COVID-19 Literature Situation Report Sept. 28, 2020

• The act of speaking, particularly during a conversation, can create air currents that can transport exhaled breath in a directed pattern out to 2 meters (6 feet), and potentially further, during a 30 second conversation.

Abkarian et al. (Sept 25, 2020). Speech Can Produce Jet-like Transport Relevant to Asymptomatic Spreading of Virus. Proceedings of the National Academy of Sciences. https://doi.org/10.1073/pnas.2012156117

• In a large sample of US adults who received dialysis (n=28,503), the seroprevalence of antibodies against SARS-CoV-2 was 8.0%, ranging from 3.5% in the west to 27.2% in the northeast. Seropositivity was higher in neighborhoods with predominantly non-Hispanic Black (OR=3.9) and Hispanic (OR=2.3) residents (vs white) and neighborhoods in the highest population density quintile (OR=10.3) (vs lowest quintile). Counties with mobility restrictions reducing workplace visits by at least 5% in early March, 2020 had lower seropositivity in July, 2020 than counties with reductions of less than 5% (OR=0.4).

Anand et al. (Sept 25, 2020). Prevalence of SARS-CoV-2 Antibodies in a Large Nationwide Sample of Patients on Dialysis in the USA: A Cross-Sectional Study. The Lancet. https://doi.org/10.1016/S0140-6736(20)32009-2

• A study that conducted mass screening for SARS-CoV-2 among two cohorts of asymptomatic persons in Japan, a contact tracing cohort (n=161) and an airport quarantine cohort (n=1,763), reported the overall sensitivity of RT-PCR testing with nasopharyngeal (NP) swabs was 86% and saliva samples was 92%, with specificity for both samples >99.9%. Due to the lack of a “gold standard” a Bayesian latent class model was used to estimate the test parameters. The true concordance probability between the NP and saliva tests was estimated at 99.8% in a setting with a prevalence of 0.3%.

Yokota et al. (Sept 25, 2020). Mass Screening of Asymptomatic Persons for SARS-CoV-2 Using Saliva. Clinical Infectious Diseases. https://doi.org/10.1093/cid/ciaa1388

• A cross-sectional study in the New York City region reported that 99.5% patients with PCR-confirmed SARS-CoV-2 infection (n=624) and 37% patients with suspected SARS-CoV-2 infection (n=719) showed evidence of seroconversion with anti-SARS-CoV-2 spike antibodies detected 4 weeks after the illness. PCR positivity was detected up to 28 days from symptom resolution.

Wajnberg et al. (Sept 25, 2020). Humoral Response and PCR Positivity in Patients with COVID-19 in the New York City Region, USA: An Observational Study. The Lancet Microbe. https://doi.org/10.1016/S2666-5247(20)30120-8

• Using national-level surveillance data from April to August in Italy, Signorelli and Odone reported the case fatality of COVID-19 varied significantly by age (ranging from 0.1-2.8% in people <60 years up to 29-35% in people ³80 years). However, the age-specific rates were similar over time, as estimated at 2, 4 and 6 months since the onset of the epidemic. The authors conclude that the less severe COVID-19 clinical outcomes reported recently in Italy and other European sites may be due an increasing proportion of infections occurring in younger age groups.

Signorelli and Odone. (Sept 25, 2020). Age-Specific COVID-19 Case-Fatality Rate: No Evidence of Changes over Time. International Journal of Public Health. https://doi.org/10.1007/s00038-020-01486-0

• During 2 weeks in March in Milwaukee, Wisconsin, COVID-19 incidence was higher among Black residents (vs. White: OR=5.4). Adjusting for zip code of residence, Black race (aOR=1.8) and poverty (aOR=3.8) were associated with a greater likelihood of have COVID-19, but only poverty was associated with COVID-19 ICU admission (aOR=3.6).

Muñoz-Price et al. (Sept 25, 2020). Racial Disparities in Incidence and Outcomes Among Patients With COVID-19. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2020.21892

• The incidence of SARS-CoV-2 infection in school-age children increased from March and peaked in July and August, followed by a decline in September. During March 1–September 19, 2020, the US reported a total of 277,285 laboratory-confirmed cases of COVID-19 in school-aged children. The average weekly COVID-19 incidence among adolescents aged 12–17 years was approximately 2-fold higher than among children aged 5–11 years (37.4 vs. 19.0 per 100,000). The weekly incidence increased to a peak of 34-38 per 100,000 in July and August and decreased with a slight rebound to 23-26 per 100,000 in early September. Trends in incidence were similar among both age groups.
• The authors note that these estimates provide a baseline to monitor transmission among school age children as schools reopen for in-person learning in some districts around the country.

Leeb et al. (Sept 28, 2020). COVID-19 Trends Among School-Aged Children — United States, March 1–September 19, 2020. MMWR. https://doi.org/10.15585/mmwr.mm6939e2

• The risk of vertical transmission of SARS-CoV-2 was very low in a multinational cohort of 250 neonates born to pregnant women with COVID-19, with only 1 infant (0.4%) testing positive by RT-PCR of pharyngeal swabs performed after delivery. The infant who tested positive was asymptomatic and had a negative RT-PCR test after 14 days of life. Overall, 7% experienced a composite adverse fetal outcome (6 miscarriage, 10 with intrauterine growth restriction, and 5 neonatal death).

Di Mascio et al. (Sept 25, 2020). Risk Factors Associated with Adverse Fetal Outcomes in Pregnancies Affected by Coronavirus Disease 2019 (COVID-19): A Secondary Analysis of the WAPM Study on COVID-19. Journal of Perinatal Medicine. https://doi.org/10.1515/jpm-2020-0355

• [Pre-print, not peer-reviewed] A systematic review of 12 studies found that receiving seasonal influenza vaccination was not associated with greater risk of SARS-CoV-2 infection or disease severity in any studies. Several studies found that influenza vaccination was associated with lower risk of SARS-CoV-2 infection, while others found no relationship (7 studies, 242,323 patients). Similarly, several studies found that influenza vaccination was associated with reduced severity of COVID-19 severity, while others found no relationship (5 studies, 111,820).

Riccio et al. (Sept 27, 2020). The Association between Influenza Vaccination and the Risk of SARS-CoV-2 Infection Severe Illness and Death a Systematic Review of the Literature. Pre-print downloaded Sept 28 from https://doi.org/10.1101/2020.09.25.20201350

• Despite a higher incidence of COVID-19 and a higher proportion of positive test results, non-Hispanic Black and Hispanic patients with COVID-19 had slightly lower risk of death than their non-Hispanic white counterparts (aHR=0.8, p=0.03 for Non-Hispanic Black and aHR=0.7, p=0.002 for Hispanic patients). These findings were based on a cohort study conducted at a medical center in New York City between March 14 and April 15, 2020 with 9,268 patients tested for SARS-CoV-2.

Kabarriti et al. (Sept 25, 2020). Association of Race and Ethnicity With Comorbidities and Survival Among Patients With COVID-19 at an Urban Medical Center in New York. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2020.19795

• [Pre-print, not peer-reviewed] In a national longitudinal survey in Australia (April-June), 49% of people strongly agreed they would get tested if they had COVID-19 symptoms and 96% agreed to some extent that they would get tested. Common barriers to testing were the belief that testing is painful (11%), not knowing how to get tested (7%), and worry about getting infected at the testing center (5%).

Bonner et al. (Sept 25, 2020). Behavioural Barriers to COVID-19 Testing in Australia. Pre-print downloaded Sept from 28 from https://doi.org/10.1101/2020.09.24.20201236

• [Pre-print, not peer-reviewed] Youth soccer clubs in the US involving 85,861 players that had restarted in-person activities reported 218 COVID-19 cases among their members. None of the cases resulted in hospitalization or death. The authors used these cases to estimate the incidence of COVID-19 among youth soccer athletes and concluded that it was lower than the overall national rate for children in the US (254 vs 477 cases per 100,000). No relationship was identified between club COVID-19 incidence and phase of return to soccer. Youth soccer clubs universally report implementing risk reduction procedures.

Watson et al. (Sept 27, 2020). COVID-19 in Youth Soccer. Pre-print downloaded Sept 28 from https://doi.org/10.1101/2020.09.25.20201616