Top 10: January 3

Copy-editor: Rob Camp

Epidemiology

Duca LM, Xu L,Price SF, McLean C. COVID-19 Stats: COVID-19 Incidence, by Age Group — United States, March 1–November 14, 2020. MMWR Morb Mortal Wkly Rep 2021;69:1664. http://dx.doi.org/10.15585/mmwr.mm695152a8

 

Prevention

Rolfes MA, Grijalva CG, Zhu Y, et al. Implications of Shortened Quarantine Among Household Contacts of Index Patients with Confirmed SARS-CoV-2 Infection – Tennessee and Wisconsin, April-September 2020. MMWR Morb Mortal Wkly Rep. 2021 Jan 1;69(5152):1633-1637. PubMed: https://pubmed.gov/33382676. Full-text: https://doi.org/10.15585/mmwr.mm695152a1

One of your household members is diagnosed with SARS-CoV-2 infection. Is a 7-day quarantine enough (7 days after the symptom onset of the index patient) even if you are asymptomatic and have a negative laboratory test result? Not always, because 19% of people in your situation will experience symptoms or receive positive test results in the following week. The recommendation by Melissa Rolfes, et al.: persons released from quarantine before 14 days should continue to avoid close contact and wear masks when around others until 14 days after their last exposure.

 

Okyere I, Chuku EO, Ekumah B, et al. Physical distancing and risk of COVID-19 in small-scale fisheries: a remote sensing assessment in coastal Ghana. Sci Rep. 2020 Dec 29;10(1):22407. PubMed: https://pubmed.gov/33376254. Full-text: https://doi.org/10.1038/s41598-020-79898-4

Fish landing sites along the Ghana coast could be transmission hotspots. To get a clearer picture, Isaac Okyere et al. employed an unmanned aerial vehicle. Aerial measurements taken at times of peak landing beach activity indicated that the highest proportion of people, representing 56%, 48%, 39% and 78% in Elmina, Winneba, Apam and Mumford respectively, were located at distances of less than one meter from their nearest neighbor.

 

Vaccine

Editorial. Messengers of hope. Nat Biotechnol. 2020 Dec 29:1. PubMed: https://pubmed.gov/33376248. Full-text: https://doi.org/10.1038/s41587-020-00807-1

Emergency Use Authorizations for two mRNA COVID-19 vaccines represent a turning point in the pandemic. They also herald a new era for vaccinology – an era where vaccines are designed on computers, iteratively optimized in discovery and manufactured on demand — all without expensive and finicky cell culture.

 

Oliver S, Gargano J, Marin M, et al. The Advisory Committee on Immunization Practices’ Interim Recommendation for Use of Moderna COVID-19 Vaccine — United States, December 2020. MMWR Morb Mortal Wkly Rep 2021;69:1653-1656. Full-text:  http://dx.doi.org/10.15585/mmwr.mm695152e1

Use of all COVID-19 vaccines authorized under an EUA should be implemented in conjunction with ACIP’s interim recommendations for allocating initial supplies of COVID-19 vaccines. Before vaccination, the EUA Fact Sheet should be provided to recipients and caregivers. Providers should counsel Moderna COVID-19 vaccine recipients about expected local and systemic reactogenicity.

 

Clinical

Heming M. Li X, Räuber S, et al. Neurological Manifestations of COVID-19 Feature T Cell Exhaustion and Dedifferentiated Monocytes in Cerebrospinal Fluid. Immunity 2020, published 22 December. Full-text: https://doi.org/10.1016/j.immuni.2020.12.011

Neuro-COVID – headache and neuroinflammatory or cerebrovascular disease – are frequent in patients with severe COVID-19. Here, Gerd Meyer zu Hörste, Michael Heming and colleagues identified specific immune alterations in the CSF of neuro-COVID patients featuring an increase of de-differentiated monocytes and exhausted T cells. They observed an IFN response in neuro-COVID that was attenuated compared with viral encephalitis. Severe neuro-COVID exhibited a broad clonal T cell expansion and curtailed IFN response compared with mild neuro-COVID.

 

Treatment

Padhi AK, Shukla R, Saudagar P, Tripathi T. High-Throughput Rational Design of the Remdesivir Binding Site in the RdRp of SARS-CoV-2: Implications for Potential Resistance. iScience 2020, published 26 December. Full-text: https://doi.org/10.1016/j.isci.2020.101992

SARS-CoV-2 can undergo positive selection and attain remdesivir resistance with very few mutations. This is the result of a study that generated a total of 100.000 mutations and provided insight into the functional outcomes of mutations in the remdesivir binding site in the nsp12 subunit of RdRp.

 

Severe COVID

Lee MH, Perl DP, Nair G, et al. Microvascular Injury in the Brains of Patients with Covid-19. N Engl J Med 2020, published 30 December. Full-text: https://doi.org/10.1056/NEJMc2033369

Avindra Nath, Myoung-Hwa Lee and colleagues from the US National Institute of Neurological Disorders and Stroke in Bethesda observed multifocal microvascular injury in the brain and olfactory bulbs in the brains of 13 patients. They found no evidence of viral infection after PCR with multiple primer sets, RNA sequencing of several areas of the brain, and RNA in situ hybridization and immunostaining.

 

Press

Tufekci Z. The Mutated Virus Is a Ticking Time Bomb. The Atlantic 2020, published 31 December. Full-text: https://www.theatlantic.com/science/archive/2020/12/virus-mutation-catastrophe/617531/

A new variant of the coronavirus, known as B.1.1.7, is spreading across the globe. It is thought that this variant will not decrease vaccine efficacy much, if at all. There is no evidence for more severe COVID-19 either. All good and no cause for alarm? Maybe not.

 


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