Covid-19 – Ressources scientifiques

Agence   nationale de sécurité du médicament et des produits de santé (

Décision du 22/12/2020 Portant   suspension d’importation, de mise sur le marché, de distribution, de   publicité et d’utilisation des dispositifs médicaux de diagnostic in vitro   dénommés VivaDiag test rapide SarsCov-2 Ag, fabriqués et mis sur le marché  par la société VivaChek, ainsi que retrait de ces produits

Centers for Diseases Control and   Prevention

We report a cluster of   surprisingly high spread of severe acute respiratory syndrome coronavirus 2   (SARS-CoV-2) associated with a single nursery in Poland. Our findings   contrast with the presumed negligible role of children in driving the   SARS-CoV-2 pandemic. Children 1–2 years of age might be effective SARS-CoV-2   spreaders.

“As the SARS-CoV-2 pandemic has   progressed, increasing attention has focused on establishing natural and   vaccine-induced immunity against this coronavirus and the disease, COVID-19,   that it causes. In this Primer, we explain the fundamental features of T cell   memory and their potential relevance for effective immunity to SARS-CoV-2.”

Males patients and elderly or   older patients (age ≥50 years) are at higher risk of developing severity,   whereas comorbidities and clinical manifestations could significantly affect   the prognosis and severity of COVID-19.

A novel SARS-CoV-2 variant, VOC   202012/01, emerged in southeast England in November 2020 and appears to be rapidly spreading towards fixation.

Cochrane France
Université de Paris
Inserm
APHP

Living mapping of research
Living network meta-analysis
Analyse recherche thérapeutique et méta-analyse en temps-réel
A suivre +++

Mapping des Cas/décès pays par   pays

Courbes d’incidence pays par   pays
Limites : pas de données sur le nombre de tests réalisés

La Haute Autorité de santé a   rendu fin septembre un avis favorable à l’utilisation des tests antigéniques   sur prélèvement nasopharyngé chez les personnes qui présentent des symptômes   de la COVID-19 : fièvre, toux sèche, perte de l’odorat ou du goût, etc. Elle   en a précisé les performances requises : une sensibilité minimale supérieure   à 80% et une spécificité minimale supérieure à 99%. Dans le même temps, la   circulation du virus s’est accélérée et il est essentiel d’offrir à chacun   une prise en charge optimale et de casser les chaînes de contamination pour   endiguer l’épidémie. Pour y parvenir, il est nécessaire de prendre en compte   d’autres paramètres que la sensibilité et la spécificité des tests, qui sont   des prérequis. Il faut d’une part tester le plus grand nombre de personnes   possible pour trouver plus de malades et d’autre part disposer de résultats   le plus rapidement possible pour mettre en place les mesures d’isolement,   tracer les personnes contacts et ainsi casser les chaines de contamination.   C’est ce qui conduit la HAS à définir la stratégie d’utilisation des tests   antigéniques dans la détection du virus. Ceux qui satisfont les critères de   la HAS sont un peu moins sensibles que les tests RT-PCR, mais sont quasiment   aussi spécifiques, permettent d’obtenir un résultat en moins de 30 minutes,   et sont réalisables en dehors des seuls laboratoires d’analyses de biologie   médicale. Aujourd’hui en France, le test RT-PCR sur prélèvement nasopharyngé   reste le test de référence dans la détection du virus SARS-CoV-2. Mais la   situation épidémique et les bonnes performances des tests antigéniques   conduisent la HAS à positionner les différents tests pour trois situations   cliniques : les patients symptomatiques, les personnes asymptomatiques   contacts détectées isolément ou au sein de clusters et les personnes   asymptomatiques qui vont être intégrées à un dépistage à grande échelle de   populations ciblées. En revanche, la HAS considère qu’il n’y a pas lieu   aujourd’hui de réaliser de dépistage non ciblé en population générale, compte   tenu de l’absence de bénéfice de ce dépistage et de son probable rendement  très faible.

Revue de littérature par I3M   Institute

– Revue de littérature de   qualité des papiers acceptés pertinents selon l’équipe I3M

Institut Pasteur, Paris

Ressources bibliographiques sur   le SARS-CoV-2 et COVID-19 – Site de l’Institut Pasteur, Paris

international, peer-reviewed,   open access, general medical journal that publishes research and commentary   on clinical care, health policy, and global health across all health   disciplines and countries for clinicians, investigators

In this double-blind,   placebo-controlled randomized clinical trial that included 132 participants   and was terminated early, there was not a significant difference in   reverse-transcriptase polymerase chain reaction–confirmed SARS-CoV-2   incidence between hydroxychloroquine and placebo cohorts

First, the authors reported   conjunctivitis in 12 of 38 patients with COVID-19 in a consecutive case   series. Notably, the prevalence of conjunctival congestion was merely 0.8% (9   of 1099 patients) in another larger study from China.

Although 41% of medical school   faculty are women,1 women appear underrepresented as authors of coronavirus   disease 2019 (COVID-19) pandemic-related publications2 and as leaders of the   US response.

C’est l’histoire d’un concept   scientifique qui a débouché, en un temps record, sur le développement et la   production à grande échelle de préparations vaccinales qui seront pour la   première fois administrées chez l’homme dans un contexte très particulier,   celui d’une maladie infectieuse pandémique.

Plusieurs pays ont commencé à   vacciner leur population contre le Covid-19 avec les premiers vaccins   autorisés. Quels sont jusqu’ici les effets secondaires ? Y a-t-il des cas   graves ? Comment les personnes vaccinées sont-elles surveillées?

Site du NCBI sur littérature   scientifique COVID

Accès à toutes les dernières   publications par pays/date/domaine (mécanism, treatment,  epidemic forectasting)

→ Pratique et complet +++

ASM JOURNAL

This is, to our knowledge, the   first BAC-based reverse genetics system for the generation of infectious   rSARS-CoV-2 that displays features in vivo similar to those of a natural   viral isolate. This SARS-CoV-2 BAC-based reverse genetics will facilitate studies   addressing several important questions in the biology of SARS-CoV-2, as well   as the identification of antivirals and development of vaccines for the   treatment of SARS-CoV-2 infection and associated COVID-19 disease.

ASM JOURNAL

Characterizing the asymptomatic   spread of SARS-CoV-2 is important for understanding the COVID-19 pandemic.   This study was aimed at determining asymptomatic spread of SARS-CoV-2 in a   suburban, Southern U.S. population during a period of state restrictions and   physical distancing mandates.

L’enquête EpiCoV a été élaborée   par l’Institut national de la santé et de la recherche médicale (Inserm) et   la DREES, en collaboration avec Santé publique France et l’Institut national   de la statistique et des études économiques (Insee) dans le contexte de la   pandémie de Covid-19. Cette enquête, réalisée auprès d’un échantillon   représentatif de la population, est la seule qui permet d’estimer la   diffusion de l’épidémie à un niveau national et départemental et les facteurs   notamment liés aux conditions de vie associés à l’exposition au virus. Elle   permet également d’étudier les répercussions du confinement et de l’épidémie   sur la population. D’après cette enquête, la séroprévalence du SARS-CoV-2,   c’est-à-dire la proportion de personnes avec des anticorps contre le virus,   estimée à partir de prélèvements réalisés au décours du confinement, en mai   2020, s’élève à 4,5 % en France métropolitaine parmi les personnes âgées de   15 ans ou plus. La séroprévalence est la plus élevée à Paris (9,0 %), dans   les départements de la petite couronne (9,5 %) et le Haut-Rhin (10,8 %).

US department of health &   human service

US department of health &   human service

A number of investigational   agents and drugs that are approved for other indications are currently being   studied in clinical trials for the treatment of COVID-19 and associated   complications.

US department of health &   human service

US department of health &   human service

We performed a cross-sectional   survey during 5 consecutive days in March 2020, within a tertiary referral   center, associated outpatient clinic, and two primary care outpatient   facilities in Paris. All SARS-CoV-2-positive patients hospitalized during the   study period and able to be interviewed (n = 198), hospital outpatients seen   during the previous month (n = 129), and all COVID-19-highly suspect patients   in two primary health centers (n = 63) were included. Hospitalized patients   were significantly more often male (64 vs 40%) and older (66 vs 43 years old   in median) and had significantly more comorbidities than outpatients.   Hyposmia and hypogeusia were reported by 33% of patients and occurred   significantly less frequently in hospitalized patients (12% and 13%,   respectively) than in the health centers’ outpatients (33% and 43%,   respectively) and in the hospital outpatients (65% and 60%, respectively).   Hyposmia and hypogeusia appeared more frequently after other COVID-19   symptoms. Patients with hyposmia and/or hypogeusia were significantly younger   and had significantly less respiratory severity criteria than patients   without these symptoms. Olfactory and gustatory dysfunction occurs frequently   in COVID-19, especially in young, non-severe patients. These symptoms might   be a useful tool for initial diagnostic work-up in patients with suspected   COVID-19.

US department of health &   human service

Learning from the lengthy fight   against HIV-1, influenza, and Ebola virus infection, broadly neutralizing   antibodies (bnAbs), directed at conserved regions of surface proteins crucial   to virus entry (Env, hemagglutinin, and GP, respectively), are an essential   resource for passive as well as active immunization. Rare in their emergence   and antigen recognition mode, bnAbs are active toward a large set of   different viral strains. Isolation, characterization and production of bnAbs   lead to their possible use in passive immunotherapy and form the basis for an   educated effort in the development of vaccines for universal coverage.   SARS-CoV-2-specific antibodies targeting the spike receptor binding domain   (RBD) may lead to antibody dependent enhancement (ADE) of infection, possibly   hampering the field of vaccine development. This perspective points to the   identification of conserved regions in the spike of SARS-CoV-2, SARS-CoV, and   MERS-CoV through investigation, dissection and recombinant production of   isolated moieties. These spike moieties should be capable of independent   folding and allow the detection as well as the elicitation of bnAbs, thus   setting the basis for an effective passive immunotherapy and the development   of a universal vaccine against human epidemic coronaviruses (HCoVs). SARS,   MERS and, most of all, COVID-19 demonstrate that humanity is the target of   HCoV, preparedness for future hits is thus no longer an option.

US department of health &   human service

Effective, sensitive, and   reliable diagnostic reagents are of paramount importance for combating the   ongoing coronavirus disease 2019 (COVID-19) pandemic when there is neither a   preventive vaccine nor a specific drug available for severe acute respiratory   syndrome coronavirus 2 (SARS-CoV-2).

US department of health &   human service

Recurrence   of positive SARS CoV‐2 PCR has been described in patients discharged from   hospital after 2 consecutive negative PCR. We discuss possible explanations   including false negative, reactivation and re‐infection and propose different   strategy to solve this issue.

US department of health &   human service

“Neutralizing   antibodies elicited by prior infection or vaccination are likely to be key   for future protection of individuals and populations against SARS-CoV-2.   Moreover, passively administered antibodies are among the most promising   therapeutic and prophylactic anti-SARS-CoV-2 agents. However, the degree to   which SARS-CoV-2 will adapt to evade neutralizing antibodies is unclear.   Using a recombinant chimeric VSV/SARS-CoV-2 reporter virus, we show that   functional SARS-CoV-2 S protein variants with mutations in the   receptor-binding domain (RBD) and N-terminal domain that confer resistance to   monoclonal antibodies or convalescent plasma can be readily selected.   Notably, SARS-CoV-2 S variants that resist commonly elicited neutralizing   antibodies are now present at low frequencies in circulating SARS-CoV-2   populations. Finally, the emergence of antibody-resistant SARS-CoV-2 variants   that might limit the therapeutic usefulness of monoclonal antibodies can be   mitigated by the use of antibody combinations that target distinct   neutralizing epitopes.”

International weekly journal of   science

A recent genetic association   study1 identified a gene cluster on chromosome 3 as a risk locus for   respiratory failure upon SARS-CoV-2 infection. A new study2 comprising 3,199   hospitalized COVID-19 patients and controls finds that this is the major   genetic risk factor for severe SARS-CoV-2 infection and hospitalization   (COVID-19 Host Genetics Initiative). Here, we show that the risk is conferred   by a genomic segment of ~50 kb that is inherited from Neanderthals and is   carried by ~50% of people in South Asia and ~16% of people in Europe today.

International weekly journal of   science

Severe acute respiratory   syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible and pathogenic   coronavirus that emerged in late 2019 and has caused a pandemic of acute   respiratory disease, named ‘coronavirus disease 2019’ (COVID-19), which   threatens human health and public safety. In this Review, we describe the   basic virology of SARS-CoV-2, including genomic characteristics and receptor   use, highlighting its key difference from previously known coronaviruses. We   summarize current knowledge of clinical, epidemiological and pathological   features of COVID-19, as well as recent progress in animal models and   antiviral treatment approaches for SARS-CoV-2 infection. We also discuss the   potential wildlife hosts and zoonotic origin of this emerging virus in   detail.

A flood of coronavirus research   swept websites and journals this year. It changed how and what scientists   study, a Nature analysis shows.

The National   Center for Biotechnology Information advances science and health by providing   access to biomedical and genomic information.

As we approach the end of 2020,   and a year since the outbreak of COVID-19 began, cases are increasing again.   We have learnt a lot about SARS-CoV-2 and our ability to test for and manage   COVID-19 has improved, but ongoing debate remains about how SARS-CoV-2 is   transmitted.

The New England Journal of   Medecine

It’s time to change how we think   about the sensitivity of testing for Covid-19. The Food and Drug   Administration (FDA) and the scientific community are currently almost   exclusively focused on test sensitivity, a measure of how well an individual   assay can detect viral protein or RNA molecules. […] To defeat Covid-19, we   believe that the FDA, the CDC, the National Institutes of Health, and others   must encourage structured evaluations of tests in the context of planned   testing regimens to identify those that will provide the best Covid filters.   Frequent use of cheap, simple, rapid tests will accomplish that aim, even if   their analytic sensitivities are vastly inferior to those of benchmark   tests.1 Such a regimen can help us stop Covid in its tracks.

The New England Journal of   Medecine

In this small study involving   older adults, adverse events associated with the mRNA-1273 vaccine were   mainly mild or moderate. The 100-μg dose induced higher binding- and   neutralizing-antibody titers than the 25-μg dose, which supports the use of   the 100-μg dose in a phase 3 vaccine trial. (Funded by the National Institute   of Allergy and Infectious Diseases and others; mRNA-1273 Study   ClinicalTrials.gov number, NCT04283461. opens in new tab.)

The New England Journal of   Medecine

To date, the development of mRNA   vaccines for the prevention of infection with the severe acute respiratory   syndrome coronavirus 2 (SARS-CoV-2) has been a success story, with no serious   concerns identified in the ongoing phase 3 clinical trials.

The New England Journal of   Medecine

Severe   acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the   resulting coronavirus disease 2019 (Covid-19) have afflicted tens of millions   of people in a worldwide pandemic. Safe and effective vaccines are needed   urgently.

The New England Journal of   Medecine

Vaccines   are needed to prevent coronavirus disease 2019 (Covid-19) and to protect   persons who are at high risk for complications.

The New England Journal of   Medecine

We conducted postmortem   high-resolution magnetic resonance imaging (magnetic resonance microscopy) of   the brains of patients with coronavirus disease 2019 (Covid-19) (median age,   50 years) and histopathological examination that focused on microvascular changes   in the olfactory bulb and brain stem.

The New England Journal of   Medecine

Monoclonal   antibody LY-CoV555, when coadministered with remdesivir, did not demonstrate   efficacy among hospitalized patients who had Covid-19 without end-organ   failure (Funded by Operation Warp Speed and others; TICO ClinicalTrials.gov   number, NCT04501978).

The New England Journal of   Medecine

The presence   of anti-spike or anti-nucleocapsid IgG antibodies was associated with a   substantially reduced risk of SARS-CoV-2 reinfection in the ensuing 6 months.

Sarbecoviruses   have emerged twice in the 21st century, causing a worldwide epidemic and   pandemic.

Real-time tracking of pathogen   evolution

Suivi évolution génome viral   SARS-CoV-2

Quelques images

REACTing : coordinating French   research response

Partage toutes les semaines une   sélection d’articles pertinents publiés sur le COVID-19

Agence Nationale de Santé   Publique

–  Veille documentaire assez complète tout en   bas à droite de la page (défaut : il faut retélécharger tous les pdf à chaque   fois à bien ouvrir celui du jour)

– Lien vers l’observatoire cartographique: GEODES à suivi indicateurs   (hospi, réa, décès,par région, classe d’age, …), intéressant +++

« En semaine 51, poursuite de la   circulation du SARS-CoV-2 à un niveau élevé.

Augmentation du nombre de cas confirmés (+23%)

Très forte augmentation de l’activité de dépistage (+74%) principalement   chez les personnes asymptomatiques

Stabilisation des nouvelles hospitalisations et admissions en réanimation à   un niveau élevé

Régions les plus touchées : Bourgogne-Franche-Comté, Auvergne-Rhône-Alpes,   Grand Est »

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

A call for diagnostic tests to   report viral load

“Advocates point to new research indicating that CT values could help   doctors flag patients at high risk for serious disease. Recent findings also   suggest the numbers could help officials determine who is infectious and   should therefore be isolated and have their contacts tracked down. CT value   is an imperfect measure, advocates concede. But whether to add it to test   results “is one of the most pressing questions out there,” says Michael Mina,   a physician and epidemiologist at Harvard University’s T.H. Chan School of   Public Health.”

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

In situ structural analysis of   SARS-CoV-2 spike reveals flexibility mediated by three hinges

“The spike protein (S) of severe acute respiratory syndrome coronavirus 2   (SARS-CoV-2) is required for cell entry and is the primary focus for vaccine   development. In this study, we combined cryo–electron tomography, subtomogram   averaging, and molecular dynamics simulations to structurally analyze S in   situ. Compared with the recombinant S, the viral S was more heavily   glycosylated and occurred mostly in the closed prefusion conformation. We   show that the stalk domain of S contains three hinges, giving the head   unexpected orientational freedom. We propose that the hinges allow S to scan   the host cell surface, shielded from antibodies by an extensive glycan coat.   The structure of native S contributes to our understanding of SARS-CoV-2   infection and potentially to the development of safe vaccines.”

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

Clinical outcome upon infection   with SARS-CoV-2 ranges from silent infection to lethal COVID-19. We have   found an enrichment in rare variants predicted to be loss-of-function (LOF)   at the 13 human loci known to govern TLR3- and IRF7-dependent type I interferon   (IFN) immunity to influenza virus, in 659 patients with life-threatening   COVID-19 pneumonia, relative to 534 subjects with asymptomatic or benign   infection. By testing these and other rare variants at these 13 loci, we   experimentally define LOF variants in 23 patients (3.5%), aged 17 to 77   years, underlying autosomal recessive or dominant deficiencies. We show that   human fibroblasts with mutations affecting this pathway are vulnerable to   SARS-CoV-2. Inborn errors of TLR3- and IRF7-dependent type I IFN immunity can   underlie life-threatening COVID-19 pneumonia in patients with no prior severe   infection

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

Understanding humoral responses   to SARS-CoV-2 is critical for improving diagnostics, therapeutics, and   vaccines. Deep serological profiling of 232 COVID-19 patients and 190   pre-COVID-19 era controls using VirScan revealed over 800 epitopes in the   SARS-CoV-2 proteome, including 10 epitopes likely recognized by neutralizing   antibodies. Pre-existing antibodies in controls recognized SARS-CoV-2 ORF1,   while only COVID-19 patients primarily recognized spike and nucleoprotein. A   machine learning model trained on VirScan data predicted SARS-CoV-2 exposure   history with 99% sensitivity and 98% specificity; a rapid Luminex-based   diagnostic was developed from the most discriminatory SARS-CoV-2 peptides.   Individuals with more severe COVID-19 exhibited stronger and broader   SARS-CoV-2 responses, weaker antibody responses to prior infections, and   higher incidence of CMV and HSV-1, possibly influenced by demographic   covariates. Among hospitalized patients, males make greater SARS-CoV-2   antibody responses than females.

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

Researchers have used CRISPR   gene-editing technology to come up with a test that detects the pandemic   coronavirus in just 5 minutes. The diagnostic doesn’t require expensive lab   equipment to run and could potentially be deployed at doctor’s offices, schools,   and office buildings.

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

Advocates point to new research   indicating that CT values could help doctors flag patients at high risk for   serious disease. Recent findings also suggest the numbers could help   officials determine who is infectious and should therefore be isolated and have   their contacts tracked down. CT value is an imperfect measure, advocates   concede. But whether to add it to test results “is one of the most pressing   questions out there,” says Michael Mina, a physician and epidemiologist at   Harvard University’s T.H. Chan School of Public Health.

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

The spike protein (S) of severe   acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is required for cell   entry and is the primary focus for vaccine development. In this study, we   combined cryo–electron tomography, subtomogram averaging, and molecular dynamics   simulations to structurally analyze S in situ. Compared with the recombinant   S, the viral S was more heavily glycosylated and occurred mostly in the   closed prefusion conformation. We show that the stalk domain of S contains   three hinges, giving the head unexpected orientational freedom. We propose   that the hinges allow S to scan the host cell surface, shielded from   antibodies by an extensive glycan coat. The structure of native S contributes   to our understanding of SARS-CoV-2 infection and potentially to the   development of safe vaccines

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

This study confirms that serum   and saliva IgG antibodies to SARS-CoV-2 are maintained in the majority of   COVID-19 patients for at least 3 months PSO. IgG responses in saliva may   serve as a surrogate measure of systemic immunity to SARS-CoV-2 based on their   correlation with serum IgG responses.

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

An urgent global quest for   effective therapies to prevent and treat COVID-19 disease is ongoing. We   previously described REGN-COV2, a cocktail of two potent neutralizing   antibodies (REGN10987+REGN10933) targeting non-overlapping epitopes on the   SARS-CoV-2 spike protein. In this report, we evaluate the in vivo efficacy of   this antibody cocktail in both rhesus macaques, which may model mild disease,   and golden hamsters, which may model more severe disease. We demonstrate that   REGN-COV-2 can greatly reduce virus load in lower and upper airways and   decrease virus induced pathological sequalae when administered   prophylactically or therapeutically in rhesus macaques. Similarly,   administration in hamsters limits weight loss and decreases lung titers and   evidence of pneumonia in the lungs. Our results provide evidence of the   therapeutic potential of this antibody cocktail.

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

For COVID-19 researchers, the   new year brings a strong sense of déjà vu. As in early 2020, the world is   anxiously watching a virus spread in one country and trying to parse the risk   for everyone else.

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

The COVID-19 pandemic has had a   major impact on cancer prevention and control in Africa, with immediate and   anticipated long-term ramifications.

Revue scientifique américaine   par l’Association américaine pour l’avancement des sciences (AAAS)

online collection of scientific,   technological and medical journals, books and reference works

This study investigates the   association between the treatment with hydroxychloroquine and mortality in   patients admitted with COVID-19. Routinely recorded, clinical data, up to the   24th of April 2020, from the 2075 patients with COVID-19, admitted in 17 hospitals   in Spain between the 1st of March and the 20th of April 2020 were used. The   following variables were extracted for this study: age, gender, temperature,   and saturation of oxygen on admission, treatment with hydroxychloroquine,   azithromycin, heparin, steroids, tocilizumab, a combination of lopinavir with   ritonavir, and oseltamivir, together with data on mortality. Multivariable   logistic regression models were used to investigate the associations. At the   time of collecting the data, 301 patients had died, 1449 had been discharged   home from the hospitals, 240 were still admitted, and 85 had been transferred   to hospitals not included in the study. Median follow-up time was 8 (IQR   5–12) days. Hydroxychloroquine had been used in 1857 patients. Hydroxychloroquine   was associated with lower mortality when the model was adjusted for age and   gender, with OR (95% CI): 0.44 (0.29–0.67). This association remained   significant when saturation of oxygen < 90% and temperature > 37 °C   were added to de model with OR 0.45 (0.30–0.68) p < 0.001, and also when   all the other drugs, and time of admission, were included as covariates. The   association between hydroxychloroquine and lower mortality observed in this   study can be acknowledged by clinicians in hospitals and in the community.   Randomized-controlled trials to assess the causal effects of   hydroxychloroquine in different therapeutic regimes are required.

Revue scientifique médicale   hebdomadaire britannique

Genomic evidence for reinfection   with SARS-CoV-2: a case study

“These findings suggest that the patient was infected by SARS-CoV-2 on two   separate occasions by a genetically distinct virus. Thus, previous exposure   to SARS-CoV-2 might not guarantee total immunity in all cases. All   individuals, whether previously diagnosed with COVID-19 or not, should take   identical precautions to avoid infection with SARS-CoV-2. The implications of   reinfections could be relevant for vaccine development and application.”

Revue scientifique médicale   hebdomadaire britannique

Our findings suggest that   environmental contamination leading to SARS-CoV-2 transmission is unlikely to   occur in real-life conditions, provided that standard cleaning procedures and   precautions are enforced. These data would support Goldman’s point that the   chance of transmission through inanimate surfaces is less frequent than   hitherto recognised

Revue scientifique médicale   hebdomadaire britannique

To summarise, false-positive   COVID-19 swab test results might be increasingly likely in the current   epidemiological climate in the UK, with substantial consequences at the   personal, health system, and societal levels (panel). Several measures might   help to minimise false-positive results and mitigate possible consequences.   Firstly, stricter standards should be imposed in laboratory testing. This   includes the development and implementation of external quality assessment   schemes and internal quality systems, such as automatic blinded replication   of a small number of tests for performance monitoring to ensure   false-positive and false-negative rates remain low, and to permit withdrawal   of a malfunctioning test at the earliest possibility. Secondly, pretest   probability assessments should be considered, and clear evidence-based   guidelines on interpretation of test results developed. Thirdly, policies   regarding the testing and prevention of virus transmission in health-care   workers might need adjustments, with an immediate second test implemented for   any health-care worker testing positive. Finally, research is urgently   required into the clinical and epidemiological significance of prolonged   virus shedding and the role of people recovering from COVID-19 in disease   transmission.

Revue scientifique médicale   hebdomadaire britannique

These findings suggest that the   patient was infected by SARS-CoV-2 on two separate occasions by a genetically   distinct virus. Thus, previous exposure to SARS-CoV-2 might not guarantee   total immunity in all cases. All individuals, whether previously diagnosed   with COVID-19 or not, should take identical precautions to avoid infection   with SARS-CoV-2. The implications of reinfections could be relevant for   vaccine development and application.

Revue scientifique médicale   hebdomadaire britannique

Patients with cancer with   different tumour types have differing susceptibility to SARS-CoV-2 infection   and COVID-19 phenotypes. We generated individualised risk tables for patients   with cancer, considering age, sex, and tumour subtype. Our results could be   useful to assist physicians in informed risk–benefit discussions to explain   COVID-19 risk and enable an evidenced-based approach to national social   isolation policies.

Revue scientifique médicale   hebdomadaire britannique

The more we realise how much   SARS-CoV-2 has changed the world, the more we question the suitability of our   prevention, management, and drug development strategies with respect to other   major pathogens

Revue scientifique médicale   hebdomadaire britannique

The final episode of the year   tells the story of COVID-19 through five Lancet articles, focusing on key   workers, low and middle-income countries, mental health, and the lessons   learned from a tumultuous year. Featuring Richard Horton, Zoe Mullan, John McConnell,   Niall Boyce, and John Carson.

Revue scientifique médicale   hebdomadaire britannique

For most of November, 2020,   England was in lockdown to force down the incidence of COVID-19 cases that   had steadily increased in the late summer and autumn. Other countries in the   UK (Wales, Scotland, and Northern Ireland) had also been reimposing and subsequently   lifting restrictions, since each of the four nations is in charge of its own   COVID-19 control plans.

We   aimed to ascertain the cumulative risk of fatal or critical care unit-treated   COVID-19 in people with diabetes and compare it with that of people without   diabetes, and to investigate risk factors for and build a cross-validated   predictive model of fatal or critical care unit-treated COVID-19 among people   with diabetes.