COVID-19 LITERATURE SITUATION REPORT DEC. 16, 2020

A study of the impacts of shelter-in-place policies in Texas found that the growth rate of COVID-19 cases and deaths decreased when a large percentage of the population stayed home. The greatest number of people sheltering occurred during the first week of the policy implementation, and steadily declined thereafter. The study did not find evidence that a top-down restrictive policy increased the number of people who practiced social distancing, and the authors suggest that shelter-in-place policies may be more effective at the local level.

Castaneda and Saygili. (Nov 26, 2020). The Effect of Shelter-in-Place Orders on Social Distancing and the Spread of the COVID-19 Pandemic: A Study of Texas. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2020.596607

A higher degree of connectedness between nursing homes via shared staff and contractors was associated with reporting COVID-19 cases. A large-scale analysis of nursing home connections via shared staff and contractors that used smartphone geolocation data found that 5% of smartphone users who visited a nursing home for at least one hour also visited another facility during the 11-week study period following the nationwide restrictions on nursing home visitors implemented in March. The analysis indicated that on average, nursing homes share connections with 7.1 other facilities, and that the number and strength of connections between nursing homes, as well as the home’s network centrality, were strongly predictive of the presence of COVID-19 cases after controlling for location, demographic variables, number of beds, and CMS quality ratings.

Chen et al. (Jan 2021). Nursing Home Staff Networks and COVID-19. Proceedings of the National Academy of Sciences of the United States of America. https://www.pnas.org/content/118/1/e2015455118

A retrospective observational study of sustained SARS-CoV-2 RT-PCR positivity in children found that of 989 pediatric patients who had tested positive, 172 had multiple subsequent tests over months, of whom 68 had two or more consecutive positive tests (median interval 14 days), and 27 of those 68 had sustained-positive status (median 26 days). In addition, four patients were suspected to have been reinfected, defined as testing positive within one to three weeks of testing negative.

Patwardhan. (Dec 10, 2020). Sustained Positivity and Reinfection With SARS-CoV-2 in Children: Does Quarantine/Isolation Period Need Reconsideration in a Pediatric Population? Cureus. https://doi.org/10.7759/cureus.12012

A descriptive study of target populations for SARS-CoV-2 vaccination among member states of the WHO found that target population sizes vary by vaccination goal and geographic region. Europe has a high share of essential workers (63 million, 9%) and people with underlying conditions (266 million, 37%) who may be important to vaccinate to maintain societal function and reduce severe COVID-19 cases. Southeast Asia has a high proportion of healthy adults (775.5 million, 59%) that may be key targets for vaccination to reduce community transmission. The study highlights that based on a literature review, 68% of the global population would be willing to receive the vaccine, which translates to about 3.7 billion adults. 

Wang et al. (Dec 15, 2020). Global, Regional, and National Estimates of Target Population Sizes for Covid-19 Vaccination: Descriptive Study. BMJ. https://doi.org/10.1136/bmj.m4704

A study assessing the durability of neutralizing antibody responses (nAb) and factors to streamline plasma donor selection found that nAb titers correlated with COVID-19 severity (aOR=6.59), age (aOR=1.03 per year), and male sex (aOR=2.08). Functional levels declined over time and a small number of individuals (2.8%) who recovered from COVID-19 lacked adaptive immune responses. Of 250 people studied a mean of 67 days after symptom onset, 97% were seropositive on at least one assay. 

Boonyaratanakornkit et al. (Dec 15, 2020). Clinical, Laboratory, and Temporal Predictors of Neutralizing Antibodies to SARS-CoV-2 among COVID-19 Convalescent Plasma Donor Candidates. Journal of Clinical Investigation. https://doi.org/10.1172/JCI144930

A study of neuroimaging manifestations in 38 children from 8 countries identified acute- and delayed-phase SARS-CoV-2-related central nervous system abnormalities ranging from mild to severe. The most common imaging patterns observed were immune-mediated disseminated encephalomyelitis-like changes of the brain (n=16), myelitis (n=8), and neural enhancement (n=13). Splenial lesions (n=7) and myositis (n=4) were predominantly observed in children with multisystem inflammatory syndrome. While most children had favorable outcomes, fatal atypical CNS co-infections were observed in four previously health children.

Lindan et al. (Dec 16, 2020). Neuroimaging Manifestations in Children with SARS-CoV-2 Infection: A Multinational, Multicentre Collaborative Study. The Lancet Child & Adolescent Health. https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30362-X/fulltext

A study of suicide patterns in Maryland during the COVID-19 pandemic found that completed suicides approximately doubled in residents who identified as Black whereas completed suicides were approximately halved in white residents. The authors reached their conclusions by comparing medical examiner records from 2020 to records from 2017 to 2019. Population size did not change substantially between 2017 and 2019. The authors highlight the need for policy interventions and targeted resource allocation to mitigate disparities impacting Black residents. 

Bray et al. (Dec 16, 2020). Racial Differences in Statewide Suicide Mortality Trends in Maryland During the Coronavirus Disease 2019 (COVID-19) Pandemic. JAMA Psychiatry. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2020.3938

The COVID-19 pandemic was associated with increases in all-cause mortality among US adults aged 25-44 from March to July of 2020. 38% of all-cause excess deaths in this age group were attributed directly to COVID-19, and while the remaining excess deaths are unexplained, the authors posit that inadequate SARS-CoV-2 testing likely contributed to the discrepancy. During surges in COVID-19 in HHS Region 2 (New York, New Jersey), the incident rate of all-cause mortality was increased by 130% relative to pre-pandemic levels and 80% of deaths were related to COVID-19. In Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, Texas) there was a 46% increase in the mortality rate and 48% were related to COVID-19. In Region 9 (Arizona, California, Hawaii, Nevada) there was a 47% increase in mortality and 40% were attributed to COVID-19. Deaths due to COVID-19 were similar to or exceeded unintentional opioid deaths that occurred during several corresponding months in 2018 in several regions.

Faust et al. (Dec 16, 2020). All-Cause Excess Mortality and COVID-19–Related Mortality Among US Adults Aged 25-44 Years, March-July 2020. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2774445