COVID-19 screening of health-care workers in a London maternity hospital


title: Morfologia da bolsa cloacal de emas, Rhea americana americana Linnaeus, 1758/ Morphology of rhea's cloacal bursa, Rhea americana americana Linnaeus, 1758

text: A bolsa cloacal é o órgão das aves responsável pela maturação e transferência de linfócitos para outros tecidos. Apesar da importância deste órgão nos mecanismos imunológicos desses animais, são escassas as informações a respeito de sua morfologia em emas. Neste estudo, objetivou-se descrever o desenvolvimento morfológico da bolsa cloacal de emas jovens. Utilizou-se 12 animais de ambos os sexos (6 machos e 6 fêmeas) para a microscopia de luz, eletrônica de transmissão e varredura. Microscopicamente, a bolsa cloacal da ema apresentou, em todas as idades a mucosa interna pregueada composta por lóbulos linfoides de diversos tamanhos, organizados como estrutura alveolar. Em cada prega verificou-se quatro componentes histológicos: as camadas mucosa, submucosa, muscular e adventícia. Esses lóbulos eram compostos de uma zona cortical, uma zona corticomedular e uma zona medular. Verificou-se a existência de linfócitos de tamanhos variados, linfoblastos, capilares sanguíneos, células reticulares epiteliais e macrófagos. Pela microscopia eletrônica de varredura, verificou-se que a superfície da mucosa dos lóbulos bursais apresentaram projeções poligonais, com a presença de curtas microvilosidades em toda a superfície. A comparação nas idades de 0 e 15 semanas de vida demostrou o desenvolvimento dos lóbulos bursais. O padrão morfológico da bolsa cloacal de emas difere do padrão comumente reportado para outras aves tais como pato selvagem, galinha da angola, ganso nativo, peru, codorna japonesa e falcão.(AU)


COVID-19: A Singapore Orthopedic Resident's Musings in the Emergency Department


title: Mielodisplasia na peritonite infecciosa felina: 16 casos (2000-2017)/ Myelodysplasia in feline infectious peritonitis: 16 cases (2000-2017)

text: Apesar da prevalência da peritonite infecciosa felina (PIF) ser alta em praticamente o mundo todo, estudos anatomopatológicos recentes acerca dessa doença são escassos. Não obstante, as características microscópicas da medula óssea de gatos com PIF estão ausentes da literatura consultada. O objetivo deste artigo é descrever alterações medulares ósseas vistas em casos espontâneos de PIF. As medulas ósseas colhidas sistematicamente da região diafisária dos fêmures de 16 gatos necropsiados no Laboratório de Patologia Veterinária (LPV) da Universidade Federal de Santa Maria (UFSM), Rio Grande do Sul, entre janeiro de 2000 e junho de 2017, e que tiveram diagnóstico definitivo de PIF, foram avaliadas fenotípica (histopatologia - hematoxilina e eosina e histoquímica - reação de Perls) e imunofenotipicamente (utilizando marcadores mieloides (anti-MAC387) e de linfócitos (anti-CD79αcy e anti-CD3). Os resultados permitem afirmar que, independentemente da apresentação clinicopatológica da doença ocorrem as seguintes alterações: 1) hiperplasia mieloide; 2) hipoplasia eritroide, 3) displasia megacariocítica (dismegacariocitopoiese) e 4) plasmocitose medular. Exclusivamente nos casos de PIF seca há hemossiderose medular óssea e hepática. Essas alterações permitem estabelecer que gatos com PIF desenvolvem mielodisplasia, uma lesão mieloproliferativa muito semelhante àquela relatada em humanos infectados pelo HIV. Sugere-se que a partir dos achados aqui descritos, a mielodisplasia seja considerada a principal responsável pelas alterações hematológicas observadas na PIF, especialmente pela anemia e trombocitopenia arregenerativas frequentemente desenvolvidas pelos pacientes com essa doença.(AU)


title: Characterization of children younger than 5 Years of age with severe community-acquired alveolar pneumonia (CAAP) requiring Pediatric Intensive Care Unit (PICU) admission

text: BACKGROUND: The purpose of this study was to determine factors characterizing children admitted to the Pediatric Intensive Care Unit (PICU) with community-acquired alveolar pneumonia (CAAP) to help clinicians assess disease severity upon initial assessment in the emergency department. METHODS: We prospectively collected demographic, clinical, and laboratory data of children <5 years with radiologically confirmed CAAP referred to the Soroka University Medical Center during 2001-2011. Three groups of children were compared: 1) those hospitalized in the PICU (PICU-CAAP); 2) those treated in the emergency department and discharged (ED-CAAP); and 3) those hospitalized in a pediatric ward (Hosp-CAAP). RESULTS: Of 9722 CAAP episodes, 367 (3.8%) were PICU-CAAP, 5552 (57.1%) Hosp-CAAP and 3803 (39.1%) ED-CAAP. In a univariate analysis, respiratory syncytial virus (RSV) was detected more commonly among PICU-CAAP than in Hosp-CAAP (P = 0.02) and ED-CAAP patients (P < 0.001). In a multivariate analysis, several factors were associated with PICU hospitalization versus ED-CAAP and Hosp-CAAP: Younger age (ORs: 1.04, [95%CI: 1.02-1.05] and 0.97 [0.96-0.98], respectively); prematurity (ORs: 2.16 [1.28-3.64] and 1.61 [1.15-2.26], respectively), lower O2 saturation (ORs: 1.32 [1.25-1.41] and 0.94[0.92-0.96]), higher respiratory rate (ORs: 1.06 [1.04-1.07] and 1.00 [1-1.01], respectively). CONCLUSION: Children admitted to PICU were younger, had more respiratory syncytial virus (RSV) detection, were premature, had lower O2 saturation, and had a higher respiratory rate than those admitted to the general ward or those visiting the emergency department and subsequently discharged.


title: Obesity is the comorbidity more strongly associated for Covid-19 in Mexico. A case-control study

text: Some comorbidities are associated with severe coronavirus disease (Covid-19) but it is unclear whether some increase susceptibility to Covid-19. In this case-control Mexican study we found that obesity represents the strongest predictor for Covid-19 followed by diabetes and hypertension in both sexes and chronic renal failure in females only. Active smoking was associated with decreased odds of Covid-19. These findings indicate that these comorbidities are not only associated with severity of disease but also predispose for getting Covid-19. Future research is needed to establish the mechanisms involved in each comorbidity and the apparent "protective" effect of cigarette smoking.


title: Health belief model for coronavirus infection risk determinants

text: OBJECTIVE To use the advantages of a ratio scale with verbal anchors in order to measure the risk perception in the novel coronavirus infection, which causes covid-19, in a health belief model-based questionnaire, as well as its validity and reproducibility. METHOD We used the health belief model, which explores four dimensions: perceived susceptibility (five questions), perceived severity (five questions), perceived benefits (five questions), and perceived barriers (five questions). Additionally, we included a fifth dimension, called pro-health motivation (four questions). The questions composed an electronic questionnaire disseminated by social networks for an one-week period. Answers were quantitative values of subjective representations, obtained by a psychophysically constructed scale with verbal anchors ratio (CentiMax ® ). Mean time for total filling was 12 minutes (standard deviation = 1.6). RESULTS We obtained 277 complete responses to the form. One was excluded because it belonged to a participant under 18 years old. Reproducibility measures were significant for 22 of the 24 questions in our questionnaire (Cronbach's α = 0.883). Convergent validity was attested by Spearman-Brown's split half reliability coefficient (r = 0.882). Significant differences among groups were more intense in perceived susceptibility and severity dimensions, and less in perceived benefits and barriers. CONCLUSION Our health belief model-based questionnaire using quantitative measures enabled the confirmation of popular beliefs about covid-19 infection risks. The advantage in our approach lays in the possibility of quickly, directly and quantitatively identifying individual belief profiles for each dimension in the questionnaire, serving as a great ally for communication processes and public health education.


title: La batalla contra la enfermedad del Coronavirus 2019 (COVID-19): Manejo de Emergencia y Control de Infecciones en un Departamento de Radiología

text: OBJETIVO: Describir las estrategias, manejo de emergencias y los procedimientos de control de infecciones de nuestro departamento durante el brote de la enfermedad por coronavirus 2019 (COVID-19). MéTODOS: Creamos un equipo de manejo de emergencias. El equipo estableció varias medidas: Reconfiguración del flujo de trabajo en el departamento de radiología, distribución de material de protección personal y adiestramiento del personal, procedimientos para la obtención de imágenes en pacientes sospechosos o confirmados con COVID-19, así como para pacientes sin historial de exposición o síntomas. Aquellos con sospecha o confirmación de COVID-19 fueron escaneados en una unidad dedicada para ello. RESULTADOS: Del 21 de enero del 2020 hasta el 9 de marzo del 2020, 3,083 personas con sospecha o confirmación de COVID-19 recibieron CT de torax. Incluyendo los exámenes iniciales y repetidos, el número total de CT fue 3,340. Como resultado de nuestras medidas de precaución, ninguno de los miembros del personal del departamento de radiología fue infectado con COVID-19. CONCLUSIóN: Las estrategias de planificación y las protecciones adecuadas pueden ayudar a proteger a los pacientes y al personal contra una enfermedad altamente infecciosa. Y a la misma vez ayudar a mantener la capacidad de atender un volumen alto de pacientes.


title: Age-dependent effects in the transmission and control of COVID-19 epidemics

text: The COVID-19 pandemic has shown a markedly low proportion of cases among children1-4. Age disparities in observed cases could be explained by children having lower susceptibility to infection, lower propensity to show clinical symptoms or both. We evaluate these possibilities by fitting an age-structured mathematical model to epidemic data from China, Italy, Japan, Singapore, Canada and South Korea. We estimate that susceptibility to infection in individuals under 20 years of age is approximately half that of adults aged over 20 years, and that clinical symptoms manifest in 21% (95% credible interval: 12-31%) of infections in 10- to 19-year-olds, rising to 69% (57-82%) of infections in people aged over 70 years. Accordingly, we find that interventions aimed at children might have a relatively small impact on reducing SARS-CoV-2 transmission, particularly if the transmissibility of subclinical infections is low. Our age-specific clinical fraction and susceptibility estimates have implications for the expected global burden of COVID-19, as a result of demographic differences across settings. In countries with younger population structures-such as many low-income countries-the expected per capita incidence of clinical cases would be lower than in countries with older population structures, although it is likely that comorbidities in low-income countries will also influence disease severity. Without effective control measures, regions with relatively older populations could see disproportionally more cases of COVID-19, particularly in the later stages of an unmitigated epidemic.


Oral mucosa lesions in COVID-19


title: Oral mucosa lesions in COVID-19

text: SARS-CoV-2 marks a new era in the medical field. The literature has outlined several signs and symptoms of COVID-19 (Lake, 2020), but there are some manifestations not yet confirmed or not entirely described. There have been reported several dermatological conditions associated with COVID-19: rash, urticaria and chickenpox-like vesicles (Recalcati, 2020) and studies on cutaneous manifestations of COVID-19 have been announced (Fernandez-Nieto et al., 2020). The main path of COVID-19 transmission is through droplets (The Chinese Preventive Medicine Association, 2020) from the oral cavity. This is why dental professionals are widely exposed to be infected, but they could also be the first ones to identify SARS-CoV-2 positive patients. Carreras-Presas et al. published a paper presenting three case reports describing oral mucosa vesiculobullous lesions developed by COVID-19 positive or suspected to be positive patients.


COVID-19 and acute myocardial injury: the heart of the matter or an innocent bystander?


Acute kidney injury in SARS-CoV-2 infected patients


title: Managing Urology Consultations During COVID-19 Pandemic: Application of a Structured Care Pathway

text: OBJECTIVE: To describe and evaluate a risk-stratified triage pathway for inpatient urology consultations during the SARS-CoV-2 (COVID-19) pandemic. This pathway seeks to outline a urology patient care strategy that reduces the transmission risk to both healthcare providers and patients, reduces the healthcare burden, and maintains appropriate patient care. MATERIALS AND METHODS: Consultations to the urology service during a 3-week period (March 16 to April 2, 2020) were triaged and managed via one of 3 pathways: Standard, Telemedicine, or High-Risk. Standard consults were in-person consults with non COVID-19 patients, High-Risk consults were in-person consults with COVID-19 positive/suspected patients, and Telemedicine consults were telephonic consults for low-acuity urologic issues in either group of patients. Patient demographics, consultation parameters and consultation outcomes were compared to consultations from the month of March 2019. Categorical variables were compared using Chi-square test and continuous variables using Mann-Whitney U test. A P value <.05 was considered significant. RESULTS: Between March 16 and April 2, 2020, 53 inpatient consultations were performed. By following our triage pathway, a total of 19/53 consultations (35.8%) were performed via Telemedicine with no in-person exposure, 10/53 consultations (18.9%) were High-Risk, in which we strictly controlled the urology team member in-person contact, and the remainder, 24/53 consultations (45.2%), were performed as Standard in-person encounters. COVID-19 associated consultations represented 18/53 (34.0%) of all consultations during this period, and of these, 8/18 (44.4%) were managed successfully via Telemedicine alone. No team member developed COVID-19 infection. CONCLUSION: During the COVID-19 pandemic, most urology consultations can be managed in a patient and physician safety-conscious manner, by implementing a novel triage pathway.


title: A Conjectural Experiment to Observe the Effect of Conditional locked-down in an Epidemic

text: In a pandemic like Covid-19, there are many countries of lower-earning cannot provide a complete locked-down within the duration of the detected case. The locked-down may result in famine throughout the region of underdeveloped countries after the outbreak. So, a conjectural setup of an epidemic has been studied by applying specific period of locked-down (30 days) in 5 different scenarios. The stochastic approach to the SEIR (Susceptible, Exposed, Infected and Recovered) model has been used to evaluate the dynamics and the effects of locked-down. It is observed that there exist a suitable period to apply locked-down where more susceptible escape from the infection. The effect of the early (as soon as the infected case detected) and late (with respect to the estimated peak of detected cases for no locked-down) implementation of the locked-down has also been studied and found that the late implementation of locked-down will take the least time to end the epidemic. The CFR (Case Fatality Rate) has also been found to be varied from 7.55 to 8.02 for all the considered scenarios.


Neumonía bilateral por SARS-CoV2: evolución radiográfica./ Neumonía bilateral por SARS-CoV2: evolución radiográfica./ SARS-CoV2 bilateral pneumonia: chest X-ray evolution


title: Daily Situation Report on Coronavirus disease (COVID-19) in Iran;March 25, 2020

text: After detection of the first confirmed cases of COVID-19 in Iran, the National Committee on COVID-19 Epidemiology in Ministry of Health and Medical Education was established This Committee is official source of gathering, analyzing, and reporting the COVID-19 data in Iran The data of all sources in the country including, medical care monitoring center (MCMC), Hospitals' Information Systems (HIS), Laboratory portal, the data of the center for communicable disease control (MOH), as well as the data from community health centers are integrated and used in this regards This factsheet contain daily situation report on coronavirus disease (covid-19) in Iran;March 25, 2020


title: A joint action in times of pandemic: the German BioImaging recommendations for operating imaging core facilities during the SARS-Cov-2 emergency

text: Operating shared resource laboratories (SRL) in times of pandemic is a challenge for research institutions. In a multi-user, high-turnover working space, the transmission of infectious agents is difficult to control. To address this challenge, imaging core facility managers being members of German BioImaging discussed how shared microscopes could be operated with minimal risk of spreading SARS-CoV-2 between users and staff. Here, we describe the resulting guidelines and explain their rationale, with a focus on separating users in space and time, protective face masks, and keeping surfaces virus-free. These recommendations may prove useful for other types of SRLs.


COVID-19: How do you self-isolate in a refugee camp?


From Containment to Mitigation of COVID-19 in the US


title: Important Steps to Control COVID-19/SARS-CoV-2 Infection

text: Elderly patients are having high mortality rates from COVID-19/SARS-CoV-2 infection compared to younger patients. The SARS-CoV-2 virus uses the ACE2 receptor as the entry point to the host cells. ARBs/ACEIs which are widely used in elderly patients, have been found to be associated with overexpression of ACE2.To decrease the severity of COVID-19 infection, ARB/ACEI should be switched to another class drug not known to cause a rise in ACE2 until the COVID-19 infection subsides. Specific human immunoglobulin can be tried for COVID-19 patients with critical conditions under supervision.


The COVID-19 pandemic is a crisis and opportunity for bipolar disorder


Spotlight on Jails: COVID-19 Mitigation Policies Needed Now


title: The efficacy and safety of Jinhua Qinggan granule (JHQG) in the treatment of coronavirus disease 2019 (COVID-19): A protocol for systematic review and meta analysis

text: BACKGROUND: Currently, the global number of infected novel coronavirus has exceeded 2.6 million and the death toll has exceeded 170,000, but the specific drug for the treatment of COVID-19 has been not appears. In the process of fighting COVID-19 in China, JHQG has been promoted by the Chinese government and widely used in the treatment of COVID-19. The purpose of this study is to systematically evaluate the efficacy and safety of JHQG for COVID-19. METHODS: We are going to search the electronic databases: PubMed, EMBASE, Cochrane library, Web of Science (WOS), Google scholar, China National Knowledge Infrastructure (CNKI), Chinese Biomedical literature Database (CBM), Chinese Scientific and Journal Database (VIP), Wan Fang database (Wanfang) for published clinical trails and search clinical trials register platforms of Chinese Clinical Trial Registry (ChiCTR) and ClinicalTrials.gov (www.ClinicalTrials.gov/) for ongoing trials of Jinhua Qinggan granule for COVID-19. The primary outcomes of the included studies contain Clinical symptom disappearance rate and the secondary outcomes obtain: TCM syndrome scale score, Hamilton anxiety scale score, and adverse events. We will use RevMan V5.3 software to perform the calculations. PRISMA-P checklist was used in writing this report. RESULTS: The study results will be submitted to a peer-reviewed journal for publication. CONCLUSION: This study will provide a high-quality evidence of the efficacy and safety of Jinhua Qinggan granule on patients with COVID-19. PROSPERO REGISTRATION NUMBER: CRD42020181919.


title: Walk-Through Screening Center for COVID-19: an Accessible and Efficient Screening System in a Pandemic Situation

text: With the ongoing novel coronavirus disease 2019 (COVID-19) pandemic, the number of individuals that need to be tested for COVID-19 has been rapidly increasing. A walk-through (WT) screening center using negative pressure booths that is inspired by the biosafety cabinet has been designed and implemented in Korea for easy screening of COVID-19 and for safe and efficient consultation for patients with fever or respiratory symptoms. Here, we present the overall concept, advantages, and limitations of the COVID-19 WT screening center. The WT center increases patient access to the screening clinics and adequately protects healthcare personnel while reducing the consumption of personal protective equipment. It can also increase the number of people tested by 9-10 fold. However, there is a risk of cross-infection at each stage of screening treatment, including the booths, and adverse reactions with disinfection of the booths. These limitations can be overcome using mobile technology and increasing the number of booths to reduce congestion inside the center, reducing booth volume for sufficient and rapid ventilation, and using an effective, harmless, and certified environmental disinfectant. A WT center can be implemented in other institutions and countries and modified depending on local needs to cope with the COVID-19 pandemic.


COVID-19 associated pulmonary thrombosis


title: The Anxiety Status of Chinese Medical Workers During the Epidemic of COVID-19: A Meta-Analysis

text: OBJECTIVE: To analysis the anxiety status of Chinese medical workers during the epidemic of COVID-19 by meta-analysis method. METHODS: CNKI, VIP, WanFang Data, SinoMed, PubMed, Cochrane, EMBASE, MEDLINE, Scopus, Google Scholar and other databases were searched to collect literature on the anxiety status of Chinese medical workers during the epidemic of COVID-19. The retrieval time is from the database construction to 11/03/2020. Meta-analysis was performed on the included articles by using Stata 16.0 software. RESULTS: A total of 7 articles were included, with a total sample size of 7,741 people. Meta-analysis using the random effects model showed that the anxiety score of Chinese medical during the epidemic of COVID-19 was significantly higher than that of the national norm in each study, the difference was statistically significant [SMD (95% CI)=1.145 (0.705-1.584), p<0.001]. CONCLUSION: The anxiety level of Chinese medical workers has increased significantly during the epidemic of COVID-19.


title: "Closed Proportional-Integral-Derivative-Loop Model"Following Control

text: The proportional-integral-derivative (PID) control law is often overlooked as a computational imitation of the critic control in human decision. This paper provides a formulation to remedy this problem. Further, based on the characteristic settling-behaviour of dynamical systems, the"closed PID-loop model"following control (CPLMFC) method is introduced for automatic PID design. Also, a method for closed-loop settling-time identification is provided. The CPLMFC algorithm and some recommended guidelines are given for setting the critic weights of the PID. Finally, two representative case-studies are simulated. Both the theoretical results and simulation results (via performance indices) illustrate that the CPLMFC can guarantee both accurate and stable closed-loop adaptive PID control performance in real-time


title: Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis

text: BACKGROUND: Very little direct evidence exists on use of corticosteroids in patients with coronavirus disease 2019 (COVID-19). Indirect evidence from related conditions must therefore inform inferences regarding benefits and harms. To support a guideline for managing COVID-19, we conducted systematic reviews examining the impact of corticosteroids in COVID-19 and related severe acute respiratory illnesses. METHODS: We searched standard international and Chinese biomedical literature databases and prepublication sources for randomized controlled trials (RCTs) and observational studies comparing corticosteroids versus no corticosteroids in patients with COVID-19, severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS). For acute respiratory distress syndrome (ARDS), influenza and community-acquired pneumonia (CAP), we updated the most recent rigorous systematic review. We conducted random-effects meta-analyses to pool relative risks and then used baseline risk in patients with COVID-19 to generate absolute effects. RESULTS: In ARDS, according to 1 small cohort study in patients with COVID-19 and 7 RCTs in non-COVID-19 populations (risk ratio [RR] 0.72, 95% confidence interval [CI] 0.55 to 0.93, mean difference 17.3% fewer; low-quality evidence), corticosteroids may reduce mortality. In patients with severe COVID-19 but without ARDS, direct evidence from 2 observational studies provided very low-quality evidence of an increase in mortality with corticosteroids (hazard ratio [HR] 2.30, 95% CI 1.00 to 5.29, mean difference 11.9% more), as did observational data from influenza studies. Observational data from SARS and MERS studies provided very low-quality evidence of a small or no reduction in mortality. Randomized controlled trials in CAP suggest that corticosteroids may reduce mortality (RR 0.70, 95% CI 0.50 to 0.98, 3.1% lower; very low-quality evidence), and may increase hyperglycemia. INTERPRETATION: Corticosteroids may reduce mortality for patients with COVID-19 and ARDS. For patients with severe COVID-19 but without ARDS, evidence regarding benefit from different bodies of evidence is inconsistent and of very low quality.


COVID-19 tracheostomy Local Safety Standard for Invasive Procedures (LocSSIP): a single-centre experience


title: Does glycemic control rescue type 2 diabetes patients from COVID-19-related deaths?

text: COVID-19 patients with diabetes are reported to have higher mortality compared with non-diabetic COVID-19 patients. However, recent investigations showed the importance of better glycemic control among diabetes patients to avoid death from COVID-19.


Patient in hospital for over a year must leave for community care, says judge


title: COVID-19: Present and Future Challenges for Dental Practice

text: COVID-19 was declared a pandemic by the World Health Organization, with a high fatality rate that may reach 8%. The disease is caused by SARS-CoV-2 which is one of the coronaviruses. Realizing the severity of outcomes associated with this disease and its high rate of transmission, dentists were instructed by regulatory authorities, such as the American Dental Association, to stop providing treatment to dental patients except those who have emergency complaints. This was mainly for protection of dental healthcare personnel, their families, contacts, and their patients from the transmission of virus, and also to preserve the much-needed supplies of personal protective equipment (PPE). Dentists at all times should competently follow cross-infection control protocols, but particularly during this critical time, they should do their best to decide on the emergency cases that are indicated for dental treatment. Dentists should also be updated on how this pandemic is related to their profession in order to be well oriented and prepared. This overview will address several issues concerned with the COVID-19 pandemic that directly relate to dental practice in terms of prevention, treatment, and orofacial clinical manifestations.


The psychological and cognitive impact of Covid-19 on individuals with neurocognitive impairments: research topics and remote intervention proposals


Sport in the tracks and fields of the corona virus: Critical issues during the exit from lockdown


title: Impact of the SARS-CoV-2 outbreak on pediatric liver transplant recipients residing in Lombardy, Northern Italy

text: The novel Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) disease (COVID-19) represents an unprecedented public health issue for the general population and for patients with underlying chronic conditions. Compared to adults, children seem to have a milder course of the disease, with very few requiring medical attention.


COVID-19 in a Preterm- Leading to Remodelling of Care


title: COVID-19: a look into the modern age pandemic

text: Aim: COVID-19 presents as a pandemic requiring the utmost attention from the world, especially the healthcare sector. This review intends to discuss the symptoms, prevention, and management carried out related to the coronavirus, while also providing the healthcare provider strategies used by different countries in combating the disease. Subject and methods: This study was conducted over a period of 2 weeks where different sources were used to assess the ongoing situation regarding COVID-19. The data used in this study was verified and collected from authentic sources only. Results: Results show that there is at present no definite cure for the disease and that prevention is the best possible defense at our disposal at the moment. Data reviewed suggests that social distancing and isolation is the best possible option at the moment. Conclusion: This study provides an overview of the developments taking place in response to the pandemic. More research is required, especially in the treatment and prevention of the disease, so that we may progress towards finding a cure as well as creating a vaccine for the COVID-19.


Top EU scientist ousted over plans for coronavirus research


title: International comparison of guidelines for managing neonates at the early phase of the SARS-CoV-2 pandemic

text: BACKGROUND: The COVID-19 pandemic threatens global newborn health. We describe the current state of national and local protocols for managing neonates born to SARS-CoV-2-positive mothers. METHODS: Care providers from neonatal intensive care units on six continents exchanged and compared protocols on the management of neonates born to SARS-CoV-2-positive mothers. Data collection was between March 14 and 21, 2020. We focused on central protocol components, including triaging, hygiene precautions, management at delivery, feeding protocols, and visiting policies. RESULTS: Data from 20 countries were available. Disease burden varied between countries at the time of analysis. In most countries, asymptomatic infants were allowed to stay with the mother and breastfeed with hygiene precautions. We detected discrepancies between national guidance in particular regarding triaging, use of personal protection equipment, viral testing, and visitor policies. Local protocols deviated from national guidance. CONCLUSIONS: At the start of the pandemic, lack of evidence-based guidance on the management of neonates born to SARS-CoV-2-positive mothers has led to ad hoc creation of national and local guidance. Compliance between collaborators to share and discuss protocols was excellent and may lead to more consensus on management, but future guidance should be built on high-level evidence, rather than expert consensus. IMPACT: At the rapid onset of the COVID19 pandemic, all countries presented protocols in place for managing infants at risk of COVID19, with a certain degree of variations among regions.A detailed review of ad hoc guidelines is presented, similarities and differences are highlighted.We provide a broad overview of currently applied recommendations highlighting the need for international context-relevant coordination.


Failure modes and effect analysis to develop transfer protocols in the management of COVID-19 patients


Beneficial impact of Baricitinib in COVID-19 moderate pneumonia; multicentre study


title: Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline

text: PURPOSE: Traditional critical care dogma regarding the benefits of early tracheostomy during invasive ventilation has had to be revisited due to the risk of COVID-19 to patients and healthcare staff. Standard practises that have evolved to minimise the risks associated with tracheostomy must be comprehensively reviewed in light of the numerous potential episodes for aerosol generating procedures. We meet the urgent need for safe practise standards by presenting the experience of two major London teaching hospitals, and synthesise our findings into an evidence-based guideline for multidisciplinary care of the tracheostomy patient. METHODS: This is a narrative review presenting the extensive experience of over 120 patients with tracheostomy, with a pragmatic analysis of currently available evidence for safe tracheostomy care in COVID-19 patients. RESULTS: Tracheostomy care involves many potentially aerosol generating procedures which may pose a risk of viral transmission to staff and patients. We make a series of recommendations to ameliorate this risk through infection control strategies, equipment modification, and individualised decannulation protocols. In addition, we discuss the multidisciplinary collaboration that is absolutely fundamental to safe and effective practise. CONCLUSION: COVID-19 requires a radical rethink of many tenets of tracheostomy care, and controversy continues to exist regarding the optimal techniques to minimise risk to patients and healthcare workers. Safe practise requires a coordinated multidisciplinary team approach to infection control, weaning and decannulation, with integrated processes for continuous prospective data collection and audit.


title: SARS-CoV-2 RNA dependent RNA polymerase (RdRp) targeting: an in silico perspective

text: New treatment against SARS-CoV-2 now is a must. Nowadays, the world encounters a huge health crisis by the COVID-19 viral infection. Nucleotide inhibitors gave a lot of promising results in terms of its efficacy against different viral infections. In this work, molecular modeling, docking, and dynamics simulations are used to build a model for the viral protein RNA-dependent RNA polymerase (RdRp) and test its binding affinity to some clinically approved drugs and drug candidates. Molecular dynamics is used to equilibrate the system upon binding calculations to ensure the successful reproduction of previous results, to include the dynamics of the RdRp, and to understand how it affects the binding. The results show the effectiveness of Sofosbuvir, Ribavirin, Galidesivir, Remdesivir, Favipiravir, Cefuroxime, Tenofovir, and Hydroxychloroquine, in binding to SARS-CoV-2 RdRp. Additionally, Setrobuvir, YAK, and IDX-184, show better results, while four novel IDX-184 derivatives show promising results in attaching to the SARS-CoV-2 RdRp. There is an urgent need to specify drugs that can selectively bind and subsequently inhibit SARS-CoV-2 proteins. The availability of a punch of FDA-approved anti-viral drugs can help us in this mission, aiming to reduce the danger of COVID-19. The compounds 2 and 3 may tightly bind to the SARS-CoV-2 RdRp and so may be successful in the treatment of COVID-19.


Covid-19: MPs call on Public Health England to publish evidence for decision to drop community testing


Viral exanthem in COVID-19, a clinical enigma with biological significance


title: Clinical characteristics of severe acute respiratory syndrome coronavirus 2 reactivation

text: OBJECTIVES: Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. However, limited data was available for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reactivation. This study aimed to evaluate the clinical characteristics of the SARS-CoV-2 reactivation. METHODS: Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for 55 patients with laboratory-confirmed COVID-19 pneumonia (i.e., with throat swab samples that were positive for SARS-CoV-2) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan. 8 to Feb. 10, 2020. RESULTS: All 55 patients had a history of epidemiological exposure to COVID-19, and 5 (9%) patients who discharged from hospital presented with SARS-CoV-2 reactivation. Among the 5 reactivated patients, other symptoms were also observed, including fever, cough, sore throat, and fatigue. One of the 5 patients had progressive lymphopenia (from 1.3 to 0.56â¯×â¯109 cells per L) and progressive neutrophilia (from 4.5 to 18.28â¯×â¯109 cells per L). All 5 reactivated patients presented normal aminotransferase levels. Throat swab samples from the 5 reactivated patients were tested for SARS-CoV-2, indicating all positive for the virus. CONCLUSIONS: Findings from this small group of cases suggested that there was currently evidence for reactivation of SARS-CoV-2 and there might be no specific clinical characteristics to distinguish them.


title: Risk factors for death in 1859 subjects with COVID-19

text: We studied 1859 subjects with confirmed COVID-19 from seven centers in Wuhan 1651 of whom recovered and 208 died. We interrogated diverse covariates for correlations with risk of death from COVID-19. In multi-variable Cox regression analyses increased hazards of in-hospital death were associated with several admission covariates: (1) older age (HR = 1.04; 95% Confidence Interval [CI], 1.03, 1.06 per year increase; P < 0.001); (2) smoking (HR = 1.84 [1.17, 2.92]; P = 0.009); (3) admission temperature per °C increase (HR = 1.32 [1.07, 1.64]; P = 0.009); (4) Log10 neutrophil-to-lymphocyte ratio (NLR; HR = 3.30 [2.10, 5.19]; P < 0.001); (5) platelets per 10 E + 9/L decrease (HR = 0.996 [0.994, 0.998]; P = 0.001); (6) activated partial thromboplastin (aPTT) per second increase (HR = 1.04 [1.02, 1.05]; P < 0.001); (7) Log10 D-dimer per mg/l increase (HR = 3.00 [2.17, 4.16]; P < 0.001); and (8) Log10 serum creatinine per µmol/L increase (HR = 4.55 [2.72, 7.62]; P < 0.001). In piecewise linear regression analyses Log10NLR the interval from ≥0.4 to ≤1.0 was significantly associated with an increased risk of death. Our data identify covariates associated with risk of in hospital death in persons with COVID-19.


Bilateral lower limb weakness: a cerebrovascular consequence of covid-19 or a complication associated with it?


title: A County-level Dataset for Informing the United States' Response to COVID-19

text: As the coronavirus disease 2019 (COVID-19) becomes a global pandemic, policy makers must enact interventions to stop its spread. Data driven approaches might supply information to support the implementation of mitigation and suppression strategies. To facilitate research in this direction, we present a machine-readable dataset that aggregates relevant data from governmental, journalistic, and academic sources on the county level. In addition to county-level time-series data from the JHU CSSE COVID-19 Dashboard, our dataset contains more than 300 variables that summarize population estimates, demographics, ethnicity, housing, education, employment and in come, climate, transit scores, and healthcare system-related metrics. Furthermore, we present aggregated out-of-home activity information for various points of interest for each county, including grocery stores and hospitals, summarizing data from SafeGraph. By collecting these data, as well as providing tools to read them, we hope to aid researchers investigating how the disease spreads and which communities are best able to accommodate stay-at-home mitigation efforts. Our dataset and associated code are available at https://github.com/JieYingWu/COVID-19_US_County-level_Summaries.


Prescribing parenteral nutrition in acute hospital setting during COVID-19: The Singapore experience


title: Providing nutritional care to cancer patients during the COVID-19 pandemic: an Italian perspective

text: The COVID-19 outbreak has drastically changed practices inside hospitals, which include oncology routines. In oncology, malnutrition was and certainly still is a frequent problem associated with an increase in treatment-related toxicity, a reduced response to cancer treatment, an impaired quality of life, and a worse overall prognosis. Even in this situation of healthcare crisis, nutritional support in cancer care is an essential element. During the current COVID-19 pandemic, there is a concrete high risk to see a dramatic worsening of cancer patients' nutritional status, who are left without adequate clinical and nutritional support. The consequences are already reasonably foreseeable and will have a severe negative impact after the emergency. Therefore, we believe that it is essential to try to continue, as far as possible, the activity of clinical nutrition in oncology, by revolutionizing the setting and the approach to patients. For this purpose, the Clinical Nutrition and Dietetics Unit and the Medical Oncology Unit of our hospital, one of the largest community hospital in Lombardy that has been involved in the COVID-19 outbreak management since its inception, have reorganized the clinical routine activity in strict collaboration since the very beginning of the emergency, to better face up to the challenge, while preserving cancer patients' needs.


The 50th anniversary of reverse transcriptase-and its ironic legacy in the time of coronavirus


Social media WeChat infers the development trend of COVID-19


title: Decreased utilization of mental health emergency service during the COVID-19 pandemic

text: During the rapid rise of the COVID-19 pandemic, a reduction of the numbers of patients presenting to emergency departments has been observed. We present an early study from a German psychiatric hospital to assess the dynamics of mental health emergency service utilization rates during the COVID-19 pandemic. Our results show that the numbers of emergency presentations decreased, and a positive correlation between these numbers and mobility of the general public suggests an impact of extended measures of social distancing. This finding underscores the necessity of raising and sustaining awareness regarding the threat to mental health in the context of the pandemic.


title: TNFα inhibitor may be effective for severe COVID-19: learning from toxic epidermal necrolysis

text: Increased inflammatory cytokines [such as tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6)] are observed in COVID-19 patients, especially in the severe group. The phenomenon of a cytokine storm may be the central inducer of apoptosis of alveolar epithelial cells, which leads to rapid progression in severe group patients. Given the similarities of clinical features and pathogenesis between toxic epidermal necrolysis (TEN) and COVID-19, we hypothesize that the application of etanercept, an inhibitor of TNFα, could attenuate disease progression in severe group COVID-19 patients by suppressing systemic auto-inflammatory responses. The reviews of this paper are available via the supplemental material section.


Coronavirus and children


COVID-19 Severity Scoring Tool for low resourced settings


Airborne Spread of SARS-CoV-2 and a Potential Role for Air Disinfection


COVID-19 and ACE2 in the liver and gastrointestinal tract: Putative biological explanations of sexual dimorphism


How fossil fuel-derived pesticides and plastics harm health, biodiversity, and the climate


Clinical considerations for managing dermatology patients on systemic immunosuppressive or biologic therapy, or both, during the COVID-19 pandemic


Pandemic Fatigue: Facing the Body's Inexorable Demands in the Time of COVID-19


Coronavirus


CCI 2020 CIT special issue


title: Are we all in this together? Longitudinal assessment of cumulative adversities by socioeconomic position in the first 3 weeks of lockdown in the UK

text: BACKGROUND: Despite media claims that coronavirus disease 2019 (COVID-19) is uniting societies and countries in shared experience, there has been concern that the pandemic is in fact exposing and widening existing inequalities within societies. Data have shown these differences for cases and fatalities, but data on other types of adversities are lacking. Therefore, this study explored the changing patterns of adversity relating to the COVID-19 pandemic by socioeconomic position (SEP) during the early weeks of lockdown in the UK. METHODS: Data were from 12 527 UK adults in the University College London COVID-19 Social Study (a panel study that involves online weekly data collection from participants during the COVID-19 pandemic). We analysed data collected from 25 March to 14 April 2020. The sample was well-stratified and weighted to population proportions of gender, age, ethnicity, education and country of living. We used Poisson and logit models to assess 10 different types of adverse experiences depending on an index of SEP over time. RESULTS: There was a clear gradient across the number of adverse events experienced each week by SEP. This was most clearly seen for adversities relating to finances (including loss of employment and cut in income) and basic needs (including access to food and medications) but less for experiences directly relating to the virus. Inequalities were maintained with no reductions in discrepancies between socioeconomic groups over time. CONCLUSIONS: There were clear inequalities in adverse experiences during the COVID-19 pandemic in the early weeks of lockdown in the UK. Results suggest that measures taken to try to reduce such adverse events did not go far enough in tackling inequality.


Remote Psychological First Aid (rPFA) in the time of Covid-19: A preliminary report of the Malaysian experience


title: Clinical interventions for severe and critical COVID-19: What are the options

text: The coronavirus disease 2019 (COVID-19) has been ongoing outbreak and declared as a global public health emergency by the World Health Organization Severe and critical COVID-19 has high fatality rate due to complications like acute respiratory distress syndrome, acute respiratory failure or multiple organ failure So far, there have been mounting research on the epidemiological and clinical characteristics of COVID-19 However, the information regarding treatment of severe and critical COVID-19 is limited The current study reviewed published evidence of clinical interventions of severe and critical COVID-19, aiming to provide an up-to-date reference for further clinical treatment


title: Are soft tissues of urban rats good indicators of exposure to heavy metal pollution? A study conducted in one of the most polluted basins of Buenos Aires, Argentina

text: The overall goal of this work was to analyze the relationship between the concentration of lead in the kidney, liver, and stomach contents of rats captured in a polluted urban basin and the concentration of this metal in the environment, meteorological factors, and different intrinsic characteristics of the individuals. To this end, we determined the concentration of lead in the kidney, liver, and stomach contents of 133 Norway rats (Rattus norvegicus) captured in the Matanza-Riachuelo River Basin (Buenos Aires, Argentina). This basin is one of the most severe cases of water pollution in Latin America and metals like lead represent the most common chemical pollutants. Rats were trapped in nine sites with different soil and water lead concentrations, between 2014 and 2015. A positive relationship was found between lead concentration in the liver and kidney of R. norvegicus and the environmental concentration of this metal in water and soil. Although the remaining variables analyzed were also related to the lead concentration in soft tissues, they did not affect the association between the lead concentration in soft tissues and that in the environment. The lead concentration in the stomach contents was not related to any of the variables analyzed. Our results constitute the first study in an urban basin with a gradient of environmental lead concentration and suggest that the quantification of lead in the kidney and liver of rats can be used as an indicator of exposure to this metal within a large city.


title: COVID-19 and Headache: A Primer for Trainees

text: OBJECTIVE: To summarize for the trainee audience the possible mechanisms of headache in patients with COVID-19 as well as to outline the impact of the pandemic on patients with headache disorders and headache medicine in clinical practice. BACKGROUND: COVID-19 is a global pandemic caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2, of which a large subset of patients features neurological symptoms, commonly headache. The virus is highly contagious and is, therefore, changing clinical practice by forcing limitations on in-person visits and procedural treatments, more quickly shifting toward the widespread adaptation of telemedicine services. DESIGN/RESULTS: We review what is currently known about the pathophysiology of COVID-19 and how it relates to possible mechanisms of headache, including indirect, potential direct, and secondary causes. Alternative options for the treatment of patients with headache disorders and the use of telemedicine are also explored. CONCLUSIONS: Limited information exists regarding the mechanisms and timing of headache in patients with COVID-19, though causes relate to plausible direct viral invasion of the nervous system as well as the cytokine release syndrome. Though headache care in the COVID-19 era requires alterations, the improved preventive treatment options now available and evidence for feasibility and safety of telemedicine well positions clinicians to take care of such patients, especially in the COVID-19 epicenter of New York City.


title: The potential effects of widespread community transmission of SARS-CoV-2 infection in the World Health Organization African Region: a predictive model

text: The spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been unprecedented in its speed and effects. Interruption of its transmission to prevent widespread community transmission is critical because its effects go beyond the number of COVID-19 cases and deaths and affect the health system capacity to provide other essential services. Highlighting the implications of such a situation, the predictions presented here are derived using a Markov chain model, with the transition states and country specific probabilities derived based on currently available knowledge. A risk of exposure, and vulnerability index are used to make the probabilities country specific. The results predict a high risk of exposure in states of small size, together with Algeria, South Africa and Cameroon. Nigeria will have the largest number of infections, followed by Algeria and South Africa. Mauritania would have the fewest cases, followed by Seychelles and Eritrea. Per capita, Mauritius, Seychelles and Equatorial Guinea would have the highest proportion of their population affected, while Niger, Mauritania and Chad would have the lowest. Of the World Health Organization's 1 billion population in Africa, 22% (16%-26%) will be infected in the first year, with 37 (29 - 44) million symptomatic cases and 150 078 (82 735-189 579) deaths. There will be an estimated 4.6 (3.6-5.5) million COVID-19 hospitalisations, of which 139 521 (81 876-167 044) would be severe cases requiring oxygen, and 89 043 (52 253-106 599) critical cases requiring breathing support. The needed mitigation measures would significantly strain health system capacities, particularly for secondary and tertiary services, while many cases may pass undetected in primary care facilities due to weak diagnostic capacity and non-specific symptoms. The effect of avoiding widespread and sustained community transmission of SARS-CoV-2 is significant, and most likely outweighs any costs of preventing such a scenario. Effective containment measures should be promoted in all countries to best manage the COVID-19 pandemic.


Hope in a global pandemic


More bricks in the wall against SARS-CoV-2 infection: involvement of Î³9Î´2 T cells


title: Persistent severe acute respiratory syndrome coronavirus 2 detection after resolution of coronavirus disease 2019-associated symptoms/signs

text: There are limited data on the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in respiratory specimens after resolution of coronavirus disease 2019 (COVID-19)-associated symptoms/signs. We determined duration of SARS-CoV-2 virus shedding in symptomatic patients after remission of symptoms. We investigated the duration of SARS-CoV-2 RNA detection using real-time reverse transcriptase polymerase chain reaction for SARS-CoV-2 in nasopharyngeal/oropharyngeal swabs or sputum or saliva. Six patients were included in the final analysis. The median (range) duration of SARS-CoV-2 viral detection after hospitalization was 34 days (22 to 67). After resolution of symptoms/signs, SARS-CoV-2 RNA was detected for median (range) of 26 days (9 to 48). Among the six patients, one had persistent detection of SARS-CoV-2 RNA until day 67 of hospitalization, which was 30 days after symptom resolution. This case represents the longest duration of SARS-CoV-2 detection, and highlights the need for long-term follow up of COVID-19 patients despite resolution of symptoms to confirm SARS-CoV-2 clearance.


Management of mCRPC patients treated with 223Radium-dicloride in the scenario of the COVID-19 outbreak


title: Government Intervention, Risk Perception, and the Adoption of Protective Action Recommendations: Evidence from the COVID-19 Prevention and Control Experience of China

text: This study examines the relationships between government interventions, risk perception, and the public's adoption of protective action recommendations (PARs) during the COVID-19 coronavirus disease emergency in mainland China. We conducted quota sampling based on the proportion of the population in each province and gender ratios in the Sixth Census and obtained a sample size of 3837. Government intervention was divided into government communication, government prevention and control, and government rescue. We used multiple regression and a bootstrap mediation effect test to study the mechanism of these three forms of government intervention on the public's adoption of PARs. The results show that government prevention and control and government rescue significantly increased the likelihood of the public adopting PARs. Risk perception was significantly associated with the public's adoption of PARs. The effects of government interventions and risk perception on the public's adoption of PARs was not found to vary by region. Risk perception is identified as an important mediating factor between government intervention and the public's adoption of PARs. These results indicate that increasing the public's risk perception is an effective strategy for governments seeking to encourage the public to adopt PARs during the COVID-19 pandemic.


title: SARS-CoV-2 prevalence in an asymptomatic cancer cohort - results and consequences for clinical routine

text: BACKGROUND: Starting in December 2019, the current pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) confronts the world with an unprecedented challenge. With no vaccine or drug being currently available to control the pandemic spread, prevention and PCR (Polymerase chain reaction) testing becomes a crucial pillar of medical systems. Aim of the present study was to report on the first results of the measures taken in a large German Department of Radiation Oncology, including PCR testing of asymptomatic cancer patients. METHODS: Pandemic-adapted hygiene regulations and prevention measures for patients and staff were implemented. A visiting ban on both wards was implemented from the beginning and medical staff and patients were required to wear face masks at all times. The waiting rooms were rearranged to ensure distance between patients of at least 1.5 m. Clinical follow up was mainly done by telephone and all patients had to complete a questionnaire regarding symptoms and contacts with COVID-19 patients before entering our department. Educational documents were created for patients to raise awareness of symptoms and avoidance strategies for interactions with other people. Indications for therapy and fractionation schemes were adapted when possible. In a subsequent step, all new asymptomatic patients were tested via nasopharyngeal swab at our screening station shortly before their simulation CT. RESULTS: All these measures and implementations have been well accepted semiquantitatively measured by the consent received from patients and staff. Regarding the PCR testing, only 1 out of 139 asymptomatic patients of our cohort so far tested positive for SARS-CoV-2, reflecting a prevalence of 0.72% in this cancer patient population. Up to this point no staff members was tested positive. The start of the treatment for the PCR-positive patient was deferred for 2 weeks. CONCLUSION: Due to the pandemic-adapted implementations, our department seems well prepared during this crisis. The initial screening helps to identify asymptomatic COVID-19 patients in order to protect other patients and our staff from infection and the observed PCR prevalence is in line with comparable studies. A regular PCR testing (e.g. twice a week) of all patients and staff would in principle be desirable but is limited due to testing capacities at present.


title: A Multimodal Multi-Institutional Solution to Remote Medical Student Education for Otolaryngology During COVID-19

text: During the coronavirus 2019 pandemic, there has been a surge in production of remote learning materials for continued otolaryngology resident education. Medical students traditionally rely on elective and away subinternship experiences for exposure to the specialty. Delays and cancellation of clinical rotations have forced medical students to pursue opportunities outside of the traditional learning paradigm. In this commentary, we discuss the multi-institutional development of a robust syllabus for medical students using a multimodal collection of resources. Medical students collaborated with faculty and residents from 2 major academic centers to identify essential otolaryngology topics. High-quality, publicly available, and open-access content from multiple sources were incorporated into a curriculum that appeals to a variety of learners. Multimodal remote education strategies can be used as a foundation for further innovation aimed at developing tomorrow's otolaryngologists.


COVID-19 research: promising tracks leading to uro-oncology


title: Development and validation of the HNC-LL score for predicting the severity of coronavirus disease 2019

text: BACKGROUND: Information regarding risk factors associated with severe coronavirus disease (COVID-19) is limited. This study aimed to develop a model for predicting COVID-19 severity. METHODS: Overall, 690 patients with confirmed COVID-19 were recruited between 1 January and 18 March 2020 from hospitals in Honghu and Nanchang; finally, 442 patients were assessed. Data were categorised into the training and test sets to develop and validate the model, respectively. FINDINGS: A predictive HNC-LL (Hypertension, Neutrophil count, C-reactive protein, Lymphocyte count, Lactate dehydrogenase) score was established using multivariate logistic regression analysis. The HNC-LL score accurately predicted disease severity in the Honghu training cohort (area under the curve [AUC]=0.861, 95% confidence interval [CI]: 0.800-0.922; P<0.001); Honghu internal validation cohort (AUC=0.871, 95% CI: 0.769-0.972; P<0.001); and Nanchang external validation cohort (AUC=0.826, 95% CI: 0.746-0.907; P<0.001) and outperformed other models, including CURB-65 (confusion, uraemia, respiratory rate, BP, age ≥65 years) score model, MuLBSTA (multilobular infiltration, hypo-lymphocytosis, bacterial coinfection, smoking history, hypertension, and age) score model, and neutrophil-to-lymphocyte ratio model. The clinical significance of HNC-LL in accurately predicting the risk of future development of severe COVID-19 was confirmed. INTERPRETATION: We developed an accurate tool for predicting disease severity among COVID-19 patients. This model can potentially be used to identify patients at risks of developing severe disease in the early stage and therefore guide treatment decisions. FUNDING: This work was supported by the National Nature Science Foundation of China (grant no. 81972897) and Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme (2015).


Novel Coronavirus-Induced NLRP3 Inflammasome Activation: A Potential Drug Target in the Treatment of COVID-19


Telehealth monitoring for hypertrophic cardiomyopathy and amyloid cardiomyopathy patients: lessons from the coronavirus disease 2019 lockdown in Italy


title: Geospatial Hotspots Need Point-of-Care Strategies to Stop Highly Infectious Outbreaks: Ebola and Coronavirus

text: Context. Point-of-care testing (POCT), diagnostic testing at or near the site of patient care, is inherently spatial, that is, performed at points of need, and also intrinsically temporal, because it produces fast actionable results. Outbreaks generate geospatial "hotspots." POC strategies help control hotspots, detect spread, and speed treatment of highly infectious diseases. Objectives. To stop outbreaks, accelerate detection, facilitate emergency response for epidemics, mobilize public health practitioners, enhance community resilience, and improve crisis standards of care. Data Sources. PubMed, WWW, newsprint, others were searched until COVID-19 was declared a pandemic, the US, a national emergency, and Europe, the epicenter. Coverage comprised interviews in Asia, email to/from Wuhan, papers, articles, chapters, documents, maps, flowcharts, schematics, and geospatial-associated concepts. EndNote X9.1 (Clarivate Analytics) consolidated literature as abstracts, ULRs, and PDFs, recovering 136 hotspot articles. More than 500 geospatial science articles were assessed for relevance to point-of-care testing. Conclusions POCT can interrupt spirals of dysfunction and delay by enhancing disease detection, decision making, contagion containment, and safe spacing, thereby softening outbreak surges and diminishing risk before human, economic, and cultural losses mount. Point-of-care tests results identify where infected individuals spread COVID-19, when delays cause death, and how to deploy resources. Results in national cloud databases help optimize outbreak control, mitigation, emergency response, and community resilience. The COVID-19 pandemic demonstrates unequivocally that governments must support POCT and multidisciplinary healthcare personnel must learn its principles, then adopt POC geospatial strategies, so that onsite diagnostic testing can ramp up to meet needs in times of crisis.


title: Revisiting conservative orthopaedic management of fractures during COVID-19 pandemic

text: COVID-19 pandemic has brought the need to revisit the conservative management of orthopaedic injuries back into sharp focus. On the advent of COVID-19 pandemic, it has been acknowledged by the British Orthopaedic Association (BOA) emergency COVID-19 and the National Health Service England (NHSE) guidelines to manage urgent orthopaedic and trauma conditions pragmatically balancing optimum treatment of patients against clinical safety with resource utilization .The current Coronavirus outbreak has refocussed orthopaedic minds on managing many injuries conservatively, which would have otherwise been managed with operative fixations. We revisit the role of conservative orthopaedic management of fractures in the context of COVID-19 and current guidelines.


A plea for unification of surgical guidelines in the COVID-19 outbreak


title: A COVID-19-betegek, tünetmentes hordozók, illetve a betegségen már átesettek periodikus monitorizálási lehetosége IgM/IgG antitest alapú gyorstesztekkel az egészségügyi személyzet körében a SARS-CoV-2-járvány idején./ Opportunity of periodic monitoring of COVID-19 patients, asymptomatic virus carriers, and postinfectious individuals with IgM/IgG rapid antibody tests among healthcare workers during SARS-CoV-2 pandemic

text: The first Hungarian COVID-19 case was reported on March 4, 2020 by Hungarian officials. Healthcare workers (HCWs) are at the highest risk of contracting the novel coronavirus (SARS-CoV-2), with 12% of total coronavirus cases confirmed among them recently. 80% of the infected persons show only mild, moderate symptoms or stay asymptomatic. The single-stranded viral RNA can be detected by RT-PCR from the respiratory tract, urine, blood and, particulary in children, from stool samples for 30-40 days. We have no valid data of how many HCWs have been infected since the Hungarian SARS-CoV-2 outbreak, due to the lack of the systematic screening. HCWs could play a critical role in transmission and might jeopardize the health of both their patients and their own family members. Both cross-sectional and longitudinal sudies are recommended to evaluate the ratio of the recovered, i.e., "already protected", the ones in the acute phase, i.e., "the infectious", and the virus-naive, i.e., "at risk" workers. Of the available molecular diagnostic options, in addition to RT-PCR it would be advisable to introduce the novel rapid antibody tests which can give quick results, reveal the timeline of the infection, are easy to handle, inexpensive and can be used periodically to monitor HCWs' viral status during the still unkown duration of the SARS-CoV-2 pandemic. Orv Hetil. 2020; 161(21): 854-860.


Pulmonary embolism in coronavirus disease-19 (COVID-19) and use of compression ultrasonography in its optimal management


Ethics and governance for digital disease surveillance


Comment on "Colchicine may not be effective in COVID-19 infection; it may even be harmful?"


A call for a global COVID-19 Neuro Research Coalition


title: OUTBREAK: A user-friendly georeferencing online tool for disease surveillance

text: The current COVID-19 pandemic has already claimed more than 100,000 victims and it will cause more deaths in the coming months. Tools that can track the number and locations of cases are critical for surveillance and can help in making policy decisions for controlling the outbreak. The current surveillance web-based dashboards run on proprietary platforms, which are often expensive and require specific computational knowledge. We present a new tool (OUTBREAK) for studying and visualizing epidemiological data. It permits even non-specialist users to input data most conveniently and track outbreaks in real-time. This tool has the potential to guide and help health authorities to intervene and minimize the effects of the outbreaks. It is freely available at http://outbreak.sysbio.tools/.


title: Real-world Treatment Patterns and Outcomes in Non-Transplant Newly Diagnosed Multiple Myeloma in France, Germany, Italy, and the United Kingdom

text: OBJECTIVES: The treatment paradigm in newly diagnosed multiple myeloma (NDMM) is evolving towards individualized, risk-directed and longer duration of therapy (DOT). The objective of this study was to describe treatment patterns and outcomes in non-transplant NDMM in four European countries. METHODS: This retrospective chart review included adults with NDMM diagnosed between January 1, 2012 and December 31, 2013 (early cohort) or April 1, 2016 and March 31, 2017 (recent cohort). RESULTS: Among 836 patients, molecular testing was performed in 21% and 35% patients of early vs. recent cohorts; proteasome inhibitor (PI)/alkylator combinations were the principal first-line (1L) therapy (39% vs. 43%). Use of immunomodulatory drug (IMID)/alkylator combinations declined from early to recent cohort (26% vs. 13%) but IMID (7% vs. 16%) use increased. Few patients (5%) received 1L maintenance therapy. Two-thirds of patients were treated with a fixed duration intent, with a median 7-month 1L DOT and progression-free survival (PFS) of 32.8 months in the early cohort. Both 1L DOT and PFS were longer with oral compared to injectable regimens. CONCLUSIONS: Although frontline treatment patterns changed significantly, 1L DOT is short. The uptake of molecular testing and 1L maintenance is low. These results highlight areas of unmet need in NDMM.


title: Fatal Eosinophilic Myocarditis in a Healthy 17-Year-Old Male with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2c)

text: Background: Cardiac damage is frequently referred to in patients with SARS-CoV-2, is usually diagnosed by enzyme elevations, and is generally thought to be due to underlying coronary artery disease. There are references to cardiomyopathies accompanying coronavirus, but there has been no histologic confirmation.Case report: A previously healthy 17 year male old presented in full cardiac arrest to the emergency department after a 2 day history of headache, dizziness, nausea and vomiting. Autopsy demonstrated an enlarged flabby heart with eosinophilic myocarditis. There was no interstitial pneumonia or diffuse alveolar damage. Postmortem nasopharyngeal swabs detected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) known to cause coronavirus disease 2019 (COVID-19). No other cause for the eosinophilic myocarditis was elucidated.Conclusion: Like other viruses, SARS-CoV-2 may be associated with fulminant myocarditis.


Unknown Unknowns: Surgical Consent during the COVID-19 Pandemic


title: Metformin and SARS-CoV-2: mechanistic lessons on air pollution to weather the cytokine/thrombotic storm in COVID-19

text: Pathological signaling in the lung induced by particulate matter (PM) air pollution partially overlaps with that provoked by COVID-19, the pandemic disease caused by infection with the novel coronavirus SARS-CoV-2. Metformin is capable of suppressing one of the molecular triggers of the proinflammatory and prothrombotic processes of urban PM air pollution, namely the mitochondrial ROS/Ca2+ release-activated Ca2+ channels (CRAC)/IL-6 cascade. Given the linkage between mitochondrial functionality, ion channels, and inflamm-aging, the ability of metformin to target mitochondrial electron transport and prevent ROS/CRAC-mediated IL-6 release might illuminate new therapeutic avenues to quell the raging of the cytokine and thrombotic-like storms that are the leading causes of COVID-19 morbidity and mortality in older people. The incorporation of infection rates, severity and lethality of SARS-CoV-2 infections as new outcomes of metformin usage in elderly populations at risk of developing severe COVID-19, together with the assessment of bronchial/serological titers of inflammatory cytokines and D-dimers, could provide a novel mechanistic basis for the consideration of metformin as a therapeutic strategy against the inflammatory and thrombotic states underlying the gerolavic traits of SARS-CoV-2 infection.


title: Perioperative care of the newborns with CHDs in the time of COVID-19

text: Coronavirus disease 2019 (COVID-19), caused by a novel betacoronavirus (SARS-CoV-2), has led to an unexpected outbreak affecting people of all ages. The first data showed that COVID-19 could cause severe pulmonary disease, cardiac injury, and death in adults, especially the elderly and those with concomitant diseases. Currently, it was demonstrated that severe COVID-19 may also develop in neonatal age, although rarely. Newborns with CHD are known to be at high risk for increased morbidity from viral lower respiratory tract infections because of underlying anatomical cardiac lesions. There are limited data on the implications of COVID-19 on patients with cardiovascular disease, especially for those with CHD. Herein, we aimed to summarise the COVID-19-specific perioperative management issues for newborns with CHD by combining available data from the perspectives of neonatology and paediatric cardiovascular surgery.


title: Evaluate severe acute respiratory syndrome coronavirus 2 infectivity by pseudoviral particles

text: Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in humans in late 2019, it has rapidly spread worldwide. To identify the biological characteristics of SARS-CoV-2 in a normal laboratory environment (biosafety level 2 [BSL-2]), a lentiviral-based nucleocapsid was used to carry the spike protein of SARS-CoV-2 onto the surface of pseudoviral particles as a surrogate model to evaluate the infective characterization of SARS-CoV-2. This study indicated that SARS-CoV-2 has extensive tissue tropism for humans and may infect monkeys and tree shrews but not rodents. More importantly, the use of pseudoviral particles in this study allows rapid assessment of neutralizing antibodies in serum in a BSL-2 laboratory. This study will provide a quick and easy tool for evaluating neutralizing antibodies in the serum of recovering patients and assessing the potency of candidate vaccines.


Breastfeeding, Human Milk Collection and Containers, and Human Milk Banking: Hot Topics During the COVID-19 Pandemic


title: Hidroxicloroquina. Mensajes desde la cardiología en tiempos de pandemia por coronavirus./ [Hydroxychloroquine. Cardiology's viewpoint in times of coronavirus pandemic]

text: Due to the coronavirus disease 2019 (COVID-19) pandemic, a wide number of compounds are under scrutiny regarding their antiviral activity, one of them being hydroxychloroquine. Cardiac aspects of the use of chloroquine and hydroxychloroquine are reviewed in this manuscript. A non-systematic review of the medical literature was performed. Information about their safety and efficacy as antimalarials, antivirals, as well as in the long-term treatment of rheumatic diseases was collected. We found an anti-inflammatory effect with reduction of longterm cardiovascular events, a very infrequent heart disease due to a lysosomal effect of the drug, and at the hemodynamic level hypotension, tachycardia, and QT interval prolongation, exacerbated when combined with azithromycin. However, the rate of adverse cardiac events of hydroxychloroquine (and chloroquine) was low.


Perplexité d'un virologue retraité face au SARS-CoV-2./ Perplexity of a retired virologist facing at SARS-CoV-2


title: Impact of immune enhancement on Covid-19 polyclonal hyperimmune globulin therapy and vaccine development

text: The pandemic spread of a novel coronavirus - SARS coronavirus-2 (SARS-CoV-2) as a cause of acute respiratory illness, named Covid-19, is placing the healthcare systems of many countries under unprecedented stress. Global economies are also spiraling towards a recession in fear of this new life-threatening disease. Vaccines that prevent SARS-CoV-2 infection and therapeutics that reduces the risk of severe Covid-19 are thus urgently needed. A rapid method to derive antiviral treatment for Covid-19 is the use of convalescent plasma derived hyperimmune globulin. However, both hyperimmune globulin and vaccine development face a common hurdle - the risk of antibody-mediated disease enhancement. The goal of this review is to examine the body of evidence supporting the hypothesis of immune enhancement that could be pertinent to Covid-19. We also discuss how this risk could be mitigated so that both hyperimmune globulin and vaccines could be rapidly translated to overcome the current global health crisis.


title: Systematic review and meta-analysis of treating meibomian gland dysfunction with azithromycin

text: To systematically review studies of managing meibomian gland dysfunction (MGD) with azithromycin and pool clinical outcomes to show its effectiveness. Eligible studies were retrieved from five main electronic databases. Symptom score was the primary outcome, while clinical signs and objective measurements were secondary outcomes. Pooled rates for adverse events were also calculated. Improvements in each outcome after administering either oral azithromycin (OA) or topical azithromycin (TA) were pooled and measured by standard mean difference (SMD) to show the overall effectiveness. Then the effectiveness was sub-grouped by TA and OA. In addition, pooled outcomes after administering TA and oral doxycycline (OD) were compared with assess their effectiveness. Finally, 18 eligible studies were included. The overall pooled symptom scores were significantly reduced after administering both TA and OA [P < 0.0001; SMD = 1.54 (95% CI: 1.15-1.92)]. Similarly, the overall combined eyelid signs, plugging of the meibomian gland, meibum quality, and tear secretion were also distinctly improved. However, significant improvements for tear break-up time (TBUT) and corneal staining (CS) were achieved by TA (TBUT: P = 0.02; CS: P = 0.02) but not by OA (TBUT: P = 0.08; CS: P = 0.14). The pooled adverse event rates for TA and OA were 25% and 7%, respectively. Moreover, TA was comparable to OD to treat MGD regarding symptom score, TBUT and tear secretion. This study showed that MGD could be treated effectively with oral or topical azithromycin by improving symptoms, clinical signs, and stabilization of tear film. Topical azithromycin seemed to be superior over oral azithromycin or doxycycline in improving the quality of tear film in the short term.


Non-COVID-19 general practice and our response to the pandemic


title: Remote Methods for Conducting Tobacco-Focused Clinical Trials

text: Most tobacco-focused clinical trials are based on locally-conducted studies that face significant challenges to implementation and successful execution. These challenges include the need for large, diverse, yet still representative study samples. This often means a protracted, costly, and inefficient recruitment process. Multi-site clinical trials can overcome some of these hurdles but incur their own unique challenges. With recent advances in mobile health (mHealth) and digital technologies, there is now a promising alternative: Remote Trials. These trials are led and coordinated by a local investigative team, but are based remotely, within a given community, state, or even nation. The remote approach affords many of the benefits of multi-site trials (more efficient recruitment of larger study samples) without the same barriers (cost, multi-site management, regulatory hurdles). The Coronavirus Disease 2019 (COVID-19) global health pandemic has resulted in rapid requirements to shift ongoing clinical trials to remote delivery and assessment platforms, making methods for the conduct of remote trials even more timely. The purpose of the present manuscript it to provide an overview of available methods for the conduct of remote tobacco-focused clinical trials as well as illustrative examples of how these methods have been implemented across recently completed and ongoing tobacco studies. We focus on key aspects of the clinical trial pipeline including remote: 1) study recruitment and screening, 2) informed consent, 3) assessment, 4) biomarker collection, and 5) medication adherence monitoring.


Why Is Modeling COVID-19 So Difficult?


title: [Laboratory testing techniques for SARS-CoV-2]

text: The ongoing epidemic of caused by the coronavirus SARS-CoV-2 starting in December 2019 poses a serious public health threat globally. The virus is highly infectious and transmitted mainly through droplets and contacts, and is associated with a high risk of pneumonia. A small number of patients may present with acute respiratory distress syndrome with severe respiratory complications, which can lead even to death. The selection of appropriate detection techniques and methods for accurate and rapid identification of pathogens therefore plays a key role in improving the diagnosis and treatment of the patients and containing the outbreak. In this review, the authors gives an overview of the virus laboratory detection technology, including virus isolation and culture, real-time fluorescent PCR, gene sequencing, serological antibody detection, and the gene editing technology based on CRISPR/Cas13 system. These techniques are expected to provide valuable assistance in controlling the epidemic and new ideas for future researches.


Trauma and orthopaedics in the COVID-19 pandemic: breaking every wave


title: Patients' Perceptions on Surgical Care Suspension for Pelvic Floor Disorders During the COVID-19 Pandemic

text: OBJECTIVES: The primary objective of the study was to evaluate patients' attitudes toward the postponement of their scheduled procedures for pelvic floor disorders (PFD) because of the COVID-19 pandemic. Secondary objectives were to identify patients who were upset with the postponement of their PFD procedures and to identify factors that are associated with being upset because of the delay in care. METHODS: This was a cross-sectional, survey-based study of women from a single urban, academic practice using a novel questionnaire. The study cohort included women whose PFD surgeries or office procedures were postponed between March 17 and April 30, 2020. RESULTS: Ninety-eight women had surgeries postponed; 68 (70%) responded to our questionnaire. Nearly half of the respondents (32/68, 47.1%) were upset about their procedures being postponed. Upset patients reported a greater impact of PFD symptoms on their mood than those who were not upset (P = 0.002). Those who were upset were also more likely to report feelings of isolation (P = 0.006), fear that their PFD would worsen because of delayed care (P < 0.001), and anxiety over surgery postponement (P < 0.001) than those who were not upset about the delays. When controlling for anxiety, social isolation, and impact of PFD symptom, anxiety (adjusted odds ratio = 15.7; 95% confidence interval = 3.7-66.6) and feeling of isolation (adjusted odds ratio = 9.7; 95% confidence interval = 1.5-63.7) remained associated with increased odds of being upset because of procedure delays. CONCLUSIONS: Half of women whose pelvic reconstructive procedures were postponed because of the COVID-19 pandemic were upset because of the delay in care, especially those who are emotionally and socially vulnerable during the COVID-19 pandemic.


title: Strong correlations between power-law growth of COVID-19 in four continents and the inefficiency of soft quarantine strategies

text: In this work, we analyze the growth of the cumulative number of confirmed infected cases by a novel coronavirus (COVID-19) until March 27, 2020, from countries of Asia, Europe, North America, and South America. Our results show that (i) power-law growth is observed in all countries; (ii) by using the distance correlation, the power-law curves between countries are statistically highly correlated, suggesting the universality of such curves around the world; and (iii) soft quarantine strategies are inefficient to flatten the growth curves. Furthermore, we present a model and strategies that allow the government to reach the flattening of the power-law curves. We found that besides the social distancing of individuals, of well known relevance, the strategy of identifying and isolating infected individuals in a large daily rate can help to flatten the power-laws. These are the essential strategies followed in the Republic of Korea. The high correlation between the power-law curves of different countries strongly indicates that the government containment measures can be applied with success around the whole world. These measures are scathing and to be applied as soon as possible.


title: Antiviral effects of probiotic metabolites on COVID-19

text: SARS coronavirus (COVID-19) is a real health challenge of the 21st century for scientists, health workers, politicians, and all humans that has severe cause epidemic worldwide. The virus exerts its pathogenic activity through by mechanism and gains the entry via spike proteins (S) and Angiotensin-Converting Enzyme 2 (ACE2) receptor proteins on host cells. The present work is an effort for a computational target to block the residual binding protein (RBP) on spike proteins (S), Angiotensin-Converting Enzyme 2 (ACE2) receptor proteins by probiotics namely Plantaricin BN, Plantaricin JLA-9, Plantaricin W, Plantaricin D along with RNA-dependent RNA polymerase (RdRp). Docking studies were designed in order to obtain the binding energies for Plantaricin metabolites. The binding energies for Plantaricin W were -14.64, -11.1 and -12.68 for polymerase, RBD and ACE2 respectively comparatively very high with other compounds. Plantaricin W, D, and JLA-9 were able to block the residues (THR556, ALA558) surrounding the deep grove catalytic site (VAL557) of RdRp making them more therapeutically active for COVID-19. Molecular dynamics studies further strengthen stability of the complexes of plantaricin w and SARS-CoV-2 RdRp enzyme, RBD of spike protein, and human ACE2 receptor. The present study present multi-way options either by blocking RBD on S proteins or interaction of S protein with ACE2 receptor proteins or inhibiting RdRp to counter any effect of COVID-19 by Plantaricin molecules paving a way that can be useful in the treatment of COVID-19 until some better option will be available.Communicated by Ramaswamy H. Sarma.


title: Leaning In to Serious Illness Care Through Stories and Science

text: This volume was planned prior to the COVID-19 pandemic as the North Carolina Institute of Medicine (NCIOM) completed a yearlong task force on serious illness. Beyond the task force report, we wanted to dedicate a special edition of the NCMJ to serious illness issues. We commissioned authors who could discuss the challenges, the current practices, and the extensive personal and professional skills needed to navigate these complicated medical diagnoses that often end in death. Little did we know how timely this would be in light of the current pandemic, and we can only speculate on how the world will look as this is published. Our pre-COVID planning reflected personal experiences we all face with the common denominator of serious illness impacting and shaping our lives. As guest editors, we considered how this NCMJ edition would address personal concerns for you, our reader, as well as ourselves. A physician, a social worker, and a nurse, we each have our stories and we want to invite you to lean in and bring both your head and your heart to this reading. We start by relating two very personal experiences that shaped not only life following loss, but also career choices, clinical practices, and scholarship. As you focus on this journal's content, we hope you will also reflect on the people you care for, as well as the issues we all inevitably face.


Mortality and psychological stress in pregnant and postnatal women during COVID-19 outbreak in West Sumatra, Indonesia


Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?


title: A case report of serious haemolysis in a glucose-6-phosphate dehydrogenase-deficient COVID-19 patient receiving hydroxychloroquine

text: While the COVID-19 epidemic occurred since December 2019, as of end April 2020, no treatment has been validated or invalidated by accurate clinical trials. Use of hydroxychloroquine has been popularised on mass media and put forward as a valid treatment option without strong evidence of efficacy. Hydroxychloroquine (HCQ) has its own side effects, some of which are very serious like acute haemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficient patients. Side effects may be worse than the disease itself. Belgian national treatment guidelines recommend the use of HCQ in mild to severe COVID-19 disease. As opinions, politics, media and beliefs are governing COVID-19 therapy, performance of randomised controlled blinded clinical trials became difficult. Results of sound clinical trials are eagerly awaited. We report a case of acute haemolysis leading to admission in intensive care unit and renal failure in a patient with uncovered G6PD deficiency.


Cardiology practice in the COVID-19 era


How poorer countries are scrambling to prevent a coronavirus disaster


title: Addressing caregiver moral distress during the COVID-19 pandemic

text: Moral distress is the psychological distress that is experienced in relation to a morally challenging situation or event. Although it was first observed within nursing, caregivers across all disciplines-including physicians, respiratory therapists, social workers and chaplains-experience moral distress. In this consult, we discuss 5 types of moral distress using examples of changes to clinical practice that have occurred due to COVID-19. We also provide suggestions for responding to moral distress and outline the resources available at Cleveland Clinic.


Schwartz rounds for healthcare personnel in coping with COVID-19 pandemic


Experiencia desde el punto de vista de un traumatólogo en el Hospital COVID-IFEMA en Madrid durante la pandemia del coronavirus en España./ Experiencia desde el punto de vista de un traumatólogo en el Hospital COVID-IFEMA en Madrid durante la pandemia del coronavirus en España./ An orthopaedic surgeon's experience at COVID-IFEMA Hospital during coronavirus pandemic in Spain


title: Implementatie van een stoppen-met-rokenprogramma in een psychiatrisch ziekenhuis: eerste resultaten./ [Implementation of a stop-smoking support program for patients and employees in a psychiatric hospital: First results]

text:
BACKGROUND: In contrast to several other countries, smoking is not an integral part of treatment during admission to a psychiatric hospital in The Netherlands.
 AIM: Implementation of a smoking cessation program for patients and employees of a psychiatric ward of an academic medical center in The Netherlands.
 METHOD: Prospective, mixed-method study of implementation of a smoking cessation program for patients and employees of a psychiatric academic hospital in Amsterdam. The program consisted of 7 weekly group meetings by certified smoking cessation coaches. Nicotine replacement therapy was provided for free, if necessary.
 RESULTS: During 14 months, 65 individuals were seeking help to stop smoking: 39 patients and 26 employees. Of these, 29 patients and 16 employees participated in group meetings with an average of 2.6 times per person. There were 20 individuals who visited the group meetings or received individual coaching at least 3 times (6 patients and 14 employees). Fifty-five percent of these individuals reported to be smoke-free at 3 months after joining the first meeting. Employees were much more likely to quit than patients. From interviews with 20 participants, it was noticed that combining patients and employees in one group was perceived as a barrier due to a gap in processing speed.
 CONCLUSION: On the psychiatric ward of an academic hospital in The Netherlands, there was a positive experience with providing smoking cessation treatment. A small number of employees and patients participated in a smoking cessation program and quitting smoking was reached by only a few patients. Supporting smoking cessation in a psychiatric hospital asks for intensive screening, diagnosing, treatment and smoke-free policies.


El tratamiento de la pandemia por COVID 19. Ante la expectativa de evitar una oportunidad perdida./ [Treatment of the COVID-19 pandemic: Preventing a missed opportunity]


title: Digital Technologies-Enabled Smart Manufacturing and Industry 4.0 in the Post-COVID-19 Era: Lessons Learnt from a Pandemic

text: The "Severe Acute Respiratory Syndrome Coronavirus Type 2" (SARS-CoV-2) has been identified as the infectious agent responsible for the generally mild but sometimes life-threatening communicable disease known as "Coronavirus Disease 2019" (COVID-19) [...].


Poor outcome of intestinal ischemic manifestations of COVID 19


title: Public Health Academic Alliance for COVID-19 Response: The Role of a National Medical Task Force in Puerto Rico

text: Alliances between the government and academic communities can be a key component of the public health response to an emergency such as the coronavirus disease 2019 (COVID-19) pandemic. The Governor of Puerto Rico designated the Puerto Rico Medical Task Force (MTF) COVID-19 to provide direct guidance and evaluation of the government response to the epidemic in Puerto Rico. Several work groups were formed within the MTF to create protocols and provide evidence-based recommendations on different public health aspects. The collaboration between the academia and the government enhanced the Puerto Rican public health response and contributed to the reduction seen in the contagion curve. Healthcare services and hospitals have not reached their maximum patient care capacity and the death toll has been controlled. Incorporating a national MTF with members of the academia into the government structure was beneficial during the COVID-19 response in Puerto Rico. A similar strategy could serve as a model for other states or territories and countries in similar scenarios.


Is molecular mimicry the culprit in the autoimmune haemolytic anaemia affecting patients with COVID-19?


Occupational skin conditions on the front line: a survey among 484 Chinese healthcare professionals caring for Covid-19 patients


El reto de una unidad de cuidados intensivos en un recinto ferial./ El reto de una unidad de cuidados intensivos en un recinto ferial./ The challenge of an intensive care unit in a fairground


Anatomy of a response


title: Acute kidney injury in pregnant women following SARS-CoV-2 infection: A case report from Iran

text: We reported a 33-year-old female case with novel coronavirus disease 2019 (COVID-19) accompanied by Acute tubular necrosis (ATN). She had a gestational age of 34 weeks. The patient referred to treatment clinic for COVID-19 in Imam Reza hospital of Tabriz (Iran) after having flu-like symptoms. In radiologic assessment, ground glass opacity (GGO) with consolidation was found in upper right lobe. Lopinavir/ritonavir (200mg/50mg) two tablet tow times, Ribavirin 200mg every six hours, and Oseltamivir 75mg tow times were given for the treatment of COVID-19. The medications used for treatment of pneumonia were Meropenem, Ciprofloxacin, Vancomycin. All doses of medications were administrated by adjusted dose assuming the patient is anephric. Also, a few supplements were also given after ATN development including daily Rocaltrol and Nephrovit (as a multivitamin appropriate for patients with renal failure), Folic acid and Calcium carbonate. The patient is still under ventilator with a Fraction of inspired oxygen (FiO2) of 60% and Positive end-expiratory pressure (PEEP) of eight. SpO2 is 94% but the patient's ATN problem has been resolved. We started weaning from mechanical ventilator. The patient is conscious with full awareness to time, person and place. The maternal well-being is achieved and her neonate was discharged.


Covid-19 and the Stiff Upper Lip - The Pandemic Response in the United Kingdom


Time to Reconsider Diverse Ways of Working in Japan to Promote Social Distancing Measures against the COVID-19


Telemedicine in prisons: A Crime in Mind perspective


title: Risk Factors for Mortality among COVID-19 Patients

text: AIMS: COVID-19 is a current globalpandemic. However, comprehensive global data analyses for its mortality risk factors are lacking. The current investigation aimed to assess the predictors of death among COVID-19 patients from worldwide open access data. METHODS: A total of 828 confirmed cases of COVID-19 with definite outcomes were retrospectively identified from open access individual-level worldwide data. Univariate followed by multivariable regression analysis were used to evaluate the association between potential risk factors and mortality. RESULTS: Majority of the patients were males 59.1% located in Asia 69.3%. Based on the data, older age (adjusted odds ratio (aOR), 1.079; 95% confidence intervals (95% CI), 1.064-1.095 per year increase), males (aOR, 1.607; 95% CI, 1.002-2.576), patients with hypertension (aOR, 3.576; 95% CI, 1.694-7.548), diabetes mellitus (aOR, 12.234; 95% CI, 4.126-36.272), and patients located in America (aOR, 7.441; 95% CI, 3.546-15.617) were identified as the risk factors of mortality among COVID-19 patients. CONCLUSIONS: Males, advanced age, hypertension patients, diabetes mellitus patients, and patients located in America were the independent risk factors of death among COVID-19 patients. Extra attention is required to be given to these factors and additional studies on the underlying mechanisms of these effects.


title: COVID-19: Social Media Sentiment Analysis on Reopening

text: The novel coronavirus (COVID-19) pandemic is the most talked topic in social media platforms in 2020. People are using social media such as Twitter to express their opinion and share information on a number of issues related to the COVID-19 in this stay at home order. In this paper, we investigate the sentiment and emotion of peoples in the United States on the subject of reopening. We choose the social media platform Twitter for our analysis and study the Tweets to discover the sentimental perspective, emotional perspective, and triggering words towards the reopening. During this COVID-19 pandemic, researchers have made some analysis on various social media dataset regarding lockdown and stay at home. However, in our analysis, we are particularly interested to analyse public sentiment on reopening. Our major finding is that when all states resorted to lockdown in March, people showed dominant emotion of fear, but as reopening starts people have less fear. While this may be true, due to this reopening phase daily positive cases are rising compared to the lockdown situation. Overall, people have a less negative sentiment towards the situation of reopening.