COVID-19 Literature Situation Report July 20, 2020

• In the open-label RECOVERY trial among hospitalized COVID-19 patients, Horby et al. found that 28-day mortality was lower for patients receiving the steroid dexamethasone than for the usual care group among patients receiving invasive mechanical ventilation (29% vs. 41%) or supplemental oxygen without invasive mechanical ventilation (23% vs. 26%), but not among those who were receiving no respiratory support at randomization (18% vs. 14%). [EDITORIAL NOTE: A version of these findings was published as a pre-print article that was included in this Literature Report on June 23, 2020] 

Horby et al. (July 17, 2020). Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa2021436 

• [pre-print, not peer-reviewed] Becker et al. developed a multiplexed immunoassay to measure IgG and IgA responses against six SARS-CoV-2 antigens, achieving a sensitivity of 90% and a specificity of 100%. By monitoring IgA response, they were able to detect an early immune response in some patients. The authors suggest that the test may be useful in monitoring vaccination studies and conducting widespread screening.  

Becker et al. (July 17, 2020). Going beyond Clinical Routine in SARS-CoV-2 Antibody Testing – A Multiplex Corona Virus Antibody Test for the Evaluation of Cross-Reactivity to Endemic Coronavirus Antigens. Pre-print downloaded July 20 from https://doi.org/10.1101/2020.07.17.20156000 

• [pre-print, not peer-reviewed] Screening for SARS-CoV-2 by RT-PCR and antibody testing in a village in Germany that had been quarantined for six weeks after a SARS-CoV-2 outbreak found that only 53% of participants with previously confirmed SARS-CoV-2 infections had detectable antibodies. Overall, 8% of the inhabitants had a positive SARS-CoV-2 antibody test (based on two or more independent tests), of whom 38% had a previous SARS-CoV-2 PCR test.  

Weis et al. (July 17, 2020). Seroprevalence of SARS-CoV-2 Antibodies in an Entirely PCR-Sampled and Quarantined Community after a COVID-19 Outbreak – the CoNAN Study. Pre-print downloaded July 20 from https://doi.org/10.1101/2020.07.15.20154112 

• [pre-print, not peer-reviewed] Hanson et al. compared healthcare worker-collected nasopharyngeal swabs (NPS) to self-collected anterior nasal swabs (ANS) and saliva for diagnosis of SARS CoV-2 infection in adults accessing drive through testing (n=268). The positive percent agreement between NPS and ANS or saliva was 86.3% and 93.8%, respectively. Negative percent agreement was 99.6% for NPS vs. ANS and 97.8% for NPS vs. saliva. All participants had symptoms suggestive of COVID-19 infection. 

Hanson et al. (July 19, 2020). Self-Collected Anterior Nasal and Saliva Specimens versus Healthcare Worker-Collected Nasopharyngeal Swabs for the Molecular Detection of SARS-CoV-2. Pre-print downloaded July 20 from https://doi.org/10.1101/2020.07.17.20155754 

• Zhu et al. conducted a randomized, double-blind, placebo-controlled, phase 2 trial of the Ad5-vectored COVID-19 vaccine to determine the immunogenicity and incidence of adverse reactions.  
• Both  doses  of  the  vaccine  induced  significant  neutralizing  antibody  responses  to  live  SARS-CoV-2. Evidence of antigen-specific T-cell responses were observed in 88-90% of vaccine recipients. 
• Within 14 days, 72% of participants in one vaccine dose group and 74% of participants in another dose group reported at least one adverse reaction, both of which were significantly higher than the 37% of participants in the placebo group. Common reactions included fatigue, fever, headache, and pain at the injection site. However, no serious adverse events were documented within 28 days after injection.  

Zhu et al. (July 20, 2020). Articles Immunogenicity and Safety of a Recombinant Adenovirus Type-5-Vectored COVID-19 Vaccine in Healthy Adults Aged 18 Years or Older : A Randomised , Double-Blind , Placebo- Controlled , Phase 2 Trial. The Lancet. https://doi.org/10.1016/S0140-6736(20)31605-6 

• Yuan et al. report that 11% of recovered COVID-19 patients were found to be SARS-CoV-2 RNA positive one or two weeks after hospital discharge, although none were symptomatic at the time of testing. Patients under 18 and patients with shorter hospital stays were more likely to have a positive re-test; no severe cases tested positive after discharge. 

Yuan et al. (July 17, 2020). Recurrence of Positive SARS-CoV-2 Viral RNA in Recovered COVID-19 Patients during Medical Isolation Observation. Scientific Reports. https://doi.org/10.1038/s41598-020-68782-w 

• Reiter et al. used a longitudinal national survey to assess the duration of acute loss of taste and smell associated with COVID-19 infection. After excluding respondents who reported a negative test, they found that after 1-month, 67% reported a return to “very good” or “good” smell and 73% reported a return to “very good” or “good” taste. 

Reiter et al. (July 8, 2020). Subjective Smell and Taste Changes during the COVID-19 Pandemic: Short Term Recovery. American Journal of Otolaryngology. https://doi.org/10.1016/j.amjoto.2020.102639 

• [pre-print, not peer-reviewed] In a systematic review and meta-analysis, Golinelli et al. concluded that SARS-CoV-2 positive individuals are more likely to have blood group A (pooled OR=1.21, 95%CI 1.08-1.37) and less likely to have blood group O (pooled OR=0.76, 95% CI 0.66-0.87). The analysis included 7 studies with 7,524 SARS-CoV-2 positive cases and 2,962,160 controls. 

Golinelli et al. (July 17, 2020). ABO Polymorphism and SARS-CoV-2 Infection – a Meta-Analysis. Pre-print downloaded July 20 from https://doi.org/10.1101/2020.07.17.20155986 

• In conducting post-mortem examinations of 14 people who died with COVID-19 in Washington state, Bradley et al. found coronavirus-like particles in the respiratory system, kidney, and gastrointestinal tract. One decedent had findings of lymphocytic myocarditis, with SARS-CoV-2 RNA detected in the myocardial tissue. All patients had clinically-significant comorbidities, with the most common being hypertension, chronic kidney disease, obstructive sleep apnea, and metabolic disease including diabetes and obesity. 

Bradley et al. (July 16, 2020). Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections in Washington State: A Case Series. The Lancet. https://doi.org/10.1016/S0140-6736(20)31305-2 

• Bilaloglu et al. found that 533 of 3334 (16%) consecutive patients hospitalized in New York City with COVID-19 had thrombotic events diagnosed during routine clinical care. Age, sex, Hispanic ethnicity, coronary artery disease, prior myocardial infarction, and higher D-dimer levels at hospital presentation were associated with a thrombotic event, and all-cause mortality was higher in those who experienced them (43% vs. 21%).  

Bilaloglu et al. (July 20, 2020). Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System. JAMA. https://doi.org/10.1001/jama.2020.13372 

• [pre-print, not peer-reviewed] Wilson et al. constructed a model to estimate the length of quarantine necessary to bring the risk of infection below a given threshold based on the degree of contact with an infected person. The model fits the framework of the Google/Apple Exposure Notification API, in which both the transmitter and the receiver carry Bluetooth-enabled devices that detect their proximity.   

Wilson et al. (July 19, 2020). Quantifying SARS-CoV-2 Infection Risk within the Apple/Google Exposure Notification Framework to Inform Quarantine Recommendations. Pre-print downloaded July 20 from https://doi.org/10.1101/2020.07.17.20156539 

• Kretzschmar et al. used a model to demonstrate the relative importance of minimizing delays and maximizing coverage of contact tracing and testing. With a delay of three days or longer in testing and tracing, even complete coverage of contacts was not sufficient to reach R values below 1, which would lead to decline of the epidemic.  

Kretzschmar et al. (July 16, 2020). Impact of Delays on Effectiveness of Contact Tracing Strategies for COVID-19: A Modelling Study. The Lancet Public Health. https://doi.org/10.1016/S2468-2667(20)30157-2