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Lung Tissue Recovers Well, Advanced Imaging Shows Nerve Damage, AI Detects SARS-CoV-2 in Chest X-Rays: COVID-19 Updates

December 4, 2020 I One-third of children asymptomatic, tackling barriers in underserved communities, immune mechanism that triggers cytokine storm, assessing the needed for repeat testing, and improved positive controls for COVID-19 assays. Plus: Aggressive and early testing decreased transmission and preliminary results from Predi-COVID study.


Research News

Early and aggressive testing for COVID-19 has decreased transmission in certain countries, finds a new study published in Health Affairs. Researchers used data from multiple online sources to quantify testing impact on COVID-19 transmissibility in over 170 countries, which accounted for 99% of the cases across the globe, between March and June 2020. They found that intense testing had the greatest influence on reducing transmission of the virus, alongside other interventions. A tenfold increase in the ratio of test to new cases reported reduced average COVID-19 transmission by 9%. The authors explain that countries such as China, Australia, and New Zealand likely achieved near elimination due to these measures. DOI:10.1377/hlthaff.2020.01409

Nanoengineers from the University of California San Diego have developed new and improved positive controls, made from virus-like particles, that will allow more accurate and rapid COVID-19 testing. The researchers say that by packaging segments of RNA from the SARS-CoV-2 virus into virus-like particles, they have created positive controls for COVID-19 testing that are stable. They can be stored for one week in temperatures up to 104 degrees F and retain 70%  of their activity after one month of storage, while current positive controls require refrigeration and degrade easily. The team’s goal is to provide more testing capabilities in low-resource and underserved areas with this advancement, and they are currently working on adapting their controls for use in diagnostic tests like the RT-LAMP test that can be done on the spot and is less complex than RT-PCR tests. This work is published in ACS Nano. DOI:10.1021/acsnano.0c08430

In a new study, published in the Journal of Experimental Medicine, researchers from Brazil pinpoint an immune mechanism that triggers cytokine storm seen in severe COVID-19. The research team demonstrated for the first time that in COVID-19 patients an immune mechanism, known as the inflammasome, plays an important role in the activation of the inflammatory process that can lead to organ damage and death. The authors suggest that their findings support the use of inflammasome activation as a marker for disease prognosis, identifying high-risk patients at an early stage, and as a potential therapeutic target in severe COVID-19. They report that there are drugs already approved for human use that are capable of inhibiting inflammasome activation and these drugs should be investigated in the context of SARS-CoV-2 infection. DOI:10.1084/jem.20201707

Advanced imaging (ultra-high-resolution ultrasound and MR neurography) can now show tiny nerves to better diagnose nerve or muscle pain associated with COVID-19. Northwestern Medicine researchers built upon their previous study, that found COVID-19 patients can experience nerve damage from being in a prone position in the intensive care unit, to take a closer look at other causes of unexplained pain after recovering from the virus by using this advanced imaging. They discovered two additional patient cohorts with COVID-19-related nerve damage. One group experienced nerve damage secondary to an inflammatory immune response that attacked the nerves, and the second patient cohort suffered nerve damage from a hematoma related to anticoagulation therapy. The research team hopes to raise awareness of this advanced imaging technology to better support physicians and their patients who may be experiencing post-COVID-19 pain and weakness. This study is published in Radiology. DOI:10.1148/radiol.2020203116

A new study by John Hopkins Medicine researchers, published in Clinical Infectious Diseases, evaluated the results of repeated polymerase chain reaction (PCR) diagnostic tests for SARS-CoV-2 RNA in over 29,000 nasopharyngeal swabs, and also placed a portion of those specimens in cell cultures to look for live virus particles, to assess the need for repeat COVID-19 testing to determine infectiousness. The researchers found that the average cycle threshold (Ct) value associated with cell culture growth of SARS-CoV-2 was 18.8 and also observed viral growth from specimens collected up to 20 days after the first positive result (mostly seen in symptomatic patients at the time of specimen sampling). Positive tests following negative ones had Ct values higher than 29.5 and were not associated with observed virus growth in culture. The research team believes that their findings support the theory that low Ct values in SARS-CoV-2 diagnostic tests are associated with recoverable virus, and that RNA detection in repeated tests may indicate someone who continues to be infectious with persistent symptoms, however, they add that additional studies are needed to confirm this. DOI:10.1093/cid/ciaa1616/5940589

University of Alberta researchers found that more than one-third of children with COVID-19 are asymptomatic. The team analyzed results from 2,463 children who were tested for the virus between March and September and, of those children tested, 1,987 tested positive for COVID-19 with 35.9%  experiencing no symptoms. Researchers of this study, published in CMAJ, also determined cough, runny nose and sore throat to be the three most common symptoms in COVID-19 positive children (25%, 19%, and 16%, respectively), however, these symptoms were actually more prominent in children who tested negative. They suggest that these findings highlight the importance of mask-wearing and social distancing even when feeling well, and COVID-19 questionnaires and self-reported symptoms of sore throat and runny nose are not good indicators for whether or not a child may be a SARS-CoV-2 carrier. DOI:10.1503/cmaj.202065

A new evaluation of current diagnostic methods for COVID-19 is published in APL Bioengineering, and researchers of the paper discuss the need for more practical, precise, and accurate testing measures that yield fast results. They explain that rapid diagnosis and rapid isolation are essential to prevent infection in pandemic outbreaks and that there is no single test available for the entire stage of disease, adding that nano-based sensor technologies may make it possible to detect the virus at any stage of infection. DOI:10.1063/5.0021554

Lung tissue of patients who suffered from severe COVID-19 recovers well in most cases, finds new research published in Clinical Infectious Diseases. The study, carried out by the Radboud University Medical Center, followed up with three groups of patients who were treated in the ICU, admitted to a general nursing floor, or were referred by a general practitioner for persistent symptoms from COVID-19. After three months, an extensive health assessment revealed the lung tissue of patients with severe disease was recovering well and showed similarities to acute pneumonia or acute respiratory distress syndrome (ARDS) recovery. Interestingly, they also found that those patients referred by a GP showed the worst recovery, even though hardly any anomalies were found in the lungs. The researchers emphasize that these findings warrant further research into explanations and treatment options for those with persistent symptoms. DOI:10.1093/cid/ciaa1750

Northwestern University researchers have developed a new artificial intelligence (AI) platform that detects COVID-19 through analyzing chest X-rays of the lungs. This AI algorithm, called DeepCOVID-XR, spotted COVID-19 in X-rays more accurately than a team of specialized thoracic radiologists (82%  accuracy vs. 76-81%  accuracy, respectively) and did so ten times faster. The researchers of this study, published in Radiology, believe this new AI system could rapidly screen patients admitted to hospitals for reasons other than COVID-19 to flag patients for isolation and testing. They note that this algorithm does not replace testing for the virus and would not detect COVID-19 in patients without manifestations in the lungs or early in the virus’ progression. DOI:10.1148/radiol.2020203511

Preliminary results from the Predi-COVID study in Luxembourg have been published in the British Medical Journal Open, and researchers from the study are seeing encouraging participation rates. Predi-COVID aims to identify clinical, epidemiological, and socio-demographic characteristics, as well as specific biomarkers from both the virus and the patient. The research team has also launched an ancillary study, called Predi-COVID-H, which includes household members of COVID-19 positive patients to study transmission of the virus in this high-risk population. Preliminary findings show that most of the enrolled participants experienced few or mild symptoms. The most prevalent symptoms included fever (26.2% ), cough (23.3% ), rhinitis (12.2% ), and sore throat (10.8% ). Common comorbidities and risk factors included smoking (18.1% ), asthma (5.4% ), diabetes (4.7% ), chronic heart disease (3.6% ), and obesity (3.3% ). Researchers are also exploring “vocal biomarkers” for easy remote monitoring of patients from their homes. DOI:10.1136/bmjopen-2020-041834

Industry News

Drawbridge Health partners with University of Cambridge researchers for the use of the OneDraw Blood Collection Device for remote blood sample collection in a large-scale surveillance study currently being conducted to assess the prevalence of previous infection with COVID-19. The study, launched in July 2020, has recruited 4,000 participants and aims to quantify the proportion of people previously infected with the virus in the Fenland cohort, which is broadly representative of the population of Cambridgeshire. The OneDraw device allows study participants to collect blood samples at home, without the need for face-to-face interaction. Based on positive user feedback and demonstrated testing suitability, Drawbridge Health and the University of Cambridge are now developing a collaboration in metabolic health, including the evaluation of nutritional biomarkers. Press Release

The Wyss Institute for Biologically Inspired Engineering at Harvard University has announced that its eRapid technology has been licensed to The iQ Group Global for COVID-19 diagnostics. The Australian consortium will integrate the biomarker technology with its transistor technology to enable specific and sensitive SARS-CoV-2 testing. The combined technologies could facilitate global serological testing for SARS-CoV-2 infections and allow for diagnostic answers in real time. Press Release

Pennington Biomedical Research Center, along with the Louisiana Clinical Translational Science Center (LA CaTS) and the Healthy BR initiative, has received $1.8 million in funding under the National Institutes of Health Rapid Acceleration of Diagnostic-Underserved Populations (RADx-UP) program to tackle barriers of COVID-19 testing in Louisiana’s Black communities. The study will find community-driven approaches to reduce barriers to testing and find best strategies to increase testing in these communities, including making tests available in more relaxed settings such as churches, schools, and community centers. Pennington Biomedical is one of 55 institutions that received an NIH award through the RADx-UP initiative. Press Release

University of Chicago Medicine and the University of Illinois at Chicago (UIC) researchers are launching an investigational study to determine the effects of increased education and access to rapid COVID-19 testing on underserved communities in the Chicago area. Funded by $2 million in support from the National Institutes of Health RADx-UP initiative, the program aims to better understand COVID-19 testing patterns and disparities in infection rates, disease progression, and outcomes among underserved and vulnerable populations. The researchers will send out testing kits to participants that allows quick sample collection at home to offer more privacy and accessibility in hopes to improve the public perception of COVID-19 testing. Press Release

Fluidigm has announced that the Central Drugs Standard Control Organization (CDSCO) in India has licensed importation and commercial sale of Fluidigm’s saliva-based Advanta Dx SARS-CoV-2 RT-PCR Assay in that country for COVID-19 testing. The CDSCO license was granted to Premas Life Sciences, a Delhi based life sciences distribution company, and the Fluidigm test is one of the first saliva-based tests for COVID-19 to be licensed in India. Press Release

Celemics has launched its Comprehensive Respiratory Virus (CRV) Panel for accurate identification and sequencing of whole respiratory virus genomes. The CRV Panel includes 39 strains of the 9 most prevalent respiratory viruses, including coronaviruses. Unlike common RT-PCR assays, which detect only one pathogen at a time, the next generation sequencing (NGS) based Celemics CRV Panel is designed to identify, detect, and sequence each pathogen and any present mutations in a single reaction. Press Release

Avacta Group plc has announced significant progress in the development of a highly scalable manufacturing process for a lateral flow SARS-CoV-2 antigen test being carried out with BBI solutions, and that lateral flow test shows very good analytical sensitivity with laboratory samples. In preparation for clinical validation of the lateral flow test, Avacta is working on both saliva and anterior nasal swab samples, and they will continue to develop both sampling methods in parallel in order to bring highly accurate COVID-19 tests to the market quickly to suit a range of uses. The performance of the test with clinical samples will now be evaluated as a precursor to a much larger clinical study with COVID-19 patients of known viral load to determine the clinical sensitivity of the test. Press Release

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