Research Roundup: COVID; Engineered T Cells

CIDRAP: Kidney Disease Tied To High Death Rates In COVID Patients 
COVID-19 patients who have chronic kidney disease (CKD) or develop coronavirus-related kidney injury in the intensive care unit (ICU) face higher odds of death than their otherwise-healthy peers, according to a study published late last week in Anaesthesia. Led by researchers at Imperial College London, the retrospective study involved 372 adult COVID-19 patients in four ICUs in the United Kingdom from Mar 10 to Jul 31. Of the 372 patients, 216 (58%) had kidney impairment, 22% of which was CKD (48 patients) and 78% of which developed during hospitalization (168 patients). (Van Beusekom, 10/19)

PLOS One: Continuous Positive Airway Pressure (CPAP) Face-Mask Ventilation Is An Easy And Cheap Option To Manage A Massive Influx Of Patients Presenting Acute Respiratory Failure During The SARS-CoV-2 Outbreak: A Retrospective Cohort Study
Because of the COVID-19 pandemic, intensive care units (ICU) can be overwhelmed by the number of hypoxemic patients. This single centre retrospective observational cohort study took place in a French hospital where the number of patients exceeded the ICU capacity despite an increase from 18 to 32 beds. Because of this, 59 (37%) of the 159 patients requiring ICU care were referred to other hospitals. From 27th March to 23rd April, consecutive patients who had respiratory failure or were unable to maintain an SpO2 > 90%, despite receiving 10–15 l/min of oxygen with a non-rebreather mask, were treated by continuous positive airway pressure (CPAP) unless the ICU physician judged that immediate intubation was indicated. We describe the characteristics, clinical course, and outcomes of these patients. The main outcome under study was CPAP discontinuation. (Alviset et al, 10/14)

PLOS One: Association Between COVID-19 Prognosis And Disease Presentation, Comorbidities And Chronic Treatment Of Hospitalized Patients
The objective of this study was to analyze the relationship between the prognosis of COVID-19 and the form of presentation of the disease, the previous pathologies of patients and their chronic treatments. (Rodriguez-Molinero et al, 10/15)

PLOS One: Physiological And Socioeconomic Characteristics Predict COVID-19 Mortality And Resource Utilization In Brazil
Given the severity and scope of the current COVID-19 pandemic, it is critical to determine predictive features of COVID-19 mortality and medical resource usage to effectively inform health, risk-based physical distancing, and work accommodation policies. Non-clinical sociodemographic features are important explanatory variables of COVID-19 outcomes, revealing existing disparities in large health care systems. (Wollenstein-Betch et al, 10/14)

CIDRAP: Trial Finds No Significant COVID Effect Of Pre-Exposure Hydroxychloroquine
A randomized, controlled clinical trial involving high-risk healthcare workers found that pre-exposure prophylaxis with hydroxychloroquine once or twice weekly did not significantly reduce COVID-19 compared with placebo, researchers reported late last week in Clinical Infectious Diseases. The randomized, double-blind trial, led by researchers with the University of Minnesota, enrolled 1,483 healthcare workers in the United States and Manitoba from Apr 6 to May 26. Participants were assigned in a 2:2:1:1 ratio to receive 400 milligrams of hydroxychloroquine once weekly or twice weekly for 12 weeks or placebo prescribed in a matched fashion. High-risk healthcare workers were defined as working in an emergency department or intensive care unit, on a dedicated COVID-19 ward, or as a first responder. Overall, 79% of the healthcare workers reported performing aerosol-generating procedures. (10/19)

PLOS One: Residual Clinical Damage After COVID-19: A Retrospective And Prospective Observational Cohort Study
Data on residual clinical damage after Coronavirus disease-2019 (COVID-19) are lacking. The aims of this study were to investigate whether COVID-19 leaves behind residual dysfunction, and identify patients who might benefit from post-discharge monitoring. (De Lorenzo et al, 10/14)

ScienceDirect: Engineered T Cells Directed At Tumors With Defined Allelic Loss 
We describe an approach to cancer therapy based on exploitation of common losses of genetic material in tumor cells (loss of heterozygosity) (Basilion et al., 1999; Beroukhim et al., 2010). This therapeutic concept addresses the fundamental problem of discrimination between tumor and normal cells and can be applied in principle to the large majority of tumors. It utilizes modular activator/blocker elements that integrate signals related to the presence and absence of ligands displayed on the cell surface (Fedorov et al., 2013). We show that the targeting system works robustly in vitro and in a mouse cancer model where absence of the HLA-A*02 allele releases a brake on engineered T cells activated by the CD19 surface antigen. This therapeutic approach potentially opens a route toward a large, new source of cancer targets. (Hamburger et al, 10/1)