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By Christian Hoffmann &
Bernd S. Kamps
4 July
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Epidemiology
Yu X, Wei D, Chen Y, et al. Retrospective detection of SARS-CoV-2 in hospitalized patients with influenza-like illness. Emerging Microbes & Infections 2020, Full-text: https://doi.org/10.1080/22221751.2020.1785952
No cryptic transmission before early officially confirmed cases. In this retrospective screening for SARS-CoV-2 RNA in 1,271 nasopharyngeal swab samples, as well as the prevalence of IgM, IgG, and total antibodies against SARS-CoV-2 in 357 matched serum samples collected from hospitalized patients with influenza-like illness between December 1, 2018 and March 31, 2020 in Shanghai Ruijin Hospital, the onset date of the earliest COVID-19 case was January 25.
Immunology, vaccine
Deng W, Bao L, Liu J, et al. Primary exposure to SARS-CoV-2 protects against reinfection in rhesus macaques. Science 02 Jul 2020. Full-text: https://doi.org/10.1126/science.abc5343
Four rhesus macaques were re-challenged intratracheally with the same dose of the SARS-CoV-2 strain at 28 days post-initial challenge with the identical SARS-CoV-2 strain. Animals did not show detectable viral dissemination, clinical manifestations of viral disease, or histopathological changes. Comparing the humoral and cellular immunity between primary infection and rechallenge revealed notably enhanced neutralizing antibody and immune responses.
Transmission
Aboubakr HA, Sharafeldin TA, Goyal SM. Stability of SARS-CoV-2 and other coronaviruses in the environment and on common touch surfaces and the influence of climatic conditions: a review. Transbound Emerg Dis. 2020 Jun 30. PubMed: https://pubmed.gov/32603505 . Full-text: https://doi.org/10.1111/tbed.13707
A comprehensive review of the available data (by May 21, 2020) on the stability of coronaviruses, including SARS‐CoV‐2, from previous reports, to help understand its environmental survival.
Edwards SJL, Santini JM. Anthroponotic risk of SARS-CoV-2, precautionary mitigation, and outbreak management. Lancet Microbe, July 02, 2020. Full-text: https://doi.org/10.1016/S2666-5247(20)30086-0
Important comment on the evidence of infection of animals with SARS-CoV-2 that has been shown experimentally both in vivo and in vitro for mammals including monkeys, cats, ferrets, rabbits, foxes, and hamsters, while bioinformatic studies also predict infectivity of pigs and wild boar among other mammals. According to the authors, we should also consider the potential for transmissibility, not just infection.
Sikkema RS, Niewenhuijse DF, O’Toole A, et al. COVID-19 in health-care workers in three hospitals in the south of the Netherlands: a cross-sectional study. Lancet Inf Dis, July 02, 2020. Full-text: https://doi.org/10.1016/S1473-3099(20)30527-2
Social events outside the hospital. In this cross-sectional study at three hospitals located in the south of the Netherlands, from 50 HCWs (and ten patients), complete and near-complete genome sequences were analyzed. Most sequences were grouped into three clusters, with two clusters showing local circulation within the region. The genomic diversity recorded was consistent with multiple introductions through community-acquired infections, and some local amplification related to specific social events in the community, rather than widespread within-hospital transmission. Thus, data do not support widespread nosocomial transmission as the source of infection in patients or health-care workers.
Diagnostics
Tollånes MC, Bakken Kran AM, Abildsnes E, Jenum PA, Breivik AC, Sandberg S. Evaluation of eleven rapid tests for detection of antibodies against SARS-CoV-2. Clin Chem Lab Med. 2020 Jun 29. PubMed: https://pubmed.gov/32598303 . Full-text: https://doi.org/10.1515/cclm-2020-0628 + https://www.degruyter.com/view/journals/cclm/ahead-of-print/article-10.1515-cclm-2020-0628/article-10.1515-cclm-2020-0628.xml
Sensitivity of rapid tests is at best moderate: the authors evaluated diagnostic performance of eleven rapid tests for detection of antibodies to SARS-CoV-2 in 20 hospitalized patients with PCR-confirmed COVID-19, 23 recovered outpatients with former PCR-confirmed COVID-19, and 49 participants with suspected COVID-19 presenting at a primary care emergency room. All eleven tests detected antibodies in hospitalized COVID-19 patients, though with varying sensitivities. In former outpatients recovered from COVID-19, there were differences between tests in the immunoglobulin type G (IgG) sensitivity, with five tests having a sensitivity below 65%. In participants with suspected COVID-19 infection, the rapid tests had very low sensitivities.
Clinical
Vestergaard LS, Nielsen J, Richter L, et al. Excess all-cause mortality during the COVID-19 pandemic in Europe – preliminary pooled estimates from the EuroMOMO network, March to April 2020. Euro Surveill. 2020;25(26). Full-text: https://doi.org/10.2807/1560-7917.ES.2020.25.26.2001214
The authors present preliminary pooled estimates of all-cause mortality for 24 European countries/federal states participating in the European monitoring of excess mortality for public health action (EuroMOMO) network, for the period March–April 2020. Excess mortality particularly affected ≥ 65-year-olds (91% of all excess deaths), to a lesser extent those 45–64 (8%) and 15–44-year-olds (1%). The cumulative excess mortality from week 1 to week 18, 2020 reached a total of 185,287 deaths, including 24,438 (13%) in persons aged 65–74 years, 55,226 (30%) in persons aged 75–84 years, and 88,598 (48%) in persons aged ≥ 85 years.
Shi D, Wu W, Wang Q, et al. Clinical characteristics and factors associated with long-term viral excretion in patients with SARS-CoV-2 infection: a single center 28-day study. J Inf Dis, 02 July 2020. Full-text: https://doi.org/10.1093/infdis/jiaa388
SARS-CoV-2 RNA clearance time was associated with sex, disease severity and lymphocyte function. Among 99 patients, 61 patients had SARS-CoV-2 clearance (virus-negative group), but 38 patients had sustained positive results (virus-positive group). Male sex (HR, 0.58), immunoglobulin use (0.42), APACHE II score (0.89), and lymphocyte count (1.81) were independent factors associated with a prolonged duration of SARS-CoV-2 shedding. Antiviral therapy and corticosteroid treatment were not independent factors.
Boscolo-Rizzo P, Borsetto D, Fabbris C, et al. Evolution of Altered Sense of Smell or Taste in Patients With Mildly Symptomatic COVID-19. JAMA Otolaryngol Head Neck Surg. 2020 Jul 2. PubMed: https://pubmed.gov/32614442 . Full-text: https://doi.org/10.1001/jamaoto.2020.1379
At 4 weeks from onset, most patients experience complete resolution or even improvement of altered sense of smell or taste. Of 202 patients completing the survey at baseline, 187 (92.6%) also completed the follow-up survey. The evaluation of 113 patients reporting sudden onset of these symptoms at baseline showed that 55 patients (49%) reported complete resolution of smell or taste impairment, 46 (41%) reported an improvement in the severity, and only 12 (11%) reported the symptom was unchanged or worse. Persistent loss of smell or taste was not associated with persistent SARS-CoV-2 infection.
Treatment
Gendelman O, Amital H, Bragazzi NL, Watad A, Chodick G. Continuous hydroxychloroquine or colchicine therapy does not prevent infection with SARS-CoV-2: Insights from a large healthcare database analysis. Autoimmun Rev 2020 Jul;19(7):102566. PubMed: https://pubmed.gov/32380315 . Full-text: https://doi.org/10.1016/j.autrev.2020.102566
No protection with HCQ and colchicine. An overall sample of 14,520 subjects from Israel were screened for SARS-CoV-2 infection and 1317 resulted positive. No significant difference was found in terms of rates of usage of hydroxychloroquine or colchicine between those who were found positive for SARS-CoV-2 and those who were found negative (0.23% versus 0.25% for hydroxychloroquine, and 0.53% versus 0.48% for colchicine, respectively).