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By Christian Hoffmann &
Bernd S. Kamps

29 May

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Epidemiology

Ball P, Maxmen A. The epic battle against coronavirus misinformation and conspiracy theories. Nature 2020, 581, 371-374. Full-text: https://doi.org/10.1038/d41586-020-01452-z

This article shows how analysts and researchers have been scrambling to track and analyse the disparate falsehoods floating around — both ‘misinformation’, which is wrong but not deliberately misleading, and ‘disinformation’, which refers to organized falsehoods that are intended to deceive. Inaccurate information doesn’t only mislead, but could be a matter of life and death if people start taking unproven drugs, ignoring public-health advice, or refusing a coronavirus vaccine if one becomes available.

 

Lam TT. Tracking the genomic footprints of SARS-CoV-2 transmission. Trends in Genetics 2020. Full-text: https://doi.org/10.1016/j.tig.2020.05.009

Analysis of SARS-CoV-2 genomes provides insights into the origin, transmission, spread and evolution. Brief review on current knowledge and research.

 

Virology, Immunology

Shen B, Yi X, Sun Y, et al. Proteomic and Metabolomic Characterization of COVID-19 Patient Sera. Cell May 27, 2020. Full-text: https://www.sciencedirect.com/science/article/pii/S0092867420306279

Molecular insights into the pathogenesis of SARS-CoV-2 infection. Authors applied proteomic and metabolomic technologies to analyze the proteome and metabolome of sera from COVID-19 patients and several control groups. Pathway analyses and network enrichment analyses of the 93 differentially expressed proteins showed that 50 of these proteins belong to three major pathways, namely activation of the complement system, macrophage function and platelet degranulation. It was found that 80 significantly changed metabolites were also involved in the three biological processes revealed in the proteomic analysis.

 

Park A, Iwasaki A. Type I and Type III Interferons – Induction, Signaling, Evasion, and Application to Combat COVID-19.  Cell Host Microbe 2020, May 27. Full-text: https://www.sciencedirect.com/science/article/abs/pii/S1931312820302900

The interferon (IFN) response constitutes the major first line of defense against viruses. This complex host defense strategy can, with accurate understanding of its biology, be translated into safe and effective antiviral therapies. In their comprehensive review, authors describe the recent progress in our understanding of both type I and type III IFN-mediated innate antiviral responses against human coronaviruses and discuss the potential use of IFNs as a treatment strategy.

 

Transmission

On Kwok K, Hin Chan HH, Huang Y, et al. Inferring super-spreading from transmission clusters of COVID-19 in Hong Kong, Japan and Singapore. J Hosp Infect. 2020 May 21:S0195-6701(20)30258-9. PubMed: https://pubmed.gov/32446721 . Full-text: https://doi.org/10.1016/j.jhin.2020.05.027

Super-spreading events in an outbreak can change the nature of an epidemic. Therefore, it is useful for public health teams to determine if an ongoing outbreak has any contribution from such events, which may be amenable to interventions. The dispersion factor (k) from empirical data on clusters of epidemiologically-linked COVID-19 cases in Hong Kong, Japan and Singapore was relatively high, indicating that large cluster sizes, compatible with super-spreading, were unlikely.

 

Comorbidities.

Kuderer NM, Choueiri TK, Shah DP. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet May 28, 2020. Full-text: https://doi.org/10.1016/S0140-6736(20)31187-9

Cohort study from the USA, Canada, and Spain, analysing 928 cancer patients with COVID-19. Median age was 66 years (IQR 57–76) and the most prevalent malignancies were breast (21%) and prostate (16%). In total 121 (13%) patients had died. Beside general risk factors (age, male sex etc), independent factors associated with increased mortality were an ECOG status of 2 or higher and “active” cancer.

 

Vizcarra P, Pérez-Elías M, Quereda C, et al. Description of COVID-19 in HIV-infected individuals: a single-centre, prospective cohort. Lancet HIV. Published: May 28, 2020. Full-text: https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(20)30164-8/fulltext

Single center study from Madrid, comparing 51 HIV+ patients with COVID-19 (35 confirmed cases) with 1,288 HIV patients without COVID-19. Six patients were critically ill and two died. There was no evidence that any specific antiretroviral drug (such as tenofovir or PIs) affected COVID-19 susceptibility or severity.

 

Geerts H, van der Graaf PH. Salvaging CNS Clinical Trials halted due to COVID-19. CPT Pharmacometrics Syst Pharmacol. 2020 May 28. PubMed: https://pubmed.gov/32468710 . Full-text: https://doi.org/10.1002/psp4.12535

COVID-19 has halted many ongoing CNS clinical trials, especially in Alzheimer’s disease. While some of these trials will need to restart, others can re-start at different points with substantial protocol amendments. Authors propose the concept of mechanistic modeling-based virtual twin patients as a possible solution to harmonize the readouts from these complex and fragmented clinical datasets in a biologically relevant way.

 

Severe COVID-19

Maatman TK, Jalali F, Feizpour C, et al. Routine Venous Thromboembolism Prophylaxis May Be Inadequate in the Hypercoagulable State of Severe Coronavirus Disease 2019. Critical Care Medicine May 27, 2020. Full-text: https://doi.org/10.1097/CCM.0000000000004466

240 consecutive patients with confirmed SARS-CoV-2 were admitted to one of three US hospitals and 109 were critically ill. Venous thromboembolism was diagnosed in 31 patients (28%) 8 ± 7 days after hospital admission. Authors conclude that routine chemical venous thromboembolism prophylaxis may be inadequate in preventing venous thromboembolism in severe COVID-19.

 

Treatment

Hernandez AV, Roman YM, Pasupuleti V, et al. Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19: A Living Systematic Review. Annals of Internal Medicine 27 May 2020. Full-text: https://doi.org/10.7326/M20-2496.

The main conclusion of this review is that there is insufficient and often conflicting evidence on the benefits and harms of using hydroxychloroquine or chloroquine to treat COVID-19. As such, it is impossible to determine the balance of benefits to harms. There are no assessments of hydroxychloroquine or chloroquine for prophylaxis against COVID-19.