title: Implicações Cardiovasculares em Pacientes Infectados com Covid-19 e a Importância do Isolamento Social para Reduzir a Disseminação da Doença./ Implicações Cardiovasculares em Pacientes Infectados com Covid-19 e a Importância do Isolamento Social para Reduzir a Disseminação da Doença./ Cardiovascular Implications in Patients Infected with Covid-19 and the Importance of Social Isolation to Reduce Dissemination of the Disease

text: Respiratory symptoms, especially the development of severe acute respiratory distress syndrome, dominate the discussion and initial concerns of the population and health professionals. However, the cardiovascular system is greatly affected by these conditions and is often responsible for complications and mortality of these patients. In order to show the cardiovascular implications in patients infected with COVID-19 and the importance of social isolation as an alternative to curb the spread of the disease, a literature review was carried out based on 37 articles, in English, Portuguese and Spanish, available on Scielo and PubMed. The findings showed that cardiac complications associated with COVID-19 infection are similar to those produced by: severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and influenza. However, COVID-19 has a much greater and faster contamination and, unlike influenza, there is no vaccine or treatment available yet. In view of this, social isolation becomes a tool that can reduce and flatten the curve of cases and thus protect the people at higher risk, decreasing the chances of serious conditions related to the disease, potential deaths and the collapse of the country's health system.


Coronavirus y personal de la salud


The Urgency of Care during the Covid-19 Pandemic - Learning as We Go


title: Universal Masking during Covid-19 Pandemic - Current Evidence and Controversies

text: The emergence of coronavirus disease 19 pandemic and novel research on the high transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised controversies over the use of face masks to prevent community transmission. Specific regulations need to be fulfilled to use a face mask as part of the personal protective equipment and high quality of evidence supporting its use to prevent respiratory viral infections, including SARS-CoV-2, is lacking. However, its widespread use is becoming a standard practice in some countries and discrepancies between health authorities on their policy have led to controversy. The aim of this review is to provide an outlook on recent research in this matter and areas of opportunity.


The need for neurologists in the care of COVID-19 patients


title: The Exponential Phase of the Covid-19 Pandemic in Central Italy: An Integrated Care Pathway

text: The Coronavirus Disease (Covid-19) pandemic is rapidly spreading across the world, representing an unparalleled challenge for health care systems. There are differences in the estimated fatality rates, which cannot be explained easily. In Italy, the estimated case fatality rate was 12.7% in mid-April, while Germany remained at 1.8%. Moreover, it is to be noted that different areas of Italy have very different lethality rates. Due to the complexity of Covid-19 patient management, it is of paramount importance to develop a well-defined clinical workflow in order to avoid the inconsistent management of patients. The Integrated Care Pathway (ICP) represents a multidisciplinary outline of anticipated care to support patient management in the Sant'Andrea Hospital, Rome. The main objective of this pilot study was to develop a new ICP evaluated by care indicators, in order to improve the COVID-19 patient management. The suggested ICP was developed by a multi-professional team composed of different specialists and administrators already involved in clinical and management processes. After a review of current internal practices and published evidences, we identified (1) the activities performed during care delivery, (2) the responsibilities for these activities, (3) hospital structural adaptation needs and potential improvements, and (4) ICP indicators. The process map formed the basis of the final ICP document; 160 COVID-19 inpatients were considered, and the effect of the ICP implementation was evaluated over time during the exponential phase of the COVID-19 pandemic. In conclusion, a rapid adoption of ICP and regular audits of quality indicators for the management of COVID-19 patients might be important tools to improve the quality of care and outcomes.


title: Assessing ACE2 expression patterns in lung tissues in the pathogenesis of COVID-19

text: It has been reported that SARS-CoV-2 may use ACE2 as a receptor to gain entry into human cells, in a way similar to that of SARS-CoV. Analyzing the distribution and expression level of ACE2 may therefore help reveal underlying mechanisms of viral susceptibility and post-infection modulation. In this study, we utilized previously uploaded information on ACE2 expression in various conditions including SARS-CoA to evaluate the role of ACE2 in SARS-CoV and extrapolate that to COVID-19. We found that the expression of ACE2 in healthy populations and patients with underlying diseases was not significantly different. However, based on the elevated expression of ACE2 in cigarette smokers, we speculate that long-term smoking may be a risk factor for COVID-19. Analysis of ACE2 in SARS-CoV infected cells suggests that ACE2 is not only a receptor but is also involved in post-infection regulation, including immune response, cytokine secretion, and viral genome replication. Moreover, we constructed Protein-protein interaction (PPI) networks and identified hub genes in viral activity and cytokine secretion. Our findings may help clinicians and researchers gain more insight into the pathogenesis of SARS-CoV-2 and design therapeutic strategies for COVID-19.


Lidocaine during intubation and extubation in patients with coronavirus disease (COVID-19)


N95 respirator associated pressure ulcer amongst COVID-19 health care workers


EHRA 2020 during COVID-19 days


title: Coronavirus: una amplia familia de virus no tan nueva

text: Empiezo esta comunicación, invitándolos a una breve reflexión acerca del manejo de la información que se recibe y difunde en estos tiempos de pandemia Ante la emergencia sanitaria que se vive en el mundo por la expansión de la Covid-19, uno de los aspectos que se pro-paga rápidamente y es igual de peligroso que el propio virus son las noticias falsas y la desinformación, lo cual ha generado un fenómeno que la Organización Mundial de la Salud (OMS) nombró como infodemia Otro fenómeno que acompaña a la pandemia de la covid-19 es la infoxicación Es decir, la sobrecarga informativa Por ejemplo, realizando una búsqueda el dia 6 de mayo de 2020 en google empleando las palabras coronavirus covid-19, el buscador nos arroja 2,800,000,000 de resultados asocia-dos a la búsqueda, lo cual representa un cúmulo de información y ello se magnifica en importancia si se tiene en cuenta lo relativamente nueva que es la pandemia


Keeping up with studies on covid-19: systematic search strategies and resources


title: Proposed Intranasal Route for Drug Administration in the Management of Central Nervous System Manifestations of COVID-19

text: There is mounting evidence of the central nervous system manifestations associated with COVID-19, particularly in severe cases. Up to 25% of COVID-19 cases exhibit neurological manifestations associated with COVID-19. In view of the devastating nature of the disease due to severe acute respiratory syndrome coronavirus 2, here we debate intranasal drug delivery, in addition to intravenous delivery, as a therapeutic strategy in the management of COVID-19 cases with central nervous system involvement.


Covid-19: Don't forget the impact on US family physicians


Risk factors for facial pressure sore of healthcare workers during the outbreak of COVID-19


[Detection of 2019-nCoV in the pathological paraffin embedded tissue]


title: Varying Presentations and Favourable Outcomes of COVID-19 Infection in Children and Young Adults with Sickle Cell Disease: An Additional Case Series with Comparisons to Published Cases

text: Patients with sickle cell disease (SCD) are theoretically at greater risk for serious illness from COVID 19 due to the underlying pathophysiology of chronic inflammation with an increased risk of thrombosis, especially at the time of a vaso-occlusive event (1). Individuals living with SCD are also considered to be immunocompromised due to autoinfarction of their spleen or surgical splenectomy, often as a result of red cell splenic sequestration (2). In addition, patients with SCD often have comorbidities and secondary organ dysfunction that can put them at risk of significant morbidity and or mortality from the severe acute respiratory coronavirus 2 (SARS-CoV-2), and its subsequent disease COVID-19.


The COVID-19 Pandemic: Setting the Mental Health Research Agenda


title: Impact of VOCs emission from iron and steel industry on regional O3 and PM2.5 pollutions

text: Iron and steel industry emission is an important industrial source of air pollution. However, little is known about the relationship between volatile organic compounds (VOCs) emitted and regional air pollution. In this study, VOCs emissions from a typical iron and steel plant in Yangtze River Delta (YRD, China) were monitored from April 2018 to March 2019. The ozone formation potential (OFP) and secondary organic aerosol (SOA) formation of VOCs were calculated to reveal the influence of VOCs emissions on regional ozone and particulate pollution, and the sensitivity analysis approach was performed to explore the qualitative and quantitative relationships between VOCs and O3, as well as VOCs and PM2.5. The VOCs concentration was 93.76 ± 266.97 ppbv during the study. The OFP was 760.08 ± 2391.90 µg m-3, and aromatics were the predominant precursors, contributing 54.05% of the total OFP. Furthermore, the SOA estimated by fractional aerosol coefficient (FAC) and time-resolved (TR) methods were 6.032 ± 13.347 µg m-3 and 0.971 ± 4.650 µg m-3, accounting for 8.65-26.39% (13.78 ± 7.46%) and 1.55-4.20% (2.22 ± 1.23%) of the PM2.5 concentrations, respectively. The results indicated that VOCs were more sensitive to O3 pollution in high pollution domains, whereas VOCs were more sensitive to PM2.5 pollution in low pollution domains. We concluded that reducing VOCs emissions might be effective in alleviating photochemical pollution episodes in areas around iron and steel industry, and the haze pollution occurred in these regions may be caused by the primary emission of PM, and the contribution of SOA was relatively small.


Balancing the need for rapid and rigorous scientific data during early phase of the COVID-19 pandemic: A further role for the scientific community


title: Telemedicine and the 2019 coronavirus (SARS-CoV-2)

text: In 2020 during the CoronaVirus Disease19 (COVID19) pandemic caused by da SARS-CoV-2, the weakness of e-health (electronic health) (ie the lack of direct contact between physician and patient) may prove to be a strength, given the high contagiousness and relative lethality of the virus. In Italy the lack of preparation for supporting the patient load (shortage of personal protection devices, shortage of Intensive Care Unit) beds in comparison with other European Countries, and the poor early diagnostic and therapeutic activity has led us to suggest a project that uses an online platform between General Practitioners and patients in order to reduce moving infected individuals and to perform the diagnosis and treatment early on.


title: Telemedicine and the 2019 Coronavirus (SARS-CoV-2)

text: In 2020 during the CoronaVirus Disease19 (COVID19) pandemic caused by da SARS-CoV-2, the weakness of e-health (electronic health) (i.e. the lack of direct contact between physician and patient) may prove to be a strength, given the high contagiousness and relative lethality of the virus. In Italy the lack of preparation for supporting the patient load (shortage of personal protection devices, shortage of Intensive Care Unit (ICU) beds in comparison to other European Countries, and the poor early diagnostic and therapeutic activity) has led us to suggest a project that uses an online platform between General Practitioners and patients, in order to reduce moving infected individuals and to perform the diagnosis and treatment early on.


Susceptibility and severity of COVID-19 in patients treated with bDMARDS and tsDMARDs: a population-based study


title: Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Exam, Labs, Imaging Accuracy and Biases

text: In December 2019 a novel viral respiratory pathogen emerged in China, ultimately named severe acute respiratory syndrome coronavirus 2 (SARS-Co-V-2) with the clinical illness dubbed coronavirus disease (COVID-19). COVID-19 became a global pandemic in early 2020 forcing governments worldwide to enact social isolation policies with dire economic ramifications. Emergency departments (ED) encountered decreased patient volumes before some in Seattle, New York City, New Orleans, and Detroit experienced waves of COVID-19 patients mixed with asymptomatic patients or those concerned about potential exposures. Diagnosing COVID-19 was hampered by inadequate supplies of reagents and kits, which was compounded by clinical and radiographic features that overlap with numerous seasonal viral respiratory infections.


title: Epidemiological characteristics of and containment measures for coronavirus disease 2019 in Busan Metropolitan City, South Korea

text: Objectives: To describe and evaluate epidemiological investigation. Results: and containment measures implemented in Busan, where 108 cases were confirmed with coronavirus disease 2019 (COVID-19) between February 21 and March 24, 2020. Methods: Any individual who tested positive for COVID-19 was classified as a confirmed case. Measures were taken to identify the source of infection and trace and quarantine contacts. Serial intervals were estimated and the effective reproduction number (R_t) was computed. Results: Of the total 18,303 COVID-19 tests performed between January 16 and March 24 in Busan, 108 yielded positive. Results: (positive test rate: 0.6%). All confirmed cases were placed in isolation at hospitals. Of the 108 confirmed cases, 59 (54.6%) were female. The most common age group was 20-29 years with 37 cases (34.3%). Regarding symptoms at the time of diagnosis, cough (n=38, 35.2%) and fever (n=34, 31.5%) were most common; 12 cases (11.1%) were asymptomatic. The source of infection was identified in 99 cases (91.7%). A total of 3,223 contacts were identified and quarantined. Household contacts accounted for 196, and the household secondary attack rate (SAR) was 8.2% (95% confidence interval [CI] 4.7-12.9%). The mean serial interval was estimated to be 5.54 days (95% CI 4.08-7.01 days). After February 26, R_t remained below 1 in Busan. Conclusion: : The early containment strategy implemented in Busan shows that control is possible if outbreaks are of limited scope. In preparation for future outbreaks, public health and healthcare systems should be re-examined and put in a ready state.


title: ICT Intervention in the Containment of the Pandemic Spread of COVID-19: An Exploratory Study

text: The objective of this article is to explore the Information and Communication Technology (ICT) interventions and its strengths, weaknesses, opportunities and threats for the containment of the pandemic spread of novel Coronavirus. The research adopted a qualitative research approach, while the study data were collected through online content review and Focus Group Discussion (FGD). Starting with a preliminary set of about 1200 electronic resources or contents, 56 were selected for review study, applying an inclusion and exclusion criteria. The review study revealed ICT interventions that include websites and dashboards, mobile applications, robotics and drones, artificial intelligence (AI), data analytic, wearable and sensor technology, social media and learning tools, and interactive voice response (IVR) as well as explored their respective usages to combat the pandemic spread of COVID-19. Later, the FGD was replicated with 22 participants and explored the possible strengths, weaknesses, opportunities, and threats (SWOT) of deploying such technologies to fight against the COVID-19 pandemic. This research not only explores the exiting status of ICT interventions to fight with the COVID-19 pandemic but also provides a number of implications for the government, practitioners, doctors, policymakers and researchers for the effective utilization of the existing ICT interventions and for the future potential research and technological development to the containment of the pandemic spread of COVID-19 and future pandemics.


title: Using random testing to manage a safe exit from the COVID-19 lockdown

text: We argue that frequent sampling of the fraction of infected people (either by random testing or by analysis of sewage water), is central to managing the COVID-19 pandemic because it both measures in real time the key variable controlled by restrictive measures, and anticipates the load on the healthcare system due to progression of the disease. Knowledge of random testing outcomes will (i) significantly improve the predictability of the pandemic, (ii) allow informed and optimized decisions on how to modify restrictive measures, with much shorter delay times than the present ones, and (iii) enable the real-time assessment of the efficiency of new means to reduce transmission rates. Here we suggest, irrespective of the size of a suitably homogeneous population, a conservative estimate of 15000 for the number of randomly tested people per day which will suffice to obtain reliable data about the current fraction of infections and its evolution in time, thus enabling close to real-time assessment of the quantitative effect of restrictive measures. Still higher testing capacity permits detection of geographical differences in spreading rates. Furthermore and most importantly, with daily sampling in place, a reboot could be attempted while the fraction of infected people is still an order of magnitude higher than the level required for a relaxation of restrictions with testing focused on symptomatic individuals. This is demonstrated by considering a feedback and control model of mitigation where the feed-back is derived from noisy sampling data.


title: Potential therapeutic targets for combating SARS-CoV-2: Drug repurposing, clinical trials and recent advancements

text: The present pandemic of SARS-CoV-2 has been a tough task for the whole world to deal with. With the absence of specific drugs or vaccines against SARS-CoV-2, the situation is very difficult to control. Apart from the absence of specific therapies, the lack of knowledge about potential therapeutic targets and individual perception is adding to the complications. The present review describes the novel SARS-CoV-2 structure, surface proteins, asymptomatic and symptomatic transmission in addition to the genotype and phenotype of SARS-CoV-2 along with genetic strains and similarity between SARS, MERS and SARS-CoV-2. Therapeutic strategies such as inhibition of the endocytic pathway and suppressing RNA polymerase activity by metal ions, which could be quite beneficial for controlling COVID-19, are outlined. The drug repurposing for SARS-CoV-2 is discussed in detail along with therapeutic classes such as antivirals, antibiotics, and amino quinolones and their probable role in suppressing SARS-CoV-2 with reference to case studies. The ongoing clinical trials both with respect to drug repurposing and vaccines are summarized along with a brief description. The recent advancements and future perspective of ongoing research for therapy and detection of SARS-CoV-2 are provided. The review, in brief, summarizes epidemiology, therapy and the current scenario for combating SARS-CoV-2.


Angiotensin II for the Treatment of COVID-19-Related Vasodilatory Shock


The COVID-19 pandemic and tuberculosis in Taiwan


COVID-19 and the Inpatient Dialysis Unit: Managing Resources during Contingency Planning Pre-Crisis


title: Gene expression network analysis of lymph node involvement in colon cancer identifies AHSA2, CDK10, and CWC22 as possible prognostic markers

text: Colon cancer has been well studied using a variety of molecular techniques, including whole genome sequencing. However, genetic markers that could be used to predict lymph node (LN) involvement, which is the most important prognostic factor for colon cancer, have not been identified. In the present study, we compared LN(+) and LN(-) colon cancer patients using differential gene expression and network analysis. Colon cancer gene expression data were obtained from the Cancer Genome Atlas and divided into two groups, LN(+) and LN(-). Gene expression networks were constructed using LASSO (Least Absolute Shrinkage and Selection Operator) regression. We identified hub genes, such as APBB1, AHSA2, ZNF767, and JAK2, that were highly differentially expressed. Survival analysis using selected hub genes, such as AHSA2, CDK10, and CWC22, showed that their expression levels were significantly associated with the survival rate of colon cancer patients, which indicates their possible use as prognostic markers. In addition, protein-protein interaction network, GO enrichment, and KEGG pathway analysis were performed with selected hub genes from each group to investigate the regulatory relationships between hub genes and LN involvement in colon cancer; these analyses revealed differences between the LN(-) and LN(+) groups. Our network analysis may help narrow down the search for novel candidate genes for the treatment of colon cancer, in addition to improving our understanding of the biological processes underlying LN involvement. All R implementation codes are available at journal website as Supplementary Materials.


Rapid immunoglobulin test confirms a suspected case of COVID-19


Overcoming post-surgery challenges in lockdown


title: COVID-19-CT-CXR: a freely accessible and weakly labeled chest X-ray and CT image collection on COVID-19 from biomedical literature

text: The latest threat to global health is the COVID-19 outbreak. Although there exist large datasets of chest X-rays (CXR) and computed tomography (CT) scans, few COVID-19 image collections are currently available due to patient privacy. At the same time, there is a rapid growth of COVID-19-relevant articles in the biomedical literature. Here, we present COVID-19-CT-CXR, a public database of COVID-19 CXR and CT images, which are automatically extracted from COVID-19-relevant articles from the PubMed Central Open Access (PMC-OA) Subset. We extracted figures, associated captions, and relevant figure descriptions in the article and separated compound figures into subfigures. We also designed a deep-learning model to distinguish them from other figure types and to classify them accordingly. The final database includes 1,327 CT and 263 CXR images (as of May 9, 2020) with their relevant text. To demonstrate the utility of COVID-19-CT-CXR, we conducted four case studies. (1) We show that COVID-19-CT-CXR, when used as additional training data, is able to contribute to improved DL performance for the classification of COVID-19 and non-COVID-19 CT. (2) We collected CT images of influenza and trained a DL baseline to distinguish a diagnosis of COVID-19, influenza, or normal or other types of diseases on CT. (3) We trained an unsupervised one-class classifier from non-COVID-19 CXR and performed anomaly detection to detect COVID-19 CXR. (4) From text-mined captions and figure descriptions, we compared clinical symptoms and clinical findings of COVID-19 vs. those of influenza to demonstrate the disease differences in the scientific publications. We believe that our work is complementary to existing resources and hope that it will contribute to medical image analysis of the COVID-19 pandemic. The dataset, code, and DL models are publicly available at https://github.com/ncbi-nlp/COVID-19-CT-CXR.


Systematic analysis of COVID-19 infection and symptoms in a systemic lupus erythematosus population: correlation with disease characteristics, hydroxychloroquine use and immunosuppressive treatments


title: Youth Mental Health in the time of COVID-19

text: Youth Mental Health is a rapidly developing field with a focus on prevention, early identification, treatment innovation and service development. In this perspective piece, we discuss the effects of COVID-19 on young people's mental health. The psychosocial effects of COVID-19 disproportionately affect young people. Both immediate and longer-term factors through which young people are affected include social isolation, changes to the delivery of therapeutic services and almost complete loss of all structured occupations (school, work and training) within this population group. Longer-term mechanisms include the effects of the predicted recession on young people's mental health. Opportunities within this crisis exist for service providers to scale up telehealth and digital services that may benefit service provision for young people's mental health in the future.


Innovative strategies to support physical distancing among individuals with active addiction


title: Impact of COVID-19 related healthcare crisis on treatments for patients with lysosomal storage disorders, the first Italian experience

text: The direct and indirect effects of Coronavirus Disease-19 (COVID-19) pandemic, on Italian patients with lysosomal storage disorders receiving therapy, were analyzed by a phone questionnaire. No proved COVID-19 emerged among 102 interviewed. No problems were reported by patients receiving oral treatments. Forty-nine% of patients receiving enzyme replacement therapy in hospitals experienced disruptions, versus 6% of those home-treated. The main reasons of missed infusions were fear of infection (62.9%) and re-organization of the infusion centers (37%).


title: Analysis of Psychological and Sleep Status and Exercise Rehabilitation of Front-Line Clinical Staff in the Fight Against COVID-19 in China

text: BACKGROUND The aim of this study was to understand the changes in psychological factors and sleep status of front-line medical staff in the fight against COVID-19 and provide evidence of exercise interventions to relieve psychological stress and improve sleep status for medical staff. MATERIAL AND METHODS A survey study was conducted among 120 front-line medical staff in the fight against COVID-19, of which 60 medical staff worked at the designated hospital (experimental group) and 60 medical staff worked at the non-designated hospital (control group). The Symptom Checklist 90 (SCL-90), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and PTSD Checklist-Civilian Version (PCL-C) were used to assess mental status. Sleep status was assessed using the Pittsburgh Sleep Quality Index (PSQI). RESULTS SCL-90 scores of somatization, depression, anxiety, and terror were higher than normal in front-line medical staff at the designated hospital. The SAS (45.89±1.117), SDS (50.13±1.813), and PCL-C (50.13±1.813) scores in the experimental group were higher than the normal control group, and were significantly different from those in the control group on SDS and PCL-C scales (P<0.05). The total average PSQI of the experimental group was 16.07±3.761, indicating that the sleep quality was poor. Among them, participants with moderate insomnia reached 61.67%, and participants with severe insomnia reached 26.67%. CONCLUSIONS There are psychological symptoms and sleep symptoms in front-line medical staff who participate in the fight against COVID-19, and they affect each other. Hospitals should improve emergency management measures, strengthen psychological counseling for clinical front-line medical staff, strengthen exercise intervention, and improve their sleep quality and mental health.


Shielding from covid-19 should be stratified by risk


Letter to the Editor on "Rehabilitation following critical illness in people with COVID-19 infection"


title: Detection of SARS-CoV-2-Specific Humoral and Cellular Immunity in COVID-19 Convalescent Individuals

text: The World Health Organization has declared SARS-CoV-2 virus outbreak a worldwide pandemic. However, there is very limited understanding on the immune responses, especially adaptive immune responses to SARS-CoV-2 infection. Here, we collected blood from COVID-19 patients who have recently become virus-free, and therefore were discharged, and detected SARS-CoV-2-specific humoral and cellular immunity in eight newly discharged patients. Follow-up analysis on another cohort of six patients 2 weeks post discharge also revealed high titers of immunoglobulin G (IgG) antibodies. In all 14 patients tested, 13 displayed serum-neutralizing activities in a pseudotype entry assay. Notably, there was a strong correlation between neutralization antibody titers and the numbers of virus-specific T cells. Our work provides a basis for further analysis of protective immunity to SARS-CoV-2, and understanding the pathogenesis of COVID-19, especially in the severe cases. It also has implications in developing an effective vaccine to SARS-CoV-2 infection.


title: Case-Fatality Risk Estimates for COVID-19 Calculated by Using a Lag Time for Fatality

text: We estimated the case-fatality risk for coronavirus disease cases in China (3.5%); China, excluding Hubei Province (0.8%); 82 countries, territories, and areas (4.2%); and on a cruise ship (0.6%). Lower estimates might be closest to the true value, but a broad range of 0.25%-3.0% probably should be considered.


title: Optimized lockdown strategies for curbing the spread of COVID-19: A South African case study

text: To curb the spread of COVID-19, many governments around the world have implemented tiered lockdowns with varying degrees of stringency. Lockdown levels are typically increased when the disease spreads and reduced when the disease abates. A predictive control approach is used to develop optimized lockdown strategies for curbing the spread of COVID-19. These strategies are then applied to South African data. The South African case is of immediate interest as the number of confirmed infectious cases does not appear to have peaked yet (at the time of writing), while at the same time the South African government is busy reducing the degree of lockdown. An epidemiological model for the spread of COVID-19 in South Africa was previously developed, and is used in conjunction with a hybrid model predictive controller to optimize lockdown management under different policy scenarios. Scenarios considered include how flatten the curve to a level that the healthcare system can cope with, how to balance lives and livelihoods, and what impact the compliance of the population to the lockdown measures has on the spread of COVID-19.


title: Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan

text: A mysterious outbreak of atypical pneumonia in late 2019 was traced to a seafood wholesale market in Wuhan of China Within a few weeks, a novel coronavirus tentatively named as 2019 novel coronavirus (2019-nCoV) was announced by the World Health Organization We performed bioinformatics analysis on a virus genome from a patient with 2019-nCoV infection and compared it with other related coronavirus genomes Overall, the genome of 2019-nCoV has 89% nucleotide identity with bat SARS-like-CoVZXC21 and 82% with that of human SARS-CoV The phylogenetic trees of their orf1a/b, Spike, Envelope, Membrane and Nucleoprotein also clustered closely with those of the bat, civet and human SARS coronaviruses However, the external subdomain of Spike's receptor binding domain of 2019-nCoV shares only 40% amino acid identity with other SARS-related coronaviruses Remarkably, its orf3b encodes a completely novel short protein Furthermore, its new orf8 likely encodes a secreted protein with an alpha-helix, following with a beta-sheet(s) containing six strands Learning from the roles of civet in SARS and camel in MERS, hunting for the animal source of 2019-nCoV and its more ancestral virus would be important for understanding the origin and evolution of this novel lineage B betacoronavirus These findings provide the basis for starting further studies on the pathogenesis, and optimizing the design of diagnostic, antiviral and vaccination strategies for this emerging infection FAU - Chan, Jasper Fuk-Woo


title: Survey Says: "COVID-19 Lockdown Hits Young Faculty and Clinical Trials"

text: COVID-19 has severely impacted laboratory research. Analysis of the International Society for Stem Cell Research (ISSCR) member survey has highlighted a particular impact on clinical trials and early-career investigators. The stem cell community needs to support young researchers and ensure that stem cell medicine does not lose its momentum.


title: Thyroid disease in the time of COVID-19

text: The novel coronavirus disease COVID-19 is produced by SARS-CoV-2. WHO has declared COVID-19 as a public health emergency, with the most susceptible populations (requiring ventilation) being the elderly, pregnant women and people with associated co-morbidities including heart failure, uncontrolled diabetes, chronic obstructive pulmonary disease, asthma and cancer. However, such general guidance does not provide information regarding COVID-19 risks in patients with suffering from pre-existing thyroid problems, and furthermore, we do not know whether patients with COVID-19 (symptomatic or without symptoms), who have not previously had thyroid issues develop endocrine thyroid dysfunction after infection. The European Society for Endocrinology recently published a statement on COVID-19 and endocrine diseases (Endocrine, 2020); however, thyroid diseases were not mentioned specifically. We have therefore reviewed the current literature on thyroid diseases (excluding cancer) and COVID-19, including data from the previous coronavirus pandemic caused by the SARS-associated coronavirus (SARS-CoV), a member of the same family Coronaviridae leading to severe acute respiratory syndrome (SARS). At the moment there are no data suggesting that thyroid patients are at higher risk of COVID-19, but this requites further research and data analysis.


COVID-19 mental-health responses neglect social realities


title: A technical report from the Italian SARS-CoV-2 outbreak. Postmortem sampling and autopsy investigation in cases of suspected or probable COVID-19

text: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a coronavirus responsible for COVID-19 (coronavirus disease 2019) which resulted in a cluster of cases of pneumonia that originated in China around 31 December 2019 and has subsequently spread across the globe. Currently, COVID-19 represents a health emergency worldwide, leading, in severe cases, to pneumonia, severe acute respiratory syndrome, multiorgan dysfunction or failure, and death. In the context of limited scientific knowledge and evidence of SARS-CoV-2 infection, guidance is becoming increasingly necessary for pathologists who have to perform postmortem investigations on COVID-19 cases. The aim of the present report is to share a procedure applicable to cases of COVID-19-related death, particularly in cases of death without medical intervention and in the absence of an ascertained SARS-CoV-2 infection and/or COVID-19 diagnosis, therefore providing support for diagnostic activity in the present COVID-19 pandemic. For this purpose, a standard operating procedure for correct swab collection, autopsy investigation and tissue sampling is provided.


title: Viral RNA Load in Mildly Symptomatic and Asymptomatic Children with COVID-19, Seoul

text: Along with positive SARS-CoV-2 RNA in nasopharyngeal swabs, viral RNA was detectable at high concentration for >3 weeks in fecal samples from 12 mildly symptomatic and asymptomatic children with COVID-19. Saliva also tested positive during the early phase of infection. If proven infectious, feces and saliva could serve as transmission sources.


Covid-19 worldwide: we need precise data by age group and sex urgently


The use of continuous perineural catheters and other practices to optimize regional anesthesia in COVID-19 patients


title: An international comparison analysis of reserve and supply system for emergency medical supplies between China, the United States, Australia, and Canada

text: Coronavirus disease 19 (COVID-19) has become a pandemic around the world. With the explosive growth of confirmed cases, emergency medical supplies are facing global shortage, which restricts the treatment of seriously ill patients and protection of medical staff. Taking China, the United States, Australia, and Canada as examples, this study compares and analyzes the reserve and supply systems of emergency medical supplies and problems exposed in response to the COVID-19 epidemic. Some common problems were found, such as insufficient types and quantities of emergency medical supplies in reserve, insufficient emergency production capacity, and imperfect command mechanism for emergency supplies deployment and transportation. A sound reserve system of emergency medical supplies is the basis and guarantee for dealing with public health emergencies such as major outbreaks. Based on the comparison of systems and practical experience, countries around the world should further improve the reserve and supply system of emergency medical supplies, and improve the coordination and cooperation mechanism for emergency supplies for international public health emergencies, so as to cope with increasingly severe public health emergencies in the context of globalization.


Re: Kristian D. Stensland, Todd M. Morgan, Alireza Moinzadeh, et al. Considerations in the Triage of Urologic Surgeries During the COVID-19 Pandemic. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2020.03.027: The Forgotten Urological Patient During the COVID-19 Pandemic: Patient Safety Safeguards


title: 'What is Inconvenient for You is Life-saving for Me': How Health Inequities are playing out during the COVID-19 Pandemic

text: The COVID-19 pandemic has had a significant impact globally. Most affected, however, are those individuals and groups routinely disadvantaged by the social injustice created by the misdistribution of power, money, and resources. Simple measures that prevent the spread of COVID-19, such as frequent hand washing and social distancing, are unavailable to millions of people in the wealthiest of nations and in the poorest of nations. Disadvantaged groups are impacted more directly and in disproportionately higher numbers due to existing poor health, and the disruption of services central to securing an income and an education will have lasting consequences for their futures. The unintended effect of exclusionary government policies is that privileged citizens and healthcare systems are also at greater risk. This paper seeks to highlight the impact of COVID-19 on those already suffering health inequities through consideration of some of the social determinants of health on groups in affluent and poorer nations. It also highlights some of the factors that may assist in tackling health inequities as we emerge from this pandemic.


The robot recruits in China's health-care system


title: Facial diplegia, a possible atypical variant of Guillain-Barré Syndrome as a rare neurological complication of SARS-CoV-2

text: We present a case of facial diplegia after 10 days of SARS-CoV-2 confirmed infection symptoms in a 61 year old patient without prior clinically relevant background. There are few known cases of Guillain-Barré Syndrome (GBS) related to SARS-CoV-2 infection; we propose this case as a rare variant of GBS in COVID-19 infection context, due to Its chronology, clinical manifestations and cerebrospinal fluid (CSF) findings.


title: Lockdown contained the spread of 2019 novel coronavirus disease in Huangshi city, China: Early epidemiological findings

text: BACKGROUND: To control the spread of 2019 novel coronavirus disease (COVID-19), China sealed Wuhan on Jan 23, 2020 and soon expanded lockdown to other twelve cities in Hubei province. We aimed to describe the epidemiological characteristics in one of the cities and highlight the effect of current implemented lockdown and nonpharmaceutical interventions. METHODS: We retrieved data of reported cases in Huangshi and Wuhan from publicly available disease databases. Local epidemiological data on suspected or confirmed cases in Huangshi were collected through field investigation. Epidemic curves were constructed with data on reported and observed cases. RESULTS: The accumulated confirmed COVID-19 cases and fatality in Huangshi were reported to be 1015 and 3.74% respectively, compared with 50006 and 5.08% in Wuhan till Mar 27, 2020. Right after Jan 24, the epidemic curve based on observed cases in Huangshi became flattened. Feb 1, 2020 was identified as the "turning point" as the epidemic in Huangshi faded soon afterwards. COVID-19 epidemic was characterized by mild cases in Huangshi, accounting for 82.66% of total cases. Moreover, 50 asymptomatic infections were identified in adults and children. Besides, we found confirmed cases in 19 familial clusters and 21 health care workers, supporting inter-human transmission. CONCLUSIONS: Our study reported the temporal dynamics and characteristics of the COVID-19 epidemic in Huangshi city, China, across the unprecedented intervention. Such new epidemiological inference might provide further guidance on current lockdown measures in high-risk cities and, subsequently, help improve public health intervention strategies against the pandemic on the country and global levels.


Original TitleCovid-19 : et notre monde se referma comme une huître…


Cancer, COVID-19 and the precautionary principle: prioritizing treatment during a global pandemic


title: Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey

text: PURPOSE: To survey healthcare workers (HCW) on availability and use of personal protective equipment (PPE) caring for COVID-19 patients in the intensive care unit (ICU). MATERIALS AND METHOD: A web-based survey distributed worldwide in April 2020. RESULTS: We received 2711 responses from 1797 (67%) physicians, 744 (27%) nurses, and 170 (6%) Allied HCW. For routine care, most (1557, 58%) reportedly used FFP2/N95 masks, waterproof long sleeve gowns (1623; 67%), and face shields/visors (1574; 62%). Powered Air-Purifying Respirators were used routinely and for intubation only by 184 (7%) and 254 (13%) respondents, respectively. Surgical masks were used for routine care by 289 (15%) and 47 (2%) for intubations. At least one piece of standard PPE was unavailable for 1402 (52%), and 817 (30%) reported reusing single-use PPE. PPE was worn for a median of 4 h (IQR 2, 5). Adverse effects of PPE were associated with longer shift durations and included heat (1266, 51%), thirst (1174, 47%), pressure areas (1088, 44%), headaches (696, 28%), Inability to use the bathroom (661, 27%) and extreme exhaustion (492, 20%). CONCLUSIONS: HCWs reported widespread shortages, frequent reuse of, and adverse effects related to PPE. Urgent action by healthcare administrators, policymakers, governments and industry is warranted.


title: Using the contact network model and Metropolis-Hastings sampling to reconstruct the COVID-19 spread on the "Diamond Princess"

text: Traditional compartmental models such as SIR (susceptible, infected, recovered) assume that the epidemic transmits in a homogeneous population, but the real contact patterns in epidemics are heterogeneous. Employing a more realistic model that considers heterogeneous contact is consequently necessary. Here, we use a contact network to reconstruct unprotected, protected contact, and airborne spread to simulate the two-stages outbreak of COVID-19 (coronavirus disease 2019) on the "Diamond Princess" cruise ship. We employ Bayesian inference and Metropolis-Hastings sampling to estimate the model parameters and quantify the uncertainties by the ensemble simulation technique. During the early epidemic with intensive social contacts, the results reveal that the average transmissibility t was 0.026 and the basic reproductive number R 0 was 6.94, triple that in the WHO report, indicating that all people would be infected in one month. The t and R 0 decreased to 0.0007 and 0.2 when quarantine was implemented. The reconstruction suggests that diluting the airborne virus concentration in closed settings is useful in addition to isolation, and high-risk susceptible should follow rigorous prevention measures in case exposed. This study can provide useful implications for control and prevention measures for the other cruise ships and closed settings.


title: Excess Ascorbate is a Chemical Stress Agent against Proteins and Cells

text: Excess ascorbate (as expected in intravenous treatment proposed for COVID-19 management, for example) oxidizes and/or degrades hemoglobin and albumin, as evidenced by UV-vis spectroscopy, gel electrophoresis, and mass spectrometry. It also degrades hemoglobin in intact blood or in isolated erythrocytes. The survival rates and metabolic activities of several leukocyte subsets implicated in the antiviral cellular immune response are also affected. Excess ascorbate is thus an unselective biological stress agent.


Preterm birth: Potential risk factor for greater COVID-19 severity?


title: Management of newborns exposed to mothers with confirmed or suspected COVID-19

text: There is limited information about newborns with confirmed or suspected COVID-19. Particularly in the hospital after delivery, clinicians have refined practices in order to prevent secondary infection. While guidance from international associations is continuously being updated, all facets of care of neonates born to women with confirmed or suspected COVID-19 are center-specific, given local customs, building infrastructure constraints, and availability of protective equipment. Based on anecdotal reports from institutions in the epicenter of the COVID-19 pandemic close to our hospital, together with our limited experience, in anticipation of increasing numbers of exposed newborns, we have developed a triage algorithm at the Penn State Hospital at Milton S. Hershey Medical Center that may be useful for other centers anticipating a similar surge. We discuss several care practices that have changed in the COVID-19 era including the use of antenatal steroids, delayed cord clamping (DCC), mother-newborn separation, and breastfeeding. Moreover, this paper provides comprehensive guidance on the most suitable respiratory support for newborns during the COVID-19 pandemic. We also present detailed recommendations about the discharge process and beyond, including providing scales and home phototherapy to families, parental teaching via telehealth and in-person education at the doors of the hospital, and telehealth newborn follow-up.


title: COVID-19 and the role of imaging: early experiences in Central Switzerland

text: The SARS-CoV-2 virus (COVID-19) was initially observed in a group of Chinese patients with unclear pneumonia in Wuhan, Hubei [1] in late December 2019. The first positive case in Switzerland was confirmed on 25 February 2020 in a patient from canton Tessin, who most likely caught the virus during a visit to Milan, Italy [2]. The country has since been preparing for an imminent public health emergency caused by the pandemic. As of 14 May 2020, the Swiss healthcare system is facing a total of 30,463 corona virus-positive people [3]. With numbers of new infections decreasing after the first pandemic wave, the continuing endemic situation will continue to be a major challenge for the Swiss healthcare system. It remains crucial to separate the clinically low-symptomatic from the severely affected patients in order to offer a specific therapeutic strategy to every SARS-CoV-2 patient. Reports from Chinese cohorts describe an increasing role of imaging strategies in the detection and surveillance of COVID-19 patients because of insufficient testing sensitivity of real-time reverse transcription polymerase chain reaction (RT-PCR) tests [4]. Chest computed tomography (CT), with a reported sensitivity of up to 97% [5, 6], gained importance particularly in patients with false negative RT-PCR results. In this short communication, we describe our first clinical experiences with 55 COVID-19 patients in Central Switzerland, who were either imaged with a standard chest x-ray, chest CT, or both. We provide an illustrative and schematic description of typical COVID-19 imaging features and suggest that imaging plays an important role in the clinical work-up of suspected or confirmed COVID-19 patients. This study was approved by the national ethics review committee (EKNZ, Switzerland) and patients’ informed consent was waived.


title: COVID-19 Deaths: Are We Sure It Is Pneumonia? Please, Autopsy, Autopsy, Autopsy!

text: The current outbreak of COVID-19 severe respiratory disease, which started in Wuhan, China, is an ongoing challenge, and a major threat to public health that requires surveillance, prompt diagnosis, and research efforts to understand this emergent pathogen and to develop an effective response. Due to the scientific community's efforts, there is an increasing body of published studies describing the virus' biology, its transmission and diagnosis, its clinical features, its radiological findings, and the development of candidate therapeutics and vaccines. Despite the decline in postmortem examination rate, autopsy remains the gold standard to determine why and how death happens. Defining the pathophysiology of death is not only limited to forensic considerations; it may also provide useful clinical and epidemiologic insights. Selective approaches to postmortem diagnosis, such as limited postmortem sampling over full autopsy, can also be useful in the control of disease outbreaks and provide valuable knowledge for managing appropriate control measures. In this scenario, we strongly recommend performing full autopsies on patients who died with suspected or confirmed COVID-19 infection, particularly in the presence of several comorbidities. Only by working with a complete set of histological samples obtained through autopsy can one ascertain the exact cause(s) of death, optimize clinical management, and assist clinicians in pointing out a timely and effective treatment to reduce mortality. Death can teach us not only about the disease, it might also help with its prevention and, above all, treatment.


Gastrointestinal Symptoms and Coronavirus Disease 2019: A Case-Control Study From the United States


title: Time Series Analysis of COVID-19 Infection Curve: A Change-Point Perspective

text: In this paper, we model the trajectory of the cumulative confirmed cases and deaths of COVID-19 (in log scale) via a piecewise linear trend model. The model naturally captures the phase transitions of the epidemic growth rate via change-points and further enjoys great interpretability due to its semiparametric nature. On the methodological front, we advance the nascent self-normalization (SN) technique (Shao, 2010) to testing and estimation of a single change-point in the linear trend of a nonstationary time series. We further combine the SN-based change-point test with the NOT algorithm (Baranowski et al., 2019) to achieve multiple change-point estimation. Using the proposed method, we analyze the trajectory of the cumulative COVID-19 cases and deaths for 30 major countries and discover interesting patterns with potentially relevant implications for effectiveness of the pandemic responses by different countries. Furthermore, based on the change-point detection algorithm and a flexible extrapolation function, we design a simple two-stage forecasting scheme for COVID-19 and demonstrate its promising performance in predicting cumulative deaths in the U.S.


title: Vogt-Koyanagi-Harada disease: recurrence rates after initial-onset disease differ according to treatment modality and geographic area

text: Background/Purpose Vogt-Koyanagi-Harada (VKH) disease is a primary autoimmune stromal choroiditis producing a spill-over panuveitis. For initial-onset VKH disease, it is increasingly thought that corticosteroid therapy is not sufficient and additional non-steroidal immunosuppressive therapy is needed. At the 11th workshop on VKH, the disease was said to be well controlled with corticosteroids alone in Japanese patients. The aim of this study was to review the literature to determine whether different levels of severity exist in different geographical areas. METHODS: Literature was reviewed for studies on the evolution of initial-onset VKH disease, looking at treatment modalities and proportion of cases with chronic evolution and/or sunset-glow fundus (SGF). RESULTS: PubMed search yielded 1249 references containing the term of Vogt-Koyanagi-Harada. Twenty references (15 from outside of Japan and 5 from Japan) contained information on the evolution of treated initial-onset disease. For the "international" group, percentage of chronic evolution after systemic corticosteroid monotherapy was 61%, and after combined steroidal and non-steroidal therapy it fell to 2% (0% in 3/4 studies). In the Japanese studies where all patients received systemic corticosteroids alone, chronic evolution was reported in 25%; however, SGF amounted to 61%. CONCLUSION: In the world at large, chronic evolution of initial-onset VKH disease treated with corticosteroids alone concerned two-thirds of patients. Japanese studies showed that chronic evolution was substantially less frequent, indicating possibly less severe disease in Japan. This proportion fell to almost zero when dual steroidal and non-steroidal immunosuppression was given at onset.


Novel coronavirus pneumonia emergency in Zhuhai: impact and challenges


The facemask in public and healthcare workers: a need, not a belief


title: Changes in air quality related to the control of coronavirus in China: Implications for traffic and industrial emissions

text: Measures taken to control the disease (Covid-19) caused by the novel coronavirus dramatically reduced the number of vehicles on the road and diminished factory production. For this study, changes in the air quality index (AQI) and the concentrations of six air pollutants (PM2.5, PM10, CO, SO2, NO2, and O3) were evaluated during the Covid-19 control period in northern China. Overall, the air quality improved, most likely due to reduced emissions from the transportation and secondary industrial sectors. Specifically, the transportation sector was linked to the NO2 emission reductions, while lower emissions from secondary industries were the major cause for the reductions of PM2.5 and CO. The reduction in SO2 concentrations was only linked to the industrial sector. However, the reductions in emissions did not fully eliminate air pollution, and O3 actually increased, possibly because lower fine particle loadings led to less scavenging of HO2 and as a result greater O3 production. These results also highlight need to control emissions from the residential sector.


title: COVID-19 and Keeping Clean: A Narrative Review To Ascertain the Efficacy of Personal Protective Equipment To Safeguard Health Care Workers Against SARS-CoV-2

text: Identifying the optimal amount of personal protective equipment (PPE) is a formidable challenge when faced with a new contagion such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Unequivocally, there are dangers to health care workers (and by extension, their patients, colleagues, and communities) if not enough equipment is donned to safeguard them. And yet, there are also dangers to patients, colleagues, and the community if resources are overconsumed and result in hoarding, shortages, and inequitable distribution, all of which are occurring as the worldwide coronavirus disease 2019 (COVID-19) pandemic continues.Research to ascertain the precise PPE required to defend specifically against SARS-CoV-2 encompasses an area of active investigation that will likely remain unresolved for some time. While awaiting more definitive conclusions, we must look to past evidence to provide a reasonable basis on which protocols and policies might be refined. What follows is a narrative review of PPE efficacy and how existing evidence might apply to protecting health care workers against COVID-19. Findings are extrapolated from investigations in 4 general domains: early investigations into SARS-CoV-2, retrospective studies about severe acute respiratory syndrome coronavirus 1, prospective studies of influenza and other common respiratory viruses, and laboratory PPE studies.Available evidence suggests that contact and droplet precautions, in addition to eye protection and standard hygiene measures, should be adequate in the vast majority of clinical settings when caring for patients with SARS-CoV-2. Adherence to guidelines promoting appropriate levels of PPE should safeguard practitioners while mitigating against resource overuse.


Covid-19: Rules on sharing confidential patient information are relaxed in England


Commentary: Long-term solutions to revive eye banking in India in COVID-19 era - Needs more than long-term corneal preservation


title: Therapeutic Drug Monitoring of Dalbavancin Treatment in Severe Necrotizing Fasciitis in 3 Critically Ill Patients: A Grand Round

text: BACKGROUND: Dalbavancin, albeit indicated for the treatment of skin structure infections, is used for a much wider range of infections. This drug is characterized by a long half-life (more than 200 hours), a favorable safety profile, and an activity against a wide array of gram-positive organisms, including several strains of Staphylococci and Enterococci. METHODS: In this study, we presented 3 cases of critically ill patients treated with dalbavancin. All patients were therapeutically monitored for plasma dalbavancin concentrations; ultrafiltrate dalbavancin concentrations were assessed in a patient undergoing continuous renal-replacement therapy. Dalbavancin concentrations were measured using a validated liquid chromatographic method coupled with mass spectrometry. RESULTS: All 3 severely ill patients experiencing necrotizing fasciitis were successfully treated during the acute phase with dalbavancin. Dalbavancin clearance in patient 3 (0.334 L/h) was considerably increased compared with values measured in the other 2 patients (0.054 and 0.075 L/h) and with data reported in the literature (0.04-0.06 L/h). CONCLUSIONS: Our case reports presented preliminary evidence that dalbavancin can be considered a therapeutic option for necrotizing fasciitis in intensive care unit patients. The role of hypoalbuminemia during dalbavancin exposure merits further investigation.


title: Two important controversial risk factors in SARS-CoV-2 infection: Obesity and smoking

text: The effects of obesity and smoking in the coronavirus disease 2019 (COVID-19) pandemic remain controversial. Angiotensin converting enzyme 2 (ACE2), a component of the renin-angiotensin system (RAS), is the human cell receptor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. ACE2 expression increases on lung alveolar epithelial cells and adipose tissue due to obesity, smoking and air pollution. A significant relationship exists between air pollution and SARS-CoV-2 infection, as more severe COVID-19 symptoms occur in smokers; comorbid conditions due to obesity or excess ectopic fat accumulation as underlying risk factors for severe COVID-19 strongly encourage the virus/ACE2 receptor-ligand interaction concept. Indeed, obesity, air pollution and smoking associated risk factors share underlying pathophysiologies that are related to the Renin-Angiotensin-System in SARS-CoV-2 infection. The aim of this review is to emphasize the mechanism of receptor-ligand interaction and its impact on the enhanced risk of death due to SARS-CoV-2 infection.


title: Genetic, antigenic and pathogenic characterization of avian coronaviruses isolated from pheasants (Phasianus colchicus) in China

text: Two viruses were isolated in 2017 from commercial pheasants with severe clinical signs and mortality in Shandong and Anhui provinces, China, respectively We examined the pathogenic effects of the viruses in chicken embryos and the size and morphology of the virus particles, performed phylogenetic analysis based on the S1 gene and complete genomic sequences, and examined the antibody responses against infectious bronchitis virus (IBV) The results suggested that the viruses I0623/17 and I0710/17 were avian coronaviruses and were identified as pheasant coronaviruses (PhCoV), with greatest similarity to IBV Further investigations of the antigenicity, complete genome organization, substitutions in multiple genes, and viral pathogenicity, replication, and shedding in chickens and pheasants showed obvious differences between PhCoV and IBV in terms of antigenicity, and viral pathogenicity, replication, and shedding in chickens and pheasants The close genetic relationship, but obvious differences between PhCoVs and IBVs suggested the IBVs could be the ancestors of PhCoVs, and that PhCoVs isolated from different outbreaks may have evolved independently from IBVs circulating in the specific region by adaption in pheasants This hypothesis was supported by analysis of the S1 gene fragments of the two PhCoVs isolated in the current study, as well as PhCoVs isolated in the UK and selected IBV strains Such analyses indicated different evolution patterns and different tissue tropisms between PhCoVs isolated in different outbreaks Further studies are needed to confirm this hypothesis by studying the complete genomic sequences of PhCoVs from different outbreaks and the pathogenicity of IBVs in pheasants to compare and clarify the relationships between PhCoVs and IBVs


Mixed central and peripheral nervous system disorders in severe SARS-CoV-2 infection


Medical Students Contribute to the Community and Medical Field During COVID-19 Pandemic


title: Chapter of Gastroenterologists professional guidance on risk mitigation for gastrointestinal endoscopy during COVID-19 pandemic in Singapore

text: In this paper, we aimed to provide professional guidance to practising gastrointestinal (GI) endoscopists for the safe conduct of GI endoscopy procedures during the current coronavirus disease 2019 (COVID-19) pandemic and future outbreaks of similar severe respiratory tract infections in Singapore. It draws on the lessons learnt during the severe acute respiratory syndrome (SARS) epidemic and available published data concerning the COVID-19 pandemic. It addresses measures before, during and after endoscopy that must be considered for both non- infected and infected patients, and provides recommendations for practical implementation.


Association of COVID-19 with pregnancy outcomes in health-care workers and general women


Pandemic Pandemonium: Pausing Clinical Research During the COVID-19 Outbreak


title: A hypothesis for pathobiology and treatment of COVID-19: The centrality of ACE1/ACE2 imbalance

text: Angiotensin Converting Enzyme2 is the cell surface binding site for the coronavirus SARS-CoV-2, which causes COVID-19. We propose that an imbalance in the action of ACE1- and ACE2-derived peptides, thereby enhancing angiotensin II (Ang II) signalling is primary driver of COVID-19 pathobiology. ACE1/ACE2 imbalance occurs due to the binding of SARS-CoV-2 to ACE2, reducing ACE2-mediated conversion of Ang II to Ang peptides that counteract pathophysiological effects of ACE1-generated ANG II. This hypothesis suggests several approaches to treat COVID-19 by restoring ACE1/ACE2 balance: (a) AT receptor antagonists; (b) ACE1 inhibitors (ACEIs); (iii) agonists of receptors activated by ACE2-derived peptides (e.g. Ang (1-7), which activates MAS1); (d) recombinant human ACE2 or ACE2 peptides as decoys for the virus. Reducing ACE1/ACE2 imbalance is predicted to blunt COVID-19-associated morbidity and mortality, especially in vulnerable patients. Importantly, approved AT antagonists and ACEIs can be rapidly repurposed to test their efficacy in treating COVID-19.


title: Band structure of twisted bilayer graphene on hexagonal boron nitride

text: The effect of an hexagonal boron nitride (hBN) layer close aligned with twisted bilayer graphene (TBG) is studied. At sufficiently low angles between twisted bilayer graphene and hBN, $\theta_{hBN} \lesssim 2^\circ$, the graphene electronic structure is strongly disturbed. The width of the low energy peak in the density of states changes from $W \sim 5 - 10$ meV for a decoupled system to $\sim 20 - 30$ meV. Spikes in the density of states due to van Hove singularities are smoothed out. We find that for a realistic combination of the twist angle in the TBG and the twist angle between the hBN and the graphene layer the system can be described using a single moir\'e unit cell.


Keep or release: experience on management of COVID-19 during maximum emergency in Bergamo and impact on patient outcomes


title: COVID-19 Outbreak: Infection Control and Management Protocol for Vascular and Interventional Radiology Departments-Consensus Document

text: COVID-19 (SARS-CoV-2 virus) pandemic was recently declared by the WHO as a global health emergency. A group of interventional radiology senior experts developed a consensus document for infection control and management of patients with COVID-19 in interventional radiology (IR) departments. This consensus statement has been brought together at short notice with the help of different protocols developed by governmental entities and scientific societies to be adapted to the current reality and needs of IR Departments. Recommendations are the specific strategies to follow in IR departments, preventive measures and regulations, step by step for donning and doffing personal protective equipment, specific IR procedures which can not be delayed, and aerosol-generating procedures in IR with COVID-19 patients. It is advisable with this document to be adapted to local workplace policies.


High prevalence of antinuclear antibodies and lupus anticoagulant in patients hospitalized for SARS-CoV2 pneumonia


title: "Go eat a bat, Chang!": An Early Look on the Emergence of Sinophobic Behavior on Web Communities in the Face of COVID-19

text: The outbreak of the COVID-19 pandemic has changed our lives in unprecedented ways. In the face of the projected catastrophic consequences, many countries have enacted social distancing measures in an attempt to limit the spread of the virus. Under these conditions, the Web has become an indispensable medium for information acquisition, communication, and entertainment. At the same time, unfortunately, the Web is being exploited for the dissemination of potentially harmful and disturbing content, such as the spread of conspiracy theories and hateful speech towards specific ethnic groups, in particular towards Chinese people since COVID-19 is believed to have originated from China. In this paper, we make a first attempt to study the emergence of Sinophobic behavior on the Web during the outbreak of the COVID-19 pandemic. We collect two large-scale datasets from Twitter and 4chan's Politically Incorrect board (/pol/) over a time period of approximately five months and analyze them to investigate whether there is a rise or important differences with regard to the dissemination of Sinophobic content. We find that COVID-19 indeed drives the rise of Sinophobia on the Web and that the dissemination of Sinophobic content is a cross-platform phenomenon: it exists on fringe Web communities like \dspol, and to a lesser extent on mainstream ones like Twitter. Also, using word embeddings over time, we characterize the evolution and emergence of new Sinophobic slurs on both Twitter and /pol/. Finally, we find interesting differences in the context in which words related to Chinese people are used on the Web before and after the COVID-19 outbreak: on Twitter we observe a shift towards blaming China for the situation, while on /pol/ we find a shift towards using more (and new) Sinophobic slurs.


title: Telemedicine in Germany during the COVID-19 Pandemic: Multiprofessional National Survey

text: BACKGROUND: In an effort to contain the effects of the COVID-19 pandemic, healthcare systems globally implemented telemedical solutions in order to overcome staffing, technical and infrastructural limitations. In Germany, a multitude of telemedical systems are already in function, while new approaches are rapidly developed in response to the crisis. However, the extent of current implementation within different healthcare settings, the user acceptance and perception as well as the hindering technical and regulatory obstacles remain unclear. OBJECTIVE: To assess the current status quo of availability as well as routine use of telemedical solutions, the user acceptance and the subjectively perceived burdens on telemedical approaches. Furthermore to assess the perception of the quality of public information amongst professional groups and their preferred communication channels. METHODS: A national online survey conducted on 14 consecutive days in March-April 2020, distributed to doctors, nurses and other medical professionals in German language. RESULTS: A total of 2827 medical professionals participated in the study. 65.6% (n=1855) identified as doctors, 29.5% (n=833) as nursing staff and 4.9% (n=139) as others, e.g. therapeutic staff. A majority of participants rated the significance of telemedicine within the crisis as high (39%, n=1065) or neutral (26.4%, n=720), however there were significant differences between doctors and nurses (p=.01) as well as between the stationary sector compared to the ambulatory sector (p <.001). Telemedicine already is in routine use in 19.6% and in partial use in 40.2% of German healthcare providers. Participants working in private practices (40.2%, n=239) or private clinics (39.0%, n=23) experience less regulatory or technical obstacles, compared to university hospitals (49.2%, n=586). A majority of doctors rated the public information quality on COVID as good (50.8%, n= 942) or very good (11.5%, n=213), nurses rated the quality of public information significantly lower (p <.01). Participant's age negatively correlated with the perception of significance of the telemedicine (Spearmans's rho = -0.23; p <.001). CONCLUSIONS: Telemedicine has a broad acceptance within German medical professionals. However, in order to establish telemedical structures within routine care, technical and regulatory burdens have to be overcome.


title: Psychosocial Support during the COVID-19 Outbreak in Korea: Activities of Multidisciplinary Mental Health Professionals

text: As of April 18, 2020, there have been a total of 10,653 confirmed cases and 232 deaths due to coronavirus disease 2019 (COVID-19) in Korea. The pathogen spread quickly, and the outbreak caused nationwide anxiety and shock. This study presented the anecdotal records that provided a detailed process of the multidisciplinary teamwork in mental health during the COVID-19 outbreak in the country. Psychosocial support is no less important than infection control during an epidemic, and collaboration and networking are at the core of disaster management. Thus, a multidisciplinary team of mental health professionals was immediately established and has collaborated effectively with its internal and external stakeholders for psychosocial support during the COVID-19 outbreak.


Prevent loss of life by providing all NHS staff with WHO standard personal protective equipment


Pediatric hematology oncology during SARS-CoV-2: A brief communication of 28 patients and changes in clinical practice from a single institute in Pakistan


title: Protocol of a population-based prospective COVID-19 cohort study Munich, Germany (KoCo19)

text: BACKGROUND: Due to the SARS-CoV-2 pandemic, public health interventions have been introduced globally in order to prevent the spread of the virus and avoid the overload of health care systems, especially for the most severely affected patients. Scientific studies to date have focused primarily on describing the clinical course of patients, identifying treatment options and developing vaccines. In Germany, as in many other regions, current tests for SARS-CoV2 are not conducted on a representative basis and in a longitudinal design. Furthermore, knowledge about the immune status of the population is lacking. Nonetheless, these data are needed to understand the dynamics of the pandemic and hence to appropriately design and evaluate interventions. For this purpose, we recently started a prospective population-based cohort in Munich, Germany, with the aim to develop a better understanding of the state and dynamics of the pandemic. METHODS: In 100 out of 755 randomly selected constituencies, 3000 Munich households are identified via random route and offered enrollment into the study. All household members are asked to complete a baseline questionnaire and subjects ≥14 years of age are asked to provide a venous blood sample of ≤3 ml for the determination of SARS-CoV-2 IgG/IgA status. The residual plasma and the blood pellet are preserved for later genetic and molecular biological investigations. For twelve months, each household member is asked to keep a diary of daily symptoms, whereabouts and contacts via WebApp. If symptoms suggestive for COVID-19 are reported, family members, including children < 14 years, are offered a pharyngeal swab taken at the Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, for molecular testing for SARS-CoV-2. In case of severe symptoms, participants will be transferred to a Munich hospital. For one year, the study teams re-visits the households for blood sampling every six weeks. DISCUSSION: With the planned study we will establish a reliable epidemiological tool to improve the understanding of the spread of SARS-CoV-2 and to better assess the effectiveness of public health measures as well as their socio-economic effects. This will support policy makers in managing the epidemic based on scientific evidence.


Protocol for awake prone positioning in COVID-19 patients: to do it earlier, easier, and longer


SARS-CoV-2 inflames the heart. The importance of awareness of myocardial injury in COVID-19 patients


Saudi Arabia's drastic measures to curb the COVID-19 outbreak: temporary suspension of the Umrah pilgrimage


Coronavirus: three things all governments and their science advisers must do now


title: Tele-ophthalmology: Need of the hour

text: Telemedicine and tele-ophthalmology have been in existence since many years, but have recently gained more importance in the present scenario of pandemic COVID-19. The attitude and perception of the doctors and patients has been changing gradually. Telemedicine has many advantages including providing care in inaccesible areas.In the present scenario, tele-ophthalmology gives an oppurtunity to patient for seeking consultation while also protecting against the contagion. There are many barriers faced by the patients and doctors that have restricted use of this technology in the past. However, with a systematic approach to designing the best suited technology, these barriers can be overcome and user friendly platforms can be created. Furthermore, the demand and use of teleconsulation had increased presently in this area of pandemic. Recent survey conducted by the All India Ophthalmological Society also reveals that many ophthalmologists who have not used tele-ophthalmology in the past are more keen to use it presently. In this article, we have reviewed telemedicine and tele-ophthalmology literature on Google and PubMed to get a holistic idea towards teleconsultation, its advantages, increased importance and prefrence during COVID-19 pandemic and various barriers faced so that the known challenges can be understood, which can pave way for better understanding and future incorporation into practice.


title: The impact of the COVID-19 infection in dentistry

text: IMPACT STATEMENT: Dentists have always been taught how to protect themselves and their patients from potential blood-borne pathogens, but the Coronavirus pandemic has brought a new unprecedented challenge to the world of dentistry; we therefore reviewed the literature to provide suggestions on how to accordingly change dental practice prevention.


title: COVID-19 related anagen effluvium

text: New COVID-19 skin manifestations continue to be described. We present a patient with COVID-19 related anagen effluvium. The patient was treated with and responded to low dose systemic steroids to treat an accompanying extensive COVID-19-related urticaria and maculopapular rash.


title: Large Outbreak of Coronavirus Disease among Wedding Attendees, Jordan

text: In March 2020, a wedding in Jordan led to a large outbreak of coronavirus disease (COVID-19). We collected data on 350 wedding attendees, 76 who of whom developed COVID-19. Our study shows high communicability of COVID-19 and the enormous risk for severe acute respiratory syndrome 2 virus transmission during mass gatherings.


title: Design of a Low-cost Miniature Robot to Assist the COVID-19 Nasopharyngeal Swab Sampling

text: Nasopharyngeal (NP) swab sampling is an effective approach for the diagnosis of coronavirus disease 2019 (COVID-19). Medical staffs carrying out the task of collecting NP specimens are in close contact with the suspected patient, thereby posing a high risk of cross-infection. We propose a low-cost miniature robot that can be easily assembled and remotely controlled. The system includes an active end-effector, a passive positioning arm, and a detachable swab gripper with integrated force sensing capability. The cost of the materials for building this robot is 55 USD and the total weight of the functional part is 0.23kg. The design of the force sensing swab gripper was justified using Finite Element (FE) modeling and the performances of the robot were validated with a simulation phantom and three pig noses. FE analysis indicated a 0.5mm magnitude displacement of the gripper's sensing beam, which meets the ideal detecting range of the optoelectronic sensor. Studies on both the phantom and the pig nose demonstrated the successful operation of the robot during the collection task. The average forces were found to be 0.35N and 0.85N, respectively. It is concluded that the proposed robot is promising and could be further developed to be used in vivo.


title: The musings of a family therapist in Asia when COVID-19 struck

text: In response to the COVID-19 crisis in Asia, a family therapist in Hong Kong shares her experiences and reflections, both personally and professionally from an Eastern lens. From a state of shock and immobilization to moments of contemplation, she highlights her struggle with being caught between her Eastern roots and Western training, which has become more salient in facing COVID-19. While the latter pulls her toward a more problem resolution stance, the former pulls her toward a more accepting position. As a result, her therapy is shaped in such a way that she tends to raise more questions instead of providing answers.


Involvement of ADAMTS13 and von Willebrand factor in thromboembolic events in patients infected with SARS-CoV-2


title: Neurological Manifestations of COVID-19: A systematic review and current update

text: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in December of 2019 in the city of Wuhan, China. Since the outbreak, various reports detail its symptoms and outcomes, primarily focusing on respiratory complications. However, reports are emerging of the virus' effects systemically, including that of the nervous system. A review of all current published literature was conducted, and we report that headache and anosmia were common neurological manifestations of SARS-CoV-2. Less common symptoms include seizure, stroke and isolated cases of Guillain-Barre syndrome. Further research is now warranted to precisely determine the relationship between those patients developing neurological sequelae, their clinical state and any subsequent morbidity and mortality.


Serum concentrations of interleukin-6 (IL-6) in the general adult population: possible implications for anti-IL-6 therapy in SARS-Cov-2 infection and IL-6-related diseases


Public Priorities and Concerns Regarding COVID-19 in an Online Discussion Forum: Longitudinal Topic Modeling


Full spectrum of COVID-19 severity still being depicted - Authors' reply


title: A Machine Learning alternative to placebo-controlled clinical trials upon new diseases: A primer

text: The appearance of a new dangerous and contagious disease requires the development of a drug therapy faster than what is foreseen by usual mechanisms. Many drug therapy developments consist in investigating through different clinical trials the effects of different specific drug combinations by delivering it into a test group of ill patients, meanwhile a placebo treatment is delivered to the remaining ill patients, known as the control group. We compare the above technique to a new technique in which all patients receive a different and reasonable combination of drugs and use this outcome to feed a Neural Network. By averaging out fluctuations and recognizing different patient features, the Neural Network learns the pattern that connects the patients initial state to the outcome of the treatments and therefore can predict the best drug therapy better than the above method. In contrast to many available works, we do not study any detail of drugs composition nor interaction, but instead pose and solve the problem from a phenomenological point of view, which allows us to compare both methods. Although the conclusion is reached through mathematical modeling and is stable upon any reasonable model, this is a proof-of-concept that should be studied within other expertises before confronting a real scenario. All calculations, tools and scripts have been made open source for the community to test, modify or expand it. Finally it should be mentioned that, although the results presented here are in the context of a new disease in medical sciences, these are useful for any field that requires a experimental technique with a control group.


No time for dilemma: mass gatherings must be suspended


title: A Recovered Case of COVID-19 Myocarditis and ARDS Treated with Corticosteroids, Tocilizumab, and Experimental AT-001

text: We describe the case of a critically-ill patient with myocarditis and severe ARDS related to COVID-19 infection. This case highlights management strategies including the use of corticosteroids, an IL-6 inhibitor, and an aldose reductase inhibitor resulting in complete clinical recovery.


Psychopathological problems related to the COVID-19 pandemic and possible prevention with music therapy


Observation and consideration on using of JAKi in clinical trials in times of COVID-19


Fetal interventions in the setting of the coronavirus disease 2019 pandemic: statement from the North American Fetal Therapy Network


title: Modeling and Simulation of COVID-19 Pandemic for Cincinnati Tri-State Area

text: In this paper, we use SIR model to simulate the COVID-19 pandemic for Cincinnati Tri-State Area. We have built a representative population of Cincinnati that includes movements for traveling to stores, schools, workplaces, and traveling to friends houses. Using this model, we simulate the effect of quarantine, return to work, and panic buying. We show that that there will be a second wave of infections when people return to work and significant increase in number of infections when there is panic buying at stores with the announcement of the quarantine measures.


Global coronavirus pandemic (2019-nCOV): implication for an Italian medium size dermatological clinic of a II level hospital


COVID-19 infection also occurs in patients taking hydroxychloroquine


Obesity and COVID-19 in New York City: A Retrospective Cohort Study


From bedside to webside: A neurological clinical teaching experience


Ethical considerations for paediatrics during the COVID-19 pandemic: A discussion paper from the Australian Paediatric Clinical Ethics Collaboration


COVID-19 pandemic: a large boulder on the head of stoma patients


Risk of reactivation or reinfection of novel coronavirus (COVID-19)


title: A fractal viewpoint to COVID-19 infection

text: One of the central tools to control the COVID-19 pandemics is the knowledge of its spreading dynamics. Here we develop a fractal model capable of describe this dynamics, in term of daily new cases, and provide quantitative criteria for some predictions. We propose a fractal dynamical model using conformed derivative and fractal time scale. A Burr-XII shaped solution of the fractal-like equation is obtained. The model is tested using data from several countries, showing that a single function is able to describe very different shapes of the outbreak. The diverse behavior of the outbreak on those countries is presented and discussed. Moreover, a criterion to determine the existence of the pandemic peak and a expression to find the time to reach herd immunity are also obtained.


COVID-19 in humanitarian settings and lessons learned from past epidemics


Gargle lavage as a safe and sensitive alternative to swab samples to diagnose COVID-19: a case report in Japan


title: Preparation of a radiology department in an Italian hospital dedicated to COVID-19 patients

text: Preparedness for the ongoing coronavirus disease 2019 (COVID-19) and its spread in Italy called for setting up of adequately equipped and dedicated health facilities to manage sick patients while protecting healthcare workers, uninfected patients, and the community. In our country, in a short time span, the demand for critical care beds exceeded supply. A new sequestered hospital completely dedicated to intensive care (IC) for isolated COVID-19 patients needed to be designed, constructed, and deployed. Along with this new initiative, the new concept of "Pandemic Radiology Unit" was implemented as a practical solution to the emerging crisis, born out of a critical and urgent acute need. The present article describes logistics, planning, and practical design issues for such a pandemic radiology and critical care unit (e.g., space, infection control, safety of healthcare workers, etc.) adopted in the IC Hospital Unit for the care and management of COVID-19 patients.


Prisons and custodial settings are part of a comprehensive response to COVID-19


title: How we treat patients with lung cancer during the SARS-CoV-2 pandemic: primum non nocere

text: New cases of the novel coronavirus, also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to rise worldwide. A few reports have showed that mortality due to SARS-CoV-2 is higher in elderly patients and other active comorbidities including cancer. To date, no effective treatment has been identified and management for critically ill patients relies on management in intensive care units. Patients with lung cancer are at risk of pulmonary complications from COVID-19. Furthermore, the use of chemotherapy might have a negative impact in patient's outcome. Therefore, the risk/benefit ratio of systemic anticancer treatment (SACT) has to be considered. For each patient, several factors including age and comorbidities, as well as the number of hospital visits for treatment, can influence this risk. Each hospital around the world has issued some internal policy guidelines for oncologists, aiming to limit risks during this difficult time. We hereby propose a tool to support oncologists and physicians in treatment decision for patients with lung cancer. There are several variables to consider, including the extent of the epidemic, the local healthcare structure capacity, the risk of infection to the individual, the status of cancer, patients' comorbidities, age and details of the treatment. Given this heterogeneity, we have based our suggestions bearing in mind some general factors There is not easy, universal solution to oncological care during this crisis and, to complicate matters, the duration of this pandemic is hard to predict. It is important to weigh the impact of each of our decisions in these trying times rather than rely on routine automatisms.


COVID-19 may affect the endocrine pancreas by activating Na+/H+ exchanger 2 and increasing lactate levels


title: Mild versus severe COVID-19: Laboratory markers

text: The number of COVID-19 patients is dramatically increasing worldwide. Treatment in intensive care units (ICU) has become a major challenge; therefore, early recognition of severe forms is absolutely essential for timely triaging of patients. While the clinical status, in particular peripheral oxygen saturation (SpO2) levels, and concurrent comorbidities of COVID-19 patients largely determine the need for their admittance to ICUs, several laboratory parameters may facilitate the assessment of disease severity. Clinicians should consider low lymphocyte count as well as the serum levels of CRP, D-dimers, ferritin, cardiac troponin and IL-6, which may be used in risk stratification to predict severe and fatal COVID-19 in hospitalised patients. It is more likely that the course of the disease will be unfavourable if some or all of these parameters are altered.


COVID-19 and cardiogenic shock. Different cardiovascular presentations with high mortality


A Viewpoint on Angiotensin-Converting Enzyme 2, Anti-Hypertensives and Coronavirus Disease 2019 (COVID-19)


title: Testing For SARS-CoV-2: The Day the World Turned its Attention to the Clinical Laboratory

text: In the last few months, an unprecedented number of laboratory tests for coronavirus disease 2019 (COVID-19) have been developed at a remarkable speed. With the rapid adoption of these tests into clinical practice, combined with the widespread publicity they received, questions arose related to the different types of tests, their utility, performance, and regulatory approval status. The aim of this publication is to provide a general landscape of laboratory testing for COVID-19 and offer a historical and regulatory perspective associated with them. Specifically, we aim to elaborate on the regulatory complexities of diagnostic testing in the United States and its implications to the present outbreak, as well as provide a synopsis of laboratory tests that have been developed for COVID-19. We will first address the detection of severe acute respiratory syndrome-coronavirus 2 directly by either nucleic acid amplification tests or by the detection of the viral protein for active infections. Subsequently, we will provide an overview of serological tests that can aid not only in diagnosis but additionally help to identify prior infections and potential immunity.


title: Evaluation of organ function in patients with severe COVID-19 infections

text: OBJECTIVE: The purpose of our study was to assess organ function in 102 patients with severe COVID-19 infections, using retrospective clinical analysis. MATERIAL AND METHODS: A retrospective analysis was conducted on 102 patients with severe COVID-19 infections. The patients were divided into a survival group (n=73) and a non-survival group (n=29) according to their prognosis. The age, sex, underlying diseases, clinical laboratory data within 48h (routine blood tests, ALT, AST, TBIL, ALB, BUN, CR, D-Dimer, PT, APTT, FIB, F VIII:C, CK-MB, CK, and LDH), and ventilation status were collected. The organ functions of these severe COVID-19 patients were assessed by comparing the differences between the two groups. RESULTS: AST, BUN, CR, CK-MB, LDH, and CK in the non-survival group were higher than those in the survival group, and the differences were statistically significant (P<0.05). D-Dimer, PT, FIB, and F VIII:C in the non-survival group were higher than the values observed in the survival group, and the differences were statistically significant (P<0.05). PLT, AST, BUN, CR, D-Dimer, PT, FIB, F VIII:C, CK-MB, CK, and LDH predicted the area under the ROC curve (AUC) of the COVID19 endpoint events and were 0.721, 0.854, 0.867, 0.757, 0.699, 0.679, 0.715, 0.811, 0.935, and 0.802, respectively. CONCLUSION: The results showed that there were different degrees of damage to the liver, kidneys, blood coagulation, and heart function in the non-survival group. In addition, PLT, AST, BUN, CR, D-Dimer, PT, FIB, F VIII:C, CK-MB, CK, and LDH had value in evaluating disease prognosis.


title: Evaluation of health-related quality of life using EQ-5D in China during the COVID-19 pandemic

text: OBJECTIVE: Since December 2019, an increasing number of cases of the 2019 novel coronavirus disease (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been identified in Wuhan, Hubei Province, China. Now, more cases have been reported in 200 other countries and regions. The pandemic disease not only affects physical health who suffered it, but also affects the mental health of the general population. This study aims to know about the impact of the COVID-19 epidemic on the health-related quality of life (HRQOL) of living using EQ-5D in general population in China. METHODS: An online-based survey was developed and participants were recruited via social media. The questionnaires included demographic and socioeconomic data, health status, the condition epidemic situation and EQ-5D scale. The relationships of all factors and the scores of EQ-5D were analyzed. Logistic regression model were used to the five health dimensions. RESULTS: The respondents obtained a mean EQ-5D index score of 0.949 and a mean VAS score of 85.52.The most frequently reported problem were pain/discomfort (19.0%) and anxiety/depression (17.6%). Logistic regression models showed that the risk of pain/discomfort and anxiety/depression among people with aging, with chronic disease, lower income, epidemic effects, worry about get COVID-19 raised significantly. CONCLUSION: The article provides important evidence on HRQOL during the COVID-19 pandemic. The risk of pain/discomfort and anxiety/depression in general population in China raised significantly with aging, with chronic disease, lower income, epidemic effects, worried about get COVID-19 during the COVID-19 pandemic. The results from each categorical data can be used for future healthcare measures among general population.


title: Correcting misperceptions of exponential coronavirus growth increases support for social distancing

text: The most effective way to stem the spread of a pandemic such as coronavirus disease 2019 (COVID-19) is social distancing, but the introduction of such measures is hampered by the fact that a sizeable part of the population fails to see their need. Three studies conducted during the mass spreading of the virus in the United States toward the end of March 2020 show that this results partially from people's misperception of the virus's exponential growth in linear terms and that overcoming this bias increases support for social distancing. Study 1 shows that American participants mistakenly perceive the virus's exponential growth in linear terms (conservatives more so than liberals). Studies 2 and 3 show that instructing people to avoid the exponential growth bias significantly increases perceptions of the virus's growth and thereby increases support for social distancing. Together, these results show the importance of statistical literacy to recruit support for fighting pandemics such as the coronavirus.