Almost 40% of hospitalized COVID-19 patients still have lung abnormalities two years later, a new oral antiviral shows promise among patients with mild-to-moderate COVID-19, and more in this week's roundup of COVID-19 news.

• Ensitrelvir, an investigational oral antiviral, was found to effectively treat patients with mild-to-moderate COVID-19 in a Phase II/III randomized trial. The drug, developed by Japanese pharmaceutical company Shionogi and Co., is a novel 3C-like protease inhibitor that targets the coronavirus. In the trial, 1,798 patients were enrolled within 120 hours of their symptoms appearing and randomized into three groups. One group received a 125-mg dose of ensitrelvir, another group received a 250-mg dose, and the last group received a placebo for five days. Overall, the researchers found that patients who received the 125-mg doses saw their symptoms resolve roughly a day earlier than those who received the placebo. In addition, SARS-CoV-2 viral titers among patients in the treatment group were negative within a median of 36.2 hours and showed an 87% reduction of infectious virus by day 4. In comparison, it took a median of 65.3 hours within the placebo group to show negative viral titers. Patients in the 250-mg group had similar, but slightly inferior, results. "We shortened the resolution of symptoms," said Takeki Uehera, SVP of drug development and regulatory science at Shionogi. "We showed statistical significance for time to cessation of the viral shedding." Researchers also followed up with patients at three and six months to determine the drug's effectiveness on long COVID and found that there was an overall 25% reduction in risk for at least one long COVID symptom. Patients who had higher scores for 14 COVID-19 symptoms at baseline saw a higher 45% risk reduction. Currently, ensitrelvir has received emergency regulatory approval to treat COVID-19 in Japan, and NIH plans to study the drug in hospitalized patients. (Hein, MedPage Today, 2/22)

• Over a third of patients who were hospitalized with COVID-19 during the early days of the pandemic still have lingering pulmonary abnormalities on chest CT scans two years later, according to a new study published in Radiology. For the study, researchers from Huazhong University of Science and Technology in China analyzed data from 144 patients who had been discharged from COVID-19 hospitalization between Jan. 15 and March 10, 2020. The average age of participants was 60, and almost half had at least one comorbidity. Overall, the incidence of persistent interstitial lung abnormalities (ILAs) decreased over time, from 54% at six months to 42% at one year and 39% at 2 years. Although the proportion of non-fibrotic ILAs declined over time, the incidence of fibrotic ILA remained at 23% throughout the study. "In particular, the proportion of fibrotic interstitial lung abnormalities, an important precursor to idiopathic pulmonary fibrosis, remained stable throughout follow-up," the researchers said. "Therefore, the fibrotic abnormalities observed in our study might represent a stable, irreversible pulmonary condition, such as lung fibrosis, after COVID-19." (Short, MedPage Today, 2/15)

• CDC earlier this month added COVID-19 vaccinations to its immunization schedule for children, adolescents, and adults. According to The Hill, the vaccine schedule reflects the agency's current recommendations to help protect people from common infectious diseases, including influenza, measles, mumps, and more. The schedule does not mean that these vaccines are mandated. Instead, they provide guidance to healthcare workers on when it is best to administer certain vaccines. Other changes to the schedule include a new measles, mumps, and rubella vaccine, a hepatitis B vaccine, and a new pneumococcal vaccine for children and seniors. CDC has also added a recommendation for a booster of the polio vaccine among adults who may be at an increased risk of the virus. According to the American College of Physicians, the new recommendations on COVID-19 and polio vaccines are a "historical change." Currently, detailed immunization schedules are available on CDC's website. They include a color-coded key explaining age requirements, risk factors, precautions, and more. (Foley, Politico, 2/9; Weixel, The Hill, 2/9; Hein, MedPage Today, 2/10)

• The Johns Hopkins Coronavirus Resource Center, which provided crucial information on COVID-19 case rates and other data early in the pandemic, will cease operations on March 10. The website, which was launched on March 3, 2020, helped guide public health policy as well as individual decision making during a time when real-time COVID-19 data was scarce. Over three years, the website drew more than 2.5 billion views. "It is a staggering amount of traffic," said Beth Blauer, an associate vice provost at Johns Hopkins University who helped run the center. "These are numbers I don't think I'll ever see again in my professional career." However, with the pandemic ebbing and less COVID-19 data being reported overall, the university decided to shut down the website. "It's bittersweet," said Lauren Gardner, an engineering professor who launched the website with one of her students. "But it's an appropriate time to move on." (Stein, "Shots," NPR, 2/10)

• Remdesivir, an antiviral COVID-19 drug, may lead to a bradycardic events, or a slowed heart rate, among hospitalized patients who have previously had bradycardia, according to a new study published in JAMA. In the study, 188 patients with COVID-19 had lower minimum heart rates after taking remdesivir compared to the lowest rates before five doses of the drug. The mean minimum heart rate was lowest following the fourth dose of the drug, decreasing by 15.2 beats per minute. According to the researchers, most of the patients who had a slowed heart rate experienced it within 24 hours of a dose of remdesivir. Based on the study's findings, researchers said healthcare workers should be aware of this potential risk when treating patients with COVID-19. (Twenter, Becker's Hospital Review, 2/15)