Thread by @MartinJuhl2

A compilation on current data on seasonality of SARS-CoV-2 as well as historic data on other virus, such as common cold HCoV's and influenza

➡️ Temperature
➡️ Humidity
➡️ UVB
➡️ Vitamin D
➡️ Indoor vs outdoor
➡️ Dose exposure
➡️ Ventilation

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Leading virus immunity expert Iwasaki on seasonality of virus: highlights the importance of the environmental factors: temperature, humidity as well as vitamin D status, in modulating immune responses to viral infections in the respiratory tract annualreviews.org/doi/10.1146/an…
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Temperature, Humidity, and Latitude Analysis to Estimate Potential Spread and Seasonality of Coronavirus Disease 2019 (COVID-19).
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jamanetwork.com/journals/jaman…

In the above cohort study of 50 cities with and without COVID-19 had distribution roughly along the 30° N to 50° N latitude corridor with consistently similar weather patterns, consisting of mean temperatures of 5 to 11 °C combined with low specific and absolute humidity.
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Seasonality of SARS-CoV-2: Will COVID-19 go away on its own in warmer weather? For the novel coronavirus SARS-CoV-2, we have reason to expect that like other betacoronaviruses, it may transmit somewhat more efficiently in winter than summer
5/x ccdd.hsph.harvard.edu/will-covid-19-…

The size of the change is expected to be modest, and not enough to stop transmission on its own. Based on the analogy of pandemic flu, we expect that SARS-CoV-2, as a virus new to humans, will face less immunity and thus transmit more readily even outside of the winter season
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@michaelmina_lab
Epidemiologist, Immunologist, Physician, Harvard Public Health/Medical School

"Mistaking ongoing transmission in the summer for a "less seasonal virus" is not smart. All evidence points in the other direction"
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https://twitter.com/MartinJuhl2/status/1314877632681517058?s=20

Study that provides an overview of the global seasonality of sCoVs. Findings offer clues to the possible postpandemic circulating season of SARS-CoV-2 and add to the knowledge pool necessary for postpandemic preparedness for SARS-CoV-2.
academic.oup.com/jid/article/22…
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Early detection of seasonality and second-wave prediction in the COVID-19 pandemic
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medrxiv.org/content/10.110…

Temperature, humidity and latitude analysis to predict potential spread and seasonality
Bottom Line
The transmission of COVID-19 is associated with the 30 to 50 degree N’ longitude corridor and weather patterns and low specific and absolute humidity cebm.net/study/covid-19…
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The seasonal differences between the Southern and Northern hemispheres might have played a role in the spread of SARS-CoV-2
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frontiersin.org/articles/10.33…

What happens to COVID19 when winter returns to the Northern Hemisphere is still uncertain, but here are some things we know
-people will spend more time indoors
-indoor air will be drier and less ventilated
-endemic CoVs have pronounced seasonality
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https://twitter.com/MartinJuhl2/status/1314877643142164481?s=20

On the epidemiology of influenza
In 1992, Hope-Simpson predicted that, "understanding the mechanism (of the seasonal stimulus) may be of critical value in designing prophylaxis against the disease."
virologyj.biomedcentral.com/articles/10.11…
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Vitamin D Status and Seasonal Variation among Danish Children and Adults: A Descriptive Study
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mdpi.com/2072-6643/10/1…

Vitamin D supplementation to prevent acute respiratory infections: Data from 39 studies. For the primary comparison of vitamin D supplementation vs. placebo, the intervention reduced risk of ARI overall (Odds Ratio [OR] 0.89) medrxiv.org/content/10.110…
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This preprint is a follow up on the 2017 BMJ metaanalysis of 25 RCT's
Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants (adjusted odds ratio 0.88, 95% confidence interval 0.81 to 0.96)
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bmj.com/content/356/bm…

Regarding Vitamin D & Covid-19:
Positive RCT data: Of 50 patients treated with calcifediol (25-hydroxy-vitamin D), one required admission to the ICU (2%), while of 26 untreated patients, 13 required admission (50%) p < 0.001 sciencedirect.com/science/articl…
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Cohort study to evaluate effect of vitamin D, magnesium, and vitamin B12 in combination on severe outcome progression in older patients with coronavirus (COVID-19) (small study)
sciencedirect.com/science/articl…
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Vitamin D Treatment Is Associated with Reduced Risk of Mortality in Patients with COVID-19
Treatment with vit D, regardless of baseline vit D levels, appears to be associated with a reduced risk of mortality in acute in-patients admitted with Covid-19
papers.ssrn.com/sol3/papers.cf…
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Vitamin D and survival in COVID-19 patients: A quasi-experimental study
Bolus vitamin D3 supplementation during or just before COVID-19 was associated with better survival rate in frail elderly.
sciencedirect.com/science/articl…
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Walkthrough by @tomaspueyo on data, including the link to bradykinin, discovered by a supercomputer in Oak Ridge in a large collaboration
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elifesciences.org/articles/59177

https://twitter.com/tomaspueyo/status/1302892639193194497?s=20

Collaboration between NIH, King's College London, University of Purdue/Oxford/Auckland/Concepcion/Virginia/Lübeck:
research indicates #VitaminD's action on #Tcells intersects with #complement pathways to counter lung inflammation in severe #COVID19.

https://twitter.com/RHCMcG/status/1285293367702614016?s=20

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Six Potential Treatments for COVID19 Identified using AI
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https://twitter.com/MartinJuhl2/status/1315693302033907717?s=20

Identification of potential treatments for COVID-19 through artificial intelligence-enabled
phenomic analysis of human cells infected with SARS-CoV-2

Hits included Vitamin D analogues
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biorxiv.org/content/10.110…

Cohort study of 489 who had a vitD level measured in the year before COVID-19 testing, the relative risk of testing pos for COVID-19 was 1.77x greater for patients deficient vitD status compared with sufficient vitD status, statistically significant jamanetwork.com/journals/jaman…
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A highly significant correlation between prevalence of vitamin D deficiency and Covid-19 incidence

➕

Between ♀️-to-♂️ ratio for severe vitamin D deficiency and ♀️-to-♂️ ratio for Covid-19 incidence in localities

medrxiv.org/content/10.110…
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Collection of studies of post-infection blood samples

Both studies which supports the vitamin D link
&
studies which does not support link to vitamin D
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vitamin-d-covid.shotwell.ca

Critical assessment of the evidence of vitamin D
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coronavirus.medium.com/vitamin-d-and-…

Did not show a correlation:
Vitamin D concentrations and COVID-19 infection in UK Biobank
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sciencedirect.com/science/articl…

A thread on how our model takes into account the seasonality of COVID-19. We anticipate a large increase in daily COVID-19 deaths in the US in late November and December......but the increase we’re projecting is driven most importantly by seasonality

https://twitter.com/IHME_UW/status/1309627883636187136?s=20

Closed environments facilitate secondary transmission of coronavirus disease 2019 (COVID-19)
The odds that a primary case transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment
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medrxiv.org/content/10.110…

Evidence of Protective Role of UVB Radiation in Reducing COVID-19 Deaths

Permanent increase in UV index is associated with a 1.2% decline in daily growth rates of C19 deaths p<0.01 as well as a 1.0% decline in the daily growth rates of CFR p<0.05
nature.com/articles/s4159…
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Find that UV light, in particular, is associated with decreased disease growth rate relative to other factors. Based on these associations with weather, predict that C19 will decrease temporarily during summer rebound by autumn, and peak next winter
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pnas.org/content/117/44…

Seasonal effect of humidity, lower viral dose due to UVB exposure, and vitamin D mentioned as factors

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SARS-CoV-2 Viral Load Predicts Mortality in Patients with and without Cancer Who Are Hospitalized with COVID-19

Fit well with historic work by Peter Aaby: the discovery that the infant mortality rate from measles was linked to initial dose
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https://twitter.com/tmprowell/status/1310222482763382784?s=20

higher indoor transmission could also lead to worse outcome➡️SARS-CoV-2 viral load predicts COVID-19 mortality
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thelancet.com/journals/lanre…

New preprint study showing the virus remains infectious longer at low temperatures and extreme relative humidities

Key finding: the virus remains infectious longer at low temperatures and extreme relative humidities

https://twitter.com/dylanhmorris/status/1317452511624790017?s=20

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Two videos showing how relative humidity plays a large role in the ability to clear virus in the airway.
RH 50% good
RH 10% bad
(Humid summer’s vs dry winter’s)
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https://twitter.com/VirusesImmunity/status/1320430656481120256?s=20

A room, a bar and a classroom: how the coronavirus is spread through the air

Highlights the importance of ventilation

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english.elpais.com/society/2020-1…

Excellent illustration using a contour plot on how seasonality and the Rt value is linked. In order to keep the Rt value ~1, while moving towards fall/winter, human societal interconnectivity has to be reduced
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https://twitter.com/trvrb/status/1327437375320932352