Infectious disease doctors affiliated with the University of Turin, Italy discussed the ambiguity and dismay among the scientific community in response to COVID-19. They identify pitfalls regarding standardization of diagnostics including RT-PCR, antibody lateral flow immunoassays and ELISA; prevention--citing a paper by Zhang et al, 2020 asserting airborne transmission as the dominant route while quarantine was not in place in many parts of the world; and therapy stating that many articles were retracted possibly due to rushed publishing followed by uncertainty.
Transmission and Prevention
A cross sectional study conducted in Spain found that in 23 household pets owned by people with confirmed COVID-19, one female cat had a positive SARS-CoV-2 RT-qPCR result from oropharyngeal swab, suggesting that the virus may be transmitted from humans to cats. The authors acknowledge the limitation of their small sample size and recommend further study into animal models as hosts for SARS-CoV-2
R&D: Diagnosis and Treatment
A single-center randomized controlled trial investigated the efficacy of combination therapy with 400 mg sofosbuvir, 60 mg daclatasvir, and 1200 mg ribavirin among 48 patients (24 in intervention group, 24 controls) with moderate COVID-19 infection. Data revealed a shorter time to recovery in the intervention group, but no significant difference in ICU admission rates, number of deaths, or median duration of hospital stay.
Understanding the Pathology
A review by the European Association for the Study of Obesity (EASO) discussed the immunological basis by which obese patients may be more susceptible to COVID-19 via mechanisms including decreased CD4/CD8 T cell activation and increased renin-angiotensin-aldosterone system (RAAS) activity. The authors advocate for COVID-19 patient phenotyping to identify subgroups at increased risk and urge further research into this area.
Cardiologists in the United States examined the potential association of viral myocarditis with SARS-CoV-2 by assessing angiotensin-converting enzyme 2 (ACE2) in the left ventricles of patients with previous heart disease. Their findings showed:
ACE2 expression was highest in pericytes but was also observed in vascular smooth muscle cells, fibroblasts, and cardiomyocytes.
No significant changes in ACE2 expression were observed in patients with dilated or hypertrophic cardiomyopathy.
ACE2 expression in patients with hypertrophic cardiomyopathy was increased in all cell types.