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September 8 | Daily COVID-19 LST Report

Epidemiology

· Experienced scientists from the Center for Tobacco Control Research and Education at the University of California San Francisco conducted a meta-analysis of 19 peer-reviewed papers (i^2 = 38%, p=0.048) involving 11,590 COVID-19 patients. They found a positive association between smoking and severe progression of COVD-19 (29.8% of smokers vs 17.6% of nonsmokers; OR 1.91, 95% CI 1.42–2.59, p = .001). Authors suggest that while this data clearly shows smoking puts COVID-19 patients at increased risk for disease progression, the actual risk may be even higher due to limitations in the reviewed papers.

Transmission & Prevention

· Infection control experts from West China Hospital of Sichuan University in Chengdu discuss prevention measures implemented to protect healthcare workers (HCW) across China, including mask-wearing for workers, securing and providing personal protective equipment, using fluid resistant protective clothing and respirators, allocating specific hospitals for COVID-19 patients, and enacting strict community lockdown procedures. Because none of the 42,600 HCWs dispatched to Hubei Province contracted SARS-CoV-2 after implementation of these measures (compared to 3387 prior), the authors suggest early adoption of these measures allowed for decreased transmission of COVID-19 to HCWs. Adjusting Practice During COVID-19

· Spanish dermatologists discuss a scabies outbreak in their region during the nationwide lockdown in March-May, 2020, with a three-fold increase in reported cases at a single hospital compared to the same period in the previous five years. Authors suggest that time spent in confinement increased fomite transmission and that individuals were less likely to seek treatment until the scabies lesions became more serious leading to more cases in family clusters, longer infection time due to reinfection, and the need for more aggressive treatment regimens to treat resistant infections. R&D: Diagnosis & Treatments

· Lab scientists from the Tamil Nadu Veterinary and Animal Sciences University in Chennai, India reviewed the limited existing literature related to antibody-dependent enhancement (ADE) and its potential impact on the effectiveness of immunotherapy and vaccine development for SARS-CoV-2. Citing evidence from research on MERS-CoV and SARS-CoV, authors suggest ADE, which occurs when non-neutralizing or poorly neutralizing antibodies increase viral entry into cells, may intensify coronavirus infection. However, they propose targeting receptor binding motifs as a possible mitigation strategy. · Entomologists from Kyushu University in Japan describe their method for producing antigenic SARS-CoV-2 spike protein (S protein) using the baculovirus expression vector system (BEVS) to induce S protein secretion in silkworm serum in ten days. Citing the speed, low-cost, and success of antigen production with this method, authors suggest BEVS could allow larger scale SARS-CoV-2 S protein production for imumunodetection kits and vaccine development.

· Health policy experts from the University of Michigan and Boston University discuss the Orphan Drug Act, which incentivizes drug development for rare diseases, and its inconsistent application to diseases eventually shown to be common, citing remdesivir's designation during the early COVID-19 crisis as an example. The authors suggest pharmaceutical companies take advantage of policy loopholes and propose amending the Orphan Drug Act so that it better serves its intended purpose.

Mental Health & Resilience Needs

· A representative panel survey of adults (n=5,470) conducted across the United States by Australian and American researchers found the mental health impact of COVID-19 disproportionately affected young adults, certain racial/ethnic minorities, essential workers, unpaid adult caregivers, and individuals with pre-existing psychiatric conditions. Authors recommend COVID-19-specific mental health interventions and prevention efforts be implemented to improve care for the at-risk populations identified by this study (see summary).

Silver Linings

· Utilizing data from the Epidemiological Surveillance Network from Madrid Autonomous Community, epidemiologists from Madrid, Spain compared the number of cases of reportable communicable diseases in the first quarter of 2020 compared to 2019. They found a decrease in both food borne illnesses (Campylobacter [1308 vs 391], Salmonella [462 vs 111]) and sexually transmitted diseases (Neisseria gonorrhea [1056 vs 196], Chlamydia infection [1212 vs 292], syphilis [425 vs 114]), though they do not provide levels of significance. The authors suggest that COVID-19 control measures (social distancing, shut down of restaurants and clubs, and decreased tourism) also drove this decrease in other communicable disease. However, they acknowledge underreporting and reluctance to seek treatment during a pandemic may also have affected data collection.


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