A Call for Randomized Controlled Trials to Test the Efficacy of Chloroquine and Hydroxychloroquine as Therapeutics against Novel Coronavirus Disease (COVID-19)


Protecting older adults during social distancing


title: Pathogenic T cells and inflammatory monocytes incite inflammatory storm in severe COVID-19 patients

text: Pathogenic human coronavirus infections, such as severe acute respiratory syndrome CoV (SARS-CoV) and Middle East respiratory syndrome CoV (MERS-CoV), cause high morbidity and mortality1, 2 Recently, a severe pneumonia-associated respiratory syndrome caused by a new coronavirus (SARS-CoV-2) was reported at December 2019 in the city Wuhan, Hubei province, China3, 4, 5, which was also named as pneumonia-associated respiratory syndrome (PARS)6 and can cause coronavirus disease 2019 (COVID-19) to seriously endanger human health Up to 24th of February 2020, at least 77779 cases have been reported with 2666 fatal cases according to the report from China CDC However, the immune mechanism that potential orchestrated acute mortality from COVID-19 patients is still unknown Here we show that after the SARS-CoV-2 infection, CD4+ T lymphocytes are rapidly activated to become pathogenic T helper (Th) 1 cells and generate GM-CSF etc The cytokines environment induces inflammatory CD14+CD16+ monocytes with high expression of IL-6 and accelerate the inflammation Given that large amount of inflammatory cells infiltrations have been observed in lungs from severe COVID-19 patients7, 8, these aberrant pathogenic Th1 cells and inflammatory monocytes may enter the pulmonary circulation in huge numbers and play an immune damaging role to causing lung functional disability and quick mortality Our results demonstrate that excessive non-effective host immune responses by pathogenic T cells and inflammatory monocytes may associate with severe lung pathology Thus, we suggest that monoclonal antibodies targeting GM-CSF or interleukin 6 may be effective in blocking inflammatory storms and, therefore, be a promising treatment of severe COVID-19 patients


title: COVID-19, SARS and MERS: are they closely related?

text: BACKGROUND: The 2019 novel coronavirus (SARS-CoV-2) is a new human coronavirus which is spreading with epidemic features in China and other Asian countries; cases have also been reported worldwide. This novel coronavirus disease (COVID-19) is associated with a respiratory illness that may lead to severe pneumonia and acute respiratory distress syndrome (ARDS). Although related to the severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS), COVID-19 shows some peculiar pathogenetic, epidemiological and clinical features which to date are not completely understood. AIMS: To provide a review of the differences in pathogenesis, epidemiology and clinical features of COVID-19, SARS and MERS. SOURCES: The most recent literature in the English language regarding COVID-19 has been reviewed, and extracted data have been compared with the current scientific evidence about SARS and MERS epidemics. CONTENT: COVID-19 seems not to be very different from SARS regarding its clinical features. However, it has a fatality rate of 2.3%, lower than that of SARS (9.5%) and much lower than that of MERS (34.4%). The possibility cannot be excluded that because of the less severe clinical picture of COVID-19 it can spread in the community more easily than MERS and SARS. The actual basic reproductive number (R0) of COVID-19 (2.0-2.5) is still controversial. It is probably slightly higher than the R0 of SARS (1.7-1.9) and higher than that of MERS (<1). A gastrointestinal route of transmission for SARS-CoV-2, which has been assumed for SARS-CoV and MERS-CoV, cannot be ruled out and needs further investigation. IMPLICATIONS: There is still much more to know about COVID-19, especially as concerns mortality and its capacity to spread on a pandemic level. Nonetheless, all of the lessons we learned in the past from the SARS and MERS epidemics are the best cultural weapons with which to face this new global threat.


Qualitative serology in patients recovered from SARS CoV 2 infection


title: PAN IIT Survey on Online Education: A Report

text: Due to the COVID-19 pandemic that set in in the middle of the semester, most of the IITs (and other institutions from across India and the world) switched to an online mode for completing the semester. Since then, many different institutions from across the world have been discussing ways and means to make online education effective, via various means, such as webinars, talks and short workshops. However, a general observation has been that there is a lack of data on online education, particularly in the Indian context. Anticipating this, we decided to conduct a pan-IIT survey on online education and compiled two sets of questionnaires (one each for faculty members and students) in discussion with the members of the pan-IIT group on Online Pedagogy (https://www.paniit-onlinepedagogy-researchgroup.net/), that has been formed for conducting research on the broad area of online education. The current survey has been steered by IIT Dharwad and IIT Jammu along with the members of the pan-IIT group on online pedagogy. The survey data was collected from 5th May 2020 to 25th May 2020. We received about 11,890 and 840 responses from students and faculty members, respectively. About 82% and 86% of the respondents were males among the students and faculty surveys, respectively. In the following, we present and discuss the survey responses pertaining to various aspects of online education. An infographic representation of the survey responses may be found in Appendix. We note that the survey conducted was a broad survey, covering various broad aspects of online education. However, a fine-grained survey may be required to obtain an in-depth understanding of specific aspects, such as on how to handle lab courses and carry out assessments.


How GPs can contribute to the challenge of covid-19


COVID-19 in Brazil: Historical cases, disease milestones, and estimated outbreak peak


title: Assessing the Effects of Metropolitan-Wide Quarantine on the Spread of COVID-19 in Public Space and Households

text: Hubei province in China has completed cycle of quarantine-resumption in 23rd Janauary and 8th April 2020, providing a unique opportunity as for now to assess its intervention impact and the pattern of SARS-COV-2 transmission during the quarantine period. In this study, we evaluate the impact of the metropolitan-wide quarantine on the trend and transmission route of the COVID-19 epidemic in Hubei, China. The intervention reduces more than 70% of new infections in both households and the public space, as well as the deaths caused by COVID-19 pneumonia. Household transmission is the dominant route of disease spread regardless of quarantine. This will provide important evidence and scientific insights to other worldwide countries that are currently under quarantine.


COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health


Renin-angiotensin system inhibitors in the COVID-19 pandemic: consequences of antihypertensive drugs


Rapid Publication, Knowledge Sharing, and Our Responsibility During the COVID-19 Pandemic


SARS-CoV-2 infection in children with febrile neutropenia


title: Clinical characteristics and radiological features of children infected with the 2019 novel coronavirus

text: AIM: To identify and summarise the common findings from 2019 novel coronavirus (2019-nCoV) infections in children. MATERIALS AND METHODS: The clinical characteristics and radiological findings (chest radiography and chest computed tomography [CT]) of nine children infected with the 2019-nCoV were reviewed in this retrospective case series. RESULTS: Among the children, six had fever (including two children with cough), one had only cough, one had a stuffy nose when initially diagnosed, and one was an asymptomatic carrier. Chest radiographs seemed mostly normal in six cases whereas increased and/or disordered bilateral bronchovascular shadows and dense hilar shadows were seen in three cases. Chest CT exhibited no obvious abnormal signs in four cases. Typical CT findings included patchy, peripheral ground-grass opacities, subpleural lamellar dense shadows, and parenchymal bands. Pleural effusions, mediastinal lymphadenopathy, cavitation, and pleural thickening were absent. CONCLUSION: The clinical manifestations and radiological findings of the 2019-nCoV-infected children were mild and lacked a typical pattern.


title: Impact de l'épidémie de COVID-19 sur les demandes de prise en charge initiale pour cancer du sein Clinical characteristics and radiological features of children infected with the 2019 novel coronavirus

text: AIM: To identify and summarise the common findings from 2019 novel coronavirus (2019-nCoV) infections in children MATERIALS AND METHODS: The clinical characteristics and radiological findings (chest radiography and chest computed tomography [CT]) of nine children infected with the 2019-nCoV were reviewed in this retrospective case series RESULTS: Among the children, six had fever (including two children with cough), one had only cough, one had a stuffy nose when initially diagnosed, and one was an asymptomatic carrier Chest radiographs seemed mostly normal in six cases whereas increased and/or disordered bilateral bronchovascular shadows and dense hilar shadows were seen in three cases Chest CT exhibited no obvious abnormal signs in four cases Typical CT findings included patchy, peripheral ground-grass opacities, subpleural lamellar dense shadows, and parenchymal bands Pleural effusions, mediastinal lymphadenopathy, cavitation, and pleural thickening were absent CONCLUSION: The clinical manifestations and radiological findings of the 2019-nCoV-infected children were mild and lacked a typical pattern


El diagnóstico COVID-19 a través de la imagen./ El diagnóstico COVID-19 a través de la imagen./ COVID-19 diagnosis through image


Economic implications of the COVID-19 pandemic on the plastic surgery community


Diagnosis and treatment of 2019 novel coronavirus infection in children: a pressing issue


Severe Acute Respiratory Syndrome Coronavirus 2-Specific Antibodies in Pets in Wuhan, China


The COVID-Box for tracheostomy: Additional complexity and unanswered questions


title: Review on the clinical pharmacology of hydroxychloroquine sulfate for the treatment of COVID-19

text: BACKGROUND: As the number of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infected people is skyrocketing worldwide, the international medical situation becomes very serious. Potential therapeutic drugs, vaccine and stem cell replacement methods are emerging, it is urgent to find specific therapeutic drugs and the best treatment regimens. After the publication of hydroxychloroquine (HCQ) with anti-SARS-COV-2 activity in vitro, a small, non-randomized, open-label clinical trial showed that HCQ treatment was significantly associated with reduced viral load in patients with coronavirus disease-19 (COVID-19). Meanwhile, a large prophylaxis study of HCQ sulfate for COVID-19 has been initiated in the United States. HCQ offered a promising efficacy in the treatment of COVID-19, but the optimal administration is still being explored. METHODS: Use the keyword 'Hydroxychloroquine' to conduct a literature search in PubMed to collect relevant literature on the mechanism of action of HCQ, clinical efficacy and safety, pharmacokinetic characteristics, precautions for clinical use and drug interactions, and extract and organize information. RESULTS: This paper reviews the mechanism, clinical efficacy and safety, pharmacokinetic characteristics, exposure-response relationship and precautions and drug interactions of HCQ, and summarized dosage recommendations for HCQ sulfate. CONCLUSION: It has been proved that HCQ, which has an established safety profile, is effective against SARS-CoV-2 with sufficient pre-clinical rationale and evidence. Data from high-quality clinical trials are urgently needed worldwide.


Correction to: Protecting Medical Trainees on the COVID-19 Frontlines Saves Us All


Protecting Medical Trainees on the COVID-19 Frontlines Saves Us All


title: Prevalence of Gastrointestinal Symptoms and Fecal Viral Shedding in Patients With Coronavirus Disease 2019: A Systematic Review and Meta-analysis

text: Importance: Coronavirus disease 2019 (COVID-19) is a global pandemic and can involve the gastrointestinal (GI) tract, including symptoms like diarrhea and shedding of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in feces. Objective: To provide a pooled estimate of GI symptoms, liver enzyme levels outside reference ranges, and fecal tests positive for SARS-CoV-2 among patients with COVID-19. Data Sources: An electronic literature search was performed for published (using MEDLINE/PubMed and Embase) and preprint (using bioRxiv and medRxiv) studies of interest conducted from November 1, 2019, to March 30, 2020. Search terms included "COVID-19," "SARS-Cov-2," and/or "novel coronavirus." Study Selection: Eligible studies were those including patients with SARS-CoV-2 infection who reported GI symptoms. Data Extraction and Synthesis: Data on patients with GI symptoms (ie, diarrhea, nausea, or vomiting), liver enzyme level changes, and fecal shedding of virus were extracted. Quality of studies was examined using methodological index for nonrandomized studies. Pooled estimates (%) were reported with 95% CIs with level of heterogeneity (I2). Main Outcomes and Measures: Study and patient characteristics with pooled detection rates for diarrhea, nausea or vomiting, liver enzyme levels outside reference ranges, and SARS-CoV-2 positivity in feces tests were analyzed. Results: Of 1484 records reviewed, 23 published and 6 preprint studies were included in the analysis, with a total of 4805 patients (mean [SD] age, 52.2 [14.8] years; 1598 [33.2%] women) with COVID-19. The pooled rates were 7.4% (95% CI, 4.3%-12.2%) of patients reporting diarrhea and 4.6% (95% CI, 2.6%-8.0%) of patients reporting nausea or vomiting. The pooled rate for aspartate aminotransferase levels outside reference ranges was 20% (95% CI, 15.3%-25.6%) of patients, and the pooled rate for alanine aminotransferase levels outside reference ranges was 14.6% (95% CI, 12.8%-16.6%) of patients. Fecal tests that were positive for SARS-CoV-2 were reported in 8 studies, and viral RNA shedding was detected in feces in 40.5% (95% CI, 27.4%-55.1%) of patients. There was high level of heterogeneity (I2 = 94%), but no statistically significant publication bias noted. Conclusions and Relevance: These findings suggest that that 12% of patients with COVID-19 will manifest GI symptoms; however, SAR-CoV-2 shedding was observed in 40.5% of patients with confirmed SARS-CoV-2 infection. This highlights the need to better understand what measures are needed to prevent further spread of this highly contagious pathogen.


title: Inpatient teledermatology during the COVID-19 pandemic

text: Coronavirus Disease 2019 (COVID-19) represents a global health crisis in which personal protective equipment has become increasingly limited. Dermatologists are poised to use technology, such as teledermatology, to innovate existing workflows and optimize dermatologic care. The state of Ohio has emerged as a leader in the United States with its response to the COVID-19 crisis. In response to the COVID-19 crisis, we developed a simple algorithm and strict guidelines to prioritize telemedicine specifically for inpatient dermatology consults. This algorithm was quickly accepted by our hospital leadership and adopted by other inpatient consultative services. In this Viewpoint, we share our experience with early adoption of teledermatology in the inpatient consultative setting in light of the COVID-19 crisis. We also highlight the limitations, ethical considerations, and areas for future research with respect to the implementation of teledermatology.


title: Infection arbitrage

text: Increasing the infection risk early in an epidemic is individually and socially optimal under some parameter values. The reason is that the early patients recover or die before the peak of the epidemic, which flattens the peak. This improves welfare if the peak exceeds the capacity of the healthcare system and the social loss rises rapidly enough in the number infected. The individual incentive to get infected early comes from the greater likelihood of receiving treatment than at the peak when the disease has overwhelmed healthcare capacity. Calibration to the Covid-19 pandemic data suggests that catching the infection at the start was individually optimal and for some loss functions would have reduced the aggregate loss.


title: Albumin-gated zwitterion-stabilized mesoporous silica nanorod as a pH-responsive drug delivery system

text: Silica nanoparticles as drug delivery systems (DDS) have received huge attention in nanomedicine research. However, their drug release processes were usually discussed in the absence of proteins, which are abundant in real delivery media and likely to affect the release behaviors. In this work, novel pH-sensitive silica-based DDSs were constructed using the endogenous protein, human serum albumin (HSA), as the gatekeeper, and their release properties in protein-containing media were measured for the first time. As-synthesized mesoporous silica nanorod (MSNR) was modified with zwitterions to suppress the nonspecific adsorption of protein and to improve the dispersity. HSA was fixed onto MSNR through drug-protein interactions and covalent bonds, respectively. Benzoic-imine bonds were introduced into the designs to realize pH responsiveness. The fluorescence quenching effect of drugs on HSA was used to monitor the drug release in simulated body fluids containing proteins. The results indicated that protein gating could effectively reduce premature release in normal blood environment. The endogenous protein capping, high dispersity and stability, considerable loading content, low cytotoxicity and favorable responsiveness to acidic microenvironment enable the present structures to be promising carriers for chemotherapy drugs.


Ethnicity and covid-19


title: Deceased Donor Liver Transplantation in India in the COVID-19 Era: Current Scenario and Future Perspectives

text: Coronavirus disease 2019 (COVID-19) has been recently declared a global pandemic. As of June 5, 2020, over 75,000 cases have been reported with nearly 2500 deaths in India alone. COVID-19 has severely impacted deceased donor liver transplant (DDLT) programs throughout the world. Acceptance of deceased liver donors has decreased worldwide because of the unknown risks associated with COVID-19 transmission or postoperative infection in the immediate post-transplant period, along with the risks to the health care workers in a multidisciplinary setting. In India, DDLT has come to a standstill in the setting of a national lockdown. Many national guidelines have emerged on how to safely perform transplant as well on immunosuppressive regimens and care of patients posttransplant. Here, we take a look at the current situation and summarize the different guidelines and future perspectives of DDLT in India in the COVID-19 era.


title: Returning to orthopaedic business as usual after COVID-19: strategies and options

text: PURPOSE: The aim of this manuscript is to review the available strategies in the international literature to efficiently and safely return to both normal orthopaedic surgical activities and to normal outpatient clinical activities in the aftermath of a large epidemic or pandemic. This information would be beneficial to adequately reorganize outpatient clinics and hospitals to provide the highest possible level of orthopaedic care to our patients in a safe and efficient manner. METHODS: A literature search was performed for relevant research articles. In addition, the World Health Organisation (WHO), the US Centers for Disease Control (CDC), American Association of Orthopaedic Surgeons (AAOS), the EU CDC and other government health agency websites were searched for any relevant information. In particular, interest was paid to strategies and advise on managing the orthopaedic patient flow during outpatient clinics as well as surgical procedures including the necessary safety measures, while still providing a high-quality patient experience. The obtained information is provided as a narrative review. RESULTS: There was not any specific literature concerning the organization of an outpatient clinic and surgical activities and the particular challenges in dealing with a high-volume practice, in the afterwave of a pandemic. CONCLUSION: As the COVID-19 crisis has abruptly halted most of the orthopaedic activities both in the outpatient clinic and the operating room, a progressive start-up scenario needs to be planned. The exact timing largely depends on factors outside of our control. After restrictions will be lifted, clinical and surgical volume will progressively increase. This paper offers key points and possible strategies to provide the highest level of safety to both the orthopaedic patient and the orthopaedic team including administrative staff and nurses, during the start-up phase. LEVEL OF EVIDENCE: Review, Level V.


title: Impact of COVID-19 on gaming disorder: Monitoring and prevention

text: The global coronavirus disease 2019 (COVID-19) outbreak has necessitated physical distancing, lockdown, contact tracing, and self-quarantine so as to prevent the spread of the disease. Amid the outbreak, gaming data usage has reportedly increased in the United States, and game download volume has reached a record high in Europe. Because gaming can be used to cope with the psychological stress from the outbreak, therefore mental health professionals should be aware of how increased gaming during the pandemic may contribute to risk of gaming disorder, especially if the pandemic persists. Mental health professionals should thus formulate safe social interaction alternatives for people, particularly adolescents, who have gaming disorder risk.


title: Indian Association of Gastrointestinal Endo Surgeons COVID-19 endoscopy recommendations

text: These are recommendations from the Indian Association of Gastro Intestinal Endo Surgeons for safe performance of diagnostic and therapeutic endoscopy during the COVID-19 pandemic.


Stresses and anxieties in the time of the COVID-19 pandemic - what we can learn


title: Challenges in Drug Development Posed by the COVID-19 Pandemic: An Opportunity for Clinical Pharmacology

text: The unprecedented challenges posed by the coronavirus disease 2019 (COVID-19) pandemic highlight the urgency for applying clinical pharmacology and model-informed drug development in (i) dosage optimization for COVID-19 therapies, (ii) approaching therapeutic dilemmas in clinical trial settings, and (iii) maximizing value of information from impacted non-COVID-19 trials. More than ever, we have a responsibility for adaptive evidence synthesis with a Totality of Evidence mindset in this race against time across biomedical research, clinical practice, drug development, and regulation.


title: The risk of the collapse of public health centres under the current system to prevent the spread of COVID-19

text: None.


title: 100 Days of COVID-19 Prevention and Control in China

text: The epidemic of novel coronavirus diseases was first reported in China in late December 2019 and has been brought under control after some two months in China. However, it has become a global pandemic and the number of cases and deaths continues to increase outside of China. We describe the emergence of the pandemic, detail the first 100 days of China's response as a Phase 1 Containment followed by Phase 2 Containment strategy, and briefly highlight areas of focus for the future. Specific, simple, and pragmatic strategies used in China for risk assessment, prioritization, and deployment of resources are described. Details of implementation, at different risk levels, of the traditional public health interventions are shared. Involvement of society in mounting a whole country response and challenges experienced with logistics and supply chains are described. Finally, the methods China is employing to cautiously re-start social life and economic activity are outlined.


Rationale of the WHO document on Risk Communication and Community Engagement (RCCE) readiness and response to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and of the Italian Decalogue for Prevention Departments


Coronavirus Disease COVID-19: A New Threat to Public Health


Licking the lungs, biting the brain: malignant MCA infarct in a patient with COVID 19 infection


[Attach importance to COVID-19 infection on maternal and infant outcomes]


title: Coronavirus Disease-2019 and Telehealth: Prevention of Exposure in a Medically Complex Patient With a Mild Presentation

text: The novel coronavirus disease-2019 (COVID-19) was declared a pandemic by the World Health Organization on March 11, 2020. We discuss a less common presentation of COVID-19 in a patient where the use of telemedicine technology prevented the exposure of the healthcare team in an academic general pediatrics clinic. A medically complex 20-year-old male presented via virtual visit for unilateral eye redness and discharge. He received topical ophthalmic antibiotics for presumed acute bacterial conjunctivitis and was counseled on return precautions. Three days later, the patient developed shortness of breath, fever to 102.6°F, and chest pain. COVID-19 testing returned positive. Conjunctivitis is a presenting symptom in 32% of COVID-19 cases. Current evidence suggests that these patients may transmit their illness at the time of presentation. Using telehealth, we avoided exposure to a COVID-19-positive patient who would not have met criteria for testing or droplet precautions. Telehealth allows providers to triage patients, identifying those who need to be seen in person, thereby minimizing exposure. Transitioning toward virtual practice, particularly during a pandemic, prepares for the possibility of healthcare workers being quarantined but still able to provide care and minimizes exposure to asymptomatic patients or those with atypical symptoms.


title: A Molecular Communication Perspective on Airborne Pathogen Transmission and Reception via Droplets Generated by Coughing and Sneezing

text: Infectious diseases spread via pathogens such as viruses and bacteria. Airborne pathogen transmission via droplets is an important mode for infectious diseases. In this paper, the spreading mechanism of infectious diseases by airborne pathogen transmission between two humans is modeled with a molecular communication perspective. An end-to-end system model which considers the pathogen-laden cough/sneeze droplets as the input and the infection state of the human as the output is proposed. This model uses the gravity, initial velocity and buoyancy for the propagation of droplets and a receiver model which considers the central part of the human face as the reception interface is proposed. Furthermore, the probability of infection for an uninfected human is derived by modeling the number of propagating droplets as a random process. The numerical results reveal that exposure time and sex of the human affect the probability of infection. In addition, the social distance for a horizontal cough should be at least 1.7 m and the safe coughing angle of a coughing human to infect less people should be less than -25$^\circ$.


Covid-19: Lack of testing in Brazil is a "major failure," says MSF


title: On the Minimization of Sobolev Norms of Time-Varying Graph Signals: Estimation of New Coronavirus Disease 2019 Cases

text: The mathematical modeling of infectious diseases is a fundamental research field for the planning of strategies to contain outbreaks. The models associated with this field of study usually have exponential prior assumptions in the number of new cases, while the exploration of spatial data has been little analyzed in these models. In this paper, we model the number of new cases of the Coronavirus Disease 2019 (COVID-19) as a problem of reconstruction of time-varying graph signals. To this end, we proposed a new method based on the minimization of the Sobolev norm in graph signal processing. Our method outperforms state-of-the-art algorithms in two COVID-19 databases provided by Johns Hopkins University. In the same way, we prove the benefits of the convergence rate of the Sobolev reconstruction method by relying on the condition number of the Hessian associated with the underlying optimization problem of our method.


Santé psychique et hygiène mentale en période de confinement


title: Development of a Laboratory-safe and Low-cost Detection Protocol for SARS-CoV-2 of the Coronavirus Disease 2019 (COVID-19)

text: The severe acute respiratory coronavirus 2 (SARS-CoV-2), which emerged in December 2019 in Wuhan, China, has spread rapidly to over a dozen countries. Especially, the spike of case numbers in South Korea sparks pandemic worries. This virus is reported to spread mainly through personto- person contact via respiratory droplets generated by coughing and sneezing, or possibly through surface contaminated by people coughing or sneezing on them. More critically, there have been reports about the possibility of this virus to transmit even before a virus-carrying person to show symptoms. Therefore, a low-cost, easy-access protocol for early detection of this virus is desperately needed. Here, we have established a real-time reverse-transcription PCR (rtPCR)-based assay protocol composed of easy specimen self-collection from a subject via pharyngeal swab, Trizolbased RNA purification, and SYBR Green-based rtPCR. This protocol shows an accuracy and sensitivity limit of 1-10 virus particles as we tested with a known lentivirus. The cost for each sample is estimated to be less than 15 US dollars. Overall time it takes for an entire protocol is estimated to be less than 4 hours. We propose a cost-effective, quick-and-easy method for early detection of SARS-CoV-2 at any conventional Biosafety Level II laboratories that are equipped with a rtPCR machine. Our newly developed protocol should be helpful for a first-hand screening of the asymptomatic virus-carriers for further prevention of transmission and early intervention and treatment for the rapidly propagating virus.


COVID-19-Associated Leukoencephalopathy


Why the immune system fails to mount an adaptive immune response to a COVID-19 infection


title: Protecting and Improving the Lives of Older Adults in the COVID-19 Era

text: The COVID-19 pandemic has impacted the lives of people throughout the world, either directly, due to exposure to the virus, or indirectly, due to measures taken to mitigate the virus' effects. Older adults have been particularly hard hit, dying in disproportionately higher numbers, especially in long-term care facilities. Local, regional, and national government actions taken to mitigate the spread of COVID-19 have thus served, in part, to shield older adults from the virus, though not without adverse side effects, including increased social isolation, enhanced economic risk, revealed ageism, delayed medical treatment, and challenges getting basic needs met. This special issue of the Journal of Aging & Social Policy explores the myriad ways in which the COVID-19 pandemic has affected older adults and their families, caregivers, and communities. It proposes policies and strategies for protecting and improving the lives of older people during the pandemic. It draws lessons for aging policy and practice more generally, given underlying challenges brought to the fore by government, provider, community, and individual responses to the pandemic.


title: Early manifestation of ARDS in COVID-19 infection in a 51- year-old man affected by Mounier-Kuhn Syndrome

text: We present the first patient of a 51-year-old man with fever, dyspnea and deterioration of his chronic coughs, who was referred to the Mounier-Kuhn syndrome (MKS). Chest computed tomography (CT) scan revealed increased diameter of his trachea (39 mm), right (30 mm) and left (26 mm) main bronchi, because of MKS. Then, COIVD-19 infection was eventually confirmed by RT-PCR. To our knowledge, COIVD-19 has not been reported in patients with the MKS.


title: Simultaneous liquefaction, saccharification, and fermentation of L-lactic acid using aging paddy rice with hull by an isolated thermotolerant Enterococcus faecalis DUT1805

text: Simultaneous liquefaction, saccharification, and fermentation (SLSF) has attracted much attention for the production of bio-based chemicals, including L-lactic acid, due to its high efficiency and low cost. In this study, a lactic acid-producing bacterium with high tolerance of temperature up to 55 °C was isolated and characterized as Enterococcus faecalis DUT1805. Various strategies of stepwise controlled temperature were proposed and investigated for glucose utilization. The results indicated that E. faecalis DUT 1805 exhibited an optimal temperature at 50 °C, which could achieve temperature compatibility of enzyme, saccharification, and fermentation, and decrease the possibility of contamination by the other microorganisms during the large-scale fermentation. To reduce the cost of raw material and operation for lactic acid production, aging paddy rice with hull (APRH) was used in L-lactic acid production by simultaneous liquefaction, saccharification, and fermentation (SLSF). An open SLSF operation at 50 °C and pH 6.5, and 17% (w/v) solid loading in 5 L bioreactors was demonstrated with the lactic acid titer, yield, and productivity of 73.75 g/L, 87% to initial starch, and 2.17 g/(L h), respectively.


COVID-19 infection with extensive thrombosis: A case of phlegmasia cerulea dolens


It is Time to Address Airborne Transmission of COVID-19


Thalidomide combined with low-dose short-term glucocorticoid in the treatment of critical Coronavirus Disease 2019


title: Use of Baricitinib in Patients with Moderate and Severe COVID-19

text: Cytokine storm and hyperinflammation are associated with increased mortality in COVID-19. In this small uncontrolled cohort of patients with moderate-severe COVID-19, treatment with baricitinib plus hydroxychloroquine was associated with recovery in 11 of 15 patients. Baricitinib for the treatment of COVID-19 should be further investigated in randomized controlled clinical trials.


title: Analysis of RNA sequences of 3636 SARS-CoV-2 collected from 55 countries reveals selective sweep of one virus type

text: Background & objectives: SARS-CoV-2 (Severe acute respiratory syndrome coronavirus-2) is evolving with the progression of the pandemic. This study was aimed to investigate the diversity and evolution of the coronavirus SARS-CoV-2 with progression of the pandemic over time and to identify similarities and differences of viral diversity and evolution across geographical regions (countries). Methods: Publicly available data on type definitions based on whole-genome sequences of the SARS-CoV-2 sampled during December and March 2020 from 3636 infected patients spread over 55 countries were collected. Phylodynamic analyses were performed and the temporal and spatial evolution of the virus was examined. Results: It was found that (i) temporal variation in frequencies of types of the coronavirus was significant; ancestral viruses of type O were replaced by evolved viruses belonging to type A2a; (ii) spatial variation was not significant; with the spread of SARS-CoV-2, the dominant virus was the A2a type virus in every geographical region; (iii) within a geographical region, there was significant micro-level variation in the frequencies of the different viral types, and (iv) the evolved coronavirus of type A2a swept rapidly across all continents. Interpretation & conclusions: SARS-CoV-2 belonging to the A2a type possesses a non-synomymous variant (D614G) that possibly eases the entry of the virus into the lung cells of the host. This may be the reason why the A2a type has an advantage to infect and survive and as a result has rapidly swept all geographical regions. Therefore, large-scale sequencing of coronavirus genomes and, as required, of host genomes should be undertaken in India to identify regional and ethnic variation in viral composition and its interaction with host genomes. Further, careful collection of clinical and immunological data of the host can provide deep learning in relation to infection and transmission of the types of coronavirus genomes.


Asma y EPOC en pacientes hospitalizados por COVID-19./ Asma y EPOC en pacientes hospitalizados por COVID-19./ Asthma and COPD in Hospitalized COVID-19 Patients


Alterations in smell or taste - Classic COVID-19?


Hospital Emergency Management of Emerging Infectious Disease using Instant Communication Technology


Unmask the mind! Importance of video consultations in psychiatry during COVID-19 pandemic


title: Notfällige Neurointerventionen, Covid-19 und Thorax-CT: SOP und Literaturübersicht./ [Acute Neurointerventions, Covid-19 and Chest-CT: SOP and Literature Review]

text: BACKGROUND AND PURPOSE: To analyze standard operating procedures (SOP) of acute stroke imaging and interventions during COVID-19 pandemic with special emphasis on chest CT within a multimodal stroke protocol. METHODS: A questionnaire was distributed via email to members of the Professional Organization of German Neuroradiologists (Berufsverband Deutscher Neuroradiologen e.V.). RESULTS: Answers were received from 25 units: eleven of them acquire chest CT, three in any patient and eight, when COVID-19 is suspected due to body temperature increase, patient's history or when the latter cannot be sufficiently obtained. Preliminary data indicate a high sensitivity and moderate negative predictive value. CONCLUSION: Different SOP reflect an uncertainty whether chest CT should be acquired as part of a multimodal stroke protocol. Accuracy of low dose chest CT cannot be determined yet. The strengths and limitations of chest CT are discussed.


Consideration of Tranexamic Acid Administration to COVID-19 Patients


COVID-19 and Dysfunctional Endothelium: The Mexican Scenario


title: Assessment of bacterial diversity of Rhipicephalus microplus ticks from two livestock agroecosystems in Antioquia, Colombia

text: Rhipicephalus microplus is recognized as a tick species highly prevalent in cattle, with a wide pantropical distribution that seems to continue spreading geographically. However, its role as a biological vector has been scarcely studied in the livestock context. In this study, a 16S rRNA next-generation sequencing analysis was used to determine bacterial diversity in salivary glands and gut of R. microplus from two contrasting livestock agroecosystems in Antioquia, Colombia. Both the culture-independent approach (CI) and the culture-dependent (CD) approach were complementarily adopted in this study. A total of 341 unique OTUs were assigned, the richness showed to be higher in the Northern than in the Middle Magdalena region, and a high diversity was found at the phylum and genus levels in the samples obtained. With the CI approach, Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria were the most common phylum of bacteria regardless of the organ, or geographic origin of the specimens analyzed. While the relative abundance of bacteria at a phylum level with the CD approach varied between analyzed samples, the data obtained suggest that a high diversity of species of bacteria occurs in R. microplus from both livestock agroecosystems. Bacterial genera such as Anaplasma, Coxiella, and Ehrlichia, recognized for their implications in tick-borne diseases, were also detected, together with endosymbionts such as Lysinibacillus, previously reported as a potential tool for biological control. This information is useful to deepen the knowledge about microbial diversity regarding the relations between endosymbionts and pathogens and could facilitate the future development of epidemiological surveillance in livestock systems.


title: Development and Implementation of a COVID-19 Disease Response Protocol at a Large Academic Medical Center

text: In response to the rapid spread of novel coronavirus disease 2019 (COVID-19), health-care systems should establish procedures for early recognition and management of suspected or confirmed cases. We describe the various steps taken for the development, implementation, and dissemination of the interdisciplinary COVID-19 protocol at Jackson Health System (JHS), a complex tertiary academic health system in Miami, Florida. Recognizing the dynamic nature of COVID-19, the protocol addresses the potential investigational treatment options and considerations for special populations. The protocol also includes infection prevention and control measures and routine care for suspected or proven COVID-19 patients.


title: Use of personal protective equipment to protect against respiratory infections in Pakistan: A systematic review

text: Like other low-income countries, limited data are available on the use of personal protective equipment (PPE) in Pakistan. We conducted a systematic review of studies on PPE use for respiratory infections in healthcare settings in Pakistan. MEDLINE, Embase and Goggle Scholar were searched for clinical, epidemiological and laboratory-based studies in English, and 13 studies were included; all were observational/cross-sectional studies. The studies examined PPE use in hospital (n=7), dental (n=4) or laboratory (n=2) settings. Policies and practices on PPE use were inconsistent. Face masks and gloves were the most commonly used PPE to protect from respiratory and other infections. PPE was not available in many facilities and its use was limited to high-risk situations. Compliance with PPE use was low among healthcare workers, and reuse of PPE was reported. Clear policies on the use of PPE and available PPE are needed to avoid inappropriate practices that could result in the spread of infection. Large, multimethod studies are recommended on PPE use to inform national infection-control guidelines.


title: The challenges and considerations of community-based preparedness at the onset of COVID-19 outbreak in Iran, 2020

text: COVID-19 as an emerging disease has spread to 183 countries and territories worldwide as of 20 March 2020. The first COVID-19 case (i.e. the index case) in Iran was observed in the city of Qom on 19 February 2020. One of the cities of Markazi Province is Delijan, which shares a border with Qom. Consequently, COVID-19 has quickly spread in this city because a large population commutes daily between the two cities. This study aimed to report the challenges and considerations of community-based preparedness at the onset of COVID-19 outbreak in a city of Iran in 2020.


title: Hypofractionated radiotherapy alone with 2.4 Gy per fraction for head and neck cancer during the COVID-19 pandemic: The Princess Margaret experience and proposal

text: BACKGROUND: The objective of this study was to identify a subgroup of patients with head and neck squamous cell carcinoma (HNSCC) who might be suitable for hypofractionated radiotherapy (RT-hypo) during the COVID-19 pandemic. METHODS: HNSCC cases (oropharynx/larynx/hypopharynx) treated with definitive RT-hypo (60 Gy in 25 fractions over 5 weeks), moderately accelerated radiotherapy (RT-acc) alone (70 Gy in 35 fractions over 6 weeks), or concurrent chemoradiotherapy (CCRT) during 2005-2017 were included. Locoregional control (LRC) and distant control (DC) after RT-hypo, RT-acc, and CCRT were compared for various subgroups. RESULTS: The study identified 994 human papillomavirus-positive (HPV+) oropharyngeal squamous cell carcinoma cases (with 61, 254, and 679 receiving RT-hypo, RT-acc, and CCRT, respectively) and 1045 HPV- HNSCC cases (with 263, 451, and 331 receiving RT-hypo, RT-acc, and CCRT, respectively). The CCRT cohort had higher T/N categories, whereas the radiotherapy-alone patients were older. The median follow-up was 4.6 years. RT-hypo, RT-acc, and CCRT produced comparable 3-year LRC and DC for HPV+ T1-2N0-N2a disease (seventh edition of the TNM system [TNM-7]; LRC, 94%, 100%, and 94%; P = .769; DC, 94%, 100%, and 94%; P = .272), T1-T2N2b disease (LRC, 90%, 94%, and 97%; P = .445; DC, 100%, 96%, and 95%; P = .697), and T1-2N2c/T3N0-N2c disease (LRC, 89%, 93%, and 95%; P = .494; DC, 89%, 90%, and 87%; P = .838). Although LRC was also similar for T4/N3 disease (78%, 84%, and 88%; P = .677), DC was significantly lower with RT-hypo or RT-acc versus CCRT (67%, 65%, and 87%; P = .005). For HPV- HNSCC, 3-year LRC and DC were similar with RT-hypo, RT-acc, and CCRT in stages I and II (LRC, 85%, 89%, and 100%; P = .320; DC, 99%, 98%, and 100%; P = .446); however, RT-hypo and RT-acc had significantly lower LRC in stage III (76%, 69%, and 91%; P = .006), whereas DC rates were similar (92%, 85%, and 90%; P = .410). Lower LRC in stage III predominated in patients with laryngeal squamous cell carcinoma receiving RT-acc (62%) but not RT-hypo (80%) or CCRT (92%; RT-hypo vs CCRT: P = .270; RT-acc vs CCRT: P = .004). CCRT had numerically higher LRC in comparison with RT-hypo or RT-acc in stage IV (73%, 65%, and 66%; P = .336). CONCLUSIONS: It is proposed that RT-hypo be considered in place of CCRT for HPV+ T1-T3N0-N2c (TNM-7) HNSCCs, HPV- T1-T2N0 HNSCCs, and select stage III HNSCCs during the COVID-19 outbreak.


Intraocular pressure measurement during COVID pandemic


title: Azithromycin added to hydroxychloroquine for patients admitted to intensive care due to coronavirus disease 2019 (COVID-19)-protocol of randomised controlled trial AZIQUINE-ICU

text: BACKGROUND: Novel coronavirus SARS-CoV-2 is known to be susceptible in vitro to exposure to hydroxychloroquine and its effect has been found to be potentiated by azithromycin. We hypothesise that early administration of hydroxychloroquine alone or in combination with azithromycin can prevent respiratory deterioration in patients admitted to intensive care due to rapidly progressive COVID-19 infection. METHODS: Design: Prospective, multi-centre, double-blind, randomised, controlled trial (RCT). PARTICIPANTS: Adult (> 18 years) within 24 h of admission to the intensive care unit with proven or suspected COVID-19 infection, whether or not mechanically ventilated. Exclusion criteria include duration symptoms of febrile disease for ≥ 1 week, treatment limitations in place or moribund patients, allergy or intolerance of any study treatment, and pregnancy. INTERVENTIONS: Patients will be randomised in 1:1:1 ratio to receive Hydroxychloroquine 800 mg orally in two doses followed by 400 mg daily in two doses and azithromycin 500 mg orally in one dose followed by 250 mg in one dose for a total of 5 days (HC-A group) or hydroxychloroquine + placebo (HC group) or placebo + placebo (C-group) in addition to the best standard of care, which may evolve during the trial period but will not differ between groups. Primary outcome is the composite percentage of patients alive and not on end-of-life pathway who are free of mechanical ventilation at day 14. SECONDARY OUTCOMES: The percentage of patients who were prevented from needing intubation until day 14, ICU length of stay, and mortality (in hospital) at day 28 and 90. DISCUSSION: Although both investigational drugs are often administered off label to patients with severe COVID-19, at present, there is no data from RCTs on their safety and efficacy. In vitro and observational trial suggests their potential to limit viral replication and the damage to lungs as the most common reason for ICU admission. Therefore, patients most likely to benefit from the treatment are those with severe but early disease. This trial is designed and powered to investigate whether the treatment in this cohort of patients leads to improved clinical patient-centred outcomes, such as mechanical ventilation-free survival. TRIAL REGISTRATION: Clinical trials.gov: NCT04339816 (Registered on 9 April 2020, amended on 22 June 2020); Eudra CT number: 2020-001456-18 (Registered on 29 March 2020).


Compensation for occupationally acquired COVID-19


title: Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks

text: Detailed data on clinical presentations and outcomes of children with COVID-19 in Europe are still lacking. In this descriptive study, we report on 130 children with confirmed COVID-19 diagnosed by 28 centers (mostly hospitals), in 10 regions in Italy, during the first months of the pandemic. Among these, 67 (51.5%) had a relative with COVID-19 while 34 (26.2%) had comorbidities, with the most frequent being respiratory, cardiac, or neuromuscular chronic diseases. Overall, 98 (75.4%) had an asymptomatic or mild disease, 11 (8.5%) had moderate disease, 11 (8.5%) had a severe disease, and 9 (6.9%) had a critical presentation with infants below 6 months having significantly increased risk of critical disease severity (OR 5.6, 95% CI 1.3 to 29.1). Seventy-five (57.7%) children were hospitalized, 15 (11.5%) needed some respiratory support, and nine (6.9%) were treated in an intensive care unit. All recovered.Conclusion:This descriptive case series of children with COVID-19, mostly encompassing of cases enrolled at hospital level, suggest that COVID-19 may have a non-negligible rate of severe presentations in selected pediatric populations with a relatively high rates of comorbidities. More studies are needed to further understand the presentation and outcomes of children with COVID-19 in children with special needs. What is Known: â¢ There is limited evidence on the clinical presentation and outcomes of children with COVID-19 in Europe, and almost no evidence on characteristics and risk factors of severe cases. What is New: â¢ Among a case series of 130 children, mostly diagnosed at hospital level, and with a relatively high rate (26.2%) of comorbidities, about three-quarter had an asymptomatic or mild disease. â¢ However, 57.7% were hospitalized, 11.5% needed some respiratory support, and 6.9% were treated in an intensive care unit.


The role of transplant during a pandemic


Delirium: a missing piece in the COVID-19 pandemic puzzle


title: Association Between Hypoxemia and Mortality in Patients With COVID-19

text: OBJECTIVE: To identify markers associated with in-hospital death in patients with coronavirus disease 2019 (COVID-19)-associated pneumonia. PATIENTS AND METHODS: A retrospective cohort study was conducted of 140 patients with moderate to critical COVID-19-associated pneumonia requiring oxygen supplementation admitted to the hospital from January 28, 2020, through February 28, 2020, and followed up through March 13, 2020, in Union Hospital, Wuhan, China. Oxygen saturation (SpO2) and other measures were tested as predictors of in-hospital mortality in survival analysis. RESULTS: Of 140 patients with COVID-19-associated pneumonia, 72 (51.4%) were men, with a median age of 60 years. Patients with SpO2 values of 90% or less were older and were more likely to be men, to have hypertension, and to present with dyspnea than those with SpO2 values greater than 90%. Overall, 36 patients (25.7%) died during hospitalization after median 14-day follow-up. Higher SpO2 levels after oxygen supplementation were associated with reduced mortality independently of age and sex (hazard ratio per 1-U SpO2, 0.93; 95% CI, 0.91 to 0.95; P<.001). The SpO2 cutoff value of 90.5% yielded 84.6% sensitivity and 97.2% specificity for prediction of survival. Dyspnea was also independently associated with death in multivariable analysis (hazard ratio, 2.60; 95% CI, 1.24 to 5.43; P=.01). CONCLUSION: In this cohort of patients with COVID-19, hypoxemia was independently associated with in-hospital mortality. These results may help guide the clinical management of patients with severe COVID-19, particularly in settings requiring strategic allocation of limited critical care resources. TRIAL REGISTRATION: Chictr.org.cn Identifier: ChiCTR2000030852.


Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is likely to be androgen mediated


title: Self-reported symptoms of SARS-CoV-2 infection in a non-hospitalized population: results from the large Italian web-based EPICOVID19 cross-sectional survey

text: BACKGROUND: Understanding the occurrence of Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2)-like symptoms in a large non-hospitalized population, when the epidemic peak was occurring in Italy, is of paramount importance but data are scarce. OBJECTIVE: Aims of this study were to evaluate the association of self-reported symptoms with SARS-CoV-2 nasopharyngeal swab (NPS) test in non-hospitalized individuals and to estimate the occurrence of COVID-19-like symptoms in a larger non-tested population. METHODS: This is an Italian countrywide self-administered cross-sectional web-based survey on voluntary adults who completed an anonymous questionnaire in the period 13-21 April 2020. The associations between symptoms potentially related to SARS-CoV-2 infection and NPS results were calculated as adjusted odds ratios with 95% confidence intervals (aOR, 95%CI) by means of multiple logistic regression analysis controlling for age, sex, education, smoking habits, and the number of co-morbidities. Thereafter, for each symptom and for their combination, we calculated sensitivity, specificity, accuracy and AUC in a ROC analysis to estimate the occurrence of COVID-19-like infections in the non-tested population. RESULTS: A total of 171,310 responded to the survey (59.9% females, mean age 47.4 years). Out of the 4,785 respondents with known NPS test result, 4,392 were not hospitalized. Among them, the NPS positive respondents (n=856) most frequently reported myalgia (61.6%), olfactory and/or taste disorders (OTDs, 59.2%), cough (54.4%), and fever (51.9%) whereas 7.7% were asymptomatic. Multiple regression analysis showed that OTDs (aOR 10.3, [95%CI 8.4-12.7]), fever (2.5, 95%CI 2.0-3.1), myalgia (1.5, 95%CI 1.2-1.8), and cough (1.3, 95%CI 1.0-1.6) were associated with NPS positivity. Having two to four of these symptoms increased the aOR from 7.4 (95%CI, 5.6-9.7) to 35.5 (95%CI, 24.6-52.2). The combination of the four symptoms showed an AUC of 0.810 (95%CI 0.795-0.825) in classifying NPS-P, and was applied to the non-hospitalized and non-tested sample (n=165,782). We found that from 4.4% to 12.1% of respondents had experienced symptoms suggestive of COVID-19 infection. CONCLUSIONS: Our results suggest that self-reported symptoms may be reliable indicators of SARS-CoV-2 infection in a pandemic context. A not negligible part (up to 12.1%) of the symptomatic respondents were left undiagnosed and potentially contributed to the spread of the infection.


title: Critical Differences between the Binding Features of the Spike Proteins of SARS-CoV-2 and SARS-CoV

text: The COVID-19 caused by SARS-CoV-2 has spread globally and caused tremendous loss of lives and properties, and it is of utmost urgency to understand its propagation process and to find ways to slow down the epidemic. In this work, we used a coarse-grained model to calculate the binding free energy of SARS-CoV-2 or SARS-CoV to their human receptor ACE2. The investigation of the free energy contribution of the interacting residues indicates that the residues located outside the receptor binding domain are the source of the stronger binding of the novel virus. Thus, the current results suggest that the essential evolution of SARS-CoV-2 happens remotely from the binding domain at the spike protein trimeric body. Such evolution may facilitate the conformational change and the infection process that occurs after the virus is bound to ACE2. By studying the binding pattern between SARS-CoV antibody m396 and SARS-CoV-2, it is found that the remote energetic contribution is missing, which might explain the absence of cross-reactivity of such antibodies.


title: How the COVID-19 pandemic changed cellular therapy at Columbia University Irving Medical Center/NewYork-Presbyterian Hospital

text: New York is at the epicenter of the coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus. Columbia University Irving Medical Center/NewYork-Presbyterian Hospital (CUIMC/NYPH) had to make changes to its cellular therapy operations to ensure patient, donor, and staff safety and well-being. In this article, we discuss the process changes we instituted for cellular therapy clinical care, collection, processing, and cryopreservation to cope with the rapidly evolving pandemic.


Severe bleeding in a patient with factor XIII deficiency and COVID-19


title: A comparison study of SARS-CoV-2 IgG antibody between male and female COVID-19 patients: A possible reason underlying different outcome between sex

text: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China at the end of 2019 has spread throughout the world and caused many thousands of deaths. The previous study reported a higher severe status rate and mortality rate in male patients in China. However, the reason underlying this difference has not been reported. The convalescent plasma containing a high level of SARS-CoV-2 immunoglobulin G (IgG) antibody has been used in clinical therapy and achieved good effects in China. In this study, to compare the differences of the SARS-CoV-2 IgG antibody between male and female patients, a total number of 331 patients confirmed SARS-CoV-2 infection were enrolled. The serum of these patients was collected during hospitalization and detected for the SARS-CoV-2 IgG antibody. Our data showed that the concentration of IgG antibody in mild, general, and recovering patients showed no difference between male and female patients. In severe status, compared with male patients, there were more female patients having a relatively high concentration of serum SARS-CoV-2 IgG antibody. In addition, the generation of IgG antibody in female patients was stronger than male patients in disease early phase. Our study identified a discrepancy in the SARS-CoV-2 IgG antibody level in male and female patients, which may be a potential cause leading to a different outcome of Coronavirus Disease 2019 between sex.


title: TweetsCOV19 -- A Knowledge Base of Semantically Annotated Tweets about the COVID-19 Pandemic

text: Publicly available social media archives facilitate research in the social sciences and provide corpora for training and testing a wide range of machine learning, NLP and information retrieval methods. With respect to the recent outbreak of COVID-19, online discourse on Twitter reflects public opinion and perception related to the pandemic itself as well as mitigating measures and their societal impact. Understanding such discourse, its evolution and interdependencies with real-world events or (mis)information can foster valuable insights. On the other hand, such corpora are crucial facilitators for computational methods addressing tasks such as sentiment analysis, event detection or entity recognition. However, obtaining, archiving and semantically annotating large amounts of tweets is costly. In this paper, we describe TweetsCOV19, a publicly available knowledge base of currently more than 8 million tweets, spanning the period Oct'19-Apr'20. Metadata about the tweets as well as extracted entities, hashtags, user mentions, sentiments, and URLs are exposed using established RDF/S vocabularies, providing an unprecedented knowledge base for a range of knowledge discovery tasks. Next to a description of the dataset and its extraction and annotation process, we present an initial analysis, use cases and usage of the corpus.


title: Older Workers in the Time of COVID-19: The Senior Community Service Employment Program and Implications for Social Work

text: It has long been the goal of many gerontological social work scholars to increase the ability and opportunity for people to be engaged in paid and unpaid work throughout the life course. Yet the COVID-19 pandemic is revealing and exacerbating the financial insecurity of many older adults. In this paper, we review information related to older workers and how they might be affected by this pandemic and its aftermath, paying particular attention to the most socioeconomically and physically vulnerable older workers. We also offer first-hand experiences from our careers working with and conducting scholarship on older workers, paying particular attention to recent actions by many in the Senior Community Service Employment Program (SCSEP) network to provide paid sick leave to its low-income, older adult participants. We conclude with implications for social work scholarship and teaching, noting the uptick in technology use among older adults and the disparities that remain, as well as teaching that integrates discussions on the lifelong and cumulative effects of inequalities and marginalization and the need for additional researcher, student, and community collaborations.


Estimation of the COVID-19 burden in Egypt through exported case detection


title: Assessment of Health Information About COVID-19 Prevention on the Internet: Infodemiological Study

text: BACKGROUND: The internet is a large source of health information and has the capacity to influence its users. However, the information found on the internet often lacks scientific rigor, as anyone may upload content. This factor is a cause of great concern to scientific societies, governments, and users. OBJECTIVE: The objective of our study was to investigate the information about the prevention of coronavirus disease 2019 (COVID-19) on the internet. METHODS: On February 29, 2020, we performed a Google search with the terms "Prevention coronavirus," "Prevention COVID-19," "Prevención coronavirus," and "Prevención COVID-19". A univariate analysis was performed to study the association between the type of authorship, country of publication, and recommendations to avoid COVID-19 according to the World Health Organization (WHO). RESULTS: In total, 80 weblinks were reviewed. Most of them were produced in the United States and Spain (n=58, 73%) by digital media sources and official public health organizations (n=60, 75%). The most mentioned WHO preventive measure was "wash your hands frequently" (n=65, 81%). A less frequent recommendation was to "stay home if you feel unwell" (n=26, 33%). The analysis by type of author (official public health organizations versus digital media) revealed significant differences regarding the recommendation to wear a mask when you are healthy only if caring for a person with suspected COVID-19 (odds ratio [OR] 4.39). According to the country of publication (Spain versus the United States), significant differences were detected regarding some recommendations such as "wash your hands frequently" (OR 9.82), "cover your mouth and nose with your bent elbow or tissue when you cough or sneeze" (OR 4.59), or "stay home if you feel unwell" (OR 0.31). CONCLUSIONS: It is necessary to urge and promote the use of the websites of official public health organizations when seeking information on COVID-19 preventive measures on the internet. In this way, users will be able to obtain high-quality information more frequently, and such websites may improve their accessibility and positioning, given that search engines justify the positioning of links obtained in a search based on the frequency of access to them.


The Ambient Ozone and COVID-19 Transmissibility in China: A Data-Driven Ecological Study of 154 Cities


title: Monitoring COVID-19 social distancing with person detection and tracking via fine-tuned YOLO v3 and Deepsort techniques

text: The rampant coronavirus disease 2019 (COVID-19) has brought global crisis with its deadly spread to more than 180 countries, and about 3,519,901 confirmed cases along with 247,630 deaths globally as on May 4, 2020. The absence of any active therapeutic agents and the lack of immunity against COVID-19 increases the vulnerability of the population. Since there are no vaccines available, social distancing is the only feasible approach to fight against this pandemic. Motivated by this notion, this article proposes a deep learning based framework for automating the task of monitoring social distancing using surveillance video. The proposed framework utilizes the YOLO v3 object detection model to segregate humans from the background and Deepsort approach to track the identified people with the help of bounding boxes and assigned IDs. The results of the YOLO v3 model are further compared with other popular state-of-the-art models, e.g. faster region-based CNN (convolution neural network) and single shot detector (SSD) in terms of mean average precision (mAP), frames per second (FPS) and loss values defined by object classification and localization. Later, the pairwise vectorized L2 norm is computed based on the three-dimensional feature space obtained by using the centroid coordinates and dimensions of the bounding box. The violation index term is proposed to quantize the non adoption of social distancing protocol. From the experimental analysis, it is observed that the YOLO v3 with Deepsort tracking scheme displayed best results with balanced mAP and FPS score to monitor the social distancing in real-time.


title: Common genetic variation in obesity, lipid transfer genes and risk of Metabolic Syndrome: Results from IDEFICS/I.Family study and meta-analysis

text: As the prevalence of metabolic syndrome (MetS) in children and young adults is increasing, a better understanding of genetics that underlie MetS will provide critical insights into the origin of the disease. We examined associations of common genetic variants and repeated MetS score from early childhood to adolescence in a pan-European, prospective IDEFICS/I.Family cohort study with baseline survey and follow-up examinations after two and six years. We tested associations in 3067 children using a linear mixed model and confirmed the results with meta-analysis of identified SNPs. With a stringent Bonferroni adjustment for multiple comparisons we obtained significant associations(p < 1.4 × 10-4) for 5 SNPs, which were in high LD (r2 > 0.85) in the 16q12.2 non-coding intronic chromosomal region of FTO gene with strongest association observed for rs8050136 (effect size(ß) = 0.31, pWald = 1.52 × 10-5). We also observed a strong association of rs708272 in CETP with increased HDL (p = 5.63 × 10-40) and decreased TRG (p = 9.60 × 10-5) levels. These findings along with meta-analysis advance etiologic understanding of childhood MetS, highlighting that genetic predisposition to MetS is largely driven by genes of obesity and lipid metabolism. Inclusion of the associated genetic variants in polygenic scores for MetS may prove to be fundamental for identifying children and subsequently adults of the high-risk group to allow earlier targeted interventions.


On the molecular determinants of the SARS-CoV-2 attack


COVID-19 and (hydroxy)chloroquine-azithromycin combination: Should we take the risk for our patients?


title: Leverage structure and stock price synchronicity: Evidence from China

text: This paper investigate the impact of leverage structure on stock price synchronicity. To better understand the mechanism of the impact of leverage, we break leverage into operating leverage and financing leverage. This breakdown reveals the impact of different component of leverage. Moreover, in this paper, we employ the quantile regression model to investigate the impact of leverage on different level of stock price synchronicity, which provides us a more comprehensive picture. Our empirical results show, operating and financing leverage have negative impact on stock price synchronicity. Moreover, the higher the stock price synchronicity becomes, the higher this impact is. Furthermore, the marginal effect of financing leverage will be attenuated as the profitability of firms becomes higher, but the interaction effect doesn't exist for operating leverage. On the contrary, the marginal effect of financing leverage will be enhanced as the market capitalization of firms becomes larger, again, it doesn't exist for operating leverage. Finally, as firms are state-owned, the marginal effect of both operating and financing leverage will be higher.


title: Using liquid chromatography mass spectrometry (LC-MS) to assess the effect of age, high-fat diet, and rat strain on the liver metabolome

text: The goal of this study was to use liquid chromatography mass spectrometry to assess metabolic changes of two different diets in three distinct rat strains. Sprague-Dawley, Fischer 344, and Brown-Norway male rats were maintained on a high-fat, or regular diet for 24 weeks. Liver tissue was collected at 4, 12, and 24 weeks to assess global small molecule metabolite changes using high resolution accurate mass spectrometry coupled to ultra-high-performance liquid chromatography. The results of the global metabolomics analysis revealed significant changes based on both age and diet within all three strains. Principal component analysis revealed that the influence of diet caused a greater variation in significantly changing metabolites than that of age for the Brown Norway and Fisher 344 strains, whereas diet had the greatest influence in the Sprague Dawley strain only at the 4-week time point. As expected, metabolites involved in lipid metabolism were changed in the animals maintained on a high fat diet compared to the regular diet. There were also significant changes observed in the concentration of Tri carboxylic acid cycle intermediates that were extracted from the liver of all three strains based on diet. The results of this study showed that a high fat diet caused significant liver and metabolic changes compared to a regular diet in multiple rat strains. The inbred Fisher 344 and Brown Norway rats were more metabolically sensitive to the diet changes than outbred Sprague Dawley strain. The study also showed that age, as was the case for Sprague Dawley, is an important variable to consider when assessing metabolic changes.


title: Incidence of thrombotic complications in critically ill ICU patients with COVID-19

text: INTRODUCTION: COVID-19 may predispose to both venous and arterial thromboembolism due to excessive inflammation, hypoxia, immobilisation and diffuse intravascular coagulation. Reports on the incidence of thrombotic complications are however not available. METHODS: We evaluated the incidence of the composite outcome of symptomatic acute pulmonary embolism (PE), deep-vein thrombosis, ischemic stroke, myocardial infarction or systemic arterial embolism in all COVID-19 patients admitted to the ICU of 2 Dutch university hospitals and 1 Dutch teaching hospital. RESULTS: We studied 184 ICU patients with proven COVID-19 pneumonia of whom 23 died (13%), 22 were discharged alive (12%) and 139 (76%) were still on the ICU on April 5th 2020. All patients received at least standard doses thromboprophylaxis. The cumulative incidence of the composite outcome was 31% (95%CI 20-41), of which CTPA and/or ultrasonography confirmed VTE in 27% (95%CI 17-37%) and arterial thrombotic events in 3.7% (95%CI 0-8.2%). PE was the most frequent thrombotic complication (n = 25, 81%). Age (adjusted hazard ratio (aHR) 1.05/per year, 95%CI 1.004-1.01) and coagulopathy, defined as spontaneous prolongation of the prothrombin time > 3 s or activated partial thromboplastin time > 5 s (aHR 4.1, 95%CI 1.9-9.1), were independent predictors of thrombotic complications. CONCLUSION: The 31% incidence of thrombotic complications in ICU patients with COVID-19 infections is remarkably high. Our findings reinforce the recommendation to strictly apply pharmacological thrombosis prophylaxis in all COVID-19 patients admitted to the ICU, and are strongly suggestive of increasing the prophylaxis towards high-prophylactic doses, even in the absence of randomized evidence.


Social psychological theory and research on the novel coronavirus disease (COVID-19) pandemic: Introduction to the rapid response special section


title: Massive viral replication and cytopathic effects in early COVID-19 pneumonia

text: SARS-CoV-2 is the cause of COVID-19 acute respiratory illness that like its predecessors, MERS and SARS, can be severe and fatal 1-4. By April of 2020, COVID-19 infections had become a worldwide pandemic with nearly 3 million infections and over 200,000 deaths. The relative contributions of virus replication and cytopathic effects or immunopathological host responses to the severe and fatal outcomes of COVID-19 lung infections have as yet to be determined. Here we show that SARS-CoV-2 replication and cytopathic effects in type II alveolar pneumocytes causes focal lung injury in an individual with no history of pulmonary symptoms. These findings point to the potential benefit of early effective antiviral treatment to prevent progression to severe and fatal COVID-19 pneumonia.


Propagation by COVID-19 at high altitude: Cusco case


title: Urban Intelligence for Pandemic Response: Viewpoint

text: Previous epidemic management research proves the importance of city-level information, but also highlights limited expertise in urban data applications during a pandemic outbreak. In this paper, we provide an overview of city-level information, in combination with analytical and operational capacity, that define urban intelligence for supporting response to disease outbreaks. We present five components (movement, facilities, people, information, and engagement) that have been previously investigated but remain siloed to successfully orchestrate an integrated pandemic response. Reflecting on the coronavirus disease (COVID-19) outbreak that was first identified in Wuhan, China, we discuss the opportunities, technical challenges, and foreseeable controversies for deploying urban intelligence during a pandemic. Finally, we emphasize the urgency of building urban intelligence through cross-disciplinary research and collaborative practice on a global scale.


title: Pipeline for Advanced Contrast Enhancement (PACE) of chest X-ray in evaluating COVID-19 patients by combining bidimensional empirical mode decomposition and CLAHE

text: COVID-19 is a new pulmonary disease which is driving stress to the hospitals due to the large number of cases worldwide. Imaging of lungs can play a key role in monitoring of the healthy status. Non-contrast chest computed tomography (CT) has been used for this purpose, mainly in China, with a significant success. However, this approach cannot be used massively mainly for both high risk and cost and in some countries also because this tool is not extensively available. Alternatively, chest X-ray, although less sensitive than CT-scan, can provide important information about the evolution of pulmonary involvement during the disease, this aspect is very important to verify the response of a patient to treatments. Here, we show how to improve the sensitivity of chest X-ray via a nonlinear post processing tool, named PACE, combining properly fast and adaptive bidimensional empirical mode decomposition and contrast limited adaptive histogram equalization (CLAHE). The results show an enhancement of the image contrast as confirmed by three widely used metrics: (i) contrast improvement index, (ii) entropy, and (iii) measure of enhancement. This improvement gives rise to a detectability of more lung lesions as identified by two radiologists, which evaluate the images separately, and confirmed by CT-scans. Based on our findings this method is proved as a flexible and effective way for medical image enhancement and can be used as a post-processing step for medical image understanding and analysis.


title: Analysis of clinical features of 153 patients with novel coronavirus pneumonia in Chongqing/ 中华临床感染病杂志

text: Objective@#To analyze the clinical data of 153 patients with novel coronavirus pneumonia (COVID-19) in chongqing ,and provide reference and thinking for the diagnosis and treatment.@*Methods@#Analyze the clinical data, laboratory examination and chest imaging characteristics of 153 COVID-19 patients in Chongqing Public Health Medical Center from January 26 to February 5, 2020. According to the relevant diagnostic criteria ,patients were divided into non-severe group(n=132) and severe group(n=21),and analyze the correlation between serum index changes and disease severity.@*Results@#Combined with diabetes and chronic respiratory diseases, the severity of the disease was statistically significant (χ2=11.04和6.94, P<0.05). No symptoms were found in patients with mild illness (χ2=4.09, P<0.05) .The proportion of fever and muscle soreness in the severe group was higher than that in the non-severe group (χ2=4.40 and 22.67,P<0.05).Among the concomitant symptoms, the proportion of cough and shortness of breath in the severe group was higher than that in the non-severe group (χ2=8.46 and 4.80,P<0.05).C-reactive protein and d-dimer were higher in the severe group than in the non-severe group (t=43.44 and 37.13, P<0.05), and the number of CD3+T lymphocyte cells, CD4+T lymphocyte cells and CD8+T lymphocyte cells in the severe group was lower than that in the non-severe group (Z=27.25, 20.60 and 17.36, P<0.05).Compared with the non-severe group, both lungs and the right lung lower lobe were more susceptible to involved (χ2=6.95和20.39, P<0.05) .@*Conclusion@#Severity of COVID-19 was associated with underlying disease, symptoms, site of involvement, C-reactive protein, d-dimer, CD3+T lymphocyte count, CD4+T lymphocyte count, and CD8+T lymphocyte count.


title: Coronavirus Disease 2019 in Newborns and Very Young Infants: a Series of Six Patients in France

text: We present here a series of 6 infants hospitalized for coronavirus disease 2019 infection from March 14 to March 30, 5 of them are newborns. All 6 patients presented with fever, it was the main symptom for all of them. Only one of them needed oxygen; the others were hospitalized for surveillance but did not need specific care. In our series, coronavirus disease 2019 infection is mostly mild in neonates.


title: Face masks for all and all for face masks in the COVID-19 pandemic: community level production to face the global shortage and shorten the epidemic

text: The current COVID-19 pandemic caused a global shortage of medical masks, leaving most exposed health personnel without appropriate protection.Since the beginning of the outbreak, the WHO has revised several times the recommendations on general use of facemasks. In various countries, the public was advised to wear facemasks, in order to ensure them to healthcare workers. Until recently, WHO recommended to limit the use of facemasks to symptomatic people and advised against off-standard solutions. Moreover, recommendations differ among and within countries, causing public confusion and individual initiative.There is wide consensus that universal appropriate use of masks may contribute both to contain the epidemic and to reduce the burden on national procurement, if a community production approach is followed. Especially in low-middle income countries, due to the scarce capacity of national industrial production or import, the use of masks produced at community level may become the only viable option.For the purpose ad hoc guidelines will be needed.Current knowledge and experience call for further and updated review of global and national guidelines in order to provide clear and consistent criteria to ensure the widest availability and appropriate use of facial protection, bearing in mind populations in socio-economic disadvantaged settings.


title: COVID-19, Australia: Epidemiology Report 13 (Reporting week to 23:59 AEST 26 April 2020)

text: Confirmed cases in Australia notified up to 26 April 2020: notifications = 6,711; deaths = 77. The reduction in international travel and domestic movement, social distancing measures and public health action have likely slowed the spread of COVID-19 in Australia. Notifications in Australia remain predominantly among people with recent overseas travel, with some locally-acquired cases being detected. Most locally-acquired cases can be linked back to a confirmed case, with a small portion unable to be epidemiologically linked to another case. The ratio of overseas-acquired cases to locally-acquired cases varies by jurisdiction. The crude case fatality rate (CFR) in Australia remains low (1.1%) compared to the World Health Organization's globally-reported rate (6.9%) and to other comparable high-income countries such as the United States of America (5.1%) and the United Kingdom (13.7%). The lower CFR in Australia is likely reflective of high case ascertainment including detection of mild cases. High case ascertainment and prompt identification of contacts enables an effective public health response and a reduction of disease transmission. Internationally, cases continue to increase. The rates of increase have started to slow in several regions, although it is too soon to tell whether this trend will be sustained. Interpretation of international epidemiology should be conducted with caution as it differs from country to country depending not only on the disease dynamics, but also on differences in case detection, testing and implemented public health measures.


Rationing of Medical Supplies, Including Ventilators, for Patients With Kidney Disease


The importance of detection and percutaneous closure of patent foramen ovale during the coronavirus disease 2019 pandemic. Authors' reply


Cardiac Troponin-I may be a predictor of complications and mortality in COVID-19 patients


title: Ultrafast physical bacterial inactivation and photocatalytic self-cleaning of ZnO nanoarrays for rapid and sustainable bactericidal applications

text: Various nanostructured surfaces have been developed recently to physically inactivate bacteria, for reducing the rapidly spreading threat of pathogenic bacteria. However, it generally takes several hours for these surfaces to inactivate most of the bacteria, which greatly limits their application in the fields favoring rapid bactericidal performance. Besides, the accumulated bacteria debris left on these surfaces is rarely discussed in the previous reports. Herein we report the nanotip-engineered ZnO nanoarrays (NAs) with ultrafast physical bactericidal rate and the ability to photocatalytically remove the bacteria debris. Neither chemical (Zn2+ or reactive oxygen species) nor photocatalytic effect leads to the ultrafast bactericidal rate, where 97.5% of E. coli and 94.9% of S. aureus are inactivated within only 1 min. The simulation analysis further supported our proposed mechanism attributing the ultrafast bactericidal activity to the great stress enabled by the uneven topography. Moreover, the re-exposure of the ZnO NAs nanotips can be achieved in only 10 min under a mild UV light source. This study not only presents an ultrafast physical bactericidal activity, but also demonstrates the potential of the recyclable and photocatalytic self-cleaning functions of theses surfaces for applications that desire rapid and sustainable bactericidal performance.


title: Rapid implementation and validation of a cold-chain free SARS-CoV-2 diagnostic testing workflow to support surge capacity

text: BACKGROUND: In January 2020 reports of unidentified severe respiratory illness were described in Wuhan, China. A rapid expansion in cases affecting most countries around the globe led to major changes in the way people live their daily lives. In the United Kingdom, the Department of Health and Social Care directed healthcare providers to establish additional resources to manage the anticipated surge in cases that could overwhelm the health services. A priority area was testing for SARS-CoV-2 RNA and its detection by qualitative RT-PCR. DESIGN: A laboratory workflow twinning research environment with clinical laboratory capabilities was implemented and validated in the University of Birmingham within 4 days of the project initiation. The diagnostic capability was centred on an IVD CE-marked RT-PCR kit and designed to provide surge capacity to the nearby Queen Elizabeth Hospital. The service was initially tasked with testing healthcare workers (HCW) using throat swabs, and subsequently the process investigated the utility of using saliva as an alternative sample type. RESULTS: Between the 8th April 2020 and the 30th April 2020, the laboratory tested a total of 1282 HCW for SARS-CoV-2 RNA in throat swabs. RNA was detected in 54 % of those who reported symptoms compatible with COVID-19, but in only 4% who were asymptomatic. CONCLUSION: This capability was established rapidly and utilised a cold-chain free methodology, applicable to a wide range of settings, and which can provide surge capacity and support to clinical laboratories facing increasing pressure during periods of national crisis.


title: [Lung Cancer and Respiratory Infections]

text: The frequency of respiratory infections as an infection in cancer patients is high. Several factors increase the risk of respiratory infections in cancer patients. These include airway obstruction, disruption of mucosal surfaces and treatment-related factors, such as radiation and chemotherapy. It has also been reported that the frequency and mortality of drug-induced lung injury associated with antineoplastic drugs are high in Japan. In the diagnosis and treatment of drug-induced lung disease, it is important to distinguish pneumonia as an infectious disorder. Immune checkpoint inhibitors(ICIs)have been widely introduced to treat several types of malignancies. It is currently believed that ICIs do not increase the risk of infections. However, immune-related adverse events(irAEs)induced by ICIs may necessitate the administration of immunosuppressive agents, which could cause opportunistic infections. Furthermore, several reports describe reactivation tuberculosis without irAEs or immunosuppressants. Further studies are needed to prevent the development of tuberculosis in patients receiving ICIs.


title: Coronavirus Disease 2019 (COVID-19) and Neurosurgery: Literature and Neurosurgical Societies Recommendations Update

text: BACKGROUND: Since January 2020, when the pathogen causing the coronavirus disease was identified in humans, the literature on coronavirus disease 2019 (COVID-19) has grown exponentially to more than 4000 publications. There is the need to provide an update for each single medical discipline, including neurosurgery, to be used by single professionals or to be distributed through the neurosurgical community and to be used by governments in designing new scenario of care. METHODS: A review of the MEDLINE database was performed on April 13, 2020. Search terms included "COVID-19," "neurosurgery," and "surgery." A review of documents published on the webpage of the WFNS (World Federation of Neurosurgical Societies) and of the 5 continental associations of neurosurgical societies, AANS (American Association of Neurological Surgeons), AASNS (Asian Australasian Society of Neurological Surgeons), CAANS (Continental Association of African Neurosurgical Societies), EANS (European Association of Neurosurgical Societies), and FLANC (Latin American Federation of Neurosurgical Societies), representing the 119 national neurosurgical societies around the world, was performed. RESULTS: The literature search yielded 38 results that were manually reviewed. Fourteen manuscripts were considered eligible. They described suggestions and considerations to optimize care of neurosurgical patients, editorials on operational models, perspectives from neurosurgical departments, letters to the editor describing experiences on how to help medical staff to be prepared in advance for pandemic situations, and descriptions of regional or departmental models and/or organizational schemes. The webpages of the searched societies reported a total of 57 documents. CONCLUSIONS: The neurosurgical scientific community has promptly reacted to the COVID-19 outbreak by producing a growing number of documents that could serve as guidance for neurosurgeons all over the world. Neurosurgical societies will represent the key institutions for guiding the neurosurgical community to overcome the COVID-19 crisis.


Heroism in the Face of the COVID-19 Pandemic


title: Coronaviruses widespread on nonliving surfaces: important questions and promising answers

text: The world is facing, while writing this review, a global pandemic due to one of the types of the coronaviruses (i.e., COVID-19), which is a new virus. Among the most important reasons for the transmission of infection between humans is the presence of this virus active on the surfaces and materials. Here, we addressed important questions such as do coronaviruses remain active on the inanimate surfaces? Do the types of inanimate surfaces affect the activity of coronaviruses? What are the most suitable ingredients that used to inactivate viruses? This review article addressed many of the works that were done in the previous periods on the survival of many viruses from the coronaviruses family on various surfaces such as steel, glass, plastic, Teflon, ceramic tiles, silicon rubber and stainless steel copper alloys, Al surface, sterile sponges, surgical gloves and sterile latex. The impacts of environmental conditions such as temperature and humidity were presented and discussed. The most important active ingredients that can deactivate viruses on the surfaces were reported here. We hope that these active ingredients will have the same effect on COVID-19.


title: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Seropositive Camel Handlers in Kenya

text: Middle East respiratory syndrome (MERS) is a respiratory disease caused by a zoonotic coronavirus (MERS-CoV). Camel handlers, including slaughterhouse workers and herders, are at risk of acquiring MERS-CoV infections. However, there is limited evidence of infections among camel handlers in Africa. The purpose of this study was to determine the presence of antibodies to MERS-CoV in high-risk groups in Kenya. Sera collected from 93 camel handlers, 58 slaughterhouse workers and 35 camel herders, were screened for MERS-CoV antibodies using ELISA and PRNT. We found four seropositive slaughterhouse workers by PRNT. Risk factors amongst the slaughterhouse workers included being the slaughterman (the person who cuts the throat of the camel) and drinking camel blood. Further research is required to understand the epidemiology of MERS-CoV in Africa in relation to occupational risk, with a need for additional studies on the transmission of MERS-CoV from dromedary camels to humans, seroprevalence and associated risk factors.


title: A case report of progressive multifocal leukoencephalopathy during steroid treatment for ANCA-associated renal vasculitis

text: CASE REPORT: an 80-year-old woman presented with rapidly progressive glomerulonephritis and was admitted to our hospital. Myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA) was positive. We diagnosed ANCA-associated renal vasculitis (ANCA-RV). Treatment was initiated with intravenous methylprednisolone pulse therapy, followed by prednisolone (PSL) at 30 mg/day. We gradually reduced the PSL dose to 7.5 mg/day over 6 months. At that time, the patient developed disturbances of consciousness which progressed subacutely. MRI revealed regions of patchy white matter with an increased signal on T2-weighted, fluid attenuated inversion recovery (FLAIR) sequences and diffusion-weighted sequences. JC virus DNA was detected in the cerebrospinal fluid (CSF) by polymerase chain reaction (PCR), leading to a diagnosis of progressive multifocal leukoencephalopathy (PML). PML is a rare infectious demyelinating disease of the central nervous system caused by JC virus infection, occurring in highly immunosuppressed individuals such as HIV-infected patients and patients using some biological agents, and having a very poor prognosis. In the present case, PML may have been associated with steroid use, although there are very few case reports of PML in patients taking only steroids. We report progressive multifocal leukoencephalopathy during steroid treatment of ANCA-RV. When patients show progressive disturbance of consciousness during treatment for ANCA-RV, we need to take PML into consideration for differential diagnosis.


title: Weathering the Cytokine Storm in COVID-19: Therapeutic Implications

text: BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recently emerged in Wuhan, Hubei-China, as responsible for the coronavirus disease 2019 (COVID-19) and then spread rapidly worldwide. While most individuals remain asymptomatic or develop only mild symptoms, approximately 5% develop severe forms of COVID-19 characterized by acute respiratory distress syndrome (ARDS) and multiple-organ failure (MOF) that usually require intensive-care support and often yield a poor prognosis. SUMMARY: The pathophysiology of COVID-19 is far from being completely understood, and the lack of effective treatments leads to a sense of urgency to develop new therapeutic strategies based on pathophysiological assumptions. The exaggerated cytokine release in response to viral infection, a condition known as cytokine release syndrome (CRS) or cytokine storm, is emerging as the mechanism leading to ARDS and MOF in COVID-19, thus endorsing the hypothesis that properly timed anti-inflammatory therapeutic strategies could improve patients' clinical outcomes and prognosis. Key Messages: The objective of this article is to explore and comment on the potential role of the promising immunomodulatory therapies using pharmacological and nonpharmacological approaches to overcome the dysregulated proinflammatory response in COVID-19.


title: Clinical Characteristics of COVID-19 Patients With Digestive Symptoms in Hubei, China: A Descriptive, Cross-Sectional, Multicenter Study

text: OBJECTIVE: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in December 2019, various digestive symptoms have been frequently reported in patients infected with the virus. In this study, we aimed to further investigate the prevalence and outcomes of COVID-19 patients with digestive symptoms. METHODS: In this descriptive, cross-sectional, multicenter study, we enrolled confirmed patients with COVID-19 who presented to 3 hospitals from January 18, 2020, to February 28, 2020. All patients were confirmed by real-time polymerase chain reaction and were analyzed for clinical characteristics, laboratory data, and treatment. Data were followed up until March 18, 2020. RESULTS: In the present study, 204 patients with COVID-19 and full laboratory, imaging, and historical data were analyzed. The average age was 52.9 years (SD ± 16), including 107 men and 97 women. Although most patients presented to the hospital with fever or respiratory symptoms, we found that 103 patients (50.5%) reported a digestive symptom, including lack of appetite (81 [78.6%] cases), diarrhea (35 [34%] cases), vomiting (4 [3.9%] cases), and abdominal pain (2 [1.9%] cases). If lack of appetite is excluded from the analysis (because it is less specific for the gastrointestinal tract), there were 38 total cases (18.6%) where patients presented with a gastrointestinal-specific symptom, including diarrhea, vomiting, or abdominal pain. Patients with digestive symptoms had a significantly longer time from onset to admission than patients without digestive symptoms (9.0 days vs 7.3 days). In 6 cases, there were digestive symptoms, but no respiratory symptoms. As the severity of the disease increased, digestive symptoms became more pronounced. Patients with digestive symptoms had higher mean liver enzyme levels, lower monocyte count, longer prothrombin time, and received more antimicrobial treatment than those without digestive symptoms. DISCUSSION: We found that digestive symptoms are common in patients with COVID-19. Moreover, these patients have a longer time from onset to admission, evidence of longer coagulation, and higher liver enzyme levels. Clinicians should recognize that digestive symptoms, such as diarrhea, are commonly among the presenting features of COVID-19 and that the index of suspicion may need to be raised earlier in at-risk patients presenting with digestive symptoms. However, further large sample studies are needed to confirm these findings.


Impact of the COVID-19 crisis on imaging in oncological trials


Home-based training strategy to maintain muscle function in older adults with diabetes during COVID-19 confinement


ADAMTS13 activity, von Willebrand factor, factor VIII and D-dimers in COVID-19 inpatients


title: Mis-infodemic: The Achilles' heel in combating the COVID-19 pandemic in an Indian perspective

text: In this ongoing SARS-CoV2 Corona virus pandemic, we are witnessing an uninhibited spread of mis-information on various social media platforms. This spread of mis-information or "mis-infodemic" is playing a negative role in our fight against the virus with far reaching consequences. International organizations like the WHO and other governmental organizations have geared up to the occasion to limit the spread of these and bring clarity in this context. In this time of crisis, risk communication is vital in the communication between organizations/government and the people. But apart from the organizations, the onus is on the people and media to realise the importance and verify the authenticity of information being circulated. It is imperative that information, being a double edged sword, is handled with caution and effective communication strategies are devised for the dissemination of accurate and scientific health related information. Social media can be used in a constructive way in mitigating the effects of this pandemic for the betterment of the society.


BK 3101: COVID-19-Infektion des HNO-Arztes ist Berufskrankheit, kein Arbeitsunfall./ [BK 3101: COVID-19 infection of the ENT physician is an occupational disease, not an occupational accident]