Top 10: June 11

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By Christian Hoffmann &
Bernd S. Kamps

11 June

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Epidemiology

ECDC Public Health Emergency Team, Danis K, Fonteneau L, et al. High impact of COVID-19 in long-term care facilities, suggestion for monitoring in the EU/EEA.  May 2020. Eurosurveillance, Volume 25, Issue 22, 04/Jun/2020 Article. Full-text: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.22.2000956

Residents in long-term care facilities contribute 30–60% of all COVID-19 deaths in many European countries. This article provides an overview of the importance of surveillance and infection prevention and control measures, in order to identify clusters early, decrease the spread within and between facilities and reduce the size and severity of outbreaks.

 

Enserink M. Coronavirus rips through Dutch mink farms, triggering culls to prevent human infections. Science Mag 2020, June 9. Full-text: https://www.sciencemag.org/news/2020/06/coronavirus-rips-through-dutch-mink-farms-triggering-culls-prevent-human-infections

Sad story on several outbreaks at Dutch mink farms. That mink are susceptible wasn’t a surprise, because they are closely related to ferrets. Once COVID-19 reaches a farm, the virus appears to spread like wildfire, even though the animals are housed in separate cages. The government decided to cull thousands of animals because the problem could become bigger in the months ahead.

 

Transmission

Behrens GM, Cossmann A, Stankov MV. et al. Perceived versus proven SARS-CoV-2-specific immune responses in health-care professionals. Infection 2020. Full-text: https://www.springermedizin.de/perceived-versus-proven-sars-cov-2-specific-immune-responses-in-/18070162

The gap between perceived risk and evidence: Upon enrollment, HCW in Hannover, Germany, were asked to estimate their personal likelihood of having had a SARS-CoV-2 infection (How high do you rate the probability of having been infected so far? 0–100%). Of 201 study participants, 19% rated their probability greater than 50%. In contrast to the high percentage of self-perceived positive SARS-CoV-2 infection status, only two tested frontline HCPs showed a clearly positive reaction to the ELISA.

 

Diagnostics

Liu ZL, Liu Y, Wan LG, et al. Antibody profiles in mild and severe cases of COVID-19. Clinical Chemistry 10 June 2020. Full-text: https://doi.org/10.1093/clinchem/hvaa137

This study analysed antibody response in 192 RT-PCR confirmed COVID-19 patients, using two commercial microparticle chemiluminescence immunoassays (Wantai). Patients were stratified by disease severity. Severe cases had significantly higher IgM titers than mild cases after day 6 post-onset. Strikingly, 34% and 14% of mild patients were consistently serologically negative for IgM and total antibody, respectively.

 

Chew KL, Tan SS, Saw S, et al. Clinical evaluation of serological IgG antibody response on the Abbott Architect for established SARS-CoV-2 infection. Clin Microbiol June 09, 2020. Full-text: https://doi.org/10.1016/j.cmi.2020.05.036

Residual sera from 177 symptomatic COVID-19 patients, and 163 non-COVID-19 patients were tested for antibody with the Abbott SARS-CoV-2 IgG assay. Specificity of the assay was 100%. The clinical sensitivity varied depending on time from onset of symptoms, increasing with longer periods since onset of clinical illness. The clinical sensitivity at ≤ 6 days was 8.6%, 7-13 days: 43.6%, 14-20 days: 84.0%, and ≥ 21 days: 84.4%.

 

Wong MC, Huang J, Lai C, et al. Detection of SARS-CoV-2 RNA in fecal specimens of patients with confirmed COVID-19: a meta-analysis. J Infection, June 11, 2020. Full-text: https://doi.org/10.1016/j.jinf.2020.06.012

In this meta-analysis of 17 studies, the pooled detection rate of fecal SARS-CoV-2 RNA was 43.7% and 33.7% by patient and number of specimens, respectively. Female individuals (59.6% vs. 53.5%), those who presented with gastrointestinal symptoms (77.1% vs. 57.7%), and patients with more severe disease (68.3% vs. 34.6%) tended to have a higher detection rate.

 

Clinical

Covino M, De Matteis G, Santoro M, et al. Clinical characteristics and prognostic factors in COVID-19 patients aged ≥80 years. Geriatr Gerontol Int. 2020 Jun 9. PubMed: https://pubmed.gov/32516861. Full-text: https://doi.org/10.1111/ggi.13960

Of 69 patients aged 80-98 years who presented at a large center in Rome, Italy, 36% had a critical COVID-19 disease. Multivariate Cox regression analysis showed that, among other factors, severe dementia was an independent risk factor for death (Hazard Ratio 3.9, 95 % CI 1.2-12.2).

 

Treatment

Piller C. Who’s to blame? These three scientists are at the heart of the Surgisphere COVID-19 scandal. Science Mag 2020, June 8. Full-text: https://www.sciencemag.org/news/2020/06/whos-blame-these-three-scientists-are-heart-surgisphere-covid-19-scandal

More insights into the research scandal about two fake COVID-19 treatment papers (published in The Lancet and the NEJM) that were retracted last week. There were several red flags that the studies warranted intensive scrutiny – scrutiny that the two journals unforgivably failed to provide. This scandal tells us a lot about scientific publishing. Answers, comments, explanations by the two journals are still pending.

 

Lim SY, Osuna CE, Best K, et al. A direct-acting antiviral drug abrogates viremia in Zika virus–infected rhesus macaques. Science Transl Med  10 Jun 2020, Vol. 12, Issue 547. Full-text: https://doi.org/10.1126/scitranslmed.aau9135

Galidesivir is a nucleoside RNA polymerase inhibitor with a broad-spectrum activity in vitro against more than 20 RNA viruses in nine different families, including coronaviruses and viral disease families that include filoviruses, togaviruses, bunyaviruses, arenaviruses, paramyxoviruses, and flaviviruses. A NIAID-funded, randomized, double-blind, placebo-controlled clinical trial to assess the safety, clinical impact and antiviral effects of galidesivir in patients with COVID-19 is underway. Of note, the drug also works against Zika: In the study presented here, galidesivir dosing in rhesus macaques was safe and offered postexposure protection against Zika virus infection.

 

Jácome R, Campillo-Balderas JA, Ponce de León S, Becerra A, Lazcano A. Sofosbuvir as a potential alternative to treat the SARS-CoV-2 epidemic. Sci Rep. 2020 Jun 9;10(1):9294. PubMed: https://pubmed.gov/32518317. Full-text: https://doi.org/10.1038/s41598-020-66440-9

Some thoughts about the possibility of using sofosbuvir against SARS-CoV-2, a nucleoside analog antiviral approved for hepatitis C virus infections. The structural superposition of the hepatitis C virus polymerase bound to sofosbuvir with the SARS-CoV polymerase shows that the residues that bind to the drug are present in the latter.