Article Summary
May 4, 2020
Longitudinal Change of SARS-Cov2 Antibodies in Patients with COVID-19
Antibody tests designed to detect envelope protein E and nucleocapsid protein N were conducted on 112 COVID-19 (PCR positive) patients admitted to a hospital in Wuhan, China in February 2020. One hundred and five (93.8%) were positive for either IgM, IgG, or both. Timing of testing with respect to disease onset varied, and was less than 10 days (i.e., possibly prior to antibody production) for…
Early Detection of SARS-CoV-2 Antibodies in COVID-19 Patients as a Serologic Marker of Infection
Using CHO cell expressed full length SARS-CoV-2 S1 protein as capturing antigen, Zhao et al. develop and validate a rapid COVID-19 serology ELISA kit able to detect SARS-CoV-2 antibody 1 day after the onset of COVID-19. The reported specificity and sensitivity of the ELISA kit was 97.5% and 97.1%, respectively, with overall accuracy rate of 97.3% (based on…
Evaluation of COVID-19 RT-QPCR Test in Multi-Sample Pools
Many healthcare systems are experiencing shortages of reagents for SARS-CoV-2 diagnostic testing. These authors were able to detect a single positive sample in pools of up to 32 negative samples, either before or after RNA extraction, with an estimated false negative rate of 10%. Single positive samples could also be recovered from pools of 64 (the highest…
Remdesivir in Adults with Severe COVID-19 : A Randomised, double-blind, placebo-controlled, multicentre trial
A randomized, double-blind, placebo controlled multicenter trial at ten hospitals in Hubei, China with 237 participants (158 randomized to remdesivir, 79 to placebo) demonstrated that time to clinical improvement did not differ by study arm, with 21 days (IQR 13-28 days) in the remdesivir group versus 23 days (IQR 15-28 days) in the placebo group (HR 1.23, 95% CI 0.87 – 1.75). Overall frequency of adverse events was similar in both…
Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19)
Use of hydroxychloroquine can increase the risk of corrected QT (QTc) prolongation, a type of cardiac arrhythmia. Among 90 patients in an academic tertiary care center in Boston with at least one positive test for SARS-CoV-2, QTc was significantly longer after initiation of hydroxychloroquine, and this effect stronger for patients receiving both hydroxychloroquine and azithromycin. The authors recommend judicious…
Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19
Using medical records from 169 hospitals in Asia, Europe, and North America, from 8,910 COVID-19 patients with known discharge status, these authors found the following factors were positively association with risk of death (i.e., higher value of the factor associated with higher risk of death): age >65 years, coronary artery disease, heart failure, cardiac arrhythmia, COPD, current smoking. Odds ratio were between 1.79 and 2.95 for all factors. For…
Direct Observation of Repeated Infections with Endemic Coronaviruses
Galanti and Shaman demonstrate that reinfections with the same endemic coronaviruses (HKU1, 229E, NL63, and OC43) are not unusual within a >1 year time window. Analyzing data collected through proactive sampling (nasal swab and self-report) in NYC from fall 2016 to spring 2018, 12 out of the 191 participants experienced one or more reinfection, with time of reoccurrence ranging…
Estimation of SARS-CoV-2 Emissions from Non-Symptomatic Cases
Previous studies have shown high levels of SARS-CoV-2 in swab and sputum samples from individuals with no or mild symptoms of COVID-19. The authors modeled the airborne concentration of SARS-CoV-2 in a room the size of a small office or examination room using data on the distribution of aerosol sizes in exhaled breath generated by coughing…
Population-Scale Testing Can Suppress the Spread of COVID-19
Authors in Sweden demonstrate that identification and isolation of the majority of infectious individuals (including those who are asymptomatic) by testing the entire population, repeatedly (i.e., through home test kits submitted by mail), would yield R0<1. False positives can be tolerated as this would simply result in unnecessary quarantine, and the authors model the impact of false negatives using both a standard epidemiological model…
May 3, 2020
Direct Diagnostic Testing of SARS-CoV-2 without the Need for Prior RNA Extraction
[pre-print, not peer reviewed] Wei et al. report on a novel method for nucleic acid amplification testing (NAAT) for point-of-care SARS-CoV-2 diagnostic testing [Loop-mediated isothermal amplification (LAMP)]. This assay can be run directly on transport media following a nasopharyngeal swab without requiring an RNA extraction step prior to amplification of the viral RNA, and provides results in 30 minutes. The…
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