Top 10: August 16

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By Christian Hoffmann &
Bernd S. Kamps

16 August


Sebhatu A, Wennberg K, Arora-Jonsson S, et al. Explaining the homogeneous diffusion of COVID-19 nonpharmaceutical interventions across heterogeneous countries. PNAS August 11, 2020. Full-text:

What drives OECD countries to adopt COVID-19 restrictive policies such as lockdowns and school closures? These Swedish researchers found that government policies are strongly driven by the policies initiated in other countries. The level of democracy also matters: While strong democracies are slower to initiate restrictive policies, they are more likely to follow the policies of nearby countries. Following the lead of others rather than making decisions based on the specific situation of the country may have led to countries locking down too early or too late.



Alm E, Broberg EK, Connor T.  Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020. Eurosurveillance Volume 25, Issue 32, 13/Aug/2020. Full-text:

How do genetic clades distribute between European countries? Erik Alm and colleagues have applied the available nomenclatures to describe broad geographical and temporal trends in the distribution of SARS-CoV-2 genetic clades and discuss potential genomic surveillance objectives at the European level.



Gniffke EP, Harrington WE, Dambauskas N, et al. Plasma from recovered COVID-19 subjects inhibits spike protein binding to ACE2 in a microsphere-based inhibition assay. J Infect Dis August 15, 2020. Full-text:

Edward Gniffke and colleagues from Seattle present a microsphere-based flow cytometry assay that quantifies the ability of plasma to inhibit the binding of spike protein to ACE2. This inhibition assay may be broadly useful in routine clinical evaluation of functional immunity in recovered patients (selecting the most potent post-convalescent plasma) and evaluating the functionality of anti-SARS2 antibodies produced in response to vaccines.



Singanayagam A, Patel M, Charlett A, et al. Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020. Eurosurveillance August 13, 2020, 25, Issue 32. Full-text:

Using the Ct values from semi-quantitative RT-PCR can be a valuable proxy for infectious virus detection and may help to inform decision-making on infection control. Culturing virus from 324 samples (253 cases) that tested positive by RT-PCR, this large study found a strong relationship between Ct value and ability to recover infectious virus. The study also adds to the evidence on duration of infectiousness following mild-to-moderate COVID-19. At 10 days after symptom onset, probability of culturing virus declined to 6%. Of note, Ct values and the presence of infectious virus were similar in samples from asymptomatic and pre-symptomatic persons.



Patterson EI, Prince T, Anderson ER, et al. Methods of inactivation of SARS-CoV-2 for downstream biological assays. J Infect Dis, August 15, 2020. Full-text:

To facilitate the transfer of infectious samples from high containment laboratories, Edward Patterson and colleagues from Liverpool School of Tropical Medicine have tested methods commonly used to inactivate virus and prepare the sample for additional experiments. Incubation at 80° C, a range of detergents, Trizol reagents and UV energies were successful at inactivating a high titer of SARS-CoV-2. Methanol and paraformaldehyde incubation of infected cells also inactivated the virus. The protocols presented here can provide a framework for in-house inactivation of SARS-CoV-2.


Hatfield KM, Reddy SC, Forsberg K, et al. Facility-Wide Testing for SARS-CoV-2 in Nursing Homes — Seven U.S. Jurisdictions, March–June 2020. MMWR Morb Mortal Wkly Rep 2020;69:1095–1099. Full-text:

Again and again: If you have a case a nursing home, test everyone, residents and HCP, immediately. In regression analyses among 88 nursing homes with a documented case before facility-wide testing occurred, each additional day between identification of the first case and completion of facility-wide testing was associated with identification of 1.3 additional cases. Among 62 facilities that could differentiate results by resident and HCP status, an estimated 1.3 HCP cases were identified for every three resident cases.



Jorgensen SC, Burry L, Tse CL, et al. Baricitinib: Impact on COVID-19 coagulopathy? Clin Infect Dis, August 2020. Full-text:

The JAK-inhibitor baricitinib interrupts the signaling of multiple cytokines implicated in COVID-19 immunopathology and may also exert antiviral effects. Several trials are underway. Sarah Jorgensen and colleagues highlight a potential adverse effect that could be problematic for COVID-19 patients: baricitinib’s dose-dependent association with arterial and venous thromboembolic events. It is possible that the pro-thrombotic tendencies could exacerbate a hypercoagulable state, underscoring the importance of restricting the use of baricitinib to clinical trials.


Cerda-Contreras C, Nuzzolo-Shihadeh L, Camacho-Ortiz A. Baricitinib as treatment for COVID-19: friend or foe of the pancreas? Clin Infect Dis, August 14m 2020. Full-text:

These authors present a case of pancreatitis occurring during baricitinib administration.


Collateral damage

Editorial. The EVALI outbreak and vaping in the COVID-19 era. The Lancet Respiratory Medicine 2020, published 14 August. Full-text:

From August 2019 to February 2020, 2,807 cases of EVALI (e-cigarette, or vaping, product use-associated lung injury) were reported to the CDC, including 68 deaths. Symptoms of EVALI may overlap with those of some infectious respiratory diseases, including COVID-19. This editorial highlights current knowledge and how the effects of vaping might now be colliding with the risk of COVID-19. Several experts have asked for e-cigarettes to be withdrawn from the market during the pandemic.


Bayram H, Köktürk N, Elbek O, et al. Interference in scientific research on COVID-19 in Turkey. Lancet 2020, 396: 463-464, August 15, 2020. Full-text:

Ethics as a second step? The Turkish Ministry of Health has announced a mandatory application for permission for research on COVID-19, before any application is made to ethics committees. Hasan Bayram and colleagues are worried about these restrictions on independent research in Turkey and hope that the decision will be taken back in compliance with the Turkish Constitution.