Authors: Heather Jones, Future Science Group
Take a look at the top ten most-read COVID-19 articles from April, including a patient case series, two remdesivir studies and a perspective article outlining possible solutions to the coronavirus crisis.
Until recently, limited information has been available to describe the characteristics and outcomes of hospitalized patients in the US following contraction of COVID-19. This first large study of COVID-19 patients admitted to hospitals in New York (USA) revealed that elderly individuals, men and those with pre-existing hypertension or diabetes were highly prevalent in this case series. Several other outcomes were measured, including morbidity and treatment.
The COVID-19 vaccine development landscape
Le et al., 2020 – Nat. Rev. Drug Discov.
Since the publishing of the genetic sequence of SARS-CoV-2, there has been intense global activity across the industry to develop a vaccine against the disease. An article published in Nature describes the development of a database that provides insights into key characteristics of the COVID-19 vaccine R&D landscape. The authors encourage strong international coordination and cooperation between vaccine developers, governments and other public bodies to ensure the development and supply of promising vaccine candidates.
In order to assess the transmission of SARS-CoV-2, researchers analyzed data from Shenzhen (China), collected over a 30-day period early on in the outbreak. This epidemiological data, concerning a group of individuals infected with the virus and their close contacts, revealed important information about virus and allowed the researchers to estimate characteristics including incubation period and reproduction number.
Pharmacologic treatments for Coronavirus Disease 2019 (COVID-19)
Sanders et al., 2020 – JAMA
Amid the rapidly expanding catalogue of drug candidates being tested, a comprehensive review of the potential therapies to treat COVID-19 describes the current state of pharmaceutical research. While there are no widely approved therapies for the virus at this stage, the authors observe the most promising therapy to be remdesivir.
Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial
Wang et al., 2020 – Lancet
A multicenter clinical trial in Hubei (China), which enrolled over 200 patients hospitalized with COVID-19, examined the use of remdesivir treatment compared with a placebo. The researchers observed no statistically significant clinical benefits from the treatment, but suggested that the numerical reduction in time to clinical improvement in those treated earlier requires confirmation in larger studies.
Compassionate use of remdesivir for patients with severe COVID-19
Grein et al., 2020 – N. Engl. J. Med.
A small cohort of hospitalized patients were enrolled in a study testing the use of remdesivir to treat COVID-19 on a compassionate-use basis. The researchers observed clinical improvement in 68% of the patients, while noting the need for ongoing randomized, placebo-controlled trials of this therapy to confirm its efficacy.
Temporal dynamics in viral shedding and transmissibility of COVID-19
He et al., 2020 – Nature
A study investigating the temporal patterns of viral shedding among a cohort of COVID-19 patients along with the infectiousness profiles of infector-infectee transmission pairs revealed that almost 50% of secondary cases were infected during the index case’s presymptomatic stage. Researchers emphasized the need for control measures that take this discovery into account.
A news article in the BMJ reported the emergence of evidence from China indicating that the majority of coronavirus infections, 130 of 166 infections in the study, do no not result in symptoms. This data apparently suggested that approximately four out of five infections caused no illness, and many researchers believe these asymptomatic cases to be an important source of contagion. Experts quoted in the article argue against extended lockdown measures that are already crippling the economy.
Effectiveness of convalescent plasma therapy in severe COVID-19 patients
Duan et al., 2020 – PNAS
Given the lack of approved antiviral agents for the novel coronavirus, a study was carried out to investigate the potential benefits of convalescent plasma therapy. Ten patients with severe COVID-19 were treated with one dose of convalescent plasma derived from recently recovered donors. The results of this small study demonstrated that this therapy was well tolerated and could potentially improve clinical outcomes in severe COVID-19 cases, though the authors acknowledged that further studies are needed in larger well-controlled trials.
Responding to COVID-19 – A Once-in-a-Century Pandemic?
Gates, 2020 – N. Engl. J. Med.
Over the past decade, Bill Gates has been warning about the worldwide lack of preparation and systems in place to respond to a pandemic. In a recent perspective article, he outlines the threat imposed by COVID-19 and the actions that are urgently required of governments and companies across the world in order to solve the immediate problem of this crisis as well as prevent it from happening again.