title: Mental health circumstances among health care workers and general public under the pandemic situation of COVID-19 (HOME-COVID-19)

text: BACKGROUND: After the spread of the coronavirus disease 2019 (COVID-19) globally, upgraded quarantine and physical distancing strategy, strict infection measures, and government's strict lockdown have been abided to confront the spread of the COVID-19 in Thailand. During the COVID-19 pandemic, concerns about the mental health and psychosocial problems among health care workers and the general population are now arising. Yet, information on mental health and psychosocial problems among health care workers and the general population have not been comprehensively reported in Thailand. As such, we conduct a cross-sectional study, a national online survey to describe the short- and long-term consequences of the COVID-19 pandemic on mental health and psychosocial problems among health care workers and the general population in Thailand. METHODS: This study is a repeated cross-sectional study, an open online voluntary national-based survey during the wave I (April 21-May 4, 2020) follow-up in the wave II (August 3-16, 2020), wave III (November 15-28, 2020), and a 1-year follow-up survey (wave IV: April 21-May 4, 2021) in Thailand. Health care workers at the hospitals and the adult general population will be invited to participate in the online survey via the SurveyMonkey that limits one-time participation per unique internet protocol address. The target sample size of at least 1182 health care workers and 1310 general populations will be required to complete the online survey for each wave of the survey. Sociodemographic characteristics and a set of measurement tools for mental and psychosocial problems for each subcohort including depression, anxiety, stress, resilient copings, neuroticism, perceived social support, wellbeing, somatic symptoms, insomnia, burnout (for healthcare workers), and public stigma toward COVID-19 infection (for the general population) will be collected. For all estimates of prevalence, we will weigh data for all wave analyses under the complex design of the survey. Subgroup analyses stratified by key characteristics will also be done to analyze the proportion differences. For the repeated cross-sectional survey, we will combine the data from the wave I to wave IV survey to analyze changes in the mental health status. We will perform multilevel logistic regression models with random intercepts to explore associations with individual-level and region-level/hospital-level predictors. We also plan to perform an ancillary systematic review and meta-analysis by incorporating data from our findings to all available evidence. RESULTS: Our findings will provide information on the short- and long-term mental health status as well as the psychosocial responses to the COVID-19 outbreak in a national sample of health care workers and the general population in Thailand. CONCLUSION: This prospective, nationally based, a repeated cross-sectional study will describe the mental health status and psychosocial problems among health care workers and the general population in Thailand during the COVID-19 pandemic. ETHICS AND DISSEMINATION: Ethical approval for the study was obtained from the Faculty of Public Health and Faculty of Pharmacy, Chiang Mai University. The findings will be disseminated through public, scientific, and professional meetings, and publications in peer-reviewed journals. THAI CLINICAL TRIALS REGISTRY (TCTR) REGISTRATION NUMBER: TCTR20200425001.


Sixty seconds on . . . Mr Bean's checklist


title: The Pandemic Effect: Raising the Bar for Ethics, Empathy, and Professional Collegiality

text: The widespread, tragic loss of life and the dedication of health care professionals have characterized the severe acute respiratory syndrome coronavirus 2 pandemic. While we mourn the loss of so many Americans to this novel virus, we also much acknowledge the positive effects to our profession, which are not insignificant. We have witnessed our larger community of otolaryngologist-head and neck surgeons pulling together in a manner not heretofore observed by this author. From the local level of practitioners to our national societies, there has been an amazing effort of collegial unity to develop the most clinically relevant guidelines for providing patient care with maximal safety, in the face of little scientific knowledge or experience with this virus. In addition, we as a specialty and individual otolaryngologists have, through our shared experiences, raised the bar for empathy, ethics, and professional interaction during these difficult times. We must reflect upon our professional growth and capture this renewal of altruism that lives at the heart of our calling.


title: Possible therapeutic role of a highly standardized mixture of active compounds derived from cultured Lentinula edodes mycelia (AHCC) in patients infected with 2019 novel coronavirus

text: The outbreak of SARS-CoV-2 disease (COVID-19) is currently, March 2020, affecting more than 100,000 people worldwide and, according to the WHO (World Health Organization), a pandemic is shortly expected. The virus infects the lower respiratory tract and causes severe pneumonia and mortality in approximately 10% and 3-5%, respectively, of cases, mainly among the elderly and/or people affected by other diseases. AHCC is an α-glucan-based standardized mushroom extract that has been extensively investigated as an immunostimulant both in animals and/or in humans affected by West Nile virus, influenza virus, avian influenza virus, hepatitis C virus, papillomavirus, herpes virus, hepatitis B virus and HIV by promoting a regulated and protective immune response. Although the efficacy of AHCC has not yet been specifically evaluated with respect to SARS-CoV-2 disease, its action in promoting a protective response to a wide range of viral infections, and the current absence of effective vaccines, could support its use in the prevention of diseases provoked by human pathogenic coronavirus, including COVID-19.


Relación entre obesidad, diabetes e ingreso en UCI en pacientes COVID-19./ Relación entre obesidad, diabetes e ingreso en UCI en pacientes COVID-19./ Relationship between obesity, diabetes and ICU admission in COVID-19 patients


title: National age and coresidence patterns shape COVID-19 vulnerability

text: Based on harmonized census data from 81 countries, we estimate how age and coresidence patterns shape the vulnerability of countries' populations to outbreaks of coronavirus disease 2019 (COVID-19). We estimate variation in deaths arising due to a simulated random infection of 10% of the population living in private households and subsequent within-household transmission of the virus. The age structures of European and North American countries increase their vulnerability to COVID-related deaths in general. The coresidence patterns of elderly persons in Africa and parts of Asia increase these countries' vulnerability to deaths induced by within-household transmission of COVID-19. Southern European countries, which have aged populations and relatively high levels of intergenerational coresidence, are, all else equal, the most vulnerable to outbreaks of COVID-19. In a second step, we estimate to what extent avoiding primary infections for specific age groups would prevent subsequent deaths due to within-household transmission of the virus. Preventing primary infections among the elderly is the most effective in countries with small households and little intergenerational coresidence, such as France, whereas confining younger age groups can have a greater impact in countries with large and intergenerational households, such as Bangladesh.


Mitigate the effects of home confinement on children during the COVID-19 outbreak


title: To Do or Not to Do?-A Review of Cancer Surgery Triage Guidelines in COVID-19 Pandemic

text: COVID-19 pandemic has emerged as a global health emergency involving more than 200 countries so far. The number of affected population is on rising, so is the mortality. This crisis has overwhelmed the healthcare infrastructures in many affected countries. Due to overall rising cancer incidence and specific concerns, a cohort of cancer patients forms a distinct subset of the population in whom a correct and timely treatment has a huge impact on the outcome. During this period, oncology care is definitely affected owing to many factors like lockdowns, reduced beds and deferral of elective cases to halt the spread of the pandemic. Surgery remains the best line of defence in many solid organ tumours especially in early stage and is potentially curative. China, the source of this pandemic, has taken more than 3 months to enter the post transitional phase of this pandemic. Deferring cancer surgeries for this long period may have a direct impact on the long-term outcomes of cancer patients. Many surgical oncology associations across the globe have come up with triage guidelines for surgical care of cancer patients; however, these are based on expert opinion rather than actual data. Herein, we intend to review these guidelines with respect to the risk of disease progression in cancer patients. In the absence of actual data on cancer surgery care during this pandemic, clinical decisions should be based on careful consideration of disease-related and patient-related factors. While some of the cancer surgeries can be safely delayed for some time, how long we can delay surgeries safely cannot be answered/ explained by any means. Thorough evaluation and discussion by an expert and experienced multidisciplinary team appears to be the most effective way forward.


Endoscopy activity in a covid-19 high-risk area (Barcelona): Moving forward (or backwards) according to the necessary resources available


title: Magnetic properties of icosahedral quasicrystals and their cubic approximants in the Cd-Mg-RE (RE = Gd, Tb, Dy, Ho, Er, and Tm) systems

text: A systematic investigation has been performed to elucidate effects of Rare-Earth (RE) type and local atomic configuration on magnetic properties of icosahedral quasicrystal (iQC) and their cubic approximants (2/1 and 1/1 ACs) in the ternary Cd-Mg-RE (RE = Gd, Tb, Dy, Ho, Er, and Tm) systems. At low temperatures, iQC and 2/1 ACs exhibit spin-glass-like freezing for RE = Gd, Tb, Dy, and Ho, while Er and Tm systems do not show freezing behaviour down to the base temperature ~ 2 K. The 1/1 ACs exhibit either spin-glass-like freezing or antiferromagnetic (AFM) ordering depending on their constituent Mg content. The Tf values show increasing trend from iQC to 2/1 and 1/1 ACs. In contrast, the absolute values of Weiss temperature for iQCs are larger than those in 2/1 and 1/1 ACs, indicating that the total AFM interactions between the neighboring spins are larger in aperiodic, rather than periodic systems. Competing spin interactions originating from the long-range Ruderman-Kittel-Kasuya-Yoshida mechanism along with chemical disorder of Cd/Mg ions presumably account for the observed spin-glass-like behavior in Cd-Mg-RE iQCs and ACs.


title: Resolviendo Una De Las Piezas Del Puzle: Covid-19 Y Diabetes Tipo 2./ [solving One of the Pieces of the Puzzle: Covid-19 and Type 2 Diabetes]

text: The emergence of the COVID-19 pandemic represents an enormous challenge. Given the considerable presence of type 2 diabetes mellitus in the current population, the pandemic is a health issue that requires an effort to provide better responses to our patients who are more vulnerable to the onset of infection and who are candidates for presenting more severe symptoms. This document attempts to address the relationship between COVID-19 infection and type 2 diabetes mellitus. To this end, we will briefly analyse whether the epidemiological data support this association and, subsequently, go in depth on the pathophysiological mechanisms that might connect the two diseases.


Favourable outcome of coronavirus disease 2019 in a 1-year-old girl with acute myeloid leukaemia and severe treatment-induced immunosuppression


COVID-19 and prisons: Providing mental health care for people in prison, minimising moral injury and psychological distress in mental health staff


title: ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019

text: OBJECTIVES: To determine mortality rates among adults with critical illness from coronavirus disease 2019. DESIGN: Observational cohort study of patients admitted from March 6, 2020, to April 17, 2020. SETTING: Six coronavirus disease 2019 designated ICUs at three hospitals within an academic health center network in Atlanta, Georgia, United States. PATIENTS: Adults greater than or equal to 18 years old with confirmed severe acute respiratory syndrome-CoV-2 disease who were admitted to an ICU during the study period. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among 217 critically ill patients, mortality for those who required mechanical ventilation was 35.7% (59/165), with 4.8% of patients (8/165) still on the ventilator at the time of this report. Overall mortality to date in this critically ill cohort is 30.9% (67/217) and 60.4% (131/217) patients have survived to hospital discharge. Mortality was significantly associated with older age, lower body mass index, chronic renal disease, higher Sequential Organ Failure Assessment score, lower PaO2/FIO2 ratio, higher D-dimer, higher C-reactive protein, and receipt of mechanical ventilation, vasopressors, renal replacement therapy, or vasodilator therapy. CONCLUSIONS: Despite multiple reports of mortality rates exceeding 50% among critically ill adults with coronavirus disease 2019, particularly among those requiring mechanical ventilation, our early experience indicates that many patients survive their critical illness.


title: Working memory capacity predicts individual differences in social-distancing compliance during the COVID-19 pandemic in the United States

text: Noncompliance with social distancing during the early stage of the coronavirus disease 2019 (COVID-19) pandemic poses a great challenge to the public health system. These noncompliance behaviors partly reflect people's concerns for the inherent costs of social distancing while discounting its public health benefits. We propose that this oversight may be associated with the limitation in one's mental capacity to simultaneously retain multiple pieces of information in working memory (WM) for rational decision making that leads to social-distancing compliance. We tested this hypothesis in 850 United States residents during the first 2 wk following the presidential declaration of national emergency because of the COVID-19 pandemic. We found that participants' social-distancing compliance at this initial stage could be predicted by individual differences in WM capacity, partly due to increased awareness of benefits over costs of social distancing among higher WM capacity individuals. Critically, the unique contribution of WM capacity to the individual differences in social-distancing compliance could not be explained by other psychological and socioeconomic factors (e.g., moods, personality, education, and income levels). Furthermore, the critical role of WM capacity in social-distancing compliance can be generalized to the compliance with another set of rules for social interactions, namely the fairness norm, in Western cultures. Collectively, our data reveal contributions of a core cognitive process underlying social-distancing compliance during the early stage of the COVID-19 pandemic, highlighting a potential cognitive venue for developing strategies to mitigate a public health crisis.


title: Inflammatory and Coagulative Considerations for the Management of Orthopaedic Trauma Patients with COVID-19: A Review of the Current Evidence and Our Surgical Experience

text: Mounting evidence suggests that the pathogenesis of coronavirus disease 2019 (COVID-19) involves a hyperinflammatory response predisposing patients to thromboembolic disease and acute respiratory distress. In the setting of severe blunt trauma, damaged tissues induce a local and systemic inflammatory response through similar pathways to COVID-19. As such, patients with COVID-19 sustaining orthopaedic trauma injuries may have an amplified response to the traumatic insult due to their baseline hyperinflammatory and hypercoagulable state. These patients may have compromised physiological reserve to withstand the insult of surgical intervention before reaching clinical instability. Herein, we review the current evidence regarding pathogenesis of COVID-19 and its implications on the management of orthopaedic trauma patients by discussing a case and the most recent literature.


title: COVID-19 infectivity profile correction

text: The infectivity profile of an individual with COVID-19 is attributed to the paper Temporal dynamics in viral shedding and transmissibility of COVID-19 by He et al., published in Nature Medicine in April 2020. However, the analysis within this paper contains a mistake such that the published infectivity profile is incorrect and the conclusion that infectiousness begins 2.3 days before symptom onset is no longer supported. In this document we discuss the error and compute the correct infectivity profile. We also establish confidence intervals on this profile, quantify the difference between the published and the corrected profiles, and discuss an issue of normalisation when fitting serial interval data. This infectivity profile plays a central role in policy and decision making, thus it is crucial that this issue is corrected with the utmost urgency to prevent the propagation of this error into further studies and policies. We hope that this preprint will reach all researchers and policy makers who are using the incorrect infectivity profile to inform their work.


[Guidance for routine pathology practice during the prevention and control period of novel coronavirus pneumonia]


Theme: Information on the Covid-19 pandemic


Dealing with loss of life across the spectrum of humankind


title: The Ocular Manifestations and Transmission of COVID-19: Recommendations for Prevention

text: BACKGROUND: Coronavirus disease-2019 (COVID-19), caused by a novel coronavirus termed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been linked to ocular signs and symptoms in several case reports. Research has demonstrated that SARS-CoV-2 is spread primarily through close contact via respiratory droplets, but there is the possibility for ocular transmission, with the conjunctiva as a conduit as well as a source of infection. DISCUSSION: Ocular manifestations of SARS-CoV-2 include follicular conjunctivitis, and have been repeatedly noted as an initial or subsequent symptom of COVID-19-positive patients. Particularly in patients with ocular manifestations, there is evidence that the virus may present in tears, based on the detection of SARS-CoV-2 in conjunctival swab samples via reverse transcription polymerase chain reaction. The virus may therefore be transmittable from the ocular surface to a new host via contact with the ocular mucosa, tears, or subsequent fomites. CONCLUSIONS: All health care professionals should ask patients about ocular symptoms consistent with SARS-CoV-2, and use eye protection such as goggles or face shields as part of the standard personal protective equipment for high-risk patients in addition to wearing of masks by both the patient and provider, and should consider tears to be potentially infectious.


title: A calibration disk for the correction of radial errors from chromatic aberration and rotor stretch in the Optima AUC™ analytical ultracentrifuge

text: Experiments performed in the analytical ultracentrifuge (AUC) measure sedimentation and diffusion coefficients, as well as the partial concentration of colloidal mixtures of molecules in the solution phase. From this information, their abundance, size, molar mass, density and anisotropy can be determined. The accuracy with which these parameters can be determined depends in part on the accuracy of the radial position recordings and the boundary conditions used in the modeling of the AUC data. The AUC instrument can spin samples at speeds up to 60,000 rpm, generating forces approaching 300,000 g. Forces of this magnitude will stretch the titanium rotors used in the instrument, shifting the boundary conditions required to solve the flow equations used in the modeling of the AUC data. A second source of error is caused by the chromatic aberration resulting from imperfections in the UV-visible absorption optics. Both errors are larger than the optical resolution of currently available instrumentation. Here, we report software routines that correct these errors, aided by a new calibration disk which can be used in place of the counterbalance to provide a calibration reference for each experiment to verify proper operation of the AUC instrument. We describe laboratory methods and software routines in UltraScan that incorporate calibrations and corrections for the rotor stretch and chromatic aberration in order to support Good Manufacturing Practices for AUC data analysis.


News at a glance


Assessing the Value of Diagnostic Tests in the New World of COVID-19 Pandemic


title: Effect of Jinhua Qinggan granules on novel coronavirus pneumonia in patients

text: OBJECTIVE: To evaluate the effectiveness and safety of Jinhua Qinggan granules in the treatment of patients with novel coronavirus pneumonia (COVID-19). METHODS: Eighty cases of COVID-19 diagnosed from January 24 to February 17, 2020 in Beijing YouAn Hospital Affiliated to Capital Medical University were retrospectively analyzed. All 80 patients received symptomatic and supportive treatment. Among them, 44 patients took Jinhua Qinggan granules (treatment group) within 24 h of admission, and the remaining 36 patients either did not take Jinhua Qinggan granules or took the granules for less than 2 d (control group). In this study, we compared the duration of viral nucleic acid detection and of pneumonia absorption improvement between the two groups. RESULTS: Among the 80 cases, 37 were male (46%) and 43 were female (54%) with age ranging from 15 to 86 years, with an average age of 51.19 years. The average duration of viral nucleic acid detection was (7 ± 4) d in the Jinhua Qinggan administration group and (10 ± 4) d for the control group (P = 0.010), following which, nucleic acid tests were negative. Of the two groups, 56.82% in the Jinhua Qinggan treatment group and 27.78% in the control group demonstrated negative nucleic acid tests within 7 d or less. The 7-day viral clearance rate was significantly higher in the Jinhua Qinggan group compared with the control group (P = 0.009). Furthermore, the pneumonia recovery time indicated by chest CT was (8 ± 4) d in the Jinhua Qinggan group, which was significantly shorter than the control group, at (10 ± 5) d (P = 0.021). No adverse reactions were found in the treatment group after taking this medicine. CONCLUSION: In patients with COVID-19, Jinhua Qinggan granules can effectively shorten the duration of nucleic acid detection and promote the absorption of pneumonia inflammatory exudate without obvious adverse reactions.


title: An automated Residual Exemplar Local Binary Pattern and iterative ReliefF based corona detection method using lung X-ray image

text: Coronavirus is normally transmitted from animal to person, but nowadays it is transmitted from person to person by changing its form. Covid-19 appeared as a very dangerous virus and unfortunately caused a worldwide pandemic disease. Radiology doctors use X-ray or CT images for the diagnosis of Covid-19. It has become crucial to help diagnose such images using image processing methods. Therefore, we proposed a novel intelligent computer vision method to automatically detect the Covid-19 virus. The proposed automatic Covid-19 detection method consists of preprocessing, feature extraction and feature selection stages. Image resizing and grayscale conversion are used in the preprocessing phase. The proposed feature generation method is called as Residual Exemplar Local Binary Pattern (ResExLBP). In the feature selection phase, a novel iterative ReliefF (IRF) based feature selection is used. Decision tree (DT), linear discriminant (LD), support vector machine (SVM), k nearest neighborhood (kNN) and subspace discriminant (SD) methods are chosen as classifiers in the classification phase. Leave one out cross-validation (LOOCV) and 10-fold cross-validation are used for training and testing. In this work, SVM classifier achieved 100.0% classification accuracy by using 10-fold cross-validation. This result clearly has shown that we reached the perfect classification rate by using X-ray image for Covid-19 detection.


title: Increased ACE2 Expression in the Bronchial Epithelium of COPD Patients who are Overweight

text: OBJECTIVE: Mortality from coronavirus disease 2019 (COVID-19) is increased in COPD patients. Furthermore, higher body mass index (BMI) is related to severe disease. SARS-CoV-2 utilises angiotensin converting enzyme 2 (ACE2) to gain cellular entry. METHODS: We have investigated whether ACE2 bronchial epithelial expression is increased in COPD patients who are overweight compared to those who are not by RNA sequencing. RESULTS: We observed increased ACE2 expression in COPD patients who are overweight (mean BMI 29 kg/m2 ) compared to those notoverweight (mean BMI 21 kg/m2 ) (p=0.004). CONCLUSION: Increased ACE2 expression may cause increased SARS-CoV-2 infection of the respiratory tract. COPD patients who are overweight may be at greater risk of developing severe COVID-19.


Rational use of face masks in the COVID-19 pandemic


Sustainable response to the COVID-19 pandemic in the operating theatre: we need more than just personal protective equipment


Recovery of non-urgent surgery - Operation backlog and proposals for a restart


title: Analytical Mechanics Allows Novel Vistas on Mathematical Epidemic Dynamics Modelling

text: This contribution aims to shed light on mathematical epidemic dynamics modelling from the viewpoint of analytical mechanics. To set the stage, it recasts the basic SIR model of mathematical epidemic dynamics in an analytical mechanics setting. Thereby, it considers two possible re-parameterizations of the basic SIR model. On the one hand, it is proposed to re-scale time, while on the other hand, to transform the coordinates, i.e.\ the independent variables. In both cases, Hamilton's equations in terms of a suited Hamiltonian as well as Hamilton's principle in terms of a suited Lagrangian are considered in minimal and extended phase and state space coordinates, respectively. The corresponding Legendre transformations relating the various options for the Hamiltonians and Lagrangians are detailed. Ultimately, this contribution expands on a multitude of novel vistas on mathematical epidemic dynamics modelling that emerge from the analytical mechanics viewpoint. As result, it is believed that interesting and relevant new research avenues open up when exploiting in depth the analogies between analytical mechanics and mathematical epidemic dynamics modelling.


title: COVID-19 (SARS-Cov-2) and the heart - An ominous association

text: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cardiovascular manifestations of COVID-19 are diverse and complex and include acute coronary syndrome, myocarditis masquerading as ST-segment elevation myocardial infarction, pericarditis and pericardial effusion. We present 2 cases of COVID-19 infection with myocardial involvement with distinct mechanistic pathways and outcomes. Important decision strategies such as the timing of cardiac catheterization (when indicated) and requirement of early hemodynamic support in critically ill patients are discussed.


title: Positional Correlation Natural Vector: A Novel Method for Genome Comparison

text: Advances in sequencing technology have made large amounts of biological data available. Evolutionary analysis of data such as DNA sequences is highly important in biological studies. As alignment methods are ineffective for analyzing large-scale data due to their inherently high costs, alignment-free methods have recently attracted attention in the field of bioinformatics. In this paper, we introduce a new positional correlation natural vector (PCNV) method that involves converting a DNA sequence into an 18-dimensional numerical feature vector. Using frequency and position correlation to represent the nucleotide distribution, it is possible to obtain a PCNV for a DNA sequence. This new numerical vector design uses six suitable features to characterize the correlation among nucleotide positions in sequences. PCNV is also very easy to compute and can be used for rapid genome comparison. To test our novel method, we performed phylogenetic analysis with several viral and bacterial genome datasets with PCNV. For comparison, an alignment-based method, Bayesian inference, and two alignment-free methods, feature frequency profile and natural vector, were performed using the same datasets. We found that the PCNV technique is fast and accurate when used for phylogenetic analysis and classification of viruses and bacteria.


Why Only Test Symptomatic Patients? Consider Random Screening for COVID-19


title: Assessing the relationship between ground levels of ozone (O3) and nitrogen dioxide (NO2) with coronavirus (COVID-19) in Milan, Italy

text: This paper investigates the correlation between the high level of coronavirus SARS-CoV-2 infection accelerated transmission and lethality, and surface air pollution in Milan metropolitan area, Lombardy region in Italy. For January-April 2020 period, time series of daily average inhalable gaseous pollutants ozone (O3) and nitrogen dioxide (NO2), together climate variables (air temperature, relative humidity, wind speed, precipitation rate, atmospheric pressure field and Planetary Boundary Layer) were analyzed. In spite of being considered primarily transmitted by indoor bioaerosols droplets and infected surfaces or direct human-to-human personal contacts, it seems that high levels of urban air pollution, and climate conditions have a significant impact on SARS-CoV-2 diffusion. Exhibited positive correlations of ambient ozone levels and negative correlations of NO2 with the increased rates of COVID-19 infections (Total number, Daily New positive and Total Deaths cases), can be attributed to airborne bioaerosols distribution. The results show positive correlation of daily averaged O3 with air temperature and inversely correlations with relative humidity and precipitation rates. Viral genome contains distinctive features, including a unique N-terminal fragment within the spike protein, which allows coronavirus attachment on ambient air pollutants. At this moment it is not clear if through airborne diffusion, in the presence of outdoor and indoor aerosols, this protein "spike" of the new COVID-19 is involved in the infectious agent transmission from a reservoir to a susceptible host during the highest nosocomial outbreak in some agglomerated industrialized urban areas like Milan is. Also, in spite of collected data for cold season (winter-early spring) period, when usually ozone levels have lower values than in summer, the findings of this study support possibility as O3 can acts as a COVID-19 virus incubator. Being a novel pandemic coronavirus version, it might be ongoing during summer conditions associated with higher air temperatures, low relative humidity and precipitation levels.


Covid-19 : protocoles de soins ou protocoles de recherche ?/ [Covid-19: care protocols or research protocols?]


title: The Coronavirus Disease 2019 (COVID-19) Pandemic

text: The present study provides an overview of the coronavirus disease 2019 (COVID-19) outbreak which has rapidly extended globally within a short period. COVID-19 is a highly infectious respiratory disease caused by a new coronavirus known as SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2). SARS-CoV-2 is different from usual coronaviruses responsible for mild sickness such as common cold among human beings. It is crucial to understand the impact and outcome of this pandemic. We therefore overview the changes in the curves of COVID-19 confirmed cases and fatality rate in China and outside of China from 31st of December 2019 to 25th of March 2020. We also aimed to assess the temporal developments and death rate of COVID-19 in China and worldwide. More than 414,179 confirmed cases of COVID-19 have been reported in 197 countries, including 81,848 cases in China and 332,331 outside of China. Furthermore, 18,440 infected patients died from COVID-19 infection; 3,287 cases were from China and 15,153 fatalities were reported worldwide. Among the worldwide infected cases, 113,802 patients have been recovered and discharged from different hospitals. Effective prevention and control measures should be taken to control the disease. The presented Chinese model (protocol) of disease prevention and control could be utilized in order to curb the pandemic situation.


COVID-19 in Bangladesh: Data deficiency to delayed decision


Organizational aspects of intensive care unit resource allocation in a primary respiratory intensive care center specialized for the treatment of SARS-COV-2 patients


An updated systematic review on the coronavirus pandemic: lessons for psychiatry


title: COVID-19 in 2 Persons with Mild Upper Respiratory Tract Symptoms on a Cruise Ship, Japan

text: We describe 2 cases of coronavirus disease in patients with mild upper respiratory symptoms. Both patients worked on a cruise ship quarantined off the coast of Japan. One patient had persistent, low-grade upper respiratory tract symptoms without fever. The other patient had rapid symptom cessation but persistent viral RNA detection.


title: Predicting intervention effect for COVID-19 in Japan: state space modeling approach

text: Japan has observed a surge in the number of confirmed cases of the coronavirus disease (COVID-19) that has caused a serious impact on the society especially after the declaration of the state of emergency on April 7, 2020. This study analyzes the real time data from March 1 to April 22, 2020 by adopting a sophisticated statistical modeling based on the state space model combined with the well-known susceptible-infected-recovered (SIR) model. The model estimation and forecasting are conducted using the Bayesian methodology. The present study provides the parameter estimates of the unknown parameters that critically determine the epidemic process derived from the SIR model and prediction of the future transition of the infectious proportion including the size and timing of the epidemic peak with the prediction intervals that naturally accounts for the uncertainty. Even though the epidemic appears to be settling down during this intervention period, the prediction results under various scenarios using the data up to May 18 reveal that the temporary reduction in the infection rate would still result in a delayed the epidemic peak unless the long-term reproduction number is controlled.


Letter: Anosmia in COVID-19: Severe Acute Respiratory Syndrome Coronavirus 2 Through the Nasoliary Epithelium and a Possible Spreading Way to the Central Nervous System-A Purpose to Study


Management recommendations for patients with chronic kidney disease during the novel coronavirus disease 2019 (COVID-19) epidemic


title: Hydroxychloroquine against COVID-19: A critical appraisal of the existing evidence

text: Hydroxychloroquine (HCQ) has sparked much interest in the therapeutics of the Coronavirus Disease 2019 (COVID-19) pandemic. Its antiviral properties have been studied for years; regarding the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), it has been shown that HCQ may act at multiple levels. These extend from the initial attachment of the virus to the respiratory epithelium to the inhibition of its replication by the alkalinisation of the phagolysosome's microenvironment and the post-translational modification of certain viral proteins. Preliminary clinical evidence from China and France showed significant virological and clinical benefit in HCQ-treated patients, while other studies, mostly including critically ill patients, did not show favorable results. In this review, we critically appraise the existing evidence on HCQ against SARS-CoV-2 with particular emphasis on its protective and therapeutic role. Safety concerns that are relevant to the short-term HCQ use are also discussed. In the context of the rapid evolution of the COVID-19 pandemic that strains the health care systems worldwide and considering limited population-wide testing rates in most of the vulnerable countries, early empiric short-term administration of HCQ in symptomatic individuals, may be a promising, safe and low-cost strategy.


title: Temporal radiographic changes in COVID-19 patients: relationship to disease severity and viral clearance

text: COVID-19 is "public enemy number one" and has placed an enormous burden on health authorities across the world. Given the wide clinical spectrum of COVID-19, understanding the factors that can predict disease severity will be essential since this will help frontline clinical staff to stratify patients with increased confidence. To investigate the diagnostic value of the temporal radiographic changes, and the relationship to disease severity and viral clearance in COVID-19 patients. In this retrospective cohort study, we included 99 patients admitted to the Renmin Hospital of Wuhan University, with laboratory confirmed moderate or severe COVID-19. Temporal radiographic changes and viral clearance were explored using appropriate statistical methods. Radiographic features from HRCT scans included ground-glass opacity, consolidation, air bronchogram, nodular opacities and pleural effusion. The HRCT scores (peak) during disease course in COVID-19 patients with severe pneumonia (median: 24.5) were higher compared to those with pneumonia (median: 10) (p = 3.56 × 10 -12), with more frequency of consolidation (p = 0.025) and air bronchogram (p = 7.50 × 10-6). The median values of days when the peak HRCT scores were reached in pneumonia or severe pneumonia patients were 12 vs. 14, respectively (p = 0.048). Log-rank test and Spearman's Rank-Order correlation suggested temporal radiographic changes as a valuable predictor for viral clearance. In addition, follow up CT scans from 11 pneumonia patients showed full recovery. Given the values of HRCT scores for both disease severity and viral clearance, a standardised HRCT score system for COVID-19 is highly demanded.


title: CSANZ Imaging Council Position Statement on Echocardiography Services During the COVID-19 Pandemic

text: This Cardiac Society of Australia and New Zealand (CSANZ) Imaging Council Position Statement aims to guide local, regional and national clinical practice, and facilitate resource and echocardiographic service planning appropriately during the current COVID-19 global pandemic. General considerations include workforce arrangements and contingency plans, patient risk assessment for COVID-19 and level of care (personal protective equipment) for staff. Both outpatient and inpatient settings are addressed, including specific considerations in the in-patient setting including scanning protocols, screening modalities and indications for echocardiograms in the context of COVID-19 infection.


Genetic variation in SARS-CoV-2 may explain variable severity of COVID-19


Be aware of misdiagnosis-Influenza A H1N1 in a pregnant patient with suspected COVID-19


title: Expanding the concept of the professional integrity of obstetrics during a public health emergency

text: The coronavirus disease 2019 (COVID-19) pandemic has placed great demands on many hospitals to maximize their capacity to care for affected patients. The requirement to reassign space has created challenges for obstetric services. We describe the nature of that challenge for an obstetric service in New York City. This experience raised an ethical challenge: whether it would be consistent with professional integrity to respond to a public health emergency with a plan for obstetric services that would create an increased risk of rare maternal mortality. We answered this question using the conceptual tools of professional ethics in obstetrics, especially the professional virtue of integrity. A public health emergency requires frameshifting from an individual-patient perspective to a population-based perspective. We show that an individual-patient-based, beneficence-based deliberative clinical judgment is not an adequate basis for organizational policy in response to a public health emergency. Instead, physicians, especially those in leadership positions, must frameshift to population-based clinical ethical judgment that focuses on reduction of mortality as much as possible in the entire population of patients served by a healthcare organization.


title: Prevalence of malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China

text: BACKGROUND/OBJECTIVES: To evaluate the prevalence of malnutrition and its related factors in elderly patients with COVID-19 in Wuhan, China. SUBJECTS/METHODS: In a cross-sectional study, we evaluated the nutritional status of elderly inpatients with COVID-19 using the Mini Nutritional Assessment (MNA). Based on MNA scores, patients were divided into non-malnutrition group (MNA ≥ 24), the group with risk of malnutrition (MNA 17-23.5) and malnutrition group (MNA score < 17). Regression analysis was conducted to screen for risk factors for malnutrition. RESULTS: A total of 182 patients were included in the study, of which 27.5% were in the group with malnutrition risk and 52.7% were in the malnutrition group. There were statistical differences in the incidence of comorbid diabetes mellitus, body mass index (BMI), calf circumference,albumin, hemoglobin, and lymphocyte counts among the three groups. Further regression analysis suggested that combined diabetes, low calf circumference, and low albumin were independent risk factors for malnutrition. CONCLUSIONS: The prevalence of malnutrition in elderly patients with COVID-19 was high, and nutritional support should be strengthened during treatment, especially for those with diabetes mellitus, low calf circumference, or low albumin.


How the coronavirus pandemic is changing virtual science communication


Defining the Epidemiology of Covid-19 - Studies Needed


An Initial Evaluation of the Agreement Between Two SARS-CoV-2 Serologic Assays


title: Occurrence of severe rotavirus gastroenteritis in children younger than three years of age before and after the introduction of rotavirus vaccine: a prospective observational study in four pediatric clinics in Shibata City, Niigata Prefecture, Japan

text: In Japan, rotavirus (RV) vaccines have already been introduced but not used for universal vaccination as of 2018. Therefore, we identified cases of severe rotavirus gastroenteritis (RVGE) in children younger than three years of age and investigated the occurrence of infection before and after the introduction of RV vaccines. An ecological study through prospective surveillance was conducted in four pediatric clinics in Shibata City, Niigata Prefecture, Japan, during the 2011 to 2018 RVGE epidemic seasons. We divided the study period into three eras: pre-vaccine introduction era (2011), low-mid coverage transitional era (2012 to 2014, RV vaccine coverage rate: 32.9-56.5%), and high coverage plateau era (2015 to 2018, 67.7-81.7%). In this study, the incidence rate of severe RVGE was significantly lower in the plateau era than in the pre-vaccine introduction and transitional eras. Furthermore, the hospitalization rate due to RVGE in Shibata City was lower in the plateau era than in the pre-vaccination introduction and transitional eras. The number of hospitalizations due to RVGE in subjects who required or did not require intravenous rehydration at the pediatric clinics significantly decreased with the increase in vaccine coverage rates by more than 70% in the plateau era.


title: Analysis of the first cluster of cases in a family of novel coronavirus pneumonia in Gansu Province

text: The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020;patient B, on January 23, 2020, diagnosed on January 31, severe cases;patient C, asymptomatic, diagnosed on January 27;patient D, asymptomatic, diagnosed on January 27;patient E, on January 24, diagnosed on January 28;patient F, asymptomatic, diagnosed on January 31;Patient G was asymptomatic and was diagnosed on January 31 In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation ;


title: [Analysis of the first cluster of cases in a family of novel coronavirus pneumonia in Gansu Province]

text: The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.


title: Mortality threats and technology effects on tourism

text: â¢Investigates people's responses to tourism during Covid-19 lockdownâ¢Uses an experimental approach in tourismâ¢Investigates preference for innovative touristic virtual tours in relation to threat and self-esteemâ¢Combines research in psychology (Terror Management Theory) with that in tourismâ¢Discusses practical and research implications and future research avenues for tourism research.


18.2 Million Individuals at Increased Risk of Severe COVID-19 Illness Are Un- or Underinsured


Potential Impact of Climate on Novel Corona Virus (COVID-19) Epidemic


COVID-19 in patients with cardiovascular diseases


The role of Neutrophil Extracellular Traps in Covid-19: Only an hypothesis or a potential new field of research?


title: Compact CAR: Low-Overhead Cache Replacement Policy for an ICN Router

text: Information-centric networking (ICN) has gained attention from network research communities due to its capability of efficient content dissemination. In-network caching function in ICN plays an important role to achieve the design motivation. However, many researchers on in-network caching have focused on where to cache rather than how to cache: the former is known as contents deployment in the network and the latter is known as cache replacement in an ICN element. Although, the cache replacement has been intensively researched in the context of web-caching and content delivery network previously, the conventional approaches cannot be directly applied to ICN due to the fine granularity of cacheable items in ICN, which eventually changes the access patterns. In this paper, we argue that ICN requires a novel cache replacement algorithm to fulfill the requirements in the design of high performance ICN element. Then, we propose a novel cache replacement algorithm to satisfy the requirements named Compact CLOCK with Adaptive Replacement (Compact CAR), which can reduce the consumption of cache memory to one-tenth compared to conventional approaches.


Cell type-specific expression of the putative SARS-CoV-2 receptor ACE2 in human hearts


title: Early impact of COVID-19 on transplant center practices and policies in the United States

text: COVID-19 is a novel, rapidly changing pandemic: consequently, evidence-based recommendations in solid organ transplantation (SOT) remain challenging and unclear. To understand the impact on transplant activity across the United States, and center-level variation in testing, clinical practice, and policies, we conducted a national survey between March 24, 2020 and March 31, 2020 and linked responses to the COVID-19 incidence map. Response rate was a very high 79.3%, reflecting a strong national priority to better understand COVID-19. Complete suspension of live donor kidney transplantation was reported by 71.8% and live donor liver by 67.7%. While complete suspension of deceased donor transplantation was less frequent, some restrictions to deceased donor kidney transplantation were reported by 84.0% and deceased donor liver by 73.3%; more stringent restrictions were associated with higher regional incidence of COVID-19. Shortage of COVID-19 tests was reported by 42.5%. Respondents reported a total of 148 COVID-19 recipients from <1 to >10 years posttransplant: 69.6% were kidney recipients, and 25.0% were critically ill. Hydroxychloroquine (HCQ) was used by 78.1% of respondents; azithromycin by 46.9%; tocilizumab by 31.3%, and remdesivir by 25.0%. There is wide heterogeneity in center-level response across the United States; ongoing national data collection, expert discussion, and clinical studies are critical to informing evidence-based practices.


title: Coronavirus Outbreak and Stress in Iranians

text: Iran has faced one of the worst COVID-19 outbreaks in the world, and no studies to date have examined COVID-19-related stress in the general Iranian population. In this first population-based study, a web-based survey was conducted during the peak of the outbreak to assess stress and its correlates in the Iranian population. A 54-item, valid, and reliable questionnaire, including items on demographic characteristics and past medical history, stress levels, awareness about signs and symptoms of COVID-19, knowledge about at-risk groups and prevention methods, knowledge about transmission methods, trust in sources of information, and availability of facemasks and sanitizers, was deployed via social and mass media networks. A total of 3787 Iranians participated in the study where the majority of the participants were females (67.4%), employed (56.1%), from developed provinces (81.6%), without chronic diseases (66.6%), and with ≥13 years of formal education (87.9%). The mean age of study participants was 34.9 years (range = 12-73), and the average stress score was 3.33 (SD = ±1.02). Stress score was significantly higher for females, those who were 30-39 years old, housewives, those with chronic diseases, individuals who were aware that there is no vaccine to prevent COVID-19, those who could not get facemasks or sanitizers, and individuals with higher knowledge about at-risk groups (p < 0.05). There was a significant correlation of stress scores with knowledge about prevention methods for COVID-19 (r = 0.21, p = 0.01) and trust in sources of information about COVID-19 (r = -0.18, p = 0.01). All of the predictors, except knowledge of two important at-risk groups and education, had a significant effect on stress scores based on a multivariate regression model. The COVID-19 outbreak could increase stress among all population groups, with certain groups at higher risk. In the high-risk groups and based on experience with previous pandemics, interventions are needed to prevent long-term psychological effects. Professional support and family-centered programs should be a part of pandemic mitigation-related policymaking and public health practices.


title: Safe surgical tracheostomy during the COVID-19 pandemic: A protocol based on experiences with Middle East Respiratory Syndrome and COVID-19 outbreaks in South Korea

text: BACKGROUND: A subset of patients with COVID-19 require intensive respiratory care and tracheostomy. Several guidelines on tracheostomy procedures and care of tracheostomized patients have been introduced. In addition to these guidelines, further details of the procedure and perioperative care would be helpful. The purpose of this study is to describe our experience and tracheostomy protocol for patients with MERS or COVID-19. MATERIALS AND METHODS: Thirteen patients with MERS were admitted to the ICU, 9 (69.2%) of whom underwent surgical tracheostomy. During the COVID-19 outbreak, surgical tracheostomy was performed in one of seven patients with COVID-19. We reviewed related documents and collected information through interviews with healthcare workers who had participated in designing a tracheostomy protocol. RESULTS: Compared with previous guidelines, our protocol consisted of enhanced PPE, simplified procedures (no limitation in the use of electrocautery and wound suction, no stay suture, and delayed cannula change) and a validated screening strategy for healthcare workers. Our protocol allowed for all associated healthcare workers to continue their routine clinical work and daily life. It guaranteed safe return to general patient care without any related complications or nosocomial transmission during the MERS and COVID-19 outbreaks. CONCLUSION: Our protocol and experience with tracheostomies for MERS and COVID-19 may be helpful to other healthcare workers in building an institutional protocol optimized for their own COVID-19 situation.


title: Phototherapeutic approach to dermatological patients during the 2019 Coronavirus pandemic: Real-life Data from the Italian Red Zone

text: Since the novel Coronavirus 2019, also known as COVID-19 or SARS CoV-2, crossed the Chinese borders and became pandemic, Italy has rapidly become the country with the highest number of patient deaths as well as confirmed and/or hospitalized patients, after China [1-2]. On March 12th Italy was declared a red-zone and special protocols were enacted to limit the spread of the virus. Although COVID-19 does not have epidermotropism, cutaneous manifestations in Cov-19 positive patients have been reported [3] and departments of dermatology are considered at high risk [4] and were ordered to admit only patients needing urgent treatments or undergoing chronic immunosuppressive therapy in order to minimize nosocomial virus spread.


title: Minimization of spreading of SARS-CoV-2 via household waste produced by subjects affected by COVID-19 or in quarantine

text: Currently available evidence supports that the predominant route of human-to-human transmission of the SARS-CoV-2 is through respiratory droplets. Indirect hands contact with surfaces contaminated by infectious droplets subsequently touching the mouth, nose or eyes seems to be another route of an indirect contact transmission. Persistence of the virus on different surfaces and other materials has been reported in recent studies: SARS-CoV-2 was more stable on plastic and stainless steel than on copper and cardboard. Viable virus was detected up to 72 h after application to different surfaces, although infectivity decay was also observed. This evidence suggests the likelihood that waste generated from patients affected by COVID-19 or subjects in quarantine treated in private houses or in areas different from hospitals and medical centres could be contaminated by SARS-CoV-2. Consequently, waste streams may represent a route for viral spreading being a potential risk also for the operators directly involved in the different phases of waste management. To address this concern, a specific multidisciplinary working group was settled by the Italian National Institute of Health (ISS) during the COVID-19 emergency, in order to establish guidelines related to solid waste collection, delivering, withdrawal, transport, treatment and disposal. Temporary stop of waste sorting, instructions for the population on how to package waste, instructions for Companies and operators for the adoption of adequate personal protection equipment (PPE), the use and sanitation of proper vehicles were among the main recommendations provided to the community by publications of freely downloadable reports and infographics in layman language. Incineration, sterilization and properly managed landfills were identified as the facilities to be preferentially adopted for the treatment of this kind of waste, considering the main inactivation strategies of SARS-CoV-2 (e.g. treatment length > 9 days and temperature > 70 °C for more than 5 min).


title: Adrenal Insufficiency and Glucocorticoid Use During the COVID-19 Pandemic

text: The coronavirus disease 2019 (COVID-19) is an emerging pandemic challenge. Acute respiratory distress syndrome (ARDS) in COVID-19 is characterized by a severe cytokine storm. Patients undergoing glucocorticoid (GC) replacement therapy for adrenal insufficiency (AI) represent a highly vulnerable group that could develop severe complications due to the SARS-CoV-2 infection. In this review, we highlight the strategies to avoid an adrenal crisis in patients with AI and COVID-19. Adrenal crisis is a medical emergency and an important cause of death. Once patients with AI present symptoms of COVID-19, the dose of GC replacement therapy should be immediately doubled. In the presence of any emergency warning signs or inability to administer oral GC doses, we recommend that patients should immediately seek Emergency services to evaluate COVID-19 symptoms and receive 100 mg hydrocortisone by intravenous injection, followed by 50 mg hydrocortisone intravenously every 6 h or 200 mg/day by continuous intravenous infusion.


title: Distinct infection process of SARS-CoV-2 in human bronchial epithelial cells line

text: COVID-19, caused by SARS-CoV-2, leads to a series of clinical symptoms of respiratory and pulmonary inflammatory reactions via unknown pathologic mechanisms related to the viral infection process in tracheal or bronchial epithelial cells. Investigation of this viral infection in the human bronchial epithelial cell line (16HBE) suggests that SARS-CoV-2 can enter these cells through interaction between its membrane-localized S protein with the ACE2 molecule on the host cell membrane. Further observation indicates distinct viral replication with a dynamic and moderate increase, whereby viral replication does not lead to a specific cytopathic effect but maintains a continuous release of progeny virions from infected cells. Although mRNA expression of various innate immune signaling molecules is altered in the cells, transcription of IFNα, IFNß and IFNÎ³ is unchanged. Furthermore, expression of some interleukins related to inflammatory reactions, such as IL-6, IL-2 and IL-8, is maintained at low levels, whereas that of interleukins involved in immune regulation is upregulated. Interestingly, IL-22, an interleukin that functions mainly in tissue repair, shows very high expression. Collectively, these data suggest a distinct infection process for this virus in respiratory epithelial cells, which may be linked to its clinicopathological mechanism. This article is protected by copyright. All rights reserved.


title: Prediction of Novel Inhibitors of the Main Protease (M-pro) of SARS-CoV-2 through Consensus Docking and Drug Reposition

text: Since the outbreak of the COVID-19 pandemic in December 2019 and its rapid spread worldwide, the scientific community has been under pressure to react and make progress in the development of an effective treatment against the virus responsible for the disease. Here, we implement an original virtual screening (VS) protocol for repositioning approved drugs in order to predict which of them could inhibit the main protease of the virus (M-pro), a key target for antiviral drugs given its essential role in the virus' replication. Two different libraries of approved drugs were docked against the structure of M-pro using Glide, FRED and AutoDock Vina, and only the equivalent high affinity binding modes predicted simultaneously by the three docking programs were considered to correspond to bioactive poses. In this way, we took advantage of the three sampling algorithms to generate hypothetic binding modes without relying on a single scoring function to rank the results. Seven possible SARS-CoV-2 M-pro inhibitors were predicted using this approach: Perampanel, Carprofen, Celecoxib, Alprazolam, Trovafloxacin, Sarafloxacin and ethyl biscoumacetate. Carprofen and Celecoxib have been selected by the COVID Moonshot initiative for in vitro testing; they show 3.97 and 11.90% M-pro inhibition at 50 µM, respectively.


title: Genetic gateways to COVID-19 infection: Implications for risk, severity, and outcomes

text: The dynamics, such as transmission, spatial epidemiology, and clinical course of Coronavirus Disease-2019 (COVID-19) have emerged as the most intriguing features and remain incompletely understood. The genetic landscape of an individual in particular, and a population in general seems to play a pivotal role in shaping the above COVID-19 dynamics. Considering the implications of host genes in the entry and replication of SARS-CoV-2 and in mounting the host immune response, it appears that multiple genes might be crucially involved in the above processes. Herein, we propose three potentially important genetic gateways to COVID-19 infection; these could explain at least in part the discrepancies of its spread, severity, and mortality. The variations within Angiotensin-converting enzyme 2 (ACE2) gene might constitute the first genetic gateway, influencing the spatial transmission dynamics of COVID-19. The Human Leukocyte Antigen locus, a master regulator of immunity against infection seems to be crucial in influencing susceptibility and severity of COVID-19 and can be the second genetic gateway. The genes regulating Toll-like receptor and complement pathways and subsequently cytokine storm induced exaggerated inflammatory pathways seem to underlie the severity of COVID-19, and such genes might represent the third genetic gateway. Host-pathogen interaction is a complex event and some additional genes might also contribute to the dynamics of COVID-19. Overall, these three genetic gateways proposed here might be the critical host determinants governing the risk, severity, and outcome of COVID-19. Genetic variations within these gateways could be key in influencing geographical discrepancies of COVID-19.


title: Thoughts on What Chemists Can Contribute to Fighting SARS-CoV-2 - A Short Note on Hand Sanitizers, Drug Candidates and Outreach

text: The SARS-CoV-2 outbreak causing the respiratory disease COVID-19 has left many chemists in academia without an obvious option to contribute to fighting the pandemic. Some of our recent experiences indicate that there are ways to overcome this dilemma. A three-pronged approach is proposed.


Increase in submissions to International Brazilian Journal of Urology during Covid-19 quarentine


title: Good clinical practice advice for the management of pregnant women with suspected or confirmed COVID-19 in Nigeria

text: The impact on healthcare services in settings with under-resourced health systems, such as Nigeria, is likely to be substantial in the coming months due to the COVID-19 pandemic, and maternity services still need to be prioritized as an essential core health service. The healthcare system should ensure the provision of safe and quality care to women during pregnancy, labor, and childbirth, and at the same time, maternity care providers including obstetricians and midwives must be protected and prioritized to continue providing care to childbearing women and their babies during the pandemic. This practical guideline was developed for the management of pregnant women with suspected or confirmed COVID-19 in Nigeria and other low-resource countries.


title: Postintubation Dysphagia During COVID-19 Outbreak-Contemporary Review

text: The COVID-19 is a global pandemic. Its rapid dissemination and serious course require a novel approach to healthcare practices. Severe disease progression is often associated with the development of the Acute Respiratory Distress Syndrome and may require some form of respiratory support, including endotracheal intubation, mechanical ventilation, and enteral nutrition through a nasogastric tube. These conditions increase the risk of dysphagia, aspiration, and aspiration pneumonia. The data on the incidence and risks of dysphagia associated with COVID-19 are not yet available. However, it is assumed that these patients are at high risk, because of respiratory symptoms and reduced lung function. These findings may exacerbate swallowing deficits. The aim of this review is to summarize available information on possible mechanisms of postintubation dysphagia in COVID-19 patients. Recommendations regarding the diagnosis and management of postintubation dysphagia in COVID-19 patients are described in this contemporary review.


title: Nurses reports of actual work hours and preferred work hours per shift among frontline nurses during coronavirus disease 2019 (COVID-19) epidemic: A cross-sectional survey

text: Background: A novel coronavirus disease that emerged in China in December 2019 (COVID-19) has rapidly spread to all over the world, leading to 823 626 people diagnosed and 40 598 deaths globally as of April 1, 2020. Nurses are providing care to patients with COVID-19 who require hospitalization. To ensure adequate response capacity and to maintain the health of nurses at risk of infection, it is important to analyse the actual work hours and the nurses reported preferred work hours per shift among frontline nurses. Objective: To analyse the actual work hours and preferred work hours per shift of nurses reports among frontline nurses fighting the COVID-19 epidemic and to explore the influencing factors on the nurses reported preferred work hours. Design: Cross-sectional survey. Settings: This study was conducted in 10 designated hospitals providing treatments to patients with COVID-19 in China. Participants: Nurses providing care to patients with COVID-19 in designated hospitals in China. Methods: A self-designed questionnaire with open-ended questions was used to assess frontline nurses caring for COVID-19 cases in 10 designated hospitals. Quantitative and qualitative methods were used to analyse the actual work hours, the nurses reported preferred work hours and factors influencing nurses reported preferred work hours among the frontline nurses. Results: A total of 109 nurses responded to the survey. The actual work hours per shift among frontline nurses were exceeded the nurses reported preferred work hours [Median (interquartile range): 5.00(2.00) h vs 4.00 (2.00)h; Minmum-Maxmum: 4-12 h vs 4-8 h], and 60.55% (66/109) of the nurses regarded 4 h as the preferred number of work hours per shift. Five key themes associated with the influencing factors emerged, including circumstances, personal preventable equipment, the physical and emotional needs of nurse, the safety needs of nurse and work intensity. Conclusions: These findings suggest that there is a gap between the actual work hours and the nurses reported preferred work hours among frontline nurses in different units and different posts. The main influencing factors were circumstances, personal preventable equipment, the physical and emotional needs of nurse, the safety needs of nurse and work intensity.


Fighting COVID-19 exhausts T cells


title: Delivery in pregnant women infected with SARS-CoV-2: A fast review

text: BACKGROUND: Few case reports and clinical series exist on pregnant women infected with SARS-CoV-2 who delivered. OBJECTIVE: To review the available information on mode of delivery, vertical/peripartum transmission, and neonatal outcome in pregnant women infected with SARS-CoV-2. SEARCH STRATEGY: Combination of the following key words: COVID-19, SARS-CoV-2, and pregnancy in Embase and PubMed databases. SELECTION CRITERIA: Papers reporting cases of women infected with SARS-CoV-2 who delivered. DATA COLLECTION AND ANALYSIS: The following was extracted: author; country; number of women; study design; gestational age at delivery; selected clinical maternal data; mode of delivery; selected neonatal outcomes. MAIN RESULTS: In the 13 studies included, vaginal delivery was reported in 6 cases (9.4%; 95% CI, 3.5-19.3). Indication for cesarean delivery was worsening of maternal conditions in 31 cases (48.4%; 95% CI, 35.8-61.3). Two newborns testing positive for SARS-CoV-2 by real-time RT-PCR assay were reported. In three neonates, SARS-CoV-2 IgG and IgM levels were elevated but the RT-PCR test was negative. CONCLUSIONS: The rate of vertical or peripartum transmission of SARS-CoV-2 is low, if any, for cesarean delivery; no data are available for vaginal delivery. Low frequency of spontaneous preterm birth and general favorable immediate neonatal outcome are reassuring.


title: Mucin-inspired, high molecular weight virus binding inhibitors show biphasic binding behavior to influenza A viruses

text: Multivalent virus binding inhibitors are a promising new class of antivirals, preventing virus infection of cells by inhibiting the first step in the viral infection cycle - binding of viruses to the cell surface. The design of multivalent virus binding inhibitors is complex as many properties, such as inhibitor size and functionalization with virus attachment factors, have a strong impact on the inhibition efficiency. In this study, we synthesized virus binding inhibitors, the design of which has been inspired by mucins, which are naturally occurring glycosylated proteins with molecular weights in the MDa range and which show high affinity in the interaction with various viruses. Hyperbranched polyglycerols (hPG), serving as polymeric scaffolds, were functionalized with sialic acids and sulfate groups at degrees of functionalization as suggested from the structure of mucins. The molecular weights of the hPG-based inhibitors ranged between 10 and 2600 kDa, thereby hitting the size of mucins (MDa scale) and allowing for comparing the inhibition efficiency of the largest, mucin-sized inhibitor (2600 kDa) with related inhibitors of lower molecular weight. Inhibition efficiencies were determined by various methods based on the inhibition of influenza A virus (IAV) binding to lipid membranes, including an assay based on total internal reflection fluorescence (TIRF) microscopy that allows for probing the interaction of IAV with its native attachment factor, sialic acid. Potent inhibition is observed in all assays already at pM concentrations for the mucin-sized inhibitor, while decreasing the inhibitor's molecular weight also decreased its inhibition efficiency. In addition, a biphasic binding behavior of the inhibitors to IAV is observed, which is attributed to differences in the binding affinity to two IAV envelope proteins, neuraminidase and hemagglutinin.


title: A Case of COVID-19 Patient with False-negative for SARS-CoV-2 of Pharyngeal Swab, from a Chinese traveller Returning from Wuhan, Hubei Province, China, January 2020

text: We report a case of patient in Japan with Coronavirus disease 2019 (COVID-19) with false-negative of reverse transcription polymerase chain reaction for Severe Acute Respiratory Syndrome Coronavirus 2 of pharyngeal swab, from a Chinese traveller returning from Wuhan, Hubei Province, China. If a patient is clinically or epidemiologically suspected of COVID-19, appropriate infection and prevention control measures such as standard, contact, and droplet precaution are needed until the patient is proven to be true-negative.


Coronavirus (COVID-19) Assessments and the Importance of Calculating the Probability of Illness


Public Health and Ethics Intersect at New Levels With Gerontological Nursing in COVID-19 Pandemic


COVID-19 in a 26-week preterm neonate


title: Possible environmental effects on the spread of COVID-19 in China

text: At the end of 2019, a novel coronavirus, designated as SARS-CoV-2, emerged in Wuhan, China and was identified as the causal pathogen of COVID-19. The epidemic scale of COVID-19 has increased dramatically, with confirmed cases increasing across China and globally. Understanding the potential affecting factors involved in COVID-19 transmission will be of great significance in containing the spread of the epidemic. Environmental and meteorological factors might impact the occurrence of COVID-19, as these have been linked to various diseases, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), whose causative pathogens belong to the same virus family as SARS-CoV-2. We collected daily data of COVID-19 confirmed cases, air quality and meteorological variables of 33 locations in China for the outbreak period of 29 January 2020 to 15 February 2020. The association between air quality index (AQI) and confirmed cases was estimated through a Poisson regression model, and the effects of temperature and humidity on the AQI-confirmed cases association were analyzed. The results show that the effect of AQI on confirmed cases associated with an increase in each unit of AQI was statistically significant in several cities. The lag effect of AQI on the confirmed cases was statistically significant on lag day 1 (relative risk (RR) = 1.0009, 95% confidence interval (CI): 1.0004, 1.0013), day 2 (RR = 1.0007, 95% CI: 1.0003, 1.0012) and day 3 (RR = 1.0008, 95% CI: 1.0003, 1.0012). The AQI effect on the confirmed cases might be stronger in the temperature range of 10 °C ≤ T < 20 °C than in other temperature ranges, while the RR of COVID-19 transmission associated with AQI was higher in the relative humidity (RH) range of 10% ≤ RH < 20%. Results may suggest an enhanced impact of AQI on the COVID-19 spread under low RH.


title: Understanding of COVID-19 based on current evidence

text: Since December 2019, a series of unexplained pneumonia cases have been reported in Wuhan, China. On 12 January 2020, the World Health Organization (WHO) temporarily named this new virus as the 2019 novel coronavirus (2019-nCoV). On 11 February 2020, the WHO officially named the disease caused by the 2019-nCoV as coronavirus disease (COVID-19). The COVID-19 epidemic is spreading all over the world, especially in China. Based on the published evidence, we systematically discuss the characteristics of COVID-19 in the hope of providing a reference for future studies and help for the prevention and control of the COVID-19 epidemic.


COVID-19 and the cardiovascular system


Managing Older Adults with Presumed COVID-19 in the Emergency Department: A Rational Approach to Rationing


title: Quantitative computed tomography analysis for stratifying the severity of Coronavirus Disease 2019

text: Purpose: To examine the feasibility of using a computer tool for stratifying the severity of Coronavirus Disease 2019 (COVID-19) based on computed tomography (CT) images. Materials and methods: We retrospectively examined 44 confirmed COVID-19 cases. All cases were evaluated separately by radiologists (visually) and through an in-house computer software. The degree of lesions was visually scored by the radiologist, as follows, for each of the 5 lung lobes: 0, no lesion present; 1, <1/3 involvement; 2, >1/3 and < 2/3 involvement; and 3, >2/3 involvement. Lesion density was assessed based on the proportion of ground-glass opacity (GGO), consolidation and fibrosis of the lesions. The parameters obtained using the computer tool included lung volume (mL), lesion volume (mL), lesion percentage (%), and mean lesion density (HU) of the whole lung, right lung, left lung, and each lobe. The scores obtained by the radiologists and quantitative results generated by the computer software were tested for correlation. A Chi-square test was used to test the consistency of radiologist- and computer-derived lesion percentage in the right/left lung, upper/lower lobe, and each of the 5 lobes. Result: The results showed a strong to moderate correlation between lesion percentage scores obtained by radiologists and the computer software (r ranged from 0.7679 to 0.8373, P < 0.05), and a moderate correlation between the proportion of GGO and mean lesion density (r = -0.5894, P < 0.05), and proportion of consolidation and mean lesion density (r = 0.6282, P < 0.05). Computer-aided quantification showed a statistical significant higher lesion percentage for lower lobes than that assessed by the radiologists (χ2 = 8.160, P = 0.004). Conclusions: Our experiments demonstrated that the computer tool could reliably and accurately assess the severity and distribution of pneumonia on CT scans.


Biotech companies prepare for COVID-19 downturn


title: Evaluation of fluid responsiveness during COVID-19 pandemic: what are the remaining choices?

text: Non-protocolized fluid administration in critically ill patients, especially those with acute respiratory distress syndrome (ARDS), is associated with poor outcomes. Therefore, fluid administration in patients with Coronavirus disease (COVID-19) should be properly guided. Choice of an index to guide fluid management during a pandemic with mass patient admissions carries an additional challenge due to the relatively limited resources. An ideal test for assessment of fluid responsiveness during this pandemic should be accurate in ARDS patients, economic, easy to interpret by junior staff, valid in patients in the prone position and performed with minimal contact with the patient to avoid spread of infection. Patients with COVID-19 ARDS are divided into two phenotypes (L phenotype and H phenotype) according to their lung compliance. Selection of the proper index for fluid responsiveness varies according to the patient phenotype. Heart-lung interaction methods can be used only in patients with L phenotype ARDS. Real-time measures, such a pulse pressure variation, are more appropriate for use during this pandemic compared to ultrasound-derived measures, because contamination of the ultrasound machine can spread infection. Preload challenge tests are suitable for use in all COVID-19 patients. Passive leg raising test is relatively better than mini-fluid challenge test, because it can be repeated without overloading the patient with fluids. Trendelenburg maneuver is a suitable alternative to the passive leg raising test in patients with prone position. If a cardiac output monitor was not available, the response to the passive leg raising test could be traced by measurement of the pulse pressure or the perfusion index. Preload modifying maneuvers, such as tidal volume challenge, can also be used in COVID-19 patients, especially if the patient was in the gray zone of other dynamic tests. However, the preload modifying maneuvers were not extensively evaluated outside the operating room. Selection of the proper test would vary according to the level of healthcare in the country and the load of admissions which might be overwhelming. Evaluation of the volume status should be comprehensive; therefore, the presence of signs of volume overload such as lower limb edema, lung edema, and severe hypoxemia should be considered beside the usual indices for fluid responsiveness.


Pandémie à Covid-19 : dangers des interruptions de traitement sans avis médical


Intergenerational Digital Engagement: A Way to Prevent Social Isolation During the COVID-19 Crisis


title: Evaluation of the effects of cell-dispensing using an inkjet-based bioprinter on cell integrity by RNA-seq analysis

text: Bioprinting technology is expected to be applied in the fields of regenerative medicine and drug discovery. There are several types of bioprinters, especially inkjet-based bioprinter, which can be used not only as a printer for arranging cells but also as a precision cell-dispensing device with controlled cell numbers similar to a fluorescence activated cell sorter (FACS). Precise cell dispensers are expected to be useful in the fields of drug discovery and single-cell analysis. However, there are enduring concerns about the impacts of cell dispensers on cell integrity, particularly on sensitive cells, such as stem cells. In response to the concerns stated above, we developed a stress-free and media-direct-dispensing inkjet bioprinter. In the present study, in addition to conventional viability assessments, we evaluated the gene expression using RNA-seq to investigate whether the developed bioprinter influenced cell integrity in mouse embryonic stem cells. We evaluated the developed bioprinter based on three dispensing methods: manual operation using a micropipette, FACS and the developed inkjet bioprinter. According to the results, the developed inkjet bioprinter exhibited cell-friendly dispensing performance, which was similar to the manual dispensing operation, based not only on cell viability but also on gene expression levels.


Lymphopenia during the COVID-19 infection: What it shows and what can be learned


title: Mediastinal Emphysema, Giant Bulla, and Pneumothorax Developed during the Course of COVID-19 Pneumonia

text: The coronavirus disease 2019 (COVID-19) pneumonia is a recent outbreak in mainland China and has rapidly spread to multiple countries worldwide. Pulmonary parenchymal opacities are often observed during chest radiography. Currently, few cases have reported the complications of severe COVID-19 pneumonia. We report a case where serial follow-up chest computed tomography revealed progression of pulmonary lesions into confluent bilateral consolidation with lower lung predominance, thereby confirming COVID-19 pneumonia. Furthermore, complications such as mediastinal emphysema, giant bulla, and pneumothorax were also observed during the course of the disease.


Covid-19: Trump says added deaths are necessary price for reopening US businesses


title: The different clinical characteristics of corona virus disease cases between children and their families in China - the character of children with COVID-19

text: This study aims to analyze the different clinical characteristics between children and their families infected with severe acute respiratory syndrome coronavirus 2. Clinical data from nine children and their 14 families were collected, including general status, clinical, laboratory test, and imaging characteristics. All the children were detected positive result after their families onset. Three children had fever (22.2%) or cough (11.2%) symptoms and six (66.7%) children had no symptom. Among the 14 adult patients, the major symptoms included fever (57.1%), cough (35.7%), chest tightness/pain (21.4%), fatigue (21.4%) and sore throat (7.1%). Nearly 70% of the patients had normal (71.4%) or decreased (28.6%) white blood cell counts, and 50% (7/14) had lymphocytopenia. There were 10 adults (71.4%) showed abnormal imaging. The main manifestations were pulmonary consolidation (70%), nodular shadow (50%), and ground glass opacity (50%). Five discharged children were admitted again because their stool showed positive result in SARS-CoV-2 PCR. COVID-19 in children is mainly caused by family transmission, and their symptoms are mild and prognosis is better than adult. However, their PCR result in stool showed longer time than their families. Because of the mild or asymptomatic clinical process, it is difficult to recognize early for pediatrician and public health staff.


Worried well and Covid-19: Re-emergence of an old quandary


title: Recent advances of therapeutic targets and potential drugs of COVID-19

text: Since December 2019, numerous cases of coronavirus disease 2019 (COVID-19) caused by the infection of the novel coronavirus (2019-nCoV) have been confirmed in Wuhan, China. The outbreak of 2019-nCoV in China embodied a significant and urgent threat to global health. 2019-nCoV was a new, highly contagious coronavirus discovered following the outbreak of SARS coronavirus (SARS-CoV) and MERS coronavirus (MERS-CoV). The novel coronavirus can cause severe respiratory disease and even death. However, no specific therapeutic drugs have been developed clinically thus far. This article examines the potential of therapeutic drugs by assessing the structure of 2019-nCoV, its mechanism in invading host cells, and the anti-viral mechanism of the human autoimmune system. We also review the latest research regarding the progress of potential therapeutic drugs and provide references for new drug developments of COVID-19.


Off-Site Radiology Workflow Changes Due to the Coronavirus Disease 2019 (COVID-19) Pandemic


Protocolo de actuación ante la epidemia de enfermedad por coronavirus en los pacientes de diálisis y trasplantados renales./ Protocolo de actuación ante la epidemia de enfermedad por coronavirus en los pacientes de diálisis y trasplantados renales./ Protocol against coronavirus diseases in patients on renal replacement therapy: Dialysis and kidney transplant


The association between severe or dead COVID-19 and autoimmune diseases: A systematic review and meta-analysis


Cancer Research after COVID-19: Where Do We Go from Here?


Ejercitarse en tiempos del COVID-19: ¿qué recomiendan los expertos hacer entre cuatro paredes?/ [Exercising in times of COVID-19: what do experts recommend doing within four walls?]


The depressive state of Denmark during the COVID-19 pandemic


Remote Glucose Monitoring of Hospitalized, Quarantined Patients With Diabetes and COVID-19


COVID19 impact on nuclear medicine: an Australian perspective


COVID-19 versus the 1918 influenza pandemic: different virus, different age mortality patterns


Impact of COVID-19 on Pain Medicine Fellowship Training


International Society for Infectious Diseases - Sustained and continuous funding for WHO


title: Fostering Existential Maturity to Manage Terror in a Pandemic

text: Background: The COVID-19 pandemic has created an environment in which existence is more fragile and existential fears or terror rises in people. Objective: Managing existential terror calls for being mature about mortality, something with which palliative care providers are familiar and in need of greater understanding. Methods: Using a case to illustrate, we describe existential terror, terror management, and existential maturity and go on to outline how existential maturity is important for not only the dying and the grieving but for also those facing risk of acquiring COVID-19. Results: Next, we describe how essential components in attaining existential maturity come together. (1) Because people experience absent attachment to important people as very similar to dying, attending to those experiences of relationship is essential. (2) That entails an internal working through of important relationships, knowing their incompleteness, until able to "hold them inside," and invest in these and other connections. (3) And what allows that is making a meaningful connection with someone around the experience of absence or death. (4) We also describe the crucial nature of a holding environment in which all of these can wobble into place. Discussion: Finally, we consider how fostering existential maturity would help populations face up to the diverse challenges that the pandemic brings up for people everywhere.


title: Psychosocial and Behavioral Impact of COVID-19 in Autism Spectrum Disorder: An Online Parent Survey

text: The 2019 coronavirus disease (COVID-19) outbreak could result in higher levels of psychological distress, especially among people suffering from pre-existing mental health conditions. Young individuals with autism spectrum disorders (ASD) are particularly at risk due to their vulnerability to unpredictable and complex changes. This study aimed to investigate the impact of the COVID-19 pandemic on ASD individuals, whether any pre-pandemic sociodemographic or clinical characteristics would predict a negative outcome, and to narratively characterize their needs. Parents and guardians of ASD individuals filled out an online survey consisting of 40 questions investigating socio-demographic and clinical characteristics of their children, impact of the COVID-19 outbreak on their wellbeing and needs to deal with the emergency. Data were available on 527 survey participants. The COVID-19 emergency resulted in a challenging period for 93.9% of families, increased difficulties in managing daily activities, especially free time (78.1%) and structured activities (75.7%), and, respectively, 35.5% and 41.5% of children presenting with more intense and more frequent behavior problems. Behavior problems predating the COVID-19 outbreak predicted a higher risk of more intense (odds ratio (OR) = 2.16, 95% confidence interval (CI) 1.42-3.29) and more frequent (OR = 1.67, 95% CI 1.13-2.48) disruptive behavior. Even though ASD children were receiving different types of support, also requiring specialist (19.1%) or emergency (1.5%) interventions in a relatively low proportion of cases, a number of needs emerged, including receiving more healthcare support (47.4%), especially in-home support (29.9%), as well as interventions to tackle a potentially disruptive quarantine (16.8%). The COVID-19 outbreak has undoubtedly resulted in increased difficulties among ASD individuals.


title: A familial cluster, including a kidney transplant recipient, of Coronavirus Disease 2019 (COVID-19) in Wuhan, China

text: In December 2019, an outbreak of COVID-19 occurred in Wuhan, China, and spread to the whole of China and to multiple countries worldwide. Unlike SARS and MERS, where secondary transmission mostly occurred in hospital settings, COVID-19 transmission occurs in large numbers within families. Herein we report three cases of a familial cluster with one family member being a kidney transplant recipient. The initial clinical symptoms of COVID-19 in these three patients were the same, but their progression was different. Based on the severity of clinical symptoms, chest computer tomography findings and SARS-Cov-2 RNA test results, we admitted the husband to the respiratory intensive care unit (RICU) and used a treatment consisting of immunosuppressant reduction/cessation and low dose methylprednisolone-based therapy, and his wife to the respiratory isolation ward. In contrast, the son received in-home isolation and home-based care. All three family members made a full recovery.


Is 0.5% hydrogen peroxide effective against SARS-CoV-2?


SARS-CoV-2 RNA more readily detected in induced sputum than in throat swabs of convalescent COVID-19 patients


Considerations for the Treatment of Oesophageal Cancer With Radiotherapy During the COVID-19 Pandemic


COVID-19 in Spain. Coming back to the "New normality" after two months of confinement


Contrasting evidence for corticosteroid treatment for coronavirus-induced cytokine storm


Exposure to SARS-CoV-2 in a high transmission setting increases the risk of severe COVID-19 compared to exposure to a low transmission setting?


title: Hematological findings in coronavirus disease 2019: indications of progression of disease

text: Coronavirus disease 2019 (COVID-19) is a new human infectious disease. The etiology for this outbreak is a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Thus far, related research on COVID-19 is still in preliminary stage. This paper summarized the latest outcomes of corresponding study from Chinese centers and clarified the hematopoietic abnormality caused by SARS-CoV-2 and potential mechanism. Lymphopenia was common in the early stage after the onset of COVID-19. A significant decrease was observed in peripheral CD4+ and CD8+ T lymphocytes. As the illness progressed, neutrophilia emerged in several cases, and patients with severe critical pulmonary conditions showed higher neutrophils than common type. Thrombocytopenia was resulting from the consumption and/or the reduced production of platelets in damaged lungs. Anemia was not observed notably, but the decrease in hemoglobin was frequent. The activation of monocyte-macrophage system aggravates the immune damage of lung and other tissues, which leads to the increase of D-dimer, prothrombin time, and platelet consumption.


title: A Comparison of Mortality-related Risk Factors of COVID-19, SARS, and MERS: A Systematic Review and Meta-analysis

text: OBJECTIVE: Coronavirus Disease 2019 (COVID-19) is a pandemic. This systematic review compares mortality risk factors including clinical, demographic and laboratory features of COVID-19, Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). The aim is to provide new strategies for COVID-19 prevention and treatment. METHODS: We performed a systematic review with meta-analysis, using five databases to compare the predictors of death for COVID-19, SARS and MERS. A random-effects model meta-analysis calculated odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: 845 articles up through 11/4/2020 were retrieved, but only 28 studies were included in this meta-analysis. The results showed that males had a higher likelihood of death than females (ORâ¯=â¯1.82, 95% CI 1.56-2.13). Age (ORâ¯=â¯7.86, 95% CI 5.46-11.29), diabetes comorbidity (ORâ¯=â¯3.73, 95% CI 2.35-5.90), chronic lung disease (ORâ¯=â¯3.43, 95% CI 1.80-6.52) and hypertension (ORâ¯=â¯3.38, 95% CI 2.45-4.67) were the mortality risk factors. The laboratory indicators lactic dehydrogenase (ORâ¯=â¯37.52, 95% CI 24.68-57.03), C-reactive protein (ORâ¯=â¯12.11, 95% CI 5.24-27.98), and neutrophils (ORâ¯=â¯17.56, 95% CI 10.67-28.90) had stronger correlations with COVID-19 mortality than with SARS or MERS mortality. Consolidation and ground-glass opacity imaging features were similar among COVID-19, SARS, and MERS patients. CONCLUSIONS: COVID-19's mortality factors are similar to those of SARS and MERS. Age and laboratory indicators could be effective predictors of COVID-19 mortality outcomes.


title: Maternal death due to COVID-19

text: BACKGROUND: Despite 2.5 million infections and 169,000 deaths worldwide (as of April 20, 2020), no maternal deaths and only a few pregnant women afflicted with severe respiratory morbidity have been reported to be related to COVID-19 disease. Given the disproportionate burden of severe and fatal respiratory disease previously documented among pregnant women following other coronavirus-related outbreaks (SARS-CoV in 2003 and MERS-CoV in 2012) and influenza pandemics over the last century, the absence of reported maternal morbidity and mortality with COVID-19 disease is unexpected. OBJECTIVE: To describe maternal and perinatal outcomes and death in a case series of pregnant women with COVID-19 disease. STUDY DESIGN: We describe here a multiinstitution adjudicated case series from Iran that includes 9 pregnant women diagnosed with severe COVID-19 disease in their second or third trimester. All 9 pregnant women received a diagnosis of SARS-CoV-2 infection by reverse transcription polymerase chain reaction nucleic acid testing. Outcomes of these women were compared with their familial/household members with contact to the affected patient on or after their symptom onset. All data were reported at death or after a minimum of 14 days from date of admission with COVID-19 disease. RESULTS: Among 9 pregnant women with severe COVID-19 disease, at the time of reporting, 7 of 9 died, 1 of 9 remains critically ill and ventilator dependent, and 1 of 9 recovered after prolonged hospitalization. We obtained self-verified familial/household cohort data in all 9 cases, and in each and every instance, maternal outcomes were more severe compared with outcomes of other high- and low-risk familial/household members (n=33 members for comparison). CONCLUSION: We report herein maternal deaths owing to COVID-19 disease. Until rigorously collected surveillance data emerge, it is prudent to be aware of the potential for maternal death among pregnant women diagnosed as having COVID-19 disease in their second or third trimester.


Utilising Point of Care Diagnostics to Minimise Nosocomial Infection in the 2019 Novel Coronavirus (SARS-CoV-2) Pandemic