title: Distribution of COVID-19 Morbidity Rate in Association with Social and Economic Factors in Wuhan, China: Implications for Urban Development

text: Social and economic factors relate to the prevention and control of infectious diseases. The purpose of this paper was to assess the distribution of COVID-19 morbidity rate in association with social and economic factors and discuss the implications for urban development that help to control infectious diseases. This study was a cross-sectional study. In this study, social and economic factors were classified into three dimensions: built environment, economic activities, and public service status. The method applied in this study was the spatial regression analysis. In the 13 districts in Wuhan, the spatial regression analysis was applied. The results showed that: 1) increasing population density, construction land area proportion, value-added of tertiary industry per unit of land area, total retail sales of consumer goods per unit of land area, public green space density, aged population density were associated with an increased COVID-19 morbidity rate due to the positive characteristics of estimated coefficients of these variables. 2) increasing average building scale, GDP per unit of land area, and hospital density were associated with a decreased COVID-19 morbidity rate due to the negative characteristics of estimated coefficients of these variables. It was concluded that it is possible to control infectious diseases, such as COVID-19, by adjusting social and economic factors. We should guide urban development to improve human health.


title: Disease spreading with social distancing: a prevention strategy in disordered multiplex networks

text: The continue emerging of diseases that have the potential to become threats at local and global scales, such as influenza A(H1N1), SARS, MERS, and COVID-19, makes it relevant to keep designing models of disease propagation and strategies to prevent or mitigate their effects in populations. Since isolated systems are very rare to find in any context, specially in human contact networks, here we examine the susceptible-infected-recovered model of disease spreading in a multiplex network formed by two distinct networks or layers that are interconnected through a fraction $q$ of shared individuals. We model the interactions between individuals in each layer through a weighted network, because person-to-person interactions are diverse (or disordered); weights represent the contact times of these interactions and we use a distribution of contact times to assign an individual disorder to each layer. Using branching theory supported by simulations, we study a social distancing strategy where we reduce the average contact time in one layer (or in both of them, if necessary). We find a set of disorder parameters - associated with average contact times - that prevents a disease from becoming an epidemic. When the disease is very likely to spread, the system is always in an epidemic phase, regardless of the disorder parameters and the fraction of shared nodes. However we find that it is still possible to protect a giant component of susceptible individuals, which is crucial to keep the functionality of the system composed by the two interconnected layers.


COVID-19: learning from experience


An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement


Key clinical research priorities for the pediatric community during the COVID-19 pandemic


Coronavirus disease-2019 in pregnancy with neurological manifestations versus pregnancy with eclampsia: Need for liberal testing to rule out the masquerades


title: [Expert consensus on Corona Virus Disease 2019 with special blood purification technology]

text: The outbreak of Corona Virus Disease 2019 (COVID-19) has spread to more than 70 countries worldwide and there was a higher mortality in those who developed serious illness.Cytokine storm syndrome is an important pathophysiological basis for COVID-19 patients developing into severe or critical conditions. It was indicated in the diagnosis and treatment scheme, by the National Health Commission of the People's Republic of China, that blood purifications such as plasma exchange, plasma adsorption, hemoperfusion, hemofiltration and plasmafiltration could be considered for use in the critical patients with cytokine storm syndrome. This expert consensus, proposed by the Chinese Society of Nephrology and the Nephrology Committee of Chinese Research Hospital Association, is to guide and standardize the clinical application of blood purifications in the treatment of severe or critical patients with COVID-19.


title: Capability, opportunity, and motivation to enact hygienic practices in the early stages of the COVID-19 outbreak in the United Kingdom

text: OBJECTIVES: The COVID-19 pandemic is one of the greatest global health threats facing humanity in recent memory. This study aimed to explore influences on hygienic practices, a set of key transmission behaviours, in relation to the Capability, Opportunity, Motivation-Behaviour (COM-B) model of behaviour change (Michie et al., 2011). DESIGN: Data from the first wave of a longitudinal survey study were used, launched in the early stages of the UK COVID-19 pandemic. METHODS: Participants were 2025 adults aged 18 and older, representative of the UK population, recruited by a survey company from a panel of research participants. Participants self-reported motivation, capability, and opportunity to enact hygienic practices during the COVID-19 outbreak. RESULTS: Using regression models, we found that all three COM-B components significantly predicted good hygienic practices, with motivation having the greatest influence on behaviour. Breaking this down further, the subscales psychological capability, social opportunity, and reflective motivation positively influenced behaviour. Reflective motivation was largely driving behaviour, with those highest in reflective motivation scoring 51% more on the measure of hygienic practices compared with those with the lowest scores. CONCLUSIONS: Our findings have clear implications for the design of behaviour change interventions to promote hygienic practices. Interventions should focus on increasing and maintaining motivation to act and include elements that promote and maintain social support and knowledge of COVID-19 transmission. Groups in particular need of targeting for interventions to increase hygienic practices are males and those living in cities and suburbs.


Comment on: "Acral findings during the COVID-19 outbreak: Chilblain-like lesions should be preferred to acro-ischemic lesions"


title: A complication of coronavirus disease 2019: delirium

text: COVID-19 is predominantly a respiratory disease. However, some cases exhibit other features including Central Nervous System symptoms. In the older adult, COVID-19 may present with atypical symptoms, including delirium and its complications. The objective of this study is to describe the relationship between the new type of coronavirus infection and delirium. Systematic research (Cochrane Library and PubMed) was carried out (only upper time limit: April 2020). Publications found through this indexed search were reviewed and manually screened to identify relevant studies. Search terms used included "COVID-19, Delirium, Dementia, Intensive Care Unit". We manually added articles identified through other sources (i.e., key journals). Older people are at the greatest risk from COVID-19. If infected, they may present delirium. Moreover, it is not exclusive to older people. Delirium is not inevitable; rather, it is preventable. Delirium prevention programs are even more crucial in the era of COVID-19 and cannot be allowed to wither despite the challenges of integrating delirium prevention with COVID-19 care. An acute change in condition, behaviour, or mental status should prompt a delirium screen. As regards the treatment, it is advisable to use non-pharmacological interventions first where possible. Medication may be needed for patients with agitation where there is intractable distress or high risk to self/others.


Letter to the Editor regarding 'Medical Student Concerns Relating to Neurosurgery EducationDuring COVID-19' : an African experience


title: Clinics in Diagnostic Imaging: COVID-19 atypical pneumonia

text: A 53-year-old man presented with high fever and a non-productive cough but had no recent travel history. He deteriorated clinically very rapidly and was intubated. The endotracheal tube microbiological culture isolated Klebsiella pneumoniae. On chest computed tomography, the presence of mixed ground-glass airspace opacities, patchy consolidation and a 'crazy paving' appearance was atypical for Klebsiella infection. As there was also a lack of cavitating nodules, lymphadenopathy and pleural effusion, atypical pneumonia due to COVID-19 was diagnosed. The patient tested positive for COVID-19. He was isolated and subsequently recovered.


title: Clinical and epidemiological features of COVID-19 family clusters in Beijing, China

text: BACKGROUND: Since its discovery, SARS-CoV-2 has been spread throughout China before becoming a global pandemic. In Beijing, family clusters are the main mode of human-human transmission accounting for 57.6% of the total confirmed cases. METHOD: We present the epidemiological and clinical features of the clusters of three large and one small families. RESULT: Our results revealed that SARS-CoV-2 is transmitted quickly through contact with index case, and a total of 22/24 infections were observed. Among those infected, 20/22 had mild symptoms and only two had moderate to severe clinical manifestations. Children in the families generally showed milder symptoms. The incubation period varied from 2 to 13 days, and the shedding of virus from the upper respiratory tract lasted from 5 to over 30 days. A prolonged period of virus shedding (>30 days) in upper respiratory tract was observed in 6/24 cases. CONCLUSION: SARS-CoV-2 is transmitted quickly in the form of family clusters. While the infection rate is high within the cluster, the disease manifestations, latent period, and virus shedding period varied greatly. We therefore recommend rigorously testing contacts even during the no-symptom phase and consider whether viral shedding has ceased before stopping isolation measures for an individual.


title: COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study

text: BACKGROUND: To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic. METHODS: This multicentre cohort study involved 82 participating health-care institutions across 25 European countries, using a well established research network-the Paediatric Tuberculosis Network European Trials Group (ptbnet)-that mainly comprises paediatric infectious diseases specialists and paediatric pulmonologists. We included all individuals aged 18 years or younger with confirmed SARS-CoV-2 infection, detected at any anatomical site by RT-PCR, between April 1 and April 24, 2020, during the initial peak of the European COVID-19 pandemic. We explored factors associated with need for intensive care unit (ICU) admission and initiation of drug treatment for COVID-19 using univariable analysis, and applied multivariable logistic regression with backwards stepwise analysis to further explore those factors significantly associated with ICU admission. FINDINGS: 582 individuals with PCR-confirmed SARS-CoV-2 infection were included, with a median age of 5·0 years (IQR 0·5-12·0) and a sex ratio of 1·15 males per female. 145 (25%) had pre-existing medical conditions. 363 (62%) individuals were admitted to hospital. 48 (8%) individuals required ICU admission, 25 (4%) mechanical ventilation (median duration 7 days, IQR 2-11, range 1-34), 19 (3%) inotropic support, and one (<1%) extracorporeal membrane oxygenation. Significant risk factors for requiring ICU admission in multivariable analyses were being younger than 1 month (odds ratio 5·06, 95% CI 1·72-14·87; p=0·0035), male sex (2·12, 1·06-4·21; p=0·033), pre-existing medical conditions (3·27, 1·67-6·42; p=0·0015), and presence of lower respiratory tract infection signs or symptoms at presentation (10·46, 5·16-21·23; p<0·0001). The most frequently used drug with antiviral activity was hydroxychloroquine (40 [7%] patients), followed by remdesivir (17 [3%] patients), lopinavir-ritonavir (six [1%] patients), and oseltamivir (three [1%] patients). Immunomodulatory medication used included corticosteroids (22 [4%] patients), intravenous immunoglobulin (seven [1%] patients), tocilizumab (four [1%] patients), anakinra (three [1%] patients), and siltuximab (one [<1%] patient). Four children died (case-fatality rate 0·69%, 95% CI 0·20-1·82); at study end, the remaining 578 were alive and only 25 (4%) were still symptomatic or requiring respiratory support. INTERPRETATION: COVID-19 is generally a mild disease in children, including infants. However, a small proportion develop severe disease requiring ICU admission and prolonged ventilation, although fatal outcome is overall rare. The data also reflect the current uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs are urgently needed. FUNDING: ptbnet is supported by Deutsche Gesellschaft für Internationale Zusammenarbeit.


title: History repeating. The plague of 1630 in Milan and the COVID-19 pandemia

text: In western democracies, individual behaviour will be crucial to control the spread of COVID-19, as well as government actions [1] that unfortunately, except China, South Korea and Italy, followed by others, seems to be generally unconvinced and, speculatively, late. Indeed human history has been marked by epidemics/pandemics which have affected, more or less, large geographical areas [2]. Italy, as well as the rest of Europe, has often been affected by these phenomena and, Lombardy, due to his position, was, as today by COVID-19, severely stroked in Italy that is, after China, the second most affected country [3]. This is also linked to the position of Lombardy and its capital, Milan, but this is beyond this brief comment. There are several differences between the past plagues and the actual COVID-19 pandemic and these must be sought in the increased ability to transmit diseases at-distance through the mobility of humans and goods [4], and in the catastrophic consequences of the breakdown of ecosystems, as told, a few years ago, by David Quammen in the book Spillover [5].


title: Respiratory Muscle Performance Screening for Infectious Disease Management Following COVID-19: A Highly Pressurized Situation

text: The 2019-2020 coronavirus pandemic elucidated how a single highly infectious virus can overburden health care systems of even highly economically developed nations. A leading contributor to these concerning outcomes is a lack of available intensive care unit (ICU) beds and mechanical ventilation support. Poorer health is associated with a higher risk for severe respiratory complications from the coronavirus. We hypothesize that impaired respiratory muscle performance is an underappreciated factor contributing to poor outcomes unfolding during the coronavirus pandemic. Although impaired respiratory muscle performance is considered to be rare, it is more frequently encountered in patients with poorer health, in particular obesity. However, measures of respiratory muscle performance are not routinely performed in clinical practice, including those with symptoms such as dyspnea. The purpose of this article is to discuss the potential role of respiratory muscle performance from the perspective of the coronavirus pandemic. We also provide a theoretical patient management model to screen for impaired respiratory muscle performance and intervention, if identified, with the goal of unburdening health care systems during future pandemic crises.


Organ procurement and transplantation during the COVID-19 pandemic


Practice of novel method of bedside postpyloric tube placement in patients with coronavirus disease 2019


title: COVID-19 : physiopathologie d'une maladie à plusieurs visages./ [COVID-19: Pathogenesis of a multi-faceted disease]

text: SARS-CoV-2 infection, named COVID-19, can lead to a dysregulated immune response and abnormal coagulation responsible for a viral sepsis. In this review, we specify physiopathological mechanisms of each phase of COVID-19 - viral, immune and pro-thrombotic - notably because they involve different treatment. Finally, we specify the physiopathological mechanisms of organ injury.


title: New regulatory strategies to manage medicines shortages in Europe

text: Medicine shortages have been spreading in European countries. In many cases, the unavailability of medicinal products has a substantial impact on the capability of National Healthcare Systems in ensuring the continuity of care. Shortages originate from multifactorial causes. In particular, they can be due to supply-related factors (e.g., manufacturing issues, regulatory issues, logistics, distribution) and demand-related ones (e.g., fluctuating drug demand, parallel market, tendering, price and reimbursement policies). However, some extraordinary geopolitical events (e.g., Brexit) may also affect medicines' availability. The capability of European Regulatory Authorities and other stakeholders, which are involved in the pharmaceutical distribution chain and the healthcare assistance services, to define suitable problem-solving strategies has been limited for years by the fragmentation of the European regulatory framework, starting from the lack of a univocal definition of a medicine shortage. Only in 2019, the EMA and HMA joint task force released the first harmonized "shortage" definition in the European Economic Area (EEA) and guidance on public communication. This manuscript aims to review the current European regulatory framework on medicine shortages. To support the activities of regulators, manufacturers and other healthcare professionals, an algorithm was also proposed to be used as a harmonized procedure to determine the shortage/unavailability impact on public health and to rationalize the problem-solving strategies adopted in all different settings.


Detroit under siege, the enemy within: The impact of the COVID-19 collision


Potential Impact of Delay in Cancer Screening due to COVID-19


title: A Fast Algorithm for Geodesic Active Contours with Applications to Medical Image Segmentation

text: The geodesic active contour model (GAC) is a commonly used segmentation model for medical image segmentation. The level set method (LSM) is the most popular approach for solving the model, via implicitly representing the contour by a level set function. However, the LSM suffers from high computation burden and numerical instability, requiring additional regularization terms or re-initialization techniques. In this paper, we use characteristic functions to implicitly approximate the contours, propose a new representation to the GAC and derive an efficient algorithm termed as the iterative convolution-thresholding method (ICTM). Compared to the LSM, the ICTM is simpler and much more efficient and stable. In addition, the ICTM enjoys most desired features (e.g., topological changes) of the level set-based methods. Extensive experiments, on 2D synthetic, 2D ultrasound, 3D CT, and 3D MR images for nodule, organ and lesion segmentation, demonstrate that the ICTM not only obtains comparable or even better segmentation results (compared to the LSM) but also achieves dozens or hundreds of times acceleration.


People experiencing homelessness urgently need to be recognised as a high risk group for COVID-19


Differential Diagnosis and Clinical Management of a Case of COVID-19 in a Patient With Stage III Lung Cancer Treated With Radio-chemotherapy and Durvalumab


The determination of release from isolation of COVID-19 patients requires ultra-high sensitivity nucleic acid test technology


title: COVID-19. Immunothrombosis and the gastrointestinal tract

text: Mönkemüller et al. brilliantly describe the pathogenesis of SARS-CoV-2 (COVID-19) in the gastrointestinal tract. Their findings highlight the local and systemic inflammatory response generated by the coronavirus. After having the opportunity to observe three cases of severe colonic ischemia and elevation of D-dimer levels in patients with COVID-19 and severe acute respiratory distress syndrome (SARS) due to SARS-CoV-2, we would like to highlight the thromboembolic complications in COVID-19, which are related to those reported by Mönkemüller and which have been mentioned by other authors.


title: In silico evaluation of marine fish proteins as nutritional supplements for COVID-19 patients

text: To date, no specific drug has been discovered for the treatment of COVID-19 and hence, people are in a state of anxiety. Thus, there is an urgent need to search for various possible strategies including nutritional supplementation. In this study, we have tried to provide a reference for protein supplementation. Specifically, 20 marine fish proteins were subjected to in silico hydrolysis by gastrointestinal enzymes, and a large number of active peptides were generated. Then, the binding abilities of these peptides to SARS-CoV-2 main protease and monoamine oxidase A were assessed. The results showed that NADH dehydrogenase could be a good protein source in generating potent binders to the two enzymes, followed by cytochrome b. In addition, some high-affinity oligopeptides (VIQY, ICIY, PISQF, VISAW, AIPAW, and PVSQF) were identified as dual binders to the two enzymes. In summary, the supplementation of some fish proteins can be helpful for COVID-19 patients; the identified oligopeptides can be used as the lead compounds to design potential inhibitors against COVID-19 and anxiety.


title: Zoonotic risks of pathogens from sheep and their milk borne transmission

text: Sheep were domesticated around 9000 BC in the Middle East, and since then milk from sheep gradually became very popular, not only for drinking but also for making cheeses and other dairy products. Nowadays, these dairy products are also important for people with an allergy to cow milk, and these products are an essential part of the local daily diet in regions of the world that are not suitable for cows and goats. Consumption of raw milk and raw milk products has a zoonotic risk, and with regard to sheep, the main pathogens associated with such dairy products are: Brucella melitensis, Campylobacter spp., Listeria spp., Salmonella spp., Shiga-toxin producing Escherichia coli, Staphylococcus aureus, tick borne encephalitis virus, and Toxoplasma gondii. Especially, young children, elderly people, pregnant women and immunocompromised (YOPI) persons, and those suffering from disease should be aware of the risk of consuming raw milk and raw milk products. This latter risk can be reduced by proper flock health management, prevention of contamination during milking, adequate milk processing, transport, and refrigerated storage. Only processes equaling pasteurization sufficiently reduce zoonotic risks from milk and milk products, but proper cooling is essential and recontamination must be prevented. Therefore, strict hygiene practices throughout the production process and supply chain especially for raw milk and raw dairy products, should be applied. Small scale production systems pose a greater risk compared to industrialized production systems because of a less protocolized and controlled production process. This manuscript describes zoonotic risks of pathogens from sheep and their milk borne transmission. Additionally, routes of contamination, possibilities for multiplication, and prevention measures thereof are described. We summarize some major human outbreaks caused by consumption of sheep milk and products made thereof, and finally discuss their implications.


title: Molecular Investigation of SARS-CoV-2 Proteins and Their Interactions with Antiviral Drugs

text: A new Coronavirus strain, named SARS-CoV-2, suddenly emerged in early December 2019. SARS-CoV-2 resulted in being dramatically infectious, with thousands of people infected. In this scenario, and without effective vaccines available, the importance of an immediate tool to support patients and against viral diffusion becomes evident. In this study, we exploit the molecular docking approach to analyze the affinity between different viral proteins and several inhibitors, originally developed for other viral infections. Our data show that, in some cases, a relevant binding can be detected. These findings support the hypothesis to develop new antiviral agents against COVID-19, on the basis of already established therapies.


Editorial. COVID-19 and spinal surgery


Hyperglycemia, Hypertriglyceridemia, and Acute Pancreatitis in COVID-19 Infection: Clinical Implications


title: Hiding in Plain Sight: an Approach to Treating Patients with Severe COVID-19 Infection

text: Patients with COVID-19 infection are at risk of acute respiratory disease syndrome (ARDS) and death. The tissue receptor for COVID-19 is ACE2, and higher levels of ACE2 can protect against ARDS. Angiotensin receptor blockers and statins upregulate ACE2. Clinical trials are needed to determine whether this drug combination might be used to treat patients with severe COVID-19 infection.


title: Viral Etiology and Outcome of Severe Lower Respiratory Tract Infections among Critically Ill Children Admitted to the Picu

text: OBJECTIVE: To determine the viral etiology of severe lower respiratory tract infections (LRTIs), their clinical significance and prognosis among critically ill children. DESIGN: A prospective descriptive study was carried out. SETTING: Pediatric Intensive Care Unit (PICU) of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey. PATIENTS: A total of 115 patients hospitalized in the PICU were evaluated for inclusion in the study. Children with underlying comorbidities and those who did not require mechanical ventilation were excluded. MAIN VARIABLES OF INTEREST: Demographic, clinical, laboratory test and radiographic data were recorded. RESULTS: A total of 63 patients were eligible for the study. The most common diagnosis was bronchiolitis (57.1%). Respiratory syncytial virus (RSV) was the most frequent causal virus (36.5%). The most common complication was acute respiratory distress syndrome (ARDS) (28.6%). Multiple viral infection was identified in 20.6% of the patients, the most common in this subgroup being rhinovirus. Patients with bocavirus infection had a higher likelihood of needing invasive mechanical ventilation (IMV) at presentation. Children who died were likely to be < 12 months old, have ARDS, hepatitis, pneumomediastinum, multiple viral infection, and required IMV support with an increased duration of MV. Additionally, they were found to have a high Pediatric Risk of Mortality III score, Predicted Death Rate and increased need for inotropic support at admission. CONCLUSIONS: Our study showed critically ill children with LRTI without known risk factors to have high mortality when aged < 12 months, in the presence of multiple agents and when certain complications (ARDS, hepatitis) and X-ray findings were identified.


title: Comparative analysis of protein synthesis rate in COVID-19 with other human coronaviruses

text: The genetic code contains information that impacts the efficiency and rate of translation. Translation elongation plays a crucial role in determining the composition of the proteome, errors within a protein contributes towards disease processes. It is important to analyze the novel coronavirus (2019-nCoV) at the codon level to find similarities and variations in hosts to compare with other human coronavirus (CoVs). This requires a comparative and comprehensive study of various human and zoonotic nature CoVs relating to codon usage bias, relative synonymous codon usage (RSCU), proportions of slow codons, and slow di-codons, the effective number of codons (ENC), mutation bias, codon adaptation index (CAI), and codon frequencies. In this work, seven different CoVs were analyzed to determine the protein synthesis rate and the adaptation of these viruses to the host cell. The result reveals that the proportions of slow codons and slow di-codons in human host of 2019-nCoV and SARS-CoV found to be similar and very less compared to the other five coronavirus types, which suggest that the 2019-nCoV and SARS-CoV have faster protein synthesis rate. Zoonotic CoVs have high RSCU and codon adaptation index than human CoVs which implies the high translation rate in zoonotic viruses. All CoVs have more AT% than GC% in genetic codon compositions. The average ENC values of seven CoVs ranged between 38.36 and 49.55, which implies the CoVs are highly conserved and are easily adapted to host cells. The mutation rate of 2019-nCoV is comparatively less than MERS-CoV and NL63 that shows an evidence for genetic diversity. Host-specific codon composition analysis portrays the relation between viral host sequences and the capability of novel virus replication in host cells. Moreover, the analysis provides useful measures for evaluating a virus-host adaptation, transmission potential of novel viruses, and thus contributes to the strategies of anti-viral drug design.


title: Simulated Assessment of Pharmacokinetically Guided Dosing for Investigational Treatments of Pediatric Patients With Coronavirus Disease 2019

text: Importance: Children of all ages appear susceptible to severe acute respiratory syndrome coronavirus 2 infection. To support pediatric clinical studies for investigational treatments of coronavirus disease 2019 (COVID-19), pediatric-specific dosing is required. Objective: To define pediatric-specific dosing regimens for hydroxychloroquine and remdesivir for COVID-19 treatment. Design, Setting, and Participants: Pharmacokinetic modeling and simulation were used to extrapolate investigated adult dosages toward children (March 2020-April 2020). Physiologically based pharmacokinetic modeling was used to inform pediatric dosing for hydroxychloroquine. For remdesivir, pediatric dosages were derived using allometric-scaling with age-dependent exponents. Dosing simulations were conducted using simulated pediatric and adult participants based on the demographics of a white US population. Interventions: Simulated drug exposures following a 5-day course of hydroxychloroquine (400 mg every 12 hours × 2 doses followed by 200 mg every 12 hours × 8 doses) and a single 200-mg intravenous dose of remdesivir were computed for simulated adult participants. A simulation-based dose-ranging study was conducted in simulated children exploring different absolute and weight-normalized dosing strategies. Main Outcomes and Measures: The primary outcome for hydroxychloroquine was average unbound plasma concentrations for 5 treatment days. Additionally, unbound interstitial lung concentrations were simulated. For remdesivir, the primary outcome was plasma exposure (area under the curve, 0 to infinity) following single-dose administration. Results: For hydroxychloroquine, the physiologically based pharmacokinetic model analysis included 500 and 600 simulated white adult and pediatric participants, respectively, and supported weight-normalized dosing for children weighing less than 50 kg. Geometric mean-simulated average unbound plasma concentration values among children within different developmental age groups (32-35 ng/mL) were congruent to adults (32 ng/mL). Simulated unbound hydroxychloroquine concentrations in lung interstitial fluid mirrored those in unbound plasma and were notably lower than in vitro concentrations needed to mediate antiviral activity. For remdesivir, the analysis included 1000 and 6000 simulated adult and pediatric participants, respectively. The proposed pediatric dosing strategy supported weight-normalized dosing for participants weighing less than 60 kg. Geometric mean-simulated plasma area under the time curve 0 to infinity values among children within different developmental age-groups (4315-5027 ng × h/mL) were similar to adults (4398 ng × h/mL). Conclusions and Relevance: This analysis provides pediatric-specific dosing suggestions for hydroxychloroquine and remdesivir and raises concerns regarding hydroxychloroquine use for COVID-19 treatment because concentrations were less than those needed to mediate an antiviral effect.


Pedagogy in the time of COVID-19


SARS-CoV-2 and Bats: From Flight to Fighting COVID-19


title: The timeline and risk factors of clinical progression of COVID-19 in Shenzhen, China

text: BACKGROUND: The novel coronavirus disease 2019 (COVID-19) broke out globally. Early prediction of the clinical progression was essential but still unclear. We aimed to evaluate the timeline of COVID-19 development and analyze risk factors of disease progression. METHODS: In this retrospective study, we included 333 patients with laboratory-confirmed COVID-19 infection hospitalized in the Third People's Hospital of Shenzhen from 10 January to 10 February 2020. Epidemiological feature, clinical records, laboratory and radiology manifestations were collected and analyzed. 323 patients with mild-moderate symptoms on admission were observed to determine whether they exacerbated to severe-critically ill conditions (progressive group) or not (stable group). We used logistic regression to identify the risk factors associated with clinical progression. RESULTS: Of all the 333 patients, 70 (21.0%) patients progressed into severe-critically ill conditions during hospitalization and assigned to the progressive group, 253 (76.0%) patients belonged to the stable group, another 10 patients were severe before admission. we found that the clinical features of aged over 40 (3.80 [1.72, 8.52]), males (2.21 [1.20, 4.07]), with comorbidities (1.78 [1.13, 2.81]) certain exposure history (0.38 [0.20, 0.71]), abnormal radiology manifestations (3.56 [1.13, 11.40]), low level of T lymphocytes (0.99 [0.997, 0.999]), high level of NLR (0.99 [0.97, 1.01]), IL-6 (1.05 [1.03, 1.07]) and CRP (1.67 [1.12, 2.47]) were the risk factors of disease progression by logistic regression. CONCLUSIONS: The potential risk factors of males, older age, with comorbidities, low T lymphocyte level and high level of NLR, CRP, IL-6 can help to predict clinical progression of COVID-19 at an early stage.


Corona-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management


COVID-19 Response in Mid-Missouri


title: Global guidance for surgical care during the COVID-19 pandemic

text: BACKGROUND: Surgeons urgently need guidance on how to deliver surgical services safely and effectively during the COVID-19 pandemic. The aim was to identify the key domains that should be considered when developing pandemic preparedness plans for surgical services. METHODS: A scoping search was conducted to identify published articles relating to management of surgical patients during pandemics. Key informant interviews were conducted with surgeons and anaesthetists with direct experience of working during infectious disease outbreaks, in order to identify key challenges and solutions to delivering effective surgical services during the COVID-19 pandemic. RESULTS: Thirteen articles were identified from the scoping search, and surgeons and anaesthetists representing 11 territories were interviewed. To mount an effective response to COVID-19, a pandemic response plan for surgical services should be developed in advance. Key domains that should be included are: provision of staff training (such as patient transfers, donning and doffing personal protection equipment, recognizing and managing COVID-19 infection); support for the overall hospital response to COVID-19 (reduction in non-urgent activities such as clinics, endoscopy, non-urgent elective surgery); establishment of a team-based approach for running emergency services; and recognition and management of COVID-19 infection in patients treated as an emergency and those who have had surgery. A backlog of procedures after the end of the COVID-19 pandemic is inevitable, and hospitals should plan how to address this effectively to ensure that patients having elective treatment have the best possible outcomes. CONCLUSION: Hospitals should prepare detailed context-specific pandemic preparedness plans addressing the identified domains. Specific guidance should be updated continuously to reflect emerging evidence during the COVID-19 pandemic.


The insidious threat of jamu and unregulated traditional medicines in the COVID-19 era


Does intranasal naloxone administration increase the risk of 2019 coronavirus disease transmission?


title: Evidence Supporting Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 While Presymptomatic or Asymptomatic

text: Recent epidemiologic, virologic, and modeling reports support the possibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission from persons who are presymptomatic (SARS-CoV-2 detected before symptom onset) or asymptomatic (SARS-CoV-2 detected but symptoms never develop). SARS-CoV-2 transmission in the absence of symptoms reinforces the value of measures that prevent the spread of SARS-CoV-2 by infected persons who may not exhibit illness despite being infectious. Critical knowledge gaps include the relative incidence of asymptomatic and symptomatic SARS-CoV-2 infection, the public health interventions that prevent asymptomatic transmission, and the question of whether asymptomatic SARS-CoV-2 infection confers protective immunity.


title: Understanding the Socio-Economic Disruption in the United States during COVID-19's Early Days

text: In this paper, we collect and study Twitter communications to understand the socio-economic impact of COVID-19 in the United States during the early days of the pandemic. Our analysis reveals that COVID-19 gripped the nation during this time as is evidenced by the significant number of trending hashtags. With infections soaring rapidly, users took to Twitter asking people to self isolate and quarantine themselves. Users also demanded closure of schools, bars, and restaurants as well as lockdown of cities and states. The communications reveal the ensuing panic buying and the unavailability of some essential goods, in particular toilet paper. We also observe users express their frustration in their communications as the virus spread continued. We methodically collect a total of 530,206 tweets by identifying and tracking trending COVID-related hashtags. We then group the hashtags into six main categories, namely 1) General COVID, 2) Quarantine, 3) Panic Buying, 4) School Closures, 5) Lockdowns, and 6) Frustration and Hope, and study the temporal evolution of tweets in these hashtags. We conduct a linguistic analysis of words common to all the hashtag groups and specific to each hashtag group. Our preliminary study presents a succinct and aggregated picture of people's response to the pandemic and lays the groundwork for future fine-grained linguistic and behavioral analysis.


Management of elective aortic valve replacement over the long term in the era of COVID-19


Behavioral and Emotional Disorders in Children during the COVID-19 Epidemic


title: Informations relatives aux psychotropes et à leurs adaptations éventuelles pour les patients souffrant de troubles psychiques en France pendant l'épidémie à SARS-CoV-2./ [Informations on psychotropics and their adaptations for patients suffering from mental disorders in France during the SARS-CoV-2 epidemic]

text: The 2019-20 coronavirus pandemic (SARS-CoV-2; severe acute respiratory syndrome coronavirus 2) has dramatic consequences on populations in terms of morbidity and mortality and in social terms, the general confinement of almost half of the world's population being a situation unprecedented in history, which is difficult today to measure the impact at the individual and collective levels. More specifically, it affects people with various risk factors, which are more frequent in patients suffering from psychiatric disorders. Psychiatrists need to know: (i) how to identify, the risks associated with the prescription of psychotropic drugs and which can prove to be counterproductive in their association with COVID-19 (coronavirus disease 2019), (ii) how to assess in terms of benefit/risk ratio, the implication of any hasty and brutal modification on psychotropic drugs that can induce confusion for a differential diagnosis with the evolution of COVID-19. We carried out a review of the literature aimed at assessing the specific benefit/risk ratio of psychotropic treatments in patients suffering from COVID-19. Clinically, symptoms suggestive of COVID-19 (fever, cough, dyspnea, digestive signs) can be caused by various psychotropic drugs and require vigilance to avoid false negatives and false positives. In infected patients, psychotropic drugs should be used with caution, especially in the elderly, considering the pulmonary risk. Lithium and Clozapine, which are the reference drugs in bipolar disorder and resistant schizophrenia, warrant specific attention. For these two treatments the possibility of a reduction in the dosage - in case of minimal infectious signs and in a situation, which does not allow rapid control - should ideally be considered taking into account the clinical response (even biological; plasma concentrations) observed in the face of previous dose reductions. Tobacco is well identified for its effects as an inducer of CYP1A2 enzyme. In a COVID+ patient, the consequences of an abrupt cessation of smoking, particularly related with the appearance of respiratory symptoms (cough, dyspnea), must therefore be anticipated for patients receiving psychotropics metabolized by CYP1A2. Plasma concentrations of these drugs are expected to decrease and can be related to an increase risk of relapse. The symptomatic treatments used in COVID-19 have frequent interactions with the most used psychotropics. If there is no curative treatment for infection to SARS-CoV-2, the interactions of the various molecules currently tested with several classes of psychotropic drugs (antidepressants, antipsychotics) are important to consider because of the risk of changes in cardiac conduction. Specific knowledge on COVID-19 remains poor today, but we must recommend rigor in this context in the use of psychotropic drugs, to avoid adding, in patients suffering from psychiatric disorders, potentially vulnerable in the epidemic context, an iatrogenic risk or loss of efficiency.


COVID-19 Ventilatory Phenotypes and Obesity: Is There a Relationship?


The first case of COVID-19 infection in a 75-day-old infant in Jahrom City, south of Iran


title: Imaging & other potential predictors of deterioration in COVID-19

text: This case report describes a young patient with COVID-19 who is initially diagnosed with CT chest imaging. Upon admission to the hospital, his clinical condition deteriorates requiring ventilatory support. We explore the value of imaging and other potential predictors of deterioration.


Offline: COVID-19 and the ethics of memory


Contact lens wear during the COVID-19 pandemic


title: MEN2-related pheochromocytoma: current state of knowledge, specific characteristics in MEN2B, and perspectives

text: Multiple endocrine neoplasia type 2 (MEN2) is a rare hereditary syndrome due to mutations of the proto-oncogene REarranged during Transfection (RET), defined by the association of medullary thyroid carcinoma (MTC) in almost 100% cases, and pheochromocytoma in roughly 50% (primary hyperparathyroidism can be seen in 10-20% of patients with MEN2A). Early thyroidectomy and the efficacy of novel tyrosine kinase inhibitors modified the natural history of MTC, with possibilities of cure or long-term control. The second main compound, pheochromocytoma, is reported with a variable penetrance, from 10 to 80% cases, depending on the mutation of RET. Pheochromocytoma constitutes the main disease to screen in patients with RET mutations. Pheochromocytoma clinical and biochemical diagnosis, as well as the way to treat it are thus crucial. This review will thus focus on the epidemiological specificities of MEN2-related pheochromocytoma, the genotype/phenotype relationship, the modern imaging modalities necessary to confirm the diagnosis in this hereditary context, as well as the optimal management and the possibilities of adrenal sparing surgery. Additional information will include the natural history of MEN2B-pheochromocytoma, the rare cases of malignant pheochromocytoma, and the factors that could modify the penetrance between individuals carrying the same mutation, especially in the same family.


title: COVID-19 Delays Cancer Screenings

text: In recent months, the COVID-19 pandemic has caused many institutions to pause routine cancer screenings-delays that may not be problematic for patients but can create challenges for healthcare providers.


title: Rigidity of the Outer Shell Predicted by a Protein Intrinsic Disorder Model Sheds Light on the COVID-19 (Wuhan-2019-nCoV) Infectivity

text: The world is currently witnessing an outbreak of a new coronavirus spreading quickly across China and affecting at least 24 other countries With almost 65,000 infected, a worldwide death toll of at least 1370 (as of 14 February 2020), and with the potential to affect up to two-thirds of the world population, COVID-19 is considered by the World Health Organization (WHO) to be a global health emergency The speed of spread and infectivity of COVID-19 (also known as Wuhan-2019-nCoV) are dramatically exceeding those of the Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV) In fact, since September 2012, the WHO has been notified of 2494 laboratory-confirmed cases of infection with MERS-CoV, whereas the 2002–2003 epidemic of SARS affected 26 countries and resulted in more than 8000 cases Therefore, although SARS, MERS, and COVID-19 are all the result of coronaviral infections, the causes of the coronaviruses differ dramatically in their transmissibility It is likely that these differences in infectivity of coronaviruses can be attributed to the differences in the rigidity of their shells which can be evaluated using computational tools for predicting intrinsic disorder predisposition of the corresponding viral proteins


How well prepared are dermatologists redeployed to COVID-19 wards?


How China is planning to go to Mars amid the coronavirus outbreak


title: Preliminary study on exploring the trajectory of patients with COVID-19 by Data mining algorithms/ 中华医学科研管理杂志

text: Objective@#To explore data mining methods and tools for the activity paths of confirmed patients, and provide data analysis tools for epidemic control.@*Methods@#The data used came from the trajectory data of confirmed cases collected by Tencent. The jieba word segmentation and word cloud map function of Python 3.6 were used to calculate the high-frequency vocabulary in the trajectory of confirmed patients. The epidemic prevention and control strategy was developed based on the high-frequency vocabulary.@*Results@#Taking Guangdong Province, the second most confirmed patients in the country, as an example, the key areas of epidemic control obtained through data mining involve Wuhan (epidemiological history), Zhuhai and Guangzhou. The key control activities include family visiting, traveling and shopping. Means of transportation include self-driving, trains and airplanes; the key patients studied were Li and Ding; the symptoms of this patient group were mainly fever and cough.@*Conclusions@#The data mining algorithm in this paper can provide an advantageous tool for epidemic prevention and control, also assist frontline personnel to adjust the deployment of epidemic prevention and control according to their priorities.


title: Sequence mismatch in PCR probes may mask the COVID-19 detection in Nepal

text: â¢Most of the COVID-19 cases in Nepal are in the Southern districts of Nepal bordering India and many cases have travel history to India.â¢Very few positive cases of COVID-19 are detected in Nepal which could either be due to early national lockdown or inefficiency of PCR methods.â¢Whole genomes of 93 clinical samples from COVID-19 patients were analysed to find the primer and probe binding sites.â¢Mutations in probe binding sites were found and this could significantly impact PCR efficiency resulting in false negative results.


The quintuple penalty of obese patients in the COVID-19 pandemic


Iranian mental health during the COVID-19 epidemic


title: Potential impact of the COVID-19 pandemic on financial toxicity in cancer survivors

text: BACKGROUND: In the context of COVID-19, cancer survivors represent a particularly vulnerable population that may be "doubly hit" by both costs of cancer treatment and financial strain imposed by the pandemic. METHODS: We performed a review of the literature pertaining to cancer, financial toxicity, and economic challenges. RESULTS: Multiple societies have put forth recommendations to modify delivery of cancer care in order to minimize patient exposure to the virus. Cancer survivors, especially patients with head and neck cancer, have been disproportionately affected by rising unemployment levels and economic recessions in the past, both of which are linked to higher cancer mortality. Patients who rely on employer-provided insurance and do not qualify for Medicaid may lose access to life-saving treatments. CONCLUSIONS: It is essential to implement interventions and policy changes in order to mitigate the effects of this pandemic but also to ensure this becomes a nonissue during the next one.


COVID-19 and emergency surgery


title: Potential RNA-dependent RNA polymerase inhibitors as prospective therapeutics against SARS-CoV-2

text: Introduction. The emergence of SARS-CoV-2 has taken humanity off guard. Following an outbreak of SARS-CoV in 2002, and MERS-CoV about 10 years later, SARS-CoV-2 is the third coronavirus in less than 20 years to cross the species barrier and start spreading by human-to-human transmission. It is the most infectious of the three, currently causing the COVID-19 pandemic. No treatment has been approved for COVID-19. We previously proposed targets that can serve as binding sites for antiviral drugs for multiple coronaviruses, and here we set out to find current drugs that can be repurposed as COVID-19 therapeutics.Aim. To identify drugs against COVID-19, we performed an in silico virtual screen with the US Food and Drug Administration (FDA)-approved drugs targeting the RNA-dependent RNA polymerase (RdRP), a critical enzyme for coronavirus replication.Methodology. Initially, no RdRP structure of SARS-CoV-2 was available. We performed basic sequence and structural analysis to determine if RdRP from SARS-CoV was a suitable replacement. We performed molecular dynamics simulations to generate multiple starting conformations that were used for the in silico virtual screen. During this work, a structure of RdRP from SARS-CoV-2 became available and was also included in the in silico virtual screen.Results. The virtual screen identified several drugs predicted to bind in the conserved RNA tunnel of RdRP, where many of the proposed targets were located. Among these candidates, quinupristin is particularly interesting because it is expected to bind across the RNA tunnel, blocking access from both sides and suggesting that it has the potential to arrest viral replication by preventing viral RNA synthesis. Quinupristin is an antibiotic that has been in clinical use for two decades and is known to cause relatively minor side effects.Conclusion. Quinupristin represents a potential anti-SARS-CoV-2 therapeutic. At present, we have no evidence that this drug is effective against SARS-CoV-2 but expect that the biomedical community will expeditiously follow up on our in silico findings.


title: When are researchers willing to share their data? - Impacts of values and uncertainty on open data in academia

text: BACKGROUND: E-science technologies have significantly increased the availability of data. Research grant providers such as the European Union increasingly require open access publishing of research results and data. However, despite its significance to research, the adoption rate of open data technology remains low across all disciplines, especially in Europe where research has primarily focused on technical solutions (such as Zenodo or the Open Science Framework) or considered only parts of the issue. METHODS AND FINDINGS: In this study, we emphasized the non-technical factors perceived value and uncertainty factors in the context of academia, which impact researchers' acceptance of open data-the idea that researchers should not only publish their findings in the form of articles or reports, but also share the corresponding raw data sets. We present the results of a broad quantitative analysis including N = 995 researchers from 13 large to medium-sized universities in Germany. In order to test 11 hypotheses regarding researchers' intentions to share their data, as well as detect any hierarchical or disciplinary differences, we employed a structured equation model (SEM) following the partial least squares (PLS) modeling approach. CONCLUSIONS: Grounded in the value-based theory, this article proclaims that most individuals in academia embrace open data when the perceived advantages outweigh the disadvantages. Furthermore, uncertainty factors impact the perceived value (consisting of the perceived advantages and disadvantages) of sharing research data. We found that researchers' assumptions about effort required during the data preparation process were diminished by awareness of e-science technologies (such as Zenodo or the Open Science Framework), which also increased their tendency to perceive personal benefits via data exchange. Uncertainty factors seem to influence the intention to share data. Effects differ between disciplines and hierarchical levels.


title: Clinical characteristics and laboratory results of pregnant women with COVID-19 in Wuhan, China

text: OBJECTIVE: To evaluate the clinical characteristics and laboratory test results in pregnant women with coronavirus disease 2019 (COVID-19). METHODS: A retrospective study to review and compare clinical data including electronic medical records and laboratory tests from pregnant and nonpregnant patients admitted the Central Hospital of Wuhan, China from December 8, 2019 to April 1, 2020. RESULTS: A total of 72 women (30 pregnant and 42 nonpregnant) with COVID-19 were included. No patients developed severe pneumonia during the study. Compared with the nonpregnant group, pregnant patients were admitted to hospital earlier (0.25 vs 11.00 days; P<0.001), presented milder symptoms, had a higher rate of asymptomatic infection (26.7% vs 0%), and shorter length of hospital stay (14.5 vs 17.0 days; P<0.01). Laboratory test results showed that levels of inflammation markers such as white blood cell count, neutrophil count and percentage, C-reactive protein, procalcitonin, and D-dimer were significantly higher in pregnant women, whereas mean lymphocyte percentage was significantly lower compared with nonpregnant women. CONCLUSION: In some respects, the clinical characteristics and laboratory test results of COVID-19 in pregnant patients seems to be distinctive from their nonpregnant counterparts. Appropriate advice and positive treatment might be critical to the prognosis when dealing with these pregnant patients. Pregnant patients with COVID-19 had their own positive clinical characteristics and special laboratory test results. Responsive medical advice and active treatment for those patients are critical to recovery.


title: [Clinical characteristics of 30 medical workers infected with new coronavirus pneumonia]

text: Objective: To investigate the clinical characteristics of medical staff with novel coronavirus pneumonia(NCP). Methods: 30 patients infected with novel coronavirus referred to jianghan university hospital between January 11, 2020 and January 3, 2020 were studied. The data reviewed included those of clinical manifestations, laboratory investigation and Radiographic features. Results: The patients consisted of 10 men and 20 women, including 22 doctors and 8 nurses,aged 21~59 years(mean 35±8 years).They were divided to 26 common type and 4 severe cases, all of whom had close(within 1m) contact with patients infected of novel coronavirus pneumonia. The average contact times were 12 (7,16) and the average cumulative contact time was 2 (1.5,2.7) h.Clinical symptoms of these patients were fever in 23 patients (76.67%) , headache in 16 petients (53.33%) , fatigue or myalgia in 21patients (70%) , nausea, vomiting or diarrhea in 9 petients (30%) , cough in 25 petients (83.33%) , and dyspnea in 14 petients (46.67%) .Routine blood test revealed WBC <4.0×10(9)/L in 8 petients (26.67%) , (4-10) ×10(9)/L in 22 petients (73.33%) , and WBC>4.0×10(9)/L in 4 petients (13.33%) during the disease.Lymphocyte count <1.0×10(9)/L occurred in 12 petients (40%),abnormal liver function in 7 petients (23.33%) ,myocardial damage in 5 petients(16.67%), elevated D-dimer (>0.5mg/l) in 5 patients (16.67%). Compared with normal patients, the average exposure times, cumulative exposure time, BMI, Fever time, white blood cell count, liver enzyme, LDH, myoenzyme and D-dimer were significantly increased in severe patients, while the lymphocyte count and albumin levels in peripheral blood were significantly decreased.Chest CT mainly showed patchy shadows and interstitial changes.According to imaging examination, 11 patients (36.67%) showed Unilateral pneumonia and 19 patients (63.33%) showed bilateral pneumonia,4 patients (13.33%) showed bilateral multiple mottling and ground-glass opacity.Compared with the patients infected in the protected period, the proportion of severe infection and bilateral pneumonia were both increased in the patients infected in unprotected period. Conclusion: Medical staffs are at higher risk of infection.Infection rates are associated with contact time, the amount of suction virus. Severe patients had BMI increased, heating time prolonged , white blood cell count, lymphocyte count, D-dimer and albumin level significantly changed and were prone to be complicated with liver damage and myocardial damage.Strict protection measures is important to prevent infection for medical workers.


title: Immunology of COVID-19: mechanisms, clinical outcome, diagnostics and perspectives - a report of the European Academy of Allergy and Clinical Immunology (EAACI)

text: With the worldwide spread of the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) resulting in declaration of a pandemic by the World Health Organization (WHO) on March 11, 2020, the SARS-CoV-2-induced Coronavirus disease-19 (COVID-19) has become one of the main challenges of our times. The high infection rate and the severe disease course led to major safety and social restriction measures worldwide. There is an urgent need of unbiased expert knowledge guiding the development of efficient treatment and prevention strategies. This report summarizes current immunological data on mechanisms associated with the SARS-CoV-2 infection and COVID-19 development and progression to the most severe forms. We characterize the differences between adequate innate and adaptive immune response in mild disease and the deep immune dysfunction in the severe multi-organ disease. The similarities of the human immune response to SARS-CoV-2 and the SARS-CoV and MERS-CoV are underlined. We also summarize known and potential SARS-CoV-2 receptors on epithelial barriers, immune cells, endothelium and clinically involved organs such as lung, gut, kidney, cardiovascular and neuronal system. Finally, we discuss the known and potential mechanisms underlying the involvement of comorbidities, gender and age in development of COVID-19. Consequently, we highlight the knowledge gaps and urgent research requirements to provide a quick roadmap for ongoing and needed COVID-19 studies.


title: Gynecological surgeries during the COVID-19 pandemic in Turkey

text: Whilst urgent gynecological and oncologic operations have continued, the SARS-CoV-2 (COVID-19) pandemic has impacted patient management through postponement of elective surgeries.[1-5] Cohen et al.[6] suggested that during the pandemic each patient should be evaluated individually with added measures for the protection of both the patient and healthcare professionals. Therefore, we conducted a study evaluating patients' and hospital workers' health status during the pandemic in Turkey.


PPE guidance for covid-19: be honest about resource shortages


title: Blood type and outcomes in patients with COVID-19

text: This study aimed to determine if there is an association between ABO blood type and severity of COVID-19 defined by intubation or death as well as ascertain if there is variability in testing positive for COVID-19 between blood types. In a multi-institutional study, all adult patients who tested positive for COVID-19 across five hospitals were identified and included from March 6th to April 16th, 2020. Hospitalization, intubation, and death were evaluated for association with blood type. Univariate analysis was conducted using standard techniques and logistic regression was used to determine the independent effect of blood type on intubation and/or death and positive testing. During the study period, there were 7648 patients who received COVID-19 testing throughout the institutions. Of these, 1289 tested positive with a known blood type. A total of 484 (37.5%) were admitted to hospital, 123 (9.5%) were admitted to the ICU, 108 (8.4%) were intubated, 3 (0.2%) required ECMO, and 89 (6.9%) died. Of the 1289 patients who tested positive, 440 (34.2%) were blood type A, 201 (15.6%) were blood type B, 61 (4.7%) were blood type AB, and 587 (45.5%) were blood type O. On univariate analysis, there was no association between blood type and any of the peak inflammatory markers (peak WBC, p = 0.25; peak LDH, p = 0.40; peak ESR, p = 0.16; peak CRP, p = 0.14) nor between blood type and any of the clinical outcomes of severity (admission p = 0.20, ICU admission p = 0.94, intubation p = 0.93, proning while intubated p = 0.58, ECMO p = 0.09, and death p = 0.49). After multivariable analysis, blood type was not independently associated with risk of intubation or death (referent blood type A; blood type B: AOR: 0.72, 95% CI: 0.42-1.26, blood type AB: AOR: 0.78, CI: 0.33-1.87, blood type O: AOR: 0.77, CI: 0.51-1.16), rhesus factor positive (Rh+): AOR: 1.03, CI: 0.93-1.86. Blood type A had no correlation with positive testing (AOR: 1.00, CI: 0.88-1.13), blood type B was associated with higher odds of testing positive for disease (AOR: 1.28, CI: 1.08-1.52), AB was also associated with higher odds of testing positive (AOR: 1.37, CI: 1.02-1.83), and O was associated with a lower risk of testing positive (AOR: 0.84, CI: 0.75-0.95). Rh+ status was associated with higher odds of testing positive (AOR: 1.23, CI: 1.003-1.50). Blood type was not associated with risk of intubation or death in patients with COVID-19. Patients with blood types B and AB who received a test were more likely to test positive and blood type O was less likely to test positive. Rh+ patients were more likely to test positive.


title: Buscas na internet sobre medidas de enfrentamento à COVID-19 no Brasil: descrição de pesquisas realizadas nos primeiros 100 dias de 2020./ Buscas na internet sobre medidas de enfrentamento à COVID-19 no Brasil: descrição de pesquisas realizadas nos primeiros 100 dias de 2020./ Internet searches for measures to address COVID-19 in Brazil: a description of searches in the first 100 days of 2020

text: OBJECTIVE: to describe profiles of interest of web search queries related to the Covid-19 epidemic in Brazil. METHODS: this was a quantitative and exploratory study using Google Health Trends. We analyzed daily data of interest, defined as search probability (Pr), in 23 terms in searches performed by users connected in Brazil from January 1 to April 9, 2020. RESULTS: the peak in interest (Pr=0.0651) on the theme of coronavirus occurred on March 21. Interest in use of face masks (Pr=0.0041), social distancing (Pr=0.0043) and hand hygiene with alcohol gel (Pr=0.0037) was greater than interest in respiratory etiquette (Pr=0.0010) and hand hygiene with soap and water (Pr=0.0005). CONCLUSION: the difference in interest in issues related to combating Covid-19 was substantial and can guide new strategies for disseminating health information.


title: Buscas na internet sobre medidas de enfrentamento à COVID-19 no Brasil: descrição de pesquisas realizadas nos primeiros 100 dias de 2020

text: OBJECTIVE: to describe profiles of interest of web search queries related to the Covid-19 epidemic in Brazil METHODS: this was a quantitative and exploratory study using Google Health Trends We analyzed daily data of interest, defined as search probability (Pr), in 23 terms in searches performed by users connected in Brazil from January 1 to April 9, 2020 RESULTS: the peak in interest (Pr=0 0651) on the theme of coronavirus occurred on March 21 Interest in use of face masks (Pr=0 0041), social distancing (Pr=0 0043) and hand hygiene with alcohol gel (Pr=0 0037) was greater than interest in respiratory etiquette (Pr=0 0010) and hand hygiene with soap and water (Pr=0 0005) CONCLUSION: the difference in interest in issues related to combating Covid-19 was substantial and can guide new strategies for disseminating health information


Demand-capacity modelling and COVID-19 disease: identifying themes for future NHS planning


La maldita pandemia: una oportunidad para la Atención Primaria de Salud./ [The damn pandemic: An opportunity for Primary Health Care]


COVID-19 battle during the toughest sanctions against Iran


title: Marine Predators Algorithm for Forecasting Confirmed Cases of COVID-19 in Italy, USA, Iran and Korea

text: The current pandemic of the new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, has received wide attention by scholars and researchers. The vast increase in infected people is a significant challenge for each country and the international community in general. The prediction and forecasting of the number of infected people (so-called confirmed cases) is a critical issue that helps in understanding the fast spread of COVID-19. Therefore, in this article, we present an improved version of the ANFIS (adaptive neuro-fuzzy inference system) model to forecast the number of infected people in four countries, Italy, Iran, Korea, and the USA. The improved version of ANFIS is based on a new nature-inspired optimizer, called the marine predators algorithm (MPA). The MPA is utilized to optimize the ANFIS parameters, enhancing its forecasting performance. Official datasets of the four countries are used to evaluate the proposed MPA-ANFIS. Moreover, we compare MPA-ANFIS to several previous methods to evaluate its forecasting performance. Overall, the outcomes show that MPA-ANFIS outperforms all compared methods in almost all performance measures, such as Root Mean Squared Error (RMSE), Mean Absolute Error (MAE), Mean Absolute Percentage Error (MAPE), Root Mean Squared Relative Error (RMSRE), and Coefficient of Determination( R 2 ). For instance, according to the results of the testing set, the R 2 of the proposed model is 96.48%, 98.59%, 98.74%, and 95.95% for Korea, Italy, Iran, and the USA, respectively. More so, the MAE is 60.31, 3951.94, 217.27, and 12,979, for Korea, Italy, Iran, and the USA, respectively.


title: Experimental, ad hoc, online, inter-university student e-contest during the pandemic: Lessons learned

text: We are reporting on lessons learned from an e-contest for students held during the current pandemic. We compare the e-contest with the 10 previous editions of the same but face-to-face contest. While apparently the competition did not suffer because of being a virtual one, some disadvantages were noted. The main conclusions are: the basic interconnectivity means arise no serious technical issue, but the interconnectivity is more limited than the face-to-face one; online jury-competitors interactivity is poorer than face-to-face interactivity; human factors, higher uncertainties in the organization process, and less time to spend in the process for the local organizers are major limiting factors; concerns on the participation and evaluation fairness are higher; involuntary gender discrimination seems lower, but persists; there are serious concerns related to privacy, including differential privacy; some peculiarities of the presented topics and of the evaluation process emerged, but it is unclear if they are related to the online nature of the competition, to the extra stress on the participants during the pandemic, to other factors, or are random. While some conclusions may be intimately related to the analyzed case, some are general enough for being worth to other online competitions.


title: Health Communication Through News Media During the Early Stage of the COVID-19 Outbreak in China: Digital Topic Modeling Approach

text: BACKGROUND: In December 2019, a few coronavirus disease (COVID-19) cases were first reported in Wuhan, Hubei, China. Soon after, increasing numbers of cases were detected in other parts of China, eventually leading to a disease outbreak in China. As this dreadful disease spreads rapidly, the mass media has been active in community education on COVID-19 by delivering health information about this novel coronavirus, such as its pathogenesis, spread, prevention, and containment. OBJECTIVE: The aim of this study was to collect media reports on COVID-19 and investigate the patterns of media-directed health communications as well as the role of the media in this ongoing COVID-19 crisis in China. METHODS: We adopted the WiseSearch database to extract related news articles about the coronavirus from major press media between January 1, 2020, and February 20, 2020. We then sorted and analyzed the data using Python software and Python package Jieba. We sought a suitable topic number with evidence of the coherence number. We operated latent Dirichlet allocation topic modeling with a suitable topic number and generated corresponding keywords and topic names. We then divided these topics into different themes by plotting them into a 2D plane via multidimensional scaling. RESULTS: After removing duplications and irrelevant reports, our search identified 7791 relevant news reports. We listed the number of articles published per day. According to the coherence value, we chose 20 as the number of topics and generated the topics' themes and keywords. These topics were categorized into nine main primary themes based on the topic visualization figure. The top three most popular themes were prevention and control procedures, medical treatment and research, and global or local social and economic influences, accounting for 32.57% (n=2538), 16.08% (n=1258), and 11.79% (n=919) of the collected reports, respectively. CONCLUSIONS: Topic modeling of news articles can produce useful information about the significance of mass media for early health communication. Comparing the number of articles for each day and the outbreak development, we noted that mass media news reports in China lagged behind the development of COVID-19. The major themes accounted for around half the content and tended to focus on the larger society rather than on individuals. The COVID-19 crisis has become a worldwide issue, and society has become concerned about donations and support as well as mental health among others. We recommend that future work addresses the mass media's actual impact on readers during the COVID-19 crisis through sentiment analysis of news data.


title: Covid-19 induced superimposed bacterial infection

text: Viral respiratory infections are very common and they are frequently eliminated from the body without any detrimental consequences. Secondary serious bacterial infection has been an apprehension expressed by health care providers, and this fear has been exacerbated in the era of Covid-19. Several published studies have shown an association between Covid-19 illness and secondary bacterial infection. However, the proposed mechanism by which a virus can develop a secondary bacterial infection is not well delineated. The aim of this commentary is to update the current evidence of the risk of bacterial infection in patients with Covid-19. We present several clinical studies related to the topic as well as a brief review of the potential pathophysiology of secondary infections that could present with Covid-19.Communicated by Ramaswamy H. Sarma.


Maintaining a Viable Donor Milk Supply During the SARS-CoV-2 (COVID-19) Pandemic


Coronavirus lockdown: What I learnt when I shut my cancer lab in 48 hours


Stopping lopinavir/ritonavir in COVID-19 patients: duration of the drug interacting effect


title: Occupational health responses to COVID-19: What lessons can we learn from SARS?

text: On 31 December 2019, the World Health Organization (WHO) received reports of pneumonia cases of unknown etiology in the city of Wuhan in Hubei Province, China. The agent responsible was subsequently identified as a coronavirus-SARS-CoV-2. The WHO declared this disease as a Public Health Emergency of International Concern at the end of January 2020. This event evoked a sense of déjà vu, as it has many similarities to the outbreak of severe acute respiratory syndrome (SARS) of 2002-2003. Both illnesses were caused by a zoonotic novel coronavirus, both originated during winter in China and both spread rapidly all over the world. However, the case-fatality rate of SARS (9.6%) is higher than that of COVID-19 (<4%). Another zoonotic novel coronavirus, MERS-CoV, was responsible for the Middle East respiratory syndrome, which had a case-fatality rate of 34%. Our experiences in coping with the previous coronavirus outbreaks have better equipped us to face the challenges posed by COVID-19, especially in the health care setting. Among the insights gained from the past outbreaks were: outbreaks caused by viruses are hazardous to healthcare workers; the impact of the disease extends beyond the infection; general principles of prevention and control are effective in containing the disease; the disease poses both a public health as well as an occupational health threat; and emerging infectious diseases pose a continuing threat to the world. Given the perspectives gained and lessons learnt from these past events, we should be better prepared to face the current COVID-19 outbreak.


title: Decision Support Algorithm for Selecting an Antivirus Mask over COVID-19 Pandemic under Spherical Normal Fuzzy Environment

text: With the rapid outbreak of COVID-19, most people are facing antivirus mask shortages. Therefore, it is necessary to reasonably select antivirus masks and optimize the use of them for everyone. However, the uncertainty of the effects of COVID-19 and limits of human cognition add to the difficulty for decision makers to perfectly realize the purpose. To maximize the utility of the antivirus mask, we proposed a decision support algorithm based on the novel concept of the spherical normal fuzzy (SpNoF) set. In it, firstly, we analyzed the new score and accuracy function, improved operational rules, and their properties. Then, in line with these operations, we developed the SpNoF Bonferroni mean operator and the weighted Bonferroni mean operator, some properties of which are also examined. Furthermore, we established a multi-criteria decision-making method, based on the proposed operators, with SpNoF information. Finally, a numerical example on antivirus mask selection over the COVID-19 pandemic was given to verify the practicability of the proposed method, which the sensitive and comparative analysis was based on and was conducted to demonstrate the availability and superiority of our method.


title: Antirheumatic drugs for COVID-19 treatment based on the phases of the disease: Current concept

text: COVID-19 disease is the most recent pandemic, since it has affected more than four and a half million people and caused more than 300,000 deaths. It is a very complex systemic disease in terms of pathogenesis, treatment, and prognosis. Pharmacological treatment may include antiviral and antimalarial drugs, antibiotics, monoclonal antibodies, corticosteroids as well as low-molecular-weight heparins to prevent the evolution of the disease from reaching the severe inflammatory phase that can lead to respiratory complications, multiple organ failure, disseminated intravascular coagulation (DIC), and finally death. Therefore, pending the development of the much sought-after vaccine, there needs to be a multidisciplinary approach to tackling this disease, and it is essential to use different medical treatments at the correct pathogenic moment. The aim of this article is to evaluate the rationale and reason behind the use of antirheumatic drugs, by expert point of view, in the various phases of the disease. Another important aspect in the management of the disease is to identify patients at high risk, both to change their lifestyle and to correct the state of their health through non-pharmacological measures for improving their immuno-balance. Our literature review reveals the important role and the therapeutic potential of antirheumatic agents in preventing the progression of the disease and aiding recovery from the disease. However, there is a lack of clinical evidence to support the use of these agents, indicating that further randomized controlled studies are required.


title: Impact of COVID-19 in spanish urology residents: Recommendations and perspective

text: The COVID-19 pandemic has seriously disrupted the day-to-day running of hospitals, affecting the activity of all medical and surgical departments It has also affected urology residents, depriving them of training at their usual workplaces and forcing them to support COVID units This has implied not only the loss of daily activities, but also the uncertainty of job opportunities for the final year residents In addition, the cancellation of numerous events such as congresses, exams,or courses has affected the annual planning of the specialty A review of the current literature on the impact of the COVID-19 pandemic, as well as the de-escalation process, on resident training has been carried out using web search and PubMed The situation of the residents has been analyzed, both through the information generated by recent literature and by the personal experience of the authors, from different areas: evaluation systems, educational and surgical aspects, as well as healthcare work As a result of this review, the negative impact of the crisison urology resident training can be observed, especially in the surgical field, but new learning opportunities or new forms of communication with the patient can also be observed These educational and healthcare resources invite the urology resident in particular, and the medical society in general, to reinvent themselves The aim of this article is to analyse the training of the urology resident in the de-escalation phase Similarly, the emerging educational resources during the pandemic are synthesized, inviting the reader, and especially the urology resident, to continue their training and learningin these times of uncertainty


From One Technologist to Another-COVID-19 Questions Answered


title: Potential neurological effects of severe COVID-19 infection

text: Coronaviruses (CoVs) are large positive stranded enveloped RNA viruses that generally cause enteric and respiratory diseases in humans and in animals. Most human CoVs have recently attracted global attention to their lethal potential and great infectious capacity. A highly pathogenic CoV, called COVID-19 or SARS-CoV-2, dramatically emerged in December 2019 in Wuhan, China. This new CoV has caused severe pneumonia in China and rapidly spreads around the world, the COVID-19 pandemic. Growing evidence pieces show that viruses, such as CoVs, can enter the central nervous system from different pathways and inducing neurotoxicity. Therefore, it is urgent to make clear whether SARS-CoV-2 has access to the central nervous system and can cause direct neuronal effects. Moreover, a brain-lung-brain axis is been proposed from the scientific community where severe neurological dysfunction and injury are associated with lung injury, and vice versa. In this axis, virus-induced inflammation and oxidative stress could be the common mechanisms responsible for CoV neurological symptoms. Therefore, is important to make clear whether SARS-CoV-2 lung damage can cause direct or indirect neuronal effects.


title: Breathing Is Enough: For the Spread of Influenza Virus and SARS-CoV-2 by Breathing Only

text: Background: The transmission of respiratory viruses such as influenza and corona viruses from one person to another is still not fully understood. Methods: A literature search showed that there is a strong scientific rationale and evidence that viruses are very efficiently spread through aerosols by the patient's breathing only. It is not necessary for the patient to cough or sneeze. Results: The exhaled aerosol particles are generated by normal breathing in the deep lung through reopening of collapsed small airways during inspiration. These mucus/surfactant aerosols (size range between 0.2 and 0.6 µm) can transport viruses out of the lungs of patients and be present in the room air for hours. Conclusion: These aerosol particles are difficult to filter out of the air; because of their physical properties, new strategies must be developed to protect people from these virus aerosols.


title: Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) has produced a significant health burden worldwide, especially in patients with cardiovascular comorbidities. The aim of this systematic review and meta-analysis was to assess the impact of underlying cardiovascular comorbidities and acute cardiac injury on in-hospital mortality risk. METHODS: PubMed, Embase and Web of Science were searched for publications that reported the relationship of underlying cardiovascular disease (CVD), hypertension and myocardial injury with in-hospital fatal outcomes in patients with COVID-19. The ORs were extracted and pooled. Subgroup and sensitivity analyses were performed to explore the potential sources of heterogeneity. RESULTS: A total of 10 studies were enrolled in this meta-analysis, including eight studies for CVD, seven for hypertension and eight for acute cardiac injury. The presence of CVD and hypertension was associated with higher odds of in-hospital mortality (unadjusted OR 4.85, 95% CI 3.07 to 7.70; I2=29%; unadjusted OR 3.67, 95% CI 2.31 to 5.83; I2=57%, respectively). Acute cardiac injury was also associated with a higher unadjusted odds of 21.15 (95% CI 10.19 to 43.94; I2=71%). CONCLUSION: COVID-19 patients with underlying cardiovascular comorbidities, including CVD and hypertension, may face a greater risk of fatal outcomes. Acute cardiac injury may act as a marker of mortality risk. Given the unadjusted results of our meta-analysis, future research are warranted.


Sample sizes in COVID-19-related research


title: Exploring the ways in which COVID-19 and lockdown has affected the lives of adult patients with anorexia nervosa and their carers

text: OBJECTIVE: This qualitative study explores the ways in which the coronavirus disease 2019 (COVID-19) pandemic and associated lockdown measures have affected the lives of adult patients with anorexia nervosa (AN) and their carers. METHOD: Semi-structured interviews were conducted with patients with AN (n = 21) and carers (n = 28) from the start of UK Government imposed lockdown. Data related directly to the impact of lockdown and COVID-19 were analysed using thematic analysis. RESULTS: Four broad themes were identified for patients and carers separately. Patients experienced: 1. reduced access to eating disorder (ED) services; 2. disruption to routine and activities in the community; 3. heightened psychological distress and ED symptoms; 4. increased attempts at self-management in recovery. Carer themes included: 1. concern over provision of professional support for patients; 2. increased practical demands placed on carers in lockdown; 3. managing new challenges around patient wellbeing; 4. new opportunities. CONCLUSIONS: Reduced access to ED services, loss of routine and heightened anxieties and ED symptoms resulting from COVID-19 and lockdown measures presented challenges for patients and carers. Increased remote support by ED services enabled the continuation of treatment and self-management resources and strategies promoted self-efficacy in both groups.


title: A novel horizontal subsurface flow constructed wetland planted with Typha angustifolia for treatment of polluted water

text: Rapid population growth and urbanization has put a lot of stress on existing water bodies in most developing countries such as the Marriott Lake of Egypt. Three constructed wetland configurations including Typha angustifolia planted with enhanced atmospheric aeration by using perforated pipes networks (CWA), planted without perforated pipe network (CWR), and a control non-planted and without perforated pipes wetland (Control) were used in the study. Changes in physicochemical properties and microbial community over four seasons and hydraulic loading rate (HLR) (50, 100, 200, 300, and 400 L day-1 m-1) were monitored using influent from Marriott Lake in Egypt. Overall, the removal performance followed the sequence CWA>CWR>control. Turbidity removal of 98.4%; biochemical oxygen demand (BOD5) removal of 83.3%; chemical oxygen demand (COD) removal of 95.8%; NH3-N removal of 99.9%; total nitrogen (TN) removal of 94.7%; NO3--N and NO2--N increased; total P (TP) removal of 99.7%, Vibrio sp. of 100%, Escherichia coli 100%; total bacterial count of 92.3%; and anaerobic bacteria reduction of 97.5% were achieved by using CWA. Seasonal variation and variation in HLRs had significant effect on performance. The modified planted CWA system enhances the removal of pollutants and could present a novel route for reducing the cost associated with integrating artificial aeration into wetlands.


title: A framework for the systematic consideration of ethics, equity, feasibility, and acceptability in vaccine program recommendations

text: For the successful implementation of population-level recommendations, it is critical to consider the full spectrum of public health science, including clinical and programmatic factors. Current frameworks may identify various factors that should be examined when making evidence-informed vaccine-related recommendations. However, while most immunization guidelines systematically assess clinical factors, such as efficacy and safety of vaccines, there is no published framework outlining how to systematically assess programmatic factors, such as the ethics, equity, feasibility, and acceptability of recommendations. We have addressed this gap with the development of the EEFA (Ethics, Equity Feasibility, Acceptability) Framework, supported by evidence-informed tools, including Ethics Integrated Filters, Equity Matrix, Feasibility Matrix, and an Acceptability Matrix. The Framework and tools are based on five years of environmental scans, systematic reviews and surveys, and refined by expert and stakeholder consultations and feedback. For each programmatic factor, the EEFA Framework summarizes the minimum threshold for consideration and when further in-depth analysis may be required, which aspects of the factor should be considered, how to assess the factor using the supporting evidence-informed tools, and who should be consulted to complete the assessment. Research, particularly in the fields of vaccine acceptability and equity, has validated the utility and comprehensiveness of the tools. The Framework has been successfully used in Canada for clear, timely, transparent vaccine guidance with positive stakeholder feedback on its comprehensiveness, relevance and appropriateness. Applying the EEFA Framework allows for the systematic consideration of the spectrum of public health science without a delay in recommendations, complementing existing decision-making frameworks. This Framework will therefore be useful for advisory groups worldwide to integrate critical factors that could impact the successful and timely implementation of comprehensive, transparent recommendations, and will further the global objective of developing practical and evidence-informed immunization policies.


title: Structure-Based Stabilization of Non-native Protein-Protein Interactions of Coronavirus Nucleocapsid Proteins in Antiviral Drug Design

text: Structure-based stabilization of protein-protein interactions (PPIs) is a promising strategy for drug discovery. However, this approach has mainly focused on the stabilization of native PPIs, and non-native PPIs have received little consideration. Here, we identified a non-native interaction interface on the three-dimensional dimeric structure of the N-terminal domain of the MERS-CoV nucleocapsid protein (MERS-CoV N-NTD). The interface formed a conserved hydrophobic cavity suitable for targeted drug screening. By considering the hydrophobic complementarity during the virtual screening step, we identified 5-benzyloxygramine as a new N protein PPI orthosteric stabilizer that exhibits both antiviral and N-NTD protein-stabilizing activities. X-ray crystallography and small-angle X-ray scattering showed that 5-benzyloxygramine stabilizes the N-NTD dimers through simultaneous hydrophobic interactions with both partners, resulting in abnormal N protein oligomerization that was further confirmed in the cell. This unique approach based on the identification and stabilization of non-native PPIs of N protein could be applied toward drug discovery against CoV diseases.


Immune Thrombocytopenia (ITP) in a SARS-CoV-2 Positive Pediatric Patient


title: Interplay of social distancing and border restrictions for pandemics (COVID-19) via the epidemic Renormalisation Group framework

text: We demonstrate that the epidemic renormalisation group approach to pandemics provides an effective and simple way to investigate the dynamics of disease transmission and spreading across different regions of the world. The framework also allows for reliable projections on the impact of travel limitations and social distancing measures on global epidemic spread. We test and calibrate it on reported cases while unveiling the mechanism that governs the delay in the relative peaks of newly infected cases among different regions of the globe. We discover that social distancing measures are more effective than travel limitations across borders in delaying the epidemic peak. We further provide the link to compartmental models such as the simplistic and time-honoured SIR-like models. We also show how to generalise the framework to account for the interactions across several regions of the world, replacing or complementing large scale simulations.


The solitary confinement of incarcerated American youth during COVID-19


title: Guidance on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period (First Edition)/ 中华实用儿科临床杂志

text: Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.


title: Critical Care Transesophageal Echocardiography in Patients during the COVID-19 Pandemic

text: BACKGROUND: The COVID-19 pandemic has placed an extraordinary strain on healthcare systems across North America. Defining the optimal approach for managing a critically ill COVID-19 patient is rapidly changing. Goal-directed transesophageal echocardiography (TEE) is frequently used by physicians caring for intubated critically ill patients as a reliable imaging modality that is well suited to answer questions at bedside. METHODS: A multidisciplinary (intensive care, critical care cardiology, and emergency medicine) group of experts in point-of-care echocardiography and TEE from the United States and Canada convened to review the available evidence, share experiences, and produce a consensus statement aiming to provide clinicians with a framework to maximize the safety of patients and healthcare providers when considering focused point-of-care TEE in critically ill patients during the COVID-19 pandemic. RESULTS: Although transthoracic echocardiography can provide the information needed in most patients, there are specific scenarios in which TEE represents the modality of choice. TEE provides acute care clinicians with a goal-directed framework to guide clinical care and represents an ideal modality to evaluate hemodynamic instability during prone ventilation, perform serial evaluations of the lungs, support cardiac arrest resuscitation, and guide veno-venous ECMO cannulation. To aid other clinicians in performing TEE during the COVID-19 pandemic, we describe a set of principles and practical aspects for performing examinations with a focus on the logistics, personnel, and equipment required before, during, and after an examination. CONCLUSIONS: In the right clinical scenario, TEE is a tool that can provide the information needed to deliver the best and safest possible care for the critically ill patients.


title: Epidemic characteristics of COVID-19 in four Chinese cities

text: In December 2019, there was an outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China. The number of patients in China has risen to 31,000. We collected patient data from four Chinese cities (Hefei, Hangzhou, Wenzhou, Shenzhen) and described epidemiologic characteristics. As of 6 February 2020, we extracted data from 950 patients from the four cities. There were 477 (50.21%) males and 473 (49.79%) females of age (mean ± SD) 45.64 ± 15.59 years. Before contracting COVID-19, 299 patients had contact with Wuhan residents or contact with patients diagnosed with COVID-19 (31.47%). Also, 138 patients had SARS-CoV-2 infection of unknown source (14.53%). COVID-19 patients in the four cities were mainly from Wuhan originally, and had spread infection locally. Therefore, the initial stage of SARS-CoV-2 transmission in cities outside Wuhan were mainly input. Cutting off input and controlling community communication would reduce local incidence.


title: The First Reactive Arthritis Case Associated with COVID-19

text: Novel coronavirus disease 2019 (COVID-19) arised from Wuhan Province in China in December 2019, has quickly become a global public health emergency. The first confirmed COVID-19 patient in Turkey was reported on 11th March 2020. A 73-year-old man with diabetes mellitus, hypertension and coronary heart disease presented to emergency department with a history of fever, weakness, and dry cough for one week. Nasopharyngeal and oropharyngeal swabs were positive for COVID-19. He was treated with ceftriaxone, hidroxychloroquine and azitromycin Severeal days after completion of COVID-19 treatment, asymetric oligoarticular arthritis in his lower extremities were developed. In the course of time, clinicians all over the world experienced several different forms of COVID-19. In this case, we report the first reactive artrhritis associated with COVID-19 infection. This article is protected by copyright. All rights reserved.


Coronavirus Disease 2019 (COVID-19) Imaging Austerity: Coming Back From the Pandemic


A dermatologist's perspective of the COVID-19 outbreak


COVID-19 in lung cancer patients receiving ALK/ROS1 inhibitors


title: Clinical ethics during the Covid-19 pandemic: Missing the trees for the forest

text: The SARS-CoV2 pandemic has exposed the acute vulnerability of the health systems of countries worldwide. While countries are scrambling to contain the spread of the infection, the focus is largely on infection prevention strategies such as isolation, quarantine, physical distancing, hand hygiene, cough etiquette and country-wide lock-down. Important ethical concerns arise in the context of the public health interventions. However, while focusing on the forest, the population, attention must also be paid to the trees, the individuals who suffer the illness. This article focuses on the ethical conflicts between the largely public health- driven focus of the Covid19 prevention and containment measures versus patient-centred care for those who suffer the illness and the consequent moral distress of healthcare providers. The key argument is for countries to mainstream clinical ethics considerations for care of patients with Covid-19 as well as "non-Covid-19" illnesses. Keywords: SARS-CoV2, Covid 19, clinical ethics, duty to care, allocation of scarce resources, moral distress.