Top 10: January 26

Copy-editor: Rob Camp


* * * Paper of the Day * * *

Tönshoff B, Müller B, Elling R, et al. Prevalence of SARS-CoV-2 Infection in Children and Their Parents in Southwest Germany. JAMA Pediatr January 22, 2021. Full-text:

In a population-based sample in southwest Germany, this large-scale, multi-center, cross-sectional investigation of 4,964 participants accurately determined anti–SARS-CoV-2 seropositivity. The estimated SARS-CoV-2 seroprevalence was low in parents (1.8%) and 3-fold lower in children aged 1 to 10 years (0.6%), indicating that young children do not play a key role in SARS-CoV-2 spreading during the current pandemic (or their parents don’t hug them enough!).



Wauters E, Van Mol P, Garg AD et al. Discriminating mild from critical COVID-19 by innate and adaptive immune single-cell profiling of bronchoalveolar lavages. Cell Res (2021). Full-text:

Using scRNA-seq data derived from BAL, Els Wauters and colleagues from Leuven, Belgium, performed deep-immune profiling of the adaptive and innate immune cell landscape within the main locale of COVID-19 pathology. Briefly, their findings support a model wherein neutrophils execute their antiviral function in an immunologically ‘controlled’ fashion, regulated by T cells with good effector functions and paralleled by ‘orderly’ phagocytic disposal of expired cells by macrophages in mild disease. In contrast, in critical disease, T cells are less abundant and dysregulated, which coupled with hyperinflammatory monocytes facilitates excessive neutrophil-based inflammation.


Shaan Lakshmanappa Y, Elizaldi SR, Roh JW et al. SARS-CoV-2 induces robust germinal center CD4 T follicular helper cell responses in rhesus macaques. Nat Commun 12, 541 (2021). Full-text:

According to the authors, these animal experiments add to our understanding of immune responses to SARS-CoV-2 in three significant ways. First, they demonstrate that robust Th1–Tfh responses are observed following SARS-CoV-2 infection. Second, Tfh responses focused on S and N are seen within lymph nodes, circulate throughout the peripheral blood, potentially seeding the spleen. Third, they showed that acute antibody kinetics are characterized by induction of IgG, predominantly to S1 and of the IgG1 sub-class, indicative of early class switching. Taken together, these data demonstrate that productive Tfh responses are elicited following SARS-CoV-2 infection in healthy adult rhesus macaques.


Tan AT, Linster M, Tan CW, et al. Early induction of functional SARS-CoV-2 specific T cells associates with rapid viral clearance and mild disease in COVID-19 patients. Cell Rep January 21, 2021. Full-text:

This longitudinal immunological analysis in a small cohort from onset till outcome suggests that early induction of IFN-γ secreting SARS-CoV-2 specific T cells is present in patients who have mild disease and accelerated viral clearance. Detection of functional SARS-CoV-2 specific T cells may be of prognostic value.



CDC COVID-19 Response Team; Food and Drug Administration. Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Moderna COVID-19 Vaccine — United States, December 21, 2020–January 10, 2021. MMWR Morb Mortal Wkly Rep. ePub: 22 January 2021. Full-text: icon.

Two in a Million: from December 21, 2020 to January 10, 2021, CDC detected 10 cases of anaphylaxis after administration of a reported 4.041.396 first doses of the Moderna COVID-19 vaccine (2.5 cases per million doses administered). No anaphylaxis-related deaths were reported. Nine events occurred in persons with a documented history of allergies or allergic reactions, five of whom had a previous history of anaphylaxis. The median interval from vaccine receipt to symptom onset was 7.5 minutes. Nine patients had onset within 15 minutes, and one had onset after 30 minutes.



Li Y, Lai D, Lei Q, et al. Systematic evaluation of IgG responses to SARS-CoV-2 spike protein-derived peptides for monitoring COVID-19 patients. Cell Mol Immunol (2021). Full-text:

Yang Li and colleagues from Shanghai identified and verified eight peptides derived from the S protein that may be of high diagnostic value. These peptides might be used in different circumstances alone or in combination as candidates to generate immunoassays for monitoring COVID-19. In comparison to the current protein-based immunoassays, peptide-based assays could be highly affordable and accessible.



Oran DP, Topol EJ. The Proportion of SARS-CoV-2 Infections That Are Asymptomatic: A Systematic Review. Ann Intern Med. 2021 Jan 22. PubMed: Full-text:

How many are asymptomatic? After screening all observational, descriptive studies and reports of mass screening for SARS-CoV-2 that were either cross-sectional or longitudinal in design published through 17 November 2020 (n = 61), Daniel P. Oran and Eric J. Topol say, “at least one third”.


Pellegrini D, Kawakami R, Guagliumi G, et al. Microthrombi As A Major Cause of Cardiac Injury in COVID-19: A Pathologic Study. Circulation. 2021 Jan 22. PubMed: Full-text:

Of 40 hearts from deceased COVID-19 patients from Bergamo, 14 (35%) had evidence of myocyte necrosis, predominantly of the left ventricle. Notably, 9/14 (64%) had microthrombi in myocardial capillaries, arterioles, and small muscular arteries. Microthrombi were different in composition as compared to intramyocardial thromboemboli from COVID-19 negative subjects and to coronary thrombi retrieved from COVID-19 positive and negative STEMI patients. Tailored anti-thrombotic strategies may be useful to counteract the cardiac effects of COVID-19 infection.


Leidman E, Duca LM, Omura JD, Proia K, Stephens JW, Sauber-Schatz EK. COVID-19 Trends Among Persons Aged 0–24 Years — United States, March 1–December 12, 2020. MMWR Morb Mortal Wkly Rep 2021;70:88–94. Full-text:

Trends in children and adolescents paralleled trends in adults. Among children, adolescents, and young adults with available data for outcomes, 30.229 (2,5%) were hospitalized, 1973 (0,8%) required ICU admission, and 654 (0,023%) died. You think that this morbidity/mortality is low? Before considering herd immunity, take these numbers and calculate the affected populations in your country.


Collateral Effects

Verma AM, Patel A, Subramanian S, et al. From intravenous to subcutaneous infliximab in patients with inflammatory bowel disease: a pandemic-driven initiative. Lancet Gastroenterology Correspondence| Volume 6, ISSUE 2, P88-89, February 01, 2021.  Full-text:

Facing the clinical imperative to minimise patient exposure to hospital facilities to mitigate against the risk of nosocomial acquisition of COVID-19, the authors switched their patients with inflammatory bowel diseases (IBD) from intravenous to subcutaneous infliximab. Experiences are encouraging: in 31 IBD patients, this strategy appeared safe and enabled patients requiring infliximab to have home treatment self-administered at their convenience on the day of dose instead of having to attend a scheduled appointment at the hospital for an infusion.



If you read Spanish, read Laborde A. Moderna confirma que su vacuna contra la covid es efectiva contra las variantes británica y sudafricana. El País 2021, published 25 January. Full-text:

La farmacéutica trabaja en una nueva versión de la vacuna para responder mejor a la cepa de Sudáfrica.


Vizoso S. Rogelia murió por covid y a los 10 días resucitó. El País 2021, published 25 January. Full-text:

La confusión de un geriátrico provoca que una familia de Lugo entierre a otra mujer pensando que era su pariente.



If you read portuguese, read Serafim S. Treze princípios para motivar as pessoas a cumprirem as restrições da covid-19. Público, published 25 January. Full-text:

Estas orientações podem ser usadas por políticos ou outras pessoas que precisem de comunicar restrições na sua cidade ou empresa. São um contributo para uma comunicação eficaz neste momento de crise.



If you read French, read Hecketsweiler C. La deuxième vague de Covid-19 vue de l’hôpital Bichat : « Les malades comme moi, ils meurent ou ils sortent vivants ? » Le Monde, published 25 January. Full-text :

Dans l’établissement parisien, après une période d’accalmie, le nombre d’hospitalisations en réanimation est reparti à la hausse, et les lits pourraient bientôt être comptés.

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