80 research outputs found
The Syair Tabut of Encik Ali: A Malay account of Muharram at Singapore, 1864
- Author
- Publication venue
- 'Informa UK Limited'
- Publication date
- 06/10/2017
- Field of study
The Physical Processes of CME/ICME Evolution
- Author
- A. Borgazzi
- A. Buergi
- A. Isavnin
- A. Lara
- A. Reinard
- A. Ruffenach
- A. Ruffenach
- A. Shanmugaraju
- A. Taktakishvili
- A. Thernisien
- A. Vourlidas
- A. Vourlidas
- A.A. Mohamed
- A.B. Galvin
- A.B. Galvin
- A.G. Kosovichev
- A.J. Hundhausen
- A.J. Hundhausen
- A.J. Hundhausen
- A.J. Hundhausen
- A.J. Hundhausen
- A.J. Prise
- A.M. Gulisano
- B. Gui
- B. Holst van der
- B. Holst van der
- B. Holst van der
- B. Jackson
- B. Kliem
- B. Kliem
- B. Kliem
- B. Lavraud
- B. Lavraud
- B. Schmieder
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B.C. Low
- B.E. Wood
- B.E. Wood
- B.E. Wood
- B.E. Wood
- B.J. Lynch
- B.J. Lynch
- B.J. Lynch
- B.J. Lynch
- B.M. Bein
- B.M. Bein
- B.V. Jackson
- C. Cid
- C. Downs
- C. Downs
- C. Farrugia
- C. Jacobs
- C. Jiang
- C. Kay
- C. Kay
- C. Kay
- C. Kay
- C. Möstl
- C. Möstl
- C. Möstl
- C. Möstl
- C. Salas-Matamoros
- C. Shen
- C. Shen
- C. Wang
- C.E. DeForest
- C.E. DeForest
- C.J. Davis
- C.J. Eyles
- C.J. Eyles
- C.J. Farrugia
- C.J. Farrugia
- C.J. Schrijver
- C.M. Hammond
- C.W. Smith
- D. Maričić
- D. Odstrcil
- D. Odstrcil
- D. Odstrcil
- D. Odstrčil
- D. Odstrčil
- D. Odstrčil
- D. Shiota
- D. Shiota
- D. Sudar
- D.B. Reisenfeld
- D.F. Smart
- D.F. Webb
- D.F. Webb
- D.G. Sime
- D.J. McComas
- D.M. Rust
- D.S. Intriligator
- D.S. Young De
- D.S. Young De
- D.V. Reames
- D.W. Billings
- E. Chané
- E.E. Fenimore
- E.K.J. Kilpua
- E.K.J. Kilpua
- E.K.J. Kilpua
- F. Fang
- F. Fang
- F. Shen
- F. Shen
- F. Valach
- F. Wei
- F.P. Zuccarello
- F.P. Zuccarello
- F.S. Wei
- G. Borrini
- G. Gloeckler
- G. Paschmann
- G. Siscoe
- G. Tóth
- G. Zhou
- G.E. Brueckner
- G.E. Brueckner
- G.M. Lindsay
- H. Aurass
- H. Cremades
- H. Hu
- H. Xie
- H.R. Gilbert
- H.V. Cane
- I.G. Richardson
- I.G. Richardson
- I.G. Richardson
- I.G. Richardson
- I.G. Richardson
- I.I. Roussev
- J. Fuller
- J. Hirshberg
- J. Linker
- J. Schmidt
- J. Uwamahoro
- J.A. Davies
- J.A. Linker
- J.C. Raymond
- J.G. Luhmann
- J.M. Schmidt
- J.M. Schmidt
- J.P. Byrne
- J.R. Gruesbeck
- J.R. Gruesbeck
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.U. Kozyra
- J.Y. Lee
- K. Marubashi
- K. Muglach
- K.E.J. Huttunen
- K.G. Ivanov
- L. Burlaga
- L. Feng
- L.E. Burlaga
- L.F. Burlaga
- L.F. Burlaga
- L.F. Burlaga
- L.F. Burlaga
- L.F. Burlaga
- L.M. Green
- M. Dryer
- M. Dryer
- M. Dryer
- M. Dryer
- M. Dumbović
- M. Dumbović
- M. Jin
- M. Jin
- M. Jin
- M. Jin
- M. Neugebauer
- M. Owens
- M. Temmer
- M. Temmer
- M. Temmer
- M. Temmer
- M. Vandas
- M. Vandas
- M. Xiong
- M. Xiong
- M.D. Andrews
- M.J. Owens
- M.J. Reiner
- M.J. Reiner
- M.J. Reiner
- M.J. Reiner
- M.L. Kaiser
- M.L. Mays
- M.R. Collier
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N.P. Savani
- N.P. Savani
- N.R. Sheeley
- N.V. Nitta
- O. Cohen
- O. Cohen
- O. Olmedo
- O.C. St. Cyr
- P. Chatterjee
- P. Démoulin
- P. Démoulin
- P. Mäkelä
- P. Pagano
- P. Riley
- P. Riley
- P. Riley
- P. Riley
- P. Riley
- P. Riley
- P. Vemareddy
- P.A. Isenberg
- P.F. Chen
- P.J. Cargill
- P.J. Cargill
- P.K. Manoharan
- P.K. Manoharan
- P.K. Manoharan
- P.K. Manoharan
- Q. Hu
- R. Esser
- R. Lionello
- R. Lionello
- R. Lionello
- R. Schwenn
- R. Schwenn
- R. Tousey
- R. Wang
- R. Wang
- R. Wang
- R.A. Harrison
- R.A. Howard
- R.A. Howard
- R.A. Jones
- R.C. Colaninno
- R.C. Colaninno
- R.M. MacQueen
- R.M. MacQueen
- R.M. Skoug
- R.M. Skoug
- R.M. Winslow
- R.M.E. Illing
- R.P. Lepping
- R.P. Lepping
- R.P. Lepping
- R.P. Lepping
- R.S. Steinolfson
- R.S. Steinolfson
- S. Dasso
- S. Dasso
- S. Dasso
- S. Gibson
- S. Kahler
- S. Mancuso
- S. Poedts
- S. Yao
- S. Yashiro
- S.E. Gibson
- S.J. Bame
- S.J. Tappin
- S.K. Antiochos
- S.P. Plunkett
- S.T. Lepri
- S.T. Lepri
- S.T. Lepri
- S.T. Lepri
- S.T. Wu
- S.T. Wu
- S.T. Wu
- S.T. Wu
- S.W. Kahler
- S.W. Kahler
- T. Amari
- T. Amari
- T. Henke
- T. Henke
- T. Nieves-Chinchilla
- T. Rollett
- T. Rollett
- T. Shi
- T. Török
- T. Török
- T. Török
- T. Török
- T. Török
- T. Žic
- T.A. Howard
- T.A. Howard
- T.A. Howard
- T.G. Forbes
- T.G. Forbes
- T.G. Forbes
- T.H. Zurbuchen
- T.H. Zurbuchen
- T.V. Falkenberg
- V. Yurchyshyn
- V. Yurchyshyn
- V.A. Osherovich
- V.B. Yurchyshyn
- V.J. Pizzo
- V.S. Titov
- V.S. Titov
- W. Manchester IV
- W. Mishra
- W. Mishra
- W. Mishra
- W. Mishra
- W.B. Manchester IV
- W.B. Manchester IV
- W.B. Manchester IV
- W.B. Manchester IV
- W.B. Manchester IV
- W.B. Manchester IV
- W.B. Manchester IV
- W.B. Manchester IV
- W.B. Manchester IV
- W.B. Manchester IV
- W.B. Manchester IV
- W.B. Manchester IV
- W.T. Thompson
- W.T. Thompson
- X. Feng
- X. Zhao
- X. Zhao
- X.H. Zhao
- Y. Fan
- Y. Fan
- Y. Liu
- Y. Liu
- Y. Liu
- Y. Liu
- Y. Liu
- Y. Liu
- Y. Liu
- Y. Liu
- Y. Liu
- Y. Liu
- Y. Wang
- Y. Wang
- Y. Wang
- Y. Wang
- Y.D. Liu
- Y.D. Liu
- Y.D. Liu
- Y.D. Liu
- Y.D. Liu
- Y.D. Liu
- Y.D. Liu
- Y.D. Liu
- Y.F. Zhou
- Y.J. Moon
- Y.J. Moon
- Y.K. Ko
- Y.M. Wang
- Y.M. Wang
- Y.M. Wang
- Y.M. Wang
- Z. Mikić
- Z. Mikić
- Z. Mikić
- Z. Mikić
- Z. Smith
- Publication venue
- Publication date
- 03/08/2017
- Field of study
As observed in Thomson-scattered white light, coronal mass ejections (CMEs) are manifest as large-scale expulsions of plasma magnetically driven from the corona in the most energetic eruptions from the Sun. It remains a tantalizing mystery as to how these erupting magnetic fields evolve to form the complex structures we observe in the solar wind at Earth. Here, we strive to provide a fresh perspective on the post-eruption and interplanetary evolution of CMEs, focusing on the physical processes that define the many complex interactions of the ejected plasma with its surroundings as it departs the corona and propagates through the heliosphere. We summarize the ways CMEs and their interplanetary CMEs (ICMEs) are rotated, reconfigured, deformed, deflected, decelerated and disguised during their journey through the solar wind. This study then leads to consideration of how structures originating in coronal eruptions can be connected to their far removed interplanetary counterparts. Given that ICMEs are the drivers of most geomagnetic storms (and the sole driver of extreme storms), this work provides a guide to the processes that must be considered in making space weather forecasts from remote observations of the corona.Peer reviewe
Long-Baseline Neutrino Facility (LBNF) and Deep Underground Neutrino Experiment (DUNE) Conceptual Design Report Volume 2: The Physics Program for DUNE at LBNF
- Author
- Acciarri R.
- Acero M.A.
- Adamowski M.
- Adams C.
- Adams D.L.
- Adamson P.
- Adhikari S.
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- Albright C.H.
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- Anghel I.
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- Ariga A.
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- Aristizabal D.
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- Aurisano A.
- Aushev V.
- Autiero D.
- Avila M.
- Back J.J.
- Bai X.
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- Baller B.
- Ballett P.
- Bambah B.
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- Barker G.J.
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- Behera B.R.
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- Publication venue
- Publication date
- 01/01/2015
- Field of study
The Physics Program for the Deep Underground Neutrino Experiment (DUNE) at the Fermilab Long-Baseline Neutrino Facility (LBNF) is described
Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.
- Author
- Aban Marites
- Abayomi Fatola
- Abeyskera Kushala
- Aboagye Jeremy
- Adam Matthew
- Adams Kirsty
- Adamson James
- Adelaja Yemi A.
- Adlou Syed
- Ahmed Khatija
- Akhalwaya Saajida
- Akhalwaya Yasmeen
- Alcock Andrew
- Aley Parvinder K.
- Ali Aabidah
- Allen Elizabeth R.
- Allen Lauren
- Almeida Thamires C. D. S. C
- Alves Mariana P.S.
- Amorim Fabio
- Andritsou Foteini
- Angus Brian
- Anslow Rachel
- Appleby Matthew
- Arbe-Barnes Edward H.
- Ariaans Mark P.
- Arns Beatriz
- Arruda Laiana
- Awedetan Gbadebo
- Azi Lorena
- Azi Paula
- Babbage Gavin
- Bailey Catherine
- Baillie Vicky L.
- Baker Kenneth F.
- Baker Megan
- Baker Natalie
- Baker Philip
- Baldwin Lisa
- Baleanu Ioana
- Bandeira Danieli
- Bara Anna
- Barbosa Marcella A.S.
- Barker Debbie
- Barlow Gavin D.
- Barnabas Shaun L.
- Barnes Eleanor
- Barr Andrew S.
- Barrett Jessica
- Barrett Jordan R.
- Bates Louise
- Batten Alexander
- Beadon Kirsten
- Beales Emily
- Beckley Rebecca
- Belij-Rammerstorfer Sandra
- Bell Jonathan
- Bellamy Duncan
- Bellei Nancy
- Belton Sue
- Berg Adam
- Bermejo Laura
- Berrie Eleanor
- Berry Lisa
- Berzenyi Daniella
- Beveridge Amy
- Bewley Kevin R.
- Bexhell Helen
- Bhikha Sutika
- Bhorat Asad E.
- Bhorat Qasim E.
- Bhorat Zaheda E.
- Bibi Sagida
- Bijker Else
- Birch Geeta
- Birch Sarah
- Bird Adam
- Bird Olivia
- Bisnauthsing Karen
- Bittaye Mustapha
- Blackstone Katherine
- Blackwell Luke
- Bletchly Heather
- Blundell Caitlin L.
- Blundell Susannah R.
- Bodalia Pritesh
- Boettger Bruno C.
- Bolam Emma
- Boland Elena
- Bormans Daan
- Borthwick Nicola
- Bowring Francesca
- Boyd Amy
- Bradley Penny
- Brenner Tanja
- Briner Carmen
- Brown Claire
- Brown Phillip
- Brown-O'Sullivan Charlie
- Bruce Scott
- Brunt Emily
- Buchan Ruaridh
- Budd William
- Bulbulia Yusuf A.
- Bull Melanie
- Burbage Jamie
- Burhan Hassan
- Burn Aileen
- Buttigieg Karen R.
- Byard Nicholas
- Cabera Puig Ingrid
- Calderon Gloria
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- Camara Susana
- Cao Michelangelo
- Cappuccini Federica
- Cardoso João R.
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- Carroll Miles W.
- Carson-Stevens Andrew
- Carvalho José A.M.
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- Chadwick Jim
- Chapman David
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- Chester Oliver
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- Crocker Wendy E.M.
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- Danos Zsofia
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- De Jager Jeanne
- De Nobrega Maristela M.D.
- De Oliveira Kalid Lis Moreno
- Dearlove David
- Demissie Tesfaye
- Desai Amisha
- Dheda Keertan
- Di Marco Stefania
- Di Maso Claudio
- Dinelli Maria I.S.
- Dinesh Tanya
- Docksey Claire
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- Dong Tao
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- Farmer Eoghan
- Farooq Mutjaba
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- Feng Shuo
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- Fraiman Pedro H.A.
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- Furze Julie
- Fuskova Michelle
- Galian-Rubio Pablo
- Galiza Eva
- Garlant Harriet
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- Gilbride Ciaran
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- Grossi Leonardo
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- Hackett Mark
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- Hyder-Wright Angela
- Ikram Sabina
- Ishwarbhai Alka
- Ivan Monica
- Iveson Poppy
- Iyer Vidyashankara
- Izu Alane
- Jackson Frederic
- Jackson Susan
- Jaumdally Shameem
- Jeffers Helen
- Jenkin Daniel
- Jesudason Natasha
- Joe Carina C. D.
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- Jones Christopher
- Jones Elizabeth
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- Jorge Marianna Rocha
- Jose Aylin
- Joshi Amar
- Júnior Eduardo A.M.S.
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- Lazarus Rajeka
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- Lees Emily A.
- Lelliott Alice
- Lemm Nana-Marie
- Lessa Alvaro
- Leung Stephanie
- Li Yuanyuan
- Lias Amelia M.
- Liatsikos Kostas
- Libri Vincenzo
- Lillie Patrick J.
- Linder Aline
- Lipworth Samuel
- Liu Shuchang
- Liu Xinxue
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- Lloyd Stephanie
- Loew Lisa
- Lopez Ramon Raquel
- Lora Leandro
- Lowthorpe Vicki
- Luz Kleber
- MacDonald Jonathan C.
- MacGregor Gordon
- Madhavan Meera
- Madhi Shabir A.
- Mainwaring David O.
- Makambwa Edson
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- Malamatsho Ross
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- Marinou Spyridoula
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- Masilela Mduduzi
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- Mathew Moncy
- Matlebjane Hosea
- Matshidiso Kedidimetse
- Mazur Olga
- Mazzella Andrea
- McCaughan Hugh
- McEwan Joanne
- McGlashan Joanna
- McGregor Alastair
- McInroy Lorna
- McIntyre Zoe
- McLenaghan Daniela
- McRobert Nicky
- McSwiggan Steve
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- Mehdipour Savviz
- Meijs Wilma
- Mendes Ana V .A.
- Mendonça Renata N.Á.
- Mentzer Alexander J.
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- Mirtorabi Neginsadat
- Mitton Celia
- Mnyakeni Sibusiso
- Moghaddas Fiona
- Molapo Kgaogelo
- Moloi Mapule
- Moore Maria
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- Moran Marni
- Morey Ella
- Morgans Róisín
- Morris Helen C.
- Morris Sheila
- Morris Susan
- Morrison Hazel
- Morselli Franca
- Morshead Gertraud
- Morter Richard
- Mottal Lynelle
- Moultrie Andrew
- Moya Nathifa
- Mpelembue Mushiya
- Msomi Sibekezelo
- Mugodi Yvonne
- Mujadidi Yama F.
- Mukhopadhyay Ekta
- Muller Jilly
- Munro Alasdair
- Munro Claire
- Murphy Sarah
- Mweu Philomena
- Myasaki Celia Hatsuko
- Naik Gurudutt
- Naker Kush
- Nana Anusha
- Nastouli Eleni
- Nazir Abida
- Ndlovu Bongani
- Neffa Fabio
- Njenga Cecilia
- Noal Helena
- Novaes Gabrielle
- Noé Andrés
- Nugent Fay L.
- Nunes Géssika
- O'Brien Katie
- O'Connor Daniel
- O'Reilly Paula
- O'Reilly Peter J.
- Odam Miranda
- Oelofse Suzette
- Oguti Blanche
- Olchawski Victoria
- Oldfield Neil J.
- Oliveira Catarina
- Oliveira Marianne G.
- Oosthuizen Angela
- Osborne Piper
- Owen David R.J.
- Owen Lydia
- Owens Daniel
- Owino Nelly
- Pacurar Mihaela
- Padayachee Sherman D.
- Paiva Brenda V.B.
- Palhares Edna M.F.
- Palmer Susan
- Parkinson Sivapriyai
- Parracho Helena M.R.T.
- Parsons Karen
- Patel Bhumika
- Patel Dipak
- Patel Faeezah
- Patel Kelly
- Patrick-Smith Maia
- Payne Ruth O.
- Peng Yanchun
- Penn Elizabeth J.
- Pennington Anna
- Peralta Alvarez Marco Polo
- Perring James
- Perry Nicola
- Perumal Rubeshan
- Petkar Sahir
- Philip Tricia
- Phillips Daniel J.
- Phillips Jennifer
- Phohu Mary Kgomotso
- Pickup Lorinda
- Pieterse Sonja
- Piper Jo
- Pipini Dimitra
- Pittella Ana
- Plank Mary
- Plested Emma
- Pollard Andrew J
- Pollard Samuel
- Pollock Katrina M.
- Pooley Jennifer
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- Poulton Ian
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- Price Vivien
- Primeira Marcelo
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- Pueschel Sophie
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- Quaid Sheena
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- Radford Alexandra
- Radia Kajal
- Rajapaska Durga
- Rajeswaran Thurkka
- Ramasamy Maheshi N.
- Ramos Lopez Fernando
- Ramos Alberto San Francisco
- Rampling Tommy
- Rand Jade
- Ratcliffe Helen
- Rawlinson Tom
- Rea David
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- Reiné Jesús
- Resuello-Dauti Mila
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- Ricamara Marivic
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- Rocchetti Talita T.
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- Roche Sophie
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- Rossouw Lindie
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- Rudiansyah Indra
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- Salvador Stephannie
- Sampaio Milla
- Samson Annette D.
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- Satti Iman
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- Souza Bruno S.D.F.
- Souza Cinthia M.C.D.L.
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- Spoors Louise
- Sprinz Eduardo
- Stafford Lizzie
- Stamford Imogen
- Starinskij Igor
- Stein Ricardo
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- Stockwell Lisa V.
- Strickland Louise H.
- Stuart Arabella C.
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- Sutherland Rebecca K.
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- Tahiri-Alaoui Abdessamad
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- Taoushanis Carol
- Tarr Alexander W.
- Tarrant Richard
- Taylor Iona Jennifer
- Taylor Justin
- Taylor Keja
- Taylor Ursula
- te Water Naude Rebecca
- Themistocleous Andreas
- Themistocleous Yrene
- Thomas Kelly
- Thomas Merin
- Thomas Tonia M.
- Thombrayil Asha
- Thompson Amber
- Thompson Ameeka
- Thompson Fawziyah
- Thompson Kevin
- Thomson Emma C.
- Thomson Julia
- Thornton-Jones Viv
- Tighe Patrick J.
- Tinoco Lygia Accioly
- Tiongson Gerlynn
- Tladinyane Bonolo
- Tomasicchio Michele
- Tomic Adriana
- Tonks Susan
- Toshner Mark
- Tran Nguyen
- Tree Julia
- Trillana Gerry
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- Trivett Rose
- Truby Adam
- Tsheko Betty Lebogang
- Turabi Aadil
- Turner Cheryl
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- Turner Richard
- Török M Estée
- Ulaszewska Marta
- Underwood Benjamin R.
- van Eck Samual
- Varughese Rachel
- Vekemans Johan
- Verbart Dennis
- Verheul Marije
- Vichos Iason
- Vieira Taiane
- Villafana Tonya L.
- Voysey Merryn
- Waddington Claire S.
- Walker Laura
- Wallis Erica
- Wand Matthew
- Warbick Deborah
- Wardell Theresa
- Warimwe George
- Warren Sarah C.
- Watkins Bridget
- Watson Ekaterina
- Watson Marion E. E.
- Webb Stewart
- Webb-Bridges Alice
- Webster Angela
- Weckx Lily Y.
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- Wells Jeanette
- West Alison
- White Caroline
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- Williams Paul
- Williams Rachel L.
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- Woodyer Mark
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- Wright Danny
- Wroblewska Marzena
- Yao Andy
- Zimmer Rafael
- Zizi Dalila
- Zuidewind Peter
- Publication venue
- 'Elsevier BV'
- Publication date
- 03/12/2020
- Field of study
BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca
Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK
- Author
- Aban Marites
- Abayomi Fatola
- Abeyskera Kushala
- Aboagye Jeremy
- Adam Matthew
- Adams Kirsty
- Adamson James
- Adelaja Yemi A.
- Adlou Syed
- Ahmed Khatija
- Akhalwaya Saajida
- Akhalwaya Yasmeen
- Alcock Andrew
- Aley Parvinder K.
- Ali Aabidah
- Allen Elizabeth R.
- Allen Lauren
- Almeida Thamires C. D. S. C
- Alves Mariana P.S.
- Amorim Fabio
- Andritsou Foteini
- Angus Brian
- Anslow Rachel
- Appleby Matthew
- Arbe-Barnes Edward H.
- Ariaans Mark P.
- Arns Beatriz
- Arruda Laiana
- Awedetan Gbadebo
- Azi Lorena
- Azi Paula
- Babbage Gavin
- Bailey Catherine
- Baillie Vicky L.
- Baker Kenneth F.
- Baker Megan
- Baker Natalie
- Baker Philip
- Baldwin Lisa
- Baleanu Ioana
- Bandeira Danieli
- Bara Anna
- Barbosa Marcella A.S.
- Barker Debbie
- Barlow Gavin D.
- Barnabas Shaun L.
- Barnes Eleanor
- Barr Andrew S.
- Barrett Jessica
- Barrett Jordan R.
- Bates Louise
- Batten Alexander
- Beadon Kirsten
- Beales Emily
- Beckley Rebecca
- Belij-Rammerstorfer Sandra
- Bell Jonathan
- Bellamy Duncan
- Bellei Nancy
- Belton Sue
- Berg Adam
- Bermejo Laura
- Berrie Eleanor
- Berry Lisa
- Berzenyi Daniella
- Beveridge Amy
- Bewley Kevin R.
- Bexhell Helen
- Bhikha Sutika
- Bhorat Asad E.
- Bhorat Qasim E.
- Bhorat Zaheda E.
- Bibi Sagida
- Bijker Else
- Birch Geeta
- Birch Sarah
- Bird Adam
- Bird Olivia
- Bisnauthsing Karen
- Bittaye Mustapha
- Blackstone Katherine
- Blackwell Luke
- Bletchly Heather
- Blundell Caitlin L.
- Blundell Susannah R.
- Bodalia Pritesh
- Boettger Bruno C.
- Bolam Emma
- Boland Elena
- Bormans Daan
- Borthwick Nicola
- Bowring Francesca
- Boyd Amy
- Bradley Penny
- Brenner Tanja
- Briner Carmen
- Brown Claire
- Brown Phillip
- Brown-O'Sullivan Charlie
- Bruce Scott
- Brunt Emily
- Buchan Ruaridh
- Budd William
- Bulbulia Yusuf A.
- Bull Melanie
- Burbage Jamie
- Burhan Hassan
- Burn Aileen
- Buttigieg Karen R.
- Byard Nicholas
- Cabera Puig Ingrid
- Calderon Gloria
- Calvert Anna
- Camara Susana
- Cao Michelangelo
- Cappuccini Federica
- Cardoso João R.
- Carr Melanie
- Carroll Miles W.
- Carson-Stevens Andrew
- Carvalho José A.M.
- Carvalho Yasmin de M.
- Casey Helen R.
- Cashen Paul
- Castro Lucia Carratala
- Castro Thais
- Cathie Katrina
- Cavey Ana
- Cerbino-Neto José
- Chadwick Jim
- Chapman David
- Charlton Sue
- Chelysheva Irina
- Chester Oliver
- Chita Sunder
- Cho Jee-Sun
- Cicconi Paola
- Cifuentes Liliana
- Clark Elizabeth
- Clark Matthew
- Clarke Andrea
- Clemens Sue Ann Costa
- Clutterbuck Elizabeth A.
- Colin-Jones Rachel
- Collins Andrea M.
- Collins Sarah L.K.
- Conlon Christopher P.
- Connarty Sean
- Coombes Naomi
- Cooper Cushla
- Cooper Rachel
- Cornelissen Lynne
- Corrah Tumena
- Cosgrove Catherine
- Cox Tony
- Crocker Wendy E.M.
- Crosbie Sarah
- Cullen Dan
- Cullen Lorraine
- Cunha Debora R.M.F.
- Cunningham Christina
- Cuthbertson Fiona C.
- Cutland Clare L.
- Da Guarda Suzete N. Farias
- da Silva Moraes Antonio Carlos
- da Silva Larissa P.
- Damratoski Brad E.
- Danos Zsofia
- Dantas Maria T.D.C.
- Darroch Paula
- Darton Thomas C.
- Datoo Mehreen S.
- Datta Chandrabali
- Davids Malika
- Davies Hannah
- Davies Sarah L.
- Davis Elizabeth
- Davis John
- Davis Judith
- De Jager Jeanne
- De Nobrega Maristela M.D.
- De Oliveira Kalid Lis Moreno
- Dearlove David
- Demissie Tesfaye
- Desai Amisha
- Dheda Keertan
- Di Marco Stefania
- Di Maso Claudio
- Dinelli Maria I.S.
- Dinesh Tanya
- Docksey Claire
- Dold Christina
- Dong Tao
- Donnellan Francesca R.
- Dos Santos Erika Pachecho
- Dos Santos Tannyth
- dos Santos Thainá G.
- Douglas Alexander D.
- Douglas Naomi
- Downing Charlotte
- Drake Jonathan
- Drake-Brockman Rachael
- Driver Kimberley
- Drury Ruth
- Du Plessis Joan
- Dunachie Susanna J.
- Duncan Christopher J. A.
- Durham Benjamin S.
- Dutra Lidiana
- Easom Nicholas J.W.
- Edwards Mandy
- Edwards Nick J.
- El Muhanna Omar M.
- Elias Sean C.
- Elmore Mike
- Emary Katherine R. W.
- English Marcus
- Esmail Alisgair
- Essack Yakub Moosa
- Ewer Katie J.
- Fairlie Lee
- Farmer Eoghan
- Farooq Mutjaba
- Farrar Madi
- Farrugia Leonard
- Faulkner Beverley
- Faust Saul N.
- Fedosyuk Sofiya
- Felle Sally
- Feng Shuo
- Feng Shuo
- Ferreira Da Silva Carla
- Ferreira Daniela M.
- Field Samantha
- Finn Adam
- Fisher Richard
- Flaxman Amy
- Fletcher James
- Fofie Hazel
- Fok Henry
- Folegatti Pedro M.
- Ford Karen J.
- Fowler Jamie
- Fraiman Pedro H.A.
- Francis Emma
- Franco Marilia M.
- Frater John
- Freire Marilúcia S.M.
- Fry Samantha H.
- Fudge Sabrina
- Furze Julie
- Fuskova Michelle
- Galian-Rubio Pablo
- Galiza Eva
- Garlant Harriet
- Gavrila Madita
- Geddes Ailsa
- Gibbons Karyna A.
- Gilbert Sarah C
- Gilbride Ciaran
- Gill Hardeep
- Glynn Sharon
- Godwin Kerry
- Gokani Karishma
- Goldoni Ursula Carvalho
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- Gonzalez Isabela G.S.
- Goodman Anna L.
- Goodwin Jayne
- Goondiwala Amina
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- Gorini Giacomo
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- Greenwood Nicola
- Greffrath Johann
- Groenewald Marisa M.
- Grossi Leonardo
- Gupta Gaurav
- Hackett Mark
- Hallis Bassam
- Hamaluba Mainga
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- Hanrath Aidan T.
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- Harris Clair
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- Harrison Thomas D.
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- Hartnell Birgit
- Hassan Shadin
- Haughney John
- Hawkins Sophia
- Hay Jodie
- Head Ian
- Heath Paul T.
- Henry John
- Hermosin Herrera Macarena
- Hettle David B.
- Hill Adrian V. S.
- Hill Catherine
- Hill Helen
- Hill Jennifer
- Hirsch Ian
- Hodges Gina
- Hodgson Susanne H. C.
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- Howe Elizabeth
- Howell Nicola
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- Humphries Holly E.
- Hurley Katrina
- Huson Claire
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- Hyder-Wright Angela
- Ikram Sabina
- Ishwarbhai Alka
- Ivan Monica
- Iveson Poppy
- Iyer Vidyashankara
- Izu Alane
- Jackson Frederic
- Jackson Susan
- Jaumdally Shameem
- Jeffers Helen
- Jenkin Daniel
- Jesudason Natasha
- Joe Carina C. D.
- Jones Bryony
- Jones Christopher
- Jones Elizabeth
- Jones Kathryn
- Jorge Marianna Rocha
- Jose Aylin
- Joshi Amar
- Júnior Eduardo A.M.S.
- Kadziola Joanne
- Kailath Reshma
- Kana Faeeza
- Karampatsas Konstantinos
- Kasanyinga Mwila
- Keen Jade
- Kelly Dearbhla M.
- Kelly Debbie
- Kelly Elizabeth J.
- Kelly Sarah
- Kerr David
- Kerridge Simon
- Kfouri Renato de Ávila
- Khan Liaquat
- Khozoee Baktash
- Kidd Sarah
- Killen Annabel
- Kinch Jasmin
- Kinch Patrick
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- Klenerman Paul
- Knapper Francesca
- Knight Julian C.
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- Koen Anthonet
- Koleva Stanislava
- Kwatra Gaurav
- Lambe Teresa
- Lang Gail
- Lang Matilda
- Larkworthy Colin W.
- Larwood Jessica P.J.
- Law Rebecca
- Lawrie Alison M.
- Lazarus Erica M.
- Lazarus Rajeka
- Leach Amanda
- Lees Emily A.
- Lelliott Alice
- Lemm Nana-Marie
- Lessa Alvaro
- Leung Stephanie
- Li Yuanyuan
- Lias Amelia M.
- Liatsikos Kostas
- Libri Vincenzo
- Lillie Patrick J.
- Linder Aline
- Lipworth Samuel
- Liu Shuchang
- Liu Xinxue
- Lloyd Adam
- Lloyd Stephanie
- Loew Lisa
- Lopez Ramon Raquel
- Lora Leandro
- Lowthorpe Vicki
- Luz Kleber
- MacDonald Jonathan C.
- MacGregor Gordon
- Madhavan Meera
- Madhi Shabir A.
- Mainwaring David O.
- Makambwa Edson
- Makinson Rebecca
- Malahleha Mookho
- Malamatsho Ross
- Mallett Garry
- Mallory Raburn
- Mansatta Kushal
- Maoko Takalani
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- Marinou Spyridoula
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- Masenya Masebole
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- Masters Shauna K.
- Mathew Moncy
- Matlebjane Hosea
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- Mazur Olga
- Mazzella Andrea
- McCaughan Hugh
- McEwan Joanne
- McGlashan Joanna
- McGregor Alastair
- McInroy Lorna
- McIntyre Zoe
- McLenaghan Daniela
- McRobert Nicky
- McSwiggan Steve
- Megson Clare
- Mehdipour Savviz
- Meijs Wilma
- Mendes Ana V .A.
- Mendonça Renata N.Á.
- Mentzer Alexander J.
- Milan Eveline P.
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- Mirtorabi Neginsadat
- Mitton Celia
- Mnyakeni Sibusiso
- Moghaddas Fiona
- Molapo Kgaogelo
- Moloi Mapule
- Moore Maria
- Moraes-Pinto M. Isabel
- Moran Marni
- Morey Ella
- Morgans Róisín
- Morris Helen C.
- Morris Sheila
- Morris Susan
- Morrison Hazel
- Morselli Franca
- Morshead Gertraud
- Morter Richard
- Mottal Lynelle
- Moultrie Andrew
- Moya Nathifa
- Mpelembue Mushiya
- Msomi Sibekezelo
- Mugodi Yvonne
- Mujadidi Yama F.
- Mukhopadhyay Ekta
- Muller Jilly
- Munro Alasdair
- Munro Claire
- Murphy Sarah
- Mweu Philomena
- Myasaki Celia Hatsuko
- Naik Gurudutt
- Naker Kush
- Nana Anusha
- Nastouli Eleni
- Nazir Abida
- Ndlovu Bongani
- Neffa Fabio
- Njenga Cecilia
- Noal Helena
- Novaes Gabrielle
- Noé Andrés
- Nugent Fay L.
- Nunes Géssika
- O'Brien Katie
- O'Connor Daniel
- O'Reilly Paula
- O'Reilly Peter J.
- Odam Miranda
- Oelofse Suzette
- Oguti Blanche
- Olchawski Victoria
- Oldfield Neil J.
- Oliveira Catarina
- Oliveira Marianne G.
- Oosthuizen Angela
- Osborne Piper
- Owen David R.J.
- Owen Lydia
- Owens Daniel
- Owino Nelly
- Pacurar Mihaela
- Padayachee Sherman D.
- Paiva Brenda V.B.
- Palhares Edna M.F.
- Palmer Susan
- Parkinson Sivapriyai
- Parracho Helena M.R.T.
- Parsons Karen
- Patel Bhumika
- Patel Dipak
- Patel Faeezah
- Patel Kelly
- Patrick-Smith Maia
- Payne Ruth O.
- Peng Yanchun
- Penn Elizabeth J.
- Pennington Anna
- Peralta Alvarez Marco Polo
- Perring James
- Perry Nicola
- Perumal Rubeshan
- Petkar Sahir
- Philip Tricia
- Phillips Daniel J.
- Phillips Jennifer
- Phohu Mary Kgomotso
- Pickup Lorinda
- Pieterse Sonja
- Piper Jo
- Pipini Dimitra
- Pittella Ana
- Plank Mary
- Plested Emma
- Pollard Andrew J
- Pollard Samuel
- Pollock Katrina M.
- Pooley Jennifer
- Pooran Anil
- Poulton Ian
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- Presa Fernando B.
- Price David A.
- Price Vivien
- Primeira Marcelo
- Proud Pamela C.
- Provstgaard-Morys Samuel
- Pueschel Sophie
- Pulido David
- Quaid Sheena
- Rabara Ria
- Radford Alexandra
- Radia Kajal
- Rajapaska Durga
- Rajeswaran Thurkka
- Ramasamy Maheshi N.
- Ramos Lopez Fernando
- Ramos Alberto San Francisco
- Rampling Tommy
- Rand Jade
- Ratcliffe Helen
- Rawlinson Tom
- Rea David
- Rees Byron
- Reiné Jesús
- Resuello-Dauti Mila
- Reyes Pabon Emilia
- Rhead Sarah
- Ribiero Carla M.
- Ricamara Marivic
- Richter Alex
- Ritchie Adam J.
- Ritchie Neil
- Robbins Alexander J.
- Roberts Hannah
- Robinson Hannah
- Robinson Ryan E.
- Rocchetti Talita T.
- Rocha Beatriz Pinho
- Roche Sophie
- Rollier Christine
- Rose Louisa
- Ross Russell Amy L.
- Rossouw Lindie
- Royal Simon
- Rudiansyah Indra
- Ruiz Sarah
- Saich Stephen
- Sala Claudia
- Sale Jessica
- Salman Ahmed M.
- Salvador Natalia
- Salvador Stephannie
- Sampaio Milla
- Samson Annette D.
- Sanchez-Gonzalez Amada
- Sanders Helen
- Sanders Katherine
- Santos Guerra Mayara F.S.
- Santos Erika
- Satti Iman
- Saunders Caroline
- Saunders Jack E.
- Sayed Aakifah
- Schim van der Loeff Ina
- Schmid Annina B.
- Schofield Ella
- Schwarzbold Alexandre V.
- Screaton Gavin
- Seddiqi Samiullah
- Segireddy Rameswara R.
- Senger Roberta
- Serrano Sonia
- Shah Rajiv
- Shaik Imam
- Sharpe Hannah E.
- Sharrocks Katherine
- Shaw Robert
- Shea Adam
- Shepherd Amy
- Shepherd James G.
- Shiham Farah
- Sidhom Emad
- Silk Sarah E.
- Silva-Junior Gilberto
- Silva-Reyes Laura
- Silveira Anderson D.
- Silveira Mariana B.V.
- Singh Nisha
- Sinha Jaisi
- Skelly Donal T.
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- Smith Catherine C.
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- Smith Holly E.
- Smith Nick
- Snape Matthew D.
- Soares Airanuédida
- Soares Tiago
- Solórzano Carla
- Song Rinn
- Sorio Guilherme L.
- Sorley Kim
- Sosa-Rodriguez Tiffany
- Souza Alessandra R.
- Souza Bruno S.D.F.
- Souza Cinthia M.C.D.L.
- Spencer Alexandra J.
- Spina Fernanda
- Spoors Louise
- Sprinz Eduardo
- Stafford Lizzie
- Stamford Imogen
- Starinskij Igor
- Stein Ricardo
- Steven Jill
- Stockdale Lisa
- Stockwell Lisa V.
- Strickland Louise H.
- Stuart Arabella C.
- Sturdy Ann
- Sutherland Rebecca K.
- Sutton Natalina
- Szigeti Anna
- Tahiri-Alaoui Abdessamad
- Tanner Rachel
- Taoushanis Carol
- Tarr Alexander W.
- Tarrant Richard
- Taylor Iona Jennifer
- Taylor Justin
- Taylor Keja
- Taylor Ursula
- te Water Naude Rebecca
- Themistocleous Andreas
- Themistocleous Yrene
- Thomas Kelly
- Thomas Merin
- Thomas Tonia M.
- Thombrayil Asha
- Thompson Amber
- Thompson Ameeka
- Thompson Fawziyah
- Thompson Kevin
- Thomson Emma C.
- Thomson Julia
- Thornton-Jones Viv
- Tighe Patrick J.
- Tinoco Lygia Accioly
- Tiongson Gerlynn
- Tladinyane Bonolo
- Tomasicchio Michele
- Tomic Adriana
- Tonks Susan
- Toshner Mark
- Tran Nguyen
- Tree Julia
- Trillana Gerry
- Trinham Charlotte
- Trivett Rose
- Truby Adam
- Tsheko Betty Lebogang
- Turabi Aadil
- Turner Cheryl
- Turner David P. J.
- Turner Richard
- Török M Estée
- Ulaszewska Marta
- Underwood Benjamin R.
- van Eck Samual
- Varughese Rachel
- Vekemans Johan
- Verbart Dennis
- Verheul Marije
- Vichos Iason
- Vieira Taiane
- Villafana Tonya L.
- Voysey Merryn
- Waddington Claire S.
- Walker Laura
- Wallis Erica
- Wand Matthew
- Warbick Deborah
- Wardell Theresa
- Warimwe George
- Warren Sarah C.
- Watkins Bridget
- Watson Ekaterina
- Watson Marion E. E.
- Webb Stewart
- Webb-Bridges Alice
- Webster Angela
- Weckx Lily Y.
- Welch Jessica
- Wells Jeanette
- West Alison
- White Caroline
- White Rachel
- Williams Christopher J.
- Williams Paul
- Williams Rachel L.
- Winslow Rebecca
- Woodyer Mark
- Worth Andrew T.
- Wright Danny
- Wroblewska Marzena
- Yao Andy
- Zimmer Rafael
- Zizi Dalila
- Zuidewind Peter
- Publication venue
- 'Elsevier BV'
- Publication date
- 09/01/2021
- Field of study
Background
A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials.
Methods
This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674.
Findings
Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation.
Interpretation
ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials
Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
- Author
- Abani O.
- Abbas A.
- Abbas F.
- Abbas M.
- Abbasi S.
- Abbass H.
- Abbott A.
- Abdallah N.
- Abdelaziz A.
- Abdelfattah M.
- Abdelqader B.
- Abdul Rasheed A.
- Abdul B.
- Abdul-Kadir R.
- Abdul-Raheem R.
- Abdulakeem A.
- Abdulmumeen A.
- Abdulshukkoor N.
- Abdusamad K.
- Abed El Khaleq Y.
- Abedalla M.
- Abeer Ul Amna A.
- Abernethy K.
- Abo-Leyah H.
- Aboaba A.
- Abou-Haggar A.
- Abouibrahim M.
- Abraham M.
- Abraham T.
- Abraheem A.
- Abrams J.
- Abu H.-J.
- Abu-Arafeh A.
- Abubacker S.M.
- Abung A.
- Aceampong Y.
- Achara A.
- Acharya D.
- Acheampong S.
- Acheson J.
- Acosta A.
- Acton C.
- Adabie-Ankrah J.
- Adam F.
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- Adcock K.
- Addai J.
- Adebiyi A.
- Adegoke K.
- Adell V.
- Adenwalla S.
- Adesemoye O.A.
- Adewunmi E.O.
- Adeyemi J.
- Adhikary R.
- Adkins G.
- Adnan A.
- Aeron-Thomas J.
- Affleck D.
- Afnan C.
- Afridi M.
- Aftab Z.A.
- Agarwal M.
- Agbeko R.
- Agbo C.
- Agent P.
- Aggarwal S.
- Aghababaie A.
- Ahamed Sadiq S.
- Ahammed Nazeer M.H.
- Ahmad M.
- Ahmad S.
- Ahmed Ali R.
- Ahmed A.
- Ahmed B.
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- Ahmed M.
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- Ahmed O.
- Ahmed R.
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/05/2021
- Field of study
Background:
In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation.
Methods:
This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936).
Findings:
Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001).
Interpretation:
In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids.
Funding:
UK Research and Innovation (Medical Research Council) and National Institute of Health Research
Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial
- Author
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- Zyengi S.
- Publication venue
- 'Elsevier BV'
- Publication date
- 29/05/2021
- Field of study
Background:
Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19.
Methods:
This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.
Findings:
Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79).
Interpretation:
In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes.
Funding:
UK Research and Innovation (Medical Research Council) and National Institute of Health Research
The Physical Processes of CME/ICME Evolution
- Author
- A. Borgazzi
- A. Buergi
- A. Isavnin
- A. Lara
- A. Reinard
- A. Ruffenach
- A. Ruffenach
- A. Shanmugaraju
- A. Taktakishvili
- A. Thernisien
- A. Vourlidas
- A. Vourlidas
- A.A. Mohamed
- A.B. Galvin
- A.B. Galvin
- A.G. Kosovichev
- A.J. Hundhausen
- A.J. Hundhausen
- A.J. Hundhausen
- A.J. Hundhausen
- A.J. Hundhausen
- A.J. Prise
- A.M. Gulisano
- B. Gui
- B. Jackson
- B. Kliem
- B. Kliem
- B. Kliem
- B. Lavraud
- B. Lavraud
- B. Schmieder
- B. van der Holst
- B. van der Holst
- B. van der Holst
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B. Vršnak
- B.C. Low
- B.E. Wood
- B.E. Wood
- B.E. Wood
- B.E. Wood
- B.J. Lynch
- B.J. Lynch
- B.J. Lynch
- B.J. Lynch
- B.M. Bein
- B.M. Bein
- B.V. Jackson
- Bojan Vršnak
- C. Cid
- C. Downs
- C. Downs
- C. Farrugia
- C. Jacobs
- C. Jiang
- C. Kay
- C. Kay
- C. Kay
- C. Kay
- C. Möstl
- C. Möstl
- C. Möstl
- C. Möstl
- C. Salas-Matamoros
- C. Shen
- C. Shen
- C. Wang
- C.E. DeForest
- C.E. DeForest
- C.J. Davis
- C.J. Eyles
- C.J. Eyles
- C.J. Farrugia
- C.J. Farrugia
- C.J. Schrijver
- C.M. Hammond
- C.W. Smith
- D. Maričić
- D. Odstrcil
- D. Odstrcil
- D. Odstrcil
- D. Odstrčil
- D. Odstrčil
- D. Odstrčil
- D. Shiota
- D. Shiota
- D. Sudar
- D.B. Reisenfeld
- D.F. Smart
- D.F. Webb
- D.F. Webb
- D.G. Sime
- D.J. McComas
- D.M. Rust
- D.S. De Young
- D.S. De Young
- D.S. Intriligator
- D.V. Reames
- D.W. Billings
- E. Chané
- E.E. Fenimore
- E.K.J. Kilpua
- E.K.J. Kilpua
- E.K.J. Kilpua
- Emilia K. J. Kilpua
- F. Fang
- F. Fang
- F. Shen
- F. Shen
- F. Valach
- F. Wei
- F.P. Zuccarello
- F.P. Zuccarello
- F.S. Wei
- G. Borrini
- G. Gloeckler
- G. Paschmann
- G. Siscoe
- G. Tóth
- G. Zhou
- G.E. Brueckner
- G.E. Brueckner
- G.M. Lindsay
- H. Aurass
- H. Cremades
- H. Hu
- H. Xie
- H.R. Gilbert
- H.V. Cane
- I.G. Richardson
- I.G. Richardson
- I.G. Richardson
- I.G. Richardson
- I.G. Richardson
- I.I. Roussev
- J. Fuller
- J. Hirshberg
- J. Linker
- J. Schmidt
- J. Uwamahoro
- J.A. Davies
- J.A. Linker
- J.C. Raymond
- J.G. Luhmann
- J.M. Schmidt
- J.M. Schmidt
- J.P. Byrne
- J.R. Gruesbeck
- J.R. Gruesbeck
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.T. Gosling
- J.U. Kozyra
- J.Y. Lee
- K. Marubashi
- K. Muglach
- K.E.J. Huttunen
- K.G. Ivanov
- L. Burlaga
- L. Feng
- L.E. Burlaga
- L.F. Burlaga
- L.F. Burlaga
- L.F. Burlaga
- L.F. Burlaga
- L.F. Burlaga
- L.M. Green
- M. Dryer
- M. Dryer
- M. Dryer
- M. Dryer
- M. Dumbović
- M. Dumbović
- M. Jin
- M. Jin
- M. Jin
- M. Jin
- M. Neugebauer
- M. Owens
- M. Temmer
- M. Temmer
- M. Temmer
- M. Temmer
- M. Vandas
- M. Vandas
- M. Xiong
- M. Xiong
- M.D. Andrews
- M.J. Owens
- M.J. Reiner
- M.J. Reiner
- M.J. Reiner
- M.J. Reiner
- M.L. Kaiser
- M.L. Mays
- M.R. Collier
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Gopalswamy
- N. Lugaz
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- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N. Lugaz
- N.P. Savani
- N.P. Savani
- N.R. Sheeley
- N.V. Nitta
- Noé Lugaz
- O. Cohen
- O. Cohen
- O. Olmedo
- O.C. St. Cyr
- P. Chatterjee
- P. Démoulin
- P. Démoulin
- P. Mäkelä
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