COVID-19 Scientific and Public Health Policy Update – 06 October 2020

In addition to our Weekly Outbreak Brief on the spread of COVID-19 and the actions that Africa CDC is taking to help African Union Member States. Africa CDC shares a weekly brief detailing the latest developments in scientific knowledge and public health policy from around the world, as well as updates to the latest guidance from WHO and other public health agencies. Contents of this document are not intended to serve as recommendations from the Africa CDC; rather, it is a summary of the scientific information available in the public space to Member States. It is important to note that the outbreak is evolving rapidly and that the nature of this information will continue to change. We will provide regular updates to ensure Member States are informed of the most critical developments in these areas.

A. Executive summary

- Two preprint studies demonstrated that SARS-CoV2 D614G substitution enhances infectivity, replication fitness, and early transmission in hamsters. Findings indicate the
D614G variant exhibited significantly faster droplet transmission between hamsters
clinical evidence that the D614G mutation could enhance viral loads in the upper respiratory tract of COVID-19 patients and may increase transmission. (Pre-print, not
peer-reviewed)

- A retrospective, propensity score-matched case-control study reports oxygen requirements on day 14 worsened in 18% of convalescent plasma recipients versus 28% of matched controls hospitalised COVID-19 patients, although survival was improved in plasma recipients. In India, the PLACID trial reports that convalescent plasma was not associated with a reduction in mortality or progression to severe disease; it was associated with resolution of dyspnea and supplemental oxygen requirement and with early
elimination of SARS-CoV-2 RNA. (Pre-print, not peer-reviewed).

- Whereas, a retrospective study of severe or critically ill COVID-19 patients in Turkey treated with convalescent plasma (CP) along with the antiviral treatment reports the effectiveness of CP in COVID-19 patients and reduced the case fatality rate (CFR)

- A retrospective cohort study suggests that the incidence of active SARS-CoV-2 infections did not differ between patients receiving hydroxychloroquine and patients not receiving hydroxychloroquine. Hydroxychloroquine was not associated with a preventive effect against SARS-CoV-2 infection in a large group of patients with rheumatological conditions.

- Findings from a randomized clinical trial indicate no clinical benefit of hydroxychloroquine administered daily for 8 weeks as pre-exposure prophylaxis in hospital-based Healthcare

- Three studies report on the phylogenetic analysis of African SARS-CoV-2 genomes deposited in GISAID and NCBI database, findings suggest that distinct patterns of viral clades in the West African countries point at its emergence from Europe and China via Asia and Europe. Phylogenetic tree analyses demonstrated variability across the various regions/countries in Africa as there were different clades in the viral proteins. However, a substantial proportion of these mutations (90%) were similar to those described in all the other settings, including the Wuhan strain. There were, however, novel mutations in the genomes of the circulating strains of the virus in African countries. (Pre-print, not peer-
reviewed).