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Top 10: August 30

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By Christian Hoffmann &
Bernd S. Kamps

 

30 August

Prevention

Jones NR, Qureshi ZU, Temple RJ, Larwood JPJ, Greenhalgh T, Bourouiba L. Two metres or one: what is the evidence for physical distancing in covid-19? BMJ. 2020 Aug 25;370:m3223. PubMed: https://pubmed.gov/32843355. Full-text: https://doi.org/10.1136/bmj.m3223

Physical distancing is only one part of a wider public health approach to containing the COVID-19 pandemic. But is one meter sufficient? Or should it be two, or even more? Follow Lydia Bourouiba, Nicolas Jones and colleagues on a tour about distance, ventilation, occupancy, exposure time, people-air-surface-space management and indoor space and air managements.

 

Bae SH, Shin H, Koo H-Y, Lee SW, Yang JM, Yon DK. Asymptomatic transmission of SARS-CoV-2 on evacuation flight. Emerg Infect Dis 2020, published 21 August. Full-text: https://doi.org/10.3201/eid2611.203353

Infected on the aircraft toilet? Dong Keon Yon and Sung Hwan Bae report data on an 11-hour flight from Milan to South Korea with 299 asymptomatic passengers. Before boarding, strict infection control procedures were implemented (physical examinations, medical interviews, body temperature checks, removal of symptomatic passengers from the flight, etc.). The authors suggest that one patient may have been infected during the flight. On the flight, she wore an N95 mask, except when she used a toilet. The toilet was shared by passengers sitting nearby, including an asymptomatic patient. She was seated 3 rows away from the asymptomatic patient. The authors discuss as most plausible explanation “that she became infected by an asymptomatic but infected passenger while using an onboard toilet”.

 

Immunology

Xu C, Li, H, Flavell RA. A special collection of reviews on frontiers in immunology. Cell Res 2020, published 28 August. Full-text: https://doi.org/10.1038/s41422-020-00403-7

And now the jewels of the day! Are you ready for an immunology tour de force? Be guided by Chenqi Xu, Hua-Bing Li and Richard Flavell through 11 reviews on the frontier of the field:

  1. Direct (tumor) and indirect (micro-environment) modifiers (Jedd Wolchok and colleagues)
  2. Future directions to reduce the risk of immune-related adverse events (irAEs; Vijay Kurchoo and colleagues)
  3. Alternative paths to target immune checkpoints in cancer (Chenqi Xu and colleagues)
  4. Antitumor roles of the cGAS-STING pathway (Zhejian Chen and colleagues)
  5. Immunometabolism (Hongbo Chi and colleagues)
  6. Interplay between immune signaling and metabolism (Richard Flavell and colleagues)
  7. Targeting metabolic intermediates and enzymes in inflammation (Eva Pålsson-McDermott and Luke O’Neill)
  8. Inflammasome activation (Thirumala-Devi Kanneganti and colleagues)
  9. ILC development/heterogeneity (Christoph Klose and David Artis)
  10. Microbiome-immunity crosstalk in the intestine and extra-intestinal organs (Eran Elinav and colleagues)
  11. Transcriptional and epigenetic basis of Treg cell development and function (Shimon Sakaguchi and Naganari Ohkura)

 

The papers in detail:

  1. Murciano-Goroff YR, Warner AB, Wolchok JD. The future of cancer immunotherapy: microenvironment-targeting combinations. Cell Res. 2020 Jun;30(6):507-519. PubMed: https://pubmed.gov/32467593. Full-text: https://doi.org/10.1038/s41422-020-0337-2
  2. Schnell A, Bod L, Madi A, Kuchroo VK. The yin and yang of co-inhibitory receptors: toward anti-tumor immunity without autoimmunity. Cell Res. 2020 Apr;30(4):285-299. PubMed: https://pubmed.gov/31974523. Full-text: https://doi.org/10.1038/s41422-020-0277-x
  3. He X, Xu C. Immune checkpoint signaling and cancer immunotherapy. Cell Res. 2020 Aug;30(8):660-669. PubMed: https://pubmed.gov/32467592. Full-text: https://doi.org/10.1038/s41422-020-0343-4
  4. Yum S, Li M, Chen ZJ. Old dogs, new trick: classic cancer therapies activate cGAS. Cell Res. 2020 Aug;30(8):639-648. PubMed: https://pubmed.gov/32541866. Full-text: https://doi.org/10.1038/s41422-020-0346-1
  5. Saravia J, Raynor JL, Chapman NM, Lim SA, Chi H. Signaling networks in immunometabolism. Cell Res. 2020 Apr;30(4):328-342. PubMed: https://pubmed.gov/32203134. Full-text: https://doi.org/10.1038/s41422-020-0301-1
  6. Shyer JA, Flavell RA, Bailis W. Metabolic signaling in T cells. Cell Res. 2020 Aug;30(8):649-659. PubMed: https://pubmed.gov/32709897. Full-text: https://doi.org/10.1038/s41422-020-0379-5
  7. Pålsson-McDermott EM, O’Neill LAJ. Targeting immunometabolism as an anti-inflammatory strategy. Cell Res. 2020 Apr;30(4):300-314. PubMed: https://pubmed.gov/32132672. Full-text: https://doi.org/10.1038/s41422-020-0291-z
  8. Christgen S, Place DE, Kanneganti TD. Toward targeting inflammasomes: insights into their regulation and activation. Cell Res. 2020 Apr;30(4):315-327. PubMed: https://pubmed.gov/32152420. Full-text: https://doi.org/10.1038/s41422-020-0295-8
  9. Klose CSN, Artis D. Innate lymphoid cells control signaling circuits to regulate tissue-specific immunity. Cell Res. 2020 Jun;30(6):475-491. PubMed: https://pubmed.gov/32376911. Full-text: https://doi.org/10.1038/s41422-020-0323-8
  10. Zheng D, Liwinski T, Elinav E. Interaction between microbiota and immunity in health and disease. Cell Res. 2020 Jun;30(6):492-506. PubMed: https://pubmed.gov/32433595. Full-text: https://doi.org/10.1038/s41422-020-0332-7
  11. Ohkura N, Sakaguchi S. Transcriptional and epigenetic basis of Treg cell development and function: its genetic anomalies or variations in autoimmune diseases. Cell Res. 2020 Jun;30(6):465-474. PubMed: https://pubmed.gov/32367041. Full-text: https://doi.org/10.1038/s41422-020-0324-7

 

Clinical

Jones E. The psychology of protecting the UK public against external threat: COVID-19 and the Blitz compared. Lancet Psychiatry 2020, published 27 August. Full-text: https://doi.org/10.1016/S2215-0366(20)30342-4

Do the SARS-CoV-2 pandemic and the German World War 2 aerial bombing campaign against the UK (The Blitz) have something in common? Exposure of the civilian population to a sustained threat, leading to a range of protective measures and behavioral regulations? Follow Edgar Jones on this trip through a phoney war, shelter occupation, deep shelter, adaptation to threat, second wave and risk communication. Your Sunday read.

 

Treatment

Nadkarni GN, Lala A, Bagiella E, et al. Anticoagulation, Mortality, Bleeding and Pathology Among Patients Hospitalized with COVID-19: A Single Health System Study. J Am Coll Cardiol 2020, published 26 August. Full-text: https://doi.org/10.1016/j.jacc.2020.08.041

In this retrospective analysis of 4,389 patients, Valentin Fuster, Girish Nadkarni, Anuradha Lala and colleagues examine the association of in-hospital anticoagulation (AC) with in-hospital outcomes and describe thromboembolic findings on autopsies. Compared to no anticoagulation, therapeutic and prophylactic anticoagulation were associated with lower in-hospital mortality and intubation.

 

Severe COVID

Comorbidities

Webb GJ, Marjot T, Cook JA, et al. Outcomes following SARS-CoV-2 infection in liver transplant recipients: an international registry study. Lancet Gastroenterol Hepatol 2020, published 28 August. Full-text: https://doi.org/10.1016/S2468-1253(20)30271-5

No increased risk of death for patients with liver transplants. In this multicenter cohort study, Gwilym Webb et al. collected data on 151 adult liver transplant recipients from 18 countries and 627 patients who had not undergone liver transplantation. After adjusting for age, sex, creatinine concentration, obesity, hypertension, diabetes, and ethnicity, liver transplantation did not significantly increase the risk of death in patients with SARS-CoV-2 infection. However, ICU admission (43 [28%] vs 52 [8%], p<0·0001) and invasive ventilation (30 [20%] vs 32 [5%], p < 0·0001) were more frequent in the liver transplant cohort.

 

Pediatrics

Swann OV, Holden KA, Turtle L, et al. Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study. BMJ 2020, published 27 August. Full-text: http://dx.doi.org/10.1136/bmj.m3249

In this prospective observational cohort study, Malcolm Semple, Olivia Swann and colleagues report on 651 children and young people aged less than 19 years. Median age was 4.6 years, 35% (225/651) were under 12 months old. 18% (116/632) of children were admitted to critical care. Six patients died in hospital, all of whom had profound comorbidity. The 11% (52/456) who met the WHO MIS-C criteria were five times more likely to be admitted to critical care. Ethnicity seems to be a factor in both critical care admission and MIS-C. The authors also identified a systemic mucocutaneous-enteric symptom cluster in acute cases that shares features with MIS-C. They suggest that the WHO MIS-C preliminary case definition be refined.

 

Society

Susskind D, Vines D. The economics of the COVID-19 pandemic: an assessment. Oxford Review of Economic Policy 2020, published 29 August. Full-text: https://doi.org/10.1093/oxrep/graa036

The COVID-19 pandemic is creating challenges that have been compared to the Spanish Flu Pandemic (minus World War I, fortunately) and the Great Depression. Here Daniel Susskind and David Vines discuss the economic effects and interventions as well as the need for reforming business and finance and international cooperation. They conclude that although the post-Second World War institutions have served the world remarkably well, now, following the COVID-19 pandemic, they need strengthening and reinvigorating. Listen to the final sentences: “Because the pandemic is such a very large event, we need to realize that the world faces a very large choice. We can do what the world did in the late 1940s, when the institutional choices which were made helped to support the golden age of global growth during the 1950s and 1960s. Or we can instead allow what happened in the 1930s to happen all over again.”