Top 10: April 5

<<< April 2020

By Christian Hoffmann &
Bernd S. Kamps


Scott SE, Zabel K, Collins J, et al. First Mildly Ill, Non-Hospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States — Maricopa County, Arizona, 2020. Clinical Infectious Diseases 2020, 02 April, ciaa374,

Is symptom severity a proxy for infectivity? Case report of a patient with mild illness and positive tests for up to 18 days after diagnosis, without evidence of transmission to 16 close contacts, among them 10 high-risk contacts.


Lu J, Gu J, Li K, et al. COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020. Emerg Infect Dis. 2020 Apr 2;26(7). PubMed: Full-text:

Outbreak in a restaurant. The distances between index patient and persons at other tables were all >1 m, suggesting that droplet transmission was prompted by air-conditioned ventilation.


Kwon SY, Kim EJ, Jung YS, Jang JS, Cho NS. Post-donation COVID-19 identification in blood donors. Vox Sang. 2020 Apr 2. PubMed: Full-text:

Korean study of seven asymptomatic blood donors who were later identified as COVID-19 confirmed cases. None out of 9 recipients of platelets or red blood cell transfusions tested positive for SARS-CoV-2 RNA. Transfusion transmission is unlikely.


Chang L, Zhao L, Gong H, Wang L, Wang L. Severe Acute Respiratory Syndrome Coronavirus 2 RNA Detected in Blood Donations. Emerg Infect Dis. 2020 Apr 3;26(7). PubMed: Full-text:

With screening of 2,430 donations in real-time, including 1,656 platelet and 774 whole blood donations from Wuhan, authors found plasma samples positive for viral RNA from 4 asymptomatic donors. It remains unclear whether detectable RNA signifies infectivity.



Vetrugno L, Bove T, Orso D, et al. Our Italian Experience Using Lung Ultrasound for Identification, Grading and Serial Follow-up of Severity of Lung Involvement for Management of Patients with COVID-19. Echocardiography. 2020 Apr 1. PubMed: Full-text:

Experience from Italy with lung ultrasound as a bedside tool to improve evaluation of lung involvement, and also reduce the use of chest x-rays and CT. A point scoring system is employed by region and ultrasound pattern.



Kimball A, Hatfield KM, Arons M, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility – King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. 2020 Apr 3;69(13):377-381. PubMed: Full-text:

Outbreak in a long-term care facility: Test them all, immediately! Following identification of a case of SARS-CoV-2 in a health care worker, 13/23 residents who tested positive were asymptomatic or presymptomatic on the day of testing.



Bavishi C, Maddox TM, Messerli FH. Coronavirus Disease 2019 (COVID-19) Infection and Renin Angiotensin System Blockers. JAMA Cardiol. 2020 Apr 3. pii: 2764299. PubMed: Full-text:

This mini-review outlines the mechanisms by which RAAS inhibitors (ACEIs/ARBs) may be of benefit in COVID-19. Overview of the current recommendations for their use in infected patients. According to the authors, the biological plausibility of salutary effects of RAAS inhibitors is intriguing and several trials of starting losartan in patients with COVID-19 are currently being planned.


Al-Shamsi HO, Alhazzani W, Alhuraiji A, et al. A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group. Oncologist. 2020 Apr 3. PubMed: Full-text:

Detailed and important review for oncologists, addressing current challenges associated with managing cancer patients during theCOVID-19 pandemic.


Volkow ND. Collision of the COVID-19 and Addiction Epidemics. Ann Intern Med. 2020 Apr 2. pii: 2764313. PubMed: Full-text:

Don’t forget or marginalize persons with substance use disorders during this crisis.


Fried JA, Ramasubbu K, Bhatt R, et al. The Variety of Cardiovascular Presentations of COVID-19. Circulation. 2020 Apr 3. PubMed: Full-text:

Four COVID-19 cases with cardiovascular presentations are described. In patients presenting with what appears to be a typical cardiac syndrome, COVID-19 infection should be in the differential during the current pandemic, even in the absence of fever or cough.