COVID-19 Roundup

New COVID-19 Treatment Guidelines Released, Spring Booster Recommended for Older Adults, and More

Jessica Ganga

New (and Final) Treatment Guidelines for COVID-19 Released by NIH1

On February 29, the NIH released a final set of COVID-19 treatment guidelines that outline the clinical management, critical care, and treatment of the disease in adult and pediatric patients.

“For close to 4 years, the COVID-19 Treatment Guidelines Panel (the Panel) has critically reviewed the growing body of research data on COVID-19 and used that information to develop and revise their recommendations for treating patients with this disease. The Panel has released a total of 72 versions of the Guidelines,” stated the Panel.

The 478-page document is available to download until August 16, 2024, when the NIH COVID-19 website will be shut down for good.

For the final version of the guidelines, the Panel reviewed several sections that were not updated back in December 2023. According to the Panel, as of February 2024, the information in every section is current.

The guidelines cover topics spanning from the therapeutic management of COVID-19 in patients, to antiviral agents approved for treatment, to special considerations in patients who are immunocompromised.

“The Panel members hope these Guidelines have been of value to health care providers, and they appreciate the support and input they have received over the past 4 years,” wrote the Panel.

Effectiveness of the COVID-19 Vaccine in Preventing Long COVID in Children2

In a retrospective cohort study, a team of researchers estimated the vaccine effectiveness against long COVID in pediatric patients aged 5 to 17 years old.

The researchers used data from 17 health systems in the RECOVER PCORnet electronic health record program, looking at visits after vaccine availability. Both symptom-based and diagnosed long COVID after vaccination cases were examined by the researchers.

Of the more than 1 million children in the study’s cohort, the vaccination rate was 67%. The incidence of symptom-based long COVID was 4.5%, whereas diagnosed long COVID was 0.8%. Further, adjusted vaccine effectiveness within 12 months was 35.4% (95% CI, 24.5 to 44.7) against probable long COVID and 41.7% (15% to 60%) against diagnosed long COVID.

Additionally, vaccine effectiveness was higher for adolescents compared with children aged 5 to 11 years old. Vaccine effectiveness was higher for pediatric patients at 6 months (61.4%) but decreased at 18 months (10.6%).

“Our results provide substantial evidence in a large and diverse cohort of children receiving health care for protective effect of vaccination in children 5 years and older,” the authors concluded. “This study adds to the growing body of knowledge about the mitigating effect of vaccines on COVID-19 while demonstrating the need for further research utilizing a range of designs to examine the protective effect of these vaccines against subsequent strains and to help guide vaccine policy.”

Spring 2024 Booster Shot Recommended for Older Adults by CDC3

The CDC recommended that adults aged 65 years or older should receive a COVID-19 booster shot in spring 2024, according to a recent article.

“Most COVID-19 deaths and hospitalizations last year were among people aged 65 years or older. An additional vaccine dose can provide added protection that may have decreased over time for those at highest risk,” said Mandy K. Cohen, MD, MPH, Director of the CDC, in an article.

Between October and December 2023, adults in this age group received more than half of the COVID-19 vaccine, according to the article.

Dr Cohen concurred with the recommendation, which was made by the CDC’s Advisory Committee on Immunization Practices (ACIP). The ACIP voted 11 to 1 to approve the recommendation, as some members noted older adult patients were asking about upcoming spring boosters.

Study Shows COVID-19 Vaccination Safe for Pregnant Individuals, Infants4

Administering a COVID-19 vaccine to a patient who is pregnant is safe for both the mother and for infant neurodevelopment to 18 months of age, according to a study.

The researchers included a total of 2487 pregnant persons at less than 10 weeks’ gestation. In total, 2261 infants aged 12 months and 1940 infants aged 18 months with neurodevelopmental assessments were included in the study. Participants self-enrolled online and all study activities were performed remotely. The researchers evaluated differences in scores on the Ages and Stages Questionnaire, third edition.

During their analysis, researchers found that 471 of 1541 exposed infants (30.6%) screened abnormally for developmental delay at 12 months vs 203 of 720 unexposed infants (28.2%). The corresponding prevalences at 18 months were 22 of 1301 exposed infants (20.1%) vs 148 of 639 unexposed infants (23.2%).

The study had several limitations. Since the study used a digital recruitment strategy, volunteer bias may have impacted the distribution of participant characteristics, which in turn limited extrapolation. Further, imperfect retention may have posed another source of selection bias.

 

References:

  1. What’s new in the guidelines. NIH: COVID-19 Treatment Guidelines. February 29, 2024. Accessed March 12, 2024. www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new/
  2. Razzaghi H, Forrest CB, Hirabayashi K, et al. Vaccine effectiveness against long COVID in children. Pediatrics. Published online March 8, 2024. doi: 10.1542/peds.2023-064446
  3. Feller S. CDC recommends spring COVID-19 booster shot for older adults. Healio. February 28, 2024. Accessed March 15, 2024. www.healio.com/news/infectious-disease/20240228/cdc-recommends-spring-covid19-booster-shot-for-older-adults
  4. Jaswa EG, Cedars MI, Lindquist KJ, et al. In utero exposure to maternal COVID-19 vaccination and offspring neurodevelopment at 12 and 18 months. JAMA Pediatr. 2024;178(3):258-265. doi:10.1001/jamapediatrics.2023.5743