Pediatric use of Covid-19 antibody drugs not advised by experts

The following is a 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.

Experts advise against antibody drugs in pediatric Covid-19

As of now, antibody therapies for Covid-19 should not be used to treat infections with the new coronavirus in children or adolescents, "including those ... at high risk of progression to hospitalization or severe disease," according to a panel of experts from 29 hospitals across North America who reviewed the available evidence.

The antibody drugs - bamlanivimab from Eli Lilly and Co and the combination of casirivimab plus imdevimab from Regeneron Pharmaceuticals - were authorized in November by the US Food and Drug Administration for emergency use in certain groups of adolescents and adults with mild-to-moderate Covid-19.

But in a paper published on Sunday in the Journal of the Pediatric Infectious Diseases Society, the panel of experts said: "The course of Covid-19 in children and adolescents is typically mild and there is no high-quality evidence supporting any high-risk groups.

There is no evidence for safety and efficacy of monoclonal antibody therapy for the treatment of Covid-19 in children or adolescents, limited evidence of modest benefit in adults, and evidence for potential harm."

Disinfecting during pandemic puts asthmatics at risk

Increased cleaning by people with asthma during the pandemic may be triggering flares of their disease, a new report suggests. Researchers who surveyed 795 US adults with asthma between May and September found the proportion who disinfected surfaces with bleach at least five times a week rose by 155% after the pandemic started.

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Use of disinfectant wipes, sprays, and other liquids also increased, the researchers reported in the Journal of Allergy & Clinical Immunology: In Practice. After accounting for other behaviors and risk factors, higher odds of having uncontrolled asthma were linked with greater household use of disinfectant wipes, disinfectant sprays, bleach and water solutions, and other disinfecting liquids.

The study does not prove that increased frequency of disinfecting caused uncontrolled asthma. Still, the authors say, people with asthma need safer cleaning options. The US Centers for Disease Control and Prevention advises asthmatics to ask someone else to clean and disinfect surfaces and to stay in another room when cleaners or disinfectants are used and right afterward. It also said soap and water may be sufficient for surfaces and objects that are seldom touched.

News reports paint an overly rosy picture of blood treatment

News reports about critically ill Covid-19 patients treated with a last-ditch procedure known as extracorporeal membrane oxygenation, or ECMO, maybe painting an unrealistic picture of outcomes, a study suggests. During ECMO, blood is pumped outside of the body through a machine that removes carbon dioxide and adds oxygen before returning the blood back to the body.

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In a review of media reports about ECMO treatment of Covid-19, doctors found that 92% of patients in the stories survived, whereas average survival rates after ECMO in large studies have ranged from 53% in children to 63% in young and middle-aged adults.

Patients receiving the ECMO treatment "remain at substantial risk" of complications and death, but most news reports of Covid-19 patients treated with ECMO did not address these risks, the researchers said on Monday in JAMA Internal Medicine.

They say recognition of the exaggerated benefit suggested by media reports may help intensive care unit doctors, patients and families have more realistic discussions about prognosis after ECMO.