Top 10: July 31

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By Christian Hoffmann &
Bernd S. Kamps

31 July

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<<< 005 | Summer Picture 006. Since 19 July, we have been preparing the Top 10 from a European beach location. While the friends enjoy the beach, we write the daily summaries.


National Academies of Sciences, Engineering, and Medicine. Reopening K-12 Schools During the COVID-19 Pandemic: Prioritizing Health, Equity, and Communities. The National Academies Press 2020. Washington, DC (accessed 31 July 2020). Full-text (download free PDF as guest):

How will schools reopen in the context of rapidly changing patterns of community SARS-CoV-2 spread (Dibner 2020)? Now the US National Academies of Sciences, Engineering, and Medicine provide a series of recommendations aimed at helping states and school districts determine both whether to open school buildings for in-person learning and, if so, how to reduce risk in the process of reopening (Reopening K-12 Schools During the COVID-19 Pandemic: Prioritizing Health, Equity, and Communities). Read also the comment by Dibner KA, Schweingruber HA and Christiakis DA. Reopening K-12 Schools During the COVID-19 Pandemic. JAMA 2020, published 29 July. Full-text:


Auger  KA, Shah  SS, Richardson  T,  et al.  Association between statewide school closure and COVID-19 incidence and mortality in the US.   JAMA 2020, published July 29. Full-text:

Was the closure of primary and secondary schools in the US associated with a decreased incidence and mortality of COVID-19? According to Katherine Auger and colleagues, it was: COVID-19 62% lower; deaths 58% lower. States that closed schools earlier, when cumulative incidence of COVID-19 was low, had the largest relative reduction in incidence and mortality. The authors caution that some of the reduction may have been related to other concurrent non-pharmaceutical interventions. See also the comment by Donohue JM, Miller E. COVID-19 and School Closures. JAMA 2020, published online July 29. Full-text:



Lei X, Dong X, Ma R, et al. Activation and evasion of type I interferon responses by SARS-CoV-2. Nat Commun 11, 3810 (2020). Full-text:

The interplay and antagonism between SARS-CoV-2 and host innate immunity determine the clinical outcome of COVID-19. Now Jiang Wei and colleagues show that SARS-CoV-2 perturbs the host innate immune response both via its structural and nonstructural proteins. They reveal that SARS-CoV-2 induces an aberrant type I IFN response in cultured cells, with expressions of IFN-β and ISG56 being barely induced early during viral infection, and suggest that this delayed antiviral response might provide a window for virus replication. They also found that IFN-β treatment effectively blocks SARS-CoV-2 replication.



Tu YP, Jennings R, Hart B, et al. Swabs Collected by Patients or Health Care Workers for SARS-CoV-2 Testing. N Engl J Med. 2020 Jul 30;383(5):494-496. PubMed: Full-text:

Ethan Berke et al. show the clinical usefulness of tongue, nasal, or mid-turbinate samples collected by patients as compared with nasopharyngeal samples collected by health care workers for the diagnosis of COVID-19. When a nasopharyngeal sample collected by a health care worker was used as the comparator, the estimated sensitivities of the tongue, nasal, and mid-turbinate samples collected by the patients were 89.8% (one-sided 97.5% confidence interval [CI], 78.2 to 100.0), 94.0% (97.5% CI, 83.8 to 100.0), and 96.2% (97.5% CI, 87.0 to 100.0), respectively. Adoption of patient sampling techniques may reduce use of personal protective equipment and provide a more comfortable patient experience.



Anderson MR, Geleris J, Anderson DR, et al. Body Mass Index and Risk for Intubation or Death in SARS-CoV-2 Infection. Ann Intern Med 2020, published 29 July. Full-text:

Should obesity be associated with increased risk for intubation or death from COVID-19 in adults younger than 65 years, but not in adults aged 65 years or older? That’s the suggestion of a large multi-ethnic cohort study by Michaela Anderson and colleagues who looked at 2466 adults hospitalized with SARS-CoV-2 infection in a quaternary academic medical center and community hospital in New York City. Compared with overweight patients, patients with obesity had higher risk for intubation or death, with the highest risk among those with class 3 obesity (hazard ratio, 1.6 [95% CI, 1.1 to 2.1]). Interestingly, this association was primarily observed among patients who were younger than 65 years, but not in older patients (p for interaction by age = 0.042). Body mass index was not associated with admission levels of biomarkers of inflammation, cardiac injury, or fibrinolysis.

Discover multiple potential mechanisms that may underlie the observed association of obesity with acute respiratory failure and death from SARS-CoV-2 infection.


Severe COVID

Bartoletti M, Pascale R, Cricca M, et al. Epidemiology of invasive pulmonary aspergillosis among COVID-19 intubated patients: a prospective study. Clin Inf Dis 2020, published 28 July. Full-text:

Michele Bartoletti and colleagues enrolled 108 patients in a prospective, multicenter study to evaluate the incidence of invasive pulmonary aspergillosis among intubated patients with critical COVID-19. Coronavirus associated pulmonary aspergillosis (CAPA) was diagnosed in 30 patients (27.7%) after a median of 4 (2-8) days from intensive care unit (ICU) admission. Kaplan-Meier curves showed a significant higher 30-day mortality rate from ICU admission among patients with either CAPA (44% vs 19%, p = 0.002) or PIPA (74% vs 26%, p < 0.001) when compared with patients not fulfilling criteria for aspergillosis.



Steardo L Jr, Steardo L, Verkhratsky A. Psychiatric face of COVID-19. Transl Psychiatry 2020;10,261. Full-text:

Your weekend review – 8 pages and 176 references? Father and son Steardo and Alexei Verkhratsky from Catanzaro, Benevento and Manchester/Bilbao/Moscow, respectively, outline possible neuropsychiatric complications of COVID-19: depression, bipolar disorders, reactive psychosis, obsessive-compulsive disorder, epilepsy, post-traumatic stress disorder. The authors predict an increased incidence of mental pathologies as a result of wide-spread SARS-CoV-2 infection.



Cousins S. COVID-19 has “devastating” effect on women and girls. Lancet 2020; 396: P301-302, 1 August. Full-text:

Fears are increasing that the COVID-19 pandemic will interfere with women’s and girls’ sexual and reproductive health and their access to care. In March, WHO issued interim guidance for maintaining essential services during an outbreak, which included advice to avert maternal and child mortality and morbidity. Will the deep existing inequalities COVID-19 has brought to the foreground encourage more action in the future?


Beyond plate borders

Cantwell M. This tiny camera can show the world from a bug’s point of view. Science 2020, published  27 July. Short comment: | YouTube video:

Strap a 248 mg camera onto a beetle’s back and stream video in almost real time. In the future, scientists could use these tiny cams to gain insight into the habits of insects outside the lab.