title: Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia

text: In an effort to mitigate the outbreak of COVID-19, many countries have imposed drastic lockdown, movement control or shelter in place orders on their residents. The effectiveness of these mitigation measures is highly dependent on cooperation and compliance of all members of society. The knowledge, attitudes and practices people hold toward the disease play an integral role in determining a society's readiness to accept behavioural change measures from health authorities. The aim of this study was to determine the knowledge levels, attitudes and practices toward COVID-19 among the Malaysian public. A cross-sectional online survey of 4,850 Malaysian residents was conducted between 27th March and 3rd April 2020. The survey instrument consisted of demographic characteristics, 13 items on knowledge, 3 items on attitudes and 3 items on practices, modified from a previously published questionnaire on COVID-19. Descriptive statistics, chi-square tests, t-tests and oneway analysis of variance (ANOVA) were conducted. The overall correct rate of the knowledge questionnaire was 80.5%. Most participants held positive attitudes toward the successful control of COVID-19 (83.1%), the ability of Malaysia to conquer the disease (95.9%) and the way the Malaysian government was handling the crisis (89.9%). Most participants were also taking recautions such as avoiding crowds (83.4%) and practising proper hand hygiene (87.8%) in the week before the movement control order started. However, the wearing of face masks was less common (51.2%). This survey is among the first to assess knowledge, attitudes and practice in response to the COVID-19 pandemic in Malaysia. The results highlight the importance of consistent messaging from health authorities and the government as well as the need for tailored health education programs to improve levels of knowledge, attitudes and practices.


title: Estimating the daily trend in the size of the COVID-19 infected population in Wuhan

text: There has been an outbreak of coronavirus disease (COVID-19) in Wuhan city, Hubei province, China since December 2019. Cases have been exported to other parts of China and more than 20 countries. We provide estimates of the daily trend in the size of the epidemic in Wuhan based on detailed information of 10,940 confirmed cases outside Hubei province.


New coronavirus outbreak


title: COVID-19: fear appeal favoring purchase behavior towards personal protective equipment/ COVID-19 (新冠肺炎): 恐惧诉求促进消费者个人防护用品的购买

text: The 2019 novel coronavirus is a non-segmented positive-sense RNA virus belonging to the Coronaviridae-Nidovirales family. We examined the swings in purchase behavior following the outbreak of the COVID-19 in Wuhan, China, and across the world based on the theory of fear appeal. We gathered published statistics (suspected, confirmed, and fatality) on the COVID-19 alongside the purchase of personal protective equipment to examine the swings in online purchase behavior. With a serial mediated analysis, we established that fear appeal is associated with the sharp dynamics in the online purchase as related to the COVID-19. The results confirmed that fear appeal promotes social presence in anticipation of seeking affection, acceptance, and social information. This feeling is a precondition for developing e-loyalty, which promotes purchase behavior. Even though our variables might not be conclusive enough, we believe the findings are fundamental to understanding the swings in the purchase trend in this and any similar situations.


title: COVID-19, fear and the future: An attachment perspective

text: This brief paper summarizes and appraises two prominent psychological accounts of the role fear plays in human life: (1) terror management theory and (2) attachment theory, highlighting research demonstrating that attachment security moderates the experience of fear. Moreover, the suggestion is made that fear of loss of loved ones, and fear of loss of love, is the primary source of fear and anxiety in human life. This paper also highlights the importance and value of showing ‘reflective functioning’ regarding our anxieties or ‘mentalizing’ fear so that we are better prepared for inevitable pandemics in the future. Public health infrastructures must be nourished and reinforced, just as heroic economic and technological changes are needed, so that we may more effectively cope with the fears, destruction and death arising on a regular basis on account of the radical adverse events (hotter and bigger wild fires, longer and more damaging storms) brought on by climate changes, directly linked to foolish and greedy human choices and behaviors.


title: Coronavirus Disease-2019: Knowledge, Attitude, and Practices of Health Care Workers at Makerere University Teaching Hospitals, Uganda

text: Background: Coronavirus disease-2019 (COVID-19) is an emerging public health problem threatening the life of over 2.4 million people globally. The present study sought to determine knowledge, attitude and practices (KAP) of health care workers (HCWs) toward COVID-19 in Makerere University Teaching Hospitals (MUTHs) in Uganda. Methods: An online cross sectional, descriptive study was undertaken through WhatsApp Messenger among HCWs in four MUTHs. HCWs aged 18 years and above constituted the study population. KAP toward COVID-19 was assessed by using a pre-validated questionnaire. Bloom's cut-off of 80% was used to determine sufficient knowledge (≥80%), positive attitude (≥4), and good practice (≥2.4). All analyses were performed using STATA 15.1 and GraphPad Prism 8.3. Results: Of the 581 HCWs approached, 136 (23%) responded. A vast majority of the participants were male (n = 87, n = 64%), with a median age of 32 (range: 20–66) years. Eighty-four (62%) were medical doctors and 125 (92%) had at least a bachelor's degree. Overall, 69% (n = 94) had sufficient knowledge, 21% (n = 29) had positive attitude, and 74% (n = 101) had good practices toward COVID-19. Factors associated with knowledge were age >40 years (aOR: 0.3; 95% CI: 0.1–1.0; p = 0.047) and news media (aOR: 4.8; 95% CI: 1.4–17.0; p = 0.015). Factors associated with good practices were age 40 years or more (aOR: 48.4; 95% CI: 3.1–742.9; p = 0.005) and holding a diploma (aOR: 18.4; 95% CI: 1–322.9; p = 0.046). Conclusions: Continued professional education is advised among HCWs in Uganda to improve knowledge of HCWs hence averting negative attitudes and promoting positive preventive and therapeutic practices. We recommend follow up studies involving teaching and non-teaching hospitals across the country.


title: Potential antiviral options against SARS-CoV-2 infection

text: As of June 2020, the number of people infected with severe acute respiratory coronavirus 2 (SARS-CoV-2) continues to skyrocket, with more than 6,5 million cases worldwide. Both the World Health Organization (WHO) and United Nations (UN) has highlighted the need for better control of SARS-CoV-2 infections. However, developing novel virus-specific vaccines, monoclonal antibodies and antiviral drugs against SARS-CoV-2 can be time-consuming and costly. Convalescent sera and safe-in-man broad-spectrum antivirals (BSAAs) are readily available treatment options. Here we developed a neutralization assay using SARS-CoV-2 strain and Vero-E6 cells. We identified most potent sera from recovered patients for treatment of SARS-CoV-2-infected patients. We also screened 136 safe-in-man broad-spectrum antivirals against SARS-CoV-2 infection in Vero-E6 cells and identified nelfinavir, salinomycin, amodiaquine, obatoclax, emetine and homoharringtonine. We found that combinations of virus-directed nelfinavir along with host-directed amodiaquine exhibited the highest synergy. Finally, we developed a website to disseminate the knowledge on available and emerging treatments of COVID-19.


title: Structural studies on the Ebola virus matrix protein VP40 indicate that matrix proteins of enveloped RNA viruses are analogues but not homologues

text: Abstract Matrix proteins are the driving force of assembly of enveloped viruses. Their main function is to interact with and polymerize at cellular membranes and link other viral components to the matrix–membrane complex resulting in individual particle shapes and ensuring the integrity of the viral particle. Although matrix proteins of different virus families show functional analogy, they share no sequence or structural homology. Their diversity is also evident in that they use a variety of late domain motifs to commit the cellular vacuolar protein sorting machinery to virus budding. Here, we discuss the structural and functional aspects of the filovirus matrix protein VP40 and compare them to other known matrix protein structures from vesicular stomatitis virus, influenza virus and retroviral matrix proteins.


title: Mesenchymal stromal cells for COVID-19: A living systematic review protocol

text: OBJECTIVE: To determine the impact of mesenchymal stromal cells outcomes important to patients with COVID-19. DESIGN: This is the protocol of a living systematic review. DATA SOURCES: We will conduct searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), grey literature and in a centralised repository in L-OVE (Living OVerview of Evidence). L-OVE is a platform that maps PICO questions to evidence from Epistemonikos database. In response to the COVID-19 emergency, L-OVE was adapted to expand the range of evidence it covers and customised to group all COVID-19 evidence in one place. The search will cover the period until the day before submission to a journal. ELIGIBILITY CRITERIA FOR SELECTING STUDIES AND METHODS: We adapted an already published common protocol for multiple parallel systematic reviews to the specificities of this question. We will include randomised trials evaluating the effect of mesenchymal stromal cells versus placebo or no treatment in patients with COVID-19. Randomised trials evaluating other coronavirus infections, such as MERS-CoV and SARS-CoV, and non-randomised studies in COVID-19 will be searched in case we find no direct evidence from randomised trials, or if the direct evidence provides low- or very low-certainty for critical outcomes. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit it every time the conclusions change or whenever there are substantial updates. ETHICS AND DISSEMINATION: No ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media. PROSPERO Registration Submitted to PROSPERO (awaiting ID allocation).


title: Chinese herbal medicine for SARS and SARS-CoV-2 treatment and prevention, encouraging using herbal medicine for COVID-19 outbreak

text: Chinese herbs and plants have been used as traditional medicine, immune system booster for human being for thousands of years in China and other parts of Asia. Seven coronaviruses are known to infect humans, three of them are serious which are SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), and SARS-CoV-2 (Covid-19). In this mini-review article, we have mentioned the key role some of the most important plants with antiviral activities and herbs against SARS and SARS-CoV-2 on the basis of traditional Chinese medicine.


title: Does TB Vaccination Reduce COVID-19 Infection?: No Evidence from a Regression Discontinuity Analysis

text: In the middle of the global COVID-19 pandemic, the BCG hypothesis, the prevalence and severity of the COVID-19 outbreak seems to be correlated with whether a country has a universal coverage of Bacillus-Calmette-Guerin (BCG), a vaccine for tuberculosis disease (TB), has emerged and attracted the attention of scientific community and media outlets. However, all existing claims are based on cross-country correlations that do not exclude the possibility of spurious correlation. We merged country-age-level case statistics with the start/termination years of BCG vaccination policy and conducted a regression discontinuity and difference-in-difference analysis. The results do not support the BCG hypothesis.


title: Rapid Systematic Review Exploring Historical and Present Day National and International Governance during Pandemics

text: Introduction Pandemics have plagued mankind since records began, and while non-communicable disease pandemics are more common in high-income nations, infectious disease pandemics continue to affect all countries worldwide. To mitigate impact, national pandemic preparedness and response policies remain crucial. And in response to emerging pathogens of pandemic potential, public health policies must be both dynamic and adaptive. Yet, this process of policy change and adaptation remains opaque. Accordingly, this rapid systematic review will synthesise and analyse evaluative policy literature to develop a roadmap of policy changes that have occurred after each pandemic event, throughout both the 20th and 21st Century, in order to better inform future policy development. Methods and Analysis A rapid systematic review will be conducted to assimilate and synthesise both peer-reviewed articles and grey literature that document the then current pandemic preparedness policy, and the subsequent changes to that policy, across high-, middle- and low-income countries. The rapid review will follow the PRISMA guidelines, and the literature search will be performed across five relevant databases, as well as various government websites to scan for grey literature. Articles will be screen against pre-agreed inclusion/ exclusion criteria, and data will be extracted using a pre-defined charting table. Ethics and Dissemination All data rely on secondary, publicly available data sources; therefore no ethical clearance is required. Upon completion, the results of this study will be disseminated via the Imperial College London Community and published in an open access, peer-reviewed journal.


title: Impact of virus testing on COVID-19 case fatality rate: estimate using a fixed-effects model

text: Background In response to the SARS-CoV2 pandemic, governments have adopted a variety of public health measures. There are variations in how much testing has been done across countries. South Korea, Germany, and Iceland take the bet of massive testing of their population. Whereas tests were not performed widely in southern European countries. As the former undergo a lower case-fatality rate due to the COVID-19 than the latter, the impact of the testing strategy must be investigated. In this study, we aimed to evaluate the impact of testing on the case fatality rate. Methods We use data on inpatients across French geographic areas and propose a novel methodology that exploits policy discontinuities at region borders to estimate the effect of COVID-19 tests on the case-fatality rate. In France, testing policies are determined locally. We compare all contiguous department pairs located on the opposite sides of a region border. The heterogeneity in testing rate between department pairs together with the similarities in other dimensions allow us to mimic the existence of treatment and control groups and to identify the impact of testing on mortality. Results The increase of one percentage point in the test rate is associated with a decrease of 0.001 percentage point in the death rate. In other words, for each additional 1000 tests, one person would have remained alive. Conclusion Massive population testing could have a significant effect on mortality in different ways. Mass testing may help decision-makers to implement healthcare measures to limit the spread of the disease.


Tele-Pharmacy: A New Opportunity for Consultation in COVID-19 Pandemic


title: Methodological Rigor in COVID-19 Clinical Research: A Systematic Review and Case-Control Analysis

text: Objective: To systematically evaluate the quality of reporting of currently available COVID-19 studies compared to historical controls. Design: A systematic review and case-control analysis Data sources: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials until May 14, 2020 Study selection: All original clinical literature evaluating COVID-19 or SARS-CoV2 were identified and 1:1 historical control of the same study type in the same published journal was matched from the previous year Data extraction: Two independent reviewers screened titles, abstracts, and full-texts and independently assessed methodological quality using Cochrane Risk of Bias Tool, Newcastle-Ottawa Scale, QUADAS-2 Score, or case series checklist. Results: 9895 titles and abstracts were screened and 686 COVID-19 articles were included in the final analysis in which 380 (55.4%) were case series, 199 (29.0%) were cohort, 63 (9.2%) were diagnostic, 38 (5.5%) were case-control, and 6 (0.9%) were randomized controlled trials. Overall, high quality/low-bias studies represented less than half of COVID-19 articles - 49.0% of case series, 43.9% of cohort, 31.6% of case-control, and 6.4% of diagnostic studies. We matched 539 control articles to COVID-19 articles from the same journal in the previous year for a final analysis of 1078 articles. The median time to acceptance was 13.0 (IQR, 5.0-25.0) days in COVID-19 articles vs. 110.0 (IQR, 71.0-156.0) days in control articles (p<0.0001). Overall, methodological quality was lower in COVID-19 articles with 220 COVID-19 articles of high quality (41.0%) vs. 392 control articles (73.3%, p<0.0001) with similar results when stratified by study design. In both unadjusted and adjusted logistic regression, COVID-19 articles were associated with lower methodological quality (odds ratio, 0.25; 95% CI, 0.20 to 0.33, p<0.0001). Conclusion: Currently published COVID-19 studies were accepted more quickly and were found to be of lower methodological quality than comparative studies published in the same journal. Given the implications of these studies to medical decision making and government policy, greater effort to appropriately weigh the existing evidence in the context of emerging high-quality research is needed. Study registration: PROSPERO: CRD42020187318


title: Identification of potential treatments for COVID-19 through artificial intelligence-enabled phenomic analysis of human cells infected with SARS-CoV-2

text: To identify potential therapeutic stop-gaps for SARS-CoV-2, we evaluated a library of 1,670 approved and reference compounds in an unbiased, cellular image-based screen for their ability to suppress the broad impacts of the SARS-CoV-2 virus on phenomic profiles of human renal cortical epithelial cells using deep learning. In our assay, remdesivir is the only antiviral tested with strong efficacy, neither chloroquine nor hydroxychloroquine have any beneficial effect in this human cell model, and a small number of compounds not currently being pursued clinically for SARS-CoV-2 have efficacy. We observed weak but beneficial class effects of β-blockers, mTOR/PI3K inhibitors and Vitamin D analogues and a mild amplification of the viral phenotype with β-agonists.


title: Navigating hospitals safely through the COVID-19 epidemic tide: predicting case load for adjusting bed capacity

text: Background The pressures exerted by the pandemic of COVID-19 pose an unprecedented demand on health care services. Hospitals become rapidly overwhelmed when patients requiring life-saving support outpace available capacities. We here describe methods used by a university hospital to forecast caseloads and time to peak incidence. Methods We developed a set of models to forecast incidence among the hospital catchment population and describe the COVID-19 patient hospital care-path. The first forecast utilized data from antecedent allopatric epidemics and parameterized the care path model according to expert opinion (static model). Once sufficient local data were available, trends for the time dependent effective reproduction number were fitted and the care-path was parameterized using hazards for real patient admission, referrals, and discharge (dynamic model). Results The static model, deployed before the epidemic, exaggerated the bed occupancy (general wards 116 forecasted vs 66 observed, ICU 47 forecasted vs 34 observed) and predicted the peak too late (general ward forecast April 9, observed April 8, ICU forecast April 19, observed April 8). After April 5, the dynamic model could be run daily and precision improved with increasing availability of empirical local data. Conclusions The models provided data-based guidance in the preparation and allocation of critical resources of a university hospital well in advance of the epidemic surge, despite overestimating the service demand. Overestimates should resolve when population contact pattern before and during restrictions can be taken into account, but for now they may provide an acceptable safety margin for preparing during times of uncertainty.


Are Children Most of the Submerged Part of SARS-CoV-2 Iceberg?


title: Estimating the case fatality ratio of the COVID-19 epidemic in China

text: Background: Corona Virus Disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan city and rapidly spread throughout China since late December 2019. Crude case fatality ratio (CFR) with dividing the number of known deaths by the number of confirmed cases does not represent the true CFR and might be off by orders of magnitude. We aim to provide a precise estimate of the CFR of COVID-19 using statistical models at the early stage of the epidemic. Methods: We extracted data from the daily released epidemic report published by the National Health Commission P. R. China from 20 Jan 2020, to 1 March 2020. Competing risk model was used to obtain the cumulative hazards for death, cure, and cure-death hazard ratio. Then the CFR was estimated based on the slope of the last piece in joinpoint regression model, which reflected the most recent trend of the epidemic. Results: As of 1 March 2020, totally 80,369 cases were diagnosed as COVID-19 in China. The CFR of COVID-19 were estimated to be 70.9% (95% CI: 66.8%-75.6%) during Jan 20-Feb 2, 20.2% (18.6%-22.1%) during Feb 3-14, 6.9% (6.4%-7.4%) during Feb 15-23, 1.5% (1.4%-1.6%) during Feb 24-March 1 in Hubei province, and 20.3% (17.0%-25.3%) during Jan 20-28, 1.9% (1.8%-2.1%) during Jan 29-Feb 12, 0.9% (0.8%-1.1%) during Feb 13-18, 0.4% (0.4%-0.5%) during Feb 19-March 1 in other areas of China, respectively. Conclusions: Based on analyses of public data, we found that the CFR in Hubei was much higher than that of other regions in China, over 3 times in all estimation. The CFR would follow a downwards trend based on our estimation from recently released data. Nevertheless, at early stage of outbreak, CFR estimates should be viewed cautiously because of limited data source on true onset and recovery time.


A Macroeconomic SIR Model for COVID-19


title: Coupled Dynamics of Behavior and Disease Contagion Among Antagonistic Groups

text: Disease transmission and behavior change are both fundamentally social phenomena. Behavior change can have profound consequences for disease transmission, and epidemic conditions can favor the more rapid adoption of behavioral innovations. We analyze a simple model of coupled behavior-change and infection in a structured population characterized by homophily and outgroup aversion. Outgroup aversion slows the rate of adoption and leads to bifurcation when outgroup aversion exceeds positive ingroup influence. When the rates of adoption differ by group, high outgroup aversion causes the later-adopting group to have a lower equilibrium adoption fraction, even when the behavior is highly desirable. When disease dynamics are coupled to the behavior-adoption model, a wide variety of dynamics are possible. Homophily can either increase or decrease the final size of the epidemic depending on its relative strength in the two groups and R0 for the infection. When R0 ≈ 1 and homophily is strong in the second group, it can be protective for this group. However, when R0 ≫ 1, we find that strong homophily in the second group, together with outgroup aversion, can lead to a much larger epidemic in that group. Similarly, if the first group is homophilic and the second is not, the second group will have a larger epidemic. Homophily and outgroup aversion can also produce a “second wave” in the first group that follows the peak of the epidemic in the second group. In general, adding outgroup aversion to a population characterized by homophily can result in paradoxical failure to adopt behavior that is protective from infection. These simple models reveal complex dynamics that are suggestive of the processes currently observed under pandemic conditions in culturally and/or politically polarized populations such as the United States.


title: Epidemic analysis of COVID-19 Outbreak and Counter-Measures in France

text: COVID-19 pandemic has triggered world-wide attention among data scientists and epidemiologists to analyze and predict the outcomes, by using previous statistical epidemic models. We propose to use a variant of the well known SEIR model to analyze the spread of COVID-19 in France, by taking in to account the national lockdown declared in March 11, 2020. Particle Swarm Optimisation (PSO) is used to find optimal parameters for the model in the case of France. We propose to fit the model based only on the number of daily fatalities, where an R2 score based error metric is used. As number of confirmed cases shall not be fully representative due to low testing especially in the first phases of the outbreak, we present that basing the model optimisation on the fatalities can provide legitimate results.


title: The Impact of Social Distancing on TheCourse of The Covid-19 Pandemic in FourEuropean Countries

text: In this article the mortality data from four European countries arising from the Covid-19 pandemic is modelled using logistic functions. The countries chosen for examination are Spain, Italy, France and the UK. They have been selected because in each the pandemic is advanced, mortality high and any prospect of containment has passed. They have also been selected because in each social distancing has been used in an attempt to reduce peak daily mortality with relatively strict enforcement following a defined date. The choices of data set and model type is justified. The impact, if any, of social distancing is examined.


title: COVID-19 Disease in Children: Clinical Course, Diagnosis and Treatment Overview and Literature Data Compilation

text: The novel Coronavirus is named as SARS-CoV-2 is a highly contagious infection agent compared to the previous human coronaviruses Each previous outbreak had distinctive danger The high potential of infectiousness is the primary danger of novel coronavirus While MERS-CoV infection is known to have higher mortality rate, SARS-CoV-2 has spread to many people all over the world in a concise time SARS-CoV-2 (like SARS-CoV and MERS) infects fewer children and results in milder clinical symptoms than in adults The primary pathogenesis of it is not known;the difference in children's immunities, less likelihood of exposure to the agent may be the reasons Nevertheless, along with being mostly asymptomatic, the child population is a potential source for infection spread


title: Syncope at SARS-CoV-2 onset due to impaired baroreflex response

text: We describe clinical and laboratory findings in 35 consecutive patients tested positive for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction on nasopharyngeal swab that presented one or multiple syncopal events at disease onset. Neurological examination and electrocardiographic findings were normal. Chest computed tomography showed findings consistent with interstitial pneumonia. Arterial blood gas analysis showed low pO2, pCO2, and P/F ratio indicating hypocapnic hypoxemia, while patients did not show the expected compensatory heart rate increase. Such mechanism could have led to syncope. We speculate that SARS-CoV-2 could have caused angiotensin-converting enzyme-2 (ACE2) receptor internalization in the nucleus of the solitary tract (NTS), thus altering the baroreflex response and inhibiting the compensatory tachycardia during acute hypocapnic hypoxemia.


title: Association of BCG vaccination policy with prevalence and mortality of COVID-19

text: There is some evidence that tuberculosis vaccine bacillus Calmette-Guérin (BCG) has non-specific beneficial effects against non-related infections. Here, we examined the possible association between BCG vaccination with prevalence and mortality by COVID-19 by using publicly available data of COVID-19 in 199 countries/regions and the BCG World Atlas. By using linear regression modeling, we found that the number of total cases and deaths per one million population were significantly associated with the country's policy concerning BCG vaccine administration. The amount of variance in cases and deaths explained by BCG vaccination policy ranged between 12.5% and 38%. Importantly, this effect remained significant after controlling for the country's life expectancy and the average temperature in February and March 2020, which themselves are significantly correlated with the cases and deaths indices, respectively. By contrast, the ratio between deaths and cases was weakly affected. This latter outcome suggested that BCG vaccination may have hindered the overall spread of the virus or progression of the disease rather than reducing mortality rates (i.e., deaths/cases ratio). Finally, by roughly dividing countries into three categories showing high, middle, or low growth rate of the cases, we found a highly significant difference between the slope categories among the BCG groups, suggesting that the time since the onset of the spread of the virus was not a major confounding factor. While this study potentially suffers from a number of unknown confounding factors, these associations support the idea that BCG vaccination may provide protection against SARS-CoV-2, which, together with its proven safety, encourages consideration of further detailed epidemiological studies, large-scale clinical trials on the efficacy of this vaccine on COVID-19, and/or re-introduction of BCG vaccination practice in the countries which are currently devoid of the practice.


title: Analysis of the mitigation strategies for COVID-19: from mathematical modelling perspective

text: In this article, a mathematical model for the transmission of COVID-19 disease is formulated and analysed. It is shown that the model exhibits a backward bifurcation at R0 = 1 when recovered individuals do not develop a permanent immunity for the disease. In the absence of reinfection, it is proved that the model is without backward bifurcation and the disease free equilibrium is globally asymptotically stable for R0 < 1. By using available data, the model is validated and parameter values are estimated. The sensitivity of the value of R0 to changes in any of the parameter values involved in its formula is analysed. Moreover, various mitigation strategies are investigated using the proposed model and it is observed that the asymptomatic infectious group of individuals may play a major role in the re-emergence of the disease in the future. Therefore, it is recommended that in the absence of vaccination, countries need to develop capacities to detect and isolate at least 30% of the asymptomatic infectious group of individuals while treating in isolation at least 50% of symptomatic patients to control the disease.


title: A Systematic Review and Meta-analysis of Therapeutic options against SARS-CoV-2

text: Importance Treatment options for Severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) are limited with no clarity on the efficacy and safety profiles. Objective To assess if the effect estimate of any intervention improves the outcomes and safety profile. Data sources PubMed, Embase, Cochrane Central were searched from December 1, 2019 to May 11, 2020. Study selection Any prospective/retrospective clinical study on SARS-CoV-2 patients above 18 years of age with report on therapeutic interventions. Data synthesis and extraction Data was screened and extracted by two independent investigators. Main outcomes and measures The primary outcome was all-cause in-hospital mortality. The secondary outcomes were rates of mechanical ventilation, viral clearance, adverse events, discharge, progression to severe disease, median time for clinical recovery and anti-viral clearance. Pooled rates and odds ratios (OR) were calculated. Results A total of 29 studies with 5207 participants were included in the analysis. The pooled all-cause in-hospital mortality rate was 12.8% (95%CI: 8.1%-17.4%) in intervention arm. There was no significant difference in mortality between both arms overall (OR: 1.36, 95% CI: 0.97-1.89). The mortality was significantly higher in the Hydroxychloroquine (HCQ) group compared to control: (1.86, 95% CI: 1.38-2.50). The need for mechanical ventilation in patients with mild-moderate disease was 13.5% vs 9.8% in intervention and control groups, with no significant difference (OR: 1.58, 95% CI: 0.60-4.15).The median duration for viral clearance in the intervention arm was 6.1 (IQR: 4.3-8.8) days and control arm was 9 (IQR: 4.5-14) days, with no significant difference between the groups (p = 0.37). There was no significant difference between pooled adverse event rates in intervention and control groups: 34% vs 29.5% (OR: 1.44, 95% CI: 0.70-2.94), respectively. However, incidence of adverse events was significantly higher in HCQ sub-group (OR: 3.88, 95% CI: 1.60-9.45, I2 = 0%). There was no significant difference in other secondary outcomes. Conclusion and relevance The use of hydroxychloroquine was associated with increased mortality and adverse event rates. No other therapeutic intervention including Lopinavir/Ritonavir, Remdesivir or Tocilizumab seem to alter the natural course of the disease. There is a further need for well-designed randomized clinical trials.


title: SSRIs and SNRIs and Risk of Death or Intubation in COVID-19: Results from an Observational Study

text: Importance: On the grounds of their anti-inflammatory and potential antiviral effects, we hypothesized that SSRIs and SNRIs might be effective treatments for Covid-19. Methods: We examined the association of antidepressant use with intubation or death in hospitalized patients with COVID-19. The primary endpoint was a composite of intubation or death in time-to-event analyses adjusted for numerous potential confounders. We compared this endpoint between patients who received antidepressants and those who did not. The primary analyses were multivariable Cox models with inverse probability weighting. Results: Of the 9,509 inpatients with positive Covid-19 RT-PCR test, 2,164 patients (22.8%) were excluded because of missing data or exclusion criterion (i.e. less than 18 years old of age). Of the remaining 7,345 adult inpatients, 460 patients (6.3%) received an antidepressant during the hospitalization. The primary endpoint occurred respectively in 143 patients exposed to antidepressants (31.1%) and 1,188 patients who were not (17.3%). After adjusting for the older age [74.8 (SD=15.5) versus 56.8 (SD=19.3); Welch's t-test=23.7; p<0.001] and the greater medical severity of patients receiving antidepressants, the primary analyses showed a significant negative association of the composite endpoint with exposure to any antidepressant (HR, 0.64; p<0.001), SSRIs (HR, 0.56; p<0.001), and SNRIs (HR, 0.57; p=0.034), but not with other antidepressant classes. Exposure to escitalopram, fluoxetine, and venlafaxine was significantly associated with lower risk of intubation or death (all p<0.05). Results were similar in multiple sensitivity analyses. Conclusions: SSRIs and SNRIs may be associated with lower risk of death or intubation in patients with COVID-19.


Severe acute respiratory syndrome coronavirus 2 (the cause of COVID 19) in different types of clinical specimens and implications for cytopathology specimen: An editorial review with recommendations


Survey research methodseditorialduring the COVID-19 crisis


title: The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19

text: SARS-CoV2 infection is typically very mild and often asymptomatic in children. A complication is the rare Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19, presenting 4-6 weeks after infection as high fever and organ dysfunction and strongly elevated markers of inflammation. The pathogenesis is unclear but has overlapping features with Kawasaki disease suggestive of vasculitis and a likely autoimmune etiology. We apply systems-level analyses of blood immune cells, cytokines and autoantibodies in healthy children, children with Kawasaki disease enrolled prior to COVID-19, children infected with SARS-CoV2 and children presenting with MIS-C. We find that the inflammatory response in MIS-C differs from the cytokine storm of severe acute COVID-19, is more similar to Kawasaki disease, but also differ from this with respect to T-cell subsets, IL-17A and biomarkers associated with arterial damage. Finally, autoantibody profiling suggests endoglin, an endothelial glycoprotein as one of several candidate targets of autoantibodies in MIS-C.


title: Emergency Medical Services resource capacity and competency amid COVID-19 in the United States: Preliminary findings from a national survey

text: This study aimed to investigate available resources, Personal Protective Equipment (PPE) availability, sanitation practices, institutional policies, and opinions among EMS professionals in the United States amid the COVID-19 pandemic using a self-report survey questionnaire. METHODS An online 42-question multiple choice survey was randomly distributed between April 1, 2020, and April 12, 2020 to various active Emergency Medical Services (EMS) paid personnel in all 50 U.S. states including the District of Columbia (n=165). We approximate a 95% confidence interval (+/- 0.0755). RESULTS An overwhelming number of EMS providers report having limited access to N95 respirators, receiving little or no benefits from COVID-19 related work, and report no institutional policy on social distancing practices despite CDC recommendations. For providers who do have access to N95 respirators, 31% report having to use the same mask for 1 week or longer. Approximately [1/3] of the surveyed participants were unsure of when a COVID-19 patient is infectious. The data suggests regular decontamination of EMS equipment after each patient contact is not a regular practice. DISCUSSION Current practices to educate EMS providers on appropriate response to the novel coronavirus may not be sufficient, and future patients may benefit from a nationally established COVID-19 EMS response protocol. Further investigation on whether current EMS practices are contributing to the spread of infection is warranted. The data reveals concerning deficits in COVID-19 related education and administrative protocols which pose as a serious public health concern that should be urgently addressed.


title: A systematic review of convalescent plasma treatment for COVID19

text: Background. Transfusion of convalescent immune plasma (CP) is commonly used in epidemics. Several articles now describe clinical report data of CP for treatment of SARS-CoV-2-induced COVID-19 disease. Methods. A systematic literature review was conducted using the NCBI curated COVID-19 related open-resource literature database LitCovid to identify studies using CP as treatment for COVID-19 patients. We retrieved and curated all COVID-19 related patient and treatment characteristics from previously reported studies. A Poisson model was developed to evaluate the association between age of the patients, older age being the most common risk factor for COVID-19 mortality, and recovery time since CP treatment using data extracted from the literature. Results. From 18,293 identified COVID-19 related articles, we included ten studies reporting results of CP treatment for COVID-19 from a total of 61 patients. Decreased symptoms of severe COVID-19 and clearance of SARS-CoV-2 RNA were the most direct observations. We found that patients over the age of sixty who received CP treatment for COVID-19 had a significantly prolonged recovery estimated by viral clearance (from 10 to 29 days since first dose of CP) compared to younger patients, who recovered from the infection in less than a week after receiving CP treatment. Conclusions. Limited published results on plasma transfusion treatment for COVID-19 disease with concomitant treatments suggest that CP therapy for COVID-19 is well tolerated and effective. First randomized clinical trial results, however, reveal no improvements in recovery time for elderly patients with severe COVID-19 between standard treatment alone and added with convalescent plasma. Accordingly, we argue that older patients may need a significantly longer time for recovery. Further randomized clinical trial data for COVID-19 with rigorous ethical standards is urgently needed.


title: Chloroquine and Hydroxychloroquine for the treatment of COVID-19: A Systematic Review and Meta-analysis

text: Background: There is no effective therapy for COVID-19. Hydroxychloroquine (HCQ) and chloroquine (CQ) have been used for its treatment but their safety and efficacy remain uncertain. Objective: We performed a systematic review to synthesize the available data on the efficacy and safety of CQ and HCQ for the treatment of COVID-19. Methods: Two reviewers searched for published and pre-published relevant articles between December 2019 to 8th June 2020. The data from the selected studies were abstracted and analyzed for efficacy and safety outcomes. Critical appraisal of the evidence was done by Cochrane risk of bias tool and Newcastle Ottawa scale. The quality of evidence was graded as per the GRADE approach. Results: We reviewed 12 observational and 3 randomized trials which included 10659 patients of whom 5713 received CQ/HCQ and 4966 received only standard of care. The efficacy of CQ/HCQ for COVID-19 was inconsistent across the studies. Meta-analysis of included studies revealed no significant reduction in mortality with HCQ use [RR 0.98 95% CI 0.66-1.46] , time to fever resolution [mean difference -0.54 days (-1.19-011)] or clinical deterioration/development of ARDS with HCQ [RR 0.90 95% CI 0.47-1.71]. There was a higher risk of ECG abnormalities/arrhythmia with HCQ/CQ [RR 1.46 95% CI 1.04 to 2.06]. The quality of evidence was graded as very low for these outcomes. Conclusions: The available evidence suggests that CQ or HCQ does not improve clinical outcomes in COVID-19. Well-designed randomized trials are required for assessing the efficacy and safety of HCQ and CQ for COVID-19.


title: Pathogenesis, transmission and response to re-exposure of SARS-CoV-2 in domestic cats

text: The pandemic caused by SARS-CoV-2 has reached nearly every country in the world with extraordinary person-to-person transmission. The most likely original source of the virus was spillover from an animal reservoir and subsequent adaptation to humans sometime during the winter of 2019 in Wuhan Province, China. Because of its genetic similarity to SARS-CoV-1, it is likely that this novel virus has a similar host range and receptor specificity. Due to concern for human-pet transmission, we investigated the susceptibility of domestic cats and dogs to infection and potential for infected cats to transmit to naïve cats. We report that cats are highly susceptible to subclinical infection, with a prolonged period of oral and nasal viral shedding that is not accompanied by clinical signs, and are capable of direct contact transmission to other cats. These studies confirm that cats are susceptible to productive SARS-CoV-2 infection, but are unlikely to develop clinical disease. Further, we document that cats develop a robust neutralizing antibody response that prevented re-infection to a second viral challenge. Conversely, we found that dogs do not shed virus following infection, but do mount an anti-viral neutralizing antibody response. There is currently no evidence that cats or dogs play a significant role in human exposure; however, reverse zoonosis is possible if infected owners expose their domestic pets during acute infection. Resistance to re-exposure holds promise that a vaccine strategy may protect cats, and by extension humans, to disease susceptibility.


title: Infants Born to Mothers With a New Coronavirus (COVID-19)

text: A novel viral respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for an epidemic of the coronavirus disease 2019 (COVID-19) in cases in China and worldwide. Four full-term, singleton infants were born to pregnant women who tested positive for COVID-19 in the city of Wuhan, the capital of Hubei province, China, where the disease was first identified. Of the three infants, for who consent to be diagnostically tested was provided, none tested positive for the virus. None of the infants developed serious clinical symptoms such as fever, cough, diarrhea, or abnormal radiologic or hematologic evidence, and all four infants were alive at the time of hospital discharge. Two infants had rashes of unknown etiology at birth, and one had facial ulcerations. One infant had tachypnea and was supported by non-invasive mechanical ventilation for 3 days. One had rashes at birth but was discharged without parental consent for a diagnostic test. This case report describes the clinical course of four live born infants, born to pregnant women with the COVID-19 infection.


title: COVID-19: Emergency Medicine Physician Empowered to Shape Perspectives on This Public Health Crisis

text: COVID-19 (Coronavirus Disease 2019) has sparked a remarkable public response in the United States. The following publication highlights the integral role that Emergency Medicine (EM) providers are afforded as a result of the public health circumstances. By embracing the unique outlet of direct patient coordination of care, EM providers can correct public misconceptions and promote more appropriate social distancing practices to the greater community.


title: MORT, a locus for apoptosis in the human immunodeficiency virus-type 1 antisense gene: implications for AIDS, Cancer, and Covid-19

text: Apoptosis, or programmed cell death, is a fundamental requirement for life in multicellular organisms, including humans, and a mechanism to maintain homeostasis and prevent unwarranted cellular proliferations such as cancer. An antisense gene in HIV-1 (Hap) induces apoptosis in human cells. Apoptotic T cell death following HIV-1 infection leads to a compromised immune system and eventually AIDS (acquired immunodeficiency syndrome). A review of several studies that focused on long-term survivors of HIV-1 reveals that these survivors had deletion-mutations in Hap. A subset of these survivors changed course and experienced CD4+ T cell death and progression to AIDS. These individuals had virus that regained Hap gene sequence that had previously been deleted. Analysis of the changes in the genetic sequences with in vivo progression of the revertant HIV-1 virus allowed identification of a specific region in Hap we are calling MORT. MORT, in Hap RNA forms a primary microRNA-like structure. Potential human mRNAs targeted by MORT mi/siRNAs include gene/RNA sequences of X-linked inhibitor of apoptosis (XIAP), survivin, and apollon, along with many other human gene sites/RNAs. Thus MORT may be acting as an RNA antagonist to cellular IAPs thereby inducing apoptotic cell death. Surprisingly, additional potential MORT targets include viral sites in human SARS-CoV-2, including the protease, nsp5 RNA. Future uses for RNA therapy and a hypothesis for an HIV intrinsic mechanism utilizing MORT for viral anti-viral (or anti-microbial) and HIV anti-immune cell defense are proposed.


title: Paper alertEuropean Society For Emergency Medicine position paper on emergency medical systems’ response to COVID-19

text: The 2019 novel coronavirus acute respiratory epidemic is creating a stressed situation in all the health systems of the affected countries Emergency medical systems and specifically the emergency departments as the front line of the health systems are suffering from overload and severe working conditions, the risk of contagion and transmission of the health professionals adds a substantial burden to their daily work Under the perspective of European Society For Emergency Medicine, the recommendations provided by the health authorities are reviewed focus on the emergency department’s activity


title: Preliminary Assessment of the COVID-19 Outbreak Using 3-Staged Model e-ISHR

text: The outbreak of coronavirus disease 2019 (COVID-19) in Wuhan has aroused widespread concern and attention from all over the world. Many articles have predicted the development of the epidemic. Most of them only use very basic SEIR model without considering the real situation. In this paper, we build a model called e-ISHR model based on SEIR model. Then we add hospital system and time delay system into the original model to simulate the spread of COVID-19 better. Besides, in order to take the government’s control and people’s awareness into consideration, we change our e-ISHR model into a 3-staged model which effectively shows the impact of these factors on the spread of the disease. By using this e-ISHR model, we fit and predict the number of confirmed cases in Wuhan and China except Hubei. We also change some of parameters in our model. The results indicate the importance of isolation and increasing the number of beds in hospital.


title: Online Learning during the COVID-19 Pandemic and Academic Stress in University Students

text: The closure of schools, universities and educational institutions across Saudi Arabia, and maintaining social distancing as a preventive and precautionary measure against COVID-19, have all changed the mode of teaching from a conventional standard system to a virtual and online framework Such a quick and sudden shift in the educational system might cause intense stress on students This content research analysis aims to identify the academic stressors by analysing the worries and fears that students at the College of Education (King Saud University) are experiencing during the time of COVID-19 The results show that the issue with the highest percentage of stress among students is their uncertainty over the end of semester exams and assessments


title: Three adjacent nucleotide changes spanning two residues in SARS-CoV-2 nucleoprotein: possible homologous recombination from the transcription-regulating sequence

text: The COVID-19 pandemic is caused by the single-stranded RNA virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a virus of zoonotic origin that was first detected in Wuhan, China in December 2019. There is evidence that homologous recombination contributed to this cross-species transmission. Since that time the virus has demonstrated a high propensity for human-to-human transmission. Here we report two newly identified adjacent amino acid polymorphisms in the nucleocapsid at positions 203 and 204 (R203K/G204R) due to three adjacent nucleotide changes across the two codons (i.e. AGG GGA to AAA CGA). This new strain within the LGG clade may have arisen by a form of homologous recombination from the core sequence (CS-B) of the transcription-regulating sequences of SAS-CoV-2 itself and has rapidly increased to approximately one third of reported sequences from Europe during the month of March 2020. We note that these polymorphisms are predicted to reduce the binding of an overlying putative HLA-C*07-restricted epitope and that HLA-C*07 is prevalent in Caucasians being carried by >40% of the population. The findings suggest that homologous recombination may have occurred since its introduction into humans and be a mechanism for increased viral fitness and adaptation of SARS-CoV-2 to human populations.


title: Systematic Review and Meta-Analysis of Sex-Specific COVID-19 Clinical Outcomes

text: To successfully mitigate the extraordinary devastation caused by the Coronavirus disease 2019 (COVID-19) pandemic, it is crucial to identify important risk factors for this disease. One such neglected health determinant is the sex of the patient. This is an essential clinical characteristic, as it can factor into a patient's clinical management and preventative measures. Some clinical studies have shown disparities in the proportion between males and females that have more severe clinical outcomes or, subsequently, die from this disease. However, this association has not been unequivocally established. Thus, the purpose of this investigation was to examine the association between male sex and COVID-19 severity. We systematically reviewed the literature, identified non-randomized studies that matched predetermined selection criteria, and performed a meta-analysis to evaluate the proportion of males among four disease severity categories. Appropriate assessment strategies were implemented to assess and minimize potential biases. The results of this meta-analysis indicated that males constituted a significantly higher proportion of those who had adverse clinical outcomes and died from COVID-19. As the coronavirus spread from the East to the West, male sex remained a consistent risk factor. Our results support the establishment of the male sex as an important risk factor for this disease. Early identification and appropriate medical care for males with lab-confirmed COVID-19 may substantially change the course of clinical prognosis, resulting in greater numbers of lives saved.


title: The UK Covid-19 lockdown weakened in April and May 2020: implications for the size of the epidemic and for outcomes had lockdown been earlier

text: The number of active cases in the UK Covid-19 epidemic, the case fatality rate, the susceptible proportion of the population, and how well the lockdown was maintained during April-May 2020 are unknown. These four have a relationship with the shape of the daily mortality curve once one considers the intervals from infection to death or recovery. Without an understanding of this relationship we cannot say that an earlier lockdown would have saved lives. Using a small stochastic model, the lockdown had to be weakened, in April and May, for simulated deaths to match ongoing actual daily deaths. Google mobility data was found to be consistent with the weakening required in the model with similar changes from baseline in time and magnitude. If in an earlier lockdown, mobility and interactions would have followed a similar course, then with a large epidemic curve an earlier lockdown might be associated with many more deaths than some currently believe. This was confirmed in the stochastic model and in two modified SIR models of epidemics of various sizes. The first SIR model had a fixed period to recovery and the second used random periods, both models had random periods to death. Weakening of the mitigations was required to tune the output in large but not in small epidemics. This gives weight to the epidemic having affected many more individuals than some reports currently suggest. In both one and two-week earlier lockdowns, total deaths were found to depend on the size of the epidemic and to vary from 2,000-49,000 deaths. There was a linear relationship between the peak proportion of the population infected and the reciprocal of the case fatality rate. This work questions the low prevalence of < 0.1%, reported by the Office for National Statistics in May and June 2020, since to accommodate a weakening lockdown, the shape of the daily mortality curve, and an acceptable case fatality rate a much larger epidemic curve is required.


title: Assessing the quality, readability and reliability of online information on COVID-19: aninfoveillance observational study

text: Objective: This study aimed to assess the quality, reliability and readability of internet-based information on COVID-19 available on Brazil most used search engines. Methods: A total of 68 websites were selected through Google, Bing, and Yahoo. The websites content quality and reliability were evaluated using the DISCERN questionnaire, the Journal of American Medical Association (JAMA) benchmark criteria, and the presence of the Health on Net (HON) certification. Readability was assessed by the Flesch Reading Ease adapted to Brazilian Portuguese (FRE-BP). Results: The web contents were considered moderate to low quality according to DISCERN and JAMA mean scores. Most of the sample presented very difficult reading levels and only 7.4% displayed HON certification. Websites of Governmental and health-related authorship nature showed lower JAMA mean scores and quality and readability measures did not correlate to the webpages content type. Conclusion: COVID-19 related contents available online were considered of low to moderate quality and not accessible.


title: Analysis of Epidemic Situation of New Coronavirus Infection at Home and Abroad Based on Rescaled Range (R/S) Method

text: 1Summary 1.1 Background The outbreak of the new coronavirus infection broke out in Wuhan City, Hubei Province in December 2019, and has spread to 97 countries and regions around the world. Apart from China, there are currently three other severely affected areas, namely Italy, South Korea, and Iran. This poses a huge threat to China's and even global public health security, challenges scientific research work such as disease surveillance and tracking, clinical treatment, and vaccine development, and it also brings huge uncertainty to the global economy. As of March 11, 2020, the epidemic situation in China is nearing its end, but the epidemic situation abroad is in the outbreak period. Italy has even taken measures to close the city nationwide, with a total of 118,020 cases of infection worldwide. 1.2 Method This article selects the data of newly confirmed cases of COVID-19 at home and abroad as the data sample. Among them: the data of newly confirmed cases abroad is represented by Italy, and the span is from February 13 to March 10. The data of newly confirmed cases at home are divided into two parts: Hubei Province and other provinces except Hubei Province, spanning from January 23 to March 3, and with February 12 as the cutting point, it is divided into two periods, the growth period and the recession period. The rescaled range (R / S) analysis method and the dimensionless fractal Hurst exponent are used to measure the correlation of time series to determine whether the time series conforms to the fractal Brownian motion, that is, a biased random process. Contrast analysis of the meaning of H value in different stages and different overall H values in the same stage. 1.3 Results Based on R / S analysis and calculated Hurst value of newly confirmed cases in Hubei and non-Hubei provinces, it was found that the H value of Hubei Province in the first stage was 0.574, which is greater than 0.5, indicating that the future time series has a positive correlation and Fractal characteristics; The H value in the second stage is 1.368, which is greater than 1, which indicates that the future epidemic situation is completely preventable and controllable, and the second stage has a downward trend characteristic, which indicates that there is a high probability that the future time series will decline. The H values of the first and second stages of non-Hubei Province are 0.223 and 0.387, respectively, which are both less than 0.5, indicating that the time series of confirmed cases in the future is likely to return to historical points, and the H value in the second stage is greater than that in the first stage, indicating that the time series of confirmed cases in the second stage is more long-term memory than the time series of confirmed cases in the first stage. The daily absolute number of newly confirmed cases in Italy was converted to the daily growth rate of confirmed cases to eliminate the volatility of the data. The H value was 1.853, which was greater than 1, indicating that the time series of future confirmed cases is similar to the trend of historical changes. The daily rate of change in cases will continue to rise. 1.4 Conclusion According to the different interpretation of the H value obtained by the R / S analysis method, hierarchical isolation measures are adopted accordingly. When the H value is greater than 0.5, it indicates that the development of the epidemic situation in the area has more long-term memory, that is, when the number of confirmed cases in the past increases rapidly, the probability of the time series of confirmed cases in the future will continue the historical trend. Therefore, it is necessary to formulate strict anti-epidemic measures in accordance with the actual conditions of various countries, to detect, isolate, and treat early to reduce the base of infectious agents.


title: The definition and risks of Cytokine Release Syndrome-Like in 11 COVID-19-Infected Pneumonia critically ill patients: Disease Characteristics and Retrospective Analysis

text: IMPORTANCE: COVID-19-infected pneumonia patients with severe immune abnormalities and risk of cytokine release syndrome. The definition, prevention, and treatment of COVID-19-infected pneumonia in critically ill patients with cytokine release syndrome symptoms is an important problem.


title: Modelling fatality curves of COVID-19 and the effectiveness of intervention strategies

text: The main objective of the present paper is twofold: first, to model the fatality curves of the COVID-19 disease, as represented by the cumulative number of deaths as a function of time; and second, to use the corresponding mathematical model to study the effectiveness of possible intervention strategies. We applied the Richards growth model (RGM) to the COVID-19 fatality curves from several countries, where we used the data from the Johns Hopkins University database up to April 1, 2020. Countries selected for analysis were China, Italy, Spain, Iran, and Brazil. The RGM was shown to describe very well the fatality curves of China, which is in a late stage of the COVID-19 outbreak, as well as of Italy, Spain, and Iran, which supposedly are in the middle of the outbreak at the time of this writing. As for Brazil, which is still in the so-called exponential growth regime, we used the generalized growth model which is more appropriate for such cases. An analytic formula for the efficiency of intervention strategies within the context of the RGM is derived. Our findings show that there is only a narrow window of opportunity, after the onset of the epidemic, during which effective countermeasures can be taken. We applied our intervention model to the COVID-19 fatality curve of Italy to illustrate the effect of several possible interventions.


COVID-19 Pandemic in India: What Lies Ahead-Letter to the Editor: Mitra P, Misra S, Sharma P. COVID-19 Pandemic in India: What Lies Ahead [published online ahead of print, 2020 Apr 20]. Indian J Clin Biochem. 2020;1–3. doi: https://doi.org/10.1007/s12291-020-00886-6


title: Meteorological Conditions and Covid-19 in Large U.S. Cities

text: To determine whether prevalence of Coronavirus disease 2019 (Covid-19) is modulated by meteorological conditions, we herein conducted meta-regression of data in large U.S. cities. We selected 33 large U.S. cities with a population of >500,000. The integrated numbers of confirmed Covid-19 cases in the country to which the city belongs on 14 May 2020, the estimated population in 2019 in the country, and monthly meteorological conditions at the city for 4 months (from January to April 2020) were obtained. Meteorological conditions consisted of mean temperature (F), total precipitation (inch), mean wind speed (MPH), mean sky cover, and mean relative humidity (%). Monthly data for 4 months were averaged or integrated. The Covid-19 prevalence was defined as the integrated number of Covid-19 cases divided by the population. Random-effects meta-regression was performed by means of OpenMetaAnalyst. In a meta-regression graph, Covid-19 prevalence (plotted as the logarithm transformed prevalence on the y-axis) was depicted as a function of a given factor (plotted as a meteorological datum on the x-axis). A slope of the meta-regression line was significantly negative (coefficient, -0.069; P < 0.001) for the mean temperature and significantly positive for the mean wind speed (coefficient, 0.174; P = 0.027) and the sky cover (coefficient, 2.220; P = 0.023). In conclusion, lower temperature and higher wind speed/sky cover may be associated with higher Covid-19 prevalence, which should be confirmed by further epidemiological researches adjusting for various risk and protective factors (in addition to meteorological conditions) of Covid-19.


title: Discovery of a 382-nt deletion during the early evolution of SARS-CoV-2

text: To date, the SARS-CoV-2 genome has been considered genetically more stable than SARS-CoV or MERS-CoV. Here we report a 382-nt deletion covering almost the entire open reading frame 8 (ORF8) of SARS-CoV-2 obtained from eight hospitalized patients in Singapore. The deletion also removes the ORF8 transcription-regulatory sequence (TRS), which in turn enhances the downstream transcription of the N gene. We also found that viruses with the deletion have been circulating for at least four weeks. During the SARS-CoV outbreak in 2003, a number of genetic variants were observed in the human population [1], and similar variation has since been observed across SARS-related CoVs in humans and bats. Overwhelmingly these viruses had mutations or deletions in ORF8, that have been associated with reduced replicative fitness of the virus [2]. This is also consistent with the observation that towards the end of the outbreak sequences obtained from human SARS cases possessed an ORF8 deletion that may be associated with host adaptation [1]. We therefore hypothesise that the major deletion revealed in this study may lead to an attenuated phenotype of SARS-CoV-2.


title: Fighting Against COVID‐19 through Government Initiatives and Collaborative Governance: Taiwan Experience

text: Taiwan is situated less than 200 km from the first Covid‐19 outbreak state, China, and has millions of international visitors yearly. Taiwan's collective efforts to block and eliminate the invisible enemy (Covid‐19) from the island, have resulted in relatively low infection and death numbers, and were hailed as a successful anomaly amid the global pandemic. In this review, I pinpoint some background on the systems and organizations that helped Taiwan streamline a task force (Command Center) in a timely manner to launch related initiatives, mobilize the public, and engage private resources to implement the strategies and policies which were further enhanced by collaborative behaviors and volunteers. Also, even subject to similar threatening conditions such as cruise ship stopover and numerous foreign immigrant workers, there were no outbreaks of community infection in Taiwan similar to Singapore, Japan, etc. Taiwan's successful measures offer good example for future comparative studies. This article is protected by copyright. All rights reserved.


title: Disparities in COVID-19 related knowledge, attitudes, beliefs and behaviours by health literacy

text: Objectives: To explore the variation in understanding, attitudes and uptake of COVID-19 health advice during the 2020 pandemic lockdown by health literacy. Study design: National cross sectional community survey. Setting: Australian general public. Participants: Adults aged over 18 years (n=4362). Main outcome measures: Knowledge, attitudes and behaviours related to COVID-19; health literacy and socio-demographic factors. Results: People with inadequate health literacy had poorer understanding of COVID-19 symptoms (49% vs 68%; p<0.001), were less able to identify behaviours to prevent infection (59% vs 72%; p<0.001), and experienced more difficulty finding information and understanding government messaging about COVID-19 than people with adequate health literacy. They were less likely to rate social distancing as important (6.1 vs 6.5, p<0.001) and reported more difficulty remembering/accessing medication since lockdown (3.6 vs 2.7, p<0.001). Importantly there was higher endorsement of misinformation beliefs related to COVID-19 and vaccination in people with lower health literacy. Similar results were observed among people who primarily speak a language other than English at home. Conclusion: Our findings show important disparities by health literacy and language in COVID-19 related knowledge, attitudes and behaviours that have the potential to undermine efforts to reduce viral transmission and may lead to social inequalities in health outcomes in Australia. Those with the greatest burden of chronic disease are most disadvantaged, and most likely to experience severe disease and die from COVID-19. Addressing the health literacy needs of the community in public health messaging about COVID-19 must now be a priority in Australia.


title: Humidifier Use and Prone Positioning in a Patient with Severe COVID-19 Pneumonia and Endotracheal Tube Impaction Due to Highly Viscous Sputum

text: COVID-19 can lead to severe pneumonia, requiring mechanical ventilation. While increased sputum secretion could cause airway obstruction during mechanical ventilation, there are few reported cases in the literature. We report a case of a 65-year-old man with diabetes and severe COVID-19 pneumonia requiring mechanical ventilation and treated with hydroxychloroquine, azithromycin, nafamostat, and prone positioning. Initially, mechanical ventilation consisted of a heat moisture exchanger, endotracheal tube aspiration, and subglottic secretion drainage using a closed suction system. However, endotracheal tube impaction by highly viscous sputum occurred during this mechanical ventilation system. Replacing the endotracheal tube, the use of a humidifier instead of a heat moisture exchanger, and prone positioning contributed to the patient being weaned off mechanical ventilation. Although anti-aerosol measures are important for severe COVID-19 pneumonia, attention should be given to potential endotracheal tube impaction during mechanical ventilation.


title: Rheumatology Drugs and COVID-19

text: Glucocorticoids have been used to treat SARS-CoV in 2003 but were associated with considerable side effects such as avascular bone necrosis [24] Glucocorticoids may also delay viral clearance and may lead to secondary infections in patients with MERS coronavirus infection [25] In fact, randomized controlled trials did not show benefit of glucocorticoids and may even aggravate lung injury in MERS and H1N1 pneumonia [26,27] With the availability of more targeted biological agents, glucocorticoids are currently out of favor for the treatment of severe COVID-19 The non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used by rheumatologists for pain related to arthritis and myalgia Ibuprofen was commonly prescribed for early symptoms of COVID-19 in Italy and has been attributed to have caused the progression of infection because of its anti-inflammatory effects required for viral clearance [28] Although the deleterious effect of NSAIDs has yet to be confirmed, some European authorities have advised against their use in COVID-19 infection Several drugs commonly used by rheumatologists have been proposed to have potential efficacy in COVID-19 Rheumatologists may be consulted for the precautions and monitoring of these drugs should they be used in severe COVID-19 The optimal dosages of these agents in the treatment of COVID-19 have to be explored further On the other hand, a linkage between micro-organisms and the onset of autoimmune diseases has long been suggested [29] It is of intense interest to watch out for the incidence of rheumatic diseases in the next 12 to 24 months in our locality The COVID-19 Global Rheumatology Alliance has created a registry to capture rheumatology patients who have been infected with COVID-19 [30]


title: Deep learning Enables Accurate Diagnosis of Novel Coronavirus (COVID-19) with CT images

text: Background A novel coronavirus (COVID-19) has emerged recently as an acute respiratory syndrome. The outbreak was originally reported in Wuhan, China, but has subsequently been spread world-widely. As the COVID-19 continues to spread rapidly across the world, computed tomography (CT) has become essentially important for fast diagnoses. Thus, it is urgent to develop an accurate computer-aided method to assist clinicians to identify COVID-19-infected patients by CT images. Materials and Methods We collected chest CT scans of 88 patients diagnosed with the COVID-19 from hospitals of two provinces in China, 101 patients infected with bacteria pneumonia, and 86 healthy persons for comparison and modeling. Based on the collected dataset, a deep learning-based CT diagnosis system (DeepPneumonia) was developed to identify patients with COVID-19. Results The experimental results showed that our model can accurately identify the COVID-19 patients from others with an excellent AUC of 0.99 and recall (sensitivity) of 0.93. In addition, our model was capable of discriminating the COVID-19 infected patients and bacteria pneumonia-infected patients with an AUC of 0.95, recall (sensitivity) of 0.96. Moreover, our model could localize the main lesion features, especially the ground-glass opacity (GGO) that is of great help to assist doctors in diagnosis. The diagnosis for a patient could be finished in 30 seconds, and the implementation on Tianhe-2 supercompueter enables a parallel executions of thousands of tasks simultaneously. An online server is available for online diagnoses with CT images by http://biomed.nscc-gz.cn/server/Ncov2019. Conclusions The established models can achieve a rapid and accurate identification of COVID-19 in human samples, thereby allowing identification of patients.


title: Rapid assessment of ligand binding to the SARS-CoV-2 main protease by saturation transfer difference NMR spectroscopy

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological cause of the coronavirus disease 2019, for which no effective therapeutics are available. The SARS-CoV-2 main protease (Mpro) is essential for viral replication and constitutes a promising therapeutic target. Recently, crystallographic fragment screening uncovered a large number of molecules binding at the Mpro active site as well as at sites of potential allostery. However, no information on fragment affinity is available. Here, we describe an efficient protocol for screening chemical compounds for binding to Mpro using saturation transfer difference nuclear magnetic resonance (STD-NMR) spectroscopy. We characterised the relative affinity of Mpro-binding fragments using STD-NMR, revealing a ~200-fold difference in binding potential. Combined with crystallographic structures of these fragments bound to Mpro, this information can assist ongoing drug design efforts.


title: The role of artificial intelligence and machine learning techniques: Race for COVID-19 vaccine

text: Context: In the healthcare system, Artificial Intelligence (AI) is emerging as a productive tool. There are instances where AI has done marvels in the diagnosis of various health conditions and the interpretation of complex medical disorders. Although AI is far from human intelligence, it can be used as an effective tool to study the SARS-CoV-2 and its capabilities, virulence, and genome. The progress of the pandemic can be tracked, and the patients can be monitored, thereby speeding up the research for the treatment of COVID-19. In this review article, we highlighted the importance of AI and Machine learning (ML) techniques that can speed up the path to the discovery of a possible cure for COVID-19. We also deal with the interactions between viromics and AI, which can hopefully find a solution to this pandemic. Evidence Acquisition: A review of different articles was conducted using the following databases: MEDLINE/PubMed, SCOPUS, Web of Science, ScienceDirect, and Google Scholar for recent studies regarding the use of AI, seeking the spread of different infectious diseases using relevant MeSH subheadings. Results: After a thorough screening of different articles, 30 articles were considered, and key information was obtained from them. Finally, the scope was broadened to obtain more information. Our findings indicated that AI/ML is a promising approach to drug development. Conclusions: The field of AI has enormous potential to predict the changes that may take place in the environment. If this technology is applied to situations of a pandemic such as COVID-19, breakthroughs could potentially pave the way for new vaccines and antiviral drugs.


title: The Framework for the Prediction of the Critical Turning Period for Outbreak of COVID-19 Spread in China based on the iSEIR Model

text: The goal of this study is to establish a general framework for predicting the so-called critical Turning Period in an infectious disease epidemic such as the COVID-19 outbreak in China early this year. This framework enabled a timely prediction of the turning period when applied to Wuhan COVID-19 epidemic and informed the relevant authority for taking appropriate and timely actions to control the epidemic. It is expected to provide insightful information on turning period for the world's current battle against the COVID-19 pandemic. The underlying mathematical model in our framework is the individual Susceptible-Exposed-Infective-Removed (iSEIR) model, which is a set of differential equations extending the classic SEIR model. We used the observed daily cases of COVID-19 in Wuhan from February 6 to 10, 2020 as the input to the iSEIR model and were able to generate the trajectory of COVID-19 cases dynamics for the following days at midnight of February 10 based on the updated model, from which we predicted that the turning period of CIVID-19 outbreak in Wuhan would arrive within one week after February 14. This prediction turned to be timely and accurate, providing adequate time for the government, hospitals, essential industry sectors and services to meet peak demands and to prepare aftermath planning. Our study also supports the observed effectiveness on flatting the epidemic curve by decisively imposing the Lockdown and Isolation Control Program in Wuhan since January 23, 2020. The Wuhan experience provides an exemplary lesson for the whole world to learn in combating COVID-19.


title: Delayed clearance of SARS-CoV2 in male compared to female patients: High ACE2 expression in testes suggests possible existence of gender-specific viral reservoirs

text: The novel coronavirus SARS-CoV2 has been observed to cause a higher incidence and greater severity of disease in males, as seen in multiple cohorts across the globe. The reasons for gender disparity in disease severity is unclear and can be due to host factors. To determine whether males have delayed viral clearance after infection, we evaluated the time to clearance in symptomatic patients tested by serial oropharyngeal/nasopharyngeal swabs followed by RT-PCR at a reference lab in Mumbai, India. A total of 68 subjects with median age of 37 years (3-75 range) were examined and included 48 (71%) males and 20 (29%) females. We observed that females were able to achieve viral clearance significantly earlier than males, with a median difference of 2 days in achieving a negative PCR result (P value = 0.038). Furthermore, examination of 3 families with both male and female patients followed serially, demonstrated that female members of the same household cleared the SARS-CoV2 infection earlier in each family. To determine reasons for delayed clearance in males, we examined the expression patterns of the SARS-CoV2 receptor, Angiotensin-converting enzyme 2 (ACE2), in tissue specific repositories. We observed that the testes was one of the highest sites of ACE2 expression in 3 independent RNA expression databases (Human Protein Atlas, FAMTOM5 and GETx). ACE2 was also determined to be highly expressed in testicular cells at the protein levels. Interestingly, very little expression of ACE2 was seen in ovarian tissue. Taken together, these observations demonstrate for the first time that male subjects have delayed viral clearance of SARS-CoV2. High expression of ACE2 in testes raises the possibility that testicular viral reservoirs may play a role in viral persistence in males and should be further investigated.


title: Diagramming the uncertainties of COVID-19: Scales, spatialities, and aesthetics

text: Diagrams of COVID-19 inform individuals how to enact specific spatial, mobile, and bodily practices. This commentary employs a non-representational lens to show how certain aesthetics used in diagramming the virus may accentuate existing public feelings of uncertainty, emergency, or threat.


title: Bayesian modeling of COVID-19 cases with a correction to account for under-reported cases

text: The novel of COVID-19 disease started in late 2019 making the worldwide governments came across a high number of critical and death cases, beyond constant fear of the collapse in their health systems. Since the beginning of the pandemic, researchers and authorities are mainly concerned with carrying out quantitative studies (modeling and predictions) overcoming the scarcity of tests that lead us to under- reporting cases. To address these issues, we introduce a Bayesian approach to the SIR model with correction for under-reporting in the analysis of COVID-19 cases in Brazil. The proposed model was enforced to obtain estimates of important quantities such as the reproductive rate and the average infection period, along with the more likely date when the pandemic peak may occur. Several under-reporting scenarios were considered in the simulation study, showing how impacting is the lack of information in the modeling.


Is reporting many cases of COVID-19 in Iran due to strength or weakness of iran’s health system?


title: Comparison of Cepheid Xpert Xpress and Abbott ID Now to Roche cobas for the Rapid Detection of SARS-CoV-2

text: The SARS-CoV-2 pandemic has created an urgent and unprecedented need for rapid large-scale diagnostic testing to inform timely patient management. This study compared two recently-authorized rapid tests, Cepheid Xpert Xpress SARS-CoV-2 and Abbott ID Now SARS-CoV-2 to the Roche cobas SARS-CoV-2 assay. A total of 113 nasopharyngeal swabs were tested, including 88 positives spanning the full range of observed Ct values on the cobas assay. Compared to cobas, the overall positive agreement was 73.9% with ID Now and 98.9% with Xpert. Negative agreement was 100% and 92.0% for ID Now and Xpert, respectively. Both ID Now and Xpert showed 100% positive agreement for medium and high viral concentrations (Ct value <30). However, for Ct values >30, positive agreement was 34.3% for ID Now and 97.1% for Xpert. These findings highlight an important limitation of ID Now for specimens collected in viral or universal transport media with low viral concentrations. Further studies are needed to evaluate the performance of ID Now for direct swabs.


title: Characterization of clinical progression of COVID-19 patients in Shenzhen, China

text: The COVID-19 pandemic has stressed healthcare care systems throughout the world. Understanding clinical progression of cases is a key public health priority that informs optimal resource allocation during an emergency. Using data from Shenzhen, China, where all cases were monitored in hospital and symptom profiles and clinical and lab results were available starting from early stages of clinical course, we characterized clinical progression of COVID-19 cases and determined important predictors for faster clinical progression to key clinical events and longer use of medical resources. Epidemiological, demographic, laboratory, clinical, and outcome data were extracted from electronic medical records. We found that those who progressed to the severe stage, developed acute respiratory distress syndrome, and were admitted to the intensive care unit (ICU) progressed on average 9.5 days (95%CI 8.7,10.3), 11.0 days (95%CI 9.7,12.3), and 10.5 days (95%CI 8.2,13.3) after symptom onset, respectively. We estimated that patients who were admitted to ICUs remained there for an average of 34.4 days (95%CI 24.1,43.2) and the average time on a ventilator was 28.5 days (95%CI 20.0,39.1) among those requiring mechanical ventilation. The median length of hospital stay was 21.3 days (95%CI, 20.5, 22.2) for the mild or moderate cases who did not progress to the severe stage, but increased to 52.1 days (95%CI, 43.3, 59.5) for those who required ICU admission. Clear characterization of clinical progression informs planning for healthcare resource allocation during COVID-19 outbreaks and provides a basis that helps assess the effectiveness of new treatment and therapeutics.


title: Brief Analysis of the ARIMA model on the COVID-19 in Italy

text: Coronavirus disease 2019 (COVID-19) has been considered as a global threat infectious disease, and various mathematical models are being used to conduct multiple studies to analyze and predict the evolution of this epidemic. We statistically analyze the epidemic data from February 24 to March 30, 2020 in Italy, and proposes a simple time series analysis model based on the Auto Regressive Integrated Moving Average (ARIMA). The cumulative number of newly diagnosed and newly diagnosed patients in Italy is preprocessed and can be used to predict the spread of the Italian COVID-19 epidemic. The conclusion is that an inflection point is expected to occur in Italy in early April, and some reliable points are put forward for the inflection point of the epidemic: strengthen regional isolation and protection, do a good job of personal hygiene, and quickly treat the team leaders existing medical forces. It is hoped that the "City Closure" decree issued by the Italian government will go in the right direction, because this is the only way to curb the epidemic.


title: Anomaly detection methods in turning based on motor data analysis

text: Abstract A cutting anomaly can be detected by using machine learning and pattern recognition in addition to the conventional method of using cutting knowledge to determine the criteria of detection. However, it is difficult to guarantee that all cutting anomalies can be detected during mass production due to various events that can occur. Moreover, machine learning and pattern recognition are not systemized for use in mass production. In this work, we investigated the detection of turning anomalies during mass production under optimized cutting conditions. We applied a method that utilizes the motor current of each operating axis to monitor the machining state without affecting the machining process and determines the correlation between turning anomalies and motor data. Our target was the unsteady anomalies that appear in mass production, such as chip biting and tool vibration. On the basis of the obtained correlation, we developed a formalized anomaly detection method using traditional statistics and a systemized anomaly detection method using discretization and pattern recognition based on the Mahalanobis Taguchi method with auto parameter tuning to eliminate the need for detailed analysis based on knowledge of cutting phenomena. Both methods achieved a detection accuracy of over 98%.


title: Fibrinolytic Therapy for Refractory COVID‐19 Acute Respiratory Distress Syndrome: Scientific Rationale and Review

text: The COVID‐19 pandemic has caused respiratory failure and associated mortality in numbers that have overwhelmed global health systems. Thrombotic coagulopathy is present in nearly three‐quarters of COVID‐19 patients admitted to the intensive care unit, and both the clinical picture and pathologic findings are consistent with microvascular occlusive phenomena being a major contributor to their unique form of respiratory failure. Numerous studies are ongoing focusing on anti‐cytokine therapies, antibiotics and anti‐viral agents, but none to‐date have focused on treating the underlying thrombotic coagulopathy in an effort to improve respiratory failure in COVID‐19. There is animal data and a previous human trial demonstrating a survival advantage with fibrinolytic therapy to treat ARDS. Here we review the extant and emerging literature on the relationship between thrombotic coagulopathy and pulmonary failure in the context of COVID‐19 and present the scientific rationale for consideration of targeting the coagulation and fibrinolytic systems to improve pulmonary function in these patients.


title: Psychiatric Symptoms Related to the COVID-19 Pandemic

text: The COVID-19 pandemic and the consequential societal changes are likely to have major health consequences way beyond those caused by the virus infection. One of the medical fields that may experience significant consequences of the pandemic is that of psychiatry. Importantly, individuals who already live with mental disorders may be particularly vulnerable to the psychological stress associated with the pandemic. However, data on how the COVID-19 pandemic affects this group of people is largely absent from the literature. Here, we report data from a quality development project conducted at the psychiatric services of the Central Denmark Region (CDR), which has a catchment area of approximately 1.3 million people covered by five psychiatric hospitals providing inpatient and outpatient treatment of all types of mental disorders. Based on a manual screening of all clinical notes from the period from February 1st to March 23rd 2020 that contained at least one of the following words: corona, COVID, virus, epidemic, pandemic, and contaminate/contamination (including compound words), we found 1357 notes from 918 adult patients that described pandemic-related psychopathology (symptoms that appeared to be caused/deteriorated by the pandemic and/or its societal consequences). To our knowledge, this is the first investigation of COVID-19 pandemic-related psychopathology from a large psychiatric treatment setting. The results clearly suggest that this phenomenon exists among individuals with mental illness. However, as the data from this investigation stems from standard clinical practice where the patients were not systematically assessed for pandemic-related psychopathology, we cannot speak to its overall prevalence. Nevertheless, we believe that our findings underline the necessity of taking urgent action to mitigate the negative effects of the COVID-19 pandemic on patients with mental disorders. A low-cost intervention would be to simply discuss the ongoing pandemic and its societal consequences with patients seeking care in psychiatric settings - as this may lead to relief of pandemic-related symptoms via general comforting, and clarification of misunderstandings/false beliefs regarding the pandemic.


Breaking News: Brace for Chloroquine Poisonings from the Pandemic


title: Social laser model for the Bandwagon effect: generation of coherent information waves

text: During the last years our society was often exposed to the coherent information waves of high amplitudes. These are waves of huge social energy. Often they are of the destructive character, a kind of information tsunami. But, they can carry as well positive improvements in the human society, as waves of decision making matching rational recommendations of societal institutes. The main distinguishing features of these waves are their high amplitude, coherence (homogeneous character of social actions generated by them), and short time needed for their generation and relaxation. Such waves can be treated as large scale exhibition of the Bandwagon effect. We show that this socio-psychic phenomenon can be modeled on the basis of the recently developed {\it social laser theory}. This theory can be used to model {\it stimulated amplification of coherent social actions}."Actions"are treated very generally, from mass protests to votes and other collective decisions, as, e.g., acceptance (often unconscious) of some societal recommendations. In this paper, we concentrate on theory of laser resonators, physical vs. social. For the latter, we analyze in very detail functioning of the internet based Echo-Chambers. Their main purpose is increasing of the power of the quantum information field as well as its coherence. Of course, the Bandwagon effect is well known and well studied in social psychology. However, the social laser theory gives the possibility to model it by using the general formalism of quantum field theory. The paper contains minimum of mathematics and it can be readable by researchers working in psychology, cognitive, social, and political sciences; it might also be interesting for experts in information theory and artificial intelligence.


title: A case of COVID-19 with tuberculous meningitis/ 新型冠状病毒肺炎合并结核性脑膜炎一例

text: COVID⁃19 is caused by a new coronavirus that infects the lungs. Although some patients with COVID⁃19 may be combined with neurological symptoms, there is no direct evidence that this new coronavirus can directly invade nerve system. A case of COVID⁃19 with tuberculous meningitis is reported to remind that when patients with COVID⁃19 present symptom of encephalitis or meningitis, a comprehensive pathogen examination is recommended.


title: Rapid Epidemiological Analysis of Comorbidities andTreatments as risk factors for COVID-19 in Scotland(REACT-SCOT): a population-based case-control study

text: Background: Why some people infected with SARS-CoV-2 develop severe COVID-19 disease and others do not is poorly understood. The objectives of this study were to identify risk factors for severe disease and to lay the basis for risk stratification based on demographic data and health records. Methods: The design was a matched case-control study. Cases were ascertained as all those with a positive nucleic acid test for SARS-CoV-2 in the national virology laboratory database. Those who had been admitted to a critical care unit or had died within 28 days of a positive test were classified as severe cases. For each case, ten controls matched for sex, age and primary care practice were selected from the population register. For cases and controls we extracted all diagnostic codes from the past five years of hospital discharge records, all drug codes from prescriptions encashed during the past nine months and we linked to the national diabetes register. Rate ratios for associations with severe COVID-19 were estimated by conditional logistic regression. The performance of predictive models for severe COVID-19 was estimated by cross-validation. Findings:In a logistic regression based on the age-sex distribution of the national population, the odds ratios were 2.26 for a 10-year increase in age and 1.86 for male sex. In the case-control analysis, the strongest risk factor was residence in a care home, with rate ratio (95% CI) 14.9 (12.7, 17.5). Univariate rate ratios (95% CIs) for conditions listed by public health agencies as conferring high risk were 4.88 (3.26, 7.31) for Type 1 diabetes, 2.58 (2.30, 2.88) for Type 2 diabetes, 2.40 (2.14, 2.70) for ischemic heart disease, 3.90 (3.52, 4.32) for other heart disease, 3.10 (2.81, 3.42) for chronic lower respiratory tract disease, 12.1 (8.4, 17.4) for chronic kidney disease, 5.5 (4.8, 6.2) for neurological disease, 4.70 (2.90, 7.62) for chronic liver disease and 4.11 (2.72, 6.21) for immune deficiency or suppression. 1443 (65%) of the severe cases and 6536 (30%) of the controls had at least one of these listed conditions. In those aged under 40 years the frequencies of any listed condition were 26 (43%) in cases and 46 (8%) in controls. The odds ratio for severe disease associated with encashment of at least one prescription in the past year was 16.6 (13.3, 20.6) and the odds ratio associated with at least one hospital admission in the past five years was 5.6 (5.0, 6.2); these associations remained strong and significant after adjusting for the listed conditions. Most cases without listed conditions had either prescriptions or hospitalisations, and highly significant associations with severe disease were seen across many hospital diagnoses and drug categories. A predictive model based on age and sex alone had an expected information for discrimination of 1.81 bits. In the model conditional on age and sex further demographic variables provided another 0.46 bits, and this increased to 0.89 bits when listed conditions were included, and to 1.5 bits when indicator variables for hospital diagnoses and prescription encashments were also included. Conclusions:Along with older age and male sex, severe COVID-19 disease is strongly associated with past medical history; most younger persons developing severe disease have an underlying medical condition. The comorbidities associated with increased risk are not limited to the lists of risk conditions designated by public health agencies. A risk classifier that uses all the information available in medical and prescribing records, rather than only a limited set of conditions, will more accurately discriminate between low-risk and high-risk individuals who may require shielding until the SARS-CoV-2 epidemic is over.


title: Novel coronavirus pneumonia combined with conjunctivitis: three cases report/ 新型冠状病毒肺炎合并结膜炎三例

text: Since January 2020, as ophthalmologists working at the center of the novel coronavirus pneumonia (COVID-19) outbreak in Wuhan, China, we found 3 cases in 30 COVID-19 patients with binocular conjunctivitis.Of them, one case visited for conjunctivitis as a first symptom and then diagnosed as COVID-19 three days later, and two cases visited for binocular conjunctivitis during the COVID-19 onset.In 3 patients, conjunctivitis was manifested as signs of viral conjunctivitis from mild to moderate.The symptoms of two patients disappeared after treatment of antiviral eyedrops for 7 to 10 days and another patient died of COVID-19.Interestingly, although we detected positive viral nucleic acid in the conjunctiva sacs of 2 of other 27 COVID-19 patients by using swabs and RT-PCR technology, no conjunctivitis occurred in these two patients.242