Morning Rounds Elizabeth Cooney

Moderna says its Covid-19 vaccine is less potent against one virus variant, but still protective

Moderna is studying adding booster doses to its vaccine regimen after finding its Covid-19 vaccine was less potent against a coronavirus variant first identified in South Africa, the company said yesterday. But despite the reduction in neutralizing antibodies against the variant, called B.1.351, antibody levels generated by its vaccine “remain above levels that are expected to be protective.” Still, the company is going to test whether adding a booster dose to its existing two-dose regimen could increase the levels of neutralizing antibodies even further. It’s also going to investigate a booster specifically designed against B.1.351. “There’s enough cushion with the vaccines that we have that we still consider them to be effective,” NIAID's Anthony Fauci said. STAT's Andrew Joseph has more.

U.S. virus numbers falling, but variants cause concern

The first known case of the P.1 coronavirus variant, first seen in Brazil, was confirmed in Minnesota yesterday. Its identification comes as coronavirus deaths and cases per day in the U.S. — still at alarmingly high levels — have dropped markedly over the past couple of weeks. Recent hot spots have improved, too, prompting California to end a 10 p.m. curfew and to lift regional stay-at-home orders in favor of county-by-county restrictions. But concern about virus variants is growing. “I think we were on track to have a good — or a better, at least — spring and summer, and I’m worried that the variants might be throwing us a curveball,” Johns Hopkins epidemiologist Caitlin Rivers told the Associated Press earlier in the day.

Lifetime smoking history associated with Covid-19 severity

How much someone has ever smoked — even if they’ve quit — has a significant bearing on their risk of becoming hospitalized or dying after Covid-19 infection. A new study that measured smoking in pack years among more than 7,100 Covid-19 patients diagnosed from March through August 2020 found that people who smoked the most were more than twice as likely to need hospitalization and almost twice as likely to die compared with never smokers. Adjusting for other conditions the smokers had lowered the odds somewhat, but the authors maintain that cumulative exposure to cigarette smoke is an independent risk factor for hospital admission and death from Covid-19.

Inside STAT: A growing share of lung cancer cases is turning up in an unexpected population

Mandi Pike, a never-smoker diagnosed with lung cancer, near her home in Edmond, Okla. (NICK OXFORD FOR STAT)

“If lung cancer in never-smokers were a separate entity, it would be in the top 10 cancers in the U.S.” for both incidence and mortality, surgeon Andrew Kaufman of Mount Sinai Hospital in New York told STAT’s Sharon Begley. Sharon died of complications of lung cancer on Jan. 16, just five days after completing this article quoting him. She was a never-smoker. Worldwide, 15% of male lung cancer patients are never-smokers, she wrote, but fully half of female lung cancer patients never smoked. And women never-smokers are twice as likely to develop lung cancer as men who never put a cigarette to their lips. Screening targets smokers, and they also respond better to the breakthrough immunotherapies, though there are signs of change coming, she wrote. Just not fast enough.

1 in 5 people in the U.S. have an STI, the CDC estimates

Sexually transmitted infections are preventable and treatable, yet the most recent U.S. research estimates there were 68 million STIs on any given day in 2018, 26 million of those infections were new, and half of those new infections were in people 15 to 24 years old. The infections also rang up $2.2 billion in costs to the health care system, mostly for treating HIV and HPV. In more human costs, when left untreated, some STIs can increase the risk of HIV infection. They can also cause chronic pelvic pain, pelvic inflammatory disease, and infertility, as well as severe pregnancy and newborn complications. That makes increasing access to quality sexual health care critical, the CDC concludes in a statement.

Reanalysis links low-dose aspirin to better pregnancy outcomes

Researchers taking a second look at whether low-dose aspirin was associated with better pregnancy outcomes after previous pregnancy loss have reached a different conclusion than the original trial: Taking low-dose aspirin at least five days a week was followed by eight more pregnancies, six fewer pregnancy losses, and 15 more births for every 100 women in the trial compared to a placebo. The new study, called a post hoc per protocol analysis, went beyond the original randomized clinical trial of more than 1,200 women that did not find better outcomes. That earlier conclusion did not take into account patients who took aspirin less frequently, the new study’s authors say, sometimes because of nausea or bleeding. The benefits they saw were stronger when aspirin was started before pregnancy and weaker after week six.

Covid-19 in the U.S.

Cases yesterday: 184,905
Deaths yesterday: 3,144


A closing note: We at STAT want to offer our deepest thanks for the outpouring from readers who sent kind, heartfelt notes after Sharon Begley’s passing, and to those who shared memories in the comments on the tributes we published. Many of you asked how you could honor her: A memorial will be organized later in the year, and Sharon's family says that anyone wishing to make contributions in her name can send them to Save the Children or another organization dedicated to helping marginalized populations.

What to read around the web today

  • 'Everything broke': global health leaders on what went wrong in the pandemic. NPR
  • Covid-19 surge leaves doctors, nurses reeling from burnout. Wall Street Journal
  • Proud of vaccine success, Warp Speed’s ex–science head talks politics, presidents, and future pandemics. Science
  • Pandemic gets increasingly local as U.S. cases keep dropping. Bloomberg 
  • Are we screening too much for skin cancer? It’s complicated. Undark

Thanks for reading! More tomorrow,

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Tuesday, January 26, 2021


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