Top 10: October 19

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By Christian Hoffmann &
Bernd S. Kamps

19 October

Epidemiology

Moozhipurath RK, Kraft L, Skiera B. Evidence of protective role of Ultraviolet-B (UVB) radiation in reducing COVID-19 deaths. Sci Rep 10, 17705 (2020). Full-text: https://doi.org/10.1038/s41598-020-74825-z

Serious? The authors applied a fixed-effect log-linear regression model to a panel dataset of 152 countries over 108 days (n = 6524). They used the cumulative number of COVID-19 deaths and case-fatality rate (CFR) as the main dependent variables and isolated the ultraviolet index (UVI) effect from potential confounding factors. After controlling for time-constant and time-varying factors, the authors found a significant negative association between UVI and COVID-19 deaths, indicating evidence of the protective role of ultraviolet B (UVB) in mitigating COVID-19 deaths. If confirmed via clinical studies, then the possibility of mitigating COVID-19 deaths via sensible sunlight exposure or vitamin D intervention would be highly attractive.

 

Virology

Lu S, Zhao Y, Yu W, et al. Comparison of nonhuman primates identified the suitable model for COVID-19. Signal Transduct Target Ther. 2020 Oct 19;5(1):157. PubMed: https://pubmed.gov/32814760. Full-text: https://doi.org/10.1038/s41392-020-00269-6

The authors characterized SARS-CoV-2 infection in three non-human primate species: Old World monkeys Macaca mulatta (M. mulatta) and Macaca fascicularis (M. fascicularis) and New World monkey Callithrix jacchus (C. jacchus). Susceptibilities of Old World and New World monkeys to SARS-CoV-2 differed markedly. Macaca mulatta seemed to be the most suitable for modeling COVID-19.

 

Immunology

Perico L, Benigni A, Casiraghi F, et al. Immunity, endothelial injury and complement-induced coagulopathy in COVID-19. Nat Rev Nephrol (2020). Full-text: https://doi.org/10.1038/s41581-020-00357-4

Nice review on pathogenic mechanisms underlying SARS-CoV-2 infection and COVID-19, as well as on the critical role of the immunological hyper-response — characterized by widespread endothelial damage, complement-induced blood clotting and systemic microangiopathy — in disease exacerbation.

 

Liu B, Han J, Cheng X et al. Reduced numbers of T cells and B cells correlates with persistent SARS-CoV-2 presence in non-severe COVID-19 patients. Sci Rep 10, 17718 (2020). Full-text: https://doi.org/10.1038/s41598-020-73955-8

In total, 37 non-severe patients with persistent SARS-CoV-2 presence that were transferred to Zhongnan hospital of Wuhan were retrospectively recruited to the PP (persistently positive) group, which was further allocated to the PPP group (n = 19) and the PPN group (n = 18), according to their testing results after 7 days (N = negative). The PPP subgroup had markedly reduced B cells and T cells compared to the PPN group and healthy subjects. Finally, paired results of these lymphocyte subpopulations from 10 PPN patients demonstrated that the number of T cells and B cells significantly increased when the SARS-CoV-2 tests turned negative.

 

Transmission

Chau NVV, Hong NTT, Ngoc NM, et al. Superspreading event of SARS-CoV-2 infection at a bar, Ho Chi Minh City, Vietnam. Emerg Infect Dis. 2021 Jan. Full-text: https://doi.org/10.3201/eid2701.203480

From 10:00 PM on March 14 until 2:30 AM of the next day, a 43-year old man participated in a St. Patrick’s Day celebration at a bar in Ho Chi Minh City. The bar had 2 indoor areas for clients, a 300 m2 area downstairs and an 50 m2 area upstairs, with no mechanical ventilation. During opening hours, the left and right entrances were typically kept closed to facilitate cooling with air conditioners that recycle indoor air; the middle entrance was kept open. The bar also has naturally ventilated outdoor spaces. Results: 12 additional cases at the bar (and more, via contacts of people infected there).

 

Clinical

Pimenoff VN, Elfström M, Baussano I, et al. Estimating total excess mortality during a COVID-19 outbreak in Stockholm, Sweden. Clinical Infectious Diseases. Full-text: https://doi.org/10.1093/cid/ciaa1593

Ville Pimenoff estimates that since January 2020, the accumulated excess mortality  in the Stockholm region at week 18 was +23% compared with the average over the previous ten years. Of note, comparison with the number of reported COVID-19-related deaths in the 5 week peak period of the outbreak found that 26% of the excess mortality during the COVID-19 epidemic was not recognized as COVID-19-related, either via public health data or by the regional  morgue.

 

Lu QB, Zhang Y, Liu MJ , et al. Epidemiological parameters of COVID-19 and its implication for infectivity among patients in China, 1 January to 11 February 2020. Euro Surveill. 2020;25(40). Full-text: https://doi.org/10.2807/1560-7917.ES.2020.25.40.2000250

Using a large database of > 2000 COVID-19 cases and potential transmission pairs of cases, the authors estimate the median incubation period to be 7.2 (95% confidence interval: 6.9‒7.5) days. The median serial and generation intervals were similar, 4.7 (95% CI: 4.2‒5.3) and 4.6 (95% CI: 4.2‒5.1) days, respectively. Pediatric cases < 18 years had a longer incubation period than adult age groups (p = 0.007).

 

Severe COVID-19

Rodrigues JY, Le Pape P, Lopez O, et al. Candida auris: a latent threat to critically ill patients with COVID-19, Clinical Infectious Diseases. Full-text: https://doi.org/10.1093/cid/ciaa1595

Jose Y Rodrigues and colleagues report on 20 cases of fungemia in hospitalized patients with SARS-CoV-2 infection in 4 institutions in the northern region of Colombia from June to September 2020. Nineteen of the 20 patients had received steroids and 15/19 were had non-albicans Candida fungemia.

 

Co-morbidities

Martínez-López J, Mateos M, Encinas C. et al. Multiple myeloma and SARS-CoV-2 infection: clinical characteristics and prognostic factors of inpatient mortality. Blood Cancer J. 10, 103 (2020). Full-text: https://doi.org/10.1038/s41408-020-00372-5

A retrospective cohort, looking at 167 MM patients from 73 Spanish hospitals. Compared to non-cancer patients, mortality was 50% higher. The main predictors of inpatient mortality for MM were male sex, age > 65 years, renal disease, and active/progressive disease.

 

Treatment

Keretsu S, Bhujbal SP, Cho SJ. Rational approach toward COVID-19 main protease inhibitors via molecular docking, molecular dynamics simulation and free energy calculation. Sci Rep 10, 17716 (2020). Full-text: https://doi.org/10.1038/s41598-020-74468-0

Saquinavir instead of lopinavir? The authors found 15 potential 3CLpro inhibitors with higher binding affinity than that of an α-ketoamide inhibitor determined via X-ray structure. Among them, saquinavir and three investigational drugs aclarubicin, TMC-310911, and faldaprevir can be suggested as potential 3CLpro inhibitors. The authors recommend further experimental investigation of these compounds.

 

 

See also the previous Top 10 papers: https://covidreference.com/top10.

 

By Christian Hoffmann &
Bernd S. Kamps

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