Top 10: July 5

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By Christian Hoffmann &
Bernd S. Kamps

5 July

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Petersen E, Koopmans M, Go U, et al. Comparing SARS-CoV-2 with SARS-CoV and influenza pandemics. Lancet Inf Dis 2020, July 03, 2020. Full-text:

The basic reproductive rate (R0) for SARS-CoV-2 is estimated to be 2·5 (range 1·8–3·6) compared with 2·0–3·0 for SARS-CoV and the 1918 influenza pandemic, 0·9 for MERS-CoV, and 1·5 for the 2009 influenza pandemic. In their viewpoint, the authors postulate that historical evidence from prior influenza pandemics indicates that pandemics tend to come in waves over the first 2–5 years as population immunity builds-up (naturally or through vaccination) and that this is the most likely trajectory for SARS-CoV-2. A combination of physical distancing, enhanced testing, quarantine, and contact tracing will be needed for a long time.



Goldman E. Exaggerated risk of transmission of COVID-19 by fomites. Lancet Inf Dis July 03, 2020. Full-text:

A note of caution, to curb excesses that become counterproductive. According to the author, the chance of transmission through inanimate surfaces is very small, and only in instances where an infected person coughs or sneezes on the surface, and someone else touches that surface soon after the cough or sneeze (within 1–2 h). Although periodically disinfecting surfaces and use of gloves are reasonable precautions especially in hospitals, he believes that fomites that have not been in contact with an infected carrier for many hours do not pose a measurable risk of transmission.



Patrício Silva AL, Prata JC, Walker TR, et al. Rethinking and optimising plastic waste management under COVID-19 pandemic: Policy solutions based on redesign and reduction of single-use plastics and personal protective equipment. Sci Total Environ. 2020 Jun 30;742:140565. PubMed: Full-text:

The amount of waste generated due to COVID-19 indeed threatens the existing waste management streams, meaning that plastic leakage/pollution may impose severe risks to both environmental and human health. Thus, it is imperative to increase monitoring (aquatic, terrestrial and aerial surveys) of plastic waste under post-COVID-19, around the world. This paper provides an overview of plastic policies and discusses the readjustments of these policies during the COVID-19 pandemic along with their potential environmental implications. Policy recommendations and future research directions are also discussed.



Bastos ML, Tavaziva G, Abidi SK, et al. Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis. BMJ July 1, 2020; 370. Full-text:

Systematic review of 40 studies on sensitivity and specificity, stratified by method of serological testing (enzyme linked immunosorbent assays, ELISAs), lateral flow immunoassays (LFIAs), or chemiluminescent immunoassays, CLIAs). The pooled sensitivity of ELISAs measuring IgG or IgM was 84.3% (95% confidence interval 75.6% to 90.9%), of LFIAs was 66.0% (49.3% to 79.3%), and of CLIAs was 97.8% (46.2% to 100%). According to the authors, higher quality clinical studies assessing the diagnostic accuracy of serological tests for COVID-19 are urgently needed. Currently, available evidence does not support the continued use of existing point-of-care serological tests.


Shi J, Han D, Zhang R, et al. Molecular and Serological Assays for SARS-CoV-2: Insights from Genome and Clinical Characteristics. Clinical Chemistry Jul 5, 2020. Full-text:

This comprehensive review summarizes the principles and related details of PCR and serological assays for SARS-CoV-2 as well as the quality assurance measures for these assays.


Guo X, Jie Y, Chen P, et al. Upper Respiratory Tract Viral RNA Load at Hospital Admission is Associated with COVID-19 Disease Severity. Open Forum Infectious Diseases Jul 5, 2020. Full-text:

The next study reporting that initial viral load is positive correlated to illness severity. Among 195 patients, the two conversely correlated indexes for initial viral load, log10 (copies/mL) and Ct value, were found to be respective significantly positive and negative correlated to severity.


Dong Y, Chi X, Hai H, et al. Antibodies in the breast milk of a maternal woman with COVID-19. Emerg Microbes Infect. 2020 Dec;9(1):1467-1469. PubMed: Full-text:

Case report of an infected mother, in which IgG and IgA antibodies were detected in breast milk, indicating the potential immune protection for the neonates. The infant negative for SARS-CoV-2 at birth had elevated IgG in serum but it quickly decayed.



Hoxha A, Wyndham-Thomas C, Klamer S, et al. Asymptomatic SARS-CoV-2 infection in Belgian long-term care facilities. Lancet Inf Dis July 03, 2020. Full-text:

Following a mass testing campaign in long-term care facilities in Belgium, no symptoms were reported for 2,185 (74.0%) staff and 4,059 (75.3%) residents. Given the cross-sectional nature of this analysis, however, it was not possible to determine whether any of the asymptomatic individuals went on to develop symptoms. If pre-symptomatic or asymptomatic: risk of under-ascertainment of symptoms, although mitigated by medical assessment, persists.



Stanworth SJ, New HV, Apelseth TO, et al. Effects of the COVID-19 pandemic on supply and use of blood for transfusion. Lancet Hematology, July 03, 2020. Full-text:

The pandemic has major implications for blood transfusion. There are uncertain patterns of demand, and transfusion institutions need to plan for reductions in donations and loss of crucial staff because of sickness and public health restrictions. This article provides a synthesis of the published literature and guidance during times of potential or actual shortage. However, a reduction in donor numbers has largely been matched by reductions in demand for transfusion.


Zhong J, Shen G, Yang H, et al. COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study. Lancet Rheumatology July 03, 2020. Full-text:

Patients with autoimmune rheumatic disease might be more susceptible. Within 42 families with at least one member suffering from a rheumatic disease, COVID-19 was diagnosed in 27 (63%) of 43 patients with a rheumatic disease and in 28 (34%) of 83 of their family members with no rheumatic disease (adjusted odds ratio 2.68, 95% CI 1.14–6.27). Patients with rheumatic disease who were taking hydroxychloroquine had a lower risk of COVID-19 infection than patients taking other disease-modifying anti-rheumatic drugs (OR 0.09, 0.01–0.94).