Top 10: May 1

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By Christian Hoffmann &
Bernd S. Kamps

1 May


Jia JS, Lu X, Yuan Y. et al. Population flow drives spatio-temporal distribution of COVID-19 in China. Nature 2020. Full-text:

When people move, they take contagious diseases with them. Using detailed mobile phone geolocation data to compute aggregate population movements, authors tracked the transit of people from Wuhan to the rest of China. The geographic flow of people anticipated the subsequent location, intensity, and timing of outbreaks in the rest of China.


Virology, Immunology

Tang Y, Wu C, Li X. On the origin and continuing evolution of SARS-CoV-2. National Science Review 2020, March 03. Full-text:

Authors from China report on a SARS-CoV-2 subtype which seems to be more aggressive and to spread more quickly. This paper has gained much attraction in the media.


MacLean O, Orton RJ, Singer JB, et al. No evidence for distinct types in the evolution of SARS-CoV-2.  Virus Evolution, veaa034, Full-text:

In this paper, Scottish researches now demonstrate very clearly that Tang et al. were wrong and that the major conclusions of that paper cannot be substantiated. Using examples from other viral outbreaks, authors discuss the difficulty in demonstrating the existence or nature of a functional effect of a viral mutation, and advise against overinterpretation of genomic data during the pandemic. Although rapid publication is critical for unfolding disease outbreaks, thorough and independent peer review should not be bypassed to get results published quickly.


Tay MZ, Poh CM, Rénia L et al. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol (2020). Full-text:

Brilliant overview of the pathophysiology of SARS-CoV-2 infection. How SARS-CoV-2 interacts with the immune system, how dysfunctional immune responses contribute to disease progression and how they could be treated.



Yin L, Moi H, Shao J. Correlation between Heart fatty acid binding protein and severe COVID-19: A case-control study. PLOS One, 29 Apr 2020.

Heart fatty acid-binding protein (HFABP), a serum biomarker for myocardial injury, is highly cardiac specific. Elevated serum HFABP may be used as an indicator of severe COVID-19. This small retrospective analysis included 45 patients, in which HFABP was measured on the day of hospital admission. In the HFABP positive group (n=15), severe illness was more common during hospitalization (87.5% vs 40%, P=0.002).



Zhang Y, Qin L, Zhao Y, et al. Interferon-induced transmembrane protein-3 genetic variant rs12252-C is associated with disease severity in COVID-19. J Infect Dis. 2020 Apr 29. pii: 5826991. PubMed: Full-text:

The first study providing some evidence for a predisposition for severe disease. Authors analyzed a genetic variant of IFITM3. This gene encodes an immune effector protein critical to viral restriction and homozygosity for the C allele has been associated with influenza severity. CC genotype was found in 12/24 (50%) patients with severe COVID-19, compared to 16/56 (29%) with mild disease. After adjusting for age groups, odds ratio for severe disease in patients with CC genotype was 6.3 (p<0.001).


Meng Y, Wu P, Lu W, et al. Sex-specific clinical characteristics and prognosis of coronavirus disease-19 infection in Wuhan, China: A retrospective study of 168 severe patients. PLOS Pathogens 2020, April 28, 2020.

This retrospective cohort highlights sex-specific differences in clinical characteristics and prognosis. Older age and the presence of comorbidities were prognostic risk factors in 86 males but not in 82 females. Some laboratory parameters showed also significant differences.



Stefanini GG, Montorfano M, Trabattoni D, et al. ST-Elevation Myocardial Infarction in Patients with COVID-19: Clinical and Angiographic Outcomes. Circulation. 2020 Apr 30. PubMed: Full-text:

STEMI may represent the first clinical manifestation of COVID-19. In 11 out of 28 patients (39%) with STEMI, a culprit lesion was not identifiable by coronary angiography.  According to the authors, a dedicated  diagnostic pathway should be delineated for COVID-19 patients with STEMI, aimed at minimizing patients procedural risks and healthcare providers risk of infection.


Yang G, Tan Z, Zhou L, et al. Effects Of ARBs And ACEIs On Virus Infection, Inflammatory Status And Clinical Outcomes In COVID-19 Patients With Hypertension: A Single Center Retrospective Study. Hypertension. 2020 Apr 29. PubMed: Full-text:

The next retrospective study analysing COVID-19 patients with hypertension, argueing against deleterious effects of angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors. Patients on these drugs (n=43) had significantly lower concentrations of CRP (p=0.049) and procalcitonin (p=0.008) than patients on other antihypertensive drugs (n=83). Furthermore, trends toward lower proportions of critical diseases (9.3% vs 22.9%; p=0.061) and death rates (4.7% vs 13.3%; p=0.216) were observed. 



Zeng QL, Yu ZJ, Gou JJ, et al. Effect of Convalescent Plasma Therapy on Viral Shedding and Survival in COVID-19 Patients. J Infect Dis. 2020 Apr 29. pii: 5826985. PubMed: Full-text:

Don’t be too late: Of 6 patients with respiratory failure receiving convalescent plasma at a median of 21 days after first detection of viral shedding, all tested RNA negative by 3 days after infusion. However, 5 died eventually.