Top 10: February 15

Copy-editor: Rob Camp


Paper of the Day

NERVTAG 20210211. Update note on B.1.1.7 severity. New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) 2021, published 12 February. Full-text:

It is now likely that infection with B.1.1.7 is associated with an increased risk of hospitalization and death compared to infection with previously circulating viruses.


Variants – 13 February update. COVID Reference 2021, published 13 February. Full-text: | See also the Comparison document with new content added between 7 and 13 February:

In most of continental Europe and the US, Easter 2021 (4 April) may be recalled later as a B.1.1.7 Easter.



Hay JA, Kennedy-Shaffer L, Kanjilal S, et al. Estimating epidemiologic dynamics from cross-sectional viral load distributions. MedRxiv 2021, posted 13 February. Full-text:

Cycle threshold (Ct) values from even limited numbers of random samples might provide estimates of an epidemic’s trajectory. Michael Mina, Marc Lipsitch, James Hay and colleagues applied their methods to Ct values from surveillance conducted during the SARS-CoV-2 pandemic in a variety of settings. A new approach for real-time estimates of epidemic trajectories for outbreak management and response?


Helix 202102. The Helix® COVID-19 Surveillance Dashboard. Helix 2021; website:

The B.1.1.7 strain is doubling every 10 days in the US. Should it be the last obstacle to achieving containment of SARS-CoV-2 in the country? Wait a few weeks before eliminating effective mitigation measures such as mask mandates and bans on gatherings.


Alpert T, Lasek-Nesselquist  E, Brito AF, et al. Early introductions and community transmission of SARS-CoV-2 variant B.1.1.7 in the United States. medRxiv 2021, posted 12 February. Full-text:

Nathan D. Grubaugh, Tara Alpert and colleagues highlight the primary ports of entry for B.1.1.7 in the US. New York is likely one of the key hubs for introductions and domestic spread. The authors also provide evidence for increased community transmission in several states.



Tarke A, Sidney J, Kidd CK, et al. Comprehensive analysis of T cell immunodominance and immunoprevalence of SARS-CoV-2 epitopes in COVID-19 cases. Cell Rep Med. 2021 Jan 26:100204. PubMed: Full-text:

Alessandro Sette, Alison Tarke and colleagues show a broad T cell repertoire, suggesting that viral escape of T cell immunity is unlikely. CD4 immunodominant regions correlate with HLA binding and not with high common cold coronavirus homology. RBD is poorly recognized by CD4s. Epitope pools can be used to optimize detection of T cell responses.


Batra M, Tian R, Zhang C, et al. Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomes. Sci Rep 11, 3455 (2021).

Mehri Mirsaeidi, Mayank Batra and colleagues at the University of Miami studied 400 RT-PCR confirmed SARS-CoV-2 patients to determine independent factors associated with poor outcomes. Their findings suggest that titers of IgG targeting the N protein of SARS-CoV-2 at admission might be a prognostic factor for the clinical course of disease.


Wu KJ. The Body Is Far From Helpless Against Coronavirus Variants. The Atlantic 2021, published 12 February. Full-text:

The mission of the human immune system is threefold. 1. Memorize the features of dangerous microbes that breach the body’s barriers. 2. Launch an attack to bring them to heel. 3. Then squirrel away intel to quash future assaults.



Shimabukuro TT, Cole M, Su JR. Reports of Anaphylaxis After Receipt of mRNA COVID-19 Vaccines in the US-December 14, 2020-January 18, 2021. JAMA. 2021 Feb 12. PubMed: Full-text:

During December 14, 2020 through January 18, 2021, a total of 9 943 247 doses of the Pfizer-BioNTech vaccine and 7 581 429 doses of the Moderna vaccine were reported administered in the US. CDC identified 66 case reports that met Brighton Collaboration case definition criteria for anaphylaxis (levels 1, 2 or 3): 47 following Pfizer-BioNTech vaccine, for a reporting rate of 4.7 cases/million doses administered, and 19 following Moderna vaccine, for a reporting rate of 2.5 cases/million doses administered.


McKie R. Life savers: the amazing story of the Oxford/AstraZeneca Covid vaccine. The Guardian 2021, published 14 February. Full-text:

A year ago, Sarah Gilbert and Andrew Pollard began work on the response to a new virus. Now, as their vaccine is being given to millions, they tell of their incredible 12 months.



Rentsch CT, Beckman JA, Tomlinson L, et al. Early initiation of prophylactic anticoagulation for prevention of coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort study. BMJ. 2021 Feb 11;372:n311. PubMed: Full-text:

Early initiation of prophylactic anti-coagulation compared with no anti-coagulation among patients admitted to hospital with COVID-19 was associated with a decreased risk of 30-day mortality and no increased risk of serious bleeding events. This is the result of a study of 4297 patients admitted to hospital with COVID-19, 3627 (84,4%) received prophylactic anti-coagulation within 24 hours of admission. More than 99% (n = 3600) of treated patients received subcutaneous heparin or enoxaparin. The cumulative incidence of mortality at 30 days was 14,3% (95% CI: 13,1% to 15,5%) among those who received prophylactic anti-coagulation and 18,7% (15,1% to 22,9%) among those who did not.



Barlow P, van Schalkwyk MCI, McKee M, Labonté R, Stuckler D. COVID-19 and the collapse of global trade: building an effective public health response. Lancet Planetary Health 2021, published 10 February. Full-text:

The pandemic affects international trade through reductions in both supply and demand. Pepita Barlow et al. describe the implications for health. Problems include reduced access to medical supplies, budgetary shortfalls, and a general decline in economic activity—leading, in many cases, to recessions, threats to social safety nets, and to increased precariousness of income, employment, and food security. The authors map a pathway for post-pandemic recovery after the collapse of trade and the global economy.



If you read Spanish, read Domínguez N. La endiablada búsqueda de una cura para la covid. El País 2021, published 12 February. Full-text:

Varios fármacos experimentales en las últimas fases de prueba muestran resultados prometedores para evitar la infección y salvar la vida a los enfermos más graves.



If you read French, read Gozlan M. Amour et sexualité à l’heure de la Covid-19. Le Monde 2021, published 14 February. Full-text :

La pandémie de Covid-19 a eu des répercussions sur la sexualité dans le monde entier dans la mesure où elle a modifié et compliqué les relations amoureuses entre individus, que ceux-ci soient confinés ensemble ou séparément, qu’ils soient en couple ou célibataires.


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