COVID-19 Update: Lung Transplant, Antibody Cocktail Trial

Ellie Kincaid

June 12, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Here are the coronavirus stories Medscape's editors around the globe think you need to know about today:

Lung Transplant 

A woman in her 20s received a double-lung transplant last week after the coronavirus damaged her respiratory system, Northwestern Medicine in Chicago announced on Thursday. Such procedures have been done for COVID-19 patients in China and Europe, but this appears to be the first in the United States, The Washington Post reported

The woman spent 6 weeks in the hospital's COVID ICU on a ventilator and life support, and developed additional bacterial infections. In early June, her lungs developed irreversible damage, and she was listed for a double transplant. After surgery, she is recovering in intensive care and is awake, eating, and talking to family members by phone, her physician told the Post.

Human Testing of COVID-19 Antibody Cocktail Begun

Regeneron Pharmaceuticals has begun human testing of its experimental antibody cocktail as a treatment for COVID-19, Reuters reports. Earlier this week, Eli Lilly also announced the beginning of human trials of experimental antibody treatments for COVID-19. 

Regeneron is testing its dual antibody, called REGN-COV2, against a placebo treatment in hospitalized COVID-19 patients, and in COVID-19 patients who are symptomatic but not hospitalized. The company also plans to study REGN-COV2 for preventing infection in people at high risk for exposure, such as healthcare workers. 

"If it goes perfectly well, within a week or two we will move to the second phase," Chief Scientific Officer George Yancopoulos told Reuters of the adaptive trial that has begun. "Within a month or so of that we will have clear data that this is or isn't working. By the end of summer, we could have sufficient data for broad utilization."

Noninvasive Ventilation for AHRF

Helmet or face-mask noninvasive ventilation may help patients survive acute hypoxemic respiratory failure (AHRF) or avoid endotracheal intubation, a new study shows. Researchers conducted a systematic review and network meta-analysis of 25 randomized clinical trials with 3804 participants and looked at all-cause mortality at the longest time point during the first 90 days after randomization. 

"There are multiple options alternative to standard oxygen which seem to be better," the lead author said. "All of these interventions could be effective, but clinicians need to know that none of these interventions should [ever] delay timely intubation."

CDC Emphasizes Pandemic Is Not Over

In the agency's first media briefing in more than 3 months, officials from the Centers for Disease Control and Prevention (CDC) warned that the COVID-19 pandemic is not over, and discussed two new sets of recommendations for deciding to go out and attending group gatherings.

"Our recommendations evolved based on new information that becomes available," CDC Director Robert Redfield, MD, said, "but it continues to be extremely important that we embrace the recommendations of social distancing, handwashing, and wearing a face covering when we're in public as some of the key defenses that we have against this virus." 

Mouthwash to Reduce Spread of COVID-19?

After reviewing evidence from more than 100 articles, researchers have concluded that some oral rinses have potential to help curb the spread of SARS-CoV-2, but more research is "desperately" needed

It is possible that dampening down the levels of shed virus, even transiently, may have an impact on transmission of disease to vulnerable people or to healthcare professionals who routinely work in the upper airway, such as ear, nose, and throat surgeons, anesthetists, and dentists, one of the researchers said. 

"This idea needs testing in clinical trials where the impact of oral rinsing on the number of infectious virions is tested before and after rinsing, and if there is an effect, how long the effect persists would then need to be determined," he added.

Trending Clinical Topic: Asymptomatic COVID-19 

The World Health Organization came under fire earlier this week when one of its experts suggested that asymptomatic transmission of SARS-CoV-2 was rare. Anthony Fauci, MD, from the White House Coronavirus Task Force, criticized the remarks, and the organization quickly walked the comments back. Our Reference team sums up what you need to know

"Unwitting Transmission"

For his part, epidemiologist Bill Hanage, PhD, from the Harvard T. H. Chan School of Public Health, proposes that "unwitting transmission" is a better way of communicating with the public about the issue of SARS-CoV-2 spread from people who don't know they are infected because they may be presymptomatic or not have classic COVID-19 symptoms. 

"It is unarguable that this is a major contributor to the pandemic spread, even if few infections remain wholly without symptoms," he writes

Nepal's Young Testing Leader

Thirty-one-year-old Ranjit Sah, MD, is one of Nepal's very few infectious disease specialists. He was the physician who recognized the constellation of symptoms in the country's first patient with COVID-19, and built his lab, previously focused on influenza research, into the biggest SARS-CoV-2 diagnostic operation in Nepal.

"If there were many experts, then probably I would not be here," Sah told Medscape Medical News . "But there are not." 

The Week That Wasn't 

This week in COVID-19 news, researchers posited that oral famotidine was associated with improved outcomes for nonhospitalized patients with COVID-19, a simulation study illustrated how viral DNA spread through a hospital from a single source, and N95 manufacturer 3M sued an Amazon merchant for selling its masks at a double-digit markup. But you didn't see these headlines on Medscape. Here's why.

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. More than 1000 throughout the world have died. 

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Ellie Kincaid is Medscape's associate managing editor. She has previously written about healthcare for Forbes, the Wall Street Journal, and Nature Medicine. She can be reached at ekincaid@medscape.net or on Twitter @ellie_kincaid .

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