Copy-editor: Rob Camp
Epidemiology
Veldhoen M, Simas JP. Endemic SARS-CoV-2 will maintain post-pandemic immunity. Nat Rev Immunol (2021). Full-text: https://doi.org/10.1038/s41577-020-00493-9
Marc Veldhoen and J. Pedro Simas predict that the maintenance of population immunity will not depend on continued vaccinations but on the endemic presence of SARS-CoV-2. The authors offer an intriguing long-term perspective: “Endemic SARS-CoV-2 will ensure maintenance of seroprevalence and mucosal immunity in the population, which will increase over time in new generations. As such, most infected individuals will ultimately endure a largely asymptomatic or mild course of disease, although similarly to the other common cold HCoVs, SARS-CoV-2 may cause fatalities in extremely vulnerable elderly or immunocompromised individuals.”
Ives AR, Bozzuto C. Estimating and explaining the spread of COVID-19 at the county level in the USA. Commun Biol 4, 60 (2021). Full-text: https://doi.org/10.1038/s42003-020-01609-6
Different states and counties in the USA, and different countries in the world, have experienced COVID-19 epidemics differently. Here, Anthony Ives and Claudio Bozzuto put numbers on these differences in the USA. The authors show that most of the high inter-county variance is explained by four factors (R2 = 0.70): the timing of the outbreak, population size, the population density, and spatial location. Their recommendation for the future: design public health interventions at the county level.
Transmission
Davies NG, Barnard RC, Jarvis CI, et al. Estimated transmissibility and severity of novel SARS-CoV-2 Variant of Concern 202012/01 in England. medRxiv 2020, posted 26 December. Full-text: https://doi.org/10.1101/2020.12.24.20248822
Nicolas Davies et al. estimate that the novel SARS-CoV-2 variant emerged in southeast England in November 2020, is 56% more transmissible (95% credible interval across three regions 50-74%) than preexisting variants of SARS-CoV-2. The author did not find evidence that VOC 202012/01 resulted in greater or lesser severity of disease than pre-existing variants. However, the increase in transmissibility is likely to lead to a large increase in incidence, with COVID-19 hospitalizations and deaths projected to reach higher levels in 2021 than were observed in 2020.
Immunology
Röltgen K, Powell AE, Wirz OF, et al. Defining the features and duration of antibody responses to SARS-CoV-2 infection associated with disease severity and outcome. Sci Immunol. 2020 Dec 7;5(54):eabe0240. PubMed: https://pubmed.gov/33288645. Full-text: https://doi.org/10.1126/sciimmunol.abe0240
Outpatients and asymptomatic individuals might have higher ratios of spike protein receptor-binding domain-specific IgG versus nucleoprotein-targeted IgG antibodies than hospitalized patients. This is the result of a study by Scott Boyd, Katharina Röltgen and colleagues who analyzed 983 longitudinal plasma samples from 79 hospitalized COVID-19 patients and 175 SARS-CoV-2-infected outpatients and asymptomatic individuals. Plasma antibody increases correlated with decreases in viral RNAemia, but antibody responses in acute illness were insufficient to predict inpatient outcomes.
Treatment
Meduri GU, Annane D, Confalonieri M, et al. Pharmacological principles guiding prolonged glucocorticoid treatment in ARDS. Intensive Care Med. 2020 Dec;46(12):2284-2296. PubMed: https://pubmed.gov/33150472. Full-text: https://doi.org/10.1007/s00134-020-06289-8
In this review, Gianfranco Umberto Meduri et al. examine the pharmacological principles guiding glucocorticoids (GC) treatment in ARDS that demonstrates how each component of the treatment protocol is relevant to achieve optimal results. The authors integrate current clinical pharmacology knowledge of various GCs, including hydrocortisone, methylprednisolone and dexamethasone. Find more about the dosage, timing of initiation, mode of administration, duration, and tapering.
Severe COVID
Contou D, Fraissé M, Pajot O, Tirolien JA, Mentec H, Plantefève G. Comparison between first and second wave among critically ill COVID-19 patients admitted to a French ICU: no prognostic improvement during the second wave? Crit Care. 2021 Jan 4;25(1):3. PubMed: https://pubmed.gov/33397421. Full-text: https://doi.org/10.1186/s13054-020-03449-6
During the first wave of the SARS-CoV-2 pandemic in Spring 2020, intensive care physicians discovered specificities of severe COVID-19 including the need for deep sedation and neuromuscular blockade, the increased risk of thrombotic and hemorrhagic events, the prolonged duration of mechanical ventilation with high rate of delirium, and the beneficial effects of early administration of glucocorticoids. Here, Damien Contou et al. report their experience during the second SARS-CoV-2 wave in Autumn 2020. Their sobering discovery: compared to the first wave, less patients required invasive mechanical ventilation, thrombotic events were less frequent and the delay between ICU admission and tracheal intubation was longer. However, ICU mortality (50% vs. 52%, p = 0.96) and duration of ICU stay did not differ between the two waves. The Kaplan–Meier survival analysis did not show a significant difference between the two waves (p = 0.90, log-rank test).
Collateral Effects
Evans DP, Hawk SR, Ripkey CE. Domestic Violence in Atlanta, Georgia Before and During COVID-19. Violence Gend 2020, published 11 December. Full-text: https://doi.org/10.1089/vio.2020.0061
Cumulative counts of domestic crimes were higher during the COVID-19 period of 2020 than in the preceeding two years suggesting increased occurrence of domestic violence, especially during shelter-in-place orders. This is the result of an analysis of 30 weeks of crime data collected from the Atlanta Police Department (APD). Dabney Evans, Shila René Hawk and Carrie Ripkey found that a spike in domestic crimes was recorded after city and statewide shelter-in-place orders. The authors summarize that the “co-occurring pandemics of COVID-19 and domestic violence come amidst a period of racial justice reckoning in the United States and that both have a disproportionate impact on Black, Indigenous, and People of Color. As the country grapples with how to deal with health and safety concerns related to the pandemic, and the unacceptable harms being perpetrated by police, a public health approach is strongly warranted to address both universal health care and violence prevention.”
French
If you read French, read Delfraissy JF, Duault LA, Benamouzig D, et al. Le clone anglais «VUI-UK » – Anticiper une reprise épidémique en janvier. Conseil scientifique COVID-19 2020, published 22 December. Full-text : https://afpa.org/recommandation/covid-19-note-dalerte-conseil-scientifique/
Les données actuelles fournies par les autorités britanniques rapportent une augmen-tation du risque de transmission (R0 augmenté de +0.4 en comparaison des autres virus), avec une augmentation modérée de la « charge virale » estimée à partir des valeurs de RT-PCR (augmentation de 0.66 log soit 2 Ct en moins), mais aucune différence n’est notée à ce jour en termes de pathogénicité (manifestations cliniques, durée de la maladie) ou d’échappement à la réponse immunitaire des personnes déjà infectées au cours de deux premières vagues.
Herzberg N. Les vaccins anti-Covid évitent-ils la transmission du SARS-CoV-2 ? Le Monde 2021, published 6 January. Full-text : https://www.lemonde.fr/planete/article/2021/01/06/les-vaccins-anti-covid-evitent-ils-la-transmission-du-sars-cov-2_6065356_3244.html
Les essais ont montré leur efficacité à combattre les symptômes du Covid, mais on ignore encore s’ils peuvent bloquer la contamination d’autres personnes.
Bettinelli M, Casteele AV. Covid-19, paludisme, sida : l’immense bilan humain de pandémies toujours actives. Full-text : https://www.lemonde.fr/planete/video/2020/12/20/covid-19-paludisme-sida-l-immense-bilan-humain-de-pandemies-toujours-actives_6064005_3244.html
Un an après la première alarme sur l’apparition d’un « virus inconnu », finalement reconnu comme un nouveau coronavirus et dont la maladie qu’il provoque fut baptisée « Covid-19 », la planète déplore des dizaines de millions de contaminations, et plus d’1,6 million de morts. Au même moment, d’autres pandémies, parfois vieilles de plusieurs milliers d’années, continuent de faucher des milliers de vies.
Kauffmann S. « Ce qui se passe depuis quatre ans aux Etats-Unis est grave, on le savait ; ce qui s’y passe depuis deux mois est gravissime » – Le Monde 2021, published 6 January. Full-text : https://www.lemonde.fr/idees/article/2021/01/06/ce-qui-se-passe-depuis-quatre-ans-aux-etats-unis-est-grave-on-le-savait-ce-qui-s-y-passe-depuis-deux-mois-est-gravissime_6065311_3232.html
En refusant de quitter le pouvoir après les élections, Donald Trump expose, dans une ultime offensive destructrice, la fragilité du système américain. Une leçon pour toutes les démocraties, estime Sylvie Kauffmann, éditorialiste au « Monde ».