Research Insights About Covid-19

We attempt to provide selected highlights in recent research findings

Last Update on 1 December 2020

A. Medicine and Health 

April 2020

April 30, 2020 (J of Clinical Virology)

Self-collection: An appropriate alternative during the SARS-CoV-2 pandemic

Michael C. Wehrhahn, Jennifer Robson, Suzanne Brown et al.

https://doi.org/10.1016/j.jcv.2020.104417

In this prospective study in Australia, the authors evaluate the reliability of self-collection of nasal and throat swabs for SARS-CoV-2 and other respiratory viruses. They found that there was a high concordance rate between the swabs taken by self collection and by healthcare workers, suggesting a reliable alternative.

April 30, 2020 (JAMA)

Second-Trimester Miscarriage in a Pregnant Woman With SARS-CoV-2 Infection

David Baud, Gilbert Greub, Guillaume Favre, et al

https://doi.org/10.1001/jama.2020.7233

This case report describes a pregnant woman with symptomatic coronavirus disease who experienced a second-trimester miscarriage in association with documented placental SARS-CoV-2 infection.

 

April 30, 3030 (Cell Research)

The ChinaMAP analytics of deep whole genome sequences in 10,588 individuals

Cao, Y., Li, L., Xu, M. et al. 

https://doi.org/10.1038/s41422-020-0322-9
The China Metabolic Analytics Project (ChinaMAP) is based on cohort studies across diverse regions and ethnic groups with metabolic phenotypic data in China. In this paper, the authors we describe the centralized analysis of the deep whole genome sequencing data and the genetic bases of metabolic traits in 10,588 individuals from the ChinaMAP. This study establishes a large-scale and deep resource for the genetics of East Asians and provides opportunities for novel genetic discoveries of metabolic characteristics and disorders.

 

April 30, 2020 (The Annals of Thoracic Surgery, Preprint)

Assessing the Collateral Damage of the Novel Coronavirus: A Call to Action for the Post-COVID-19 Era

Vervoort D, Luc JGY, Percy E, Hirji S, Lee R

https://doi.org/10.1016/j.athoracsur.2020.04.015

The COVID-19 pandemic has resulted in many elective surgeries being cancelled around the world. This paper explores the contemporary issues impacting healthcare resources during the pandemic and makes recommendations for identifying an appropriate balance of their use to optimize patient care.

April 29, 2020 (Proceedings of the National Academy of Sciences)

Effective treatment of severe COVID-19 patients with tocilizumab

Xiaoling Xu, Mingfeng Han, Tiantian Li, Wei Sun, Dongsheng Wang, Binqing Fu, Yonggang Zhou, Xiaohu Zheng, Yun Yang, Xiuyong Li, Xiaohua Zhang, Aijun Pan, Haiming Wei

https://doi.org/10.1073/pnas.2005615117

Chinese investigators conducted a retrospective, uncontrolled study of 21 patients with severe COVID-19 symptoms (as defined by prespecified criteria) who received treatment with the IL-6 blocker tocilizumab. Within 24 hours of starting tocilizumab therapy, fevers and elevated C-reactive protein levels resolved, and levels of IL-6 and other proinflammatory cytokines declined. Use of supplemental oxygen dropped in 15 patients, oxygen saturation levels stabilized or improved in all patients, the 2 ventilated patients were weaned, and all patients subsequently were discharged alive.

April 29, 2020 (Nature Medicine)

Responding to the hidden pandemic for healthcare workers: stress

Krystal, J.H., McNeil, R.L. 

https://doi.org/10.1038/s41591-020-0878-4

In the COVID-19 pandemic, frontline healthcare workers are having to work under particularly intense stress levels. The author shares how videoconferencing can be harnessed to provide mental-health support, and also addresses ‘tele-health’ fatigue.

 

April 29, 2020 (Science)

Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China

Juanjuan Zhang, Maria Litvinova, Yuxia Liang, Yan Wang, Wei Wang, Shanlu Zhao, Qianhui Wu, Stefano Merler, Cécile Viboud, Alessandro Vespignani, Marco Ajelli, Hongjie Yu

https://doi.org/10.1126/science.abb8001

As transmission intensifies, the interplay between age, contact patterns, social distancing, susceptibility to infection, and COVID-19 dynamics remains unclear. To answer these questions, the authors analyze contact surveys data for Wuhan and Shanghai before and during the outbreak and contact tracing information from Hunan Province. Based on their findings, the authors build a transmission model to study the impact of social distancing and school closure on transmission. They found that social distancing alone, as implemented in China during the outbreak, is sufficient to control COVID-19. While proactive school closures cannot interrupt transmission on their own, they can reduce peak incidence by 40-60% and delay the epidemic.

 

April 29, 2020 (The Lancet)

Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multi centre trial

Yeming Wang, Dingyu Zhang, Prof Guanhua Du, Prof Ronghui Du,

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

As the search continues for the effective treatment of COVID-19, the authors carried out a double-blinded, placebo-controlled RCT on Remdesivir, a nucleoside analogue prodrug that has inhibitory effects on SARS-CoV2 in vitro. They found that In this study of adult patients admitted to hospital for severe COVID-19, remdesivir was not associated with statistically significant clinical benefits.

 

April 28, 2020  (Emerg Infect Dis.)

Evaluating the Effectiveness of Social Distancing Interventions to Delay or Flatten the Epidemic Curve of Coronavirus Disease

Laura Matrajt and Tiffany Leung

https://doi.org/10.3201/eid2608.201093

The authors used a mathematical model to investigate the effectiveness of social distancing interventions carried out in different age groups, over 6 weeks in a mid-sized city. They found that interventions started earlier in the epidemic delay the epidemic curve and interventions started later flatten the epidemic curve. They also highlight that when interventions ended, the epidemic rebounded, suggesting that social distancing can provide crucial time to increase healthcare capacity but must occur in conjunction with testing and contact tracing of all suspected cases to mitigate virus transmission.

 

April 28, 2020 (Nature)

The race for coronavirus vaccines: a graphical guide

Ewen Callaway

https://www.nature.com/articles/d41586-020-01221-y

Researchers are trialling different technologies to come up with a vaccine for SARS-CoV2. With the use of infographics, this easy to understand article explains COVID-19 vaccine designs and developments.

 

April 28, 2020 (American Journal of Obstetrics and Gynaecology)

Maternal Death Due to COVID-19 Disease

Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, Seferovic MD, et al.

https://doi.org/10.1016/j.ajog.2020.04.030

In this multi-centre case series in Iran, the authors describe the outcome of 9 pregnant women with laboratory confirmed severe COVID-19 disease during their late 2nd or 3rd trimester.

 

April 27, 2020 (Nature)

Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals

Liu, Y., Ning, Z., Chen, Y. et al.

https://doi.org/10.1038/s41586-020-2271-3

This study investigated the aerodynamic nature of SARS-CoV-2 by measuring viral RNA in aerosols in different areas of two Wuhan hospitals during the COVID-19 outbreak in February and March 2020. They found that some medical staff areas initially had high concentrations of viral RNA which were reduced to undetectable levels after implementation of rigorous sanitization procedures. The identification of the virus however does not reflect the infectivity of the virus detected. 

 

April 27, 2020 (The Lancet)

Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study

Qifang Bi, Yongsheng Wu, Shujiang Mei, Chenfei Ye, Xuan Zou, Zhen Zhang et al.

https://doi.org/10.1016/S1473-3099(20)30287-5

In this retrospective study, data analysis showed that isolation and contact tracing reduce the time during which cases are infectious in the community.  The overall impact of isolation and contact tracing, however, is uncertain and highly dependent on the number of asymptomatic cases.

 

April 27, 2020 (J of Arthroplasty)

Understanding Antibody Testing for COVID-19

David Jacofsky, Emilia M. Jacofsky, Marc Jacofsky

https://doi.org/10.1016/j.arth.2020.04.055

The authors explain the science behind antibody testing, the principle of antibody assays, and interpretation of point-of-care antibody tests.  

April 27, 2020 (ID Cases)

SARS-CoV-2 infection in a patient on chronic hydroxychloroquine therapy: Implications for prophylaxis

Khalid M. Dousa, Sharad S. Malavade, Jennifer Furin, Barbara Gripshover, Marjorie Hatszegi, Leila Hojat, Elie Saade, Robert A.Salata

https://doi.org/10.1016/j.idcr.2020.e00778

Hydroxychloroquine and chloroquine have been used as treatment for COVID-19 and are being considered as prophylaxis, especially for health care workers who are at high risk. In this case report of a patient who contracted COVID-19 despite being on Hydroxychloroquine, the authors question the role of these medications as preventive therapy.

April 26, 2020 (CellPress, Pre-proof)

Imbalanced host response to SARS-CoV-2 drives development of COVID-19

Daniel Blanco-Melo, Benjamin E. Nilsson-Payant, Wen-Chun Liu, Skyler Uhl, Daisy Hoagland, Rasmus Møller, Tristan X. Jordan, et al.

https://doi.org/10.1016/j.cell.2020.04.026

The transcriptional response to infection with SARS-CoV2 is investigated in vitro (cell lines and primary cells), in vivo (ferrets) and ex vivo (lung tissue from COVID19 patients) and compared to uninfected. They also compare SARS-CoV2 with other respiratory viruses including SARS-CoV1 and IAV. Overall, SARS-CoV2 fails to induce a robust type I/III interferon response even in cells permissive to viral replication, although a subset of ISGs is induced independently of IFN signalling. In contrast, SARS-CoV2 constantly induces the expression of high levels of inflammatory chemokines. Further, they detect similar imbalanced immune response in SARS-CoV-2 infected ferrets and the serum in a cohort of 24 SARS-CoV2+ patients.

April 26, 2020 (J of Clinical Virology)

A RT-PCR assay for the detection of coronaviruses from four genera

Leshan Xiu, Raquel A.Binder, Natalie A. Alarja, Kara Kochek et al.

https://doi.org/10.1016/j.jcv.2020.104391

The authors describe their work in the development of a diagnostic test that is able to detect all coronaviruses from the four main genera. The assay was highly specific and sensitive in detecting CoVs, and performed well on different sample types.

 

April 25, 2020 (Science of the Total Environment)

Follow-up studies in COVID-19 recovered patients - is it mandatory?

Vellingiri Balachandar, Iyer Mahalaxmi, Mohandevi Subramaniam et al.

https://doi.org/10.1016/j.scitotenv.2020.139021

The authors recommend a longitudinal study to assess the health status of COVID-19 recovered patients to evaluate any changes in the other organs in human systems. They provide an overview of the multi-system involvement from current data available and also share their recommendations for COVID-19 recovered patients.

 

April 24, 2020 (JAMA Pediatrics)

Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China

Xie X et al.

https://doi.org/10.1001/jamapediatrics.2020.1619

To examine children's psychological adjustment, researchers surveyed 1784 children in grades 2 to 6 living in Hubei province whose schools had been closed for over a month. Overall, 22.6% of students reported depression symptoms and 18.9% reported anxiety symptoms, both rates are higher than baseline rates reported for children in Asia.

April 24, 2020 (JAMA)
Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial

Mayla Gabriela Silva Borba, Fernando Fonseca Almeida Val, Vanderson Souza Sampaio et al.

https://doi.org/10.1001/jamanetworkopen.2020.8857

There is yet to be a specific antiviral therapy recommended for the treatment of COVID-19. However, in-vitro studies have indicated that high doses of chloroquine diphosphate (CQ) has antiviral effects. In this double-blinded RCT, the authors evaluate the safety and efficacy of 2 different doses of CQ and their preliminary findings suggest that higher dosages of CQ should not be recommended for the treatment of severe COVID-19 because of safety concerns regarding QTc interval prolongation and increased lethality.

 

April 24, 2020 (NEJM)

Mild or moderate COVID-19

Rajesh T. Gandhi, John B. Lynch, and Carlos del Rio

https://doi.org/10.1056/NEJMcp2009249

Using a case vignette, the authors provide an excellent overview on COVID-19 covering disease transmission, clinical manifestations, diagnosis, evaluation, management options and infection prevention and control.

 

April 24, 2020 (Front. Microbiol.)

The Current and Future State of Vaccines, Antivirals and Gene Therapies Against Emerging Coronaviruses

Longping V. Tse, Rita M. Meganck, Rachel L. Graham, Ralph S. Baric

https://doi.org/10.3389/fmicb.2020.00658

Vaccine development targeting coronaviruses is indeed challenging. In this review, the authors summarize the key advancements of current vaccines and antivirals against SARS-CoV and MERS-CoV as well as discuss the challenges and opportunities in the current SARS-CoV-2 crisis. They then advocate the development of a “plug-and-play” platform technologies that could allow quick manufacturing and administration of broad-spectrum countermeasures in an outbreak setting.

 

April 24, 2020 (JMIR Public Health Surveill.)

Regulation and Trust: 3-Month Follow-up Study on COVID-19 Mortality in 25 European Countries

Atte Oksanen, Markus Kaakinen, Rita Latikka, Iina Savolainen, Nina Savela, Aki Koivula

https://doi.org/10.2196/19218

Although Europe has been greatly affected by the COVID-19 pandemic, there are major country differences in both the spread of the virus and measures taken to stop the virus. In this study, the authors examined country variations of COVID-19 mortality in Europe by analyzing social risk factors explaining the spread of the disease, restrictions and control measures, and institutional trust.

 

April 23, 2020 (Biomedicine & Pharmacotherapy)

COVID-19: an exploratory randomized controlled trial

Yuhao Zhang, Xiuchao Geng, Yanli Tan et al. 

https://doi.org/10.1016/j.biopha.2020.110195

In this paper, the authors systematically review the pathogenic features, transmission routes, and infection mechanisms of SARS-CoV-2, as well as any adverse effects on the digestive system, urogenital system, central nervous system, and circulatory system, in order to provide a theoretical and clinical basis for the diagnosis, classification, treatment, and prognosis assessment of SARS-CoV-2 infection.

 

April 23, 2020 (JAMA)

Association of Renin-Angiotensin System Inhibitors With Severity or Risk of Death in Patients With Hypertension Hospitalized for Coronavirus Disease 2019 (COVID-19) Infection in Wuhan, China

Juyi Li, Xiufang Wang, Jian Chen, et al

https://doi.org/10.1001/jamacardio.2020.1624

SARS-CoV2 uses the angiotensin-converting enzyme (ACE) 2 receptor to gain entry into host cells. ACE-inhibitors (ACE-I) and Angiotensin receptor blockers (ARBs) are commonly used in the management of patients with hypertension. This case series seeks to answer the question on whether hypertensive patients on ACE-I or ARB treatment have greater illness severity or increased risk of mortality during hospitalization for COVID-19 infection.

April 23, 2020 (Laboratory Diagnositics)

A SARS-CoV-2 surrogate virus neutralization test (sVNT) based on antibody-mediated blockage of ACE2-spike (RBD) protein-protein interaction

Chee Wah Tan, Wan Ni Chia, Mark I-C Chen et al.

https://doi.org/10.21203/rs.3.rs-24574/v1

At this time of the COVID-19 pandemic, there is an urgent need for a robust, validated and accessible serological test to detect neutralizing antibodies to SARS-CoV-2. Here, the authors report a validated SARS-CoV-2 surrogate virus neutralization test (sVNT) that is designed to detect total neutralizing antibodies in an isotype- and species-independent manner. They report that their simple and rapid test is based on antibody-mediated blockage of virus-host interaction between the ACE2 receptor protein and the receptor binding domain (RBD) of the viral spike protein.

April 23, 2020 (NEJM)

Ten Weeks to Crush the Curve

Harvey V. Fineberg

https://doi.org/10.1056/NEJMe2007263

In this editorial piece, Dr Fineberg illustrates six steps to mobilize and organize the nation with the aim of defeating COVID-19 by June 2020.

 

April 22, 2020 (J Clin Nurs.)

Covid-19: Supporting Nurses' Psychological and Mental Health

Jill Maben, Jackie Bridges

https://doi.org/10.1111/jocn.15307

Nurses are truly the heart of the healthcare system. In the COVID-19 pandemic, nurses are on the front line of health and social care in the most extreme of circumstances. This article highlights the stressors and challenges nurses face during this time, and provide meures to support them during this difficult time.

 

April 22, 2020 (Brain Behave Immun.)

Current Status of Potential Therapeutic Candidates for the COVID-19 Crisis

Jiancheng Zhang, Bing Xie, Kenji Hashimoto

https://doi.org/10.1016/j.bbi.2020.04.046

There are intensive research and clinical trials underway to assess the efficacy of existing drugs and identify potential therapeutic targets to develop new drugs for treating COVID-19. In this article, the authors summarize the current potential therapeutic approaches for diseases related to COVID-19 infection and introduce their mechanisms of action, safety, and effectiveness.

April 22, 2020 (Front. Med.)

Thanks to all medical workers fighting against COVID-19

Chen, X.

https://doi.org/10.1007/s11684-020-0789-2

A citizen of Wuhan pens down heartfelt gratitude to all those involved in fighting COVID-19.

April 21, 2020 (The BMJ)

Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study

Zheng Shufa, Fan Jian, Yu Fei, Feng Baihuan, Lou Bin, Zou Qianda et al.

https://doi.org/10.1136/bmj.m1443

In this retrospective study, the authors evaluated SARS-CoV2 viral loads from various samples at different stages of diseases progression in COVID-19 positive patients and found that the duration of SARS-CoV2 is significantly longer in stool samples than in respiratory and serum samples. They also conclude that the virus persists longer with higher load and peaks later in the respiratory tissues of patients with severe disease.

 

April 21, 2020 (The Lancet)

Connecting clusters of COVID-19: an epidemiological and serological investigation

Sarah Ee Fang Yong, Danielle Elizabeth Anderson, Wycliffe E Wei, Junxiong Pang, Wan Ni Chia, Chee Wah Tan

https://doi.org/10.1016/S1473-3099(20)30273-5

Identification of the source of COVID-19 infections and elucidating the chain of disease transmission are crucial for effective disease containment. The authors describe an epidemiological investigation carried out in Singapore that established links between three clusters of COVID-19, with the use of SARS-CoV-2 serological assays.

April 21, 2020 (The Lancet)

Ethnicity and COVID-19: an urgent public health research priority

Manish Pareek, Mansoor N Bangash, Nilesh Pareek, Daniel Pan, Shirley Sze, Jatinder S Minhas et al.

https://doi.org/10.1016/S0140-6736(20)30922-3

The authors noticed that early reports from China and Italy showed a striking difference in mortality indicating that ethnicity might affect disease outcome. They reviewed published papers and national surveillance reports on notifications and outcomes of COVID-19 to ascertain ethnicity data reporting patterns, associations, and outcomes. They found that none of the ten highest COVID-19 case-notifying countries reported data related to ethnicity.

April 20, 2020 (Cell, Preprint)

SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues
Ziegler, C.G.K., Allon, S.J., Nyquist, S.K., et al https://doi.org/10.1016/j.cell.2020.04.035

In this paper, the authors investigate the cell subsets targeted by SARS-CoV-2 in host tissues, and the factors that regulate ACE2 expression. Based on human and animal single-cell RNA-sequencing (scRNA-seq) datasets across health and disease, they identified ACE2 and TMPRSS2 co-expressing cells within lung type II pneumocytes, ileal absorptive enterocytes, and nasal goblet secretory cells.  They discover that ACE2 is a human interferon-stimulated gene (ISG) in vitro using airway epithelial cells, and extend their findings to in vivo viral infections.

April 20, 2020 (Eur J of Radiology)

Radiology department strategies to protect Radiologic Technologists against COVID19: experience from Wuhan

Yanjie Zhao, Chunlin Xiang, Shaofang Wang, Chengdong Peng, Qian Zou, Junwu Hu

https://doi.org/10.1016/j.ejrad.2020.108996

Computed Tomography (CT) of the chest has become an important investigative tool in COVID-19. As such, radiologic technologists who conduct this procedure for the infected patients are at a high risk of contracting the disease themselves. The authors share systematic strategies encompassing personnel arrangements, environmental modification, protection levels and configurations, radiological imaging (CT and radiography), and disinfection methods to combat COVID-19 in the radiology department.

 

April 20, 2020 (Eur J Clin Invest.)

COVID-19 Diagnosis Does Not Rule Out Other Concomitant Diseases

Alberto Borghetti, Arturo Ciccullo, Elena Visconti, Enrica Tamburrini, Simona Di Giambenedetto

https://doi.org/10.1111/eci.13241

Although in this pandemic phase, it must not be forgotten that the diagnosis of COVID-19 does not imply the exclusion of other concomitant diseases. In this letter, the authors share a case vignette highlighting the importance of evaluating patients as a whole, and the need for clinicians to maintain a high level of attention when evaluating patients with COVID-19.

April 17, 2020 (The Lancet)

Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study

Prof Benjamin J Cowling, Sheikh Taslim Ali, Tiffany W Y Ng, Tim K Tsan, Julian C M Li, Peng Wu… Prof Gabriel M Leung

https://doi.org/10.1016/S2468-2667(20)30090-6

The authors examined the effect of these interventions and behavioural changes of the public on the incidence of COVID-19. When Peng Wu at the University of Hong Kong and her colleagues surveyed residents in early March, 99% said they wore a mask in public and 85% said they avoided crowds.

 

April 17, 2020 (JAMA)

Educate, Amplify, and Focus to Address COVID-19 Misinformation

Valerie A. Earnshaw, Ingrid T. Katz

https://jamanetwork.com/channels/health-forum/fullarticle/2764847?resultClick=1

Technology has made information readily available to all. The downside to this is that there is a growing surge of misinformation which needs to be urgently addressed. The authors emphasize on the role of health care professionals in dispelling misinformation. 

April 17, 2020 (JAMA)

The Promise and Peril of Antibody Testing for COVID-19

Abbasi J.

https://doi.org/10.1001/jama.2020.6170

There are recommendations for health-care providers to use serological tests to detect antibodies to SARS-CoV-2 to help identify people who may have been exposed to the virus or have recovered from the COVID-19 infection. This article discusses how antibody tests should—and should not—be used during the SARS-CoV-2 pandemic.

 

April 17, 2020 (Stem Cells and Development, Preprint)

Stem Cell-Based Therapy for Coronavirus Diseases 2019

Rober Chunhua Zhao

https://doi.org/10.1089/scd.2020.0071

Currently, there is still no specific effective antiviral treatment for COVID-19. It is also known that the immune response plays a vital part in the course of this disease. In this article, the author describes basic research and ongoing clinical trials on mesenchymal stem cells (MSCs) and discusses it’s potential use as an effective treatment for patients with COVID-19.

April 17, 2020 (Asian Journal of Psychiatry)

Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review

Mamidipalli Sai Spoorthy, Sree,  Karthik Pratapa, Supriya Mahant

https://doi.org/10.1016/j.ajp.2020.102119

This review was done to conduct a systematic appraisal of studies on Mental health problems faced by healthcare workers due to the COVID-19 pandemic. The review showed that several socio-demographic variables like gender, profession, age, place of work, department of work were associated with increased stress, anxiety, depressive symptoms and insomnia in HCW.

 

April 16, 2020 (JAMA)

Finding Ways to Reduce Coronavirus Exposure During Dialysis

Rubin R.

https://doi.org/10.1001/jama.2020.6158

This Medical News Feature examines what hemodialysis centers are doing to protect their high-risk patients from COVID-19.

 

April 16, 2020 (JAMA)

Meeting the Care Needs of Older Adults Isolated at Home During the COVID-19 Pandemic

Steinman MA, Perry L, Perissinotto CM.

https://doi.org/10.1001/jamainternmed.2020.1661

The COVID19 pandemic has resulted in the need for social distancing and isolation. This can adversely affect the older adults. This viewpoint stresses the importance of recognising the challenges created by COVID-19 and addresses how clinicians can help reduce these potentially negative effects.

 

April 16, 2020 (Baylor University Medical Centre Proceedings)

SARS-CoV-2 (COVID-19) and intravascular volume management strategies in the critically ill

Amir Kazory, Claudio Ronco & Peter A. McCullough

https://doi.org/10.1080/08998280.2020.1754700

A subset of patients with COVID-19 develop a more severe form of the diseases characterized by expanding pulmonary lesions, sepsis, acute respiratory distress syndrome, and respiratory failure. Due to lack of data on treatment strategies specific to this group, current management of the critically ill is extrapolated and customized to their clinical needs. The article calls attention to fluid stewardship in the critically ill patients with COVID-19 by judiciously applying the evidence-based resuscitation principles to their specific clinical features such as high rates of cardiac injury. This strategy is likely to help reduce potential complications.

 

April 15, 2020 (J Med Virol.)

Possibly Critical Role of Wearing Masks in General Population in Controlling COVID-19

Guangshu Han, Yi-Hua Zhou

https://doi.org/10.1002/jmv.25886

The authors summarise existing evidence on the spread of COVID-19 and the use of masks in prevention. They advocate the need for wearing masks in the general population to control COVID-19.

April 15, 2020 (Nature Medicine)

Temporal dynamics in viral shedding and transmissibility of COVID-19

He, X., Lau, E.H.Y., Wu, P. et al.

https://doi.org/10.1038/s41591-020-0869-5

The authors report temporal patterns of viral shedding in 94 patients with laboratory-confirmed COVID-19 and modeled COVID-19 infectiousness profiles from a separate sample of 77 infector–infectee transmission pairs. Their findings infer that infectiousness peaked on or before symptom onset.

 

April 14, 2020 (New Microbes and New Infections)

Review on the global epidemiological situation and the efficacy of chloroquine and hydroxychloroquine for the treatment of COVID-19

S. Saqrane, M.A. El Mhammedi

https://doi.org/10.1016/j.nmni.2020.100680

The authors summarise the current epidemiological situation of the coronavirus outbreak as well as current information available on Hydroxycholoroquine as potential treatment for the disease.

 

April 14, 2020 (Viruses)

Molecular Investigation of SARS–CoV-2 Proteins and Their Interactions with Antiviral Drugs

Paolo Calligari, Sara Bobone, Giorgio Ricci, Alessio Bocedi

https://doi.org/10.3390/v12040445

With the vast number of people affected by SARS-CoV2, and with no vaccination available, there is an urgent need to find effective treatment strategies. In this article, the Italians share with us their work on using the molecular docking approach to analyze the affinity between different viral proteins and several inhibitors, originally developed for other viral infections. Their data show that, in some cases, a relevant binding can be detected, supporting the hypothesis to develop new antiviral agents against COVID-19, on the basis of already established therapies.

 

April 14, 2020 (Science)

Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period

Stephen M. Kissler, Christine Tedijanto, Edward Goldstein, Yonatan H. Grad, Marc Lipsitch

https://doi.org/10.1126/science.abb5793

Yonatan Grad, Marc Lipsitch and their colleagues at the Harvard T.H. Chan School of Public Health in Boston, Massachusetts, modelled the spread of coronaviruses in places that have temperate climates, such as the United States. The results helped the team to predict the spread of SARS-CoV-2, the coronavirus that causes COVID-19.

 

 

April 14, 2020 (MedRxiv, Preprint)

Hydroxychloroquine in patients with COVID-19: an open-label, randomized, controlled trial

Wei Tang, Zhujun Cao, Mingfeng Han, Qing Xie et al.

https://doi.org/10.1101/2020.04.10.20060558

In this multicenter, open label, randomised control trial, the authors set out to assess the efficacy and safety of hydroxychloroquine (HCQ) plus standard-of-care (SOC) compared with SOC alone in adult patients with COVID-19.

 

 

April 14, 2020 (Intensive and Critical Care Nursing)

End-of-life decisions and care in the midst of a global coronavirus (COVID-19) pandemic

Natalie Pattison

https://doi.org/10.1016/j.iccn.2020.102862

The author broaches a very important aspect of medicine in this article discussing end-of-life decisions and care, as well as bereavement support amidst the COVID-19 pandemic

 

April 14, 2020 (Science)

Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period

Stephen M. Kissler, Christine Tedijanto, Edward Goldstein, Yonatan H. Grad, Marc Lipsitch.

https://doi.org/10.1126/science.abb5793

The authors highlight the urgent need to understand the future of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) transmission. In this article, they used estimates of seasonality, immunity, and cross-immunity for betacoronaviruses OC43 and HKU1 from time series data from the USA to inform a model of SARS-CoV-2 transmission.

 

April 13, 2020 (J of Medical Virology)

Coronavirus disease 2019: new things to know!

Souheil Zayet, Kadiane‐Oussou N'dri Juliette, Pierre‐Yves Royer, Lynda Toko, Vincent Gendrin, Timothee Klopfenstein

https://doi.org/10.1002/jmv.25874

In this article, the authors report their findings from a retrospective study carried out in a single centre. They highlight clinical features that are not just confined to the respiratory tract.  

 

April 13, 2020 (JAMA) 

Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19) A Review

James M. Sanders, Marguerite L. Monogue, Tomasz Z. Jodlowski et al

https://doi.org/10.1001/jama.2020.6019

In this review, the authors summarise an extensive literature review on pharmacologic treatments for COVID-19. They discuss all available pharmacological options at present, and share current clinical treatment experience and recommendations.

 

 

April 12, 2020 (Wiley Connections)

We urgently need guidelines for managing COVID‐19 in children with comorbidities

Devi Dayal

https://doi.org/10.1111/apa.15304

In this letter, Dr Dayal summarises current evidence available for the management of COVID-19 in children and identifies the gaps in research.

 

April 11, 2020 (The Lancet)

Regulators split on antimalarials for COVID-19

Susan Jaffe

https://doi.org/10.1016/S0140-6736(20)30817-5

The use of antimalarials such as chloroquine and hydroxychloroquine in the treatment of COVID-19 has sparked much debate. In this article, the author discusses the various viewpoints of international regulators regarding this topic.

 

April 10, 2020 (J R Coll Physicians Edinb)

Have we found the panacea to COVID-19 with remdesivir, an old but newly packaged drug?

Abdul Malik Mohamed Thalha, Yeong Yeh Lee, Alwi Besari, Sharifah Faridah Syed Omar

https://doi.org/10.4997/JRCPE.2020.217

In this piece, the authors share their opinion on the use of Remdisivir for the treatment of COVID-19. They summarise the current available evidence on Remdisivir and are of the opinion that whilst they are studies suggesting clinical benefit, remdesivir is not a panacea.

April 10, 2020 (J of Infection) 

Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis

Leiwen Fu, Bingyi Wang, Tanwei Yuan, Xiaoting Chen, Yunlong Ao, Thomas Fitzpatrick et al.

https://doi.org/10.1016/j.jinf.2020.03.041

The authors performed an extensive systematic review and meta-analysis to provide a comprehensive characterisation of COVID-19 to better inform efforts to treat and control the current outbreak. They reviewed studies from 4 different databases and reviewed for methodological quality prior to selecting 43 COVID-19 studies involving a total of 3600 patients from across the world. They performed extensive data analysis and also assessed heterogeneity between studies. They summarise the clinical signs, risk factors, laboratory and chest CT findings, complications, and treatments of COVID-19. The authors found that the majority of COVID-19 cases are symptomatic with a moderate case fatality rate (CFR). Additionally, patients living in Wuhan, older patients, and those with medical co-morbidities tend to have more severe clinical symptoms and higher CFR.

April 10, 2020 (JAMA)

Association of Public Health Interventions With the Epidemiology of the COVID-19 Outbreak in Wuhan, China

Pan A, Liu L, Wang C, et al. 

https://doi.org/10.1001/jama.2020.6130

In this cohort study, the authors evaluate the association of public health interventions with the epidemiological features of the COVID-19 outbreak in Wuhan by 5 periods according to key events and interventions. They included 32 583 patients with laboratory-confirmed COVID-19 in Wuhan from December 8, 2019, through March 8, 2020. The interventions include cordons sanitaire, traffic restriction, social distancing, home quarantine, centralized quarantine, and universal symptom survey. The found that these interventions were temporally associated with reduced effective reproduction number of SARS-CoV-2 (secondary transmission) and the number of confirmed cases per day across age groups, sex, and geographic regions.

April 10, 2020 (Emerg Infect Dis., Early Release)

Aerosol and Surface Distribution of Severe Acute Respiratory Syndrome Coronavirus 2 in Hospital Wards, Wuhan, China, 2020

Guo Z-D, Wang Z-Y, Zhang S-F, Li X, Li L, Li C, et al.

https://doi.org/10.3201/eid2607.200885

The main transmission routes for SARS-CoV-2 are respiratory droplets and close contact. It is important to know the extent of environmental contamination of SARS-CoV-2 in COVID-19 wards to improve safety practices for health care workers, and to also address public concerns regarding transmission. In this study, air and surface samples were taken from intensive care units and general wards of two hospitals treating COVID-19 patients in Wuhan.

April 10, 2020 (JAMA)

Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China

Mao L, Jin H, Wang M, et al.

https://doi.org/10.1001/jamaneurol.2020.1127

In this retrospective study, the authors take a look at neurological manifestations of patients with COVID-19. They also highlight the importance to consider the diagnosis of COVID-19 in patients with neurological manifestations.

 

April 10, 2020 (Journal of Infection 2020)

Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: a prospective contact-tracing study.

L. Huang, X. Zhang and X. Zhang et al.

https://doi.org/10.1016/j.jinf.2020.03.006

This is a contact-tracing study of a Covid-19 patient in Feidong province, China, returning from Wuhan. His close contacts, during both pre-symptomatic and symptomatic periods, were traced and followed-up to determine any. The authors described the type, and significance of contacts, and identified amongst them those that went on to develop Covid-19 and vice-versa.

 

 

April 10, 2020. (CDC Mortality and Morbidity Weekly Report)

Presymptomatic Transmission of SARS-CoV-2 — Singapore, January 23–March 16, 2020.

Wei WE, Li Z, Chiew CJ, Yong SE, Toh MP, Lee VJ

http://dx.doi.org/10.15585/mmwr.mm6914e1

This is a CDC report with a summary of 8 separate clusters in Singapore, that demonstrated pre-symptomatic transmissions of Covid-19 cases. The reported transmissions ranged between 1-3 days before the source started developing symptoms. The cases were either from direct respiratory droplets or indirect transmission via environmental or fomite contamination.

 

 

April 10, 2020 (J of Autoimmunity) 

Can we use interleukin-6 (IL-6) blockade for coronavirus disease 2019 (COVID-19)-induced cytokine release syndrome (CRS)?

Bingwen Liu, Min Li, Zhiguang Zhou, Xuan Guan, YuFei Xiang

https://doi.org/10.1016/j.jaut.2020.102452

Cytokine release syndrome has been implicated as the cause of severe illness in COVID-19. Here, the authors explain the pathogenesis of CRS not only in COVID-19, but also in SARS and MERS, comparing the three. They also summarize the existing therapies for CRS.  Additionally, they discuss the use of interleukin-6 (IL-6) blockade to manage COVID-19-induced CRS, including factors that should be taken into consideration for its clinical application.

 

 

April 9, 2020 (Nature)

Structure of Mpro from COVID-19 virus and discovery of its inhibitors

Jin, Z., Du, X., Xu, Y. et al.

https://doi.org/10.1038/s41586-020-2223-y

Mpro is an important coronavirus enzyme, which plays a pivotal role in mediating viral replication and transcription, making it an attractive drug target for this virus. The authors describe the structure of Mpro and their mechanism of discovery of its inhibitors. This could lead to the rapid discovery of drug leads with clinical potential.

April 9, 2020 (Eur J Preventive Cardiology) 

Physical inactivity and cardiovascular disease at the time of coronavirus disease 2019 (COVID-19)

Giuseppe Lippi, Brandon M Henry, Fabian Sanchis-Gomar.

https://doi.org/10.1177/2047487320916823

During quarantine, staying active and maintaining a physical exercise routine is  essential for mental and physical health. The authors encourage authorities to include clear exceptions for physical activity such as allowing for safe performance of outdoor physical activities (e.g. walking or running where an adequate interpersonal distance can be maintained), and thus prevent unfavourable cardiovascular diseases.


 

April 8, 2020 (BMC Med)

Optimising strategies to address mental ill-health in doctors and medical students: ‘Care Under Pressure’ realist review and implementation guidance

Carrieri, D., Mattick, K., Pearson, M. et al.

https://doi.org/10.1186/s12916-020-01532-x

The authors suggest that successful and effective interventions to tackle doctors’ and students’ mental ill-health are likely to be multidimensional and multilevel and involve multiple stakeholders. The review indicates that evaluating and improving existing interventions is likely to be more effective than developing new ones.

 

April 8, 2020 (Nature Biomed Eng)

Humanity tested 

https://doi.org/10.1038/s41551-020-0553-6

This must-read editorial mentions that the world needs mass at-home serological testing for antibodies elicited by SARS-CoV-2, and rapid and frequent point-of-care testing for the presence of the virus’ RNA in selected populations.

April 8, 2020 (Clinical Microbiology and Infection)

Challenges and issues about organizing a hospital to respond to the COVID-19 outbreak: experience from a French reference centre

N. Peiffer-Smadja, J.-C. Lucet, G. Bendjelloul et al.

https://doi.org/10.1016/j.cmi.2020.04.002

In order to provide data on the resilience of health systems during the COVID-19 pandemic, the authors describe, at the hospital level, the key elements of the response to COVID-19, including the challenges and issues to anticipate following the experience of their centre, one of the largest hospital system in Europe.

April 7, 2020 (Maturitas)

COVID-19: The forgotten priorities of the pandemic

Cristina Mesa Vieira, Oscar H. Franco, Carlos Gomez Restrepo, Thomas Abel

https://doi.org/10.1016/j.maturitas.2020.04.004

This article has been awarded the Editor’s choice for the June edition of Maturitas. In the paper, the authors describe some implications of social distancing that can be detrimental to people’s mental health, especially of those who do not have an extensive support network.

April 7, 2020 (MedRxiv, pre print)

Loss of smell and taste in combination with other symptoms is a strong predictor of COVID-19 infection

Cristina Menni, Ana Valdes, Maxim B Freydin, … Tim Spector

https://doi.org/10.1101/2020.04.05.20048421

The authors perform a community survey to investigate the prevalence of loss of smell and taste among COVID-19 diagnosed individuals and to identify the combination of symptoms, besides loss of smell and taste, that most likely corresponds to a positive COVID-19 diagnosis in non-severe cases.

April 6, 2020 (PNAS)

Effectiveness of convalescent plasma therapy in severe COVID-19 patients

Kai Duan, Bende Liu, Cesheng Li, et al.

https://www.pnas.org/content/early/2020/04/02/2004168117

In this study, 10 severe patients confirmed by real-time viral RNA test were enrolled prospectively for convalescent plasma (CP) treatment. Their preliminary results indicate that CP can serve as a promising rescue option for severe COVID-19 patients.

April 4, 2020 (J of Hospital Infection)

Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong

Wong SC-Y, Kwong RT-S, Wu TC, Chan JWM, Chu MY, Lee SY, Wong HY, Lung DC
https://doi.org/10.1016/j.jhin.2020.03.036

In this contact investigation revolving around one patient, the authors findings suggest that SARS-CoV-2 is not spread by an airborne route, and nosocomial transmissions can be prevented through vigilant basic infection control measures, including wearing of surgical masks, hand and environmental hygiene.

April 3, 2020 (Asian J of Psychiatry)

Issues relevant to mental health promotion in frontline health care providers managing quarantined/isolated COVID19 patients

Ritin Mohindra, Ravaki R, Vikas Suri et al.

https://doi.org/10.1016/j.ajp.2020.102084

The authors conducted interviews with health care providers managing COVID-19 patients to find out the perceived motivations influencing morale. They identified three themes: positive Motivational factors (that need to be strengthened), Negatives, frustrations associated with patient care, and personal fears and annoyances experienced by doctors. They present their findings with a view to disseminate so that hospitals facing or preparing for COVID-19 can factor in these issues.

April 3, 2020 (IJID 2020)

The enlightenment from two cases of asymptomatic infection with SARS-CoV-2: is it safe after 14 days of isolation?  International Journal of Infectious Diseases

Zhi-Qun Mao, Ren Wan, Li-Yi He, Yue-Chun Hu, Wei Chen.

https://doi.org/10.1016/j.ijid.2020.03.041

This is a case report of 2 asymptomatic infections in China, which showed persistence of SARS-CoV2 genome beyond 14 days of isolation.  Both received antiviral treatments but remained asymptomatic throughout the period. Serial chest radiographs remained negative. They both achieved 1st negative swab on Day 19 and Day 22 of contact, and 2nd negative swabs 2 days later and discharged. There were no records of infections to close contacts.

April 2, 2020 (Infect Control Hosp Epidemiol.)

Potential impact of contaminated bronchoscopes on novel coronavirus disease (COVID-19) patients

Ofstead CL, et al.

https://doi.org/10.1017/ice.2020.102

In this letter to the editor, the authors bring up the possibility of bronchoscopy-associated transmission of COVID-19 given previous evidence of bronchoscopy related nosocomial outbreaks of other pathogens.

April 2, 2020 (Nature) 

Masks could cut spread of COVID-19 virus

https://www.nature.com/articles/d41586-020-00502-w

To mask or not to mask, the effectiveness of masking

April 1, 2020 (J. Zhejiang Univ. Sci. B)

Dialectical behavior therapy-based psychological intervention for woman in late pregnancy and early postpartum suffering from COVID-19: a case report

Huang, J., Zhou, X., Lu, S. et al.

https://doi.org/10.1631/jzus.B2010012

The authors share their experience using dialectical behaviour therapy-based psychological intervention involving mindfulness training, relaxation exercise for regulating negative emotions, distress tolerance skills, as well as interpersonal skills to share distress and gain support on a pregnant COVID-19 positive patient.

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