title: Do underlying cardiovascular diseases have any impact on hospitalised patients with COVID-19?

text: OBJECTIVES: An outbreak of the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has sickened thousands of people in China. The purpose of this study was to explore the early clinical characteristics of COVID-19 patients with cardiovascular disease (CVD). METHODS: This is a retrospective analysis of patients with COVID-19 from a single centre. All patients underwent real-time reverse transcription PCR for SARS-CoV-2 on admission. Demographic and clinical factors and laboratory data were reviewed and collected to evaluate for significant associations. RESULTS: The study included 541 patients with COVID-19. A total of 144 (26.6%) patients had a history of CVD. The mortality of patients with CVD reached 22.2%, which was higher than that of the overall population of this study (9.8%). Patients with CVD were also more likely to develop liver function abnormality, elevated blood creatinine and lactic dehydrogenase (p<0.05). Symptoms of sputum production were more common in patients with CVD (p=0.026). Lymphocytes, haemoglobin and albumin below the normal range were pervasive in the CVD group (p<0.05). The proportion of critically ill patients in the CVD group (27.8%) was significantly higher than that in the non-CVD group (8.8%). Multivariable logistic regression analysis revealed that CVD (OR: 2.735 (95% CI 1.495 to 5.003), p=0.001) was associated with critical COVID-19 condition, while patients with coronary heart disease were less likely to reach recovery standards (OR: 0.331 (95% CI 0.125 to 0.880), p=0.027). CONCLUSIONS: Considering the high prevalence of CVD, a thorough CVD assessment at diagnosis and early intervention are recommended in COVID-19 patients with CVD. Patients with CVD are more vulnerable to deterioration.


title: Preservação da privacidade no enfrentamento da COVID-19: dados pessoais e a pandemia global./ Preservação da privacidade no enfrentamento da COVID-19: dados pessoais e a pandemia global./ Personal data usage and privacy considerations in the COVID-19 global pandemic

text: Data has become increasingly important and valuable for both scientists and health authorities searching for answers to the COVID-19 crisis. Due to difficulties in diagnosing this infection in populations around the world, initiatives supported by digital technologies are being developed by governments and private companies to enable the tracking of the public's symptoms, contacts and movements. Considering the current scenario, initiatives designed to support infection surveillance and monitoring are essential and necessary. Nonetheless, ethical, legal and technical questions abound regarding the amount and types of personal data being collected, processed, shared and used in the name of public health, as well as the concomitant or posterior use of this data. These challenges demonstrate the need for new models of responsible and transparent data and technology governance in efforts to control SARS-COV2, as well as in future public health emergencies.


Dermatology practices as vectors for COVID-19 transmission: A call for immediate cessation of nonemergent dermatology visits


COVID-19 vaccines: neutralizing antibodies and the alum advantage


Clinical features and outcomes of adult COVID-19 patients co-infected with Mycoplasma pneumoniae


title: Convergent antibody responses to SARS-CoV-2 in convalescent individuals

text: During the COVID-19 pandemic, SARS-CoV-2 infected millions of people and claimed hundreds of thousands of lives. Virus entry into cells depends on the receptor binding domain (RBD) of the SARS-CoV-2 spike protein (S). Although there is no vaccine, it is likely that antibodies will be essential for protection. However, little is known about the human antibody response to SARS-CoV-21-5. Here we report on 149 COVID-19 convalescent individuals. Plasmas collected an average of 39 days after the onset of symptoms had variable half-maximal pseudovirus neutralizing titres: less than 1:50 in 33% and below 1:1,000 in 79%, while only 1% showed titres above 1:5,000. Antibody sequencing revealed expanded clones of RBD-specific memory B cells expressing closely related antibodies in different individuals. Despite low plasma titres, antibodies to three distinct epitopes on RBD neutralized at half-maximal inhibitory concentrations (IC50 values) as low as single digit nanograms per millitre. Thus, most convalescent plasmas obtained from individuals who recover from COVID-19 do not contain high levels of neutralizing activity. Nevertheless, rare but recurring RBD-specific antibodies with potent antiviral activity were found in all individuals tested, suggesting that a vaccine designed to elicit such antibodies could be broadly effective.


Independent Correlates of Hospitalization in 2040 Patients with COVID-19 at a Large Hospital System in Michigan, United States


title: COVID-19 transmission in Mainland China is associated with temperature and humidity: A time-series analysis

text: COVID-19 has become a pandemic. The influence of meteorological factors on the transmission and spread of COVID-19 is of interest. This study sought to examine the associations of daily average temperature (AT) and relative humidity (ARH) with the daily counts of COVID-19 cases in 30 Chinese provinces (in Hubei from December 1, 2019 to February 11, 2020 and in other provinces from January 20, 2020 to Februarys 11, 2020). A Generalized Additive Model (GAM) was fitted to quantify the province-specific associations between meteorological variables and the daily cases of COVID-19 during the study periods. In the model, the 14-day exponential moving averages (EMAs) of AT and ARH, and their interaction were included with time trend and health-seeking behavior adjusted. Their spatial distributions were visualized. AT and ARH showed significantly negative associations with COVID-19 with a significant interaction between them (0.04, 95% confidence interval: 0.004-0.07) in Hubei. Every 1 °C increase in the AT led to a decrease in the daily confirmed cases by 36% to 57% when ARH was in the range from 67% to 85.5%. Every 1% increase in ARH led to a decrease in the daily confirmed cases by 11% to 22% when AT was in the range from 5.04 °C to 8.2 °C. However, these associations were not consistent throughout Mainland China.


title: COVID-19 and the liver: overview

text: On 12 March 2020, the WHO declared that the coronavirus disease 2019 (COVID-19) constitutes a pandemic. Cases of liver damage or dysfunction (mainly characterized by moderately elevated serum aspartate aminotransferase levels) have been reported among patients with COVID-19. However, it is currently uncertain whether the COVID-19 related liver damage/dysfunction is due mainly to the viral infection by itself or other coexisting conditions, such as the use of potentially hepatotoxic medications and the coexistence of systemic inflammatory response, respiratory distress syndrome-induced hypoxia, and multiple organ dysfunction. Individuals at high risk for severe COVID-19 are typical of older age and/or present with comorbid conditions such as diabetes, cardiovascular disease, and hypertension. This is also the same profile for those at increased risk for unrecognized underlying liver disease, especially nonalcoholic fatty liver disease. This could make them more susceptible to liver injury from the virus, medications used in supportive management, or hypoxia. So the aim of this review was to illustrate the clinical implications of COVID-19 on the liver in healthy and diseased states as well as the implications of common liver disorders on the outcome of COVID-19.


title: Correlation between Chest Computed Tomography Scan Findings and Mortality of COVID-19 Cases;a Cross sectional Study

text: INTRODUCTION: Predicting the outcomes of COVID-19 cases using different clinical, laboratory, and imaging parameters is one of the most interesting fields of research in this regard This study aimed to evaluate the correlation between chest computed tomography (CT) scan findings and outcomes of COVID-19 cases METHODS: This cross sectional study was carried out on confirmed COVID-19 cases with clinical manifestations and chest CT scan findings based on Iran's National Guidelines for defining COVID-19 Baseline and chest CT scan characteristics of patients were investigated and their correlation with mortality was analyzed and reported using SPSS 21 0 RESULTS: 380 patients with the mean age of 53 62 ± 16 66 years were evaluated (66 1% male) The most frequent chest CT scan abnormalities were in peripheral (86 6%) and peribronchovascular interstitium (34 6%), with ground glass pattern (54 1%), and round (53 6%) or linear (46 7%) shape There was a significant correlation between shape of abnormalities (p = 0 003), CT scan Severity Score (CTSS) (p <0 0001), and pulmonary artery CT diameter (p = 0 01) with mortality The mean CTSS of non-survived cases was significantly higher (13 68 ± 4 59 versus 8 72 ± 4 42;<0 0001) The area under the receiver operating characteristic (ROC) curve of CTSS in predicting the patients' mortality was 0 800 (95% CI: 0 716-0 884) The best cut off point of chest CTSS in this regard was 12 with 75 82% (95% CI: 56 07%-88 98%) sensitivity and 75 78% (95% CI: 70 88%-80 10%) specificity The mean main pulmonary artery diameter in patients with CTSS ≥ 12 was higher than cases with CTSS < 12 (27 89 ± 3 73 vs 26 24 ± 3 14 mm;p < 0 0001) CONCLUSION: Based on the results of the present study it seems that there is a significant correlation between chest CT scan characteristics and mortality of COVID-19 cases Patients with lower CTSS, lower pulmonary artery CT diameter, and round shape opacity had lower mortality


title: Coronavirus Disease 2019 in Children Cared for at Texas Children's Hospital: Initial Clinical Characteristics and Outcomes

text: We describe the clinical course of 57 children with coronavirus disease 2019 (COVID-19) cared for through a single hospital system. Most children were mildly symptomatic, and only a few patients with underlying medical conditions required hospitalization. System-wide patient evaluation processes allowed for prompt identification and management of COVID-19 patients.


title: Combination antiviral therapy with lopinavir/ritonavir, arbidol and interferon-α1b for COVID-19

text: Since the outbreak of coronavirus disease (COVID-19) that was discovered in 2019 in Wuhan, China, no standard therapy guideline has been set despite the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its high infectivity. The globally pandemic outbreak suggests that COVID-19 was highly infectious and difficult to control. A dual-combination of ribavirin and interferon-α has been the widely used regimen for the treatment of this disease in China. However, due to the varying results of treatment with these drugs, a novel antiviral combination therapy is urgently needed. This case reports the usage of lopinavir/ritonavir-based combination antiviral regimen for a patient with SARS-CoV-2 infection.


Management of CO2 absorbent while using the anesthesia machine as a mechanical ventilator on patients with COVID-19


title: COVID-19 pandemic: an overview of epidemiology, pathogenesis, diagnostics and potential vaccines and therapeutics

text: At the time of writing this review, severe acute respiratory coronavirus syndrome-2 (SARS-CoV-2) has infected more than 2,355,853 patients and resulted in more than 164,656 deaths worldwide (as of 20 April 2020). This review highlights the preventive measures, available clinical therapies and the potential of vaccine development against SARS-CoV-2 by taking into consideration the strong genetic similarities of the 2003 epidemic SARS-CoV. Recent studies are investigating the repurposing of US FDA-approved drugs as there is no available vaccine yet with many attempts under clinical evaluation. Several antivirals, antimalarials and immunomodulators that have shown activity against SARS-CoV and Middle East coronavirus respiratory syndromes are being evaluated. In particular, hydroxychloroquine, remdesivir, favipiravir, arbidol, tocilizumab and bevacizumab have shown promising results. The main aim of this review is to provide an overview of this pandemic and where we currently stand.


title: Low-tech solutions for the COVID-19 supply chain crisis

text: A global effort is ongoing in the scientific community and in the maker movement, which focuses on creating devices and tinkering with them, to reverse-engineer commercial medical equipment and get it to healthcare workers. For these 'low-tech' solutions to have a real impact, it is important for them to coalesce around approved designs.


title: Low-tech solutions for the COVID19 supply chain crisis

text: A global effort is ongoing in the scientific community and in the Maker Movement, which focuses on creating devices and tinkering with them, to reverse engineer commercial medical equipment and get it to healthcare workers. For these low-tech solutions to have a real impact, it is important for them to coalesce around approved designs.


title: The Fight Against Obesity Escalates: New Drugs on the Horizon and Metabolic Implications

text: PURPOSE OF REVIEW: There is currently a steep rise in the global prevalence of obesity. Pharmaceutical therapy is a valuable component of conservative obesity therapy. Herein, medications currently in the phase of preclinical or clinical testing are reviewed, along with an overview of the mechanisms that regulate energy intake and expenditure. In addition, the current and potential future directions of obesity drug therapy are discussed. RECENT FINDINGS: Although the current arsenal of obesity pharmacotherapy is limited, a considerable number of agents that exert their actions through a variety of pharmacodynamic targets and mechanisms are in the pipeline. This expansion shapes a potential near future of obesity conservative management, characterized by tailored combined therapeutic regimens, targeting not only weight loss but also improved overall health outcomes. The progress regarding the elucidation of the mechanisms which regulate the bodily energy equilibrium has led to medications which mimic hormonal adaptations that follow bariatric surgery, in the quest for a "Medical bypass." These, combined with agents which could increase energy expenditure, point to a brilliant future in the conservative treatment of obesity.


Commentary: Vulnerability and resilience demonstrated: Cardiac surgeons during coronavirus disease 2019 (COVID-19)


title: Additional cusp reconstruction does not compromise valve durability and mid-term survival after the David procedure: results from 449 patients

text: OBJECTIVES: The aim of this study was to evaluate whether additional cusp interventions and valve types affect aortic valve-related reoperation and mortality rates after the David procedure. METHODS: Between 1997 and 2018, a total of 449 patients {372 males; mean age 54.2 [standard deviation (SD) 15.2] years, range: 12.7-79.9 years} underwent elective valve-sparing aortic root replacement (David procedure) for aortic regurgitation and were prospectively followed up clinically and echocardiographically. RESULTS: The follow-up was 94% complete. Cumulative follow-up time was 2268 patient-years [mean follow-up time 5.1 (4.3 SD) years]. Thirty-day mortality was 2.2% (n = 10). Late (>30 days) survival did not differ from that of the age- and gender-matched general population. Freedom from reoperation in patients without additional cusp reconstruction was 94% [95% confidence interval (CI) 91-98] and 92% (95% CI 88-97) at 5 and 10 years, respectively, which was not significantly different (P = 1) for patients who did require additional cusp reconstruction 98% (95% CI 95-100) and 89% (95% CI 81-99). In patients with tricuspid aortic valves (n = 338), freedom from reoperation was 96% (95% CI 94-99) and 93% (95% CI 88-97) at 5 and 10 years, respectively. Patients with bicuspid aortic valves (n = 111) had a freedom from reoperation of 94% (95% CI 89-99) at 5 years and 88% (95% CI 79-98) at 10 years (P = 0.021 for the comparison to tricuspid aortic valve). Overall, 23 patients (5%; 1%/patient-year) required reoperation with a mean interval of 4.5 (4.8 SD) months. CONCLUSIONS: The David procedure revealed low mid-term reoperation risk and excellent survival independent of adjunctive cusp interventions/valve morphology and is comparable with that of the age- and gender-matched general population.


Guest Editorial: Ethics and equity in the time of Coronavirus


title: Reverse-Surge Planning During the COVID-19 Pandemic: A Cautionary Ramp-up for the Otolaryngologist

text: As the coronavirus disease 2019 (COVID-19) pandemic continues to evolve through the United States and other countries, differing rates of progression and decline are occurring based on varied population densities. While some health systems are reaching a steady state of new patient cases, others are seeing a leveling off or decline, allowing for restoration of normal practices. This "reverse-surge" planning and implementation process is a colossal undertaking for health systems trying to reacquire patient access and financial stability while preserving necessary resources and maintaining precautions for another potential surge. For the otolaryngologist, reverse-surge planning involves additional workflow adjustments in the outpatient and operating room settings given the abundance of COVID-19 virus in the upper aerodigestive tract. As the reverse-surge best practices are still under development, open communication between otolaryngology colleagues and health system leadership is paramount to optimize efficiency and maintain an adequate measure of safety for patients and our health care teams.


COVID-19 and Katrina: recalcitrant racial disparities


title: Structural Basis for Potent Neutralization of Betacoronaviruses by Single-Domain Camelid Antibodies

text: Coronaviruses make use of a large envelope protein called spike (S) to engage host cell receptors and catalyze membrane fusion. Because of the vital role that these S proteins play, they represent a vulnerable target for the development of therapeutics. Here, we describe the isolation of single-domain antibodies (VHHs) from a llama immunized with prefusion-stabilized coronavirus spikes. These VHHs neutralize MERS-CoV or SARS-CoV-1 S pseudotyped viruses, respectively. Crystal structures of these VHHs bound to their respective viral targets reveal two distinct epitopes, but both VHHs interfere with receptor binding. We also show cross-reactivity between the SARS-CoV-1 S-directed VHH and SARS-CoV-2 S and demonstrate that this cross-reactive VHH neutralizes SARS-CoV-2 S pseudotyped viruses as a bivalent human IgG Fc-fusion. These data provide a molecular basis for the neutralization of pathogenic betacoronaviruses by VHHs and suggest that these molecules may serve as useful therapeutics during coronavirus outbreaks.


title: Facts and myths: Efficacies of repurposing chloroquine and hydroxychloroquine for the treatment of COVID-19

text: The emergence of coronavirus disease 2019 (COVID-19) is caused by the 2019 novel coronavirus (2019-nCoV). The 2019-nCoV first broke out in Wuhan and subsequently spreads worldwide owing to its extreme transmission efficiency. The fact that the COVID-19 cases and mortalities are reported in globally and the WHO has declared this outbreak as the pandemic. The international health authorities have focused on rapid diagnosis and isolation of patients as well as search for therapies able to counter the disease severity. Due to the lack of known specific, effective and proven therapies as well as the situation of public-health emergency, drug repurposing appears to be the best armour to find therapeutic solution against 2019-nCoV infection. Repurposing anti-malarial drugs, chloroquine (CQ)/ hydroxychloroquine (HCQ) have shown efficacy to inhibit most coronaviruses, including SARS-CoV-1 coronavirus. These CQ analogues have shown potential efficacy to inhibit 2019-nCoV in vitro that lead to focus in several future clinical trials. This review discusses the possible effective roles and mechanisms of CQ analogues for interfering with the 2019-nCoV replication cycle and infection.


title: Parasitos gastrintestinais em caprinos no município de Quixadá, Ceará/ Gastrointestinal parasites in goats from Quixadá, Ceará

text: O objetivo desse trabalho foi avaliar a ocorrência dos principais parasitos gastrintestinais que acometem caprinos adultos e jovens do município de Quixadá-Ceará durante a época seca e chuvosa, além de identificar e quantificar as espécies de Eimeria presentes no rebanho. Foram utilizados 654 animais, sendo 334 animais no período seco, dos quais eram 149 matrizes e 185 crias e 320 animais no período chuvoso, sendo 106 matrizes e 214 crias, independente de padrão racial e sistema de criação. As coletas foram realizadas nos meses de novembro e dezembro de 2012 e maio de 2013 no município de Quixadá-Ceará e encaminhadas ao Laboratório de Parasitologia da Embrapa Caprinos e Ovinos na cidade de Sobral-Ceará. Foram coletadas fezes para contagem do número de ovos por gramas de fezes (OPG), contagem de Oocistos por gramas de fezes (OOPG), coprocultura e identificação das espécies de Eimeria com base na morfometria. As matrizes apresentaram maiores médias de ovos do tipo Strongyloidea (372,03) e Strongyloides (8,45) no período seco e no período chuvoso apresentaram maiores médias apenas para Strongyloidea (502,85). O inverso aconteceu com o OOPG, onde as crias apresentaram maiores médias no período seco (9387,41) e no chuvoso (9630,37). O gênero de nematódeo mais frequente na coprocultura foi o Trichostrongylus sp. (63,67%) no período seco e o Haemonchus sp. no chuvoso (66,67%). Em 100% dos rebanhos, foram encontrados oocistos de Eimeria, com 81% dos animais infectados. A ocorrência da eimeriose nas categorias jovens e adultas foi de 64,3% e 83,2% no período seco e de 87,4% e 92,4% no período chuvoso. As espécies identificadas foram: Eimeria alijevi, E. apsheronica, E. arloingi, E. caprina, E. caprovina, E. christenseni, E. hirci, E. jolchijevi e E. ninakohlyakimovae. Nas crias a E. alijevi foi a mais freqüente no período seco e a E. ninakohlyakimovae no chuvoso. Já nas matrizes a espécie E. alijevi apresentou a maior frequência em ambos os períodos. Nos rebanhos estudados foi evidenciado a presença de ovos de nematódeos gastrointestinais e oocistos de Eimeria spp. independente da categoria animal.(AU)


Comment on "Epidemiological and clinical characteristics of heart transplant recipients during the 2019 coronavirus outbreak in Wuhan, China" by Ren et al


Cancer guidelines during the COVID-19 pandemic


title: Anosmia Is a Key Symptom of COVID-19 Infection and Should Be Used as a Diagnostic Tool

text: Based on observations described in our letter, we can draw the following conclusions: (1) anosmia must imperatively be added to the list of specific symptoms of COVID-19 infection, (2) anosmia can serve as a free and specific diagnostic tool for developing countries currently affected by the pandemic, (3) the mechanisms of COVID-19 anosmia seem not to directly involve nasal obstruction but rather seem to be related to damage the olfactory neuroepithelium.


title: Spatial Disparities in Coronavirus Incidence and Mortality in the United States: An Ecological Analysis as of May 2020

text: PURPOSE: This ecological analysis investigates the spatial patterns of the COVID-19 epidemic in the United States in relation to socioeconomic variables that characterize US counties. METHODS: Data on confirmed cases and deaths from COVID-19 for 2,814 US counties were obtained from Johns Hopkins University. We used Geographic Information Systems (GIS) to map the spatial aspects of this pandemic and investigate the disparities between metropolitan and nonmetropolitan communities. Multiple regression models were used to explore the contextual risk factors of infections and death across US counties. We included population density, percent of population aged 65+, percent population in poverty, percent minority population, and percent of the uninsured as independent variables. A state-level measure of the percent of the population that has been tested for COVID-19 was used to control for the impact of testing. FINDINGS: The impact of COVID-19 in the United States has been extremely uneven. Although densely populated large cities and their surrounding metropolitan areas are hotspots of the pandemic, it is counterintuitive that incidence and mortality rates in some small cities and nonmetropolitan counties approximate those in epicenters such as New York City. Regression analyses support the hypotheses of positive correlations between COVID-19 incidence and mortality rates and socioeconomic factors including population density, proportions of elderly residents, poverty, and percent population tested. CONCLUSIONS: Knowledge about the spatial aspects of the COVID-19 epidemic and its socioeconomic correlates can inform first responders and government efforts. Directives for social distancing and to "shelter-in-place" should continue to stem the spread of COVID-19.


title: Rare Anaemias, Sickle-Cell Disease and COVID-19

text: For rare haematological diseases (RHD), the first question to be answered is if patients with be- nign red blood cell (RBC) defects like haemoglobinopathies, membranopathies and enzymopathies are more vulnerable to COVID-19 infection. Up to now, there is no yet literature on the subject, but, like in general population, the presence of comorbidities such as diabetes, heart disease, pulmonary hypertension, reduced kidney and/or liver function, worsen the effects of the infection. Splenectomy may be an additional risk factor.


A cluster of COVID-19 cases in a small Italian town: a successful example of contact tracing and swab collection


title: Mutations on COVID-19 diagnostic targets

text: Effective, sensitive, and reliable diagnostic reagents are of paramount importance for combating the ongoing coronavirus disease 2019 (COVID-19) pandemic at a time there is no preventive vaccine nor specific drug available for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It would be an absolute tragedy if currently used diagnostic reagents are undermined in any manner. Based on the genotyping of 7818 SARS-CoV-2 genome samples collected up to May 1, 2020, we reveal that essentially all of the current COVID-19 diagnostic targets have had mutations. We further show that SARS-CoV-2 has the most devastating mutations on the targets of various nucleocapsid (N) gene primers and probes, which have been unfortunately used by countries around the world to diagnose COVID-19. Our findings explain what has seriously gone wrong with a specific diagnostic reagent made in China. To understand whether SARS-CoV-2 genes have mutated unevenly, we have computed the mutation ratio and mutation $h$-index of all SARS-CoV genes, indicating that the N gene is the most non-conservative gene in the SARS-CoV-2 genome. Our findings enable researchers to target the most conservative SARS-CoV-2 genes and proteins for the design and development of COVID-19 diagnostic reagents, preventive vaccines, and therapeutic medicines.


title: Management of patients with ovarian cancer in the COVID-19 era

text: At the beginning of 2020, coronavirus disease 2019 (COVID-19) spreads worldwide. Patients with ovarian cancer should be considered at high-risk of developing severe morbidity related to COVID-19. Most of them are diagnosed in advanced stages of disease, and they are fragile. Here, we evaluated the major impact of COVID-19 on patients with ovarian cancer, discussing the effect of the outbreak on medical and surgical treatment.


Shifting Paradigms in Head and Neck Reconstructive Surgery During the COVID-19 Crisis


Management of ART and COVID-19: Infertility in Times of Pandemic. What Now?


Protecting health-care workers: Use of a Body Covering Transparent Sheet during and after Intubation of Patients with Covid-19


[Perioperative management of cesarean section for pregnant women with suspected or confirmed COVID-19]


Heparin-Related Major Bleeding in Covid-19-Positive Patient: Perspective from the Outbreak


Cancer care under the outbreak of COVID-19: A perspective from Italian tertiary referral center for surgical oncology


COVID 19 Outbreak: Potential of Biochemistry Speciality


The hidden vulnerability of homelessness in the COVID-19 pandemic: Perspectives from India


Prevention and infection control of COVID-19 in Nursing Homes: experience from China


Praticiens de la cavité orale. Recommandations professionnelles. Risques infectieux par le COVID-19. Faire front pour faire face./ [Practitioners specialized in oral health and coronavirus disease 2019: Professional guidelines from the French society of stomatology, maxillofacial surgery and oral surgery, to form a common front against the infectious risk]


title: What Does Resilience Signify? An Evaluation of Concepts and Directions for Future Research

text: Throughout the life course, individuals are confronted with adversities that challenge their ability to live the life they imagined. Adversities that are the most prominently studied and shown to bring about the most serious consequences for adjustment across the adult lifespan include job loss, disease and disability onset, and spousal and child bereavement. However, not all individuals show sustained declines to adversity; some are able to bounce back. The resilience literature is built on the premise that individuals are able to bounce back, or adapt to adversity. The past 15-20 years have seen an abundance of resilience research examining resilience to diverse types of adversity across the adult life-span. The overarching goal of this paper is to evaluate psychological concepts of resilience in adulthood and old age and recommend avenues for future research. To do so, I first evaluate and discuss definitions of resilience and their overlap across literatures with an emphasis on sociological approaches to studying adversity across the adult lifespan. Second, I discuss promising conceptual and methodological approaches to advance the resilience literature in adulthood and old age. Conceptual approaches to furthering the resilience literature include incorporating an anticipation component into the definition of resilience. Methodological approaches to furthering the resilience literature include prospective longitudinal designs that incorporate quantitative and qualitative approaches, multidimensional assessments, and the need to examine repeated adversities or multiple adversities that transpire in relatively close proximity to one another.


Comment on "Are erythema multiforme and urticaria related to a better outcome of COVID 19?" Eosinophil count in seven patients with COVID-19 and urticarial rash


title: The amount of cytokine-release defines different shades of Sars-Cov2 infection

text: The recent outbreak of coronavirus disease (COVID 19), spreading from China all around the world in early 2020, has led scientists to investigate the immuno-mediated mechanisms underlying the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) infection. Depending on the amount of cytokines released as the result of the immunological activation induced by SARS-CoV2, three major clinical phenotypes can be identified: "mild",symbolized as a "drizzle" of cytokines, severe as a "storm", and critical as a "hurricane". In patients with mild symptoms, the release of pro-inflammatory cytokines is balanced to obtain a defense response against the virus which is often self-limiting and overcomes without tissue damage. In severe phenotype, resembling a "cytokine-release syndrome", SARS-CoV2 causes the lysis of the immune-mediators leading to a cytokine storm able to induce lung epithelium damage and acute respiratory distress syndrome. In critical patients, the immune response may become uncontrolled, thus the cytokine burst resembles a form of secondary hemophagocytic lymphohistiocytosis which may result in a multi organ failure. In addition to the standard of care, an immune-modulatory therapy tailored to each one of the different phenotypes should be used in order to prevent or reduce the release of cytokines responsible for organ damage and disease progression.


title: The Synthetic Curcumin Analogue GO-Y030 Effectively Suppresses the Development of Pressure Overload-induced Heart Failure in Mice

text: Curcumin is a naturally occurring p300-histone acetyltransferase (p300-HAT) inhibitor that suppresses cardiomyocyte hypertrophy and the development of heart failure in experimental animal models. To enhance the therapeutic potential of curcumin against heart failure, we produced a series of synthetic curcumin analogues and investigated their inhibitory activity against p300-HAT. The compound with the strongest activity was further evaluated to determine its effects on cardiomyocyte hypertrophy and pressure overload-induced heart failure in mice. We synthesised five synthetic curcumin analogues and found that a compound we have named GO-Y030 most strongly inhibited p300-HAT activity. Furthermore, 1 µM GO-Y030, in a manner equivalent to 10 µM curcumin, suppressed phenylephrine-induced hypertrophic responses in cultured cardiomyocytes. In mice undergoing transverse aortic constriction surgery, administration of GO-Y030 at a mere 1% of an equivalently-effective dose of curcumin significantly attenuated cardiac hypertrophy and systolic dysfunction. In addition, this low dose of GO-Y030 almost completely blocked histone H3K9 acetylation and eliminated left ventricular fibrosis. A low dose of the synthetic curcumin analogue GO-Y030 effectively inhibits p300-HAT activity and markedly suppresses the development of heart failure in mice.


title: Neurosonology during the COVID-19 pandemic (Editorial commentary from the chairs of the ultrasound panel of the EAN)

text: The COVID-19 pandemic is seriously affecting the lives of billions of people around the world, especially in the healthcare systems.1 Although the impact of pandemic on health services are mostly negative, there is still a chance to use this situation as an opportunity for positive changes. Neurosonological examination involves direct contact between the patient and the sonographer, often for several tens of minutes.


Introduction. On pandemics: the impact of COVID-19 on the practice of neurosurgery


Mental health services in Italy during the COVID-19 outbreak


Seroconversion in household members of COVID-19 outpatients


title: Modelling the role of media induced fear conditioning in mitigating post-lockdown COVID-19 pandemic: perspectives on India

text: Several countries that have been successful in constraining the severity of COVID-19 pandemic via"lockdown"are now considering to slowly end it, mainly because of enormous socio-economic side-effects. An abrupt ending of lockdown can increase the basic reproductive number and undo everything; therefore, carefully designed exit strategies are needed to sustain its benefits post upliftment. To study the role of fear conditioning on mitigating the spread of COVID-19 in post-lockdown phase, in this work, we propose an age- and social contact- structures dependent Susceptible, Feared, Exposed, Infected and Recovered (SFEIR) model. Simulating the SFEIR model on Indian population with fear conditioning via mass media (like, television, community radio, internet and print media) along with positive reinforcement, it is found that increase in fraction of feared people results in the significant decrease in the growth of infected population. The present study suggests that, during post-lockdown phase, media induced fear conditioning in conjunction with closure of schools for about one more year can serve as an important non-pharmaceutical intervention to substantially mitigate this pandemic in India. The proposed SFEIR model, by quantifying the influence of media in inducing fear conditioning, underlies the importance of community driven changes in country specific mitigation of COVID-19 spread in post-lockdown phase.


title: Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings

text: PURPOSE: To investigate the epidemiological and clinical characteristics of COVID-19 patients with abnormal imaging findings. METHODS: Patients confirmed with SARS-CoV-2 infection in Zhejiang province from January 17 to February 8 who had undergone CT or X-ray were enrolled. Epidemiological and clinical data were analyzed among those with abnormal or normal imaging findings. RESULTS: Excluding 72 patients with normal images, 230 of 573 patients showed abnormalities affecting more than two lung lobes. The median radiographic score was 2.0, and there was a negative correlation between that score and the oxygenation index (ρ = -0.657, P < 0.001). Patients with abnormal images were older (46.65 ± 13.82), with a higher rate of coexisting condition (28.8%), a lower rate of exposure history, and longer time between onset and confirmation (5 days) than non-pneumonia patients (all P < 0.05). A higher rate of fever, cough, expectoration and headache, a lower level of lymphocytes, albumin, and serum sodium levels and a higher total bilirubin, creatine kinase, lactate dehydrogenase, and C-reactive protein levels and a lower oxygenation index were observed in pneumonia patients (all P < 0.05). Muscle ache, shortness of breath, nausea and vomiting, lower lymphocytes levels, and higher serum creatinine and radiographic score at admission were predictive factors for the severe/critical subtype. CONCLUSION: Patients with abnormal images have more obvious clinical manifestations and laboratory changes. Combing clinical features and radiographic scores can effectively predict severe/critical types.


title: Teamworking in Endoscopy: a Human Factors Toolkit for the Covid-19 Era

text: Background and Aims Endoscopy services have had to rapidly adapt working practices in response to COVID-19. As recovery of endoscopy proceeds, there are numerous challenges facing our workforce which can impair effective teamworking. We designed and developed a novel toolkit to support teamworking in endoscopy during the pandemic. Methods A human factors model was developed to understand the impact of COVID-19 on endoscopy teams. From this, we identified a set of key teamworking goals which informed the development of a toolkit to support several team processes. The toolkit was refined following expert input and refinement over a six-week period. Results The toolkit consists of four cognitive aids that can be used to support team huddles, briefings and debriefs, alongside techniques to optimise endoscopic non-technical skills across the patient procedure pathway. We describe the processes that local endoscopy units can employ to implement this toolkit. Conclusion A toolkit of cognitive aids, based on human factors principles, may be useful in supporting teams, helping them adapt to working safely in the era of COVID-19.


title: Avaliação da frequência cardíaca materna, fetal e neonatal e sua variabilidade em equinos da raça Paint Horse/ Maternal, fetal and neonatal heart rate evaluation and its variability in the Paint Horse breed

text: Os objetivos deste estudo foram descrever a frequência cardíaca (FC) e os índices de variabilidade da frequência cardíaca (VFC) materna e fetal no terço final da gestação, bem como descrever a evolução do desenvolvimento do sistema nervoso autônomo durante o período fetal e neonatal. Foram avaliados 20 animais de cada categoria, cujos exames eletrocardiográficos, maternos e fetais, foram realizados aos 15 e sete dias pré-parto. Quanto ao eletrocardiograma neonatal, os momentos avaliados foram ao nascimento até as primeiras 48 horas de vida, e posteriormente, uma vez por semana até os 35 dias de idade. Ocorreram diferenças significativas na frequência cardíaca fetal (FCF) no período avaliado, porém os índices de VFC fetais não se alteraram. Não foram encontradas diferenças significativas nos índices de VFC materna. A média da FCF diminuiu significativamente dos 15 para sete dias do pré-parto (95,6±11,4 bpm; 83,1±12,6, respectivamente), entretanto os índices de VFC fetal não diminuíram. Os resultados obtidos da VFC fetal e neonatal deste estudo, quando comparados aos maternos, indicaram predomínio parassimpático durante a fase fetal e, simpático durante a neonatal, até a terceira e/ou quarta semanas de idade, momento no qual se inicia o equilíbrio entre os dois sistemas.(AU)


Ultrasound in COVID-19: a timeline of ultrasound findings in relation to CT


title: Social and administrative issues related to the COVID-19 pandemic in Pakistan: better late than never

text: The study critically reviewed Pakistan's provincial updates of coronavirus disease 2019 (COVID-19) and discussed the current challenges faced by the government in a given context. The coronavirus-associated death tolls have been increasing rapidly in a country. The provincial status of confirmed cases of coronavirus is higher in Punjab, followed by the Sindh, Khyber Pakhtunkhwa (KPK), and Balochistan. The case fatality ratio shows that KPK has a higher ratio, i.e., 5.11%, followed by the Punjab, i.e., 1.82%; Sindh, i.e., 1.80%; Balochistan, i.e., 1.28%; Gilgit-Baltistan, i.e., 0.71%; and Federal territory, i.e., 0.66%. The country has a less testing capacity to identify more suspected coronavirus patients. The study calculated that if we increase five times our testing capacity from the current date, the total registered cases will be reached to 137,370 and death tolls will increase up to 3090. It is highly needed to increase testing capacity across Pakistan in order to minimize the outbreak of coronavirus. The provincial government should follow the Federal Government instructions to contain coronavirus by increasing testing capacities, tracing suspected patients, smart lockdowns, emergency relief to the poor, and vigilant monitoring system.


title: [The Agreed Experts' Position of the Eurasian Association of Therapists on Some new Mechanisms of COVID-19 Pathways: Focus on Hemostasis, Hemotransfusion Issues and Blood gas Exchange]

text: The article discusses pathogenesis and treatment of COVID-19. The authors presented state-of-the-art insight into hemostatic disorders in patients with COVID-19 and clinical recommendations on prevention of thrombosis and thromboembolism in patients infected with SARS-CoV-2. The article discussed in detail a new hypothesis proposed by Chinese physicians about a new component in the pathogenesis of COVID-19, namely, about the effect of SARS-CoV-2 virus on the hemoglobin beta-chain and the formation of a complex with porphyrin, which results in displacement of the iron ion. Thus, hemoglobin loses the capability for transporting oxygen, which aggravates hypoxia and worsens the prognosis. The article stated rules of hemotransfusion safety in the conditions of COVID-19 pandemic.


title: [risk Assessment for Aerosol Infection by the New Corona Virus and Protection by Respirators]

text: INTRODUCTION: SARS-CoV-2 is dispersed from patients by talking, coughing and sneezing. The generated micro-droplets aerosols can travel up to 8 meters, stay suspended for long periods and preserve viral infectivity for a median of 2.7 hours. An unprotected person exposed to this cloud, might inhale a considerable amount of infectious viral doses, which will attach to the ACE 2 receptors on alveoli epithelium, resulting in infection. N95 respirators and surgical masks block 95% and 50-60% respectively of inhalable particles and protect the wearer from infection. Surgical masks and N95 without exhalation valve, protect both the wearer and the environment from carriers and sick people.


[Protection suggestions on medical staff in obstetrics and gynecology in COVID-19-designated hospitals]


title: Hospital preparedness for COVID-19 pandemic: experience from department of medicine at Veterans Affairs Connecticut Healthcare System

text: The 2019-2020 pandemic Coronavirus Disease 2019 (COVID-19) has inundated hospital systems globally, as they prepare to accommodate surge of patients requiring advanced levels of care. Pandemic preparedness has not been this urgently and widely needed in the last several decades. According to epidemiologic predictions, the peak of this pandemic has still not been reached, and hospitals everywhere need to ensure readiness to care for more patients than they usually do, and safety for healthcare workers who strive to save lives. We share our hospital-wide rapid preparedness and response to COVID-19 to help provide information to other healthcare systems globally.


title: A three-component cyclocondensation reaction for the synthesis of new triazolo[1,5-a]pyrimidine scaffolds using 3-aminotriazole, aldehydes and ketene N,S-acetal

text: This study describes the use of 3-aminotriazole, different aldehydes and N-methyl-1-(methylthio)-2-nitroethenamine as a ketene N,S-acetal in a three-component condensation for the synthesis of a novel library of triazolo[1,5-a]pyrimidine scaffolds. The presence of trichloroacetic acid as a Brønsted-Lowry acidic promoter in acetonitrile or water solvent and room temperature condition resulting novel triazolo[1,5-a]pyrimidine systems named N-methyl-6-nitro-5-aryl-3,5-dihydro-[1, 2, 4]triazolo[1,5-a]pyrimidine-7-amine. The structure of products and direction of the N-cyclization could be confirmed using spectral data. The effect of various solvents on the progress of process was investigated in the paper. The presence of five nitrogen heteroatoms, the use of various aldehydes affording a range of skeletally distinct triazolo[1,5-a]pyrimidine-based heterocycles, the potency to create numerous hydrogen bonds in the product structure, and direction of cyclization are attractive features of this reaction.


The COVID-19 outbreak: a snapshot from down under


title: Seizing the Moment: Policy Advocacy to End Mass Incarceration in the Time of COVID-19

text: The mass human and economic casualties wrought by the COVID-19 pandemic laid bare the deep inequities at the base of the disproportionate losses and suffering experienced by diverse U.S. populations. But the urgency and enormity of unmet needs requiring bold policy action also provided a unique opportunity to learn from and partner with community-based organizations that often are at the frontlines of such work. Following a review of Kingdon's model of the policy-making process, we illustrate how a partnership in a large California county navigated the streams in the policy-making process and used the window of opportunity provided by the pandemic to address a major public health problem: the incarceration of over 2 million people, disproportionately African American and Latinx, in overcrowded, unsafe jails, prisons, and detention centers. We highlight tactics and strategies used, challenges faced, and implications for health educators as policy advocates during and beyond the pandemic.


Challenges for the Pediatricians During the Coronavirus Disease 2019 Pandemic Start From the Neonatal Period


Early Detection of Covid-19 through a Citywide Pandemic Surveillance Platform


title: Preliminary case report on the SARS-CoV-2 cluster in the UK, France, and Spain

text: Almost half of the confirmed COVID-19 cases detected so far in the United Kingdom are part of a large cluster of 13 British nationals who tested positive for SARS-CoV-2 in the UK, Spain, and France Transmissions among this cluster occurred at a ski resort in France, and originated from a single infected traveller returning from a conference in Singapore where he acquired the virus At least 21 individuals were exposed to the virus, tested, and quarantined, with 13 of those testing positive between the period of 6th February and 15th February Here, all publicly available information about the primarily UK/France cluster is consolidated, providing a complete and accessible summary of the cases and their connections Notable in this cluster are the number of individuals infected, the apparent absence of any severe illness among those infected, and a case of a "delayed positive" test during isolation after initially testing negative, at least 7 days after last possible contact


title: Clearance and persistence of SARS-CoV-2 RNA in patients with COVID-19

text: Patients with coronavirus disease-2019 may be discharged based on clinical resolution of symptoms, and evidence for viral RNA clearance from the upper respiratory tract. Understanding the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral clearance profile is crucial to establish a re-testing plan on discharge and ending isolation of patients. We aimed to evaluate the number of days that a patient needed to achieve undetectable levels of SARS-CoV-2 in upper respiratory tract specimens (nasopharyngeal swab and/or an oropharyngeal swab). The clearance and persistence of viral RNA was evaluated in two groups of positive patients: those who achieved two negative reverse transcription-polymerase chain reaction (RT-PCR) tests and those who kept testing positive. Patients were organized thereafter in two subgroups, mild illness patients discharged home and inpatients who had moderate to severe illness. Results from RT-PCR tests were then correlated with results from the evaluation of the immune response. The study evidenced that most patients tested positive for more than 2 weeks and that persistence of viral RNA is not necessarily associated with severe disease but may result from a weaker immune response instead.


Teledermatology for patient management, dermatology education and research during the COVID-19 pandemic


Una herramienta para apoyar el trabajo de los equipos quirúrgicos y afrontar la COVID-19./ Una herramienta para apoyar el trabajo de los equipos quirúrgicos y afrontar la COVID-19./ A tool to support the work of surgical teams and face the COVID-19 pandemic


title: Clinical and CT findings of COVID-19: differences among three age groups

text: BACKGROUND: The novel coronavirus pneumonia (coronavirus disease 2019, COVID-19) has spread around the world. We aimed to recapitulate the clinical and CT imaging features of COVID-19 and their differences in three age groups. METHODS: The clinical and CT data of patients with COVID-19 (n = 307) that had been divided into three groups (Group 1: < 40 years old; Group 2: 40 ≤ age < 60 years old; Group 3: ≥ 60 years old) according to age were analyzed retrospectively. RESULTS: Of all patients, 114 (37.1%) had histories of epidemiological exposure, 48 (15.6%) were severe/critical cases, 31 had hypertension (10.1%), 15 had diabetes mellitus (4.9%), 3 had chronic obstructive pulmonary disease (COPD, 1%). Among the three groups, severe/critical type, hypertension and diabetes occurred more commonly in the elderly group compared with Group 1&2 (P < 0.05, respectively). Cough and chest tightness/pain were more commonly appeared in Group 2&3 compared with Group 1 (P < 0.05, respectively). Compared with Group 1 and 2, there were more abnormal laboratory examination indexes (including CRP increase, abnormal percentage of lymphocytes, neutrophils and monocytes) in Group 3 (P < 0.05, respectively). CT images revealed that more lobes were affected and more subpleural lesions were involved in the elderly group, besides, crazy paving sign, bronchodilatation and pleural thickening were more commonly seen in the elderly group, with significant difference between Group 1&2, Group 2&3 (P < 0.05, respectively). CONCLUSIONS: COVID-19 presented representative clinical manifestations, laboratory examinations and CT findings, but three age groups possessed their own specific characteristics. Grasping the clinical and CT features stratified by age will be helpful for early definite diagnosis of COVID-19.


title: Generalized logistic growth modeling of the COVID-19 outbreak in 29 provinces in China and in the rest of the world

text: The COVID-19 has been successfully contained in China but is spreading all over the world. We calibrate the logistic growth model, the generalized logistic growth model, the generalized Richards model and the generalized growth model to the reported number of infected cases from for the whole of China, 29 provinces in China, and 19 countries and regions that are undergoing major outbreaks. We dissect the development of the epidemics in China and the impact of the drastic control measures both at the aggregate level and within each province. We quantitatively document four phases of the outbreak in China with a detailed analysis on the heterogeneous situations across provinces. The extreme containment measures implemented by China were very effective with some instructive variations across provinces. Borrowing from the experience of China, we made scenario projections on the development of the outbreak in other countries. We identified that Europe and US have passed the inflection point and entered into an after-peak trajectory, which is estimated longer than what a classical Logistic model predicts, in contrast to most provinces in China where the after-peak trajectory is much faster. We expect Europe to have 1.83 million final total confirmed cases (2452 per million population) and US to have 1.26 million final total confirmed cases (3851 per million population). We identified three groups of countries in different level of outbreak progress, and provide informative implications for the current global pandemic.


Combined mobile-phone and social-media sampling for web survey on social effects of COVID-19 in Spain Reply


title: Laboratory predictors of death from coronavirus disease 2019 (COVID-19) in the area of Valcamonica, Italy

text: Background Comprehensive information has been published on laboratory tests which may predict worse outcome in Asian populations with coronavirus disease 2019 (COVID-19). The aim of this study is to describe laboratory findings in a group of Italian COVID-19 patients in the area of Valcamonica, and correlate abnormalities with disease severity. Methods The final study population consisted of 144 patients diagnosed with COVID-19 (70 who died during hospital stay and 74 who survived and could be discharged) between March 1 and 30, 2020, in Valcamonica Hospital. Demographical, clinical and laboratory data were collected upon hospital admission and were then correlated with outcome (i.e. in-hospital death vs. discharge). Results Compared to patients who could be finally discharged, those who died during hospital stay displayed significantly higher values of serum glucose, aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), urea, creatinine, high-sensitivity cardiac troponin I (hscTnI), prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time (APTT), D-dimer, C reactive protein (CRP), ferritin and leukocytes (especially neutrophils), whilst values of albumin, hemoglobin and lymphocytes were significantly decreased. In multiple regression analysis, LDH, CRP, neutrophils, lymphocytes, albumin, APTT and age remained significant predictors of in-hospital death. A regression model incorporating these variables explained 80% of overall variance of in-hospital death. Conclusions The most important laboratory abnormalities described here in a subset of European COVID-19 patients residing in Valcamonica are highly predictive of in-hospital death and may be useful for guiding risk assessment and clinical decision-making.


title: Considerations for the management of home parenteral nutrition during the SARS-CoV-2 pandemic: A position paper from the Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN

text: The management of patients with chronic intestinal failure requiring home parenteral nutrition has been and will continue to be impaired during the SARS-CoV-2 pandemic. Multidisciplinary intestinal failure teams may have to adapt their clinical approaches to home care, outpatient care as well as hospital admission and discharge in order to keep this vulnerable group of patients as safe and well as possible during the unprecedented challenges that countries are facing during the pandemic. Equally, it is important that expert advice from intestinal failure teams is available when home parenteral nutrition (HPN)-dependent patients require admission with SARS-CoV-2 infection. The Home Artificial Nutrition & Chronic Intestinal Failure Special Interest Group of the European Society for Clinical Nutrition and Metabolism (ESPEN) has developed a position paper to outline areas for intestinal failure teams to consider when managing patients with chronic intestinal failure during the SARS-CoV-2 pandemic.


title: Random Information Spread in Networks

text: Let G=(V,E) be an undirected loopless graph with possible parallel edges and s and t be two vertices of G. Assume that vertex s is labelled at the initial time step and that every labelled vertex copies its labelling to neighbouring vertices along edges with one labelled endpoint independently with probability p in one time step. In this paper, we establish the equivalence between the expected s-t first arrival time of the above spread process and the notion of the stochastic shortest s-t path. Moreover, we give a short discussion of analytical results on special graphs including the complete graph and s-t series-parallel graphs. Finally, we propose some lower bounds for the expected s-t first arrival time.


title: Guillain-Barré syndrome: The first documented COVID-19-triggered autoimmune neurologic disease: More to come with myositis in the offing

text: OBJECTIVE: To present the COVID-19-associated GBS, the prototypic viral-triggered autoimmune disease, in the context of other emerging COVID-19-triggered autoimmunities, and discuss potential concerns with ongoing neuroimmunotherapies. METHODS: Eleven GBS cases in four key COVID-19 hotspots are discussed regarding presenting symptoms, response to therapies and cross-reactivity of COVID spike proteins with nerve glycolipids. Emerging cases of COVID-19-triggered autoimmune necrotizing myositis (NAM) and encephalopathies are also reviewed in the context of viral invasion, autoimmunity and ongoing immunotherapies. RESULTS: Collective data indicate that in this pandemic any patient presenting with an acute paralytic disease-like GBS, encephalomyelitis or myositis-even without systemic symptoms, may represent the first manifestation of COVID-19. Anosmia, ageusia, other cranial neuropathies and lymphocytopenia are red flags enhancing early diagnostic suspicion. In Miller-Fisher Syndrome, ganglioside antibodies against GD1b, instead of QG1b, were found; because the COVID-19 spike protein also binds to sialic acid-containing glycoproteins for cell-entry and anti-GD1b antibodies typically cause ataxic neuropathy, cross-reactivity between COVID-19-bearing gangliosides and peripheral nerve glycolipids was addressed. Elevated Creatine Kinase (>10,000) is reported in 10% of COVID-19-infected patients; two such patients presented with painful muscle weakness responding to IVIg indicating that COVID-19-triggered NAM is an overlooked entity. Cases of acute necrotizing brainstem encephalitis, cranial neuropathies with leptomeningeal enhancement, and tumefactive postgadolinium-enhanced demyelinating lesions are now emerging with the need to explore neuroinvasion and autoimmunity. Concerns for modifications-if any-of chronic immunotherapies with steroids, mycophenolate, azathioprine, IVIg, and anti-B-cell agents were addressed; the role of complement in innate immunity to viral responses and anti-complement therapeutics (i.e. eculizumab) were reviewed. CONCLUSIONS: Emerging data indicate that COVID-19 can trigger not only GBS but other autoimmune neurological diseases necessitating vigilance for early diagnosis and therapy initiation. Although COVID-19 infection, like most other viruses, can potentially worsen patients with pre-existing autoimmunity, there is no evidence that patients with autoimmune neurological diseases stable on common immunotherapies are facing increased risks of infection.


title: Surgery in COVID-19 patients: operational directives

text: The current COVID-19 pandemic underlines the importance of a mindful utilization of financial and human resources. Preserving resources and manpower is paramount in healthcare. It is important to ensure the ability of surgeons and specialized professionals to function through the pandemic. A conscious effort should be made to minimize infection in this sector. A high mortality rate within this group would be detrimental.This manuscript is the result of a collaboration between the major Italian surgical and anesthesiologic societies: ACOI, SIC, SICUT, SICO, SICG, SIFIPAC, SICE, and SIAARTI. We aim to describe recommended clinical pathways for COVID-19-positive patients requiring acute non-deferrable surgical care. All hospitals should organize dedicated protocols and workforce training as part of the effort to face the current pandemic.


Intensive care unit admissions for pregnant and nonpregnant women with coronavirus disease 2019


Some drugs for COVID-19


Efforts to Minimize the Impact of Lockdown on Migrant Workers in India During the COVID-19 Pandemic


Diagnosis of coronavirus disease 2019 pneumonia in pregnant women: can we rely on lung ultrasound?


Callous attitude toward doctors during COVID-19


title: Open visiting in the NHS

text: Sam Foster, Chief Nurse, Oxford University Hospitals, considers the balance of the benefits of enabling visiting with infection prevention and control practice during this pandemic.


Collateral Damage During the COVID-19 Pandemic


title: Guidance for the Procurement of COVID-19 Convalescent Plasma: Differences between High and Low-Middle Income Countries

text: BACKGROUND AND OBJECTIVES: COVID-19 convalescent plasma (CCP) has been used, predominantly in high-income countries (HICs) to treat COVID-19; available data suggest the safety and efficacy of use. We sought to develop guidance for procurement and use of CCP, particularly in low and middle-income countries (LMICs) for which data are lacking. MATERIALS AND METHODS: A multidisciplinary, geographically representative group of individuals with expertise spanning transfusion medicine, infectious diseases and hematology was tasked with the development of a guidance document for CCP, drawing on expert opinion, survey of group members and review of available evidence. Three subgroups (i.e. donor, product and patient) were established based on self-identified expertise and interest. Here, the donor and product-related challenges are summarized and contrasted between HICs and LMICs with a view to guide related practices. RESULTS: The challenges to advance CCP therapy are different between HICs and LMICs. Early challenges in HICs related to recruitment and qualification of sufficient donors to meet the growing demand. Antibody testing also posed a specific obstacle given lack of standardization, variable performance of the assays in use and uncertain interpretation of results. In LMICs, an extant transfusion deficit, suboptimal models of donor recruitment (e.g. reliance on replacement and paid donors), limited laboratory capacity for pre-donation qualification and operational considerations could impede wide adoption. CONCLUSION: There has been wide scale adoption of CCP in many HICs, which could increase if clinical trials show efficacy of use. By contrast, LMICs, having received little attention, require locally applicable strategies for adoption of CCP.


Global perspectives on Covid-19 from the editorial board


Organoids of human airways to study infectivity and cytopathy of SARS-CoV-2


GP who was suspended for forging out-of-hours form can resume work to assist in pandemic


Cytosine drives evolution of SARS-CoV-2


Lessons in contact tracing from Germany


Differences in race and other state-level characteristics and associations with mortality from COVID-19 infection


Financial crisis at PAHO in the time of COVID-19: a call for action


title: [Analysis on the epidemic factors for the Corona Virus Disease]

text: Since December 2019, corona virus disease 2019 (COVID-19) , an emerging infection disease occurred in Wuhan, has spread in the mainland China. The epidemic factors on the basis of knowledge of SARS-CoV-2 were discussed in this paper. This puts a lot of pressure on clinical resources and care. SARS-CoV-2 is a novel corona virus, the onset of COVID-19 is slow, and the pathogenesis of SARS-CoV-2 remains unclear and may lead to multiple organ damage. These put a lot of pressure on clinical resources and care. Source of infection including the patients, asymptomatic carrier and patients in the incubation period are contagious. It is difficult to control source of infection. Routes of SARS-CoV-2 transmission are diversified and the main routes of transmission for COVID-19 are droplet transmission and close contact transmission. All population have susceptibility to SARS-CoV-2. Social factors such population movements and aggregation accelerated the spread of SARS-CoV-2. The Chinese government's adopted measures are positive and effective, and are accepted by the expert group from the World Health Organization. However, it will be a long-term hard work in the future to seriously summarize and think deeply to achieve public health security in China.


title: Analysis on the epidemic factors for the Corona Virus Disease/ 中华预防医学杂志

text: Since December 2019, corona virus disease 2019 (COVID-19) , an emerging infection disease occurred in Wuhan, has spread in the mainland China. The epidemic factors on the basis of knowledge of SARS-CoV-2 were discussed in this paper. This puts a lot of pressure on clinical resources and care. SARS-CoV-2 is a novel corona virus, the onset of COVID-19 is slow, and the pathogenesis of SARS-CoV-2 remains unclear and may lead to multiple organ damage. These put a lot of pressure on clinical resources and care. Source of infection including the patients, asymptomatic carrier and patients in the incubation period are contagious. It is difficult to control source of infection. Routes of SARS-CoV-2 transmission are diversified and the main routes of transmission for COVID-19 are droplet transmission and close contact transmission. All population have susceptibility to SARS-CoV-2. Social factors such population movements and aggregation accelerated the spread of SARS-CoV-2. The Chinese government’s adopted measures are positive and effective, and are accepted by the expert group from the World Health Organization. However, it will be a long-term hard work in the future to seriously summarize and think deeply to achieve public health security in China.


title: COVID-19 disease emergency operational instructions for Mental Health Departments issued by the Italian Society of Epidemiological Psychiatry

text: During the current COVID-19 disease emergency, it is not only an ethical imperative but also a public health responsibility to keep the network of community psychiatry services operational, particularly for the most vulnerable subjects (those with mental illness, disability, and chronic conditions). At the same time, it is necessary to reduce the spread of the COVID-19 disease within the outpatient and inpatient services affiliated with Mental Health Departments. These instructions, first published online on 16 March 2020 in their original Italian version, provide a detailed description of actions, proposed by the Italian Society of Epidemiological Psychiatry, addressed to Italian Mental Health Departments during the current COVID-19 pandemic. The overall goal of the operational instructions is to guarantee, during the current health emergency, the provision of the best health care possible, taking into account both public health necessities and the safety of procedures. These instructions could represent a useful resource to mental health providers, and stakeholders to face the current pandemic for which most of Mental Health Departments worldwide are not prepared to. These instructions could provide guidance and offer practical tools which can enable professionals and decision makers to foresee challenges, like those already experienced in Italy, which in part can be avoided or minimised if timely planned. These strategies can be shared and adopted, with the appropriate adjustments, by Mental Health Departments in other countries.


title: Clinical Manifestation and Laboratory Characteristics of SARS-CoV-2 Infection in Pregnant Women

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic has become a major challenge to public health in China and other countries, considering its pathogenicity across all age groups. Pregnancy is a unique physiological condition, and is characterized by altered immunity and elevated hormone levels to actively tolerate the semi-allogeneic fetus, which undergoes a sudden and substantial fluctuation during the immediate postpartum period. Changes in clinical features, laboratory characteristics, and imaging features of pregnant women during the pre-partum and post-partum periods require further elucidation. Here, we retrospectively analyzed the clinical features, laboratory characteristics, and imaging features of eight pregnant cases of SARS-CoV-2 infection during the pre-partum and post-partum periods. Our results showed that four of the eight pregnant women were asymptomatic before delivery but became symptomatic post-partum. Correspondingly, white blood cell (WBC) counts increased and lymphocyte (LYMPH) counts decreased. C-reactive protein (CRP) levels in the serum also increased to a higher level than those in general pregnancy. Therefore, it is imperative to closely monitor laboratory parameters including the WBC count, LYMPH count, and CRP, along with other imaging features in chest CT scans, to promptly prevent, diagnose, and treat a SARS-CoV-2 infection during pregnancy.


title: A chatbot architecture for promoting youth resilience

text: E-health technologies have the potential to provide scalable and accessible interventions for youth mental health. As part of a developing an ecosystem of e-screening and e-therapy tools for New Zealand young people, a dialog agent, Headstrong, has been designed to promote resilience with methods grounded in cognitive behavioral therapy and positive psychology. This paper describes the architecture underlying the chatbot. The architecture supports a range of over 20 activities delivered in a 4-week program by relatable personas. The architecture provides a visual authoring interface to its content management system. In addition to supporting the original adolescent resilience chatbot, the architecture has been reused to create a 3-week 'stress-detox' intervention for undergraduates, and subsequently for a chatbot to support young people with the impacts of the COVID-19 pandemic, with all three systems having been used in field trials. The Headstrong architecture illustrates the feasibility of creating a domain-focused authoring environment in the context of e-therapy that supports non-technical expert input and rapid deployment.


title: Assessing disability and relapses in multiple sclerosis on tele-neurology

text: BACKGROUND: As a consequence of the coronavirus disease 2019 (COVID-19) pandemic, a large amount of consultations will be delivered through tele-medicine, especially for diseases causing chronic disability and requiring immunomodulatory treatments, such as multiple sclerosis (MS). METHODS: We have hereby reviewed available tools for tele-neurology examination in MS, including components of neurological examination that can be assessed through video, patient-reported outcome measures (PROMs), and digital technology. RESULTS: Overall, we have suggested a battery for assessing MS disability and relapses on tele-medicine, which brings together conventional examination, PROMs (e.g., Patient Determined Disease Steps, MS Impact Scale), and cognitive tests (Symbol Digit Modalities Test) that can be delivered remotely and in multiple languages. DISCUSSION: The use of common tools for neurological examination could improve tele-neurology practice for both general neurologists and MS specialists, and quality of care for people with MS.


Rethinking the role of the school after COVID-19


title: Increased ozone levels during the COVID-19 lockdown: Analysis for the city of Rio de Janeiro, Brazil

text: The first COVID-19 case in Brazil was confirmed on February 25, 2020. Partial lockdown measures came into force in the city of Rio de Janeiro, Brazil, on March 23. While CO and NO2 levels showed significant reductions, PM10 levels were only reduced in the first partial lockdown week. By contrast, ozone levels increased in all studied locations. In this study, the factors leading to this behavior were analyzed. Monitoring data obtained at two automatic monitoring stations showed higher ratios between non-methane hydrocarbons and nitrogen oxides (NMHC/NOx) during the partial lockdown (up to 37.3%). The increase in ozone concentrations during the social distancing measures could be attributed to the increase in NMHC/NOx ratios since atmospheric chemistry in Rio de Janeiro is under VOC-controlled conditions. However, the increase was higher when air masses arrived from the industrial areas, not only because of the higher NMHC/NOx ratios, but also because the reactivity of VOC was highly increased by these air masses, which are rich in aromatic compounds.


Coronavirus disease 19 (Covid-19) and non-steroidal anti-inflammatory drugs (NSAID)


COVID-19 drives new threat to bats in China


title: Fast and accurate detection of Covid-19-related pneumonia from chest X-ray images with novel deep learning model

text: Background: Novel coronavirus disease has spread rapidly worldwide. As recent radiological literatures on Covid-19 related pneumonia is primarily focused on CT findings, the American College of Radiology (ACR) recommends using portable chest X-radiograph (CXR). A tool to assist for detection and monitoring of Covid-19 cases from CXR is highly required. Purpose: To develop a fully automatic framework to detect Covid-19 related pneumonia using CXR images and evaluate its performance. Materials and Methods: In this study, a novel deep learning model, named CovIDNet (Covid-19 Indonesia Neural-Network), was developed to extract visual features from chest x-ray images for the detection of Covid-19 related pneumonia. The model was trained and validated by chest x-rays datasets collected from several open source provided by GitHub and Kaggle. Results and Discussion: In the validation stage using open-source data, the accuracy to recognize Covid-19 and others classes reaches 98.44%, that is, 100% Covid-19 precision and 97% others precision. Discussion: The use of the model to classify Covid-19 and other pathologies might slightly decrease the accuracy. Although SoftMax was used to handle classification bias, this indicates the benefit of additional training upon the introduction of new set of data. Conclusion: The model has been tested and get 98.4% accuracy for open source datasets, the sensitivity and specificity are 100% and 96.97%, respectively.


Enhancing intensive care capacity: COVID-19 experience from a Tertiary Center in Israel


title: A model based study on the dynamics of COVID-19: Prediction and control

text: As there is no vaccination and proper medicine for treatment, the recent pandemic caused by COVID-19 has drawn attention to the strategies of quarantine and other governmental measures, like lockdown, media coverage on social isolation, and improvement of public hygiene, etc to control the disease. The mathematical model can help when these intervention measures are the best strategies for disease control as well as how they might affect the disease dynamics. Motivated by this, in this article, we have formulated a mathematical model introducing a quarantine class and governmental intervention measures to mitigate disease transmission. We study a thorough dynamical behavior of the model in terms of the basic reproduction number. Further, we perform the sensitivity analysis of the essential reproduction number and found that reducing the contact of exposed and susceptible humans is the most critical factor in achieving disease control. To lessen the infected individuals as well as to minimize the cost of implementing government control measures, we formulate an optimal control problem, and optimal control is determined. Finally, we forecast a short-term trend of COVID-19 for the three highly affected states, Maharashtra, Delhi, and Tamil Nadu, in India, and it suggests that the first two states need further monitoring of control measures to reduce the contact of exposed and susceptible humans.


title: Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China

text: Importance: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. Risk factors for the clinical outcomes of COVID-19 pneumonia have not yet been well delineated. Objective: To describe the clinical characteristics and outcomes in patients with COVID-19 pneumonia who developed acute respiratory distress syndrome (ARDS) or died. Design, Setting, and Participants: Retrospective cohort study of 201 patients with confirmed COVID-19 pneumonia admitted to Wuhan Jinyintan Hospital in China between December 25, 2019, and January 26, 2020. The final date of follow-up was February 13, 2020. Exposures: Confirmed COVID-19 pneumonia. Main Outcomes and Measures: The development of ARDS and death. Epidemiological, demographic, clinical, laboratory, management, treatment, and outcome data were also collected and analyzed. Results: Of 201 patients, the median age was 51 years (interquartile range, 43-60 years), and 128 (63.7%) patients were men. Eighty-four patients (41.8%) developed ARDS, and of those 84 patients, 44 (52.4%) died. In those who developed ARDS, compared with those who did not, more patients presented with dyspnea (50 of 84 [59.5%] patients and 30 of 117 [25.6%] patients, respectively [difference, 33.9%; 95% CI, 19.7%-48.1%]) and had comorbidities such as hypertension (23 of 84 [27.4%] patients and 16 of 117 [13.7%] patients, respectively [difference, 13.7%; 95% CI, 1.3%-26.1%]) and diabetes (16 of 84 [19.0%] patients and 6 of 117 [5.1%] patients, respectively [difference, 13.9%; 95% CI, 3.6%-24.2%]). In bivariate Cox regression analysis, risk factors associated with the development of ARDS and progression from ARDS to death included older age (hazard ratio [HR], 3.26; 95% CI 2.08-5.11; and HR, 6.17; 95% CI, 3.26-11.67, respectively), neutrophilia (HR, 1.14; 95% CI, 1.09-1.19; and HR, 1.08; 95% CI, 1.01-1.17, respectively), and organ and coagulation dysfunction (eg, higher lactate dehydrogenase [HR, 1.61; 95% CI, 1.44-1.79; and HR, 1.30; 95% CI, 1.11-1.52, respectively] and D-dimer [HR, 1.03; 95% CI, 1.01-1.04; and HR, 1.02; 95% CI, 1.01-1.04, respectively]). High fever (≥39 °C) was associated with higher likelihood of ARDS development (HR, 1.77; 95% CI, 1.11-2.84) and lower likelihood of death (HR, 0.41; 95% CI, 0.21-0.82). Among patients with ARDS, treatment with methylprednisolone decreased the risk of death (HR, 0.38; 95% CI, 0.20-0.72). Conclusions and Relevance: Older age was associated with greater risk of development of ARDS and death likely owing to less rigorous immune response. Although high fever was associated with the development of ARDS, it was also associated with better outcomes among patients with ARDS. Moreover, treatment with methylprednisolone may be beneficial for patients who develop ARDS.


title: Update on treatment of COVID-19: ongoing studies between promising and disappointing results

text: The COVID-19 pandemic represents the greatest global public health crisis since the pandemic influenza outbreak of 1918. We are facing a new virus, so several antiviral agents previously used to treat other coronavirus infections such as SARS and MERS are being considered as the first potential candidates to treat COVID-19. Thus, several agents have been used by the beginning of the current outbreak in China first and all over the word successively, as reported in several different guidelines and therapeutic recommendations. At the same time, a great number of clinical trials have been launched to investigate the potential efficacy therapies for COVID-19 highlighting the urgent need to get as quickly as possible high-quality evidence. Through PubMed, we explored the relevant articles published on treatment of COVID-19 and on trials ongoing up to April 15, 2020.


A possible role for B cells in COVID-19? Lesson from patients with agammaglobulinemia


Ethical outpatient dermatology care during the coronavirus (COVID-19) pandemic


Covid-19 infection in psoriasis patients treated with cyclosporin


title: Healthcare Ethics During a Pandemic

text: As clinicians and support personnel struggle with their responsibilities to treat during the current COVID-19 pandemic, several ethical issues have emerged. Will healthcare workers and support staff fulfill their duty to treat in the face of high risks? Will institutional and government leaders at all levels do the right things to help alleviate healthcare workers risks and fears? Will physicians be willing to make hard, resource-allocation decisions if they cannot first husband or improvise alternatives?With our healthcare facilities and governments unprepared for this inevitable disaster, front-line doctors, advanced providers, nurses, EMS, and support personnel struggle with acute shortages of equipment-both to treat patients and protect themselves. With their personal and possibly their family's lives and health at risk, they must weigh the option of continuing to work or retreat to safety. This decision, made daily, is based on professional and personal values, how they perceive existing risks-including available protective measures, and their perception of the level and transparency of information they receive. Often, while clinicians get this information, support personnel do not, leading to absenteeism and deteriorating healthcare services. Leadership can use good risk communication (complete, widely transmitted, and transparent) to align healthcare workers' risk perceptions with reality. They also can address the common problems healthcare workers must overcome to continue working (ie, risk mitigation techniques). Physicians, if they cannot sufficiently husband or improvise lifesaving resources, will have to face difficult triage decisions. Ideally, they will use a predetermined plan, probably based on the principles of Utilitarianism (maximizing the greatest good) and derived from professional and community input. Unfortunately, none of these plans is optimal.


title: Preliminary CT findings of coronavirus disease 2019 (COVID-19)

text: OBJECTIVES: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This paper aims to examine the CT imaging characteristics of COVID-19. METHODS: We evaluated CT images obtained between 10 January 2019 and 16 February 2020 at Taihe Hospital. Scans were conducted 2-6 times per patient and the re-testing interval was 2-7 days. Ninety-five patients with positive SARS-CoV-2 nucleic acid test results were included in this study and we retrospectively analysed their CT imaging characteristics. RESULTS: Ninety-five patients underwent 2-3 SARS-CoV-2 nucleic acid tests and received a definitive diagnosis of COVID-19. Fifty-three were male and 42 were female, and their mean age was 42 ± 12 years (range: 10 months to 81 years). Sixty-nine patients (72.6%) experienced fever, fatigue, and dry cough, while 15 (15.8%) had poor appetite and fatigue, and 11 (11.6%) had a dry cough and no fever. On CT imaging, early stage patients (n = 53, 55.8%) showed peripheral subpleural ground-glass opacities; these were mainly local patches (22/53, 41.5%), while some lesions were accompanied by interlobular septal thickening. Thirty-four (35.8%) patients were classified in the 'progression stage' based on CT imaging; these patients typically showed lesions in multiple lung segments and lobes (21/34ï¼61.8%), and an uneven increase in ground-glass opacity density accompanied by consolidation and grid-like or cord-like shadows(30.5%). Two patients (2.1%) showed a severe presentation on CT. These showed diffuse bilateral lung lesions, mixed ground-glass opacities and consolidation with cord-like interstitial thickening and air bronchograms, entire lung involvement with a "white lung" presentation, and mild pleural effusion. Six patients in remission (6.3%), visible lesion absorption, fibrotic lesions. Based on clinical signs, 71 (74.7%), 22 (23.2%), and 2 (2.1%) patients had mild or moderate, severe, and critical disease, respectively. Within the follow-up period, 93 patients recovered and were discharged, including the 53 early stage patients and 34 progression stage patients. The length of hospitalisation was 7-28 days (mean: 10 ± 3.5 days). On discharge, lesions were significantly reduced in area and had in many cases completely disappeared, while slight pulmonary fibrosis was present in some patients. One severe stage patient was still hospitalised at the end of the follow-up period and the other severe stage patient died. The overall mortality rate was 1.05%. CONCLUSIONS: Understanding the CT imaging characteristics of COVID-19 is important for early lesion detection, determining the nature of lesions, and assessing disease severity.


title: Cytokine storm in COVID-19 and parthenolide: Preclinical evidence

text: A group of patients with pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were reported from China in December 2019. Although several antiviral drugs are widely tested, none of them has been approved as specific antiviral therapy for coronavirus disease 2019 (COVID-19). Accumulating evidence established a hyperinflammatory states or cytokine storm in COVID-19. Among these cytokines, IL-6 plays a key role in cytokine storm and can predict the adverse clinical outcomes and fatality in these patients. Based on the evidence of the significant role of IL-6 in cytokine storm, diabetes mellitus, and cardiovascular diseases as principal comorbidities, it seems that anti-cytokine therapy may be useful in patients with severe COVID-19 to reduce mortality. Recent studies demonstrated that herbal-derived natural products had immunosuppressive and anti-inflammatory properties and exhibited exceptional act on mediators of inflammation. Parthenolide is the principal sesquiterpene lactones and the main biologically active constituent Tanacetum parthenium (commonly known as feverfew) which has could significantly reduce IL-1, IL-2, IL-6, IL-8, and TNF-α production pathways established in several human cell line models in vitro and in vivo studies. Therefore, parthenolide may be one of the herbal candidates for clinical evaluation.


title: Risk factors for predicting mortality in elderly patients with COVID-19: A review of clinical data in China

text: While elderly patients are at high risk of fatality, research concerning COVID-19 has largely been done on clarifying the clinical features. As such, the present work aims to identify risk factors for mortality in elderly patients with COVID-19. Given that single-centre studies are less likely informative as elderly remains a minority in the total Chinese population, the present study reviewed the clinical data of geriatric COVID-19 patients gathered from different sources in the public domain. Based on the data of 154 individuals from 26 provinces, age remained a key mortality risk factor among geriatric patients of different ages. While dyspnoea and chest pain/discomfort were more commonly seen in deceased patients as they represented severe pneumonia, fever was more prominent in surviving patients. This was likely due to the lower baseline body temperature observed in elderly which translated to a lower maximum temperature of fever. However, lowering the threshold temperature for fever is not recommended in surveillance. Instead, baseline body temperature measured on a regular basis should be used to define the threshold temperature for fever. Against mixed results, more research should be done on identifying comorbidities associated with mortality in geriatric patients.


Social Media can have an impact on how we manage and investigate the COVID-19 pandemic


Hospitalized patients with COVID-19 and HIV: a case series


title: SARS-CoV-2 and COVID-19: From the Bench to the Bedside

text: First isolated in China in early 2020, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is the novel coronavirus responsible for the ongoing pandemic of Coronavirus Disease 2019 (COVID-19). The disease has been spreading rapidly across the globe, with the largest burden falling on China, Europe, and the United States. COVID-19 is a new clinical syndrome, characterized by respiratory symptoms with varying degrees of severity, from mild upper respiratory illness to severe interstitial pneumonia and acute respiratory distress syndrome, aggravated by thrombosis in the pulmonary microcirculation. Three main phases of disease progression have been proposed for COVID-19: an early infection phase, a pulmonary phase, and a hyperinflammation phase. Although current understanding of COVID-19 treatment is mainly derived from small uncontrolled trials that are affected by a number of biases, strong background noise, and a litany of confounding factors, emerging awareness suggests that drugs currently used to treat COVID-19 (antiviral drugs, antimalarial drugs, immunomodulators, anticoagulants, and antibodies) should be evaluated in relation to the pathophysiology of disease progression. Drawing upon the dramatic experiences taking place in Italy and around the world, here we review the changes in the evolution of the disease and focus on current treatment uncertainties and promising new therapies.


Playing into Stereotypes: Engaging Millennials and Generation Z in the COVID-19 Pandemic Response


What the stock market tells us about the post-COVID-19 world


title: Transition Probabilities for Flavor Eigenstates of Non-Hermitian Hamiltonians in the PT-Broken Phase

text: We investigate the transition probabilities for the"flavor"eigenstates in the two-level quantum system, which is described by a non-Hermitian Hamiltonian with the parity and time-reversal (PT) symmetry. Particularly, we concentrate on the so-called PT-broken phase, where two eigenvalues of the non-Hermitian Hamiltonian turn out to be a complex conjugate pair. In this case, we find that the transition probabilities will be unbounded in the limit of infinite time $t \to +\infty$. After making a connection between the PT-broken phase and the neutral-meson system in particle physics, we observe that the infinite-time behavior of the transition probabilities can be attributed to the negative decay width of one eigenstate of the non-Hermitian Hamiltonian. We also present some brief remarks on the situation at the so-called exceptional point, where both the eigenvalues and eigenvectors of the Hamiltonian coalesce.


title: A Compressed Sensing Approach to Group-testing for COVID-19 Detection

text: We propose Tapestry, a novel approach to pooled testing with application to COVID-19 testing with quantitative Polymerase Chain Reaction (PCR) that can result in shorter testing time and conservation of reagents and testing kits. Tapestry combines ideas from compressed sensing and combinatorial group testing with a novel noise model for PCR. Unlike Boolean group testing algorithms, the input is a quantitative readout from each test, and the output is a list of viral loads for each sample. While other pooling techniques require a second confirmatory assay, Tapestry obtains individual sample-level results in a single round of testing. When testing $n$ samples with $t$ tests, as many as $k= O(t / \log n)$ infected samples can be identified at clinically-acceptable false positive and false negative rates. This makes Tapestry viable even at prevalence rates as high as 10\%. Tapestry has been validated in simulations as well as in wet lab experiments with oligomers. Clinical trials with Covid-19 samples are underway. An accompanying Android application Byom Smart Testing which makes the Tapestry protocol straightforward to implement in testing centres is available for free download.


Perspectives on Surgery in the Time of COVID-19: Safety First


Head and neck cancer care in the COVID-19 pandemic: A brief update


title: 3D CT of Novel Coronavirus (COVID-19) Pneumonia

text: This article has online supplemental material.


The Outbreak Cases with the Novel Coronavirus Suggest Upgraded Quarantine and Isolation in Korea


title: A Bayesian - Deep Learning model for estimating Covid-19 evolution in Spain

text: This work proposes a semi-parametric approach to estimate Covid-19 (SARS-CoV-2) evolution in Spain. Considering the sequences of cases, deaths, and recovered of all Spanish regions, it combines modern Deep Learning (DL) techniques for analyzing sequences with the usual Bayesian Poisson-Gamma model for counts. DL model provides a suitable description of observed sequences but no reliable uncertainty quantification around it can be obtained. To overcome this we use the prediction from DL as an expert elicitation of the expected number of counts and thus obtaining the posterior predictive distribution of counts in an orthodox Bayesian analysis. The overall resulting model allows us to either predict the future evolution of the sequences on all regions, as well as, estimating the consequences of eventual future scenarios.


title: Prevalence of Covid-19 Infection and Subsequent Cohorting in a Residential Substance Use Treatment Program in Boston, MA

text: OBJECTIVES: The global pandemic of coronavirus disease 2019 (Covid-19) may disproportionately affect persons in congregate settings, including those in residential substance use treatment facilities. To limit the spread of SARS-CoV-2 through congregate settings, universal testing may be necessary. We aimed to determine the point prevalence of SARS-CoV-2 in a residential treatment program setting and to understand the unique challenges of Covid-19 transmission in this setting. METHODS: We performed a case series of SARS-CoV-2 rT-PCR testing via nasopharyngeal in a residential substance use treatment program for women in Boston. Staff and residents of the treatment program were tested for SARS-CoV-2. The primary outcome was SARS-CoV-2 test result. RESULTS: A total of 31 residents and staff were tested. Twenty-seven percent (6/22) of the residents and 44% (4/9) of staff tested positive for SARS-CoV-2. All of the SARS-CoV-2 positive residents resided in the same residential unit. Two positive cases resided together with two negative cases in a 4-person room. Two other positive cases resided together in a 2-person room. One positive case resided with two negative cases in a 3-person room. One positive case resided with a negative case in a 2-person room. Based on test results, residents were cohorted by infection status and continued to participate in addiction treatment on-site. CONCLUSIONS: SARS-CoV-2 infection was common among staff and residents within a residential substance use treatment program for women in Boston. Universal SARS-CoV-2 testing in residential substance use programs can be instituted to reduce the risk of further transmission and continue addiction treatment programming when accompanied by adequate space, supplies, and staffing.


title: Estimating the Number of Infected Cases in COVID-19 Pandemic

text: The COVID-19 pandemic has caused major disturbance to human life. An important reason behind the widespread social anxiety is the huge uncertainty about the pandemic. One major uncertainty is how many or what percentage of people have been infected? There are published and frequently updated data on various statistics of the pandemic, at local, country or global level. However, due to various reasons, many cases were not included in those reported numbers. We propose a structured approach for the estimation of the number of unreported cases, where we distinguish cases that arrive late in the reported numbers and those who had mild or no symptoms and thus were not captured by any medical system at all. We use post-report data for the estimation of the former and population matching to the latter. We estimate that the reported number of infected cases in the US should be corrected by multiplying a factor of 220.54% as of Apr 20, 2020. The infection ratio out of the US population is estimated to be 0.53%, implying a case mortality rate at 2.85% which is close to the 3.4% suggested by the WHO.


title: Guía técnica para el cuidado de la salud mental del personal de la salud en el contexto del COVID-19

text: El documento contiene los procedimientos para el cuidado y autocuidado de la salud mental del personal de la salud que brinda atención a las personas con sospecha o con diagnóstico de infección por COVID-19


title: The Family Caregiving Crisis Meets an Actual Pandemic

text: The coronavirus disease 2019 (COVID-19) pandemic presents unique challenges to those who work with the seriously ill population, including both health care providers and the family caregivers providing unpaid care. We rely on this lay workforce as health care routinely transitions care to the home, and now more than ever, we are depending on them in the current pandemic. As palliative care and other health care providers become overwhelmed with patients critically ill with COVID-19, and routine care becomes delayed, we have a charge to recognize and work with family caregivers. Our commentary provides rationale for the need to focus on family caregivers and key considerations for how to include them in pandemic clinical decision making.