A plea for equitable global access to COVID‐19 diagnostics, vaccination and therapy: The NeuroCOVID‐19 Task Force of the European Academy of Neurology

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Abstract

Coronavirus disease 2019 (COVID‐19), a multi‐organ disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), continues to challenge health and care systems around the globe. The pandemic has disrupted acute neurology services and routine patient care and has impacted the clinical course in patients with chronic neurological disease. COVID‐19 appears to have exposed inequalities of societies and healthcare systems and had a disproportionate impact on already vulnerable communities. The next challenge will be to set up initiatives to stop disparities in all aspects related to COVID‐19. From the medical perspective, there is a need to consider inequalities in prevention, treatment and long‐term consequences. Some of the issues of direct relevance to neurologists are summarised. With this appraisal, the European Academy of Neurology NeuroCOVID‐19 Task Force intends to raise awareness of the potential impact of COVID‐19 on inequalities in healthcare and calls for action to prevent disparity at individual, national and supranational levels.

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Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

Fernando P Polack, Stephen J. Thomas, Nicholas R.E. Kitchin … (2023)

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (Covid-19) have afflicted tens of millions of people in a worldwide pandemic. Safe and effective vaccines are needed urgently. Methods In an ongoing multinational, placebo-controlled, observer-blinded, pivotal efficacy trial, we randomly assigned persons 16 years of age or older in a 1:1 ratio to receive two doses, 21 days apart, of either placebo or the BNT162b2 vaccine candidate (30 μg per dose). BNT162b2 is a lipid nanoparticle–formulated, nucleoside-modified RNA vaccine that encodes a prefusion stabilized, membrane-anchored SARS-CoV-2 full-length spike protein. The primary end points were efficacy of the vaccine against laboratory-confirmed Covid-19 and safety. Results A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). Similar vaccine efficacy (generally 90 to 100%) was observed across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions. Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient. The safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups. Conclusions A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older. Safety over a median of 2 months was similar to that of other viral vaccines. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728.)

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Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy

Giacomo Grasselli, Massimiliano Greco, Alberto Zanella … (2020)

Many patients with coronavirus disease 2019 (COVID-19) are critically ill and require care in the intensive care unit (ICU).

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Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission

Hannah Peckham, Nina de Gruijter, Charles Raine … (2020)

Anecdotal evidence suggests that Coronavirus disease 2019 (COVID-19), caused by the coronavirus SARS-CoV-2, exhibits differences in morbidity and mortality between sexes. Here, we present a meta-analysis of 3,111,714 reported global cases to demonstrate that, whilst there is no difference in the proportion of males and females with confirmed COVID-19, male patients have almost three times the odds of requiring intensive treatment unit (ITU) admission (OR = 2.84; 95% CI = 2.06, 3.92) and higher odds of death (OR = 1.39; 95% CI = 1.31, 1.47) compared to females. With few exceptions, the sex bias observed in COVID-19 is a worldwide phenomenon. An appreciation of how sex is influencing COVID-19 outcomes will have important implications for clinical management and mitigation strategies for this disease.

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Author and article information

Contributors

Johann Sellner:

ORCID: https://orcid.org/0000-0001-8749-5533

johann.sellner@mistelbach.lknoe.at

Journal

Journal ID (nlm-ta): Eur J Neurol

Journal ID (iso-abbrev): Eur J Neurol

Journal ID (doi): 10.1111/(ISSN)1468-1331

Journal ID (publisher-id): ENE

Title: European Journal of Neurology

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 1351-5101

ISSN (Electronic): 1468-1331

Publication date (Electronic): 05 February 2021

Electronic Location Identifier: 10.1111/ene.14741

Affiliations

[ ¹ ] Department of Neurology Landesklinikum Mistelbach‐Gänserndorf Mistelbach Austria

[ ² ] Department of Neurology Christian Doppler Medical Center Paracelsus Medical University Salzburg Austria

[ ³ ] Department of Neurology Klinikum rechts der Isar Technische Universität München München Germany

[ ⁴ ] Sheffield Institute for Translational Neuroscience University of Sheffield Sheffield UK

[ ⁵ ] Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK

[ ⁶ ] Faculty of Medicine Johannes‐Kepler Universität Linz Austria

[ ⁷ ] Department of Neurology 1 Kepler Universitätsklinikum Linz Austria

[ ⁸ ] Department of Neurology Inselspital University of Bern Bern Switzerland

[ ⁹ ] Istituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy

[ ¹⁰ ] Department of Neurology Semmelweis University Budapest Hungary

[ ¹¹ ] Department of Neurology Saint‐Antoine Hospital APHP Sorbonne University Paris France

[ ¹² ] Neurology Unit Neuromotor and Rehabilitation Department Azienda USL‐IRCCS di Reggio Emilia Reggio Emilia Italy

[ ¹³ ] Clinical and Experimental Medicine PhD Program University of Modena and Reggio Emilia Modena Italy

[ ¹⁴ ] Department of Clinical Neurosciences Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland

[ ¹⁵ ] Department of Neurology Medical University of Innsbruck Innsbruck Austria

[ ¹⁶ ] Walton Centre NHS Foundation Trust Liverpool UK

[ ¹⁷ ] School of Psychology Faculty of Health and Life Sciences University of Liverpool Liverpool UK

[ ¹⁸ ] Department of Neurology Hospital Santo António Centro Hospitalar Universitário do Porto Porto Portugal

[ ¹⁹ ] i3S ‐ Instituto de Investigação e Inovação em Saúde Universidade do Porto Porto Portugal

[ ²⁰ ] Department of Neurology Hospital Clinico San Carlos Madrid Spain

[ ²¹ ] Departamento de Medicina Facultad de Medicina Universidad Complutense de Madrid (UCM Madrid Spain

[ ²² ] IdISSC Madrid Spain

[ ²³ ] Department of Neurology Faculty of Medicine Selcuk University Konya Turkey

[ ²⁴ ] Department of Neurology University Medical Centre Maribor Maribor Slovenia

[ ²⁵ ] Department of Brain and Behavioral Sciences University of Pavia Pavia Italy

[ ²⁶ ] IRCCS Mondino Foundation Pavia Italy

[ ²⁷ ] Division of Neurology Department of Neurology ‘Aldo Ravelli’ Research Center University of Milan and ASST Santi Paolo e Carlo Milan Italy

[ ²⁸ ] Department of Neurology University Hospital Cologne Cologne Germany

[ ²⁹ ] King's College Hospital National Parkinson Foundation International Centre of Excellence London UK

[ ³⁰ ] Division of Neuro‐Oncology Department of Neuroscience University of Turin Turin Italy

[ ³¹ ] Department of Neurology and Neurosurgery Institute of Clinical Medicine University of Tartu Tartu Estonia

[ ³² ] European Academy of Neurology (EAN) Head Office Vienna Austria

[ ³³ ] Division of Neurology CHU of Grenoble Grenoble Institute of Neurosciences Grenoble Alpes University Grenoble France

Author notes

[*] [* ] Correspondence

Johann Sellner, Department of Neurology, Landesklinikum Mistelbach‐Gänserndorf, Liechtensteinstr. 67, 2130 Mistelbach, Austria.

Email: johann.sellner@ 123456mistelbach.lknoe.at

Author information

Johann Sellner https://orcid.org/0000-0001-8749-5533

Tim J. von Oertzen https://orcid.org/0000-0003-2164-7842

Claudio L. Bassetti https://orcid.org/0000-0002-4535-0245

Ettore Beghi https://orcid.org/0000-0003-2542-0469

Daniel Bereczki https://orcid.org/0000-0002-8374-0500

Raimund Helbok https://orcid.org/0000-0001-5682-0145

Martin Rakusa https://orcid.org/0000-0003-4433-3985

Alberto Priori https://orcid.org/0000-0002-1549-3851

Pille Taba https://orcid.org/0000-0002-5439-1022

Article

Publisher ID: ENE14741

DOI: 10.1111/ene.14741

PMC ID: 8014664

PubMed ID: 33460486

SO-VID: c2f6ea93-afbf-40de-8284-2f62ab6e23a8

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

History

Date received : 05 January 2021

Date accepted : 13 January 2021

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Figures: 0, Tables: 0, Pages: 7, Words: 15374

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ScienceOpen disciplines: Neurology

Keywords: advocacy,covid‐19,disparity,equitable global health,neurology,primary prevention,sars‐cov‐2

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ScienceOpen disciplines: Neurology

Keywords: advocacy, covid‐19, disparity, equitable global health, neurology, primary prevention, sars‐cov‐2

A plea for equitable global access to COVID‐19 diagnostics, vaccination and therapy: The NeuroCOVID‐19 Task Force of the European Academy of Neurology

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Most cited references 80

Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy

Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission

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