COVID-19 Literature Situation Report August 6, 2020

• Komine-Aizawa et al. performed a narrative review summarizing evidence from pathological examinations of placental tissues in mothers with COVID-19, finding that these tissues are often infected with SARS-CoV-2 although fetuses are not always infected. They review potential mechanisms for SARS-CoV-2 vertical transmission. The authors conclude that although placentas are susceptible to SARS-CoV-2 infection, they may partially protect fetuses. 

Komine-Aizawa et al. (July 25, 2020). Placental Barrier against COVID-19. Placenta. https://doi.org/10.1016/j.placenta.2020.07.022 

• Lee et al. examined viral shedding among asymptomatic (36%) and symptomatic (64%) patients with SARS-CoV-2 infection who were isolated in a community treatment center in South Korea (n=303) and found that viral loads did not differ significantly between the groups based on amplification of 3 viral genes (RdRp, N, env). During isolation, the proportion who converted to a negative RT-PCR test result was similar between asymptomatic and symptomatic patients (34% vs. 30% at day 14, 75% vs. 70% at day 21) without a statistically significant difference in time–to–conversion (median 17 days among asymptomatic v. 19.5 days among symptomatic patients, p-value = 0.07). 

Lee et al. (Aug 6, 2020). Clinical Course and Molecular Viral Shedding Among Asymptomatic and Symptomatic Patients With SARS-CoV-2 Infection in a Community Treatment Center in the Republic of Korea. JAMA Internal Medicine. https://doi.org/doi:10.1001/jamainternmed.2020.3862  

• [Preprint, not peer-reviewed] Cooper et al. isolated CD4 and CD8 memory T cells specific to SARS-CoV-2 spike, nucleocapsid, and membrane antigens from convalescent plasma donors who had recovered from mild SARS-CoV-2 infection. They report that these T cells can be rapidly expanded to therapeutic doses while maintaining the desired central memory phenotype required for protective immune responses against severe COVID-19 infections. 

Cooper et al. (Aug 5, 2020). Rapid GMP-Compliant Expansion of SARS-CoV-2-Specific T Cells from Convalescent Donors for Use as an Allogeneic Cell Therapy for COVID-19. Pre-print downloaded Aug 6 from https://doi.org/10.1101/2020.08.05.237867 

• Goyal et al. performed a cross-sectional study of 1,000 children attending a community-based SARS-CoV-2 testing site from March 21-April 28, 2020 in Washington, DC and determined infection rates by race/ethnicity and estimated median family income (MFI). They found that the infection rates were significantly higher among racial and ethnic minority children (30% among non-Hispanic Black children, 46% among Hispanic children, 7% among non-Hispanic-white children) and among children in less socioeconomically advantaged households (9% in 4th MFI quartile, 24% in 3rd quartile: 27% in 2nd quartile: 38% in 1st quartile).  

Goyal et al. (Aug 1, 2020). Racial/Ethnic and Socioeconomic Disparities of SARS-CoV-2 Infection Among Children. Pediatrics. https://doi.org/10.1542/peds.2020-009951     

• Zheng et al. conducted a meta-analysis of 14 eligible studies (n=410 patients) to estimate the risk of SARS-CoV-2 infection among children. The pooled proportion of asymptomatic infection was 41% (95%CI 24-57%), and the pooled proportion of infections associated with family or household infections was 84% (95% CI 76-90%). No differences by gender were observed.  

Zheng et al. (Aug 5, 2020). An Increasing Public Health Burden Arising from Children Infected with SARS-CoV2: A Systematic Review and Meta-Analysis. Pediatric Pulmonology. https://doi.org/10.1002/ppul.25008  

• Joy et al. used data from a large cohort study in the UK to calculate the excess mortality from COVID-19.  They estimated that the mortality risk between early January and mid-May 2020 was 1,089 per 100,000 person-years. The excess mortality rose steadily from late March to a peak in mid-April, after which it declined.  

Joy et al. (Aug 4, 2020). Excess Mortality from COVID-19 in an English Sentinel Network Population. The Lancet Infectious Diseases. https://doi.org/10.1016/S1473-3099(20)30632-0 

• Among 46,117 healthcare workers at a large New York State health system who underwent SARS-CoV-2 antibody testing, 13.7% were seropositive. In a multivariate analysis, high self-reported suspicion of virus exposure was associated with seropositivity (RR=1.2, 95%CI 1.2-1.3). 
• Seropositivity was significantly lower among healthcare workers with no previous RT-PCR test result (9%, 3077/34251), compared to those with a prior RT-PCR test (34%, 2186/6078). Among individuals with a prior positive RT-PCR test result, 94% (2044/2186) were also seropositive. Among individuals with a prior negative RT-PCR test result, 90% (3490/3892) were also seronegative.  

Moscola et al. (Aug 6, 2020). Prevalence of SARS-CoV-2 Antibodies in Health Care Personnel in the New York City Area. JAMA. https://doi.org/10.1001/jama.2020.14765 

• Kim et al. conducted a cross-sectional telephone survey among patients with pre-existing alcohol disorders (n=182) in London 2 months after lockdown started in the UK. During lockdown, 43 (24%) reported an increase and 34 (19%) reported a decrease in their alcohol intake as assessed by AUDIT score. In a subset of 69 (38%) patients who were abstinent before lockdown, 12 (17%) relapsed during lockdown. Mean AUDIT score within the relapse group was 16 (SD 10), representing a 226% mean increase with a mean weekly consumption of 49 units (SD 63) during lockdown.  

Kim et al. (Aug 4, 2020). Effect of COVID-19 Lockdown on Alcohol Consumption in Patients with Pre-Existing Alcohol Use Disorder. The Lancet Gastroenterology & Hepatology. https://doi.org/10.1016/S2468-1253(20)30251-X 

• Ling et al. collected data at a large, community health system in Georgia from February 1–June 12, 2020 and describe a decrease in heart failure hospitalizations during the emergency declaration and shelter-in-place periods, followed by a return to a level similar to baseline after the reopening. These data were compared to the same period in 2019 (Jan 31 to June 12).  
• The weekly hospitalization admission rate for heart failure during weeks 1-5 (prior to emergency declaration) were comparable (27.4/week in 2019 vs. 28.2/week in 2020). During the state of emergency and shelter-in-place (weeks 6-14), the mean rate of admissions fell by 37% from 33.2/week in 2019 to 21.1/week in 2020 (p<0.001). From weeks 15-19, two weeks after the reopening, the rate returned to a similar level (28.4/week in 2019 vs. 29.8/week in 2020).  

Ling et al. (Aug 2, 2020). Lifting COVID-19 Shelter-in-Place Restrictions: Impact on Heart Failure Hospitalizations in Northeast Georgia. Journal of Cardiac Failure. https://doi.org/10.1016/j.cardfail.2020.07.017  

• Steinberg et al. reported an outbreak of COVID-19 among employees at a meat processing facility in South Dakota during March 16–April 25, 2020. A total of 929 (26%) employees and 210 (9%) of their contacts were diagnosed with COVID-19. Two employees died. The highest attack rates occurred among employees who worked <6 feet from one another on the production line.  

Steinberg et al. (Aug 7, 2020). COVID-19 Outbreak Among Employees at a Meat Processing Facility — South Dakota, March–April 2020. MMWR. https://doi.org/10.15585/mmwr.mm6931a2