Top 10: November 4

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.


O’Driscoll M, Dos Santos GR, Wang L, et al. Age-specific mortality and immunity patterns of SARS-CoV-2. Nature (2020). Full-text:

The age distribution of deaths in younger age groups (<65 years) is consistent across different settings. This is the result of a study by Henrik Salje, Megan O’Driscoll and colleagues who used age-specific COVID-19 death data from 45 countries and the results of 22 seroprevalence studies to investigate the fatality patterns across multiple countries. The authors also demonstrate how outbreaks in nursing homes can drive overall population IFRs infection-to-fatality ratio), through both increased attack rates and increased vulnerability. They estimate that around 5% of the populations had been infected by the 1st of September 2020, with much higher transmission likely to have occurred in a number of Latin American countries.


Vijayan T, Shin M, Adamson PC, et al. Beyond the 405 and the 5: Geographic variations and factors associated with SARS-CoV-2 positivity rates in Los Angeles County. Clin Infect Dis 2020, published 3 November. Full-text:

SARS-CoV-2 infection was more frequent in communities with high proportions of Latino/a residents, those living below the federal poverty line and with high household densities. This is the conclusion of a study by Tara Vijayan et al. in Los Angeles County (LAC) after analyzing more than 800,000 SARS-CoV-2 tests. The overall positivity rate was 10.2%.



Zohar T, Loos C, Fischinger S, et al. Compromised humoral functional evolution tracks with SARS-CoV-2 mortality. Cell 2020, pubished 3 November. Full-text:

Both IgA and IgM evolve rapidly across all levels of disease severity, but rapid and potent IgG class switching is linked to survival. This is the key message of a paper by Galit Alter, Tomer Zohar and colleagues who analyzed the early evolution of the humoral response in 193 hospitalized individuals with moderate to severe COVID-19. The data highlight distinct humoral trajectories associated with resolution of SARS-CoV-2 infection.


Files JK, Boppana S, Perez MD, et al. Sustained cellular immune dysregulation in individuals recovering from SARS-CoV-2 infection. J Clin Invest. 2020 Oct 29:140491. PubMed: Full-text:

A prolonged period of immune dysregulation may follow SARS-CoV-2, both in hospitalized and non-hospitalized patients. This is the result of a study by Nathaniel Erdman, Jacob Files and colleagues who analyzed samples and data from 46 hospitalized and 29 non-hospitalized patients as well as 20 controls. The authors also report that the dysregulation of T-cell activation and exhaustion markers in non-hospitalized individuals appears to be more pronounced in the elderly.


Stervbo U, Rahmann S, Roch T, et al. Epitope similarity cannot explain the pre-formed T cell immunity towards structural SARS-CoV-2 proteins. Sci Rep 10, 18995 (2020). Full-text:

Biobanked venous blood contains T cells reactive to SARS-CoV-2 S-protein even before the outbreak in Wuhan, suggesting that there is a preformed T cell memory towards structural proteins in individuals not exposed to SARS-CoV-2. Here, Ulrik Stervbo et al. utilize a combination of epitope prediction and similarity to common human pathogens to identify potential sources of the SARS-CoV-2 T cell memory. Their data suggests that the observed SARS-CoV-2 pre-formed immunity to structural proteins is not driven by near-identical epitopes.


Chen Y, Zuiani A, Fischinger S, and al. Quick COVID-19 Healers Sustain Anti-SARS-CoV-2 Antibody Production. Cell 2020, published 3 November. Full-text:

After SARS-CoV-2 infection, some individuals maintain stable or increased SARS-CoV-2 IgG, displaying an immune phenotype that connects rapid symptom clearance to differential antibody durability dynamics. Those who sustain virus-specific IgG production might tend to have shorter disease courses despite similar distribution of initial anti-SARS-CoV-2 IgG levels, and their anti-S memory B cells harbor increased levels of somatic hypermutation (SHM) shortly after disease resolution. This is a result of an analysis by Duane Wesemann, Yuezhou Chen and colleagues who charted longitudinal antibody responses to SARS-CoV-2 in 76 subjects after symptomatic COVID-19 followed longitudinally to ∼100 days.


Custódio TF, Das H, Sheward DJ, et al. Selection, biophysical and structural analysis of synthetic nanobodies that effectively neutralize SARS-CoV-2. Nat Commun 11, 5588 (2020). Full-text:

Traditional antibody production is hampered by long development times and costly production. Here, Christian Löw, Tânia Custódio and colleagues report the rapid isolation and characterization of nanobodies that target the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein. Several of the 85 binders isolated by the authors had low nanomolar affinities and efficient neutralization activity.


Severe COVID

Evans RM, Lippman SM. Shining Light on the COVID-19 Pandemic: A Vitamin D Receptor Checkpoint in Defense of Unregulated Wound Healing. Cell Metab. 2020 Sep 11;32(5):704-9. PubMed: Full-text:

Ronald Evans and Scott Lippman propose repurposing paricalcitol (vitamin D analog) infusion therapy to restrain the COVID-19 cytokine storm, reasoning that vitamin D deficiency and the failure to activate the vitamin D receptor can aggravate this respiratory syndrome by igniting a wounding response in stellate cells of the lung. Find out what could be the appropriate dose and the potential complications.



Hurst JH, Heston SM, Chambers HN, et al. SARS-CoV-2 Infections Among Children in the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study. Clin Infect Dis 2020, published 3 November. Full-text:

Children ages 6-13 years are frequently asymptomatic (39%) and have respiratory symptoms less often than younger children (29% vs. 48%) or adolescents (29% vs. 60%). However, Matthew Kelly, Jillian Hurst and colleagues found no differences in nasopharyngeal viral load by age or between symptomatic and asymptomatic children.

6-13 years 14-20 years
Respiratory symptoms 29% 60%
Influenza-like symptoms 39% 61%
Gastrointestinal symptoms 9% 27%
Sensory symptoms 9% 42%
Disease duration 4 (IQR 3,8) 7 (4,12)



Editors (Int J Refug Law). Human Mobility and Human Rights in the COVID-19 Pandemic: Principles of Protection for Migrants, Refugees, and Other Displaced Persons. Int J Refug Law 2020, published 4 November. Full-text:

During the SARS-CoV-2 pandemic, many States have taken harsh and unprecedented measures against migrants, refugees, and other displaced persons. These have included border closures, quarantines, expulsions, and lock-downs of migrant worker communities and refugee camps. Read about

  • Equal treatment and non-discrimination
  • Right to health
  • State obligations to combat stigma, racism and xenophobia
  • Restrictions on movement between and within States
  • Enforcement of immigration law, including detention
  • Right to protection of life and health for persons in camps, collective shelters, and settlements
  • Right to information and protection of privacy
  • Gender considerations and labor rights of workers



If you read Spanish, read De Benito E. La niebla en la mente que deja el virus: “Soy filóloga y se me olvidan palabras como sartén” – El País 2020, published 4 November. Full-text:

Afectados por la covid sufren pérdidas de memoria o problemas de concentración meses después de erradicar la infección



If you read French, read Gaudin C. Covid-19 : « Dans les mesures sanitaires, il y a des nuances entre pays européens, mais un gouffre entre l’Asie et l’Occident » – Le Monde 2020, published 4 November. Full-text:

Les jeunes démocraties de Taïwan et de Corée du Sud font face à l’épidémie bien mieux que la dictature chinoise et sans attenter aux libertés. C’est d’elles que l’Occident doit s’inspirer, souligne le politiste Christophe Gaudin, maître de conférences à Séoul, dans une tribune au « Monde ».


Cabut S. Covid-19 : le taux de mortalité des patients en réanimation lors de la première vague a baissé. Le Monde 2020, published 3 November. Full-text :

Selon une étude menée au printemps sur plus de 4 200 malades, le taux de mortalité est passé de 42 % à 25 %. Ces cas graves sont surtout des hommes, souvent en surpoids. Un quart a moins de 54 ans.


Mandard S. Covid-19 : 15 % des décès attribuables à la pollution de l’air. Le Monde 2020, published 3 November. Full-text :

Une étude internationale évalue à 15 % la part de décès dus au nouveau coronavirus liée à l’exposition aux particules fines.

Home | First Home | Daily TOP 10

By Christian Hoffmann &
Bernd S. Kamps