Trasplante hepático urgente por hepatitis autoinmune en el epicentro de la pandemia COVID-19 en España./ Trasplante hepático urgente por hepatitis autoinmune en el epicentro de la pandemia COVID-19 en España./ Successful urgent liver transplant due to fulminant autoimmune hepatitis during the height of the COVID-19 pandemic in Spain


title: Radiology Residency Preparedness and Response to the COVID-19 Pandemic

text: This article provides a guideline for radiology residency programs to prepare and respond to the impact of coronavirus disease 2019, by offering specific examples from three programs, and provides a list of resources for distance learning and maintaining well-being.


Psychiatric disorders and suicide in the COVID-19 era


title: COVID-19 Hangover: A Rising Tide of Alcohol Use Disorder and Alcohol-Associated Liver Disease

text: The coronavirus disease 2019 (COVID-19) pandemic has had a tremendous global impact since it began in November of 2019. However, there are concerns that the COVID-19 pandemic will not affect all equally and some populations will be particularly vulnerable. Relevant to liver disease, patients with alcohol use disorder (AUD) and alcohol-associated liver disease (ALD) may be amongst the populations that are the most severely impacted. The reasons for this include being at a higher risk of severe COVID-19 infection due to a depressed immune system and high-risk underlying comorbidities, the injurious effect of COVID-19 on the liver, the inability to attend regular visits with providers, diversion of hospital resources, and social isolation leading to psychological decompensation and increased drinking or relapse. As a result, we fear that there will be a dramatic rising tide of alcohol relapse, admissions for decompensated ALD, and an increase in newly diagnosed patients with AUD/ALD post-COVID-19 pandemic. Providers and their institutions should implement pre-emptive strategies such as telehealth and aggressive patient outreach programs now to curb this anticipated problem. Liver transplantation (LT) centers should adapt to the pandemic by considering leniency to some LT candidates with ALD who cannot access appropriate alcohol treatment due to the current situation. In conclusion, the COVID-19 pandemic will likely be especially detrimental to patients with AUD/ALD and actions need to be taken now to limit the scope of this anticipated problem.


title: Factores asociados a la incidencia y la mortalidad por COVID-19 en las comunidades autónomas./ [Factors associated with the incidence and mortality from COVID-19 in the autonomous communities of Spain]

text: OBJECTIVE: Analyze the evolution of the epidemic of COVID-19 after the alarm state and identify factors associated with the differences between the autonomous communities. METHOD: Ecological study that used epidemiological, demographic, environmental and variables on the structure of health services as explanatory variables. The analysis period was from March 15th (the start of the alarm state) until April 22nd, 2020. Incidence and mortality rates were the main response variables. The magnitude of the associations has been estimated using the Spearman correlation coefficient and multiple regression analysis. RESULTS: Incidence and mortality rates at the time of decree of alarm status are associated with current incidence, mortality and hospital demand rates. Higher mean temperatures are significantly associated with a lower current incidence of COVID-19 in the autonomous communities. Likewise, a higher proportion of older people in nursing homes is significantly associated with a higher current mortality in the autonomous communities. CONCLUSION: It is possible to predict the evolution of the epidemic through the analysis of incidence and mortality. Lower temperatures and the proportion of older people in residences are factors associated with a worse prognosis. These parameters must be considered in decisions about the timing and intensity of the implementation of containment measures. In this sense, strengthening epidemiological surveillance is essential to improve predictions.


title: Proper scoring rules for evaluating asymmetry in density forecasting

text: This paper proposes a novel asymmetric continuous probabilistic score (ACPS) for evaluating and comparing density forecasts. It extends the proposed score and defines a weighted version, which emphasizes regions of interest, such as the tails or the center of a variable's range. The ACPS is of general use in any situation where the decision maker has asymmetric preferences in the evaluation of the forecasts. In an artificial experiment, the implications of varying the level of asymmetry are illustrated. Then, the proposed score is applied to assess and compare density forecasts of macroeconomic relevant datasets (unemployment rate) and of commodity prices (oil and electricity prices) with a particular focus on the recent COVID crisis period.


Preventing the Spread of COVID-19 to Nursing Homes: Experience from a Singapore Geriatric Centre


Send cat and dog samples to test for SARS-CoV-2


title: The Pan London Emergency Cardiac Surgery service: Coordinating a response to the COVID-19 pandemic

text: Over the last 4 months, the novel coronavirus, SARS-CoV-2, has caused a significant economic, political, and public health impact on a global scale. The natural history of the disease and surge in the need for invasive ventilation has required the provision of intensive care beds in London to be reallocated. NHS England have proposed the formation of a Pan-London Emergency Cardiac surgery (PLECS) service to provide urgent and emergency cardiac surgery for the whole of London. In this initial report, we outline our experience of setting up and delivering a pan-regional service for the delivery of urgent and emergency cardiac surgery with a focus on maintaining a COVID-free in-hospital environment. In doing so, we hope that other regions can use this as a starting point in developing their own region-specific pathways if the spread of coronavirus necessitates similar measures be put in place across the United Kingdom.


Our response to "A response to: Determining Urgent/Emergent status of Gastrointestinal (GI) Endoscopic Procedures in an Ambulatory Care Setting during the Coronavirus Disease of 2019 (COVID-19)"


title: COVID-19 Sets off Mass Migration in India

text: The communication discusses COVID-19 triggered reverse migration in India. India has witnessed the second largest mass migration in its history after the Partition of India in 1947, where more than 14 million people were displaced and migrated to India and Pakistan respectively, depending on their religious faiths. The opinion describes the trend of migration and related effects on the migrants as well as the nation at large.


COVID-19 and thrombotic complications: Pulmonary thrombosis rather than embolism?


title: Terapie antitrombotiche in pazienti con infezione da SARS-CoV-2: dalle attuali evidenze alle ragionevoli raccomandazioni  Position paper del Gruppo di Studio Aterosclerosi, Trombosi e Biologia Vascolare./ [Antithrombotic treatments in patients with SARS-CoV-2 infection: from current evidence to reasonable recommendations - A position paper from the Italian Working Group on Atherosclerosis, Thrombosis and Vascular Biology]

text: Given the high prevalence of preexisting cardiovascular diseases and the increased incidence of adverse cardiovascular events in patients hospitalized for SARS-CoV-2 infection, the identification of optimal antithrombotic approaches in terms of risk/benefit ratio and outcome improvement appears crucial in this setting. In the present position paper we collected current evidence from the literature to provide practical recommendations on the management of antithrombotic therapies (antiplatelet and anticoagulant) in various clinical contexts prevalent during the SARS-CoV-2 outbreak: in-home management of oral anticoagulant therapy; interactions between drugs used in the SARS-CoV-2 infection and antithrombotic agents; in-hospital management of antithrombotic therapies; diagnosis, risk stratification and treatment of in-hospital thrombotic complications.


title: The TLR4-MyD88-NF-κB pathway is involved in sIgA-mediated IgA nephropathy

text: Previous studies have shown that secretory IgA (sIgA) was critically involved in IgA nephropathy (IgAN) immune responses. Toll-like receptors (TLRs), especially TLR4 which participates in mucosal immunity, may be involved in the pathogenesis of IgAN. The purpose of this study was to investigate whether sIgA and TLR4 interact to mediate kidney damage in IgAN patients. IgAN patients with positive sIgA deposition in renal tissues were screened by immunofluorescence assay. Patient salivary sIgA (P-sIgA) was collected and purified by jacalin affinity chromatography. Salivary sIgA from healthy volunteers was used as a control (N-sIgA). Expression of TLR4, MyD88, NF-κB, TNF-α, IL-6, and MCP-1 were detected in the mesangial area of IgAN patients by immunohistochemistry, the expression levels in patients with positive sIgA deposition were higher than that with negative sIgA deposition. Human renal mesangial cells (HRMCs) were cultured in vitro, flow cytometry showed that P-sIgA bound HRMCs significantly better than N-sIgA. HRMCs were cultured in the presence of sIgA (400 µg/mL) for 24 h, compared with cells cultured with N-sIgA, HRMCs cultured in vitro with P-sIgA showed enhanced expression of TLR4, increased secretion of TNF-α, IL-6, and MCP-1, and increased expression of MyD88/NF-κB. TLR4 shRNA silencing and NF-κB inhibition both reduced the ability of HRMCs to synthesize TNF-α, IL-6, and MCP-1. Our results indicate that sIgA may induce high expression of TLR4 in HRMCs and further activate downstream signalling pathways, prompting HRMCs to secrete multiple cytokines and thereby mediating kidney damage in IgAN patients.


A crisis for elderly with mental disorders: Relapse of symptoms due to heightened anxiety due to COVID-19


title: Coronavirus and sports leagues: how to obtain a fair ranking if the season cannot resume?

text: Many sports leagues are played in a tightly scheduled round-robin format, leaving a limited time window to postpone matches. If the season cannot resume due to an external shock such as the coronavirus outbreak in 2020, the ranking of the teams becomes non-trivial because it is necessary to account for schedule imbalances. We identify a set of desired axioms for ranking in such incomplete tournaments and verify that the generalized row sum, a parametric family of scoring rules, satisfies all of them. In particular, the well-established least squares method maximizes the role of the opponents. Our approach is applied for the five major premier European soccer competitions, where the rankings are found to be robust concerning the weight of adjustment for the opponents. Since disregarding the majority of the matches without promotion, relegation, and qualification for international cups would be unfair and unjustified, some simpler alternative policies are also discussed.


title: Telehealth Uptake into Prenatal Care and Provider Attitudes during the COVID-19 Pandemic in New York City: A Quantitative and Qualitative Analysis

text: OBJECTIVE: This study aimed to (1) determine to what degree prenatal care was able to be transitioned to telehealth at prenatal practices associated with two affiliated hospitals in New York City during the novel coronavirus disease 2019 (COVID-19) pandemic and (2) describe providers' experience with this transition. STUDY DESIGN: Trends in whether prenatal care visits were conducted in-person or via telehealth were analyzed by week for a 5-week period from March 9 to April 12 at Columbia University Irving Medical Center (CUIMC)-affiliated prenatal practices in New York City during the COVID-19 pandemic. Visits were analyzed for maternal-fetal medicine (MFM) and general obstetrical faculty practices, as well as a clinic system serving patients with public insurance. The proportion of visits that were telehealth was analyzed by visit type by week. A survey and semistructured interviews of providers were conducted evaluating resources and obstacles in the uptake of telehealth. RESULTS: During the study period, there were 4,248 visits, of which approximately one-third were performed by telehealth (n = 1,352, 31.8%). By the fifth week, 56.1% of generalist visits, 61.5% of MFM visits, and 41.5% of clinic visits were performed via telehealth. A total of 36 providers completed the survey and 11 were interviewed. Accessing technology and performing visits, documentation, and follow-up using the telehealth electronic medical record were all viewed favorably by providers. In transitioning to telehealth, operational challenges were more significant for health clinics than for MFM and generalist faculty practices with patients receiving public insurance experiencing greater difficulties and barriers to care. Additional resources on the patient and operational level were required to optimize attendance at in-person and video visits for clinic patients. CONCLUSION: Telehealth was rapidly implemented in the setting of the COVID-19 pandemic and was viewed favorably by providers. Limited barriers to care were observed for practices serving patients with commercial insurance. However, to optimize access for patients with Medicaid, additional patient-level and operational supports were required. KEY POINTS: · Telehealth uptake differed based on insurance.. · Medicaid patients may require increased assistance for telehealth.. · Quick adoption of telehealth is feasible..


title: Functional Cell Receptors for Human Coronavirus

text: Viruses infect host cells by binding to receptors on thesurface of cells Receptor is an important factor affecting host range and interspecific transmission In December 2019, an outbreak of unexplained pneumonia occurred in Wuhan, Hubei province The pathogen was a new coronavirus, named 2019 NovelCoronavirus (2019-nCoV) by WHO Angiotensin-converting enzyme 2 (ACE2) was found to be the receptor of 2019-nCoV This review provides a brief overview of human coronavirus receptors and their applications, with a view to providing references for the tracing, cross-species transmission, epidemiological analysis and antiviral and vaccine studies of 2019-nCoV


The "mind" behind the "mask": Assessing mental states and creating therapeutic alliance amidst COVID-19


Variability in State Regulations Pertaining to Infection Control and Pandemic Response in US Assisted Living Communities


title: Dermatology residents and COVID-19: life behind the frontlines

text: the CoronaVirus Disease 2019 (COVID-19) pandemic outbreak in Italy completely changed patients' access to healthcare systems and therefore the doctor-patient relationship, in particular during the national lockdown (from March 11th to May 18th).


ICU outcomes of COVID-19 critically ill patients: An international comparative study


Neutralizing Antibodies against SARS-CoV-2 and Other Human Coronaviruses: (Trends in Immunology 41, 355-359; 2020)


title: Neutralizing Antibodies against SARS-CoV-2 and Other Human Coronaviruses

text: Coronavirus (CoV) disease 2019 (COVID-19) caused by severe acute respiratory syndrome (SARS)-CoV-2 (also known as 2019-nCoV) is threatening global public health, social stability, and economic development. To meet this challenge, this article discusses advances in the research and development of neutralizing antibodies (nAbs) for the prevention and treatment of infection by SARS-CoV-2 and other human CoVs.


title: Clinical Performance of SARS-CoV-2 Molecular Testing

text: Molecular testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the gold standard for diagnosis of coronavirus disease 2019 (COVID-19), but the clinical performance of these tests is still poorly understood, particularly with regard to disease course, patient-specific factors, and viral shedding. From 3/10/2020-5/1/2020 NewYork-Presbyterian laboratories performed 27,377 SARS-CoV-2 molecular assays from 22,338 patients. Repeat testing was performed for 3,432 patients, of which 2,413 had initial negative and 802 had initial positive results. Repeat-tested patients were more likely to have severe disease and low viral loads. The negative predictive value of the first day result among repeat-tested patients was 81.3% The clinical sensitivity of SARS-CoV-2 molecular assays was estimated between 58 % and 96%, depending on the unknown number of false negative results in single-tested patients. Conversion to negative was unlikely to occur before 15 to 20 days after initial testing or 20-30 days after the onset of symptoms, with 50% conversion occurring at 28 days after initial testing. Conversion from first day negative to positive results increased linearly with each day of testing, reaching 25% probability in 20 days. Sixty patients fluctuated between positive and negative results over several weeks suggesting caution when acting on single results. In summary, our study provides estimates of the clinical performance of SARS-CoV-2 molecular assays and suggests time frames for appropriate repeat testing, namely 15 to 20 days after a positive test and the same or next 2 days after a negative test in patients with high suspicion for COVID-19.


Transmission of coronavirus by nebulizer: a serious, underappreciated risk


Video laryngoscopy in COVID-19 patients: a word of caution


The arrival of SARS-CoV-2 in Venezuela


title: Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19)

text: A novel zoonotic coronavirus outbreak is spreading all over the world. This pandemic disease has now been defined as novel coronavirus disease 2019 (COVID-19), and is sustained by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As the current gold standard for the etiological diagnosis of SARS-CoV-2 infection is (real time) reverse transcription polymerase chain reaction (rRT-PCR) on respiratory tract specimens, the diagnostic accuracy of this technique shall be considered a foremost prerequisite. Overall, potential RT-PCR vulnerabilities include general preanalytical issues such as identification problems, inadequate procedures for collection, handling, transport and storage of the swabs, collection of inappropriate or inadequate material (for quality or volume), presence of interfering substances, manual errors, as well as specific aspects such as sample contamination and testing patients receiving antiretroviral therapy. Some analytical problems may also contribute to jeopardize the diagnostic accuracy, including testing outside the diagnostic window, active viral recombination, use of inadequately validated assays, insufficient harmonization, instrument malfunctioning, along with other specific technical issues. Some practical indications can hence be identified for minimizing the risk of diagnostic errors, encompassing the improvement of diagnostic accuracy by combining clinical evidence with results of chest computed tomography (CT) and RT-PCR, interpretation of RT-PCR results according to epidemiologic, clinical and radiological factors, recollection and testing of upper (or lower) respiratory specimens in patients with negative RT-PCR test results and high suspicion or probability of infection, dissemination of clear instructions for specimen (especially swab) collection, management and storage, together with refinement of molecular target(s) and thorough compliance with analytical procedures, including quality assurance.


Covid-19: Government is criticised for "scandalous" £10bn spent on test and trace programme


Neumonía vírica bilateral por COVID-19 como hallazgo casual en 18F-FDG-PET-TC de estadificación de paciente con melanoma gemelar derecho./ Neumonía vírica bilateral por COVID-19 como hallazgo casual en 18F-FDG-PET-TC de estadificación de paciente con melanoma gemelar derecho./ Bilateral viral pneumonia by COVID-19 as a chance finding in staging with 18F-FGD-PET/CT of patient with right calf melanoma


title: Characterization of novel monoclonal antibodies against MERS-coronavirus spike protein

text: Middle East Respiratory Syndrome coronavirus (MERS-CoV) causes severe pulmonary infection, with â¼35 % mortality. Spike glycoprotein (S) of MERS-CoV is a key target for vaccines and therapeutics because S mediates viral entry and membrane-fusion to host cells. Here, four different S subunit proteins, receptor-binding domain (RBD; 358-606 aa), S1 (1-751 aa), S2 (752-1296 aa), and SΔTM (1-1296 aa), were generated using the baculoviral system and immunized in mice to develop neutralizing antibodies. We developed 77 hybridomas and selected five neutralizing mAbs by immunization with SΔTM against MERS-CoV EMC/2012 strain S-pseudotyped lentivirus. However, all five monoclonal antibodies (mAb) did not neutralize the pseudotyped V534A mutation. Additionally, one mAb RBD-14F8 did not show neutralizing activity against pseudoviruses with amino acid substitution of L506â¯F or D509â¯G (England1 strain, EMC/2012 L506â¯F, and EMC/2012 D509â¯G), and RBD-43E4 mAb could not neutralize the pseudotyped I529â¯T mutation, while three other neutralizing mAbs showed broad neutralizing activity. This implies that the mutation in residue 506-509, 529, and 534 of S is critical to generate neutralization escape variants of MERS-CoV. Interestingly, all five neutralizing mAbs have binding affinity to RBD, although most mAbs generated by RBD did not have neutralizing activity. Additionally, chimeric antibodies of RBD-14F8 and RBD-43E4 with human Fc and light chain showed neutralizing effect against wild type MERS-CoV KOR/KNIH/002, similar to the original mouse mAbs. Thus, our mAbs can be utilized for the identification of specific mutations of MERS-CoV.


Rapid Scholarly Dissemination and Cardiovascular Community Engagement to Combat the Infodemic of the COVID-19 Pandemic


title: Encephalopathy and seizure activity in a COVID-19 well controlled HIV patient

text: A 41-year-old male with a history of well controlled HIV presented with confusion and was found to have COVID-19. Lumbar puncture was negative. He had worsening encephalopathy with tonic-clonic seizure requiring intubation. He was treated with hydroxychloroquine and azithromycin with improvement in mental status back to baseline after 6 days.


Errors in Units of Measure and Reference Value for Laboratory Tests and Numbers of Patients in Study of COVID-19 in Wuhan, China


Spread of SARS-CoV-2


title: Occupational radiation exposure in femoral artery approach is higher than radial artery approach during coronary angiography or percutaneous coronary intervention

text: Medical radiation exposure is a significant concern for interventional cardiologists (IC). This study was aimed at estimating the radiation exposure of IC operators and assistants in real clinical practice. The radiation exposure of the operator and assistant was evaluated by conducting two types of procedures via coronary angiography (CAG) and percutaneous coronary intervention (PCI) on 1090 patients in 11-cardiovascular centers in Korea. Radiation exposure was measured using an electronic personal dosimeter (EPD). EPD were attached at 3 points on each participant: on the apron on the left anterior chest (A1), under the apron on the sternum (A2), and on the thyroid shield (T). Average radiation exposure (ARE) of operators at A1, A2, and T was 19.219 uSv, 4.398 uSv, and 16.949 uSv during CAG and 68.618 uSv, 15.213 uSv, and 51.197 uSv during PCI, respectively. ARE of assistants at A1, A2, and T was 4.941 uSv, 0.860 uSv, and 5.232 uSv during CAG and 20.517 uSv, 4.455 uSv, and 16.109 uSv during PCI, respectively. AED of operator was 3.4 times greater during PCI than during CAG.


title: Managing the IVF laboratory during a pandemic: international perspectives from laboratory managers

text: Fertility societies worldwide responded to the COVID-19 pandemic by recommending that fertility clinics close, or sharply reduce, the clinical operation, leading to a shift in the management of IVF laboratories in three phases: shutdown preparation; maintenance during shutdown; and restart. Each of these phases carries distinct risks that need identification and mitigation, forcing laboratory managers to rethink and adapt their procedures in response to the pandemic. The sudden and unprecedented nature of the pandemic forced laboratory managers from around the world to base decisions on opinion and experience when evidence-based response options were unavailable. These perspectives on pandemic response were presented during a virtual international symposium on COVID-19, held on 3 April 2020, and organized by the London Laboratory Managers' Group. Laboratory managers from seven different countries at different stages of the pandemic (China, Italy, Spain, France, UK, Brazil and Australia) presented their personal experiences to a select audience of experienced laboratory managers from 19 different countries. The intention of this paper is to collect the learnings and considerations from this group of laboratory managers who collaborated to share personal experiences to contribute to the debate surrounding what constitutes good IVF laboratory practice in extraordinary circumstances, such as the COVID-19 pandemic.


Modelado estadístico y matemático en la epidemía del coronavirus: Algunas consideraciones para minimizar los sesgos en los resultados./ [Statistical and mathematical modeling in the Coronavirus epidemic: some considerations to minimize biases in the results]


title: Role of Tissue Engineering in COVID-19 and Future Viral Outbreaks

text: In light of the current novel coronavirus (COVID-19) pandemic, as well as other viral outbreaks in the 21st century, there is a dire need for new diagnostic and therapeutic strategies to combat infectious diseases worldwide. As a convergence science, tissue engineering has traditionally focused on the application of engineering principles to biological systems, collaboration across disciplines, and rapid translation of technologies from the benchtop to the bedside. Given these strengths, tissue engineers are particularly well suited to apply their skill set to the current crisis and viral outbreaks in general. This work introduces the basics of virology and epidemiology for tissue engineers, and highlights important developments in the field of tissue engineering relevant to the current pandemic, including in vitro model systems, vaccine technology, and small-molecule drug delivery. COVID-19 serves as a call to arms for scientists across all disciplines, and tissue engineers are well trained to be leaders and contributors in this time of need. Impact statement Given the steep mortality caused by the recent novel coronavirus (COVID-19) pandemic, there is clear need for advances in diagnostics and therapeutics for viral outbreaks. Tissue engineering has the potential for critical impact on clinical outcomes in viral outbreaks. Tissue engineers, if mobilized, could play key roles as leaders in the outbreak, given their ability to apply engineering principles to biological processes, experience in collaborative environments, and penchant for technological translation from benchtop to bedside. In this work, three areas pioneered by tissue engineers that could be applied to the current COVID-19 crisis and future viral outbreaks are highlighted.


title: Airborne route and bad use of ventilation systems as non-negligible factors in SARS-CoV-2 transmission

text: The world is facing a pandemic of unseen proportions caused by a corona virus named SARS-CoV-2 with unprecedent worldwide measures being taken to tackle its contagion. Person-to-person transmission is accepted but WHO only considers aerosol transmission when procedures or support treatments that produce aerosol are performed. Transmission mechanisms are not fully understood and there is evidence for an airborne route to be considered, as the virus remains viable in aerosols for at least 3 h and that mask usage was the best intervention to prevent infection. Heating, Ventilation and Air Conditioning Systems (HVAC) are used as a primary infection disease control measure. However, if not correctly used, they may contribute to the transmission/spreading of airborne diseases as proposed in the past for SARS. The authors believe that airborne transmission is possible and that HVAC systems when not adequately used may contribute to the transmission of the virus, as suggested by descriptions from Japan, Germany, and the Diamond Princess Cruise Ship. Previous SARS outbreaks reported at Amoy Gardens, Emergency Rooms and Hotels, also suggested an airborne transmission. Further studies are warranted to confirm our hypotheses but the assumption of such way of transmission would cause a major shift in measures recommended to prevent infection such as the disseminated use of masks and structural changes to hospital and other facilities with HVAC systems.


Potential pharmacological perspectives for the treatment/prevention of the SARS-COV-2 infection in opioid dependent patients


Low- and middle-income countries face up to COVID-19


title: Influence of Different Inactivation Methods on Severe Acute Respiratory Syndrome Coronavirus 2 RNA Copy Number

text: The outbreak of COVID-19 has spread across the world and was characterized as a pandemic. To protect medical laboratory personnel from infection, most laboratories inactivate the clinical samples before testing. However, the effect of inactivation on the detection results remains unknown. Here, we used a digital PCR assay to determine the absolute SARS-CoV-2 RNA copy number in 63 nasopharyngeal samples and assess the effect of inactivation methods on viral RNA copy number. Viral inactivation was performed with three different methods: (1) incubation with TRIzol® LS Reagent for 10 min at room temperature, (2) heating in a waterbath at 56°C for 30 min, and (3) high-temperature treatment, including 121°C autoclaving for 20 min, 100°C boiling for 20 min, and 80°C heating for 20 min. Compared to the amount of RNA in the original sample, TRIzol treatment destroyed 47.54% of N gene and 39.85% of ORF 1ab. For samples treated at 56°C for 30 min, the copy number of N gene and ORF 1ab was reduced by 48.55% and 56.40%, respectively. Viral RNA copy number dropped by 50-66% after 80°C heating for 20 min. Nearly no viral RNA was detected after autoclaving at 121°C or boiling at 100°C for 20 min. These results indicated that inactivation reduced the quantity of detectable viral RNA and may cause false negative results especially in weakly positive cases. Thus, TRIzol is recommended for sample inactivation in comparison to heat inactivation as Trizol has the least effect on RNA copy number among the tested methods.


Response to COVID-19 and ACEI/ARB: NOT ASSOCIATED?


Redundancy in reporting on COVID-19


title: COVID-19 in Tuberculosis patients: a report of three cases

text: The clinical features and treatment of pulmonary tuberculosis patients with COVID-19 is unclear and understudied. Here, three pulmonary tuberculosis patients with COVID-19 infection were prospectively followed from hospital admission to discharge. We provide information and experience with treatment of pulmonary tuberculosis cases with confirmed COVID-19 infection. This article is protected by copyright. All rights reserved.


title: Generalized pustular figurate erythema: A newly delineated severe cutaneous drug reaction linked with hydroxychloroquine

text: A severe cutaneous drug reaction resembling acute generalized exanthematous pustulosis resulting from ingestion of hydroxychloroquine has been documented. It is distinguishable by its longer incubation period, more varied morphology with initially urticarial and later targetoid and arcuate plaques, recalcitrance to therapy and longer duration. Given the anticipated surge in the use of hydroxychloroquine due to its reported benefits in those with coronavirus disease 2019, specific recognition of this entity is pivotal. We delineate it as generalized pustular figurate erythema.


The use of exoskeletons to help with prone positioning in the intensive care unit during COVID-19


Broken jaws in the COVID era


title: TERAVOLT: Thoracic Cancers International COVID-19 Collaboration

text: Prior publications on small subsets of cancer patients infected with SARS CoV-2 have shown an increased risk of mortality compared to the general population. Furthermore, patients with thoracic malignancies are thought to be at particularly high risk given their older age, smoking habits, and pre-existing cardio-pulmonary comorbidities. For this reason, physicians around the world have formed TERAVOLT, a global consortium dedicated to understanding the impact of COVID-19 on patients with thoracic malignancies.


title: Practical Implications of Physical Distancing, Social Isolation, and Reduced Physicality for Older Adults in Response to COVID-19

text: The public health response to the COVID-19 pandemic involves physical distancing measures which have the potential to lead to increased social isolation among older adults. Implications of social isolation are potentially wide-ranging including poorer health outcomes, disruption of social interactions and routines, reduced meaningful activity, reduced social and emotional support, loneliness, potential for grief, loss, and trauma responses, limited access to resources, and reduced physicality. Social workers must advocate for the value of social relationships and identify creative ways to enhance the social connections of older adults during pandemic responses or other situations that require physical distancing measures.


Impact of the SARS-CoV-2 pandemic on health-care workers


The Future of Cardiovascular Prevention: Unprecedented Times


title: SARS-CoV-2 (COVID-19) by the numbers

text: The current SARS-CoV-2 pandemic is a harsh reminder of the fact that, whether in a single human host or a wave of infection across continents, viral dynamics is often a story about the numbers. In this snapshot, our aim is to provide a one-stop, curated graphical source for the key numbers that help us understand the virus driving our current global crisis. The discussion is framed around two broad themes: 1) the biology of the virus itself and 2) the characteristics of the infection of a single human host. Our one-page summary provides the key numbers pertaining to SARS-CoV-2, based mostly on peer-reviewed literature. The numbers reported in summary format are substantiated by the annotated references below. Readers are urged to remember that much uncertainty remains and knowledge of this pandemic and the virus driving it is rapidly evolving. In the paragraphs below we provide"back of the envelope"calculations that exemplify the insights that can be gained from knowing some key numbers and using quantitative logic. These calculations serve to improve our intuition through sanity checks, but do not replace detailed epidemiological analysis.


title: SARS-CoV-2 (COVID-19) by the numbers

text: The COVID-19 pandemic is a harsh reminder of the fact that, whether in a single human host or a wave of infection across continents, viral dynamics is often a story about the numbers. In this article we provide a one-stop, curated graphical source for the key numbers (based mostly on the peer-reviewed literature) about the SARS-CoV-2 virus that is responsible for the pandemic. The discussion is framed around two broad themes: i) the biology of the virus itself; ii) the characteristics of the infection of a single human host.


title: Considerations for cardiac catheterization laboratory procedures during the COVID-19 pandemic perspectives from the Society for Cardiovascular Angiography and Interventions Emerging Leader Mentorship (SCAI ELM) Members and Graduates

text: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly infectious, carries significant morbidity and mortality, and has rapidly resulted in strained health care system and hospital resources. In addition to patient-related care concerns in infected individuals, focus must also relate to diminishing community spread, protection of staff, case selection, and concentration of resources. The current document based on available data and consensus opinion addresses appropriate catheterization laboratory preparedness for treating these patients, including procedure-room readiness to minimize external contamination, safe donning and doffing of personal protective equipment (PPE) to eliminate risk to staff, and staffing algorithms to minimize exposure and maximize team availability. Case selection and management of both emergent and urgent procedures are discussed in detail, including procedures that may be safely deferred or performed bedside.


title: Decoding SARS-CoV-2 Hijacking of Host Mitochondria in Pathogenesis of COVID-19

text: Due to ongoing pandemic around the world, the mechanisms underlying the SARS-CoV-2 induced COVID-19 are subject to intense investigation. Based on available data for the SARS-CoV-1 virus, we suggest how CoV-2 localization of RNA transcripts in mitochondria hijacks the host cell's mitochondrial function to viral advantage. Besides viral RNA transcripts, RNA also localizes to mitochondria. SARS-CoV-2 may manipulate mitochondrial function indirectly, first by ACE2 regulation of mitochondrial function, and once it enters the host cell, ORFS such as ORF-9b can directly manipulate mitochondrial function to evade host cell immunity and facilitate virus replication and COVID-19 disease. Manipulations of host mitochondria by viral ORFs can release mitochondrial DNA (mtDNA) in the cytoplasm and activate mtDNA induced inflammasome and suppress innate and adaptive immunity. We argue that a decline in ACE2 function in aged individuals, coupled with the age-associated decline in mitochondrial functions resulting in chronic metabolic disorders like diabetes or cancer, may make the host more vulnerable to infection and health complications to mortality. These observations suggest that distinct localization of viral RNA and proteins in mitochondria must play essential roles in SARS-CoV-2 pathogenesis. Understanding the mechanisms underlying virus communication with host mitochondria may provide critical insights into COVID-19 pathologies. An investigation into the SARS-CoV-2 hijacking of mitochondria should lead to novel approaches to prevent and treat COVID-19.


Declining Admissions for Acute Cardiovascular Illness: The Covid-19 Paradox


title: Spontaneous pneumothorax and subcutaneous emphysema in COVID-19 patient: Case report

text: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome virus coronavirus 2 (SARS-CoV-2). As known, COVID-19 has become a global pandemic and serious health problem. Disease mainly affects lungs and common findings are fever cough and shortness of breath. Computerized tomography (CT) has an important role in initial evaluation and follow up of COVID-19. Main (CT) finding of the disease is bilateral extensive ground-glass opacification (GGO) with a peripheral or posterior distribution, mainly involving the lower lobes. In this case report, we present a pneumothorax and subcutaneous emphysema case in a patient with COVID-19. To the best of authors' knowledge, it is the first illustrated case of pneumothorax accompanying COVID-19 pneumonia.


title: [Comparison of epidemiological and clinical characteristics of SARS, pandemic (H1N1) 2009 and COVID-19, and consideration on prevention and control strategies of COVID-19]

text: We compared the epidemiological and clinical characteristics of severe acute respiratory syndrome (SARS), pandemic (H1N1) 2009 and COVID-19 and found that COVID-19 was more contagious, more concealed in transmission, with greater infectious intensity and more severe clinical manifestations. If the COVID-19 epidemic is not effectively controlled, it will have a serious impact on human health, and even social development. Recognizing the characteristics of three diseases, especially COVID-19, and improving the disease awareness of COVID-19 will help better implement the guidelines of "scientific prevention and treatment, precise implementation" and prevent and control COVID-19.


title: The Epidemic-Driven Collapse in a System with Limited Economic Resource

text: We consider the possibility of social and economical collapse of population caused by epidemics. We exploit a simplest toy model with negative feedback for the dynamics of epidemic spreading in population with its mutual influence on some formal resource (economical, financial, etc). For epidemics spreading we use the simple SIS model, supplemented with the simplest equation for the dynamics of the resource whose generation is determined by the active labor resource. We note that the patient's characteristic rehabilitation rate or recovery time depends on the cost of health services, cost of the bare subsistence level of consumption, $E$, and the availability of some formal resource $\rho$, e.g. money. Since the cost of services is fixed, the service is terminated if there is not enough personal, private, or collective financial resource $\rho\ll E$, the service is absent. Therefore, we suppose that recovery rate should have an activation character $\sim\exp(-E/\rho)$. We show that depending on the rate of epidemics spreading and on the availability of formal resource, the system can come back to normal life, can overcome the stress or move to another stable but more"poor"state. Otherwise, the system can collapse. While collapsing, the system can pass through a number of quasi-stable states, its dynamics being resembling the so-called devil's staircase.


The role of mental health home hospitalization care during the COVID-19 pandemic


COVID-19: a new challenge for human beings


title: General practice, COVID-19 and living with uncertainty

text: A lifetime of general practice brings with it the privilege of acquired wisdom. We swim in uncertainty and have learned to work within its scope.


Makeshift hospitals for COVID-19 patients: where health-care workers and patients need sufficient ventilation for more protection


E-mental health options in the COVID-19 pandemic and beyond


title: A novel anti-NS2BNS3pro antibody-based indirect ELISA test for the diagnosis of dengue virus infections

text: Dengue virus reportedly circulates as four genetically distinct serotypes for which there is no widely accepted vaccine or drug at present. Morbidity and mortality caused by this virus are alarming for the possible increased threat to human health. A Suitable diagnostic test is the prerequisite for designing and developing control measures. But, the tests being employed at present possess one or the other drawback for this disease diagnosis. During the dengue virus infections, NS2B is essential for the stability and catalytic activity of the NS3 protease. N-terminal 185 amino acids of NS3 protease domain along with hydrophilic portion of NS2B (NS2BNS3pro) is being used to screen dengue inhibitors but not for diagnosis until now. In the present study, we have used purified NS2BNS3pro as an antigen to trap anti-NS2BNS3pro antibodies of the clinical samples. Antibodies were detected successfully in both western blotting and ELISA tests. In ELISA, antibodies were detected in both primary and secondary infections of all serotypes. Interestingly, 17 samples declared as other febrile infections by NS1 and IgM/IgG tests were found to be positive in present test, which were further confirmed by RT-PCR. In silico studies suggested the absence of conserved epitopes between NS2BNS3pro and the counterpart in JEV, Zika, and CHIKV, indicating less possibility of crossreaction, which was in turn confirmed by using synthetic peptides representing the above epitopes. Statistical analysis with 76% specificity, 87% sensitivity, and 95% concordance also supported the present test as a suitable test for large scale diagnosis of dengue virus infections. This article is protected by copyright. All rights reserved.


PDA Responds to the Novel Coronavirus Situation


title: Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)

text: Importance: Virus infection has been widely described as one of the most common causes of myocarditis. However, less is known about the cardiac involvement as a complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Objective: To describe the presentation of acute myocardial inflammation in a patient with coronavirus disease 2019 (COVID-19) who recovered from the influenzalike syndrome and developed fatigue and signs and symptoms of heart failure a week after upper respiratory tract symptoms. Design, Setting, and Participant: This case report describes an otherwise healthy 53-year-old woman who tested positive for COVID-19 and was admitted to the cardiac care unit in March 2020 for acute myopericarditis with systolic dysfunction, confirmed on cardiac magnetic resonance imaging, the week after onset of fever and dry cough due to COVID-19. The patient did not show any respiratory involvement during the clinical course. Exposure: Cardiac involvement with COVID-19. Main Outcomes and Measures: Detection of cardiac involvement with an increase in levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin T, echocardiography changes, and diffuse biventricular myocardial edema and late gadolinium enhancement on cardiac magnetic resonance imaging. Results: An otherwise healthy 53-year-old white woman presented to the emergency department with severe fatigue. She described fever and dry cough the week before. She was afebrile but hypotensive; electrocardiography showed diffuse ST elevation, and elevated high-sensitivity troponin T and NT-proBNP levels were detected. Findings on chest radiography were normal. There was no evidence of obstructive coronary disease on coronary angiography. Based on the COVID-19 outbreak, a nasopharyngeal swab was performed, with a positive result for SARS-CoV-2 on real-time reverse transcriptase-polymerase chain reaction assay. Cardiac magnetic resonance imaging showed increased wall thickness with diffuse biventricular hypokinesis, especially in the apical segments, and severe left ventricular dysfunction (left ventricular ejection fraction of 35%). Short tau inversion recovery and T2-mapping sequences showed marked biventricular myocardial interstitial edema, and there was also diffuse late gadolinium enhancement involving the entire biventricular wall. There was a circumferential pericardial effusion that was most notable around the right cardiac chambers. These findings were all consistent with acute myopericarditis. She was treated with dobutamine, antiviral drugs (lopinavir/ritonavir), steroids, chloroquine, and medical treatment for heart failure, with progressive clinical and instrumental stabilization. Conclusions and Relevance: This case highlights cardiac involvement as a complication associated with COVID-19, even without symptoms and signs of interstitial pneumonia.


COVID-19: a new work-related disease threatening healthcare workers


Could urinary ACE2 protein level help identify individuals susceptible to SARS-CoV-2 infection and complication?


Age and sex differences in soluble ACE2 may give insights for COVID-19


title: [Viral Hepatitis]

text: HBV and HCV infection proceeds to chronic infection, and anti-cancer chemotherapy is contraindicated in patients with decompasated liver cirrhosis caused by both viruses. Reactivation of HBV refers to an increase in the HBV load caused by chemotherapy in a patient with HBV infection. Reactivation of HBV is classified into 2 categories: reactivation in a carrier and reactivation in a patient with resolved HBV infection. Because hepatitis caused by HBV reactivation is more likely to become severe and makes the treatment of original diseases difficult, it is most important to prevent the onset of hepatitis. The basic strategy for prevention and treatment of HBV reactivation associated with powerful chemotherapy regimens should follow the guidelines for the management of hepatitis B virus infection by the Japan Society of Hepatology. Risk of HBV reactivation is determined by HBV infection status and the degree of immunosuppression. HBV infection status is classified into chronic active hepatitis, inactive carrier, and resolved infection. This corresponds, in descending order, to the risk of reactivation. Patients undergoing chemotherapy should be screened for HBV infection. HBsAg levels should be measured in all patients prior to commencement of treatment. In HBsAg-positive patients, HBeAg, anti-HBe antibody, and HBV DNA levels should also be measured. In HBsAg-negative patients, anti-HBc antibody and anti-HBs antibody should be measured. The next step for patients with resolved HBV infection is measurement of HBV DNA levels. In patients with resolved HBV infection whose HBV DNA level is 20 IU/mL or higher, as in inactive carriers, prophylactic therapy should be commenced before chemotherapy. In patients with resolved HBV infection whose HBV DNA level is less than 20 IU/mL, periodic monitoring of HBV DNA should be performed during and after chemotherapy. Preemptive therapy should be started immediately if the HBV DNA level ex- ceeds 20 IU/mL.


title: Involvement of the open-source community in combating the worldwide COVID-19 pandemic: a review

text: The ongoing COVID-19 pandemic is unprecedented in the modern age both due to its scale and its disruption to daily life throughout the world. Widespread social isolation and restrictions in the age of modern communicative technology, coupled with some early successes for makers, have united the open-source community towards a common goal in a way not previously seen. Local hospitals and care facilities are turning to makers to print essential consumable parts, such as simple visors, while in the hardest hit areas, critical pieces of medical technology are being fabricated. While important and effective innovations are appearing almost daily, there are also some worrying trends towards hobbyists attempting manufacture of complex medical devices with little understanding of the clinical or scientific rationale behind their design. The nature of the open-source community, an area of intensive innovation, fluidity, and experimentation, jars with the exacting standards of medical device regulation. Here, we review the involvement of rapid prototyping and the open-source community in the key areas of personal protective equipment (PPE), diagnostics, critical care technology, and information acquisition and sharing, highlighting where makers and hackers have clashed with medical device regulations, and areas where the system has worked well to facilitate change.


title: [Medical management and prevention instruction of chronic obstructive pulmonary disease during the coronavirus disease 2019 epidemic]

text: Currently, coronavirus disease 2019 (COVID-19) was of clustering onset in China and challenging the Chinese healthcare system. Epidemiological data showed that older patients with chronic diseases were at high risk of the involvement of the severe and critical type of COVID-19, especially patients with chronic obstructive pulmonary disease (COPD) resulting in high mortalities. There were nearly 100 million COPD patients in China, and most of them were elderly. Once infected with COVID-19, it would be life-threatening for the COPD patients. Therefore, during the epidemic, it was of vital significance for us to attach great importance to optimize the management of COPD patients. Based on these considerations, the COPD Group of the Chinese Thoracic Society (CTS) and the COPD working Committee of the Chinese Association of Chest Physicians (CACP) altogether drafted the instruction for medical management and prevention of COPD during the COVID-19 epidemic period for the healthcare practitioner and patients.


title: New onset acute symptomatic seizure and risk factors in coronavirus disease 2019: A retrospective multicenter study

text: Our aim was to clarify the incidence and risk of acute symptomatic seizures in people with coronavirus disease 2019 (COVID-19). This multicenter retrospective study enrolled people with COVID-19 from January 18 to February 18, 2020 at 42 government-designated hospitals in Hubei province, the epicenter of the epidemic in China; Sichuan province; and Chongqing municipality. Data were collected from medical records by 11 neurologists using a standard case report form. A total of 304 people were enrolled, of whom 108 had a severe condition. None in this cohort had a known history of epilepsy. Neither acute symptomatic seizures nor status epilepticus was observed. Two people had seizurelike symptoms during hospitalization due to acute stress reaction and hypocalcemia, and 84 (27%) had brain insults or metabolic imbalances during the disease course known to increase the risk of seizures. There was no evidence suggesting an additional risk of acute symptomatic seizures in people with COVID-19. Neither the virus nor potential risk factors for seizures seem to be significant risks for the occurrence of acute symptomatic seizures in COVID-19.


Consideration on pathogen of viral fulminant myocarditis


CNS inflammatory vasculopathy with antimyelin oligodendrocyte glycoprotein antibodies in COVID-19


title: Struggling to get started

text: As the world attempts to cope with the devastating impact of the COVID-19 pandemic, researchers about to start PhDs and postdocs face particular challenges.


Clinical presentation of Covid-19 in health care workers from a French University Hospital


Mortality from Covid-19 Increases with Unsaturated Fat, and May Be Reduced by Early Calcium and Albumin Supplementation


Cancer surgery in a time of COVID-19: Many questions, few certainties


title: COVID-19 with acute cerebral infarction: one case report/ 中华神经科杂志

text: COVID-19 is caused by the 2019 novel coronavirus, which is characterized by hidden onset, long incubation period, and high contagion. The study found that the COVID-19 not only attacks the respiratory system, but also affects other systems such as the heart, kidney, and digestive tract, and could be combined with multiple system diseases such as acute cerebrovascular disease. If doctors, especially non-infective or respiratory doctors, do not pay great attention to the patient when they are receiving patients, and take good care of them, they may easily cause their own infection. This article summarizes the case of a concealed onset COVID-19 patient with cerebral infarction, which caused a medical staff infection after intravenous thrombolytic therapy, explores its clinical characteristics, treatment process and analyzes its prevention and control links to help the epidemic situation. In the prevention and control, the first-time doctor should pay attention to identification, reduce missed diagnosis, and scientific investigation to reduce occupational infection.


title: A Proposed Strategy for Management of Immunosuppression in Heart Transplant Patients with COVID-19

text: There is limited experience in management of orthotopic heart transplant (OHT) patients with COVID-19. In this study, we present our initial experience using a standardized management algorithm. Data collection was performed on OHT patients with COVID-19 after March 10, 2020 (declaration of state-of-emergency in Massachusetts). Among the 358 OHT patients currently followed at our program, 5 patients (1.4%) tested positive for COVID-19 (median age 50 years [IQR, 49-58], duration post-OHT 21 years [IQR, 6-25], and 4 of 5 (80%) were men). Among the 5 OHT patients, 2 of 5 (20%) had mild disease, and had no change in baseline immunosuppression therapy. Two of 5 (20%) had moderate disease, and received remdesivir as part of a clinical trial, and reduced immunosuppression therapy. One patient (20%) died prior to presenting to the hospital, consistent with 20% case fatality rate.


title: Are patients with Down syndrome vulnerable to life-threatening COVID-19?

text: Patients with Down syndrome are at increased risk of respiratory syncytial virus- and H1N1-related death. Literature on COVID-19 in Down syndrome patients is unavailable thus far. We describe the clinical course of 4 patients with Down syndrome during an outbreak of COVID-19. In all four patients, disease course was severe, warranting hospital care in three patients, with fatal outcome in one patient. Another patient receives supportive care in our institution. Our case series is the first report on probable increased risk of life-threatening disease course of COVID-19 in patients with Down syndrome. Proper surveillance, the adherence of social distancing, and the use of personal protective equipment will be essential in reducing morbidity and mortality in our patients.


United we stand, divided we fall


Telemedicine for Diabetes After the COVID-19 Pandemic: We Can't Put the Toothpaste Back in the Tube or Turn Back the Clock


The impact on outcomes of the ACS committee on trauma delayed trauma center verifications secondary to COVID19


Survival study of hospitalised patients with concurrent COVID-19 and haematological malignancies


Survival strategy of urology department during the COVID-19 era


title: Type I astrocytes and microglia induce a cytokine response in an encephalitic murine coronavirus infection

text: The pathogenesis of viral infections involves an immune response by cytokines, causing a deleterious effect on organ function, in addition to tissue destruction due to viral replication. Clinical symptoms and laboratory findings of the human coronavirus disease COVID-19, caused by the novel coronavirus SARS CoV-2, indicate cytokine involvement. Our laboratory showed that an experimental murine coronavirus (MHV-A59) can be transmitted into the brain by intranasal or intracerebral exposure and that neurovirulence is mediated by cytokine secretion. In this study we investigated which cells in the brain produce cytokines, thus functioning as the brain's innate immune system. Using tissue cultures of microglia, and clonal populations of astrocytes, we found that microglia and type I astrocytes (but not types II and III), produced pro-inflammatory cytokines in response to MHV-A59 infection. A molecularly closely related, non-encephalitic strain of the virus (MHV-2) caused in vitro infection, but without cytokine induction. Furthermore, immunofluorescence and immunohistochemistry revealed that type I astrocytes and microglia have perivascular foot processes necessary for the formation of the perivascular glymphatic system, the anatomical site of the brain's innate immune system. Cytokine secretion by type I astrocytes and microglia, as part of the brain's glymphatic and innate immune system, contributes to the pathogenesis of an encephalitic coronavirus infection, and indicates the rationale for anti-cytokine therapies for COVID-19.


title: Pitfalls in SARS-CoV-2 PCR diagnostics

text: To combat the COVID-19 pandemic, millions of PCR tests are performed worldwide. Any deviation of the diagnostic sensitivity and specificity will reduce the predictive values of the test. Here, we report the occurrence of contaminations of commercial primers/probe sets with the SARS-CoV-2 target sequence of the RT-qPCR as an example for pitfalls during PCR diagnostics affecting diagnostic specificity. In several purchased in-house primers/probe sets, quantification cycle values as low as 17 were measured for negative control samples. However, there were also primers/probe sets that displayed very low-level contaminations, which were detected only during thorough internal validation. Hence, it appears imperative to pre-test each batch of reagents extensively before use in routine diagnosis, to avoid false-positive results and low positive predictive value in low-prevalence situations. As such, contaminations may have happened more widely, and COVID-19 diagnostic results should be re-assessed retrospectively to validate the epidemiological basis for control measures.


title: Resuming elective surgery in the time of COVID-19: a safe and comprehensive strategy

text: The 2019 novel corona virus and the disease it causes (COVID-19) is a public health crisis that has profoundly modified the way medical and surgical care is delivered. Countries around the globe had a variable initial response to the COVID-19 pandemic from imposing massive lock downs and quarantine to surrendering to herd immunity. However, healthcare bodies worldwide recognized early on that a triumph against COVID-19 could only be achieved by maintaining the infrastructure of healthcare systems and their capacity to accommodate a potentially overwhelming increase in critical patient care needs. Therefore, they reacted by restricting medical care to emergency cases and postponing elective surgical procedures in all disciplines. The priority was made for treatment of COVID-19 patients and emergency cases. Nevertheless, the battle against the COVID-19 pandemic is still ongoing. In the absence of vaccines or effective drug treatments, its timeline remains uncertain and it cannot be forecast how long healthcare systems will need to cope with it in managing inpatient and outpatient services. Accordingly, extreme measures and restriction may become a recipe for a disaster in the context of the potential adverse health implications imposed by delaying timely medical and surgical care. Therefore, restrictive measures should be substituted with a comprehensive surgical and medical care strategy. One that provides a safe balance between the prevention of COVID-19 and the delivery of essential surgical care. This article provides an overview on how to safely deliver essential surgical care in the time of COIVD-19.


Covid-19: UK holds off closing schools and restricts testing to people in hospital


Safe operating room protocols during the COVID-19 pandemic


Why not to use colchicine in COVID-19? An oldanti-inflammatory drug for a novel auto-inflammatory disease


title: Cancer treatment during COVID-19 pandemic

text: Currently world is fighting with global pandemic of coronavirus disease 2019 (COVID-19). At this time of uncertainty, oncologists are struggling to provide appropriate care to cancer patients. They have to weigh risk and benefit of giving cancer treatment vs chances of getting them infected with COVID-19. As cancer patients are immunocompromised and there are high chances of exposure during hospital visits and if they get infected, outcome can be fatal. So through the column of this article, we would like to provide basic guideline in management of cancer patients during COVID-19 pandemic.


title: Harnessing adenosine A2A receptors as a strategy for suppressing the lung inflammation and thrombotic complications of COVID-19: Potential of pentoxifylline and dipyridamole

text: Counterproductive lung inflammation and dysregulated thrombosis contribute importantly to the lethality of advanced COVID-19. Adenosine A2A receptors (A2AR), expressed by a wide range of immune cells, as well as endothelial cells and platelets, exert cAMP-mediated anti-inflammatory and anti-thrombotic effects that potentially could be highly protective in this regard. The venerable drug pentoxifylline (PTX) exerts both anti-inflammatory and antithrombotic effects that reflect its ability to boost the responsiveness of A2AR to extracellular adenosine. The platelet-stabilizing drug dipyridamole (DIP) blocks intracellular uptake of extracellularly-generated adenosine, thereby up-regulating A2AR signaling in a way that should be functionally complementary to the impact of PTX in that regard. Moreover, DIP has recently been reported to slow the cellular replication of SARS-CoV-2 in clinically feasible concentrations. Both PTX and DIP are reasonably safe, well-tolerated, widely available, and inexpensive drugs. When COVID-19 patients can be treated within several days of symptom onset, using PTX + DIP in conjunction with hydroxychloroquine (HCQ) and an antibiotic - azithromycin (AZM) or doxycycline - might be warranted. HCQ and AZM can suppress SARS-CoV-2 proliferation in vitro and may slow the cell-to-cell spread of the virus; a large case series evaluating this combination in early-stage patients reported an impressively low mortality rate. However, whereas HCQ and AZM can promote QT interval lengthening and may be contraindicated in more advanced COVID-19 entailing cardiac damage, doxycycline has no such effect and exerts a potentially beneficial anti-inflammatory action. In contrast to HCQ, we propose that the combination of PTX + DIP can be used in both early and advanced stages of COVID-19. Concurrent use of certain nutraceuticals - yeast beta-glucan, zinc, vitamin D, spirulina, phase 2 inducers, N-acetylcysteine, glucosamine, quercetin, and magnesium - might also improve therapeutic outcomes in COVID-19.


title: Respiratory Support in COVID-19 Patients, with a Focus on Resource-Limited Settings

text: The ongoing novel coronavirus disease (COVID-19) pandemic is threatening the global human population, including in countries with resource-limited health facilities. Severe bilateral pneumonia is the main feature of severe COVID-19, and adequate ventilatory support is crucial for patient survival. Although our knowledge of the disease is still rapidly increasing, this review summarizes current guidance on the best provision of ventilatory support, with a focus on resource-limited settings. Key messages include that supplemental oxygen is a first essential step for the treatment of severe COVID-19 patients with hypoxemia and should be a primary focus in resource-limited settings where capacity for invasive ventilation is limited. Oxygen delivery can be increased by using a non-rebreathing mask and prone positioning. The presence of only hypoxemia should in general not trigger intubation because hypoxemia is often remarkably well tolerated. Patients with fatigue and at risk for exhaustion, because of respiratory distress, will require invasive ventilation. In these patients, lung protective ventilation is essential. Severe pneumonia in COVID-19 differs in some important aspects from other causes of severe pneumonia or acute respiratory distress syndrome, and limiting the positive end-expiratory pressure level on the ventilator may be important. This ventilation strategy might reduce the currently very high case fatality rate of more than 50% in invasively ventilated COVID-19 patients.


title: Not just little adults: preparing a children's emergency department for COVID-19

text: COVID-19 presented unique challenges in preparing our stand-alone children's emergency department for the pandemic and has demonstrated well the paediatric adage, 'children aren't little adults'.


title: Post-Acute Care Preparedness in a COVID-19 World

text: Coronavirus disease 2019 (COVID-19) has led to a surge of patients requiring post-acute care. In order to support federal, state and corporate planning, we offer a four-stage regionally oriented approach to achieving optimal systemwide resource allocation across a region's post-acute service settings and providers over time. In the first stage, the post-acute care system must, to the extent possible, help relieve acute hospitals of non-COVID-19 patients to create as much inpatient capacity as possible over the surge period. In the second stage after the initial surge as subsided, post-acute providers must protect vulnerable populations from COVID-19, prepare treat-in-place protocols for non-COVID-19 admissions, and create and formalize COVID-19 specific settings. In the third stage after a vaccine has been developed or an effective prophylactic option is available, post-acute care providers must assist with distribution and administration of vaccinations and prophylaxis, develop strategies to deliver non-COVID-19 related medical care, and begin to transition to the post-COVID-19 landscape. In the final stage, we must create health advisory bodies to review post-acute sector's response, identify opportunities to improve performance going forward, and develop a pandemic response plan for post-acute care providers. J Am Geriatr Soc 68:1150-1154, 2020.


Computational Identification of Small Interfering RNA Targets in SARS-CoV-2


title: Public Mental Health Crisis during COVID-19 Pandemic, China

text: The 2019 novel coronavirus disease emerged in China in late 2019-early 2020 and spread rapidly. China has been implementing emergency psychological crisis interventions to reduce the negative psychosocial impact on public mental health, but challenges exist. Public mental health interventions should be formally integrated into public health preparedness and emergency response plans.


Personal protective equipment during the COVID-19 pandemic: a comment


Typically Atypical: COVID-19 Presenting as a Fall in an Older Adult


Repercusión cardiovascular de la infección por el nuevo coronavirus SARS-CoV-2 (COVID-19)


Intubation and Ventilation amid COVID-19: Reply


The Brazilian government's actions against the CoViD-19


title: Detection of SARS-CoV-2 in Human Retinal Biopsies of Deceased COVID-19 Patients

text: PURPOSE: To report the presence of viral ribonucleic acid (RNA) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in human retina in deceased patients with confirmed novel coronavirus disease 2019 (COVID-19). PATIENTS AND METHODS: Fourteen eyes of 14 deceased patients with confirmed COVID-19 disease were enucleated during autopsy. A sample of human retina was secured and fixed in RNAlater™. Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) was performed to detect three different viral RNA sequences (RdRp-gene, E-gene and Orf1 gene) of SARS-CoV-2. RESULTS: In three out of 14 eyes SARS-CoV-2 viral RNA was detected in the retina of deceased COVID-19 patients. As analysis for three different sequences (RdRp-gene, E-gene and Orf1 gene) revealed positive results in RT-PCR, the existence of SARS-CoV-2 viral RNA in human retina is proven according to the standards of the World-Health-Organization. CONCLUSION: Viral RNA of SARS-CoV-2 is detectable in the retina of COVID-19 patients.


title: Informing emergency care for all patients: The Registry for Emergency Care (REC) Project protocol

text: OBJECTIVE: In Australia, the current ED burden related to COVID-19 is from 'suspected' rather than 'confirmed' cases. The initial aim of the Registry for Emergency Care (REC) Project is to determine the impact of isolation processes on the emergency care of all patients. METHODS: The REC Project builds on the COVID-19 Emergency Department Quality Improvement (COVED) Project. Outcomes measured include times to critical assessment and management. RESULTS: Clinical tools will be generated to inform emergency care, both during and beyond the COVID-19 pandemic. CONCLUSIONS: The REC Project will support ED clinicians in the emergency care of all patients.


title: Lack of sensitivity of an IVD/CE-labeled kit targeting the S gene for detection of SARS-CoV-2

text: OBJECTIVES: New molecular tests for SARS-CoV-2 are rapidly launched in response to the COVID-19 pandemic. The aim of this study was to evaluate the analytical and the clinical performance of the VIASURE SARS-CoV-2 S gene RT-PCR Kit on the BD Max™ system and to compare results with those obtained with the cobas® SARS-CoV-2 test on the cobas® 6800 system. METHODS: For testing the analytical performance, reference material was used. Clinical samples (n=101) obtained from patients with symptoms compatible to COVID-19 were studied. Oro- and nasopharyngeal swabs were collected by using either ESwab™ or UTM™ collection systems. RESULTS: When the analytical performance was evaluated, the sample containing the lowest SARS-CoV-2 concentration tested negative with the VIASURE test while results obtained with the cobas® test were found to be concordant with the results expected. Six out of the 101 clinical samples (5.9%) showed an inhibition with the VIASURE test. When analyzing the remaining 95 clinical samples, 27 were found to be negative with both assays. Of 68 samples positive with the cobas® test, the VIASURE test missed 21 (30.9 %) samples. All of those 21 samples had shown Ct values ≥ 31 with the cobas® 6800 system. None of the samples tested positive with the VIASURE test and negative with the cobas® test. CONCLUSIONS: The VIASURE test was impaired by a lack of sensitivity and a relatively high number of invalid results. When using the VIASURE test for routine testing, a significant number of COVID-19 positive samples would have been missed.


Rationale for the Routine Application of Lung Ultrasound in the Management of Coronavirus Disease 2019 (COVID-19) Patients in Middle- to Low-Income Countries


Covid-19: Doctors face shortages of vital drugs, gases, and therapeutics, survey finds


title: Evidence-Based Practical Guidance for the Antithrombotic Management in Patients With Coronavirus Disease (COVID-19) in 2020

text: This practical guidance, endorsed by the Brazilian Society of Thrombosis and Hemostasis and The Brazilian Society of Angiology and Vascular Surgery, the International Union of Angiology and the European Venous Forum, aims to provide physicians with clear guidance, based on current best evidence-based data, on clinical strategies to manage antithrombotic strategies in patients with coronavirus disease 2019.


What are the factors influencing the COVID-19 outbreak in Latin America?


title: [Technologies and requirements of protection and disinfection in key places during the novel coronavirus pneumonia (NCP) outbreak]

text: Novel coronavirus pneumonia (NCP), a new respiratory infectious disease, has become an important public health problem. Inappropriate protection and disinfection measures are potential risk factors of transmission and outbreak of NCP in key places. This theme issue is concerned with the prevention and control of NCP. Comprehensive measures and suggestions for protection and disinfection are put forward from perspectives of functional areas in key places, such as hotels, mobile cabin hospitals, passenger transport stations and public transport facilities, environment and facilities, personal protection, operation management system, etc., so as to provide technical support for the prevention and control of new respiratory infectious diseases.


title: Chinese Society of Anesthesiology Expert Consensus on Anesthetic Management of Cardiac Surgical Patients With Suspected or Confirmed Coronavirus Disease 2019

text: The outbreak of a new coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) in China in December 2019 has brought serious challenges to disease prevention and public health. Patients with severe coronavirus disease 2019 (COVID-19) who undergo cardiovascular surgery necessitate extremely high demands from anesthesia personnel, and face high risks of mortality and morbidity. Based on the current understanding of COVID-19 and the clinical characteristics of cardiovascular surgical patients, the authors provide anesthesia management guidelines for cardiovascular surgery along with the prevention and control of COVID-19.


title: Summary of 20 tracheal intubation by anesthesiologists for patients with severe COVID-19 pneumonia: retrospective case series

text: SARS-CoV-2 pandemic is announced and it is very important to share our experience to the critical care community in the early stage. Urgent intubation team was organized by anesthesiologists and was dispatched upon request. We have retrospectively reviewed medical charts of 20 critically ill patients with Covid-19 pneumonia who required tracheal intubation from February 17 to March 19 in Wuhan No.1 hospital, China. We collected their demographics, vital signs, blood gas analysis before and after tracheal intubation, and 7-day outcome after tracheal intubation. Out of 20 patients, 90% were over 60 years old and 15 were with at least one comorbidity. All meet the indication for tracheal intubation announced by treatment expert group. We had successfully intubated all patients using personal protective equipment without circulatory collapse during tracheal intubation. During the observational period, none of 17 anesthesiologists were infected. Although intubation improved SPO2, reduced PaCO2 and blood lactate, seven of 20 patients died within 7-days after tracheal intubation. Non-survivors showed significantly lower SPO2 and higher PaCO2 and blood lactate compared to survivors. For those who are anticipated to deteriorate severe pneumonia with poor prognosis, earlier respiratory support with tracheal intubation may be advised to improve outcome.


title: Grief During the COVID-19 Pandemic: Considerations for Palliative Care Providers

text: The COVID-19 pandemic is anticipated to continue spreading widely across the globe throughout 2020. To mitigate the devastating impact of COVID-19, social distancing and visitor restrictions in health care facilities have been widely implemented. Such policies and practices, along with the direct impact of the spread of COVID-19, complicate issues of grief that are relevant to medical providers. We describe the relationship of the COVID-19 pandemic to anticipatory grief, disenfranchised grief, and complicated grief for individuals, families, and their providers. Furthermore, we provide discussion regarding countering this grief through communication, advance care planning, and self-care practices. We provide resources for health care providers, in addition to calling on palliative care providers to consider their own role as a resource to other specialties during this public health emergency.


Fulminant myocarditis and COVID-19


title: Chest CT features and their role in COVID-19

text: Since December 2019, the novel coronavirus disease (COVID-19) has spread rapidly throughout China. This article reviews the chest CT features of COVID-19 and analyzes the role of chest CT in this health emergency.


title: Bmi1 inhibitor PTC-209 promotes Chemically-induced Direct Cardiac Reprogramming of cardiac fibroblasts into cardiomyocytes

text: The development of therapeutic approaches based on direct cardiac reprogramming of fibroblasts into induced-cardiomyocytes (iCM) has emerged as an attractive strategy to repair the injured myocardium. The identification of the mechanisms driving lineage conversion represents a crucial step toward the development of new and more efficient regenerative strategies. To this aim, here we show that pre-treatment with the Bmi1 inhibitor PTC-209 is sufficient to increase the efficiency of Chemical-induced Direct Cardiac Reprogramming both in mouse embryonic fibroblasts and adult cardiac fibroblasts. PTC-209 induces an overall increase of spontaneously beating iCM at end-stage of reprogramming, expressing high levels of late cardiac markers Troponin T and myosin muscle light chain-2v. The inhibition of Bmi1 expression occurring upon PTC-209 pre-treatment was maintained throughout the reprogramming protocol, contributing to a significant gene expression de-regulation. RNA profiling revealed that, upon Bmi1 inhibition a significant down-regulation of genes associated with immune and inflammatory signalling pathways occurred, with repression of different genes involved in interleukin, cytokine and chemokine pathways. Accordingly, we observed the down-regulation of both JAK/STAT3 and MAPK/ERK1-2 pathway activation, highlighting the crucial role of these pathways as a barrier for cardiac reprogramming. These findings have significant implications for the development of new cardiac regenerative therapies.


title: The use of convalescent plasma therapy and remdesivir in the successful management of a critically ill obstetric patient with novel coronavirus 2019 infection: A case report

text: Remdesivir is a novel therapeutic with known activity against SARS CoV-2 and related coronaviruses. Remdesivir, as well as convalescent plasma therapy, are currently under investigation as potential therapies for patients with Coronavirus Disease 19 (COVID-19). In this case report we summarize the use of convalescent plasma therapy and then remdesivir as a late addition in the treatment of a critically ill obstetric patient with COVID-19. The patient subsequently improved, was extubated 5â¯days after initiation of remdesivir, was transitioned to room air 24â¯h later, and discharged at the completion of remdesivir therapy.


title: Do established infection prevention and control measures prevent spread of SARS-CoV-2 to the hospital environment beyond the patient room?

text: The role of the hospital environment in the transmission of infection is well described. With an emerging infection whose mode of transmission is under investigation, strict infection prevention and control measures, including patient isolation, hand hygiene, personal protective equipment that is doffed on exiting the patient room, and environmental cleaning should be implemented to prevent spread. Environmental testing demonstrated that COVID-19 patients contaminated the patient area (11/26, 42.3% of tests) but contamination of general ward areas was minimal (1/30, 3%) and the virus was detected after cleaning on one item only (1/25, 4%) which was noted to be in disrepair.


Letter: Neurosurgical Management of Spinal Pathology Via Telemedicine During the COVID-19 Pandemic: Early Experience and Unique Challenges


title: What We Learned about COVID-19 So Far? Notes from Underground

text: The novel coronavirus pandemic poses a major global threat to public health. Our knowledge concerning every aspect of COVID-19 is evolving rapidly, given the increasing data from all over the world. In this narrative review, the Turkish Thoracic Society Early Career Taskforce members aimed to provide a summary on recent literature regarding epidemiology, clinical findings, diagnosis, treatment, prevention, and control of COVID-19. Studies revealed that the genetic sequence of the novel coronavirus showed significant identity to SARS-CoV and MERS-CoV. Angiotensin-converting enzyme 2 receptor is an important target of the SARS-CoV-2 while entering an organism. Smokers were more likely to develop the disease and have a higher risk for ICU admission. The mean incubation period was 6.4 days, whereas asymptomatic transmission was reported up to 25 days after infection. Fever and cough were the most common symptoms, and cardiovascular diseases and hypertension were reported to be the most common comorbidities among patients. Clinical manifestations range from asymptomatic and mild disease to severe acute respiratory distress syndrome. Several patients showed typical symptoms and radiological changes with negative RT-PCR but positive IgG and IgM antibodies. Although radiological findings may vary, bilateral, peripherally distributed, ground-glass opacities were typical of COVID-19. Poor prognosis was associated with older age, higher Sequential Organ Failure Assessment score, and high D-dimer level. Chloroquine was found to be effective in reducing viral replication in vitro. Likewise, protease inhibitors, including lopinavir/ritonavir, favipiravir, and nucleoside analogue remdesivir were proposed to be the potential drug candidates in COVID-19 management. Despite these efforts, we still have much to learn regarding the transmission, treatment, and prevention of COVID-19.


Covid-19: Antibody tests will not be rolled out in UK until at least May, MPs hear


title: Why the ABCs Matter More than Ever in Medical Education

text: Addressing social drivers of health in medical education-through community engagement experiences-is essential for health equity and the development of future physicians. While this was written before the COVID-19 pandemic, these practices will gain even more importance as we come together to better understand its health and community implications in North Carolina and the United States.


title: Mental Health, Risk Factors, and Social Media Use During the COVID-19 Epidemic and Cordon Sanitaire Among the Community and Health Professionals in Wuhan, China: Cross-Sectional Survey

text: BACKGROUND: The mental health consequences of the coronavirus disease (COVID-19) pandemic, community-wide interventions, and social media use during a pandemic are unclear. The first and most draconian interventions have been implemented in Wuhan, China, and these countermeasures have been increasingly deployed by countries around the world. OBJECTIVE: The aim of this study was to examine risk factors, including the use of social media, for probable anxiety and depression in the community and among health professionals in the epicenter, Wuhan, China. METHODS: We conducted an online survey via WeChat, the most widely used social media platform in China, which was administered to 1577 community-based adults and 214 health professionals in Wuhan. Probable anxiety and probable depression were assessed by the validated Generalized Anxiety Disorder-2 (cutoff ≥3) and Patient Health Questionnaire-2 (cutoff ≥3), respectively. A multivariable logistic regression analysis was used to examine factors associated with probable anxiety and probable depression. RESULTS: Of the 1577 community-based adults, about one-fifth of respondents reported probable anxiety (n=376, 23.84%, 95% CI 21.8-26.0) and probable depression (n=303, 19.21%, 95% CI 17.3-21.2). Similarly, of the 214 health professionals, about one-fifth of surveyed health professionals reported probable anxiety (n=47, 22.0%, 95% CI 16.6-28.1) or probable depression (n=41, 19.2%, 95% CI 14.1-25.1). Around one-third of community-based adults and health professionals spent ≥2 hours daily on COVID-19 news via social media. Close contact with individuals with COVID-19 and spending ≥2 hours daily on COVID-19 news via social media were associated with probable anxiety and depression in community-based adults. Social support was associated with less probable anxiety and depression in both health professionals and community-based adults. CONCLUSIONS: The internet could be harnessed for telemedicine and restoring daily routines, yet caution is warranted toward spending excessive time searching for COVID-19 news on social media given the infodemic and emotional contagion through online social networks. Online platforms may be used to monitor the toll of the pandemic on mental health.


Contributions and challenges of general practitioners in China fighting against the novel coronavirus crisis


Aeromedical evacuations during the COVID-19 pandemic: practical considerations for patient transport


title: Cardiac function in relation to myocardial injury in hospitalised patients with COVID-19

text: BACKGROUND: Previous studies have reported on myocardial injury in patients with coronavirus infectious disease 19 (COVID-19) defined as elevated cardiac biomarkers. Whether elevated biomarkers truly represent myocardial dysfunction is not known. The aim of this study was to explore the incidence of ventricular dysfunction and assess its relationship with biomarker analyses. METHODS: This cross-sectional study ran from April 1 to May 12, 2020, and consisted of all consecutively admitted patients to the Radboud university medical centre nursing ward for COVID-19. Laboratory assessment included high-sensitivity Troponin T and Nterminal pro-B-type natriuretic peptide (NT-proBNP). Echocardiographic evaluation focused on left and right ventricular systolic function and global longitudinal strain (GLS). RESULTS: In total, 51 patients were included, with a median age of 63 years (range 51-68 years) of whom 80% was male. Troponin T was elevated (>14â¯ng/l) in 47%, and a clinically relevant Troponin T elevation (10â¯× URL) was found in three patients (6%). NT-proBNP was elevated (>300â¯pg/ml) in 24 patients (47%), and in four (8%) the NT-proBNP concentration was >1,000â¯pg/ml. Left ventricular dysfunction (ejection fraction <52% and/or GLS >-18%) was observed in 27%, while right ventricular dysfunction (TAPSE <17â¯mm and/or RV S'â¯< 10â¯cm/s) was seen in 10%. There was no association between elevated Troponin T or NT-proBNP and left or right ventricular dysfunction. Patients with confirmed pulmonary embolism had normal right ventricular function. CONCLUSIONS: In hospitalised patients, it seems that COVID-19 predominantly affects the respiratory system, while cardiac dysfunction occurs less often. Based on a single echocardiographic evaluation, we found no relation between elevated Troponin T or NT-proBNP, and ventricular dysfunction. Echocardiography has limited value in screening for ventricular dysfunction.


title: Olfactory and gustatory dysfunctions due to the coronavirus disease (COVID-19): a review of current evidence

text: INTRODUCTION: It is reported that coronavirus disease (COVID-19) can affect the sense of smell and taste of infected people. The pathobiology of this virus is still incompletely known, and it is therefore important to explore the impact of COVID-19 infections on olfactory and gustatory functions. We aimed to review current evidence on olfactory and gustatory dysfunctions caused by COVID-19. METHODS: This study was a narrative review performed in 2020 to investigate the olfactory and gustatory dysfunctions of the COVID-19. We searched eight keywords in six databases to determine the related documents on the main objective of the study. To discover studies meeting the inclusion criteria, the authors screened the titles and abstracts of the identified articles. The appropriate studies were included and their results were discussed to make the final selection. RESULTS: We have studied 24 current articles on the olfactory and gustatory dysfunctions due to COVID-19. A review of current studies has shown that we have a surge in the spread of olfactory and gustatory dysfunctions that happened during the epidemic of COVID-19 infection. Most studies (95.8%) have confirmed the symptoms of anosmia in patients with SARS-CoV-2 infection. A review of current studies showed that, in addition to anosmia, evidence of ageusia and dysgeusia (parageusia) was also seen in patients with COVID-19. CONCLUSION: The results of our study support recent reports that SARS-CoV-2 may infect oral and nasal tissues and cause olfactory and gustatory dysfunctions. These findings may aid future research on the diagnosis, prevention, and treatment of COVID-19 consequences.


The precautions required for the safe return of elective surgery - a letter to the editor in response to "Impact of the coronavirus (COVID-19) pandemic on surgical practice - Part 2 (surgical prioritisation)Ë®


Sex-based dimorphism in the SARS-CoV2 virulence


Intramatricial methotrexate for treatment of resistant acrodermatitis continua of Hallopeau: An alternative in COVID-19


Young Children Presenting With Fever and Rash in the Midst of SARS-CoV-2 Outbreak in New York


Primary B Cell Lymphoma of the Pancreas


title: Continuous Intravenous Anakinra Infusion to Calm the Cytokine Storm in Macrophage Activation Syndrome

text: OBJECTIVE: The objective of this study was to report the benefit of a therapeutic approach consisting of intravenous (IV) continuous anakinra (recombinant human interleukin-1 receptor antagonist) infusions in treating severely ill adult patients with secondary hemophagocytic lymphohistiocytosis or macrophage activation syndrome (MAS). METHODS: A retrospective chart review of five patients treated at Regions Hospital from 2016 to 2019 was conducted. Demographic, clinical, and laboratory characteristics and outcomes were recorded. RESULTS: Continuous IV anakinra infusions up to 2400 mg/d resulted in rapid serologic, then clinical response in 4 of 5 severely ill patients who were refractory to all other therapies, including subcutaneous anakinra. Subsequently, 3 of 5 patients have been maintained on anakinra or canakinumab, with no recurrence of MAS. CONCLUSION: Continuous infusion of IV anakinra may result in rapid serologic and subsequent clinical improvement in adult patients with MAS. This method for treating cytokine storm should be considered in the current COVID-19 pandemic in the subgroup of patients with severe disease who have a cytokine storm presentation.


title: COVID-19 pandemic and its implications on sexual life: Recommendations from the Italian Society of Andrology

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the coronavirus that causes an infectious disease, called COVID-19, first detected in patients with pneumonia in Wuhan (People's Republic of China) on December 2019. Italy was the first European country to state the outbreak of the infection and its Council of Ministers declared the state of health emergency on 31.01.2020, then the World Health Organization ruled a global pandemic on 11.03.2020. The nasopharyngeal swab is based on the detection of virus RNA and is the only reliable one for declaring COVID-19 infection. The most common symptoms observed in COVID-19 patients before hospitalization may be fever, chills, cough, dyspnea, asthenia, myalgia and/or arthralgia. This symptomatology can be often complicated in a dramatically increasing manner such as to require hospitalization starting from the third-fourth week. COVID-19 outbreak has dramatically affected the quality of life by changing inter-personal relationships, community life and obviously sexual health. The purpose of this work, based on available evidence, is to provide recommendations to help the population to face their sexual life in this critical period.


title: Rheumatology practice amidst the COVID-19 pandemic: a pragmatic view

text: The coronavirus disease 2019 (COVID-19) pandemic has come with many challenges for healthcare providers and patients alike. In addition to the direct burden it has placed on societies and health systems, it had a significant impact in the care of patients with chronic diseases, as healthcare resources were deployed to fight the crisis, and major travel and social restrictions were adopted. In the field of rheumatology, this has required notable efforts from departments and clinicians to adapt to the novel status quo and assure the follow-up of patients with rheumatic and musculoskeletal diseases. In the present viewpoint, we provide a practical approach to tackle this reality. Key measures include setting up preventive team management strategies, optimising communication with patients and reorganising patient care in all its dimensions. We then anticipate the nuances of rheumatology practice as restrictive measures are progressively lifted, while an effective vaccine is still pending. This includes the need to reimpose the same strategy as further waves unfold. Finally, we look ahead and address the lessons we can incorporate into post-COVID-19 rheumatology.


title: Case Report: Death due to COVID-19 in Three Brothers

text: We report fatal cases of novel coronavirus disease (COVID-19) in three brothers in Iran. An increased susceptibility to specific pathogens has been reported for a number of genetic defects. Considering the fact that most of them who are affected by COVID-19 recover, deaths in three brothers who lived separately and had no known underlying disease suggest genetic predisposition to COVID-19 in some individuals.


title: Evaluating the Effects of COVID-19 on Plastic Surgery Emergencies: Protocols and Analysis From a Level I Trauma Center

text: BACKGROUND: The COVID-19 crisis has brought many unique challenges to the health care system. Across the United States, social distancing measures have been put in place, including stay-at-home (SAH) orders, to combat the spread of this infection. This has impacted the type and volume of traumatic injuries sustained during this time. Meanwhile, steps have been taken in our health care system to assure that adequate resources are available to maintain a high standard of patient care while recognizing the importance of protecting health care providers. Using comparative data, we aim to describe the trends in traumatic injuries managed by our plastic surgery service and detail the changes in consultation policies made to minimize provider exposure. METHODS: A retrospective chart review was performed of all plastic surgery emergencies at our institution during the 3 weeks preceding the issuance of SAH orders in Chicago and the 3 weeks after. The electronic medical record was queried for patient age, type and mechanism of injury, location where injury was sustained, presence of domestic violence, length of inpatient hospital stays, and treatment rendered. The two 3-week periods were then comparatively analyzed to determine differences and trends in these variables and treatment rendered. The 2 periods were then comparatively analyzed to determine differences and trends in these variables. RESULTS: There was a significant decrease in trauma consults since the issuance of SAH (88 pre-SAH vs 62 post-SAH) with a marked decrease in trauma-related hand injuries. There was an increase in the percentage of assault-related injuries including those associated with domestic violence, whereas there was an overall decrease in motor vehicle collisions. There was no notable change in the location where injuries were sustained. Significantly fewer patients were seen by house staff in the emergency room, whereas those requiring surgical intervention were able to receive care without delay. CONCLUSIONS: Stay-at-home orders in Chicago have impacted traumatic injury patterns seen by the Section of Plastic and Reconstructive Surgery at a level I Trauma Center. Safe and timely care can continue to be provided with thorough communication, vigilance, and guidance from our colleagues.