title: Updates on the Pharmacology of Chloroquine against Coronavirus Disease 2019 (COVID-19): A Perspective on its Use in the General and Geriatric Population

text: BACKGROUND: Chloroquine has been used to treat malaria for more than 70 years. Its safety profile and costeffectiveness are well-documented. Scientists have found that chloroquine has in vitro activity against novel coronavirus (SARS-CoV-2). Currently, chloroquine has been adopted in the Protocol for Managing Coronavirus Disease 2019 (COVID19) (Version 7) issued by China National Health Commission for clinically managing COVID-19. OBJECT: This review will focus on the antiviral mechanism, effectiveness and safety, dosage and DDIs of chloroquine, for the purpose to provide evidence-based support for rational use of chloroquine in the treatment of COVID-19. Methodï¼Use the search terms 'chloroquine' linked with 'effectiveness', 'safety', 'mechanism', 'drug-drug interaction (DDIs)' or other terms respectively to search relevant literature through PubMed. RESULT: After searching, we found literature about antivirus mechanism, dosage, DDIs of chloroquine. However, studies of effectiveness and safety on chloroquine treatment of COVID-19 for the general and geriatric patients are not enough. CONCLUSION: According to literature reports, chloroquine has been proved to have anti-SARS-CoV-2 effect in vitro and the potential mechanism of chloroquine in vivo. Pharmacokinetic characteristics and DDIs study are helpful to guide rational drug use in general and geriatric patients. Although there have been reports of successful clinical application of chloroquine in treatment COVID-19ï¼more clinical test data are still needed to prove its effectiveness and safety.


title: Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic

text: The current coronavirus disease 2019 (COVID-19) pandemic has caused significant strain on medical centers resources. Thus, concerns about the reducing and management of COVID-19 are on the rise, as there is need to provide diagnosis, treatment, monitoring, and follow-ups during the pandemic. Therefore, the COVID-19 pandemic has radically and quickly altered how medical practitioners provide care to patients. Medical centers are now responding to COVID-19 through rapid adoption of digital tools and technologies such as telemedicine and virtual care which refer to the delivery of healthcare services digital or at a distance using Information and Communications Technology (ICT) for treatment of patients. Telemedicine is expected to deliver timely care while minimizing exposure to protect medical practitioners and patients. Accordingly, a rapid literature review was conducted, and 35 research studies published from 2019 to May 2020 were employed to provide theoretical and practical evidence on the significance of using telemedicine and virtual care for remote treatment of patients during the COVID-19 pandemic. This article provides practical guide based on how to use telemedicine and virtual care during the COVID-19 pandemic. This study provides implication on the potentials of consolidating virtual care solutions in the near future towards contributing to integrate digital technologies into healthcare.


title: Current State of Knowledge About SARS-CoV-2 and COVID-19 Disease in Pregnant Women

text: During any epidemic of infectious diseases, pregnant women constitute an extremely sensitive group due to altered physiology and immune functions, and thus altered susceptibility to infection. With regard to the management of pregnant COVID-19 patients, in addition to the treatment of the infection itself, which is not that different from generally accepted principles, it is interesting to consider which obstetric procedures should be used to minimize the adverse effects on mother and child. Questions arise concerning the continuation of pregnancy, how to terminate the pregnancy, the possibility of virus transmission through the placenta, isolation of the newborn after birth, and breastfeeding. The aim of this study was to review the current state of knowledge about SARS-CoV-2 infection and COVID-19 disease in pregnant women. Because the epidemic began in China, most of the available literature comes from studies conducted there. The studies used to prepare this review article are the first non-randomized studies containing small groups of examined women. They do not provide clear indications, but show that in an epidemic situation, special care should be taken in pregnancy management, making decisions about termination of pregnancy, and handling of the newborn baby to minimize the risk of subsequent health consequences. Further analysis is needed on the incidence of COVID-19 among pregnant women and its consequences. This will allow us to develop recommendations on how to deal with patients in the future in case of repeated epidemic emergencies.


title: Expression of SARS-CoV-2 Entry Molecules ACE2 and TMPRSS2 in the Gut of Patients With IBD

text: BACKGROUND: Patients with inflammatory bowel disease (IBD) have intestinal inflammation and are treated with immune-modulating medications. In the face of the coronavirus disease-19 pandemic, we do not know whether patients with IBD will be more susceptible to infection or disease. We hypothesized that the viral entry molecules angiotensin I converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) are expressed in the intestine. We further hypothesized that their expression could be affected by inflammation or medication usage. METHODS: We examined the expression of Ace2 and Tmprss2 by quantitative polymerase chain reacion in animal models of IBD. Publicly available data from organoids and mucosal biopsies from patients with IBD were examined for expression of ACE2 and TMPRSS2. We conducted RNA sequencing for CD11b-enriched cells and peripheral and lamina propria T-cells from well-annotated patient samples. RESULTS: ACE2 and TMPRSS2 were abundantly expressed in the ileum and colon and had high expression in intestinal epithelial cells. In animal models, inflammation led to downregulation of epithelial Ace2. Expression of ACE2 and TMPRSS2 was not increased in samples from patients with compared with those of control patients. In CD11b-enriched cells but not T-cells, the level of expression of ACE2 and TMPRSS2 in the mucosa was comparable to other functional mucosal genes and was not affected by inflammation. Anti-tumor necrosis factor drugs, vedolizumab, ustekinumab, and steroids were linked to significantly lower expression of ACE2 in CD11b-enriched cells. CONCLUSIONS: The viral entry molecules ACE2 and TMPRSS2 are expressed in the ileum and colon. Patients with IBD do not have higher expression during inflammation; medical therapy is associated with lower levels of ACE2. These data provide reassurance for patients with IBD.


Coronavirus Disease 2019 (COVID-19): Considerations for the Competitive Athlete


Editorial. Neurosurgery in the storm of COVID-19: suggestions from the Lombardy region, Italy (ex malo bonum)


title: Arctic Oscillation: possible trigger of COVID-19 outbreak

text: The current COVID-19 pandemic is having detrimental consequences worldwide. The pandemic started to develop strongly by the end of January and beginning of February 2020, first in China with subsequent rapid spread to other countries with new epicenters of the outbreaks concentrated mainly within the 30-50 degrees North latitudinal band (e.g., South Korea, Japan, Iran, Italy, Spain). Simultaneously, an unusual persistent anticyclonic situation prevailing at latitudes around 40 degrees North was observed on global scale, in line with an anomalously strong positive phase of the Arctic Oscillation. This atypical situation could have resulted in favorable meteorological conditions for a quicker spread of the virus over the latitude band detailed above. This possible connection needs further attention in order to understand the meteorological and climatological factors related to the COVID-19 outbreak, and for anticipating the spatio-temporal distribution of possible future pandemics.


title: Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States

text: BACKGROUND: On March 12, 2020, the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic. On that date, there were 134,576 reported cases and 4981 deaths worldwide. By March 26, 2020, just 2 weeks later, reported cases had increased four-fold to 531,865, and deaths increased five-fold to 24,073. Older people are both major users of telehealth services and are more likely to die as a result of COVID-19. OBJECTIVE: This paper examines the extent that Australia, the United Kingdom, and the United States, during the 2 weeks following the pandemic announcement, sought to promote telehealth as a tool that could help identify COVID-19 among older people who may live alone, be frail, or be self-isolating, and give support to or facilitate the treatment of people who are or may be infected. METHODS: This paper reports, for the 2-week period previously mentioned and immediately prior, on activities and initiatives in the three countries taken by governments or their agencies (at national or state levels) together with publications or guidance issued by professional, trade, and charitable bodies. Different sources of information are drawn upon that point to the perceived likely benefits of telehealth in fighting the pandemic. It is not the purpose of this paper to draw together or analyze information that reflects growing knowledge about COVID-19, except where telehealth is seen as a component. RESULTS: The picture that emerges for the three countries, based on the sources identified, shows a number of differences. These differences center on the nature of their health services, the extent of attention given to older people (and the circumstances that can relate to them), the different geographies (notably concerned with rurality), and the changes to funding frameworks that could impact these. Common to all three countries is the value attributed to maintaining quality safeguards in the wider context of their health services but where such services are noted as sometimes having precluded significant telehealth use. CONCLUSIONS: The COVID-19 pandemic is forcing changes and may help to establish telehealth more firmly in its aftermath. Some of the changes may not be long-lasting. However, the momentum is such that telehealth will almost certainly find a stronger place within health service frameworks for each of the three countries and is likely to have increased acceptance among both patients and health care providers.


Lesiones pernióticas y acrales en España durante el confinamiento por COVID: análisis retrospectivo de 12 casos./ Lesiones pernióticas y acrales en España durante el confinamiento por COVID: análisis retrospectivo de 12 casos./ Chilblain and Acral Purpuric Lesions in Spain during Covid Confinement: Retrospective Analysis of 12 Cases


Mind the gap: The hospital breakroom


title: Influence of COVID-19 pandemic on hospitalizations at the tertiary dermatology department in south-west Poland

text: New virus SARS-Cov-2 infection has spread over the world affecting all daily activities, including functioning of health services. Due to pandemic, many hospitals were ordered to re-organize their work. The aim of the current report was to evaluate the influence of COVID-19 pandemic on the hospitalizations at the tertiary dermatology department in south-west Poland. Two corresponding periods of 2019 and 2020 were compared in aspect of number of hospitalizations, sex, and age profile of inpatients. We clearly showed a significant reduction of hospitalized patients during the pandemic period, with marked reduction of female patients. Moreover, the significant decrease of admissions to dermatology ward was observed within children and patients older than 70 years. Patients with chronic inflammatory dermatoses (eg, atopic dermatitis, eczemas, lichen planus, pityriasis rubra pilaris) were less often hospitalized during the pandemic period. In contrast, patients suffering from dermatitis due to substances taken internally, erysipelas, syphilis, and primary cutaneous lymphomas constituted significantly higher rate of hospitalized subjects in the year 2020.


title: COVID-19 and toxicity from potential treatments: Panacea or poison

text: Since December 2019, coronavirus disease (COVID-19) has been increasingly spreading from its origin in Wuhan, China to many countries around the world eventuating in morbidity and mortality affecting millions of people. This pandemic has proven to be a challenge given that there is no immediate cure, no vaccine is currently available and medications or treatments being used are still undergoing clinical trials. There have already been examples of self-medication and overdose. Clearly, there is a need to further define the efficacy of treatments used in the management of COVID-19. This evidence needs to be backed by large randomised-controlled clinical trials. In the meantime, there will no doubt be further off-label use of these medications by patients and practitioners and possibly related toxicity.


title: American Indian Reservations and COVID-19: Correlates of Early Infection Rates in the Pandemic

text: OBJECTIVE: To determine the household and community characteristics most closely associated with variation in COVID-19 incidence on American Indian reservations in the lower 48 states. DESIGN: Multivariate analysis with population weights. SETTING: Two hundred eighty-seven American Indian Reservations and tribal homelands (in Oklahoma) and, as of April 10, 2020, 861 COVID-19 cases on these reservation lands. MAIN OUTCOME MEASURES: The relationship between rate per 1000 individuals of publicly reported COVID-19 cases at the tribal reservation and/or community level and average household characteristics from the 2018 5-Year American Community Survey records. RESULTS: By April 10, 2020, in regression analysis, COVID-19 cases were more likely by the proportion of homes lacking indoor plumbing (10.83, P = .001) and were less likely according to the percentage of reservation households that were English-only (-2.43, P = .03). Household overcrowding measures were not statistically significant in this analysis (-6.40, P = .326). CONCLUSIONS: Failure to account for the lack of complete indoor plumbing and access to potable water in a pandemic may be an important determinant of the increased incidence of COVID-19 cases. Access to relevant information that is communicated in the language spoken by many reservation residents may play a key role in the spread of COVID-19 in some tribal communities. Household overcrowding does not appear to be associated with COVID-19 infections in our data at the current time. Previous studies have identified household plumbing and overcrowding, and language, as potential pandemic and disease infection risk factors. These risk factors persist. Funding investments in tribal public health and household infrastructure, as delineated in treaties and other agreements, are necessary to protect American Indian communities.


title: Collateral benefits on other respiratory infections during fighting COVID-19

text: PURPOSE: Influenza virus infection is associated with a high disease burden. COVID-19 caused by SARS-CoV-2 has become a pandemic outbreak since January 2020. Taiwan has effectively contained COVID-19 community transmission. We aimed to validate whether fighting COVID-19 could help to control other respiratory infections in Taiwan. METHOD: We collected week-case data of severe influenza, invasive Streptococcus pneumoniae disease and death toll from pneumonia among 25 calendar weeks of the influenza season for four years (2016-2020), which were reported to Taiwan CDC. Trend and slope differences between years were compared. RESULT: A downturn trend of severe influenza, invasive S. pneumoniae disease and the death toll from pneumonia per week in 2019/2020 season and significant trend difference in comparison to previous seasons were noted, especially after initiation of several disease prevention measures to fight potential COVID-19 outbreak in Taiwan. CONCLUSIONS: Fighting COVID-19 achieved collateral benefits on significant reductions of severe influenza burden, invasive S. pneumoniae disease activity, and the death toll from pneumonia reported to CDC in Taiwan.


The importance of designing and implementing participatory surveillance system: An approach as early detection and prevention of novel coronavirus (2019-nCov)


Challenges and opportunities for graduate students in public health during the COVID-19 pandemic


Negative-Pressure Aerosol Cover for COVID-19 Tracheostomy


title: Overview of Coronavirus Disease 2019 (COVID-19): Treatment Updates and Advances

text: In late December 2019, several cases of pneumonia with unknown cause were reported in Wuhan, China, and this new type of pneumonia spread rapidly to across provinces during the subsequent weeks. The pathogen was identified quickly and was named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The infectious disease caused by this virus is referred to as coronavirus disease 2019 (COVID-19). Within months, it has caused a global pandemic and posed a major threat to public health worldwide. As of May 23, 2020, 5,252,452 patients have been confirmed to have the disease, and 339,026 deaths have been reported. Multiple therapeutic trials are ongoing, and some promising results have been released. A vaccine would provide the most effective approach to fight the virus by preventing infection, but none are currently available. To control the COVID-19 outbreak, large-scale measures have been applied to reduce human-to-human transmission of SARS-CoV-2. Susceptible populations, including older adults, children, and health care providers, warrant particular attention to avoid transmission and infection. This review introduces current understanding of SARS-CoV-2 infection and treatment strategies, emphasizing the relevant challenges associated with prevention, diagnosis, and management.


Atypical erythema multiforme palmar plaques lesions due to Sars-Cov-2


title: Identification of SARS-CoV RBD-targeting monoclonal antibodies with cross-reactive or neutralizing activity against SARS-CoV-2

text: SARS-CoV-2-caused COVID-19 cases are growing globally, calling for developing effective therapeutics to control the current pandemic. SARS-CoV-2 and SARS-CoV recognize angiotensin-converting enzyme 2 (ACE2) receptor via the receptor-binding domain (RBD). Here, we identified six SARS-CoV RBD-specific neutralizing monoclonal antibodies (nAbs) that cross-reacted with SARS-CoV-2 RBD, two of which, 18F3 and 7B11, neutralized SARS-CoV-2 infection. 18F3 recognized conserved epitopes on SARS-CoV and SARS-CoV-2 RBDs, whereas 7B11 recognized epitopes on SARS-CoV RBD not fully conserved in SARS-CoV-2 RBD. The 18F3-recognizing epitopes on RBD did not overlap with the ACE2-binding sites, whereas those recognized by 7B11 were close to the ACE2-binding sites, explaining why 7B11 could, but 18F3 could not, block SARS-CoV or SARS-CoV-2 RBD binding to ACE2 receptor. Our study provides an alternative approach to prevent SARS-CoV-2 infection using anti-SARS-CoV nAbs.


Review of Societal Recommendations Regarding Management of Patients With Inflammatory Bowel Disease During the SARS-CoV-2 Pandemic


And now for something completely different: from 2019-nCoV and COVID-19 to 2020-nMan


Guiding airway management and personal protective equipment for COVID-19 intubation teams


Biologics for patients affected by hidradenitis suppurativa in the COVID-19 era: data from a referral center of Southern Italy


title: RetinaMask: A Face Mask detector

text: Coronavirus disease 2019 has affected the world seriously. One major protection method for people is to wear masks in public areas. Furthermore, many public service providers require customers to use the service only if they wear masks correctly. However, there are only a few research studies about face mask detection based on image analysis. In this paper, we propose RetinaFaceMask, which is a high-accuracy and efficient face mask detector. The proposed RetinaFaceMask is a one-stage detector, which consists of a feature pyramid network to fuse high-level semantic information with multiple feature maps, and a novel context attention module to focus on detecting face masks. In addition, we also propose a novel cross-class object removal algorithm to reject predictions with low confidences and the high intersection of union. Experiment results show that RetinaFaceMask achieves state-of-the-art results on a public face mask dataset with $2.3\%$ and $1.5\%$ higher than the baseline result in the face and mask detection precision, respectively, and $11.0\%$ and $5.9\%$ higher than baseline for recall. Besides, we also explore the possibility of implementing RetinaFaceMask with a light-weighted neural network MobileNet for embedded or mobile devices.


Covid-19: trainees will not move jobs in April


Use of contemporary live tele-video conferencing for continuing surgical training at the time of COVID-19 pandemic


title: Alternative Global Health Security Indexes for Risk Analysis of COVID-19

text: Given the volume of research and discussion on the health, medical, economic, financial, political, and travel advisory aspects of the SARS-CoV-2 virus that causes the COVID-19 disease, it is essential to enquire if an outbreak of the epidemic might have been anticipated, given the well-documented history of SARS and MERS, among other infectious diseases. If various issues directly related to health security risks could have been predicted accurately, public health and medical contingency plans might have been prepared and activated in advance of an epidemic such as COVID-19. This paper evaluates an important source of health security, the Global Health Security Index (2019), which provided data before the discovery of COVID-19 in December 2019. Therefore, it is possible to evaluate how countries might have been prepared for a global epidemic, or pandemic, and acted accordingly in an effective and timely manner. The GHS index numerical scores are calculated as the arithmetic (AM), geometric (GM), and harmonic (HM) means of six categories, where AM uses equal weights for each category. The GHS Index scores are regressed on the numerical score rankings of the six categories to check if the use of equal weights of 0.167 in the calculation of the GHS Index using AM is justified, with GM and HM providing a check of the robustness of the arithmetic mean. The highest weights are determined to be around 0.244-0.246, while the lowest weights are around 0.186-0.187 for AM. The ordinal GHS Index is regressed on the ordinal rankings of the six categories to check for the optimal weights in the calculation of the ordinal Global Health Security (GHS) Index, where the highest weight is 0.368, while the lowest is 0.142, so the estimated results are wider apart than for the numerical score rankings. Overall, Rapid Response and Detection and Reporting have the largest impacts on the GHS Index score, whereas Risk Environment and Prevention have the smallest effects. The quantitative and qualitative results are different when GM and HM are used.


Coronavirus Disease-2019 Pandemic: Hopes Ride High on Targeting Known Drugs against Unkown


Helping Africa to breathe when COVID-19 strikes


Surfing the Waves of the COVID-19 Pandemic As A Cardiovascular Clinician


BRAF-Mutated Metastatic Colon Cancers During COVID-19 Pandemic


Towards precision management of cardiovascular patients with COVID-19 to reduce mortality


Coronavirus shows how UK must act quickly before being shut out of Europe's health protection systems


title: A review of spatial causal inference methods for environmental and epidemiological applications

text: The scientific rigor and computational methods of causal inference have had great impacts on many disciplines, but have only recently begun to take hold in spatial applications. Spatial casual inference poses analytic challenges due to complex correlation structures and interference between the treatment at one location and the outcomes at others. In this paper, we review the current literature on spatial causal inference and identify areas of future work. We first discuss methods that exploit spatial structure to account for unmeasured confounding variables. We then discuss causal analysis in the presence of spatial interference including several common assumptions used to reduce the complexity of the interference patterns under consideration. These methods are extended to the spatiotemporal case where we compare and contrast the potential outcomes framework with Granger causality, and to geostatistical analyses involving spatial random fields of treatments and responses. The methods are introduced in the context of observational environmental and epidemiological studies, and are compared using both a simulation study and analysis of the effect of ambient air pollution on COVID-19 mortality rate. Code to implement many of the methods using the popular Bayesian software OpenBUGS is provided.


title: COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis

text: The aim of this study was to analyze the clinical data, discharge rate, and fatality rate of COVID-19 patients for clinical help. The clinical data of COVID-19 patients from December 2019 to February 2020 were retrieved from four databases. We statistically analyzed the clinical symptoms and laboratory results of COVID-19 patients and explained the discharge rate and fatality rate with a single-arm meta-analysis. The available data of 1994 patients in 10 literatures were included in our study. The main clinical symptoms of COVID-19 patients were fever (88.5%), cough (68.6%), myalgia or fatigue (35.8%), expectoration (28.2%), and dyspnea (21.9%). Minor symptoms include headache or dizziness (12.1%), diarrhea (4.8%), nausea and vomiting (3.9%). The results of the laboratory showed that the lymphocytopenia (64.5%), increase of C-reactive protein (44.3%), increase of lactic dehydrogenase (28.3%), and leukocytopenia (29.4%) were more common. The results of single-arm meta-analysis showed that the male took a larger percentage in the gender distribution of COVID-19 patients 60% (95% CI [0.54, 0.65]), the discharge rate of COVID-19 patients was 52% (95% CI [0.34,0.70]), and the fatality rate was 5% (95% CI [0.01,0.11]).


G6PD and chloroquine: Selecting the treatment against SARS-CoV-2?


title: Arbidol: A potential antiviral drug for the treatment of SARS-CoV-2 by blocking trimerization of the spike glycoprotein

text: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic is a global public health emergency, and new therapeutics are needed. This article reports the potential drug target and mechanism of action of Arbidol (umifenovir) to treat coronavirus disease 2019 (COVID-19). Molecular dynamics and structural analysis were used to show how Arbidol targets the SARS-CoV-2 spike glycoprotein and impedes its trimerization, which is key for host cell adhesion and hijacking, indicating the potential of Arbidol to treat COVID-19. It is hoped that knowledge of the potential drug target and mechanism of action of Arbidol will help in the development of new therapeutics for SARS-CoV-2.


Fangcang shelter hospitals in COVID-19 pandemic: the practice and its significance


Impact of Gaucher disease on COVID-19


Effect of regular intravenous immunoglobulin therapy on prognosis of severe pneumonia in patients with COVID-19


title: Author Correction: Dual-energy CT perfusion imaging for differentiating WHO subtypes of thymic epithelial tumors

text: An amendment to this paper has been published and can be accessed via a link at the top of the paper.


title: Reducing mortality and morbidity in patients with severe COVID-19 disease by advancing ongoing trials of Mesenchymal Stromal (stem) Cell (MSC) therapy - Achieving global consensus and visibility for cellular host-directed therapies

text: As of May 17th 2020, the novel coronavirus disease 2019 (COVID-19) pandemic has caused 307,395 deaths worldwide, out of 3,917,366 cases reported to the World Health Organization. No specific treatments for reducing mortality or morbidity are yet available. Deaths from COVID-19 will continue to rise globally until effective and appropriate treatments and/or vaccines are found. In search of effective treatments, the global medical, scientific, pharma and funding communities have rapidly initiated over 500 COVID-19 clinical trials on a range of antiviral drug regimens and repurposed drugs in various combinations. A paradigm shift is underway from the current focus of drug development targeting the pathogen, to advancing cellular Host-Directed Therapies (HDTs) for tackling the aberrant host immune and inflammatory responses which underlie the pathogenesis of SARS-CoV-2 and high COVID-19 mortality rates. We focus this editorial specifically on the background to, and the rationale for, the use and evaluation of mesenchymal stromal (Stem) cells (MSCs) in treatment trials of patients with severe COVID-19 disease. Currently, the ClinicalTrials.gov and the WHO Clinical Trials Registry Platform (WHO ICTRP) report a combined 28 trials exploring the potential of MSCs or their products for treatment of COVID-19. MSCs should also be trialed for treatment of other circulating WHO priority Blueprint pathogens such as MERS-CoV which causes upto 34% mortality rates. It's about time funding agencies invested more into development MSCs per se, and also for a range of other HDTs, in combination with other therapeutic interventions. MSC therapy could turn out to be an important contribution to bringing an end to the high COVID-19 death rates and preventing long-term functional disability in those who survive disease.


title: Changes in population movement make COVID-19 spread differently from SARS

text: This comment discusses the contribution of population movement to the spread of COVID-19, with a reference to the spread of SARS 17 years ago. We argue that the changing geography of migration, the diversification of jobs taken by migrants, the rapid growth of tourism and business trips, and the longer distance taken by people for family reunion are what make the spread of COVID-19 so differently from that of SARS. These changes in population movement are expected to continue. Hence, new strategies in disease prevention and control should be taken accordingly, which are also proposed in the comment.


title: Laboratory findings of COVID-19: a systematic review and meta-analysis

text: The Coronavirus Disease (COVID-19) pandemic first broke out in December 2019 in Wuhan, China, and has now spread worldwide. Laboratory findings have been only partially described in some observational studies. To date, more comprehensive systematic reviews of laboratory findings on COVID-19 are missing. We performed a systematic review with a meta-analysis to assess laboratory findings in patients with COVID-19. Observational studies from three databases were selected. We calculated pooled proportions and 95% confidence interval (95% CI) using the random-effects model meta-analysis. A total of 1106 articles were identified from PubMed, Web of Science, CNKI (China), and other sources. After screening, 28 and 7 studies were selected for a systematic review and a meta-analysis, respectively. Of the 4,663 patients included, the most prevalent laboratory finding was increased C-reactive protein (CRP; 73.6%, 95% CI 65.0-81.3%), followed by decreased albumin (62.9%, 95% CI 28.3-91.2%), increased erythrocyte sedimentation rate (61.2%, 95% CI 41.3-81.0%), decreased eosinophils (58.4%, 95% CI 46.5-69.8%), increased interleukin-6 (53.1%, 95% CI 36.0-70.0%), lymphopenia (47.9%, 95% CI 41.6-54.9%), and increased lactate dehydrogenase (LDH; 46.2%, 95% CI 37.9-54.7%). A meta-analysis of seven studies with 1905 patients showed that increased CRP (OR 3.0, 95% CI: 2.1-4.4), lymphopenia (OR 4.5, 95% CI: 3.3-6.0), and increased LDH (OR 6.7, 95% CI: 2.4-18.9) were significantly associated with severity. These results demonstrated that more attention is warranted when interpreting laboratory findings in patients with COVID-19. Patients with elevated CRP levels, lymphopenia, or elevated LDH require proper management and, if necessary, transfer to the intensive care unit.


title: Traditional Chinese herbal medicine for novel coronavirus (COVID-19)

text: No one expected that the new coronavirus infection (COVID-19) would spread globally at the time of overshooting in Wuhan, China In Japan, it has not spread all at once from the initial infection phase of the Diamond Princess, a returnee from Wuhan, but recently the danger of overshoot has been alarmed For unknown infections, specialists in infectious diseases and respiratory organs are trying various drugs in clinical settings, and basic researchers are devoted to elucidating the onset mechanism and developing new drugs and vaccines I've thought it plausible to mention Kampo medicine However, as the spread of infection became apparent, there were more opportunities to be asked about Kampo treatment by people who were transferred overseas, who had a family of returnees, or who had an underlying disease At the request of Mr Lu Xin Xin of National Chinese Medicine Administration Bureau, which is a government agency specializing in traditional Chinese medicine, we interviewed Wumatsu 1st Secretary and Party Shikatsu 2nd Secretary who are in charge of science and technology of the Chinese Embassy The role of Kampo in Japan was discussed First of all, it is necessary to understand the situation in each country, and the members of the Cabinet Secretariat research study “Survey of demonstrability for the preparation of evidence of Oriental medicine for the realization of the“ Asia health concept ”in China and South Korea in 2019・ I decided to get information from a traditional medicine expert in Taiwan At that point, the guidelines of traditional medicine for COVID-19 in each country were immediately sent Especially in China, traditional medical treatment is incorporated into the guidelines of government agencies In this paper, I would like to summarize the contents and describe what Kampo medicine can do as a countermeasure against COVID-19 in Japan


Detection of serum IgM and IgG for COVID-19 diagnosis


title: News&Views: The distance rule in times of Corona

text: The paper discussed the recent findings of Lydia Bourouiba and her group (MIT) on disease spreading, in the context of the Corona pandemic.


title: Herpes Zoster (shingles) complicating the course of COVID19 infection

text: Different skin presentations and patterns of cutaneous signs were reported in COVID19 patients. Varicella-zoster virus (VZV) infection is responsible for two very common skin conditions. Varicella (chichkenpox) is the initial presentation for infection with VZV and is characterized by a diffuse vesicular rash. It is after this initial attack, that VZV remains latent in the dorsal root ganglia before reactivating to present as herpes zoster (HZ) in middle age groups. Cutaneous skin findings remain to be emerging every day as a marker or a complication of COVID 19. We report a case of HZ complication in a 44 years old COVID 19 positive male.


Additional safety consideration for azithromycin in the management of SARS-CoV-2 infection


title: Molecular docking and dynamic simulations for antiviral compounds against SARS-CoV-2: A computational study

text: The aim of this study was to develop an appropriate anti-viral drug against the SARS-CoV-2 virus. An immediately qualifying strategy would be to use existing powerful drugs from various virus treatments. The strategy in virtual screening of antiviral databases for possible therapeutic effect would be to identify promising drug molecules, as there is currently no vaccine or treatment approved against COVID-19. Targeting the main protease (pdb id: 6LU7) is gaining importance in anti-CoV drug design. In this conceptual context, an attempt has been made to suggest an in silico computational relationship between US-FDA approved drugs, plant-derived natural drugs, and Coronavirus main protease (6LU7) protein. The evaluation of results was made based on Glide (Schrödinger) dock score. Out of 62 screened compounds, the best docking scores with the targets were found for compounds: lopinavir, amodiaquine, and theaflavin digallate (TFDG). Molecular dynamic (MD) simulation study was also performed for 20 ns to confirm the stability behaviour of the main protease and inhibitor complexes. The MD simulation study validated the stability of three compounds in the protein binding pocket as potent binders.


title: The Effect of COVID-19 on Youth Mental Health

text: The purposes of this study was to assess the youth mental health after the coronavirus disease 19 (COVID-19) occurred in China two weeks later, and to investigate factors of mental health among youth groups. A cross-sectional study was conducted two weeks after the occurrence of COVID-19 in China. A total of 584 youth enrolled in this study and completed the question about cognitive status of COVID-19, the General Health Questionnaire(GHQ-12), the PTSD Checklist-Civilian Version (PCL-C) and the Negative coping styles scale. Univariate analysis and univariate logistic regression were used to evaluate the effect of COVID-19 on youth mental health. The results of this cross-sectional study suggest that nearly 40.4% the sampled youth were found to be prone to psychological problems and 14.4% the sampled youth with Post-traumatic stress disorder (PTSD) symptoms. Univariate logistic regression revealed that youth mental health was significantly related to being less educated (OR = 8.71, 95%CI:1.97-38.43), being the enterprise employee (OR = 2.36, 95%CI:1.09-5.09), suffering from the PTSD symptom (OR = 1.05, 95%CI:1.03-1.07) and using negative coping styles (OR = 1.03, 95%CI:1.00-1.07). Results of this study suggest that nearly 40.4% of the youth group had a tendency to have psychological problems. Thus, this was a remarkable evidence that infectious diseases, such as COVID-19, may have an immense influence on youth mental health. Therefor, local governments should develop effective psychological interventions for youth groups, moreover, it is important to consider the educational level and occupation of the youth during the interventions.


Challenges to testing COVID-19 in conflict zones: Yemen as an example


Resilience of the restructured obstetric anaesthesia training programme during the COVID-19 outbreak in Singapore


Outpatient Management of the Kidney Transplant Recipient during the SARS-CoV-2 Virus Pandemic


title: Resilience in the time of pandemic: The experience of community pharmacists during COVID-19

text: BACKGROUND: As a result of the COVID-19 pandemic, there has been a significant disruption of the practice of pharmacy. Importantly, in many parts of the world, this disruption occurred literally overnight, requiring pharmacists to demonstrate significant adaptability and resiliency in order to manage continuing and in some cases expanding needs of patients. OBJECTIVES: The objective of this research was to characterize how community pharmacy in Ontario (Canada) responded to the COVID-19 pandemic of winter/spring 2020, in particular in understanding what factors may influence or predict resiliency of individual practitioners and their workplaces. METHODS: One-on-one interviews mediated through technology (Microsoft Teams) were used, following a semi-structured interview protocol. Verbatim transcripts were produced and analyzed by two independent researchers, using an inductive coding process to identify and characterize themes. RESULTS: A total of 21 pharmacists participated in this study. Six themes were identified: a) use of and comfort with technology; b) early adoption of corporate and professional guidance; c) workplaces that emphasized task-focus rather than multi-tasking were more resilient; d) scheduling methods and practices in the workplace are important for personal resilience; e) dedicated specialty staff allowed pharmacists to focus on their work; and f) provision of personal protective equipment was essential. CONCLUSIONS: Traditionally, resilience in professional practice has been characterized as a personal, not a workplace, issue. This study suggests that personal resiliency for pharmacists requires substantial workplace support; further work in this area is required to better understand how pharmacists adapt to complex and difficult situations such as pandemics.


title: Novel Coronavirus in Cape Town Informal Settlements: Feasibility of Using Informal Dwelling Outlines to Identify High Risk Areas for COVID-19 Transmission From A Social Distancing Perspective

text: BACKGROUND: The challenges faced by the Global South during the coronavirus disease (COVID-19) pandemic are compounded by the presence of informal settlements, which are typically densely populated and lacking in formalized sanitation infrastructure. Social distancing measures in informal settlements may be difficult to implement due to the density and layout of settlements. This study measures the distance between dwellings in informal settlements in Cape Town to identify the risk of COVID-19 transmission. OBJECTIVE: The aim of this paper is to determine if social distancing measures are achievable in informal settlements in Cape Town, using two settlements as an example. We will first examine the distance between dwellings and their first, second, and third nearest neighbors and then identify clusters of dwellings in which residents would be unable to effectively practice social isolation due to the close proximity of their homes. METHODS: Dwellings in the settlements of Masiphumelele and Klipfontein Glebe were extracted from a geographic information system data set of outlines of all informal dwellings in Cape Town. The distance to each dwelling's first, second, and third nearest neighbors was calculated for each settlement. A social distance measure of 2 m was used (buffer of 1 m, as dwellings less than 2 m apart are joined) to identify clusters of dwellings that are unable to effectively practice social distancing in each settlement. RESULTS: The distance to each dwelling's first 3 nearest neighbors illustrates that the settlement of Masiphumelele is constructed in a denser fashion as compared to the Klipfontein Glebe settlement. This implies that implementing social distancing will likely be more challenging in Masiphumelele than in Klipfontein Glebe. However, using a 2-m social distancing measure, it was demonstrated that large portions of Klipfontein Glebe would also be unable to effectively implement social distancing. CONCLUSIONS: Effectively implementing social distancing may be a challenge in informal settlements due to their density. This paper uses dwelling outlines for informal settlements in the city of Cape Town to demonstrate that with a 2 m measure, effective social distancing will be challenging.


title: Coronavirus disease 2019 in children: Current status

text: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged from China in December 2019. The outbreak further exploded in Europe and America in mid-March 2020 to become a global health emergency. We reviewed recent published articles and on-line open messages on SARS-CoV-2-positive infants and children younger than 20 years of age. Symptoms are usually less severe in children than in adults. Twelve critically or mortally ill children were found in the published or news reports before April 6, 2020. Vertical transmission from the mother to her fetus or neonate has not been proven definitively. However, six early-onset (<7 days) and 3 late-onset neonatal SARS-CoV-2 infections were found in the literature. We also summarized the presentations and contact information of 24 SARS-CoV-2-positive children announced by the Taiwan Centers for Disease Control. Early identification and isolation, adequate management, prevention, and vaccine development are the keys to controlling the disease spread. Clinical physicians should be alert to asymptomatic children with COVID-19. Multidirectional investigations are crucial in the global fight against COVID-19.


[Editor's Note]


COVID-19 : pourquoi tester ? Qui tester ? Comment tester ?


title: Hydroxychloroquine safety: A meta-analysis of randomized controlled trials

text: BACKGROUND: Hydroxychloroquine (HCQ) is currently being examined for COVID-19. No previous meta-analysis has evaluated its side effects versus placebo. We conducted this meta-analysis to compare the safety of HCQ versus placebo. METHODS: Two authors independently searched PubMed and EMBASE databases for randomized controlled trials (RCTs) of adults comparing the adverse events (AEs) of HCQ versus placebo for any indication. Peto odds ratios (Peto ORs) and 95% confidence intervals (CIs) were calculated based on random-effects models. The heterogeneity (I2) was assessed using Cochran's Q test. RESULTS: Nine RCTs (eight were double-blind) with a total of 916 patients were included. HCQ caused significantly more skin pigmentation than placebo (Peto OR, 4.64; 95% CI, 1.13 to 19.00; P-valueâ¯=â¯0.033; I2â¯=â¯0%). The increase in other AEs did not reach statistical significance: rash (Peto OR, 1.11; 95% CI, 0.3 to 3.77; P-valueâ¯=â¯0.03; I2â¯=â¯0%); gastrointestinal AEs (Peto OR, 1.43; 95% CI, 0.55 to 3.72; P-valueâ¯=â¯0.46; I2â¯=â¯15.17%); headache (Peto OR, 1.94; 95% CI, 0.65 to 5.78; P-valueâ¯=â¯0.23; I2â¯=â¯9.99%); dizziness (Peto OR, 1.32; 95% CI, 0.49 to 3.52; P-valueâ¯=â¯0.58; I2â¯=â¯0%); fatigue (Peto OR, 2.13; 95% CI, 0.76 to 5.98; P-valueâ¯=â¯0.15; I2â¯=â¯0%); and visual AEs (Peto OR, 1.61; 95% CI, 0.76 to 3.41; P-valueâ¯=â¯0.22; I2â¯=â¯0%). Cardiac toxicity was not reported. CONCLUSIONS: This meta-analysis of RCTs found a significantly higher risk of skin pigmentation in HCQ users versus placebo. More data are needed to evaluate HCQ in the context of COVID-19 treatment.


title: Psychological resilience during the COVID-19 lockdown

text: Some individuals are more psychologically resilient to adversity than others, an issue of great importance during the emerging mental health issues associated with the COVID-19 pandemic. To identify factors that may contribute to greater psychological resilience during the first weeks of the nation-wide lockdown efforts, we asked 1,004 U.S. adults to complete assessments of resilience, mental health, and daily behaviors and relationships. Average resilience was lower than published norms, but was greater among those who tended to get outside more often, exercise more, perceive more social support from family, friends, and significant others, sleep better, and pray more often. Psychological resilience in the face of the pandemic is related to modifiable factors.


title: Inhibition of SARS-CoV-2 Infection by the Cyclophilin Inhibitor Alisporivir (Debio 025)

text: Cyclophilins play a key role in the life cycle of coronaviruses. Alisporivir (Debio 025) is a nonimmunosuppressive analogue of cyclosporine with potent cyclophilin inhibition properties. Alisporivir reduced SARS-CoV-2 RNA production in a dose-dependent manner in Vero E6 cells, with a 50% effective concentration (EC50) of 0.46 ± 0.04 µM. Alisporivir inhibited a postentry step of the SARS-CoV-2 life cycle. These results justify rapidly conducting a proof-of-concept phase 2 trial with alisporivir in patients with SARS-CoV-2 infection.


title: Geriatric Care during Public Health Emergencies: Lessons Learned from Novel Corona Virus Disease (COVID-19) Pandemic

text: Geriatric care in public health emergencies is a serious concern, while, high case-fatalities among older adults across the globe in COVID-19 pandemic implies lack of preparedness. Most of the countries irrespective of developing and developed one enormously struggling because of an inchoate response system ignorant of geriatric health needs. Therefore, a robust approach is highly essential that requires an integrated emergency preparedness by addressing geriatric care.


Impact of anticoagulation prior to COVID-19 infection: a propensity score-matched cohort study


Elevation of plasma angiotensin II level is a potential pathogenesis for the critically ill COVID-19 patients


title: Successful guselkumab treatment in a psoriatic patient affected with Cornelia de Lange syndrome, and prosecution during the COVID-19 pandemic

text: Psychomotor delay and intellectual disability are potential limitations in psoriasis management, due to low compliance, and strict dependence from caregivers intervention. We report our successful experience with a 58-year-old woman, who was genetically affected by Cornelia De Lange syndrome, which causes intellectual disability and psychomotor disorders. The patient had been already treated with topical and traditional therapies, without any clinical benefits. Eventually, she adhered to guselkumab treatment. The compliance was excellent, significant improvements were observed after only 3 months of treatment, without adverse effects. During follow-up, the COVID-19 pandemic address concern on the possible increased risk of infection due to immunosuppression. In agreement with current Italian recommendations, risk and benefits profile was discussed with the patient's legal tutor and the decision to continue the treatment was taken. Psoriasis complete clarification was maintained during the most difficult period of the Italian outbreak, allowing the patient to remain safely at home.


Negative Pressure Tent to Reduce Exposure of Health Care Workers to SARS CoV-2 During Aerosol Generating Respiratory Therapies


title: BUDS: Balancing Utility and Differential Privacy by Shuffling

text: Balancing utility and differential privacy by shuffling or \textit{BUDS} is an approach towards crowd-sourced, statistical databases, with strong privacy and utility balance using differential privacy theory. Here, a novel algorithm is proposed using one-hot encoding and iterative shuffling with the loss estimation and risk minimization techniques, to balance both the utility and privacy. In this work, after collecting one-hot encoded data from different sources and clients, a step of novel attribute shuffling technique using iterative shuffling (based on the query asked by the analyst) and loss estimation with an updation function and risk minimization produces a utility and privacy balanced differential private report. During empirical test of balanced utility and privacy, BUDS produces $\epsilon = 0.02$ which is a very promising result. Our algorithm maintains a privacy bound of $\epsilon = ln [t/((n_1 - 1)^S)]$ and loss bound of $c' \bigg|e^{ln[t/((n_1 - 1)^S)]} - 1\bigg|$.


title: Umgang mit psychischer Belastung bei Gesundheitsfachkräften im Rahmen der Covid-19-Pandemie./ [Dealing with psychological distress by healthcare professionals during the COVID-19 pandemia]

text: BACKGROUND: In the current COVID-19 pandemia, health workers from all professions are facing great challenges in coping with the crisis. In this situation health professionals are confronted with specific stressors and risks not only for the physical but also for the mental health. OBJECTIVE: This article summarizes the first recommendations for the reduction of stress and psychological burden in health professionals during the current COVID-19 pandemia. METHODS: The recommendations of the World Health Organization, the United Nations and the International Red Cross Society are summarized. Recommendations for the reduction of stress and psychological distress in health professionals as well as important factors that team leaders can consider in order to reduce psychological distress in employees are presented. RESULTS: The normalization of strong emotions and stress, the fulfillment of basic needs, social support, clear communication and distribution of tasks, flexible working hours and the utilization of psychosocial and psychological help without stigmatization seem to be particularly important measures. CONCLUSION: This article presents guidelines for health professionals and team leaders in healthcare that help to maintain mental health during the COVID-19 pandemia.


Children are at Risk from COVID-19


title: COVID-19 Outbreak Perception in Italian Dentists

text: The aim of this study is an evaluation of the Italian dentists' knowledge regarding COVID-19 and their perception of the risks associated with COVID-19, their attitude in resuming their activities, and how they judge the institutional intervention on a health and economic basis. METHODS: This research evaluated Italian dentists from 11 to 18 April 2020, using a questionnaire submitted via Google Forms (Alphabet, Mountain View, CA, USA). It consisted of different investigations about sociodemographic aspects, profession-related characteristics, knowledge about COVID-19 infection transmission modalities, symptoms, and attitude in treating potentially infected patients. Statistical analysis was performed using the Pearson chi2 test and Student t-test. The α-level was fixed at p = 0.05. All data were analyzed with STATA 16 (StataCorp LP, College Station, TX, USA). RESULTS: 1500 dentists (664 men and 836 women) completed the questionnaire. The majority of respondents declared having been trained in infection prevention procedures (64.3%) but not specifically to prevent the spread of COVID-19 (48.7%). A total of 57.2% declared that they were not trained sufficiently to restart working after lockdown, with a significantly higher prevalence (Pearson chi2 test, p < 0.001) among women (62.3%) than men (50.9%). CONCLUSION: Italian dentists were informed correctly on the mode of transmission but partially missed COVID-19 symptoms. Dentists considered the virus infection highly dangerous, and they were not confident in being able to work safely. The lack of precise operating guidelines creates uncertainties on infection control measures and appropriate personal protective equipment (PPE) use. The participants revealed apprehension for their health and the current and future economic situation of their practices.


title: Domain Adaptation in Highly Imbalanced and Overlapping Datasets

text: In many machine learning domains, datasets are characterized by highly imbalanced and overlapping classes. Particularly in the medical domain, a specific list of symptoms can be labeled as one of various different conditions. Some of these conditions may be more prevalent than others by several orders of magnitude. Here we present a novel unsupervised domain adaptation scheme for such datasets. The scheme, based on a specific type of Quantification, is designed to work under both label and conditional shifts. It is demonstrated on datasets generated from electronic health records and provides high quality results for both Quantification and Domain Adaptation in very challenging scenarios. Potential benefits of using this scheme in the current COVID-19 outbreak, for estimation of prevalence and probability of infection are discussed.


Identification of the hyper-variable genomic hotspot for the novel coronavirus SARS-CoV-2


Involving antimicrobial stewardship programs in COVID-19 response efforts: All hands on deck


The need for urogenital tract monitoring in COVID-19


Potential influences of obstructive sleep apnea and obesity on COVID-19 severity


Analysis of dermatology-related search engine trends during the COVID-19 pandemic: implications for patient demand for outpatient services and telehealth


title: Computer-based and paper-and-pencil tests: A study in calculus for STEM majors

text: Computer-based testing is an expanding use of technology offering advantages to teachers and students. We studied Calculus II classes for STEM majors using different testing modes. Three sections with 324 students employed: Paper-and-pencil testing, computer-based testing, and both. Computer tests gave immediate feedback, allowed multiple submissions, and pooling. Paper-and-pencil tests required work and explanation allowing inspection of high cognitive demand tasks. Each test mode used the strength of its method. Students were given the same lecture by the same instructor on the same day and the same homework assignments and due dates. The design is quasi-experimental, but students were not aware of the testing mode at registration. Two basic questions examined were: (1) Do paper-and-pencil and computer-based tests measure knowledge and skill in STEM Calculus II in a consistent manner? (2) How does the knowledge and skill gained by students in a fully computer-based Calculus II class compare to students in a class requiring pencil-and-paper tests and hence some paper-and-pencil work. These results indicate that computer-based tests are as consistent with paper-and-pencil tests as computer-based tests are with themselves. Results are also consistent with classes using paper-and-pencil tests having slightly better outcomes than fully computer-based classes using only computer assessments.


title: Homeopathic Clinical Features of 18 Patients in COVID-19 Outbreaks in Hong Kong

text: BACKGROUND: Hong Kong is geographically located in the province of Guangdong which, after Hubei, has been the region of China second-most affected by the COVID-19 pandemic. Compared to the pathognomonic symptoms of the named disease, homeopathic symptoms are always more helpful for homeopathic prescriptions. AIM: This study reports and summarizes the homeopathic symptoms observed in 18 confirmed/suspected epidemiologically related cases in cluster outbreaks of COVID-19 in Hong Kong in early 2020. METHODS: Homeopathic symptoms from this case series were collected from 18 consecutive patients who, in addition to their concurrent conventional treatment or traditional Chinese medicine, actively sought help from homeopathy as an adjunctive measure for symptomatic relief from COVID-19. Cases were categorized according to outbreak clusters, focusing mainly on the homeopathic symptoms. In the analysis, frequency of all homeopathic medicines, common rubrics in all the cases, common rubrics in each of the top-ranked remedies, and differentiating symptoms for each top-ranked remedy were determined. RESULTS: Homeopathic symptoms of 18 cases, each identified as mild and belonging to one of six separate clusters, are reported. Eighteen common symptoms screened out of 79 selected rubrics constituted two sets of homeopathic symptom pictures: Bryonia alba (n = 4) and Gelsemium sempervirens (n = 12). Eight and seven differentiating features, respectively, were identified for Bryonia alba and Gelsemium sempervirens. CONCLUSION: The common symptoms of 18 mild COVID-19 cases constituted two sets of homeopathic symptom pictures, indicating Bryonia alba or Gelsemium sempervirens; they were indicated in 4 and 12 cases, respectively, out of the 18 in total.


Key Takeaways From the U.S. CDC's 2019 Antibiotic Resistance Threats Report for Frontline Providers


title: An empirical analysis of the Ebola outbreak in West Africa

text: The data for the Ebola outbreak that occurred in 2014-2016 in three countries of West Africa are analysed within a common framework. The analysis is made using the results of an agent based Susceptible-Infected-Removed (SIR) model on a Euclidean network, where nodes at a distance $l$ are connected with probability $P(l) \propto l^{-\delta }$, $\delta$ determining the range of the interaction, in addition to nearest neighbors. The cumulative (total) density of infected population here has the form $R(t) = \frac{a\exp(t/T)}{1+c\exp(t/T)}$, where the parameters depend on $\delta$ and the infection probability $q$. This form is seen to fit well with the data. Using the best fitting parameters, the time at which the peak is reached is estimated and is shown to be consistent with the data. We also show that in the Euclidean model, one can choose $\delta$ and $q$ values which reproduce the data for the three countries qualitatively. These choices are correlated with population density, control schemes and other factors. Comparing the real data and the results from the model one can also estimate the size of the actual population susceptible to the disease. Rescaling the real data a reasonably good quantitative agreement with the simulation results is obtained.


Coronavirus disease 2019 in pregnancy: consider thromboembolic disorders and thromboprophylaxis


COVID-19 resurgence in Iran


Authors' response re: From the frontlines of COVID-19-How prepared are we as obstetricians: a commentary


Making a brochure about coronavirus disease (COVID-19) for children with autism spectrum disorder and their family members


Making brochure of Coronavirus disease (COVID-19) for children with autism spectrum disorder and their family members


The Challenges Wrought by COVID-19


title: Vaccines against Coronaviruses: The State of the Art

text: The emerging epidemic caused by the new coronavirus SARS-CoV-2 represents the most important socio-health threat of the 21st century. The high contagiousness of the virus, the strong impact on the health system of the various countries and the absence to date of treatments able to improve the prognosis of the disease make the introduction of a vaccine indispensable, even though there are currently no approved human coronavirus vaccines. The aim of the study is to carry out a review of the medical literature concerning vaccine candidates for the main coronaviruses responsible for human epidemics, including recent advances in the development of a vaccine against COVID-19. This extensive review carried out on the vaccine candidates of the main epidemic coronaviruses of the past has shown that the studies in animal models suggest a high efficacy of potential vaccines in providing protection against viral challenges. Similar human studies have not yet been carried out, as the main trials are aimed at assessing mainly vaccine safety and immunogenicity. Whereas the severe acute respiratory syndrome (SARS-CoV) epidemic ended almost two decades ago and the Middle East respiratory syndrome (MERS-CoV) epidemic is now better controlled, as it is less contagious due to the high lethality of the virus, the current SARS-CoV-2 pandemic represents a problem that is certainly more compelling, which pushes us to accelerate the studies not only for the production of vaccines but also for innovative pharmacological treatments. SARS-CoV-2 vaccines might come too late to affect the first wave of this pandemic, but they might be useful if additional subsequent waves occur or in a post-pandemic perspective in which the virus continues to circulate as a seasonal virus.


Treating multiple sclerosis and neuromyelitis optica spectrum disorder during the COVID-19 pandemic


Re-Opening Schools Safely: The Case for Collaboration, Constructive Disruption of Pre-COVID Expectations, and Creative Solutions


title: The Covid-19 pandemic in Denmark: Big lessons from a small country

text: Denmark, a Scandinavian country of 5.8 million people has weathered the Covid-19 crisis with a relatively low rate of infection and death. Denmark has also become one of the first European countries to partially re-open its society. We offer the perspective that the combination of rapid response from the government, trust and a high level of confidence in government by Danish citizens, and the importance of social heritage contributed to the effective management of the coronavirus crisis.


Could IL-17 represent a new therapeutic target for the treatment and/or management of COVID-19-related respiratory syndrome?


title: City-scale dark fiber DAS measurements of infrastructure use during the COVID-19 pandemic

text: Throughout the recent COVID-19 pandemic when government officials around the world ordered citizens to quarantine inside their homes, real-time measurements about the use of roads, hospitals, grocery stores, and other public infrastructure became vital to accurately forecast viral infection rates and inform future government decisions. Although mobile phone locations provide some information about community-level activity, dense distributed geophysical sensing of ground motions across a city are more complete and also natively anonymous. In this paper, we demonstrate how fiber-optic Distributed Acoustic Sensing (DAS) connected to a telecommunication cable beneath Palo Alto, CA captured seismic and geodetic signals produced by vehicles during the COVID-19 pandemic outbreak and subsequent quarantine. We utilize DAS strain measurements of roadbed deformation caused by local cars and trucks in an automatic template matching detection algorithm to count the number of vehicles traveling per day over a two-month period around the timing of the San Francisco Bay Area shelter-in-place order. Using a segment of the optical fiber near a major grocery store on Sand Hill Road we find a 50% decrease in vehicle count immediately following the order, but data from near Stanford Hospital showed a far more subtle change due to on-going hospital activities. We compare the information derived from DAS measurements to other quarantine response metrics and find a strong correlation with the relative changes reported by Google and Apple using mobile phone data.


Burnout in the age of COVID-19


COVID-19 suicidal behavior among couples and suicide pacts: Case study evidence from press reports


[â ¡.Strategy of Treatment for Untreated Transplant-Ineligible Multiple Myeloma]


A Promising Anti-Cytokine-Storm Targeted Therapy for COVID-19: The Artificial-Liver Blood-Purification System


Editorial - Covid-19


title: Exploring Opportunities for Household-Level Chronic Care Management Using Linked Electronic Health Records of Adults and Children: A Retrospective Cohort Study

text: OBJECTIVE: Linking electronic health records (EHR) of pediatric and adult patients living in the same household has the potential to improve chronic care management efficiencies by facilitating the delivery of services to multiple household members at once. However, little is known about relationship between the chronic medical (CM) and behavioral health (CBH) of adults and children living in common households. METHODS: EHR data for children were linked to the EHR data of adults living at the same address during the same time in a retrospective cohort study from 2006 to 2014 to evaluate associations between adult and child CM and CBH conditions within a Boston safety-net primary care patient sample. RESULTS: Of the 13,845 included children, 61.6% lived with at least one adult with ≥ 1 CM or CBH condition. Compared to children living with an adult(s) without a chronic condition, children living with an adult with a CM or CBH condition had a respective 16.2% and 18.1% increased likelihood of having a chronic condition themselves, with multiple adult chronic conditions in adults increasing children's likelihood. CONCLUSIONS FOR PRACTICE: We found a positive association between the chronic diseases of adult and child household members. Given the clustering of child and adult chronic disease within households, using EHR data to support the care management needs of multiple members of households may be a promising approach to improving child and adult health in safety-net settings.


title: Antibody responses to SARS-CoV-2 in patients with COVID-19

text: We report acute antibody responses to SARS-CoV-2 in 285 patients with COVID-19. Within 19 days after symptom onset, 100% of patients tested positive for antiviral immunoglobulin-G (IgG). Seroconversion for IgG and IgM occurred simultaneously or sequentially. Both IgG and IgM titers plateaued within 6 days after seroconversion. Serological testing may be helpful for the diagnosis of suspected patients with negative RT-PCR results and for the identification of asymptomatic infections.


title: Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis

text: BACKGROUND: Antiviral medications are being given empirically to some patients with coronavirus disease 2019 (COVID-19). To support the development of a COVID-19 management guideline, we conducted a systematic review that addressed the benefits and harms of 7 antiviral treatments for COVID-19. METHODS: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed and 3 Chinese databases (CNKI, WANFANG and SinoMed) through Apr. 19, medRxiv and Chinaxiv through Apr. 27, and Chongqing VIP through Apr. 30, 2020. We included studies of ribavirin, chloroquine, hydroxychloroquine, umifenovir (arbidol), favipravir, interferon and lopinavir/ritonavir. If direct evidence from COVID-19 studies was not available, we included indirect evidence from studies of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) for efficacy outcomes and other acute respiratory viral infections for safety outcomes. RESULTS: In patients with nonsevere COVID-19 illness, the death rate was extremely low, precluding an important effect on mortality. We found only very low-quality evidence with little or no suggestion of benefit for most treatments and outcomes in both nonsevere and severe COVID-19. An exception was treatment with lopinavir/ritonavir, for which we found low-quality evidence for a decrease in length of stay in the intensive care unit (risk difference 5 d shorter, 95% confidence interval [CI] 0 to 9 d) and hospital stay (risk difference 1 d shorter, 95% CI 0 to 2 d). For safety outcomes, evidence was of low or very low quality, with the exception of treatment with lopinavir/ritonavir for which moderate-quality evidence suggested likely increases in diarrhea, nausea and vomiting. INTERPRETATION: To date, persuasive evidence of important benefit in COVID-19 does not exist for any antiviral treatments, although for each treatment evidence has not excluded important benefit. Additional randomized controlled trials involving patients with COVID-19 will be needed before such treatments can be administered with confidence.


title: Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARSCoV-2 and other acute viral infections: a systematic review and meta-analysis


Author reply to Letters to the Editor "COVID-19 pneumonia in Taiwan"


title: Blood Donor Recruitment in Guangzhou, China, during the 2019 Novel Coronavirus (COVID-19) Epidemic

text: BACKGROUND: The coronavirus disease 2019 (COVID-19) epidemic affected blood collection in Guangzhou, China. STUDY DESIGN AND METHODS: This paper included three studies. The observational study reported the trends of blood collection during the epidemic in Guangzhou, China. The cross-sectional survey investigated factors influencing blood donation during the COVID-19 epidemic, and a self-administered questionnaire was given to 1,584 street whole blood donors (SWBDs) who donated during the epidemic. The randomized controlled trial involved 19,491 SWBDs who donated in 2019 but did not donate during the epidemic. Trial participants were randomly assigned to two intervention groups: group 1 completed Questionnaire 1, which contained precautionary measures in response to COVID-19 and other messages about blood donation during the epidemic; and group 2 completed Questionnaire 2, which did not include this information. A control group did not receive any questionnaire. RESULTS: As measures implemented, the number of blood donors increased accordingly. Both first-time and repeat SWBDs perceived the same level of blood need and donated blood because it would save lives. SWBDs who completed Questionnaire 1 expressed a greater intention to donate during the epidemic. Enabling blood donors to perceive a higher level of blood need and a lower level of COVID-19 infection risk related to blood donation mobilized experienced SWBDs to donate within three weeks. Intention-to-treat analyses and average-treatment-effect-on-the-treated estimations confirmed that Questionnaire 1 could motivate SWBDs to actually donate blood. CONCLUSION: Various measures could ease blood shortage during the COVID-19 epidemic. Administration of Questionnaire 1 could increase blood donations during the epidemic. This article is protected by copyright. All rights reserved.


title: Genomic variance of the 2019-nCoV coronavirus

text: There is a rising global concern for the recently emerged novel coronavirus (2019-nCoV). Full genomic sequences have been released by the worldwide scientific community in the last few weeks to understand the evolutionary origin and molecular characteristics of this virus. Taking advantage of all the genomic information currently available, we constructed a phylogenetic tree including also representatives of other coronaviridae, such as Bat coronavirus (BCoV) and severe acute respiratory syndrome. We confirm high sequence similarity (>99%) between all sequenced 2019-nCoVs genomes available, with the closest BCoV sequence sharing 96.2% sequence identity, confirming the notion of a zoonotic origin of 2019-nCoV. Despite the low heterogeneity of the 2019-nCoV genomes, we could identify at least two hypervariable genomic hotspots, one of which is responsible for a Serine/Leucine variation in the viral ORF8-encoded protein. Finally, we perform a full proteomic comparison with other coronaviridae, identifying key aminoacidic differences to be considered for antiviral strategies deriving from previous anti-coronavirus approaches.


SARS-Coronavirus-2


How to demystify COVID-19 and reduce social stigma


Temporary Emergency Guidance to STEMI Systems of Care During the COVID-19 Pandemic: AHA's Mission: Lifeline


COVID 19 and its mental health consequences


title: Decision-making on management of ms and nmosd patients during the COVID-19 pandemic: A latin american survey

text: BACKGROUND: The emergence of COVID-19 and its vertiginous spreading speed represents a unique challenge to neurologists managing multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). The need for data on the impact of the virus on these patients grows rapidly. There is an urgent necessity of sharing information to enable evidence-based decision making on the clinical management. There are no data on what physicians are doing on clinical practice in Latin American countries. AIM: to investigate current management opinion of Latin American MS and/or NMOSD expert neurologists based on their experience and recommendations. METHODS: we developed a voluntary web-based survey based on hypothetical situations that these patients may encounter, while taking into account the potential risk of developing severe COVID-19 infection. RESULTS: 60% of the experts had the possibility of monitoring their patients by telemedicine. Most neurologists postpone magnetic resonance. Laboratory blood tests delay is associated with the type of treatment. Platform therapies, dimethyl-fumarate and natalizumab are considered safe options to initiate in naive patients. CONCLUSION: decision-making about MS and NMOSD patients has become even more complex in order to adapt to the COVID-19 pandemic. Risks and benefits should be taken into consideration throughout the patient follow-up.


title: How many infections of COVID-19 there will be in the"Diamond Princess"-Predicted by a virus transmission model based on the simulation of crowd flow

text: Objectives: Simulate the transmission process of COVID-19 in a cruise ship, and then to judge how many infections there will be in the 3711 people in the"Diamond Princess"and analyze measures that could have prevented mass transmission. Methods: Based on the crowd flow model, the virus transmission rule between pedestrians is established, to simulate the spread of the virus caused by the close contact during pedestrians' daily activities on the cruise ship. Measurements and main results: Three types of simulation scenarios are designed, the Basic scenario focus on the process of virus transmission caused by a virus carrier and the effect of the personal protective measure against the virus. The condition that the original virus carriers had disembarked halfway and more and more people strengthen self-protection are considered in the Self-protection scenario, which would comparatively accord with the actual situation of"Diamond princess"cruise. Control scenario are set to simulate the effect of taking recommended or mandatory measures on virus transmission Conclusions: There are 850~1009 persons (with large probability) who have been infected with COVID-19 during the voyage of"Diamond Princess". The crowd infection percentage would be controlled effectively if the recommended or mandatory measures can be taken immediately during the alert phase of COVID-19 outbreaks.


title: Digital Ariadne: Citizen Empowerment for Epidemic Control

text: The COVID-19 crisis represents the most dangerous threat to public health since the H1N1 influenza pandemic of 1918. So far, the disease due to the SARS-CoV-2 virus has been countered with extreme measures at national level that attempt to suppress epidemic growth. However, these approaches require quick adoption and enforcement in order to effectively curb virus spread, and may cause unprecedented socio-economic impact. A viable alternative to mass surveillance and rule enforcement is harnessing collective intelligence by means of citizen empowerment. Mobile applications running on personal devices could significantly support this kind of approach by exploiting context/location awareness and data collection capabilities. In particular, technology-assisted location and contact tracing, if broadly adopted, may help limit the spread of infectious diseases by raising end-user awareness and enabling the adoption of selective quarantine measures. In this paper, we outline general requirements and design principles of personal applications for epidemic containment running on common smartphones, and we present a tool, called 'diAry' or 'digital Ariadne', based on voluntary location and Bluetooth tracking on personal devices, supporting a distributed query system that enables fully anonymous, privacy-preserving contact tracing. We look forward to comments, feedback, and further discussion regarding contact tracing solutions for pandemic containment.


title: Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals

text: Understanding adaptive immunity to SARS-CoV-2 is important for vaccine development, interpreting coronavirus disease 2019 (COVID-19) pathogenesis, and calibration of pandemic control measures. Using HLA class I and II predicted peptide "megapools," circulating SARS-CoV-2-specific CD8+ and CD4+ T cells were identified in â¼70% and 100% of COVID-19 convalescent patients, respectively. CD4+ T cell responses to spike, the main target of most vaccine efforts, were robust and correlated with the magnitude of the anti-SARS-CoV-2 IgG and IgA titers. The M, spike, and N proteins each accounted for 11%-27% of the total CD4+ response, with additional responses commonly targeting nsp3, nsp4, ORF3a, and ORF8, among others. For CD8+ T cells, spike and M were recognized, with at least eight SARS-CoV-2 ORFs targeted. Importantly, we detected SARS-CoV-2-reactive CD4+ T cells in â¼40%-60% of unexposed individuals, suggesting cross-reactive T cell recognition between circulating "common cold" coronaviruses and SARS-CoV-2.


title: The COVID-19 Global Pandemic: Implications for People With Schizophrenia and Related Disorders

text: The coronavirus disease-19 (COVID-19) global pandemic has already had an unprecedented impact on populations around the world, and is anticipated to have a disproportionate burden on people with schizophrenia and related disorders. We discuss the implications of the COVID-19 global pandemic with respect to: (1) increased risk of infection and poor outcomes among people with schizophrenia, (2) anticipated adverse mental health consequences for people with schizophrenia, (3) considerations for mental health service delivery in inpatient and outpatient settings, and (4) potential impact on clinical research in schizophrenia. Recommendations emphasize rapid implementation of measures to both decrease the risk of COVID-19 transmission and maintain continuity of clinical care and research to preserve safety of both people with schizophrenia and the public.


title: A first case of meningitis/encephalitis associated with SARS-Coronavirus-2

text: Novel coronavirus (SARS-Coronavirus-2:SARS-CoV-2) which emerged in Wuhan, China, has spread to multiple countries rapidly. We report the first case of meningitis associated with SARS-CoV-2 who was brought in by ambulance due to a convulsion accompanied by unconsciousness. He had never been to any foreign countries. He felt generalized fatigue and fever (day 1). He saw doctors nearby twice (day 2 and 5) and was prescribed Laninamivir and antipyretic agents, His family visited his home and found that he was unconsciousness and lying on the floor in his vomit. He was immediately transported to this hospital by ambulance (day 9). Under emergency transport, he had transient generalized seizures that lasted about a minute. He had obvious neck stiffness. The specific SARS-CoV-2 RNA was not detected in the nasopharyngeal swab but was detected in a CSF. Anti- HSV 1 and varicella-zoster IgM antibodies were not detected in serum samples. A brain MRI showed hyperintensity along the wall of right lateral ventricle and hyperintense signal changes in the right mesial temporal lobe and hippocampus, suggesting the possibility of SARS-CoV-2 meningitis. This case warns the physicians of patients who have CNS symptoms.


title: Covid-19 and infection in health-care workers: An emerging problem

text: The 2019 coronavirus infection (called SARS-CoV-2) began in Wuhan, spread rapidly throughout the world. In many countries the exponential growth of Covid-19 cases is overwhelming health care systems with overcrowding of hospitals and overflowing Intensive Care Units. While people must stay at home to reduce the spread of this virus health-care workers do the exact opposite. In some countries doctors are working with insufficient protection and are constantly at risk of contracting Covid-19. Health-care workers should be constantly monitored because if they are infected they may spread the virus to colleagues, hospitalized patients and even family members. Increased rates of infection in health-care workers could cause the health-care system to collapse and a further worsening of the pandemic; if there are too few doctors it will be even more difficult to manage.


title: Highly efficient nitrate and phosphorus removal and adsorption of tetracycline by precipitation in a chitosan/polyvinyl alcohol immobilized bioreactor

text: Single denitrification using bacteria has been widely investigated, but few studies have focused on the simultaneous removal of nitrate, phosphorus. and tetracycline. Strain L2, an iron-reducing bacteria, was immobilized using chitosan/polyvinyl alcohol to simultaneously remove nitrate and phosphorus. The effects of carbon/nitrogen ratio (1:1, 1.5:1, and 2:1), initial Fe2+ concentration (0, 15, and 30 mg·L-1), and HRT (2, 4, and 6 h) were assessed in bioreactors and optimum conditions were established. Results showed that the nitrate and phosphorus removal efficiency reached 100.00% (2.697 mg·L-1·h-1) and 81.93% (1.533 mg·L-1·h-1) under the conditions of carbon/nitrogen of 2:1, Fe2+ concentration of 30 mg·L-1 and HRT of 6 h. The precipitation of bioreactor, which identified as FeOOH by XRD, had significant adsorption on tetracycline. The results of high-throughput sequencing indicated that strain L2 played a significant role in denitrification. This bioreactor provided effective method for the treatment of polluted water contaminated by nitrate, phosphorus, and tetracycline.


Cancer care during and after the pandemic


title: COVID-19, hipertensión y enfermedad cardiovascular./ [COVID-19 and its relationship with hypertension and cardiovascular disease]

text: The association between hypertension, diabetes, cardio and cerebrovascular disease and severe and fatal COVID-19, described in different countries, is remarkable. Myocardial damage and myocardial dysfunction are postulated as a possible causal nexus. Frequent findings of elevated troponin levels and electrocardiographic anomalies support this concept. On the other hand, hypotheses in favour and against a deleterious effect of angiotensin converting enzyme inhibitors and angiotensin receptor blockers, a usual treatment for cardiovascular disease, have been raised. There is currently no solid evidence and thus properly designed studies on this subject are urgently needed. In this context, patients with cardiovascular disease should especially avoid being exposed to the virus, should not self-medicate and rapidly seek medical advice should they show symptoms of infection.


title: Coronavirus Disease 19 Infection Does Not Result in Acute Kidney Injury: An Analysis of 116 Hospitalized Patients from Wuhan, China

text: BACKGROUND: Whether the patients with coronavirus disease 19 (COVID-19) infected by severe acute respiratory syndrome (SARS)-CoV-2 would commonly develop acute kidney injury (AKI) is an important issue worthy of clinical attention. This study aimed to explore the effects of SARS-CoV-2 infection on renal function through analyzing the clinical data of 116 hospitalized COVID-19-confirmed patients. METHODS: One hundred sixteen COVID-19-confirmed patients enrolled in this study were hospitalized in the Department of Infectious Diseases, Renmin Hospital of Wuhan University from January 14 to February 13, 2020. The recorded information includes demographic data, medical history, contact history, potential comorbidities, symptoms, signs, laboratory test results, chest computer tomography scans, and treatment measures. SARS-CoV-2 RNA in 53 urine sediments of enrolled patients was detected by real-time reverse transcription-polymerase chain reaction. RESULTS: Twelve (10.8%) patients showed mild increase of blood urea nitrogen or creatinine (<26 µmol/L within 48 h), and 8 (7.2%) patients showed trace or 1+ albuminuria in 111 COVID-19-confirmed patients without chronic kidney disease (CKD). All these patients did not meet the diagnostic criteria of AKI. In addition, 5 patients with CKD who were undergone regular continuous renal replacement therapy (CRRT) before admission were confirmed infection of SARS-CoV-2 and diagnosed as COVID-19. In addition to therapy for COVID-19, CRRT was also applied 3 times weekly during hospitalization for these 5 patients with CKD. In the course of treatment, the renal function indicators showed stable state in all 5 patients with CKD, without exacerbation of CKD, and pulmonary inflammation was gradually absorbed. All 5 patients with CKD were survived. Moreover, SARS-CoV-2 RNA in urine sediments was positive only in 3 patients from 48 cases without CKD, and 1 patient had a positive for SARS-CoV-2 open reading frame 1ab from 5 cases with CKD. CONCLUSION: AKI was uncommon in COVID-19. SARS-CoV-2 infection does not result in AKI, or aggravate CKD in the COVID-19 patients.


Ventiladores mecánicos de emergencia para la COVID-19./ Ventiladores mecánicos de emergencia para la COVID-19./ Emergency Mechanical Ventilators for Covid-19


Binge watching behavior during COVID 19 pandemic: A cross-sectional, cross-national online survey


title: Optional antiviral agents for the 2019 novel coronavirus and the liver injury

text: The most important treatment of anti 2019 novel coronavirus is antiviral and supportive treatment Currently, the anti novel coronavirus drugs in clinical trials include broad-spectrum antiviral drugs (Alpha interferon and Ribavirin), hemagglutinin inhibitors (Arbidol), human immunodeficiency virus protease inhibitors (Lopinavir/Ritonavir and Darunavir/Cobicistat), nucleoside analogues (Favipiravir and Remdesivir) and antimalarial drug (chloroquine), however, some patients suffered from liver damage during the actual usage This article reviews the research on liver damage associated with anti novel coronavirus drugs, aiming at promoting the rational, safe and effective use of anti novel coronavirus drugs


title: First case of convalescent plasma transfusion in a child with COVID-19-associated severe aplastic anemia

text: We present the case of a six-year-old girl with severe COVID-19, in whom SARS-CoV-2 was successfully eliminated after convalescent plasma transfusion. Children show a variable clinical course of COVID-19, from asymptomatic to critical. In our patient, we diagnosed COVID-19-associated aplastic anemia with severe pancytopenia. The correlation between SARS-CoV-2 infection with aplastic anemia remains unclear. At the beginning of the disease, we used antiviral drugs and immune modulators as therapy but without any positive results. After providing a transfusion of convalescent plasma, the elimination of SARS-CoV-2 was observed. We did not observe any adverse events of this treatment. The girl still has a diagnosis of aplastic anemia and requires specialist therapy.


title: Antibody cocktail to SARS-CoV-2 spike protein prevents rapid mutational escape seen with individual antibodies

text: Antibodies targeting the spike protein of SARS-CoV-2 present a promising approach to combat the COVID19 pandemic; however, concerns remain that mutations can yield antibody resistance. We investigate the development of resistance against four antibodies to the spike protein that potently neutralize SARS-CoV-2, individually as well as when combined into cocktails. These antibodies remain effective against spike variants that have arisen in the human population. However, novel spike mutants rapidly appeared following in vitro passaging in the presence of individual antibodies, resulting in loss of neutralization; such escape also occurred with combinations of antibodies binding diverse but overlapping regions of the spike protein. Importantly, escape mutants were not generated following treatment with a non-competing antibody cocktail.


title: Adding crust to BPS Skyrme neutron stars

text: The Skyrme model and its generalisations provide a conceptually appealing field-theory basis for the description of nuclear matter and, after its coupling to gravity, also of neutron stars. In particular, a specific Skyrme submodel, the so-called Bogomol'nyi-Prasad-Sommerfield (BPS) Skyrme model, allows both for an exact field-theoretic and a mean-field treatment of neutron stars, as a consequence of its perfect fluid property. A pure BPS Skyrme model description of neutron stars, however, only describes the neutron star core, by construction. Here we consider different possibilities to extrapolate a BPS Skyrme neutron star at high baryon density to a description valid at lower densities. In the exact field-theoretic case, a simple effective description of the neutron star crust can be used, because the exact BPS Skyrme neutron star solutions formally extend to sufficiently low densities. In the mean-field case, on the other hand, the BPS Skyrme neutron star solutions always remain above the nuclear saturation density and, therefore, must be joined to a different nuclear physics equation of state already for the outer core. We study the resulting neutron stars in both cases, facilitating an even more complete comparison between Skyrmionic neutron stars and neutron stars obtained from other approaches, as well as with observations.


title: Momentum Contrastive Learning for Few-Shot COVID-19 Diagnosis from Chest CT Images

text: The current pandemic, caused by the outbreak of a novel coronavirus (COVID-19) in December 2019, has led to a global emergency that has significantly impacted economies, healthcare systems and personal wellbeing all around the world. Controlling the rapidly evolving disease requires highly sensitive and specific diagnostics. While real-time RT-PCR is the most commonly used, these can take up to 8 hours, and require significant effort from healthcare professionals. As such, there is a critical need for a quick and automatic diagnostic system. Diagnosis from chest CT images is a promising direction. However, current studies are limited by the lack of sufficient training samples, as acquiring annotated CT images is time-consuming. To this end, we propose a new deep learning algorithm for the automated diagnosis of COVID-19, which only requires a few samples for training. Specifically, we use contrastive learning to train an encoder which can capture expressive feature representations on large and publicly available lung datasets and adopt the prototypical network for classification. We validate the efficacy of the proposed model in comparison with other competing methods on two publicly available and annotated COVID-19 CT datasets. Our results demonstrate the superior performance of our model for the accurate diagnosis of COVID-19 based on chest CT images.


title: Characteristics and outcomes of COVID-19 positive patients with diabetes managed as outpatients

text: We analyzed disease outcomes for patients with diabetes and laboratory-confirmed COVID-19 who were managed outpatient and followed by the Emory COVID-19 Virtual Outpatient Management Clinic (ECVOMC). The rate of hospitalization for patients with diabetes was double the overall rate of hospitalization for patients in the ECVOMC.


title: A Patient with COVID-19 Disease in a Referral Hospital in Iran: A Typical Case

text: After the initial Wuhan outbreak in the end of December 2019, many new cases were found in other provinces of China and also many other countries over the world, including South Korea, Italy, Iran, Japan, and 68 other countries. We presented a 61-year-old woman with a history of diabetes mellitus was referred to the emergency department of a referral hospital in Tehran, Iran. The patient presented with fever, chills, and myalgia within three days. Laboratory analysis showed increased levels of erythrocyte sedimentation rate (ESR), and mild leukopenia. SARSCoV-2 PCR test -under Iran Ministry of Health and Medical Education (MoH&ME) guidelines - result was positive and the chest X-ray shows bilateral ground glass opacity. O2 saturation was 87% (without O2 therapy). The patient was hospitalized and treated with Oseltamivir 75 mg every 12 hours, Lopinavir/Ritonavir (Kaletra) 400/100 mg every 12 hours and hydroxychloroquine 400 mg stat. The patient last O2 saturation measured was 93% and had no fever in the 10th day of hospitalization. So she has been discharged from hospital and homeisolated according to Iran Ministry of Health protocol.


title: Using open-source intelligence to detect early signals of COVID-19 in China, Descriptive study

text: BACKGROUND: COVID-19 in China was first reported to the World Health Organization on December 31st 2019. The first cases were officially identified around December 8th 2019. The origin of COVID-19 is not confirmed, but half the early cases were linked to a seafood market in Wuhan. The first two documented cases did not attend the seafood market. News reports, social media and informal sources may contain information about outbreaks prior to formal notification. OBJECTIVE: To identify early signals of pneumonia and/or severe acute respiratory illness (SARI) in China, prior to official recognition of the COVID 19 outbreak in December 2019, using open source data. METHODS: In order to capture early reports we searched an open source epidemic observatory, Epiwatch from 1st October2019 in China, for severe acute respiratory illness (SARI) or pneumonia related illnesses. Google and Chinese search engine Baidu were used. RESULTS: There was an increase in reports following the official notification of COVID 19 to WHO on December 31 2019, and a retracted report on December 26th 2019. A report of severe pneumonia was identified on November 22 2019 in Xiangyang, Index patient was retrospectively identified on 17 November. CONCLUSIONS: The lack of reports of a SARI outbreaks prior to December 31st, with a retracted report on December 26th suggests media censorship, given formal reports that cases began on December 8th. However, the findings also support relatively recent origin of COVID-19 in November 2019. The case reported on November 22nd was transferred to Wuhan approximately 1 incubation period before the first reported cases on December 8th, and should be further investigated, as only half of the early cases had exposure to the seafood market. It has since been reported that another case of COVID 19 has been retrospectively identified in Hubei on November 17th, confirming that the infection was present prior to December.


The impact of health worker gap in Italy on the COVID-19 pandemic. A good time to improve the quality of the Italian National Health System (NHS)?


A Urology Department's Experience at the Epicenter of the COVID-19 Pandemic


The friendly use of chloroquine in the COVID-19 disease: a warning for the G6PD-deficient males and for the unaware carriers of pathogenic alterations of the G6PD gene


title: Remdesivir in COVID-19: A critical review of pharmacology, pre-clinical and clinical studies

text: BACKGROUND & AIMS: Remdesivir is a broad spectrum anti-viral drug that has shown to inhibit SARS-CoV-2, in vitro and in vivo. In absence of any effective treatment for SARS-CoV-2 infection (COVID-19), remdesivir has been tried for a compassionate use in severe COVID-19. Newer randomized controlled studies that have recently become available, showed a mixed result. We aimed to systematically search the literature to understand the pharmacology and clinical effects of remdesivir in patients with COVID-19. METHODS: We systematically searched the PubMed, ClinicalTrial.Org and MedRxiv database up till May 5, 2020 using specific key words such as "Remdesivir" or 'GS-5734â³ AND "COVID-19" or "SARS-CoV-2" and retrieved all the article published in English language, that have reported the pharmacology and the clinical outcomes of remdesivir in patients with COVID-19. RESULTS: Initial compassionate use of remdesivir has shown a fairly good result, but difficult to quantify, in the absence of control arm. While the very first double-blind, placebo-controlled, randomized trial conducted in Wuhan, did not find any significant benefit compared to the control, the preliminary result of another similar multi-country trial has shown a significant faster time to recovery but without any difference in mortality. CONCLUSIONS: Remdesivir has shown a mixed result in patients with COVID-19 with an acceptable side effect. However, jury is still out while awaiting the results from the forthcoming trials.


Urticaria-like lesions in COVID-19 patients are not really urticaria - a case with clinicopathological correlation