Breaking research advances announced ahead of virtual COVID-19 Conference

Important advances in COVID-19 research, including promising data on new treatments, were announced today ahead of the virtual COVID-19 Conference, the world’s first abstract-driven scientific meeting dedicated to the global pandemic.
 
Hosted by IAS – International AIDS Society, the COVID-19 Conference will take place on 10 July (extending into July 11 in some time zones), following the 23rd International AIDS Conference, also known as AIDS 2020: Virtual. Accessible at https://covid19.aids2020.org, the COVID-19 Conference is open to all and free of charge.
 
“We convened this conference to tackle the many urgent questions related to COVID-19 epidemiology, prevention, treatment and care,” IAS President Anton Pozniak said. “The studies presented at this gathering underwent rigorous scientific vetting and capture critical insights from the front lines in hard-hit communities worldwide.”
 
Today’s press briefing featured remarks from National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony Fauci, who will also speak at the COVID-19 Conference. Other conference speakers will include Bill Gates, Jane Goodall, World Health Organization Director-General Tedros Adhanom Ghebreyesus, US Coronavirus Task Force Coordinator Deborah Birx, and Professor Salim Abdool Karim of the Centre for the AIDS Programme of Research in South Africa (CAPRISA).
 
The press briefing highlighted the following studies, selected from about 140 scientific abstracts being presented at the COVID-19 Conference.
 
Promising data on sofosbuvir and daclatasvir as a potential treatment for COVID-19

Andrew Hill of Liverpool University presented promising results from a study of sofosbuvir and daclatasvir – a drug combination currently used for hepatitis C – as a treatment for moderate or severe COVID-19. This open-label trial included 66 adults with COVID-19 admitted to four Iranian University hospitals. Patients were randomized to standard care (hydroxychloroquine ± lopinavir/ritonavir, drugs that were standard at the time of the study, but are now thought to have no benefit for COVID-19) either with or without sofosbuvir and daclatasvir.
 
The study team found that the group of patients receiving sofosbuvir and daclatasvir had better 14-day clinical recovery rates and shorter hospital stays. The study concludes that larger confirmatory trials are needed to support worldwide regulatory approval of sofosbuvir and daclatasvir to treat COVID-19. [Summary based on submitted abstract; updated data may be presented on site.]
 
Abstract: Sofosbuvir and daclatasvir as a potential candidate for moderate or severe COVID-19 treatment, results from a randomised controlled trial
 
Session: Clinical science & care, testing & diagnoses, natural history & more (available on demand from 10 July)
 
Study identifies characteristics associated with clinical improvement and mortality in patients with severe COVID-19 treated with remdesivir
 
Kristen Marks of Weill Cornell Medicine presented a study that examined characteristics associated with clinical improvement and mortality in patients with severe COVID-19 who were treated with remdesivir. Remdesivir has demonstrated potent in vitro and in vivo activity against SARS-CoV-2 and favourable clinical efficacy and good tolerability in patients with COVID-19 treated through compassionate use.
 
In this open-label, phase 3 trial, hospitalized COVID-19 patients were randomized to receive either five or 10 days of intravenous remdesivir once daily. Of the 397 study patients, 31% were on high-grade oxygen support at baseline. Through median follow up of 10 days, 256 patients had clinical improvement in oxygen support (2 or more points of improvement on a 7-point scale) and 44 had died.
 
The study team found that the following were associated with higher rates of clinical improvement: lower-grade respiratory support, age under 65, location outside of Italy, no concomitant biologic medication and – perhaps most notably – Black race. The characteristics associated with all-cause mortality were high-grade oxygen support, a medical history of chronic obstructive pulmonary disease (COPD) and age over 65. [Summary based on submitted abstract; updated data may be presented on site.]
 
Abstract: Baseline characteristics associated with clinical improvement and mortality in hospitalized patients with severe COVID-19 treated with remdesivir
 
Session: Clinical science & care, testing & diagnoses, natural history & more (available on demand from 10 July)
 
Strong evidence that in utero vertical transmission of SARS-CoV-2 is possible

Claudio Fenizia of the University of Milan presented results of a study that investigated whether vertical transmission of SARS-CoV-2 is possible and whether this results in foetal involvement. The study also analysed the role of the antibody and the inflammatory responses in placenta and plasma from SARS-CoV-2-positive pregnant women and foetuses.
 
The study enrolled 31 pregnant women, all of whom had SARS-CoV-2. The virus was found in an at-term placenta and in the umbilical cord blood, in the vagina of a pregnant woman and in milk. Furthermore, the study found specific anti-SARS-CoV-2 IgM and IgG antibodies in the umbilical cord blood of pregnant women, as well as in milk specimens. Finally, a specific inflammatory response was triggered by SARS-CoV-2 infection in pregnant women at the systemic and placental levels and in umbilical cord blood plasma.
 
According to the researchers, the study provides strong evidence that in utero vertical transmission is possible in women who have SARS-CoV-2. [Summary based on submitted abstract; updated data may be presented on site.]
 
Abstract: In-utero mother-to-child SARS-CoV-2 transmission – viral detection and fetal immune response
 
Session: Basic science, pathogenesis, virology, immunology, inflammation (available on demand from 10 July)
 
New insights from a large COVID-19 testing campaign in the US
 
Carina Marquez of the University of California, San Francisco, presented new findings from a mass testing campaign that offered SARS-CoV-2 PCR and antibody tests to all residents older than four years – regardless of symptoms – in a census tract in the Mission District of San Francisco. Six weeks into San Francisco’s shelter-in-place policy, the study tested nearly 4,000 people over four days, making it the largest mass testing campaign performed in a single district in the United States.
 
In May, the study released initial results showing that 95% of those who tested PCR positive for SARS-CoV-2 in the district were Latinx individuals, most of whom had been unable to shelter in place for financial reasons.
 
At today’s press briefing, the study shared three new findings. First, the rate of asymptomatic infection with SARS-CoV-2 can only be defined by mass testing a whole community regardless of symptoms and following them over time. The study found that 53% of patients were asymptomatic at the time of testing and 42% remained so. Second, the study found that viral loads of SARS-CoV-2 in nasopharyngeal swabs as estimated by PCR were as high among those who were asymptomatic early on in infection as among symptomatic individuals. Third, based on phylogenetic analysis, the study found multiple SARS-CoV-2 strains in the census district, suggestive of multiple introductions over time acquired from across the city. [Summary is based on late-breaking information that is not in the study abstract; details will be presented at the conference.]
 
Abstract: High prevalence of asymptomatic SARS-CoV-2 infection found in a Latinx population in San Francisco in a mass testing campaign
 
Session: Epidemiology, transmission dynamics, prevention, medicine (available on demand from 10 July)