Top 10: January 30

Copy-editor: Rob Camp


Paper of the Day

Thomson E, Rosen LE, Shepherd JG, et al. Circulating SARS-CoV-2 spike N439K variants maintain fitness while evading antibody-mediated immunity. Cell 2021, published 28 January. Full-text:

Over the past months, the receptor-binding motif (RBM) mutation N439K has emerged independently in multiple SARS-CoV-2 lineages. N439K increases spike affinity for hACE2. Gyorgy Snell, Emma Thomson and colleagues show that the N439K mutation confers resistance against several neutralizing monoclonal antibodies, including one authorized for emergency use by the FDA, and reduces the activity of some polyclonal sera from persons recovered from infection.

Liu Z, VanBlargan LA, Bloyet LM, et al. Identification of SARS-CoV-2 spike mutations that attenuate monoclonal and serum antibody neutralization. Cell Host Microbe 2021, published 27 January. Full-text:

Hard time ahead for anti-clonals. Sean Whelan, Zhuoming Liu and colleagues show that the mutation S477N confers resistance to neutralization by multiple monoclonal antibodies. Also E484K, the bad boy on the block (see yesterday’s presentation of the Wang paper (Increased Resistance of SARS-CoV-2 Variants B.1.351 and B.1.1.7 to Antibody Neutralization) is less sensitive to neutralization by convalescent human sera.


Hope JL, Bradley LM. Lessons in antiviral immunity. Science. 2021 Jan 29;371(6528):464-465. PubMed: Full-text:

The COVID-19 pandemic is revealing widely varying immune responses and diverse clinical outcomes in SARS-CoV-2 infection, raising questions about how antiviral responses are orchestrated, factors that influence the longevity of immunological memory, and approaches that mediate robust protection from viral infections.



Martin MA, VanInsberghe D, Koelle K. Insights from SARS-CoV-2 sequences. Science. 2021 Jan 29;371(6528):466-467. PubMed: Full-text:

In many ways, the SARS-CoV-2 pandemic offers a distinct opportunity for the field of phylodynamics. Methods development over the past 10 to 15 years, the widespread availability of sequencing technologies, open data sharing, and the tireless efforts of clinicians and scientists who collect these data mean that more can be learned from viral genomes than ever before.



da Silva Francisco R, Benittes F, Lamarca AP, et al. Pervasive transmission of E484K and emergence of VUI-NP13L with evidence of SARS-CoV-2 co-infection events by two different lineages in Rio Grande do Sul, Brazil. medRxiv 2021, posted 26 January. Full-text:

Fernando Rosado Spilki, Ronaldo da Silva Francisco and colleagues report two co-infection events caused by the simultaneous occurrence of B.1.1.28 (E484K) and other lineages. Both patients had typical mild to moderate flu-like symptoms with favorable outcomes after disease, no required hospitalization and spontaneous recovery. The possibility of co-infection by E484K adds a new factor to the complex interaction between immune response systems and SARS-CoV-2 Spike mutations.



Bellan M, Soddu D, Balbo PE, et al. Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge. JAMA Netw Open. 2021 Jan 4;4(1):e2036142. PubMed: Full-text:

A consecutive series of 238 patients aged 18 years and older (or their caregivers) who had received a confirmed diagnosis of SARS-CoV-2 infection severe enough to require hospital admission from March 1 to June 29, 2020. (Out of 767 patients, 494 (64,4%) refused to participate, and 35 (4,6%) died during follow-up.) After 4 months, 128/238 patients (53,8%) had functional impairment. Post-traumatic stress symptoms were reported in a total of 41 patients (17,2%).


Daher, A., Balfanz, P., Aetou, M. et al. Clinical course of COVID-19 patients needing supplemental oxygen outside the intensive care unit. Sci Rep 11, 2256 (2021).

Patients with COVID-19 requiring oxygen therapy need long-term inpatient care with a median of 12 days in hospital including 8 days on supplemental oxygen, which should be taken into account when planning treatment capacity. The authors explain this result by the prolonged inflammatory course of the disease.



Rubin EJ, Baden LR, Morrissey S. A Covid-19 Conversation with Anthony Fauci. Audio interview (43 minutes). N Engl J Med 2021; 384: e22. Access:

The editors are joined by Dr. Anthony Fauci, U.S. Chief Medical Advisor, NIAID, to discuss COVID-19 testing, therapeutics, and vaccines.



If you read French, read Audureau W, Maad A. Ce que nous apprend la campagne de vaccination massive en Israël. Le Monde 2021, published 29 January. Full-text :

Alors qu’un tiers des Israéliens sont déjà vaccinés, les premières études évoquent une baisse des infections après deux doses.


Saliba F, Delcas M, Montoya A, et al. En Amérique latine, la course chaotique aux vaccins contre le Covid-19. Le Monde 2021, published 29 January. Full-text :

L’achat de produits pharmaceutiques reste un défi majeur pour des pays durement touchés par l’épidémie. D’autant plus que les Etats riches ont préempté une quantité astronomique de doses.


Herzberg N. Le variant sud-africain affaiblit un premier vaccin contre le Covid-19, celui de Novavax. Le Monde 2021, published 29 January. Full-text :

Les études conduites sur le candidat de la firme américaine confirment que le mutant présent dans près de 30 pays peut diminuer l’efficacité vaccinale.



If you read Portuguese, read Serafim  TS. Variante do Reino Unido tem potencial de maior letalidade, como disse a ministra da Saúde? Público 2021, published 29 January. Full-text:

A ministra da Saúde afirmou no Parlamento, nesta quinta-feira, que a variante do Reino Unido tem começado agora a ser descrita como tendo um potencial de maior letalidade. É mesmo assim?


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