title: Helping doctors hasten COVID-19 treatment: Towards a rescue framework for the transfusion of best convalescent plasma to the most critical patients based on biological requirements via ml and novel MCDM methods

text: CONTEXT: People who have recently recovered from the threat of deteriorating coronavirus disease-2019 (COVID-19) have antibodies to the coronavirus circulating in their blood. Thus, the transfusion of these antibodies to deteriorating patients could theoretically help boost their immune system. Biologically, two challenges need to be surmounted to allow convalescent plasma (CP) transfusion to rescue the most severe COVID-19 patients. First, convalescent subjects must meet donor selection plasma criteria and comply with national health requirements and known standard routine procedures. Second, multi-criteria decision-making (MCDM) problems should be considered in the selection of the most suitable CP and the prioritisation of patients with COVID-19. OBJECTIVE: This paper presents a rescue framework for the transfusion of the best CP to the most critical patients with COVID-19 on the basis of biological requirements by using machine learning and novel MCDM methods. METHOD: The proposed framework is illustrated on the basis of two distinct and consecutive phases (i.e. testing and development). In testing, ABO compatibility is assessed after classifying donors into the four blood types, namely, A, B, AB and O, to indicate the suitability and safety of plasma for administration in order to refine the CP tested list repository. The development phase includes patient and donor sides. In the patient side, prioritisation is performed using a contracted patient decision matrix constructed between 'serological/protein biomarkers and the ratio of the partial pressure of oxygen in arterial blood to fractional inspired oxygen criteria' and 'patient list based on novel MCDM method known as subjective and objective decision by opinion score method'. Then, the patients with the most urgent need are classified into the four blood types and matched with a tested CP list from the test phase in the donor side. Thereafter, the prioritisation of CP tested list is performed using the contracted CP decision matrix. RESULT: An intelligence-integrated concept is proposed to identify the most appropriate CP for corresponding prioritised patients with COVID-19 to help doctors hasten treatments. DISCUSSION: The proposed framework implies the benefits of providing effective care and prevention of the extremely rapidly spreading COVID-19 from affecting patients and the medical sector.


title: Challenges of SARS-CoV-2 and lessons learnt from SARS in Guangdong Province, China

text: With lessons learnt from the SARS outbreak in 2003, Guangdong Province is taking the lead in bringing COVID-19 under control by multiple strict regulations in combination with effective healthcare provision.


title: Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases

text: Acute respiratory failure and a systemic coagulopathy are critical aspects of the morbidity and mortality characterizing infection with severe acute respiratory distress syndrome-associated coronavirus-2, the etiologic agent of Coronavirus disease 2019 (COVID-19). We examined skin and lung tissues from 5 patients with severe COVID-19 characterized by respiratory failure (n= 5) and purpuric skin rash (nâ¯=â¯3). COVID-19 pneumonitis was predominantly a pauci-inflammatory septal capillary injury with significant septal capillary mural and luminal fibrin deposition and permeation of the interalveolar septa by neutrophils. No viral cytopathic changes were observed and the diffuse alveolar damage (DAD) with hyaline membranes, inflammation, and type II pneumocyte hyperplasia, hallmarks of classic acute respiratory distress syndrome, were not prominent. These pulmonary findings were accompanied by significant deposits of terminal complement components C5b-9 (membrane attack complex), C4d, and mannose binding lectin (MBL)-associated serine protease (MASP)2, in the microvasculature, consistent with sustained, systemic activation of the complement pathways. The purpuric skin lesions similarly showed a pauci-inflammatory thrombogenic vasculopathy, with deposition of C5b-9 and C4d in both grossly involved and normally-appearing skin. In addition, there was co-localization of COVID-19 spike glycoproteins with C4d and C5b-9 in the interalveolar septa and the cutaneous microvasculature of 2 cases examined. In conclusion, at least a subset of sustained, severe COVID-19 may define a type of catastrophic microvascular injury syndrome mediated by activation of complement pathways and an associated procoagulant state. It provides a foundation for further exploration of the pathophysiologic importance of complement in COVID-19, and could suggest targets for specific intervention.


Ethical framework for head and neck endocrine surgery in the COVID-19 pandemic


title: Risk Factors for Mortality and Respiratory Support in Elderly Patients Hospitalized with COVID-19 in Korea

text: BACKGROUND: The mortality risk of coronavirus disease 2019 (COVID-19) is higher in patients with older age, and many elderly patients are reported to require advanced respiratory support. METHODS: We reviewed medical records of 98 patients aged ≥ 65 years who were hospitalized with COVID-19 during a regional outbreak in Daegu/Gyeongsangbuk-do province of Korea. The outcome measures were in-hospital mortality and the treatment with mechanical ventilation (MV) or high-flow nasal cannula (HFNC). RESULTS: The median age of the patients was 72 years; 55.1% were female. Most (74.5%) had at least one underlying condition. Overall case fatality rate (CFR) was 20.4%, and median time to death after admission was 8 days. The CFR was 6.1% among patients aged 65-69 years, 22.7% among those aged 70-79 years, and 38.1% among those aged ≥ 80 years. The CFR among patients who required MV was 43.8%, and the proportion of patients received MV/HFNC was 28.6%. Nosocomial acquisition, diabetes, chronic lung diseases, and chronic neurologic diseases were significant risk factors for both death and MV/HFNC. Hypotension, hypoxia, and altered mental status on admission were also associated with poor outcome. CRP > 8.0 mg/dL was strongly associated with MV/HFNC (odds ratio, 26.31; 95% confidence interval, 7.78-88.92; P < 0.001), and showed better diagnostic characteristics compared to commonly used clinical scores. CONCLUSION: Patients aged ≥ 80 years had a high risk of requiring MV/HFNC, and mortality among those severe patients was very high. Severe initial presentation and laboratory abnormalities, especially high CRP, were identified as risk factors for mortality and severe hospital course.


Message to the Food and Nutrition Bulletin Community


title: Decoding the evolution and transmissions of the novel pneumonia coronavirus (SARS-CoV-2 / HCoV-19) using whole genomic data

text: The outbreak of COVID-19 started in mid-December 2019 in Wuhan, China. Up to 29 February 2020, SARS-CoV-2 (HCoV-19 / 2019-nCoV) had infected more than 85 000 people in the world. In this study, we used 93 complete genomes of SARS-CoV-2 from the GISAID EpiFlu TM database to investigate the evolution and human-to-human transmissions of SARS-CoV-2 in the first two months of the outbreak. We constructed haplotypes of the SARS-CoV-2 genomes, performed phylogenomic analyses and estimated the potential population size changes of the virus. The date of population expansion was calculated based on the expansion parameter tau ( τ) using the formula t= τ/2 u. A total of 120 substitution sites with 119 codons, including 79 non-synonymous and 40 synonymous substitutions, were found in eight coding-regions in the SARS-CoV-2 genomes. Forty non-synonymous substitutions are potentially associated with virus adaptation. No combinations were detected. The 58 haplotypes (31 found in samples from China and 31 from outside China) were identified in 93 viral genomes under study and could be classified into five groups. By applying the reported bat coronavirus genome (bat-RaTG13-CoV) as the outgroup, we found that haplotypes H13 and H38 might be considered as ancestral haplotypes, and later H1 was derived from the intermediate haplotype H3. The population size of the SARS-CoV-2 was estimated to have undergone a recent expansion on 06 January 2020, and an early expansion on 08 December 2019. Furthermore, phyloepidemiologic approaches have recovered specific directions of human-to-human transmissions and the potential sources for international infected cases.


title: Clinical characteristics of coronavirus disease (COVID-19) early findings from a teaching hospital in Pavia, North Italy, 21 to 28 February 2020

text: We describe clinical characteristics, treatments and outcomes of 44 Caucasian patients with coronavirus disease (COVID-19) at a single hospital in Pavia, Italy, from 21-28 February 2020, at the beginning of the outbreak in Europe. Seventeen patients developed severe disease, two died. After a median of 6 days, 14 patients were discharged from hospital. Predictors of lower odds of discharge were age > 65 years, antiviral treatment and for severe disease, lactate dehydrogenase > 300 mg/dL.


Positive RT-PCR Test Results in Patients Recovered From COVID-19


Household COVID-19 Prevalence


COVID-19 and Crimean-Congo Hemorrhagic Fever: Similarities and Differences


"Pandemic fear" and COVID-19: mental health burden and strategies


As lockdowns lift, new hazards lurk in the water


Diagnosis of COVID-19 in children: the story evolves


title: Chinese herbal medicine for coronavirus disease 2019: A systematic review and meta-analysis

text: Currently, coronavirus disease 2019 (COVID-19), which can lead to severe respiratory failure and death, is now a global pandemic with no specific anti-viral drugs or vaccines. However, It is worth noting that traditional Chinese medicine (TCM), especially Chinese herbal medicine (CHM), has been widely applied in mainland China since outbreak, bringing new hope for the prevention and control of COVID-19. A comprehensive literature searching was conducted in 7 electronic databases from their inception up to June 21, 2020 to evaluate the efficacy and safety of CHM for COVID-19. Eighteen randomized controlled trials (RCTs) involving 2275 patients were enrolled. Most of CHMs were originated from classical Chinese herbal formulas. Liquoric Root (Gancao, Radix Glycyrrhizae), Baical Skullcap Root (Huangqin, Radix Scutellariae Baicalensis), Pinellia Rhizome (Banxia, Rhizoma Pinelliae Tematae), Forsythia Fruit (Lianqiao, Fructus Forsythiae Suspensae), and Bitter Apricot Seed (Kuxingren, Semen Armeniacae Amarum) were most frequently used Chinese herbs. The most commonly used dosage formulation was decoction. Our meta-analyses found that comparing CHM group and conventional western medicine group, CHM group has improvements in several clinical parameters including lung CT, clinical cure rate, ranging from mild to critical cases, length of hospital stay, total score of clinical symptoms, fever reduction time, symptom score of fever, number of cough reduction cases, symptom score of cough, number of fatigue reduction cases, symptom score of fatigue, disappearing time of fatigue, TCM syndrome, viral nucleic acid testing, and inflammatory biomarkers (C-reactive protein). Besides, no severe adverse effects was identified by CHM. CHM, especially classical Chinese herbal formulas, could be used as potential candidates for COVID-19 in this battle.


title: Compliance measurement and observed influencing factors of hand hygiene based on COVID-19 guidelines in China

text: BACKGROUND: Higher requirement is put forward in the measurement of hand hygiene (HH) during a pandemic. This study aimed to describe HH compliance measurement and explore observed influencing factors with respect to coronavirus disease 2019 (COVID-19) guidelines in China. METHODS: Compliance was measured as the percentage of compliant opportunities based on criteria for 17 moments. The criteria for compliance included HH behavior, procedure, duration, hand drying method, and the overall that counts them all. The observed influencing factors included different departments and areas and protection motivation. Descriptive analysis and logistic regression were performed. RESULTS: The compliance of overall criteria, HH behavior, procedure, duration, and hand drying method were 79.44%, 96.71%, 95.74%, 88.93%, and 88.42%, respectively, which were significantly different from each other (P < .001). Meanwhile, the overall and hand drying method compliance in semi-contaminated areas (odds ratio [OR]â¯=â¯1.829, P < .001; ORâ¯=â¯2.149, Pâ¯=â¯.001) and hygienic areas (ORâ¯=â¯1.689, Pâ¯=â¯.004; ORâ¯=â¯1.959, Pâ¯=â¯.015) were significantly higher than those in contaminated area. The compliance with HH behavior for the motivation of patient-protection (ORâ¯=â¯0.362, P < .001) was lower than that for the motivation of self-protection. CONCLUSIONS: HH compliance was firstly measured using different criteria for 17 moments according to COVID-19 guidelines in China. The measurement of HH compliance needs clearer definition and comprehensive practice. Contaminated areas and motivation of patient-protection contribute to lower compliance, which may be addressed by allocating more human resources and increasing supervision and education.


COVID-19 and the release of mafia bosses: The importance of medico-legal evaluations


title: Practical management of inflammatory bowel disease patients during the COVID-19 pandemic: expert commentary from the Gastroenterological Society of Australia Inflammatory Bowel Disease faculty

text: The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has emerged as a public health emergency and challenged healthcare systems globally. In a minority of patients, SARS-CoV-2 manifests with a severe acute respiratory illness and currently there is insufficient data regarding the virulence of COVID-19 in inflammatory bowel disease patients taking immunosuppressive therapy. This review aims to summarise the current literature and provide guidance on the management of inflammatory bowel disease patients in the context of the COVID-19 pandemic in the Australasian setting.


Characterization of eight novel full-length genomes of SARS-CoV-2 among imported COVID-19 cases from abroad in Yunnan, China


title: A Case Series of Five People Living with HIV Hospitalized with COVID-19 in Chicago, Illinois

text: The risk of COVID-19 among people living with HIV (PLWH) is largely unknown and there have been very few reported cases in the literature. We report a case series of five PLWH with COVID-19. We identified all patients with a diagnosis of HIV who tested positive for SARS-CoV-2 at University of Chicago Medicine between March 1, 2020, and April 7, 2020. We retrospectively collected data regarding demographics, comorbidities, medications, laboratory test results, radiology results, and outcomes associated with COVID-19. All five PLWH with COVID-19 were African American; 80% (4/5) were cisgender females. The mean age of patients was 48 years old (range 38-53). The majority of patients presented with cough, fever, and shortness of breath. Three patients had diarrhea. One patient presented with predominantly cardiac symptoms. All were taking antiretroviral therapy (ART) with CD4 count >200 cells/mm3 and suppressed HIV viral loads at the time of COVID-19 diagnosis. All five patients were hospitalized, two required supplemental oxygen, and none required mechanical ventilation. Four patients were treated with azithromycin and a cephalosporin and two were also treated with hydroxychloroquine. The median length of stay was 3 days (range 2-7). All patients recovered. More research is needed to understand the risks of COVID-19 among PLWH and the impact of ART on outcomes for patients with COVID-19.


title: A Deep Neural Network to Distinguish COVID-19 from other Chest Diseases using X-ray Images

text: BACKGROUND: Scanning patient's lungs to detect a Coronavirus 2019 (COVID-19) may lead to similar imaging with other chest diseases that strongly requires a multidisciplinary approach to confirm the diagnosis. There are only few works targeted pathological x-ray images. Most of the works targeted only single disease detection which is not good enough. Some works have provided for all classes however the results suffer due to lack of data for rare classes and data unbalancing problem. METHODS: Due to arise of COVID-19 virus medical facilities of many countries are overwhelmed and there is a need of intelligent system to detect it. There have been few works regarding detection of the coronavirus but there are many cases where it can be misclassified as some techniques do not provide any goodness if it can only identify type of diseases and ignore the rest. This work is a deep learning-based model to distinguish between cases of COVID-19 from other chest diseases which is need of today. RESULTS: A Deep Neural Network model provides a significant contribution in terms of detecting COVID-19 and provide effective analysis of chest related diseases with respect to age and gender. Our model achieves 87% accuracy in terms of Gan based synthetic data and four different types of deep learning- based models which provided state of the art comparable results. CONCLUSION: If the gap in identifying of all viral pneumonias is not filled with effective automation of chest disease detection the healthcare industry may have to bear unfavorable circumstances.


A proposed scoring system for triage of patients who require vascular access creation in times of COVID-19


A British Society of Thoracic Imaging statement: considerations in designing local imaging diagnostic algorithms for the COVID-19 pandemic


title: Development of a Portable, Ultra-Rapid and Ultra-Sensitive Cell-Based Biosensor for the Direct Detection of the SARS-CoV-2 S1 Spike Protein Antigen

text: One of the key challenges of the recent COVID-19 pandemic is the ability to accurately estimate the number of infected individuals, particularly asymptomatic and/or early-stage patients. We herewith report the proof-of-concept development of a biosensor able to detect the SARS-CoV-2 S1 spike protein expressed on the surface of the virus. The biosensor is based on membrane-engineered mammalian cells bearing the human chimeric spike S1 antibody. We demonstrate that the attachment of the protein to the membrane-bound antibodies resulted in a selective and considerable change in the cellular bioelectric properties measured by means of a Bioelectric Recognition Assay. The novel biosensor provided results in an ultra-rapid manner (3 min), with a detection limit of 1 fg/mL and a semi-linear range of response between 10 fg and 1 µg/mL. In addition, no cross-reactivity was observed against the SARS-CoV-2 nucleocapsid protein. Furthermore, the biosensor was configured as a ready-to-use platform, including a portable read-out device operated via smartphone/tablet. In this way, we demonstrate that the novel biosensor can be potentially applied for the mass screening of SARS-CoV-2 surface antigens without prior sample processing, therefore offering a possible solution for the timely monitoring and eventual control of the global coronavirus pandemic.


Shielding for patients using a single-use vinyl-box under continuous aerosol suction to minimize SARS-CoV-2 transmission during emergency endoscopy


title: Acute myocarditis associated with COVID-19 infection

text: We present the case of a 20-year-old male patient without previous history of cardiovascular disease who was admitted to our hospital with a new onset febrile sensation and chest pain. Chest computed tomography revealed a subpleural consolidation with a halo of ground-glass opacification. Blood tests revealed elevated levels of markers of myocyte necrosis (troponin I and creatine kinase-MB). Nasopharyngeal swab was positive for COVID-19. Cardiac MRI showed myocardial edema and late gadolinium enhancement compatible with myocarditis associated with COVID-19 infection. This case showed that acute myocarditis can be the initial presentation of patients with COVID-19 infection.


title: The pathogenesis and treatment of the `Cytokine Storm' in COVID-19

text: Cytokine storm is an excessive immune response to external stimuli. The pathogenesis of the cytokine storm is complex. The disease progresses rapidly, and the mortality is high. Certain evidence shows that, during the coronavirus disease 2019 (COVID-19) epidemic, the severe deterioration of some patients has been closely related to the cytokine storm in their bodies. This article reviews the occurrence mechanism and treatment strategies of the COVID-19 virus-induced inflammatory storm in attempt to provide valuable medication guidance for clinical treatment.


title: Management of primary hepatic malignancies during the COVID-19 pandemic: recommendations for risk mitigation from a multidisciplinary perspective

text: Around the world, recommendations for cancer treatment are being adapted in real time in response to the pandemic of COVID-19. We, as a multidisciplinary team, reviewed the standard management options, according to the Barcelona Clinic Liver Cancer classification system, for hepatocellular carcinoma. We propose treatment recommendations related to COVID-19 for the different stages of hepatocellular carcinoma (ie, 0, A, B, and C), specifically in relation to surgery, locoregional therapies, and systemic therapy. We suggest potential strategies to modify risk during the pandemic and aid multidisciplinary treatment decision making. We also review the multidisciplinary management of intrahepatic cholangiocarcinoma as a potentially curable and incurable diagnosis in the setting of COVID-19.


title: Connecting the Dots of COVID-19 Transmissions in India

text: Witnessing its first case in late January 2020 India has seen a sharp rise in the number of positive cases of COVID-19. 34 States/UT (s) of the country have been found to be affected by the pandemic to date. We in this work, study the progress of COVID-19 pandemic in India. We aim to create transmission network visualization (s) of COVID-19 in India and perform analysis upon them. Using the transmission networks obtained we attempt to find the possible Super Spreader Individual (s) and Super Spreader Events (SSE) responsible for the outbreak in their respective regions. We discuss the potentials of network analysis in mitigating the further spread of the disease. This is one of the initial studies of the outbreak in India and the first attempt to study the pandemic in the country from a transmission network perspective.


IBD in the Times of COVID-19


title: Prevalence of Asymptomatic SARS-CoV-2 Infection: A Narrative Review

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world since the first cases of coronavirus disease 2019 (COVID-19) were observed in December 2019 in Wuhan, China. It has been suspected that infected persons who remain asymptomatic play a significant role in the ongoing pandemic, but their relative number and effect have been uncertain. The authors sought to review and synthesize the available evidence on asymptomatic SARS-CoV-2 infection. Asymptomatic persons seem to account for approximately 40% to 45% of SARS-CoV-2 infections, and they can transmit the virus to others for an extended period, perhaps longer than 14 days. Asymptomatic infection may be associated with subclinical lung abnormalities, as detected by computed tomography. Because of the high risk for silent spread by asymptomatic persons, it is imperative that testing programs include those without symptoms. To supplement conventional diagnostic testing, which is constrained by capacity, cost, and its one-off nature, innovative tactics for public health surveillance, such as crowdsourcing digital wearable data and monitoring sewage sludge, might be helpful.


title: Coronavirus Disease 2019 (COVID-19) Information for Cardiologistsã- Systematic Literature Review and Additional Analysis

text: BACKGROUND: Despite the rapidly increasing attention being given to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, more commonly known as coronavirus disease 2019 (COVID-19), the relationship between cardiovascular disease and COVID-19 has not been fully described.MethodsâandâResults:A systematic review was undertaken to summarize the important aspects of COVID-19 for cardiologists. Protection both for patients and healthcare providers, indication for treatments, collaboration with other departments and hospitals, and regular update of information are essentials to front COVID-19 patients. CONCLUSIONS: Because the chief manifestations of COVID-19 infection are respiratory and acute respiratory distress syndrome, cardiologists do not see infected patients directly. Cardiologists need to be better prepared regarding standard disinfection procedures, and be aware of the indications for extracorporeal membrane oxygenation and its use in the critical care setting.


Mania Precipitated by COVID-19 Pandemic-Related Stress


title: Suppression of Groups Intermingling as Appealing Option For Flattening and Delaying the Epidemiological Curve While Allowing Economic and Social Life at Bearable Level During COVID-19 Pandemic

text: In this work, we simulate the COVID-19 pandemic dynamics in a population modeled as a network of groups wherein infection can propagate both via intra-group and via inter-group interactions. Our results emphasize the importance of diminishing the inter-group infections in the effort of substantial flattening and delaying of the epi(demiologic) curve with concomitant mitigation of disastrous economy and social consequences. To exemplify with a limiting case, splitting a population into m (say, 5 or 10) noninteracting groups while keeping intra-group interaction unchanged yields a stretched epidemiologic curve having the maximum number of daily infections reduced and postponed in time by the same factor $m$ (5 or 10). More generally, our study suggests a practical approach to fight against SARS-CoV-2 virus spread based on population splitting into groups and minimizing intermingling between them. This strategy can be pursued by large-scale infrastructure reorganization of activity at different levels in big logistic units (e.g., large productive networks, factories, enterprises, warehouses, schools, (seasonal) harvest work). Importantly, unlike total lockdwon strategy, the proposed approach prevents economic ruin and keeps social life at a more bearable level than distancing everyone from anyone. Last but not least, the declaration, for the first time in Europe, that COVID-19 epidemic ended in the two million people Slovenia may be taken as confirming the advantage of the strategy proposed in this paper.


title: Patient safety reports round-up during the COVID-19 pandemic

text: John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent patient safety reports, revealing that patient safety concerns continue during the current pandemic.


title: Tracing open data in emergencies: the case of the COVID-19 pandemic

text: BACKGROUND: The COVID-19 pandemic constitutes an ongoing, burning Public Health Emergency of International Concern (PHEIC). In 2015, the World Health Organization (WHO) adopted an open-data policy recommendation in such situations. OBJECTIVES: The present cross-sectional meta-research study aimed to assess the availability of open data and metrics and of articles pertaining to the COVID-19 outbreak in five high-impact journals. METHODS: All articles regarding the SARS-CoV-2, published in five high impact journals (Ann Intern Med, BMJ, JAMA, NEJM and Lancet) until March 14, 2020 were retrieved. Meta-data (namely the type of article, number of authors, number of patients, citations, errata, news and social media mentions) were extracted for each article in each journal in a systematic way. Google Scholar and Scopus were used for citations and author metrics respectively, and Altmetrics and PlumX were used for news and social media mentions retrieval. The degree of adherence to the PHEIC open data call was also evaluated. RESULTS: A total of 140 articles were published until March 14, 2020, mostly opinion papers. Sixteen errata followed these publications. The number of authors in each article ranged from 1 to 63, whereas the number of patients with a laboratory-confirmed SARS-CoV-2 infection reached 2,645. The impact of these publications reached a total of 4,210 cumulative crude citations and 342,790 news and social media mentions. Only one publication (0.7%) provided complete open data, while 32 (22.9%) included patient data. CONCLUSIONS: Even though a large number of manuscripts was produced since the pandemic, availability of open data remains restricted.


Falsely low fibrinogen levels in COVID-19 patients on direct thrombin inhibitors


Taking the right measures to control COVID-19


title: No current evidence supporting risk of using Ibuprofen in patients with COVID-19

text: SARS-CoV-2 is a novel RNA virus that infects cells expressing the angiotensin-converting enzyme (ACE2) receptor and is associated with an acute respiratory disease named COVID-19. It has been hypothesized that ACE2 expression can be increased by Ibuprofen leading to a higher risk for severe COVID-19 (1). Despite the reasonable mechanistic background and results from studies suggesting that Ibuprofen may be associated with complications of community-acquired pneumonia in children (2,3), there is no current evidence that this NSAID aggravates a SARS-CoV-2 infection in any age group.


title: COVID-19-Related Web Search Behaviors and Infodemic Attitudes in Italy: Infodemiological Study

text: BACKGROUND: Since the beginning of the novel coronavirus disease (COVID-19) outbreak, fake news and misleading information have circulated worldwide, which can profoundly affect public health communication. OBJECTIVE: We investigated online search behavior related to the COVID-19 outbreak and the attitudes of "infodemic monikers" (ie, erroneous information that gives rise to interpretative mistakes, fake news, episodes of racism, etc) circulating in Italy. METHODS: By using Google Trends to explore the internet search activity related to COVID-19 from January to March 2020, article titles from the most read newspapers and government websites were mined to investigate the attitudes of infodemic monikers circulating across various regions and cities in Italy. Search volume values and average peak comparison (APC) values were used to analyze the results. RESULTS: Keywords such as "novel coronavirus," "China coronavirus," "COVID-19," "2019-nCOV," and "SARS-COV-2" were the top infodemic and scientific COVID-19 terms trending in Italy. The top five searches related to health were "face masks," "amuchina" (disinfectant), "symptoms of the novel coronavirus," "health bulletin," and "vaccines for coronavirus." The regions of Umbria and Basilicata recorded a high number of infodemic monikers (APC weighted total >140). Misinformation was widely circulated in the Campania region, and racism-related information was widespread in Umbria and Basilicata. These monikers were frequently searched (APC weighted total >100) in more than 10 major cities in Italy, including Rome. CONCLUSIONS: We identified a growing regional and population-level interest in COVID-19 in Italy. The majority of searches were related to amuchina, face masks, health bulletins, and COVID-19 symptoms. Since a large number of infodemic monikers were observed across Italy, we recommend that health agencies use Google Trends to predict human behavior as well as to manage misinformation circulation in Italy.


title: Diagnostic efficacy of anti-SARS-CoV-2 IgG/IgM test for COVID-19: A meta-analysis

text: The serological testing of anti-SARS-CoV-2 immunoglobulin G (IgG) and/or IgM is widely used in the diagnosis of COVID-19. However, its diagnostic efficacy remains unclear. In this study, we searched for diagnostic studies from the Web of Science, PubMed, Embase, CNKI, and Wanfang databases to calculate the pooled diagnostic accuracy measures using bivariate random-effects model meta-analysis. As a result, 22 from a total of 1613 articles, including 2282 patients with SARS-CoV-2 and 1485 healthy persons or patients without SARS-CoV-2, were selected for a meta-analysis. Pooled sensitivity, specificity, and area under curve of the summary receiver operator curve (SROC) were: (a) 0.85 (95% confidence interval [CI]: 0.79-0.90), 0.99 (95% CI: 0.98-1.00), and 0.99 (95% CI: 0.97-0.99) for anti-SARS-CoV-2 IgG and (b) 0.74 (95% CI: 0.65-0.81), 0.99 (95% CI: 0.97-1.00), and 0.95 (95% CI: 0.93-0.97) for IgM. A subgroup analysis among detection methods indicated the sensitivity of IgG and IgM using enzyme-linked immunosorbent assay were slightly lower than those using gold immunochromatography assay (GICA) and chemiluminescence immunoassay (P > .05). These results showed that the detection of anti-SARS-CoV-2 IgG and IgM had high diagnostic efficiency to assist the diagnosis of SARS-CoV-2 infection. And, GICA might be used as the preferred method for its accuracy and simplicity.


title: Immuno-epidemiological model of two-stage epidemic growth

text: Epidemiological data on seasonal influenza show that the growth rate of the number of infected individuals can increase passing from one exponential growth rate to another one with a larger exponent. Such behavior is not described by conventional epidemiological models. In this work an immuno-epidemiological model is proposed in order to describe this two-stage growth. It takes into account that the growth in the number of infected individuals increases the initial viral load and provides a passage from the first stage of epidemic where only people with weak immune response are infected to the second stage where people with strong immune response are also infected. This scenario may be viewed as an increase of the effective number of susceptible increasing the effective growth rate of infected.


title: 'Masking the evidence': perspectives of the COVID-19 pandemic

text: The COVID-19 pandemic presents a severe and acute public health emergency around the world. The event of the pandemic has seen an upsurge in the general public wearing of disposable surgical masks (DSM) and other types of face masks. The World Health Organisation of mask wearing has been widely debated in the press a(WHO) have changed their advice, to now recommend the routine wearing of fabric masks by the general public as a means of preventing the spread of COVID-19 (WHO 2020a).


title: Response and role of palliative care during the COVID-19 pandemic: A national telephone survey of hospices in Italy

text: BACKGROUND: Palliative care is an important component of health care in pandemics, contributing to symptom control, psychological support, and supporting triage and complex decision making. AIM: To examine preparedness for, and impact of, the COVID-19 pandemic on hospices in Italy to inform the response in other countries. DESIGN: Cross-sectional telephone survey, in March 2020. SETTING: Italian hospices, purposively sampled according to COVID-19 regional prevalence categorised as high (>25), medium (15-25) and low prevalence (<15) COVID-19 cases per 100,000 inhabitants. A brief questionnaire was developed to guide the interviews. Analysis was descriptive. RESULTS: Seven high, five medium and four low prevalence hospices provided data. Two high prevalence hospices had experienced COVID-19 cases among both patients and staff. All hospices had implemented policy changes, and several had rapidly implemented changes in practice including transfer of staff from inpatient to community settings, change in admission criteria and daily telephone support for families. Concerns included scarcity of personal protective equipment, a lack of hospice-specific guidance on COVID-19, anxiety about needing to care for children and other relatives, and poor integration of palliative care in the acute planning response. CONCLUSION: The hospice sector is capable of responding flexibly and rapidly to the COVID-19 pandemic. Governments must urgently recognise the essential contribution of hospice and palliative care to the COVID-19 pandemic and ensure these services are integrated into the health care system response. Availability of personal protective equipment and setting-specific guidance is essential. Hospices may also need to be proactive in connecting with the acute pandemic response.


title: COVID-19: An update on diagnostic and therapeutic approaches

text: The unexpected pandemic set off by the novel coronavirus 2019 (COVID-19) has caused severe panic among people worldwide COVID-19 has created havoc, and scientists and physicians are urged to test the efficiency and safety of drugs used to treat this disease In such a pandemic situation, various steps have been taken by government to control and prevent the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) This pandemic situation has forced scientists to rework strategies to combat infectious diseases through drugs, treatment, and control measures COVID-19 treatment requires both limiting viral multiplication and neutralizing tissue damage induced by inappropriate immune reaction Currently, various diagnostic kits to test for COVID-19 are available, and repurposing therapeutics for COVID-19 has shown to be clinically effective As the global demand for diagnostics and therapeutics continues to rise, it is essential to rapidly develop various algorithms to successfully identify and contain the virus This review discusses the updates on specimens/samples, recent efficient diagnostics, and therapeutic approaches to control the disease and repurposed drugs mainly focusing on chloroquine/hydroxychloroquine and convalescent plasma (CP) More research is required for further understanding of the influence of diagnostics and therapeutic approaches to developing vaccines and drugs for COVID-19


Response to: 'Comparative analysis of synovial inflammation after SARS-CoV-2 infection' by Alivernini et al


title: The propagation of the economic impact through supply chains: The case of a mega-city lockdown against the spread of COVID-19

text: This study quantifies the economic effect of a possible lockdown of Tokyo to prevent spread of COVID-19. The negative effect of the lockdown may propagate to other regions through supply chains because of shortage of supply and demand. Applying an agent-based model to the actual supply chains of nearly 1.6 million firms in Japan, we simulate what would happen to production activities outside Tokyo when production activities that are not essential to citizens' survival in Tokyo were shut down for a certain period. We find that when Tokyo is locked down for a month, the indirect effect on other regions would be twice as large as the direct effect on Tokyo, leading to a total production loss of 27 trillion yen in Japan, or 5.3% of its annual GDP. Although the production shut down in Tokyo accounts for 21% of the total production in Japan, the lockdown would result in a reduction of the daily production in Japan by 86% in a month.


Building an "Army of Disease Detectives" to Trace COVID-19 Contacts


title: Structural and Evolutionary Analysis Indicate That the SARS-CoV-2 Mpro Is a Challenging Target for Small-Molecule Inhibitor Design

text: The novel coronavirus whose outbreak took place in December 2019 continues to spread at a rapid rate worldwide. In the absence of an effective vaccine, inhibitor repurposing or de novo drug design may offer a longer-term strategy to combat this and future infections due to similar viruses. Here, we report on detailed classical and mixed-solvent molecular dynamics simulations of the main protease (Mpro) enriched by evolutionary and stability analysis of the protein. The results were compared with those for a highly similar severe acute respiratory syndrome (SARS) Mpro protein. In spite of a high level of sequence similarity, the active sites in both proteins showed major differences in both shape and size, indicating that repurposing SARS drugs for COVID-19 may be futile. Furthermore, analysis of the binding site's conformational changes during the simulation time indicated its flexibility and plasticity, which dashes hopes for rapid and reliable drug design. Conversely, structural stability of the protein with respect to flexible loop mutations indicated that the virus' mutability will pose a further challenge to the rational design of small-molecule inhibitors. However, few residues contribute significantly to the protein stability and thus can be considered as key anchoring residues for Mpro inhibitor design.


title: El SRAA y el SARS-CoV-2: el acertijo a resolver./ [The RAAS and SARS-CoV-2: A riddle to solve]

text: The first case of COVID-19 was reported on 31 December 2019 in Wuhan, China. Ever since there has been unprecedented and growing interest in learning about all aspects of this new disease. Debate has been generated as to the association between antihypertensive therapy with renin-angiotensin-aldosterone system (RAAS) inhibitors and SARS-CoV-2 infection. While many questions as yet remain unanswered, the aim of this report is to inform health professionals about the current state of knowledge. Because this is an ever-evolving topic, the recommendation is that it be updated as new evidence becomes available. Below, we provide a review of pre-clinical and clinical studies that link coronavirus to the RAAS.


Reply to "Radiologic Findings of Coronavirus Disease (COVID-19): Clinical Correlation Is Recommended"


Understanding immune effects of oestrogens to explain the reduced morbidity and mortality in female versus male COVID-19 patients. Comparisons with autoimmunity and vaccination


Coping with COVID-19 - The life changing pandemic


Letter to the editor in response to the article: "Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis (Kumar et al.)"


Acute pulmonary embolism in COVID-19 disease


title: The Role of Health Technology and Informatics in Global Public Health Emergency: Practices and Implications from the COVID-19 Pandemic

text: UNSTRUCTURED: At present, COVID-19 is spreading around the world. It is a critical and important task to take all-out efforts to prevent and control the pandemic. Compared with Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome, COVID-19 spreads more rapidly owing to increased globalization, longer incubation period, and unobvious symptoms. As the coronavirus has the characteristics of strong transmission and weak lethality, and since the large-scale increase of infected people may drag down the healthcare systems, efforts are needed to treat critical patients, track and manage the health status of residents, and isolate suspected patients. The application of emerging health technologies and digital practices in healthcare such as artificial intelligence, telemedicine/telehealth, mobile health, big data, 5G, and the internet of things have become powerful "weapons" to fight against the pandemic and provide strong support in pandemic prevention and control. Applications and evaluations of all of these technologies or health delivery services are highlighted.


title: Autonomy in HIV testing: a call for a rethink of personal autonomy in the HIV response in sub-Saharan Africa

text: The author reviews various conceptions of autonomy to show that humans are actually not autonomous, strictly speaking. He argues for a need to rethink the personal autonomy approaches to HIV testing in sub-Saharan Africa (SSA) countries. HIV/AIDS has remained a leading cause of disease burden in SSA. It is important to bring this disease burden under control, especially given the availability of current effective antiretroviral regimens in low- and middle-income countries. In most SSA countries the ethic or value of personal autonomy or self-determination is promoted as primary in HIV testing decision-making. SSA policymakers have an ontological and moral duty to adopt HIV testing policies that reflect human and medical realities, relationships, local contexts, and respect human rights for both individuals and others who are affected by HIV in society. Without rethinking the value of autonomy in HIV testing decision-making, the article cautions that attainment of the Sustainable Development Goal (SDG) 3 and the UNAIDS fast-track strategy that explicitly call to end the epidemic by 2030 will not be feasible for SSA.


title: Tilorone: a Broad-Spectrum Antiviral Invented in the USA and Commercialized in Russia and beyond

text: For the last 50 years we have known of a broad-spectrum agent tilorone dihydrochloride (Tilorone). This is a small-molecule orally bioavailable drug that was originally discovered in the USA and is currently used clinically as an antiviral in Russia and the Ukraine. Over the years there have been numerous clinical and non-clinical reports of its broad spectrum of antiviral activity. More recently we have identified additional promising antiviral activities against Middle East Respiratory Syndrome, Chikungunya, Ebola and Marburg which highlights that this old drug may have other uses against new viruses. This may in turn inform the types of drugs that we need for virus outbreaks such as for the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Tilorone has been long neglected by the west in many respects but it deserves further reassessment in light of current and future needs for broad-spectrum antivirals.


title: An Infinite-Dimensional SIS Model

text: In this article, we introduce an infinite-dimensional deterministic SIS model which takes into account the heterogeneity of the infections and the social network among a large population. We study the long-time behavior of the dynamic. We identify the basic reproduction number $R_0$ which determines whether there exists a stable endemic steady state (super-critical case: $R_0>1$) or if the only equilibrium is disease-free (critical and sub-critical case: $R_0\leq1$). As an application of this general study, we prove that the so-called ``leaky'' and ``all-or-nothing'' vaccination mechanism have the same effect on $R_0$. This framework is also very natural and intuitive to model lockdown policies and study their impact.


最悪の事態に備えるべき理由 : 新型コロナウイルスにどう対処するか (新型ウイルスの封じ込め・管理はできるのか)


title: Medical Transport for 769 COVID-19 Patients on a Cruise Ship by Japan Disaster Medical Assistance Team

text: The Diamond Princess cruise ship, carrying 3711 passengers and crew members, docked at Yokohama Port in Japan on February 3, 2020. A quarantine was immediately instituted because 1 passenger who had disembarked in Hong Kong was confirmed to have tested positive for coronavirus disease 2019 (COVID-19). After the quarantine began, all passengers and crew were tested using the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) polymerase chain reaction assay on the ship, 696 of whom tested positive. In total, 769 patients, including 696 with COVID-19, required transport to a hospital. The Japan Disaster Medical Assistance Team (DMAT) successfully picked up and safely transported the COVID-19 patients using a novel classification system to prioritize patients. The Japan DMAT transported 203 patients to hospitals in Kanagawa and another 566 patients to hospitals in 15 different prefectures.


title: COVID-19 in Parkinson's Disease Patients Living in Lombardy, Italy

text: BACKGROUND: It is unknown whether patients with PD are at greater risk of COVID-19, what their risk factors are, and whether their clinical manifestations differ from the general population. OBJECTIVES: The study aimed to address all these issues. METHODS: In a case-controlled survey, we interviewed 1,486 PD patients attending a single tertiary center in Lombardy, Italy and 1,207 family members (controls). RESULTS: One hundred five (7.1%) and 92 controls (7.6%) were identified as COVID-19 cases. COVID-19 patients were younger, more likely to suffer from chronic obstructive pulmonary disease, to be obese, and vitamin D nonsupplemented than unaffected patients. Six patients (5.7%) and 7 family members (7.6%) died from COVID-19. Patients were less likely to report shortness of breath and require hospitalization. CONCLUSIONS: In an unselected large cohort of nonadvanced PD patients, COVID-19 risk and mortality did not differ from the general population, but symptoms appeared to be milder. The possible protective role of vitamin D supplementation warrants future studies. © 2020 International Parkinson and Movement Disorder Society.


title: COVID-19 Lung Injury and High Altitude Pulmonary Edema: A False Equation with Dangerous Implications

text: Amid efforts to care for the large number of patients with COVID-19, there has been considerable speculation about whether the lung injury seen in these patients is different than ARDS from other causes. One idea that has garnered considerable attention, particularly on social media and in free open access medicine is the notion that lung injury due to COVID-19 is more similar to high altitude pulmonary edema (HAPE). Drawing on this concept, it has also been proposed that treatments typically employed in the management of HAPE and other forms of acute altitude illness, pulmonary vasodilators and acetazolamide, should be considered for COVID-19. Despite some similarities in clinical features between the two entities, such as hypoxemia, radiographic opacities and altered lung compliance, the pathophysiological mechanisms of HAPE and lung injury due to COVID-19 are fundamentally different and the entities cannot be viewed as equivalent. While of high utility in the management of HAPE and acute mountain sickness, systemically delivered pulmonary vasodilators and acetazolamide should not be used in the treatment of COVID-19, as they carry the risk of multiple adverse consequences including worsened ventilation-perfusion matching, impaired carbon dioxide transport, systemic hypotension and increased work of breathing.


title: Clinical and epidemiologic profile of the initial COVID-19 patients at a tertiary care centre in India

text: COVID-19 has now become a pandemic. It has spread from Wuhan, China, in December 2019 to a large number of countries within three months. The objective of this work is to report the initial experience with epidemiologic and clinical features, as well as with the management of COVID-19 patients in India. This is a descriptive case series of the first 21 COVID-19 infected patients confirmed with polymerase chain reaction (PCR) and admitted to a tertiary care centre in India from 01.02.2020 to 19.03.2020. Clinical, laboratory, and radiologic data were collected, including age, sex, nationality, travel history, symptoms, duration of stay, and comorbidities. The mean age of the population was 40.3 years with a male preponderance. Thirteen (62%) patients had recent travel history outside India in the previous 30 days, two thirds of whom had travelled to Italy. The most common symptoms were fever and cough (42.9%) followed by sore throat, headache and breathlessness. Vital and laboratory parameters were preserved in all patients and none of them required ventilatory support. Among the first 21 patients diagnosed with COVID-19 infection in India, the typical clinical presentation consisted in a mild upper respiratory tract infection predominantly affecting the young male population. One patient required supplemental oxygen. All patients recovered with no residual symptoms. *The Safdarjung Hospital COVID 2019 working group: Nitesh Gupta, Sumita Agrawal, Pranav Ish, Suruchi Mishra, Rajni Gaind, Ganapathy Usha, Balvinder Singh, Manas Kamal Sen, Shibdas Chakrabarti (Consultant and Head, Pulmonary Medicine); NK Gupta (Professor, Pulmonary medicine); Dipak Bhattacharya (Consultant, Pulmonary medicine); Rohit Kumar (Assistant Professor, Pulmonary Medicine); Siddharth R. Yadav (Assistant Professor, Pulmonary Medicine); Rushika Saksena (Specialist, Microbiology); Rojaleen Das (Assistant Professor, Microbiology); Vikramjeet Dutta (Assistant Professor, Microbiology); Anupam Kr Anveshi (Senior Resident, Microbiology); Santvana Kohli (Assistant Professor, Anaesthesiology); Naveen KV (Assistant Professor, Anaesthesiology); Amandeep Jaswal (Assistant Professor, Anaesthesiology).


title: Cardiovigilance in COVID 19

text: The COVID19 (Corona Virus Disease: pandemic started in 2019) pandemic has created not only a public health problem, but as a clinical challenge as well. To the cardiologist, COVID 19 presents a wide spectrum of possibilities for clinical decision-making intervention and improvement. Cardiac dysfunction has been identified as a risk factor, a prognostic factor, a diagnostic tool, differential diagnosis, a complication of COVID 19, and a side effect of its treatment. Certain cardiotropic drugs have been implicated in the pathogenesis of COVID 19. The risk of transmission of COVID 19 is an occupational hazard which cannot be ignored by cardiologists. This review discusses the need and scope of cardio vigilance in COVID 19 management.


The Coronavirus Pandemic and the Impact on Donation and Transplantation in Brazil


title: Epidemiological characteristics of the first 100 cases of coronavirus disease 2019 (COVID-19) in Hong Kong Special Administrative Region, China, a city with a stringent containment policy

text: BACKGROUND: Hong Kong (HK) is a densely populated city near the epicentre of the coronavirus disease 2019 (COVID-19) outbreak. Stringent border control together with aggressive case finding, contact tracing, social distancing and quarantine measures were implemented to halt the importation and spread of the virus. METHODS: We performed an epidemiological study using government information covering the first 100 confirmed cases to examine the epidemic curve, incidence, clusters, reproduction number (Rt), incubation period and time to containment. RESULTS: A total of 93 of the 100 cases were HK residents (6 infected in Mainland China, 10 on the Diamond Princess Cruise). Seven were visitors infected in Mainland China before entering HK. The majority (76%) were aged ≥45 years, and the incidence increased with age (P < 0.001). Escalation of border control measures correlated with a decrease in the proportion (62.5% to 0%) of cases imported from Mainland China, and a reduction in Rt (1.07 to 0.75). The median incubation period was 4.2 days [95% confidence interval (CI), 4.0-4.5; 5th and 95th percentiles: 1.3 and 14.0). Most clusters with identifiable epidemiological links were households involving 2-4 people. Three medium-spreading events were identified: two from New Year gatherings (6-11 people), and another from environmental contamination of a worship hall (12 people). Despite intensified contact tracing, containment was delayed in 78.9% of cases (mean = 5.96 days, range = 0-24 days). An unusual transmission in a multi-storey building via faulty toilet plumbing was suspected with >100 residents evacuated overnight. Our analysis indicated that faulty plumbing was unlikely to be the source of this transmission. CONCLUSIONS: Timely stringent containment policies minimized the importation and transmission of COVID-19 in HK.


Telehealth and Telemedicine in the COVID-19 era: A World of Opportunities for the Neurosurgeons


title: An exclusive 42 amino acid signature in pp1ab protein provides insights into the evolutive history of the 2019 novel human-pathogenic coronavirus (SARS-CoV-2)

text: The city of Wuhan, Hubei province, China, was the origin of a severe pneumonia outbreak in December 2019, attributed to a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]), causing a total of 2761 deaths and 81109 cases (25 February 2020). SARS-CoV-2 belongs to genus Betacoronavirus, subgenus Sarbecovirus. The polyprotein 1ab (pp1ab) remains unstudied thoroughly since it is similar to other sarbecoviruses. In this short communication, we performed phylogenetic-structural sequence analysis of pp1ab protein of SARS-CoV-2. The analysis showed that the viral pp1ab has not changed in most isolates throughout the outbreak time, but interestingly a deletion of 8 aa in the virulence factor nonstructural protein 1 was found in a virus isolated from a Japanese patient that did not display critical symptoms. While comparing pp1ab protein with other betacoronaviruses, we found a 42 amino acid signature that is only present in SARS-CoV-2 (AS-SCoV2). Members from clade 2 of sarbecoviruses have traces of this signature. The AS-SCoV2 located in the acidic-domain of papain-like protein of SARS-CoV-2 and bat-SL-CoV-RatG13 guided us to suggest that the novel 2019 coronavirus probably emerged by genetic drift from bat-SL-CoV-RaTG13. The implication of this amino acid signature in papain-like protein structure arrangement and function is something worth to be explored.


Heparin induced thrombocytopenia antibodies in COVID-19


title: Persistent hiccups as an atypical presenting complaint of COVID-19

text: Hiccups (singultus) are reflex inspiratory movements that involve the swallowing reflex arc and can be classified as acute (<48 h) or persistent (>48 h). A 62-year-old man with no history of malignancy or pulmonary disease presented to the Emergency Department with a four-day history of persistent hiccups. Other than episodic hiccupping, his physical examination was otherwise unremarkable. An abnormal chest X-ray led to a CT scan of the chest with IV contrast, which demonstrated regional, peripheral groundglass opacities of the upper lobes with small focal groundglass opacities scattered throughout the lungs. He was tested for COVID-19 per admission protocol, started on hydroxychloroquine, his hiccups improved, and he was discharged to home after 3 days. An emergency medicine physician should keep COVID-19 on the differential and be vigilant of exposure in atypical presentations.


Dealing with COVID-19: initial perspectives of a small radiology department


title: Masters of disasters? Challenges and opportunities for SMEs in times of crisis

text: Small and medium-sized enterprises (SMEs) are the backbone of every economy. So, when an external crisis jeopardizes markets, such as the recent COVID-19 outbreak, SMEs are hit with great force. Their so-called liability of smallness, a lack of resources that would shield them from outside shocks, worsens the situation. This manuscript conducts a literature study on 69 manuscripts that studied SMEs in previous crises and proposes ways to overcome economic downturns in the areas of finance, strategy and the institutional environment. The paper finds a "strategy/funding chicken-and-egg-problem" and proposes an effectual world view when dealing with situations of great uncertainty.


title: Excess deaths hidden 100 days after the quarantine in Peru by COVID-19

text: Objective: To make an estimate of the excess deaths caused by COVID-19 in the non-violent mortality of Peru, controlling for the effect of quarantine. Methods: Analysis of longitudinal data from the departments of Peru using official public information from the National Death Information System and the Ministry of Health of Peru. The analysis is performed between January 1, 2018 and June 23, 2020 (100 days of quarantine). The daily death rate per million inhabitants has been used. The days in which the departments were quarantined with a limit number of accumulated cases of COVID-19 were used to estimate the quarantine impact. Three limits were established for cases: less than 1, 10 and 100 cases. Result: In Peru, the daily death rate per million inhabitants decreased by -1.89 (95% CI: -2.70; -1.07) on quarantine days and without COVID-19 cases. When comparing this result with the total number of non-violent deaths, the excess deaths during the first 100 days of quarantine is 36,230. This estimate is 1.12 times the estimate with data from 2019 and 4.2 times the deaths officers by COVID-19. Conclusion: Quarantine reduced nonviolent deaths; however, they are overshadowed by the increase as a direct or indirect cause of the pandemic. Therefore, the difference between the number of current deaths and that of past years underestimates the real excess of deaths.


title: Fangcang shelter hospitals: a novel concept for responding to public health emergencies

text: Fangcang shelter hospitals are a novel public health concept. They were implemented for the first time in China in February, 2020, to tackle the coronavirus disease 2019 (COVID-19) outbreak. The Fangcang shelter hospitals in China were large-scale, temporary hospitals, rapidly built by converting existing public venues, such as stadiums and exhibition centres, into health-care facilities. They served to isolate patients with mild to moderate COVID-19 from their families and communities, while providing medical care, disease monitoring, food, shelter, and social activities. We document the development of Fangcang shelter hospitals during the COVID-19 outbreak in China and explain their three key characteristics (rapid construction, massive scale, and low cost) and five essential functions (isolation, triage, basic medical care, frequent monitoring and rapid referral, and essential living and social engagement). Fangcang shelter hospitals could be powerful components of national responses to the COVID-19 pandemic, as well as future epidemics and public health emergencies.


Phototherapy and vitamin D: the importance in COVID-19 era


title: Adaptation of the National Plan for the Prevention and Fight Against Pandemic Influenza to the 2020 COVID-19 Epidemic in France

text: On Tuesday, March 17, 2020, at noon, France became the third European country to impose a nationwide containment policy in the fight against epidemic coronavirus disease 2019 (COVID-19) viral infection. Announcing that the country was at "war," President Macron called upon all to play a role in mitigating against further development of contagion. This extreme measure never seen before during peace time was the result of adapting not only the French Pandemic Influenza Plan (PIP) being applied to the national context but also real-time clinical, epidemiological, and scientific information about the evolution of COVID-19 infection in the country. The situation was further complicated by local municipal elections and political agendas by populist opinions. Despite mass communication about the importance of individual behavioral attitudes to counter disease propagation, few heeded government advice. Consequently, the situation rapidly deteriorated with increasing number of cases that started to overwhelm health services. As a result, decisive and immediate action was taken by the State for the national public health interest. This report from the field details the timely events that contributed to this extreme policy decision taken by France. A policy decision that other Western democracies have since applied as the pandemic disseminated across the globe.


title: Prostate Cancer Radiotherapy Recommendations in Response to COVID-19

text: Purpose: During a global pandemic the benefit of routine visits and treatment of cancer patients must be weighed against the risks to patients, staff, and society. Prostate cancer is one of the most common cancers Radiation Oncology departments treat, and efficient resource utilization is essential in the setting of a pandemic. Herein, we aim to establish recommendations and a framework by which to evaluate prostate radiotherapy management decisions. Patients and Methods: Radiation Oncologists from the United States and United Kingdom rapidly conducted a systematic review and agreed upon recommendations to safely manage prostate cancer patients during the COVID-19 pandemic. A RADS framework was created: Remote visits, and Avoidance, Deferment, and Shortening of radiotherapy was applied to determine appropriate approaches. Results: Recommendations are provided by National Comprehensive Cancer Network (NCCN) risk group, including clinical node positive, post-prostatectomy, oligometastatic, and low volume M1 disease. Across all prostate cancer stages, telemedicine consultations and return visits were recommended when resources/staff available. Delays in consultations and return visits was deemed safe based on stage of disease between 1-6 months. Treatment can be avoided or delayed until safe for very low, low, and favorable intermediate-risk disease. Unfavorable intermediate-risk, high-risk, clinical node positive, recurrence post-surgery, oligometastatic, and low-volume M1 disease can receive neoadjuvant hormone therapy for 4-6 months as necessary. Ultrahypofractionation was preferred for localized, oligometastatic, and low volume M1, and moderate hypofractionation was preferred for post-prostatectomy and clinical node positive disease. Salvage was preferred to adjuvant radiation. Conclusion: Resources can be reduced for all identified stages of prostate cancer. The RADS (Remote visits, and Avoidance, Deferment, and Shortening of radiotherapy) framework can be applied to other disease sites to help with decision making in a global pandemic.


title: Treatment algorithm for COVID-19: a multidisciplinary point of view

text: The novel coronavirus (Sars-CoV-2) pandemic has spread rapidly, from December to the end of March, to 185 countries, and there have been over 3,000,000 cases identified and over 200,000 deaths. For a proportion of hospitalized patients, death can occur within a few days, mainly for adult respiratory distress syndrome or multi-organ dysfunction syndrome. In these patients, clinical signs and symptoms, as well as laboratory abnormalities, suggest a cytokine storm syndrome in response to the viral infection. No current targeted treatment is yet available for COVID-19, an unknown disease up to 2 months ago, which challenges doctors and researchers to find new drugs or reallocate other treatments for these patients. Since the beginning of the COVID-19 outbreak, a growing body of information on diagnostic and therapeutic strategies has emerged, mainly based on preliminary experience on retrospective studies or small case series. Antivirals, antimalarials, corticosteroids, biotechnological and small molecules, convalescent plasma and anticoagulants are among the drugs proposed for the treatment or in tested for COVID-19. Given the complexity of this new condition, a multidisciplinary management seems to be the best approach. Sharing and integrating knowledge between specialists, to evaluate the correct timing and setting of every treatment, could greatly benefit our patients. We reviewed the literature, combining it with our experiences and our specialist knowledge, to propose a management algorithm, correlating the clinical features with laboratory and imaging findings to establish the right timing for each treatment.Key Pointsâ¢ Critically ill COVID-19 patients show signs of cytokine storm syndrome.â¢ No current targeted therapy is available, but a lot of drugs are in tested.â¢ A multidisciplinary approach is crucial to manage COVID-19.â¢ Choosing the correct timing of treatment is of pivotal importance to avoid the most severe complications.


A Novel Coronavirus Outbreak from Wuhan City in China, Rapid Need for Emergency Departments Preparedness and Response;a Letter to Editor


title: The Impact of Isolation Measures Due to COVID-19 on Energy Intake and Physical Activity Levels in Australian University Students

text: The coronavirus disease 2019 (COVID-19) pandemic resulted in physical isolation measures in many parts of the world. In Australia, nationwide restrictions included staying at home, unless seeking medical care, providing care, purchasing food, undertaking exercise, or attending work in an essential service. All undergraduate university classes transitioned to online, mostly home-based learning. We, therefore, examined the effect of isolation measures during the early phase of the COVID-19 pandemic in Australia (March/April) on diet (24-h recall) and physical activity (Active Australia Survey) patterns in third-year biomedical students. Findings were compared with students enrolled in the same course in the previous two years. In females, but not males, energy intake was ~20% greater during the pandemic, and snacking frequency and energy density of consumed snacks also increased compared with 2018 and 2019. Physical activity was impacted for both sexes during the pandemic with ~30% fewer students achieving "sufficient" levels of activity, defined by at least 150 min over at least five sessions, compared with the previous two years. In a follow-up study six to eight weeks later (14-18% response rate), during gradual easing of nationwide restrictions albeit continued gym closures and online learning, higher energy intake in females and reduced physical activity levels in both sexes persisted. These data demonstrate the health impacts of isolation measures, with the potential to affect long-term diet and activity behaviours.


Perinatal mental health and COVID-19 in Japan


title: Global Preparedness Against COVID-19: We Must Leverage the Power of Digital Health

text: The coronavirus disease (COVID-19) pandemic has revealed many areas of public health preparedness that are lacking, especially in lower- and middle-income countries. Digital interventions provide many opportunities for strengthening health systems and could be vital resources in the current public health emergency. We provide several use cases for infection control, home-based diagnosis and screening, empowerment through information, public health surveillance and epidemiology, and leveraging crowd-sourced data. A thoughtful, concerted effort-leveraging existing experience and robust enterprise-grade technologies-can have a substantive impact on the immediate and distal consequences of COVID-19.


title: Discharged COVID-19 Patients Testing Positive Again for SARS-CoV-2 RNA: A Minireview of Published Studies from China

text: In the ongoing COVID-19 pandemic, one potential cause of concern is that some discharged COVID-19 patients are testing positive again for SARS-CoV-2 RNA. To better understand what is happening and to provide public health policy planners and clinicians timely information, we have searched and reviewed published studies about discharged patients testing positive again for the SARS-CoV-2 RNA. Our search found 12 reports, all of which described patients in China. Our review of these reports indicates the presence of discharged patients who remain asymptomatic but test positive. However, it is unclear whether they are contagious because a positive RT-PCR test does not necessarily indicate the presence of replicating and transmissible virus. Our review suggests the need for timely, parallel testing of different samples, including for example, fecal specimens, from COVID-19 patients before and after they are discharged from hospitals. This article is protected by copyright. All rights reserved.


Outbreak of a novel coronavirus


COVID-19 and ectodermal dysplasias. Recommendations are necessary


In reply: Making transesophageal echocardiography safer during COVID-19: is there a role for probe protective equipment (pPE)?


COVID-19: Magnifying the Effect of Health Disparities


Cancer and COVID-19 - potentially deleterious effects of delaying radiotherapy


title: Digital personal health libraries: a systematic literature review

text: Objective: This paper gives context on recent literature regarding the development of digital personal health libraries (PHL) and provides insights into the potential application of consumer health informatics in diverse clinical specialties. Materials and Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Here, 2,850 records were retrieved from PubMed and EMBASE in March 2020 using search terms: personal, health, and library. Information related to the health topic, target population, study purpose, library function, data source, data science method, evaluation measure, and status were extracted from each eligible study. In addition, knowledge discovery methods, including co-occurrence analysis and multiple correspondence analysis, were used to explore research trends of PHL. Results: After screening, this systematic review focused on a dozen articles related to PHL. These encompassed health topics such as infectious diseases, congestive heart failure, electronic prescribing. Data science methods included relational database, information retrieval technology, ontology construction technology. Evaluation measures were heterogeneous regarding PHL functions and settings. At the time of writing, only one of the PHLs described in these articles is available for the public while the others are either prototypes or in the pilot stage. Discussion: Although PHL researches have used different methods to address problems in diverse health domains, there is a lack of an effective PHL to meet the needs of older adults. Conclusion: The development of PHLs may create an unprecedented opportunity for promoting the health of older consumers by providing diverse health information.


Concerns About COVID-Related Collateral Damage for Patients With COPD


title: Protection and response of a tertiary hospital in South Korea to the COVID-19 outbreak

text: OBJECTIVE: Here, we present an overview of how a tertiary hospital responded to maintain necessary activities and protect patients and staff from COVID-19 outbreak. METHODS: Gil Medical Center, a tertiary hospital in Incheon, operated special response team since January 21, 2020. All visitors were assessed for body temperature and respiratory symptoms, and were screened for recent overseas travel. Suspected COVID-19 patients were taken to a screening clinic. All febrile patients with or without respiratory symptoms were taken to a respiratory safety clinic. An isolation ward, which consisted of 10 negative-pressure rooms, was used to treat confirmed-cases. More than 120 beds were prepared for the outbreak and patients with pneumonia were preemptively isolated. RESULTS: By May 5th, 480,960 visitors were assessed at control station, 3,350 patients visited the triage center, and 1,794 were treated in the respiratory safety clinic. Seventeen confirmed-cases were admitted to the negative isolation ward, and 350 patients with pneumonia were preemptively isolated. Total 2,977 SARS-CoV-2 PCR tests were performed. CONCLUSIONS: Tertiary hospitals play an important role in both treating COVID-19 patients and non-COVID-19 patients. Hospitals have to protect themselves from unexpected in-hospital transmission. Multifaceted response must be undertaken to protect tertiary hospitals during the COVID-19 epidemic.


Surviving the first COVID-19 wave and learning lessons for the second


Un numéro spécial Covid-19 du Journal de chirurgie viscérale : quels problèmes, quels dangers et quelles solutions sont identifiés?/ [A special edition of the Journal of Visceral Surgery on Covid-19: what problems, dangers and solutions have been identified?]


title: Mesenchymal stem cell (MSc) secretome: A possible therapeutic strategy for intensive-care COVID-19 patients

text: As an emerging global health challenge, COVID-19 requires international knowledge to reach novel possible therapeutic strategies, especially for intensive-care patients. During the early stages of infection, pneumocytes II are the primary infected cells, harming the respiratory system. We have previous evidence in murine models that MSc's secretome can be used to treat pulmonary injuries induced with bleomycin, due to its content: growth factors, extracellular vesicles, and exosomes. We hypothesize and strongly recommend MSc secretome testing and production, in xenofree conditions, to be used as an alternative approach in SARS-Cov-2 patients in critical conditions.


title: Parametric analysis of early data on COVID-19 expansion in selected European countries

text: We analyze the early data on COVID-19 expansion in selected European countries using an analytical parametric model. A description of the time dependence of the disease expansion and a method to evaluate trends of the expansion are proposed. Several features are observed in the data, namely a high predictability of the expansion of disease in Italy and a convergence of the"pushback"parameter towards a limiting value in all the countries where restrictive measures have been adopted. Basic predictions for the evolution of the disease expansion are made for selected countries with a stable evolution in the parametric space of the model. The findings presented here should contribute to the understanding of the behavior of the disease expansion and the role of the restrictive measures on the evolution of the expansion.


Transcatheter Aortic Valve Replacement in the Coronavirus Disease 2019 (COVID-19) Era


title: Estimation of the serial interval and basic reproduction number of COVID-19 in Qom, Iran, and three other countries: A data-driven analysis in the early phase of the outbreak

text: The outbreak of COVID-19 was first reported from China, and on 19 February 2020, the first case was confirmed in Qom, Iran. The basic reproduction number (R0 ) of infection is variable in different populations and periods. This study aimed to estimate the R0 of COVID-19 in Qom, Iran, and compare it with that in other countries. For estimation of the serial interval, we used data of the 51 confirmed cases of COVID-19 and their 318 close contacts in Qom, Iran. The number of confirmed cases daily in the early phase of the outbreak and estimated serial interval were used for R0 estimation. We used the time-varying method as a method with the least bias to estimate R0 in Qom, Iran, and in China, Italy and South Korea. The serial interval was estimated with a gamma distribution, a mean of 4.55 days and a standard deviation of 3.30 days for the COVID-19 epidemic based on Qom data. The R0 in this study was estimated to be between 2 and 3 in Qom. Of the four countries studied, the lowest R0 was estimated in South Korea (1.5-2) and the highest in Iran (4-5). Sensitivity analyses demonstrated that R0 is sensitive to the applied mean generation time. To the best of the authors' knowledge, this study is the first to estimate R0 in Qom. To control the epidemic, the reproduction number should be reduced by decreasing the contact rate, decreasing the transmission probability and decreasing the duration of the infectious period.


title: Locus CauMT1 provides a higher resolution alternative to ribosomal gene sequencing for initial Candida auris genotyping

text: Prior to SARS-CoV-2, New York City was the epicenter for another recently emerged pathogen: Candida auris. .


title: A three-generation family cluster with COVID-19 infection: should quarantine be prolonged?

text: OBJECTIVES: Families are a transmission route for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) because of the close contact. Monitoring of the viral load will be a valuable method to reduce the optimal number of quarantine days, especially in presymptomatic and symptomatic carriers of their households. The traditional three-generation families living together are seen frequently in East Asia, including in Taiwan. STUDY DESIGN: We report on a family cluster with six individuals infected with coronavirus disease in Taiwan. METHODS: The current public policy in Taiwan is quarantine for at least 14 days, based on the incubation period, or until the patient has tested negative three days in a row using the SARS-CoV-2 reverse transcription polymerase chain reaction. Details on the onset date of clinical symptoms, throat swab conversion, and course of disease were collected from medical records retrospectively. RESULTS: In the household of this three-generation Taiwanese family, the infection rate was 60%. The ratio of males to females was 4:2, and the age range was 11-85 years. The prevalence of asymptomatic disease was 33.3% (2/6). The longest throat swab conversion time was 37 days, and the estimated course of disease from symptoms to first conversion of throat swab was 59 days. CONCLUSIONS: Large families, including three-generation families in a single dwelling, should be monitored when the index case is found. Presymptomatic and symptomatic family members could be quarantined for an appropriate duration which, in our experience, is 2 months.


title: Possible long-term endocrine-metabolic complications in COVID-19: lesson from the SARS model

text: The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is centralizing the interest of the scientific world. In the next months, long-term consequences on the endocrine system may arise following COVID-19. In this article, we hypothesized the effects of SARS-CoV-2 taking into account what learned from the severe acute respiratory syndrome coronavirus (SARS-CoV) that caused SARS in 2003.


title: Effective immunity and second waves: a dynamic causal modelling study

text: This technical report addresses a pressing issue in the trajectory of the coronavirus outbreak; namely, the rate at which effective immunity is lost following the first wave of the pandemic. This is a crucial epidemiological parameter that speaks to both the consequences of relaxing lockdown and the propensity for a second wave of infections. Using a dynamic causal model of reported cases and deaths from multiple countries, we evaluated the evidence models of progressively longer periods of immunity. The results speak to an effective population immunity of about three months that, under the model, defers any second wave for approximately six months in most countries. This may have implications for the window of opportunity for tracking and tracing, as well as for developing vaccination programmes, and other therapeutic interventions.


Genetic epilepsies and COVID-19 pandemic: Lessons from the caregiver perspective


title: The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak

text: Motivated by the rapid spread of coronavirus disease 2019 (COVID-19) in mainland China, we use a global metapopulation disease transmission model to project the impact of travel limitations on the national and international spread of the epidemic. The model is calibrated on the basis of internationally reported cases and shows that, at the start of the travel ban from Wuhan on 23 January 2020, most Chinese cities had already received many infected travelers. The travel quarantine of Wuhan delayed the overall epidemic progression by only 3 to 5 days in mainland China but had a more marked effect on the international scale, where case importations were reduced by nearly 80% until mid-February. Modeling results also indicate that sustained 90% travel restrictions to and from mainland China only modestly affect the epidemic trajectory unless combined with a 50% or higher reduction of transmission in the community.


Nursing Home in the COVID-19 Outbreakï¼Challengeï¼Recovery, and Resiliency


Acute kidney injury is associated with the mortality of coronavirus disease 2019


title: Valor nutritivo e características fermentativas da silagem de capim-elefante com diferentes proporções de casca de café/ Nutritional value and characteristics of elephant grass silage with different proportions of coffe hulls

text: Avaliaram-se o valor nutritivo e as características bromatológicas de silagens de capim-elefante (CE), cultivar mineiro, cortado aos 70 dias de rebrota, com adição de quatro níveis de casca de café (1-CE; 2-CE + 10%; 3-CE + 20% e 4-CE + 30%). Utilizou-se o delineamento experimental em blocos casualizados com quatro tratamentos e seis repetições. Foram determinados nas silagens os teores de lignina, celulose, cafeína, DIVMS, pH, N-NH3 e as perdas de efluente e gás. Os valores de MS aumentaram enquanto o pH reduziu linearmente com o aumento da casca de café na silagem de capim elefante. A produção de efluente ocorreu somente na silagem sem casca de café nos cinco primeiros dias, com maior produção nos três primeiros. Os valores de N-NH3 decresceram linearmente com o aumento da casca de café. Houve aumento do teor de PB à medida do aumento da casca de café. Houve aumento de FDN e redução FDA e DIVMS linear com o aumento da casca de café. Esses resultados mostram que a casca de café como aditivo foi efetivo em melhorar as características da silagem de capim-elefante cortado aos 70 dias de idade.(AU)


title: Patients Perceptions of Telemedicine Visits Before and After the Coronavirus Disease 2019 Pandemic

text: Purpose: This study sought to determine whether the necessitated use of telemedicine due to coronavirus disease 2019, and limited choice of both the provider and patient, impacts the perceptions of telemedicine by patients who experienced telemedicine prepandemic and those who first experienced telemedicine during the pandemic. Methodology: Participants for this survey were a convenience sample. An invitation to participate was shared through social media and e-mail listservs. To participate, individuals had to be at least 18 years of age and gave consent to their data being used. The online survey took â¼10-15 min to complete, the survey was available from March 31 to April 20, 2020. Results: Two hundred sixty-four (n = 264, 60.8%) individuals had used telemedicine on or before December 2019 and 170 (39.2%) individuals used telemedicine for the first time January 2020 or later. There were no significant differences in demographics between groups, except that new users were more likely to have a primary care physician [F(407) = 13.51, p < 0.001]. Satisfaction of telemedicine was measured using a 10-item scale, demonstrating that all participants were overall satisfied with their telemedicine experience(s), (mean = 1.67, standard deviation = 0.61). Broadly, the differences in perceptions between the groups included the reasons for using telemedicine, perceptions of quality of in-person care, continuity of care, and a technical issue. Conclusions: Overall, patients are satisfied using telemedicine, however, for new users, both providers and patients, some acclimation needs to occur.


European Task Force on Atopic Dermatitis statement on severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection and atopic dermatitis


title: Obesity is associated with worse outcomes in COVID-19: Analysis of Early Data From New York City

text: OBJECTIVE: The 2019 novel coronavirus disease (COVID-19) has triggered a rapidly-expanding global pandemic in which patients exhibit a wide spectrum of disease severity. Given the high prevalence of obesity in the United States, we hypothesized that the presence of obesity may play a role in the clinical course of COVID-19 patients. METHODS: This is a retrospective review of adult patients admitted with confirmed SARS-CoV-2. Demographics, clinical characteristics, laboratory data, and clinical outcomes were abstracted. BMI (kg/m2 ) was analyzed with regard to a composite outcome of ICU admission or death, and intubation rate. RESULTS: 770 patients were included (61% male, mean age 63.5 yrs). Obese patients were more likely to present with fever, cough and shortness of breath. Obesity was also associated with a significantly higher rate of ICU admission or death (RR = 1.58, p = 0.002) even after adjusting for age, race and troponin level. CONCLUSIONS: Obese patients had an increased risk of critical illness leading to ICU admission or death compared to normal weight individuals. This study confirms that obesity is a major risk factor for COVID-19 disease severity, significantly impacting disease presentation and critical care requirements.


title: Crucial Inflammatory Mediators and Efficacy of Drug Interventions in Pneumonia Inflated COVID-19: An Invivo Mathematical Modelling Study

text: The virus SARS-COV-2 caused disease COVID-19 has been declared a pandemic by WHO. Currently, over 210 countries and territories have been affected. Careful, well-designed drugs and vaccine for the total elimination of this virus seem to be the need of the hour. In this context, the invivo mathematical modelling studies can be extremely helpful in understanding the efficacy of the drug interventions. These studies can also help understand the role of the crucial inflammatory mediators and the behaviour of immune response towards this novel coronavirus. Motivated by these facts, in this paper, we study the invivo dynamics of Covid-19. The results obtained here are inline with some of the clinical findings for Covid-19. This invivo modelling study involving the crucial biomarkers of Covid-19 is the first of its kind and the results obtained from this can be helpful to researchers, epidemiologists, clinicians and doctors who are working in this field.


COVID-19 and Down syndrome


Distance learning for vascular surgeons in the era of a pandemic


Profile of a killer: the complex biology powering the coronavirus pandemic


Predictive models for COVID-19-related deaths and infections


Beginn der Lösung der COVID-19-Pandemie in China  Kann das Virus zurückkehren?/ Initial resolution of the COVID-19 pandemic in China-can the virus return?


title: Systematic rapid living review on rehabilitation needs due to Covid-19: update to May 31st 2020

text: BACKGROUND: This paper adds to the series of systematic rapid living reviews, started in April 2020, to provide the rehabilitation community with updates on the latest scientific literature on rehabilitation needs due to the Covid-19 pandemic. OBJECTIVES: To present the results of a systematic search performed on papers published from May 1st to May 31st, 2020. METHODS: An extensive search on the main medical literature databases for articles published (including Epub), in English, from May 1st to May 31st, 2020 was performed, according to the methodology already described in the previous 2 rapid reviews, with 2 important improvements: first, we made the search string more comprehensive; second, we relied on accredited terminologies to describe the study designs and report the rehabilitation settings. RESULTS: Fifty-eight out of 618 articles were finally included for qualitative analysis. The number of primary studies has increased, with respect to the previous months, although still around 60% papers are just expert opinions. Six papers report on the prevalence and /or characteristics of emerging disability after COVID-19, 12 on rehabilitation approaches to COVID-19 patients, up to 25 on the organization of rehabilitation services after COVID-19, 13 papers on the impact of COVID-19 on health conditions of rehabilitative interest and only 2 on late complications due to COVID-19 that may be of rehabilitative interest. CONCLUSIONS: Nowadays, all patients with disability, regardless of COVID-19 infection, are suffering because of restrictions imposed to rehabilitation service delivery. Neurological involvement is often present during acute and post-acute stage, conveying the risk of a long-lasting disability. Accordingly, careful neurological monitoring should be granted. Although new therapies are under development, the main gap in the available scientific literature is the lack of high-quality primary studies, so experimental studies on the effects of rehabilitation are still warranted.


Unlocking the lockdown of science and demystifying COVID-19: how autopsies contribute to our understanding of a deadly pandemic


Harnessing the natural anti-glycan immune response to limit the transmission of enveloped viruses such as SARS-CoV-2


Response to recent commentaries regarding the involvement of angiotensin-converting enzyme 2 (ACE2) and renin-angiotensin system blockers in SARS-CoV-2 infections


Impact of the coronavirus disease 2019 pandemic on spinal surgery in Singapore


title: Letter to the Editor "COVID-19 and Neurosurgical Education in Africa: Making Lemonade from Lemons"

text: Never in history has the fabric of African neurosurgery been challenged as it is today with the advent of the novel coronavirus identified in 2019 (COVID-19). Even the most robust and resilient neurosurgical educational systems in the continent have been brought to their knees with neurosurgical trainees and young neurosurgeons bearing the brunt. In the face of this new reality, and in order to limit the impact of the current COVID-19 pandemic, multiple programs have implemented physical distancing to reduce in-person interactions. In some cases, residents have been asked to stay home at least until they are instructed otherwise. This unfortunate event presents an innovative opportunity for neurosurgical education in Africa. Herein, we detail the framework of an online neurosurgical education initiative to advance the education of African residents and young neurosurgeons during and after the COVID-19 pandemic.


title: Preliminary epidemiological analysis on children and adolescents with novel coronavirus disease (2019-nCoV) in a central area of Calabria region

text: not available.


title: Laboratory testing of SARS-CoV, MERS-CoV, and SARS-CoV-2 (2019-nCoV): Current status, challenges, and countermeasures

text: Emerging and reemerging infectious diseases are global public concerns. With the outbreak of unknown pneumonia in Wuhan, China in December 2019, a new coronavirus, SARS-CoV-2 has been attracting tremendous attention. Rapid and accurate laboratory testing of SARS-CoV-2 is essential for early discovery, early reporting, early quarantine, early treatment, and cutting off epidemic transmission. The genome structure, transmission, and pathogenesis of SARS-CoV-2 are basically similar to SARS-CoV and MERS-CoV, the other two beta-CoVs of medical importance. During the SARS-CoV and MERS-CoV epidemics, a variety of molecular and serological diagnostic assays were established and should be referred to for SARS-CoV-2. In this review, by summarizing the articles and guidelines about specimen collection, nucleic acid tests (NAT) and serological tests for SARS-CoV, MERS-CoV, and SARS-CoV-2, several suggestions are put forward to improve the laboratory testing of SARS-CoV-2. In summary, for NAT: collecting stool and blood samples at later periods of illness to improve the positive rate if lower respiratory tract specimens are unavailable; increasing template volume to raise the sensitivity of detection; putting samples in reagents containing guanidine salt to inactivate virus as well as protect RNA; setting proper positive, negative and inhibition controls to ensure high-quality results; simultaneously amplifying human RNase P gene to avoid false-negative results. For antibody test, diverse assays targeting different antigens, and collecting paired samples are needed.


Epidemiological and Clinical Characteristics of Three Family Clusters of COVID-19 Transmitted by Latent Patients in China


title: Strategy of hospital logistic support to the battle against novel coronavirus pneumonia/ 中华医院管理杂志

text: Nowadays hospitals have been at the forefront fighting against novel coronavirus pneumonia, with diagnosing and treating of patients as a top priority. In order to ensure the smooth progress of diagnosis and treatment, and prevent the occurrence of nosocomial infection, logistics support needs to make allowances for the isolation ward in time from the perspectives of logistics, facilities and equipment, and to transform the in-and-out double channels of ward access as required, thus setting up the partition of the three zones. Secondly, logistics support needs to optimize the logistics service workflow, including the medical waste management, the environmental disinfection isolation, and to optimize the catering service within hospitals to reduce the gathering and flow of personnel. Thirdly, logistics support needs to increase personnel training, and to eliminate psychological panic as well as to stabilize the logistics support team by putting logistics management cadres on the front line. Meanwhile, the logistics department needs to take over the hospital access screening work, strictly manage those who enter the hospital, maximize the safety and reliability of the logistics support within the hospital, and ensure the smooth progress of the epidemic prevention work.


title: A decision support system for optimizing the cost of social distancing in order to stop the spread of COVID-19

text: Currently there are many attempts around the world to use computers, smartphones, tablets and other electronic devices in order to stop the spread of COVID-19. Most of these attempts focus on collecting information about infected people, in order to help healthy people avoid contact with them. However, social distancing decisions are still taken by the governments empirically. That is, the authorities do not have an automated tool to recommend which decisions to make in order to maximize social distancing and to minimize the impact for the economy. In this paper we address the aforementioned problem and we design an algorithm that provides social distancing methods (i.e., what schools, shops, factories, etc. to close) that are efficient (i.e., that help reduce the spread of the virus) and have low impact on the economy. On short: a) we propose several models (i.e., combinatorial optimization problems); b) we show some theoretical results regarding the computational complexity of the formulated problems; c) we give an algorithm for the most complex of the previously formulated problems; d) we implement and test our algorithm; and e) we show an integer linear program formulation for our problem.


title: Molecular immune pathogenesis and diagnosis of COVID-19

text: Coronavirus disease 2019 (COVID-19) is a kind of viral pneumonia with an unusual outbreak in Wuhan, China, in December 2019, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence of SARS-CoV-2 has been marked as the third introduction of a highly pathogenic coronavirus into the human population after the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) in the twenty-first century. In this minireview, we provide a brief introduction of the general features of SARS-CoV-2 and discuss current knowledge of molecular immune pathogenesis, diagnosis and treatment of COVID-19 on the base of the present understanding of SARS-CoV and MERS-CoV infections, which may be helpful in offering novel insights and potential therapeutic targets for combating the SARS-CoV-2 infection.