Top 10: November 28

Copy-editor: Rob Camp


Rupert Muiry, Vaughan Parsons, Ira Madan, Risks posed by COVID-19 to healthcare workers. Occup Med 2020, published 28 November. Full-text:

What is the exact nature of the risks posed by SARS-CoV-2 to healthcare workers? Rupert Muiry, Vaughan Parsons and Ira Madan summarize the current literature, including consideration of broader biopsychosocial morbidities.


Bajema K, Wiegand RE, Cuffe K, et al. Estimated SARS-CoV-2 Seroprevalence in the US as of September 2020. JAMA Intern Med 2020, published 24 November. Full-text:

In this cross-sectional study of 177.919 clinical specimens, Chris Edens, Kristina Bajema and colleagues found that as of September 2020, fewer than 10% of people had detectable SARS-CoV-2 antibodies. Seroprevalence estimates varied between sexes, across age groups, and between metropolitan/non-metropolitan area.



Cunningham L, Nicholson PJ, O’Cnnor J, McFadden JP. Cold working environments as an occupational risk factor for COVID-19. Occup Med 2020, published 28 November. Full-text:

Employers and their occupational health and safety professionals should consider work in cold environments to be an independent occupational risk factor for developing COVID-19. Follow Louise Cunningham et al. on their tour in cold environments.



Editors. The COVID vaccine challenges that lie ahead. Nature. 2020 Nov;587(7835):522. PubMed: Full-text:

Large clinical trials of four vaccine candidates are showing remarkable promise, with three exceeding 90% efficacy — all unexpectedly high. None reported worrying safety signals and one has shown promise in older adults who are particularly vulnerable to SARS-CoV-2 but sometimes respond less well to vaccines. But, there remains a lot of work to do for researchers and clinicians.


Cohen J. After dosing mix-up, latest COVID-19 vaccine success comes with big question mark. Science 2020, published 25 November. Full-text:

Callaway E. Why Oxford’s positive COVID vaccine results are puzzling scientists. Nature 2020, published 23 November. Full-text:

Preliminary data from the AstraZeneca vaccine are puzzling. Two full doses given a month apart would be 62% effective, but a half dose followed by a full dose would be 90% effective. Now researchers are trying desperately to instill meaning into these results. Let Jon Cohen and Ewen Callaway explain, sort of.


Editors. Nanomedicine and the COVID-19 vaccines. Nat. Nanotechnol 2020, published 27 November. Full-text:

If approved, BNT162b2 (BioNTech/Pfizer) and mRNA-1273 (Moderna/NIH), credited in press releases with sky-rocketing efficacy, would be the first messenger RNA (mRNA)-based vaccines to be used in large populations. mRNA vaccines use nanotechnology platforms to deliver the genetic sequence of specific viral proteins to the host cells. Find more about the founding principles of nanomedicine in this short editorial.



Alexandersen S, Chamings A, Bhatta TR. SARS-CoV-2 genomic and subgenomic RNAs in diagnostic samples are not an indicator of active replication. Nat Commun 11, 6059 (2020). Full-text:

In patients with mild or moderate SARS-CoV-2 infection, a positive RT-PCR test 10 days or more after the onset of symptoms is generally not considered proof of infectiousness. But why do tests continue to be positive? Now, Soren Alexandersen, Anthony Chamings and Tarka Raj Bhatta provide a preliminary answer. Subgenomic RNAs, like virion RNA, are rather stable and are likely protected from nucleases by cellular membranes. This information may pave the way for development of better strategies to define active SARS-CoV-2 infection as opposed to extended presence of what most likely represent highly stable virus genomic and subgenomic RNAs present in, and at least in part protected by, cellular membranes. The message for national Health Services: Don’t lock your citizens down for weeks and weeks.



Wehbe RM, Sheng J, Dutta S, et al. DeepCOVID-XR: An Artificial Intelligence Algorithm to Detect COVID-19 on Chest Radiographs Trained and Tested on a Large US Clinical Dataset. Radiology. 2020 Nov 24:203511. PubMed: Full-text:

Artificial intelligence (AI) is a significant threat to radiologists and radiology as a specialty. Here, Ramsey Wehbe et al. show that an AI algorithm detected COVID-19 on chest radiographs with a performance similar to a consensus of experienced thoracic radiologists. See also the editorial by van Ginneken B. The Potential of Artificial Intelligence to Analyze Chest Radiographs for Signs of COVID-19 Pneumonia. Radiology. 2020 Nov 24:204238. PubMed: Full-text:


Collateral Effects

Clark JJ, Dwyer D, Pinwill N, Clark P, Johnson P, Hackshaw A. The effect of clinical decision making for initiation of systemic anticancer treatments in response to the COVID-19 pandemic in England: a retrospective analysis. Lancet Oncol 2020, published 27 November. Full-text:

During the 2020 spring lockdown and immediately thereafter, there was an important reduction in systemic anti-cancer treatment initiation in England: 32% in April and 10% in May. In June, the number of registrations for new systemic anti-cancer treatments increased by 15% compared to the 6 pre-COVID months (September, 2019, to February, 2020). James Clark et al. recommend continuing to assess the effects of delaying treatment initiation for advanced cancers and neoadjuvant therapies.



Guglielmi G. Italian labs shape-shift to fight the pandemic. Nature Italy 2020, published 21 November. Full-text:

In Italy, one of the early epicenters of the COVID pandemic, scientists from all fields have re-focused expertise and equipment to study the virus. Go on a short trip to this peninsula in the Mediterranean.


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