title: Estimation of testing bias in covid-19

text: COVID-19 testing studies have become a standard approach for estimating prevalence and fatality rates which then assist in public health decision making to contain and mitigate the spread of the disease. The sampling designs used are often biased in that they do not reflect the true underlying populations. For instance, individuals with strong symptoms are more likely to be tested than those with no symptoms. This results in biased estimates of prevalence (too high) and over-estimation of fatality rates. Typical post-sampling corrections are not always possible. Here we present a simple bias correction methodology derived and adapted from a correction for publication bias in meta analysis studies. The methodology is general enough to allow a wide variety of customization making it more useful in practice. Implementation is easily done using already collected information. We show via an example that the bias corrections can provide dramatic reductions in estimation error.


Clinical findings in a patient with haemophilia A affected by COVID-19


title: The Royal College of Pathologists of Australasia (RCPA) position statement on COVID-19

text: For the detection of early COVID-19 disease, RCPA supports the use of molecular tests for SARS-CoV-2 and strongly opposes the introduction of COVID-19 IgG/IgM rapid tests for this purpose.


title: 3D-Printing to Address COVID-19 Testing Supply Shortages

text: The recent SARS-CoV-2 outbreak has placed immense pressure on supply chains, including shortages in nasopharyngeal (NP) swabs. Here, we report our experience of using 3D-printing to rapidly develop and deploy custom-made NP swabs to address supply shortages at our healthcare institution.


COVID-19 and inequality: are we all in this together?


title: Compliance and Psychological Impact of Quarantine in Children and Adolescents due to Covid-19 Pandemic

text: OBJECTIVES: To examine a cohort of children and adolescents quarantined during Coronavirus disease 2019 outbreak in India and to describe their understanding of, compliance with and the psychological impact of quarantine experience. METHODS: One hundred twenty one children and adolescents along with their parents were interviewed regarding their compliance and psychological distress during the quarantine period. A comparable data was also obtained from 131 children and adolescents who were not quarantined. RESULTS: Most of the children and adolescents were non-compliant as compliance with all requirements was low (7.43%), though compliance with community protective measures (17.35%) was better than compliance with household protective measures (10.71%). Quarantined children and adolescents experienced greater psychological distress than non-quarantined children and adolescents (p Ë0.001). Worry (68.59%), helplessness (66.11%) and fear (61.98%) were the most common feelings experienced under quarantine. CONCLUSIONS: The low compliance with quarantine requirements as seen in this study raises a serious concern about the effectiveness of quarantine as a preventive measure of disease transmission. Compliance and mental health problems can be improved by providing adequate financial support and enhanced knowledge about pandemic planning.


Creation of a Dedicated Line Service in the New Jersey Epicenter of COVID-19


title: Rash as a presenting complaint in a child with COVID-19

text: Cutaneous manifestations are becoming increasingly well-documented in adults with COVID-19. There is now also a growing body of literature regarding skin involvement in children, with reports of papulovesicular, petechial and widespread macular and papular lesions, as well as chilblains (pernio). We describe the case of a thirteen-year-old boy with confirmed COVID-19 in the United Kingdom who presented with skin findings localized to the plantar aspects of the feet, axillae and lower limbs. The morphology was predominantly maculopapular but also included petechiae and annular lesions.


title: COVID-19 Pandemic and the Crisis of Health Systems: The Experience of the Apulia Cancer Network and of the Comprehensive Cancer Center Istituto Tumori "Giovanni Paolo II" of Bari

text: On 11 March 2020, the World Health Organization declared a new disease caused by a novel virus characterized by rapid human-to-human transmission and named severe acute respiratory syndrome coronoavirus-2 (SARS-CoV-2) a pandemic. In terms of this ongoing international scenario, we report the situation in Apulia, a region of southern Italy that, as of April 2, has not yet been overwhelmed by this health emergency. In particular, we consider the care models that have been adopted, especially those that manage the requests of cancer patients.


title: Phenotype and kinetics of SARS-CoV-2-specific T cells in COVID-19 patients with acute respiratory distress syndrome

text: SARS-CoV-2 has been identified as the causative agent of a global outbreak of respiratory tract disease (COVID-19). In some patients the infection results in moderate to severe acute respiratory distress syndrome (ARDS), requiring invasive mechanical ventilation. High serum levels of IL-6, IL-10 and an immune hyperresponsiveness referred to as a 'cytokine storm' have been associated with poor clinical outcome. Despite the large numbers of COVID-19 cases and deaths, information on the phenotype and kinetics of SARS-CoV-2-specific T cells is limited. Here, we studied 10 COVID-19 patients who required admission to an intensive care unit and detected SARS-CoV-2-specific CD4+ and CD8+ T cells in 10 out of 10 and 8 out of 10 patients, respectively. We also detected low levels of SARS-CoV-2-reactive T cells in 2 out of 10 healthy controls not previously exposed to SARS-CoV-2, which is indicative of cross-reactivity due to past infection with 'common cold' coronaviruses. The strongest T-cell responses were directed to the spike (S) surface glycoprotein, and SARS-CoV-2-specific T cells predominantly produced effector and Th1 cytokines, although Th2 and Th17 cytokines were also detected. Furthermore, we studied T-cell kinetics and showed that SARS-CoV-2-specific T cells are present relatively early and increase over time. Collectively, these data shed light on the potential variations in T-cell responses as a function of disease severity, an issue that is key to understanding the potential role of immunopathology in the disease, and also inform vaccine design and evaluation.


title: Elevated N-terminal pro-brain natriuretic peptide is associated with increased mortality in patients with COVID-19: systematic review and meta-analysis

text: OBJECTIVES: This systematic review and meta-analysis aimed to assess the association between N-terminal pro-brain natriuretic peptide (NT-proBNP) and mortality in patients with COVID-19. METHODS: Systematic literature search from several electronic databases were performed. The outcome was mortality (non-survivor) in patients with COVID-19 pneumonia. NT-proBNP data were in continuous variable (pg/mL), dichotomous data (elevated/non-elevated) and effect estimate adjusted to cardiac injury/elevated biomarkers of cardiac injury. RESULTS: A total of 967 patients from six studies were included in this analysis. NT-proBNP was higher in non-survivor group (standardised mean difference 0.75 (0.44, 1.07), p<0.001; I2: 61%). Elevated NT-proBNP was associated with increased mortality (RR 3.63 (92.21, 5.95), p<0.001; I2: 60%). Sensitivity analysis by removing a study reduces heterogeneity (risk ratio 3.47 (2.36, 5.11), p<0.001; I2: 49%). Pooled adjusted HR (adjusted to cardiac injury/elevated biomarkers of cardiac injury) showed that elevated NT-proBNP was independently associated with mortality (HR 1.37 (1.19, 1.57), p<0.001; I2: 0%, p=0.77). Pooled analysis of multiple cut-off point resulted in a sensitivity of 76% (46%-92%) and specificity of 88% (71%-96%). Summary receiver operating characteristic curve analysis demonstrates an area under curve of 0.90 (0.87-0.93). Elevated NT-proBNP has a likelihood ratio (LR) +6.4 and LR -0.3. CONCLUSION: Elevated NT-proBNP level was associated with increased mortality in COVID-19 pneumonia.


title: COVID-19 and diabetes from IDF MENA region

text: The whole world are facing the current COVID-19 pandemic, the most serious health crisis in modern times. All countries with the support of national and international agencies are making great efforts to fight this devastating pandemic with disastrous medical, economic and social consequences. This pandemic affects all people but it's serious in case of diabetes, elderly and in chronic and complicated diseases. The current work on the theme " COVID-19 and Diabetes" attempts to bring together all the data available at MENA level through medical and scientific publications. It also includes all the efforts made by the governments and the responses of associations and their efforts in this field. Even if it is admitted that diabetes with its comorbidity represents a high risk factor for severe forms and mortality, the health consequences of the epidemic, does not seem as dramatic in terms of both morbidity and mortality of COVID-19 with diabetes in the majority of MENA countries. If the crises continues longer, the supply of insulin, oral drugs, self monitoring equipment of diabetes and other tools, will be affected. To this, we must expect great difficulties in supplying food for many countries. Certainely, it is important to remember that containment and hygiene measures, associated with other factors such as the young average age of the population, the higher temperature in these countries, the differences in the immune status of populations and the role of BCG vaccine have something to do with it. All of this deserves to be studied in depth.


Preventing Infection of Patients and Healthcare Workers Should Be the New Normal in the Era of Novel Coronavirus Epidemics: Reply


title: Design and preliminary application of regional control and prevention auxiliary information system under the attack of COVID-19 infectious disease/ 中华医学科研管理杂志

text: Objective@#To propose the concept of a novel regional control and prevention (RCP) system for the outbreak of COVID-19 infectious disease, design an emergency epidemic prevention information system based on the existing network architecture and information system in the region, and a remote intelligent medical consultation and remote office platform, research and develop the technology of risk assessment and early warning for people in the region, and improve the regions’prevention and control ability facing emergency of major infectious diseases.@*Methods@#Taking colleges, affiliated (teaching) hospitals, and cloud applications as typical RCP regional units, the existing local area network interaction methods between the cloud and universities and affiliated (teaching) hospitals are established to realize remote work in the network environment, remote medical imaging, psychological and ethical consultation and interaction; applying multi-agent propagation model based on complex network, combining Global Positioning System (GPS), Radio Frequency Identification (RFID), and electronic fence technology, to realize the risk classification and early warning of units and personnel in the area.@*Results@#In the RCP, a system architecture combining campus network, affiliated (teaching) hospital intranet, and the Internet is used. Dynamic connection is made using distributed technology and cloud storage. The data buffer mechanism of the intermediary database in the network realized telemedicine consultation and telecommuting. Relying on the platform, multi-agent propagation model based on complex network and cellular automaton model are used to realize the score and early warning of population exposure risk in the region by using GPS, RFID and electronic fence technology.@*Conclusions@#In the epidemic phase of major infectious diseases, the construction of RCP can improve the response speed of wartime epidemic prevention, provide reasonable data-based warnings and risk ratings, and reduce the exposure risk of susceptible people. The design and development of RCP is a systematic project that needs to combine regional structural and functional characteristics, and the foundation of the early informatization work in the region and the level of the emergency development team determine the development progress, maintenance, and actual application effects. It is recommended to establish a peacetime and wartime combined RCP mode and incorporate it into the government's disease control system to improve the national and regional level of prevention and control of major infectious diseases.


title: Risk factors for myocardial injury and death in patients with COVID-19: insights from a cohort study with chest computed tomography

text: AIMS: Whether pulmonary artery (PA) dimension and coronary artery calcium (CAC) score, as assessed by chest computed tomography (CT), are associated with myocardial injury in patients with coronavirus disease 2019 (COVID-19) is not known. The aim of this study was to explore the risk factors for myocardial injury and death and to investigate whether myocardial injury has an independent association with all-cause mortality in patients with COVID-19. METHODS AND RESULTS: This is a single-centre cohort study including consecutive patients with laboratory-confirmed COVID-19 undergoing chest CT on admission. Myocardial injury was defined as high-sensitivity troponin I > 20 ng/L on admission. A total of 332 patients with a median follow-up of 12 days were included. There were 68 (20.5%) deaths; 123 (37%) patients had myocardial injury. PA diameter was higher in patients with myocardial injury compared with patients without myocardial injury [29.0 (25th-75th percentile, 27-32) mm vs. 27.7 (25-30) mm, <iP > < 0.001). PA diameter was independently associated with an increased risk of myocardial injury [adjusted odds ratio 1.10, 95% confidence interval (CI) 1.02-1.19, P = 0.01] and death [adjusted hazard ratio (HR) 1.09, 95% CI 1.02-1.17, P = 0.01]. Compared with patients without myocardial injury, patients with myocardial injury had a lower prevalence of a CAC score of zero (25% vs. 55%, <iP > < 0.001); however, the CAC score did not emerge as a predictor of myocardial injury by multivariable logistic regression. Myocardial injury was independently associated with an increased risk of death by multivariable Cox regression (adjusted HR 2.25, 95% CI 1.27-3.96, P = 0.005). Older age, lower estimated glomerular filtration rate, and lower PaO<sub2>/FiO<sub2> ratio on admission were other independent predictors for both myocardial injury and death. CONCLUSIONS: An increased PA diameter, as assessed by chest CT, is an independent risk factor for myocardial injury and mortality in patients with COVID-19. Myocardial injury is independently associated with an approximately two-fold increased risk of death. TRANSLATIONAL PERSPECTIVE: The present study identifies myocardial injury as a clinically relevant independent risk factor for death in the short term in a population of hospitalized patients with laboratory-confirmed COVID-19 outside of China undergoing chest computed tomography for suspected pneumonia on admission.The study also provides novel insights into the risk factors for myocardial injury, showing that an increased pulmonary artery diameter, assessed by chest computed tomography, is an independent predictor of myocardial injury as well as of mortality, suggesting that pulmonary circulation dysfunction is a pivotal pathological event with cardiac implications in COVID-19.


How the coronavirus pandemic is affecting the world's biggest physics experiments


title: Diagnostic performance of seven rapid IgG/IgM antibody tests and the Euroimmun IgA/IgG ELISA in COVID-19 patients

text: OBJECTIVES: To evaluate the diagnostic performance of seven rapid IgG/IgM tests and the Euroimmun IgA/IgG ELISA for antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in COVID-19 patients. METHODS: Specificity was evaluated in 103 samples collected before January 2020. Sensitivity and time to seropositivity was evaluated in 167 samples from 94 patients with COVID-19 confirmed with RT-PCR on nasopharyngeal swab. RESULTS: Specificity (confidence interval) of lateral flow assays (LFAs) was ≥91.3% (84.0-95.5) for IgM, ≥90.3% (82.9-94.8) for IgG, and ≥85.4% (77.2-91.1) for the combination IgM OR IgG. Specificity of the ELISA was 96.1% (90.1-98.8) for IgG and only 73.8% (64.5-81.4) for IgA. Sensitivity 14-25 days after the onset of symptoms was between ≥92.1% (78.5-98.0) and 100% (95.7-100) for IgG LFA compared to 89.5% (75.3-96.4) for IgG ELISA. Positivity of IgM OR IgG for LFA resulted in a decrease in specificity compared to IgG alone without a gain in diagnostic performance, except for VivaDiag. The results for IgM varied significantly between the LFAs with an average overall agreement of only 70% compared to 89% for IgG. The average dynamic trend to seropositivity for IgM was not shorter than for IgG. At the time of hospital admission the sensitivity of LFA was <60%. CONCLUSIONS: Sensitivity for the detection of IgG antibodies 14-25 days after the onset of symptoms was ≥92.1% for all seven LFAs compared to 89.5% for the IgG ELISA. The results for IgM varied significantly, and including IgM antibodies in addition to IgG for the interpretation of LFAs did not improve the diagnostic performance.


title: Correction to: Contrast-enhanced ultrasound (CEUS) of the lung reveals multiple areas of microthrombi in a COVID-19 patient

text: The original version of this article unfortunately contained two mistakes.


title: The Importance of Developing Rigorous Social Science Methods for Community Engagement and Behavior Change During Outbreak Response

text: Despite growing international attention, the anthropological and socio-behavioral elements of epidemics continue to be understudied and under resourced and lag behind the traditional outbreak response infrastructure. As seen in the current 2019 coronavirus disease (COVID-19) pandemic, the importance of socio-behavioral elements in understanding transmission and facilitating control of many outbreak-prone pathogens, this is problematic. Beyond the recent strengthening of global outbreak response capacities and global health security measures, a greater focus on the socio-behavioral components of outbreak response is required. We add to the current discussion by briefly highlighting the importance of socio-behavior in the Ebola virus disease (EVD) response, and describe vital areas of future development, including methods for community engagement and validated frameworks for behavioral modeling and change in outbreak settings.


title: Molecular Diagnosis of COVID-19: Challenges and Research Needs

text: Molecular diagnosis of COVID-19 primarily relies on the detection of RNA of the SARS-CoV-2 virus, the causative infectious agent of the pandemic. Reverse transcription polymerase chain reaction (RT-PCR) enables sensitive detection of specific sequences of genes that encode the RNA dependent RNA polymerase (RdRP), nucleocapsid (N), envelope (E), and spike (S) proteins of the virus. Although RT-PCR tests have been widely used and many alternative assays have been developed, the current testing capacity and availability cannot meet the unprecedented global demands for rapid, reliable, and widely accessible molecular diagnosis. Challenges remain throughout the entire analytical process, from the collection and treatment of specimens to the amplification and detection of viral RNA and the validation of clinical sensitivity and specificity. We highlight the main issues surrounding molecular diagnosis of COVID-19, including false negatives from the detection of viral RNA, temporal variations of viral loads, selection and treatment of specimens, and limiting factors in detecting viral proteins. We discuss critical research needs, such as improvements in RT-PCR, development of alternative nucleic acid amplification techniques, incorporating CRISPR technology for point-of-care (POC) applications, validation of POC tests, and sequencing of viral RNA and its mutations. Improved assays are also needed for environmental surveillance or wastewater-based epidemiology, which gauges infection on the community level through analyses of viral components in the community's wastewater. Public health surveillance benefits from large-scale analyses of antibodies in serum, although the current serological tests do not quantify neutralizing antibodies. Further advances in analytical technology and research through multidisciplinary collaboration will contribute to the development of mitigation strategies, therapeutics, and vaccines. Lessons learned from molecular diagnosis of COVID-19 are valuable for better preparedness in response to other infectious diseases.


title: Safeguarding Non-COVID-19 Research: Looking Up from Ground Zero

text: The COVID-19 pandemic has kicked off a global race to launch clinical trials of experimental vaccines and treatments for the coronavirus. Worldwide, as resources are directed toward accelerating the research into unravelling the mechanism of COVID-19 pathophysiology, concerns have been raised regarding the future of clinical research in United Kingdom and elsewhere during the current pandemic. However, the real immediate impact of these restrictions due to lock-down is most acutely felt by scientists working on non-COVID-19 biomedical research bench and clinical researchers whose drug trials have to be delayed, suspended or ceased. Here, we highlight our views from "ground zero" as we represent those whose work are deeply affected by the restrictions. We draw attention to some of the practical realities and emotions experienced in the laboratory. In addition, we also highlight the difficulties for policy makers to maintain equanimity in prioritizing their decisions cross the different fields of science.


What a US exit from the WHO means for COVID-19 and global health


Comparison of short-term mortality between mechanically ventilated patients with COVID-19 and influenza in a setting of sustainable healthcare system


COVID-19 and Diabetes-A View From India


title: Hazard Pay for COVID-19? Yes, But It's Not a Substitute for a Living Wage and Enforceable Worker Protections

text: The COVID-19 pandemic is exposing critical failures in public and occupational health in the United States. So-called hazard pay for essential workers is a necessary but insufficient response to the lack of workplace protections. The roots of these failures in the weakening of the Occupational Safety and Health Administration enforcement and pandemic preparedness and the dramatic shifts in the economy and labor market in recent decades are explored along with the history of hazard pay. The current prominence of COVID-19-related workplace hazards, and the mobilization by both nonunion and union workers experiencing them, presents opportunities amid the crisis and tragic losses to envision a revival of worker protection measures. Strategies are needed for organizing and legislative advocacy to address the disparate impact of both normal and crisis conditions on low-wage workers, especially women and workers of color.


Low transmission risk of 9 asymptomatic carriers tested positive for both SARS-CoV-2 nucleic acid and serum IgG


title: Diagnosis and clinical management of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection: an operational recommendation of Peking Union Medical College Hospital (V2.0)

text: Since December 2019, China has been experiencing an outbreak of a new infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical features include fever, coughing, shortness of breath, and inflammatory lung infiltration. China rapidly listed SARS-CoV-2-related pneumonia as a statutory infectious disease. To standardize the diagnosis and treatment of this new infectious disease, an operational recommendation for the diagnosis and management of SARS-CoV-2 infection is developed by Peking Union Medical College Hospital.


title: Indications for healthcare surge capacity in European countries facing an exponential increase in coronavirus disease (COVID-19) cases, March 2020

text: European healthcare systems face extreme pressure from coronavirus disease (COVID-19). We relate country-specific accumulated COVID-19 deaths (intensity approach) and active COVID-19 cases (magnitude approach) to measures of healthcare system capacity: hospital beds, healthcare workers and healthcare expenditure. Modelled by the intensity approach with a composite measure for healthcare capacity, the countries experiencing the highest pressure on 25 March 2020 - relative to Italy on 11 March - were Italy, Spain, the Netherlands and France (www.covid-hcpressure.org).


title: Adamantanes might be protective from COVID-19 in patients with neurological diseases: multiple sclerosis, parkinsonism and cognitive impairment

text: Facing the outbreak of coronavirus disease 2019 (COVID-19) pandemic, there is an urgent need to find protective or curable drugs to prevent or to stop the course of the coronavirus SARS-CoV-2 infection. Recent evidence accumulates that adamantanes, widely used in different neurological diseases, could be repurposed for COVID-19. We hereby report on a questionnaire-based study performed to assess severity of COVID-19 in patients suffering from multiple sclerosis (n=10), Parkinson's disease (n=5) or cognitive impairment (n=7). In all patients infection with SARS-CoV-2 was confirmed by rtPCR of nasopharyngeal swabs. They were receiving treatment with either amantadine (n=15) or memantine (n=7) in stable registered doses. All of them had two-week quarantine since documented exposure and none of them developed clinical manifestations of infectious disease. They also did not report any significant changes in neurological status in the course of primary nervous system disease. Above results warrant further studies on protective effects of adamantanes against COVID-19 manifestation, especially in subjects suffering from neurological disease.


title: [Health protection guideline of hotels reconstructed as isolation places for close contacts during COVID-19 outbreak]

text: This guideline stipulates the health protection requirements for hotels reconstructed as isolation places for close contacts during COVID-19 outbreak, including requirements for hotels, personal health protection, and management. It is applicable to hotels reconstructed as isolation places for close contacts, such as general hotels, conference center, sanitariums, etc.


Preparing for the aftermath of COVID-19: important considerations for healthcare providers and hospital administrators


Counselling Clients During New York City's Covid-19 Pandemic: Observations on fundamental elements of emotions management


title: The added value of pirfenidone to fight inflammation and fibrotic state induced by SARS-CoV-2 : Anti-inflammatory and anti-fibrotic therapy could solve the lung complications of the infection?

text: AIM: SARS-CoV-2 infection has been divided by scientific opinion into three phases: the first as asymptomatic or slightly symptomatic and the second and the third with greater severity, characterized by a hyperinflammatory and fibrotic state, responsible for lung lesions, in some cases fatal. The development of antiviral drugs directed against SARS-CoV-2 and effective vaccines is progressing; meanwhile, the best pharmacological objective is related to the management of all the complications caused by this viral infection, mainly controlling the inflammatory and fibrotic state and preventing the infection from moving into the most serious phases. SUBJECT AND METHOD: Describe the scientific rationale related to the use of an antifibrotic therapy with pirfenidone, as monotherapy and/or in combination with anti-inflammatory drugs to manage and control complications of SARS-CoV-2 infection. RESULTS: Based on the scientific literature and epidemiological results and considering the pathophysiological, biological, and molecular characteristics of SARS-CoV-2, an antifibrotic drug such as pirfenidone as monotherapy or in combination with anti-inflammatory drugs can be (acting early, at the right doses and at the right time) therapeutically effective to avoid serious complications during viral infection. The same approach can also be effective as postinfection therapy in patients with residual pulmonary fibrotic damage. Management of inflammation and fibrotic status with a combination therapy of pirfenidone and IL-6 or IL-1 inhibitors could represent a pharmacological synergy with added value. CONCLUSION: In this article, we consider the role of antifibrotic therapy with pirfenidone in patients with SARS-CoV-2 infection on going or in the stage of postinfection with pulmonary fibrotic consequences. The scientific rationale for its use is also described.


La práctica de la Cardiología ante la pandemia por COVID-19. Recomendaciones de la comunidad cardiológica mexicana


title: Dynamic interventions to control COVID-19 pandemic: a multivariate prediction modelling study comparing 16 worldwide countries

text: To date, non-pharmacological interventions (NPI) have been the mainstay for controlling the coronavirus disease-2019 (COVID-19) pandemic. While NPIs are effective in preventing health systems overload, these long-term measures are likely to have significant adverse economic consequences. Therefore, many countries are currently considering to lift the NPIs-increasing the likelihood of disease resurgence. In this regard, dynamic NPIs, with intervals of relaxed social distancing, may provide a more suitable alternative. However, the ideal frequency and duration of intermittent NPIs, and the ideal "break" when interventions can be temporarily relaxed, remain uncertain, especially in resource-poor settings. We employed a multivariate prediction model, based on up-to-date transmission and clinical parameters, to simulate outbreak trajectories in 16 countries, from diverse regions and economic categories. In each country, we then modelled the impacts on intensive care unit (ICU) admissions and deaths over an 18-month period for following scenarios: (1) no intervention, (2) consecutive cycles of mitigation measures followed by a relaxation period, and (3) consecutive cycles of suppression measures followed by a relaxation period. We defined these dynamic interventions based on reduction of the mean reproduction number during each cycle, assuming a basic reproduction number (R0) of 2.2 for no intervention, and subsequent effective reproduction numbers (R) of 0.8 and 0.5 for illustrative dynamic mitigation and suppression interventions, respectively. We found that dynamic cycles of 50-day mitigation followed by a 30-day relaxation reduced transmission, however, were unsuccessful in lowering ICU hospitalizations below manageable limits. By contrast, dynamic cycles of 50-day suppression followed by a 30-day relaxation kept the ICU demands below the national capacities. Additionally, we estimated that a significant number of new infections and deaths, especially in resource-poor countries, would be averted if these dynamic suppression measures were kept in place over an 18-month period. This multi-country analysis demonstrates that intermittent reductions of R below 1 through a potential combination of suppression interventions and relaxation can be an effective strategy for COVID-19 pandemic control. Such a "schedule" of social distancing might be particularly relevant to low-income countries, where a single, prolonged suppression intervention is unsustainable. Efficient implementation of dynamic suppression interventions, therefore, confers a pragmatic option to: (1) prevent critical care overload and deaths, (2) gain time to develop preventive and clinical measures, and (3) reduce economic hardship globally.


title: En mann i 90-årene med feber og tørrhoste./ En mann i 90-årene med feber og tørrhoste./ A man in his nineties with fever and dry cough

text: BACKGROUND: COVID-19 can cause a fatal outcome in elderly patients, as this case report illustrates. CASE PRESENTATION: An active male in his nineties with a high level of function, despite several severe chronic diseases, was admitted to Oslo University Hospital after two days of fatigue, fever, dyspnoea and dry cough. He scored qSOFA 1 of 3 points due to high respiratory rate, and SIRS 2 of 4 points due to high respiratory rate and fever of 39.4º C. PCR for influenza virus was negative and he received benzylpenicillin for pneumonia. The chest X-ray taken initially showed no lung affection. On day 5 after symptom debut he was tested for COVID-19 which was positive. He had not been travelling to high-risk areas or been exposed to any known confirmed COVID-19 patients. On the same day, a chest CT scan was performed that showed ground-glass opacities. In subsequent days the patient's health rapidly deteriorated. He developed irreversible respiratory failure with hypoxia without hypercapnia despite substantial oxygen support. Chest X-ray taken on disease day 7 showed progression of consolidations. The patient died 9 days after symptom debut. INTERPRETATION: This case illustrates a severe course of COVID-19 with fatal outcome. The patient was also one of the earliest admitted with COVID-19 in a Norwegian hospital and marked a new phase of the epidemic, as he had not been travelling to high-risk areas or been exposed to any confirmed COVID-19 patients.


Delayed access to care and late presentations in children during the COVID-19 pandemic: a snapshot survey of 4075 paediatricians in the UK and Ireland


title: Mass spectrometry-based absolute quantification of amyloid proteins in pathology tissue specimens: Merits and limitations

text: To clarify the significance of quantitative analyses of amyloid proteins in clinical practice and in research relating to systemic amyloidoses, we applied mass spectrometry-based quantification by isotope-labeled cell-free products (MS-QBIC) to formalin-fixed, paraffin-embedded (FFPE) tissues. The technique was applied to amyloid tissues collected by laser microdissection of Congo red-stained lesions of FFPE specimens. Twelve of 13 amyloid precursor proteins were successfully quantified, including serum amyloid A (SAA), transthyretin (TTR), immunoglobulin kappa light chain (IGK), immunoglobulin lambda light chain (IGL), beta-2-microglobulin (B2M), apolipoprotein (Apo) A1, Apo A4, Apo E, lysozyme, Apo A2, gelsolin, and fibrinogen alpha chain; leukocyte cell-derived chemotaxin-2 was not detected. The quantification of SAA, TTR, IGK, IGL, and B2M confirmed the responsible proteins, even when the immunohistochemical results were not decisive. Considerable amounts of Apo A1, Apo A4, and Apo E were deposited in parallel amounts with the responsible proteins. Quantification of amyloid protein by MS-QBIC is feasible and useful for the classification of and research on systemic amyloidoses.


title: Patients with specific skin disorders who are affected by COVID-19: What do experiences say about management strategies? A systematic review

text: In patients with specific dermatologic disorders who are affected by new corona virus, we know little about disease course (underlying disease and new onset infection), and the most proper management strategies include both issues that are what this systematic review targets. Databases of PubMed, Scopus, Google Scholar, Medscape, and Centre of Evidence-Based Dermatology, coronavirus dermatology resource of Nottingham University searched completely up to May 15, 2020, and initial 237 articles were selected to further review and finally 9 articles (including 12 patients) entered to this study. From 12 patients with chronic underlying dermatologic disease treated with systemic therapies, only 1 patient required Intensive Care Unit admission, the others have been treated for mild-moderate symptoms with conventional therapies. The biologic or immunosuppressive/immunomodulator agents have been ceased during the course of disease. The course of coronovirus diseases 2019 (COVID-19) and its management was as similar as normal populations. Their underlying dermatologic disease were exacerbating from mild to moderate. Their treatment has been continued as before, after the symptoms improved. Exacerbation of patients underlying dermatologic disease was mild to moderate. Discontinuing the treatment in the acute period of COVID and the restart after recovery may prevent severe recurrence and disturbing cytokine storms in these patients.


title: Schizophrenia and COVID-19 delirium

text: Since its outbreak, coronavirus disease 2019 has been producing atypical manifestations aside from fever, coughing and dysnea. One of the most common is delirium, which, however, is highly overlooked. This has consequences in the treatment of patients and also may lead to underdiagnosing the infection. In this work, we present the case of a man diagnosed with schizophrenia, who had been stable for more than 20 years and that presented with an atypical picture of psychotic and confusional symptoms related to COVID-19 infection.


How should I manage immunosuppression in a kidney transplant patient with COVID-19? An ERA-EDTA DESCARTES expert opinion


Low-dose CT in COVID-19 outbreak: radiation safety, image wisely, and image gently pledge


title: Addressing General Surgery Residents' Concerns in the Early Phase of the COVID-19 Pandemic

text: OBJECTIVE: The purpose of this study was to determine the concerns of General Surgery residents as they prepare to be in the frontlines of the response against coronavirus disease 2019 (COVID-19_). DESIGN, SETTING, AND PARTICIPANTS: A qualitative study with voluntary dyadic and focus group interviews with a total of 30 General Surgery residents enrolled at 2 academic medical centers in Boston, Massachusetts was conducted between March 12 to 16, 2020. RESULTS: The most commonly reported personal concern related to the COVID-19 outbreak was the health of their family (30 of 30 [100%]), followed by the risk of their transmitting COVID-19 infection to their family members (24 of 30 [80%]); risk of their transmitting COVID-19 infection their patients (19 of 30 [63%]); anticipated overwork for taking care of a high number of patients (15 of 30 [50%]); and risk of their acquiring COVID-19 infection from their patients (8 of 30 [27%]) . The responses were comparable when stratified by sex, resident training level, and residency program. All residents self-expressed their readiness to take care of COVID-19 patients despite the risk of personal or familial harm . To improve their preparedness, they recommend increasing testing capacity, ensuring personal protective equipment availability, and transitioning to a shift schedule in order to minimize exposure risk and prevent burnout. CONCLUSIONS: General Surgery residents are fully dedicated to taking care of patients with COVID-19 infection despite the risk of personal or familial harm. Surgery departments should protect the physical and psychosocial wellbeing of General Surgery residents in order to increase their ability to provide care in the frontlines of the COVID-19 pandemic.


title: Epidemic characteristics of the COVID-19 outbreak in Tianjin, a well-developed city in China

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is already a pandemic. Few studies investigated the epidemic characteristics of the COVID-19 outbreak in the well-developed cities. METHODS: Epidemiological data of 136 confirmed COVID-19 cases were collected from the dataset of COVID-19 in Tianjin. All confirmed cases were categorized according to their potential infection sources. Daily numbers of confirmed cases of each category were plotted by date of onset, and the epidemic form of each category was inferred. RESULTS: Among the 136 confirmed COVID-19 cases, 48 cases were categorized as imported cases and their close contacts, which were the majority of early cases. A total of 43 cases were found an epidemiological link to the Baodi department store, and they were inferred to be a common-source outbreak. Additionally, 35 cases were considered as familial clusters of COVID-19 cases, and 10 cases were sporadic. The 45 cases were inferred to be a propagated epidemic. CONCLUSIONS: Local transmission of COVID-19 mainly occurred within families and a poorly ventilated public place in Tianjin. Besides the imported cases, the pattern of local transmission of COVID-19 was a mixture of the propagated epidemic and the common-source outbreak in Tianjin.


Severe SARS-CoV-2 pneumonia in a 58-year-old patient with HIV: a clinical case report from the Republic of Cyprus


title: Simulating human interactions in supermarkets to measure the risk of COVID-19 contagion at scale

text: Taking the context of simulating a retail environment using agent based modelling, a theoretical model is presented that describes the probability distribution of customer"collisions"using a novel space transformation to the Torus $Tor^2$. A method for generating the distribution of customer paths based on historical basket data is developed. Finally a calculation of the number of simulations required for statistical significance is developed. An implementation of this modelling approach to run simulations on multiple store geometries at industrial scale is being developed with current progress detailed in the technical appendix.


title: Outpatient management of kidney transplant recipients with suspected COVID-19-Single-center experience during the New York City surge

text: Data describing the clinical progression of coronavirus disease 2019 (COVID-19) in transplant recipients are limited. In New York City during the surge in COVID-19 cases, a systematic approach to monitoring and triaging immunocompromised transplant patients was required in the context of strained healthcare resources, limited outpatient testing, and heightened hospital exposure risks. Public health guidance at the onset of the COVID-19 outbreak recommended outpatient monitoring of mildly symptomatic patients without specific recommendations for special populations such as transplant recipients. We developed and implemented a systematic monitoring algorithm for kidney transplant recipients at our transplant center who reported mild symptoms suggestive of COVID-19. We describe the outcomes of the first 44 patients monitored through this algorithm. A total of 44 kidney transplant recipients thought to be symptomatic for COVID-19 disease were followed for a minimum of 14 days. The majority of mildly symptomatic patients (34/44) had clinical progression of disease and were referred to the emergency department where they all tested PCR positive and required hospitalization. More than half of these patients presented with hypoxia requiring supplemental oxygen, 39% were intubated within 48 hours, and 53% developed acute kidney injury but did not require dialysis. There were 6 deaths. During surge outbreaks, kidney transplant patients with even mild symptoms have a high likelihood of COVID-19 disease and most will worsen requiring hospitalization for supportive measures. Earlier outpatient testing and hospitalization may improve COVID-19 outcomes among transplant recipients.


title: Early responses of neurosurgical practice to the COVID-19 pandemic: a rapid review

text: INTRODUCTION: The novel coronavirus and subsequent pandemic have drastically transfigured healthcare delivery. Surgical specialties have seen severe alterations or reductions to practice, neurosurgery being one example where staff and resource reallocation has occurred to meet wider public health needs. This review summaries the published evidence detailing early experiences and changes to neurosurgical practice in response to the COVID-19 pandemic. MATERIALS AND METHODS: A systematic review was conducted up until 21st April in accordance with PRISMA guidelines, searching Medline, EMBASE, Pubmed, Scopus, Cochrane Central and Web of Science Core Collection databases. Individual studies were qualitatively assessed to outline core themes detailing changes to practice. Iterative analysis allowed themes to be developed and applied to all studies included in the review. RESULTS: 13 themes from 18 studies were identified, grouped into three overriding themes: logistics, human resources and clinical delivery. Studies originated from three of the most affected countries (USA, China and Italy), comprising of expert opinions, letters to the editor, editorials, case reports or perspective pieces. The commonest themes discussed include cancellation of elective operations, reduction in outpatient services and pandemic rotas. DISCUSSION: This review summaries the early responses of the neurosurgical community to the COVID-19 pandemic and presents a menu of interventions to be considered in future pandemic response, or in recurrent outbreaks of COVID-19. Whilst our review is limited by the low quality of evidence and rapid rate of change in our understanding of COVID-19, it provides a valuable summary of initial responses by the neurosurgical community to a global pandemic.


The risk of respiratory tract infections and symptoms in psoriasis patients treated with interleukin 17 pathway-inhibiting biologics: A meta-estimate of pivotal trials relevant to decision making during the COVID-19 pandemic


title: NAIST COVID: Multilingual COVID-19 Twitter and Weibo Dataset

text: Since the outbreak of coronavirus disease 2019 (COVID-19) in the late 2019, it has affected over 200 countries and billions of people worldwide. This has affected the social life of people owing to enforcements, such as"social distancing"and"stay at home."This has resulted in an increasing interaction through social media. Given that social media can bring us valuable information about COVID-19 at a global scale, it is important to share the data and encourage social media studies against COVID-19 or other infectious diseases. Therefore, we have released a multilingual dataset of social media posts related to COVID-19, consisting of microblogs in English and Japanese from Twitter and those in Chinese from Weibo. The data cover microblogs from January 20, 2020, to March 24, 2020. This paper also provides a quantitative as well as qualitative analysis of these datasets by creating daily word clouds as an example of text-mining analysis. The dataset is now available on Github. This dataset can be analyzed in a multitude of ways and is expected to help in efficient communication of precautions related to COVID-19.


Reply to: "Reply: A dermatologic manifestation of COVID-19: Transient livedo reticularis"


title: Challenges in teaching human anatomy to students with intellectual disabilities during the Covid-19 pandemic

text: In the context of the Covid-19 pandemic and the various subsequent changes and behavioral adjustments necessary in the educational field, two important articles were recently published in Anatomical Sciences Education (Franchi, 2020; Srinivasan, 2020). The first study (Franchi, 2020) reported the impact of the pandemic on human anatomy education in the United Kingdom. This article described from the perspective of a medical student how the lack of practical teaching with cadavers can adversely impact training and lead to losses for students.


title: Off-the-shelf barrier for emergency intubation in the cardiac catheterization laboratory during the coronavirus disease 2019 (COVID-19) pandemic

text: With the spread of SARS-CoV-2, it is expected that cases of acute coronary syndrome in the setting of coronavirus disease 2019 (COVID-19) develop. As expensive and sophisticated protection devices are not widely available, we have been working on a simple, off-the-shelf protection device for endotracheal intubation of potentially infected patients. For this purpose, we used a large transparent plastic bag (such as the sterile protective cover of the lead glass shield) for protection from airborne infections. The cover is moved over the patient's head from cranial to caudal, covering the catheter table including the torso with no need for patient mobilization. The intubation is done conventionally under direct visual control.


Today's actions shape tomorrow's world: is the Coronavirus Pandemic (COVID-19) eroding our privacy?


Serology-positive but minimally symptomatic COVID-19 may still cause lung injury and lung function impairment


title: Association of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use With COVID-19 Diagnosis and Mortality

text: Importance: It has been hypothesized that angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) may make patients more susceptible to coronavirus disease 2019 (COVID-19) and to worse outcomes through upregulation of the functional receptor of the virus, angiotensin-converting enzyme 2. Objective: To examine whether use of ACEI/ARBs was associated with COVID-19 diagnosis and worse outcomes in patients with COVID-19. Design, Setting, and Participants: To examine outcomes among patients with COVID-19, a retrospective cohort study using data from Danish national administrative registries was conducted. Patients with COVID-19 from February 22 to May 4, 2020, were identified using ICD-10 codes and followed up from day of diagnosis to outcome or end of study period (May 4, 2020). To examine susceptibility to COVID-19, a Cox regression model with a nested case-control framework was used to examine the association between use of ACEI/ARBs vs other antihypertensive drugs and the incidence rate of a COVID-19 diagnosis in a cohort of patients with hypertension from February 1 to May 4, 2020. Exposures: ACEI/ARB use was defined as prescription fillings 6 months prior to the index date. Main Outcomes and Measures: In the retrospective cohort study, the primary outcome was death, and a secondary outcome was a composite outcome of death or severe COVID-19. In the nested case-control susceptibility analysis, the outcome was COVID-19 diagnosis. Results: In the retrospective cohort study, 4480 patients with COVID-19 were included (median age, 54.7 years [interquartile range, 40.9-72.0]; 47.9% men). There were 895 users (20.0%) of ACEI/ARBs and 3585 nonusers (80.0%). In the ACEI/ARB group, 18.1% died within 30 days vs 7.3% in the nonuser group, but this association was not significant after adjustment for age, sex, and medical history (adjusted hazard ratio [HR], 0.83 [95% CI, 0.67-1.03]). Death or severe COVID-19 occurred in 31.9% of ACEI/ARB users vs 14.2% of nonusers by 30 days (adjusted HR, 1.04 [95% CI, 0.89-1.23]). In the nested case-control analysis of COVID-19 susceptibility, 571 patients with COVID-19 and prior hypertension (median age, 73.9 years; 54.3% men) were compared with 5710 age- and sex-matched controls with prior hypertension but not COVID-19. Among those with COVID-19, 86.5% used ACEI/ARBs vs 85.4% of controls; ACEI/ARB use compared with other antihypertensive drugs was not significantly associated with higher incidence of COVID-19 (adjusted HR, 1.05 [95% CI, 0.80-1.36]). Conclusions and Relevance: Prior use of ACEI/ARBs was not significantly associated with COVID-19 diagnosis among patients with hypertension or with mortality or severe disease among patients diagnosed as having COVID-19. These findings do not support discontinuation of ACEI/ARB medications that are clinically indicated in the context of the COVID-19 pandemic.


title: Early assessment of the impact of mitigation measures on the COVID-19 outbreak in Italy

text: BACKGROUND: On March 11, 2020, the World Health Organization characterized the novel coronavirus disease 2019 (COVID-19) outbreak as a pandemic. The first cases in Italy were reported on January 30, 2020, and the outbreak quickly escalated. On March 19, 2020, deaths in Italy surpassed those in China. The Italian government implemented progressively restrictive measures leading to a nationwide lockdown on March 8, 2020. This study aimed to assess the impact of mitigation measures implemented in Italy on the spread of COVID-19. METHODS: Publicly available data were used to evaluate changes in the growth curve of the number of patients hospitalized in intensive care (IC) at three time intervals between February 19, 2020, and April 9, 2020, after the implementation of progressive measures: (1) containment and travel restrictions, (2) lockdown of the epicenter of the outbreak, and (3) school closures and nationwide lockdown. The models that showed the highest reliability according to the Akaike information criterion and based on data from the three time intervals were projected to assess how the epidemic would have evolved if no other measure had been implemented. RESULTS: The most reliable models were (1) exponential, (2) quadratic, and (3) cubic (R2 = 0.99, >0.99, and > 0.99 respectively), indicating a progressive decrease in the growth of the curve. CONCLUSION: This study suggests the measures were effective in flattening the epidemic curve and bought valuable time, allowing for the number of IC beds to be nearly doubled before the national health system reached maximum capacity.


title: Navigating regulatory statutes during the Coronavirus Disease 2019

text: Disclaimer: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.


title: The dark cloud with a silver lining: Assessing the impact of the SARS COVID-19 pandemic on the global environment

text: The Severe Acute Respiratory Syndrome-Coronavirus Disease 2019 (COVID-19) pandemic caused by a novel coronavirus known as SARS-CoV-2 has caused tremendous suffering and huge economic losses. We hypothesized that extreme measures of partial-to-total shutdown might have influenced the quality of the global environment because of decreased emissions of atmospheric pollutants. We tested this hypothesis using satellite imagery, climatic datasets (temperature, and absolute humidity), and COVID-19 cases available in the public domain. While the majority of the cases were recorded from Western countries, where mortality rates were strongly positively correlated with age, the number of cases in tropical regions was relatively lower than European and North American regions, possibly attributed to faster human-to-human transmission. There was a substantial reduction in the level of nitrogen dioxide (NO2: 0.00002 mol m-2), a low reduction in CO (<0.03 mol m-2), and a low-to-moderate reduction in Aerosol Optical Depth (AOD: ~0.1-0.2) in the major hotspots of COVID-19 outbreak during February-March 2020, which may be attributed to the mass lockdowns. Our study projects an increasing coverage of high COVID-19 hazard at absolute humidity levels ranging from 4 to 9 g m-3 across a large part of the globe during April-July 2020 due to a high prospective meteorological suitability for COVID-19 spread. Our findings suggest that there is ample scope for restoring the global environment from the ill-effects of anthropogenic activities through temporary shutdown measures.


The Path Forward: Academic Neurology Responds to COVID-19


Heart Failure Editorial Emergencies in the COVID-19 Era


Covid-19 and lack of linked datasets for care homes


title: Correction to: Energy replacement diminishes the postprandial triglyceridelowering effect from accumulated walking in older women

text: The original version of this article unfortunately contained a mistake. The error of NEFA AUC values in first (mean and 95% CI) and the main text (effect size and 95% CI).


A chilblain epidemic during the COVID-19 pandemic. A sign of natural resistance to SARS-CoV-2?


Wissenschaft in Zeiten von Corona - alles und nichts geht


With COVID-19, modeling takes on life and death importance


Baricitinib therapy in COVID-19: A pilot study on safety and clinical impact


Editorial - High dose intravenous immunoglobulins as a therapeutic option for COVID-19 patients


title: Play or science?: a study of learning and framing in crowdscience games

text: Crowdscience games may hold unique potentials as learning opportunities compared to games made for fun or education. They are part of an actual science problem solving process: By playing, players help scientists, and thereby interact with real continuous research processes. This mixes the two worlds of play and science in new ways. During usability testing we discovered that users of the crowdscience game Quantum Dreams tended to answer questions in game terms, even when directed explicitly to give science explanations.We then examined these competing frames of understanding through a mixed correlational and grounded theory analysis. This essay presents the core ideas of crowdscience games as learning opportunities, and reports how a group of players used"game","science"and"conceptual"frames to interpret their experience. Our results suggest that oscillating between the frames instead of sticking to just one led to the largest number of correct science interpretations, as players could participate legitimately and autonomously at multiple levels of understanding.


title: Caffeine removal using Elaeis guineensis activated carbon: adsorption and RSM studies

text: The palm (Elaeis guineensis), known as dendê, is an important oleaginous Brazilian plant with a high performance of oil production. In this work, a 23 full experimental design was performed and the response surface method (RSM) was used to indicate the optimum parameter of caffeine adsorption on Elaeis guineensis endocarp activated carbon, since the endocarp is the main by-product from dendê oil production. It was set the adsorbent point of zero charge (pHpzc), and the material was characterized by Fourier transform infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA), and scanning electron microscopy (SEM). The RSM results indicate removal efficiency (%) at the optimal conditions, 0.20 g of adsorbent, and caffeine initial concentration of 20 mg/L, and acidic medium was about 95%. Based on ANOVA and F test (Fcalculated > Fstandard), the mathematical/statistical model obtained fits well to the experimental data. The overall kinetic studies showed time was achieved after 5 h and caffeine adsorption followed the pseudo-second-order model suggesting chemisorption is a predominant mechanism. Redlich-Peterson and Sips models best represented the experimental data (0.967 < R2 < 0.993). Thermodynamic revealed that caffeine adsorption was spontaneous at all temperatures studied, exothermic, and probably with changes in the adsorbate-adsorbent complex during the process. The tests conducted in different water matrixes corroborate the suitability of this adsorbent to be used in caffeine removal even in a complex solution.


Using echocardiography to guide the treatment of novel coronavirus pneumonia


title: The role of testing in infectious disease control: A case of COVID-19 in Africa

text: The dramatic increase in COVID-19 suspected cases in Africa has placed enormous burden on public and private clinical facilities. Till date, the most commonly used method for the identification and confirmation of the virus is the laboratory-based reverse transcription-polymerase chain reaction (RT-PCR) testing. Unfortunately, testing capacities have been limited in many parts of Africa because of inadequate test kits which have restricted scaling up beyond the few public health laboratories at designated locations. We present in this mini-review Africa's preparedness and readiness toward testing, why testing is crucial, the need to immediately strengthen existing facilities and what it involves as combined approaches for managing the COVID-19 crisis. The review highlights the urgent need for speedy expansion and distribution of several laboratory testing platforms to public health facilities and fully accredited private clinical laboratories, including real-time PCR and serological assays.


title: Just the Facts: Airway management during the coronavirus disease 2019 (COVID-19) pandemic

text: A previously healthy 42-year-old male developed a fever and cough shortly after returning to Canada from overseas. Initially, he had mild upper respiratory tract infection symptoms and a cough. He was aware of the coronavirus disease-2019 (COVID-19) and the advisory to self-isolate and did so; however, he developed increasing respiratory distress over several days and called 911. On arrival at the emergency department (ED), his heart rate was 130 beats/min, respiratory rate 32 per/min, and oxygenation saturation 82% on room air. As per emergency medical services (EMS) protocol, they placed him on nasal prongs under a surgical mask at 5 L/min and his oxygen saturation improved to 86%.


Structural Basis for Potent Neutralization of Betacoronaviruses by Single-Domain Camelid Antibodies


title: Medical leadership in the NHS during the COVID-19 pandemic

text: Amid the global COVID-19 pandemic, adaptation of healthcare systems, with strong medical leadership, has been integral to coping with the ever-changing situation. This article is based on the personal experiences of doctors in the NHS and insights into the frontline response to this situation. It reflects on leadership dilemmas and strategies implemented to overcome them, with a focus on systems thinking and adaptive leadership.


Editorial. Impact of COVID-19 on neurosurgery resident training and education


title: [An analysis of global research on SARS-CoV-2]

text: The SARS-CoV-2 has been spread to 26 countries around the world since its outbreak. By February 16, 2020, more than 68 000 people had been diagnosed with COVID-19. Researchers from all over the world have carried out timely studies on this public health emergency and produced a number of scientific publications. This review aims to re-analyze and summarize the current research findings in a timely manner to guide scholars in relevant fields to further SARS-CoV-2 research and assist healthcare professionals in their work and decision-making. The SARS-CoV-2 related terms were selected in both English and Chinese and were searched in several major databases, including Pubmed, Web of Science, CNKI, Wanfang, and VIP databases. The reference list of each search result was screened for relevance, which was further supplemented to the search results. The included studies were categorized by topics with key characteristics extracted, re-analyzed, and summarized. A total of 301 articles were finally included with 136 in Chinese and 165 in English. The number of publications has rapidly increased since mid-January, 2020, and a peak day was 6th February on which 50 articles were published. The top three countries publishing articles were China, the United States and the United Kingdom. The Lancet and its specialty journals have published the most articles, with contribution also from journals such as New England Journal of Medicine ( NEJM), The Journal of the American Medical Association ( JAMA), and Nature. All articles were categorized into epidemiology, clinical diagnosis and treatment, basic research, pregnant women and children, mental health, epidemic prevention & control, and others. The literatures related to SARS-CoV-2 are emerging rapidly. It is necessary to sort out and summarize the research topic in time, which has a good reference value for staff in different positions. At the same time, it is necessary to strengthen the judgment of the quality of literatures.


title: Self-Control Moderates the Association Between Perceived Severity of Coronavirus Disease 2019 (COVID-19) and Mental Health Problems Among the Chinese Public

text: Coronavirus disease 2019 (COVID-19) has caused thousands of deaths in China. Prior research suggests that individuals' perceived severity of COVID-19 is related to a range of negative emotional and behavioral reactions among the Chinese public. However, scant research has examined the underlying mechanisms. Drawing upon the risk-resilience model, this study proposes that self-control, as a resilient factor, would potentially moderate the association between perceived severity of COVID-19 and mental health problems. Data from a national survey was used to examine this idea. Participants were 4607 citizens from 31 regions in China (Mage = 23.71 years, 72.5% female) who completed a national survey at the beginning of February 2020. Results of hierarchical regression showed that after controlling for a number of demographic variables, perceived severity of COVID-19 and self-control were positively and negatively related to mental health problems, respectively. More importantly, self-control moderated the "perceived severity of COVID-19-mental health problems" association, with this link attenuating as the levels of self-control increased. These findings suggest that compared to those with high self-control, individuals with low self-control are more vulnerable and are more in need of psychological aids to maintain mental health in the encounter of the COVID-19 outbreak. Practically, enhancing individuals' self-control ability might be a promising way to improve individuals' mental health during the early period of the COVID-19 outbreak.


title: A cluster of COVID-19 in pilgrims to Israel

text: This report describes a cluster of SARS-CoV-2 infections in pilgrims returning from Israel to Greece. Out of 53 pilgrims, 48 (90.5%) were tested positive for SARS-CoV-2; of them, 41 (85.4%) developed symptoms consistent with COVID-19, and 7 (14.6%) remained asymptomatic. These cases suggest a high risk of COVID-19 infection for pilgrims traveling during the pandemic. Although at that time the prevalence of the disease was low in the origin and destination countries, crowded exposure to other pilgrims from many other countries led to this cluster. Increasing awareness about the risks in pilgrims is important and particularly for elderly pilgrims and those with underlying conditions.


The effective use of telemedicine to save lives and maintain structure in a healthcare system: Current response to COVID-19


title: COVID-19 Outbreak: An Overview on Dentistry

text: Coronavirus disease 2019, also called COVID-19, is the latest infectious disease to rapidly develop worldwide [...].


title: Scientific comment on"Tail risk of contagious diseases"

text: Cirillo and Taleb [Nature Phys. 16, 606-613 (2020)] study the size of major epidemics in human history in terms of the number of fatalities. Using the figures from 72 epidemics, from the plague of Athens (429 BC) to the COVID-19 (2019-2020), they claim that the resulting fatality distribution is ``extremely fat-tailed'', i.e., asymptotically a power law. This has important consequences for risk, as the mean value of the fatality distribution becomes infinite. Reanalyzing the same data, we find that, although the data may be compatible with a power-law tail, these results are not conclusive, and other distributions, not fat-tailed, could explain the data equally well. Simulation of a log-normally distributed random variable provides synthetic data whose statistics are undistinguishable from the statistics of the empirical data.


Unprecedented surge in publications related to COVID-19 in the first three months of pandemic: A bibliometric analytic report


Everything Old is New again: COVID-19 and Public Health


title: Screening for COVID-19: Patient factors predicting positive PCR test

text: To inform the efficient allocation of testing resources, we evaluated the characteristics of those tested for COVID-19 to determine predictors of a positive test. Recent travel and exposure to a confirmed case were both highly predictive of positive testing. Symptom-based screening strategies alone may be inadequate to control the ongoing pandemic.


How Do We Balance Tensions Between COVID-19 Public Health Responses and Stigma Mitigation? Learning from HIV Research


title: COVID-19: What Should Interventional Radiologists Know and What Can They Do?

text: The outbreak of coronavirus disease 2019 (COVID-19) in late December 2019 in Wuhan, China, has been characterized as a "pandemic" by the World Health Organization and has resulted in 81,603 confirmed cases in China, among the 334,981 cases confirmed in 189 countries as of 09:00 am, March 24, 2020 (China central standard time). During the past 3 months, hundreds of thousands of Chinese health care workers, including interventional radiologists (IRs), have been fighting this battle against the horrifying COVID-19 disease. As IRs, what should we know and what can we do when facing this challenge? This paper shares the experience we have gone through.


COVID-19: Considerations of Diabetes and Cardiovascular Disease Management


title: Mütter-Screening in einem COVID-19-Niedrig-Pandemiegebiet: Bestimmung SARS-CoV-2-spezifischer Antikörper bei 401 Rostocker Müttern mittels ELISA und Immunfluoreszenz-Bestätigungstest./ [Screening of Mothers in a COVID-19 Low-Prevalence Region: Determination of SARS-CoV-2 Antibodies in 401 Mothers from Rostock by ELISA and Confirmation by Immunofluorescence]

text: BACKGROUND: In children, the infection with SARS-CoV-2, the cause of COVID-19, tends to be clinically inapparent more often or less severe than in adults. The spread of this infection from children poses a danger to vulnerable adults. Therefore, child care institutions and schools currently are widely closed. METHODS: Since the status of infection tends to be congruent in mothers and their children, we tested 401 mothers of children between 1 and 10 years in the city of Rostock (State of Mecklenburg-Westpomerania, northeast of Germany), for the presence of RNA of SARS-CoV-2 in throat swabs, and of antibodies against SARS-CoV-2 in serum. RESULTS: In none of the mothers tested, RNA of this virus was detected in the throat swab. In the ELISA test, IgG antibodies were positive in one serum sample, IgA antibodies were positive in 11, and borderline in 3 serum samples. All 401 sera were negative in the indirect immunofluorescence test (IIFT) with FITC-labeled IgG, IgA, und IgM antibodies. CONCLUSION: At the time of this study, neither SARS-CoV-2 RNA, nor specific antibodies against SARS-CoV-2 were detectable in the mothers tested in Rostock.


Reverse quarantine in Kerala: managing the 2019 novel coronavirus in a state with a relatively large elderly population


Immunomodulation for the management of corona virus disease (COVID-19)


title: Contact Tracing: An Overview of Technologies and Cyber Risks

text: The 2020 COVID-19 pandemic has led to a global lockdown with severe health and economical consequences. As a result, authorities around the globe have expressed their needs for better tools to monitor the spread of the virus and to support human labor. Researchers and technology companies such as Google and Apple have offered to develop such tools in the form of contact tracing applications. The goal of these applications is to continuously track people's proximity and to make the smartphone users aware if they have ever been in contact with positively diagnosed people, so that they could self-quarantine and possibly have an infection test. A fundamental challenge with these smartphone-based contact tracing technologies is to ensure the security and privacy of their users. Moving from manual to smartphone-based contact tracing creates new cyber risks that could suddenly affect the entire population. Major risks include for example the abuse of the people's private data by companies and/or authorities, or the spreading of wrong alerts by malicious users in order to force individuals to go into quarantine. In April 2020, the Pan-European Privacy-Preserving Proximity Tracing (PEPP-PT) was announced with the goal to develop and evaluate secure solutions for European countries. However, after a while, several team members left this consortium and created DP-3T which has led to an international debate among the experts. At this time, it is confusing for the non-expert to follow this debate; this report aims to shed light on the various proposed technologies by providing an objective assessment of the cybersecurity and privacy risks. We first review the state-of-the-art in digital contact tracing technologies and then explore the risk-utility trade-offs of the techniques proposed for COVID-19. We focus specifically on the technologies that are already adopted by certain countries.


title: Coronavirus and financial volatility: 40 days of fasting and fear

text: 40 days after the start of the international monitoring of COVID-19, we search for the effect of official announcements regarding new cases of infection and death ratio on the financial markets volatility index (VIX). Whereas the new cases reported in China and outside China have a mixed effect on financial volatility, the death ratio positively influences VIX, that outside China triggering a more important impact. In addition, the higher the number of affected countries, the higher the financial volatility is.


title: CT imaging features of 34 patients infected with COVID-19

text: Objective: To retrospectively analyze the CT findings in patients infected with Coronavirus disease 2019 (COVID-19). Materials and methods: The thirty-four cases, 15 females and 19 males, with an age ranging from 7 to 88â¯years old, confirmed by real-time reverse-transcriptase-polymerase chain reaction (RT-PCR), were used for our study. All thin-section CT scans of the lungs were performed in all of patients. The clinical, laboratory and CT imaging were available to evaluate in all patients. Results: The patients present with fever (85.29%, nâ¯=â¯29), cough (67.65%, nâ¯=â¯23), fatigue or myalgia (26.47%, nâ¯=â¯9), and pharyngalgia (8.82%, nâ¯=â¯3). The 4 patients (11.76%) with no symptoms were identified during screening for close contacts, who had typical CT findings. On initial CT scans, the bilateral lung involved was shown in 24 cases (70.59%), while 29 (82.35%) cases were distributed in peripheral. The pure ground glass opacity (GGO) was shown in 18 cases (52.94%), the GGO with consolidation was in 12 cases (35.29%), and full consolidation only in 3 cases. The lesion with air bronchogram was seen in 14 (41.18%) cases, with enlarged blood vessel in 17 (50.00%) cases, with crazy-paving pattern in 8 (23.53%) cases, with fine reticular pattern in 4 (11.77%) cases, and with intralesional vacuole sign in 6 (17.65%) cases. The pleural effusion was seen in one patient. Follow-up imaging in 19 patients during the study time window demonstrated mild, moderate or severe progression of disease, as manifested by increasing extent and density of lung opacities. Conclusions: The bilateral GGO with air bronchogram, enlarged blood vessel, fine reticular pattern, and peripheral distribution are the early CT findings of COVID-19. The crazy-paving pattern and intralesional vacuole sign are the features of progressive stage.


The BTK inhibitor ibrutinib may protect against pulmonary injury in COVID-19-infected patients


title: An urgent impetus for action: safe inhalation interventions to reduce COVID-19 transmission and fatality risk among people who smoke crack cocaine in the United Kingdom

text: Crack cocaine use is rising in the United Kingdom (UK), with smoking the primary form of administration. Provision of safe inhalation equipment for crack cocaine is prohibited under UK law. Pipes used for crack cocaine smoking are often homemade and/or in short supply, exacerbating COVID-19 transmission and respiratory risk. This is of concern, given high prevalence of respiratory health harms such as chronic obstructive pulmonary disease (COPD) among people who smoke illegal drugs. This commentary draws on scoping review and mixed method empirical evidence to argue for provision of safe crack inhalation equipment in the UK, with commensurate legal reform. Review of crack inhalation interventions illustrates the health protective and service engagement benefits of smoking equipment supply. Survey data generated with 455 people who inject drugs in London illustrate high prevalence of current crack use (66%, n=299). Qualitative accounts illustrate perceptions of relative smoking safety - alongside accounts of severe respiratory-related health harms. To date, injecting drug use has been of primary concern in relation to harm reduction initiatives. It is crucial that people who smoke illegal drugs are considered a vulnerable population in regard to COVID 19 transmission and fatality risk, with innovative harm reduction measures scaled up in response.


Optical techniques for fast screening - Towards prevention of the coronavirus COVID-19 outbreak


title: O papel da atenção primária no combate ao Covid-19: impacto na saúde pública e perspectivas futuras

text: A doença do novo Coronavírus (Covid-19) é causada pelo SARS-CoV-2 e representa o agente causador de uma doença potencialmente fatal que tem se revelado um problema de saúde pública global A pandemia causada pelo Covid-19 tem causado prejuízos severos nos sistemas de saúde em diversos países Diante do grande número de pessoas infectadas e da ausência de tratamento específico, várias nações têm enfrentado superlotação em seus hospitais Com a confirmação de casos desta doença no Brasil, várias ações têm sido tomadas por gestores públicos e privados, tanto a nível hospitalar quanto em nível de atenção primária, a fim de minimizar os impactos para o Sistema Único de Saúde (SUS) O presente artigo apresenta uma breve análise do papel da atenção primária na luta contra o Covid-19 em âmbito nacional, além do impacto em saúde pública e das futuras perspectivas Com base no grande número de pessoas infectadas no mundo e a experiência de diversos sistemas de saúde, torna-se imperativo a adaptação e adequação do SUS na condução de mecanismos de resposta para pandemia, sendo a atenção primária peça fundamental neste processo The new coronavirus (Covid-19) disease is caused by SARS-CoV-2 and represents the causative agent of a potentially fatal disease that has proved to be a global public health problem The pandemic caused by Covid-19 has caused severe damage to health systems in several countries In view of the large number of infected people and the lack of specific treatment, several nations have faced overcrowding in their hospitals With the confirmation of cases of this disease in Brazil, several actions have been taken by managers, both at the hospital level and at the level of primary care, in order to minimize the damage in the Unified Health System (SUS) This article presents a brief analysis of the role of primary care in the fight against Covid-19 at the national level, in addition to the impact on public health and future perspectives Based on the large number of infected people in the world and the experience of different health systems, it is imperative to adapt and adequation the SUS in conducting response mechanisms for the pandemic, with primary care being a fundamental part of this process La enfermedad del nuevo coronavirus (Covid-19) es causada por el SARS-CoV-2 y representa el agente causal de una enfermedad potencialmente mortal que ha demostrado ser un problema global de salud pública La pandemia causada por Covid-19 ha causado graves daños a los sistemas de salud en varios países En vista de la gran cantidad de personas infectadas y la falta de tratamiento específico, varias naciones han enfrentado hacinamiento en sus hospitales Con la confirmación de los casos de esta enfermedad en Brasil, los gerentes han tomado varias medidas, tanto a nivel hospitalario como a nivel de atención primaria, para minimizar el daño en el Sistema Único de Salud (SUS) Este artículo presenta un breve análisis del papel de la atención primaria en la lucha contra Covid-19 en todo el país, además del impacto en la salud pública y las perspectivas futuras Basado en la gran cantidad de personas infectadas en el mundo y la experiencia de diferentes sistemas de salud, es imperativo adaptar y adaptar el SUS en la conducción de mecanismos de respuesta a la pandemia, siendo la atención primaria una parte fundamental de este proceso


title: Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

text: BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. METHODS: We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respiratory syndrome, and Middle East respiratory syndrome from 21 standard WHO-specific and COVID-19-specific sources. We searched these data sources from database inception to May 3, 2020, with no restriction by language, for comparative studies and for contextual factors of acceptability, feasibility, resource use, and equity. We screened records, extracted data, and assessed risk of bias in duplicate. We did frequentist and Bayesian meta-analyses and random-effects meta-regressions. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO, CRD42020177047. FINDINGS: Our search identified 172 observational studies across 16 countries and six continents, with no randomised controlled trials and 44 relevant comparative studies in health-care and non-health-care settings (n=25â697 patients). Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10â736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] -10·2%, 95% CI -11·5 to -7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD -14·3%, -15·9 to -10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12-16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD -10·6%, 95% CI -12·5 to -7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings. INTERPRETATION: The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance. FUNDING: World Health Organization.


Safe delivery for pregnancies affected by COVID-19


title: Unlikely SARS-CoV-2 vertical transmission from mother to child: A case report

text: As the 2019 novel coronavirus disease (COVID-19) rapidly spread across China and to more than 70 countries, an increasing number of pregnant women were affected. The vertical transmission potential of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is of great concern to the obstetrics, neonatologists, and public health agencies. Though some studies indicated the risk of vertical transmission is low, few cases have been reported with comprehensive serial tests from multiple specimens. In this case, a female preterm infant was born to a mother with confirmed COVID-19. She presented with mild respiratory distress and received general management and a short period of nasal continuous positive airway pressure support. During her stay at the hospital, a series of SARS-CoV-2 nucleic test from her throat and anal swab, serum, bronchoalveolar lavage fluid, and urine were negative. The nucleic acid test from the mother's amniotic fluid, vaginal secretions, cord blood, placenta, serum, anal swab, and breast milk were also negative. The most comprehensively tested case reported to date confirmed that the vertical transmission of COVID is unlikely, but still, more evidence is needed.


Impact of the COVID-19 Epidemic on a Pan-Asian Academic Oncology Clinical Trial


title: Asymptomatic COVID-19: What the Neuroradiologist Needs to Know about Pulmonary Manifestations

text: Coronavirus disease 2019 (COVID-19) is an infectious disease with a high asymptomatic incidence. Asymptomatic infections within a population will inevitably lead to diagnosis via unrelated medical imaging. We report the case of an asymptomatic patient undergoing a spine CT examination for trauma who was incidentally found to have lung abnormalities later confirmed to be COVID-19. We aim to familiarize neuroradiologists with the spectrum of COVID-19 pulmonary manifestations that are likely to be observed on neck and spine CT imaging.


title: 'Do not resuscitate me in Barbados'

text: New ways of encouraging discussion and education around the topic of do not attempt cardiopulmonary resuscitation (DNACPR) decisions in healthcare can prove challenging. Cardiopulmonary resuscitation is still portrayed as an intervention that is successful even in people with multiple long-term conditions. In 2020, during the first months of the COVID-19 pandemic, a letter from a palliative care doctor to his patient was read out as part of an online campaign entitled #ReadALetter, organised by the organisation Letters Live. The letter addresses misconceptions regarding DNACPR decisions and encourages thoughtful dialogue. In particular, it promotes an individualised approach for clinicians, and investigates one patient's journey: from initially rejecting the concept, to later on fully embracing it as part of his holistic care. A journey that took him to Barbados, amongst other places.


title: Suicide risk during the lockdown due to coronavirus disease (COVID-19) in Colombia

text: The study aimed to estimate the high suicide risk during the COVID-19 lockdown in the Colombian population. A total of 700 adults aged between 18 and 76 years (M = 37.1, SD = 12.7; 68.0% women) completed an online questionnaire. Findings showed that 7.6% of participants reported a high suicide risk. High suicide risk was associated with high perceived stress related to COVID-19, risk of depressive episode, and insomnia. Our study suggests that 1 out of 13 Colombians in a non-probability sample reports a high suicide risk during COVID-19. Findings need to be corroborated in a representative sample of Colombians.


title: [Current status for urpper tract transitional cell carcinoma during COVID-19 pandemia.]

text: INTRODUCTION: First cases of COVID-19 were reported in China on December 2019 and rapidly spread globally The explosive increase in number of cases requiring hospitalization has led to a delay in a big number of surgical interventions, including oncologic surgeries Collateral effects of this increase means a challenge for urologists, who have been forced to redistribute their resources Due to its poor pronostic, patients suffering from by upper tract urinary tumours will be negatively affected by this pandemic METHODS: A non sistematic review was performed using literature published until May 23, 2020, using "Uppertract urothelial tumours", "COVID-19" and "nephroureterectomy" as keywords The resulting manuscript was critically revised by national authors in order to establish common criteria about treatment and follow up EVIDENCE SYNTHESIS: Four studies were identified that assessed the impact of delaying radical nephrouretrectomy as curative treatment These studies showed that surgery delays decrease overall survival and cancer specific survival rates in high-risk groups On the other hand, delaying radical nephrouretrectomy due to ureteroscopy did not affect survival in cohorts of patients with predominately low-grade disease CONCLUSIONS: A delay in curative treatment of upper tract urothelial tumours for more than three months results in adverse outcomes as overal survival and cancer specific survival Hence, it is important to prioritize the timely care of this group of patients as far as COVID-19 pandemic allows it


title: Current status for urpper tract transitional cell carcinoma during COVID-19 pandemia./ Situacion actual de los tumores del tracto urinario superior en el contexto de la pandemia por Covid-19

text: INTRODUCTION: First cases of COVID-19 were reported in China on December 2019 and rapidly spread globally The explosive increase in number of cases requiring hospitalization has led to a delay in a big number of surgical interventions, including oncologic surgeries Collateral effects of this increase means a challenge for urologists, who have been forced to redistribute their resources Due to its poor pronostic, patients suffering from by upper tract urinary tumours will be negatively affected by this pandemic METHODS: A non sistematic review was performed using literature published until May 23, 2020, using "Uppertract urothelial tumours", "COVID-19" and "nephroureterectomy" as keywords The resulting manuscript was critically revised by national authors in order to establish common criteria about treatment and follow up EVIDENCE SYNTHESIS: Four studies were identified that assessed the impact of delaying radical nephrouretrectomy as curative treatment These studies showed that surgery delays decrease overall survival and cancer specific survival rates in high-risk groups On the other hand, delaying radical nephrouretrectomy due to ureteroscopy did not affect survival in cohorts of patients with predominately low-grade disease CONCLUSIONS: A delay in curative treatment of upper tract urothelial tumours for more than three months results in adverse outcomes as overal survival and cancer specific survival Hence, it is important to prioritize the timely care of this group of patients as far as COVID-19 pandemic allows it INTRODUCCION: Los primeros casos de la enfermedad por coronavirus (Coronavirus Disease 19, tambien denominada COVID-19) aparecieron en China en diciembre de 2019, desde donde se extendieron al resto del mundo La rapida aparicion de casos y el alto volumen de pacientes que han requerido hospitalizacion han provocado la demora de un gran numero de intervenciones quirurgicas, incluidas las cirugias oncologicas Todo ello esta suponiendo un reto para los servicios de urologia de todo el mundo, y obliga a una redistribucion de sus recursos Los pacientes con tumores del tracto urotelial superior (TUS), en muchos casos de mal pronostico, se pueden ver potencialmente afectadospor esta situacion MATERIAL Y METODOS: Se realizo una busqueda no sistematica en web y en PubMed utilizando las palabras clave Upper tract urothelial tumours, COVID-19 ,nephroureterectomy Se realizo una revision narrativa de la literatura incluyendo solo articulos y documentos escritos en lengua espanola e inglesa Se remitio el documento a varios autores nacionales expertos en patologia del urotelio superior, con el fin de unificar criterios y experiencias para llegar a un rapido consenso sobre la importancia relativa de las distintas actividades, problemas y soluciones EVIDENCIA CIENTIFICA: Diversos estudios tratan de determinar el impacto que presenta el retraso en la realizacion de la nefroureterectomia como tratamiento curativo, siendo el punto de corte de 3 meses en la mayoria de ellos Tres de ellos concluyen que dicha demora implica una disminucion de la supervivencia global y cancer especifica, mientras que el retraso de la nefroureterectomia radical debido a la realizacion de ureterorrenoscopia (URS) como tratamiento conservador en tumores de bajo grado no parece tener impacto en la supervivencia CONCLUSIONES: El retraso en el tratamiento de los tumores del TUS a 3 meses supone una disminucion de la supervivencia global y cancer especifica Por ello, el tratamiento de esta patologia no deberia demorarse, en la medida en que los recursos hospitalarios y la alerta sanitaria por COVID-19 lo permita


Should patients stop their biologic treatment during the COVID-19 pandemic


title: Community pharmacists and communication in the time of COVID-19: Applying the health belief model

text: The emergence of the novel coronavirus disease (COVID-19) pandemic presents an unprecedented health communications challenge. Healthcare providers should reinforce behaviors that limit the spread of the pandemic, including social distancing and remaining in the home whenever possible. Formal communications toolkits may not be prepared in a timely fashion. Community pharmacists can reinforce mitigation behaviors by applying the health belief model (HBM). This commentary provides an overview of the HBM and offers suggestions on how community pharmacists can use it as a guide to patient communication in these uncertain contexts.


title: The COVID-19 pandemic: is there a role for magnesium? Hypotheses and perspectives

text: More and more studies are accumulating about COVID-19. Some aspects of the pathogenesis of the disease recall events occurring in Mg deficiency, such as a drop of T cells, increased plasma concentration of inflammatory cytokines, and endothelial dysfunction. We hypothesize that a low Mg status, which is rather common, might foment the transition from mild to critical clinical manifestations of the disease. Epidemiological, clinical, and fundamental research is needed to clarify the potential role of Mg deficiency in COVID-19.


title: Clinical Pathway for Management of Suspected or Positive Novel Coronavirus-19 Patients With ST-Segment Elevation Myocardial Infarction

text: Novel coronavirus-19 disease (COVID-19) is an escalating, highly infectious global pandemic that is quickly overwhelming healthcare systems. This has implications on standard cardiac care for ST-elevation myocardial infarctions (STEMIs). In the setting of anticipated resource scarcity in the future, we are forced to reconsider fibrinolytic therapy in our management algorithms. We encourage clinicians to maintain a high level of suspicion for STEMI mimics, such as myopericarditis which is a known, not infrequent, complication of COVID-19 disease. Herein, we present a pathway developed by a multidisciplinary panel of stakeholders at NewYork-Presbyterian/Columbia University Irving Medical Center for the management of STEMI in suspected or confirmed COVID-19 patients.


Madagascar's mysterious, murderous cats identified


title: A Case Series of the 2019 Novel Coronavirus (SARS-CoV-2) in 3 Febrile Infants in New York

text: We describe 3 febrile infants <2 months of age admitted to a large tertiary care children's hospital in New York and subsequently found to be infected with severe acute respiratory syndrome coronavirus 2. All 3 patients presented with fever, feeding difficulty, lymphopenia, and thrombocytosis on laboratory evaluation. Two of the 3 patients were found to have neutropenia, and 2 had known exposures to sick contacts. In this case series, we describe 3 of the youngest patients to be reported with severe acute respiratory syndrome coronavirus 2 in the United States.


BACKGROUND: Despite the mainly reassuring outcomes for pregnant women with COVID-19 infection reported by previous case series with small sample sizes, some recent reports of severe maternal morbidity requiring intubation and of maternal deaths show the need for additional data about the impact of COVID-19 on pregnancy outcomes. This study aimed to report the maternal characteristics and clinical outcomes of pregnant women with COVID-19 disease. STUDY DESIGN: This retrospective single-center study includes all consecutive pregnant women with confirmed (laboratory-confirmed) or suspected (according to version 7.0 of the Chinese management guideline) COVID-19 infection, regardless of gestational age at diagnosis, admitted to the Strasbourg University Hospital (France) from March 1 to April 3, 2020. Maternal characteristics, laboratory and imaging findings, and maternal and neonatal outcomes were extracted from medical records. RESULTS: The study includes 54 pregnant women with confirmed (n=38) and suspected (n=16) COVID-19 infection. Of these, 32 had an ongoing pregnancy, one a miscarriage, and 21 live births: 12 vaginal and 9 cesarean deliveries. Among the women who gave birth, preterm deliveries were medically indicated for their COVID-19-related condition for 23.8% (5/21): 14.3% (3/21) before 32 weeks' gestation and 9.5% (2/21) before 28 weeks. Oxygen support was required for 24.1% (13/54), including high flow oxygen (n=2), noninvasive (n=1) and invasive (n=3) mechanical ventilation, and extracorporeal membrane oxygenation (n=1). Of these, three, aged 35 years or older with positive COVID-19 RT-PCR, had respiratory failure requiring indicated delivery before 29 weeks' gestation. All three women were overweight or obese, and two had an additional comorbidity. CONCLUSION: COVID-19 in pregnancy was associated with maternal morbidity and preterm birth. Its association with other well-known risk factors for severe maternal morbidity in noninfected pregnant women, including maternal age above 35 years, overweight, and obesity, suggests further studies are required to determine whether these risk factors are also associated with poorer maternal outcome in these women.