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Coronavirus

To support urgent research to combat the ongoing outbreak of COVID-19, caused by the novel coronavirus SARS-CoV-2, the editorial teams at Nature Research have curated a collection of relevant articles. Our collection includes research into the basic biology of coronavirus infection, its detection, treatment and evolution, research into the epidemiology of emerging viral diseases, and our coverage of current events. The articles will remain free to access for as long as the outbreak remains a public health emergency of international concern.

Latest SARS-CoV-2/COVID-19 research

Early and accurate clinical assessment of disease severity in COVID-19 patients is essential for planning the allocation of scarce hospital resources. An explainable machine learning tool trained on blood sample data from 485 patients from Wuhan selected three biomarkers for predicting mortality of individual patients with high accuracy.

Article | | Nature Machine Intelligence

Vaccines and targeted therapeutics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are currently lacking. Here, the authors report a human monoclonal antibody capable of neutralizing both authentic SARS-CoV and SARS-CoV-2 by targeting a common epitope.

Article | Open Access | | Nature Communications

SARS-CoV-2 uses ACE2 as the entry receptor. Here, the authors show that an ACE2-Ig fusion protein inhibits entry of virus pseudotyped with the SARS-CoV-2 spike protein, show differential binding kinetics of SARS-CoV and SARSCoV-2 spike proteins to ACE2, and determine pharmakocinetic parameters of ACE2-Ig in mice.

Article | Open Access | | Nature Communications

A programme of structure-assisted drug design and high-throughput screening identifies six compounds that inhibit the main protease of SARS-CoV-2, demonstrating the ability of this strategy to isolate drug leads with clinical potential.

Article | | Nature

A study of 246 individuals with seasonal respiratory virus infections randomized to wear or not wear a surgical face mask showed that masks can significantly reduce detection of coronavirus and influenza virus in exhaled breath and may help interrupt virus transmission.

Brief Communication | | Nature Medicine

The crystal structure of the receptor-binding domain of the SARS-CoV-2 spike in complex with human ACE2, compared with the receptor-binding domain of SARS-CoV, sheds light on the structural features that increase its binding affinity to ACE2.

Article | | Nature

This study describes the development of an approach to rapidly screen lineage B betacoronaviruses, such as SARS-CoV and the recently emerged SARS-CoV-2, for receptor usage and their ability to infect cell types from different species. Using it, they confirm human ACE2 as the receptor for SARs-CoV-2 and show that host protease processing during viral entry is a significant barrier for viral entry.

Article | | Nature Microbiology

News and Comment

The coronavirus disease 2019 (COVID-19) pandemic is affecting and changing the daily practice of gastrointestinal endoscopy worldwide. To protect patients and endoscopy unit personnel, endoscopy units have had to postpone a large proportion of endoscopic procedures. These delays might have an effect on the screening for and surveillance of digestive cancers.

Comment | | Nature Reviews Gastroenterology & Hepatology

The urgent need to address COVID-19 has highlighted the delicate relationships among science, politics and the media. To achieve a successful long-term response to the pandemic, stakeholders need to be guided by data, integrity and a sense of responsibility toward the public.

Editorial | | Nature Cancer

In response to the COVID-19 pandemic, the need to safely provide patient care meant that many health-care providers rapidly implemented and integrated telehealth into their practice. However, telehealth will continue to be an integral part of urology after the pandemic and our field should embrace telehealth and develop strategies to overcome associated challenges.

Comment | | Nature Reviews Urology

The COVID-19 pandemic has resulted in immediate effects on urological practice, in particular the vast reduction in elective surgeries. These changes are likely to have long-term effects for both patients and for urologists, which will persist even after the pandemic resolves. The many facets of COVID-19’s effects on urology remain to be seen, but they might also offer opportunities to reassess and improve patient management in urology and beyond.

Comment | | Nature Reviews Urology

The coronavirus disease 19 (COVID-19) pandemic has become the focus of attention worldwide, and herein we seek to highlight the potential problem of ‘collateral mortality’ from delayed or deferred treatments in patients with cancer. We propose potential solutions to ensure continuity of care in the field of surgical oncology.

Comment | | Nature Reviews Clinical Oncology

A global effort is ongoing in the scientific community and in the maker movement, which focuses on creating devices and tinkering with them, to reverse-engineer commercial medical equipment and get it to healthcare workers. For these ‘low-tech’ solutions to have a real impact, it is important for them to coalesce around approved designs.

Comment | | Nature Reviews Materials

Energy plays a central role in responding to emergencies such as the COVID-19 pandemic, from ensuring adequate healthcare services to supporting households during lockdowns. Protecting the renewable energy industry and its contribution to providing sustainable energy access for all must be an urgent priority in the current crisis.

Comment | | Nature Energy

The COVID-19 pandemic and associated changes in social and economic conditions may affect the prevalence of energy insecurity. Essential relief must be provided to the growing number of households that are energy insecure and protect them from even more dire circumstances caused by utility disconnections and unpaid energy bills.

Comment | | Nature Energy

Nearly 100 years since it was first used in humans as a vaccine for tuberculosis, Bacillus Calmette–Guérin (BCG) has been suggested as a possible agent to prevent coronavirus disease 2019 (COVID-19). A number of studies are underway to investigate this possibility but — even if they prove effective — many questions will remain.

Comment | | Nature Reviews Urology

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, which invades a cell through binding to the ACE2 receptor and TMPRSS2 priming. Patients with severe disease predominantly present with pneumonia-related symptoms. However, evidence suggests that COVID-19 infection also has implications for the urogenital tract. Thus, urogenital organs should be considered when treating COVID-19.

Comment | | Nature Reviews Urology

Preliminary data suggest that people with obesity are at increased risk of severe COVID-19. However, as data on metabolic parameters (such as BMI and levels of glucose and insulin) in patients with COVID-19 are scarce, increased reporting is needed to improve our understanding of COVID-19 and the care of affected patients.

Comment | | Nature Reviews Endocrinology

Crowdsourcing efforts are currently underway to collect and analyze data from patients with cancer who are affected by the COVID-19 pandemic. These community-led initiatives will fill key knowledge gaps to tackle crucial clinical questions on the complexities of infection with the causative coronavirus SARS-Cov-2 in the large, heterogeneous group of vulnerable patients with cancer.

Comment | | Nature Cancer

Health-care services are rapidly transforming their organization and workforce in response to the coronavirus disease 2019 (COVID-19) pandemic. These changes, and a desire to mitigate infection risk, are having profound effects on other vital aspects of care, including the care of patients with cancer. Difficult decisions are being made regarding the prioritization of both active treatments and palliative care, despite limited evidence that cancer is an independent risk factor for infection and mortality.

Comment | | Nature Reviews Clinical Oncology

Over 180 clinical trials of proposed COVID-19 drugs are already recruiting patients, and another 150 are registered to start recruiting patients soon. But many of these trials are small and not designed to identify the best treatment strategies for the COVID-19 pandemic. For Chief Executive of the Research Council of Norway John-Arne Røttingen, a more collaborative approach is now needed. And as Chair of the Executive Group and the International Steering Committee of the WHO’s recently launched Solidarity trial, he hopes this mega-trial can provide a blueprint, he told Asher Mullard.

An Audience With | | Nature Reviews Drug Discovery

As the COVID-19 pandemic continues, mathematical epidemiologists share their views on what models reveal about how the disease has spread, the current state of play and what work still needs to be done.

Viewpoint | | Nature Reviews Physics

As the COVID-19 pandemic sweeps through the world, we must reassess the principles that guide our individual and collective responses and the way we operate in society. In the face of crisis, we must lead with science and humanity.

Editorial | | Nature Cancer

As the spread of SARS-CoV-2 has triggered worldwide closures of research labs and facilities, Kostas Kostarelos shares his views on what may be going wrong in the fight against COVID-19 and how the nanoscience community could and should contribute.

Thesis | | Nature Nanotechnology

The prevalence of direct kidney involvement in novel coronavirus disease (COVID-19) is low, but such involvement is a marker of multiple organ dysfunction and severe disease. Here, we explore potential pathways of kidney damage and discuss the rationale for extracorporeal support with various blood purification strategies in patients who are critically ill with COVID-19.

Comment | | Nature Reviews Nephrology

Patients on haemodialysis or peritoneal dialysis are likely to be at increased risk of novel coronavirus disease (COVID-19). Preventive strategies must be implemented to minimize the risk of disease transmission in dialysis facilities, including education of staff and patients, screening for COVID-19 and separation of infected or symptomatic and non-infected patients.

Comment | | Nature Reviews Nephrology

COVID-19 has started to reach Africa, a continent that has in recent decades faced the ongoing HIV/AIDS pandemic and the Ebola epidemic of 2014–2016. Dr Matshidiso Moeti, WHO Regional Director for Africa, talks to Nature Human Behaviour about the African response to COVID-19.

Q&A | | Nature Human Behaviour

Growth-at-any-cost economics has health costs, a reality the COVID-19 pandemic brings into sharp relief. Governments must manage the tension between economics and health, but they should not stray from their original mandate to protect people. Too much dependence on the private sector weakened pandemic response, argues Susan Erikson.

World View | | Nature Human Behaviour

The debate over whether autocracies or democracies are better at fighting epidemics is misguided. Under President Xi Jinping’s centralized command, his administration has both succeeded and failed at handling the COVID-19 crisis. While it effectively curbed infections within China after the virus had spread, it failed to stem the outbreak before it went global.

Comment | | Nature Human Behaviour

The human tendency to impose a single interpretation in ambiguous situations carries huge dangers in addressing COVID-19. We need to search actively for multiple interpretations, and governments need to choose policies that are robust if their preferred theory turns out to be wrong, argues Nick Chater.

World View | | Nature Human Behaviour

In the current absence of medical treatment and vaccination, the unfolding COVID-19 pandemic can only be brought under control by massive and rapid behaviour change. To achieve this we need to systematically monitor and understand how different individuals perceive risk and what prompts them to act upon it, argues Cornelia Betsch.

World View | | Nature Human Behaviour

The past decade has allowed the development of a multitude of digital tools. Now they can be used to remediate the COVID-19 outbreak.

Comment | | Nature Medicine

COVID-19 has affected vulnerable populations disproportionately across China and the world. Solid social and scientific evidence to tackle health inequity in the current COVID-19 pandemic is in urgent need.

Comment | | Nature Medicine

The coronavirus disease (COVID-19) worldwide outbreak has led to a dramatic challenge for all healthcare systems, including inflammatory bowel disease (IBD) centres. Here, we describe the fast changes and clinical issues that IBD specialists could face during this SARS-CoV-2 infection pandemic, highlighting the potential rearrangements of care and resetting of clinical priorities.

Comment | | Nature Reviews Gastroenterology & Hepatology

The world is currently in the grip of the COVID-19 pandemic. Rapid changes in medical priorities are being enforced across all health-care systems. Urologists have had to reduce or halt their clinical activity and assist on COVID-19 wards. The repercussions on urological patient outcomes for delayed treatments and diagnosis remain to be defined.

Comment | | Nature Reviews Urology

The outbreak of 2019-novel coronavirus disease (COVID-19) that is caused by SARS-CoV-2 has spread rapidly in China, and has developed to be a Public Health Emergency of International Concern. However, no specific antiviral treatments or vaccines are available yet. This work aims to share strategies and candidate antigens to develop safe and effective vaccines against SARS-CoV-2.

Comment | Open Access | | npj Vaccines

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells through ACE2 receptors, leading to coronavirus disease (COVID-19)-related pneumonia, while also causing acute myocardial injury and chronic damage to the cardiovascular system. Therefore, particular attention should be given to cardiovascular protection during treatment for COVID-19.

Comment | | Nature Reviews Cardiology

Mutation. The word naturally conjures fears of unexpected and freakish changes. Ill-informed discussions of mutations thrive during virus outbreaks, including the ongoing spread of SARS-CoV-2. In reality, mutations are a natural part of the virus life cycle and rarely impact outbreaks dramatically.

Comment | | Nature Microbiology

As the international community responds to an outbreak of coronavirus-induced pneumonia in Wuhan, China, early and open data sharing — which are vital for its control — depend on the trust that the data will not be used without proper attribution to those who generated it.

Editorial | | Nature Microbiology

Reviews and Perspectives

This Progress article from Merad and Martin examines our current understanding of the excessive inflammatory responses seen in patients with severe COVID-19. The authors focus on the emerging pathological roles of monocytes and macrophages and discuss the inflammatory pathways that are currently being targeted in the clinic.

Progress | | Nature Reviews Immunology

Recovery efforts in the wake of COVID-19 must invest in energy systems that will prove cleaner and more resilient in the face of future disasters.

Editorial | | Nature Energy

Here a group of leaders in the field define our current understanding of ‘trained immunity’, which refers to the memory-type responses that occur in the innate immune system. The authors discuss our current understanding of the key epigenetic and metabolic processes involved in trained immunity and consider its relevance in immune-mediated diseases and cancer.

Review Article | | Nature Reviews Immunology

In the short time since SARS-CoV-2 infections emerged in humans, much has been learned about the immunological processes that underlie the clinical manifestation of COVID-19. Here, the authors provide an overview of the pathophysiology of SARS-CoV-2 infection and discuss potential therapeutic approaches.

Review Article | | Nature Reviews Immunology

In this Perspective article, the authors recount the earliest stages of translational research into IL-6 biology and the subsequent development of therapeutic IL-6 pathway inhibitors for the treatment of autoimmune rheumatic diseases and potentially numerous other indications.

Perspective | | Nature Reviews Rheumatology

Clinical metagenomic next-generation sequencing (mNGS) is rapidly moving from bench to bedside. This Review discusses the clinical applications of mNGS, including infectious disease diagnostics, microbiome analyses, host response analyses and oncology applications. Moreover, the authors review the challenges that need to be overcome for mNGS to be successfully implemented in the clinical laboratory and propose solutions to maximize the benefits of clinical mNGS for patients.

Review Article | | Nature Reviews Genetics

Acute respiratory distress syndrome (ARDS) is the rapid onset of noncardiogenic pulmonary oedema, hypoxaemia and the need for mechanical ventilation in hospitalized patients. This Primer describes the risk factors for ARDS, the underlying pulmonary damage and repair in ARDS and the long-term consequences for survivors.

Primer | | Nature Reviews Disease Primers

This Review Article describes how recent advances in viral genome sequencing and phylogenetics have enabled key issues associated with outbreak epidemiology to be more accurately addressed, and highlights the requirements and challenges for generating, sharing and using such data when tackling a viral outbreak.

Review Article | | Nature Microbiology

Coronaviruses have a broad host range and distribution, and some highly pathogenic lineages have spilled over to humans and animals. Here, Cui, Li and Shi explore the viral factors that enabled the emergence of diseases such as severe acute respiratory syndrome and Middle East respiratory syndrome.

Review Article | | Nature Reviews Microbiology

The virulence of viruses is a major determinant of the health burden of viral infections in humans and other species. In this article, Geoghegan and Holmes discuss how largely disparate research fields — theoretical modelling of virulence evolution and experimental dissection of genetic virulence determinants in laboratory model systems — can be bridged by considering real genomic data of viral evolution in a phylogenetic context. They describe the underlying principles of virulence evolution and how they apply to real-world viral infections and outbreaks of global importance.

Review Article | | Nature Reviews Genetics

Ubiquitin-like protein ISG15 is an interferon-induced protein that has been implicated as a central player in the host antiviral response. In this Review, Perng and Lenschow provide new insights into how ISG15 restricts and shapes the host response to viral infection and the viral immune-evasion strategies that counteract ISG15.

Review Article | | Nature Reviews Microbiology

So-called super-antibodies are highly potent, broadly reactive antiviral antibodies that offer promise for the treatment of various chronic and emerging viruses. This Review describes how recent technological advances led to their isolation from rare, infected individuals and their development for the prevention and treatment of various viral infections.

Review Article | | Nature Reviews Immunology

Next-generation sequencing has the potential to support public health surveillance systems to improve the early detection of emerging infectious diseases. This Review delineates the role of genomics in rapid outbreak response and the challenges that need to be tackled for genomics-informed pathogen surveillance to become a global reality.

Review Article | | Nature Reviews Genetics

Deubiquitylating enzymes (DUBs) have been implicated in several human diseases, including cancer, neurodegenerative diseases, inflammatory and autoimmune disorders, as well as infectious diseases. Here, Jackson and colleagues discuss the pathological roles of DUBs, consider the challenges in the development of selective DUB inhibitors and highlight first-generation agents approaching clinical trials.

Review Article | | Nature Reviews Drug Discovery

Related research

Remdesivir (RDV) is a broad-spectrum antiviral drug with activity against MERS coronavirus, but in vivo efficacy has not been evaluated. Here, the authors show that RDV has superior anti-MERS activity in vitro and in vivo compared to combination therapy with lopinavir, ritonavir and interferon beta and reduces severe lung pathology.

Article | Open Access | | Nature Communications

Antibodies that target the N-terminal domain (NTD) of the MERS-CoV spike remain poorly characterized. Here, Zhou et al. report the structural and functional analysis of the NTD-targeting mAb 7D10 and show that it synergizes with antibodies targeting the receptor-binding domain against different MERS-CoV strains.

Article | Open Access | | Nature Communications

Dampened activation of the NLR family pyrin domain containing 3 (NLRP3) inflammasome in bat primary immune cells in response to infection with multiple zoonotic viruses is caused by decreased transcriptional priming, the presence of a unique splice variant and an altered leucine-rich repeat domain of bat NLRP3.

Article | | Nature Microbiology

Rachel Graham et al. show that coronaviruses with extensively rewired transcription regulatory networks are effective vaccine candidates against Severe Acute Respiratory Syndrome Coronavirus. The reversion of live-attenuated vaccine strains to virulence can be avoided with these vaccines.

Article | Open Access | | Communications Biology

Corticosteroid therapy is frequently used for chronic obstructive pulmonary disease (COPD) but its use is associated with increased risk of pneumonia. Here the authors show that corticosteroid use impairs innate and adaptive immunity to rhinovirus infection, which is restored by exogenous IFNβ.

Article | Open Access | | Nature Communications

Understanding global epidemics spread is crucial for preparedness and response. Here the authors introduce an analytical framework to study epidemic spread on air transport networks, and demonstrate its power to estimate key epidemic parameters by application to the recent influenza pandemic and Ebola outbreak.

Article | Open Access | | Nature Communications