With misinformation and deliberate disinformation running almost as rampant as the virus that causes COVID-19, we thought it would be best to go to the source for the latest insights. Compiled by veteran medical journalist Brian Owens, Hakai Magazine in partnership with The Tyee regularly presents this roundup of some of the newest science on the COVID-19 pandemic, straight from the scientific journals.
Masks may help prevent infected people from spreading the coronavirus that causes COVID-19
Surgical facemasks may be helpful in limiting the spread of coronaviruses from people who are infected. Masks were shown to significantly reduce the detection of influenza virus in respiratory droplets, and seasonal coronaviruses in aerosols. It is important to note, however, that the study did not examine SARS-CoV-2, the cause of COVID-19, specifically, and does not address whether masks work in the opposite direction: by preventing infections in the wearer.
Nature Medicine, April 3, 2020
Keep taking heart and kidney medication
Recently we highlighted a study that suggested that drugs commonly used to treat chronic heart and kidney diseases may increase the risk of complications from COVID-19. This study was based on animal experiments that showed that those drugs increased the number of ACE2 receptors in the animal. The coronavirus that causes COVID-19 uses ACE2 cells to enter the body.
Now, a group of researchers has completed a detailed review of more than 60 studies and concluded that none reported an increase in ACE2 levels in humans caused by these same drugs. They recommend patients currently taking these medications continue to do so without interruption.
Mayo Clinic Proceedings, March 30, 2020
Patients may still be infectious even after they recover
Two studies of patients who had recovered from COVID-19 found that they may still be infectious even after symptoms have disappeared. One study looked at people who had mild infections and found that half of them continued to test positive for up to eight days after their symptoms disappeared. The other study found that the virus could still be detected in a patient's mucous and feces even after they had tested negative on two consecutive throat swabs. The researchers recommend that if you were quarantined at home with mild symptoms, you should extend your quarantine for another two weeks even after you feel better.
American Journal of Respiratory and Critical Care Medicine, March 23, 2020
Annals of Internal Medicine, March 30, 2020
Patients shed the virus at high rates early in infection
Scientists in Germany have found that shedding of SARS-CoV-2 in the upper respiratory tract occurs most efficiently early on, when patients still have mild symptoms. They could detect the infectious form of the virus in the throat and lungs until day eight of symptoms, and viral RNA in mucus from the lungs after the symptoms were gone. They did not detect the virus in blood or urine, and did not find the infectious form in feces, despite high levels of viral RNA.
Potential vaccine shows promise in mice
A potential vaccine against SARS-CoV-2, developed at the University of Pittsburgh, has been tested in mice. The vaccine was found to produce antibodies specific to the virus at quantities thought to be sufficient to neutralize the virus. The vaccine uses lab-made pieces of viral protein to trigger an immune response — the same way that current flu vaccines work. It is delivered using a microneedle array, a fingertip-sized patch of 400 tiny needles made of sugar that goes on like a Band-Aid and delivers the vaccine into the skin. The researchers expect to start trials in humans within a few months.
Potential treatment drug identified by University of British Columbia scientists
A drug that has already been tested against lung disease could potentially be a useful treatment for COVID-19. The drug, called human recombinant soluble angiotensin-converting enzyme 2, blocks the ACE2 receptor that the virus uses to enter cells. In cell cultures, hrsACE2 reduced viral growth by a factor of 1,000 to 5,000.
What affects adherence to quarantine?
A person's compliance with quarantine rules during infectious disease outbreaks can vary from as little as zero per cent up to 92.8 per cent, according to a review of existing research. The factors that have the biggest effect of adherence are the knowledge people had about the disease and quarantine procedure, social norms, perceived benefits of quarantine and perceived risk of the disease, as well as practical issues such as running out of supplies or the financial consequences of being out of work. Public health officials should take these factors into account to improve adherence, the researchers say.
No evidence for or against ibuprofen
Despite speculation that non-steroidal anti-inflammatory drugs such as ibuprofen might make things worse for some COVID-19 patients, a review of existing research found no evidence either for or against the use of NSAIDs for COVID-19. The researchers also found that other types of drugs such as TNF blockers and JAK inhibitors, used to treat arthritis or other forms of inflammation, were safe to use, and there is some evidence that corticosteroids may be helpful if used in the early acute phase of infection, but the evidence is not conclusive. Health authorities that had previously warned against the use of NSAIDs have since backed off that claim.
eCancerMedicalScience, March 30, 2020
Structure of the virus's receptor binding domain
Two groups of scientists have determined the structure of SARS-CoV-2's receptor binding domain, the protein that allows it to attach to human cells. They found that it was nearly identical to the one on SARS-CoV (the original SARS virus), but with a few changes that allow it to bind more effectively. The research helps us understand the evolutionary history of the virus and will help guide the development of treatments and vaccines.
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