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By Christian Hoffmann &
Bernd S. Kamps

30 July

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Epidemiology

Dawood FS, Ricks P, Njie GJ, et al. Observations of the global epidemiology of COVID-19 from the prepandemic period using web-based surveillance: a cross-sectional analysis. Lancet Infect Dis 2020, published 29 July. Full-text: https://doi.org/10.1016/S1473-3099(20)30581-8

Fatimah Dawood and colleagues describe the global spread of SARS-CoV-2 and characteristics of COVID-19 cases and clusters before WHO declared COVID-19 as a pandemic on 11 March 2020 (i.e., pre-pandemic). They identified cases of COVID-19 from official websites, press releases, press conference transcripts, and social media feeds of national ministries of health or other government agencies. Cases with travel links to China, Italy, or Iran accounted for almost two-thirds of the first reported COVID-19 cases from affected countries. There were many clusters of household transmission among early cases; however, clusters in occupational or community settings tended to be larger. This is good news for future pandemic waves. Keep your distance and slow the spread of SARS-CoV-2.

 

Virology

Shin D, Mukherjee R, Grewe D et al. Papain-like protease regulates SARS-CoV-2 viral spread and innate immunity. Nature 2020, published 29 July. Full-text: https://doi.org/10.1038/s41586-020-2601-5

The papain-like protease PLpro, an essential coronavirus enzyme required for generating a functional replicase complex, is also implicated in evasion mechanisms against host anti-viral immune responses. Now Ivan Dikic and colleagues from Frankfurt Goethe University show that SCoV2-PLpro attenuates type I interferon responses and that inhibition of SCoV2-PLpro with the naphthalene-based inhibitor GRL-0617 impairs virus-induced cytopathogenic effects, fosters the anti-viral interferon pathway and reduces viral replication in infected cells. The authors conclude that targeting of SCoV2-PLpro could suppress SARS-CoV-2 infection and promote anti-viral immunity.

 

Transmission

Chen Y, Qin G, Chen J, et al. Comparison of Face-Touching Behaviors Before and During the Coronavirus Disease 2019 Pandemic. JAMA Netw Open 2020;3(7):e2016924. https://doi.org/10.1001/jamanetworkopen.2020.16924

Is wearing face masks really associated with reduced face-touching behaviors? To answer the question, Xing Li and colleagues from Sun Yat-sen University, Guangzhou, China, used videos recorded in public transportation stations, streets, and parks among the general population in China, Japan, South Korea, Western Europe (ie, England, France, Germany, Spain, and Italy), and the US to analyze mask-wearing and face-touching behavior in public areas. The authors found that mask wearing was associated with reduced face-touching behavior, especially touching of the eyes, nose, and mouth. They conclude that the reduction of face-touching behaviors by mask wearing could contribute to curbing the COVID-19 pandemic. Excellent news for the coming months.

 

Santarpia JL, Rivera DN, Herrera VL et al. Aerosol and surface contamination of SARS-CoV-2 observed in quarantine and isolation care. Sci Rep 10, 12732 (2020). Full-text: https://doi.org/10.1038/s41598-020-69286-3

After evacuation from the Diamond Princess cruise ship in March 2020, 11 were admitted to a hospital in Nebraska, two in a biocontainment unit and 9 in a quarantine unit. Key features of both units included: (1) individual rooms with private bathrooms; (2) negative-pressure rooms (> 12 ACH) and negative-pressure hallways; (3) key-card access control; (4) unit-specific infection prevention and control (IPC) protocols including hand hygiene and changing of gloves between rooms; and (5) personal protective equipment (PPE) for staff that included contact and aerosol protection. Joshua Santarpia and colleagues collected air and surface samples to examine viral shedding from isolated individuals and detected viral contamination among all samples. Their data suggest that SARS-CoV-2 environmental contamination around COVID-19 patients is extensive, and hospital IPC procedures should account for the risk of fomite, and potentially airborne, transmission of the virus.

 

Vaccine

van Doremalen N, Lambe T, Spencer A, et al. ChAdOx1 nCoV-19 vaccine prevents SARS-CoV-2 pneumonia in rhesus macaques. Nature 2020, published 30 July. Full-text: https://doi.org/10.1038/s41586-020-2608-y

The good news first or the bad news first? OK, the good news: Vincent Munster, Sarah Gilbert and colleagues showed that vaccination with the adenovirus-vectored ChAdOx1 vaccine (see the July 20 Top 10) induced a balanced Th1/Th2 humoral and cellular immune response in rhesus macaques. The authors observed a significantly reduced viral load in bronchoalveolar lavage fluid and lower respiratory tract tissue, and no pneumonia was observed in vaccinated animals. The bad news (for prevention policies in general and for anti-vaxxers in particular): there was no difference in nasal shedding between vaccinated and control animals. Back to the good news: there was no evidence of immune-enhanced disease following viral challenge in vaccinated animals.

 

Mercado NB, Zahn R, Wegmann F et al. Single-shot Ad26 vaccine protects against SARS-CoV-2 in rhesus macaques. Nature 2020, published 30 July. Full-text: https://doi.org/10.1038/s41586-020-2607-z

For global deployment and pandemic control, a vaccine that requires only a single immunization would be optimal. Hanneke Schuitemaker, Dan Barouch and colleagues developed a series of adenovirus serotype 26 (Ad26) vectors encoding different variants of the SARS-CoV-2 spike (S) protein and showed the immunogenicity and protective efficacy of a single dose of Ad26 vector-based vaccines in 52 rhesus macaques. The optimal Ad26 vaccine induced robust neutralizing antibody responses and provided complete or near-complete protection in bronchoalveolar lavage and nasal swabs following SARS-CoV-2 challenge.

 

Yang J, Wang W, Chen Z et al. A vaccine targeting the RBD of the S protein of SARS-CoV-2 induces protective immunity. Nature 2020, published 29 July. Full-text: https://doi.org/10.1038/s41586-020-2599-8

The authors show that a recombinant vaccine comprising residues 319-545 of the Spike protein receptor-binding domain (S-RBD) can induce a potent functional antibody response in mice, rabbits and non-human primates as early as 7 or 14 days after a single dose injection. Antibodies shared common binding epitopes from infected patients, neutralizing activity was strong, and a simple adjuvant like Alum could further enhance the immune response. Even one dose of the vaccine generated viral neutralizing activity. The vaccine protected non-human primates from live SARS-CoV-2 challenge 28 days after the first vaccination.

 

Rubin EJ, Baden LR, Morrissey S. New SARS-CoV-2 Vaccine Results. N Engl J Med 2020; 383:e57. Access: https://www.nejm.org/doi/full/10.1056/NEJMe2026514

Audio interview (19:56) with Peter Piot who talks about his own experience with COVID-19, as well as recent developments in SARS-CoV-2 vaccines.

 

Education

Newton-Cheh C, Zlotoff DA, Hung J, Rupasov A, Crowley JC, and Funamoto M. Case 24-2020: A 44-Year-Old Woman with Chest Pain, Dyspnea, and Shock. N Engl J Med 2020; 383:475-484, published 30 July. Full-text: https://doi.org/10.1056/NEJMcpc2004975

Eight days before admission — and 3 days after her husband had begun to have fatigue, a non-productive cough, and fever — the patient started to have chills, a sore throat, a non-productive cough, and myalgias.

 

Sharma A, Eisen JE, Shepard JAO, Bernheim A, and Little BP. Case 25-2020: A 47-Year-Old Woman with a Lung Mass. N Engl J Med 2020, published 29 July. Full-text: https://doi.org/10.1056/NEJMcpc2004977

The patient had been well until 2 months before this evaluation, when intermittent non-productive cough and wheezing developed. She had no fever, chills, or shortness of breath. Two days before this evaluation, the cough worsened in frequency and severity and new shortness of breath developed.

 

Society

Adhikari S, Pantaleo NP, Feldman JM, Ogedegbe O, Thorpe L, Troxel AB. Assessment of Community-Level Disparities in Coronavirus Disease 2019 (COVID-19) Infections and Deaths in Large US Metropolitan Areas. JAMA Netw Open 2020;3(7):e2016938. Full-text: https://doi.org/10.1001/jamanetworkopen.2020.16938

Urban counties in large metropolitan areas in the United States are among the most affected by the pandemic. In this cross-sectional study, Adhikari Samrachana and colleagues examined the association of neighborhood race/ethnicity and poverty with COVID-19 infections and related deaths. In poorer counties (median income: $60,240), those with substantially non-white populations had an infection rate nearly 8 times that of counties with substantially white populations and a death rate more than 9 times higher. Racial and ethnic disparities in COVID-19 infections and deaths existe even beyond those explained by differences in income.

 

Beyond plate borders

Pennisi E. Scientists pull living microbes, possibly 100 million years old, from beneath the sea. Science 2020, published 28 July. Full-text: https://www.sciencemag.org/news/2020/07/scientists-pull-living-microbes-100-million-years-beneath-sea

If you bring back to the lab microbes buried beneath the sea floor, will they start to multiply? Life is persistent, here on Earth and perhaps elsewhere.