In COVID-19 clinical update #115, Dr. Griffin reviews cross-variant immunity without vaccination, EUA for boosters in 5-11 year olds, B.1.1.529 attack rate, scent dogs, Omicron and pets, Paxlovid, Veklury, Fluvoxamine, antigen positivity after isolation, inflammasome activation and severe disease, and GI persistence and fecal shedding.
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Links for this episode
- Limited cross-variant immunity without vaccination (Nature) 7:01
- EUA for boosters in 5-11 year olds (FDA) 8:02
- Stages of COVID-19 (AIDS Rev) 8:40
- B.1.1.529 attack rate in Australia (JID) 11:13
- Scent dogs (BMJ) 16:11
- Does Omicron affect pets? (CVMBS News) 18:59
- Paxlovid eligibility checklist (FDA) 23:02
- Supratherapeutic tacrolimus with nirmatrelvir/ritonavir (Op For Inf Dis) 24:33
- Is longer Paxlovid needed? (Reuters) 26:01
- How about Veklury? (Gilead) 28:02
- Fluvoxamine declined (FDA) 31:14
- Antigen positivity after isolation (MMWR) 36:26
- Inflammasome activation drives COVID-19 pathology (TWiV 900, Nature) 50:40
- PASC and viral antigen persistence in gut (Gastroenterol) 53:11
- GI symptoms and fecal shedding (Med) 51:42
- Contribute to ASTMH fundraiser at PW 56:48
- Dr. Griffin’s treatment guide (pdf)
- Letters read on TWiV 901 57:21
- Timestamps by Jolene. Thanks!
Intro music is by Ronald Jenkees
Send your questions for Dr. Griffin to daniel@microbe.tv
Paxlovid…family member took it after trip across country, symptoms on day 4. Tested positive. Teledoc prescribed it; Two years ago, Z-pack worked in 5 days. This time, doc refused that med. Seemed better but now two days after pills gone going back to when it started: Congested, fatigue. But since it’s experimental is it really worth taking another round? Not so much.
Dofetilide, brand name Tikosyn (Pfizer), is a potassium channel blocker given for the prevention of atrial fibrillation and it metabolized through the P450 CYP3A4 pathway. Increased levels lead to prolonged QT intervals and torsades de pointes, a difficult to treat and potentially fatal ventricular arrhythmia. Dofetilide is not included specifically on the FDA list of Paxlovid drug interactions. Please mention this as it is a potentially fatal interaction with a drug that is most often given to elderly patients which would also be eligible for Paxlovid. These patients should be given remdesivir or molnupiravir.