title: Kinetics of viral load and antibody response in relation to COVID-19 severity

text: The SARS-CoV-2 is the causative agent for COVID-19 pneumonia. Little is known about the kinetics, tissue distribution, cross-reactivity and neutralization antibody response in COVID-19 patients. Two groups of RT-PCR confirmed COVID-19 patients were enrolled in this study, including 12 severe patients in ICUs who needed mechanical ventilation and 11 mild patients in isolation wards. Serial clinical samples were collected for laboratory detection. Results showed that most of the severe patients had viral shedding in a variety of tissues for 20~40 days post onset of disease (8/12, 66.7%); while the majority of mild patients had viral shedding restricted to the respiratory tract and had no detectable virus RNA after 10 days post-onset (9/11, 81.8%). Mild patients showed significantly lower IgM response compared with that of the severe group. IgG responses were detected in most patients in both severe and mild groups at 9 days post onset and remained high level throughout the study. Antibodies cross-reactive to SARS-CoV and SARS-CoV-2 were detected in COVID-19 patients but not in MERS patients. High-levels of neutralizing antibodies were induced after about 10 days post onset in both severe and mild patients which were higher in the severe group. SARS-CoV-2 pseudotype neutralization test and focus reduction neutralization test with authentic virus showed consistent results. Sera from COVID-19 patients, but not convalescent SARS and MERS patients inhibited SARS-CoV-2 entry. Anti-SARS-CoV-2 S and N IgG level exhibited moderate correlation with neutralization titers in patients' plasma. This study improves our understanding of immune response in human after SARS-CoV-2 infection.


title: Clinical characteristics and management of a liver transplanted patient admitted with SARS-CoV-2 infection

text: We present here the case of a 62-year-old man, who was referred to the emergency department with fever and cough for 3 days. He underwent liver transplantation 4 years earlier due to HCV and NASH-related cirrhosis with hepatocellular carcinoma. At admission he was in reduced general conditions. Nasopharyngeal smear specimen resulted positive for SARS-CoV-2 infection. Pulmonary low-dose CT-scan revealed bilateral subpleural ground-glass infiltrates. O2 saturation was 93%. A treatment with lopinavir/ritonavir and hydroxychloroquine twice daily was started. The patient received also cefepime and remained in isolation. Seven days later imaging showed a progression of the pulmonary infiltrates. Cefepime was replaced by meropenem. During the following 3 days the fever resolved, and the general conditions of the patient significantly improved. Consequently, treatment with lopinavir/ritonavir and hydroxychloroquine was stopped. The evolution of SARS-CoV-2 interstitial pneumonia in this immunosuppressed patient was moderate to severe and liver injury was not clinically significant. Despite its limitations, this case report confirm that the liver may be only mildly affected during SARS-CoV-2 infection, also in liver transplanted patients. Further studies are needed to assess whether the outcome of SARS-CoV-2 infection is worse in immunosuppressed patients than in the general population.


Adipose-derived stromal stem cells (ASCs) as a new regenerative immediate therapy combating coronavirus (COVID-19)-induced pneumonia


title: Screening of immune-related differentially expressed genes from primary lymphatic organs of broilers fed with probiotic bacillus cereus PAS38 based on suppression subtractive hybridization

text: To explore the molecular mechanism of the effect of Bacillus cereus PAS38 on the immunity of broilers, sixty 7-day-old broilers were divided into two groups with three replicates. The control group was fed with basal diet, and the treatment group was fed with basal diet containing Bacillus cereus PAS38 1×106 CFU/g. Thymus and bursa of fabricius were taken from two groups of broilers at the age of 42 days, total RNA was extracted, differential gene library was constructed by SSH technology, and immune-related differential genes were screened. Then, we used siRNA to interfere with the expression of some differential genes in the original generation lymphocytes of broiler blood to detect the change of cytokines mRNA expression level. A total of 42 immune-related differentially expressed genes were screened, including 22 up-regulated genes and 20 down-regulated genes. When 7 differentially up-regulated genes associated with enhanced immune function were interfered with in lymphocytes, some immune-promoting cytokines were down-regulated. These results showed that Bacillus cereus PAS38 might up-regulate the expression of JCHAIN, PRDX1, CD3E, CDK6 and other genes in immune organs of broilers, thereby affecting the development of immune organs, the expression of various cytokines and the transduction of immune signals, improving the immune capacity of broilers.


COVID-19, impact on myeloma patients


Why we need longitudinal mental health research with children and youth during (and after) the COVID-19 pandemic


Coronavirus covid-19 has killed more people than SARS and MERS combined, despite lower case fatality rate


title: Characterization of SARS-CoV-2 Dynamics in the Host

text: While many epidemiological models have being proposed to understand and handle COVID-19, too little has been invested to understand how the virus replicates in the human body and potential antiviral can be used to control the replication cycle. In this work, using a control theoretical approach, validated mathematical models of SARS-CoV-2 in humans are properly characterized. A complete analysis of the main dynamic characteristic is developed based on the reproduction number. The equilibrium regions of the system are fully characterized, and the stability of such a regions, formally established. Mathematical analysis highlights critical conditions to decrease monotonically SARS-CoV-2 in the host, such conditions are relevant to tailor future antiviral treatments. Simulation results show the potential benefits of the aforementioned system characterization.


title: Preventive and Control Measures for the ï»¿Coronavirus Pandemic in Clinical Dentistry

text: A severe public health crisis has been declared worldwide since coronavirus disease 2019 (COVID-19) was classified as a pandemic of acute respiratory infectious disease by the World Health Organisation (WHO). China has taken strict measures to curb the spread of the disease to save lives, and has managed to control the outbreak. COVID-19 is mainly transmitted through respiratory droplets and close physical contact, so it is challenging to prevent nosocomial infection and possible spread during dental treatment. Since the initial phase of the COVID-19 outbreak, a disease prevention and control strategy based on the new concept of population risk classification and rational use of personal protective equipment has been implemented by the Peking University Hospital of Stomatology. Nosocomial infection prevention and control concepts and measures relating to dental diagnosis and treatment are critically checked in the hospital. Our experiences in handling this situation are shared here and may have wide-ranging implications for infection prevention and control (IPC) for COVID-19 in dental practices worldwide.


COVID-19: Universal health coverage now more than ever


COVID-19 in einer stationären Pflegeeinrichtung : Corona-Pandemie 2020./ [COVID-19 in the nursing home: a case report]


title: Bedside Transcervical-transtracheal Post-intubation Injury Repair in a Covid-19 Patient

text: SARS-Co-2 disease 2019 (COVID-19) has rapidly spread worldwide since December 2019. A relevant rate of patients develops an acute respiratory distress syndrome that require hospitalization. Among them, a non-negligible rate (9.8%-15.2%) requires tracheal intubation for invasive ventilation. We report the case of a COVID-19 patient developing pneumomediastinum and subcutaneous emphysema secondary to post-intubation tracheal injury. The management of COVID-19 patient can be challenging due to the risk of disease transmission to caregivers and epidemic spread. We performed a bedside tracheal injury surgical repair, after failure of conservative management, with resolution of pneumomediastinum and subcutaneous emphysema and improvement of patient's conditions.


title: Point-of-care ultrasound and COVID-19

text: Point-of-care ultrasound has an important role in the management of patients with COVID-19 infection. Because the utility of each application varies by setting, individual institutions should consider how they can best use ultrasound within their specific environments. In general, procedural guidance and focused echocardiography are high yield. Lung ultrasound has the potential to aid the diagnosis and management of patients with COVID-19 infection. Lower extremity point-of-care ultrasound for deep vein thrombosis may help guide decision making regarding anticoagulation or undifferentiated shock. It is of the utmost priority that ultrasound not spread infection, so point-of-care ultrasound must be used only when clinically indicated. Institutions should have protocols for machine disinfection.


Seven days in medicine: 1-7 April 2020


Physician drug prescribing preferences and availability for ventilation of patients with COVID-19


The Novel Coronavirus Originating in Wuhan, China: Challenges for Global Health Governance


title: Expanded Umbilical Cord Mesenchymal Stem Cells (UC-MSCs) as a Therapeutic Strategy in Managing Critically Ill COVID-19 Patients: The Case for Compassionate Use

text: COVID-19 has affected the United States leading to a national emergency with health care and economic impact, propelling the country into a recession with disrupted lifestyles not seen in recent history. COVID-19 is a serious illness leading to multiple deaths in various countries including the United States. Several million Americans satisfy the Center for Disease Control and Prevention (CDC) criteria for being high risk. Unfortunately, the available supply of medical beds and equipment for mechanical ventilation are much less than is projected to be needed. The World Health Organization (WHO) and multiple agencies led by the CDC in the United States have attempted to organize intensive outbreak investigation programs utilizing appropriate preventive measures, evaluation, and treatment. The clinical spectrum of COVID-19 varies from asymptomatic forms to conditions encompassing multiorgan and systemic manifestations in terms of septic shock, and multiple organ dysfunction (MOD) syndromes. The presently approved treatments are supportive but not curative for the disease. There are multiple treatments being studied. These include vaccines, medications Remdesivir and hydroxychloroquine and potentially combination therapy. Finally, expanded umbilical cord mesenchymal stem cells or (UC-MSCs) may have a role and are being studied. The cure of COVID-19 is essentially dependent on the patients' own immune system. When the immune system is over activated in an attempt to kill the virus, this can lead to the production of a large number of inflammatory factors, resulting in severe cytokine storm. The cytokine storm may induce organ damage followed by the edema, dysfunction of air exchange, acute respiratory distress syndrome (ARDS), acute cardiac injury, and secondary infection, which may lead to death. Thus, at this point, the avoidance of the cytokine storm may be the key for the treatment of HCOV-19 infected patients.In China, where there was limited availability of effective modalities to manage COVID-19 several patients were treated with expanded UC-MSCs. Additionally, the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care have reported guidelines to treat coronavirus patients with stem cells in the hope of decreasing the number of patients going to the ICU, and, also relatively quickly getting them out of ICU. In this manuscript, we describe the urgent need for various solutions, pathogenesis of coronavirus and the clinical evidence for treatment of COVID-19 with stem cells. The limited but emerging evidence regarding UC MSC in managing COVID-19 suggests that it might be considered for compassionate use in critically ill patients to reduce morbidity and mortality in the United States. The administration and Coronavirus Task Force might wish to approach the potential of expanded UC-MSCs as an evolutionary therapeutic strategy in managing COVID-19 illness with a 3-pronged approach: If proven safe and effective on a specific and limited basis 1. Minimize regulatory burden by all agencies so that critically ill COVID-19 patients will have access regardless of their financial circumstance.2. Institute appropriate safeguards to avoid negative consequences from unscrupulous actors.3. With proper informed consent from patients or proxy when necessary, and subject to accumulation of data in that cohort, allow the procedure to be initiated in critically ill patients who are not responding to conventional therapies.KEY WORDS: Coronavirus, COVID-19, cytokine storm, multiorgan failure, expanded umbilical cord mesenchymal stem cells.


[Suggestions on delivery management of pregnant women with COVID-19]


title: Predicting COVID-19 Pneumonia Severity on Chest X-ray with Deep Learning

text: Purpose: The need to streamline patient management for COVID-19 has become more pressing than ever. Chest X-rays provide a non-invasive (potentially bedside) tool to monitor the progression of the disease. In this study, we present a severity score prediction model for COVID-19 pneumonia for frontal chest X-ray images. Such a tool can gauge severity of COVID-19 lung infections (and pneumonia in general) that can be used for escalation or de-escalation of care as well as monitoring treatment efficacy, especially in the ICU. Methods: Images from a public COVID-19 database were scored retrospectively by three blinded experts in terms of the extent of lung involvement as well as the degree of opacity. A neural network model that was pre-trained on large (non-COVID-19) chest X-ray datasets is used to construct features for COVID-19 images which are predictive for our task. Results: This study finds that training a regression model on a subset of the outputs from an this pre-trained chest X-ray model predicts our geographic extent score (range 0-8) with 1.14 mean absolute error (MAE) and our lung opacity score (range 0-6) with 0.78 MAE. Conclusions: These results indicate that our model's ability to gauge severity of COVID-19 lung infections could be used for escalation or de-escalation of care as well as monitoring treatment efficacy, especially in the intensive care unit (ICU). A proper clinical trial is needed to evaluate efficacy. To enable this we make our code, labels, and data available online at https://github.com/mlmed/torchxrayvision/tree/master/scripts/covid-severity and https://github.com/ieee8023/covid-chestxray-dataset


title: Recommendation of a practical guideline for safe tracheostomy during the COVID-19 pandemic

text: PURPOSE: The COVID-19 pandemic is placing unprecedented demand upon critical care services for invasive mechanical ventilation. There is current uncertainty regarding the role of tracheostomy for weaning ventilated patients with COVID-19 pneumonia. This is due to a number of factors including prognosis, optimal healthcare resource utilisation, and safety of healthcare workers when performing such a high-risk aerosol-generating procedure. METHODS: Literature review and proposed practical guideline based on the experience of a tertiary healthcare institution with 195 critical care admissions for COVID-19 up until 4th April 2020. RESULTS: A synthesis of the current international literature and reported experience is presented with respect to prognosis, viral load and staff safety, thus leading to a pragmatic recommendation that tracheostomy is not performed until at least 14 days after endotracheal intubation in COVID-19 patients. Practical steps to minimise aerosol generation in percutaneous tracheostomy are outlined and we describe the process and framework for setting up a dedicated tracheostomy team. CONCLUSION: In selected COVID-19 patients, there is a role for tracheostomy to aid in weaning and optimise healthcare resource utilisation. Both percutaneous and open techniques can be performed safely with careful modifications to technique and appropriate enhanced personal protective equipment. ORL-HNS surgeons can play a valuable role in forming tracheostomy teams to support critical care teams during this global pandemic.


title: Propranolol suppresses the growth of colorectal cancer through simultaneously activating autologous CD8+ T cells and inhibiting tumor AKT/MAPK pathway

text: Propranolol suppresses tumor growth in a variety of preclinical solid tumor models, with a number of proposed cell signaling and immunological mechanisms. We want to confirm the potential mechanisms, including reduced phosphorylation of AKT/MAPK pathways, as well as enhanced CD8+ T-cell-mediated antitumor immune response. To clarify the mechanism of propranolol activity in colorectal cancer, the therapeutic activity of propranolol was then assessed in CT26WT tumors engrafted in BALB/C mice. Then the effect of propranolol treatment was also examined by randomizing patients undergoing surgical resection of a previously untreated colorectal cancer to propranolol or placebo group and treated for 1 week prior to surgery. CT26WT tumor size was smaller after propranolol than vehicle control. Propranolol downregulated the expression of p-AKT/p-ERK/p-MEK in tumor tissue. The frequency of tumor CD8+ T cells was significantly elevated in propranolol-treated mice. The expression of GzmB/IFN-Î³/T-bet in the CD8+ T-cell population was significantly increased in propranolol treated mice tumor tissue. In propranolol-treated surgical specimens, the expression of p-ERK was decreased and the frequency of CD8+ was significantly elevated. The expression of GzmB in the CD8+ T-cell population was significantly increased in propranolol-treated subjects. Together these data show propranolol simultaneously activating autologous CD8+ T cells and decreasing the expression of p-AKT/p-ERK/p-MEK in mouse tumor models, while inhibiting the expression of p-ERK in clinical colorectal cancer. Effort is now needed to further dissect whether both pathways are required for anti-tumor effect, as the activity of this old drug is moved forward.


Experience in patients with hidradenitis suppurativa and COVID-19 symptoms


A Case Report of Oligosymptomatic Kidney Transplant Patients with COVID-19: Do They Pose a Risk to Other Recipients?


Academic coaching of medical students during the COVID-19 pandemic


title: Academic Coaching of Medical Students During COVID-19

text: Social distancing measures due to the COVID-19 pandemic has required many medical schools to adapt existing on-site medical education activities to delivery via online platforms. The sudden switch to a new, unfamiliar model of learning led to additional challenges for students. We observed that students requiring academic support often had ineffective learning strategies, poor motivation, and suboptimal communication skills, all of which were magnified by home-based learning. We therefore established a virtual academic coaching programme to engage these students and to address specific challenges that arose from an adapted educational programme.


Distant virtual medical education during COVID-19: Half a loaf of bread


Can Nigeria contain the COVID-19 outbreak using lessons from recent epidemics?


Blood and blood product use during COVID-19 infection


title: Use of Lung Ultrasound to Differentiate Coronavirus Disease 2019 (COVID-19) Pneumonia From Community-Acquired Pneumonia

text: To investigate the feasibility of lung ultrasound in evaluating coronavirus disease 2019 (COVID-19) and distinguish the sonographic features between COVID-19 and community-acquired pneumonia (CAP), a total of 12 COVID-19 patients and 20 CAP patients were selected and underwent lung ultrasound. The modified Buda scoring system for interstitial lung disease was used to evaluate the severity and treatment effect of COVID-19 on ultrasonography. The differences between modified lung ultrasound (MLUS) score and high-resolution computed tomography (HRCT) Warrick score were analyzed to evaluate their correlation. COVID-19 showed the following sonographic features: thickening (12/12), blurred (9/12), discontinuous (6/12) pleural line; rocket sign (4/12), partially diffused B-line (12/12), completely diffused B-line (10/12), waterfall sign (4/12); C-line sign (5/12); pleural effusion (1/12) and pulmonary balloon (Am line, 1/12). The last two features were rarely seen. Differences of ultrasonic features, including lesion range, lung signs and pneumonia-related complications, between COVID-19 and CAP were statistically significant (pË 0.05 or 0.001). MLUS scores (pâ¯=â¯0.006) and HRCT Warrick scores (pâ¯=â¯0.015) increased as the severity of COVID-19 increased. The differences between moderate (29.00 [25.75-37.50]) and severe (43.00 [38.75-47.25]) (pâ¯=â¯0.022) or between moderate and critical (47.50 [44.25-50.00]) (pâ¯=â¯0.002) type COVID-19 were statistically significant, compared with those between severe and critical types. Correlation between MLUS scores and HRCT Warrick scores was positive (râ¯=â¯0.54, pâ¯=â¯0.048). MLUS scores (Zâ¯=â¯2.61, pâ¯=â¯0.009) and HRCT Warrick scores (Zâ¯=â¯2.63, pâ¯=â¯0.009) of five severe or critical COVID-19 patients significantly decreased as their conditions improved after treatment. The differences of sonographic features between COVID-19 and CAP patients were notable. The MLUS scoring system could be used to evaluate the severity and treatment effect of COVID-19.


title: Correction: Delivering siRNA to control osteogenic differentiation and real-time detection of cell differentiation in human mesenchymal stem cells using multifunctional gold nanoparticles

text: Correction for 'Delivering siRNA to control osteogenic differentiation and real-time detection of cell differentiation in human mesenchymal stem cells using multifunctional gold nanoparticles' by Qian Wu et al., J. Mater. Chem. B, 2020, 8, 3016-3027, DOI: .


"Masked" empathy-A post-pandemic reality: Psychodermatological perspective


title: Coronavirus disease 2019 pandemic: staged management of surgical services for gynecology and obstetrics

text: The coronavirus disease 2019 pandemic warrants an unprecedented global healthcare response requiring maintenance of existing hospital-based services while simultaneously preparing for high-acuity care for infected and sick individuals. Hospitals must protect patients and the diverse healthcare workforce by conserving personal protective equipment and redeployment of facility resources. While each hospital or health system must evaluate their own capabilities and surge capacity, we present principles of management of surgical services during a health emergency and provide specific guidance to help with decision making. We review the limited evidence from past hospital and community responses to various health emergencies and focus on systematic methods for adjusting surgical services to create capacity, addressing the specific risks of coronavirus disease 2019. Successful strategies for tiered reduction of surgical cases involve multidisciplinary engagement of the entire healthcare system and use of a structured risk-assessment categorization scheme that can be applied across the institution. Our institution developed and operationalized this approach over 3 working days, indicating that immediate implementation is feasible in response to an unforeseen healthcare emergency.


Between Scylla and Charybdis - Oncologic Decision Making in the Time of Covid-19


Pearls to Pivoting a Multidisciplinary Prostate Cancer Survivorship Program During the COVID-19 Pandemic


title: Grandpa, grandpa, tell me the one about Bitcoin being a safe haven: Evidence from the COVID-19 pandemics

text: Bitcoin being a safe haven asset is one of the traditional stories in the cryptocurrency community. However, during its existence and relevant presence, i.e. approximately since 2013, there has been no severe situation on the financial markets globally to prove or disprove this story until the COVID-19 pandemics. We study the quantile correlations of Bitcoin and two benchmarks -- S\&P500 and VIX -- and we make comparison with gold as the traditional safe haven asset. The Bitcoin safe haven story is shown and discussed to be unsubstantiated and far-fetched, while gold comes out as a clear winner in this contest.


What organisations around the world are doing to help improve doctors' wellbeing


Chloroquine for COVID-19: rationale, facts, hopes


Are Patients Suffering from Severe Obesity Getting a Raw Deal During COVID-19 Pandemic?


[Epidemiology and clinical features of highly pathogenic human coronavirus infection in children]


title: An Integrated P2P Framework for E-Learning

text: The paper is concerned with the design and development of a P2P Presentation System (P2P-PS) for live streaming of lectures coupled with a shareable whiteboard. Video streaming uses a data-driven modified mesh architecture which supports dynamic fanout. The whiteboard may be used in synchronization with an active video streaming session. It is shared by both the presenter and the participants in the audience for graphic illustrations during the lecture. P2P-PS provides an important feature called {\em ask doubt} that allows any participant to send a query (or a doubt) during an active presentation session. The query is disseminated to all other peers by preserving the causality between {\em ask doubt} and its resolution. A buffered approach is employed to boost the performance of the whiteboard. The simulations experiments were performed with over 1000 peer nodes on Emulab using 200 physical nodes. The results show that the proposed overlay eventually stabilizes even in the presence of a churning rate of up to 30\%. The maximum path length being just six hops. The estimated throughput is found to be close to our theoretical results.


Psychopathological responses and face mask restrictions during the COVID-19 outbreak: Results from a nationwide survey


title: The Three Steps Needed to End the COVID-19 Pandemic: Bold Public Health Leadership, Rapid Innovations, and Courageous Political Will

text: The world is experiencing the expansive spread of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) in a global pandemic that is placing strain on health care, economic, and social systems. Commitment to implementing proven public health strategies will require bold public health leadership and courageous acts by politicians. Developing new innovative communication, mitigation, and health care approaches, particularly in the era of social media, is also clearly warranted. We believe that the best public health evidence must inform activities in three priority areas to stop this pandemic: (1) coordinated and consistent stay-at-home orders across multiple jurisdictions, including potential nationwide mandates; (2) rapid scale-up of SARS-CoV-2 testing; and (3) improved health care capacity to respond. This editorial outlines those areas, the rationale behind them, and the call for innovation and engagement of bold public health leadership to empower courageous political action to reduce the number of deaths during this pandemic.


title: Is returning to work during the COVID-19 pandemic stressful? A study on immediate mental health status and psychoneuroimmunity prevention measures of Chinese workforce

text: This study aimed to quantify the immediate psychological effects and psychoneuroimmunity prevention measures of a workforce returning to work during the COVID-19 epidemic. Workforce returning to work was invited to complete an online questionnaire regarding their attitude toward the COVID-19 epidemic and return-to-work along with psychological parameters including the Impact of Event Scale-Revised, Depression, Anxiety, Stress Scale- 21 (DASS-21) and Insomnia Severity Index (ISI). Psychoneuroimmunity prevention measures include precautions at personal and organization levels. From 673 valid questionnaires, we found that 10.8% of respondents met the diagnosis of post-traumatic stress disorder (PTSD) after returning to work. The respondents reported a low prevalence of anxiety (3.8%), depression (3.7%), stress (1.5%) and insomnia (2.3%). There were no significant differences in the severity of psychiatric symptoms between workers/technicians and executives/managers. >95% reported psychoneuroimmunity prevention measures including good ventilation in the workplace and wore a face mask as protective. Factors that were associated with the severity of psychiatric symptoms in the workforce were marital status, presence of physical symptom, poor physical health and viewing return to work as a health hazard (p < 0.05). In contrast, personal psychoneuroimmunity prevention measures including hand hygiene and wearing face masks as well as organizational measures including significant improvement of workplace hygiene and concerns from the company were associated with less severe psychiatric symptoms (p < 0.05). Contrary to expectations, returning to work had not caused a high level of psychiatric symptoms in the workforce. The low prevalence of psychiatric symptoms could be due to confidence instilled by psychoneuroimmunity prevention measures before the resumption of work. Our findings would provide information for other countries during the COVID-19 pandemic.


Lessons learned from HIV can inform our approach to COVID-19 stigma


title: Telemedicine in the face of the COVID-19 pandemic

text: The novel coronavirus SARS-CoV-2 is a positive single-stranded RNA virus that can be immediately translated and integrated into the host cell with its own RNA messenger, facilitating replication inside the cell and infectivity. The rapid progression of the disease presents a real challenge for the whole world. As the usual capacity for citizen care is exceeded, health professionals and governments struggle. One of the most important strategies to reduce and mitigate the advance of the epidemic are social distance measures; this is where telemedicine can help, and provide support to the healthcare systems, especially in the areas of public health, prevention and clinical practices, just as it is doing in others sectors. Telemedicine connects the convenience, low cost, and ready accessibility of health-related information and communication using the Internet and associated technologies. Telemedicine during the coronavirus epidemic has been the doctors' first line of defense to slow the spread of the coronavirus, keeping social distancing and providing services by phone or videoconferencing for mild to focus personal care and limited supplies to the most urgent cases.


title: US faces endemic Covid-19 infections and deaths

text: A new epidemic model for Covid-19 has been constructed and simulated for eight US states. The coefficients for this model, based on seven coupled differential equations, are carefully evaluated against recorded data on cases and deaths. These projections reveal that Covid-19 will become endemic, spreading for more than two years. If stay-at-home orders are relaxed, most states may experience a secondary peak in 2021. The number of Covid-19 deaths could have been significantly lower in most states that opened up, if lockdowns had been maintained. Additionally, our model predicts that decreasing contact rate by 10%, or increasing testing by approximately 15%, or doubling lockdown compliance (from the current $\sim$ 15%) will eradicate infections in Texas within a year. Applied to the entire US, the predictions based on the current situation indicate about 11 million total infections (including undetected), 8 million cumulative confirmed cases, and 630,000 cumulative deaths by November 1, 2020.


title: RNA aptamer capture of macromolecular complexes for mass spectrometry analysis

text: Specific genomic functions are dictated by macromolecular complexes (MCs) containing multiple proteins. Affinity purification of these complexes, often using antibodies, followed by mass spectrometry (MS) has revolutionized our ability to identify the composition of MCs. However, conventional immunoprecipitations suffer from contaminating antibody/serum-derived peptides that limit the sensitivity of detection for low-abundant interacting partners using MS. Here, we present AptA-MS (aptamer affinity-mass spectrometry), a robust strategy primarily using a specific, high-affinity RNA aptamer against Green Fluorescent Protein (GFP) to identify interactors of a GFP-tagged protein of interest by high-resolution MS. Utilizing this approach, we have identified the known molecular chaperones that interact with human Heat Shock Factor 1 (HSF1), and observed an increased association with several proteins upon heat shock, including translation elongation factors and histones. HSF1 is known to be regulated by multiple post-translational modifications (PTMs), and we observe both known and new sites of modifications on HSF1. We show that AptA-MS provides a dramatic target enrichment and detection sensitivity in evolutionarily diverse organisms and allows identification of PTMs without the need for modification-specific enrichments. In combination with the expanding libraries of GFP-tagged cell lines, this strategy offers a general, inexpensive, and high-resolution alternative to conventional approaches for studying MCs.


title: Protective measures for COVID-19 for healthcare providers and laboratory personnel

text: In the COVID-19 pandemic, which affects the whole world, healthcare professionals (HCP) are at high risk of transmission due to their direct contact with patients with COVID-19. Therefore, how to ensure the triage of the patient with acute respiratory symptoms should be determined in advance, the contact distance should be arranged to be at least 2 m, COVID-19 suspect or diagnosed patient should be instructed to wear a surgical mask. During the care of these patients, HCP should wear their personal protective equipment (PPE) in accordance with the procedure and should not neglect hand hygiene. The samples of the patient with known or suspected COVID-19, patient should also be known to be risky in terms of contamination, and a risk assessment should be performed for the procedures to be performed in laboratories. The PPE should be used in accordance with the procedure to be performed. The protection of the HCP, who sacrifice at the risk of life, is possible only by complying with infection control and precautions.


The South African Precariat, COVID-19 and #BIGNOW


Mental health care for medical staff in China during the COVID-19 outbreak


All That Glitters Isn't Gold: Critical Care in the Time of COVID-19


title: Reactive Social distancing in a SIR model of epidemics such as COVID-19

text: A model of reactive social distancing in epidemics is proposed, in which the infection rate changes with the number infected. The final-size equation for the total number that the epidemic will infect can be derived analytically, as can the peak infection proportion. This model could assist planners during for example the COVID-19 pandemic.


Behind the Mask


Mental health burden of frontline health professionals treating imported patients with COVID-19 in China during the pandemic


Mental health burden of frontline health professionals in screening and caring the imported COVID-19 patients in China during the pandemic


title: Ethical considerations regarding heart and lung transplantation and mechanical circulatory support during the COVID-19 pandemic: an ISHLT COVID-19 Task Force statement

text: To understand the challenges for thoracic transplantation and mechanical circulatory support during the current coronavirus disease 2019 pandemic, we propose separating the effects of the pandemic into 5 distinct stages from a healthcare system perspective. We discuss how the classical ethical principles of utility, justice, and efficiency may need to be adapted, and we give specific recommendations for thoracic transplantation and mechanical circulatory support centers to balance their clinical decisions and strategies for advanced heart and lung disease during the current pandemic.


title: Delirium in COVID-19: A case series and exploration of potential mechanisms for central nervous system involvement

text: INTRODUCTION: Neuropsychiatric manifestations of the coronavirus disease 2019 (COVID-19) have been described, including anosmia, ageusia, headache, paresthesia, encephalitis and encephalopathy. Little is known about the mechanisms by which the virus causes central nervous system (CNS) symptoms, and therefore little guidance is available regarding potential workup or management options. CASES: We present a series of four consecutive cases, seen by our psychiatry consultation service over a one-week period, each of which manifested delirium as a result of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). DISCUSSION: The four cases highlighted here all occurred in older patients with premorbid evidence of cognitive decline. Unique features seen in multiple cases included rigidity, alogia, abulia, and elevated inflammatory markers. In all four cases, a change in mental status was the presenting symptom, and three of the four cases lacked significant respiratory symptoms. In addition to discussing unique features of the cases, we discuss possible pathophysiologic explanations for COVID-19 delirium. CONCLUSIONS: Delirium should be recognized as a potential feature of infection with SARS-CoV-2 and may be the only presenting symptom. Based on the high rates of delirium demonstrated in prior studies, hospitals should consider adding mental status changes to the list of testing criteria. Further research is needed to determine if delirium in COVID-19 represents a primary encephalopathy heralding invasion of the CNS by the virus, or a secondary encephalopathy related to systemic inflammatory response or other factors.


title: Laughing it off: Coronavirus superspreaders, anxiety, and fear in Jordan and Australia

text: This short piece is a reflection on some of the stark cultural, social, and official differences between Australian and Jordanian handling of the mental health crisis triggered by COVID-19 seen through the eyes of two researchers living in the 2 countries. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Adopting agile approaches to the classroom


Safety of cancer surgery during the COVID-19 pandemic


title: Effectiveness of convalescent plasma therapy in severe COVID-19 patients

text: Currently, there are no approved specific antiviral agents for novel coronavirus disease 2019 (COVID-19). In this study, 10 severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL of convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 d after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 d. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 d. Several parameters tended to improve as compared to pretransfusion, including increased lymphocyte counts (0.65 × 109/L vs. 0.76 × 109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesions within 7 d. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was well tolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials.


Management of patients with melanoma and non-melanoma skin cancers in the coronavirus disease 2019 era


Practical workflow recommendations for emergency endotracheal intubation in critically ill patients with COVID-19 based on the experience of Wuhan Union Hospital


Coronavirus epidemic snarls science worldwide


title: Current Perspectives of Anticoagulation in Patients with COVID-19

text: Thromboembolism and myocardial injury are common in COVID-19 patients. Low molecular weight heparin appears to be associated with good prognosis in COVID-19 patients and has the ability to reduce coagulation and inflammation markers. Hospitalized COVID-19 patients should be placed on thromboprophylaxis with the option of full-therapeutic anticoagulation or tissue plasminogen activator (tPA) in high risk or mechanically ventilated patients. Thromboprophylaxis should also be considered at hospital discharge for high risk patients. Clinical judgment should be utilized to evaluate the bleeding and safety risk of anticoagulation in COVID-19 patients without confirmed data.


title: Cytokine storm intervention in the early stages of COVID-19 pneumonia

text: Clinical intervention in patients with corona virus disease 2019 (COVID-19) has demonstrated a strong upregulation of cytokine production in patients who are critically ill with SARS-CoV2-induced pneumonia. In a retrospective study of 41 patients with COVID-19, most patients with SARS-CoV-2 infection developed mild symptoms, whereas some patients later developed aggravated disease symptoms, and eventually passed away because of multiple organ dysfunction syndrome (MODS), as a consequence of a severe cytokine storm. Guidelines for the diagnosis and treatment of SARS-CoV-2 infected pneumonia were first published January 30th, 2020; these guidelines recommended for the first time that cytokine monitoring should be applied in severely ill patients to reduce pneumonia related mortality. The cytokine storm observed in COVID-19 illness is also an important component of mortality in other viral diseases, including SARS, MERS and influenza. In view of the severe morbidity and mortality of COVID-19 pneumonia, we review the current understanding of treatment of human coronavirus infections from the perspective of a dysregulated cytokine and immune response.


title: Clinical role of lung ultrasound for diagnosis and monitoring of COVID-19 pneumonia in pregnant women

text: Lung ultrasound has been suggested recently by the Chinese Critical Care Ultrasound Study Group and Italian Academy of Thoracic Ultrasound as an accurate tool to detect lung involvement in COVID-19. Although chest computed tomography (CT) represents the gold standard to assess lung involvement, with a specificity superior even to that of the nasopharyngeal swab for diagnosis, lung ultrasound examination can be a valid alternative to CT scan, with certain advantages, particularly for pregnant women. Ultrasound can be performed directly at the bed-side by a single operator, reducing the risk of spreading the disease among health professionals. Furthermore, it is a radiation-free exam, making it safer and easier to monitor those patients who require a series of exams. We report on four cases of pregnant women affected by COVID-19 who were monitored with lung ultrasound examination. All patients showed sonographic features indicative of COVID-19 pneumonia at admission: irregular pleural lines and vertical artifacts (B-lines) were observed in all four cases, and patchy areas of white lung were observed in two. Lung ultrasound was more sensitive than was chest X-ray in detecting COVID-19. In three patients, we observed almost complete resolution of lung pathology on ultrasound within 96 h of admission. Two pregnancies were ongoing at the time of writing, and two had undergone Cesarean delivery with no fetal complications. Reverse transcription polymerase chain reaction analysis of cord blood and newborn swabs was negative in both of these cases. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.


Impact of Nutrition and Diet on COVID-19 Infection and Implications for Kidney Health and Kidney Disease Management


title: An overview of COVID-19

text: Pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection emerged in Wuhan City, Hubei Province, China in December 2019. By Feb. 11, 2020, the World Health Organization (WHO) officially named the disease resulting from infection with SARS-CoV-2 as coronavirus disease 2019 (COVID-19). COVID-19 represents a spectrum of clinical manifestations that typically include fever, dry cough, and fatigue, often with pulmonary involvement. SARS-CoV-2 is highly contagious and most individuals within the population at large are susceptible to infection. Wild animal hosts and infected patients are currently the main sources of disease which is transmitted via respiratory droplets and direct contact. Since the outbreak, the Chinese government and scientific community have acted rapidly to identify the causative agent and promptly shared the viral gene sequence, and have carried out measures to contain the epidemic. Meanwhile, recent research has revealed critical aspects of SARS-CoV-2 biology and disease pathogenesis; other studies have focused on epidemiology, clinical features, diagnosis, management, as well as drug and vaccine development. This review aims to summarize the latest research findings and to provide expert consensus. We will also share ongoing efforts and experience in China, which may provide insight on how to contain the epidemic and improve our understanding of this emerging infectious disease, together with updated guidance for prevention, control, and critical management of this pandemic.


title: Vulnerable Immigrant Populations in the New York Metropolitan Area and COVID-19: Lessons Learned in the Epicenter of the Crisis

text: The epicenter of the COVID-19 crisis since March 17, 2020-the New York metropolitan area-is home to some of the largest Latino immigrant communities in the nation. These communities have long faced barriers to health care access, challenges due to immigration status, and financial and labor instability. The COVID-19 pandemic has aggravated these existing issues in a vulnerable, often forgotten, immigrant community. It is challenging for this population to access public information regarding COVID-19 testing, treatment, and assistance programs because this information is seldom disseminated in Spanish and even less frequently in Portuguese. While long-term solutions will require time and changes to policy, some short-term measures can mitigate the current situation. The authors share their experience from Newark, New Jersey, where partnerships of public and private community-based organizations (CBOs) have been successful in establishing trust between the health care system and a fearful Latino community. The Ironbound Initiative, a student group at Rutgers New Jersey Medical School in Newark, New Jersey, has partnered with Mantena Global Care, a Brazilian CBO in Newark, to facilitate dissemination of COVID-19-relevant information. Medical student volunteers, removed from their clinical duties, serve as virtual patient navigators, using social media to reach community members with the goals of improving awareness of precautions to take during the pandemic and of increasing access to needed medical care. These students have collaborated with colleagues in other disciplines to provide necessary legal guidance to community members fearful of seeking care because of their immigration status. The authors urge other academic institutions across the country to recruit multidisciplinary teams of medical, health professional, and law students invested in their local communities and to empower students to partner with CBOs, immigrant community leaders, faith-based organizations, hospitals, and local authorities to support these vulnerable communities during this crisis.


Liability claims in Spain post-COVID-19: A predictable scenario


Purposing Saikosaponins for the treatment of COVID-19


Active smoking and COVID-19: a double-edged sword


Associations between Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blocker Use, Gastrointestinal Symptoms, and Mortality among Patients with COVID-19


Eating disorders in the age of COVID-19


title: [The differential diagnosis for novel coronavirus pneumonia and similar lung diseases in general hospitals]

text: Novel coronavirus pneumonia was a novel coronavirus infection that has dominated pulmonary infection since December 2019. The main manifestations were fever, dry cough, shortness of breath, normal or leukopenia in peripheral blood and changes in chest CT and in severe cases, multiple organ failure might occur. The National Health Commission, PRC has revised the consensus on diagnosis and treatment seven times in a short period of time, indicating the growing understanding of the disease. Patients with novel coronavirus pneumonia usually had history of travelling or living in the epidemic area including Wuhan within 14 days before onset, or have been exposed to patients who had fever or respiratory symptoms from the epidemic area, or had clustering diseases. However, novel coronavirus pneumonia was becoming more and more blurred after vanishing epidemic. The diagnosis and differential diagnosis of novel coronavirus pneumonia were challenges not only because of large number of tourists increasing dramatically after the relieving of epidemic, but also patients with other diseases from different areas to search for medical care. In this article, the clinical and chest imaging features of the novel coronavirus pneumonia were reviewed and compared with other infections and non-infectious diffuse pulmonary diseases. We try to find the similarities and differences among them, and to identify clues to the diagnosis of novel coronavirus pneumonia, so as to ensure accurate diagnosis and treatment.


title: Distributed Link Removal Strategy for Networked Meta-Population Epidemics and Its Application to the Control of the COVID-19 Pandemic

text: In this paper, we investigate the distributed link removal strategy for networked meta-population epidemics. In particular, a deterministic networked susceptible-infected-recovered (SIR) model is considered to describe the epidemic evolving process. In order to curb the spread of epidemics, we present the spectrum-based optimization problem involving the Perron-Frobenius eigenvalue of the matrix constructed by the network topology and transition rates. A modified distributed link removal strategy is developed such that it can be applied to the SIR model with heterogeneous transition rates on weighted digraphs. The proposed approach is implemented to control the COVID-19 pandemic by using the reported infected and recovered data in each state of Germany. The numerical experiment shows that the infected percentage can be significantly reduced by using the distributed link removal strategy.


title: What further should be done to control COVID-19 outbreaks in addition to cases isolation and contact tracing measures?

text: Historically, these interventions have been successfully applied for controlling a variety of emerging infectious disease outbreaks, such as smallpox and SARS, but only partially effective for foot-and-mouth disease, and likely not effective for influenza [2,3,4] Currently, it is not yet clear whether case isolation and contact tracing measures are sufficient to contain a new outbreak from COVID-19 Recently, Hellewell and colleagues developed a stochastic transmission model to assess the potential effectiveness of case isolation and contact tracing in controlling COVID-19 outbreak [5] They suggested that in most modeled scenarios contact tracing and case isolation alone might be insufficient to control a new outbreak of COVID-19 within 3 months, especially when longer delays from symptom onset to isolation, fewer cases ascertained by contact tracing, and increased transmission before symptoms exist It is the first study using a stochastic model to evaluate the effects of isolation and contact tracing intervention for outbreak of COVID-19 In this study, the authors simplified the outputs of their model to the effects of contact tracing and isolation on the control of outbreaks under different scenarios of transmission, and included several parameters (e g , the basic reproduction number R0, the delay from symptom onset to isolation, and the probability contacts were traced) other than merely focusing on R0 This interesting study provides a timely evaluation strategy to quantify the potential effectiveness of case isolation and contact tracing measures and may bring insights for the control the COVID-19 outbreak in China and probably other areas of the world as wellDO - 10 1186/s12916-020-01551-8


Ethics and extracorporeal membrane oxygenation during coronavirus disease 2019 outbreak


Redundancy and methodological issues in articles on COVID-19


title: A general approach for biomimetic mineralization of MOF particles using biomolecules

text: Biomineralization of metal organic frameworks (MOFs) using biomolecules has recently attracted significant interest because of the benign process including room temperature, neutral pH and without the requirement of any other chemical reagents. Also, these biomolecule incorporated MOFs (biomolecules@MOFs) have demonstrated their potential in biomolecule encapsulation, protection and controlled release. This work aims to develop a general strategy to make biomolecules@MOFs via a biomimetic mineralization process. A library of biomolecules (peptides and proteins) with different charges were systematically studied to fundamentally understand the role of biomolecules and their proprieties in biomolecule-mediated MOF biomineralization. Biomolecule charge, amino acid sequence and stirring speed have been demonstrated to play important roles in controlling biomineralization reaction rate, particle shape and morphology.


Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State


The life at the times of coronavirus: Microbes rule the world!


title: Case Report: Implementation of a Digital Chatbot to Screen Health System Employees during the COVID-19 Pandemic

text: The screening of healthcare workers for COVID-19 symptoms and exposures prior to every clinical shift is important for preventing nosocomial spread of infection but creates a major logistical challenge. To make the screening process simple and efficient, UCSF Health designed and implemented a digital chatbot-based workflow. Within one week of forming a team, we conducted a product development sprint and deployed the digital screening process. In the first two months of use, over 270,000 digital screens have been conducted. This process has reduced wait times for employees entering our hospitals during shift changes, allowed for physical distancing at hospital entrances, prevented higher-risk individuals from coming to work, and provided our healthcare leaders with robust, real-time data for make staffing decisions.


title: COVID-19 and ENT Surgery

text: In Otorhinolaryngology - Head and Neck Surgery, clinical examination and invasive procedures on the respiratory tract and on airway-connected cavities, such as paranasal sinuses and the middle ear, expose people to direct transmission of SARS-CoV-2 by inhalation or ocular projection of contaminated droplets, and to indirect transmission by contact with contaminated hands, objects or surfaces. Estimating an R0 of COVID-19 at around 3 justified postponing non-urgent face-to-face consultations and expanding the use of teleconsultation in order to limit the risks of SARS-CoV-2 infection of patients or health workers and comply with the lockdown. The health authority recommends cancellation of all medical or surgical activities, which are not urgent as long as this does not involve a loss of chance for the patient. The purpose of this cancellation is to significantly increase critical care capacity, prioritise the reception of patients with COVID-19, prioritise the allocation of staff and provision of the equipment necessary for their medical or surgical management, and contribute to the smooth running of downstream critical care within their establishment. Another goal is to reduce the risks of patient contamination within healthcare facilities. This document provides guidance on how to proceed with and adapt ENT surgery in the current pandemic context, as well as on the management of postponed operations. This best practice advice must of course be adapted in each region according to the development of the epidemic and pre-existing arrangements. Their local application can only be decided within the framework of collaboration between the ENT teams, the operational hygiene units and all the other specialties concerned.


title: Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe

text: Following the emergence of a novel coronavirus1 (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics. In response, many European countries have implemented unprecedented non-pharmaceutical interventions such as closure of schools and national lockdowns. We study the impact of major interventions across 11 European countries for the period from the start of COVID-19 until the 4th of May 2020 when lockdowns started to be lifted. Our model calculates backwards from observed deaths to estimate transmission that occurred several weeks prior, allowing for the time lag between infection and death. We use partial pooling of information between countries with both individual and shared effects on the reproduction number. Pooling allows more information to be used, helps overcome data idiosyncrasies, and enables more timely estimates. Our model relies on fixed estimates of some epidemiological parameters such as the infection fatality rate, does not include importation or subnational variation and assumes that changes in the reproduction number are an immediate response to interventions rather than gradual changes in behavior. Amidst the ongoing pandemic, we rely on death data that is incomplete, with systematic biases in reporting, and subject to future consolidation. We estimate that, for all the countries we consider, current interventions have been sufficient to drive the reproduction number [Formula: see text] below 1 (probability [Formula: see text]< 1.0 is 99.9%) and achieve epidemic control. We estimate that, across all 11 countries, between 12 and 15 million individuals have been infected with SARS-CoV-2 up to 4th May, representing between 3.2% and 4.0% of the population. Our results show that major non-pharmaceutical interventions and lockdown in particular have had a large effect on reducing transmission. Continued intervention should be considered to keep transmission of SARS-CoV-2 under control.


title: COVID-19 and Older Adults: What We Know

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus that causes COVID-19 infection, has recently emerged and caused a deadly pandemic. Studies have shown that this virus causes worse outcomes and a higher mortality rate in older adults and those with comorbidities such as hypertension, cardiovascular disease, diabetes, chronic respiratory disease, and chronic kidney disease (CKD). A significant percentage of older American adults have these diseases, putting them at a higher risk of infection. Additionally, many adults with hypertension, diabetes, and CKD are placed on angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers. Studies have shown that these medications upregulate the ACE-2 receptor, the very receptor that the SARS-CoV-2 virus uses to enter host cells. Although it has been hypothesized that this may cause a further increased risk of infection, more studies on the role of these medications in COVID-19 infections are necessary. In this review, we discuss the transmission, symptomatology, and mortality of COVID-19 as they relate to older adults, and possible treatments that are currently under investigation. J Am Geriatr Soc 68:926-929, 2020.


title: Prognostic Value of Leukocytosis and Lymphopenia for Coronavirus Disease Severity

text: To evaluate lymphopenia as a marker for coronavirus disease severity, we conducted a meta-analysis of 10 studies. Severe illness was associated with lower lymphocyte and higher leukocyte counts. Using these markers for early identification of patients with severe disease may help healthcare providers prioritize the need to obtain therapy.


title: World leaders' usage of Twitter in response to the COVID-19 pandemic: a content analysis

text: BACKGROUND: It is crucial that world leaders mount effective public health measures in response to COVID-19. Twitter may represent a powerful tool to help achieve this. Here, we explore the role of Twitter as used by Group of Seven (G7) world leaders in response to COVID-19. METHODS: This was a qualitative study with content analysis. Inclusion criteria were as follows: viral tweets from G7 world leaders, attracting a minimum of 500 'likes'; keywords 'COVID-19' or 'coronavirus'; search dates 17 November 2019 to 17 March 2020. We performed content analysis to categorize tweets into appropriate themes and analyzed associated Twitter data. RESULTS: Eight out of nine (88.9%) G7 world leaders had verified and active Twitter accounts, with a total following of 85.7 million users. Out of a total 203 viral tweets, 166 (82.8%) were classified as 'Informative', of which 48 (28.6%) had weblinks to government-based sources, while 19 (9.4%) were 'Morale-boosting' and 14 (6.9%) were 'Political'. Numbers of followers and viral tweets were not strictly related. CONCLUSIONS: Twitter may represent a powerful tool for world leaders to rapidly communicate public health information with citizens. We would urge general caution when using Twitter for health information, with a preference for tweets containing official government-based information sources.


A metastatic tumor is no different to a viral pandemic: lessons learnt from COVID-19 may teach us to change the PRRT paradigm


The COVID-19 Pandemic in the US: A Clinical Update


title: Evidence of Protective Effect of Hydroxychloroquine on COVID-19

text: We would like to share ideas on the report "Hydroxychloroquine in Patients with Rheumatic Disease Complicated by COVID-19: Clarifying Target Exposures and the Need for Clinical Trials"1 Balevic noted that "well-designed clinical trials that include patients with rheumatic disease are urgently needed to characterize the efficacy, safety, and target exposures for hydroxychloroquine1".


Erratum: Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries


title: Comparing South Korea and Italy's healthcare systems and initiatives to combat COVID-19

text: Italy and South Korea have two distinctly different healthcare systems, causing them to respond to public health crises such as the COVID-19 pandemic in markedly different ways Differences exist in medical education for both countries, allowing South Korean medical graduates to have a more holistic education in comparison to their Italian counterparts, who specialize in medical education earlier on Additionally, there are fewer South Korean physicians per 1000 people in South Korea compared to Italian physicians per 1000 people in Italy However, both countries have a national healthcare system with universal healthcare coverage Despite this underlying similarity, the two countries addressed COVID-19 in nearly opposite manners South Korea employed technology and the holistic education of its physician community, despite having a smaller proportion of physicians in society, to its advantage by implementing efficacious drive-through centers that test suspected individuals rapidly and with little to no contact with healthcare staff, decreasing the possibility of transmission of COVID-19 Conversely, Italy is presently considered the epicenter of the outbreak in Europe and has recorded the highest death toll of any country outside of mainland China This is partially due to the reactionary nature of Italy's public health measures compared to South Korea's proactive response The different healthcare responses of South Korea and Italy can inform decisions made by public health bodies in other countries, especially in countries across the Americas, which can selectively adopt policies that have worked in curtailing the spread of COVID-19 and learn from mistakes made by both countries (AU) Italia y Corea del Sur tienen dos sistemas de atención sanitaria claramente diferentes, lo que hace que respondan a crisis de salud pública como la pandemia por COVID-19 de maneras marcadamente distintas Existen diferencias en la educación médica de ambos países, lo que permite a los graduados de medicina de Corea del Sur tener una educación más holística en comparación con sus homólogos italianos, que siguen una especialización médica de manera más temprana Además, en Corea del Sur hay menos médicos por cada 1 000 personas en comparación con Italia Sin embargo, ambos países tienen un sistema nacional de salud con cobertura universal A pesar de esta similitud subyacente, los dos países abordaron la COVID-19 de maneras casi opuestas A pesar de contar con una proporción menor de médicos en la sociedad, Corea del Sur empleó la tecnología y la educación holística de su comunidad médica a su favor al implementar centros de examen de personas con sospecha de infección sin descender del automóvil, que permitían una atención rápida y con poco o ningún contacto con el personal de salud, lo que disminuyó la posibilidad de transmisión de la enfermedad Por el contrario, Italia es considerada actualmente el epicentro del brote en Europa y ha registrado el mayor número de muertes que cualquier otro país fuera de la China continental Esto se debe en parte a la naturaleza reactiva de las medidas de salud pública de Italia en comparación con la respuesta proactiva de Corea del Sur Las diferentes respuestas sanitarias de Corea del Sur e Italia pueden orientar las decisiones que deben tomar los organismos de salud pública de otros países, especialmente en la Región de las Américas, que pueden adoptar selectivamente políticas que han funcionado para reducir la propagación de la COVID-19 y aprender de los errores cometidos por ambos países (AU) A Itália e a Coreia do Sul têm dois sistemas de saúde distintos, o que os leva a responder a crises de saúde pública, como a pandemia COVID-19, de formas marcadamente diferentes Existem diferenças na educação médica dos dois países, permitindo que os médicos sul-coreanos tenham uma educação mais holística em comparação com os seus homólogos italianos, que seguem uma especialização médica mais cedo Além disso, há menos médicos por 1 000 pessoas na Coreia do Sul do que em Itália No entanto, ambos os países têm um sistema nacional de saúde com cobertura de saúde universal Apesar desta semelhança subjacente, os dois países abordaram a COVID-19 de maneiras quase opostas Apesar de ter uma proporção menor de médicos na sociedade, a Coreia do Sul utilizou a tecnologia e a educação holística de sua comunidade médica a seu favor, implementando centros de rastreio para pessoas com suspeita de infecção sem sair do carro, o que permitiu cuidados imediatos e pouco ou nenhum contacto com o pessoal de saúde, diminuindo assim a possibilidade de transmissão da COVID-19 Por outro lado, a Itália é atualmente considerada o epicentro do surto na Europa e tem registrado o maior número de mortes de qualquer país fora da China continental Isto deve-se em parte à natureza reactiva das medidas de saúde pública da Itália em comparação com a resposta pró-ativa da Coreia do Sul As diferentes respostas de saúde da Coreia do Sul e da Itália podem informar as decisões das agências de saúde pública de outros países, especialmente da Região das Américas, que podem adoptar seletivamente políticas que tenham funcionado na redução da disseminação da COVID-19 e aprender com os erros cometidos por ambos os países (AU)


Coronaviruses: origin and evolution


Health inequity during the COVID-19 pandemic: a cry for ethical global leadership


A Research Agenda on the Sexual and Reproductive Health Dimensions of the COVID-19 Pandemic in Africa


Clinical features and short-term outcomes of 18 patients with corona virus disease 2019 in intensive care unit


How Should U.S. Hospitals Prepare for Coronavirus Disease 2019 (COVID-19)?


COVID-19 presenting as a viral exanthem and detected during admission prescreening in a hematopoietic cell transplant recipient


Estimating severe and critical illness in children with COVID-19


COVID-19 and SARS: Differences and similarities


Operationalizing the Operating Room: Ensuring Appropriate Surgical Care in the Era of COVID-19


title: Annals for Hospitalists Inpatient Notes - Preparing for Battle: How Hospitalists Can Manage the Stress of COVID-19

text: [Figure: see text].


title: Psychological intervention in oral patients in novel coronavirus pneumonia outbreak period/ 中华口腔医学杂志

text: Public health emergencies have an impact on the public mental health. The outbreak of the novel coronavirus has affected the normal diagnosis and treatment services in oral medical institutions across the country. Delay of non-emergency dental service will have a potential impact on the experience, cognition, treatment and rehabilitation of patients with oral diseases. Through literature review, this paper reviewed the oral psychosomatic diseases closely related to patients' psychological state, such as oral mucosal disease, temporomandibular joint disease, bruxism, periodontal disease and so on. It was believed that these patients might be more susceptible to the impact of stress events, and dental specialists should pay more attention to them. At the same time, this paper analyzes the possible psychological stress symptoms of patients with different oral diseases, and puts forward suggestions for remote consultation and emergency treatment of dentists. From the perspective of social role, dentists not only played the role of expert in dental home professional guidance, but also played the role of psychological counseling for patients.


title: Case report: COVID-19 Masquerading as an Acute Surgical Abdomen

text: SARS-CoV-2 infection can present with various clinical features, among which gastrointestinal manifestations such as nausea, diarrhea, vomiting, and mild abdominal pain have been reported. Recognition of rare presentations of SARS-CoV-2 infection has increased over time. These atypical and rare presentations may lead to difficulties in establishing the diagnosis in a timely manner; furthermore, they may lead to unnecessary investigations, extended hospital stays, adverse outcomes, and more strain on healthcare resources. We present three cases admitted to our hospital with a picture that mimicked an acute abdomen, necessitating surgical assessment and evaluation. All cases turned out to be SARS-CoV-2 positive and did not require surgical management. We discuss the management course, highlight the importance of abdominal symptoms in the setting of COVID-19, and discuss the implications of this association for medical practice amid the current pandemic in both resource-rich and resource-limited settings.


title: Characteristics of peripheral blood leukocyte differential counts in patients with COVID-19/ 中华内科杂志

text: To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to Shanghai Jiao Tong University Affiliated Sixth People’s Hospital and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells were analyzed. Patients in COVID-19 group showed relatively lower absolute white blood cell (WBC) count 4.95(3.90,6.03)×109/L, lymphocyte absolute count 1.20(0.98,1.50)×109/L and eosinophil absolute count 0.01(0.01,0.01)×109/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20 (6.78,9.03) ×109/L (P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×109/L(P=0.036), eosinophil absolute count 0.02(0.01,0.03)×109/L(P=0.05). Lymphocytopenia occurred in (16.7%) patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non- COVID-19 patients.


title: [Characteristics of peripheral blood leukocyte differential counts in patients with COVID-19]

text: To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to Shanghai Jiao Tong University Affiliated Sixth People's Hospital and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells were analyzed. Patients in COVID-19 group showed relatively lower absolute white blood cell (WBC) count 4.95(3.90,6.03)×10(9)/L, lymphocyte absolute count 1.20(0.98,1.50)×10(9)/L and eosinophil absolute count 0.01(0.01,0.01)×10(9)/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20 (6.78,9.03) ×10(9)/L (P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×10(9)/L(P=0.036), eosinophil absolute count 0.02(0.01,0.03)×10(9)/L(P=0.05). Lymphocytopenia occurred in (16.7%) patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non- COVID-19 patients.


Preserving mental health and resilience in frontline healthcare workers during COVID-19


SARS-CoV-2-related myocarditis-like syndromes Shakespeare's question: what's in a name?


title: Virtual Read-Out: Radiology Education for the 21st Century During the COVID-19 Pandemic

text: Technologic advances have resulted in the expansion of web-based conferencing and education. While historically video-conferencing has been used for didactic educational sessions, we present its novel use in virtual radiology read-outs in the face of the COVID-19 pandemic. Knowledge of key aspects of set-up, implementation, and possible pitfalls of video-conferencing technology in the application of virtual read-outs can help to improve the educational experience of radiology trainees and promote potential future distance learning and collaboration.


title: An Analysis of the Growth in Uptake of OpenWHO's Online Learning Resources for COVID-19

text: From 26 January - 21 April 2020, 9 online courses for COVID-19 were published on OpenWHO.org. The courses are available in 18 different languages, totalling 53 learning resources and more than 1.5 million course enrolments. This paper analyses key trends in the growth of enrolments in these resources. The number of enrolments increased significantly between 26 January and 21 April, with distinct spikes in growth preceded by important global milestones in the timeline of the outbreak. The surge in users demonstrates that the platform is serving as a source of digitized learning for COVID-19, helping meet the broad demand for outbreak-related information.


title: Telemedicine for Delivery of Care in Frontotemporal Lobar Degeneration During COVID-19 Pandemic: Results from Southern Italy

text: BACKGROUND: The COVID-19 pandemic is changing clinical practice in neurology, after the governments decided the introduction of social distancing and interruption of medical non-emergency services in many countries. Teleneurology is an effective tool for the remote evaluation of patients but its adoption for frontotemporal lobar dementia (FTD) is in a preliminary stage. OBJECTIVE: We evaluated multidisciplinary assessment of patients with FTD using telehealth during the COVID-19 pandemic. METHODS: All patients received a diagnosis of FTD during 2018-2019 according to international criteria. A structured questionnaire and Clinical Dementia Rating Scale (CDR)-FTD were used by the neurologist with patients and/or caregivers. Index symptoms of COVID-19 infection were searched. RESULTS: Twenty-eight clinical interviews were completed with caregivers and four with both patients/caregivers. Most patients and caregivers were satisfied with the neurological interview and expressed their willingness to continue to be included in remote evaluation programs (90%). Fifty percent of patients experienced significant worsening of clinical picture and quality of life since the start of social distancing. The CDR-FTD scale revealed a significant worsening of behavior (pâ=â0.01) and language functions (pâ=â0.009), compared to the last in-person evaluation at the center. One patient presented index symptoms of COVID-19 infection and was confirmed to be positive for COVID-19 with pharyngeal swab. CONCLUSION: The study was conducted in Italy, one of the countries hit particularly hard by the COVID-19 pandemic, with interruption of all non-emergency medical services. Our study indicates that telemedicine is a valid tool to triage patients with FTD to increase practice outreach and efficiency.


title: Real-time forecasts of the COVID-19 epidemic in China from February 5th to February 24th, 2020

text: The initial cluster of severe pneumonia cases that triggered the COVID-19 epidemic was identified in Wuhan, China in December 2019. While early cases of the disease were linked to a wet market, human-to-human transmission has driven the rapid spread of the virus throughout China. The Chinese government has implemented containment strategies of city-wide lockdowns, screening at airports and train stations, and isolation of suspected patients; however, the cumulative case count keeps growing every day. The ongoing outbreak presents a challenge for modelers, as limited data are available on the early growth trajectory, and the epidemiological characteristics of the novel coronavirus are yet to be fully elucidated. We use phenomenological models that have been validated during previous outbreaks to generate and assess short-term forecasts of the cumulative number of confirmed reported cases in Hubei province, the epicenter of the epidemic, and for the overall trajectory in China, excluding the province of Hubei. We collect daily reported cumulative confirmed cases for the 2019-nCoV outbreak for each Chinese province from the National Health Commission of China. Here, we provide 5, 10, and 15 day forecasts for five consecutive days, February 5th through February 9th, with quantified uncertainty based on a generalized logistic growth model, the Richards growth model, and a sub-epidemic wave model. Our most recent forecasts reported here, based on data up until February 9, 2020, largely agree across the three models presented and suggest an average range of 7409-7496 additional confirmed cases in Hubei and 1128-1929 additional cases in other provinces within the next five days. Models also predict an average total cumulative case count between 37,415 and 38,028 in Hubei and 11,588-13,499 in other provinces by February 24, 2020. Mean estimates and uncertainty bounds for both Hubei and other provinces have remained relatively stable in the last three reporting dates (February 7th - 9th). We also observe that each of the models predicts that the epidemic has reached saturation in both Hubei and other provinces. Our findings suggest that the containment strategies implemented in China are successfully reducing transmission and that the epidemic growth has slowed in recent days.


title: Real-time forecasts of the 2019-nCoV epidemic in China from February 5th to February 24th, 2020

text: The initial cluster of severe pneumonia cases that triggered the 2019-nCoV epidemic was identified in Wuhan, China in December 2019. While early cases of the disease were linked to a wet market, human-to-human transmission has driven the rapid spread of the virus throughout China. The ongoing outbreak presents a challenge for modelers, as limited data are available on the early growth trajectory, and the epidemiological characteristics of the novel coronavirus are yet to be fully elucidated. We provide timely short-term forecasts of the cumulative number of confirmed reported cases in Hubei province, the epicenter of the epidemic, and for the overall trajectory in China, excluding the province of Hubei. We collect daily reported cumulative case data for the 2019-nCoV outbreak for each Chinese province from the National Health Commission of China. Here, we provide 5, 10, and 15 day forecasts for five consecutive days, February 5th through February 9th, with quantified uncertainty based on a generalized logistic growth model, the Richards growth model, and a sub-epidemic wave model. Our most recent forecasts reported here based on data up until February 9, 2020, largely agree across the three models presented and suggest an average range of 7,409-7,496 additional cases in Hubei and 1,128-1,929 additional cases in other provinces within the next five days. Models also predict an average total cumulative case count between 37,415 - 38,028 in Hubei and 11,588 - 13,499 in other provinces by February 24, 2020. Mean estimates and uncertainty bounds for both Hubei and other provinces have remained relatively stable in the last three reporting dates (February 7th - 9th). Our forecasts suggest that the containment strategies implemented in China are successfully reducing transmission and that the epidemic growth has slowed in recent days.


text: The initial cluster of severe pneumonia cases that triggered the COVID-19 epidemic was identified in Wuhan, China in December 2019. While early cases of the disease were linked to a wet market, human-to-human transmission has driven the rapid spread of the virus throughout China. The Chinese government has implemented containment strategies of city-wide lockdowns, screening at airports and train stations, and isolation of suspected patients; however, the cumulative case count keeps growing every day. The ongoing outbreak presents a challenge for modelers, as limited data are available on the early growth trajectory, and the epidemiological characteristics of the novel coronavirus are yet to be fully elucidated.We use phenomenological models that have been validated during previous outbreaks to generate and assess short-term forecasts of the cumulative number of confirmed reported cases in Hubei province, the epicenter of the epidemic, and for the overall trajectory in China, excluding the province of Hubei. We collect daily reported cumulative confirmed cases for the 2019-nCoV outbreak for each Chinese province from the National Health Commission of China. Here, we provide 5, 10, and 15 day forecasts for five consecutive days, February 5th through February 9th, with quantified uncertainty based on a generalized logistic growth model, the Richards growth model, and a sub-epidemic wave model.Our most recent forecasts reported here, based on data up until February 9, 2020, largely agree across the three models presented and suggest an average range of 7409–7496 additional confirmed cases in Hubei and 1128–1929 additional cases in other provinces within the next five days. Models also predict an average total cumulative case count between 37,415 and 38,028 in Hubei and 11,588–13,499 in other provinces by February 24, 2020.Mean estimates and uncertainty bounds for both Hubei and other provinces have remained relatively stable in the last three reporting dates (February 7th – 9th). We also observe that each of the models predicts that the epidemic has reached saturation in both Hubei and other provinces. Our findings suggest that the containment strategies implemented in China are successfully reducing transmission and that the epidemic growth has slowed in recent days. Keywords: COVID-19, Coronavirus, China, Real-time forecasts, Phenomenological models


N95 Respirator Cleaning and Reuse Methods Proposed by the Inventor of the N95 Mask Material


title: Coronavirus Covid-19 infection and breastfeeding: an exploratory review/ Infeccion por coronavirus Covid-19 y lactancia materna: una revision exploratoria

text: BACKGROUND: The new coronavirus disease is an infectious disease caused by the SARS-Cov-2 virus, considered by the World Health Organization (WHO) an international public health emergency that may have negative consequences during breastfeeding The objective of this work is to investigate the action plan on breastfeeding in postpartum women with SARS-CoV-2 and her newborn METHODS: A literature search has been conducted through the Medline, Web of Science, Scopus, BVS, and Cuiden databases The methodological quality of the articles has been assessed using the "Grading of Recommendations Assessment, Development and Evaluation" (GRADE) This study has not been registered in PROSPERO RESULTS: A total of 14 documents have been found, of which 9 are observational empirical studies Most of the studies were conducted in China, Italy, the USA, and Australia A total of 114 mothers infected with coronavirus with their respective newborns have been assessed The analyzed investigations state that it is best for the newborn to be breastfed;given that mother's milk samples were analyzed, detecting the presence of antibodies of the coronavirus in them, being a protective factor against infection CONCLUSIONS: Breastfeeding in postpartum women with SARS-CoV-2 is highly recommended for the newborn, if the health of the mother and newborn allow it When direct breastfeeding is favoured, the appropriate respiratory hygiene measures always have to be considered Whether the mother's health does not permit direct breastfeeding, her breast milk should be previously extracted and kept unpasteurized To secure the newborn feeding, milk banks are also an appropriate option OBJETIVO: El nuevo coronavirus es una enfermedad infecciosa causada por el virus SARS-Cov-2, considerada por la Organizacion Mundial de la Salud (OMS) una emergencia de salud publica de interes internacional (ESPII), la cual podria tener consecuencias negativas durante la lactancia materna El objetivo de este trabajo fue conocer el plan de actuacion sobre la lactancia materna ante una mujer recien parida enferma de SARS-CoV-2 y su recien nacido METODOS: Se realizo una busqueda de la literatura a traves de las bases de datos Medline, Web of Science, Scopus, BVS y Cuiden Se evaluo la calidad metodologica de los articulos mediante la herramienta Grading of Recommendations Assessment, Development and Evaluation (GRADE) No se registro en PROSPERO RESULTADOS: En total se encontraron 14 documentos, de los cuales 9 estudios empiricos estaban realizados mayormente en China, Italia, EEUU y Australia, estando basados en 114 madres infectadas de coronavirus SARS-CoV-2 y sus respectivos recien nacidos Los estudios analizados afirmaron que lo mejor para el recien nacido es ser alimentado con la leche materna, ya que se analizaron muestras de leche de madres infectadas por coronavirus detectandose la presencia de anticuerpos del virus en las mismas, siendo un factor protector contra la infeccion del virus CONCLUSIONES: La lactancia materna en recien paridas con SARS-CoV-2 es muy recomendable para el recien nacido, si el estado de salud de la madre y del neonato lo permiten, favoreciendose el amamantamiento de forma directa y teniendo siempre las medidas adecuadas de higiene respiratoria En el caso de que el estado de salud de la madre no permita el amamantamiento directo se deberia alimentar con leche materna extraida previamente de su madre y sin pasteurizar, o procedente de un banco de leche


title: [Coronavirus Covid-19 infection and breastfeeding: an exploratory review]

text: BACKGROUND: The new coronavirus disease is an infectious disease caused by the SARS-Cov-2 virus, considered by the World Health Organization (WHO) an international public health emergency that may have negative consequences during breastfeeding The objective of this work is to investigate the action plan on breastfeeding in postpartum women with SARS-CoV-2 and her newborn METHODS: A literature search has been conducted through the Medline, Web of Science, Scopus, BVS, and Cuiden databases The methodological quality of the articles has been assessed using the "Grading of Recommendations Assessment, Development and Evaluation" (GRADE) This study has not been registered in PROSPERO RESULTS: A total of 14 documents have been found, of which 9 are observational empirical studies Most of the studies were conducted in China, Italy, the USA, and Australia A total of 114 mothers infected with coronavirus with their respective newborns have been assessed The analyzed investigations state that it is best for the newborn to be breastfed;given that mother's milk samples were analyzed, detecting the presence of antibodies of the coronavirus in them, being a protective factor against infection CONCLUSIONS: Breastfeeding in postpartum women with SARS-CoV-2 is highly recommended for the newborn, if the health of the mother and newborn allow it When direct breastfeeding is favoured, the appropriate respiratory hygiene measures always have to be considered Whether the mother's health does not permit direct breastfeeding, her breast milk should be previously extracted and kept unpasteurized To secure the newborn feeding, milk banks are also an appropriate option


title: COVID-19 and applications of smartphone technology in the current pandemic

text: BACKGROUND: With restrictions on face to face clinical consultations in the COVID-19 pandemic and the challenges faced by health care systems in delivering patient care, alternative information technologies like telemedicine and smartphone are playing a key role. AIMS: We assess the role and applications of smartphone technology as an extension of telemedicine in provide continuity of care to our patients and surveillance during the current COVID-19 pandemic. METHODS: We have done a comprehensive review of the literature using suitable keywords on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the first week of May 2020. RESULTS: Through the published literature on this topic, we discuss role, common applications and its support in extended role of telemedicine technology in several aspects of current COVID-19 pandemic. CONCLUSION: Smartphone technology on its own and as extension of telemedicine has significant applications in the current COVID-19 pandemic. As the smartphone technology further evolves with fifth generation cellular network expansion, it is going to play a key role in future of health medicine, patient referral, consultation, ergonomics and many other extended applications of health care.


title: Geographic Differences in COVID-19 Cases, Deaths, and Incidence - United States, February 12-April 7, 2020

text: Community transmission of coronavirus disease 2019 (COVID-19) was first detected in the United States in February 2020. By mid-March, all 50 states, the District of Columbia (DC), New York City (NYC), and four U.S. territories had reported cases of COVID-19. This report describes the geographic distribution of laboratory-confirmed COVID-19 cases and related deaths reported by each U.S. state, each territory and freely associated state,* DC, and NYC during February 12-April 7, 2020, and estimates cumulative incidence for each jurisdiction. In addition, it projects the jurisdiction-level trajectory of this pandemic by estimating case doubling times on April 7 and changes in cumulative incidence during the most recent 7-day period (March 31-April 7). As of April 7, 2020, a total of 395,926 cases of COVID-19, including 12,757 related deaths, were reported in the United States. Cumulative COVID-19 incidence varied substantially by jurisdiction, ranging from 20.6 cases per 100,000 in Minnesota to 915.3 in NYC. On April 7, national case doubling time was approximately 6.5 days, although this ranged from 5.5 to 8.0 days in the 10 jurisdictions reporting the most cases. Absolute change in cumulative incidence during March 31-April 7 also varied widely, ranging from an increase of 8.3 cases per 100,000 in Minnesota to 418.0 in NYC. Geographic differences in numbers of COVID-19 cases and deaths, cumulative incidence, and changes in incidence likely reflect a combination of jurisdiction-specific epidemiologic and population-level factors, including 1) the timing of COVID-19 introductions; 2) population density; 3) age distribution and prevalence of underlying medical conditions among COVID-19 patients (1-3); 4) the timing and extent of community mitigation measures; 5) diagnostic testing capacity; and 6) public health reporting practices. Monitoring jurisdiction-level numbers of COVID-19 cases, deaths, and changes in incidence is critical for understanding community risk and making decisions about community mitigation, including social distancing, and strategic health care resource allocation.


Therapeutic efficacy of Pudilan Xiaoyan Oral Liquid (PDL) for COVID-19 in vitro and in vivo


title: Monitoring the immune system to fight COVID-19: CD4 status, lymphopenia, and infectivity

text: The COVID-19 pandemic has struck the global population with unparalleled speed and ferocity In this webinar, we will explore what scientists are learning by using flow cytometry to study patients with COVID-19 in order to elucidate risk and disease severity These experts are global leaders in cytometry and infectious disease, working on the frontlines of the COVID-19 outbreaks


title: Sex-Specific Modulation of Blood Pressure and the Renin-Angiotensin System by ACE (Angiotensin-Converting Enzyme) 2

text: We showed ACE (angiotensin-converting enzyme) 2 is higher in the kidney of male compared with female mice. To further investigate this sex difference, we examined the role of ACE2 in Ang-[1-8] (angiotensin [1-8])-induced hypertension and regulation of the renin-angiotensin system in the kidney of WT (wild type) and Ace2 KO (knockout) mice. Mean arterial pressure rose faster in WT male than WT female mice after Ang-[1-8] infusion. This sex difference was attenuated in ACE2 KO mice. Ang-[1-8] infusion reduced glomerular AT1R (angiotensin type 1 receptor) binding in WT female mice by 30%, and deletion of Ace2 abolished this effect. In contrast, Ang-[1-8] infusion increased glomerular AT1R binding in WT male mice by 1.2-fold, and this effect of Ang-[1-8] persisted in Ace2 KO male mice (1.3-fold). ACE2 also had an effect on renal protein expression of the neutral endopeptidase NEP (neprilysin), the enzyme that catabolizes Ang-[1-10] (angiotensin [1-10]), the precursor of Ang-[1-8]. Ang-[1-8] infusion downregulated NEP protein expression by 20% in WT male, whereas there was a slight increase in NEP expression in WT female mice. Deletion of Ace2 resulted in lowered NEP expression after Ang-[1-8] infusion in both sexes. These findings suggest sex-specific ACE2 regulation of the renin-angiotensin system contributes to female protection from Ang-[1-8]-induced hypertension. These findings have ramifications for the current coronavirus disease 2019 (COVID-19) pandemic, especially in hypertension since ACE2 is the SARS-CoV-2 receptor and hypertension is a major risk factor for poor outcomes.


Modeling infectious disease dynamics


title: Global oncology pharmacy response to COVID-19 pandemic: Medication access and safety

text: Response, action, and adaptation of the way health services are delivered will impact our ability to provide optimized and continuity of care while acting within resource constraints imposed by COVID-19. Care for patients with cancer is particularly important given increased infection rates and worse outcomes from COVID-19 in this patient population, as well as potential adverse outcomes if treatment pathways need to be compromised. In this commentary, we provide a global oncology pharmacy perspective (including both developed and developing nations) on how COVID-19 has impacted access to and delivery of cancer therapies. This perspective was prepared by the International Society of Oncology Pharmacy Practitioners, with input from national and regional oncology pharmacy practice groups (42 practice leaders from 28 countries and regions) who contributed to a snapshot survey between 10 and 22 April 2020. Specifically, we highlight challenges related to safe handling of hazardous drugs and maintaining high-quality medication safety standards that have impacted various stakeholders.


Transparency and information sharing could help abate the COVID-19 pandemic


title: Structural and Functional Basis of SARS-CoV-2 Entry by Using Human ACE2

text: The recent emergence of a novel coronavirus (SARS-CoV-2) in China has caused significant public health concerns. Recently, ACE2 was reported as an entry receptor for SARS-CoV-2. In this study, we present the crystal structure of the C-terminal domain of SARS-CoV-2 (SARS-CoV-2-CTD) spike (S) protein in complex with human ACE2 (hACE2), which reveals a hACE2-binding mode similar overall to that observed for SARS-CoV. However, atomic details at the binding interface demonstrate that key residue substitutions in SARS-CoV-2-CTD slightly strengthen the interaction and lead to higher affinity for receptor binding than SARS-RBD. Additionally, a panel of murine monoclonal antibodies (mAbs) and polyclonal antibodies (pAbs) against SARS-CoV-S1/receptor-binding domain (RBD) were unable to interact with the SARS-CoV-2 S protein, indicating notable differences in antigenicity between SARS-CoV and SARS-CoV-2. These findings shed light on the viral pathogenesis and provide important structural information regarding development of therapeutic countermeasures against the emerging virus.