Top 10: August 17

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By Christian Hoffmann &
Bernd S. Kamps

17 August

Virology

Sarkar M, Saha S. Structural insight into the role of novel SARS-CoV-2 E protein: A potential target for vaccine development and other therapeutic strategies. PLoS ONE August 13, 15(8). Full-text:  https://doi.org/10.1371/journal.pone.0237300 Full-text:

Coronaviruses have four main structural proteins: Nucleocapsid protein (N), Spike protein (S), Membrane protein (M), and Envelope protein (E). The E protein is the smallest and is involved in a wide spectrum of functional repertoire. Using the bioinformatics and structural modelling approach, the authors modelled the structure of E and give insights into the functional role of this protein that has a low disparity and low mutability.

 

Lau SKP, Wong ACP, Luk HKH, Li KSM, Fung J, He Z, et al. Differential tropism of SARS-CoV and SARS-CoV-2 in bat cells. Emerg Infect Dis. 2020 Dec [date cited]. Full-text:  https://doi.org/10.3201/eid2612.202308

SARS-CoV-2 did not replicate efficiently in 13 bat cell lines, whereas SARS-CoV replicated efficiently in kidney cells of its ancestral host, the Rhinolophus sinicus bat, suggesting different evolutionary origins. Structural modeling showed that RBD/RsACE2 binding may contribute to the differential cellular tropism. Although SARS-CoV-2 is closely related to SARS-CoVs in bats and pangolins, none of the existing animal viruses represents the immediate ancestor of SARS-CoV-2.

 

Transmission

Lewis NM, Chu VT, Ye D, et  al. Household Transmission of SARS-CoV-2 in the United States. Clinical Infectious Diseases, 16 August 2020. Full-text: https://doi.org/10.1093/cid/ciaa1166

Nathaniel M Lewis and colleagues sought to estimate the household secondary infection rate (SIR) of SARS-CoV-2 and evaluate potential risk factors for secondary infection among 58 households in Utah and Wisconsin. Fifty-two of 188 household contacts acquired secondary infections (SIR: 28%, 95% CI: 22–34%). Of note, household contacts to COVID-19 patients with immunocompromised conditions had increased odds of infection (OR: 15.9, 95% CI: 2.4–106.9) as well as household contacts who themselves had diabetes mellitus (OR: 7.1, 95% CI: 1.2–42.5).

 

Garigliany M, Van Laere A-S, Clercx C, Giet D, Escriou N, Huon C, et al. SARS-CoV-2 natural transmission from human to cat, Belgium, March 2020. Emerg Infect Dis. 2020 Dec [date cited]. Full-text: https://doi.org/10.3201/eid2612.202223

Mutien Garigliany from Liège, Belgium, and colleagues report a human-to-cat transmission. A household cat was productively infected with the SARS-CoV-2 virus excreted by its owner, and the infection caused a non-fatal but nevertheless severe disease.

 

Diagnostics

González-González E, Trujillo-de Santiago G, Lara-Mayorga IM. Portable and accurate diagnostics for COVID-19: Combined use of the miniPCR thermocycler and a well-plate reader for SARS-CoV-2 virus detection. PLOS August 13, 2020. Full-text:  https://doi.org/10.1371/journal.pone.0237418

These Mexican researchers demonstrate the use of the mini-PCR, a commercial compact and portable PCR device recently available on the market, in combination with a commercial well-plate reader as a diagnostic system. The accuracy and simplicity of this diagnostics strategy may provide a cost-efficient and reliable alternative for COVID-19 pandemic testing, particularly in underdeveloped regions but also for deployment in point-of-care SARS-CoV-2 detection.

 

Clinical

Tatu AL, Nadasdy T, Bujoreanu FC. Familial Clustering of COVID-19 Skin Manifestations. Dermatol Ther. 2020 Aug 14:e14181. PubMed: https://pubmed.gov/32794366. Full-text: https://doi.org/10.1111/dth.14181

Does genetics play a role in the manifestation of viral exanthems? Probably, according to this report of a familial clustering of a maculopapular COVID-19 rash. Among 8 people in a family who contracted SARS-CoV-2 infection, only the 4 who were related by blood presented dermatological manifestations.

 

Comorbidities

Lee J, Foote MB, Lumish M, et al. Chemotherapy and COVID-19 Outcomes in Patients With Cancer. J Clin Oncol 2020, August 14, 2020. Full-text: https://ascopubs.org/doi/full/10.1200/JCO.20.01307

Among a total of 309 patients with cancer and concurrent COVID-19 at the Memorial Sloan Kettering Cancer Center, cytotoxic chemotherapy administered within 35 days of a COVID-19 diagnosis was not significantly associated with a severe or critical COVID-19 event (HR, 1.10; 95% CI, 0.73 to 1.60). However, patients with active hematologic or lung malignancies, peri–COVID-19 lymphopenia, or baseline neutropenia had worse COVID-19 outcomes. Findings remained consistent in a multivariate model and in multiple sensitivity analyses.

 

Boettler T, Marjot T, Newsome N, et al. Impact of COVID-19 on the care of patients with liver disease: EASL-ESCMID position paper after 6 months of the pandemic. J Hepatol 2020, Aug 4. Full-text: https://doi.org/10.1016/j.jhepr.2020.100169

High COVID-19 mortality rates have been reported in patients with pre-existing chronic liver disease and cirrhosis: this excellent review serves as an update on the previous position paper summarizing the evidence for liver disease involvement during COVID-19 and also provide some recommendations on how to return to routine care.

 

Solomon MD, McNulty EJ, Rana JS, et al. The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction. N Engl J Med 2020; 383:691-693, August 13, 2020. Full-text: https://doi.org/10.1056/NEJMc2015630

Using data from Kaiser Permanente Northern California, a large health care delivery system with 255 clinics providing care for more than 4.4 million persons throughout Northern California, Mathew Solomon and colleagues show that the weekly rates of hospitalization for acute myocardial infarction decreased by up to 48% during the COVID-19 period. Decreases were similar among patients with NSTEMI (incidence rate ratio, 0.51) and those with STEMI (0.60). Of note, demographic characteristics, hemodynamic measures on admission, initial and peak troponin I values, and the burden of other examined co-existing conditions were similar in patients who presented during the COVID-19 period and in those who presented before the first case of COVID-19 occurred.

 

Treatment

Singh VP, El-Kurdi B, Rood C. What underlies the benefit of famotidine formulations used during COVID-19? Gastroenterology. 2020 Aug 7. PubMed: https://pubmed.gov/32777281. Full-text: https://doi.org/10.1053/j.gastro.2020.07.051

While results of the randomized clinical trial on the benefits of intravenous famotidine in treating COVID-19 (NCT04370262) are excitedly awaited, Vijay P. Singh and colleagues speculate on the potential mechanisms of action of this drug.