Copy-editor: Rob Camp
Epidemiology
Jeong JM, Radeos MS, Shee B, et al. COVID-19 Seroconversion in Emergency Professionals at an Urban Academic Emergency Department in New York City. Ann Emerg Med. 2020 Dec;76(6):815-816. PubMed: https://pubmed.gov/33222793. Full-text: https://doi.org/10.1016/j.annemergmed.2020.06.038
Emergency professionals as a high-risk group. Between February 1, 2020, and April 30, 2020, an overwhelming number greater than 1,000 patients with a diagnosis of COVID-19 presented at an emergency department (ED) in Brooklyn, NY. Results: The overall rate of seroconversion among emergency professionals was incredibly high (46%). Rates for attending physicians, emergency medicine residents, and physician assistants were 64%, 36%, and 29%, respectively.
Prevention
Xu J, Xiao X, Zhang W, et al. Air-Filtering Masks for Respiratory Protection from PM2.5 and Pandemic Pathogens. One Earth Volume 3, ISSUE 5, P574-589, November 20, 2020. Full-text: https://doi.org/10.1016/j.oneear.2020.10.014
Air-filtering masks, also known as respirators, protect wearers from inhaling fine particulate matter (PM2.5) in polluted air, as well as airborne pathogens. Fibrous medium, used as the filtration layer, is the most essential component of an air-filtering mask. This comprehensive review gives an overview of the development of fibrous media for air filtration.
Vaccine
Sun W, Leist SR, McCroskery S, et al. Newcastle disease virus (NDV) expressing the spike protein of SARS-CoV-2 as a live virus vaccine candidate. EBioMedicine November 21, 2020. Full-text: https://doi.org/10.1016/j.ebiom.2020.103132
The Newcastle disease virus vector vaccine has some advantages similar to those of other viral vector vaccines. The NDV vector can be amplified in embryonated chicken eggs, which allows for high yields and low costs perdose. Also, the NDV vector is not a human pathogen, therefore the delivery of the foreign antigen would not be compromised by any pre-existing immunity in humans. Weina Sun and colleagues describe NDV vector vaccines expressing the spike protein of SARS-CoV-2 in its wild type format or a membrane-anchored format lacking the polybasic cleavage site. The NDV vector vaccines elicited high levels of antibodies that are neutralizing when the vaccine is given intramuscularly in mice. Importantly, these COVID-19 vaccine candidates protect mice from a mouse-adapted SARS-CoV-2 challenge with no detectable viral titer and viral antigen in the lungs. The results suggested that the NDV vector expressing either the wild type S or membrane-anchored S without the polybasic cleavage site could be used as live vector vaccine against SARS-CoV-2.
McClung N, Chamberland M, Kinlaw K, et al. The Advisory Committee on Immunization Practices’ Ethical Principles for Allocating Initial Supplies of COVID-19 Vaccine — United States, 2020. MMWR Morb Mortal Wkly Rep. ePub: 23 November 2020. Full-text: http://dx.doi.org/10.15585/mmwr.mm6947e3
Four ethical principles will assist the Advisory Committee on Immunization Practices (ACIP) in formulating recommendations for the initial allocation of COVID-19 vaccine: 1) maximizing benefits and minimizing harms; 2) promoting justice; 3) mitigating health inequities; and 4) promoting transparency. Read how application of ethical principles to four candidate groups for initial COVID-19 vaccine allocation is planned in the US.
Immunology
Rodda LB, Netland JH, Shehata L, et al. Functional SARS-CoV-2-specific immune memory persists after mild COVID-19. Cell November 23, 2020. Full-text: https://doi.org/10.1016/j.cell.2020.11.029
Even mild COVID-19 elicits memory lymphocytes that persist and display functional hallmarks of antiviral immunity. Lauren Rodda found that three months after mildly symptomatic COVID-19, 15 recovered individuals had formed an expanded arsenal of SARS-CoV-2-specific immune memory B-cells (MBCs) that exhibited protective antiviral functions. Recovered individuals had increased neutralizing antibodies, IgG+ classical MBCs with BCRs that formed neutralizing antibodies, Th1 cytokine-producing CXCR5+ circulating T follicular helper(Tfh) cells and CXCR5- non-Tfh cells, proliferating CXCR3+ CD4+memory cells and IFN-γ-producing CD8+ T cells. These components of immune memory have all been associated with protection from other viruses in humans.
Prado-Vivar B, Becerra-Wong M, Guadalupe JJ, et al. A case of SARS-CoV-2 reinfection in Ecuador. Lancet November 23, 2020. Full-text: https://doi.org/10.1016/S1473-3099(20)30910-5
A 46-year-old man from Quito, Ecuador, presenting with a second infection, only 2 months after the first episode. Phylogenetic analysis revealed that the first infection variant belonged to clade 20A and lineage B1.p9, whereas the second infection variant belonged to clade 19B and lineage A.1.1. Of note, the second episode was more severe.
Clinical
Perrot L, Hemon M, Busnel JM, et al. First flare of ACPA-positive rheumatoid arthritis after SARS-CoV-2 infection. Lancet Rheumatology, November 23, 2020. Full-text: https://doi.org/10.1016/S2665-9913(20)30396-9
The first definitive case of ACPA-positive rheumatoid arthritis developing after SARS-CoV-2 infection (ie, with samples taken before and after arthritis onset) in a 60-year-old woman from Marseille, France, with infection as a potential trigger for epitope spreading and onset of clinical rheumatoid arthritis symptoms.
Comorbidities
Yu B, Li C, Sun Y, et al. Insulin treatment is associated with increased mortality in patients with COVID-19. Cell Metabolism November 23, 2020. Full-text: https://doi.org/10.1016/j.cmet.2020.11.014
Oops! In this retrospective study on 689 patients with COVID-19 and Type 2 diabetes from Wuhan, China, insulin treatment was associated with a significant increase in mortality (27.2% vs. 3.5%; adjusted HR, 5.38). Further analysis showed that insulin treatment was associated with enhanced systemic inflammation and aggravated injuries of vital organs. However, this was a retrospective observation which could not establish a causal effect relationship between insulin treatment and high mortality. Moreover, there were significant differences in several baseline characteristics and laboratory indices at admission (for examples, SpO2, NT-proBNP and albumin), which may contribute to the different severity and outcome observed in patients treated with insulin.
Collateral
Morgan L, Protopopova A, Birkler RID, et al. Human–dog relationships during the COVID-19 pandemic: booming dog adoption during social isolation. Humanit Soc Sci Commun 7, 155 (2020). Full-text: https://doi.org/10.1057/s41599-020-00649-x
Good news (for dogs) from Israel: the stricter the social isolation became during the COVID-19 pandemic, the greater the interest in dog adoption. Dog abandonment has decreased and the rates of dog adoptions improved significantly; the demand for adoptable dogs and the requests to serve as foster families increased significantly, and accordingly, the length of stay of dogs at the shelter was significantly shorter.
Figure 2. Dogs’ adoption and abandonment measures, during the COVID-19 outbreak in Israel. Each row represents data of a different variable: upper row (panels a–c) number of abandoned dogs (marked in red); middle row (panels d–f) number of adoption requests made by potential… | Continue reading at https://doi.org/10.1057/s41599-020-00649-x. Reproduced with permission.
Pediatrics
Bailey LC, Razzaghi H, Burrows EK, et al. Assessment of 135 794 Pediatric Patients Tested for Severe Acute Respiratory Syndrome Coronavirus 2 Across the United States. JAMA Pediatr. 2020 Nov 23. PubMed: https://pubmed.gov/33226415. Full-text: https://doi.org/10.1001/jamapediatrics.2020.5052
In this large cohort study of 135,794 US pediatric patients, SARS-CoV-2 infection rates were low (5374 = 4% were infected), and clinical manifestations were typically mild. Black, Hispanic, and Asian race/ethnicity; adolescence and young adulthood; and nonrespiratory chronic medical conditions were associated with identified infection. Among the 5374 patients with positive test results, 359 (7%) were hospitalized for respiratory, hypotensive, or COVID-19–specific illness. Of these, 99 (28%) required intensive care unit services, and 33 (9%) required mechanical ventilation. The case fatality rate was 0.2% (8 of 5374). The number of patients with a diagnosis of Kawasaki disease in early 2020 was 40% lower (259 vs 433 and 430) than in 2018 or 2019.
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