Copy-editor: Rob Camp
Brotons P, Launes C, Buetas E, et al. Susceptibility to Sars-COV-2 Infection Among Children And Adults: A Seroprevalence Study of Family Households in the Barcelona Metropolitan Region, Spain. Clinical Infectious Diseases, November 12, 2020. Full-text: https://doi.org/10.1093/cid/ciaa1721
Children have similar probability as adults to become infected by SARS-CoV-2 in quarantined family households. Pedro Brotons and colleagues from Barcelona performed a large cross-sectional seroprevalence study, enrolling 381 family households including 381 first-reported PCR-positive adult cases and 1084 contacts (672 children, 412 adults). SARS-CoV-2 infection seroprevalence rates were 18% (118/672) in children and 19% (77/335) in adult contacts. Nearly all positive pediatric contacts were asymptomatic or had mild symptoms.
Ebrahim SH, Ahmed Y, Algahtani SA, et al. The Hajj pilgrimage during the COVID-19 pandemic in 2020: event hosting without the mass gathering. Journal of Travel Medicine November 13, 2020. Full-text: https://academic.oup.com/jtm/advance-article/doi/10.1093/jtm/taaa194/5979518
Examples of religious congregations that resulted in seeding or surging of domestic and international COVID-19 outbreaks include events in Daegu, South Korea; Qom, Iran; Albany, Georgia; Arkansas + Maine, USA; and Mulhouse, France. Read how the science-driven steering of the 2020 Hajj with vastly reduced pilgrim numbers allowing for full compliance of the mitigation strategies avoided the cancellation of the event.
Shomuradova AS, Vagida MS, Sheetilov SA. SARS-CoV-2 epitopes are recognized by a public and diverse repertoire of human T cell receptors. Immunity November 13, 2020. Full-text: https://doi.org/10.1016/j.immuni.2020.11.004
Cellular and humoral immune response to SARS-CoV-2 were analyzed in 34 donors from Moscow who had recently recovered from COVID-19, as well as in two small control cohorts of healthy donors sampled before or during the pandemic. Some of the 14 healthy donors examined during the pandemic exhibited increased numbers of SARS-CoV-2-specific T cells, but no humoral response. It therefore seems possible that some people are protected by a pre-existing cross-reactive T cell response induced by other coronaviruses or had developed an asymptomatic infection that was cleared without the help of the humoral response. But can we believe this? The numbers were low and there is no doubt that his hypothesis needs to be validated in a larger cohort of donors.
Liotti FM, Menchinelli G, Marchetti S, et al. Assessment of SARS-CoV-2 RNA Test Results Among Patients Who Recovered From COVID-19 With Prior Negative Results. JAMA Intern Med, November 12, 2020. Full-text: https://doi.org/10.1001/jamainternmed.2020.7570
Many patients who recovered from COVID-19 may still be positive (albeit at lower levels) for SARS-CoV-2 RNA, but only a minority of the patients may carry replicating SARS-CoV-2 in the respiratory tract. Flora Marzia Liotti and colleagues from Rome, Italy analyzed nasal/oropharyngeal swab samples of 176 recovered patients with no fever and with 2 negative RT-PCR results for SARS-CoV-2 RNA 24 hours apart. In total, 32 of 176 samples (18%) tested positive for total SARS-CoV-2 RNA. All had low viral loads and only one of the 32 samples (3.1%) had replicative SARS-CoV-2 RNA.
Liao X, Wang Y, He Z, et al. Three-month pulmonary function and radiological outcomes in COVID-19 survivors: a longitudinal patient cohort study. Open Forum Infectious Diseases, 14 November 2020. Full-text: https://doi.org/10.1093/ofid/ofaa540
More on “Long COVID-19”. In this study, 172 survivors (33 with severe COVID-19) underwent high resolution CT of the thorax and pulmonary function tests at three months after hospital discharge. An abnormal pulmonary function was found in 11 (6%), and abnormal small airway function (FEF25-75%) in 12 (7%) patients. Obstructive and restrictive ventilation impairment was observed in six (3.5%) patients each. Lung function parameters did not differ between non-severe and severe cases. Of 142 CT scans, 122 (86%) showed residual CT abnormalities and 52 (37%) showed chronic and fibrotic changes.
Luo X, Liao Q, Shen Y, et al. Vitamin D Deficiency Is Inversely Associated with COVID-19 Incidence and Disease Severity in Chinese People. The Journal of Nutrition 13 November 2020. Full-text: https://doi.org/10.1093/jn/nxaa332
Vitamin D might have beneficial potential due to its immunomodulatory and anti-inflammatory properties. But is a deficiency associated with disease severity? Perhaps. In this cross-sectional study, 335 COVID-19 patients admitted to the Wuhan Tongji Hospital were retrospectively analyzed. A vitamin D deficiency (< 30 nmol/L) was significantly associated with COVID-19 severity (OR 2.7). Prospective studies have to confirm these results.
Monnet DL, Harbarth S. Will coronavirus disease (COVID-19) have an impact on antimicrobial resistance? Euro Surveill. 2020;25(45):pii=2001886. Full-text: https://doi.org/10.2807/1560-7917.ES.2020.25.45.2001886.
Good question. We don’t know yet. After summarizing various determinants that may result in either an increase or, inversely, a decrease in antimicrobial resistance (AMR), the authors found them to be balanced. The truth is that the impact of the COVID-19 pandemic on AMR will only become clear in the coming months and years as data gradually become available. Changes in AMR will most likely vary depending on the setting—e.g., ICUs vs other hospital units, hospital vs community settings—and possibly between countries.
Chan PS, Girotra S, Tang Y. Outcomes for Out-of-Hospital Cardiac Arrest in the United States During the Coronavirus Disease 2019 Pandemic. JAMA Cardiology November 14, 2020, Full-text: https://doi.org/10.1001/jamacardio.2020.6210
What is the association between the SARS-CoV-2 pandemic and out-of-hospital cardiac arrest (OHCA) outcomes in the US? This large registry study of 19,303 cases in 2019 and 2020 showed that the return of spontaneous circulation (ROSC) for OHCA was 18% lower overall than before the pandemic. Although the decrease was more prominent in counties most affected by the COVID-19 pandemic, lower rates of sustained ROSC and higher rates of termination of resuscitation were also observed in counties with low COVID-19 mortality rates. Delays in seeking medical care during the lockdown may not entirely explain the findings. The authors speculate that the interim recommendations for emergency medical service during this pandemic (for protecting frontline health care workers from unnecessary exposure) may also have decreased the likelihood of a successful resuscitation.
Hueso T, Pouderoux C, Péré H, et al. Convalescent plasma therapy for B-cell–depleted patients with protracted COVID-19. Blood 136 (20): 2290–2295. Full-text: https://doi.org/10.1182/blood.2020008423
The secondary humoral deficiency induced by anti-CD20 monoclonal antibodies such as rituximab may prevent the elicitation of a specific SARS-CoV-2 antibody response. Thomas Hueso and colleagues from France report on 17 consecutive patients with profound B cell lymphopenia and prolonged COVID-19 symptoms, negative SARS-CoV-2 serology, and positive RNAemia who were treated with four units of convalescent plasma. Within 48 hours of transfusion, all but 1 patient experienced an improvement of clinical symptoms. The inflammatory syndrome abated within a week. Of note, SARS-CoV-2 RNAemia decreased to below the sensitivity threshold in all 9 evaluated patients. This small series indicates that convalescent plasma could be promising at least in patients unable to mount a specific humoral response.
Mehew J, Johnson R, Roberts D, et al. Convalescent plasma for COVID-19: male gender, older age and hospitalisation associated with high neutralising antibody levels, England, 22 April to 12 May 2020. Euro Surveill. 2020;25(45):pii=2001754. Full-text: https://doi.org/10.2807/1560-7917.ES.2020.25.45.2001754
How to select donors of convalescent plasma (CP)? The answer: take older males with blood group AB and with severe disease – and don’t wait too long. In this study from the UK, 275/330 donors had detectable neutralizing antibodies against SARS-CoV-2. For these 275 donors, median levels of neutralizing antibodies were higher in men compared with women, in those hospitalized compared with non-hospitalized, in those with blood group AB compared with other groups. Neutralizing antibody levels decreased as the time between SARS-CoV-2 diagnosis and donation increased. According to the authors, their data will be of value in the timely recruitment of CP donors most likely to have high levels of neutralizing antibodies for ongoing studies investigating its effectiveness.
Wieder T. Vaccin anti-Covid : la « success story » du couple fondateur du laboratoire allemand BioNTech – Le Monde 2020, published 15 November. Full-text : https://www.lemonde.fr/planete/article/2020/11/15/vaccin-anti-covid-la-success-story-du-couple-fondateur-du-laboratoire-allemand-biontech_6059786_3244.html
Ugur Sahin et Ozlem Türeci, aujourd’hui classés parmi les 100 personnes les plus riches d’Allemagne, sont des enfants d’immigrés turcs.
Hecketsweiler C. Covid-19 : dans le service de réanimation de Bichat, « si le respirateur me lâche, je n’existe plus » – Le Monde 2020, published 14 November. Full-text : https://www.lemonde.fr/planete/article/2020/11/14/covid-19-dans-le-service-de-reanimation-de-bichat-si-le-respirateur-me-lache-je-n-existe-plus_6059752_3244.html
Le nombre de patients atteints par le Covid-19 a considérablement augmenté en quinze jours dans ce centre hospitalier parisien où les personnels font face à la détresse des malades et, parfois, à la défiance des familles.
Aeberhardt C. Covid-19 : « On ne vaccinera sans doute pas la population française dans son ensemble » – Full-text : https://www.lemonde.fr/planete/article/2020/11/14/covid-19-on-ne-vaccinera-sans-doute-pas-la-population-francaise-dans-son-ensemble_6059736_3244.html
La vaccinologue Marie-Paule Kieny estime que les premiers vaccins pourraient être proposés en France début 2021. Selon elle, même si le virus ne pourra être éradiqué, la situation sanitaire devrait être meilleure d’ici quelques mois.