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

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


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


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

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


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


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

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


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

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


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

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


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

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


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


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


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

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


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


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

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


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


Are COVID-19 survivors at increased risk for suicide?


Masks and Coronavirus Disease 2019 (COVID-19)


Covid-19: Frontline doctors continue PPE fight


SARS-CoV-2 Infection: Beyond the Interstitial Pneumonia


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


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


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


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


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

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


COVID-19 lockdown of Roma settlements in Slovakia


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


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

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


'Most vaccinations should not be carried out'


Current Mental Health Issues in the Era of Covid-19


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

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


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

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


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

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


Family in the Age of COVID-19


docid: lcizppqu

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


Is virtual existence our new reality?


COVID-19 and improved prevention of hospital-acquired infection


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


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


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


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

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


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

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


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

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


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

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


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

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


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

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


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

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


docid: esvzplur

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


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

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


Rapid deployment of virtual ICU support when resources are compromised


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


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


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

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


Obesity and impaired metabolic health in patients with COVID-19


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

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


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

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


COVID-19 and pulmonary rehabilitation: preparing for phase three


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

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


docid: tldxsmsd

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

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


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


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


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

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


Racism and discrimination in COVID-19 responses


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

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


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

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


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


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

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


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

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


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

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


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


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


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

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


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


Child Abuse Awareness Month During the Coronavirus Disease 2019 Pandemic


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


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


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


title: COVID-19, children and anxiety in 2020

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


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

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


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

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


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

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


Thalassemic Child Presenting with Anosmia due to COVID-19


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

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


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


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


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

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


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


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


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

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


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


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

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


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


title: ACOUSTIC-TURF: Acoustic-based Privacy-Preserving COVID-19 Contact Tracing

text: In this paper, we propose a new privacy-preserving, automated contact tracing system, ACOUSTIC-TURF, to fight COVID-19 using acoustic signals sent from ubiquitous mobile devices. At a high level, ACOUSTIC-TURF adaptively broadcasts inaudible ultrasonic signals with randomly generated IDs in the vicinity. Simultaneously, the system receives other ultrasonic signals sent from nearby (e.g., 6 feet) users. In such a system, individual user IDs are not disclosed to others and the system can accurately detect encounters in physical proximity with 6-foot granularity. We have implemented a prototype of ACOUSTIC-TURF on Android and evaluated its performance in terms of acoustic-signal-based encounter detection accuracy and power consumption at different ranges and under various occlusion scenarios. Experimental results show that ACOUSTIC-TURF can detect multiple contacts within a 6-foot range for mobile phones placed in pockets and outside pockets. Furthermore, our acoustic-signal-based system achieves greater precision than wireless-signal-based approaches when contact tracing is performed through walls. ACOUSTIC-TURF correctly determines that people on opposite sides of a wall are not in contact with one another, whereas the Bluetooth-based approaches detect nonexistent contacts among them.


title: Review of trials currently testing treatment and prevention of COVID-19

text: BACKGROUND: As COVID-19 cases continue to rise globally, evidence from large randomized controlled trials is still lacking. Currently, numerous trials testing potential treatment and preventative options are being undertaken all over the world. OBJECTIVES: We summarized all registered clinical trials examining treatment and prevention options for COVID-19. Additionally, we evaluated the quality of the retrieved studies. DATA SOURCES: Clinicaltrials.gov, the Chinese Clinical Trial Registry and the European Union Clinical Trials Register were systematically searched. STUDY ELIGIBILITY CRITERIA: Registered clinical trials examining treatment and/or prevention options for COVID-19 were included. No language, country or study design restrictions were applied. We excluded withdrawn or cancelled studies and trials not reporting therapeutic or preventative strategies for COVID-19. PARTICIPANTS AND INTERVENTIONS: No restrictions in terms of participants' age and medical background or type of intervention were enforced. METHODS: The registries were searched using the term 'coronavirus' or 'COVID-19' from their inception until 26 March 2020. Additional manual search of the registries was also performed. Eligible studies were summarized and tabulated. Interventional trials were methodologically analysed, excluding expanded access studies and trials testing traditional Chinese medicine. RESULTS: In total, 309 trials evaluating therapeutic management options, 23 studies assessing preventive strategies and three studies examining both were retrieved. Finally, 214 studies were methodologically reviewed. Interventional treatment studies were mostly randomized (n = 150/198, 76%) and open label (n = 73/198, 37%) with a median number of planned inclusions of 90 (interquartile range 40-200). Major categories of interventions that are currently being investigated are discussed. CONCLUSIONS: Numerous clinical trials have been registered since the onset of the COVID-19 pandemic. Summarized data on these trials will assist physicians and researchers to promote patient care and guide future research efforts for COVID-19 pandemic containment.


title: What the COVID-19 pandemic tells us about the need to develop resilience in the nursing workforce

text: Most research on resilience in healthcare systems such as the NHS is based on organisational crises, such as nurse shortages, an ageing workforce and financial restrictions. However, nursing can learn lessons from the past to consider how to become more resilient, particularly considering the 2020 COVID-19 pandemic. This article briefly looks at previous pandemics and disasters that have affected healthcare systems, as well as the 2020 COVID-19 pandemic, and considers how nurse leaders can support staff and show organisational resilience during such emergencies. The article also discusses how nurse leaders can develop their own resilience.


COVID-19: what is next for public health?


Gross examination report of a COVID-19 death autopsy


title: COVID-19 and telehealth, education, and research adaptations

text: For decades, there have been government funded services to provide healthcare telephonically to remote sites both on the earth and in the air. This capability has evolved into what we now know as telehealth. The use of telehealth dramatically accelerated as a result of concerns for patient and healthcare provider safety during the SARS-CoV2 pandemic. Similarly, concerns regarding transmission of infection have required medical schools to provide robust, easily accessible virtual education options. At short notice, faculties have had to develop new telehealth focused curriculum components. However, telehealth, online education, and internet enabled research should not be simply a new way to do traditional jobs but rather, an opportunity to take advantage of how technology can best be used to develop new and better ways to provide care, educate health care providers, and support research.


title: Bayesian semiparametric time varying model for count data to study the spread of the COVID-19 cases

text: Recent outbreak of the novel corona virus COVID-19 has affected all of our lives in one way or the other. While medical researchers are working hard to find a cure and doctors/nurses to attend the affected individuals, measures such as `lockdown', `stay-at-home', `social distancing' are being implemented in different parts of the world to curb its further spread. To model this spread which is assumed to be a non-stationary count-valued time series, we propose a novel time varying semiparametric AR$(p)$ model for the count valued data of newly affected cases, collected every day and also extend it to propose a novel time varying semiparametric INGARCH model. We calculate posterior contraction rates of the proposed Bayesian methods. Our proposed structures of the models are amenable to Hamiltonian Monte Carlo (HMC) sampling for efficient computation. We show excellent performance in simulations. Our method is then applied on the daily time series data of newly confirmed cases to study its spread through different government interventions.


title: The role of telemedicine in the delivery of healthcare in the COVID-19 Pandemic

text: On 11 March 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) a pandemic. Recently, Hermans, et.al., outlined the challenges the COVID-19 pandemic pose for the bleeding disorders community 1 . The general response to the pandemic has included increased measures focused on personal hygiene, social distancing, symptom monitoring, early diagnosis, patient isolation, shelter in place, and public health quarantine. Accordingly, such measures have led to concerns over how to maintain access to haemophilia treatment products and to the specialized integrated care medical follow up within the haemophilia treatment centers (HTCs). As part of the medical response to disasters such as a world-wide pandemic, telemedicine has emerged as one proposed solution to address this type of global challenge 2 .


When internal and emergency medicine speak to each other: organization in the time of COVID


Treating the mental health effects of COVID-19: The need for at-home neurotherapeutics is now


title: COVID-19: progression of disease and intravascular coagulation - present status and future perspectives

text: The timely and accurate diagnosis of infection with severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), remains the cornerstone of efforts to provide appropriated treatment for patients, to limit further spread of the virus and ultimately to eliminate the virus from the human society. We focus this article on (a) developments for improvement of diagnosis of specific SARS-CoV-2 virus, (b) laboratory changes in the immunologic and coagulation system, (c) therapeutic options for anticoagulant treatment of seriously affected patients and (d) on the perspectives through improvement of diagnostic and therapeutic medical procedures.


title: Neurotropic mechanisms in COVID-19 and their potential influence on neuropsychological outcomes in children

text: Children have shown more physical resilience to COVID-19 than adults, but there is a cohort of vulnerable infants and young children who may experience disease burden, both in the acute phase and chronically. Children may have had early undocumented exposure to COVID-19. Even when the risk of exposure was known, developmental variables may have made the avoidance of physical proximity difficult for children. Preliminary hypotheses concerning neurotropic factors have been documented by researchers. Children with COVID-19 and comorbid physical or mental disorders may be vulnerable to exacerbations of neurotropic factors and comorbidities, the neural impact of which has been documented for other coronaviruses. Researchers are investigating COVID-19 symptom descriptions, neurotropic mechanisms at the genomic and transcriptomatic levels, neurological manifestations, and the impact of comorbid health complications. Neuropsychologists need information concerning the likely impact of COVID-19 on children. With a view toward that goal, this article provides recommendations for some initial updates in neuropsychology practice.


title: Impacto psicológico de la COVID-19 en una muestra de profesionales sanitarios españoles./ Impacto psicológico de la COVID-19 en una muestra de profesionales sanitarios españoles./ Psychological impact of COVID-19 on a sample of Spanish health professionals

text: INTRODUCTION: After the outbreak of the COVID-19 was considered a global pandemic in March 2020, the state of alarm was declared in Spain. In this situation, health professionals are experiencing high levels of stress due to the overload of work the pandemic is generating and the conditions in which they are working. The aim of this study was to evaluate the factors that can destabilize the mental health of these professionals in our context. MATERIALS AND METHODS: The sample was composed of 421 health professionals. The data were gathered by an online questionnaire sent to them by e-mail. The DASS-21 was used to assess anxiety, stress and depression, and the EAI to measure sleep difficulties. In addition, other descriptive variables that could be related to psychological symptomatology were collected from the sample. RESULTS: The results show that the COVID-19 pandemic has generated symptoms of stress, anxiety, depression and insomnia among health workers, with higher levels among women and older professionals. Some factors such as having been in contact with the virus or fear at work, triggered greater symptomatology. CONCLUSIONS: In this critical situation, professionals are in the front line and therefore, are directly exposed to certain risks and stressors. This contributes to the development of diverse psychological symptoms. Consequently, it is recommended to offer them psychological help in order to reduce the emotional impact of the COVID-19, and thus, to ensure not only the mental health of our health professionals, but also the adequate care they provide.


title: Treatment for emerging viruses: Convalescent plasma and COVID-19

text: Use of convalescent plasma transfusions could be of great value in the current pandemic of coronavirus disease (COVID-19), given the lack of specific preventative and therapeutic options. This convalescent plasma therapy is of particular interest when a vaccine or specific therapy is not yet available for emerging viruses, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. This report summarizes existing literature around convalescent plasma as a therapeutic option for COVID-19. It also includes recommendations for establishing a convalescent plasma program, enhancement considerations for convalescent plasma, and considerations around pathogen reduction treatment of convalescent plasma. Time is of the essence to set up protocols for collection, preparation, and administration of apheresis-collected convalescent plasma in response to the current pandemic. The immediate use of convalescent plasma provides prompt availability of a promising treatment while specific vaccines and treatments are evaluated and brought to scale. Further development of improved convalescent plasma, vaccines and other therapeutics depends on quick generation of additional data on pathogenesis and immune response. Additionally, given the lack of information around the natural history of this disease, PRT should be considered to add a layer of safety to protect recipients of convalescent plasma.


docid: wqkqcjzl

title: COVID-19 outbreak control, example of ministry of health of Turkey

text: Our first COVID-19 case in Turkey was a 44-year-old male who referred to the hospital on March 9, 2020. The first related death occurred on March 17, 2020. Preparedness for the pandemic has been ongoing before the first case was detected. The National Pandemic Plan was published in 2006. The Pandemic Influenza National Preparedness Plan was available after being updated in light of experiences gained during the 2009 Influenza A pandemic. Accordingly, Pandemic Coordination Boards and Operation Centers have been established on the national and provincial levels. This was an adaptable plan to the Novel Coronavirus Disease (COVID-19). We formed teams to work on a 24/7 basis and established a Scientific Committee at the Public Health Emergency Operation Center within the General Directorate of Public Health. "COVID-19 Risk Assessment", "COVID-19 Guideline" and "Case Report Form", regulations of personal protective equipment along with need-based guidelines, treatment algorithms, brochures and related documents have been released. For the case-based follow-up, Public Health Management System (HSYS) is being used. PCR and rapid diagnostic kits are being used to analyze the samples at the central Microbiology Reference Laboratory and the authorized laboratories in several provinces. Various preventive measures were implemented including flight restrictions to certain countries, gradually expanded to suspending all flights and prohibiting the entry of foreign nationals, 14-day isolation and symptom monitoring for those that came from countries under risk. Persons with chronic diseases have been granted an administrative leave, on campus education at schools and activities of public rest and entertainment areas were temporarily suspended. The measures have been implemented for penitentiary institutions, dormitories, nursing homes, public transport and intercity buses, and also weekend curfews are implemented. In accordance with the pandemic plan, actions have been carried out with a multi-sectoral approach, and preventive measures have been implemented to cover the society as a whole.


Big studies dim hopes for hydroxychloroquine


docid: fdrdcspd

title: Statin therapy in COVID-19 infection


Managing Your Chronic Lung Disease During the COVID-19 Pandemic


COVID-19, grossesse et accouchement


title: Kidney disease is associated with in-hospital death of patients with COVID-19

text: In December 2019, a coronavirus 2019 (COVID-19) disease outbreak occurred in Wuhan, Hubei Province, China, and rapidly spread to other areas worldwide. Although diffuse alveolar damage and acute respiratory failure were the main features, the involvement of other organs needs to be explored. Since information on kidney disease in patients with COVID-19 is limited, we determined the prevalence of acute kidney injury (AKI) in patients with COVID-19. Further, we evaluated the association between markers of abnormal kidney function and death in patients with COVID-19. This was a prospective cohort study of 701 patients with COVID-19 admitted in a tertiary teaching hospital that also encompassed three affiliates following this major outbreak in Wuhan in 2020 of whom 113 (16.1%) died in hospital. Median age of the patients was 63 years (interquartile range, 50-71), including 367 men and 334 women. On admission, 43.9% of patients had proteinuria and 26.7% had hematuria. The prevalence of elevated serum creatinine, elevated blood urea nitrogen and estimated glomerular filtration under 60 ml/min/1.73m2 were 14.4, 13.1 and 13.1%, respectively. During the study period, AKI occurred in 5.1% patients. Kaplan-Meier analysis demonstrated that patients with kidney disease had a significantly higher risk for in-hospital death. Cox proportional hazard regression confirmed that elevated baseline serum creatinine (hazard ratio: 2.10, 95% confidence interval: 1.36-3.26), elevated baseline blood urea nitrogen (3.97, 2.57-6.14), AKI stage 1 (1.90, 0.76-4.76), stage 2 (3.51, 1.49-8.26), stage 3 (4.38, 2.31-8.31), proteinuria 1+ (1.80, 0.81-4.00), 2+â¼3+ (4.84, 2.00-11.70), and hematuria 1+ (2.99, 1.39-6.42), 2+â¼3+ (5.56,2.58- 12.01) were independent risk factors for in-hospital death after adjusting for age, sex, disease severity, comorbidity and leukocyte count. Thus, our findings show the prevalence of kidney disease on admission and the development of AKI during hospitalization in patients with COVID-19 is high and is associated with in-hospital mortality. Hence, clinicians should increase their awareness of kidney disease in patients with severe COVID-19.


MRI appearance of COVID-19 infection


docid: lhfzcfai

title: Mental health and COVID-19: change the conversation


Protecting health care workers in the front line: Innovation in COVID-19 pandemic


title: Lymphopenia that may develop in patients treated with temozolomide and immune control check-point inhibitor may be a high risk for mortality during the COVID-19 outbreak

text: As we know more about the clinical and laboratory features of COVID-19, which is now accepted as a pandemic, many questions have been raised about how to manage and monitor the treatment of cancer patients. It was determined that the incidence of lymphopenia increased in COVID-19 and there was a significant relationship between lymphopenia and mortality. This can be thought of as an unresponsive problem in how to maintain anti-cancer drugs that cause lymphopenia. This article was written for a hypothetical approach in cancer patients diagnosed with COVID-19 in order to be an idea of collecting data for treatment with anti-cancer drugs that cause lymphopenia.


title: Fear and agony of the pandemic leading to stress and mental illness: An emerging crisis in the novel coronavirus (COVID-19) outbreak

text: The outbreak of novel Coronavirus (COVID-19), later named as a pandemic affecting nearly 210 countries and territories has led to negative emotions of fear and agony in the general population and healthcare staff professionals. The healthcare regulators and the governments have imposed emergencies and lockdowns in their countries which has led to an adverse effect on the mental health of people ultimately leading to a rise in anxiety, depression, and associated mental illness. The fear and uncertainty increased by the COVID-19 crisis are putting extreme pressure on our finite resources. This report aims to synthesis the dilemma of mental illness as a result of pandemic and initiates suggestions to help the general public, healthcare professionals, and workers mitigate the negative emotions to improve the mental wellbeing in this detached period of isolation.


title: Cardiac MRI of Children with Multisystem Inflammatory Syndrome (MIS-C) Associated with COVID-19: Case Series

text: This case series examines cardiac MRI findings in four children and adolescents admitted to intensive care in April 2020 for multisystem inflammatory syndrome and Kawasaki disease-like features related to COVID-19. Acute myocarditis occurred less than 1 week after onset of fever and gastrointestinal symptoms. Physical examination showed rash and cheilitis/conjunctivitis. All patients recovered after intravenous immunoglobulin therapy. SARS-CoV-2 RT-PCR was negative on nasopharyngeal, stool, and respiratory samples and was positive on serology. Cardiac MRI showed diffuse myocardial edema on T2-STIR sequences and native-T1 mapping, with no evidence of late gadolinium enhancement suggestive of replacement fibrosis or focal necrosis. These findings favor post-infectious myocarditis in children and adolescents with COVID-19.


COVID-19 infection in a northern-Italian cohort of systemic lupus erythematosus assessed by telemedicine


O manejo do absorvedor de CO2 durante o uso do aparelho de anestesia como respirador mecânico em pacientes com COVID19./ [Management of CO2 absorbent while using the anesthesia machine as a mechanical ventilator on patients with COVID-19]


Impaired interferon signature in severe COVID-19


title: A spatio-temporal analysis for exploring the effect of temperature on COVID-19 early evolution in Spain

text: The new SARS-CoV-2 coronavirus, which causes the COVID-19 disease, was reported in Wuhan, China, in December 2019. This new pathogen has spread rapidly around more than 200 countries, in which Spain has one of the world's highest mortality rates so far. Previous studies have supported an epidemiological hypothesis that weather conditions may affect the survival and spread of droplet-mediated viral diseases. However, some contradictory studies have also been reported in the same research line. In addition, many of these studies have been performed considering only meteorological factors, which can limit the reliability of the results. Herein, we report a spatio-temporal analysis for exploring the effect of daily temperature (mean, minimum and maximum) on the accumulated number of COVID-19 cases in the provinces of Spain. Non-meteorological factors such as population density, population by age, number of travellers and number of companies have also been considered for the analysis. No evidence suggesting a reduction in COVID-19 cases at warmer mean, minimum and maximum temperatures has been found. Nevertheless, these results need to be interpreted cautiously given the existing uncertainty about COVID-19 data, and should not be extrapolated to temperature ranges other than those analysed here for the early evolution period.


title: Time Series Forecasting of COVID-19 transmission in Canada Using LSTM Networks

text: On March 11 th 2020, World Health Organization (WHO) declared the 2019 novel corona virus as global pandemic. Corona virus, also known as COVID-19 was first originated in Wuhan, Hubei province in China around December 2019 and spread out all over the world within few weeks. Based on the public datasets provided by John Hopkins university and Canadian health authority, we have developed a forecasting model of COVID-19 outbreak in Canada using state-of-the-art Deep Learning (DL) models. In this novel research, we evaluated the key features to predict the trends and possible stopping time of the current COVID-19 outbreak in Canada and around the world. In this paper we presented the Long short-term memory (LSTM) networks, a deep learning approach to forecast the future COVID-19 cases. Based on the results of our Long short-term memory (LSTM) network, we predicted the possible ending point of this outbreak will be around June 2020. In addition to that, we compared transmission rates of Canada with Italy and USA. Here we also presented the 2, 4, 6, 8, 10, 12 and 14 th day predictions for 2 successive days. Our forecasts in this paper is based on the available data until March 31, 2020. To the best of our knowledge, this of the few studies to use LSTM networks to forecast the infectious diseases.


title: Regional changes in tuberculosis disease burden among adolescents in South Africa (2005-2015)

text: BACKGROUND: Adolescents in the Western Cape Province of South Africa had high force of Mycobacterium tuberculosis (MTB) infection (14% per annum) and high TB incidence (710 per 100,000 person-years) in 2005. We describe subsequent temporal changes in adolescent TB disease notification rates for the decade 2005-2015. METHOD: We conducted an analysis of patient-level adolescent (age 10-19 years) TB disease data, obtained from an electronic TB register in the Breede Valley sub-district, Western Cape Province, South Africa, for 2005-2015. Numerators were annual TB notifications (HIV-related and HIV-unrelated); denominators were mid-year population estimates. Period averages of TB rates were obtained using time series modeling. Temporal trends in TB rates were explored using the Mann-Kendall test. FINDINGS: The average adolescent TB disease notification rate was 477 per 100,000 for all TB patients (all-TB) and 361 per 100,000 for microbiologically-confirmed patients. The adolescent all-TB rate declined by 45% from 662 to 361 per 100,000 and the microbiologically-confirmed TB rate by 38% from 492 to 305 per 100,000 between 2005-2015, driven mainly by rapid decreases for the period 2005-2009. There was a statistically significant negative temporal trend in both all-TB (per 100,000) (declined by 48%; from 662 to 343; p = 0·028) and microbiologically confirmed TB (per 100,000) (declined by 49%; from 492 to 252; p = 0·027) for 2005-2009, which was not observed for the period 2009-2015 (rose 5%; from 343 to 361; p = 0·764 and rose 21%; from 252 to 305; p = 1·000, respectively). INTERPRETATION: We observed an encouraging fall in adolescent TB disease rates between 2005-2009 with a subsequent plateau during 2010-2015, suggesting that additional interventions are needed to sustain initial advances in TB control.


Image-proven thromboembolism in patients with severe COVID-19 in a tertiary critical care unit in the United Kingdom


title: Multi-Channel Transfer Learning of Chest X-ray Images for Screening of COVID-19

text: The 2019 novel coronavirus (COVID-19) has spread rapidly all over the world and it is affecting the whole society. The current gold standard test for screening COVID-19 patients is the polymerase chain reaction test. However, the COVID-19 test kits are not widely available and time-consuming. Thus, as an alternative, chest X-rays are being considered for quick screening. Since the presentation of COVID-19 in chest X-rays is varied in features and specialization in reading COVID-19 chest X-rays are required thus limiting its use for diagnosis. To address this challenge of reading chest X-rays by radiologists quickly, we present a multi-channel transfer learning model based on ResNet architecture to facilitate the diagnosis of COVID-19 chest X-ray. Three ResNet-based models (Models a, b, and c) were retrained using Dataset_A (1579 normal and 4429 diseased), Dataset_B (4245 pneumonia and 1763 non-pneumonia), and Dataset_C (184 COVID-19 and 5824 Non-COVID19), respectively, to classify (a) normal or diseased, (b) pneumonia or non-pneumonia, and (c) COVID-19 or non-COVID19. Finally, these three models were ensembled and fine-tuned using Dataset_D (1579 normal, 4245 pneumonia, and 184 COVID-19) to classify normal, pneumonia, and COVID-19 cases. Our results show that the ensemble model is more accurate than the single ResNet model, which is also re-trained using Dataset_D as it extracts more relevant semantic features for each class. Our approach provides a precision of 94 % and a recall of 100%. Thus, our method could potentially help clinicians in screening patients for COVID-19, thus facilitating immediate triaging and treatment for better outcomes.


Factors associated with mortality in patients with COVID-19. A quantitative evidence synthesis of clinical and laboratory data


title: Zinc and respiratory tract infections: Perspectives for COVID19 (Review)

text: In view of the emerging COVID19 pandemic caused by SARSCoV2 virus, the search for potential protective and therapeutic antiviral strategies is of particular and urgent interest. Zinc is known to modulate antiviral and antibacterial immunity and regulate inflammatory response. Despite the lack of clinical data, certain indications suggest that modulation of zinc status may be beneficial in COVID19. In vitro experiments demonstrate that Zn2+ possesses antiviral activity through inhibition of SARSCoV RNA polymerase. This effect may underlie therapeutic efficiency of chloroquine known to act as zinc ionophore. Indirect evidence also indicates that Zn2+ may decrease the activity of angiotensinconverting enzyme 2 (ACE2), known to be the receptor for SARSCoV2. Improved antiviral immunity by zinc may also occur through upregulation of interferon α production and increasing its antiviral activity. Zinc possesses antiinflammatory activity by inhibiting NFκB signaling and modulation of regulatory Tcell functions that may limit the cytokine storm in COVID19. Improved Zn status may also reduce the risk of bacterial coinfection by improving mucociliary clearance and barrier function of the respiratory epithelium, as well as direct antibacterial effects against S. pneumoniae. Zinc status is also tightly associated with risk factors for severe COVID19 including ageing, immune deficiency, obesity, diabetes, and atherosclerosis, since these are known risk groups for zinc deficiency. Therefore, Zn may possess protective effect as preventive and adjuvant therapy of COVID19 through reducing inflammation, improvement of mucociliary clearance, prevention of ventilatorinduced lung injury, modulation of antiviral and antibacterial immunity. However, further clinical and experimental studies are required.


Incidence and determinants of QT interval prolongation in COVID-19 patients treated with hydroxychloroquine and azithromycin


Impact of Covid19 on a tertiary care pediatric oncology and stem cell transplant unit in Riyadh, Saudi Arabia


title: Knowledge, attitude, and practices related to COVID-19 pandemic among social media users in J&K, India

text: Background: A series of measures have been suggested to reduce Covid-19 infection, including knowledge training for prevention and control, isolation, disinfection, classified protections at different degrees in infection areas, and protection of confirmed cases. Objectives: We conducted this study with an aim to assess the knowledge, attitude and practice among the general population regarding COVID-19. Methods: This was a cross-sectional study carried out by the Department of Community Medicine, Government Medical College, Srinagar in the month of April 2020. The questionnaire had four segments to collect data regarding social-demographic details, knowledge regarding Covid-19, attitude and practice based questions. The questionnaire was shared via social media applications like face book and Whatsapp to reach the target population. Continuous variables were summarized as frequency and percentage. All the analysis was done using Microsoft Excel 2016. Among participants who responded, 1252 (82%) were in the age group of 18-40 years and 912 (60%) from urban areas. Results: A total of 934 (61%) respondents had heard details on COVID-19 from the social media, 1358 (89%) knew all ways of coronavirus transmission, 602 (40%) felt that COVID-19 is a serious disease, 1184 (78%) responded that they totally agree with the lockdown decision, and 1296 (85%) responded that lockdown is helping in reducing the number of cases. The majority, i.e. 1318 (87%), followed advisories and reported washing hands with soap and water regularly, 1108 (73%) reported regularly wearing masks, 1344 (89%) reported following lockdown guidelines, and 1306 (87%) reported maintaining social distancing. The respondents exhibited good knowledge, positive attitude, and sensible practices regarding COVID-19. Conclusion: Our study showed that the respondents have exhibited good knowledge, positive attitude and sensible practices regarding covid-19 during the pandemic.


Changes in radiotherapy practice during COVID-19 outbreak in Turkey: A report from the Turkish Society for Radiation Oncology


The model of epidemic (COVID-19) prevention and control in rural of China


title: Public health strategies for a gradual public sector lockdown lifting in Jordan and United Arab Emirates during COVID-19 crisis

text: UNSTRUCTURED: This review perspective presents on the public policies and public health strategies for a gradual lockdown lifting during the 'COVID-19 crisis' for the country cases of Jordan and the United Arab Emirates. While managing pandemics is critical in terms of the levels of preparedness, response, and recovery phases, it is equally vital to ensure that the measures for the exit of the lockdown period are most efficient and effective. It is critical to learn from first-wave lessons to systematize responses during times of crisis and executing the necessary public policies and public health strategies. The viewpoint highlights at times of lockdown lifting, areas concerned including pandemic control, healthcare capacity, training, scaling up of resources and systems, and priority setting of public policies via acknowledging the challenges, developing the policy insights, and setting the policy direction. The systematic approaches and leadership thinking required for lifting lockdowns in times of crisis include the three R's: Readiness, Responses and Resilience & Recovery.


title: Caring for Frail Older Adults During COVID-19: Integrating Public Health Ethics into Clinical Practice

text: During the coronavirus disease 2019 (COVID-19) pandemic, principles from both clinical and public health ethics cue clinicians and healthcare administrators to plan alternatives for frail older adults who prefer to avoid critical care, and for when critical care is not available due to crisis triaging. This article will explore the COVID-19 Ethical Decision Making Framework, published in British Columbia (BC), Canada, to familiarize clinicians and policy makers with how ethical principles can guide systems change, in the service of frail older adults. In BC, the healthcare system has launched resources to support clinicians in proactive advance care planning discussions, and is providing enhanced supportive and palliative care options to residents of long-term care facilities. If the pandemic truly overwhelms the healthcare system, frailty, but not age alone, provides a fair and evidence-based means of triaging patients for critical care and could be included into ventilator allocation frameworks.


US deportation policies in the time of COVID-19: a public health threat to the Americas


title: Novel coronavirus 2019 (COVID-19): A case report and review of treatments

text: RATIONALE: Novel coronavirus 2019 (COVID-19) also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped, non-segmented positive-sense RNA virus belonging to the beta-coronaviridae family. This virus is known to cause severe bilateral pneumonia and acute respiratory distress syndrome (ARDS) which can lead to difficulty breathing requiring mechanical ventilation and intensive care unit management. PATIENT CONCERNS: A 77-year-old female with a history of hypertension and hyperlipidemia who presented as a transfer to our hospital facility with worsening fevers, cough, and respiratory distress. DIAGNOSIS: Chest X-rays revealed bilateral infiltrates worse at the lung bases and CT scan of the chest showed bilateral ground-glass opacities consistent with COVID-19. While our testing revealed a negative COVID-19 result at our institution, the result at a previous hospital returned a positive result. INTERVENTIONS: She was being treated aggressively in the intensive care unit with high dose intravenous ascorbic acid, hydroxychloroquine, and anti-interleukin-6 monoclonal antibody. She also received a loading dose of remdesivir however was unable to complete the course due to organ failure and requirement of vasopressors for hemodynamic stability. OUTCOMES: She remained critically ill and was eventually placed on comfort care as per the family's wishes and passed away. LESSONS: With a rapidly growing death rate and more than 200,000 confirmed cases worldwide, COVID-19 has become a global pandemic and major hit to our healthcare systems. While several companies have already begun vaccine trials and healthcare facilities have been using a wide-range of medications to treat the virus and symptoms, there is not yet an approved medication regimen for COVID-19 infections. The alarming increase in cases per day adds additional pressure to find a cure and decrease the global health burden and mortality rate.


Is minimal access surgery possible and safe during the COVID-19 pandemic?


Is the coronavirus airborne? Experts can't agree


title: Innovation Born in Isolation: Rapid Transformation of an In-Person Medical Student Radiology Elective to a Remote Learning Experience During the COVID-19 Pandemic

text: RATIONALE AND OBJECTIVES: With social distancing measures in place both nationally and globally, the current COVID-19 pandemic has forced the cancellation of in-person classes at universities and medical schools across the country. This has presented unique challenges for educators in all fields as they have embarked, many for the first time, on the journey into remote education in order to provide distance learning opportunities for students. MATERIALS AND METHODS: In this article we will review our approach to rapidly converting an in-person diagnostic radiology elective to an entirely remote learning experience for medical students at our institution, including modification of course structure, software tools and materials utilized, and strategies for learner engagement and collaboration. RESULTS: Development of an online elective led to a 10-fold increase in student enrollment compared to the traditional course offering, providing a unique opportunity to reach a broad number of students, many of whom were in the early clinical stages of their medical school career. Lastly, we will review faculty feedback after participating in the remote course as well as lessons learned from the transition to distance learning and its implications for future work CONCLUSION: The current state of technology makes radiology particularly well-suited for distance learning, and with the proper tools and approaches, effective remote radiology instruction can be achieved.


title: CoViD-19 epidemic follows the "kinetics" of enzymes with cooperative substrate binding

text: The Hill equation, which models the cooperative ligand-receptor binding equilibrium, turns out to be useful in modeling the progression of infectious disease outbreaks such as CoViD-19. The equation fits well the data for total and daily case numbers, allows tentative predictions for the half-point and end point of the epidemic, and presents a mathematical characterization of how social interventions "flatten the curve" of the disease progression.


title: Assessment and treatment of older individuals with COVID 19 multi-system disease: Clinical and ethical implications

text: Covid-19 infection is a multisystem disease more frequent in older individuals, especially in those with multiple chronic diseases. This multimorbid and frail population requires attention and a personalized comprehensive assessment in order to avoid the occurrence of adverse outcomes. As other diseases, the COVID-19 presentation in older patients is often atypical with less severe and unspecific symptoms. These subjects both at home and during hospitalization suffer isolation and the lack of support of caregivers. The geriatric care in COVID-19 wards is often missing. The application of additional instruments would be necessary to facilitate and personalize the clinical approach, not only based on diseases but also on functional status. This narrative review starts from diagnostic evaluation, continues with adapted pharmacologic treatment and ends with the recovery phase targeting the nutrition and physical exercise. We developed a check-list of respiratory, gastro-intestinal and other less-specific symptoms, summarized in a table and easily to be filled-up by patients, nurses and general practitioners. As second step, we reported the clinical phases of this disease. Far to be considered just viral infective and respiratory, this disease is also an inflammatory and thrombotic condition with frequent bacterial over-infection. We finally considered timing and selection of treatment, which depend on the disease phase, co-administration of other drugs and require the monitoring of renal, liver and cardiac function. This underlines the role of age not just as a limitation, but also an opportunity to increase the quality and the appropriateness of multidisciplinary and multidimensional intervention in this population.