title: Sensitivity of different RT-qPCR solutions for SARS-CoV-2 detection

text: Objectives: The ongoing COVID-19 pandemic continues imposing a demand for diagnostic screening. In anticipation that the recurrence of outbreaks and the measures for lifting the lockdown worldwide may cause supply chain issues over the coming months, we assessed the sensitivity of a number of one-step retrotranscription and quantitative PCR (RT-qPCR) solutions to detect SARS-CoV-2. Methods: We evaluated six different RT-qPCR alternatives for SARS-CoV-2/COVID-19 diagnosis based on standard RNA extractions. That of best sensitivity was also assessed with direct nasopharyngeal swab viral transmission medium (VTM) heating, overcoming the RNA extraction step. Results: We found a wide variability in the sensitivity of RT-qPCR solutions that associated with a range of false negatives from as low as 2% (0.3-7.9%) to as much as 39.8% (30.2-50.2). Direct preheating of VTM combined with the best solution provided a sensitivity of 72.5% (62.5-81.0), in the range of some of the solutions based on standard RNA extractions. Conclusions: We evidenced sensitivity limitations of currently used RT-qPCR solutions. Our results will help to calibrate the impact of false negative diagnoses of COVID-19, and to detect and control new SARS-CoV-2 outbreaks and community transmissions.


title: Time series forecasting of COVID-19 confirmed cases with ARIMA model in the South East Asian countries of India and Thailand: a comparative case study

text: Abstract: Background: As economic burden makes it increasingly difficult for countries to continue imposing control measures, it is vital for countries to make predictions using time series forecasting before making decisions on lifting the restrictions. Aim: Since apparent differences were noted in the disease transmission between the two South East Asian countries of India and Thailand, the study aims to draw comparative account of the progression of COVID 19 in near future between these two countries. Methods: The study used data of COVID 19 confirmed cases in India and Thailand from WHO COVID 19 situation reports during the time period between 25th March, 2020 and 14th May, 2020. After determination of stationarity in the data and differencing, observation of autocorrelation function (ACF) and partial autocorrelation function (PACF), Auto Regressive Integrated Moving Average (ARIMA) (2,2,1) model was used to forecast the COVID 19 confirmed cases in both these countries for two weeks (i.e. 28th May, 2020). IBM SPSS version 20.0 software was used for data analysis. Results: The study demonstrated a possible increasing trend in number of COVID 19 cases in India in the coming two weeks with an estimated point forecast of 1,28,772 (95% CI 115023 to 142520) by 28th May, 2020. A stationary phase was forecasted for Thailand with a difference of only 43 cases between 14th May (the last case of input data) and 28th May. Conclusion: The time series forecasting employed in the present study warrants thorough preparation on part of the Indian health care system and authorities and calls for caution with regard to decisions made on lifting the control measures. The difference in the time series forecasting between these two South East Asian countries also highlights the need for strengthening of public health systems.


title: Mental health outcomes among front and second line health workers associated with the COVID-19 pandemic in Italy.

text: In this study, we report on mental health outcomes among health workers (HWs) involved with the COVID-19 pandemic in Italy. Data on mental health on 1379 HWs were collected between March 27th and March 31th 2020 using an on-line questionnaire spread throughout social networks, using a snowball technique along with sponsored social network advertisement. Key mental health outcomes were Post-Traumatic Stress Disorder symptoms (PTSD), severe depression, anxiety, insomnia and perceived stress. PTSD symptoms, severe depression, anxiety and insomnia, and high perceived stress were endorsed respectively by 681 (49.38%), 341 (24.73%), 273 (19.80%), 114 (8.27%) and 302 (21.90%) respondents. Regression analysis show that younger age, female gender, being a front-line HWs, having a colleague deceased, hospitalised or in quarantine were associated with poor mental health outcomes. This is the first report on mental health outcomes and associated risk factors among HWs associated with the COVID-19 pandemic in Italy, confirming a substantial proportion of health workers involved with the COVID-19 pandemic having mental health issues, in particular young women, first-line HWs.


title: A Reference Human-centric Architecture Model: a skill-based approach for education of future workforce

text: Abstract As Industry 4.0 sets foot as the next Industrial Revolution, it is necessary to bear in mind the new challenges from the human workforce perspective. There is a need for such challenges to inform educational and training programs, for them to enable skill development from a holistic viewpoint. Yet, most of the educational programs seem to be technological or subject-based, i.e. not skilled-based. There is an opportunity for a new approach to support and create educational programs and training for both university graduates and industry workers. This paper presents a human-centric model based on competences, age groups, and environment scenarios. The proposal supports the development of more robust means to look at educational gaps by visualizing and adapting a competency-based scenario. The aim is to provide a novel approach that is holistic, inclusive, and flexible in better preparing the future workforce.


title: Mathematical assessment of the impact of non-pharmaceutical interventions on curtailing the 2019 novel Coronavirus

text: A pandemic of a novel Coronavirus emerged in December of 2019 (COVID-19), causing devastating public health impact across the world. In the absence of a safe and effective vaccine or antivirals, strategies for con- trolling and mitigating the burden of the pandemic are focused on non-pharmaceutical interventions, such as social-distancing, contact-tracing, quarantine, isolation and the use of face-masks in public. We develop a new mathematical model for assessing the population-level impact of the aforementioned control and mitigation strategies. Rigorous analysis of the model shows that the disease-free equilibrium is locally-asymptotically stable if a certain epidemiological threshold, known as the reproduction number (denoted by Rc), is less than unity. This equilibrium is globally-asymptotically stable, for a special case of the model where quarantined-susceptible individuals do not acquire COVID-19 infection during quarantine, when Rc is less than unity. The epidemiological consequence of this theoretical result is that, the community-wide implementation of control interventions that can bring (and maintain) Rc to a value less than unity will lead to the effective control (or elimination) of COVID-19 in the community. Simulations of the model, using data relevant to COVID-19 transmission dynamics in the US state of New York and the entire US, show that the pandemic burden will peak in mid and late April, respectively. The worst-case scenario projections for cumulative mortality (based on baseline levels of interventions) are 105, 100 for New York state and 164, 000 for the entire US by the end of the pandemic. These numbers dramatically decreased by 80% and 64%, respectively, if adherence to strict social-distancing measures is improved and maintained until the end of May or June. The duration and timing of the relaxation or termination of the strict social-distancing measures are crucially important in determining the future trajectory of the COVID-19 pandemic. This study shows that early termination of the strict social-distancing measures could trigger a devastating second wave with burden similar to those projected before the onset of the strict social-distance measures were implemented. The use of efficacious face-masks (such as surgical masks, with estimated efficacy ≥ 70%) in public could lead to the elimination of the pandemic if at least 70% of the residents of New York state use such masks in public consistently (nationwide, a compliance of at least 80% will be required using such masks). The use of low efficacy masks, such as cloth masks (of estimated efficacy less than 30%), could also lead to significant reduction of COVID-19 burden (albeit, they are not able to lead to elimination). Combining low efficacy masks with improved levels of the other anti-COVID-19 intervention strategies can lead to the elimination of the pandemic. This study emphasizes the important role social-distancing plays in curtailing the burden of COVID-19. Increases in the adherence level of social-distancing protocols result in dramatic reduction of the burden of the pandemic, and the timely implementation of social-distancing measures in numerous states of the US may have averted a catastrophic outcome with respect to the burden of COVID-19. Using face-masks in public (including the low efficacy cloth masks) is very useful in minimizing community transmission and burden of COVID-19, provided their coverage level is high. The masks coverage needed to eliminate COVID-19 decreases if the masks-based intervention is combined with the strict social-distancing strategy.


title: Analysis of the epidemic growth of the early 2019-nCoV outbreak using internationally confirmed cases

text: Background: On January 23, 2020, a quarantine was imposed on travel in and out of Wuhan, where the 2019 novel coronavirus (2019-nCoV) outbreak originated from. Previous analyses estimated the basic epidemiological parameters using symptom onset dates of the confirmed cases in Wuhan and outside China. Methods: We obtained information on the 46 coronavirus cases who traveled from Wuhan before January 23 and have been subsequently confirmed in Hong Kong, Japan, Korea, Macau, Singapore, and Taiwan as of February 5, 2020. Most cases have detailed travel history and disease progress. Compared to previous analyses, an important distinction is that we used this data to informatively simulate the infection time of each case using the symptom onset time, previously reported incubation interval, and travel history. We then fitted a simple exponential growth model with adjustment for the January 23 travel ban to the distribution of the simulated infection time. We used a Bayesian analysis with diffuse priors to quantify the uncertainty of the estimated epidemiological parameters. We performed sensitivity analysis to different choices of incubation interval and the hyperparameters in the prior specification. Results: We found that our model provides good fit to the distribution of the infection time. Assuming the travel rate to the selected countries and regions is constant over the study period, we found that the epidemic was doubling in size every 2.9 days (95% credible interval [CrI], 2 days--4.1 days). Using previously reported serial interval for 2019-nCoV, the estimated basic reproduction number is 5.7 (95% CrI, 3.4--9.2). The estimates did not change substantially if we assumed the travel rate doubled in the last 3 days before January 23, when we used previously reported incubation interval for severe acute respiratory syndrome (SARS), or when we changed the hyperparameters in our prior specification. Conclusions: Our estimated epidemiological parameters are higher than an earlier report using confirmed cases in Wuhan. This indicates the 2019-nCoV could have been spreading faster than previous estimates.


title: Mandatory social distancing associated with increased doubling time: an example using hyperlocal data

text: In a hyperlocal analysis of doubling time of COVID-19, we found that a county that implemented mandatory social distancing and other measures to reduce spread of infection saw an earlier increase in doubling time than surrounding counties.


title: 2019 Coronavirus pandemic in Turkey and across the world/ Dünyada ve Türkiye'de 2019 Koronavirüs Pandemisi

text: The novel coronavirus, which was called 2019-nCoV at the beginning of the outbreak, was named SARS-CoV-2 later. The clinical disease caused by the virus was also called Coronavirus disease 2019 (COVID-19). World Health Organization declared COVID-19 a global pandemic on 11.03.2020. As of 26.03.2020, there have been 462.684 confirmed cases and 20.834 deaths globally, and these numbers are expected to increase in the coming days. The dynamics of virus spread are investigated with various models and outbreak parameters such as incubation time and basic reproduction number (R0) is tried to be illuminated. According to official numbers, as of 03.26.2020, there have also been 3629 cases and 75 deaths in Turkey. COVID-19 Guideline prepared by the Ministry of Health of the Republic of Turkey is constantly updated with additional prevention and treatment strategies. Various predictions are made for the future course of the pandemic, and the contribution of the spread of the virus in Africa and seasonal changes on this issue has been investigated.


title: Insight into the workforce advancing fields of science and technology

text: Advances in biomedicine and other fields of science and technology depend on research teams and their peer-reviewed publications. The scientific literature represents an invaluable socioeconomic resource guiding future research. Typically, this growing body of information is explored by queries in bibliographic databases concerning topics of interest and by subsequent scrutiny of matching publications. This approach informs readily about content, but leaves the workforce driving the field largely unexplored. The hurdle can be overcome by a transparent team-centered analysis that visualizes the teams working in a field of interest and that delineates their genealogic and collaborative relations. Context-specific, but citation-independent metrics gauge team impact and reveal key contributors valuing publication output, mentorship and collaboration. The new insight into the structure, dynamics and performance of the workforce driving research in distinct disciplines complements ongoing efforts to mine the scientific literature, foster collaboration, evaluate research and guide future policies and investments.


title: Early Mandated Social Distancing is a Strong Predictor of Reduction in Highest Number of New COVID-19 cases per Day within Various Geographic Regions

text: Mandated social distancing has been globally applied to limit the spread of corona virus disease 2019 (COVID-19) from highly pathogenic severe acute respiratory syndrome (SARS) -associated coronavirus 2 (SARS-CoV-2). The benefit of this community-based intervention in limiting COVID-19 has not been proven nor quantified. We examined the effect of timing of mandated social distancing on the rate of COVID-19 in 119 geographic regions derived from 41 states within United States and 78 countries. We found that highest number of new COVID-19 cases per day per million persons was significantly associated with total number of COVID-19 cases per million persons on the day before mandated social distancing (Beta;=0.66, p<0.0001). Our findings suggest that the initiation of mandated social distancing for each doubling in number of existing COVID-19 cases would result in eventual peak with 58% higher number of COVID-19 infections per day. Subgroup analysis on those regions where the highest number of new COVID-19 cases per day have peaked increased Beta to .85 (p<0.0001). We demonstrate that initiating mandated social distancing at a 10 times smaller number of COVID-19 cases will reduce the number of daily new COVID-19 cases at peak by 80% highlighting the importance of this community-based intervention.


title: COVID-19 to delay clinical trials

text: Big drug companies and biotech firms are working overtime on therapies and vaccines aimed at stopping COVID-19, the disease caused by the novel coronavirus, SARS-CoV-2 At the same time, these companies are struggling, amid social distancing and the diversion of clinical resources, to keep clinical trials going for the rest of their therapeutic pipelines Eli Lilly and Company’s stated strategy is typical of big pharma The firm says it will delay the start of most new studies and pause enrollment in most ongoing ones Lilly will continue clinical trials for people who are already enrolled “By delaying most new study starts and pausing enrollment of new patients or healthy volunteers in most ongoing studies, we hope to ease the burden on participating healthcare facilities and allow physicians to focus more of their efforts on combatting COVID-19,” Tim Garnett, Lilly’s chief medical officer, says in a statement “We will maintain ongoing


title: Impact of policy interventions and social distancing on SARS-CoV-2 transmission in the United States

text: Background: Policymakers have employed various non-pharmaceutical interventions (NPIs) such as stay-at-home orders and school closures to limit the spread of Coronavirus disease (COVID-19). However, these measures are not without cost, and careful analysis is critical to quantify their impact on disease spread and guide future initiatives. This study aims to measure the impact of NPIs on the effective reproductive number (Rt) and other COVID-19 outcomes in U.S. states. Methods: In order to standardize the stage of disease spread in each state, this study analyzes the weeks immediately after each state reached 500 cases. The primary outcomes were average Rt in the week following 500 cases and doubling time from 500 to 1000 cases. Linear and logistic regressions were performed in R to assess the impact of various NPIs while controlling for population density, GDP, and certain health metrics. This analysis was repeated for deaths with doubling time from 50 to 100 deaths and included several healthcare infrastructure control variables. Results: States that had a stay-at-home order in place at the time of their 500th case are associated with lower average Rt the following week compared to states without a stay-at-home order (p < 0.001) and are significantly less likely to have an Rt>1 (OR 0.07, 95% CI 0.01 to 0.37, p = 0.004). These states also experienced a significantly longer doubling time from 500 to 1000 cases (HR 0.35, 95% CI 0.17 to 0.72, p = 0.004). States in the highest quartile of average time spent at home were also slower to reach 1000 cases than those in the lowest quartile (HR 0.18, 95% CI 0.06 to 0.53, p = 0.002). Discussion: Few studies have analyzed the effect of statewide stay-at-home orders, school closures, and other social distancing measures in the U.S., which has faced the largest COVID-19 case burden. States with stay-at-home orders have a 93% decrease in the odds of having a positive Rt at a standardized point in disease burden. States that plan to scale back such measures should carefully monitor transmission metrics. Key words: COVID-19, SARS-CoV-2, Coronavirus, Public Policy, Social Distancing, Non-pharmaceutical Interventions, Stay-at-home Order, Shelter-in-place.


title: It's OK not to be OK: Shared Reflections from two PhD Parents in a Time of Pandemic

text: Adopting an intersectional feminist lens, we explore our identities as single and co‐parents thrust into the new reality of the UK COVID‐19 lock‐down. As two PhD students, we present shared reflections on our intersectional and divergent experiences of parenting and our attempts to protect our work and families during a pandemic. We reflect on the social constructions of 'masculinities' and 'emphasised femininities' (Connell, 2005) as complicated influence on our roles as parents. Finally, we highlight the importance of time and self‐care as ways of managing our shared realities during this uncertain period. Through sharing reflections, we became closer friends in mutual appreciation and solidarity as we learned about each other's struggles and vulnerabilities.


title: Blindness: behaviour in an epidemic†

text: In ‘Blindness’ José Saramago transports us into a society in which an unexpected epidemic of blindness spreads quickly, disseminating chaos between citizens and institutions This new reality acts as a magnifying glass highlighting the weaknesses and (few) forces of individuals and community From this masterpiece we can learn many insights useful to understand the SARS-CoV-2 pandemic


title: ACE2 expression by colonic epithelial cells is associated with viral infection, immunity and energy metabolism

text: Respiratory disease caused by the 2019 novel coronavirus (2019-nCoV) pneumonia first emerged in Wuhan, Hubei Province, China, in December 2019 and spread rapidly to other provinces and other countries. Angiotensin-converting enzyme 2 (ACE2) is the receptor for SARS-CoV and has been suggested to be also the receptor for 2019-nCoV. Paradoxically, ACE2 expression in the lung protects mice from SARS-CoV spike protein induced lung injury by attenuating the renin-angiotensin system. In the intestine, ACE2 also suppresses intestinal inflammation by maintaining amino acid homeostasis, antimicrobial peptide expression and ecology of the gut microbiome. Upon analysis of single cell-RNA sequencing data from control subjects and those with colitis or inflammatory bowel disease (IBD), we found that ACE2 expression in the colonocytes was positively associated with genes regulating viral infection, innate and cellular immunity, but was negatively associated with viral transcription, protein translation, humoral immunity, phagocytosis and complement activation. In summary, we suggest that ACE2 may play dual roles in mediating the susceptibility and immunity of 2019-nCoV infection.


title: Novel coronavirus (COVID-19): Its implications for anesthesia

text: Once again in the same decade, global health delivery systems are facing with the daunting challenge of another variant of Coronavirus (COVID-19). Over the last 20 years at least six different variants of coronavirus have emerged. Infections caused by these viruses mainly cause life threatening respiratory implications. The recent outbreak of a novel Coronavirus in Wuhan, China has been labelled as public health emergency of international concern (PHEIC). Previous experiences of Coronavirus outbreaks have shown that health care workers are at a high risk of acquiring this infection. Anesthesiologists, are particularly vulnerable due to their frequent exposure to infected respiratory secretions. Therefore, to minimize the transmission of nCoV-2019 infection, proper infection control measures like correct workplace practices, appropriate usage of personal protective equipment, airborne and droplet precautions are mandatory while managing a suspected case of infected patient.


title: Assessing the Intervention's Effectiveness and Health System Efficiency During COVID-19 Crisis using A Signal-to-Noise Ratio Index

text: In this paper, a signal to noise ratio like index, (snr) is introduced in an attempt to evaluate the efficiency of the health system as well as the effectiveness of the interventions taken by the stakeholders in an effort to control the virus spread during any health-related crisis. Using this proposed index (snr), it was possible to carry out a data-driven comparison among different countries in their efforts of dealing with the crisis. The primary focus of this study was to assess the interventions' effectiveness by the decision makers along with the health system's efficiency of the countries that experienced a relatively high pressure on their systems. In this study, 19 countries were selected based on predefined criteria that included: (1) reported confirmed cases should exceed 5,000, and (2) confirmed cases per 1 million people should exceed 200, at the time this study was concluded. According to the proposed, snr index, the findings showed that Germany and South Korea were ahead of the game, compared to other countries such as the USA, Spain, Italy, Belgium, Netherlands, and UK. Some other countries, such as Canada, Austria, Switzerland managed to slightly pivot their interventions at a later stage in effective manners according to the snr index. The study explains the foundation, and the underlying calculations of the proposed, snr index. Moreover, the study shows how reliably the snr index measures the interventions' effectiveness and health system's efficiency during the crisis or during any health-related crisis. An additional, yet interesting finding from this study, was that the snr curve showed a persistent four-episode (segment) structure during the pandemic. This finding could suggest a benchmark of the expected pattern of the fight against the virus spread during the pandemic that could offer a significant tool, for the decision makers. Finally, it is worth mentioning that the implementation of this proposed index is only valid and meaningful during a crisis. In a none-crisis time, the required data to calculate the snr index is not available and rather mathematically misleading.


The dilemma of being non COVID-19 hospital in the era of COVID-19


title: Forecasting COVID-19 and Analyzing the Effect of Government Interventions

text: One key question in the ongoing COVID-19 pandemic is understanding the impact of government interventions, and when society can return to normal. To this end, we develop DELPHI, a novel epidemiological model that captures the effect of under-detection and government intervention. We applied DELPHI across 167 geographical areas since early April, and recorded 6% and 11% two-week out-of-sample Median Absolute Percentage Error on cases and deaths respectively. Furthermore, DELPHI successfully predicted the large-scale epidemics in many areas months before, including US, UK and Russia. Using the extracted government response, we find mass gathering restrictions and school closings on average reduced infection rates the most, at 29.9 {+/-} 6.9% and 17.3 {+/-} 6.7%, respectively. The most stringent policy, stay-at-home, on average reduced the infection rate by 74.4 {+/-} 3.7% from baseline across countries that implemented it. We also illustrate how DELPHI can be extended to provide insights on reopening societies under different policies.


title: Medicine lines and COVID-19: Indigenous geographies of imagined bordering

text: In response to COVID-19, this commentary explores the disproportionate impacts that the pandemic is having on Indigenous nations of Turtle Island (North America) and the rendering of Indigenous borders as sites of compassionate community care. I argue that settler colonialism during COVID-19 is enacted through travel and second-home escapism of urban elites.


title: Rapid, sensitive, full genome sequencing of Severe Acute Respiratory Syndrome Virus Coronavirus 2 (SARS-CoV-2)

text: SARS-CoV-2 recently emerged, resulting a global pandemic. Rapid genomic information is critical to understanding transmission and pathogenesis. Here, we describe validated protocols for generating high-quality full-length genomes from primary samples. The first employs multiplex RT-PCR followed by MinION or MiSeq sequencing. The second uses singleplex, nested RT-PCR and Sanger sequencing.


title: Smoke and particulate filters in endoscopic surgery reviewed during COVID-19 pandemic

text: Aim: This study aimed to evaluate the efficacy of smoke filters for use in endoscopic surgery and their significance during the present COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: The literature was reviewed by analyzing articles on PubMed using the search terms “smoke”, “filter”, and “laparoscopy”. Results: A systematic literature search revealed six smoke filter clinical studies pertinent to endoscopic surgery. The studies focused on the different aspects and efficacy of these filters: (1) UGF1 filter (Pall Biomedical, St. Germaine en Laye, France) investigated captured mesothelial cells and other debris, (2) Valve-less trocar AirSeal™ (SurgiQuest, Orange, CT) fitted with an ultra-low particulate air (ULPA) filter investigated smoke evacuation and filtration to reduce exposure of staff to hazardous fumes, (3) automatic smoke evacuator (IES2, ERBE) equipped with ULPA identified 37 filtered carcinogenic substances, (4/5) the Tropian trocar (Tropian Tech., Gunpo, Korea), a charcoal filter, investigated in two studies focused on filtration of further hazardous compounds, and (6) charcoal/ULPA combination filter by Dyeing and Finishing Technology Institute investigated filtration rates of volatile organic compounds. Conclusions: Surgical plume can be cleared of hazardous chemical through smoke filters. There were six different filter studies identified with regards to endoscopic surgery which can aid in protecting the surgical staff from dangerous smoke by filtering cells, recirculating, and filtering gas, and removal of carbon-based substances. No clinical study has specifically investigated the removal of viruses by smoke filters including the SARS-CoV-2.


title: Survival and predictors of deaths of patients hospitalized due to COVID-19 from a retrospective and multicenter cohort study in Brazil

text: The epidemic caused by COVID-19 in Brazil is associated with an unfavorable political scenario, aggravated by intense social inequality and low number of available hospital beds. Therefore, this study aimed to analyze the survival of patients admitted to Brazilian hospitals due to the COVID-19 and estimate prognostic factors. This is a retrospective, multicenter cohort study, based on data from 46285 hospitalizations for COVID-19 in Brazil. Survival functions were calculated using the Kaplan-Meier method. The Log-rank test compared the survival functions for each variable and from that, hazard ratios were calculated and the proportional hazards model was used in Cox multiple regression. The smallest survival curves were the ones for patients at the age of 68 years or more, black / brown race, illiterate, living in the countryside, dyspnea, respiratory distress, influenza-like outbreak, O2 saturation <95%, X-ray change, length of stay in the ICU, invasive ventilatory support, previous heart disease, pneumopathy, diabetes, down's syndrome, neurological disease and kidney disease. Better survival was observed in the symptoms and in an asthmatic patient. The multiple model for increased risk of death when they were admitted to the ICU HR 1.28 (95% CI 1.21;1.35), diabetes HR 1.17 (95% CI 1.11;1.24), neurological disease HR 1.34 (95% CI 1.22;1.46), kidney disease HR 1.11 (95% CI 1.02;1.21), heart disease HR 1.14 (95% CI 1.08;1.20), black or brown race of HR 1.50 (95% CI 1.43;1.58), asthma HR 0.71 (95% CI 0.61;0.81) and pneumopathy HR 1.12 (95% CI 1.02;1.23). The overall survival time was low in hospitalizations for COVID-19 and this reinforces the importance of sociodemographic and clinical factors as a prognosis for death. The lack of a protocol for scientific clinical management puts a greater risk of death for about 80 million Brazilians, who are chronically ill or living in poverty. COVID-19 can promote selective mortality that borders the eugenics of specific social segments in Brazil.


title: Evolutionary Dynamics And Geographic Dispersal Of Beta Coronaviruses In African Bats

text: Bats have been shown to serve as reserviour host of various viral agents including coronaviruses. They have also been associated with the novel coronavirus SARS-CoV-2. This has made them an all important agent for CoV evolution and transmission. Our objective in this study was to investigate the dispersal, phylogenomics and evolution of betacoronaviruses (β-CoV) among African bats. Three data sets were generated from sequences of the partial RNA depedent RNA polymerase (RdRP) gene of Bat coronaviruses from seven African, three Asian, and four European countries. Phylogenetic trees was infered using MEGA Vs 7, Phylogeography and Evolutionary analysis were carried out, using Markov Chain Monte Carlo (MCMC) implemented in BEAST, and visualised with SPREAD3. Results showed that majority of the African strains fell within lineage D. Evololutionary rate of the African Bt-β-CoV was 1.301 × 10-3, HPD (1.064 × 10-3 – 1.434 × 10-3), the MCC tree of the African strains showed two clades, lineage D, and lineage C. The TMRCA for lineage D strains was 1972, 95% HPD (1951-1990), and 2010, 95% HPD (2006-2014) for the South African strains. There were inter-continental dispersal of Bt-CoV from China and Hong Kong into Central and Southern Africa. In conclusion we advocate for broader studies of whole genome sequences of BtCoV to further understand the drivers for their emergence and zoonotic spillovers into human population.


title: A Review on the Novel Coronavirus Disease based on In-silico Analysis of Various Drugs and Target Proteins

text: Coronavirus Disease (COVID-19) is a new disease that emerged in Wuhan, China which spreads through close contact of people, often by small droplets produced during coughing or sneezing Detail mechanism by which it spreads between people are under investigation The World Health Organization (WHO) declared this disease as a pandemic after the severity of the disease increased Many scientific reports gathered have suggested many drugs that could be potential candidates for the treatment Although, clinical effectiveness has not been fully evaluated In this review, we have aggregated the data from few research articles, official news websites and few review papers regarding its phylogenetic relation, genomic constitution, transmission, replication and in-silico analysis done by researchers for few potent drugs that are currently used to cure COVID-19 SARS-CoV-2 belongs to Betacoronavirus genus with Genome structure consists 14 Open Reading Frames (ORFs) that encode 27 proteins Coronavirus replicates into the host cells having unique mechanisms like ribosome frame-shifting and synthesis of genomic and sub genomic RNAs In-silico methods have the advantage that they can make fast predictions for a large set of compounds in a high-throughput mode and also make their prediction based on the structure of a compound even before it has been synthesized In-silico softwares have been used to find or to improve a novel bioactive compound, which may exhibit a strong affinity to a particular target in the drug development process


title: Fear of COVID-19: Insights from evolutionary behavioral science

text: Fear of infectious disease is substantially different from that evoked by other medical conditions. Such a difference depends on psychological and behavioral adaptations shaped by natural selection throughout the evolutionary history of Homo sapiens. Selective pressures have favored the evolution of a behavioral immune system that is separate from, and complementary to, the physiological immune system. The two systems interact in a complex way. The psychological mechanisms (i.e. disgust and fear) involved in the behavioral immune system impact also on aspects that pertain to social psychology (i.e. xenophobia, conformism, and authoritarianism). Acknowledging the existence of psychological and behavioral adaptations to avoid infection has important implications for public health programs, including the necessity of fighting stigma and the dubious utility of trauma debriefing for healthcare workers facing the COVID-19 emergency.


title: An exploratory randomized controlled study on the efficacy and safety of lopinavir/ritonavir or arbidol treating adult patients hospitalized with mild/moderate COVID-19 (ELACOI)

text: Background: Antiviral therapies against the novel coronavirus SARS-CoV-2, which has caused a global pandemic of respiratory illness called COVID-19, are still lacking. Methods: Our study (NCT04252885, named ELACOI), was an exploratory randomized (2:2:1) controlled trial assessing the efficacy and safety of lopinavir/ritonavir (LPV/r) or arbidol monotherapy for treating patients with mild/moderate COVID-19. Findings: This study successfully enrolled 86 patients with mild/moderate COVID-19 with 34 randomly assigned to receive LPV/r, 35 to arbidol and 17 with no antiviral medication as control. Baseline characteristics of the three groups were comparable. The primary endpoints, the average time of positive-to-negative conversion of SARS-CoV-2 nucleic acid and conversion rates at days 7 and 14, were similar between groups (all P>0.05). There were no differences between groups in the secondary endpoints, the rates of antipyresis, cough alleviation, or improvement of chest CT at days 7 or 14 (all P>0.05). At day 7, eight (23.5%) patients in the LPV/r group, 3 (8.6%) in the arbidol group and 2(11.8%) in the control group showed a deterioration in clinical status from moderate to severe/critical(P =0.206). Overall, 12 (35.3%) patients in the LPV/r group and 5 (14.3%) in the arbidol group experienced adverse events during the follow-up period. No apparent adverse event occurred in the control group. Conclusions: LPV/r or arbidol monotherapy present little benefit for improving the clinical outcome of patients hospitalized with mild/moderate COVID-19 over supportive care.


title: DeepEMhancer: a deep learning solution for cryo-EM volume post-processing

text: Cryo-electron microscopy (cryo-EM) maps are among the most valuable sources of information for protein structure modeling. However, due to the loss of contrast at high frequencies, they generally need to be post-processed before modeling in order to improve their interpretability. To that end, approaches based on B-factor correction are the most popular choices, yet they suffer from some limitations such as the fact that the correction is applied globally, ignoring the presence of heterogeneity in the map local quality that cryo-EM reconstructions tend to exhibit. With the aim of overcoming these limitations, here we present DeepEMhancer, a deep learning approach designed to perform automatic post-processing of cryo-EM maps. Trained on a dataset of pairs of experimental cryo-EM maps and maps sharpened by LocScape using their respective atomic models, DeepEMhancer has automatically learned how to post-process experimental maps performing masking-like and sharpening-like operations in a single step. DeepEMhancer has been evaluated on a testing set of 20 different experimental maps, showing its ability to obtain much cleaner and detailed versions of the experimental maps, thus, improving their interpretability. Additionally, we have illustrated the benefits of DeepEMhancer with a use case in which the structure of the SARS-CoV 2 RNA polymerase is improved.


title: A COVID-19 panacea in digital technologies? Challenges for democracy and higher education

text: Universities have transitioned to online education in order to slow the spread of COVID-19. This transition mobilizes the technological utopian imaginary that digital technologies can rescue populations from the disease. It also raises the risk of deepening neoliberal educational reforms and, by extension, poses a threat to democracy itself. This commentary explores this risk and suggests ways to resist the resulting neoliberalization of education that it could entail.


title: The 2019–2020 Chilean protests: A first look at their causes and participants

text: On 18 October 2019, after weeks of subway fare evasions in a protest for a fare increase, protesters occupied some stations of the Metropolitan Public Transport Network in Santiago, Chile’s capital city. An explosive and surprising escalation of violence ensued later that night marking the beginning of an ongoing social crisis that extended to other regions of the country, and reshaped, probably permanently, the political landscape. It is not yet possible to provide a definitive account of events that are still unfolding. We do not aim (nor can) settle the debate, nor give an exhaustive account of all arguments in such a short text. Instead, we describe the main facts of the still ongoing social crisis and the context leading to this crisis, and suggest some explanations based on current body of research and on survey data fielded during the crisis.


title: Global Analysis of an SEIRS Model for COVID-19 Capturing Saturated Incidence with Treatment Response

text: Sequel to [10], who studied the dynamics of COVID-19 using an SEIRUS model. We consider an SEIRS model capturing saturated incidence with treatment response. In this theoretical model, we assumed that the treatment response is proportional to the number of infected as long as the incidence cases are within the capacity of the healthcare system, after which the value becomes constant, when the number of confirmed cases exceed the carrying capacity of the available medical facilities. Thus, we obtain the reproduction number stating that when , the disease free equilibrium is globally asymptotically stable. Also, we studied the existence of the local and global stability of the disease free and endemic equilibria and found that the kind of treatment response and inhibitory measures deployed in tackling the COVID-19 pandemic determines whether the disease will die out or become endemic.


title: Preventive behavior of Vietnamese people in response to the COVID-19 pandemic

text: We sought to evaluate the adherence of Vietnamese adults to COVID-19 preventive measures, and gain insight into the effects of the epidemic on the daily lives of Vietnamese people. An online questionnaire survey was organized from March 31 to April 6, 2020. The questionnaire assessed preventive behavior using multiple answer responses to indicate the extent of adherence. In total, 2175 respondents completed the questionnaire (age range: 18-69 years). The mean adherence scores for personal and community preventive measures were 7.23 {+/-} 1.63 (range 1-9) and 9.57 {+/-} 1.12 (range 1-11), respectively. Perceived adaptation of the community to lockdown ({beta}=2.64, 95% CI 1.25 -4.03), fears/worries concerning one's health ({beta}=2.87, 95% CI 0.04-5.70), residing in large cities ({beta}=19.40, 95% CI 13.78-25.03), access to official COVID19 information sources ({beta}=16.45, 95% CI 6.82-26.08), and belonging to the healthcare sector ({beta}=22.53, 95% CI 16.00-29.07) were associated with a higher adherence score to anti -COVID instructions. The study indicates excellent preventive behavior of the Vietnamese population which explains the low number of COVID-19 infections and zero recorded mortality up to the first week of May 2020. Further monitoring is recommended to assess the sustainability of COVID-19 prevention via behavior change in the medium and long-term.


title: Tamoxifen reduces inflammatory infiltration of neutrophils in the airways

text: Tamoxifen is a drug of choice for treatment of breast cancer but it has also been reported to bear anti-inflammatory activity. Previously, we have observed that tamoxifen treatment successfully reduced inflammation in horses affected by equine asthma syndrome. More notorious, tamoxifen was effective at reducing the infiltration of neutrophils in the inflamed airways by a mechanism that increases efferocytosis, allowing the resolution of inflammation. Due to the emerging increase in patients with chronic inflammatory lung diseases, there is an urgent need for therapies that help reduce airway inflammation. Thus we tested the effect of tamoxifen on airway neutrophil infiltration by using three different mouse models for acute and chronic inflammation of the lung. We found that the drug was able to produce a significant reduction in neutrophils in all scenarios. Ussing chamber experiments demonstrated that tamoxifen has no effect on fluid secretion and absorption, discarding a possible reduction in mucociliary clearance due to the known ion-channel blocking effects of tamoxifen. Since this drug has been largely used in human medicine, tamoxifen might be a “low hanging fruit” for a novel anti-inflammatory therapy for airway diseases characterized by neutrophilic inflammation.


title: A Bayesian reanalysis of the effects of hydroxychloroquine and azithromycin on viral carriage in patients with COVID-19

text: Gautret and colleagues reported results of a non-randomised open-label case series which examined the effects of hydroxychloroquine and azithromycin on viral load in the upper respiratory tract of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients. The authors report that hydroxychloroquine (HCQ) had significant virus reducing effects, and that dual treatment of both HCQ and azithromycin further enhanced virus reduction. This data has triggered speculation whether these drugs should be considered as candidates for the treatment of severe COVID-19. However, questions have been raised regarding the study's data integrity, statistical analyses, and experimental design. We therefore reanalysed the original data to interrogate the main claims of the paper. Here we apply Bayesian statistics to assess the robustness of the original papers claims by testing four variants of the data: 1) The original data; 2) Data including patients who deteriorated; 3) Data including patients who deteriorated with exclusion of untested patients in the comparison group; 4) Data that includes patients who deteriorated with the assumption that untested patients were negative. To ask if HCQ monotherapy is effective, we performed an A/B test for a model which assumes a positive effect, compared to a model of no effect. We find that the statistical evidence is highly sensitive to these data variants. Statistical evidence for the positive effect model ranged from strong for the original data (BF ~11), to moderate when including patients who deteriorated (BF ~4.35), to anecdotal when excluding untested patients (BF ~2), and to anecdotal negative evidence if untested patients were assumed positive (BF ~0.6). To assess whether HCQ is more effective when combined with AZ, we performed the same tests, and found only anecdotal evidence for the positive effect model for the original data (BF ~2.8), and moderate evidence for all other variants of the data (BF ~5.6). Our analyses only explore the effects of different assumptions about excluded and untested patients. These assumptions are not adequately reported, nor are they justified in the original paper, and we find that varying them causes substantive changes to the evidential support for the main claims of the original paper. This statistical uncertainty is exacerbated by the fact that the treatments were not randomised, and subject to several confounding variables including the patients' consent to treatment, different care centres, and clinical decision-making. Furthermore, while the viral load measurements were noisy, showing multiple reversals between test outcomes, there is greater certainty around other clinical outcomes such as the 4 patients who seriously deteriorated. The fact that all of these belonged to the HCQ monotherapy group should be assigned greater weight when evaluating the potential clinical efficacy of HCQ. Randomised controlled trials are currently underway, and will be critical in resolving this uncertainty as to whether HCQ and AZ are effective as a treatment for COVID-19.


Lung changes on chest ct during 2019 novel coronavirus (Covid-19) pneumonia


title: Replication-competent vesicular stomatitis virus vaccine vector protects against SARS-CoV-2-mediated pathogenesis

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of human infections and hundreds of thousands of deaths. Accordingly, an effective vaccine is of critical importance in mitigating coronavirus induced disease 2019 (COVID-19) and curtailing the pandemic. We developed a replication-competent vesicular stomatitis virus (VSV)-based vaccine by introducing a modified form of the SARS-CoV-2 spike gene in place of the native glycoprotein gene (VSV-eGFP-SARS-CoV-2). Immunization of mice with VSV-eGFP-SARS-CoV-2 elicits high titers of antibodies that neutralize SARS-CoV-2 infection and target the receptor binding domain that engages human angiotensin converting enzyme-2 (ACE2). Upon challenge with a human isolate of SARS-CoV-2, mice expressing human ACE2 and immunized with VSV-eGFP-SARS-CoV-2 show profoundly reduced viral infection and inflammation in the lung indicating protection against pneumonia. Finally, passive transfer of sera from VSV-eGFP-SARS-CoV-2-immunized animals protects naïve mice from SARS-CoV-2 challenge. These data support development of VSV-eGFP-SARS-CoV-2 as an attenuated, replication-competent vaccine against SARS-CoV-2.


title: Trend Analysis and Forecasting of COVID-19 outbreak in India

text: COVID-19 is spreading really fast around the world. The current study describes the situation of the outbreak of this disease in India and predicts the number of cases expected to rise in India. The study also discusses the regional analysis of Indian states and presents the preparedness level of India in combating this outbreak. The study uses exploratory data analysis to report the current situation and uses time-series forecasting methods to predict the future trends. The data has been considered from the repository of John Hopkins University and covers up the time period from 30th January 2020 when the first case occurred in India till the end of 24th March 2020 when the Prime Minister of India declared a complete lockdown in the country for 21 days starting 25th March 2020. The major findings show that number of infected cases in India is rising quickly with the average infected cases per day rising from 10 to 73 from the first case to the 300th case. The current mortality rate for India stands around 1.9. Kerala and Maharashtra are the top two infected states in India with more than 100 infected cases reported in each state, respectively. A total of 25 states have reported at least one infected case, however only 8 of them have reported deaths due to COVID-19. The ARIMA model prediction shows that the infected cases in India may reach up to 700 thousands in next 30 days in worst case scenario while most optimistic scenario may restrict the numbers up to 1000-1200. Also, the average forecast by ARIMA model in next 30 days is around 7000 patients from the current numbers of 536. Based on the forecasting model by Holts linear trends, an expected 3 million people may get infected if control measures are not taken in the near future. This study will be useful for the key stakeholders like Government Officials and Medical Practitioners in assessing the trends for India and preparing a combat plan with stringent measures. Also, this study will be helpful for data scientists, statisticians, mathematicians and analytics professionals in predicting outbreak numbers with better accuracy.


title: Models of transmission of COVID-19 with time under the influence of meteorological determinants

text: Based on the statistical analyses of the data on the number of confirmed COVID-19 cases and meteorological determinants in some of the severely affected cities in Spain, Italy and the USA, some models are constructed showing the relationship of I' (the number of infected individuals divided by the total population of a city) with temperature, relative humidity, wind velocity and time. Three models are based on the data before lockdown/travel restrictions in these cities, and the other three models are based on data both before and after lockdown/travel restrictions. These models, in general, indicate that the transmission of COVID-19 could be relatively high either for elevated temperatures with lower relative humidity or for lower temperatures with higher relative humidity conditions. Although one model indicates exponential increase in number of infection cases with time, the more statistically significant models show that the number of cases varies quadratically with time. We have discussed in short, how all these features could be linked with the alterations of structural characteristics of the SARS-CoV-2 virus. Finally, the possibility of natutal disappearance of COVID-19 pandemic, at the global level, has been discussed in the context of the most statistically significant model.


Grappling with Chronic Pain and Poverty during the COVID-19 Pandemic


title: How Close are We to a COVID-19 Vaccine?

text: This review provides an overview regarding the main aspects of candidate COVID-19 vaccines and pathophysiology of disease The types of biotechnological candidate vaccines to be developed against COVID-19, their degree of protection and the pathophysiological mechanism of the disease were analyzed in this review article The literature data on which cruxes for the development of biotechnological candidate vaccines to be wended are based was researched Data that could give reference to various biotechnological candidate vaccines were reviewed For this purpose, up-to-date literature data was utilized The ways to succeed in the development of a vaccine requiring a technological infrastructure are to synthesize the data obtained from long term trials and to put them into practice subsequently The vaccines to be developed by means of recombinant DNA technology will be a source of inspiration to people for further studies After a rapid process of vaccine development, the use of COVID-19 vaccine can be mainstreamed among people to prevent the disease As a result of these practices, the evaluation of which vaccine will be more safe, reliable and effective will be performed after phase studies


title: Estimating the size of the COVID-19 outbreak in Italy: Application of an exponential decay model to the weighted and cumulative average daily growth rate

text: To estimate the size of the novel coronavirus (COVID-19) outbreak in Italy, this paper introduces the cumulated and weighted average daily growth rate (WR) to evaluate an epidemic curve, On the basis of an exponential decay model (EDM), we provide estimations of the WR in four-time intervals from February 27 to April 07, 2020. By calibrating the parameters of the EDM to the reported data in Hubei Province of China, we also attempt to forecast the evolution of the outbreak. We compare the EDM applied to WR and the Gompertz model, which is based on exponential decay and is often used to estimate cumulative events. Specifically, we assess the performance of each model to short-term forecast of the epidemic, and to predict the final epidemic size. Based on the official counts for confirmed cases, the model applied to data from February 27 until the 17st of March estimate that the cumulative number of infected could reach 131,280 (with a credibility interval 71,415-263,501) by April 25 (credibility interval April 12 to May 3). With the data available until the 24st of March the peak date should be reached on May 3 (April 23 to May 23) with 197,179 cumulative infections expected (130033-315,269); with data available until the 31st of March the peak should be reached on May 4 (April 25 to May 18) with 202,210 cumulative infections expected (155.235-270,737); with data available until the 07st of April the peak should be reached on May 3 (April 26 to May 11) with 191,586 (160,861-232,023) cumulative infections expected. Based on the average mean absolute percentage error (MAPE), cumulated infections forecasts provided by the EDM applied to WR performed better across all scenarios than the Gompertz model. An exponential decay model applied to the cumulated and weighted average daily growth rate appears to be useful in estimating the number of cases and peak of the COVID-19 outbreak in Italy and the model was more reliable in the exponential growth phase.


title: Prediction of non-canonical routes for SARS-CoV-2 infection in human placenta cells

text: The SARS-CoV-2 is the causative agent of the COVID-19 pandemic. The data available about COVID-19 during pregnancy have demonstrated placental infection; however, the intrauterine transmission of SARS-CoV-2 is still debated. Intriguingly, while canonical SARS-CoV-2 cell entry mediators are expressed at low levels in placental cells, the receptors for viruses that cause congenital infections such as the cytomegalovirus and Zika virus are highly expressed in these cells. Here we analyzed the transcriptional profile (microarray and single-cell RNA-Seq) of proteins potentially interacting with coronaviruses to identify non-canonical mediators of SARS-CoV-2 infection and replication in the placenta. We show that, despite low levels of the canonical cell entry mediators ACE2 and TMPRSS2, villous trophoblast cells co-express high levels of the potential non-canonical cell-entry mediators DPP4 and CTSL. We also found changes in the expression of DAAM1 and PAICS genes during pregnancy, which are translated into proteins also predicted to interact with coronaviruses proteins. These results provide new insight into the interaction between SARS-CoV-2 and host proteins that may act as non-canonical routes for SARS-CoV-2 infection and replication in the placenta cells.


title: Cerebral Venous Sinus Thrombosis as a Presentation of COVID-19

text: Coronavirus disease 19 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe the case of a 59-year-old man who presented with headache, hypertension and a single episode of fever with no other symptoms. He subsequently developed unilateral weakness. Computer tomography identified a cerebral venous sinus thrombosis (CVST). A subsequent test for COVID-19 was positive. This is the first report of CVST as a presenting symptom of COVID-19 infection. LEARNING POINTS: Thrombotic events may be the initial presenting symptom of COVID-19. These thrombotic events include stroke, venous thromboembolism, pulmonary embolism and cardiac complications. Clinicians should carefully consider the risk of thrombosis in patients positive for COVID-19, including prophylaxis and treatment beyond discharge.


title: Modulation of COVID-19 Epidemiology by UV-B and -A Photons from the Sun

text: It is well known that 200-290 nm ultraviolet photons (hereinafter UV-C radiation) photo-chemically interacts with DNA and RNA and are endowed with germicidal properties that are also effective on viruses. Fortunately, Solar UV-C photons of this wavelength are filtered out by the Ozone layer of the upper Atmosphere, at around 35 km. Softer UV photons from the Sun with wavelengths in the range 290-320 nm (UV-B) and 320-400 nm (UV-A), however, do reach the Earth s surface. The effect of these photons on Single- and Double-Stranded RNA/DNA viruses and the possible role they play on the seasonality of epidemics, are nevertheless little studied and highly debated in alternative or complementarity to other environmental causes. Notably though, the effects of both direct and indirect radiation from the Sun needs to be considered in order to completely explain the effects of UV radiations in life processes (with e.g. the UV virucidal effect enhanced in combination to the concomitant process of water droplets depletion because of Solar heat). Herein we present a number of concurring circumstantial evidence suggesting that the evolution and strength of the recent Severe Acute Respiratory Syndrome (SARS-Cov-2) pandemics, might be have been modulated by the intensity of UV-B and UV-A Solar radiation hitting different regions of Earth during the diffusion of the outbreak between January and May 2020. Out findings, if confirmed by more in depth data analysis and modeling of the epidemics, which includes Solar modulation, could help in designing the social behaviors to be adopted depending on season and environmental conditions.


title: Clinical characteristics of 25 death cases infected with COVID-19 pneumonia: a retrospective review of medical records in a single medical center, Wuhan, China

text: Summary Background The pneumonia caused by the 2019 novel coronavirus (SARS-CoV-2) is a highly infectious disease, which was occurred in Wuhan, Hubei Province, China in December 2019. As of February 13, 2020, a total of 59883 cases of COVID-19 in China have been confirmed and 1368 patients have died from the disease. However, the clinical characteristics of the dyed patients were still not clearly clarified. This study aims to summarize the clinical characteristics of death cases with COVID-19 and to identify critically ill patients of COVID-19 early and reduce their mortality. Methods The clinical records, laboratory findings and radiologic assessments included chest X-ray or computed tomography were extracted from electronic medical records of 25 died patients with COVID-19 in Renmin Hospital of Wuhan University from Jan 14 to Feb 13, 2020. Two experienced clinicians reviewed and abstracted the data. Findings The mean age of the dead was 71.48 years, the average course of the disease was 10.56 days, all patients eventually died of respiratory failure. All of those who died had underlying diseases, the most common of which was hypertension (16/25, 64%), followed by diabetes (10/25, 40%), heart diseases (8/25, 32%), kidney diseases (5/25, 20%), cerebral infarction (4/25, 16%), chronic obstructive pulmonary disease (COPD, 2/25, 8%), malignant tumors (2/25, 8%) and acute pancreatitis (1/25, 4%). The most common organ damage outside the lungs was the heart, followed by kidney and liver. In the patients' last examination before death, white blood cell and neutrophil counts were elevated in 17 patients (17/25, 68%) and 18 patients (18/25, 72%), lymphocyte counts were decreased in 22 patients (22/25, 88%). Most patients' PCT, CRP and SAA levels were elevated, the percentages were 90.5% (19/21), 85% (19/20) and 100% (21/21) respectively. The levels of the last test of neutrophils (15/16, 93.8%), PCT (11/11, 100%), CRP (11/13, 84.6%), cTnI (8/9, 88.9%), D-Dimer (11/12, 91.6%) and LDH (9/9, 100%) were increased as compared to the first test, while the levels of lymphocytes were decreased (14/16, 87.5%). Interpretation The age and underlying diseases (hypertension, diabetes, etc.) were the most important risk factors for death of COVID-19 pneumonia. Bacterial infections may play an important role in promoting the death of patients. Malnutrition was common to severe patients. Multiple organ dysfunction can be observed, the most common organ damage was lung, followed by heart, kidney and liver. The rising of neutrophils, SAA, PCT, CRP, cTnI, D-Dimer and LDH levels can be used as indicators of disease progression, as well as the decline of lymphocytes counts.


title: Demand Analysis and Management Suggestion: Sharing Epidemiological Data Among Medical Institutions in Megacities for Epidemic Prevention and Control

text: During the prevention of coronavirus disease 2019 (COVID-19), epidemiological data is essential for controlling the source of infection, cutting off the route of transmission, and protecting vulnerable populations. Following Law of the People’s Republic of China on Prevention and Treatment of Infectious Diseases and other related regulations, medical institutions have been authorized to collect the detailed information of patients, while it is still a formidable task in megacities because of the significant patient mobility and the existing information sharing barrier. As a smart city which strengthens precise epidemic prevention and control, Shanghai has established a multi-department platform named “one-net management” on dynamic information monitoring. By sharing epidemiological data with medical institutions under a safe environment, we believe that the ability to prevent and control epidemics among medical institutions will be effectively and comprehensively improved.


title: Assessment of spread of SARS-CoV-2 by RT-PCR and concomitant serology in children in a region heavily affected by COVID-19 pandemic

text: Background. Several studies indicated that children seem to be less frequently infected with SARS-CoV-2 and potentially less contagious. To examine the spread of SARS-CoV-2 we combined both RT-PCR testing and serology in children in the most affected region in France, during the COVID-19 epidemic. Methods. From April 14, 2020 to May 12, 2020, we conducted a cross-sectional prospective, multicenter study. Healthy controls and pauci-symptomatic children from birth to age 15 years were enrolled by 27 ambulatory pediatricians. A nasopharyngeal swab was taken for detection of SARS-CoV-2 by RT-PCR and a microsample of blood for micro-method serology. Results. Among the 605 children, 322 (53.2%) were asymptomatic and 283 (46.8%) symptomatic. RT-PCR testing and serology were positive for 11 (1.8%) and 65 (10.7%) of all children, respectively. Only 3 children were RT-PCR-positive without any antibody response have been detected. The frequency of positivity on RT-PCR for SARS-CoV-2 was significantly higher in children with positive serology than those with a negative one (12.3% vs 0.6%, p<0.001). Contact with a person with proven COVID-19 increased the odds of positivity on RT-PCR (OR 7.8, 95% confidence interval [1.5; 40.7]) and serology (15.1 [6.6; 34.6]). Conclusion. In area heavily affected by COVID-19, after the peak of the first epidemic wave and during the lockdown, the rate of children with positive SARS-CoV-2 RT-PCR was very low (1.8%), but the rate of positive on serology was higher (10.7%). Most of PCR positive children had at the same time, positive serology suggesting a low risk of transmission.


title: Evidence that higher temperatures are associated with lower incidence of COVID-19 in pandemic state, cumulative cases reported up to March 27, 2020

text: Seasonal temperature variation may impact the trajectories of COVID-19 in different global regions. Cumulative data reported by the World Health Organization, for dates up to March 27, 20201, show association between COVID-19 incidence and regions at or above 30° latitude. Historic climate data also show significant reduction of case rates with mean maximum temperature above approximately 22.5 degrees Celsius. Variance at the local level, however, could not be well explained by geography and temperature. These preliminary findings support continued countermeasures and study of SARS-CoV-2/COVID-19 transmission rates by temperature and humidity.


title: A feasibility study of continuous grain refinement of sheet metal

text: Abstract Various severe plastic deformation (SPD) techniques have been used to develop ultrafine-grained (UFG) materials to enhance material properties. Equal channel angular extrusion/pressing (ECAE/ECAP) is an effective technique to severely deform material and refine grains, however, the drawback is that a continuous process on sheet metal is confined due to the process mechanism. Equal channel angular drawing (ECAD), a continuous strip drawing process, has limitations in achieving grain refinement because drawing is a stretching phenomenon contrary to an extrusion or pressing process. In the present work, experiments were conducted on interstitial-free (IF) steel to demonstrate that grain refinement of thin sheets can be achieved through pack extrusion; and while there was shear deformation, ECAD failed to produce UFG microstructure. The finite element analysis showed the sheet metals have distinctive stress-strain states after ECAE and ECAD. The feasibility of combining ECAE and ECAD to approach the stress-strain state of the sheet metal in pack extrusion for grain refinement was investigated. Simulation results showed that with proper loading conditions, continuous grain refinement of thin metal strips is sufficiently possible.


title: Understanding of COVID-19 in children from different perspectives of traditional Chinese medicine and western medicine/ 中西医不同角度对儿童新型冠状病毒肺炎（COVID-19）的认识

text: Since December 2019, Wuhan city of Hubei Province has been the center of a number of patients infected with coronavirus disease 2019 (COVID-19). People are susceptible to be infected. The infection has spread to newborn and small infants, and severe cases of children have now occurred. Cases of infection in children have drawn great attention from the society. The pathogenesis of COVID-19 is unclear, and there is no specific drug for treatment, which brings great difficulties to epidemic prevention and clinical treatment. In this paper, we try to understand COVID-19 in children from different perspectives of TCM and western medicine. We also try to analyze the etiology, epidemic characteristics, disease development characteristics and treatment measures of COVID-19 in children. At the same time, we try to explore the etiology, pathogenesis, syndrome differentiation and treatment of COVID-19 in children with TCM. It is hoped that the combination of TCM and western medicine can better understand the new coronavirus pneumonia in children and its pathological basis, analyze the current trend of the epidemic situation, so as to find out safe and effective prevention and control measures and provide reference for clinical prevention and treatment of COVID-19 in children.


title: Microstructural and mechanical properties of complex phase steel to aluminium alloy welded dissimilar joint

text: Abstract Lightweight dissimilar materials that exhibit increased performance and functionality are of great interest in the field of automobiles to reduce fuel consumption and improve fuel economy. The properties of different lightweight materials are jointly utilised to achieve the product performance. In this study, dissimilar materials such as complex phase steel and aluminium alloy are joined using a high power fiber coupled diode laser. Laser processing parameters (laser power and scanning speed) are optimized such that the thickness of the intermetallics is minimum, so as to obtain maximum mechanical strength. The intermetallics formed at the weld interface are mostly aluminium rich, which are brittle in nature and deteriorate the strength of the joint. The microstructural characterization results showed that the depth of penetration of the weld increased with increase in laser power or decrease in scanning speed. The maximum depth achieved was 1200 µm at a laser condition of power 3 kW and 8 mm/s scanning speed. However, due to increased depth of penetration the intermetallic thickness also increased to 17 µm. Maximum mechanical resistance of 254 N/mm was achieved at a laser power of 4 kW and scanning speed of 12 mm/s, when the intermetallics thickness was in the range of 11 µm.


title: Fabrication and Self-sensing Control of Soft Electrothermal Actuator

text: Abstract Soft electrothermal actuators have attracted wide attention due to their high flexibility, adaptability and light weight. These characteristics give them great potentials to be used in biomimetic and soft robotics applications. In this paper, an electrothermal actuator with directly printed microfilament heater was designed, fabricated and characterized. The soft actuator used polyimide (PI) and polydimethylsiloxane (PDMS) as the structural materials due to their large mismatch of thermal expansion. A microfilament heater was electrohydrodynamic (EHD) printed using a low melting point alloy Bi58/Sn42, and embedded in-between the PI and PDMS layers. The fabricated actuator achieved a maximum curvature of 1.0 cm −1 under a supply voltage as low as 3 V. Resistive self-sensing technology was used to sense the deflection of the actuator and to develop the closed-loop control of the actuator. The bending curvature of the actuator is resulted from the temperature change of the actuator, which can be detected by the electrical resistance change of the embedded heater as they are linearly related. A PID controller was designed for the closed-loop operation of the actuator. Compared with the open-loop operation, the closed-loop controlled actuator demonstrated more rapid and precise response. The developed electrothermal actuator was successfully demonstrated for applications as a soft lifter and soft gripper.


title: Transformed time series analysis of first-wave COVID-19: universal similarities found in the Group of Twenty (G20) Countries

text: As of April 30, 2020, the number of cumulative confirmed coronavirus disease 2019 (COVID-19) cases exceeded 3 million worldwide and 1 million in the US with an estimated fatality rate of more than 7 percent. Because the patterns of the occurrence of new confirmed cases and deaths over time are complex and seemingly country-specific, estimating the long-term pandemic spread is challenging. I developed a simple transformation algorithm to investigate the characteristics of the case and death time series per nation, and described the universal similarities observed in the transformed time series of 19 nations in the Group of Twenty (G20). To investigate the universal similarities among the cumulative profiles of confirmed cases and deaths of 19 individual nations in the G20, a transformation algorithm of the time series data sets was developed with open-source software programs. The algorithm was used to extract and analyze statistical information from daily updated COVID-19 pandemic data sets from the European Centre for Disease Prevention and Control (ECDC). Two new parameters for each nation were suggested as factors for time-shifting and time-scaling to define reduced time, which was used to quantify the degree of universal similarities among nations. After the cumulative confirmed case and death profiles of a nation were transformed by using reduced time, most of the 19 nations, with few exceptions, had transformed profiles that closely converged to those of Italy after the onset of cases and deaths. The initial profiles of the cumulative confirmed cases per nation universally showed 3 - 4 week latency periods, during which the total number of cases remained at approximately ten. The latency period of the cumulative number of deaths was approximately half the latency number of cumulative cases, and subsequent uncontrollable increases in human deaths seemed unavoidable because the coronavirus had already widely spread. Immediate governmental actions, including responsive public-health policy-making and enforcement, are observed to be critical to minimize (and possibly stop) further infections and subsequent deaths. In the pandemic spread of infectious viral diseases, such as COVID-19 studied in this work, different nations show dissimilar and seemingly uncorrelated time series profiles of infected cases and deaths. After these statistical phenomena were viewed as identical events occurring at a distinct rate in each country, the reported algorithm of the data transformation using the reduced time revealed a nation-independent, universal profile (especially initial periods of the pandemic spread) from which a nation-specific, predictive estimation could be made and used to assist in immediate public-health policy-making.


title: Passive Monitoring of Physiological Data and Self-reported Symptoms to Detect Clusters of People with COVID-19

text: Traditional screening for COVID-19 typically includes survey questions about symptoms, travel history, and sometimes temperature measurements. We explored whether longitudinal, personal sensor data can help identify subtle changes which may indicate an infection, such as COVID-19. To do this we developed an app that collects smartwatch and activity tracker data, as well as self-reported symptoms and diagnostic testing results from participants living in the US. We assessed whether symptoms and sensor data could differentiate COVID-19 positive versus negative cases in symptomatic individuals. Between March 25 and June 7, 2020, we enrolled 30,529 participants, of whom 3,811 reported symptoms, 54 reported testing positive for COVID-19, and 279 negative. We found that a combination of symptom and sensor data resulted in an AUC=0.80 [0.73 - 0.86] which was significantly better (p < 0.01) than a model which just considered symptoms alone (AUC=0.71 [0.63 - 0.79]) in the discrimination between symptomatic individuals positive or negative for COVID-19. Such orthogonal, continuous, passively captured data may be complementary to virus testing that is generally a one-off, or infrequent, sampling assay.


title: In Parallel With My Actual Diary: On Re-writing an Exile

text: How can the production of migratory texts provide social and political agency for migrants? My starting point for investigating connections between literary acts of resistance and literal acts of resistance is in fact multiple: the discontinuous pathways of exile. In re-drafting Walter Benjamin’s seven-year exile from Paris to Lourdes, Lourdes to Marseilles, Marseilles to Port-Vendres, Port-Vendres to Portbou, ‘In Parallel With My Actual Diary’ also re-evaluates the xenophobic culture of the European cities that we each traverse, bridging gaps between 1940 and today to shed light on the often undocumented microhistories of migration and the dead end of diaspora: the largest human displacement since the Second World War. In my endeavour to converge past and present, I collage letters written by Benjamin during his exile; scenes of departure culled from interviews, photographic evidence, and testimonies; reportage of political and social upheaval in Europe in the summer of 2017; and finally, my own letters, written to Walter as I read him back. The goal of re-writing Benjamin’s exile as epistolary essay is to engender empathy, while forming parallels between his piecemeal, processual, itinerant (and unfinished) Arcades Project and the migratory–collaborative, anonymous, transmedial–texts produced by displaced persons today.


title: DEMO: BTLEmap: Nmap for Bluetooth Low Energy

text: The market for Bluetooth Low Energy devices is booming and, at the same time, has become an attractive target for adversaries. To improve BLE security at large, we present BTLEmap, an auditing application for BLE environments. BTLEmap is inspired by network discovery and security auditing tools such as Nmap for IP-based networks. It allows for device enumeration, GATT service discovery, and device fingerprinting. It goes even further by integrating a BLE advertisement dissector, data exporter, and a user-friendly UI, including a proximity view. BTLEmap currently runs on iOS and macOS using Apple's CoreBluetooth API but also accepts alternative data inputs such as a Raspberry Pi to overcome the restricted vendor API. The open-source project is under active development and will provide more advanced capabilities such as long-term device tracking (in spite of MAC address randomization) in the future.


Understanding the Bias between the Number of Confirmed Cases and Actual Number of Infections in the COVID-19 Pandemic


title: Estimation of true number of COVID-19 infected people in Japan using LINE questionnaire

text: The authors estimated the true number of COVID-19 infected people in Japan using the LINE questionnaire data and the PCR test results. A statistically significant correlation was observed between the infection rate per prefecture with PCR test and the rate of high fever. Using this correlation, true number of COVID-19 infected people in Japan was estimated approximately twenty thousand (+/− ten thousand) as of April 1, 2020.


title: Timing of non-pharmaceutical interventions to mitigate COVID-19 transmission and their effects on mobility: A cross-country analysis

text: Non-pharmaceutical interventions (NPIs) that encourage physical distancing can decrease and delay the transmission of COVID-19. They have been implemented globally during the pandemic, however, the specific NPIs implemented and the timing of interventions has varied widely. We validated two published datasets on the implementation of NPIs globally. The health and socioeconomic factors associated with delay in implementation of NPIs was analyzed using fractional logit and probit models, and beta regression models. The probability of timely NPI implementation by a country was analyzed using a probit model. The effects of these interventions on mobility changes using Google social mobility reports, were analyzed with propensity score matching methods. Three NPIs were analyzed: national school closure, national lockdown, and global travel ban. Countries with higher incomes, larger populations, and better health preparedness measures had greater delays in implementation. Countries with greater population density, more democratic political systems, lower case detection capacity, and later arrival of first cases were more likely to implement NPIs. Implementation of lockdowns significantly reduced physical mobility. Mobility was further reduced when lockdowns were enforced with curfews or fines, or were more strictly defined. National school closures did not significantly change mobility. The implementation of NPIs is a global public good during pandemics, and the international community needs to address constraints and design incentives so countries implement NPIs in a timely manner. Further analysis is needed on the effect of NPI variations on mobility and transmission, and their associated costs.


title: Analysis of adaptive immune cell populations and phenotypes in the patients infected by SARS-CoV-2

text: Coronavirus disease-2019 (COVID-19), caused by SARS-CoV-2, has rapidly spread to most of countries in the world, threatening the health and lives of many people. Unfortunately, information regarding the immunological characteristics in COVID-19 patients remains limited. Here we collected the blood samples from 18 healthy donors (HD) and 38 COVID-19 patients to analyze changes in the adaptive immune cell populations and phenotypes. In comparison to HD, the lymphocyte percentage was slightly decreased, the percentages of CD4 and CD8 T cells in lymphocytes are similar, whereas B cell percentage increased in COVID-19 patients. T cells, especially CD8 T cells, showed an enhanced expression of late activation marker CD25 and exhaustion marker PD-1. Importantly, SARS-CoV-2 induced an increased percentage of T follicular helpher (Tfh)- and germinal center B-like (GCB-like) cells in the blood. However, the parameters in COVD-19 patients remained unchanged across various age groups. Therefore, we demonstrated that the T and B cells can be activated normally and exhibit functional features. These data provide a clue that the adaptive immunity in most people could be primed to induce a significant immune response against SARS-CoV-2 infection upon receiving standard medical care.


title: Expression of Ace2, Tmprss2, and Furin in mouse ear tissue

text: Objectives Intracellular entry of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) depends on the interaction between its spike protein to a cellular receptor named angiotensin-converting enzyme 2 (ACE2) and depends on Furin-mediated spike 23 protein cleavage and spike protein priming by host cell proteases including 24 transmembrane protease serine 2 (TMPRSS2). Tmprss1, Tmprss3, and Tmprss5 are expressed in the spiral ganglion neurons and the organ of Corti in the inner ear; however, Ace2, Tmprss2, and Furin expression profiles in the middle ear remain unclear. Therefore, this study aimed to analyze Ace2, Tmprss2, and Furin expression in the middle and inner ear of mice. Study Design Animal research. Setting Department of Otolaryngology and Head and Neck Surgery, University of Tokyo. Methods We performed immunohistochemical analysis to examine the distribution of Ace2, Tmprss2, and Furin in the eustachian tube, middle ear space, and cochlea of mice. Results Ace2 was expressed in the cytoplasm in the middle ear epithelium, eustachian tube epithelium, stria vascularis, and spiral ganglion. Tmprss2 and Furin were widely expressed in the middle ear spaces and the cochlea. Conclusion Co-expression of Ace2, Tmprss2, and Furin in the middle ear indicates that the middle ear is susceptible to SARS-CoV-2 infections, thus warranting the use of personal protective equipment during mastoidectomy for coronavirus disease (COVID-19) patients.


title: Analysis on the Clinical Characteristics of 36 Cases of Novel Coronavirus Pneumonia in Kunming

text: Objective: To analyze the clinical characteristics of patients with novel coronavirus pneumonia in Kunming City, and to study the correlation between nutritional status and immune function. Methods: Clinical data of 36 patients with novel coronavirus pneumonia in isolation area of Kunming Third People's Hospital from January 31 to February 15, 2020 were collected, and the basic situation, clinical characteristics, laboratory examination and CT imaging characteristics were analyzed. Serum albumin (ALB), prealbumin (PAB), hypersensitive c-reactive protein (hs-crp), CD3T cells, CD4T cells, CD8T cells and normal control group were analyzed. A simple linear regression analysis of the relationship between proalbumin and T cell subpopulation counts in the blood of patients. Results: (1) The patients with new coronavirus pneumonia in Kunming were mainly of common type. (2) 50% of the patients' first symptoms were fever and cough; (3) The total number of white blood cells in peripheral blood was normal or decreased in 23 cases (79%), and the lymphocyte count decreased in 5 cases (13.89%), without anemia. Hypersensitive c-reactive protein increased in 19 (52.78%) cases, and procalcitonin increased in 1 case. Albumin decreased in 5 cases (13.89%), proalbumin decreased in 15 cases (41.67%), alanine transaminase increased slightly in 4 cases (11.11%), alanine transaminase increased slightly in 4 cases (11.11%), total bilirubin increased slightly in 11 cases (30.56%), and renal function and blood coagulation were normal. Absolute value of CD3+T cells is with a decrease in 21 cases (58.3%), CD4+T in 28 cases (77.8%), CD8+T in 17 cases (47.2%), and CD4+/ CD8+ inverse in 6 cases (16.7%). (4) The prealbumin, CD3 T cells, CD4 T cells and CD8 T cells in the new coronavirus pneumonia group were significantly lower than those in the normal control group, and the hypersensitive c-reactive protein was higher than that in the normal control group. (5) The levels of PAB in the serum of the patients were linearly correlated with hs-crp, CD3 T cells, CD4 T cells and CD8 T cells, and the correlation coefficients were -0.474, 0.558, 0.467 and 0.613, respectively, showing statistical differences. Conclusion: The clinical characteristics of the novel coronavirus pneumonia in Kunming are different from those in Wuhan. The changes of serum proalbumin and T cell subsets are relatively obvious. Changes in serum proalbumin may contribute to the early warning of novel coronavirus pneumonia. The nutritional status of patients with common and mild pneumonia should be considered.


title: Clinical characteristics of 60 discharged cases of 2019 novel coronavirus-infected pneumonia in Taizhou, China

text: Background: The number of patients with pneumonia stemming from the 2019 novel coronavirus (COVID-19) infection has increased rapidly. However, the clinical characteristics of discharged patients remain little known. Here, we attempt to describe the clinical characteristics and treatment experiences of discharged cases from Taizhou, China. Methods: A total of 60 patients with COVID-19-infected pneumonia who were discharged from Taizhou Enze Medical Center (Group), from January 31, 2020, to February 16, 2020, were included in the analysis. The discharge criteria were based on the New Coronavirus Pneumonia Prevention and Control Program (Fifth Edition, China). Results: Of the 60 patients, the median age was 41 years, and 58.3% were male. Only 13.3% of patients were identified as having severe novel coronavirus pneumonia. All patients received combined antiviral treatment on admission, including ß-interferon, lopinavir/tonavir, Abidol and oseltamivir. All patients with severe conditions received gamma globulin and hormone therapy. No patients had endotracheal intubation or died. The median duration from symptom onset to hospitalization was 3 (range, 0–15) days. The median duration of COVID-19 shedding was 14 (range, 5–26) days, and the median duration of hospital stay was 15 (range, 7–23) days. Conclusions: Early therapy and comprehensive therapy are key to the outcome for patients with COVID-19-infected pneumonia, especially for those with severe pneumonia.


title: Estimation of risk factors for COVID-19 mortality - preliminary results

text: Since late December 2019 a new epidemic outbreak has emerged from Whuhan, China. Rapidly the new coronavirus has spread worldwide. China CDC has reported results of a descriptive exploratory analysis of all cases diagnosed until the 11th February 2020, presenting the epidemiologic curves and geo-temporal spread of COVID-19 along with case fatality rate according to some baseline characteristics, such as age, gender and several well-established high prevalence comorbidities. Despite this, we intend to increase even further the predictive value of that manuscript by presenting the odds ratio for mortality due to COVID-19 adjusted for the presence of those comorbidities and baseline characteristics such as age and gender. Besides, we present a way to determine the risk of each particular patient, given his characteristics. We found that age is the variable that presents higher risk of COVID-19 mortality, where 60 or older patients have an OR = 18.8161 (CI95%[7.1997; 41.5517]). Regarding comorbidities, cardiovascular disease appears to be the riskiest (OR=12.8328 CI95%[10.2736; 15.8643], along with chronic respiratory disease (OR=7.7925 CI95%[5.5446; 10.4319]). Males are more likely to die from COVID-19 (OR=1.8518 (CI95%[1.5996; 2.1270]). Some limitations such as the lack of information about the correct prevalence of gender per age or about comorbidities per age and gender or the assumption of independence between risk factors are expected to have a small impact on results. A final point of paramount importance is that the equation presented here can be used to determine the probability of dying from COVID-19 for a particular patient, given its age interval, gender and comorbidities associated.


title: A perspective of viruses and the outbreak of a novel coronavirus SARS-CoV-2

text: The article presents some introductory remarks on viruses and in general how they lead to diseases. With reference to same, it discusses the emergence of a fairly novel coronavirus, 2019-CoV-2 and its possible medication.


Oncology care in the era of pandemics


title: Wuhan novel coronavirus 2019nCoV

text: Information about the open-access article 'Wuhan novel coronavirus 2019nCoV' in DOAJ DOAJ is an online directory that indexes and provides access to quality open access, peer-reviewed journals


title: SARS-CoV-2 infection in Health Care Workers in a large public hospital in Madrid, Spain, during March 2020

text: Background On January 31st the first case of COVID-19 was detected in Spain, an imported case from Germany in Canary Islands, and thereafter on February 25th the first case was detected in Madrid. The first case of COVID-19 was confirmed at the Hospital Universitario 12 de Octubre on March 1st, a large public hospital with 1200 beds, covering an area over 400000 inhabitants in southern Madrid. During March 2020 highly active circulation of SARS-CoV-2 was experienced in Madrid with 24090 cases officially reported by March 29th. Methods Since the beginning of the epidemics the Occupational Health and Safety Service (OHSS) organized the consulting and testing of the hospital personnel with confirmed exposure and also those presenting symptoms suggestive of viral respiratory infection. For molecular diagnosis of SARS-CoV-2 infection both nasopharyngeal and oropharyngeal swabs were obtained from suspected cases and processed at the Microbiology Laboratory by automatized specific PCR methods that was operative from February 25th as part of the preparedness. Results From a total of 6800 employees of the hospital, 2085 (30,6 %) were tested during the period 1-29 March 2020, some of them repeatedly (2286 total samples). The first HCW infected was confirmed on March 9th. A total of 791 HCW and personnel were confirmed to be infected by March 29th, representing 38% of those tested and 11,6 % of all the hospital workers. The proportion of infected individuals was estimated among the different groups of occupational exposure and the evolution of the cases during the expansive epidemic wave was compared between HCW and those patients attending at the Emergency Department (ER) during the same period and adjusted by the same age range. There were no statistically significant differences in the proportion of SARS-CoV-2 positive PCR detection between HCW from high risk areas involved in close contact with COVID-19 patients in comparison with clerical, administrative or laboratory personnel without direct contact with patients. The curves of evolution of accumulated cases between patients and HCW during March 2020 showed an almost parallel shape. Discussion The recommendation from our OHSS did not include testing of asymptomatic cases but was highly proactive in testing even patients with minor symptoms therefore, a high proportion of HCW and non-sanitary personnel was tested in March 2020 during the rapid period of expansion of the epidemics in Madrid, accounting for a total of 30,6 % of the hospital employees. Most of the COVID-19 cases among the hospital HCW and personnel were mild and managed at home under self-isolation measures, however 23 (3%) required hospitalization mostly due to severe bilateral interstitial pneumonia, two of those cases required mechanical ventilation at the ICU. No fatalities occurred during the study period. Although there were some cases of highly probable transmission from COVID-19 patients to HCWs, mainly at the first phase of the epidemics, there were no significant differences on the infection rates of HCW and hospital personnel that can be related to working in areas of high exposure risk. Furthermore, the evolution of cases during the same time period (March 2020) between patients attending the ER and hospital staff suggests that both groups were driven by the same dynamics. This experience is similar to the communicated from Wuhan verified by the WHO Joint Mission and also from recent experiences at hospital in the Netherlands, where most of the infections of HCW were related to household or community contacts. Significance Since the collective of hospital HCW are exhaustively screened in specific centers, their rate of infection for SARS-CoV-2 could be an indicator of the epidemic dynamics in the community. There appears to be a close connection between HCW infection and the driving forces of transmission in the community. Although we cannot exclude an additional risk factor of infection by SARS-CoV-2 due to the fact of the hospital environment, the similar proportions of positive cases among all the areas of the hospital and the evolutive wave of infection, as compared with the community, are clear arguments against a major factor of occupational risk. Exhaustive testing, such as the one carried out in our institution, covering over one third of all the workers, could be used as a reference of the population infected in the community. Since a significant proportion of COVID-19 cases can be asymptomatic and not all the hospital employees were actually tested, it is highly likely that this 11,6 % is a minimum estimation of the impact of SARS-CoV-2 circulation in Madrid during the first 4 weeks of the epidemics. This is in high and clear contrast with the official figures circulating at national and international levels. This has important implications to more precisely estimate the actual number of cases in the community and to develop public health policies for containment, treatment and recovery.


The Unique Challenges and Lessons Imparted by the Cystic Fibrosis Community in the Time of COVID-19 Pandemic


title: The ongoing COVID-19 epidemic in Minas Gerais, Brazil: insights from epidemiological data and SARS-CoV-2 whole genome sequencing.

text: The recent emergence of a previously unknown coronavirus (SARS-CoV-2), first confirmed in the city of Wuhan in China in December 2019, has caused serious public health and economic issues due to its rapid dissemination worldwide. Although 61,888 confirmed cases had been reported in Brazil by 28 April 2020, little was known about the SARS-CoV-2 epidemic in the country. To better understand the recent epidemic in the second most populous state in southeast Brazil (Minas Gerais, MG), we looked at existing epidemiological data from 3 states and sequenced 40 complete genomes from MG cases using Nanopore. We found evidence of multiple independent introductions from outside MG, both from genome analyses and the overly dispersed distribution of reported cases and deaths. Epidemiological estimates of the reproductive number using different data sources and theoretical assumptions all suggest a reduction in transmission potential since the first reported case, but potential for sustained transmission in the near future. The estimated date of introduction in Brazil was consistent with epidemiological data from the first case of a returning-traveler from Lombardia, Italy. These findings highlight the unique reality of MGs epidemic and reinforce the need for real-time and continued genomic surveillance strategies as a way of understanding and therefore preparing against the epidemic spread of emerging viral pathogens.


title: Lectin-like Intestinal Defensin Inhibits 2019-nCoV Spike binding to ACE2

text: The burgeoning epidemic caused by novel coronavirus 2019 (2019-nCoV) is currently a global concern. Angiotensin-converting enzyme-2 (ACE2) is a receptor of 2019-nCoV spike 1 protein (S1) and mediates viral entry into host cells. Despite the abundance of ACE2 in small intestine, few digestive symptoms are observed in patients infected by 2019-nCoV. Herein, we investigated the interactions between ACE2 and human defensins (HDs) specifically secreted by intestinal Paneth cells. The lectin-like HD5, rather than HD6, bound ACE2 with a high affinity of 39.3 nM and weakened the subsequent recruitment of 2019-nCoV S1. The cloak of HD5 on the ligand-binding domain of ACE2 was confirmed by molecular dynamic simulation. A remarkable dose-dependent preventive effect of HD5 on 2019-nCoV S1 binding to intestinal epithelial cells was further evidenced by in vitro experiments. Our findings unmasked the innate defense function of lectin-like intestinal defensin against 2019-nCoV, which may provide new insights into the prevention and treatment of 2019-nCoV infection.