title: Ictus como complicación y como factor pronóstico de COVID-19./ Ictus como complicación y como factor pronóstico de COVID-19./ Stroke as a complication and prognostic factor of COVID-19

text: INTRODUCTION: Contradictory data have been reported on the incidence of stroke in patients with COVID-19 and the risk of SARS-CoV-2 infection among patients with history of stroke. METHODS: This study systematically reviews case series reporting stroke as a complication of COVID-19, and analyses the prognosis of patients with COVID-19 and history of stroke. The pathophysiological mechanisms of stroke in patients with COVID-19 are also reviewed. CONCLUSIONS: History of stroke increases the risk of death due to COVID-19 by 3 times. Stroke currently seems not to be one of the main complications of COVID-19.


After COVID-19: Thinking Differently About Running the Health Care System


Chilblains-like dermatologic manifestation of COVID-19 diagnosed by serology via multidisciplinary virtual care


Resident Education in the Time of a Global Pandemic: Development of the Collaborative OMS Virtual Interinstitutional Didactic (COVID) Program


title: Treating Covid-19 at the Inflection Point

text: We appreciate the interest by Moura and colleague in our editorial regarding the role of the rheumatologist during the Covid-19 pandemic (1). The letter by Drs. Carlos Antonio Moura and Ana Luísa Cerqueira de Sant'Ana Costa emphasizes the need to understand mechanisms of disease underlying the more serious complications of Covid-19 infection as well as provide the best treatment possible to large numbers of seriously ill patients during a global pandemic (2).


Caring for Newborns Born to Mothers with COVID-19: More Questions than Answers


Clinical outcomes and prognosis of patients with HIV and SARS-CoV-2 coinfection


title: Clinical Outcomes and Prognosis of Patients with HIV and SARS-CoV-2 Co-infection

text: Dear Editor, I read with interest the review, "Living with HIV in the time of COVID-19: a glimpse of hope" by Adadi et al. published in the Journal of Medical Virology. However, I believe that the conclusions made within this article should be taken with caution as the outcomes of patients co-infected with HIV and SARS-CoV-2 are not definitive and evidence regarding this matter is constantly evolving. This article is protected by copyright. All rights reserved.


No Benefit for Lopinavir-Ritonavir in Severe COVID-19


Covid-19: schools set to close across UK except for children of health and social care workers


Covid-19: Time for a paradigm change


title: Human T leukaemia Type 1 and COVID-19

text: In the absence of clinical data on Human T leukaemia Type 1 and COVID-19 infection, we are providing guidance to clinicians who look after people living with HTLV-1.


The Wakley-Wu Lien Teh Prize Essay 2020: Chinese health workers' experiences during the COVID-19 pandemic


title: SARS-CoV-2 and DPP4 inhibition: Is it time to pray for Janus Bifrons?

text: Diabetes could be a risk factor for severity and mortality in patients with coronavirus disease 2019 COVID-19. It has been hypothesized that DPP4 inhibition, a therapy currently available for type 2 diabetes, might represent a target for decreasing the risk of the acute respiratory complications of the COVID-19 infection but (1) lack of demonstration of SARS-CoV2 binding to DPP4 (2) possible protective role of sDPP4 in Middle East respiratory Syndrome (MERS-CoV) (3) demonstrated inhibition and downregulation of DPP4 by HIV1 and MERS-CoV and (4) not exclusive role of the receptor binding in tropism of the Coronavirus family, support that DPP4 inhibition at present doesn't represent a plausible approach to mitigate COVID-19.


title: Nurses need support during Covid-19 pandemic

text: Stress in mental health nursing has long been recognised as impacting on individual performance, sickness and employment retention (see Edwards, D. & Burnard, 2003). Schwartz Rounds (SR) are interdisciplinary fora designed for staff to come together to reflect on the emotional and challenges associated with working in healthcare. They are utilised to promote compassion and to prevent burnout among caregivers across care services (Pepper et al, 2012), including mental health services (Farr & Barker, 2017).


Secure communication conduits during COVID-19 lockdown


COVID-19 Infection Unmasking Brugada Syndrome


Veterinary oncologists adapting to COVID-19 pandemic


title: Effects of ambient temperature and humidity on droplet lifetime - A perspective of exhalation sneeze droplets with COVID-19 virus transmission

text: A one-dimensional droplet evaporation model is used to estimate the droplet lifetime from evaporation in air. The mathematical model invokes assumptions of spherical symmetry, ideal gas mixture, binary diffusion, no re-condensation on droplet surface, and constant properties. Four initial droplet diameters (0.001, 0.01, 0.1, and 1â¯mm), two ambient temperatures (20 and 30â¯oC) and a range of ambient relative humidity are considered. For the conditions studied, the results show that the ambient relative humidity plays an important role in the droplet lifetime calculation. Increasing the ambient temperature does not necessarily decrease the droplet lifetime; it occurs only when the ambient relative humidity is set below 37%. When the ambient relative humidity is higher than 37%, the higher ambient temperature (30â¯oC) results in a longer droplet lifetime for the same initial droplet diameter considered. The results also suggest that there may exist a critical ambient relative humidity; beyond which, the droplet lifetime will increase exponentially. For ambient temperature at 30â¯oC, the critical ambient relative humidity is around 55.7%. It must be mentioned that the results of this study do not imply that the COVID-19 virus will be deactivated at the end of the droplet lifetime. The study simply shows the potential effects resulting from the ambient temperature and ambient relative humidity on virus carrying drops.


Cardiovascular Disease in the Post-COVID-19 Era - the Impending Tsunami?


title: Inside the Mind of Investors During the COVID-19 Pandemic: Evidence from the StockTwits Data

text: We study the investor beliefs, sentiment and disagreement, about stock market returns during the COVID-19 pandemic using a large number of messages of investors on a social media investing platform, \textit{StockTwits}. The rich and multimodal features of StockTwits data allow us to explore the evolution of sentiment and disagreement within and across investors, sectors, and even industries. We find that the sentiment (disagreement) has a sharp decrease (increase) across all investors with any investment philosophy, horizon, and experience between February 19, 2020, and March 23, 2020, where a historical market high followed by a record drop. Surprisingly, these measures have a sharp reverse toward the end of March. However, the performance of these measures across various sectors is heterogeneous. Financial and healthcare sectors are the most pessimistic and optimistic divisions, respectively.


Impaired Breakdown of Bradykinin and Its Metabolites as a Possible Cause for Pulmonary Edema in COVID-19 Infection


title: Comment on "Cutaneous manifestations in COVID-19: a first perspective " by Recalcati S

text: Since the coronavirus disease 2019 (COVID 19) outbreak was first reported in the Chinese city of Wuhan on December 31, 2019, it has stricken more than 1,000,000 persons worldwide, of whom over 50,000 have died (1). Having been infected by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), patients with COVID-19 mainly present with fever and respiratory symptoms (2). Isolated sudden onset anosmia has also frequently been reported (3). Less frequently, rhinorrhea, diarrhoea and dysgeusia may be associated. While only a few reports have evoked cutaneous manifestations (4), we read with interest an initial study on the topic entitled "Cutaneous manifestations in COVID-19: a first perspective " by Recalcati S. (5).


COVID-19 Highlights the Need for Trained Social Workers in Nursing Homes


title: Covid-19: avaliação remota em Atenção Primária à Saúde

text: O que você precisa saber? A maioria dos pacientes com Covid-19 podem ser manejados remotamente com aconselhamento de manejo de sintomas e autoisolamento;Apesar da maioria das consultas poderem ser feitas por telefone, a imagem de vídeo fornece pistas adicionais visuais e a presença terapêutica do profissional de saúde para o paciente;Falta de ar é um sintoma preocupante, embora, hoje, não há ferramenta validada para avaliá-la remotamente;Aconselhamento sobre rede de segurança para o paciente é crucial, uma vez que, alguns pacientes deterioram muito a sua condição de saúde em 2 semanas, mais comumente por pneumonia


title: SARS-CoV-2 infection in healthcare personnel with high-risk occupational exposure: evaluation of seven-day exclusion from work policy

text: BACKGROUND: Starting in late February 2020, Greece is experiencing a coronavirus disease 2019 (COVID-19) epidemic. Healthcare personnel (HCP) were disproportionately affected, accounting for approximately 10% of notified cases. Exclusion from work for 7 days was recommended for HCP with high-risk occupational exposure. Our aim was to evaluate the 7-day exclusion from work policy for HCP with high-risk exposure. METHODS: HCP with a history of occupational exposure to COVID-19 were notified to the Hellenic National Public Health Organization, regardless of their exposure risk category. Exposed HCP were followed for 14 days after last exposure. RESULTS: We prospectively studied 3398 occupationally exposed HCP; nursing personnel accounted for most exposures (n=1705; 50.2%). Of the 3398 exposed HCP, 1599 (47.1%) were classified as low-risk, 765 (22.5%) as moderate-risk, and 1031 (30.4%) as high-risk exposures. Sixty-six (1.9%) HCP developed COVID-19 at a mean of 3.65 days (range: 0-17 days) post-exposure. Of the 66 HCP with COVID-19, 46, 7, and 13 had a history of high-, moderate- or low-risk exposure (4.5%, 0.9%, and 0.8% of all high-, moderate-, and low-risk exposures, respectively). Hospitalization and absenteeism were more prevalent among HCP with high-risk exposure. A logistic regression analysis showed that the following variables were significantly associated with an increased risk for the onset of COVID-19: male, administrative personnel, underlying disease and high-risk exposure. CONCLUSION: HCP with high-risk occupational exposure to COVID-19 had increased probability of serious morbidity, healthcare seeking, hospitalization and absenteeism. Our findings justify the 7-day exclusion from work policy for HCP with high-risk exposure.


title: COVID-19, Australia: Epidemiology Report 2 (Reporting week ending 19:00 AEDT 8 February 2020)

text: This is the second epidemiological report for coronavirus disease (COVID-19), previously known as novel coronavirus (2019-nCoV), reported in Australia as at 19:00 Australian Eastern Daylight Time [AEDT] 8 February 2020. It includes data on Australian cases notified during the week ending 19:00 AEDT 8 February 2020, the international situation and current information on the severity, transmission and spread of the COVID-19 infection.


New FDA Guidance on General Clinical Trial Conduct in the Era of COVID-19


title: Clinical features of pediatric patients with COVID-19: a report of two family cluster cases

text: BACKGROUND: Coronovirus disease 2019 (COVID-19) has spread rapidly across the globe. People of all ages are susceptible to COVID-19. However, literature reports on pediatric patients are limited. METHODS: To improve the recognition of COVID-19 infection in children, we retrospectively reviewed two confirmed pediatric cases from two family clusters. Both clinical features and laboratory examination results of the children and their family members were described. RESULTS: The two confirmed children only presented with mild respiratory or gastrointestinal symptoms. Both of them had normal chest CT images. After general and symptomatic treatments, both children recovered quickly. Both families had travel histories to Hubei Province. CONCLUSIONS: Pediatric patients with COVID-19 are mostly owing to family cluster or with a close contact history. Infected children have relatively milder clinical symptoms than infected adults. We should attach importance to early recognition, early diagnosis, and early treatment of infected children.


The important role of serology for COVID-19 control


Corticosteroid use in selected patients with severe acute respiratory distress syndrome related to COVID-19


title: Pervasive Communications Technologies For Managing Pandemics

text: Pandemics always have had serious consequences unless they were effectively contained. Recent experiences with COVID-19 show that by using a smart and swift approach to deal with pandemics, avoids overwhelming of healthcare systems, and reduces the loss of precious life. This paper is about using smart technologies such as Mobile Edge Clouds (MEC), Internet of Things (IoT), and Artificial Intelligence (AI), as an approach to effectively manage pandemics. IoT provides pervasive connectivity among various devices and can be used for collecting information such as location and symptoms of potentially infected individuals. MECs provide cloud services on the edge, integrating IoT infrastructure and execution of sophisticated AI algorithms in the Cloud. In this paper, we develop a prototype to demonstrate the convergence of pervasive technologies to support research in managing pandemics. Low-cost Single Board Computers (SBC) based clusters are integrated within MEC to support remote medical teams in the field. The prototype implements a lightweight Docker container orchestrated by Kubernetes eco-system which is deployed on the clusters. The prototype successfully demonstrates that mobile medical facilities can utilize the proposed solution to collect information and execute AI algorithms while on the go. Finally, we present a discussion on the role of converging pervasive technologies on managing pandemics.


COVID-19 and parasitology


Household infection: The predominant risk factor for close contacts of patients with COVID-19


title: Experiences and perceptions risk of health-care workers from coronavirus: A protocol for systematic review

text: BACKGROUND: Healthcare workers (HCWs) were at the frontline during the battle against coronavirus. Understanding and managing their fears and anxieties may hold lessons for handling future outbreaks. However, the experiences and perceptions risk of HCWs from coronavirus still remains to be controversial. Thus, the objective of this review is to identify, appraise, and synthesize available evidence related to the experiences and perceptions of risk of HCWs from coronavirus. METHODS: The studies were gathered from PubMed, Cochrane Library, EMBASE, CBMdisc, CNKI, WKSP, CSJFT, Google Scholar, and PsycINFO, along with several sources of gray literature. The retrieval of full-text studies, data extraction, and quality assessment of the included studies will be independently conducted by 2 reviewers. The meta-aggregative will be used for findings pooling and a summary of ConQual findings tables will be presented in future. RESULTS: This study will be submitted to a peer-reviewed journal for publication. CONCLUSION: The literature will provide a high-quality analysis of the current evidence to assess the experiences and perceptions risk of health-care workers from coronavirus. REGISTRATION INFORMATION: CRD42020170388.


title: Performance Characteristics of the Abbott Architect SARS-CoV-2 IgG Assay and Seroprevalence in Boise, Idaho

text: Coronavirus disease-19 (COVID19), the novel respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with severe morbidity and mortality. The rollout of diagnostic testing in the United States was slow, leading to numerous cases that were not tested for SARS-CoV-2 in February and March 2020, necessitating the use of serological testing to determine past infections. Here, we evaluated the Abbott SARS-CoV-2 IgG test for detection of anti-SARS-CoV-2 IgG antibodies by testing 3 distinct patient populations. We tested 1,020 serum specimens collected prior to SARS-CoV-2 circulation in the United States and found one false positive, indicating a specificity of 99.90%. We tested 125 patients who tested RT-PCR positive for SARS-CoV-2 for which 689 excess serum specimens were available and found sensitivity reached 100% at day 17 after symptom onset and day 13 after PCR positivity. Alternative index value thresholds for positivity resulted in 100% sensitivity and 100% specificity in this cohort. We tested 4,856 individuals from Boise, Idaho collected over one week in April 2020 as part of the Crush the Curve initiative and detected 87 positives for a positivity rate of 1.79%. These data demonstrate excellent analytical performance of the Abbott SARS-CoV-2 IgG test as well as the limited circulation of the virus in the western United States. We expect the availability of high-quality serological testing will be a key tool in the fight against SARS-CoV-2.


title: Why Are Lopinavir and Ritonavir Effective against the Newly Emerged Coronavirus 2019? Atomistic Insights into the Inhibitory Mechanisms

text: Since the emergence of a novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported from Wuhan, China, neither a specific vaccine nor an antiviral drug against SARS-CoV-2 has become available. However, a combination of two HIV-1 protease inhibitors, lopinavir and ritonavir, has been found to be effective against SARS-CoV, and both drugs could bind well to the SARS-CoV 3C-like protease (SARS-CoV 3CLpro). In this work, molecular complexation between each inhibitor and SARS-CoV-2 3CLpro was studied using all-atom molecular dynamics simulations, free energy calculations, and pair interaction energy analyses based on MM/PB(GB)SA and FMO-MP2/PCM/6-31G* methods. Both anti-HIV drugs interacted well with the residues at the active site of SARS-CoV-2 3CLpro. Ritonavir showed a somewhat higher number atomic contacts, a somewhat higher binding efficiency, and a somewhat higher number of key binding residues compared to lopinavir, which correspond with the slightly lower water accessibility at the 3CLpro active site. In addition, only ritonavir could interact with the oxyanion hole residues N142 and G143 via the formation of two hydrogen bonds. The interactions in terms of electrostatics, dispersion, and charge transfer played an important role in the drug binding. The obtained results demonstrated how repurposed anti-HIV drugs could be used to combat COVID-19.


title: In silico study the inhibition of angiotensin converting enzyme 2 receptor of COVID-19 by Ammoides verticillata components harvested from Western Algeria

text: The objective of this present study is to focus on the in silico study to screen for an alternative drug that can block the activity of the angiotensin converting enzyme 2 (ACE2) as a receptor for SARS-CoV-2, potential therapeutic target of the COVID-19 virus using natural compounds (Isothymol, Thymol, Limonene, P-cymene and Î³-terpinene) derived from the essential oil of the antiviral and antimicrobial plant Ammoides verticillata (Desf.) Briq. which is located in the occidental Algeria areas. This study reveals that Isothymol, a major component of this plant, gives the best docking scores, compared to, the co-crystallized inhibitor ß-D-mannose of the enzyme ACE2, to Captropil drug as good ACE2 inhibitor and to Chloroquine antiviral drug also involved in other mechanisms as inhibition of ACE2 cellular receptor. In silico (ADME), drug-likeness, PASS & P450 site of metabolism prediction, pharmacophore Mapper showed that the compound Isothymol has given a good tests results compared to the ß-D-mannose co-crystallized inhibitor, to Captopril and Chloroquine drugs. Also the other natural compounds gave good results. The Molecular Dynamics Simulation study showed good result for the Isotymol- ACE2 docked complex. This study revealed for the first time that Isothymol is a functional inhibitor of angiotensin converting enzyme 2 activity and the components of essential oils Ammoides verticillata can be used as potential inhibitors to the ACE2 receptor of SARS-CoV-2.Communicated by Ramaswamy H. Sarma.


Narrative Medicine: Thinking With Stories During The Plague


title: Just the Facts: Protected code blue - Cardiopulmonary resuscitation in the emergency department during the coronavirus disease 2019 pandemic

text: Emergency medical services (EMS) is called for a 65-year-old man with a 1-week history of cough, fever, and mild shortness of breath now reporting chest pain. Vitals on scene were HR 110, BP 135/90, SpO2 88% on room air. EMS arrives at the emergency department (ED). As the patient is moved to a negative pressure room, he becomes unresponsive with no palpable pulse. What next steps should be discussed in order to protect the team and achieve the best possible patient outcome?


David Oliver: Covid-19 will make us stop some activities for good


title: Potential Applications of Plant Biotechnology against SARS-CoV-2

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus responsible for an ongoing human pandemic (COVID-19). There is a massive international effort underway to develop diagnostic reagents, vaccines, and antiviral drugs in a bid to slow down the spread of the disease and save lives. One part of that international effort involves the research community working with plants, bringing researchers from all over the world together with commercial enterprises to achieve the rapid supply of protein antigens and antibodies for diagnostic kits, and scalable production systems for the emergency manufacturing of vaccines and antiviral drugs. Here, we look at some of the ways in which plants can and are being used in the fight against COVID-19.


Palliative care in advanced coronavirus disease in intensive care units


Systematic review of simulated airway management whilst wearing personal protective equipment


title: A multi-region variant of the SIR model and its extensions

text: In this note, we describe simple generalizations of the basic SIR model for epidemic, in case of a multi-region scenario, to be used for predicting the COVID-19 epidemic spread in Italy.


Rapidly scalable mechanical ventilator for the COVID-19 pandemic


title: Chloroquine in COVID-19: the evidence

text: To the Editor The Coronavirus disease 2019 (COVID-19) has been declared as a pandemic by World Health Organisation (WHO). The global mortality has increased, especially in countries like Italy and Iran. With the increasing morbidity and mortality, search for a cure has been the global demand.


title: Globalisation in the time of COVID-19: repositioning Africa to meet the immediate and remote challenges

text: The COVID-19 pandemic has ushered in a new climate of uncertainty which is fuelling protectionism and playing into nationalist narratives. Globalisation is under significant threat as governments scramble to reduce their vulnerability to the virus by limiting global trade and flows of people. With the imposition of border closures and strict migration measures, there have been major disruptions in Africa's global supply chains with adverse impacts on employment and poverty. The African economies overly reliant on single export-orientated industries, such as oil and gas, are expected to be severely hit. This situation is further aggravated by tumbling oil prices and a lowered global demand for African non-oil products. The agricultural sector, which should buffer these shocks, is also being affected by the enforcement of lockdowns which threaten people's livelihoods and food security. Lockdowns may not be the answer in Africa and the issue of public health pandemic response will need to be addressed by enacting context-specific policies which should be implemented in a humane way. In addressing the socioeconomic impact of COVID-19 on African nations, we argue that governments should prioritize social protection programmes to provide people with resources to maintain economic productivity while limiting job losses. International funders are committing assistance to Africa for this purpose, but generally as loans (adding to debt burdens) rather than as grants. G20 agreement so suspend debt payments for a year will help, but is insufficient to fiscal need. Maintaining cross-border trade and cooperation to continue generating public revenues is desirable. New strategies for diversifying African economies and limiting their dependence on external funding by promoting trade with a more regionalised (continental) focus as promoted by the African Continental Free Trade Agreement, while not without limitations, should be explored. While it is premature to judge the final economic and death toll of COVID-19, African leaders' response to the pandemic, and the support they receive from wealthier nations, will determine its eventual outcomes.


Type 1 diabetes onset triggered by COVID-19


title: COVID-19: Generate and apply local modelled transmission and morbidity effects to provide an estimate of the variation in overall relative healthcare resource impact at general practice granularity

text: INTRODUCTION: Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is the name given to the 2019 novel coronavirus. COVID-19 is the name given to the disease associated with the virus. SARS-CoV-2 is a new strain of coronavirus not been previously identified in humans. METHODS: Two key factors, case incidence and case morbidity, were analysed for England. When taken together they give an estimate of relative demand on healthcare utilisation. To analyse case incidence, the latest values for indicators that could be associated with infection transmission rates were collected from the Office of National Statistics (ONS) and Quality Outcome Framework (QOF) sources. These included population density, %age >16, at fulltime work/education, %age over 60, %BME ethnicity, social deprivation as IMD2019, location as latitude/longitude, and patient engagement as %self-confident in their own long-term condition management. Average case morbidity was calculated. To provide a comparative measure of overall healthcare resource impact, individual GP practice impact scores were compared against the median practice. RESULTS: The case incidence regression is a dynamic situation but it currently shows that Urban, %Working, and age >60 were the strongest determinants of case incidence. The local population comorbidity remains unchanged. The range of relative healthcare impact was wide with 80% of practices falling at 20%-250% of the national median. Once practice population numbers were included we found that the top 33% of GP practices supporting 45% of the patient population would require 68% of COVID-19 healthcare resources. The model provides useful information about the relative impact of Covid-19 on healthcare workload at GP practice granularity in all parts of England. CONCLUSION: Covid-19 is impacting on the utilisation of health/social care resources across the world. This model provides a way of predicting relative local levels of disease burden based on defined criteria, thereby providing a method for targeting limited care resources to optimise national/regional/local responses to the COVID-19 outbreak.


Covid-19 in care homes: the many determinants of this perfect storm


title: SARS-CoV-2 will continue to circulate in the human population: an opinion from the point of view of the virus-host relationship

text: At the population level, the virus-host relationship is not set up to end with the complete elimination of either or both. Pathogen-resistant individuals will always remain in the host population. In turn, the virus can never completely eliminate the host population, because evolutionarily such an event is a dead end for the virus as an obligate intracellular parasite. A certain existential balance exists in the virus-host relationship. Against this backdrop, viral epidemics and pandemics only become manifest and egregious to human beings when tens and hundreds of thousands of people die and the question emerges what caused the high mortality peaks on the death chart. The answer seems clear; the emerging strain of the virus is new to the host population, and new mutations of the virus and natural selection will lead to a survival of only genetically resistant individuals in a host population. The dangers inherent to a novel virus are due to new features generally inthe molecular structure of proteins, which enable the virus to infect the cells of the host organism more intensively, dramatically challenging host immunity, and thus be transmitted more readily in the host population. In this article, we will concentrate on the facts currently available about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has caused COVID-19 (coronavirus disease 2019) pandemic and try to predict its development and consequences based on the virus-host relationship. In fact, only two scenarios will occur simultaneously in the very near future: people who are genetically resistant to the virus will get sick, recover, and develop immunity, while people who are sensitive to the virus will need drugs and vaccines, which will have to be researched and developed if they are to recover. If the pandemic does not stop, in a few decades it is anticipated that SARS-CoV-2 will become as safe as the four non-severe acute respiratory syndrome human coronaviruses (HCoV-NL63, HCoV-HKU1, HCoV-OC43, and HCoV-229E) currently circulating but causing low mortality in the human population.


title: From plague to coronavirus: On the value of ship traffic data for epidemic modeling

text: In addition to moving people and goods, ships can spread disease. Ship traffic may complement air traffic as a source of import risk, and cruise ships - with large passenger volumes and multiple stops - are potential hotspots, in particular for diseases with long incubation periods. Vessel trajectory data from ship Automatic Identification Systems (AIS) is available online and it is possible to extract and analyze this data. We illustrate this in the case of the current coronavirus epidemic, in which hundreds of infected individuals have traveled in ships captured in the AIS dataset. This real time and historical data should be included in epidemiological models of disease to inform the corresponding operational response.


title: Beyond just"flattening the curve": Optimal control of epidemics with purely non-pharmaceutical interventions

text: When effective medical treatment and vaccination are not available, non-pharmaceutical interventions such as social distancing, home quarantine and far-reaching shutdown of public life are the only available strategies to prevent the spread of epidemics. Based on an extended SEIR (susceptible-exposed-infectious-recovered) model and continuous-time optimal control theory, we compute the optimal non-pharmaceutical intervention strategy for the case that a vaccine is never found and complete containment (eradication of the epidemic) is impossible. In this case, the optimal control must meet competing requirements: First, the minimization of disease-related deaths, and, second, the establishment of a sufficient degree of natural immunity at the end of the measures, in order to exclude a second wave. Moreover, the socio-economic costs of the intervention shall be kept at a minimum. The numerically computed optimal control strategy is a single-intervention scenario that goes beyond heuristically motivated interventions and simple"flattening of the curve."Careful analysis of the computed control strategy reveals, however, that the obtained solution is in fact a tightrope walk close to the stability boundary of the system, where socio-economic costs and the risk of a new outbreak must be constantly balanced against one another. The model system is calibrated to reproduce the initial exponential growth phase of the COVID-19 pandemic in Germany.


title: Psychological Support for Medical Rescue Teams in Emergencies/ 中山大学学报(医学科学版)

text: @# Emergencies refer to those events that cause serious social harm, including natural disasters and public health events, and require emergency response. Medical rescue team is the main emergency rescue team. While carrying out the rescue mission, they are under great pressure both physically and mentally due to the unadaptability of the rescue environment, the lack of protective materials, overwork and other reasons, often resulting in fear, tension, anxiety, pessimism, self-blame and even acute stress disorder. Without timely and effective psychological support, long-term psychological problems such as post-traumatic stress disorder will remain after the event. Comprehensive psychological support includes psychological measurement of the whole rescue process, team formation before rescue and detailed psychological support intervention training, self-relaxation during rescue, basic life and safety guarantee, drug treatment, online psychological assistance, withdrawal of stressors after rescue and lifestyle reconstruction.


title: An Empirical Methodology for Detecting and Prioritizing Needs during Crisis Events

text: In times of crisis, identifying the essential needs is a crucial step to providing appropriate resources and services to affected entities. Social media platforms such as Twitter contain vast amount of information about the general public's needs. However, the sparsity of the information as well as the amount of noisy content present a challenge to practitioners to effectively identify shared information on these platforms. In this study, we propose two novel methods for two distinct but related needs detection tasks: the identification of 1) a list of resources needed ranked by priority, and 2) sentences that specify who-needs-what resources. We evaluated our methods on a set of tweets about the COVID-19 crisis. For task 1 (detecting top needs), we compared our results against two given lists of resources and achieved 64% precision. For task 2 (detecting who-needs-what), we compared our results on a set of 1,000 annotated tweets and achieved a 68% F1-score.


Does Cigarette Smoking Protect Against SARS-CoV-2 Infection?


A 5-point strategy for improved connection with relatives of critically ill patients with COVID-19


Can Covid Catalyze an Educational Transformation? Competency-Based Advancement in a Crisis


title: GPU-Accelerated Drug Discovery with Docking on the Summit Supercomputer: Porting, Optimization, and Application to COVID-19 Research

text: Protein-ligand docking is an in silico tool used to screen potential drug compounds for their ability to bind to a given protein receptor within a drug-discovery campaign. Experimental drug screening is expensive and time consuming, and it is desirable to carry out large scale docking calculations in a high-throughput manner to narrow the experimental search space. Few of the existing computational docking tools were designed with high performance computing in mind. Therefore, optimizations to maximize use of high-performance computational resources available at leadership-class computing facilities enables these facilities to be leveraged for drug discovery. Here we present the porting, optimization, and validation of the AutoDock-GPU program for the Summit supercomputer, and its application to initial compound screening efforts to target proteins of the SARS-CoV-2 virus responsible for the current COVID-19 pandemic.


Severe COVID-19 in a pregnant patient admitted to hospital in Wuhan


Critical Care During the Coronavirus Crisis-Reflections on the Roles of Anesthesiologists in Meeting the Challenges of the Pandemic


Producing Independent, Systematic Review Evidence: Cochrane's Response to COVID-19


HMGB1: A Possible Crucial Therapeutic Target for COVID-19?


title: Correction to: The COVID-19 Pandemic and its Impact on the Cardio-Oncology Population

text: In light of the recent retraction of the New England Journal of Medicine article entitled "Cardiovascular Disease, Drug Therapy, and Mortality in COVID-19" (Mehra et al., full citation provided below), the authors would like to remove the following statement, which appeared on page 2, under the heading Cardiovascular Disease and COVID-19.


Coronavirus puts drug repurposing on the fast track


Walter Gusmini : patients COVID ou non COVID, telle est la question


patients COVID ou non COVID, telle est la question


title: Coronavirus just caused the American Physical Society to cancel its biggest meeting of the year ;Science ;AAAS

text: Citing the growing threat of the coronavirus, the American Physical Society (APS), the 55,000 member professional society for physicists and researchers in associated fields, cancelled its largest meeting of the year just 34 hours before it was supposed to begin APS’s March Meeting was to be held this week at the Colorado Convention Center in Denver, and the society anticipated more than 10,000 people from all over the world would attend However, late yesterday, APS issued a statement abruptly calling off the meeting “The decision to cancel was based on the latest scientific data being reported, and the fact that a large number of attendees at this meeting are coming from outside the U S ,” including countries where the virus is circulating and for which the U S Centers for Disease Control and Prevention have advised people to avoid non-essential travel, the APS statement says “[T]his decision was made out of deep concern for the health and well-being of our registrants, staff, vendors, and the Denver community ”


Residency and Fellowship Program Accreditation: Effects of the Novel Coronavirus (COVID-19) Pandemic


Preventing stroke in symptomatic carotid artery disease during the COVID-19 pandemic


title: Hyperinflammation and derangement of renin-angiotensin-aldosterone system in COVID-19: A novel hypothesis for clinically suspected hypercoagulopathy and microvascular immunothrombosis

text: Early clinical evidence suggests that severe cases of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are frequently characterized by hyperinflammation, imbalance of renin-angiotensin-aldosterone system, and a particular form of vasculopathy, thrombotic microangiopathy, and intravascular coagulopathy. In this paper, we present an immunothrombosis model of COVID-19. We discuss the underlying pathogenesis and the interaction between multiple systems, resulting in propagation of immunothrombosis, which through investigation in the coming weeks, may lead to both an improved understanding of COVID-19 pathophysiology and identification of innovative and efficient therapeutic targets to reverse the otherwise unfavorable clinical outcome of many of these patients.


Dermatologic surgery in the COVID-19 era: Observations and practical suggestions


Comments on "coinfection of SARS-CoV-2 and HIV in a patient in Wuhan city, China"


title: Care of newborns born to mothers with COVID-19 infection; a review of existing evidence

text: Background: The novel Coronavirus disease 2019 (COVID-19) pandemic is already wreaking havoc on families and communities' welfare. It is critical to discuss newborn care of infected mothers with COVID-19 based on the latest international guidelines and national guidelines of countries with the highest incidence of COVID-19 cases.Objective: We discuss how to care for a newborn of a suspected or infected mother with COVID-19 using existing evidence.Method: As of 16 April 2020, we reviewed articles and guidelines related to COVID-19 in the reproductive health field, mother, and newborn health. Our review yielded in 10 categories (i) the risk of diagnostic procedures in suspected mothers on fetus/infant health, (ii) the risk of intrauterine or postpartum transmission to the fetus/infant, (iii) appropriate method and delivery time in women with confirmed COVID-19, (iv) umbilical cord clamping and skin to skin contact, (v) clinical manifestations of infected infants, (vi) confirmation of infection in a suspected neonate/infant, (vii) instructions for infant's care and how to feed her/him, (viii) bathing the baby, (ix) the criteria of discharging baby from the hospital, (x) the impact of isolation on the maternal mental health.Results: Our findings showed that the possibility of intrauterine or perinatal transmission of COVID-19 is still questionable and ambiguous. However, what has been agreed upon in the existing texts and guidelines is that the close contact of mother and infant after birth can transmit the virus to the baby through droplets or micro-droplets.Conclusions: Based on our findings, it is recommended to separate the baby from the mother with confirmed (or suspected) COVID-19 infection for at least 2 weeks. Since the motivation and stable situation of mothers allow breastfeeding during the isolation, infected mothers should be taught about breast expression skills, common breast problems, the symptoms of their baby's infection, and the principles of personal hygiene to protect the infant against COVID-19 infection.


title: Expression of SARS-CoV-2 receptor ACE2 and TMPRSS2 in human primary conjunctival and pterygium cell lines and in mouse cornea

text: PURPOSE: To determine the expressions of SARS-CoV-2 receptor angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2) genes in human and mouse ocular cells and comparison to other tissue cells. METHODS: Human conjunctiva and primary pterygium tissues were collected from pterygium patients who underwent surgery. The expression of ACE2 and TMPRSS2 genes was determined in human primary conjunctival and pterygium cells, human ocular and other tissue cell lines, mesenchymal stem cells as well as mouse ocular and other tissues by reverse transcription-polymerase chain reaction (RT-PCR) and SYBR green PCR. RESULTS: RT-PCR analysis showed consistent expression by 2 ACE2 gene primers in 2 out of 3 human conjunctival cells and pterygium cell lines. Expression by 2 TMPRSS2 gene primers could only be found in 1 out of 3 pterygium cell lines, but not in any conjunctival cells. Compared with the lung A549 cells, similar expression was noted in conjunctival and pterygium cells. In addition, mouse cornea had comparable expression of Tmprss2 gene and lower but prominent Ace2 gene expression compared with the lung tissue. CONCLUSION: Considering the necessity of both ACE2 and TMPRSS2 for SARS-CoV-2 infection, our results suggest that conjunctiva would be less likely to be infected by SARS-CoV-2, whereas pterygium possesses some possibility of SARS-CoV-2 infection. With high and consistent expression of Ace2 and Tmprss2 in cornea, cornea rather than conjunctiva has higher potential to be infected by SARS-CoV-2. Precaution is necessary to prevent possible SARS-CoV-2 infection through ocular surface in clinical practice.


Surgery in the COVID-19 Phase 2 Italian scenario: lessons learned in Northern Italy spoke hospitals


ICU pharmacist describes challenges in COVID-19 care


Preliminary Findings on Control of Dispersion of Aerosols and Droplets During High-Velocity Nasal Insufflation Therapy Using a Simple Surgical Mask: Implications for the High-Flow Nasal Cannula


title: The race to unravel the United States’ biggest coronavirus outbreak

text: Rohit Shankar left the virology laboratory at 2 a m on Wednesday, and was back at the lab bench by 7 a m the same day “It’s okay,” he says, “I had a doughnut and a coffee ” Shankar, a medical scientist, and his colleagues at the University of Washington in Seattle are poised to exponentially drive up the number of confirmed cases of the coronavirus disease COVID-19 around the city, in western Washington state That’s because this week, they began analysing a mountain of nose and throat swabs collected from hospitals in the region Already, the researchers are seeing clear signs that the virus has infected vastly more people than have been formally detected Scientists fear coronavirus spread in countries least able to contain it Washington state has become the United States’ ground zero for COVID-19, which has now spread to more than 90 countries worldwide in what seems to be a new and dangerous phase of the outbreak Washington has declared a state emergency, and ten people there have died from the disease But the number of confirmed cases in Washington — 70 — is still an underestimate resulting from a lack of testing, researchers agree A genomic analysis posted online on 29 February suggested that hundreds of people in western Washington might already be infected Academic scientists have mostly been prevented from measuring the extent of the US outbreak because of federal rules restricting the number of labs qualified to run diagnostic tests But that is changing now, and helps account for why the state's caseload jumped from 10 to 70 this week Dozens of virologists and genomicists have now kicked into high gear in Seattle, dropping or adapting projects to devote resources to the outbreak Researchers are working around the clock to find out how many people have the disease in the area Others are analysing genomes to reveal how the virus is transmitted or developing new therapies The scientists are racing to help Washington avoid the fate of Hubei province in China, where more than 2,900 people have died of COVID-19 so far The coronavirus emerged in the province’s city Wuhan in December, and the initial response from officials was slow “We are past the point of containment,” says Helen Chu, an infectious-disease specialist at the University of Washington School of Medicine (UW Medicine) in Seattle “So now we need to keep the people who are vulnerable from getting sick ”


Closing the circle: an agroecological response to covid-19


title: Experience With Hydroxychloroquine and Azithromycin in the Coronavirus Disease 2019 Pandemic: Implications for QT Interval Monitoring

text: Background Despite a lack of clinical evidence, hydroxychloroquine and azithromycin are being administered widely to patients with verified or suspected coronavirus disease 2019 (COVID-19). Both drugs may increase risk of lethal arrhythmias associated with QT interval prolongation. Methods and Results We analyzed a case series of COVID-19-positive/suspected patients admitted between February 1, 2020, and April 4, 2020, who were treated with azithromycin, hydroxychloroquine, or a combination of both drugs. We evaluated baseline and postmedication QT interval (corrected QT interval [QTc]; Bazett) using 12-lead ECGs. Critical QTc prolongation was defined as follows: (1) maximum QTc ≥500 ms (if QRS <120 ms) or QTc ≥550 ms (if QRS ≥120 ms) and (2) QTc increase of ≥60 ms. Tisdale score and Elixhauser comorbidity index were calculated. Of 490 COVID-19-positive/suspected patients, 314 (64%) received either/both drugs and 98 (73 COVID-19 positive and 25 suspected) met study criteria (age, 62±17 years; 61% men). Azithromycin was prescribed in 28%, hydroxychloroquine in 10%, and both in 62%. Baseline mean QTc was 448±29 ms and increased to 459±36 ms (P=0.005) with medications. Significant prolongation was observed only in men (18±43 ms versus -0.2±28 ms in women; P=0.02). A total of 12% of patients reached critical QTc prolongation. Changes in QTc were highest with the combination compared with either drug, with much greater prolongation with combination versus azithromycin (17±39 ms versus 0.5±40 ms; P=0.07). No patients manifested torsades de pointes. Conclusions Overall, 12% of patients manifested critical QTc prolongation, and the combination caused greater prolongation than either drug alone. The balance between uncertain benefit and potential risk when treating COVID-19 patients should be carefully assessed.


title: SARS-CoV-2 orthologs of pathogenesis-involved small viral RNAs of SARS-CoV

text: Background: The COVID-19 pandemic clock is ticking and the survival of many of mankind's modern institutions and or survival of many individuals is at stake. There is a need for treatments to significantly reduce the morbidity and mortality of COVID-19. Hence, we delved deep into the SARS-CoV-2 genome, which is the virus that has caused COVID-19. SARS-CoV-2 is from the same family as SARS-CoV in which three small viral RNAs (svRNA) were recently identified; those svRNAs play a significant role in the virus pathogenesis in mice. Contribution: In this paper, we report potential orthologs of those three svRNAs in the SARS-CoV-2 genome. Instead of off-the-shelf search and alignment algorithms, which failed to discover the orthologs, we used a special alignment scoring that does not penalize C/T and A/G mismatches. RNA bases C and U both can bind to G; similarly, A and G both can bind to U, hence, our scoring. To validate our results, we confirmed the discovered orthologs are fully conserved in all the publicly available genomes of various strains of SARS-CoV-2; the loci at which the SARS-CoV-2 orthologs occur are close to the loci at which SARS-CoV svRNAs occur. We also report potential targets for these svRNAs. We hypothesize that the discovered orthologs play a role in pathogenesis of SARS-CoV-2, and therefore, antagomir-mediated inhibition of these SARS-CoV-2 svRNAs inhibits COVID-19.


title: Incidental COVID-19 related lung apical findings on stroke CTA during the COVID-19 pandemic

text: BACKGROUND: Authors have noticed an increase in lung apex abnormalities on CT angiography (CTA) of the head and neck performed for stroke workup during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: To evaluate the incidence of these CTA findings and their relation to COVID-19 infection. METHODS: In this retrospective multicenter institutional review board-approved study, assessment was made of CTA findings of code patients who had a stroke between March 16 and April 5, 2020 at six hospitals across New York City. Demographic data, comorbidities, COVID-19 status, and neurological findings were collected. Assessment of COVID-19 related lung findings on CTA was made blinded to COVID-19 status. Incidence rates of COVID-19 related apical findings were assessed in all code patients who had a stroke and in patients with a stroke confirmed by imaging. RESULTS: The cohort consisted of a total of 118 patients with mean±SD age of 64.9±15.7 years and 57.6% (68/118) were male. Among all code patients who had a stroke, 28% (33/118) had COVID-19 related lung findings. RT-PCR was positive for COVID-19 in 93.9% (31/33) of these patients with apical CTA findings.Among patients who had a stroke confirmed by imaging, 37.5% (18/48) had COVID-19 related apical findings. RT-PCR was positive for COVID-19 in all (18/18) of these patients with apical findings. CONCLUSION: The incidence of COVID-19 related lung findings in stroke CTA scans was 28% in all code patients who had a stroke and 37.5% in patients with a stroke confirmed by imaging. Stroke teams should closely assess the lung apices during this COVID-19 pandemic as CTA findings may be the first indicator of COVID-19 infection.


title: Ethnic and regional variations in hospital mortality from COVID-19 in Brazil: a cross-sectional observational study

text: BACKGROUND: Brazil ranks second worldwide in total number of COVID-19 cases and deaths. Understanding the possible socioeconomic and ethnic health inequities is particularly important given the diverse population and fragile political and economic situation. We aimed to characterise the COVID-19 pandemic in Brazil and assess variations in mortality according to region, ethnicity, comorbidities, and symptoms. METHODS: We conducted a cross-sectional observational study of COVID-19 hospital mortality using data from the SIVEP-Gripe (Sistema de Informação de Vigilância Epidemiológica da Gripe) dataset to characterise the COVID-19 pandemic in Brazil. In the study, we included hospitalised patients who had a positive RT-PCR test for severe acute respiratory syndrome coronavirus 2 and who had ethnicity information in the dataset. Ethnicity of participants was classified according to the five categories used by the Brazilian Institute of Geography and Statistics: Branco (White), Preto (Black), Amarelo (East Asian), Indígeno (Indigenous), or Pardo (mixed ethnicity). We assessed regional variations in patients with COVID-19 admitted to hospital by state and by two socioeconomically grouped regions (north and central-south). We used mixed-effects Cox regression survival analysis to estimate the effects of ethnicity and comorbidity at an individual level in the context of regional variation. FINDINGS: Of 99â557 patients in the SIVEP-Gripe dataset, we included 11â321 patients in our study. 9278 (82·0%) of these patients were from the central-south region, and 2043 (18·0%) were from the north region. Compared with White Brazilians, Pardo and Black Brazilians with COVID-19 who were admitted to hospital had significantly higher risk of mortality (hazard ratio [HR] 1·45, 95% CI 1·33-1·58 for Pardo Brazilians; 1·32, 1·15-1·52 for Black Brazilians). Pardo ethnicity was the second most important risk factor (after age) for death. Comorbidities were more common in Brazilians admitted to hospital in the north region than in the central-south, with similar proportions between the various ethnic groups. States in the north had higher HRs compared with those of the central-south, except for Rio de Janeiro, which had a much higher HR than that of the other central-south states. INTERPRETATION: We found evidence of two distinct but associated effects: increased mortality in the north region (regional effect) and in the Pardo and Black populations (ethnicity effect). We speculate that the regional effect is driven by increasing comorbidity burden in regions with lower levels of socioeconomic development. The ethnicity effect might be related to differences in susceptibility to COVID-19 and access to health care (including intensive care) across ethnicities. Our analysis supports an urgent effort on the part of Brazilian authorities to consider how the national response to COVID-19 can better protect Pardo and Black Brazilians, as well as the population of poorer states, from their higher risk of dying of COVID-19. FUNDING: None.


Influenza-like illnesses caused by a cluster of imported Italian COVID-19


Response to: 'Hydroxychloroquine shortages during the COVID-19 pandemic' by Mendel et al


Letter to the Editor Regarding: "An Imperative Need for Research on the Role of Environmental Factors in Transmission of Novel Coronavirus (COVID-19)" -Secondhand and Thirdhand Smoke As Potential Sources of COVID-19


Washing our hands of the problem


title: Shape-based Machine Learning Models for the potential Novel COVID-19 protease inhibitors assisted by Molecular Dynamics Simulation

text: BACKGROUND: The vast geographical expansion of novel coronavirus and an increasing number of COVID-19 affected cases has overwhelmed health and public health services. AI and ML algorithms have extended its major role in tracking the disease patterns, and in identifying possible treatment of disease. OBJECTIVE: To identify potential COVID-19 protease inhibitor through shape-based Machine Learning assisted by Molecular docking and Molecular Dynamics simulation. METHODS: 31 repurposed compounds have been selected targeting coronavirus protease (6LU7) and a machine learning approach was employed to generate shape-based molecules starting from 3D shape to pharmacophoric features of its seed compound. Ligand-Receptor docking was performed with Optimized Potential for Liquid Simulations (OPLS3) algorithms to identify high-affinity compounds from the list of selected candidates for 6LU7. This compound was subjected to Molecular Dynamic Simulations followed by ADMET studies and other analysis. RESULTS: Shape-based Machine learning reported Remdesivir, Valrubicin, Aprepitant, and Fulvestrant and a novel therapeutic compound as the best therapeutic agents with the highest affinity for its target protein. Among the best shape-based compounds, the novel theoretical compound was not indexed in any chemical databases (PubChem, Zinc, or ChEMBL). Hence, the novel compound was named 'nCorvEMBS'. Further, toxicity analysis showed nCorv-EMBS to be efficacious that can be qualified as a 6LU7 inhibitor in COVID-19. CONCLUSION: An effective ACE-II, GAK, AAK1, and protease 3C blockers that can serve a novel therapeutic approach to block the binding and attachment of COVID-19 protein (PDB ID: 6LU7) to the host cell and thus inhibit the infection at AT2 Lung cells. The novel theoretical compound nCorv-EMBS herein proposed stands as a promising inhibitor that can be extended for entering phases of clinical trials for COVID-19 treatment.


title: Intravenous infusion of human umbilical cord Wharton's jelly-derived mesenchymal stem cells as a potential treatment for patients with COVID-19 pneumonia

text: The novel coronavirus disease 2019 (COVID-19) has grown to be a global public health emergency since patients were first detected in Wuhan, China. Thus far, no specific drugs or vaccines are available to cure the patients with COVID-19 infection. The immune system and inflammation are proposed to play a central role in COVID-19 pathogenesis. Mesenchymal stem cells (MSCs) have been shown to possess a comprehensive powerful immunomodulatory function. Intravenous infusion of MSCs has shown promising results in COVID-19 treatment. Here, we report a case of a severe COVID-19 patient treated with human umbilical cord Wharton's jelly-derived MSCs (hWJCs) from a healthy donor in Liaocheng People's Hospital, China, from February 24, 2020. The pulmonary function and symptoms of the patient with COVID-19 pneumonia was significantly improved in 2 days after hWJC transplantation, and recovered and discharged in 7 days after treatment. After treatment, the percentage and counts of lymphocyte subsets (CD3+, CD4+, and CD8+ T cell) were increased, and the level of IL-6, TNF-α, and C-reactive protein is significantly decreased after hWJC treatment. Thus, the intravenous transplantation of hWJCs was safe and effective for the treatment of patients with COVID-19 pneumonia, especially for the patients in a critically severe condition. This report highlights the potential of hWJC infusions as an effective treatment for COVID-19 pneumonia.


title: Correction: A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations

text: [This corrects the article DOI: 10.1136/gpsych-2020-100213.].


Épidémie de COVID-19 : recommandations à l'usage des professionnels de l'oncologie radiothérapie./ [Covid-19 epidemic: guidelines issued by the French society of oncology radiotherapy (SFRO) for oncology radiotherapy professionals]


What we do when a COVID-19 patient needs an operation: operating room preparation and guidance


Covid care creates oxygen drought


Is it Crohn's disease?


title: From the Black-Karasinski to the Verhulst model to accommodate the unconventional Fed's policy

text: In this paper, we argue that some of the most popular short-term interest models have to be revisited and modified to reflect current market conditions better. In particular, we propose a modification of the popular Black-Karasinski model, which is widely used by practitioners for modeling interest rates, credit, and commodities. Our adjustment gives rise to the stochastic Verhulst model, which is well-known in the population dynamics and epidemiology as a logistic model. We demonstrate that the Verhulst model's dynamics are well suited to the current economic environment and the Fed's actions. Besides, we derive new integral equations for the zero-coupon bond prices for both the BK and Verhulst models. For the BK model for small maturities up to 2 years, we solve the corresponding integral equation by using the reduced differential transform method. For the Verhulst integral equation, under some mild assumptions, we find the closed-form solution. Numerical examples show that computationally our approach is significantly more efficient than the standard finite difference method.


Universal SARS-CoV-2 testing on admission to the labor and delivery unit: Low prevalence among asymptomatic obstetric patients


title: COVID-19 Impact on Well-Being and Education in Radiology Residencies: A Survey of the Association of Program Directors in Radiology

text: RATIONALE AND OBJECTIVES: The COVID-19 pandemic has forced rapid evolution of the healthcare environment. Efforts to mitigate the spread of the virus through social distancing and shelter-at-home edicts have unintended consequences upon clinical and educational missions and mental well-being of radiology departments. We sought to understand the impact of the COVID-19 pandemic on radiology residencies with respect to the educational mission and perceptions of impact on well-being. MATERIALS AND METHODS: This study was IRB exempt. An anonymous 22 question survey regarding the impact of COVID-19 pandemic on educational and clinical missions of residencies, its perceived impact upon morale of radiologists and trainees and a query of innovative solutions devised in response, was emailed to the Association of Program Directors in Radiology membership. Survey data were collected using SurveyMonkey (San Mateo, California). RESULTS: Respondents felt the COVID-19 pandemic has negatively impacted their residency programs. Regarding the educational mission impact, 70.1% (75/107) report moderate/marked negative impact and 2.8% (3/107) that educational activities have ceased. Regarding the pandemic's impact on resident morale, 44.8% (48/107) perceive moderate/marked negative effect; perceived resident morale in programs with redeployment is significantly worse with 57.1% (12/21) reporting moderate/marked decrease. Respondents overwhelmingly report adequate resident access to mental health resources during the acute phase of the pandemic (88.8%, 95/107). Regarding morale of program directors, 61% (65/106) report either mild or marked decreased morale. Program innovations reported by program directors were catalogued and shared. CONCLUSION: The COVID-19 pandemic has markedly impacted the perceived well-being and educational missions of radiology residency programs across the United States.


Elevated nucleoprotein-induced interferon-Î³ release in COVID-19 patients detected in a SARS-CoV-2 enzyme-linked immunosorbent spot assay


title: Best practice statements and recommendations for caring for critically ill patients with COVID-19

text: SOURCE CITATION: Alhazzani W, Møller MH, Arabi YM, et al. Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Crit Care Med. 2020;48:e440-69. 32224769.


De UCI hepática a UCI COVID: historia de una transformación./ De UCI hepática a UCI COVID: historia de una transformación./ From the liver ICU to the COVID ICU: The story of a transformation


title: Non-parametric Estimation of Quadratic Hawkes Processes for Order Book Events

text: We propose an actionable calibration procedure for general Quadratic Hawkes models of order book events (market orders, limit orders, cancellations). One of the main features of such models is to encode not only the influence of past events on future events but also, crucially, the influence of past price changes on such events. We show that the empirically calibrated quadratic kernel is well described by a diagonal contribution (that captures past realised volatility), plus a rank-one"Zumbach"contribution (that captures the effect of past trends). We find that the Zumbach kernel is a power-law of time, as are all other feedback kernels. As in many previous studies, the rate of truly exogenous events is found to be a small fraction of the total event rate. These two features suggest that the system is close to a critical point -- in the sense that stronger feedback kernels would lead to instabilities.


title: Potential mechanisms of hemorrhagic stroke in elderly COVID-19 patients

text: The novel severe acute respiratory syndrome coronavirus 2 is the causative agent of coronavirus disease 2019, a new human infectious disease. While fever, cough, and respiratory distress are typical first symptoms, a fraction of those affected present instead with neurological symptoms suggestive of central nervous system compromise. This review summarizes the potential contribution of coronavirus disease 2019 to hemorrhagic stroke in the elderly and proposes possible mechanisms. Reports show that the most affected patients have underlying chronic diseases such as hypertension and diabetes, which are two key risk factors for hemorrhagic stroke. Angiotensin-converting enzyme 2 is the main host cell surface receptor interacting with the severe acute respiratory syndrome coronavirus 2 spike glycoprotein to allow viral entry and infection. We speculate that ensuing downregulation of angiotensin-converting enzyme 2 expression may compound the risk conferred by pre-existing comorbidities and critically influence the pathogenesis of hemorrhagic stroke by elevating blood pressure and impairing cerebrovascular endothelial function. Additionally, both age- and/or disease-related immune dysfunction and enhanced catecholamine release secondary to anxiety and stress may also aggravate central nervous system symptoms of severe acute respiratory syndrome coronavirus 2 infection. Thus, assessment of systemic inflammatory biomarkers and tight control of hemodynamic parameters upon admission are crucial to minimize mortality and morbidity in coronavirus disease 2019 patients with central nervous system symptoms suggestive of incipient stroke.


COVID-19 treatments, QT interval, and arrhythmic risk: The need for an international registry on arrhythmias


Pain Management During the COVID-19 Pandemic in China: Lessons Learned


Extubation is as important as intubation in COVID 19


title: Chronic treatment with hydroxychloroquine and SARS-CoV-2 infection

text: BACKGROUND: Hydroxychloroquine sulphate (HCQ) is being scrutinized for repositioning in the treatment and prevention of SARS-Cov-2 infection. This antimalarial drug is also chronically used to treat patients with autoimmune diseases. METHODS: By analysing the Portuguese anonymized data on private and public based medical prescriptions we have identified all cases chronically receiving HCQ for the management of diseases such as systemic lupus erythematosus, rheumatoid arthritis, and other autoimmune diseases. Additionally, we have detected all laboratory confirmed cases of SARS-CoV-2 infection and all laboratory confirmed negative cases in the Portuguese population (mandatorily registered in a centrally managed database). Cross linking the two sets of data has allowed us to compare the proportion of HCQ chronic treatment (at least 2 grams per month) in laboratory confirmed cases of SARS-CoV-2 infection with laboratory confirmed negative cases. RESULTS: Out of 26,815 SARS-CoV-2 positive patients, 77 (0.29%) were chronically treated with HCQ, while 1,215 (0.36%) out of 333,489 negative patients were receiving it chronically (P=0.04). After adjustment for age, sex, and chronic treatment with corticosteroids and/or immunosuppressants, the odds ratio of SARS-CoV-2 infection for chronic treatment with HCQ has been 0.51 (0.37-0.70). CONCLUSIONS: Our data suggest that chronic treatment with HCQ confer protection against SARS-CoV-2 infection. This article is protected by copyright. All rights reserved.


The indispensable role of chest CT in the detection of coronavirus disease 2019 (COVID-19)


title: Caring for Nephrology Patients and Staff During the COVID-19 Pandemic: Experiences of the Northwest Kidney Centers

text: The Northwest Kidney Center (NWC) in Seattle, Washington, has been a leader in nephrology care for almost 60 years, opening the first hemodialysis unit in the United States in 1962. In February 2020, one of their patients was the first reported death from COVID-19 in the United States. On April 6, 2020, as a part of NNJ Extra - the Nephrology Nursing Journal's podcast series, Beth Ulrich, EdD, RN, FACHE, FAONL, FAAN, Editor-in-Chief of the Nephrology Nursing Journal, talked with the leaders of the Northwest Kidney Centers - Suzanne Watnick, MD, the Chief Medical Officer, and Liz McNamara, MN, RN, Vice President of Patient Care Services and the Chief Nursing Officer, who discussed dealing with the onset of COVID-19 at NWC, how their team worked together to provide care for their patients and support for their staff members, and the lessons they learned that can benefit others.


Letter to the Editor: Embracing Disruptive Change During the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic


Percutaneous tracheostomy in patients with COVID-19: sealing the bronchoscope with an in-line suction sheath


title: European Research Council: bottom-up principles of the Scientific Council and top-down proposal of the resigned President

text: The recent resignation of the President of the European Research Council (ERC) Mauro Ferrari has opened a wide discussion both on the method of designation of the President of the ERC and on the validity of the different funding mechanisms for scientific research. From this point of view, Sars-CoV-2 was not only responsible for the pandemic, but also triggered a debate on an alleged primacy of applied research over the fundamental research.


title: Beating the odds with systematic individualized care Nationwide prospective follow-up of all patients with COVID-19 in Iceland

text: The current pandemic of a novel coronavirus disease 2019 (COVID-19) began in December 2019 in Wuhan, China, and has since spread worldwide. Pandemic preparedness has been an ongoing project in Iceland since the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003-2004. In mid-January 2020, The Directorate of Health (DOH) and The Department of Civil Protection and Emergency Management (DCPEM) revised the current pandemic preparedness response plan. The DOH and DCPEM, in close collaboration with the Department of Clinical Microbiology and Internal Medicine Services at Landspitali-The National University Hospital (LUH) and deCODE genetics, initiated a nationwide surveillance program for COVID-19, including diagnostic testing which began on 31 January. A report on the extensive screening efforts in Iceland has recently been published.


Corona crisis and politics: Thoughts from the BVDD and the DDG


title: Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies

text: INTRODUCTION: The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has exposed vulnerable populations to an unprecedented global health crisis. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The objective of this study was to summarize the clinical manifestations and maternal and perinatal outcomes of COVID-19 during pregnancy. MATERIAL AND METHODS: We searched databases for all case reports and series from 12 February to 4 April 2020. Multiple terms and combinations were used including COVID-19, pregnancy, maternal mortality, maternal morbidity, complications, clinical manifestations, neonatal morbidity, intrauterine fetal death, neonatal mortality and SARS-CoV-2. Eligibility criteria included peer-reviewed publications written in English or Chinese and quantitative real-time polymerase chain reaction (PCR) or dual fluorescence PCR-confirmed SARS-CoV-2 infection. Unpublished reports, unspecified date and location of the study or suspicion of duplicate reporting, cases with suspected COVID-19 that were not confirmed by a laboratory test, and unreported maternal or perinatal outcomes were excluded. Data on clinical manifestations, maternal and perinatal outcomes including vertical transmission were extracted and analyzed. RESULTS: Eighteen articles reporting data from 108 pregnancies between 8 December 2019 and 1 April 2020 were included in the current study. Most reports described women presenting in the third trimester with fever (68%) and coughing (34%). Lymphocytopenia (59%) with elevated C-reactive protein (70%) was observed and 91% of the women were delivered by cesarean section. Three maternal intensive care unit admissions were noted but no maternal deaths. One neonatal death and one intrauterine death were also reported. CONCLUSIONS: Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 and perinatal deaths were reported. Vertical transmission of the COVID-19 could not be ruled out. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted.


title: Radiotherapy in Southern Italy at the time of COVID-19: options for radiation oncology units

text: INTRODUCTION: The outbreak of coronavirus disease 2019 (COVID-19) has spread to many countries and has been declared a global health emergency. Our center is located in the south of Italy where the infection rates were low and the clusters of COVID-19 positive patients were small and inhomogeneous. The aim of this short report is to share our experience as a starting point for the management of the steady state of the pandemic. METHODS: The safety of the patients and department staff required a strict plan to minimize the risk of infection between operators whose absence would have made it impossible to carry out the radiotherapy treatments. The head of the radiotherapy unit and members of the Hospital Crisis Unit have put in place a series of measures to manage the emergency. RESULTS: A "clean" team has been established whose members are kept out of the radiotherapy unit for 2 weeks on rotation. Several separate work areas have been made in order to reduce direct contact between the staff. Each staff member has to wear protective equipment if close contact with patients is required. Before confirming a radiotherapy consult or a follow-up visit, telephone clinical and epidemiological screening is performed by nurses through a questionnaire regarding the presence of respiratory symptoms or eventual social contacts with COVID-19 positive people. Once the patients arrive in the hospital, a triage point at the entrance to the hospital performs a second screening and a temperature check. CONCLUSIONS: This management experience of a radiotherapy unit in Southern Italy could serve as a useful example for the future. In fact, in the steady state of infection many centers may face epidemiologically contagious numbers similar to those that we currently have in our region. These numbers require the maintenance of alert and precautionary measures which in our case seem to have worked.


title: On setting expectations for a SARS-CoV-2 Vaccine

text: The global coronavirus pandemic is unlike any other since 1918. A century of dramatic medical advances has produced a public expectation that the medical field will rapidly provide solutions to restore normalcy. In under 6 months, since SARS-CoV-2 was identified, the massive international effort to develop a SARS-CoV-2 vaccine has generated more than 140 vaccines in different stages of development with 9 already recruiting into clinical trials posted on clinicaltrials.gov. The long-term strategy to handle COVID-19 will almost certainly rely on vaccines. But, what type of protection can we realistically expect to achieve from vaccines and when?


Centralized air-conditioning and transmission of novel coronavirus


title: A dynamic modeling tool for estimating healthcare demand from the COVID19 epidemic and evaluating population-wide interventions

text: Objectives. Public health officials need tools to assist with anticipating the healthcare resources required to confront the SARS-COV-2 pandemic. We built a modeling tool to aid practicing public health officials with estimating healthcare demand from the pandemic in their jurisdictions and to evaluate the potential impacts of population-wide social-distancing interventions. Methods. The tool uses a SEIR compartmental model to project the local spread of the pandemic. Users input case counts, healthcare resources, and select intervention strategies to evaluate. Outputs include the number of infections and deaths with and without intervention, and the demand for hospital and critical care beds and ventilators relative to existing capacity. We illustrate the tool using data from three regions of Chile. Results. Our scenarios indicate a surge in COVID-19 patients could overwhelm Chilean hospitals by June, peaking in July or August at 6 to 50 times the current supply of beds and ventilators. A lockdown strategy or combination of case isolation, home quarantine, social distancing of individuals greater than 70 years, and telework interventions may keep treatment demand below capacity. Conclusions. Aggressive interventions can avert substantial morbidity and mortality from COVID-19. Our tool permits rapid evaluation of locally-applicable policy scenarios and updating of results as new data become available.


text: OBJECTIVES: Public health officials need tools to assist in anticipating the healthcare resources required to confront the SARS-COV-2 pandemic. We constructed a modeling tool to aid active public health officials to estimate healthcare demand from the pandemic in their jurisdictions and to evaluate the potential impact of population-wide social-distancing interventions. METHODS: The tool uses an SEIR compartmental model to project the pandemic's local spread. Users input case counts, healthcare resources, and select intervention strategies to evaluate. Outputs include the number of infections and deaths with and without intervention, and the demand for hospital and critical care beds and ventilators relative to existing capacity. We illustrate the tool using data from three regions of Chile. RESULTS: Our scenarios indicate a surge in COVID-19 patients could overwhelm Chilean hospitals by June, peaking in July or August at six to 50 times the current supply of beds and ventilators. A lockdown strategy or combination of case isolation, home quarantine, social distancing of individuals >70 years, and telework interventions may keep treatment demand below capacity. CONCLUSIONS: Aggressive interventions can avert substantial morbidity and mortality from COVID-19. Our tool permits rapid evaluation of locally-applicable policy scenarios and updating of results as new data become available.


Reply: Possible impact of membrane ACE2 expression on COVID-19 infection


title: ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of Cushing's syndrome

text: Clinical evaluation should guide those needing immediate investigation. Strict adherence to COVID-19 protection measures is necessary. Alternative ways of consultations (telephone, video) should be used. Early discussion with regional/national experts about investigation and management of potential and existing patients is strongly encouraged. Patients with moderate or severe clinical features need urgent investigation and management. Patients with active Cushing's syndrome, especially when severe, are immunocompromised and vigorous adherence to the principles of social isolation is recommended. In patients with mild features or in whom a diagnosis is less likely, clinical re-evaluation should be repeated at 3 and 6 months or deferred until the prevalence of SARS-CoV-2 has significantly decreased; however, those individuals should be encouraged to maintain social distancing. Diagnostic pathways may need to be very different from usual recommendations in order to reduce possible exposure to SARS-CoV-2. When extensive differential diagnostic testing and/or surgery is not feasible, it should be deferred and medical treatment should be initiated. Transsphenoidal pituitary surgery should be delayed during high SARS-CoV-2 viral prevalence. Medical management rather than surgery will be the used for most patients, since the short- to mid-term prognosis depends in most cases on hypercortisolism rather than its cause; it should be initiated promptly to minimize the risk of infection in these immunosuppressed patients. The risk/benefit ratio of these recommendations will need re-evaluation every 2-3 months from April 2020 in each country (and possibly local areas) and will depend on the local health care structure and phase of pandemic.


COVID-19 Initiatives and a New Associate Editor


Any possible role of phosphodiesterase type 5 inhibitors in the treatment of severe COVID19 infections? A lesson from urology


COVID-19, ECMO, and lymphopenia: a word of caution


title: Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19

text: In this study, we collected a total of 610 hospitalized patients from Wuhan between February 2, 2020, and February 17, 2020. We reported a potentially high false negative rate of real-time reverse-transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 in the 610 hospitalized patients clinically diagnosed with COVID-19 during the 2019 outbreak. We also found that the RT-PCR results from several tests at different points were variable from the same patients during the course of diagnosis and treatment of these patients. Our results indicate that in addition to the emphasis on RT-PCR testing, clinical indicators such as computed tomography images should also be used not only for diagnosis and treatment but also for isolation, recovery/discharge, and transferring for hospitalized patients clinically diagnosed with COVID-19 during the current epidemic. These results suggested the urgent needs for the standard of procedures of sampling from different anatomic sites, sample transportation, optimization of RT-PCR, serology diagnosis/screening for SARS-CoV-2 infection, and distinct diagnosis from other respiratory diseases such as fluenza infections as well.


Delayed umbilical cord clamping and breastfeeding after childbirth in mothers affected by COVID 19: Recommended or not?


Endocrine complications of COVID-19: what happens to the thyroid and adrenal glands?


COVID-19 and myocardial injury


Telemedicine in the Era of COVID-19


title: The consequence of COVID-19 on the global supply of medical products: Why Indian generics matter for the world?

text: While the world is facing the urgency of the COVID-19 pandemic, policymakers must plan for the direct response to the outbreak while minimising its collateral impact. Maintaining the supply chain of pharmaceutical products is not only paramount to cover the immediate medical response but will be fundamental to reducing disruption of the healthcare delivery system, which requires constant medicines, diagnostic tools and vaccines for smooth functioning. In this equation, the role of the Indian pharmaceutical industry will not only be critical to meet the domestic need of over 1.3 billion inhabitants but will equally be important for the rest of the world, including wealthy economies. Preventing a significant disruption of the Indian pharmaceutical supply chain during the outbreak and preparing it for large scale production for COVID-19 therapeutic or preventive medical products will not only help India but will assist the global response to this outbreak.


Severe COVID-19 infection associated with endothelial activation


title: Answering the Call: Impact of Tele-ICU Nurses During the COVID-19 Pandemic

text: BACKGROUND: The coronavirus disease 2019 pandemic has exacerbated staffing challenges already facing critical care nurses in intensive care units. Many intensive care units have been understaffed and the majority of nurses working in these units have little experience. OBJECTIVE: To describe how the skilled tele-intensive care unit nurses in our health system quickly changed from a patient-focused strategy to a clinician-focused approach during the coronavirus disease 2019 crisis. METHODS: We modified workflows, deployed home workstations, and changed staffing models with the goal of providing additional clinical support to bedside colleagues while reducing exposure time and conserving personal protective equipment for those caring for this highly contagious patient population. The unit changed focus and granted more than 300 clinicians access to technology that enabled them to care for patients remotely, added nearly 200 mobile carts, and allowed more than 20 tele-intensive care unit nurses to work from home. RESULTS: Tele-intensive care unit nursing provided clinical knowledge to the nurses covering current and expanded critical care units. Using technology, virtual rounding, and increased collaboration with nurses, tele-intensive care unit nursing minimized the risk to bedside nurses while maintaining a high level of care for patients. CONCLUSION: Tele-intensive care unit nurses provided a proactive, holistic approach to caring for critically ill patients via camera as part of their routine workflow. In addition, during the coronavirus disease 2019 pandemic, these nurses created a new strategy in virtual health care to be implemented during a crisis.


Where are we now with COVID-19?


COVID-19: Situation of European Countries so Far


Increased Psychological Well-being after the Apex of the COVID-19 Pandemic


The price of being a doctor during the COVID-19 outbreak


title: Outbreak investigation in cargo ship in times of COVID-19 crisis, Port of Santos, Brazil

text: In February 2020, a Chinese cargo ship docked at the Port of Santos with reports of crew members with a feverish and respiratory condition. A team was gathered to verify the existence of suspected cases of COVID-19 inside the vessel and define its clearance. All 25 crew members were interviewed, and no suspected cases were found. The vessel was then cleared for port activities. The investigation resulted from the implementation of the contingency plan to face a public health emergency of international importance and several surveillance entities cooperated.


COVID-19: risk for cytokine targeting in chronic inflammatory diseases?


COVID-19 and fungal co-infections: We must keep them in mind


Preventing Infection of Patients and Healthcare Workers Should Be the New Normal in the Era of Novel Coronavirus Epidemics


title: The effects of nonconventional palliative and end-of-life care during COVID-19 pandemic on mental health-Junior doctors' perspective

text: The COVID-19 pandemic has changed the way doctors approach palliative and end-of-life care, which has undoubtedly affected the mental health of patients, families, and health care professionals. Given these circumstances, doctors working on the front line are vulnerable to moral injury and compassion fatigue. This is a reflection of 2 junior doctors experiencing firsthand demands of caring for patients during the outbreak. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


How Neurosurgeons Are Coping with COVID-19 and How It Impacts Our Neurosurgical Practice: Report from Geneva University Medical Center


title: Response to Bistrian BR. Parenteral Fish-Oil Emulsions in Critically Ill COVID-19 Emulsions

text: In this letter we discuss the proposition of Bristian BR (2020) to use the intravenous administration of fish-oil emulsions in critically ill patients with Coronavirus Disease 2019 (COVID-19). We consider that immune-modulatory properties of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, rapidly provided in high amounts by fish-oil emulsions, may be important to change the course of COVID-19's death pathway. Prescriptions should be based on body weight (eg, 0.2-g pure fish-oil lipid emulsion/kg body weight/d) and also should consider combining the parenteral administration of fish-oil emulsions with low oral aspirin intake to trigger resolvin synthesis from EPA and DHA.


COVID-19 Pandemic - Call for National Preparedness


title: Purim: a rapid method with reduced cost for massive detection of CoVid-19

text: The CoVid-19 is spreading pandemically all over the world. A rapid defeat of the pandemic requires carrying out on the population a mass screening, able to separate positive from negative cases. Such a cleaning will free a flow of productive population. The current rate and cost of testing, performed with the common PCR (polymerase chain reaction) method and with the available resources, is forcing a selection of the subjects to be tested. Indeed, each one must be examined individually at the cost of precious time. Moreover, the exclusion of potentially positive individuals from screening induces health risks, a broad slowdown in the effort to curb the viral spread, and the consequent mortality rates. We present a new procedure, the Purified by Unified Resampling of Infected Multitudes, in short Purim, able to untangle any massive candidate sample with inexpensive screening, through the cross-correlated analysis of the joint speciments. This procedure can reveal and detect most negative patients and in most cases discover the identity of the few positives already in the first or few secondary tests. We investigate the the two-dimensional correlation case in function of the infection probability. The multi-dimensional topology, the scaled Purim procedure are also considered. Extensive Purim tests may measure and weight the degree of epidemic: their outcome may identify focal regions in the early stages. Assuming hundreds or thousand subjects, the saving both in time and in cost will be remarkable. Purim may be able to filter scheduled flights, scholar acceptance, popular international event participants. The optimal extension of Purim outcome is growing as the inverse of the epidemia expansion. Therefore, the earlier, the better.


title: COVID-19 Hits Cancer Research Funding

text: As the COVID-19 pandemic stretches on, investigators are becoming increasingly concerned about longer-term effects on grants and funding for cancer research. Institutions and philanthropic organizations are especially likely to be hit hard by the economic crisis, with effects that will be particularly acute for early-career investigators.


Leveraging polymerase chain reaction technique (GeneXpert) to upscaling testing capacity for SARS-CoV-2 (COVID-19) in Nigeria: a game changer


Letter to the editor in response to the article "COVID-19 and diabetes: Can DPP4 inhibition play a role?"


Ambitious rhetoric and appalling reality: the UK government's response to covid-19


title: Asymptomatic SARS-CoV-2 Infection in Nursing Homes, Barcelona, Spain, April 2020

text: During the coronavirus disease pandemic in Spain, from April 10-24, 2020, a total of 5,869 persons were screened for severe acute respiratory syndrome coronavirus 2 at nursing homes. Among residents, 768 (23.9%) tested positive; among staff, 403 (15.2%). Of those testing positive, 69.7% of residents and 55.8% of staff were asymptomatic.


title: Risk assessment of airborne transmission of COVID-19 by asymptomatic individuals under different practical settings

text: The lack of quantitative risk assessment of airborne transmission of COVID-19 under practical settings leads to large uncertainties and inconsistencies in our preventive measures. Combining in situ measurements and numerical simulations, we quantify the exhaled aerosols from normal respiratory behaviors and their transport under elevator, small classroom and supermarket settings to evaluate the risk of inhaling potentially virus-containing aerosols. Our results show that the design of ventilation is critical for reducing the risk of aerosol encounters. Inappropriate design can significantly limit the efficiency of aerosol removal, create local hot spots with orders of magnitude higher risks, and enhance aerosol deposition causing surface contamination. Additionally, our measurements reveal the presence of substantial fraction of crystalline aerosols from normal breathing and its strong correlation with breathing depth.


title: Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel

text: Chronic pain causes significant suffering, limitation of daily activities and reduced quality of life. Infection from COVID-19 is responsible for an ongoing pandemic that causes severe acute respiratory syndrome, leading to systemic complications and death. Led by the World Health Organization, healthcare systems across the world are engaged in limiting the spread of infection. As a result, all elective surgical procedures, outpatient procedures and patient visits, including pain management services, have been postponed or cancelled. This has affected the care of chronic pain patients. Most are elderly with multiple comorbidities, which puts them at risk of COVID-19 infection. Important considerations that need to be recognised during this pandemic for chronic pain patients include: ensuring continuity of care and pain medications, especially opioids; use of telemedicine; maintaining biopsychosocial management; use of anti-inflammatory drugs; use of steroids; and prioritising necessary procedural visits. There are no guidelines to inform physicians and healthcare providers engaged in caring for patients with pain during this period of crisis. We assembled an expert panel of pain physicians, psychologists and researchers from North America and Europe to formulate recommendations to guide practice. As the COVID-19 situation continues to evolve rapidly, these recommendations are based on the best available evidence and expert opinion at this present time and may need adapting to local workplace policies.


Letter to the Editor: Are severe COVID-19 patients more susceptible to conjunctivitis?


title: Architectural and ultrastructural features of tessellated calcified cartilage in modern and extinct chondrichthyan fishes

text: Tessellated calcified cartilage (TCC) is a distinctive kind of biomineralized perichondral tissue found in many modern and extinct chondrichthyans (sharks, rays, chimaeroids and their extinct allies). Customarily, this feature has been treated somewhat superficially in phylogenetic analyses, often as a single 'defining' character of a chondrichthyan clade. TCC is actually a complex hard tissue with numerous distinctive attributes, but its utility as a character complex for phylogenetic analysis has not yet been optimized. In this paper, we attempt to improve this situation by presenting new terminology for certain aspects of tesseral architecture, including single-monolayered, multiple-monolayered, polylayered and voussoir tesserae; new histological data, including thin sections of TCC in several Paleozoic taxa; and new proposals for ways in which various characters and states (many of which are defined here for the first time) could be applied in future phylogenetic analyses of chondrichthyan fishes. We conclude that many, but not all of the unique attributes of modern TCC were evolved by the Early Devonian (ca 400 MY). The globular calcified cartilage reported in Silurian sinacanthids, and the so-called 'sub-tessellated' perichondral biomineralization (with irregular and ill-defined geometries of a layer or layers of calcified cartilage blocks) of certain extinct 'acanthodians' (e.g., Climatius, Ischnacanthus, Cheiracanthus) could represent evolutionary precursors of TCC, which seems to characterize only part of the chondrichthyan total group. We hypothesize that heavily biomineralized 'layer-cake' TCC in certain Paleozoic chondrichthyans perhaps served a dual physiological role, as a phosphate sink and in providing increased skeletal density in very large (7+ m) Devonian-Permian marine sharks such as ctenacanths, and as an adaptation to calcium-deficient environments among Permo-Carboniferous non-marine sharks such as xenacanths. By contrast, the equivalent tissue in modern elasmobranchs probably serves only to reinforce regions of cartilage (mostly in the jaws) subjected to high loading. We also note that much of the variation observed in tesseral architecture (including localized remodeling), ultrastructure and histology in modern and extinct chondrichthyans is confined to the perichondrally-facing cap zone (where Type-1 collagen matrix predominates in modern TCC), whereas the main body of the tessera (where Type-2 collagen matrix predominates) exhibits comparatively little evidence of remodeling and histological or structural variation. This article is protected by copyright. All rights reserved.


title: Metabolism and biological activity of α-tocopherol derived from vitamin E-enriched transgenic maize in broilers

text: BACKGROUND: The aim of this study was to investigate the metabolism of α-tocopherol derived from vitamin E-enriched transgenic maize (VER) and its effects on antioxidant and immune functions in broilers aged 1 to 42 days. A total of 360 1-day-old male broilers were randomly divided into three groups containing six replicates with 20 broilers per replicate. The negative control (NC) group and the positive control (PC) group were given non-GM maize and non-GM maize plus exogenous vitamin E (VE), respectively, and the VER group was given VER replacing the non-GM maize given to the NC group. Between days 1 and 21 and days 22 and 42, VE levels were 4.38 and 4.63 mg kg-1 in the NC group, and 14.11 and 14.91 mg kg-1 in the PC and VER group, respectively. RESULTS: The results showed that α-tocopherol from both VER and additives increased α-tocopherol transfer protein and cytochrome P450 concentrations. Additionally, serum α-tocopherol and α-tocopherylquinone levels of broilers in the PC and VER groups were significantly higher than those in the NC group (P < 0.05). Compared with the NC group, broilers in both groups that received α-tocopherol had reduced NF-κB p65 concentrations, significantly decreased serum prostaglandin E2 , IL-6, malondialdehyde, and hydrogen peroxide levels (P < 0.05), and significantly increased glutathione, glutathione peroxidase, and total antioxidant capacity (P < 0.05). CONCLUSION: In summary, both VER and non-GM maize fortified with exogenous VE showed similar effects on broilers, indicating that the α-tocopherol in VER has sufficient biological activity. This article is protected by copyright. All rights reserved.