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ANH-Intl Covid-19 information tracker - Week 15
Science |
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Origins |
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Global shifts in mammalian population trends reveal key predictors of virus spillover risk Authors: Johnson CK et al Date of publication: 8 April 2020 Journal: Proceedings of the Royal Society B DOI: 10.1098/rspb.2019.2736 Emerging infectious diseases in humans are frequently caused by pathogens originating from animal hosts, and zoonotic disease outbreaks present a major challenge to global health. To investigate drivers of virus spillover, we evaluated the number of viruses mammalian species have shared with humans. We discovered that the number of zoonotic viruses detected in mammalian species scales positively with global species abundance, suggesting that virus transmission risk has been highest from animal species that have increased in abundance and even expanded their range by adapting to human-dominated landscapes. Domesticated species, primates and bats were identified as having more zoonotic viruses than other species. Among threatened wildlife species, those with population reductions owing to exploitation and loss of habitat shared more viruses with humans. Exploitation of wildlife through hunting and trade facilitates close contact between wildlife and humans, and our findings provide further evidence that exploitation, as well as anthropogenic activities that have caused losses in wildlife habitat quality, have increased opportunities for animal–human interactions and facilitated zoonotic disease transmission. Our study provides new evidence for assessing spillover risk from mammalian species and highlights convergent processes whereby the causes of wildlife population declines have facilitated the transmission of animal viruses to humans. |
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Pathogenesis |
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Authors: Wenzhong Lio, Jualan Li Institutions: School of Computer Science and Engineering, Sichuan University of Science & Engineering, Zigong, China, School of Life Science and Food Engineering, Yibin University, Yibin, China Publication date: 30 March 2020 Journal: ChemRXiv The novel coronavirus pneumonia (COVID-19) is an infectious acute respiratory infection caused by the novel coronavirus. The virus is a positive-strand RNA virus with high homology to bat coronavirus. In this study, conserved domain analysis, homology modeling, and molecular docking were used to compare the biological roles of certain proteins of the novel coronavirus. The results showed the ORF8 and surface glycoprotein could bind to the porphyrin, respectively. At the same time, orf1ab, ORF10, and ORF3a proteins could coordinate attack the heme on the 1-beta chain of hemoglobin to dissociate the iron to form the porphyrin. The attack will cause less and less hemoglobin that can carry oxygen and carbon dioxide. The lung cells have extremely intense poisoning and inflammatory due to the inability to exchange carbon dioxide and oxygen frequently, which eventually results in ground-glass-like lung images. The mechanism also interfered with the normal heme anabolic pathway of the human body, is expected to result in human disease. According to the validation analysis of these finds, chloroquine could prevent orf1ab, ORF3a, and ORF10 to attack the heme to form the porphyrin, and inhibit the binding of ORF8 and surface glycoproteins to porphyrins to a certain extent, effectively relieve the symptoms of respiratory distress. Favipiravir could inhibit the envelope protein and ORF7a protein bind to porphyrin, prevent the virus from entering host cells, and catching free porphyrins. Because the novel coronavirus is dependent on porphyrins, it may originate from an ancient virus. Therefore, this research is of high value to contemporary biological experiments, disease prevention, and clinical treatment. Authors: Justin D Silverman and Alex D Washburne Publication date: 3 April 2020 Journal: medRxiv preprint DOI: 10.1101/2020.04.01.20050542 Detection of SARS-CoV-2 infections to date has relied on RT-PCR testing. However, a failure to identify early cases imported to a country, bottlenecks in RT-PCR testing, and the existence of infections which are asymptomatic, sub-clinical, or with an alternative presentation than the standard cough and fever have resulted in an under-counting of the true prevalence of SARS-CoV-2. Here, we show how publicly available CDC influenza-like illness (ILI) outpatient surveillance data can be repurposed to estimate the detection rate of symptomatic SARS-CoV-2 infections. We find a surge of non-influenza ILI above the seasonal average and show that this surge is correlated with COVID case counts across states. By quantifying the number of excess ILI patients in March relative to previous years and comparing excess ILI to confirmed COVID case counts, we estimate the symptomatic case detection rate of SARS-CoV-2 in the US to be 1/100 to 1/1000. This corresponds to approximately 10 million presumed symptomatic SARS-CoV-2 patients across the US during the week starting on March 15, 2020. Combining excess ILI counts with the date of onset of community transmission in the US, we also show that the early epidemic in the US was unlikely to be doubling slower than every three days. Together these results suggest a conceptual model for the COVID epidemic in the US in which rapid spread across the US are combined with a large population of infected patients with presumably mild-to-moderate clinical symptoms. We emphasize the importance of testing these findings with seroprevalence data, and discuss the broader potential to repurpose outpatient time series for early detection and understanding of emerging infectious diseases. Read more... Virological assessment of hospitalized patients with COVID-2019 Authors: Wölfel R et al Publication date: 1 April 2020 Journal: Nature DOI: 10.1038/s41586-020-2196-x Abstract Coronavirus disease 2019 (COVID-19) is an acute respiratory tract infection that emerged in late 20191,2. Initial outbreaks in China involved 13.8% cases with severe, and 6.1% with critical courses3. This severe presentation corresponds to the usage of a virus receptor that is expressed predominantly in the lung2,4. By causing an early onset of severe symptoms, this same receptor tropism is thought to have determined pathogenicity, but also aided the control, of severe acute respiratory syndrome (SARS) in 20035. However, there are reports of COVID-19 cases with mild upper respiratory tract symptoms, suggesting the potential for pre- or oligosymptomatic transmission6–8. There is an urgent need for information on body site-specific virus replication, immunity, and infectivity. Here we provide a detailed virological analysis of nine cases, providing proof of active virus replication in upper respiratory tract tissues. Pharyngeal virus shedding was very high during the first week of symptoms (peak at 7.11 × 108 RNA copies per throat swab, day 4). Infectious virus was readily isolated from throat- and lung-derived samples, but not from stool samples, in spite of high virus RNA concentration. Blood and urine never yielded virus. Active replication in the throat was confirmed by viral replicative RNA intermediates in throat samples. Sequence-distinct virus populations were consistently detected in throat and lung samples from the same patient, proving independent replication. Shedding of viral RNA from sputum outlasted the end of symptoms. Seroconversion occurred after 7 days in 50% of patients (14 days in all), but was not followed by a rapid decline in viral load. COVID-19 can present as a mild upper respiratory tract illness. Active virus replication in the upper respiratory tract puts the prospects of COVID-19 containment in perspective. Read more... |
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Epidemiology |
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Author: Knutt M Wittkowski Publication date: 1st & 2nd April 2020 Source: Pandemic Parallax About one month after the COVID-19 epidemic peaked in Mainland China and SARS-CoV-2 migrated to Europe and then the U.S., the epidemiological data begin to provide important insights into the risks associated with the disease and the effectiveness of intervention strategies such as travel restrictions and social distancing. Respiratory diseases, including the 2003 SARS epidemic, remain only about two months in any given population, although peak incidence and lethality can vary. The epidemiological data suggest that at least two strains of the 2020 SARS-CoV-2 virus have evolved during its migration from Mainland China to Europe. South Korea, Iran, Italy, and Italy’s neighbors were hit by the more dangerous “SKII” variant. While the epidemic in continental Asia is about to end, and in Europe about to level off, the more recent epidemic in the younger US population is still increasing, albeit not exponentially anymore. The peak level will likely depend on which of the strains has entered the U.S. first. The same models that help us to understand the epidemic also help us to choose prevention strategies. Containment of high-risk people, like the elderly, and reducing disease severity, either by vaccination or by early treatment of complications, is the best strategy against a respiratory virus disease. Social distancing or “lockdowns” can be effective during the month following the peak incidence in infections, when the exponential increase of cases ends. Earlier containment of low-risk people merely prolongs the time the virus needs to circulate until the incidence is high enough to initiate “herd immunity”. Later containment is not helpful, unless to prevent a rebound if containment started too early. Authors: Peeri NC et al Publication date: 12 February 2020 Journal: International Journal of Epidemiology DOI: 10.1093/ije/dyaa033 Objectives: To provide an overview of the three major deadly coronaviruses and identify areas for improvement of future preparedness plans, as well as provide a critical assessment of the risk factors and actionable items for stopping their spread, utilizing lessons learned from the first two deadly coronavirus outbreaks, as well as initial reports from the current novel coronavirus (COVID-19) epidemic in Wuhan, China. Methods: Utilizing the Centers for Disease Control and Prevention (CDC, USA) website, and a comprehensive review of PubMed literature, we obtained information regarding clinical signs and symptoms, treatment and diagnosis, transmission methods, protection methods and risk factors for Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS) and COVID-19. Comparisons between the viruses were made. Results: Inadequate risk assessment regarding the urgency of the situation, and limited reporting on the virus within China has, in part, led to the rapid spread of COVID-19 throughout mainland China and into proximal and distant countries. Compared with SARS and MERS, COVID-19 has spread more rapidly, due in part to increased globalization and the focus of the epidemic. Wuhan, China is a large hub connecting the North, South, East and West of China via railways and a major international airport. The availability of connecting flights, the timing of the outbreak during the Chinese (Lunar) New Year, and the massive rail transit hub located in Wuhan has enabled the virus to perforate throughout China, and eventually, globally. Conclusions: We conclude that we did not learn from the two prior epidemics of coronavirus and were ill-prepared to deal with the challenges the COVID-19 epidemic has posed. Future research should attempt to address the uses and implications of internet of things (IoT) technologies for mapping the spread of infection. Read more... COVID-19 Outbreak: An Overview Authors: Ciotti M et al Publication date: 7 April 2020 Journal: Chemotherapy DOI: 10.1159/000507423 Background: In late December 2019, Chinese health authorities reported an outbreak of pneumonia of unknown origin in Wuhan, Hubei Province. Summary: A few days later, the genome of a novel coronavirus was released (http://virological.org/t/novel-2019-coronavirus-genome/319; Wuhan-Hu-1, GenBank accession No. MN908947) and made publicly available to the scientific community. This novel coronavirus was provisionally named 2019-nCoV, now SARS-CoV-2 according to the Coronavirus Study Group of the International Committee on Taxonomy of Viruses. SARS-CoV-2 belongs to the Coronaviridae family, Betacoronavirus genus, subgenus Sarbecovirus. Since its discovery, the virus has spread globally, causing thousands of deaths and having an enormous impact on our health systems and economies. In this review, we summarize the current knowledge about the epidemiology, phylogenesis, homology modeling, and molecular diagnostics of SARS-CoV-2. Key Messages: Phylogenetic analysis is essential to understand viral evolution, whereas homology modeling is important for vaccine strategies and therapies. Highly sensitive and specific diagnostic assays are key to case identification, contact tracing, identification of the animal source, and implementation of control measures. Read more... |
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Mortality & morbidity |
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The COVID-19 Pandemic in the US - A Clinical Update Authors: Saad B Omer PhD, Preeti Malani MD and Carlos del Rio MD Publication date: 6 April 2020 Journal: JAMA DOI: 10.1001/jama.2020.5788 A yet unanswered question that adds to uncertainty around the outbreak involves the case-fatality rate (CFR), defined as the percentage of deaths among all cases. Presently, global mortality is reported at 4.7% but this varies widely by location from a high of 10.8% in Italy to a low of 0.7% in Germany. Several factors influence the CFR including a reliable estimate of the total number of cases. Among the first 140 904 cases in the US, 1.7% died; however, given the uncertainty in the denominator, this is not a reliable CFR estimate. For example, the crude CFR in Wuhan, China, was reported to be 5.8% on February 1, whereas more methodologically robust estimates using novel methods to estimate the actual number of cases reported the CFR as 1.4%.1 In the coming weeks, surge capacity at US hospitals will influence the CFR. However, to have reliable estimates, better approximations of the overall population (denominator) are essential, and methods such as serosurveys using statistical sampling generalizable to the populations of interest will inform these estimates. Epidemiological and Clinical Aspects of COVID-19; a Narrative Review Authors: Kolifarhood G et al Publication date: 1 April 2020 Journal: Archives of Academic Emergency Medicine PMID: 32259130 There are significant misconceptions and many obstacles in the way of illuminating the epidemiological and clinical aspects of COVID-19 as a new emerging epidemic. In addition, usefulness of some evidence published in the context of the recent epidemic for decision making in clinic as well as public health is questionable. However, misinterpreting or ignoring strong evidence in clinical practice and public health probably results in less effective and somehow more harmful decisions for individuals as well as subgroups in general populations of countries in the initial stages of this epidemic. Accordingly, our narrative review appraised epidemiological and clinical aspects of the disease including genetic diversity of coronavirus genus, mode of transmission, incubation period, infectivity, pathogenicity, virulence, immunogenicity, diagnosis, surveillance, clinical case management and also successful measures for preventing its spread in some communities. |
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Tracking |
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Launched by UK-based Kings College London and Guy’s and St Thomas’ Biomedical Research Team to collect data allowing researchers to track the spread of COVID-19 and assess those most at risk. The app encourages users to share data whether you are well or ill. It’s available in the UK and US. New York State Department of Health Covid-19 tracker Lown Institute Covid Curve Tracker Most others charts are based on complex modeling that guesses at how many people will contract the virus and die. We start at the other end: we look at the deaths that have already occurred and create a reference curve based on that data. So the path we project for a region is informed by the known paths already taken by other regions. The reference curve is recalculated each day to include the most recent data. COVID-19 Heat map [UK] Covid-19 heat map of UK. Covid-19 data visualisation pack COVID-19 projections assuming full social distancing through May 2020 Data from The Institute for Health Metrics and Evaluation (IHME) predicting coronavirus disease peaks around the globe. |
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Testing |
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Author: Dr Zoë Harcombe PhD Publication date: 6 April 2020 The key message from the World Health Organization about COVID-19 has been "test, test, test." While much is being said about testing, less is being said about test reliability. There are two key attributes of a medical test – test sensitivity and test specificity. Test sensitivity is the ability of a test to correctly identify those with the disease. Test specificity is the ability of a test to correctly identify those without the disease. “Test, test, test” is the right strategy in principle, but, in practice, test limitations need to be accounted for and other options need to be explored. |
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Covid-19 patients |
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Authors: Grasselli, G MD, Zangrillo Alberto, MD and Zanella A MD et al Publication date: 6 April 2020 Journal: JAMA DOI: 10.1001/jama.2020.5394 Conclusions and Relevance In this case series of critically ill patients with laboratory-confirmed COVID-19 admitted to ICUs in Lombardy, Italy, the majority were older men, a large proportion required mechanical ventilation and high levels of PEEP, and ICU mortality was 26%. Read more... Authors: Sandro Gentil, Felice Strollo and Antonio Ceriello Publication date: 4 April 2020 Journal: Diabetes Research and Clinical Practice DOI: 10.1016/j.diabres.2020.108137 As of today March 27, 2020, 86,499 Italian people have been found to be SARS-CoV2 (leading to COVID-19 disease) positive in terms of viral nucleic acid test results on throat swab samples after January 30, when the epidemic conventionally started based on the first documented case in our country, i.e. Mattia [1]. The latter, classified as patient 1, was asymptomatic when coming back from Germany to Codogno, his hometown, from where the infection exponentially spread to Bergamo, Lombardy, bordering regions and even further. After that he was diagnosed severe lung disease (which is typically characterized by dyspnea, respiratory rate >30/min, <3% blood oxygen saturation, and/or over 50% lung infiltrates), hospitalized in critical condition (mostly contributed by respiratory failure, septic, and multiple organ dysfunction) and kept in the ICU for 20 days. Read more... UK report on 2249 patients critically ill with COVID-19 Report on the first reported 2249 UK patients critically ill with COVID-19. Institution: Intensive Care National Audit & Research Centre (ICNARC) Publication date: 4 April 2020 Read more... Coronavirus (COVID-19) Update: Critical Care Source: JAMA Network Learning Publication date: 3 April 2020 Video interview Noninvasive ventilation (NIV), working with dying patients’ families, use of experimental therapies, and more. JAMA Associate Editor Derek Angus, MD, MPH, Distinguished Professor and Chair of Critical Care Medicine at the University of Pittsburgh, provides a COVID-19 ICU management update for people with very severe respiratory distress. Covid-19 in Critically Ill Patients in the Seattle Region — Case Series Authors: Bhatraju PK et al Publication date: 30 March 2020 Journal: The New England Journal of Medicine DOI: 10.1056/NEJMoa2004500 During the first 3 weeks of the Covid-19 outbreak in the Seattle area, the most common reasons for admission to the ICU were hypoxemic respiratory failure leading to mechanical ventilation, hypotension requiring vasopressor treatment, or both. Mortality among these critically ill patients was high. (Funded by the National Institutes of Health.) Coronavirus Disease-19: The First 7,755 Cases in the Republic of Korea Author: Jeonge K Publication date: 20 March 2020 Journal: Osong Public Health and Research Perspectives DOI: 10.24171/j.phrp.2020.11.2.05 We report the first 7,755 patients with confirmed COVID-19 in Korea as of March 12th, 2020. A total of 66 deaths have been recorded, giving a case fatality proportion of 0.9%. Older people, and those with comorbidities were at a higher risk of a fatal outcome. The highest number of cases of COVID-19 were in Daegu, followed by Gyeongbuk. This summary may help to understand the disease dynamics in the early phase of the COVID-19 outbreaks, and may therefore, guide future public health measures. Read more... Covid-19: a remote assessment in primary care Author: Trish Greenhalgh Publication date: 25 March 2020 Journal: The BMJ DOI: 10.1136/bmj.m1182
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Susceptibility |
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23andMe Engages Its Millions of Research Participants to Study COVID-19 During this global health crisis, 23andMe is activating its millions of consenting research participants to help contribute to our collective understanding of the new virus that causes COVID-19. This week, 23andMe scientists began a study of COVID-19, to understand how genetics may influence the differences in severity of the disease among people. Publication date: 6 April 2020 Source: 23andMe Press release |
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Therapeutics |
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The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro Authors: Caly L et al Publication date: 3 April 2020 Journal: Antiviral Research DOI: 10.1016/j.antiviral.2020.104787 Although several clinical trials are now underway to test possible therapies, the worldwide response to the COVID-19 outbreak has been largely limited to monitoring/containment. We report here that Ivermectin, an FDA-approved anti-parasitic previously shown to have broad-spectrum anti-viral activity in vitro, is an inhibitor of the causative virus (SARS-CoV-2), with a single addition to Vero-hSLAM cells 2 hours post infection with SARS-CoV-2 able to effect ∼5000-fold reduction in viral RNA at 48 h. Ivermectin therefore warrants further investigation for possible benefits in humans. Read more... Concerns expressed over hydroxychloroquine study Statement of concern: Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial (Gautret P et al. PMID 32205204) Publication date: 3 April 2020 Source: International Society of Antimicrobial Chemotherapy ISAC shares the concerns regarding the above article published recently in the International Journal of Antimicrobial Agents (IJAA). The ISAC Board believes the article does not meet the Society’s expected standard, especially relating to the lack of better explanations of the inclusion criteria and the triage of patients to ensure patient safety. Read more... Authors: Grant WB et al Publication date: 2 April 2020 Journal: Nutrients DOI: 10.3390/nu12040988. The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations. Read more... Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial Authors: Chen Z et al Publication date: 31 March 2020 Journal: medRxiv preprint DOI: 10.1101/2020.03.22.20040758 Aims: Studies have indicated that chloroquine (CQ) shows antagonism against COVID-19 in vitro. However, evidence regarding its effects in patients is limited. This study aims to evaluate the efficacy of hydroxychloroquine (HCQ) in the treatment of patients with COVID-19. Main methods: From February 4 to February 28, 2020, 62 patients suffering from COVID-19 were diagnosed and admitted to Renmin Hospital of Wuhan University. All participants were randomized in a parallel-group trial, 31 patients were assigned to receive an additional 5-day HCQ (400 mg/d) treatment, Time to clinical recovery (TTCR), clinical characteristics, and radiological results were assessed at baseline and 5 days after treatment to evaluate the effect of HCQ. Key findings: For the 62 COVID-19 patients, 46.8% (29 of 62) were male and 53.2% (33 of 62) were female, the mean age was 44.7 (15.3) years. No difference in the age and sex distribution between the control group and the HCQ group. But for TTCR, the body temperature recovery time and the cough remission time were significantly shortened in the HCQ treatment group. Besides, a larger proportion of patients with improved pneumonia in the HCQ treatment group (80.6%, 25 of 32) compared with the control group (54.8%, 17 of 32). Notably, all 4 patients progressed to severe illness that occurred in the control group. However, there were 2 patients with mild adverse reactions in the HCQ treatment group. Significance: Among patients with COVID-19, the use of HCQ could significantly shorten TTCR and promote the absorption of pneumonia. Read more... Authors: Russell B et al Institutions: Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK, Guy’s Cancer Centre, Guy’s and St Thomas’ NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK Publication date: 30 March 2020 Journal: eCancer DOI: 10.3332/ecancer.2020.1023 Given the current SARS-CoV-2 (COVID-19) pandemic, the availability of reliable information for clinicians and patients is paramount. There have been a number of reports stating that non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids may exacerbate symptoms in COVID-19 patients. Therefore, this review aimed to collate information available in published articles to identify any evidence behind these claims with the aim of advising clinicians on how best to treat patients. This review found no published evidence for or against the use of NSAIDs in COVID-19 patients. Meanwhile, there appeared to be some evidence that corticosteroids may be beneficial if utilised in the early acute phase of infection, however, conflicting evidence from the World Health Organisation surrounding corticosteroid use in certain viral infections means this evidence is not conclusive. Given the current availability of literature, caution should be exercised until further evidence emerges surrounding the use of NSAIDs and corticosteroids in COVID-19 patients. Read more... Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial Authors: Chen Z et al Publication date: 31 March 2020 Journal: MedRxiv preprint DOI: 10.1101/2020.03.22.20040758 Aims: Studies have indicated that chloroquine (CQ) shows antagonism against COVID-19 in vitro. However, evidence regarding its effects in patients is limited. This study aims to evaluate the efficacy of hydroxychloroquine (HCQ) in the treatment of patients with COVID-19. Main methods: From February 4 to February 28, 2020, 62 patients suffering from COVID-19 were diagnosed and admitted to Renmin Hospital of Wuhan University. All participants were randomized in a parallel-group trial, 31 patients were assigned to receive an additional 5-day HCQ (400 mg/d) treatment, Time to clinical recovery (TTCR), clinical characteristics, and radiological results were assessed at baseline and 5 days after treatment to evaluate the effect of HCQ. Key findings: For the 62 COVID-19 patients, 46.8% (29 of 62) were male and 53.2% (33 of 62) were female, the mean age was 44.7 (15.3) years. No difference in the age and sex distribution between the control group and the HCQ group. But for TTCR, the body temperature recovery time and the cough remission time were significantly shortened in the HCQ treatment group. Besides, a larger proportion of patients with improved pneumonia in the HCQ treatment group (80.6%, 25 of 32) compared with the control group (54.8%, 17 of 32). Notably, all 4 patients progressed to severe illness that occurred in the control group. However, there were 2 patients with mild adverse reactions in the HCQ treatment group. Significance: Among patients with COVID-19, the use of HCQ could significantly shorten TTCR and promote the absorption of pneumonia. Authors: Liu J et al Publication date: 18 March 2020 Journal: Cell Discovery DOI: 10.1038/s41421-020-0156-0 Clinical investigation found that high concentration of cytokines were detected in the plasma of critically ill patients infected with SARS-CoV-2, suggesting that cytokine storm was associated with disease severity12. Other than its direct antiviral activity, HCQ is a safe and successful anti-inflammatory agent that has been used extensively in autoimmune diseases and can significantly decrease the production of cytokines and, in particular, pro-inflammatory factors. Therefore, in COVID-19 patients, HCQ may also contribute to attenuating the inflammatory response. In conclusion, our results show that HCQ can efficiently inhibit SARS-CoV-2 infection in vitro. In combination with its anti-inflammatory function, we predict that the drug has a good potential to combat the disease. This possibility awaits confirmation by clinical trials. We need to point out, although HCQ is less toxic than CQ, prolonged and overdose usage can still cause poisoning. And the relatively low SI of HCQ requires careful designing and conducting of clinical trials to achieve efficient and safe control of the SARS-CoV-2 infection. Authors: Mark F McCarty and James J Di Nicolantonio Publication date: 12 February 2020 Journal: Progress in Cardiovascular Diseases DOI: 10.1016/j.pcad.2020.02.007 Activation of toll-like receptor 7 (TLR7) by single-stranded viral RNA trapped within endosomes provides a key stimulus to type 1 interferon induction by RNA viruses.1 Selemidis and colleagues have recently demonstrated that, within the endosomes of human alveolar macrophages, such viruses evoke superoxide production by NOX2-dependent NADPH oxidase complexes; the presence of TLR7 is required for this effect.2 This phenomenon was demonstrated with a wide range of RNA viruses, including rhinovirus, respiratory syncytial virus, human parainfluenza virus, human metapneumonia virus, Sendai virus, Dengue virus, and HIV. Furthermore, the subsequent generation of hydrogen peroxide within these endosomes leads to an oxidation of Cys98 on TLR7 that blocks the ability of this receptor to transmit a signal boosting type 1 interferon production. In macrophages deficient in NOX2 activity, either genetically or owing to administration of a targeted NOX2 inhibitor (gp91ds-TAT), the production of type 1 interferon was markedly higher in response to RNA virus infection. When genetically normal or NOX2 knockout mice were exposed to an inactive strain of influenza virus, the interferon-beta response and the antibody response evoked by this virus were markedly higher in the NOX2 knockout mice. Read more... |
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Vaccines |
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SARS-CoV-2 Vaccines: Status Report Authors: Fatima Amanat and Florain Krammer Publication date: 6 April 2020 Journal: Immunity DOI: 10.1016/j.immuni.2020.03.007 SARS-CoV-2, the causal agent of COVID-19, first emerged in late 2019 in China. It has since infected more than 870,000 individuals and caused more than 43,000 deaths globally. Here, we discuss therapeutic and prophylactic interventions for SARS-CoV-2 with a focus on vaccine development and its challenges. Vaccines are being rapidly developed but will likely come too late to affect the first wave of a potential pandemic. Nevertheless, critical lessons can be learned for the development of vaccines against rapidly emerging viruses. Importantly, SARS-CoV-2 vaccines will be essential to reducing morbidity and mortality if the virus establishes itself in the population. Read more... |
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Co-infections |
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Average detection rate of SARS-CoV-2 infections is estimated around six percent Authors: Christian Bommer & Sebastian Vollmer Publication date: 2 April 2020 Institution: University of Gottingen Actual number of infections may already have reached several tens of millions The number of confirmed cases for the novel coronavirus disease COVID-19 officially issued by countries and widely commented on by national and international media outlets dramatically understates the true number of infections, a recent report from the University of Göttingen suggests. Dr Christian Bommer and Professor Sebastian Vollmer from Göttingen University have used estimates of COVID-19 mortality and time until death from a recent study published in The Lancet Infectious Diseases to test the quality of official case records. Their data shows that countries have only discovered on average about 6% of coronavirus infections and the true number of infected people worldwide may already have reached several tens of millions. Read more... |
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Comorbidities |
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Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis Authors: Wang B et al Publication date: 8 April 2020 Journal: Aging (Albany, NY) DOI: 10.18632/aging.103000 Currently, the number of patients with coronavirus disease 2019 (COVID-19) has increased rapidly, but relationship between comorbidity and patients with COVID-19 still not clear. The aim was to explore whether the presence of common comorbidities increases COVID-19 patients' risk. A literature search was performed using the electronic platforms (PubMed, Cochrane Library, Embase, and other databases) to obtain relevant research studies published up to March 1, 2020. Relevant data of research endpoints in each study were extracted and merged. All data analysis was performed using Stata12.0 software. A total of 1558 patients with COVID-19 in 6 studies were enrolled in our meta-analysis eventually. Hypertension (OR: 2.29, P<0.001), diabetes (OR: 2.47, P<0.001), chronic obstructive pulmonary disease (COPD) (OR: 5.97, P<0.001), cardiovascular disease (OR: 2.93, P<0.001), and cerebrovascular disease (OR:3.89, P=0.002)were independent risk factors associated with COVID-19 patients. The meta-analysis revealed no correlation between increased risk of COVID-19 and liver disease, malignancy, or renal disease. Hypertension, diabetes, COPD, cardiovascular disease, and cerebrovascular disease are major risk factors for patients with COVID-19. Knowledge of these risk factors can be a resource for clinicians in the early appropriate medical management of patients with COVID-19. Read more... Clinical Features of 85 Fatal Cases of COVID-19 from Wuhan: A Retrospective Observational Study Authors: Yingzhen Du et al Publication date: 3 April 2020 Journal: American Journal of Respiratory and Critical Care Medicine DOI: 10.1164/rccm.202003-0543OC Conclusions: In this depictive study of 85 fatal cases of COVID-19, most cases were male aged over 50 years old with noncommunicable chronic diseases. The majority of the patients died of multiple organ failure. Early onset of shortness of breath may be used as an observational symptom for COVID-19 exacerbations. Eosinophilopenia may indicate a poor prognosis. The combination of anti-microbial drugs did not offer considerable benefit to the outcome of this group of patients. Endocrine and metabolic link to coronavirus infection Authors: Bornstein SR et al Publication date: 2 April 2020 Journal: Nature Reviews Endocrinology DOI: 10.1038/s41574-020-0353-9 Type 2 diabetes mellitus and hypertension are the most common comorbidities in patients with coronavirus infections. Emerging evidence demonstrates an important direct metabolic and endocrine mechanistic link to the viral disease process. Clinicians need to ensure early and thorough metabolic control for all patients affected by COVID-19. Read more... |
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Second wave infections |
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Authors: Leung K et al Publication date: 8 April 2020 Journal: The Lancet DOI: 10.1016/S0140-6736(20)30746-7 Background As of March 18, 2020, 13 415 confirmed cases and 120 deaths related to coronavirus disease 2019 (COVID-19) in mainland China, outside Hubei province—the epicentre of the outbreak—had been reported. Since late January, massive public health interventions have been implemented nationwide to contain the outbreak. We provide an impact assessment of the transmissibility and severity of COVID-19 during the first wave in mainland Chinese locations outside Hubei. Interpretation The first wave of COVID-19 outside of Hubei has abated because of aggressive non-pharmaceutical interventions. However, given the substantial risk of viral reintroduction, particularly from overseas importation, close monitoring of Rt and cCFR is needed to inform strategies against a potential second wave to achieve an optimal balance between health and economic protection. Read more... |
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Social distancing |
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Social Distancing v2.0: During Walking, Running and Cycling Authors: Blocken B et al Publication date: 8 April 2020 Source: Urban Physics Walking, running or cycling are welcome activities to ease one’s mind in times of COVID‐19. But it is best not to exercise these outdoor sports in each other's slipstream, according to recent research by Eindhoven University of Technology in the Netherlands and KU Leuven in Belgium. The 1.5 meter distance rule announced by several governments is “very effective” for people who stand still indoors or outdoors in calm weather. But those who go walking, running or cycling should be a bit more careful. “If someone exhales, coughs or sneezes while walking, running or cycling, most of the microdroplets are entrained in the wake or slipstream behind the runner or cyclist. The other person who runs or cycles just behind this leading person in the slipstream then moves through that cloud of droplets, ”says Bert Blocken, professor of civil engineering at Eindhoven University of Technology and KU Leuven. Read more... Authors: Ashleigh R. Tuite, David N. Fisman and Amy L. Greer Publication date: 8 April 2020 Journal: CMAJ DOI: 10.1503/cmaj.200476 Interpretation: Without substantial physical distancing or a combination of moderate physical distancing with enhanced case finding, we project that ICU resources would be overwhelmed. Dynamic physical distancing could maintain health-system capacity and also allow periodic psychological andeconomic respite for populations. Authors: Nussbaumer-Streit B et al Publication date: 8 April 2020 Institution: Cochrane DOI: 10.1002/14651858.CD013574 Current evidence for COVID‐19 is limited to modelling studies that make parameter assumptions based on the current, fragmented knowledge. Findings consistently indicate that quarantine is important in reducing incidence and mortality during the COVID‐19 pandemic. Early implementation of quarantine and combining quarantine with other public health measures is important to ensure effectiveness. In order to maintain the best possible balance of measures, decision makers must constantly monitor the outbreak situation and the impact of the measures implemented. Testing in representative samples in different settings could help assess the true prevalence of infection, and would reduce uncertainty of modelling assumptions. This review was commissioned by WHO and supported by Danube‐University‐Krems. Read more... Authors: Viner Prof RM PhD et al Publication date: 6 April 20 Institution: University College London, London DOI: 10.1016/S2352-4642(20)30095-X In response to the coronavirus disease 2019 (COVID-19) pandemic, 107 countries had implemented national school closures by March 18, 2020. It is unknown whether school measures are effective in coronavirus outbreaks (eg, due to severe acute respiratory syndrome [SARS], Middle East respiratory syndrome, or COVID-19). We undertook a systematic review by searching three electronic databases to identify what is known about the effectiveness of school closures and other school social distancing practices during coronavirus outbreaks. We included 16 of 616 identified articles. School closures were deployed rapidly across mainland China and Hong Kong for COVID-19. However, there are no data on the relative contribution of school closures to transmission control. Data from the SARS outbreak in mainland China, Hong Kong, and Singapore suggest that school closures did not contribute to the control of the epidemic. Modelling studies of SARS produced conflicting results. Recent modelling studies of COVID-19 predict that school closures alone would prevent only 2–4% of deaths, much less than other social distancing interventions. Policy makers need to be aware of the equivocal evidence when considering school closures for COVID-19, and that combinations of social distancing measures should be considered. Other less disruptive social distancing interventions in schools require further consideration if restrictive social distancing policies are implemented for long periods. |
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Environmental factors |
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Exposure to air pollution and COVID-19 mortality in the United States Authors: Wu X et al Institution: Harvard University Publication date: 7 April 2020 Journal: medRxiv DOI: 10.1101/2020.04.05.20054502v1 Abstract Background: United States government scientists estimate that COVID-19 may kill between 100,000 and 240,000 Americans. The majority of the pre-existing conditions that increase the risk of death for COVID-19 are the same diseases that are affected by long-term exposure to air pollution. We investigate whether long-term average exposure to fine particulate matter (PM2.5) increases the risk of COVID-19 deaths in the United States. Methods: Data was collected for approximately 3,000 counties in the United States (98% of the population) up to April 04, 2020. We fit zero-inflated negative binomial mixed models using county-level COVID-19 deaths as the outcome and county level long-term average of PM2.5 as the exposure. We adjust by population size, hospital beds, number of individuals tested, weather, and socioeconomic and behavioral variables including, but not limited to obesity and smoking. We include a random intercept by state to account for potential correlation in counties within the same state. Results: We found that an increase of only 1 μg/m3 in PM2.5 is associated with a 15% increase in the COVID-19 death rate, 95% confidence interval (CI) (5%, 25%). Results are statistically significant and robust to secondary and sensitivity analyses. Conclusions: A small increase in long-term exposure to PM2.5 leads to a large increase in COVID-19 death rate, with the magnitude of increase 20 times that observed for PM2.5 and all-cause mortality. The study results underscore the importance of continuing to enforce existing air pollution regulations to protect human health both during and after the COVID-19 crisis. Early evidence that COVID-19 government policies reduce urban air pollution Author: Marc W Cadotte Publication date: 31 March 2020 Journal: EarthArXiv Preprints DOI: 10.31223/osf.io/nhgj3 Governments have a solemn responsibility to ensure the health and well-being of the populations 15they govern. The COVID-19 pandemic reveals just how serious governments take this responsibility and that restricting activity to limit pathogen spread can have other public healthrepercussions. Comparisons between February 2019 and 2020 air quality measures reveal that six cities that were impacted early by government restrictions in response to COVID-19 show consistent declines in five of six major air pollutants.Given that air pollution causes more than 20four million premature deaths annually, the declines in air pollution in response to activity changes confirm that governments have the capability to improve air quality through policy change Read more... |
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Clinical trials |
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National Institutes of Health (NIH) ClinicalTrials.gov website: Covid-19 related trials
Anti-inflammatory/Antioxidant Oral Nutrition Supplementation in COVID-19 (ONSCOVID19) Sponsor: Kind Saud University Brief Summary: COVID-19 pandemic threatens patients, societies and healthcare systems around the world. The host immunity determines the progress of the disease and its lethality. The associated cytokine storm mainly affects the lungs; leading to acute lung injury with variable degrees. Modulation of cytokine production using Immunonutrition is a novel concept that has been applied to other diseases. Using specific nutrients such as n3- fatty acids and antioxidant vitamins in extraordinary doses modulate the host immune response and ameliorate the cytokine storm associated with viral diseases such as COVID-19. In this proposal, we will conduct a prospective double-blinded controlled trial for 14 days on 30 SARS-CoV-2 positive cases. The participant will be randomly assigned to two groups (n=15/each); intervention (IG) and placebo (PG) groups. The IG group will be provided with an anti-inflammatory and antioxidant oral nutrition supplement (ONS) on a daily basis, while the PG will be given an isocaloric placebo. Basal and weekly nutritional screening, as well as recording of anthropometric, clinical and biochemical parameters, will be done. The main biochemical parameters include serum ferritin level, cytokine storm parameters (interleukin-6, Tumor necrosis factor-α, and monocyte chemoattractant protein 1), C-reactive protein, total leukocyte count, differential lymphocytic count and neutrophil to lymphocyte ratio. It is expected that the anti-inflammatory-antioxidant ONS might help in the reduction of the COVID-19 severity with more preservation of the nutritional status of infected cases. |
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Surveillance |
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Authors: Justin D Silverman and Alex D Washburne Institution: Penn State, Montana State University Publication date: 3 April 2020 Journal: medRxiv – preprint DOI: 10.1101/2020.04.01.20050542 Detection of SARS-CoV-2 infections to date has relied on RT-PCR testing. However, a failure to identify early cases imported to a country, bottlenecks in RT-PCR testing, and the existence of infections which are asymptomatic, sub-clinical, or with an alternative presentation than the standard cough and fever have resulted in an under-counting of the true prevalence of SARS-CoV-2. Here, we show how publicly available CDC influenza-like illness (ILI) outpatient surveillance data can be repurposed to estimate the detection rate of symptomatic SARS-CoV-2 infections. We find a surge of non-influenza ILI above the seasonal average and show that this surge is correlated with COVID case counts across states. By quantifying the number of excess ILI patients in March relative to previous years and comparing excess ILI to confirmed COVID case counts, we estimate the symptomatic case detection rate of SARS-CoV-2 in the US to be 1/100 to 1/1000. This corresponds to approximately 10 million presumed symptomatic SARS-CoV-2 patients across the US during the week starting on March 15, 2020. Combining excess ILI counts with the date of onset of community transmission in the US, we also show that the early epidemic in the US was unlikely to be doubling slower than every three days. Together these results suggest a conceptual model for the COVID epidemic in the US in which rapid spread across the US are combined with a large population of infected patients with presumably mild-to-moderate clinical symptoms. We emphasize the importance of testing these findings with seroprevalence data, and discuss the broader potential to repurpose outpatient time series for early detection and understanding of emerging infectious diseases. |
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Personal protection |
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Authors: Bae S MD et al Publication date: 6 April 2020 Journal: Annals of Internal Medicine DOI: 10.7326/M20-1342 In conclusion, both surgical and cotton masks seem to be ineffective in preventing the dissemination of SARS–CoV-2 from the coughs of patients with COVID-19 to the environment and external mask surface. Authors: Bartoszko JJ et al Institution: McMaster University, Hamilton, Ontario, Canada Publication date: 4 April 2020 Journal: Influenza and other respiratory viruses DOI: 10.1111/irv.12745 Background Respiratory protective devices are critical in protecting against infection in health care workers at high risk of novel 2019 coronavirus disease (COVID‐19); however, recommendations are conflicting and epidemiological data on their relative effectiveness against COVID‐19 are limited. Conclusions Low certainty evidence suggests that medical masks and N95 respirators offer similar protection against viral respiratory infection including coronavirus in health care workers during non‐aerosol generating care. Preservation of N95 respirators for high‐risk, aerosol generating procedures in this pandemic should be considered when in short supply. Author: Dr Zoë Harcombe PhD Publication date: 1 April 2020 The official positions from the World Health Organisation (WHO), the US Centres for Disease Control (CDC), the US Surgeon General and the UK Deputy Chief Medical officer are similar – you don’t need a mask. Some go even further and suggest that wearing a mask may do more harm than good. Others caution that masks should be saved for caregivers. The evidence shows that wearing a mask protects against virus transmission. We can avoid any claimed harms by making our own masks (protect supplies for healthcare workers) and caring for them carefully (protect against contamination). The official advice might change soon – it needs to. |
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Reverse zoonotic disease transmission |
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Susceptibility of ferrets, cats, dogs, and different domestic animals to SARS-coronavirus-2 Authors: Shi J et al Publication date: 31 March 2020 Journal: bioRxiv preprint DOI: 10.1101/2020.03.30.015347 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the infectious disease COVID-19, which was first reported in Wuhan, China in December, 2019. Despite the tremendous efforts to control the disease, COVID-19 has now spread to over 100 countries and caused a global pandemic. SARS-CoV- 2 is thought to have originated in bats; however, the intermediate animal sources of the virus are completely unknown. Here, we investigated the susceptibility of ferrets and animals in close contact with humans to SARS-CoV-2. We found that SARS-CoV-2 replicates poorly in dogs, pigs, chickens, and ducks, but efficiently in ferrets and cats. We found that the virus transmits in cats via respiratory droplets. Our study provides important insights into the animal reservoirs of SARS-CoV-2 and animal management for COVID-19 control. Read more... |
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Mental health |
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Authors: Zhang SX et al Publication date: 4 April 2020 Journal: Psychiatry Research DOI: 10.1016/j.psychres.2020.112958 We assess the health and wellbeing of normal adults living and working after one month of confinement to contain the COVID-19 outbreak in China. On Feb 20–21, 2020, we surveyed 369 adults in 64 cities in China that varied in their rates of confirmed coronavirus cases on their health conditions, distress and life satisfaction. 27% of the participants worked at the office, 38% resorted to working from home, and 25% stopped working due to the outbreak. Those who stopped working reported worse mental and physical health conditions as well as distress. The severity of COVID-19 in an individual's home city predicts their life satisfaction, and this relationship is contingent upon individuals’ existing chronic health issues and their hours of exercise. Our evidence supports the need to pay attention to the health of people who were not affected by the virus epidemiologically, especially for people who stopped working during the outbreak. Our results highlight that physically active people might be more susceptible to wellbeing issues during the lockdown. Policymakers who are considering introducing restrictive measures to contain COVID-19 may benefit from understanding such health and wellbeing implications. Read more... Addressing the COVID-19 Pandemic in Populations With Serious Mental Illness Author: Benjamin G. Druss, MD, MPH Publication date: 3 April 2020 Journal: JAMA Psychiatry DOI: 10.1001/jamapsychiatry.2020.0894 The coronavirus disease 2019 (COVID-19) pandemic will present an unprecedented stressor to patients and health care systems across the globe. Because there is currently no vaccine or treatment for the underlying infection, current health efforts are focused on providing prevention and screening, maintaining continuity of treatment for other chronic conditions, and ensuring access to appropriately intensive services for those with the most severe symptoms. Read more... Researchers appeal to public for help to assess mental health impact of the COVID-19 pandemic Publication date: 8 April 2020 Source: NIHR Maudsley biomedical Research Centre Scientists are appealing to the public for help to assess the mental health impact of the COVID-19 pandemic, with the aim to inform and improve future policies concerning pandemics. The Repeated Assessment of Mental health in Pandemics (RAMP) study from researchers at King’s College London aims to measure the mental health and wellbeing of the population throughout the Covid-19 pandemic, and examine what factors influence these changes. The researchers will look at contextual, psychological and behavioural factors that may affect risk and resilience to mental health problems during the pandemic. The questions will assess symptoms of common mental health disorders, in both individuals with and without existing mental health problems. They will also examine how life circumstances such as loneliness and employment, thought processes such as distracting oneself when worried, and self-care behaviours such as yoga or exercise, are affecting these symptoms. The RAMP study is UK wide and open to any residents of England, Scotland, Wales or Northern Ireland who are over the age of 16 and have access to the internet. This study is in partnership with MQ, the UK’s leading mental health research charity. Read more... |
Media |
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Co-infections |
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Higher co-infection rates in COVID19 Author: Nigam Shah Publication date: 18 March 2020 Source: Medium.com Several Stanford Medicine Data Scientists are working on various aspects of COVID19. Below is one trend regarding co-infection rates that might be of help to healthcare professionals. Read more... |
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Pathogenesis |
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The hypoxia of C19 mimics an extravascular hemolytic anemia Publication date: 6 April 2020 Source: Dr Jack Kruse Facebook page From my initial post mortem of data, I have gathered from my contacts on the front line in New York and New Orleans this virus is hijacking hemoglobin's ability to carry oxygen to tissues. The lung tissue then responds to this insult to mimic pulmonary hypertension as we see in high altitude sickness. This idea implies how we treat COVID19 must change. It also implies Trump might be correct about his push to use drugs and Fauci might be wrong. These ideas are supported by laboratory and imaging studies ER docs are seeing on the front lines in New Orleans and NYC. Have a look at this very clinical blog that links the viral illness to quantum biologic processes we know are happening globally to mankind in the modern world. |
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Susceptibility |
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Why do some young people die of coronavirus? Author: Robin McKie Publication date: 5 April 2020 Source: The Guardian Covid-19 hits the old hardest, but young people are dying too. Scientists say it may be down to genes or ‘viral load’. It remains one of the biggest puzzles of the Covid-19 pandemic. The disease generally causes serious problems only in older people or those with underlying health problems. But occasionally it strikes down young, apparently fit individuals, including medical staff exposed to patients with the virus. In some cases, previously undiagnosed conditions are later revealed but in others no such explanations are available, leaving scientists struggling to find reasons for the behaviour of the coronavirus. 'It's a racial justice issue': Black Americans are dying in greater numbers from Covid-19 Publication date: 8 April 2020 Source: The Guardian The coronavirus can infect anybody but African Americans are dying in disproportionate numbers, especially in certain big cities. While New York’s Governor Andrew Cuomo once called the coronavirus a “great equalizer”, data shows the virus has been anything but indiscriminate. As the US climbed to more than 10,000 coronavirus deaths on Monday state health officials grappled with its disproportionate impact on black Americans. The disparity is especially stark in cities like New Orleans, Chicago and Detroit, where high concentrations of African Americans live. Read more... |
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Epidemiology |
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Obesity is major COVID-19 risk factor, says French chief epidemiologist Author: Geert de Clercq Publication date: 8 April 2020 Source: Reuters Being overweight is a major risk for people infected with the new coronavirus and the United States is particularly vulnerable because of high obesity levels there, France’s chief epidemiologist said on Wednesday. Read more... |
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Dietary & lifestyle factors |
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Healthy eating as important as social distancing in fight against COVID-19, experts warn By: University of Sussex Publication date: 3 April 2020 The Government [UK] is being urged to launch an urgent mass public messaging campaign promoting how healthy eating can boost the body's immune system against the threat of the novel coronavirus, COVID-19, by three leading food specialists. Read more... |
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Self-help |
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JK Rowling: Breathing video helped my coronavirus symptoms Author: Ben Ellery Publication date: 7 April 2020 Source: The Times When Sarfaraz Munshi posted a video on Whatsapp to show breathing techniques to his mother who had coronavirus symptoms, he had no idea that it would also help JK Rowling. Dr Munshi, 36, was surprised when the author tweeted a link to the video to her 14.5 million followers and wrote: I'm fully recovered & [this] technique helped a lot. Now the video has been watched nearly two million times and Dr Munshi said that he had been overwhelmed by the response. I’m not on social media and I didn’t mean for this to go public but I hope it gives people some guidance," he said. Read more... |
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Therapeutics |
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Israeli COVID-19 treatment shows 100% survival rate - preliminary data Author: Maayan Jaffe-Hoffman Publicaton date: 8 April 2020 Source: The Jerusalem Post Six critically ill coronavirus patients in Israel who are considered high-risk for mortality have been treated with Pluristem’s placenta-based cell-therapy product and survived, according to preliminary data provided by the Haifa-based company. The patients were treated at three different Israeli medical centers for one week under the country’s compassionate use program and were suffering from acute respiratory failure and inflammatory complications associated with COVID-19. Four of the patients also demonstrated failure of other organ systems, including cardiovascular and kidney failure. Read more... Author: Michael Doyle Publication date: 7 April 2020 Source: The Globe and Mail, Canada A team of blood transfusion experts from across Canada is planning the world’s largest clinical trial of a potential treatment for COVID-19. The study, which will involve 1,000 patients from across the country, will include at least 40 Canadian hospitals, and is being overseen by doctors from the University of Montreal, University of Ottawa, University of Toronto, McMaster and the University of British Columbia, among other schools. The experimental treatment involves injecting antibody-rich plasma from patients who have recovered from the virus into those who are still infected. This approach has only been tried in small trials in China, Singapore, South Korea and the U.S. It is part of a global race to find a treatment for the disease, with researchers also focusing on antivirals and medications used to treat malaria. Hydroxychloroquine Update For April 6 Author: Derek Lowe Publication date: 6 April 2020 There’s a lot of news to catch up on, and to keep things straight I’ll divide the hydroxychloroquine part out into this post, and cover others in the next one. My previous reviews of the clinical data in this area are here. Author: Woodruff Sciences Health Centre Publication date: 6 April 2020 Source: Emory University Scientists are hopeful that a new drug discovered by researchers at Emory could change the way doctors treat COVID-19. The drug, called EIDD-2801, shows promise in reducing lung damage and has finished testing in mice. It will soon move to human clinical trials. As of today, the novel coronavirus SARS-CoV-2 has infected more than 1.3 million people with COVID-19 and caused nearly 74,000 deaths in a worldwide pandemic. Currently, no antiviral drugs have been approved to treat SARS-CoV-2 or any of the other coronaviruses that cause human disease. Researchers at the UNC-Chapel Hill Gillings School of Global Public Health are playing a key role in the development of EIDD-2801. Viral epidemiologists in the lab of Ralph Baric, PhD, William R. Kenan Jr. Distinguished Professor of Epidemiology at the University of North Carolina-Chapel Hill, are working with colleagues at Vanderbilt University Medical Center (VUMC) and the nonprofit DRIVE (Drug Innovation Ventures at Emory) to test the drug, which was discovered by scientists at the Emory Institute for Drug Development (EIDD). Read more... With ventilators running out, doctors say the machines are overused for Covid-19 Author: Sharon Begley Publication date: 8 April 2020 Source: Stat News Even as hospitals and governors raise the alarm about a shortage of ventilators, some critical care physicians are questioning the widespread use of the breathing machines for Covid-19 patients, saying that large numbers of patients could instead be treated with less intensive respiratory support. If the iconoclasts are right, putting coronavirus patients on ventilators could be of little benefit to many and even harmful to some. What’s driving this reassessment is a baffling observation about Covid-19: Many patients have blood oxygen levels so low they should be dead. But they’re not gasping for air, their hearts aren’t racing, and their brains show no signs of blinking off from lack of oxygen. Read more... Do COVID-19 Vent Protocols Need a Second Look? - See article above Video Interview: John Whyte, MD, MPH; Cameron Kyle-Sidell, MD Publication date: 6 April 2020 Source: Stat News After treating patients with COVID-19, a New York city physician suggests ventilator protocols may need revisiting |
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Testing |
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UK Coronavirus: Some antibody tests not accurate enough, Downing Street says Author: Andrew Woodcock, Political Editor Publication date: 3 April 2020 Source: The Independent Some coronavirus antibody tests submitted for approval to Public Health England have failed to meet required levels of accuracy, Downing Street has revealed. Read more... USA: Questions About Accuracy of Coronavirus Tests Sow Worry Author: Christopher Weaver Publication date: 2 April 2020 Source: Wall Street Journal Experts believe nearly one in three infected patients are nevertheless getting negative test results Read more... Breaking Down the Two Tests That Could Help Contain the COVID-19 Pandemic Author: Katherine J Wu Publication date: 7 April 2020 Source: Smithsonian Magazine One detects an active infection; another signals that the virus has already left the body. Both are critical for tracking the spread of disease. The new coronavirus, SARS-CoV-2, has proved to be extremely stealthy, often spreading without the obvious hallmark of symptoms. But no pathogen is truly invisible. When deployed at the right time and in enough individuals, modern molecular tests can guide treatments, map out how quickly and where a disease is spreading and pinpoint the people a pathogen has already touched. Amidst a slew of shortages and logistical hurdles, American researchers are now slowly rolling out two crucial and very different tests to fight the COVID-19 pandemic: one that can detect an ongoing SARS-CoV-2 infection and another that can tell if the pathogen already passed through the body. These two tests aren’t interchangeable, but they are complementary—and together, they’re likely to play a crucial role in giving health workers and the public the information they need to contain and end this pandemic. Read more... |
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Mortality & morbidity |
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Coronavirus: China reports no Covid-19 deaths for first time Publication date: 7 April 2020 Source: BBC News China reported no coronavirus deaths on Tuesday, the first time since it started publishing daily figures in January. Why is New Orleans' coronavirus death rate twice New York's? Obesity is a factor Author: Brad Brooks Publication date: 2 April 2020 Source: Reuters The coronavirus has been a far deadlier threat in New Orleans than the rest of the United States, with a per-capita death rate twice that of New York City. Doctors, public health officials and available data say the Big Easy’s high levels of obesity and related ailments may be part of the problem. Coronavirus tracked: the latest figures as the pandemic spreads | Free to read Financial Times analysis of death rates across the world How to understand – and report – figures for ‘Covid deaths’ Author: Dr John Lee Publication date: 29 March 20 Every day, now, we are seeing figures for ‘Covid deaths’. These numbers are often expressed on graphs showing an exponential rise. But care must be taken when reading (and reporting) these figures. Given the extraordinary response to the emergence of this virus, it’s vital to have a clear-eyed view of its progress and what the figures mean. The world of disease reporting has its own dynamics, ones that are worth understanding. How accurate, or comparable, are these figures comparing Covid-19 deaths in various countries? |
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Tracking lockdowns |
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Google data shines light on whether coronavirus lockdowns worldwide are working Author: Paresh Dave Date of publication: 3 April 2020 Source: Reuters Alphabet Inc’s Google has published charts showing how the coronavirus has brought hard-hit Italy to a standstill, led to runs on grocery stores around the world and prompted a stark drop in going-out between Mardi Gras and St. Patrick’s Day. The company released reports for 131 countries with charts that compare traffic from Feb. 16 to March 29 to retail and recreational venues, train and bus stations, grocery stores and workplaces with a five-week period earlier this year. |
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Risk |
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How much ‘normal’ risk does Covid represent? Author: David Spiegelhalter Publication date: 21 March 2020 An article by Nick Triggle on BBC Online raises the issue of whether many deaths from COVID-19 would have occurred anyway as part of the ‘normal’ risks faced by people, particularly the elderly and those with chronic health problems who are the main victims of COVID. To provide some background, I’ve had a look at how much ‘normal’ risk COVID seems to represent. BBC Radio 4 - More or Less: Behind the stats David Spiegelhalter puts the risks of Covid-19 into perspective. We’ll try to understand what restrictions mean for the UK’s economy, and look into coronavirus numbers in Iran. Coronavirus: How to understand the death toll Author: Nick Triggle Publication date: 1 April 2020 Each day, news of more deaths is a huge source of alarm to people across the country - as well as a tragedy for the families involved. Projections of how bad the outbreak could get have prompted ministers to put the country into lockdown. But what are death figures really telling us? And how bad is it going to get? Is coronavirus causing the deaths? The death figures being reported daily are hospital cases where a person dies with the coronavirus infection in their body - because it is a notifiable disease cases have to be reported. But what the figures do not tell us is to what extent the virus is causing the death. It could be the major cause, a contributory factor or simply present when they are dying of something else. Why Some COVID-19 Patients Crash: The Body's Immune System Might Be To Blame Author: Geoff Brumel Source: NPR Publication date: 7 April 2020 It's a strange and tragic pattern in some cases of COVID-19: The patient struggles through the first week of illness, and perhaps even begins to feel a little better. Then suddenly they crash. Now doctors and researchers are increasingly convinced that, in some cases at least, the cause is the body's own immune system overreacting to the virus. The problem, known broadly as a "cytokine storm," can happen when the immune system triggers a runaway response that causes more damage to its own cells than to the invader it's trying to fight. |
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Vaccines |
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Fauci Outlines Ambitious Plan to Scale Up Covid-19 Vaccine Author: Jeannie Baumann Publication date: 27 March 2020 Source: Bloomberg Law A Covid-19 vaccine will go into production while researchers are still studying if it works, under an ambitious plan by NIH’s Anthony S. Fauci to get a vaccine across the finish line in record time. The proposal to start ramping up production while the candidate is still in a clinical trial is a risky step for a manufacturer, which would have to start assembling raw materials to make a vaccine without knowing whether it would work. INOVIO Initiates Phase 1 Clinical Trial Of Its COVID-19 Vaccine and Plans First Dose Today Publication date: 6 April 2020 Source: Inovio press release - Up to 40 Healthy Volunteers To Participate at Two Trial Locations - Preclinical Animal Studies Show Promising Immune Responses - Rapid Advancement Possible Through a Global Coalition of Collaborators, Partners, and Funders Coronavirus vaccines: What we know about testing and availability Author: Andrew Dunn Publication date: 7 April 2020 Source: Business Insider The World Health Organization says that there are more than 40 research effort to develop a coronavirus vaccine. Two vaccine candidates are already undergoing human testing that could produce a coronavirus vaccine by as early as this fall. Business Insider compiled a list of all the coronavirus vaccine candidates that are undergoing research or human trials. |
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Indirect effects on healthcare system |
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Where Have All the Heart Attacks Gone? Author: Harlan M Krumholz MD Source: New York Times Publication date: 6 April 2020 The hospitals are eerily quiet, except for Covid-19. I have heard this sentiment from fellow doctors across the United States and in many other countries. We are all asking: Where are all the patients with heart attacks and stroke? They are missing from our hospitals. |
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Human to animal transmission |
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Coronavirus can infect cats — dogs, not so much Author: Smriti Mallapaty Publication date: 1 April 2020 Source: Nature But scientists say it’s unclear whether felines can spread the virus to people, so pet owners need not panic yet. Cats can be infected with the coronavirus that causes COVID-19, and can spread it to other cats, but dogs are not really susceptible to the infection, say researchers in China. The team, at Harbin Veterinary Research Institute, also concludes that chickens, pigs and ducks are not likely to catch the virus. Read more... Coronavirus: Cat owners crash vet website over COVID-19 fears Author: Tania Snuggs Publication date: 8 April 2020 Source: Sky News Vets say only cats from households infected with coronavirus or where their owners are self-isolating should be kept indoors, after the British Veterinary Association's website crashed on Wednesday. The BVA has clarified its advice after responding to questions from the BBC about what owners should do during the COVID-19 lockdown. The move comes following reports the animals should be "kept indoors" during the pandemic, causing the website to crash. Read more... |
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Mental Health |
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COVID-19 Is Likely to Lead to an Increase in Suicides Author: Adriana Payani Publication date: 3 April 2020 Source: Scientific American The psychosocial repercussions of this crisis could make the tragedy even worse Of all the literary masterpieces describing humanity’s experience of disease pandemics, none describes suicide more vividly than Ovid's Metamorphoses, when in response to the psychosocial distress of the plague the citizens “hanged themselves, to kill the fears of death by death’s own hand.” Just like a pandemic became a reality for the first time in more than a century, in a destructive "life imitating art imitating life" way, news of suicides linked to the COVID-19 crisis have swept the globe and sadly show no signs of abating. Read more... Nursing Times launches new campaign to support nurse mental health amid Covid-19 crisis Author: Steve Ford Publication date: 8 April 2020 Source: Nursing Times Nursing Times is launching a new campaign – Covid-19: Are you okay? – to highlight the mental health pressures and needs of nurses during and after the coronavirus pandemic. Concerns around lack of equipment, heightened staff shortages, coping with deployment, the risks posed to staff themselves and their friends and families and the death of colleagues will all take their toll, as will the lockdown while not at work and a range of other factors. Once the outbreak peak has flattened and in time Covid-19 has gone away, the question remains how will life get back to normal, if entirely ever, at both work and at home. Will staff be supported in the long term, with post-traumatic stress disorder a potential factor? Read more... |
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Covid spread |
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Have Australia and New Zealand stopped Covid-19 in its tracks? Authors: Eleanor Ainge Roy and Ben Doherty Publication date: 9 April 2020 Source: The Guardian Southern hemisphere neighbours have developed different strategies but both are working – for now Read more... Experts: COVID-19 pandemic unlikely to ebb as weather warms Author: Mary Van Beusekom Publication date: 8 April 2020 Source: University of Minnesota, Center for Infectious Disease Research and Policy Although some pundits have suggested that the COVID-19 pandemic will dissipate with coming warm temperatures and high humidity in the Northern Hemisphere, the virus is unlikely to be seasonal in nature, according to a paper published yesterday by the National Academy of Sciences, Engineering, and Medicine. Read more... |
Corporate |
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COVID-19 is Changing the Food Industry Author: Mike Geraghty Source: Naturally Colourful In a paper published in mid-March 2020, data and insights leader Nielsen discussed a study identifying six key consumer behavior shifts happening because of the COVID-19 outbreak. These “behavior thresholds”, as Nielsen calls them, signal changes in consumer spending. The six behaviors evolve from consumers’ state of early preparedness to the new normal state of living post-COVID-19. These behavior shifts are having a major impact on the food industry and will likely lead to permanent changes in how consumers shop for food and how supply chains respond to changing consumer demand. Read more... |
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