Medicine

Vaccine Challenge Trials, Desperate PPE Measures

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Here are the coronavirus stories Medscape’s editors around the globe think you need to know about today:

Vaccine Challenge Trials

More than 32,000 people have volunteered to participate in challenge trials for COVID-19 vaccines, which would involve intentional exposure to SARS-CoV-2 in an attempt to speed up vaccine development and availability.

Bioethicists and physicians are debating the approach, which no vaccine trials are currently using. Advocates of the idea say challenge trials could shave months off development timelines, but others are concerned the extra risk for the volunteers could come at a high cost: their health, or potentially their life.

In a Friday speech, American Medical Association (AMA) president Susan Bailey, MD, said that deliberately exposing people to SARS-CoV-2 “would be unethical.” Trials are recruiting healthcare workers who are exposed to the virus more often than the general public, she said, but to understand how well the vaccines work, “it’s going to take time to see how many people in their regular course of life and work get the virus.”

Desperate PPE Measures

Small, independent practices have struggled to acquire adequate personal protective equipment (PPE) during the pandemic, causing delays in reopening and putting healthcare providers at risk. But nonprofits and medical associations have started stepping in to fill the gap, organizing programs to pool physicians’ orders so they can buy PPE in bulk.

The medical associations collect orders from their members during a 1-week period, then the nonprofit buys the supplies and distributes them. The demand has been greater than the organizers anticipated.

“This is not a long-term solution,” AMA president Bailey said. “We’re just trying to fill the gap and urge the administration to pull every lever it can to ramp up PPE production.”

Testing: Who, When, and How?

Diagnostic testing for COVID-19 is critical, yet who, when, and how to test is not always clear. Medscape has those answers and more in a guide to diagnostic testing.

Fatal Pulmonary Fibrosis

Physicians in Denmark described the case of a woman with COVID-19 who developed fatal pulmonary fibrosis after acute respiratory distress syndrome (ARDS). As many as 42% of hospitalized patients with COVID-19 develop ARDS, which is a known cause of pulmonary fibrosis.

“In practice, what this means for clinicians looking after patients with COVID-19, especially those with ARDS, is that they need to be vigilant for the development of pulmonary fibrosis even after mild disease, and there should be a low threshold for repeating CT scans and lung function in patients who have persisting or worsening breathlessness weeks to months after their acute COVID-19,” one doctor from London commented.

Severe COVID-19 Rare in Children

Critical pediatric COVID-19 is rare, with variable symptoms and generally good outcomes compared with adults, according to preliminary data from the Critical Coronavirus and Kids Epidemiology study.

The researchers are collecting information from 65 pediatric intensive care units in 18 countries, and in a new paper described initial insights from the first 17 children with severe or critical COVID-19 from 10 pediatric intensive care units in Chile, Colombia, Italy, Spain, and the United States.

NIH Remdesivir Clinical Trial Update

A randomized, controlled clinical trial evaluating the safety and efficacy of the immunomodulator interferon beta-1a in combination with remdesivir in COVID-19 patients has begun, the National Institutes of Health (NIH) announced on Thursday. The study, also known as the Adaptive COVID-19 Treatment Trial 3, is aiming to enroll more than 1000 hospitalized COVID-19 patients at about 100 sites globally.

All participants will receive standard doses of remdesivir and either interferon beta-1a or a placebo. Investigators will evaluate whether time to recovery is shorter in the combination therapy group relative to the remdesivir-only group.

FDA Revokes Diagnostic Rapid Test

After issuing an emergency use authorization for Autobio Diagnostics’ Anti-SARS-CoV-2 Rapid Test on April 24, the US Food and Drug Administration (FDA) revoked it on Thursday, according to a letter from Denise M. Hinton, FDA’s chief scientist.

After more testing, the FDA “has concluded that it is unlikely that this test is effective in detecting SARS-CoV-2 IgM antibodies and that the known and potential benefits of its use do not outweigh the known and potential risks,” Hinton wrote.

Trending Clinical Topic: Vitamin D

Results of a study published online in The FEBS Journal showed that low-plasma vitamin D levels are an independent risk factor for COVID-19 infection and hospitalization. This new finding caught our readers’ attention, so we featured it as our latest trending clinical topic.

The Week That Wasn’t in COVID-19

In recent COVID-19 news, scientists experimented with a do-it-yourself vaccine, researchers proposed that a compound extracted from seaweed could be a more effective antiviral than remdesivir, and a study suggested that eating cabbage was associated with lower mortality from COVID-19. But you didn’t see these headlines on Medscape Medical News. Here’s why.

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. Thousands throughout the world have died.

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form.

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Victoria Giardina is Medscape’s editorial intern. She has previously written for The Dr. Oz Show and is currently a national lifestyle writer for Her Campus. She can be reached at vgiardina@webmd.net or on Twitter @VickyRGiardina.

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