Copy-editor: Rob Camp
Kirby T. New variant of SARS-CoV-2 in UK causes surge of COVID-19. Lancet Respir Med 2021, published 5 January. Full-text: https://doi.org/10.1016/S2213-2600(21)00005-9
The UK remains one of the most badly affected countries. As of 6 January 2021, it had recorded more than 2,8 million cases of SARS-CoV-2 infection and almost 80.000 deaths. Driven by the new variant’s increased infectiousness, the UK has recently reported more than 60.000 cases a day, and there are fears that the pandemic may get very much worse before it gets better. The only hope now is that deaths and hospitalizations will plummet as the number of elderly and vulnerable people receiving a vaccine sharply increases in the coming weeks.
Meinhardt J, Radke J, Dittmayer C, et al. Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19. Nat Neurosci (2020). Full-text: https://doi.org/10.1038/s41593-020-00758-5
Given the neurological symptoms observed in a large majority of individuals with COVID-19, does SARS-CoV-2 penetrate into the CNS? Here Frank Heppner, Jenny Meinhardt and colleagues demonstrate the presence of SARS-CoV-2 RNA and protein in anatomically distinct regions of the nasopharynx and brain. Watch SARS-CoV-2 crossing the neural–mucosal interface in olfactory mucosa (exploiting the close vicinity of olfactory mucosal, endothelial and nervous tissue), following neuroanatomical structures and penetrating defined neuroanatomical areas including the primary respiratory and cardiovascular control center in the medulla oblongata.
See also the comment by Yates D. A CNS gateway for SARS-CoV-2. Nat Rev Neurosci (2021). Full-text: https://doi.org/10.1038/s41583-020-00427-3
Dan JM, Mateus J, Kato Y, et al. Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science 2021, published 6 January. Full-text: https://doi.org/10.1126/science.abf4063
After Year 1 of the SARS-CoV-2 pandemic, we realize that although millions of people were infected during spring 2020, there is no sizeable epidemic of re-infections. This observation suggests that SARS-CoV-2 infection might confer a solid immunity. Now, Shane Crotty, Alessandro Sette, Daniela Weiskopf, Jennifer Dan and colleagues publish in Science the pre-print paper we presented on 13 November. The authors analyzed multiple compartments of circulating immune memory to SARS-CoV-2 in 188 COVID-19 cases, including 43 cases at > 6 months post-infection. The result: Spike-specific memory B cells were more abundant at 6 months than at 1 month post symptom onset. SARS-CoV-2-specific CD4+ T cells and CD8+ T cells declined with a half-life of 3-5 months. These findings might suggest that after SARS-CoV-2 infection (or after vaccination), the vast majority of people could be protected from severe COVID-19 for years. Read also the NYTimes article by Mandavilli A. Immunity to the Coronavirus May Last Years, New Data Hint. The New York Times 2020, published 17 November. Full-text: https://www.nytimes.com/2020/11/17/health/coronavirus-immunity.html
Widge AT, Rouphael NG, Jackson LA, et al. Durability of Responses after SARS-CoV-2 mRNA-1273 Vaccination. N Engl J Med 2021; 384:80-82. Full-text: https://doi.org/10.1056/NEJMc2032195
Correlates of protection against SARS-CoV-2 infection in humans are not yet established. Here, Alicia Widge et al. describe immunogenicity data 119 days after the first vaccination in 34 healthy adult participants. Despite a slight expected decline in titers of binding and neutralizing antibodies, mRNA-1273 might have the potential to provide durable humoral immunity.
CDC 20210106. Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine — United States, December 14–23, 2020. MMWR Morb Mortal Wkly Rep. ePub: 6 January 2021. DOI: http://dx.doi.org/10.15585/mmwr.mm7002e1
One case of anaphylaxis in 100.000 vaccine recipients of the BioNTech/Pfizer vaccine Comirnaty. That is the result of the 10 days of monitoring (14-23 December) by the Vaccine Adverse Event Reporting System which detected 21 cases of anaphylaxis after administration of a reported 1.893.360 first doses of the vaccine (11,1 cases per million doses). Note that 71% of these occurred within 15 minutes of vaccination. Screen recipients for contraindications and precautions; have the necessary supplies available to manage anaphylaxis; implement the recommended post-vaccination observation periods; and immediately treat suspected cases of anaphylaxis with intramuscular injection of epinephrine! For detailed insight, check also Castells MC, Phillips EJ. Maintaining Safety with SARS-CoV-2 Vaccines. N Engl J Med 2020, published 30 December. Full-text: https://doi.org/10.1056/NEJMra2035343 which we presented on 1 January.
Iacobucci G, Mahase E. Covid-19 vaccination: What’s the evidence for extending the dosing interval? BMJ 2021, published 6 January. Full-text: https://doi.org/10.1136/bmj.n18
On 30 December the four UK chief medical officers announced that the second doses of the COVID vaccines should be given towards the end of 12 weeks rather than in the previously recommended 3-4 weeks. German authorities will issue a similar recommendation soon. Gareth Iacobucci and Elisabeth Mahase look at the questions this has raised.
Libster R, Marc PG, Wappner D, et al. Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults. N Engl J Med 2021, published 6 January. Full-text: https://doi.org/10.1056/NEJMoa2033700
Early administration of high-titer convalescent plasma against SARS-CoV-2 to mildly ill infected older adults might reduce the progression of COVID-19. This is the result of a randomized, double-blind, placebo-controlled trial of convalescent plasma with high IgG titers against SARS-CoV-2 by Fernando P. Polack, Romina Libster and colleagues. The authors randomized 160 patients. Severe respiratory disease developed in 13 of 80 patients (16%) who received convalescent plasma and 25 of 80 patients (31%) who received placebo (relative risk, 0.52; 95% confidence interval [CI], 0.29 to 0.94; p = 0.03). Relative risk reduction: 48%.
Salama C, Han J, Yau L, et al. Tocilizumab in Patients Hospitalized with Covid-19 Pneumonia. N Engl J Med 2021; 384:20-30. Full-text: https://doi.org/10.1056/NEJMoa2030340
In hospitalized patients with COVID-19 pneumonia who were not receiving mechanical ventilation, tocilizumab did not improve survival, but it reduced the likelihood of progression to the composite outcome of mechanical ventilation or death. This is the result of a trial that randomized 249 patients into the tocilizumab group and 128 patients into the placebo group. Shalini Mohan, Carlos Salama and colleagues report that death from any cause by day 28 occurred in 10,4% of the patients in the tocilizumab group and 8,6% of those in the placebo group.
Sarvey D, Welsh JW. Adolescent substance use: Challenges and opportunities related to COVID-19. J Subst Abuse Treat. 2020 Nov 24:108212. PubMed: https://pubmed.gov/33272731. Full-text: https://doi.org/10.1016/j.jsat.2020.108212
Adolescent substance use is a significant and largely undertreated public health concern. The COVID-19 pandemic has exacerbated many pre-existing risk factors for adolescent substance use, such as early life stress, social isolation, school connections, and boredom. Here, Dana Sarvey and Justine Welsh give a short overview of changing risk and protective factors for substance use and potential opportunities during the pandemic. They recommend that practitioners should consider any and all means of reaching out to these youth and their families and addressing other co-occurring psychiatric symptoms, such as depression and anxiety.
Smith D. Fears mount that final 13 days pose a security threat. The Guardian 2021, published 7 January. Full-text: https://www.theguardian.com/us-news/2021/jan/07/donald-trump-final-13-days-security-threat-politicians-activists-warn
“Twitter at one point decided he shouldn’t be able to have access to his Twitter, and yet this is someone who has access to our launch nuclear launch codes. There’s an incongruity there.”
Ducourtieux C. Possibilité de « mélange » vaccinal et délai de douze semaines entre deux injections : le pari britannique contre le Covid-19. Le Monde 2021, published 7 January. Full-text : https://www.lemonde.fr/international/article/2021/01/07/covid-19-le-pari-vaccinal-britannique_6065503_3210.html
Le Royaume-Uni s’est lancé dans une course de vitesse contre le virus et son variant apparu dans le Kent, à l’heure où la mortalité causée par la pandémie reste très importante.