Dr. Boarhead’s Summary of Global Updates on the 2019 Novel Coronavirus: 29th November 2020
1.
New England Journal of Medicine
:
667 patients were assigned in a 1:1:1 ratio to receive standard care, standard care plus hydroxychloroquine at a dose of 400 mg twice daily, or standard care plus hydroxychloroquine at a dose of 400 mg twice daily plus azithromycin at a dose of 500 mg once daily for 7 days. As compared with standard care, the proportional odds of having a higher score on the seven-point ordinal scale within 15 days were not affected by either hydroxychloroquine alone or hydroxychloroquine plus azithromycin.
[key info]
The use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status.
https://www.nejm.org/doi/full/10.1056/NEJMoa2019014?query=featured_coronavirus
2.
Lancet
:
According to a systematic review and meta-analysis of viral load dynamics, duration of viral shedding, and infectiousness of SARS-CoV-2, SARS-CoV, and MERS-CoV, the viral load of SARS-CoV-2 in the upper respiratory tract appeared to peak in the first week of illness after symptom onset, whereas that of SARS-CoV peaked within 10–14 days and that of MERS-CoV peaked within 7–10 days. In addition, viable SARS-CoV-2 in respiratory samples was isolated primarily within the first week of illness, which means patients were likely to be the most infectious in the first week of illness.
[key info]
People infected with SARS-CoV-2 should be quarantined within the first week of illness.
https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(20)30172-5/fulltext
3. AstraZeneca:
Positive high-level results from an interim analysis of clinical trials of AZD1222 showed the vaccine was highly effective in preventing COVID-19, and no hospitalization or severe case of the disease was reported in participants receiving the vaccine. One dosing regimen showed vaccine efficacy of 90% when AZD1222 was given as a half dose, followed by a full dose at least one month apart, and another dosing regimen showed 62% efficacy when given as two full doses at least one month apart. The combined analysis from both dosing regimens resulted in average efficacy of 70%.
<23 Nov.>
[key info]
AZD1222 is 70% effective in preventing COVID-19.
https://www.astrazeneca.com/media-centre/press-releases/2020/azd1222hlr.html
4.
Science Translational Medicine
:
Researchers provided an analysis of SARS-CoV-2 superspreading during the first wave of infections in Austria. They identified major SARS-CoV-2 clusters and performed deep whole-genome sequencing of more than 500 virus samples. Phylogenetic-epidemiological analysis enabled the reconstruction of superspreading events and charted a map of tourism-related viral spread originating in spring 2020. Moreover, they exploited epidemiologically well-defined clusters to quantify SARS-CoV-2 mutational dynamics, including the observation of a low-frequency mutation that progressed to fixation within the infection chain.
<23 Nov.>
[key info]
The combination of epidemiological analysis with viral genome sequencing unravels the spread of SARS-CoV-2 in Austria.
https://stm.sciencemag.org/content/early/2020/11/20/scitranslmed.abe2555.full
5.
Cell
:
In a longitudinal assessment, individuals who had recovered from mild COVID-19 developed SARS-CoV-2-specific IgG antibodies, neutralizing plasma, memory B cells, and memory T cells that persisted for at least three months. It was also revealed that SARS-CoV-2-specific IgG memory B cells increased over time and expressed receptors capable of neutralizing the virus when expressed as monoclonal antibodies.
<23 Nov.>
[key info]
Mild COVID-19 induces persistent immune memory for at least three months.
https://www.cell.com/cell/fulltext/S0092-8674(20)31565-8?rss=yes
6.
New England Journal of Medicine
:
In a study, a group of hospitalized adult patients with severe COVID-19 were randomly assigned to receive convalescent plasma or placebo. On day 30, no significant difference was noted between the two groups in the distribution of clinical outcomes. Overall mortality was 10.96% in the convalescent plasma group and 11.43% in the placebo group. Adverse events and serious adverse events were similar in the two groups.
[key info]
There is slight difference between the convalescent plasma and the placebo group.
https://www.nejm.org/doi/full/10.1056/NEJMoa2031304?query-featured_coronavirus=
7.
New England Journal of Medicine
:
An analysis, aiming to study the role of hydroxychloroquine as a postexposure therapy, included 2,314 healthy contacts of 672 index case patients with COVID-19. A total of 1,116 contacts were randomly assigned to receive hydroxychloroquine and 1,198 to receive standard care. Results were similar in the two groups with respect to the incidence of PCR-confirmed, symptomatic COVID-19. In addition, hydroxychloroquine was not associated with a lower incidence of SARS-CoV-2 transmission than standard care. The incidence of adverse events was higher in the hydroxychloroquine group than in the standard care group, but no treatment-related serious adverse events were reported.
[key info]
For close contacts of COVID-19 patients, hydroxychloroquine did not prevent infection.
https://www.nejm.org/doi/full/10.1056/NEJMoa2021801?query=featured_coronavirus
8.
Nature
:
Several animal species, including rodents, ferrets, and nonhuman primates (NHPs), have been used as models to reveal possible immune complications elicited by vaccines and therapies before their release to the public. NHPs have the closest physiological resemblance to humans. Among them, African green monkeys support robust SARS-CoV-2 replication and develop pronounced respiratory disease, which may more accurately reflect human COVID-19 cases than other NHPs.
<24 Nov.>
[key info]
African green monkeys may serve as a better model for testing vaccines than other animals.
https://www.nature.com/articles/s41590-020-00835-8
9.
Nature
:
An index was developed and applied to a curated set of recurrent mutations identified within a dataset of 46,723 SARS-CoV-2 genomes isolated from patients worldwide, but no recurrent mutation was identified as convincingly associated with increased viral transmission. Instead, recurrent mutations currently in circulation appear to be evolutionarily neutral and primarily induced by the human immune system via RNA editing, which means they may not be signatures of adaptation.
<25 Nov.>
[key info]
No recurrent mutation shows evidence of being associated with viral transmissibility.
https://www.nature.com/articles/s41467-020-19818-2
This is issue forty-eight
, edited on the basis of information from the official websites including but not limited to those of
The World Health Organization,
The European Centre for Disease Prevention and Control,
The Centers for Disease Control and Prevention of the United States of America, &
The Center for Infectious Disease Research and Policy of the University of Minnesota
and from the forums of FluTrackers.com.
This issue is edited by Alex Sun, Fred Wong, Dorothy Fang, and Dora Zhang under the supervision of Dr. Jason Chu and Conch Zhang.
2020 © The Chung Kwong Wui
