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By Christian Hoffmann &
Bernd S. Kamps
8 July
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Epidemiology
Kang CR, Lee JY, Park Y, Huh IS, Ham HJ, Han JK, et al. Coronavirus disease exposure and spread from nightclubs, South Korea. Emerg Infect Dis. 2020 Sep. Full-text: https://doi.org/10.3201/eid2610.202573
Despite low incidence, superspreading related to visiting nightclubs has the potential to spark a resurgence of cases. This article describes large-scale testing for active case-finding among persons who visited 5 Itaewon nightclubs in downtown Seoul, South Korea. Nightclubs had reopened ahead of the April 30–May 5 Golden Week holiday. Among the 41,612 total tests (!) conducted by May 25, positive results were found in 0.19% (67/35,827) of nightclub visitors, 0.88% (51/5,785) of their contacts, and 0.06% (1/1,627) of anonymously tested persons. 246 COVID-19 cases were associated with the reopening of nightclubs in Seoul. Hooray for the Asian thoroughness and some strong arguments against reopening nightclubs…
Yehya N, Venkataramani A, Harhay MO. Statewide Interventions and Covid-19 Mortality in the United States: An Observational Study. Clin Infect Dis. 2020 Jul 8. PubMed: https://pubmed.gov/32634828. Full-text: https://doi.org/10.1093/cid/ciaa923
Every day counts. In this large, nationwide study, later statewide emergency declarations and school closures were associated with higher COVID-19 mortality. Each day of delay increased mortality risk by 5 to 6%.
Waltenburg MA, Victoroff T, Rose CE, et al. Update: COVID-19 Among Workers in Meat and Poultry Processing Facilities ― United States, April–May 2020. MMWR Morb Mortal Wkly Rep. ePub: 7 July 2020. Full-text: https://www.cdc.gov/mmwr/volumes/69/wr/mm6927e2.htm
One more reason to go veg. Overall, 239 facilities reported 16,233 COVID-19 cases and 86 COVID-19–related deaths among workers. The percentage of workers with COVID-19 ranged from 3.1% to 24.5% per facility. Among seven facilities that implemented facility-wide testing, the crude prevalence of asymptomatic or presymptomatic infections among 5,572 workers who had positive SARS-CoV-2 test results was 14.4%.
Virology
Sharma A, Garcia G, Arumugaswami V, Svendsen CN. Human iPSC-Derived Cardiomyocytes are Susceptible to SARS-CoV-2 Infection. bioRxiv. 2020 Apr 21:2020.04.21.051912. PubMed: https://pubmed.gov/32511402. Full-text: https://doi.org/10.1101/2020.04.21.051912
In this study, human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) were used as a model to examine the mechanisms of cardiomyocyte-specific infection by SARS-CoV-2. Microscopy and RNA-sequencing demonstrated that SARS-CoV-2 can enter hiPSC-CMs via ACE2. Viral replication and cytopathic effect induce hiPSC-CM apoptosis and cessation of beating after 72 hours of infection.
Qian Q, Fan L, Liu W, et al. Direct evidence of active SARS-CoV-2 replication in the intestine. Clin Inf Dis 2020, July 8. Full-text: https://doi.org/10.1093/cid/ciaa925
The virus is not only in the heart but also in the rectum. In this case report, quantitative RT-PCR was performed on rectal tissue specimens obtained from surgical resection in a COVID-19 patient with rectal adenocarcinoma. RNA of SARS-CoV-2 was detected in surgically resected rectal specimens, but not in samples collected 37 days after discharge. Notably, coinciding with rectal tissues of surgical specimens nucleic acid positive for SARS-CoV-2, typical coronavirus virions in rectal tissue were observed under electron microscopy. Moreover, abundant lymphocytes and macrophages (some are SARS-CoV-2 positive) infiltrating the lamina propria were found with no significant mucosal damage.
Transmission
Zhou J, Otter JA, Price JR, et al. Investigating SARS-CoV-2 surface and air contamination in an acute healthcare setting during the peak of the COVID-19 pandemic in London. Clin Infect Dis. 2020 Jul 8:ciaa905. PubMed: https://pubmed.gov/32634826. Full-text: https://doi.org/10.1093/cid/ciaa905
Cross-sectional observational study in a multi-site London hospital. Air and surface samples were collected from several areas. Viral RNA was detected on 114/218 (52.3%) of surfaces and 14/31 (38.7%) air samples but no virus was cultured. Viral RNA was more likely to be found in areas immediately occupied by COVID-19 patients than in other areas. The high PCR Ct value for all samples (> 30) indicated that the virus would not be culturable.
Schlottau K, Rissmann M, Graaf A, et al. SARS-CoV-2 in fruit bats, ferrets, pigs, and chickens: an experimental transmission study. Lancet Microbe July 07, 2020. Full-text: https://doi.org/10.1016/S2666-5247(20)30089-6
Lucky pigs. The authors intranasally inoculated twelve fruit bats (Rousettus aegyptiacus), 12 ferrets (Mustela putorius), pigs (Sus scrofa domesticus), and 20 chickens (Gallus gallus domesticus) with TCID50 of a SARS-CoV-2 isolate per animal. Pigs and chickens could not be infected intranasally or oculo-oronasally by SARS-CoV-2, whereas fruit bats showed characteristics of a reservoir host. Virus replication in ferrets resembled a subclinical human infection with efficient spread.
Diagnostics
Dharavath B, Yadav N, Desai N, et al. A one-step, one-tube real-time RT-PCR based assay with an automated analysis for detection of SARS-CoV-2. Heliyon. July 07, 2020. Full-text: https://doi.org/10.1016/j.heliyon.2020.e04405
The authors present a rapid, easy-to-implement real-time PCR based assay with automated analysis using a novel COVID qPCR Analyzer tool with graphical user interface to analyze the raw qRT-PCR data in an unbiased manner at a cost of less than $3 per reaction and turn-around time of less than 2h, to enable in-house SARS-CoV-2 testing across laboratories.
Wang Y, Zhang L, Sang L, et al. Kinetics of viral load and antibody response in relation to COVID-19 severity. J Clin Invest. 2020 Jul 7:138759. PubMed: https://pubmed.gov/32634129. Full-text: https://doi.org/10.1172/JCI138759
In 8/12 patients with severe COVID-19, viral shedding was shown in a variety of tissues for 20~40 days post-onset of disease; in contrast 9/11 patients with mild disease had viral shedding restricted to the respiratory tract and had no detectable virus RNA after 10 days post-onset.
Treatment
Gladstone DE, Kim BS, Mooney K, et al. Regulatory T Cells for Treating Patients With COVID-19 and Acute Respiratory Distress Syndrome: Two Case Reports. Ann Int Med 2020, Jul 6. Full-text: https://www.acpjournals.org/doi/10.7326/L20-0681
Regulatory T cells (also known as Tregs) migrate into inflamed tissues, dampening inflammatory responses and hastening tissue repair. Two patients who became critically ill despite receiving tocilizumab were treated with Tregs and recovered. Infusions were rapidly followed by decreases in interleukin-6, tumor necrosis factor-α, and interferon-γ.