title: Distribution of Transmission Potential during Non-Severe COVID-19 Illness

text: BACKGROUND: Patients recovering from coronavirus disease 2019 (COVID-19) often continue to test positive for the causative virus by PCR even after clinical recovery, thereby complicating return-to-work plans. The purpose of this study was to evaluate transmission potential of COVID-19 by examining viral load with respect to time. METHODS: Health care personnel (HCP) at Cleveland Clinic diagnosed with COVID-19, who recovered without needing hospitalization, were identified. Threshold cycle (Ct) for positive PCR tests were obtained and viral loads calculated. Association of viral load with days since symptom onset was examined in a multivariable regression model, which was reduced by stepwise backward selection to only keep variables significant at a level of 0.05. Viral loads by day since symptom onset were predicted using the model and transmission potential evaluated by examination of a viral load-time curve. RESULTS: Over six weeks, 230 HCP had 528 tests performed. Viral loads declined by orders of magnitude within a few days of symptom onset. The only variable significantly associated with viral load was time since onset of symptoms. Of the area under the curve (AUC) spanning symptom onset to 30 days, 96.9% lay within the first 7 days, and 99.7% within 10 days. Findings were very similar when validated using split-sample and 10-fold cross-validation. CONCLUSIONS: Among patients with non-severe COVID-19, viral loads in upper respiratory specimens peak by two or three days from symptom onset and decrease rapidly thereafter. The vast majority of the viral load-time AUC lies within 10 days of symptom onset.


title: Parameter Estimation from ICC curves

text: Incidence - Cumulative Cases (ICC) curves are introduced and shown to provide a simple framework for parameter identification in the case of the most elementary epidemiological model, consisting of susceptible, infected, and removed compartments. This novel methodology is used to estimate the basic reproductive number of recent outbreaks, including the ongoing COVID-19 epidemic.


title: Coronaviruses pathogenesis, comorbidities and multi-organ damage - A review

text: Human coronaviruses, especially COVID-19, is an emerging pandemic infectious disease with high morbidity and mortality. Coronaviruses are associated with comorbidities, along with the symptoms of it. SARS-CoV-2 is one of the highly pathogenic coronaviruses that causes a high death rate compared to the SARS-CoV and MERS. In this review, we focused on the mechanism of coronavirus with comorbidities and impairment in multi-organ function. The main dysfunction upon coronavirus infection is damage to alveolar and acute respiratory failure. It is associated with the other organ damage such as cardiovascular risk via an increased level of hypertension through ACE2, gastrointestinal dysfunction, chronic kidney disease, diabetes mellitus, liver dysfunction, lung injury, CNS risk, ocular risks such as chemosis, conjunctivitis, and conjunctival hyperemia, cancer risk, venous thromboembolism, tuberculosis, aging, and cardiovascular dysfunction and reproductive risk. Along with this, we have discussed the immunopathology and coronaviruses at a molecular level and therapeutic approaches for the coronavirus infection. The comorbidities and multi-organ failure of COVID-19 have been explained at a molecular level along with the base of the SARS-CoV and MERS-CoV. This review would help us to understand the comorbidities associated with the coronaviruses with multi-organ damage.


title: Dynamic changes in routine blood parameters of a severe COVID-19 case

text: BACKGROUND: Novel coronavirus infectious disease (COVID-19) has been spreading worldwide, and tracking laboratory indexes during the diagnosis and treatment of patients with severe COVID-19 can provide a reference for patients in other countries and regions. METHODS: We closely tracked the epidemiological history, diagnosis and treatment process, as well as dynamic changes in routine blood indicators, of a severe COVID-19 patient who was hospitalized for 26 days. RESULTS: Our study found that the patient's condition worsened in the first week after admission, white blood cells (WBCs), neutrophils, lymphocytes, monocytes, eosinophils, red blood cells (RBCs), hemoglobin, neutrophil lymphocyte ratio (NLR), platelets (PLT) and platelet lymphocyte ratio (PLR) decreased. On the 7th day of admission, the levels of these cells decreased to their lowest values, though the red blood cell distribution width (RDW) and C-reactive protein (CRP) level remained at high values. From 8 to 14 days of admission, the patient's condition improved, hypoxemia was corrected, and mechanical ventilation was discontinued. The number of WBCs, neutrophils, monocytes, eosinophils and lymphocytes increased gradually, and the erythrocyte parameters stopped declining and stabilized in a certain range; CRP decreased rapidly. On the 20th day of admission, the nucleic acid test was negative, WBC, neutrophil, CRP, NLR and PLR decreased gradually, and monocyte, lymphocyte, and eosinophil counts increased. Although RBCs and hemoglobin (Hb) levels continued to decrease, RDW gradually increased, indicating the recovery of hematopoiesis. In addition, it should be noted that monocytes and eosinophils were at extremely low levels within 10 days after admission; the recovery time of eosinophils was approximately 12 days after admission, which was earlier than other parameters, which might be of great value in judging the progress of the disease. CONCLUSIONS: Dynamic changes in routine blood parameters might be helpful for the prognosis of COVID-19 patients and evaluation of the treatment effect.


title: Postnatal BPA is associated with increasing executive function difficulties in preschool children

text: BACKGROUND: Early bisphenol exposure may have consequences for executive function development, but less is known about potential sex effects. We hypothesized that early bisphenol A (BPA) and bisphenol S (BPS) exposures would be associated with sex-dependent changes in preschool executive function. METHODS: A subsample of the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort (n = 312) provided maternal second trimester (prenatal) and 3-month postpartum (postnatal) urine samples, from which BPA and BPS concentrations were quantified. When children were age 2 and 4, mothers completed the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Changes in standardized T scores on the BRIEF-P indexes of inhibitory self-control, flexibility, and emergent metacognition were investigated. RESULTS: Adjusted multivariate regression analyses showed that child sex modified the associations between maternal postnatal BPA and changes in executive function. Higher maternal postnatal BPA concentrations predicted increasing difficulties from age 2 to 4 in the domains of inhibitory self-control and emergent metacognition in female, but not male children. The other bisphenol concentrations were not associated with changes in executive function. CONCLUSION: Due to the ubiquity of BPA exposure among breastfeeding women, these findings justify further investigation on the effects of postnatal bisphenol exposure on child cognitive development. IMPACT: Higher concentrations of maternal BPA at 3-month postpartum were associated with increasing difficulties in inhibitory self-control and emergent metacognition from age 2 to 4 in girls, but not boys.Prenatal BPA and prenatal/postnatal BPS were not significant predictors of change in executive function in boys and girls.The current study extends previous research to show that maternal postnatal BPA could also impact child executive function.Due to the ubiquity of BPA exposure among breastfeeding women, the current findings suggest that additional precautions may be needed to protect infants' neurodevelopment from indirect exposure to BPA.


Mental health and a novel coronavirus (2019-nCoV) in China


title: School Opening Delay Effect on Transmission Dynamics of Coronavirus Disease 2019 in Korea: Based on Mathematical Modeling and Simulation Study

text: BACKGROUND: Nonpharmaceutical intervention strategy is significantly important to mitigate the coronavirus disease 2019 (COVID-19) spread. One of the interventions implemented by the government is a school closure. The Ministry of Education decided to postpone the school opening from March 2 to April 6 to minimize epidemic size. We aimed to quantify the school closure effect on the COVID-19 epidemic. METHODS: The potential effects of school opening were measured using a mathematical model considering two age groups: children (aged 19 years and younger) and adults (aged over 19). Based on susceptible-exposed-infectious-recovered model, isolation and behavior-changed susceptible individuals are additionally considered. The transmission parameters were estimated from the laboratory confirmed data reported by the Korea Centers for Disease Control and Prevention from February 16 to March 22. The model was extended with estimated parameters and estimated the expected number of confirmed cases as the transmission rate increased after school opening. RESULTS: Assuming the transmission rate between children group would be increasing 10 fold after the schools open, approximately additional 60 cases are expected to occur from March 2 to March 9, and approximately additional 100 children cases are expected from March 9 to March 23. After March 23, the number of expected cases for children is 28.4 for 7 days and 33.6 for 14 days. CONCLUSION: The simulation results show that the government could reduce at least 200 cases, with two announcements by the Ministry of education. After March 23, although the possibility of massive transmission in the children's age group is lower, group transmission is possible to occur.


title: Gender and Age Differences Reveal Risk Patterns in COVID-19 Outbreak

text: By April 28th 2020, the global number of people that were viciously infected with the newfound novel corona virus (COVID-19) stood at a staggering 3 077 133 cases, as per the confirmed data released by the WHO. It has been reported that women from the Chinese Han population are associated with essential hypertension due to their relation with the 5 SNPs, namely, rs1514283, rs4646155, rs4646176, rs2285666, and rs879922, which belong to the ACE2 gene. The level of ACE2 activity was very low in normal healthy younger persons, and was reported to be increased in patients with cardiovascular diseases. Thus, there might be severe myocarditis, that may result in acute heart failure and cardiac complexities in the elderly subjects.


The SARS-Cov-2 Pandemic: A Good Time for Stem Cell Transplantation?


title: Mortality statistics in England and Wales: the SARS-CoV-2 paradox

text: OBJECTIVE: To analyse mortality statistics in the United Kingdom during the initial phases of the severe acute respiratory coronavirus 2 (SARS-CoV-2) pandemic and to understand the impact of the pandemic on national mortality. METHODS: Retrospective review of weekly national mortality statistics in the United Kingdom over the past 5 years, including subgroup analysis of respiratory mortality rates. RESULTS: During the early phases of the SARS-CoV-2 pandemic in the first months of 2020, there were consistently fewer deaths per week compared with the preceding 5 years. This pattern was not observed at any other time within the past 5 years. We have termed this phenomenon the "SARS-CoV-2 paradox." We postulate potential explanations for this seeming paradox and explore the implications of these data. CONCLUSIONS: Paradoxically, but potentially importantly, lower rather than higher weekly mortality rates were observed during the early stages of the SARS-CoV-2 pandemic. This paradox may have implications for current and future healthcare utilisation. A rebound increase in non-SARS-CoV-2 mortality later this year might coincide with the peak of SARS-CoV-2 admissions and mortality.


title: COVID-19 puzzle in China: a serendipitous interplay between transmissibility and social distancing measures

text: A number of models in mathematical epidemiology have been developed to account for control measures such as vaccination or quarantine. However, COVID-19 has brought unprecedented social distancing measures, with a challenge on how to include these in a manner that can explain the data, but avoid overfitting in parameter inference. We here develop a simple non-homologous model, where social distancing effects are introduced analogous to course grained models of gene expression control in systems biology. We apply our approach to understand drastic differences in COVID-19 infection and fatality counts (observed between Hubei (Wuhan) and other Mainland China provinces), which we explain through interplay of transmissibility and effective protection differences. That is, we obtain a negative feedback (also commonly encountered in systems biology) between transmissibility and effects of social distancing, with Hubei being an outlier with both large transmissibility and lower social distancing effects. While Case Fatality Rate is significantly larger for Hubei, we find that Infection Fatality Rates (IFRs) are much more uniform/consistent across all the provinces. Even for Wuhan, our inferred Infection Attack Rate is much below the herd immunity threshold, raising a major reemission risk. The obtained results demonstrate applicability of our developed method to extract key infection parameters directly from the data (publicly available for a number of countries), so that it can be applied globally to potential future outbreaks of COVID-19, or other infectious diseases.


Intra-articular injections in people with haemophilia in the COVID-19 era


title: Alfabetización en salud pública ante la emergencia de la pandemia por Covid-19./ [Public health literacy in the face of the Covid-19 pandemic emergency]

text: Health literacy is the process of obtaining knowledge, motivation and individual competencies to understand and access information, express opinions and make decisions with respect to health promotion and maintenance. This applies in different contexts, environments, and throughout life. This conceptual perspective is very necessary in the face of the SARS-CoV-2 virus emergency. This virus produces the Covid-19 disease, which has become a pandemic of devastating effects not only healthwise, but also, importantly, from an economic, political and social point of view. This essay seeks to establish the scientific evidence-based elements that guide public policies for prevention and control. Some of these elements are: a) epidemiologic intelligence. This includes not only the strategy of public surveillance, but also sentinel and event-based surveillance, as it is impossible to actually identify all positive cases; b) Mitigating measures against the spread of the epidemic, such as social distancing and hygiene, washing hands, quarantine, restricting movement and using masks, among others; c) Measures to suppress transmission when the number of cases is very high, such as strict measures to stay at home; d) strengthening health services 'capacity for medical attention and improving health services' ability to prevent transmission, including the use of diagnostic tests; e) the development of prophylactic vaccines against Covid-19, as well as the development of therapeutic agents. All of these actions must be rapidly implemented, from a multidisciplinary and multisectorial public health perspective, and they absolutely must also be taken with the community's participation as shared responsibility. Therefore, public health literacy is needed.


Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus


"The Art of War" in the Era of Coronavirus Disease 2019 (COVID-19)


title: The pivotal link between ACE2 deficiency and SARS-CoV-2 infection

text: Angiotensin converting enzyme-2 (ACE2) receptors mediate the entry into the cell of three strains of coronavirus: SARS-CoV, NL63 and SARS-CoV-2. ACE2 receptors are ubiquitous and widely expressed in the heart, vessels, gut, lung (particularly in type 2 pneumocytes and macrophages), kidney, testis and brain. ACE2 is mostly bound to cell membranes and only scarcely present in the circulation in a soluble form. An important salutary function of membrane-bound and soluble ACE2 is the degradation of angiotensin II to angiotensin1-7. Consequently, ACE2 receptors limit several detrimental effects resulting from binding of angiotensin II to AT1 receptors, which include vasoconstriction, enhanced inflammation and thrombosis. The increased generation of angiotensin1-7 also triggers counter-regulatory protective effects through binding to G-protein coupled Mas receptors. Unfortunately, the entry of SARS-CoV2 into the cells through membrane fusion markedly down-regulates ACE2 receptors, with loss of the catalytic effect of these receptors at the external site of the membrane. Increased pulmonary inflammation and coagulation have been reported as unwanted effects of enhanced and unopposed angiotensin II effects via the ACEâAngiotensin IIâAT1 receptor axis. Clinical reports of patients infected with SARS-CoV-2 show that several features associated with infection and severity of the disease (i.e., older age, hypertension, diabetes, cardiovascular disease) share a variable degree of ACE2 deficiency. We suggest that ACE2 down-regulation induced by viral invasion may be especially detrimental in people with baseline ACE2 deficiency associated with the above conditions. The additional ACE2 deficiency after viral invasion might amplify the dysregulation between the 'adverse' ACEâAngiotensin IIâAT1 receptor axis and the 'protective' ACE2âAngiotensin1-7âMas receptor axis. In the lungs, such dysregulation would favor the progression of inflammatory and thrombotic processes triggered by local angiotensin II hyperactivity unopposed by angiotensin1-7. In this setting, recombinant ACE2, angiotensin1-7 and angiotensin II type 1 receptor blockers could be promising therapeutic approaches in patients with SARS-CoV-2 infection.


Clinical and Psychological Issues in Children with Inflammatory Bowel Disease During COVID-19 Pandemic


Rational perioperative utilisation and management during the COVID-19 pandemic


title: Cardiopulmonary Resuscitation in Intensive Care Unit Patients With Coronavirus Disease 2019

text: Cardiopulmonary resuscitation (CPR) in patients with severe acute respiratory syndrome coronavirus-2-associated disease (coronavirus disease 2019) poses a unique challenge to health- care providers due to the risk of viral aerosolization and disease transmission. This has caused some centers to modify existing CPR procedures, limit the duration of CPR, or consider avoiding CPR altogether. In this review, the authors propose a procedure for CPR in the intensive care unit that minimizes the number of personnel in the immediate vicinity of the patient and conserves the use of scarce personal protective equipment. Highlighting the low likelihood of successful resuscitation in high-risk patients may prompt patients to decline CPR. The authors recommend the preemptive placement of central venous lines in high-risk patients with intravenous tubing extensions that allow for medication delivery from outside the patients' rooms. During CPR, this practice can be used to deliver critical medications without delay. The use of a mechanical compression system for CPR further reduces the risk of infectious exposure to health- care providers. Extracorporeal membrane oxygenation should be reserved for patients with few comorbidities and a single failing organ system. Reliable teleconferencing tools are essential to facilitate communication between providers inside and outside the patients' rooms. General principles regarding the ethics and peri-resuscitative management of coronavirus 2019 patients also are discussed.


title: CT Features of Coronavirus Disease (COVID-19) in 30 Pediatric Patients

text: OBJECTIVE. The purpose of this study is to characterize the CT findings of 30 children from mainland China who had laboratory-confirmed coronavirus disease (COVID-19). Although recent American College of Radiology recommendations assert that CT should not be used as a screening or diagnostic tool for patients with suspected COVID-19, radiologists should be familiar with the imaging appearance of this disease to identify its presence in patients undergoing CT for other reasons. MATERIALS AND METHODS. We retrospectively reviewed the CT findings and clinical symptoms of 30 pediatric patients with laboratory-confirmed COVID-19 who were seen at six centers in China from January 23, 2020, to February 8, 2020. Patient age ranged from 10 months to 18 years. Patients older than 18 years of age or those without chest CT examinations were excluded. Two cardiothoracic radiologists and a cardiothoracic imaging fellow characterized and scored the extent of lung involvement. Cohen kappa coefficient was used to calculate interobserver agreement between the readers. RESULTS. Among children, CT findings were often negative (77%). Positive CT findings seen in children included ground-glass opacities with a peripheral lung distribution, a crazy paving pattern, and the halo and reverse halo signs. There was a correlation between increasing age and increasing severity of findings, consistent with reported symptomatology in children. Eleven of 30 patients (37%) underwent follow-up chest CT, with 10 of 11 examinations (91%) showing no change, raising questions about the utility of CT in the diagnosis and management of COVID-19 in children. CONCLUSION. The present study describes the chest CT findings encountered in children with COVID-19 and questions the utility of CT in the diagnosis and management of pediatric patients.


title: Modeling the case of early detection of Ebola virus disease

text: The most recent Ebola outbreak in West Africa highlighted critical weaknesses in the medical infrastructure of the affected countries, including effective diagnostics tools, sufficient isolation wards, and enough medical personnel. Here, we develop and analyze a mathematical model to assess the impact of early diagnosis of pre-symptomatic individuals on the transmission dynamics of Ebola virus disease in West Africa in scenarios where Ebola may remain at low levels in the population. Our findings highlight the importance of implementing integrated control measures of early diagnosis and isolation. The mathematical analysis shows a threshold where early diagnosis of pre-symptomatic individuals, combined with a sufficient level of effective isolation, can lead to an epidemic control of Ebola virus disease. That is, the local erradication of the disease or the effective management of the disease at low levels of endemicity.


Covid-19: UK death toll overtakes Italy's to become worst in Europe


title: Animal toxins - Nature's evolutionary-refined toolkit for basic research and drug discovery

text: Venomous animals have evolved toxins that interfere with specific components of their victim's core physiological systems, thereby causing biological dysfunction that aids in prey capture, defense against predators, or other roles such as intraspecific competition. Many animal lineages evolved venom systems independently, highlighting the success of this strategy. Over the course of evolution, toxins with exceptional specificity and high potency for their intended molecular targets have prevailed, making venoms an invaluable and almost inexhaustible source of bioactive molecules, some of which have found use as pharmacological tools, human therapeutics, and bioinsecticides. Current biomedically-focused research on venoms is directed towards their use in delineating the physiological role of toxin molecular targets such as ion channels and receptors, studying or treating human diseases, targeting vectors of human diseases, and treating microbial and parasitic infections. We provide examples of each of these areas of venom research, highlighting the potential that venom molecules hold for basic research and drug development.


Immune thrombocytopenia due to COVID-19 during pregnancy


title: Topological dynamics of the 2015 South Korea MERS-CoV spread-on-contact networks

text: Network analysis to examine infectious contact relations provides an important means to uncover the topologies of individual infectious contact networks. This study aims to investigate the spread of diseases among individuals over contact networks by exploring the 2015 Middle East Respiratory Syndrome (MERS) outbreak in Korea. We present several distinct features of MERS transmission by employing a comprehensive approach in network research to examine both the traced relationship matrix of infected individuals and their bipartite transmission routes among healthcare facilities visited for treatment. The results indicate that a few super-spreaders were more likely to hold certain structural advantages by linking to an exceptional number of other individuals, causing several ongoing transmission events in neighbourhoods without the aid of any intermediary. Thus, the infectious contact network exhibited small-world dynamics characterised by locally clustered contacts exposed to transmission paths via short path lengths. In addition, nosocomial infection analysis shows the pattern of a common-source outbreak followed by secondary person-to-person transmission of the disease. Based on the results, we suggest policy implications related to the redesign of prevention and control strategies against the spread of epidemics.


title: Cantor-solus and Cantor-multus Distributions

text: The Cantor distribution is obtained from bitstrings; the Cantor-solus distribution (a new name) admits only strings without adjacent 1 bits. We review moments and order statistics associated with these. The Cantor-multus distribution is introduced -- which instead admits only strings without isolated 1 bits -- and more complicated formulas emerge.


Sense and sensibility through confusing surgical practices during COVID-19 pandemic


Testing times


COVID-19 data sources in Latin America and the Caribbean


title: Genomic determinants of pathogenicity in SARS-CoV-2 and other human coronaviruses

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses an immediate, major threat to public health across the globe. Here we report an in-depth molecular analysis to reconstruct the evolutionary origins of the enhanced pathogenicity of SARS-CoV-2 and other coronaviruses that are severe human pathogens. Using integrated comparative genomics and machine learning techniques, we identify key genomic features that differentiate SARS-CoV-2 and the viruses behind the two previous deadly coronavirus outbreaks, SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), from less pathogenic coronaviruses. These features include enhancement of the nuclear localization signals in the nucleocapsid protein and distinct inserts in the spike glycoprotein that appear to be associated with high case fatality rate of these coronaviruses as well as the host switch from animals to humans. The identified features could be crucial contributors to coronavirus pathogenicity and possible targets for diagnostics, prognostication, and interventions.


Coronavirus Infections-More Than Just the Common Cold


Imatinib for COVID-19: A case report


title: Incretin-Based Therapies Role in COVID-19 Era: Evolving Insights

text: The current coronavirus disease 2019 (COVID-19) pandemic has led the scientific community to breach new frontiers in the understanding of human physiology and disease pathogenesis. It has been hypothesized that the human dipeptidyl peptidase 4 (DPP4) enzyme receptor may be a functional target for the spike proteins of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Since DPP4-inhibitors are currently used for the treatment of patients with type-2 diabetes (T2DM), there is currently high interest in the possibility that these agents, or incretin-based therapies (IBTs) in general, may be of benefit against the new coronavirus infection. Diabetes is associated with increased COVID-19 severity and mortality, and accumulating evidence suggests that IBTs may favorably alter the clinical course of SARS-CoV-2 infection due to their inherent mechanisms of action. Further research into prognostic variables associated with various antidiabetic treatment regimens, and in particular the IBT, in patients with T2DM affected by the COVID-19 pandemic is therefore warranted.


title: Identification of Repurposal Drugs and Adverse Drug Reactions for Various Courses of Coronavirus Disease 2019 (COVID-19) Based on Single-cell RNA Sequencing Data

text: With more than 3.8 million people infected Coronavirus Disease 2019 (COVID-19), caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses a critical threat to human health. There is no proven vaccine or specific drug to date, which highlights the urgent need for rapid development of therapeutics for COVID-19. To identify potentially repurposable drugs, we employed a systematic approach to mine candidates from U.S. FDA approved drugs and pre-clinical small-molecule compounds by integrating the gene expression perturbation data by chemicals from the Library of Integrated Network-Based Cellular Signatures (LINCS) project with publically available single-cell RNA sequencing dataset from mild and severe COVID-19 patients. We identified 281 FDA approved drugs that have the potential to be effective against SARS-CoV-2 infection, 10 of which are currently undergoing clinical trials to evaluate their efficacy against COVID-19. In conclusion, we have identified a list of repurposable anti-SARS- CoV-2 drugs using a systems biology approach.


All about COVID-19 in brief


Corrigendum to "Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents" [J Hosp Infect 104 (2020) 246-251]


title: Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak - United States, December 31, 2019-February 4, 2020

text: On December 31, 2019, Chinese health officials reported a cluster of cases of acute respiratory illness in persons associated with the Hunan seafood and animal market in the city of Wuhan, Hubei Province, in central China. On January 7, 2020, Chinese health officials confirmed that a novel coronavirus (2019-nCoV) was associated with this initial cluster (1). As of February 4, 2020, a total of 20,471 confirmed cases, including 2,788 (13.6%) with severe illness,* and 425 deaths (2.1%) had been reported by the National Health Commission of China (2). Cases have also been reported in 26 locations outside of mainland China, including documentation of some person-to-person transmission and one death (2). As of February 4, 11 cases had been reported in the United States. On January 30, the World Health Organization (WHO) Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern. On January 31, the U.S. Department of Health and Human Services (HHS) Secretary declared a U.S. public health emergency to respond to 2019-nCoV.§ Also on January 31, the president of the United States signed a "Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus," which limits entry into the United States of persons who traveled to mainland China to U.S. citizens and lawful permanent residents and their families (3). CDC, multiple other federal agencies, state and local health departments, and other partners are implementing aggressive measures to slow transmission of 2019-nCoV in the United States (4,5). These measures require the identification of cases and their contacts in the United States and the appropriate assessment and care of travelers arriving from mainland China to the United States. These measures are being implemented in anticipation of additional 2019-nCoV cases in the United States. Although these measures might not prevent the eventual establishment of ongoing, widespread transmission of the virus in the United States, they are being implemented to 1) slow the spread of illness; 2) provide time to better prepare health care systems and the general public to be ready if widespread transmission with substantial associated illness occurs; and 3) better characterize 2019-nCoV infection to guide public health recommendations and the development of medical countermeasures including diagnostics, therapeutics, and vaccines. Public health authorities are monitoring the situation closely. As more is learned about this novel virus and this outbreak, CDC will rapidly incorporate new knowledge into guidance for action by CDC and state and local health departments.


title: New measures for COVID-19 response: a lesson from the Wenzhou experience

text: As the outbreak of COVID-19 has spread globally, determining how to prevent the spread is of paramount importance. We reported the effectiveness of different responses of four affected cities in preventing the COVID-19 spread. We expect Wenzhou anti-COVID-19 measures may provide experience for cities around the world that are experiencing this epidemic.


COVID-19 heralds a new era for chronic diseases in primary care


title: Machine-Learning Driven Drug Repurposing for COVID-19

text: The integration of machine learning methods into bioinformatics provides particular benefits in identifying how therapeutics effective in one context might have utility in an unknown clinical context or against a novel pathology. We aim to discover the underlying associations between viral proteins and antiviral therapeutics that are effective against them by employing neural network models. Using the National Center for Biotechnology Information virus protein database and the DrugVirus database, which provides a comprehensive report of broad-spectrum antiviral agents (BSAAs) and viruses they inhibit, we trained ANN models with virus protein sequences as inputs and antiviral agents deemed safe-in-humans as outputs. Model training excluded SARS-CoV-2 proteins and included only Phases II, III, IV and Approved level drugs. Using sequences for SARS-CoV-2 (the coronavirus that causes COVID-19) as inputs to the trained models produces outputs of tentative safe-in-human antiviral candidates for treating COVID-19. Our results suggest multiple drug candidates, some of which complement recent findings from noteworthy clinical studies. Our in-silico approach to drug repurposing has promise in identifying new drug candidates and treatments for other viruses.


A new world of heme function


Lay-off of Endoscopy services for the COVID-19 pandemic: how can we resume the practice of routine cases?


title: Effect of advanced nursing care on psychological disorder in patients with COVID-19: A protocol of systematic review

text: BACKGROUND: This study will explore the effect of advanced nursing care (ANC) on psychological disorder (PD) in patients with Coronavirus Disease 2019 (COVID-19). METHODS: This study will search the following electronic databases up to June 30, 2020: Cochrane Library, PUBMED, EMBASE, PsycINFO, Web of Science, OpenGrey, Cumulative Index to Nursing and Allied Health Literature, CNKI, and WANGFANG. We will not impose any language limitations. Two authors will independently identify titles/abstracts and full-text of all potential studies, and will collect data from eligible studies. Additionally, study quality will be assessed by Cochrane risk of bias. If necessary, we will conduct meta-analysis if sufficient trials are included. RESULTS: This study will explore the effect of ANC on PD in patients with COVID-19 through outcome indicators. CONCLUSION: The findings of this study may supply summarized evidence of ANC for the management of PD in COVID-19. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42020187610.


title: Milk-alkali syndrome: a 'quick ease' or a 'long-lasting problem'

text: Summary: We report the case of a 65-year-old female who presented with symptomatic hypercalcaemia (corrected calcium of 4.57 mmol/L) with confusion, myalgias and abdominal discomfort. She had a concomitant metabolic alkalosis (pH 7.46, HCO3- 40 mmol/L, pCO2 54.6 mmHg). A history of significant Quick-Eze use (a calcium carbonate based antacid) for abdominal discomfort, for 2 weeks prior to presentation, suggested a diagnosis of milk-alkali syndrome (MAS). Further investigations did not demonstrate malignancy or primary hyperparathyroidism. Following management with i.v. fluid rehydration and a single dose of i.v. bisphosphonate, she developed symptomatic hypocalcaemia requiring oral and parenteral calcium replacement. She was discharged from the hospital with stable biochemistry on follow-up. This case demonstrates the importance of a detailed history in the diagnosis of severe hypercalcaemia, with MAS representing the third most common cause of hypercalcaemia. We discuss its pathophysiology and clinical importance, which can often present with severe hypercalcaemia that can respond precipitously to calcium-lowering therapy. Learning points: Milk-alkali syndrome is an often unrecognised cause for hypercalcaemia, but is the third most common cause of admission for hypercalcaemia. Calcium ingestion leading to MAS can occur at intakes as low as 1.0-1.5 g per day in those with risk factors. Early recognition of this syndrome can avoid the use of calcium-lowering therapy such as bisphosphonates which can precipitate hypocalcaemia.


2020 - The Year that needed the nurse: Considerations for critical care nursing research and practice emerging in the midst of COVID-19


SCAI initiatives during the COVID-19 pandemic


title: Performing gynecologic cancer surgery during the COVID-19 pandemic in Turkey: A multicenter retrospective observational study

text: OBJECTIVE: To report the perioperative outcomes of 200 patients with gynecologic cancer who underwent surgery during the Novel Coronavirus Disease (COVID-19) pandemic and the safety of surgical approach. METHODS: Data of patients operated between March 10 and May 20, 2020, were collected retrospectively. Data were statistically analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows v. SP21.0. RESULTS: Data of 200 patients were included. Their mean age was 56 years. Of the patients, 54% (n=108), 27.5% (n=55), 12.5% (n=25), and 2% (n=4) were diagnosed as having endometrial, ovarian, cervical, and vulvar cancer, respectively. Of them, 98% underwent non-emergent surgery. A minimally invasive surgical approach was used in 18%. Stage 1 cancer was found in 68% of patients. Surgeons reported COVID-related changes in 10% of the cases. The rate of postoperative complications was 12%. Only two patients had cough and suspected pneumonic lesions on thoracic computed tomography postoperatively, but neither was positive for COVID-19 on polymerase chain reaction testing. CONCLUSION: Based on the present findings, it is thought that gynecologic cancer surgery should continue during the COVID-19 pandemic while adhering to the measures. Postponement or non-surgical management should only be considered in patients with documented infection.


title: Die Pestarztmaske im Deutschen Medizinhistorischen Museum Ingolstadt./ [The "Plague Doctor's Mask" in the German Museum for the History of Medicine, Ingolstadt]

text: This paper is part of Forum COVID-19: Perspectives in the Humanities and Social Sciences. The figure of the plague doctor with the beak mask has become the symbol of the plague par excellence. It's little wonder that the plague mask in the collection of the German Museum of the History of Medicine in Ingolstadt (Bavaria) is one of the museum's most popular objects and motifs. This forum paper investigates the figure of the plague doctor on several levels: first, it analyses contemporary textual and image sources in regard to protective clothing used in times of plague and the respective role of the beak-like part of the mask. Then it takes a close look at the Ingolstadt specimen. By examining the mask's materiality and fabrication, questions of its authenticity and practicability are raised. Finally, the Ingolstadt mask is compared with the specimen at the German Historical Museum in Berlin.The conclusion: the beak mask is not mentioned before the mid-seventeenth century, and then only in Italy and Southern France. There is no proof at all of its use during plague outbreaks in Middle Europe. And the specimens in Ingolstadt and Berlin? Both masks present details which suggest that they were not used as protective clothing at all. We do not know, however, if they were produced as replicas for historic reasons or as fakes for the modern art market.


title: COVID-19: Threat and fear in Indonesia

text: The purpose of this article is to provide a brief report on how the Indonesian population has experienced the COVID-19 pandemic in the first 2 months since the establishment of COVID-19 Rapid Response Task Force on March 13. The discussion will focus on the psychological trauma that the population has experienced due to the lack of preparedness, the poorly equipped health care system, and lockdown policies in dealing with the spread of the coronavirus. Four different types of psychological trauma were increasingly observed, based on digital communication with people affected and reports from the news and social media. These 4 types of psychological trauma were social withdrawal, hysteria, individual violence, and collective violence. On the basis of the described psychological consequences of the pandemic, it can be assumed that both the individual and collective reactions must be considered to reduce harm of the coronavirus pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: First Successful Treatment of Coronavirus Disease 2019 Induced Refractory Cardiogenic Plus Vasoplegic Shock by Combination of Percutaneous Ventricular Assist Device and Extracorporeal Membrane Oxygenation: A Case Report

text: The novel coronavirus severe acute respiratory syndrome coronavirus 2 is infecting hundreds of thousands of humans around the globe. The coronavirus disease 2019 (COVID-19) is known to generate mild as well as critical courses. Complications on the intensive care units include acute respiratory distress syndrome, acute cardiac, and kidney injury as well as shock. Here, we present the first case report of a successful treatment of a COVID-19 patient presenting with adult respiratory distress syndrome plus refractory combined cardiogenic and vasoplegic shock, which could be successfully stabilized after implantation of a percutaneous ventricular assist device plus an extracorporeal membrane oxygenation. Although such intense treatment might not be feasible in case of a health care disaster as described for the hot spots of the COVID-19 pandemic, it might encourage treatment of younger patients on intensive care units not overcrowded by critically ill patients.


title: The DeepFake Detection Challenge Dataset

text: Deepfakes are a recent off-the-shelf manipulation technique that allows anyone to swap two identities in a single video. In addition to Deepfakes, a variety of GAN-based face swapping methods have also been published with accompanying code. To counter this emerging threat, we have constructed an extremely large face swap video dataset to enable the training of detection models, and organized the accompanying DeepFake Detection Challenge (DFDC) Kaggle competition. Importantly, all recorded subjects agreed to participate in and have their likenesses modified during the construction of the face-swapped dataset. The DFDC dataset is by far the largest currently and publicly available face swap video dataset, with over 100,000 total clips sourced from 3,426 paid actors, produced with several Deepfake, GAN-based, and non-learned methods. In addition to describing the methods used to construct the dataset, we provide a detailed analysis of the top submissions from the Kaggle contest. We show although Deepfake detection is extremely difficult and still an unsolved problem, a Deepfake detection model trained only on the DFDC can generalize to real"in-the-wild"Deepfake videos, and such a model can be a valuable analysis tool when analyzing potentially Deepfaked videos. Training, validation and testing corpuses can be downloaded from https://ai.facebook.com/datasets/dfdc.


title: Performance Evaluation of UAV-Enabled LoRa Networks for Disaster Management Applications

text: In hostile and remote environments, such as mountains, forests or suburban areas, traditional communications may not be available, especially after a disaster, such as a flood, a forest fire or an earthquake. In these situations, the wireless networks may become congested or completely disrupted and may not be adequate to support the traffic generated by rescuers. It is also considered as the key tool in Corona Virus (COVID-19) battle. Moreover, the conventional approaches with fixed gateways may not work either, and this might lead to decoding errors due to the large distance between mobile nodes and the gateway. To avoid the decoding errors and improve the reliability of the messages, we propose to use intermediate Unmanned Aerial Vehicles (UAVs) to transfer messages from ground-based Long Range (LoRa) nodes to the remote base station (BS). Specifically, this UAV-enabled LoRa architecture is based on the ad hoc WiFi network, wherein, UAVs act as relays for the traffic generated between LoRa nodes and BS. To make the architecture more efficient, a distributed topology control algorithm is also proposed for UAVs. The algorithm is based on virtual spring forces and movement prediction technique that periodically updates the UAV topology to adapt to the movement of the ground-based LoRa nodes that move on the surface. The simulation results show the feasibility of the proposed approach for packet reception rate and average delay quality of service (QoS) metrics. It is observed that the mechanisms implemented in a UAV-enabled LoRa network effectively help to improve the packet reception rate with nominal buffer delays.


title: Simple Formulas for a Two-Tier Strategy to Flatten the Curve

text: Some basic facts that enable or constrain efforts to"flatten the curve"by non-pharmaceutical interventions (NPI) are summarized and placed in the current context of the COVID-19 epidemic. Analytical formulas are presented for a simple two-tier NPI strategy that places different social distancing targets for high- and low-risk groups. The results aim to facilitate rapid what-if analysis rather than replace detailed simulation, which remains indispensable for informed decision making. The appearance of the oft neglected Lambert function in the resulting formulas is noted.


Gathering evidence on the decreased emergency room visits during the coronavirus disease 19 pandemic


Effectiveness of rapid lung ultrasound training program for gynecologists and obstetricians managing pregnant women with suspected COVID-19


Long-Term Care Facilities and the COVID-19 Pandemic: Lessons Learned in Madrid


title: Ciliary muscle dimensions measured by swept-source optical coherence tomography in eyes with primary open-angle glaucoma and healthy eyes

text: PURPOSE: To compare in vivo swept-source optical coherence tomography (SS-OCT) measurements of the ciliary muscle (CM) in patients with primary open-angle glaucoma (POAG) and healthy subjects, and examine correlations between CM dimensions and several covariates. METHODS: This was a cross-sectional study of the right eyes of 181 subjects: 89 POAG patients and 92 healthy subjects. Using the Triton SS-OCT device (Topcon, Tokyo, Japan), CM length (CML), area (CMA) and thickness measured 1000 µm (CMT1), 2000 µm (CMT2) and 3000 µm (CMT3) from the scleral spur were determined in the temporal and nasal quadrants. POAG patients were subjected to visual field (VF) and peripapillary retinal nerve fiber layer (RNFL) assessment. CM dimensions were then assessed for correlation with VF mean defect (MD), mean RNFL thickness and intraocular pressure (IOP). RESULTS: Mean CMLs were 4325 ± 340 µm and 4195 ± 843 µm for the healthy subjects and POAG patients, respectively (p = 0.17). Mean CM thicknesses were CMT1 = 546 ± 56 µm, CMT2 = 326 ± 44 µm and CMT3 = 174 ± 16 µm in the healthy eyes versus CMT1 = 534 ± 108, CMT2 = 332 ± 99 and CMT3 = 183 ± 74 in the POAG eyes, with no significant differences detected (all p ≥ 0.25). In the temporal quadrant, mean CMA was 1.12 ± 0.29 mm2 and 1.15 ± 0.24 mm2 for the healthy and POAG subjects, respectively (p = 0.45). No correlations were observed between CM measurements and RNFL thickness (p ≥ 0.15), IOP or VF MD (p ≥ 0.14) in POAG subjects irrespective of glaucoma severity (p ≥ 0.19). CONCLUSIONS: While SS-OCT proved useful to measure CM dimensions in vivo, these dimensions did not differ between healthy individuals and POAG subjects. In the patients with POAG, no correlations were detected between CM dimensions and VF, RNFL or IOP.


title: Constituents of buriti oil (Mauritia flexuosa L.) like inhibitors of the SARS-Coronavirus main peptidase: an investigation by docking and molecular dynamics

text: Statistics show alarming numbers of infected and killed in the world, caused by the Covid-19 pandemic, which still doesn't have a specific treatment and effective in combating all efforts to seek treatments and medications against this disease. Natural products are of relevant interest in the search for new drugs. Thus, Buriti oil (Mauritia flexuosa L.) is a natural product extracted from the fruit of the palm and is quite common in the legal Amazon region, Brazil. In the present work, the anti-Covid-19 biological activity of some constituents of Buriti oil was investigated using in silico methods of Molecular Docking and Molecular Dynamics Simulations. The main results of Molecular Docking revealed favorable interaction energies in the formation of the 2GTB peptidase complex (main peptidase of SARS-CoV) with the 13-cis-ß-carotene ligands (ΔGbind = -10.23Kcal mol-1), 9-cis -ß-carotene (ΔGbind = -9.82Kcal mol-1), and α-carotene (ΔGbind = -8.34Kcal mol-1). Molecular Dynamics simulations demonstrated considerable interaction for these ligands with emphasis on α-carotene. Such theoretical results encourage and enable a direction for experimental studies in vitro and in vivo, essential in the development of new drugs with enzymatic inhibitory action for Covid-19.Communicated by Ramaswamy H. Sarma.


title: Novel Coronavirus Pneumonia Outbreak in 2019: Computed Tomographic Findings in Two Cases

text: Since the 2019 novel coronavirus (2019-nCoV or officially named by the World Health Organization as COVID-19) outbreak in Wuhan, Hubei Province, China in 2019, there have been a few reports of its imaging findings. Here, we report two confirmed cases of 2019-nCoV pneumonia with chest computed tomography findings of multiple regions of patchy consolidation and ground-glass opacities in both lungs. These findings were characteristically located along the bronchial bundle or subpleural lungs.


Physical activity during the coronavirus disease-19 global pandemic


Preventing and Controlling Measures of 2019 Coronavirus Disease (COVID-19): Practice in Psychogeriatric Ward


title: COVID-19 no Estado do Ceará: Comportamentos e crenças na chegada da pandemia

text: O objetivo deste estudo foi avaliar os aspectos comportamentais e as crenças da população cearense frente a pandemia de COVID-19 Foi realizado um questionário onlinesobre aspectos sociodemográficos e opiniões relacionados a pandemia Foram calculadas frequências absoluta e relativa, a associação entre variáveis foi realizada comQui-quadrado eo nível de significância foi de 5% A amostra final contou com 2 259 participantes e foi observada associação entre o gênero feminino com um alto risco de contaminação (p=0,044) e o gênero masculino com a não realização voluntária da quarentena (p<0,001) Pessoas com 80 anos ou mais realizaram quarentena parcialmente devido ao fluxo de pessoas em casa (p<0,001) Os participantes com o ensino fundamental consideraram que estão em um nível de risco menos alto que os participantes com grau de escolaridade mais elevado (p<0,001) Neste grupo estão as pessoas que menos fizeram quarentena voluntária (p<0,001) Os participantes que moram no interior do Estado, tiveram menos contato direto com alguém testado positivamente para o coronavírus (p=0,031) e estão menos reclusos (p<0,001) É possível concluir que a abordagem frente a pandemia de COVID-19 varia de acordo com aspectos sociais, como gênero, idade, escolaridade e local de residência, assim como o sistema de crenças da população do Estado do Ceará The aim of this study as to evaluate the behavior al aspects and belief sof the population of Ceará in the face of the COVID-19 pandemic An online questionnaire was conducted on sociodemographic aspects and opinions related to the pandemic Absolute and relative requencies were calculated, the association between variables was performed with Chi-square and the level of significance as 5% The final sample had 2,259 participants and an association was observed between the female gender with a high riskofcontamination (p = 0 044) and the male gender with voluntary non-performance of the quarantine (p <0 001) People aged 80 and over werepartiallyquarantinedduetotheflowofpeopleat home (p <0 001) Participants with primary education considered that they were at a lower risk level than participants with a higher level of education (p <0 001) In this group are the people who did the least voluntary quarantine (p <0 001) Participants who live in the interior of the state hadless direct contact with someone tested positive for the coronavírus (p = 0 031) and are lessinmates (p <0 001) It is possible to conclude that the approach to the COVID-19 pandemic varies according to social aspects, such as gender, age, education and place of residence, as well as the belief system of the population of the Stateof Ceará (AU)


title: Early histologic findings of pulmonary SARS-CoV-2 infection detected in a surgical specimen

text: Despite the current pandemic season, reports on pathologic features of coronavirus disease 19 (Covid-19) are exceedingly rare at the present time. Here we describe the pathologic features of early lung involvement by Covid-19 in a surgical sample resected for carcinoma from a patient who developed SARS-CoV-2 infection soon after surgery. The main histologic findings observed were pneumocyte damage, alveolar hemorrhages with clustering of macrophages, prominent and diffuse neutrophilic margination within septal vessels, and interstitial inflammatory infiltrates, mainly represented by CD8+ T lymphocytes. These features are similar to those previously described in SARS-CoV-1 infection. Subtle histologic changes suggestive pulmonary involvement by Covid-19 may be accidentally encountered in routine pathology practice, especially when extensive sampling is performed for histology. These findings should be carefully interpreted in light of the clinical context of the patient and could prompt a pharyngeal swab PCR test to rule out the possibility of SARS-CoV-2 infection in asymptomatic patients.


Chinese medical staff request international medical assistance in fighting against COVID-19


title: Número de casos COVID-19 en Chile a 120 días con datos al 21/03/2020 y umbral del esfuerzo diario para aplanar la epi-curva./ Number of COVID-19 cases in Chile at 120 days with data at 21/03/2020 and threshold of daily effort to flatten the epi-curve

text: We present a straightforward projection with data up to 21/03/2020 of the evolution of the number of COVID-19 cases per day in Chile using data from the Ministry of Health. Assuming an arithmetical growth in the second variation of the data, we present a cubic adjustment model in which we estimate over 100 000 cases at 120 days consistent with the data recorded to date. Furthermore, we use an exponential total case model to represent (using a parameter) the daily effort to reduce a high initial daily growth rate. We simulate this model with different numerical scenarios of feasibility and desired future prevalence.


Sars-CoV-2 and black population: ACE2 as shield or blade?


News Feature: Avoiding pitfalls in the pursuit of a COVID-19 vaccine


title: The COVID-19 outbreak in dermatologic surgery: resetting clinical priorities

text: Emilia-Romagna was one of the Italian regions mostly affected by the COVID-19 pandemic and lockdown measures were taken to slow the COVID-19 outbreak. All routine activities in Modena hospitals were suspended; however, urgent procedures were still to be performed. Setting the priority of procedures in oncological dermatology in the COVID-19 era is challenging.


Tracheostomy in the COVID-19 Era: The Apneic Approach


The immediate mental health impacts of the COVID-19 pandemic among people with or without quarantine managements


title: Clinical and Transmission Characteristics of Covid-19 - A Retrospective Study of 25 Cases from a Single Thoracic Surgery Department

text: The outbreak of corona virus disease 2019 (Covid-19) imposes a major challenge in managing patients undergoing surgical operation. In this study, we analyzed clinical and transmission features of 25 cases of Covid-19 from a single thoracic department, including 13 patients and 12 health care staff. There were 13 males and 12 females. The median age of the patients was 61 (range: 51 to 69) years. The median age of the health care staff was 35 (range: 22 to 51) years. By the end of follow-up date (Mar. 3, 2020), there were 16 non-severe cases (64%) and 9 severe cases (36%), 5 cases were dead (20%). Nineteen (76%) of the infected cases were confirmed by SARS-CoV-2 nucleic acid test, the rest were clinically diagnosed as suspected Covid-19 cases, and 19 (76%) of the infected cases had positive exposure history. We found that COPD was significantly associated with severity and death (P=0.040, and P=0.038, respectively), and chest operation was significantly associated with death for Covid-19 patients (P=0.039). A potential "super spreader" may be the source of the transmission before the implementation of quarantine and comprehensive protection. It was concluded that Covid-19 is associated with poor prognosis for patients undergoing thoracic operation, especially for those with COPD. Implementation of comprehensive protective measures is important to control nosocomial infection.


title: A Systematic Review of COVID-19 Epidemiology Based on Current Evidence

text: As the novel coronavirus (SARS-CoV-2) continues to spread rapidly across the globe, we aimed to identify and summarize the existing evidence on epidemiological characteristics of SARS-CoV-2 and the effectiveness of control measures to inform policymakers and leaders in formulating management guidelines, and to provide directions for future research. We conducted a systematic review of the published literature and preprints on the coronavirus disease (COVID-19) outbreak following predefined eligibility criteria. Of 317 research articles generated from our initial search on PubMed and preprint archives on 21 February 2020, 41 met our inclusion criteria and were included in the review. Current evidence suggests that it takes about 3-7 days for the epidemic to double in size. Of 21 estimates for the basic reproduction number ranging from 1.9 to 6.5, 13 were between 2.0 and 3.0. The incubation period was estimated to be 4-6 days, whereas the serial interval was estimated to be 4-8 days. Though the true case fatality risk is yet unknown, current model-based estimates ranged from 0.3% to 1.4% for outside China. There is an urgent need for rigorous research focusing on the mitigation efforts to minimize the impact on society.


title: Possible role of vitamin D in Covid-19 infection in pediatric population

text: PURPOSE: Covid-19 is a pandemic of unprecedented proportion, whose understanding and management is still under way. In the emergency setting new or available therapies to contrast the spread of COVID-19 are urgently needed. Elderly males, especially those affected by previous diseases or with comorbidities, are more prone to develop interstitial pneumonia that can deteriorate evolving to ARDS (acute respiratory distress syndrome) that require hospitalization in Intensive Care Units (ICUs). Even children and young patients are not spared by SARS-CoV 2 infection, yet they seem to develop a milder form of disease. In this setting the immunomodulatory role of Vitamin D, should be further investigated. METHODS: We reviewed the literature about the immunomodulatory role of Vitamin D collecting data from the databases Medline and Embase. RESULTS: Vitamin D proved to interact both with the innate immune system, by activating Toll-like receptors (TLRs) or increasing the levels of cathelicidins and ß-defensins, and adaptive immune system, by reducing immunoglobulin secretion by plasma cells and pro-inflammatory cytokines production, thus modulating T cells function. Promising results have been extensively described as regards the supplementation of vitamin D in respiratory tract infections, autoimmune diseases and even pulmonary fibrosis. CONCLUSIONS: In this review, we suggest that vitamin D supplementation might play a role in the prevention and/or treatment to SARS-CoV-2 infection disease, by modulating the immune response to the virus both in the adult and pediatric population.


Safety Measures in Dermatology Help Minimize Spread of COVID-19


Safety measures in dermatology help minimize spread of COVID-19


COVID-19 anticoagulation recommendations in children


title: A Novel Reverse Transcription Loop-Mediated Isothermal Amplification Method for Rapid Detection of SARS-CoV-2

text: COVID-19 has become a major global public health burden, currently causing a rapidly growing number of infections and significant morbidity and mortality around the world. Early detection with fast and sensitive assays and timely intervention are crucial for interrupting the spread of the COVID-19 virus (SARS-CoV-2). Using a mismatch-tolerant amplification technique, we developed a simple, rapid, sensitive and visual reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for SARS-CoV-2 detection based on its N gene. The assay has a high specificity and sensitivity, and robust reproducibility, and its results can be monitored using a real-time PCR machine or visualized via colorimetric change from red to yellow. The limit of detection (LOD) of the assay is 118.6 copies of SARS-CoV-2 RNA per 25 µL reaction. The reaction can be completed within 30 min for real-time fluorescence monitoring, or 40 min for visual detection when the template input is more than 200 copies per 25 µL reaction. To evaluate the viability of the assay, a comparison between the RT-LAMP and a commercial RT-qPCR assay was made using 56 clinical samples. The SARS-CoV-2 RT-LAMP assay showed perfect agreement in detection with the RT-qPCR assay. The newly-developed SARS-CoV-2 RT-LAMP assay is a simple and rapid method for COVID-19 surveillance.


title: High mortality in COVID-19 patients with mild respiratory disease

text: INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected 189 000 people in Italy, with more than 25 000 deaths. Several predictive factors of mortality have been identified; however, none has been validated in patients presenting with mild disease. METHODS: Patients with a diagnosis of interstitial pneumonia caused by SARS-CoV-2, presenting with mild symptoms, and requiring hospitalization in a non-intensive care unit with known discharge status were prospectively collected and retrospectively analysed. Demographical, clinical and biochemical parameters were recorded, as need for non-invasive mechanical ventilation and admission in intensive care unit. Univariate and multivariate logistic regression analyses were used to identify independent predictors of death. RESULTS: Between 28 February and 10 April 2020, 229 consecutive patients were included in the study cohort; the majority were males with a mean age of 60 years. 54% of patients had at least one comorbidity, with hypertension being the most commonly represented, followed by diabetes mellitus. 196 patients were discharged after a mean of 9 days, while 14.4% died during hospitalization because of respiratory failure. Age higher than 75 years, low platelet count (<150 × 103 /mm3 ) and higher ferritin levels (>750 ng/mL) were independent predictors of death. Comorbidities were not independently associated with in-hospital mortality. CONCLUSIONS: In-hospital mortality of patients with COVID-19 presenting with mild symptoms is high and is associated with older age, platelet count and ferritin levels. Identifying early predictors of outcome can be useful in the clinical practice to better stratify and manage patients with COVID-19.


A Call to Action: The Need for Autopsies to Determine the Full Extent of Organ Involvement Associated With COVID-19


title: Bringing Cuban Biotech Research to Bear on COVID-19:All Hands and Minds on Deck

text: This MEDICC Review roundtable gathers some of Cuba's top researchers in the fi elds of vaccines and biotechnology, all of whom work in institutions belonging to BioCubaFarma, the umbrella company of Cuban biotech and pharmaceutical R&D, production, distribution and export. Founded in 2012, the company is comprised of 34 enterprises with 61 lines of production and some 20,000 employees. A total of 765 of its products are registered in 53 countries and exported to an-other 50. Its scientists' research has resulted in 2640 patents in Cuba and globally.


Platelets and Immunity: Going Viral


title: Effectiveness of Cloth Masks for Protection Against Severe Acute Respiratory Syndrome Coronavirus 2

text: Cloth masks have been used in healthcare and community settings to protect the wearer from respiratory infections. The use of cloth masks during the coronavirus disease (COVID-19) pandemic is under debate. The filtration effectiveness of cloth masks is generally lower than that of medical masks and respirators; however, cloth masks may provide some protection if well designed and used correctly. Multilayer cloth masks, designed to fit around the face and made of water-resistant fabric with a high number of threads and finer weave, may provide reasonable protection. Until a cloth mask design is proven to be equally effective as a medical or N95 mask, wearing cloth masks should not be mandated for healthcare workers. In community settings, however, cloth masks may be used to prevent community spread of infections by sick or asymptomatically infected persons, and the public should be educated about their correct use.


Psychological impact of coronavirus disease 2019 in pregnant women


Fighting covid-19: One radiology department’s experience


title: The COVID-19 Pandemic and Paradigm Change in Global Scientific Research

text: The current pandemic has rocked the lives of human beings every-where in ways never imagined, forcing us to question where our civilization is headed. In this article, we explore and discuss scien-tifi c evidence that helps explain recent events in the context of the COVID-19 pandemic.COVID-19 is caused by infection with a zoonotic-origin novel virus, SARS-CoV-2, that is genetically close to two coronavirus types iso-lated in bats. The transmission dynamics to humans from the original and intermediary hosts remain poorly understood, but it is highly likely that the SARS-CoV-2 virus infected humans after undergoing an inter-species transfer from bats to an intermediate species, and from there to human beings. Crossing the species barrier is largely fostered by industrial-scale agricultural practices that simplify original ecosystem connections by reducing biodiversity, facilitating the emergence of new infectious diseases. The scientifi c community has played an exemplary role in responding to this global emergency, working to fi nd timely, relevant solutions for governments and society as a whole. We need to take this opportunity to promote a global and open science that delves into the interrelation-ships of the biological, environmental, social and economic dimen-sions of this and other diseases while questioning current modes of production and their impact on the environment, and thus on human health worldwide. Keywords: Coronavirus infections; communicable diseases; zoonoses; ecosystems; technology, industry, and agriculture; pandemics; global health; Mexico.


title: Anti-cardiolipin IgG autoantibodies are an independent risk factor of COVID-19 severity

text: A growing body of evidence indicates that patients with cardiovascular complications are at a higher risk for developing severe Coronavirus Disease 2019 (COVID-19) (1). In addition, the high incidence of thromboembolic events suggests an important role of COVID-19-induced coagulopathy (2). Antiphospholipid autoantibodies (aPL), that are essential markers for antiphospholipid syndrome, are considered as a cardiovascular risk factor.


Special Issue on the COVID-19 Pandemic and Psycholinguistic Research: A Call for Papers


title: Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2

text: OBJECTIVES: In many countries around the world, the COVID-19 pandemic has resulted in health services being diverted to manage patients with the condition. There are situations however that still require the undertaking of aerosol generating procedures (AGP) with potentially high exposure of healthcare workers to SARS-CoV-2 transmission through droplet, contact and possibly airborne routes. The objective of this paper is to explore a structured way for the operative team to approach AGP to reduce aerosolisation of secretions, decrease open airway time and minimise staff exposure. METHODS: The authors (otolaryngologists, anaesthetists and nursing staff) created a unified operative team checklist based on collation of national and international specialty society statements, local state government recommendations, hospital policies and literature review. Simulation was undertaken and the checklist was refined after performing AGP on patients with unknown (presumed positive) COVID-19 status. RESULTS: An 8 step operative team checklist is provided describing details for the immediate pre-operative, intra-operative and post-operative journey of the patient to encourage healthcare workers to reflect upon and modify usual practice during AGP to mitigate exposure to SARS-CoV-2. The example of paediatric laryngo-bronchoscopy for diagnostic purposes or retrieval of an inhaled airway foreign body is used to illustrate the steps however the checklist structure is modifiable for other AGP and adaptable for local needs. CONCLUSIONS: At a time of overwhelming and changing information and recommendations, an operative team checklist may provide some structure to healthcare workers undertaking AGP to reduce anxiety, maintain focus, prompt consideration of alternatives and potentially reduce risk.


Patients with bullous disorders during COVID-19 period: management and adherence to treatment


title: The contagion of mortality: A terror management health model for pandemics

text: The novel coronavirus, COVID-19, proliferates as a contagious psychological threat just like the physical disease itself. Due to the growing death toll and constant coverage this pandemic gets, it is likely to activate mortality awareness, to greater or lesser extents, depending on a variety of situational factors. Using terror management theory and the terror management health model, we outline reactions to the pandemic that consist of proximal defences aimed at reducing perceived vulnerability to (as well as denial of) the threat, and distal defences bound by ideological frameworks from which symbolic meaning can be derived. We provide predictions and recommendations for shifting reactions to this pandemic towards behaviours that decrease, rather than increase, the spread of the virus. We conclude by considering the benefits of shifting towards collective mindsets to more effectively combat COVID-19 and to better prepare for the next inevitable pandemic.


Conducting Inpatient Dermatology Consultations and Maintaining Resident Education in the COVID-19 Telemedicine Era


title: Contact Tracing Assessment of COVID-19 Transmission Dynamics in Taiwan and Risk at Different Exposure Periods Before and After Symptom Onset

text: Importance: The dynamics of coronavirus disease 2019 (COVID-19) transmissibility are yet to be fully understood. Better understanding of the transmission dynamics is important for the development and evaluation of effective control policies. Objective: To delineate the transmission dynamics of COVID-19 and evaluate the transmission risk at different exposure window periods before and after symptom onset. Design, Setting, and Participants: This prospective case-ascertained study in Taiwan included laboratory-confirmed cases of COVID-19 and their contacts. The study period was from January 15 to March 18, 2020. All close contacts were quarantined at home for 14 days after their last exposure to the index case. During the quarantine period, any relevant symptoms (fever, cough, or other respiratory symptoms) of contacts triggered a COVID-19 test. The final follow-up date was April 2, 2020. Main Outcomes and Measures: Secondary clinical attack rate (considering symptomatic cases only) for different exposure time windows of the index cases and for different exposure settings (such as household, family, and health care). Results: We enrolled 100 confirmed patients, with a median age of 44 years (range, 11-88 years), including 56 men and 44 women. Among their 2761 close contacts, there were 22 paired index-secondary cases. The overall secondary clinical attack rate was 0.7% (95% CI, 0.4%-1.0%). The attack rate was higher among the 1818 contacts whose exposure to index cases started within 5 days of symptom onset (1.0% [95% CI, 0.6%-1.6%]) compared with those who were exposed later (0 cases from 852 contacts; 95% CI, 0%-0.4%). The 299 contacts with exclusive presymptomatic exposures were also at risk (attack rate, 0.7% [95% CI, 0.2%-2.4%]). The attack rate was higher among household (4.6% [95% CI, 2.3%-9.3%]) and nonhousehold (5.3% [95% CI, 2.1%-12.8%]) family contacts than that in health care or other settings. The attack rates were higher among those aged 40 to 59 years (1.1% [95% CI, 0.6%-2.1%]) and those aged 60 years and older (0.9% [95% CI, 0.3%-2.6%]). Conclusions and Relevance: In this study, high transmissibility of COVID-19 before and immediately after symptom onset suggests that finding and isolating symptomatic patients alone may not suffice to contain the epidemic, and more generalized measures may be required, such as social distancing.


title: Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome

text: BACKGROUND: The prognostic significance of diabetes mellitus (DM) in patients with coronavirus 2019 disease (COVID-19) remains unknown. OBJECTIVES: To assess the risk of ICU admission and morality risk in diabetic COVID-19 patients. STUDY DESING: A database search was conducted to identify studies comparing diabetic COVID-19 patients hospitalized in intensive care unit (ICU) and those reporting the overall mortality of these patients published up to March 25, 2020 within MEDLINE, Scopus and Web of Science. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in abstracting data and assessing validity. Quality assessment was performed using the Newcastle-Ottawa quality assessment scale. The main outcome was the risk of ICU admission in diabetic patients with COVID-19 infection while the second was the mortality risk in overall diabetic COVID-19 patients. Data were pooled using the Mantel-Haenszel random effects models with odds ratio (OR) as the effect measure with the related 95 % confidence interval (CI). Statistical heterogeneity between groups was measured using the Higgins I2 statistic. RESULTS: Among 1382 patients (mean age 51.5 years, 798 males), DM resulted to be the second more frequent comorbidities. Diabetic patients resulted to have a significant increased risk of ICU admission (OR: 2.79, 95 % CI 1.85-4.22, p < 0.0001, I2 = 46 %). In 471 patients (mean age 56.6 years, 294 males) analysed for the secondary outcome diabetic subjects resulted to be at higher mortality risk (OR 3.21, 95 % CI 1.82-5.64, p < 0.0001, I2 = 16 %). CONCLUSIONS: Diabetic patients with COVID-19 patients are at higher risk of ICU admission and show an higher mortality risk.


title: Neural Networks Fail to Learn Periodic Functions and How to Fix It

text: Previous literature offers limited clues on how to learn a periodic function using modern neural networks. We start with a study of the extrapolation properties of neural networks; we prove and demonstrate experimentally that the standard activations functions, such as ReLU, tanh, sigmoid, along with their variants, all fail to learn to extrapolate simple periodic functions. We hypothesize that this is due to their lack of a"periodic"inductive bias. As a fix of this problem, we propose a new activation, namely, $x + \sin^2(x)$, which achieves the desired periodic inductive bias to learn a periodic function while maintaining a favorable optimization property of the ReLU-based activations. Experimentally, we apply the proposed method to temperature and financial data prediction.


title: Emerging Attack and Management Strategies for Nuclear Medicine in Responding to COVID-19-ACNM Member Experience and Advice

text: As the World Health Organization declared COVID-19 as "global pandemic," it is important for everyone, including nuclear medicine personnel, to know how to stop transmission, contain, and prevent the spread of COVID-19. We reach out to our ACNM (American College of Nuclear Medicine) international members from Wuhan, China and Singapore, who have participated in dealing with COVID-19 for the last 2 months, to learn from their lessons and experiences, so to provide advice to all ACNM members for their clinical practice and management strategies in responding to COVID-19.


Behavioral and psychosocial responses of people receiving treatment for advanced lung cancer during the COVID-19 pandemic: a qualitative analysis


title: Drug targets for corona virus: A systematic review

text: The 2019-novel coronavirus (nCoV) is a major source of disaster in the 21th century. However, the lack of specific drugs to prevent/treat an attack is a major need at this current point of time. In this regard, we conducted a systematic review to identify major druggable targets in coronavirus (CoV). We searched PubMed and RCSB database with keywords HCoV, NCoV, corona virus, SERS-CoV, MERS-CoV, 2019-nCoV, crystal structure, X-ray crystallography structure, NMR structure, target, and drug target till Feb 3, 2020. The search identified seven major targets (spike protein, envelop protein, membrane protein, protease, nucleocapsid protein, hemagglutinin esterase, and helicase) for which drug design can be considered. There are other 16 nonstructural proteins (NSPs), which can also be considered from the drug design perspective. The major structural proteins and NSPs may serve an important role from drug design perspectives. However, the occurrence of frequent recombination events is a major deterrent factor toward the development of CoV-specific vaccines/drugs.


Informal home care providers: the forgotten health-care workers during the COVID-19 pandemic


title: Could we have prevented all this? A comparison of the British and South Korean primary dental care response to COVID-19

text: To limit the spread of the novel coronavirus (COVID-19), Britain enforced a strict national lockdown, which is affecting the lives of millions, including dental professionals. As a result, all routine dental work has been suspended and general dental practitioners (GDPs) are inevitably faced with financial difficulties, as well as an impending strain on dental services once the lockdown is lifted. In contrast, South Korea (SK) has effectively managed to keep the virus at bay without a lockdown and continues to deliver routine dental care throughout this period. This article compares the current status of primary dental care in the UK and SK under COVID-19, in order to explore how the dental profession can better mitigate the repercussions of a future epidemic crisis.


title: Proposition d'un algorithme basé sur l'échographie pulmonaire et le phénotype physiologique pour la prise en charge des patients atteints de la COVID-19 souffrant d'insuffisance respiratoire aiguë./ A proposed lung ultrasound and phenotypic algorithm for the care of COVID-19 patients with acute respiratory failure

text: Pulmonary complications are the most common clinical manifestations of coronavirus disease (COVID-19). From recent clinical observation, two phenotypes have emerged: a low elastance or L-type and a high elastance or H-type. Clinical presentation, pathophysiology, pulmonary mechanics, radiological and ultrasound findings of these two phenotypes are different. Consequently, the therapeutic approach also varies between the two. We propose a management algorithm that combines the respiratory rate and oxygenation index with bedside lung ultrasound examination and monitoring that could help determine earlier the requirement for intubation and other surveillance of COVID-19 patients with respiratory failure.


Respuesta de autores a: A propósito de la carta científica «Sospecha de abdomen agudo como manifestación extrapulmonar de infección COVID-19¼./ Respuesta de autores a: A propósito de la carta científica «Sospecha de abdomen agudo como manifestación extrapulmonar de infección COVID-19¼./ Authors response to: «About the scientific letter: Suspected Acute Abdomen as an Extrapulmonary Manifestation of Covid-19 Infection¼


title: Characteristics of respiratory virus infection during the outbreak of 2019 novel coronavirus in Beijing

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is spreading. Here, we summarized the composition of pathogens in fever clinic patients and analyzed the characteristics of different respiratory viral infections. METHODS: Retrospectively collected patients with definite etiological results using nasal and pharyngeal swabs in a fever clinic. RESULTS: Overall, 1860 patients were screened, and 136 patients were enrolled. 72 (52.94%) of them were diagnosed as influenza (Flu) A virus infection. 32 (23.53%) of them were diagnosed as Flu B virus infection. 18 (13.24%) and 14 (10.29%) of them were diagnosed as COVID-19 and respiratory syncytial virus (RSV) infections, respectively. The COVID-19 group had a higher rate of contact with the epidemic area within 14 days and of clustering onset than other groups. Fever was the most common symptom in these patients. The ratio of fever to the highest temperature was higher in Flu A virus infection patients than in COVID-19 patients. COVID-19 patients had a lower white blood cell count and neutrophil count than Flu A virus and RSV infection groups, but higher lymphocyte count than Flu A and B virus infection groups. The COVID-19 group (83.33%) had a higher rate of pneumonia in chest CT scans than Flu A and B virus infection groups. CONCLUSIONS: Influenza viruses accounted for a large proportion of respiratory virus infection even during the epidemic of COVID-19 in Beijing. No single symptom or laboratory finding was suggestive of a specific respiratory virus; however, epidemic history was significant for the screening of COVID-19.


Mental Well-Being of Nursing Staff During the Coronavirus Disease 2019 Outbreak: A Cultural Perspective


title: The effects of regional climatic condition on the spread of COVID-19 at global scale

text: The pandemic outbreak of the novel coronavirus epidemic disease (COVID-19) is spreading like a diffusion-reaction in the world and almost 208 countries and territories are being affected around the globe. It became a sever health and socio-economic problem, while the world has no vaccine to combat this virus. This research aims to analyze the connection between the fast spread of COVID-19 and regional climate parameters over a global scale. In this research, we collected the data of COVID-19 cases from the time of 1st reported case to the 5th June 2020 in different affected countries and regional climatic parameters data from January 2020 to 5th June 2020. It was found that most of the countries located in the relatively lower temperature region show a rapid increase in the COVID-19 cases than the countries locating in the warmer climatic regions despite their better socio-economic conditions. A correlation between metrological parameters and COVID-19 cases was observed. Average daylight hours are correlated to total the COVID-19 cases with a coefficient of determination of 0.42, while average high-temperature shows a correlation of 0.59 and 0.42 with total COVID-19 cases and death cases respectively. The finding of the study will help international health organizations and local administrations to combat and well manage the spread of COVID-19.


Validating QT-Interval Measurement Using the Apple Watch ECG to Enable Remote Monitoring During the COVID-19 Pandemic


Infection control in non-clinical areas during the COVID-19 pandemic


title: Geroprotective and senoremediative strategies to reduce the comorbidity, infection rates, severity, and lethality in gerophilic and gerolavic infections

text: The recently identified SARS-CoV-2 betacoronavirus responsible for the COVID-19 pandemic has uncovered the age-associated vulnerability in the burden of disease and put aging research in the spotlight. The limited data available indicates that COVID-19 should be referred to as a gerolavic (from Greek, géros "old man" and epilavís, "harmful") infection because the infection rates, severity, and lethality are substantially higher in the population aged 60 and older. This is primarily due to comorbidity but may be partially due to immunosenescence, decreased immune function in the elderly, and general loss of function, fitness, and increased frailty associated with aging. Immunosenescence is a major factor affecting vaccination response, as well as the severity and lethality of infectious diseases. While vaccination reduces infection rates, and therapeutic interventions reduce the severity and lethality of infections, these interventions have limitations. Previous studies showed that postulated geroprotectors, such as sirolimus (rapamycin) and its close derivative rapalog everolimus (RAD001), decreased infection rates in a small sample of elderly patients. This article presents a review of the limited literature available on geroprotective and senoremediative interventions that may be investigated to decrease the disease burden of gerolavic infections. This article also highlights a need for rigorous clinical validation of deep aging clocks as surrogate markers of biological age. These could be used to assess the need for, and efficacy of, geroprotective and senoremediative interventions and provide better protection for elderly populations from gerolavic infections. This article does not represent medical advice and the medications described are not yet licensed or recommended as immune system boosters, as they have not undergone clinical evaluation for this purpose.


title: Orthopaedic Guidelines for the COVID-19 Post-Outbreak Period: Experience from Wuhan, People's Republic of China

text: Currently, the coronavirus disease 2019 (COVID-19) crisis has rapidly spread worldwide. As the earliest outbreak area of the pandemic, Wuhan, People's Republic of China, is gradually recovering to its normal state under the effective control of government authorities. Outpatient services in major hospitals are now being restored. An accumulation of asymptomatic infections is a potential risk for medical personnel, especially when there is crowding in hospitals. As the biggest center for orthopaedic patients in Wuhan, our orthopaedic outpatient department admits >300 patients per day. Optimal guidelines on how to handle this huge number of patients during the post-outbreak stage of the COVID-19 pandemic, particularly with regard to potential asymptomatic infection, are urgently needed for orthopaedic surgeons. We have developed and proposed applicable guidelines to fill this knowledge gap, including the necessary protective strategies for medical personnel in orthopaedic outpatient and inpatient wards as well as during surgery. We also have provided mental health recommendations for health-care workers. To the best of our knowledge, these guidelines are the first of their kind for orthopaedic surgeons who are slowly reestablishing medical activity following the pandemic.


title: COVID-19 in Neonates and Infants: Progression and Recovery

text: Between March 10, 2020 and April 17, 2020, of 8/70 (11.4%) SARS-CoV-2 positive infants that presented, 5/8 (63%) developed fever, 4/8 (50%) had lower respiratory tract involvement, 2/8 (25%) had neutropenia and thrombocytosis, and 4/8 infants (50%) were treated for suspected sepsis with broad-spectrum antibiotics. Only 1/8 (13%) required pediatric intensive care. All patients were eventually discharged home well.


Hydroxychloroquine as Prophylaxis for Coronavirus SARS-CoV-2 Infection: Review of the Ongoing Clinical Trials


COVID-19 & Allergy: Allergists Workload During the Pandemic


Vitamin d and covid-19: A note of caution


High-throughput sequencing for confirmation of suspected 2019-nCoV infection identified by fluorescence quantitative polymerase chain reaction


title: Minimal epidemic model considering external infected injection and governmental quarantine policies: Application to COVID-19 pandemic

text: Due to modern transportation networks (airplanes, cruise ships, etc.) an epidemic in a given country or city may be triggered by the arrival of external infected agents. Posterior government quarantine policies are usually taken in order to control the epidemic growth. We formulate a minimal epidemic evolution model that takes into account these components. The previous and posterior evolutions to the quarantine policy are modeled in a separate way by considering different complexities parameters in each stage. Application of this model to COVID-19 data in different countries is implemented. Estimations of the infected peak time-occurrence and epidemic saturation values as well as possible post-quarantine scenarios are analyzed over the basis of the model, reported data, and the fraction of the population that adopts the quarantine policy.


The Evolving COVID-19 Effect on Hip Fracture Patients


title: Laboratory surveillance for SARS-CoV-2 in India: Performance of testing & descriptive epidemiology of detected COVID-19, January 22 - April 30, 2020

text: Background & objectives: India has been reporting the cases of coronavirus disease 2019 (COVID-19) since January 30, 2020. The Indian Council of Medical Research (ICMR) formulated and established laboratory surveillance for COVID-19. In this study, an analysis of the surveillance data was done to describe the testing performance and descriptive epidemiology of COVID-19 cases by time, place and person. Methods: The data were extracted from January 22 to April 30, 2020. The frequencies of testing performance were described over time and by place. We described cases by time (epidemic curve by date of specimen collection; seven-day moving average), place (area map) and person (attack rate by age, sex and contact status), and trends were represented along with public health measures and events. Results: Between January 22 and April 30, 2020, a total of 1,021,518 individuals were tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Testing increased from about 250 individuals per day in the beginning of March to 50,000 specimens per day by the end of April 2020. Overall, 40,184 (3.9%) tests were reported positive. The proportion of positive cases was highest among symptomatic and asymptomatic contacts, 2-3-fold higher than among those with severe acute respiratory infection, or those with an international travel history or healthcare workers. The attack rate (per million) by age was highest among those aged 50-69 yr (63.3) and was lowest among those under 10 yr (6.1). The attack rate was higher among males (41.6) than females (24.3). The secondary attack rate was 6.0 per cent. Overall, 99.0 per cent of 736 districts reported testing and 71.1 per cent reported COVID-19 cases. Interpretation & conclusions: The coverage and frequency of ICMR's laboratory surveillance for SARS-CoV-2 improved over time. COVID-19 was reported from most parts of India, and the attack rate was more among men and the elderly and common among close contacts. Analysis of the data indicates that for further insight, additional surveillance tools and strategies at the national and sub-national levels are needed.


Surgeons' response to COVID-19: modified workflow to adapt to the new normal


title: Infectious diseases in children and adolescents in China: analysis of national surveillance data from 2008 to 2017

text: OBJECTIVES: To outline which infectious diseases in the pre-covid-19 era persist in children and adolescents in China and to describe recent trends and variations by age, sex, season, and province. DESIGN: National surveillance studies, 2008-17. SETTING: 31 provinces in mainland China. PARTICIPANTS: 4 959 790 Chinese students aged 6 to 22 years with a diagnosis of any of 44 notifiable infectious diseases. The diseases were categorised into seven groups: quarantinable; vaccine preventable; gastrointestinal and enteroviral; vectorborne; zoonotic; bacterial; and sexually transmitted and bloodborne. MAIN OUTCOME MEASURES: Diagnosis of, and deaths from, 44 notifiable infectious diseases. RESULTS: From 2008 to 2017, 44 notifiable infectious diseases were diagnosed in 4 959 790 participants (3 045 905 males, 1 913 885 females) and there were 2532 deaths (1663 males, 869 females). The leading causes of death among infectious diseases shifted from rabies and tuberculosis to HIV/AIDS, particularly in males. Mortality from infectious diseases decreased steadily from 0.21 per 100 000 population in 2008 to 0.07 per 100 000 in 2017. Quarantinable conditions with high mortality have effectively disappeared. The incidence of notifiable infectious diseases in children and adolescents decreased from 280 per 100 000 in 2008 to 162 per 100 000 in 2015, but rose again to 242 per 100 000 in 2017, largely related to mumps and seasonal influenza. Excluding mumps and influenza, the incidence of vaccine preventable diseases fell from 96 per 100 000 in 2008 to 7 per 100 000 in 2017. The incidence of gastrointestinal and enterovirus diseases remained constant, but typhoid, paratyphoid, and dysentery continued to decline. Vectorborne diseases all declined, with a particularly noticeable reduction in malaria. Zoonotic infections remained at low incidence, but there were still unpredictable outbreaks, such as pandemic A/H1N1 2009 influenza. Tuberculosis remained the most common bacterial infection, although cases of scarlet fever doubled between 2008 and 2017. Sexually transmitted diseases and bloodborne infections increased significantly, particularly from 2011 to 2017, among which HIV/AIDS increased fivefold, particularly in males. Difference was noticeable between regions, with children and adolescents in western China continuing to carry a disproportionate burden from infectious diseases. CONCLUSIONS: China's success in infectious disease control in the pre-covid-19 era was notable, with deaths due to infectious diseases in children and adolescents aged 6-22 years becoming rare. Many challenges remain around reducing regional inequalities, scaling-up of vaccination, prevention of further escalation of HIV/AIDS, renewed efforts for persisting diseases, and undertaking early and effective response to highly transmissible seasonal and unpredictable diseases such as that caused by the novel SARS-CoV-2 virus.


title: Risk factors analysis and nomogram construction of non-survivors in critical patients with COVID-19

text: A pandemic named coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbroke in China since December 2019. This disease has caused more than 70000 deaths worldwide. We intend to analyze the risk factors of death and establish a prognosis nomogram for critical patients with COVID-19. We analyzed the clinical data of COVID-19 patients in Zhongnan Hospital of Wuhan University who were critical cases with COVID-19 before March 20, 2020. Data were collected at admission and compared between survivors and non-survivors and analyzed by univariable and multivariable logistic regression analysis. Finally, 104 patients were included, and 50 of whom died. Age [ OR 5.73 (95% CI, 1.14-28.81)], chest tightness [OR 5.50 (95%CI, 1.02-29.64)], AST [OR 6.57 (95%CI, 1.33-32.48)]and BUN [5.59 (95%CI, 1.05-29.74)] at admission were considered to predict the risk of death in critical patients and were selected to construct the nomogram. Subsequently, we established a nomogram model and validated it. The sensitivity and specificity of the nomogram were 96.0% and 74.1%, respectively. The AUC was 0.893 (95% CI, 0.807-0.980).


title: Practical exploration of the informationization support for prevention and control of the new coronavirus pneumonia with Tongji Hospital as an example/ 中华医院管理杂志

text: December of 2019 witnessed the outbreak of new coronavirus pneumonia in Wuhan city and a few localities. As a designated hospital, Tongji Hospital is designated as a hospital for the diagnosis and treatment of numerous patients of such a disease. Based on the medical cloud platform, the hospital has initiated a regional remote diagnosis center; based on its IT system, the hospital to operate its epidemic prevention and management mechanism, set up the self-service system for patients at the fever clinic, launched its online diagnosis and treatment services, and established a hospital epidemic supervision platform. By strengthening the informational support needed for epidemic prevention and control, the hospital has enhanced its efficiency of epidemic prevention and control, reducing the risk of cross-infection, and ensuring data security. Its experiences offer references for informationization support for other regions and hospitals in China.