title: American College of Rheumatology Guidance for the Management of Rheumatic Disease in Adult Patients During the COVID-19 Pandemic: Version 1

text: OBJECTIVE: To provide guidance to rheumatology providers on the management of adult rheumatic disease in the context of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A task force, including 10 rheumatologists and 4 infectious disease specialists from North America, was convened. Clinical questions were collated, and an evidence report was rapidly generated and disseminated. Questions and drafted statements were reviewed and assessed using a modified Delphi process. This included 2 rounds of asynchronous anonymous voting by e-mail and 3 webinars with the entire panel. Task force members voted on agreement with draft statements using a 1-9-point numerical scoring system, and consensus was determined to be low, moderate, or high based on the dispersion of votes. For approval, median votes were required to meet predefined levels of agreement (median values of 7-9, 4-6, and 1-3 defined as agreement, uncertainty, or disagreement, respectively) with either moderate or high levels of consensus. RESULTS: The task force approved 77 initial guidance statements: 36 with moderate and 41 with high consensus. These were combined, resulting in 25 final guidance statements. CONCLUSION: These guidance statements are provided to promote optimal care during the current pandemic. However, given the low level of available evidence and the rapidly evolving literature, this guidance is presented as a "living document," and future updates are anticipated.


Hydrocolloid dressing strip over bridge of nose to relieve pain and pressure from Filtered Face Piece (FFP) masks during the coronavirus (COVID-19) pandemic


Tocilizumab en niño con leucemia linfoblástica aguda y síndrome de liberación de citoquinas asociado a COVID-19./ [Tocilizumab in a child with acute lymphoblastic leukaemia and COVID-19-related cytokine release syndrome]


Covid-19: Japan declares state of emergency as Tokyo cases soar


Correction to the article "Cesarean Section in a Pregnant Woman with COVID-19: First Case in Portugal", published on Acta Med Port 2020 Jun;33(6):429-431


title: Costs of Respiratory Syncytial Virus Hospitalizations in Colombia

text: BACKGROUND: Several clinical practice guidelines exist for the management of respiratory syncytial virus (RSV) infection, but the use and overuse of medications and medical tests with insufficient evidence of effectiveness remains substantial. OBJECTIVE: This study aimed to evaluate the medical costs associated with bronchiolitis hospitalizations caused by RSV infection among infants aged < 2 years in Colombia. METHODS: This was a prevalence-based cost-of-illness multicentric study performed from the societal perspective during 2016-2017. A case was defined as a laboratory-confirmed RSV infection with hospitalization. All costs and use of resources were collected directly from medical invoices and health records. RESULTS: This study included 193 patients with a diagnosis of RSV. The average hospital stay duration was 5.55 days. The major contributors to hospitalization costs were room costs (31.5%), drugs (21.8%), and indirect costs (14.9%). Medications with the highest costs were nebulization with a hypertonic solution and systemic antibiotics. In total, 96% of ß-lactam antibiotics, 90% of bronchodilators, and 86% of corticosteroids and epinephrine were classified as inappropriate. CONCLUSION: RSV infection in Colombia places a high economic burden on the health system. Generating comprehensive data on healthcare resource use and costs associated with RSV will help to provide valuable information for the development of cost-effectiveness models and to guide RSV-prevention strategies.


Acute neurology during the COVID-19 pandemic: Supporting the front line


Clinical course of severe and critically ill patients with coronavirus disease 2019 (COVID-19): A comparative study


title: Novel corona virus disease (COVID-19) awareness among the dental interns, dental auxiliaries and dental specialists in Saudi Arabia: A nationwide study

text: BACKGROUND: Dental health care workers (DHCW's) are invariably at a higher risk of contracting COVID-19. The objectives were; to investigate the current knowledge on COVID-19 among the DHCW's; and to conduct quasi-experiment among the DHCW's who were unaware of the disseminated COVID-19 information. METHODS: A nationwide cross-sectional study targeting dental interns, auxiliaries, and specialists with a two-staged cluster sampling technique was performed. A 17-item questionnaire was subjected to reliability and validity tests before being administered. The participants for quasi-experiment were separated from the original sample after their initial response. Chi-square test assessed responses to knowledge statements between the participants. Difference in mean knowledge scores between the categories of DHCW's and sources of COVID-19 information was assessed using ANOVA. Data from the quasi experiment (pre vs post knowledge intervention) was subjected to paired t-test. Percentage of DHCWs providing correct or wrong responses to each knowledge statement at baseline and after 7 days were compared using McNemar test. RESULTS: The overall sample consisted of 706 (N) participants, and the DHCW's with no prior knowledge on COVID-19 (N=206) were part of the quasi experiment. Findings from cross-sectional study revealed that knowledge was significantly (p<0.05) related to the qualification level (interns vs auxiliaries vs specialists). However, the difference in the source of information (WHO/CDC vs Journal articles vs MoH) did not demonstrate any effect. Number of participants with correct responses to knowledge questions had significantly (p<0.05) increased after intervention. Also, the overall mean knowledge score (10.74±2.32 vs 12.47±1.68; p<0.001) had increased significantly after the intervention. CONCLUSION: In conclusion, the basic knowledge on COVID-19 among the DHCW's in Saudi Arabia is acceptable. Timely dissemination of information by the Ministry of Health, Saudi Arabia had a positive impact on the COVID-19 knowledge score of the DHCW's.


title: Sudden Attention Shifts on Wikipedia Following COVID-19 Mobility Restrictions

text: We study how the coronavirus disease 2019 (COVID-19) pandemic, alongside the severe mobility restrictions that ensued, has impacted information access on Wikipedia, the world's largest online encyclopedia. A longitudinal analysis that combines pageview statistics for 12 Wikipedia language editions with mobility reports published by Apple and Google reveals a massive increase in access volume, accompanied by a stark shift in topical interests. Health- and entertainment- related topics are found to have gained, and sports- and transportation- related topics, to have lost attention. Interestingly, while the interest in health-related topics was transient, that in entertainment topics is lingering and even increasing. These changes began at the time when mobility was restricted and are most pronounced for language editions associated with countries, in which the most severe mobility restrictions were implemented, indicating that the interest shift might be caused by people's spending more time at home. Our results highlight the utility of Wikipedia for studying reactions to the pandemic across the globe, and illustrate how the disease is rippling through society.


COVID-19 Q&A: Collaborating and coordinating keeps a zebrafish facility going


Lung ultrasound: a valuable tool for the assessment of dialysis patients with COVID-19


Sex and Gender Disparities in the COVID-19 Pandemic


title: Single-cell transcriptome analysis of the novel coronavirus (SARS-CoV-2) associated gene ACE2 expression in normal and non-obstructive azoospermia (NOA) human male testes

text: Being infected by SARS-CoV-2 may cause damage to multiple organs in patients, such as the lung, liver and heart. Angiotensin-converting enzyme 2 (ACE2), reported as a SARS-CoV-2 receptor, is also expressed in human male testes. This suggests a potential risk in human male reproductive system. However, the characteristics of ACE2-positive cells and the expression of other SARS-CoV-2 process-related genes are still worthy of further investigation. Here, we performed singlecell RNA seq (scRNA-seq) analysis on 853 male embryo primordial germ cells (PGCs) and 2,854 normal testis cells to assess the effects of the SARS-CoV-2 virus on the male reproductive system from embryonic stage to adulthood. We also collected and constructed the scRNA-seq library on 228 Sertoli cells from three non-obstructive azoospermia (NOA) patients to assess the effects at disease state. We found that ACE2 expressing cells existed in almost all testis cell types and Sertoli cells had highest expression level and positive cells ratio. Moreover, ACE2 was also expressed in human male PGCs. In adulthood, the level of ACE2 expression decreased with the increase of age. We also found that ACE2 positive cells had high expressions of stress response and immune activation-related genes. Interestingly, some potential SARS-CoV-2 process-related genes such as TMPRSS2, BSG, CTSL and CTSB had different expression patterns in the same cell type. Furthermore, ACE2 expression level in NOA donors' Sertoli cells was significantly decreased. Our work would help to assess the risk of SARS-CoV-2 infection in the male reproductive system.


Clinical performance of the Elecsys electrochemiluminescent immunoassay for the detection of SARS-CoV-2 total antibodies


title: COVID-19 and Kidney Disease: Molecular Determinants and Clinical Implications in Renal Cancer

text: CONTEXT: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic that erupted in December 2019 has affected more than a million people from over 200 countries, claiming over 70 000 lives (by April 7, 2020). As the viral infection is driven by increased angiotensin-converting enzyme-2 (ACE2) expression, with the kidney exhibiting the highest expression, it is crucial to gain insights into the mechanisms underlying renal cell carcinoma (RCC) and coronavirus disease 2019 (COVID-19). OBJECTIVE: This study considers up-to-date information on the biological determinants shared by COVID-19 and renal disease, and aims to provide evidence-based recommendations for the clinical management of RCC patients with COVID-19. EVIDENCE ACQUISITION: A literature search was performed using all sources (MEDLINE, EMBASE, ScienceDirect, Cochrane Libraries, and Web of Science). As of March 31, 2020, the Center for Disease Control reported that of the adults hospitalized for COVID-19 with underlying conditions in the USA, 74.8% had chronic renal disease. EVIDENCE SYNTHESIS: Evidence is discussed from epidemiological studies on SARS-CoV-2 pandemic and molecular studies on the role of kidney in facilitating routes for SARS-CoV-2 entry, leading to increased virulence of SARS-CoV-2 and clinical manifestation of symptoms in RCC. CONCLUSIONS: This analysis will advance our understanding of (1) the molecular signatures shared by RCC and COVID-19 and (2) the clinical implications of overlapping signaling pathways in the therapeutic management of RCC and COVID-19 patients. PATIENT SUMMARY: Amid the coronavirus disease 2019 (COVID-19) pandemic, patients diagnosed with renal cell carcinoma and infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may receive complimentary treatment modalities to enhance therapeutic response.


title: Clinical and imaging features of COVID-19

text: Since December 2019, multiple cases of 2019 coronavirus disease (COVID-19) have been reported in Wuhan in China's Hubei Province, a disease which has subsequently spread rapidly across the entire country. Highly infectious, COVID-19 has numerous transmission channels and humans are highly susceptible to infection. The main clinical symptoms of COVID-19 are fever, fatigue, and a dry cough. Laboratory examination in the early stage of the disease shows a normal or decreased white blood cell count, and a decreased lymphocyte count. While CT examination serves as the screening and diagnostic basis for COVID-19, its accuracy is limited. The nucleic acid testing is the gold standard for the diagnosis of COVID-19, but has a low sensitivity is low. There is clearly a divide between the two means of examination. This paper reviews the published literature, guidelines and consensus, and summarizes the clinical and imaging characteristics of COVID-19, in order to provide a reliable basis for early diagnosis and treatment.


Association between population migration and epidemic control of Coronavirus disease 2019


title: Sustainable Diabetes Care Services during COVID-19 Pandemic

text: INTRODUCTION: The COVID-19 pandemic creates a challenge in the provision of care for patients with diabetes. Furthermore, those with uncontrolled diabetes are at a higher risk for complications due to COVID-19. The purpose of this study is to find an innovative method to sustain effective diabetes care services amidst the COVID-19 pandemic. METHODS: Outpatient diabetes care was successfully transformed from traditional face-to-face encounters in the clinic to an online telemedicine service. RESULTS: 1,972 patients were encountered over a 4-week study period during which we had a low proportion of unreached patients (4%). Some patients were still seen in person because they came as walk-in visits or insisted to be seen in person. CONCLUSION: Telemedicine has become an essential healthcare service and could be augmented by the use of technology like web-based applications and communication via transfer of data from patients' glucometer, insulin pumps, or sensors. Diabetes care can be transitioned to telemedicine effectively and would be successful in reaching more patients than by traditional face-to-face visits. This model of care is time consuming and unfortunately does not reduce the need for medical staff.


Clinical and CT features of early stage patients with COVID-19: a retrospective analysis of imported cases in Shanghai, China


title: Biopsychopharmacosocial approach to assess impact of social distancing and isolation on mental health in older adults

text: It is impossible to predict or comprehend the impact of the ongoing COVID-19 pandemic. The UK Government's advice for vulnerable people, including older adults, to move towards self-isolation and social distancing is likely to reduce rates of transmission, the risk of severe illness and the impact on the acute health services. Although justified and necessary, this process of isolation is likely to have a negative impact on the mental health of these vulnerable groups, especially older people. It will become increasingly important for community health professionals to assess subtle changes in older persons' mental health, as the duration of this period of isolation remains unclear. The biopsychopharmacosocial model provides one method of assessing mental health and planning health and social care needs. This article hopes to guide community health professionals through the specifics of this assessment model in relation to the growing COVID-19 pandemic.


title: COVID-19 outbreak: An elusive enemy

text: A novel coronavirus, officially termed as severe acute respiratory syndrome (SARS)-CoV-2, emerged in Wuhan, China, toward the end of 2019. Just four months later, more than 100,000 people were diagnosed with COVID-19, the resulting disease. The genetic analysis of SARS-CoV-2 revealed that this virus is a new Betacoronavirus, closely related to bat-derived SARS-like coronaviruses. Clinical data from hospitals in China have revealed that approximately 10% of the infected patients have severe disease requiring intensive care. Since containment of the outbreak may have partially failed due to asymptomatic transmission, it is imperative to accelerate the development of rapid point-of-care diagnostic tests, vaccines, and therapeutics for the COVID-19 epidemic.


Morphology of COVID-19-affected cells in peripheral blood film


Management strategy of novel coronavirus (COVID-19) pneumonia in the radiology department: a Chinese experience


title: Forecasting the novel coronavirus COVID-19

text: What will be the global impact of the novel coronavirus (COVID-19)? Answering this question requires accurate forecasting the spread of confirmed cases as well as analysis of the number of deaths and recoveries. Forecasting, however, requires ample historical data. At the same time, no prediction is certain as the future rarely repeats itself in the same way as the past. Moreover, forecasts are influenced by the reliability of the data, vested interests, and what variables are being predicted. Also, psychological factors play a significant role in how people perceive and react to the danger from the disease and the fear that it may affect them personally. This paper introduces an objective approach to predicting the continuation of the COVID-19 using a simple, but powerful method to do so. Assuming that the data used is reliable and that the future will continue to follow the past pattern of the disease, our forecasts suggest a continuing increase in the confirmed COVID-19 cases with sizable associated uncertainty. The risks are far from symmetric as underestimating its spread like a pandemic and not doing enough to contain it is much more severe than overspending and being over careful when it will not be needed. This paper describes the timeline of a live forecasting exercise with massive potential implications for planning and decision making and provides objective forecasts for the confirmed cases of COVID-19.


title: Will Buying Follow Others Ease Their Threat of Death? An Analysis of Consumer Data during the Period of COVID-19 in China

text: How to overcome informational conformity consumer behavior when faced with threats of death is a social problem in response to COVID-19. This research is based on the terror management theory, the need to belong theory and the materialism theory. It uses a theoretical model to determine the relationships between threats of death and informational conformity consumer behavior. From 1453 samples collected during outbreak of COVID-19 in China, we used a structural equation model to test multiple research hypotheses. The result shows that threats of death are positively associated with a need to belong, materialism and informational conformity consumer behavior. The need to belong and materialism can play a mediating role between threats of death and information conformity consumption behavior, and perceived social support can play a moderating role between threats of death and information conformity consumption behavior.


title: The role of bridge nodes in epidemic spreading: different regimes and crossovers

text: Power-law behaviors are common in many disciplines, especially in network science. Real-world networks, like disease spreading among people, are more likely to be interconnected communities, and show richer power-law behaviors than isolated networks. In this paper, we look at the system of two communities, which are connected by bridge links between a fraction $r$ of bridge nodes, and study the effect of bridge nodes to the final state of the Susceptible-Infected-Recovered model, by mapping it to link percolation. By keeping a fixed average connectivity, but allowing different transmissibilities along internal and bridge links, we theoretically derive different power-law asymptotic behaviors of the total fraction of the recovered $R$ in the final state as $r$ goes to zero, for different combinations of internal and bridge link transmissibilities. We also find crossover points where $R$ follows different power-law behaviors with $r$ on both sides when the internal transmissibility is below but close to its critical value, for different bridge link transmissibilities. All of these power-law behaviors can be explained through different mechanisms of how finite clusters in each community are connected into the giant component of the whole system, and enable us to pick effective epidemic strategies and to better predict their impacts.


title: Estimating required 'lockdown' cycles before immunity to SARS-CoV-2: Model-based analyses of susceptible population sizes, 'S0', in seven European countries including the UK and Ireland

text: We used Bayesian model inversion to estimate epidemic parameters from the reported case and death rates from seven countries using data from late January 2020 to April 5th 2020. Two distinct generative model types were employed: first a continuous time dynamical-systems implementation of a Susceptible-Exposed-Infectious-Recovered (SEIR) model and second: a partially observable Markov Decision Process (MDP) or hidden Markov model (HMM) implementation of an SEIR model. Both models parameterise the size of the initial susceptible population (S0), as well as epidemic parameters. Parameter estimation (data fitting) was performed using a standard Bayesian scheme (variational Laplace) designed to allow for latent unobservable states and uncertainty in model parameters. Both models recapitulated the dynamics of transmissions and disease as given by case and death rates. The peaks of the current waves were predicted to be in the past for four countries (Italy, Spain, Germany and Switzerland) and to emerge in 0.5-2 weeks in Ireland and 1-3 weeks in the UK. For France one model estimated the peak within the past week and the other in the future in two weeks. Crucially, Maximum a posteriori (MAP) estimates of S0 for each country indicated effective population sizes of below 20% (of total population size), under both the continuous time and HMM models. With a Bayesian weighted average across all seven countries and both models, we estimated that 6.4% of the total population would be immune. From the two models the maximum percentage of the effective population was estimated at 19.6% of the total population for the UK, 16.7% for Ireland, 11.4% for Italy, 12.8% for Spain, 18.8% for France, 4.7% for Germany and 12.9% for Switzerland. Our results indicate that after the current wave, a large proportion of the total population will remain without immunity.


SARS-CoV-2 Serology: Much Hype, Little Data


title: Detection of SARS-CoV-2 in formalin-fixed paraffin-embedded tissue sections using commercially available reagents

text: Coronavirus Disease-19 (COVID-19), caused by the coronavirus SARS-CoV-2, was initially recognized in Wuhan, China and subsequently spread to all continents. The disease primarily affects the lower respiratory system, but may involve other organs and systems. Histopathologic evaluation of tissue from affected patients is crucial for diagnostic purposes, but also for advancing our understanding of the disease. For that reason, we developed immunohistochemical (IHC) and in situ hybridization (ISH) assays for detection of the. virus. A total of eight autopsy lungs, one placenta, and ten kidney biopsies from COVID-19 patients were stained with a panel of commercially available antibodies for IHC and commercially available RNA probes for ISH. Similarly, autopsy lungs, placentas and renal biopsies from non-COVID-19 patients were stained with the same antibodies and probes. All eight lungs and the placenta from COVID-19 patients stained positive by IHC and ISH, while the kidney biopsies stained negative by both methodologies. As expected, all specimens from non-COVID-19 patients were IHC and ISH negative. These two assays represent a sensitive and specific method for detecting the virus in tissue samples. We provide the protocols and the list of commercially available antibodies and probes for these assays, so they can be readily implemented in pathology laboratories and medical examiner offices for diagnostic and research purposes.


title: Need for ensuring care for neuro-emergencies-lessons learned from the COVID-19 pandemic

text: BACKGROUND: To investigate whether patients with critical emergency conditions are seeking or receiving the medical care that they require, we characterized the reality of care for patients presenting with neuro-emergencies during the first phase of the COVID-19 pandemic. METHODS: In this observational, longitudinal cohort study, all neurosurgical admissions that presented to our department between February 1 and April 15 during the COVID-19 pandemic and during the same time period in 2019 were identified and categorized according to the presence of a neuro-emergency, the route of admission, management, and the category of disease. Further, the clinical course of patients with aneurysmal subarachnoid hemorrhage (aSAH) and chronic subdural hematoma (cSDH) was investigated representatively for severe vascular and semi-urgent traumatic conditions that present with a wide variety of symptoms. RESULTS: During the pandemic, the percentage of neuro-emergencies among all neurosurgical admissions remained similar but a larger proportion presented through the emergency department than through the outpatient clinic or by referral (*p = 0.009). The total number of neuro-emergencies was significantly reduced (*p = 0.0007) across all types of disease, particularly in vascular (*p = 0.036) but also in spinal (*p = 0.007) and hydrocephalus (*p = 0.048) emergencies. Patients with spinal emergencies presented 48 h later (*p = 0.001) despite comparable symptom severity. For aSAH, the number of cases, aSAH grade, aneurysm localization, and treatment modality did not change but strikingly, elderly patients with cSDH presented less frequently, with more severe symptoms (*p = 0.046), and were less likely to reach favorable outcome (*p = 0.003) at discharge compared with previous years. CONCLUSIONS: Despite pandemic-related restrictive measures and reallocation of resources, patients with neuro-emergencies should be encouraged to present regardless of the severity of symptoms because deferred presentation may result in adverse outcome. Thus, conservation of critical healthcare resources remains essential in spite of fighting COVID-19.


title: Unit groups of some multiquadratic number fields and $2$-class groups

text: Let $p\equiv -q \equiv 5\pmod 8$ be two prime integers. In this paper, we investigate the unit groups of the fields $ L_1 =\mathbb{Q}(\sqrt 2, \sqrt{p}, \sqrt{q}, \sqrt{-1} )$ and $ L_1^+=\mathbb{Q}(\sqrt 2, \sqrt{p}, \sqrt{q} )$. Furthermore , we give the second $ 2$-class groups of the subextensions of $L_1$ as well the $2$-class groups of the fields $ L_n =\mathbb{Q}( \sqrt{p}, \sqrt{q}, \zeta_{2^{n+2}} )$ and their maximal real subfelds.


A simple custom appliance against droplet and aerosol transmission of COVID-19 during advanced airway management


title: Intracellular ABCB1 as a Possible Mechanism to Explain the Synergistic Effect of Hydroxychloroquine-Azithromycin Combination in COVID-19 Therapy

text: The co-administration of hydroxychloroquine with azithromycin is proposed in COVID-19 therapy. We hypothesize a new mechanism supporting the synergistic interaction between these drugs. Azithromycin is a substrate of ABCB1 (P-glycoprotein) which is localized in endosomes and lysosomes with a polarized substrate transport from the cell cytosol into the vesicle interior. SARS-CoV-2 and drugs meet in these acidic organelles and both basic drugs, which are potent lysosomotropic compounds, will become protonated and trapped within these vesicles. Consequently, their intra-vesicular concentrations can attain low micromolar effective cytotoxic concentrations on SARS-CoV-2 while concomitantly increase the intra-vesicular pH up to around neutrality. This last effect inhibits lysosomal enzyme activities responsible in virus entry and replication cycle. Based on these considerations, we hypothesize that ABCB1 could be a possible enhancer by confining azithromycin more extensively than expected when the trapping is solely dependent on the passive diffusion. This additional mechanism may therefore explain the synergistic effect when azithromycin is added to hydroxychloroquine, leading to apparently more rapid virus clearance and better clinical benefit, when compared to monotherapy with hydroxychloroquine alone.


title: An evaluation of co-use of chloroquine or hydroxychloroquine plus azithromycin on cardiac outcomes: A pharmacoepidemiological study to inform use during the COVID19 pandemic

text: BACKGROUND: Chloroquine or hydroxychloroquine (chloroquine) plus azithromycin is considered as therapy for COVID-19. With benefit evaluations underway, safety concerns due to potential additive effects on QTc prolongation should be addressed. OBJECTIVE: We compared risk of cardiac adverse events between combinations of chloroquine and azithromycin and chloroquine and amoxicillin. METHODS: We conducted a retrospective cohort study using the IBM MarketScan Commercial Claims and Medicare Supplemental Databases, 2005-2018. We included autoimmune disease patients aged ≥18 years initiating azithromycin or amoxicillin for ≥5 days during chloroquine treatment. Patients had continuous insurance coverage ≥6 months before combination use until 5 days thereafter or inpatient death. Two outcomes were sudden cardiac arrest/ventricular arrhythmias (SCA/VA) and cardiac symptoms. We followed patients for up to 5 days to estimate hazard ratios (HR). Covariates were adjusted using stabilized inverse probability treatment weighting. RESULTS: We identified two SVC/VA events among >145,000 combination users. The adjusted incidence of cardiac symptoms among azithromycin and amoxicillin users was 276 vs 254 per 10,000 person-years with an adjusted HR of 1.10 (95%CI, 0.62-1.95). CONCLUSION: Combination use of chloroquine and azithromycin at routine doses did not show pronounced increases in arrhythmias in this real-world population, though small sample size and outcome rates limit conclusions.


Does lopinavir really inhibit SARS-CoV-2?


title: An Updated Systematic Review of the Therapeutic Role of Hydroxychloroquine in Coronavirus Disease-19 (COVID-19)

text: BACKGROUND AND OBJECTIVE: The world is currently experiencing the Coronavirus Disease-19 (COVID-19) pandemic. There is no approved drug for the definitive treatment of the disease. Various drugs are being tried for the treatment of COVID-19, including hydroxychloroquine (HCQ). This study was performed to systematically review the therapeutic role of HCQ in COVID-19 from the available literature. METHODS: PubMed, Embase, ClinicalTrials.gov, ICTRP (WHO), Cochrane Library databases, and two pre-print servers (medRxiv.org and Research Square) were searched for clinical studies that evaluated the therapeutic role of HCQ on COVID-19 until 10 May 2020. The available studies were critically analyzed and the data were extracted. RESULTS: A total of 663 articles were screened and 12 clinical studies (seven peer-reviewed and published studies and five non-peer-reviewed studies from pre-print servers) with a total sample size of 3543 patients were included. Some of the clinical studies demonstrated good virological and clinical outcomes with HCQ alone or in combination with azithromycin in COVID-19 patients, although the studies had major methodological limitations. Some of the other studies showed negative results with HCQ therapy along with the risk of adverse reactions. CONCLUSION: The results of efficacy and safety of HCQ in COVID-19, as obtained from the clinical studies, are not satisfactory, although many of these studies had major methodological limitations. Stronger evidence from well-designed robust randomized clinical trials is required before conclusively determining the role of HCQ in the treatment of COVID-19. Clinical prudence is required in advocating HCQ as a therapeutic armamentarium in COVID-19.


title: Real-time tentative assessment of the epidemiological characteristics of novel coronavirus infections in Wuhan, China, as at 22 January 2020

text: A novel coronavirus (2019-nCoV) causing severe acute respiratory disease emerged recently in Wuhan, China. Information on reported cases strongly indicates human-to-human spread, and the most recent information is increasingly indicative of sustained human-to-human transmission. While the overall severity profile among cases may change as more mild cases are identified, we estimate a risk of fatality among hospitalised cases at 14% (95% confidence interval: 3.9-32%).


Social isolation during Covid-19: Boon or bane to diabetes management


title: Critical role of histone H3 lysine 27 demethylase Kdm6b in the homeostasis and function of medullary thymic epithelial cells

text: Medullary thymic epithelial cells (mTECs) play a central role in the establishment of T cell central immunological tolerance by promiscuously expressing tissue-restricted antigens (TRAs) and presenting them to developing T cells, leading to deletion of T cells responding to self-antigens. However, molecular mechanisms especially epigenetic regulation of mTEC homeostasis and TRA expression remain elusive. Here we show that the H3K27 demethylase Kdm6b is essential to maintain the postnatal thymic medulla by promoting mTEC survival and regulating the expression of TRA genes. Moreover, mice lacking Kdm6b developed pathological autoimmune disorders. Mechanically, Kdm6b exerted its function by reducing repressive H3K27 trimethylation (H3K27me3) at the promoters of anti-apoptotic gene Bcl2 and a set of Aire-dependent TRA genes. Thus, our findings reveal a dual role of Kdm6b in the regulation of mTEC-mediated T cell central tolerance.


title: COVID-19 with rheumatic diseases: a report of 5 cases

text: The coronavirus disease 2019 (COVID-19), the result of an infection with the new virus, SARS-CoV-2, is rapidly spreading worldwide. It is largely unknown whether the occurrence of COVID-19 in patients with rheumatic immune diseases has some specific manifestations, or makes them more prone to rapidly progress into severe COVID-19. In this case report, we describe the clinical features of 5 rheumatic immune disease patients with the concomitant presence of COVID-19. Amongst these patients, 4 had rheumatoid arthritis (RA) and 1 had systemic sclerosis (SSc). Two patients had a history of close contact with a COVID-19 patient. The age of the patients ranged between 51 and 79 years. Fever (80%), cough (80%), dyspnea (40%), and fatigue (20%) were the most common presenting symptoms. Laboratory investigations revealed leukopenia and lymphopenia in 2 patients. In all the patients, chest computerized tomography (CT) revealed patchy ground glass opacities in the lungs. During the hospital stay, the condition of two patients remained the same (i.e., mild COVID-19), two patients progressed to the severe COVID-19, and one patient worsened to the critically ill COVID-19. These patients were treated with antiviral agents for COVID-19, antibiotics for secondary bacterial infections, and immunomodulatory agents for rheumatic immune diseases. All the patients responded well, were cured of COVID-19, and subsequently discharged.


title: Development of an enhanced acute care surgery service in response to the COVID-19 global pandemic

text: BACKGROUND: As the COVID-19 pandemic sweeps across the world, healthcare departments must adapt to meet the challenges of service provision and staff/patient protection. Unlike elective surgery, acute care surgery (ACS) workloads cannot be artificially reduced providing a unique challenge for administrators to balance healthcare resources between the COVID-19 surge and regular patient admissions. METHODS: An enhanced ACS (eACS) model of care is described with the aim of limiting COVID-19 healthcare worker and patient cross-infection as well as providing 24/7 management of emergency general surgical (GS) and trauma patients. The eACS service comprised 5 independent teams covering a rolling 1:5 24-hr call. Attempts to completely separate eACS teams and patients from the elective side were made. The service was compared to the existing ACS service in terms of clinical and efficiency outcomes. Finally, a survey of staff attitudes towards these changes, concerns regarding COVID-19 and psychological well-being was assessed. RESULTS: There were no staff/patient COVID-19 cross-infections. Compared to the ACS service, eACS patients had reduced overall length of stay (2-days), time spent in the Emergency Room (46 min) and time from surgery to discharge (2.4-hours). The eACS model of care saved financial resources and bed-days for the organisation. The changes were well received by team-members who also felt that their safety was prioritised. CONCLUSION: In healthcare systems not overwhelmed by COVID-19, an eACS model may assist in preserving psychological well-being for healthcare staff whilst providing 24/7 care for emergency GS and trauma patients.


Covid-19: "Staggering number" of extra deaths in community is not explained by covid-19


title: Optimal Resolution of Change-Point Detection with Empirically Observed Statistics and Erasures

text: This paper revisits the offline change-point detection problem from a statistical learning perspective. Instead of assuming that the underlying pre- and post-change distributions are known, it is assumed that we have partial knowledge of these distributions based on empirically observed statistics in the form of training sequences. Our problem formulation finds a variety of real-life applications from detecting when climate change occurred to detecting when a virus mutated. Using the training sequences as well as the test sequence consisting of a single-change and allowing for the erasure or rejection option, we derive the optimal resolution between the estimated and true change-points under two different asymptotic regimes on the undetected error probability---namely, the large and moderate deviations regimes. In both regimes, strong converses are also proved. In the moderate deviations case, the optimal resolution is a simple function of a symmetrized version of the chi-square distance.


title: A Model of Supply-Chain Decisions for Resource Sharing with an Application to Ventilator Allocation to Combat COVID-19

text: This paper presents a stochastic optimization model for allocating and sharing a critical resource in the case of a pandemic. The demand for different entities peaks at different times, and an initial inventory from a central agency is to be allocated. The entities (states) may share the critical resource with a different state under a risk-averse condition. The model is applied to study the allocation of ventilator inventory in the COVID-19 pandemic by the Federal Emergency Management Agency of the US Department of Homeland Security (FEMA) to different states in the US. Findings suggest that if less than 60% of the ventilator inventory is available for non-COVID-19 patients, FEMA's stockpile of 20,000 ventilators (as of 03/23/2020) would be nearly adequate to meet the projected needs. However, when more than 75% of the available ventilator inventory must be reserved for non-COVID-19 patients, various degrees of shortfall are expected. In an extreme case, where the demand is assumed to be concentrated in the top-most quartile of the forecast confidence interval, the total shortfall over the planning horizon (till 05/31/20) is about 28,500 ventilator days, with a peak shortfall of 2,700 ventilators on 04/12/20. The results also suggest that in the worse-than-average to severe demand scenario cases, NY requires between 7,600-9,200 additional ventilators for COVID-19 patients during its peak demand. However, between 400 to 2,000 of these ventilators can be given to a different state after the peak demand in NY has subsided.


title: The pandemic characteristics of 2019-nCoV: case-control study for severity and geographic locations for 2019-nCoV epidemics worldwide

text: Using available official data we found 248 epidemics curves caused worldwide by the 2019-nCoV in the period December 2019-March 31st 2020. The analysis of this material allowed two main observations: 1) it is possible to describe the main geographical pathway of the diffusion of the virus in different directions. This strongly suggests a unique point of origin of the pandemics in Wuhan, China, from where it spread in many different directions. 2) of the 74 epidemics which were characterized by at least 1000 cases, 65 (90%) were located in the geographic region of the world delimitated by 52-30 degrees latitude North. Viceversa 110 (60%) of the 176 epidemics with less than 1000 cases were located outside the cited geographical world region. These results suggest considerations on the pandemic characteristics of 2019-nCoV.


Physical activity during COVID-19 quarantine


title: Coronavirus 2019-nCoV: A brief perspective from the front line

text: A novel coronavirus, designated as 2019-nCoV, hit the central Chinese city of Wuhan in late December 2019, and subsequently spread rapidly to all provinces of China and multiple countries. As of 0:00 am February 9, 2020, a total of 37,287 cases have been confirmed infection of 2019-nCoV in China mainland, and 302 cases have also been cumulatively reported from 24 countries. According to the latest data, a total of 813 deaths occurred in China mainland, with the mortality reaching approximately 2.2%. At present, there is no vaccine or specific drugs for the human coronavirus. Therefore, it is critical to understand the nature of the virus and its clinical characteristics, in order to respond to the 2019-nCoV outbreak. Thus, the present study briefly but comprehensively summarizes the not much but timely reports on the 2019-nCoV.


title: Pandemie- und Seuchengeschichte als Pflegegeschichte?/ [Pandemic and Epidemic History as Nursing History?]

text: This paper is part of Forum COVID-19: Perspectives in the Humanities and Social Sciences. In the current COVID 19 pandemic, the importance of professional nursing is widely recognized. In German-speaking and international research, the history of nursing during pandemics and epidemics is largely unwritten. This paper gives an overview of questions and results in this research area and discusses the potential of a pandemic nursing history.


title: Redefining undergraduate nurse teaching during the coronavirus pandemic: use of digital technologies

text: During the current coronavirus pandemic, undergraduate nurse teaching is facing many challenges. Universities have had to close their campuses, which means that academics are working from home and may be coping with unfamiliar technology to deliver the theoretical part of the undergraduate nursing curriculum. Emergency standards from the Nursing and Midwifery Council have allowed theoretical instruction to be replaced with distance learning, requiring nursing academics to adapt to providing a completely virtual approach to their teaching. This article provides examples of tools that can be used to deliver the theoretical component of the undergraduate nursing curriculum and ways of supporting students and colleagues in these unprecedented times.


title: Holography from Decoherence and Entanglement

text: We describe an explicit mechanism for the emergence of a dynamical holographic bulk from the structure of entanglement in a quantum state. We start with a generic system in complete isolation, assuming it has a classical limit involving coherent states. Then we entangle it with another system of that kind, and subject the pair to a decohering process. We make a number of broadly applicable and physically reasonable assumptions about this setup. First, we assume that the states selected by the decoherence (called pointer states) have the same local symmetries as the isolated systems, in a sense which is made precise. We also assume that the modular Hamiltonians of pointer states scale inversely with Planck's constant, so that the pointer states are highly entangled in the classical limit. Finally, we require the timescale of decoherence to scale in a certain way with Planck's constant, so that decoherence happens very frequently in the classical limit, but not too frequently. Given these assumptions, we demonstrate that the semiclassical evolution of the system is dominated by a certain dynamical generalisation of Uhlmann holonomy. We construct a coherent state path integral for this evolution, showing that the semiclassical fields evolve in a spacetime with one more dimension than the isolated case. The additional dimension is generated by modular flow.


title: The COVID-19 Pandemic: a Call to Action to Identify and Address Racial and Ethnic Disparities

text: The Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted and devastated the world. As the infection spreads, the projected mortality and economic devastation are unprecedented. In particular, racial and ethnic minorities may be at a particular disadvantage as many already assume the status of a marginalized group. Black Americans have a long-standing history of disadvantage and are in a vulnerable position to experience the impact of this crisis and the myth of Black immunity to COVID-19 is detrimental to promoting and maintaining preventative measures. We are the first to present the earliest available data in the peer-reviewed literature on the racial and ethnic distribution of COVID-19-confirmed cases and fatalities in the state of Connecticut. We also seek to explode the myth of Black immunity to the virus. Finally, we call for a National Commission on COVID-19 Racial and Ethnic Health Disparities to further explore and respond to the unique challenges that the crisis presents for Black and Brown communities.


title: Experience of treating severe cases of 2019 novel coronavirus pneumonia in Changde area/ 中华危重病急救医学

text: Since the cluster of the 2019 novel coronavirus (2019-nCoV) pneumonia, a large number of patients gathered, the mortality of critical patients has remained high and the treatment was unclear. In this outbreak, Hunan Changde region immediately set up a hospital and intensive care unit. The patients relieved through respiratory support, hemodynamics management, nutritional support, the application of antiviral drugs, analgesic and sedation. The treatment experience in severe cases of 2019-nCov pneumonia patients were summarized as follows: in terms of respiratory support, we needed to pay attention to the advantages of high-flow nasal cannula oxygen therapy (HFNC) and the intervention of mechanical ventilation, pay attention to the ventilator parameters, and adopt prone position timely. In the aspects of fluid resuscitation and volume management, we should pay attention to the characteristics of severe patients' volume status, perform early evaluation, and clinicians should focused on hemodynamic management beside the bed. In the aspect of nutritional support and evaluation and maintenance of intestinal function, early enteral nutrition should be adopted in time. However, the trade-off between the risk of intestinal function and nutritional support in patients with mechanical ventilation and the antiviral benefits of Kaletra needed to be reevaluated, the optimized way of analgesia and sedation was adopted, at the same time, the usage and side effects of antiviral drugs should be paid attention to. We should grasp the opportunity of transportation for severe patients. It is suggested that some warning scores should be used to facilitate early recognition of patients with severe infection and then they should be earlier transferred to the designated hospital for intensive care.


East meets West in COVID-19 therapeutics


title: Public Concern and the Financial Markets during the COVID-19 outbreak

text: We measure the public concern during the outbreak of COVID-19 disease using three data sources from Google Trends (YouTube, Google News, and Google Search). Our findings are three-fold. First, the public concern in Italy is found to be a driver of the concerns in other countries. Second, we document that Google Trends data for Italy better explains the stock index returns of France, Germany, Great Britain, the United States, and Spain with respect to their country-based indicators. Finally, we perform a time-varying analysis and identify that the most severe impacts in the financial markets occur at each step of the Italian lock-down process.


title: Drug repurposing against SARS-CoV-2 using E-pharmacophore based virtual screening, molecular docking and molecular dynamics with main protease as the target

text: Since its first report in December 2019 from China, the COVID-19 pandemic caused by the beta-coronavirus SARS-CoV-2 has spread at an alarming pace infecting about 5.59 million, and claiming the lives of more than 0.35 million individuals across the globe. The lack of a clinically approved vaccine or drug remains the biggest bottleneck in combating the pandemic. Drug repurposing can expedite the process of drug development by identifying known drugs which are effective against SARS-CoV-2. The SARS-CoV-2 main protease is a promising drug target due to its indispensable role in viral multiplication inside the host. In the present study an E-pharmacophore hypothesis was generated using a crystal structure of the viral protease in complex with an imidazole carbaximide inhibitor. Drugs available in the superDRUG2 database were used to identify candidate drugs for repurposing. The hits obtained from the pharmacophore based screening were further screened using a structure based approach involving molecular docking at different precisions. The binding energies of the most promising compounds were estimated using MM-GBSA. The stability of the interactions between the selected drugs and the target were further explored using molecular dynamics simulation at 100 ns. The results showed that the drugs Binifibrate and Bamifylline bind strongly to the enzyme active site and hence they can be repurposed against SARS-CoV-2. However, U.S Food and Drug Administration have withdrawn Binifibrate from the market as it was having some adverse health effects on patients.Communicated by Ramaswamy H. Sarma.


In Memoriam: Physicians Who Have Died of COVID-19 in the United States


title: Placental lesions associated with abortion and stillbirth in goats naturally infected by Neospora caninum/ Lesões placentárias associadas a abortos e natimortos em cabras naturalmente infectadas pelo Neospora caninum

text: Neospora caninum has been described as a parasite that sporadically causes reproductive problems in goats. Several aspects of the pathogenesis of neosporosis in naturally infected goats remain to be established. The aims of the present study were to characterize the placental lesions in goats naturally infected by N. caninum and to evaluate several diagnostic techniques for effective detection of this protozoan in the goat placenta. Some placentas in this study originated from abortion and stillbirth in which there were severe lesions. The lesions were characterized mainly by necrosis involving the mesenchyme of the chorionic villi and trophoblast cells often alongside mononuclear inflammation and in some cases with neutrophilic infiltration. N. caninum DNA was detected in these placentas, but parasite structures were not visualized through immunohistochemistry (IHC). However, five of 11 placentas from N. caninum-infected goats that gave birth to healthy kids had histological lesions characterized by mononuclear inflammation. Of these 11 placentas, N. caninum DNA was detected in seven, and N. caninum tachyzoites were detected in only one of these seven placentas using IHC. The present study demonstrates that severe lesions in the placenta are associated with abortion and stillbirth in caprine neosporosis and the placental alterations are likely involved in abortion pathogenesis. Moreover, the results highlight the importance of using more than one diagnostic technique for the detection of the protozoan in placentas because N. caninum cannot be reliably detected by histological and immunohistochemical tests.(AU)


title: Course of the first month of the COVID 19 outbreak in the New York State counties

text: We illustrate and study the evolution of reported infections over the month from March 1st to April 1st in the New York State as a whole, as well as in each individual county. We search for exponential trends, and try to understand whether there is any correlation of the timing and dynamics of these trends with state mandated measures on social distancing and testing. We conclude that the reports on April 1st may be dramatically under-representing the actual number of state-wide infections, and we propose reassessment of the data over the coming weeks, to monitor for effects of the PAUSE directive, and for the increasing number of casualties as a validating measure.


Clinical and conceptual comments on "Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis"


title: A Qualitative Evaluation of Language Models on Automatic Question-Answering for COVID-19

text: COVID-19 has resulted in an ongoing pandemic and as of 12 June 2020, has caused more than 7.4 million cases and over 418,000 deaths. The highly dynamic and rapidly evolving situation with COVID-19 has made it difficult to access accurate, on-demand information regarding the disease. Online communities, forums, and social media provide potential venues to search for relevant questions and answers, or post questions and seek answers from other members. However, due to the nature of such sites, there are always a limited number of relevant questions and responses to search from, and posted questions are rarely answered immediately. With the advancements in the field of natural language processing, particularly in the domain of language models, it has become possible to design chatbots that can automatically answer consumer questions. However, such models are rarely applied and evaluated in the healthcare domain, to meet the information needs with accurate and up-to-date healthcare data. In this paper, we propose to apply a language model for automatically answering questions related to COVID-19 and qualitatively evaluate the generated responses. We utilized the GPT-2 language model and applied transfer learning to retrain it on the COVID-19 Open Research Dataset (CORD-19) corpus. In order to improve the quality of the generated responses, we applied 4 different approaches, namely tf-idf, BERT, BioBERT, and USE to filter and retain relevant sentences in the responses. In the performance evaluation step, we asked two medical experts to rate the responses. We found that BERT and BioBERT, on average, outperform both tf-idf and USE in relevance-based sentence filtering tasks. Additionally, based on the chatbot, we created a user-friendly interactive web application to be hosted online.


SARS-COVID-19 transformed the world and urological practice


The dynamics of antibodies to SARS-CoV-2 in a case of SARS-CoV-2 infection


title: Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation

text: The outbreak of a novel coronavirus (2019-nCoV) represents a pandemic threat that has been declared a public health emergency of international concern. The CoV spike (S) glycoprotein is a key target for vaccines, therapeutic antibodies, and diagnostics. To facilitate medical countermeasure development, we determined a 3.5-angstrom-resolution cryo-electron microscopy structure of the 2019-nCoV S trimer in the prefusion conformation. The predominant state of the trimer has one of the three receptor-binding domains (RBDs) rotated up in a receptor-accessible conformation. We also provide biophysical and structural evidence that the 2019-nCoV S protein binds angiotensin-converting enzyme 2 (ACE2) with higher affinity than does severe acute respiratory syndrome (SARS)-CoV S. Additionally, we tested several published SARS-CoV RBD-specific monoclonal antibodies and found that they do not have appreciable binding to 2019-nCoV S, suggesting that antibody cross-reactivity may be limited between the two RBDs. The structure of 2019-nCoV S should enable the rapid development and evaluation of medical countermeasures to address the ongoing public health crisis.


title: Mild course of Coronavirus disease 2019 and spontaneous severe acute respiratory syndrome coronavirus 2 clearance in a patient with depleted peripheral blood B-cells due to treatment with rituximab

text: Over 4 million cases of Coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been confirmed worldwide. Up to 20% of cases develop severe disease and the fatality rate are high.[1] Little is known however on the course of the infection in immunosuppressed patients. We therefore report the case of a patient with COVID-19 under immunosuppression with rituximab. This 77-year-old woman was admitted to the hospital with a 5-week history of unclear fever (up to 38.5°C), hypotension (80 mmHg systolic on self-measurement), occasional mild shortness of breath and intermittent dry cough.


title: [Real-world efficacy and safety of lopinavir/ritonavir and arbidol in treating with COVID-19 : an observational cohort study]

text: Objective: To evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) and arbidol in the treatment of COVID-19 in the real world. Methods: The clinical data of 178 patients diagnosed with COVID-19 admitted to Guangzhou Eighth People's Hospital were retrospectively analyzed from January 21 to February 9, 2020. According to the patient's antiviral treatment regimen, 178 patients were divided into 4 groups including LPV/r group (59 patients), arbidol group (36 patients), combination therapy with LPV/r plus arbidol group (25 patients) and the conventional treatment group without any antiviral drugs (58 patients). The main observation end points of the study was the negative conversion time of nucleic acid of the novel coronavirus (2019-nCoV) in pharyngeal swab. Results: The baseline of 4 groups before treatment was consistent and comparable. The negative conversion time of nucleic acid of the 2019-nCoV in pharyngeal swab was (10.20 ± 3.49), (10.11 ± 4.68), (10.86 ± 4.74), (8.44 ± 3.51) days separately in the LPV/r group, the arbidol group, the combination therapy group, and the conventional treatment group without significant difference (F = 2.556, P = 0.058). There was also no significant difference in the rate of negative conversion rate of 2019-nCoV nucleic acid, the improvement ration in clinical symptoms, and the improvement ration of pulmonary infection in the lung CT imaging (P> 0.05). However, a statistically significant difference was found in the proportion of deterioration changing from mild/moderate to severe/critical type at day 7 (χ(2) = 9.311, P = 0.017) as follows: the combination therapy group (24.0%, 6/25), the arbidol group ( 16.7%, 6/36), LPV/r group (5.4%, 3/56) and conventional treatment group (5.2%, 3/58). Moreover, the frequency of adverse reactions in the three groups receiving antiviral drugs was significantly higher than that in the conventional treatment group (χ(2) = 14.875, P = 0.002). Conclusions: No evidences could prove that LPV/r and arbidol could shorten the negative conversion time of novel coronavirus nucleic acid in pharyngeal swab nor improve the symptoms of patients. Furthermore, the combination usage of LPV/r and arbidol may not benefit for improving the disease. Noteworthy, the adverse reactions of the antiviral drugs should be paid careful attention during the treatment.


Shiftworking keeps locked-down lab on track


Cardiac injury and prognosis in COVID-19: Methodological considerations and updated meta-analysis


title: Financial implications of the CoviD-19 epidemic for hospitals: A case study

text: A concern about the COVID-19 pandemic is that U S hospitals may not have the capacity to serve all the patients seeking care With all these new patients, could the pandemic be financially beneficial for hospitals? We suggest the answer is likely no for three reasons First, many hospitals have experienced reductions in both surgical and clinic volumes resulting in substantial revenue losses Second, there are reports of increases in the cost of supplies Finally, the increase in intensive care services required to respond to the surge of COVID-19 patients will result in a shift of patient volume from acute to intensive care, and this shift will not likely improve profitability To estimate the possible magnitude of each of these effects, we analyze 2019 financial data from a profitable, well-run hospital in Washington State Our estimates suggest that the COVID-19 epidemic will cause dramatic financial losses for hospitals and that the bulk of those losses will result from lost revenue We suggest that these losses will be sufficiently large to create major changes in the hospital industry including changes in ownership, changes in access to credit, changes in care delivery and changes in choices of community benefit provision


title: Extracorporeal blood purification treatment options for COVID-19: The role of immunoadsorption

text: The activation of the innate and adaptive immune systems by SARS-CoV-2 causes the release of several inflammatory cytokines, including IL-6. The inflammatory hypercytokinemia causes immunopathological changes in the lungs including vascular leakage, and alveolar edema. As a result of these changes in the lungs, hypoxia and acute respiratory distress syndrome occur in patients with COVID-19. Even though there are clinical trials on the development of therapeutics and vaccines, there are currently no licensed vaccines or therapeutics for COVID-19. Pharmacological approaches have shown poor results in sepsis-like syndromes caused by the hypercytokinemia. Suppressing the cytokine storm is an important way to prevent the organ damage in patients with COVID-19. Extracorporeal blood purification could be proposed as an adjunctive therapy for sepsis, aiming to control the associated dysregulation of the immune system, which is known to protect organ functions. Several extracorporeal blood purification therapies are now available, and most of them target endotoxins and/or the cytokines and aim improving the immune response. For this purpose, plasmapheresis and immunoadsorption may be an important adjunctive treatment option to manage the complications caused by cytokine storm in critically ill patients with COVID-19.


title: Rapid design and implementation of an integrated patient self-triage and self-scheduling tool for COVID-19

text: OBJECTIVE: To rapidly deploy a digital patient-facing self-triage and self-scheduling tool in a large academic health system to address the COVID-19 pandemic. MATERIALS AND METHODS: We created a patient portal-based COVID-19 self-triage and self-scheduling tool and made it available to all primary care patients at the University of California, San Francisco Health, a large academic health system. Asymptomatic patients were asked about exposure history and were then provided relevant information. Symptomatic patients were triaged into 1 of 4 categories-emergent, urgent, nonurgent, or self-care-and then connected with the appropriate level of care via direct scheduling or telephone hotline. RESULTS: This self-triage and self-scheduling tool was designed and implemented in under 2 weeks. During the first 16 days of use, it was completed 1129 times by 950 unique patients. Of completed sessions, 315 (28%) were by asymptomatic patients, and 814 (72%) were by symptomatic patients. Symptomatic patient triage dispositions were as follows: 193 emergent (24%), 193 urgent (24%), 99 nonurgent (12%), 329 self-care (40%). Sensitivity for detecting emergency-level care was 87.5% (95% CI 61.7-98.5%). DISCUSSION: This self-triage and self-scheduling tool has been widely used by patients and is being rapidly expanded to other populations and health systems. The tool has recommended emergency-level care with high sensitivity, and decreased triage time for patients with less severe illness. The data suggests it also prevents unnecessary triage messages, phone calls, and in-person visits. CONCLUSION: Patient self-triage tools integrated into electronic health record systems have the potential to greatly improve triage efficiency and prevent unnecessary visits during the COVID-19 pandemic.


title: Spine Surgical Procedures during Coronavirus Disease 2019 Pandemic: Is It Still Possible to Take Care of Patients? Results of an Observational Study in the First Month of Confinement

text: Study Design: Observational study. Purpose: The actual sanitary crisis led to a massive mobilization of the sanitary system toward intensive care units and management of coronavirus disease 2019 (COVID-19) patients. However, some patients still require spinal interventions. The present study aimed to assess the impact of the COVID-19 pandemic on spine surgical in a moderate COVID-19 cluster region. Overview of Literature: Previous studies have reported screening and management of patients with spinal conditions during the COVID-19 pandemic. However, to date, knowledge, no observational study on spine surgeries during the pandemic has not been reported. Methods: Between March 17, 2020 and April 17, 2020, information on spine surgical activity was prospectively collected at our institution. This surgical activity related to the first month of confinement in France was compared to the activity during the same period in 2019 to evaluate the impact of the COVID-19 pandemic on surgical activities. Results: In order to reduce the contamination rate of patients and medical staff during hospitalization, the spine department was completely reorganized. Non-urgent elective spine surgeries were cancelled. When considering the global amount of surgeries procedures during the first month of confinement, a decrease of almost 50% was observed in the number of surgical procedures. During the study period, 62 patients were eligible for spine surgery. The numbers of patients managed for tumor and infectious cases were stable, while a considerable reduction was observed in the number of trauma and degenerative cases. During the follow-up period, two patients were tested as COVID+ during the postoperative course, and no cases of medical or paramedical staff contamination were reported using polymerase chain reaction-testing. Conclusions: During the COVID-19 pandemic, it is possible to maintain spine surgical activity. Each surgical procedure must be discussed and organized with all the caregivers involved. Indications for surgery must be in line with the scientific guidelines and adapted to each healthcare facility.


title: SARS-CoV-2: diagnostic and design conundrums in the context of male factor infertility

text: The question of whether SARS-CoV-2 (severe acute respiratory syndrome-related coronavirus-2 [SARS-CoV-2], leading to the COVID-19 infection) can be harboured in the testes and/or semen is currently unanswered. It is essential to understand the limitations of both antibody and real-time PCR tests in interpreting SARS-CoV-2 data in relation to analyses of semen and testicular tissue without appropriate controls. This article critically analyses the evidence so far on this, and the possible implications. The limitations of diagnostic tests in both sampling and testing methodologies, their validation and their relevance in interpreting data are also highlighted.


Going Viral: Management of IBD in the Era of the COVID-19 Pandemic


Vet nurse consultations could help financial recovery from Covid-19


title: Spatio-temporal propagation of COVID-19 pandemics

text: The new coronavirus known as COVID-19 is spread world-wide since December 2019. Without any vaccination or medicine, the means of controlling it are limited to quarantine and social distancing. Here we study the spatio-temporal propagation of the first wave of the COVID-19 virus in China and compare it to other global locations. We provide a comprehensive picture of the spatial propagation from Hubei to other provinces in China in terms of distance, population size, and human mobility and their scaling relations. Since strict quarantine has been usually applied between cities, more insight about the temporal evolution of the disease can be obtained by analyzing the epidemic within cities, especially the time evolution of the infection, death, and recovery rates which affected by policies. We study and compare the infection rate in different cities in China and provinces in Italy and find that the disease spread is characterized by a two-stages process. At early times, at order of few days, the infection rate is close to a constant probably due to the lack of means to detect infected individuals before infection symptoms are observed. Then at later times it decays approximately exponentially due to quarantines. The time evolution of the death and recovery rates also distinguish between these two stages and reflect the health system situation which could be overloaded.


Regarding COVID-19 and the Otolaryngologist: Preliminary Evidence-Based Review


title: What motivates students to enter nursing? Findings from a cross-sectional study

text: INTRODUCTION: It is expected that future nurses have high levels of emotional intelligence and empathy, because of their everyday interaction with people in a clinical environment. Thus, nursing students must show interest in nursing studies and in work with people. Moreover, it is desired that they have good communication skills. On the other hand, students who choose nursing as their future career may have high expectations from nursing education. The aim of this study was to explore nursing students' reasons for pursuing nursing studies. METHODS: A cross-sectional study was conducted among undergraduate nursing students in Slovenia and Croatia. RESULTS: A total of 314 students participated in the study. General satisfaction with their studies is higher among those students who are satisfied with their chosen study programme. The most important reasons to enter nursing studies were interest in the subject and good employment possibilities. As the biggest disadvantage of studying nursing, Slovenian students listed crowded schedules, while Croatian students mentioned faculty organization. Students from both countries agreed that the biggest advantage is the ease of finding a job after graduation. DISCUSSION: As there is a lack of workforce in the healthcare sector, particularly a lack of nurses, universities must adjust their demands and improve study conditions to gain students' attention. Therefore, it is important to notice that nursing students perceive more advantages of studying nursing than disadvantages. CONCLUSION: There are many different reasons to enter nursing studies. Students perceive many advantages in studying nursing, such as ease of employment, getting many hours of clinical practice and the possibility for promotion. On the other hand, there are some challenges in studying nursing, such as the schedule and organization of lectures, seminars and clinical placement. There is a need for further research in the field of nursing student's motivation, especially due to their decreasing motivation during the studies.


Chest Computed Tomography for Detection of Coronavirus Disease 2019 (COVID-19): Don't Rush the Science


title: A Decade of Social Bot Detection

text: On the morning of November 9th 2016, the world woke up to the shocking outcome of the US Presidential elections: Donald Trump was the 45th President of the United States of America. An unexpected event that still has tremendous consequences all over the world. Today, we know that a minority of social bots, automated social media accounts mimicking humans, played a central role in spreading divisive messages and disinformation, possibly contributing to Trump's victory. In the aftermath of the 2016 US elections, the world started to realize the gravity of widespread deception in social media. Following Trump's exploit, we witnessed to the emergence of a strident dissonance between the multitude of efforts for detecting and removing bots, and the increasing effects that these malicious actors seem to have on our societies. This paradox opens a burning question: What strategies should we enforce in order to stop this social bot pandemic? In these times, during the run-up to the 2020 US elections, the question appears as more crucial than ever. What stroke social, political and economic analysts after 2016, deception and automation, has been however a matter of study for computer scientists since at least 2010. In this work, we briefly survey the first decade of research in social bot detection. Via a longitudinal analysis, we discuss the main trends of research in the fight against bots, the major results that were achieved, and the factors that make this never-ending battle so challenging. Capitalizing on lessons learned from our extensive analysis, we suggest possible innovations that could give us the upper hand against deception and manipulation. Studying a decade of endeavours at social bot detection can also inform strategies for detecting and mitigating the effects of other, more recent, forms of online deception, such as strategic information operations and political trolls.


Mucosal involvement in a COVID-19-positive patient: A case report


Occupational skin disease among health care workers during the coronavirus (COVID-19) epidemic


title: Comparative impacts of angiotensin converting enzyme inhibitors versus angiotensin II receptor blockers on the risk of COVID-19 mortality

text: N/A.


Comparative Impacts of ACE (Angiotensin-Converting Enzyme) Inhibitors Versus Angiotensin II Receptor Blockers on the Risk of COVID-19 Mortality


Laboratory Findings in SARS-CoV-2 Infections in Zigong, China: Key Points for Serum Prealbumin


Mitigating the Impacts of the COVID-19 Pandemic Response on At-Risk Children


Letter to Editor: Central Pancreatectomy Versus Distal Pancreatectomy and Pancreaticoduodenectomy for Benign and Low-Grade Malignant Neoplasms: A Retrospective and Propensity Score-Matched Study with Long-Term Functional Outcomes and Pancreas Volumetry


title: Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts

text: The ongoing COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 is a global public health crisis. Multiple observations indicate poorer post-infection outcomes for patients with cancer than for the general population. Herein, we highlight the challenges in caring for patients with acute leukaemias and myeloid neoplasms amid the COVID-19 pandemic. We summarise key changes related to service allocation, clinical and supportive care, clinical trial participation, and ethical considerations regarding the use of lifesaving measures for these patients. We recognise that these recommendations might be more applicable to high-income countries and might not be generalisable because of regional differences in health-care infrastructure, individual circumstances, and a complex and highly fluid health-care environment. Despite these limitations, we aim to provide a general framework for the care of patients with acute leukaemias and myeloid neoplasms during the COVID-19 pandemic on the basis of recommendations from international experts.


title: Management of COVID-19 in people with epilepsy: drug considerations

text: People with epilepsy (PWE) are neither more likely to be infected by the coronavirus nor are they more likely to have severe COVID-19 manifestations because they suffer from epilepsy. However, management of COVID-19 in PWE may be more complicated than that in other individuals. Drug-drug interactions could pose significant challenges and cardiac, hepatic, or renal problems, which may happen in patients with severe COVID-19, may require adjustment to antiepileptic drugs (AEDs). In this review, we first summarize the potential drug-drug interactions between AEDs and drugs currently used in the management of COVID-19. We then summarize other challenging issues that may happen in PWE, who have COVID-19 and are receiving treatment.


title: An Alert to COVID-19 Literature in Predatory Publishing Venues

text: The COVID-19 pandemic, which has led to a flood of papers and preprints, has placed multiple challenges on academic publishing, the most obvious one being sustained integrity under the pressure to publish quickly. There are risks of this high volume-to-speed ratio. Many letters, editorials, and supposedly "peer reviewed" papers in ranked and indexed journals were published in a matter of days, suggesting that peer review was either fleeting or non-existential, or that papers were rapidly approved by editors based on their perceived interest and topicality, rather than on their intrinsic academic value. In academic publishing circles, the claim of "peer review", when in fact it has not been conducted, is a core characteristic of "predatory publishing", and is also a "fake" element that may undermine efforts in recent years to build trust in science's budding serials crisis. While the world is still centrally focused on COVID-19, the issue of "predatory publishing" is being ignored, or not being given sufficient attention. The risks to the scholarly community, academic publishing and ultimately public health are at stake when exploitative and predatory publishing are left unchallenged.


title: Clinical and transmission dynamics characteristics of 406 children with coronavirus disease 2019 in China: A review

text: OBJECTIVE: Chinese pediatricians are working on the front line to fight COVID-19. They have published a great amount of first-hand clinical data. Collecting their data and forming a large sample for analysis is more conducive to the recognition, prevention and treatment of coronavirus disease 2019 in children. The epidemic prevention and control experience of Chinese pediatricians should be shared with the world. METHODS: By searching Chinese and English literature, the data of 406 children with COVID-19 in China were analyzed. RESULTS: It was found that the clustered incidence of children's families is a dynamic transmission feature; the incidence is low; asymptomatic infections and mild cases account for 44.8%, with only 7 cases of critical illness; laboratory examination of lymphocyte counts is not reduced, as it is for adults; chest CT findings are less severe than those for adults. These presentations are the clinical features of COVID-19 in children. Only 55 of the 406 cases were tested by anal swab for virus nucleic acid, 45 of which were positive, accounting for 81.8% of stool samples. CONCLUSION: There are more children than adults with asymptomatic infections, milder conditions, faster recovery, and a better prognosis. Some concealed morbidity characteristics also bring difficulties to the early identification, prevention and control of COVID-19. COVID-19 screening is needed in the pediatric fever clinic, and respiratory and digestive tract nucleic acid tests should be performed. Efforts should be made to prevent children from becoming a hidden source of transmission in kindergartens, schools or families. Furthermore, China's experience in treating COVID-19 in children has led to faster recovery of sick children.


Evidence for Gastrointestinal Infection of SARS-CoV-2


Sport Integrity Opportunities in the Time of Coronavirus


title: COVID-19 in Children, Pregnancy and Neonates: A Review of Epidemiologic and Clinical Features

text: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has spread rapidly across the globe. In contrast to initial reports, recent studies suggest that children are just as likely as adults to become infected with the virus but have fewer symptoms and less severe disease. In this review, we summarize the epidemiologic and clinical features of children infected with SARS-CoV-2 reported in pediatric case series to date. We also summarize the perinatal outcomes of neonates born to women infected with SARS-CoV-2 in pregnancy. We found 11 case series including a total of 333 infants and children. Overall, 83% of the children had a positive contact history, mostly with family members. The incubation period varied between 2 and 25 days with a mean of 7 days. The virus could be isolated from nasopharyngeal secretions for up to 22 days and from stool for more than 30 days. Co-infections were reported in up to 79% of children (mainly mycoplasma and influenza). Up to 35% of children were asymptomatic. The most common symptoms were cough (48%; range 19%-100%), fever (42%; 11%-100%) and pharyngitis (30%; 11%-100%). Further symptoms were nasal congestion, rhinorrhea, tachypnoea, wheezing, diarrhea, vomiting, headache and fatigue. Laboratory test parameters were only minimally altered. Radiologic findings were unspecific and included unilateral or bilateral infiltrates with, in some cases, ground-glass opacities or consolidation with a surrounding halo sign. Children rarely needed admission to intensive care units (3%), and to date, only a small number of deaths have been reported in children globally. Nine case series and 2 case reports described outcomes of maternal SARS-CoV-2 infection during pregnancy in 65 women and 67 neonates. Two mothers (3%) were admitted to intensive care unit. Fetal distress was reported in 30% of pregnancies. Thirty-seven percent of women delivered preterm. Neonatal complications included respiratory distress or pneumonia (18%), disseminated intravascular coagulation (3%), asphyxia (2%) and 2 perinatal deaths. Four neonates (3 with pneumonia) have been reported to be SARS-CoV-2 positive despite strict infection control and prevention procedures during delivery and separation of mother and neonates, meaning vertical transmission could not be excluded.


title: Biomarker variation in patients successfully treated with tocilizumab for severe coronavirus disease 2019 (COVID-19): results of a multidisciplinary collaboration

text: OBJECTIVES: Acute respiratory distress syndrome (ARDS) related to SARS-CoV-2 is likely due to a cytokine storm characterised by a major release of pro-inflammatory cytokines, including interleukin-6 (IL-6) Blocking excessive IL-6 production might be the key to the COVID-19-ARDS treatment Beneficial effects of IL-6 blockade using a humanised anti-IL-6 receptor antibody, tocilizumab (TCZ) were previously reported in patients with COVID-19 related ARDS The aim of the study was to study the variation over time of several biomarkers, demonstrated to be predictors of poor prognostic, in subjects successfully treated with TCZ for severe COVID-19 METHODS: Retrospective analysis of a case series of patients with COVID-19-ARDS, evidenced by RT-PCR and lung CT-scan Patients with increasing O2 requirements, within the window of opportunity for TCZ treatment (Day 7 to Day 17 after onset of symptoms) were treated with TCZ (2 infusions of 8 mg/kg) Demographic, biological and clinical data were collected from the patients' files Serum levels of CRP, ferritin, fibrinogen, lymphocytes, platelets, creatinine, D-dimer and liver enzymes were assayed at the time of the first TCZ administration, then every two days for 8 days RESULTS: 40 patients were treated with TCZ Most of them had several comorbidities, and all had multiple biological abnormalities (lymphopenia, increased CRP, ferritin, fibrinogen, D-dimer, liver enzymes) 30 patients (75%) benefited from TCZ and 10 patients died In the survivors, following TCZ administration CRP decreased dramatically as early as day 4 (-86 7%, p<0 0001) and returned to normal at day 6 Fibrinogen and lymphocyte count returned to normal values at day 6 Ferritin also decreased significantly No significant change was observed for D-dimer (p=0 68) and other studied biomarkers (haemoglobin, leucocyte count, AST) CONCLUSIONS: In patients with COVID-19 acute respiratory distress syndrome, treatment with TCZ resulted in favourable evolution in 75% of the cases Biomarkers of inflammation (CRP, ferritin, fibrinogen) decreased dramatically as early as the 4th day after TCZ injection Lymphopenia, a predictor of poor prognostic, was reversed 6 days after TCZ injection


title: Changing Clusters of Indian States with respect to number of Cases of COVID-19 using incrementalKMN Method

text: The novel Coronavirus (COVID-19) incidence in India is currently experiencing exponential rise but with apparent spatial variation in growth rate and doubling time rate. We classify the states into five clusters with low to the high-risk category and study how the different states moved from one cluster to the other since the onset of the first case on $30^{th}$ January 2020 till the end of unlock 1 that is $30^{th}$ June 2020. We have implemented a new clustering technique called the incrementalKMN (Prasad, R. K., Sarmah, R., Chakraborty, S.(2019))


Lab life - rebuild it better after coronavirus lockdowns ease


Urticaria in the times of COVID-19


title: Spreading of infections on random graphs: A percolation-type model for COVID-19

text: We introduce an epidemic spreading model on a network using concepts from percolation theory. The model is motivated by discussing the standard SIR model, with extensions to describe effects of lockdowns within a population. The underlying ideas and behavior of the lattice model, implemented using the same lockdown scheme as for the SIR scheme, are discussed in detail and illustrated with extensive simulations. A comparison between both models is presented for the case of COVID-19 data from the USA. Both fits to the empirical data are very good, but some differences emerge between the two approaches which indicate the usefulness of having an alternative approach to the widespread SIR model.


COVID-19 e os Danos Invisíveis: O Papel do Médico de Família./ [COVID-19 and The Invisible Damage: The Role of The Family Physician]


Coronavirus Disease 2019: Is Everything Lawful to Create an Effective Vaccine?


title: Publisher Correction: Risk factors for death from COVID-19

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


Simplified immune-dysregulation index: a novel marker predicts 28-day mortality of intensive care patients with COVID-19


Novel method of performing brachial plexus block using an aerosol box during COVID-19 pandemic


title: Estimación del efecto en el tamaño y la supervivencia de los tumores cutáneos debido al confinamiento por COVID-19: modelo basado en un crecimiento exponencial./ Estimación del efecto en el tamaño y la supervivencia de los tumores cutáneos debido al confinamiento por COVID-19: modelo basado en un crecimiento exponencial./ Estimated Effect of COVID-19 Lockdown on Skin Tumor Size and Survival: An Exponential Growth Model

text: BACKGROUND AND OBJECTIVES: Spain is in a situation of indefinite lockdown due to the ongoing coronavirus disease 2019 (COVID-19) pandemic. One of the consequences of this lockdown is delays in medical and surgical procedures for common diseases. The aim of this study was to model the impact on survival of tumor growth caused by such delays in patients with squamous cell carcinoma (SCC) and melanoma. MATERIAL AND METHODS: Multicenter, retrospective, observational cohort study. We constructed an exponential growth model for both SCC and melanoma to estimate tumor growth between patient-reported onset and surgical excision at different time points. RESULTS: Data from 200 patients with SCC of the head and neck and 1000 patients with cutaneous melanoma were included. An exponential growth curve was calculated for each tumor type and we estimated tumor size after 1, 2, and 3 months of potential surgical delay. The proportion of patients with T3 SCC (diameter >4cm or thickness >6mm) increased from 41.5% (83 patients) in the initial study group to an estimated 58.5%, 70.5%, and 72% after 1, 2, and 3 months of delay. Disease-specific survival at 2, 5, and 10 years in patients whose surgery was delayed by 3 months decreased by 6.2%, 8.2%, and 5.2%, respectively. The proportion of patients with ultrathick melanoma (>6mm) increased from 6.9% in the initial study group to 21.9%, 30.2%, and 30.2% at 1, 2, and 3 months. Five- and 10-year disease-specific survival both decreased by 14.4% in patients treated after a potential delay of 3 months. CONCLUSIONS: In the absence of adequate diagnosis and treatment of SCC and melanoma in the current lockdown situation in Spain, we can expect to see to a considerable increase in large and thick SCCs and melanomas. Efforts must be taken to encourage self-examination and facilitate access to dermatologists in order to prevent further delays.


title: Provision of dental services at a single institution in the UK's epicentre during the COVID-19 pandemic

text: Coronavirus disease 2019 (COVID-19) has had a significant impact on dentistry in the UK due to the perceived risks associated with infection control. These concerns have led to a complete paralysis of routine dental care with provisions for emergency dental care only, which have been scarce. Considering the latter, this article presents a service evaluation of a hospital-based acute dental care service, which was rapidly adapted and enhanced to continue managing dental emergencies during the COVID-19 pandemic. The analysis is based upon the dental diagnoses, management and geography of travel of over 1,500 attending patients in a five-week period during the rise and peak of COVID-19 in the UK. In addition, we assess our dental workforce's COVID-19 sickness reporting for those providing urgent dental care within this enhanced service. The article aims to provide additional and valuable frontline clinical information, experience and outcomes, including our categorisation of personal protective equipment used for varying face-to-face dental management during COVID-19.


Will science save us?


title: Misinformation Has High Perplexity

text: Debunking misinformation is an important and time-critical task as there could be adverse consequences when misinformation is not quashed promptly. However, the usual supervised approach to debunking via misinformation classification requires human-annotated data and is not suited to the fast time-frame of newly emerging events such as the COVID-19 outbreak. In this paper, we postulate that misinformation itself has higher perplexity compared to truthful statements, and propose to leverage the perplexity to debunk false claims in an unsupervised manner. First, we extract reliable evidence from scientific and news sources according to sentence similarity to the claims. Second, we prime a language model with the extracted evidence and finally evaluate the correctness of given claims based on the perplexity scores at debunking time. We construct two new COVID-19-related test sets, one is scientific, and another is political in content, and empirically verify that our system performs favorably compared to existing systems. We are releasing these datasets publicly to encourage more research in debunking misinformation on COVID-19 and other topics.


Reply to: Self-reported olfactory loss in COVID-19: is it really a favorable prognostic factor?


Genome analyses help track coronavirus' moves


title: Structural Identifiability and Observability of Compartmental Models of the COVID-19 Pandemic

text: The recent coronavirus disease (COVID-19) outbreak has dramatically increased the public awareness and appreciation of the utility of dynamic models. At the same time, the dissemination of contradictory model predictions has highlighted their limitations. If some parameters and/or state variables of a model cannot be determined from output measurements, its ability to yield correct insights -- as well as the possibility of controlling the system -- may be compromised. Epidemic dynamics are commonly analysed using compartmental models, and many variations of such models have been used for analysing and predicting the evolution of the COVID-19 pandemic. In this paper we survey the different models proposed in the literature, assembling a list of 36 model structures and assessing their ability to provide reliable information. We address the problem using the control theoretic concepts of structural identifiability and observability. Since some parameters can vary during the course of an epidemic, we consider both the constant and time-varying parameter assumptions. We analyse the structural identifiability and observability of all of the models, considering all plausible choices of outputs and time-varying parameters, which leads us to analyse 255 different model versions. We classify the models according to their structural identifiability and observability under the different assumptions and discuss the implications of the results. We also illustrate with an example several alternative ways of remedying the lack of observability of a model. Our analyses provide guidelines for choosing the most informative model for each purpose, taking into account the available knowledge and measurements.


Covid-19: New York City deaths pass 1000 as Trump tells Americans to distance for 30 days


title: Antibodies against canine distemper virus, parvovirus and Ehrlichia spp. in wild captive carnivores in midwestern Brazil/ Anticorpos contra o vírus da cinomose canina, parvovírus e Ehrlichia spp. em carnívoros selvagens cativos no centro-oeste do Brasil

text: The occurrence of antibodies against canine distemper virus (CDV), parvovirus and Ehrlichia spp. in wild captive carnivores was evaluated in a zoological park in midwestern Brazil. Serum samples were collected between 2007 and 2014 from 45 carnivores. Antibodies were evaluated by virus neutralization assay for CDV, hemagglutination inhibition test for parvovirus, indirect immunofluorescent and Enzyme-linked immunosorbent assay for Ehrlichia spp. Antibodies against CDV and parvovirus were detected in 75% of Canidae and Felidae. Procyonidae were negative for CDV, although one Mustelidae was positive. TwoCanidae presented antibodies reactive to E. canis antigens. The high antibodies rates to CDV and parvovirus suggest the contact with both pathogens, however since no clinical history of disease are registered in the Zoo-UFMT, we can presume that carnivores have responded satisfactorily against the antigens. The low serological rates observed against Ehrlichia spp. may be resulted to the low occurrence of ticks among carnivores.(AU)


Balancing aesthetic and conventional dermatology practice in the COVID-19 era


Death in the ICU from COVID-19: more research on its effects on families needed


Evidence for (mis-)understanding or obfuscation in the COVID-19 and digit ratio relationship? A reply to Jones et al


Physical Distancing in COVID-19 May Exacerbate Experiences of Social Isolation among People Living with HIV


On Becoming a Plague Doctor


[The way to reduce the"false negative results"of 2019 novel coronavirus nucleic acid detection]


title: Global food crisis looms

text: The covid-19 pandemic could lead to extreme poverty that leaves many struggling to afford food, reports Adam Vaughan.


COVID-19 and ovarian cancer: Exploring alternatives to intravenous (IV) therapies


title: Evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as coronavirus disease 2019 (COVID-19) pandemic: A global health emergency

text: According to data compiled by researchers at Johns Hopkins University in Baltimore, Maryland, more than two and half million cases of coronavirus disease 2019 (COVID-19), caused by a newly discovered virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been confirmed on April 20, 2020 (Nature, 2020b). Since the emergence of this infectious disease in Asia (Wuhan, China) late last year, it has been subsequently span to every continent of the world except Antarctica (Rodríguez-Morales et al., 2020). Along with a foothold in every country, the current disease pandemic is disrupting practically every aspect of life all over the world. As the outbreak are continuing to evolve, several research activities have been conducted for better understanding the origin, functions, treatments, and preventions of this novel coronavirus. This review will be a summa of the key features of novel coronavirus (nCoV), the virus causing disease 2019 and the present epidemic situation worldwide up to April 20, 2020. It is expected that this record will play an important role to take more preventive measures for overcoming the challenges faced during this current pandemic.