Research Insights About Covid-19

We attempt to provide selected highlights in recent research findings

Last Update on 25 June 2020

A. Medicine and Health 

June 2020

June 19, 2020 (Science)

Structure-based design of antiviral drug candidates targeting the SARS-CoV-2 main protease

Wenhao Dai, Bing Zhang, Xia-Ming Jiang et al.

https://doi.org/10.1126/science.abb4489

With no vaccine or proven effective drug against the SARS-CoV2 virus, scientists are racing to find clinical antiviral treatments. A promising drug target is the viral main protease Mpro, which plays a key role in viral replication and transcription. Dai et al.designed two inhibitors, 11a and 11b, based on analyzing the structure of the Mpro active site. Both strongly inhibited the activity of Mpro and showed good antiviral activity in cell culture. Compound 11a had better pharmacokinetic properties and low toxicity when tested in mice and dogs, suggesting that this compound is a promising drug candidate.

 

June 19, 2020 (Science)

COVID-19 and cancer

Norman E. Sharpless

https://doi.org/10.1126/science.abd3377

The author discusses the impact of the COVID-19 pandemic on cancer. From causing delayed diagnosis and suboptimal care for people with cancer, to unprecedented disruption throughout the cancer research community, there is valid concern that this will be a step backwards for the cancer community.

 

 

June 19, 2020 (JAMA)

Association of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use With COVID-19 Diagnosis and Mortality

Emil L. Fosbøl, Jawad H. Butt, Lauge Østergaard, et al

https://doi.org/10.1001/jama.2020.11301

This cohort study uses Danish registry data to estimate the association between a prescription for angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in the 6 months prior to a coronavirus disease 2019 (COVID-19) diagnosis and mortality among all patients and those with hypertension.

 

June 18, 2020 (JAMA Otolaryngol Head Neck Surg.)

Prevalence of Taste and Smell Dysfunction in Coronavirus Disease 2019

Giuseppe Mercante, Fabio Ferreli, Armando De Virgilio et al.

https://doi.org/10.1001/jamaoto.2020.1155

This survey study of patients with coronavirus disease 2019 investigates the presence of sinonasal manifestations at the onset of the disease to achieve an earlier diagnosis.

 

June 18, 2020 (The Lancet Diabetes & Endocrinology)

Association between high serum total cortisol concentrations and mortality from COVID-19

Tricia Tan, Bernard Khoo, Edouard G Mills et al.

https://doi.org/10.1016/S2213-8587(20)30216-3

The increase in cortisol is an essential part of the body's stress response, triggering adaptive changes in metabolism, cardiovascular function, and immune regulation. The authors performed a cohort study describing the acute cortisol concentrations observed in patients with COVID-19. They found that cortisol seemed to be a better independent predictor than were other laboratory markers associated with COVID-19, such as CRP, D-dimer, and neutrophil to leukocyte ratio. 

 

June 17, 2020 (Jama Int. Med.)

Prone Positioning in Awake, Nonintubated Patients With COVID-19 Hypoxemic Respiratory Failure

Alison E. Thompson, Benjamin L. Ranard, Ying Wei, Sanja Jelic.

https://doi.org/10.1001/jamainternmed.2020.3030

This cohort study investigates whether the prone position is associated with improved oxygenation and decreased risk for intubation in spontaneously breathing patients with severe COVID-19 hypoxemic respiratory failure.    

 

June 16, 2020 (The Lancet Rheumatology)

GM-CSF blockade with mavrilimumab in severe COVID-19 pneumonia and systemic hyperinflammation: a single-centre, prospective cohort study

Giacomo De Luca, Giulio Cavalli, Corrado Campochiaro et al.

https://doi.org/10.1016/S2665-9913(20)30170-3

This single-centre prospective cohort study included patients aged 18 years or older with severe COVID-19 pneumonia, hypoxia, and systemic hyperinflammation. Patients received a single intravenous dose (6 mg/kg) of mavrilimumab added to standard care given by the hospital at the time. The control group consisted of contemporaneous patients with similar baseline characteristics who received standard care at the same hospital. Mavrilimumab treatment was associated with improved clinical outcomes compared with standard care in non-mechanically ventilated patients with severe COVID-19 pneumonia and systemic hyperinflammation. 


 

June 15, 2020 (Chest)

Tocilizumab treatment for Cytokine Release Syndrome in hospitalized COVID-19 patients: survival and clinical outcomes

Christina C.Price, Frederick L.Altice, YuShyr

https://doi.org/10.1016/j.chest.2020.06.006

In this observational study, the authors followed through COVID-19 patients who were treated with tocilizumab using an algorithm that targeted Cytokine Release Syndrome (CRS). The authors found that in tocilizumab-treated patients, oxygenation and inflammatory biomarkers improved with higher than expected survival.

June 15, 2020 (JAMA)

Monoclonal Antibodies for Prevention and Treatment of COVID-19

Mary Marovich, John R. Mascola, Myron S. Cohen

https://doi.org/10.1001/jama.2020.10245

This Viewpoint discusses the potential role of neutralizing monoclonal antibodies (MAbs) as a treatment for coronavirus disease 2019 (COVID-19) and as a means of prevention in high-risk populations, and it also raises possible limitations of the approach that need to be disproven or addressed for the strategy to be effective.

       

    

June 12, 2020 (JAMA Patient Page)

Convalescent Plasma and COVID-19

Anurag N. Malani, John P. Sherbeck, Preeti N. Malani

https://doi.org/10.1001/jama.2020.10699

This JAMA Patient Page describes the possible benefits of convalescent plasma transfusion in the treatment of COVID-19 as well as plasma donation eligibility criteria.

 

June 12, 2020 (JAMA Surgery)

Factors Associated With Surgical Mortality and Complications Among Patients With and Without Coronavirus Disease 2019 (COVID-19) in Italy

Francesco Doglietto, Marika Vezzoli, Federico Gheza et al.

https://doi.org/10.1001/jamasurg.2020.2713

This cohort study compares early surgical outcomes of patients in Italy with and without COVID-19 in different subspecialties. In this study of 41 surgical patients with COVID-19 and 82 tightly matched control patients without COVID-19, significant differences were documented regarding rates of early mortality and complications, pneumonia and thrombotic complications were significantly associated with COVID-19. Based on these results, the authors suggest that surgery should be postponed in patients with COVID-19, wherever possible.

 

June 12, 2020 (Science)

A noncompeting pair of human neutralizing antibodies block COVID-19 virus binding to its receptor ACE2

Yan Wu, Feiran Wang, Chenguang Shen et al.

https://doi.org/10.1126/science.abc.2241

One of the responses of the immune system to invading viruses is the production of antibodies. Some of these are neutralizing, meaning that they prevent the virus from being infectious, and can thus be used to treat viral diseases. Wu et al. isolated four neutralizing antibodies from a convalescent coronavirus disease 2019 (COVID-19) patient and describe them in detail in this article.

 

June 11, 2020 (JAMA Network Open)

Temperature, Humidity, and Latitude Analysis to Estimate Potential Spread and Seasonality of Coronavirus Disease 2019 (COVID-19)

Mohammad M. Sajadi, Parham Habibzadeh, Augustin Vintzileos et al.

https://doi.org/10.1001/jamanetworkopen.2020.11834

This cohort study examines the association between climate and the spread of coronavirus disease 2019 (COVID-19) infection.

 

June 11, 2020 (The Lancet)

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP): a population-based study

Silvia Stringhini, Ania Wisniak, Giovanni Piumatti et al.

https://doi.org/10.1016/S0140-6736(20)31304-0

The authors perform a population based study to measure the prevalence of anti-SARS-CoV-2-IgG antibodies using a commercially available ELISA. They performed weekly measurements and report the results of 5 weeks of measurement between April 6, 2020 - May 9, 2020. Assuming that the presence of IgG antibodies is associated with immunity, the results suggest tha  most of the population of Geneva remained uninfected during this wave of the pandemic. The authors estimate that for every reported confirmed case, there were 11·6 infections in the community. They hope to continue this study to complete 12 weeks.

 

June 11, 2020 (JAMA Network Open)

Assessment of Hypokalemia and Clinical Characteristics in Patients With Coronavirus Disease 2019 in Wenzhou, China

Dong Chen, Xiaokun Li, Qifa Song, et al.

https://doi.org/10.1001/jamanetworkopen.2020.11122

This cohort study investigates the prevalence, causes, and clinical implications of hypokalemia, including its possible association with treatment outcomes, among patients with coronavirus disease 2019 (COVID-19) in Wenzhou, China.

 

June 9, 2020 (JAMA)

Respiratory Parameters in Patients With COVID-19 After Using Noninvasive Ventilation in the Prone Position Outside the Intensive Care Unit

Chiara Sartini, Moreno Tresoldi, Paolo Scarpellini et al.

https://doi.org/10.1001/jama.2020.7861

This study measured respiratory parameters of 15 non-ICU patients before, during, and after receiving noninvasive ventilation in the prone position.

 

June 6, 2020 (Mayo Clinic Proceedings)

Innovation Lessons From the COVID-19 Pandemic

Gianrico Farrugia, Roshelle W. Plutowski

https://doi.org/10.1016/j.mayocp.2020.05.0.24

The authors highlight how health care organizations, industry partners, and government agencies worldwide have quickly come together to address the challenges of the COVID19 pandemic such as scaling high-quality laboratory tests, conducting treatment research, and enabling virtual health care in a time of social distancing. These accomplishments demonstrate the opportunity for future cross-sector partnerships in science and technology to fight the disease, while simultaneously creating the new digital health care solutions that our world greatly needs.

 

June 6, 2020 (European J of Medicinal Chemistry)

A Promising Antiviral Candidate Drug for the COVID-19 Pandemic: A Mini-Review of Remdesivir

Chengyuan Liang, Lei Tian, Yuzhi Liu et al.

https://doi.org/10.1016/j.ejmech.2020.112527

This article provides a comprehensive overview of remdesivir (GS-5734), a viral RNA-dependent RNA polymerase (RdRP) inhibitor. The remdesivir synthetic routes were comprehensively collected and are presented as a compilation of roadmaps. The authors also summarise clinical trial information of remdesivir for the treatment of COVID-19.

 

June 5, 2020 (Infection, Disease & Health)

Concerns for low-resource countries, with under-prepared intensive care units, facing the COVID-19 pandemic

Muhammad Elhadi, Ahmed Msherghi, Mohammed Alkeelani et al.

https://doi.org/10.1016/j.idh.2020.05.008

The authors report the healthcare system preparedness for COVID-19 in low resource settings and provides insight to the shortage of personal protective equipment in Africa. They also highlight the health care situation during the civil war and COVID 19 outbreak in Libya, as well as the infrastructure status of intensive care units in Libya.

 

June 4, 2020 (JAMA)

Correlation Between N95 Extended Use and Reuse and Fit Failure in an Emergency Department

Nida F. Degesys, Ralph C. Wang, Elizabeth Kwan et al.

https://doi.org/10.1001/jama.2020.9843

This cross-sectional study examines prevalence of fit test failure of 2 types of N95 mask (dome-shaped and duckbill) during extended use or reuse among health care workers over 2 days in April 2020 in the UCSF emergency department. They found that duckbill N95s had a high failure rate. Failure of dome-shaped masks was associated with increased use.

 

June 2, 2020 (Int J of Infectious Diseases)

COVID-19 Outbreak in Malaysia: Actions Taken by the Malaysian Government

Ain Umaira Md Shah, Syafiqah Nur Azrie Safri, Rathedevi Thevadas et al.

https://doi.org/10.1016/j.ijid.2020.05.093

This article shares the Malaysian experience of managing the COVID-19 pandemic. The authors share the actions taken by the Malaysian government such as the movement control order, amongst other steps to mitigate the spread of the disease.

 

June 4, 2020 (JAMA)

Challenge Trials—Could Deliberate Coronavirus Exposure Hasten Vaccine Development?

Rita Rubin

https://doi.org/10.1001/jama.2020.9881

This Medical News feature discusses the debate over human challenge trials to test the safety and efficacy of coronavirus disease 2019 (COVID-19) vaccine candidates.

 

June 3, 2020 (NEJM)

A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19

David R. Boulware, Matthew F. Pullen, Ananta S. Bangdiwala et al.

https://doi.org/10.1056/NEJMoa2016638

In this double-blind, randomised trial, 821 asymptomatic persons with a high-risk or moderate-risk exposure to SARS-CoV-2 were assigned to receive hydroxychloroquine or placebo within 4 days after the exposure. No benefit in preventing illness compatible with COVID-19 was found.

 

June 3, 2020 (NEJM)

Swabs Collected by Patients or Health Care Workers for SARS-CoV-2 Testing

Yuan-Po Tu, Rachel Jennings, Gerard A. Cangelosi, et al.

https://doi.org/10.1056/NEJMc2016321

Tongue, nasal and mid-turbinate swabs to detect SARS-CoV-2 were collected by 530 outpatients before a health care worker collected nasopharyngeal swabs from these patienta. Both the mid-turbinate and nasal samples collected by the patients themselves may be clinically acceptable, with estimated sensitivities above 90%.

 

June 3, 2020 (The Lancet)

The impact of ethnicity on clinical outcomes in COVID-19: A systematic review

Daniel Pan, Shirley Sze, Jatinder S. Minhas, et al.

https://doi.org/10.1016/j.eclinm.2020.100404
The authors performed a systematic review to assess whether ethnicity has been reported in patients with COVID-19 and its relation to clinical outcomes. Data on ethnicity in patients with COVID-19 in the published medical literature remains limited. However, emerging data from the grey literature and preprint articles suggest Black, Asian and Minority Ethnic (BAME) individuals are at an increased risk of acquiring SARS-CoV-2 infection compared to White individuals and also worse clinical outcomes from COVID-19. 

 

June 3, 2020 (JAMA)

Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial

Ling Li, Wei Zhang, Yu Hu, et al.

https://doi.org/10.1001/jama.2020.10044

This randomized trial compares the effects of convalescent plasma therapy with standard care vs standard care alone on time to clinical improvement among patients with severe or life-threatening COVID-19 disease in China. The authors found that among patients with severe or life-threatening COVID-19, convalescent plasma therapy added to standard treatment, compared with standard treatment alone, did not result in a statistically significant improvement in time to clinical improvement within 28 days. 

 

June 2, 2020 (The Lancet Public Health)

Effects of non-pharmaceutical interventions on COVID-19 cases, deaths, and demand for hospital services in the UK: a modelling study

Nicholas G Davies, Adam J Kucharski, Rosalind M Eggo, et al

https://doi.org/10.1016/S2468-2667(20)30133-X

 

Non-pharmaceutical interventions have been implemented to reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the UK. This study assesses the potential impact of different control measures for mitigating the burden of COVID-19 in the UK.

 

June 1, 2020 (The Lancet)

Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

Derek K Chu, Elie A Akl, Stephanie Duda, et al.

https://doi.org/10.1016/S0140-6736(20)31142-9
 

The authors performed systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. They reviewed 172 observational studies across 16 countries and six continents and their findings  support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. 

June 2020 (American Journal of Infection Control)

A qualitative study on the psychological experience of caregivers of COVID-19 patients

Niuniu Sun, Luoqun Wei, Suling Shi et al.

https://doi.org/10.1016/j.ajic.2020.03.018

In this qualitative study, the authors explore the psychology of nurses caring for COVID-19 patients. They enrolled 20 nurses who provided care for COVID-19 patients using a phenomenological approach. They found that nurses showed interweaving positive and negative emotions during outbreak of COVID-19, with negative emotions being dominant in the early stages of the COVID-19 outbreak. They emphasised that coping styles and psychological growth are important for maintaining mental health.

June 2020 (Journal of Nursing Research)

Nursing Perspectives on the Impacts of COVID-19

CHEN, Shu-Ching, LAI, Yeur-Hur, TSAY, Shiow-Luan

https://doi.org/10.1097/NRJ.0000000000000389

Nurses are the frontline healthcare professionals who work across acute care hospitals, long-term care agencies, nursing homes, schools, community, and government healthcare agencies. The multiple roles and functions played by nurses are particularly important during this COVID-19 pandemic and the authors highlight the nurses contribution across 5 main domains. They also discuss the key challenges faced by nursing professionals during this pandemic. 

May 2020

May 30, 2020 (European Radiology)

CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients

Ojha, V., Mani, A., Pandey, N.N. et al. 

https://doi.org/10.1007/s00330-020-06975-7

The authors performed a systematic review to evaluate the key imaging manifestations of COVID-19 on chest CT in adult patients. They included 45 studies comprising 4410 patients. This review describes the imaging features for diagnosis, stratification, and follow-up of COVID-19 patients. The most common CT manifestations are bilateral, peripheral/subpleural, posterior GGOs with or without consolidations with a lower lobe predominance.

 

May 29, 2020 (JAMA Neurology)

Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019: A Review

Adeel S. Zubair, Lindsay S. McAlpine, Tova Gardin et al.

https://doi.org/10.1001/jamaneurol.2020.2065

This narrative review identifies potential tissue targets and routes of entry of severe acute respiratory syndrome coronavirus 2 into the central nervous system and reported neurological complications of coronavirus disease 2019.

 

May 29, 2020 (Science)

The Search for a COVID-19 Animal Model

Seema S. Lakdawala, Vineet D. Menachery

https://doi.org/10.1126/science.abc6141

Translating data from a single animal model to the varied disease outcomes in humans is not only challenging, but potentially misleading. Studies examining the efficacy of vaccines and antiviral drugs traditionally use models of severe disease, which may not mimic the common pathology in the majority of COVID-19 patients and could limit understanding of other important questions, including infection dynamics and transmission. Here, the authors compare currently available animal models for SARS-CoV-2 infection and COVID-19 in search for the best animal model to study COVID-19.

 

May 28, 2020 (Experimental Biology and Medicine)

The amount of cytokine-release defines different shades of Sars-Cov2 infection

S Bindolli, M Felicetti, P Sfriso et al.

https://doi.org/10.1177/1535370220928964

This minireview contributes to providing a point of view regarding the immunological mechanisms beyond COVID-19 infection. Base on current evidence, the authors suggest to classify patients into three main clinical phenotypes according to the amount and pattern of cytokines released during the infection. By evaluating the degree of immunological activation provoked by SARS-CoV2, this article contributes in understanding better how to choose the correct clinical approach with immuno-modulatory therapies which, in turn, may help in curbing the hyper-inflammatory condition of patients affected.

 

May 28, 2020 (The Lancet Oncology)

Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study

Nicole M Kuderer, Toni K Choueiri, Dimpy P Shah et al.

https://doi.org/10.1016/S0140-6736(20)31187-9

The authors characterise the outcomes of a cohort of 928 patients with cancer and COVID-19 and identify potential prognostic factors for mortality and severe illness.

 

May 27, 2020 (Cell)

SARS-CoV-2 Reverse Genetics Reveals a Variable Infection Gradient in the Respiratory Tract

Yixuan J. Hou, Kenichi Okuda, Caitlin E. Edwards et al.

https://doi.org/10.1016/j.cell.2020.05.042

The authors utilized a reverse genetics system to generate a GFP reporter virus to explore SARS-CoV-2 pathogenesis. The found that the reagents used provide a foundation for investigations into virus-host interactions in protective immunity, host susceptibility, and virus pathogenesis.

May 27, 2020 (Science)

Reducing transmission of SARS-CoV-2

Kimberly A. Prather, Chia C Wang, Robert T. Schooley

https://doi.org/10.1126/science.abc6197

The authors discuss the role of aerosol spread of the SARS-CoV2 virus and emphasise the need for masks to combat asymptomatic spread in aerosols and droplets.

 

May 27, 2020 (JAMA Internal Medicine)

Opening Hospitals to More Patients During the COVID-19 Pandemic—Making It Safe and Making It Feel Safe

David A. Asch

https://doi.org/10.1001/jamainternmed.2020.2626

This essay details the importance in the COVID-19 era of making the changes needed to ensure that hospitals are safe for all patients who want to use them and, as importantly, to ensure that the patients feel that they are safe.

 

May 27, 2020 (JAMA)

Comparison of Clinical Characteristics of Patients with Asymptomatic vs Symptomatic Coronavirus Disease 2019 in Wuhan, China

Rongrong Yang, Xien Gui, Yong Xiong

https://doi.org/10.1001/jamanetworkopen.2020.10182

This case series examines clinical characteristics of patients with asymptomatic vs symptomatic coronavirus disease 2019 in Wuhan, China.

 

May 27, 2020 (JAMA Psychiatry)

Psychiatry in Times of the Coronavirus Disease 2019 (COVID-19) Pandemic: An Imperative for Psychiatrists to Act Now

Luykx JJ, Vinkers CH, Tijdink JK.

https://doi.org/10.1001/jamapsychiatry.2020.1225

This Viewpoint discusses how psychiatrists can contribute to diminish the effects of the coronavirus disease 2019 (COVID-19) pandemic.

 

May 27, 2020 (NEJM)

Remdesivir for 5 or 10 Days in Patients with Severe Covid-19

Jason D. Goldman, David C.B. Lye,David S. Hui, Kristen M. Marks et al.

https://doi.org/10.1056/NEJMoa2015301

The authors conducted a randomized, open-label, phase 3 trial involving hospitalized patients with confirmed severe SARS-CoV-2 infection. 397 patients were randomly assigned in a 1:1 ratio to receive intravenous remdesivir for either 5 days or 10 days. All patients received 200 mg of remdesivir on day 1 and 100 mg once daily on subsequent days. In patients with severe Covid-19 not requiring mechanical ventilation, the trial did not show a significant difference between a 5-day course and a 10-day course of remdesivir. With no placebo control, however, the magnitude of benefit cannot be determined. 

May 26, 2020 (Clinica Chimica Acta)

COVID-19: Transmission, prevention, and potential therapeutic opportunities

Melika Lotfi, Michael R. Hamblin, Nima Rezaei

https://doi.org/10.1016/j.cca.2020.05.044

The authors review current evidence and present current therapeutic options, preventive methods and transmission routes of COVID-19 

May 26, 2020 (United European Gastroenterology Journal)

Liver Injury in COVID-19: The Current Evidence

Saleh A Alqahtani, Jorn M Schattenberg

https://doi.org/10.1177/2050640620924157

This review summarizes current evidence related to hepatobiliary complications in COVID-19, provides an overview of the available case series and critically elucidates the proposed mechanisms and provides recommendations for clinicians.

 

May 26, 2020 (Otolaryngology– Head and Neck Surgery)

Inappropriate Nasopharyngeal Sampling for SARS-CoV-2 Detection Is a Relevant Cause of False-Negative Reports

Antonio Piras, Davide Rizzo, Sergio Uzzau et al.

https://doi.org/10.1177/0194599820931793

The authors describe 4 symptomatic patients with negative RT-PCR results at the first nasopharyngeal swab, which became positive when collected a few hours later by an otolaryngologist, suggesting that inadequate nasopharyngeal sampling performed by untrained operators in the presence of nasal obstruction can be a relevant case of false-negative findings at RT-PCR, with a clear negative impact on the efforts to contain the current outbreak.

 

May 22, 2020 (The Lancet)

Safety, tolerability, and immunogenicity of a recombinant adenovirus type-5 vectored COVID-19 vaccine: a dose-escalation, open-label, non-randomised, first-in-human trial

 Feng-Cai Zhu,  Yu-Hua Li,  Xu-Hua Guan, et al

https://doi.org/10.1016/S0140-6736(20)31208-3
The authors assessed the safety, tolerability, and immunogenicity of a recombinant adenovirus type-5 (Ad5) vectored COVID-19 vaccine expressing the spike glycoprotein of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain. Their findings show that the Ad5 vectored COVID-19 vaccine is tolerable and immunogenic at 28 days post-vaccination, suggesting that this vaccine warrants further investigation.

May 22, 2020 (JAMA)

Coronavirus Disease 2019 Test Results After Clinical Recovery and Hospital Discharge Among Patients in China

Jinru Wu, Xinyi Liu, Jianjun Liu, Han Liao, Sixuan Long, Ning Zhou, Pa Wu

https://doi.org/10.1001/jamanetworkopen.2020.9759

This cross-sectional study used reverse transcriptase–polymerase chain reaction tests to assess potential viral shedding among patients who previously had been diagnosed with and had clinically recovered from coronavirus disease 2019.

May 22, 2020 (JAMA)

Nursing Home Care in Crisis in the Wake of COVID-19

David C. Grabowski, Vincent Mor

https://doi.org/10.1001/jama.2020.8524

This Viewpoint discusses the long-standing deficiencies in nursing home financing and organization made worse by the spread of coronavirus disease 2019 (COVID-19), and proposes ways to improve testing and personal protective equipment availability, and payment reforms to incentivize quality care for residents and decrease emergency department and hospital use.


 

May 22, 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

Kissler et al. used existing data to build a deterministic model of multiyear interactions between existing coronaviruses, with a focus on the United States, and used this to project the potential epidemic dynamics and pressures on critical care capacity over the next 5 years. The long-term dynamics of SARS-CoV-2 strongly depends on immune responses and immune cross-reactions between the coronaviruses, as well as the timing of introduction of the new virus into a population. One scenario is that a resurgence in SARS-CoV-2 could occur as far into the future as 2025.

 

May 22, 2020 (The Lancet)

Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis

Prof Mandeep R Mehra, Sapan S Desai, Prof Frank Ruschitzka, Amit N Patel

https://doi.org/10.1016/S0140-6736(20)31180-6

The authors performed a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents. They were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.

 

May 22, 2020 (Clinical Infectious Diseases)

Predicting infectious SARS-CoV-2 from diagnostic samples 

Jared Bullard, Kerry Dust, Duane Funk, James E Strong, David Alexander et al.

https://doi.org/10.1093/cid/ciaa638

An RT-PCR test for SARS-CoV2 detects RNA but not infectious virus, thus its ability to determine duration of infectivity of patients is limited. Infectivity is a critical determinant in informing public health guidelines/interventions. Here, the authors perform a retrospective cross-sectional study and took SARS-CoV-2 RT-PCR confirmed positive samples and determined their ability to infect Vero cell lines. They found that cell infectivity was only observed for samples with PCR Cycle time < 24 and from patients with < 8 days from symptom onset.

 

May 21, 2020 (JAMA)

Postmortem Examination of Patients With COVID-19

Tina Schaller, Klaus Hirschbühl, Katrin Burkhardt, Georg Braun, Martin Trepel, Bruno Märkl, Rainer Claus

https://doi.org/10.1001/jama.2020.8907

This case series describes autopsy findings in 10 patients with proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who died at a university medical center in Germany. They found that acute and organizing diffuse alveolar damage and SARS-CoV-2 persistence in the respiratory tract were the predominant histopathologic findings and constituted the leading cause of death in patients with and without invasive ventilation.

May 21, 2020 (Int J of Social Psychiatry)

Impact of Social Distancing on Mental Health during the COVID-19 Pandemic: An Urgent Discussion

Matias Carvalho Aguiar Melo, Douglas de Sousa Soares

https://doi.org/10.1177/0020764020927047

In this letter to the editor, the authors discuss the psychological impact of social distancing and emphasise the urgent need to conduct more researches to clarify the effect of social distancing in short- and long-term mental health.

 

May 20, 2020 (Nature Communications)

Immunogenicity of a DNA vaccine candidate for COVID-19

Smith, T.R.F., Patel, A., Ramos, S. et al.

https://doi.org/10.1038/s41467-020-16505-0

In this paper, the authors discuss their findings after generating a synthetic DNA-based vaccine candidate targeting SARS-CoV-2 S protein. The engineered construct, INO-4800, results in robust expression of the S protein in vitro. Following immunization of mice and guinea pigs with INO-4800, they measured antigen-specific T cell responses, functional antibodies which neutralize the SARS-CoV-2 infection and block Spike protein binding to the ACE2 receptor, and biodistribution of SARS-CoV-2 targeting antibodies to the lungs. This preliminary dataset identifies INO-4800 as a potential COVID-19 vaccine candidate, supporting further translational study.

 

May 20, 2020 (Science)

DNA vaccine protection against SARS-CoV-2 in rhesus macaques

Jingyou Yu, Lisa H. Tostanoski, Lauren Peter et al.

https://doi.org/10.1126/science.abc6284

The authors developed a series of DNA vaccine candidates expressing different forms of the SARS-CoV-2 Spike (S) protein and evaluated them in 35 rhesus macaques.  They found that vaccinated animals developed humoral and cellular immune responses, including neutralizing antibody titers comparable to those found in convalescent humans and macaques infected with SARS-CoV-2. Following vaccination, all animals were challenged with SARS-CoV-2, and the authors found reductions in median viral loads in bronchoalveolar lavage and nasal mucosa samples from these macaques, as compared with sham controls. Vaccine-elicited neutralizing antibody titers correlated with protective efficacy, suggesting an immune correlate of protection. These data demonstrate vaccine protection against SARS-CoV-2 in nonhuman primates.

 

May 20, 2020 (NEJM)

Pandemic as Teacher — Forcing Clinicians to Inhabit the Experience of Serious Illness

Jane deLima Thomas

https://doi.org/10.1056/NEJMp2015024
The author shares her experience and challenges as a palliative care physician in preparing for the COVID-19 pandemic.

 

May 20, 2020 (JAMA)

Nasal Gene Expression of Angiotensin-Converting Enzyme 2 in Children and Adults

Supinda Bunyavanich, Anh Do, Alfin Vicencio

https://doi.org/10.1001/jama.2020.8707

The authors conducted a retrospective examination of nasal epithelium collected from individuals aged 4 to 60 years encountered within the Mount Sinai Health System, New York, during 2015-2018. They investigated ACE2 gene expression in the nasal epithelium of these children and adult samples and found that there is age-dependent expression of ACE2 in nasal epithelium, possibly explaining why COVID-19 is less prevalent in children.

 

May 20, 2020 (JAMA)

Olfactory Dysfunction in COVID-19: Diagnosis and management

Katherine Lisa Whitcroft, Thomas Hummel
https://doi.org/10.1001/jama.2020.8391

This JAMA Insights Clinical Update discusses the presumed mechanism of COVID-19–related olfactory dysfunction and proposes assessment and management strategies, including olfactory training and adjuvant medication treatments.

 

May 20, 2020 (JAMA)

Assessment of Proficiency of N95 Mask Donning Among the General Public in Singapore

Wesley Yeung, Kennedy Ng, J. M. Nigel Fong, Judy Sng, Bee Choo Tai, Sin Eng Chia

https://doi.org/10.1001/jamanetworkopen.2020.9670

The authors conducted a cross-sectional study to evaluate the proficiency of members of the Singapore public in wearing N95 masks. Participants were provided with the same model of masks and an instruction sheet. Interviewers administered a visual mask fit (VMF) test and a user seal check following the manufacturer’s instructions. They found that there was a low N95 VMF pass rate amongst participants.

 

May 20, 2020 (JAMA)

How Academic Health Systems Can Move Forward Once COVID-19 Wanes

Steven D. Shapiro, Paul B. Rothman

https://doi.org/10.1001/jama.2020.8002

This Viewpoint discusses the role academic health systems can play in response to public health deficiencies identified in the coronavirus disease 2019 (COVID-19) pandemic, including developing early warning systems to identify future outbreaks, addressing community mental health needs more broadly, and working to reduce structural health inequities.

 

May 19, 2020 (NEJM)

The COVID-19 Pandemic and the Incidence of Acute Myocardial Infarction

Matthew D. Solomon, Edward J. McNulty, Jamal S. Rana et al.

https://doi.org/10.1056/NEJMc2015630

During the Covid-19 pandemic, reports have suggested a decrease in the number of patients presenting to hospitals because of emergency conditions such as acute myocardial infarction. The authors examined this issue using data from a large integrated health care delivery system with 21 medical centers and 255 clinics that provides comprehensive care for more than 4.4 million persons throughout Northern California. They found that the incidence of hospitalization for acute myocardial infarction declined after March 4, 2020, during the Covid-19 pandemic, more than would be expected on the basis of typical seasonal variation alone. 

 

May 18, 2020 (Medscape)

A Quick Summary of the COVID-19 Literature So Far

Eric A. Meyerowitz, Aaron G. Richterman

https://www.medscape.com/viewarticle/930588

In this update, the authors summarise key takeaways regarding COVID-19 covering April 23 to May 5, during which more than 3000 COVID- related papers were published on PubMed and another 766 were released in preprint form. In succinct tables, they summarise the major RCTs on COVID-19 therapeutics and discuss additional therapeutic data from press releases. They also summarise key transmission findings and discuss important learning points on COVID-19.

 

May 18, 2020 (Science Advances)

Evidence for host-dependent RNA editing in the transcriptome of SARS-CoV-2

Salvatore Di Giorgio, Filippo Martignano, Maria Gabriella Torcia, Giorgio Mattiuz, Silvestro G. Conticello

https://doi.org/10.1126/sciadv.abb5813

The authors analyze RNA sequences from bronchoalveolar lavage fluids derived from COVID-19 infected patients. They identify nucleotide changes that may be signatures of RNA editing: Adenosine-to-Inosine changes from ADAR deaminases and Cytosine-to-Uracil changes from APOBEC ones. Their results suggest that both APOBECs and ADARs are involved in Coronavirus genome editing, a process that may shape the fate of both virus and patient.

 

May 18, 2020 (Nature)

Cross-neutralization of SARS-CoV-2 by a human monoclonal SARS-CoV antibody

Pinto, D., Park, Y., Beltramello, M. et al.

https://doi.org/10.1038/s41586-020-2349-y

Vaccine and therapeutic discovery efforts are paramount to curb the pandemic spread of this SARS-CoV2 virus. The SARS-CoV-2 spike (S) glycoprotein promotes entry into host cells and is the main target of neutralizing antibodies. Here the authors describe multiple monoclonal antibodies targeting SARS-CoV-2 S identified from memory B cells of an individual who was infected with SARS-CoV in 2003. They explain the potential of using S309- and S309-containing antibody cocktails for prophylaxis in individuals at high risk of exposure or as a post-exposure therapy to limit or treat severe disease.

 

May 15, 2020 (MMWR Morb Mortal Wkly Rep)

High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice — Skagit County, Washington, March 2020

Hamner L, Dubbel P, Capron I, et al. 

http://dx.doi.org/10.15585/mmwr.mm6919e6

Superspreading events involving SARS-CoV2 have been reported. The authors describe a cluster of infections and their outcomes which occurred after choir practice attended by 61 persons. Citing this event, they emphasise on the importance of physical distancing, including avoiding gathering in large groups, to control spread of COVID-19. Additionally, enhancing community awareness can encourage symptomatic persons and contacts of ill persons to isolate or self-quarantine to prevent ongoing transmission.

May 15, 2020 (JAMA)

Respiratory Parameters in Patients With COVID-19 After Using Noninvasive Ventilation in the Prone Position Outside the Intensive Care Unit

Chiara Sartini, Moreno Tresoldi, Paolo Scarpellini, Andrea Tettamanti, Francesco Carcò, Giovanni Landoni, Alberto Zangrillo

https://doi.org/10.1001/jama.2020.7861

This study, conducted in a single centre in Italy, measured respiratory parameters of 15 non-ICU patients before, during, and after receiving noninvasive ventilation in the prone position and found that it was feasible to do so.

 

May 14, 2020 (Journal of the Royal Society of Medicine)

The coronavirus pandemic: can we handle such epidemics better?

Peter C Gøtzsche

https://doi.org/10.1177/0141076820924587

In this commentary, the author summaries various SARS-CoV2 related publications in the form of a question and answer format and provides a thorough insight on what has happened so far, and where we may be heading.

May 13, 2020 (JAMA)

SARS-CoV-2 Rates in BCG Vaccinated and Unvaccinated Young Adults

Uri Hamiel, Eran Kozer, Ilan Youngster

https://doi.org/10.1001/jama.2020.8189

In this study, the authors collected data on COVID-19 patients from Israel’s National Central Bureau of Statistics. They compared infection rates and proportions with severe COVID-19 disease in 2 similar populations with differing BCG status: individuals born during the 3 years before and 3 years after cessation of the universal BCG vaccine program. They found that BCG vaccination in childhood does not have a protective effect against COVID-19 in adulthood.

 

May 13, 2020 (Science)

Estimating the burden of SARS-CoV-2 in France

Henrik Salje, Cécile Tran Kiem, Noémie Lefrancq, Noémie Courtejoie, Paolo Bosetti et al.

https://doi.org//10.1126/science.abc3517

Despite more than 27,000 confirmed deaths from COVID-19 in France, only about 4.4% of people have been infected. The percentage is still far below the required level of above 50%

 

May 13, 2020 (JAMA Cardiology)

A Game Plan for the Resumption of Sport and Exercise After Coronavirus Disease 2019 (COVID-19) Infection

Dermot Phelan, Jonathan H. Kim, Eugene H. Chung

https://doi.org/10.1001/jamacardio.2020.2136

Significant cardiac morbidity has been observed among hospitalized patients with COVID-19. Evidenced-based recommendations for return-to-play guidelines are currently limited. Here, the authors provide recommendations that are exclusive to cardiovascular considerations and illustrate with an algorithm.

 

May 13, 2020 (JAMA Pediatrics)

School Closure During the Coronavirus Disease 2019 (COVID-19) Pandemic

An Effective Intervention at the Global Level?

Susanna Esposito, Nicola Principi

https://doi.org/10.1001/jamapediatrics.2020.1892

This Viewpoint discusses the effectiveness of school closure as a preventive measure during the coronavirus disease 2019 (COVID-19) pandemic.

 

May 13, 2020 (JAMA)

Global Effort to Collect Data on Ventilated Patients With COVID-19

Rita Rubin

https://doi.org/10.1001/jama.2020.8341

This Medical News feature describes an international effort to compile data about ventilated patients with COVID-19.

May 12, 2020 (Prehospital and Disaster Medicine)

Hospital Emergency Management of Emerging Infectious Disease using Instant Communication Technology

Lin, C., Hsieh, C., & Chi, C. 

https://doi.org/10.1017/S1049023X20000618

In this letter to the editor, the authors share three considerations related to using innovative applications to manage the threat of emerging infectious disease.

May 12, 2020 (European Radiology)

Comparison of chest CT findings between COVID-19 pneumonia and other types of viral pneumonia: a two-center retrospective study

Xiao Li, Xu Fang, Yun Bian, Jianping Lu

https://doi.org/10.1007/s00330-020-06925-3\

In this retrospective review, High-resolution CT (HRCT) of the chest was performed on 154 patients with RT-PCR-confirmed COVID-19 pneumonia and compared with 100 patients with other types of viral pneumonia from two hospitals. The authors found that a peripheral distribution, a lesion range > 10 cm, involvement of 5 lobes, presence of hilar and mediastinal lymph node enlargement, and no pleural effusion were significantly associated with COVID-19.

 

May 12, 2020 (JAMA)

Management of Critically Ill Adults With COVID-19

Jason T. Poston, Bhakti K. Patel, Andrew M. Davis

https://doi.org/10.1001/jama.2020.4914

This JAMA Clinical Guidelines Synopsis summarizes the 2020 Surviving Sepsis Campaign guidelines on the treatment of critically ill adults with coronavirus disease 2019 (COVID-19).

 

May 12, 2020 (The Lancet)

Retinal findings in patients with COVID-19

Paula M Marinho, Allexya A A Marcos, Andre C Romano, Heloisa Nascimento, Rubens Belfort Jr

https://doi.org/10.1016/S0140-6736(20)31014-X

Optical coherence tomography (OCT) is a non-invasive imaging technique that is useful for demonstrating subclinical retinal changes in systemic conditions such as diabetes, Parkinson's disease, and Alzheimer's disease, as well as many viral infections. The authors used OCT to evaluate 12 adult patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and describe their findings.

 

May 12, 2020 (JAMA Internal Medicine)

Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19

Wenhua Liang, Hengrui Liang, Limin Ou, Binfeng Chen, Ailan Chen, Caichen Li, Yimin Li, Weijie Guan, Ling Sang, Jiatao Lu, Yuanda Xu, Guoqiang Chen, Haiyan Guo, Jun Guo, Zisheng Chen, Yi Zhao, Shiyue Li, Nuofu Zhang, Nanshan Zhong, Jianxing He for the China Medical Treatment Expert Group for COVID-19

https://doi.org/10.1001/jamainternmed.2020.2033

This cohort study examines the characteristics of patients admitted to the hospital with COVID-19 will need admission to an intensive care unit, mechanical ventilation, or will die, and develops a COVID-19 risk score to predict outcomes.

 

May 12, 2020 (The Lancet)

Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study

Timothy Roberton, Emily D Carter, Victoria B Chou, Angela R Stegmuller, Bianca D Jackson, Yvonne Tam et al.

https://doi.org/10.1016/S2214-109X(20)30229-1

In this study, the authors estimate the additional maternal and under-5 child deaths resulting from the potential disruption of health systems and decreased access to food due to the COVID-19 pandemic. They modelled three different scenarios and used the Lives Saved Tool to estimate the additional maternal and under-5 child deaths under each scenario, in low and middle-income countries.

May 11, 2020 (Life Sciences)

A systematic review on use of aminoquinolines for the therapeutic management of COVID-19: Efficacy, safety and clinical trials

Vaishali M. Patil, Shipra Singhal, Neeraj Masand

https://doi.org/10.1016/j.lfs.2020.117775

This review elaborates the mechanism of action, safety (side effects, adverse effects, toxicity) and details of clinical trials for chloroquine and hydroxychloroquine to benefit the clinicians, medicinal chemists,  and pharmacologists actively involved in controlling the pandemic and to provide therapeutics for the treatment of COVID-19 infection.

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 (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 (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.

March 2020

March 29, 2020

The FDA has released a FACT SHEET FOR HEALTHCARE PERSONNEL

Battelle Decontamination System for Decontaminating Compatible N95 Respirators

https://www.fda.gov/media/136530/download

March 28, 2020 (J Microbiol Biotechnol) 

Current Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19)

Ahn DG, Shin HJ, Kim MH, Lee S, Kim HS, Myoung J, Kim BT, Kim SJ.  ​

http://www.jmb.or.kr/journal/viewJournal.html?doi=10.4014/jmb.2003.03011

March 28, 2020 (MedRxiv - Preprint)

Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study

Aaron Miller, Mac Josh Reandelar, Kimberly Fasciglione, Violeta Roumenova, Yan Li, Gonzalo H Otazu

https://doi.org/10.1101/2020.03.24.20042937

COVID-19 is a global pandemic, with varying impact amongst different countries. The authors propose that national differences in COVID-19 impact could be partially explained by the different national policies respect to Bacillus Calmette-Guerin (BCG) childhood vaccination. BCG vaccination has been reported to offer broad protection to respiratory infections.  The authors compared a large number of countries BCG vaccination policies with the morbidity and mortality for COVID-19 and found that countries without universal policies of BCG vaccination are more severely affected.

March 27, 2020 (Diagn Interv Radiol)

Interventional radiology and COVID-19: evidence-based measures to limit transmission

Chandy PE, Nasir MU, Srinivasan S, Klass D, Nicolaou S, Babu SB.

https://doi.org/10.5152/dir.2020.20166

The authors put forth an all-encompassing review of infection control measures that cover the dynamics of patient care and staff protocols to limit transmission of COVID-19 in an interventional radiology department.

March 26, 2020 (JAMA) 

Covid-19 — Navigating the Uncharted

https://www.nejm.org/doi/full/10.1056/nejme2002387

A must-read editorial by Dr. A Fauci, the National Institute of Allergy and Infectious Diseases

March 25, 2020 (European Journal of Radiology) 

Diagnosis of the coronavirus disease (COVID-19): rRT-PCR or CT

https://www.sciencedirect.com/science/article/pii/S0720048X20301509

Researchers explored the diagnostic value of CT and real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR) for COVID-19 pneumonia

March 24, 2020 (Clinical and Translational Radiation Oncology)

COVID-19: Global radiation oncology’s targeted response for pandemic preparedness

Richard Simcock, Toms Vengaloor Thomas, Christopher Estes, Andrea R. Filippi, Matthew S. Katz, Ian J. Pereira, Hina Saeed

https://doi.org/10.1016/j.ctro.2020.03.009

As the global COVID-19 pandemic escalates there is a need within radiation oncology to work to support patients in the best way possible. Measures are required to reduce infection spread between patients and within the workforce. The #radonc community held an urgent online journal club on Twitter in March 2020 to discuss these issues and create some consensus on crucial next steps. This document summarises these discussions around themes of infection prevention, rationalisation of workload and working practice in the presence of infection.

March 23, 2020 (The Lancet)

Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study

Kelvin Kai-WangTo, Owen Tak-YinTsang, Wai-Shing Leung, Anthony RaymondTam, Tak-Chiu Wu David Christopher Lung, Cyril Chik-Yan Yip, Jian-Piao Cai, …Kwok-Yung Yuen

https://doi.org/10.1016/S1473-3099(20)30196-1

The more viral RNA detected in a person’s body, the more they excrete when coughing or sneezing. The authors say that the high levels of SARS-CoV-2 particles detected at the onset of symptoms suggest that the virus can be transmitted easily between people, even when symptoms are relatively mild. The results are consistent with another study by L. Zou et al. (shared below).

March 20, 2020 (Int. J of Inf. Diseases)

COVID-19: Four Paediatric Cases in Malaysia

K.C. See, S.M. Liew, David C.E. Ng , E.L. Chew , E.M. Khoo , C.H. Sam, D. Sheena, Z. Zahilah Filzah, S.Y. Chin, P.Y. Lee, L.P. Tan, Z. Farah Najwa et al.

https://doi.org/10.1016/j.ijid.2020.03.049

The authors briefly report 4 paediatric cases of confirmed COVID-19 in Malaysia. They discuss the major issues regarding the care of infected children. Firstly, the quarantine of an infected child with a parent who tested negative was an ethical dilemma. Secondly, oropharyngeal and nasal swabs in children were at risk of false negative results. These issues have implications for infection control. They conclude that there is a need for clearer guidelines for child quarantine and testing methods in the management of COVID-19 in children.

March 20, 2020 (Clinical Infectious Diseases) 

Epidemiological and clinical predictors of COVID-19

https://www.ncbi.nlm.nih.gov/pubmed/32211755

The authors conclude that clinical and laboratory data could identify individuals at high risk of COVID-19 and enable prioritization of PCR-testing and containment efforts. Basic laboratory test results are crucial to prediction models.

March 19, 2020 (J of Reproductive Immunology)

Why are pregnant women susceptible to COVID-19? An immunological viewpoint

Hong Liu, Li-Ling Wang, Si-Jia Zhao, Joanne Kwak-Kim,  Gil Mor, Ai-Hua Liao

https://doi.org/10.1016/j.jri.2020.103122

The COVID-19 may alter the maternal symmetrical and local immune responses, and affect the well-being of mothers and infants. Pregnant women are more susceptible to respiratory pathogens; hence, they may be more susceptible to SARS-CoV-2 than the general population. Here, the authors focused on the immunological factor of the susceptibility of pregnant women to COVID-19 and the potential damages to mother and fetus.

March 19, 2020 (NEJM)

SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients

Lirong Zou, Feng Ruan, Mingxing Huang, Lijun Liang, Huitao HUang, Zhongsi Hong, Jianxiang Yu, Jinyu Xia, Qianfang Guo, Hui-Ling Yen, Jie Wu

https://doi.org/10.1056/NEJMc2001737

The authors analyse the SARS-CoV2 virus from nose and throat swabs from 18 people with COVID-19. The concentrations of viral RNA in the 17 symptomatic patients were similar to that in the one asymptomatic patient.

March 3, 2020 (Journal of Zhejiang University SCIENCE B)

Clinical value of the emergency department in screening and diagnosis of coronavirus disease 2019 in China

Qin Zhang, Jian Pan, Min-xing Zhao, Yuan-qiang Lu

http://www.jzus.zju.edu.cn/iparticle.php?doi=10.1631/jzus.B2010011

The emergency department shoulders a heavy responsibility of screening COVID-19 while treating all kinds of other non-communicable acute and critical diseases. In this article, the authors retrospectively analyze four representative cases of COVID-19 that were recently screened and diagnosed in their emergency department. These cases demonstrate that the emergency department has irreplaceable clinical value in the accurate screening and diagnosis of COVID-19.

February 26, 2020 (J of Autoimmunity)

The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak

Hussin A. Rothan, Siddappa N. Byrareddy

https://doi.org/10.1016/j.jaut.2020.102433

In this review, the authors highlight the symptoms, epidemiology, transmission, pathogenesis, phylogenetic analysis and future directions to control the spread of COVID-19.

February 2020

 
 
 
 
 

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