title: Saliva sampling is an excellent option to increase the number of SARS CoV2 diagnostic tests in settings with supply shortages

text: As part of any plan to lift or ease the confinement restrictions that are in place in many different countries, there is an urgent need to increase the capacity of laboratory testing for SARS CoV-2. Detection of the viral genome through RT-qPCR is the golden standard for this test, however, the high demand of the materials and reagents needed to sample individuals, purify the viral RNA, and perform the RT-qPCR test has resulted in a worldwide shortage of several of these supplies. Here, we show that directly lysed saliva samples can serve as a suitable source for viral RNA detection that is cheaper and can be as efficient as the classical protocol that involves column purification of the viral RNA. In addition, it surpasses the need for swab sampling, decreases the risk of the healthcare personnel involved in this process, and accelerates the diagnostic procedure.


title: Classroom Study of Online Education Experiment in China under Epidemic Control Situation

text: In year 2020, in response to unexpected Coronavirus, the Chinese Ministry of Education put forward the requirements of ＂classes suspended but teaching won't stop, classes suspended but learning won't stop＂ The ＂Learning Revolution＂ in education has been furtherpromoted With the strong support and cooperation of the government, radio and television stations, network companies and parents, 200 million students in China achieved home-based classes


title: Detecting SARS-CoV-2 at point of care: Preliminary data comparing Loop-mediated isothermal amplification (LAMP) to PCR

text: Background: The need for a fast and reliable test for COVID-19 is paramount in managing the current pandemic. A cost effective and efficient diagnostic tool as near to the point of care (PoC) as possible would be a game changer in current testing. We tested reverse transcription loop mediated isothermal amplification (RT-LAMP), a method which can produce results in under 30 minutes, alongside standard methods in a real-life clinical setting. Methods: This service improvement project piloted a research RT-LAMP method on nasal and pharyngeal swabs on 21 residents in an NHS Category 1 care home, with two index COVID-19 cases, and compared it to multiplex tandem reverse transcription polymerase chain reaction (RT-PCR). We calculated the sensitivity, specificity, positive and negative predictive values of a single RT-LAMP swab compared to RT-PCR, as per STARD guidelines. We also recorded vital signs of patients to correlate clinical and laboratory information. Findings: The novel method accurately detected 8/10 PCR positive cases and identified a further 3 positive cases. Eight further cases were negative using both methods. Using repeated RT-PCR as a 'gold standard', the sensitivity and specificity of the novel test were 80% and 73% respectively. Positive predictive value (PPV) was 73% and negative predictive value (NPV) was 83%. We also observed hypothermia to be a significant early clinical sign in a number of COVID-19 patients in this setting. Interpretation: RT-LAMP testing for SARS-CoV-2 was found to be promising, fast, easy to use and to work equivalently to RT-PCR methods. Definitive studies to evaluate this method in larger cohorts are underway. RT-LAMP has the potential to transform COVID-19 detection, bringing rapid and accurate testing to the point of care. This method could be deployed in mobile testing units in the community, care homes and hospitals to detect disease early and prevent spread.


title: SARS-CoV-2 SEROPREVALENCE AMONG ALL WORKERS IN A TEACHING HOSPITAL IN SPAIN: UNMASKING THE RISK.

text: Background: Health-care workers (HCW) are at increased risk for SARS-CoV-2 infection, but few studies have evaluated prevalence of antibodies against SARS-CoV-2 among them. Objective: To determine the seroprevalence against SARS-CoV-2 in all HCW. Methods. Cross-sectional study (April 14th- 27th , 2020) of all HCW at Hospital Universitario Fundacion Alcorcon, a second level teaching hospital in Madrid, Spain. SARS-CoV-2 IgG was measured by ELISA. HCW were classified by professional category, working area, and risk for SARS-CoV-2 exposure. Results: Among 2919 HCW, 2590 (90.5%) were evaluated. Mean age was 43.8 years (SD 11.1) and 73.9% were females. Globally, 818 (31.6%) workers were IgG positive, with no differences for age, sex or previous diseases. Among them, 48.5% did not report previous symptoms. Seropositivity was more frequent in high (33.1%) and medium (33.8%) than in low-risk areas (25.8%, p=0.007), but no difference was found for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p=NS). HCW with a previous SARS-CoV2 PCR positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis, seropositivity was associated with being physicians (OR 2.37, CI95% 1.61-3.49), nurses (OR 1.67, CI95% 1.14-2.46), or nurse- assistants (OR 1.84, CI95% 1.24-2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22-2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30-2.73), and at the Emergency Room (OR 1.51, CI95% 1.01-2.27) Conclusions: Seroprevalence uncovered a high rate of infection previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic HCW may be a relevant source for nosocomial SARS-CoV-2 transmission.


Rapid Mobilization of a Virtual Pediatric Chronic Pain Clinic in Canada During the COVID-19 Pandemic


title: Clinical characteristics and factors associated with admission to intensive care units inhospitalized COVID-19 patients in Lyon University Hospitals, France

text: Introduction: A new respiratory virus, SARS-CoV-2, has emerged and spread worldwide since late 2019. This study aims at analyzing clinical presentation on admission and the determinants associated with direct admission or transfer to intensive care units (ICUs) in hospitalized COVID-19 patients. Patients and Methods: In this prospective hospital-based study, socio-demographic, clinical and biological characteristics, on admission, of adult COVID-19 hospitalized patients were prospectively collected and analyzed. The outcome was admission/transfer to intensive care units compared with total hospital stay in medical wards according to patient characteristics. Results: Of the 412 patients included, 325 were discharged and 87 died in hospital. Multivariable regression showed increasing odds of admission/transfer to ICUs with male gender (OR, 1.99 [95%CI, 1.07-3.73]), temperature (OR, 1.37 [95% CI, 1.01-1.88] per degree Celsius increase), abnormal lung auscultation on admission (OR, 2.62 [95% CI, 1.40-4.90]), elevated level of CRP (OR, 6.96 [95% CI, 1.45-33.35 for CRP>100mg/L vs CRP<10mg/L). Increased time was observed between symptom onset and hospital admission (OR, 4.82 [95% CI, 1.61-14.43] for time >10 days vs time <3 days) and monocytopenia (OR, 2.49 [95% CI, 1.29-4.82]). Monocytosis was associated with lower risk of admission/transfer to ICUs (OR, 0.25 [95% CI, 0.05-1.13]). Conclusions: Clinical and biological features on admission and time until admission were associated with admission to ICUs. Signs to predict worsening on admission could be partially associated with the time until admission. This finding reinforces the need for appropriate guidelines to manage COVID-19 patients in this time window.


title: Clinical Characteristics and Outcomes of Venous Thromboembolism in Patients Hospitalized for COVID-19: Systematic Review and Meta-Analysis

text: Objective: To investigate the clinical characteristics and outcomes of Coronavirus Disease of 2019 (COVID-19) patients complicated with venous thromboembolism (VTE) Method: We performed a comprehensive literature search of several databases to find studies that assessed VTE in hospitalized COVID-19 patients with a primary outcome of all-cause mortality and secondary outcomes of intensive care unit (ICU) admission and mechanical ventilation. We also evaluated the clinical characteristics of VTE sufferers. Results: Eight studies have been included with a total of 1237 pooled subjects. Venous thromboembolism was associated with higher mortality (2.48 (1.35, 4.55), p=0.003; I2 5%, p=0.35) after we performed sensitivity analysis, ICU admission (RR 2.32 (1.53, 3.52), p<0.0001; 80%, p <0.0001), and mechanical ventilation need (RR 2.73 (1.56, 4.78), p=0.0004; 77%, p=0.001). Furthermore, it was also associated to male gender (RR 1.21 (1.08, 1.35), p=0.0007; I2 12%, p=0.34), higher white blood cells count (MD 1.24 (0.08, 2.41), 0.04; I2 0%; 0.26), D-dimer (MD 4.49 (2.74, 6.25), p<0.00001; I2 67%, p=0.009) and LDH levels (MD 70.93 (19.33, 122.54), p<0.007; I2 21%, p=0.28). In addition, after sensitivity analysis was conducted, VTE also associated with older age (MD 2.79 (0.06, 5.53), p=0.05; I2 25%, p=0.24) and higher CRP levels (MD 2.57 (0.88, 4.26); p=0.003; I2 0%, p=0.96). Conclusion: Venous thromboembolism in COVID-19 patients was associated with increased mortality, ICU admission, and mechanical ventilation requirement. Male gender, older age, higher levels of biomarkers, including WBC count, D-Dimer, and LDH were also being considerably risks for developing VTE in COVID-19 patients during hospitalization.


title: How and when to end the COVID-19 lockdown: an optimisation approach

text: Countries around the world are in a state of lockdown to help limit the spread of SARS-CoV-2. However, as the number of new daily confirmed cases begins to decrease, governments must decide how to release their populations from quarantine as efficiently as possible without overwhelming their health services. We applied an optimal control framework to an adapted Susceptible-Exposure-Infection-Recovery (SEIR) model framework to investigate the efficacy of two potential lockdown release strategies, focusing on the UK population as a test case. To limit recurrent spread, we find that ending quarantine for the entire population simultaneously is a high-risk strategy, and that a gradual re-integration approach would be more reliable. Furthermore, to increase the number of people that can be first released, lockdown should not be ended until the number of new daily confirmed cases reaches a sufficiently low threshold. We model a gradual release strategy by allowing different fractions of those in lockdown to re-enter the working non-quarantined population. Mathematical optimisation methods, combined with our adapted SEIR model, determine how to maximise those working while preventing the health service from being overwhelmed. The optimal strategy is broadly found to be to release approximately half the population two-to-four weeks from the end of an initial infection peak, then wait another three-to-four months to allow for a second peak before releasing everyone else. We also modelled an ''on-off'' strategy, of releasing everyone, but re-establishing lockdown if infections become too high. We conclude that the worst-case scenario of a gradual release is more manageable than the worst-case scenario of an on-off strategy, and caution against lockdown-release strategies based on a threshold-dependent on-off mechanism. The two quantities most critical in determining the optimal solution are transmission rate and the recovery rate, where the latter is defined as the fraction of infected people in any given day that then become classed as recovered. We suggest that the accurate identification of these values is of particular importance to the ongoing monitoring of the pandemic.


title: Relative COVID-19 viral persistence and antibody kinetics

text: Importance: The COVID-19 antibody response is a critical indicator for evaluating immunity and also serves as the knowledge base for vaccine development. The picture is still not clear because of many limitations including testing tools, time of sampling, and the unclear impact of varying clinical status. In addition to these problems, antibody levels may not be equivalent to protective capacity. Objective: To define the key factor for the different patterns of COVID-19 antibody response. Design: We elucidated the antibody response with time-series throat and serum samples for viral loads and antibody levels, then used a neutralization test to evaluate protectiveness. Setting: A medical center that typically cares for patients with moderate to severe diseases. Because of the low prevalence of COVID-19 in Taiwan and local government policy, however, we also admit COVID-19 patients with mild disease or even those without symptoms for inpatient care. Participants: RT-PCR-confirmed COVID-19 patients. Results: We found that only patients with relative persistence of virus at pharynx displayed strong antibody responses that were proportional to the pharyngeal viral load. They also had proportional neutralization titers per unit of serum. Although antibody levels decreased around 2 weeks after symptom onset, the neutralization efficacy per unit antibody remained steady and even continued to increase over time. The antibody response in patients with rapid virus clearance was weak, but the neutralization efficacy per unit antibody in these patients was comparable to those with persistent presence of virus. The deceased were with higher viral load, higher level of antibody, and higher neutralization titers in the serum, but the neutralization capacity per unit antibody is relatively low. Conclusions and Relevance: Strong antibody response depends on the relative persistence of the virus, instead of the absolute virus amount. The antibody response is still weak if large amount of virus is cleared quickly. The neutralization efficacy per unit antibody is comparable between high and low antibody patterns. Strong antibody response contains more inefficient and maybe even harmful antibodies. Low antibody response is also equipped with a capable B cell pool of efficient antibodies, which may expand with next virus encounter and confer protection.


title: A compound Dirichlet-Multinomial model for provincial level Covid-19 predictions in South Africa

text: Accurate prediction of COVID-19 related indicators such as confirmed cases, deaths and recoveries play an important in understanding the spread and impact of the virus, as well as resource planning and allocation. In this study, we approach the prediction problem from a statistical perspective and predict confirmed cases and deaths on a provincial level. We propose the compound Dirichlet Multinomial distribution to estimate the proportion parameter of each province as mutually exclusive outcomes. Furthermore, we make an assumption of exponential growth of the total cummulative counts in order to predict future total counts. The outcomes of this approach is not only prediction. The variation of the proportion parameter is characterised by the Dirichlet distribution, which provides insight in the movement of the pandemic across provinces over time.


title: Physical interventions to interrupt or reduce the spread of respiratory viruses. Part 2 - Hand hygiene and other hygiene measures: systematic review and meta-analysis.

text: OBJECTIVE: To assess the effectiveness of hand hygiene, surface disinfecting, and other hygiene interventions in preventing or reducing the spread of illnesses from respiratory viruses. DESIGN: Update of a systematic review and meta-analysis focussing on randomised controlled trials (RCTs) and cluster-RCTs (c-RCTs) evidence only. DATA SOURCES: Eligible trials from the previous Cochrane review, search of the Cochrane Central Register of Controlled Trials, PubMed, Embase and CINAHL from 01 October 2010 to 01 April 2020, and forward and backward citation analysis of included studies. DATA SELECTION: RCTs and c-RCTs involving people of any age, testing the use of hand hygiene methods, surface disinfection or cleaning, and other miscellaneous barrier interventions. Face masks, eye protection, and person distancing are covered in Part 1 of our systematic review. Outcomes included acute respiratory illness (ARI), influenza-like illness (ILI) or laboratory-confirmed influenza (influenza) and/or related consequences (e.g. death, absenteeism from school or work). DATA EXTRACTION AND ANALYSIS: Six authors working in pairs independently assessed risk of bias using the Cochrane tool and extracted data. The generalised inverse variance method was used for pooling by using the random-effects model, and results reported with risk ratios (RR) and 95% confidence intervals (CIs). RESULTS: We identified 51 eligible trials. We included 25 randomised trials comparing hand hygiene interventions with a control; 15 of these could be included in meta-analyses. We pooled 8 trials for the outcome of ARI. Hand hygiene showed a 16% relative reduction in the number of participants with ARI (RR 0.84, 95% CI 0.82 to 0.86) in the intervention group. When we considered the more strictly defined outcomes of ILI and influenza, the RR for ILI was 0.98 (95% CI 0.85 to 1.14), and for influenza the RR was 0.91 (95% CI 0.61 to 1.34). Three trials measured absenteeism. We found a 36% relative reduction in absentee numbers in the hand hygiene group (RR 0.64, 95% CI 0.58 to 0.71). Comparison of different hand hygiene interventions did not favour one intervention type over another. We found no incremental effects of combining hand hygiene with using face masks or disinfecting surfaces or objects. CONCLUSIONS: Despite the lack of evidence for the impact of hand hygiene in reducing ILI and influenza, the modest evidence for reducing the burden of ARIs, and related absenteeism, justifies reinforcing the standard recommendation for hand hygiene measures to reduce the spread of respiratory viruses. Funding for relevant trials with an emphasis on adherence and compliance with such a measure is crucial to inform policy and global pandemic preparedness with confidence and precision.


title: Experience of quantitative SARS-CoV-2 antibody screening of health-care workers in the southern part of Kyoto city during COVID-19 peri-pandemic period

text: Background: Pandemic of coronavirus disease-2019 (COVID-19) puts a heavy burden not only on patients physical and mental health but also on regional health care resource and economic activity across the world. Although we accumulate incidence rate and case fatality rate by the multidisciplinary approach, epidemiological data of prevalence of serum severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) antibody in health-care workers during COVID-19 peri-pandemic period is insufficient. Methods: We prospectively recruited health-care workers from our hospital between April 10 and April 20, 2020. We collected serum samples from these participants and evaluated quantitative SARS-CoV-2 IgG antibody by enzyme-linked immunosorbent assay. Results: Five (5.4%), 15 (16.3%) and 72 (78.3%) participants showed positive, borderline and negative results of the serum SARS-CoV-2 IgG antibody, respectively. We found mean titer of the antibody levels of all, positive group, borderline group and negative group were clearly distinguished. Participants belonging to otolaryngology ward and/or having a history of seasonal common cold symptoms had significantly higher titer of SARS-CoV-2 IgG antibody (p=0.046, p=0.046, respectively). Conclusions: Five (5.4%) and 15 (16.3%) participants showed positive and borderline SARS-CoV-2 IgG antibody during COVID-19 peri-pandemic period. These rates were much higher than the rates expected from situation reports of the government. Higher rates of positive and borderline antibody suggested that COVID-19 had already spread at early stage of pandemic in the southern part of Kyoto city.


title: VIRAL MUTATIONS AS A POSSIBLE MECHANISM OF HIDDEN IMMUNIZATION AND CONTAINMENT OF A PANDEMIA

text: An impact of viral mutations on the extent of an epidemic is examined. A mechanism of immunization of the population via spread of weakly mutated strain as a natural factor terminating the epidemic is indicated. An epidemic model which details this mechanism is proposed.


title: Covid-19: The need of non-traditional techniques to screen for the virus

text: BACKGROUND: At the present moment, the etiological diagnosis of SARS-CoV-2 is based on the polymerase chain reaction (PCR). False negative cases are increasingly reported in several studies using reverse transcription-PCR (RT-PCR). For example, the positive rate of RT-PCR for throat swabs was reported to be about 60% in early stage of COVID-19. AIM: We aimed to present metagenomic next-generation sequencing (mNGS) as a potential tool to detect pathogens. METHODS: In the recent year, mNGS is shown the potential to detect pathogens without the need of hypothesis guided approach and is proven to be highly effective. RESULTS: A recent prospective study in the United States compared the diagnostic performance of routine diagnostic tests with mNGS and showed that mNGS detected a bacteria or virus in the CSF of 13 of 58 patients presenting with meningoencephalitis who were negative for or not assessed with routine diagnostic test including PCR. NGS also has the advantage to cover entire viral genomes. CONCLUSION: As viral metagenomics has significantly improved in recent years and become more cost effective, we think that a change in the approach toward a shot-gun metagenomic testing should be explored and could potentially aid the diagnosis of COVID-19 cases and the management of this pandemic.


title: Prediction of the time evolution of the Covid-19 Pandemic in Italy by a Gauss Error Function and Monte Carlo simulations

text: In this paper are presented predictions on the evolution in time of the number of positive cases in Italy of the Covid-19 pandemic based on official data and on the use of a function of the type of a Gauss Error Function as a Cumulative Distribution Function (CDF). We have analyzed the available data for China and Italy. The evolution in time of the number of cumulative diagnosed positive cases of Covid-19 in China very well approximates a distribution of the type of the Error Function, that is, the integral of a normal, Gaussian distribution. We have then used such a function to study the potential evolution in time of the number of positive cases in Italy by performing a number of fits of the official data so far available. We then found a statistical prediction for the day in which the peak of the number of daily positive cases in Italy occurs, corresponding to the flex of the fit, i.e., to the change in sign of its second derivative (that is the change from acceleration to deceleration) as well as of the day in which a substantial attenuation of such number of daily cases is reached. We have then performed 150 Monte Carlo simulations in the attempt to have a more robust prediction of the day of the above-mentioned peak and of the day of the substantial decrease of the number of daily positive cases. Although, official data have been used, these predictions are obtained with a heuristic approach, since those predictions are based on statistical approach and do not take into account either a number of relevant issues (such as medical, social distancing, virologic, epidemiological, etc.) or models of contamination diffusion.


title: How Nutrition can help to fight against COVID-19 Pandemic

text: Currently Covid-19 pandemic is a leading challenge across the globe. It is mandatory to attain and maintain good nutritional status to fight against virus. Nutritional status of individual is affected by several factors such as age, sex, health status, life style and medications. Nutritional status of individuals has been used as resilience towards destabilization during this COVID-19 pandemic. Optimal nutrition and dietary nutrient intake impact the immune system, therefore the only sustainable way to survive in current context is to strengthen the immune system. There is no evidence found that supplement can cure the immune system except Vit C, which is one of the best way to improve immune system. A proper diet can ensure that the body is in proper state to defeat the virus. However along with the dietary management guidelines the food safety management and good food practices is compulsory. This article explores the importance of nutrition to boost immunity and gives some professional and authentic dietary guidelines about nutrition and food safety to withstand COVID-19.


title: A Review on coronavirus family persistency and considerations of novel type, covid-19 features

text: The arrival of new types of viral diseases, namely coronavirus family, have posed a serious threat for global health A new kind of coronavirus (CoV) named intense respiratory syndrome CoV-2 (SARS-CoV-2 or COVID-19) firstly diagnosed in Huanan Seafood Wholesale, Wuhan City, China The COVID-19 origination is likely to be from an animal host like bat and followed by person-person transmission unless the other routes possibility should be taken into account The COVID-19 has been spread so fast all over the world, with more than 1,569,504 infected cases and 95,269 mortality as of April, 11th 2020, regardless of potent control and quarantine policy in more countries Moreover, the SARS-CoV2 known as a novel coronavirus as it's initial genomic was less likely to be matched with the former CoV types The human-human transmission range reported to be 2-14 days and its spread expansions would be comforted by surfaces, infected hands and droplets This review focused on the persistency of different coronaviruses, like avain H7H9, SARS-CoV, MERS-CoV, Ebola virus and COVID-19, on varied surfaces as well as considering of COVID-19 features such as transmission, preventable policies, symptoms and suggested treatment ways to combat COVID-19


title: A brief transdiagnostic pandemic mental health maintenance intervention

text: The COVID-19 pandemic qualifies as a major national and global disaster. Behavioral health providers are poised to provide psychological crisis interventions to reduce the psychosocial effects. This paper presents a brief transdiagnostic mental health maintenance intervention tailored to treat adults and families with distress symptoms. The intervention components include evidence-based techniques which have been strategically selected to address distress related to the pandemic and to prevent the escalation of distress. The intervention aims to be flexibly incorporated into care based on the provider and needs of the presenting individuals. The intervention incorporates components of evidence-based treatments such as Cognitive Behavioral Therapy and associated “third wave” therapies (e.g. Dialectical Behavioral Therapy and Acceptance and Commitment Therapy). The intervention can be delivered via telehealth and includes the following modules: 1) Agenda Setting & Avoidance Identification; 2) Responding to Difficult News/Normalizing Reactions; 3) Perspective Taking; 4) Situational Control/Acceptance; 5) Maintaining a Healthy Routine; 6) Coping with Stress; 7) Insomnia Preventions; and 8) Building Resiliency & Hope. The intervention includes a list of home based pleasurable activities, a list of technology modalities to maintain social interactions, and a handout for patients. Research is needed to further test this intervention and assess implementation strategies.


title: On the estimation of the total number of SARS-CoV-2 infections

text: We introduce a simple methodology to estimate the total number of infected with SARS-CoV-2 based on the number of deaths in households with at least one confirmed case of COVID-19. If we are willing to assume that a single member of a household with $n$ members will infect the remaining members with probability 1, then the number of deaths in a household follows a binomial distribution with parameters $(n-1,p)$ where $p$ is the CFR. Although the method may be affected by classification errors, its simplicity will allow to reduce the error of the estimates by increasing the sample size, since it requires minimal laboratory testing capabilities. We illustrate our methodology with data from Mexico and estimate the CFR in 0.34 \%, that is, we estimate that the total number of infections is about $300$ times larger than the number of deaths. We specify some dataset limitations. In comparison, using the number of deaths to date and a recently published results from random tests in Iceland, we calculated the ratio estimated infections/deaths in about $200$ for that country.


title: COVID-19 cases are less prevalent in countries where malaria is endemic, suggesting a role for anti-malarial drugs as prophylaxis

text: Almost every country across the world has felt the repercussions of the pandemic of disease termed coronavirus disease 2019 (COVID-19) caused by the novel coronavirus identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A recently published article points to a method of prevention and prophylaxis of COVID-19 through the use of anti-malarial drugs such as the 4-aminoquinolones: chloroquine and hydroxychloroquine, based on their mechanisms of action against SARS-CoV-2. This report aims to explore the correlation between COVID-19 cases and countries where malaria is prevalent using statistical means. It is hypothesized that countries where malaria is endemic will have few cases of COVID-19 since these countries use the 4-aminoquinolone antimalarial drugs for prophylaxis. Statistical analysis demonstrates that the numbers and incidence of COVID-19 cases and COVID-19 related deaths are substantially lower (multiple-fold lower) in countries with the highest prevalence of malaria. The difference between both the COVID-19 incidence rate and the COVID-19 mortality rate in malaria prevalent countries compared to COVID-19 prevalent countries is statistically significant (p = 0.02 and p = 0.04 respectively). This study provides further evidence that anti-malaria drugs may prove essential to breaking the spread of SARS-CoV-2 and preventing COVID-19 and COVID-19 related mortality. As the pandemic continues to evolve and doctors and researchers across the globe try to attenuate or stop the spread of SARS-CoV-2, the medical community should not overlook the potential role of the 4-aminoquinolones anti-malarial drugs, chloroquine and hydroxychloroquine, and 8-aminoquinolone anti-malaria drugs, tafenoquine and primaquine, as a prophylaxis.


title: Covid-19 nephropathy; probable mechanisms of kidney failure

text: The mechanistic understanding of signaling pathways that contributes to the kidney involvement by coronavirus disease 2019 (COVID-19) is an extremely critical point for improving therapeutic options. These pathways consist of the production of pro-inflammatory factors, the infiltration of pro-inflammatory cells into the renal interstitium, the activation of C5b-9 complexes, and receptorangiotensin converting enzyme 2 (ACE2). Cytopathogenic effects and invasion into renal tubular cells have been confirmed.


title: Physician Suicide: A Scoping Review to Highlight Opportunities for Prevention

text: Objective: The aim of this scoping review is to map the current landscape of published research and perspectives on physician suicide. Findings could serve as a roadmap for further investigations and potentially inform efforts to prevent physician suicide. Methods: Ovid MEDLINE, PsycInfo, and Scopus were searched for English-language publications from August 21, 2017 through April 28, 2018. Inclusion criteria were a primary outcome or thesis focused on suicide (including suicide completion, attempts, and thoughts or ideation) among medical students, postgraduate trainees, or attending physicians. Opinion articles were included. Studies that were non-English, or those that only mentioned physician burnout, mental health or substance use disorders were excluded. Data extraction was performed by two authors. Results: The search yielded 1,596 articles, of which 347 articles passed to the full-text review round. The oldest article was an editorial from 1903; 210 (60.3%) articles were published from 2000 to present. Authors originated from 37 countries and 143 (41.2%) were opinion articles. Most discussed were suicide risk factors and culture of practice issues, while least discussed themes included public health and postvention. Conclusions: Consistency and reliability of data and information about physician suicides could be improved. Data limitations partly contribute to these issues. Also, various suicide risk factors for physicians have been explored, and several remain poorly understood. Based on this scoping review, a public health approach, including surveillance and early warning systems, investigations of sentinel cases, and postvention may be impactful next steps in preventing physician deaths by suicide.


title: SARS-COV-2 and fabry nephropathy: Potential risks and the pathophysiological perspective

text: Fabry disease is an X-linked disorder due to mutations in alpha-galactosidase A gene. It affects the kidney in virtually all patients with classical and some late onset variants. Podocytes, endothelial cells, vascular smooth muscle, tubular and mesangial cells are involved in different ways. Proteinuria and chronic kidney disease are the result of the progressive accumulation of the enzyme substrates globotriaosylceramide (GB3) and lyso-GB3 in the cytoplasm of these cells (mainly in lysosomes), which leads to cellular and organ dysfunction and eventually renal failure and end-stage kidney disease. Specific enzyme replacement therapy and pharmacological chaperone are at present the main therapeutic approach. After enzyme infusion, the delivered enzyme is differentially uptaken by kidney cells in three different ways: By Mannose-6-phosphate receptor, megalin and sortilin. The delivered enzyme gradually clears cells from the accumulation of the glycosphingolipids and contributes to a cellular healthier status. The recent pandemic caused by SARS-CoV-2 has led to the collapse of health systems around the world and to thousands of deaths. Kidney involvement has been reported to range from proteinuria to acute kidney injury, 30% of which may require renal replacement therapy. In this review the potential causes for which Fabry patients should be at increased risk and the necessity not to discontinue therapy are discussed.


title: Oscillatory dynamics in infectivity and death rates of COVID-19

text: The analysis of systematically collected data for COVID-19 infectivity and death rates has revealed in many countries around the world a typical oscillatory pattern with a 7-days (circaseptan) period. Additionally, in some countries the 3.5-days (hemicircaseptan) and 14-days periodicities have been also observed. Interestingly, the 7-days infectivity and death rates oscillations are almost in phase, showing local maxima on Thursdays/Fridays and local minima on Sundays/Mondays. These observations are in stark contrast with a known pattern, correlating the death rate with the reduced medical staff in hospitals on the weekends. One possible hypothesis addressing these observations is that they reflect a gradually increasing stress with the progressing week, which can trigger the maximal death rates observed on Thursdays/Fridays. Moreover, assuming the weekends provide the likely time for new infections, the maximum number of new cases might fall again on Thursdays/Fridays. These observations deserve further study to provide better understanding of the COVID-19 dynamics.


title: Spread of COVID-19 in India: A Simple Algebraic Study

text: The number of patients, infected with COVID-19, began to increase very rapidly in India from March 2020. The country was put under lockdown from 25 March 2020. The present study is aimed at providing a simple algebraic analysis of the trend that is evident in the spread of the disease in this part of the world. The purpose of this algebraic approach is to simplify the calculation sufficiently by deviating from the standard techniques that are conventionally used to construct mathematical models of epidemics. The predictions, obtained from this algebraic study, are found to be in reasonable agreement with the recorded data. Using this mathematical formulation we have determined the time variation of the number of asymptomatic patients, who are believed to play a major role in spreading the disease. We have discussed the effect of lockdown in reducing the rate of transmission of the disease. On the basis of the proposed models, predictions have been made regarding the possible trend of the rise in the number of cases beyond the withdrawal of lockdown. All these things have been calculated by using very simple mathematical expressions which can be easily understood and used by those who have a rudimentary knowledge of algebra.


title: Information-rich wheat markets in the early days of COVID-19

text: This paper uses the information implicit in commodity futures and options prices to infer market beliefs about the impact of early-stages COVID-19 on commodity market fundamentals. The particular commodity examined is soft red winter (SRW) wheat, and the timeframe is early February to late March 2020. The analysis highlights various adjustments in the cash and futures price of SRW wheat in light of surging short-run demand from consumer hoarding of staple food products, and a weakening long-run market from growing wheat stocks and an emerging global recession. This split is causing the forward curve to flatten and basis levels to invert. The change over time in the price of options on wheat futures reveals increased price volatility in response to growing uncertainty about the COVID-19 impacts. Similarly, changes in the skewness of the option's volatility smile illustrate a shift in traders’ perception about risk in the right versus left tail of the price distribution.


title: Knowledge, Attitudes, Anxiety, and Coping Strategies of Students during COVID-19 Pandemic

text: COVID-19 is a global concern affecting Higher Education Institutions (HEIs). This pandemic led to a strong reaction among students who experiences anxiety. This cross-sectional study aimed to examine students’ knowledge, attitudes, anxiety, and coping strategies during the COVID-19 pandemic. Results showed that students possessed sufficient knowledge and high-risk perceptions. Non-medical prevention measures were perceived as highly effective. Students were satisfied with the government’s actions to mitigate problems. However, an unwillingness with the online-blended learning approach was observed. Students utilized various ways to cope up with mental health challenges. It is necessary to address students’ mental health during this COVID-19 pandemic among HEIs.


title: Indication for SARS-CoV-2 serology: first month follow-up

text: SARS-CoV-2 detection is mainly performed by RT-PCR but recently serological tests were made available. A first one month follow-up of the SARS-CoV-2 serology records was performed in our laboratory to precise the diversity and proportion of the SARS-CoV-2 serology test indications and to identify new valid indications (meningoencephalitis, vasculitis, etc)


title: Revealing COVID-19 Transmission by SARS-CoV-2 Genome Sequencing and Agent Based Modelling

text: Community transmission of the new coronavirus SARS-CoV-2 is a major public health concern that remains difficult to assess. We present a genomic survey of SARS-CoV-2 from a during the first 10 weeks of COVID-19 activity in New South Wales, Australia. Transmission events were monitored prospectively during the critical period of implementation of national control measures. SARS-CoV-2 genomes were sequenced from 209 patients diagnosed with COVID-19 infection between January and March 2020. Only a quarter of cases appeared to be locally acquired and genomic-based estimates of local transmission rates were concordant with predictions from a computational agent-based model. This convergent assessment indicates that genome sequencing provides key information to inform public health action and has improved our understanding of the COVID-19 evolution from outbreak to epidemic.


title: SARS-CoV-2 infection leads to acute infection with dynamic cellular and inflammatory flux in the lung that varies across nonhuman primate species

text: There are no known cures or vaccines for COVID-19, the defining pandemic of this era. Animal models are essential to fast track new interventions and nonhuman primate (NHP) models of other infectious diseases have proven extremely valuable. Here we compare SARS-CoV-2 infection in three species of experimentally infected NHPs (rhesus macaques, baboons, and marmosets). During the first 3 days, macaques developed clinical signatures of viral infection and systemic inflammation, coupled with early evidence of viral replication and mild-to-moderate interstitial and alveolar pneumonitis, as well as extra-pulmonary pathologies. Cone-beam CT scans showed evidence of moderate pneumonia, which progressed over 3 days. Longitudinal studies showed that while both young and old macaques developed early signs of COVID-19, both groups recovered within a two-week period. Recovery was characterized by low-levels of viral persistence in the lung, suggesting mechanisms by which individuals with compromised immune systems may be susceptible to prolonged and progressive COVID-19. The lung compartment contained a complex early inflammatory milieu with an influx of innate and adaptive immune cells, particularly interstitial macrophages, neutrophils and plasmacytoid dendritic cells, and a prominent Type I-interferon response. While macaques developed moderate disease, baboons exhibited prolonged shedding of virus and extensive pathology following infection; and marmosets demonstrated a milder form of infection. These results showcase in critical detail, the robust early cellular immune responses to SARS-CoV-2 infection, which are not sterilizing and likely impact development of antibody responses. Thus, various NHP genera recapitulate heterogeneous progression of COVID-19. Rhesus macaques and baboons develop different, quantifiable disease attributes making them immediately available essential models to test new vaccines and therapies.


Patient Counseling in Plastic Surgery during Coronavirus Disease 2019


title: Engineered niches support the development of human dendritic cells in humanized mice

text: Classical dendritic cells (cDCs) are rare sentinel cells specialized in the regulation of adaptive immunity. Modeling cDC development is both crucial to study cDCs and harness their potential in immunotherapy. Here we addressed whether cDCs could differentiate in response to trophic cues delivered by mesenchymal components of the hematopoietic niche where they physiologically develop and maintain. We found that expression of the membrane bound form of human FLT3L and SCF together with CXCL12 in a bone marrow mesenchymal stromal cell line is sufficient to induce the contact-dependent specification of both type 1 and type 2 cDCs from CD34+ hematopoietic stem and progenitor cells (HSPCs). Engraftment of these engineered mesenchymal stromal cells (eMSCs) together with CD34+ HSPCs creates an in vivo synthetic niche in the dermis of immunodeficient mice. Cell-to-cell contact between HSPCs and stromal cells within these organoids drive the local specification of cDCs and CD123+AXL+CD327+ pre/AS-DCs. cDCs generated in vivo display higher levels of resemblance with human blood cDCs unattained by in vitro generated subsets. Altogether, eMSCs provide a novel and unique platform recapitulating the full spectrum of cDC subsets enabling their functional characterization in vivo.


title: Deregulated cellular circuits driving immunoglobulins and complement consumption associate with the severity of COVID-19

text: Background: SARS-CoV-2 infection causes an abrupt response by the host immune system, which is largely responsible for the pathogenesis and outcome of COVID-19. We aimed to investigate which specific responses from either cellular or humoral immunity associate to severity and progression of COVID-19. Methods: A cohort of 276 patients classified in mild, moderate and severe, was studied. Peripheral blood lymphocyte subpopulations were quantified by flow cytometry, and immunoglobulins and complement proteins by nephelometry. Results: At admission, dramatic lymphopenia of T, B and NK cells associated to severity. However, only the proportion of B cells increased, while T and NK cells appeared unaffected. Accordingly, the number of plasma cells and circulating follicular helper T cells (cTfh) increased, but levels of IgM, IgA and IgG were unaffected. When degrees of severity were considered, IgG was lower in severe patients, suggesting an IgG consumption by complement activation or antibody-dependent cellular cytotoxicity (ADCC). Activated CD56-CD16+ NK-cells, which mediate ADCC, were increased. Regarding complement, C3 and C4 protein levels were higher in mild and moderate, but not in severe patients, compared to healthy donors. Moreover, IgG and C4 decreased from day 0 to day 10 in patients who were hospitalized for more than two weeks, but not in patients who were discharged earlier. Conclusion: Our study provides important clues to understand the immune response observed in COVID-19 patients, which is probably related to viral clearance, but also underlies its pathogenesis and severity. This study associates for the first time COVID-19 severity with an imbalanced humoral immune response characterized by excessive consumption of IgG and C4, identifying new targets for therapeutic intervention.


COVID-19 pandemic/ COVID-19-Pandämie


title: Impact of enhanced personal protective equipment on colonoscopy performance during the COVID-19 pandemic

text: Background and study aims Using personal protective equipment (PPE) can reduce risk of disease transmission. During the COVID-19 pandemic, enhanced PPE (EPPE) is recommended when performing endoscopy. We aimed to evaluate the impact of EPPE on colonoscopy performance when compared to standard PPE (SPPE). Patients and methods A review of electronic medical records and endoscopy reports of consecutive patients who underwent colonoscopy during two similar one-month time periods (in 2019 and during the COVID-19 pandemic in 2020) was performed. SPPE was used in 2019 and EPPE was used in 2020. Patient clinical data and procedure-related information were captured and analyzed. The primary outcomes were time to cecum (TTC) and total procedure time. Secondary outcomes were adenoma detection rate (ADR), polyp detection rate (PDR) and cecal intubation rate (CIR). Statistical analysis was performed using STATA v16.1. Results Two hundred and forty-seven colonoscopy procedures were analyzed. Baseline demographics and indications for colonoscopy of patients in both groups were similar. There were no significant differences in median TTC (10.0 vs 10.0 min, P = 0.524) or total procedure time (22.5 vs 23.0 min, P = 0.946) between colonoscopy performed in SPPE and EPPE. The ADR, PDR and CIR were also similar. Conclusion Our findings suggest that use of EPPE does not affect colonoscopy performance.


title: Flattening the COVID 19 curve in susceptible forest indigenous tribes using SIR model

text: COVID 19 is a global threat and globally spreading. The international cooperation involving indigenous peoples and local communities is urgently required in joint prevention to control the epidemic. Currently, many indigenous populations are continuing to face COVID 19. This study is concerned about the dynamic of COVID 19 pandemic among indigenous populations living in the remote Amazon rainforest enclaves. Using the Susceptible Infectious Recovered (SIR) model, the spread of the COVID 19 under 3 intervention scenarios (low, moderate, high) is simulated and predicted in indigenous tribe populations. The SIR model forecasts that without intervention, the epidemic peak may reach within 10 20 days. Nonetheless the peak can be reduced with strict interventions. Under low intervention, the COVID 19 cases are reduced to 73% and 56% of the total populations. While, in the scenario of high intervention, the COVID 19 peaks can be reduced to values ranging from 53% to 15% .To conclude, the simulated interventions tested by SIR model have reduced the pandemic peak and flattened the COVID 19 curve in indigenous populations. Nonetheless, it is mandatory to strengthen all mitigation efforts, reduce exposures, and decrease transmission rate as possible for COVID 19 containment.


Managing device‐aided treatments in Parkinson's disease in times of COVID‐19


title: Distribution of COVID-19 and phylogenetic tree construction of sars-CoV-2 in Indonesia

text: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has spread quickly across the world and has been declared a pandemic. Indonesia has many COVID-19 cases, with a high mortality rate. This study aimed to describe the distribution of COVID-19 in Indonesia and constructed the SARS-CoV-2 phylogenetic tree from Indonesian isolates and those from other countries, including other CoVs to determine their relationship. The distribution data of COVID-19 in Indonesia were obtained from the COVID-19 Management Handling Unit and descriptively analyzed. SARS-CoV-2 isolates were retrieved from the GenBank® (National Center of Biotechnology Information, USA) and GISAID EpiCoV™ databases and were used to construct phylogenetic trees using MEGA X software. Of the 37 provinces in Indonesia, five provinces with the highest case fatality rates were DKI Jakarta, Jawa Barat, Jawa Timur, and Banten, and the five provinces with the highest cure rate were Kepulauan Riau, Bali, Aceh, Gorontalo, and DI Yogyakarta. SARS-CoV-2 Indonesian isolates were closely related to SARS-CoV-2 isolates from other countries. The rapid and widespread distribution of SARS-CoV-2 in Indonesia was caused by the lack of compliance with territorial restrictions and dishonesty with medical personnel. These data revealed that mutations can occur during the transmission process, which can be caused by a history of travel and increased patient immunity.


title: A Simple Method of Finding an Approximate Pattern of the COVID-19 Spread

text: ABSTRACT We are going to show that the pattern of spread of COVID-19 outside China is not monotonic. We have considered the data outside China because we are going to study the data starting from March 21, and by that time the spread had almost come to a stop in China. We have used for our analysis data on total cases outside China till April 25, 2020, and data from April 26 to April 30 for comparison of forecasts and observed values. Right from the beginning the spread pattern was nonlinear, and by the end of the third week of March the nonlinearity became nearly exponential. The exponential pattern thereafter has changed by around March 28, April 5, April 11 and April 18. Since March 21, the spread is following a nearly exponential pattern of growth changing observably at almost regular intervals of seven days. It is but natural that at some point of time the countries that had been contributing in observably large numbers to the total cases would start to show diminishing growth patterns. Therefore long term forecasts using our method would give us slightly overestimated results. However, for short term forecasting our simple method does work very well when we consider the total number of cases in the world and not in any particular country.


title: Timeline from receipt to online publication of COVID-19 original research articles

text: Objective: To examine the timeline from submission of Coronavirus Disease 2019 (COVID)-related original articles compared with non-COVID-related original articles. Background: There have been growing concerns about the speed and rigor of the review process for COVID-related articles by journals. Methods: Using Dimensions, an online searchable platform, we identified PubMed-indexed journals that published >50 COVID-related articles (regardless of article type) between 1/1/2020 and 5/16/2020 and had available data on the date of article receipt. For the control group, we included consecutive full-length original investigations with available receipt date (regardless of topic) published in these journals starting from 3/1/2019 until a 1:2 ratio of COVID to non-COVID-related articles per journal was achieved. Results: The final number included 294 COVID-related full-length original investigations with available article receipt dates published in 16 journals with corresponding 588 control articles from the same journals. The median time from article receipt to online publication was 20 (11-32) days for COVID-articles vs. 119 (62-182) days for controls (P<0.001). The median time to final acceptance (available for 97% of the articles) was 13 (5-23) days for COVID vs. 102 (55-161) days for controls (P<0.001). These observations were seen across all the included journals in the analysis. Conclusions: In this analysis of full-length original investigations published in 16 medical journals, the median time from receipt to final acceptance of COVID-related articles was 8 times faster compared to non-COVID-related articles published in a similar time frame in the previous year. Online publication was 6 times faster for COVID-related articles compared to controls.


title: COVID-19 Induced Hepatitis B Virus Reactivation: A Novel Case From the United Arab Emirates

text: The novel coronavirus disease 2019 (COVID-19) clinically manifests as respiratory and gastrointestinal presentations, most commonly vomiting, diarrhea, and abdominal pain. Although the impaired liver function is prevalent in COVID-19, it is poorly understood. We report the first case of hepatitis B virus (HBV) reactivation caused by COVID-19 in a young adult with altered mental status and severe transaminitis. The patient was asymptomatic, hypothermic, his skin was jaundiced with the icteric sclera, with very high levels of aspartate aminotransferase (AST; 4,933 U/L), alanine aminotransferase (ALT; 4,758 U/L), and total bilirubin (183.9 mmol/L) levels. It is warranted that patients with abnormal liver functions tend to have an increased risk of COVID-19. Thus, increased attention should be paid to the care of patients with abnormal liver functions, and testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA is warranted in the COVID era.


title: Sensitive detection of SARS-CoV-2-specific-antibodies in dried blood spot samples

text: Abstract Importance: Population-wide serological testing is an essential component in understanding the COVID-19 pandemic. The logistical challenges of undertaking widespread serological testing could be eased through use of a reliable dried blood spot (DBS) sampling method. Objective: To validate the use of dried blood spot sampling for the detection of SARS-CoV-2-specific antibodies. Design, setting and participants: Eighty-seven matched DBS and serum samples were obtained from eighty individuals, including thirty-one who were previously PCR-positive for SARS-CoV-2. DBS eluates and sera were used in an ELISA to detect antibodies to the viral spike protein. Results: Specific anti-SARS-Cov-2 spike glycoprotein antibodies were detectable in both serum and DBS eluate and there was a significant correlation between the antibody levels detected in matched samples (r = 0.96, p<0.0001). Using serum as the gold standard in the assay, matched DBS samples achieved a Cohens kappa coefficient of 0.975 (near-perfect agreement), a sensitivity of 98.1% and specificity of 100%, for detecting anti-spike glycoprotein antibodies. Conclusions and relevance: Eluates from DBS samples are a reliable and reproducible source of antibodies to be used for the detection of SARS-CoV-2-specific antibodies. The use of DBS sampling could complement the use of venepuncture in the immunosurveillance of COVID-19 in both low and high income settings.


title: Host transcriptome-guided drug repurposing for COVID-19 treatment: a meta-analysis based approach

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been declared a pandemic by the World Health Organization, and the identification of effective therapeutic strategy is a need of the hour to combat SARS-CoV-2 infection. In this scenario, the drug repurposing approach is widely used for the rapid identification of potential drugs against SARS-CoV-2, considering viral and host factors. METHODS: We adopted a host transcriptome-based drug repurposing strategy utilizing the publicly available high throughput gene expression data on SARS-CoV-2 and other respiratory infection viruses. Based on the consistency in expression status of host factors in different cell types and previous evidence reported in the literature, pro-viral factors of SARS-CoV-2 identified and subject to drug repurposing analysis based on DrugBank and Connectivity Map (CMap) using the web tool, CLUE. RESULTS: The upregulated pro-viral factors such as TYMP, PTGS2, C1S, CFB, IFI44, XAF1, CXCL2, and CXCL3 were identified in early infection models of SARS-CoV-2. By further analysis of the drug-perturbed expression profiles in the connectivity map, 27 drugs that can reverse the expression of pro-viral factors were identified, and importantly, twelve of them reported to have anti-viral activity. The direct inhibition of the PTGS2 gene product can be considered as another therapeutic strategy for SARS-CoV-2 infection and could suggest six approved PTGS2 inhibitor drugs for the treatment of COVID-19. The computational study could propose candidate repurposable drugs against COVID-19, and further experimental studies are required for validation.


title: Clinical importance of reporting SARS-CoV-2 viral loads across the different stages of the COVID-19 pandemic

text: On April 25th, corresponding to the first deconfinement phase after the end of the lockdown in Switzerland, a universal admission screening strategy for COVID-19 was introduced in our hospital. All patients, including asymptomatic patients were tested for SARS-CoV-2 by quantitative reverse transcription polymerase chain reaction (RT-PCR). In addition to a qualitative answer, providing viral load values to the RT-PCR results not only helped the clinician to evaluate the stage of the infection but addressed patient contagiousness and guided infection control decisions. Here, we discuss the importance of reporting viral load values when a shift from a symptomatic to a universal screening strategy was performed.


Ambient nitrogen dioxide pollution and spread ability of COVID-19 in Chinese cities


Recommandations pour les équipes de santé au travail prenant en charge des établissements de santé où sont hospitalisés des patients Covid-19+, 23 mars 2020


How SARS-CoV-2 binds to human cells


title: Clinical and epidemiological characteristics of Coronavirus Disease 2019 (COVID-19) patients

text: Background: Numerous groups have reported the clinical and epidemiological characteristics of Coronavirus Disease 2019 (COVID-19) cases; however, the data remained inconsistent. This paper aimed to pool the available data to provide a more complete picture of the characteristics of COVID-19 patients. Methods: A systematic review and pooled analysis was performed. Eligible studies were identified from database and hand searches up to March 2, 2020. Data on clinical (including laboratory and radiological) and epidemiological (including demographic) characteristics of confirmed COVID-19 cases were extracted and combined by simple pooling. Results: Of 644 studies identified, 69 studies (involving 48,926 patients) were included in the analysis. The average age of the patients was 49.16 years. A total of 51.46% of the patients were men and 52.32% were non-smokers. Hypertension (50.82%) and diabetes (20.89%) were the most frequent comorbidities observed. The most common symptoms were fever (83.21%), cough (61.74%), and myalgia or fatigue (30.22%). Altered levels of blood and biochemical parameters were observed in a proportion of the patients. Most of the patients (78.50%) had bilateral lung involvements, and 5.86% showed no CT findings indicative of viral pneumonia. Acute respiratory distress syndrome (28.36%), acute cardiac injury (7.89%) and acute kidney injury (7.60%) were the most common complications recorded. Conclusions: Clinical and epidemiological characteristics of COVID-19 patients were mostly heterogeneous and non-specific. This is the most comprehensive report of the characteristics of COVID-19 patients to date. The information presented is important for improving our understanding of the spectrum and impact of this novel disease.


title: Who is more susceptible to Covid-19 infection and mortality in the States?

text: Background: A novel coronavirus was detected in Wuhan, China and reported to WHO on 31 December 2019. WHO declared a global pandemic on 11 March 2020. The first case in the US was reported in January 2020. Since mid-March 2020, the number of confirmed cases has increased exponentially in the States, with 1.1 million confirmed cases, and 57.4 thousand deaths as of 30 April 2020. Even though some believe that this new lethal coronavirus does not show any partiality to the rich, previous epidemiological studies find that the poor in the US are more susceptible to the epidemics due to their limited access to preventive measures and crowded living conditions. In this study, we postulate that the rich is more susceptible to Covid-19 infection during the early stage before social distancing measures have been introduced. This may be attributed to the higher mobility (both inter- and intra-city), given their higher tendency to travel for business/education, and to more social interactions. However, we postulate after the lockdown/social distancing has been imposed, the infection among the rich may be reduced due to better living conditions. Further, the rich may be able to afford better medical treatment once infected, hence a relatively lower mortality. In contrast, without proper medical insurance coverage, the poor may be prevented from receiving timely and proper medical treatment, hence a higher mortality. Method: We will collect the number of confirmed Covid-19 cases in the US during the period of Jan 2020 to Apr 2020 from Johns Hopkins University, also the number of Covid-19 tests in the US from the health departments across the States. County-level socio-economic status (SES) including age, sex, race/ethnicity, income, education, occupation, employment status, immigration status, and housing price, will be collected from the US Census Bureau. State/county-level health conditions including the prevalence of chronic diseases will be collected from the US CDC. State/county-level movement data including international and domestic flights will be collected from the US Bureau of Transportation Statistics. We will also collect the periods of lockdown/social distancing. Regression models are constructed to examine the relationship between SES, and Covid-19 infection and mortality at the state/county-level before and after lockdown/social distancing, while accounting for Covid-19 testing capacities and co-morbidities. Expected Findings: We expect that there is a positive correlation between Covid-19 infection and SES at the state/county-level in the US before social distancing. In addition, we expect a negative correlation between Covid-19 mortality and SES.


title: Flatten the Curve! Modeling SARS-CoV-2/COVID-19 Growth in Germany on the County Level

text: Since the emerging of the "novel coronavirus" SARS-CoV-2 and the corresponding respiratory disease COVID-19, the virus has spread all over the world. In Europe, Germany is currently one of the most affected countries. In March 2020, a "lockdown" was established to contain the virus spread, including the closure of schools and child day care facilities as well as forced social distancing and bans of any public gathering. The present study attempts to analyze whether these governmental interventions had an impact on the declared aim of "flattening the curve", referring to the epidemic curve of new infections. This analysis is conducted from a regional perspective. On the level of the 412 German counties, logistic growth models were estimated based on reported cases of infections, aiming at determining the regional growth rate of infections and the point of inflection where infection rates begin to decrease and the curve flattens. All German counties exceeded the peak of new infections between the beginning of March and the middle of April. In a large majority of German counties, the epidemic curve has flattened before the social ban was established (March 23). In a minority of counties, the peak was already exceeded before school closures. The growth rates of infections vary spatially depending on the time the virus emerged. Counties belonging to states which established an additional curfew show no significant improvement with respect to growth rates and mortality. On the contrary, growth rates and mortality are significantly higher in Bavaria compared to whole Germany. The results raise the question whether social ban measures and curfews really contributed to the curve flattening. Furthermore, mortality varies strongly across German counties, which can be attributed to infections of people belonging to the "risk group", especially residents of retirement homes.


title: Modeling the Impact of Nationwide BCG Vaccine Recommendations on COVID-19 Transmission, Severity, and Mortality

text: COVID-19 was declared as pandemic on 11th March 2020 by WHO. There are apparent dissimilarities in incidence and mortality of COVID-19 cases in different parts of world. Developing countries in Asia and Africa with fragile health system have shown lower incidence and mortality compared to developed countries with superior health system in Europe and America. Most countries in Asia and Africa have national BCG vaccination program while Europe and America do not have such program, or have ceased it. At present, there is no known therapy to treat COVID-19 disease. There is no vaccine available currently to prevent COVID- 19 disease. As mathematical modelling is ideal for predicting the rate of disease transmission as well as evaluating efficacy of possible public health prevention measures, we have created a mathematical model with seven compartments to understand nationwide BCG vaccine recommendation on COVID-19 transmission, severity and mortality. We have computed two basic reproduction number, one at vaccine free equilibrium point and other at non-vaccine free equilibrium point and carried out local stability, sensitivity and numerical analysis. Our result showed that individuals with BCG vaccinations have lower risk of getting COVID-19 infection, shorter hospital stays, and increased rate of recovery. Furthermore, countries with long-standing universal BCG vaccination policies have reduced incidence, mortality, and severity of COVID-19. Further research will focus on exploring the immediate benefits of vaccination to healthcare workers and patients as well as benefits of BCG re-vaccination.


title: Age Pattern of Premature Mortality under varying scenarios of COVID-19 Infection in India

text: Background India is vulnerable to community infection of COVID-19 due to crowded and poor living condition, high density, slums in urban areas and poor health care system. The number of COVID-19 infection has crossed 120,000 with over 3500 deaths despite a prolonged period of lockdown and restrictions in public spaces. Given the likely scale and magnitude of this pandemic, this is a modest attempt to assess its impact on the age pattern of mortality under the varying scenarios. Data and Methods Data from the Sample Registration System (SRS), covid19india.org and country-specific data from worldmeter are used in the analysis. Descriptive statistics, case fatality ratio, case fatality ratio with 14 days delay, abridged life table, years of potential life lost (YPLL), disability-adjusted life years (DALY) are used. Results The case fatality ratio (CFR) with 14 days delay for India is at least twice higher (8.0) than CFR of 3.4. Considering 8% mortality rate rate and varying scenarios of community infection by 0.5%, 1% and 2%, India's life expectancy will reduce by 0.8, 1.5 and 3.0 years and potential life lost by 12.1 million, 24.3 million and 48.6 million years respectively. A community infection of 0.5% may result in DALY by 6.2 per 1000 population. Major share of PYLL and DALY is accounted for the working ages. Conclusion COVID-19 has a visible impact on mortality with loss of productive life years in working ages. The sustained effort at containing the transmission at each administrative unit is recommended to arrest mortality owing by the working ages. Key Words: COVID-19, life expectancy, mortality, premature, DALY, India


title: Timing COVID-19 - Synchronization of longitudinal patient data to the underlying disease progression using CRP as a temporal marker

text: Advances in medical technology and IT infrastructure have led to increased availability of continuous patient data that allows to investigate the longitudinal progression of novel and known diseases in unprecedented detail. However, to accurately describe any underlying pathophysiology with longitudinal data, the individual patient trajectories have to be synchronized based on temporal markers. In this study, we use longitudinal data from 28 critically ill ICU COVID-19 patients to compare the commonly used alignment markers "onset of symptoms", "hospital admission" and "ICU admission" with a novel objective method based on the peak value of inflammatory marker C-reactive protein (CRP). By applying our CRP-based method to align the progression of neutrophils and lymphocytes, we were able to define a pathophysiological window that allowed further mortality risk stratification in our COVID-19 patient cohort. Our data highlights that proper synchronization of patient data to the underlying pathophysiology is crucial to differentiate severity subgroups and to allow reliable interpatient comparisons.


title: COVID-19: Persistence, Precautions, Diagnosis and Challenges

text: After a century, the whole world fighting against the pandemic viral infection: a novel coronavirus, COVID-19 Currently, more than 210 countries are suffering from COVID-19 with the number of affected countries and patients are exponentially increasing day by day It became a global health issue where more than 2 7 million cases were reported with a death ratio of approximate 7% globally by World Health Organization (WHO) (as of 24 April 2020) which is a 22 times higher numbers in 1 5 month and this figure increasing day by day at an alarming rate The maximum infected cases reported from the most developed country and the world leader America however, the maximum death cases are from the world's second health service provider country Italy China, the origin country of COVID-19, has taken serious actions in terms of prevention, control against the spreading of this coronavirus through lockdown, sanitation, medication, and social distancing The risk of transmissions of coronavirus from humans to humans is more and thus a social distancing is the best way for its persistence and precautions Thus, the COVID-19 outbreak continues must explore and evolve, certain strict and mandatory precautions to stop this dangerous devil virus Also, it is a major challenge for all global scientists to find out an effective remedial drug to control this deadly coronavirus before uncontrolled conditions Thus, considering the depth of the spreading of coronavirus and its impact on global health, it is necessitating to know the dos and don'ts for persistence, precautions, and diagnostic strategies against the challenging COVID-19


title: High-density amplicon sequencing identifies community spread and ongoing evolution of SARS-CoV-2 in the Southern United States

text: SARS-CoV-2 is constantly evolving. Prior studies have focused on high case-density locations, such as the Northern and Western metropolitan areas in the U.S. This study demonstrates continued SARS-CoV-2 evolution in a suburban Southern U.S. region by high-density amplicon sequencing of symptomatic cases. 57% of strains carried the spike D614G variant. The presence of D614G was associated with a higher genome copy number and its prevalence expanded with time. Four strains carried a deletion in a predicted stem loop of the 3’ untranslated region. The data are consistent with community spread within the local population and the larger continental U.S. No strain had mutations in the target sites used in common diagnostic assays. The data instill confidence in the sensitivity of current tests and validate “testing by sequencing” as a new option to uncover cases, particularly those not conforming to the standard clinical presentation of COVID-19. This study contributes to the understanding of COVID-19 by providing an extensive set of genomes from a non-urban setting and further informs vaccine design by defining D614G as a dominant and emergent SARS-CoV-2 isolate in the U.S.


title: Hidden periods, duration and final size of COVID-19 pandemic

text: The SIR (susceptible-infected-removed) model, statistical approach for the parameter identification and the official WHO data about the confirmed cumulative number of cases were used to estimate the characteristics of COVID-19 pandemic in USA, Germany, UK, South Korea and in the world. Epidemic in every country has rather long hidden period before fist cases were confirmed. In particular, the pandemic began in China no later than October, 2019. If current trends continue, the end of the pandemic should be expected no earlier than March 2021, the global number of cases will exceed 5 million.


title: Forecasting the CoViD19 Diffusion in Italy and the Related Occupancy of Intensive Care Units

text: This paper provides a model based method for the forecast of the total number of currently CoVoD19 positive individuals and of the occupancy of the available Intensive Care Units in Italy. The predictions obtained, for a time horizon of 10 days starting from March 29th, will be provided at a national as well as at a more disaggregate levels, following a criterion based on the magnitude of the phenomenon. While the Regions which have been hit the most by the pandemic have been kept separated, the less affected ones have been aggregated into homogeneous macroareas. Results show that , within the forecast period considered (March 29th April 7th ) , all of the Italian regions will show a decreasing number of CoViD-19 positive people. Same for the number of people who will need to be hospitalized in a Intensive Care Unit (ICU). These estimates are valid under constancy of the Government s current containment policies. In this scenario, Northern Regions will remain the most affected ones and no significant outbreak are foreseen in the southern regions.


title: A structured model for COVID-19 spread: modelling age and healthcare inequities

text: We use stochastic branching process model, structured by age and level of healthcare access, to look at the heterogeneous spread of COVID-19 within a population. We examine the effect of control scenarios targeted at particular groups, such as school closures or social distancing by older people. Although we currently lack detailed empirical data about contact and infection rates between different age groups and groups with different levels of healthcare access within New Zealand, these scenarios illustrate how such evidence could be used to inform specific interventions. We find that an increase in the transmission rates amongst children as a result of reopening schools is, on its own, unlikely to significantly increase the number of cases. However, if this is accompanied by a change in adult behaviour, for example increased contact rates among parents, it could have a much bigger effect. We also find that there is a risk of undetected outbreaks occurring in communities that have low access to healthcare and that are socially isolated from more privileged communities. The greater the inequity and the greater the degree of social segregation, the longer it will take before any outbreaks are detected. Well-established evidence for health inequities, particularly in accessing primary healthcare and testing, indicates that M[a]ori and Pacific peoples are at higher risk of undetected outbreaks in Aotearoa New Zealand. This highlights the importance of ensuring that community needs for access to healthcare, including early proactive testing, rapid contact tracing, and the ability to isolate, are being met equitably. Finally, these scenarios illustrate how information concerning contact and infection rates across different demographic groups may be useful in informing specific policy interventions.


title: Assessing the impact of coordinated COVID-19 exit strategies across Europe

text: As rates of new COVID-19 cases decline across Europe due to non-pharmaceutical interventions such as social distancing policies and lockdown measures, countries require guidance on how to ease restrictions while minimizing the risk of resurgent outbreaks. Here, we use mobility and case data to quantify how coordinated exit strategies could delay continental resurgence and limit community transmission of COVID-19. We find that a resurgent continental epidemic could occur as many as 5 weeks earlier when well-connected countries with stringent existing interventions end their interventions prematurely. Further, we found that appropriate coordination can greatly improve the likelihood of eliminating community transmission throughout Europe. In particular, synchronizing intermittent lockdowns across Europe meant half as many lockdown periods were required to end community transmission continent-wide.


title: Clinical features of icu admitted and intubated novel corona virus-infected patients in iran

text: Background: Recently, a novel coronavirus was reported from Wuhan, Hubei Province, China. The novel coronavirus infection was spread from China to other countries, including Iran. Objectives: We report the clinical characteristics, laboratory findings, and chest exams of infected patients. Methods: All patients suspected to the novel coronavirus were hospitalized in a special airborne protection room. We collected and analyzed the characteristics of confirmed patients by data extraction from electronic medical records. Results: The Computerized Tomography (CT) scan and radiography results showed ground glass in the lung of patients, and real-time PCR confirmed the infection. The myocardial and liver function tests showed abnormalities in infected patients. Conclusions: Most patients admitted to the Intensive Care Unit (ICU) showed respiratory problems, and their infection was confirmed by virological tests and chest images. The main reason for the patient’s death was the signs of acute heart failure, such as hypotension and cardiac arrhythmia.


title: Seroprevalence of SARS-CoV-2 IgG significantly varies with age: results from a mass population screening (SARS-2-SCREEN-CdA).

text: Castiglione D'Adda is one of the towns earlier and more severely affected by the SARS-CoV-2 epidemic in Lombardy. In a mass screening involving 4174 out of about 4550 total inhabits, significant age-related differences in anti SARS-CoV-2 IgG seroprevalence were found, with the lowest prevalence in the youngest inhabitants.


title: Time Dynamics of COVID-19

text: We apply tools from functional data analysis to model cumulative trajectories of COVID-19 cases across countries, establishing a framework for quantifying and comparing cases and deaths across countries longitudinally. It emerges that a country's trajectory during an initial first month "priming period" largely determines how the situation unfolds subsequently. We also propose a method for forecasting case counts, which takes advantage of the common, latent information in the entire sample of curves, instead of just the history of a single country. Our framework facilitates to quantify the effects of demographic covariates and social mobility on doubling rates and case fatality rates through a time-varying regression model. Decreased workplace mobility is associated with lower doubling rates with a roughly two week delay, and case fatality rates exhibit a positive feedback pattern.


title: EARLY DETECTION OF COVID-19

text: Since SARS-Cov-2 epidemic appeared in Wuhan China, it became challenge for health authorities to counter Covid-19 epidemic. Early evaluation of suspects, screening for Covid-19 and management posed challenge to health authorities especially in developing countries which were not ready to cope with it. Early mild symptoms appeared during course of disease provide a chance to early detect Covid-19. We use retrospective methodology to collect available data on early sign and symptoms of Covid-19 through accessing World Health Organization (WHO) webpages, New England Journal of Medicine (NEJM), Nature Journal, Journal of American Medical Association (JAMA) network, British Medical Journal (BJM), Lancet and other world renowned journal publications to establish a relationship of early symptoms for detection of Covid-19. Data of 2707 Covid-19 laboratory confirmed cases was collected and analyzed for early signs. Available data was categorized into physical and blood biomarkers. This categorized data was assessed for scoring early detection of Covid-19 by scoring Hashmi-Asif Covid-19 formula. Each characteristic was given a score in Hashmi-Asif Covid-19 chart with maximum score of 28. Scoring 16 on chart means Covid-19 will fully develop in near future. Correlation of each sign and symptoms with development of Covid-19 in formula showed significant correlation assessed by Pearson correlation and Spearman Correlation coefficient (rho) showed significant correlation of development of Covid-19 with fever 64.11% (P=0.001), cough 65% and dry mucus 19.67% equally sensitive (P=0.000), leukopenia 19.06% (P=0.006), lymphopenia 52.93% (P=0.005), thrombopenia 19.1% (P=0.013), elevated Aspartate aminotransferase 12.79% (P=0.007) and elevated Alanine aminotransferase 11.34% (P=0.006). Chart can sense Covid-19 progression 72-96 hours earlier compared to usual course of disease and detection by standard method. Chart for early detection provides early quarantine decision to reduce disease spread and give ample time for intervening disease progression to reduce morbidity time due to Covid-19


title: COVID-19 causing HELLP-like syndrome in pregnancy and role of angiogenic factors for differential diagnosis

text: Importance: The clinical presentation of hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is one of the more severe forms of preeclampsia. COVID-19 infection exhibits signs that are shared with preeclampsia and HELLP syndrome, which may lead to needless interventions and iatrogenic preterm delivery. Objective: We evaluated the prevalence of HELLP-like signs in pregnant women admitted for COVID-19 and the value of angiogenic factors to rule out preeclampsia. Methods: a consecutive series of 27 pregnant women beyond 20 weeks of gestation, with symptomatic COVID-19. Clinical and analytical features were recorded and those cases with signs of HELLP syndrome were tested for sFlt-1/PlGF ratio. Results: Seven patients (25.9%) presented at least one sign of suspected HELLP syndrome, of which 2 (7.4%) were diagnosed clinically with PE because of hypertension and high transaminases and 5 (18.5%) had only elevated transaminases. sFlt-1/PlGF ratio was normal in 6 of 7. Conclusion: Symptomatic COVID-19 may simulate severe preeclampsia in pregnancy. Angiogenic factors may be essential to avoid false diagnosis and needless interventions. These data were presented in a Virtual Symposium on Covid-19 and Pregnancy on 17 April: 2020:(http://medicinafetalbarcelona.org/simposiocovid19/ [Spanish] and https://medicinafetalbarcelona.org/symposiumcovid19/ [English]


title: Economic and Monetary Union at twenty: a stocktaking of a tumultuous second decade: introduction

text: This contribution discusses the two main asymmetries of European Economic and Monetary Union (EMU) as they developed over the past two decades since the launch of the Single Currency. From the outset, EMU involved asymmetric degrees of integration in the area of ‘economic’ union (less centralised governance) versus ‘monetary’ union (more supranational governance). With the outbreak of the Sovereign Debt Crisis in 2010, the regime-shaping relevance of a second asymmetry emerged: one roughly between the member states of the Euro Area ‘core’ and those in the ‘periphery’. Each of the two asymmetries have created a range of challenges — institutional, policy and political — that undermine the stability and sustainability of the EMU project.


title: Effects of temperature on COVID-19 transmission

text: Coronavirus disease 2019 (COVID19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV2), it was first identified in 2019 in Wuhan, China and has resulted in the 2019-20 coronavirus pandemic. As of March 1, 2020, 79,968 patients in China and 7169 outside of China had tested positive for COVID19 and a mortality rate of 3.6% has been observed amongst Chinese patients. Its primary mode of transmission is via respiratory droplets from coughs and sneezes. The virus can remain viable for up to three days on plastic and stainless steel or in aerosols for upto 3 hours and is relatively more stable than the known human coronaviruses. It is stable in faeces at room temperature for at least 1-2 days and can be stable in infected patients for up to 4 days. Heat at 56 degree Celsius kills the SARS coronavirus at around 10000 units per 15 minutes. Thus, temperature is an important factor in survival of COVID19 virus and this article focuses on understanding the relationship between temperature and COVID19 transmission from the data available between January-March 2020.


In a time of COVID-19 pandemic, stay healthy, connected, productive, and learning: words from the editorial team of HRDI


title: Acute Pulmonary Embolism in Critically Ill Patients with COVID-19

text: Since the discovery of the novel coronavirus (SARS-Co-V-2) in December 2019, multiple characteristics have been reported, as our understanding of this new disease unfolds. One such association is its tendency to cause thromboembolic events, particularly venous thromboembolism (1,2). In a four-week period during the initial spread of COVID-19 at a 300 bed community hospital in western Massachusetts, 23 patients who were PCR positive for SARS-CoV-2 RNA required treatment in either the intensive care unit (ICU) or intermediate/step-down unit (SDU). All patients were treated with standard DVT prophylaxis from the time of admission, except for two patients who were on full anticoagulation for chronic atrial fibrillation. Of the 23 patients, 7 (30%) were diagnosed with acute, clinically significant, pulmonary embolism (PE). Four of the 7 manifested evidence of acute cor pulmonale, one of whom succumbed as a direct consequence of a massive PE. Other markers were reviewed in the 7 patients to identify trends that could allow for early suspicion of PE in COVID-19 patients. Although D-dimer tended to rise during the hospitalization relative to the control group, the results were inconsistent, and there were no other meaningful distinguishing features between the groups at the time of admission.


title: Critical Complications of COVID-19: A systematic Review and Meta-Analysis study

text: Background: Coronavirus disease 2019 (COVID-19) is a novel coronavirus infection that has spread worldwide in a short period and caused a pandemic. The goal of this meta-analysis is to evaluate the prevalence of most common symptoms and complications of COVID-19. Methods: All related studies assessing the clinical complications of COVID-19 have been identified through web search databases (PubMed and Scopus). Relevant data were extracted from these studies and analyzed by stata (ver 14) random-effects model. The heterogeneity of studies were assessed by I2 index. The publication bias was examined by Funnel plots and Eggers test. Results: 30 studies were in our meta-analysis including 6 389 infected patients. The prevalence of most common symptoms were: fever 84.30% (95% CI: 77.13-90.37; I2=97.74%), cough 63.01% (95% CI: 57.63-68.23; I2=93.73%), dyspnea 37.16% (95% CI: 27.31-47.57%; I2=98.32%), fatigue 34.22% (95% CI: 26.29-42.62; I2=97.29%) and diarrhea 11.47 %(95% CI: 6.96-16.87; I2=95.58%), respectively. The most prevalent complications were acute respiratory distress syndrome (ARDS) 33.15% (95% CI: 23.35-43.73; I2=98.56%), acute cardiac injury 13.77% (95% CI: 9.66-18.45; I2=91.36%), arrhythmia 16.64% (95% CI: 9.34-25.5; I2=92.29%), heart failure 11.50% (95% CI: 3.45-22.83; I2=89.48%), and acute kidney injury (AKI) 8.40 %(95% CI: 5.15-12.31; I2=95.22%, respectively. According to our analysis, mortality rate of COVID-19 patients were 12.29% (95% CI: 6.20-19.99; I2=98.29%). Conclusion: We assessed the prevalence of the main clinical complications of COVID-19 and found that after respiratory complications, cardiac and renal complications are the most common clinical complications of COVID-19.


title: Acute myelitis after SARS-CoV-2 infection: a case report.

text: We report a case of acute myelitis in a patient infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A 66-year-old man with coronavirus disease 2019 was admitted with acute flaccid paralysis of the bilateral lower limbs and urinary and bowel incontinence. All serum microbiological test results were negative, except for SARS-CoV-2 nucleic acid testing. Clinical findings indicated post-infectious acute myelitis. He received treatment containing ganciclovir, lopinavir/ritonavir, moxifloxacin, dexamethasone, human immunoglobulin, and mecobalamin. With a diagnosis of post-infectious acute myelitis and comprehensive treatment, paralysis of the bilateral lower extremities ameliorated. After two negative novel coronavirus RNA nasopharyngeal swab tests, he was discharged and transferred to a designated hospital for isolation and rehabilitation therapy.


title: Empiric model for short-time prediction of COVID-19spreading

text: Covid-19 appearance and fast spreading took by surprise the international community. Collaboration between researchers, public health workers and politicians has been established to deal with the epidemic. One important contribution from researchers in epidemiology is the analysis of trends so that both current state and short-term future trends can be carefully evaluated. Gompertz model has shown to correctly describe the dynamics of cumulative confirmed cases, since it is characterized by a decrease in growth rate that is able to show the effect of control measures. Thus, it provides a way to systematically quantify the Covid-19 spreading velocity. Moreover, it allows to carry out short-term predictions and long-term estimations that may facilitate policy decisions and the revision of in-place confinement measures and the development of new protocols. This model has been employed to fit the cumulative cases of Covid-19 from several Chinese provinces and from other countries with a successful containment of the disease. Results show that there are systematic differences in spreading velocity between countries. In countries that are in the initial stages of the Covid-19 outbreak, model predictions provide a reliable picture of its short-term evolution and may permit to unveil some characteristics of the long-term evolution. These predictions can also be generalized to short-term hospital and Intensive Care Units (ICU) requirements, which together with the equivalent predictions on mortality provide key information for health officials.


title: The perceived impact of the Covid-19 epidemic: evidence from a sample of 4807 SMEs in Sichuan Province, China

text: The outbreak of the coronavirus disease (Covid-19) in January 2020 in Wuhan has had a significant impact on the Chinese economy, and especially on the small and medium-sized enterprises (SMEs). In February 2020 an online questionnaire and follow-up interviews were conducted on 4807 SMEs in Sichuan to assess the challenges associated with work resumption and the associated policy requirements. It was found that most SMEs were unable to resume work because of a shortage of epidemic mitigation materials, the inability of employees to return to work, disrupted supply chains, and reduced market demand. Many SMEs were also facing cash flow risks as they had to continue to pay for various fixed expenditures even though they had little or no revenue. As these delays in work resumption have put unprecedented pressures on the survival of many SMEs, recommendations relevant to China and other affected countries regarding cash flow relief, work resumption and consumption stimulation are given to assist SME survival and economic recovery from the disaster situation.


title: COVID-19 follow-up planning: what will we be missing?

text: There is a real need for a discharge plan for COVID-19 survivors in the UK. Follow-up imaging could help assess the resolution of infection, exclude underlying malignancy and identify post-inflammatory fibrosis. https://bit.ly/2YJ8hyg


title: Finding disease modules for cancer and COVID-19 in gene co-expression networks with the Core&Peel method

text: Diseases imply dysregulation of cell’s functions at several levels. The study of differentially expressed genes in case-control cohorts of patients is often the first step in understanding the details of the cell’s dysregulation. A further level of analysis is introduced by noticing that genes are organized in functional modules (often called pathways), thus their action and their dysregulation may be better understood by the identification of the modules most affected by the disease (aka disease modules, or active subnetworks). We describe how an algorithm based on the Core&Peel method developed originally for detecting protein complexes in PPI networks, can be adapted to detect disease modules in co-expression networks of genes. We first validate Core&Peel for the easier general task of functional module detection by comparison with 42 methods participating in the Disease Module Identification DREAM challenge of 2019. Next, we use four specific disease test cases (colorectal cancer, prostate cancer, asthma and rheumatoid arthritis), four state-of-the-art algorithms (ModuleDiscoverer, Degas, KeyPathwayMiner and ClustEx), and several pathway databases to validate the proposed algorithm. Core&Peel is the only method able to find significant associations of the predicted disease module with known validated relevant pathways for all four diseases. Moreover for the two cancer data sets, Core&Peel detects further nine relevant pathways enriched in the predicted disease module, not discovered by the other methods used in the comparative analysis. Finally we apply Core&Peel, along with other methods, to explore the transcriptional response of human cells to SARS-CoV-2 infection, at a modular level, aiming at finding supporting evidence for drug repositioning efforts.


title: Forecasting trajectories of an emerging epidemic with mathematical modeling in an online dashboard: The case of COVID-19

text: We offer an efficient mathematical model for forecasting the course of an emerging epidemic, with COVID-19 as a use case. We predict the future course of confirmed cases in a number of countries, and present the results in a modern online dashboard, updated daily and accessible to the public.


The Outbreak of COVID-19 in Italy: Fighting the Pandemic


title: National Early Warning Scores (NEWS / NEWS2) and COVID-19 deaths in care homes: a longitudinal ecological study

text: Objectives:To investigate whether patterns of National Early Warning Scores (NEWS/NEWS2) in care homes during the COVID pandemic correspond with area-level COVID-19 death registrations from care homes. Study design: Longitudinal ecological study. Setting: 460 Care home units using the same software package to collect data on residents, from 46 local authority areas in England. Participants: 6,464 care home residents with at least one NEWS recording. Exposure measure: 29,656 anonymised person-level NEWS from 29/12/2019 to 20/05/2020 with component physiological measures: systolic blood pressure, respiratory rate, pulse rate, temperature, and oxygen saturation. Baseline values for each measure calculated using 80th and 20th centile scores before March 2020. Outcome measure: Time series comparison with Office for National Statistics (ONS) weekly reported registered deaths of care home residents where COVID-19 was the underlying cause of death, and all other deaths (excluding COVID-19) up to 10/05/2020. Results: Deaths due to COVID-19 were registered from 23/03/2020 in the study geographical areas. Between 23/03/2020 and 10/05/2020, there were 5,753 deaths (1,532 involving COVID-19 and 4,221 other causes). The proportion of above-baseline NEWS increased from 16/03/2020 and closely followed the rise and fall in COVID-19 deaths over the study period. The proportion of above-baseline oxygen saturation, respiratory rate and temperature measurements also increased approximately two weeks before peaks in care home deaths in corresponding geographical areas. Conclusions: NEWS may make a useful contribution to disease surveillance in care homes during the COVID-19 pandemic. Oxygen saturation, respiratory rate and temperature could be prioritised as they appear to signal rise in mortality almost as well as total NEWS. This study reinforces the need to collate data from care homes, to monitor and protect residents' health. Further work using individual level outcome data is needed to evaluate the role of NEWS in the early detection of resident illness.


Management Practice of Allergic Rhinitis in China During the COVID-19 Pandemic