Top 10: December 22

Copy-editor: Rob Camp


Aschele C, Negru M, Pastorino A, et al. Incidence of SARS-CoV-2 Infection Among Patients Undergoing Active Antitumor Treatment in Italy. JAMA Oncol December 17, 2020; Full-text:

Large investigation on the incidence of SARS-CoV-2 in almost 60.000 patients with cancer. The 0,68% rate of infection was relatively low. Notably, the rate remained below 1% even in areas with the greatest COVID-19 spread, partly reflecting reorganization measures implemented in medical oncology units in Italy at the onset of this outbreak, supporting the continuation of most oncologic treatments in the adjuvant and metastatic setting. Based on these data, delaying active antitumor treatment to avoid SARS-CoV-2 transmission should not be routinely recommended.



Schoof M, Faust B, Saunders RA, et al. An ultrapotent synthetic nanobody neutralizes SARS-CoV-2 by stabilizing inactive Spike. Science 2020, Vol. 370, Issue 6523, pp. 1473-1479. Full-text:

Monoclonal antibodies that target SARS-CoV-2 must be produced in mammalian cells and need to be delivered intravenously. By contrast, nanobodies can be produced in bacteria or yeast, and their stability may enable aerosol delivery. Here, Aashish Manglik, Michael Schoof and colleagues describe nanobodies that disrupt the interaction between the SARS-CoV-2 Spike protein and the host cell receptor angiotensin-converting enzyme 2 (ACE2). Cryo–electron microscopy (cryo-EM) revealed that one nanobody, Nb6, binds Spike in a fully inactive conformation with its receptor binding domains locked into their inaccessible down state, incapable of binding ACE2.

Figure 2. Cryo-EM structures of Nb6 and Nb11 bound to Spike. | (A) Cryo-EM maps of the SpikeS2P-Nb6 complex in either closed (left) or open (right) SpikeS2P conformation. (B) Cryo-EM maps of the SpikeS2P-Nb11 complex in either closed (left) or open (right)… | Continue reading at


Xiang Y, Nambulli S, Xiao Z, et al. Versatile and multivalent nanobodies efficiently neutralize SARS-CoV-2. Science 2020, Vol. 370, Issue 6523, pp. 1479-1484. Full-text: Full-text:

In yet another paper on nanobodies, Yi She, Yufei Xiang and colleagues describe neutralizing nanobodies (Nbs) with picomolar to femtomolar affinities that inhibit viral infection at concentrations below the nanograms-per-milliliter level. The authors determined a structure of one of the most potent Nbs in complex with the RBD. Multivalent constructs of selected nanobodies achieved even more potent neutralization.

Figure 3. Crystal structure analysis of an ultrahigh-affinity Nb in complex with the RBD. | (A) Cartoon presentation of Nb20 in complex with the RBD. CDR1, -2, and -3 are in red, green, and orange, respectively. (B) Zoomed-in view of an extensive polar interaction network that… | Continue reading at



Spaccaferri G, Larrieu S, Pouey J, et al. Early assessment of the impact of mitigation measures to control COVID-19 in 22 French metropolitan areas, October to November 2020. Euro Surveill. 2020;25(50):pii=2001974.

To control this second SARS-CoV-2 pandemic wave, French national and local authorities implemented a series of mitigation measures in certain metropolitan areas starting mid-October, followed by a countrywide lockdown on 30 October. Here, Guillaume Spaccaferri, Sophie Larrieu and colleagues assess the impact and timeliness of these measures, mainly curfews, describing COVID-19 spread and severity in the 22 French metropolitan areas. A considerable decrease in incidence and hospital admissions was observed 7 to 10 days after the measures were put in place, occurring earlier in metropolitan areas where these had first been undertaken.

Figure 2. Evolution of 7-day rolling rate of hospital admissions for COVID-19 by group of metropolitan areas, France, 27 June–15 November 2020 (n = 3 groups of metropolitan areas).


Tufekci Z. Hang On for 3 More Months. The Atlantic 2020, published 17 December. Full-text:

Some simple advice for anyone contemplating a holiday gathering: Wait until March or Easter 2021: 4 April.



Ball P. The lightning-fast quest for COVID vaccines — and what it means for other diseases. Nature 2020, published 18 December. Full-text:

The speedy approach used to tackle SARS-CoV-2 could change the future of vaccine science. “It shows how fast vaccine development can proceed when there is a true global emergency and sufficient resources,” says Dan Barouch, director of the Center for Virology and Vaccine Research at Harvard Medical School in Boston, Massachusetts.


Rubin EJ, Baden LR, Barocas JA, Morrissey S. Covid-19 Vaccine Fundamentals. Audio interview (19:46). N Engl J Med 2020; 383: e146. Access:

The editors discuss the five types of COVID-19 vaccine under study, as well as trial results of the therapeutic agent baricitinib.

Photo: Eric Rubin and Lindsey Baden


Severe COVID

Berlin DA, Gulick RM, Martinez FJ. Severe Covid-19. N Engl J Med 2020, published 17 December. Full-text:

David Berlin, Roy Gulick and Fernando Martinez describe the case of a 50-year-old, previously healthy man who presented to the emergency department with 2 days of worsening dyspnea. He had fever, cough, and fatigue during the week before presentation. The authors discuss various strategies, review some guidelines for severe COVID-19 (American Thoracic Society, Infectious Diseases Society of America, National Institutes of Health, and Surviving Sepsis Campaign) and conclude with recommendations.

Figure 3. Invasive Mechanical Ventilation for COVID-19–Related Respiratory Failure. | As shown in Panel A, a life-threatening problem in the purple box or a combination of less severe problems in the purple and tan boxes determines the need for endotracheal intubation. In Panel B, “lung de-recruitment” refers to the collapse of alveoli. All pressures are measured in the ventilator circuit and referenced to atmospheric pressure. ARDS denotes acute respiratory distress syndrome, and PEEP positive end-expiratory pressure.


Journal Feature

Gaind N. The best science images of 2020. Nature, December 2020. Full-text:

It’s almost Christmas. Let’s enjoy some pictures about wafer-thin solar cells, gene‑edited squids, a 30-micrometre boat and many more.



Oransky I, Marcus A. The Top Retractions of 2020. The Scientist 2020, published 15 December. Full-text:

According to Retraction Watch in early December, 39 articles about the novel coronavirus have been retracted from preprint servers or peer-reviewed journals so far—a number we’re confident will grow. (That number does not include the retraction of an article from a Johns Hopkins student newspaper claiming that COVID-19 has had “relatively no effect on deaths in the United States.”)

Picture: The “Retraction Star 2020” [  🙁  ]


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