title: Coronavirus: Comparing COVID-19, SARS and MERS in the eyes of AI

text: Novel Coronavirus disease (COVID-19) is an extremely contagious and quickly spreading Coronavirus disease. Severe Acute Respiratory Syndrome (SARS)-CoV, Middle East Respiratory Syndrome (MERS)-CoV outbreak in 2002 and 2011 and current COVID-19 pandemic all from the same family of Coronavirus. The fatality rate due to SARS and MERS were higher than COVID-19 however, the spread of those were limited to few countries while COVID-19 affected more than two-hundred countries of the world. In this work, authors used deep machine learning algorithms along with innovative image pre-processing techniques to distinguish COVID-19 images from SARS and MERS images. Several deep learning algorithms were trained, and tested and four outperforming algorithms were reported: SqueezeNet, ResNet18, Inceptionv3 and DenseNet201. Original, Contrast limited adaptive histogram equalized and complemented image were used individually and in concatenation as the inputs to the networks. It was observed that inceptionv3 outperforms all networks for 3-channel concatenation technique and provide an excellent sensitivity of 99.5%, 93.1% and 97% for classifying COVID-19, MERS and SARS images respectively. Investigating deep layer activation mapping of the correctly classified images and miss-classified images, it was observed that some overlapping features between COVID-19 and MERS images were identified by the deep layer network. Interestingly these features were present in MERS images and 10 out of 144 images were miss-classified as COVID while only one out of 423 COVID-19 images was miss-classified as MERS. None of the MERS images was miss-classified to SARS and only one COVID-19 image was miss-classified as SARS. Therefore, it can be summarized that SARS images are significantly different from MERS and COVID-19 in the eyes of AI while there are some overlapping feature available between MERS and COVID-19.


O Anestesiologista e a COVID19./ [The Anesthesiologist and COVID-19]


title: Molecular conservation and differential mutation on ORF3a gene in Indian SARS-CoV2 genomes

text: A global emergency due to the COVID-19 pandemic demands various studies related to genes and genomes of the SARS-CoV2. Among other important proteins, the role of accessory proteins are of immense importance in replication, regulation of infections of the coronavirus in the hosts. The largest accessory protein in the SARS-CoV2 genome is ORF3a which modulates the host response to the virus infection and consequently it plays an important role in pathogenesis. In this study, an attempt is made to decipher the conservation of nucleotides, dimers, codons and amino acids in the ORF3a genes across thirty-two genomes of Indian patients. ORF3a gene possesses single and double point mutations in Indian SARS-CoV2 genomes suggesting the change of SARS-CoV2's virulence property in Indian patients. We find that the parental origin of the ORF3a gene over the genomes of SARS-CoV2 and Pangolin-CoV is same from the phylogenetic analysis based on conservation of nucleotides and so on. This study highlights the accumulation of mutation on ORF3a in Indian SARS-CoV2 genomes which may provide the designing therapeutic approach against SARS-CoV2.


title: An evaluation of COVID-19 serological assays informs future diagnostics and exposure assessment

text: The world is entering a new era of the COVID-19 pandemic in which there is an increasing call for reliable antibody testing. To support decision making on the deployment of serology for either population screening or diagnostics, we present a detailed comparison of serological COVID-19 assays. We show that among the selected assays there is a wide diversity in assay performance in different scenarios and when correlated to virus neutralizing antibodies. The Wantai ELISA detecting total immunoglobulins against the receptor binding domain of SARS CoV-2, has the best overall characteristics to detect functional antibodies in different stages and severity of disease, including the potential to set a cut-off indicating the presence of protective antibodies. The large variety of available serological assays requires proper assay validation before deciding on deployment of assays for specific applications.


title: Cholecystectomia során bekövetkezo epeútsérülések ellátása

text: Biliary injury is a rare but a very serious complication of laparoscopic cholecystectomy (LC). Our aim was to analyse the incidence of the biliary injuries and its therapeutic outcome on patients who underwent LC or converted LC. Our research was conducted at the 1st Department of Surgery, Semmelweis University, Budapest between 2006 and 2016, retrospectively. We analysed the LCs and converted LCs performed at our Department and as well as cases where the primary operations were conducted at other institutions but they were unable to provide the adequate therapy for the injury, thus the patients were transferred to our institution. At the 1st Department of Surgery complications occurred in 0,66% (30/4885) of all LCs. 327 converted LCs were done, complications occurred in 26 (7.95%) times. 22 patients were transferred to the 1st Department of Surgery from other institutions. Bilio-vascular injuries occurred in 61% (41/78). ERCP was performed in 25 cases with a 92% success rate. Reoperation was needed in 41% (28/41). Biliary reconstruction during the reoperation was performed via hepaticojejunostomy in 82% of all reoperations. The therapeutic solutions of LC's complications are complex. Therefore, the treatment is recommended only in institutions with appropriate experience.


Illicit drug use and harms in Australia in the context of COVID-19 and associated restrictions: Anticipated consequences and initial responses


Ethics Committee Reviews of Applications for Research Studies at 1 Hospital in China During the 2019 Novel Coronavirus Epidemic


title: Japanese citizens' behavioral changes and preparedness against COVID-19: An online survey during the early phase of the pandemic

text: The Japanese government instituted countermeasures against COVID-19, a pneumonia caused by the new coronavirus, in January 2020. Seeking "people's behavioral changes," in which the government called on the public to take precautionary measures or exercise self-restraint, was one of the important strategies. The purpose of this study is to investigate how and from when Japanese citizens have changed their precautionary behavior under circumstances in which the government has only requested their cooperation. This study uses micro data from a cross-sectional survey conducted on an online platform of an online research company, based on quota sampling that is representative of the Japanese population. By the end of March 2020, a total of 11,342 respondents, aged from 20 to 64 years, were recruited. About 85 percent reported practising the social distancing measures recommended by the government including more females than males and more older than younger participants. Frequent handwashing is conducted by 86 percent of all participants, 92 percent of female, and 87.9 percent of over-40 participants. The most important event influencing these precautionary actions was the infection aboard the Diamond Princess cruise ship, which occurred in early February 2020 (23 percent). Information from the central and local governments, received by 60 percent of the participants, was deemed trustworthy by 50 percent. However, the results also showed that about 20 percent of the participants were reluctant to implement proper prevention measures. The statistical analysis indicated that the typical characteristics of those people were male, younger (under 30 years old), unmarried, from lower-income households, a drinking or smoking habit, and a higher extraversion score. To prevent the spread of infection in Japan, it is imperative to address these individuals and encourage their behavioural changes using various means to reach and influence them.


Inequity in Crisis Standards of Care


title: Evaluating epidemic forecasts in an interval format

text: For practical reasons, many forecasts of case, hospitalization and death counts in the context of the current COVID-19 pandemic are issued in the form of central predictive intervals at various levels. This is also the case for the forecasts collected in the COVID-19 Forecast Hub run by the UMass-Amherst Influenza Forecasting Center of Excellence. Forecast evaluation metrics like the logarithmic score, which has been applied in several infectious disease forecasting challenges, are then not available as they require full predictive distributions. This note provides an overview of how established methods for the evaluation of quantile and interval forecasts can be applied to epidemic forecasts. Specifically, we discuss the computation and interpretation of the weighted interval score, which is a proper score that approximates the continuous ranked probability score. It can be interpreted as a generalization of the absolute error to probabilistic forecasts and allows for a simple decomposition into a measure of sharpness and penalties for over- and underprediction.


title: Short-Term Dexamethasone in Sars-CoV-2 Patients

text: BACKGROUND: Dexamethasone, a synthetic glucocorticoid, has anti-inflammatory and immunosuppressive properties There is a hyperinflammatory response involved in the clinical course of patients with pneumonia due to SARS-CoV-2 To date, there has been no definite therapy for COVID-19 We reviewed the charts of SARS-CoV-2 patients with pneumonia and moderate to severely elevated CRP and worsening hypoxemia who were treated with early, short-term dexamethasone METHODS: We describe a series of 21 patients who tested positive for SARS-CoV-2 and were admitted to The Miriam Hospital in Providence, RI, and were treated with a short course of dexamethasone, either alone or in addition to current investigative therapies RESULTS: CRP levels decreased significantly following the start of dexamethasone from mean initial levels of 129 52 to 40 73 mg/L at time of discharge 71% percent of the patients were discharged home with a mean length of stay of 7 8 days None of the patients had escalation of care, leading to mechanical ventilation Two patients were transferred to inpatient hospice facilities on account of persistent hypoxemia, in line with their documented goals of care CONCLUSIONS: A short course of systemic corticosteroids among inpatients with SARS-CoV-2 with hypoxic respiratory failure was well tolerated, and most patients had improved outcomes This limited case series may not offer concrete evidence towards the benefit of corticosteroids in COVID-19 However, patients' positive response to short-term corticosteroids demonstrates that they may help blunt the severity of inflammation and prevent a severe hyperinflammatory phase, in turn reducing the length of stay, ICU admissions, and healthcare costs


Immune checkpoint inhibitors in SARS-CoV-2 infected cancer patients: the spark that ignites the fire?


title: Possible Cause of Inflammatory Storm and Septic Shock in Patients Diagnosed with (COVID-19)

text: The novel coronavirus (SARS-CoV-2) infection which has been known as Coronavirus diseases 2019 COVID-19 has become an endemic emergent situation by the World Health Organization. So far, no successful specific treatment has been found for this disease. As has been reported, most of non-survivor patients with COVID-19 (70%) had septic shock which was significantly higher than survived ones. Although the exact pathophysiology of septic shock in these patients is still unclear, it seems to be possible that part of it would be due to the administration of empiric antibiotics with inflammatory properties especially in the absence of bacterial infection. Herein, we have reviewed possible molecular pathways of septic shock in the patients who have received antibiotics with inflammatory properties which mainly is release of interleukin 1ß (IL-1ß), IL-6, and tumor necrosis factor α (TNF- α) through different routes. Altogether, we highly recommend clinicians to look after those antibiotics with anti-inflammatory activity for both empiric antibiotic therapy and reducing the inflammation to prevent septic shock in patients with diagnosed COVID-19.


title: COVID-19: Analytics Of Contagion On Inhomogeneous Random Social Networks

text: Motivated by the need for novel robust approaches to modelling the Covid-19 epidemic, this paper treats a population of $N$ individuals as an inhomogeneous random social network (IRSN). The nodes of the network represent different types of individuals and the edges represent significant social relationships. An epidemic is pictured as a contagion process that changes daily, triggered on day $0$ by a seed infection introduced into the population. Individuals' social behaviour and health status are assumed to be random, with probability distributions that vary with their type. First a formulation and analysis is given for the basic SI ("susceptible-infective") network contagion model, which focusses on the cumulative number of people that have been infected. The main result is an analytical formula valid in the large $N$ limit for the state of the system on day $t$ in terms of the initial conditions. The formula involves only one-dimensional integration. Next, more realistic SIR and SEIR network models, including"removed"(R) and"exposed"(E) classes, are formulated. These models also lead to analytical formulas that generalize the results for the SI network model. The framework can be easily adapted for analysis of different kinds of public health interventions, including vaccination, social distancing and quarantine. The formulas can be implemented numerically by an algorithm that efficiently incorporates the fast Fourier transform. Finally a number of open questions and avenues of investigation are suggested, such as the framework's relation to ordinary differential equation SIR models and agent based contagion models that are more commonly used in real world epidemic modelling.


COVID-19-associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features


How to address the coronavirus's outsized toll on people of colour


Managing hypertension during the COVID-19 pandemic


title: On the effectiveness of imposing restrictive measures in a graded Self-Organized Criticality epidemic spread model The case of COVID-19

text: The scope of this work is to serve as a guiding tool against subjective estimations on real pandemic situations (mainly due to the inability to acquire objective real data over whole populations). The previously introduced model of closed self-organized criticality (SOC), is adapted in the case of a virus-induced epidemic. In this version this physical model can distinguish the virus spread according to the virus aggressiveness. The study presented, highlights the critical value of virus density over a population. For low values of the initial virus density (lower than the critical value) it is proved that the virus-diffusion behavior is safe and quantitatively similar to usual real epidemical data. However, it is revealed that very close to the critical point, the critical slowing-down (CSD) phenomenon, introduced by the theory of critical phenomena, emerges, leading to a tremendous increase of both the percentage of active carriers and the duration of the epidemic. A behavior of the epidemic obeying to a second order phase transition, also occurs. For virus density values higher than the critical value, the epidemic duration becomes extremely prolonged. Additionally, the effect of the closed system population size revealed interesting properties. All these results, together with an investigation of the effectiveness of applying physical contact restriction measures, document scientifically their worthiness, while they also demonstrate the limits for which herd immunity holds safely. Finally, the model has been compared against real epidemic data in the case of Greece, which imposed restrictive measures consistently and in time.


title: Identification of COVID-19 can be quicker through artificial intelligence framework using a mobile phone-based survey when cities and towns are under quarantine

text: We propose the use of a machine learning algorithm to improve possible COVID-19 case identification more quickly using a mobile phone-based web survey. This method could reduce the spread of the virus in susceptible populations under quarantine.


title: The Definition and Risks of Cytokine Release Syndrome in 11 COVID-19-Affected Critically Ill Patients with Pneumonia: Analysis of Disease Characteristics

text: Corona Virus Disease 2019(COVID-19)-affected patients with severe immune abnormalities have a risk of cytokine release syndrome. The definition, prevention, and treatment of symptoms of cytokine release syndrome in critically ill patients with COVID-19 are important problems. This was a single-center case series of 11 COVID-19 patients with acute respiratory distress syndrome (ARDS) from The First Affiliated Hospital of Guangzhou Medical University in China from January 26, 2020 to February 18, 2020. The termination date of follow-up was February 19, 2020. In this single-center analysis of 11 critically ill patients with COVID-19, 8 patients were determined to have characteristics of cytokine release syndrome (CRS), including pulmonary inflammation, fever, and dysfunction of non-pulmonary organs; an increase of- Interleukin-6 (IL-6) in peripheral blood was the highest risk factor and an early indicator of CRS in COVID-19.


title: Clinical Pharmacology Considerations for Developing Small-Molecule Treatments for COVID-19

text: Numerous drugs are being investigated for the treatment of COVID-19, including antivirals and therapies targeting complications related to COVID-19. The clinical presentation of COVID-19 varies from mild fever, cough, and dyspnea in the early stages of disease to severe complications such as acute respiratory distress syndrome, systemic hyperinflammation, and sepsis. A thorough understanding of the disease pathogenesis and the disease complications is essential to developing effective therapies to treat this potentially life-threatening disease. This review offers key clinical pharmacology considerations involved in the development of small molecules for the treatment of COVID-19. They are based on the major observed disease complications that impact drug absorption, distribution, metabolism, and elimination. We also address considerations regarding potential drug interactions, alternative routes and methods of administration, and dosing in patients on hemodialysis.


title: COVID-19 presenting as severe, persistent abdominal pain and causing late respiratory compromise in a 33-year-old man

text: A 33-year-old man presented repeatedly with severe abdominal pain and diarrhoea. Renal colic was suspected, and he was admitted for pain management. Questioning elicited an additional history of sore throat and mild, dry cough. Inflammatory markers were mildly raised (C reactive protein (CRP) 40 mg/L). Initial nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by PCR. CT of the kidneys, ureters and bladder (CT KUB) was normal; however, CT of the thorax showed multifocal bilateral peripheral areas of consolidation consistent with COVID-19 infection. He developed respiratory compromise and was transferred to the intensive care unit (ICU). Sputum was positive for SARS-CoV-2 by PCR, and culture grew Yersinia enterocolitica He recovered following supportive management and treatment with piperacillin-tazobactam.


title: Exploring the non-technical competencies for on-scene public health responders in chemical, biological, radiological, and nuclear emergencies: a qualitative study

text: OBJECTIVES: The purpose of this study was to define and delineate specific non-technical competencies for first-line public health responders in Chemical, Biological, Radiological, and Nuclear (CBRN) emergencies in China. STUDY DESIGN: A qualitative study was conducted in China involving interviews with key informants in the field of health response to CBRN disasters. METHODS: One-on-one in-depth interviews were carried out with 20 participants, including expert members of National Medical Response Teams for CBRN disasters, officials at emergency management authorities, and scholars of academic institutions related to CBRN emergency. Interviews were recorded using audio equipment, transcribed, and coded into codable passages as per grounded theory using NVivo software. Themes were identified within the transcriptions by using thematic analysis. RESULTS: A total of 159 codable passages were produced. Eight domains of non-technical core competencies were identified: (1) situation awareness, (2) communication skills, (3) collaboration, (4) resource management, (5) task management, (6) cultural competency, (7) austere environment skills, and (8) physical stamina. CONCLUSIONS: The study identified a variety of competencies for on-scene public health responders in CBRN emergencies. The findings of this study could specifically benefit development of strategy and improvement of content of education and training. Further research that involves input from the disaster response community at large is needed for the validation of these competencies.


COVID-19 Pandemic in India: What Lies Ahead


Managing the supportive care needs of those affected by COVID-19


title: What's New With the Old Coronaviruses?

text: Coronaviruses contribute to the burden of respiratory diseases in children, frequently manifesting in upper respiratory symptoms considered to be part of the "common cold." Recent epidemics of novel coronaviruses recognized in the 21st century have highlighted issues of zoonotic origins of transmissible respiratory viruses and potential transmission, disease, and mortality related to these viruses. In this review, we discuss what is known about the virology, epidemiology, and disease associated with pediatric infection with the common community-acquired human coronaviruses, including species 229E, OC43, NL63, and HKU1, and the coronaviruses responsible for past world-wide epidemics due to severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus.


title: Transition to a virtual multidisciplinary tumor board during the COVID-19 pandemic: University of Pittsburgh experience

text: Multidisciplinary conferences (MDC) are an important component of head and neck oncologic care including diagnosis, treatment, and survivorship. Virtual MDC allows for improved collaboration between providers at distant sites and proper allocation of health care resources in a time of crisis. When approached systematically, a virtual MDC is feasible to design and implement in a large academic medical center with multiple satellite hospitals.


The COVID-19 crisis: A unique opportunity to expand dermatology to underserved populations


title: The spectrum of COVID-19-associated dermatologic manifestations: an international registry of 716 patients from 31 countries

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) has associated cutaneous manifestations. OBJECTIVE: To characterize the diversity of cutaneous manifestations of COVID-19, and facilitate understanding of underlying pathophysiology. METHODS: Case series from an international registry from the American Academy of Dermatology and International League of Dermatological Societies. RESULTS: The registry collected 716 cases of new-onset dermatologic symptoms in patients with confirmed/suspected COVID-19. Of the 171 patients in the registry with laboratory-confirmed COVID-19, the most common morphologies were morbilliform (22%), pernio-like (18%), urticarial (16%), macular erythema (13%), vesicular (11%), papulosquamous (9.9%), and retiform purpura (6.4%). Pernio-like lesions were common in patients with mild disease, while retiform purpura presented exclusively in ill, hospitalized patients. LIMITATIONS: We cannot estimate incidence or prevalence. Confirmation bias is possible. CONCLUSION: This study highlights the array of cutaneous manifestations associated with COVID-19. Many morphologies were non-specific, while others may provide insight into potential immune or inflammatory pathways in COVID-19 pathophysiology.


title: Quarantine and its legal dimension

text: Quarantine and isolation are public health measures used for centuries to prevent the spread of infectious diseases. Quarantine is separation of persons who have been exposed to an infection but asymptomatic, while isolation is separation of infected patients. Voluntary quarantine is preferred, but if necessary, it can be mandatory. These implementations can lead to restrictions on individual liberties, leading to ethical and legal problems. Isolation and quarantine enforcement are regulated by laws. Those who do not follow the quarantine rules could be punished. Isolation and quarantine practices in our country are described in General Hygiene Law. In this study the importance of quarantine, when and how it is applied, and its ethical and especially legal dimension are discussed.


Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient


Editorial. A neurosurgery resident's response to COVID-19: anything but routine


Returning Chinese school-aged children and adolescents to physical activity in the wake of COVID-19: Actions and precautions


Role of Helmet-Delivered Noninvasive Pressure Support Ventilation in COVID-19 Patients


title: Staggered release policies for COVID-19 control: Costs and benefits of relaxing restrictions by age and risk

text: Lockdown and social distancing restrictions have been widely used as part of policy efforts aimed at controlling the ongoing COVID-19 pandemic. Since these restrictions have a negative impact on the economy, there exists a strong incentive to relax these policies while protecting public health. Using a modified SEIR epidemiological model, this paper explores the costs and benefits associated with the sequential release of specific groups based on age and risk from lockdown and social distancing measures. The results in this paper suggest that properly designed staggered-release policies can do better than simultaneous-release policies in terms of protecting the most vulnerable members of a population, reducing health risks overall, and increasing economic activity.


Impact of COVID-19 pandemic on general surgery training program: An Italian experience


Mitigate risks of medication interruption due to COVID-19 for elderly with chronic diseases


title: Using informatics to guide public health policy during the COVID-19 pandemic in the USA

text: BACKGROUND: Current and future pandemics will require informatics solutions to assess the risks, resources and policies to guide better public health decision-making. METHODS: Cross-sectional study of all COVID-19 cases and deaths in the USA on a population- and resource-adjusted basis (as of 24 April 2020) by applying biomedical informatics and data visualization tools to several public and federal government datasets, including analysis of the impact of statewide stay-at-home orders. RESULTS: There were 2753.2 cases and 158.0 deaths per million residents, respectively, in the USA with variable distributions throughout divisions, regions and states. Forty-two states and Washington, DC, (84.3%) had statewide stay-at-home orders, with the remaining states having population-adjusted characteristics in the highest risk quartile. CONCLUSIONS: Effective national preparedness requires clearly understanding states' ability to predict, manage and balance public health needs through all stages of a pandemic. This will require leveraging data quickly, correctly and responsibly into sound public health policies.


Health psychology and the coronavirus (COVID-19) global pandemic: A call for research


Public health perspectives of smokeless tobacco and areca nut use in the COVID-19 era


title: COVID-19 Is an Independent Risk Factor for Acute Ischemic Stroke

text: BACKGROUND AND PURPOSE: Coronavirus disease 2019 (COVID-19) is an active worldwide pandemic with diverse complications. Stroke as a presentation has not been strongly associated with COVID-19. The authors aimed to retrospectively review a link between COVID-19 and acute stroke. MATERIALS AND METHODS: We conducted a retrospective case-control study of 41 cases and 82 control subjects matched by age, sex, and risk factors. Cases were patients who underwent stroke alert imaging with confirmed acute stroke on imaging between March 16 and April 5, 2020, at 6 hospitals across New York City. Control subjects were those who underwent stroke alertimaging during the same timeframe without imaging evidence of acute infarction. Data pertaining to diagnosis of COVID-19 infection, patient demographics, and risk factors were collected. A univariate analysis was performed to assess the covariate effect of risk factors and COVID-19 status on stroke imaging with positive findings. RESULTS: The mean age for cases and controls was 65.5 ± 15.3 years and 68.8 ± 13.2 years, respectively. Of patients with acute ischemic stroke, 46.3% had COVID-19 infection compared with 18.3% of controls (P = .001). After adjusting for age, sex, and risk factors, COVID-19 infection had a significant independent association with acute ischemic stroke compared with control subjects (OR, 3.9; 95% CI, 1.7-8.9; P = .001). CONCLUSIONS: We demonstrated that COVID-19 infection is significantly associated with imaging confirmation of acute ischemic stroke, and patients with COVID-19 should undergo more aggressive monitoring for stroke.


title: Isolation of a Chinook Salmon Bafinivirus (CSBV) in Imported Goldfish Carassius auratus L. in the United Kingdom and Evaluation of Its Virulence in Resident Fish Species

text: This is the first record of a fish nidovirus isolated from a consignment of goldfish at the United Kingdom (UK) border. The full-length viral genome was 25,985 nt, sharing a 97.9% nucleotide identity with the Chinook salmon bafinivirus (CSBV) NIDO with two deletions of 537 and 480 nt on the ORF Ia protein. To assess the potential impact on UK fish species, Atlantic salmon, common carp and goldfish were exposed to the virus via an intraperitoneal (IP) injection and bath challenge. Moribundity was recorded in only 8% of IP-injected goldfish. A high viral load, ≈107 of the CSBV PpIa gene, was measured in the kidney of moribund goldfish. Mild histopathological changes were observed in the kidneys of challenged carps. Ultrastructural observations in renal tubule epithelial cells of goldfish showed cylindrical tubes (≈15 nm in diameter) and tubular structures budding spherical virions (≈200 nm in diameter) with external spike-like structures. Negative staining showed both circular and bacilliform virions. Seroconversion was measured in common carp and goldfish but not in Atlantic salmon. This study reinforces the potential risk of novel and emerging pathogens being introduced to recipient countries via the international ornamental fish trade and the importance of regular full health screens at the border inspection posts to reduce this risk.


Foot and ankle service adaptation in response to COVID-19 and beyond


SARS-CoV-2 diagnostic testing in Africa: needs and challenges


title: China experience from COVID-19: Mental health in mandatory quarantine zones urgently requires intervention

text: The study investigated the quarantine of COVID-19 and its impact on mental health. The results showed that there was a significant difference in PTSD Checklist for DSM-5 scores between the quarantine group and the non-quarantine group. As a result, the mental health of residents in mandatory quarantine zones urgently requires intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Clinical characteristics of COVID-19 patients combined with allergy


"Mag ik weer op het spreekuur komen, dokter?"


title: Erythropoietin Induced Hemoglobin Sub-Unit Beta may Stimulate Innate Immune RNA Virus Pattern Recognition, Suppress Reactive Oxygen Species, Reduce ACE2 Viral Doorway Opening and Neutrophil Extracellular Traps against Covid-19

text: Erythropoietin may stimulate innate immunity against RNA viruses, such as Covid-19, through hemoglobin sub-unit Beta acting on the retinoic acid inducible gene I (RIG-1) and melanoma differentiation associated gene 5 (MDA5) viral pattern recognition receptors, causing interferon production and also maintains the vascular endothelium, a major target of SARS-CoV-2, possibly reducing thrombotic events which are becoming increasingly recognized complications of COVID19. This article is protected by copyright. All rights reserved.


title: Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic

text: INTRODUCTION: The performance of tracheotomy is a common procedural request by critical care departments to the surgical services of general surgery, thoracic surgery and otolaryngology - head & neck surgery. A Canadian Society of Otolaryngology - Head & Neck Surgery (CSO-HNS) task force was convened with multi-specialty involvement from otolaryngology-head & neck surgery, general surgery, critical care and anesthesiology to develop a set of recommendations for the performance of tracheotomies during the COVID-19 pandemic. MAIN BODY: The tracheotomy procedure is highly aerosol generating and directly exposes the entire surgical team to the viral aerosol plume and secretions, thereby increasing the risk of transmission to healthcare providers. As such, we believe extended endotracheal intubation should be the standard of care for the entire duration of ventilation in the vast majority of patients. Pre-operative COVID-19 testing is highly recommended for any non-emergent procedure. CONCLUSION: The set of recommendations in this document highlight the importance of avoiding tracheotomy procedures in patients who are COVID-19 positive if at all possible. Recommendations for appropriate PPE and environment are made for COVID-19 positive, negative and unknown patients requiring consideration of tracheotomy. The safety of healthcare professionals who care for ill patients and who keep critical infrastructure operating is paramount.


title: Confronting Another Pandemic: Lessons from HIV can Inform Our COVID-19 Response

text: The novel coronavirus 2019 illness (COVID-19) has completely transformed and uprooted lives across the globe. While different diseases, there are critical observations and lessons to be learned from the ongoing HIV epidemic to inform our response to COVID-19. We reflect on how this relates to (1) testing, including contact tracing; (2) health system redesign; (3) telehealth; (4) health disparities; (5) political denial, with inadequate and uncoordinated governmental response; (6) occupational exposure; and (7) complex reactions among healthcare providers. Decades of experiences with HIV provide an important framework for moving forward as we combat COVID-19.


title: COVID-19 and myeloma: what are the implications for now and in the future?

text: The pandemic has affected every aspect of myeloma care. Immediate focus is minimising risk of contracting coronavirus disease 2019 (COVID-19) and the sequelae of infection. However, what does the future hold for our patients? What lessons will be taken forward to tackle myeloma in the fiscally constrained future? If we embrace the challenges that will emerge in the post-pandemic environment, the treatment delivered to patients could be more cost-effective and better tailored than before. Healthcare delivery post-COVID-19 will not return to how it was, and now is the time to invest in novel strategies to deliver the best possible outcomes for patients.


Functional characteristics of patients with SARS-CoV-2 pneumonia at 30â days post infection


title: Is the lockdown important to prevent the COVID-9 pandemic? Effects on psychology, environment and economy-perspective

text: COVID-19's daily increasing cases and deaths have led to worldwide lockdown, quarantine and some restrictions. This study aims to analyze the effect of lockdown days on the spread of coronavirus in countries. COVID-19 cases and lockdown days data were collected for 49 countries that implemented the lockdown between certain dates (without interruption). The correlation tests were used for data analysis based on unconstrained (normal) and constrained (Tukey-lambda). The lockdown days was significantly correlated with COVID-19 pandemic based on unconstrained (r = -0.9126, F-ratio = 6.1654; t-ratio = 2.40; prob > .0203 with 49 observations) and based on Tukey-lambda (r = 0.7402, λ = 0.14). The lockdown, one of the social isolation restrictions, has been observed to prevent the COVID-19 pandemic, and showed that the spread of the virus can be significantly reduced by this preventive restriction in this study. This study offers initial evidence that the COVID-19 pandemic can be suppressed by a lockdown. The application of lockdown by governments is also thought to be effective on psychology, environment and economy besides having impact on Covid-19.


title: Prospects and limits of SIR-type Mathematical Models to Capture the COVID-19 Pandemic

text: For the description of a pandemic mathematical models could be interesting. Both for physicians and politicians as a base for decisions to treat the disease. The responsible estimation of parameters is a main issue of mathematical pandemic models. Especially a good choice of $\beta$ as the number of others that one infected person encounters per unit time (per day) influences the adequateness of the results of the model. For the actual COVID-19 pandemic some aspects of the parameter choice will be discussed. Because of the incompatibility of the data of the Johns-Hopkins-University to the data of the German Robert-Koch-Institut we use the COVID-19 data of the European Centre for Disease Prevention and Control (ECDC) as a base for the parameter estimation. Two different mathematical methods for the data analysis will be discussed in this paper and possible sources of trouble will be shown. As example of the parameter choice serve the data of the USA and the UK. The resulting parameters will be used estimated and used in W.\,O. Kermack and A.\,G. McKendrick's SIR model. Strategies for the commencing and ending of social and economic shutdown measures are discussed. The numerical solution of the ordinary differential equation system of the modified SIR model is being done with a Runge-Kutta integration method of fourth order. At the end the applicability of the SIR model could be shown essentially. Suggestions about appropriate points in time at which to commence with lockdown measures based on the acceleration rate of infections conclude the paper.


title: First Principle Simulation of Coated Hydroxychloroquine on Ag, Au and Pt Nanoparticle as a Potential Candidate for Treatment of SARS-CoV-2 (COVID-19)

text: The {\it{in vitro}} antiviral activity of Hydroxychloroquine (HCQ) and chloroquine (CQ) against SARS-CoV-2 from the first month of pandemic proposed these drugs as the appropriate therapeutic candidate, although their side effect directed the clinical test toward optimizing the safe utilization strategies. The noble metal nanoparticles (NP) as promising materials with antiviral and antibacterial properties can deliver the drug to the target agent and decrease the side effect. In this work, we have applied quantum mechanical and classical atomistic molecular dynamics computational approaches to demonstrate the adsorption properties of HCQ on Ag, Au, AgAu, and Pt nanoparticles. The adsorption energies (less than -30 kcal/mole) were established for HCQ, and the (non)perturbative effects of this drug on the plasmonic absorption spectra of AgNP and AuNP have characterized with time-dependent density functional theory. The effect of size and compositions of nanoparticle on the coating with HCQ and CQ have obtained and proposed the appropriate candidate for drug delivery. This kind of modeling could help the experimental groups to find the efficient and safe therapies.


Coronella, pour une surveillance efficace du COVID-19


Hematologic parameters in patients with COVID-19 infection: a reply


Acute Kidney Injury Due to Collapsing Glomerulopathy Following COVID-19 Infection


title: Laboratory Findings of COVID-19 Infection are Conflicting in Different Age Groups and Pregnant Women: A Literature Review

text: Coronavirus disease 2019 (COVID-19), a new type and rapidly spread viral pneumonia, is now producing an outbreak of pandemic proportions. The clinical features and laboratory results of different age groups are different due to the general susceptibility of the disease. The laboratory findings of COVID-19 in pregnant women are also conflicting. Para-clinical investigations including laboratory tests and radiologic findings play an important role in early diagnosis and treatment monitoring of COVID-19. The majority of previous reports on the COVID-19 laboratory results were based on data from the general population and limited information is available based on age difference and pregnancy status. This review aimed to describe the COVID-19 laboratory findings in neonates, children, adults, elderly and pregnant women altogether for the first time. The most attracting and reliable markers of COVID-19 in patients were: normal C-reactive protein (CRP) and very different and conflicting laboratory results regardless of clinical symptoms in neonates, normal or temporary elevated CRP, conflicting WBC count results and procalcitonin elevation in children, lymphopenia and elevated lactate dehydrogenase (LDH) in adult patients, lymphopenia and elevated CRP and LDH in the elderly people, leukocytosis and elevated neutrophil ratio in pregnant women.


Ethics for surgeons during the COVID-19 pandemic


title: Respiratory disease in rhesus macaques inoculated with SARS-CoV-2

text: An outbreak of coronavirus disease 2019 (COVID-19), which is caused by a novel coronavirus (named SARS-CoV-2) and has a case fatality rate of approximately 2%, started in Wuhan (China) in December 20191,2. Following an unprecedented global spread3, the World Health Organization declared COVID-19 a pandemic on 11 March 2020. Although data on COVID-19 in humans are emerging at a steady pace, some aspects of the pathogenesis of SARS-CoV-2 can be studied in detail only in animal models, in which repeated sampling and tissue collection is possible. Here we show that SARS-CoV-2 causes a respiratory disease in rhesus macaques that lasts between 8 and 16 days. Pulmonary infiltrates, which are a hallmark of COVID-19 in humans, were visible in lung radiographs. We detected high viral loads in swabs from the nose and throat of all of the macaques, as well as in bronchoalveolar lavages; in one macaque, we observed prolonged rectal shedding. Taken together, the rhesus macaque recapitulates the moderate disease that has been observed in the majority of human cases of COVID-19. The establishment of the rhesus macaque as a model of COVID-19 will increase our understanding of the pathogenesis of this disease, and aid in the development and testing of medical countermeasures.


COVID-19: the physician's response in the first phase


Pandemic preparedness: doctor leads campaign for UK government to release report


Sacubitril/valsartan in COVID-19 patients: the need for trials


How to manage obsessive-compulsive disorder (OCD) under COVID-19: A clinician's guide from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) and the Obsessive-Compulsive and Related Disorders Research Network (OCRN) of the European College of Neuropsychopharmacology


title: Dynamic evolution of COVID-19 on chest computed tomography: experience from Jiangsu Province of China

text: OBJECTIVES: To determine the patterns of chest computed tomography (CT) evolution according to disease severity in a large coronavirus disease 2019 (COVID-19) cohort in Jiangsu Province, China. METHODS: This retrospective cohort study was conducted from January 10, 2020, to February 18, 2020. All patients diagnosed with COVID-19 in Jiangsu Province were included, retrospectively. Quantitative CT measurements of pulmonary opacities including volume, density, and location were extracted by deep learning algorithm. Dynamic evolution of these measurements was investigated from symptom onset (day 1) to beyond day 15. Comparison was made between severity groups. RESULTS: A total of 484 patients (median age of 47 years, interquartile range 33-57) with 954 CT examinations were included, and each was assigned to one of the three groups: asymptomatic/mild (n = 63), moderate (n = 378), severe/critically ill (n = 43). Time series showed different evolution patterns of CT measurements in the groups. Following disease onset, posteroinferior subpleural area of the lung was the most common location for pulmonary opacities. Opacity volume continued to increase beyond 15 days in the severe/critically ill group, compared with peaking on days 13-15 in the moderate group. Asymptomatic/mild group had the lowest opacity volume which almost resolved after 15 days. The opacity density began to drop from day 10 to day 12 for moderately ill patients. CONCLUSIONS: Volume, density, and location of the pulmonary opacity and their evolution on CT varied with disease severity in COVID-19. These findings are valuable in understanding the nature of the disease and monitoring the patient's condition during the course of illness. KEY POINTS: â¢ Volume, density, and location of the pulmonary opacity on CT change over time in COVID-19. â¢ The evolution of CT appearance follows specific pattern, varying with disease severity.


title: Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens

text: AIMS: This retrospective case-control study was aimed at identifying potential independent predictors of severe/lethal COVID-19, including the treatment with Angiotensin-Converting Enzyme inhibitors (ACEi) and/or Angiotensin II Receptor Blockers (ARBs). METHODS AND RESULTS: All adults with SARS-CoV-2 infection in two Italian provinces were followed for a median of 24 days. ARBs and/or ACEi treatments, and hypertension, diabetes, cancer, COPD, renal and major cardiovascular diseases (CVD) were extracted from clinical charts and electronic health records, up to two years before infection. The sample consisted of 1603 subjects (mean age 58.0y; 47.3% males): 454 (28.3%) had severe symptoms, 192 (12.0%) very severe or lethal disease (154 deaths; mean age 79.3 years; 70.8% hypertensive, 42.2% with CVD). The youngest deceased person aged 44 years. Among hypertensive subjects (n = 543), the proportion of those treated with ARBs or ACEi were 88.4%, 78.7% and 80.6% among patients with mild, severe and very severe/lethal disease, respectively. At multivariate analysis, no association was observed between therapy and disease severity (Adjusted OR for very severe/lethal COVID-19: 0.87; 95% CI: 0.50-1.49). Significant predictors of severe disease were older age (with AORs largely increasing after 70 years of age), male gender (AOR: 1.76; 1.40-2.23), diabetes (AOR: 1.52; 1.05-2.18), CVD (AOR: 1.88; 1.32-2.70) and COPD (AOR: 1.88; 1.11-3.20). Only gender, age and diabetes also predicted very severe/lethal disease. CONCLUSION: No association was found between COVID-19 severity and treatment with ARBs and/or ACEi, supporting the recommendation to continue medication for all patients unless otherwise advised by their physicians.


title: Breast Cancer and COVID-19: The Effect of Fear on Patients' Decision-making Process

text: BACKGROUND/AIM: Coronavirus-19 (COVID-19) pandemic outbreak is currently having a huge impact on medical resource allocation. Breast Cancer (BC) patients are concerned both with BC treatment and COVID-19. This study aimed to estimate the impact of anxiety among patients, caused by the spreading of COVID-19. PATIENTS AND METHODS: Between the 16th of January and the 20th of March 2020, we retrospectively enrolled 160 patients. Eighty-two patients with a suspected breast lesion (SBL) were divided into two groups: PRE-COVID-19-SBL and POST-COVID-19-SBL. Seventy-eight BC patients were divided into PRE-COVID-19-BC and POST-COVID-19-BC. Patient characteristics including age, marital status, SBL/BC diameter, personal and family history of BC, clinical stage and molecular subtype were recorded. Procedure Refusal (PR) and Surgical Refusal (SR) were also recorded with their reason. RESULTS: BC and SBL analysis showed no difference in pre-treatment characteristics (p>0.05). Both POST-COVID-19-SBL and POST-COVID-19-BC groups showed higher rates of PR and SR (p=0.0208, p=0.0065 respectively). Infection risk represented primary reason for refusal among POST-COVID-19 patients. CONCLUSION: COVID-19-related anxiety could affect patients' decision-making process.


Overcoming the Covid-19 Crisis and Planing for the Future


title: Covid-19: a comprehensive review of a formidable foe and the road ahead

text: INTRODUCTION: The Coronavirus disease-19 (COVID-19) caused by the novel beta coronavirus named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) started in late December 2019 in Wuhan, China. Within a short span, COVID-19 was declared a global public health emergency affecting 214 countries with 5,939,234 confirmed cases and 3,67,255 deaths as of 30 May 2020. With limited knowledge about SARS-CoV-2, no approved treatment or vaccine is available till date. AREAS COVERED: We performed a review of literature on PubMed on the SARS-CoV-2 virus and COVID-19 illness including trials of preventive and therapeutic measures. This review presents the basic biology of coronaviruses, epidemiology of COVID-19, clinical presentations, investigational therapies and vaccines, infection prevention and control measures and the lessons from the present pandemic. EXPERT OPINION: The scale of the outbreak has brought the governments, health-care professionals, and scientists around the world under tremendous pressure to devise control strategies and develop novel prevention measures. While availability of vaccine for COVID-19 may take time, the disease may be contained through hand hygiene, physical distancing, travel restriction, and aggressive steps such as 'lockdown.' Clinical trials at different phases are ongoing across different countries to expedite the development of effective drugs and vaccine to overcome the pandemic.


title: Covid-19: A Comprehensive Review of a Formidable Foe and the Road Ahead

text: INTRODUCTION: The Coronavirus disease-19 (COVID-19) caused by the novel beta coronavirus named Severe Acute Respiratory Syndromecoronavirus-2 (SARS-CoV-2) started in late December 2019 in Wuhan, China. Within a short span, COVID-19 was declared a global public health emergency affecting 214 countries with 5,939,234 confirmed cases and 3,67,255 deaths as of 30 May, 2020. With limited knowledge about SARS-CoV-2, no approved treatment or vaccine is available till date. AREAS COVERED: We performed a review of literature on PubMed on the SARS-CoV-2 virus and COVID-19 illness including trials of preventive and therapeutic measures. This review presents the basic biology of coronaviruses, epidemiology of COVID-19, clinical presentations, investigational therapies and vaccines, infection prevention and control measures and the lessons from the present pandemic. EXPERT OPINION: The scale of the outbreak has brought the governments, healthcare professionals and scientists around the world under tremendous pressure to devise control strategies and develop novel prevention measures. While availability of vaccine for COVID-19 may take time, the disease may be contained through hand hygiene, physical distancing, travel restriction and aggressive steps such as 'lockdown'. Clinical trials at different phases are ongoing across different countries to expedite development of effective drugs and vaccine to overcome the pandemic.


title: COVID-19 in Yemen: a crisis within crises

text: Yemen is suffering deadly airstrikes and heavy bombardment since March 2015 which has created one of the most severe humanitarian crises worldwide. In this miserable situation, several communicable diseases have massively re-emerged including cholera, diarrhea, dengue, and measles, as a result of weapons used during the years of war according to geospatial patterns of the infected cases. According to the world health organization (WHO), only 51% of health care facilities across the country are fully functional, mainly due to the war. The fragile health system has extremely limited capacity to adopt and implement effective preparedness and response measures to the COVID-19 outbreak. The first and most imperative step to combat COVID-19 in Yemen is ending the devastating war without delay and terminating the land, sea and air blockade imposed by the coalition. International humanitarian organizations should also dedicate a high level joint action to implement a series of well-coordinated measures emphasizing both whole-of-government and whole-of-society approach to protect Yemenis' right in life and health.


"If the virus doesn't kill me ": socioeconomic impacts of COVID-19 on rural working people in the Global South


Hospital-based dental externship during COVID-19 pandemic: Think virtual!


title: Glycemic Control in Type 1 Diabetes Mellitus During COVID-19 Quarantine and the Role of In-Home Physical Activity

text: Background: To limit the spread of coronavirus disease 2019 (COVID-19), governments have ordered a series of restrictions that may affect glycemic control in individuals with type 1 diabetes mellitus (T1DM), since physical activity (PA) was not allowed outside home. Methods: We retrospectively evaluated glycemic control of individuals with T1DM using hybrid closed loop (HCL) system in the period before the SARS-CoV-2 outbreak in Italy (February 10-23, 2020-Time 1), when movements were only reduced (February 24-March 8, 2020-Time 2) and during complete lockdown (March 9-22, 2020-Time 3). Information about regular PA (at least 3 h per week) prior and during the quarantine was collected. Results: The study included 13 individuals with a median age of 14.2 years and a good glycemic control at baseline (glucose management indicator of 7%, time in range [TIR] of 68%, time below range [TBR] of 2%). All individuals continued to show good glycemic control throughout the study period. There was an increase in TIR during the study period (+3%) and TIR was significantly higher during Time 3 (72%) than during Time 2 (66%). TBR was significantly lower during Time 3 (1%) both compared with Time 1 and Time 2 (2%). A meaningful variance in TIR at Time 3 between individuals who performed or not PA during quarantine and a significant increase in TIR between Time 2 and Time 3 in individuals both doing PA at baseline and during quarantine was found. At logistic regression, only the presence of PA during quarantine significantly predicted a TIR >70%. Conclusions: Glycemic control of T1DM in adolescents using HCL system did not worsen during the restrictions due to COVID-19 pandemics and further improved in those who continued PA during the quarantine. Maintaining regular PA in a safe home environment is an essential strategy for young individuals with T1DM during the COVID-19 crisis.


title: A review of modern technologies for tackling COVID-19 pandemic

text: OBJECTIVE: Science and technology sector constituting of data science, machine learning and artificial intelligence are contributing towards COVID-19. The aim of the present study is to discuss the various aspects of modern technology used to fight against COVID-19 crisis at different scales, including medical image processing, disease tracking, prediction outcomes, computational biology and medicines. METHODS: A progressive search of the database related to modern technology towards COVID-19 is made. Further, a brief review is done on the extracted information by assessing the various aspects of modern technologies for tackling COVID-19 pandemic. RESULTS: We provide a window of thoughts on review of the technology advances used to decrease and smother the substantial impact of the outburst. Though different studies relating to modern technology towards COVID-19 have come up, yet there are still constrained applications and contributions of technology in this fight. CONCLUSIONS: On-going progress in the modern technology has contributed in improving people's lives and hence there is a solid conviction that validated research plans including artificial intelligence will be of significant advantage in helping people to fight this infection.


title: COVID-19, chronicle of an expected pandemic

text: What is COVID-19? What are the causes, parameters, and effects of this disease? What are the short- and long-term prospects? Philippe Sansonetti, Infectious disease specialist and Chief Editor of EMBO Molecular Medicine, explains why the fate of the epidemic is in our hands.


title: Review on the study of spreading of the COVID-19 based on dynamic models/ 中华医学科研管理杂志

text: Objective@#To Summarize mathematical and statistical models used in the area of infectious diseases modelling, to provide ideas and suggestions for the model-based analysis and decision-making of COVID-19.@*Methods@#By reviewing the commonly used mathematical and statistical models in the analysis of infectious diseases, with a focus on the mathematical models of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) that have been published and their practical effects.@*Results@#Infectious diseases modelling based on multi-source information has become the main research trend, and the published mathematical models of COVID-19 epidemic need to be improved in terms of accuracy and scalability.@*Conclusions@#It is recommended to build a more advanced mathematical/statistical model by allowing for the characteristics of new coronaviruses and to use more informative data to improve the analysis and decision-making of the new epidemic.


title: Human needs in COVID-19 isolation

text: To reduce the spread of COVID-19, the World Health Organization and the majority of governments have recommended that the entire human population should 'stay-at-home'. A significant proportion of the population live alone or are vulnerable to mental health problems yet, in the vast majority of cases, individuals in social isolation have no access to mental healthcare. The only resource is people themselves using self-help, self-medication and self-care. During prolonged COVID-19 isolation, an in-built system of homeostasis can help rebalance activity, thought and feeling. Increased physical activity enables a reset of physical and mental well-being. During periods of lockdown, it is recommended that exercise should be as vigorously promoted as social distancing itself.


title: Tyramide signal amplification mass spectrometry (TSA-MS) ratio identifies nuclear speckle proteins

text: We present a simple ratio method to infer protein composition within cellular structures using proximity labeling approaches but compensating for the diffusion of free radicals. We used tyramide signal amplification (TSA) and label-free mass spectrometry (MS) to compare proteins in nuclear speckles versus centromeres. Our "TSA-MS ratio" approach successfully identified known nuclear speckle proteins. For example, 96% and 67% of proteins in the top 30 and 100 sorted proteins, respectively, are known nuclear speckle proteins, including proteins that we validated here as enriched in nuclear speckles. We show that MFAP1, among the top 20 in our list, forms droplets under certain circumstances and that MFAP1 expression levels modulate the size, stability, and dynamics of nuclear speckles. Localization of MFAP1 and its binding partner, PRPF38A, in droplet-like nuclear bodies precedes formation of nuclear speckles during telophase. Our results update older proteomic studies of nuclear speckles and should provide a useful reference dataset to guide future experimental dissection of nuclear speckle structure and function.


Covid-19: "Illogical" lack of testing is causing healthy staff to self-isolate, BMA chief warns


title: Hydroxychloroquine in COVID-19 patients: what still needs to be known about the kinetics

text: Different dosage regimens of hydroxychloroquine are used to manage COVID-19 patients, without information on the pharmacokinetics in this population.Blood samples (n=101) were collected from 57 COVID-19 patients for 7 days and concentrations were compared with simulated kinetic profiles.Hydroxychloroquine exposure is low and cannot be predicted by other populations.


title: Efeitos do banho prévio, da tricotomia e da antissepsia na redução da contaminação do sítio cirúrgico em cadelas submetidas à OSH eletiva/ Effects of the previous bath, trichotomy and antisepsis in reducing contamination of the surgical site in bitches undergoing elective OSH

text: O objetivo deste estudo foi analisar a influencia do banho 24 horas antes do procedimento cirúrgico e da tricotomia pré-operatória na redução da contagem microbiana da pele do campo operatório, bem como a eficiência antisséptica do gluconato de clorexidina 0,5% e da polivinilpirrolidona iodada 10% para antissepsia do sítio cirúrgico, verificando sua ação 4 minutos e 2 horas após aplicação. Utilizaram-se 20 cadelas hígidas, alocadas ao acaso em 2 grupos de 10 animais: os animais do Grupo I foram submetidos ao banho 24 horas antes do procedimento cirúrgico, enquanto os do Grupo II não passaram por este procedimento. Foram isolados diversos gêneros bacterianos antes e após o uso dos antissépticos. Significância estatística foi verificada entre os grupos quanto ao efeito do banho prévio à cirurgia, apenas 2 horas após a aplicação de clorexidina. A tricotomia reduziu 26,48% da carga microbiana nos animais do Grupo I e elevou a carga microbiana em 41,19% nos animais do Grupo II, revelando diferença estatística. Após o uso dos antissépticos, não foi observada diferença estatística entre os grupos em nenhum momento. Do mesmo modo, a comparação da eficiência dos antissépticos com ou sem banho, não revelou significância estatística. A polivinilpirrolidona iodada causou reação alérgica em 15% dos animais e não foi observada irritação cutânea causada pela clorexidina. Conclui-se que o banho prévio tem efeito na redução da carga bacteriana apenas após 2 horas de antissepsia com clorexidina; a tricotomia é mais eficaz na redução microbiana quando o animal é submetido ao banho e os dois antissépticos são igualmente eficazes na antissepsia cirúrgica por até 2 horas quer o animal tome banho ou não previamente à cirurgia.(AU)


Clinical Judgment Is Paramount When Performing Cognitive Screening during COVID-19


title: The eye as the discrete but defensible portal of coronavirus infection

text: Oculo-centric factors may provide a key to understanding invasion success by SARS-CoV-2, a highly contagious, potentially lethal, virus with ocular tropism. Respiratory infection transmission via the eye and lacrimal-nasal pathway elucidated during the 1918 influenza pandemic, remains to be explored in this crisis. The eye and its adnexae represent a large surface area directly exposed to airborne viral particles and hand contact. The virus may bind to corneal and conjunctival angiotensin converting enzyme 2 (ACE2) receptors and potentially to the lipophilic periocular skin and superficial tear film with downstream carriage into the nasopharynx and subsequent access to the lungs and gut. Adenoviruses and influenza viruses share this ocular tropism and despite differing ocular and systemic manifestations and disease patterns, common lessons, particularly in management, emerge. Slit lamp usage places ophthalmologists at particular risk of exposure to high viral loads (and poor prognosis) and as for adenoviral epidemics, this may be a setting for disease transmission. Local, rather than systemic treatments blocking virus binding in this pathway (advocated for adenovirus) are worth considering. This pathway is accessible with eye drops or aerosols containing drugs which appear efficacious via systemic administration. A combination such as hydroxychloroquine, azithromycin and zinc, all of which have previously been used topically in the eye and which work at least in part by blocking ACE2 receptors, may offer a safe, cost-effective and resource-sparing intervention.


title: Grundlagen der Replikation und der Immunologie von SARS-CoV-2./ [Basic principles of replication and immunology of SARS-CoV-2]

text: Coronaviruses are a genetically highly variable family of viruses that infect vertebrates and have succeeded in infecting humans many times by overcoming the species barrier. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which initially appeared in China at the end of 2019, exhibits a high infectivity and pathogenicity compared to other coronaviruses. As the viral coat and other viral components are recognized as being foreign by the immune system, this can lead to initial symptoms, which are induced by the very efficiently working immune defense system via the respiratory epithelium. During severe courses a systemically expressed proinflammatory cytokine storm and subsequent changes in the coagulation and complement systems can occur. Virus-specific antibodies, the long-term expression of which is ensured by the formation of B memory cell clones, generate a specific immune response that is also detectable in blood (seroconversion). Specifically effective cytotoxic CD8+ Tcell populations are also formed, which recognize viral epitopes as pathogen-specific patterns in combination with MHC presentation on the cell surface of virus-infected cells and destroy these cells. At the current point in time it is unclear how regular, robust and durable this immune status is constructed. Experiences with other coronavirus infections (SARS and Middle East respiratory syndrome, MERS) indicate that the immunity could persist for several years. Based on animal experiments, already acquired data on other coronavirus types and plausibility assumptions, it can be assumed that seroconverted patients have an immunity of limited duration and only a very low risk of reinfection. Knowledge of the molecular mechanisms of viral cycles and immunity is an important prerequisite for the development of vaccination strategies and development of effective drugs.


title: Pharmacy's Call for Authorities to Aggressively Enforce Laws Addressing Price Gouging

text: Early reports of potential treatment for coronavirus disease (COVID-19) have raised concerns related to pharmaceutical distribution. Despite the lack of high-quality evidence, the mere hope of effectiveness of potential treatments, such as hydroxychloroquine, has led to surges in demand for these products, and many pharmacists are already informally reporting shortages through social channels. As manufacturers and wholesale distributors struggle to fulfill orders for drugs such as hydroxychloroquine, short-term price increases may seem reasonable in a free market when demand increases. However, any price increases by manufacturers, wholesale distributors, and pharmacies might be seen as exploitive gouging of consumers during a declared emergency. In addition to concerns of price gouging, increases in prescription drug utilization during the pandemic may lead to increases in spending for all payers as members may be treated for COVID-19. This article explores pharmaceutical supply chain and drug pricing nuances that may cause problems for payers and pharmacies as the country battles this global pandemic. DISCLOSURES: No funding supported the writing of this article. Mattingly reports unrelated consulting fees from the National Health Council, Bristol Myers Squibb, G&W Laboratories, Allergy and Asthma Foundation of American, and the Massachusetts Health Policy Commission. Hogue has nothing to disclose.


title: Obesity and COVID-19: an Italian snapshot

text: OBJECTIVE: The clinical manifestations of COVID-19 run from asymptomatic disease to severe acute respiratory syndrome. Older age and comorbidities are associated to more severe disease. A role of obesity is suspected. METHODS: We enrolled patients hospitalized in the medical COVID-19 ward with SARS-CoV-2 related pneumonia. Primary outcome of the study was to assess the relationship between the severity of COVID-19 and obesity classes according to BMI. RESULTS: 92 patients (61.9% males; age 70.5±13.3 years) were enrolled. Patients with overweight and obesity were younger than normal-weight patients (68.0±12.6 and 67.0±12.6 years vs. 76.1±13.0 years, p<0.01). A higher need for assisted ventilation beyond pure oxygen support (Invasive Mechanical Ventilation or Non-Invasive Ventilation) and a higher admission to intensive or semi-intensive care units was observed in patients with overweight and obesity (p<0.01 and p < 0.05, respectively) even after adjusting for sex, age and comorbidities (p<0.05 and p<0.001, respectively), or when patients with dementia or advanced cancer were removed from the analysis (p<0.05). CONCLUSION: Patients with overweight and obesity admitted in a medical ward for SARS-CoV-2 related pneumonia, despite their younger age, required more frequently assisted ventilation and access to intensive or semi-intensive care units than normal weight patients.


title: Guidelines for the management of diabetes services and patients during the COVID-19 pandemic

text: The UK National Diabetes Inpatient COVID Response Group was formed at the end of March 2020 to support the provision of diabetes inpatient care during the COVID pandemic. It was formed in response to two emerging needs. First to ensure that basic diabetes services are secured and maintained at a time when there was a call for re-deployment to support the need for general medical expertise across secondary care services. The second was to provide simple safe diabetes guidelines for use by specialists and non-specialists treating inpatients with or suspected of COVID-19 infection. To date the group, comprising UK-based specialists in diabetes, pharmacy and psychology, have produced two sets of guidelines which will be continually revised as new evidence emerges. It is supported by Diabetes UK, the Association of British Clinical Diabetologists and NHS England.


Identifying causal role of COVID-19 in immunopsychiatry models


title: On the derivation of the renewal equation from an age-dependent branching process: an epidemic modelling perspective

text: Renewal processes are a popular approach used in modelling infectious disease outbreaks. In a renewal process, previous infections give rise to future infections. However, while this formulation seems sensible, its application to infectious disease can be difficult to justify from first principles. It has been shown from the seminal work of Bellman and Harris that the renewal equation arises as the expectation of an age-dependent branching process. In this paper we provide a detailed derivation of the original Bellman Harris process. We introduce generalisations, that allow for time-varying reproduction numbers and the accounting of exogenous events, such as importations. We show how inference on the renewal equation is easy to accomplish within a Bayesian hierarchical framework. Using off the shelf MCMC packages, we fit to South Korea COVID-19 case data to estimate reproduction numbers and importations. Our derivation provides the mathematical fundamentals and assumptions underpinning the use of the renewal equation for modelling outbreaks.


Coronavirus disease - 2019 assessment zone: A community hospital's rapid response to a novel infectious pandemic


Incidence of Anxiety in Parkinson's Disease During the Coronavirus Disease (COVID-19) Pandemic


title: A consensus statement on the use of angiotensin receptor blockers and angiotensin converting enzyme inhibitors in relation to COVID-19 (corona virus disease 2019)

text: There has been a lot of speculation that patients with coronavirus disease 2019 (COVID-19) who are receiving angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) may be at increased risk for adverse outcomes We reviewed the available evidence, and have not found this to be the case We recommend that patients on such medications should continue on them unless there is a clinical indication to stop their use


title: Use of hydroxychloroquine and interferon alpha-2b for the prophylaxis of COVID-19

text: The ongoing pandemic of COVID-19 infection demands efforts to reduce spread. In order to eradicate an infectious disease, a method of prevention with low social cost is the most effective way. While we wait for new therapies and a vaccine, we are proposing a solution based on the existing knowledge in biomedical sciences. Here we propose to use low doses of hydroxychloroquine (50-100 mg daily orally) and intranasal interferon alpha-2b (IFN α-2b) spray (0.5 × 106 IU twice daily) for the prophylaxis of COVID-19. Although there are ongoing clinical trials to test the efficacy of hydroxychloroquine for prophylaxis, there has not been any proposal to test the efficacy of IFN α-2b together with hydroxychloroquine to increase protection against COVID-19. Since the two act on two different mechanisms, we strongly believe that the two could have additive effects in prophylaxis against COVID-19. We recommend using a randomized control study to prove efficacy and safety.


Real estimates of mortality following COVID-19 infection


title: Favorable Anakinra Responses in Severe Covid-19 Patients with Secondary Hemophagocytic Lymphohistiocytosis

text: Dysregulation of inflammation is hypothesized to play a crucial role in the severe complications of COVID-19, with the IL-1/IL-6 pathway being central. Here, we report on the treatment of eight severe COVID-19 pneumonia patients-seven hospitalized in intensive care units (ICUs) in Greece and one non-ICU patient in the Netherlands-with the interleukin-1 receptor antagonist Anakinra. All patients scored positive for the hemophagocytosis score (HScore) and were diagnosed with secondary hemophagocytic lymphohistocytosis (sHLH) characterized by pancytopenia, hyper-coagulation, acute kidney injury, and hepatobiliary dysfunction. At the end of treatment, ICU patients had less need for vasopressors, significantly improved respiratory function, and lower HScore. Although three patients died, the mortality was lower than historical series of patients with sHLH in sepsis. These data suggest that administration of Anakinra may be beneficial for treating severe COVID-19 patients with sHLH as determined by the HScore, and they support the need for larger clinical studies to validate this concept.


Investigating the sex differences in COVID-19: Another step forward, but many unanswered questions


COVID-19: what if the brain had a role in causing the deaths?


Hemorrhagic Problem Among the Patients With COVID-19: Clinical Summary of 41 Thai Infected Patients


Reply to "Varicella-like exanthem as a specific COVID-19-associated skin manifestation: multicenter case series of 22 patients": Discussing specificity


Perspectives on Pediatric Appendicitis and Appendectomy During the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic


title: COVID-19 transmission and blood transfusion: A case report

text: The recent outbreak of the novel coronavirus disease 2019 (COVID-19) has been labelled as a pandemic by the World Health Organization. Although person-to-person transmission of the etiologic agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been confirmed, it is not known whether COVID-19 may be transmitted by blood transfusion. Notwithstanding the urgent requirement of blood, it is critical to know whether the SARS-CoV-2 virus can be transmitted by blood transfusion because many individuals may be asymptomatic carriers and may donate blood. Several cases in which specific viral RNA could be detected in the serum from patients with COVID-19 have already been reported; these findings suggest that blood donation may be an unexplored route of transmission. However, the American Association of Blood Banks and Centers for Disease Control and Prevention have not recommended any specific SARS-CoV-2-related actions to be taken at blood collection centres at this time. In this report, we describe a case of a 21-year-old man with very severe aplastic anaemia who received apheresis platelet transfusion from an individual who was subsequently diagnosed with COVID-19. Our patient tested negative for COVID-19 and is awaiting allogeneic stem cell transplantation.


title: The impact of the COVID-19 epidemic on the utilization of emergency dental services

text: Background/Purpose: To assess how the current COVID-19 epidemic influenced peoples' utilization of emergency dental services in Beijing, China. Methods: The first-visit patients seeking emergency dental services before or at the beginning of the COVID-19 epidemic were retrieved. Their demographic characteristics and the reasons for visiting were recorded and analyzed. Results: There were 2,537 patients involved in this study. Thirty-eight percent fewer patients visited the dental urgency at the beginning of the COVID-19 epidemic than before. The distribution of dental problems has changed significantly. The proportion of dental and oral infection raised from 51.0% of pre-COVID-19 to 71.9% during COVID-19, and dental trauma decreased from 14.2% to 10.5%. Meanwhile, the non-urgency cases reduced to three-tenths of pre-COVID-19. Conclusion: Within the limitation of this study, the COVID-19 epidemic had a strong influence on the utilization of emergency dental services.


Coronavirus disease 2019 : Mehr Sicherheit durch kompakte Fakten und Handlungsempfehlungen./ [Coronavirus disease 2019 : More safety through compact facts and recommendantions for action]


API Guidelines on Immunizations during COVID 19 Pandemic


The ARDSnet protocol may be detrimental in COVID-19


Covert COVID-19 and false-positive dengue serology in Singapore


title: The difference in the incubation period of 2019 novel coronavirus (SARS-CoV-2) infection between travelers to Hubei and nontravelers: The need for a longer quarantine period

text: Data collected from the individual cases reported by the media were used to estimate the distribution of the incubation period of travelers to Hubei versus that of nontravelers. Because a longer and more volatile incubation period has been observed in travelers, the duration of quarantine should be extended to 3 weeks.


title: COVID-19 and urology: a comprehensive review of the literature

text: OBJECTIVE: To discuss the impact of COVID-19 on global health, particularly on urological practice and to review some of the available recommendations reported in the literature. MATERIAL AND METHODS: In the current narrative review the PubMed database was searched to identify all the related reports discussing the impact of COVID-19 on the urological field. RESULTS: The COVID-19 pandemic is the latest and biggest global health threat. Medical and surgical priorities have changed dramatically to cope with the current challenge. These changes include postponements of all elective outpatient visits and surgical procedures to save facilities and resources for urgent cases and patients with COVID-19 patients. This review discuss some of the related changes in urology. CONCLUSIONS: Over the coming weeks, healthcare workers including urologists will be facing increasingly difficult challenges, and consequently, they should adopt triage strategy to avoid wasting of medical resources and they should endorse sufficient protection policies to guard against infection when dealing with COVID-19 patients.


title: Validation of SARS-CoV-2 detection across multiple specimen types

text: BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused considerable disruption across the world, resulting in more than 235,000 deaths since December 2019. SARS-CoV-2 has a wide tropism and detection of the virus has been described in multiple specimen types, including various respiratory secretions, cerebrospinal fluid, and stool. OBJECTIVE: To evaluate the accuracy and sensitivity of a laboratory modified CDCbased SARS-CoV-2 N1 and N2 assay across a range of sample types. Study Design We compared the matrix effect on the analytical sensitivity of SARS-CoV-2 detection by qRT-PCR in nasal swabs collected in viral transport medium (VTM), bronchoalveolar lavage (BAL), sputum, plasma, cerebral spinal fluid (CSF), stool, VTM, phosphate buffered saline (PBS), and Hanks' Balanced Salt Solution (HBSS). Initial limits of detection (LoD) were subsequently narrowed to confirm an LoD for each specimen type and target gene. RESULTS: LoDs were established using a modified CDC-based laboratory developed test and ranged from a mean CT cut-off of 33.8-35.7 (10-20 copies/reaction) for the N1 gene target, and 34.0-36.2 (1-10 copies/reaction) for N2. Alternatives to VTM such as PBS and HBSS had comparable LoDs. The N2 gene target was found to be most sensitive in CSF. CONCLUSION: A modified CDC-based laboratory developed test is able to detect SARSCoV- 2 accurately with similar sensitivity across all sample types tested.


title: COVID-19 Testing, Epidemic Features, Hospital Outcomes, and Household Prevalence, New York State-March 2020

text: BACKGROUND: The United States' COVID-19 epidemic has grown extensively since February 2020, with substantial associated hospitalizations and mortality; New York State (NYS) has emerged as the national epicenter. We report on the extent of testing and test results during the month of March in NYS, along with risk factors, outcomes, and household prevalence among initial cases subject to in-depth investigations. METHODS: Specimen collection for COVID-19 testing was conducted in healthcare settings, community-based collection sites, and by home testing teams. Information on demographics, risk factors, and hospital outcomes of cases was obtained through epidemiological investigations and an electronic medical records match, and summarized descriptively. Active testing of initial case's households enabled estimation of household prevalence. RESULTS: During March In NYS, outside of New York City, a total of 47,326 persons tested positive for SARS-CoV-2, out of 141,495 tests (33% test-positive), with the highest number of cases located in the metropolitan region counties. Among 229 initial cases diagnosed through March 12, by March 30 13% were hospitalized and 2% died. Testing conducted among 498 members of these case's households found prevalent infection among 57%; excluding first-reported cases 38%. In these homes, we found a significant age gradient in prevalence, from 23% among those <5 years to 68% among those ≥65 years (p<.0001). CONCLUSIONS: New York State faced a substantial and increasing COVID-19 outbreak during March 2020. The earliest cases had high levels of infection in their households and by the end of the month, the risks of hospitalization and death were high.


A Call for Pediatric COVID-19 Clinical Trials


Drugs and the renin-angiotensin system in covid-19


Rethinking pandemic preparation: Global Health Security Index (GHSI) is predictive of COVID-19 burden, but in the opposite direction


title: Chromatographic methods development for clinical practice: requirements and limitations

text: Development of a chromatographic method in bioanalysis is a challenging and complex procedure with many pitfalls and often unexpected reversals that can require several months to accomplish. Even an experienced analytical team must contend many limitations mainly in connection with the strict requirements imposed on current clinical research. These restrictions typically persist throughout the whole development process, from clinical trial assignment, across optimization of extraction of biological materials and chromatographic separation, to validation and data interpretation. This paper describes questions and their possible answers raised during the pre-analytical phase such as use of modern sample preparation techniques in clinical methods, application of internal standards, as well as selection of stationary phases and detection techniques in the analytical phase. Validation problems and interpretation of results are demonstrated with three typical examples of characteristics to be considered, i.e. recovery, matrix effect, and limit of detection vs. lower limit of quantification.


title: An Exploratory Characterization of Bugs in COVID-19 Software Projects

text: Context: The dire consequences of the COVID-19 pandemic has influenced development of COVID-19 software i.e., software used for analysis and mitigation of COVID-19. Bugs in COVID-19 software can be consequential, as COVID-19 software projects can impact public health policy and user data privacy. Objective: The goal of this paper is to help practitioners and researchers improve the quality of COVID-19 software through an empirical study of open source software projects related to COVID-19. Methodology: We use 129 open source COVID-19 software projects hosted on GitHub to conduct our empirical study. Next, we apply qualitative analysis on 550 bug reports from the collected projects to identify bug categories. Findings: We identify 8 bug categories, which include data bugs i.e., bugs that occur during mining and storage of COVID-19 data. The identified bug categories appear for 7 categories of software projects including (i) projects that use statistical modeling to perform predictions related to COVID-19, and (ii) medical equipment software that are used to design and implement medical equipment, such as ventilators. Conclusion: Based on our findings, we advocate for robust statistical model construction through better synergies between data science practitioners and public health experts. Existence of security bugs in user tracking software necessitates development of tools that will detect data privacy violations and security weaknesses.


title: Head and neck oncological ablation and reconstruction in the COVID-19 era - our experience to date

text: The COVID-19 pandemic has caused unprecedented disruption to the routine operations of healthcare services across the world. As the potential duration of the pandemic remains uncertain, the need to develop strategies to continue urgent elective services has received increasing attention. A solution adopted in the Kent, Sussex and Surrey area of England has been to create COVID-19-protected cancer hubs. The Queen Victoria Hospital is the designated hub for head and neck cancer services in the area. We report on the evolution of the head and neck cancer care pathway and standard operating protocols put in place and how these have combined both national guidelines and local problem solving. It is hoped that our experience can help guide other centres as they re-establish head and neck cancer services during the ongoing pandemic.


title: Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19

text: BACKGROUND: Progressive respiratory failure is the primary cause of death in the coronavirus disease 2019 (Covid-19) pandemic. Despite widespread interest in the pathophysiology of the disease, relatively little is known about the associated morphologic and molecular changes in the peripheral lung of patients who die from Covid-19. METHODS: We examined 7 lungs obtained during autopsy from patients who died from Covid-19 and compared them with 7 lungs obtained during autopsy from patients who died from acute respiratory distress syndrome (ARDS) secondary to influenza A(H1N1) infection and 10 age-matched, uninfected control lungs. The lungs were studied with the use of seven-color immunohistochemical analysis, micro-computed tomographic imaging, scanning electron microscopy, corrosion casting, and direct multiplexed measurement of gene expression. RESULTS: In patients who died from Covid-19-associated or influenza-associated respiratory failure, the histologic pattern in the peripheral lung was diffuse alveolar damage with perivascular T-cell infiltration. The lungs from patients with Covid-19 also showed distinctive vascular features, consisting of severe endothelial injury associated with the presence of intracellular virus and disrupted cell membranes. Histologic analysis of pulmonary vessels in patients with Covid-19 showed widespread thrombosis with microangiopathy. Alveolar capillary microthrombi were 9 times as prevalent in patients with Covid-19 as in patients with influenza (P<0.001). In lungs from patients with Covid-19, the amount of new vessel growth - predominantly through a mechanism of intussusceptive angiogenesis - was 2.7 times as high as that in the lungs from patients with influenza (P<0.001). CONCLUSIONS: In our small series, vascular angiogenesis distinguished the pulmonary pathobiology of Covid-19 from that of equally severe influenza virus infection. The universality and clinical implications of our observations require further research to define. (Funded by the National Institutes of Health and others.).


Act now! Covid-19 pandemic: the coordinated support of the international community to low- and middle-income countries is needed immediately


title: Happy Hypoxemia in COVID-19-A Neural Hypothesis

text: Many COVID-19 patients are presenting with atypical clinical features. Happy hypoxemia with almost normal breathing, anosmia in the absence of rhinitis or nasal obstruction, and ageusia are some of the reported atypical clinical findings. Based on the clinical manifestations of the disease, we are proposing a new hypothesis that SARS-CoV-2 mediated inflammation of the nucleus tractus solitarius may be the reason for happy hypoxemia in COVID-19 patients.


Re: Esposito et al.: To mask or not to mask children to overcome COVID-19


The influence of preventive strategies on the COVID-2019 epidemic in Shenzhen, China


title: SARS-CoV-2 pandemic and research gaps: Understanding SARS-CoV-2 interaction with the ACE2 receptor and implications for therapy

text: The COVID-19 pandemic is an emerging threat to global public health. While our current understanding of COVID-19 pathogenesis is limited, a better understanding will help us develop efficacious treatment and prevention strategies for COVID-19. One potential therapeutic target is angiotensin converting enzyme 2 (ACE2). ACE2 primarily catalyzes the conversion of angiotensin I (Ang I) to a nonapeptide angiotensin or the conversion of angiotensin II (Ang II) to angiotensin 1-7 (Ang 1-7) and has direct effects on cardiac function and multiple organs via counter-regulation of the renin-angiotensin system (RAS). Significant to COVID-19, ACE2 is postulated to serve as a major entry receptor for SARS-CoV-2 in human cells, as it does for SARS-CoV. Many infected individuals develop COVID-19 with fever, cough, and shortness of breath that can progress to pneumonia. Disease progression promotes the activation of immune cells, platelets, and coagulation pathways that can lead to multiple organ failure and death. ACE2 is expressed by epithelial cells of the lungs at high level, a major target of the disease, as seen in post-mortem lung tissue of patients who died with COVID-19, which reveals diffuse alveolar damage with cellular fibromyxoid exudates bilaterally. Comparatively, ACE2 is expressed at low level by vascular endothelial cells of the heart and kidney but may also be targeted by the virus in severe COVID-19 cases. Interestingly, SARS-CoV-2 infection downregulates ACE2 expression, which may also play a critical pathogenic role in COVID-19. Importantly, targeting ACE2/Ang 1-7 axis and blocking ACE2 interaction with the S protein of SARS-CoV-2 to curtail SARS-CoV-2 infection are becoming very attractive therapeutics potential for treatment and prevention of COVID-19. Here, we will discuss the following subtopics: 1) ACE2 as a receptor of SARS-CoV-2; 2) clinical and pathological features of COVID-19; 3) role of ACE2 in the infection and pathogenesis of SARS; 4) potential pathogenic role of ACE2 in COVID-19; 5) animal models for pathological studies and therapeutics; and 6) therapeutics development for COVID-19.


Reduction in length of stay of patients admitted to a regional burn centre during COVID-19 pandemic


Early combination of Tocilizumab and Corticosteroids: An upgrade in anti-inflammatory therapy for severe COVID


Ref. no. DLD-20-852: Onset of ulcerative colitis during SARS-Cov-2 infection


title: [Healthcare management during COVID-19 pandemia.]

text: OBJECTIVES: To describe the organization of a hospital during the COVID-19 pandemic, paying attention to both organizational and leadership aspects, and considering all hospital areas, including the operating room MATERIAL AND METHODS: Review of the literatureregarding the organizational councils for hospital management within the pandemic In addition, the recommendations of societies, institutions such as the WHO, the CDC, the ECDC, the National Ministry of Health and the Ministry of Health of Madrid and the center's own experience have been taken into account RESULTS: Description of the key elements for the organization,as well as the different areas of action within a hospital: emergencies, consultations, hospitalization and operating rooms CONCLUSIONS: Management during a pandemic requires a high degree of agility in response and plasticity in people All hospital structures must adapt to a situationfor which they have not been conceived and all staff must place themselves at the service of a disease that conditions all decisions Being able to adapt and try to anticipate what is going to happen are the keys to success


Modelling the epidemic spread of COVID-19 virus infection in Northern African countries


title: From predictions to prescriptions: A data-driven response to COVID-19

text: The COVID-19 pandemic has created unprecedented challenges worldwide. Strained healthcare providers make difficult decisions on patient triage, treatment and care management on a daily basis. Policy makers have imposed social distancing measures to slow the disease, at a steep economic price. We design analytical tools to support these decisions and combat the pandemic. Specifically, we propose a comprehensive data-driven approach to understand the clinical characteristics of COVID-19, predict its mortality, forecast its evolution, and ultimately alleviate its impact. By leveraging cohort-level clinical data, patient-level hospital data, and census-level epidemiological data, we develop an integrated four-step approach, combining descriptive, predictive and prescriptive analytics. First, we aggregate hundreds of clinical studies into the most comprehensive database on COVID-19 to paint a new macroscopic picture of the disease. Second, we build personalized calculators to predict the risk of infection and mortality as a function of demographics, symptoms, comorbidities, and lab values. Third, we develop a novel epidemiological model to project the pandemic's spread and inform social distancing policies. Fourth, we propose an optimization model to re-allocate ventilators and alleviate shortages. Our results have been used at the clinical level by several hospitals to triage patients, guide care management, plan ICU capacity, and re-distribute ventilators. At the policy level, they are currently supporting safe back-to-work policies at a major institution and equitable vaccine distribution planning at a major pharmaceutical company, and have been integrated into the US Center for Disease Control's pandemic forecast.


title: Anesthetic Management of Patients with COVID 19 Infections during Emergency Procedures

text: OBJECTIVES: The aim of the present study was to prevent cross-infection in the operating room during emergency procedures for patients with confirmed or suspected 2019 novel coronavirus (2019-nCoV) by following anesthesia management protocols, and to document clinical- and anesthesia-related characteristics of these patients. DESIGN: This was a retrospective, multicenter clinical study. SETTING: This study used a multicenter dataset from 4 hospitals in Wuhan, China. PARTICIPANTS: Patients and health care providers with confirmed or suspected 2019-nCoV from January 23 to 31, 2020, at the Wuhan Union Hospital, the Wuhan Children's Hospital, The Central Hospital of Wuhan, and the Wuhan Fourth Hospital in Wuhan, China. INTERVENTIONS: Anesthetic management and infection control guidelines for emergency procedures for patients with suspected 2019-nCoV were drafted and applied in 4 hospitals in Wuhan. MEASUREMENTS AND MAIN RESULTS: Cross-infection in the operating rooms of the 4 hospitals was effectively reduced by implementing the new measures and procedures. The majority of patients with laboratory-confirmed 2019-nCoV infection or suspected infection were female (23 [62%] of 37), and the mean age was 41.0 years old (standard deviation 19.6; range 4-78). 10 (27%) patients had chronic medical illnesses, including 4 (11%) with diabetes, 8 (22%) with hypertension, and 8 (22%) with digestive system disease. Twenty-five (68%) patients presented with lymphopenia, and 23 (62%) patients exhibited multiple mottling and ground-glass opacity on computed tomography scanning. CONCLUSIONS: The present study indicates that COVID 19-specific guidelines for emergency procedures for patients with confirmed or suspected 2019-nCoV may effectively prevent cross-infection in the operating room. Most patients with confirmed or suspected COVID 19 presented with fever and dry cough and demonstrated bilateral multiple mottling and ground-glass opacity on chest computed tomography scans.


title: Asymptomatic transmission and the infection fatality risk for COVID-19: Implications for school reopening

text: Asymptomatic infection occurs for numerous respiratory viral diseases, including influenza and COVID-19. We seek to clarify confusion in three areas: age-specific risks of transmission and/or disease; various definitions for the COVID-19 "mortality rate", each useful for specific purposes; and implications for student return strategies from pre-school through university settings.


Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV): An Unprecedented Partnership for Unprecedented Times


Low prevalence of bronchial asthma and chronic obstructive lung disease among intensive care unit patients with COVID-19