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Transmission
Ng OT, Marimuthu K, Koh V, et al. SARS-CoV-2 seroprevalence and transmission risk factors among high-risk close contacts: a retrospective cohort study. Lancet Infect Dis 2020, published 2 November. Full-text: https://doi.org/10.1016/S1473-3099(20)30833-1
Excellent retrospective cohort study by Vernon Lee, Oon Tek Ng and colleagues Between Jan 23 and April 3, 2020, the authors identified 7,518 close contacts (1779 [23%] household contacts, 2231 [30%] work contacts, and 3508 [47%] social contacts) linked to 1114 PCR-confirmed index cases. The secondary clinical attack rate:
Household contacts: 5.9% (95% CI 4.9–7.1).
Particular risk factors:
- Sharing a bedroom (multivariable odds ratio [OR] 5.38)
- Being spoken to by an index case for 30 min or longer (7.86)
Non-household contact: Work contacts, 1.3% (0.9–1.9); social contacts, 1.3% (1.0–1.7).
Particular risk factors:
- Exposure to more than one case (3.92)
- Being spoken to by an index case for 30 min or longer (2.67)
- Sharing a vehicle with an index case (3.07).
Among both household and non-household contacts, indirect contact, meal sharing, and lavatory co-usage were not independently associated with SARS-CoV-2 transmission.
Prevention
Immunology
Khoury DS, Wheatley AK, Ramuta MD, et al. Measuring immunity to SARS-CoV-2 infection: comparing assays and animal models. Nat Rev Immunol (2020). Full-text: https://doi.org/10.1038/s41577-020-00471-1
Assays to measure naturally acquired immunity and test the efficacy of immune interventions are key to the development of novel prophylactic and therapeutic interventions. Here, Miles Davenport, David Khoury and colleagues analyze a selection of existing assays for measuring antibody-mediated virus neutralization and animal models of infection with SARS-CoV-2. Their message: identify what you want to measure and match these goals to your experimental design.
Bošnjak B, Stein SC, Willenzon S, et al. Low serum neutralizing anti-SARS-CoV-2 S antibody levels in mildly affected COVID-19 convalescent patients revealed by two different detection methods. Cell Mol Immunol (2020). Full-text: https://doi.org/10.1038/s41423-020-00573-9
Reinhold Förster, Berislav Bošnjak and colleagues performed a surrogate virus neutralization test (sVNT) and SARS-CoV-2 S protein-pseudotyped vesicular stomatitis virus (VSV) vector-based neutralization assay (pVNT) to assess the degree to which serum antibodies from coronavirus disease 2019 (COVID-19) convalescent patients interfere with the binding of SARS-CoV-2 S to ACE2. They analyzed 40 patients with mild SARS-CoV-2 infection, 10 patients with severe infection and 12 healthy controls. Both tests revealed neutralizing anti-SARS-CoV-2 S antibodies in the sera of approximately 90% of mildly and 100% of severely affected COVID-19 convalescent patients. Levels of neutralizing antibodies correlated with the duration and severity of clinical symptoms but not with patient age. The authors conclude that that sVNT is technically less complicated, cheaper, and much faster than pVNT, making it more suitable for the rapid screening of a large number of samples.
Meffre, E, Iwasaki A. Interferon deficiency can lead to severe COVID. Nature 2020, published 2 November. Full-text: https://www.nature.com/articles/d41586-020-03070-1
In this News & Views articles, the authors highlight the possible key role for the signaling pathway mediated by type I interferon proteins in the development of severe COVID-19. The authors discuss the papers by Bastard et al. and Zhang et al. we presented on September 25:
Bastard P, Rosen LB, Zhang Q, et al. Auto-antibodies against type I IFNs in patients with life-threatening COVID-19. Science 2020, published 24 September. Full-text: https://science.sciencemag.org/content/early/2020/09/23/science.abd4585
Zhang Q, Bastard P, Liu Z, et al: Inborn errors of type I IFN immunity in patients with life-threatening COVID-19. Science 2020, published 24 September. Full-text: https://science.sciencemag.org/content/early/2020/09/23/science.abd4570
Clinical
Zhong P, Xu J, Yang D, et al. COVID-19-associated gastrointestinal and liver injury: clinical features and potential mechanisms. Sig Transduct Target Ther 5, 256 (2020). Full-text: https://doi.org/10.1038/s41392-020-00373-7
Besides common respiratory symptoms, some patients with COVID-19 experience gastrointestinal symptoms, such as diarrhea, nausea, vomiting, and loss of appetite. In this review, Yangbai Sun, Peijie Zhong and colleagues highlight the manifestations and potential mechanisms of gastrointestinal and hepatic injuries in COVID-19.
(Future?) Treatment
Sokolowska, M. Outsmarting SARS-CoV-2 by empowering a decoy ACE2. Sig Transduct Target Ther 5, 260 (2020), published 3 November. Full-text: https://doi.org/10.1038/s41392-020-00370-w
There are currently a few therapeutic approaches which focus on blocking SARS-CoV-2 binding to its key receptor, an angiotensin-converting enzyme 2 (ACE2), or on inhibition of virus spike cleavage. Milena Sokolowska discusses soluble recombinant human ACE2 (rhACE2) and a paper we presented on August 4: Chan KK, Dorosky D, Sharma P, et al. Engineering human ACE2 to optimize binding to the spike protein of SARS coronavirus 2. Science 2020, published 4 August. Full-text: https://science.sciencemag.org/content/early/2020/08/03/science.abc0870
Abd El-Aziz TM, Al-Sabi A, Stockand JD. Human recombinant soluble ACE2 (hrsACE2) shows promise for treating severe COVID19. Sig Transduct Target Ther 5, 258 (2020). Full-text: https://doi.org/10.1038/s41392-020-00374-6
Tarek Mohamed Abd El-Aziz and colleagues discuss encouraging data from the first severe COVID-19 patient successfully treated with human recombinant soluble angiotensin-converting enzyme-2 (hrsACE2): the disappearance of the virus from the serum, the nasal cavity and lungs, and a reduction of inflammatory cytokine. (See the paper by Zoufaly et al. we presented on September 25: Zoufaly A, Poglitsch M, Aberle JH, et al. Human recombinant soluble ACE2 in severe COVID-19. Lancet Resp Med September 24, 2020. Full-text: https://doi.org/10.1016/S2213-2600(20)30418-5.) Notably, the use of hrsACE2 did not impede the generation of neutralizing antibodies. The patient improved rapidly.
Pediatrics
Martinez OM, Bridges ND, Goldmunth E, et al. The immune roadmap for understanding multi-system inflammatory syndrome in children: opportunities and challenges. Nat Med (2020). Full-text: https://doi.org/10.1038/s41591-020-1140-9
In June 2020, immunologists and clinicians met to identify key questions surrounding the ‘multi-system inflammatory syndrome in children’ (MIS-C). This Meeting Report describes the main findings from the workshop. Read about B cell immunity, T cell immunity, innate immunity, genetics and epigenetics.
Spanish
If you read Spanish, read Mouzo J, Valdés I, Battista G. Los médicos en las UCI: “Aún no es el infierno, pero sí el purgatorio” – El País, published 31 October. Full-text: https://elpais.com/sociedad/2020-10-30/los-medicos-en-las-uci-aun-no-es-el-infierno-pero-si-el-purgatorio.html
Una cuarta parte de las UCI españolas están ocupadas por pacientes con covid-19. EL PAÍS entra en dos unidades, en Madrid y Barcelona, que bordean el colapso
French
If you read French, read Jérôme B. Covid-19 : dans le Grand Paris, les personnes âgées défavorisées sont les premières victimes. Full-text : Le Monde 2020, published 3 November. Full-text: https://www.lemonde.fr/planete/article/2020/11/03/dans-le-grand-paris-les-personnes-agees-defavorisees-premieres-victimes-du-covid-19_6058265_3244.html
Au printemps, en Ile-de-France, le virus a d’abord fauché les plus de 65 ans dans les communes où les revenus sont les plus bas et les logements les plus exigus, selon une étude universitaire qu’a pu se procurer « Le Monde ».
Jérôme B. Covid-19 : « Le tissu social doit devenir notre allié, plus encore que lors de la première vague ». Le Monde 2020, published 3 November. Full-text: https://www.lemonde.fr/planete/article/2020/11/03/covid-19-le-tissu-social-doit-devenir-notre-allie-plus-encore-que-lors-de-la-premiere-vague_6058334_3244.html
Le directeur de la santé publique de l’agence régionale de santé d’Ile-de-France, Luc Ginot, évoque la surmortalité dans les villes pauvres de la région et les moyens mis en œuvre pour y faire face.