Top 10: November 30

Copy-editor: Rob Camp


Vos ERA, den Hartog G, Schepp RM, et al. Nationwide seroprevalence of SARS-CoV-2 and identification of risk factors in the general population of the Netherlands during the first epidemic wave. J Epidemiol Community Health. 2020 Nov 28:jech-2020-215678. PubMed: Full-text:

During the first wave of the epidemic in April 2020, overall seroprevalence in the Netherlands was 2,8% (95% CI 2.1 to 3.7), with no differences between sexes or ethnic background, and regionally ranging between 1,3 and 4,0%. This is in striking contrast with the 30-fold lower number of reported cases.



Perreault J, Tremblay T, Fournier MJ, et al. Waning of SARS-CoV-2 RBD antibodies in longitudinal convalescent plasma samples within 4 months after symptom onset. Blood. 2020 Nov 26;136(22):2588-2591. PubMed: Full-text:

Anti-RBD antibody response in 15 CCP donors who donated at least 4 times, during a time interval after symptom onset ranging from 33 to 77 days for the first donation to 66 to 114 days for the last donation. Interestingly, the decrease during a period of about 20 days (considering the mean and median of third and fourth quartiles, both of 76 and 95 days, respectively) was reminiscent of the plasma immunoglobulin G half-life of 21 days. This suggests that de novo synthesis of anti-RBD antibodies stopped between the third and fourth quartiles in all CCP donors.


Self WH, Tenforde MW, Stubblefield WB, et al. Decline in SARS-CoV-2 Antibodies After Mild Infection Among Frontline Health Care Personnel in a Multistate Hospital Network — 12 States, April–August 2020. MMWR Morb Mortal Wkly Rep 2020;69:1762–1766. Full-text:

Among 156 frontline health care personnel who had positive SARS-CoV-2 antibody test results in spring 2020, 94% experienced a decline at repeat testing approximately 60 days later, and 28% sero-reverted to below the threshold of positivity. A higher percentage of those with low baseline antibody levels sero-reverted (65%) than did those with high baseline titers (7%). These results suggest that a substantial proportion of persons infected with SARS-CoV-2 might have negative serologic test results in the months following infection.



MacPherson A, Hutchinson N, Schneider O, et al. Probability of Success and Timelines for the Development of Vaccines for Emerging and Reemerged Viral Infectious Diseases. Ann Int Med 24 November 2020. Full-text:

If a SARS-CoV-2 vaccine is licensed within 18 months of the start of the pandemic, it will mark an unprecedented achievement for non-influenza viral vaccine development. The authors took a look at other vaccines for emerging and re-emerged viral infectious diseases at in total, 606 clinical trials that formed part of 220 distinct development trajectories were identified. The probability of vaccines progressing from Phase II to licensure within 10 years was 10,0%, with most approvals representing H1N1 or H5N1 vaccines. The average timeline from Phase II to approval was 4,4 years. The probabilities of advancing from Phase I to II, Phase II to III, and Phase III to licensure within the total available follow-up time were 38,2%, 38,3%, and 61,1%, respectively.



Bowles KH, McDonald M, Barró Y. Surviving COVID-19 After Hospital Discharge: Symptom, Functional, and Adverse Outcomes of Home Health Recipients. Ann Int Med 24 November 2020. Full-text:

A retrospective observational cohort from New York City, evaluating 1409 patients with COVID-19 admitted to home health care (HHC) between 1 April and 15 June 2020 after hospitalization. After an average of 32 days in HHC, 94% of patients were discharged and most achieved statistically significant improvements in symptoms and function. Eleven patients (1%) died, 137 (10%) were re-hospitalized, and 23 (2%) remain hospitalized. Comorbid conditions of heart failure and diabetes, as well as characteristics present at admission (male gender, white ethnicity), identified patients at greatest risk for an adverse event.


Merello M, Bhatia KP, Obeso JA. SARS-CoV-2 and the risk of Parkinson’s disease: facts and fantasy. Lancet Neurology November 27, 2020. Full-text:

In this well-balanced review, Marcelo Merello, Kailash Bhatia, Jose Obeso argue that the causal association of SARS-CoV-2 infection with the development of Parkinson’s disease is not supported by robust evidence yet. The authors are concerned about unjustified claims and speculations anticipating a future high incidence of Parkinson’s disease, secondary to the SARS-CoV-2 pandemic. A coordinated international effort to investigate viral effects is essential and should be based on well-designed prospective studies.


Lersy F, Benotmane I, Helms J, et al. Cerebrospinal fluid features in COVID-19 patients with neurologic manifestations: correlation with brain MRI findings in 58 patients. J Infect Dis. 2020 Nov 29:jiaa745. PubMed: Full-text:

In this single-center study, the authors describe neurological manifestations in 58 patients, regarding cerebrospinal fluid (CSF) analysis and neuroimaging findings. Protein and albumin levels in CSF were increased in 38% and 23%, respectively. 40% of patients displayed an elevated albumin quotient suggesting impaired blood‐brain barrier integrity. A CSF-specific IgG oligoclonal band was found in five (11%) cases, suggesting an intrathecal synthesis of IgG, and 26 (55%) patients presented identical oligoclonal bands in serum and CSF. Only four (7%) patients harbored a positive SARS-CoV-2 RT-PCR in CSF.


Ioanno GN, Liang P, Locke E, et al. Cirrhosis and SARS‐CoV‐2 infection in US Veterans: risk of infection, hospitalization, ventilation and mortality. Hepatology 21 November 2020. Full-text:

Among 88.747 patients tested for SARS‐CoV‐2 between January and mid-May in the US Veterans Affairs (VA) national healthcare system, cirrhosis was associated with a 1,7‐fold increase in mortality in patients with SARS‐CoV‐2 infection.


Collateral damage

Singhai R, Tahrani AA, Ludwig C, et al. Global 30-day outcomes after bariatric surgery during the COVID-19 pandemic (GENEVA): an international cohort study. Lancet Diabetes Endocrinology  November 27, 2020. Full-text:

This international cohort study GENEVA investigated the outcomes of bariatric and metabolic surgery (BMS) performed in 2116 adults (≥ 18 years) between May 1 and July 10 from 133 hospitals in 38 countries. Overall, 30-day morbidity and mortality following BMS during the COVID-19 pandemic with locally appropriate perioperative COVID-19 protocols in place seemed to be similar to pre-pandemic levels. Of the ten patients with symptomatic post-operative COVID-19, none needed ventilation and none died.



Mishra GP, Mulani J. Corticosteroids for COVID-19: the search for an optimum duration of therapy. Lancet Resp Med November 26, 2020. Full-text:

According to this comment by Gyanshankar P Mishra and Jasmin Mulani, corticosteroids seem to be a double-edged sword and need to be used judiciously, considering the risk–benefit ratio, as a short-course (up to 10 days) therapeutic agent in a select group of patients with COVID-19 for whom a survival benefit has been reported. Extended courses of steroids may be detrimental.



If you read German, read Dinklage F, Ehmann A, Erdmann E, Klack M, Mast M, Stahnke J, Tröger J, Vallentin C, Blickle P. So schnell verbreitet sich das Coronavirus in Innenräumen. Die Zeit 2020, published 26 November. Full-text: | English version:

Ob daheim, im Klassenzimmer oder Restaurant: Unser Rechner zeigt, wann sich Menschen in geschlossenen Räumen infizieren können. Testen Sie, wie sicher Ihre Umgebung ist.



If you read Spanish, read Domínguez N, Galocha A. ARN, la molécula que puede sacarnos de esta pandemia. El País 2020, published 29 November. Full-text:

Dos de las vacunas más eficaces contra la covid se basan en un compuesto sin el que la vida en la Tierra no podría existir. Su aprobación puede ser el comienzo de una nueva era de tratamientos contra el cáncer, enfermedades raras y vacunas universales.


Lipovetsky G. Son tiempos tristes: las discotecas están cerradas, ya no nos besamos. El País 2020, published 28 November. Full-text:

El universo de la seducción está en peligro con la pandemia, escribe para ‘Ideas’ el filósofo francés Gilles Lipovetsky. Pero prevalecerá: nos gusta demasiado.


Altares G. Mi hermano Juan: 50 días en coma por el coronavirus. El País 2020, published 29 November. Full-text:

Durante los meses más duros de la pandemia Juan Altares sufrió todas las complicaciones de una enfermedad entonces desconocida. Así vivió una familia el día a día de un paciente crítico.


de Miguel R. Los hospitales ingleses recibirán las primeras dosis de la vacuna contra el coronavirus a partir del 7 de diciembre. El País 2020, published 28 November. Full-text:

La Agencia Reguladora de Medicamentos y Productos Sanitarios del Reino Unido aún no ha dado luz verde a la inmunización, pero se espera que lo haga la semana que viene.



If you read French, read Covid-19 : la Haute Autorité de santé préconise une stratégie de vaccination en cinq étapes. Le Monde 2020, published 30 November. Full-text :

Selon la Haute Autorité de santé, les personnes âgées résidant en Ehpad doivent être vaccinées en priorité « à l’arrivée des toutes premières doses », « compte tenu du nombre limité de doses qui seront disponibles au démarrage de la campagne de vaccination ».


Stromboni C. « Pendant ce temps, on ne sait pas comment le cancer évolue » : les « déprogrammés » de la deuxième vague du Covid-19 entre colère et résignation. Le Monde 2020, published 30 November. Full-text :

Sous la pression de la crise épidémique, les hôpitaux ont mis à l’arrêt une partie de leur activité, dans une proportion moindre qu’au printemps, mais suscitant la même anxiété chez les malades concernés par les reports.


Delacroix G. A Pune, en Inde, un vaccin anti-Covid est déjà produit par millions de doses. Le Monde 2020, published 28 November. Full-text :

Depuis plusieurs semaines, le Serum Institute of India fabrique le vaccin AstraZeneca au rythme de 6 millions de flacons par mois. Reportage chez le plus grand producteur au monde.


Bernard P. « Le Covid-19 est un terrible révélateur des fractures sanitaires de la planète ». Le Monde 2020, published 28 November. Full-text :

Les habitants des pays pauvres risquent d’être les derniers servis en vaccin anti-Covid-19, mais aussi de subir le dramatique retour des maladies « classiques » induit par cette épidémie, observe Philippe Bernard, éditorialiste au « Monde », dans sa chronique.


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