title: N-Acetylcysteine: A potential therapeutic agent for SARS-CoV-2

text: COVID-19, a respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread across the globe. Predisposing factors such as age, diabetes, cardiovascular disease, and lowered immune function increase the risk of disease severity. T cell exhaustion, high viral load, and high levels of TNF-É, IL1ß, IL6, IL10 have been associated with severe SARS-CoV-2. Cytokine and antigen overstimulation are potentially responsible for poor humoral response to the virus. Lower cellular redox status, which leads to pro-inflammatory states mediated by TNF-É is also potentially implicated. In vivo, in vitro, and human clinical trials have demonstrated N-acetylcysteine (NAC) as an effective method of improving redox status, especially when under oxidative stress. In human clinical trials, NAC has been used to replenish glutathione stores and increase the proliferative response of T cells. NAC has also been shown to inhibit the NLRP3 inflammasome pathway (IL1ß and IL18) in vitro, and decrease plasma TNF-É in human clinical trials. Mediation of the viral load could occur through NAC's ability to increase cellular redox status via maximizing the rate limiting step of glutathione synthesis, and thereby potentially decreasing the effects of virally induced oxidative stress and cell death. We hypothesize that NAC could act as a potential therapeutic agent in the treatment of COVID-19 through a variety of potential mechanisms, including increasing glutathione, improving T cell response, and modulating inflammation. In this article, we present evidence to support the use of NAC as a potential therapeutic agent in the treatment of COVID-19.


title: Back to Normal: An Old Physics Route to Reduce SARS-CoV-2 Transmission in Indoor Spaces

text: We advocate the widespread use of UV-C light as a short-term, easily deployable, and affordable way to limit virus spread in the current SARS-CoV-2 pandemic. Radical social distancing with the associated shutdown of schools, restaurants, sport clubs, workplaces, and traveling has been shown to be effective in reducing virus spread, but its economic and social costs are unsustainable in the medium term. Simple measures like frequent handwashing, facial masks, and other physical barriers are being commonly adopted to prevent virus transmission. However, their efficacy may be limited, particularly in shared indoor spaces, where, in addition to airborne transmission, elements with small surface areas such as elevator buttons, door handles, and handrails are frequently used and can also mediate transmission. We argue that additional measures are necessary to reduce virus transmission when people resume attending schools and jobs that require proximity or some degree of physical contact. Among the available alternatives, UV-C light satisfies the requirements of rapid, widespread, and economically viable deployment. Its implementation is only limited by current production capacities, an increase of which requires swift intervention by industry and authorities.


title: The Appropriate Use of Testing for COVID-19

text: Many public officials are calling for increased testing for the 2019 novel coronavirus disease (COVID-19), and some governments have taken extraordinary measures to increase the availability of testing. However, little has been published about the sensitivity and specificity of the reverse transcriptase-polymerase chain reaction (RT-PCR) nasopharyngeal swabs that are commonly used for testing. This narrative review evaluates the literature regarding the accuracy of these tests, and makes recommendations based on this literature. In brief, a negative RT-PCR nasopharyngeal swab test is insufficient to rule out COVID-19. Thus, over-reliance on the results of the test may be dangerous, and the push for widespread testing may be overstated.


title: Preventing adverse cutaneous reactions from amplified hygiene practices during the COVID-19 pandemic: how dermatologists can help through anticipatory guidance

text: The COVID-19 pandemic has swept the globe with more than 2,000,000 confirmed cases of SARS-CoV-2 infection in 184 countries and territories. According to the Centers for Disease Control and Prevention (CDC), two crucial actions can reduce the risk of person-to-person viral transmission: frequent hand washing and surface decontamination with specific environmental protection agency (EPA)-registered disinfectants. As hygiene recommendations evolve during the COVID-19 pandemic and community members adopt changing practices, dermatologists are likely to see a rise in adverse cutaneous reactions from prolonged irritant exposures and widespread use of antimicrobials. The purposes of this report are to familiarize dermatologists with the hygiene practices recommended for COVID-19 prevention, to highlight adverse cutaneous reactions associated with repeated exposures to detergents and disinfectants, and to discuss strategies which patients can implement during the COVID-19 pandemic to minimize skin irritation white still performing hygiene practices effectively.


To test or not to test? An opportunity to restart dentistry sustainably in the 'COVID-19 era'


title: Infection of bat and human intestinal organoids by SARS-CoV-2

text: A novel coronavirus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-emerged in humans in Wuhan, China, in December 2019 and has since disseminated globally1,2. As of April 16, 2020, the confirmed case count of coronavirus disease 2019 (COVID-19) had surpassed 2 million. Based on full-genome sequence analysis, SARS-CoV-2 shows high homology to SARS-related coronaviruses identified in horseshoe bats1,2. Here we show the establishment and characterization of expandable intestinal organoids derived from horseshoe bats of the Rhinolophus sinicus species that can recapitulate bat intestinal epithelium. These bat enteroids are fully susceptible to SARS-CoV-2 infection and sustain robust viral replication. Development of gastrointestinal symptoms in some patients with COVID-19 and detection of viral RNA in fecal specimens suggest that SARS-CoV-2 might cause enteric, in addition to respiratory, infection3,4. Here we demonstrate active replication of SARS-CoV-2 in human intestinal organoids and isolation of infectious virus from the stool specimen of a patient with diarrheal COVID-19. Collectively, we established the first expandable organoid culture system of bat intestinal epithelium and present evidence that SARS-CoV-2 can infect bat intestinal cells. The robust SARS-CoV-2 replication in human intestinal organoids suggests that the human intestinal tract might be a transmission route of SARS-CoV-2.


title: Real-time tracking of self-reported symptoms to predict potential COVID-19

text: A total of 2,618,862 participants reported their potential symptoms of COVID-19 on a smartphone-based app. Among the 18,401 who had undergone a SARS-CoV-2 test, the proportion of participants who reported loss of smell and taste was higher in those with a positive test result (4,668 of 7,178 individuals; 65.03%) than in those with a negative test result (2,436 of 11,223 participants; 21.71%) (odds ratio = 6.74; 95% confidence interval = 6.31-7.21). A model combining symptoms to predict probable infection was applied to the data from all app users who reported symptoms (805,753) and predicted that 140,312 (17.42%) participants are likely to have COVID-19.


title: Filtration Efficiencies of Nanoscale Aerosol by Cloth Mask Materials Used to Slow the Spread of SARS-CoV-2

text: Filtration efficiency (FE), differential pressure (ΔP), quality factor (QF), and construction parameters were measured for 32 cloth materials (14 cotton, 1 wool, 9 synthetic, 4 synthetic blends, and 4 synthetic/cotton blends) used in cloth masks intended for protection from the SARS-CoV-2 virus (diameter 100 ± 10 nm). Seven polypropylene-based fiber filter materials were also measured including surgical masks and N95 respirators. Additional measurements were performed on both multilayered and mixed-material samples of natural, synthetic, or natural-synthetic blends to mimic cloth mask construction methods. Materials were microimaged and tested against size selected NaCl aerosol with particle mobility diameters between 50 and 825 nm. Three of the top five best performing samples were woven 100% cotton with high to moderate yarn counts, and the other two were woven synthetics of moderate yarn counts. In contrast to recently published studies, samples utilizing mixed materials did not exhibit a significant difference in the measured FE when compared to the product of the individual FE for the components. The FE and ΔP increased monotonically with the number of cloth layers for a lightweight flannel, suggesting that multilayered cloth masks may offer increased protection from nanometer-sized aerosol with a maximum FE dictated by breathability (i.e., ΔP).


title: Filtration Efficiencies of Nanoscale Aerosol by Cloth Mask Materials Used to Slow the Spread of SARS CoV-2

text: Filtration efficiency (FE), differential pressure (ΔP), quality factor (QF) and construction parameters were measured for 32 cloth materials (14 cotton, 1 wool, 9 synthetic, 4 synthetic blends, and 4 synthetic/cotton blends) used in cloth masks intended for protection from the SARS CoV-2 virus (diameter 100 ± 10 nm). Seven polypropylene-based fiber filter materials were also measured, including surgical masks and N95 respirators. Additional measurements were performed on both multi-layered and mixed-material samples of natural, synthetic, or natural-synthetic blends to mimic cloth mask construction methods. Materials were micro-imaged and tested against size selected NaCl aerosol with particle mobility diameters between 50 nm and 825 nm. Three of the top five best performing samples were woven 100% cotton with high to moderate yarn counts and the other two were woven synthetics of moderate yarn counts. In contrast to recently published studies, samples utilizing mixed materials did not exhibit a significant difference in the measured FE when compared to the product of the individual FE for the components. The FE and ΔP increased monotonically with the number of cloth layers for a lightweight flannel, suggesting that multi-layered cloth masks may offer increased protection from nanometer-sized aerosol with a maximum FE dictated by breathability (i.e. ΔP).


title: Registries Offer Insights on COVID-19-Cancer Connection

text: Findings from CCC19 and TERAVOLT suggest that patients with cancer may be more likely to die from COVID-19 than people in the general population. Additional mortality risk factors may include age, performance status, treatment with chemotherapy, and exposure to hydroxychloroquine plus azithromycin.


title: "We're staying at home". Association of self-perceptions of aging, personal and family resources and loneliness with psychological distress during the lock-down period of COVID-19

text: OBJECTIVES: Families are going through a very stressful time because of the COVID-19 outbreak, with age being a risk factor for this illness. Negative self-perceptions of aging, among other personal and relational variables may be associated with loneliness and distress caused by the pandemic crisis. METHOD: Participants are 1310 Spanish people (age range: 18-88 years) during a lock-down period at home. In addition to specific questions about risk for COVID-19, self-perceptions of aging, family and personal resources, loneliness and psychological distress were measured. Hierarchical regression analyses were done for assessing the correlates of loneliness and psychological distress. RESULTS: The measured variables allow for an explanation of 48% and 33% of the variance of distress and loneliness, respectively. Being female, younger, having negative self-perceptions about aging, more time exposed to news about COVID-19, more contact with relatives different to those that co-reside, fewer positive emotions, less perceived self-efficacy, lower quality of sleep, higher expressed emotion and higher loneliness were associated with higher distress. Being female, younger, having negative self-perceptions about aging, more time exposed to news about COVID-19, lower contact with relatives, higher self-perception as a burden, fewer positive emotions, lower resources for entertaining oneself, lower quality of sleep and higher expressed emotion were associated with higher loneliness.


Pediatric COVID-19: An Update on the Expanding Pandemic


title: Assessing Knowledge, Attitudes and Practices of dental practitioners regarding the COVID-19 pandemic: A multinational study

text: BACKGROUND: Coronavirus Disease 2019 (COVID-19) has been declared a global public health emergency that is affecting people across the globe. OBJECTIVES: The aim of this study was to assess the Knowledge, Attitudes and Practices (KAP) of dental practitioners regarding the Coronavirus Disease 2019 (COVID-2019) pandemic. MATERIAL AND METHODS: An online questionnaire was distributed among dentists across the globe using a combination of convenience and snowball sampling. The questionnaire was divided into 4 sections: the 1st one contained personal information, whereas the 2nd, 3rd and 4th sections assessed knowledge (11 questions), attitudes (6 questions) and practices (7 questions) of the dentists. The data was subjected to the Shapiro-Wilk test, one-way analysis of variance (ANOVA), multivariate linear regression, and Pearson's correlation; 95% confidence interval (CI) was calculated and odds ratio (OR) was obtained. The analysis was done using IBM SPSS for Windows, v. 21.0. RESULTS: The total number of the responses received (860) was divided with regard to various continents (Asia, Americas - North and South, Europe, Africa, and other - Australia and Antarctica). The largest number of dentists came from the Asian continent (264; 30.7%). Most dentists had a degree of MDS (Master of Dental Science) (301; 35.0%), followed by BDS (Bachelor of Dental Surgery) (282; 32.8%) and DDS (Doctor of Dental Surgery) (226; 26.3%). High/Good knowledge and practice scores were observed among 92.7% and 79.5 % of the dentists, respectively. Good knowledge scores were significantly associated with qualifications (p = 0.04) and years of practice (p = 0.02); good practice scores were associated with qualifications only (p = 0.03). CONCLUSIONS: The dentists were found to have good knowledge and practice scores, which is important to combat COVID-19. They are advised to follow the Centers of Disease Control and Prevention (CDC) and World Health Organization (WHO) guidelines in their clinics, and sensitize their staff so that no stone is left unturned in defeating this pandemic.


title: Effectiveness of N95 Respirator Decontamination and Reuse against SARS-CoV-2 Virus

text: The coronavirus pandemic has created worldwide shortages of N95 respirators. We analyzed 4 decontamination methods for effectiveness in deactivating severe acute respiratory syndrome coronavirus 2 virus and effect on respirator function. Our results indicate that N95 respirators can be decontaminated and reused, but the integrity of respirator fit and seal must be maintained.


Dermatology patients' knowledge and concerns regarding their immunomodulatory medication during the COVID-19 pandemic


Tough times call for rapid techniques: combating the novel coronavirus


Could Patients With Inflammatory Bowel Disease Treated with Immunomodulators or Biologics Be at Lower Risk for Severe Forms of Covid-19?


title: The Performance of Chest CT in Evaluating the Clinical Severity of COVID-19 Pneumonia: Identifying Critical Cases Based on CT Characteristics

text: OBJECTIVES: The aim of this study was to assess the clinical severity of COVID-19 pneumonia using qualitative and/or quantitative chest computed tomography (CT) indicators and identify the CT characteristics of critical cases. MATERIALS AND METHODS: Fifty-one patients with COVID-19 pneumonia including ordinary cases (group A, n = 12), severe cases (group B, n = 15), and critical cases (group C, n = 24) were retrospectively enrolled. The qualitative and quantitative indicators from chest CT were recorded and compared using Fisher exact test, one-way analysis of variance, Kruskal-Wallis H test, and receiver operating characteristic analysis. RESULTS: Depending on the severity of the disease, the number of involved lung segments and lobes, the frequencies of consolidation, crazy-paving pattern, and air bronchogram increased in more severe cases. Qualitative indicators including total severity score for the whole lung and total score for crazy-paving and consolidation could distinguish groups B and C from A (69% sensitivity, 83% specificity, and 73% accuracy) but were similar between group B and group C. Combined qualitative and quantitative indicators could distinguish these 3 groups with high sensitivity (B + C vs A, 90%; C vs B, 92%), specificity (100%, 87%), and accuracy (92%, 90%). Critical cases had higher total severity score (>10) and higher total score for crazy-paving and consolidation (>4) than ordinary cases, and had higher mean lung density (>-779 HU) and full width at half maximum (>128 HU) but lower relative volume of normal lung density (â¦50%) than ordinary/severe cases. In our critical cases, 8 patients with relative volume of normal lung density smaller than 40% received mechanical ventilation for supportive treatment, and 2 of them had died. CONCLUSIONS: A rapid, accurate severity assessment of COVID-19 pneumonia based on chest CT would be feasible and could provide help for making management decisions, especially for the critical cases.


Sensitivity of the Wondfo One Step COVID-19 test using serum samples


Letter: Emergency Response Plan During the COVID-19 Pandemic: The University of Alabama at Birmingham Experience


title: Quest: Practical and Oblivious Mitigation Strategies for COVID-19 using WiFi Datasets

text: Contact tracing has emerged as one of the main mitigation strategies to prevent the spread of pandemics such as COVID-19. Recently, several efforts have been initiated to track individuals, their movements, and interactions using technologies, e.g., Bluetooth beacons, cellular data records, and smartphone applications. Such solutions are often intrusive, potentially violating individual privacy rights and are often subject to regulations (e.g., GDPR and CCPR) that mandate the need for opt-in policies to gather and use personal information. In this paper, we introduce Quest, a system that empowers organizations to observe individuals and spaces to implement policies for social distancing and contact tracing using WiFi connectivity data in a passive and privacy-preserving manner. The goal is to ensure the safety of employees and occupants at an organization, while protecting the privacy of all parties. Quest incorporates computationally- and information-theoretically-secure protocols that prevent adversaries from gaining knowledge of an individual's location history (based on WiFi data); it includes support for accurately identifying users who were in the vicinity of a confirmed patient, and then informing them via opt-in mechanisms. Quest supports a range of privacy-enabled applications to ensure adherence to social distancing, monitor the flow of people through spaces, identify potentially impacted regions, and raise exposure alerts. We describe the architecture, design choices, and implementation of the proposed security/privacy techniques in Quest. We, also, validate the practicality of Quest and evaluate it thoroughly via an actual campus-scale deployment at UC Irvine over a very large dataset of over 50M tuples.


title: Coronavirus infection and pregnancy (Covid-19)

text: Guidelines The Czech Society for Ultrasound in Obstetrics and Gynecology of the Czech Medical Association of J E Purkyně issues this opinion in connection with statements of the World Health Organization (WHO) and other international authorities regarding the concerns about COVID-19 infection in pregnancy The impact of this year‘s coronavirus COVID-19 infection on pregnant women seems to be less severe than in previous years of H1N1 influenza type A, SARS-CoV or MERS-CoV From the information published so far it was not possible to prove the transmission of infection from mother to fetus It also seems that there is no risk of vertical transmission during breastfeeding This opinion does not replace the recommendations and opinions issued by governmental bodies such as the Ministry of Health and others, and concerns solely consultation of pregnant women


title: In-hospital airway management of COVID-19 patients

text: Those involved in the airway management of COVID-19 patients are particularly at risk. Here, we describe a practical, stepwise protocol for safe in-hospital airway management in patients with suspected or confirmed COVID-19 infection.


COVID-19 and access to labour epidural analgesia in UK hospitals


COVID-19 and Neonatal Resuscitation


Use of systemic immunomodulatory therapies during the coronavirus disease 2019 (COVID-19) pandemic


title: Elevated Serum Endothelial Cell Adhesion Molecules Expression in COVID-19 Patients

text: In a retrospective study of 39 COVID-19 patients and 32 control participants in China, we collected clinical data and examined the expression of endothelial cell adhesion molecules by enzyme-linked immunosorbent assays. Serum levels of fractalkine, vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and vascular adhesion protein-1 (VAP-1) elevated in mild patients, dramatically in severe cases, while decreased in the convalescence phase. In conclusion, the increased expression of endothelial cell adhesion molecules is related to COVID-19 and disease severity and may contribute to coagulation dysfunction.


title: Comparative in silico design and validation of GPS™ CoVID-19 dtec-RT-qPCR Test

text: AIMS: Providing a ready-to-use RT-qPCR method fully validated to detect the SARS-CoV-2 with a higher exclusivity than this shown by early published RT-qPCR designs. METHODS AND RESULTS: The specificity of the GPS™ CoVID-19 dtec-RT-qPCR Test by analysis of sequence alignments was approached and compared with other RT-qPCR designs. The GPS™ CoVID-19 dtec-RT-qPCR Test was validated following criteria of UNE/EN ISO 17025:2005 and ISO/IEC 15189:2012. Diagnostic validation was achieved by two independent reference laboratories, the Instituto de Salud Carlos III, (Madrid, Spain), the Public Health England (Colindale, London, UK), and received the label CE-IVD. The GPS™ design showed the highest exclusivity and passed all parameters of validation with strict acceptance criteria. Results from reference laboratories 100 % correlated with these obtained by using reference methods and showed 100 % of diagnostic sensitivity and specificity. CONCLUSIONS: The CE-IVD GPS™ CoVID-19 dtec-RT-qPCR Test, available worldwide with full analytical and diagnostic validation, is the more exclusive for SARS-CoV-2 by far. SIGNIFICANCE: Considering the CoVID-19 pandemic status, the exclusivity of RT-qPCR tests is crucial to avoid false positives due to related coronaviruses. IMPACT OF STUDY: This work provides of a highly specific and validated RT-qPCR method for detection of SARS-CoV-2, which represents a case of efficient transfer of technology successfully used since the pandemic was declared.


Hydroxychloroquine for Treatment of SARS-CoV-2 Infection? Improving Our Confidence in a Model-Based Approach to Dose Selection


title: La gestione del paziente cardiologico nella fase post-pandemia COVID-19: la proposta dell'ANMCO Regionale Veneto./ [Managing cardiac patients post-COVID-19 pandemic: a proposal by the ANMCO Veneto Region]

text: The COVID-19 post-lockdown period and the subsequent progressive withdrawal of the quarantine measures are currently allowing the gradual resumption of the ordinary clinical activities, which have been suppressed during the COVID-19 pandemic. In this phase, it is crucial to minimize the risk of infection to limit COVID-19-related morbidity and mortality and the number of new cases. Indeed, COVID-19 manifestations may be equivocal, including asymptomatic or mildly symptomatic patients. In order to ensure the safety of patients and healthcare providers, therefore, it is mandatory to stratify the risk of post-COVID-19 pandemic infection during the clinical and instrumental evaluation of cardiac patients, who are at low risk for COVID-19. Here we discuss the most common diagnostic procedures and therapeutic activities, the type of personal protective equipment according to the different tests, the timetable of the different diagnostic examinations, the tele-health services or alternative strategies, and the structural and management requirements, that should be applied to protect patients and healthcare providers in the post-COVID-19 era.


Covid-19: ensuring equality of access to testing for ethnic minorities


title: Mobile smartphone tracing can detect almost all SARS-CoV-2 infections

text: Currently, many countries are considering the introduction of tracing software on mobile smartphones with the main purpose to inform and alarm the mobile app user. Here, we demonstrate that, in addition to alarming and informing, mobile tracing can detect nearly all individuals that are infected by SARS-CoV-2, including the notorious asymptomatic infections. Besides voluntary reports of the infectious health status, our algorithm requires the location information of an overwhelming part of the population and then guarantees that almost all SARS-CoV-2 infections in that closed population can be detected. Our algorithm is based on a hidden Markov epidemic model and recursive Bayesian filtering. The potential that mobile tracing apps, in addition to medical testing and quarantining, can eradicate COVID-19 may persuade citizens to trade-off privacy against public health.


The ORF3a protein of SARS-CoV-2 induces apoptosis in cells


title: Amantadine as a drug to mitigate the effects of COVID-19

text: The SARS-CoV-2 virus has spread around the world. At this time, there is no vaccine that can help people prevent the spread of coronavirus. We are proposing amantadine as a drug that can be used to mitigate the effects of the virus. It is demonstrated by docking models how amantadine can exert its action on Coronavirus viroporin E.


title: Evaluating the national PPE guidance for NHS healthcare workers during the COVID-19 pandemic

text: Tragically, many of the infections and deaths recorded in the global coronavirus disease 2019 (COVID-19) pandemic have occurred in healthcare workers. Some have attributed this to inadequate provision of personal protective equipment (PPE). In the UK, several organisations have voiced their concerns that the national PPE guidance issued by Public Health England is inadequate. Despite recent revisions to these guidelines, concerns remain that they offer insufficient protection to frontline NHS healthcare workers. In this report, we evaluate whether these concerns are merited, through critical appraisal of the available evidence, review of international PPE guidance, and consideration of the ethical implications.


title: Anesthetic concerns for pediatric patients in the era of COVID-19

text: After a novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was reported in China in December 2019, the disease quickly reached pandemic level. On January 30, 2020, the World Health Organization (WHO) declared that the SARS-CoV-2 outbreak constituted a Public Health Emergency of International Concern. The caseload has increased exponentially, with WHO reporting 182 000 global cases by March 17, 2020, and over 2.6 million by 23 April. The clinical situation is complex, with children presenting different clinical features compared to adults. Several articles with recommendations on the anesthetic management of adult patients with COVID-19 have been published, but no specific recommendations for pediatric anesthesiologists have been made yet. This article addresses specific concerns for the anesthetic management of the pediatric population with COVID-19.


Pooling of nasopharyngeal swab specimens for SARS-CoV-2 detection by RT-PCR


title: Why are pregnant women susceptible to COVID-19? An immunological viewpoint

text: The 2019 novel coronavirus disease (COVID-19) was first detected in December 2019 and became epidemic in Wuhan, Hubei Province, China. COVID-19 has been rapidly spreading out in China and all over the world. The virus causing COVID-19, SARS-CoV-2 has been known to be genetically similar to severe acute respiratory syndrome coronavirus (SARS-CoV) but distinct from it. Clinical manifestation of COVID-19 can be characterized by mild upper respiratory tract infection, lower respiratory tract infection involving non-life threatening pneumonia, and life-threatening pneumonia with acute respiratory distress syndrome. It affects all age groups, including newborns, to the elders. Particularly, pregnant women may be more susceptible to COVID-19 since pregnant women, in general, are vulnerable to respiratory infection. In pregnant women with COVID-19, there is no evidence for vertical transmission of the virus, but an increased prevalence of preterm deliveries has been noticed. The COVID-19 may alter immune responses at the maternal-fetal interface, and affect the well-being of mothers and infants. In this review, we focused on the reason why pregnant women are more susceptible to COVID-19 and the potential maternal and fetal complications from an immunological viewpoint.


Refugees besieged: The lurking threat of COVID-19 in Syrian war refugee camps


Could MEFV mutation carriage status have a protective role for COVID-19 pandemic?


title: Clinical characteristics of 34 COVID-19 patients admitted to intensive care unit in Hangzhou, China

text: OBJECTIVE: This study summarizes and compares clinical and laboratory characteristics of 34 patients admitted to the intensive care unit (ICU) for complications from coronavirus disease 2019 (COVID-19) at the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China from Jan. 22 to Mar. 5, 2020. METHODS: A total of 34 patients were divided into two groups, including those who required noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) with additional extracorporeal membrane oxygenation (ECMO) in 11 patients. Clinical features of COVID-19 patients were described and the parameters of clinical characteristics between the two groups were compared. RESULTS: The rates of the acute cardiac and kidney complications were higher in IMV cases than those in NIV cases. Most patients had lymphocytopenia on admission, with lymphocyte levels dropping progressively on the following days, and the more severe lymphopenia developed in the IMV group. In both groups, T lymphocyte counts were below typical lower limit norms compared to B lymphocytes. On admission, both groups had higher than expected amounts of plasma interleukin-6 (IL-6), which over time declined more in NIV patients. The prothrombin time was increased and the levels of platelet, hemoglobin, blood urea nitrogen (BUN), D-dimer, lactate dehydrogenase (LDH), and IL-6 were higher in IMV cases compared with NIV cases during hospitalization. CONCLUSIONS: Data showed that the rates of complications, dynamics of lymphocytopenia, and changes in levels of platelet, hemoglobin, BUN, D-dimer, LDH and IL-6, and prothrombin time in these ICU patients were significantly different between IMV and NIV cases.


Limiting the spread of COVID-19 in Africa: one size mitigation strategies do not fit all countries


From bench to bedside - Development of an integrated COVID-19 patient flow management system


title: COVID-19 in the UK and Occupational Health and Safety: Predictable not Inevitable Failures by Government, and Trade Union and Nongovernmental Organization Responses

text: This commentary examines the occupational health and safety issues faced by the UK workers in the COVID-19 pandemic, against the background of government cuts in health care and in occupational health and safety budgets, and a deregulatory climate. The UK government has been obsessed, blinkered, and distracted by the desire to leave the European Union (Brexit). The state of knowledge about the virus, especially from international agencies that identified pandemic threats and strategies to combat it, is outlined. UK politicians, government bodies, medical and scientific advisors, and employers periodically ignored or abused that knowledge. Regulatory and ministerial inaction and errors on the workplace virus risks emerged. In contrast, several trade unions, health professional bodies, and nongovernmental organizations identified COVID-19 threats from poor personal protection equipment, working practices, and knowledge gaps and offered solutions for health care workers, social care workers, production workers, and service workers in "essential" occupations.


title: Security Survey and Analysis of Vote-by-Mail Systems

text: Voting by mail has been gaining traction for decades in the United States and has emerged as the preferred voting method during the COVID-19 pandemic. In this paper, we examine the security of electronic systems used in the process of voting by mail, including online voter registration and online ballot tracking systems. The goals of these systems, to facilitate voter registration and increase public confidence in elections, are laudable. They indisputably provide a critical public good. It is for these reasons that understanding the security and privacy posture of the mail-in voting process is paramount. We find that online voter registration systems in some states have vulnerabilities that allow adversaries to alter or effectively prevent a voter's registration. We additionally find that ballot tracking systems raise serious privacy questions surrounding ease of access to voter data. While the vulnerabilities discussed here are unlikely to enable an adversary to modify votes, several could have the effect of disenfranchising voters and reducing voter confidence in U.S. elections infrastructure, thereby undermining the very purpose of these systems.


title: Positive Public Health Ethics: Toward Flourishing and Resilient Communities and Individuals

text: The COVID-19 pandemic is a global contagion of unprecedented proportions and health, economic, and social consequences. As with many health problems, its impact is uneven. This article argues the COVID-19 pandemic is a global health injustice due to moral failures of national governments and international organizations to prepare for, prevent and control it. Global and national health communities had a moral obligation to act in accordance with the current state of knowledge of pandemic preparedness. This obligation-a positive duty to develop and implement systems to reduce threats to and safeguard individuals' and, communities' abilities to flourish-stems from theories of global health justice and governance. The COVID-19 pandemic revealed and amplified the fragility and deficiencies in our global and domestic health institutions and systems. Moving forward, positive public health ethics is needed to set ethical standards for building and operating robust public health systems for resilient individuals and communities.


title: Validating a low-cost laser speckle contrast imaging system as a quantitative tool for assessing retinal vascular function

text: The ability to monitor progression of retinal vascular diseases like diabetic retinopathy in small animal models is often complicated by their failure to develop the end-stage complications which characterize the human phenotypes in disease. Interestingly, as micro-vascular dysfunction typically precedes the onset of retinal vascular and even some neurodegenerative diseases, the ability to visualize and quantify hemodynamic changes (e.g. decreased flow or occlusion) in retinal vessels may serve as a useful diagnostic indicator of disease progression and as a therapeutic outcome measure in response to treatment. Nevertheless, the ability to precisely and accurately quantify retinal hemodynamics remains an unmet challenge in ophthalmic research. Herein we demonstrate the ability to modify a commercial fundus camera into a low-cost laser speckle contrast imaging (LSCI) system for contrast-free and non-invasive quantification of relative changes to retinal hemodynamics over a wide field-of-view in a rodent model.


Feasibility Study of Mixing Throat Swab Samples for Severe Acute Respiratory Syndrome Coronavirus-2 Screening


Convalescent plasma therapy: A passive therapy for an aggressive COVID-19


COVID-19: differences de symptomatologie entre la Chine et lEurope


Defining causality in COVID-19 and neurological disorders


title: COVID-19-Related Factors Associated with Sleep Disturbance and Suicidal Thoughts among the Taiwanese Public: A Facebook Survey

text: Coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of people's lives all over the world. This Facebook survey study aimed to investigate the COVID-19-related factors that were associated with sleep disturbance and suicidal thoughts among members of the public during the COVID-19 pandemic in Taiwan. The online survey recruited 1970 participants through a Facebook advertisement. Their self-reported experience of sleep disturbance and suicidal thoughts in the previous week were collected along with a number of COVID-19-related factors, including level of worry, change in social interaction and daily lives, any academic/occupational interference, levels of social and specific support, and self-reported physical health. In total, 55.8% of the participants reported sleep disturbance, and 10.8% reported having suicidal thoughts in the previous week. Multiple COVID-19-related factors were associated with sleep disturbance and suicidal thoughts in the COVID-19 pandemic. Increased worry about COVID-19, more severe impact of COVID-19 on social interaction, lower perceived social support, more severe academic/occupational interference due to COVID-19, lower COVID-19-specified support, and poorer self-reported physical health were significantly associated with sleep disturbance. Less handwashing, lower perceived social support, lower COVID-19-specified support, poorer self-reported physical health, and younger age were significantly associated with suicidal thoughts. Further investigation is needed to understand the changes in mental health among the public since the mitigation of the COVID-19 pandemic.


title: Association of viral load with serum biomakers among COVID-19 cases

text: Since SARS-CoV-2 spreads rapidly around the world, data have been needed on the natural fluctuation of viral load and clinical indicators associated with it. We measured and compared viral loads of SARS-CoV-2 from pharyngeal swab, IgM anti-SARS-CoV-2, CRP and SAA from serum of 114 COVID-19 patients on admission. Positive rates of IgM anti-SARS-CoV-2, CRP and SAA were 80.7%, 36% and 75.4% respectively. Among IgM-positive patients, viral loads showed different trends among cases with different severity, While viral loads of IgM-negative patients tended to increase along with the time after onset. As the worsening of severity, the positive rates of CRP and SAA also showed trends of increase. Different CRP/SAA type showed associations with viral loads in patients in different severity and different time after onset. Combination of the IgM and CRP/SAA with time after onset and severity may give suggestions on the viral load and condition judgment of COVID-19 patients.


title: Forecasting COVID-19 Transmission and Healthcare Capacity in Bali, Indonesia

text: OBJECTIVES: In the current early phase of the coronavirus disease 2019 (COVID-19) outbreak, Bali needs to prepare to face the escalation of cases, with a particular focus on the readiness of healthcare services. We simulated the future trajectory of the epidemic under current conditions, projected the impact of policy interventions, and analyzed the implications for healthcare capacity. METHODS: Our study was based on the first month of publicly accessible data on new confirmed daily cases. A susceptible, exposed, infected, recovered (SEIR) model for COVID-19 was employed to compare the current dynamics of the disease with those predicted under various scenarios. RESULTS: The fitted model for the cumulative number of confirmed cases in Bali indicated an effective reproduction number of 1.4. Interventions have decreased the possible maximum number of cases from 71 125 on day 86 to 22 340 on day 119, and have prolonged the doubling time from about 9 days to 21 days. This corresponds to an approximately 30% reduction in transmissions from cases of mild infections. There will be 2780 available hospital beds, and at the peak (on day 132), the number of severe cases is estimated to be roughly 6105. Of these cases, 1831 will need intensive care unit (ICU) beds, whereas the number of currently available ICU beds is roughly 446. CONCLUSIONS: The healthcare system in Bali is in danger of collapse; thus, serious efforts are needed to improve COVID-19 interventions and to prepare the healthcare system in Bali to the greatest extent possible.


title: The CREST-2 experience with the evolving challenges of COVID-19: A clinical trial in a pandemic

text: The coronavirus disease 2019 pandemic has disrupted the lives of whole communities and nations. The multinational multicenter National Institute of Neurological Disorders and Stroke Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial stroke prevention trial rapidly experienced the effects of the pandemic and had to temporarily suspend new enrollments and shift patient follow-up activities from in-person clinic visits to telephone contacts. There is an ethical obligation to the patients to protect their health while taking every feasible step to ensure that the goals of the trial are successfully met. Here, we describe the effects of the pandemic on the trial and steps that are being taken to mitigate the effects of the pandemic so that trial objectives can be met.


Virtual clinics: Need of the hour, a way forward in the future. Adapting practice during a healthcare crisis


title: Will the Current COVID-19 Pandemic Impact on Long-Term Cannabis Buying Practices?

text: The COVID-19 pandemic and the response to have resulted in an increase in sales activity levels on darknet markets during the first three months of 2020, mainly related to cannabis products. One key question is whether more people will become used to this form of purchasing their drugs and will they continue with it post COVID-19 lockdown. As one-to-one encrypted communication services or social media apps are increasingly being used, monitoring and interdiction will become much more challenging.


Nursing homes and COVID-19: We can and should do better


Effective strategies to prevent in-hospital infection in the emergency department during the novel coronavirus disease 2019 pandemic


title: Ly6cLo non-classical monocytes promote resolution of rhesus rotavirus-mediated perinatal hepatic inflammation

text: Perinatal hepatic inflammation can have devastating consequences. Monocytes play an important role in the initiation and resolution of inflammation, and their diverse functions can be attributed to specific cellular subsets: pro-inflammatory or classical monocytes (Ly6cHi) and pro-reparative or non-classical monocytes (Ly6cLo). We hypothesized that inherent differences in Ly6cHi classical monocytes and Ly6cLo non-classical monocytes determine susceptibility to perinatal hepatic inflammation in late gestation fetuses and neonates. We found an anti-inflammatory transcriptional profile expressed by Ly6cLo non-classical monocytes, and a physiologic abundance of these cells in the late gestation fetal liver. Unlike neonatal pups, late gestation fetuses proved to be resistant to rhesus rotavirus (RRV) mediated liver inflammation. Furthermore, neonatal pups were rendered resistant to RRV-mediated liver injury when Ly6cLo non-classical monocytes were expanded. Pharmacologic inhibition of Ly6cLo non-classical monocytes in this setting restored susceptibility to RRV-mediated disease. These data demonstrate that Ly6cLo monocytes promote resolution of perinatal liver inflammation in the late gestation fetus, where there is a physiologic expansion of non-classical monocytes, and in the neonatal liver upon experimental expansion of these cells. Therapeutic strategies directed towards enhancing Ly6cLo non-classical monocyte function may mitigate the detrimental effects of perinatal liver inflammation.


title: Epidemiological and clinical features of asymptomatic patients with SARS-CoV-2 infection

text: Few studies reported the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients with completely asymptomatic throughout the disease course. We investigated the epidemiological and clinical features of patients infected by SARS-CoV-2 without any symptoms. Patients with confirmed SARS-CoV-2 infection were retrospectively recruited. The demographic characteristics, clinical data, treatment, and outcomes of SARS-CoV-2 infected patients without any symptoms were analyzed. Fifteen (4.4%) of 342 SARS-CoV-2 infected patients did not develop any symptom during the course of the disease. The median time from exposure to diagnosis was 7.0 days (interquartile range [IQR]: 1.0-15.0 days). Of the 15 patients, 14 patients were diagnosed by tested positive for SARS-CoV-2 in throat swabs, while one patient was only tested positive for SARS-CoV-2 in anal swabs. During hospitalization, only 1 (6.7%) patient developed lymphopenia. Abnormalities of chest computed tomography examinations were detected in 8 (53.4%) patients on admission. As of 8 March 2020, all patients have been discharged. The median time of SARS-CoV-2 tested negative from admission was 7.0 days (IQR: 4.0-9.0 days). Patients without any symptoms but with SARS-CoV-2 exposure should be closely monitored and tested for SARS-CoV-2 both in anal and throat swabs to excluded the infection. Asymptomatic patients infected by SARS-CoV-2 have favorable outcomes.


The COVID-19 pandemic will redefine the future delivery of glaucoma care


title: Prognostic value of NT-proBNP in patients with severe COVID-19

text: BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China has been declared a public health emergency of international concern. The cardiac injury is a common condition among the hospitalized patients with COVID-19. However, whether N terminal pro B type natriuretic peptide (NT-proBNP) predicted outcome of severe COVID-19 patients was unknown. METHODS: The study initially enrolled 102 patients with severe COVID-19 from a continuous sample. After screening out the ineligible cases, 54 patients were analyzed in this study. The primary outcome was in-hospital death defined as the case fatality rate. Research information and following-up data were obtained from their medical records. RESULTS: The best cut-off value of NT-proBNP for predicting in-hospital death was 88.64 pg/mL with the sensitivity for 100% and the specificity for 66.67%. Patients with high NT-proBNP values (> 88.64 pg/mL) had a significantly increased risk of death during the days of following-up compared with those with low values (≤88.64 pg/mL). After adjustment for potential risk factors, NT-proBNP was independently correlated with in-hospital death. CONCLUSION: NT-proBNP might be an independent risk factor for in-hospital death in patients with severe COVID-19. TRIAL REGISTRATION: ClinicalTrials, NCT04292964. Registered 03 March 2020.


title: Impact of new coronavirus epidemics on HIV-infected patients

text: Since the first report of a cluster of pneumonia cases in Wuhan (China) at the end of 2019 due to a new airborne highly transmissible coronavirus known as SARS-CoV-2, large-scale spreading has rapidly become a global concern Up to the end of February 2020, more than 85,000 cases had been confirmed worldwide, mostly in China, with more than 3,000 deaths Figures are increasing on a daily basis, being unpredictable what will happen next Table 1 summarizes figures for major outbreaks due to acute viral infections recorded during the past 50 years


Covid-19: Doctors performing resuscitation need higher level of PPE, says royal college


Reshaping the future of ethnobiology research after the COVID-19 pandemic


title: Direct Comparison of SARS-CoV-2 Analytical Limits of Detection across Seven Molecular Assays

text: Analytical sensitivity for SARS-CoV-2 detection is a key performance metric for evaluation of viral detection assays. We determined analytical limits of detection for seven SARS-CoV-2 assays using serial dilutions of pooled patient material quantified with droplet digital PCR. Limits of detection ranged from ≤10-74 copies/mL for commercial high-throughput laboratory analyzers (Roche Cobas, Abbott m2000, Hologic Panther Fusion) and 167-511 copies/mL for sample to answer (Diasorin Simplexa, Genmark ePlex) and point of care instruments (Abbott ID NOW). The CDC assay yielded limits of detection ranging from 85-499 copies/mL, depending on the extraction method and thermocycler used. These results can help to inform the assay choice for testing approaches to manage the current COVID-19 outbreak.


Radiology Department Preparedness for COVID-19: Radiology Scientific Expert Panel


title: The management of surgical patients during the coronavirus disease 2019 (COVID-19) pandemic

text: BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has raised several issues regarding the management of surgical patients. The aim of the current study was to clarify the management of oncologic and surgical patients during the pandemic. METHODS: Relevant publications reporting on the epidemiology of the pandemic, the diagnosis of the severe acute respiratory syndrome coronavirus 2 infection, and the clinical management of cancer and surgical patients, as well as studies concerning health care workers' safety, were included. The last date of research for this study was April 4, 2020. RESULTS: We analyzed 28 papers. Real-time polymerase chain reaction was considered the gold standard for the diagnosis of COVID-19, and computed tomography scans were considered useful for cases of diagnostic uncertainty. Cancer patients and surgical patients were confirmed to be particularly at risk of infection and negative outcome. To guarantee adequate care to these patients, while minimizing the risk for infection, the early postponing of elective surgery, the creation of COVID-free facilities and the identification of COVID- dedicated operating theaters and teams have been proposed. The correct use of personal protective equipment was also strongly advocated, along with the institution of facilities for the psychologic support of health care workers. CONCLUSION: Clinicians should be aware of the importance of providing adequate care to patients with urgent and nondeferrable clinical issues, such as cancer. Every effort should be made to contain the virus spread in the hospital setting. Also, clinicians should value the importance of self-protection and mental health care.


title: Serum Hydrogen Sulfide and Outcome Association in Pneumonia by the SARS-CoV-2 Corona virus

text: BACKGROUND: The pneumonia of COVID-19 illness has often a subtle initial presentation making mandatory the use of biomarkers for evaluation of severity and prediction of final patient disposition. We evaluated the use of hydrogen sulfide (H2S) for the outcome of COVID-19 pneumonia. MATERIALS & METHODS: We studied 74 patients with COVID-19. Clinical data were collected, and survival predictors were calculated. Blood was collected within 24âhours after admission (day 1) and on day 7. H2S was measured in sera by monobromobimane derivation (MBB) followed by high performance liquid chromatography and correlated to other markers like procalcitonin (PCT) and C- reactive protein (CRP). Tumor necrosis factor alpha (TNFα) and interleukin (IL)-6 were also measured in serum. RESULTS: Survivors had significantly higher H2S levels on day 1 and 7 after admission. A cut-off point of 150.44âµM could discriminate survivors from non-survivors with 80% sensitivity, 73.4% specificity and negative predictive value 95.9%. Mortality after 28 days was 32% with admission levels lower or equal to 150.44âµΜ and 4.1% with levels above 150.44âµΜ (p: 0.0008). Mortality was significantly greater among patients with a decrease of H2S levels from day 1 to day 7 greater or equal to 36% (p: 0.0005). Serum H2S on day 1 was negatively correlated with IL- 6 and CRP and positively correlated with the absolute lymphocyte count in peripheral blood. CONCLUSION: It is concluded that H2S is a potential marker for severity and final outcome of pneumonia by the SARS-CoV-2 coronavirus. Its correlation with IL- 6 suggests anti-inflammatory properties.


title: Severe air pollution links to higher mortality in COVID-19 patients: The "double-hit" hypothesis

text: OBJECTIVES: In areas of SARS-CoV-2 outbreak worldwide mean air pollutants concentrations vastly exceed the maximum limits. Chronic exposure to air pollutants have been associated with lung ACE-2 over-expression which is known to be the main receptor for SARS-CoV-2. The aim of this study was to analyse the relationship between air pollutants concentration (PM 2.5 and NO2) and COVID-19 outbreak, in terms of transmission, number of patients, severity of presentation and number of deaths. METHODS: COVID-19 cases, ICU admissions and mortality rate were correlated with severity of air pollution in the Italian regions. RESULTS: The highest number of COVID-19 cases were recorded in the most polluted regions with patients presenting with more severe forms of the disease requiring ICU admission. In these regions, mortality was two-fold higher than the other regions. CONCLUSIONS: From the data available we propose a "double-hit hypothesis": chronic exposure to PM 2.5 causes alveolar ACE-2 receptor overexpression. This may increase viral load in patients exposed to pollutants in turn depleting ACE-2 receptors and impairing host defences. High atmospheric NO2 may provide a second hit causing a severe form of SARS-CoV-2 in ACE-2 depleted lungs resulting in a worse outcome.


title: Ethical dilemmas in clinical care during COVID-19 pandemic

text: In a short span of a few weeks, the COVID-19 pandemic has affected the entire world like no other event in modern history. Healthcare institutions and providers have been at the forefront of containing the ravages of this disease, and are experiencing unprecedented challenges. Medical decision making has become all the more complex because of the moral weight of difficult decisions that need to be made. This paper discusses three areas where ethical decision making is extremely important: dealing with those patients with COVID-19 who no longer have access to their doctors; following ethical criteria for assigning risky duties to healthcare professionals; and in making life and death decisions while allocating scarce resources. This paper describes a national level guidance document for the COVID-19 pandemic that is designed to facilitate ethical decision-making.


title: Using Patient Engagement Platforms in the Postoperative Management of Patients

text: PURPOSE OF REVIEW: The purpose of this review is to contextualize the topic of patient engagement in orthopedic surgery. There will be a specific focus on patient engagement platforms and the impact on outcomes and orthopedic clinical workflows. RECENT FINDINGS: In an attempt to engage patients and optimize the orthopedic perioperative surgical home, patient engagement platforms have emerged in the form of portals, mobile health applications, and chatbots. Collectively, these platforms have improved patient satisfaction scores and outcomes. Patient portals, mobile health applications, and chatbots can engage orthopedic patients and improve the effectiveness of the perioperative orthopedic surgical home. There are specific differences in these applications that should be noted and accounted for. When deciding to incorporate one of these systems into your practice, it is paramount to identify what you are looking to improve upon within your health system and choose a platform accordingly.


The other side of novel coronavirus outbreak: Fear of performing cardiopulmonary resuscitation


title: Relational lockdown and relational trauma* in the time of Coronavirus: a reflection from a UK family therapist

text: Like a meteor hitting the earth's surface, 41,698* unexpected deaths have shaken, disturbed and saddened the core of our Nation. This reflection considers the consequences of the Coronavirus crisis on the UK with particular reference to the impact on families and on the practice of family therapists. The perspective presented can only be partial because of the fast changing situation and the limited access to alternative perspectives that is available during this period of relational lockdown. The author provides a systemic understanding of what has happened and what is happening.


Recommendations for diagnosis and treatment of onychomycosis during the COVID-19 pandemic


Looking at intra-hospital non COVID-19 mortality among elderly patients during COVID-19 pandemic


title: Lymphopenia in COVID-19: Therapeutic opportunities

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is uncontrollably spread all over the world. The host immune responses strongly try to confront it with all the potential cells and cytokines. With chronically condition of SARS-CoV-2, natural killer cells and T cells become exhausted and decreasing their count leads to lymphopenia. Inability to eradicate the infected organ makes hyperinitiation of the immune system, which releases the excessive inflammatory cytokines to compensate the exhausted one as well as the low lymphocytes counts; it consequently leads to the cytokine storm syndrome. These mechanisms and the potential therapeutic targeting are discussed in this paper.


title: COVID-19 and clinical mimics. Correct diagnosis is the key to appropriate therapy

text: As of 29 April 2020, across the globe, there are 3,216,353 confirmed Coronavirus disease 2019 (COVID-19 disease) with 227,894 deaths. The health care infrastructure of most of the countries is overwhelmed due to the gigantic upsurge of the new cases within a short time period. Most of the beds in the regular wards and critical care units are currently occupied by either people under investigation (PUI) or COVID-19 confirmed cases. We hereby discuss the challenges faced while approaching any case of shortness of breath, or other common upper respiratory symptoms during the current COVID-19 pandemic era.


Operational protocol for donation of anti-COVID-19 convalescent plasma in Italy


title: Depression Detection with Multi-Modalities Using a Hybrid Deep Learning Model on Social Media

text: Social networks enable people to interact with one another by sharing information, sending messages, making friends, and having discussions, which generates massive amounts of data every day, popularly called as the user-generated content. This data is present in various forms such as images, text, videos, links, and others and reflects user behaviours including their mental states. It is challenging yet promising to automatically detect mental health problems from such data which is short, sparse and sometimes poorly phrased. However, there are efforts to automatically learn patterns using computational models on such user-generated content. While many previous works have largely studied the problem on a small-scale by assuming uni-modality of data which may not give us faithful results, we propose a novel scalable hybrid model that combines Bidirectional Gated Recurrent Units (BiGRUs) and Convolutional Neural Networks to detect depressed users on social media such as Twitter-based on multi-modal features. Specifically, we encode words in user posts using pre-trained word embeddings and BiGRUs to capture latent behavioural patterns, long-term dependencies, and correlation across the modalities, including semantic sequence features from the user timelines (posts). The CNN model then helps learn useful features. Our experiments show that our model outperforms several popular and strong baseline methods, demonstrating the effectiveness of combining deep learning with multi-modal features. We also show that our model helps improve predictive performance when detecting depression in users who are posting messages publicly on social media.


title: How to perform a nasopharyngeal swab in adults and children in the COVID-19 era

text: The nasopharyngeal swab is currently the main testing method used to diagnose COVID-19. The principle is to collect respiratory cells infected by the virus and to use the RT-PCR (Reverse Transcription - Polymerase Chain Reaction) technique to detect the RNA of the virus. The false negative rate is high, about 30%, which can mainly be explained by an incorrect execution of the technique may increase the false negative rate and decrease the test's sensitivity. The aim of this note is to help healthcare providers to perform this test correctly in adults and children.


In 1969 man landed on the moon, how can we also eradicate COVID-19?


title: Covid-19: factors associated with emotional distress and psychological morbidity in spanish population./ COVID-19: Factores asociados al malestar emocional y morbilidad psiquica en poblacion espanola

text: OBJECTIVE: The socio-health emergency caused by COVID-19 may have a significant psychological impact on the population For this reason, it is necessary to identify especially vulnerable social groups and protective factors that may reduce this impact, which was the objective of this study METHODS: Using snowball sampling approach, 1,596 people residing in Spain during the lockdown answered an online questionnaire that included information on sociodemographic variables, symptoms, and contact with the disease, risk perception, precautionary measures to prevent infection and coping strategies during lockdown Psychological impact was assessed using the Impact of Event Scale-Revised (IES-R), and mental health status with the Goldberg's General Health Questionnaire (GHQ-12) Simple linear regression models were performed to analyze the associations between the study variables and the psychological impact of the pandemic and the mental health of the participants RESULTS: Of all respondents, 24 7% reported a moderate or severe psychological impact, and 48 8% showed mental health problems Women, students and the population with a lower level of economic income, in addition to those having less available space per person in the household presented a more significant psychological impact and worse mental health Living with someone from the high-risk vulnerable group, and anticipating the adverse economic effects of social-health crisis raised the emotional distress and psychological morbidity Precautionary measures to prevent infection did not present a connection to the psychological impact of the pandemic;however, several coping strategies did help to reduce it CONCLUSIONS: These findings outline the existence of especially vulnerable social groups to the impact of the pandemic, and suggest lines of action that help reduce the psychosocial consequences of COVID-19 OBJETIVO: La emergencia socio-sanitaria provocada por la COVID-19 puede tener un importante impacto psicologico en la poblacion Por este motivo, resulta necesario identificar los grupos sociales especialmente vulnerables al impacto de la pandemia y los factores de proteccion que pueden reducirlo, lo que constituyo el objetivo de este estudio METODOS: Mediante muestreo tipo bola de nieve, 1 596 personas residentes en Espana durante la cuarentena contestaron un cuestionario online que incluyo informacion sobre variables sociodemograficas, sintomas y contacto con la enfermedad, percepcion del riesgo, conductas para prevenir el contagio y estrategias para afrontar la cuarentena El impacto psicologico se evaluo mediante la Escala de Impacto de Evento-Revisada (IES-R), y el estado de salud mental con el Cuestionario de Salud General de Goldberg (GHQ-12) Mediante diferentes modelos de regresion lineal simple se analizo la relacion de las variables del estudio con el impacto psicologico de la pandemia y la salud mental de los participantes RESULTADOS: El 24,7% de los participantes presento un impacto psicologico moderado o severo y el 48,8% mostro deterioro de la salud mental Las mujeres, los estudiantes y la poblacion con menor nivel de ingresos economicos, ademas de con menos espacio disponible por persona en la vivienda, presentaron mayor impacto psicologico y peor salud mental Convivir con personas de riesgo y prever los efectos economicos negativos de la crisis socio-sanitaria elevaron el malestar emocional y la morbilidad psiquica Aunque las medidas para prevenir el contagio no se relacionaron con el impacto psicologico, determinadas estrategias de afrontamiento si ayudaron a reducirlo CONCLUSIONES: Estos hallazgos perfilan la existencia de determinados grupos sociales especialmente sensibles al impacto de la pandemia, y sugieren lineas de accion que ayuden a reducir las secuelas psicosociales de la COVID-19


title: [Covid-19: factors associated with emotional distress and psychological morbidity in spanish population.]

text: OBJECTIVE: The socio-health emergency caused by COVID-19 may have a significant psychological impact on the population For this reason, it is necessary to identify especially vulnerable social groups and protective factors that may reduce this impact, which was the objective of this study METHODS: Using snowball sampling approach, 1,596 people residing in Spain during the lockdown answered an online questionnaire that included information on sociodemographic variables, symptoms, and contact with the disease, risk perception, precautionary measures to prevent infection and coping strategies during lockdown Psychological impact was assessed using the Impact of Event Scale-Revised (IES-R), and mental health status with the Goldberg's General Health Questionnaire (GHQ-12) Simple linear regression models were performed to analyze the associations between the study variables and the psychological impact of the pandemic and the mental health of the participants RESULTS: Of all respondents, 24 7% reported a moderate or severe psychological impact, and 48 8% showed mental health problems Women, students and the population with a lower level of economic income, in addition to those having less available space per person in the household presented a more significant psychological impact and worse mental health Living with someone from the high-risk vulnerable group, and anticipating the adverse economic effects of social-health crisis raised the emotional distress and psychological morbidity Precautionary measures to prevent infection did not present a connection to the psychological impact of the pandemic;however, several coping strategies did help to reduce it CONCLUSIONS: These findings outline the existence of especially vulnerable social groups to the impact of the pandemic, and suggest lines of action that help reduce the psychosocial consequences of COVID-19


title: Patients of COVID-19 may benefit from sustained Lopinavir-combined regimen and the increase of Eosinophil may predict the outcome of COVID-19 progression

text: OBJECTIVES: To explore the epidemiological information, clinical characteristics, therapeutic outcomes and temporal progression of laboratory findings in 2019-coronavirus disease (COVID-19) patients exposed to lopinavir. METHODS: We collected data from ten COVID-19 patients admitted between January 22, 2020 and February 11, 2020 at Xixi hospital in Hangzhou, China. RESULTS: Of ten patients, secondary, tertiary and quartus patients emerged; the incubation period was 3-7 days. Mainly initial symptoms were cough and low fever (37.3-38.0°C). An asymptomatic case presented normal radiography, the others had ground glass opacities. All cases (three transferred, seven discharged) were exposed to lopinavir on initial hospitalization. Three patients stopped lopinavir because of adverse effects, two of them deteriorated, one was hospitalized longer than others who with sustained lopinavir use. Levels of potassium, albumin, and lymphocytes were low, but increased persistently after treatment. Eosinophil values were low on initial hospitalization, then all returned to normal before discharge. Viral load of SARS-CoV-2, radiography and eosinophil improved continuously in 3-14, 6-8 and 7-9 days, respectively. CONCLUSIONS: Increasing eosinophils may be an indicator of COVID-19 improvement. The COVID-19 patients may benefit from sustained lopinavir use. More research on a larger scale is needed to verify these points.


Posttraumatic stress symptoms and attitude toward crisis mental health services among clinically stable patients with COVID-19 in China


Bracing the storm: infection control for endoscopy trainees during the COVID-19 pandemic in New York City


title: Cyberpsychology research and COVID-19

text: â¢Research in cyberpsychology is needed during the COVID-19 pandemic.â¢COVID-19 elicits new challenges for cyrberpsychology research.â¢Online technologies will be part of the solution to mitigate the crisis.


title: Inducción de tormenta de citocinas en pacientes infectados con SARS- CoV-2 y desarrollo de COVID-19: Tiene el tracto gastrointestinal alguna relación en la gravedad?

text: Los coronavirus son una extensa familia de virus;algunos pueden ser causa de diversas enfermedades humanas, que van desde el resfriado común hasta el síndrome respiratorio agudo severo La enfermedad por coronavirus (COVID-19) es causada por el coronavirus zoonótico SARS-CoV-2, y comenzó en China en diciembre de 2019 En marzo de 2020, la Organización Mundial de la Salud (OMS) lo declaró una pandemia mundial Esta enfermedad tiene un gran espectro de signos y síntomas, predominantemente se presenta con tos y fiebre, lo que resulta en una proporción de pacientes que desarrollan síndrome de dificultad respiratoria aguda (SDRA) Se ha planteado que la afectación pulmonar grave por el virus puede ser causada también por hiperinflamación y un cuadro similar a la linfohistiocitosis hemofagocítica (HLH), el cual es un síndrome clínico provocado por una respuesta inadecuada del sistema inmunológico a un desencadenante, sea infec-cioso, neoplásico, metabólico o reumatológico, que resulta en una reacción inflamatoria desproporcionada Esta respuesta inmune altamente activada causa una liberación exagerada o tormenta de citocinas respon-sable del cuadro clínico De allí la importancia de revisar el concepto actual y su desenlace en COVID-19 Recientemente se han publicado artículos en los que se sugiere que la presencia de síntomas gastrointesti-nales se ha asociado a COVID 19 con mayores indicadores de gravedad, lo que motiva al gastroenterólogo a explorar cómo el sistema digestivo podría impactar en esta hiperinflamación (AU)Coronaviruses are an extensive family of viruses, some of them can produce different kind of human diseases, ranging from the common cold to severe acute respiratory syndrome Coronavirus disease (COVID-19) is caused by the SARS-CoV-2 zoonotic coronavirus and started in China in December 2019 In March 2020, the World Health Organization (WHO) declared it a global pandemic This disease has a wide spectrum of signs and symptoms, predominantly presenting with cough and fever, resulting in a proportion of patients who develop acute respiratory distress syndrome (ARDS) It has been argued that severe lung involvement by the virus may also be caused by hyperinflammation and a condition similar to hemophagocytic lymphohistiocyto-sis (HLH), which is a clinical syndrome caused by an inadequate response of the immune system to a trigger, whether infectious, neoplastic, metabolic, or rheumatologic, leading to a disproportionate inflammatory reac-tion This activated immune response producing an exaggerated release or storm of cytokines responsible for this disease There are recently publications suggesting that the presence of gastrointestinal symptoms is associated with COVID 19 disease with higher indicators of severity, which motivates the gastroenterologist to explore how the digestive system could impact this hyperinflammation


title: Google Dataset Search by the Numbers

text: Scientists, governments, and companies increasingly publish datasets on the Web. Google's Dataset Search extracts dataset metadata -- expressed using schema.org and similar vocabularies -- from Web pages in order to make datasets discoverable. Since we started the work on Dataset Search in 2016, the number of datasets described in schema.org has grown from about 500K to almost 30M. Thus, this corpus has become a valuable snapshot of data on the Web. To the best of our knowledge, this corpus is the largest and most diverse of its kind. We analyze this corpus and discuss where the datasets originate from, what topics they cover, which form they take, and what people searching for datasets are interested in. Based on this analysis, we identify gaps and possible future work to help make data more discoverable.


title: COVID-19 and telemedicine in hemophilia in a patient with severe hemophilia A and orthopedic surgery

text: We describe the case of a patient with severe hemophilia A who underwent major orthopedic surgery managed postoperatively by telemedicine (TM). The case is a splendid example of the implementation of TM and good collaboration between a Comprehensive Hemophilia Treatment Center (CHTC) and a local hospital.


Aprendiendo en casa durante la pandemia del Covid-19, una iniciativa de estudiantes de latinoamerica./ Aprendiendo en casa durante la pandemia del Covid-19, una iniciativa de estudiantes de latinoamerica./ [Learning at home during the COVID-19 pandemic: An initiative of Latin American students]


Rho kinase inhibitors for SARS-CoV-2 induced acute respiratory distress syndrome: Support from Bartter's and Gitelman's syndrome patients


title: The Visual Social Distancing Problem

text: One of the main and most effective measures to contain the recent viral outbreak is the maintenance of the so-called Social Distancing (SD). To comply with this constraint, workplaces, public institutions, transports and schools will likely adopt restrictions over the minimum inter-personal distance between people. Given this actual scenario, it is crucial to massively measure the compliance to such physical constraint in our life, in order to figure out the reasons of the possible breaks of such distance limitations, and understand if this implies a possible threat given the scene context. All of this, complying with privacy policies and making the measurement acceptable. To this end, we introduce the Visual Social Distancing (VSD) problem, defined as the automatic estimation of the inter-personal distance from an image, and the characterization of the related people aggregations. VSD is pivotal for a non-invasive analysis to whether people comply with the SD restriction, and to provide statistics about the level of safety of specific areas whenever this constraint is violated. We then discuss how VSD relates with previous literature in Social Signal Processing and indicate which existing Computer Vision methods can be used to manage such problem. We conclude with future challenges related to the effectiveness of VSD systems, ethical implications and future application scenarios.


title: Understanding novel COVID-19: Its impact on organ failure and risk assessment for diabetic and cancer patients

text: The current pandemic outbreak of COVID-19 originated from Wuhan, China. It is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with significant mortality and morbidity rate. The severe risk factors are commonly detected in patients of older age and with medical comorbidities like cancer and diabetes. Scientists and doctors have scrambled to gain knowledge about the novel virus and its pathophysiology in order to discover possible therapeutic regimens and vaccines for COVID-19. The therapeutic strategies like targeting the viral genome emphasize the promising approach to target COVID-19. Additionally, blocking the receptor, ACE2 via the neutralizing antibodies for viral escape that prevents it from entering into the cells provides another therapeutic regimen. In this review article, we have presented the effect of SARS-CoV-2 infection in comorbid patients and discussed organ failure caused by this virus. Based on the data available from the scientific literature and ongoing clinical trials, we have focused on therapeutic strategies. We hope that we would fill the gaps that puzzled the researchers and clinicians with the best of our knowledge collected for the betterment of the patients for the coming future.


title: The role of Angiology and Vascular Surgery in the COVID-19 pandemic

text: The New Coronavirus Epidemic (2019-nCoV), discovered in the city of Wuhan, China, in December 2019, presents mainly with pulmonary pneumonia that is preceded by fever, cough and myalgia. However, as the disease spread globally and the number of hospitalizations increased exponentially, it was noted that most serious patients hospitalized by COVID-19 have laboratory changes worthy of attention, such as lymphopenia, neutrophilia, increased time of prothrombin and increased levels of D-dimer. Due to these changes proving to be crucial for the mortality and morbidity rates in this subset of infected people, several studies focusing on the pathophysiology, mainly hematological, of the disease appear every day. Deepening these studies, several published works have shown SarsCoV-2 infection to the installation of a prothrombotic state in hospitalized patients, which leads to the potential occurrence of thrombotic or arterial events in this cohort. Thus, in order to understand how the departments of Angiology and Vascular Surgery are acting in the context of the COVID-19 pandemic, this work aims to gather studies that reveal from protocols applied in vascular services in the current situation, until to the role of vascular surgeons and angiologists in the clinical and surgical management of patients infected or not, as a way of helping and clarifying this specialty during the context of a pandemic due to the new coranavirus. For the selection of works, the following search criteria were used: "Coronavirus and venous thrombosis", "Coronavirus and thrombosis", "COVID-19 and venous thrombosis" and "COVID-19 Coronavirus and thrombosis".


title: The diagnosis of pandemic coronavirus pneumonia: A review of radiology examination and laboratory test

text: Since the outbreak of novel coronavirus disease 2019 (COVID-19), epidemic prevention strategies have been implemented worldwide. For the sake of controlling the infectious coronavirus pneumonia, early diagnosis and quarantine play an imperative role. Currently, the mainstream diagnostic methods are imaging and laboratory diagnosis, which differ in their efficacy of diagnosis. To compare the detection rate, we reviewed numerous literature on pneumonia caused by coronaviruses (SARS, MERS, and SARS-CoV-2) and analyzed two different ways of diagnosis. The results showed that the detection rate of computed tomography (CT) diagnosis was significantly higher than that of real-time quantitative polymerase chain reaction (qPCR) (P = 0.00697). Still, clinicians should combine radiology and laboratory methods to achieve a higher detection rate, so that instant isolation and treatment could be effectively conducted to curb the rampant spread of the epidemic.


title: Analyzing COVID-19 on Online Social Media: Trends, Sentiments and Emotions

text: At the time of writing, the ongoing pandemic of coronavirus disease (COVID-19) has caused severe impacts on society, economy and people's daily lives. People constantly express their opinions on various aspects of the pandemic on social media, making user-generated content an important source for understanding public emotions and concerns. In this paper, we perform a comprehensive analysis on the affective trajectories of the American people and the Chinese people based on Twitter and Weibo posts between January 20th, 2020 and May 11th 2020. Specifically, by identifying people's sentiments, emotions (i.e., anger, disgust, fear, happiness, sadness, surprise) and the emotional triggers (e.g., what a user is angry/sad about) we are able to depict the dynamics of public affect in the time of COVID-19. By contrasting two very different countries, China and the Unites States, we reveal sharp differences in people's views on COVID-19 in different cultures. Our study provides a computational approach to unveiling public emotions and concerns on the pandemic in real-time, which would potentially help policy-makers better understand people's need and thus make optimal policy.


Anthony Fauci, MD, on COVID-19 Vaccines, Schools, and Larry Kramer


High-resolution computed tomography features of 17 cases of coronavirus disease 2019 in Sichuan province, China


title: A contemporary review on pathogenesis and immunity of COVID-19 infection

text: Emerging of the COVID-19 pandemic has raised interests in the field of biology and pathogenesis of coronaviruses; including interactions between host immune reactions specific, and viral factors. Deep knowledge about the interaction between coronaviruses and the host factors could be useful to provide a better support for the disease sufferers and be advantageous for managing and treatment of the lung infection caused by the virus. At this study, we reviewed the updated information on the pathogenesis of the COVID-19 and the immune responses toward it, with a special focus on structure, genetics, and viral accessory proteins, viral replication, viral receptors, the human immune reactions, cytopathic effects, and host-related factors.


title: How Does COVID-19 impact Students with Disabilities/Health Concerns?

text: The impact of COVID-19 on students has been enormous, with an increase in worries about fiscal and physical health, a rapid shift to online learning, and increased isolation. In addition to these changes, students with disabilities/health concerns may face accessibility problems with online learning or communication tools, and their stress may be compounded by additional risks such as financial stress or pre-existing conditions. To our knowledge, no one has looked specifically at the impact of COVID-19 on students with disabilities/health concerns. In this paper, we present data from a survey of 147 students with and without disabilities collected in late March to early April of 2020 to assess the impact of COVID-19 on these students' education and mental health. Our findings show that students with disabilities/health concerns were more concerned about classes going online than their peers without disabilities. In addition, students with disabilities/health concerns also reported that they have experienced more COVID-19 related adversities compared to their peers without disabilities/health concerns. We argue that students with disabilities/health concerns in higher education need confidence in the accessibility of the online learning tools that are becoming increasingly prevalent in higher education not only because of COVID-19 but also more generally. In addition, educational technologies will be more accessible if they consider the learning context, and are designed to provide a supportive, calm, and connecting learning environment.


title: Aesthetic dermatology procedures in coronavirus days

text: BACKGROUND: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2; COVID-19), which causes coronavirus disease 2019, is highly contagious and a particularly popular problem in all around the world and also in all departments of every hospital. AIMS: Protecting the well-being of the aesthetic dermatologists while providing a sufficient workforce is vital for pandemic planning. RESULTS AND CONCLUSIONS: In this article, we will discuss this problem from an aesthetic dermatology aspect and we will review whether these procedures are safe or not.


title: Heparin 2.0: A New Approach to the Infection Crisis

text: In April 2020, the US Food and Drug Administration granted emergency use authorization for certain medical devices to be used in patients with coronavirus disease 2019 (CO-VID-19). This included extracorporeal blood purification devices. This narrative review will give a brief overview regarding some of the extracorporeal devices that could be used to treat COVID-19 patients, including the Seraph® 100 Microbind® Affinity Blood Filter, produced by ExThera Medical (Martinez, CA, USA), first licensed in the European Economic Area in 2019. The Seraph® 100 contains ultrahigh molecular weight polyethylene beads with end point-attached heparin and is approved for the reduction of pathogens from the bloodstream either as a single agent or as an adjunct to conventional anti-infective agents. Bacteria, viruses, fungi, and toxins have been shown to bind to the immobilized heparin in a similar way to the interaction with heparan sulfate on the cell surface. This binding is nonreversible and as such, the pathogens are removed from the bloodstream. In this review, we describe the pathophysiological basis and rationale for using heparin for pathogen removal from the blood as well as exploring the technology behind the adaptation of heparin to deprive it of its systemic anticoagulant activity. In addition, we summarize the in vitro data as well as the available preclinical testing and published clinical reports. Finally, we discuss the enormous potential of this technology in an era of increasing antibiotic resistance and high mortality associated with sepsis and consider the application of this as a possible treatment option for COVID-19.


title: Criticism of the Oxford Coronavirus Vaccine

text: This piece at Forbes by Bill Haseltine has set off a lot of comment – it’s a look at the Oxford group’s vaccine candidate as compared to the SinoVac candidate, and you may recall (background here) that these are the two teams that have separately reported that their vaccines appear to protect rhesus monkeys from infection after exposure to the coronavirus Haseltine has some criticisms of the Oxford data, and as you will see from that link to his name, his opinions deserve to be taken seriously So what’s going on? Update: here’s the take on this at BioCentury Looking at the preprint on the Oxford results, Haseltine has a problem with the claim that the monkeys were protected from infection by a dose of ChAdOx1 nCoV-19 The key data are in the preprint’s Figure 3 The Oxford team checked for viral RNA several different ways One was using bronchoaveolar lavage (BAL fluid), a sampling technique that involves running a bronchoscope down into the lungs and washing out aveolar spaces – a pretty darn invasive assay, which is why you don’t hear about it all that much compared to the still-not-so-nonivasive nose swabs BAL fluid of the virus-exposed unvaccinated animals showed coronavirus genomic RNA throughout the study, and viral subgenomic RNA (more indicative of active replication) at days 3 and 5 after exposure Meanwhile, the vaccinated animals showed the genomic RNA in only two monkeys, and no subgenomic RNA at all


title: COVID-19 in Italian pediatric patients: the experience of a tertiary children's hospital

text: Coronavirus disease (COVID-19) caused by the novel SARS-CoV-2 has spread worldwide since its onset in Wuhan in December 2019. In Italy COVID-19 rapidly increased in February 2020 and by 12 May 2020, 2.0 % of the confirmed cases were under 18 years and 3.7% of those had been hospitalized. This case series report reviews the demographic characteristics, clinical course, laboratory findings, radiologic features and treatment of children admitted with COVID-19 to a tertiary care hospital in Italy.


title: 2019 Novel Coronavirus (COVID-19) Pneumonia: Serial Computed Tomography Findings

text: From December 2019, Coronavirus disease 2019 (COVID-19) pneumonia (formerly known as the 2019 novel Coronavirus [2019-nCoV]) broke out in Wuhan, China. In this study, we present serial CT findings in a 40-year-old female patient with COVID-19 pneumonia who presented with the symptoms of fever, chest tightness, and fatigue. She was diagnosed with COVID-19 infection confirmed by real-time reverse-transcriptase-polymerase chain reaction. CT showed rapidly progressing peripheral consolidations and ground-glass opacities in both lungs. After treatment, the lesions were shown to be almost absorbed leaving the fibrous lesions.


The line starts to form for a coronavirus vaccine


title: Lung Ultrasound in Patients with Acute Respiratory Failure Reduces Conventional Imaging and Health Care Provider Exposure to COVID-19

text: Lung ultrasound gained a leading position in the last year as an imaging technique for the assessment and management of patients with acute respiratory failure. In coronavirus disease 2019 (COVID-19), its role may be of further importance because it is performed bedside and may limit chest X-ray and the need for transport to radiology for computed tomography (CT) scan. Since February 21, we progressively turned into a coronavirus-dedicated intensive care unit and applied an ultrasound-based approach to avoid traditional imaging and limit contamination as much as possible. We performed a complete daily examination with lung ultrasound score computation and systematic search of complications (pneumothorax, ventilator-associated pneumonia); on-duty physicians were free to perform CT or chest X-ray when deemed indicated. We compared conventional imaging exams performed in the first 4 wk of the COVID-19 epidemic with those in the same time frame in 2019: there were 84 patients in 2020 and 112 in 2019; 64 and 22 (76.2% vs. 19.6%, p < 0.001) had acute respiratory failure, respectively, of which 55 (85.9%) were COVID-19 in 2020. When COVID-19 patients in 2020 were compared with acute respiratory failure patients in 2019, the median number of chest X-rays was 1.0 (1.0-2.0) versus 3.0 (1.0-4.0) (pâ¯=â¯0.0098); 2 patients 2 (3.6%) versus 7 patients (31.8%) had undergone at least one thoracic CT scan (pâ¯=â¯0.001). A self-imposed ultrasound-based approach reduces the number of chest X-rays and thoracic CT scans in COVID-19 patients compared with patients with standard acute respiratory failure, thus reducing the number of health care providers exposed to possible contamination and sparing personal protective equipment.


Community Pharmacists in Taiwan at the Frontline Against the Novel Coronavirus Pandemic: Gatekeepers for the Rationing of Personal Protective Equipment


Status and situation of postgraduate medical students in China under the influence of COVID-19


title: How accurate is self-testing?

text: The UK has embarked on a programme of self-testing for coronavirus, but can swabs taken at home be trusted? Michael Brooks reports.


The importance of credible information about contact lens wear during pandemic


Guiding Principles for Cancer Surgery during the COVID-19 Pandemic


The association of SARS-CoV-2 infection and acute disseminated encephalomyelitis without prominent clinical pulmonary symptoms


title: Impact of COVID-19 on thyroid cancer surgery and adjunct therapy

text: COVID-19 has profoundly modified the way healthcare is delivered. Jordan imposed lockdown and restrictive policies between March 17 and May 20, 2020. We aimed to assess the impact of such measures on thyroid cancer treatment plans. In the specified period, 12 patients were scheduled for surgery. Since papillary carcinoma was the preoperative diagnosis in all cases, radioactive iodine ablation (RIA) therapy was also planned 3-4 weeks following surgery after withdrawing thyroxine and achieving a thyroid stimulating hormone (TSH) level > 30 mU/L. Thyroxine withdrawal is the routine method applied for RIA in Jordan as it is less costly compared to the rapid method of exogenous stimulation using recombinant TSH. All surgical procedures were performed without delay since all patients were asymptomatic per flu-like illness and came from a region of low COVID-19 prevalence. These included total thyroidectomy (n = 11), bilateral therapeutic central compartment neck dissection (n = 7), lateral compartment neck dissection (n = 5). However, the RIA treatment plan was altered considerably according to the period in which they were operated. 6 out of the 7 patients operated in March changed to the stimulated method of RIA at a considerable additional extra cost. The seventh patient and the April patient opt to delay RIA until after lockdown. The remaining cases (operated in May) followed the usual withdrawal method as restrictions were due to an end. The restrictive measures applied during COVID-19 did not affect the safe and timely delivery of surgical care. However, it added a financial and psychological burden to the entire cancer management plan.


title: A cross-sectional community-based observational study of asymptomatic SARS-CoV-2 prevalence in the greater Indianapolis area

text: The Asymptomatic novel CORonavirus iNfection (ACORN) study was designed to investigate the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the asymptomatic adult population of the Indianapolis metropolitan area, to follow individuals testing positive for the development of symptoms, and to understand duration of positive test results. ACORN is a cross-sectional community-based observational study of adult residents presenting asymptomatic for COVID-like illness, defined as the self-reported absence of the following three symptoms in the last 7 days: fever (≥100°F), new-onset or worsening cough, and new-onset or worsening shortness of breath. SARS-CoV-2 infection was determined by real-time reverse transcription-polymerase chain reaction in nasopharyngeal swab samples. SARS-CoV-2 infection prevalence was expressed as a point estimate with 95% confidence interval (CI). Test results are reported for 2953 participants who enrolled and underwent nasopharyngeal swab testing between 7 April 2020 and 16 May 2020. Among tested participants, 91 (3.1%; 95% CI: 2.5%-3.7%) were positive for SARS-CoV-2. Overall, baseline characteristics, medical history, and infection risk factors were comparable between SARS-CoV-2 positive and negative participants. Within the ongoing 14-day follow-up period for positive participants, 58 (71.6%) of 81 assessed participants remained asymptomatic while others (n = 23, 28.4%) reported one or more symptoms. Indiana had "Stay-at-Home" orders in place during nearly the entire test period reported here, yet 3.1% of asymptomatic participants tested positive for SARS-CoV-2. These results indicate screening questions had limited predictive utility for testing in an asymptomatic population and suggest broader testing strategies are needed. Importantly, these findings underscore that more research is needed to understand the viral transmission and the role asymptomatic and presymptomatic individuals play in this global pandemic.


The response of Milan's Emergency Medical System to the COVID-19 outbreak in Italy


Would ACEIs/ARBs be beneficial for COVID-19 patients without hypertension?


title: Opinions on the corona virus disease 2019

text: The corona virus disease 2019 (COVID-19) has drawn much attention lately It has the characteristics of hidden infection sources, diverse transmission channels, great differences in clinical characteristics and limited diagnostic methods Additionally, the population is generally susceptible, and no specific medicines are available now, therefore, the prevention and control of the disease faces greater challenges Mastering the characteristics of it for comprehensive prevention and control is the main strategy against the disease This article systematically expounded the latest understanding of the disease


The Effects of COVID-19 on Academic Activities and Surgical Education in Italy


title: A pilot study of the antiviral activity of anionic and cationic polyamidoamine dendrimers against the Middle East respiratory syndrome coronavirus

text: The Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging virus that causes infection with a potentially fatal outcome. Dendrimers are highly branched molecules that can be added to antiviral preparations to improve their delivery, as well as their intrinsic antiviral activity. Studies on identifying anti-MERS-CoV agents are few. Three types of polyanionic dendrimers comprising the terminal groups sodium carboxylate (generations 1.5, 2.5, 3.5, and 4.5), hydroxyl (generations 2, 3, 4, and 5), and succinamic acid (generations 2, 3, 4, and 5) and polycationic dendrimers containing primary amine (generations 2, 3, 4, and 5) were used to assess their antiviral activity with the MERS-CoV plaque inhibition assay. The hydroxyl polyanionic set showed a 17.36% to 29.75% decrease in MERS-CoV plaque formation. The most potent inhibition of MERS-CoV plaque formation was seen by G(1.5)-16COONa (40.5% inhibition), followed by G(5)-128SA (39.77% inhibition). In contrast, the cationic dendrimers were cytotoxic to Vero cells. Polyanionic dendrimers can be added to antiviral preparations to improve the delivery of antivirals, as well as the intrinsic antiviral activity.