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2nd THREAD:
Starting a new thread on the unfolding research picture on #2019nCoV as the outbreak enters its 2nd month

This thread compiles scientific data (w links) on what we know so far on #nCoV2019

Note: Only scientifically sound research articles included
You can see the major research from the first month of #2019nCoV outbreak at this thread:



Or in this thread roll #nCoV2019 : threadreaderapp.com/thread/1221020…
1\ In a case-series of 138 hospitalized #2019nCoV patients in Wuhan, presenting symptoms included fever (99%), fatigue (67%), dry cough (60%). 10% initially developed diarrhoea & nausea. 41% were presumed nosocomial infection inc 40 (29%) medical staff.

jamanetwork.com/journals/jama/…
2\ In the same case-series of hospitalised #2019nCoV pts, 1/4 required ICU, 1/5 had ARDS, 6 died (4.3%), 1/3 were discharged, & 2/3 remain hospitalized. Those requiring ICU were older, had an underlying condition, and more commonly had dyspnea & anorexia.

jamanetwork.com/journals/jama/…
3\ The dynamic profile of laboratory findings in 33 #2019nCoV pts (5 nonsurvivors/ 28 survivors) suggests an upward trend in neutrophil count, D-dimer, urea, and creatinine levels & downward trend in lymphocytes in non-survivors. #nCoV2019

jamanetwork.com/journals/jama/…
4\ A new report in @JAMA_current included 13 hospitalised #2019nCoV patients in 3 hospitals in Beijing. The median age was younger than Wuhan cohort; 34years; 2 were children (<15y), 10 (77%) were male, none with an underlying condition. All recovered.

jamanetwork.com/journals/jama/…
5\ Remdesivir has been recently recognized as a promising antiviral drug against a wide array of RNA viruses (including SARS/MERS-CoV). In this study, remdesivir was highly effective against #2019nCoV in Vero E6 cells & human cell line (Huh-7 cells).

nature.com/articles/s4142…
6/ In this study, it has been shown that remdesivir acts early in #2019nCoV infection and decreases RNA levels in a dose-dependent manner that parallels impairment of viral titer and there is a high genetic barrier to achieve resistance. #nCoV2019

mbio.asm.org/content/9/2/e0…
7/ Remdesivir has now entered clinical development against #2019nCoV in China.

This is one of the first randomised control trials assessing the effectiveness of remdesevir in mild/moderate hospitalised #nCoV2019 cases

clinicaltrials.gov/ct2/show/NCT04…
8/ Another Phase 3 clinical trial assessing the effectiveness of remdesivir in severe #2019nCoV cases. #nCoV2019

clinicaltrials.gov/ct2/show/NCT04…
9/ In this @TheLancet article, Richardson et al. used BenevolentAI to search for approved drugs and identified baricitinib, which is predicted to reduce the ability of the #2019nCoV to infect lung cells. This requires further detailed work.

thelancet.com/journals/lance…
10/ In this commentary, Wang et al. provides contingency plan for the management of #2019nCoV in neonatal ICUs.

"Neonates might get 2019-nCoV infection through close contact with virus-infected patients or virus carriers." #nCoV2019

thelancet.com/journals/lanch…
11/ In this commentary, Russell et al. discuss the clinical outcomes of corticosteroid use in other coronaviruses and similar outbreaks & argues the use of corticosteroids in #2019nCoV #nCoV2019

@clarkdrussell @kennethbaillie

thelancet.com/journals/lance…
12\ @BQuilty et al. estimated the effectiveness of airport screening. Based on conservative assumptions, they find that 46 of 100 infected travellers will enter undetected. #nCoV2019 #2019nCoV

eurosurveillance.org/content/10.280…
@samcliffor @StfnFlsch @rozeggo
13/ This review paper suggests that coronaviruses can persist on surfaces like metal, glass or plastic for up to 9d, but can be inactivated by surface disinfection. #2019nCoV #nCoV2019

sciencedirect.com/science/articl…
14/ In this preliminary analysis (preprint), Eggo et al. use a branching process model and current estimates of #2019nCoV & determines under which scenarios it may work and what % of contacts need to be traced. #nCoV2019

@rozeggo @HellewellJoel @sbfnk

cmmid.github.io/ncov/isolation…
15/ In this updated pre-print, using travel patterns in historical data and spread risk estimation, the authors assess the spread risk of #2019nCoV within and beyond China. #nCoV2019

@WorldPopProject @BogochIsaac

medrxiv.org/content/10.110…
16/ In this pre-print, based on air travel volume estimates and generalized linear regression model Salazar et al. identify locations which may potentially have underdetected imported #2019nCoV cases. #nCoV2019

@NeneRiehus @Caroline_OF_B @mlipsitch

medrxiv.org/content/10.110…
17/ This review paper by @sauer929 @NicoleErrett suggests the lack of evidence for travel bans as a control measure. #2019nCoV #nCoV2019

"there is an urgent need for additional research to inform policy decisions on the use of travel bans"

wmpllc.org/ojs/index.php/…
17/ Preliminary estimate of case fatality ratio suggests CRF #2019nCoV at 1.5% (0.1%-6.6%)

"While there remains considerable uncertainty, CFR is higher than what is observed for seasonal influenza, but lower than SARS or MERS." @C_Althaus

github.com/calthaus/ncov-…
18/ In this preprint, Huaiyu Tian and colleagues estimate the early evaluation of the Wuhan City travel restrictions in response to the 2019 novel coronavirus outbreak #2019nCoV

@EvolveDotZoo @MOUGK

medrxiv.org/content/10.110…
19/ Largest study (preprint) to date of 1099 hospitalised #2019nCoV cases from 552 hospitals in China

Median age was 47y, median incubation period was 3days (0-24). 79% pts had pneumonia, 5% was admitted to ICU, 3% had ARDS & 15 (1.36%) died. #nCoV2019

medrxiv.org/content/10.110…
20/ First clinical data of #COVID19 in pregnancy incl 9 pregnant women at 3rd trimester who presented w a similar clinical picture to non-pregnant adults. No intrauterine transmission reported in this cohort of women in late pregnancy who had C-section.

thelancet.com/lancet/article…
@TheLancet @TheLancetInfDis 21/ Evolution of CT changes in a 42yo man recovering from #COVID19 (d0-31). The patient was treated with supportive care, antivirals & antibiotics. By d15 evolution to a mixed pattern of ground-glass & consolidation, on d31 CT shows complete resolution.

doi.org/10.1148/radiol…
@TheLancet @TheLancetInfDis 22/ Based on first-hand experience in dealing with the #COVID19 outbreak, considering the high volume of pts and resource constraints & weighing patient safety and infection control measures, clinicians in Wuhan have developed this clinical algorithm.

thelancet.com/journals/lanre…
@TheLancet @TheLancetInfDis @LancetRespirMed 23/ First report of hospitalised infants < 1 Year of Age in China. From Dec to 6 Feb 2020, only 9 infants with #COVID19 were identified, all with at least one #SARSCoV2 infected family member. Symptoms suggest mild infection, none requiring NICU care.

jamanetwork.com/journals/jama/…
24/ A large study on diagnosis of 8274 samples from close #COVID19 contacts describes the challenges of using RT-PCR in Wuhan

33% +ve
64% -ve
3% inconclusive

316 tested for multiple pathogens; 6% of #SARSCoV2 +ve & 18% of -ve pts had other infections

medrxiv.org/content/10.110…
25/ Largest and very detailed dataset including ~72k #COVID19 cases in China

Among ~ 44k lab-confirmed #SARSCoV2
- 81% had mild disease
- Mortality was higher among >60, in men, and in Hubei
- The overall case fatality rate was 2.3%, highest among >80yo
weekly.chinacdc.cn/fileCCDCW/jour…
26/ No super spreading events in the healthcare settings have been reported.

Out of 72k, 3,019 healthcare workers have been infected (1,716 confirmed) & 5 have died. Severe/critical #COVID19 cases among HCW are declining (from 45.0% in Jan to 8.7% Feb)

weekly.chinacdc.cn/fileCCDCW/jour…
27/ A detailed report of a family cluster indicating potential presymptomatic transmission

This is the first report suggesting infectivity during the incubation period; however, it remains a question whether this is a common/rare occurrence #COVID19

academic.oup.com/jid/advance-ar…
28/ New paper in @NEJM:
2 out of 114 persons (1.8%) in a cohort of travelers who had passed symptoms-based screening was positive for #SARSCoV2 in throat swab (ct value, 24.39 & 30.25) demonstrating viral shedding in asymptomatic patients

#COVID19
nejm.org/doi/full/10.10…
@NEJM 29/ A familial cluster of 5 pts with potential transmission from a presumed* asymptomatic #COVID19 carrier

The index case had no recorded or self-reported fever and no GI/respiratory symptoms reported or observed by the physicians. CT image was normal.

jamanetwork.com/journals/jama/…
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