title: Prevalence and Recovery From Olfactory and Gustatory Dysfunctions in Covid-19 Infection: A Prospective Multicenter Study

text: BACKGROUND: Covid-19 is defined by an association of multiple symptoms, including frequently reported olfactory and gustatory disorders. OBJECTIVE: The main purpose of this study was to analyze the prevalence of these neurosensory impairments in patients with Covid-19, and to assess short-term recovery. METHODS: We performed a multicenter case series study during the Covid-19 epidemic. All patients presenting a RT-PCR-confirmed SARS-CoV-2 infection were included, whether hospitalized or treated at home. To analyze the prevalence and features of olfactory and gustatory dysfunctions, a phone interview was conducted 5 days after the positive PCR result. The questionnaire was submitted again 10 days later to patients having reported olfactory and gustatory disorders, in order to assess their recovery. RESULTS: 115 patients were included in our study. 81 patients (70%) reported olfactory and gustatory disorders without nasal obstruction or rhinorrhea. These impairments were more frequently reported in the female population, young people, and house-bound patients with mild symptomatic forms. Short-term recovery assessed at Day 15 was complete for 64% of the patients, and incomplete in 33%. Median recovery time was 15 days (4-27 days) after olfactory or gustatory symptom onset. CONCLUSION: Olfactory and gustatory dysfunctions related to Covid-19 are frequently reported and prevalent in mild symptomatic forms of the disease. Recovery in most cases seems rapid and complete.


title: Repurposing minocycline for COVID-19 management: mechanisms, opportunities, and challenges

text: INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly grown into a public health emergency that has placed the national health systems as well as scientific research communities under enormous pressures. Drug repurposing or repositioning is a well-known strategy that seeks to deploy existing licensed drugs for newer indications and provides the quickest possible transition from bench to clinics for unmet therapeutic needs. Given the current, urgent, and dire need for effective therapies against novel coronavirus-19, this approach is particularly appealing. AREAS COVERED: Here, we review the significant anti-inflammatory, immunomodulatory, and antiviral properties of minocycline as potential mechanisms for efficacy against the novel coronavirus and highlight the promises and pitfalls of this approach. EXPERT OPINION: As compared to other agents being investigated for COVID-19, minocycline offers distinct advantages in terms of potential efficacy in patients with life-threatening acute respiratory distress syndrome (ARDS) and myocardial injury, well-known safety and interaction profile, relatively low costs, and widespread availability. We call upon public and private funders to facilitate urgent and rigorous research efforts before evidence-based recommendations for its widespread use can be made.


COVID-19 pandemic - is virtual urology clinic the answer to keeping the cancer pathway moving?


title: The reliability and validity of the International Spinal Cord Injury Quality of Life Basic Data set in people with spinal cord injuries from a middle-income country: a psychometric study of the Thai version

text: STUDY DESIGN: A cross-sectional study. OBJECTIVES: To examine psychometric properties, including internal consistency, construct validity, and test-retest reliability, of the Thai version of the International Spinal Cord Injury (ISCI) Quality of Life Basic Data Set (QoL-BDS). SETTING: Outpatient rehabilitation clinic, urodynamic clinic, and rehabilitation ward at Maharaj Nakorn Chiang Mai Hospital. METHODS: Participants were assigned to complete two assessment tools, the Thai version of QoL-BDS which consisted of three single items on satisfaction with life as a whole, physical health and psychological health, and the Thai version of the World Health Organization Quality of Life instrument (WHOQOL-BREF) completed by face to face interview. After 2 weeks, the participants were evaluated the QoL-BDS again via telephone interviewing to assess test-retest reliability. RESULTS: One hundred and thirty people with spinal cord injury (SCI) were included in the study. Of all participants, 103 people had a traumatic SCI. The mean (SD) age was 43.0 (13.1) years and the median (IQR) time after SCI was 7.5 (1-14) years. The Thai version of QoL-BDS had good internal consistency (Cronbach's alpha = 0.89), fair to good construct validity (Spearman's rank correlation coefficient of 0.43-0.57, p < 0.01) and good to excellent test-retest reliability (Intraclass correlation coefficient of 0.73-0.86). CONCLUSIONS: The Thai version of QoL-BDS had acceptable psychometric properties. As it is concise, QoL-BDS should be encouraged in healthcare providers to investigate QoL in people with SCI, especially in middle-income countries.


Forgotten key players in public health: news media as agents of information and persuasion during the COVID-19 pandemic


COVID-19: preparing for superspreader potential among Umrah pilgrims to Saudi Arabia


SARS-CoV-2 infection: the same virus can cause different cutaneous manifestations


Recommendation from Peking Union Medical College Hospital for urgent hemodialysis during the COVID-19 pandemic


title: Expression of ACE2 in Human Neurons Supports the Neuro-Invasive Potential of COVID-19 Virus

text: The recent outbreak of 2019 coronavirus disease (COVID-19), caused by a novel coronavirus, has now spread quickly worldwide. Like the severe acute respiratory syndrome coronavirus (SARS-CoV), this novel type of coronavirus, SARS-CoV-2, has been demonstrated to utilize angiotensin-converting enzyme 2 (ACE2) as an entry point to the cells. There is a growing body of reports indicating that COVID-19 patients, especially those in severe condition, exhibit neurological symptoms, thus supporting the possibility that SARS-CoV-2 could infect and damage neurons within the central nervous system in humans. Using human pluripotent stem cells-derived neurons, here we show the expression of ACE2 in human neurons via immunocytochemistry. From this perspective, we elaborate on the idea that the neuro-invasive potential of SARS-CoV-2 should be considered as a possible contributory factor, as well as a therapeutic target, for the severe respiratory symptoms in critical COVID-19 cases.


title: In and Beyond COVID-19: US Academic Pharmaceutical Science and Engineering Community Must Engage to Meet Critical National Needs

text: The supply of affordable, high-quality pharmaceuticals to US patients has been on a critical path for decades. In and beyond the COVID-19 pandemic, this critical path has become tortuous. To regain reliability, reshoring of the pharmaceutical supply chain to the USA is now a vital national security need. Reshoring the pharmaceutical supply with old know-how and outdated technologies that cause inherent unpredictability and adverse environmental impact will neither provide the security we seek nor will it be competitive and affordable. The challenge at hand is complex akin to redesigning systems, including corporate and public research and development, manufacturing, regulatory, and education ones. The US academic community must be engaged in progressing solutions needed to counter emergencies in the COVID-19 pandemic and in building new methods to reshore the pharmaceutical supply chain beyond the pandemic.


Impact of COVID-19 outbreak on dermatology services: Dermatology in isolation


Reply to: "Current smoking is not associated with COVID-19"


Policies and procedures for personal protective equipment: Does inconsistency increase risk of contamination and infection?


The network effect: studying COVID-19 pathology with the Human Cell Atlas


title: The Impact of COVID-19 on European Health Care and Urology Trainees

text: The COVID-19 pandemic has had rapid and inevitable effects on health care systems and the training and work plans of urology residents. Smart learning is a valuable strategy for maintaining the learning curve of residents.


Optometry in times of pandemic: Spanish flu (1919) versus COVID-19 (2020)


title: The nasal tent: an adjuvant for performing endoscopic endonasal surgery in the Covid era and beyond

text: PURPOSE: To propose a cost-effective reproducible barrier method to safely perform endoscopic endonasal surgery during the Covid-19 pandemic. METHODS: This manuscript highlights the use of a clear, cost-effective disposable plastic sheet that is draped as a tent over the operating area to contain aerolization of particles. This is then connected to a suction to remove airborne particles and thus reduce transmission of the virus. CONCLUSION: The use of a nasal tent is a simple and affordable method to limit particle spread during high-risk aerolisation procedures during the Covid era and beyond.


title: Severe Acute Respiratory Syndrome-Coronavirus-2 Infection and Patients With Lung Cancer: The Potential Role of Interleukin-17 Target Therapy

text: The coronavirus disease 2019 outbreak is evolving rapidly worldwide. The lungs are the target of the primary infection and patients with lung cancer seem to have a poor prognosis. To our knowledge, this is the first reported investigation of a possible role of interleukin-17 target therapy in patients with lung cancer and concomitant severe acute respiratory syndrome-coronavirus-2 infection.


title: Cerebral ischemic and hemorrhagic complications of coronavirus disease 2019

text: BACKGROUND: The coronavirus disease 2019 is associated with neurological manifestations including stroke. OBJECTIVES: We present a case series of coronavirus disease 2019 patients from two institutions with acute cerebrovascular pathologies. In addition, we present a pooled analysis of published data on large vessel occlusion in the setting of coronavirus disease 2019 and a concise summary of the pathophysiology of acute cerebrovascular disease in the setting of coronavirus disease 2019. METHODS: A retrospective study across two institutions was conducted between 20 March 2020 and 20 May 2020, for patients developing acute cerebrovascular disease and diagnosed with coronavirus disease 2019. We performed a literature review using the PubMed search engine. RESULTS: The total sample size was 22 patients. The mean age was 59.5 years, and 12 patients were female. The cerebrovascular pathologies were 17 cases of acute ischemic stroke, 3 cases of aneurysm rupture, and 2 cases of sinus thrombosis. Of the stroke and sinus thrombosis patients, the mean National Institute of Health Stroke Scale was 13.8 ± 8.0, and 16 (84.2%) patients underwent a mechanical thrombectomy procedure. A favorable thrombolysis in cerebral infarction score was achieved in all patients. Of the 16 patients that underwent a mechanical thrombectomy, the mortality incidence was five (31.3%). Of all patients (22), three (13.6%) patients developed hemorrhagic conversion requiring decompressive surgery. Eleven (50%) patients had a poor functional status (modified Rankin Score 3-6) at discharge, and the total mortality incidence was eight (36.4%). CONCLUSIONS: Despite timely intervention and favorable reperfusion, the mortality rate in coronavirus disease 2019 patients with large vessel occlusion was high in our series and in the pooled analysis. Notable features were younger age group, involvement of both the arterial and venous vasculature, multivessel involvement, and complicated procedures due to the clot consistency and burden.


title: How to restart? An agent-based simulation model towards the definition of strategies for COVID-19"second phase"in public buildings

text: Restarting public buildings activities in the"second phase"of COVID-19 emergency should be supported by operational measures to avoid a second virus spreading. Buildings hosting the continuous presence of the same users and significant overcrowd conditions over space/time (e.g. large offices, universities) are critical scenarios due to the prolonged contact with infectors. Beside individual's risk-mitigation strategies performed (facial masks), stakeholders should promote additional strategies, i.e. occupants' load limitation (towards"social distancing") and access control. Simulators could support the measures effectiveness evaluation. This work provides an Agent-Based Model to estimate the virus spreading in the closed built environment. The model adopts a probabilistic approach to jointly simulate occupants' movement and virus transmission according to proximity-based and exposure-time-based rules proposed by international health organizations. Scenarios can be defined in terms of building occupancy, mitigation strategies and virus-related aspects. The model is calibrated on experimental data ("Diamond Princess"cruise) and then applied to a relevant case-study (a part of a university campus). Results demonstrate the model capabilities. Concerning the case-study, adopting facial masks seems to be a paramount strategy to reduce virus spreading in each initial condition, by maintaining an acceptable infected people's number. The building capacity limitation could support such measure by potentially moving from FFPk masks to surgical masks use by occupants (thus improving users' comfort issues). A preliminary model to combine acceptable mask filters-occupants' density combination is proposed. The model could be modified to consider other recurring scenarios in other public buildings (e.g. tourist facilities, cultural buildings).


title: Artificial intelligence approach fighting COVID-19 with repurposing drugs

text: Background: The ongoing COVID-19 pandemic has caused more than 193,825 deaths during the past few months. A quick-to-be-identified cure for the disease will be a therapeutic medicine that has prior use experiences in patients in order to resolve the current pandemic situation before it could become worsening. Artificial intelligence (AI) technology is hereby applied to identify the marketed drugs with potential for treating COVID-19. Material and methods: An AI platform was established to identify potential old drugs with anti-coronavirus activities by using two different learning databases; one consisted of the compounds reported or proven active against SARS-CoV, SARS-CoV-2, human immunodeficiency virus, influenza virus, and the other one containing the known 3C-like protease inhibitors. All AI predicted drugs were then tested for activities against a feline coronavirus in in vitro cell-based assay. These assay results were feedbacks to the AI system for relearning and thus to generate a modified AI model to search for old drugs again. Results: After a few runs of AI learning and prediction processes, the AI system identified 80 marketed drugs with potential. Among them, 8 drugs (bedaquiline, brequinar, celecoxib, clofazimine, conivaptan, gemcitabine, tolcapone, and vismodegib) showed in vitro activities against the proliferation of a feline infectious peritonitis (FIP) virus in Fcwf-4 cells. In addition, 5 other drugs (boceprevir, chloroquine, homoharringtonine, tilorone, and salinomycin) were also found active during the exercises of AI approaches. Conclusion: Having taken advantages of AI, we identified old drugs with activities against FIP coronavirus. Further studies are underway to demonstrate their activities against SARS-CoV-2 in vitro and in vivo at clinically achievable concentrations and doses. With prior use experiences in patients, these old drugs if proven active against SARS-CoV-2 can readily be applied for fighting COVID-19 pandemic.


Pathogenesis of COVID-19 from a cell biology perspective


title: Development of a Palliative Care Toolkit for the COVID-19 Pandemic

text: The Coronavirus disease 2019 (COVID-19) pandemic has led to high numbers of critically ill and dying patients in need of expert management of dyspnea, delirium, and serious illness communication. The rapid spread of severe acute respiratory syndrome-Coronavirus-2 creates surges of infected patients requiring hospitalization and puts palliative care programs at risk of being overwhelmed by patients, families, and clinicians seeking help. In response to this unprecedented need for palliative care, our program sought to create a collection of palliative care resources for nonpalliative care clinicians. A workgroup of interdisciplinary palliative care clinicians developed the Palliative Care Toolkit, consisting of a detailed chapter in a COVID-19 online resource, a mobile and desktop Web application, one-page guides, pocket cards, and communication skills training videos. The suite of resources provides expert and evidence-based guidance on symptom management including dyspnea, pain, and delirium, as well as on serious illness communication, including conversations about goals of care, code status, and end of life. We also created a nurse resource hotline staffed by palliative care nurse practitioners and virtual office hours staffed by a palliative care attending physician. Since its development, the Toolkit has helped us disseminate best practices to nonpalliative care clinicians delivering primary palliative care, allowing our team to focus on the highest-need consults and increasing acceptance of palliative care across hospital settings.


title: Regulatory consideration on preparation and clinical use of COVID-19 convalescent plasma

text: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease (COVID-19), spreading from Wuhan to worldwide has been emerged since December 2019. Although scientists and researchers have been racing to develop specific therapeutic agents or vaccines against SARS-CoV-2 since the identification of the agent, either a drug or a vaccine has not been approved to treat or to prevent COVID-19 up to date. On the base of historical experiences, Convalescent Plasma (CP), a passive antibody therapy, has been evaluated as a hopeful and potential therapeutic option since the beginning of the COVID-19 outbreak. Immune plasma had been used previously for the treatment of H1N1 influenza virus, SARS-CoV-1 and MERS-CoV epidemics successfully. In this scope competent authorities are responsible to set up certain principles and criteria for the collection and clinical use of COVID-19 Convalescent Plasma (CCP). This document has been prepared to aid both for the convalescent plasma suppliers and the clinicians. The first part encompasses the supply of CCP and the second part lead the clinical use of CCP for the treatment of patients with severe COVID-19 infection. Turkish Ministry of Health developed a guide on collection and clinical use of CCP and created a web-based monitoring system to follow-up the patients treated with convalescent plasma in universal. This follow-up process is thought to be crucial for the creation and development of current and future treatment modalities. This guide would be a pathfinder for clinicians and/or institutions those eager to conduct CCP treatment more effectively.


Dramatically improved hand hygiene performance rates at time of coronavirus pandemic


title: Prevalence of COVID-19-like symptoms in Italy and Lombardy, March-April 2020, and their implications on cancer prevention, diagnosis and management

text: Two population-based surveys on coronavirus disease-2019 (Covid-19)-like symptoms were conducted by BVA-Doxa on representative samples of the general population from Italy and its largest region, Lombardy, with over 10 million inhabitants and heavily struck by Covid-19, on 27-30 March and 3-7 April, on a total of 2000 individuals - 353 from Lombardy. Overall, 14.2% of Italians - and 19.6% in Lombardy - reported Covid-19-like symptoms. The estimated prevalence was higher in the young, in smokers, and in Lombardy over the period 20 March to 7 April. Although the influenza season was ended by mid-March, at least part of the symptoms may be not Covid-19 related. Even assuming that only half are, at least 7% of Italians and 10% in Lombardy had been affected by Covid-19. To these, asymptomatic or paucisymptomatic cases have to be added. These estimates are at least one or two orders of magnitude larger than official registered cases. This has major implications for cancer prevention, management and treatment.


Allocating Medical Resources in the Time of Covid-19


title: A Novel Negative Pressure Isolation Device for Aerosol Transmissible COVID-19

text: The Covid-19 pandemic creates a need to protect healthcare workers from patients undergoing aerosol-generating procedures which may transmit the SARS CoV-2 virus. Existing personal containment devices (PCDs) may protect healthcare workers (HCWs) from respiratory droplets but not from potentially dangerous respiratory-generated aerosols. We describe a new PCD and its aerosol containment capabilities. The device ships flat and folds into a chamber. With its torso drape and protective arm sleeves mounted, it provides contact, droplet, and aerosol isolation during intubation and cardiopulmonary resuscitation (CPR). Significantly improved ergonomics, single-use workflow, and ease of removal distinguish this device from previously published designs.


title: A First Instagram Dataset on COVID-19

text: The novel coronavirus (COVID-19) pandemic outbreak is drastically shaping and reshaping many aspects of our life, with a huge impact on our social life. In this era of lockdown policies in most of the major cities around the world, we see a huge increase in people and professional engagement in social media. Social media is playing an important role in news propagation as well as keeping people in contact. At the same time, this source is both a blessing and a curse as the coronavirus infodemic has become a major concern, and is already a topic that needs special attention and further research. In this paper, we provide a multilingual coronavirus (COVID-19) Instagram dataset that we have been continuously collected since March 30, 2020. We are making our dataset available to the research community at Github. We believe that this contribution will help the community to better understand the dynamics behind this phenomenon in Instagram, as one of the major social media. This dataset could also help study the propagation of misinformation related to this outbreak.


title: Extensive Partnership, Collaboration, and Teamwork is Required to Stop the COVID-19 Outbreak

text: The COVID-19 outbreak is a disaster now throughout the world. To stop this outbreak, we appeal through the paper for extensive partnership, collaboration and teamwork among the all levels of workers such as scientist, doctors, medical professionals, social workers, policy makers, governments, pharmaceutical firms, funding aid agencies to stop the pandemic immediately.


title: Practice Management During the COVID-19 Pandemic

text: On March 14, 2020, the Surgeon General of the United States urged a widespread cessation of all elective surgery across the country. The suddenness of this mandate and the concomitant spread of the COVID-19 virus left many hospital systems, orthopaedic practices, and patients with notable anxiety and confusion as to the near, intermediate, and long-term future of our healthcare system. As with most businesses in the United States during this time, many orthopaedic practices have been emotionally and fiscally devastated because of this crisis. Furthermore, this pandemic is occurring at a time where small and midsized orthopaedic groups are already struggling to cover practice overhead and to maintain autonomy from larger health systems. It is anticipated that many groups will experience financial demise, leading to substantial global consolidation. Because the authors represent some of the larger musculoskeletal multispecialty groups in the country, we are uniquely positioned to provide a framework with recommendations to best weather the ensuing months. We think these recommendations will allow providers and their staff to return to an infrastructure that can adjust immediately to the pent-up healthcare demand that may occur after the COVID-19 pandemic. In this editorial, we address practice finances, staffing, telehealth, operational plans after the crisis, and ethical considerations.


title: Effects of social distancing and isolation on epidemic spreading: a dynamical density functional theory model

text: For preventing the spread of epidemics such as the coronavirus disease COVID-19, social distancing and the isolation of infected persons are crucial. However, existing reaction-diffusion equations for epidemic spreading are incapable of describing these effects. We present an extended model for disease spread based on combining an SIR model with a dynamical density functional theory where social distancing and isolation of infected persons are explicitly taken into account. The model shows interesting nonequilibrium phase separation associated with a reduction of the number of infections, and allows for new insights into the control of pandemics.


COVID-19: Don't Neglect the Gastrointestinal Tract!


title: COVID-19: Don`t neglect the Gastrointestinal Tract!

text: n/a.


title: Classification of the COVID-19 infected patients using DenseNet201 based deep transfer learning

text: Deep learning models are widely used in the automatic analysis of radiological images. These techniques can train the weights of networks on large datasets as well as fine tuning the weights of pre-trained networks on small datasets. Due to the small COVID-19 dataset available, the pre-trained neural networks can be used for diagnosis of coronavirus. However, these techniques applied on chest CT image is very limited till now. Hence, the main aim of this paper to use the pre-trained deep learning architectures as an automated tool to detection and diagnosis of COVID-19 in chest CT. A DenseNet201 based deep transfer learning (DTL) is proposed to classify the patients as COVID infected or not i.e. COVID-19 (+) or COVID (-). The proposed model is utilized to extract features by using its own learned weights on the ImageNet dataset along with a convolutional neural structure. Extensive experiments are performed to evaluate the performance of the propose DTL model on COVID-19 chest CT scan images. Comparative analyses reveal that the proposed DTL based COVID-19 classification model outperforms the competitive approaches.Communicated by Ramaswamy H. Sarma.


title: The implications of silent transmission for the control of COVID-19 outbreaks

text: Since the emergence of coronavirus disease 2019 (COVID-19), unprecedented movement restrictions and social distancing measures have been implemented worldwide. The socioeconomic repercussions have fueled calls to lift these measures. In the absence of population-wide restrictions, isolation of infected individuals is key to curtailing transmission. However, the effectiveness of symptom-based isolation in preventing a resurgence depends on the extent of presymptomatic and asymptomatic transmission. We evaluate the contribution of presymptomatic and asymptomatic transmission based on recent individual-level data regarding infectiousness prior to symptom onset and the asymptomatic proportion among all infections. We found that the majority of incidences may be attributable to silent transmission from a combination of the presymptomatic stage and asymptomatic infections. Consequently, even if all symptomatic cases are isolated, a vast outbreak may nonetheless unfold. We further quantified the effect of isolating silent infections in addition to symptomatic cases, finding that over one-third of silent infections must be isolated to suppress a future outbreak below 1% of the population. Our results indicate that symptom-based isolation must be supplemented by rapid contact tracing and testing that identifies asymptomatic and presymptomatic cases, in order to safely lift current restrictions and minimize the risk of resurgence.


title: Potential neurological impact of coronaviruses: implications for the novel SARS-CoV-2

text: Coronaviruses (CoV) are viruses widely known to cause severe respiratory distress due to the prominent clinical symptoms presented. These symptoms, which include fever and dry cough, are frequently found in individuals with CoV infection. Neurological manifestations of CoV have often been neglected; however, recent studies have reported neurological consequences of CoV infection. Here, we review these literatures and discuss the neurologic impact of CoV while highlighting potential implications of the novel SARS-CoV-2 in the nervous system. We also discuss the possible routes by which these viruses invade the nervous system and the mechanism by which they may induce neurological damage.


Cull, release or bring them home: Coronavirus crisis forces hard decisions for labs with animals


title: AAN position statement: The COVID-19 pandemic and the ethical duties of the neurologist

text: Patients, clinicians, and hospitals have undergone monumental changes during the coronavirus disease 2019 (COVID-19) pandemic. This crisis has forced us to consider the obligations that we neurologists have to our individual patients as well as the greater community. By returning to our fundamental understanding of these duties, we can ensure that we are providing the most ethically appropriate contingency and crisis care possible. We recommend specific adaptations to both the inpatient and outpatient settings, as well as changes to medical and trainee education. Furthermore, we explore the daunting but potentially necessary implementation of scare resource allocation protocols. As the pandemic evolves, we will need to adapt continuously to these rapidly changing circumstances and consider both national and regional standards and variation.


title: Epidemiology of COVID-19 Among Children in China

text: OBJECTIVE: To identify the epidemiological characteristics and transmission patterns of pediatric patients with the 2019 novel coronavirus disease (COVID-19) in China. METHODS: Nationwide case series of 2135 pediatric patients with COVID-19 reported to the Chinese Center for Disease Control and Prevention from January 16, 2020, to February 8, 2020, were included. The epidemic curves were constructed by key dates of disease onset and case diagnosis. Onset-to-diagnosis curves were constructed by fitting a log-normal distribution to data on both onset and diagnosis dates. RESULTS: There were 728 (34.1%) laboratory-confirmed cases and 1407 (65.9%) suspected cases. The median age of all patients was 7 years (interquartile range: 2-13 years), and 1208 case patients (56.6%) were boys. More than 90% of all patients had asymptomatic, mild, or moderate cases. The median time from illness onset to diagnoses was 2 days (range: 0-42 days). There was a rapid increase of disease at the early stage of the epidemic, and then there was a gradual and steady decrease. The disease rapidly spread from Hubei province to surrounding provinces over time. More children were infected in Hubei province than any other province. CONCLUSIONS: Children of all ages appeared susceptible to COVID-19, and there was no significant sex difference. Although clinical manifestations of children's COVID-19 cases were generally less severe than those of adult patients, young children, particularly infants, were vulnerable to infection. The distribution of children's COVID-19 cases varied with time and space, and most of the cases were concentrated in Hubei province and surrounding areas. Furthermore, this study provides strong evidence of human-to-human transmission.


Comment on "Psoriasis, COVID-19, and acute respiratory distress syndrome: Focusing on the risk of concomitant biological treatment"


Managing mental health challenges faced by healthcare workers during covid-19 pandemic


title: Title: The Emergency Medicine Facing the Challenge of Open Science

text: (1) Background: The availability of research datasets can strengthen and facilitate research processes This is specifically relevant in the emergency medicine field due to the importance of providing immediate care in critical situations as the very current Coronavirus (COVID-19) Pandemic is showing to the scientific community This work aims to show which Emergency Medicine journals indexed in Journal Citation Reports (JCR) currently meet data sharing criteria (2) Methods: This study analyzes the editorial policies regarding the data deposit of the journals in the emergency medicine category of the JCR and evaluates the Supplementary material of the articles published in these journals that have been deposited in the PubMed Central repository (3) Results: It has been observed that 19 out of the 24 journals contained in the emergency medicine category of Journal Citation Reports are also located in PubMed Central (PMC), yielding a total of 5983 articles Out of these, only 9 4% of the articles contain supplemental material Although second quartile journals of JCR emergency medicine category have quantitatively more articles in PMC, the main journals involved in the deposit of supplemental material belong to the first quartile, of which the most used format in the articles is pdf, followed by text documents (4) Conclusion: This study reveals that data sharing remains an incipient practice in the emergency medicine field, as there are still barriers between researchers to participate in data sharing Therefore, it is necessary to promote dynamics to improve this practice both qualitatively (the quality and format of datasets) and quantitatively (the quantity of datasets in absolute terms) in research


CMR and serology to diagnose COVID-19 infection with primary cardiac involvement


title: A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)

text: In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.


title: To Protect Health Care Workers Better, To Save More Lives With COVID-19

text: The coronavirus disease 2019 (COVID-19) pandemic has thus far caused a total of 81,747 confirmed cases with 3283 deaths in China and more than 370,000 confirmed cases including over 16,000 deaths around the world by March 24, 2020. This issue has received extensive attention from the international community and has become a major public health priority. As the pandemic progresses, it is regrettable to know the health care workers, including anesthesiologists, are being infected constantly. Therefore, we would like to share our firsthand practical experience and perspective in China, focusing on the personal protection of health care workers and the risk factors related to their infection, based on the different stages of the COVID-19 epidemic in China.


title: The Impact of the Coronavirus Disease 2019 Outbreak on the Attendance of Patients with Surgical Complaints at a Tertiary Hospital Emergency Department

text: Introduction: Emergency departments (EDs) during the novel coronavirus disease 2019 (COVID-19) pandemic are perceived as possible sources of infection. The effects of COVID-19 on patients presenting to the hospital with surgical complaints remain uncertain. Methods: A single tertiary center retrospective study analysis compared the ED attendance rate and severity of patients with surgical complaints between March 2020 (COVID-19 outbreak) and pre-COVID-19 periods: February 2020 and the same 2 months in 2019 and 2018. Results: Overall, 6,017 patients were included. The mean daily ED visits of patients with nontrauma surgical complaints in the COVID-19 outbreak period declined by 27%-32% (P value <.01) compared with pre-COVID-19 periods. The log number of confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in Israel in March 2020 was negatively correlated with the number of ED visits (Pearson's r = -0.59, P < .01). The proportion of patients requiring hospitalization increased by up to 8% during the outbreak period (P < .01), and there was a higher proportion of tachycardic patients (20% versus 15.5%, P = .01). The percentage of visits to the ED by men declined by 5% (P < .01). The ED diagnosis distribution significantly changed during COVID-19 (P = .013), with an 84% decrease in the number of patients hospitalized for diverticular disease (P < .05). Conclusion: During the COVID-19 outbreak, the overall number of patients presenting at the ED with surgical complaints decreased significantly, and there was a higher admissions ratio. The extent to which the pandemic affects hospital ED attendance can help health care professionals prepare for future such events. ClinicalTrials.gov ID: NCT04338672.


title: Women worry about family, men about the economy: Gender differences in emotional responses to COVID-19

text: Among the critical challenges around the COVID-19 pandemic is dealing with potentially detrimental effects on people's mental health. Designing appropriate interventions and identifying the concerns of those most at risk requires methods that can extract worries, concerns and emotional responses from text data. We examine gender differences and the effect of document length on worries about the ongoing COVID-19 situation. Our findings suggest that i) shorter texts do not offer an as adequate insight into psychological processes as longer texts. We further find ii) marked gender differences in topics concerning emotional responses. Women worried more about their loved ones and severe health concerns while men were more occupied with effects on the economy and society. The findings align with general gender differences in language found elsewhere, but the current unique circumstances likely amplified these effects. We close this paper with a call for more high-quality datasets due to the limitations of Tweet-sized data.


COVID-19: Risk of increase in smoking rates among England's 6 million smokers and relapse among England's 11 million ex-smokers


title: Time Series Analysis and Forecasting of COVID-19 Cases Using LSTM and ARIMA Models

text: Coronavirus disease 2019 (COVID-19) is a global public health crisis that has been declared a pandemic by World Health Organization. Forecasting country-wise COVID-19 cases is necessary to help policymakers and healthcare providers prepare for the future. This study explores the performance of several Long Short-Term Memory (LSTM) models and Auto-Regressive Integrated Moving Average (ARIMA) model in forecasting the number of confirmed COVID-19 cases. Time series of daily cumulative COVID-19 cases were used for generating 1-day, 3-day, and 5-day forecasts using several LSTM models and ARIMA. Two novel k-period performance metrics - k-day Mean Absolute Percentage Error (kMAPE) and k-day Median Symmetric Accuracy (kMdSA) - were developed for evaluating the performance of the models in forecasting time series values for multiple days. Errors in prediction using kMAPE and kMdSA for LSTM models were both as low as 0.05%, while those for ARIMA were 0.07% and 0.06% respectively. LSTM models slightly underestimated while ARIMA slightly overestimated the numbers in the forecasts. The performance of LSTM models is comparable to ARIMA in forecasting COVID-19 cases. While ARIMA requires longer sequences, LSTMs can perform reasonably well with sequence sizes as small as 3. However, LSTMs require a large number of training samples. Further, the development of k-period performance metrics proposed is likely to be useful for performance evaluation of time series models in predicting multiple periods. Based on the k-period performance metrics proposed, both LSTMs and ARIMA are useful for time series analysis and forecasting for COVID-19.


Change in the Incidence of Stillbirth and Preterm Delivery During the COVID-19 Pandemic


title: Critical Care Management of Patients with COVID-19: Early Experience in Thailand

text: Since late December 2019, the world has been challenged with an outbreak of COVID-19. In Thailand, an upper middle-income country with a limited healthcare infrastructure and restricted human resources, nearly 3,000 confirmed COVID-19 cases have been reported as of early May 2020. Public health policies aimed at preventing new COVID-19 cases were very effective in halting the pandemic in Thailand. Case fatality in Thailand has been low (1.7%), at least in part due to early stratification according to risk of disease severity and timely initiation of supportive care with affordable measures. We present our initial experience with COVID-19 in Thailand, focusing on several aspects that may have played a crucial role in curtailment of the pandemic, and elements of care for severely ill COVID-19 patients, including stratification, isolation, and affordable diagnostic approaches and supportive care measures. We also discuss local considerations concerning some proposed experimental treatments.


Scientists' worlds will shrink in the wake of the pandemic


title: Preparedness of European diagnostic microbiology labs for detection of SARS-CoV-2, March 2020

text: BACKGROUND: To track the European spread of SARS-CoV-2, decentralized testing became necessary and test capacity needed to be expanded outside reference laboratories rapidly. METHODS: We assessed via an online questionnaire the preparedness of European hospital laboratories for detection of SARS-CoV-2 and listed the main drawbacks for implementation. RESULTS: Forty-five percent of the surveyed labs had a test in place by March 26th which is well into the first wave of the pandemic in most countries. CONCLUSIONS: The main implementation barriers for introduction of a SARSCoV-2 molecular assay in European diagnostic laboratories were availability of positive controls and a specificity panel.


Covid-19, the pandemic war: Implication for neurologists


title: Political Intrusions into the International Health Regulations Treaty and Its Impact on Management of Rapidly Emerging Zoonotic Pandemics: What History Tells Us

text: For a large number of health care providers world-wide, the coronavirus disease 2019 (COVID-19) pandemic is their first experience in population-based care. In past decades, lower population densities, infectious disease outbreaks, epidemics, and pandemics were rare and driven almost exclusively by natural disasters, predatory animals, and war. In the early 1900s, Sir William Osler first advanced the knowledge of zoonotic diseases that are spread from reservoir animals to human animals. Once rare, they now make up 71% or more of new diseases. Globally, zoonotic spread occurs for many reasons. Because the human population has grown in numbers and density, the spread of these diseases accelerated though rapid unsustainable urbanization, biodiversity loss, and climate change. Furthermore, they are exacerbated by an increasing number of vulnerable populations suffering from chronic deficiencies in food, water, and energy. The World Health Organization (WHO) and its International Health Regulation (IHR) Treaty, organized to manage population-based diseases such as Influenza, severe acute respiratory syndrome (SARS), H1N1, Middle East respiratory syndrome (MERS), HIV, and Ebola, have failed to meet population-based expectations. In part, this is due to influence from powerful political donors, which has become most evident in the current COVID-19 pandemic. The global community can no longer tolerate an ineffectual and passive international response system, nor tolerate the self-serving political interference that authoritarian regimes and others have exercised over the WHO. In a highly integrated globalized world, both the WHO with its IHR Treaty have the potential to become one of the most effective mechanisms for crisis response and risk reduction world-wide. Practitioners and health decision-makers must break their silence and advocate for a stronger treaty, a return of the WHO's singular global authority, and support highly coordinated population-based management. As Osler recognized, his concept of "one medicine, one health" defines what global public health is today.


title: AfricaOS: Using a distributed, proposal-based, replicated state machine towards liberation from the Berlin Conference of 1885

text: The Berlin Conference of 1885 has influenced the way native Africans, and the African Diaspora live their daily lives. France contractually controls several resources generated by the continent of Africa. Herein lies a technical proposal to free Africa from the financial and economic agreements coerced upon the continent over a century ago by utilizing decentralized collaboration through advanced technology. AfricaOS (AOS) aims to provide a philosophical, and fundamental framework for implementing a simple, distributed, collaborative computer for agreement amongst peers. The work also demonstrates an algebra over transactions, use of the protocol for privatization, a method for tokenizing barter economies, and methods to design mechanisms for use in implementing protocol behavior.


Covid-19 and retinoblastoma: How we manage it


SARS-CoV-2 virus and liver expression of host receptors: Putative mechanisms of liver involvement in COVID-19


title: Assessment of adequacy of respiratory infection prevention in hospitals of Inner Mongolia, China: a cross-sectional study using unannounced standardized patients

text: INTRODUCTION: Recent respiratory infectious disease (RID) outbreaks of influenza and the novel coronavirus have resulted in global pandemics. RIDs can trigger nosocomial infections if not adequately prevented. OBJECTIVE: The objective of this study was to rate the adequacy of healthcare workers (HCWs) and hospital settings on RID prevention using unannounced standardized patients (USP) in clinical settings of hospital gateways. METHODS: Trained USPs visited 5 clinical settings: information desks, registration desks, two outpatient departments and the emergency departments in 10 hospitals across 3 cities of Inner Mongolia, China. USPs observed the hospital air ventilation and distance from the nearest hand-washing facilities to each clinical setting, then mimicked symptoms of either tuberculosis or influenza before observing the HCW's behavior. A total of 480 clinical-setting assessments were made by 19 USPs. RESULTS: The overall adequacy of triage services was 86.7% and for prevention of the spread of airborne droplets was 83.5%. Almost all hospitals offered adequate air ventilation. Compared to the information desk, adequacy of triage and preventing the spread of airborne droplets by physicians in the three clinical departments was less likely to be adequate. Triage services for USPs simulating symptoms of influenza were 2.6 times more likely to be adequate than for those simulating symptoms of tuberculosis but there was no significant difference in the prevention of the spread of airborne droplets. CONCLUSIONS: There is a need to improve respiratory infectious disease procedures in our study hospitals, especially in outpatient and emergency departments.


title: Emerging and reemerging respiratory viral infections up to Covid-19

text: Infectious diseases remain as the significant causes of human and animal morbidity and mortality, leading to extensive outbreaks and epidemics. Acute respiratory viral diseases claim over 4 million deaths and cause millions of hospitalizations in developing countries every year. Emerging viruses, especially the RNA viruses, are more pathogenic since most people have no herd immunity. The RNA viruses can adapt to the rapidly changing global and local environment due to the high error rate of their polymerases that replicate their genomes. Currently, coronavirus disease 2019 (COVID-19) is determined as an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first identified in 2019 in Wuhan. Herein we discuss emerging and reemerging respiratory viral infections till to SARS-CoV-2.


Prevention of COVID-19 in the workplace


COVID-19 Policies can Perpetuate Violence Against Transgender Communities: Insights from Peru


title: Cross-Domain Segmentation with Adversarial Loss and Covariate Shift for Biomedical Imaging

text: Despite the widespread use of deep learning methods for semantic segmentation of images that are acquired from a single source, clinicians often use multi-domain data for a detailed analysis. For instance, CT and MRI have advantages over each other in terms of imaging quality, artifacts, and output characteristics that lead to differential diagnosis. The capacity of current segmentation techniques is only allow to work for an individual domain due to their differences. However, the models that are capable of working on all modalities are essentially needed for a complete solution. Furthermore, robustness is drastically affected by the number of samples in the training step, especially for deep learning models. Hence, there is a necessity that all available data regardless of data domain should be used for reliable methods. For this purpose, this manuscript aims to implement a novel model that can learn robust representations from cross-domain data by encapsulating distinct and shared patterns from different modalities. Precisely, covariate shift property is retained with structural modification and adversarial loss where sparse and rich representations are obtained. Hence, a single parameter set is used to perform cross-domain segmentation task. The superiority of the proposed method is that no information related to modalities are provided in either training or inference phase. The tests on CT and MRI liver data acquired in routine clinical workflows show that the proposed model outperforms all other baseline with a large margin. Experiments are also conducted on Covid-19 dataset that it consists of CT data where significant intra-class visual differences are observed. Similarly, the proposed method achieves the best performance.


Virtual melanoma checks during a pandemic


Managing COVID-19 in Patients With Cancer: A Double Blow for Oncologists


title: Zero-Shot Learning and its Applications from Autonomous Vehicles to COVID-19 Diagnosis: A Review

text: The challenge of learning a new concept, object, or a new medical disease recognition without receiving any examples beforehand is called Zero-Shot Learning (ZSL). One of the major issues in deep learning based methodologies such as in Medical Imaging, Autonomous Systems and other real-world applications is the requirement of feeding a large annotated and labelled datasets, prepared by an expert human to train the network model. ZSL is known for having minimal human intervention by mainly relying only on previously known concepts and current auxiliary information. This is an ever-growing research for the cases where we have very limited or no datasets available and at the same time, the detection/recognition system has human-like characteristics in learning new concepts. Therefore, it makes it applicable in real-world scenarios, from developing autonomous vehicles to medical imaging and COVID-19 Chest X-Ray (CXR) based diagnosis. In this review paper, we present the definition of the problem, we review over fundamentals, and the challenging steps of Zero-Shot Learning, including state-of-the-art categories of solutions as well as our recommended solution, motivations behind each approach, and their advantages over each category to guide the researchers to proceed with the best techniques and practices based on their applications. Inspired from different settings and extensions, we introduce a novel and broaden solution called one/few-shot learning. We then review through different image datasets inducing medical and non-medical images, the variety of splits, and the evaluation protocols proposed so far. Finally, we discuss the recent applications and future directions of ZSL. We aim to convey a useful intuition through this paper towards the goal of handling complex computer vision learning tasks more similar to the way humans learn.


title: Management of acute kidney injury in patients with COVID-19

text: The outbreak of coronavirus disease 2019 (COVID-19) has rapidly evolved into a global pandemic. Most patients with COVID-19 have mild symptoms, but about 5% develop severe symptoms, which can include acute respiratory distress syndrome, septic shock, and multiple organ failure. Kidney involvement is frequent, with clinical presentation ranging from mild proteinuria to progressive acute kidney injury (AKI) necessitating renal replacement therapy (RRT). An understanding of the pathophysiology and mechanisms of kidney damage and AKI in the setting of critical illness and COVID-19 is emerging, although further research is needed to identify patients at risk of AKI and to guide management strategies. As no specific treatment options exist for AKI secondary to COVID-19, intensive care is largely supportive. Current approaches to prevention and management of AKI, and identification of potential indications for use of RRT and sequential extracorporeal therapies, are based mainly on clinical experience, and AKI strategies are adapted empirically to patients with COVID-19. International collaborative and cross-disciplinary research is needed to obtain adequate evidence to support current clinical approaches and to develop new approaches to management.


title: Keep cystic fibrosis patients out of the hospital

text: No specific data exists regarding management of patients with cystic fibrosis (CF) who are infected with COVID-19. Based on expert opinion, strategies for outpatient management include use of elexacaftor-tezacaftor-ivacaftor to reduce pulmonary exacerbations, telemedicine, adherence to prescribed regimens, prompt and aggressive treatment of CF exacerbations, and communication about COVID-19 with patients with CF. Strategies for inpatient management may vary due to special precautions to avoid the aerosolization of COVID-19 with the use of nebulized medications and other therapies.


title: Quantify the role of superspreaders -opinion leaders- on COVID-19 information propagation in the Chinese Sina-microblog

text: BACKGROUD: Effective communication of accurate information through social media constitutes an important component of public health interventions in modern time, when traditional public health approaches such as contact tracing, quarantine and isolation are among the few options for the containing the disease spread in the population. The success of control of COVID-19 outbreak started from Wuhan, the capital city of Hubei Province of China relies heavily on the resilience of residents to follow public health interventions which induce substantial interruption of social-economic activities, and evidence shows that opinion leaders have been playing significant roles in the propagation of epidemic information and public health policy and implementations. METHODS: We design a mathematical model to quantify the roles of information superspreaders in single specific information which outbreaks rapidly and usually has a short duration period, and to examine the information propagation dynamics in the Chinese Sina-microblog. Our opinion-leader susceptible-forwarding-immune (OL-SFI) model is formulated to track the temporal evolution of forwarding quantities generated by opinion leaders and normal users. RESULTS: Data fitting from the real data of COVID-19 obtained from Chinese Sina-microblog can identify the different contact rates and forwarding probabilities (and hence calculate the basic information forwarding reproduction number of superspreaders), and can be used to evaluate the roles of opinion leaders in different stages of the information propagation and the outbreak unfolding. CONCLUSIONS: The parameterized model can be used to nearcast the information propagation trend, and the model-based sensitivity analysis can help to explore important factors for the roles of opinion leaders.


title: Development and Validation of a Clinical Risk Score for Intensive Care Resource Utilization After Colon Cancer Surgery: a Practical Guide to the Selection of Patients During COVID-19

text: BACKGROUND: The purpose of this study was to develop and validate a prediction model and clinical risk score for Intensive Care Resource Utilization after colon cancer surgery. METHODS: Adult (≥ 18 years old) patients from the 2012 to 2018 ACS-NSQIP colectomy-targeted database who underwent elective colon cancer surgery were identified. A prediction model for 30-day postoperative Intensive Care Resource Utilization was developed and transformed into a clinical risk score based on the regression coefficients. Model performance was assessed using the area under the receiver operating characteristic curve (AUC) and Hosmer-Lemeshow goodness-of-fit test. The model was validated in a separate test set of similar patients. RESULTS: In total, 54,893 patients underwent an elective colon cancer resection, of which 1224 (2.2%) required postoperative Intensive Care Resource Utilization. The final prediction model retained six variables: age (≥ 70; OR 1.90, 95% CI 1.68-2.14), sex (male; OR 1.73, 95% CI 1.54-1.95), American Society of Anesthesiologists score (III/IV; OR 2.52, 95% CI 2.15-2.95), cardiorespiratory disease (yes; OR 2.22, 95% CI 1.94-2.53), functional status (dependent; OR 2.81, 95% CI 2.22-3.56), and operative approach (open surgery; OR 1.70, 95% CI 1.51-1.93). The model demonstrated good discrimination (AUC = 0.73). A clinical risk score was developed, and the risk of requiring postoperative Intensive Care Resource Utilization ranged from 0.03 (0 points) to 19.0% (8 points). The model performed well on test set validation (AUC = 0.73). CONCLUSION: A prediction model and clinical risk score for postoperative Intensive Care Resource Utilization after colon cancer surgery was developed and validated.


Psoriasis and COVID-19: a multifactorial consideration


COVID-19: Zoonotic aspects


Targeting the entry step of SARS-CoV-2: a promising therapeutic approach


title: Understanding of Young People About COVID-19 During Early Outbreak in Indonesia

text: To control the spread of COVID-19 transmission, Indonesia government has broadcasted information about the pandemic. The aim of this study is to evaluate the understanding of young people, about COVID-19 during the early outbreak in Indonesia. An online-based cross-sectional data collection was conducted from adolescents aged 10 to 25 years, based on 10 questions regarding general COVID-19 information. There were 355 subjects from 25 out of 34 Indonesian provinces who participated in the study, with mean age of 19.93 ± 2.91 years. Better understanding was found in the female and higher-income population. Largely, the subjects got the information from social media, instead of the official government site for COVID-19. Lack of understanding about crucial preventive measures was found, such as handwashing and physical distancing. In conclusion, the participants have an overall moderate-good initial understanding toward COVID-19 during the early outbreak in Indonesia. These results can be used as baseline data for development of awareness measurement tools.


title: When rheumatoid arthritis is mentioned, should only dryness come to mind?

text: OBJECTIVE: To evaluate corneal parameters of rheumatoid arthritis (RA) patients by corneal topography. METHODS: One hundred two RA patients and 60 control subjects were enrolled. Corneal topography measurements and ophthalmologic findings were examined from all participants' files. RESULTS: Corneal thickness measurements were significantly lower in the RA group (p = 0.025). All values of corneal curvatures (K1, K2, Kmean) in 3 mm, 5 mm, and 7 mm zones were found statistically significantly higher in the RA group compared with the control group. Forty-five RA patients had a dry eye. Disease duration was correlated with dry eye in the RA group. There was a significant correlation between the duration of disease in RA patients and mean corneal curvatures (p 0.012/0.010/0.007, 3/5/7 mm respectively) and central corneal thickness (p 0.025). There is no statistical difference between other topographic measurements. CONCLUSIONS: The results suggest that RA patients have thinner and steeper corneas compared with control subjects. These parameters change in negative correlation as the duration of the disease increases.Key Pointsâ¢ Rheumatoid arthritis is an autoimmune disease with systemic involvement.â¢ In rheumatoid arthritis, systemic involvement is affected in the eyes.â¢ When it comes to eye involvement, it comes to mind that it makes the eyes more dryness.â¢ In addition to dryness in the eyes, rheumatoid arthritis makes morphological changes in the cornea.


Coagulation changes and thromboembolic risk in COVID-19 obstetric patients


Coagulation changes and thromboembolic risk in Covid-19 obstetric patients


Coagulation changes and thromboembolic risk in COVID-19 pregnant patients


title: Guillain-Barré syndrome associated with leptomeningeal enhancement following SARS-CoV-2 infection

text: INTRODUCTION: Patients with coronavirus disease 2019 (COVID-19) typically present with respiratory symptoms, but little is known about the disease's potential neurological complications.We report a case of Guillain-Barré syndrome (GBS) following a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, in association with leptomeningeal enhancement. CASE PRESENTATION: A 56-year-old woman presented with recent unsteadiness and paraesthesia in both hands. Fifteen days earlier, she complained of fever, dry cough and shortness of breath. Her chest X-ray showed a lobar consolidation and PCR was positive for SARS-CoV-2; she was admitted due to mild COVID-19 pneumonia.In the first 48 hours of hospitalisation, she started to experience lumbar pain and weakness of the proximal lower extremities, progressing to bilateral facial nerve palsy, oropharyngeal weakness and severe proximal tetraparesis with cervical flexion 2/5 on the MRC scale. A full spine magnetic resonance imaging (MRI) scan showed a brainstem and cervical leptomeningeal enhancement. Analysis of cerebrospinal fluid (CSF) revealed albumin-cytological dissociation. Microbiological studies on CSF, including SARS-CoV-2, were negative. Nerve conduction studies were consistent with demyelinating neuropathy. She was treated with intravenous immunoglobulin, with significant neurological improvement noted over the next 2 weeks. CONCLUSION: Leptomeningeal enhancement is an atypical feature in GBS, but could be a marker of its association with SARS-CoV-2 infection.


[Principles in health policy during the SARS-CoV-2 outbreak - major lessons from South East-Asia]


title: COVIDApp: A Health Application as an Innovative Strategy for the Management and Follow-Up of the COVID-19 Pandemic in Long-Term Care Facilities in Catalonia

text: BACKGROUND: The COVID-19 pandemic has caused an unprecedented worldwide public health crisis that requires new approaches. COVIDApp is a mobile application for the management of institutionalized individuals in long-term care facilities (LTCF). OBJECTIVE: Report the use of this innovative tool for the management of LTCF residents as a high-risk population, specifically for the early identification and self-isolation of suspected cases, the remote monitoring of mild cases and the real-time monitoring of the progression of the infection. METHODS: COVIDApp was implemented in 196 care centers in collaboration with 64 primary care teams. Objectives: early detection; self-isolation of suspected cases and rapid diagnosis; remote treatment and monitoring of mild cases; and real-time monitoring of the progression of the infection. The following parameters of COVID-19 were reported daily: signs/symptoms; diagnosis by polymerase chain reaction; absence of symptoms for ≥14 days; total deaths; and healthcare workers isolated with suspected COVID-19. The number of centers at risk was also described. RESULTS: Data were recorded from ≥10,000 institutionalized individuals and up to 4,000 healthcare workers between April 1st and 30th, 2020. A rapid increase in suspected cases was seen until day 6 but decreased during the 2 last weeks (from 1,084 to 282 cases). Confirmed cases increased from 419 cases (day 6) to 1,293 cases (day 22), remaining stable during the last week. Around 50% remained asymptomatic ≥14 days. A total of 854 (8%) deaths were reported (383 in suspected/confirmed cases). The number of isolated healthcare workers remained high over the 30 days; suspected cases decreased during the last 2 weeks. The number of high-risk LTCF decreased from 9.5% to 1.5%. CONCLUSIONS: COVIDApp could help clinicians to rapidly detect and remotely monitor suspected and confirmed cases of COVID-19 among institutionalized individuals, thus limiting the risk of spreading the virus. The platform shows the progression of infection in real time and can help us to design new strategies.


Teleconsultation-mediated nasoalveolar molding therapy for babies with cleft lip/palate during the COVID-19 outbreak: Implementing change at pandemic speed


title: Collateral Crises of Gun Preparation and the COVID-19 Pandemic: Infodemiology Study

text: BACKGROUND: In the past, national emergencies in the United States have resulted in increased gun preparation (ie, purchasing new guns or removing guns from storage); in turn, these gun actions have effected increases in firearm injuries and deaths. OBJECTIVE: The aim of this paper was to assess the extent to which interest in gun preparation has increased amid the coronavirus disease (COVID-19) pandemic using data from Google searches related to purchasing and cleaning guns. METHODS: We fit an Autoregressive Integrated Moving Average (ARIMA) model over Google search data from January 2004 up to the week that US President Donald Trump declared COVID-19 a national emergency. We used this model to forecast Google search volumes, creating a counterfactual of the number of gun preparation searches we would expect if the COVID-19 pandemic had not occurred, and reported observed deviations from this counterfactual. RESULTS: Google searches related to preparing guns have surged to unprecedented levels, approximately 40% higher than previously reported spikes following the Sandy Hook, CT and Parkland, FL shootings and 158% (95% CI 73-270) greater than would be expected if the COVID-19 pandemic had not occurred. In absolute terms, approximately 2.1 million searches related to gun preparation were performed over just 34 days. States severely affected by COVID-19 appear to have some of the greatest increases in the number of searches. CONCLUSIONS: Our results corroborate media reports that gun purchases are increasing amid the COVID-19 pandemic and provide more precise geographic and temporal trends. Policy makers should invest in disseminating evidence-based educational tools about gun risks and safety procedures to avert a collateral public health crisis.


title: Coagulation Panel in Patients with SARS-CoV2 Infection (COVID-19)

text: The 2019 novel coronavirus (SARS-CoV2) is the causal agent of the newly-termed Coronavirus Disease 2019 (COVID-19). In January 2020, the World Health Association (WHO) declared the CO-VID-19 as an epidemic. Abnormal coagulation parameters in COVID-19 patients currently are considered as prognostic factors of severity. Our aim is to summarize the current data available in the literature. MATERIALS AND METHODS: An electronic search was performed in the Database of publications on coronavirus disease (COVID-19) of the World Health Organization. Thrombin Time (TT), Prothrombin Time (PT), Fibrinogen (FIB), Activated Partial Thromboplastin Time (APPT), and D-Dimer have been detected as parameters to study in every COVID-19 patient. CLINICAL APPLICATION: The coagulation function panel has been described to be altered in critical COVID-2019 patients. DIC, which plays an important role in advanced stage, is known to be associated with sepsis. Anticoagulant therapy, mainly with low molecular weight heparin (LMWH), appears to be associated with better prognosis in patients with severe COV-ID-19. DISCUSSION: Coagulation function in patients with SARS-CoV2 infection is significantly deranged compared with normal patients. FIB and D-Dimer/FDP are the most significantly altered values and the early deetection of alteration could be useful to address therapies. D-Dimer/FDP (DD/FDP) alteration correlates with severity. Markedly elevated D-Dimer can be used to guide the introduction of anticoagulation therapy and evaluate prognosis of COVID-19. In every patient admitted with SARS-CoV2 infection PT, FIB, D-Dimer/FDP, and platelets must be ordered. We suggest daily extraction for every patient admitted and tested positive for COVID-19.


title: Delivery of infection from asymptomatic carriers of COVID-19 in a familial cluster

text: OBJECTIVES: With the ongoing outbreak of COVID-19 around the world, it has become a worldwide health concern. One previous study reported a family cluster with an asymptomatic transmission of COVID-19. Here, we report another series of cases and further demonstrate the repeatability of the transmission of COVID-19 by pre-symptomatic carriers. METHODS: A familial cluster of five patients associated with COVID-19 was enrolled in the hospital. We collected epidemiological and clinical characteristics, laboratory outcomes from electronic medical records, and also verified them with the patients and their families. RESULTS: Among them, three family members (Case 3/4/5) had returned from Wuhan. Additionally, two family members, those who had not traveled to Wuhan, also contracted COVID-19 after contacting with the other three family members. Case 1 developed severe pneumonia and was admitted to the ICU. Case 3 and Case 5 presented fever and cough on days two through three of hospitalization and had ground-glass opacity changes in their lungs. Case 4 presented with diarrhea and pharyngalgia after admission without radiographic abnormalities. Case 2 presented no clinical nor radiographic abnormalities. All five cases had an increasing level of C-reactive protein. CONCLUSIONS: Our findings indicate that COVID-19 can be transmitted by asymptomatic carriers during the incubation period.


title: [Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia]

text: Objective: To analyze the clinical characteristics of 2019 novel coronavirus (2019-nCoV) pneumonia and to investigate the correlation between serum inflammatory cytokines and severity of the disease. Methods: 29 patients with 2019-ncov admitted to the isolation ward of Tongji hospital affiliated to Tongji medical college of Huazhong University of Science and Technology in January 2020 were selected as the study subjects. Clinical data were collected and the general information, clinical symptoms, blood test and CT imaging characteristics were analyzed. According to the relevant diagnostic criteria, the patients were divided into three groups: mild (15 cases), severe (9 cases) and critical (5 cases). The expression levels of inflammatory cytokines and other markers in the serum of each group were detected, and the changes of these indicators of the three groups were compared and analyzed, as well as their relationship with the clinical classification of the disease. Results: (1) The main symptoms of 2019-nCoV pneumonia was fever (28/29) with or without respiratory and other systemic symptoms. Two patients died with underlying disease and co-bacterial infection, respectively. (2) The blood test of the patients showed normal or decreased white blood cell count (23/29), decreased lymphocyte count (20/29), increased hypersensitive C reactive protein (hs-CRP) (27/29), and normal procalcitonin. In most patients,serum lactate dehydrogenase (LDH) was significantly increased (20/29), while albumin was decreased(15/29). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (Tbil), serum creatinine (Scr) and other items showed no significant changes. (3) CT findings of typical cases were single or multiple patchy ground glass shadows accompanied by septal thickening. When the disease progresses, the lesion increases and the scope expands, and the ground glass shadow coexists with the solid shadow or the stripe shadow. (4) There were statistically significant differences in the expression levels of interleukin-2 receptor (IL-2R) and IL-6 in the serum of the three groups (P<0.05), among which the critical group was higher than the severe group and the severe group was higher than the mildgroup. However, there were no statistically significant differences in serum levels of tumor necrosis factor-alpha (TNF-α), IL-1, IL-8, IL-10, hs-CRP, lymphocyte count and LDH among the three groups (P>0.05). Conclusion: The clinical characteristics of 2019-nCoV pneumonia are similar to those of common viral pneumonia. High resolution CT is of great value in the differential diagnosis of this disease. The increased expression of IL-2R and IL-6 in serum is expected to predict the severity of the 2019-nCoV pneumonia and the prognosis of patients.


A Tale of Two Eras: The Effect of the COVID-19 Pandemic on Stone Disease Presentations


title: Genetic Programming visitation scheduling solution can deliver a less austere COVID-19 pandemic population lockdown

text: A computational methodology is introduced to minimize infection opportunities for people suffering some degree of lockdown in response to a pandemic, as is the 2020 COVID-19 pandemic. Persons use their mobile phone or computational device to request trips to places of their need or interest indicating a rough time of day: `morning', `afternoon', `night' or `any time' when they would like to undertake these outings as well as the desired place to visit. An artificial intelligence methodology which is a variant of Genetic Programming studies all requests and responds with specific time allocations for such visits that minimize the overall risks of infection, hospitalization and death of people. A number of alternatives for this computation are presented and results of numerical experiments involving over 230 people of various ages and background health levels in over 1700 visits that take place over three consecutive days. A novel partial infection model is introduced to discuss these proof of concept solutions which are compared to round robin uninformed time scheduling for visits to places. The computations indicate vast improvements with far fewer dead and hospitalized. These auger well for a more realistic study using accurate infection models with the view to test deployment in the real world. The input that drives the infection model is the degree of infection by taxonomic class, such as the information that may arise from population testing for COVID-19 or, alternatively, any contamination model. The taxonomy class assumed in the computations is the likely level of infection by age group.


title: Operationalizing COVID-19 testing: Who, what, when, where, why, and how

text: The authors review the rationale behind and approaches to testing for COVID-19, the quality of currently available tests, the role of data analytics in strategizing testing, and using the electronic medical record and other programs designed to steward COVID-19 testing and follow-up of patients.


Vertebral compression fractures in multiple myeloma: redefining the priorities during the COVID-19 pandemic


title: 2019 Novel Coronavirus Pandemic: What Do We Know?

text: The pandemic caused by SARS-COV2 Virus/COVID-19, which was initially reported in China in December 2019, has become a major global health concern COVID-19 can manifest with cytokine storm - an exaggerated systemic inflammatory phenomenon due to over-production of proinflammatory cytokines by immune cells that results in diffuse inflammatory lung disease and acute respiratory distress syndrome It may be complicated by septic shock and subsequent multi-organ failure Based on the most recently published evidence, this article will review and discuss comprehensive information on its clinical manifestations, laboratory tests, potential therapeutics, and prevention guidelines


title: Como o Brasil pode deter a COVID-19./ Como o Brasil pode deter a COVID-19./ How Brazil can hold back COVID-19

text: This article presents the strategies and actions adopted by the Brazilian Ministry of Health to hold back COVID-19. The response to the disease was immediate and occurred prior to the first case being detected in Brazil. Provision of information and communication to the population and the press was adopted as a fundamental strategy for addressing the epidemic. Guidance provided to the population has been clear, stressing the importance of coronavirus transmission prevention measures. Efforts have been directed towards strengthening health surveillance and health care, as well as boosting research, development and innovation. Actions have targeted human resource training and expanding coverage afforded by the Brazilian National Health System (SUS). Protecting health workers is a priority. All SUS health workers, managers and directors are dedicated to preserving the health and life of each and every Brazilian citizen.


title: Prognostic Factors for Severe Coronavirus Disease 2019 in Daegu, Korea

text: BACKGROUND: Since its first detection in December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 infection has spread rapidly around the world. Although there have been several studies investigating prognostic factors for severe COVID-19, there have been no such studies in Korea. METHODS: We performed a retrospective observational study of 110 patients with confirmed COVID-19 hospitalized at a tertiary hospital in Daegu, Korea. Demographic, clinical, laboratory, and outcome data were collected and analyzed. Severe disease was defined as a composite outcome of acute respiratory distress syndrome, intensive care unit care, or death. RESULTS: Diabetes mellitus (odds ratio [OR], 19.15; 95% confidence interval [CI], 1.90-193.42; P = 0.012), body temperature ≥ 37.8°C (OR, 10.91; 95% CI, 1.35-88.36; P = 0.025), peripheral oxygen saturation < 92% (OR, 33.31; 95% CI, 2.45-452.22; P = 0.008), and creatine kinase-MB (CK-MB) > 6.3 (OR, 56.84; 95% CI, 2.64-1,223.78, P = 0.010) at admission were associated with higher risk of severe COVID-19. The likelihood of development of severe COVID-19 increased with an increasing number of prognostic factors. CONCLUSION: In conclusion, we found that diabetes mellitus, body temperature ≥ 37.8°C, peripheral oxygen saturation < 92%, and CK-MB > 6.3 are independent predictors of severe disease in hospitalized COVID-19 patients. Appropriate assessment of prognostic factors and close monitoring to provide the necessary interventions at the appropriate time in high-risk patients may reduce the case fatality rate of COVID-19.


Alteration of taste or smell as a predictor of COVID-19


Biggest COVID-19 trial tests repurposed drugs first


Italian society of colorectal surgery recommendations for good clinical practice in colorectal surgery during the novel coronavirus pandemic


title: The death rate for COVID-19 is positively associated with gross domestic products

text: N/A - Letter to the Editor.


Ethical road map through the covid-19 pandemic


title: Masks and thermometers: Paramount measures to stop the rapid spread of SARS-CoV-2 in the United States

text: In the United States, there is currently an exponential growth for the COVID-19 cases. The US president's coronavirus guidelines for Americans "30 Days to Slow The Spread" are necessary. To effectively curb the rapid spread of SARS-CoV-2, two more control measures masks and thermometers are strongly suggested to be included in the Guidelines.


title: Case report of COVID-19 in a kidney transplant recipient: Does immunosuppression alter the clinical presentation?

text: COVID-19 is novel infectious disease with an evolving understanding of its epidemiology and clinical manifestations. Immunocompromised patients often present atypical presentations of viral diseases. Herein we report a case of a COVID-19 infection in a solid organ transplant recipient, in which the first clinical symptoms were of gastrointestinal viral disease and fever, which further progressed to respiratory symptoms in 48 hours. In these high risk populations, protocols for screening for SARS-Cov2 may be needed to be re-evaluated.


Is it ethically appropriate to continue surgical clinical trials during the COVID-19 pandemic?


State of Missouri Supported by Four Essential Pillars for COVID-19 Response


COVID-19 and Cushing's syndrome: recommendations for a special population with endogenous glucocorticoid excess


title: A prospective clinical study of detailed neurological manifestations in patients with COVID-19

text: BACKGROUND: COVID-19 is a virus pandemic. According to the first obtained data, COVID-19 has defined with findings such as cough, fever, diarrhea, and fatigue although neurological symptoms of patients with COVID-19 have not been investigated in detail. This study aims to investigate the neurological findings via obtained face-to-face anamnesis and detailed neurological examination in patients with COVID-19. METHODS: Two hundred thirty-nine consecutive inpatients with COVID-19, supported with laboratory tests, were evaluated. Detailed neurological examinations and evaluations of all patients were performed. All evaluations and examinations were performed by two neurologists who have at least five-year experience. RESULTS: This study was carried out 239 patients (133 male + 106 female) with diagnosed COVID-19. Neurological findings were present in 83 of 239 patients (34.7%). The most common neurological finding was a headache (27.6%). D-dimer blood levels were detected to be significantly higher in patients with at least one neurological symptom than patients without the neurological symptom (p < 0.05). IL-6 level was found to be significantly higher in patients with headache than without headache (p < 0.05). Creatine kinase (CK) level was detected to be significantly higher in patients with muscle pain (p < 0.05). CONCLUSION: Neurological symptoms are often seen in patients with COVID-19. Headache was the most common seen neurological symptom in this disease. Dizziness, impaired consciousness, smell and gustation impairments, cerebrovascular disorders, epileptic seizures, and myalgia were detected as other findings apart from the headache. It is suggested that determining these neurological symptoms prevents the diagnosis delay and helps to prohibit virus spread.


Initial data from the COVID-19 Global Rheumatology Alliance provider registries - Authors' reply


COVID-19 distresses the depressed while schizophrenic patients are unimpressed: A study on psychiatric inpatients


title: Atrial Fibrillation in COVID-19: From epidemiological association to pharmacological implications

text: Coronavirus disease 2019 (COVID-19) outbreak is a public health emergency of international concern due to a highly pathogenic human coronavirus (HCoV), actually named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite much emerging data about the epidemiological association between cardiovascular diseases and COVID-19, little is still known atrial fibrillation (AF) and its optimal management in this clinical contest. The aim of our review is to describe the pharmacological interactions between cardiovascular drugs more commonly used in AF management and experimental COVID-19 therapies, based on European (EU) and Unites States (US) summaries of product characteristics.


Editorial. Lessons learned: special precautions for performing emergency cerebrovascular procedures amid the COVID-19 pandemic


title: Natural antiviral compound silvestrol modulates human monocyte-derived macrophages and dendritic cells

text: Outbreaks of infections with viruses like Sars-CoV-2, Ebola virus and Zika virus lead to major global health and economic problems because of limited treatment options. Therefore, new antiviral drug candidates are urgently needed. The promising new antiviral drug candidate silvestrol effectively inhibited replication of Corona-, Ebola-, Zika-, Picorna-, Hepatis E and Chikungunya viruses. Besides a direct impact on pathogens, modulation of the host immune system provides an additional facet to antiviral drug development because suitable immune modulation can boost innate defence mechanisms against the pathogens. In the present study, silvestrol down-regulated several pro- and anti-inflammatory cytokines (IL-6, IL-8, IL-10, CCL2, CCL18) and increased TNF-α during differentiation and activation of M1-macrophages, suggesting that the effects of silvestrol might cancel each other out. However, silvestrol amplified the anti-inflammatory potential of M2-macrophages by increasing expression of anti-inflammatory surface markers CD206, TREM2 and reducing release of pro-inflammatory IL-8 and CCL2. The differentiation of dendritic cells in the presence of silvestrol is characterized by down-regulation of several surface markers and cytokines indicating that differentiation is impaired by silvestrol. In conclusion, silvestrol influences the inflammatory status of immune cells depending on the cell type and activation status.


Medical education during the COVID-19 pandemic: perspectives from UK trainees


title: Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis

text: OBJECTIVE: We aim to summarize reliable evidence of evidence-based medicine for the treatment and prevention of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by analyzing all the published studies on the clinical characteristics of patients with SARS-CoV-2. METHODS: PubMed, Cochrane Library, Embase, and other databases were searched. Several studies on the clinical characteristics of SARS-CoV-2 infection were collected for meta-analysis. RESULTS: Ten studies were included in Meta-analysis, including a total number of 50466 patients with SARS-CoV-2 infection. Meta-analysis shows that, among these patients, the incidence of fever was 0.891 (95% CI: 0.818, 0.945), the incidence of cough was 0.722 (95% CI: 0.657, 0.782), and the incidence of muscle soreness or fatigue was 0.425 (95% CI: 0.213, 0.652). The incidence of acute respiratory distress syndrome (ARDS) was 0.148 (95% CI: 0.046, 0.296), the incidence of abnormal chest computer tomography (CT) was 0.966 (95% CI: 0.921, 0.993), the percentage of severe cases in all infected cases was 0.181 (95% CI: 0.127, 0.243), and the case fatality rate of patients with SARS-CoV-2 infection was 0.043 (95% CI: 0.027, 0.061). CONCLUSION: Fever and cough are the most common symptoms in patients with SARS-CoV-2 infection, and most of these patients have abnormal chest CT examination. Several people have muscle soreness or fatigue as well as ARDS. Diarrhea, hemoptysis, headache, sore throat, shock, and other symptoms are rare. The case fatality rate of patients with SARS-CoV-2 infection is lower than that of Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). This meta-analysis also has limitations, so the conclusions of this Meta-analysis still need to be verified by more relevant studies with more careful design, more rigorous execution, and larger sample size.


Covid-19: how Japan squandered its early jump on the pandemic


The need of COVID19 free hospitals to maintain cancer care


The Effect on Trauma Care Secondary to the COVID-19 Pandemic: Collateral Damage from Diversion of Resources


title: Association between Initial Chest CT or Clinical Features and Clinical Course in Patients with Coronavirus Disease 2019 Pneumonia

text: OBJECTIVE: To identify the initial chest computed tomography (CT) findings and clinical characteristics associated with the course of coronavirus disease 2019 (COVID-19) pneumonia. MATERIALS AND METHODS: Baseline CT scans and clinical and laboratory data of 72 patients admitted with COVID-19 pneumonia (39 men, 46.2 ± 15.9 years) were retrospectively analyzed. Baseline CT findings including lobar distribution, presence of ground glass opacities, consolidation, linear opacities, and lung severity score were evaluated. The outcome event was recovery with hospital discharge. The time from symptom onset to discharge or the end of follow-up (for those remained hospitalized) was recorded. Data were censored in events such as death or discharge without recovery. Multivariable Cox proportional hazard regression was used to explore the association between initial CT, clinical or laboratory findings, and discharge with recovery, whereby hazard ratio (HR) values < 1 indicated a lower rate of discharge at four weeks and longer time until discharge. RESULTS: Thirty-two patients recovered and were discharged during the study period with a median length of admission of 16 days (range, 9 to 25 days), while the rest remained hospitalized at the end of this study (median, 17.5 days; range, 4 to 27 days). None died during the study period. After controlling for age, onset time, lesion characteristics, number of lung lobes affected, and bilateral involvement, the lung severity score on baseline CT (> 4 vs. ≤ 4 [reference]: adjusted HR = 0.41 [95% confidence interval, CI = 0.18-0.92], p = 0.031) and initial lymphocyte count (reduced vs. normal or elevated [reference]: adjusted HR = 0.14 [95% CI = 0.03-0.60], p = 0.008) were two significant independent factors that influenced recovery and discharge. CONCLUSION: Lung severity score > 4 and reduced lymphocyte count at initial evaluation were independently associated with a significantly lower rate of recovery and discharge and extended hospitalization in patients admitted for COVID-19 pneumonia.


Management of the first patient with confirmed COVID-19 in pregnancy in India: From guidelines to frontlines


Return to sports after COVID-19 infection


title: Guillain-Barre Syndrome Associated with SARS-CoV-2 Detection and a COVID-19 Infection in a Child

text: Coronavirus disease (COVID-19) is caused by SARS-CoV-2. Physicians in China reported what is believed to be the first adult case of a SARS-CoV-2 infection associated with acute Guillain-Barré syndrome (GBS), followed by five adult Italian patients and another case in the United States of America. In the current report we present one of the first descriptions of an association of GBS and SARS-CoV-2 infection within a child. In our facility, and eleven year old boy presented with typical features of GBS and after five days a morbilliform skin rash over the palms of both hands. Three weeks before the start of the neurological symptoms, the boy had experienced an episode of mild febrile illness with mild respiratory manifestations and a persisting cough. The diagnosis of the SARS-CoV-2 infection was confirmed by oropharyngeal swab on reverse transcription polymerase chain reaction assay. The disease course of our patient strongly suggests a possible relationship between the development of GBS and SARS-CoV-2 infection. The case is discussed in view of the previous case reports with the association of GBS and Covid-19.


COVID-19 impact on research, lessons learned from COVID-19 research, implications for pediatric research


Authors' response: SARS-CoV-2 detection by real-time RT-PCR


Challenges with the management of older patients with cancer during the COVID-19 pandemic


title: Where do urologists stand in the era of novel coronavirus-2019 disease

text: PURPOSE OF REVIEW: The novel coronavirus-2019 disease (COVID-19) pandemic has had devastating consequences on healthcare systems globally. The effect this has on urologists and the patients they care for is not fully understood and presents the challenge of prioritizing the most urgent cases. We aim to review the impact on urology services and evaluate strategies to minimize disruption. RECENT FINDINGS: Various healthcare systems have been forced to postpone treatment for many urological conditions as resources are dedicated to the treatment of COVID-19. Training has been postponed as staff are reallocated to areas of need. Face-to-face contact is largely minimized and innovative, virtual communication methods are used in the outpatient setting and multidisciplinary team meetings. Surgical practice is changing because of the risks posed by COVID-19 and procedures can be prioritized in a nonurgent, low priority, high priority or emergency category. SUMMARY: Although the COVID-19 pandemic will inevitably affect urological services, steps can be taken to mitigate the impact and prioritize the patients most in need of urgent care. Similarly, in future; simulation, e-learning and webinars will allow interaction to share, discuss and debate focused training and education.


title: [Current Topics of Cancer and HIV]

text: Antiretroviral therapy(ART)has been associated with reduced AIDS- and non-AIDS-related morbidity and mortality in people living with HIV/AIDS(PLWH). Nevertheless, the incidence of many comorbid conditions remains higher in PLWH than in the general population, including AIDS-defining malignancies(ADM)as well as several non-AIDS-defining malignancies (NADM). It's important to prevent ADM/NADM, like periodic health checkup for early diagnosis, to quit smoking, and cooperation with cancer and HIV specialists.


title: Simulation-Based Inference for Global Health Decisions

text: The COVID-19 pandemic has highlighted the importance of in-silico epidemiological modelling in predicting the dynamics of infectious diseases to inform health policy and decision makers about suitable prevention and containment strategies. Work in this setting involves solving challenging inference and control problems in individual-based models of ever increasing complexity. Here we discuss recent breakthroughs in machine learning, specifically in simulation-based inference, and explore its potential as a novel venue for model calibration to support the design and evaluation of public health interventions. To further stimulate research, we are developing software interfaces that turn two cornerstone COVID-19 and malaria epidemiology models COVID-sim, (https://github.com/mrc-ide/covid-sim/) and OpenMalaria (https://github.com/SwissTPH/openmalaria) into probabilistic programs, enabling efficient interpretable Bayesian inference within those simulators.


title: Inter nation social lockdown versus medical care against COVID-19, a mild environmental insight with special reference to India

text: Infection by coronavirus (CoV-19) has led to emergence of a pandemic called as Coronavirus Disease (COVID-19) that has so far affected about 210 countries. The dynamic data indicate that the pandemic by CoV-19 so far has infected 2,403,963 individuals, and among these 624,698 have recovered while, it has been fatal for 165,229. Without much experience, currently, the medicines that are clinically being evaluated for COVID-19 include chloroquine, hydroxychloroquine, azithromycin, tocilizumab, lopinavir, ritonavir, tocilizumab and corticosteroids. Therefore, countries such as Italy, USA, Spain and France with the most advanced health care system are partially successful to control CoV-19 infection. India being the 2nd largest populous country, where, the healthcare system is underdeveloped, major portion of population follow unhygienic lifestyle, is able to restrict the rate of both infection and death of its citizens from COVID-19. India has followed an early and a very strict social distancing by lockdown and has issued advisory to clean hands regularly by soap and/or by alcohol based sterilizers. Rolling data on the global index of the CoV infection is 13,306, and the index of some countries such as USA (66,148), Italy (175,055), Spain (210,126), France (83,363) and Switzerland (262,122) is high. The index of India has remained very low (161) so far, mainly due to early implementation of social lockdown, social distancing, and sanitizing hands. However, articles on social lockdown as a preventive measure against COVID-19 in PubMed are scanty. It has been observed that social lockdown has also drastic impacts on the environment especially on reduction of NO2 and CO2 emission. Slow infection rate under strict social distancing will offer time to researchers to come up with exact medicines/vaccines against CoV-19. Therefore, it is concluded that stringent social distancing via lockdown is highly important to control COVID-19 and also to contribute for self-regeneration of nature.


title: Author Correction: Caring for patients with cancer in the COVID-19 era

text: An amendment to this paper has been published and can be accessed via a link at the top of the paper.