Top 10: September 19

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By Christian Hoffmann &
Bernd S. Kamps


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.

19 September


After more than six months of studying the scientific COVID-19 literature you might wish to take a break. What if you did something completely different? For example, learning a few Italian words. The Covid Reference team has prepared for you a fine free package of audio files and PDFs. (Even a cellphone app!)

Enjoy: !



Ruktanonchai NW, Floyd JR, Lai S, et al. Assessing the impact of coordinated COVID-19 exit strategies across Europe. Science 2020, published 18 September. Full-text:

Ruktanonchai et al. used mobility data from smartphones to estimate movements between administrative units across Europe before and after the implementation of NPIs for coronavirus disease 2019 (COVID-19). The result: if countries do not coordinate their nonpharmaceutical interventions (NPIs) when they relax lockdown, resurgence of disease occurs sooner. Remember: collaboration is better than unilateralism. Some people should have thought about it before voting Brexit.



Chia ML, Chau DHH, Lim KS. Managing COVID-19 in a Novel, Rapidly Deployable Community Isolation Quarantine Facility. Ann Intern Med 2020, published 17 September. Full-text:

Where would you ideally accommodate low-risk COVID-19 patients? Singapore chose to implement large-scale institutional isolation units, so-called Community Care Facilities (CCFs). These massive-scale isolation facilities are a delicate balance between prioritizing safety for all and ensuring holistic patient care. Read about converting existing public spaces, augmented by telemedicine and 3758 patient admissions.


CDC 20200918. Overview of Testing for SARS-CoV-2 (COVID-19). Centers for Disease Control 2020, updated 18 September. Accessed 19 September. Full-text:

As often this year, the US is arriving late. Yesterday, the CDC rectified their recommendation on testing. The update: any person who comes into contact with a known carrier of the virus should be tested for the virus, even if the person is asymptomatic. See also the comment by McCarthy T. CDC makes U-turn on Covid testing guidelines that prompted backlash. The Guardian 2020, published 18 September. Full-text:



Norman M, Gilboa T, Ogata AF, et al. Ultrasensitive high-resolution profiling of early seroconversion in patients with COVID-19. Nat Biomed Eng (2020).

The authors describe an assay which uses dye-encoded antigen-coated beads to quantify the levels of immunoglobulin G (IgG), IgM and IgA antibodies against four SARS-CoV-2 antigens – as early as the day of the first positive nasopharyngeal PCR test after symptom onset. The ultra-sensitivity enables plasma to be diluted 4,000×, greatly reducing the degree of non-specific circulating immunoglobulin binding.


Ding X, Yin K, Li Z, et al. Ultrasensitive and visual detection of SARS-CoV-2 using all-in-one dual CRISPR-Cas12a assay. Nat Commun 11, 4711 (2020).

The authors describe an All-In-One Dual CRISPR-Cas12a (AIOD-CRISPR) assay which allows all components to be incubated in one pot for CRISPR-based nucleic acid detection, enabling simple, all-in-one molecular diagnostics without need for separate and complex manual operations. Furthermore, a low-cost hand warmer (~$0.3) was used as an incubator of the AIOD-CRISPR assay to detect clinical samples within 20 min, enabling an instrument-free, visual SARS-CoV-2 detection at the point of care.


Lee SW, Yang JM, Moon SY, et al. Association between mental illness and COVID-19 susceptibility and clinical outcomes in South Korea: a nationwide cohort study. Lancet Psychiatry 2020, published 17 September. Full-text:

People with a pre-existing diagnosis of a mental illness are not at increased risk of infection with SARS-CoV-2. This is the result of a large-scale cohort study with propensity score matching using a South Korean national health insurance claims database. Among the patients who tested positive for SARS-CoV-2, after propensity score matching, 109 (8·3%) of 1320 patients without a mental illness had severe clinical outcomes of COVID-19 compared with 128 (9·7%) of 1320 with a mental illness (adjusted OR 1·27, 95% CI 1·01–1·66).



Zhou Y, Wang F, Tang J, Nussinov R, Cheng F. Artificial intelligence in COVID-19 drug repurposing. Lancet Digital Health 2020, published 18 September. Full-text:

Drug repurposing (a technique whereby existing drugs are used to treat emerging and challenging diseases such as COVID-19) might reduce development timelines and overall costs. This review introduces guidelines on how to use artificial intelligence (AI) for accelerating drug repurposing.



Agren D. Understanding Mexican health worker COVID-19 deaths. Lancet 2020, published 19 September. Full-text:

More health workers seem to have died in Mexico than anywhere else. Why?



Harwood R, Allin B, Jones CE, et al. A national consensus management pathway for paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS): results of a national Delphi process. Lancet Child Adolesc Health 2020, published 18 September. Full-text:

The document describes the initial investigation of children with suspected pediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS), including blood markers to help determine the severity of disease, an echocardiogram, and a viral and septic screen to exclude other infectious causes of illness. Find more about the recommended treatment options which include intravenous immunoglobulin, methylprednisolone, and biological therapies. These include IL-1 antagonists (eg, anakinra), IL-6 receptor blockers (eg, tocilizumab), and anti-TNF agents (eg, infliximab) for children with Kawasaki disease-like phenotype and non-specific presentations.



If you read French, read Gozlan M. Covid-19: quand de jeunes enfants ramènent le coronavirus à la maison. Le Monde 2020, published 17 September. Full-text :

Les jeunes enfants infectés par le coronavirus au sein de crèches et garderies peuvent transmettre le virus à la maison aux membres de la famille.


Morel S. Madrid, de nouveau épicentre du Covid-19, limite la liberté de mouvement de 850 000 personnes. Le Monde 2020, published 19 September. Full-text:

A compter de lundi, les rassemblements de plus de six personnes sont interdits dans toute la région, forte de 6,6 millions d’habitants, et la liberté de mouvement est sérieusement restreinte dans 37 quartiers de Madrid et de sa proche banlieue, représentant plus de 850 000 personnes.