Top 10: September 16

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By Christian Hoffmann &
Bernd S. Kamps

16 September


Kissle SM, Kishore N, Prabhu M, et al. Reductions in commuting mobility correlate with geographic differences in SARS-CoV-2 prevalence in New York City. Nat Commun 11, 4674 (2020). Full-text:

SARS-CoV-2 prevalence varied substantially between New York City boroughs between 22 March and 3 May 2020 (for example, Manhattan: 11.3%; South Queens: 26.0%). These differences in prevalence correlate with antecedent reductions in commuting-style mobility between the boroughs. Prevalence was lowest in boroughs with the greatest reductions in morning movements out of and evening movements into the borough.


Rogers JH, Link AC, McCulloch D, et al. Characteristics of COVID-19 in Homeless Shelters. Ann Intern Med 2020, published 15 September. Full-text:

In this cross-sectional, community-based surveillance study of 14 homeless shelters in King County, Washington, Helen Chu, Julia Rogers and colleagues divided the number of positive cases by the total number of participant encounters, regardless of symptoms. Among 1434 encounters, 29 (2%) cases of SARS-CoV-2 infection were detected across 5 shelters. Eighty-six percent of persons with positive test results slept in a communal space rather than in a private or shared room.



Milani GP, Bottino I, Rocchi A, et al. Frequency of Children vs Adults Carrying Severe Acute Respiratory Syndrome Coronavirus 2 Asymptomatically. JAMA Pediatr. Published online September 14, 2020. Full-text:

Early reports suggested that children, often asymptomatic, might be facilitators of SARS-CoV-2 transmission and amplify local outbreaks. Here, Carlo Agostini, Gregorio Milani and colleagues conducted a study among individuals hospitalized in Milan. About 1% of children and 9% of adults without any symptoms or signs of SARS-CoV-2 infection tested positive for SARS-CoV-2. The authors conclude that their data do not support the hypothesis that children are at higher risk of carrying SARS-CoV-2 asymptomatically than adults. Attention: a retrospective analysis.



Dubbink JH, Branco TM, Ballah Kamara KB, et al. COVID-19 treatment in sub-Saharan Africa: if the best is not available, the available becomes the best. Travel Med Infect Dis. 2020 Sep 11:101878. PubMed: Full-text:

Martin Grobusch, Jan Dubbink and colleagues discuss the management of COVID-19 in sub-Saharan Africa, in a context of lack of health care workers and health care infrastructure. The authors conclude that locally accessible resources should be adapted to deliver realistic solutions. The highest possible, yet realistic level of care is better than no care at all.



Sorokina M, Teixeira MC, Barrera J, et al. Structural models of human ACE2 variants with SARS-CoV-2 Spike protein for structure-based drug design. Sci Data 7, 309 (2020). Full-text:

Understanding the variation of ACE2 in the human population is of critical importance for the development of therapeutic strategies against coronaviruses. Here, the authors built 242 structural models of variants of human ACE2 bound to the receptor binding domain (RBD) of the SARS-CoV-2 surface spike glycoprotein (S protein). They hope that their dataset will help accelerate the design of therapeutics against SARS-CoV-2.



Greaney AJ, Starr TN, Gilchuk P, et al. Complete mapping of mutations to the SARS-CoV-2 spike receptor-binding domain that escape antibody recognition. bioRxiv 2020, posted 10 September. Full-text:

The authors describe a mutational scanning method to map how all amino-acid mutations in the SARS-CoV-2 spike receptor-binding domain (RBD) could prevent binding by ten human antibodies. The complete escape maps might allow for the design of escape-resistant antibody cocktails–including cocktails of antibodies that compete for binding to the same surface of the RBD but have different escape mutations. A surprise finding: antibody cocktails do not have to target distinct regions of the RBD in order to resist viral escape. The paper has not yet been peer reviewed.



Bixler D, Miller AD, Mattison CP, et al. SARS-CoV-2–Associated Deaths Among Persons Aged <21 Years — United States, February 12–July 31, 2020. MMWR Morb Mortal Wkly Rep. ePub: 15 September 2020. Full-text:

SARS-CoV-2 infection is usually mild in children. Who are those who die nonetheless? Danae Bixler et al. analyzed 121 SARS-CoV-2–associated deaths among persons aged < 21 years. 12 (10%) were infants and 85 (70%) were aged 10–20 years. Hispanic, non-Hispanic Black and non-Hispanic American Indian/Alaskan Native persons accounted for 94 (78%) of these deaths. They conclude that (1) all persons aged < 21 years exposed to SARS-CoV-2 should be monitored for complications and that (2) infants, children, adolescents, and young adults, particularly those from racial and ethnic minority groups at higher risk, those with underlying medical conditions, and their caregivers, need clear, consistent, and developmentally, linguistically, and culturally appropriate COVID-19 prevention messages (e.g., related to mask wearing, physical distancing, hand hygiene).



Editorial. Scientific American Endorses Joe Biden. Scientific American 2020, published 15 September. Full-text:

A species unable to adapt to climate change will either perish or, at best, see their numbers or ecological impact decline. This principle partly applies to human super-organizations such as nations. Here, the editors of the 175-year-old magazine Scientific American set an example of promising flexibility. Climate change is currently humanity’s greatest challenge, infinitely greater than the comparatively innocuous SARS-CoV-2, but human inventiveness – and flexibility! – should ultimately find a global treatment.


The Lancet COVID-19 Commissioners, Task Force Chairs, and Commission Secretariat. Lancet COVID-19 Commission Statement on the occasion of the 75th session of the UN General Assembly. Lancet 2020, published 14 September. Full-text:

The Lancet Commission statement defines the four main global challenges posed by the pandemic:

  1. Suppressing the pandemic by means of pharmaceutical and non-pharmaceutical interventions;
  2. Overcoming humanitarian emergencies, including poverty, hunger, and mental distress, caused by the pandemic;
  3. Restructuring public and private finances in the wake of the pandemic;
  4. Rebuilding the world economy in an inclusive, resilient, and sustainable way.

Find the proposals for governments, civil society, and UN institutions in this 19-page read for your next weekend.


Journal Feature

Marshall M. How COVID-19 can damage the brain. Nature 2020, published 15 September. Full-text:

Some people who become ill with the coronavirus develop neurological symptoms. Scientists are struggling to understand why.



If you read Spanish, read Blanco PR, Clemente Y. Qué debe hacer un colegio cuando detecta algún caso de covid. El País, 16 September. Full-text:

Sanidad ha elaborado una guía de actuación con pautas para contener la expansión del coronavirus en los centros educativos aunque serán las comunidades autónomas las que elaboren los protocolos concretos.