title: SurviveCovid-19 -- A Game for Improving Awareness of Social Distancing and Health Measures for Covid-19 Pandemic

text: Pandemics have threatened human race many a times. One of the most important tasks during a pandemic is to bring awareness among people. Bringing awareness contributes a lot in controlling any pandemic. Covid-19 has been causing severe loss to the human race. Considering the mode of spread and the level of severity of this disease, it is extremely important to make people aware of various safety precautions such as using sanitizers and masks and maintaining social distancing, that are to be followed to prevent the disease and break the chain of spread. This mode of educating individuals about the disease is being widely carried out as announcements through online or physical awareness campaigns, advertisements in the media and so on. The younger generations in the present day spend considerably more time on mobile phones and games. However, there are very few mobile applications or games, aimed to bring awareness about a pandemic, which is much lesser in case of Covid-19. Also, considering the lockdown scenario across the world, games also act as a good pass time indoors. Hence, we propose a 2D survival based game, SurviveCovid-19, aimed to educate people about safety precautions to be taken for Covid-19 outside their homes, by incorporating social distancing and usage of masks and sanitizers in the game. SurviveCovid-19 has been designed as an Android based mobile game and has been evaluated through a remote qualitative user survey, with 20 volunteers. The results of the survey are promising with all the questions of survey having mean value greater than 3.6.


Is the COVID-19 Pandemic an Opportunity to Enlarge the Telemedicine Boundaries? (Re: Telemed J E Health 2020;26:571-573)


title: Metabolic Impacts of Confinement during the COVID-19 Pandemic Due to Modified Diet and Physical Activity Habits

text: While the detrimental effects of a chronic positive energy balance due to a sedentary lifestyle have been well established, the impacts of a short period of abruptly reduced physical activity and overeating arising from strict confinement due to the COVID-19 pandemic will soon start to emerge. To reasonably anticipate major consequences according to the available evidence, we hereby review the literature for studies that have explored the health impacts of several weeks of a reduction in physical activity and daily step-count combined with modified eating habits. These studies identify as main metabolic consequences increases in insulin resistance, total body fat, abdominal fat and inflammatory cytokines. All these factors have been strongly associated with the development of metabolic syndrome, which in turn increases the risk of multiple chronic diseases. A plausible mechanism involved in these impacts could be a positive energy balance promoted by maintaining usual dietary intake while reducing energy expenditure. This means that just as calorie intake restriction could help mitigate the deleterious impacts of a bout of physical inactivity, overeating under conditions of home confinement is very likely to exacerbate these consequences. Moreover, hypertension, diabetes, and cardiovascular disease have been identified as potential risk factors for more severely ill patients with COVID-19. Thus, adequate control of metabolic disorders could be important to reduce the risk of severe COVID-19.


Assessing Operating Room Preparedness for COVID-19 Patients through In-Situ Simulations


title: Estimate of the Basic Reproduction Number for COVID-19: A Systematic Review and Meta-analysis

text: OBJECTIVES: The outbreak of coronavirus disease 2019 (COVID-19) is one of the main public health challenges currently facing the world. Because of its high transmissibility, COVID-19 has already caused extensive morbidity and mortality in many countries throughout the world. An accurate estimation of the basic reproduction number (R0) of COVID-19 would be beneficial for prevention programs. In light of discrepancies in original research on this issue, this systematic review and meta-analysis aimed to estimate the pooled R0 for COVID-19 in the current outbreak. METHODS: International databases (including Google Scholar, Science Direct, PubMed, and Scopus) were searched to identify studies conducted regarding the R0 of COVID-19. Articles were searched using the following keywords: "COVID-19" and "basic reproduction number" or "R0." The heterogeneity among studies was assessed using the I2 index, the Cochran Q test, and T2. A random-effects model was used to estimate R0 in this study. RESULTS: The mean reported R0 in the identified articles was 3.38±1.40, with a range of 1.90 to 6.49. According to the results of the random-effects model, the pooled R0 for COVID-19 was estimated as 3.32 (95% confidence interval, 2.81 to 3.82). According to the results of the meta-regression analysis, the type of model used to estimate R0 did not have a significant effect on heterogeneity among studies (p=0.81). CONCLUSIONS: Considering the estimated R0 for COVID-19, reducing the number of contacts within the population is a necessary step to control the epidemic. The estimated overall R0 was higher than the World Health Organization estimate.


title: A comparative study on the time to achieve negative nucleic acid testing and hospital stays between danoprevir and lopinavir/ritonavir in the treatment of patients with COVID-19

text: In late December 2019, coronavirus disease 2019 (COVID-19) first broke out in Wuhan, China, and has now become a global pandemic. However, there is no specific antiviral treatment for COVID-19. This study enrolled 33 COVID-19 patients in the nineth hospital of Nanchang from 27th January to 24th February 2020. Clinical indexes of patients upon admission/discharge were examined. Patients were divided into two groups according to different treatment plans (danoprevir and lopinavir/ritonavir). The days to achieve negative nucleic acid testing and the days of hospital stays were counted and statistically analyzed. COVID-19 patients treated with danoprevir or lopinavir/ritonavir were all improved and discharged. Indexes like blood routine, inflammation and immune-related indexes were significantly recovered after treatment. Additionally, under the circumstance that there was no significant difference in patients' general information between the two groups, we found that the mean time to achieve both negative nucleic acid testing and hospital stays of patients treated with danoprevir were significantly shorter than those of patients with lopinavir/ritonavir. Collectively, applying danoprevir is a good treatment plan for COVID-19 patients.


title: All India Ophthalmological Society - Preferred practice in refractive surgery during the COVID-19 pandemic

text: Coronavirus pandemic has strained the healthcare system with mortality and morbidity. A number of elective surgeries have come to standstill due to lockdown and movement restrictions. Refractive surgery being a purely elective procedure and quite a fresh subset of ophthalmology, there is a lack of unanimity as to what precautions should be followed to resume the practice of same. This article attempts to highlight simple guidelines in accordance with an expert panel, which can be followed by all those involved directly or indirectly in refractive surgery services while addressing safety of doctors, supporting staff as well as patients as a primary concern.


title: Optimizing resilience and wellbeing for healthcare professions trainees and healthcare professionals during public health crises - Practical tips for an 'integrative resilience' approach

text: Public health crises, including pandemics, are associated with significant health risk and concomitant stress, fear, decreased sense of control, and uncertainty. Deleterious impact on both physical and mental health can result, including for healthcare professionals and health professions trainees. Changes in governmental policies and hospital protocols for healthcare professionals as well as disruption of educational formats and requirements for trainees can ensue. Difficult anxiety-provoking realities of public health crises including pandemics which involve caring for many seriously ill patients, moral distress including difficult care decisions, personal health risk, and/or potential risk to one's family can take a dire toll on the mental health of healthcare professionals at all stages of the professional lifecycle. Educational disruptions can create significant anxiety for trainees about completing requirements and achieving competencies. Within this, coping skills may be challenged and strengths may be elucidated as well. Such crises create an imperative for medical educators to support trainees' wellbeing through adaptive flexibility for curriculum innovation and culturally sensitive resilience and wellbeing interventions. Strategies ('tips') to optimize resilience and wellbeing with an integrative resilience approach of individual, learning environment, and organization/systems factors are presented.


Preparing African anticancer centres in the COVID-19 outbreak


Prone positioning in non-intubated patients with COVID-19: raising the bar


Commentary: Message in a Bottle - Sending out an SOS to the World


title: COVID-19: Preliminary Clinical Guidelines for Ophthalmology Practices

text: The zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and its resultant human coronavirus disease (COVID-19) recently appeared as a global health threat that can cause severe respiratory infection and terminal respiratory distress By the first week of April, more than 1 3 million people had been globally infected and more than 70,000 had lost their lives to this contagious virus Clinical manifestations occur shortly after exposure, or a few days later There is controversy regarding the transmission of the virus through the tear and conjunctiva;however, there are reports that the ocular surface might be a potential target for COVID-19 The ease of transmission of this virus at close proximity presents a risk to eyecare workers Several recommendations have been issued by local and national organizations to address the issue of safe ophthalmic practice during the ongoing COVID-19 pandemic These guidelines have numerous similarities;however, subtle differences exist The purpose of this paper was to discuss measures, with a specific focus on standard precautions, to prevent further dissemination of COVID-19 at Eye Clinics We have proposed procedures to triage suspected cases of COVID-19, considering emergency conditions


Laparoscopy at all costs? Not now during COVID-19 outbreak and not for acute care surgery and emergency colorectal surgery: A practical algorithm from a hub tertiary teaching hospital in Northern Lombardy, Italy


title: Cross-sectional prevalence study of MERS-CoV in local and imported dromedary camels in Saudi Arabia, 2016-2018

text: The Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) is an endemic virus in dromedaries. Annually, Saudi Arabia imports thousands of camels from the Horn of Africa, yet the epidemiology of MERS-CoV in these animals is largely unknown. Here, MERS-CoV prevalence was compared in imported African camels and their local counterparts. A total of 1399 paired sera and nasal swabs were collected from camels between 2016 and 2018. Imported animals from Sudan (n = 829) and Djibouti (n = 328) were sampled on incoming ships at Jeddah Islamic seaport before unloading, and local camels were sampled from Jeddah (n = 242). Samples were screened for neutralizing antibodies (nAbs) and MERS-CoV viral RNA. The overall seroprevalence was 92.7% and RNA detection rate was 17.2%. Imported camels had higher seroprevalence compared to resident herds (93.8% vs 87.6%, p <0.01) in contrast to RNA detection (13.3% vs 35.5%, p <0.0001). Seroprevalence significantly increased with age (p<0.0001) and viral RNA detection rate was ~2-folds higher in camels <2-year-old compared to older animals. RNA detection was higher in males verses females (24.3% vs 12.6%, p<0.0001) but seroprevalence was similar. Concurrent positivity for viral RNA and nAbs was found in >87% of the RNA positive animals, increased with age and was sex-dependent. Importantly, reduced viral RNA load was positively correlated with nAb titers. Our data confirm the widespread of MERS-CoV in imported and domestic camels in Saudi Arabia and highlight the need for continuous active surveillance and better prevention measures. Further studies are also warranted to understand camels correlates of protection for proper vaccine development.


title: Cross-sectional prevalence study of MERS-CoV in local and imported dromedary camels in Saudi Arabia, 2016-2018 ;Directory of Open Access Journals

text: The Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) is an endemic virus in Middle Eastern and African dromedaries Annually, Saudi Arabia imports thousands of camels from the Horn of Africa, yet the epidemiology of the virus in these animals is largely unknown Here, MERS-CoV prevalence was compared in imported African camels and their local counterparts A total of 1399 paired sera and nasal swabs were collected between 2016 and 2018 from camels from Sudan (n = 829), Djibouti (n = 328) and Jeddah (n = 242) Imported animals were sampled on incoming ships at Jeddah Islamic seaport before unloading Samples were screened for neutralizing antibodies (nAbs) and MERS-CoV viral RNA by RT-PCR The overall seroprevalence was 92 7% and RNA detection rate was 17 2 % Imported camels had higher seroprevalence compared to resident herds (93 8% vs 87 6%, p 87 % of the RNA positive animals, increased with age and was sex-dependent Importantly, reduced viral RNA load was positively correlated with nAb titers Our data confirm MERS-CoV widespread in imported and domestic camels in Saudi Arabia and highlight the need for continuous active surveillance and better prevention measures Further studies are also warranted to understand the correlates of protection in camels for proper vaccine development


Inmunoglobulinas por vía intravenosa: una alternativa terapéutica a tener en cuenta en el paciente trasplantado renal con COVID-19./ Inmunoglobulinas por vía intravenosa: una alternativa terapéutica a tener en cuenta en el paciente trasplantado renal con COVID-19./ Intravenous immunoglobulins: A therapeutic alternative to consider in kidney transplant patients with COVID-19


title: COVID-19 vaccines: Knowing the unknown

text: Vaccine development against SARS-CoV-2 has drawn attention around the globe due to the exploding pandemic. Although COVID-19 is caused by a new coronavirus, SARS-CoV-2, previous research on other coronavirus vaccines, such as FIPV, SARS, and MERS, has provided valuable information for the rapid development of COVID-19 vaccine. However, important knowledge gaps remain - some are specific to SARS-CoV-2, others are fundamental to immunology and vaccinology. Here, we discuss areas that need to be addressed for COVID-19 vaccine development, and what can be learned from examples of vaccine development in the past. Since the beginning of the outbreak, the research progress on COVID-19 has been remarkable. We are therefore optimistic about the rapid development of COVID-19 vaccine.


title: Development of a specific AFLP-based SCAR marker for Chinese Race 34MKG of Puccinia graminis f. sp. tritici

text: Wheat stem rust, caused by Puccinia graminis f. sp. tritici (Pgt), is a fungus that causes the devastating fungalwheat stem rust disease in wheat production. Rapid identification of the physiological races of Pgt are very importance for the prevention of wheat stem rust. In this paper we developed a molecular method to identify the most prevalent race of Pgt, as a supplement for traditionally used host-specific methods. Amplified fragment length polymorphism (AFLP) was employed as a means of analyzing DNA polymorphisms in six common physiological races of Pgt in China and Ug99. In total, 64 pairs of primers were used for AFLP screening of race-specific molecular markers. One primer pair-namely, E7/M7 (5'-GACTGCGTACCAATTCG G-3'/5'-GATGAGTCCTGAGTAACGG-3')-yielded a unique band for the race 34MKG that was purified and cloned into the pGEM-T vector for sequencing. We then designed a new primer pairs (sequence-characterized amplified region marker) to amplify the 171-bp fragment and confirmed that the marker was highly specific for 34MKG. These results provide a new tool for monitoring different races of Pgt for improved control of wheat stem rust in China.


title: LinearDesign: Efficient Algorithms for Optimized mRNA Sequence Design

text: A messenger RNA (mRNA) vaccine has emerged as a promising direction to combat the current COVID-19 pandemic. This requires an mRNA sequence that is stable and highly productive in protein expression, features which have been shown to benefit from greater mRNA secondary structure folding stability and optimal codon usage. However, sequence design remains a hard problem due to the exponentially many synonymous mRNA sequences that encode the same protein. We show that this design problem can be reduced to a classical problem in formal language theory and computational linguistics that can be solved in O(n^3) time, where n is the mRNA sequence length. This algorithm could still be too slow for large n (e.g., n = 3, 822 nucleotides for the spike protein of SARS-CoV-2), so we further developed a linear-time approximate version, LinearDesign, inspired by our recent work, LinearFold. This algorithm, LinearDesign, can compute the approximate minimum free energy mRNA sequence for this spike protein in just 11 minutes using beam size b = 1, 000, with only 0.6% loss in free energy change compared to exact search (i.e., b = +infinity, which costs 1 hour). We also develop two algorithms for incorporating the codon optimality into the design, one based on k-best parsing to find alternative sequences and one directly incorporating codon optimality into the dynamic programming. Our work provides efficient computational tools to speed up and improve mRNA vaccine development.


Possible link between anosmia and COVID-19: sniffing out the truth


Cardiovascular disease as a biomarker for an increased risk of COVID-19 infection and related poor prognosis


Going Virtual to Support Anatomy Education: A STOPGAP in the Midst of the Covid-19 Pandemic


title: Three Insights on Psychoneuroimmunology of Mood Disorders to Be Taken from the Covid-19 Pandemic

text: In the recent months, the world was taken by surprise by the outbreak of a coronavirus (SARS-CoV-2) pandemic (COVID-19). The COVID-19 pandemic is a unique opportunity to advance the understanding of the association of respiratory viruses with mood disorders and suicide. In this editorial, we explore three insights to the neuropsychoneuroimmunology of mood disorders that could be taken from the COVID-19 pandemic.


COVID-19: And this shall also pass


title: Does Non-COVID19 Lung Lesion Help? Investigating Transferability in COVID-19 CT Image Segmentation

text: Coronavirus disease 2019 (COVID-19) is a highly contagious virus spreading all around the world. Deep learning has been adopted as an effective technique to aid COVID-19 detection and segmentation from computed tomography (CT) images. The major challenge lies in the inadequate public COVID-19 datasets. Recently, transfer learning has become a widely used technique that leverages the knowledge gained while solving one problem and applying it to a different but related problem. However, it remains unclear whether various non-COVID19 lung lesions could contribute to segmenting COVID-19 infection areas and how to better conduct this transfer procedure. This paper provides a way to understand the transferability of non-COVID19 lung lesions. Based on a publicly available COVID-19 CT dataset and three public non-COVID19 datasets, we evaluate four transfer learning methods using 3D U-Net as a standard encoder-decoder method. The results reveal the benefits of transferring knowledge from non-COVID19 lung lesions, and learning from multiple lung lesion datasets can extract more general features, leading to accurate and robust pre-trained models. We further show the capability of the encoder to learn feature representations of lung lesions, which improves segmentation accuracy and facilitates training convergence. In addition, our proposed Multi-encoder learning method incorporates transferred lung lesion features from non-COVID19 datasets effectively and achieves significant improvement. These findings promote new insights into transfer learning for COVID-19 CT image segmentation, which can also be further generalized to other medical tasks.


title: [Clinical study of artesunate in the treatment of coronavirus disease 2019]

text: OBJECTIVE: To discuss the effective of artesunate in the treatment of coronavirus disease 2019 (COVID-19). METHODS: Using prospective method, the 43 cases of confirmed COVID-19 patients in Nanning Fourth People's Hospital from January 22nd to February 15th in 2020 were enrolled and divided into routine treatment group (n = 25) and artesunate treatment group (n = 18) by odd-even rule after admission. According to the guidelines, the routine treatment group was recommended to receive lopinavir/ritonavir 500 mg + α-aerosolized interferon 500×104 U, twice daily; the artesunate treatment group was given artesunate 60 mg, twice daily besides the routine treatment, for 10 days in both groups. During the treatment period, the pharynx swab test of 2019 novel coronavirus (2019-nCoV) nucleic acid was carried out every 2 days, and the routine blood test, liver and kidney functions, blood coagulation function and myocardial enzymes were re-examined. Chest CT was checked every 3 days after the treatment, and re-examined every 5 days after the condition was improved. The routine blood test and biochemical results of two groups were observed, and the efficacy evaluation was performed by monitoring the time for significant improvement of symptoms, negative conversion time of throat swab virus nucleic acid, lung lesion absorption time, adverse drug reactions and the length of hospital stay of the two groups. RESULTS: There were no significant differences between the two groups in terms of gender, age, body weight, routine blood test and biochemical results before treatment. In artesunate treatment group, the time for significant improvement of symptoms (days: 3.33±1.91 vs. 4.84±2.19), negative conversion time of 2019-nCoV nucleic acid (days: 4.72±2.16 vs. 6.68±3.76), lung lesion absorption starting time (days: 5.39±2.36 vs. 7.48±3.78), lung lesion absorption greater than 70% time (days: 14.11±4.16 vs. 17.04±4.42) and the length of hospital stay (days: 16.56±3.71 vs. 18.04±3.97) were significantly shorter than those in routine treatment group, with significant differences (all P < 0.05). The incidence of adverse drug reactions in two groups had no significant difference (72.2% vs. 80.0%, P > 0.05). CONCLUSIONS: Artesunate can shorten the treatment time of COVID-19, improve prognosis and eliminate pathogens, with fewer adverse reactions and a good application prospect.


Traditional Chinese Herbal Medication for corona-virus 2019


title: Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19

text: Importance: Early identification of patients with novel corona virus disease 2019 (COVID-19) who may develop critical illness is of great importance and may aid in delivering proper treatment and optimizing use of resources. Objective: To develop and validate a clinical score at hospital admission for predicting which patients with COVID-19 will develop critical illness based on a nationwide cohort in China. Design, Setting, and Participants: Collaborating with the National Health Commission of China, we established a retrospective cohort of patients with COVID-19 from 575 hospitals in 31 provincial administrative regions as of January 31, 2020. Epidemiological, clinical, laboratory, and imaging variables ascertained at hospital admission were screened using Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression to construct a predictive risk score (COVID-GRAM). The score provides an estimate of the risk that a hospitalized patient with COVID-19 will develop critical illness. Accuracy of the score was measured by the area under the receiver operating characteristic curve (AUC). Data from 4 additional cohorts in China hospitalized with COVID-19 were used to validate the score. Data were analyzed between February 20, 2020 and March 17, 2020. Main Outcomes and Measures: Among patients with COVID-19 admitted to the hospital, critical illness was defined as the composite measure of admission to the intensive care unit, invasive ventilation, or death. Results: The development cohort included 1590 patients. the mean (SD) age of patients in the cohort was 48.9 (15.7) years; 904 (57.3%) were men. The validation cohort included 710 patients with a mean (SD) age of 48.2 (15.2) years, and 382 (53.8%) were men and 172 (24.2%). From 72 potential predictors, 10 variables were independent predictive factors and were included in the risk score: chest radiographic abnormality (OR, 3.39; 95% CI, 2.14-5.38), age (OR, 1.03; 95% CI, 1.01-1.05), hemoptysis (OR, 4.53; 95% CI, 1.36-15.15), dyspnea (OR, 1.88; 95% CI, 1.18-3.01), unconsciousness (OR, 4.71; 95% CI, 1.39-15.98), number of comorbidities (OR, 1.60; 95% CI, 1.27-2.00), cancer history (OR, 4.07; 95% CI, 1.23-13.43), neutrophil-to-lymphocyte ratio (OR, 1.06; 95% CI, 1.02-1.10), lactate dehydrogenase (OR, 1.002; 95% CI, 1.001-1.004) and direct bilirubin (OR, 1.15; 95% CI, 1.06-1.24). The mean AUC in the development cohort was 0.88 (95% CI, 0.85-0.91) and the AUC in the validation cohort was 0.88 (95% CI, 0.84-0.93). The score has been translated into an online risk calculator that is freely available to the public (http://118.126.104.170/). Conclusions and Relevance: In this study, a risk score based on characteristics of COVID-19 patients at the time of admission to the hospital was developed that may help predict a patient's risk of developing critical illness.


title: Prolonged Persistence of SARS-CoV-2 RNA in Body Fluids

text: We prospectively assessed 49 coronavirus disease cases in Guangdong, China, to estimate the frequency and duration of detectable severe acute respiratory syndrome coronavirus 2 RNA in human body fluids. The prolonged persistence of virus RNA in various body fluids may guide the clinical diagnosis and prevention of onward virus transmission.


title: AI Augmentation of Radiologist Performance in Distinguishing COVID-19 from Pneumonia of Other Etiology on Chest CT

text: Background COVID-19 and pneumonia of other etiology share similar CT characteristics, contributing to the challenges in differentiating them with high accuracy. Purpose To establish and evaluate an artificial intelligence (AI) system in differentiating COVID-19 and other pneumonia on chest CT and assess radiologist performance without and with AI assistance. Methods 521 patients with positive RT-PCR for COVID-19 and abnormal chest CT findings were retrospectively identified from ten hospitals from January 2020 to April 2020. 665 patients with non-COVID-19 pneumonia and definite evidence of pneumonia on chest CT were retrospectively selected from three hospitals between 2017 and 2019. To classify COVID-19 versus other pneumonia for each patient, abnormal CT slices were input into the EfficientNet B4 deep neural network architecture after lung segmentation, followed by two-layer fully-connected neural network to pool slices together. Our final cohort of 1,186 patients (132,583 CT slices) was divided into training, validation and test sets in a 7:2:1 and equal ratio. Independent testing was performed by evaluating model performance on separate hospitals. Studies were blindly reviewed by six radiologists without and then with AI assistance. Results Our final model achieved a test accuracy of 96% (95% CI: 90-98%), sensitivity 95% (95% CI: 83-100%) and specificity of 96% (95% CI: 88-99%) with Receiver Operating Characteristic (ROC) AUC of 0.95 and Precision-Recall (PR) AUC of 0.90. On independent testing, our model achieved an accuracy of 87% (95% CI: 82-90%), sensitivity of 89% (95% CI: 81-94%) and specificity of 86% (95% CI: 80-90%) with ROC AUC of 0.90 and PR AUC of 0.87. Assisted by the models' probabilities, the radiologists achieved a higher average test accuracy (90% vs. 85%, Δ=5, p<0.001), sensitivity (88% vs. 79%, Δ=9, p<0.001) and specificity (91% vs. 88%, Δ=3, p=0.001). Conclusion AI assistance improved radiologists' performance in distinguishing COVID-19 from non-COVID-19 pneumonia on chest CT.


A distinct name is needed for the new coronavirus


title: An algorithmic approach to diagnosis and treatment of coronavirus disease 2019 (COVID-19) in children: Iranian expert’s consensus statement

text: After the outbreak of 2019 novel corona virus infection in China, we have the outbreak of disease in Iran and until March 05, 2020 have been reported a total number of confirmed cases more than 3500 and approximately 3 3% deaths The corona virus disease 2019 (COVID-19) infection as a newly emerging disease in East Asia has caused a great challenge in managing the patients and controlling the disease especially in children This algorithm is based on the standard diagnosis and treatment strategies for pediatric viral infections and available strategies to prevention of COVID-19 infection It is hoped that with international co-operation, this global dilemma will end with the least burden of disease Due to the lack of scientific evidences in children, this algorithm is essential for decision making


title: Methodology for Modelling the new COVID-19 Pandemic Spread and Implementation to European Countries

text: After the breakout of the disease caused by the new virus COVID-19, the mitigation stage has been reached in most of the countries in the world. During this stage, a more accurate data analysis of the daily reported cases and other parameters became possible for the European countries and has been performed in this work. Based on a proposed parametrization model appropriate for implementation to an epidemic in a large population, we focused on the disease spread and we studied the obtained curves, as well as, we investigated probable correlations between the country's characteristics and the parameters of the parametrization. We have also developed a methodology for coupling our model to the SIR-based models determining the basic and the effective reproductive number referring to the parameter space. The obtained results and conclusions could be useful in the case of a recurrence of this repulsive disease in the future.


title: Polyps of the jellyfish Aurelia aurita are unaffected by chronic exposure to a combination of pesticides

text: Pesticides are a major contaminant in coastal waters and can cause adverse effects in marine invertebrates such as jellyfish. Most studies have investigated short-term responses of organisms to unrealistically high concentrations of pesticides; however, chronic exposure to persistent low concentrations, which are more likely to occur in the environment, are rarely analyzed. Here, we tested the response of polyps of the Moon jellyfish Aurelia aurita, to environmental concentrations of the herbicide atrazine and the insecticide chlorpyrifos, individually and in combination, over nine weeks. We hypothesized that exposure to individual pesticides would reduce rates of asexual reproduction and alter polyps' metabolite profiles, and that the results would be more severe when polyps were exposed to the combined pesticides. Polyps survived and reproduced (through budding) in all treatments and no differences among treatments were observed. Proton nuclear magnetic resonance (1 H NMR) spectroscopy revealed no difference in profiles of polar metabolites of polyps exposed to the individual or combined pesticides. Our results suggest that A. aurita polyps are unaffected by chronic exposure to atrazine and chlorpyrifos at concentrations recommended as being protective by current Australian water quality guidelines. This article is protected by copyright. All rights reserved.


title: Functional Compounds From Olive Pomace to Obtain High-Added Value Foods - A Review

text: Olive pomace, the solid by-product from virgin olive oil extraction, constitutes a remarkable source of functional compounds and has been exploited by several authors to formulate high-added value foods and, consequently, to foster the sustainability of the olive-oil chain. In this framework, the aim of the present review was to summarize the results on the application of functional compounds from olive pomace in food products. Phenolics-rich extracts from olive pomace were added to vegetable oils, fish burgers, fermented milk and in the edible coating of fruit, in order to take advantage of their antioxidant and antimicrobial activities. Moreover, olive pomace was directly used in the formulation of pasta and baked goods, by exploiting polyunsaturated fatty acids, phenolic compounds and dietary fiber to obtain high-value added healthy foods and/or to extend their shelf-life. With the same scope, olive pomace was also added to animal feeds obtaining healthy-improved animal products. Furthermore, different authors used olive pomace to produce biodegradable materials and/or active packaging able to increase the content of bioactive compounds and the oxidative stability of foods. Overall, the results highlighted in most cases the effectiveness of the addition of olive pomace-derived functional compounds in improving the nutritional value, the quality and/or the shelf-life of foods. However, more challenging was found to be the direct addition of olive pomace, especially due to alterations of sensory and textural features of food. This article is protected by copyright. All rights reserved.


More clinical warning indicators should be explored for monitoring COVID-19 patients' condition


Diagnostic testing for gestational diabetes mellitus during the COVID-19 pandemic: an opportunity to revisit Glucose-Based testing


title: [Logical Explanation of Medical Condition for Patients with Terminal Cancer at Home-Retrospective Analysis of 145 Cases]

text: Frequently, patients with advanced cancer are suffered by various symptoms at the end of life. Furthermore, sometime experience unexpected loss of consciousness(LOC)and/or respiratory arrest. I examined carefully following neck stiffness, LOC, masked face, urinary retention, tonic and/or clonic convulsions, apnea, dysphagia, head rotation, neurogenic pain, hyperthermia, mydriasis 145 patients with advanced cancer. By assuming meningeal carcinomatosis, multifocal neurological findings are logically expected. As a result, before the LOC or respiratory arrest, I was able to logically explain to almost all families of patients, who with suspected neurological signs, expected multifocal neurological signs including LOC or respiratory arrest.


D-dimer Triage for COVID-19


title: Digital Health Strategies to Fight COVID-19 Worldwide: Challenges, Recommendations, and a Call for Papers

text: The coronavirus disease (COVID-19) pandemic has created an urgent need for coordinated mechanisms to respond to the outbreak across health sectors, and digital health solutions have been identified as promising approaches to address this challenge. This editorial discusses the current situation regarding digital health solutions to fight COVID-19 as well as the challenges and ethical hurdles to broad and long-term implementation of these solutions. To decrease the risk of infection, telemedicine has been used as a successful health care model in both emergency and primary care. Official communication plans should promote facile and diverse channels to inform people about the pandemic and to avoid rumors and reduce threats to public health. Social media platforms such as Twitter and Google Trends analyses are highly beneficial to model pandemic trends as well as to monitor the evolution of patients' symptoms or public reaction to the pandemic over time. However, acceptability of digital solutions may face challenges due to potential conflicts with users' cultural, moral, and religious backgrounds. Digital tools can provide collective public health benefits; however, they may be intrusive and can erode individual freedoms or leave vulnerable populations behind. The COVID-19 pandemic has demonstrated the strong potential of various digital health solutions that have been tested during the crisis. More concerted measures should be implemented to ensure that future digital health initiatives will have a greater impact on the epidemic and meet the most strategic needs to ease the life of people who are at the forefront of the crisis.


title: Simulation of the COVID-19 pandemic on the social network of Slovenia: estimating the intrinsic forecast uncertainty

text: In the article a virus transmission model is constructed on a simplified social network. The social network consists of more than 2 million nodes, each representing an inhabitant of Slovenia. The nodes are organised and interconnected according to the real household and elderly-care center distribution, while their connections outside these clusters are semi-randomly distributed and fully-linked. The virus spread model is coupled to the disease progression model. The ensemble approach with the perturbed transmission and disease parameters is used to quantify the ensemble spread, a proxy for the forecast uncertainty. The presented ongoing forecasts of COVID-19 epidemic in Slovenia are compared with the collected Slovenian data. Results show that infection is currently twice more likely to transmit within households/elderly care centers than outside them. We use an ensemble of simulations (N = 1000) to inversely obtain posterior distributions of model parameters and to estimate the COVID-19 forecast uncertainty. We found that in the uncontrolled epidemic, the intrinsic uncertainty mostly originates from the uncertainty of the virus biology, i.e. its reproductive number. In the controlled epidemic with low ratio of infected population, the randomness of the social network becomes the major source of forecast uncertainty, particularly for the short-range forecasts. Social-network-based models are thus essential for improving epidemics forecasting.


title: Venous thrombosis and arteriosclerosis obliterans of lower extremities in a very severe patient with 2019 novel coronavirus disease: a case report

text: The outbreak of 2019 novel coronavirus disease (COVID-19) began since early December 2019, and has been declared as a public health emergency by the World Health Organization. Due to the hypercoagulable state, blood stasis and endothelial injury, severe patients with COVID-19 are at high risk for thrombosis. We report a case of very severe COVID-19 complicated with venous thrombosis and arteriosclerosis obliterans of lower extremities. Risk stratification for deep vein thrombosis and peripheral arterial disease are of vital importance for the prognosis of COVID-19.


title: Leveraging parent-child interaction therapy and telehealth capacities to address the unique needs of young children during the COVID-19 public health crisis

text: COVID-19 and related efforts to mitigate its spread have dramatically transformed the structure and predictability of modern childhood, resulting in growing concerns children may be particularly vulnerable to serious mental health consequences. Worldwide stay-at-home directives and emergency changes in healthcare policy and reimbursement have smoothed the trail for broad implementation of technology-based remote mental health services for children. Parent-Child Interaction Therapy (PCIT) is particularly well-positioned to address some of the most pressing child and parental needs that arise during stressful times, and telehealth formats of PCIT, such as Internet-delivered PCIT (iPCIT), have already been supported in controlled trials. This commentary explores PCIT implementation during the COVID-19 public health crisis and the challenges encountered in the move toward Internet-delivered services. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


COVID-19 patients may suffer from proximally displaced endotracheal tubes misdiagnosed as cuff leaks


title: Evaluation of Nutritional Risk and its Association With Mortality Risk in Severe and Critically Ill COVID-19 Patients

text: BACKGROUND: The nutritional status of COVID-19 patients is unknown. This study evaluates the clinical and nutritional characteristics of severe and critically ill patients infected with SARS-CoV-2, and investigates the relationship between nutritional risk and clinical outcomes. METHODS: A retrospective, observational study was conducted at West Campus of Union Hospital in Wuhan. Patients confirmed with SARS-CoV-2 infection by a nucleic acid-positive test and identified as severe or critically ill, were enrolled in this study. Clinical data and outcomes information was collected and nutritional risk was assessed by using Nutritional Risk Screening 2002 (NRS). RESULTS: Totally, 413 patients were enrolled in this study, including 346 severe patients and 67 critically ill patients. Most patients, especially critically ill patients, had significant changes in nutrition-related parameters and inflammatory markers. As for nutritional risk, the critically ill patients had significantly higher proportion of high NRS scores (P<0.001), which were correlated with inflammatory and nutrition-related markers. Among 342 patients with NRS score ≥3, only 84 (25%) received nutritional support. The critically ill patients and the patients with higher NRS score had a higher risk of mortality and longer stay in hospital. In logistic regression models, one unit increased in NRS score was associated with the risk of mortality increased by 1.23 times (adjusted OR = 2.23, 95% CI: 1.10, 4.51, P = 0.026). CONCLUSIONS: Most severe and critically ill patients infected with SARS-CoV-2 are at nutritional risk. The patients with higher nutrition risk have worse outcome, and require nutritional therapy. This article is protected by copyright. All rights reserved.


title: Establishing prison-led contact tracing to prevent outbreaks of COVID-19 in prisons in Ireland

text: BACKGROUND: Preventing transmission of COVID-19 within prisons is both important and challenging. The confined conditions in prisons can encourage person-to-person spread with the potential for outbreaks occurring. Contact tracing is an important contributor to the longer-term management strategy for COVID-19 in prisons as well as in the community but is highly resource-intensive. This paper describes the approach to contact tracing taken by the Irish Prison Service (IPS). METHODS: The IPS National Infection Control Team, in collaboration with the National Quality Improvement (QI) team and Health Service Executive (HSE) in Ireland, implemented a programme to develop and train in-prison contact tracing teams (CTTs). CTTs were run by prison staff with experience of working with detainees, prison IT systems and CCTV. Protocols for undertaking contact tracing for both detainee and staff cases of COVID-19 were established. RESULTS: All prisons, and two support agencies, within the IPS now have fully functional in-prison CTTs. Every CTT has responded to at least one case COVID-19, undertaken contact tracing and instigated quarantine of contacts. CONCLUSIONS: A partnership approach with development of prison-led CTTs can provide an effective mechanism for contact tracing of COVID-19 cases within the prison setting.


20 Years Later: Continued Relevance of Cancer, Culture, and Literacy in Cancer Education for Social Justice and Health Equity


title: Prognostic Value of Right Ventricular Longitudinal Strain in Patients With COVID-19

text: OBJECTIVES: The aim of this study was to investigate whether right ventricular longitudinal strain (RVLS) was independently predictive of higher mortality in patients with coronavirus disease 2019 (COVID-19). BACKGROUND: RVLS obtained from 2-dimensional speckle-tracking echocardiography has been recently demonstrated to be a more accurate and sensitive tool to estimate right ventricular (RV) function. The prognostic value of RVLS in patients with COVID-19 remains unknown. METHODS: One hundred twenty consecutive patients with COVID-19 who underwent echocardiographic examinations were enrolled in our study. Conventional RV functional parameters, including RV fractional area change, tricuspid annular plane systolic excursion, and tricuspid tissue Doppler annular velocity, were obtained. RVLS was determined using 2-dimensional speckle-tracking echocardiography. RV function was categorized in tertiles of RVLS. RESULTS: Compared with patients in the highest RVLS tertile, those in the lowest tertile were more likely to have higher heart rate; elevated levels of D-dimer and C-reactive protein; more high-flow oxygen and invasive mechanical ventilation therapy; higher incidence of acute heart injury, acute respiratory distress syndrome, and deep vein thrombosis; and higher mortality. After a median follow-up period of 51 days, 18 patients died. Compared with survivors, nonsurvivors displayed enlarged right heart chambers, diminished RV function, and elevated pulmonary artery systolic pressure. Male sex, acute respiratory distress syndrome, RVLS, RV fractional area change, and tricuspid annular plane systolic excursion were significant univariate predictors of higher risk for mortality (p < 0.05 for all). A Cox model using RVLS (hazard ratio: 1.33; 95% confidence interval [CI]: 1.15 to 1.53; p < 0.001; Akaike information criterion = 129; C-index = 0.89) was found to predict higher mortality more accurately than a model with RV fractional area change (Akaike information criterion = 142, C-index = 0.84) and tricuspid annular plane systolic excursion (Akaike information criterion = 144, C-index = 0.83). The best cutoff value of RVLS for prediction of outcome was -23% (AUC: 0.87; p < 0.001; sensitivity, 94.4%; specificity, 64.7%). CONCLUSIONS: RVLS is a powerful predictor of higher mortality in patients with COVID-19. These results support the application of RVLS to identify higher risk patients with COVID-19.


Classification system and case definition for SARS-CoV-2 infection in pregnant women, fetuses, and neonates


title: COVID-19 Infection: Strategies on When to Discontinue Isolation, a retrospective study

text: OBJECTIVE: Add to available understanding of COVID-19 to help decrease further spread of SARS-CoV-2 by providing protocol providers can consider when giving patients recommendations to retest as well as length of time for self-isolation. METHODS: We retrospectively collected data from the electronic medical record of patients in the Mayo Clinic Florida's COVID Virtual Clinic. 118 patients with detectable results for the virus were followed. Data reviewed in this study included: 1) length of time from detectable to undetectable results; 2) length of time from onset of symptoms to undetectable result; 3) length of time from resolution of fever to undetectable result. RESULTS: 53% of studied patients eligible for discontinuation of self-isolation had detectable viral RNA and therefore underwent repeat testing. In these patients, the mean from the date of their first detectable result to attaining an undetectable result was 14.89 days. The mean time for onset of symptoms to undetectable testing was 21.5 days. CONCLUSION: 118 patients with detectable results for SARS-CoV-2 were followed in the Mayo Clinic Florida COVID Virtual Clinic; 53% of patients still showed detectable viral RNA despite meeting CDC guidelines for discontinuation of self-isolation, prompting us to propose following a more cautious guideline that other providers could consider as a strategy to discontinue self-isolation, including increasing length of days since symptom onset.


title: Existing bitter medicines for fighting 2019-nCoV-associated infectious diseases

text: The sudden outbreak of COVID-19 has led to more than seven thousand deaths. Unfortunately, there are no specific drugs available to cure this disease. Type 2 taste receptors (TAS2Rs) may play an important role in host defense mechanisms. Based on the idea of host-directed therapy (HDT), we performed a negative co-expression analysis using big data of 60 000 Affymetrix expression arrays and 5000 TCGA data sets to determine the functions of TAS2R10, which can be activated by numerous bitter substances. Excitingly, we found that the main functions of TAS2R10 involved controlling infectious diseases caused by bacteria, viruses, and parasites, suggesting that TAS2R10 is a key trigger of host defense pathways. To quickly guide the clinical treatment of 2019-nCoV, we searched currently available drugs that are agonists of TAS2Rs. We identified many cheap, available, and safe medicines, such as diphenidol, quinine, chloroquine, artemisinin, chlorpheniramine, yohimbine, and dextromethorphan, which may target the most common symptoms caused by 2019-nCoV. We suggest that a cocktail-like recipe of existing bitter drugs may help doctors to fight this catastrophic disease and that the general public may drink or eat bitter substances, such as coffee, tea, or bitter vegetables, to reduce the risk of infection.


Movement Disorder Society-Unified Parkinson's Disease Rating Scale Use in the Covid-19 Era


title: Public health measures to slow community spread of COVID-19 ;The Journal of Infectious Diseases ;Oxford Academic

text: COVID-19 was initially identified in an outbreak of viral pneumonia in Wuhan in December 2019, and has now been recognized in 77 countries with over 90,000 laboratory-confirmed cases and over 3,000 deaths as of 3 March 2020 [1] The epidemiology of COVID-19 has recently become clearer as incident cases continue to rise and researchers refine estimates of the severity, transmissibility, and populations affected Based on available data, COVID-19 is efficiently transmitted in the community, and the proportion of infections leading to severe illness is particularly high among adults ≥50 years of age and among individuals with comorbid health conditions Although rare, severe cases have also been reported among younger individuals Thus far, the estimated basic reproductive number (R0) of COVID-19 is higher than that of influenza [2], as is the case fatality risk for adults and older individuals An estimated 80% of COVID-19 cases are mild [1] This is not a glass half full statistic, as 20% of infections result in clinically severe cases that have the potential to overwhelm already overburdened health facilities Given the lack of vaccines and effective antivirals, nonpharmaceutical interventions (NPIs) are the most effective available interventions for local and global control and mitigation of COVID-19 To date, measures aimed at slowing introduction of infection globally have included travel restrictions, isolation of confirmed cases, and quarantine of exposed persons In the United States, NPIs have reduced the number of infected persons entering the country, but recent outbreaks in multiple US states make it clear that these measures have delayed but not prevented community transmission In 2009, NPIs were able to delay large epidemic waves of pandemic influenza A(H1N1)pdm09 in some locations until after the summer, since influenza transmission tends to be reduced by higher temperatures and humidity It is unclear whether COVID-19 transmission will be heavily affected by seasonal weather variation, given that transmission is now occurring in multiple tropical and sub-tropical locations


title: Tests of general relativity using multiband observations of intermediate mass binary black hole mergers

text: Observation of gravitational waves (GWs) in two different frequency bands is referred to as {\it multiband GW astronomy}. With the planned Laser Interferometric Space Antenna (LISA) operating in the $10^{-4}-0.1$ Hz range, and third generation (3G) ground-based detectors such as the Cosmic Explorer (CE) and Einstein Telescope (ET), operating in the $1$--$10^4$ Hz range, multiband GW astronomy could be a reality in about a decade. In this paper we present the potential of multiband observations of intermediate mass binary black holes (IMBBHs) of component masses ${\sim}10^2$--$10^3M_{\odot}$ to test general relativity (GR). We show that mutiband observations of IMBBHs would permit multiparameter tests of GR---tests where more than one post-Newtonian (PN) coefficient is simultaneously measured yielding more rigorous constraints on possible modifications to GR. We also find that the improvement due to multibanding can often be much larger than the best of the bounds from either of the two observatories. The origin of this result, as we shall demonstrate, can be traced to the lifting of degeneracies among the various parameters when the information from LISA and 3G are taken together. We obtain the best multiband bounds for an IMBBH with a total redshifted mass of $200M_{\odot}$ and a mass ratio of 2. For single-parameter tests, this system at 1 Gpc would allow us to constrain the deviations on all the PN coefficients to below 10\% and derive simultaneous bounds on the first seven PN coefficients to below 50\% (with low spins).


title: 2019 novel coronavirus of pneumonia in Wuhan, China: emerging attack and management strategies

text: An ongoing outbreak of 2019-nCoV pneumonia was first identified in Wuhan, Hubei province, China at the end of 2019. With the spread of the new coronavirus accelerating, person-to-person transmission in family homes or hospitals, and intercity spread of 2019-nCoV occurred. At least 40,261 cases confirmed, 23,589 cases suspected, 909 cases death and 3444 cases cured in China and worldwide 24 countries confirmed 383 cases being diagnosed, 1 case death in February 10th, 2020. At present, the mortality of 2019-nCoV in China is 2.3%, compared with 9.6% of SARS and 34.4% of MERS reported by WHO. It seems the new virus is not as fatal as many people thought. Chinese authorities improved surveillance network, made the laboratory be able to recognize the outbreak within a few weeks and announced the virus genome that provide efficient epidemiological control. More comprehensive information is required to understand 2019-nCoV feature, the epidemiology of origin and spreading, and the clinical phenomina. According to the current status, blocking transmission, isolation, protection, and alternative medication are the urgent management strategies against 2019-nCoV.


title: Storm, typhoon, cyclone or hurricane in patients with COVID-19? Beware of the same storm that has a different origin

text: Some of the articles being published during the severe acute respiratory syndrome-coronavirus (SARS-CoV)-2 pandemic highlight a link between severe forms of coronavirus disease 2019 (COVID-19) and the so-called cytokine storm, also with increased ferritin levels. However, this scenario is more complex than initially thought due to the heterogeneity of hyperinflammation. Some patients with coronavirus 2019 disease (COVID-19) develop a fully blown secondary haemophagocytic lymphohistiocytosis (sHLH), whereas others, despite a consistent release of pro-inflammatory cytokines, do not fulfil sHLH criteria but still show some features resembling the phenotype of the hyperferritinemic syndrome. Despite the final event (the cytokine storm) is shared by various conditions leading to sHLH, the aetiology, either infectious, autoimmune or neoplastic, accounts for the differences in the various phases of this process. Moreover, the evidence of a hyperinflammatory microenvironment provided the rationale to employ immunomodulating agents for therapeutic purposes in severe COVID-19. This viewpoint aims at discussing the pitfalls and issues to be considered with regard to the use of immunomodulating agents in COVID-19, such as timing of treatment based on the viral load and the extent of cytokine/ferritin overexpression. Furthermore, it encompasses recent findings in the paediatric field about a novel multisystem inflammatory disease resembling toxic shock syndrome and atypical Kawasaki disease observed in children with proven SARS-CoV2 infection. Finally, it includes arguments in favour of adding COVID-19 to the spectrum of the recently defined 'hyperferritinemic syndrome', which already includes adult-onset Still's disease, macrophage activation syndrome, septic shock and catastrophic anti-phospholipid syndrome.


title: Fabry disease during the COVID-19 pandemic. Why and how treatment should be continued

text: Fabry disease is an X-linked disease due to a deficiency of the lysosomal enzyme alpha-galactosidase A. Clinical symptoms in classically affected males include acroparesthesia, anhydrosis and angiokeratoma, which may present during childhood followed by cardiac, cerebral and renal complications. Even though pulmonary involvement is not widely appreciated by clinicians, an obstructive lung disease is another recognized component of Fabry disease. Coronavirus Disease-19 (COVID-19), caused by the SARS-CoV-2 virus was labeled as a global pandemic and patients with Fabry disease can be considered at high risk of developing severe complications. The impact of COVID-19 on patients with Fabry disease receiving enzyme replacement therapy is still unknown. Many patients who receive treatment in the hospital experienced infusion disruptions due to fear of infection. Effects of temporary treatment interruption was described in more detail in other lysosomal storage diseases, but the recommencement of therapy does not fully reverse clinical decline due to the temporary discontinuation. When possible, home-therapy seems to be the most efficient way to maintain enzyme replacement therapy access during pandemic. Sentence take-home message: Home-therapy, when possible, seems to be the most efficient way to maintain enzyme replacement therapy access during pandemic in patients with Fabry disease.


COVID-19 in hem/onc news


title: Precautions and Procedures for Coronary and Structural Cardiac Interventions During the COVID-19 Pandemic: Guidance from Canadian Association of Interventional Cardiology

text: The globe is currently in the midst of a COVID-19 pandemic, resulting in significant morbidity and mortality. This pandemic has placed considerable stress on health care resources and providers. This document from the Canadian Association of Interventional Cardiology- Association Canadienne de Cardiologie d'intervention, specifically addresses the implications for the care of patients in the cardiac catheterization laboratory (CCL) in Canada during the COVID-19 pandemic. The key principles of this document are to maintain essential interventional cardiovascular care while minimizing risks of COVID-19 to patients and staff and maintaining the overall health care resources. As the COVID-19 pandemic evolves, procedures will be increased or reduced based on the current level of restriction to health care services. Although some consistency across the country is desirable, provincial and regional considerations will influence how these recommendations are implemented. We believe the framework and recommendations in this document will provide crucial guidance for clinicians and policy makers on the management of coronary and structural procedures in the CCL as the COVID-19 pandemic escalates and eventually abates.


Audio Interview: Capitalizing on Immune Responses to Covid-19


title: α-glucosidase inhibitors as host-directed antiviral agents with potential for the treatment of COVID-19

text: The ongoing COVID-19 pandemic, caused by SARS-CoV-2, has pushed the health systems of many countries to breaking point and precipitated social distancing measures that have crippled economic activities across the globe. A return to normality is unlikely until effective therapeutics and a vaccine are available. The immediacy of this problem suggests that drug strategies should focus on repurposing approved drugs or late-stage clinical candidates, as these have the shortest path to use in the clinic. Here, we review and discuss the role of host cell N-glycosylation pathways to virus replication and the drugs available to disrupt these pathways. In particular, we make a case for evaluation of the well-tolerated drugs miglitol, celgosivir and especially miglustat for the treatment of COVID-19.


title: Containing COVID-19 Among 627,386 Persons in Contact With the Diamond Princess Cruise Ship Passengers Who Disembarked in Taiwan: Big Data Analytics

text: BACKGROUND: Low infection and case-fatality rates have been thus far observed in Taiwan. One of the reasons for this major success is better use of big data analytics in efficient contact tracing and management and surveillance of those who require quarantine and isolation. OBJECTIVE: We present here a unique application of big data analytics among Taiwanese people who had contact with more than 3000 passengers that disembarked at Keelung harbor in Taiwan for a 1-day tour on January 31, 2020, 5 days before the outbreak of coronavirus disease (COVID-19) on the Diamond Princess cruise ship on February 5, 2020, after an index case was identified on January 20, 2020. METHODS: The smart contact tracing-based mobile sensor data, cross-validated by other big sensor surveillance data, were analyzed by the mobile geopositioning method and rapid analysis to identify 627,386 potential contact-persons. Information on self-monitoring and self-quarantine was provided via SMS, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were offered for symptomatic contacts. National Health Insurance claims big data were linked, to follow-up on the outcome related to COVID-19 among those who were hospitalized due to pneumonia and advised to undergo screening for SARS-CoV-2. RESULTS: As of February 29, a total of 67 contacts who were tested by reverse transcription-polymerase chain reaction were all negative and no confirmed COVID-19 cases were found. Less cases of respiratory syndrome and pneumonia were found after the follow-up of the contact population compared with the general population until March 10, 2020. CONCLUSIONS: Big data analytics with smart contact tracing, automated alert messaging for self-restriction, and follow-up of the outcome related to COVID-19 using health insurance data could curtail the resources required for conventional epidemiological contact tracing.


title: Weather-inspired ensemble-based probabilistic prediction of COVID-19

text: The objective of this work is to predict the spread of COVID-19 starting from observed data, using a forecast method inspired by probabilistic weather prediction systems operational today. Results show that this method works well for China: on day 25 we could have predicted well the outcome for the next 35 days. The same method has been applied to Italy and South Korea, and forecasts for the forthcoming weeks are included in this work. For Italy, forecasts based on data collected up to today (24 March) indicate that number of observed cases could grow from the current value of 69,176, to between 101k-180k, with a 50% probability of being between 110k-135k. For South Korea, it suggests that the number of observed cases could grow from the current value of 9,018 (as of the 23rd of March), to values between 8,500 and 9,300, with a 50% probability of being between 8,700 and 8,900. We conclude by suggesting that probabilistic disease prediction systems are possible and could be developed following key ideas and methods from weather forecasting. Having access to skilful daily updated forecasts could help taking better informed decisions on how to manage the spread of diseases such as COVID-19.


title: On being human in the face of a pandemic

text: As the COVID-19 pandemic sweeps through the world, we must reassess the principles that guide our individual and collective responses and the way we operate in society. In the face of crisis, we must lead with science and humanity.


Attacks against health-care personnel must stop, especially as the world fights COVID-19


title: [Recommendations for treatment of severe coronavirus disease 2019 based on critical care ultrasound]

text: Severe patients with COVID-19 are characterized by persistent lung damage, causing respiratory failure, secondary circulatory changes and multiple organ dysfunction after virus invasion. Because of its dynamic, real-time, non-invasive, repeatable and other advantages, critical ultrasonography can be widely used in the diagnosis, assessment and guidance of treatment for severe patients. Based on the recommendations of critical care experts from all over the country who fight against the epidemic in Wuhan, this article summarizes the guidelines for the treatment of COVID-19 based on critical ultrasonography, hoping to provide help for the treatment of severe patients. The recommendations mainly cover the following aspects: (1) lung ultrasound in patients with COVID-19 is mainly manifested by thickened and irregular pleural lines, different types of B-lines, shred signs, and other consolidation like dynamic air bronchogram; (2) Echocardiography may show right heart dysfunction, diffuse cardiac function enhancement, stress cardiomyopathy, diffuse cardiac depression and other multiple abnormalities; (3) Critical ultrasonography helps with initiating early treatment in the suspect patient, screening confirmed patients after intensive care unit admission, early assessment of sudden critical events, rapid grading assessment and treatment based on it; (4) Critical ultrasonography helps to quickly screen for the etiology of respiratory failure in patients with COVID-19, make oxygen therapeutic strategy, guide the implementation of lung protective ventilation, graded management and precise off-ventilator; (5) Critical ultrasonography is helpful for assessing the circulatory status of patients with COVID-19, finding chronic cardiopulmonary diseases and guiding extracorporeal membrane oxygenation management; (6) Critical ultrasonography Contributes to the management of organs besides based on cardiopulmonary oxygen transport; (7) Critical ultrasonography can help to improve the success of operation; (8) Critical ultrasonography can help to improve the safety and quality of nursing; (9) When performing critical ultrasonography for patients with COVID-19, it needs to implement three-level protection standard, pay attention to disinfect the machine and strictly obey the rules from nosocomial infection. (10) Telemedicine and artificial intelligence centered on critical ultrasonography may help to improve the efficiency of treatment for the patients with COVID-19.In the face of the global spread of the epidemic, all we can do is to share experience, build a defense line, We hope this recommendations can help COVID-19patients therapy.


Multigroup, Adaptively Randomized Trials Are Advantageous for Comparing Coronavirus Disease 2019 (COVID-19) Interventions


title: Management of COVID-19 Response in a Secure Forensic Mental Health Setting

text: OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic presents major challenges to places of detention, including secure forensic hospitals. International guidance presents a range of approaches to assist in decreasing the risk of COVID-19 outbreaks as well as responses to manage outbreaks of infection should they occur. METHODS: We conducted a literature search on pandemic or outbreak management in forensic mental health settings, including gray literature sources, from 2000 to April 2020. We describe the evolution of a COVID-19 outbreak in our own facility, and the design, and staffing of a forensic isolation unit. RESULTS: We found a range of useful guidance but no published experience of implementing these approaches. We experienced outbreaks of COVID-19 on two secure forensic units with 13 patients and 10 staff becoming positive. One patient died. The outbreaks lasted for 41 days on each unit from declaration to resolution. We describe the approaches taken to reduction of infection risk, social distancing and changes to the care delivery model. CONCLUSIONS: Forensic secure settings present major challenges as some proposals for pandemic management such as decarceration or early release are not possible, and facilities may present challenges to achieve sustained social distancing. Assertive testing, cohorting, and isolation units are appropriate responses to these challenges.


Merkmale der COVID-19-Pandemie und der Folgen für die öffentliche Gesundheit./ Characteristics of COVID-19 pandemic and public health consequences


Smoking pack years calculator


title: Potential of live pathogen vaccines for defeating the COVID-19 pandemic: History and mechanism

text: The whole world has entered a terrible crisis with a huge and increasing number of human deaths and economic losses in fighting the pandemic of COVID-19 caused by the novel coronavirus termed SARS-CoV-2. The live pathogen vaccine (LPV) strategy, which originated in ancient China for fighting smallpox, has been applied successfully by US military recruits for decades to control acute respiratory diseases caused by types 4 and 7 adenoviruses. This strategy has also been widely employed in veterinary medicine. These facts suggest a fast way out of the current pandemic crisis, namely that SARS-CoV-2 could be directly used as a live vaccine. Beyond the two traditional mechanisms to guarantee the LPV's safety (the LPV seed strain is properly selected; the LPV is inoculated bypassing the respiratory sites of pathology), three novel mechanisms to further ensure the LPV's safety are available (the virus replication is inhibited with early use of an antiviral drug; symptomatic LPV recipients are cured with convalescent plasma; the LPV is inoculated in the hot season). This LPV strategy has multiple potential advantages over other options and could reduce morbidity and mortality greatly as well as the economic loss caused by the pandemic. The safety and efficacy of this strategy should be investigated strictly using animal experiments and clinical trials, and even if the experiments and trials all support the strategy, it should be implemented with enough caution.


Donning and doffing of personal protective equipment (PPE) for angiography during the COVID-19 crisis


How to train the health personnel for protecting themselves from novel coronavirus (COVID-19) infection during their patient or suspected case care


title: Azithromycin and COVID-19: Prompt early use at first signs of this infection in adults and children, an approach worthy of consideration

text: The devastating effects of the coronavirus designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have led to urgent attempts to find effective therapeutic agents for inpatient and outpatient treatment of COVID-19. Initial enthusiasm for the combination of hydroxychloroquine and azithromycin has abated. However, as a result of positive clinical experience with azithromycin used alone during the first few days of the flu-like illness caused by this coronavirus, we recommend formal clinical trials using azithromycin early in the course of a COVID-19 infection. There is one clinical trial initiated, the individually randomized, telemedicine-based, "Azithromycin for COVID-19 Treatment in Outpatients Nationwide" based at the University of California San Francisco. This placebo-controlled trial is designed to determine the efficacy of a single 1.2-g dose of oral azithromycin to prevent COVID-19 patient progression to hospitalization. We recommend formal clinical trials of azithromycin in its prepackaged form at the first sign of COVID-19 infection in adults and children, using an initial adult dose of 500 mg followed by 250 mg per day for 4 days, a total cumulative dose of 1.5 g, and for children 5 to 18 years of age, 10 mg/kg on the first day followed by 5 mg/kg for 4 days.


title: Recommendations on management of gynecological malignancies during the COVID-19 pandemic: perspectives from Chinese gynecological oncologists

text: The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.


title: Identification of Falsified Chloroquine Tablets in Africa at the Time of the COVID-19 Pandemic

text: Reports that chloroquine and hydroxychloroquine may be effective against COVID-19 have received worldwide attention, increasing the risk of the introduction of falsified versions of these medicines. Five different types of falsified chloroquine tablets were discovered between March 31, 2020 and April 4, 2020, in Cameroon and the Democratic Republic of Congo by locally conducted thin layer chromatographic analysis. Subsequent investigation by liquid chromatography and mass spectrometry in Germany proved the absence of detectable amounts of chloroquine and the presence of undeclared active pharmaceutical ingredients, that is, paracetamol and metronidazole, in four of the samples. The fifth sample contained chloroquine, but only 22% of the declared amount. Such products represent a serious risk to patients. Their occurrence exemplifies that once medicines or vaccines against COVID-19 may be developed, falsified products will enter the market immediately, especially in low- and middle-income countries (LMICs). Timely preparations for the detection of such products are required, including the establishment of appropriate screening technologies in LMICs.


Conception and deployment of a 30-bed field military intensive care hospital in Eastern France during the 2020 COVID-19 pandemic


Diabetic retinopathy screening during the coronavirus disease 2019 pandemic


title: Characteristics and Outcomes of 241 Births to Women With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection at Five New York City Medical Centers

text: OBJECTIVE: To describe the characteristics and birth outcomes of women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as community spread in New York City was detected in March 2020. METHODS: We performed a prospective cohort study of pregnant women with laboratory-confirmed SARS-CoV-2 infection who gave birth from March 13 to April 12, 2020, identified at five New York City medical centers. Demographic and clinical data from delivery hospitalization records were collected, and follow-up was completed on April 20, 2020. RESULTS: Among this cohort (241 women), using evolving criteria for testing, 61.4% of women were asymptomatic for coronavirus disease 2019 (COVID-19) at the time of admission. Throughout the delivery hospitalization, 26.5% of women met World Health Organization criteria for mild COVID-19, 26.1% for severe, and 5% for critical. Cesarean birth was the mode of delivery for 52.4% of women with severe and 91.7% with critical COVID-19. The singleton preterm birth rate was 14.6%. Admission to the intensive care unit was reported for 17 women (7.1%), and nine (3.7%) were intubated during their delivery hospitalization. There were no maternal deaths. Body mass index (BMI) 30 or higher was associated with COVID-19 severity (P=.001). Nearly all newborns tested negative for SARS-CoV-2 infection immediately after birth (97.5%). CONCLUSION: During the first month of the SARS-CoV-2 outbreak in New York City and with evolving testing criteria, most women with laboratory-confirmed infection admitted for delivery did not have symptoms of COVID-19. Almost one third of women who were asymptomatic on admission became symptomatic during their delivery hospitalization. Obesity was associated with COVID-19 severity. Disease severity was associated with higher rates of cesarean and preterm birth.


title: Riboflavin-overproducing lactobacilli for the enrichment of fermented soymilk: insights into improved nutritional and functional attributes

text: The influence of riboflavin (B2)-overproducing lactobacilli on the antioxidant status, isoflavone conversion, off-flavor reduction, amino acid profile, and viscosity of B2-bio-enriched fermented soymilk was investigated. Results showed that B2 in fermented soymilk was notably increased from 0.2 to 3.8 µg/mL for Lactobacillus fermentum UFG169 and to 1.9 µg/mL for Lactobacillus plantarum UFG10. The apparent viscosity significantly changed with rising acidity and agglutination of protein. The off-flavor volatile substances (hexanal and nonanal) were significantly reduced in fermented soymilk. Furthermore, a large amount of glucoside form isoflavones was deglycosylated into bioactive aglycones after 4 h up to 32 h. B2 content and isoflavones significantly improved the antioxidant status of soymilk. Partial least squares regression analysis correlated the strain activity and fermentation time with the improved nutritional and functional soymilk qualities. This study demonstrated the strategy for strain development for B2-bio-enriched fermentation to extend the health-promoting benefits of soymilk and soy-related foods. KEY POINTS: â¢ B 2 -enriched fermentation enhanced the nutrition and functional status of soymilk. â¢ Fermentation time significantly affected the apparent viscosity of fermented soymilk. â¢ Off-flavor volatile substances were significantly reduced or even diminished. â¢ Increased B 2 and bioactive isoflavones contributed to improved antioxidant potential.


title: Review of Hygiene and Disinfection Recommendations for Outpatient Glaucoma Care: A COVID Era Update

text: This review focuses on best practices and recommendations for hygiene and disinfection to limit exposure and transmission of infection in outpatient glaucoma clinics during the current COVID-19 pandemic.


COVID-19 Pandemic on Canadian Radiology Residency Education-Impact and Solutions: University of Toronto Perspective


Interleukin-17: A potential therapeutic target in COVID-19


A call for more utilization of laser dentistry at the time of coronavirus pandemic


title: A call for more utilization of laser dentistry at time of coronavirus pandemic

text: Since the eruption of coronavirus pandemic the face of the world has dramatically changed. Sadly, the impact of this health crisis on human beings and the world at large has been massive. To date, the world is struggling to find a cure/vaccination to this deadly virus. Globally, protection procedures to avoid infection with coronavirus have become the slogan of this era of time.


title: Novel coronavirus disease 2019: predicting prognosis by using a computed tomography severity score and clinicolaboratory data

text: INTRODUCTION: Currently there are known contributing factors but no comprehensive methods for predicting the risk of mortality or ICU admission in patients with Novel Corona Virus infection (COVID-19). OBJECTIVES: The aim of this study is to explore risk factors of mortality and ICU admission in COVID-19 patients using combined CT and clinicolaboratory data. PATIENTS AND METHODS: Patients with polymerase chain reaction (PCR) confirmed COVID-19 (N= 63) from University Hospitals in Tehran, Iran were studied. All patients underwent CT examination and a total CT score and the number of involved lung lobes were calculated and compared against collected laboratory and clinical information. Univariable and multivariate proportional hazards analysis were used to determine the relationship between the CT, laboratory and clinical data and ICU admission and in-hospital death. RESULTS: By univariable analysis, in-hospital mortality was higher in patients with lower O2 saturation on admission (<88%), higher CT scores and higher number of lung lobes (> 4) involved with a diffuse parenchymal pattern. By multivariable analysis, in-hospital mortality was higher in patients with O2 saturation below 88% on admission and a higher number of lung lobes involved with diffuse parenchymal pattern. The risk of ICU admission was higher with comorbidities (hypertension and ischemic heart disease), SaO2 below 88% and pericardial effusion. CONCLUSIONS: We can identify factors affecting in-hospital death and ICU admission in COVID-19. This can help to determine which patients are likely to require ICU admission and to help inform strategic health care planning in critical conditions such as the COVID-19 pandemic.


Corona and clergy - The missing link for effective social distancing in Pakistan: Time for some unpopular decisions


VI-RADS Scoring Criteria for Alternative Risk-adapted Strategies in the Management of Bladder Cancer During the COVID-19 Pandemic


title: Balancing the Covid-19-motivated vascular access guidelines and patient-centred care of pre-dialysis candidates

text: The recommendations recently proposed by the European and American Vascular Societies in this new 'Covid-19' era regarding the triage of various vascular operations into urgent, emergent and programmed based on the nature of their pathology aim at reserving health care expenses and hospital staff towards managing the current unexpected worldwide pandemic to the highest possible degree. The suggestion for implementation of these changes into real-world practice, however, does not come without a cost. In particular, the recommendation for deferral of access creation in pre-dialysis patients, ethical, socio-economic and medico-legal issues arise which should be seriously taken into consideration. At the end of the day, vascular access creation is the lifeline of haemodialysis patients and the indication for surgery warrants patient-specific clinical judgement rather than 'group labelling'.


title: Defining trauma and a trauma-informed COVID-19 response

text: The ubiquitous exposure to COVID-19 argues for governments to use a trauma-informed response as a universal precaution, with the goal of promoting the recovery and resilience of their residents. How a system defines trauma will drive its administrative policies, research, and clinical services. The Substance Abuse and Mental Health Services Administration's Concept of Trauma and Guidance for a Trauma-Informed Approach offers governments a framework to define trauma and incorporate trauma-informed principles and tasks into their COVID-19 responses. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Global Consortium Study of Neurological Dysfunction in COVID-19 (GCS-NeuroCOVID): Study Design and Rationale

text: BACKGROUND: As the COVID-19 pandemic developed, reports of neurological dysfunctions spanning the central and peripheral nervous systems have emerged. The spectrum of acute neurological dysfunctions may implicate direct viral invasion, para-infectious complications, neurological manifestations of systemic diseases, or co-incident neurological dysfunction in the context of high SARS-CoV-2 prevalence. A rapid and pragmatic approach to understanding the prevalence, phenotypes, pathophysiology and prognostic implications of COVID-19 neurological syndromes is urgently needed. METHODS: The Global Consortium to Study Neurological dysfunction in COVID-19 (GCS-NeuroCOVID), endorsed by the Neurocritical Care Society (NCS), was rapidly established to address this need in a tiered approach. Tier-1 consists of focused, pragmatic, low-cost, observational common data element (CDE) collection, which can be launched immediately at many sites in the first phase of this pandemic and is designed for expedited ethical board review with waiver-of-consent. Tier 2 consists of prospective functional and cognitive outcomes assessments with more detailed clinical, laboratory and radiographic data collection that would require informed consent. Tier 3 overlays Tiers 1 and 2 with experimental molecular, electrophysiology, pathology and imaging studies with longitudinal outcomes assessment and would require centers with specific resources. A multicenter pediatrics core has developed and launched a parallel study focusing on patients ages <18 years. Study sites are eligible for participation if they provide clinical care to COVID-19 patients and are able to conduct patient-oriented research under approval of an internal or global ethics committee. Hospitalized pediatric and adult patients with SARS-CoV-2 and with acute neurological signs or symptoms are eligible to participate. The primary study outcome is the overall prevalence of neurological complications among hospitalized COVID-19 patients, which will be calculated by pooled estimates of each neurological finding divided by the average census of COVID-19 positive patients over the study period. Secondary outcomes include: in-hospital, 30 and 90-day morality, discharge modified Rankin score, ventilator-free survival, ventilator days, discharge disposition, and hospital length of stay. RESULTS: In a one-month period (3/27/20-4/27/20) the GCS-NeuroCOVID consortium was able to recruit 71 adult study sites, representing 17 countries and 5 continents and 34 pediatrics study sites. CONCLUSIONS: This is one of the first large-scale global research collaboratives urgently assembled to evaluate acute neurological events in the context of a pandemic. The innovative and pragmatic tiered study approach has allowed for rapid recruitment and activation of numerous sites across the world-an approach essential to capture real-time critical neurological data to inform treatment strategies in this pandemic crisis.


title: Facial Skin Temperature and Discomfort When Wearing Protective Face Masks: Thermal Infrared Imaging Evaluation and Hands Moving the Mask

text: Individual respiratory protective devices and face masks represent critical tools in protecting health care workers in hospitals and clinics, and play a central role in decreasing the spread of the high-risk pandemic infection of 2019, coronavirus disease (COVID-19). The aim of the present study was to compare the facial skin temperature and the heat flow when wearing medical surgical masks to the same factors when wearing N95 respirators. A total of 20 subjects were recruited and during the evaluation, each subject was invited to wear a surgical mask or respirator for 1 h. The next day in the morning at the same hour, the same subject wore a N95 mask for 1 h with the same protocol. Infrared thermal evaluation was performed to measure the facial temperature of the perioral region and the perception ratings related to the humidity, heat, breathing difficulty, and discomfort were recorded. A significant difference in heat flow and perioral region temperature was recorded between the surgical mask and the N95 respirator (p < 0.05). A statistically significant difference in humidity, heat, breathing difficulty, and discomfort was present between the groups. The study results suggest that N95 respirators are able to induce an increased facial skin temperature, greater discomfort and lower wearing adherence when compared to the medical surgical masks.


title: Arrhythmic profile and 24-hour QT interval variability in COVID-19 patients treated with hydroxychloroquine and azithromycin

text: BACKGROUND: Hydroxychloroquine and azithromycin combination therapy is often prescribed for coronavirus disease 2019 (COVID-19). Electrocardiographic (ECG) monitoring is warranted because both medications cause corrected QT-interval (QTc) prolongation. Whether QTc duration significantly varies during the day, potentially requiring multiple ECGs, remains to be established. METHODS: We performed 12lead ECGs and 12lead 24-h Holter ECG monitoring in all patients aged <80 years admitted to our medical unit for COVID-19, in oral therapy with hydroxychloroquine (200 mg, twice daily) and azithromycin (500 mg, once daily) for at least 3 days. A group of healthy individuals matched for age and sex served as control. RESULTS: Out of 126 patients, 22 (median age 64, 82% men) met the inclusion criteria. ECG after therapy showed longer QTc-interval than before therapy (450 vs 426 ms, p = .02). Four patients had a QTc ≥ 480 ms: they showed higher values of aspartate aminotransferase (52 vs 30 U/L, p = .03) and alanine aminotransferase (108 vs 33 U/L, p < .01) compared with those with QTc < 480 ms. At 24-h Holter ECG monitoring, 1 COVID-19 patient and no control had ≥1 run of non-sustained ventricular tachycardia (p = .4). No patients showed "R on T" premature ventricular beats. Analysis of 24-h QTc dynamics revealed that COVID-19 patients had higher QTc values than controls, with no significant hourly variability. CONCLUSION: Therapy with hydroxychloroquine and azithromycin prolongs QTc interval in patients with COVID-19, particularly in those with high levels of transaminases. Because QTc duration remains stable during the 24 h, multiple daily ECG are not recommendable.


Get rid of the bad first: Therapeutic plasma exchange with convalescent plasma for severe COVID-19


title: Scholarship During a Pandemic: Secondary Data Analysis

text: The COVID-19 pandemic has disrupted nearly every aspect of life in the United States and around the globe, including significant impacts to higher education, both in its teaching-learning and research missions. With the physical closure of so many college and university campuses, a looming challenge is how nurse researchers can continue to generate new knowledge during a temporary but extended period of social distancing where conducting research requiring physical interaction with participants is impossible. In this Methodology Corner installment, a brief overview of secondary data analysis is provided, and resources for locating potentially useful data are described. Although secondary data analysis will not replace the dominant approaches used in nursing education research, current circumstances require it to take a much more prominent place in the toolbox of nursing education researchers. [J Nurs Educ. 2020;59(5):245-247.].


Carta ao Editor sobre o Artigo "Estimativa do Excesso de Mortalidade Durante a Pandemia COVID-19: Dados Preliminares Portugueses https://doi.org/10.20344/amp.13928"./ [Letter to the Editor about the Article: "Excess Mortality Estimation During the COVID-19 Pandemic: Preliminary Data from Portugal https://doi.org/10.20344/amp.13928"]


title: SLEDGE: A Simple Yet Effective Baseline for Coronavirus Scientific Knowledge Search

text: With worldwide concerns surrounding the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), there is a rapidly growing body of literature on the virus. Clinicians, researchers, and policy-makers need a way to effectively search these articles. In this work, we present a search system called SLEDGE, which utilizes SciBERT to effectively re-rank articles. We train the model on a general-domain answer ranking dataset, and transfer the relevance signals to SARS-CoV-2 for evaluation. We observe SLEDGE's effectiveness as a strong baseline on the TREC-COVID challenge (topping the learderboard with an nDCG@10 of 0.6844). Insights provided by a detailed analysis provide some potential future directions to explore, including the importance of filtering by date and the potential of neural methods that rely more heavily on count signals. We release the code to facilitate future work on this critical task at https://github.com/Georgetown-IR-Lab/covid-neural-ir


Cochrane Corner: Coronavirus (COVID-19): infection control and prevention measures


title: What should be done to support the mental health of healthcare staff treating COVID-19 patients?

text: There is an urgent need to provide evidence-based well-being and mental health support for front-line clinical staff managing the COVID-19 pandemic who are at risk of moral injury and mental illness. We describe the evidence base for a tiered model of care, and practical steps on its implementation.


SARS-CoV-2 is an appropriate name for the new coronavirus


Telenephrology with Remote Peritoneal Dialysis Monitoring during Coronavirus Disease 19


title: Personalizing vulvar cancer workflow in COVID-19 era: a proposal from Vul.Can MDT

text: INTRODUCTION: Since the community spread of Coronavirus disease 2019 (COVID-19), the practice of oncologic care at our comprehensive cancer center has changed. Postponing cancer treatment without consideration of its implications could cost more lives than can be saved. In this special situation, we must continue to provide our cancer patients with the highest quality of medical services assuring the safety. This article provides general guidance on supporting curative treatment strategies in vulvar cancer patients. METHODS: At our institution, a vulvar cancer multidisciplinary team (Vul.Can MDT) of specialists is responsible for personalized treatment of this disease. The phase 2 period necessarily requires specific procedures for both outpatient and inpatient pathways and to provide strategies concerning the management of vulvar cancer patients even in case of an eventually concomitant SARS-CoV-2 infection. In brief, an accurate remote and in person triage must be provided routinely and patients submitted to specific diagnostic tests prior to every major treatment or procedure (surgery, RT, and CT) or in case of suspicion for COVID-19 syndrome. The decisional workflow for these women often old and frail, have been rapidly adjusted by our Vul.Can MDT to mitigate the potential risks of COVID-19. RESULTS: The team produced two types of recommendations concerning: (1) safety regulations of care pathways, patients and health care providers, (2) personalized treatment strategies. We present a protocol that can be applied in clinical practice: the flowcharts provided, include the modulation of treatment intensity designed for surgical procedures and radiation, stratified for FIGO stage of disease and intention. CONCLUSION: We suggest that our proposals are applicable in this setting of patients, considering anyway current international recommendations and guidelines.


title: "The Most Dangerous Strain"

text: Socioeconomic inequities have direct implications in COVID presentation, severity of illness and prognosis. From practice of prophylactic measures to availability of personal protective equipment, from access to diagnostic tests to treatment resources, there are many facets and distinct disease processes of a virus that, among many things, serves to expose and highlight our global disparities.


First ultrastructural autoptic findings of SARS -Cov-2 in olfactory pathways and brainstem


title: Remdesivir: Review of Pharmacology, Pre-clinical Data, and Emerging Clinical Experience for COVID-19

text: The global pandemic of novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created an urgent need for effective antivirals. Remdesivir (formerly GS-5734) is a nucleoside analogue pro-drug currently being evaluated in COVID-19 clinical trials. Its unique structural features allow high concentrations of the active triphosphate metabolite to be delivered intracellularly and it evades proofreading to successfully inhibit viral RNA synthesis. In pre-clinical models, remdesivir has demonstrated potent antiviral activity against diverse human and zoonotic ß-coronaviruses, including SARS-CoV-2. In this article, we critically review available data on remdesivir with an emphasis on biochemistry, pharmacology, pharmacokinetics, and in vitro activity against coronaviruses as well as clinical experience and current progress in COVID-19 clinical trials.


title: Asymptomatic SARS-CoV-2 infection and COVID-19 mortality during an outbreak investigation in a skilled nursing facility

text: BACKGROUND: Outbreaks of COVID-19 have been reported in nursing homes and assisted living facilities; however, the extent of asymptomatic and pre-symptomatic SARS-CoV-2 infection in this high-risk population remains unclear. METHODS: We conducted an investigation of the first known outbreak of SARS-CoV-2 at a skilled nursing facility (SNF) in Illinois on March 15, 2020 and followed residents for 30 days. We tested 126/127 residents for SARS-CoV-2 via RT-PCR and performed symptom assessments. We calculated the point prevalence of SARS-CoV-2 and assessed symptom onset over 30-day follow-up to determine: 1) the proportion of cases who were symptomatic, pre-symptomatic, and asymptomatic and 2) incidence of symptoms among those who tested negative. We used the Kaplan-Meier method to determine the 30-day probability of death for cases. RESULTS: Of 126 residents tested, 33 had confirmed SARS-CoV-2 on March 15. Nineteen (58%) had symptoms at the time of testing, 1 (3%) developed symptoms over follow-up, and 13 (39%) remained asymptomatic. Thirty-five residents who tested negative on March 15 developed symptoms over follow-up; of these, 3 were re-tested and 2 were positive. The 30-day probability of death among cases was 29%. CONCLUSIONS: SNFs are particularly vulnerable to SARS-CoV-2, and residents are at risk of severe outcomes. Attention must be paid to preventing outbreaks in these and other congregate care settings. Widespread testing and infection control are key to help prevent COVID-19 morbidity and mortality in these high-risk populations.


title: A guide to the NMC emergency standards for nurse education during the current deployment of student nurses

text: The Nursing and Midwifery Council (NMC) recognises the important contribution that nursing students are making to the national response to the COVID-19 pandemic. This article reports on the Greater Manchester Supervision and Delegation Framework, providing practical guidance for students and practice staff (practice supervisor/practice assessor and registered nurse) on how to support student nurses who have opted into a paid (deployed) healthcare role. The framework operationalises NMC emergency standards for Nursing and Midwifery education, enabling students to complete their pre-registration undergraduate or postgraduate nursing programme while also supporting the healthcare workforce (NMC, 2020).


Diabetes patients with COVID-19 need better blood glucose management in Wuhan, China