This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing the text to give it early visibility.
Virology
Miller D, Martin MA, Harel N et al. Full genome viral sequences inform patterns of SARS-CoV-2 spread into and within Israel. Nat Commun 11, 5518 (2020). Full-text: https://doi.org/10.1038/s41467-020-19248-0
This group from Israel has analyzed 212 SARS-CoV-2 sequences, in order to perform a comprehensive analysis to trace the origins and spread of the virus. Travelers returning from the US significantly contributed to viral spread in Israel. The basic reproduction number of the virus was initially around 2.5, dropping by more than two-thirds following the implementation of social distancing measures. Transmission heterogeneity in SARS-CoV-2 spread was high, with between 2-10% of infected individuals resulting in 80% of secondary infections.
Du P, Ding N, Li J, et al. Genomic surveillance of COVID-19 cases in Beijing. Nat Commun. 2020 Oct 30;11(1):5503. PubMed: https://pubmed.gov/33127911. Full-text: https://doi.org/10.1038/s41467-020-19345-0
To understand the genetic characteristics of SARS-CoV-2 in Beijing, the authors collected pharyngeal swabs and sputa samples from 126 patients to perform viral genome sequencing after admission and consent procedures. Here they present genomic surveillance data on 102 imported cases, which account for 17.2% of the total cases in Beijing. Genomic comparisons reveal higher genomic diversity in the imported group compared to both the Wuhan exposure and local transmission groups, indicating continuous genomic evolution during global transmission.
Borges V, Isidrfo J, Cortes-Martins H. Massive dissemination of a SARS-CoV-2 Spike Y839 variant in Portugal. Emerg Microbes Infect 2020 Nov 2;1-58. Full-text: https://doi.org/10.1080/22221751.2020.1844552
Here, the authors track the geotemporal spread of a SARS-CoV-2 variant with a mutation (D839Y) in a potential host-interacting region involving the Spike fusion peptide, which is a target motif of anti-viral drugs that plays a key role in SARS-CoV-2 infectivity. The Spike Y839 variant was most likely imported from Italy in mid-late February and massively disseminated in Portugal during the early epidemic. Between March 14th and April 9th (covering the exponential epidemic phase) the relative frequency of the Spike Y839 variant increased at a rate of 12.1% every three days, being potentially associated with 24.8% of all COVID-19 cases in Portugal during this period. The data supports population/epidemiological (founder) effects contributing to the Y839 variant superspread. This variant was likely one of the first SARS-CoV-2 to be introduced in Portugal, so it might have had more opportunity to spread. Its introduction is strongly linked to an international trade fair in Milan with many Portuguese attendees. The potential existence of selective advantage is also discussed, although experimental validation is required.
Diagnostic
Chan CW, Shahul S, Coleman C, et al. Evaluation of the Truvian Easy Check COVID-19 IgM/IgG Lateral Flow Device for Rapid Anti-SARS-CoV-2 Antibody Detection. American Journal of Clinical Pathology, 02 November 2020, aqaa22. Full-text: https://doi.org/10.1093/ajcp/aqaa221
Clarence W. Chan and colleagues from Chicago evaluated the analytical and clinical performance of the Truvian Easy Check COVID-19 IgM/IgG antibody test. This test was designed to detect the nucleocapsid and S1 spike protein RBD epitopes of SARS-CoV-2. Results are available at 10 minutes after test initiation for serum and possibly fingerstick blood samples. The Easy Check device showed excellent clinical and analytical performance; the test compares well with the Roche Elecsys anti-SARS-CoV-2 antibody assay. Of 99 patient samples that were positively confirmed by PCR for SARS-CoV-2, antibodies against the virus were detected by both tests in 88 of the samples, whereas 9 of the 99 samples eluded detection by both testing modalities. All samples from 41 prepandemic volunteers remained negative.
Clinical
Gandhi RT, Lynch JB, del Rio C. Mild or Moderate Covid-19. N Engl J Med, October 29, 2020; 383:1757-1766. Full-text: https://doi.org/10.1056/NEJMcp2009249
Brief overview for clinicians. In patients with moderate disease, dexamethasone is not efficacious (and may be harmful) and data are insufficient to recommend for or against routine use of remdesivir. Efforts center on personal protective equipment for health care workers, social distancing, and testing.
Giustino G, Croft LB, Stefanini GG, et al. Characterization of Myocardial Injury in Patients With COVID-19. J Am Coll Cardiol. 2020 Nov 3;76(18):2043-2055. PubMed: https://pubmed.gov/33121710. Full-text: https://doi.org/10.1016/j.jacc.2020.08.069
This multicenter cohort study (7 hospitals in New York City and Milan) analyzed hospitalized COVID-19 patients who had undergone transthoracic echocardiographic (TTE) and electrocardiographic evaluation during their index hospitalization. Myocardial injury was defined as any elevation in cardiac troponin at the time of clinical presentation or during the hospitalization. Overall, myocardial injury was observed in 190 patients (62.3%). Among patients with COVID-19 who underwent TTE, cardiac structural abnormalities were present in nearly two-thirds of patients with myocardial injury. Rates of in-hospital mortality were 5.2%, 18.6%, and 31.7% in patients without myocardial injury, with myocardial injury without TTE abnormalities, and with myocardial injury and TTE abnormalities.
Collateral damage
Qu Z, Oedingen C, Bartling T, Schrem H, Krauth C. Organ procurement and transplantation in Germany during the COVID-19 pandemic. Lancet. 2020 Oct 31;396(10260):1395. PubMed: https://pubmed.gov/33129390. Full-text: https://doi.org/10.1016/S0140-6736(20)32213-3
No damage in this area: Compared with the previous year, the cumulative numbers of deceased organ donors and transplants showed no significant reduction in Germany. Kidney transplantation numbers were stable, while the numbers of heart, lung, and liver transplantations from deceased donors even increased from January to April, 2020, when compared with the same period of the previous year. In contrast, transplant activities in Italy and Spain were reduced by 30–50%.
Sors F, Grassi M, Agostini T, Murgia M. The sound of silence in association football: Home advantage and referee bias decrease in matches played without spectators. Eur J Sport Sci. 2020 Nov 1;1-21. Full-text: https://doi.org/10.1080/17461391.2020.1845814
We have eagerly awaited this news for decades: spectators can significantly contribute to determine the dynamics and the outcomes of professional football matches (home advantage and referee bias are two well-documented phenomena in professional sports). COVID-19 has made it possible: focusing on the first and second divisions of the top four UEFA countries, the authors analyzed 841 matches behind closed doors during the pandemic. This extremely important work revealed that observed frequencies for home victories, draws and away victories were significantly different from the expected frequencies calculated based on the last three complete seasons with spectators. The absence of a referee bias in favor of the home teams for yellow cards indicated that this factor might be particularly affected by the presence/absence of social pressure by spectators. Various parameters were considered, and the analyses revealed a reduction of home advantage and the absence of referee bias. They´ll walk alone now.
Pregnancy
Sahin D, Tanacan A, Erol SA, et al. Updated experience of a tertiary pandemic center on 533 pregnant women with COVID-19 infection: A prospective cohort study from Turkey. Int J Gynaecol Obstet. 2020 Nov 1. PubMed: https://pubmed.gov/33131057. Full-text: https://doi.org/10.1002/ijgo.13460
Huge prospective cohort from Turkey: Of 533 cases, 509 (95.5%) had mild disease, 7 (1.3%) were admitted to the intensive care unit (ICU), and invasive mechanical ventilation was necessary in 2 (0.4%) patients. Maternal mortality was observed in 2 (0.4%) cases. In total, 66 (12.4) had pregnancy complications (preterm delivery 4.1%). All neonates were negative for COVID-19. The rate of admission to the neonatal ICU was 9.9%. One specimen of breast milk was positive for the infection.
Pediatrics
Belhadjer Z, Auriau J, Méot M, et al. Addition of Corticosteroids to Immune Globulins is Associated with Recovery of Cardiac Function in Multi-inflammatory Syndrome in Children (MIS-C). Circulation, 28 October 2020. Full-text: https://doi.org/10.1161/CIRCULATIONAHA.120.050147
Steroids may help in MIS-C: 18 patients admitted before 1 May received immune globulins (IVIG 2g/Kg once) as first line treatment, and the 22 patients admitted after this date received a combination of IVIG and intravenous methylprednisolone (0.8mg/kg/day during 5 days). These two populations had similar clinical, cardiac and biological characteristics at baseline. The main finding was the reduction of time to recovery of left ventricle ejection fraction (LVEF) and isovolumic relaxation time (IVRT), as well as pediatric intensive care unit (PICU) stay in the group receiving a combination of IVIG and steroids compared to the group receiving only IVIG: respectively 2.9 vs. 5.4 days, 6.4 vs. 20.6 days, and 3.4 vs. 5.3 days (p<0.05).