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July 15, 2020
Association Between Universal Masking in a Health Care System and SARS-CoV-2 Positivity Among Health Care Workers
Among 9,850 health care workers Massachusetts between March 1 and April 30, 2020 13% were positive for SARS-CoV-2 by RT-PCR. Prior to implementation of universal masking (March 1-24, 2020), the SARS-CoV-2 positivity rate increased exponentially from 0% to 21%, with a case doubling time of 3.6 days (95%CI 3.0-4.5 days). After implementation of universal masking (April 11-30, 2020), the positivity rate decreased linearly from 14.7% to 11.5%, with a weighted mean…
Comparison of Mortality Risk in Patients with Cirrhosis and COVID-19 Compared with Patients with Cirrhosis Alone and COVID-19 Alone: Multicentre Matched Cohort
A multicenter study in the US compared 37 inpatients with cirrhosis and COVID-19 to age– and gender-matched patients with COVID-19 alone (n=108) or cirrhosis alone (n=127). Results showed that patients with cirrhosis and COVID-19 had a non-significantly higher mortality compared to patients with cirrhosis alone (30% vs 20%, p=0.16), and significantly higher mortality than patients with COVID-19 alone (30% vs 13%, p=0.03). The elevated mortality among those with cirrhosis and COVID-19 may…
An MRNA Vaccine against SARS-CoV-2 — Preliminary Report
The candidate vaccine mRNA-1273 was shown to induce antibody and T-cell immune responses in all participants (n=45). Jackson et al. conducted a phase 1, dose-escalation, open-label trial including 45 healthy adults, to test the candidate vaccine mRNA-1273 encoding the stabilized prefusion of SARS-CoV-2 spike protein. Participants received two vaccinations, 28 days apart in three dose groups. After the first vaccination,…
SARS-CoV-2 Antibody Responses Do Not Predict COVID-19 Disease Severity
Based on a sample of 172 suspected cases of SARS-CoV-2 and 795 negative plasma samples, IgG antibody testing had a 100% specificity (0/795) and IgG tests were positive for 83% of suspected cases among samples collected more than 14 days from symptom onset. There was no association between the level of IgG and IgM reactivity and mild versus severe disease course. Phipps et al. (July 15, 2020)….
At What Times during Infection Is SARS-CoV-2 Detectable and No Longer Detectable Using RT-PCR Based Tests A Systematic Review of Individual Participant Data
[Preprint, not peer-reviewed] A systematic review (32 studies with 1,023 SARS-CoV-2 infected patients) showed the highest percentage of detection of SARS-CoV-2 by RT-PCR was from nasopharyngeal sampling between 0 to 4 days post-symptom onset at 89% (95%CI 83%-93%). The percentage dropped to 54% (95%CI 47%-61%) after 10 to 14 days. Up to 30% of participants with SARS-CoV-2 detected in respiratory samples did not have detectable…
Significantly Improved COVID-19 Outcomes in Countries with Higher BCG Vaccination Coverage: A Multivariable Analysis
An ecological study conducted by Klinger et al. find a strong negative correlation between the years of BCG administration and the deaths per million from COVID-19 based on data from 55 countries. Countries with BCG immunization policies over the past 15 years have a significantly lower rate of COVID-19 deaths than countries with no BCG in last 15 years (p=0.0004). [EDITORIAL NOTE: Results from ecological…
Detection of SARS-CoV-2 RNA in Commercial Passenger Aircraft and Cruise Ship Wastewater: A Surveillance Tool for Assessing the Presence of COVID-19 Infected Travelers
Detection of SARS-CoV-2 RNA was reported in 21 samples from aircraft and cruise ship wastewater sanitation systems (adsorption-extraction by electronegative membrane [n=13] and ultrafiltration by Amicon [n=8]). Concentrations were near the limit of detection for the assay. Findings suggested the surveillance of wastewater from large transport vessels with their own sanitation systems could be a complementary data source to prioritize clinical testing and contact tracing…
Transplacental Transmission of SARS-CoV-2 Infection
Vivanti et al. demonstrated a transplacental transmission of SARS-CoV-2 in a neonate born to a mother infected in the third trimester and delivered at the Paris Saclay University Hospitals. RT-PCR testing for SARS-CoV-2 was positive from multiple sites from the neonate, including blood, bronchoalveolar lavage fluid, nasopharyngeal and rectal swabs, and placental samples. The neonate presented with neurological manifestations, similar to those described in adult patients. Vivanti et al. (Dec 14, 2020). Transplacental Transmission of SARS-CoV-2 Infection. Nature…
Age-Specific Social Mixing of School-Aged Children in a US Setting Using Proximity Detecting Sensors and Contact Surveys
[Preprint, not peer-reviewed] Grantz et al. compared data from self-reported contact surveys and wearable proximity sensors from 730 schoolchildren in the Pittsburgh metropolitan area. The two methods produced highly correlated data on age-specific mixing patterns relevant to the dynamics of respiratory virus transmission. The results from the methods differed in that participants reported fewer but longer contacts in surveys relative…
July 14, 2020
Investigation and Serologic Follow-Up of Contacts of Early Confirmed Case-Patient with COVID-19, United States
A contact investigation for an early confirmed COVID-19 case from Washington State identified 50 contacts, none of whom had evidence of SARS-CoV-2 infection through 6 weeks of follow-up. All contacts were monitored daily for 14 days following exposure. Eight developed symptoms but tested negative via rRT-PCR. Thirty-eight contacts underwent voluntary enhanced contact investigation, revealing varying degrees of unprotected face-to-face interactions with the case-patient. Negative rRT-PCR and serologic follow–up collected approximately 6 weeks post exposure suggest…
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