Research Roundup: COVID; Brain Death; MRSA; Sinusitis; And More

SciTechDaily: COVID-19 Breakthrough: Scientists Identify Possible “Achilles’ Heel” Of SARS-CoV-2 Virus
In the case of an infection, the SARS-CoV-2 virus must overcome various defense mechanisms of the human body, including its non-specific or innate immune defense. During this process, infected body cells release messenger substances known as type 1 interferons. These attract natural killer cells, which kill the infected cells. One of the reasons the SARS-CoV-2 virus is so successful — and thus dangerous — is that it can suppress the non-specific immune response. In addition, it lets the human cell produce the viral protein PLpro (papain-like protease). PLpro has two functions: It plays a role in the maturation and release of new viral particles, and it suppresses the development of type 1 interferons. The German and Dutch researchers have now been able to monitor these processes in cell culture experiments. Moreover, if they blocked PLpro, virus production was inhibited and the innate immune response of the human cells was strengthened at the same time. (Goethe University Frankfurt, 8/2)

JAMA: Determination Of Brain Death/Death By Neurologic Criteria: The World Brain Death Project 
This report provides recommendations for the minimum clinical standards for determination of brain death/death by neurologic criteria in adults and children with clear guidance for various clinical circumstances. The recommendations have widespread international society endorsement and can serve to guide professional societies and countries in the revision or development of protocols and procedures for determination of brain death/death by neurologic criteria, leading to greater consistency within and between countries. (Greer et al, 8/3)

CIDRAP: Trial Evaluates Antibiotic Combination For MRSA Bacteremia, Endocarditis
A randomized phase 3 trial found that the combination of daptomycin and fosfomycin provided higher treatment success than daptomycin alone for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and endocarditis, but the difference did not reach statistical significance, Spanish researchers reported yesterday in Clinical Infectious Diseases. The open-label superiority trial was conducted in 18 Spanish hospitals, with patients randomly assigned to receive either 10 milligrams (mg) of intravenous daptomycin per kilogram daily plus 2 grams of intravenous fosfomycin every 6 hours or 10 mg of daptomycin per kilogram daily. The primary endpoint was treatment success 6 weeks after the end of therapy. Secondary endpoints included microbiological failure, complicated bacteremia, and adverse events leading to treatment discontinuation. (7/30)

CIDRAP: Health Workers, Especially Minorities, At High Risk For COVID, Even With PPE
At the peak of the pandemic in the United States and the United Kingdom, frontline healthcare workers (HCWs) who had adequate personal protective equipment (PPE) were still at more than three times the risk of COVID-19 infection than the general public—even after accounting for differences in testing frequency, according to a study published late last week in The Lancet Public Health. (8/3)

American Academy Of Pediatrics: Race, Postoperative Complications, And Death In Apparently Healthy Children 
Even among apparently healthy children, being AA is strongly associated with a higher risk of postoperative complications and mortality. Mechanisms underlying the established racial differences in postoperative outcomes may not be fully explained by the racial variation in preoperative comorbidity. (Nafiu et al, 8/1)

American Academy Of Pediatrics: International Practice Patterns Of Antibiotic Therapy And Laboratory Testing In Bronchiolitis
The rate of antibiotic use in bronchiolitis was low across networks and was associated with CXR, fever, and apnea. Nonindicated testing was common outside of the United Kingdom and Ireland and varied across networks irrespective of patient characteristics. (Zipursky et al, 8/1)

American Academy Of Pediatrics: Opioids Or Steroids For Pneumonia Or Sinusitis
School-aged children received opioid and steroid prescriptions for pneumonia or sinusitis at a higher frequency in the ED versus the ambulatory setting. (Phang et al, 8/1)