Scientists find 'exquisitely potent' antibodies; a blood test may identify who needs steroids

By Nancy Lapid

The following is a brief roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Coronavirus antibodies with "exquisite potency" found

Scientists have found 19 potent antibodies that neutralize the new coronavirus, including nine that exhibit "exquisite potency," according to a study published in Nature. Compared to previously isolated antibodies, some of the new ones target different regions of the so-called spike protein. "Finding antibodies directed to different regions of the spike allows for more/better possibility of forming antibody cocktails to attach the virus and to avoid viral resistance," Dr. David Ho, Director of the Aaron Diamond AIDS Research Center at Columbia University, told Reuters. Furthermore, the newly found antibodies can be easily generated by the immune system, and potentially be used both to treat and prevent infection, he added. "An antibody cocktail could be administered to infected patients early in the course of infection, especially if they are elderly or have underlying chronic conditions," Ho said, citing nursing home residents as an example. "These folks generally do not mount a robust immune response to vaccines, hence antibodies might be an ideal approach." (https://go.nature.com/2ZXZLeU)

With precautions, newborns can stay with infected mothers

A study of 120 babies born to mothers with COVID-19 found no cases of virus transmission during childbirth or after two weeks of breastfeeding and skin-to-skin contact, bolstering the case for newborns to stay with their mothers as long as safety precautions are observed. Early in the pandemic, some experts advised infected mothers to be temporarily separated from their newborns, but more recently the World Health Organization and the American Academy of Pediatrics have said breastfeeding and room-sharing can be safe with appropriate precautions. In the new study, published in The Lancet Child & Adolescent Health on Thursday, the babies were kept in enclosed cribs except during feeding, and mothers wore surgical masks and followed frequent hand and breast washing procedures. "We know that skin-to-skin contact and breastfeeding are important both for mother-infant bonding and for long-term child health," co-author Dr. Patricia DeLaMora of Weill Cornell Medicine-New York Presbyterian said in a news release. "Our findings suggest that babies born to mothers with COVID-19 infection can still benefit from these safely, if appropriate infection control measures are followed." (https://bit.ly/39oUCQk)

Blood test may identify COVID-19 patients who need steroids

A blood test may help identify coronavirus patients who would benefit from steroids early in their illness, researchers said, after a gold-standard trial published last week showed dexamethasone reduced deaths in COVID-19 patients who needed oxygen or mechanical ventilation. In a report in the Journal of Hospital Medicine on Wednesday, doctors said two other widely available steroid drugs are also helpful. They studied more than 1,800 hospitalized COVID-19 patients, including 140 who were treated in the first 48 hours with dexamethasone, prednisone, or methylprednisolone. Overall, the steroids did not appear to reduce rates of mechanical ventilation or death. However, early steroid treatments in patients with high levels of C-reactive protein (CRP) in their blood - indicating high levels of inflammation - reduced the chance of mechanical ventilation by 80% and the risk of death by 77%. Using CRP levels to identify COVID-19 patients who might benefit from steroids is a potentially good idea, the doctors say. But to prove that, and also to see whether different steroids might yield different results, a randomized controlled trial is needed. (https://bit.ly/3jAORUv)

COVID-19 viral loads similar in kids and adults

Children and adults who had been ill with COVID-19 for a few days had similar amounts of the virus in their noses and throats, according to a study posted on medRxiv in advance of peer review. Coronavirus infections are less common and generally milder in children, but their role as COVID-19 carriers is as yet unclear. "Overall, we cannot tell if children are as likely to infect others as adults, but at least from the amount of virus that is found in their upper respiratory tract, biologically it would be possible that they can infect others," said study leader Dr. Isabella Eckerle of the Geneva Centre for Emerging Viral Diseases. She noted that the amount of virus is only one factor among many that contribute to infectiousness, and the study only included sick children, whereas many infected children have no symptoms. (https://bit.ly/2OQ06dz)

Open https://graphics.reuters.com/HEALTH-CORONAVIRUS/yxmvjqywprz/index.html in an external browser for a Reuters graphic on vaccines and treatments in development.