Poll: One-Third of US Military Find Exercise Difficult 1 Month After COVID

One-third of active-duty US military service members who tested positive for COVID-19 reported new onset or more difficulty with exercise and daily activities 1 month after diagnosis, but these symptoms declined to levels of pre-infection after 6 to 9 months, according to research presented this week at the Infectious Diseases Society of America (IDSA) Identification Week in Washington, DC.

The research, presented by Stephanie Richard, PhD, of the Uniformed Services University of the Health Sciences, consisted of fitness surveys conducted 1, 3, 6, 9 and 12 months after diagnosis of COVID-19. Of the 5,910 respondents, 55% tested positive for COVID-19 at least once during the study period. More than 75% were young adults and more than half were men.

In addition to the 34.3% of respondents who reported a decrease in exercise tolerance (compared to 14.8% in uninfected participants), 43.2% reported that their results in fitness tests mandated by service were still below normal at 1 year, compared to 24.3% of uninfected participants.

Reports from infected participants of difficulty exercising and performing daily activities were received more often in the month following diagnosis, with the prevalence decreasing slightly, to 24% and 18%, respectively, at 1 year. .

The most common symptoms were shortness of breath and fatigue.

“Contracting COVID-19 can negatively impact functioning, including performing daily activities and exercising,” Richard said in the statement. “Even in a younger and generally healthier population like the US military, the effects of COVID-19 can linger for months and months.”

The surveys also revealed the protective effect of COVID-19 vaccines. “Vaccinated individuals, even if they had breakthrough infections, did not experience as much of a long-term effect on exercise and daily activities,” lead author Simon Pollett, MBBS, also said. from the Uniformed Services University of the Health Sciences. “These findings underscore the value of vaccination, not only in preventing death and disease, but also in preserving long-term quality of life.”
October 20 IDSA press release

Effectiveness of COVID-19 mRNA vaccine in adults drops after 4 months, data show

Estimated vaccine efficacy (VE) of monovalent mRNA COVID-19 vaccines against hospitalization in US adults declined over time, from 79% at 120 days to 41% thereafter during the Omicron-dominant period BA.1/BA.2 and 60% to 29% during BA.4/BA.5 dominance, according to a study published today in Morbidity and Mortality Weekly Report (MMWR).

Unlike the newly licensed bivalent (two-strain) COVID-19 booster vaccines, the monovalent (one-strain) version does not contain mRNA of the currently dominant BA.4/BA.5 subvariants.

The Centers for Disease Control and Prevention (CDC) COVID-19 Emergency Response Team led the study, which compared VE with hospitalization of two, three and four doses of monovalent mRNA vaccine COVID-19 without vaccination in adults with a healthy immune system. from December 26, 2021 to August 31, 2022.

Participants (2,406 infected case-patients and 2,324 uninfected controls) were enrolled at 21 IVY network hospitals in 18 states. The median age of patients during BA.1/BA.2 and BA.4/BA.5 was 65 and 69 years, respectively. Of the patients enrolled in BA.1/BA.2, 34% were unvaccinated, 30% received two doses, 34% received three doses and 2% received four doses.

Of 1,378 patients included during BA.4/BA.5, 27% were not vaccinated, 24% received two doses, 37% received three doses and 12% received four doses. BA.1 became the dominant SARS-CoV-2 subvariant in circulation in December 2021, followed by BA.2 in March 2022 and BA.4/BA.5 in June 2022.

In the middle of BA.1/BA.2, the VE versus hospitalization was 63% 14 to 150 days after a second dose, falling to 34% after 150 days. Similarly, the VE was 79% after a third dose, falling to 41% after 120 days. Seven to 120 days after a fourth dose, the VE was 61%.

Similar trends were observed during BA.4/BA.5, although confidence intervals for VE estimates between time intervals since last dose overlapped. Fourteen to 150 days and more than 150 days after a second dose, the VE was 83% and 37%, respectively.

VE 7-120 days after a third dose was 60%, decreasing to 29% after more than 120 days. Seven to 120 days after a fourth dose, the VE was 61%.

“Eligible adults ≥ 18 years of age should receive an updated bivalent COVID-19 mRNA vaccine to maximize protection against BA.4/BA.5 sublines and to prevent hospitalizations associated with COVID-19,” wrote the researchers.
21st of October MMWR study

Microbiome drug for recurrences it’s hard shows a lasting response

Secondary analysis of Phase 3 trial results shows experimental microbiome treatment reduced recurrence rates Clostridioides difficile (rCDI) for 24 weeks and was well tolerated, researchers reported this week in JAMA.

For the analysis, researchers assessed data on rCDI rates and treatment-related adverse events over 24 weeks from ECOSPOR III, a double-blind, multicenter trial conducted from July 2017 to September 2020. The trial randomized adults with rCDI to receive four daily capsules of SER -109—a therapeutic composed of purified Firmicutes bacterial spores developed by Seres Therapeutics—or a placebo for 3 days. Previously published results showed that SER-109 was superior to placebo for 8 weeks for the treatment of rCDI (defined as three or more episodes in 12 months).

Of the 182 randomized patients, 63 had rCDI for 24 weeks, with a significantly lower proportion in the SER-109 group (19 [21.3%] against 44 [47.3%] patients on placebo). The benefit of SER-109 was evident at week 2.

Treatment-related adverse events (including abdominal distension, constipation and diarrhoea) occurred in 5% of patients, and more frequently in the SER-109 group than in the placebo group. Serious adverse events occurred in 15 patients in the SER-109 group and 19 in the placebo group, but none were considered drug-related. Adverse events were reported in 7 patients (4 in the SER-109 group and 3 in the placebo group).

“These data support a potential role for this therapeutic experimental oral microbiome in the treatment of patients with this debilitating infection,” the authors wrote.
October 19 JAMA search letter
January 21 Analysis of CIDRAP news