title: COVID-19 pandemic: the effects of quarantine on cardiovascular risk

text: COVID-19 is causing a global pandemic with a high number of deaths and infected people. To contain the diffusion of COVID-19 virus, Governments have enforced restrictions on outdoor activities or even collective quarantine on the population. One important consequence of quarantine is a change in lifestyle: reduced physical activity and unhealthy diet. 2019 guidelines for primary prevention of cardiovascular disease indicate that "Adults should engage in at least 150 minute per week of accumulated moderate-intensity or 75 minute per week of vigorous-intensity aerobic physical activity (or an equivalent combination of moderate and vigorous activity) to reduce ASCVD risk." During quarantine, strategies to further increase home-based physical activity and to follow a healthy diet should be implemented. Quarantine carries some long-term effects on cardiovascular disease, mainly related to unhealthy lifestyle and anxiety. Following quarantine a global action supporting healthy diet and physical activity is mandatory to encourage people to return to good lifestyle.


Scientific publishing in the COVID-19 era: successes and pitfalls


title: Response of a comprehensive cancer center to the COVID-19 pandemic: the experience of the Fondazione IRCCS-Istituto Nazionale dei Tumori di Milano

text: BACKGROUND: The rapid spread of coronavirus disease (COVID-19) is affecting many countries. While healthcare systems need to cope with the need to treat a large number of people with different degrees of respiratory failure, actions to preserve aliquots of the healthcare system to guarantee treatment to patients are mandatory. METHODS: In order to protect the Fondazione IRCCS-Istituto Nazionale dei Tumori di Milano from the spread of COVID-19, a number of to-hospital and within-hospital filters were applied. Among others, a triage process to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity in patients with cancer was developed consisting of high-resolution low-dose computed tomography (CT) scan followed by reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 in nose-throat swabs whenever CT was suggestive of lung infection. To serve symptomatic patients who were already admitted to the hospital or in need of hospitalization while waiting for RT-PCR laboratory confirmation of infection, a COVID-19 surveillance zone was set up. RESULTS: A total of 301 patients were screened between March 6 and April 3, 2020. Of these, 47 were hospitalized, 53 needed a differential diagnosis to continue with their cancer treatment, and 201 were about to undergo surgery. RT-PCR was positive in 13 of 40 hospitalized patients (32%), 14 of 52 day hospital patients (27%), and 6 of 201 surgical patients (3%). CONCLUSION: Applying filters to protect our comprehensive cancer center from COVID-19 spread contributed to guaranteeing cancer care during the COVID-19 crisis in Milan. A surveillance area and surgical triage allowed us to protect the hospital from as many as 33 patients infected with SARS-CoV-2.


title: Practical recommendations for gynecologic surgery during the COVID-19 pandemic

text: Surgery in suspected/confirmed COVID-19 patients is a high-risk venture. In infected patients, COVID-19 is present in the body cavity. During surgery it could be nebulized in the spray generated by surgical instruments and could theoretically infect members of the surgical team. Nevertheless, some surgical gynecologic pathologies cannot be postponed. We present a list of the most frequent gynecologic diseases and recommendations on their surgical management during the COVID-19 pandemic, based on expert opinion, current available information, and international scientific society recommendations to support the work of gynecologists worldwide. In brief, any kind of surgical treatment should be scrutinized and postponed if possible. Nonoperative conservative treatment including pharmacological therapies for hormone-sensitive pathologies should be implemented. Health risk assessment by patient history and COVID-19 test before elective surgery are pivotal to protect both patients and healthcare providers. In confirmed COVID-19 patients or highly suspected cases, elective surgery should be postponed until full recovery.


How to Support Residents During the COVID-19 Pandemic


title: Clinical features of deaths in the novel coronavirus epidemic in China

text: In response to the recent novel coronavirus outbreak originating in Wuhan, Hubei province, China, observations concerning novel coronavirus mortality are of urgent public health importance. The present work presents the first review of the fatal novel coronavirus cases in China. Clinical data of fatal cases published by the Chinese Government were studied. As of 2 February 2020, the clinical data of 46 fatal cases were identified. The case fatality rate was significantly higher in Hubei province than the rest of China. While 67% of all deceased patients were male, gender was unlikely to be associated with mortality. Diabetes was likely to be associated with mortality. There is, however, not yet sufficient evidence to support the association between hypertension and mortality as similar prevalence of hypertension was also observed in the Hubei population.


Adaptación de una UCI pediátrica a Unidad de Adultos Críticos durante la pandemia COVID-19./ [Repurposing the PICU for caring critically ill adult patients during the COVID-19 pandemic]


title: Epidemiological and Clinical Aspects of COVID-19;a Narrative Review

text: There are significant misconceptions and many obstacles in the way of illuminating the epidemiological and clinical aspects of COVID-19 as a new emerging epidemic In addition, usefulness of some evidence published in the context of the recent epidemic for decision making in clinic as well as public health is questionable However, misinterpreting or ignoring strong evidence in clinical practice and public health probably results in less effective and somehow more harmful decisions for individuals as well as subgroups in general populations of countries in the initial stages of this epidemic Accordingly, our narrative review appraised epidemiological and clinical aspects of the disease including genetic diversity of coronavirus genus, mode of transmission, incubation period, infectivity, pathogenicity, virulence, immunogenicity, diagnosis, surveillance, clinical case management and also successful measures for preventing its spread in some communities


Clinical Features and Treatment Protocol in Eleven Chinese Children with Mild COVID-19


Early administered antibiotics do not impact mortality in critically ill patients with COVID-19


Is shortening the response-to-treatment waiting time appropriate during the Covid-19 pandemic?


Letter to the Editor on "Bonafè M, Prattichizzo F, Giuliani A, Storci G, Sabbatinelli J, Olivieri F. Inflamm-aging: Why older men are the most susceptible to SARS-CoV-2 complicated outcomes. Cytokine Growth Factor Rev"


title: Global epidemiology of coronavirus disease 2019 (COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status

text: It has been 2 months since the first case of coronavirus disease 2019 (COVID-19) was reported in Wuhan, China. So far, COVID-19 has affected 85 403 patients in 57 countries/territories and has caused 2924 deaths in 9 countries. However, epidemiological data differ between countries. Although China had higher morbidity and mortality than other sites, the number of new daily cases in China has been lower than outside of China since 26 February 2020. The incidence ranged from 61.44 per 1 000 000 people in the Republic of Korea to 0.0002 per 1 000 000 people in India. The daily cumulative index (DCI) of COVID-19 (cumulative cases/no. of days between the first reported case and 29 February 2020) was greatest in China (1320.85), followed by the Republic of Korea (78.78), Iran (43.11) and Italy (30.62). However, the DCIs in other countries/territories were <10 per day. Several effective measures including restricting travel from China, controlling the distribution of masks, extensive investigation of COVID-19 spread, and once-daily press conferences by the government to inform and educate people were aggressively conducted in Taiwan. This is probably the reason why there was only 39 cases (as of 29 February 2020) with a DCI of 1 case per day in Taiwan, which is much lower than that of nearby countries such as the Republic of Korea and Japan. In addition, the incidence and mortality were correlated with the DCI. However, further study and continued monitoring are needed to better understand the underlying mechanism of COVID-19.


COVID-19 y la esperanza de la inmunidad./ [COVID-19 and the hope for immunity]


Thinking more about therapy with convalescent plasma for COVID-19 patients


Pharmacokinetics of Lopinavir and Ritonavir in Patients Hospitalized With Coronavirus Disease 2019 (COVID-19)


title: UK neurology response to the COVID-19 crisis

text: COVID-19 has led to seismic changes in neurological practice in a matter of weeks. The Association of British Neurologists has supported neurology specialists and patients during this rapid reorganisation and its attendant challenges. We have written guidance on structured service transformation, considering the need to sustain long term care while responding to acute developments; we have recognised that staff experience differs and that this, as well as individual risk factors should be considered when redeployment occurs. Appreciating that there may be understandable anxiety when facing a working routine outside normal practice, we have signposted ethical and psychological support for individuals. We have also focused on our patients: we have facilitated a national alert system to register all neurological COVID cases, coordinating research efforts on this new disease; finally we have defined how to identify the most vulnerable patients under our care. When this initial wave of the pandemic subsides, we will have planned for return to the new 'norm', ready to embrace innovation where appropriate, aiming to minimise fall-out in our chronic disease population, and potentially having enhanced and modernised our services.


title: Early Description of Coronavirus 2019 Disease in Kidney Transplant Recipients in New York

text: BACKGROUND: The novel SARS-CoV-2 virus has caused a global pandemic of coronavirus disease 2019 (COVID-19). Although immunosuppressed individuals are thought to be at an increased risk of severe disease, little is known about their clinical presentation, disease course, or outcomes. METHODS: We report 15 kidney transplant recipients from the Columbia University kidney transplant program who required hospitalization for confirmed COVID-19, and describe their management, clinical course, and outcomes. RESULTS: Patients presented most often with a fever (87%) and/or cough (67%). Initial chest x-ray most commonly showed bilateral infiltrates, but 33% had no acute radiographic findings. Patients were managed with immunosuppression reduction and the addition of hydroxychloroquine and azithromycin. Although 27% of our patients needed mechanical ventilation, over half were discharged home by the end of follow-up. CONCLUSIONS: Kidney transplant recipients with COVID-19 have presentations that are similar to that of the general population. Our current treatment protocol appears to be associated with favorable outcomes, but longer follow-up of a larger cohort of patients is needed.


CT Findings of Pregnant Women With Coronavirus Disease (COVID-19) Pneumonia


title: Dynamic profile for the detection of anti-SARS-CoV-2 antibodies using four immunochromatographic assays

text: In order to fight the SARS-CoV-2 pandemic infection, there is a growing need and demand for diagnostic tools that are complementary and different from the RT-PCR currently in use. Multiple serological tests are or will be very soon available but need to be evaluated and validated. We have thus tested 4 immunochromatographic tests for the detection of antibodies to SARS-CoV-2. In addition, we assessed the kinetics of antibody appearance using these assays in 22 patients after they were tested positive by RT-PCR. We observed great heterogeneity in antibody detection post-symptom onset. The median antibody detection time was between 8 and 10 days according to the manufacturers. All the tests showed a sensitivity of 60 to 80% on day 10 and 100% on day 15. In addition, a single cross-reaction was observed with other human coronavirus infections. Thus, immunochromatographic tests for the detection of anti-SARS-CoV-2 antibodies may have their place for the diagnostic panel of COVID-19.


title: Could anti-hypertensive drug therapy affect the clinical prognosis of hypertensive patients with COVID-19 infection? Data from centers of southern Italy

text: Background Coronavirus-19 (COVID-19) is the cause of a pandemic disease, with severe acute respiratory syndrome by binding target epithelial lung cells through angiotensin converting enzyme 2 (ACE2) in humans. Thus, hypertensive patients with COVID-19 could have worse prognosis. Indeed, angiotensin converting enzyme (ACEi) inhibitors and/or angiotensin receptor blockers (ARBs) may interfere with ACE2 expression/activity. Thus, hypertensive patients undergoing ACEi and/or ARBs drug therapy may be at a higher risk of contracting a serious COVID-19 infection and should be monitored. Moreover, in the present study we investigated the effects of ACEi vs. ARBs vs. calcium channel blockers on clinical outcomes as mechanical ventilation, Intensive Care Unit (ICU) admissions, heart injury and death in 62 hypertensive patients hospitalized for COVID-19 infection. Methods and Results The multicenter study was prospectively conducted at Department of Infectious Diseases of Sant'Anna Hospital of Caserta, and of University of Campania "Luigi Vanvitelli" of Naples, at Department of Advanced Surgical and Medical Sciences of University of Campania "Luigi Vanvitelli", Naples, and at General Medical Assistance Unit "FIMG", Naples, Italy. Lowest values of left ventricle ejection fraction predicted deaths (1.142; [1.008-1.294], p <0.05), while highest values of interleukin 6 (IL6) predicted the admission to ICU (1.617; [1.094-2.389]), mechanical ventilation (1.149; [1.082-1.219]), heart injuries (1.367; [1.054-1.772]) and deaths (4.742; [1.788-8.524]). ConclusionsAnti-hypertensive drugs didn't affect the prognosis in COVID-19 patients. Consequently, tailored anti-inflammatory and immune therapies in addition to chronic antihypertensive therapy, could prevent a worse prognosis, as well as improve the clinical outcomes in hypertensive patients with COVID-19 infection.


Cardiopulmonary resuscitation in the COVID-19 era - Will the risk-benefit shift in resource-poor settings?


title: The Epidemiological and Clinical Characteristics of 81 Children with COVID-19 in a Pandemic Hospital in Turkey: an Observational Cohort Study

text: BACKGROUND: Coronavirus disease-2019 (COVID-19) pandemic has affected millions of people throughout the world since December 2019. However, there is a limited amount of data about pediatric patients infected with the disease agent, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: The epidemiological, laboratory, radiological, and treatment features of the pediatric patients who were positive for SARS-CoV-2 based on the reverse-transcription polymerase chain reaction (RT-PCR) test, were investigated retrospectively. RESULTS: The median age of 81 children included in the study was 9.50 years (0-17.75 years). The most frequent symptoms at the time of admission were fever (58%), cough (52%), and fatigue or myalgia (19%). The abnormal laboratory findings in these cases were decreased lymphocytes (2.5%, n = 2), leucopenia (5%, n = 4), and increased lactate dehydrogenase (17.2%, n = 14), C-reactive protein (16%, n = 13), procalcitonin (3.7%, n = 3), and D-dimer (12.3%, n = 10). Three (4%) patients had consolidation in chest computed tomography, and three (4%) had ground-glass opacities. None of the patients needed intensive care except for the newborns. The median time to turn SARS-CoV-2 negative in the RT-PCR test was 5 (3-10) days. The median length of hospital stay was 5 (4-10) days. The time to turn SARS-CoV-2 negative in the RT-PCR test and the length of hospital stay were significantly longer for those aged five years or younger than others (P = 0.037, P = 0.01). CONCLUSION: Compared to adults, COVID-19 is milder and more distinctive in children. As a result, more conservative approaches might be preferred in children for the diagnostic, clinical, and even therapeutic applications.


title: How an Australian researcher ended up in the spotlight at a White House coronavirus briefing ;Science ;AAAS

text: When Craig Dalton heard that his name came up at a nationally televised White House press briefing Monday, the medical epidemiologist at the University of Newcastle in Australia says, “I didn’t believe it ” Dalton did a quick web search and his disbelief transformed into amazement “Turned out, it was actually true,” he told ScienceInsider Dalton’s unexpected moment in the media spotlight came as Deborah Birx, the White House’s coronavirus response coordinator, and Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, stepped to the White House lectern to describe a new set of guidelines that the U S government would distribute as part of its effort to slow the spread of the illness caused by the novel coronavirus in the United States


title: Evaluating the efficiency of specimen pooling for PCR-based detection of COVID-19

text: In the age of a pandemic, such as the ongoing one caused by SARS-CoV-2, the world faces a limited supply of tests, personal protective equipment, and factories and supply chains are struggling to meet the growing demands. This study aimed to evaluate the efficacy of specimen pooling for testing of SARS-CoV-2 virus, to determine whether costs and resource savings could be achieved without impacting the sensitivity of the testing. Ten previously tested nasopharyngeal and throat swab specimens by real-time PCR, were pooled for testing, containing either one or two known positive specimens of varying viral concentrations. Specimen pooling did not affect the sensitivity of detecting SARS-CoV-2 when the PCR cycle threshold (Ct) of original specimen was lower than 35. In specimens with low viral load (Ct>35), 2 out of 15 pools (13.3%) were false negative. Pooling specimens to test for COVID-19 infection in low prevalence (≤1%) areas or in low risk populations can dramatically decrease the resource burden on laboratory operations by up to 80%. This paves the way for large-scale population screening, allowing for assured policy decisions by governmental bodies to ease lockdown restrictions in areas with a low incidence of infection, or with lower risk populations. This article is protected by copyright. All rights reserved.


Deep venous thrombosis in a non-critically ill patient with novel COVID-19 infection


title: Trypsin promotes porcine deltacoronavirus mediating cell-to-cell fusion in a cell type-dependent manner

text: Porcine deltacoronavirus (PDCoV) is a newly emerging threat to the global porcine industry. PDCoV has been successfully isolated using various medium additives including trypsin, and although we know it is important for viral replication, the mechanism has not been fully elucidated. Here, we systematically investigated the role of trypsin in PDCoV replication including cell entry, cell-to-cell membrane fusion and virus release. Using pseudovirus entry assays, we demonstrated that PDCoV entry is not trypsin dependent. Furthermore, unlike porcine epidemic diarrhea virus (PEDV), in which trypsin is important for the release of virus from infected cells, PDCoV release was not affected by trypsin. We also demonstrated that trypsin promotes PDCoV replication by enhancing cell-to-cell membrane fusion. Most importantly, our study illustrates two distinct spreading patterns from infected cells to uninfected cells during PDCoV transmission, and the role of trypsin in PDCoV replication in cells with different virus spreading types. Overall, these results clarify that trypsin promotes PDCoV replication by mediating cell-to-cell fusion transmission but is not crucial for viral entry. This knowledge can potentially contribute to improvement of virus production efficiency in culture, not only for vaccine preparation but also to develop antiviral treatments.


title: Risk Stratification and Personal Protective Equipment Use in Pediatric Endoscopy During the Coronavirus Disease 2019 Outbreak: A Single-center Protocol

text: SARS-CoV-2, the novel coronavirus causing coronavirus disease 2019 (COVID-19), is now a global pandemic. Human-to-human transmission has been documented to occur through respiratory secretions, feces, aerosols, and contaminated environmental surfaces. Pediatric patients present a unique challenge as they may have minimal symptoms and yet transmit disease. Endoscopists face risk for infection with viruses like SARS-CoV-2, as the aerosol generating nature of endoscopy diffuses respiratory disease that can be spread via an airborne and droplet route. We describe our center's methodology for pediatric patient risk stratification to facilitate responsible use of endoscopic resources during this crisis. We also describe our recommendations for use of personal protective equipment by endoscopists, with the goal of ensuring the safety of ourselves, our anesthesiology and endoscopy staff, and our patients.


Necrotizing periodontal disease: Oral manifestation of COVID-19


Converting a Small Surgical Team into a Pandemic Response Team for an Isolated Population


Efficacy of Almitrine in the Treatment of Hypoxemia in Sars-Cov-2 Acute Respiratory Distress Syndrome


Clarification of Mortality Rate and Data in Abstract, Results, and Table 2


German endoscopy unit preparations for the COVID-19 pandemic: A nationwide survey


title: Follow up investigation of asymptomatic COVID-19 cases at diagnosis in Busan, Korea

text: Objectives: The objective of the study was to conduct a follow-up investigation of 10 asymptomatic patients at diagnosis among the 98 confirmed COVID-19 cases reported in Busan between February 21 and March 13, 2020 to determine whether asymptomatic infection and transmission during asymptomatic period are possible. Methods: The study analyzed 10 asymptomatic, confirmed COVID-19 cases to determine whether asymptomatic infection is possible. We conducted in-depth interviews with patients and guardians; interviews with primary physicians; review of medical records and drug utilization review (DUR) reports; and base station-based location tracking. Results: Among the 98, confirmed COVID-19 cases reported in Busan, the study analyzed 10 (10.2%) asymptomatic patients at diagnosis. The Results confirmed that two (2.0%) patients reported to be asymptomatic during the initial epidemiological investigation, but turned symptomatic before diagnosis as per the in-depth interview results. Four cases (4.0%) of early detection led to confirmed diagnosis during the incubation period and presentation of symptoms after diagnosis. In addition, the remaining four patients (4.0%), having no subjective symptoms nor specific findings on chest radiography and Computed Tomography, remained asymptomatic until the isolation order was lifted. With regard to whether transmission during the asymptomatic period is possible, it was found that one out of 23 household contacts of the confirmed patients was identified as an additional confirmed case after coming in close contact with an index patient during the presymptomatic period. Conclusion: Among the 98 confirmed cases, asymptomatic infection was confirmed in four cases (4.0%). In addition, there was one additional confirmed case in which the patient was a family member who came in close contact with an index patient during the incubation period, thereby confirming that transmission during the asymptomatic period is possible. The possibility of transmission during the asymptomatic period has been confirmed; therefore, it is necessary to review the measures for expanding contact tracing that is currently being applied starting one day prior to the onset of symptoms.


title: Does Wuhan Need to be in Lockdown during the Chinese Lunar New Year?

text: On 23 January 2020, the government of China announced a lockdown of all public transportationdeparting from Wuhan, including airports, trains, and buses [...].


Laboratory Diagnosis of COVID 19 - Perspectives


title: Flowing into the unknown: inferred paleodrainages for studying the ichthyofauna of Brazilian coastal rivers

text: The eastern coastal basins of Brazil are a series of small and isolated rivers that drain directly into the Atlantic Ocean. During the Pleistocene, sea-level retreat caused by glaciations exposed the continental shelf, resulting in enlarged paleodrainages that connected rivers that are isolated today. Using Geographic Information System (GIS), we infer the distribution of these paleodrainages, and their properties for the east Brazilian coast. Specifically, using elevation/bathymetric data for the largest sea-level retreats during the Pleistocene, the paleodrainages, their area and the number of contemporary basins connected by each palaeodrainage, was inferred. For the 145 inferred paleodrainages, total paleodrainage area is strongly correlated with the contemporary area encompassed by each paleodrainage, as well as with the number of contemporary basins encompassed by a paleodrainage. Differences in the continental shelf exposure along the coast affected the degree of past connectivity among contemporary rivers. With our results freely available, we discuss how paleodrainages have tremendous utility in biological studies, especially in regions with limited geologic data. With respect to the diverse ichthyofauna of the Brazilian coast, and its high endemism, we highlight how the inferred paleodrainages provide a backdrop to test hypotheses about the effect of past riverine connectivity on diversity patterns.(AU)


Is the increased risk for MAFLD patients to develop severe COVID-19 linked to perturbation of the gut-liver axis?


title: Directiva sanitaria que establece disposiciones y medidas para operativizar las inmunizaciones en el Perú en el contexto del COVID-19/ Health directive that establishes provisions and measures to operationalize immunizations in Peru in the context of COVID-19

text: El documento contiene las disposiciones y medidas para operativizar las inmunizaciones en el contexto del COVID-19.


title: The Impact of COVID-19 on Flight Networks

text: As COVID-19 transmissions spread worldwide, governments have announced and enforced travel restrictions to prevent further infections. Such restrictions have a direct effect on the volume of international flights among these countries, resulting in extensive social and economic costs. To better understand the situation in a quantitative manner, we used the Opensky network data to clarify flight patterns and flight densities around the world and observe relationships between flight numbers with new infections, and with the economy (unemployment rate) in Barcelona. We found that the number of daily flights gradually decreased and suddenly dropped 64% during the second half of March in 2020 after the US and Europe enacted travel restrictions. We also observed a 51% decrease in the global flight network density decreased during this period. Regarding new COVID-19 cases, the world had an unexpected surge regardless of travel restrictions. Finally, the layoffs for temporary workers in the tourism and airplane business increased by 4.3 fold in the weeks following Spain's decision to close its borders.


SARS-Cov-2 (human) and COVID-19: Primer 2020


title: Pediatric Telebehavioral Health: A Transformational Shift in Care Delivery in the Era of COVID-19

text: UNSTRUCTURED: Telebehavioral Health has been expanding for the past decade to improve access and address the critical shortage of psychiatric workforce. The sudden shift from traditional in-person visits to alternatives modalities has been forced as a result of coronavirus disease 2019 (COVID-19). There are key factors associated with successful transitional and large-scale implementation of telehealth with existing resources. We describe the experience of a large health system in utilizing telehealth technology, identify strategies and discuss considerations for long term sustainability after the pandemic.


Post-intensive care syndrome in paediatrics: setting our sights on survivorship


title: Caution of coronavirus transmission through ocular surface/ 国际眼科杂志(Guoji Yanke Zazhi)

text: @#At present, the new coronavirus(COVID-19)epidemic is spreading rapidly in Wuhan city Hubei province of China, and has aroused great attention of the international community. There have been clues that the conjunctiva may be one of the entries for the new coronavirus(SARS-CoV-2). In the absence of clinical evidence on ocular infection with SARS-CoV-2. Therefore, understanding the mechanism and cell receptors of coronavirus transmission through ocular surface and the transmission characteristics of homologous coronavirus can provide some suggestions for appropriately ocular protection and identify COVID-19 coexisting with ocular signs for ophthalmologists during this epidemic disease.


Clinical distancing of hospitalized patients with advanced heart failure and cardiac transplantation during COVID-19


Giant Retroperitoneal Hematoma During Extracorporeal Membrane Oxygenation in a Patient With Coronavirus Disease-2019 Pneumonia


A Post-COVID-19 Parkinsonism in the Future?


Silencing of immune activation with methotrexate in patients with COVID-19


title: COVID-DA: Deep Domain Adaptation from Typical Pneumonia to COVID-19

text: The outbreak of novel coronavirus disease 2019 (COVID-19) has already infected millions of people and is still rapidly spreading all over the globe. Most COVID-19 patients suffer from lung infection, so one important diagnostic method is to screen chest radiography images, e.g., X-Ray or CT images. However, such examinations are time-consuming and labor-intensive, leading to limited diagnostic efficiency. To solve this issue, AI-based technologies, such as deep learning, have been used recently as effective computer-aided means to improve diagnostic efficiency. However, one practical and critical difficulty is the limited availability of annotated COVID-19 data, due to the prohibitive annotation costs and urgent work of doctors to fight against the pandemic. This makes the learning of deep diagnosis models very challenging. To address this, motivated by that typical pneumonia has similar characteristics with COVID-19 and many pneumonia datasets are publicly available, we propose to conduct domain knowledge adaptation from typical pneumonia to COVID-19. There are two main challenges: 1) the discrepancy of data distributions between domains; 2) the task difference between the diagnosis of typical pneumonia and COVID-19. To address them, we propose a new deep domain adaptation method for COVID-19 diagnosis, namely COVID-DA. Specifically, we alleviate the domain discrepancy via feature adversarial adaptation and handle the task difference issue via a novel classifier separation scheme. In this way, COVID-DA is able to diagnose COVID-19 effectively with only a small number of COVID-19 annotations. Extensive experiments verify the effectiveness of COVID-DA and its great potential for real-world applications.


title: Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

text: The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.


title: A New Prediction of Daily Number of New Cases and Total Number Infected for nCOVID-19 Plague Infections In Indonesia with the Modification of the Bernoulli Differential Equation

text: The application of differential equations is commonly used in mathematics and physics, as well as various other sciences to explain a phenomenon in a system. This paper explains the mathematical modeling in the analysis of the nCOVID-19 plague in Indonesia on March 3, 2020, to April 19, 2020, with the modification of the Bernoulli equation and the simulation by MATLAB. In this study, it can be concluded that it was found that the daily number of nCOVID-19 cases in Indonesia will have the highest case at a maximum of around 400 and the total number of positive nCOVID-19 in Indonesia will reach 12000 people with a quiet period in mid-June. In this modeling, it has also been found that the value of R2 = 0.9927 on the total number of positive nCOVID-19 in Indonesia taken from 3 March 2020 to 19 April 2020, while the value of R2 = 0.807 daily number of positive new cases of nCOVID-19 in Indonesia taken from March 3, 2020, to April 19, 2020. Based on this research, it can be shown that the nCOVID-19 model for a case in the Indonesia plague is quite accurately compared by the real data.


title: Systematic Review and Meta-Analysis of the Efficacy of Nanoscale Materials Against Coronaviruses-Possible Potential Antiviral Agents for SARS-CoV-2

text: The available antiviral agents and their potential for the management of coronavirus disease 2019 (COVID-19) outbreak are important interventions. A systematic review and meta-analysis was performed to summarize the available evidence on the efficacy of nanoscale materials against coronaviruses in vitro and in animal models. PubMed, Scopus and Wiley Online Library databases were searched up to 4 March 2020. Studies that developed the efficacy of nanoscale materials against coronaviruses were included. Two reviewers independently extracted study characteristics and assessed risk of bias and applicability in the included studies. Meta-analyses were conducted to determine the overall inhibition efficacy of nanoscale materials against coronaviruses. A total of 21 studies were identified. Positive association was found between efficacy of nanoscale materials and coronaviruses in vitro and in animal models. The inhibition efficacy of nanoscale materials against coronavirus in vitro and in animal models were 1.84 (95% CI: 1.57, 2.15) and 1.66 (95% CI: 1.36, 2.02), respectively. Results of subgroup analysis of selected studies revealed that the nanoscale materials with spherical morphology were found to be more antiviral activity than the other morphologies against Middle East respiratory syndrome-coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV). Using systematic review and meta-analysis, our results indicate that nanoscale materials are positive affect against coronaviruses. We might clarify the possible potential for the use of nanoscale materials for SARS-CoV-2.


Most Adaptable to Change


title: Coronavirus Disease 2019 (COVID-19): Chinese Radiologists Are Acting

text: The ongoing outbreak of Coronavirus Disease 2019 (COVID-19) has spread rapidly throughout China and other countries, and has been characterized as a pandemic. With the strict prevention and control measures implemented by the Chinese government, the spread of the epidemic in China has come under preliminary control by the end of February, 2020, whereas the situation of some countries outside China is not optimistic and raises great public concern. In fighting COVID-19, radiologic examinations played a critical role in the early diagnosis of COVID-19, and could also help assess disease course and severity. There is an urgent need to share useful experience and effective measures internationally. This article outlines the collaborative actions and efforts by the Chinese radiology field and the situation of front-line health care workers in radiology departments to present the world with experiences and examples of Chinese radiology during the COVID-19 outbreak.


title: Impact of quarantine measures on chemical compositions of PM2.5 during the COVID-19 epidemic in Shanghai, China

text: The COVID-19 epidemic broke out in Wuhan, Hubei in December 2019 and in January 2020 and was later transmitted to the entire country. Quarantine measures during Chinese New Year effectively alleviated the spread of the epidemic, but they simultaneously resulted in a decline in anthropogenic emissions from industry, transportation, and import and export of goods. Herein, we present the major chemical composition of non-refractory PM2.5 (NR-PM2.5) and the concentrations of gaseous pollutants in an urban site in Shanghai before and during the quarantine period of the COVID-19 epidemic, which was Jan. 8-23 and Jan. 24-Feb. 8, respectively. The observed results show that the reduction in PM2.5 can be mainly attributed to decreasing concentrations of nitrate and primary aerosols. Nitrate accounted for 37% of NR-PM2.5 before the quarantine period when there was no emission reduction. During the quarantine period, the nitrate concentration decreased by approximately 60%, which is attributed to a reduction in the NOx concentration. Ammonium, as the main balancing cation, showed an approximately 45% simultaneous decrease in concentration. The concentrations of chloride and hydrocarbon-like organic aerosols from primary emissions also declined due to limited human activities. By contrast, sulphate and oxygenated organic aerosols showed a slight decrease in concentration, with their contributions increasing to 27% and 18%, respectively, during the quarantine period, which resulted in two pollution episodes with PM2.5 exceeding 100 µg/m3. This study provides a better understanding of the impact of quarantine measures on variations of the PM2.5 concentration and chemical compositions. Atmospheric oxidation capacities based on the oxidant (Ox = O3 + NO2) and oxidation ratios have been discussed for elucidating the source and formation of haze in an environment with lower anthropogenic emissions. With increasing contribution of secondary aerosols, lower NOx and nitrate concentrations did not completely avoid haze in Shanghai during the epidemic.


title: Predictability: Can the turning point and end of an expanding epidemic be precisely forecast?

text: No, they can't. Exponentially growing dynamics are intrinsically unpredictable. The time at which the number of infected individuals starts decreasing cannot be reliably calculated before it is actually attained. A standard SIR model with confinement shows that infection spread is inhibited only above a threshold. Confinement induces a slow-down in the expansion phase that does not guarantee an eventual control of the epidemic. A Bayesian fit to the on-going COVID-19 pandemic in Spain shows that we can infer neither its peaking time nor whether there is a peak at all. The dispersion of possible trajectories grows extremely fast, yielding a short horizon for reliable prediction. As unpredictability is intrinsic, not due to incomplete or wrong data, our study advocates for a scenario of probabilistic forecasting.


Characteristics of deaths amongst health workers in China during the outbreak of COVID-19 infection


The Impact of COVID-19 on Diabetes Research in Canada


Coronavirus confinement: A chance to learn on oral cancer-The Spanish experience


title: Inelastic Dark Matter Electron Scattering and the XENON1T Excess

text: Detection of electron recoils by dark matter (DM) may reveal the structure of the dark sector. We consider a scenario where a heavier DM particle inelastically scatters off an electron and is converted into a lighter DM particle. A small mass difference between the two DM particles is transferred into electron recoil energy. We investigate the DM-electron interaction mediated by a massive dark photon and evaluate the inelastic DM scattering rate, taking account of the atomic structure. It is found that the scattering rate is significantly enhanced because of the small mass splitting, which allows for a small momentum transfer matched with the size of the electron wave function. We show that there exists a viable parameter space which explains the excess of electron recoil events around 2-3 keV recently reported by the XENON1T experiment.


title: Antenatal corticosteroids for pregnant women with COVID-19 infection and preterm prelabor rupture of membranes: a decision analysis

text: Background: While antenatal corticosteroids are routinely used to decrease adverse neonatal outcomes following preterm delivery, corticosteroids are also associated with worse outcomes in patients with viral respiratory infections. Currently in the setting of the COVID-19 pandemic, it is unclear whether antenatal corticosteroids for infant benefit outweigh the potential harm to a pregnant woman with a COVID-19 infection.Objective: To determine at which gestational ages administering antenatal corticosteroids is the optimal management strategy for hospitalized women with preterm prelabor rupture of membranes (PPROM) who have a COVID-19 infection.Methods: We designed a decision-analytic model to assess the maternal and infant outcomes associated with antenatal corticosteroid administration for risk of preterm delivery following rupture of membranes in the setting of a COVID-19 infection. We used a theoretical cohort of 10,000 women at each gestational age between 24 and 32 weeks who were hospitalized with PPROM and found to be COVID-19 positive. Maternal outcomes included intensive care unit admission and death related to COVID-19 infection. The infant outcomes of interest included respiratory distress syndrome, intraventricular hemorrhage, neurodevelopmental delay, and death, and were assessed along with maternal and infant quality-adjusted life years (QALYs). Deterministic and probabilistic sensitivity analyses were used to evaluate model assumptions.Results: In our theoretical cohort of 10,000 women with COVID-19 infection and preterm prelabor rupture of membrane between 24 and 32 weeks, corticosteroid administration resulted in 2,200 women admitted to the ICU and 110 maternal deaths at each gestational age. No antenatal corticosteroid use resulted in 1,500 ICU admissions and 75 maternal deaths at each gestational age. Antenatal corticosteroid administration also resulted in fewer cases of respiratory distress syndrome, intraventricular hemorrhage, and infant death. Overall, we found that between 24 and 30 weeks of gestation, administering antenatal corticosteroids was the optimal management strategy as it resulted in higher combined QALYs than no corticosteroid use. For 31 and 32 weeks of gestation, antenatal corticosteroid administration resulted in lower combined QALYs. On sensitivity analyses, we found that with increasing gestational age, the probability which antenatal corticosteroids was the optimal management strategy decreased.Conclusion: Administration of antenatal corticosteroids was an effective management strategy compared to no corticosteroid administration at gestational ages less than 31 weeks. These results provide data for clinicians to utilize when counseling pregnant patients hospitalized with PPROM and have a COVID-19 infection.


A case of subacute thyroiditis associated with Covid-19 infection


title: [Health protection guideline of mobile cabin hospitals during Novel Coronavirus Pneumonia (NPC) outbreak]

text: This guideline is applicable to the health protection requirements of large indoor stadiums which are reconstructed as treatment sites for the Novel Coronavirus Pneumonia (NPC) patients with mild symptoms during the outbreak. Focusing on the health emergency scenario of severe virus infectious diseases and atypical places where NPC patients with mild symptom gather, from perspectives of functional zones, hygiene facilities, personal protection, and management system, health risk protection recommendations and countermeasures are comprehensively proposed to mainly protect staffs and surrounding environment. The implementation of this guideline will provide technique support for emergency requirements of indoor stadiums reconstructed as mobile cabin hospitals.


title: [Clinical features and high resolution CT imaging evolution of coronavirus disease 2019]

text: Objective: To investigate the clinical manifestations of the clinical characteristics of 141 patients with coronavirus disease 2019 (COVID-19) and the imaging evolution characteristics of High Resolution CT (HRCT) in the chest. Methods: From January 20, 2020 to February 8, 141 COVID-19 patients in Renmin Hospital of Wuhan University, 77 males and 64 females, with a median age of 49 (9,87) , were retrospectively analyzed. The clinical features, laboratory examination indexes and HRCT evolution findings of 141 COVID-19 patients were analyzed. Results: Laboratory examinations of 141 COVID-19 patients showed a decrease in white blood cell count and lymphocyte ratio. Among the 141 patients with COVID-19, fever (>37.5 â) was the most common clinical manifestation in 139 cases (98.58%) , and occasionally non-respiratory symptoms such as diarrhea in 4 cases (2.84%) . 141 patients with COVID-19 had abnormal HRCT. 52 (36.88%) chest HRCT images showed ground-glass opacity (GGO) , mainly under pleural; 23 (16.31%) GGO with focal consolidation; 27 (19.15%) small flaky shadows; 20 cases (14.18%) large flaky consolidation shadows; 48 cases (34.04%) bronchovascular bundle thickening and vascular penetrating signs; 5 cases (3.55%) had air bronchial signs; 7 cases (4.96%) of small nodule shadows; 5 cases (3.55%) of fibrosis, grid shadows or strand shadows.135 cases (95.74%) were positive for the first time nucleic acid test, 6 cases (4.26%) were negative, and 71 cases (50.35%) of common type, 47 cases (33.33%) of severe type and 23 cases (16.31%) of critical type were found during the same period. The average time from onset of each type to the first CT examination was: (2.51±1.32) , (5.02±2.01) , and (5.91±1.76) days; 19 (19/47, 40.43%) of which were severe for the first time CT classification worsened at the second examination and lessened at the third examination. 141 cases (100%) were positive for the second nucleic acid test, and the HRCT results for the same period were 44 cases (31.21%) of common type, 53 cases (37.59%) of severe type, and 44 cases (31.21%) of critical type; the average interval time was (3.32±1.61) , (3.93±1.84) , (4.15±1.57) days;the third nucleic acid test were positive among 113 cases and 28 cases were negative, HRCT results of the same period were 79 cases (56.03%) of common type, 46 cases (32.62%) of severe type, and 16 cases (11.35%) of critical type;the average interval from the first CT examination were: (5.59±1.83) , (7.32±1.37) , (7.55±1.78) days. The differences in CT typing at different time were statistically significant (P<0.05) . Conclusion: The clinical features of COVID-19 and HRCT images are diverse, extensive GGO and infiltrates in both lungs are typical. Viral nucleic acid tests usually occur earlier or at the same time as the CT examination positive, and there are false negatives in nucleic acid tests. In some epidemiological backgrounds, CT imaging manifestations and evolutionary characteristics are of great significance for early warning of lung injury, assessment of disease severity, and assistance in clinical typing and post-treatment follow-up.


Covid-19: Projections of mortality in the US rise as states open up


Adapting a GI Fellowship to a Pandemic: Novel Approaches to Accommodating a Novel Virus


The COVID-19 outbreak in Italy: Preventive and protective measures adopted by the Dermatology Unit of Bologna University Hospital


title: Novel Coronavirus 2019 (2019-nCoV) Infection: Part I - Preparedness and Management in the Pediatric Intensive Care Unit in Resource-limited Settings

text: First reported in China, the 2019 novel coronavirus has been spreading across the globe. Till 26 March, 2020, 416,686 cases have been diagnosed and 18,589 have died the world over. The coronavirus disease mainly starts with a respiratory illness and about 5-16% require intensive care management for acute respiratory distress syndrome (ARDS) and multi-organ dysfunction. Children account for about 1-2% of the total cases, and 6% of these fall under severe or critical category requiring pediatric intensive care unit (PICU) care. Diagnosis involves a combination of clinical and epidemiological features with laboratory confirmation. Preparedness strategies for managing this pandemic are the need of the hour, and involve setting up cohort ICUs with isolation rooms. Re-allocation of resources in managing this crisis involves careful planning, halting elective surgeries and training of healthcare workers. Strict adherence to infection control like personal protective equipment and disinfection is the key to contain the disease transmission. Although many therapies have been tried in various regions, there is a lack of strong evidence to recommend anti-virals or immunomodulatory drugs.


title: A social identity perspective on COVID-19: Health risk is affected by shared group membership

text: In the face of a novel infectious disease, changing our collective behaviour is critical to saving lives. One determinant of risk perception and risk behaviour that is often overlooked is the degree to which we share psychological group membership with others. We outline, and summarize supporting evidence for, a theoretical model that articulates the role of shared group membership in attenuating health risk perception and increasing health risk behaviour. We emphasize the importance of attending to these processes in the context of the ongoing response to COVID-19 and conclude with three recommendations for how group processes can be harnessed to improve this response.


Molecular diagnostics at the times of SARS-CoV-2 outbreak


Myocardial work index: a glimmer of hope in COVID-19


Social distancing during the COVID-19 pandemic: Staying home save lives


title: A summary of the diagnostic and prognostic value of hemocytometry markers in COVID-19 patients

text: Many studies have reported hemocytometric changes in COVID-19 infection at admission and during the course of disease, but an overview is lacking. We provide a summary of the literature of hemocytometric changes and evaluate whether these changes may assist clinicians in diagnosing and predicting disease progression of COVID-19. Eighty-three out of 250 articles from December 2019 to 20 May 2020 were included from the databases, PubMed, Web of Science Core Collection, Embase, Cochrane and MedRxiv. Our review of the literature indicates that lymphopenia and an elevated neutrophil/lymphocyte ratio are the most consistent abnormal hemocytometric findings and that these alterations may augment in the course of time, especially in those with severe disease.


title: Effect of income on the cumulative incidence of COVID-19: an ecological study

text: OBJECTIVE: to analyze the relationship between per capita income and the cumulative incidence of COVID-19 in the neighborhoods of the city of Rio de Janeiro, RJ, Brazil. METHOD: an ecological study using neighborhoods as units of analysis. The cumulative incidence rate per 100,000 inhabitants and the median of potential confounding variables (sex, race, and age) were calculated. Multiple analysis included quantile regression, estimating the regression coefficients of the variable income for every five percentiles from the 10th to 90th percentiles to verify the relationship between income and incidence. RESULTS: the city's rate was 36.58 new cases per 100,000 inhabitants. In general, the highest rates were observed in the wealthiest regions. Multiple analysis was consistent with this observation since the per capita income affected all percentiles analyzed, with a median regression coefficient of 0.02 (p-value <0.001; R2 32.93). That is, there is an increase of R$ 0.02 in the neighborhood's per capita income for every unit of incidence. CONCLUSION: cumulative incident rates of COVID-19 are influenced by one's neighborhood of residency, suggesting that access to testing is uneven.


Assuring mental health during our current pandemic


title: Approaches to the management of patients in oral and maxillofacial surgery during COVID-19 pandemic

text: Oral and maxillofacial surgery is correlated with a high risk of SARS-CoV-2 transmission. Therefore, the aim of the review is to collect and discuss aspects of the management of patients in oral and maxillofacial surgery during the COVID-19 pandemic. In order to save resources and to avoid unnecessary exposure to infected patients, there is the need to schedule interventions depending on their priority. During the peak of the pandemic, no elective surgery should be performed. Even urgent procedures might be postponed if there is a view to recovery of a COVID-19 patient within a few days. Emergency procedures do not allow any delay. Specialties with overlap in therapies should have well defined arrangements among each other concerning the treatment spectra in order to avoid redundancy and loss of resources. Inpatient and outpatient units have to be organized in such a way that the risk of cross-infection among patients is reduced to a minimum. Especially, testing of patients for SARS-CoV-2 is important to detect the infected patients at an early stage. When surgery is performed on COVID-19 patients, adequate personal protective equipment is crucial. There must be negative pressure in the operating room, and aerosol formation must be reduced to a minimum. In order to address the COVID-19 challenge adequately, significant changes in the infrastructure of outpatient units, inpatient units, and operating rooms are needed. In addition, the demands concerning personal protective equipment increase significantly. The major aim is to protect patients as well as the medical staff from unnecessary infection, and to keep the healthcare system running effectively. Therefore, every effort should be taken to make the necessary investments.


Covid-19 and refugees, asylum seekers, and migrants in Greece


Psychosocial support for healthcare frontliners during COVID-19 pandemic in Malaysia


title: A possible strategy to fight COVID-19: Interfering with spike glycoprotein trimerization

text: The recent release of COVID-19 spike glycoprotein allows detailed analysis of the structural features that are required for stabilizing the infective form of its quaternary assembly. Trying to disassemble the trimeric structure of COVID-19 spike glycoprotein, we analyzed single protomer surfaces searching for concave moieties that are located at the three protomer-protomer interfaces. The presence of some druggable pockets at these interfaces suggested that some of the available drugs in Drug Bank could destabilize the quaternary spike glycoprotein formation by binding to these pockets, therefore interfering with COVID-19 life cycle. The approach we propose here can be an additional strategy to fight against the deadly virus. Ligands of COVID-19 spike glycoprotein that we have predicted in the present computational investigation, might be the basis for new experimental studies in vitro and in vivo.


title: Trials and tribulations: so many potential treatments, so few answers

text: PURPOSE: The purpose of this review is to quantify the landscape of current clinical trials ongoing for therapies in the treatment of COVID-19. A secondary purpose is to examine the relationship between public and scientific interests in potential therapies for COVID-19. METHODS: A systematic search of clinicaltrials.gov was undertaken on April 22, 2020, to identify all currently registered clinical trials investigating potential therapies for patients with COVID-19. Public interest in the various therapies was quantified utilizing Google Trends. Public interest in hydroxychloroquine and chloroquine was plotted against the cumulative number of active clinical trials evaluating antimalarials as potential COVID-19 therapies over time. RESULTS: There were 341 interventional studies and 208 different therapies actively registered on clinicaltrials.gov whose primary aim is the treatment of COVID-19. The median sample size was 120 patients (range 4-6000) with 154 (45%) trials reporting a planned sample size of 100 patients or less. There was a strong positive correlation (r = 0.76, p = 0.01) between the number of registered clinical trials and the public interest in the top ten proposed therapies. Following the spike in public interest, the average number of new trials increased tenfold with respect to antimalarial therapies. CONCLUSIONS: The relatively small sample sizes and the number of independent trials investigating similar therapies are concerning. Resources may not be being allocated based on scientific merit and may be driven by public consciousness and speculation. Moving forward, a concerted effort focused on implementing large, well-coordinated and carefully designed multi-armed clinical trials will help to ensure that the most promising therapeutic options are rigorously studied and clinically meaningful results produced.


title: Estimating the infection horizon of COVID-19 in eight countries with a data-driven approach

text: The COVID-19 pandemic has affected all countries of the world producing a substantial number of fatalities accompanied by a major disruption in their social, financial and educational organization. The strict disciplinary measures implemented by China were very effective and thus were subsequently adopted by most world countries to various degrees. The infection duration and number of infected persons are of critical importance for the battle against the pandemic. We use the quantitative landscape of the disease spreading in China as a benchmark and utilize infection data from eight countries to estimate the complete evolution of the infection in each of these countries. The analysis predicts successfully both the expected number of daily infections per country and, perhaps more importantly, the duration of the epidemic in each country. Our quantitative approach is based on a Gaussian spreading hypothesis that is shown to arise as a result of imposed measures in a simple dynamical infection model. This may have consequences and shed light in the efficiency of policies once the phenomenon is over.


Medical education and care in dermatology during the SARS-CoV2 pandemia: challenges and chances


title: A review of the international early recommendations for departments organization and cancer management priorities during the global COVID-19 pandemic: applicability in low- and middle-income countries

text: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new virus that has never been identified in humans before. COVID-19 caused at the time of writing of this article, 2.5 million cases of infections in 193 countries with 165,000 deaths, including two-third in Europe. In this context, Oncology Departments of the affected countries had to adapt quickly their health system care and establish new organizations and priorities. Thus, numerous recommendations and therapeutic options have been reported to optimize therapy delivery to patients with chronic disease and cancer. Obviously, while these cancer care recommendations are immediately applicable in Europe, they may not be applicable in certain emerging and low- and middle-income countries (LMICs). In this review, we aimed to summarize these international guidelines in accordance with cancer types, making a synthesis for daily practice to protect patients, staff and tailor anti-cancer therapy delivery taking into account patients/tumour criteria and tools availability. Thus, we will discuss their applicability in the LMICs with different organizations, limited means and different constraints.


title: Building trust in digital policing: A scoping review of community policing apps

text: Perceptions of police trustworthiness are linked to citizens' willingness to cooperate with police. Trust can be fostered by introducing accountability mechanisms, or by increasing a shared police/citizen identity, both which can be achieved digitally. Digital mechanisms can also be designed to safeguard, engage, reassure, inform, and empower diverse communities. We systematically scoped 240 existing online citizen-police and relevant third-party communication apps, to examine whether they sought to meet community needs and policing visions. We found that 82% required registration or login details, 55% of those with a reporting mechanism allowed for anonymous reporting, and 10% provided an understandable privacy policy. Police apps were more likely to seek to reassure, safeguard and inform users, while third-party apps were more likely to seek to empower users. As poorly designed apps risk amplifying mistrust and undermining policing efforts, we suggest 12 design considerations to help ensure the development of high quality/fit for purpose Police/Citizen apps.


Need for integrated surveillance at human-animal interface for rapid detection & response to emerging coronavirus infections using One Health approach


title: The broad-spectrum antiviral recommendations for drug discovery against COVID-19

text: Despite to outbreaks of highly pathogenic beta and alpha coronaviruses including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and human coronavirus, the newly emerged 2019 coronavirus (COVID-19) is considered as a lethal zoonotic virus due to its deadly respiratory syndrome and high mortality rate among the human. Globally, more than 3,517,345 cases have been confirmed with 243,401 deaths due to Acute Respiratory Distress Syndrome (ARDS) caused by COVID-19. The antiviral drug discovery activity is required to control the persistence of COVID-19 circulation and the potential of the future emergence of coronavirus. However, the present review aims to highlight the important antiviral approaches, including interferons, ribavirin, mycophenolic acids, ritonavir, lopinavir, inhibitors, and monoclonal antibodies (mAbs) to provoke the nonstructural proteins and deactivate the structural and essential host elements of the virus to control and treat the infection of COVID-19 by inhibiting the viral entry, viral RNA replication and suppressing the viral protein expression. Moreover, the present review investigates the epidemiology, diagnosis, structure, and replication of COVID-19 for better understanding. It is recommended that these proteases, inhibitors, and antibodies could be a good therapeutic option in drug discovery to control the newly emerged coronavirus.HighlightsCOVID-19 has more than 79.5% identical sequence to SARS-CoV and a 96% identical sequence of the whole genome of bat coronaviruses.Acute respiratory distress syndrome (ARDS), renal failure, and septic shock are the possible clinical symptoms associated with COVID-19.Different antivirals, including interferons, ribavirin, lopinavir, and monoclonal antibodies (mAbs) could be the potent therapeutic agents against COVID-19.The initial clinical trials on hydroquinone in combination with azithromycin showed an admirable result in the reduction of COVID-19.The overexpression of inflammation response, cytokine dysregulation, and induction of apoptosis could be an well-organized factors to reduce the pathogenicity of COVID-19.


title: Recomendaciones Del Grupo Español De Investigación En Dermatitis De Contacto Y Alergia Cutánea (Geidac ) De La Aedv En Relación A La Realización De Pruebas Epicutáneas Durante La Pandemia Por Sars-Cov-2 ( Covid-19)./ Recomendaciones Del Grupo Español De Investigación En Dermatitis De Contacto Y Alergia Cutánea (Geidac ) De La Aedv En Relación A La Realización De Pruebas Epicutáneas Durante La Pandemia Por Sars-Cov-2 ( Covid-19)./ Patch Testing During the COVID-19 Pandemic: Recommendations of the AEDV's Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC)

text: As the COVID-19 pandemic gradually comes under control, the members of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) have drawn up a proposed list of the requirements, limitations, and conditioning factors affecting the resumption of work in contact dermatitis units. The assumption is that the severe acute respiratory syndrome coronavirus 2 is still circulating and that occasional or seasonal outbreaks will occur. They recommend that the first step should be to assess how many patch tests each clinic can handle and review the waiting list to prioritize cases according to disease severity and urgency. Digital technologies can, where possible, be used to send and receive the documentation necessary for the patch test (information, instructions, informed consent, etc.). If the necessary infrastructure is available, patients can be offered the option of a remote initial consultation. Likewise, in selected cases, the patch test results can be read in a virtual visit using photographs taken by the patient or a video visit can be scheduled to allow the physician to evaluate the site of application remotely. These measures will reduce the number of face-to-face visits required, but will not affect the time spent on each case, which must be scheduled in the normal manner. All of these recommendations are suggestions and should be adapted to the needs and possibilities of each health centre.


COVID-19 and non-traditional mask use: How do various materials compare in reducing the infection risk for mask wearers?


title: The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China

text: The 2019-nCoV is officially called SARS-CoV-2 and the disease is named COVID-19. This viral epidemic in China has led to the deaths of over 1800 people, mostly elderly or those with an underlying chronic disease or immunosuppressed state. This is the third serious Coronavirus outbreak in less than 20 years, following SARS in 2002-2003 and MERS in 2012. While human strains of Coronavirus are associated with about 15% of cases of the common cold, the SARS-CoV-2 may present with varying degrees of severity, from flu-like symptoms to death. It is currently believed that this deadly Coronavirus strain originated from wild animals at the Huanan market in Wuhan, a city in Hubei province. Bats, snakes and pangolins have been cited as potential carriers based on the sequence homology of CoV isolated from these animals and the viral nucleic acids of the virus isolated from SARS-CoV-2 infected patients. Extreme quarantine measures, including sealing off large cities, closing borders and confining people to their homes, were instituted in January 2020 to prevent spread of the virus, but by that time much of the damage had been done, as human-human transmission became evident. While these quarantine measures are necessary and have prevented a historical disaster along the lines of the Spanish flu, earlier recognition and earlier implementation of quarantine measures may have been even more effective. Lessons learned from SARS resulted in faster determination of the nucleic acid sequence and a more robust quarantine strategy. However, it is clear that finding an effective antiviral and developing a vaccine are still significant challenges. The costs of the epidemic are not limited to medical aspects, as the virus has led to significant sociological, psychological and economic effects globally. Unfortunately, emergence of SARS-CoV-2 has led to numerous reports of Asians being subjected to racist behavior and hate crimes across the world.


title: Scoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources: Application to the Coronavirus Disease 2019 (COVID-19) Pandemic and Beyond

text: BACKGROUND: As of May 4, 2020, the coronavirus disease 2019 (COVID-19) pandemic has affected >3.5 million people and touched every inhabited continent. Accordingly, it has stressed health systems worldwide, leading to the cancellation of elective surgical cases and discussions regarding health care resource rationing. It is expected that rationing of surgical resources will continue even after the pandemic peak and may recur with future pandemics, creating a need for a means of triaging patients for emergent and elective spine surgery. METHODS: Using a modified Delphi technique, a cohort of 16 fellowship-trained spine surgeons from 10 academic medical centers constructed a scoring system for the triage and prioritization of emergent and elective spine surgeries. Three separate rounds of videoconferencing and written correspondence were used to reach a final scoring system. Sixteen test cases were used to optimize the scoring system so that it could categorize cases as requiring emergent, urgent, high-priority elective, or low-priority elective scheduling. RESULTS: The devised scoring system included 8 independent components: neurologic status, underlying spine stability, presentation of a high-risk postoperative complication, patient medical comorbidities, expected hospital course, expected discharge disposition, facility resource limitations, and local disease burden. The resultant calculator was deployed as a freely available Web-based calculator (https://jhuspine3.shinyapps.io/SpineUrgencyCalculator/). CONCLUSIONS: We present the first quantitative urgency scoring system for the triage and prioritizing of spine surgery cases in resource-limited settings. We believe that our scoring system, although not all encompassing, has potential value as a guide for triaging spine surgical cases during the COVID pandemic and post-COVID period.


Nutrition in critically ill patients with COVID-19: Challenges and special considerations


Supportive treatment of COVID 19 patients with mild respiratory failure in a primary hospital


Adapting WOC Nursing Practice to the COVID-19 Pandemic: A View From Here


title: New (re)Purpose for an old drug: purinergic receptor blockade may extinguish the COVID-19 thrombo-inflammatory firestorm

text: Purinergic modulators, such as dipyridamole, target multiple pathways that have been implicated in COVID-19 pathogenesis, and thus the therapeutic benefit of these should be explored.


title: Correction: Risk factors affecting dairy cattle protective grouping behavior, commonly known as bunching, against Stomoxys calcitrans (L.) on California dairies

text: [This corrects the article DOI: 10.1371/journal.pone.0224987.].


Preparation in the Big Apple: New York City, a New Epicenter of the COVID-19 Pandemic


title: Vasculopathy and Coagulopathy Associated with SARS-CoV-2 Infection

text: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has resulted in > 500,000 deaths worldwide, including > 125,000 deaths in the U.S. since its emergence in late December 2019 and June 2020. Neither curative anti-viral drugs nor a protective vaccine is currently available for the treatment and prevention of COVID-19. Recently, new clinical syndromes associated with coagulopathy and vasculopathy have emerged as a cause of sudden death and other serious clinical manifestations in younger patients infected with SARS-CoV-2 infection. Angiotensin converting enzyme 2 (ACE2), the receptor for SARS-CoV-2 and other coronaviruses, is a transmembrane protein expressed by lung alveolar epithelial cells, enterocytes, and vascular endothelial cells, whose physiologic role is to induce the maturation of angiotensin I to generate angiotensin 1-7, a peptide hormone that controls vasoconstriction and blood pressure. In this review, we provide the general context of the molecular and cellular mechanisms of SARS-CoV-2 infection with a focus on endothelial cells, describe the vasculopathy and coagulopathy syndromes in patients with SARS-CoV-2, and outline current understanding of the underlying mechanistic aspects.


title: Stiripentol fails to lower plasma oxalate in a dialysis-dependent PH1 patient

text: BACKGROUND: Primary hyperoxaluria type 1 (PH1) is a multisystemic metabolic disorder caused by an excessive production of oxalate by the liver. The majority of patients presenting in early infancy have end-stage renal disease (ESRD). While awaiting the results of sRNAi trials, the current standard treatment is combined liver-kidney transplantation. Recently, Stiripentol has been reported as a promising drug in the treatment of primary hyperoxaluria by reducing urinary oxalate (UOx). Stiripentol is an anti-convulsive drug used in the treatment of children suffering from Dravet syndrome. It causes blockage of the last step in oxalate production by inhibition of hepatic lactate dehydrogenase 5 (LDH5). CASE: We administered Stiripentol as compassionate use in an anuric infant with dialysis-dependent PH1 over a period of 4 months. Although achieving plasma concentrations of Stiripentol that were recently reported to lower UOx excretion, we did not observe significant reduction to plasma oxalate concentrations (POx). CONCLUSION: We conclude that Stiripentol may not be useful to reduce POx in PH patients with advanced chronic kidney disease (CKD), but larger studies are needed to confirm this finding.


Health Care Heroes of the COVID-19 Pandemic


Preparedness and Rapid Implementation of External Quality Assessment Helped Quickly Increase COVID-19 Testing Capacity in the Republic of Korea


title: Bariatric and metabolic surgery during and after the COVID-19 pandemic: DSS recommendations for management of surgical candidates and postoperative patients and prioritisation of access to surgery

text: The coronavirus disease 2019 pandemic is wreaking havoc on society, especially health-care systems, including disrupting bariatric and metabolic surgery. The current limitations on accessibility to non-urgent care undermine postoperative monitoring of patients who have undergone such operations. Furthermore, like most elective surgery, new bariatric and metabolic procedures are being postponed worldwide during the pandemic. When the outbreak abates, a backlog of people seeking these operations will exist. Hence, surgical candidates face prolonged delays of beneficial treatment. Because of the progressive nature of obesity and diabetes, delaying surgery increases risks for morbidity and mortality, thus requiring strategies to mitigate harm. The risk of harm, however, varies among patients, depending on the type and severity of their comorbidities. A triaging strategy is therefore needed. The traditional weight-centric patient-selection criteria do not favour cases based on actual clinical needs. In this Personal View, experts from the Diabetes Surgery Summit consensus conference series provide guidance for the management of patients while surgery is delayed and for postoperative surveillance. We also offer a strategy to prioritise bariatric and metabolic surgery candidates on the basis of the diseases that are most likely to be ameliorated postoperatively. Although our system will be particularly germane in the immediate future, it also provides a framework for long-term clinically meaningful prioritisation.


Am I Part of the Cure or Am I Part of the Disease? Keeping Coronavirus Out When a Doctor Comes Home


When interferon tiptoes through COVID-19: Pernio-like lesions and their prognostic implications during SARS-CoV-2 infection


Olfactory Disorders in Sars-cov-2 Infection: Considerations in Aging


Coagulopathy of COVID-19 and antiphospholipid antibodies


Syndrome of inappropriate antidiuretic hormone as the initial presentation of COVID-19: A novel case report


Covid-19: Japan prepares to extend state of emergency nationwide as "untraceable" cases soar


title: Optimal Management of Acute Lymphoblastic Leukemia (ALL) in Adult Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic

text: The outbreak of coronavirus disease 2019 (COVID-19) has become a public health emergency of major international concern. In December 2019, an outbreak of atypical pneumonia known as COVID-19 was identified in Wuhan, China. The newly identified zoonotic coronavirus, severe acute respiratory syndrome coronavirus-2 (SARSCoV-2), is characterized by rapid human-to-human transmission. Acute lymphoblastic leukemia (ALL) patients are often in need for intensive chemotherapy to induce remission that will be complicated with prolonged period of cytopenias. They are often recalled to the hospital for treatment and disease surveillance. These patients may be immunocompromised due to the underlying malignancy or anti-cancer therapy. ALL patients are at higher risk of developing life-threatening infections. Several factors increase the risk of infection and the presence of multiple risk factors in the same patient is common. Cancer patients had an estimated 2-fold increased risk of contracting SARS-CoV-2 than the general population. With the World Health Organization declaring the novel coronavirus outbreak a pandemic, there is an urgent need to address the impact of such pandemic on ALL patients. This include changes to resource allocation, clinical care, and the consent process during a pandemic. Currently and due to limited data, there are no international guidelines to address the optimal management of ALL patients in any infectious pandemic. In this review, we will address the potential challenges associated with managing ALL patients during the COVID-19 infection pandemic with suggestions of some practical approaches, focusing on screening asymptomatic ALL patients, diagnostic and response evaluation and choice of chemotherapy in different scenarios and setting and use of hematopoietic stem cell transplantation (HSCT).


Response to COVID-19 by the surgical community


Inflammatory Bowel Diseases and COVID-19: The Invisible Enemy


title: Debate: COVID-19 and children in India

text: The COVID-19 pandemic impact on children is a growing concern. The United Nations and its agencies (the World Health Organization and UNICEF), Indian Association For Child and Adolescent Mental Health and National Institute of Mental Health and Neuroscience in India warn about the broader impacts on children and call for urgent action to support the world's children amidst the pandemic which may have lasting consequences. The COVID-19 pandemic and unprecedented control measures to prevent its spread have disrupted nearly every aspect of children's lives - their health, development, learning, behaviour and their families' economic security, including protection from violence and abuse. Given this background, there is an urgent need for action through screening to minimize the mental health issues of children in India who constitute a substantial proportion of the population.


Invasive pulmonary aspergillosis complicating SARS-CoV-2 pneumonia: A diagnostic challenge


title: A Quantitative Portrait of Wikipedia's High-Tempo Collaborations during the 2020 Coronavirus Pandemic

text: The 2020 coronavirus pandemic was a historic social disruption with significant consequences felt around the globe. Wikipedia is a freely-available, peer-produced encyclopedia with a remarkable ability to create and revise content following current events. Using 973,940 revisions from 134,337 editors to 4,238 articles, this study examines the dynamics of the English Wikipedia's response to the coronavirus pandemic through the first five months of 2020 as a"quantitative portrait"describing the emergent collaborative behavior at three levels of analysis: article revision, editor contributions, and network dynamics. Across multiple data sources, quantitative methods, and levels of analysis, we find four consistent themes characterizing Wikipedia's unique large-scale, high-tempo, and temporary online collaborations: external events as drivers of activity, spillovers of activity, complex patterns of editor engagement, and the shadows of the future. In light of increasing concerns about online social platforms' abilities to govern the conduct and content of their users, we identify implications from Wikipedia's coronavirus collaborations for improving the resilience of socio-technical systems during a crisis.


Epidemiological characteristics of SARS-CoV-2 infections in Shaanxi, China by 8 February 2020


title: Mental health of family, friends, and co-workers of COVID-19 patients in Japan

text: As the coronavirus disease 2019 (COVID-19) pandemic rages on, the mental health of both the infected and non-infected is a rising concern. We used administrative survey data (16402 responses in the last two weeks) using a chatbot on LINE, the most popular social networking service (SNS) in Japan, to show that people with COVID-19 patients in a close setting had higher psychological distress level than those without. We believe that the results indicate an urgent need to prioritize the establishment and implementation of mental health and psychosocial support tailored to family, close relatives, and friends of COVID-19 patients.


title: A doubt of multiple introduction of SARS-CoV-2 in Italy: A preliminary overview

text: The emergence of the novel betacoronavirus, recently renamed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised serious concerns due to the virus's rapid dissemination worldwide. Nevertheless, there is limited information about the genomic epidemiology of SARS-CoV-2 circulating in Italy from surveillance studies. The shortage of complete genomic sequences available impairs our understanding of the SARS-CoV-2 introduction and establishment in the country. To better understand its dynamics in Italy, we analyzed complete genomes of SARS-CoV-2 isolates, obtained directly from clinical samples. Our phylogenetic reconstructions suggest possible multiple introduction of SARS-CoV-2. Continued genomic surveillance strategies are needed to improve monitoring and understanding of the current SARS-CoV-2 epidemics, which might help to attenuate public health impact of infectious diseases.


Glucose-6-phosphate dehydrogenase deficiency-associated hemolysis and methemoglobinemia in a COVID-19 patient treated with chloroquine


Red cell bound antibodies and transfusion requirements in hospitalized patients with COVID-19


The convalescent sera option for containing COVID-19


Covid-19: MPs call on government to produce detailed plans for PPE in England


title: Reflections of the Angiotensin Receptor Blocker Recall by the FDA and Repercussions on Healthcare

text: PURPOSE: Beginning in July of 2018, the FDA issued a voluntary recall regarding the presence of a contaminant found in the manufacturing of valsartan. What would ensue has become a largely unprecedented sequence of alarming events since the FDA began reporting public recalls, withdrawals and safety alerts on their website in 2016. Since then, the United States has been significantly impacted by drug recalls affecting angiotensin receptor blockers. This report arms clinicians with additional guidance and provides a framework for responding appropriately to future similar incidents and includes an overview of the angiotensin receptor blockers, and their effects and safety profiles. METHODS: This report includes a review of data from all pertinent clinical and scientific sources including information from the FDA's inspection documents and recall website. Additional information is provided on the specific bottles including all lot numbers, expiration dates, etc. RESULTS: The recalls/withdrawals are attributable to the presence of cancer-causing contaminants identified during the manufacturing process from drug manufacturers abroad. The root causes behind the recalls and subsequent shortage appear multifactorial, and stem to a certain extent from the outsourcing of medication manufacturing overseas and lack of quality checks and appropriate oversight. CONCLUSIONS: This inherent issue is not likely to resolve soon and has eroded the public trust of/in the healthcare system and the pharmaceutical industry. Patients and healthcare providers are significantly affected and should have a full understanding of the matter in order to guide appropriate response and actions.


title: Infection Control in Dental Anesthesiology: A Time for Preliminary Reconsideration of Current Practices

text: Relegated to clinical afterthought, the topic of infection control has never taken center stage in our modern dental sedation and anesthesiology practices. Surgical and procedural masks, gloves, gowns, protective eyewear, and appropriate surgical attire have remained de rigueur in both fashion and custom for decades. However, the emergence of certain seminal events throughout health care history has driven mandated changes when practitioners, staff, patients, and the surrounding communities were exposed or put at risk of exposure to infectious disease. Hepatitis, human immunodeficiency virus, and now the global COVID-19 pandemic involving the novel coronavirus SARS-CoV-2, have forced us into rethinking our current practices. This review article will contextualize previous epidemics and their influence on infection control in dental settings, and it will explore the rapid evolution of current modifications to personal protective equipment and infection mitigation practices specific to sedation and anesthesia in dentistry.


Coronavirus COVID-19 impacts to dentistry and potential salivary diagnosis


Searching for a traumatic brain injury biomarker to aid clinical decision making in the emergency department


Potential contribution of increased soluble IL-2R to lymphopenia in COVID-19 patients


The importance of a centralized line service during the COVID-19 pandemic


What policy makers need to know about COVID-19 protective immunity


title: Sewage Pooling Test for SARS-CoV-2

text: CoVID-19 is currently one of the biggest threats to mankind. To date, it is the reason for infections of over 35 lakhs and the death of over 2 lakh human beings. We propose a procedure to detect CoVID-19 affected localities using a sewage mass testing and pooling mechanism which has gained ground in recent times. The proposed method named Sewage Pooling Algorithm tests wastewater samples from sewage systems to pinpoint the regions which are affected by maximum chances of the virus spread. The algorithm also uses a priority-based backtracking procedure to perform testing in sewage links depending on the probability of infection in the sub-areas. For places with very rare CoVID cases, we present a gradient-based search method to prune those areas. The proposed method has less human intervention and increases the effective tests/million people over current in-place methods.


COVID-19: Coronavirus replication, pathogenesis, and therapeutic strategies


title: Harmony-Search and Otsu based System for Coronavirus Disease (COVID-19) Detection using Lung CT Scan Images

text: Pneumonia is one of the foremost lung diseases and untreated pneumonia will lead to serious threats for all age groups. The proposed work aims to extract and evaluate the Coronavirus disease (COVID-19) caused pneumonia infection in lung using CT scans. We propose an image-assisted system to extract COVID-19 infected sections from lung CT scans (coronal view). It includes following steps: (i) Threshold filter to extract the lung region by eliminating possible artifacts; (ii) Image enhancement using Harmony-Search-Optimization and Otsu thresholding; (iii) Image segmentation to extract infected region(s); and (iv) Region-of-interest (ROI) extraction (features) from binary image to compute level of severity. The features that are extracted from ROI are then employed to identify the pixel ratio between the lung and infection sections to identify infection level of severity. The primary objective of the tool is to assist the pulmonologist not only to detect but also to help plan treatment process. As a consequence, for mass screening processing, it will help prevent diagnostic burden.


Race for a COVID-19 vaccine


title: Effect of Systemic Inflammatory Response to SARS-CoV-2 on Lopinavir and Hydroxychloroquine Plasma Concentrations

text: Background: Coronavirus disease 2019 (COVID-19) leads to inflammatory cytokine release, which can downregulate the expression of metabolizing enzymes. This cascade affects drug concentrations in the plasma. We investigated the association between lopinavir (LPV) and hydroxychloroquine (HCQ) plasma concentrations and the values of acute phase inflammation marker C-reactive protein (CRP).Methods: LPV plasma concentrations were prospectively collected in 92 patients hospitalized at our institution. Lopinavir/ritonavir was administered 12-hourly, 800/200 mg on day 1, and 400/100 mg on day 2 until day 5 or 7. HCQ was given at 800 mg, followed by 400 mg after 6, 24 and 48 hours. Hematological, liver, kidney, and inflammation laboratory values were analyzed on the day of drug level determination.Results: The median age of study participants was 59 (range 24-85) years, and 71% were male. The median duration from symptom onset to hospitalization and treatment initiation was 7 days (IQR 4-10) and 8 days (IQR 5-10), respectively. The median LPV trough concentration on day 3 of treatment was 26.5 µg/mL (IQR 18.9-31.5). LPV plasma concentrations positively correlated with CRP values (r=0.37, p<0.001), and were significantly lower when tocilizumab was preadministrated. No correlation was found between HCQ concentrations and CRP values.Conclusions: High LPV plasma concentrations were observed in COVID-19 patients. The ratio of calculated unbound drug fraction to published SARS-CoV-2 EC50 values indicated insufficient LPV concentrations in the lung. CRP values significantly correlated with LPV but not HCQ plasma concentrations, implying inhibition of cytochrome P450 3A4 (CYP3A4) metabolism by inflammation.


Estimating case fatality ratio during COVID-19 epidemics: Pitfalls and alternatives


Striving to protect patients and healthcare professionals in endoscopy units during pandemics: from SARS to COVID-19


Covid-19 and healthcare workers


title: Recommendations on diagnosis and treatment in hepatobiliary surgery under 2019-nCoV epidemic

text: 2019 novel coronavirus pneumonia is a serious life-threatening disease and it has affected many people globally, especially the people who live in China. A high prevalence of hepatobiliary diseases has been observed in 2019-nCoV patients and some may require emergency surgery. In the context of the novel coronavirus pneumonia, new challenges have arisen for surgeons in terms of ways to effectively treat outpatients, safety of medical staffs in performing surgery treatment, and the lack of efficient postoperative management and follow-up procedure. It is hoped that through this article, surgeons will have a better system in hepatobiliary diseases classification, treatment selection, and protective measures to improve the clinical practice in accordance with the guidelines for the diagnosis and treatment of the novel coronavirus pneumonia.


COVID-19 and children. From Luis Sepulveda to Madam Mim


title: Hemogram Data as a Tool for Decision-making in COVID-19 Management: Applications to Resource Scarcity Scenarios

text: COVID-19 pandemics has challenged emergency response systems worldwide, with widespread reports of essential services breakdown and collapse of health care structure. A critical element involves essential workforce management since current protocols recommend release from duty for symptomatic individuals, including essential personnel. Testing capacity is also problematic in several countries, where diagnosis demand outnumbers available local testing capacity. This work describes a machine learning model derived from hemogram exam data performed in symptomatic patients and how they can be used to predict qRT-PCR test results. Methods: A Naive-Bayes model for machine learning is proposed for handling different scarcity scenarios, including managing symptomatic essential workforce and absence of diagnostic tests. Hemogram result data was used to predict qRT-PCR results in situations where the latter was not performed, or results are not yet available. Adjusts in assumed prior probabilities allow fine-tuning of the model, according to actual prediction context. Proposed models can predict COVID-19 qRT-PCR results in symptomatic individuals with high accuracy, sensitivity and specificity. Data assessment can be performed in an individual or simultaneous basis, according to desired outcome. Based on hemogram data and background scarcity context, resource distribution is significantly optimized when model-based patient selection is observed, compared to random choice. The model can help manage testing deficiency and other critical circumstances. Machine learning models can be derived from widely available, quick, and inexpensive exam data in order to predict qRT-PCR results used in COVID-19 diagnosis. These models can be used to assist strategic decision-making in resource scarcity scenarios, including personnel shortage, lack of medical resources, and testing insufficiency.


title: Porcine epidemic diarrhea virus: Viral RNA detection and quantification using a validated one-step real time RT-PCR

text: Since 2014, porcine epidemic diarrhea virus (PEDV) has reemerged in Europe. RT-PCR methods have been described for the detection of PEDV, but none have been validated according to a norm. In this study we described the development and validation of a SYBR™ Green one-step RT-qPCR according to the French norm NF U47-600, for the detection and quantification of PEDV viral RNA. The method was validated from sample preparation (feces or jejunum) through to nucleic acid extraction and RT-qPCR detection. Specificity and sensitivity, limit of detection (LoD), limit of quantification (LQ), linearity, intra and inter assay variability were evaluated using transcribed RNA and fecal and jejunum matrices spiked with virus. The analytical and diagnostic specificities and sensitivities of this RT-qPCR were 100% in this study. A LoD of 50 genome copies/5 µl of extract from fecal matrices spiked with virus or RNA transcript and 100 genome copies/5 µl of extract from jejunum matrices spiked with virus were obtained. The Lower LQ (LLQ) was 100 genome copies/5 µl and the Upper LQ (ULQ) 108 copies/5 µl. This method is the first, validated according a norm for PEDV and may serve as a global reference method to harmonize detection and quantification of PEDV viral RNA in both field and experimental settings.


Brain MRI Findings in Patients in the Intensive Care Unit with COVID-19 Infection


title: Exportin 1 inhibition as antiviral therapy

text: Coronavirus 2019 (COVID-19; caused by Severe Acute Respiratory Syndrome Coronavirus 2; SARS-CoV-2) is a currently global health problem. Previous studies showed that blocking nucleocytoplasmic transport with exportin 1 (XPO1) inhibitors originally developed as anticancer drugs can quarantine key viral accessory proteins and genomic materials in the nucleus of host cell and reduce virus replication and immunopathogenicity. These observations support the concept of the inhibition of nuclear export as an effective strategy against an array of viruses, including influenza A, B, and SARS-CoV. Clinical studies using the XPO1 inhibitor selinexor as a therapy for COVID-19 infection are in progress.


Integration of telemedicine into the public health response to COVID-19 must include dentists