Dr. Melvin Sanicas 🩺🔬 Profile picture
Physician Scientist FRSPH FRSA • #GlobalHealth #InfectiousDiseases • 🎓 UPManila 🇵🇭 HSA 🇸🇬 @LSHTM Leicester 🇬🇧 @UniSiena 🇮🇹 HKS BMGF 🇺🇸 @UniZar 🇪🇸
Patrick D. Profile picture Däbüh Profile picture 2 added to My Authors
8 Jan
#Plasma from recovered #COVID19 patients with high levels of #antibodies appeared to delay / stop progression of illness in mildly ill older adults infected with #SARSCoV2, a study published in @NEJM concluded. 🧵nejm.org/doi/full/10.10…
Researchers at Fundacion INFANT in Buenos Aires, #Argentina, led the small randomized, controlled, double-blind #clinicaltrial of the effects of infusing #convalescent #plasma in 160 older adults within 72 hours of symptom onset, half of whom received the treatment.
The patients were either 75 years and older with or without underlying illnesses, or 65 to 74 years with at least one underlying condition. The trial was stopped early because #COVID19 cases substantially declined in #BuenosAires, precluding continued recruitment.
Read 6 tweets
26 Oct 20
Curious to know the top #ConspiracyTheory themes or #misinformation sub-topics in the #COVID19 #infodemic? Check this out & vaccinate yourself against false information. Excellent study by @Sarah_Evanega @mark_lynas Jordan Adams & Karinne Smolenyak @ScienceAlly #thread 🧵
The “miracle cures” sub-topic accounts for more #misinformation coverage than the other ten sub-topics combined. It is dominated by a peak on April 24 corresponding with President Trump’s press conference statements about the potential of using #bleach or other #disinfectants.
Mentions of #conspiracytheories linked to alleged "secret new world orders” or “deep state” government bodies existed throughout the time period and were referenced in passing in conversations that mentioned or listed widespread conspiracies.
Read 7 tweets
25 Oct 20
The 1st large study looking at #SARSCoV2 viral loads (VL) in asymptomatic children found that viral loads (VL) were significantly lower compared with symptomatic kids - consistent with the difference in median cycle threshold (Ct) values - 10.3 cycles - between the 2 groups.
Findings published in @JClinMicro were consistent across age (0 - 17 yo), race / ethnicity, sex, institution, although the researchers found that both magnitude of Ct difference & VL lessened with older subgroups. #PCR tests were used for initial #COVID19 detection.
Median adjusted Ct value was 8.6 cycles in asymptomatic children vs. -1.7 cycles in symptomatic kids. Median VL was 2.0 X 103 in asymptomatic children & 1.3 X 107 in symptomatic children. Asymptomatic children with diabetes were most likely to be in the top 25% of asymptomatic VL
Read 4 tweets
9 Jul 20
#Airborne transmission: defined as the spread of an infectious agent caused by the dissemination of droplet nuclei (#aerosols) that remain infectious when suspended in air over long distances & time. What do we know about this route for #COVID19 #SARSCoV2? A #thread 🧵
Experimental studies have generated #aerosols of infectious samples using high-powered jet nebulizers under controlled laboratory conditions. #SARSCoV2 #Covid_19 #IDtwitter
Some studies in #healthcare settings where symptomatic #COVID19 patients were cared for but where #aerosol generating procedures were not performed found #SARSCoV2 #RNA but the quantity of RNA detected was in extremely low numbers. #airborne #transmission
Read 4 tweets
29 Apr 20
At least 7 teams are developing #SARSCoV2 #vaccines using a weakened / inactivated virus. Several existing vaccines are made this way, i.e. #measles & #polio #vaccine. Sinovac Biotech started to test an inactivated SARS-CoV-2 #COVID19 vaccine. #scicomm
At least 25 groups are working on viral-vector #SARSCoV2 #COVID19 #vaccines. A #virus such as #measles or #adenovirus is genetically engineered so it can produce #coronavirus #proteins in the body. These #viruses are weakened so they CANNOT cause disease.
At least 20 teams are using genetic instructions (#DNA or #RNA) for a #SARSCoV2 #coronavirus #protein that prompts an immune response. The nucleic acid is inserted into human cells, which churn out copies of the #virus protein; most encode the virus’s spike protein. #COVID19
Read 5 tweets
25 Apr 20
Some have suggested that detection of #SARSCoV2 antibodies could be a basis for an “immunity passport” / “risk-free certificate” that will enable individuals to return to work. Currently, there is no evidence those who have recovered from #COVID19 are protected from re-infection.
Immunity to a pathogen through natural infection is a multi-step process that usually takes place over 1-2 weeks. The body responds to a viral infection immediately with a non-specific innate response: macrophages, neutrophils, dendritic cells slow the progress of the virus.
This non-specific response is followed by an adaptive response i.e. body makes #antibodies that specifically bind to the #virus. These #antibodies are proteins called #immunoglobulins. The body also makes T-cells that recognize & eliminate other cells infected with the virus.
Read 8 tweets
23 Apr 20
A #thread on the origin of the Severe Acute Respiratory Syndrome #coronavirus-2 #SARSCoV2, the #virus causing #COVID19. SARS-CoV-2 was identified early January 2020; genetic sequence shared publicly on 11 January. #scicomm [image 감사합니다 @IBS_media] @Virologist_11 @dirgarambe
Full genetic sequence of #SARSCoV2 from early human cases & sequences of other virus isolated from human cases from China & all over the world since then show that SARS-CoV-2 has an ecological origin in #bats.
All available evidence to date suggests that #SARSCoV2 #coronavirus has a natural animal origin and is not a manipulated or constructed virus. nature.com/articles/s4159…
Read 8 tweets
13 Apr 20
There is no evidence that the Bacille Calmette-Guérin (BCG) #vaccine protects people against #infection with #SARSCoV2 #coronavirus causing #COVID19. But, 2 #clinicaltrials addressing this question are underway. WHO does not recommend BCG vaccine for the prevention of COVID-19.
There is EXPERIMENTAL evidence from animal & human studies that #BCG #vaccine has non-specific effects on the immune system. These effects have not been well characterized; clinical relevance is unknown. WHO updated its evidence review of major scientific databases on this topic
The review yielded 3 pre-prints (before peer-review), where authors compared incidence of #COVID19 cases in countries where the #BCGvaccine is used vs. countries where it is not used & observed countries that routinely used BCG in neonates had less #COVID19 cases to date.
Read 7 tweets
11 Apr 20
This is not a randomized controlled trial. It's a publication summarizing results of 53 #COVIDー19 patients given #remdesivir (compassionate-use). Clinical improvement observed in 36 / 53 (68%). Randomized, placebo-controlled trials should be done next. nejm.org/doi/full/10.10…
Patients were enrolled in the United States (22 patients), Japan (9), Italy (12), Austria (1), France (4), Germany (2), Netherlands (1), Spain (1), Canada (1). At baseline, majority of patients were receiving invasive ventilation, 57% receiving mechanical ventilation, 8% ECMO.
For each oxygen-support category, percentages were calculated with the number of #COVIDー19 patients at baseline as the denominator. Improvement (blue cells), no change (beige) and worsening (gray) in oxygen-support status are shown.
Read 11 tweets
9 Apr 20
We need some #GoodNews. Yes, this is a study in mice but this is so far the first peer-reviewed #coronavirus #vaccine study with promising results in @EBioMedicine published by @TheLancet from @PittTweet @UPMCnews @PittHealthSci vaccinologists
When tested in mice, the #vaccine, delivered through a fingertip-sized patch, produces #antibodies specific to #SARSCoV2 #virus. Researchers were able to act quickly because they already laid the groundwork during earlier #coronavirus #epidemics.
Compared to the experimental #mRNA #vaccine that entered clinical trials, this one - called #PittCoVacc, short for #Pittsburgh #Coronavirus Vaccine - follows a more established approach, using lab-made pieces of viral protein to build immunity (same way current #flu shots work)
Read 8 tweets
8 Apr 20
Although related to the Severe Acute Respiratory Syndrome (#SARSCoV) & the Middle East Respiratory Syndrome (#MERS), #COVID19 virus #SARSCoV2 shows some peculiar pathogenetic, epidemiological & clinical features which have not been completely understood to date.
#SARSCoV2 is more phylogenetically related to #SARSCoV than to #MERS. Only minor differences have been found in the #genome sequences of SARS-CoV-2 comparing with SARS-CoV. SARS-CoV-2 affinity for angiotensin converting enzyme 2 (#ACE2) receptor is higher than in SARS-CoV.
Read 9 tweets
3 Apr 20
#Thread on symptomatic, pre-symptomatic, asymptomatic #transmission. A symptomatic #COVID19 case is a patient who developed signs & symptoms compatible with #SARSCoV2 #coronavirus #infection. Symptomatic transmission refers to transmission from a person experiencing symptoms.
Data from published epidemiology & virologic studies provide evidence that #COVID19 is PRIMARILY transmitted from symptomatic people to others in close contact through respiratory droplets, by direct contact with infected persons or by contact with contaminated objects & surfaces
This is supported by experiences shared by WHO technical partners & presentations by Ministries of Health. Data from studies that have collected repeated samples from patients show that #COVID19 shedding is highest in upper respiratory tract early in the course of the disease.
Read 11 tweets
28 Mar 20
Lessons from past #coronavirus & #influenza #epidemics suggest that #viral #infections can trigger acute coronary syndromes, arrhythmias, exacerbation of heart failure owing to a combination of a significant systemic inflammatory response plus localized vascular inflammation.
#COVID19 may either induce new cardiac pathologies &/or exacerbate underlying cardiovascular diseases. A large proportion of patients have underlying cardiovascular disease &/or cardiac risk factors. Factors associated with mortality include male sex, advanced age, comorbidities.
Acute cardiac injury determined by elevated high-sensitivity #troponin levels is commonly observed in severe #COVID19 cases & strongly associated with mortality. Acute respiratory distress syndrome is also strongly associated with mortality in patients with #SARSCoV2 infection
Read 6 tweets
9 Mar 20
The death rate is NOT a biological constant. It is not fixed to a pathogen. It reflects the severity of the disease in a particular context, at a particular time, in a particular population. The probability that one dies from a disease is not only dependent on the disease itself.
It also reflects the social AND individual response to it: the level, quality, AND timing of treatment / care they receive, and the ability of the given individual to recover from it. Remember the epidemiological triangle? #epitwitter #scicomm
There are a number of rates, risk, ratios important in an #outbreak. The fatality rates can decrease or increase over time, and that it can vary by location and by the characteristics of the infected population (age, sex, pre-existing conditions). #scicomm #COVID2019 #COVID19
Read 4 tweets
6 Mar 20
As the #COVID19 #outbreak evolves, comparisons have been made with #influenza. Both cause respiratory disease but there are important differences between #SARSCoV2 #virus causing COVID-19 & the influenza virus causing the #flu [from WHO COVID situation report 06.03.2020] #scicomm
Similarity #1. Both #COVID19 & the #flu have a similar disease presentation. Both cause respiratory disease, which presents as a wide range of illness from asymptomatic or mild through to severe disease and even death.
Similarity #2. Both #SARSCoV2 & #influenza viruses are transmitted by contact, droplets & fomites so same #publichealth measures (hand hygiene, good respiratory etiquette (coughing into elbow / into a tissue, immediately disposing of the tissue) are important to prevent infection
Read 13 tweets
28 Feb 20
🧼🚰🙌🏻#Handwashing with soap & water removes germs (i.e. #SARS_CoV_2 that causes #COVID19) from hands. This helps prevent infections because people frequently touch their 👀👃🏻👄without even realizing it. Germs can get into the body through the eyes, nose, mouth & make us sick.
Germs from unwashed hands can get into food & drinks while people prepare / consume them. Germs can multiply in some types of food / drinks, under certain conditions, and make people sick. [h/t Donna Gill Allen] #handwashing #scicomm iflscience.com/chemistry/this…
Germs from unwashed hands can be transferred to other objects, like handrails, table tops, or toys, and then transferred to another person’s hands. #handwashing #scicomm [h/t US CDC]
Read 7 tweets
26 Feb 20
There's a seasonality to many respiratory #viruses. Will #SARSCoV2 [#COVID19] follow a similar pattern? We hope so BUT we don't really know. We know when air is humid / warm ➡️droplets gather more moisture ➡️too heavy to stay airborne / fall more quickly➡️transmission harder. Image
There was a significant correlation between #SARS cases & environmental temperature. A sharp rise or decrease in the environmental temperature related to the cold spell led to an increase of SARS cases because of the possible influence of the weather on the human immune system. Image
Plus the winter season has a profound effect on how human #genes work - this may explain why some illnesses are aggravated in the #winter. During cold, winter months, genes involved with #immunity & specifically #inflammation were more active. nature.com/articles/ncomm…
Read 6 tweets
21 Feb 20
About 60% of newly emerged & re-emerging pathogens share a common origin: #animals. When we cut down the forests where they live, they roost in our backyards & farms instead. #OneHealth @dirgarambe @mdkimhsdubai @Virologist_11
@dirgarambe @mdkimhsdubai @Virologist_11 #Marburg #virus 1970s-80s: cases in #SouthAfrica & #Kenya. 1998: 2nd biggest outbreak - 154 cases in the #DRCongo. 2005: biggest outbreak - #Angola with 374 cases with 329 deaths (fatality rate: 88%). 2017: outbreak in #Uganda contained through early detection & response.
@dirgarambe @mdkimhsdubai @Virologist_11 #Ebola #virus 2014–16: #outbreak started in #Guinea & moved to #SierraLeone #Liberia - largest since the virus was first discovered in 1976. Current 2018-19 outbreak in eastern #DRCongo (#Zaire species) - highly complex, with insecurity adversely affecting #publichealth response.
Read 7 tweets
24 Jan 19
Origins of the "Vaccines cause autism" hoax. In 1998, Andrew Wakefield released a paper claiming to have linked the measles, mumps, and rubella (MMR) vaccine to the onset of autism. His work has since been described as “the most damaging medical hoax of the last 100 years."
Wakefield also had major financial conflicts of interest. While he was discrediting the combination MMR vaccine and suggesting parents should give their children single shots over a longer period of time, he was filing patents for single-disease vaccines.
The General Medical Council (the UK’s medical regulator) found that he had paid children at his son’s 10th birthday party to donate their blood for his research.
Read 7 tweets