treatment

COVID-19 Roundup: Booster Recommendations, WHO Treatment Guidelines, Omicron Variant

Booster Vaccine Interval1

The US Food and Drug Administration (FDA) has shorted the required time between completion of the primary dose series and a booster dose for the Moderna COVID-19 vaccine.

Individuals aged 18 years or older are now eligible to receive a booster dose of the vaccine 5 months after full vaccination instead of the previous 6-month requirement. Pain, redness and swelling at injection site, fatigue, headache, muscle or joint pain, and chills were among the commonly reported adverse effects for the Moderna booster dose.

World Health Organization Treatment Guidelines2

The World Health Organization (WHO) has updated its COVID-19 treatment guidelines to recommend the use of a Janus-kinase (JAK) inhibitor, baricitinib, to treat COVID-19 in patients with severe disease.

Baricitinib is now strongly recommended following moderate-certainty evidence of a reduced need for ventilation, improved survival rates, and no observed increase in adverse effects. The medication should be used in combination with corticosteroids and is recommended to be used as an alternative to IL-6 inhibitors. IL-6 inhibitors and baricitinib should not be used concomitantly.

However, WHO recommends against 2 other JAK inhibitors, ruxolitinib and tofacitinib, in patients with severe disease, as research has suggested a potential increase in serious adverse effects.

WHO’s Guideline and Development Group has also made a conditional recommendation on the use of the monoclonal antibody sotrovimab. Sotrovimab is to be used in patients with nonsevere COVID-19 who are at high risk of hospitalization.

“The latest recommendations are based on evidence from 7 trials involving over 4000 patients with non-severe, severe, and critical COVID-19,” the researchers concluded. “They add to previous recommendations for the use of interleukin 6 receptor blockers and systemic corticosteroids in patients with severe or critical COVID-19; conditional recommendations for the use of casirivimab-imdevimab, another monoclonal antibody treatment, in selected patients; and recommendations against the use of convalescent plasma, ivermectin, and hydroxychloroquine in patients with COVID-19 regardless of disease severity.”

Omicron Patient Outcomes3

The omicron variant of COVID-19 results in less severe outcomes than prior variants, according to the results of a recent study.

Included were 4468 symptomatic patients seeking care in the Houston Methodist health care system in Houston, Texas, from November 2021 to January 2022.

Individuals with COVID-19 who are infected with the omicron variant are younger, have higher rates of vaccine breakthroughs, and were significantly less likely to be hospitalized compared with patients infected with the alpha or delta variants. These patients also required less-intense respiratory support and required shorter hospital stays.

At 3 weeks following first detection of the omicron variant, 90% of all new COVID-19 cases were due to omicron. At the end of the study period, 98% of all new cases were due to omicron.

 

—Leigh Precopio

 

References:

  1. Coronavirus (COVID-19) Update: FDA shortens interval for booster dose of Moderna COVID-19 vaccine to 5 months. News release. US Food and Drug Administration; January 7, 2022. Accessed February 4, 2022. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-shortens-interval-booster-dose-moderna-covid-19-vaccine-five-months?utm_medium=email&utm_source=govdelivery
  2. Agarwal A, Lamontagne F, Siemieniuk RAC, et al. A living WHO guideline on drugs for COVID-19. BMJ. Published online January 13, 2022. Updated January 13, 2022. https://www.bmj.com/content/370/bmj.m3379
  3. Christensen PA, Olsen RJ, Long SW. Signals of significantly increased vaccine breakthrough, decreased hospitalization rates, and less severe disease in patients with COVID-19 caused by the omicron variant of SARS-CoV-2 in Houston, Texas. Am J Pathol. Published online February 3, 2022. https://ajp.amjpathol.org/article/S0002-9440(22)00044-X/fulltext