Copy-editor: Rob Camp
Immunology
Dan JM, Mateus J, Kato Y, et al. Immunological memory to SARS-CoV-2 assessed for greater than six months after infection. bioRxiv 2020, posted 16 November. Full-text: https://doi.org/10.1101/2020.11.15.383323
As we approach the end of Year 1 of the SARS-CoV-2 pandemic, we realize that although millions of people were infected during spring 2020, there is now, 8 months later, no sizeable epidemic of re-infections. This observation suggests that SARS-CoV-2 infection might confer a solid immunity. Now, Shane Crotty, Alessandro Sette, Daniela Weiskopf, Jennifer Dan and colleagues analyzed multiple compartments of circulating immune memory to SARS-CoV-2 in 185 COVID-19 cases, including 41 cases at > 6 months post-infection. The result: Spike IgG was relatively stable over 6+ months. Spike-specific memory B cells were more abundant at 6 months than at 1 month. SARS-CoV-2-specific CD4+ T cells and CD8+ T cells declined with a half-life of 3-5 months. These findings might suggest that after SARS-CoV-2 infection (or after vaccination), the vast majority of people could be protected against severe COVID-19 for years.
Read also the NYTimes article by Mandavilli A. Immunity to the Coronavirus May Last Years, New Data Hint. The New York Times 2020, published 17 November. Full-text: https://www.nytimes.com/2020/11/17/health/coronavirus-immunity.html
Epidemiology
Xing Y, Wong GWK, Ni W, Hu X, Xing Q. Rapid Response to an Outbreak in Qingdao, China. N Engl J Med 2020, published 18 November. Full-text: https://doi.org/10.1056/NEJMc2032361
Three COVID-19 cases in Qingdao in October: a taxi driver who was admitted to Qingdao Central Hospital for a transient ischemic attack on October 10; his wife who had been working part-time as a nursing assistant at Qingdao Chest Hospital; and a man with pulmonary tuberculosis who was treated at the same hospital. These were the first cases after a 2-month period without local SARS-CoV-2 transmission in China. What would you have done during the next 7 days? The Chinese authorities tested 10.9 million people and identified another 9 cases related to the initial cluster. The outbreak was controlled without a lockdown.
Prevention
Bundgaard H, Bundgaard JS, Raaschou-Pedersen DET, et al. Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers : A Randomized Controlled Trial. Ann Intern Med. 2020 Nov 18. PubMed: https://pubmed.gov/33205991. Full-text: https://doi.org/10.7326/M20-6817
Ammunition for your friends who deny the usefulness of wearing face masks? This Danish study finds that wearing surgical masks doesn’t really reduce the SARS-CoV-2 infection rate among wearers. Don’t read the article without reading the comment by Laine C, Goodman SN, Guallar E. The Role of Masks in Mitigating the SARS-CoV-2 Pandemic: Another Piece of the Puzzle. Ann Intern Med. 2020 Nov 18. PubMed: https://pubmed.gov/33205993. Full-text: https://doi.org/10.7326/M20-7448 and the editorial by Frieden TR, Cash-Goldwasser S. Of Masks and Methods. Ann Intern Med. 2020 Nov 18. PubMed: https://pubmed.gov/33205992. Full-text: https://doi.org/10.7326/M20-7499. And maybe we should ask researchers from South-East Asia to repeat the study.
Continue wearing face masks!
Vaccine
Ramasamy MN, Minassian AM, Ewer KJ, et al. Safety and immunogenicity of ChAdOx1 nCoV-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): a single-blind, randomised, controlled, phase 2/3 trial. Lancet 2020, published 18 November. Full-text: https://doi.org/10.1016/S0140-6736(20)32466-1
Phase II results of a single-blind, randomized, controlled trial that describe the safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine in a wide range of participants, including adults aged 70 years and older. The results are encouraging: ChAdOx1 nCoV-19 appears to be better tolerated in older adults than in younger adults and has similar immunogenicity across all age groups after a boost dose.
See also the comment by Andrew MK, McElhaney JE. Age and frailty in COVID-19 vaccine development. Lancet 2020, published 18 November. Full-text: https://doi.org/10.1016/S0140-6736(20)32481-8
Knipe DM, Levy O, Fitzgerald KA, Mühberger E. Ensuring vaccine safety. Science 2020, published 17 November. Full-text: https://doi.org/10.1126/science.abf0357
Vaccines are among the most successful medical and public health measures ever implemented and prevent ~6 million deaths globally per year. Efficient SARS-CoV-2 vaccines might prevent a similar number of deaths over the coming years. However, caution the authors, the urgent need for COVID-19 vaccines must be balanced with the imperative of ensuring safety and public confidence in vaccines by following the established clinical safety testing protocols throughout vaccine development, including both pre- and post-deployment.
Wadman M. Fever, aches from Pfizer, Moderna jabs aren’t dangerous but may be intense for some. Science 2020, published 18 November. Full-text: https://www.sciencemag.org/news/2020/11/fever-aches-pfizer-moderna-jabs-aren-t-dangerous-may-be-intense-some
Both the BioNTech/Pfizer and the Moderna/NIH mRNA vaccine reached 95% efficacy in clinical trials of tens of thousands of people. The trials revealed no serious safety concerns. We will learn to accept fever and aches as signs that the vaccine works. Even bone and muscle aches and an almost unbearable 38.9°C fever that lasts 12 hours…
Clinical
Dhawan R, Gopalan D, Howard L, et al. Beyond the clot: perfusion imaging of the pulmonary vasculature after COVID-19. Lancet Repiratory Medicine 2020, published 17 October. Full-text: https://doi.org/10.1016/S2213-2600(20)30407-0
The long-term outcomes in survivors of COVID-19 are unknown at present. As pulmonary thrombosis and thromboembolism occur during clinical SARS-CoV-2 infection, the authors propose a proactive follow-up strategy to evaluate residual clot burden, small vessel injury, and potential hemodynamic sequelae that might affect quality of life for a long time.
Education
Rubin EJ, Baden LR, Morrissey S. Covid-19 in Europe and New Information on Vaccines. Audio interview (26:44). N Engl J Med 2020; 383: e134. Access: https://doi.org/10.1056/NEJMe2033666
The editors discuss both recent vaccine trial results and the state of the pandemic in Europe.
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