Top 10: March 13

Copy-editor: Rob Camp


Paper of the Day

Collier DA, De Marco A, Ferreira IA, et al. Sensitivity of SARS-CoV-2 B.1.1.7 to mRNA vaccine-elicited antibodies. Nature March 11, 2021.

A pseudovirus bearing S protein with the full set of mutations present in the B.1.1.7 variant did result in a small reduction in neutralization by sera from vaccinees that was more marked following the first dose vs the second dose. Worryingly, Dami A. Collier and colleagues measured further reduction in neutralization titers by vaccine sera when E484K was present alongside the B.1.1.7 S mutations. They conclude that “E484K emergence on a B.1.1.7 background represents a threat to the vaccine BNT162b”.


Borges V, Sousa C, Menezes L, et al. Tracking SARS-CoV-2 lineage B.1.1.7 dissemination: insights from nationwide spike gene target failure (SGTF) and spike gene late detection (SGTL) data, Portugal, week 49 2020 to week 3 2021. Eurosurveillance Mar 11, 2021, Article Volume 26, Issue 10.

Dissemination of the B.1.1.7 lineage in Portugal. Both SGTF and SGTL (a proxy for monitoring trends of B.1.1.7) samples had significantly lower median Ct values of N and ORF1ab gene targets (ca 3.5 and 1.8 Ct units, respectively) compared with samples where the S gene was unbiasedly detected.



Sartorius B, Lawson AB, Pullan RL. Modelling and predicting the spatio-temporal spread of COVID-19, associated deaths and impact of key risk factors in England. Sci Rep 11, March 8, 2021, 5378.

This high resolution spatial–temporal model highlights differences in epidemic dynamics across small areas in England, emphasizing the importance of monitoring at a granular sub-national scale. A geographically staggered approach combined with enhanced community surveillance will be increasingly important.


Boffetta P, Violante F, Durando P, et al. Determinants of SARS-CoV-2 infection in Italian healthcare workers: a multicenter study. Sci Rep March 11, 2021, 5788.

The prevalence of infection ranged from 3% to 22%, and was correlated with that of the respective areas within Italy. Of note, there was a lack of a clear pattern in risk according to job categories.



Krammer F, Srivastava K, Alshammary H, et al. Antibody Responses in Seropositive Persons after a Single Dose of SARS-CoV-2 mRNA Vaccine. March 10, 2021.

In 110 vaccinees, the antibody titers of those with pre-existing infection were 10 to 45 times higher than those of vaccinees without pre-existing immunity at the same time points after the first mRNA vaccine dose. The problem with all these studies: until we know whether this translates into similar protection, the one-shot strategy will not gain widespread acceptance. When we do know one day, this will largely not matter (there will be enough vaccine available) and will only be interesting for cost reasons.


Steinberg J, Thomas A, Iravavi A. 18Fluorodeoxyglucose PET/CT findings in a systemic inflammatory response syndrome after COVID-19 vaccine. Lancet March 08, 2021.

Julie Steinberg and colleagues from St. Louis describe an interesting case of a (self-resolving) systemic inflammatory response syndrome in a 65-year-old woman, starting one day after Moderna’s mRNA vaccine. PET/CT showed uptake in the fat stranding posterior to the right deltoid, moderately increased uptake within multiple right axillary lymph nodes and diffusely increased splenic uptake.


Fernández-Prada M, Rivero-Calle I, Calvache-González A, Martinón-Torres F. Acute onset supraclavicular lymphadenopathy coinciding with intramuscular mRNA vaccination against COVID-19 may be related to vaccine injection technique, Spain, January and February 2021. Euro Surveill. 2021;26(10):pii=2100193.

María Fernández-Prada and colleagues report on 20 female HCWs with acute onset of a single supraclavicular lymphadenopathy coinciding with the ipsilateral intramuscular administration of an mRNA vaccine. Of note, 17 reported that the injection point had been unusually high. All lymphadenopathies had inflammatory symptoms (pain, swelling), were rounded and mobile, and all but one appeared in the first 24 h to 9 days after vaccine administration. All improved clinically, and 15 completely resolved between 5 and 16 days from onset.



Klompas M, Baker MA, Griesbach D, et al. Transmission of SARS-CoV-2 from asymptomatic and presymptomatic individuals in healthcare settings despite medical masks and eye protection. Clinical Infectious Diseases, 11 March 2021. ciab218,

Three instances of SARS-CoV-2 transmission in Boston, despite medical masks and eye protection, including one transmission despite both parties being masked. Whole genome sequencing confirmed perfect homology between source and exposed persons’ viruses in all cases. These findings teach the importance of not relying upon medical masks and eye protection alone.


Pan X, Li X, Kong P, et al. Assessment of Use and Fit of Face Masks Among Individuals in Public During the COVID-19 Pandemic in China. JAMA Netw Open March 11, 2021, 4(3):e212574.

“Wear a mask.” If it were only that simple, even in China! For this study, during July and August 2020, 6003 (!) people wearing masks were assessed at public places, such as markets, train stations, airports, hospitals, and schools in Beijing, Yunnan, Shanxi, and Jiangsu. Face mask airtightness was commonly suboptimal, mostly secondary to gaps at the upper face mask edge. Sealing the upper face mask edge with an adhesive tape was associated with significantly improving the airtightness of commonly used face masks.


Long COVID-19

Sudre CH, Murray B, Varsavsky T, et al. Attributes and predictors of long COVID. Nat Med March 10, 2021.

Is it possible to predict long COVID-19? Among 4182 people who self-reported their symptoms prospectively in the COVID Symptom Study app, a total of 558 (13.3%) reported symptoms lasting ≥ 28 days, 189 (4.5%) for ≥ 8 weeks and 95 (2.3%) for ≥ 12 weeks. Experiencing more than five symptoms during the first week of illness was associated with long COVID in all sexes and age groups (odds ratio = 3.5). Main caveat: the population was limited by being confined to app contributors (disproportionately female patients). May not be generalizable.


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