Single dose of Pfizer BioNTech vaccine reduces asymptomatic infections and potential for SARS-CoV-2 transmission

New data from Addenbrooke’s Hospital suggests that a single dose of the Pfizer BioNTech vaccine can reduce by 75% the number of asymptomatic SARS-CoV-2 infections.

This implies that the vaccine could significantly reduce the risk of transmission of the virus from people who are asymptomatic, as well as protecting others from getting ill.

The study analysed results from thousands of COVID-19 tests carried out each week as part its screening programmes on hospital staff who showed no signs of infection.

The results were then separated out to identify unvaccinated staff, and staff who had been vaccinated more than 12 days prior to testing (when protection against symptomatic infection is thought to occur). The study found that 0·8% of tests from unvaccinated healthcare workers were positive, compared with 0.37% of tests from healthcare workers less than 12 days post-vaccination and 0·2% from healthcare workers at 12 days or more post-vaccination.

This suggests a four-fold decrease in the risk of asymptomatic COVID-19 infection amongst healthcare workers who have been vaccinated for more than 12 days (75 percent protection). The level of asymptomatic infection was also halved in those vaccinated for less than 12 days.

When the team included symptomatic healthcare workers, their analyses showed similar reductions. 1·71% unvaccinated healthcare workers tested positive, compared with 0·4% healthcare workers at 12 or more days post-vaccination.

This is an abridged version of the press release which was first published on our website on March 2, 2021.

Cambridge trial targets immune response to treat COVID-19 patients

TACTIC -R Logo

A new national study, supported by the NIHR Biomedical Research Centre: Cambridge and the Cambridge Clinical Trials Unit, will test whether two drugs that are already in use to treat other immune-related conditions can prevent the development of severe COVID-19 infection.

The TACTIC-R trial will target patients as they are admitted to hospital, and test whether drugs that suppress the immune system can prevent the body from ‘over-reacting’ to infection and destroy healthy tissues as well as virus-infected ones, leading to severe COVID-19 disease.

For the majority of people who have COVID-19, the infection causes only mild symptoms including a fever and cough. However, around 15% of patients develop severe disease, which includes serious damage to the lungs and multiple organ failure. This lung and organ damage appears to be mostly caused by the body’s own immune system responding to the presence of infected cells. Researchers hope that preventing the immune ‘over-reaction’ using drugs that stop or ‘suppress’ the immune response will stop patients developing the severest form of COVID-19, preventing the need for intensive care.

TACTIC will initially test two drugs – Ravulizumab and Baricitinib – that used to treat other conditions caused by an overactive immune system.

Ravulizumab is usually used to treat autoimmune conditions where the body destroys red blood cells.

Baricitinib is used to treat people with rheumatoid arthritis.

Both these drugs have been carefully selected by a consortium of doctors and scientists with expertise in treating immune-mediated diseases, and are thought to have a high chance of reducing the immune ‘over-reactions’ seen in very sick patients with COVID-19.

This is an abridged version of the news story that was first published on our website on 16 May 2020.

Speeding up the diagnosis of COVID-19 in a hospital setting using a SAMBA II

Nurses using SAMBA II - Image from NIHR Cambridge CRF

COVIDx, a study supported by the NIHR BRC: Cambridge and NIHR Cambridge CRF, aims to investigate the impact of two new tests for COVID-19 on delivering faster diagnoses and understanding the development of immunity following infection.

The first part of the study will evaluate the accuracy of the new SAMBA II-based test and whether it speeds up the diagnosis of COVID-19 in a ‘real-time’ hospital setting at the point of care.

The second part will investigate a point of care finger prick ‘antibody’ test of the blood, to determine how quickly markers of immunity appear following infection and a positive SAMBA test. These antibody tests will be important for understanding which patients and staff have already had the infection, and may be safe to return to work following recovery.

Research nurses from the NIHR Cambridge CRF are collecting samples from patients with suspected COVID-19 to support the COVIDx study, using the SAMBA II machine to test nasal and throat swabs to determine if a patient has COVID-19 and if the new device is an improved source of testing.

The SAMBA II test can provide extremely reliable results in less than two hours, meaning decisions about clinical care or self-isolation can be made much more rapidly. The antibody tests require serum from blood samples, which will be tested in specialised facilities at the Cambridge Institute for Therapeutic Immunology and Infectious Diseases (CITIID).

Once the two diagnostic tests have been validated in patients with confirmed COVID-19, the study will enrol a second group of participants – healthcare workers. The SAMBA II test will be able to quickly identify staff who are positive for COVID-19, even if they have no symptoms, allowing them to self-isolate or access treatment if required.

This is an abridged version of the news item posted on our website on April 17, 2020.

BloodCounts! Consortium wins Trinity Challenge Prize for breakthrough in infectious disease detection

BloodCounts! – an international consortium of scientists, led by Professor Carola-Bibiane Schönlieb of the Department of Applied Mathematics and Theoretical Physics at the University of Cambridge, has been awarded a substantial prize by the Trinity Challenge to further develop their innovative infectious disease outbreak detection system.

The loss of 3.8 million lives in the ongoing COVID-19 pandemic has highlighted that there is a critical need for simple, affordable, and scalable technologies for early detection of novel emerging infectious disease outbreaks. To drive development of these tools the Trinity Challenge, a global call for solutions to this problem, was set.

The BloodCounts! solution, developed by Dr Michael Roberts and Dr Nicholas Gleadall, uses data from routine blood tests and powerful AI-based techniques to provide a “Tsunami-like” early warning system for novel disease outbreaks.

Dr Roberts from the University of Cambridge said: “Since the beginning of the pandemic I have been developing AI-based methods to aid in medical decision making for COVID-19 patients, starting with analysis of Chest X-ray data. Echoing the observations made by the clinical teams, we saw profound and unique differences in the medical measurements of infected individuals, particularly in their full blood count data. It is these changes that we can train models to detect at scale.”

Unlike many current test methods their approach doesn’t require any prior knowledge of a specific pathogen to work, instead, they use full blood count data to exploit the pathogen detecting abilities of the human immune system by observing changes in the blood measurements associated with infection.

As the full blood count is the world’s most common medical laboratory test, with over 3.6 billion being performed worldwide each year, the BloodCounts! team can rapidly apply their methods to scan for abnormal changes in the blood cells of large populations – alerting public health agencies to potential outbreaks of pathogen infection.

This unique solution is a powerful demonstration of how the application of AI-based methods, built upon rigorous mathematics, can lead to huge healthcare benefits when applied in many areas of medicine. It also highlights the importance of strong collaboration between leading organisations, as the development of these algorithms was only possible due the EpiCov data sharing initiative pioneered by Cambridge University Hospitals and supported by the NIHR BRC: Cambridge.

Dr Gleadall from the University of Cambridge and NHS Blood and Transplant said: “We realised that hundreds of millions of full blood count tests were being performed every day worldwide, and this meant that we could apply our AI-methods at population scale. Usually the rich measurement data are discarded after summary results have been reported, but by working with Cambridge University, Barts Health London, and University College London, NHS Hospitals we have rescued throughout the pandemic the rich data from 2.8 million full blood count tests.”

Professor Bryan Williams, the Director of the NIHR University College London Hospitals Biomedical Research Centre who was an early supporter of applying AI to the full blood count data, said: “The BloodCounts! approach has huge potential and if this works, it could provide a readily scalable and cheap population surveillance method for outbreak detection of SARS-CoV-2 and other viruses. A major advantage is that the NHS already performs more than 100 million FBC tests every year, with over half of these performed by general practitioners in the community, so the programme aims to get more information from tests we already perform.”

 

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