title: SARS-CoV-2 in Pregnancy: A Comprehensive Summary of Current Guidelines

text: Since the declaration of the global pandemic of COVID-19 by the World Health Organization on 11 March 2020, we have continued to see a steady rise in the number of patients infected by SARS-CoV-2. However, there is still very limited data on the course and outcomes of this serious infection in a vulnerable population of pregnant patients and their fetuses. International perinatal societies and institutions including SMFM, ACOG, RCOG, ISUOG, CDC, CNGOF, ISS/SIEOG, and CatSalut have released guidelines for the care of these patients. We aim to summarize these current guidelines in a comprehensive review for patients, healthcare workers, and healthcare institutions. We included 15 papers from 10 societies through a literature search of direct review of society's websites and their journal publications up till 20 April 2020. Recommendations specific to antepartum, intrapartum, and postpartum were abstracted from the publications and summarized into Tables. The summary of guidelines for the management of COVID-19 in pregnancy across different perinatal societies is fairly consistent, with some variation in the strength of recommendations. It is important to recognize that these guidelines are frequently updated, as we continue to learn more about the course and impact of COVID-19 in pregnancy.


title: Care for adult non-ICU Covid-19 patients: early experiences from a Belgian tertiary care centre

text: The current Covid-19 outbreak poses many challenges on hospital organisation and patient care. Our hospital lies at the epicentre of the Belgian epidemic. On April 1st, a total of 235 Covid-19 patients had been admitted to our hospital. This demanded an unprecedented adaptation of our hospital organisation, and we have met many clinical issues in the care for Covid-19 patients. In this article, we share our experience in the handling of some of the practical and organisational issues in the care for Covid-19 patients.


title: HyPE study: hydroxychloroquine prophylaxis-related adverse events' analysis among healthcare workers during COVID-19 pandemic: a rising public health concern

text: BACKGROUND: The rising burden of Coronavirus disease (COVID-19) has led to the mass use of hydroxychloroquine by healthcare workers (HCWs). Adverse event profile of this drug when used as prophylaxis is not well known in the literature. METHODS: A retrospective, cross-sectional study was conducted across the country using semi-structured web-based questionnaire among COVID-19 negative and asymptomatic healthcare workers, taking hydroxychloroquine prophylaxis. Descriptive and multivariate logistic-regression models were applied for analysis. RESULTS: Of the 166 participants, at least one adverse event was experienced by 37.9% participants, gastrointestinal being the most common (30.7%). Risk was higher in participants <40 years age (odd's ratio (OR): 2.44, 95% confidence interval (CI): 1.18-5.05) and after first dose of hydroxychloroquine (51.2%, OR: 2.38, 95%CI: 1.17-4.84). Hydroxychloroquine prophylaxis was initiated without electrocardiography by 80.1% of HCWs. Only 21.6% of those with cardiovascular disease could get prior ECG. CONCLUSIONS: A higher incidence of adverse events was observed when results were compared with studies involving patients on long-term hydroxychloroquine therapy. Younger age and first dose were associated with greater incidence of adverse events though all were self-limiting. Monitoring prior and during prophylaxis was inadequate even among those with cardiovascular disease and risk-factors. However, no serious cardiovascular events were reported.


Moving Personal Protective Equipment Into the Community: Face Shields and Containment of COVID-19


title: Coronaviren: von der banalen Erkältung zum schweren Lungenversagen: Chronologie einer Pandemie./ [Coronavirus: from common cold to severe pulmonary failure]

text: In December 2019 a new human coronavirus emerged in Wuhan, China, which is known as SARS-CoV2. The clinical course of the disease known as coronavirus disease 2019 (COVID-19) ranges from mild respiratory symptoms to severe lung failure. The virus is currently rapidly spreading around the world and pushing health systems to the limits of their capacity due to the exponential increase in the number of cases. The origin of SARS-CoV2 lies in the bat coronavirus pool and has now emerged in the human population due to interspecies transmission. Molecular diagnostic methods have been established in a very short time and a number of clinical studies on the effectiveness of different antiviral drugs are ongoing. The development of a vaccine using different approaches is also under investigation.Considering the high number of cases and mortality rates of up to 9% there is an urgent need for action. This article summarizes the current state of knowledge on human coronaviruses with a strong focus on the current data on SARS-CoV2. Due to the daily changing level of knowledge, the article reflects the status up to 21 March 2020.


Travellers give wings to novel coronavirus (2019-nCoV)


title: Prevalence and Clinical Presentation of Health Care Workers With Symptoms of Coronavirus Disease 2019 in 2 Dutch Hospitals During an Early Phase of the Pandemic

text: Importance: On February 27, 2020, the first patient with coronavirus disease 2019 (COVID-19) was reported in the Netherlands. During the following weeks, at 2 Dutch teaching hospitals, 9 health care workers (HCWs) received a diagnosis of COVID-19, 8 of whom had no history of travel to China or northern Italy, raising the question of whether undetected community circulation was occurring. Objective: To determine the prevalence and clinical presentation of COVID-19 among HCWs with self-reported fever or respiratory symptoms. Design, Setting, and Participants: This cross-sectional study was performed in 2 teaching hospitals in the southern part of the Netherlands in March 2020, during the early phase of the COVID-19 pandemic. Health care workers employed in the participating hospitals who experienced fever or respiratory symptoms were asked to voluntarily participate in a screening for infection with the severe acute respiratory syndrome coronavirus 2. Data analysis was performed in March 2020. Main Outcomes and Measures: The prevalence of severe acute respiratory syndrome coronavirus 2 infection was determined by semiquantitative real-time reverse transcriptase-polymerase chain reaction on oropharyngeal samples. Structured interviews were conducted to document symptoms for all HCWs with confirmed COVID-19. Results: Of 9705 HCWs employed (1722 male [18%]), 1353 (14%) reported fever or respiratory symptoms and were tested. Of those, 86 HCWs (6%) were infected with severe acute respiratory syndrome coronavirus 2 (median age, 49 years [range, 22-66 years]; 15 [17%] male), representing 1% of all HCWs employed. Most HCWs experienced mild disease, and only 46 (53%) reported fever. Eighty HCWs (93%) met a case definition of fever and/or coughing and/or shortness of breath. Only 3 (3%) of the HCWs identified through the screening had a history of travel to China or northern Italy, and 3 (3%) reported having been exposed to an inpatient with a known diagnosis of COVID-19 before the onset of symptoms. Conclusions and Relevance: Within 2 weeks after the first Dutch case was detected, a substantial proportion of HCWs with self-reported fever or respiratory symptoms were infected with severe acute respiratory syndrome coronavirus 2, likely as a result of acquisition of the virus in the community during the early phase of local spread. The high prevalence of mild clinical presentations, frequently not including fever, suggests that the currently recommended case definition for suspected COVID-19 should be used less stringently.


title: Ethical considerations for epidemic vaccine trials

text: Vaccines are a powerful measure to protect the health of individuals and to combat outbreaks such as the COVID-19 pandemic. An ethical dilemma arises when one effective vaccine has been successfully developed against an epidemic disease and researchers seek to test the efficacy of another vaccine for the same pathogen in clinical trials involving human subjects. On the one hand, there are compelling reasons why it would be unethical to trial a novel vaccine when an effective product exists already. First, it is a firm principle of medical ethics that an effective treatment or vaccine should not be withheld from patients if their life may depend on it. Second, since epidemic outbreaks often emerge in settings with less-resourced health systems, there is a pronounced risk that any trial withholding an effective vaccine would disproportionately affect the vulnerable populations that historically have been exploited for biomedical research. Third, clinical trials for novel vaccines may be at odds with efforts to control active outbreaks. On the other hand, it may be justified to conduct a trial for a candidate vaccine if it is expected to have certain advantages compared with the existing product. This essay discusses key factors for comparing vaccines against epidemic pathogens, including immunological, logistical and economic considerations. Alongside a case study of the development of vaccines for Ebola, the essay seeks to establish a general framework that should be expanded and populated by immunologists, epidemiologists, economists and bioethicists, and ultimately could be applied to the case of COVID-19 vaccines.


Acute pulmonary embolism in a patient with COVID-19 pneumonia


title: All India Ophthalmological Society - Indian Journal of Ophthalmology consensus statement on preferred practices during the COVID-19 pandemic

text: The COVID-19 pandemic has taken tragic proportions and has disrupted lives globally. In the wake of governmental lockdowns, ophthalmologists need practical and actionable guidelines based on advisories from national health departments on how to conduct their duties during nationwide lockdowns and after these are lifted. In this paper, we present a preferred practice pattern (PPP) based on consensus discussions between leading ophthalmologists and health care professionals in India including representatives from major governmental and private institutions as well as the All India Ophthalmological Society leadership. In this document, the expert panel clearly defines the range of activities for Indian ophthalmologists during the ongoing lockdown phase and precautions to be taken once the lockdown is lifted. Guidelines for triage, governmental guidelines for use of personal protective equipment from ophthalmologists' point of view, precautions to be taken in the OPD and operating room as well as care of various ophthalmic equipment have been described in detail. These guidelines will be applicable to all practice settings including tertiary institutions, corporate and group practices and individual eye clinics and should help Indian ophthalmologists in performing their professional responsibilities without being foci of disease transmission.


title: Manifestaciones gastrointestinales de la infección por el nuevo coronavirus

text: El 11 de marzo del 2020 la Organización Mundial de la Salud (OMS) declaró la pandemia por el brote de la enfer-medad por coronavirus 2019 (COVID-19) Los primeros datos acerca de las manifestaciones clínicas provienen de estudios retrospectivos de Wuhan, China, epicentro de la pandemia;además del compromiso respiratorio, se ha descrito la afectación del sistema gastrointestinal Aunque no está del todo claro el porqué del tropismo de COVID-19 por el tracto gastrointestinal, se ha demostrado que la enzima convertidora de angiotensina 2 (ECA2), la cual tiene una alta expresión en el sistema gastrointestinal, es empleada como receptor de entrada del virus Se ha logrado documentar la posibilidad de trasmisión fecal-oral luego de demostrar la existencia del virus en las heces, incluso hasta dentro de 7-12 días después de la conversión negativa en la muestra faríngea, inde-pendientemente de la presencia o no de síntomas gastrointestinales La afectación del sistema gastrointestinal en pacientes con infección por COVID-19 no es infrecuente;los datos reportan que los pacientes con síntomas gastrointestinales tienen un peor pronóstico El conocimiento de estas manifestaciones nos permite aumentar la sospecha clínica y, de esta manera, establecer diagnósticos tempranos (AU)The World Ìs Heath Organization (WHO) declared the new coronavirus infection COVID-19 a pandemic in March 11 2020 The first data about the disease clinical features were reported from Wuhan China the epi-center of the outbreak;aside from the respiratory involvement, gastrointestinal manifestations have been described Even though the exact mechanism for the new coronavirus tropism for the gastrointestinal tract is not well understood, angiotensin converting enzyme 2 receptor seems to play an important role as the entry site for the virus, since it is widespread located throughout the enteric mucosa Fecal oral transmission is a possible contagion route, regardless of the presence of gastrointestinal symptoms, the virus has been isolated from feces even 7-12 days after a negative pharyngeal swab COVID's-19 gastrointestinal involvement is not an infrequent event, data reports patients who present with these symptoms have worst prognosis Knowing the possible gastrointestinal manifestations might rise our clinical suspicion in order to establish earlier and timely diagnosis (AU)


Impact of the COVID-19 lockdown on basic science research in ophthalmology: the experience of a highly specialized research facility in France


A European roadmap out of the covid-19 pandemic


Severe COVID-19 in Children and Young Adults


The interplay between COVID 19 and non-communicable diseases


title: Structural basis of SARS-CoV-2 3CLpro and anti-COVID-19 drug discovery from medicinal plants

text: The recent outbreak of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 in December 2019 raised global health concerns. The viral 3-chymotrypsin-like cysteine protease (3CLpro) enzyme controls coronavirus replication and is essential for its life cycle. 3CLpro is a proven drug discovery target in the case of severe acute respiratory syndrome coronavirus (SARS-CoV) and middle east respiratory syndrome coronavirus (MERS-CoV). Recent studies revealed that the genome sequence of SARS-CoV-2 is very similar to that of SARS-CoV. Therefore, herein, we analysed the 3CLpro sequence, constructed its 3D homology model, and screened it against a medicinal plant library containing 32,297 potential anti-viral phytochemicals/traditional Chinese medicinal compounds. Our analyses revealed that the top nine hits might serve as potential anti- SARS-CoV-2 lead molecules for further optimisation and drug development process to combat COVID-19.


Teenage swimmers' perspectives of coronavirus pandemic


Battling COVID-19 in Bangladesh: A Conversation with Dr. John Clemens of icddr,b.


title: Analysis of Austrian COVID-19 deaths by age and sex

text: We analyze the age and sex distribution of the reported COVID-19 deaths in Austria. In accordance with international studies, the Austrian data also suggests that the risk of death increases substantially with age. The observed age dependency of the proportions of registered COVID-19 deaths in relation to the population sizes in the age groups is approximately exponential, similar to the age dependency of the general age specific mortality rate. Furthermore, we compare the general age specific mortality rate in Austria with the estimates of the SARS-CoV2 infection fatality rate by Ferguson et al. (2020). The parallels to the general age specific mortality rates do not imply that COVID-19 does not pose an additional risk. On the contrary, it follows from the structure and magnitude of the infection fatality rate that it is substantial, especially for higher age groups. However, since in many cases persons with severe pre-existing conditions are affected, it is not yet possible to estimate what effects COVID-19 will have on life expectancy.


Novel paediatric presentation of COVID-19 with ARDS and cytokine storm syndrome without respiratory symptoms


title: Recent discovery and development of inhibitors targeting coronaviruses

text: Human coronaviruses (CoVs) are enveloped viruses with a positive-sense single-stranded RNA genome. Currently, six human CoVs have been reported including human coronavirus 229E (HCoV-229E), OC43 (HCoV-OC43), NL63 (HCoV-NL63), HKU1 (HCoV-HKU1), severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV), and MiddleEast respiratory syndrome (MERS) coronavirus (MERS-CoV). They cause moderate to severe respiratory and intestinal infections in humans. In this review, we focus on recent advances in the research and development of small-molecule anti-human coronavirus therapies targeting different stages of the CoV life cycle.


Response to: Correspondence regarding research letter to the editor by Mathian et al, 'Clinical course of coronavirus disease 2019 (COVID-19) in a series of 17 patients with systemic lupus under long-term treatment with hydroxychloroquine'' by Nikpour et al


title: [the Psychological Impact of a Pandemic Outbreak on Medical Staff - Literature Review]

text: INTRODUCTION: In January 2020, the World Health Organization (WHO) declared an international emergency due to the outbreak of COVID-19. In March 2020 the WHO announced that the epidemic could be characterized as a pandemic. Subsequently, the WHO acknowledged the importance of providing support to the medical teams, realizing the enormous burden and stress facing this group. The aim of the present study is to review the up-to-date professional literature dealing with the psychological impact of a pandemic outbreak on medical staff. The literature existing so-far is scarce. It does, however, provide evidence of the short- and long-term impact of such epidemics on the mental health of the medical teams. Direct exposure to affected patients, the risk of contagion, a subjectively negative perception of one's medical condition and being in isolation or quarantine, all constitute risk factors for mental symptoms such as depression, anxiety and post-trauma. A sense of control, especially regarding the means of protection and controlling infection, altruistic acceptance of the work-related risks, social support, good team-spirit in the medical unit and support from superiors are all protective factors.


title: Monitoring transmissibility and mortality of COVID-19 in Europe

text: OBJECTIVES: As a global pandemic is inevitable, real-time monitoring of transmission is vital for containing the spread of COVID-19. The main objective of this study was to report the real-time effective reproduction numbers (R(t)) and case fatality rates (CFR) in Europe. METHODS: Data for this study were obtained mainly from the World Health Organization website, up to March 9, 2020. R(t) were estimated by exponential growth rate (EG) and time-dependent (TD) methods. 'R0' package in R was employed to estimate R(t) by fitting the existing epidemic curve. Both the naïve CFR (nCFR) and adjusted CFR (aCFR) were estimated. RESULTS: With the EG method, R(t) was 3.27 (95% confidence interval (CI) 3.17-3.38) for Italy, 6.32 (95% CI 5.72-6.99) for France, 6.07 (95% CI 5.51-6.69) for Germany, and 5.08 (95% CI 4.51-5.74) for Spain. With the TD method, the R value for March 9 was 3.10 (95% CI 2.21-4.11) for Italy, 6.56 (95% CI 2.04-12.26) for France, 4.43 (95% CI 1.83-7.92) for Germany, and 3.95 (95% CI 0-10.19) for Spain. CONCLUSIONS: This study provides important findings on the early outbreak of COVID-19 in Europe. Due to the recent rapid increase in new cases of COVID-19, real-time monitoring of the transmissibility and mortality in Spain and France is a priority.


What to expect from antibody assays of SARS-CoV-2?


title: COVID-19: Pandemic Contingency Planning for the Allergy and Immunology Clinic

text: In the event of a global infectious pandemic, drastic measures may be needed that limit or require adjustment of ambulatory allergy services. However, no rationale for how to prioritize service shut down and patient care exists. A consensus-based ad-hoc expert panel of allergy/immunology specialists from the United States and Canada developed a service and patient prioritization schematic to temporarily triage allergy/immunology services. Recommendations and feedback were developed iteratively, using an adapted modified Delphi methodology to achieve consensus. During the ongoing pandemic while social distancing is being encouraged, most allergy/immunology care could be postponed/delayed or handled through virtual care. With the exception of many patients with primary immunodeficiency, patients on venom immunotherapy, and patients with asthma of a certain severity, there is limited need for face-to-face visits under such conditions. These suggestions are intended to help provide a logical approach to quickly adjust service to mitigate risk to both medical staff and patients. Importantly, individual community circumstances may be unique and require contextual consideration. The decision to enact any of these measures rests with the judgment of each clinician and individual health care system. Pandemics are unanticipated, and enforced social distancing/quarantining is highly unusual. This expert panel consensus document offers a prioritization rational to help guide decision making when such situations arise and an allergist/immunologist is forced to reduce services or makes the decision on his or her own to do so.


title: Respiratory conditions in coronavirus disease 2019 (COVID-19): Important considerations regarding novel treatment strategies to reduce mortality

text: A novel virus named 2019 novel coronavirus (2019-nCoV/SARS-CoV-2) causes symptoms that are classified as coronavirus disease (COVID-19). Respiratory conditions are extensively described among more serious cases of COVID-19, and the onset of acute respiratory distress syndrome (ARDS) is one of the hallmark features of critical COVID-19 cases. ARDS can be directly life-threatening because it is associated with low blood oxygenation levels and can result in organ failure. There are no generally recognized effective treatments for COVID-19, but treatments are urgently needed. Anti-viral medications and vaccines are in the early developmental stages and may take many months or even years to fully develop. At present, management of COVID-19 with respiratory and ventilator support are standard therapeutic treatments, but unfortunately such treatments are associated with high mortality rates. Therefore, it is imperative to consider novel new therapeutic interventions to treat/ameliorate respiratory conditions associated with COVID-19. Alternate treatment strategies utilizing clinically available treatments such as hyperbaric oxygen therapy (HBOT), packed red blood cell (pRBC) transfusions, or erthropoiesis-stimulating agent (ESA) therapy were hypothesized to increase oxygenation of tissues by alternative means than standard respiratory and ventilator treatments. It was also revealed that alternative treatments currently being considered for COVID-19 such as chloroquine and hydroxychloroquine by increasing hemoglobin production and increasing hemoglobin availability for oxygen binding and acetazolamine (for the treatment of altitude sickness) by causing hyperventilation with associated increasing levels of oxygen and decreasing levels of carbon dioxide in the blood may significantly ameliorate COVID-19 respiratory symptoms. In conclusion, is recommend, given HBOT, pRBC, and ESA therapies are currently available and routinely utilized in the treatment of other conditions, that such therapies be tried among COVID-19 patients with serious respiratory conditions and that future controlled-clinical trials explore the potential usefulness of such treatments among COVID-19 patients with respiratory conditions.


Pulmonary embolism in returning traveler with COVID-19 pneumonia


title: Managing Prostate Cancer Surgical Patients during the COVID-19 Pandemic: A Brief Report of the Duke Cancer Institute's Initial Experience

text: The coronavirus disease 2019 pandemic has rapidly placed tremendous stress on health systems around the world In response, multiple health systems have postponed elective surgeries in order to conserve hospital beds and personal protective equipment, minimize patient traffic, and prevent unnecessary utilization and exposure of healthcare workers The American College of Surgeons released the following statement on March 13, 2020: "Each hospital, health system and surgeon should thoughtfully review all scheduled elective procedures with a plan to minimize, postpone, or cancel electively scheduled operations, endoscopes, or other invasive procedures until we have passed the predicted inflection point in the exposure graph and can be confident that our health care infrastructure can support a potentially rapid and overwhelming uptick in critical patient care needs " In our state, North Carolina, Governor Roy Cooper requested that all hospitals postpone elective and non-urgent procedures and surgeries effective March 23, 2020


Renin-angiotensin system and SARS-CoV-2 infection: there is a before and after


title: Assessment of Knowledge, Attitudes, and Practices towards New Coronavirus (SARS-CoV-2) of Health Care Professionals in Greece before the Outbreak Period

text: INTRODUCTION: The ongoing severe acute respiratory syndrome (SARS)-CoV-2 pandemic has expanded globally. The aim of the current study is to investigate the knowledge, attitudes, and practices (KAP) of health care professionals in Greece towards SARS-CoV-2. METHODS: From 10-25 February 2020, 500 health care workers were approached. Knowledge, attitudes, and practices towards SARS-CoV-2 were assessed via a personal interview questionnaire. For knowledge, each correct answer was given 1 point; attitudes, or concerns aimed at prevention of SARS-CoV-2 infection, and practices, or behaviors towards performing preventive practices, were assigned 1 point each. Points were summed and a score for each category was calculated. RESULTS: A total of 461 health care workers returned the questionnaire and were included in the analysis (mean age ± SD: 44.2 ± 10.78 years, 74% females). The majority were nurses (47.5%), followed by physicians (30.5%) and paramedics (19%). The majority of subjects (88.28%) had a good level of knowledge (knowledge score equal to 4, or more). The majority of participants (71%) agreed with the temporary traveling restrictions ban. The uptake of a future vaccine against SARS-CoV-2 was estimated at 43%. Knowledge score was significantly associated with both attitudes score (p = 0.011) and practices score (p < 0.001), indicating that subjects with a high knowledge score demonstrated a more positive perception on preventive measures and would practice more preventive measures. Attitudes score was significantly associated with practices score (p = 0.009) indicating that subjects with a higher attitudes score are more likely to perform practices towards the prevention of SARS-CoV-2 transmission. CONCLUSION: There is a high level of knowledge concerning SARS-CoV-2 pandemic among Greek health care workers and this is significantly associated with positive attitudes and practices towards preventive health measures. The high level of knowledge of health professionals about SARS-CoV-2 may have contributed considerably to the successful management of the pandemic in Greece. Tailored educational campaigns aiming to increase the proportion of health care workers willing to accept a potential SARS-CoV-2 vaccine could be of paramount importance in future proactive vaccine educational campaigns.


The red half-moon nail sign: a novel manifestation of coronavirus infection


title: Depriving Iron Supply to the Virus Represents a Promising Adjuvant Therapeutic Against Viral Survival

text: Purpose of the review: The ongoing outbreak of novel coronavirus pneumonia (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) in China is lifting widespread concerns. Thus, therapeutic options are urgently needed, and will be discussed in this review. Recent findings: Iron-containing enzymes are required for viruses most likely including coronaviruses (CoVs) to complete their replication process. Moreover, poor prognosis occurred in the conditions of iron overload for patients upon infections of viruses. Thus, limiting iron represents a promising adjuvant strategy in treating viral infection through oral uptake or venous injection of iron chelators, or through the manipulation of the key iron regulators. For example, treatment with iron chelator deferiprone has been shown to prolong the survival of acquired immunodeficiency syndrome (AIDS) patients. Increasing intracellular iron efflux via increasing iron exporter ferroportin expression also exhibits antiviral effect on human immunodeficiency virus (HIV). The implications of other metals besides iron are also briefly discussed. Summary: For even though we know little about iron regulation in COVID-19 patients thus far, it could be deduced from other viral infections that iron chelation might be an alternative beneficial adjuvant in treating COVID-19.


Potential Implications of the COVID-19 Pandemic on the Homeless Population


This newly recognized coronavirus makes one wonder why we were so unprepared


title: Covid-19 and cardiovascular disease

text: Guideline: Diagnosis and management of cardiovascular disease during the covid-19 pandemicPublished by the European Society of Cardiology.This summary is based on the version published on 21 April 2020 (https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance).


title: Physician deaths from corona virus (COVID-19) disease

text: BACKGROUND: The COVID-19 pandemic has caused much morbidity and mortality to patients but also health care providers. AIMS: We tabulated the cases of physician deaths from COVID-19 associated with front-line work in hopes of mitigating future events. METHODS: On 15 April 2020, a Google internet search was performed using the keywords 'doctor', 'physician', 'death', 'COVID' and 'coronavirus' in English and Farsi, and Chinese using the Baidu search engine. The age, sex and medical speciality of physicians who died from COVID-19 in the line of duty were recorded. Individuals greater than 90 years of age were excluded. RESULTS: We found 278 physicians who died with COVID-19 infection, but complete details were missing for 108 individuals. The average age of the physicians was 63.7 years with a median age of 66 years, and 90% were male (235/261). General practitioners and emergency room doctors (108/254), respirologists (5/254), internal medicine specialists (13/254) and anaesthesiologists (6/254) comprised 52% of those dying. Two per cent of the deceased were epidemiologists (5/254), 2% were infectious disease specialists (4/254), 6% were dentists (16/254), 4% were ENT (9/254) and 3% were ophthalmologists (8/254). The countries with the most reported physician deaths were Italy (121/278; 44%), Iran (43/278; 15%), Philippines (21/278; 8%), Indonesia (17/278; 6%), China (16/278; 6%), Spain (12/278; 4%), USA (12/278; 4%) and UK (11/278;4%). CONCLUSIONS: Physicians from all specialities may die from COVID. Lack of personal protective equipment was cited as a common cause of death. Consideration should be made to exclude older physicians from front-line work.


The Disproportionate Impact of COVID-19 on Minority Groups: A Social Justice Concern


Medical education: COVID-19 and surgery


title: Effect Evaluation of Strychnos nux-vomica L. with Integrative Methods for Bortezomib-Induced Peripheral Neuropathy in Multiple Myeloma Patients: A Self-Controlled Clinical Trial

text: OBJECTIVE: To explore the clinical effect and adverse reactions of Strychnos nux-vomica in bortezomib-induced peripheral neuropathy (BIPN) of patients with multiple myeloma (MM). METHODS: A total of 19 MM patients with BIPN were enrolled and Nux Vomica Capsule (NVC, 0.4 g, thrice daily) were orally administrated for 30 days. Comparative analysis on parameters between pre- and post-therapy, including peripheral neuropathy (PN) grade, neurotoxicity score, Chinese medicine (CM) syndrome score, total neuropathy score (TNS), coagulation function, and serum nerve growth factor (NGF) levels were conducted. The adverse events were monitored. RESULTS: In BIPN of MM patients who received NVC, PN grade was lowered, neurotoxicity score was obviously decreased (Pâ©½0.01), and both CM syndrome score and TNS were remarkably decreased (P<0.01). After the therapy, activated partial thromboplastin time was prolonged (P<0.01) and fibrinogen was declined (P<0.05), showing improvement in the hypercoagulable state of patients. No significant difference of NGF recovery degrees was detected between pre- and post-therapy (P>0.05). No evident adverse reactions were observed during the course of treatment. CONCLUSION: Strychnos nux-vomica L. has significantly effect with a good safety in treatment of BIPN in MM patients.


Severe COVID-19 infection and thrombotic microangiopathy: success does not come easily


Letter in response to the article: Vitamin D concentrations and COVID-19 infection in UK biobank (Hastie et al.)


title: Réactivité et pérennité des soins psychiatriques en France à l'épreuve du COVID-19./ [Responsiveness and sustainability of psychiatric care in France during COVID-19 epidemic]

text: OBJECTIVES: The sudden changes of healthcare system due to COVID-19 particularly affect the organization of psychiatry. The objective of this review is to examine the adaptations of psychiatric care in France during this pandemic. METHOD: This narrative review is based on the observation of changes made in French psychiatric hospitals and on an analysis of the literature. RESULTS: Regarding psychiatric hospitalization, the COVID-19 epidemic required rapid measures that profoundly modified the conditions of patients' reception, forcing the medical staffs to adapt their methods of care. The authors noted the creation of at least 89 wards specifically dedicated to patients with COVID-19 needing psychiatric hospitalization, allowing dual care of general medicine and psychiatry. Regarding ambulatory care, maintaining patients with long-term follow-up was a priority. Patients recalling and teleconsultation have been precious resources but cannot entirely replace face-to-face consultations. DISCUSSION: COVID-19 epidemic created unprecedented situation of large-scale upheavals in the healthcare system and in society. Despite the absence of previous recommendations on the subject, French psychiatry has shown great adaptability. Some changes could inspire post-COVID-19 care.


title: A Systematic Review of Asymptomatic Infections with COVID-19

text: Since the outbreak of coronavirus disease 2019 (COVID-19) in late December 2019, it has brought significant harm and challenges to over 200 countries and regions around the world. However, there is increasing evidence that many patients with COVID-19 are asymptomatic or have only mild symptoms, but they are able to transmit the virus to others. There are difficulties in screening for asymptomatic infections, which makes it more difficult for national prevention and control of this epidemic. This article reviews the characteristics, treatment, and outcomes of asymptomatic infections with COVID-19, hoping it would be helpful for early prevention and control of this severe public health threat worldwide.


title: Critically ill patients with COVID-19 in Hong Kong: a multicentre retrospective observational cohort study

text: OBJECTIVE: To report the first eight cases of critically ill patients with coronavirus disease 2019 (COVID-19) in Hong Kong, describing the treatments and supportive care they received and their 28-day outcomes DESIGN: Multicentre retrospective observational cohort study SETTING: Three multidisciplinary intensive care units (ICUs) in Hong Kong PARTICIPANTS: All adult critically ill patients with confirmed COVID-19 admitted to ICUs in Hong Kong between 22 January and 11 February 2020 MAIN OUTCOME MEASURE: 28-day mortality RESULTS: Eight out of 49 patients with COVID-19 (16%) were admitted to Hong Kong ICUs during the study period The median age was 64 5 years (range, 42–70) with a median admission Sequential Organ Failure Assessment (SOFA) score of 6 (IQR, 4–7) Six patients (75%) required mechanical ventilation, six patients (75%) required vasopressors and two (25%) required renal replacement therapy None of the patients required prone ventilation, nitric oxide or extracorporeal membrane oxygenation The median times to shock reversal and extubation were 9 and 11 days respectively At 28 days, one patient (12%) had died and the remaining seven (88%) all survived to ICU discharge Only one of the survivors (14%) still required oxygen at 28 days CONCLUSION: Critically ill patients with COVID-19 often require a moderate duration of mechanical ventilation and vasopressor support Most of these patients recover and survive to ICU discharge with supportive care using lung protective ventilation strategies, avoiding excess fluids, screening and treating bacterial co-infection, and timely intubation Lower rather than upper respiratory tract viral burden correlates with clinical severity of illness


Medical School Admissions and Enhancing Holistic Review Practices During COVID-19


title: Geriatric Health in Bangladesh during COVID-19: Challenges and Recommendations

text: The novel coronavirus disease (COVID-19) is impacting health globally, whereas older adults are highly susceptible and more likely to have adverse health outcomes. In Bangladesh, the elderly population has been increasing over the past few decades, who often live with poor socioeconomic conditions and inadequate access to healthcare services. These disparities are likely to increase amid COVID-19, which may result in high mortality and morbidity among Bangladeshi older adults. We recommend that multifaceted interventions should be adopted for strengthening social care and health systems approach to ensure wellbeing, promote preventive measures, and facilitate access to healthcare among older adults in Bangladesh. Such multipronged measures would require policy-level commitment and collaborative efforts of health and social care providers and institutions to protect health and wellbeing among this vulnerable population during the COVID-19 pandemic.


Urgent need of a management plan for survivors of COVID-19


COVID-19, mobile health and serious mental illness


title: Gravitational Waves Induced by Scalar Perturbations with a Lognormal Peak

text: We study the stochastic gravitational wave (GW) background induced by the primordial scalar perturbation with the spectrum having a lognormal peak of width $\Delta$ at $k=k_*$. We derive an analytical formula for the GW spectrum $\Omega_\text{GW}$ for both narrow ($\Delta\ll1$) and broad ($\Delta\gtrsim1$) peaks. In the narrow-peak case, the spectrum has a double peak feature with the sharper peak at $k= 2k_*/\sqrt{3}$. On the infrared (IR) side of the spectrum, we find power-law behavior with a break at $k=k_b$ in the power-law index where it chages from $k^3$ on the far IR side to $k^2$ on the near IR side. We find the ratio of the break frequency to the peak frequency is determined by $\Delta$ as $f_b/f_p\approx\sqrt{3}\Delta$, where $f_b$ and $f_p$ are the break and peak frequencies, respectively. In the broad-peak case, we find the GW spectrum also has a lognormal peak at $k=k_*$ but with a smaller width of $\Delta/\sqrt2$. Using these derived analytic formulae, we also present expressions for the maximum values of $\Omega_\text{GW}$ for both narrow and broad cases. Our results will provide a useful tool in searching for the induced GW signals in the coming decades.


title: Automatic classification between COVID-19 pneumonia, non-COVID-19 pneumonia, and the healthy on chest X-ray image: combination of data augmentation methods

text: Purpose: This study aimed to develop and validate computer-aided diagnosis (CXDx) system for classification between COVID-19 pneumonia, non-COVID-19 pneumonia, and the healthy on chest X-ray (CXR) images. Materials and Methods: From two public datasets, 1248 CXR images were obtained, which included 215, 533, and 500 CXR images of COVID-19 pneumonia patients, non-COVID-19 pneumonia patients, and the healthy samples. The proposed CADx system utilized VGG16 as a pre-trained model and combination of conventional method and mixup as data augmentation methods. Other types of pre-trained models were compared with the VGG16-based model. Single type or no data augmentation methods were also evaluated. Splitting of training/validation/test sets was used when building and evaluating the CADx system. Three-category accuracy was evaluated for test set with 125 CXR images. Results: The three-category accuracy of the CAD system was 83.6% between COVID-19 pneumonia, non-COVID-19 pneumonia, and the healthy. Sensitivity for COVID-19 pneumonia was more than 90%. The combination of conventional method and mixup was more useful than single type or no data augmentation method. Conclusion: This study was able to create an accurate CADx system for the 3-category classification. Source code of our CADx system is available as open source for COVID-19 research.


title: Clinical characteristics and short-term outcomes of patients with coronavirus disease 2019: a retrospective single-center experience of a designated hospital in Poland

text: INTRODUCTION: Since the first reported case of coronavirus disease 2019 (COVID19) in Poland, the worldwide pandemic has spread throughout the country, leading to many hospital admissions. There has been an urgent need to determine clinical characteristics of Polish patients with laboratoryconfirmed severe acute respiratory syndrome coronavirus 2 (SARSCoV 2) infection in the clinical setting. OBJECTIVES: The aim of this retrospective study was to outline characteristics and short term outcomes of SARSCoV2-positive patients. PATIENTS AND METHODS: We retrospectively assessed 169 consecutive patients with laboratory confirmed COVID 19 with regard to their clinical manifestations, radiological findings, treatment, complications, and outcomes. RESULTS: Of the 169 patients, more than half was aged 65 years or older (88; 52.1%), 51.5% were male, and 78.3% had comorbidities. The majority of patients (106; 62.7%) were transferred from outbreak locations in medical facilities. The most common symptoms on admission were fever (42%), shortness of breath (35%), and fatigue (33%). Twenty seven (15.4%) patients required intensive care unit admission. Overall mortality was 26.3% (n = 46) and was significantly higher in patients transferred from other facilities (38 out of 106; 35.8%), than in patients admitted directly to the hospital (8 out of 63; 12.69%; P <0.001). Seventeen out of 29 patients admitted to the intensive care unit died (mortality, 58.6%), including 30 out of 41 patients with acute respiratory distress syndrome (73.2% mortality rate). CONCLUSIONS: Polish patients with COVID19 have similar characteristics and risk factors for adverse outcomes to those observed in countries in which outbreaks occurred earlier. Significantly higher mortality in patients transferred from other centers warrants special attention and transfer policy should be verified.


COVID-19 in Libya: Fewer Cases So Far. Any Speculations?


title: Modeling of Contact Tracing in Epidemic Populations Structured by Disease Age

text: We consider an age-structured epidemic model with two basic public health interventions: (i) identifying and isolating symptomatic cases, and (ii) tracing and quarantine of the contacts of identified infectives. The dynamics of the infected population are modeled by a nonlinear infection-age-dependent partial differential equation, which is coupled with an ordinary differential equation that describes the dynamics of the susceptible population. Theoretical results about global existence and uniqueness of positive solutions are proved. We also present two practical applications of our model: (1) we assess public health guidelines about emergency preparedness and response in the event of a smallpox bioterrorist attack; (2) we simulate the 2003 SARS outbreak in Taiwan and estimate the number of cases avoided by contact tracing. Our model can be applied as a rational basis for decision makers to guide interventions and deploy public health resources in future epidemics.


title: Correlation between climate indicators and COVID-19 pandemic in New York, USA

text: This study analyzed the association between COVID-19 and climate indicators in New York City, USA. We used secondary published data from New York city health services and National weather service, USA. The climate indicators included in the study are average temperature, minimum temperature, maximum temperature, rainfall, average humidity, wind speed, and air quality. Kendall and Spearman rank correlation tests were chosen for data analysis. We find that average temperature, minimum temperature, and air quality were significantly associated with the COVID-19 pandemic. The findings of this study will help World Health Organization and health regulators such as Center for Disease Control (CDC) to combat COVID-19 in New York and the rest of the world.


Rehabilitering etter covid-19


Genetic Roadmap for Kidney Involvement of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection


title: Clinical analysis of ten pregnant women with COVID-19 in Wuhan, China: A retrospective study

text: BACKGROUND: COVID-19 is spreading globally. This study aims to evaluate the clinical characteristics and outcomes of pregnant women confirmed with COVID-19 to provide reference for clinical work. METHODS: The clinical features and outcomes of 10 pregnant women confirmed with COVID-19 at Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, a tertiary- care teaching hospital in Hubei province, Wuhan, China from January 23 to February 23, 2020 were retrospectively analyzed. RESULTS: All the 10 observed pregnant women including 9 singletons and 1 twin were native people in Wuhan. All of them were diagnosed mild COVID-19, and none of the patients developed severe COVID-19 or died. Among the 10 patients, two patients underwent vaginal delivery, two patients underwent intrapartum cesarean section, and the remaining six patients underwent elective cesarean section. All of 10 patients showed lung abnormalities by pulmonary CT images after delivery. Their eleven newborns were recorded and no neonatal asphyxia was observed. CONCLUSIONS: Pulmonary CT screening on admission may be necessary to reduce the risk of nosocomial transmission of COVID-19 during the outbreak period. And COVID-19 is not an indication of cesarean section.


On the Necessity of Trademark Portfolio Planning: Transitioning into an Epidemic-Resilient Industry in the Face of COVID-19's Global Outbreak


Presidential Powers and Response to COVID-19


title: Evaluation of Transport Media and Specimen Transport Conditions for the Detection of SARS-CoV-2 Using Real Time Reverse Transcription PCR

text: The global COVID-19 pandemic has resulted in a worldwide shortage of viral transport media and raised questions about specimen stability. The objective of this study was to determine the stability of SARS-CoV-2 virus RNA in specimen transport media under various storage conditions. Transport medium tested included: VCM, UTM®-RT, ESwab™, M4 and saline (0.9% NaCl). Specimen types tested included Nasopharyngeal/Oropharyngeal (NP/OP) swabs in the above transport media, bronchoalveolar lavage (BAL) and Sputum. A high-titer SARS-CoV-2 remnant patient specimen was spiked into pooled SARS-CoV-2 RNA-negative specimen remnants for the various media types. Aliquots of samples were stored at 18°C to 25°C, 2°C to 8°C and -10°C to -30°C and then tested at time points up to 14 days. Specimens consistently yielded amplifiable RNA with mean Ct differences of <3 over the various conditions assayed, thus supporting the use and transport of alternative collection media and specimen types under a variety of temperature storage conditions.


title: Coronaviruses and SARS-CoV-2: A Brief Overview

text: In late December 2019, several cases of pneumonia of unknown origin were reported from China, which in early January 2020 were announced to be caused by a novel coronavirus. The virus was later denominated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and defined as the causal agent of coronavirus disease 2019 (COVID-19). Despite massive attempts to contain the disease in China, the virus has spread globally, and COVID-19 was declared a pandemic by the World Health Organization (WHO) in March 2020. Here we provide a short background on coronaviruses, and describe in more detail the novel SARS-CoV-2 and attempts to identify effective therapies against COVID-19.


Comment on "Generalized pustular figurate erythema: A newly delineated severe cutaneous drug reaction linked with hydroxychloroquine": Report of a COVID-19 patient with particular findings


Midwifery education in COVID-19- time: Challenges and opportunities


Persistent Symptoms in Patients After Acute COVID-19


title: The genetic landscape of COVID-19: A South Asian perspective

text: COVID-19 has taken the world by storm in the ongoing pandemic. The virus responsible for COVID-19 disease is 'severe acute respiratory syndrome coronavirus-2' SARS-CoV-2, an enveloped RNA beta-coronavirus from the family Coronaviridae. There have been similar beta-coronavirus disease outbreaks previously: Severe acute respiratory syndrome (SARS - 2002) and Middle East respiratory syndrome (MERS - 2012) epidemics. SARS-CoV-2 origins have been traced to bat reservoirs. A virus with a high capacity for mutation, SARS-CoV-2 poses unique challenges both in the current form of disease control and management, while also leaving the door open for future novel diseases and pandemics. An understanding of the virion structure and genomic organisation will help us in understanding their origins and likely course of future evolution. Moreover, novel cost-effective methodologies for genetic surveillance may help in mitigating the emergence of these viral infections in future. In this manuscript, the authors have detailed the unique aspects of the SARS-CoV-2 virus genome and its clinical implications.


Video consultations for covid-19


Editorial: Stay safe during this coronavirus crisis


title: Fragment Molecular Orbital Based Interaction Analyses on COVID-19 Main Protease - Inhibitor N3 Complex (PDB ID: 6LU7)

text: The worldwide spread of COVID-19 (new coronavirus found in 2019) is an emergent issue to be tackled. In fact, a great amount of works in various fields have been made in a rather short period. Here, we report a fragment molecular orbital (FMO) based interaction analysis on a complex between the SARS-CoV-2 main protease (Mpro) and its peptide-like inhibitor N3 (PDB ID: 6LU7). The target inhibitor molecule was segmented into five fragments in order to capture site specific interactions with amino acid residues of the protease. The interaction energies were decomposed into several contributions, and then the characteristics of hydrogen bonding and dispersion stabilization were made clear. Furthermore, the hydration effect was incorporated by the Poisson-Boltzmann (PB) scheme. From the present FMO study, His41, His163, His164, and Glu166 were found to be the most important amino acid residues of Mpro in interacting with the inhibitor, mainly due to hydrogen bonding. A guideline for optimizations of the inhibitor molecule was suggested as well based on the FMO analysis.


Virtual Surgical Training During COVID-19: Operating Room Simulation Platforms Accessible from Home


title: Infections and Identified Cases of COVID-19 from Random Testing Data

text: There are many hard-to-reconcile numbers circulating concerning Covid-19. Using reports from random testing, the fatality ratio per infection is evaluated and used to extract further information on the actual fraction of infections and the success of their identification for different countries.


title: Correlation between weather and Covid-19 pandemic in Jakarta, Indonesia

text: This study aims to analyze the correlation between weather and covid-19 pandemic in Jakarta Indonesia. This study employed a secondary data analysis of surveillance data of covid-19 from the Ministry of Health of the Republic of Indonesia and weather from the Meteorological Department of the Republic of Indonesia. The components of weather include minimum temperature (°C), maximum temperature (°C), temperature average (°C), humidity (%), and amount of rainfall (mm). Spearman-rank correlation test was used for data analysis. Among the components of the weather, only temperature average (°C) was significantly correlated with covid-19 pandemic (r = 0.392; p < .01). The finding serves as an input to reduce the incidence rate of covid-19 in Indonesia.


title: Supply and demand shocks in the COVID-19 pandemic: An industry and occupation perspective

text: We provide quantitative predictions of first order supply and demand shocks for the U.S. economy associated with the COVID-19 pandemic at the level of individual occupations and industries. To analyze the supply shock, we classify industries as essential or non-essential and construct a Remote Labor Index, which measures the ability of different occupations to work from home. Demand shocks are based on a study of the likely effect of a severe influenza epidemic developed by the US Congressional Budget Office. Compared to the pre-COVID period, these shocks would threaten around 22% of the US economy's GDP, jeopardise 24% of jobs and reduce total wage income by 17%. At the industry level, sectors such as transport are likely to have output constrained by demand shocks, while sectors relating to manufacturing, mining and services are more likely to be constrained by supply shocks. Entertainment, restaurants and tourism face large supply and demand shocks. At the occupation level, we show that high-wage occupations are relatively immune from adverse supply and demand-side shocks, while low-wage occupations are much more vulnerable. We should emphasize that our results are only first-order shocks -- we expect them to be substantially amplified by feedback effects in the production network.


title: [Thoughts on the outbreak phases of the COVID-19 changed from emergency response to the combination of emergent response and regular prevention and control activities]

text: Given the scope and speed of the spread, the COVID-19 pandemic is not only complex but dangerous. Complicated objective factors such as the long-term existence of source of infection, difficulty in completely blocking the transmission route and a large susceptible population suggested that the COVID-19 pandemic might stay with us for long term. Therefore, we should be ready for a tough and long-term battle against the COVID-19 epidemic. The strategy should adhere to the principle of combining emergency response with regular prevention and control measures, and all efforts should be well harnessed in a coordinated way to keep the epidemic under control.


title: COVID-19 Clinical Trial Oversight at a Major Academic Medical Center: Approach of the Michigan Medicine COVID-19 Clinical Trial Committees

text: Clinicians - eager to offer the best care in the absence of guiding data - have provided patients with COVID-19 diverse clinical interventions. This usage has led to perceptions of efficacy of some interventions that, while receiving media coverage, lack robust evidence. Moving forward, randomized controlled clinical trials (RCTs) are necessary to ensure that clinicians can treat patients effectively during this outbreak and the next. To do so, academic medical centers must address two key research issues: (1) how to effectively and efficiently determine which trials have the best chance of benefiting current and future patients, and (2) how to establish a transparent and ethical process for subject recruitment while maintaining research integrity and without overburdening patients or staff. We share here the current methods used by the University of Michigan to address these issues.


Audio Interview: A Look at SARS-CoV-2 Transmission


GATA3 and stemness of high-grade serous ovarian carcinoma: novel hope for the deadliest type of ovarian cancer


title: ß-Glucan extracts from the same edible shiitake mushroom Lentinus edodes produce differential in-vitro immunomodulatory and pulmonary cytoprotective effects - Implications for coronavirus disease (COVID-19) immunotherapies

text: Coronavirus pneumonia is accompanied by rapid virus replication, where a large number of inflammatory cell infiltration and cytokine storm may lead to acute lung injury, acute respiratory distress syndrome (ARDS) and death. The uncontrolled release of pro-inflammatory cytokines, including interleukin (IL)-1ß and IL-6, is associated with ARDS. This constituted the first study to report on the variability in physicochemical properties of ß-glucans extracts from the same edible mushroom Lentinus edodes on the reduction of these pro-inflammatory cytokines and oxidative stress. Specifically, the impact on the immunomodulatory and cytoprotective properties of our novel in 'house' (IH-Lentinan, IHL) and a commercial (Carbosynth-Lentinan, CL) Lentinan extract were investigated using in vitro models of lung injury and macrophage phagocytosis. CL comprised higher amounts of α-glucans and correspondingly less ß-glucans. The two lentinan extracts demonstrated varying immunomodulatory activities. Both Lentinan extracts reduced cytokine-induced NF-κB activation in human alveolar epithelial A549 cells, with the IHL extract proving more effective at lower doses. In contrast, in activated THP-1 derived macrophages, the CL extract more effectively attenuated pro-inflammatory cytokine production (TNF-α, IL-8, IL-2, IL-6, IL-22) as well as TGF-ß and IL-10. The CL extract attenuated oxidative stress-induced early apoptosis, while the IHL extract attenuated late apoptosis. Our findings demonstrate significant physicochemical differences between Lentinan extracts, which produce differential in vitro immunomodulatory and pulmonary cytoprotective effects that may also have positive relevance to candidate COVID-19 therapeutics targeting cytokine storm.


title: Impact of Cardiovascular Disease on Clinical Characteristics and Outcomes of Coronavirus Disease 2019 (COVID-19)

text: BACKGROUND: To investigate the effect of cardiovascular disease (CVD) on the global pandemic, coronavirus disease 2019 (COVID-19), we analyzed the cases of laboratory-confirmed COVID-19 patients in Wuhan.MethodsâandâResults:Data were extracted from the medical records. SARS-CoV-2 RNA was confirmed by RT-PCR. A total of 33 (53.2%) of 62 cases with CVD, who had higher prevalence of severe COVID-19 compared with non-CVD patients (P=0.027). The median age of all patients was 66.0 (53.3, 73.0) years old. Coronary artery disease (11.3%) and hypertension (38.7%) were the common coexisting CVDs in COVID-19 patients. High-sensitivity cardiac troponin I (hs-cTnI), creatinine, high-density lipoprotein-cholesterol, interleukin-6, C-reactive protein, prothrombin time, and D-dimer levels in the severe COVID-19 with CVD group were higher than in the non-severe COVID-19 with CVD group (P<0.05). For all patients, chest computed tomography (CT) showed ground-glass opacity (66.1%), local (21.0%), bilateral (77.4%), and interstitial abnormalities (4.8%). In COVID-19 patients with CVD, 27 (81.8%) were cured and discharged. 6 (18.2%) remained in hospital, including 2 (3.2%) patients requiring intubation and mechanical ventilation. The hs-cTnI levels in the remaining hospitalized patients were higher than in the discharged patients (P=0.047). CONCLUSIONS: CVDs play a vital role in the disease severity of COVID-19. COVID-19 could result in myocardial injury, which affects the prognosis of COVID-19.


Management of Patients With Severe Mental Illness During the Coronavirus Disease 2019 Pandemic


title: Review of safety and minimum pricing of nitazoxanide for potential treatment of COVID-19

text: Background: Many treatments are being assessed for repurposing to treat coronavirus disease 2019 (COVID-19) One drug that has shown promising results in vitro is nitazoxanide Unlike other postulated drugs, nitazoxanide shows a high ratio of maximum plasma concentration (Cmax), after 1 day of 500 mg twice daily (BD), to the concentration required to inhibit 50% replication (EC50) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Cmax : EC50 roughly equal to 14:1) As such, it is important to investigate the safety of nitazoxanide for further trials Furthermore, treatments for COVID-19 should be cheap to promote global access, but prices of many drugs are far higher than the costs of production We aimed to conduct a review of the safety of nitazoxanide for any prior indication and calculate its minimum costs of production Methods: A review of nitazoxanide clinical research was conducted using EMBASE and MEDLINE databases, supplemented by ClinicalTrials gov We searched for phase 2 or 3 randomised controlled trials (RCTs) comparing nitazoxanide with placebo or active control for 5-14 days in participants experiencing acute infections of any kind Data extracted were grade 1-4 and serious adverse events (AEs) Data were also extracted on gastrointestinal (GI) AEs, as well as hepatorenal and cardiovascular effects Active pharmaceutical ingredient cost data from 2016 to 2019 were extracted from the Panjiva database and adjusted for 5% loss during production, costs of excipients, formulation, a 10% profit margin and tax Two dosages, at 500 mg BD and a higher dose of 1100 mg three times daily (TDS), were considered Our estimated costs were compared with publicly available list prices from a selection of countries Results: Nine RCTs of nitazoxanide were identified for inclusion These RCTs accounted for 1514 participants and an estimated 95 3 person-years-of-follow-up No significant differences were found in any of the AE endpoints assessed, across all trials or on subgroup analyses of active- or placebo-controlled trials Mild GI AEs increased with dose No hepatorenal or cardiovascular concerns were raised, but few appropriate metrics were reported There were no teratogenic concerns, but the evidence base was very limited Based on a weighted-mean cost of US $61/kg, a 14-day course of treatment with nitazoxanide 500 mg BD would cost $1 41 The daily cost would therefore be $0 10 The same 14-day course could cost $3944 in US commercial pharmacies, and $3 per course in Pakistan, India and Bangladesh At a higher dose of 1100 mg TDS, our estimated cost was $4 08 per 14-day course, equivalent to $0 29 per day Conclusion: Nitazoxanide demonstrates a good safety profile at approved doses However, further evidence is required regarding hepatorenal and cardiovascular effects, as well as teratogenicity We estimate that it would be possible to manufacture nitazoxanide as generic for $1 41 for a 14-day treatment course at 500 mg BD, up to $4 08 at 1100 mg TDS Further trials in COVID-19 patients should be initiated If efficacy against SARS-CoV-2 is demonstrated in clinical studies, nitazoxanide may represent a safe and affordable treatment in the ongoing pandemic


Social inequalities and collateral damages of the COVID-19 pandemic: when basic needs challenge mental health care


The SARS-CoV-2 receptor, ACE-2, is expressed on many different cell types: implications for ACE-inhibitor- and angiotensin II receptor blocker-based cardiovascular therapies: comment


title: Correction to: Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China

text: Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China.


Emergency front-of-neck airway in the COVID-19 patient: cannula or surgical cricothyroidotomy?


title: Efficacy and safety of Lian-Hua Qing-Wen granule for COVID-2019: A protocol for systematic review and meta-analysis

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Since the outbreak, the disease has caused more than 60,502 deaths worldwide. Lian-Hua Qing-Wen Granule (LHQWG) is widely used in treating COVID-19 in China. However, there is no evidence that LHQWG is effective for COVID-19. METHODS AND ANALYSIS: A comprehensive literature search will be conducted. Two methodological trained researchers will read the title, abstract and full texts and independently select the qualified literature according to inclusion and exclusion criteria. After assessment of the risk of bias and data extraction, we will conduct meta-analyses for outcomes related to COVID-19. The heterogeneity of data will be investigated by Cochrane X and I tests. Publication bias assessment will be conducted by funnel plot analysis and Egger test. RESULTS: The results of our research will be published in a peer-reviewed journal. CONCLUSION: Our study aims to systematically present the clinical evidence of LHQWG in treating COVID-19, which will be of significant meaning for further research and clinical practice. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/27SBU.


Reflections from an emergency department junior doctor: the Covid legacy


title: Molecular and serological assays for SARS-CoV-2: insights from genome and clinical characteristics

text: BACKGROUND: The ongoing outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has posed a challenge for worldwide public health. A reliable laboratory assay is essential both to confirm suspected patients and to exclude patients infected with other respiratory viruses, thereby facilitating the control of global outbreak scenarios. CONTENT: In this review, we focus on the genomic, transmission and clinical characteristics of SARS-CoV-2, and comprehensively summarize the principles and related details of assays for SARS-CoV-2. We also explore the quality assurance measures for these assays. SUMMARY: SARS-CoV-2 has some unique gene sequences and specific transmission and clinical features that can inform the conduct of molecular and serological assays in many aspects, including the design of primers, the selection of specimens and testing strategies at different disease stages. Appropriate quality assurance measures for molecular and serological assays are needed to maintain testing proficiency. Because serological assays have the potential to identify later stages of the infection and to confirm highly suspected cases with negative molecular assay results, a combination of these two assays is needed to achieve a reliable capacity to detect SARS-CoV-2.


Universal use of face masks for success against COVID-19: evidence and implications for prevention policies


title: Chest CT Findings in Patients With Coronavirus Disease 2019 and Its Relationship With Clinical Features

text: OBJECTIVES: The aim of this study was to investigate the chest computed tomography (CT) findings in patients with confirmed coronavirus disease 2019 (COVID-19) and to evaluate its relationship with clinical features. MATERIALS AND METHODS: Study sample consisted of 80 patients diagnosed as COVID-19 from January to February 2020. The chest CT images and clinical data were reviewed, and the relationship between them was analyzed. RESULTS: Totally, 80 patients diagnosed with COVID-19 were included. With regards to the clinical manifestations, 58 (73%) of the 80 patients had cough, and 61 (76%) of the 80 patients had high temperature levels. The most frequent CT abnormalities observed were ground glass opacity (73/80 cases, 91%), consolidation (50/80 cases, 63%), and interlobular septal thickening (47/80, 59%). Most of the lesions were multiple, with an average of 12 ± 6 lung segments involved. The most common involved lung segments were the dorsal segment of the right lower lobe (69/80, 86%), the posterior basal segment of the right lower lobe (68/80, 85%), the lateral basal segment of the right lower lobe (64/80, 80%), the dorsal segment of the left lower lobe (61/80, 76%), and the posterior basal segment of the left lower lobe (65/80, 81%). The average pulmonary inflammation index value was (34% ± 20%) for all the patients. Correlation analysis showed that the pulmonary inflammation index value was significantly correlated with the values of lymphocyte count, monocyte count, C-reactive protein, procalcitonin, days from illness onset, and body temperature (P < 0.05). CONCLUSIONS: The common chest CT findings of COVID-19 are multiple ground glass opacity, consolidation, and interlobular septal thickening in both lungs, which are mostly distributed under the pleura. There are significant correlations between the degree of pulmonary inflammation and the main clinical symptoms and laboratory results. Computed tomography plays an important role in the diagnosis and evaluation of this emerging global health emergency.


Comparisons between countries are essential for the control of COVID-19


title: CAR T-cell treatment during the COVID-19 pandemic: Management strategies and challenges

text: The pandemic of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly across the world. Currently, the COVID-19 pandemic is affecting the continuity of essential routine healthcare services and procedures, including chimeric antigen receptor T-cell (CAR-T) therapy, a life-saving option for patients with relapsed/refractory (R/R) hematologic malignancies. Due to the rapid disease progression of hematological malignancies, there is an urgent need to manufacture and utilize CAR T-cells. However, CAR-T treatment has become extraordinarily challenging during this COVID-19 pandemic. Thus, many medical and technical factors must now be taken into consideration before, during, and after CAR-T therapy. The purpose of this review is to provide brief suggestions for rational decision-making strategies in evaluating and selecting CAR T-cell treatment and appropriate CAR T-cell products, and protective strategies for medical staff and patients to prevent infection in the midst of the current COVID-19 pandemic.


title: Composite Monte Carlo decision making under high uncertainty of novel coronavirus epidemic using hybridized deep learning and fuzzy rule induction

text: In the advent of the novel coronavirus epidemic since December 2019, governments and authorities have been struggling to make critical decisions under high uncertainty at their best efforts. In computer science, this represents a typical problem of machine learning over incomplete or limited data in early epidemic Composite Monte-Carlo (CMC) simulation is a forecasting method which extrapolates available data which are broken down from multiple correlated/casual micro-data sources into many possible future outcomes by drawing random samples from some probability distributions. For instance, the overall trend and propagation of the infested cases in China are influenced by the temporal-spatial data of the nearby cities around the Wuhan city (where the virus is originated from), in terms of the population density, travel mobility, medical resources such as hospital beds and the timeliness of quarantine control in each city etc. Hence a CMC is reliable only up to the closeness of the underlying statistical distribution of a CMC, that is supposed to represent the behaviour of the future events, and the correctness of the composite data relationships. In this paper, a case study of using CMC that is enhanced by deep learning network and fuzzy rule induction for gaining better stochastic insights about the epidemic development is experimented. Instead of applying simplistic and uniform assumptions for a MC which is a common practice, a deep learning-based CMC is used in conjunction of fuzzy rule induction techniques. As a result, decision makers are benefited from a better fitted MC outputs complemented by min-max rules that foretell about the extreme ranges of future possibilities with respect to the epidemic.


title: Composite Monte Carlo Decision Making under High Uncertainty of Novel Coronavirus Epidemic Using Hybridized Deep Learning and Fuzzy Rule Induction

text: In the advent of the novel coronavirus epidemic since December 2019, governments and authorities have been struggling to make critical decisions under high uncertainty at their best efforts. Composite Monte-Carlo (CMC) simulation is a forecasting method which extrapolates available data which are broken down from multiple correlated/casual micro-data sources into many possible future outcomes by drawing random samples from some probability distributions. For instance, the overall trend and propagation of the infested cases in China are influenced by the temporal-spatial data of the nearby cities around the Wuhan city (where the virus is originated from), in terms of the population density, travel mobility, medical resources such as hospital beds and the timeliness of quarantine control in each city etc. Hence a CMC is reliable only up to the closeness of the underlying statistical distribution of a CMC, that is supposed to represent the behaviour of the future events, and the correctness of the composite data relationships. In this paper, a case study of using CMC that is enhanced by deep learning network and fuzzy rule induction for gaining better stochastic insights about the epidemic development is experimented. Instead of applying simplistic and uniform assumptions for a MC which is a common practice, a deep learning-based CMC is used in conjunction of fuzzy rule induction techniques. As a result, decision makers are benefited from a better fitted MC outputs complemented by min-max rules that foretell about the extreme ranges of future possibilities with respect to the epidemic.


title: SARS-CoV-2, COVID-19 et Åil : le point sur les données publiées./ [SARS-CoV-2, COVID-19 and the eye: An update on publis>hed data]

text: The COVID-19 pandemic has dramatically changed our daily lives as ophthalmologists. This general review firstly provides a better understanding of the virus responsible for the pandemic: the SARS-CoV-2, and the clinical manifestations of the COVID-19 disease. The second part is detailing the pathophysiology, clinical signs and challenges of ocular involvement, which seems rare and not functionally severe, but which may be a potential source of contamination. Finally, we discuss the preventive measures that need to be implemented in our daily practice to avoid any viral dissemination.


title: How the Law of Excluded Middle Pertains to the Second Incompleteness Theorem and its Boundary-Case Exceptions

text: Our earlier publications showed semantic tableau admits partial exceptions to the Second Incompleteness Theorem where a formalism recognizes its self consistency and views multiplication as a 3-way relation (rather than as a total function). We now show these boundary-case evasions will collapse if the Law of the Excluded Middle is treated by tableau as a schema of logical axioms (instead of as derived theorems).


title: Geographic access to United States SARS-CoV-2 testing sites highlights healthcare disparities and may bias transmission estimates

text: We paired high-resolution travel-time metrics with a SARS-CoV-2 testing location database in the United States. Median travel time to testing sites is longer in counties with lower population density, and a higher percent of minority and uninsured individuals. Differential geographic accessibility to testing can recapitulate healthcare disparities and bias transmission estimates.


title: Essential Case Management Practices Amidst the Novel Coronavirus Disease 2019 (COVID-19) Crisis: Part 1: Tele-Case Management, Surge Capacity, Discharge Planning, and Transitions of Care

text: OBJECTIVES: This is the first of a 2-part article that discusses essential case management practices and strategies amidst the novel coronavirus disease 2019 (COVID-19). The series showcases the potential professional case managers have in support of managing during a crisis such as this global pandemic. Part I discusses reenvisioned roles and responsibilities of case managers and leaders known to address patients' needs during a crisis, with a special focus on telehealth, tele-case management, surge capacity, redeployment, discharge planning, and transitions of care. PRIMARY PRACTICE SETTINGS: Applicable to the various case management practice settings across the continuum of health and human services, especially acute care. FINDINGS CONCLUSIONS: The COVID-19 global pandemic crisis has brought an unprecedented challenge to professional case managers and health care professionals. It also has provided opportunities for innovation and partnerships within and across health care organizations and the various care settings where patients/support systems access necessary services. Most importantly, it created a renewed interest in telehealth and facilitated a wider adoption of such approach to care delivery than ever before. This pandemic has also increased the use of nontraditional sites of care, most importantly those that operate virtually on electronic networks and health information system technologies such as remote visits, e-visits, virtual care, and tele-monitoring. Undoubtedly, these have provided new opportunities for tele-case management services and roles for professional case managers in the virtual world of health and human service delivery. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Professional case managers are integral members of interprofessional health care teams. Their roles are even more necessary during a global pandemic such as COVID-19. The practice of case management will forever change-for the better. The experience of this crisis in health care has brought about ever-lasting implications for case management professionals. It has raised awareness to sites of care never were as popular before, resulting in an increased need and recognition for tele-case management practice and virtual case managers. It has also forced partnerships and collaborations among the diverse contexts of health care organizations (public, private, or both) and other industries, regardless of whether directly involved in the delivery of care or having a support service role. These new and innovative approaches in the provision of care and case management services will without a doubt become routine expectations beyond the current pandemic period. Of special note are the enhanced roles of case managers in discharge planning and transitions of care.


Solving the global challenge of adolescent mental ill-health


Dementia in the COVID-19 Period


Athletes as community; athletes in community: covid-19, sporting mega-events and athlete health protection


Covid-19: Cancer Research urges mass testing to enable care to continue during pandemic


title: Urgent and Emergent Eye Care Strategies to Protect Against COVID-19

text: Objective: This article presents additional strategies to the medical professional and support tactics to keep both the health care provider and patient as safe as possible during the COVID-19 pandemic Observations: Follicular conjunctivitis has been reported as an early sign of infection or during hospitalization for severe COVID-19 disease It has been confirmed that COVID-19 is transmitted through both respiratory droplets and direct contact Another possible route of viral transmission is entry through aerosolized droplets into the tears, which then pass through the nasolacrimal ducts and into the respiratory tract For nonemergent care, eye care providers should use telehealth Eye care providers should prioritize patient care in order of absolute necessity, such as sudden vision loss, sudden onset flashes and floaters, and eye trauma In those cases, exposure should be minimized The close proximity between eye care providers and their patients during slit-lamp examination may require further precautions, such as shields, barriers, and mask use to lower the risk of transmission via droplets or through hand to eye contact Conclusions: All nonemergent eye care appointments should be delayed or conducted remotely For emergent in-person appointments, careful and appropriate adherence to Centers for Disease Control and Prevention recommendations may minimize exposure for both the health care provider and patient


title: Surgery during the COVID-19 pandemic: operating room suggestions from an international Delphi process

text: BACKGROUND: Operating room (OR) practice during the COVID-19 pandemic is driven by basic principles, shared experience and nascent literature. This study aimed to identify the knowledge needs of the global OR workforce, and characterize supportive evidence to establish consensus. METHODS: A rapid, modified Delphi exercise was performed, open to all stakeholders, informed via an online international collaborative evaluation. RESULTS: The consensus exercise was completed by 339 individuals from 41 countries (64·3 per cent UK). Consensus was reached on 71 of 100 statements, predominantly standardization of OR pathways, OR staffing and preoperative screening or diagnosis. The highest levels of consensus were observed in statements relating to appropriate personal protective equipment (PPE) and risk distribution (96-99 per cent), clear consent processes (96 per cent), multidisciplinary decision-making and working (97 per cent). Statements yielding equivocal responses predominantly related to technical and procedure choices, including: decontamination (40-68 per cent), laminar flow systems (13-61 per cent), PPE reuse (58 per cent), risk stratification of patients (21-48 per cent), open versus laparoscopic surgery (63 per cent), preferential cholecystostomy in biliary disease (48 per cent), and definition of aerosol-generating procedures (19 per cent). CONCLUSION: High levels of consensus existed for many statements within each domain, supporting much of the initial guidance issued by professional bodies. However, there were several contentious areas, which represent urgent targets for investigation to delineate safe COVID-19-related OR practice.


Obesity and risk of COVID-19: analysis of UK biobank


COVID19 and Breastfeeding: Not That Simple


"You Have to Wait a Little Longer": Transgender (Mental) Health at Risk as a Consequence of Deferring Gender-Affirming Treatments During COVID-19


An Invited Commentary on "World Health Organization declares global emergency: A review of the 2019 novel Coronavirus (COVID-19)": Emergency or new reality?


title: Radiographic findings in 240 patients with COVID-19 pneumonia: time-dependence after the onset of symptoms

text: OBJECTIVE: To analyze the most frequent radiographic features of COVID-19 pneumonia and assess the effectiveness of chest X-ray (CXR) in detecting pulmonary alterations. MATERIALS AND METHODS: CXR of 240 symptomatic patients (70% male, mean age 65 ± 16 years), with SARS-CoV-2 infection confirmed by RT-PCR, was retrospectively evaluated. Patients were clustered in four groups based on the number of days between symptom onset and CXR: group A (0-2 days), 49 patients; group B (3-5), 75 patients; group C (6-9), 85 patients; and group D (> 9), 31 patients. Alteration's type (reticular/ground-glass opacity (GGO)/consolidation) and distribution (bilateral/unilateral, upper/middle/lower fields, peripheral/central) were noted. Statistical significance was tested using chi-square test. RESULTS: Among 240 patients who underwent CXR, 180 (75%) showed alterations (group A, 63.3%; group B, 72%; group C, 81.2%; group D, 83.9%). GGO was observed in 124/180 patients (68.8%), reticular alteration in 113/180 (62.7%), and consolidation in 71/180 (39.4%). Consolidation was significantly less frequent (p < 0.01). Distribution among groups was as follows: reticular alteration (group A, 70.9%; group B, 72.2%; group C, 57.9%; group D, 46.1%), GGO (group A, 67.7%; group B, 62.9%; group C, 71%; group D, 76.9%), and consolidation (group A, 35.5%; group B, 31.4%; group C, 47.8%; group D, 38.5%). Alterations were bilateral in 73.3%. Upper, middle, and lower fields were involved in 36.7%, 79.4%, and 87.8%, respectively. Lesions were peripheral in 49.4%, central in 11.1%, or both in 39.4%. Upper fields and central zones were significantly less involved (p < 0.01). CONCLUSIONS: The most frequent lesions in COVID-19 patients were GGO (intermediate/late phase) and reticular alteration (early phase) while consolidation gradually increased over time. The most frequent distribution was bilateral, peripheral, and with middle/lower predominance. Overall rate of negative CXR was 25%, which progressively decreased over time. KEY POINTS: â¢ The predominant lung changes were GGO and reticular alteration, while consolidation was less frequent. â¢ The typical distribution pattern was bilateral, peripheral, or both peripheral and central and involved predominantly the lower and middle fields. â¢ Chest radiography showed lung abnormalities in 75% of patients with confirmed SARS-CoV-2 infection, range varied from 63.3 to 83.9%, respectively, at 0-2 days and > 9 days from the onset of symptoms.


La protección de los sanitarios frente a COVID-19 importa demasiado


title: Availability of COVID-19 Information From National Plastic Surgery Society Web Sites

text: BACKGROUND: National plastic surgery society web sites are an important source of information for patients, family members, and healthcare professionals. There are currently no standardized recommendations for the information provided on web sites. The aim of this study was to assess the information available on each national plastic surgery society web site on the current pandemic of COVID-19. METHODS: A Google search was performed of United Nations member sovereign states to determine whether they had a national plastic surgery society web site and to assess its contents. The presence of COVID-19 information was recorded. Access to contact information, Facebook page, Twitter, and Instagram handles were noted. RESULTS: Thirty-five percent of sovereign states had plastic surgery society web sites. Twenty-two percent of national society web sites had a specific COVID-19 section. Fourteen (93%) of these 15 web sites had COVID-19-specific guidelines available for health care professionals. CONCLUSIONS: COVID-19 information provided by national plastic surgery society web sites is sparse. Two-thirds of national plastic surgery societies do not have a web presence. The availability of COVID-19 clinical guidelines and patient information sheets on national plastic surgery society web sites is limited. This study suggests that improvement and increase in COVID-19 information provided by many national plastic surgery society web sites are needed.


title: Availability of COVID-19 information from national plastic surgery society websites

text: BACKGROUND: National plastic surgery society websites are an important source of information for patients, family members and healthcare professionals. There are currently no standardized recommendations for the information provided on websites. The aim of this study was to assess the information available on each national plastic surgery society websites on the current pandemic of COVID-19. METHODS: A Google search was performed of United Nations member sovereign states to determine whether they had a national plastic surgery society website and to assess its contents. The presence of COVID-19 information was recorded. Access to contact information, Facebook page, Twitter and Instagram handles were noted. RESULTS: 35% of sovereign states had plastic surgery society websites. 22% of national society websites had a specific COVID-19 section. 14/15 (93%) of these websites had COVID-19-specific guidelines available for health care professionals. CONCLUSION: COVID-19 information provided by national plastic surgery society websites is sparse. Two-thirds of national plastic surgery societies do not have a web presence. The availability of COVID-19 clinical guidelines and patient information sheets on national plastic surgery society websites is limited. This study suggests that improvement and increase in COVID-19 information provided by many national plastic surgery society websites is needed.


Faecal calprotectin indicates intestinal inflammation in COVID-19


COVID-19 puts societies to the test


Respiratory Mechanics of COVID-19 vs. Non-COVID-19 Associated Acute Respiratory Distress Syndrome


New Data and the Covid-19 Pandemic Mandate a Rethink of Antiplatelet Strategies in Patients With TIA or Minor Stroke Associated With Atherosclerotic Carotid Stenosis


title: COVID-19 in otolaryngologist practice: a review of current knowledge

text: PURPOSE: Otorhinolaryngological manifestations are common symptoms of COVID-19. This study provides a brief and precise review of the current knowledge regarding COVID-19, including disease transmission, clinical characteristics, diagnosis, and potential treatment. The article focused on COVID-19-related information useful in otolaryngologist practice. METHODS: The Medline and Web of Science databases were searched without a time limit using terms "COVID-19", "SARS-CoV-2" in conjunction with "otorhinolaryngological manifestation", "ENT", and "olfaction". RESULTS: The most common otolaryngological dysfunctions of COVID-19 were cough, sore throat, and dyspnea. Rhinorrhea, nasal congestion and dizziness were also present. COVID-19 could manifest as an isolated sudden hyposmia/anosmia. Upper respiratory tract (URT) symptoms were commonly observed in younger patients and usually appeared initially. They could be present even before the molecular confirmation of SARS-CoV-2. Otolaryngologists are of great risk of becoming infected with SARS-CoV-2 as they cope with URT. ENT surgeons could be easily infected by SARS-CoV-2 during performing surgery in COVID-19 patients. CONCLUSION: Ear, nose and throat (ENT) symptoms may precede the development of severe COVID-19. During COVID-19 pandemic, patients with cough, sore throat, dyspnea, hyposmia/anosmia and a history of travel to the region with confirmed COVID-19 patients, should be considered as potential COVID-19 cases. An otolaryngologist should wear FFP3/N95 mask, glasses, disposable and fluid resistant gloves and gown while examining such individuals. Not urgent ENT surgeries should be postponed. Additional studies analyzing why some patients develop ENT symptoms during COVID-19 and others do not are needed. Further research is needed to determine the mechanism leading to anosmia.


COVID-19 and emergency planning


Training and Fit Testing of Health Care Personnel for Reusable Elastomeric Half-Mask Respirators Compared With Disposable N95 Respirators


title: Safe and informed prescribing of psychotropic medication during the COVID-19 pandemic

text: Treatment with psychotropic medication may sometimes be jeopardised because of the COVID-19 pandemic. One underlying reason is the lack of COVID-19-specific psychopharmacology guidelines. Here, we discuss five considerations arising from our clinical experience and pharmacological background knowledge to enable safe and well-informed psychopharmacotherapy during the COVID-19 pandemic.


title: A Smartphone enabled Approach to Manage COVID-19 Lockdown and Economic Crisis

text: The emergence of novel COVID-19 causing an overload in health system and high mortality rate. The key priority is to contain the epidemic and prevent the infection rate. In this context, many countries are now in some degree of lockdown to ensure extreme social distancing of entire population and hence slowing down the epidemic spread. Further, authorities use case quarantine strategy and manual second/third contact-tracing to contain the COVID-19 disease. However, manual contact tracing is time consuming and labor-intensive task which tremendously overload public health systems. In this paper, we developed a smartphone-based approach to automatically and widely trace the contacts for confirmed COVID-19 cases. Particularly, contact-tracing approach creates a list of individuals in the vicinity and notifying contacts or officials of confirmed COVID-19 cases. This approach is not only providing awareness to individuals they are in the proximity to the infected area, but also tracks the incidental contacts that the COVID-19 carrier might not recall. Thereafter, we developed a dashboard to provide a plan for government officials on how lockdown/mass quarantine can be safely lifted, and hence tackling the economic crisis. The dashboard used to predict the level of lockdown area based on collected positions and distance measurements of the registered users in the vicinity. The prediction model uses K-means algorithm as an unsupervised machine learning technique for lockdown management.


The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction


The big challenge for neurologists in treating patients with multiple sclerosis in the post-COVID-19 era


title: The experience of women infected by the COVID-19 during pregnancy in Brazil: a qualitative study protocol

text: BACKGROUND: The Coronavirus disease (COVID-19) is highly infectious, with the recent World Health Organization decree confirming a global public health emergency. The outcomes related to maternal and fetal health among pregnant women infected with the virus are still poorly understood. The world population has been waiting for answers and remains constantly alert about the pandemic's progress. It is not yet known what impact this pandemic experience will have on the population's mental health, especially pregnant women. METHOD: We aim to understand and discuss the experiences of women who were infected by COVID-19 during pregnancy, in relation to the illness process, community relations, and social media influences. This is a qualitative study in which we will interview women who were infected by COVID-19 during pregnancy and received medical care from a tertiary university hospital specializing in women's health in Brazil. We will use the techniques of Semi-Directed Interviews of Open and In-depth Questions, socio-demographic and health data sheets, and Field Diaries. We will use purposive sampling and the criterion of theoretical saturation for its construction. The interviews will be conducted by phone or video call, with audio recorded for later transcription. The treatment of the data will be completed through Thematic Analysis and discussed in light of the Health Psychology framework, with the production of categories that answer the proposed research questions. DISCUSSION: It is expected that the results contribute to the understanding about the demands that come to the health professional of women infected by COVID-19 during pregnancy in a pandemic situation. INTRODUçãO: A doença causada pelo coronavírus (COVID-19) é altamente infecciosa, com a recente declaração da Organização Mundial de Saúde confirmando emergência global de saúde pública. Os desfechos relacionados a saúde materno-fetal entre gestantes infectadas pelo vírus ainda são pouco conhecidos. A população mundial tem aguardado respostas e se mantém constantemente em alerta sobre o progresso da pandemia. Ainda não se sabe qual será o impacto da experiência da pandemia sobre a saúde mental da população, especialmente entre mulheres grávidas. MéTODO: O objetivo deste estudo é compreender e discutir as experiências de mulheres infectadas pelo COVID-19 durante a gravidez, em relação ao processo de adoecimento, às relações comunitárias e a influência de mídias sociais. Este é um estudo qualitativo em que serão entrevistadas mulheres infectadas pelo COVID-19 durante a gestação, atendidas em um hospital universitário terciário especializado em saúde da mulher no Brasil. Serão usadas as técnicas de Entrevistas Semi-Dirigidas de Perguntas Abertas em Profundidade, ficha de dados sociodemográficos e de saúde e diários de campo. A amostra será selecionada intencionalmente, usando o critério de saturação teórica para a sua construção. As entrevistas serão conduzidas por telefone ou videoconferência, com áudio gravado para posterior transcrição. O tratamento dos dados seguirá a Análise Temática e os resultados serão discutidos sob conceitos de Psicologia da Saúde, com a produção de categorias que respondam as questões de pesquisa propostas. DISCUSSãO: Espera-se que os resultados contribuam para a compreensão de demandas emergentes entre profissionais de saúde para mulheres infectadas pelo COVID-19 durante a gestação em situação de pandemia.


Reply to "Subcutaneous terbutaline as an alternative to aerosolized albuterol"


title: Intracranial hemorrhage complicating anticoagulant prophylactic therapy in three hospitalized COVID-19 patients

text: SARS-CoV2 has led to a global pandemic affecting almost 3 million people in almost over 3 months. Various clinical presentations have been reported so far and no definite therapy is established. Anticoagulation is recommended by several experts to address the potential prothrombotic complications from COVID-19, but its safety and regimen need further clinical trials and safety and efficacy profile. Here, we present three cases of intracranial hemorrhage in three critically ill patients with COVID-19 and discuss their course in relation to various regimens of anticoagulation used.


COVID-19 pneumonia in a dual heart-kidney recipient


The 2019 novel cornoavirus pneumonia with onset of oculomotor nerve palsy: a case study


title: Differential diagnosis of illness in patients under investigation for the novel coronavirus (SARS-CoV-2), Italy, February 2020

text: A novel coronavirus (SARS-CoV-2) has been identified as the causative pathogen of an ongoing outbreak of respiratory disease, now named COVID-19. Most cases and sustained transmission occurred in China, but travel-associated cases have been reported in other countries, including Europe and Italy. Since the symptoms are similar to other respiratory infections, differential diagnosis in travellers arriving from countries with wide-spread COVID-19 must include other more common infections such as influenza and other respiratory tract diseases.