title: Orbital cellulitis, sinusitis and intracranial abnormalities in two adolescents with COVID-19

text: We review two cases of adolescents with orbital cellulitis, sinusitis and SARS- CoV-2 infection presenting to emergency departments within a 24 hour period. SARS-CoV-2 samples obtained within 24 hours were positive, supporting prior infection despite relatively limited early symptoms of COVID-19. Unusual clinical and radiographic characteristics included hemorrhagic abscess with blood of varying age in the first, intracranial epidural abscess in the second, radiographic signal consistent with hemorrhagic or thrombotic phenomena, retro-maxillary antral fat changes, and meningeal enhancement or extension in both cases. Radiographic findings thereby mimic fungal infection, although final cultures and ancillary investigation for allergic and invasive fungal disease have remained negative. These cases highlight two unusual orbital presentations of cellulitis occurring in the context of SARS-CoV-2 co-infection.


Covid-19: public health experts demand evidence behind UK's short self-isolation advice


COVID-19 and the Duty to Protect from Communicable Diseases


title: Internalized Stigmatization, Social Support, and Individual Mental Health Problems in the Public Health Crisis

text: This study investigates the relationship between internalized stigmatization brought on by epicenter travel experiences and mental health problems (including anxiety, depression, and shame) during the period of the novel coronavirus disease emergency in China. The cross-sectional data were collected using the time-lag design to avoid the common method bias as much as possible. Regression results using structural equation modeling show that the internalized stigmatization of epicenter travel experiences may have positive relationships with mental health problems (i.e., anxiety, depression, and shame), and such relationships can be moderated by social support. Specifically, the positive relationships between internalized stigmatization and mental health problems are buffered/strengthened when social support is at a high/low level. The findings of this study suggest that, in this epidemic, people who have epicenter travel experience could be affected by internalized stigmatization, no matter whether they have ever got infected.


title: 2019-nCoV (Wuhan virus), a novel Coronavirus: human-to-human transmission, travel-related cases, and vaccine readiness

text: On 31 December 2019 the Wuhan Health Commission reported a cluster of atypical pneumonia cases that was linked to a wet market in the city of Wuhan, China. The first patients began experiencing symptoms of illness in mid-December 2019. Clinical isolates were found to contain a novel coronavirus with similarity to bat coronaviruses. As of 28 January 2020, there are in excess of 4,500 laboratory-confirmed cases, with > 100 known deaths. As with the SARS-CoV, infections in children appear to be rare. Travel-related cases have been confirmed in multiple countries and regions outside mainland China including Germany, France, Thailand, Japan, South Korea, Vietnam, Canada, and the United States, as well as Hong Kong and Taiwan. Domestically in China, the virus has also been noted in several cities and provinces with cases in all but one provinence. While zoonotic transmission appears to be the original source of infections, the most alarming development is that human-to-human transmission is now prevelant. Of particular concern is that many healthcare workers have been infected in the current epidemic. There are several critical clinical questions that need to be resolved, including how efficient is human-to-human transmission? What is the animal reservoir? Is there an intermediate animal reservoir? Do the vaccines generated to the SARS-CoV or MERS-CoV or their proteins offer protection against 2019-nCoV? We offer a research perspective on the next steps for the generation of vaccines. We also present data on the use of in silico docking in gaining insight into 2019-nCoV Spike-receptor binding to aid in therapeutic development. Diagnostic PCR protocols can be found at https://www.who.int/health-topics/coronavirus/laboratory-diagnostics-for-novel-coronavirus.


title: The hypothetical role of phosphatidic acid in subverting ER membranes during SARS-CoV infection

text: Positive sense (+) RNA viruses exploit membranes from a variety of cellular organelles to support the amplification of their genomes. This association concurs with the formation of vesicles whose main morphological feature is that of being wrapped by a double membrane. In the case of the SARS-CoV virus, the outer membrane is not discrete for each vesicle, but seems to be continuous and shared between many individual vesicles, a difference with other +RNA viruses whose nature has remained elusive. I present morphological, biochemical and pharmacological arguments defending the striking analogy of this arrangement and that of entangled, nascent Lipid Droplets whose birth has been aborted by an excess of Phosphatidic Acid. Since Phosphatidic Acid can be targeted with therapeutical purposes, considering this working hypothesis may prove important in tackling SARS-CoV infection.


title: Walls

text: In a field that strives to care for patients and families together, what can palliative care clinicians do when patients' families are physically absent? The Covid-19 pandemic has put both literal and figurative walls between health care professionals and families. How health care workers respond to these disconnections might have a lasting impact on patients, on families, and on our practice. Recently, I saw this in the case of a patient our palliative care team was consulted to see. Mr. B was minimally responsive and dying from multisystem organ failure of unclear etiology. As in other cases during this pandemic, our team became a facilitator of interaction between the patient and the physically absent family, seeing an intimacy we normally would not, in this case, by being present while our intern held the phone to Mr. B's ear for an end-of-life call from his wife, son, and daughter. Such moments force us clinicians to be even more present for our families and patients, and they allow us to bear witness to the strength and sadness and love that we might otherwise miss.


title: Renal cell carcinoma and COVID-19 pandemia: Management strategies adapted to current practice

text: The COVID-19 pandemic caused by SARS-CoV-2 virus has caused an important health impact that has affected renal cell carcinoma management, among other urology areas The high cancellation rate of surgeries, including those related to renal cancer, will cause an inevitable healthcare overload and probably a potential negative impact on its oncological outcomes, especially in locally advanced and metastatic renal cancer Kidney cancer scenarios are quite different depending on their stage, distinguishing mainly between low priority of localized disease or high priority of locally advanced and metastatic under active treatment The unknown pandemic duration and possibly fluctuating prevalence of the virus are likely to force an adaptation in the management of renal cell carcinoma among urology and oncology departments, ideally individualized ona case-by-case basis within multidisciplinary units To this end, we present algorithms and tables regarding renal cell carcinoma management adapted to the COVID-19 period and stratified according to oncological stage, which might be useful for specialists dedicated to this uro-oncology area


Vascularized Composite Allotransplantation in a Post-COVID-19 Pandemic World


title: Potential specific therapies in COVID-19

text: COVID-19 has grown into a global pandemic that has strained healthcare throughout the world. There is a sense of urgency in finding a cure for this deadly virus. In this study, we reviewed the empiric options used in common practice for COVID-19, based on the literature available online, with an emphasis on human experiences with these treatments on severe acute respiratory syndrome-associated coronavirus (SARS-COV-1) and other viruses. Convalescent blood products are the most promising potential treatment for use in COVID-19. The use of chloroquine or hydroxychloroquine (HCQ), remdesivir, and tocilizumab are some of the other promising potential therapies; however, they are yet to be tested in randomized clinical trials (RCTs). The use of lopinavir-ritonavir did not prove beneficial in a large RCT. The use of corticosteroids should be avoided in COVID-19 pneumonia unless used for other indications, based on the suggestion of harm in patients with SARS-COV-1 and Middle Eastern Respiratory Syndrome (MERS) infection. The reviews of this paper are available via the supplemental material section.


title: Drug treatment options for the 2019-new coronavirus (2019-nCoV)

text: As of January 22, 2020, a total of 571 cases of the 2019-new coronavirus (2019-nCoV) have been reported in 25 provinces (districts and cities) in China. At present, there is no vaccine or antiviral treatment for human and animal coronavirus, so that identifying the drug treatment options as soon as possible is critical for the response to the 2019-nCoV outbreak. Three general methods, which include existing broad-spectrum antiviral drugs using standard assays, screening of a chemical library containing many existing compounds or databases, and the redevelopment of new specific drugs based on the genome and biophysical understanding of individual coronaviruses, are used to discover the potential antiviral treatment of human pathogen coronavirus. Lopinavir /Ritonavir, Nucleoside analogues, Neuraminidase inhibitors, Remdesivir, peptide (EK1), abidol, RNA synthesis inhibitors (such as TDF, 3TC), anti-inflammatory drugs (such as hormones and other molecules), Chinese traditional medicine, such ShuFengJieDu Capsules and Lianhuaqingwen Capsule, could be the drug treatment options for 2019-nCoV. However, the efficacy and safety of these drugs for 2019- nCoV still need to be further confirmed by clinical experiments.


Stay fit, don't quit: Geriatric Exercise Prescription in COVID-19 Pandemic


Bioanalytical research and training in academia during the COVID-19 pandemic


title: Optimization of primer sets and detection protocols for SARS-CoV-2 of coronavirus disease 2019 (COVID-19) using PCR and real-time PCR

text: SARS-CoV-2 is very contagious and has rapidly spread globally. Due to various symptomatic and asymptomatic cases and the possibility of asymptomatic transmission, there is a pressing need for a fast and sensitive detection protocol to diagnose asymptomatic people. Various SARS-CoV-2 diagnostic kits are already available from many companies and national health agencies. However, publicly available information on these diagnostic kits is lacking. In response to the growing need and the lack of information, we developed and made available a low-cost, easy-access, real-time PCR-based protocol for the early detection of the virus in a previous study. During the development of the detection protocol, we found that unoptimized primer sets could inadvertently show false-positive results, raising the possibility that commercially available diagnostic kits might also contain primer sets that produce false-positive results. Here, we provide three-step guidelines for the design and optimization of specific primer sets. The three steps include (1) the selection of primer sets for target genes (RdRP, N, E, and S) in the genome of interest (SARS-CoV-2), (2) the in silico validation of primer and amplicon sequences, and (3) the optimization of PCR conditions (i.e., primer concentrations and annealing temperatures) for specific hybridization between the primers and target genes, and the elimination of spurious primer dimers. Furthermore, we have expanded the previously developed real-time PCR-based protocol to more conventional PCR-based protocols and applied a multiplex PCR-based protocol that allows the simultaneous testing of primer sets for RdRP, N, E, and S all in one reaction. Our newly optimized protocol should be helpful for the large-scale, high-fidelity screening of asymptomatic people, even without any high-specification equipment, for the further prevention of transmission, and to achieve early intervention and treatment for the rapidly propagating virus.


title: Intact Brain Network Function in an Unresponsive Patient with COVID-19

text: Many patients with severe coronavirus disease 2019 (COVID-19) remain unresponsive after surviving critical illness. Although several structural brain abnormalities have been described, their impact on brain function and implications for prognosis are unknown. Functional neuroimaging, which has prognostic significance, has yet to be explored in this population. Here we describe a patient with severe COVID-19 who, despite prolonged unresponsiveness and structural brain abnormalities, demonstrated intact functional network connectivity, and weeks later recovered the ability to follow commands. When prognosticating for survivors of severe COVID-19, clinicians should consider that brain networks may remain functionally intact despite structural injury and prolonged unresponsiveness.


The New Challenge of Geriatrics: Saving Frail Older People from the SARS-COV-2 Pandemic Infection


Management of SARS-CoV-2 infection: recommendations of the Polish Association of Epidemiologists and Infectiologists. Annex no. 1 as of June 8, 2020


Dramatic presentation of acquired TTP associated with COVID-19


Coronavirus is spreading under the radar in US homeless shelters


title: Management of COVID-19-Positive Pediatric Patients Undergoing Minimally Invasive Surgical Procedures: Systematic Review and Recommendations of the Board of European Society of Pediatric Endoscopic Surgeons

text: Introduction: Hospital response to the COVID-19 outbreak has involved the cancellation of elective, deferrable surgeries throughout Europe in order to ensure capacity for emergent surgery and a selection of elective but non-deferrable surgeries. The purpose of this document is to propose technical strategies to assist the pediatric surgeons to minimize the potential aerosolization of viral particles in COVID-19 patients undergoing urgent or emergent surgical treatment using laparoscopic approaches, based on the currently available literature. The situation and recommendations are subject to change with emerging information. Materials and Methods: The Scientific Committee and the Board of the European Society of Pediatric Endoscopic Surgeons gathered together in order to address the issue of minimally invasive surgery during this COVID-19 pandemic. A systematic search through PubMed, Embase, and World Wide Web of the terms "COVID-19," "Coronavirus," and "SARS-CoV-2" matched with "pneumoperitoneum," "laparoscopy," "thoracoscopy," "retroperitoneoscopy," and "surgery" was performed. Non-English language papers were excluded. A PRISMA report was performed. Criticalities were identified and a consensus was achieved over a number of key aspects. Results: We identified 121 documents. A total of 11 full-text documents were assessed to address all concerns related to the adoption of minimally invasive surgery. All aspect of pediatric minimally invasive surgery, including elective surgery, urgent surgery, laparoscopy, thoracoscopy, retroperitoneoscopy, and pneumoperitoneum creation and maintainance were extensively addressed through systematic review. A consensus regarding urgent laparoscopic procedures, setting and operation techniques was obtained within the Committee and the Board. Conclusions: The ESPES proposes the following recommendations in case minimally invasive surgery is needed in a COVID-19 positive pediatric patients: (1) consider conservative treatment whenever safely possible, (2) dedicate a theater, columns and reusable laparoscopic instrumentation to COVID-19 pediatric patients, (3) prefer disposable instrumentation and cables, (4) use low CO2 insufflation pressures, (5) use low power electrocautery, (6) prefer closed-systems CO2 insufflation and desufflation systems, and (7) avoid leaks through ports. These recommendations are subject to change with emerging information and might be amended in the near future.


Point-of-care ultrasound in COVID-19 pandemic


title: Prospective Prediction of Future SARS-CoV-2 Infections Using Empirical Data on a National Level to Gauge Response Effectiveness

text: Predicting an accurate expected number of future COVID-19 cases is essential to properly evaluate the effectiveness of any treatment or preventive measure. This study aimed to identify the most appropriate mathematical model to prospectively predict the expected number of cases without any intervention. The total number of cases for the COVID-19 epidemic in 28 countries was analyzed and fitted to several simple rate models including the logistic, Gompertz, quadratic, simple square, and simple exponential growth models. The resulting model parameters were used to extrapolate predictions for more recent data. While the Gompertz growth models (mean R2 = 0.998) best fitted the current data, uncertainties in the eventual case limit made future predictions with logistic models prone to errors. Of the other models, the quadratic rate model (mean R2 = 0.992) fitted the current data best for 25 (89 %) countries as determined by R2 values. The simple square and quadratic models accurately predicted the number of future total cases 37 and 36 days in advance respectively, compared to only 15 days for the simple exponential model. The simple exponential model significantly overpredicted the total number of future cases while the quadratic and simple square models did not. These results demonstrated that accurate future predictions of the case load in a given country can be made significantly in advance without the need for complicated models of population behavior and generate a reliable assessment of the efficacy of current prescriptive measures against disease spread.


Erupción tipo pitiriasis rosada de Gibert en una paciente asintomática con positividad para COVID-19./ Erupción tipo pitiriasis rosada de Gibert en una paciente asintomática con positividad para COVID-19./ Pityriasis rosea Gibert type rash in an asymptomatic patient that tested positive for COVID-19


CT chest findings in coronavirus disease-19 (COVID-19)


The Use of Positron Emission Tomography in Coronavirus Disease 2019 Cases


title: [Pregnant women complicated with COVID-19: a clinical analysis of 3 cases]

text: OBJECTIVE: To analyze the clinical characteristics and pregnancy outcomes of pregnant women complicated with coronavirus disease 2019 (COVID-19). METHODS: The clinical data of 3 pregnant women with COVID-19 admitted to the First Affiliated Hospital of Zhejiang University School of Medicine from January 19 to February 10, 2020 were retrospectively analyzed. RESULTS: There was one case in the first-trimester pregnancy (case 1), one in the second-trimester pregnancy (case 2) and one in third-trimester pregnancy (case 3). Cough, fever, fatigue, lung imaging changes were the main manifestations. The white cell count, lymphocyte percentage had no significantly changes in case 1 and case 3, while the levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), IL-6 and IL-10 elevated. The lymphocyte count and lymphocyte percentage decreased and the inflammatory indicators significantly increased in case 2. All patients were treated with antiviral, antitussive, oxygen inhalation; case 3 received glucocorticoids, case 2 with severe illness received glucocorticoids and additionally gamma globulin. All three cases were cured and discharged. Case 1 with early pregnancy chose to terminate pregnancy after discharge; case 2 chose to continue pregnancy without obstetric complications; and case 3 had cesarean section delivery due to abnormal fetal heart monitoring. CONCLUSIONS: The report shows that COVID-19 in pregnancy women could be cured with active treatment, and the maternal and fetal outcomes can be satisfactory.


2019 Coronavirus Disease, Beware of Psychogenic Issue


title: SEIR Modeling of the Italian Epidemic of SARS-CoV-2 Using Computational Swarm Intelligence

text: We applied a generalized SEIR epidemiological model to the recent SARS-CoV-2 outbreak in the world, with a focus on Italy and its Lombardy, Piedmont, and Veneto regions. We focused on the application of a stochastic approach in fitting the model parameters using a Particle Swarm Optimization (PSO) solver, to improve the reliability of predictions in the medium term (30 days). We analyzed the official data and the predicted evolution of the epidemic in the Italian regions, and we compared the results with the data and predictions of Spain and South Korea. We linked the model equations to the changes in people's mobility, with reference to Google's COVID-19 Community Mobility Reports. We discussed the effectiveness of policies taken by different regions and countries and how they have an impact on past and future infection scenarios.


title: ACE2 the Janus-faced protein - from cardiovascular protection to severe acute respiratory syndrome-coronavirus and COVID-19

text: Angiotensin converting enzyme 2 (ACE2) is the major enzyme responsible for conversion of Ang II into Ang-(1-7). It also acts as the receptor for severe acute respiratory syndrome (SARS)-coronavirus (CoV)-2, which causes Coronavirus Disease (COVID)-19. In recognition of the importance of ACE2 and to celebrate 20 years since its discovery, the journal will publish a focused issue on the basic science and (patho)physiological role of this multifunctional protein.


title: SARS-CoV-2 Infection in Febrile Neonates

text: Most severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in pediatric patients are mild or asymptomatic. However, infants have emerged at higher risk of hospitalization and severe outcomes in pediatric coronavirus disease 2019 (COVID-19). We report a case series of four full term neonates hospitalized with fever and found to have SARS-CoV-2 infection with a spectrum of illness severities. Two neonates required admission to the intensive care unit for respiratory insufficiency and end organ involvement. Half of the patients were found to have a co-infection. One neonate received antiviral therapy with remdesivir and is, to our knowledge, the youngest patient to receive this drug for COVID-19. All neonates had favorable outcomes.


title: Coronavirus Disease among Persons with Sickle Cell Disease, United States, March 20-May 21, 2020

text: Sickle cell disease (SCD) disproportionately affects Black or African American persons in the United States and can cause multisystem organ damage and reduced lifespan. Among 178 persons with SCD in the United States who were reported to an SCD-coronavirus disease case registry, 122 (69%) were hospitalized and 13 (7%) died.


title: Convalescent plasma: A possible treatment of COVID-19 in India

text: In India, SARS-CoV-2 virus-induced coronavirus disease 2019 (COVID-19) has already infected close to 5500 people, causing the death of 164. While these numbers are not comparable with values observed for the USA, Italy, or Spain, given the population of India, and the fact that the pandemic is now in an exponential stage of growth, the risks of a contagion that affects a large sector of the Indian population are real. There are no current effective strategies to prevent the spread, other than minimizing contact through social distancing, while no fully effective drugs to prevent or treat COVID-19 exist, although several candidate drugs and repurposed antiviral and immune-modulating pharmacotherapies are being tested or in compassionate use. One postexposure prophylaxis, convalescent (immune) plasma (CP), has shown some success in China and previously in the cure and therapy of other coronaviruses, SARS-1 and Middle East respiratory syndrome. Drawn from current patients who are infected with COVID-19, its CP (human anti-SARS-CoV-2 plasma) might be one way to modulate the infectivity of this virus or its effects postinfection.


title: Risk of COVID-19 importation to the Pacific islands through global air travel

text: On 30 January 2020, WHO declared coronavirus (COVID-19) a global public health emergency. As of 12 March 2020, 125 048 confirmed COVID-19 cases in 118 countries had been reported. On 12 March 2020, the first case in the Pacific islands was reported in French Polynesia; no other Pacific island country or territory has reported cases. The purpose of our analysis is to show how travellers may introduce COVID-19 into the Pacific islands and discuss the role robust health systems play in protecting health and reducing transmission risk. We analyse travel and Global Health Security Index data using a scoring tool to produce quantitative estimates of COVID-19 importation risk, by departing and arriving country. Our analysis indicates that, as of 12 March 2020, the highest risk air routes by which COVID-19 may be imported into the Pacific islands are from east Asian countries (specifically, China, Korea and Japan) to north Pacific airports (likely Guam, Commonwealth of the Northern Mariana Islands or, to a less extent, Palau); or from China, Japan, Singapore, the United States of America or France to south Pacific ports (likely, Fiji, Papua New Guinea, French Polynesia or New Caledonia). Other importation routes include from other east Asian countries to Guam, and from Australia, New Zealand and other European countries to the south Pacific. The tool provides a useful method for assessing COVID-19 importation risk and may be useful in other settings.


Covid-19: NHS will restart some paused services this week


Re: "Maxillofacial Trauma Management During COVID-19: Multidisciplinary Recommendations," by Edwards et al. and "A Guide to Facial Trauma Triage and Precautions in the COVID-19 Pandemic" by Hsieh et al


title: An infant with a mild SARS-CoV-2 infection detected only by anal swabs: a case report

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China and has spread rapidly worldwide. We present a mild SARS-CoV-2 infection in a baby with non-productive cough and normal chest computed tomography, in whom only anal swabs tested positive by real-time PCR testing for SARS-CoV-2. She was given atomization inhalation therapy with recombinant human interferon alfa-1b for 10 days. Her anal swabs remained positive for eight days, whereas her throat swabs were persistently negative by real-time PCR testing. Mild and asymptomatic cases, especially in children, might present with PCR negative pharyngeal/nasal swabs and PCR positive anal swabs. Those patients are potential sources of infection via fecal-oral transmission for COVID-19.


Clinical ethics recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances: the Italian perspective during the COVID-19 epidemic


title: Health Equity, Social Policy, and Promoting Recovery from COVID-19

text: The COVID-19 pandemic has revealed starkly and publicly the close interconnections between social and economic inequality, health equity, and population health. To better understand what social policies would best promote population health, economic recovery, and preparedness for future pandemics, we must look both upstream and abroad for inspiration. In this essay, I argue for a suite of near-term and longer-term interventions, including universal health insurance and paid sick leave, upgraded wage insurance policies, tax reform, investments in parental leave, child care, and education, and upgraded government record systems. Policies that equalize the distribution of the social determinants of health and promote social solidarity will also improve population health and economic performance and allow us to confront future pandemics more successfully.


title: Chest CT for detecting COVID-19: a systematic review and meta-analysis of diagnostic accuracy

text: OBJECTIVE: The purpose of this article was to perform a systematic review and meta-analysis regarding the diagnostic test accuracy of chest CT for detecting coronavirus disease 2019 (COVID-19). METHODS: PubMed, Embase, Web of Science, and CNKI were searched up to March 12, 2020. We included studies providing information regarding diagnostic test accuracy of chest CT for COVID-19 detection. The methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled. RESULTS: Sixteen studies (n = 3186 patients) were included. The risks of bias in all studies were moderate in general. Pooled sensitivity was 92% (95% CI = 86-96%), and two studies reported specificity (25% [95% CI = 22-30%] and 33% [95% CI = 23-44%], respectively). There was substantial heterogeneity according to Cochran's Q test (p < 0.01) and Higgins I2 heterogeneity index (96% for sensitivity). After dividing the studies into two groups based on the study site, we found that the sensitivity of chest CT was great in Wuhan (the most affected city by the epidemic) and the sensitivity values were very close to each other (97%, 96%, and 99%, respectively). In the regions other than Wuhan, the sensitivity varied from 61 to 98%. CONCLUSION: Chest CT offers the great sensitivity for detecting COVID-19, especially in a region with severe epidemic situation. However, the specificity is low. In the context of emergency disease control, chest CT provides a fast, convenient, and effective method to early recognize suspicious cases and might contribute to confine epidemic. KEY POINTS: â¢ Chest CT has a high sensitivity for detecting COVID-19, especially in a region with severe epidemic, which is helpful to early recognize suspicious cases and might contribute to confine epidemic.


Tobacco Smoking Increases the Lung Gene Expression of ACE2, the Receptor of SARS-CoV-2


Management of Graves' hyperthyroidism and orbitopathy in time of COVID-19 pandemic


title: Coronavirus infections reported by ProMED, February 2000-January 2020

text: INTRODUCTION: Sources describing the global burden of emerging diseases accurately are still limited. We reviewed coronavirus infections reported by ProMED and assessed the reliability of the data retrieved compared to published reports. We evaluated the effectiveness of ProMED as a source of epidemiological data on coronavirus. METHODS: Using the keyword "coronavirus" in the ProMED search engine, we reviewed all the information from the reports and collected data using a structured form, including year, country, gender, occupation, the number of infected individuals, and the number of fatal cases. RESULTS: We identified 109 entries reported between February 29, 2000 and January 22, 2020. A total of 966 cases were reported, with death reported in 188 cases, suggesting an overall case fatality rate (CFR) of 19.5%. Of 70 cases for which the gender was reported, 47 (67.1%) were male. Most of the cases were reported from China, the United Arab Emirates, and Saudi Arabia, with reports from other countries, including imported cases in Europe and North America. CONCLUSIONS: Internet-based reporting systems such as ProMED are useful to gather information and synthesize knowledge on emerging infections. Although certain areas need to be improved, ProMED provided useful information about coronaviruses especially during outbreaks.


The psychophysical impact that COVID-19 has on children must not be underestimated


Orientierung in der Corona-Krise? Nicht mit Doppelbotschaften


Impact of COVID-19 on mental healthcare of older adults: insights from Lebanon (Middle East)


Meta-analysis is not always the best way to round out a systematic review: a few thoughts prompted by the COVID-19 pandemic and "spiced-up" with an earthquake


title: Do Not Forget Afghanistan in Times of COVID-19: Telemedicine and the Internet of Things to Strengthen Planetary Health Systems

text: Health care does not always take place in a setting of peace, prosperity, and social order, a point that is often overlooked in quotidian medical practice. This has become most evident with the current COVID-19 pandemic by the new coronavirus that is wreaking havoc across the planet. Health care providers are facing unprecedented challenges to intervene on numerous nonlinear uncertainties in science and society as the pandemic evolves. In Afghanistan, health care delivery is already a major crosscutting challenge. Although efforts to rebuild the health care systems in Afghanistan have been made (Acerra et al.), both acute and chronic illnesses remain as major medical and critical governance gaps to be remedied. In addition, health care facilities and medical equipment are not adequate in the country. There is a need for medical and scientific expertise to clinically and sociologically contextualize and interpret diagnostic tests as well as drugs and vaccines that will be deployed in the coming months as part of the planetary collective response to the COVID-19 pandemic. In a time of pandemic and facing a novel infectious pathogen, health care workers are in need of planetary scale consultation and support. Even creating a small consultation network using mobile applications might offer improved health outcomes. The Internet of Things and digital health ought to be considered in concert with telemedicine as part of an effective pandemic response.


title: Healthcare impact of COVID-19 epidemic in India: A stochastic mathematical model

text: Background: In India, the SARS-CoV2 COVID-19 epidemic has grown to 1,251 cases and 32 deaths as on 30 Mar 2020. The healthcare impact of the epidemic in India was studied with a stochastic mathematical model. Methods: A compartmental SEIR model was developed, in which the flow of individuals through compartments is modeled using a set of differential equations. Different scenarios were modeled with 1000 runs of Monte Carlo simulation each using MATLAB. Hospitalization, ICU requirements and deaths were modeled on SimVoi software. The impact of Non-Pharmacological Interventions (NPI) including social distancing and lockdown on checking the epidemic was estimated. Results: Uninterrupted epidemic in India would have resulted in over 364 million cases and 1.56 million deaths with peak by mid-July. As per the model, at growth rate of 1.15, India is likely to reach approximately 3 million cases by 25 May, implying 125,455 (±18,034) hospitalizations, 26,130 (±3,298) ICU admissions and 13,447 (±1,819) deaths. This would overwhelm India's healthcare system. The model shows that with immediate institution of NPIs, the epidemic might still be checked by mid-April 2020. It would then result in 241,974 (±33,735) total infections, 10,214 (±1,649) hospitalizations, 2,121 (±334) ICU admissions and 1,081(±169) deaths. Conclusion: At current growth rate of epidemic, India's healthcare resources will be overwhelmed by end-May. With the immediate institution of NPIs, total cases, hospitalizations, ICU requirements and deaths can be reduced by almost 90%.


title: Inflammatory Cell Infiltration of Adrenals in COVID-19

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was originated in November-December 2019 in Wuhan, China, and has rapidly spread around the world causing severe health and socioeconomical damage to the entire civilization. The key feature of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is upper respiratory tract infection, which may be complicated by bilateral pneumonia. Angiotensin converting enzyme 2 (ACE2) has been identified as a key host factor, required for virus entry into cells. Interestingly, ACE2 is expressed not only in the respiratory system, but also in the other organs and systems including adrenal glands. Here we provide the first description of the pathomorphological changes in adrenal glands in patients with severe COVID-19 characterized by perivascular infiltration of CD3+ and CD8+ T-lymphocytes. Due to the central role of the adrenals in the stress response of the organism, this finding is of potential clinical relevance, because infection with the SARS-CoV-2 virus might critically impair adrenal function under pathophysiological conditions.


The COVID-19 vaccine development landscape


Coronavirus disease 2019 and obstructive sleep apnea syndrome


title: An SIS model for the epidemic dynamics with two phases of the human day-to-day activity

text: An SIS model is analyzed to consider the contribution of community structure to the risk of the spread of a transmissible disease. We focus on the human day-to-day activity introduced by commuting to a central place for the social activity. We assume that the community is classified into two subpopulations: commuter and non-commuter, of which the commuter has two phases of the day-to-day activity: private and social. Further we take account of the combination of contact patterns in two phases, making use of mass-action and ratio-dependent types for the infection force. We investigate the dependence of the basic reproduction number on the commuter ratio and the daily expected duration at the social phase as essential factors characterizing the community structure, and show that the dependence is significantly affected by the combination of contact patterns, and that the difference in the commuter ratio could make the risk of the spread of a transmissible disease significantly different.


title: Considering grief in mental health outcomes of COVID-19

text: The novel coronavirus disease of 2019 (COVID-19) pandemic has created challenging circumstances for the physical and mental health of individuals across the United States. This commentary addresses the role of grief in mental health outcomes relating to the pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Lung Base Findings of Coronavirus Disease (COVID-19) on Abdominal CT in Patients With Predominant Gastrointestinal Symptoms

text: OBJECTIVE. This series of patients presented to the emergency department (ED) with abdominal pain, without the respiratory symptoms typical of coronavirus disease (COVID-19), and the abdominal radiologist was the first to suggest COVID-19 infection because of findings in the lung bases on CT of the abdomen. CONCLUSION. COVID-19 infection can present primarily with abdominal symptoms, and the abdominal radiologist must suggest the diagnosis when evaluating the lung bases for typical findings.


COVID-19 as a STING disorder with delayed over-secretion of interferon-beta


title: Lopinavir-Ritonavir in the Treatment of COVID-19: A Dynamic Systematic Benefit-Risk Assessment

text: INTRODUCTION AND OBJECTIVE: COVID-19 is an ongoing, global public health crisis for which safe and effective treatments need to be identified. The benefit-risk balance for the use of lopinavir-ritonavir in COVID-19 needs to be monitored on an ongoing basis, therefore a systematic benefit-risk assessment was designed and conducted. A key objective of this study was to provide a platform for a dynamic systematic benefit-risk evaluation; although initially this evaluation is likely to contain limited information, it is required because of the urgent unmet public need. Importantly, it allows additional data to be incorporated as they become available, and re-evaluation of the benefit-risk profile. METHODS: A systematic benefit-risk assessment was conducted using the Benefit-Risk Action Team (BRAT) framework. The exposure of interest was lopinavir-ritonavir treatment in severe COVID-19 compared to standard of care, placebo or other treatments. A literature search was conducted in PubMed and Embase to identify peer-reviewed papers reporting clinical outcomes. Two clinicians constructed a value tree and ranked key benefits and risks in order of considered clinical importance. RESULTS: We screened 143 papers from PubMed and 264 papers from Embase for lopinavir-ritonavir; seven papers were included in the final benefit-risk assessment. In comparison to standard of care, data for several key benefits and risks were identified for lopinavir-ritonavir. Time to clinical improvement was not significantly different for lopinavir-ritonavir in comparison to standard of care (hazard ratio 1.31, 95% confidence interval 0.95-1.80). From one study, there were fewer cases of acute respiratory distress syndrome with lopinavir-ritonavir compared with standard of care (13% vs 27%). There also appeared to be fewer serious adverse events with lopinavir-ritonavir (20%) vs standard of care (32%). Limited data were available for comparison of lopinavir-ritonavir to other treatments. CONCLUSIONS: Based on currently available data, there was no clear benefit for the use of lopinavir-ritonavir compared to standard of care in severe COVID-19. Risk data suggested a possible decrease in serious adverse events. There was a reduction in acute respiratory distress syndrome with lopinavir-ritonavir in one study. Overall, the benefit-risk profile for lopinavir-ritonavir in severe COVID-19 cannot be considered positive until further efficacy and effectiveness data become available.


Obesity, overweight and survival in critically ill patients with SARS-CoV-2 pneumonia: is there an obesity paradox? Preliminary results from Italy


The precarious position of postdocs during COVID-19


Characteristics of SARS-CoV-2 isolated from asymptomatic carrier in Tokyo


Anaesthesia and intensive care in obstetrics during the COVID-19 pandemic


Moderately Severe Diarrhea and Impaired Renal Function With COVID-19 Infection


title: Risk Perception of COVID-19 Among the Portuguese Healthcare Professionals and General Population

text: Risk perception assessment of COVID-19 among Portuguese Healthcare Professionals (HCP) and General Population (GPop) was evaluated in a snowball 3 403 individual's sample. 54.9% of HCP believed there is a high probability of becoming infected, in contrast with 24.0% of GPop (p <0.001) and, in more than 1/4, that this could happen to their family. Regarding prophylactic isolation, more than 70% agreed with its effectiveness. A large proportion perceived that health services are poorly prepared (50.1% GPop versus 63.5% HCP, p<0.001). Regarding Health Authorities' communication, about 60% were "moderately" satisfied. 46.7% GPop and 52.8% HCP had the opinion the pandemic could be controlled in three to six months (p=0.01).


Hypotension, SIRS and COVID-19: a clinical conundrum


title: Asymmetric nexus between temperature and COVID-19 in the top ten affected provinces of China: A current application of quantile-on-quantile approach

text: The present study examines the asymmetrical effect of temperature on COVID-19 (Coronavirus Disease) from 22 January 2020 to 31 March 2020 in the 10 most affected provinces in China. This study used the Sim & Zhou' quantile-on-quantile (QQ) approach to analyze how the temperature quantities affect the different quantiles of COVID-19. Daily COVID-19 and, temperature data collected from the official websites of the Chinese National Health Commission and Weather Underground Company (WUC) respectively. Empirical results have shown that the relationship between temperature and COVID-19 is mostly positive for Hubei, Hunan, and Anhui, while mostly negative for Zhejiang and Shandong provinces. The remaining five provinces Guangdong, Henan, Jiangxi, Jiangsu, and Heilongjiang are showing the mixed trends. These differences among the provinces can be explained by the differences in the number of COVID-19 cases, temperature, and the province's overall hospital facilitations. The study concludes that maintaining a safe and comfortable atmosphere for patients while COVID-19 is being treated may be rational.


Breastfeeding Risk from Detectable Severe Acute Respiratory Syndrome Coronavirus 2 in Breastmilk


Detection of serum immunoglobulin M and immunoglobulin G antibodies in 2019 novel coronavirus infected patients from different stages


COVID-19 pandemic reveals the peril of ignoring metadata standards


Absence of contamination of personal protective equipment (PPE) by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)


title: How does stock market reflect the change in economic demand? A study on the industry-specific volatility spillover networks of China's stock market during the outbreak of COVID-19

text: Using the carefully selected industry classification standard, we divide 102 industry securities indices in China's stock market into four demand-oriented sector groups and identify demand-oriented industry-specific volatility spillover networks. The"deman-oriented"is a new idea of reconstructing the structure of the networks considering the relationship between industry sectors and the economic demand their outputs meeting. Networks with the new structure help us improve the understanding of the economic demand change, especially when the macroeconomic is dramatically influenced by exogenous shocks like the outbreak of COVID-19. At the beginning of the outbreak of COVID-19, in China's stock market, spillover effects from industry indices of sectors meeting the investment demand to those meeting the consumption demands rose significantly. However, these spillover effects fell after the outbreak containment in China appeared to be effective. Besides, some services sectors including utility, transportation and information services have played increasingly important roles in the networks of industry-specific volatility spillovers as of the COVID-19 out broke. By implication, firstly, being led by Chinese government, the COVID-19 is successfully contained and the work resumption is organized with a high efficiency in China. The risk of the investment demand therefore was controlled and eliminated relatively fast. Secondly, the intensive using of non-pharmaceutical interventions (NPIs) led to supply restriction in services in China. It will still be a potential threat for the Chinese economic recovery in the next stage.


Another coronavirus, another epidemic, another warning


Recommendation of fecal specimen for routine molecular detection of SARS-CoV-2 and for COVID-19 discharge criteria


title: Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists

text: Since its initial recognition in December 2019, Coronavirus disease 19 (COVID-19) has quickly spread to a pandemic infectious disease. The causative agent has been recognized as a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily affecting the respiratory tract. To date, no vaccines are available nor any specific treatment. To limit the number of infections, strict directives have been issued by governments that have been translated into equally rigorous guidelines notably for post-mortem examinations by international and national scientific societies. The recommendations for biosafety control required during specimen collection and handling have strongly limited the practice of autopsies of the COVID-19 patients to a few adequate laboratories. A full pathological examination has always been considered an important tool to better understand the pathophysiology of diseases, especially when the knowledge of an emerging disorder is limited and the impact on the healthcare system is significant. The first evidence of diffuse alveolar damage in the context of an acute respiratory distress syndrome has now been joined by the latest findings that report a more complex scenario in COVID-19, including a vascular involvement and a wide spectrum of associated pathologies. Ancillary tools such as electron microscopy and molecular biology used on autoptic tissue samples from autopsy are also significantly contributing to confirm and/or identify new aspects useful for a deeper knowledge of the pathogenetic mechanisms. This article will review and summarize the pathological findings described in COVID-19 until now, chiefly focusing on the respiratory tract, highlighting the importance of autopsy towards a better knowledge of this disease.


Coronavirus research updates: Massive contact-tracing effort finds hundreds of cases linked to nightclubs


title: [Clinical observation of heat-sensitive moxibustion treatment for coronavirus disease 2019]

text: OBJECTIVE: To observe clinical effect of heat-sensitive moxibustion on coronavirus disease 2019 (COVID-19) and to discusses the effective moxibustion treatment program. METHODS: A total of 42 patients with COVID-19 (general type) were treated with heat-sensitive moxibustion at the acupoint area of Shenque (CV 8) and Tianshu (ST 25). The treatment was conducted under the standards of heat-sensitive moxibustion manipulation, which were "locating acupoint by feeling, moxibustion by differentiate sensation, dosage varies individually, ending after sufficient dosage". The incidence of deqi after first heat-sensitive moxibustion, the reduction of negative emotions, the improvement of chest distress and impaired appetite, and the active acceptance rate of moxibustion before and after treatment were observed. RESULTS: â The deqi rate of heat-sensitive moxibustion for 20 minã40 minã1 h were respectively 52.4% (22/42), 90.5% (38/42), 100.0% (42/42). â¡ The incidences of feeling relaxed and comfortable immediately after the first, second, and third heat-sensitive moxibustion were 61.9% (26/42), 73.8% (31/42), and 92.9% (39/42), which were higher than 42.9% (18/42) before heat-sensitive moxibustion treatment (P<0.05). â¢ The incidences of chest distress after the first, second, and third heat-sensitive moxibustion were 23.8% (10/42), 16.7% (7/42), and 9.5% (4/42), which were lower than 50.0% (21/42) before heat-sensitive moxibustion treatment (P<0.05); the incidences of impaired appetite after the first, second, and third heat-sensitive moxibustion were 26.2% (11/42), 19.0% (8/42), 9.5% (4/42), which were lower than 57.1% (24/42) before heat-sensitive moxibustion treatment (P<0.05). â£ After the first treatment, the active acceptance rate of patients for heat-sensitive moxibustion was 100.0% (42/42), which was higher than 11.9% (5/42) before heat-sensitive moxibustion (P<0.05). CONCLUSION: The heat-sensitive moxibustion can effectively reduce the negative emotions and improve the symptoms of chest distress and impaired appetite with COVID-19. It is generally accepted by patients, and worthy of popularization and application in clinical treatment.


COVID-19, Ethics and Equity-What Is Our Role as Surgeons?


title: Applied Clinical Pharmacology in a Crisis: Interleukin-6 Axis Blockade and COVID-19

text: The global pandemic of coronavirus disease 2019 (COVID-19) represents an emergent threat to the public health. Mitigation strategies have been employed to varying effect in many Western nations. Treatment strategies to effectively address COVID-19 and equitably distribute resources are needed, especially in overwhelmed hospitals.


The global path forward - Healthy Living for Pandemic Event Protection (HL - PIVOT)


title: Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): anti-inflammatory strategies

text: Coronavirus-19 (COVI-19) involves humans as well as animals and may cause serious damage to the respiratory tract, including the lung: coronavirus disease (COVID-19). This pathogenic virus has been identified in swabs performed on the throat and nose of patients who suffer from or are suspected of the disease. When COVI-19 infect the upper and lower respiratory tract it can cause mild or highly acute respiratory syndrome with consequent release of pro-inflammatory cytokines, including interleukin (IL)-1ß and IL-6. The binding of COVI-19 to the Toll Like Receptor (TLR) causes the release of pro-IL-1ß which is cleaved by caspase-1, followed by inflammasome activation and production of active mature IL-1ß which is a mediator of lung inflammation, fever and fibrosis. Suppression of pro-inflammatory IL-1 family members and IL-6 have been shown to have a therapeutic effect in many inflammatory diseases, including viral infections. Cytokine IL-37 has the ability to suppress innate and acquired immune response and also has the capacity to inhibit inflammation by acting on IL-18Rα receptor. IL-37 performs its immunosuppressive activity by acting on mTOR and increasing the adenosine monophosphate (AMP) kinase. This cytokine inhibits class II histocompatibility complex (MHC) molecules and inflammation in inflammatory diseases by suppressing MyD88 and subsequently IL-1ß, IL-6, TNF and CCL2. The suppression of IL-1ß by IL-37 in inflammatory state induced by coronavirus-19 can have a new therapeutic effect previously unknown. Another inhibitory cytokine is IL-38, the newest cytokine of the IL-1 family members, produced by several immune cells including B cells and macrophages. IL-38 is also a suppressor cytokine which inhibits IL-1ß and other pro-inflammatory IL-family members. IL-38 is a potential therapeutic cytokine which inhibits inflammation in viral infections including that caused by coronavirus-19, providing a new relevant strategy.


title: Adaptive Invariance for Molecule Property Prediction

text: Effective property prediction methods can help accelerate the search for COVID-19 antivirals either through accurate in-silico screens or by effectively guiding on-going at-scale experimental efforts. However, existing prediction tools have limited ability to accommodate scarce or fragmented training data currently available. In this paper, we introduce a novel approach to learn predictors that can generalize or extrapolate beyond the heterogeneous data. Our method builds on and extends recently proposed invariant risk minimization, adaptively forcing the predictor to avoid nuisance variation. We achieve this by continually exercising and manipulating latent representations of molecules to highlight undesirable variation to the predictor. To test the method we use a combination of three data sources: SARS-CoV-2 antiviral screening data, molecular fragments that bind to SARS-CoV-2 main protease and large screening data for SARS-CoV-1. Our predictor outperforms state-of-the-art transfer learning methods by significant margin. We also report the top 20 predictions of our model on Broad drug repurposing hub.


COVID-19: The time for action is just now; It's still not too late


Improvement of physical training by performance-enhancing substances


COVID-19 deaths in Lombardy, Italy: data in context (vol 5, pg e310, 2020)


COVID-19 deaths in Lombardy, Italy: data in context


The perfect storm: COVID-19, mass incarceration and the opioid epidemic


title: Risk Factors for Mortality in 244 Older Adults With COVID-19 in Wuhan, China: A Retrospective Study

text: BACKGROUND/OBJECTIVES: Previous studies have reported that older patients may experience worse outcome(s) after infection with severe acute respiratory syndrome coronavirus-2 than younger individuals. This study aimed to identify potential risk factors for mortality in older patients with coronavirus disease 2019 (COVID-19) on admission, which may help identify those with poor prognosis at an early stage. DESIGN: Retrospective case-control. SETTING: Fever ward of Sino-French New City Branch of Tongji Hospital, Wuhan, China. PARTICIPANTS: Patients aged 60 years or older with COVID-19 (n = 244) were included, of whom 123 were discharged and 121 died in hospital. MEASUREMENTS: Data retrieved from electronic medical records regarding symptoms, signs, and laboratory findings on admission, and final outcomes of all older patients with COVID-19, were retrospectively reviewed. Univariate and multivariate logistic regression analyses were used to explore risk factors for death. RESULTS: Univariate analysis revealed that several clinical characteristics and laboratory variables were significantly different (ie, P < .05) between discharged and deceased patients. Multivariable logistic regression analysis revealed that lymphocyte (LYM) count (odds ratio [OR] = 0.009; 95% confidence interval [CI] = 0.001-0.138; P = .001) and older age (OR = 1.122; 95% CI = 1.007-1.249; P = .037) were independently associated with hospital mortality. White blood cell count was also an important risk factor (P = .052). The area under the receiver operating characteristic curve in the logistic regression model was 0.913. Risk factors for in-hospital death were similar between older men and women. CONCLUSION: Older age and lower LYM count on admission were associated with death in hospitalized COVID-19 patients. Stringent monitoring and early intervention are needed to reduce mortality in these patients. J Am Geriatr Soc 68:E19-E23, 2020.


What do differences in case fatality ratios between children and adults tell us about COVID-19?


title: Characterization and Noncovalent Inhibition of the Deubiquitinase and deISGylase Activity of SARS-CoV-2 Papain-Like Protease

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent for COVID-19, is a novel human betacoronavirus that is rapidly spreading worldwide. The outbreak currently includes over 3.7 million cases and 260,000 fatalities. As a betacoronavirus, SARS-CoV-2 encodes for a papain-like protease (PLpro) that is likely responsible for cleavage of the coronavirus (CoV) viral polypeptide. The PLpro is also responsible for suppression of host innate immune responses by virtue of its ability to reverse host ubiquitination and ISGylation events. Here, the biochemical activity of SARS-CoV-2 PLpro against ubiquitin (Ub) and interferon-stimulated gene product 15 (ISG15) substrates is evaluated, revealing that the protease has a marked reduction in its ability to process K48 linked Ub substrates compared to its counterpart in SARS-CoV. Additionally, its substrate activity more closely mirrors that of the PLpro from the Middle East respiratory syndrome coronavirus and prefers ISG15s from certain species including humans. Additionally, naphthalene based PLpro inhibitors are shown to be effective at halting SARS-CoV-2 PLpro activity as well as SARS-CoV-2 replication.


title: Digital Translucence: Adapting Telemedicine Delivery Post-COVID-19

text: In nearly 1 month, with a rapidly expanding corona virus disease 2019 (COVID-19), telemedicine has been transformed into an essential service for delivering routine clinical care. This transformation occurred as a crisis management response-driven by the need to provide care for patients with physical distancing measures in place. However, the current rapid adoption of telemedicine presents a transitional state between one that existed before the pandemic and one that could potentially be better aligned with the delivery of a personalized model of care. Using the conceptual framework of digital translucence-situating virtual encounters with more nuanced information regarding patients-we describe the role of integrated remote monitoring and virtual care tools aligned with the patient's electronic health record for adapting telemedicine delivery post-COVID-19.


Obesity and COVID-19: a call for action from people living with obesity


Protection of CT suites from COVID19 infection in a tertiary emergency hospital


title: Groupe de travail SFBC « Marqueurs biochimiques de COVID-19 ¼./ SFBC working group "Biochemical markers of COVID-19"

text: The SARS-CoV-2 virus is responsible for an epidemic disease called COVID-19, which was initially evidenced in Wuhan, China, and spread very rapidly in China and around the world. In France, the first isolated case seems now to be reported in December 2019, stage 3 of the COVID-19 epidemic was triggered on March 14th, the start of the planned containment exit from May 11th. Healthcare services have faced a large influx of patients who may be beyond their capacity to receive and care, particularly in the Large-East and Ile-de-France regions. Some patients show an evolution of the disease never observed before with other coronaviruses and develop in a few days a very important inflammatory reaction, which can lead to death of patients. A working group of the French Society of Clinical Biology (SFBC) was set up with the objective of providing updated information on the current status of the biological prescriptions (focusing on biochemistry ones) and their evolution during the epidemic, and of analyzing the biological parameters associated with comorbidities and patient evolution in order to link biological results with medical events. The expanded working group covers all sectors of medical biology in France and extends to the French-speaking world: hospital sectors (CHU and CH, Army Training Hospitals) and the private sector opening a field of view on the biological situation in establishments for dependent elderly, social establishments and clinical medical institutions. The purpose of this article is the presentation of this working group and its immediate and future actions.


Reproductive Autonomy Is Nonnegotiable, Even in the Time of COVID-19


The Impact of COVID-19 on Syringe Services Programs in the United States


title: COVID-19: Unanswered questions on immune response and pathogenesis

text: The novel coronavirus disease 2019 has rapidly increased in pandemic scale since it first appeared in Wuhan, China, in December 2019. In these troubled days the scientific community is asking for rapid replies to prevent and combat the emergency. It is generally accepted that only achieving a better understanding of the interactions between the virus and the host immune response and of the pathogenesis of infection is crucial to identify valid therapeutic tools to control virus entry, replication, and spread as well as to impair its lethal effects. On the basis of recent research progress of severe acute respiratory syndrome coronavirus 2 and the results on previous coronaviruses, in this contribution we underscore some of the main unsolved problems, mostly focusing on pathogenetic aspects and host immunity to the virus. On this basis, we also touch important aspects regarding the immune response in asymptomatic subjects, the immune evasion of severe acute respiratory syndrome coronavirus 2 in severe patients, and differences in disease severity by age and sex.


title: Respiratory Distress in Postanesthesia Care Unit: First Presentation of Coronavirus Disease 2019 in a 17-Year-Old Girl: A Case Report

text: A 17-year-old healthy girl underwent an uneventful esthetic septorhinoplasty. She was easily extubated and transferred to the postanesthesia care unit (PACU) with oxygen saturation (SpO2) of 96%. About 30 minutes after arrival in the PACU, she developed dyspnea with SpO2 of 84% and promptly received oxygen with bilevel positive airway pressure in conjunction with low-dose corticosteroid. The subsequent chest computed tomography (CT) revealed bilateral patchy infiltrates similar to the radiologic findings of Coronavirus Disease 2019 (COVID-19). Finally, a reverse transcriptase polymerase chain reaction (RT-PCR) of a pharyngeal specimen confirmed the diagnosis of COVID-19.


title: Is Hypertension a Real Risk Factor for Poor Prognosis in the COVID-19 Pandemic?

text: PURPOSE OF REVIEW: There is increasing evidence indicating an association between several risk factors and worse prognosis in patients with coronavirus disease 2019 (COVID-19), including older age, hypertension, heart failure, diabetes, and pulmonary disease. Hypertension is of particular interest because it is common in adults and there are concerns related to the use of renin-angiotensin system (RAS) inhibitors in patients with hypertension infected with COVID-19. Levels of angiotensin-converting enzyme 2 (ACE2), a protein that facilitates entry of coronavirus into cells, may increase in patients using RAS inhibitors. Thus, chronic use of RAS inhibition could potentially lead to a more severe and fatal form of COVID-19. In this review, we provide a critical review to the following questions: (1) Does hypertension influence immunity or ACE2 expression favoring viral infections? (2) Are the risks of complications in hypertension mediated by its treatment? (3) Is aging a major factor associated with worse prognosis in patients with COVID-19 and hypertension? RECENT FINDINGS: Despite the potential involvement of immune responses in the pathogenesis of hypertension, there is no evidence supporting that hypothesis that hypertension or RAS inhibitors contributes to unfavorable outcomes in viral infections. Future investigations adopting a strict protocol for confirming hypertension status as well as assessing associated comorbidities that may influence outcomes are necessary. From the therapeutic perspective, recombinant ACE2 may serve as a potential therapy, but relevant studies in humans are lacking. Definitive evidence regarding the use of RAS inhibitors in patients with COVID-19 is needed; 5 randomized trials examining this issue are currently underway. There is no current scientific support for claiming that hypertension or its treatment with RAS inhibitors contribute to unfavorable outcomes in COVID-19.


Stroke care in Europe during the COVID-19 pandemic


Decrease in ST-segment elevation myocardial infarction admissions in Catalonia during the COVID-19 pandemic


title: COVID-19-Associated Bifacial Weakness with Paresthesia Subtype of Guillain-Barré Syndrome

text: We report a case of bifacial weakness with paresthesia, a recognized Guillain-Barré syndrome subtype characterized by rapidly progressive facial weakness and paresthesia without ataxia or other cranial neuropathies, which was temporally associated with antecedent coronavirus 2019 (COVID-19). This case highlights a potentially novel but critically important neurologic association of the COVID-19 disease process. Herein, we detail the clinicoradiologic work-up and diagnosis, clinical course, and multidisciplinary medical management of this patient with COVID-19. This case is illustrative of the increasingly recognized but potentially underreported neurologic manifestations of COVID-19, which must be considered and further investigated in this pandemic disease.


title: Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations From ASAIO-A "Living Working Document"

text: The severe acute respiratory syndrome (SARS)-CoV-2 is an emerging viral pathogen responsible for the global coronavirus disease 2019 (COVID)-19 pandemic resulting in significant human morbidity and mortality. Based on preliminary clinical reports, hypoxic respiratory failure complicated by acute respiratory distress syndrome is the leading cause of death. Further, septic shock, late-onset cardiac dysfunction, and multiorgan system failure are also described as contributors to overall mortality. Although extracorporeal membrane oxygenation and other modalities of mechanical cardiopulmonary support are increasingly being utilized in the treatment of respiratory and circulatory failure refractory to conventional management, their role and efficacy as support modalities in the present pandemic are unclear. We review the rapidly changing epidemiology, pathophysiology, emerging therapy, and clinical outcomes of COVID-19; and based on these data and previous experience with artificial cardiopulmonary support strategies, particularly in the setting of infectious diseases, provide consensus recommendations from ASAIO. Of note, this is a "living document," which will be updated periodically, as additional information and understanding emerges.


title: Remdesivir (GS-5734) as a therapeutic option of 2019-nCOV main protease - in silico approach

text: 2019 - Novel Coronavirus (2019-nCOV), enclosed large genome positive-sense RNA virus characterized by crown-like spikes that protrude from their surface, and have a distinctive replication strategy. The 2019-nCOV belongs to the Coronaviridae family, principally consists of virulent pathogens showing zoonotic property, has emerged as a pandemic outbreak with high mortality and high morbidity rate around the globe and no therapeutic vaccine or drugs against 2019-nCoV are discovered till now. In this study, in silico methods and algorithms were used for sequence, structure analysis and molecular docking on Mpro of 2019-nCOV. The co-crystal structure of 2019-nCOV protease, 6LU7 have â¼99% identity with SARS-CoV protease. The 6LU7 residues, Cys145 and His164 are playing a significant role in replication and are essential for the survival of 2019-nCOV. Alongside, 2019-nCOV Mpro sequence is non-homologous to human host-pathogen. Complete genome sequence analysis, structural and molecular docking results revealed that Remdesivir is having a better binding affinity with -8.2 kcal/mol than the rest of protease inhibitors, and peptide. Remdesivir is strongly forming h-bonds with crucial Mpro residues, Cys145, and His164. Further, MD simulation analysis also confirmed, that these residues are forming H-bond with Remdesivir during 100 ns simulations run and found stable (â¼99%) by RMSD and RMSF. Thus, present in silico study at molecular approaches suggest that, Remdesivir is a potent therapeutic inhibitor against 2019-nCoV.Communicated by Ramaswamy H. Sarma.


Viral enanthema in oral mucosa: a possible diagnostic challenge in the COVID-19 pandemic


title: A Public Health Laboratory Response to the COVID-19 Pandemic

text: An outbreak of coronavirus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) began in Wuhan, Hubei, China, in December 2019, and spread rapidly worldwide. The response by the Alberta Precision Laboratories, Public Health Laboratory (ProvLab), Alberta, Canada, included the development and implementation of nucleic acid detection based assays and dynamic changes in testing protocols for the identification of cases as the epidemic curve increased exponentially. This rapid response was essential to slow down and contain transmission and provide valuable time to the local health authorities to prepare appropriate response strategies. As of May 24, 2020, 236,077 specimens were tested with 6475 (2.74%) positives detected in the province of Alberta, Canada. Several commercial assays are now available; however, the response from commercial vendors to develop and market validated tests is a time-consuming process. In addition, the massive global demand made it difficult to secure a reliable commercial supply of testing kits and reagents.A public health laboratory serves a unique and important role in the delivery of health care. One of its functions is to anticipate and prepare for novel emerging pathogens with a plan for pandemic preparedness. Here we outline the response that involved the development and deployment of testing methodologies that evolved as SARS-CoV-2 spread world-wide, the challenges encountered, and mitigation strategies. We also provide insight into the organizational structure of how a public health response is coordinated in Alberta and its benefits.


Research towards treating COVID-19


title: The basic reproduction number and prediction of the epidemic size of the novel coronavirus (COVID-19) in Shahroud, Iran

text: The aim of this study was to estimate the basic reproduction number (R0) of COVID-19 in the early stage of the epidemic and predict the expected number of new cases in Shahroud in Northeastern Iran. The R0 of COVID-19 was estimated using the serial interval distribution and the number of incidence cases. The 30-day probable incidence and cumulative incidence were predicted using the assumption that daily incidence follows a Poisson distribution determined by daily infectiousness. Data analysis was done using 'earlyR' and 'projections' packages in R software. The maximum-likelihood value of R0 was 2.7 (95% confidence interval (CI): 2.1-3.4) for the COVID-19 epidemic in the early 14 days and decreased to 1.13 (95% CI 1.03-1.25) by the end of day 42. The expected average number of new cases in Shahroud was 9.0 ± 3.8 cases/day, which means an estimated total of 271 (95% CI: 178-383) new cases for the period between 02 April to 03 May 2020. By day 67 (27 April), the effective reproduction number (Rt), which had a descending trend and was around 1, reduced to 0.70. Based on the Rt for the last 21 days (days 46-67 of the epidemic), the prediction for 27 April to 26 May is a mean daily cases of 2.9 ± 2.0 with 87 (48-136) new cases. In order to maintain R below 1, we strongly recommend enforcing and continuing the current preventive measures, restricting travel and providing screening tests for a larger proportion of the population.


title: What do we know about the SARS-CoV-2 coronavirus in the environment?

text: In view of the current situation regarding the Covid-19 disease, a discussion is proposed on the need for research focusing on the presence and evolution of the SARS-CoV-2 virus in water, soils and other environmental compartments, reached through wastewater and sewage sludge spreading. Also, the evaluation of current treatments for wastewater and sewage sludge, as well as the eventual development of new specific techniques, based on sorption, nanotechnology, etc., would be of great interest for controlling the environmental dissemination of these viruses in the current and eventual future outbreaks.


Dépistage et diagnostic du cancer du sein à la fin de période de confinement COVID-19, aspects pratiques et hiérarchisation des priorités./ [Breast cancer screening and diagnosis at the end of the COVID-19 confinement period, practical aspects and prioritization rules: recommendations of 6 French health professionals societies]


title: Personalization of Hearing Aid Compression by Human-In-Loop Deep Reinforcement Learning

text: Existing prescriptive compression strategies used in hearing aid fitting are designed based on gain averages from a group of users which are not necessarily optimal for a specific user. Nearly half of hearing aid users prefer settings that differ from the commonly prescribed settings. This paper presents a human-in-loop deep reinforcement learning approach that personalizes hearing aid compression to achieve improved hearing perception. The developed approach is designed to learn a specific user's hearing preferences in order to optimize compression based on the user's feedbacks. Both simulation and subject testing results are reported which demonstrate the effectiveness of the developed personalized compression.


title: Implication of Inter-State Movement of Migrant Workers during COVID 19 Lockdown using Modified SEIR Model

text: A modified SEIR model is used in the paper to evaluate the effect of inter-state migrant worker transportation during the lockdown in India. The model considers different levels of COVID-19 transmission during travel, daily arrival rate and total migrant workers. Indian states with significant migrant workers are considered to estimate the rise in confirmed and active COVID-19 cases. It is observed that reduced daily arrival rate of migrant workers can help Uttar Pradesh and Bihar to lower the rise in confirmed and active cases. By the end of May, 2020, the daily arrival rate of migrant workers will have similar effect on Rajasthan. For the daily arrival rate of migrant workers considered, Madhya Pradesh may experience higher rise in confirmed and active cases. Maharashtra, on the other hand, may experience marginal rise in the confirmed and active cases. A stringent policy to screen migrant workers for possible trace COVID-19 virus prior to the travel and stricter isolation norm after reaching the destination state can be helpful in reducing the rise in confirmed and actives cases attributed to the migrant worker transportation.


title: Health-related concerns and precautions during the COVID-19 pandemic: A comparison of Canadians with and without underlying health conditions

text: BACKGROUND: The risk of experiencing adverse outcomes from the coronavirus disease 2019 (COVID-19), such as hospitalization, admission to intensive care units and death, is elevated for older individuals and those with certain underlying health conditions including diabetes, chronic conditions affecting lungs, heart or kidneys, and a compromised immune system. DATA AND METHODS: Data collected between March 29 and April 3, 2020 from the Canadian Perspectives Survey Series 1: Impacts of COVID-19 (n=4,627) were used to estimate the prevalence of underlying health conditions, health concerns and precautionary behaviours among Canadians aged 15 or older living in the provinces. Multivariate analyses examined associations between these variables after accounting for age, sex and education. RESULTS: Close to 1 in 4 Canadians (24%) had an underlying health condition that increased their risk of adverse outcomes from COVID-19. Overall, 36% of the population were very or extremely concerned about the impact of COVID-19 on their own health. Individuals with underlying health conditions had higher odds (odds ratio: 2.0, 95% confidence interval: 1.6 to 2.5) of being highly concerned than those without these conditions, after adjustment for demographic characteristics. High percentages of Canadians took precautions to reduce the risk of infection regardless of whether or not they had underlying health conditions. DISCUSSION: Health status was associated with higher levels of concern for one's own health in the early period of the COVID-19 pandemic. Most Canadians were taking precautions recommended by public health authorities to protect themselves and others.


Treatment adherence of patients with systemic rheumatic diseases in COVID-19 pandemic


title: Gastrointestinal and liver manifestations of COVID-19

text: The novel coronavirus 2 (SARS-CoV-2) has spread worldwide. While patients typically present with fever and symptoms of a respiratory illness, patients have also presented with gastrointestinal symptoms such as diarrhea, vomiting and abdominal pain. In addition, some patients were reported to have liver injury. In this article, we review gastrointestinal and liver aspects of COVID-19. In addition, we provide general gastroenterologists with guidance on the management of patients with gastrointestinal and liver disorders from COVID-19.


title: Current laboratory diagnostics of coronavirus disease 2019 (COVID-19)

text: Laboratory medicine provides an almost irreplaceable contribution to the diagnostic reasoning and managed care of most human pathologies. The novel coronavirus disease 2019 (COVID-19) is not an exception to this paradigm. Although the relatively recent emergence does not allow to draw definitive conclusions on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostics, some standpoints can be conveyed. First and foremost, it seems now clear that we will be living together with this virus for quite a long time, so that our vigilance and responsiveness against the emergence of new local outbreaks shall be maintained at the highest possible levels. The etiological diagnosis of COVID-19 is, and will remain for the foreseeable future, deeply based on direct identification of viral RNA by means of molecular biology techniques in biological materials, especially upper and lower respiratory tract specimens. Whether other materials, such as blood, urine, stools, saliva and throat washing, will become valid alternatives has not been unequivocally defined so far. As concerns serological testing, promising information can be garnered from preliminary investigations, showing that the vast majority of COVID-19 patients seem to develop a sustained immune response against the virus, characterized especially by emergence of anti-SARS-CoV-2 IgG and IgA, 1 to 2 weeks after the onset of fever and/or respiratory symptoms. Whether these antibodies will have persistent neutralizing activity against the virus is still to be elucidated on individual and general basis. The availability of rapid tests for detecting either viral antigens or anti-SARS-CoV-2 antibodies are a potentially viable opportunity for purposes of epidemiologic surveillance, though more information is needed on accuracy and reliability of these portable immunoassays.


COVID-19 Pandemic Triggers Telemedicine Regulation and Intensifies Diabetes Management Technology Adoption in Brazil


title: Lack of cytomegalovirus (CMV)-specific cell-mediated immune response using QuantiFERON-CMV assay in CMV-seropositive healthy volunteers: fact not artifact

text: The QuantiFERON-CMV (QF) assay measures cell-mediated immunity against cytomegalovirus (CMV-CMI), which is particularly useful in individuals susceptible to CMV infection such as transplant patients. A positive QF result identifies patients that are better protected against CMV infection. However, the significance of a negative QF result in CMV-seropositive individuals needs to be clarified. CMV-CMI was analyzed in healthy subjects using the QF assay, and, in parallel, the Flow-cytometric Assay of Specific Cell-mediated Immune response in Activated whole blood (FASCIA). FASCIA assay measures T-cell proliferation using CMV lysate as stimulus whereas QF assay use a mix of peptides. A total of 93 healthy volunteers were enrolled, and 13/71 CMV-seropositive individuals (18.3%) showed humoral/cellular discordance using QF assay (CMV+ QF-). Interestingly, with FASCIA assay CD4+ and CD8+ T-cell proliferations were lower in CMV+ QF- than in CMV+ QF+ individuals. Furthermore, CMV+ QF- volunteers had a lower level of anti-CMV IgG than CMV+ QF+ subjects. Discordant CMV+ QF- volunteers can be defined as low responder individuals since they show lower CMV-specific humoral and cellular immune responses in comparison to CMV+ QF+ individuals. Immune discordance shows the high heterogeneity of immunity to CMV in healthy subjects.


title: Resource Reallocation during the COVID-19 Pandemic in a Suburban Hospital System: Implications for Outpatient Hip and Knee Arthroplasty

text: The COVID pandemic of 2020 has emerged as a global threat to patients, health care providers, and to the global economy. Owing to this particular novel and highly infectious strain of coronavirus, the rapid community spread and clinical severity of the subsequent respiratory syndrome created a substantial strain on hospitals and health care systems around the world. The rapid surge of patients presenting over a small period for emergent clinical care, admission to the hospital, and intensive care units with many requiring mechanically assisted ventilators for respiratory support demonstrated the potential to overwhelm health care workers, hospitals, and health care systems. The purpose of this article is to describe an effective system for redeployment of health care supplies, resources, and personnel to hospitals within a suburban academic hospital system to optimize the care of COVID patients, while treating orthopedic patients in an equally ideal setting to maximize their surgical and clinical care. This article will provide a particular focus on the current and future role of a specialty hip and knee hospital and its partnering ambulatory surgery center in the context of an outpatient arthroplasty program.


President's Message: The Fabric of the World


title: The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey

text: The coronavirus disease 2019 (COVID-19) outbreak caused by the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2 virus) has been sustained in China since December 2019, and has become a pandemic. The mental health of frontline medical staff is a concern. In this study, we aimed to identify the factors influencing medical worker anxiety in China during the COVID-19 outbreak. We conducted a cross-sectional study to estimate the prevalence of anxiety among medical staff in China from 10 February 2020 to 20 February 2020 using the Zung Self-rating Anxiety Scale (SAS) to assess anxiety, with the criteria of normal (â©½49), mild (50-59), moderate (60-70) and severe anxiety (â©¾70). We used multivariable linear regression to determine the factors (e.g. having direct contact when treating infected patients, being a medical staff worker from Hubei province, being a suspect case) for anxiety. We also used adjusted models to confirm independent factors for anxiety after adjusting for gender, age, education and marital status. Of 512 medical staff in China, 164 (32.03%) had had direct contact treating infected patients. The prevalence of anxiety was 12.5%, with 53 workers suffering from mild (10.35%), seven workers suffering from moderate (1.36%) and four workers suffering from severe anxiety (0.78%). After adjusting for sociodemographic characteristics (gender, age, education and marital status), medical staff who had had direct contact treating infected patients experienced higher anxiety scores than those who had not had direct contact (ß value = 2.33, confidence interval (CI) 0.65-4.00; P = 0.0068). A similar trend was observed in medical staff from Hubei province, compared with those from other parts of China (ß value = 3.67, CI 1.44-5.89; P = 0.0013). The most important variable was suspect cases with high anxiety scores, compared to non-suspect cases (ß value = 4.44, CI 1.55-7.33; P = 0.0028). In this survey of hospital medical workers during the COVID-19 outbreak in China, we found that study participants experienced anxiety symptoms, especially those who had direct clinical contact with infected patients; as did those in the worst affected areas, including Hubei province; and those who were suspect cases. Governments and healthcare authorities should proactively implement appropriate psychological intervention programmes, to prevent, alleviate or treat increased anxiety.


title: Perspectives on monoclonal antibody therapy as potential therapeutic intervention for Coronavirus disease-19 (COVID-19)

text: Last decade witnessed the outbreak of many life-threatening human pathogens including Nipah, Ebola, Chikungunya, Zika, Middle East respiratory syndrome coronavirus (MERS-CoV), Severe Acute respiratory syndrome coronavirus (SARS-CoV) and more recently novel coronavirus (2019-nCoV or SARS-CoV-2). The disease condition associated with novel coronavirus, referred to as Coronavirus disease (COVID-19). The emergence of novel coronavirus in 2019 in Wuhan, China marked the third highly pathogenic coronavirus infecting humans in the 21st century. The continuing emergence of coronaviruses at regular intervals poses a significant threat to human health and economy. Ironically, even after a decade of research on coronavirus, still there are no licensed vaccines or therapeutic agents to treat coronavirus infection which highlights an urgent need to develop effective vaccines or post-exposure prophylaxis to prevent future epidemics. Several clinical, genetic and epidemiological features of COVID-19 resemble SARS-CoV infection. Hence, the research advancements on SARS-CoV treatment might help scientific community in quick understanding of this virus pathogenesis and develop effective therapeutic/prophylactic agents to treat and prevent this infection. Monoclonal antibodies represent the major class of biotherapeutics for passive immunotherapy to fight against viral infection. The therapeutic potential of monoclonal antibodies has been well recognized in the treatment of many diseases. Here, we summarize the potential monoclonal antibody based therapeutic intervention for COVID-19 by considering the existing knowledge on the neutralizing monoclonal antibodies against similar coronaviruses SARS-CoV and MERS-CoV. Further research on COVID-19 pathogenesis could identify appropriate therapeutic targets to develop specific anti-virals against this newly emerging pathogen.


2019-nCoV epidemic: what about pregnancies?


title: Implementation and analysis of a telephone support service during COVID-19

text: BACKGROUND: During the COVID-19 pandemic, it has been essential for occupational health services (OHS) providers to react rapidly to increased demand and to utilize resources in novel ways. The impact of the COVID-19 pandemic on the psychological well-being of staff is already identified as an area of high risk; therefore, providing timely access to psychological support may be vital, although limited evidence is available on how these risks are best managed. AIMS: To describe implementation and analysis of a psychology-led COVID-19 telephone support line in a National Health Service OHS. METHODS: Data from calls made to the support line were collected over the first 4 weeks of service implementation. Numerical data including frequency of calls and average waiting time were first considered. A content analysis was then conducted on call notes to identify prevalence of themes. RESULTS: Six hundred and fifty-five calls were received, and 362 notes included sufficient information for use within the content analysis. Frequency of calls peaked within the first week followed by a reduction in the number of calls received per day over time. Most calls included discussion around clarification of guidance (68%) with a smaller subset of calls offering support around anxiety (29%). Prevalence of themes did not appear to change over time. CONCLUSIONS: Clear and timely information is vital to support the well-being of healthcare staff. A psychologically informed telephone support line was a good use of occupational health service resources in the interim while more tailored advice and services could be established.


title: A Big Data Based Framework for Executing Complex Query Over COVID-19 Datasets (COVID-QF)

text: COVID-19's rapid global spread has driven innovative tools for Big Data Analytics. These have guided organizations in all fields of the health industry to track and minimized the effects of virus. Researchers are required to detect coronaviruses through artificial intelligence, machine learning, and natural language processing, and to gain a complete understanding of the disease. COVID-19 takes place in different countries in the world, with which only big data application and the work of NOSQL databases are suitable. There is a great number of platforms used for processing NOSQL Databases model like: Spark, H2O and Hadoop HDFS/MapReduce, which are proper to control and manage the enormous amount of data. Many challenges faced by large applications programmers, especially those that work on the COVID-19 databases through hybrid data models through different APIs and query. In this context, this paper proposes a storage framework to handle both SQL and NOSQL databases named (COVID-QF) for COVID-19 datasets in order to treat and handle the problems caused by virus spreading worldwide by reducing treatment times. In case of NoSQL database, COVID-QF uses Hadoop HDFS/Map Reduce and Apache Spark. The COVID-QF consists of three Layers: data collection layer, storage layer, and query Processing layer. The data is collected in the data collection layer. The storage layer divides data into collection of data-saving and processing blocks, and it connects the Connector of the spark with different databases engine to reduce time of saving and retrieving. While the Processing layer executes the request query and sends results. The proposed framework used three datasets increased for time for COVID-19 data (COVID-19-Merging, COVID-19-inside-Hubei and COVID-19-ex-Hubei) to test experiments of this study. The results obtained insure the superiority of the COVID-QF framework.


title: Orthopaedic Systems Response to and Return from the COVID-19 Pandemic: Lessons for Future Crisis Management

text: The coronavirus disease 2019 (COVID-19) pandemic has become the dominant health-care issue of this generation and has reached every corner of the health-care delivery spectrum. Our 3 orthopaedic departments enacted a response to the COVID-19 pandemic within our organizations. We discuss our health-care systems' response to the outbreak and offer discussion for the recovery of the orthopaedic service line within large health-care systems.


title: Manejo quirúrgico de pacientes con infección por COVID-19. Recomendaciones de la Asociación Española de Cirujanos./ Manejo quirúrgico de pacientes con infección por COVID-19. Recomendaciones de la Asociación Española de Cirujanos./ Surgical Management of Patients With COVID-19 Infection. Recommendations of the Spanish Association of Surgeons

text: Due to the current pandemic of respiratory disease known as coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus, many patients with confirmed or suspected COVID-19 infection will require elective surgery, surgery that cannot be postponed, or emergency surgical treatment. In these situations, special measures need to be adopted in order to minimize the possibility of transmission between patients, exposure of healthcare personnel and the development of postoperative complications. This document explains the main principles to consider when managing confirmed or suspected COVID-19 patients during evaluation as well as when surgical treatment is required.


title: Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study

text: The aim of this study was to identify factors associated with the death of patients with COVID-19 pneumonia caused by the novel coronavirus SARS-CoV-2.All clinical and laboratory parameters were collected prospectively from a cohort of patients with COVID-19 pneumonia who were hospitalised to Wuhan Pulmonary Hospital (Wuhan City, Hubei Province, China) between 25 December 2019 and 7 February 2020. Univariate and multivariate logistic regression was performed to investigate the relationship between each variable and the risk of death of COVID-19 pneumonia patients.In total, 179 patients with COVID-19 pneumonia (97 male and 82 female) were included in the present prospective study, of whom 21 died. Univariate and multivariate logistic regression analysis revealed that age ≥65â years (OR 3.765, 95% CI 1.146â17.394; p=0.023), pre-existing concurrent cardiovascular or cerebrovascular diseases (OR 2.464, 95% CI 0.755â8.044; p=0.007), CD3+CD8+ T-cells ≤75â cells·µL-1 (OR 3.982, 95% CI 1.132â14.006; p<0.001) and cardiac troponin I ≥0.05â ng·mL-1 (OR 4.077, 95% CI 1.166â14.253; p<0.001) were associated with an increase in risk of mortality from COVID-19 pneumonia. In a sex-, age- and comorbid illness-matched case-control study, CD3+CD8+ T-cells ≤75â cells·µL-1 and cardiac troponin I ≥0.05â ng·mL-1 remained as predictors for high mortality from COVID-19 pneumonia.We identified four risk factors: age ≥65â years, pre-existing concurrent cardiovascular or cerebrovascular diseases, CD3+CD8+ T-cells ≤75â cells·µL-1 and cardiac troponin I ≥0.05â ng·mL-1 The latter two factors, especially, were predictors for mortality of COVID-19 pneumonia patients.


Initial Experience of an Emergency Department in Shenzhen in Responding to the Emerging Wuhan Coronavirus Pneumonia


Regional difference in the rate of spread of SARS-CoV-2


title: Palliativ farmakologisk behandling vid svår covid-19./ [Palliation in patients with severe COVID-19]

text: Coronavirus Disease 2019 (COVID-19) can cause severe respiratory failure and distressing symptoms including fever, cough, breathlessness and anxiety. Symptomatic (palliative) treatment is of fundamental importance both in conjuncture with life-sustaining interventions and in end of life care. Based on the evidence to date, there are several treatment options to consider for the relief of fever (acetaminophen, NSAID, oral glucocorticoids), cough (morphine), breathlessness (morphine, oxygen, fan), anxiety (benzodiazepines) and pain (NSAID, morphine). Top priorities include precautions to protect staff and people at-risk from infection and planning how to provide adequate treatment for each individual depending on setting, including palliative care.


COVID-19 and Kawasaki disease in children


title: Recommendations for the prevention, mitigation and containment of the emerging SARS-CoV-2 (COVID-19) pandemic in haemodialysis centres

text: COVID-19, a disease caused by a novel coronavirus, is a major global human threat that has turned into a pandemic. This novel coronavirus has specifically high morbidity in the elderly and in comorbid populations. Uraemic patients on dialysis combine an intrinsic fragility and a very frequent burden of comorbidities with a specific setting in which many patients are repeatedly treated in the same area (haemodialysis centres). Moreover, if infected, the intensity of dialysis requiring specialized resources and staff is further complicated by requirements for isolation, control and prevention, putting healthcare systems under exceptional additional strain. Therefore, all measures to slow if not to eradicate the pandemic and to control unmanageably high incidence rates must be taken very seriously. The aim of the present review of the European Dialysis (EUDIAL) Working Group of ERA-EDTA is to provide recommendations for the prevention, mitigation and containment in haemodialysis centres of the emerging COVID-19 pandemic. The management of patients on dialysis affected by COVID-19 must be carried out according to strict protocols to minimize the risk for other patients and personnel taking care of these patients. Measures of prevention, protection, screening, isolation and distribution have been shown to be efficient in similar settings. They are essential in the management of the pandemic and should be taken in the early stages of the disease.


title: Recommendations for the prevention, mitigation and containment of the emerging SARS-CoV-2 (COVID-19) pandemic in haemodialysis centres ;Nephrology Dialysis Transplantation ;Oxford Academic

text: COVID-19, a disease caused by a novel coronavirus, is a major global human threat that has turned into a pandemic This novel coronavirus has specifically high morbidity in the elderly and in comorbid populations Uraemic patients on dialysis combine an intrinsic fragility and a very frequent burden of comorbidities with a specific setting in which many patients are repeatedly treated in the same area (haemodialysis centres) Moreover, if infected, the intensity of dialysis requiring specialized resources and staff is further complicated by requirements for isolation, control and prevention, putting healthcare systems under exceptional additional strain Therefore, all measures to slow if not to eradicate the pandemic and to control unmanageably high incidence rates must be taken very seriously The aim of the present review of the European Dialysis (EUDIAL) Working Group of ERA-EDTA is to provide recommendations for the prevention, mitigation and containment in haemodialysis centres of the emerging COVID-19 pandemic The management of patients on dialysis affected by COVID-19 must be carried out according to strict protocols to minimize the risk for other patients and personnel taking care of these patients Measures of prevention, protection, screening, isolation and distribution have been shown to be efficient in similar settings They are essential in the management of the pandemic and should be taken in the early stages of the disease


Letter to the Editor: Contact lens practice in the time of COVID-19