesday it will begin its testing in the second half of July.
Moderna. Moderna's vaccine, mRNA-1273, uses messenger RNA, an approach that does not require a virus to make the vaccine. The messenger RNA, or mRNA, carries instructions for making the spike protein, a key protein on the surface of the SARS-CoV-2 virus that allows the virus to enter cells when a person gets infected. When the vaccine with this instruction molecule is injected, it goes to the immune cells and instructs them to make copies of the spike protein, acting as if the cells have been infected with the coronavirus. Allowing other immune cells to develop ways to protect you gives immunity.
mRNA-1273 is in phase II of its clinical trial, designed to evaluate safety and effectiveness. Moderna, a biotechnology company working with the National Institute of Allergy and Infectious Diseases, intends to enroll 600 healthy volunteers equally divided into two age groups: 18 to 55, and 55 and older. The company announced on June 11 that it will start phase III of its trial in July with 30,000 volunteers. Phase III, the final clinical trial phase, evaluates effectiveness in a much larger group and compares how well the vaccine works compared to a placebo. Moderna will test a 100 microgram dose and said the company is on track to deliver 500 million doses per year. In mid-May, the company announced that all eight initial trial volunteers given two different dose amounts reached or surpassed the level of antibodies capable of neutralizing the virus.
University of Oxford and AstraZeneca. University of Oxford scientists are partnering with AstraZeneca to develop a COVID-19 vaccine made from a weakened version of a common cold virus, the adenovirus, taken from chimpanzees. The adenovirus is genetically altered so it can’t reproduce itself. The vaccine is combined with genes of the spike protein to trigger production of vaccines against it that allows the immune system to destroy the SARS-CoV-2 virus.
A phase I/II clinical trial began in April in the U.K. to assess its safety and how well it works in more than 1,000 healthy volunteers 18 to 55 years old. Now, recruiting has begun for phase II/III trials, which will enroll up to 10,260 adults and children. For both phase II and III, volunteers will receive one or two doses of either the COVID-19 vaccine or a licensed vaccine that will be used as a control for comparison. In early June, Brazil, hard hit with COVID-19 cases, joined the clinical trials, planning to test 2,000 volunteers there.
After reaching a license agreement with Oxford University and others, AstraZeneca agreed to supply more than 2 billion doses globally, anticipating delivery of 400 million doses before the end of 2020.
Pfizer and BioNTech. The companies are testing four vaccines, each using messenger RNA, with a different combination of mRNA to targeted antigens (to produce antibodies). Called BNT162, volunteers in Germany and the U.S. have received the vaccine in a phase I/II clinical trial. This trial will evaluate the safety, ability to give immunity, and the optimal dose of the four candidates in a single and continuous study. Initially they are testing the vaccine on people 18 to 55. Once a given dose level is proven safe and effective, older adults will be immunized. Pfizer is predicting the production of millions of vaccine doses in 2020, increasing to hundreds of millions in 2021. Manufacturing sites have been identified both in the U.S. and elsewhere.
Inovio. Inovio's vaccine, INO-4800, is a DNA vaccine in phase I clinical trials, with 40 volunteers. The technology uses DNA designed to produce a specific immune response. A handheld smart device uses a brief electrical pulse to open small pores in the skin to deliver the vaccine. Once the DNA is inside a cell, it instructs it to make many copies of the artificial DNA, and this stimulates the body's natural immune response.
Results from the U.S. phase I trial are expected in June, and a phase II/III trial is expected then to begin. Human trials are also expected to begin this summer in China and South Korea. Multiple partners and collaborators are involved, including the Bill & Melinda Gates Foundation, the National Institutes of Health, and others.
CanSino. CanSino Biologics in Tianjin, China, is working with the Beijing Institute of Biotechnology on a coronavirus vaccine using a type of genetically altered adenovirus known as Ad-5. The platform has been used successfully to develop the Ebola virus vaccine.
In late May, researchers reported on results of the phase I safety study, in which 108 people got three doses (low, middle, high) of the vaccine. Most volunteers developed immune responses, but fewer had the neutralizing antibodies experts say are crucial to fight off the virus.
The company launched phase II in mid-April, with over 500 enrolled.
Sinovac Biotech. Sinovac Biotech's vaccine, CoronaVac, uses an inactivated version of the virus. Early results of a Phase II clinical trial released in June show that the vaccine induced antibodies to neutralize the virus after 14 days in 90% of people who received it. The vaccine requires two injections, given two weeks apart, according to the company. No serious side effects have been reported in either phase I or II trials, which included 743 healthy volunteers.
Sinovac will partner with Instituto Butantan in Brazil to launch a phase III trial. The company said it will develop the vaccine for global use.
Imperial College London— Scientists at Imperial College London have developed a vaccine using a concept called ''self-amplifying RNA." The vaccine uses synthetic strands of genetic code, or RNA, based on the genetic material known about the coronavirus. Once injected, that RNA makes copies of itself, then instructs the body's cells to make copies of the spike protein found on the outside of the virus. This is meant to train the immune system to respond to and fight off the coronavirus.
Investigators will launch a combined phase I/II study the week of June 15, initially giving the vaccine to 300 healthy volunteers. They will receive two doses over two visits, separated by a four-week interval. If the vaccine is shown to be safe and to produce an immune response, Phase III trials would be launched later this year with about 6,000 volunteers. Investigators hope the vaccine could be available by spring 2021.
Johnson & Johnson. The company said it expected to start testing its vaccine in people in the second half of July. The vaccine combines genes from the coronavirus with a modified adenovirus. The first trial will include more than 1,000 healthy adults aged 18 to 55 and others 65 and older, and will take place in the U.S. and Belgium.
Other efforts. The Trump administration chose five companies for Operation Warp Speed, the national program to accelerate the development, making, and distribution of COVID-19 vaccines, treatments, and diagnostics. They are: Moderna, Johnson & Johnson, Merck, Pfizer and BioNTech, and AstraZeneca/Oxford University.
WebMD Health News Reviewed by Brunilda Nazario, MD on June 10, 2020
Sources
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Key Updates for Week 24, ending June 13, 2020
The overall percentage of respiratory specimens testing positive for SARS-CoV-2 increased slightly from week 23 (6.1%) to week 24 (6.4%), driven by increases in five regions. National percentages by type of laboratory:
Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 11.4% during week 23 to 7.1% during week 24 but remained above baseline. This is the eighth week of a declining percentage of deaths due to PIC, but this may change as more death certificates are processed, particularly for recent weeks.
Last updated on June 21, 2020
TOTAL CASES2,248,02932,411 New Cases*
TOTAL DEATHS119,615560 New Deaths*
· *Compared to yesterday's data
· About the Data
weekend of March 21–22, 2020.
The U.S. has now reported 35,000 cases of COVID-19 and 471 associated deaths. New York City alone accounts for around 5% of all cases globally.
Last updated: June 21, 2020, 21:09 GMT
United States
Coronavirus Cases:
2,350,474
Deaths:
122,217
Recovered:
977,546
Projections
CLOSED CASES
1,099,763
Cases which had an outcome:
977,546 (89%)
Recovered / Discharged
122,217 (11%)
Deaths
Show Graph
Feb 15May 24Feb 26Mar 08Mar 19Mar 30Apr 10Apr 21May 02May 13Jun 04Jun 150%50%100%
Show Statistics
Learn more about Worldometer's COVID-19 data
Report coronavirus cases
Total #of deaths as of June 21,2020: 237 deaths
As of June 19, 2020, the coronavirus disease (COVID-19) had been confirmed in around 210 countries and territories around the world. There had been around 8.59 million cases and around 456,500 deaths.
What Is Convalescent Plasma?
Most people who recover from COVID-19 develop antibodies (proteins that the immune system produces in response to infection) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Antibodies are found in plasma, the yellow liquid portion of blood. Plasma is collected from donors who have recovered from COVID-19 through a process called apheresis, which uses a special machine to separate the blood into different components. The plasma is removed, while the rest of the blood components are returned into the donor’s body.
Researchers hope that convalescent plasma can be given to patients with severe COVID-19 to boost their ability to fight the virus. Studies are underway to evaluate use of convalescent plasma as treatment for patients with severe COVID-19 and to prevent infection (prophylaxis) in certain high-risk patients exposed to COVID-19.
JAMA:2020: Convalescent plasma has been used to treat other infections and may be beneficial for COVID-19. Researchers hope that convalescent plasma can be given to patients with severe COVID-19 to boost their ability to fight the virus. Studies are underway to evaluate use of convalescent plasma as treatment for patients with severe COVID-19 and to prevent infection (prophylaxis) in certain high-risk patients exposed to COVID-19. Convalescent plasma might provide immunity by giving patients neutralizing antibodies for SARS-CoV-2. Although there is a lot that is unknown, convalescent plasma may work best for patients earlier in the disease course. Currently, convalescent plasma is being given to small numbers of hospitalized patients with severe or life-threatening COVID-19 illness. Several case reports suggest treatment is helpful, but larger studies are still needed.