title: Cell-based therapy to reduce mortality from COVID-19: Systematic review and meta-analysis of human studies on acute respiratory distress syndrome

text: Severe cases of COVID-19 infection, often leading to death, have been associated with variants of acute respiratory distress syndrome (ARDS). Cell therapy with mesenchymal stromal cells (MSCs) is a potential treatment for COVID-19 ARDS based on preclinical and clinical studies supporting the concept that MSCs modulate the inflammatory and remodeling processes and restore alveolo-capillary barriers. The authors performed a systematic literature review and random-effects meta-analysis to determine the potential value of MSC therapy for treating COVID-19-infected patients with ARDS. Publications in all languages from 1990 to March 31, 2020 were reviewed, yielding 2691 studies, of which nine were included. MSCs were intravenously or intratracheally administered in 117 participants, who were followed for 14 days to 5 years. All MSCs were allogeneic from bone marrow, umbilical cord, menstrual blood, adipose tissue, or unreported sources. Combined mortality showed a favorable trend but did not reach statistical significance. No related serious adverse events were reported and mild adverse events resolved spontaneously. A trend was found of improved radiographic findings, pulmonary function (lung compliance, tidal volumes, PaO2 /FiO2 ratio, alveolo-capillary injury), and inflammatory biomarker levels. No comparisons were made between MSCs of different sources.


Association of Hydroxychloroquine with QTc Interval in Patients with COVID-19


title: Coronaviridae-Old friends, new enemy!

text: Coronaviridae is a family of single-stranded positive enveloped RNA viruses. This article aimed to review the history of these viruses in the last 60 years since their discovery to understand what lessons can be learned from the past. A review of the PubMed database was carried out, describing taxonomy, classification, virology, genetic recombination, host adaptation, and main symptoms related to each type of virus. SARS-CoV-2 is responsible for the ongoing global pandemic, and SARS-CoV and MERS-CoV were responsible for causing severe respiratory illness and regional epidemics in the past while the four other strains of CoVs (229-E OC43, NL63, and HKU1) circulate worldwide and normally only cause mild upper respiratory tract infections. Given the enormous diversity of coronavirus viruses in wildlife and their continuous evolution and adaptation to humans, future outbreaks would undoubtedly occur. Restricting or banning all trade in wild animals in wet markets would be a necessary measure to reduce future zoonotic infections.


Increased Severity of COVID-19 in People with Obesity: Are We Overlooking Plausible Biological Mechanisms?


title: Disability through COVID-19 pandemic: Neurorehabilitation cannot wait

text: Coronavirus disease 2019 (CoViD-19) pandemic is strongly impacting all domains of our healthcare systems, including rehabilitation. In Italy, the first hit European country, medical activities were postponed to allow shifting of staff and facilities to intensive care, with neurorehabilitation limited to time-dependent diseases,1 including CoViD-19 complications.2,3 Hospital access to people with chronic neurodegenerative conditions such as multiple sclerosis, movement disorders or dementia, more at risks of serious consequences from the infection,4 has been postponed. Patients also seek less for hospital care, with over 50% reduced stroke admissions as from an Italian survey,5 possibly in fear of being infected or denied to see their families after being hospitalized. This situation can be bearable only for a short time, as any initial freezing reaction to a danger.


COVID-19, hypertension and angiotensin receptor-blocking drugs


title: POCIS calibration for organic compound sampling in small headwater streams

text: Field-based atrazine sampling rates (Rs ) by the polar organic chemical integrative sampler (POCIS) were measured in nine headwater streams in three years covering 5 to 6 exposure periods of 2 to 3 weeks per site per year. Rates were best in line with the model Rs = 148 mL/d, with a standard deviation of 0.17 log units (factor 1.5). POCIS canisters reduced mass transfer coefficients of the water boundary layer by a factor of 2 as measured by alabaster dissolution rates. A mechanistic model that accounts for flow and temperature effects yielded a fair estimate of the effective exchange surface area (12.5 ± 0.8 cm2 ). This model could only be tested for higher flow velocities because of uncertainties associated with the measurement of flow velocities < 1 cm/s. Pictures of sorbent distributions in POCIS showed that the effective exchange surface area varied with time during the exposures. Error analysis indicated that sorbent distributions and chemical analysis were minor error sources. The main conclusion of this study is that an atrazine sampling rate of 148 mL/d yields consistent results for all three years across nine headwater streams. This article is protected by copyright. All rights reserved.


title: Cathepsin L-selective inhibitors: A potentially promising treatment for COVID-19 patients

text: The widespread coronavirus SARS-CoV-2 has already infected over 4 million people worldwide, with a death toll over 280,000. Current treatment of COVID-19 patients relies mainly on antiviral drugs lopinavir/ritonavir, arbidol, and remdesivir, the anti-malarial drugs hydroxychloroquine and chloroquine, and traditional Chinese medicine. There are over 2118 on-going clinical trials underway, but to date none of these drugs have consistently proven effective. Cathepsin L (CatL) is an endosomal cysteine protease. It mediates the cleavage of the S1 subunit of the coronavirus surface spike glycoprotein. This cleavage is necessary for coronavirus entry into human host cells, virus and host cell endosome membrane fusion, and viral RNA release for next round of replication. Here we summarize data regarding seven CatL-selective inhibitors that block coronavirus entry into cultured host cells and provide a mechanism to block SARS-CoV-2 infection in humans. Given the rapid growth of the SARS-CoV-2-positive population worldwide, ready-to-use CatL inhibitors should be explored as a treatment option. We identify ten US FDA-approved drugs that have CatL inhibitory activity. We provide evidence that supports the combined use of serine protease and CatL inhibitors as a possibly safer and more effective therapy than other available therapeutics to block coronavirus host cell entry and intracellular replication, without compromising the immune system.


COVID-19: ban 'orientalism' by critics of wildlife trade


title: Telehealth-guided home-based maggot debridement therapy for chronic complex wounds: Peri- and post-pandemic potential

text: Patients with complex chronic lower extremity wounds require a great deal of interaction with outpatient and inpatient services. Paradoxically, these are the very patients that, because of their chronic comorbidities, are at greatest risk for COVID-related morbidity and mortality. Disinfected Phaenicia (Lucilia) sericata (Medical Maggots; Monarch Labs, Irvine, California) were applied in a standardised fashion by a home-health nurse with direct monitoring, guidance, and collaboration of the attending surgeon. A family member was able to change the outer dressing daily based on normal wound exudate. The inner maggot debridement therapy (MDT) dressing was changed at 2 days showing dramatic reduction in necrotic tissue, elimination of profound malodor, and no evidence of local or advancing infection. The entire initial telehealth-guided application took approximately 20 minutes. The first telehealth-guided MDT dressing change took 14 minutes. We used an artificial-intelligence-based algorithm to measure changes in wound characteristics. At day 0, 46% of the total surface area was covered in malodorous black, necrotic tissue. The first dressing change saw an elimination in assessed malodor with necrotic tissue constituting 14% of total surface area. The second dressing change at 5 days showed a greater than 99% reduction in necrotic tissue. This manuscript constitutes what we believe to be the first telehealth-guided MDT conducted during a resource-limited peri-pandemic period. We believe that MDT, which is an extension of efforts regularly performed in clinic and hospital, may have the potential to reduce resource usage while potentially improving care and quality of life for people with limb and life-threatening complications of diabetes and other chronic diseases.


Ensuring and Sustaining a Pandemic Workforce


title: Serious games for serious crises: reflections from an infectious disease outbreak matrix game

text: BACKGROUND: While there is widespread recognition of global health failures when it comes to infectious disease outbreaks, there is little discussion on how policy-makers and global health organizations can learn to better prepare and respond. Serious games provide an underutilized tool to promote learning and innovation around global health crises. In order to explore the potential of Serious Games as a policy learning tool, Global Affairs Canada, in collaboration with the Department of National Defense and academic partners, developed and implemented a matrix game aimed at prompting critical reflection and gender-based analysis on infectious disease outbreak preparedness and response. This commentary, written by the core development team, reflects on the process and outcomes of the gaming exercise, which we believe will be of interest to others hoping to promote innovative thinking and learning around global health policy and crisis response, as well as the application of serious games more broadly. MAIN BODY: Participants reported, through discussions and a post-game survey, that they felt the game was reflective of real-world decision-making and priority-setting challenges during a crisis. They reflected on the challenges that emerge around global health co-operation and outbreak preparedness, particularly noting the importance of learning to work with private actors. While participants only sporadically applied gender-based analysis or considered the social determinants of health during the game, post-game discussions led to reflection on the ways in which equity concerns are put aside during a crisis scenario and on why this happens, offering critical learning opportunities. CONCLUSION: Matrix games provide opportunities for policy-makers and health professionals to experience the challenges of global health co-operation, test ideas and explore how biases, such as those around gender, influence policy-making and implementation. Due to their flexibility, adaptability and accessibility, serious games offer a potentially powerful learning tool for global health policy-makers and practitioners.


title: Rehabilitation management of patients with COVID-19. Lessons learned from the first experiences in China

text: Corona virus disease 2019 (COVID-19) is a new disease characterized by lung damage and involvement in multiple tissues and organs in the whole body. Some of the patients may have long-term impairment and dysfunctions, including pulmonary fibrosis, heart, liver, kidney, nerve and immune system. Rehabilitation has certain beneficial effect in the acute stage, and especially in the recovery stage, including improving respiratory function, exercise endurance, self-care in daily living activities, as well as psychological support, etc. Rehabilitation is not offside or absent. A reasonable rehabilitation program needs scientific research to avoid arbitrary conclusions.


Toothbrushing against coronavirus


title: [Recent advances in treatment of viral pneumonia using Chinese patent medicine]

text: Viral pneumonia is caused by a spreading of lung infection caused by respiratory viruses. Some virus infections were found to be highly aggressive, leading to lung inflammation and severe damage in respiratory system with high fatality rate. Currently, there is no effective therapeutic drugs in the clinic. The common clinical symptoms of viral pneumonias include fever, rhinitis, runny nose, nonproductive cough, fatigue, myalgias and headaches after the immune system being tricked by driving cytokines and overactivated immune response induced by cytokine storms. Patients with severe symptoms could get persistent high fever, dysfunctional breathing, consciousness disorders and even respiratory failure, post-inflammatory pulmonary fibrosis, multi-organ damages, shock and so on. Most clinical treatments are used to inhibit virus replication, relieve symptoms, inhibit excessive inflammatory response, regulate immune balance and protect organs. Both applied and basic research demonstrate that Chinese patent medicine has certain anti-viral effects, effectively inhibiting viral pneumonia transiting from mild to severe, rapid relieving of patient symptoms because of their multi-component and multi-target integrated roles. This review has summarized the reports on the treatment of viral pneumonia. Based on the pathogenic characteristics of viral pneumonia, this paper summarizes the diverse roles of the marketed Chinese patent medicine, such as their effects in inhibiting the progress of viral replication and overactivated inflammatory response, regulating immune balance, attenuating pulmonary fibrosis and so forth. Our paper summarizes the advantages of Chinese patient medicine in the treatment of viral pneumonia, based on which improvements of clinical therapy are expected to be made soon.


Severe Coronavirus Bronchiolitis in the Pre-COVID-19 Era


The Impact of Asthma on Mortality in Patients With COVID-19


Ecological and epidemiological models are both useful for SARS-CoV-2


Letter to Editor in response to "COVID-19: From bench to bedside" by Singh et al


title: Withdrawn: Letter to editor in response to "COVID-19: From bench to bedside" by Singh A et al

text: The Publisher regrets that this article is an accidental duplication of an article that has already been published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews, volume 14 (2020) 807 first page - 807 last page, https://doi.org/10.1016/j.dsx.2020.06.011. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.


title: Anosmia and the Need for COVID-19 Screening during the Pandemic

text: In this commentary, we briefly summarize the available data from Iran and other countries on the sudden increase in anosmia, hyposmia, and hypogeusia that has coincided with the COVID-19 pandemic. Alarmingly, a high proportion of patients with severe COVID-19 had isolated anosmia as the sole initial presenting symptom, which is likely due to the direct neuropathic effect of the virus rather than being secondary to nasal congestion and obstruction. Since isolated anosmia is not yet considered a prerequisite for screening for COVID-19, we wish to raise awareness on the association of anosmia with COVID-19, urging international and national health authorities to consider this association in their efforts for early detection and isolation of infected individuals and for breaking the chain of transmission. We urge our colleagues who assess patients with new-onset anosmia to strictly adhere to the safety guidelines to reduce the risk of exposure and infection during this nascent pandemic.


Covid-19: No large hidden outbreak in Africa but health worker shortage worsens


title: Efficacy of orally administered porcine epidemic diarrhea vaccine-loaded hydroxypropyl methylcellulose phthalate microspheres and RANKL-secreting L. lactis

text: Here, we examined the efficacy of are combinant subunit antigen-based oral vaccine for preventing porcine epidemic diarrhea virus (PEDV). First, we generated a soluble recombinant partial spike S1 protein (aP2) from PEDV in E. coli and then evaluated the utility of aP2 subunit vaccine-loaded hydroxypropyl methylcellulose phthalate microspheres (HPMCP) and RANKL-secreting L. lactis (LLRANKL) as a candidate oral vaccine in pregnant sows. Pregnant sows were vaccinated twice (with a 2 week interval between doses) at 4 weeks before farrowing. Titers of virus-specific IgA antibodies in colostrum, and neutralizing antibodies in serum, of sows vaccinated with HPMCP (aP2) plus LL RANKL increased significantly at 4 weeks post-first vaccination. Furthermore, the survival rate of newborn suckling piglets delivered by sows vaccinated with HPMCP (aP2) plus LL RANKL was similar to that of piglets delivered by sows vaccinated with a commercial killed porcine epidemic diarrhea virus (PED) vaccine. The South Korean government promotes a PED vaccine program (live-killed-killed) to increase the titers of IgA and IgG antibodies in pregnant sows and prevent PEDV. The oral vaccine strategy described herein, which is based on a safe and efficient recombinant subunit antigen, is an alternative PED vaccination strategy that could replace the traditional strategy, which relies on attenuated live oral vaccines or artificial infection with virulent PEDV.


title: Vergesellschaftung unter Ansteckenden  für eine Körpergeschichte der Seuche./ [Infectious Socialization-The History of Contagious Bodies]

text: This paper is part of Forum COVID-19: Perspectives in the Humanities and Social Sciences. Being a "trauma of mankind" epidemics have been a major subject of historical research for a long time and regarding every historical period. Recurring to the concept of Rudolf Schlögl ("Vergesellschaftung unter Anwesenden") my proposal is to research epidemics as a history of the communicating body and thus including the contagium as part of this communication.


Immune thrombocytopenia flare with mild COVID-19 infection in pregnancy: A case report


COVID-19 and the liver-related deaths to come


title: Efficacy of remdesivir in patients with COVID-19: a protocol for systematic review and meta-analysis of randomised controlled trials

text: BACKGROUND: Despite global containment measures to fight the coronavirus disease 2019 (COVID-19), the pandemic continued to rise, rapidly spread across the world, and resulting in 2.6 million confirmed cases and 185 061 deaths worldwide as of 23 April 2020. Yet, there are no approved vaccines or drugs to make the disease less deadly, while efforts are underway. Remdesivir, a nucleotide-analogue antiviral drug developed for Ebola, is determined to prevent and stop infections with COVID-19, while results are yet controversial. Here, we aim to conduct a systematic review and meta-analysis of randomised controlled trials (RCTs) to evaluate the efficacy of remdesivir in patients with COVID-19. METHOD AND ANALYSIS: We will search MEDLINE-PubMed, Embase, Cochrane Library, ClinicalTrials.gov and Google scholar databases for articles published as of 30 June 2020 and we will complete the study on 30 August 2020. We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines for the design and reporting of the results. We will include RCTs that assessed the efficacy of remdesivir versus placebo or standard of care. The primary endpoint will be time to clinical recovery. The secondary endpoints will be proportion of participants relieved from clinical symptoms defined at the time (in hours) from initiation of the study treatment, all-cause mortality, discharged date, frequency of respiratory progression and treatment-emergent adverse events. RevMan V.5.3 software will be used for statistical analysis. Random effects model will be carried out to calculate mean differences for continuous outcome data and risk ratio for dichotomous outcome data between remdesivir and placebo or standard of care. ETHICS AND DISSEMINATION: There are no ethical considerations associated with this study as we will use publicly available data from previously published studies. We plan to publish results in open-access peer-reviewed journals and present at international and national conferences. PROSPERO REGISTRATION NUMBER: CRD42020177953.


COVID-19-related acute genital ulcers


title: Strategies to Promote Social Connections Among Older Adults During 'Social Distancing' Restrictions

text: Older age and medical comorbidity are factors associated with more severe illness and risk of death due to COVID-19 infection. Social distancing is an important public health strategy for controlling the spread of the virus and minimizing its impact on the older adult population. It comes at a cost, however. Loneliness is associated with myriad adverse health outcomes, one of which is impaired immune functioning, which adds even greater risk for corona virus infection, complications and death. Older adults, therefore, are at compound risk, making effective management of loneliness and social isolation in our older patients a high priority target for preventive intervention. In this paper, we describe a cognitive-behavioral framework for social connectedness, including evidence-informed strategies clinicians can use to help patients develop a 'Connections Plan' to stay connected and promote their social, mental, and physical health during 'social distancing' restrictions. This set of strategies can be provided during brief (30 minute) telephone sessions and is analogous to creating a 'Safety Plan' for suicide risk. The approach is illustrated with three case examples.


Bereavement Care in the Wake of COVID-19: Offering Condolences and Referrals


title: Anesthetic Management of Endovascular Treatment of Acute Ischemic Stroke During COVID-19 Pandemic: Consensus Statement From Society for Neuroscience in Anesthesiology & Critical Care (SNACC): Endorsed by Society of Vascular & Interventional Neurology (SVIN), Society of NeuroInterventional Surgery (SNIS), Neurocritical Care Society (NCS), European Society of Minimally Invasive Neurological Therapy (ESMINT) and American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) Cerebrovascular Section

text: The pandemic of coronavirus disease 2019 (COVID-19) has unique implications for the anesthetic management of endovascular therapy for acute ischemic stroke. The Society for Neuroscience in Anesthesiology and Critical Care appointed a task force to provide timely, consensus-based expert recommendations using available evidence for the safe and effective anesthetic management of endovascular therapy for acute ischemic stroke during the COVID-19 pandemic. The goal of this consensus statement is to provide recommendations for anesthetic management considering the following (and they are): (1) optimal neurological outcomes for patients; (2) minimizing the risk for health care professionals, and (3) facilitating judicious use of resources while accounting for existing variability in care. It provides a framework for selecting the optimal anesthetic technique (general anesthesia or monitored anesthesia care) for a given patient and offers suggestions for best practices for anesthesia care during the pandemic. Institutions and health care providers are encouraged to adapt these recommendations to best suit local needs, considering existing practice standards and resource availability to ensure safety of patients and providers.


title: Assistência perioperatória de paciente com infecção pelo SARSCoV2 (COVID19) submetido a ressecção de tumor de hipófise urgente. Relato de caso e diretrizes para manejo de via aérea./ [Pituitary tumor resection in a patient with SARS-CoV-2 (COVID-19) infection. A case report and suggested airway management guidelines]

text: The 2020 pandemic caused by the novel coronavirus, COVID-19, had its headquarters in China. It causes Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and presents a broad spectrum of clinical manifestations, ranging from entirely asymptomatic through severe acute respiratory failure and death. Presuming a significant quantity of ventilator-dependent patients, several institutions strategically delayed elective surgeries. Particularly procedures performed involving the nasal mucosa, such as a transsphenoidal approach of the pituitary gland, considering the tremendous level of viral shedding. Nevertheless, critical cases demand expeditious resolution. Those situations are severe pituitary apoplexy, declining consciousness level, or risk of acute visual loss. This case presents a successful urgent perioperative management of a 47 year-old male COVID-19 positive patient who presented to the Emergency Department with a left frontal headache that culminated with diplopia, left eye ptosis, and left visual acuity loss after 5 days. Transsphenoidal hypophysectomy was uneventfully performed, and the patient was discharged from the hospital on postoperative day four. It additionally describes in detail the University of Mississippi Medical Center airway management algorithm for patients infected with the novel coronavirus who need emergent surgical attention.


Humanismo e educação médica em tempos de COVID-19


title: A multinational report to characterise SARS-CoV-2 infection in people with cystic fibrosis

text: Information is lacking on the clinical impact of the novel coronavirus, SARS-CoV-2, on people with cystic fibrosis (CF). Our aim was to characterise SARS-CoV-2 infection in people with cystic fibrosis. METHODS: Anonymised data submitted by each participating country to their National CF Registry was reported using a standardised template, then collated and summarised. RESULTS: 40 cases have been reported across 8 countries. Of the 40 cases, 31 (78%) were symptomatic for SARS-CoV-2 at presentation, with 24 (60%) having a fever. 70% have recovered, 30% remain unresolved at time of reporting, and no deaths have been submitted. CONCLUSIONS: This early report shows good recovery from SARS-CoV-2 in this heterogeneous CF cohort. The disease course does not seem to differ from the general population, but the current numbers are too small to draw firm conclusions and people with CF should continue to strictly follow public health advice to protect themselves from infection.


COVID-19 and pregnancy


title: A privacy-preserving tests optimization algorithm for epidemics containment

text: The SARS-CoV-2 outbreak changed the everyday life of almost all the people over the world.Currently, we are facing with the problem of containing the spread of the virus both using the more effective forced lockdown, which has the drawback of slowing down the economy of the involved countries, and by identifying and isolating the positive individuals, which, instead, is an hard task in general due to the lack of information. For this specific disease, the identificato of the infected is particularly challenging since there exists cathegories, namely the asymptomatics, who are positive and potentially contagious, but do not show any of the symptoms of SARS-CoV-2. Until the developement and distribution of a vaccine is not yet ready, we need to design ways of selecting those individuals which are most likely infected, given the limited amount of tests which are available each day. In this paper, we make use of available data collected by the so called contact tracing apps to develop an algorithm, namely PPTO, that identifies those individuals that are most likely positive and, therefore, should be tested. While in the past these analysis have been conducted by centralized algorithms, requiring that all the app users data are gathered in a single database, our protocol is able to work on a device level, by exploiting the communication of anonymized information to other devices.


Acute intestinal ischemia in a patient with COVID-19


Managing patients with rheumatic conditions during the covid-19 pandemic


Epidemiological studies on COVID-19 pandemic in India: Too little and too late?


title: An Interactive Online Dashboard for Tracking COVID-19 in U.S. Counties, Cities, and States in Real Time

text: OBJECTIVE: To create an online resource that informs the public of COVID-19 outbreaks in their area. MATERIALS AND METHODS: This R Shiny application aggregates data from multiple resources that track COVID-19 and visualizes them through an interactive, online dashboard. RESULTS: The web resource, called the COVID-19 Watcher, can be accessed at https://covid19watcher.research.cchmc.org/. It displays COVID-19 data from every county and 188 metropolitan areas in the U.S. Features include rankings of the worst affected areas and auto-generating plots that depict temporal changes in testing capacity, cases, and deaths. DISCUSSION: The Centers for Disease Control and Prevention (CDC) do not publish COVID-19 data for local municipalities, so it is critical that academic resources fill this void so the public can stay informed. The data used have limitations and likely underestimate the scale of the outbreak. CONCLUSIONS: The COVID-19 Watcher can provide the public with real-time updates of outbreaks in their area.


Reliable Postmortem Computed Tomography Scan Diagnosis of COVID-19 Pneumonia


COVID-19 travel restrictions and the International Health Regulations - Call for an open debate on easing of travel restrictions


title: COVID-19 and orthopaedic surgeons: the Indian scenario

text: The emergence of COVID-19 has impacted orthopaedic surgery worldwide. India, with its large population and limited health resources, will be overwrought over the coming days due to the number of cases of critically ill patients with COVID-19. It is important to understand the challenges for orthopaedic (and other) surgeons in India when dealing with patients during the COVID-19 pandemic. This article highlights the challenges in the triaging of patients, care in dealing with a patient with COVID-19 in orthopaedic surgery, and the effects on academics and research activities; it also suggests immediate measures and recommendations that also apply to other specialties.


Imaging features of 2019 novel coronavirus pneumonia


title: A Taxonomy Proposal for the Assessment of the Changes in Soundscape Resulting from the COVID-19 Lockdown

text: Many countries around the world have chosen lockdown and restrictions on people's mobility as the main strategies to combat the COVID-19 pandemic. These actions have significantly affected environmental noise and modified urban soundscapes, opening up an unprecedented opportunity for research in the field. In order to enable these investigations to be carried out in a more harmonized and consistent manner, this paper makes a proposal for a set of indicators that will enable to address the challenge from a number of different approaches. It proposes a minimum set of basic energetic indicators, and the taxonomy that will allow their communication and reporting. In addition, an extended set of descriptors is outlined which better enables the application of more novel approaches to the evaluation of the effect of this new soundscape on people's subjective perception.


title: Physiological and pathological regulation of ACE2, the SARS-CoV-2 receptor

text: The renin-angiotensin system (RAS) is crucial for the physiology and pathology of all the organs. Angiotensin-converting enzyme 2 (ACE2) maintains the homeostasis of RAS as a negative regulator. Recently, ACE2 was identified as the receptor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the coronavirus that is causing the pandemic of Coronavirus disease 2019 (COVID-19). Since SARS-CoV-2 must bind with ACE2 before entering the host cells in humans, the distribution and expression of ACE2 may be critical for the target organ of the SARS-CoV-2 infection. Moreover, accumulating evidence has demonstrated the implication of ACE2 in the pathological progression in tissue injury and several chronic diseases, ACE2 may also be essential in the progression and clinical outcomes of COVID-19. Therefore, we summarized the expression and activity of ACE2 in various physiological and pathological conditions, and discussed its potential implication in the susceptibility of SARS-CoV-2 infection and the progression and prognosis of COVID-19 patients in the current review.


Distinct changes in the real-time PCR detectability of certain SARS-CoV-2 target sequences


title: Impact of COVID-19 Outbreak on Healthcare Workers in Italy: Results from a National E-Survey

text: Italy has been the first-hit European country to face the outbreak of coronavirus disease 2019 (COVID-19). Aim of this survey was to assess in depth the impact of the outbreak on healthcare workers (HCW). A 40-item online survey was disseminated via social media inviting Italian HCW, with questions exploring demographics, health status and work environment of respondents. A total of 527 were invited to take part in March 2020, of whom 74% (n = 388) responded to the survey. Of these, 235 (61%) were women. HCW were mostly physicians (74%), from high-prevalence regions (52%). 25% experienced typical symptoms during the last 14 days prior to survey completion, with only 45% of them being tested for COVID-19. Among the tested population, 18 (18%) resulted positive for COVID-19, with 33% being asymptomatic. Only 22% of HCW considered personal protective equipment adequate for quality and quantity. Females and respondents working in high-risk sectors were more likely to rate psychological support as useful (OR, 1.78 [CI 95% 1.14-2.78] P = 0.012, and 2.02 [1.12-3.65] P = 0.020, respectively) and workload as increased (mean increase, 0.38 [0.06-0.69] P = 0.018; and 0.54 [0.16-0.92] P = 0.005, respectively). The insights from this survey may help authorities in countries where COVID-19 epidemic has not yet broken out. Management strategies should be promptly undertaken in order to enhance safety and optimise resource allocation.


title: Reproductive biology of the eyespot skate Atlantoraja cyclophora (Elasmobranchii: Arhynchobatidae) an endemic species of the Southwestern Atlantic Ocean (34ºS - 42ºS)

text: Atlantoraja cyclophoraé uma patim endémica para a plataforma continental do Sudoeste do Oceano Atlântico (22ºS-47ºS) e uma espécie de captura acessória na pesca comercial de arrasto de fundo. As relações morfométricas, o tamanho na maturidade e o ciclo reprodutivo desta espécie foram analisados, com amostras coletadas entre 34ºS e 42ºS. A faixa de tamanho foi de 190 a 674 mm de comprimento total (TL) para machos e de 135 a 709 mm para fêmeas. O dimorfismo sexual entre as relações TL - largura do disco e TL - peso total foi encontrado, com as fêmeas mais largas e mais pesadas que os machos. O tamanho médio na maturidade para machos foi estimado em 530 mm TL e para fêmeas em 570 mm TL. O índice gonadossomático (IGS) em fêmeas maduras variou sazonalmente e apresentou o maior valor em dezembro. O diâmetro folicular máximo e a largura da glândula do oviduto não apresentaram nenhum padrão sazonal. Fêmeas com ovos no útero estavam presentes a maior parte do ano. A atividade reprodutiva nos machos seria contínua ao longo do ano, evidenciada pela falta de variação do IGS entre as estações do ano. Os resultados obtidos sugerem queA. cyclophora pode passar por um ciclo reprodutivo anual, em coincidência com o relatado para esta espécie em populações brasileiras.(AU)


title: COVID-19 occurring during Natalizumab treatment: a case report in a patient with extended interval dosing approach

text: BACKGROUND: The novel Coronavirus SARS-CoV-2, which was identified after a recent outbreak in Wuhan, China, in December 2019, has generated a global pandemic impacting over 200 countries around the world. Recent reports suggest that ACE2, which is the target protein to invade the host, has a ubiquitous presence in human organs, including lung parenchyma, gastrointestinal tract, nasal mucosa, renal and urinary tract, airway epithelia, lymphoid tissues, reproductive organs, vascular endothelium and neurons. In this scenario, neurologists are particularly involved into considering even more specific therapeutic strategies according to the available data during the pandemic. In particular, MS patients are usually receiving disease-modifying therapies (DMTs) with immunosuppressant or immunomodulatory effects, which increase the risk of infections and morbidity, compared with the general population. Development of PML or other serious opportunistic infections during treatment with natalizumab forces to consider whether de-risking strategies are needed in this particular context and how to manage a high-efficacy treatment. METHODS: In this paper we report on a patient treated with natalizumab for relapsing MS who developed COVID-19 and recovered in a few days without complications. RESULTS: After recovery natalizumab has been administered in the window of the extended interval dosing (EID), without reporting any worsening or new symptoms. DISCUSSION: This case supports the opportunity to avoid discontinuing or delaying the retreatment over 8 weeks in patients recovered from a recent COVID-19.


title: Comparison of Hospitalized Patients With ARDS Caused by COVID-19 and H1N1

text: BACKGROUND: Since the outbreak of coronavirus disease 2019 (COVID-19) in China in December 2019, considerable attention has been focused on its elucidation. However, it is also important for clinicians and epidemiologists to differentiate COVID-19 from other respiratory infectious diseases such as influenza viruses. RESEARCH QUESTION: The aim of this study was to explore the different clinical presentations between COVID-19 and influenza A (H1N1) pneumonia in patients with ARDS. STUDY DESIGN AND METHODS: This analysis was a retrospective case-control study. Two independent cohorts of patients with ARDS infected with either COVID-19 (n = 73) or H1N1 (n = 75) were compared. Their clinical manifestations, imaging characteristics, treatments, and prognosis were analyzed and compared. RESULTS: The median age of patients with COVID-19 was higher than that of patients with H1N1, and there was a higher proportion of male subjects among the H1N1 cohort (P < .05). Patients with COVID-19 exhibited higher proportions of nonproductive coughs, fatigue, and GI symptoms than those of patients with H1N1 (P < .05). Patients with H1N1 had higher Sequential Organ Failure Assessment (SOFA) scores than patients with COVID-19 (P < .05). The Pao2/Fio2 of 198.5 mm Hg in the COVID-19 cohort was significantly higher than the Pao2/Fio2 of 107.0 mm Hg in the H1N1 cohort (P < .001). Ground-glass opacities was more common in patients with COVID-19 than in patients with H1N1 (P < .001). There was a greater variety of antiviral therapies administered to COVID-19 patients than to H1N1 patients. The in-hospital mortality of patients with COVID-19 was 28.8%, whereas that of patients with H1N1 was 34.7% (P = .483). SOFA score-adjusted mortality of H1N1 patients was significantly higher than that of COVID-19 patients, with a rate ratio of 2.009 (95% CI, 1.563-2.583; P < .001). INTERPRETATION: There were many differences in clinical presentations between patients with ARDS infected with either COVID-19 or H1N1. Compared with H1N1 patients, patients with COVID-19-induced ARDS had lower severity of illness scores at presentation and lower SOFA score-adjusted mortality.


title: The early phase of the COVID-19 outbreak in Lombardy, Italy

text: In the night of February 20, 2020, the first case of novel coronavirus disease (COVID-19) was confirmed in the Lombardy Region, Italy. In the week that followed, Lombardy experienced a very rapid increase in the number of cases. We analyzed the first 5,830 laboratory-confirmed cases to provide the first epidemiological characterization of a COVID-19 outbreak in a Western Country. Epidemiological data were collected through standardized interviews of confirmed cases and their close contacts. We collected demographic backgrounds, dates of symptom onset, clinical features, respiratory tract specimen results, hospitalization, contact tracing. We provide estimates of the reproduction number and serial interval. The epidemic in Italy started much earlier than February 20, 2020. At the time of detection of the first COVID-19 case, the epidemic had already spread in most municipalities of Southern-Lombardy. The median age for of cases is 69 years (range, 1 month to 101 years). 47% of positive subjects were hospitalized. Among these, 18% required intensive care. The mean serial interval is estimated to be 6.6 days (95% CI, 0.7 to 19). We estimate the basic reproduction number at 3.1 (95% CI, 2.9 to 3.2). We estimated a decreasing trend in the net reproduction number starting around February 20, 2020. We did not observe significantly different viral loads in nasal swabs between symptomatic and asymptomatic. The transmission potential of COVID-19 is very high and the number of critical cases may become largely unsustainable for the healthcare system in a very short-time horizon. We observed a slight decrease of the reproduction number, possibly connected with an increased population awareness and early effect of interventions. Aggressive containment strategies are required to control COVID-19 spread and catastrophic outcomes for the healthcare system.


title: COVID-19: Epidemiology, Evolution, and Cross-Disciplinary Perspectives

text: The recent outbreak of COVID-19 in Wuhan turned into a public health emergency of international concern. With no antiviral drugs nor vaccines, and the presence of carriers without obvious symptoms, traditional public health intervention measures are significantly less effective. Here, we report the epidemiological and virological characteristics of the COVID-19 outbreak. Originated in bats, 2019-nCoV/ severe acute respiratory syndrome coronavirus (SARS-CoV)-2 likely experienced adaptive evolution in intermediate hosts before transfer to humans at a concentrated source of transmission. Similarities of receptor sequence binding to 2019-nCoV between humans and animals suggest a low species barrier for transmission of the virus to farm animals. We propose, based on the One Health model, that veterinarians and animal specialists should be involved in a cross-disciplinary collaboration in the fight against this epidemic.


Leading through COVID-19 crisis


title: Benign COVID-19 in an immunocompromised cancer patient - the case of a married couple

text: Respiratory failure in COVID-19 is a common feature in fatal cases and has been considered as a failure of the immune system to control the virus. Here we report the case of COVID-19 affecting an immunocompromised women and her presumably immunocompetent spouse. A married couple (age 60 years) was simultaneously admitted to the emergency department on 10 March 2020 because of dyspnoea and fever, consistent with COVID-19. The wife (patient 1) was partially immunocompromised as a consequence of a recently started chemotherapy with fulvestrant and abemaciclid for recurring breast cancer, her husband (patient 2) had been healthy except for a history of controlled arterial hypertension. Both patients were treated with darunavir/cobicistat and hydroxychloroquine. The clinical course of the immunocompromised partner was benign, without need of intensive care. She was able to leave the hospital on day 6 after admission. In contrast, her husband needed intensive care and his recovery was slow, although eventually successful too. These findings suggest that the course of COVID-19 is not necessarily ominous in the presence of a compromised immune response and tend to reinforce the emerging therapeutic concepts of a controlled mitigation of the immune cascade following SARS CoV-2 infection.


Letter to the Editor: Priority Considerations of Patients with Peripheral Nerve Pathology in the Time of COVID-19


COVID-19 and impact of personal protective equipment use: From occupational to generalized skin care need


COVID-19 and eye banking


title: Home-based exercise note in Covid-19 quarantine situation for office workers: A commentary

text: Staying at home for the prevention of Covid-19 virus is an accepted fact for everyone. Office workers are a group of people, who had to wake up early in the morning and at least had a fixed pattern of sleeping and working. In this situation, complaints about neck, shoulder and lower back tend to increase and this is a good time to learn and do some practical exercise at home. This letter presents some of the home-based exercise notes for prevention of musculoskeletal disorders among office workers, following the guidelines prepared by American College of Sports Medicine.


Balancing the Effects of COVID-19 Against Potential Progression and Mortality in High-risk Prostate Cancer


Covid-19: Woman with terminal cancer should be released from care home to die with family, says judge


title: A Facile Approach to High Precision Detection of Cell-to-Cell Variation for Li-ion Batteries

text: Over the past decade, it has been repeatedly demonstrated that homogeneity in electrochemical performance of lithium-ion cells plays a major role in determining the life and safety of lithium-ion battery modules or packs. Generally, the homogeneity of a battery pack is evaluated by characterizing the cells individually in terms of capacity, mass, impedance. Particularly, high quality electrochemical data heavily relies on the availability of high precision current source to minimize the discrepancy induced by the channel-to-channel variation. Here, a facile and precise measurement method is reported for screening cell-to-cell variations, in which voltage is the only indicator parameter independent of high precision current source. In detail, by connecting the cells in series (CiS), the measurement error of electrochemical data caused by stability and discrepancy of current sources among different charge/discharge equipment can be effectively avoided. The findings of this work showed that the cell-to-cell variations can be simply and sensitively detected with CiS configuration. For example, the relative standard deviation, which is the evaluation criterion of battery homogeneity, was 2.14% based on CiS while it was 0.43% based on individual measurements. The simple and precise CiS measurement is promising for evaluation of cell quality or module integration quality. In addition, this work can also provide a solid foundation for the development of detection algorithms for battery management systems to rapidly monitor battery homogeneity.


title: SARS-COV-2 infection presenting as ST-elevationmyocardial infarction

text: We describe a patient presenting with chest discomfort, anterolateral ST elevation, and developing acute cardiogenic shock secondary to SARS-COV-2infection-patient zero presenting to our institution's cardiac catheterization laboratory. The emergent presentation with limited clinical information led to exposure of personnel. The diagnosis was complicated by two negative tests for SARS-COV-2, and high-clinical suspicion from the patient's occupational history led to additional testing in order to confirm the diagnosis.


title: COVID-19 and Power in Global Health

text: Political scientists bring important tools to the analysis of the coronavirus disease 2019 (COVID-19) pandemic, particularly a focus on the crucial role of power in global health politics. We delineate different kinds of power at play during the COVID-19 crisis, showing how a dearth of compulsory, institutional, and epistemic power undermined global cooperation and fueled the pandemic, with its significant loss to human life and huge economic toll. Through the pandemic response, productive and structural power became apparent, as issue frames stressing security and then preserving livelihoods overwhelmed public health and human rights considerations. Structural power rooted in economic inequalities between and within countries conditioned responses and shaped vulnerabilities, as the crisis threatened to deepen power imbalances along multiple lines. Calls for global health security will surely take on a new urgency in the aftermath of the pandemic and the forms of power delineated here will shape their outcome.


Awake Prone Positioning for Non-intubated Oxygen Dependent COVID-19 Pneumonia Patients


Acute pancreatitis in a COVID-19 patient


title: Integrating Prior Knowledge in Mixed Initiative Social Network Clustering

text: We propose a new paradigm---called PK-clustering---to help social scientists create meaningful clusters in social networks. Many clustering algorithms exist but most social scientists find them difficult to understand, and tools do not provide any guidance to choose algorithms, or to evaluate results taking into account the prior knowledge of the scientists. Our work introduces a new clustering paradigm and a visual analytics user interface that address this issue. It is based on a process that 1) captures the prior knowledge of the scientists as a set of incomplete clusters, 2) runs multiple clustering algorithms (similarly to clustering ensemble methods), 3) visualizes the results of all the algorithms ranked and summarized by how well each algorithm matches the prior knowledge, 5) evaluates the consensus between user-selected algorithms and 6) allows users to review details and iteratively update the acquired knowledge. We describe our paradigm using an initial functional prototype, then provide two examples of use and early feedback from social scientists. We believe our clustering paradigm offers a novel constructive method to iteratively build knowledge while avoiding being overly influenced by the results of often-randomly selected black-box clustering algorithms.


title: Epidemiology of coronavirus disease 2019(COVID-19) caused by SARS-CoV-2

text: In December, 2019, an infection outbreak occurred in Wuhan of unknown cause, which attracts intense attention. Shortly after the virus was identified with the name of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), the epidemic of coronavirus disease 2019 (COVID-19) broke out and an information storm occurred. At that time, two important aspects: the stage and the links of epidemic, were unclear. Answers to the questions, what are the sources, how do infections occur, and who will be affected should be clarified as the outbreak continues to evolve. Furthermore, the epidemic process and the stage of epidemic should be explored and discussed. Based on information of SARS, middle east respiratory syndrome(MERS) and COVID-19, the links of epidemic (the sources, the routes of infection, and the susceptible population) will be discussed as well as the role of the natural and the social factors. Epidemiology characteristics of patients will be traced based on current information.


title: Tracheostomy during SARS-CoV-2 pandemic: Recommendations from the New York Head and Neck Society

text: The rapid spread of SARS-CoV-2 in 2019 and 2020 has resulted in a worldwide pandemic characterized by severe pulmonary inflammation, effusions, and rapid respiratory compromise. The result of this pandemic is a large and increasing number of patients requiring endotracheal intubation and prolonged ventilator support. The rapid rise in endotracheal intubations coupled with prolonged ventilation requirements will certainly lead to an increase in tracheostomy procedures in the coming weeks and months. Performing tracheostomy in the setting of active SARS-CoV-2, when necessary, poses a unique situation, with unique risks and benefits for both the patient and the health care providers. The New York Head and Neck Society has collaborated on this document to provide guidance on the performance of tracheostomies during the SARS-CoV-2 pandemic.


title: Identifiability and estimation under the test-negative design with population controls with the goal of identifying risk and preventive factors for SARS-CoV-2 infection

text: Due to the rapidly evolving COVID-19 pandemic caused by the SARS-CoV-2 virus, quick public health investigations of the relationships between behaviours and infection risk are essential. Recently the test-negative design was proposed to recruit and survey participants who are being tested for SARS-CoV-2 infection in order to evaluate associations between their characteristics and testing positive on the test. It was also proposed to recruit additional untested controls who are part of the general public in order to have a baseline comparison group. This study design involves two major challenges for statistical risk factor analysis: 1) the selection bias invoked by selecting on people being tested and 2) imperfect sensitivity and specificity of the SARS-CoV-2 test. In this study, we investigate the nonparametric identifiability of potential statistical parameters of interest under a hypothetical data structure, expressed through missing data directed acyclic graphs. We clarify the types of data that must be collected in order to correctly estimate the parameter of interest. We then propose a novel inverse probability weighting estimator that can consistently estimate the parameter of interest under correctly specified nuisance models.


title: Need for a population health approach to understand and address psychosocial consequences of COVID-19

text: This commentary article provides observations on the psychosocial consequences of the coronavirus disease 2019 (COVID-19) among people in China and articulates a population health perspective to understand and address identified issues. We highlight key psychosocial effects of COVID-19, such as anxiety, insomnia, and trauma response, in the context of salient factors that shape Chinese people's psychological experiences, including the availability of Internet and technology, large-scale quarantine, economic impact, and the rise of xenophobia globally. Further, from a population health perspective, we make recommendations in COVID-19-related research and interventions that aim to promote the psychosocial health of Chinese people. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Ontology-based systematic classification and analysis of coronaviruses, hosts, and host-coronavirus interactions towards deep understanding of COVID-19

text: Given the existing COVID-19 pandemic worldwide, it is critical to systematically study the interactions between hosts and coronaviruses including SARS-Cov, MERS-Cov, and SARS-CoV-2 (cause of COVID-19). We first created four host-pathogen interaction (HPI)-Outcome postulates, and generated a HPI-Outcome model as the basis for understanding host-coronavirus interactions (HCI) and their relations with the disease outcomes. We hypothesized that ontology can be used as an integrative platform to classify and analyze HCI and disease outcomes. Accordingly, we annotated and categorized different coronaviruses, hosts, and phenotypes using ontologies and identified their relations. Various COVID-19 phenotypes are hypothesized to be caused by the backend HCI mechanisms. To further identify the causal HCI-outcome relations, we collected 35 experimentally-verified HCI protein-protein interactions (PPIs), and applied literature mining to identify additional host PPIs in response to coronavirus infections. The results were formulated in a logical ontology representation for integrative HCI-outcome understanding. Using known PPIs as baits, we also developed and applied a domain-inferred prediction method to predict new PPIs and identified their pathological targets on multiple organs. Overall, our proposed ontology-based integrative framework combined with computational predictions can be used to support fundamental understanding of the intricate interactions between human patients and coronaviruses (including SARS-CoV-2) and their association with various disease outcomes.


title: COVID-19 and Cardiovascular diseases. Scoping review study

text: BACKGROUND: Many patients with COVID-19 have pre-existing cardiovascular (CV) co-morbidities or develop acute heart damage during the course of the disease. OBJECTIVES: To study the risk of COVID-19 infection in the presence of preexisting CV diseases and to describe new CV manifestations during COVID-19. METHODS: A "scoping review" was carried out via PubMed, to synthesize the results of research currently published on this subject. RESULTS: Patients with cardiovascular disease were at greater risk of developing COVID-19, especially in its severe form. These patients were five to ten times more at risk of death. Cardiac manifestations, de novo, were dominated by acute myocardial damage, defined by a significant elevation of cardiac troponins. These occurred in 7 to 17% of hospitalized patients. The presence of a new heart lesion in patients with COVID-19 was consistently associated with a poor prognosis. CONCLUSION: Given the enormous cardiovascular challenge posed by the COVID-19 pandemic and the prognostic impact of heart damage, additional research at a high level of evidence will be necessary.


Tocilizumab, an anti-IL-6 receptor antibody, to treat COVID-19-related respiratory failure: a case report


title: [Prostate cancer and COVID-19 pandemia: Current recommendations.]

text: OBJECTIVE: The objective of this publicationis to provide recommendations in the management of prostate cancer (PC) in a new reality framework based on the presence of COVID-19 disease MATERIAL AND METHODS: The document is based on the scarce evidence on SARS/Cov-2 and the experience of the authors in handling COVID-19 in their institutions, including specialists from Andalusia, Cantabria, Catalonia, Madrid and the Valencian Community RESULTS: The authors defined different priorities for the different clinical situations in PC Emergency/urgency (life-threatening or urgent even in normal situation), highpriority/elective urgency (potentially dangerous if postponed for more than 1 month), intermediate/electivepriority (it is recommended not to delay more than 6 months), low priority/delayed (can be postponed more than 6 months) According to this classification, the working panel agreed on the distribution of the different diagnostic, therapeutic and follow-up scenarios for PC The risk of severe morbidity as a result of SARS-CoV-2 infection may out weigh the risk of PC morbidity/mortalityin many men;therefore, in the short term it is unlikely that delays in diagnosis or treatment can led to worse cancer outcomes CONCLUSIONS: The COVID-19 pandemic has resulted in a challenge for our health system, which raises several considerations in the treatment of patients with PC The redistribution of surgical procedures according to the degrees of priority is essential during the period of the pandemic and the transition to the new normality The change of the out-clinics with the adequate security measures for healthcare practitioners and patients, andt he development of a telemedicine program is highly recommended


title: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): a global pandemic and treatment strategies

text: The emergence and rapid spread of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a potentially fatal disease, is swiftly leading to public health crises worldwide. The origin of SARS-CoV-2 infection was first reported in people exposed to a seafood market in Wuhan City, China in December 2019. It has been suggested that the infection is likely to be of zoonotic origin and transmitted to humans through a not-yet-known intermediary. As of 22 May 2020, the World Health Organization reported that there were approximately 4,995,996 confirmed cases and 327,821 deaths. SARS-CoV-2 is transmitted via inhalation or direct contact with droplets from infected people. It has an incubation period ranging from 2 to ≥14 days. The rate of spread of SARS-CoV-2 is greater than that for severe acute respiratory syndrome coronavirus and Middle East respiratory coronavirus. The symptoms are similar to influenza (i.e. breathlessness, sore throat and fatigue) and infected cases are isolated and treated. Infection is mild in most cases, but in elderly (>50 years) patients and those with cardiac and respiratory disorders, it may progress to pneumonia, acute respiratory distress syndrome and multi-organ failure. People with strong immunity or those who have developed herd immunity are asymptomatic. The fatality rate ranges from 3% to 4%. Recommended methods for diagnosis of COVID-19 are molecular tests (e.g. polymerase chain reaction) on respiratory secretions, chest scan and common laboratory diagnosis. Currently, treatment is essentially supportive, and the role of antiviral agents is yet to be established as a vaccine is not yet available. This review will focus on epidemiology, symptoms, transmission, pathogenesis, ongoing available treatments and future perspectives of SARS-CoV-2.


title: Bluetooth Smartphone Apps: Are they the most private and effective solution for COVID-19 contact tracing?

text: Many digital solutions mainly involving Bluetooth technology are being proposed for Contact Tracing Apps (CTA) to reduce the spread of COVID-19. Concerns have been raised regarding privacy, consent, uptake required in a given population, and the degree to which use of CTAs can impact individual behaviours. However, very few groups have taken a holistic approach and presented a combined solution. None has presented their CTA in such a way as to ensure that even the most suggestible member of our community does not become complacent and assume that CTA operates as an invisible shield, making us and our families impenetrable or immune to the disease. We propose to build on some of the digital solutions already under development that, with addition of a Bayesian model that predicts likelihood for infection supplemented by traditional symptom and contact tracing, that can enable us to reach 90% of a population. When combined with an effective communication strategy and social distancing, we believe solutions like the one proposed here can have a very beneficial effect on containing the spread of this pandemic.


title: Plasminogen improves lung lesions and hypoxemia in patients with COVID-19

text: BACKGROUND: Lungs from patients with coronavirus disease 2019 (COVID-19) have shown typical signs of acute respiratory distress syndrome (ARDS), formation of hyaline membrane mainly composed of fibrin, and 'ground-glass' opacity. Previously, we showed plasminogen itself is a key regulator in fibrin degradation, wound healing and infection. AIM: We aimed to investigate whether plasminogen can improve lung lesions and hypoxemia of COVID-19. DESIGN: Thirteen clinically moderate, severe or critical COVID-19 patients were treated with atomization inhalation of freeze-dried plasminogen. METHODS: Levels of their lung lesions, oxygen saturation and heart rates were compared before and after treatment by CT scanning images and patient monitor. RESULTS: After plasminogen inhalation, conditions of lung lesions in 5 clinically moderate patients have quickly improved, shown as the decreased range and density of 'ground glass' opacity. Improvements of oxygen saturation were observed in 6 clinically severe patients. In the 2 patients with critical conditions, the oxygen levels have significantly increased from 79-82% to 91% just about 1 hour after the first inhalation. In 8 of 13 patients the heart rates had slowed down. For the 5 clinically moderate patients, the difference is even statistically significant. Furthermore, a general relief of chest tightness was observed. CONCLUSION: Whereas it is reported that plasminogen is dramatically increased in adults with ARDS, this study suggests that additional plasminogen may be effective and efficient in treating lung lesions and hypoxemia during COVID-19 infections. Although further studies are needed, this study highlights a possible hope of efficiently combating this rapid epidemic emergency.


Coronavirus Disease 2019 and the Pediatric Gastroenterologist


Cerebral involvement in COVID-19 is associated with metabolic and coagulation derangements: an EEG study


Phone-based data collection in a refugee community under COVID-19 lockdown


Reply to "CT Findings of Pregnant Women With Coronavirus Disease (COVID-19) Pneumonia"


title: [Risks factors for death among COVID-19 patients combined with hypertension, coronary heart disease or diabetes]

text: OBJECTIVE: The pathogenesis of myocardial injury upon corona virus disease 2019 (COVID-19) infection remain unknown,evidence of impact on outcome is insufficient, therefore, we aim to investigate the risk factors for death among COVID-19 patients combined with hypertension, coronary heart disease or diabetes in this study. METHODS: This was a single-centered, retrospective, observational study. Patients of Sino-French Eco-City section of Tongji Hospital, Wuhan, China attended by Peking University Supporting Medical Team and admitted from Jan. 29, 2020 to Mar. 20, 2020 were included. The positive nucleic acid of COVID-19 virus and combination with hypertension, coronary heart disease or diabetes were in the standard. We collected the clinical data and laboratory examination results of the eligible patients to evaluate the related factors of death. RESULTS: In the study, 94 COVID-19 patients enrolled were divided into the group of death (13 cases) and the group of survivors (81 cases), the average age was 66.7 years. Compared with the survival group, the death group had faster basal heart rate(103.2 beats/min vs. 88.4 beats /min, P=0.004), shortness of breath(29.0 beats /min vs. 20.0 beats /min, P<0.001), higher neutrophil count(9.2×109/L vs. 3.8×109/L, P<0.001), lower lymphocyte count(0.5×109/L vs. 1.1×109/L, P<0.001), creatine kinase MB(CK-MB, 3.2 µg/L vs. 0.8 µg/L, P<0.001), high sensitivity cardiac troponin â (hs-cTnâ , 217.2 ng/L vs. 4.9 ng/L, P<0.001), N-terminal pro brain natriuretic peptide(NT-proBNP; 945.0 µg/L vs. 154.0 µg/L, P<0.001), inflammatory factor ferritin(770.2 µg/L vs. 622.8 µg/L , P=0.050), interleukin-2 recepter(IL-2R, 1 586.0 U/mL vs. 694.0 U/mL, P<0.001), interleukin-6(IL-6, 82.3 ng/L vs. 13.0 ng/L, P<0.001), interleukin-10(IL-10, 9.8 ng/L vs. 5.0 ng/L, P<0.001)were higher than those in the survival group. Univariate logistic regression analysis showed that the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, abnormal increase of IL 2R, IL-6, and IL-10. Multivariate regression showed that old age (OR=1.11, 95%CI=1.03-1.19, P=0.026), low non oxygen saturation(OR=0.85, 95%CI=0.72-0.99, P=0.041), and abnormal increase of IL-10(ï¼9.1 ng/L, OR=101.93, 95%CI=4.74-2190.71, P=0.003)were independent risk factors for COVID-19 patients combined with hypertension, coronary heart disease or diabetes. CONCLUSION: In COVID-19 patients combined with hypertension, coronary heart disease or diabetes, the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, and abnormal increase of IL-2R, IL-6, and IL-10. Old age, low non oxygen saturation and abnormal increase of IL-10 were independent risk factors.


Covid-19: the challenge of patient rehabilitation after intensive care


title: Otolaryngology Education in the Setting of COVID-19: Current and Future Implications

text: The COVID-19 pandemic continues to garner extensive international attention. The pandemic has resulted in significant changes in clinical practice for otolaryngologists in the United States; many changes have been implemented to mitigate risks identified by otolaryngologists in other countries. COVID-19-induced limitations include social distancing and triaging of patient acuity. Additionally, a recent publication by Stanford University has drawn attention to the risks that otolaryngologists may face with regard to manipulation of the upper airway and mucosal disruption. As a result of COVID-19 recommendations, multiple institutions have overhauled resident clinical rotations and resident education. The result has been a rapid and significant change in resident education at most academic institutions. This commentary outlines the development of the otolaryngology resident education consortiums, with implications for future education within and outside of otolaryngology.


title: Pandemia COVID-19: impacto y reacción rápida de la Urología./ Pandemia COVID-19: impacto y reacción rápida de la Urología./ COVID-19 Pandemic: Impact and rapid reaction of Urology

text: The COVID-19 pandemic caused by the SARS-CoV-2 virus has caused tens of thousands of deaths in Spain and has managed to breakdown the healthcare system hospitals in the Community of Madrid, largely due to its tendency to cause severe pneumonia, requiring ventilatory support. This fact has caused our center to collapse, with 130% of its beds occupied by COVID-19 patients, thus causing the absolute cessation of activity of the urology service, the practical disappearance of resident training programs, and the incorporation of a good part of the urology staff into the group of medical personnel attending these patients. In order to recover from this extraordinary level of suspended activity, we will be obliged to prioritize pathologies based on purely clinical criteria, for which tables including the relevance of each pathology within each area of urology are being proposed. Technology tools such as online training courses or surgical simulators may be convenient for the necessary reestablishment of resident education.


title: TMPRSS2 and TMPRSS4 promote SARS-CoV-2 infection of human small intestinal enterocytes

text: Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA are frequently observed in COVID-19 patients. However, it is unclear whether SARS-CoV-2 replicates in the human intestine and contributes to possible fecal-oral transmission. Here, we report productive infection of SARS-CoV-2 in ACE2+ mature enterocytes in human small intestinal enteroids. Expression of two mucosa-specific serine proteases, TMPRSS2 and TMPRSS4, facilitated SARS-CoV-2 spike fusogenic activity and promoted virus entry into host cells. We also demonstrate that viruses released into the intestinal lumen were inactivated by simulated human colonic fluid, and infectious virus was not recovered from the stool specimens of COVID-19 patients. Our results highlight the intestine as a potential site of SARS-CoV-2 replication, which may contribute to local and systemic illness and overall disease progression.


title: Global Storm of Stress-Related Psychopathological Symptoms: A Brief Overview on the Usefulness of Virtual Reality in Facing the Mental Health Impact of COVID-19

text: The coronavirus disease 2019 (COVID-19) pandemic is a global health emergency requiring clinicians to be prepared to cope with the increase in the future incidence of trauma and stress-related psychopathological symptoms. The early detection of psychological distress and timely intervention are strongly recommended. Clinicians should also consider integrating new technologies such as virtual reality (VR) in the treatment of these trauma and stress-related psychopathological symptoms. Here we provide a brief overview of how VR can help to cope with the potential short-term and long-term mental health consequences related to this global emergency.


title: Utility of extracorporeal membrane oxygenation in COVID-19

text: Extracorporeal membrane oxygenation (ECMO) is a means of cardiopulmonary support for refractory respiratory and cardiac failure. ECMO is a resource-intensive therapy that can be considered in highly selected patients. Expert centers should employ an evidence-based ARDS treatment algorithm and a multidisciplinary approach to recommending ECMO upon failure of conventional therapy. Caring for ECMO patients requires adequate infection control and safety precautions for healthcare workers.


title: Loss Rate Forecasting Framework Based on Macroeconomic Changes: Application to US Credit Card Industry

text: A major part of the balance sheets of the largest US banks consists of credit card portfolios. Hence, managing the charge-off rates is a vital task for the profitability of the credit card industry. Different macroeconomic conditions affect individuals' behavior in paying down their debts. In this paper, we propose an expert system for loss forecasting in the credit card industry using macroeconomic indicators. We select the indicators based on a thorough review of the literature and experts' opinions covering all aspects of the economy, consumer, business, and government sectors. The state of the art machine learning models are used to develop the proposed expert system framework. We develop two versions of the forecasting expert system, which utilize different approaches to select between the lags added to each indicator. Among 19 macroeconomic indicators that were used as the input, six were used in the model with optimal lags, and seven indicators were selected by the model using all lags. The features that were selected by each of these models covered all three sectors of the economy. Using the charge-off data for the top 100 US banks ranked by assets from the first quarter of 1985 to the second quarter of 2019, we achieve mean squared error values of 1.15E-03 and 1.04E-03 using the model with optimal lags and the model with all lags, respectively. The proposed expert system gives a holistic view of the economy to the practitioners in the credit card industry and helps them to see the impact of different macroeconomic conditions on their future loss.


End-Stage Heart Failure With COVID-19: Strong Evidence of Myocardial Injury by 2019-nCoV


title: A New System for Surveillance and Digital Contact Tracing for COVID-19: Spatiotemporal Reporting Over Network and GPS

text: The current pandemic of the coronavirus disease (COVID-19) has highlighted the importance of rapid control of the transmission of infectious diseases. This is particularly important for COVID-19, where many individuals are asymptomatic or have only mild symptoms but can still spread the disease. Current systems for controlling transmission rely on patients to report their symptoms to medical professionals and be able to recall and trace all their contacts from the previous few days. This is unrealistic in the modern world. However, existing smartphone-based GPS and social media technology may provide a suitable alternative. We, therefore, developed a mini-program within the app WeChat. This analyzes data from all users and traces close contacts of all patients. This permits early tracing and quarantine of potential sources of infection. Data from the mini-program can also be merged with other data to predict epidemic trends, calculate individual and population risks, and provide recommendations for individual and population protection action. It may also improve our understanding of how the disease spreads. However, there are a number of unresolved questions about the use of smartphone data for health surveillance, including how to protect individual privacy and provide safeguards against data breaches.


COVID-19 pandemic: new rules of engagement in endocrine surgery


Contingency Planning in the Clinical Laboratory: Lessons Learned Amidst COVID-19


TheEditor's Desk: Burnout


Thromboembolic events in patients with SARS-CoV-2


title: 2-Vinyl-4H-1,3-Dithiin, a Bioavailable Compound from Garlic, Inhibits Vascular Smooth Muscle Cells Proliferation and Migration by Reducing Oxidative Stress

text: Organosulfur compounds (OSCs) of garlic have various health benefits including anti-hypertensive effect. It has been described that volatile OSCs uptake occurs into a moderate extent. Among the bioavailable OSCs present in garlic, 2-vinyl-4H-1,3-dithiin (2VD) is a main component in garlic macerated oil and stir-fried garlic but has been poorly investigated compared with others OSCs, such allyl mercaptan (AM) and S-allyl cysteine (SAC). The aim of this study was to evaluate the effects of 2VD on vascular smooth muscle cells (VSMCs) isolated from spontaneous hypertensive rats (SHR) and compare them with those produced by AM and SAC. Cell viability and proliferation were measured using tetrazolium dye MTT assay and flow cytometry. Cell migration was evaluated by scrape-wound migration assay. OSCs anti-oxidative capacity was determined by measuring reactive oxygen species (ROS) generation, and total antioxidant status (TAS). Non-toxic plasmatic concentrations (10 µg L-1) of 2VD and AM inhibited VSMCs proliferation stimulated with 5% fetal bovine serum and impaired cell migration. In further flow cytometry analysis 2VD treatment resulted in a partial cell cycle arrest at G2 phase. The OSCs tested were able to prevent ROS increase after angiotensin II stimulation and surprisingly 2VD induced higher total antioxidant status compared with AM and SAC. Our results showed that 2VD produces equivalent or superior beneficial effects on VSMCs to those reported for other bioavailable compounds of garlic. This preliminary evidence suggests that 2VD intake could also exert important protective effects against arterial remodeling in hypertension.


Serologic testing of coronaviruses from MERS-CoV to SARS-CoV-2: Learning from the past and anticipating the future


title: Whole genome and phylogenetic analysis of two SARS-CoV-2 strains isolated in Italy in January and February 2020: additional clues on multiple introductions and further circulation in Europe

text: Whole genome sequences of SARS-CoV-2 obtained from two patients, a Chinese tourist visiting Rome and an Italian, were compared with sequences from Europe and elsewhere. In a phylogenetic tree, the Italian patient's sequence clustered with sequences from Germany while the tourist's sequence clustered with other European sequences. Some additional European sequences in the tree segregated outside the two clusters containing the patients' sequences. This suggests multiple SARS-CoV-2 introductions in Europe or virus evolution during circulation.


title: The Enemy Which Sealed the World: Effects of COVID-19 Diffusion on the Psychological State of the Italian Population

text: BACKGROUND: Starting from the first months of 2020, worldwide population has been facing the COVID-19 pandemic. Many nations, including Italy, took extreme actions to reduce the diffusion of the virus, profoundly changing lifestyles. The Italians have been faced with both the fear of contracting the infection and the consequences of enforcing social distancing. This study was aimed to understand the psychological impact of the COVID-19 outbreak and the psychopathological outcomes related to the first phase of this emergency. METHODS: The study included 2291 respondents. An online survey collected information on socio-demographic variables, history of direct or indirect contact with COVID-19, and additional information concerning the COVID-19 emergency. Moreover, psychopathological symptoms such as anxiety, mood alterations and post-traumatic symptomatology were assessed. RESULTS: The results revealed that respectively 31.38%, 37.19% and 27.72% of respondents reported levels of general psychopathological symptomatology, anxiety, and PTSD symptoms over the cut-off scores. Furthermore, a significant worsening of mood has emerged. Being a female or under the age of 50 years, having had direct contact with people infected by the COVID-19, and experiencing uncertainty about the risk of contagion represent risk factors for psychological distress. CONCLUSIONS: Our findings indicate that the first weeks of the COVID-19 pandemic appear to impact not only on physical health but also on psychological well-being. Although these results need to be considered with caution being based on self-reported data collected at the beginning of this emergency, they should be used as a starting point for further studies aimed to develop interventions to minimize both the brief and long-term psychological consequences of the COVID-19 pandemic.


title: COVID 19 era: a beginning of upsurge in unwanted pregnancies, unmet need for contraception and other women related issues

text: The Novel Coronavirus disease that started in Wuhan city of China in December 2019 has emerged as one of the fastest spreading pandemics all over the world affecting millions of people and causing millions of deaths worldwide. In an attempt to control its spread, countries have imposed local and national lockdowns, affecting many healthcare services, especially sexual and reproductive health services which are actually essential and lifesaving. In near future this will result in a large number of grave consequences including increased unmet need for modern contraceptives, unintended pregnancies, increased unsafe abortions, maternal and neonatal deaths and other harmful practices like female genital mutilation and child marriages in developing countries. The present short review focusses on such issues which will be dramatically increased depending on the duration of lockdowns and the time for which the sexual and reproductive health services will remain halted. It also reflects the need for considering reproductive health services as essential, allowing the people to avail these services without any fear and hence, saving many more lives which will be lost not due to coronavirus infection. Methodology: The data was searched from various governmental and non-governmental organisation sites including the World Health Organisation, United Nations, United Nations Population Fund, Guttmacher Institute and many PubMed indexed journals.


title: Experience from a Singapore tertiary hospital with restructuring of a vascular surgery practice in response to national and institutional policies during the COVID-19 pandemic

text: Singapore was one of the first countries to be affected by COVID-19, with the index patient diagnosed on January 23, 2020. For 2 weeks in February, we had the highest number of COVID-19 cases behind China. In this article, we summarize the key national and institutional policies that were implemented in response to COVID-19. We also describe in detail, with relevant data, how our vascular surgery practice has changed because of these policies and COVID-19. We show that with a segregated team model, the vascular surgery unit can still function while reducing risk of cross-contamination. We explain the various strategies adopted to reduce outpatient and inpatient volume. We provide a detailed breakdown of the type of vascular surgical cases that were performed during the COVID-19 pandemic and compare it with preceding months. We discuss our operating room and personal protective equipment protocols in managing a COVID-19 patient and share how we continue surgical training amid the pandemic. We also discuss the challenges we might face in the future as COVID-19 regresses.


title: [Clinical Study and CT Findings of a Familial Cluster of Pneumonia with Coronavirus Disease 2019 (COVID-19)]

text: We studied the epidemiological and clinical data collected from a family with 5 people, in which there were 3 family member diagnosed as coronavirus disease 2019 (COVID-19). We found that the first patient in this family had Wuhan city travel history. Close contact in daily life was the route of infection. The most common symptoms were fever, cough and weakness. Characteristic imaging changes were found with grass opacity (GGO), consolidation and septal thickening mainly distributed in peripheral and posterior area by thoracic CT scan in the 3 patients. The abnormality in laborotary test included lower white blood cell count, neutrophil count and lymphocyte countï¼increasing fibrinogen and C-reactive proteinï¼decreasing myohaemoglobin and increasing lactate dehydrogenase. The epidemiological and clinical features could provide quicker diagnosis and better management for the COVID-19 infected patients.


The Essential Role of Home- and Community-Based Physical Therapists During the COVID-19 Pandemic


title: Objective olfactory evaluation of self-reported loss of smell in a case series of 86 COVID-19 patients

text: OBJECTIVE: To investigate olfactory dysfunction (OD) in patients with mild coronavirus disease 2019 (COVID-19) through patient-reported outcome questionnaires and objective psychophysical testing. METHODS: COVID-19 patients with self-reported sudden-onset OD were recruited. Epidemiological and clinical data were collected. Nasal complaints were evaluated with the sinonasal outcome-22. Subjective olfactory and gustatory status was evaluated with the National Health and Nutrition Examination Survey. Objective OD was evaluated using psychophysical tests. RESULTS: Eighty-six patients completed the study. The most common symptoms were fatigue (72.9%), headache (60.0%), nasal obstruction (58.6%), and postnasal drip (48.6%). Total loss of smell was self-reported by 61.4% of patients. Objective olfactory testings identified 41 anosmic (47.7%), 12 hyposmic (14.0%), and 33 normosmic (38.3%) patients. There was no correlation between the objective test results and subjective reports of nasal obstruction or postnasal drip. CONCLUSION: A significant proportion of COVID-19 patients reporting OD do not have OD on objective testing.


title: Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 mimicking Kawasaki disease (Kawa-COVID-19): a multicentre cohort

text: BACKGROUND: Current data suggest that COVID-19 is less frequent in children, with a milder course. However, over the past weeks, an increase in the number of children presenting to hospitals in the greater Paris region with a phenotype resembling Kawasaki disease (KD) has led to an alert by the French national health authorities. METHODS: Multicentre compilation of patients with KD in Paris region since April 2020, associated with the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ('Kawa-COVID-19'). A historical cohort of 'classical' KD served as a comparator. RESULTS: Sixteen patients were included (sex ratio=1, median age 10 years IQR (4·7 to 12.5)). SARS-CoV-2 was detected in 12 cases (69%), while a further three cases had documented recent contact with a quantitative PCR-positive individual (19%). Cardiac involvement included myocarditis in 44% (n=7). Factors prognostic for the development of severe disease (ie, requiring intensive care, n=7) were age over 5 years and ferritinaemia >1400 µg/L. Only five patients (31%) were successfully treated with a single intravenous immunoglobulin (IVIg) infusion, while 10 patients (62%) required a second line of treatment. The Kawa-COVID-19 cohort differed from a comparator group of 'classical' KD by older age at onset 10 vs 2 years (p<0.0001), lower platelet count (188 vs 383 G/L (p<0.0001)), a higher rate of myocarditis 7/16 vs 3/220 (p=0.0001) and resistance to first IVIg treatment 10/16 vs 45/220 (p=0.004). CONCLUSION: Kawa-COVID-19 likely represents a new systemic inflammatory syndrome temporally associated with SARS-CoV-2 infection in children. Further prospective international studies are necessary to confirm these findings and better understand the pathophysiology of Kawa-COVID-19. Trial registration number NCT02377245.


Petechial Skin Rash Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection


title: YouTube as a source of information on COVID-19 and rheumatic disease link

text: INTRODUCTION/OBJECTIVES: The current 2019 novel coronavirus outbreak is continuing to spread rapidly despite all efforts. Patients with rheumatic disease may have higher levels of anxiety due to their disease characteristics and medications. The web-based platforms are widely used sources for gaining medical information. YouTube presents a wide range of medical information, but there are concerns on its quality. Therefore, we aimed to evaluate the quality of the YouTube videos about COVID-19 and rheumatic diseases link. METHOD: This is a descriptive study. A total of 360 videos listed by the YouTube search engine (www.youtube.com) in response to six search terms were evaluated. The Global Quality Scale (GQS) was performed to evaluate video quality. Three groups were formed according to GQS scores: high quality, moderate quality, and low quality. Video parameters were compared between these groups. RESULTS: After the exclusion criteria, 46 videos were reviewed. Of the videos, 41.4% (n = 19) were of high-quality group, 21.7% (n = 10) were moderate-quality group, and 36.9% (n = 17) were of low-quality group. Significant difference was detected between the quality groups in terms of views per day (p = 0.004). No significant difference was detected in comments per day (p = 0.139) and like ratio (p = 0.232). CONCLUSIONS: Besides high-quality videos, there were substantially low-quality videos that could cause misleading information to spread rapidly during the pandemic. Videos from trustworthy sources such as universities, academics, and physicians should be kept in the foreground.Key Pointsâ¢Web-based platforms have become an important source of health-related information. One of the most important online sources is YouTube because it is easy accessible and free.â¢Of the videos evaluating the link between COVID-19 and rheumatic diseases, 41.4% (n = 19) were of high quality.â¢The main sources of high-quality videos were academics/universities and physicians.â¢The most frequently discussed topics in videos were the place of hydroxychloroquine in the treatment of COVID-19 and whether to continue the use of existing rheumatological drugs.


title: Severe COVID-19 in a patient with chronic graft-versus-host disease after hematopoietic stem cell transplant successfully treated with ruxolitinib

text: Graft-versus-host disease (GVHD) is a common complication of hematopoietic stem cell transplant, which is known to be mediated by cytotoxic T-cell effectors and dysregulated inflammatory cytokines. Similarly, the lung injury observed in severe COVID-19 cases appears to be related to a massive production of proinflammatory cytokines. The selective JAK1/2 inhibitor ruxolitinib has shown promising results in the context of GVHD, and different trials are currently underway in patients with severe COVID-19; nevertheless no clinical observation of safety or efficacy of treatment with ruxolitinib in this context has been published yet. We describe a first case of severe COVID-19 developed after hematopoietic stem cell transplantation in a patient with a concomitant chronic GVHD (cGVHD), in which a treatment with ruxolitinib was administered with good tolerance and positive outcome.


Convalescent plasma and covid-19 treatment


Comment on: "To consider varicella-like exanthem associated with COVID-19, virus varicella zoster and virus herpes simplex must be ruled out. Characterization of herpetic lesions in hospitalized COVID-19 patients."


Audio Interview: What Clinicians Need to Know in Diagnosing and Treating Covid-19


title: The theoretical mortality risk of an asymptomatic patient with a negative SARS-CoV-2 test developing COVID-19 following elective orthopaedic surgery

text: AIMS: The risk to patients and healthcare workers of resuming elective orthopaedic surgery following the peak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been difficult to quantify. This has prompted governing bodies to adopt a cautious approach that may be impractical and financially unsustainable. The lack of evidence has made it impossible for surgeons to give patients an informed perspective of the consequences of elective surgery in the presence of SARS-CoV-2. This study aims to determine, for the UK population, the probability of a patient being admitted with an undetected SARS-CoV-2 infection and their resulting risk of death; taking into consideration the current disease prevalence, reverse transcription-polymerase chain reaction (RT-PCR) testing, and preassessment pathway. METHODS: The probability of SARS-CoV-2 infection with a false negative test was calculated using a lower-end RT-PCR sensitivity of 71%, specificity of 95%, and the UK disease prevalence of 0.24% reported in May 2020. Subsequently, a case fatality rate of 20.5% was applied as a worst-case scenario. RESULTS: The probability of SARS-CoV-2 infection with a false negative preoperative test was 0.07% (around 1 in 1,400). The risk of a patient with an undetected infection being admitted for surgery and subsequently dying from the coronavirus disease 2019 (COVID-19) is estimated at approximately 1 in 7,000. However, if an estimate of the current global infection fatality rate (1.04%) is applied, the risk of death would be around 1 in 140,000, at most. This calculation does not take into account the risk of nosocomial infection. Conversely, it does not factor in that patients will also be clinically assessed and asked to self-isolate prior to surgery. CONCLUSION: Our estimation suggests that the risk of patients being inadvertently admitted with an undetected SARS-CoV-2 infection for elective orthopaedic surgery is relatively low. Accordingly, the risk of death following elective orthopaedic surgery is low, even when applying the worst-case fatality rate.


title: An open-access clicker question bank for numerical analysis

text: We present a question bank consisting of over 250 multiple-choice and true-false questions covering a broad range of material typically taught in an introductory undergraduate course in numerical analysis or scientific computing. The questions are ideal for polling students during lectures by means of a student response system that uses clicker remotes or smartphones running a suitable app. We describe our experiences implementing these clicker questions in a recent class and provide evidence of their effectiveness in terms of testing students' prior knowledge, gauging understanding of new material, increasing participation, and especially improving student satisfaction. Our conclusions are supported by a mid-semester student survey as well as anecdotal observations. The question bank has been released as an open-access educational resource under a Creative Commons license (BY-NC-SA) for free use by the mathematics community.


title: The Correlation of Comorbidities on the Mortality in Patients with COVID-19: an Observational Study Based on the Korean National Health Insurance Big Data

text: BACKGROUND: Mortality of coronavirus disease 2019 (COVID-19) is a major concern for quarantine departments in all countries. This is because the mortality of infectious diseases determines the basic policy stance of measures to prevent infectious diseases. Early screening of high-risk groups and taking action are the basics of disease management. This study examined the correlation of comorbidities on the mortality of patients with COVID-19. METHODS: We constructed epidemiologic characteristics and medical history database based on the Korean National Health Insurance Service Big Data and linked COVID-19 registry data of Korea Centers for Disease Control & Prevention (KCDC) for this emergent observational cohort study. A total of 9,148 patients with confirmed COVID-19 were included. Mortalities by sex, age, district, income level and all range of comorbidities classified by International Classification of Diseases-10 based 298 categories were estimated. RESULTS: There were 3,556 male confirmed cases, 67 deaths, and crude death rate (CDR) of 1.88%. There were 5,592 females, 63 deaths, and CDR of 1.13%. The most confirmed cases were 1,352 patients between the ages of 20 to 24, followed by 25 to 29. As a result of multivariate logistic regression analysis that adjusted epidemiologic factors to view the risk of death, the odds ratio of death would be hemorrhagic conditions and other diseases of blood and blood-forming organs 3.88-fold (95% confidence interval [CI], 1.52-9.88), heart failure 3.17-fold (95% CI, 1.88-5.34), renal failure 3.07-fold (95% CI, 1.43-6.61), prostate malignant neoplasm 2.88-fold (95% CI, 1.01-8.22), acute myocardial infarction 2.38-fold (95% CI, 1.03-5.49), diabetes was 1.82-fold (95% CI, 1.25-2.67), and other ischemic heart disease 1.71-fold (95% CI, 1.09-2.66). CONCLUSION: We hope that this study could provide information on high risk groups for preemptive interventions. In the future, if a vaccine for COVID-19 is developed, it is expected that this study will be the basic data for recommending immunization by selecting those with chronic disease that had high risk of death, as recommended target diseases for vaccination.


title: The effect of stay-at-home orders on COVID-19 cases and fatalities in the United States

text: Governments issue"stay at home"orders to reduce the spread of contagious diseases, but the magnitude of such orders' effectiveness is uncertain. In the United States these orders were not coordinated at the national level during the coronavirus disease 2019 (COVID-19) pandemic, which creates an opportunity to use spatial and temporal variation to measure the policies' effect with greater accuracy. Here, we combine data on the timing of stay-at-home orders with daily confirmed COVID-19 cases and fatalities at the county level in the United States. We estimate the effect of stay-at-home orders using a difference-in-differences design that accounts for unmeasured local variation in factors like health systems and demographics and for unmeasured temporal variation in factors like national mitigation actions and access to tests. Compared to counties that did not implement stay-at-home orders, the results show that the orders are associated with a 30.2 percent (11.0 to 45.2) reduction in weekly cases after one week, a 40.0 percent (23.4 to 53.0) reduction after two weeks, and a 48.6 percent (31.1 to 61.7) reduction after three weeks. Stay-at-home orders are also associated with a 59.8 percent (18.3 to 80.2) reduction in weekly fatalities after three weeks. These results suggest that stay-at-home orders reduced confirmed cases by 390,000 (170,000 to 680,000) and fatalities by 41,000 (27,000 to 59,000) within the first three weeks in localities where they were implemented.


title: Lab-on-a-Chip Devices for Point-of-Care Medical Diagnostics

text: The recent coronavirus (COVID-19) pandemic has underscored the need to move from traditional lab-centralized diagnostics to point-of-care (PoC) settings. Lab-on-a-chip (LoC) platforms facilitate the translation to PoC settings via the miniaturization, portability, integration, and automation of multiple assay functions onto a single chip. For this purpose, paper-based assays and microfluidic platforms are currently being extensively studied, and much focus is being directed towards simplifying their design while simultaneously improving multiplexing and automation capabilities. Signal amplification strategies are being applied to improve the performance of assays with respect to both sensitivity and selectivity, while smartphones are being integrated to expand the analytical power of the technology and promote its accessibility. In this chapter, we review the main technologies in the field of LoC platforms for PoC medical diagnostics and survey recent approaches for improving these assays.