COVID-19 Scientific Resources

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This online resource page is provided by the Geneva Centre for Education & Research in Humanitarian Action, the University of Geneva and the Graduate Institute of International and Development Studies (IHEID), and aims to inform governments, humanitarian organisations and media representatives on the latest evidence on the COVID-19 virus. This page, updated daily, includes systematic reviews and primary and secondary analysis and it also refers to online resources from reputable organisations where updated information is published.

If you need more detailed information, please contact our Director, Professor Karl Blanchet (

The Centre is also hosting a weekly webinar series on COVID-19 and humanitarian settings, in collaboration with the READY Initiative, the London School of Hygiene and Tropical Medicine (LSHTM) and the Centre for Humanitarian Health at Johns Hopkins University.


Scientific evidence on covid-19 virus

08 April, 2020, 12.45 CET

COVID-19 and cancer: what we know so far
Peter Sidaway
7 April 2020, in Nature reviews Clinical Oncology
Infection with SARS-CoV-2, resulting in coronavirus disease (COVID-19), can lead to acute respiratory distress syndrome (ARDS) requiring admission to an intensive care unit (ICU), and sometimes death, in a subset of patients. So far, we know that individuals ≥60 years of age and/or those with a supressed immune system are particularly vulnerable to COVID-19, although how these risks apply to patients with cancer remains unclear. Several reports are beginning to emerge.

SARS-CoV-2 detection in patients with influenza-like illness
Wen-Hua Kong et al.
7 April 2020, in Nature Microbiology
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, Hubei Province, China in late December 2019. We re-analysed 640 throat swabs collected from patients in Wuhan with influenza-like-illness from 6 October 2019 to 21 January 2020 and found that 9 of the 640 throat swabs were positive for SARS-CoV-2 RNA by quantitative PCR, suggesting community transmission of SARS-CoV2 in Wuhan in early January 2020.

Rapid detection of African swine fever virus using Cas12a-based portable paper diagnostics
Shuhan Lu et al.
7 April 2020, in Cell Discovery
African swine fever virus (ASFV) is a dsDNA virus responsible for a severe, highly contagious, and lethal disease affecting both domestic and wild pigs. ASFV has brought enormous economic loss to a number of countries, and effective vaccine and therapy are still lacking. Therefore, a rapid, sensitive, and field-deployable detection of ASFV is important for disease surveillance and control. Herein, we developed a Cas12a-mediated portable paper assay to rapidly and precisely detect ASFV.We identified a robust set of crRNAs that recognized the highly conserved region of essential ASFV genes. The Cas12a-mediated detection assay showed low tolerance for mismatch mutations, and no cross-reactivity against other common swine pathogens. We further developed a paper-based assay to allow instrument-free detection of ASFV. Specifically, we applied gold nanoparticle–antibody conjugate to engineer homemade strips and combined it with Cas12a-mediated ASFV detection.

The relationship of COVID-19 severity with cardiovascular disease and its traditional risk factors: A systematic review and meta-analysis
Kunihiro Matsushita et al.
7 April 2020, in medRxiv
Whether cardiovascular disease (CVD) and its traditional risk factors predict severe coronavirus disease 2019 (COVID-19) is uncertain, in part, because of potential confounding by age and sex. Methods: We performed a systematic review of studies that explored pre-existing CVD and its traditional risk factors as risk factors of severe COVID-19 (defined as death, acute respiratory distress syndrome, mechanical ventilation, or intensive care unit admission). We searched PubMed and Embase for papers in English with original data (≥10 cases of severe COVID-19). Using random-effects models, we pooled relative risk (RR) estimates and conducted meta-regression analyses.

Analysis and Applications of Non-Adaptive and Adaptive Group Testing Methods for COVID-19
Cassidy Mentus et al.
7 April 2020, in medRxiv
Testing strategies for Covid-19 to maximize number of people tested is urgently needed. Recently, it has been demonstrated that RT-PCR has the sensitivity to detect one positive case in a mixed sample 32 cases [9]. In this paper we propose non-adaptive and adaptive group testing strategies based on generalized binary splitting (GBS) [2] where we restrict the group test to the largest group that can be used. The method starts by choosing a group from the population to be tested, performing a test on the combined sample from the entire group and progressively splitting the group further into subgroups. Compared to individual testing at 4% prevalence we save 74% at 1% we save 91% and at 1% we save 97% of tests. We analyze the number of times each sample is used and show the method is still efficient if we resort to testing a case individually if the sample is running low.

Study of Epidemiological Characteristics and In-silico Analysis of the Effect of Interventions in the SARS-CoV-2 Epidemic in India
Archisman Mazumder et al.
7 April 2020, in medRxiv
After SARS-CoV-2 set foot in India, the Indian Government took a number of steps to limit the spread of the disease in the country. This study involves assessing how the disease affected the population in the initial days of the epidemic. Data was collected from government controlled and crowdsourced websites and then put through analysis and calculations. With a study on age and sex parameters of 413 patients, the median age of the affected individuals was found out to be 36 years (IQR 25-54 years) with 20-39 years males being the most affected group. The number of affected males (66.34%) was more than that of the females(33.66%).Using SIR model, the range of contact rate(β) of India was calculated and the role of public health interventions was assessed which proved that the interventions were effective for a little while but the effect reduced due to violations.

COVID-19 pandemic: Impact of lockdown, contact and non-contact transmissions on infection dynamics
Shovolnal Roy
7 April 2020, in medRxiv
COVID-19 coronavirus pandemic has virtually locked down the entire world of human population, and through its rapid and unstoppable spread COVID-19 has essentially compartmentalised the population merely into susceptible, exposed, infected and recovered classes. Adapting the classical epidemic modelling framework, two distinct routes of COVID-19 transmission are incorporated into a model: (a) direct person-to-person contact transmission, and (b) indirect airborne and fomites-driven transmission. The indirect non-contact transmission route needs to explored in models of COVID-19 spread, because evidences show that this route of transmission is entirely viable with hugely uncertain level of relative contribution.

A Bayesian Logistic Growth Model for the Spread of COVID-19 in New York
Svetoslav Bliznashki
7 April 2020, in medRxiv
We use Bayesian Estimation for the logistic growth model in order to estimate the spread of the coronavirus epidemic in the state of New York. Models weighting all data points equally as well as models with normal error structure prove inadequate to model the process accurately. On the other hand, a model with larger weights for more recent data points and with t-distributed errors seems reasonably capable of making at least short term predictions.

Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy
Giacomo Grasselli et al.
6 April 2020, in Jama Network
Objective :To characterize patients with coronavirus disease 2019 (COVID-19) requiring treatment in an intensive care unit (ICU) in the Lombardy region of Italy.
Design, Setting, and Participants : Retrospective case series of 1591 consecutive patients with laboratory-confirmed COVID-19 referred for ICU admission to the coordinator center (Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy) of the COVID-19 Lombardy ICU Network and treated at one of the ICUs of the 72 hospitals in this network between February 20 and March 18, 2020. Date of final follow-up was March 25, 2020.
Exposures : SARS-CoV-2 infection confirmed by real-time reverse transcriptase–polymerase chain reaction (RT-PCR) assay of nasal and pharyngeal swabs.
Main Outcomes and Measures : Demographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality. Data were recorded by the coordinator center on an electronic worksheet during telephone calls by the staff of the COVID-19 Lombardy ICU Network.

Infection and Rapid Transmission of SARS-CoV-2 in Ferrets
Young-Il Kim et al.
PMID: 32259477, 5 April 2020, in ScienceDirect
The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China and rapidly spread worldwide. To prevent SARS-CoV-2 dissemination, understanding the in vivo characteristics of SARS-CoV-2 is a high priority. We report a ferret model of SARS-CoV-2 infection and transmission that recapitulates aspects of human disease. SARS-CoV-2-infected ferrets exhibit elevated body temperatures and virus replication.

Novel Coronavirus Infection in Children Outside of Wuhan, China
Qinxue Shen et al.
PMID: 32259403, 5 April 2020, in Pediatric Pulmonology
Background: Since December 8, 2019, an epidemic of coronavirus disease 2019 (COVID-19) has spread rapidly, but information about children with COVID-19 is limited.
Methods: This retrospective and the single-center study were done at the Public Health Clinic Center of Changsha, Hunan, China. We identified all hospitalized children diagnosed with COVID-19 between January 8, 2019 and February 19, 2020, in Changsha. Epidemiological and clinical data of these children were collected and analyzed. Outcomes were followed until February 26th, 2020.

Maternal and Perinatal Outcomes with COVID‐19: a systematic review of 108 pregnancies
Mehreen Zaigham et Ola Andersson
PMID: 32259279, 7 April 2020, in Acta Obstetricia et Gynecologica Scandinavica

Introduction: The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has exposed vulnerable populations to an unprecedented global health crisis. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The objective of this study was to summarize the clinical manifestations and maternal and perinatal outcomes of COVID-19 during pregnancy.
Material and methods: We searched databases for all case reports and series from February 12 to April 4, 2020. Multiple terms and combinations were used including COVID-19, pregnancy, maternal mortality, maternal morbidity, complications, clinical manifestations, neonatal morbidity, intrauterine fetal death, neonatal mortality and SARS-CoV-2. Eligibility criteria included peer-reviewed publications written in English or Chinese and quantitative real-time polymerase chain reaction (PCR) or dual fluorescence PCR confirmed SARS-CoV-2 infection. Unpublished reports, unspecified date and location of the study or suspicion of duplicate reporting, cases with suspected COVID-19 that were not confirmed by a laboratory test, and unreported maternal or perinatal outcomes were excluded. Data on clinical manifestations, maternal and perinatal outcomes including vertical transmission were extracted and analyzed.


07 April, 2020, 1.45 CET

School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review
Russel M. Viner et al.
6 April 2020, in The Lancet Child and Adolescent Health
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.

Structural Variations in Human ACE2 may Influence its Binding with SARS‐CoV‐2 Spike Protein
Mushtaq Hussain et al.
PMID: 32249956, 6 April 2020, in Journal of Medical Virology
The recent pandemic of COVID-19, caused by SARS-CoV-2, is unarguably the most fearsome compared to the earlier outbreaks caused by other coronaviruses, SARS-CoV and MERS-CoV. Human ACE2 is now established as a receptor for the SARS-CoV-2 spike protein. Where variations in the viral spike protein in turn lead to the cross species transmission of the virus, genetic variations in the host receptor ACE2, may also contribute to the susceptibility and/or resistance against the viral infection. This study aims to explore the binding of the proteins encoded by different human ACE2 allelic variants with SARS-CoV-2 spike protein. Briefly, coding variants of ACE2 corresponding to the reported binding sites for its attachment with coronavirus spike protein were selected and molecular models of these variants were constructed by homology modelling. The models were then superimposed over the native ACE2 and ACE2-spike protein complex, to observe structural changes in the ACE2 variants and their intermolecular interactions with SARS-CoV-2 spike protein respectively.

An Analysis of Spatiotemporal Pattern for COIVD-19 in China Based on Space-Time Cube
Chunbao Mo et al.
PMID: 3224995, 6 April 2020, in Journal of Medical Virology
This study seeks to examine and analyze the spatial and temporal patterns of COVID-19 outbreaks and identify the spatiotemporal distribution characteristics and changing trends of cases. Hence, local outlier analysis and emerging spatiotemporal hot spot analysis were performed to analyze the spatiotemporal clustering pattern and cold\hot spot trends of COVID-19 cases based on space-time cube during the period from January 23, 2020 to February 24, 2020.

A Comparative-Descriptive Analysis of Clinical Characteristics in 2019-Coronavirus-infected Children and Adults
Ya-Nah Han et al.
PMID: 32249943, 6 April 2020, in Journal of Medical Virology
Acute respiratory disease (ARD) caused by 2019 novel coronavirus (2019-nCoV) has rapidly spread throughout China. Children and adults show a different clinical course. The purpose of the current study is to comparatively analyze the clinical characteristics of 2019-nCoV infection in children and adults and to explore the possible causes for the discrepancies present. The medical records of 25 adults and 7 children confirmed cases of 2019-nCoV ARD were reviewed retrospectively. All children were family clusters. The total adult patients were differentiated into: the local residents of Wuhan, a history of travel to Wuhan and direct contact with people from Wuhan.

COVID‐19 and Urology: A Comprehensive Review of the Literature
Stefano Puliatti et al.
PMID: 32249538, 6 April 2020, in BJUI International
Covid‐19 pandemic is the newest and biggest global health threat worldwide. Medical and surgical priorities were changed dramatically at the time of this pandemic. Postponement for all outpatient and elective activities to save facilities and resources for urgent cases and Covid‐19 patients was adopted by most of hospitals in the affected countries. Over the coming weeks healthcare workers including urologists will be facing increasingly difficult challenges and consequently they should adopt sufficient protection strategies to guard against infection when dealing with COVID‐19 patients. In this review we discussed the impact of Covid‐19 on global health, urinary tract and uro‐oncologic surgeries . Additionally, we reviewed some of the available recommendations reported on oncological surgeries practice during this pandemic.


Computational Studies of Drug Repurposing and Synergism of Lopinavir, Oseltamivir and Ritonavir Binding With SARS-CoV-2 Protease Against COVID-19
Nisha Muralidharan et al.
PMID: 32248766, 6 April 2020, in Journal of Biomolecular Structure and Dynamics
A novel coronavirus (SARS-CoV-2) has caused a major outbreak in humans all over the world, and it is the latest pandemic in the series of other infectious diseases. The concept of drug repurposing has been used successfully for many years for known diseases. Considering the emergency and urgency, drug repurposing concept is being explored for coronavirus disease (COVID-19) as well. Recently, the combination of three known drugs, lopinavir, oseltamivir and ritonavir has been proposed to control the virulence to a great extent in COVID-19 affected patients within 48 hours. Hence, we tried to understand the effect of synergism of these drugs against the SARS-CoV-2 protease using sequential docking studies. As a result, combination of three drugs showed a better binding energy than that of individual drugs. Further, the complex was subjected to molecular dynamics simulations to get insights into the stability of the complex, considering the simultaneous interactions between three drugs and the protein. The protein complexed with three drugs remained stable during the simulations. Hence, these drugs can be explored further for drug repurposing against the successful inhibition of COVID-19.

Maternal and Neonatal Outcomes of Pregnant Women With COVID-19 Pneumonia: A Case-Control Study
Na Li et al.
PMID: 32249918, 30 March 2020, in Clinical Infectious Diseases
Background: The ongoing epidemics of coronavirus disease 2019 (COVID-19) have caused serious concerns about its potential adverse effects on pregnancy. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia.
Methods: We conducted a case-control study to compare clinical characteristics, maternal and neonatal outcomes of pregnant women with and without COVID-19 pneumonia.

06 April, 2020, 1.30 CET

Neutrophil-to-Lymphocyte Ratio and Lymphocyte-to-C-reactive Protein Ratio in Patients With Severe Coronavirus Disease 2019 (COVID-19): A Meta-Analysis
Francisco Alejandro Lagunas-Rangel
PMID: 32242950, 3 April 2020, in Journal of Medical Virology
Since March 11, 2020, the World Health Organization (WHO) defined Coronavirus disease 2019 (COVID-19) as a pandemic, with a series of confirmed cases that currently exceeded 300,000 people worldwide and with approximately 14,500 deaths. Accumulated evidence suggests that a subgroup of patients with severe COVID-19 could have a dysregulation of the immune response that allows the development of viral hyperinflammation. Thus, all patients with severe COVID-19 should be screened for hyperinflammation using laboratory parameters in order to improve mortality. Neutrophil-to-Lymphocyte ratio (NLR) and Lymphocyte-to-C-reactive protein ratio (LCR) are established inflammation markers that reflect systemic inflammatory response, and both are available in almost all laboratories. In this study, a meta-analysis was performed to investigate whether NLR and LCR values can help predict clinical severity in patients with COVID-19.


Imaging and Clinical Features of Patients With 2019 Novel Coronavirus SARS-CoV-2: A Systematic Review and Meta-Analysis
Yinghao Cao et al.
PMID : 32242947, 3 April 2020, in Journal of Medical Virology
Background: Currently, the epidemic of Coronavirus Disease 2019 (COVID-19) has begun to spread worldwide. We aim to explore reliable evidences for the diagnosis and treatment of the COVID-19 by analyzing all the published studies by Chinese scholars on the clinical and imaging features in novel coronavirus pneumonia (NCP) caused by SARS-CoV-2.
Methods: We searched five medical databases including two Chinese and three English databases for all published articles on COVID-19 since the outbreak. A random-effects model was designed, and the imaging and clinical data from all studies were collected for meta-analysis.


Clinical Features of 85 Fatal Cases of COVID-19 From Wuhan: A Retrospective Observational Study
Yingzhen Du et al.
PMID: 32242738, 3 April 2020, in American Journal of Respiratory and Critical Care Medicine
Background: The global death toll from COVID-19 virus exceeds 21000. The risk factors for death were attributed to advanced age and co-morbidities, but haven't been accurately defined.
Objectives: To report the clinical features of 85 fatal cases with COVID-19 in two hospitals in Wuhan.
Method: Medical records of 85 fatal cases of COVID-19 between January 9 and February 15, 2020 were collected. Information recorded included medical history, exposure history, comorbidities, symptoms, laboratory findings, CT scans and clinical management.


Clinical Course and Outcomes of Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a Preliminary Report of the First 28 Patients from the Korean Cohort Study on COVID-19
Eu Suk Kim et al.
PMID: 32242348, 6 April 2020, in Journal of Korean Medical Science
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pneumonia emerged in Wuhan, China in December 2019. In this retrospective multicenter study, we investigated the clinical course and outcomes of novel coronavirus disease 2019 (COVID-19) from early cases in Republic of Korea. Methods: All of the cases confirmed by real time polymerase chain reaction were enrolled from the 1st to the 28th patient nationwide. Clinical data were collected and analyzed for changes in clinical severity including laboratory, radiological, and virologic dynamics during the progression of illness.


Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection
Lu Lin et al.
PMID: 32241899, 2 April 2020, in Gut
Objective: To study the GI symptoms in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients.
Design: We analysed epidemiological, demographic, clinical and laboratory data of 95 cases with SARS-CoV-2 caused coronavirus disease 2019. Real-time reverse transcriptase PCR was used to detect the presence of SARS-CoV-2 in faeces and GI tissues.


Characterization of spike glycoprotein of SARS-CoV-2 on virus entry and its immunecross-reactivity with SARS-CoV
Xiuyuan Ou et al.
27 March 2020, in Nature
Since 2002, beta coronaviruses (CoV) have caused three zoonotic outbreaks, SARS-CoV in 2002–2003, MERS-CoV in 2012, and the newly emerged SARS-CoV-2 in late 2019. However, little is currently known about the biology of SARS-CoV-2. Here, using SARS-CoV-2 S protein pseudovirus system, we confirm that human angiotensin converting enzyme 2 (hACE2) is the receptor for SARS-CoV-2, find that SARS-CoV-2 enters 293/hACE2 cells mainly through endocytosis, that PIKfyve, TPC2, and cathepsin L are critical for entry, and that SARS-CoV-2 S protein is less stable than SARS-CoV S. Polyclonal anti-SARS S1 antibodies T62 inhibit entry of SARS-CoV S but not SARS-CoV-2 S pseudovirions. Further studies using recovered SARS and COVID-19 patients’ sera show limited cross-neutralization, suggesting that recovery from one infection might not protect against the other. Our results present potential targets for development of drugs and vaccines for SARS-CoV-2.


Evolving epidemiology and transmission dynamics ofcoronavirus disease 2019 outside Hubei province, China: a descriptive and modelling study
Juanjuan Zhang et al.
2 April 2020, in The Lancet Infectious Diseases
Background The coronavirus disease 2019 (COVID-19) epidemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in Wuhan city, Hubei province, in December, 2019, and has spread throughout China. Understanding the evolving epidemiology and transmission dynamics of the outbreak beyond Hubei would provide timely information to guide intervention policy. Methods We collected individual information from official public sources on laboratory-confirmed cases reported outside Hubei in mainland China for the period of Jan 19 to Feb 17, 2020. We used the date of the fourth revision of the case definition (Jan 27) to divide the epidemic into two time periods (Dec 24 to Jan 27, and Jan 28 to Feb 17) as the date of symptom onset. We estimated trends in the demographic characteristics of cases and key time-to-event intervals. We used a Bayesian approach to estimate the dynamics of the net reproduction number (Rt ) at the provincial level.


03 April, 2020, 1.30pm CET

Liver Impairment in COVID-19 Patients: A Retrospective Analysis of 115 Cases from a Single Center in Wuhan City, China
Yafei Zhang et al.
PMID: 32239796, 3 April 2020, in Liver International
Background: The SARS-CoV-2 pandemic is an ongoing global health emergency. The aim of our study was to investigate the changes of liver function and its clinical significance in COVID-19 patients.
Method: This retrospective, single-center study was conducted on 115 confirmed cases of COVID-19 in Zhongnan hospital of Wuhan University from Jan 18 to Feb 22, 2020. Liver function and related indexes were analyzed to evaluate its relationship with disease progression in COVID-19 patients.


Identification of Chymotrypsin-like Protease Inhibitors of SARS-CoV-2 Via Integrated Computational Approach
Salman Ali Khan et al.
PMID: 32238094, 2 April 2020, in Journal of Biomolecular Structure and Dynamics
Recently, the world has witnessed outbreak of a novel Coronavirus (SARS-CoV-2), the virus which initially emerged in Wuhan, China has now made its way to a large part of the world, resulting in a public emergency of international concern. The functional importance of Chymotrypsin-like protease (3CLpro) in viral replication and maturation turns it into an attractive target for the development of effective antiviral drugs against SARS and other coronaviruses. At present, there is no standard drug regime nor any vaccine available against the infection. The rapid development and identification of efficient interventions against SARS-CoV-2 remains a major challenge. Based on the available knowledge of closely related coronavirus and their safety profiles, repurposing of existing antiviral drugs and screening of available databases is considered a near term strategic and economic way to contain the SARS-CoV-2 pandemic. Herein, we applied computational drug design methods to identify Chymotrypsin-like protease inhibitors from FDA approved antiviral drugs and our in-house database of natural and drug-like compounds of synthetic origin. As a result three FDA approved drugs ( Remdesivir, Saquinavir and Darunavir) and two natural compounds (. flavone and coumarine derivatives) were identified as promising hits. Further, MD simulation and binding free energy calculations were performed to evaluate the dynamic behavior, stability of protein-ligand contact, and binding affinity of the hit compounds.


Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility — King County, Washington, March 2020
Anne Kimball et al.
PMID: 32240128, 3 April 2020, in Morbidity and Mortality Weekly Report (CDC)
What is already known about this topic?
Once SARS-CoV-2 is introduced in a long-term care skilled nursing facility (SNF), rapid transmission can occur.
What is added by this report?
Following identification of a case of coronavirus disease 2019 (COVID-19) in a health care worker, 76 of 82 residents of an SNF were tested for SARS-CoV-2; 23 (30.3%) had positive test results, approximately half of whom were asymptomatic or presymptomatic on the day of testing.


SARS-CoV-2 Is Not Detectable in the Vaginal Fluid of Women With Severe COVID-19 Infection
Lin Qiu et al.
PMID: 32241022, 2 April 2020, in Clinical Infectious Diseases
Background : Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) is mainly spread through respiratory droplets or direct contact. But the infection condition of genital system is still unknown. This study aimed to evaluate whether or not SARS-CoV-2 is found in the vaginal fluid of women with COVID-19 illness.
Methods : 10 women with confirmed severe COVID-19 pneumonia admitted to in Tongji Zhongfa Hospital Intensive care union(ICU) ward from Feb 4, 2020 to Feb 24, 2020 were included. Clinical records, laboratory results, and computer tomography(CT)-scan examination were retrospectively reviewed. The evidence of genital infection potential was accessed by testing for the presence of SARS-CoV-2 in vaginal fluids obtained from vaginal swab samples. Reverse transcriptase polymerase chain reaction(RT-PCR) was used to confirm the SARS-CoV-2 infection in vaginal fluids.


Computational inference of selection underlying the evolution of the novel coronavirus, SARS-CoV-2
Rachele Cagliani et al.
PMID: 32238584, 1 April 2020, in Journal of Virology
The novel coronavirus (SARS-CoV-2) recently emerged in China is thought to have a bat origin, as its closest known relative (BatCoV RaTG13) was described in horseshoe bats. We analyzed the selective events that accompanied the divergence of SARS-CoV-2 from BatCoV RaTG13. To this aim, we applied a population genetics-phylogenetics approach, which leverages within-population variation and divergence from an outgroup. Results indicated that most sites in the viral ORFs evolved under strong to moderate purifying selection.


Clinical Findings in a Patient With Hemophilia A Affected by COVID-19
Dongyan Cui et al.
PMID : 32239590, 1 April 2020, in Haemophilia
Minimal information is available regarding COVID-19 patients with hemophilia A. Herein, we retrospectively analyzed the epidemiological, clinical, laboratory and radiological characteristics, treatment and clinical outcomes of an infected patient with hemophilia A in Wuhan. This case report may be a good example in the management of mild COVID-19 cases with hemophilia A.


SARS-CoV-2 Spike Protein Favors ACE2 From Bovidae and Cricetidae
Junwen Luan et al.
PMID: 32239522, 1 April 2020, in The Journal of Medical Virology
SARS-CoV-2 causes the recent COVID-19 public health crisis. Bat is the widely believed original host of SARS-CoV-2. However, its intermediate host before transmitting to human is not clear. Some studies proposed pangolin, snake or turtle as the intermediate hosts. ACE2 is the receptor for SARS-CoV-2, which determines the potential host range for SARS-CoV-2. Based on the structural information of the complex of human ACE2 and SARS-CoV-2 RBD, we analyzed the affinity to S protein of the 20 key residues in ACE2 from mammal, bird, turtle and snake. Several ACE2 proteins from Primates, Bovidae, Cricetidae and Cetacea maintained the majority of key residues in ACE2 for associating with SARS-CoV-2 RBD. The simulated structures indicated that ACE2 proteins from Bovidae and Cricetidae were able to associate with SARS-CoV-2 RBD. We found that nearly half of the key residues in turtle, snake and bird are changed. The simulated structures showed several key contacts with SARS-CoV-2 RBD in turtle and snake ACE2 were abolished. Our study demonstrated that neither snake nor turtle was the intermediate hosts for SARS-CoV-2, which further reinforced the concept that the reptiles are resistant against infection of coronavirus. Our study suggested that Bovidae and Cricetidae should be included in the screening of intermediate hosts for SARS-CoV-2.


Isolation and Full-Length Genome Characterization of SARS-CoV-2 From COVID-19 Cases in Northern Italy
Danilo Licastro et al.
PMID: 32238585, 1 April 2020, in Journal of Virology
In December 2019, the novel coronavirus Severe Acquired Respiratory Syndrome SARS-CoV-2 emerged in the city of Wuhan in the Hubei province, People's Republic of China, as the etiologic agent of coronavirus disease 2019 (COVID-19), which has hence spread worldwide causing a global pandemic. Cell culture supernatant from passage 1 (P1) of four isolates were collcted, and RNA was extracted with QiAmp Viral RNA mini kit (Qiagen ) and quantified with an in vitro transcribed RNA standard.

COVID-19 in Hemodialysis Patients: A Report of 5 Cases
Rui Wang et al.
PMID: 32240718, 31 March 2020, in American Journal of Kidney Diseases
In December 2019, an outbreak of coronavirus disease (COVID-19) due to the novel SARS-CoV-2 virus began in China and spread rapidly worldwide. It is unknown whether hemodialysis patients represent a distinct group of patients with certain characteristics that may make them susceptible to infection or severe disease. In this Case Report, we describe the clinical and epidemiological features of COVID-19 in 201 maintenance hemodialysis patients in Zhongnan Hospital of Wuhan university, including 5 maintenance hemodialysis patients who contracted COVID-19 disease.


02 April, 2020, 3pm, CET

COVID-19 pandemic in west Africa
Melissa Martinez-Alvarez et al.
1 April 2020, in The Lancet Global Health
The coronavirus disease 2019 (COVID-19) outbreak, which started in the Hubei province of China in 2019, has now spread to all continents, affecting 177 countries by March 27, 2020. Successful efforts in containing the COVID-19 virus in Asia resulted in WHO declaring Europe as the epicentre of the disease on March 13. Whether warmer temperatures will slow the spread of the COVID-19 virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been a point of much speculation. This hypothesis has led some European countries to produce initial policies relying on decreased transmission rates during the summer months, and the belief that African countries will face smaller epidemics than their European counterparts. However, no strong evidence base exists for such claims; SARS-CoV-2 might have simply arrived later to warmer countries.

Epidemiological analysis of COVID-19 and practical experience from China
Qing Ye et al.
PMID: 32237160, 1 April 2020, in Journal of Medical Virology
The rapid spread of the epidemic has aroused widespread concern in the international community. SARS-COV-2 originated from Wuhan's Huanan wholesale seafood market, with bats as the likely original hosts and pangolins as potential intermediate hosts. The current source of the disease is mainly patients infected with SARS-COV-2. Patients in the incubation period may also become sources of infection. The virus is mainly transmitted via respiratory droplets and contact, and the population is generally susceptible. The epidemic has progressed through the local outbreak stage and community transmission stage due to exposure at Wuhan's Huanan wholesale seafood market and is now in the stage of large-scale transmission due to the spread of the epidemic. The basic productive number (R0) at the beginning of the epidemic was 2.2, with an average incubation period of 5.2 days. The proportion of critically ill patients was 23.4%, the mortality rate was lower than those of SARS and MERS, and 96.5% of deaths occurred in Hubei Province, where the outbreak occurred first. Among them, elderly men with underlying diseases had a higher mortality rate. Chinese medical staff have summarized a set of effective strategies and methods in the diagnosis and treatment of this disease that are worthy of reference for their international counterparts. With powerful government intervention and the efforts of Chinese medical staff, China's outbreak has gradually improved.

Differences Between COVID-19 and Suspected Then Confirmed SARS-CoV-2-negative Pneumonia: A Retrospective Study From a Single Center
Xinyi Chen et al.
PMID: 32237148, 1 April 2020, in Journal of Medical Virology
Coronavirus disease 2019 (COVID-19) broke out in Wuhan, Hubei, China in December 2019. Tens thousands of people have been infected with the disease. Our aim was to distinguish severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients from SARS-CoV-2-negative patients. We retrospectively compared the data of COVID-19 patients with those of suspected and confirmed SARS-CoV-2-negative patients (control patients). There were 78 COVID-19 patients and 26 control patients, whose median ages were significantly different (P=0.001). The percentage of COVID-19 patients admitting exposure to Wuhan was obviously higher than that of control patients (X2 =29.130, P<0.001). Fever and cough appeared more frequently in COVID-19 patients than in the control patients. The routine blood work-up parameters of COVID-19 patients did not change much and their mean counts were in normal range. There were 38.5% of control patients had higher procalcitonin (PCT) levels than 0.5ng/ml, which was significantly higher than that percentage of COVID-19 patients (X2 =22.636, P <0.05), and COVID-19 patients were also more likely to have decreased or normal urea and creatinine levels than control patients (X2 =24.930, 8.480, P <0.05).Younger age, exposure to Wuhan, fever, cough, and slight changes in routine blood work-up parameters, urea and creatinine were important features discriminating COVID-19 from control patients. Slightly increased, but far less than 0.5ng/ml, PCT levels also differentiated COVID-19 patients from control patients.


Identification of a potential mechanism of acute kidney injury during the COVID-19 outbreak: a study based on single-cell transcriptome analysis
Xiu-Wu Pan et al.
PMID: 32236644, 31 March 2020, in Intensive Care Medicine
Tens of thousands of humans were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within a short period of time, and the infection spread quickly across China and throughout the world. Acute kidney injury (AKI) is one of the important complications of the 2019 novel coronavirus disease (COVID19), occurring in 0.5–7% of cases and in 2.9–23% of ICU patients. However, whether the AKI of COVID-19 is caused by a coronavirus-induced cytopathic efect or cytokine storm-induced systemic infammatory response remains unclear.

A Comparative Study of Chest Computed Tomography Features in Young and Older Adults With Corona Virus Disease (COVID-19)
Tingting Zhu et al.
PMID: 32235187, 31 March 2020, in Jounal of Thoracic Imaging
The objective here is to analyze the most common computed tomography (CT) findings of pneumonia caused by new coronavirus in younger patients (60 and younger) and older adults (older than 60). The chest CT images of 72 symptomatic patients with corona virus disease (COVID-19) were analyzed retrospectively, including 44 younger patients (47.5±8.7 y old) and 28 older patients (68.4±6.0 y old). CT findings including density (pure ground-glass opacities, ground-glass opacities with consolidation, consolidation), the number of lobes involved, lesion distribution, and the main accompanying signs were analyzed and compared.

Spatial-temporal Distribution of COVID-19 in China and Its Prediction: A Data-Driven Modeling Analysis
Rui Hang et al.
PMID: 32235084, 31 March 2020, in The Jounral of Infection in Developing Countries
Currently, the outbreak of COVID-19 is rapidly spreading especially in Wuhan city, and threatens 14 million people in central China. In the present study we applied the Moran index, a strong statistical tool, to the spatial panel to show that COVID-19 infection is spatially dependent and mainly spread from Hubei Province in Central China to neighbouring areas. Logistic model was employed according to the trend of available data, which shows the difference between Hubei Province and outside of it. We also calculated the reproduction number R0 for the range of [2.23, 2.51] via SEIR model. The measures to reduce or prevent the virus spread should be implemented, and we expect our data-driven modeling analysis providing some insights to identify and prepare for the future virus control.

Molecular Characterization of SARS-CoV-2 in the First COVID-19 Cluster in France Reveals an Amino-Acid Deletion in nsp2 (Asp268Del)
Antonin Bal et al.
PMID: 32234449, 28 March 2020, in Clinical Microbiology and Infection
In December 2019, a novel coronavirus emerged in China, causing outbreaks of unexplained pneumonia [1]. The virus was subsequently identified as a beta-coronavirus and named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is responsible of the coronavirus disease 2019 (COVID-19) pandemic which includes asymptomatic, upper, and lower respiratory tract infections. Among the first European cases of COVID-19, 6 were associated with a cluster of transmission in the French Alps in late January 2020 [2]. The index case of this cluster travelled from Singapore to France and went back to the United Kingdom (UK) where he was tested positive for SARS-CoV-2 on February 6th. Here, we aimed to investigate the French cases related to this cluster using metagenomic next-generation sequencing (mNGS) analysis.

Spinal anaesthesia for patients with coronavirus disease 2019 and possible transmission rates in anaesthetists: retrospective, single-centre, observational cohort study
Qi Zhong et al.
PMID: 32234250, 28 March 2020, in British Journal of Anaesthesia
Background: The safety of performing spinal anaesthesia for both patients and anaesthetists alike in the presence of active infection with the novel coronavirus disease 2019 (COVID-19) is unclear. Here, we report the clinical characteristics and outcomes for both patients with COVID-19 and the anaesthetists who provided their spinal anaesthesia.
Methods: Forty-nine patients with radiologically confirmed COVID-19 for Caesarean section or lower-limb surgery undergoing spinal anaesthesia in Zhongnan Hospital, Wuhan, China participated in this retrospective study. Clinical characteristics and perioperative outcomes were recorded. For anaesthesiologists exposed to patients with COVID-19 by providing spinal anaesthesia, the level of personal protective equipment (PPE) used, clinical outcomes (pulmonary CT scans), and confirmed COVID-19 transmission rates (polymerase chain reaction [PCR]) were reviewed.


01 April, 2020, 2pm, CET

The correlation between viral clearance and biochemical outcomes of 94 COVID-19 infected discharged patients
Jing Yuan et al.
PMID: 32227274, 30 March 2020, in Inflammation Research
This study aims to evaluate the correlation between viral clearance and blood biochemical index of 94 discharged patients with COVID-19 infection in Shenzhen Third People’s Hospital, enrolled from Jan 5 to Feb 13, 2020. The clinical and laboratory fndings were extracted from the electronic medical records of the patients. The data were analysed and reviewed by a trained team of physicians. Information on clinical signs and symptoms, medical treatment, virus clearance, and laboratory parameters including interleukin 6 (IL-6) and C-reactive protein were collected.


SARS-CoV-2–Positive Sputum and Faeces After Conversion of Pharyngeal Samples in Patients With COVID-19
Chen Chen et al.
PMID: 32227141, 30 March 2020, in Annals of Internal Medicine
Objective: To assess the results of RT-qPCR for SARS–CoV2 RNA of sputum and fecal samples from a group of patients after conversion of their pharyngeal samples from positive to negative.


Characteristics of peripheral lymphocyte subset alteration in COVID-19 pneumonia
Fan Wang et al.
PMID: 32227123, 30 March 2020, in The Journal of Infectious Diseases
Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. We aimed to clarify the characteristics and clinical significance of peripheral lymphocyte subset alteration in COVID-19.The levels of peripheral lymphocyte subsets were measured by flow cytometry in 60 hospitalized COVID-19 patients before and after treatment, and their association with clinical characteristics and treatment efficacy was analyzed.


The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2
Liang Chen et al.
PMID: 32227090, 30 March 2020, in Cardiovascular Research
Cardiac injury is a prevalent complication of severe patients, exacerbating the disease severity in coronavirus disease 2019 (COVID-19) patients. Angiotensin-converting enzyme 2 (ACE2), the key host cellular receptor of SARS-CoV-2, has been identified in multiple organs, but its cellular distribution in human heart is not illuminated clearly. This study performed the first state-of-art single cell atlas of adult human heart, and revealed that pericytes with high expression of ACE2 might act as the target cardiac cell of SARS-CoV-2. The pericytes injury due to virus infection may result in capillary endothelial cells dysfunction, inducing microvascular dysfunction.


Atlas of ACE2 gene expression in mammals reveals novel insights in transmisson of SARS-Cov-2
Kun Sun et al.
31 March 2020, in bioRxiv
COVID-19 has become a worldwide pandemic. It is caused by a novel coronavirus named SARS-CoV-2 with elusive origin. SARS-CoV-2 infects mammalian cells by binding to ACE2, a transmembrane protein. Therefore, the conservation of ACE2 and its expression pattern across mammalian species, which are yet to be comprehensively investigated, may provide valuable insights into tracing potential hosts of SARS-CoV-2. Methods: We analyzed gene conservation of ACE2 across mammals and collected more than 140 transcriptome datasets from human and common mammalian species, including presumed hosts of SARS-CoV-2 and other animals in close contact with humans. In order to enable comparisons across species and tissues, we used a unified pipeline to quantify and normalize ACE2 expression levels.

Sequence variation among SARS-CoV-2 isolates in Taiwan
Yu-Nong Gong et al.
31 March 2020, in bioRxiv
Taiwan experienced two waves of imported cases of coronavirus disease 2019 (COVID-19), first from China in January to late February, followed by those from other countries starting in early March. Additionally, several cases could not be traced to any imported cases and were suspected as sporadic local transmission. Twelve full viral genomes were determined in this study by Illumina sequencing either from virus isolates or directly from specimens, among which 5 originated from clustered infections. Phylogenetic tree analysis revealed that these sequences were in different clades, indicating that no major strain has been circulating in Taiwan. A deletion in open reading frame 8 was found in one isolate. Only a 4-nucleotide difference was observed among the 5 genomes from clustered infections.


31 March, 2020, 3pm, CET

Estimates of the severity of coronavirus disease 2019: a model-based analysis
Robert Verity et al.
30 March 2020, in The Lancet, Infectious Diseases
In the face of rapidly changing data, a range of case fatality ratio estimates for coronavirus disease 2019 (COVID-19) have been produced that differ substantially in magnitude. We aimed to provide robust estimates, accounting for censoring and ascertainment biases.

We collected individual-case data for patients who died from COVID-19 in Hubei, mainland China (reported by national and provincial health commissions to Feb 8, 2020), and for cases outside of mainland China (from government or ministry of health websites and media reports for 37 countries, as well as Hong Kong and Macau, until Feb 25, 2020). These individual-case data were used to estimate the time between onset of symptoms and outcome (death or discharge from hospital). We next obtained age-stratified estimates of the case fatality ratio by relating the aggregate distribution of cases to the observed cumulative deaths in China, assuming a constant attack rate by age and adjusting for demography and age-based and location-based under-ascertainment. We also estimated the case fatality ratio from individual line-list data on 1334 cases identified outside of mainland China. Using data on the prevalence of PCR-confirmed cases in international residents repatriated from China, we obtained age-stratified estimates of the infection fatality ratio. Furthermore, data on age-stratified severity in a subset of 3665 cases from China were used to estimate the proportion of infected individuals who are likely to require hospitalization.


Covid-19 in Critically ill Patients in the Seattle Region — Case Series
Pavan K. Bhatraju et al.
30 March 2020, in The New England Jounral of Medicine

Community transmission of coronavirus 2019 (Covid-19) was detected in the state of Washington in February 2020. We identified patients from nine Seattle-area hospitals who were admitted to the intensive care unit (ICU) with confirmed infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Clinical data were obtained through review of medical records. The data reported here are those available through March 23, 2020. Each patient had at least 14 days of follow-up.


Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study
Tao Chen et al.
26 March 2020, in The BMJ
Objective: To delineate the clinical characteristics of patients with coronavirus disease 2019 (covid-19) who died.
Design: Retrospective case series.
Setting: Tongji Hospital in Wuhan, China.
Participants: Among a cohort of 799 patients, 113 who died and 161 who recovered with a diagnosis of covid-19 were analysed. Data were collected until 28 February 2020.
Main outcome measures: Clinical characteristics and laboratory findings were obtained from electronic medical records with data collection forms.

This article has a correction, please see here

Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19)
Tao Guo et al.
27 March 2020, in JAMA Cardiology

Increasing numbers of confirmed cases and mortality rates of coronavirus disease 2019 (COVID-19) are occurring in several countries and continents. Information regarding the impact of cardiovascular complication on fatal outcome is scarce. The objective is to evaluate the association of underlying cardiovascular disease (CVD) and myocardial injury with fatal outcomes in patients with COVID-19. This retrospective single-center case series analyzed patients with COVID-19 at the Seventh Hospital of Wuhan City, China, from January 23, 2020, to February 23, 2020. Analysis began February 25, 2020.


Antibodies in Infants Born to Mothers With COVID-19 Pneumonia
Hui Zeng et al.
26 March 2020, in JAMA
Tests for IgG and IgM antibodies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became available in February 2020. On March 4, 2020, the seventh edition of the New Coronavirus Pneumonia Prevention and Control Protocol for the novel coronavirus disease 2019 (COVID-19) was released by the National Health Commission of the People’s Republic of China and added serological diagnostic criteria. A previous study of 9 pregnant women and their infants found no maternal-infant transmission of SARS-CoV-2 based on reverse transcriptase–polymerase chain reaction (RT-PCR). We applied these new criteria to 6 pregnant women with confirmed COVID-19 and their infants because serologic criteria would allow more detailed investigation of infection in newborns.

Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn
Lan Dong et al.
26 March 2020, in JAMA
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly infectious, with multiple possible routes of transmission controversy exists regarding whether SARS-CoV-2 can be transmitted in utero from an infected mother to her infant before birth. A series of 9 pregnant women found no mother-child transmission. We report a newborn with elevated IgM antibodies to SARS-CoV-2 born to a mother with coronavirus disease 2019 (COVID-19).

30 March, 2020, 3.30pm, CET

Genomic Characterisation and Phylogenetic Analysis of SARS-CoV-2 in Italy
Gianguglielmo Zehender et al.
PMID: 32222993, 29 March 2020, in Journal of Medical Virology

This report describes the isolation, molecular characterisation and phylogenetic analysis of the first three complete genomes of SARS‐CoV‐2 isolated from three patients involved in the first outbreak of COVID‐19 in Lombardy, Italy. Early molecular epidemiological tracing suggests that SARS‐CoV‐2 was present in Italy weeks before the first reported cases of infection.


Detectable SARS-CoV-2 Viral RNA in Feces of Three Children During Recovery Period of COVID-19 Pneumonia
Tongqiang Zhang et al.
PMID: 32222992, 29 March 2020, in Journal of Medical Virology
Coronavirus Disease 2019 (COVID-19) is a newly emerging infectious disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). After its first occurrence in Wuhan of China from December 2019, COVID-19 rapidly spread around the world. According to the World Health Organization (WHO) statement on March 13, 2020, there had been over 132,500 confirmed cases globally. Nevertheless, the case reports of children are rare, which result in the lack of evidence for preventing and controlling of children's infection. Here, we report 3 cases of SARS-CoV-2 infected children diagnosed from February 3 to February 17, 2020 in Tianjin, China. All of these three cases experienced mild illness and recovered soon after treatment, with the nucleic acid of throat swab turning negative within 14, 11, 7 days after diagnosis respectively. However, after been discharged, all the three cases were tested SARS-CoV-2 positive in the stool samples within 10 days, in spite of their remained negative nucleic acid in throat swab specimens. Therefore, it is necessary to be aware of the possibility of fecal-oral transmission of SARS-CoV-2 infection, especially for children cases


Clinical Characteristics of 54 Medical Staff With COVID-19: A Retrospective Study in a Single Center in Wuhan, China
Jiaojiao Chu et al.
PMID: 32222986, 29 March 2020, in Journal of Medical Virology
54 cases of SARS-Cov-2 infected medical staff from Tongji Hospital between January 7th to February 11th of 2020 were analyzed in this retrospective study. Clinical and epidemiological characteristics were compared between different groups by statistical method.


A Case of Novel Coronavirus Disease 19 in a Chronic Hemodialysis Patient Presenting with Gastroenteritis and Developing Severe Pulmonary Disease
Antoney J. Ferrey et al.
PMID: 32222713, 28 March 2020, in American Journal of Nephrology
Novel coronavirus disease 2019 (COVID-19) is a highly infectious, rapidly spreading viral disease with an alarming case fatality rate up to 5%. The risk factors for severe presentations are concentrated in patients with chronic kidney disease, particularly patients with end-stage renal disease (ESRD) who are dialysis dependent. We report the first US case of a 56-year-old nondiabetic male with ESRD secondary to IgA nephropathy undergoing thrice-weekly maintenance hemodialysis for 3 years, who developed COVID-19 infection. He has hypertension controlled with angiotensin receptor blocker losartan 100 mg/day and coronary artery disease status-post stent placement. During the first 5 days of his febrile disease, he presented to an urgent care, 3 emergency rooms, 1 cardiology clinic, and 2 dialysis centers in California and Utah. During this interval, he reported nausea, vomiting, diarrhea, and low-grade fevers but was not suspected of COVID-19 infection until he developed respiratory symptoms and was admitted to the hospital. Imaging studies upon admission were consistent with bilateral interstitial pneumonia. He was placed in droplet-eye precautions while awaiting COVID-19 test results. Within the first 24 h, he deteriorated quickly and developed acute respiratory distress syndrome (ARDS), requiring intubation and increasing respiratory support. Losartan was withheld due to hypotension and septic shock. COVID-19 was reported positive on hospital day 3. He remained in critical condition being treated with hydroxychloroquine and tocilizumab in addition to the standard medical management for septic shock and ARDS. Our case is unique in its atypical initial presentation and highlights the importance of early testing.


Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients
Fengting Yu et al.
PMID: 32221523, 28 March 2020, in Clinical Infectious Disease
Coronavirus disease 2019 (COVID-19) has become a public health emergency. The widely used reverse transcription PCR (RT-PCR) method has limitations for clinical diagnosis and treatment. Here, a total of 323 samples from 76 COVID-19 confirmed patients were analyzed by droplet digital PCR (ddPCR) and RT-PCR based two target genes (ORF1ab and N). Nasal swabs, throat swabs, sputum, blood, and urine were collected. Clinical and imaging data were obtained for clinical staging.


Clinical analysis of pregnant women with 2019 novel coronavirus pneumonia
Siyu Chen et al.
PMID: 32222119, 28 March 2020, in Journal of Medical Virology
In this article, we aim to evaluate the pregnant women infected with coronavirus disease 2019 (COVID-19) and provide help for clinical prevention and treatment.All 5 cases of pregnant women confirmed COVID-19 were collected among patients who admitted in Maternal and Child Hospital of Hubei Province between January 20 and February 10, 2020.


Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019
Juanjuan Zhao et al.
PMID: 32221519, 28 March 2020, in Clinical Infectious Disease
The novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patient remains largely unknown, and the clinical values of antibody testing have not been fully demonstrated. Here, a total of 173 patients with SARS-CoV-2 infection were enrolled. Their serial plasma samples (n=535) collected during the hospitalization were tested for total antibodies (Ab), IgM and IgG against SARS-CoV-2. The dynamics of antibodies with the disease progress was analyzed.


68 Consecutive Patients Assessed for COVID-19 Infection; Experience From a UK Regional Infectious Disease Unit
Nicholas Easom et al.
PMID: 32223012, 29 March 2020, in Influenza and other respiratory viruses
Assessment of possible infection with SARS-CoV-2, the novel coronavirus responsible for COVID-19 illness, has been a major activity of infection services since the first reports of cases in December 2019. We report a series of 68 patients assessed at a Regional Infection Unit in the UK.
Between the 29th Jan 2020 - 24th Feb 2020 demographic, clinical, epidemiological and laboratory data were collected. We compared clinical features between patients not requiring admission for clinical reasons or antimicrobials with those assessed as needing either admission or antimicrobial treatment.


Clinical and epidemiological features of 36 children withcoronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study
Haiyan Qiu et al.
25 March 2020, in The Lancet, Infectious Diseases
Since December, 2019, an outbreak of coronavirus disease 2019 (COVID-19) has spread globally. Little is known about the epidemiological and clinical features of paediatric patients with COVID-19. We retrospectively retrieved data for paediatric patients (aged 0–16 years) with confirmed COVID-19 from electronic medical records in three hospitals in Zhejiang, China. We recorded patients’ epidemiological and clinical features.

Clinical and virological data of the first cases of COVID-19in Europe: a case series
François-Xavier Lescure et al.
27 March 2020, in The Lancet, Infectious Diseases
In this case series, we followed five patients admitted to Bichat-Claude Bernard University Hospital (Paris, France) and Pellegrin University Hospital (Bordeaux, France) and diagnosed with COVID-19 by semi-quantitative RT-PCR on nasopharyngeal swabs. We assessed patterns of clinical disease and viral load from different samples (nasopharyngeal and blood, urine, and stool samples), which were obtained once daily for 3 days from hospital admission, and once every 2 or 3 days until patient discharge. All samples were refrigerated and shipped to laboratories in the National Reference Center for Respiratory Viruses (The Institut Pasteur, Paris, and Hospices Civils de Lyon, Lyon, France), where RNA extraction, real-time RT-PCR, and virus isolation and titration procedures were done.

Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington
Temet M. McMichael et al.
27 March 2020, in The New England Journal of Medicine
Long-term care facilities are high-risk settings for severe outcomes from outbreaks of Covid-19, owing to both the advanced age and frequent chronic underlying health conditions of the residents and the movement of health care personnel among facilities in a region. METHODS After identification on February 28, 2020, of a confirmed case of Covid-19 in a skilled nursing facility in King County, Washington, Public Health–Seattle and King County, aided by the Centers for Disease Control and Prevention, launched a case investigation, contact tracing, quarantine of exposed persons, isolation of confirmed and suspected cases, and on-site enhancement of infection prevention and control.


27 March, 2020, 2pm CET

The Effect of Human Mobility and Control Measures on the COVID-19 Epidemic in China
Moritz U. G. Kraemer et al.
PMID: 32213647, 25 March 2020, in Science
The ongoing COVID-19 outbreak expanded rapidly throughout China. Major behavioral, clinical, and state interventions have been undertaken to mitigate the epidemic and prevent the persistence of the virus in human populations in China and worldwide. It remains unclear how these unprecedented interventions, including travel restrictions, affected COVID-19 spread in China. We use real-time mobility data from Wuhan and detailed case data including travel history to elucidate the role of case importation on transmission in cities across China and ascertain the impact of control measures. Early on, the spatial distribution of COVID-19 cases in China was explained well by human mobility data. Following the implementation of control measures, this correlation dropped and growth rates became negative in most locations, although shifts in the demographics of reported cases were still indicative of local chains of transmission outside Wuhan. This study shows that the drastic control measures implemented in China substantially mitigated the spread of COVID-19.


Structural and biochemical characterization of SADS‐CoV Papain Like protease 2
Lu Wang et al.
PMID: 32216114, 26 March 2020, in Protein Science
Swine acute diarrhea syndrome coronavirus (SADS-CoV) is a novel coronavirus that is involved in severe diarrhea disease in piglets, causing considerable agricultural and economic loss in China. The emergence of this new coronavirus increases the importance of understanding SADS-CoV as well as antivirals. Coronaviral proteases, including main proteases and papain-like proteases (PLP), are attractive antiviral targets because of their essential roles in polyprotein processing and thus virus maturation. Here, we describe the biochemical and structural identification of recombinant SADS papain-like protease 2 (PLP2) domain of nsp3. The SADS-CoV PLP2 was shown to cleave nsp1 proteins and also peptides mimicking the nsp2|nsp3 cleavage site and also had deubiquitinating and deISGynating activity by in vitro assay. The crystal structure adopts an architecture resembling that of PLPs from other coronaviruses. We characterize both conserved and unique structural features likely directing the interaction of PLP2 with the substrates, also including the tentative mapping of active site and other essential residues. These results provide a foundation for understanding the molecular basis of coronaviral PLPs's catalytic mechanism and for the screening and design of therapeutics to combat infection by SADS coronavirus.


Covid‐19 and the Digestive System
Sunny H. Wong et al.
PMID: 32215956, 25 March 2020, Journal of Gastroenterology and Hepatology
The novel coronavirus disease (Covid‐19) is currently causing a major pandemic. It is caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), a member of the Betacoronavirus genus that also includes the SARS‐CoV and Middle East Respiratory Syndrome Coronavirus (MERS‐CoV). While patients typically present with fever and a respiratory illness, some patients also report gastrointestinal symptoms such as diarrhoea, vomiting and abdominal pain. Studies have identified the SARS‐CoV‐2 RNA in stool specimens of infected patients, and its viral receptor angiotensin converting enzyme 2 (ACE2) was found to be highly expressed in gastrointestinal epithelial cells. These suggest that SARS‐CoV‐2 can actively infect and replicate in the gastrointestinal tract. This has important implications to the disease management, transmission, and infection control. In this article, we review the important gastrointestinal aspects of the disease.


CT morphology of COVID-19: Case report and review of literature
Okka Wilkea Hamer et al.
PMID: 32215898, 26 March 2020, in Roefo
The number of patients with COVID-19 is rapidly increasing in Europe. The lethality of the disease appears to be higher than that of seasonal flu, for example, especially in older patients. RT-PCR is the gold standard for establishing a diagnosis. In many patients, chest CT seems to provide an image that is suggestive for diagnosis. The cardinal signs are ground glass opacities, consolidation and crazy paving, predominantly located in the periphery of the lower lobes. This CT morphology can support the diagnosis and differentiation from other viral pneumonia. This is particularly important because RT-PCR can initially provide a false negative result.

CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19)
Kunwei Li et al.
PMID: 32215691, 25 March 2020, in European Radiology
Objectives here is to explore the relationship between the imaging manifestations and clinical classification of COVID-19. We conducted a retrospective single-center study on patients with COVID-19 from Jan. 18, 2020 to Feb. 7, 2020 in Zhuhai, China. Patients were divided into 3 types based on Chinese guideline: mild (patients with minimal symptoms and negative CT findings), common, and severe-critical (patients with positive CT findings and different extent of clinical manifestations). CT visual quantitative evaluation was based on summing up the acute lung inflammatory lesions involving each lobe, which was scored as 0 (0%), 1 (1–25%), 2 (26–50%), 3 (51–75%), or 4 (76–100%), respectively. The total severity score (TSS) was reached by summing the five lobe scores. The consistency of two observers was evaluated. The TSS was compared with the clinical classification. ROC was used to test the diagnosis ability of TSS for severe-critical type.


Simulation of the Clinical and Pathological Manifestations of Coronavirus Disease 2019 (COVID-19) in Golden Syrian Hamster Model: Implications for Disease Pathogenesis and Transmissibility
Jasper Fuk-Woo Chan et al.
PMID: 32215622, 26 March 2020, in Clinical Infectious Disease
A novel, readily available, and physiological small animal model of Syrian hamster for SARSCoV-2 infection that recapitulates the clinical, virological, histopathological, and immunological characteristics of human disease was established to study the pathogenesis, transmission, and passive immunisation effect of COVID-19.


Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) —United States, February 12–March 16, 2020
CDC COVID Respose team
PMID: 32214079, 27 March 2020
Globally, approximately 170,000 confirmed cases of coronavirus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) have been reported, including an estimated 7,000 deaths in approximately 150 countries (1). On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic (2). Data from China have indicated that older adults, particularly those with serious underlying health conditions, are at higher risk for severe COVID-19–associated illness and death than are younger persons (3). Although the majority of reported COVID-19 cases in China were mild (81%), approximately 80% of deaths occurred among adults aged ≥60 years; only one (0.1%) death occurred in a person aged ≤19 years (3). In this report, COVID-19 cases in the United States that occurred during February 12–March 16, 2020 and severity of disease (hospitalization, admission to intensive care unit [ICU], and death) were analyzed by age group. As of March 16, a total of 4,226 COVID-19 cases in the United States had been reported to CDC, with multiple cases reported among older adults living in long-term care facilities.

26 March, 2020, 3pm CET

Using the spike protein feature to predict infection risk and monitor the evolutionary dynamic of coronavirus
Xiao-Li Qiang et al.
PMID: 32209118, 25 March 2020, in Infectious Diseases of Poverty
Coronavirus can cross the species barrier and infect humans with a severe respiratory syndrome. SARS-CoV-2 with potential origin of bat is still circulating in China. In this study, a prediction model is proposed to evaluate the infection risk of non-human-origin coronavirus for early warning.


Analysis of Epidemiological and Clinical Features in Older Patients With Corona Virus Disease 2019 (COVID-19) Out of Wuhan
Jiangshan Lian et al.
PMID: 32211844, 25 March 2020, in Clinical Infectious Diseases
The outbreak of COVID-19 has become a big threat to China, with high contagious capacity and varied mortality. This study aimed to investigate the epidemiological and clinical characteristics of older patients with COVID-19 out of Wuhan. A retrospective study was performed, with collecting data from medical records of confirmed COVID-19 patients in Zhejiang province from Jan 17 to Feb 12, 2020. Epidemiological, clinical and treatment data were analyzed between those older (≥60y) and younger (<60y) patients.

Evolutionary Trajectory for the Emergence of Novel Coronavirus SARS-CoV-2
Saif Ur Rehman et al.
32210130, 23 March 2020, in Pathogens
Over the last two decades, the world experienced three outbreaks of coronaviruses with elevated morbidity rates. Currently, the global community is facing emerging virus SARS-CoV-2 belonging to Betacoronavirus, which appears to be more transmissible but less deadly than SARS-CoV. The current study aimed to track the evolutionary ancestors and different evolutionary strategies that were genetically adapted by SARS-CoV-2. Our whole-genome analysis revealed that SARS-CoV-2 was the descendant of Bat SARS/SARS-like CoVs and bats served as a natural reservoir. SARS-CoV-2 used mutations and recombination as crucial strategies in different genomic regions including the envelop, membrane, nucleocapsid, and spike glycoproteins to become a novel infectious agent. We confirmed that mutations in different genomic regions of SARS-CoV-2 have specific influence on virus reproductive adaptability, allowing for genotype adjustment and adaptations in rapidly changing environments. Moreover, for the first time we identified nine putative recombination patterns in SARS-CoV-2, which encompass spike glycoprotein, RdRp, helicase and ORF3a. Six recombination regions were spotted in the S gene and are undoubtedly important for evolutionary survival, meanwhile this permitted the virus to modify superficial antigenicity to find a way from immune reconnaissance in animals and adapt to a human host. With these combined natural selected strategies, SARS-CoV-2 emerged as a novel virus in human society.


The Clinical Characteristics of Myocardial injury 1 in Severe and Very Severe Patients with 2019 Novel Coronavirus Disease
Bo Zhou et al.
PMID: 32209382, 21 March 2020, in Journal of Infection
The 2019 Novel coronavirus disease (COVID-19) has drawn global intensive attention. .Previous studies suggest that severe COVID-19 may present with acute cardiac injury. However, few have investigated the cardiac lesion markers and their correlation to disease severity. In this letter, we explored the cardiac lesion biomarkers in patients with severe and very severe COVID-19.


Comparisons of nucleic acid conversion time of SARS-CoV-2 of different samples in ICU and non-ICU patients
Zhixiong Fang et al.
PMID: 32209381, 21 March 2020, in Journal of Infection
Since outbreak of unexplained pneumonia cases in Wuhan, China in December, 2019, the coronavirus disease 2019 (COVID-19) has spread to more than 90 countries. By 7th March, the infection of SARS-CoV-2 has influenced 101,918 patients globally. Recommended by World Health Organization (WHO), a positive real-time reverse transcriptase polymerase chain-reaction (RT-PCR) result could confirm the diagnosis of suspected COVID-19 patients. However, there still lacks thoroughly research concerning nucleic acid conversion time among different samples in COVID-19 patients. Here we compared the nucleic acid conversion time of SARS-CoV-2 in different samples of intensive care unit (ICU) and non-ICU patients and analyzed their characteristics.


Clinical Characteristics of Fatal and Recovered Cases of Coronavirus Disease 2019 (COVID-19) in Wuhan, China: A Retrospective Study
Deng Yan et al.
PMID: 32209890, 20 March 2020, in Chinese Medical Journal
The 2019 novel coronavirus (2019-nCoV) has caused the outbreak of the acute respiratory disease in Wuhan, Hubei Province of China since December 2019. This study is performed to analyze the clinical characteristics of patients who succumbed to and who recovered from 2019 novel coronavirus disease (COVID-19).Clinical data were collected from two tertiary hospitals in Wuhan. A retrospective investigation was conducted to analyze the clinical characteristics of fatal cases of COVID-19 (death group) and compare them with recovered patients (recovered group). Continuous variables were analyzed using the Mann-Whitney U test. Categorical variables were analyzed by χ test or Fisher's exact tests as appropriate.


Role of Changes in SARS-CoV-2 Spike Protein in the Interaction with the Human ACE2 Receptor: An in silico Analysis
Joseph T. Ortega et al.
PMID: 32210742, 18 March 2020
Many human viral diseases are a consequence of a zoonotic event. Some of the diseases caused by these zoonotic events have affected millions of people around the world, some of which have resulted in high rates of morbidity/mortality in humans. Changes in the viral proteins that function as ligands of the host receptor may promote the spillover between species. The most recent of these zoonotic events that have caused an ongoing epidemic of high magnitude is the Covid-19 epidemics caused by SARS-CoV-2. The aim of this study was to determine the mutation(s) in the sequence of the spike protein of the SARS-CoV-2 that might be favoring human to human transmission. An in silico approach was performed, and changes were detected in the S1 subunit of the receptor-binding domain of spike. The observed changes have significant effect on SARS-CoV-2 spike/ACE2 interaction and produce a reduction in the binding energy, compared to the one of the Bat-CoV to this receptor. The data presented in this study suggest a higher affinity of the SARS-Cov-2 spike protein to the human ACE2 receptor, compared to the one of Bat-CoV spike and ACE2. This could be the cause of the rapid viral spread of SARS-CoV-2 in humans.


Unrevealing Sequence and Structural Features of Novel Coronavirus Using in silico Approaches: The Main Protease as Molecular Target
Joseph T. Ortega et al.
PMID: 32210741, 17 March 2020
Direct-acting antivirals are effective tools to control viral infections. SARS-CoV-2 is a coronavirus associated with the epidemiological outbreak in late 2019. Previous reports showed that HIV-1 protease inhibitors could block SARS-CoV main protease. Based on that and using an in silico approach, we evaluated SARS-CoV-2 main protease as a target for HIV-1 protease inhibitors to reveal the structural features related to their antiviral effect. Our results showed that several HIV inhibitors such as lopinavir, ritonavir, and saquinavir produce strong interaction with the active site of SARS-CoV-2 main protease. Furthermore, broad library protease inhibitors obtained from PubChem and ZINC ( were evaluated. Our analysis revealed 20 compounds that could be clustered into three groups based on their chemical features. Then, these structures could serve as leading compounds to develop a series of derivatives optimizing their activity against SARS-CoV-2 and other coronaviruses. Altogether, the results presented in this work contribute to gain a deep understanding of the molecular pharmacology of SARS-CoV-2 treatment and validate the use of protease inhibitors against SARS-CoV-2.


25 March 2020, 2.30pm CET

Identifying Locations with Possible Undetected Imported Severe Acute Respiratory Syndrome Coronavirus 2 Cases by Using Importation Predictions
Pablo Martinez De Salazar et al.
PMID: 32207679, 24 March 2020, in Emerging Infectious Diseases
Cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exported from mainland China could lead to self-sustained outbreaks in other countries. By February 2020, several countries were reporting imported SARS-CoV-2 cases. To contain the virus, early detection of imported SARS-CoV-2 cases is critical. We used air travel volume estimates from Wuhan, China, to international destinations and a generalized linear regression model to identify locations that could have undetected imported cases. Our model can be adjusted to account for exportation of cases from other locations as the virus spreads and more information on importations and transmission becomes available. Early detection and appropriate control measures can reduce the risk for transmission in all locations.


Structural, glycosylation and antigenic variation between 2019 novel coronavirus (2019-nCoV) and SARS coronavirus (SARS-CoV)
Swatantra Kumar et al.
PMID: 32206694, March 2020, in Virus Disease
The emergence of 2019 novel coronavirus (2019-nCoV) is of global concern and might have emerged from RNA recombination among existing coronaviruses. CoV spike (S) protein which is crucial for receptor binding, membrane fusion via conformational changes, internalization of the virus, host tissue tropism and comprises crucial targets for vaccine development, remain largely uncharacterized. Therefore, the present study has been planned to determine the sequence variation, structural and antigenic divergence of S glycoprotein which may be helpful for the management of 2019-nCoV infection. The sequences of spike glycoprotein of 2019-nCoV and SARS coronavirus (SARS-CoV) were used for the comparison. The sequence variations were determined using EMBOSS Needle pairwise sequence alignment tools.


Mediastinal Emphysema, Giant Bulla, and Pneumothorax Developed during the Course of COVID-19 Pneumonia
Ruihong Sun
PMID: 32207255, March 2020, in Korean Journal of Radiology
The coronavirus disease 2019 (COVID-19) pneumonia is a recent outbreak in mainland China and has rapidly spread to multiple countries worldwide. Pulmonary parenchymal opacities are often observed during chest radiography. Currently, few cases have reported the complications of severe COVID-19 pneumonia. We report a case where serial follow-up chest computed tomography revealed progression of pulmonary lesions into confluent bilateral consolidation with lower lung predominance, thereby confirming COVID-19 pneumonia. Furthermore, complications such as mediastinal emphysema, giant bulla, and pneumothorax were also observed during the course of the disease.


Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China
Fang Zheng et al.
PMID: 32207032, 24 March 2020, Current Medical Science
Since December 2019, COVID-19 has occurred unexpectedly and emerged as a health problem worldwide. Despite the rapidly increasing number of cases in subsequent weeks, the clinical characteristics of pediatric cases are rarely described. A cross-sectional multicenter study was carried out in 10 hospitals across Hubei province. A total of 25 confirmed pediatric cases of COVID-19 were collected. The demographic data, epidemiological history, underlying diseases, clinical manifestations, laboratory and radiological data, treatments, and outcomes were analyzed. 



24 March, 2020, 2.45pm CET

Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019
Jianbo Lai et al.
23 March 2020, in JAMA Network
What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? The aim of this paper is to assess the magnitude of mental health outcomes and associated factors among health care workers treating patients exposed to COVID-19 in China.


Characterization of the receptor-binding domain (RBD) of 2019 novel coronavirus: implication for development of RBD protein as a viral attachment inhibitor and vaccine
Wanbo Tai et al.
PMID: 32203189, 19 March 2020, in Cellular & Molecular Immunology
The CoV spike (S) protein plays the most important roles in viral attachment, fusion and entry, and serves as a target for development of antibodies, entry inhibitors and vaccines. Here, we identified the receptor-binding domain (RBD) in SARS-CoV-2 S protein and found that the RBD protein bound strongly to human and bat angiotensin-converting enzyme 2 (ACE2) receptors. SARS-CoV-2 RBD exhibited significantly higher binding affinity to ACE2 receptor than SARS-CoV RBD and could block the binding and, hence, attachment of SARS-CoV-2 RBD and SARS-CoV RBD to ACE2-expressing cells, thus inhibiting their infection to host cells. SARS-CoV RBD-specific antibodies could cross-react with SARS-CoV-2 RBD protein, and SARS-CoV RBD-induced antisera could cross-neutralize SARS-CoV-2, suggesting the potential to develop SARS-CoV RBD-based vaccines for prevention of SARS-CoV-2 and SARS-CoV infection.


Spike protein recognition of mammalian ACE2 predicts the host rangeand an optimized ACE2 for SARS-CoV-2 infection
Junwen Luan et al.
PMID: 32201080, 19 March 2020, in ScienceDirect
SARS-CoV-2 causes the recent global COVID-19 public health emergency. ACE2 is the receptor for bothSARS-CoV-2 and SARS-CoV. To predict the potential host range of SARS-CoV-2, we analyzed the keyresidues of ACE2 for recognizing S protein. We found that most of the selected mammals including pets(dog and cat), pangolin andCircetidaemammals remained the most of key residues for association with Sprotein from SARS-CoV and SARS-CoV-2. The interaction interface between cat/dog/pangolin/Chinesehamster ACE2 and SARS-CoV/SARS-CoV-2 S protein was simulated through homology modeling. Weidentified that N82 in ACE2 showed a closer contact with SARS-CoV-2 S protein than M82 in humanACE2. Ourfinding will provide important insights into the host range of SARS-CoV-2 and a new strategyto design an optimized ACE2 for SARS-CoV-2 infection.

Functional exhaustion of antiviral lymphocytes in COVID-19 patients
Meijuan Zheng et al.
PMID: 32203188, 19 March 2020, in Cellular & Molecular Immunology
Cytotoxic lymphocytes such as cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells are necessary for the control of viral infection, and the functional exhaustion of cytotoxic lymphocytes is correlated with disease progression.2 However, whether the cytotoxic lymphocytes in patients infected with SARS-CoV-2 become functionally exhausted has not been reported.
We showed that the total number of NK and CD8+ T cells was decreased markedly in patients with SARS-CoV-2 infection. The function of NK and CD8+ T cells was exhausted with the increased expression of NKG2A in COVID-19 patients. Importantly, in patients convalescing after therapy, the number of NK and CD8+ T cells was restored with reduced expression of NKG2A. These results suggest that the functional exhaustion of cytotoxic lymphocytes is associated with SRAS-CoV-2 infection. Hence, SARS-CoV-2 infection may break down antiviral immunity at an early stage.

Elevated exhaustion levels and reduced functional diversity ofT cells in peripheral blood may predict severe progression inCOVID-19 patients
Hong-Yi Zheng et al.
PMID: 32203186, 17 March 2020, in Cellular & Molecular Immunology
Recent studies have shown that in addition to dyspnea, hypoxemia, and acute respiratory distress, lymphopenia, and cytokine release syndrome are also important clinical features in patients with severe SARS-CoV-2 infection.3 This suggests that homeostasis of the immune system plays an important role in the development of COVID-19 pneumonia. To provide direct evidence on leukocyte homeostasis, we studied the immunological characteristics of peripheral blood leukocytes from 16 patients admitted to the Yunnan Provincial Hospital of Infectious Diseases, Kunming, China.


23 March, 2020, 4pm CET

Crystal structure of SARS-CoV-2 main protease provides a basis for design of improved α-ketoamide inhibitors
Linlin Zhang et al.
PMID: 32198291, 20 March 2020, in Science
The COVID-19 pandemic caused by SARS-CoV-2 is a global health emergency. An attractive drug target among coronaviruses is the main protease (Mpro, 3CLpro), due to its essential role in processing the polyproteins that are translated from the viral RNA. We report the X-ray structures of the unliganded SARS-CoV-2 Mpro and its complex with an α-ketoamide inhibitor. This was derived from a previously designed inhibitor but with the P3-P2 amide bond incorporated into a pyridone ring to enhance the half-life of the compound in plasma. Based on the structure, we developed the lead compound into a potent inhibitor of the SARS-CoV-2 Mpro The pharmacokinetic characterization of the optimized inhibitor reveals a pronounced lung tropism and suitability for administration by the inhalative route.


Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19)
Li Guo et al.
PMID: 32198501, 21 March 2020, in Clinical Infectious Diseases
We here aim to describe the time kinetics of various antibodies produced against the 2019 novel coronavirus (SARS-CoV-2) and evaluate the potential of antibody testing to diagnose COVID-19. The host humoral response against SARS-CoV-2 including IgA, IgM and IgG response were examined by using an ELISA based assay on the recombinant viral nucleocapsid protein. 208 plasma samples were collected from 82 confirmed and 58 probable cases (qPCR negative but had typical manifestation). The diagnostic value of IgM was evaluated in this cohort.


The Clinical Characteristics of Pneumonia Patients Co-Infected With 2019 Novel Coronavirus and Influenza Virus in Wuhan, China
Qiang Ding et al.
PMID: 32196707, 20 March 2020, in Journal of Medical Virology
In this study, we describe the clinical characteristics of those patients who got infected with COVID‐19 as well as influenza virus. Common symptoms at onset of illness included fever (5 [100%] patients), Cough (5 [100%] patients), shortness of breath (5 [100%] patients), nasal tampon (3 [60%] patients), pharyngalgia (3 [60%] patients), myalgia (2 [40%] patients), fatigue (2 [40%] patients), headache (2 [40%] patients), and expectoration (2 [40%] patients). The laboratory results showed that compared to the normal values, the patients' lymphocytes were reduced (4 [80%] patients), and liver function ALT and AST (2 [40%] patients, 2 [40%] patients) and C‐reactive protein (4 [80%] patients) were increased when admitted to hospital. They stayed in hospital for 14, 30, 17, 12, and 19 days (28.4±7.02), respectively. The main complications for the patients were acute respiratory distress syndrome (ARDS) (1 [20%] patients), acute liver injury (3 [60%] patients), and diarrhea (2 [40%] patients).

Effect of Gastrointestinal Symptoms on Patients Infected With COVID-19
Zili Zhou et al.
PMID: 32199880, 18 March 2020
Fever and respiratory symptoms tend to be initial and major, whereas gastrointestinal symptoms (GI symptoms) were also observed in a significant portion of patients. RT-PCR positive findings from patients’ stool further revealed that COVID-19 may spread by fecal-oral transmission. In addition, recent studies have shown that the receptor of ACE2, which is essential for cells infected by COVID-19, is highly expressed not only in lung AT2 cells but also in absorptive enterocytes in the ileum and colon. These results further confirmed that the digestive system may be a potential route for COVID-19 infection. Therefore, a study exploring the correlation between GI symptoms and patients’ symptoms, diagnosis, treatment, and outcomes is of great importance to improve the diagnosis and treatment plan of novel coronavirus-infected pneumonia (NCIP).

Predicting the angiotensin converting enzyme 2 (ACE2) utilizing capability as the receptor of SARS-CoV-2
Ye Qiu et al.
PMID: 32199943, 18 March 2020, in ScienceDirect
SARS-CoV-2, the newly identified human coronavirus causing severe pneumonia epidemic, was probably originated from Chinese horseshoe bats. However, direct transmission of the virus from bats to humans is unlikely due to lack of direct contact, implying the existence of unknown intermediate hosts. Angiotensin converting enzyme 2 (ACE2) is the receptor of SARS-CoV-2, but only ACE2s of certain species can be utilized by SARS-CoV-2. Here, we evaluated and ranked the receptor-utilizing capability of ACE2s from various species by phylogenetic clustering and sequence alignment with the currently known ACE2s utilized by SARS-CoV-2. As a result, we predicted that SARS-CoV-2 tends to utilize ACE2s of various mammals, except murines, and some birds, such as pigeon. This prediction may help to screen the intermediate hosts of SARS-CoV-2.

Global epidemiology of coronavirus disease 2019: disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status
Chih-Cheng Lai et al.
PMID: 32199877, 18 March 2020, in ScienceDirect
It has been 2 months since the first case of coronavirus disease 2019 (COVID-19) was reported in Wuhan. So far, COVID-19 has affected 84,503 patients in 57 countries/territories and caused 2,924 deaths in nine countries. However, the epidemiology data differ across countries. Although China had higher morbidity and mortality than other sites, the number of new cases per day in China is lesser than that outside of China since February 26, 2020. The incidence ranged from 61.4 per 1,000,000 people in Republic of Korea to 0.0002 per 1,000,000 people in India. The daily cumulative index (DCI) of COVID-19 (cumulative cases/no. of days between the first reported case and February 29, 2020) was greatest in China (1,320.85 per day), followed by Republic of Korea (78.78 per day), Iran (43.11 per day), and Italy (30.62 per day). However, the DCI in other countries/territories were less than 10 per day. Several effective measures including restricting travel from China, controlling the distribution of masks, extensive investigation of COVID-19 spread, and at once daily press conference by government to inform and educate people were aggressively conducted in Taiwan. This is probably the reason why there was only 39 cases (as of February 29, 2020) with a DCI of 1 case per day in Taiwan, which was much lower than that of nearby countries, such as Republic of Korea and Japan. Additionally, the incidence and mortality were correlated with DCI. However, further study and continued monitoring are needed to better understand the underlying mechanism of COVID-19.


20 March, 2020, 5pm CET

Evaluation of the Effectiveness of Surveillance and Containment Measures for the First 100 Patients with COVID-19 in Singapore — January 2–February 29, 2020
Yixiang Ng et al.
PMID: 32191691, 20 March 2020, in Centers for Disease Control and Prevention
This report analyzes the first 100 COVID-19 patients in Singapore to determine the effectiveness of the surveillance and containment measures. Rapid identification and isolation of cases, quarantine of close contacts, and active monitoring of other contacts have been effective in suppressing expansion of the outbreak and have implications for other countries experiencing outbreaks.


Analysis of COVID-19 infection spread in Japan based on stochastic transition model
Kenji Karako et al.
PMID: 32188819, 19 March 2020
To assess the effectiveness of response strategies of avoiding large gatherings or crowded areas and to predict the spread of COVID-19 infections in Japan, we developed a stochastic transmission model by extending the Susceptible-Infected-Removed (SIR) epidemiological model with an additional modeling of the individual action on whether to stay away from the crowded areas.

Coronavirus Endoribonuclease and Deubiquitinating Interferon Antagonists Differentially Modulate the Host Response during Replication in Macrophages
Aaron Volk et al.
PMID: 32188729, 18 March 2020, in Journal of Virology
Coronaviruses encode multiple interferon antagonists that modulate the host response to virus replication. Here, we evaluated the host transcriptional response to infection with murine coronaviruses encoding independent mutations in one of two different viral antagonists: the deubiquitinase (DUB) within nonstructural protein 3 or the endoribonuclease (EndoU) within nonstructural protein 15. We used transcriptomics approaches to compare the scope and kinetics of the host response to the wild-type, DUBmut, and EndoUmut viruses in infected macrophages.


Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China
Mingli Yuan et al.
PMID: 32191764, 19 March 2020
Radiologic characteristics of 2019 novel coronavirus (2019-nCoV) infected pneumonia (NCIP) which had not been fully understood are especially important for diagnosing and predicting prognosis. We retrospective studied 27 consecutive patients who were confirmed NCIP, the clinical characteristics and CT image findings were collected, and the association of radiologic findings with mortality of patients was evaluated. 27 patients included 12 men and 15 women, with median age of 60 years (IQR 47–69). 17 patients discharged in recovered condition and 10 patients died in hospital.


Natural Small Molecules as Inhibitors of Coronavirus Lipid-Dependent Attachment to Host Cells: A Possible Strategy for Reducing SARS-COV-2 Infectivity?
Mirko Baglivo et al.
PMID: 32191676, 19 March 2020, in Acta Biomedica
Viral infectivity depends on interactions between components of the host cell plasma membrane and the virus envelope. Here we review strategies that could help stem the advance of the SARS-COV-2 epidemic.

Artificial Intelligence Distinguishes COVID-19 From Community Acquired Pneumonia on Chest CT
Lin Li et al.
PMID: 32191588, 20 March 2020
It is desirable to develop automatic and accurate detection of COVID-19 using chest CT. Purpose To develop a fully automatic framework to detect COVID-19 using chest CT and evaluate its performances. Materials and Methods In this retrospective and multi-center study, a deep learning model, COVID-19 detection neural network (COVNet), was developed to extract visual features from volumetric chest CT exams for the detection of COVID-19. Community acquired pneumonia (CAP) and other non-pneumonia CT exams were included to test the robustness of the model. The datasets were collected from 6 hospitals between August 2016 and February 2020. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC), sensitivity and specificity.


Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study
Yuhui Wang et al.
PMID: 32191587, 19 March 2020
CT plays a central role in the diagnosis and management of COVID-19 pneumonia. Previous efforts to analyze CT manifestations have continued. Some papers demonstrated the CT findings to be diverse, with the main abnormalities including ground-glass opacity and consolidation. Pan described the evolution of CT findings in 21 mild COVID-19 pneumonia patients. A better understanding of the progression of CT findings in COVID-19 pneumonia may help facilitate accurate diagnosis and disease stage. Thus, we performed a longitudinal study to analyze the serial CT findings in patients with COVID19 pneumonia for temporal change.


19 March 2020, 3pm CET

Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis
Dehan Liu et al.
PMID: 32186894, 18 March 2020, in American Journal of Roentgenology
The purpose of this study was to describe the clinical manifestations and CT features of coronavirus disease (COVID-19) pneumonia in 15 pregnant women and to provide some initial evidence that can be used for guiding treatment of pregnant women with COVID-19 pneumonia.


Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China
Joseph T. Wu et al.
19 March 2020, in Nature Medicine
A key public health priority during the emergence of a novel pathogen is estimating clinical severity, which requires properly adjusting for the case ascertainment rate and the delay between symptoms onset and death. Using public and published information, we estimate that the overall symptomatic case fatality risk (the probability of dying after developing symptoms) of COVID-19 in Wuhan was 1.4% (0.9–2.1%), which is substantially lower than both the corresponding crude or naïve confirmed case fatality risk (2,169/48,557 = 4.5%) and the approximator1 of deaths/deaths + recoveries (2,169/2,169 + 17,572 = 11%) as of 29 February 2020.

Coronaviruses and the cardiovascular system: acute and long-term implications  
Tian-Yuan Xiong et al.
PMID: 32186331, 18 March 2020, in European Heart Journal
Acute and chronic cardiovascular complications of pneumonia are common and result from various mechanisms, including relative ischaemia, systemic inflammation, and pathogen-mediated damage. There is, however, only limited published data concerning cardiovascular presentations in the wake of viral epidemics. The present COVID-19 outbreak emphasizes the need for greater awareness of the immediate and long-term cardiovascular implications of viral infection and the significant gaps in knowledge that future research will need to address.

Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19).
Kristin Tolksdorf et al.
PMID: 32186278, 18 March 2020, in Europe's journal on infectious disease surveillance, epidemiology, prevention and control.
With a simple approach, we give a preliminary assessment of individual seriousness of COVID-19 using well-described case series of hospitalised COVID-19 pneumonia patients from the cities of Wuhan, Beijing, Shenzhen and the provinces of Hubei and Zhejiang [5-12]. We defined a reference group from a well-known setting: in 73 German sentinel hospitals, we extracted the data of all inpatients diagnosed with pneumonia (International Classification of Diseases, 10th revision codes J12-J18, primary diagnosis [13]) that were admitted during three consecutive weeks, after the start and before the peak of the influenza epidemic in the years 2015 to 2019. We compared severity parameters that were described for COVID-19 patients (acute respiratory distress syndrome, ventilation, intensive care, case fatality) with those from the German sentinel system.

The difference in the incubation period of 2019 novel coronavirus (SARS-CoV-2) infection between travelers to Hubei and non-travelers: The need of a longer quarantine period
Char Leung
PMID: 32183920, 18 March 2020, in Cambridge University Press
Different preventive measures have been implemented by health authorities with the 14-day quarantine being the commonly used. While previous studies have estimated the incubation period of SARS-CoV-2 to help determining the length of quarantine, it has recently been observed that some patients rather had mild symptoms such as cough and low-grade fever or even no symptoms and that the incubation period might have been 24 days , constituting greater threats to the effectiveness of entry screening. Against this background, the present work estimated the distribution of incubation periods of patients infected in and outside Hubei.

SARS-CoV-2 Infection in Children
Xiaoxia Lu et al.
PMID: 32187458, 18 March 2020, in The New England Journal of Medicine.
A recent review of 72,314 cases by the Chinese Center for Disease Control and Prevention showed that less than 1% of the cases were in children younger than 10 years of age. In order to determine the spectrum of disease in children, we evaluated children infected with SARS-CoV-2 and treated at the Wuhan Children’s Hospital, the only center assigned by the central government for treating infected children under 16 years of age in Wuhan. Both symptomatic and asymptomatic children with known contact with persons having confirmed or suspected SARS-CoV-2 infection were evaluated.

Rapidly increasing cumulative incidence of coronavirus disease (COVID-19) in the European Union/European Economic Area and the United Kingdom, 1 January to 15 March 2020  
Pete Kinross et al.
PMID: 32186277, 19 March 2020, in Europe's journal on infectious disease surveillance, epidemiology, prevention and control.
In this study, we assess the trends in the cumulative incidence of COVID-19 in each European Union/European Economic Area (EU/EEA) country and the United Kingdom (UK) and compare them to that of Hubei Province, China. We also compare the current number of COVID-19 cases in EU/EEA countries and the UK with that in Italy during 31 January–15 March 2020.


A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19
Bin Cao et al.
PMID: 32187464, 18 March 2020, in The New England Journal of Medicine.
We conducted a randomized, controlled, open-label trial involving hospitalized adult patients with confirmed SARS-CoV-2 infection, which causes the respiratory illness Covid-19, and an oxygen saturation (Sao2 ) of 94% or less while they were breathing ambient air or a ratio of the partial pressure of oxygen (Pao2 ) to the fraction of inspired oxygen (Fio2 ) of less than 300 mm Hg. Patients were randomly assigned in a 1:1 ratio to receive either lopinavir–ritonavir (400 mg and 100 mg, respectively) twice a day for 14 days, in addition to standard care, or standard care alone. The primary end point was the time to clinical improvement, defined as the time from randomization to either an improvement of two points on a seven-category ordinal scale or discharge from the hospital, whichever came first.

Post-discharge surveillance and positive virus detection in two medical staff recovered from coronavirus disease 2019 (COVID-19), China, January to February 2020
Yuanyuan Xing
PMID: 32183934, March 2020, Europe's journal on infectious disease surveillance, epidemiology, prevention and control.
At 5 March 2020, a total of 80,409 COVID-19 cases and 3,012 deaths (3.75%) have been reported in mainland China. The 52,045 recovered cases (64.73%) were further quarantined at home for at least 2 weeks. However, potential infectivity of these recovered cases was still unclear. Thus, we implemented consecutive virus surveillance among medical staff recovered from COVID-19 at our hospital and aimed to investigate their potential infectivity after discharge.

Spatial transmission of COVID-19 via public and private transportation in China
Ruizhi Zheng et al.
PMID: 32184132, 14 March 2020, in Travel Medicine and Infectious Disease
In order to evaluate the role of public transportation in the spatial transmission of COVID-19, we searched daily flights, buses, and trains from Wuhan to these cities in January.

Comparison of clinical characteristics of coronavirus disease (COVID-19) and severe acute respiratory syndrome (SARS) as experienced in Taiwan  
Yu-Jang Su & Yen-Chun Lai
PMID: 32184131, 14 March 2020, in Travel Medicine and Infectious Disease
We analysed the clinical picture of the first ten coronavirus disease (COVID-19) cases in Taiwan till 31 January 2020, and compared them to SARS in terms of epidemiology, symptoms, laboratory characteristics, and outcome.


 18 March 2020, 3pm CET

First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA
Isaac Ghinai et al.
PMID: 32178768, 17 March 2020
This article describes the first person-to-person transmission of COVID-19 in the USA, including the clinical and laboratory features of both patients and the assessment and monitoring of several hundred individuals with potential exposure to SARS-CoV-2.

A 55-Day-Old Female Infant Infected With COVID 19: Presenting With Pneumonia, Liver Injury, and Heart Damage
Yuxia Cui et al.
PMID: 32179908, 17 March 2020, in The Journal of Infectious Diseases.
We report a 55-day-old case with COVID-19 confirmed in China and describe the identification, diagnosis, clinical course, and treatment of the patient, including the disease progression from day 7 to day 11 of illness. This case highlights that children with COVID-19 can also present with multiple organ damage and rapid disease changes.

Clinical outcome of 55 asymptomatic cases at the time of hospital admission infected with SARS-Coronavirus-2 in Shenzhen, China
anrong Wang et al
PMID: 32179910, 17 March 2020, in The Journal of Infectious Diseases.
We study the epidemiological and clinical outcomes of 55 asymptomatic carriers who were laboratory-confirmed positive for the SARS-Coronavirus-2 by testing the nucleic acid of the pharyngeal swab samples. The evidence showed that asymptomatic carriers occurred more often in middle-aged people who had close contact with infected family members. The majority of the cases developed to be mild and ordinary COVID-19 during hospital.

Clinical features of pediatric patients with COVID‑19: a report of two family cluster cases
Li-Na Ji 1 et al.
PMID: 32180140, 16 March 2020
We retrospectively reviewed two confirmed pediatric cases from two family clusters. Both clinical features and laboratory examination results of the children and their family members were described.

An Analysis of 38 Pregnant Women With COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes
David A Schwartz
PMID: 32180426, 17 March 2020
This communication reviews the effects of two previous coronavirus infections - severe acute respiratory syndrome (SARS) caused by SARS-CoV and the Middle East respiratory syndrome (MERS) caused by MERS-CoV - on pregnancy outcomes. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants including clinical, laboratory and virologic data, and the transmissibility of the virus from mother to fetus. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses

Correlation between travelers departing from Wuhan before the Spring Festival and subsequent spread of COVID-19 to all provinces in China

Ping Zhong et al.
PMID: 32181483, 17 March 2020, in the Journal of Travel Medicine.
The aim of this essay is to explore the correlation between travelers departing from Wuhan before the Spring Festival and the extent of amplification of the outbreak of COVID-19 in China.

The Positive Impact of Lockdown in Wuhan on Containing the COVID-19 Outbreak in China 
Hien Lau et al.
PMID: 32181488  17 March 2020, in the Journal of Travel Medicine.
We analyzed available data on the development of confirmed domestic and international COVID-19 cases before and after lockdown measures. We evaluated the correlation of domestic air traffic to the number of confirmed COVID-19 cases and determined the growth curves of COVID-19 cases within China before and after lockdown as well as after changes in COVID-19 diagnostic criteria.

Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia
Rui Han et al.
PMID: 32181672  17 March 2020, in the American Journal of Roentgenology
The purpose of this study was to investigate early clinical and CT manifestations of coronavirus disease (COVID-19) pneumonia.

Successful recovery of COVID‐19 pneumonia in a renal transplant recipient with long‐term immunosuppression

Lan Zhu et al.
PMID: 32181990, 17 March 2020.
We report here the clinical features and therapeutic course of the first reported renal transplant recipient with confirmed COVID-19 pneumonia. This is a 52-year-old man who received kidney transplantation 12 years ago. His overall clinical characteristics (symptoms, laboratory examinations, and chest CT) were similar to those of non-transplanted COVID-19 patients. 

Platelet‐to‐lymphocyte ratio is associated with prognosis in patients with Corona Virus Disease‐19
Rong Qu et al.
PMID: 32181903, 17 March 2020, in the Journal of Medical Virology
Since December 2019, novel coronavirus infected pneumonia emerged in Wuhan city and rapidly spread throughout China. In severe novel coronavirus pneumonia cases, the number of platelets, their dynamic changes during the treatment, platelet-to-lymphocyte ratio(PLR)were a concern. We sought to describe the platelet feature of these cases.


17 March 2020, 3pm CET


Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand.

Neil M Ferguson et al.

Here we present the results of epidemiological modelling which has informed policymaking in the UK and other countries in recent weeks. In the absence of a COVID-19 vaccine, we assess the potential role of a number of public health measures – so-called non-pharmaceutical interventions (NPIs) – aimed at reducing contact rates in the population and thereby reducing transmission of the virus. In the results presented here, we apply a previously published microsimulation model to two countries: the UK (Great Britain specifically) and the US. We conclude that the effectiveness of any one intervention in isolation is likely to be limited, requiring multiple interventions to be combined to have a substantial impact on transmission.


Potential Impact of Seasonal Forcing on a SARS-CoV-2 Pandemic

Neher Richard A. et al.
16 March 2020, Swiss Med Wkly. 2020;150:w20224

Here, we explore how seasonal variation in transmissibility could modulate a SARS-CoV-2 pandemic. Data from routine diagnostics show a strong and consistent seasonal variation of the four endemic coronaviruses (229E, HKU1, NL63, OC43) and we parameterize our model for SARS-CoV-2 using these data. The model allows for many subpopulations of different size with variable parameters. Simulations of different scenarios show that plausible parameters result in a small peak in early 2020 in temperate regions of the Northern Hemisphere and a larger peak in winter 2020/2021. Variation in transmission and migration rates can result in substantial variation in prevalence between regions.

Clinical Features of 69 Cases with Coronavirus Disease 2019 in Wuhan, China
Zhongliang Wang et al.
16 March 2020
A review of 69 patients who were hospitalized in Union hospital in Wuhan between January 16 to January 29, 2020. All patients were confirmed to be infected with SARS-CoV-2 and the final date of follow-up was February 4, 2020.

Estimation of Coronavirus Disease 2019 (COVID-19) Burden and Potential for International Dissemination of Infection From Iran

Ashleigh R Tuite et al.

PMID: 31176272, 16 March 2020, in Ann Intern Med. 2020 
The objective of this article is to quantify the COVID-19 outbreak size in Iran on the basis of known exported case counts and air travel links between Iran and other countries and to anticipate where infections originating in Iran may spread next.


Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals

Ivan Seah et Rupesh Agrawal

PMID: 32175797, 16 March 2020

The ocular implications of human CoV infections have not been widely studied. However, CoVs have been known to cause various ocular infections in animals. Clinical entities such as conjunctivitis, anterior uveitis, retinitis, and optic neuritis have been documented in feline and murine models. In this article, the current evidence suggesting possible human CoV infection of ocular tissue is reviewed. The review article will also highlight animal CoVs and their associated ocular infections. We hope that this article will serve as a start for further research into the ocular implications of human CoV infections.

A tug-of-war between severe acute respiratory syndrome coronavirus 2 and host antiviral defence: lessons from other pathogenic viruse

Sin-Yee Fung et al.
14 March 2020 in Emerging Microbes & Infections, 9:1, 558-570.
Here, we review the discovery, zoonotic origin, animal hosts, transmissibility and pathogenicity of SARS-CoV-2 in relation to its interplay with host antiviral defence. A comparison with SARS-CoV, Middle East respiratory syndrome coronavirus, community-acquired human coronaviruses and other pathogenic viruses including human immunodeficiency viruses is made. We summarize the current understanding of the induction of a proinflammatory cytokine storm by other highly pathogenic human coronaviruses, their adaptation to humans and their usurpation of the cell death programmes.



16 March 2020, 3pm CET

COVID-19 in the Shadows of MERS-CoV in the Kingdom of Saudi Arabia.

Barry M et al.

PMID: 32175703, 10 March 2020

This challenge will now be faced by the whole global health community dealing with COVID-19 since both coronaviruses have a similar presentation. Those patients should now be tested for both MERS-CoV and SARS-CoV-2 simultaneously, and with the continuing wide international spread of SARS-CoV-2, the travel history to China in the last 14 days will be of less significance.


Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients.

Salehi S. et al.

PMID: 32174129, 14 March 2020

Available information on CT features of the 2019 novel coronavirus disease (COVID-19) is scattered in different publications, and a cohesive literature review has yet to be compiled. ...This systematic review of the current literature on COVID-19 provides insight into the initial and follow-up CT characteristics of the disease.