title: ACE2, Much More Than Just a Receptor for SARS-COV-2

text: The rapidly evolving pandemic of severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection worldwide cost many lives. The angiotensin converting enzyme-2 (ACE-2) has been identified as the receptor for the SARS-CoV-2 viral entry. As such, it is now receiving renewed attention as a potential target for anti-viral therapeutics. We review the physiological functions of ACE2 in the cardiovascular system and the lungs, and how the activation of ACE2/MAS/G protein coupled receptor contributes in reducing acute injury and inhibiting fibrogenesis of the lungs and protecting the cardiovascular system. In this perspective, we predominantly focus on the impact of SARS-CoV-2 infection on ACE2 and dysregulation of the protective effect of ACE2/MAS/G protein pathway vs. the deleterious effect of Renin/Angiotensin/Aldosterone. We discuss the potential effect of invasion of SARS-CoV-2 on the function of ACE2 and the loss of the protective effect of the ACE2/MAS pathway in alveolar epithelial cells and how this may amplify systemic deleterious effect of renin-angiotensin aldosterone system (RAS) in the host. Furthermore, we speculate the potential of exploiting the modulation of ACE2/MAS pathway as a natural protection of lung injury by modulation of ACE2/MAS axis or by developing targeted drugs to inhibit proteases required for viral entry.


Response to Ribeiro da Silva et al,"Role of nonstructural proteins in the pathogenesis of SARS-CoV-2"


title: Development of a Novel, Genome Subtraction-Derived, SARS-CoV-2-Specific COVID-19-nsp2 Real-Time RT-PCR Assay and Its Evaluation Using Clinical Specimens

text: The pandemic novel coronavirus infection, Coronavirus Disease 2019 (COVID-19), has affected at least 190 countries or territories, with 465,915 confirmed cases and 21,031 deaths. In a containment-based strategy, rapid, sensitive and specific testing is important in epidemiological control and clinical management. Using 96 SARS-CoV-2 and 104 non-SARS-CoV-2 coronavirus genomes and our in-house program, GolayMetaMiner, four specific regions longer than 50 nucleotides in the SARS-CoV-2 genome were identified. Primers were designed to target the longest and previously untargeted nsp2 region and optimized as a probe-free real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. The new COVID-19-nsp2 assay had a limit of detection (LOD) of 1.8 TCID50/mL and did not amplify other human-pathogenic coronaviruses and respiratory viruses. Assay reproducibility in terms of cycle threshold (Cp) values was satisfactory, with the total imprecision (% CV) values well below 5%. Evaluation of the new assay using 59 clinical specimens from 14 confirmed cases showed 100% concordance with our previously developed COVID-19-RdRp/Hel reference assay. A rapid, sensitive, SARS-CoV-2-specific real-time RT-PCR assay, COVID-19-nsp2, was developed.


A need for consensus on mortality reporting related to the COVID-19 pandemic in ongoing and future vascular registries and trials


COVID-19: it is time to balance infection management and person-centered care to maintain mental health of people living in German nursing homes


The COVID Surgery Service (CSS) within the Salzburg COVID-Emergency Plan (SCEP)


title: Distribution of 5-methylcytosine and 5-hydroxymethylcytosine in bovine fetal tissue of the placenta/ Distribuição de 5-metilcitosina e 5-hidroximetilcitosina em placenta fetal bovina

text: 5-methylcytosine (5-mC) and 5-hydroxymethylcytosine (5-hmC) are modified cytosines found in mammals that are involved in the regulation of gene expression. The aim of this study was to characterize the global patterns of 5-mC and 5-hmC of the fetal placenta of Nellore cattle as well as blood and sperm as controls. 5-mC and 5-hmC levels were determined using MethylFlash Methylated/Hydroxymethylated DNA Quantification Kit, respectively. Placenta tissues showed lower levels of 5-mC and 5-hmC compared to sperm. The male cotyledon showed higher levels of 5-hmC than the female. For the first time, the levels of 5-mC and 5-hmC in Bos taurus indicus were characterized, which may contribute to our understanding of the mechanisms of epigenetic regulation in the placenta. The presence of 5-hmC in somatic tissues suggest that 5-hmC has its own biological function and it is not only a byproduct from the oxidation of 5-mC. These results may be of interest in ARTs, especially in cloning in the diagnosis/prognosis of aberrant placentation and the viability of pregnancies.(AU)


Visualizing an unseen enemy; mobilizing structural biology to counter COVID-19


title: The effectiveness of quarantine and isolation determine the trend of the COVID-19 epidemics in the final phase of the current outbreak in China

text: OBJECTIVES: Since January 23rd 2020, stringent measures for controlling the novel coronavirus epidemics have been gradually enforced and strengthened in mainland China. The detection and diagnosis have been improved as well. However, the daily reported cases staying in a high level make the epidemics trend prediction difficult. METHODS: Since the traditional SEIR model does not evaluate the effectiveness of control strategies, a novel model in line with the current epidemics process and control measures was proposed, utilizing multisource datasets including cumulative number of reported, death, quarantined and suspected cases. RESULTS: Results show that the trend of the epidemics mainly depends on quarantined and suspected cases. The predicted cumulative numbers of quarantined and suspected cases nearly reached static states and their inflection points have already been achieved, with the epidemics peak coming soon. The estimated effective reproduction numbers using model-free and model-based methods are decreasing, as well as new infections, while new reported cases are increasing. Most infected cases have been quarantined or put in suspected class, which has been ignored in existing models. CONCLUSIONS: The uncertainty analyses reveal that the epidemics is still uncertain and it is important to continue enhancing the quarantine and isolation strategy and improving the detection rate in mainland China.


title: "Pairing assistance": the effective way to solve the breakdown of health services system caused by COVID-19 pandemic

text: The most terrifying thing about pandemic could be the large number of patients running against the health service system, which causes a serious shortage of health resources, especially medical personnel. Plotting mortality and diagnosis rates against medical staff resources in 16 cities in Hubei Province, where the epidemic was initially concerned and the most severe, shows a significant negative correlation, indicating the critical role of medical staff resources in controlling epidemics. Nevertheless, it is difficult to ensure that there exist enough medical personnel in cities severely hit by the outbreak. China provides solutions by adopting nationwide "pairing assistance" measures with at least one province assisting one city to alleviate pressure in the most severe area. By plotting the number of patients receiving treatment against day, it is clear that implementing "pairing assistance" is a turning point in China's fight against epidemics.


title: Do Google Trend data contain more predictability than price returns?

text: Using non-linear machine learning methods and a proper backtest procedure, we critically examine the claim that Google Trends can predict future price returns. We first review the many potential biases that may influence backtests with this kind of data positively, the choice of keywords being by far the greatest culprit. We then argue that the real question is whether such data contain more predictability than price returns themselves: our backtest yields a performance of about 17bps per week which only weakly depends on the kind of data on which predictors are based, i.e. either past price returns or Google Trends data, or both.


title: One month of the novel coronavirus 2019 outbreak: Is it still a threat?

text: The novel coronavirus 2019 disease (COVID-19) is now in an outbreak not only in China but also around the world, suspected to be originated from a wet market in Wuhan, Hubei province, China. The flare-up of COVID-19, it has already been infected 78,811 people with 2462 fatalities in 1 month window. The most alarming issue is the virus can transmit from host to host and still asymptomatic. Currently, 24 counties with 505 confirmed cases have been reported. Presently, there is no specific treatment or vaccine but physicians are battling with the use of antibiotics, steroid, anti-viral and anti-HIV drugs and some of the infected cases are testified improved. WHO and China National health Commission are cooperatively striving to come up with elucidation but it will take a minimum of 3 to 4 months at least to undergo a phase-1 trial. However, the soaring rates of spreading each day has become much stable which might even improve within the next few weeks in China but not for some other countries. Healthy peoples are instructed to avoid public gathering, always wearing the mask and frequently wash hands. Currently, China has able to hold up more than 97.7% infection within China but a scientific breakthrough is crucial before it's too late.


title: Psychological stress of medical staffs during outbreak of COVID-19 and adjustment strategy

text: COVID-19 has a significant impact on public health and poses a challenge to medical staffs, especially to front-line medical staffs who are exposed to and in direct contact with patients. To understand the psychological stress status of medical staffs during the outbreak of COVID-19, random sample questionnaire survey was conducted among 2110 medical staffs and 2158 college students in all provinces of China through a questionnaire, which was compiled and completed through the Questionnaire Star platform relying on Wechat, QQ, and other social software. The differences in psychological stress status of different groups were compared through the analysis of the questionnaire. Results revealed that in all provinces of China, medical staffs scored significantly higher on all items of psychological stress than college students (P < .001). In Wuhan, medical staffs scored significantly higher than college students in all items of psychological stress (P < .001). While among medical staffs, the group in Wuhan area scored significantly higher than the group outside Wuhan on the following items: "Thought of being in danger," "The possibility of self-illness," "Worrying about family infection" (P < .05), "Poor sleep quality," "Needing psychological guidance," and "Worrying about being infected" (P < .01) in the Psychological Stress Questionnaire, but on the item "Confidence in the victory of the epidemic," the group in Wuhan area scored significantly lower than the group outside Wuhan (P < .05). The emotion, cognition, physical, and mental response of front-line medical staff showed obvious "exposure effect", which calls for a psychological crisis intervention strategy that can be helpful.


A potential treatment of COVID-19 with TGF-ß blockade


Ageing out of place in COVID-19 pandemic era: How does the situation look like for older refugees in camps?


title: Angiotensin receptor blockers as tentative SARS-CoV-2 therapeutics

text: At the time of writing this commentary (February 2020), the coronavirus COVID-19 epidemic has already resulted in more fatalities compared with the SARS and MERS coronavirus epidemics combined. Therapeutics that may assist to contain its rapid spread and reduce its high mortality rates are urgently needed. Developing vaccines against the SARS-CoV-2 virus may take many months. Moreover, vaccines based on viral-encoded peptides may not be effective against future coronavirus epidemics, as virus mutations could make them futile. Indeed, new Influenza virus strains emerge every year, requiring new immunizations. A tentative suggestion based on existing therapeutics, which would likely be resistant to new coronavirus mutations, is to use available angiotensin receptor 1 (AT1R) blockers, such as losartan, as therapeutics for reducing the aggressiveness and mortality from SARS-CoV-2 virus infections. This idea is based on observations that the angiotensin-converting enzyme 2 (ACE2) very likely serves as the binding site for SARS-CoV-2, the strain implicated in the current COVID-19 epidemic, similarly to strain SARS-CoV implicated in the 2002-2003 SARS epidemic. This commentary elaborates on the idea of considering AT1R blockers as tentative treatment for SARS-CoV-2 infections, and proposes a research direction based on datamining of clinical patient records for assessing its feasibility.


Children returning to schools following COVID-19: A balance of probabilities - Letter to the Editor


title: Testing for SARS-CoV-2: Can We Stop at Two?

text: The COVID-19 epidemic requires accurate identification and isolation of confirmed cases for effective control. This report describes the effectiveness of our testing strategy and highlights the importance of repeat testing in suspect cases in our cohort.


High-fluorescent lymphocytes are increased in patients with COVID-19


Vulnerable Youth and the COVID-19 Pandemic


Iran's success in controlling Covid-19 outbreak


title: Coronavirus disease 2019 (COVID-19): strengthening our resolve to achieve universal palliative care

text: In this paper, we strongly advocate for universal palliative care access during the COVID-19 pandemic. The delivery of universal palliative care services has been called for by leading global health organizations and experts. Nurses are critical to realizing this goal. COVID-19 diagnoses and fatalities continue to rise, underscoring the importance of palliative care, particularly in the context of scant resources. To inform the writing of this paper, we undertook a review of the COVID-19 and palliative care literature and drew on our experiences. It is very clear that investment in nurses is needed to ensure appropriate palliative care services now and into the future. Avoiding futile interventions and alleviating suffering is an ethical imperative for nurses regardless of the setting. Multi-level practices and policies to foster the delivery of safe, high-quality palliative care for all are urgently needed.


Facing in real time the challenges of the Covid-19 epidemic for rehabilitation


title: The Reconstruction and Prediction Algorithm of the Fractional TDD for the Local Outbreak of COVID-19

text: From late December, 2019, the novel Corona-Virus began to spread in the mainland of China. For predicting the trend of the Corona Virus spread, several time delay dynamic systems (TDD) are proposed. In this paper, we establish a novel fractional time delay dynamic system (FTDD) to describe the local outbreak of COVID-19. The fractional derivative is introduced to account for the sub-diffusion process of the confirmed and cured peoples growth. Based on the public health data by the government, we propose a stable reconstruction algorithm of the coefficients. The reconstructed coefficients are used to predict the trend of the Corona-Virus. The numerical results are in good agreement with the public data.


title: Ensuring Exclusive Human Milk Diet for All Babies in COVID-19 Times

text: The coronavirus disease (COVID-19) pandemic has ramifications for the delivery of newborn nutrition and care services. World Health Organization recommends continuation of breastfeeding in these difficult times, with due precautions. If direct breastfeeding is not possible, milk expression should be explored. Pasteurized donor human milk from milk banks may be fed if mother's own milk is not available. To universalize access to human milk, the Indian government has proposed the establishment of comprehensive lactation management centers/milk banks, lactation management units, and lactation support units at all levels of the public health system. Due to COVID-19, these centers are encountering additional challenges cutting across interventions of rooming in, breastfeeding, milk expression, and provision of donor milk and kangaroo mother care. We discuss issues faced and alleviation measures taken by these centres in relation to provision of an exclusive human milk diet for infants during the pandemic.


title: Implementation of an Elastomeric Mask Program as a Strategy to Eliminate Disposable N95 Mask Use and Resterilization: Results from a Large Academic Medical Center

text: BACKGROUND: The COVD-19 global pandemic has placed a large demand on personal protective equipment for healthcare workers. N-95 respirators, required to perform aerosolizing procedures, are in short supply and have increased significantly in cost. The lack of a clear end to the pandemic requires that hospitals need to create a long-term, cost effective solution to the N95 shortage. We initially used previously described methods to reuse and resterilize N95 masks however we found they did not solve the issues related to just in time fit-testing and cost. METHODS: We initiated a program with the aim to reduce our dependence on N95 masks by initiating a phased program to acquire industrial style elastomeric P100 masks as a substitute for reuse and resterilization of disposable N95s. We created an allocation strategy based on availability of the masks, as well as an operational plan to fit test, educate, and disinfect the masks. RESULTS: Within 1 month we were able to reduce the number of N95s needed by our network by 95%. We also found due that the cost was conservatively 10 times less per month than purchasing disposable N95s and the cost benefit increases the longer that they are needed. CONCLUSION: Establishing an elastomeric mask program is feasible and less expensive than programs focused on reusing and disinfecting disposable N95 masks. A well thought out elastomeric distribution and disinfection program does not pose greater operational challenges than an N95 reuse and resterilization program. In addition, elastomeric masks can be stored for future surges and should be considered an essential part of all healthcare facilities' supply of personal protective equipment. Implementation of the program has eliminated our dependence on disposable N95s to maintain normal operations during the global pandemic.


Low-dose radiation therapy: could it be a game-changer for COVID-19?


Aspectos médico-legales derivados de la pandemia de la COVID-19./ Aspectos médico-legales derivados de la pandemia de la COVID-19./ Medico-legal issues regarding from the COVID-19 pandemic


title: [Acral ischaemia with multiple microthromboses and imminent gangrene in a 73-year-old woman with COVID-19]

text: This is a report of an atypical presentation of COVID-19. The patient had sparse pulmonary symptoms despite characteristic COVID-19 lesions on CT-thorax and developed severe acral ischaemic change, after a few days of hospitalisation. The condition could not be explained by classical sepsis with hypotension and hypoperfusion, disseminated intravascular coagulation, vasculitis, endocarditis or severe peripheral arteriosclerosis. A skin biopsy showed microthrombosis, interpreted as an activation of the coagulation system associated with COVID-19. Apparently, there are multiple COVID-19 phenotypes.


title: Forecast analysis of the epidemics trend of COVID-19 in the United States by a generalized fractional-order SEIR model

text: In this paper, a generalized fractional-order SEIR model is proposed, denoted by SEIQRP model, which has a basic guiding significance for the prediction of the possible outbreak of infectious diseases like COVID-19 and other insect diseases in the future. Firstly, some qualitative properties of the model are analyzed. The basic reproduction number $R_{0}$ is derived. When $R_{0}<1$, the disease-free equilibrium point is unique and locally asymptotically stable. When $R_{0}>1$, the endemic equilibrium point is also unique. Furthermore, some conditions are established to ensure the local asymptotic stability of disease-free and endemic equilibrium points. The trend of COVID-19 spread in the United States is predicted. Considering the influence of the individual behavior and government mitigation measurement, a modified SEIQRP model is proposed, defined as SEIQRPD model. According to the real data of the United States, it is found that our improved model has a better prediction ability for the epidemic trend in the next two weeks. Hence, the epidemic trend of the United States in the next two weeks is investigated, and the peak of isolated cases are predicted. The modified SEIQRP model successfully capture the development process of COVID-19, which provides an important reference for understanding the trend of the outbreak.


title: Should lCU COVID-19 patients empirically receive therapeutic doses of anticoagulant?

text: In spite of many ongoing attempts to repurpose existing antivirals, no drugs have emerged yet with the desirable activity against SARS-CoV-2 Hydroxychloroquine, lopinavir/ritonavir, remdesivir, umifenovir, favipiravir, ribavirin and beta-interferon-1 gave rise to variable but still inconsistent proof of clinical efficacy in the treatment of COVID-19 Pathogenetic studies have shown significant differences between commonly defined viral pneumonia and COVID-19 pulmonary disease In severe forms, immune/inflammatory alterations reminiscent of disease forms like Macrophage Activation Syndrome (MAS) have been described, and therapeutic options other than anti-infective have been proposed and implemented, such as anti-inflammatory and anticoagulative agents The thrombotic phenomena described in the pulmonary vascular bed of patients with severe COVID-19 suggest the administration of low-molecular weight heparin (LMWH) as standard measure in hospitalized patients with COVID-19


title: Business Email Compromise (BEC) and Cyberpsychology

text: The paper gives a brief introduction about what BEC (Business Email Compromise) is and why we should be concerned about. In addition, it presents 2 examples, Ubiquity and Peebles Media Group, which have been chosen to analyse the phenomena of BEC and underpin how universal BEC threat is for all companies. The psychology behind this scam has been, then, studied. In particular, the Big Five Framework has been analysed to understand how personality traits play an important role in Social Engineering-based attacks. Furthermore, the 6 basic principles of influence, by Cialdini, have been presented to show which strategies are adopted in such scam. The paper follows with the analysis of the BEC impacts, the incidents evaluation and, finally, with the description of some precautions, that companies should undertake in order to mitigate the likelihood of a Business Email Compromise.


Too little or too much? Missing the Goldilocks zone of hospital capacity during covid-19


title: Towards treatment planning of COVID-19: Rationale and hypothesis for the use of multiple immunosuppressive agents: Anti-antibodies, immunoglobulins, and corticosteroids

text: The novel coronavirus, SARS-CoV2, can cause a potentially fatal disease, COVID-19, in humans. Here, we will provide an overview of therapeutic options for COVID-19. Plasma from patients recovered from COVID-19 that contains antibodies against SARS-CoV2 has shown promising results in patients with severe COVID-19. Also, IVIG, combined with moderate-dose of corticosteroids, might improve patient outcomes. Evidence links COVID-19 to variable degrees of inflammation. Studies show that the use of corticosteroids might accelerate recovery from COVID-19. There are, however, no controlled clinical trials that show whether the use of corticosteroids can reduce COVID-19-related death. Also, the pro-inflammatory cytokine IL6 is the best-documented cytokine in COVID-19 correlated with severity, criticality, viral load, and prognosis of patients with COVID-19. Tocilizumab, a monoclonal antibody against IL6, could confer clinical benefit in patients with high IL6 levels. Essential elements that process SARS-CoV2 cell entry and specific characteristics that allow SARS-CoV2 to escape the immune system have the potential as targets for COVID-19 therapy.


title: Leading on the Edge of Insanity

text: COVID-19 has officially consumed every nurse leader's time and efforts. The purpose of this article is to share early learnings from the west coast of the United States, where the first U.S case was cared for. In this article, I describe the emerging principles allowing us to respond to an unprecedented crisis: Prevent, Protect, and Control. By the time this crisis is over, I do not doubt that we will have additional science and experience to support our frontline nurses and our nurse leaders. That said, I felt it was important to share our expertise in real-time for others to benefit from. I would also point out that writing about what you are feeling is cathartic-I encourage my colleagues to join me in writing about what you are experiencing.


title: Computational Inference of Selection Underlying the Evolution of the Novel Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2

text: The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that recently emerged in China is thought to have a bat origin, as its closest known relative (BatCoV RaTG13) was described previously in horseshoe bats. We analyzed the selective events that accompanied the divergence of SARS-CoV-2 from BatCoV RaTG13. To this end, we applied a population genetics-phylogenetics approach, which leverages within-population variation and divergence from an outgroup. Results indicated that most sites in the viral open reading frames (ORFs) evolved under conditions of strong to moderate purifying selection. The most highly constrained sequences corresponded to some nonstructural proteins (nsps) and to the M protein. Conversely, nsp1 and accessory ORFs, particularly ORF8, had a nonnegligible proportion of codons evolving under conditions of very weak purifying selection or close to selective neutrality. Overall, limited evidence of positive selection was detected. The 6 bona fide positively selected sites were located in the N protein, in ORF8, and in nsp1. A signal of positive selection was also detected in the receptor-binding motif (RBM) of the spike protein but most likely resulted from a recombination event that involved the BatCoV RaTG13 sequence. In line with previous data, we suggest that the common ancestor of SARS-CoV-2 and BatCoV RaTG13 encoded/encodes an RBM similar to that observed in SARS-CoV-2 itself and in some pangolin viruses. It is presently unknown whether the common ancestor still exists and, if so, which animals it infects. Our data, however, indicate that divergence of SARS-CoV-2 from BatCoV RaTG13 was accompanied by limited episodes of positive selection, suggesting that the common ancestor of the two viruses was poised for human infection.IMPORTANCE Coronaviruses are dangerous zoonotic pathogens; in the last 2 decades, three coronaviruses have crossed the species barrier and caused human epidemics. One of these is the recently emerged SARS-CoV-2. We investigated how, since its divergence from a closely related bat virus, natural selection shaped the genome of SARS-CoV-2. We found that distinct coding regions in the SARS-CoV-2 genome evolved under conditions of different degrees of constraint and are consequently more or less prone to tolerate amino acid substitutions. In practical terms, the level of constraint provides indications about which proteins/protein regions are better suited as possible targets for the development of antivirals or vaccines. We also detected limited signals of positive selection in three viral ORFs. However, we warn that, in the absence of knowledge about the chain of events that determined the human spillover, these signals should not be necessarily interpreted as evidence of an adaptation to our species.


title: Bayesian Optimization of Risk Measures

text: We consider Bayesian optimization of objective functions of the form $\rho[ F(x, W) ]$, where $F$ is a black-box expensive-to-evaluate function and $\rho$ denotes either the VaR or CVaR risk measure, computed with respect to the randomness induced by the environmental random variable $W$. Such problems arise in decision making under uncertainty, such as in portfolio optimization and robust systems design. We propose a family of novel Bayesian optimization algorithms that exploit the structure of the objective function to substantially improve sampling efficiency. Instead of modeling the objective function directly as is typical in Bayesian optimization, these algorithms model $F$ as a Gaussian process, and use the implied posterior on the objective function to decide which points to evaluate. We demonstrate the effectiveness of our approach in a variety of numerical experiments.


A special edition of the Journal of Visceral Surgery on COVID-19: What problems, dangers and solutions have been identified?


Novel coronavirus takes flight from bats?


Letter to the Editor "A longitudinal study on the mental health of general population during the COVID-19 epidemic in China"


Which medical specialties should be prioritised to fill staffing gaps caused by COVID-19 in the United Kingdom? A network analysis


Preventing Infection of Patients and Healthcare Workers Should Be the New Normal in the Era of Novel Coronavirus Epidemics: Comment


title: Out-of-Hospital Cohort Treatment of Coronavirus Disease 2019 Patients with Mild Symptoms in Korea: an Experience from a Single Community Treatment Center

text: The outbreak of Coronavirus Disease 2019 (COVID-19) caused a worldwide pandemic. Less than 6 weeks after the first confirmed cases in Korea, the patient number exceeded 5,000, which overcrowded limited hospital resources and forced confirmed patients to stay at home. To allocate medical resources efficiently, Korea implemented a novel institution for the purpose of treating patients with cohort isolation out of hospital, namely the Community Treatment Center (CTC). Herein, we report results of the initial management of patients at one of the largest CTC in Korea. A total of 309 patients were admitted to our CTC. During the first two weeks, 7 patients were transferred to the hospital because of symptom aggravation and 107 patients were discharged without any complication. Although it is a novel concept and may have some limitations, CTC may be a very cost-effective and resource-saving strategy in managing massive cases of COVID-19 or other emerging infectious diseases.


Supporting Adolescents and Young Adults Exposed to or Experiencing Violence During the COVID-19 Pandemic


title: The first 2 months of COVID-19 contact tracing in the Northern Territory of Australia, March-April 2020

text: The Northern Territory (NT) Centre for Disease Control (CDC) undertook contact tracing of all notified cases of coronavirus disease 2019 (COVID-19) within the Territory. There were 28 cases of COVID-19 notified in the NT between 1 March and 30 April 2020. In total 527 people were identified as close contacts over the same period; 493 were successfully contacted; 445 were located in the NT and were subsequently quarantined and monitored for disease symptoms daily for 14 days after contact with a confirmed COVID-19 case. Of these 445 close contacts, 4 tested positive for COVID-19 after developing symptoms; 2/46 contacts who were cruise ship passengers (4.3%, 95% CI 0.5-14.8%) and 2/51 household contacts (3.9%, 95% CI 0.5-13.5%). None of the 326 aircraft passengers or 4 healthcare workers who were being monitored in the NT as close contacts became cases.


COVID-19 and stigma: Social discrimination towards frontline healthcare providers and COVID-19 recovered patients in Nepal


Healthy communication in the promotion of healthy aging during COVID-19 pandemic


COVID-19, Type 1 Diabetes Clinical Practice, Research, and Remote Medical Care: A View From the Land Down-Under


title: Uncovering psychobehavioral implications of SARS-CoV-2 infection in Iran

text: Iran is the country in Western Asia most impacted by the COVID-19 outbreak. A survey was conducted among the general public in Iran aimed at investigating psychobehavioural issues related to the COVID-19 outbreak, namely: 1) barriers to preventive measures against SARS-CoV-2 infection; 2) negative emotions toward SARS-CoV-2 infection; and 3) anxiety levels among the general public in Iran. A cross-sectional, web-based survey using an online questionnaire was carried out between 16 March and 1 April 2020. The six-item version of the State-Trait Anxiety Inventory (STAI-6) was used to assess anxiety levels. A total of 1,789 complete responses were received. Nearly 60% reported having difficulty in wearing a face mask to protect against SARS-CoV-2 infection. The mean and standard deviation (SD) for the total prevention barrier score was 35.8 (SD ± 7.1; range 18 to 68) out of a possible score of 72. Male respondents [odds ratio (OR) = 1.25; 95% confidence interval (CI) 1.03 to 1.51] and respondents who perceived their health status as poor/fair (OR = 1.49; 95% CI 1.31 to 1.82) were predictors of high prevention barriers. Negative emotions such as fear (74.6%), followed by depression (43.4%) and stigma (23.0%) associated with SARS-CoV-2 infection were reported. Respondents who perceived their health as poor/fair (OR = 2.19; 95% CI 1.57 to 3.04) reported a higher likelihood of having higher negative emotions. Findings on anxiety level revealed 68.0% (95% CI 65.8 to 70.1) reported moderate to severe anxiety. Respondents who perceived their health as poor/fair (OR = 3.46; 95% CI 12.22 to 5.40) and who were females (OR = 1.91; 95% CI 1.55 to 2.36) were predictors of moderate to severe anxiety. In conclusion, psychobehavioural interventions are needed to facilitate management and control of the COVID-19 outbreak.


title: Protective role of endothelial calpain knockout in lipopolysaccharide-induced acute kidney injury via attenuation of the p38-iNOS pathway and NO/ROS production

text: To explore the role of calpain and its signaling pathway in lipopolysaccharide (LPS)-induced acute kidney injury (AKI), animal models of endotoxemia were established by administration of LPS to mice with endothelial-specific Capn4 knockout (TEK/Capn4-/-), mice with calpastatin (an endogenous calpain inhibitor) overexpression (Tg-CAST) and mice with myeloid-specific Capn4 knockout (LYZ/Capn4-/-). Mouse pulmonary microvascular endothelial cells (PMECs) were used as a model of the microvascular endothelium and were stimulated with LPS. Renal function, renal inducible nitric oxide synthase (iNOS) and endothelial NOS (eNOS) expression, cellular apoptosis, plasma and renal levels of NO and reactive oxygen species (ROS), and phosphorylation of mitogen-activated protein kinase (MAPK) family members (p38, ERK1/2, and JNK1/2) were examined. Moreover, a calpain inhibitor, calpastatin overexpression adenoviruses and MAPK inhibitors were used. Significant renal dysfunction was induced by LPS stimulation, and recovery was observed in TEK/Capn4-/- and Tg-CAST mice but not in LYZ/Capn4-/- mice. Endothelial Capn4 knockout also abrogated the LPS-induced increases in renal iNOS expression, caspase-3 activity and apoptosis and plasma and renal NO and ROS levels but did not obviously affect renal eNOS expression. Moreover, LPS increased both calpain and caspase-3 activity, and only the expression of iNOS in PMECs was accompanied by increased phosphorylation of p38 and JNK. Inhibiting calpain activity or p38 phosphorylation alleviated the increased iNOS expression, NO/ROS production, and cellular apoptosis induced by LPS. These results suggest that endothelial calpain plays a protective role in LPS-induced AKI by inhibiting p38 phosphorylation, thus attenuating iNOS expression and further decreasing NO and ROS overproduction-induced endothelial apoptosis.


Author Response: Coronavirus Disease 2019 (COVID-19), Infectivity, and the Incubation Period


Lindring av truende kvelning hos døende pasienter med covid-19./ Lindring av truende kvelning hos døende pasienter med covid-19./ Relieving the sensation of suffocation in patients dying with COVID-19


Domestic Violence and Safe Storage of Firearms in the COVID-19 Era


title: Characteristics and assessment of the usefulness of serological tests in the diagnostic of infections caused by coronavirus SARS-CoV-2 on the basis of available manufacturer's data and literature review

text: Recognized in 2019 in Wuhan, China, the new SARS-CoV-2 coronavirus is responsible for the occurrence of a global pandemic disease called COVID-19. So far, confirmation of infection is based on the detection of virus RNA in a sample taken from a person meeting the suspected case definition. However, in the laboratory diagnosis of SARS-CoV-2 infections, in addition to genetic tests, serological methods can also be used to detect specific antibodies of the IgM, IgG and IgA class produced after contact with antigens or to detect viral antigen. Currently, a number of rapid immunochromatographic, chemiluminescent and ELISA immunoassay tests developed by different manufacturers for the diagnosis of COVID-19 are available on the market. Despite this fact, so far there is no WHO or ECDC recommendations or even reliable research regarding the usefulness of serological investigations in the laboratory diagnosis of infections caused by SARS-CoV-2.


title: Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19)

text: The current coronavirus (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence, it is time to step back and ask why telehealth is not mainstreamed. In this article, we highlight key requirements for this to occur. Strategies to ensure that telehealth is used regularly in acute, post-acute and emergency situations, alongside conventional service delivery methods, include flexible funding arrangements, training and accrediting our health workforce. Telehealth uptake also requires a significant change in management effort and the redesign of existing models of care. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long-term, and help with the everyday (and emergency) challenges in healthcare.


Extracorporeal Membrane Oxygenation - Crucial Considerations during the Coronavirus Crisis


title: COVID-19 severity correlates with airway epithelium-immune cell interactions identified by single-cell analysis

text: To investigate the immune response and mechanisms associated with severe coronavirus disease 2019 (COVID-19), we performed single-cell RNA sequencing on nasopharyngeal and bronchial samples from 19 clinically well-characterized patients with moderate or critical disease and from five healthy controls. We identified airway epithelial cell types and states vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In patients with COVID-19, epithelial cells showed an average three-fold increase in expression of the SARS-CoV-2 entry receptor ACE2, which correlated with interferon signals by immune cells. Compared to moderate cases, critical cases exhibited stronger interactions between epithelial and immune cells, as indicated by ligand-receptor expression profiles, and activated immune cells, including inflammatory macrophages expressing CCL2, CCL3, CCL20, CXCL1, CXCL3, CXCL10, IL8, IL1B and TNF. The transcriptional differences in critical cases compared to moderate cases likely contribute to clinical observations of heightened inflammatory tissue damage, lung injury and respiratory failure. Our data suggest that pharmacologic inhibition of the CCR1 and/or CCR5 pathways might suppress immune hyperactivation in critical COVID-19.


Can SARS-CoV-2 Infection Be Acquired In Utero?: More Definitive Evidence Is Needed


title: Predictors of progression from moderate to severe coronavirus disease 2019: a retrospective cohort

text: OBJECTIVE: Most cases of coronavirus disease 2019 (COVID-19) are identified as moderate, which is defined as having a fever or dry cough and lung imaging with ground-glass opacities. The risk factors and predictors of prognosis in such cohorts remain uncertain. METHODS: All adults with COVID-19 of moderate severity diagnosed using quantitative RT-PCR and hospitalized at the Central Hospital of Wuhan, China, from 1 January to 20 March 2020 were enrolled in this retrospective study. The main outcomes were progression from moderate to severe or critical condition or death. RESULTS: Among the 456 enrolled patients with moderate COVID-19, 251/456 (55.0%) had poor prognosis. Multivariate logistic regression analysis identified higher neutrophil count: lymphocyte count ratio (NLR) on admission (OR 1.032, 95% CI 1.042-1.230, p 0.004) and higher C-reactive protein (CRP) on admission (OR 3.017, 95% CI 1.941-4.690, p < 0.001) were associated with increased OR of poor prognosis. The area under the receiver operating characteristic curve (AUC) for NLR and CRP in predicting progression to critical condition was 0.77 (95% CI 0.694-0.846, p < 0.001) and 0.84 (95% CI 0.780-0.905, p < 0.001), with a cut-off value of 2.79 and 25.95 mg/L, respectively. The AUC of NLR and CRP in predicting death was 0.81 (95% CI 0.732-0.878, p < 0.001) and 0.89 (95% CI 0.825-0.946, p < 0.001), with a cut-off value of 3.19 and 33.4 mg/L, respectively. CONCLUSIONS: Higher levels of NLR and CRP at admission were associated with poor prognosis of individuals with moderate COVID-19. NLR and CRP were good predictors of progression to critical condition and death.


Endocrinology in the time of COVID-19


Syndrome respiratoire aigu sévère dû au coronavirus 2 (SRAS-CoV-2) : faut-il cibler le virus, la cellule ou la maladie ?/ Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): Should we target the virus, the cell or the disease?


People are to blame for Covid-19


Paying SPECIAL consideration to the digital sharing of information during the COVID-19 pandemic and beyond


title: Can we predict the occurrence of COVID-19 cases? Considerations using a simple model of growth

text: This study aimed to present a simple model to follow the evolution of the COVID-19 (CV-19) pandemic in different countries. The cumulative distribution function (CDF) and its first derivative were employed for this task. The simulations showed that it is almost impossible to predict based on the initial CV-19 cases (1st 2nd or 3rd weeks) how the pandemic will evolve. However, the results presented here revealed that this approach can be used as an alternative for the exponential growth model, traditionally employed as a prediction model, and serve as a valuable tool for investigating how protective measures are changing the evolution of the pandemic.


Response to the commentary by Alexandra A. Chudnovsky on 'Assessing nitrogen dioxide (NO2) levels as a contributing factor to coronavirus (COVID-19) fatality'


title: La réhabilitation: indispensable pour les survivants d'un COVID-19 sévère./ [Rehabilitation is crucial for severe COVID-19 survivors]

text: COVID-19 survivors can have serious complications from this viral infection, particularly respiratory and cardiovascular with severe asthenia and fatigue. Several studies have already demonstrated the benefit of early rehabilitation after the acute phase, especially in patients who have been in intensive care. The authors present a rehabilitation program including interdisciplinary care with simple and reproducible clinical criteria.


An Imperative Need for Research on the Role of Environmental Factors in Transmission of Novel Coronavirus (COVID-19)


title: Metaplasia in swim bladder epithelium of the endangered annual fish Austrolebias nigrofasciatus (Cyprinodontiformes: Rivulidae) results in inadequate swimming and delayed growth

text: Laboratory breeding of annual fish is often impaired when fish fail to inflate the swim bladder after hatching. These fish, which are known as belly-sliders, cannot swim in the water column, moving mainly on the bottom of water. Therefore, we wanted to understand the factors underlying failed inflation of swim bladder in the annual fish Austrolebias nigrofasciatus and determine the implications of this condition on the growth of juveniles. To identify how the initial filling of the gaseous vesicle is compromised, and to determine the implications of this condition on juvenile growth, we analysed the histology of the swim bladder of both normal swimming fish and belly-sliders during their initial growth phase (first month of life). In addition to slower growth rate compared with fish swimming normally, we found that belly-sliders have metaplasia characterized by epithelium peeling of the swim bladder and the presence of haemorrhage. Based on our findings, it can be concluded that metaplasia of the swim bladder is recurrent in annual fish bred in the laboratory, which explains the large number of unviable larvae. However, its causes remain unknown.(AU)


title: The Risk of Diabetes on Clinical Outcomes in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study

text: BACKGROUND: To determine the role of diabetes mellitus (DM) in the coronavirus disease 2019 (COVID-19), we explored the clinical characteristics of patients with DM and compared risk factors such as age, glycemic control, and medications to those without DM. METHODS: This was a retrospective cohort study of 117 confirmed patients with COVID-19 which conducted at a tertiary hospital in Daegu, South Korea. The primary outcome was defined as the severe and critical outcome (SCO), of which the composite outcomes of acute respiratory distress syndrome, septic shock, intensive care unit care, and 28-day mortality. We analyzed what clinical features and glycemic control-related factors affect the prognosis of COVID-19 in the DM group. RESULTS: After exclusion, 110 participants were finally included. DM patients (n=29) was older, and showed higher blood pressure compared to non-DM patients. DM group showed higher levels of inflammation-related biomarkers and severity score, and highly progressed to SCO. After adjustment with other risk factors, DM increased the risk of SCO (odds ratio [OR], 10.771; P<0.001). Among the DM patients, SCO was more prevalent in elderly patients of ≥70 years old and age was an independent risk factor for SCO in patients with DM (OR, 1.175; P=0.014), while glycemic control was not. The use of medication did not affect the SCO, but the renin-angiotensin system inhibitors showed protective effects against acute cardiac injury (OR, 0.048; P=0.045). CONCLUSION: The COVID-19 patients with DM had higher severity and resulted in SCO. Intensive and aggressive monitoring of COVID-19 clinical outcomes in DM group, especially in elderly patients is warranted.


title: Trials and tribulations of young residents fighting COVID-19

text: No one could foresee that an unknown novel virus far away in Asia eventually would end up as world's largest disaster. As days went by, COVID-19 soon began gaining international attention with its significant infectiousness, rapidly deteriorating course and mortality, even in young people.


title: Influence of the pandemic dissemination of COVID-19 on radiotherapy practice: A flash survey in Germany, Austria and Switzerland

text: BACKGROUND: The COVID-19 pandemic has already changed our globalised world and its long-term impact is not yet known. It is apparent that businesses and institutions are increasingly affected. COVID-19 discussions often focus on intensive care units in hospitals. However, COVID-19 also effects life-saving and -prolonging radiotherapy for patients suffering from cancer. METHOD: We have conducted a structured online survey among medical physicists in Germany, Austria and Switzerland from March 23rd to 26th 2020. In total 154 responses (82 completed, 72 partially completed) were analysed in the context of the COVID-19 dissemination. RESULTS: 72.4% of the respondent's state that their processes are affected due to COVID-19, while the top three answers are longer processing times (54.2%), patient no-shows (42.5%) and staff reduction (36.7%). 75.8% expect further unavailability of their personnel in the upcoming weeks. All participants have already taken several measures, especially providing information for patients at the entrance (89.6%) or over the phone (73.6%), restricting access for accompanying persons (77.4%) and providing disinfectant at the entrance (72.6%). DISCUSSION: The results presented in this article aim to support business continuity and risk management for radiotherapy centres to prepare for future challenges. The results show that most radiotherapy centres has implemented initial contingency measures, applying them pragmatically. The main problem however remains, that is the high risk of infection both for patients and medical personnel along with the associated risk of temporarily loss of personnel and ordered closure of business.


Tele(oral)medicine: A new approach during the COVID-19 crisis


Long-term suicide prevention during and after the COVID-19 epidemic


title: Hazardous Postoperative Outcomes of Unexpected COVID-19 Infected Patients: A Call for Global Consideration of Sampling all Asymptomatic Patients Before Surgical Treatment

text: BACKGROUND: In December 2019, a novel coronavirus was identified as the cause of many pneumonia cases in China and eventually declared as a pandemic as the virus spread globally. Few reports were published on the outcome of surgical procedures in diagnosed COVID-19 patients and even fewer on the surgical outcomes of asymptomatic undiagnosed COVID-19 surgical patients. We aimed to review all published data regarding surgical outcomes of preoperatively asymptomatic untested coronavirus disease 2019 (COVID-19) patients. METHODS: This report is a review on the perioperative period in COVID-19 patients who were preoperatively asymptomatic and not tested for COVID-19. Searches were conducted in PubMed April 4th, 2020. All publications, of any design, were considered for inclusion. RESULTS: Four reports were identified through our literature search, comprising 64 COVID-19 carriers, of them 51 were diagnosed only in the postoperative period. Synthesis of these reports, concerning the postoperative outcomes of patients diagnosed with COVID-19 during the perioperative period, suggested a 14/51 (27.5%) postoperative mortality rate and severe mostly pulmonic complications, as well as medical staff exposure and transmission. CONCLUSIONS: COVID-19 may have potential hazardous implications on the perioperative course. Our review presents results of unacceptable mortality rate and a high rate of severe complications. These observations warrant further well-designed studies, yet we believe it is time for a global consideration of sampling all asymptomatic patients before surgical treatment.


Aerosol box, An Operating Room Security Measure in COVID-19 Pandemic


title: Intergenerational Relationships, Family Caregiving Policy, and COVID-19 in the United States

text: Families and intergenerational relationships are important sources of risk for COVID-19 infection, especially for older adults who are at high risk of complications from the disease. If one family member is exposed to the virus they could serve as a source of transmission or, if they fall ill, the resources they provide to others could be severed. These risks may be especially heightened for family members who work outside the home and provide care, or for those family members who care for multiple generations. Policies have the potential to help families bear the burden of these decisions. This essay argues that policies that address health, employment, and other social issues have implications for families, and that policies aimed at families and caregivers can affect the health, employment, and the general well-being of the nation.


How COVID-19 affects patients receiving anticytokine and JAK inhibitors in rheumatology and dermatology


Are COVID-19 survivors at increased risk for suicide?


Masks and Coronavirus Disease 2019 (COVID-19)


Covid-19: Frontline doctors continue PPE fight


SARS-CoV-2 Infection: Beyond the Interstitial Pneumonia


Real-world assessment of the clinical impact of symptomatic infection with severe acute respiratory syndrome coronavirus (COVID-19 disease) in patients with multiple myeloma receiving systemic anti-cancer therapy


Continuation versus discontinuation of ACE inhibitors or angiotensin II receptor blockers in COVID-19: effects on blood pressure control and mortality


Besides population age structure, health and other demographic factors can contribute to understanding the COVID-19 burden


COVID-19: GENERAL GUIDELINES FOR CARDIOVASCULAR SURGEONS (standard guidelines - subject to change)


title: Diagnostic performances and thresholds: The key to harmonization in serological SARS-CoV-2 assays?

text: BACKGROUND: The evaluation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) specific antibody (Ab) assay performances is of the utmost importance in establishing and monitoring virus spread in the community. In this study focusing on IgG antibodies, we compare reliability of three chemiluminescent (CLIA) and two enzyme linked immunosorbent (ELISA) assays. METHODS: Sera from a total of 271 subjects, including 64 reverse transcription-polymerase chain reaction (RT-PCR) confirmed SARS-CoV-2 patients were tested for specific Ab using Maglumi (Snibe), Liaison (Diasorin), iFlash (Yhlo), Euroimmun (Medizinische Labordiagnostika AG) and Wantai (Wantai Biological Pharmacy) assays. Diagnostic sensitivity and specificity, positive and negative likelihood ratios were evaluated using manufacturers' and optimized thresholds. RESULTS: Optimized thresholds (Maglumi 2 kAU/L, Liaison 6.2 kAU/L and iFlash 15.0 kAU/L) allowed us to achieve a negative likelihood ratio and an accuracy of: 0.06 and 93.5% for Maglumi; 0.03 and 93.1% for Liaison; 0.03 and 91% for iFlash. Diagnostic sensitivities and specificities were above 93.8% and 85.9%, respectively for all CLIA assays. Overall agreement was 90.3% (Cohen's kappa = 0.805 and SE = 0.041) for CLIA, and 98.4% (Cohen's kappa = 0.962 and SE = 0.126) for ELISA. CONCLUSIONS: The results obtained indicate that, for CLIA assays, it might be possible to define thresholds that improve the negative likelihood ratio. Thus, a negative test result enables the identification of subjects at risk of being infected, who should then be closely monitored over time with a view to preventing further viral spread. Redefined thresholds, in addition, improved the overall inter-assay agreement, paving the way to a better harmonization of serologic tests.


COVID-19 lockdown of Roma settlements in Slovakia


Secondary Emotional Reactions to the COVID-19 Outbreak Should Be Identified and Treated in Korea


title: Janus sword actions of chloroquine and hydroxychloroquine against COVID-19

text: Chloroquine (CQ) and its analogue hydroxychloroquine (HCQ) have been thrust into our everyday vernacular because some believe, based on very limited basic and clinical data, that they might be helpful in preventing and/or lessening the severity of the pandemic coronavirus disease 2019 (COVID-19). However, lacking is a temperance in enthusiasm for their possible use as well as sufficient perspective on their effects and side-effects. CQ and HCQ have well-known properties of being diprotic weak bases that preferentially accumulate in acidic organelles (endolysosomes and Golgi apparatus) and neutralize luminal pH of acidic organelles. These primary actions of CQ and HCQ are responsible for their anti-malarial effects; malaria parasites rely on acidic digestive vacuoles for survival. Similarly, de-acidification of endolysosomes and Golgi by CQ and HCQ may block severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) integration into host cells because SARS-CoV-2 may require an acidic environment for its entry and for its ability to bud and infect bystander cells. Further, de-acidification of endolysosomes and Golgi may underly the immunosuppressive effects of these two drugs. However, modern cell biology studies have shown clearly that de-acidification results in profound changes in the structure, function and cellular positioning of endolysosomes and Golgi, in signaling between these organelles and other subcellular organelles, and in fundamental cellular functions. Thus, studying the possible therapeutic effects of CQ and HCQ against COVID-19 must occur concurrent with studies of the extent to which these drugs affect organellar and cell biology. When comprehensively examined, a better understanding of the Janus sword actions of these and other drugs might yield better decisions and better outcomes.


'Most vaccinations should not be carried out'


Current Mental Health Issues in the Era of Covid-19


title: Master Regulator Analysis of the SARS-CoV-2/Human Interactome

text: The recent epidemic outbreak of a novel human coronavirus called SARS-CoV-2 causing the respiratory tract disease COVID-19 has reached worldwide resonance and a global effort is being undertaken to characterize the molecular features and evolutionary origins of this virus. In this paper, we set out to shed light on the SARS-CoV-2/host receptor recognition, a crucial factor for successful virus infection. Based on the current knowledge of the interactome between SARS-CoV-2 and host cell proteins, we performed Master Regulator Analysis to detect which parts of the human interactome are most affected by the infection. We detected, amongst others, affected apoptotic and mitochondrial mechanisms, and a downregulation of the ACE2 protein receptor, notions that can be used to develop specific therapies against this new virus.


title: Covid-19 and medical liability: A delicate balance

text: During the Covid-19 pandemic, many countries around the world are considering whether and how to provide liability protection to front-line healthcare staff. The guiding principle of liability protection for physicians and others is to ensure that, in a serious emergency situation, health professionals can devote themselves exclusively to their work and to patient care, without the fear of future claims for unforeseeable, but above all unavoidable, injury, loss and damage caused by their conduct. Great care is needed to balance the interests and rights of all those involved. Liability protection could have risky consequences with the final result that doctors will not be protected, but institutions such as health facilities will be even if they were in fact responsible for foreseeable and avoidable damage.


title: Prediction of the transition from sub-exponential to the exponential transmission of SARS-CoV-2 and epidemic nowcasting for metro-zones: Experiences from Chennai-Metro-Merge, India

text: BACKGROUND: Several countries adopted lockdown to slowdown the exponential transmission of the COVID-19 epidemic. Disease transmission models and the epidemic forecasts at national level steer the policy to implement appropriate intervention strategies and budgeting. However, it is critical to design a data-driven reliable model for nowcasting for the small population, in particular metro cities. OBJECTIVE: The objective of this work is to analyze the transition of the epidemic from sub-exponential to exponential transmission in Chennai metro-zone and to analyze the probability of SARS-CoV-2 secondary infections while availing the public transport systems in the city. METHODS: A single geographical zone "Chennai-Metro-Merge" was constructed by combining Chennai district with three bordering districts. Sub-exponential and exponential models were developed to analyze and predict the progression of COVID-19 epidemic. Probabilistic models were applied to assess the probability of secondary infections while availing the public transport after the release of the lockdown. RESULTS: The model predicted that transition from sub-exponential to exponential transmission occurs around eighth week after the reporting a cluster of cases. The probability of the secondary infections with a single index case in an enclosure of the city bus and the sub-urban train general coach and ladies coach was found to be 0.192, 0.074 and 0.114 respectively. CONCLUSIONS: Nowcasting at the early stage of the epidemic predicts the probable time point of the exponential transmission and alerts the public health system. After the lockdown release, public transports will be the major sources of SARS-CoV-2 transmission in metro cities and appropriate strategies based on nowcasting are highly desirable.


Family in the Age of COVID-19


Fecal Shedding of SARS CoV-2: Implications for Disease Spread and Quarantine


Is virtual existence our new reality?


COVID-19 and improved prevention of hospital-acquired infection


Excess mortality from COVID-19: a commentary on the Italian experience


Paediatric COVID-19 admissions in a region with open schools during the two first months of the pandemic


Cardiopulmonary Considerations for High School Student-Athletes During the COVID-19 Pandemic: NFHS-AMSSM Guidance Statement


title: Understanding the Perceived Mental Health of Canadians During the COVID-19 Pandemic

text: BACKGROUND: While the physical health implications of the COVID-19 pandemic are regularly publicly available, the mental health toll on Canadians is unknown. This article examines the self-perceived mental health of Canadians during the COVID-19 pandemic and explores associations with various concerns after accounting for socioeconomic and health factors. DATA: The cross-sectional Canadian Perspectives Survey Series 1 collected information related to COVID-19 in late March and early April 2020 concerning labour market participation, behaviours, and health for the Canadian population 15 years and older living in the 10 provinces. METHODS: Socioeconomic and health characteristics of respondents as well as concerns about the impact of COVID-19 were examined to determine differences in experiencing excellent or very good compared to good, fair or poor perceived mental health. RESULTS: Just over half of Canadians aged 15 and older (54%) reported excellent or very good mental health during the COVID-19 pandemic. Several concerns were also associated with mental health. Notably, after considering the effects of socioeconomic and health characteristics, women, youth, individuals with a physical health condition and those who were very or extremely concerned with family stress from confinement were less likely to report excellent or very good mental health. DISCUSSION: These findings point to particular risks for lower perceived mental health during the COVID-19 pandemic. Results highlight various concerns of Canadians which may be associated with mental health, in particular, family stress in the home.


title: [Kritikus állapotú, légzéstámogatást igénylo COVID19-fertozött beteg ellátásának gyakorlati szempontjai]/ Practical aspects of intensive care for critically ill COVID-19 patients requiring respiratory support

text: In December 2019, a novel outbreak of pneumonia was reported in Wuhan city, China. Initially, the zoonitic infection spread from human to human, causing a pandemic. This viral disease (COVID-19) can appear in a variety of forms, from asymptomatic through the spectrum of mild symptoms to severe respiratory failure, requiring intensive care. Caring for this latter group of patients puts a significant burden on health care. The purpose of this summary is to present the practical aspects of intensive care for patients requiring respiratory support and mechanical ventilation. Orv Hetil. 2020; 161(17): 678684.


title: Dysregulation of the immune system as a driver of the critical course of the novel coronavirus disease 2019

text: Novel coronavirus disease-2019 (COVID-19) is a highly contagious respiratory-related disease induced by the newly emerged virus SARS-CoV-2. Given that inflammatory immune cells may induce severe lung injury, the involvement of immune factors in the pathogenesis of the disease cannot be overestimated. It has been demonstrated that coronaviruses (CoVs) have developed mechanisms of immune evasion, making them invisible to the immune system at an early stage of infection. The mechanism relies on inhibition of the anti-viral response of type I interferons (IFNs), which supports uncontrolled viral replication in epithelial cells. There is growing body of evidence that the fatal hyperinflammation ('cytokine storm') responsible for the severe course of COVID-19 is a consequence of massive SARS-CoV-2 replication rather than inappropriate hyperresponsiveness of the immune system. Therefore, a dampened innate anti-viral immune response seems to be the primary cause of the delayed critical cascade of uncontrolled immune events leading to fulminating systemic inflammation. The occurrence of virus transmission even in asymptomatic subjects infected with SARS-CoV-2 clearly strengthens the evidence for a key role of sufficient immune control of viral replication in a subset of cases (e.g. in children, a population with highly effective innate immune responses). Although administration of immunomodulatory therapeutics is recommended under certain conditions in the guidelines of COVID-19 management, controversies regarding treatment protocols in immunocompromised patients infected with SARS-CoV-2 still exist. Extended knowledge of clinicians on the dysregulated immune response, which is a driver of the COVID-19 outcome, may improve both therapeutic protocols and the prognosis of SARS-CoV-2 infected patients.


title: Cognitive, Affective, and Behavioral Constructs of COVID-19 Health Beliefs: A Comparison Between Sexual Minority and Heterosexual Individuals in Taiwan

text: This online survey study aimed to compare the cognitive, affective, and behavioral constructs of health beliefs related to coronavirus disease 2019 (COVID-19) between sexual minority and heterosexual individuals in Taiwan. In total, 533 sexual minority and 1421 heterosexual participants were recruited through a Facebook advertisement. The constructs pertaining to cognition (perceived relative susceptibility to COVID-19, perceived COVID-19 severity, having sufficient knowledge and information on COVID-19, and confidence in coping with COVID-19), affect (worry toward COVID-19), and behavior (adoption of health-protective behaviors) in relation to health beliefs about COVID-19 were compared between sexual minority and heterosexual participants. The results indicated that sexual minority participants had lower perceived susceptibility to COVID-19, greater self-confidence in coping with COVID-19, and lower worry about COVID-19 and were less likely to maintain good indoor ventilation and disinfect their household than heterosexual individuals. Sexual orientation is the modifying factor for the Health Belief Model in the COVID-19 pandemic and should be taken into consideration when medical professionals establish prevention programs for COVID-19.


title: Nanotechnology for COVID-19: Therapeutics and Vaccine Research

text: The current global health threat by the novel coronavirus disease 2019 (COVID-19) requires an urgent deployment of advanced therapeutic options available. The role of nanotechnology is highly relevant to counter this "virus" nano enemy. Nano intervention is discussed in terms of designing effective nanocarriers to counter the conventional limitations of antiviral and biological therapeutics. This strategy directs the safe and effective delivery of available therapeutic options using engineered nanocarriers, blocking the initial interactions of viral spike glycoprotein with host cell surface receptors, and disruption of virion construction. Controlling and eliminating the spread and reoccurrence of this pandemic demands a safe and effective vaccine strategy. Nanocarriers have potential to design risk-free and effective immunization strategies for severe acute respiratory syndrome coronavirus 2 vaccine candidates such as protein constructs and nucleic acids. We discuss recent as well as ongoing nanotechnology-based therapeutic and prophylactic strategies to fight against this pandemic, outlining the key areas for nanoscientists to step in.


title: How to perform lung ultrasound in pregnant women with suspected COVID-19

text: Under certain circumstances, such as during the current COVID-19 outbreak, pregnant women can be a target for respiratory infection, and lung examination may be required as part of their clinical evaluation, ideally while avoiding exposure to radiation. We propose a practical approach for obstetricians/gynecologists to perform lung ultrasound examination, discussing potential applications, semiology and practical aspects, which could be of particular importance in emergency situations, such as the current pandemic infection of COVID-19. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.


title: SARS-CoV2 and immunosuppression: a double-edged sword

text: Severe acute respiratory syndrome Coronavirus 2 (SARS-Cov2) outbreak has caused a pandemic rapidly impacting on the way of life of the entire world. This impact in the specific setting of transplantation and immunosuppression has been poorly explored to date. Discordant data exist on the impact of previous coronavirus outbreaks on immunosuppressed patients. Overall, only a very limited number of cases have been reported in literature, suggesting that transplanted patients not necessarily present an increased risk of severe SARS-Cov2-related disease compared to the general population. We conducted a literature review related to the impact of immunosuppression on coronavirus infections including case reports and series describing immunosuppression management in transplant recipients. The role of steroids, calcineurin inhibitors and mycophenolic acid has been explored more in detail. A point-in-time snapshot of the yet released literature and some considerations in relation to the use of immunosuppression in SARS-Cov2 infected transplant recipients are provided here for the physicians dealing with immunocompromised patients.


Pronóstico perinatal y de la paciente embarazada con infección por COVID-19./ [Pregnancy and perinatal outcome of a woman with COVID-19 infection]


title: Management strategies for the burn ward during COVID-19 pandemic

text: COVID-19 pandemic is sweeping the globe. Any outpatient or new inpatient especial in burn department during the pandemic should be as a potential infectious source of COVID-19. It is very important to manage the patients and wards carefully and correctly to prevent epidemic of the virus in burn centers. This paper provides some strategies regarding management of burn ward during the epidemic of COVID-19 or other respiratory infectious diseases.


Rapid deployment of virtual ICU support when resources are compromised


COVID-19-Related Stroke: Barking up the Wrong Tree?


Situación clínica de infección por SARS-CoV-2 en pacientes con carcinoma broncogénico: contexto actual./ Situación clínica de infección por SARS-CoV-2 en pacientes con carcinoma broncogénico: contexto actual./ SARS-CoV-2 Infection in Patients with Lung Cancer: Current Clinical Context


title: Decentralised, privacy-preserving Bayesian inference for mobile phone contact tracing

text: Many countries are currently gearing up to use smart-phone apps to perform contact tracing as part of the effort to manage the COVID-19 pandemic and prevent resurgences of the disease after the initial outbreak. With the announcement of the Apple/Google partnership to introduce contact-tracing functionality to iOS and Android, it seems likely that this will be adopted in many countries. An important part of the functionality of the app will be to decide whether a person should be advised to self-isolate, be tested or end isolation. However, the privacy preserving nature of the Apple/Google contact tracing algorithm means that centralised curation of these decisions is not possible so each phone must use its own"risk model"to inform decisions. Ideally, the risk model should use Bayesian inference to decide the best course of action given the test results of the user and those of other users. Here we present a decentralised algorithm that estimates the Bayesian posterior probability of viral transmission events and evaluates when a user should be notified, tested or released from isolation while preserving user privacy. The algorithm also allows the disease models on the phones to learn from everyone's contact-tracing data and will allow Epidemiologists to better understand the dynamics of the disease. The algorithm is a message passing algorithm, based on belief propagation, so each smart-phone can be used to execute a small part of the algorithm without releasing any sensitive information. In this way, the network of all participating smart-phones forms a distributed computation device that performs Bayesian inference, informs each user when they should start/end isolation or be tested and learns about the disease from user's data.


Obesity and impaired metabolic health in patients with COVID-19


title: Altered Mental Status as a Novel Initial Clinical Presentation for COVID-19 Infection in the Elderly

text: The coronavirus disease of 2019 or COVID-19 was first identified in Hubei Province in China in November of 2019 and quickly spread to become a global pandemic. The virus, SARS-Coronavirus-2 (2-SARS-CoV-2), is particularly virulent in the elderly who can develop symptoms and become mortally ill within days of contracting the virus. The virus is easily transmitted by droplets (e.g., sneezing, coughing) and communal living settings such as personal care homes can be vulnerable to the spread of the virus. Identifying patients early in the disease process is important to providing appropriate medical interventions. To date, most of the medical literature, including Center for Disease Control guidelines, has relied on three necessary symptoms in making the diagnosis of COVID-19: fever, cough and shortness of breath. We present four cases of elderly patients who developed altered mental status as their presenting symptom without associated fever or respiratory symptoms.


title: Probiotics and COVID-19: is there any link?

text: Understanding mechanisms of the novel SARS-CoV2 infection and progression, can provide potential novel targets for prevention and/or treatment. This could be achieved via the inhibition of viral entry and/or replication, or by suppression the immunologic response that is provoked by the infection (known as the cytokine storm). Probiotics are defined as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host". There is scarcity of evidence about the relationship between COVID-19 and gut microbiota. So, whether or not these supplements can prevent or ameliorate COVID-19 associated symptoms is not fully understood. The aim of this paper is to provide an indirect evidence about the utility of probiotics in combating COVID-19 or its associated symptoms, through the review of its antiviral and anti-inflammatory properties in vitro, animal models, and human trials.


COVID-19 and pulmonary rehabilitation: preparing for phase three


title: Fear of COVID-19 and the mental health consequences in America

text: The intent of this work was to examine the intersection of COVID-19 fear with social vulnerabilities and mental health consequences among adults living in the United States. Data are from a nationally representative sample (n = 10,368) of U.S. adults surveyed online during demographic subgroups (gender, age, income, race and ethnicity, geography). The sample week of March 23, 2020. The sample was poststratification weighted to ensure a balanced representation across social and demographic subgroups (gender, age, income, race or ethnicity, geography). The sample comprised 51% female; 23% non-White; 18% Hispanic; 25% of households with children under 18 years of age; 55% unmarried; and nearly 20% unemployed, laid off, or furloughed at the time of the interview. Respondents were fearful, averaging a score of nearly 7 on a scale of 10 when asked how fearful they were of COVID-19. Preliminary analysis suggests clear spatial diffusion of COVID-19 fear. Fear appears to be concentrated in regions with the highest reported COVID-19 cases. Significant differences across several U.S. census regions are noted (p < .01). Additionally, significant bivariate relationships were found between socially vulnerable respondents (female, Asians, Hispanic, foreign-born, families with children) and fear, as well as with mental health consequences (anxiety and depressive symptoms). Depressive symptoms, on average, were high (16+ on the Center for Epidemiologic Studies Depression scale), and more than 25% of the sample reported moderate to severe anxiety symptoms. More in-depth psychosocial research is needed using nationally representative samples that can help to inform potential mental health risks, as well as by targeting specific mental health interventions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: The early landscape of coronavirus disease 2019 vaccine development in the UK and rest of the world

text: Since the first World Health Organization notification on 31 December 2019, coronavirus disease 2019 (COVID-19), the respiratory disease caused by the coronavirus severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been responsible for over four million confirmed infections and almost 300 000 deaths worldwide. The pandemic has led to over half of the world's population living under lockdown conditions. To allow normal life to resume, public health interventions will be needed to prevent further waves of infections as lockdown measures are lifted. As one of the most effective countermeasures against infectious diseases, an efficacious vaccine is considered crucial to containing the COVID-19 pandemic. Following the publication of the genome sequence of SARS-CoV-2, vaccine development has accelerated at an unprecedented pace across the world. Here we review the different platforms employed to develop vaccines, the standard timelines of development and how they can be condensed in a pandemic situation. We focus on vaccine development in the UK and vaccines that have entered clinical trials around the world.


Retraso diagnóstico durante la pandemia por COVID-19: absceso hepático secundario a colecistitis aguda litiásica./ Retraso diagnóstico durante la pandemia por COVID-19: absceso hepático secundario a colecistitis aguda litiásica./ Diagnostic Delay During the COVID-19 Pandemic: Liver Abscess Secondary to Acute Lithiasic Cholecystitis


Harnessing HLA-E-restricted CD8 T lymphocytes for adoptive cell therapy of patients with severe COVID-19


title: CoronaVis: A Real-time COVID-19 Tweets Data Analyzer and Data Repository

text: Due to the nature of the data and public interaction, twitter is becoming more and more useful to understand and model various events. The goal of CoronaVis is to use tweets as the information shared by the people to visualize topic modeling, study subjectivity, and to model the human emotions during the COVID-19 pandemic. The main objective is to explore the psychology and behavior of the societies at large which can assist in managing the economic and social crisis during the ongoing pandemic as well as the after-effects of it. The novel coronavirus (COVID-19) pandemic forced people to stay at home to reduce the spread of the virus by maintaining social distancing. However, social media is keeping people connected both locally and globally. People are sharing information (e.g. personal opinions, some facts, news, status, etc.) on social media platforms which can be helpful to understand the various public behavior such as emotions, sentiments, and mobility during the ongoing pandemic. In this work, we develop a live application to observe the tweets on COVID-19 generated from the USA. In this paper, we have generated various data analytics over a period of time to study the changes in topics, subjectivity, and human emotions. We also share a cleaned and processed dataset named CoronaVis Twitter dataset (focused on the United States) available to the research community at https://github.com/mykabir/COVID19. This will enable the community to find more useful insights and create different applications and models to fight with COVID-19 pandemic and future pandemics as well.


Racism and discrimination in COVID-19 responses


title: Covid-19: Como Transformar Un Ventilador De No Invasiva En Un Ventilador De Criticos

text: COVID-19 pandemic caused not only many deaths around the world but also made evident technical limitations of hospital and intensive care units (ICU). The growing demand of ICU ventilators in a short lapse of time constitutes one of the main community concerns. The main goal of this communication is to give simple solutions to transform a noninvasive ventilator in an invasive one for intubated patients. The proposal can be applied in two well defined strategies for the COVID-19 pandemic: To replace anesthesia workstations, leaving those machines to be used in patients. To apply this option in COVID-19 patients by way of a therapeutic "bridge", waiting for the release of a ventilator in the ICU.


title: Predicted Effects of Stopping COVID-19 Lockdown on Italian Hospital Demand

text: OBJECTIVES: Italy has been one of the first countries to implement mitigation measures to curb the coronavirus disease 2019 (COVID-19) pandemic. There is currently a debate on when and how such measures should be loosened. To forecast the demand for hospital intensive care unit (ICU) and non-ICU beds for COVID-19 patients from May to September, we developed 2 models, assuming a gradual easing of restrictions or an intermittent lockdown. METHODS: We used a compartmental model to evaluate 2 scenarios: (A) an intermittent lockdown; (B) a gradual relaxation of the lockdown. Predicted ICU and non-ICU demand was compared with the peak in hospital bed use observed in April 2020. RESULTS: Under scenario A, while ICU demand will remain below the peak, the number of non-ICU will substantially rise and will exceed it (133%; 95% confidence interval [CI]: 94-171). Under scenario B, a rise in ICU and non-ICU demand will start in July and will progressively increase over the summer 2020, reaching 95% (95% CI: 71-121) and 237% (95% CI: 191-282) of the April peak. CONCLUSIONS: Italian hospital demand is likely to remain high in the next months. If restrictions are reduced, planning for the next several months should consider an increase in health-care resources to maintain surge capacity across the country.


Novel tip to prevent ear irritation with surgical face masks (FRSM) during the coronavirus (COVID-19) pandemic


title: Analytical and Clinical Comparison of Three Nucleic Acid Amplification Tests for SARS-CoV-2 Detection

text: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was first identified in December 2019 and has quickly become a worldwide pandemic. In response, many diagnostic manufacturers have developed molecular assays for SARS-CoV-2 under the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) pathway. This study compared 3 of these assays: the Hologic Panther Fusion SARS-CoV-2 assay (Fusion), the Hologic Aptima SARS-CoV-2 assay (Aptima) and the BioFire Defense COVID-19 test (BioFire), to determine analytical and clinical performance, as well as workflow. All 3 assays showed a similar limit of detection (LOD) using inactivated virus, with 100% detection ranging from 500-1,000 genome equivalents/ml, whereas use of a quantified RNA transcript standard showed the same trend, but had values ranging from 62.5 to 125 copies/ml, confirming variability in absolute quantification of reference standards. The clinical correlation found that the Fusion and BioFire assays had a positive percent agreement (PPA) of 98.7%, followed by the Aptima assay at 94.7% when compared to the consensus result. All three assays exhibited 100% negative percent agreement (NPA). Analysis of discordant results revealed that all 4 samples missed by the Aptima assay had Ct values >37 on the Fusion assay.In conclusion, while all three assays showed similar relative LODs, we showed differences in absolute LODs depending on which standard was employed. In addition, the Fusion and BioFire assays showed better clinical performance, while the Aptima assay showed a modest decrease in overall PPA. These findings should be kept in mind when making platform testing decisions.


title: Upper and lower bounds to the spectrum obtained by the finite-difference methods

text: Finite-difference method (FDM) is a dominant approach in the solution of differential equations by numerical means. It is ubiquitous in the solution of a large variety of problems in science and technology. Here, we present a procedure to obtain upper and lower bounds to the spectrum of the time-independent atomic-molecular-optical Hamiltonian utilizing the FDM. The procedure combines two FDM approaches with the same representation of the Laplacian. The standard FDM fixes the box size and increases the grid density with the number of grid points. In contrast, the second approach keeps the grid density constant and increases the box size with the number of points. The estimation of the error in the computation of the spectrum can be increased simply by calculating the upper and lower bounds. A number of illustrative numerical examples are given, involving the calculation of the spectra of known analytical solutions. The relevance of our finding to other grid methods is discussed.


title: Olfactory and rhinological evaluations in SARS-CoV-2 patients complaining of olfactory loss

text: Since December 2019, a novel coronavirus SARS-CoV-2 (Covid-19) outbreak emerged in China and spread rapidly in several countries. As of April 5, 2020, 1.218.474 cases were confirmed with 65.884 deaths worldwide (1). The clinical manifestations of Covid-19 range from asymptomatic carrier status to severe pneumonia. In a study of 7,736 Covid-19 patients in China, of all the clinical symptoms, hyposmia was not reported in any patient(2). Anyway, it is now clear that olfactory dysfunction may also be present in these patients(3) as the only or prevalent manifestation(4).


Time to Expand Access and Utilization of Home Dialysis: Lessons From the COVID-19 Pandemic


Criterios para la gestión de personas especialmente vulnerables y trabajadores/as especialmente sensibles frente al SARS-CoV-2 en las empresas de Cataluña en el contexto de pandemia./ [Management guidelines for vulnerable workers and persons and SARS-CoV-2 in Catalonian businesses]


title: [Expert consensus for bronchoscopy during the epidemic of 2019 Novel Coronavirus infection (Trial version)]

text: Infection with 2019 Novel Coronavirus (2019-nCoV) is mainly transmitted by respiratory droplets, airborne transmission and direct contact. However, conducting bronchoscopy on patients with 2019-nCoV is a high-risk procedure in which health care workers are directly exposed to the virus, and the protection and operation procedures need to be strictly regulated. According to the characteristics of bronchoscopy, it is necessary to formulate the procedure, requirements and precautions when conducting bronchoscopy in the current epidemic situation. Relevant standards for preventing from infections should be strictly implemented in the operation of bronchoscopy. It needs to emphasize that bronchoscopy should not be used as a routine means for the diagnosis of 2019-nCoV infection sampling. The indications for bronchoscopy for other diseases should be strictly mastered, and it is suggested that bronchoscopy should be postponed for those patients who is not in urgent situation.


Use of transparent curtains on bedside of patients with COVID-19


Child Abuse Awareness Month During the Coronavirus Disease 2019 Pandemic


Roles and challenges of primary care physicians facing a dual outbreak of COVID-19 and dengue in Singapore


Is a more aggressive COVID-19 case detection approach mitigating the burden on ICUs? Some reflections from Italy


Maxillofacial services in the COVID-19 (SARS-CoV-2) pandemic - early lessons from the Italian experience


title: COVID-19, children and anxiety in 2020

text: The ongoing economic and social impacts of the COVID-19 pandemic are likely to produce significant ongoing stresses for children and families.


title: Lessons from Hurricane Katrina for predicting the indirect health consequences of the COVID-19 pandemic

text: Beyond their immediate effects on mortality, disasters have widespread, indirect impacts on mental and physical well-being by exposing survivors to stress and potential trauma. Identifying the disaster-related stressors that predict health adversity will help officials prepare for the coronavirus disease 2019 (COVID-19) pandemic. Using data from a prospective study of young, low-income mothers who survived Hurricane Katrina, we find that bereavement, fearing for loved ones' well-being, and lacking access to medical care and medications predict adverse mental and physical health 1 y postdisaster, and some effects persist 12 y later. Adjusting for preexisting health and socioeconomic conditions attenuates, but does not eliminate, these associations. The findings, while drawn from a demographically unique sample, suggest that, to mitigate the indirect effects of COVID-19, lapses in medical care and medication use must be minimized, and public health resources should be directed to those with preexisting medical conditions, their social networks, and the bereaved.


title: The Effect of Coronavirus (COVID-19) on Breast Cancer Teamwork: A Multicentric Survey

text: BACKGROUND/AIM: Despite the large amount of clinical data available of Coronavirus-19 (COVID-19), not many studies have been conducted about the psychological toll on Health Care Workers (HCWs). PATIENTS AND METHODS: In this multicentric descriptive study, surveys were distributed among 4 different Breast Cancer Centers (BCC). BCCs were distinguished according to COVID-19 tertiary care hospital (COVID/No-COVID) and district prevalence (DP) (High vs. Low). DASS-21 score, PSS score and demographic data (age, sex, work) were evaluated. RESULTS: A total of 51 HCWs were analyzed in the study. Age, work and sex did not demonstrate statistically significant values. Statistically significant distribution was found between DASS-21-stress score and COVID/No-COVID (p=0.043). No difference was found in the remaining DASS-21 and PSS scores, dividing the HCWs according to COVID-19-hospital and DP. CONCLUSION: Working in a COVID-19-hospital represents a factor that negatively affects psychosocial well-being. However, DP seems not to affect the psychosocial well-being of BCC HCWs. During the outbreak, psychological support for low risk HCWs should be provided regardless DP.


title: First-wave COVID-19 transmissibility and severity in China outside Hubei after control measures, and second-wave scenario planning: a modelling impact assessment

text: BACKGROUND: As of March 18, 2020, 13â415 confirmed cases and 120 deaths related to coronavirus disease 2019 (COVID-19) in mainland China, outside Hubei province-the epicentre of the outbreak-had been reported. Since late January, massive public health interventions have been implemented nationwide to contain the outbreak. We provide an impact assessment of the transmissibility and severity of COVID-19 during the first wave in mainland Chinese locations outside Hubei. METHODS: We estimated the instantaneous reproduction number (Rt) of COVID-19 in Beijing, Shanghai, Shenzhen, Wenzhou, and the ten Chinese provinces that had the highest number of confirmed COVID-19 cases; and the confirmed case-fatality risk (cCFR) in Beijing, Shanghai, Shenzhen, and Wenzhou, and all 31 Chinese provinces. We used a susceptible-infectious-recovered model to show the potential effects of relaxing containment measures after the first wave of infection, in anticipation of a possible second wave. FINDINGS: In all selected cities and provinces, the Rt decreased substantially since Jan 23, when control measures were implemented, and have since remained below 1. The cCFR outside Hubei was 0·98% (95% CI 0·82-1·16), which was almost five times lower than that in Hubei (5·91%, 5·73-6·09). Relaxing the interventions (resulting in Rt >1) when the epidemic size was still small would increase the cumulative case count exponentially as a function of relaxation duration, even if aggressive interventions could subsequently push disease prevalence back to the baseline level. INTERPRETATION: The first wave of COVID-19 outside of Hubei has abated because of aggressive non-pharmaceutical interventions. However, given the substantial risk of viral reintroduction, particularly from overseas importation, close monitoring of Rt and cCFR is needed to inform strategies against a potential second wave to achieve an optimal balance between health and economic protection. FUNDING: Health and Medical Research Fund, Hong Kong, China.


Thalassemic Child Presenting with Anosmia due to COVID-19


title: Emergency surgery during the COVID-19 pandemic: what you need to know for practice

text: INTRODUCTION: Several articles have been published about the reorganisation of surgical activity during the COVID-19 pandemic but few, if any, have focused on the impact that this has had on emergency and trauma surgery. Our aim was to review the most current data on COVID-19 to provide essential suggestions on how to manage the acute abdomen during the pandemic. METHODS: A systematic review was conducted of the most relevant English language articles on COVID-19 and surgery published between 15 December 2019 and 30 March 2020. FINDINGS: Access to the operating theatre is almost exclusively restricted to emergencies and oncological procedures. The use of laparoscopy in COVID-19 positive patients should be cautiously considered. The main risk lies in the presence of the virus in the pneumoperitoneum: the aerosol released in the operating theatre could contaminate both staff and the environment. CONCLUSIONS: During the COVID-19 pandemic, all efforts should be deployed in order to evaluate the feasibility of postponing surgery until the patient is no longer considered potentially infectious or at risk of perioperative complications. If surgery is deemed necessary, the emergency surgeon must minimise the risk of exposure to the virus by involving a minimal number of healthcare staff and shortening the occupation of the operating theatre. In case of a lack of security measures to enable safe laparoscopy, open surgery should be considered.


Characteristics and Palliative Care Needs of COVID-19 Patients Receiving Comfort-Directed Care


The COVID-19 global inflection point and Europe's predicament


title: Mass Spectrometric Identification of SARS-CoV-2 Proteins from Gargle Solution Samples of COVID-19 Patients

text: Mass spectrometry (MS) can deliver valuable diagnostic data that complement genomic information and allow us to increase our current knowledge of the COVID-19 disease caused by the SARS-CoV-2 virus. We developed a simple, MS-based method to specifically detect SARS-CoV-2 proteins from gargle solution samples of COVID-19 patients. The protocol consists of an acetone precipitation and tryptic digestion of proteins contained within the gargle solution, followed by a targeted MS analysis. Our methodology identifies unique peptides originating from SARS-CoV-2 nucleoprotein. Building on these promising initial results, faster MS protocols can now be developed as routine diagnostic tools for COVID-19 patients. Data are available via ProteomeXchange with identifier PXD019423.


Leptomeningeal involvement in a patient with systemic lupus erythematosus infected by COVID-19


Infection control strategies of medical institutions in response to COVID-19


title: [Surgical treatment for esophageal cancer during the outbreak of COVID-19]

text: Since December 2019, unexplained pneumonia has appeared in Wuhan City, Hubei Province, and a new type of coronavirus infection was confirmed as COVID-19. COVID-19 spread rapidly nationwide and abroad. The COVID-19 has brought huge impacts to all the people and walks of life, especially to the medical and health systems. It has also brought great challenges to the treatment of patients with cancer. Esophageal cancer is a common malignant tumor in China and most of the patients are in the middle and advanced stage when diagnosed, with immunosuppressive and poor prognosis. The selection of surgical procedures and perioperative managements of esophageal cancer require all thoracic surgeons work together to figure out a reasonable system of surgical treatment and emergency response.


Clarifying appropriate personal protective equipment for obstetric anaesthetists amongst controversy and confusion in COVID-19


title: Patient-Worn Enhanced Protection Face Shield for Flexible Endoscopy

text: OBJECTIVES: The primary objective of this study was to compare the protection afforded by a standard face shield design with a new enhanced design in a controlled setting. METHODS: This study was exempted from review by institutional review board waiver. A flexible fiberoptic endoscopy was placed through stellate openings in the standard face shield and the enhanced face shield. A series of simulated coughs were created with bursts of fluorescein dye through an atomizer tip placed within the test participant's mouth. Ultraviolet lighting illuminated the test area, and areas of dye splatter were noted. RESULTS: Fluorescein dye is easily aerosolized along the lateral inferior aspect of a standard shield with significant contamination of the surrounds. The enhanced face shield maintained a barrier to the aerosolized dye. DISCUSSION: Face shields, rather than face masks, should be considered a preferred alternative for the public and for health care professionals alike, as they address many of the personal protective equipment concerns especially during the COVID-19 pandemic. Otolaryngologists are at high risk from aerosol-generating procedures, such as flexible fiberoptic endoscopy, even when wearing personal protective equipment. Here we describe a uniquely designed face shield to be worn by the patient as another layer of protection for the environment and for medical personnel. IMPLICATIONS FOR PRACTICE: During the course of a flexible fiberoptic endoscopy, medical personnel are safely isolated from potential infectious particles with a newly designed face shield.


Imaging in Neurological Disease of Hospitalized COVID-19 Patients: An Italian Multicenter Retrospective Observational Study