COVID-19 Literature Situation Report Sept. 3, 2020

• Based on location data from mobile devices, mandatory stay-at-home orders issued by states or territories were associated with decreased median population movement compared to the period before orders were implemented. The period after the first state relaxed a stay-at-home order was associated with increased population movement even in states or territories that still had a mandate in place. The analysis included all 50 US states, the District of Columbia, and five US territories.

Moreland et al. (Sept 4, 2020). Timing of State and Territorial COVID-19 Stay-at-Home Orders and Changes in Population Movement — United States, March 1–May 31, 2020. MMWR. https://doi.org/10.15585/mmwr.mm6935a2

• [Pre-print, not peer reviewed] Clipman et al. found strong dose-response relationships between frequency of movement (e.g. traveling for non-essential services) and self-reported SARS-CoV-2 positivity. Social distancing practices were associated with a lower likelihood of reporting a history of SARS-CoV-2 infection. Travel using public transport and visiting a place of worship were also associated with a history of SARS-CoV-2 infection, even after adjusting for social distancing. These findings were based on sampling of 1,030 individuals in Maryland.

Clipman et al. (Aug 1, 2020). Rapid Real-Time Tracking of Non-Pharmaceutical Interventions and Their Association SARS-CoV-2 Positivity: The COVID-19 Pandemic Pulse Study. Pre-print downloaded Sep 3 from https://doi.org/10.1101/2020.07.29.20164665

• [Pre-print, not peer reviewed] A modeling analysis considering air flow and aerosol transport parameters suggests that physical distancing guidelines should also include a contact time recommendation. The authors recommend less than 5 minutes of contact at a distance of one meter apart and less than 15 minutes for two meters apart in scenarios where an asymptomatic individual is speaking to a susceptible individual in a poorly ventilated environment with neither person wearing a mask.
• If the asymptomatic individual is a superspreader, the infection risk is high within less than one minute at three meters of separation.

Yang et al. (Sept 2, 2020). Towards Improved Social Distancing Guidelines Space and Time Dependence of Virus Transmission from Speech-Driven Aerosol Transport Between Two Individuals. Pre-print downloaded Sep 3 from https://doi.org/10.1101/2020.08.31.20185439

• Intravenous dexamethasone plus standard of care compared with standard care alone resulted in 2.3 days (95%CI 0.02-4.4, p=0.04) more ventilator-free days during the first 28 days in a randomized clinical trial among patients with COVID-19 who had moderate to severe respiratory failure (n=299) in Brazil.
• The trial was stopped early before reaching the planned sample size of 350 patients following publication of a related study.

Tomazini et al. (Sept 2, 2020). Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19. JAMA. https://doi.org/10.1001/jama.2020.17021

• Administration of hydrocortisone, either as a 7-day fixed-dose course, or dosing only during periods of shock, was associated with being alive and free of ICU-based respiratory or cardiovascular support within 21 days, according to findings of a randomized control trial (n=384) which was stopped early after results were released from another trial. The fixed-dose course and shock-dependent dosing resulted in Bayesian probabilities of superiority of 93% and 80%, respectively.

Angus et al. (Sept 2, 2020). Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19. JAMA. https://doi.org/10.1001/jama.2020.17022

• Greater disease severity was associated with higher levels of serum neutralizing capacity among 59 patients recovered from COVID-19 in China. Generation of antibodies capable of completely neutralizing pseudovirus was observed in 80% of patients who recovered from severe illness, while asymptomatic patients failed to generate competent neutralizing antibodies. Complete neutralization was observed in 47% of recovered patients with moderate symptoms and 25% of those with mild symptoms.

Chen et al. (Sept 2, 2020). Disease Severity Dictates SARS-CoV-2-Specific Neutralizing Antibody Responses in COVID-19. Signal Transduction and Targeted Therapy. https://doi.org/10.1038/s41392-020-00301-9

• NVX-CoV2373, a recombinant nanoparticle vaccine, induced higher levels of anti-spike IgG and neutralizing antibody responses compared to convalescent serum of mostly symptomatic COVID-19 patients. There were no serious adverse events, and events such as fever and sore arm were mild and not long-lasting. These results were from a primary analysis at day 35 of a randomized control trial (n=83). [EDITORIAL NOTE: A summary of a pre-print version of this manuscript appeared in the Lit Rep on August 6]

Keech et al. (Sept 2, 2020). Phase 1–2 Trial of a SARS-CoV-2 Recombinant Spike Protein Nanoparticle Vaccine. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa2026920

• A survey of young people (age 16-24 years; n=2,372) in Mexico found 53% did not adhere to COVID-19 prevention guidelines. Among respondents with asthma, 31% did not comply with basic prevention guidelines. Among those with asthma, male sex, active smoker status, and belief that COVID-19 does not more severely affect people with asthma were associated with non-adherence to guidelines.

Vázquez-Nava et al. (Sept 2, 2020). Risk Factors of Non-Adherence to Guidelines for the Prevention of COVID-19 among Young Adults with Asthma in a Region with a High Risk of a COVID-19 Outbreak. Journal of Asthma. https://doi.org/10.1080/02770903.2020.1818774

• [Pre-print, not peer reviewed] The 7-day average percentage of SARS-CoV-2 test positivity among people who had died and were identified as possible recent COVID-19 cases and were posthumously tested (n=237) closely matched the trajectory of percent positivity in the catchment population, according to the Wayne County Medical Examiner’s office in Michigan.
• SARS-CoV-2 positive flagged decedents were more likely to be Black compared to a random sample of known positive decedents (89% vs 51%).

Brouwer et al. (Aug 7, 2020). SARS-CoV-2 Surveillance in Decedents in a Large Urban Medical Examiner’s Office. Pre-print downloaded Sep 3 from https://doi.org/10.1101/2020.08.03.20162883

• The overall infection fatality ratio (IFR) for the state of Indiana, excluding institutionalized persons and children under 12 years of age, was 0.3%. Stratifying the IFR across demographic groups resulted in an IFR of 0.01% among those <40 years of age, 1.7% among those ≥60 years of age, 0.2 among white patients, and 0.6% among non-white patients. The investigators used a statewide non-random sample to obtain 187,802 cumulative infections.

Blackburn et al. (Sept 2, 2020). Infection Fatality Ratios for COVID-19 Among Noninstitutionalized Persons 12 and Older: Results of a Random-Sample Prevalence Study. Annals of Internal Medicine. https://doi.org/10.7326/M20-5352