Top 10: December 11

Copy-editor: Rob Camp


Becker AD, Grantz KH, Hegde ST, et al. Development and dissemination of infectious disease dynamic transmission models during the COVID-19 pandemic: what can we learn from other pathogens and how can we move forward? Lancet Digital Health 2020, published 7 December. Full-text:

Transmission models offer a systematic way to investigate transmission dynamics and produce predictions that integrate assumptions about biological, behavioral, and epidemiological processes. These models also generate possible trajectories of disease burden, evaluate the effectiveness of intervention strategies, and estimate key transmission variables. In this review, the authors highlight key aspects of the history of infectious disease dynamic models. Learn more about malaria, HIV/AIDS, measles, rubella, foot and mouth disease and Ebola.



Fajgenbaum DC, June CH. Cytokine Storm. N Engl J Med 2020; 383:2255-2273. Full-text:

David Fajgenbaum and Carl June remind us that 2020 marks 10 years since the first description of a cytokine storm that developed after chimeric antigen receptor (CAR) T cell therapy and 27 years since the term was first used in the literature to describe the engraftment syndrome of acute graft-versus-host disease after allogeneic hematopoietic stem-cell transplantation.  Follow them on their suspense-packed narrative. The 19-page review for your weekend.



Polack FP, Thomas SJ, Kitchin N, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med 2020, published 10 December. Full-text:

Safety and efficacy findings from the phase 2/3 trial evaluating the safety, immunogenicity, and efficacy of 30 μg of the Pfizer/BioNTech vaccine candidate BNT162b2. A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older. Reactogenicity was generally mild or moderate, and reactions were less common and milder in older adults than in younger adults. A must-read.


Keech C, Albert G, Cho I, et al. Phase 1–2 Trial of a SARS-CoV-2 Recombinant Spike Protein Nanoparticle Vaccine. N Engl J Med 2020; 383:2320-2332. Full-text:

The first Phase I-II results of NVX-CoV2373 (Novavax), a recombinant nanoparticle vaccine. Cheryl Keech et al. evaluated the safety and immunogenicity of the vaccine in 131 adults using 5-μg and 25-μg doses, with or without Matrix-M1 adjuvant. Reactogenicity was absent or mild in the majority of participants and more common with adjuvant. The addition of adjuvant resulted in enhanced immune responses, was antigen dose–sparing, and induced CD4+ T cell responses that were biased toward a Th1 phenotype. The two-dose 5-μg adjuvant regimen induced geometric mean anti-spike IgG (63,160 ELISA units) and neutralization (3906) responses that exceeded geometric mean responses in convalescent serum from mostly symptomatic COVID-19 patients (8344 and 983, respectively). NVX-CoV2373 is composed of trimeric full-length SARS-CoV-2 spike glycoproteins and a Matrix-M1 adjuvant.



Meyerowitz EA, Richterman A, bogoch I, Low N, Cevik M. Towards an accurate and systematic characterisation of persistently asymptomatic infection with SARS-CoV-2. Lancet Infect Dis 2020, published 7 December. Full-text:

Transmission of SARS-CoV-2 from individuals without symptoms is a major force driving pandemics. Eric Meyerowith and colleagues describe three methodological issues that hinder attempts to estimate the proportion of asymptomatic or pre-symptomatic individuals. First, incomplete symptom assessment may overestimate the asymptomatic fraction; second, studies with inadequate follow-up misclassify pre-symptomatic individuals; and third, serological studies might identify people with previously unrecognised infection, but reliance on poorly defined antibody responses and retrospective symptom assessment might result in misclassification. Discover the answers to these issues.



Fancourt D, Steptoe A, Feifei Bu. Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study. Lancet Psychiatry 2020, published 9 December. Full-text:

Several studies suggest that mental health deteriorated in many countries before and during lockdowns. The authors show that the highest levels of depression and anxiety occurred in the early stages of lockdown but declined fairly rapidly, possibly because individuals adapted to circumstances.


FAI2R / SFR / SNFMI / SOFREMIP / CRI / IMIDIATE consortium and contributors. Severity of COVID-19 and survival in patients with rheumatic and inflammatory diseases: data from the French RMD COVID-19 cohort of 694 patients. Ann Rheum Dis. 2020 Dec 2:annrheumdis-2020-218310. PubMed: Full-text:

Large French database, including patients with inflammatory rheumatic and musculoskeletal diseases (iRMD). Of 694 adults, 438 (63%) developed mild (not hospitalized), 169 (24%) moderate (hospitalized non-ICU) and 87 (13%) severe (ICU/deceased) disease. In multivariable imputed analyses, the variables associated with severe infection were age, male gender, hypertension and higher BMI. Use of corticosteroids (OR=1.97), mycophenolate mofetil (OR=6.6) and rituximab (OR=4.21) were also risk factors.



Millen GC, Arnold R, Cazier JB, et al. Severity of COVID-19 in children with cancer: Report from the United Kingdom Paediatric Coronavirus Cancer Monitoring Project. Br J Cancer 2020, published 10 December. Full-text:

Children with cancer with SARS-CoV-2 infection do not appear at increased risk of severe infection compared to the general pediatric population. This is reassuring result of a retrospective and prospective observational study of all children in the UK under 16 diagnosed with cancer. Between 12 March 2020 and 31 July 2020, Gerard Millen et al identified 54 cases: 15 (28%) were asymptomatic, 34 (63%) had mild infections and 5 (10%) moderate, severe or critical infections. No patients died and only three patients required intensive care support due to COVID-19. The estimated incidence of hospital identified SARS-CoV-2 infection in children with cancer under 16 was 3%.


Collateral Effects

Mackie SL, Brouwer E, Conway R, et al. Clinical pathways for patients with giant cell arteritis during the COVID-19 pandemic: an international perspective. Lancet Rheumatol 2020, published 8 December. Full-text: ???

Giant cell arteritis, a common primary systemic vasculitis affecting older people, presents acutely as a medical emergency and requires rapid specialist assessment and treatment to prevent irreversible vision loss. The authors show that during the COVID-19 pandemic, patients might be involved in the reshaping of clinical services.



Rubin EJ, Baden LR, Barocas JA, Morrissey S. SARS-CoV-2 Vaccination and Vulnerable Populations. Audio interview (39:49). N Engl J Med 2020; 383: e143. Access:

The editors discuss who should be first in line as COVID-19 vaccines are rolled out.



If you read Spanish, read Agudo A. Choque entre el norte y el sur por las patentes covid-19. El País 2020, published 10 December. Full-text:

India y Sudáfrica lideran una petición ante la Organización Mundial del Comercio para que se suspenda temporalmente la propiedad intelectual sobre tecnologías, medicamentos y vacunas contra el nuevo coronavirus mientras dure la pandemia; 99 países les apoyan, el mundo rico se resiste



If you read French, read Illouz E. « Croire à la science ou pas est devenu une question éminemment politique, sans doute celle qui va décider de l’avenir du monde » – Le Monde 2020, published 10 December. Full-text :

La sociologue Eva Illouz retrace l’histoire du complotisme et analyse les causes profondes de l’importance qu’il a prise cette dernière décennie, jusqu’à remettre en question « le pari que les démocraties ont fait sur la liberté d’expression et sur la force de la vérité ».



If you read German, read Fischer S. Wir haben uns den Lockdown redlich verdient. Der Spiegel 2020, published 10 December. Full-text:

Zu hohe Infektionszahlen, zu viele Tote – und jeder Tag zählt. Eigentlich müssten wir sofort das öffentliche Leben herunterfahren. Aber jetzt soll erst mal das Weihnachtsgeschäft laufen, und dann sehen wir weiter: in den Abgrund.

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