title: COVID-19 Image Data Collection: Prospective Predictions Are the Future

text: Across the world's coronavirus disease 2019 (COVID-19) hot spots, the need to streamline patient diagnosis and management has become more pressing than ever. As one of the main imaging tools, chest X-rays (CXRs) are common, fast, non-invasive, relatively cheap, and potentially bedside to monitor the progression of the disease. This paper describes the first public COVID-19 image data collection as well as a preliminary exploration of possible use cases for the data. This dataset currently contains hundreds of frontal view X-rays and is the largest public resource for COVID-19 image and prognostic data, making it a necessary resource to develop and evaluate tools to aid in the treatment of COVID-19. It was manually aggregated from publication figures as well as various web based repositories into a machine learning (ML) friendly format with accompanying dataloader code. We collected frontal and lateral view imagery and metadata such as the time since first symptoms, intensive care unit (ICU) status, survival status, intubation status, or hospital location. We present multiple possible use cases for the data such as predicting the need for the ICU, predicting patient survival, and understanding a patient's trajectory during treatment. Data can be accessed here: https://github.com/ieee8023/covid-chestxray-dataset


COVID-19 in a tertiary hospital from Romania: Epidemiology, preparedness and clinical challenges


title: Urologic surgery in a safe hospital during the COVID-19 pandemic scenario

text: The COVID-19 pandemic induced a global emergency that overwhelmed most hospitals around the world. Access to Hospitals has been restricted to selective oncological and urgent patients to minimize surgeries requiring Intensive Care Unit care. All other kind of non- urgent and benign surgeries have been rescheduled. The burden of oncological and urgent cases on the healthcare system has increased. We have been asked to become the referral center for major oncological and urgent urological surgeries, increasing our surgical volume. Through meticulous hospital protocols on PPE, use of nasopharyngeal swabs, controlled hospital access and the prompt management of suspected/positive cases, we were able to perform 31% more urological surgical procedures during the COVID-19 pandemic compared to the same period in 2019. We observed a 72% increase in oncological surgical procedures and 150% in urgent procedures. Our experience shows how the management of oncological and urgent cases can be maintained during unexpected, global emergencies, such as COVID-19.


Two cases of cutaneous eruptions due to CoVID-19 infection in Singapore: new insights into the spectrum of clinical presentation and histopathology


title: Keeping Patients With Cancer Exercising in the Age of COVID-19

text: The novel 2019 coronavirus disease (COVID-19) pandemic is a global public health emergency. To date, physical distancing and good personal hygiene have been the only effective measures to limit spread. The pandemic has altered routine cancer care, including allied health and supportive care interventions. Clinicians must adapt and find ways to continue to deliver optimal patient care at this time. The prescription of exercise to people with cancer has been demonstrated to have meaningful benefits for both physical and mental health and quality of life, and may even enhance survival. Such exercise interventions provide the largest benefit to patients when delivered in a supervised, group, clinic-based setting. In the age of COVID-19, group-based exercise in communal facilities presents risks for both aerosol and surface transmission of the virus among people exercising, necessitating a pivot from the usual methods of exercise delivery to home-based exercise programs. In this article, we discuss the challenges that need to be overcome in moving to a home-based program for patients with cancer while maintaining the benefits of targeted and high-fidelity exercise medicine. We provide practical recommendations for how home-based exercise can be supported and nurtured by qualified exercise professionals who treat people living with cancer, as well as pointing to resources that are available online to assist practitioners. Despite the challenges faced during this pandemic, we believe that it is important for people to continue to benefit from exercise in a safe environment with the support of exercise specialists.


Cov19, études de séroprévalence et Comités de protection des personnes : n'ajoutons pas une charge administrative au défi technologique et organisationnel./ [Cov19, seroprevalence studies and Individuals Protection Committees: aren't the technological and organizational challenges enough ?]


title: Thoracic Surgical Oncology -Maintaining a High-Volume Surgical Program during the Covid-19 Pandemic

text: Thoracic surgical oncology is a time sensitive, high resource, complex surgical speciality to which Coronavirus has posed a unique challenge. In response to the evolving situation in mainland Europe, our department rapidly established a Covid-free site to maintain elective cancer surgery. This necessitated a strict admission pathway and perioperative patient management. It resulted in the maintenance of a high-volume, high-quality thoracic surgical oncology program with no Covid-19 positive cases to date. Maintaining satisfactory training levels amongst surgical and anaesthetic trainees has also been achieved. We suggest that this model could be adapted to local resource capabilities.


title: Immune responses and pathogenesis of SARS-CoV-2 during an outbreak in Iran: Comparison with SARS and MERS

text: The beginning of 2020 has seen the emergence of COVID-19, an outbreak caused by a novel coronavirus, SARS-CoV-2, an important pathogen for humans. There is an urgent need to better understand this new virus and to develop ways to control its spread. In Iran, the first case of the COVID-19 was reported after spread from China and other countries. Fever, cough, and fatigue were the most common symptoms of this virus. In worldwide, the incubation period of COVID-19 was 3 to 7 days and approximately 80% of infections are mild or asymptomatic, 15% are severe, requiring oxygen, and 5% are critical infections, requiring ventilation. To mount an antiviral response, the innate immune system recognizes molecular structures that are produced by the invasion of the virus. COVID-19 infection induces IgG antibodies against N protein that can be detected by serum as early as day 4 after the onset of disease and with most patients seroconverting by day 14. Laboratory evidence of clinical patients showed that a specific T-cell response against SARS-CoV-2 is important for the recognition and killing of infected cells, particularly in the lungs of infected individuals. At present, there is no specific antiviral therapy for COVID-19 and the main treatments are supportive. In this review, we investigated the innate and acquired immune responses in patients who recovered from COVID-19, which could inform the design of prophylactic vaccines and immunotherapy for the future.


title: Analysis of misinformation during the COVID-19 outbreak in China: cultural, social and political entanglements

text: COVID-19 resulted in an infodemic, which could erode public trust, impede virus containment, and outlive the pandemic itself. The evolving and fragmented media landscape is a key driver of the spread of misinformation. Using misinformation identified by the fact-checking platform by Tencent and posts on Weibo, our results showed that the evolution of misinformation follows an issue-attention cycle, pertaining to topics such as city lockdown, cures, and preventions, and school reopening. Sources of authority weigh in on these topics, but their influence is complicated by peoples' pre-existing beliefs and cultural practices. Finally, social media has a complicated relationship with established or legacy media systems. Sometimes they reinforce each other, but in general, social media may have a topic cycle of its own making. Our findings shed light on the distinct characteristics of misinformation during the COVID-19 and offer insights into combating misinformation in China and across the world at large.


Collaboration in TB and COVID-19 control in Moscow


title: The operational readiness capacities of the grassroots health system in responses to epidemics: Implications for COVID-19 control in Vietnam

text: Background: There is a paucity of data on the operational readiness capacities of the grassroots health system in Vietnam while it plays a vital role as a first-line defense against health emergencies, including the coronavirus disease (COVID-19). This study, therefore, aims to assess the operational readiness capacities of the grassroots health system in response to epidemics and provides implications for controlling COVID-19 in Vietnam. Methods: An online cross-sectional study using the respondent-driven sampling technique was conducted with 6029 health professionals and medical students in Vietnam from December 2019 to February 2020. The operational readiness capacities of the health system were assessed by the sufficiency of health professionals, administrative and logistics staffs, equipment and facilities, and general capacity of health professionals. Kruskal-Wallis test, Fisher exact test and χ2 test were employed to identify the differences among variables. Tobit and censored regression models were operated to determine associated factors. Results: The operational readiness capacities of the grassroots health system for four assessed criteria were at moderate levels, ranging from 6.3 to 6.8 over 10. In Vietnam, the grassroots health system in rural areas, in the South, and at the district level were more likely to be vulnerable compared to their counterparts. Conclusions: According to empirical data, this study reveals the vulnerability of the grassroots health system in Vietnam and provides the rationality of prompt and vigorous actions of the Vietnamese Government against COVID-19. Findings also offer useful insights for effective strategies to strengthen the grassroots health system in the long term. In the short term, practicing precautionary measures and mobilizing human resources, as well as medical equipment, are needed to successfully contain COVID-19 in Vietnam.


title: Flattening the curves: on-off lock-down strategies for COVID-19 with an application to Brazi

text: The current COVID-19 pandemic is affecting different countries in different ways. The assortment of reporting techniques alongside other issues, such as underreporting and budgetary constraints, makes predicting the spread and lethality of the virus a challenging task. This work attempts to gain a better understanding of how COVID-19 will affect one of the least studied countries, namely Brazil. Currently, several Brazilian states are in a state of lock-down. However, there is political pressure for this type of measures to be lifted. This work considers the impact that such a termination would have on how the virus evolves locally. This was done by extending the SEIR model with an on / off strategy. Given the simplicity of SEIR we also attempted to gain more insight by developing a neural regressor. We chose to employ features that current clinical studies have pinpointed has having a connection to the lethality of COVID-19. We discuss how this data can be processed in order to obtain a robust assessment.


Decrease in surgical activity in the COVID-19 pandemic: an economic crisis


Preliminary results of a clinical study to evaluate the performance and safety of swallowing in critical patients with COVID-19


title: PET/CT of COVID-19 as an Organizing Pneumonia

text: An 85-year-old woman with history of melanoma is referred for a follow-up F-FDG PET/CT. F-FDG PET/CT scan showed bilateral and peripheral ground-glass opacities in upper and lower pulmonary lobes surrounded by consolidations of crescent shape with increased FDG uptake, findings compatible with organizing pneumonia. Following further inquiry, the patient reported low-grade fever, sore throat, and fatigue for the past 6 days. Because of the ongoing COVID-19 pandemic, the patient was tested for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which resulted positive.


Open for outbreaks


title: Efficacy and safety of umifenovir for coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis

text: BACKGROUND: We conducted this systemic review and meta-analysis in an attempt to evaluate the efficacy and safety of umifenovir in COVID-19. METHODS: We searched PubMed, Web of Science, Embase, Cochrane Library, CNKI and medRxiv database. We included both retrospective and prospective studies. The mean difference (MD) and risk ratio (RR) with 95% confidence intervals (CI) were applied to assess the effectiveness of umifenovir for COVID-19. RESULTS: A total of 12 studies with 1052 patients were included in our final studies. Compared with control group, umifenovir is associated with higher negative rate of PCR on day 14 (RR:1.27; 95% CI: 1.04 to 1.55). However, umifenovir is not related to nucleus acid negative conversion time(MD: 0.09; 95% CI: -1.48 to 1.65), negative rate on day 7(RR:1.09; 95% CI: 0.91 to 1.31), incidence of composite endpoint (RR:1.20; 95% CI: 0.61 to 2.37), rate of fever alleviation on day 7 (RR:1.00; 95% CI: 0.91 to 1.10), rate of cough alleviation on day 7 (RR:1.00; 95% CI: 0.85 to 1.18), or hospital length of stay (LOS) (MD: 1.34; 95% CI: -2.08 to 4.76). Additionally, umifenovir was safe in COVID-19 patients (RR for incidence of adverse events:1.29; 95% CI: 0.57 to 2.92). The results of sensitivity analysis and subgroup analysis were similar to pooled results. CONCLUSIONS: There is no evidence to support the use of umifenovir for improving patient-important outcomes in patients with COVID-19. This article is protected by copyright. All rights reserved.


title: Quantitative computed tomography of the coronavirus disease 2019 (COVID-19) pneumonia

text: Objective: To quantify coronavirus diseases 2019 (COVID-19) pneumonia and to explore whether quantitative computer tomography (CT) could be used to assess severity on admission. Materials and methods: From January 17 to February 9, 2020, 38 hospitalized patients with COVID-19 pneumonia were consecutively enrolled in our hospitals. All clinical data and the chest CT on admission were retrospectively reviewed and analyzed. Firstly, a quantitative method based on multi-scale convolutional neural networks was used to assess the infected lung segments and this was compared with the semi-quantitative method. Secondly, the quantitative method was tested with laboratory results and the pneumonia severity index (PSI) by correlation analyses. Thirdly, both quantitative and semi-quantitative parameters between patients with different PSI were compared. Results: Thirty cases were finally enrolled: 16 (53.33%) of them were male, and the mean age was 48 years old. The interval from onset symptoms to first chest CT scan was 8 days. The proportion of ground glass opacity (GGO), consolidation and the total lesion based on the quantitative method was positively correlated with the semi-quantitative CT score (P < 0.001 for all; rs = 0.88, 0.87, 0.90), CRP (P = 0.0278, 0.0168, 0.0078; rs = 0.40, 0.43, 0.48) and ESR (P = 0.0296, 0.0408, 0.0048; rs = 0.46, 0.44, 0.58), respectively, and was negatively correlated with the lymphocyte count (P = 0.0222, 0.0024, 0.0068; rs = -0.42, -0.53, -0.48). There was a positive correlation trend between the proportion of total infection and the pneumonia severity index (P = 0.0994; rs = 0.30) and a tendency that patients with severe COVID-19 pneumonia had higher percentage of consolidation and total infection (P = 0.0903, 0.0989). Conclusions: Quantitative CT may have potential in assessing the severity of COVID-19 pneumonia on admission.


title: Leveraging open hardware to alleviate the burden of COVID-19 on global health systems

text: With the current rapid spread of COVID-19, global health systems are increasingly overburdened by the sheer number of people that need diagnosis, isolation and treatment. Shortcomings are evident across the board, from staffing, facilities for rapid and reliable testing to availability of hospital beds and key medical-grade equipment. The scale and breadth of the problem calls for an equally substantive response not only from frontline workers such as medical staff and scientists, but from skilled members of the public who have the time, facilities and knowledge to meaningfully contribute to a consolidated global response. Here, we summarise community-driven approaches based on Free and Open Source scientific and medical Hardware (FOSH) as well as personal protective equipment (PPE) currently being developed and deployed to support the global response for COVID-19 prevention, patient treatment and diagnostics.


Mitigating lockdown challenges in response to COVID-19 in Sub-Saharan Africa


title: Unprecedented disruption of lives and work: Health, distress and life satisfaction of working adults in China one month into the COVID-19 outbreak

text: We assess the health and wellbeing of normal adults living and working after one month of confinement to contain the COVID-19 outbreak in China. On Feb 20-21, 2020, we surveyed 369 adults in 64 cities in China that varied in their rates of confirmed coronavirus cases on their health conditions, distress and life satisfaction. 27% of the participants worked at the office, 38% resorted to working from home, and 25% stopped working due to the outbreak. Those who stopped working reported worse mental and physical health conditions as well as distress. The severity of COVID-19 in an individual's home city predicts their life satisfaction, and this relationship is contingent upon individuals' existing chronic health issues and their hours of exercise. Our evidence supports the need to pay attention to the health of people who were not infected by the virus, especially for people who stopped working during the outbreak. Our results highlight that physically active people might be more susceptible to wellbeing issues during the lockdown. Policymakers who are considering introducing restrictive measures to contain COVID-19 may benefit from understanding such health and wellbeing implications.


title: Preventing airborne infection

text: Good ventilation is essential in indoor spaces including planes.


title: Defining the reproductive period of freshwater fish species using the Gonadosomatic Index: a proposed protocol applied to ten species of the Patos Lagoon basin

text: This contribution records the reproductive periods of ten dominant freshwater fish species from the Patos Lagoon and Guaíba Lake (Astyanax fasciatus, Cyphocharax voga, Hoplias malabaricus, Oligosarcus jenynsii, Oligosarcus robustus, Hoplosternum littorale, Loricariichthys anus, Parapimelodus nigribarbis, Trachelyopterus lucenai, Pachyurus bonariensis). Data were derived from monthly samples in Casamento Lake (northern Patos Lagoon; Nov. 2002 to Apr. 2004) and Guaíba Lake (Jun. 2005 to May 2006). The reproductive period was determined according to the monthly variation of the gonadosomatic index (GSI). Fish reproduction was identified during all months of the year. Oligosarcus jenynsii started reproduction in winter, but extended spawning to spring (early warming-water reproduction). Three species also presented reproduction during warming water months, but beginning in spring and finishing in summer (late warm-water reproduction): P. nigribarbis, T. lucenai and P. bonariensis. Three species presented relatively short reproduction periods on summer (spotted warm-water reproduction): H. malabaricus, H. littorale and L. anus, and only one species reproduces almost continuously during warmer waters (long-season warm-water reproduction): A. fasciatus. Finally, two other species presented a very distinct reproductive pattern, starting reproduction on late summer but increasing GSI values along autumn and winter (long-season cooling-water reproducers): C. voga and O. robustus.(AU)


Finding motivation while working from home as a PhD student during the coronavirus pandemic


COVID-19 Infection: Perioperative Implications: Reply


Erythema multiforme and Kawasaki disease associated with COVID-19 infection in children


title: Catastrophe In Radiology: Considerations Beyond Common Emergencies

text: Disasters often occur without warning and have the potential to affect large numbers of people. Those in the radiology environment experience unique effects on them, their equipment, and their ability to provide quality patient care. Lessons can be learned by reviewing events and their impact on imaging departments around the world. Radiology departments need to be actively involved in the disaster planning and the management of disasters when they occur. Common themes emerge regardless of the type of disaster and these themes should be included in all planning.


COVID-19 in Latin America: Novel transmission dynamics for a global pandemic?


title: Identification of a Druggable Intermediate along the Folding Pathway of the SARS-CoV-2 Receptor ACE2

text: The steep climbing of victims caused by the new coronavirus disease 2019 (COVID-19) throughout the planet is sparking an unprecedented effort to identify effective therapeutic regimens to tackle the pandemic. The SARS-CoV-2 virus is known to gain entry into various cell types through the binding of one of its surface proteins (spike) to the host Angiotensin Converting Enzyme 2 (ACE2). Thus, the spike-ACE2 interaction represents a major target for vaccines and antiviral drugs. We recently described a novel method to pharmacologically down-regulate the expression of target proteins at the post-translational level. This technology builds on computational advancements in the simulation of folding mechanisms to rationally block protein expression by targeting folding intermediates, hence hampering the folding process. Here, we report the all-atom simulation of the entire sequence of events underlying the folding pathway of ACE2. Our data reveal the existence of a folding intermediate showing druggable pockets hidden in the native conformation. Both pockets were targeted by a virtual screening repurposing campaign aimed at quickly identifying drugs capable to decrease the expression of ACE2. Importantly, among the different virtual hits, we identified mefloquine, a quinoline-derivative belonging to a class of antimalaria agents (e.g. chloroquine and hydroxychloroquine) recently described for their effects on ACE2 maturation. Thus, our results suggest that these drugs could act against SARS-CoV-2 by altering the folding pathway of its receptor ACE2.


title: A Mathematical Description of the Dynamics of Coronavirus Disease (COVID-19): A Case Study of Brazil

text: This paper deals with the mathematical modeling and numerical simulations related to the coronavirus dynamics. A description is developed based on the framework of susceptible-exposed-infectious-recovered model. Initially, a model verification is carried out calibrating system parameters with data from China, Italy, Iran and Brazil. Afterward, numerical simulations are performed to analyzed different scenarios of COVID-19 in Brazil. Results show the importance of governmental and individual actions to control the number and the period of the critical situations related to the pandemic.


title: High-altitude populations need special considerations for COVID-19

text: The atmospheric pressure that decreases with altitude affects lung physiology. However, these changes in physiology are not usually considered in ventilator design and testing. We argue that high altitude human populations require special attention to access the international supply of ventilators.


Sampling bias and incorrect rooting make phylogenetic network tracing of SARS-COV-2 infections unreliable


Is temperature reducing the transmission of COVID-19 ?


title: COVID-19 and Liver

text: The current pandemic coronavirus labelled as Severe Acute Respiratory Distress Syndrome Coronavirus -2 (SARS -CoV-2) is a significant public health threat over for past few months. Overall case fatality rates range between 2-6%; however, the rates are higher in patients with severe disease, advanced age and underlying comorbidities like diabetes, hypertension and heart disease. Recent reports showed about 2-11% of patients with COVID-19 had underlying chronic liver disease. Experience from previous SARS epidemic suggest that 60% of patients developed various degrees of liver damage. In the current COVID-19 pandemic, hepatic dysfunction was seen in 14-53% of patients, particularly in those with severe disease. Cases of acute liver injury have been reported, associated with higher mortality. Hepatic involvement in COVID-19 could be multifactorial related to any of direct cytopathic effect of the virus, uncontrolled immune reaction, sepsis or drug induced liver injury. The postulated mechanism of viral entry is through the host ACE2 receptors that are abundantly present in type 2 alveolar cells. Interestingly, the expression of ACE2 receptors were identified in the gastrointestinal tract, vascular endothelium and cholangiocytes of the liver. Liver transplant recipients with COVID-19 have been reported recently. Effects of COVID-19 on underlying chronic liver disease requires a detailed evaluation and currently data is lacking and further research is warranted in this area. With lack of definitive therapy, patient education, hand hygiene and social distancing appears to be the cornerstone in minimising the disease spread.


Miocarditis fulminante por COVID-19./ [Fulminant myocarditis due to COVID-19]


The CALL score for predicting outcomes in patients with COVID-19


title: Recommendations for Designing, Conducting and Reporting Observational Studies in Homeopathy

text: BACKGROUND: Randomized placebo-controlled trials are considered to be the gold standard in clinical research and have the highest importance in the hierarchical system of evidence-based medicine. However, from the viewpoint of decision makers, due to lower external validity, practical results of efficacy research are often not in line with the huge investments made over decades. METHOD: We conducted a narrative review. With a special focus on homeopathy, we give an overview on cohort, comparative cohort, case-control and cross-sectional study designs and explain guidelines and tools that help to improve the quality of observational studies, such as the STROBE Statement, RECORD, GRACE and ENCePP Guide. RESULTS: Within the conventional medical research field, two types of arguments have been employed in favor of observational studies. First, observational studies allow for a more generalizable and robust estimation of effects in clinical practice, and if cohorts are large enough, there is no over-estimation of effect sizes, as is often feared. We argue that observational research is needed to balance the current over-emphasis on internal validity at the expense of external validity. Thus, observational research can be considered an important research tool to describe "real-world" care settings and can assist with the design and inform the results of randomised controlled trails. CONCLUSIONS: We present recommendations for designing, conducting and reporting observational studies in homeopathy and provide recommendations to complement the STROBE Statement for homeopathic observational studies.


title: Mitarbeiterinfektionsschutz in Zeiten der Coronavirus-Pandemie: Die akute Implementierung von telemedizinischen Mitarbeiterkonferenzen "von Null auf Hundert"./ [Protecting Medical Professionals from Infection During the Coronavirus Pandemic: Overnight Implementation of Virtual Medical Boards]

text: BACKGROUND: For medical professionals in hospitals, it is nearly impossible to abide by the rules of social distancing to prevent coronavirus transmission. In order to avoid unnecessary contact between medical staff, virtual medical boards were implemented. METHODS: Technical requirements for virtual boards were established overnight. Standard web cams and one license for a licensed provider of virtual boards were acquired. Most of the other technical gear required was readily available. Frequent and typical errors during the virtual boards were recorded and analyzed. RESULTS: Virtual boards provided the means for adequate patient care in spite of social distancing among the medical staff. Over a period of 4 weeks, 956 face-to-face contacts were avoided. Most errors occurred during first-time participation and concerned audio transmission. By muting the microphone of inactive participants, most of these errors could be avoided. CONCLUSIONS: Virtual boards for medical staff can be implemented with minimal effort und standard technical gear to slow down the transmission of coronavirus among medical professionals in the hospital setting.


title: The liver injury and gastrointestinal symptoms in patients with Coronavirus Disease 19: A systematic review and meta-analysis

text: BACKGROUNDS: Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. Our study aimed to evaluate the association of liver injury and gastrointestinal symptoms (GIS) with the progression of COVID-19. METHODS: A comprehensive search was performed on the PubMed to identify eligible studies that summarized the liver injury and GIS in COVID-19. RESULTS: A total of 21 studies with 3024 patients were included. Up to 53% patients had liver dysfunctions and the degree of liver damage was associated the severity of the disease. The prevalence of diarrhoea, nausea/vomiting or abdominal pain in patients with COVID-19 were 9.1%, 5.2% and 3.5%, respectively. No significant was found in the prevalence of diarrhoea (OR, 1.24; 95%CI, 0.90 to 1.72; I2=0%, P=0.19) and nausea/vomiting (OR, 1.24; 95%CI, 0.57 to 2.69; I2=61%, P=0.58) between severe and non-severe patients. In addition, diarrhoea (OR, 1.22; 95%CI, 0.50 to 2.98; I2=0%, P=0.66) and nausea/vomiting (OR, 1.09; 95%CI, 0.46 to 2.62; I2=0%, P=0.84) were not associated with the prognosis of COVID-19 patients. CONCLUSIONS: The incidences of GIS in patients with COVID-19 is relatively low and are not associated with the COVID-19 progression. Gastroenterologists should pay more attention to the liver injury induced by SARS-CoV-2 during the course of infection.


Successful Treatment of Topical Imiquimod-resistant Basal Cell Carcinoma by Electronic X-ray Brachytherapy


title: Risk Attitudes and Human Mobility during the COVID-19 Pandemic

text: Behavioral responses to pandemics are less shaped by actual mortality or hospitalization risks than they are by risk attitudes. We explore human mobility patterns as a measure of behavioral responses during the COVID-19 pandemic. Our results indicate that risk-taking attitude is a critical factor in predicting reduction in human mobility and increase social confinement around the globe. We find that the sharp decline in movement after the WHO (World Health Organization) declared COVID-19 to be a pandemic can be attributed to risk attitudes. Our results suggest that regions with risk-averse attitudes are more likely to adjust their behavioral activity in response to the declaration of a pandemic even before most official government lockdowns. Further understanding of the basis of responses to epidemics, e.g., precautionary behavior, will help improve the containment of the spread of the virus.


title: An approach towards development of monoclonal IgY antibodies against SARS CoV-2 spike protein (S) using phage display method: A review

text: The present state of diagnostic and therapeutic developmental race for vaccines against the SARS CoV-2 (nCOVID-19) focuses on prevention and control of this global pandemic which also represents a critical challenge to the global health community. Although development of novel vaccines can prevent the SARS CoV-2 infections, it is still impeded by several other factors and therefore novel approaches towards treatment and management of this disease is the urgent need. Passive immunotherapy plays a vital role as a possible alternative to meet this challenge and among various antibody sources, chicken egg yolk antibodies (IgY) can be used as an alternative to mammalian antibodies which have been previously studied against SARS CoV outbreak in China. In this review, we discuss the strategies for the use of chicken egg yolk (IgY) antibodies in the development of rapid diagnosis and immunotherapy against SARS CoV-2. Also, IgY antibodies have previously been used against various respiratory bacterial and viral infections in humans and animals. Compared to mammalian antibodies (IgG), chicken egg yolk antibodies (IgY) have greater binding affinity to specific antigens, ease of extraction and lower production costs, hence possessing remarkable pathogen-neutralizing activity of pathogens in respiratory and lungs. We provide an overall importance for the use of monoclonal chicken egg yolk antibodies (IgY) using phage display method describing their potential passive immunotherapeutic application for the treatment and prevention of SARS CoV-2 infection which is simple, fast and safe way of approach for treating patients effectively.


title: COVID-19 outbreak response, a dataset to assess mobility changes in Italy following national lockdown

text: Italy has been severely affected by the COVID-19 pandemic, reporting the highest death toll in Europe as of April 2020. Following the identification of the first infections, on February 21, 2020, national authorities have put in place an increasing number of restrictions aimed at containing the outbreak and delaying the epidemic peak. On March 12, the government imposed a national lockdown. To aid the evaluation of the impact of interventions, we present daily time-series of three different aggregated mobility metrics: the origin-destination movements between Italian provinces, the radius of gyration, and the average degree of a spatial proximity network. All metrics were computed by processing a large-scale dataset of anonymously shared positions of about 170,000 de-identified smartphone users before and during the outbreak, at the sub-national scale. This dataset can help to monitor the impact of the lockdown on the epidemic trajectory and inform future public health decision making.


title: Non-steroidal anti-inflammatory drugs, pharmacology, and COVID-19 infection

text: Non-steroidal anti-inflammatory drugs (NSAIDs) have an optional prescription status that has resulted in frequent use, in particular for the symptomatic treatment of fever and non-rheumatic pain. In 2019, a multi-source analysis of complementary pharmacological data showed that using NSAIDs in these indications (potentially indicative of an underlying infection) increases the risk of a severe bacterial complication, in particular in the case of lung infections. First, the clinical observations of the French Pharmacovigilance Network showed that severe bacterial infections can occur even after a short NSAID treatment, and even if the NSAID is associated with an antibiotic. Second, pharmacoepidemiological studies, some of which minimized the protopathic bias, all converged and confirmed the risk. Third, experimental in vitro and in vivo animal studies suggest several biological mechanisms, which strengthens a causal link beyond the well-known risk of delaying the care of the infection (immunomodulatory effects, effects on S. pyogenes infections, and reduced antibiotics efficacy). Therefore, in case of infection, symptomatic treatment with NSAIDs for non-severe symptoms (fever, pain, or myalgia) is not to be recommended, given a range of clinical and scientific arguments supporting an increased risk of severe bacterial complication. Besides, the existence of a safer drug alternative, with paracetamol at recommended doses, makes this recommendation of precaution and common sense even more legitimate. In 2020, such recommendation is more topical than ever with the emergence of COVID-19, especially since it results in fever, headaches, muscular pain, and cough, and is further complicated with pneumopathy, and given experimental data suggesting a link between ibuprofen and the level of expression of angiotensin-converting enzyme 2.


title: Encephalopathy in patients with COVID-19: 'Causality or coincidence?'

text: The main tropism of the novel coronavirus disease 2019 (COVID-19) is respiratory. Increasing evidences show that SARS-CoV-2 is not always confined to the respiratory tract but can also invade the central nervous system (CNS) and induce neurological diseases. We report two cases illustrating this phenomenon. This article is protected by copyright. All rights reserved.


[Effects of novel coronavirus therapeutic drugs on cardiovascular system]


title: A pandemic-resilient open-inquiry physical science lab course which leverages the Maker movement

text: Without any major changes, a pilot version of a physical science lab course was able to continue when the COVID-19 crisis necessitated the abrupt suspension of on-campus education. The 'Maker Lab' course, in which students conceive and set up their own experiments using affordable microcontrollers, required students to follow the entire arc of the empirical research cycle twice. The decision for and facilitation of such open-inquiry projects was based on and warranted by the literature on teaching the process of experimental research and the scientific method. The flipped classroom approach was used, where contact time is devoted to discussions and the students' actual experiments were carried out independently at home or elsewhere without the supervision of an instructor. Despite the COVID-19 measures, all students were able to produce interesting and successful research projects. While there were of course difficulties encountered in the abrupt transition to online teaching, we found several counterbalancing advantages that bear consideration for inclusion even when all teaching activities can return to campus. We believe that three components in the design of the course were vital to the resilience of the course: the choice for fully open-inquiry projects, the decision to use Arduinos as measurement tools, and the flipped aspect of the instruction methods. We also include considerations for adapting these pandemic-resilient methods in other courses and programs.


RETRACTED ARTICLE: SARS-CoV-2 infects T lymphocytes through its spike protein-mediated membrane fusion


title: Safe management of bodies of deceased persons with suspected or confirmed COVID-19: a rapid systematic review

text: INTRODUCTION: Proper strategies to minimise the risk of infection in individuals handling the bodies of deceased persons infected with 2019 novel coronavirus (2019-nCoV) are urgently needed. The objective of this study was to systematically review the literature to scope and assess the effects of specific strategies for the management of the bodies. METHODS: We searched five general, three Chinese and four coronavirus disease (COVID-19)-specific electronic databases. We searched registries of clinical trials, websites of governmental and other relevant organisations, reference lists of the included papers and relevant systematic reviews, and Epistemonikos for relevant systematic reviews. We included guidance documents providing practical advice on the handling of bodies of deceased persons with suspected or confirmed COVID-19. Then, we sought primary evidence of any study design reporting on the efficacy and safety of the identified strategies in coronaviruses. We included evidence relevant to contextual factors (ie, acceptability). A single reviewer extracted data using a pilot-tested form and graded the certainty of the evidence using the GRADE approach. A second reviewer verified the data and assessments. RESULTS: We identified one study proposing an uncommon strategy for autopsies for patients with severe acute respiratory syndrome. The study provided very low-certainty evidence that it reduced the risk of transmission. We identified 23 guidance documents providing practical advice on the steps of handling the bodies: preparation, packing, and others and advice related to both the handling of the dead bodies and the use of personal protective equipment by individuals handling them. We did not identify COVID-19 evidence relevant to any of these steps. CONCLUSION: While a substantive number of guidance documents propose specific strategies, we identified no study providing direct evidence for the effects of any of those strategies. While this review highlights major research gaps, it allows interested entities to build their own guidance.


Don't forget our dual public health crises


title: The Economic Impact of the COVID-19 Pandemic on Radiology Practices

text: The COVID-19 pandemic will have a profound impact on Radiology practices across the country. Policy measures adopted to slow the transmission of disease are decreasing the demand for imaging independent of COVID-19. Hospital preparations to expand crisis capacity are further diminishing the amount of appropriate medical imaging that can be safely performed. While economic recessions generally tend to result in decreased health care expenditures, radiology groups have never experienced an economic shock that is simultaneously exacerbated by the need to restrict the availability of imaging. Outpatient heavy practices will feel the biggest impact of these changes, but all imaging volumes will decrease. Anecdotal experience suggests that radiology practices should anticipate 50%-70% decreases in imaging volume that will last a minimum of 3-4 months, depending on the location of practice and the severity of the COVID-19 pandemic in each region. The CARES Act provides multiple means of direct and indirect aid to healthcare providers and small businesses. The final allocation of this funding is not yet clear, and it is likely that additional congressional action will be necessary to stabilize health care markets. Administrators and practice leaders need to be proactive with practice modifications and financial maneuvers that can position them to emerge from this pandemic in the most viable economic position. It is possible that this crisis will have lasting effects on the structure of the radiology field.


title: Notes from the Field: Concerns of Health-Related Higher Education Students in Brazil Pertaining to Distance Learning During the Coronavirus Pandemic

text: This survey aimed to assess the concerns of students of health-related higher education in Brazil regarding distance learning during the coronavirus pandemic. A Google Forms anonymous questionnaire was sent by WhatsApp Messenger to students at a private university. Seven hundred and four students answered the questionnaire (566 female, 138 male, mean age = 23.09 years), reflecting approximately a third of the students in health-related disciplines. Students reported feeling anxious due to the pandemic. Most of the students agreed with having the ability to continue education through distance learning, but relatively few of them enjoyed it. Also, students were concerned that learning of clinical material and professional training would be impaired, and they were afraid of failing the year of education. Health-related higher education private institutions in Brazil should focus on reassessing and prioritizing their policies and protocols and include a detailed plan for the future.


The Zombie Apocalypse and COVID-19


title: Early risk factors of the exacerbation of Coronavirus disease 2019 pneumonia

text: The purpose of this study was to investigate the early risk factors for the exacerbation of coronavirus disease 2019 (COVID-19) pneumonia. Restrospective analysis of clinical data of 85 patients infected with SARS-CoV-2, including gender, age, comorbidities, symptoms, blood routine, clotting profile, biochemical examination, albumin, myocardial enzyme profile, inflammatory markers, and chest CT. All laboratory examination were measured within first 24 hours after admission, and chest CT were performed before admission. 56 (65.9%) patients had a history of exposure to Huanan seafood market in Wuhan. Fever and dry cough accounted for the highest percentage of all symptoms. Male COVID-2019 patients were more likely to develop severe pneumonia. Patients with severe and critical conditions are older and have higher rates of hypertension (p=0.003) and coronary heart disease (p=0.017). All severe and critical patients infected with SARS-CoV-2 showed bilateral lung involvement and have more multiple lobes involvement than common patients (p<0.001). Severe and critical patients showed higher WBC count (p=0.006), NEU count (p=0.001), NEU% (p=0.002), PCT (p=0.011), CRP (p=0.003), PT (p=0.035), D-dimer (p=0.025), AST (p=0.006), and lower LYM count (p=0.019), LYM% (p=0.001), ALB (p<0.001). Logistic regression analysis showed NEU count is a independent risk factor for deterioration, with the threshold of 6.5×109 ·L-1 . We concluded that the laboratory independent risk factor for the progression of COVID-19 pneumonia is NEU count. In addition, COVID-19 patients with bilateral lung involvement or multiple lobes involvement should be taken seriously and actively treated to prevent deterioration of the disease. This article is protected by copyright. All rights reserved.


title: Selenium Deficiency via the TLR4/TRIF/NF-κB Signaling Pathway Leading to Inflammatory Injury in Chicken Spleen

text: The aim of the present study was to investigate the effect of selenium (Se) deficiency on the expression of the toll-like receptor (TLR) signal transduction pathway in the spleen of chickens and explore the relationship between the TLR4/TRIF/NF-κB signaling pathway and inflammatory spleen injury. A total of 200 one-day-old healthy broilers were allocated to two groups. The experimental group was fed a self-made low-Se diet (0.004 mg/kg) while the control group was fed a complete formula feed (0.2 mg/kg) for 15, 25, 35, 45, and 55 days, respectively. We observed histopathological changes in the chicken spleens. The messenger RNA(mRNA) expression levels of 8 kinds of ChTLRs, myeloid differential protein-88 (MyD88), toll-interleukine-1 receptor domain-containing adapter-inducing interferon-ß (TRIF), nuclear factor-κB (NF-κB), and cytokine (IL-6, TNF-α, IL-2, and IFN-Î³) were detected via quantitative real-time PCR. Western blotting was used to detect the protein expression level of TLR4. Then principal component analysis (PCA) was used to analyze the correlation between the ChTLRs, MyD88, TRIF, and NF-κB. The results showed that the boundary between red pulp and white pulp was unclear, the number of lymphocytes decreased, and the nucleus was fragmented and dissolved in the experimental group at 25-55 days. At 15-45 days, the relative expression of TLR4 mRNA was higher than in the control group, and the difference was extremely significant on day 15 (P < 0.01).The relative expression of TRIF mRNA in the experimental group was higher than in the control group at 25-55 days, and the relative expression of NF-κB mRNA in the experimental group was higher than in the control group at 15-45 days. The relative expression of IL-6 mRNA in the experimental group was higher than in the control group at 15-45 days. The protein expression level of TLR4 in the experimental group was higher than in the control group at 15-45 days. The PCA results showed that there was a strong correlation between TLR4, TRIF, and component 1. The results suggest that TLR4 plays an important role in regulating the expression of inflammatory cytokines in the spleens of Se-deficient chickens, and Se deficiency may cause inflammatory injury through the TLR4/TRIF/NF-κB signaling pathway in chicken spleen.


title: Obesity prolongs the hospital stay in patients affected by COVID-19, and may impact on SARS-COV-2 shedding

text: INTRODUCTION: On the last three months the new SARS-COV-2 coronavirus has created a pandemic, rapidly spreading all around the world. The aim of the study is to investigate whether obesity impacts on COVID-19 morbidity. METHODS: One hundred consecutive patients with COVID-19 pneumonia admitted in our Medical Unit were evaluated. Anthropometric parameters and past medical history were registered. Nasopharyngeal swab samples and biochemical analysis were obtained at admission and during hospital stay. RESULTS: Patients with (OB, 29) and without obesity (N-OB, 71) were similar in age, gender and comorbidities, with the exception of hypertension that was more frequent in OB group. At admission, inflammatory markers were higher in OB than N-OB group. OB group showed a worse pulmonary clinical picture, with lower PaO2 (57 ± 15 vs. 68 ± 14 mmHg, p = 0.042), and SaO2 (88 ± 6 vs. 92 ± 5%, p = 0.049) at admission consequently requiring higher volumes of oxygen (Fi02: 38 ± 15 vs. 29 ± 19%, p = 0.047) and a longer period to achieve oxygen weaning (10 ± 6 vs. 15 ± 7 days, p = 0.03). OB group also had positive swabs for longer time (19 ± 8 vs. 13 ± 7, days, p = 0.002), and required longer hospital stay (21 ± 8 vs. 13 ± 8, days, p = 0.0008). Partial least square regression analysis showed that BMI, age and CRP at admission were related to longer length of hospital stay, and time for negative swab. On the contrary, in this cohort, obesity did not predict higher mortality. CONCLUSIONS: Subjects with obesity affected by COVID-19 require longer hospitalization, more intensive and longer oxygen treatment, and they may have longer SARS-COV-2 shedding.


The Role of Non-Contrast Chest CT in Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) Pediatric Patients


title: DVT incidence and risk factors in critically ill patients with COVID-19

text: Few data are available on the incidence of deep vein thrombosis (DVT) in critically ill COVID-19 with thrombosis prophylaxis. This study retrospectively included 88 patients in the ICU with critically ill COVID-19 at Jinyintan Hospital in Wuhan, China. All patients underwent compression ultrasonography for identifying DVT. Firth logistic regression was used to examine the association of DVT with sex, age, hypoalbuminemia, D-dimer, and SOFA score. The median (interquartile range [IQR]) age and SOFA score of 88 patients were 63 (55-71) years old and 5 (4-6), respectively. Despite all patients receiving guideline-recommended low-molecular-weight heparin (LMWH) thromboprophylaxis, the incidence of DVT was 46% (95% CI 35-56%). Proximal DVT was recognized in 9% (95% CI 3-15%) of the patients, while 46% (95% CI 35-56%) of patients had distal DVT. All of the proximal DVT combined with distal DVT. Risk factors of DVT extension occurred in all distal DVT patients. As Padua score ≥ 4 or IMPROVE score ≥ 2, 53% and 46% of patients had DVT, respectively. Mortality was higher in patients with acute DVT (30%) compared with non-DVT (17%), but did not reach statistical significance. Hypoalbuminemia (odds ratio [OR], 0.17; 95% CI 0.06-0.05, P = 0.001), higher SOFA score (OR per IQR, 2.07; 95% CI 1.38-3.39, P = 0.001), and elevated D-dimer (OR per IQR, 1.04; 95% CI 1.03-1.84, P = 0.029) were significant DVT risk factors in multivariable analyses. High incidence of DVT was identified in patients with critically ill COVID-19, despite the use of guideline-recommended pharmacologic thromboprophylaxis. The presence of hypoalbuminemia, higher SOFA score, and elevated D-dimer were significantly independent risk factors of DVT. More effective VTE prevention and management strategies may need to be addressed.


title: Navigating Immunosuppression in a Pandemic: A Guide for the Dermatologist from the COVID Task Force of the Medical Dermatology Society and Society of Dermatology Hospitalists

text: Dermatologists treating immune-mediated skin disease must now contend with the uncertainties associated with immunosuppressive use in the context of the SARS-CoV-2 pandemic. Though the risk of infection with many commonly used immunosuppressive agents remains low, direct data evaluating the safety of such agents in COVID-19 are scarce. This article reviews and offers guidance based upon currently available safety data, and the most recent COVID-19 outcome data, in patients with immune-mediated dermatologic disease. The interdisciplinary panel of experts emphasize a stepwise, shared decision-making approach in the management of immunosuppressive therapy. The goal of this article is to help providers minimize the risk of disease flares while simultaneously minimizing the risk of iatrogenic harm during an evolving pandemic.


title: Innate Immune Signaling and Proteolytic Pathways in the Resolution or Exacerbation of SARS-CoV-2 in Covid-19: Key Therapeutic Targets?

text: COVID-19 is caused by the Severe Acute Respiratory Syndrome (SARS) coronavirus (Cov)-2, an enveloped virus with a positive-polarity, single-stranded RNA genome. The initial outbreak of the pandemic began in December 2019, and it is affecting the human health of the global community. In common with previous pandemics (Influenza H1N1 and SARS-CoV) and the epidemics of Middle east respiratory syndrome (MERS)-CoV, CoVs target bronchial and alveolar epithelial cells. Virus protein ligands (e.g., haemagglutinin or trimeric spike glycoprotein for Influenza and CoV, respectively) interact with cellular receptors, such as (depending on the virus) either sialic acids, Dipeptidyl peptidase 4 (DPP4), or angiotensin-converting enzyme 2 (ACE2). Host proteases, e.g., cathepsins, furin, or members of the type II transmembrane serine proteases (TTSP) family, such as Transmembrane protease serine 2 (TMPRSS2), are involved in virus entry by proteolytically activating virus ligands. Also involved are Toll Like Receptor (TLR) family members, which upregulate anti-viral and pro-inflammatory mediators [interleukin (IL)-6 and IL-8 and type I and type III Interferons among others], through the activation of Nuclear Factor (NF)-kB. When these events (virus cellular entry and innate immune responses) are uncontrolled, a deleterious systemic response is sometimes encountered in infected patients, leading to the well-described "cytokine storm" and an ensuing multiple organ failure promoted by a downregulation of dendritic cell, macrophage, and T-cell function. We aim to describe how the lung and systemic host innate immune responses affect survival either positively, through downregulating initial viral load, or negatively, by triggering uncontrolled inflammation. An emphasis will be put on host cellular signaling pathways and proteases involved with a view on tackling these therapeutically.


title: Agent-based Simulation of Pedestrian Dynamics for Exposure Time Estimation in Epidemic Risk Assessment

text: With the Corona Virus Disease 2019 (COVID-19) pandemic spreading across the world, protective measures for containing the virus are essential, especially as long as no vaccine or effective treatment is available. One important measure is the so-called physical distancing or social distancing. In this paper, we propose an agent-based numerical simulation of pedestrian dynamics in order to assess behaviour of pedestrians in public places in the context of contact-transmission of infectious diseases like COVID-19, and to gather insights about exposure times and the overall effectiveness of distancing measures. To abide the minimum distance of $1.5m$ stipulated by the German government at an infection rate of 2%, our simulation results suggest that a density of one person per $16m^2$ or below is sufficient. The results of this study give insight about how physical distancing as a protective measure can be carried out more efficiently to help reduce the spread of COVID-19.


COVID-19: the perspective of Italian embryologists managing the IVF laboratory in pandemic emergency


title: [Robotic and laparosocpic urological surgery during COVID-19 pandemia.]

text: OBJECTIVE: SARS-CoV-2 pandemic hashigh repercussion on urologic minimally invasive surgery (MIS) Controversy about safety of MIS procedures during COVID-19 pandemic has been published Nowadays, our priority should be create agreement in order to restart and organize MIS with safety conditions for patients and healthcare workers METHODS: Pubmed and web search was conducted with following terms: "SARS-CoV-2", "COVID19", "COVID19 Urology", COVID19 Surgery", "COVID19 transmission", "SARS-CoV-2 transmission", "COVID19 nd minimally invasive surgery", "SARS-CoV-2 and CO 2insuflation" A narrative review of available literature and scientific evidence summary was done A modify nominal group technique was used to achieve an expert consensus First draft was circulated amongst authors Definitive document was approved in May 26th RESULTS: Non evidence supports higher risk of SARSCoV-2 healthcare workers infection with MIS compared to open surgery MIS is associated with shorter hospital stay than open surgery Modify MIS indications to open surgery, with no scientific evidence, could spend valuable resources in detriment to COVID-19 patients MIS indications should be prioritized attending to available resources and pandemic intensity SARS-CoV-2screening 72 hours prior to surgery by clinical and epidemiological questionnaire and nasopharyngeal PCRis recommended, in order to prevent nosocomial transmission, professional infections and to minimize postoperative complications Intraoperative steps should be established to reduce professional exposure to surgical aerosols, including: surgical room reorganization, adequate personal protective equipment, surgical technique optimization and management of CO2 and surgical smoke CONCLUSIONS: In COVID-19 pandemic de-escalation, MIS carried out with optimal safety measurements, could contribute to reduce hospital resources utilization With current evidence, MIS should not be limited or reconverted to open surgery during COVID-19 pandemic


title: Robotic and laparosocpic urological surgery during COVID-19 pandemia./ Situacion de la cirugia laparoscopica y robotica urologica durante la pandemia COVID-19

text: OBJECTIVE: SARS-CoV-2 pandemic hashigh repercussion on urologic minimally invasive surgery (MIS) Controversy about safety of MIS procedures during COVID-19 pandemic has been published Nowadays, our priority should be create agreement in order to restart and organize MIS with safety conditions for patients and healthcare workers METHODS: Pubmed and web search was conducted with following terms: "SARS-CoV-2", "COVID19", "COVID19 Urology", COVID19 Surgery", "COVID19 transmission", "SARS-CoV-2 transmission", "COVID19 nd minimally invasive surgery", "SARS-CoV-2 and CO 2insuflation" A narrative review of available literature and scientific evidence summary was done A modify nominal group technique was used to achieve an expert consensus First draft was circulated amongst authors Definitive document was approved in May 26th RESULTS: Non evidence supports higher risk of SARSCoV-2 healthcare workers infection with MIS compared to open surgery MIS is associated with shorter hospital stay than open surgery Modify MIS indications to open surgery, with no scientific evidence, could spend valuable resources in detriment to COVID-19 patients MIS indications should be prioritized attending to available resources and pandemic intensity SARS-CoV-2screening 72 hours prior to surgery by clinical and epidemiological questionnaire and nasopharyngeal PCRis recommended, in order to prevent nosocomial transmission, professional infections and to minimize postoperative complications Intraoperative steps should be established to reduce professional exposure to surgical aerosols, including: surgical room reorganization, adequate personal protective equipment, surgical technique optimization and management of CO2 and surgical smoke CONCLUSIONS: In COVID-19 pandemic de-escalation, MIS carried out with optimal safety measurements, could contribute to reduce hospital resources utilization With current evidence, MIS should not be limited or reconverted to open surgery during COVID-19 pandemic OBJETIVO: La pandemia provocada por el nuevo coronavirus SARS-CoV-2 ha tenido una elevada repercusion sobre la cirugia minimamente invasiva (CMI) Ha surgido una importante controversia sobre la realizacion de CMI durante la pandemia COVID-19 Es prioritario, establecer un consenso sobre la organizacion y realizacion con seguridad de la CMI durante la pandemia MATERIAL Y METODOS: Se realizo una busqueda web y en PubMed con los terminos: SARS-CoV-2, COVID19,COVID19 Urology, COVID19 Surgery, COVID19 transmission, SARS-CoV-2 transmission, COVID19 and minimally invasive surgery, SARSCoV-2 and CO2 insuflation Se realizo una revision narrativa de la literatura y una sintesis de la evidencia disponible Se ha utilizado una tecnica de grupo nominal modificada, circulando un primer borrador a todos los autores y aprobandose la version definitiva el dia 26 de Mayo de 2020 RESULTADOS: No existe evidencia sobre una mayor exposicion a SARS-CoV-2 en CMI respecto a cirugia abierta La CMI se asocia a una menor estancia hospitalaria por lo que cambiar, sin justificacion, la indicacionde CMI puede retrotraer recursos que podrian ser utilizados para la pandemia COVID-19 Se debepriorizar la CMI segun los recursos disponibles y la intensidad de la pandemia en cada momento Se recomienda realizar despistaje de SARS-CoV-2 mediante cuestionario clinico-epidemiologico y PCR nasofaringea 72 horas antes de la CMI electiva, para minimizar las complicaciones postoperatorias, evitar la transmisioncruzada entre pacientes y la posible exposicion de los profesionales sanitarios Se recomienda establecer medidas de organizacion en quirofano, de proteccion personal, tecnica quirurgica y manejo del CO2 y aerosoles generados para reducir la exposicion y riesgos del personal sanitario CONCLUSIONES: La CMI realizada con las medidasd e seguridad adecuadas para el paciente y profesionales, puede contribuir durante la desescalada a una menor utilizacion de recursos sanitarios y por tanto, no debe limitarse su utilizacion o cambiar sus indicaciones


Letter to the Editor: COVID-19 and Perioperative Considerations


Reply to: Hedenstierna et al, Haouzi et al, Maley et al, Fowler et al, Bhatia and Mohammed, Bos, & Koumbourlis and Motoyama


title: Management of a delivery suite during the COVID-19 epidemic

text: BACKGROUND: Since the first report of the new coronavirus (COVID-19) infection in December of 2019, it has become rapidly prevalent and been declared as a Public Health Emergency of International Concern by the World Health Organization. There are quite a few cases reported involving delivery with COVID-19 infection, but little valuable suggestion was provided about what healthcare providers of obstetrics and neonatology should do in their clinic practice for unknown status or presumed negative women. Here, we summarized the current practice of delivery management in China that successfully prevented rapid increase in adverse pregnancy outcomes and nosocomial infection in departments of obstetrics and neonatology during the pandemic of COVID-19.


title: SBDiEM: A new Mathematical model of Infectious Disease Dynamics

text: A worldwide multi-scale interplay among a plethora of factors, ranging from micro-pathogens and individual or population interactions to macro-scale environmental, socio-economic and demographic conditions, entails the development of highly sophisticated mathematical models for robust representation of the contagious disease dynamics that would lead to the improvement of current outbreak control strategies and vaccination and prevention policies. Due to the complexity of the underlying interactions, both deterministic and stochastic epidemiological models are built upon incomplete information regarding the infectious network. Hence, rigorous mathematical epidemiology models can be utilized to combat epidemic outbreaks. We introduce a new spatiotemporal approach (SBDiEM) for modeling, forecasting and nowcasting infectious dynamics, particularly in light of recent efforts to establish a global surveillance network for combating pandemics with the use of artificial intelligence. This model can be adjusted to describe past outbreaks as well as COVID-19. Our novel methodology may have important implications for national health systems, international stakeholders and policy makers.


Sanitization of glaucoma clinic instruments in COVID-19 era


title: Molecular basis of COVID-19 relationships in different species: a one health perspective

text: Outside the Hubei province, China, the mild form of infection and the progressive recover of the COVID-19 patients suggest the intervention of "unconventional" biological mechanisms worthy of attention. Based on the high-homology between the Spike protein epitopes of taxonomically-related coronaviruses, we hypothesized that past contact with infected dogs shield humans against the circulating SARS-CoV-2. Elseways, the recurrent virus exposure over a short time-lapse might result in the Antibody Dependent Enhancement, triggering the violent immune reaction responsible for the severe clinical outcomes observed in the Hubei province. Nevertheless, further experimental studies are desired for a confidential evaluation of the postulated hypotheses.


title: Clinical orthodontic management during the COVID-19 pandemic

text: OBJECTIVES: To provide a comprehensive summary of the implications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) on orthodontic treatment, contingency management, and provision of emergency orthodontic treatment, using currently available data and literature. MATERIALS AND METHODS: Orthodontically relevant sources of information were searched using electronic databases including PubMed and Google Scholar and current reports from major health bodies such as Centers of Disease Control and Prevention, World Health Organization, National Institutes of Health, and major national orthodontic associations. RESULTS: Where available, peer-reviewed and more recent publications were given priority. Due to the rapidly evolving nature of COVID-19 and limitations in quality of evidence, a narrative synthesis was undertaken. Relevant to orthodontics, human-to human transmission of SARS-CoV-2 occurs predominantly through the respiratory tract via droplets, secretions (cough, sneeze), and or direct contact, where the virus enters the mucous membrane of the mouth, nose, and eyes. The virus can remain stable for days on plastic and stainless steel. Most infected persons experience a mild form of disease, but those with advanced age or underlying comorbidities may suffer severe respiratory and multiorgan complications. CONCLUSIONS: During the spread of the COVID-19 pandemic, elective orthodontic treatment should be suspended and resumed only when permitted by federal, provincial, and local health regulatory authorities. Emergency orthodontic treatment can be provided by following a contingency plan founded on effective communication and triage. Treatment advice should be delivered remotely first when possible, and where necessary, in-person treatment can be performed in a well-prepared operatory following the necessary precautions and infection prevention and control (IPAC) protocol.


title: Coronavirus Outbreak in Nigeria: Burden and Socio-Medical Response during the First 100 Days

text: BACKGROUND: The coronavirus disease of 2019 (COVID-19) pandemic shocked the world, overwhelming the health systems of even high-income countries. Expectedly, the situation has elicited social and medical responses from the public and governments respectively. Nigeria recorded an imported case from Italy on February 27, 2020. Hence, this paper assesses the early socio-medical response to COVID-19 in Nigeria within the first 100 days after the index case. The paper employs analytical methods and collates data from various media reports and official sources. FINDINGS: The incidence of COVID-19 grows steadily in Nigeria, moving from an imported case and elitist pattern to community transmission. The case fatality stood at 2.8%. The country recorded an upsurge (52% of total cases) in the transmission of COVID-19 during the short period the lockdown was relaxed. The paper presents a concise response framework to highlight some specific multisectoral responses to the pandemic. A combination of social and medical responses help Nigeria to curtail the spread of the virus to a large extent. CONCLUSION: The potential of overwhelming COVID-19 is still imminent in Nigeria as the country is attempting to hurriedly open the economy, which could sacrifice public health gains for temporary economic gains.


title: Covid-19 impact on air quality in megacities

text: Air pollution is among the highest contributors to mortality worldwide, especially in urban areas. During spring 2020, many countries enacted social distancing measures in order to slow down the ongoing Covid-19 pandemic. A particularly drastic measure, the"lockdown", urged people to stay at home and thereby prevent new Covid-19 infections. In turn, it also reduced traffic and industrial activities. But how much did these lockdown measures improve air quality in large cities, and are there differences in how air quality was affected? Here, we analyse data from two megacities: London as an example for Europe and Delhi as an example for Asia. We consider data during and before the lockdown and compare these to a similar time period from 2019. Overall, we find a reduction in almost all air pollutants with intriguing differences between the two cities. In London, despite smaller average concentrations, we still observe high-pollutant states and an increased tendency towards extreme events (a higher kurtosis during lockdown). For Delhi, we observe a much stronger decrease of pollution concentrations, including high pollution states. These results could help to design rules to improve long-term air quality in megacities.


title: Characteristics and Clinical Outcomes of COVID-19 Patients in an Underserved-Inner City Population: A Single Tertiary Center Cohort

text: BACKGROUND: There is limited information describing the characteristics and clinical outcomes of patients infected with coronavirus disease 2019 (COVID-19) especially those in underserved urban area with minority population in the United States. METHODS: This is a retrospective single center study for patients who were admitted with COVID-19 infection. Data collection was from March 1 through April 24,2020. Demographic, clinical, laboratory, and treatment data were presented using descriptive statistics and frequencies. Chi-square test and multivariate logistic regression were used to determine association of risk factors and clinical outcomes. RESULTS: A total of 242 inpatients were included with a mean age of 66 ±14.75 (±SD). 50% were female and 70% were African American. Comorbidities included hypertension (74%), diabetes mellitus (49%), and 19% had either COPD or asthma. Older age was associated with higher risk of inpatient death OR 1.056 [95% CI 1.023 to 1.090; p=0.001]. Inpatient mortality occurred in 70% who needed mechanical ventilation (OR: 29.51; 95% CI: 13.28-65.60; p<0.0001), 58% who required continuous renal replacement therapy/hemodialysis (CRRT/HD) (OR: 6.63; 95% CI: 2.74-16.05; p<0.0001), and 69% who needed vasopressors (OR: 30.64; 95% CI: 13.56 to 69.20; p<0.0001). Amongst biomarkers of disease severity, only baseline CRP levels (145±116 mg/L) were associated with mortality OR 1.008 [95% CI 1.003 to 1.012; p=0.002]. CONCLUSION: Majority of hospitalized patients had hypertension and diabetes. Older age was an independent risk factor for inpatient mortality. Requirement of mechanical ventilation, vasopressor use, and CRRT/HD were associated significantly with inpatient mortality. Higher baseline CRP was significantly associated with inpatient death. This article is protected by copyright. All rights reserved.


title: Nasal Swab as Preferred Clinical Specimen for Covid-19 Testing in Children

text: The first pediatric study demonstrating significantly higher positivity rate of nasal (mid-turbinate) swab testing over oropharyngeal swab testing in detecting SARS-CoV-2 (Fisher exact test 0.046, Cohen K 0.43, confidence interval 95%, 0.014-0.855). Benefits might include lower collection-related hazard for healthcare workers. We recommend it as preferred choice for swab-based SARS-CoV-2 testing in children.


Keeping a cut above the coronavirus disease: surgical perspectives from a public health institution in Singapore during Covid-19


title: Children's Respiratory Infections in Tianjin Area, China: Associations with Home Environments and Lifestyles

text: Children spend most of their indoors time at home, which may have substantial influence on their health. We conducted a cross-sectional study in the Tianjin area, China to quantify the incidence of respiratory infections among children, and its association with home environments and lifestyles. The lifetime-ever incidences of croup, pneumonia and ear infection among children aged 0-8 in Tianjin area was 9.2%, 28.7% and 11.6%, respectively. The incidence of common cold infections more than twice per year was 31.3%. Home environments and lifestyles included strong risk factors for childhood respiratory infections. Perceived dry air had the greatest association with childhood common colds (population attributable fraction (PAF = 15.0%). Modern floor covering had the greatest association with croup (PAF = 14.7%) and ear infection (PAF = 34.5%), while infrequent bedding sun-curing had the greatest association with pneumonia (PAF = 18.7%). Condensation (a proxy of poor ventilation) accounted for 12.2% of the incidence of croup (PAF = 12.2%) and frequent common colds (PAF = 8.4%). Our findings indicate that factors related to "modern" home environments and lifestyles are risks for childhood respiratory infections. Modifying such factors might reduce the incidence of respiratory infections among children.


title: Clinical Characteristics and Outcome for Four SARS-CoV-2-infected Cancer Patients Treated with Immune Checkpoint Inhibitors

text: Preliminary data suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with higher mortality among cancer patients, particularly in those on systemic therapy. It is unclear whether this applies to patients receiving immune checkpoint inhibitors (ICIs). In this case series, 74 patients from a single institution with genitourinary (GU) cancer on ICI were followed up during a 12-wk period. During this period, 11 patients (15%) developed symptoms consistent with coronavirus disease 2019 (COVID-19) and four (5%) tested positive. Two patients had metastatic urothelial cancer (treated with atezolizumab) and two had metastatic renal cancer (treated with ipilimumab and nivolumab). All had additional risk factors associated with COVID-19 mortality and two received steroids within 1 mo of infection. Two patients developed symptoms requiring hospitalisation. All four are alive 32-45 d after their first symptoms and 28-38 d after testing positive. These patients all had multiple risk factors associated with severe COVID-19. These data suggest that the higher risk of COVID-19 death associated with systemic therapy in cancer may not apply to patients on ICIs. Assessment of COVID-19 severity in these patients can be complicated by the underlying cancer and its treatment.


title: COVID-19 Exposes the Cracks in Our Already Fragile Mental Health System

text: The coronavirus pandemic has caused enormous concern among many people. Every morning, we are met with an increasing deluge of dire news about the most recent number of people to contract COVID-19 and to die from it, decreases in the stock market, and countries implementing broad travel restrictions and stay-at-home orders.1,2 The current state of affairs is having a negative effect on the mental well-being of our country's residents. It also highlights the policy gaps in our current system that inhibit the vital conditions for well-being and resiliency.3 Although the primary focus has rightfully been on stopping the spread of COVID-19, we should also quickly prepare to address the mental toll the pandemic is taking on individuals and communities across the country. (Am J Public Health. Published online ahead of print May 21, 2020: e1-e2. doi:10.2105/AJPH.2020.305699).


The role of hysteroscopy during COVID-19 outbreak: Safeguarding lives and saving resources


title: Presence of viral RNA of SARS-CoV-2 in conjunctival swab specimens of COVID-19 patients

text: Purpose: To detect the presence of viral RNA of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in conjunctival swab specimens of coronavirus disease-19 (COVID-19) patients. Methods: Forty-five COVID-19 patients positive for real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 in nasopharyngeal swab with or without ocular manifestations were included in the study. The conjunctival swab of each patient was collected by an ophthalmologist posted for COVID duty. Results: Out of 45 patients, 35 (77.77%) were males and the rest were females. The mean age was 31.26 ± 12.81 years. None of the patients had any ocular manifestations. One (2.23%) out of 45 patients was positive for RT-PCR SARS-CoV-2 in the conjunctival swab. Conclusion: This study shows that SARS-CoV-2 can be detected in conjunctival swabs of confirmed cases of COVID-19 patients. Though the positivity rate of detecting SARS-CoV-2 in conjunctival swabs is very less, care should be exercised during the ocular examination of patients of COVID-19.


title: Assessment of the impact of media coverage in coronavirus-related Google Trends: Infodemiology study

text: BACKGROUND: The influence of media coverage in online searches may hamper the role of Google Trends (GT) for Covid-19 monitoring. OBJECTIVE: To assess whether Covid-19-related GT - particularly on ageusia and anosmia - were primarily related to media coverage or with epidemic trends. METHODS: We retrieved GT data for searches on "coronavirus", "cough", "anosmia" and "ageusia", plotting them for a period of 5 years. In addition, we analysed the trends of those queries for 17 countries throughout the year of 2020, particularly concerning rises and peaks of searches. For anosmia and ageusia, we assessed whether the respective GT correlated with Covid-19 cases and deaths both throughout 2020 and specifically before March 16, 2020 (i.e., the date when the media started reporting that those symptoms could be associated with Covid-19). RESULTS: Over the last five years, peaks of "coronavirus" GT were only observed during the Winter of 2020. Rises and peaks in "coronavirus" searches were similar in time in the 17 different assessed countries, irrespectively of their epidemic situation. In 15 of these countries, rises in "anosmia" and "ageusia" GT occurred in the same week or one week after they were identified in the media as symptoms of Covid-19. Analysing data prior to March 16, 2020, anosmia/ageusia GT were found to have variable correlation with Covid-19 cases and deaths in the different countries. CONCLUSIONS: Covid-19-related GT is more related to media coverage than with epidemic trends.


COVID-19: Immense necessity and challenges in meeting the needs of minorities, especially asylum seekers and undocumented migrants


Dental sleep medicine perspectives post-COVID-19: interprofessional adaptation and directions


RAAS inhibitors do not increase the risk of COVID-19


title: Practical exploration of paperless medical records for COVID-19 : Tongji Hospital as an example/ 中华医院管理杂志

text: December 2019 witnessed the outbreak of COVID-19 in Wuhan city and its rapid spread to other parts of China, and overseas as well. Tongji Hospital, as a designated hospital for treatment of critically ill patients, shoulders the diagnosis and treatment tasks of numerous critically ill patients of such a disease. For the purpose of handling their medical records and effectively preventing the nosocomial infection of the disease, the hospital puts in place both the electronic signature system of patients based on a Wechat applet and a paperless medical record total solution based on the data center. These measures overcome the challenges incurred by patients’ signature on paper-based records and medical records archiving during the epidemic. On the other hand, they can not only downsize the paper-based medical records, minimize the risk of infection caused by paper-based medical records via contacts, but also effectively save the hospital of its operating costs and improve its efficiency of clinical work.


title: COVID-19 Challenges Basic Researchers

text: As COVID-19 continues to surge, cancer scientists engaged in basic research face unique challenges. At centers throughout the United States, investigators are confronting difficult decisions about which experiments to continue, while securing supplies and creating contingency plans for a complete shutdown.


The Early Natural History of SARS-CoV-2 Infection: Clinical Observations From an Urban, Ambulatory COVID-19 Clinic


title: Estimation of the actual disease occurrence based on official case numbers during a COVID outbreak in Germany 2020

text: Since the beginning of March 2020, the cumulative numbers of cases of infection with the novel coronavirus SARS-CoV-2 in Germany have been reported on a daily basis. The reports originate from national laws, according to which positive test findings must be submitted to the Federal Health Authorities, the Robert Koch Institute, via the local health authorities. Since an enormous number of unreported cases can be expected, the question of how widespread the disease has been in the population cannot be answered based on these administrative reports. Using mathematical modeling, however, estimates can be made. These estimates indicate that the small numbers of diagnostic tests carried out at the beginning of the outbreak overlooked considerable parts of the infection. In order to cover the initial phase of future waves of the disease, wide-spread and comprehensive tests are recommended.


title: ReCOVery: A Multimodal Repository for COVID-19 News Credibility Research

text: First identified in Wuhan, China, in December 2019, the outbreak of COVID-19 has been declared as a global emergency in January, and a pandemic in March 2020 by the World Health Organization (WHO). Along with this pandemic, we are also experiencing an"infodemic"of information with low credibility such as fake news and conspiracies. In this work, we present ReCOVery, a repository designed and constructed to facilitate the studies of combating such information regarding COVID-19. We first broadly search and investigate ~2,000 news publishers, from which 61 are identified with extreme [high or low] levels of credibility. By inheriting the credibility of the media on which they were published, a total of 2,029 news articles on coronavirus, published from January to May 2020, are collected in the repository, along with 140,820 tweets that reveal how these news articles are spread on the social network. The repository provides multimodal information of news articles on coronavirus, including textual, visual, temporal, and network information. The way that news credibility is obtained allows a trade-off between dataset scalability and label accuracy. Extensive experiments are conducted to present data statistics and distributions, as well as to provide baseline performances for predicting news credibility so that future methods can be directly compared. Our repository is available at http://coronavirus-fakenews.com, which will be timely updated.


title: Multi-Objective DNN-based Precoder for MIMO Communications

text: This paper introduces a unified deep neural network (DNN)-based precoder for two-user multiple-input multiple-output (MIMO) networks with five objectives: data transmission, energy harvesting, simultaneous wireless information and power transfer, physical layer (PHY) security, and multicasting. First, a rotation-based precoding is developed to solve the above problems independently. Rotation-based precoding is new precoding and power allocation that beats existing solutions in PHY security and multicasting and is reliable in different antenna settings. Next, a DNN-based precoder is designed to unify the solution for all objectives. The proposed DNN concurrently learns the solutions given by conventional methods, i.e., analytical or rotation-based solutions. A binary vector is designed as an input feature to distinguish the objectives. Numerical results demonstrate that, compared to the conventional solutions, the proposed DNN-based precoder reduces on-the-fly computational complexity more than an order of magnitude while reaching near-optimal performance (99.45\% of the averaged optimal solutions). The new precoder is also more robust to the variations of the numbers of antennas at the receivers.


Impact of COVID-19 pandemic on medical postgraduate training in the United States


title: Commentary: Could iron chelators prove to be useful as an adjunct to COVID-19 Treatment Regimens?

text: The pandemic of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a significant threat to global health. Currently, no specific prophylactic and therapeutic treatment is available. No evidence from randomized clinical trials (RCTs) that a treatment may ameliorate the clinical outcome of patients with COVID-19 exists with the only exception of preliminary evidence from remdesivir trials. Here, we present evidence from the literature and a compelling hypothesis on the potential immunomodulatory, iron chelating and anti-oxidant effects of iron chelators in the treatment of COVID-19 and its complications. Interestingly, iron chelation has been shown in vitro to suppress endothelial inflammation in viral infection, which is the main pathophysiologic mechanism behind systemic organ involvement induced by SARS-CoV-2, by inhibiting IL-6 synthesis through decreasing NF-kB. Iron chelators exhibit iron chelating, antiviral and immunomodulatory effects in vitro and in vivo, particularly against RNA viruses. These agents could attenuate ARDS and help control SARS-CoV-2 via multiple mechanisms including: 1) inhibition of viral replication; 2) decrease of iron availability; 3) upregulation of B cells; 4) improvement of the neutralizing anti-viral antibody titer; 5) inhibition of endothelial inflammation and 6) prevention of pulmonary fibrosis and lung decline via reduction of pulmonary iron accumulation. Both retrospective analyses of data in electronic health records, as well as proof of concept studies in humans and large RCTs are needed to fully elucidate the efficacy and safety of iron chelating agents in the therapeutic armamentarium of COVID-19, probably as an adjunctive treatment.


Surgical Stabilization of Rib Fractures during the COVID-19 Pandemic


title: Chinese medicine for COVID-19: A protocol for systematic review and meta-analysis

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus that was first identified during an investigation into an outbreak in Wuhan, China. The clinical spectrum of SARS-CoV-2 infection appears to be wide, encompassing asymptomatic infection, mild upper respiratory tract illness, and severe viral pneumonia with respiratory failure and even death, with many patients being hospitalised with pneumonia. In China and East Asia, Chinese medicine has been widely used to treat diverse diseases for thousands of years. As an important means of treatment now, Chinese medicine plays a significant role in the treatment of respiratory diseases in China. The aim of this study is to assess the efficacy and safety of Chinese medicine for COVID-19. METHODS: We will search the following sources for the identification of trials: The Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science and Technique Journals Database (VIP), and the Wanfang Database. All the above databases will be searched from the available date of inception until the latest issue. No language or publication restriction will be used. Randomized controlled trials will be included if they recruited participants with COVID-19 for assessing the effect of Chinese medicine vs control (placebo, no treatment, and other therapeutic agents). Primary outcomes will include chest CT and nucleic acid detection of respiratory samples. Two authors will independently scan the articles searched, extract the data from articles included, and assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by consensus or the involvement of a third party. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Dichotomous variables will be reported as risk ratio or odds ratio with 95% confidence intervals (CIs) and continuous variables will be summarized as mean difference or standard mean difference with 95% CIs. RESULTS AND CONCLUSION: The available evidence of the treatment of COVID-19 with traditional Chinese medicine will be summarized, and evaluation of the efficacy and the adverse effects of these treatments will be made. This review will be disseminated in print by peer-review.


title: Genome analysis of SARS-CoV-2 isolates occurring in India: Present scenario

text: Background: The origin of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is still a debatable topic. The association of the virus spread from the market is supported by the close relation of genome sequences of environmental surface samples with virus samples from earliest patients by phylogenetic analysis. Objectives: To have an insight into the SARS-CoV-2 genome sequences reported from India for better understanding on their epidemiology and virulence. Methods: Genome sequences of Indian isolates of SARS-CoV-2 were analyzed to understand their phylogeny and divergence with respect to other isolates reported from other countries. Amino acid sequences of individual open reading frames (ORFs) from SARS-CoV-2 Indian isolates were aligned with sequences of isolates reported from other countries to identify the mutations occurred in Indian isolates. Results: Our analysis suggests that Indian SARS-CoV-2 isolates are closely related to isolates reported from other parts of the world. Most ORFs are highly conserved; mutations were also detected in some ORFs. We found that most isolates reported from India have key mutations at 614th position of the S protein and 84th position of the ORF 8, which has been reported to be associated with high virulence and high transmission rate. Conclusion: An attempt was made to understand the SARS-CoV-2 virus reported from India. SARS-CoV-2 reported from India was closely similar to other SARS-CoV-2 reported from other parts of the world, which suggests that vaccines and other therapeutic methods generated from other countries might work well in India. In addition, available sequence data suggest that majority of Indian isolates are capable of high transmission and virulence.


Scientific and ethical basis for social-distancing interventions against COVID-19


How Community-Based Health Systems Embrace Research During the COVID-19 Pandemic


title: Proposed Changes to the 2021 Residency Application Process in the Wake of COVID-19

text: The COVID-19 pandemic has brought unique challenges to the delivery of undergraduate medical education, particularly for current third-year medical students who are preparing to apply to residency. In mid-March, medical schools suspended all clinical rotations for the remainder of the 2019-2020 academic year. As such, third-year medical students may not be able to complete sufficient clinical experiences to make important career choices before they have to submit their residency applications. While the decision to suspend clinical rotations was necessary to protect students, specialty organizations and residency programs must mitigate the deficits in students' clinical education caused by the COVID-19 pandemic.In this Perspective, the authors identify potential challenges for third-year medical students and advocate for solutions to improve the residency application process for students and programs. First, they propose delaying the date that programs can access applicant data through the Electronic Residency Application Service, thereby affording students more time to complete clinical experiences, solidify their specialty decision, and strengthen their residency application. Second, the authors recommend a restriction on the number of visiting rotations that students are expected to complete to allow for a more equitable distribution of these important experiences. Third, they suggest that program directors from each specialty agree on a maximum number of applications per applicant (based on historical data) to curb an upsurge in applications that may stem from the unique circumstances created by COVID-19 without causing applicants undue stress. Lastly, the authors advocate that residency programs develop infrastructure to conduct video-based interviews and engage students through virtual networking events.Amidst the unique environment created by COVID-19, the authors urge governing bodies, specialty organizations, and residency programs to consider these recommendations to improve the efficiency and reduce the stress surrounding the 2021 Match.


title: Coronavirus Disease Outbreak in Call Center, South Korea

text: We describe the epidemiology of a coronavirus disease (COVID-19) outbreak in a call center in South Korea. We obtained information on demographic characteristics by using standardized epidemiologic investigation forms. We performed descriptive analyses and reported the results as frequencies and proportions for categoric variables. Of 1,143 persons who were tested for COVID-19, a total of 97 (8.5%, 95% CI 7.0%-10.3%) had confirmed cases. Of these, 94 were working in an 11th-floor call center with 216 employees, translating to an attack rate of 43.5% (95% CI 36.9%-50.4%). The household secondary attack rate among symptomatic case-patients was 16.2% (95% CI 11.6%- 22.0%). Of the 97 persons with confirmed COVID-19, only 4 (1.9%) remained asymptomatic within 14 days of quarantine, and none of their household contacts acquired secondary infections. Extensive contact tracing, testing all contacts, and early quarantine blocked further transmission and might be effective for containing rapid outbreaks in crowded work settings.


title: [Clinical analysis of kidney injury in patients with COVID-19]

text: Objective: To investigate the relationship between novel coronavirus pneumonia (COVID-19) and kidney injury. Methods: A retrospective analysis was performed on COVID-19 confirmed patients in the Central Theater Command General Hospital of Chinese PLA on March 12, 2020. A total of 87 hospitalized COVID-19 confirmed patients were enrolled in the study, and they were hospitalized at least one week. The recorded information included clinical data and indicators of kidney-related laboratory tests. Results: The average age of patients was (65.2±17.1) years, and 34.5% (30/87) patients were ≥ 75 years old and 31.0% (27/87) patients were 60~74 years old. Male and female patients accounted for 59.8% (52/87) and 40.2% (35/87), respectively. There were 29.9% (26/87) and 12.6% (11/87) patients who had already showed mild elevation of blood urea nitrogen (BUN) and serum creatinine (SCr) at admission. Moreover, 25.3% (22/87) and 4.6% (4/87) patients still exhibited mild elevation of BUN and SCr one week after admission. However, 28.7% (25/87) patients showed an elevation of BUN one week later after admission, though their BUN levels were normal at admission. Likewise, 16.1% (14/87) patients showed an elevation of SCr one week later after admission, while their SCr levels were normal at admission. Only two patients had an increase of SCr ≥26.5 µmol/L, and both of them were over 75 years old. Conclusions: COVID-19 patients with severe acute kidney injury are uncommon. However, attention should be paid to acute kidney injury of the elderly patients in the diagnosis and treatment of COVID-19.


Comment on "Smooth or Risky Revisit of an Old Malaria Drug for COVID-19?"


COVID-19 stigma induced by press releases in Japan: It's time to reconsider risk communication learned from the Fukushima Daiichi Nuclear Disaster


Bolstering the surgical response to COVID-19: how virtual technology will save lives and safeguard surgical practice


Airborne precautions are needed against COVID-19


title: Clinical Trials for COVID-19: Can we Better Use the Short Window of Opportunity?

text: The scientific community has risen to the coronavirus disease 2019 (COVID-19) challenge, coming up with an impressive list of candidate drugs and vaccines targeting an array of pharmacological and immunological mechanisms. Yet, generating clinical evidence of efficacy and safety of these candidate treatments may be frustrated by the absence of comprehensive trial coordination mechanisms. Many small stand-alone trials and observational studies of single-agent interventions are currently running or in planning; many of these will likely not deliver robust results that could support regulatory and patient-level treatment decisions. In this paper, we discuss actions that all stakeholders in the clinical trial ecosystem need to take to ensure that the window of opportunity during this pandemic will not shut, both for patients in need of treatment and for researchers to conduct decision-relevant clinical trials.


title: [Az aneszteziológiai és intenzív ellátás kihívásai a COVID19-fertozéssel kapcsolatban. Gyakorlati ajánlás]/ Challenges of intensive care and anesthesiology related to COVID-19 pandemic. Practical considerations

text: Due to the coronavirus epidemic, healthcare systems face growing challenges all around the world nowadays. These challenges are the most critical in the field of intensive treatment and anesthesiology. One of the most important prerequisites of effective critical care treatment is preserving the involved healthcare workers from the infection, by providing them with detailed practical advices on the preventive measures and treatment strategies. The aim of the present review is to summarize the most important related knowledge available from previous experiences. Orv Hetil. 2020; 161(17): 652659.