Top 10: December 8

Copy-editor: Rob Camp


Haag C, Höglinger M, Moser A, et al. Social mixing and risk exposures for SARS-CoV-2 infections in elderly persons. Swiss Med Wkly. 2020 Dec 5;150:w20416. PubMed: . Full-text:

Although many elderly persons continued to follow the recommended preventive measures during the transitional phase between the two pandemic waves, social mixing with younger persons constitutes a way for transmission of infections across age groups. In this large survey from Switzerland, about one quarter of all elderly were still strictly adhering to social distancing and preventive measures. In contrast, a minority of 10% of the elderly had many social contacts and were lacking adherence to preventive measures. The remaining groups seemed to fall in between: while they did have multiple personal contacts, they did maintain the recommended distance. Thus, preventive measures remain important among all age groups.


Balabdaoui F, Mohr D. Age-stratified discrete compartment model of the COVID-19 epidemic with application to Switzerland. Sci Rep. 2020 Dec 4;10(1):21306. PubMed: Full-text:

A discrete modeling framework is proposed to capture the dynamics of highly age-sensitive epidemics and to evaluate the effect of social contact patterns on the load of hospitals and their intensive care units. According to the authors, there should be sufficient time for governments to take corrective measures in case they detect a significant increase in hospitalizations after relaxing the lockdown. Even though the second wave may not lead to a collapse of the healthcare system in Switzerland, it is still important to maintain the overall reproduction number always below one to avoid any silent multiplication of the total number of fatalities.



Muller N, Kunze M, Steitz F, et al. Severe Acute Respiratory Syndrome Coronavirus 2 Outbreak Related to a Nightclub, Germany, 2020. Emerg Infect Dis. 2020 Dec 2;27(2). PubMed: Full-text:

Club X is located in a basement in Berlin, Germany. The area accessible to guests is 150 m2 with a height of 3 m. Ventilation of the space is ensured by a mechanical air exhaust and supply system and maintenance was performed according to the manufacturer’s instructions. To avoid noise pollution in the surrounding neighborhood, windows are usually closed during events. On February 29, Club X held an event attended by 300 guests and an index patient who had self-reported initial symptoms one day before attending event. Results: 74 reported cases were linked to the outbreak. Staff members were particularly affected (attack rate 56%) and likely caused sustained viral transmission after an event at the club. This outbreak illustrates the potential for superspreader events and supports current club closures.



Wajnberg A, Amanat F, Firpo A, et al. Robust neutralizing antibodies to SARS-CoV-2 infection persist for months. Science. 2020 Dec 4;370(6521):1227-1230. PubMed: Full-text:

Ania Wajnberg and colleagues used a cohort of 30.082 infected individuals with mild to moderate COVID-19 symptoms screened at Mount Sinai Health System in New York City to determine the robustness and longevity of the anti–SARS-CoV-2 antibody response. They found that neutralizing antibody titers against the SARS-CoV-2 spike protein persisted for at least 5 months after infection. The authors plan to follow this cohort over a longer period of time.


Singh H, Choudhari R, Nema V, Khan AA. ACE2 and TMPRSS2 polymorphisms in various diseases with special reference to its impact on COVID-19 disease. Microb Pathog. 2020 Dec 2:104621. PubMed: Full-text:

There are diversities in distribution of ACE2 and TMPRSS2 polymorphisms among different populations. According to this systematic review, analyzing the genetic variants and expression of ACE2 and TMPRSS2 genes in a population may provide the genetic marker for susceptibility or resistance against the coronavirus infection. This might be useful for identifying susceptible population groups for targeted interventions and for making relevant public health policy decisions.



Mitze T, Kosfeld R, Rode J, Wälde K. Face masks considerably reduce COVID-19 cases in Germany. Proc Natl Acad Sci U S A. 2020 Dec 3:202015954. PubMed: Full-text:

Face masks became mandatory at different points in time across different regions in Germany. Timo Mitze and colleagues compared the rise in infections in regions with masks and regions without masks. Weighing various estimates, they concluded that face masks reduced the daily growth rate of reported infections by around 47%.



Lani-Louzada R, Ramos CDVF, Cordeiro RM, Sadun AA. Retinal changes in COVID-19 hospitalized cases. PLoS One. 2020 Dec 3;15(12):e0243346. PubMed: Full-text:

Surprisingly, of the 25 patients with severe or critical disease in this study from Brazil, only three (12%) manifested convincing retinal changes (microhemorrhages, flame-shaped hemorrhage and nerve fiber layer infarcts). These retinal changes were likely secondary to clinical intercurrences or co-morbidities.


Collateral damage

Friedman J, Beletsky L, Schriger DL. Overdose-Related Cardiac Arrests Observed by Emergency Medical Services During the US COVID-19 Epidemic. JAMA Psychiatry December 3, 2020. 2020. Full-text:

The authors leveraged a large, national US EMS database to characterize emergent trends in overdose mortality fueled by the pandemic. They describe a large-magnitude, national surge in overdose-related cardiac arrest during the initial months of the COVID-19 epidemic in the US. Peak rates in May 2020 were more than double the baseline from 2018 and 2019, and overall 2020 values were elevated by approximately 50%. Results suggest that the fallout from the COVID-19 pandemic—perhaps especially social isolation—is sharply accelerating fatal overdose trends.



Butt JH, Gerds TA, Schou M, et al. Association between statin use and outcomes in patients with coronavirus disease 2019 (COVID-19): a nationwide cohort study. BMJ Open. 2020 Dec 4;10(12):e044421. PubMed: Full-text:

In this observational cohort study using data from Danish nationwide registries, 843/4842 (17%) COVID-19 patients redeemed a prescription of statins in the 6 months prior to COVID-19 diagnosis. Recent statin exposure was not associated with an increased or decreased risk of all-cause mortality or severe infection. The results were consistent across subgroups of age, sex and presumed indication for statin therapy. Among patients with statin exposure, there was no difference between statin drug or treatment intensity with respect to outcomes.


Spagnuolo V, Guffanti M, Galli L, et al. Viral clearance after early corticosteroid treatment in patients with moderate or severe covid-19. Sci Rep. 2020 Dec 4;10(1):21291. PubMed: Full-text:

In this retrospective analysis on 280 patients admitted to the San Raffaele Hospital (Milan, Italy) with moderate/severe COVID-19, time to negativization of nasopharyngeal swabs was similar in steroid and non-steroid users. According to multivariate analysis, SARS-CoV-2 clearance was associated with age ≤ 70 years, a shorter duration of symptoms at admission, a baseline PaO2/FiO2 > 200 mmHg, and a lymphocyte count at admission > 1.0 × 109/L. SARS-CoV-2 clearance was not associated with corticosteroid use.



If you read French, read Collectif. « Vous ne vouliez pas occuper cette dernière place en réanimation… » : l’hommage ému de soignants à « Denise », une patiente âgée morte du Covid-19 – Le Monde 2020, published 7 December. Full-text :

Dans une adresse émue à Denise que « Le Monde » publie, trois réanimateurs et une sociologue évoquent leur admiration pour cette patiente âgée, décédée des suites du Covid-19 et qui avait choisi de ne pas occuper le dernier lit disponible en réanimation.


Piarroux R, Riou B. « Malgré le vaccin, le risque d’une troisième vague de Covid-19 dans les mois qui viennent existe toujours » – Le Monde 2020, published 7 December. Full-text :

Il faudra du temps pour contrôler l’épidémie alors que les conditions de propagation du virus persistent, expliquent Renaud Piarroux et Bruno Riou, l’épidémiologiste et le directeur du centre de crise de l’Assistance publique.


Herzberg N, Hecketsweiler. Covid-19 : la saga du vaccin à ARN messager désormais dans le sprint final. Le Monde 2020, published 30 November. Full-text :

Contre toute attente, c’est une technologie encore jamais éprouvée sur l’homme qui a permis de proposer le plus rapidement des solutions vaccinales contre le SARS-CoV-2, via les projets de Pfizer/BioNTech et de Moderna. Retour sur une course de vitesse lancée il y a plusieurs décennies.


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By Christian Hoffmann &
Bernd Sebastian Kamps

Copy-editor: Rob Camp