Daily curated COVID-19 literature
WP11 - The objective of this work package is to respond to requests concerning the current scientific knowledge on SARS-CoV-2. Based on the latest scientific literature the team will compile findings and give advice when needed
Expert Summary: To better understand the spreading of respiratory droplets and possible preventive measures, the authors analysed droplet production due to coughs and speech. The authors show that transmission by aerosols of the small droplets can only be prevented by use of high-performance face masks; a conventional surgical mask only stops 30% of those for inhaled breath; for exhaled breath the efficacy is higher. The study shows that better ventilation of spaces substantially reduces the airborne time of respiratory droplets.
Expert Summary: About 5% of patients with COVID-19 require ICU management. These patients are at high risk of developing secondary infections including invasive pulmonary aspergillosis (IPA) which leads to enhanced illness severity and mortality. An algorithm to discriminate Aspergillus spp colonization from putative IPA was developed for patients in ICU based on 3 mycological criteria combining culture from respiratory specimens and galactomannan detection in the bronchoalveolar lavage (BAL) and serum. The authors believe that IPA is more probable if 2 mycological criteria are met.
Expert Summary: The authors recommend the use of human airway organoids as a model to study SARS-CoV-2 replication kinetics, tropism and host response. They could be used in different context for example in co-culture with different immune cells to study the immune response to the virus and to explore the activity of immunomodulatory drugs. The organoids could also be used to discover antiviral drugs predicting their potential measuring viral load by RT-PCR or the number of cells infected by immunofluorescence.
Expert Summary: The authors present a man who developed rapidly progressive pulmonary disease and, following two negative NP tests, was diagnosed with COVID-19 based on bronchoscopic biopsy and BAL after 9 days of illness. This case represents a presentation of COVID-19 with atypical features, including sudden onset with a mild cytokine storm profile, apparent early response to antibiotics followed by rapid clinical worsening, and two negative RT-PCR tests of NP swabs, which delayed the diagnosis of COVID-19.
Expert Summary: The authors provide recommendations on the use of tracheostomy during the COVID-19 pandemic to reduce the use of ventilatory support, which are scarce. They also provide guidelines for health-care workers to perform the procedure safely.
Tropism, replication competence, and innate immune responses of the coronavirus SARS-CoV-2 in human respiratory tract and conjunctiva: an analysis in ex-vivo and in-vitro cultures
Expert Summary: The authors evaluate tissue and cellular tropism of SARS-CoV-2in human respiratory tract, conjunctiva, and innate immune responses in comparison with other coronavirus and influenza virus. The conjunctival epithelium and conducting airways appear to be potential portals of infection for SARS-CoV-2. Both SARS-CoV and SARS-CoV-2 replicated similarly in the alveolar epithelium; SARS-CoV-2 replicated more extensively in the bronchus than SARS-CoV. These findings provide important insights into the transmissibility and pathogenesis of SARS-CoV-2 infection and differences with other respiratory p...
Expert Summary: In this comment, the authors describe the interaction of SARS-CoV-2 with the inflammatory system and therapy targets within this system. They propose potential benefits from other immunomodulators. In conclusion, they suggest JAK and IL-1 inhibitors as therapeutic targets warranting rapid investigation.
Expert Summary: The authors share the algorithm used in Timor-Leste for triage and screening of potential COVID-19 patients, which is fundamental in environments where there are limitations in PPE, laboratory testing and trained clinicians.