Research Roundup: MIS-C; Repurposed Antiviral Drugs; Tuberculosis; HUS; Typhoid Fever
Each week, KHN compiles a selection of recently released health policy studies and briefs.
American Academy Of Pediatrics:
Multisystem Inflammatory Syndrome In Children: An International Survey
To describe presentation, hospital course, and predictors of bad outcome in multisystem inflammatory syndrome in children (MIS-C). Retrospective data review of a case series of children meeting the published definition for MIS-C who were discharged or died between March 1, 2020, and June 15, 2020, from 33 participating European, Asian, and American hospitals. Data were collected through a Web-based survey and included clinical, laboratory, electrocardiographic, and echocardiographic findings and treatment management. (Bautista-Rodriguez et al, 2/1)
New England Journal of Medicine:
Repurposed Antiviral Drugs For Covid-19 — Interim WHO Solidarity Trial Results
World Health Organization expert groups recommended mortality trials of four repurposed antiviral drugs — remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a — in patients hospitalized with coronavirus disease 2019 (Covid-19). We randomly assigned inpatients with Covid-19 equally between one of the trial drug regimens that was locally available and open control (up to five options, four active and the local standard of care). The intention-to-treat primary analyses examined in-hospital mortality in the four pairwise comparisons of each trial drug and its control (drug available but patient assigned to the same care without that drug). Rate ratios for death were calculated with stratification according to age and status regarding mechanical ventilation at trial entry. (WHO Solidarity Trial Consortium, 2/11)
Also —
CIDRAP:
Phase 2 Data Support Bedaquiline-Delamanid Combo For Resistant TB
The results of a National Institutes of Health-funded phase 2 study indicate the new tuberculosis (TB) drugs delamanid and bedaquiline, when combined, have only a modest effect on the electrical activity of the heart, US, South African, and Peruvian researchers reported last week in the Lancet Infectious Diseases. In the phase 2 randomized controlled trial, patients in South Africa and Peru with multidrug-resistant or rifampicin-resistant TB were randomized 1:1:1 to receive bedaquiline, delamanid, or both for 24 weeks. The two new drugs are considered critical components of a shorter, less toxic regimen for multidrug-resistant and rifampicin-resistant TB, but the cardiac and microbiologic safety of combining the two has not been well-established. (2/15)
CIDRAP:
Neurologic Problems Noted In Children With Hemolytic Uremic Syndrome
Pediatric patients who develop hemolytic uremic syndrome (HUS)—a rare kidney failure that follows an Escherichia coli infection—are at risk for severe acute neurologic symptoms (ANS), according to a study based on almost 4,000 US patients. The findings were published today in Pediatrics. The study was the largest to date to describe ANS following HUS, and showed a strong correlation between increased multiple neurological symptoms and mortality. The authors used the Pediatric Health Information System database to identify HUS-related inpatient visits between 2004 and 2018. (2/15)
CIDRAP:
CDC Issues Health Advisory On Extensively Drug-Resistant Typhoid
The Centers for Disease Control and Prevention (CDC) says that it has identified nine US cases of extensively drug-resistant (XDR) typhoid fever that aren't linked to travel. The news came in a Health Advisory issued late last week by the CDC, which said that, as of Jan 14, it has received 71 reports of XDR typhoid infections in the United States dating back to 2018, when surveillance for the pathogen began. Of the 67 patients with a travel history, 58 reported travel to Pakistan in the 30 days before their illness began. Nine patients from six states reported no travel to Pakistan or any other country. (Dall, 2/15)
