Atypical antipsychotic medications may protect against coronavirus infection, the United States may limit access to next-generation Covid-19 vaccines this fall if more funding is not approved, and more in this week's roundup of Covid-19 news.

• More than half of patients who were hospitalized with Covid-19 during the initial coronavirus outbreak in Wuhan, China, are still reporting at least one symptom years later, according to a new study published in Lancet Respiratory Medicine. For the study, researchers from the China-Japan Friendship Hospital in Beijing examined data from 1,192 Covid-19 patients who had been discharged from Jinyintan Hospital in Wuhan between Jan. 7 and May 29, 2020. Of these patients, 70% received supplementary oxygen while hospitalized, 8% received "higher-level" respiratory support, and 4% were admitted to the ICU. The median age at discharge was 57 years, and 54% of the patients were men. Overall, 68% of patients reported at least one symptom six months after infection, which decreased to 55% at the two-year mark. The most frequently reported symptoms were fatigue and muscle weakness. In addition, the researchers found that patients with long Covid symptoms were more likely to experience anxiety or depression, pain or discomfort, and mobility issues. "Ongoing follow-up of COVID-19 survivors, particularly those with symptoms of long COVID, is essential to understand the longer course of the illness, as is further exploration of the benefits of rehabilitation [programs] for recovery," said Bin Cao, one of the study's authors. "There is a clear need to provide continued support to a significant proportion of people who've had COVID-19, and to understand how vaccines, emerging treatments, and variants affect long-term health outcomes." (Walker, MedPage Today, 5/11)

• According to a senior Biden administration official, the United States may have to limit the availability of next-generation Covid-19 vaccines this fall if Congress fails to approve funding for new shots soon. "We will be able to get some vaccines of the new generation but it'll be a very limited amount and really only for the highest-risk individuals, but it will not be available for everybody,” the official said. To have vaccines available for the fall, Congress will need to pass funding within the next few weeks to allow the federal government to negotiate contracts and production expectations with vaccine manufacturers, the official said. However, Moderna CEO Stephane Bancel said that even if funding does become available, the short timeline may still make it difficult for vaccine manufacturers to have the necessary doses ready by the fall. "If you look at the timelines, I don't think any manufacturer will be able to be ready in August to fill the channel with product," Bancel said. On Pfizer's end, CEO Albert Bourla said the company will be ready to start manufacturing doses of its next-generation vaccines as soon as FDA provides guidance on how to proceed. "It's going to be a pretty tough fall and winter if Congress abdicates its responsibilities and does not show up with funding for the American people," the official said. "We're going to do what we can but at the end of the day, our hands are going to be tied." (Kimball, CNBC, 5/9; Bean, Becker's Hospital Review, 5/10)

• Most coronavirus transmission—potentially as much as 60%—may be from people who are asymptomatic or pre-symptomatic, a 2021 modeling study published in JAMA Network Open found. According to Helen Chu, an infectious diseases physician at the University of Washington School of Medicine, the rate of asymptomatic infections may be even higher now after the winter omicron surge significantly boosted population immunity, reducing the risk of severe symptoms. "Spaces that are not well ventilated, have large numbers of individuals, and places where people are speaking loudly or eating, those are the spaces that we should be most concerned about," she said. In addition, these high rates of asymptomatic transmission highlight a need for continued safety precautions, particularly to protect vulnerable populations like the immunocompromised and children under 5 who cannot yet be vaccinated. "Given that community transmission levels are rising in most of the U.S., it is important we continue to layer mitigation measures to prevent further spread and exposure to the virus even if you are vaccinated," said Syra Madad, from Harvard University's Belfer Center for Science and International Affairs. "While the risk at the individual level may be low if you are not in the high-risk category, and we have more tools to manage the disease including antivirals, the risk to the overall community is still high." (Henderson, MedPage Today, 5/10)

• Second-generation antipsychotic medication, also known as atypical antipsychotics, may prevent coronavirus infection in patients with serious mental illness, according to a new study published in JAMA Network Open. For the study, researchers analyzed 1,958 inpatients at 18 New York State Office of Mental Health psychiatric hospitals between March 8 and July 1, 2020. Among all patients, 46.5% had an affective psychotic disorder, including schizoaffective disorder or bipolar 1 disorder, and the remainder has schizophrenia delusional disorder. Most of the patients were taking multiple psychotic medications, with 61.2% on first-generation antipsychotics, 91.6% on second-generation antipsychotics, 53.3% on mood stabilizers, 51.9% on benzodiazepines, and 27.9% on antidepressants. Overall, patients who were taking any kind of second-generation antipsychotic medication had a 38% lower risk of infection. After adjusting for age and sex, use of clozapine, paliperidone, risperidone (Risperdal), and olanzapine (Zyprexa) were associated with lower odds of infection. However, mood stabilizers, including valproic acid, lithium, and lamotrigine, were associated with an increased risk of infection. (Monaco, MedPage Today, 5/6)

• The omicron subvariant BA.2.12.1, which is driving a Covid-19 surge in New York state, continues to grow in prevalence in the United States, making up almost 43% of new cases for the week ending May 7, according to CDC data. Since the week ending April 23, BA.2.12.1's prevalence has grown around 20 percentage points. As of May 10, the daily average for new cases nationwide was 77,092, up 52% over the last two weeks. In addition, hospitalizations also increased 19% during the same time, reaching a daily average of 19,270 on May 10. Thirty-seven states are currently reporting an increase in new Covid-19 hospitalizations, and federal modeling predicts that hospital admissions will continue to increase nationwide over the next few weeks. (Carbajal, Becker's Hospital Review, 5/11)