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July 23, 2020
Potent Neutralizing Antibodies Directed to Multiple Epitopes on SARS-CoV-2 Spike
A large number of monoclonal antibodies that potently neutralize the SARS-CoV-2 virus were identified from COVID-19 cases from New York. Liu et al. report the isolation of 61 SARS-CoV-2-neutralizing monoclonal antibodies from 5 infected patients hospitalized with severe disease at the Columbia University Irving Medical Center in New York City. Among these are 19 antibodies that potently…
Delaying the COVID-19 Epidemic in Australia: Evaluating the Effectiveness of International Travel Bans
Adekunle et al. estimated that there was a 79% reduction in imported COVID-19 cases in Australia as of March 2, 2020 and a one-month delay in the COVID-19 outbreak that was attributable to the travel bans imposed on January 24, 2020. Their model results aligned with the observed imported cases in Australia. Adekunle et al. (July 22, 2020). Delaying the COVID-19 Epidemic in Australia:…
The Effect of Border Controls on the Risk of COVID-19 Reincursion from International Arrivals
[Preprint, not peer reviewed] Steyn et al. predicted the risk of undetected COVID-19 cases within managed isolation and quarantine facilities and the risk of infectious cases being released into the community using data during a two-week period (June 23 to July 6, 2020) in New Zealand. Under the current 14-day quarantine order, a combination of testing on days 3 and 12, daily symptom checks, and complete isolation…
Estimated County-Level Prevalence of Selected Underlying Medical Conditions Associated with Increased Risk for Severe COVID-19 Illness — United States, 2018
Based on data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) survey, the median county prevalence of any of five underlying medical conditions (chronic obstructive pulmonary disease, heart disease, diabetes, chronic kidney disease, and obesity) that are associated with increased risk for severe COVID-19 disease was 47% across 3,142 U.S. counties. While the total number of those with co-morbidities follows the overall population distribution, the prevalence of co-morbidities is higher in the southeastern United States and…
The Contribution of the Age Distribution of Cases to COVID-19 Case Fatality Across Countries: A 9-Country Demographic Study
In a cross-sectional study using population-based data on COVID-19 cases and deaths in 9 countries, Sudharsanan et al. observed an overall large variation in case-fatality. The highest case-fatality was reported in Italy (9.3%), and the lowest in Germany (0.7%). Adjustment for the age distribution of cases explains 66% of the between-country variation. The resulting age-standardized median…
Risk Factors Associated With Mortality Among Residents With Coronavirus Disease 2019 (COVID-19) in Long-Term Care Facilities in Ontario, Canada
Based on a cohort study among 627 long-term care (LTC) facilities in Ontario, Canada, the incidence of deaths related to COVID-19 was 13-fold higher among LTC residents compared to adults older than 69 years living in the community. This excess risk increased from 8-fold to 87-fold between March 29 and April 11. Infection among LTC staff was associated with death among residents with a 6-day lag. Fisman et al….
Historically Controlled Comparison of Glucocorticoids with or without Tocilizumab versus Supportive Care Only in Patients with COVID-19-Associated Cytokine Storm Syndrome: Results of the CHIC Study
Ramiro et al. evaluated clinical records of 86 patients with severe COVID-19-associated cytokine storm syndrome who received an intensive course of glucocorticoids. Compared to an untreated historical group of patients who received supportive care only (1:1 match on sex and age), treated patients had a higher rate of reaching respiratory recovery (HR=1.8), were less likely to die (HR=0.35), and had a lower rate of invasive mechanical ventilation (HR=0.29). Ramiro et al….
Chloroquine Does Not Inhibit Infection of Human Lung Cells with SARS-CoV-2
TMPRSS2 is a cellular protease gene that activates SARS-CoV-2 for entry into lung cells. Hoffmann et al. report that the engineered expression of TMPRSS2 in ex-vivo Vero cells renders SARS-CoV-2 infection insensitive to chloroquine. Moreover, chloroquine did not block SARS-CoV-2 infection in TMPRSS2-positive lung cells. The authors conclude results indicate that chloroquine targets a pathway for viral activation that is not operative in lung cells and is unlikely to protect against…
Saliva as a Diagnostic Specimen for Detection of SARS-CoV-2 in Suspected Patients: A Scoping Review
A review of 9 studies (293 total samples) found no statistically significant difference in viral loads between saliva, nasopharyngeal, or sputum specimens obtained for the detection of SARS-CoV-2. The authors suggest that these findings indicate that self-collected saliva may be a reliable and non-invasive approach for the detection of SARS-CoV-2 using RT-PCR. Fakheran et al. (July 15, 2020). Saliva as a Diagnostic Specimen for Detection of SARS-CoV-2 in Suspected Patients: A Scoping Review. Infectious Diseases of Poverty. https://doi.org/10.1186/s40249-020-00728-w
Comparison of Unsupervised Home Self-Collected Midnasal Swabs With Clinician-Collected Nasopharyngeal Swabs for Detection of SARS-CoV-2 Infection
Compared to clinician-collected swabs, home-based self-collected swabs had a sensitivity of 80.0% (95% CI: 63–91%) and a specificity of 97.9% (95% CI: 94–99.5%). These results were based on a cohort of 185 symptomatic people who presented at drive-through clinics in Washington State who underwent both an unsupervised home self-collected swab and a clinician-collected nasopharyngeal swabs for diagnosis of SARS-CoV-2 infection by RT-PCR. McCulloch et al. (July 22, 2020). Comparison of Unsupervised Home Self-Collected Midnasal Swabs With Clinician-Collected Nasopharyngeal Swabs…
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