Collection
The 25 most downloadedNature Communicationsarticles* on COVID-19 published in 2021 illustrate the collaborative efforts of the international community to combat the ongoing pandemic. These papers highlight valuable research into the biology of coronavirus infection, its detection, treatment as well as into vaccine development and the epidemiology of the disease.
Browse all Top 25 subject area collectionshere.
*Data obtained from SN Insights (based on Digital Science's Dimensions) and normalised to account for articles published later in the year.
Research highlights
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Anti-spike antibody response to natural SARS-CoV-2 infection in the general population
Most people who are infected with SARS-CoV-2 seroconvert within a few weeks, but the determinants and duration of the antibody response are not known. Here, the authors characterise these features of the immune response using data from a large representative community sample of the UK population.
- Jia Wei
- Philippa C. Matthews
- the COVID-19 Infection Survey team
ArticleOpen Access Nature Communications
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Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials
Hydroxychloroquine and chloroquine have been investigated as a potential treatment for Covid-19 in several clinical trials. Here the authors report a meta-analysis of published and unpublished trials, and show that treatment with hydroxychloroquine for patients with Covid-19 was associated with increased mortality, and there was no benefit from chloroquine.
- Cathrine Axfors
- Andreas M. Schmitt
- Lars G. Hemkens
ArticleOpen Access Nature Communications
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Malignant cerebral infarction after ChAdOx1 nCov-19 vaccination: a catastrophic variant of vaccine-induced immune thrombotic thrombocytopenia
Vaccination is an effective strategy in suppressing COVID-19 pandemic, but rare adverse effects have been reported, including cerebral venous thrombosis. Here the authors report two cases of middle cerebral artery infarct within 9-10 days following ChAdOx1 nCov-19 vaccination that also manifest pulmonary and portal vein thrombosis.
- M. De Michele
- M. Iacobucci
- D. Toni
ArticleOpen Access Nature Communications
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Correlation of SARS-CoV-2-breakthrough infections to time-from-vaccine
The duration of effectiveness of SARS-CoV-2 vaccination is not yet known. Here, the authors present preliminary evidence of BNT162b2 vaccine waning across all age groups above 16, with a higher incidence of infection in people who received their second dose early in 2021 compared to later in the year.
- Barak Mizrahi
- Roni Lotan
- Tal Patalon
ArticleOpen Access Nature Communications
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COVID-19 mRNA vaccine induced antibody responses against three SARS-CoV-2 variants
Emerging SARS-CoV-2 variants contain mutations in the spike protein that may affect vaccine efficacy. Here, Jalkanen et al. show, using sera from 180 BNT162b2-vaccinated health care workers, that neutralization of SARS-CoV2 variant B.1.1.7 is not affected, while neutralization of B.1.351 variant is five-fold reduced.
- Pinja Jalkanen
- Pekka Kolehmainen
- Ilkka Julkunen
ArticleOpen Access Nature Communications
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Exposure to SARS-CoV-2 generates T-cell memory in the absence of a detectable viral infection
T cells compose a critical component of the immune response to coronavirus infection with SARS-CoV-2. Here the authors characterise the T cell response to SARS CoV-2 in patients and their close contacts, and show the presence of SARS-CoV-2 specific T cells in the absence of detectable virus infection.
- Zhongfang Wang
- Xiaoyun Yang
- Pixin Ran
ArticleOpen Access Nature Communications
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Rapid decline of neutralizing antibodies against SARS-CoV-2 among infected healthcare workers
The humoral immune response to SARS-CoV-2 infection is not yet fully understood. Here, Marot et al. monitor the longitudinal profile and neutralizing activity of IgG, IgA, and IgM among 26 healthcare workers and provide evidence for a short-lasting humoral immune protection due to a decrease of neutralizing antibody titers within 3 months.
- Stéphane Marot
- Isabelle Malet
- Anne-Geneviève Marcelin
ArticleOpen Access Nature Communications
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Efficacy and tolerability of bevacizumab in patients with severe Covid-19
In this single-arm clinical trial, the authors show that treatment of COVID-19 patients with bevacizumab, an anti-vascular endothelial growth factor drug, can improve PaO2/FiO2 ratios and oxygen-support status. Relative to an external control group, bevacizumab shows clinical efficacy by improving oxygenation.
- Jiaojiao Pang
- Feng Xu
- Yihai Cao
ArticleOpen Access Nature Communications
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Evidence for SARS-CoV-2 related coronaviruses circulating in bats and pangolins in Southeast Asia
A bat origin for SARS-CoV-2 has been proposed. Here, by sampling wild Rhinolophus acuminatus bats from Thailand, the authors identified a SARS-CoV-2-related coronavirus (SC2r-CoV), designated as RacCS203, with 91.5% genome similarity to SARS-CoV-2, and show that sera obtained from bats and Malayan pangolin neutralize SARS-CoV-2.
- Supap*rn Wacharapluesadee
- Chee Wah Tan
- Lin-Fa Wang
ArticleOpen Access Nature Communications
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SARS-CoV-2 gene content and COVID-19 mutation impact by comparing 44 Sarbecovirus genomes
The SARS-CoV-2 gene set remains unresolved, hindering dissection of COVID-19 biology. Comparing 44 Sarbecovirus genomes provides a high-confidence protein-coding gene set. The study characterizes protein-level and nucleotide-level evolutionary constraints, and prioritizes functional mutations from the ongoing COVID-19 pandemic.
- Irwin Jungreis
- Rachel Sealfon
- Manolis Kellis
ArticleOpen Access Nature Communications
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Neutralizing antibody responses to SARS-CoV-2 in symptomatic COVID-19 is persistent and critical for survival
Antibody responses are critical for protection from developing severe COVID-19 following SARS-CoV-2 infection. Here the authors show that antibody responses against SARS-CoV-2 spike protein correlate with neutralizing capacity and protection, are not affected by heterologous boosting of influenza or common cold immunity, and can last up to 8 months.
- Stefania Dispinseri
- Massimiliano Secchi
- Gabriella Scarlatti
ArticleOpen Access Nature Communications
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New-onset IgG autoantibodies in hospitalized patients with COVID-19
Infection with SARS-CoV2 and the development of Coronavirus disease 2019 (COVID-19) has been linked to induction of autoimmunity and autoantibody production. Here the authors characterise the new-onset IgG autoantibody response in hospitalised patients with COVID-19 which they correlate to the magnitude of the SARS-CoV2 response.
- Sarah Esther Chang
- Allan Feng
- Paul J. Utz
ArticleOpen Access Nature Communications
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SARS-CoV-2 vaccine breakthrough infections with the alpha variant are asymptomatic or mildly symptomatic among health care workers
Several COVID-19 vaccines have shown good efficacy in clinical trials. Here, the authors provide real world effectiveness data in a group of BNT162b2 vaccinated health care workers and find that breakthrough infections are asymptomatic or mild.
- Francesca Rovida
- Irene Cassaniti
- Fausto Baldanti
ArticleOpen Access Nature Communications
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Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19)
Duration of infectious SARS-CoV-2 shedding is an important measure for improved disease control. Here, the authors use virus cultures of respiratory tract samples from COVID-19 patients and observe a median shedding duration of 8 days and a drop below 5% after 15,2 days post onset of symptoms.
- Jeroen J. A. van Kampen
- David A. M. C. van de Vijver
- Annemiek A. van der Eijk
ArticleOpen Access Nature Communications
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A novel SARS-CoV-2 related coronavirus in bats from Cambodia
In this study, Delaune et al., isolate and characterise a SARS-CoV-2-related coronavirus from two bats sampled in Cambodia. Their findings suggest that the geographic distribution of SARS-CoV-2-related viruses is wider than previously reported.
- Deborah Delaune
- Vibol Hul
- Veasna Duong
ArticleOpen Access Nature Communications
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Neutralizing antibody titres in SARS-CoV-2 infections
Here, the authors perform plaque reduction neutralization (PRNT) assays quantitating SARS-CoV-2 specific neutralizing antibodies from 195 patients in different disease states and find that patients with severe disease exhibit higher peaks of neutralizing antibody titres than patients with mild or asymptomatic infections and that serum neutralizing antibody persists for over 6 months in most people.
- Eric H. Y. Lau
- Owen T. Y. Tsang
- Malik Peiris
ArticleOpen Access Nature Communications
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SARS-CoV-2 antibody dynamics and transmission from community-wide serological testing in the Italian municipality of Vo’
Vo’, Italy, is a unique setting for studying SARS-CoV-2 antibody dynamics because mass testing was conducted there early in the pandemic. Here, the authors perform two follow-up serological surveys and estimate seroprevalence, the extent of within-household transmission, and the impact of contact tracing.
- Ilaria Dorigatti
- Enrico Lavezzo
- Andrea Crisanti
ArticleOpen Access Nature Communications
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Discrete SARS-CoV-2 antibody titers track with functional humoral stability
The extent of antibody protection against SARS-CoV-2 remains unclear. Here, using a cohort of 120 seroconverted individuals, the authors longitudinally characterize neutralization, Fc-function, and SARS-CoV-2 specific T cell responses, which they show to be prominent only in those subjects that elicited receptor-binding domain (RBD)-specific antibody titers above a certain threshold, suggesting that development of T cell responses to be related to anti-RBD Ab production.
- Yannic C. Bartsch
- Stephanie Fischinger
- Galit Alter
ArticleOpen Access Nature Communications
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Mechanisms of SARS-CoV-2 neutralization by shark variable new antigen receptors elucidated through X-ray crystallography
Shark antibodies (Variable New Antigen Receptors, VNARs) are the smallest naturally occurring antibody fragments. Here, the authors screen a VNAR phage display library against the SARS-CoV2 receptor binding domain (RBD) and identify VNARs that neutralize the SARSCoV-2 virus and discuss their mechanisms of viral neutralization.
- Obinna C. Ubah
- Eric W. Lake
- Caroline J. Barelle
ArticleOpen Access Nature Communications
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Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand
New Zealand has been relatively successful in controlling COVID-19 due to implementation of strict non-pharmaceutical interventions. Here, the authors demonstrate a striking decline in reports of influenza and other non-influenza respiratory pathogens over winter months in which the interventions have been in place.
- Q. Sue Huang
- Tim Wood
- Richard J. Webby
ArticleOpen Access Nature Communications
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A potent SARS-CoV-2 neutralising nanobody shows therapeutic efficacy in the Syrian golden hamster model of COVID-19
Neutralizing nanobodies (Nb) are of considerable interest as therapeutic agents for COVID-19 treatment. Here, the authors functionally and structurally characterize Nbs that bind with high affinity to the receptor binding domain of the SARS-CoV-2 spike protein and show that an engineered hom*otrimeric Nb prevents disease progression in a Syrian hamster model of COVID-19 when administered intranasally.
- Jiandong Huo
- Halina Mikolajek
- Raymond J. Owens
ArticleOpen Access Nature Communications
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Reprogrammed CRISPR-Cas13b suppresses SARS-CoV-2 replication and circumvents its mutational escape through mismatch tolerance
Cas13b can be harnessed to target and degrade RNA transcripts inside a cellular environment. Here the authors reprogram Cas13b to target SARSCoV-2 transcripts in infected mammalian cells and reveal its resilience to variants thanks to single mismatch tolerance.
- Mohamed Fareh
- Wei Zhao
- Joseph A. Trapani
ArticleOpen Access Nature Communications
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SARS-CoV-2-specific T cell memory is sustained in COVID-19 convalescent patients for 10 months with successful development of stem cell-like memory T cells
T cells are instrumental to protective immune responses against SARS-CoV-2, the pathogen responsible for the COVID-19 pandemic. Here the authors show that, in convalescent COVID-19 patients, memory T cell responses are detectable up to 317 days post-symptom onset, in which the presence of stem cell-like memory T cells further hints long-lasting immunity.
- Jae Hyung Jung
- Min-Seok Rha
- Eui-Cheol Shin
ArticleOpen Access Nature Communications
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Seven-month kinetics of SARS-CoV-2 antibodies and role of pre-existing antibodies to human coronaviruses
Long-term characterisation of SARS-CoV-2 antibody kinetics is needed to understand the protective role of the immune response. Here the authors describe antibody levels and neutralisation activity in healthcare workers over seven months and investigate the role of immunity to endemic human coronaviruses.
- Natalia Ortega
- Marta Ribes
- Carlota Dobaño
ArticleOpen Access Nature Communications
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Mechanism of SARS-CoV-2 polymerase stalling by remdesivir
Remdesivir is a nucleoside analog that inhibits the SARS-CoV-2 RNA dependent RNA polymerase (RdRp) and is used as a drug to treat COVID19 patients. Here, the authors provide insights into the mechanism of remdesivir-induced RdRp stalling by determining the cryo-EM structures of SARS-CoV-2 RdRp with bound RNA molecules that contain remdesivir at defined positions and observe that addition of the fourth nucleotide following remdesivir incorporation into the RNA product is impaired by a barrier to further RNA translocation.
- Goran Kokic
- Hauke S. Hillen
- Patrick Cramer
ArticleOpen Access Nature Communications