Top 10: November 14

Copy-editor: Rob Camp

Epidemiology

Malani A, Shah D, Kang G, et al. Seroprevalence of SARS-CoV-2 in slums versus non-slums in Mumbai, India. Lancet Global Health 2020, published 13 November. Full-text: https://doi.org/10.1016/S2214-109X(20)30467-8

This is the final article of a pre-print study we presented on August 4: Kolthur-Seetharam U, Shah D, Shastri J, Juneja S, Kang G, Malani A, Mohanan M, Lobo GN, Velhal G, Gomare M. SARS-CoV2 Serological Survey in Mumbai by NITI-BMC-TIFR. Tata Institute of Fundamental Research (TIFR) 2020, published 29 June. Full-text: https://www.tifr.res.in/TSN/article/Mumbai-Serosurvey%20Technical%20report-NITI.pdf

“We usually prefer peer-reviewed studies and seldom present pre-published papers. We are even less readily inclined to present a PDF with just the technical details of an unpublished study. Today we make an exception. In a cross-sectional survey in Mumbai, India, Ullas Kolthur-Seetharam and colleagues estimated the prevalence of SARS-CoV-2 infection in three Mumbai areas (called ‘wards’) in July 2020. The authors found, on average, a prevalence of around 57% in the slum areas of Chembur, Matunga and Dahisar, and 16% in neighboring non-slums. If these data are confirmed, some Mumbai areas would soon reach herd immunity and could return to a pre-COVID way of life.”

 

See also a short comment in The Economist. Anonymous. A minority of people with covid-19 account for the bulk of transmission. The Economist 2020, published 7 November. Full-text: https://www.economist.com/graphic-detail/2020/11/07/a-minority-of-people-with-covid-19-account-for-the-bulk-of-transmission

Find more information about superspreading events at https://kmswinkels.medium.com/covid-19-superspreading-events-database-4c0a7aa2342b

 

Prevention

Buchan AG, Yang L, Atkinson KD. Predicting airborne coronavirus inactivation by far-UVC in populated rooms using a high-fidelity coupled radiation-CFD model. Sci Rep 10, 19659 (2020). Full-text: https://doi.org/10.1038/s41598-020-76597-y

To mitigate transmission of aerosolised SARS-CoV-2 coronavirus, we are all following one or more of three key principles: minimize time of exposure to virus (by limiting interactions), maximize distance from sources of virus (social distancing), and/or shield yourself from the virus (wear PPE). Here, the authors propose using narrow bandwidth, short wavelength UVC (207–222 nm) to mitigate further SARS-CoV-2 transmission. Their model shows that disinfection rates are increased by a further 50-85% when using far UVC within currently recommended exposure levels compared to the room’s ventilation alone. [Unlike typical UVC, which has been used to kill microorganisms but is carcinogenic and cataractogenic, recent evidence has shown that far UVC is safe to use around humans.]

 

Immunology

Schulien I, Kemming J, Oberhardt V, et al. Characterization of pre-existing and induced SARS-CoV-2-specific CD8+ T cells. Nat Med (2020). Full-text: https://doi.org/10.1038/s41591-020-01143-2

Are differences in pre-existing and induced SARS-CoV-2-specific CD8+ T cell responses linked to different courses of infection? We don’t know yet. In particular, little is known about the abundance, phenotype, functional capacity and fate of pre-existing and induced SARS-CoV-2-specific CD8+ T cell responses during the natural course of SARS-CoV-2 infection. In this study, Robert Thimme, Maike Hofmann, Christoph Neumann-Haefelin and colleagues established experimental tools for high-resolution ex vivo analyses of SARS-CoV-2-specific CD8+ T cells. Find out what they discovered about heterogeneous and functionally competent cross-reactive and induced memory CD8+ T cell responses in cross-sectionally analyzed individuals with mild SARS-CoV-2 disease.

 

Clinical

Choi B, Choudhary MC, Regan J, et al. Persistence and Evolution of SARS-CoV-2 in an Immunocompromised Host. N Engl J Med 2020, published 11 November. Full-text: https://doi.org/10.1056/NEJMc2031364

Under special circumstances, for example in an immunocompromised state, SARS-CoV-2 has the potential for persistent infection and accelerated viral evolution. This is the result of a case report by Manuela Cernadas, Jonathan Li, Bina Choi and colleagues who describe the clinical course of a 45-year-old man with long-standing antiphospholipid syndrome, an autoimmune disorder. Before his death five months after the initial COVID-19 diagnosis, SARS-CoV-2 infection subsided and came back twice.

 

Wong CKH, Wong JY, Tang EHM, et al. Clinical presentations, laboratory and radiological findings, and treatments for 11,028 COVID-19 patients: a systematic review and meta-analysis. Sci Rep 10, 19765 (2020). Full-text: https://doi.org/10.1038/s41598-020-74988-9

Meta-analysis of 76 studies published from January-March 2020 on clinical presentation, laboratory findings and treatments of COVID-19 patients, accounting for a total of 11,028 COVID-19 patients. The most common co-morbidities were hypertension (18%), followed by cardiovascular disease (12%) and diabetes (10%). The most frequently identified symptoms were fever (72%) and cough (56%). Notably, 62% and 20% of in-patients received oxygen therapy and non-invasive mechanical ventilation, respectively. In this review, radiological findings of SARS-CoV-2 pneumonia were non-specific.

 

Severe COVID

Zietz M, Zucker J, Tatonetti NP. Associations between blood type and COVID-19 infection, intubation, and death. Nat Commun 11, 5761 (2020). Full-text: https://doi.org/10.1038/s41467-020-19623-x

This next study is about the association between ABO and Rh blood types and infection, intubation, and death. Here, the authors used observational healthcare data on 14,112 individuals tested for SARS-CoV-2 with known blood type in the New York Presbyterian hospital system. Risk of intubation was decreased among A and increased among AB and B types, compared with type O, while risk of death was increased for type AB and decreased for types A and B. Rh-negative blood type might have a protective effect for all three outcomes.

 

Gude F, Riveiro V, Rodríguez-Núñez N, et al. Development and validation of a clinical score to estimate progression to severe or critical state in COVID-19 pneumonia hospitalized patients. Sci Rep 10, 19794 (2020). Full-text: https://doi.org/10.1038/s41598-020-75651-z

Five predictors determined within 24 h of hospital admission may identify patients at risk for COVID-19 disease progression: diabetes, higher age, a low lymphocyte count, decreasing SaO2, and any pH alteration. This is the outcome of a study by Lucía Ferreiro, Francisco Gude and colleagues who analyzed 229 patients who were admitted for pneumonia. The prediction model showed a good clinical performance, including discrimination (AUC 0.87 CI 0.81, 0.92) and calibration (Brier score = 0.11). In total, 0%, 12%, and 50% of patients with severity risk scores ≤ 5%, 6–25%, and > 25% exhibited disease progression, respectively.

 

Co-morbidities

Lim S, Bae JH, Kwon HS, et al. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol (2020). Full-text: https://doi.org/10.1038/s41574-020-00435-4

Patients with diabetes mellitus are at increased risk of severe COVID-19. The authors discuss potential pathogenetic links between COVID-19 and diabetes mellitus; tight control of glucose levels; explain that insulin and dipeptidyl peptidase 4 inhibitors can be used safely in patients with diabetes mellitus and COVID-19; and caution that metformin and sodium–glucose co-transporter 2 inhibitors might need to be withdrawn in patients at high risk of severe disease.

 

Spanish

If you read Spanish, read Andrino B, Grasso D, Llaneras K. Consulta la incidencia del virus en 2.500 municipios: 40 capitales de provincia siguen en riesgo extremo. El País 2020, published 14 November. Full-text: https://elpais.com/sociedad/2020-11-14/consulta-la-incidencia-del-virus-en-2500-municipios-40-capitales-de-provincia-siguen-en-riesgo-extremo.html

El 70% de la población española vive en localidades que superan los 250 casos por 100.000 habitantes. El virus ha crecido en las últimas dos semanas en 1.400 de ellas.

 

French

If you read French, read Piketty T. « La planète est traversée par de multiples fractures inégalitaires, que la pandémie va encore aggraver » – Le Monde 2020, published 14 November. Full-text : https://www.lemonde.fr/idees/article/2020/11/14/thomas-piketty-la-planete-est-traversee-par-de-multiples-fractures-inegalitaires-que-la-pandemie-va-encore-aggraver_6059700_3232.html

De nouveaux indicateurs permettent une compréhension à la fois plus fine et plus exhaustive des inégalités au niveau mondial, détaille l’économiste Thomas Piketty dans sa chronique.

 

Audureau W. Vaccins, Bill Gates, hydroxychloroquine… Nos réponses à 36 questions très partagées sur la crise du Covid-19. Le Monde 2020, published 13 November. Full-text : https://www.lemonde.fr/les-decodeurs/article/2020/11/13/pourquoi-pour-qui-nos-reponses-a-36-questions-tres-partagees-sur-la-crise-du-covid_6059644_4355770.html

Pourquoi les médecins perçoivent plus d’argent avec un cas de Covid-19 ? Pourquoi les métros sont-ils ouverts ? « Le Monde » répond à un long et populaire message viral sur Facebook.

 

Collectif. Journal de crise des blouses blanches : « J’ai l’impression d’être embourbé dans une guerre de tranchée » – Le Monde 2020, published 14 November. Full-text : https://www.lemonde.fr/journal-blouses-blanches/article/2020/11/14/journal-de-crise-des-blouses-blanches-j-ai-l-impression-d-etre-embourbe-dans-une-guerre-de-tranchee_6059764_6033712.html

Comme pendant la première vague épidémique au printemps, « Le Monde » donne à nouveau la parole à des personnels soignants en première ligne contre le Covid-19. Ils racontent « leur » crise sanitaire.

 

 


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