Tulane Outbreak Daily | May 22, 2020

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Featured Headlines

China’s New Outbreak Shows Signs the Virus Could Be Changing​ – Bloomberg

Chinese doctors are seeing the coronavirus manifest differently among patients in its new cluster of cases in the northeast region compared to the original outbreak in Wuhan, suggesting that the pathogen may be changing in unknown ways and complicating efforts to stamp it out.

New Study Published in the New England Journal of Medicine Shows COVID-19 Causes Blood Vessel Damage – Ortho Spine News

The Angiogenesis Foundation reports today that new research published in the New England Journal of Medicine shows that the respiratory virus SARS-CoV-2, which causes COVID-19, causes severe damage to blood vessels, leading to widespread thrombosis, or blood clotting, in the lung1. The study was conducted by an international team of medical scientists who compared the lungs of patients who died from COVID-19 with lungs of patients who died from influenza as well as with healthy lungs donated for transplantation. These researchers discovered an unexpected disease pattern in COVID-19 lungs: The virus invaded the cells that line blood vessels, called endothelial cells, and this was accompanied by blood clots. Compared to the flu, COVID-19 lungs had 9-fold more blood clots and the blood vessels were injured by the virus causing an unusual reaction of blood vessel growth. [Related Study NEJM]

Huge Study Throws Cold Water on Antimalarials for COVID-19​ – Medical News Today

​No support for continued use seen in analysis of 15,000 patients who got controversial drugs​

With COVID-19 Patients in the ICU, Watch for Atrial Arrhythmia – Med News Today

Of the 115 patients admitted to the University of Alabama at Birmingham (UAB) Hospital from Feb. 29 to April 10 of this year with confirmed infection with SARS-CoV-2, the virus that causes COVID-19, 16.5% developed an atrial tachyarrhythmia that had not been present on admission, reported Chad Colon, MD, and other UAB colleagues.

Young adults are also affected by Kawasaki-like disease linked to coronavirus – Washington Post

Recent public health warnings about a severe and puzzling inflammatory syndrome linked to covid-19 have focused on children. But some doctors say they are also seeing the illness, similar to Kawasaki disease, in a few young adults.

Targeting Immune Responses in Kids’ COVID-19 Inflammatory Disorder – Med Page Today

Empirical treatment with immunomodulators has worked quickly for severe cases of the multisystem inflammatory syndrome in children (MIS-C) apparently connected to COVID-19, according to some reports, although other groups suggest a more conservative approach is just as effective. [Related Study]

There May Be a Unique Coronavirus Immune Response – Science

We already know the RNA sequence of the virus very well, naturally, and that’s allowing us both to track mutations and to lay out exactly what proteins it forces a cell to make once it gets ahold of the machinery. That post has some background on some of these, and this earlier one mentions a number of them as well, with an eye to existing drugs that might interact with them. There aren’t very many in total – viruses in general are rather stripped-down. Recall that they start off by forcing the expression of a long polypeptide that (with the help of hijacked cellular proteins) starts cleaving itself into many of these necessary viral pieces, an alarmingly compact and efficient “autoloader” mechanism. The limited number of viral proteins means that you can usually assign a clear and necessary function (or more than one) to every one of them – it’s a lot like working at a small startup! There are no associate VPs in charge of facilitation of planning modalities in a viral genome; they are lean and mean. [Related Study]

‘It’s something I have never seen’: How the Covid-19 virus hijacks cells – Stat

A deep dive into how the new coronavirus infects cells has found that it orchestrates a hostile takeover of their genes unlike any other known viruses do, producing what one leading scientist calls “unique” and “aberrant” changes.

T cells found in coronavirus patients ‘bode well’ for long-term immunity – Science

T cells are among the immune system’s most powerful weapons, but their importance for battling SARS-CoV-2, the virus that causes COVID-19, has been unclear. Now, two studies show infected people harbor T cells that target the virus—and may help them recover. Both studies also found that some people never infected with SARS-CoV-2 have these cellular defenses, most likely because they were previously infected with other coronaviruses that cause the common cold.

Studies: 1% of healthcare workers had COVID-19 – CIDRAP

Two studies published today in JAMA Network Open reveal a 1% COVID-19 infection rate in healthcare workers (HCWs) in hospitals in the southern Netherlands and Wuhan, China, but with higher rates in HCWs who reported no exposure to COVID-19 patients. [Related Study 1] [Related Study 2]

Did a mink just give the coronavirus to a human? Here’s what we know. – Nat Geo

Analysis found strong similarities between the virus in the worker and in the minks, making it plausible that the virus jumped species. “Based on this comparison and the position of that form of the virus in the family tree, the researchers concluded that it is likely that one staff member at an infected farm has been infected by mink,” the Dutch government said in a statement.

Covid-19: Lungs Tell More of SARS-CoV-2 Story – Physicians Weekly

Death from Covid-19 marks the lungs in ways that are distinct from the lungs of persons whose death was caused by severe influenza infection, according to a small study that compared lungs from victims of each disease. The findings, published online by The New England Journal of Medicine, add more pieces to the Covid-19 puzzle. A team of researchers from Boston, along with an international team from Belgium, Germany, and Switzerland joined to conduct an analysis comparing seven lungs of persons who died from acute respiratory distress syndrome (ARDS) secondary to infection with influenza A (H1N1) to seven lungs from Covid-19 victims in the hope that this examination would aid in the understanding of the disease that has killed close to 100,000 persons in the United States. [Related Study NEJM]

 

Official Reporting for May 22, 2020

WHO SITREP #122 ECDC Johns Hopkins
Confirmed Cases 4,893,186 5,067,579 5,159,674
Deaths 323,256 332,711 335,418

 

NEW:
Total cases: 1,551,095
Total deaths: 93,061
(Numbers close out at 4 p.m. the day before reporting.)

Surveillance Headlines

USA

U.S. Govt Agencies: These Federal Agencies Have Seen the Most COVID-19 Deaths – Gov Tech

Southern California: Reinforcements sent to California border hospital hit by coronavirus surge – Reuters

Alabama: Dire Situation In Alabama Capital: ICUs Full, Coronavirus Cases Double In May – Forbes

Washington (State): State epidemiologists: COVID-19-related deaths likely being undercounted in WA – Local News

EUROPE

Spain: Spain allows outdoor dining again in Madrid and Barcelona – Reuters

Sweden: Sweden is still nowhere near ‘herd immunity,’ even though it didn’t go into lockdown – CNN

AFRICA

Tanzania: Tanzania says virus defeated through prayer, but fears grow – AP

 


Science and Tech

Fitbit is studying how to detect coronavirus before symptoms show up—and you can help – MacWorld

The Charge 4 and Versa 2 already do a lot to keep you healthy, but as the coronavirus pandemic sweeps around the world, Fitbit wants them to do even more using the data your devices are already collecting.

Therapeutics

Dana-Farber to test blood cancer drug in COVID-19 patients – Dana Farber.org

Scientists at Dana-Farber Cancer Institute are participating as lead investigators in a clinical test of a blood cancer drug in patients infected with the COVID-19 virus. The test follows several case reports indicating that the drug, ibrutinib, may protect against lung damage and respiratory distress caused by the virus.

Rapid repurposing of drugs for COVID-19 – Science

In late fall 2019, a novel acute respiratory disease, called coronavirus disease 2019 (COVID-19) emerged in Wuhan, China. COVID-19 is caused by severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) (1, 2). COVID-19 has been declared a pandemic by the World Health Organization and continues to spread across the globe. Most patients recover within 1 to 3 weeks. However, a small proportion (∼5%) develop severe illness that can progress to acute respiratory distress syndrome (ARDS), which can lead to death. Currently, only supportive care is available; patients would greatly benefit from the availability of direct therapeutic approaches. One approach to identifying therapeutics is to repurpose approved drugs developed for other uses, which takes advantage of existing detailed information on human pharmacology and toxicology to enable rapid clinical trials and regulatory review.

Vaccine

Harvard animal studies suggest COVID-19 protection can come from previous infection or DNA vaccine – Fierce Biotech

In all the excitement over the potential for a quick vaccine to prevent COVID-19, one burning question has emerged: Are the antibodies that form in response to the virus adequate for fending off future infections? Scientists led by Harvard University have published two studies that they believe begin to answer that question.

What the phase 1 trials of the first COVID-19 vaccine really mean – The Conversation

Early morning on May 18, Moderna, a biotechnology company, revealed the preliminary findings for the much anticipated phase I trial of an mRNA COVID-19 vaccine. The information sent Moderna’s stock soaring by more than 20% and helped fuel a rally on Wall Street.


The Road Back to Normal

For In-Person College, Coronavirus Testing Will Be Key. But Is That Feasible? – NPR

[6 minute audio at the link] The coronavirus test wasn’t as bad as Celeste Torres imagined. Standing outside a dorm at the University of California, San Diego, Torres stuck a swab up a nostril, scanned a QR code, and went on with the day. [CDC Guidance]

Is There Any Safe Way to Socialize – Time

In a perfect infectious-disease-fighting model, everybody would stay home and socialize only with their cohabitants. But the realities of human existence are messier.

Hospitals Consider Opening Their Doors to Visitors Again – Med Page Today

One pilot project in New York will allow time-limited visits, with mandatory PPE

Prepare to be tracked and tested as you return to work – MIT Tech Review

Many reopening businesses will be asking workers to take coronavirus tests, report symptoms, don masks, wear dongles, and work under the gaze of new sensors and cameras.

 


Infection Prevention

Cleaning and Disinfection for Households – CDC

Running Essential Errands – CDC

Grocery Shopping, Take-Out, Banking, Getting Gas, and Doctor Visits


Published Research

Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic – Circulation

Imbalanced Host Response to SARS-CoV-2 Drives Development of COVID-19 – Cell

Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China – JAMA

Prevalence and Clinical Presentation of Health Care Workers With Symptoms of Coronavirus Disease 2019 in 2 Dutch Hospitals During an Early Phase of the Pandemic – JAMA

Postmortem Examination of Patients With COVID-19 – JAMA

Simulated Sunlight Rapidly Inactivates SARS-CoV-2 on Surfaces – Journal of Infectious Diseases

Neurological manifestations and neuro‐invasive mechanisms of the severe acute respiratory syndrome coronavirus type 2 – European Journal of Neurology

Deep Vein Thrombosis in Hospitalized Patients with Coronavirus Disease 2019 (COVID-19) in Wuhan, China: Prevalence, Risk Factors, and Outcome – Circulation

Pre-Pub (not yet peer reviewed, should not be regarded as conclusive)

 


Coping in Quarantine

Alone Together Duets – NPR

Before the pandemic hit, bassist Linda May Han Oh and pianist Fabian Almazan were already forces to be reckoned with, but for the most part, they kept their creative practices separate.

Music teacher writes song about quarantine

This creative melodic treat expresses how most of us feel about now