docid: kescttce

title: AGA Institute Rapid Review of the Gastrointestinal and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19

text: BACKGROUND & AIMS: Multiple gastrointestinal (GI) symptoms, including diarrhea, nausea/vomiting, and abdominal pain, as well as liver enzyme abnormalities, have been variably reported in patients with coronavirus disease 2019 (COVID-19). The American Gastroenterological Association Institute Clinical Guideline Committee and Clinical Practice Updates Committee performed a systematic review and meta-analysis of international data on GI and liver manifestations of COVID-19. METHODS: We performed a systematic literature search to identify published and unpublished studies using OVID Medline and preprint servers (medRxiv, LitCovid, and SSRN [Social Science Research] up until April 5, 2020; major journal sites were monitored for US publications until April 19, 2020. We analyzed the prevalence of diarrhea, nausea, vomiting, and abdominal pain, as well as liver function tests abnormalities, using a fixed-effect model and assessed the certainty of evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. RESULTS: We identified 118 studies and used a hierarchal study selection process to identify unique cohorts. We performed a meta-analysis of 47 studies including 10,890 unique patients. Pooled prevalence estimates of GI symptoms were as follows: diarrhea 7.7% (95% confidence interval [CI], 7.2%-8.2%), nausea/vomiting 7.8% (95% CI, 7.1%-8.5%), and abdominal pain 2.7% (95% CI, 2.0%-3.4%). Most studies reported on hospitalized patients. The pooled prevalence estimates of elevated liver abnormalities were as follows: aspartate transaminase 15.0% (95% CI, 13.6%-16.5%) and alanine transaminase 15.0% (95% CI, 13.6%-16.4%). When analyzed comparing data from China to studies from countries other than China, diarrhea, nausea/vomiting, and liver abnormalities were more prevalent outside of China, with diarrhea reported in 18.3% (95% CI, 16.6%-20.1%). Isolated GI symptoms were reported rarely. We also summarized the Gl and liver adverse effects of the most commonly utilized medications for COVID-19. CONCLUSIONS: GI symptoms are associated with COVID-19 in <10% of patients. In studies outside of China, estimates are higher. Further studies are needed with standardized GI symptoms questionnaires and liver function test checks on admission to better quantify and qualify the association of these symptoms with COVID-19. Based on findings from our meta-analysis, we provide several Best Practice Statements for the consultative management of COVID-19.


title: Quantifying the improvement in confirmation efficiency of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the early phase of the outbreak in Hong Kong in 2020

text: BACKGROUNDS: The emerging virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused a large outbreak of coronavirus disease, COVID-19, in Wuhan, China, since December 2019. COVID-19 soon spread to other regions of China and overseas. In Hong Kong, local mitigation measures were implemented since the first imported case was confirmed on January 23, 2020. Here we evaluated the temporal variation of detection delay from symptoms onset to laboratory confirmation of SARS-CoV-2 in Hong Kong. METHODS: A regression model is adopted to quantify the association between the SARS-CoV-2 detection delay and calendar time. The association is tested and further validated by a Cox proportional hazard model. FINDINGS: The estimated median detection delay was 9.5 days (95%CI: 6.5-11.5) in the second half of January, reduced to 6.0 days (95%CI: 5.5-9.5) in the first half of February 2020. We estimate that SARS-CoV-2 detection efficiency improved at a daily rate of 5.40% (95%CI: 2.54-8.33) in Hong Kong. CONCLUSIONS: The detection efficiency of SARS-CoV-2 was likely being improved substantially in Hong Kong since the first imported case was detected. Sustaining enforcement in timely detection and other effective control measures are recommended to prevent the SARS-CoV-2 infection.


Home PAP devices in COVID-19 infected patients


title: Triage of critical care resources in COVID-19: a stronger role for justice

text: Some ethicists assert that there is a consensus that maximising medical outcomes takes precedence as a principle of resource allocation in emergency triage of absolutely scarce resources. But the nature of the current severe acute respiratory syndrome-related coronavirus 2 pandemic and the history of debate about balancing equity and efficiency in resource allocation do not support this assertion. I distinguish a number of concerns with justice and balancing considerations that should play a role in critical care triage policy, focusing on discrimination and on fundamental egalitarian and social justice concerns.


title: Pandemic preparedness of community pharmacies for COVID-19

text: BACKGROUND: Community pharmacies provide an important healthcare service, which is broadly established, and constitutes the preferred and initial contact for members of the community. The significant value of community pharmacies was further highlighted during the COVID-19 pandemic crisis. OBJECTIVE: The assessment of community pharmacies preparedness for the COVID-19 pandemic. METHODS: A cross-sectional interview survey of 1018 community pharmacies working in four regions of Egypt (South, East, Centre, and North). Data collection was conducted from 8-19 April 2020. RESULTS: Availability of personal protective equipment (PPE) and medication was better than alcohol (70% conc.). Home delivery services were available in 49.1% of pharmacies. Infection control measures covering interactions between staff were in place in up to 99.5% of pharmacies. Conversely, there was less frequent availability of contactless payment (29.1%), hand sanitizers (62.1%) or masks (86.5%) for customer use, or a separate area for patients with suspected COVID-19 (64%). Verbal customer education (90.4%) was used preferably to written (81.3%). Despite high clinical knowledge and awareness (97.6%-99.2%), only 8.8% of pharmacists had reported suspected COVID-19 cases, however this varied significantly with pharmacist demographics (geographic region P < 0.001; pandemic training p < 0.001; position p = 0.019; age p = 0.046). CONCLUSIONS: Government and policymakers strive to mitigate the shortage of PPE and medication. More attention should be given to infection control measures around interactions between staff and customers to ensure community pharmacists are fit and able to provide continuity in their important role. Educating customers using regularly-updated posters, banners or signs will contribute to decreasing contact with patients, and reducing the number and duration of visits to the pharmacy. Pandemic preparedness of community pharmacists must also extend to reporting procedures. By avoiding under-reporting or over-reporting, community pharmacists will contribute to accurate monitoring of the national spread of infection.


title: Prolonged Infectivity of SARS-CoV-2 in Fomites

text: We spotted severe acute respiratory syndrome coronavirus 2 on polystyrene plastic, aluminum, and glass for 96 hours with and without bovine serum albumin (3 g/L). We observed a steady infectivity (<1 log10 drop) on plastic, a 3.5 log10 decrease on glass, and a 6 log10 drop on aluminum. The presence of proteins noticeably prolonged infectivity.


First case of student suicide in India due to the COVID-19 education crisis: A brief report and preventive measures


Students Supporting Critical Care - A contention plan to prevent the decompensation of ICUs in the COVID-19 pandemic:Translating Bjorn Ibsens' polio-lessons to modern times


title: Co-infection of Coronavirus Disease 2019 and Influenza A: A Report from Iran

text: BACKGROUND: In late December 2019, a viral pneumonia known as coronavirus disease 2019 (COVID-19) originated from China and spread very rapidly in the world. Since then, COVID-19 has become a global concern and health problem. METHODS: We present four patients in this study, selected from among patients who presented with pneumonia symptoms and were suspicious for COVID-19. They were referred to the intended centers for COVID-19 diagnosis and management of Shiraz University of Medical Sciences in southern Iran. Two nasopharyngeal and oropharyngeal throat swab samples were collected from each patient and tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using real-time reverse-transcriptase- polymerase-chain-reaction (RT-PCR). The samples were also tested for influenza viruses and the complete respiratory panel. RESULTS: In the present report, four patients were diagnosed in the starting days of COVID-19 disease in our center in southern Iran with co-infection of SARS-CoV-2 and influenza A virus. CONCLUSION: This co-infection of COVID-19 and influenza A highlights the importance of considering SARS-CoV-2 PCR assay regardless of other positive findings for other pathogens in the primary test during the epidemic.


title: Encountering COVID-19 as Endocrinologists

text: The world is entering an era of disaster and chaos due to coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2. Since its first emergence in December 2019 in Wuhan, China, COVID-19 has swept through Asia and propagated throughout the world to Europe and North America. As of April 13, 1,773,084 people were infected and 111,652 people had died from COVID-19 globally, and new record levels of infection are being reported every day. Based on the data that have been amassed so far, the primary risk factors for a severe disease course or even mortality from COVID-19 are underlying diseases such as diabetes and hypertension. As the global prevalence of diabetes continues to increase, patients with endocrine diseases such as diabetes mellitus and those who are on long-term corticosteroid therapy due to adrenal insufficiency or hypopituitarism are at risk for a poor prognosis of COVID-19. As endocrinologists, we would like to briefly review the current knowledge about the relationship between COVID-19 and endocrine diseases and to discuss what we can do for the safety and health of our patients with endocrine diseases in this globally threatening situation.


title: Managing Patients with Multiple Myeloma during the COVID-19 Pandemic: Recommendations from an Expert Panel - ABHH Monoclonal Gammopathies Committe

text: Since the World has been facing the COVID-19 pandemic, special attention has been taken concerning cancer patients; related to their immunosuppression status, adding risk for more aggressive COVID-19 and mortality, but also concerns about the access and the quality of care in cancer therapy. The COVID-19 pandemic impacts the number of infected, its related mortality, as well as the care of cancer patients. Multiple myeloma patients are a particular group with several important aspects to be considered during pandemic times. In essence, they are immunosuppressed in different intensities during their treatment. Most of them are elderly and all of them require long-term therapy, with prolonged contact with the health care system, possibly including a stem cell transplant during the treatment. A panel of experts in multiple myeloma and infectious diseases discusses pieces of evidence and the lack of the same in the scenario of COVID-19 in myeloma patients, while also exposing what is expected for the next phases of the COVID-19 pandemic.


title: Low-Cost and High-Throughput Testing of COVID-19 Viruses and Antibodies via Compressed Sensing: System Concepts and Computational Experiments

text: Coronavirus disease 2019 (COVID-19) is an ongoing pandemic infectious disease outbreak that has significantly harmed and threatened the health and lives of millions or even billions of people. COVID-19 has also negatively impacted the social and economic activities of many countries significantly. With no approved vaccine available at this moment, extensive testing of COVID-19 viruses in people are essential for disease diagnosis, virus spread confinement, contact tracing, and determining right conditions for people to return to normal economic activities. Identifying people who have antibodies for COVID-19 can also help select persons who are suitable for undertaking certain essential activities or returning to workforce. However, the throughputs of current testing technologies for COVID-19 viruses and antibodies are often quite limited, which are not sufficient for dealing with COVID-19 viruses' anticipated fast oscillating waves of spread affecting a significant portion of the earth's population. In this paper, we propose to use compressed sensing (group testing can be seen as a special case of compressed sensing when it is applied to COVID-19 detection) to achieve high-throughput rapid testing of COVID-19 viruses and antibodies, which can potentially provide tens or even more folds of speedup compared with current testing technologies. The proposed compressed sensing system for high-throughput testing can utilize expander graph based compressed sensing matrices developed by us \cite{Weiyuexpander2007}.


title: Consensus on standardized diagnosis and treatment for osteoporotic vertebral compression fracture patients during epidemic of corona virus disease 2019/ 中华创伤杂志

text: Since December 2019, the corona virus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (2019-nCoV) has been reported in Wuhan, Hubei Province. Almost 70% of patients susceptible to 2019-nCoV are over age of 50 years, with extremely large proportion of critical illness and death of the elderly patients. Meanwhile, the elderly patients are at high risk of osteoporotic fractures especially osteoporotic vertebral compression fractures (OVCF). During the prevention and control of COVID-19 epidemic, orthopedists are confronted with the following difficulties including how to screen and protect OVCF patients, how to accurately diagnose and assess the condition of OVCF patients with suspected or confirmed COVID-19, and how to develop reasonable treatment plans and comprehensive protective measures in emergency and outpatient clinics. In order to standardize the diagnosis and treatment of patients with OVCF diagnosed with COVID-19, the authors jointly develop this expert consensus. The consensus systematically recommends the standardized emergency and outpatient screening and confirmation procedures for OVCF patients with suspected or confirmed COVID-19 and protective measures for emergency and outpatient clinics. Moreover, the consensus describes the grading and classification of OVCF patients diagnosed with COVID-19 according to the severity of illness and recommends different treatment plans and corresponding protective measures based on the different types and epidemic prevention and control requirements.


title: Care of Patients With a Laryngectomy During the COVID-19 Pandemic

text: Patients with a laryngectomy are at increased risk for droplet-transmitted diseases and, therefore, COVID-19, which has now caused a worldwide pandemic. Adaptive measures to protect patients with a laryngectomy and their families were designed and implemented in the Hong Kong SAR (HK). Driven by the fear of severe acute respiratory syndrome in 2003, hospitals in HK have since modified infection control routines to prevent a repeat public health nightmare. To face COVID-19, caused by SARS-CoV-2, we have adapted guidelines for our patients with a laryngectomy. Contact precautions, droplet precautions with physical barriers, and hand and equipment hygiene are our mainstays of prevention against COVID-19, and sharing these routines is the aim of this article. The COVID-19 pandemic is still roaring ahead. Awareness and precautions for patients with a laryngectomy who may be at higher risk are outlined here and should be maintained during the current pandemic.


Covid-19: Increased demand for steroid inhalers causes "distressing" shortages


Let us not forget the mask in our attempts to stall the spread of COVID-19


Enteric involvement in hospitalised patients with COVID-19 outside Wuhan


title: Continuing medical education during a pandemic: an academic institution's experience

text: The COVID-19 pandemic has affected healthcare systems worldwide. The disruption to hospital routines has affected continuing medical education (CME) for specialty trainees (STs). We share our academic institution's experience in mitigating the disruption on the CME programme amidst the pandemic. Most specialty training programmes had switched to videoconferencing to maintain teaching. Some programmes also utilized small group teachings with precautions and e-learning modules. Surgical residencies were disproportionately affected due to reductions in elective procedures but some ways to provide continued surgical exposure include going through archived surgical videos with technical pointers from experienced faculty and usage of surgical simulators . We should adapt CME sessions to keep trainees up to date with core clinical competencies as they will continue to manage both COVID-19 and non-COVID-19 cases and this pandemic may last until year's end.


Initiating adjunct low-dose hydroxyurea therapy for stroke prevention in children with SCA during the COVID-19 pandemic


Covid-19: healthcare staff in hotspot areas are prioritised as testing expands


title: COVID-19, an opportunity to reevaluate the correlation between long-term effects of anthropogenic pollutants on viral epidemic/pandemic events and prevalence

text: Occupational, residential, dietary and environmental exposures to mixtures of synthetic anthropogenic chemicals after World War II have a strong relationship with the increase of chronic diseases, health cost and environmental pollution. The link between environment and immunity is particularly intriguing as it is known that chemicals and drugs can cause immunotoxicity (e.g., allergies and autoimmune diseases). In this review, we emphasize the relationship between long-term exposure to xenobiotic mixtures and immune deficiency inherent to chronic diseases and epidemics/pandemics. We also address the immunotoxicologic risk of vulnerable groups, taking into account biochemical and biophysical properties of SARS-CoV-2 and its immunopathological implications. We particularly underline the common mechanisms by which xenobiotics and SARS-CoV-2 act at the cellular and molecular level. We discuss how long-term exposure to thousand chemicals in mixtures, mostly fossil fuel derivatives, exposure toparticle matters, metals, ultraviolet (UV)-B radiation, ionizing radiation and lifestyle contribute to immunodeficiency observed in the contemporary pandemic, such as COVID-19, and thus threaten global public health, human prosperity and achievements, and global economy. Finally, we propose metrics which are needed to address the diverse health effects of anthropogenic COVID-19 crisis at present and those required to prevent similar future pandemics.


title: Surgical management strategies for orthopedic trauma patients under epidemic of novel coronavirus pneumonia/ 中华创伤杂志

text: With the outbreak of novel coronavirus pneumonia (NCP) induced by 2019 novel coronavirus (2019-nCoV) in Wuhan, Hubei Province in December 2019, more and more suspected or confirmed cases have been found in various regions of China. Although China has adopted unprecedented strict quarantine and closed management measures to prevent the spreading of the disease, Department of Traumatic Orthopedics may still have to manage NCP patients with open fractures or severe trauma that require emergency surgery. Therefore, the identification and management of 2019-nCoV infection as soon as possible as well as the protection of all medical staff involved in the emergency treatment of patients are the severe challenges faced by orthopedic traumatologists during the prevention and control of NCP. Based on the characteristics of such patients and related diagnosis and treatment experiences during the epidemic of NCP, the authors formulate the surgical management strategies for orthopedic trauma patients.


title: Guidelines on the Prevention and Control of Disease in Dental Practice during the Coronavirus Outbreak

text: Coronavirus disease 2019 has become a worldwide pandemic that is seriously jeopardising people's health. The National Health Commission and regional health administrations have issued regulations on the prevention and control of coronavirus disease 2019. Dentistry involves many invasive treatments, which differentiates it from other forms of medical practice. The following guidelines were produced by experts from the Stomatological Healthcare Service branch of the Chinese Stomatological Association to prevent the spread of coronavirus disease 2019 in dental clinics. The guidelines are in accordance with the relevant laws and documents from the health administration and range from technical guidelines to advice on how dental treatment should be conducted. Dental institutions can take these suggestions as a reference, based on the current local epidemic situation. It is anticipated that the guidelines will help dental institutions of different sizes to prevent the spread of the epidemic.


Prevention of COVID-19 by drug repurposing: rationale from drugs prescribed for mental disorders


title: "The storm has arrived": the impact of SARS-CoV-2 on medical students

text: In a few weeks, the global community has witnessed, and for some of us experienced first-hand, the human costs of the COVID-19 pandemic. There is incredible variability in how countries are choosing to thwart the disease's outbreak, sparking intense discussions around what it means to teach and learn in the era of COVID-19, and more specifically, the role medical students play in the midst of the pandemic. A multi-national and multi-institutional group made up of a dedicated medical student from Austria, passionate clinicians and educators from Switzerland, and a PhD scientist involved in Medical Education from Canada, have assembled to summarize the ingenious ways medical students around the world are contributing to emergency efforts. They argue that such efforts change COVID-19 from a "disruption" to medical students learning to something more tangible, more important, allowing students to become stakeholders in the expansion and delivery of healthcare.


Specific pathways to prevent SARS-CoV-2 infection in case of repeated hospital admissions for radiotherapy


docid: xtyxychf

title: COVID-19 in Pakistan: Impact on global polio eradication initiative


docid: doiketyf

title: Homeless mentally ill people and COVID-19 pandemic: The two-way sword for LMICs


title: Scientific Collaboration During the COVID-19 Pandemic: N95DECON.org

text: Many academics and researchers have responded to the COVID-19 pandemic by forming on-line national and international collaborative groups to rapidly investigate issues of prevention and treatment. This commentary describes the spontaneous formation of an international team of 115 researchers who summarized the literature on safe methods for decontaminating N95 filtering facepiece respirators in response to the supply crisis. The summary reports and fact sheets on the (www.n95decon.org) website have had more than 200 000 unique visits and the organization's webinars have reached health care professionals from more than 50 countries. The team is extending its mission to cover other personal protective equipment. The success of these collaborations may alter how scientific questions are tackled in the future.


title: Inflammation resolution: a dual-pronged approach to averting cytokine storms in COVID-19?

text: Severe coronavirus disease (COVID-19) is characterized by pulmonary hyper-inflammation and potentially life-threatening "cytokine storms". Controlling the local and systemic inflammatory response in COVID-19 may be as important as anti-viral therapies. Endogenous lipid autacoid mediators, referred to as eicosanoids, play a critical role in the induction of inflammation and pro-inflammatory cytokine production. SARS-CoV-2 may trigger a cell death ("debris")-induced "eicosanoid storm", including prostaglandins and leukotrienes, which in turn initiates a robust inflammatory response. A paradigm shift is emerging in our understanding of the resolution of inflammation as an active biochemical process with the discovery of novel endogenous specialized pro-resolving lipid autacoid mediators (SPMs), such as resolvins. Resolvins and other SPMs stimulate macrophage-mediated clearance of debris and counter pro-inflammatory cytokine production, a process called inflammation resolution. SPMs and their lipid precursors exhibit anti-viral activity at nanogram doses in the setting of influenza without being immunosuppressive. SPMs also promote anti-viral B cell antibodies and lymphocyte activity, highlighting their potential use in the treatment of COVID-19. Soluble epoxide hydrolase (sEH) inhibitors stabilize arachidonic acid-derived epoxyeicosatrienoic acids (EETs), which also stimulate inflammation resolution by promoting the production of pro-resolution mediators, activating anti-inflammatory processes, and preventing the cytokine storm. Both resolvins and EETs also attenuate pathological thrombosis and promote clot removal, which is emerging as a key pathology of COVID-19 infection. Thus, both SPMs and sEH inhibitors may promote the resolution of inflammation in COVID-19, thereby reducing acute respiratory distress syndrome (ARDS) and other life-threatening complications associated with robust viral-induced inflammation. While most COVID-19 clinical trials focus on "anti-viral" and "anti-inflammatory" strategies, stimulating inflammation resolution is a novel host-centric therapeutic avenue. Importantly, SPMs and sEH inhibitors are currently in clinical trials for other inflammatory diseases and could be rapidly translated for the management of COVID-19 via debris clearance and inflammatory cytokine suppression. Here, we discuss using pro-resolution mediators as a potential complement to current anti-viral strategies for COVID-19.


title: Citokinellenes terápia az új típusú koronavírus okozta megbetegedés (COVID-19) kezelésében - tocilizumab elsoként való alkalmazása egy hazai infektológiai osztályon./ Anti-cytokine therapy in novel coronavirus disease (COVID-19)  the first administration of tocilizumab in Hungary at a department of infectology

text: During the past few months, a pandemic originating from China named new coronavirus disease (COVID-19) has shown how vulnerable the world is. To date, no medication supported by randomized clinical trials has been approved for the treatment of COVID-19. At the time of writing of this paper, severe acute respiratory syndrome caused by coronavirus-2 (SARS-CoV-2) has been responsible - according to modest estimations - for around 4 million of infections and 300 000 deaths. Unveiling details of patomechanism, in fatal cases the role of immune dysregulation, namely cytokine release syndrome (CRS) has been discovered. Based on the current knowledge, interleukin-6 (IL6) plays a pivotal role in COVID-19 associated CRS. Case reports and result of small case series suggest efficacy of an IL6 inhibitor monoclonal antibody (tocilizumab) in treating CRS. Authors describe a case and review recent knowledge on the treatment of COVID-19. To our knowledge, the first case of severe COVID-19-associated cytokine storm syndrome - treated succesfully with IL6 monoclocal antibody at a Hungarian department of infectology - is presented here. Orv Hetil. 2020; 161(26): 1070-1077.


title: Coronavirus membrane fusion mechanism offers a potential target for antiviral development

text: The coronavirus disease 2019 (COVID-19) pandemic has focused attention on the need to develop effective therapies against the causative agent, SARS-CoV-2, and also against other pathogenic coronaviruses (CoV) that have emerged in the past or might appear in future. Researchers are therefore focusing on steps in the CoV replication cycle that may be vulnerable to inhibition by broad-spectrum or specific antiviral agents. The conserved nature of the fusion domain and mechanism across the CoV family make it a valuable target to elucidate and develop pan-CoV therapeutics. In this article, we review the role of the CoV spike protein in mediating fusion of the viral and host cell membranes, summarizing the results of research on SARS-CoV, MERS-CoV, and recent peer-reviewed studies of SARS-CoV-2, and suggest that the fusion mechanism be investigated as a potential antiviral target. We also provide a supplemental file containing background information on the biology, epidemiology, and clinical features of all human-infecting coronaviruses, along with a phylogenetic tree of these coronaviruses.


title: Energetics and IC50 based epitope screening in SARS CoV-2 (COVID 19) spike protein by immunoinformatic analysis implicating for a suitable vaccine development

text: BACKGROUND: The recent outbreak by SARS-CoV-2 has generated a chaos in global health and economy and claimed/infected a large number of lives. Closely resembling with SARS CoV, the present strain has manifested exceptionally higher degree of spreadability, virulence and stability possibly due to some unidentified mutations. The viral spike glycoprotein is very likely to interact with host Angiotensin-Converting Enzyme 2 (ACE2) and transmits its genetic materials and hijacks host machinery with extreme fidelity for self propagation. Few attempts have been made to develop a suitable vaccine or ACE2 blocker or virus-receptor inhibitor within this short period of time. METHODS: Here, attempt was taken to develop some therapeutic and vaccination strategies with a comparison of spike glycoproteins among SARS-CoV, MERS-CoV and the SARS-CoV-2. We verified their structure quality (SWISS-MODEL, Phyre2, and Pymol) topology (ProFunc), motifs (MEME Suite, GLAM2Scan), gene ontology based conserved domain (InterPro database) and screened several epitopes (SVMTrip) of SARS CoV-2 based on their energetics, IC50 and antigenicity with regard to their possible glycosylation and MHC/paratope binding (Vaxigen v2.0, HawkDock, ZDOCK Server) effects. RESULTS: We screened here few pairs of spike protein epitopic regions and selected their energetic, Inhibitory Concentration50 (IC50), MHC II reactivity and found some of those to be very good target for vaccination. A possible role of glycosylation on epitopic region showed profound effects on epitopic recognition. CONCLUSION: The present work might be helpful for the urgent development of a suitable vaccination regimen against SARS CoV-2.


Public health might be endangered by possible prolonged discharge of SARS-CoV-2 in stool


title: Characteristics of and Public Health Emergency Responses to COVID-19 and H1N1 Outbreaks: A Case-Comparison Study

text: BACKGROUND: Recently, the novel coronavirus disease (COVID-19) has already spread rapidly as a global pandemic, just like the H1N1 swine influenza in 2009. Evidences have indicated that the efficiency of emergency response was considered crucial to curb the spread of the emerging infectious disease. However, studies of COVID-19 on this topic are relatively few. METHODS: A qualitative comparative study was conducted to compare the timeline of emergency responses to H1N1 (2009) and COVID-19, by using a set of six key time nodes selected from international literature. Besides, we also explored the spread speed and peak time of COVID-19 and H1N1 swine influenza by comparing the confirmed cases in the same time interval. RESULTS: The government's entire emergency responses to the epidemic, H1N1 swine influenza (2009) completed in 28 days, and COVID-19 (2019) completed in 46 days. Emergency responses speed for H1N1 was 18 days faster. As for the epidemic spread speed, the peak time of H1N1 came about 4 weeks later than that of COVID-19, and the H1N1 curve in America was flatter than COVID-19 in China within the first four months after the disease emerged. CONCLUSIONS: The speed of the emergency responses to H1N1 was faster than COVID-19, which might be an important influential factor for slowing down the arrival of the peak time at the beginning of the epidemic. Although COVID-19 in China is coming to an end, the government should improve the public health emergency system, in order to control the spread of the epidemic and lessen the adverse social effects in possible future outbreaks.


title: Suggestions on the prevention of COVID-19 for health care workers in department of otorhinolaryngology head and neck surgery

text: The epidemic of the Coronavirus Disease 2019 (COVID-19) has presented as a grim and complex situation recently. More than 77,000 cases of COVID-19 has been confirmed in China until February 25th, 2020, which are causing great impact on economy and society, as well as seriously interfering with ordinary medical practice in the department of otorhinolaryngology head and neck surgery. This article discussed medical precautions required in the clinic, inpatient ward and operation room of otorhinolaryngology head and neck department, which aims to protect health care workers from COVID-19.


Guillain-Barré Syndrome Associated with SARS-CoV-2


Initial Observations of COVID-19 in US Children


Who Needs a Corona?


Covid-19: FDA approves use of convalescent plasma to treat critically ill patients


docid: lxmwpyin

title: Four cases from a family cluster were diagnosed as COVID-19 after 14-day of quarantine period


title: Influences of cyclosporin A and non-immunosuppressive derivatives on cellular cyclophilins and viral nucleocapsid protein during human coronavirus 229E replication

text: The well-known immunosuppressive drug cyclosporin A inhibits replication of various viruses including coronaviruses by binding to cellular cyclophilins thus inactivating their cis-trans peptidyl-prolyl isomerase function Viral nucleocapsid proteins are inevitable for genome encapsidation and replication Here we demonstrate the interaction between the N protein of HCoV-229E and cyclophilin A, not cyclophilin B Cyclophilin inhibitors abolish this interaction Upon infection, cyclophilin A stays evenly distributed throughout the cell, whereas cyclophilin B concentrates at ER-bleb-like structures We further show the inhibitory potential of non-immunosuppressive CsA derivatives Alisporivir, NIM811, compound 3 on HCoV-229E-GFP and -Luciferase replication in human Huh-7 5 hepatoma cells at 18 and 48 h time points post infection with EC50 s at low micromolar ranges Thus, non-immunosuppressive CsA derivatives effectively inhibit HCoV-229E replication suggesting them as possible candidates for the treatment of HCoV infection The interruption of interaction between CypA and N protein by CsA and its derivatives suggest a mechanism how CypA inhibitors suppress viral replication , Highlights:, * HCoV-229E replication is inhibited by Alisporivir, NIM811 and other non-immunosuppressive Cyclosporin A derivatives , * HCoV-229E N protein interacts with cyclophilin A , * Cyclophilin A is required for coronavirus replication , * Cyclophilin B concentrates in bleb-like structures of the ER in HCoV-infected Huh7 cells , (C) 2020Elsevier, Inc


title: Infection rate and clinical management of cancer patients during the COVID-19 pandemic: experience from a tertiary care hospital in northern Italy

text: BACKGROUND: Optimal management of patients with cancer during COVID-19 pandemic is still pending. METHODS: Our patients were advised to maintain their scheduled appointments, and planned cancer treatment was continued without unnecessary delays in an outpatient setting. Additional strict preventive infection measures were rapidly implemented at our outpatient department. When COVID-19 test became widely available, universal testing of healthcare workers and vigorous screening of all patients coming to our facility for COVID-19 infection were performed by SARS-CoV-2 real-time reverse transcription PCR on rhinopharyngeal swab. RESULTS: As of the data cut-off on 9 April 2020, a total of 156 oncology patients with a median age of 67 (range 26-86) years and 63 haematology patients (median age 69 years, range 23-89) were screened for COVID-19 during active cancer treatment. Prevalence (1.8%; 4/219) of COVID-19 in patients with cancer was significantly higher compared with a respective control group of asymptomatic counterparts (p=0.018). Outcomes of COVID-19 positive patients were good, with only one observed death due to progression of advanced metastatic disease. CONCLUSION: Our data indicate that continuation of anticancer treatment in epidemic areas during the COVID-19 pandemic seems to be safe and feasible, if adequate and strict preventive measures are vigorously and successfully carried out.


docid: ttduytys

title: RelDenClu:A Relative Density based Biclustering Method for identifying non-linear feature relations with an Application to identify factors effecting spread of COVID-19

text: The existing biclustering algorithms for finding feature relation based biclusters often depend on assumptions like monotonicity or linearity. Though a few algorithms overcome this problem by using density-based methods, they tend to miss out many biclusters because they use global criteria for identifying dense regions. The proposed method, RelDenClu uses the local variations in marginal and joint densities for each pair of features to find the subset of observations, which forms the bases of the relation between them. It then finds the set of features connected by a common set of observations, resulting in a bicluster. To show the effectiveness of the proposed methodology, experimentation has been carried out on fifteen types of simulated data. It has been used for unsupervised learning using three real-life datasets. Applicability of the algorithm is also explored on three real-life datasets to see its utility as an aid to supervised learning. For all the cases the performance of the proposed method is compared with that of seven different state-of-the-art algorithms. The proposed algorithm produces better results. The efficacy of the algorithm is shown on COVID-19 dataset and found out that some features (genetic, demographics and others) are likely to affect the spread of COVID-19.


title: Dispersion of speech aerosols in the context of physical distancing recommendations

text: High-speed particle image velocimetry (PIV) was used to quantify the dispersion of aerosol-laden gas clouds generated during phonetic vocalization by a human subject at different sound intensity levels. The measured PIV data was used to quantify the initial penetration depth. Using classical pulsed jet scaling laws propagation distances were computed for time periods beyond the measured duration. Our results indicate that the penetration distance was comparable between loud intensity speech (for example during singing, classroom lectures, parties etc.) and moderate intensity cough. Based on theoretical aerosol propagation distance and time, the 6 feet physical distancing recommendations are likely sufficient to avoid incidental exposure by the initial penetration of the aerosol cloud, but insufficient for prolonged exposure to slow propagating aerosol clouds.


COVID-19 and ethical considerations: Valuable decision-making tools from the leading medical societies in France


Scalable and robust SARS-CoV-2 testing in an academic center


Evidence of short-range aerosol transmission of SARS-CoV-2 and call for universal airborne precautions for anesthesiologists during the COVID-19 pandemic


title: [Health protection guideline of schools and other educational institutions during COVID-19 outbreak]

text: This guideline stipulates the management requirements, on-site hygiene operation, personal protection and comprehensive security of schools and other educational institutions. It is applicable to the unified standard prevention and control of schools and other educational institutions during COVID-19 outbreak.


title: Quantifying the Risk of SARS-CoV-2 Transmission in the United States

text: In the United States, the rate of symptomatic transmission of SARS-CoV-2 to contacts was only 0 45%, but was 10 5% in household contacts;there were tertiary symptomatic transmissions However, since only symptomatic individuals underwent testing, the actual overall rate of transmission with or without resultant symptomatic illness is likely to be higher , (C) 2020 AHC Media LLC


Patients with advanced basal cell carcinomas in treatment with sonic hedgehog inhibitors during the coronavirus disease 2019 (COVID-19) period: Management and adherence to treatment


Patient care during the COVID-19 pandemic: do not leave delirium behind


docid: tmyoycqk

title: Novel Coronavirus (COVID-19): A Global Pandemic


Letter to the Editor: "Medical Student Concerns Relating to Neurosurgery Education During COVID-19"


title: Study of lockdown/testing mitigation strategies on stochastic SIR model and its comparison with South Korea, Germany and New York data

text: We are currently facing a highly critical case of a world-wide pandemic. The novel coronavirus (SARS-CoV-2, a.k.a. COVID-19) has proved to be extremely contagious and the original outbreak from Asia has now spread to all continents. This situation will fruitfully profit from the study in regards of the spread of the virus, assessing effective countermeasures to weight the impact of the adopted strategies. The standard Susceptible-Infectious-Recovered (SIR) model is a very successful and widely used mathematical model for predicting the spread of an epidemic. We adopt the SIR model on a random network and extend the model to include control strategies {\em lockdown} and {\em testing} -- two often employed mitigation strategies. The ability of these strategies in controlling the pandemic spread is investigated by varying the effectiveness with which they are implemented. The possibility of a second outbreak is evaluated in detail after the mitigation strategies are withdrawn. We notice that, in any case, a sudden interruption of such mitigation strategies will likely induce a resurgence of a second outbreak, whose peak will be correlated to the number of susceptible individuals. In fact, we find that a population will remain vulnerable to the infection until the herd immunity is achieved. We also test our model with real statistics and information on the epidemic spread in South Korea, Germany, and New York and find a remarkable agreement with the simulation data.


Health Care Policy After the COVID-19 Pandemic


COVID-19 and the American Board of Ophthalmology: When the Best-Laid Plans Go Awry


Strengthening early testing and surveillance of COVID-19 to enhance identification of asymptomatic patients


Skin manifestations in COVID-19: A case series of five patients from Elazig, Turkey


Glucocorticoid therapy delays the clearance of SARS-CoV-2 RNA in an asymptomatic COVID-19 patient


Immunotherapies for COVID-19: lessons learned from sepsis


Neuroradiologists and the Novel Coronavirus


title: A short review on antibody therapy for COVID-19

text: The beginning of the novel SARS-CoV-2 human coronavirus in Wuhan, China, has triggered a worldwide respiratory disease outbreak (COVID-19). By April 07, 2020, SARS-CoV-2 has affected more than 1.36 million people worldwide and caused more than 75,900 deaths. To date, the anti-malaria drug hydroxychloroquine found to be a treatment option for SARS-CoV-2. In addition to supportive treatment, such as oxygen supply in moderate cases and extracorporeal membrane oxygenation in critically ill patients, unique medications for this condition are also under investigation. Here we reviewed the antibody therapy might be an immediate strategy for emergency prophylaxis and SARS-CoV-2 therapy.


title: Effect of hydroxychloroquine on prevention of COVID-19 virus infection among healthcare professionals: a structured summary of a study protocol for a randomised controlled trial

text: OBJECTIVES: Comparison of the effect of hydroxychloroquine with placebo to prevent infection from the COVID -19 virus among healthcare professionals TRIAL DESIGN: Single centre, 2-arm, double-blind randomised (ratio 1:1) placebo-controlled trial PARTICIPANTS: Treatment staff who are in contact with patients and have at least 3 shifts a week in Arash hospital affiliated with Tehran University of Medical Sciences, in Iran and who consent to participate in the study. Exclusion criteria include: History of COVID -19 virus infection, clinical symptoms such as fever, nausea, dyspnea and myalgia in the past two months, history of underlying diseases hypersensitivity to hydroxychloroquine and G6PD enzyme deficiency. INTERVENTION AND COMPARATOR: Intervention group: Hydroxychloroquine 200 mg tablet of Amin Pharmaceutical. CONTROL GROUP: placebo which is completely similar in form and taste to 200 mg hydroxychloroquine tablet and is manufactured by the same factory (Amin Pharmacy). The dosage is two tablets daily, once a week for one to three months (based on the duration of the Coronavirus epidemic in Tehran). MAIN OUTCOMES: Confirmed COVID-19 virus infection using Polymerase chain reaction (PCR) test is the primary outcome. The time period for measuring the primary outcome is any infection within the trial period up to one month after taking the last dose. RANDOMISATION: The randomized block allocation method was developed using Stata version 15 software by an independent researcher, using a block size of six. Allocation to the two treatment groups will be conducted by this researcher using paper labels (random 10-digit codes) in a 1:1 ratio t The labels will be attached to the drug packages in order of randomization. Drug packages will be arranged in a box according to the randomization list. BLINDING (MASKING): Participants and caregivers are blinded to group assignment and the data will be analyzed by an independent statistical expert who is unaware of the treatment allocation. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): A total of 282 participants will be randomised with 141 participants the Hydroxychloroquineeach intervention group and 141 participants to the placebo control group TRIAL STATUS: The protocol version number is 99-1-101-47091 and the approval ID is IR.TUMS.VCR.REC.1399.001 and recruitment began April 7, 2020, and is anticipated to be complete by August 7, 2020. TRIAL REGISTRATION: The name of the trial register is Iranian registry of clinical trial (IRCT), registration number is IRCT20120826010664N6, date of trial registration is April 7, 2020, FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


docid: ufjdefak

title: Surgical chief resident, a resilient figure during the COVID-19 pandemic


Rapid Detection of COVID-19 Coronavirus Using a Reverse Transcriptional Loop-Mediated Isothermal Amplification (RT-LAMP) Diagnostic Platform


Spontaneous reporting of onset of disturbing dreams and nightmares related to early life traumatic experiences during the COVID-19 pandemic by patients with posttraumatic stress disorder in remission


Covid-19: Woman whose father died in care home launches legal review over government's "litany of failures"


title: Anti-SARS-CoV-2 hyperimmune plasma workflow

text: Coronavirus disease 2019 (COVID-19) caused by the novel coronavirus has become a Public Health Emergency of International Concern. Among the various treatment proposals for COVID-19 infection, passive immunotherapy using plasma from recovering patients - "convalescent plasma" (CP)- could be a promising option in the treatment of SARS-CoV-2 infections. Immune (i.e. "convalescent") plasma refers to plasma that is collected from individuals, following resolution of infection and development of antibodies. Passive antibody administration through transfusion of convalescent plasma may offer the only short-term strategy to confer immediate immunity to susceptible individuals. According to the World Health Organization (WHO), the use of plasma therapy is permitted when faced with «serious diseases for which there are no effective pharmacological treatments¼. Several clinical trials are underway to test the effectiveness of hyperimmune plasma at various stages of SARS-CoV2.The Food and Drug Administration (FDA), the U.S. regulatory authority, has approved the use of CP for compassionate use in the treatment of patients with a critical COVID-19 infection. Below are the general indications for drawing up clinical protocols for the integral management of "COVID-19-convalescent plasma" for which the validation and approval of the Ethics Committees is still necessary.


title: Effects of nationwide lockdown during COVID-19 epidemic on lifestyle and other medical issues of patients with type 2 diabetes in north India

text: BACKGROUND AND AIMS: During the current pandemic of COVID-19, India is under lockdown which could cause disruption in diet and lifestyle in patients with type 2 diabetes (T2DM). We aimed to study lifestyle changes and other common issues related to treatment in our previously seen and treated patients with T2DM. METHODS: Patients (n, 150) who were regularly following up before lockdown were interviewed telephonically (after 45 days of start of lockdown) regarding lifestyle changes, stress and other diabetes-related questions. RESULT: Carbohydrate consumption and frequency of snacking increased in 21% and 23% patients, respectively. Interestingly, 27% patients reported an increase in consumption of fruits. Exercise duration was reduced in 42% and weight gain occurred in 19% patients. Frequency of doing self-monitoring of blood glucose (SMBG) was decreased in 23% patients. 'Mental stress' of any kind was reported in 87% patients. Availability of medicines and insulin was uninterrupted in 91% patients. Knowledge about telemedicine was present in 69% and majority (92%) of these patients preferred video consultation. CONCLUSION: During 45 days of lockdown increase in carbohydrate intake, decrease in exercise, decreased SMBG and widespread mental stress in patients with T2DM was recorded, factors which may destabilize or exacerbate hyperglycemia and hypertension. Some positive changes (e.g. increased intake of fruits) were also observed.


title: Is the mental health of young students and their family members affected during the quarantine period? Evidence from the COVID-19 pandemic in Albania

text: INTRODUCTION: The use of quarantine method has a significant impact on mental health status. AIM: This study aimed to assess the levels of depression among bachelor and master university students (nurses/midwives) and their family members' during the quarantine period of COVID-19 pandemic. METHOD: A cross-sectional study was conducted in Vlora University, Albania. Patient Health Questionnaire (PHQ-9) was used. Institutional e-mails of all active students were used for their recruitment. RESULTS: In total, 863 students and 249 family members participated in the study. The mean PHQ-9 score was 6.220 (SD=5.803) and 6.280 (SD=5.857) for students and family members, respectively. Being unsatisfied with COVID-19 prevention measures, beliefs that COVID-19 infection and quarantine process can cause problems on their health status were the key factors for students to be screened positive for mental problems in multiple regression analysis. For parents, the last two factors were found to contribute significantly. DISCUSSION: Our findings indicate that quarantine measures have a significant impact on the levels of depression among both university students and their family members. Broader population studies are necessary to safeguard these results. IMPLICATIONS FOR PRACTICE: Provision of mental health services during the quarantine period is of paramount significance. Mental health first aid trainingand support could benefit both students and their parents significantly. Additionally, follow up services after the end of quarantine are recommended.


COVID-19 and SIC (!)


title: The Efficacy of Lockdown Against COVID-19: A Cross-Country Panel Analysis

text: BACKGROUND: There has been much debate about the effectiveness of lockdown measures in containing COVID-19, and their appropriateness given the economic and social cost they entail. To the best of our knowledge, no existing contribution to the literature has attempted to gauge the effectiveness of lockdown measures over time in a longitudinal cross-country perspective. OBJECTIVES: This paper aims to fill the gap in the literature by assessing, at an international level, the effect of lockdown measures (or the lack of such measures) on the numbers of new infections. Given this policy's expected change in effectiveness over time, we also measure the effect of having a lockdown implemented over a given number of days (from 7 to 20 days). METHODS: We pursue our objectives by means of a quantitative panel analysis, building a longitudinal dataset with observations from countries all over the world, and estimating the impact of lockdown via feasible generalized least squares fixed effect, random effects, generalized estimating equation, and hierarchical linear models. RESULTS: Our results show that lockdown is effective in reducing the number of new cases in the countries that implement it, compared with those countries that do not. This is especially true around 10 days after the implementation of the policy. Its efficacy continues to grow up to 20 days after implementation. CONCLUSION: Results suggest that lockdown is effective in reducing the R0, i.e. the number of people infected by each infected person, and that, unlike what has been suggested in previous analyses, its efficacy continues to hold 20 days after the introduction of the policy.


Treating Insomnia during the COVID-19 Pandemic: Observations and Perspectives from a Behavioral Sleep Medicine Clinic


title: Emergency Center Curbside Screening during the COVID-19 Pandemic

text: UNSTRUCTURED: Coronavirus Disease (COVID-19) is a global pandemic that has placed a significant burden on the healthcare systems. Michigan has been one of the top states affected by COVID-19. We described the curbside testing procedure implemented at Beaumont Hospital, a large hospital in Royal Oak, Michigan. We aimed at evaluating its safety and efficiency. We reported on time to medical decision, time spent documenting electronic medical records (EMR), overall time of screening, and emergency center return evaluations. Because of the large volume of patients and testing that was required near the beginning of this pandemic, curbside screening became a safe and efficient way of delivering SARS-CoV-2 testing as it allowed for a medical decision within a median of 15 minutes from arrival. Less than 10% of these patients returned to the emergency center for evaluation at a minimum of 7 days follow up. Our curbside testing model encourages the incorporation of this model at other high-volume facilities during an infectious disease pandemic.


The impact of COVID policies on acute ophthalmology services-experiences from Moorfields Eye Hospital NHS Foundation Trust


title: Behavior of the PR interval with increasing heart rate in patients with COVID-19

text: BACKGROUND: Myriad manifestations of cardiovascular involvement have been described in patients with coronavirus disease 2019 (COVID-19), but there have been no reports of COVID-19 affecting the cardiac conduction system. The PR interval on the electrocardiogram (ECG) normally shortens with increasing heart rate (HR). The case of a patient with COVID-19 manifesting Mobitz type 1 atrioventricular (AV) block that normalized as the patient's condition improved prompted us to investigate PR interval behavior in patients with COVID-19. OBJECTIVE: The purpose of this study was to characterize PR interval behavior in hospitalized patients with COVID-19 and to correlate that behavior with clinical outcomes. METHODS: This study was a cross-sectional cohort analysis of confirmed COVID-19 cases (March 26, 2020, to April 25, 2020). We reviewed pre-COVID-19 and COVID-19 ECGs to characterize AV conduction by calculating the PR interval to HR (PR:HR) slope. Clinical endpoints were death or need for endotracheal intubation. RESULTS: ECGs from 75 patients (246 pre-COVID-19 ECGs and 246 COVID-19 ECGs) were analyzed for PR:HR slope. Of these patients, 38 (50.7%) showed the expected PR interval shortening with increasing HR (negative PR:HR slope), whereas 37 (49.3%) showed either no change (8 with PR:HR slope = 0) or paradoxical PR interval prolongation (29 with positive PR:HR slope) with increasing HR. Patients without PR interval shortening were more likely to die (11/37 [29.7%] vs 3/38 [7.9%]; P = .019) or require endotracheal intubation (16/37 [43.2%] vs 8/38 [21.1%]; P = .05) compared to patients with PR interval shortening. CONCLUSION: Half of patients with COVID-19 showed abnormal PR interval behavior (paradoxical prolongation or lack of shortening) with increasing HR. This finding was associated with increased risk of death and need for endotracheal intubation.


Multiple internal border zone infarcts in a patient with COVID-19 and CADASIL


title: Hybridization Chain Reactions Targeting the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

text: In this work, hybridization chain reactions (HCRs) toward Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) nucleocapsid phosphoproteins gene loci and human RNase P are proposed to provide an isothermal amplification screening tool. The proposed chain reactions target the complementary DNA (cDNA) of SARS-CoV-2, with loci corresponding to gold-standard polymerase chain reaction (PCR) loci. Four hybridization chain reaction reactions are demonstrated herein, targeting N1/N2/N3 loci and human RNase P. The design of the hybridization chain reaction, herein, is assisted with an algorithm. The algorithm helps to search target sequences with low local secondary structure and high hybridization efficiency. The loop domain of the fuel hairpin molecule H1 and H2, which are the tunable segments in such reactions, are used as an optimization parameter to improve the hybridization efficiency of the chain reaction. The algorithm-derived HCR reactions were validated with gel electrophoresis. All proposed reactions exhibit a hybridization complex with a molecular mass >1.5k base pairs, which is clear evidence of chain reaction. The hybridization efficiency trend revealed by gel electrophoresis corresponds nicely to the simulated data from the algorithm. The HCR reactions and the corresponding algorithm serve as a basis to further SARS-CoV-2 sensing applications and facilitate better screening strategies for the prevention of on-going pandemics.


COVID-19 and the nicotinic cholinergic system


Reordering gender systems: can COVID-19 lead to improved gender equality and health?


Permettre aux médecins et aux soignants d'exercer leur mission en accord avec leur devoir d'humanité


Incidence of COVID-19 in Pediatric Surgical Patients Among 3 US Children's Hospitals


title: COVID-19 infection and diffusion among the healthcare workforce in a large university-hospital in northwest Italy

text: Backgroud: Since the beginning of the coronavirus disease 2019 (COVID-19) outbreak, healthcare workers (HCWs) have been the workers most likely to contract the disease. Intensive focus is therefore needed on hospital strategies that minimize exposure and diffusion, confer protection and facilitate early detection and isolation of infected personnel. METHODS: To evaluate the early impact of a structured risk-management for exposed COVID-19 HCWs and describe how their characteristics contributed to infection and diffusion. Socio-demographic and clinical data, aspects of the event-exposure (date, place, length and distance of exposure, use of PPE) and details of the contact person were collected. RESULTS: The 2411 HCWs reported 2924 COVID-19 contacts. Among 830 HCWs who were at 'high or medium risk', 80 tested positive (9.6%). Physicians (OR=2.03), and non-medical services -resulted in an increased risk (OR=4.23). Patient care did not increase the risk but sharing the work environment did (OR=2.63). There was a significant time reduction between exposure and warning, exposure and test, and warning and test since protocol implementation. HCWs with management postitions were the main source of infection due to the high number of interactions. DISCUSSION: A proactive system that includes prompt detection of contagious staff and identification of sources of exposure helps to lower the intra-hospital spread of infection. A speedier return to work of staff who would otherwise have had to self-isolate as a precautionary measure improves staff morale and patient care by reducing the stress imposed by excessive workloads arising from staff shortages.


Responding to hospital system and student curricular needs: COVID-19 Student Service Corps


title: Responding to Hospital System and Student Curricular Needs: COVID-19 Student Service Corps

text: Throughout March 2020, cases of COVID-19 grew exponentially, and New York emerged as an epicenter of the crisis. Social distancing, shortages of personal protective equipment, and clinical care needs necessitated that students be removed from the clinical setting. A group of students, faculty members, and administrators formed to identify ways in which students could be involved in supporting the health system.


docid: blbadpqo

title: Relationship between Chest CT manifestations and immune response in COVID-19 patients

text: OBJECTIVES: To study the and correlations of lymphocytes and cytokines between changes of lung lesion volumes in patients with COVID-19, and to predict their correlation. METHODS: 93 patients with COVID-19 were divided into mild and severe groups. The data of lymphocyte subgroups and cytokines were collected, the imaging characteristics were measured and correlation analysis was performed to analyze the differences. RESULTS: 60 mild and 33 severe patients were included, Lymphocyte subsets decreased in both groups. The percentages of reduction of absolute lymphocytes value in mild and severe groups were 32% and 64% respectively. The lung CT lesion volume of all patients was 241.45 ± 282.92 cm3, among which the mild group was 151.29 ± 226.04 cm3 and the severe group was 405.38 ± 304.90 cm3, respectively. In critically ill patients, the decrease of absolute value of CD4 + T cells and increase of IL-6 level are significantly correlated with the volume of lung lesions. CONCLUSIONS: The absolute values of CD3+, CD4+, and CD8 + T cells are lower in patients with COVID-19, the levels of IL-6 and IL-10 are increased. The severity of lung lesions predicts poor clinical outcomes and may be a predictor of the transition from mild to severe.


Cardiovascular disease as a risk factor of disease progression in COVID-19: The corrected effect size and forest plot


Covid-19 Pandemic: Looking after the Mental Health of our Healthcare Workers


title: Contact tracing: a lesson from the Nipah virus in the time of COVID-19

text: Without a vaccine or proven therapeutic options in COVID-19, the World Health Organization (WHO) recommends a combination of measures: rapid diagnosis and immediate isolation of cases; rigorous contact tracing; and precautionary self-isolation of close contacts to curb the spread of COVID-19. During a Nipah outbreak in Kerala, India in 2019, it was confined to a single case. The authors were involved in the in-hospital contact tracing. With a single patient producing a contact list of 98 in a healthcare setting, the implications in a community setting during a pandemic of the scale of COVID-19 are huge but it proves that early and rigorous tracing with quarantining is an effective strategy to limit clusters. We believe that if the public is encouraged to maintain their own contact list on a daily basis, it would help in significantly reducing the time and effort invested into contact tracing in the event of a person contracting COVID-19.


Inflammatory bowel disease and the SARS-CoV-2 pandemic: more speed, less haste


Possibly critical role of wearing masks in general population in controlling COVID-19


Severe asthma at COVID-19 time: what's new on biologic therapies


Public Health and COVID-19: From Response to Recovery


Symptom Screening at Illness Onset of Health Care Personnel With SARS-CoV-2 Infection in King County, Washington


title: Multicenter initial guidance on use of antivirals for children with COVID-19/SARS-CoV-2

text: BACKGROUND: Although Coronavirus Disease 2019 (COVID-19) is mild in nearly all children, a small proportion of pediatric patients develops severe or critical illness. Guidance is therefore needed regarding use of agents with potential activity against severe acute respiratory syndrome coronavirus 2 in pediatrics. METHODS: A panel of pediatric infectious diseases physicians and pharmacists from 18 geographically diverse North American institutions was convened. Through a series of teleconferences and web-based surveys, a set of guidance statements was developed and refined based on review of best available evidence and expert opinion. RESULTS: Given the typically mild course of pediatric COVID-19, supportive care alone is suggested for the overwhelming majority of cases. The panel suggests a decision-making framework for antiviral therapy that weighs risks and benefits based on disease severity as indicated by respiratory support needs, with consideration on a case-by-case basis of potential pediatric risk factors for disease progression. If an antiviral is used, the panel suggests remdesivir as the preferred agent. Hydroxychloroquine could be considered for patients who are not candidates for remdesivir or when remdesivir is not available. Antivirals should preferably be used as part of a clinical trial if available. CONCLUSIONS: Antiviral therapy for COVID-19 is not necessary for the great majority of pediatric patients. For those rare children who develop severe or critical disease, this guidance offer an approach for decision-making regarding antivirals, informed by available data. As evidence continues to evolve rapidly, the need for updates to the guidance is anticipated.


How we mitigated and contained the COVID-19 outbreak in a hemodialysis center: Lessons and experience


title: Behaviour of occupational health services during the COVID-19 pandemic

text: BACKGROUND: Disasters, crises and pandemics are emergencies which impact on businesses severely. The COVID-19 pandemic reached its peak in mid-April 2020 in the UK. During this period, NHS Occupational Health Services (OHS) were stretched to their limit along with other health services. OHS may have had to change their pattern of operation, operating times, services offered, etc. to cope with the pandemic. Data about business model modifications, services offered by the OHS businesses during the pandemic could help in better utilization of OHS resources in the future. AIMS: To understand the behaviour of OHS in different parts of the country during the COVID-19 pandemic. METHODS: An online survey link was sent to both accredited and unaccredited UK Occupational Health Physicians (OHPs). RESULTS: Sixty-two OHPs responded to the survey. In the current pandemic, 51% of the OHS (95% CI 0.38-0.62) offered weekend or out-of-hours (OOH) services, 21% had to employ extra staff (95% CI 0.13-0.33) and 54% had to change their working hours (95% CI 0.41-0.65). Ninety per cent of the OHS (95% CI 0.78-0.94) continued to offer routine services; however, there was a decline in offering vaccination services. Fifty-six per cent of the OHS (95% CI 0.42-0.67) offered a dedicated telephone line and 46% of the OHS (95% CI 0.32-0.56) started a dedicated COVID-19 queries inbox. CONCLUSIONS: There was a change in the behaviour of the OHS to cope with the pandemic. Having a dedicated helpline to manage the crisis situation seemed a logical step whilst offering routine services.


Voices from the Frontlines: Social Workers Confront the COVID-19 Pandemic


title: Brief Report: Increased Addictive Internet and Substance Use Behavior During the COVID-19 Pandemic in China

text: BACKGROUND AND OBJECTIVES: The COVID-19 pandemic and control measures may have increased the risk of abusing addictive substances as well as addictive behaviors. METHODS: We present an initial online survey in 6416 Chinese about the relation between the COVID-19 pandemic and addictive behavior in China. RESULTS: During the COVID-19 pandemic, 46.8% of the subjects reported increased dependence on internet use, and 16.6% had longer hours of internet use. The prevalence (4.3%) of severe internet dependence rose up to 23% than that (3.5%) before the COVID-19 pandemic occurred, and their dependence degree rose 20 times more often than being declined (60% vs 3%). Relapses to abuse from alcohol and smoking abstinence were relatively common at 19% and 25%, respectively. Similarly, 32% of regular alcohol drinkers and 20% of regular smokers increased their usage amount during the pandemic. CONCLUSION AND SCIENTIFIC SIGNIFICANCE: These three coping behaviors (internet, alcohol, and smoking) during this COVID-19-related crisis appear to have increased the risk for substance use disorders and internet addiction. (Am J Addict 2020;00:00-00).


title: Running a Radiation Oncology Department at the time of coronavirus: an Italian experience

text: Starting from Wuhan, China, SARS-CoV-2 has been a catastrophic epidemic involving many countries worldwide. After China, Italy has been heavily affected and severe measures to limit the spread have been taken in the last weeks. Radiation Oncology departments must guarantee optimal cancer treatments even in such a challenging scenario of an ongoing aggressive epidemic. Adopted preventive measures and recommendations are highlighted for patients, professionals and clinical operations to minimize the risk of infection while safely treating cancer patients.


Emergent materials and industry 4.0 contribution toward pandemic diseases such as COVID-19


docid: cgvxmktm

title: Occurrence of Acute Pulmonary Embolism in COVID-19 - A Case Series


Baricitinib as potential treatment for 2019-nCoV acute respiratory disease


How New York City Health + Hospitals System-Wide Special Pathogens Program Responded to COVID-19


title: [Advances on presymptomatic or asymptomatic carrier transmission of COVID-19]

text: COVID-19 is rapidly spreading. Patients in incubation period and healthy carriers are possible sources for transmission. However, such sources of infection cannot be effectively identified due to the symptoms absent. The research evidence is very lacking so far, although there are a few studies suggesting that presymptomatic or asymptomatic carrier may cause COVID-19 transmission. Nearly half of the literature is in the state of preprint without peer review. The question of "the degree to which presymptomatic or asymptomatic infections can transmit" is not fully understood. There is an urgent need to screen infected carriers in larger close contacts or in the general population, and assess their risk for transmission.


title: COVID-19 and dermatology

text: Sars-CoV-2 virus infection (COVID-19) was observed in China in the last months of 2019. In the following period, this infection spread all over the world. In March 2020, the World Health Organization announced the existence of a pandemic. The aim of this manuscript is to investigate skin diseases associated with COVID-19 under three main headings: Skin problems related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infection and finally skin findings due to COVID- 19 treatment agents. Pressure injury, contact dermatitis, itch, pressure urticaria, exacerbation of pre-existing skin diseases and new skin lesion occurence / new skin disease occurence may be due to personal protective equipment. Skin problems related to personal hygiene measures could cause itch, dryness and contact dermatitis. Skin findings could also be observed in SARS-CoV-2 virus infection. The incidence of skin lesions because of COVID-19 was reported between 0.2% and 29%. Many skin lesions such as maculopapular, urticarial, vesicular, chilblain- like, thrombotic / ischemic etc. could be observed in COVID-19. Some authors state that the SARS-CoV-2 virus infection specific skin finding is absent. But, especially in asymptomatic or pre-symptomatic COVID-19 patients, skin lesions can lead to the diagnosis of COVID-19. In addition skin lesions could occur due to COVID-19 treatment agents. As a result, many skin lesions could appear because of COVID-19. Even if there were no COVID-19 diagnosis, skin findings should be evaluated carrefully in this pandemic period. Key worlds: SARS-CoV-2, COVID-19, dermatology, skin findings.


[Diagnosis and treatment recommendation for pediatric coronavirus disease-19]


Elective surgeries during the COVID-19 outbreak


title: Linear Regression Analysis to predict the number of deaths in India due to SARS-CoV-2 at 6 weeks from day 0 (100 cases - March 14th 2020)

text: INTRODUCTION: and Aims: No valid treatment or preventative strategy has evolved till date to counter the SARS CoV 2 (Novel Coronavirus) epidemic that originated in China in late 2019 and have since wrought havoc on millions across the world with illness, socioeconomic recession and death. This analysis was aimed at tracing a trend related to death counts expected at the 5th and 6th week of the COVID-19 in India. MATERIAL AND METHODS: Validated database was used to procure global and Indian data related to coronavirus and related outcomes. Multiple regression and linear regression analyses were used interchangeably. Since the week 6 death count data was not correlated significantly with any of the chosen inputs, an auto-regression technique was employed to improve the predictive ability of the regression model. RESULTS: A linear regression analysis predicted average week 5 death count to be 211 with a 95% CI: 1.31-2.60). Similarly, week 6 death count, in spite of a strong correlation with input variables, did not pass the test of statistical significance. Using auto-regression technique and using week 5 death count as input the linear regression model predicted week 6 death count in India to be 467, while keeping at the back of our mind the risk of over-estimation by most of the risk-based models. CONCLUSION: According to our analysis, if situation continue in present state; projected death rate (n) is 211 and467 at the end of the 5th and 6th week from now, respectively.


COVID-19 Outbreak and Cancer Radiotherapy Disruption in Lombardy, Northern Italy


title: Coronavirus (COVID-19) in the United Kingdom: A personality-based perspective on concerns and intention to self-isolate

text: Objectives Public behaviour change is necessary to contain the spread of coronavirus (COVID-19). Based on the reinforcement sensitivity theory (RST) framework, this study presents an examination of individual differences in some relevant psychological factors. Design Cross-sectional psychometric. Methods UK respondents (N = 202) completed a personality questionnaire (RST-PQ), measures of illness attitudes, concerns about the impact of coronavirus on health services and socio-economic infrastructures, personal safety, and likelihood of voluntary self-isolation. Results Respondents most concerned were older, had negative illness attitudes, and scored higher on reward reactivity (RR), indicating the motivation to take positive approach action despite prevailing worry/anxiety. Personal safety concerns were highest in those with negative illness attitudes and higher fight-flight-freeze system (FFFS, reflecting fear/avoidance) scores. Results suggest people are experiencing psychological conflict: between the urge to stay safe (FFFF-related) and the desire to maintain a normal, pleasurable (RR-related) life. Ways of ameliorating conflict may include maladaptive behaviours (panic buying), reflecting reward-related displacement activity. Intended self-isolation related to FFFS, but also low behavioural inhibition system (related to anxiety) scores. Older people reported themselves less likely to self-isolate. Conclusions Interventions need to consider individual differences in psychological factors in behaviour change, and we discuss relevant literature to inform policy makers and communicators. Statement of contribution What is already known on this subject? Reinforcement sensitivity theory (RST) personality systems can influence perception of persuasive health messages. However, there is limited evidence for their direct effects on health concerns and behaviours, and none relating to specific infectious diseases. What does this study add? Reward reactivity (RR) is associated with concern about impact of coronavirus on the NHS and other social infrastructures, indicating the motivation to take positive-approach action despite worry/anxiety. Personal safety concerns are related to fight-flight-freeze system traits (FFFS, reflecting fear/avoidance). Intended self-isolation related to FFFS, but also low behavioural inhibition system (related to anxiety) scores. Older people reported themselves less likely to self-isolate. Results suggest psychological conflict: between the urge to stay safe (FFFF-related) and the desire to maintain a normal, pleasurable life (RR-related). Ways of ameliorating conflict may include maladaptive behaviours (panic buying), reflecting reward-related displacement activity.


title: Un altro effetto di CoViD-19: accendere le luci sulla situazione carceraria italiana./ [Another effect of CoViD-19: turning on the lights on the Italian prison situation.]

text: Some violence related to CoViD-19 counteracting measures occurred in some Italian prison last month. Epidemic CoViD-19 reflects the higher risk of infections among inmates and personnel, due to closed proximity, prison overcrowding and structural conditions of Italian prisons. In the world, the higher risk infections among prisoners has been investigated in many studies, showing that, compared with the general public, people in prisons have a higher prevalence of infection such as HIV, hepatitis C virus (HCV) and tuberculosis. This is recognized as a major issue for the health of people in prisons, as well as the general population, because the majority of people who have been incarcerated will subsequently return to their communities. In Italy there are no enough available data to know the sanitary impact of such epidemic, so that preventive measures are extremely urgent.


Stroke: "striking reductions" are seen in number of people with symptoms seeking help


Regional anesthesia during the COVID-19 pandemic: a time to reconsider practices? (Letter #2)


title: Association of Renin-Angiotensin System Inhibitors With Severity or Risk of Death in Patients With Hypertension Hospitalized for Coronavirus Disease 2019 (COVID-19) Infection in Wuhan, China

text: Importance: Data are lacking whether patients with hypertension who are taking angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) have increased severity or risk of mortality during hospitalization for coronavirus disease 2019 (COVID-19). Objective: To investigate the association between ACEIs/ARBs and severity of illness and mortality in patients with hypertension hospitalized for COVID-19 infection. Design, Setting, and Participants: Retrospective, single-center case series of the 1178 hospitalized patients with COVID-19 infections at the Central Hospital of Wuhan, China, from January 15 to March 15, 2020. Main Outcomes and Measures: COVID-19 was confirmed by real-time reverse transcription-polymerase chain reaction and epidemiologic, clinical, radiologic, laboratory, and drug therapy data were analyzed in all patients. The percentage of patients with hypertension taking ACEIs/ARBs was compared between those with severe vs nonsevere illness and between survivors vs nonsurvivors. Results: Of the 1178 patients with COVID-19, the median age was 55.5 years (interquartile range, 38-67 years) and 545 (46.3%) were men. The overall in-hospital mortality was 11.0%. There were 362 patients with hypertension (30.7% of the total group; median age, 66.0 years [interquartile range, 59-73 years]; 189 [52.2%] were men), of whom 115 (31.8%) were taking ACEI/ARBs. The in-hospital mortality in the patients with hypertension was 21.3%. The percentage of patients with hypertension taking ACEIs/ARBs did not differ between those with severe and nonsevere infections (32.9% vs 30.7%; P = .65) nor did it differ between nonsurvivors and survivors (27.3% vs 33.0%; P = .34). Similar findings were observed when data were analyzed for patients taking ACEIs and those taking ARBs. Conclusions and Relevance: This study provides clinical data on the association between ACEIs/ARBs and outcomes in patients with hypertension hospitalized with COVID-19 infections, suggesting that ACEIs/ARBs are not associated with the severity or mortality of COVID-19 in such patients. These data support current guidelines and societal recommendations for treating hypertension during the COVID-19 pandemic.


title: Hand hygiene in high-complexity sectors as an integrating element in the combat of Sars-CoV-2

text: OBJECTIVE: to perform a situational diagnosis of the behavior of health professionals concerning hand hygiene practices in highly-complex sectors. METHODS: this quantitative and retrospective study was based on reports (2016 and 2017) of Adult and Pediatric ICUs of a Federal hospital in Rio de Janeiro. RESULTS: one thousand two hundred fifty-eight opportunities for hand hygiene were analysed. The chance of professionals sanitizing hands in Pediatric ICUs is 41.61% higher than in Adult ICUs. Concerning proper hand hygiene, the medical team had a 39.44% lower chance than the nursing team. Others had a 30.62% lower chance when compared to the nursing team. The moment "after contact with the patient" presented 4.5275 times the chance in relation "before contact with the patient". CONCLUSION: in front of hand hygiene recommendations to control COVID-19, diagnostic assessment and previous analysis of the behavior of professionals proved to be positive.


title: The epidemiological characteristics of 2019 novel coronavirus diseases (COVID-19) in Jingmen, Hubei, China

text: There is currently a global outbreak of coronavirus disease 2019 (COVID-19), and its epidemic characteristics in the areas where the outbreak has been successfully controlled are rarely reported.Describe the epidemic characteristics of COVID-19 in Jingmen, Hubei, introduce the local prevention and control experience, and observe the impact of various prevention and control measures on the number of new cases.All the COVID-19 patients diagnosed in the municipal districts of Jingmen from January 12 to February 29, 2020 were enrolled in this study. We described epidemiological data and observed the impact of control measures on the epidemic.Of the 219 cases (110 men and 109 women), 88 (40%) had exposure to Wuhan. The median age was 48 years (range, 2-88 years; IQR, 35-60). Thirty-three severe patients with a median age of 66 years (range, 33-82 years, IQR, 57-76) were treated in intensive care units; out of these patients, 66.7% (22) were men and 19 (57.5%) had chronic diseases, including hypertension, diabetes, heart failure, stroke, and renal insufficiency. Under the control measures, the number of new patients gradually decreased and nearly disappeared after 18 days. Wearing masks in all kinds of situations prevents most infections and is one of the most effective prevention and control measures.In conclusion, all people are susceptible to COVID-19, and older males and those with comorbid conditions are more likely to become severe cases. Even though COVID-19 is highly contagious, control measures have proven to be very effective, particularly wearing masks, which could prevent most infections.


docid: fiyhpafu

title: Targeting T-cell senescence and cytokine storm with rapamycin to prevent severe progression in COVID-19


title: Interdisciplinary care for spinal cord injured refugees

text: INTRODUCTION: For war-injured refugees, spinal cord injury (SCI) is a leading cause of catastrophic neurologic injury and literature focused on the care of this vulnerable population is sparse. This case series describes the unique challenges presented to an outpatient interdisciplinary rehabilitation team in providing SCI care in the USA for refugees who suffered their SCI in their home countries. CASE PRESENTATION: Our interdisciplinary rehabilitation team faced challenges related to language, cultural and educational barriers which impacted the typical standard rehabilitation care offered to these individuals. Many of the individuals were focused on curative treatments. As such, managing expectations and educating individuals to rehabilitation practices for chronic SCI and lack of curative treatments for associated medical complications affected the provision of care across all disciplines of the rehabilitation team. DISCUSSION: This case series showcases the challenges of caring for international refugees with SCI. The care offered to these individuals highlights the benefits that an interdisciplinary SCI rehabilitation approach can provide to comprehensively care for this vulnerable population.


Covid-19 and the documented failure of the American illness profit system - We have to stop treating our doctors, nurses, healthcare workers, and ourselves this way


Personal Experience With COVID-19 and Community Screening of Diabetic Retinopathy in Iran


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title: Potential ocular and systemic COVID-19 prophylaxis approaches for healthcare professionals

text: The COVID-19 pandemic has brought with it, innumerable challenges in healthcare, both through the direct burden of morbidity and mortality of the disease, and also by the curtailing of other essential albeit less emergency medical services to reduce the risk of community spread. Reports from around the world are showing mounting number of cases even in healthcare professionals spite of usage of adequate personal protective equipment. There are a number of factors which could account for this, be it the affinity of the virus to the respiratory and other mucosa or to patient risk factors for developing severe forms of the disease. In view of the growing need for resuming other medical services, it is essential to find newer ways to protect ourselves better, whether by systemic or topical mucosal prophylaxis with various medications or lifestyle changes promoting wellbeing and immunity. This article discusses additional prophylactic measures including drug repurposing or new indication paradigms to render protection. Certain medications such as chloroquine, trehalose, antihistaminics, and interferons used topically for various ocular conditions with reasonably good safety records are known to have anti-viral properties. Hence, can be harnessed in preventing SARS-CoV-2 attachment, entry, and/or replication in host cells. Similarly, use of hypertonic saline for nasal and oral mucosa and dietary changes are possible methods of improving our resistance. These additional prophylactic measures can be cautiously explored by healthcare professionals to protect themselves and their patients.


title: Comicolorization: Semi-Automatic Manga Colorization

text: We developed"Comicolorization", a semi-automatic colorization system for manga images. Given a monochrome manga and reference images as inputs, our system generates a plausible color version of the manga. This is the first work to address the colorization of an entire manga title (a set of manga pages). Our method colorizes a whole page (not a single panel) semi-automatically, with the same color for the same character across multiple panels. To colorize the target character by the color from the reference image, we extract a color feature from the reference and feed it to the colorization network to help the colorization. Our approach employs adversarial loss to encourage the effect of the color features. Optionally, our tool allows users to revise the colorization result interactively. By feeding the color features to our deep colorization network, we accomplish colorization of the entire manga using the desired colors for each panel.


Unprecedented solutions for extraordinary times: Helping long-term care settings deal with the COVID-19 pandemic


Incidentally discovered COVID-19 pneumonia: the role of diagnostic imaging


Essere cardiologo ai tempi del SARS-COVID-19: è tempo di riconsiderare il nostro modo di lavorare? ADDENDA ONLINE


The Course of Eating Disorders During COVID-19


title: Red blood cell exchange to avoid intubating a COVID-19 positive patient with sickle cell disease?

text: As the COVID-19 pandemic continues to claim lives across the globe, insufficient data exists regarding the optimal treatment. It is well known that patients 55 years of age or older and patients with certain chronic diseases are at higher risk of severe illness, including acute respiratory distress syndrome and death. A potentially fatal pulmonary complication of sickle cell disease, acute chest syndrome, can be precipitated by acute infections, including respiratory viruses. We report the case of a patient with sickle cell disease (HbSC) who developed COVID-19 pneumonia and acute chest syndrome who was treated with emergent red blood cell exchange in order to avoid endotracheal intubation.


title: Perspectives for the use of therapeutic Botulinum toxin as a multifaceted candidate drug to attenuate COVID-19

text: The recent outbreak of coronavirus disease (COVID-19) resulting from a distinctive severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) continues to evolve in many countries and pose life-threatening clinical issues to global public health. While the lungs are the primary target for the SARS-CoV-2-mediated pathological consequence, SARS-CoV-2 appear to invade the brain and cause neurological deficits. In the later stage, COVID-19 can progress to pneumonia, acute respiratory failure, neurological deficits and multi-organ dysfunctions leading to death. Though a significant portion of SARS-CoV-2 infected individuals has been recovering from pathological symptoms, the impact of the COVID-19 on the structural and functional properties of the lungs, heart, brain and other organs at the post-recovery state remains unknown. Presently, there is an urgent need for a remedial measure to combat this devastating COVID-19. Botulinum toxins (BoNTs) are potent neurotoxins that can induce paralysis of muscle and acute respiratory arrest in human. However, a mild dose of the purified form of BoNT has been known to attenuate chronic cough, dyspnoea, pneumonia, acute respiratory failure, abnormal circulation, cardiac defects and various neurological deficits that have been recognised as the prominent clinical symptoms of COVID-19. Considering the fact, this review article provides 1) an overview on the SARS-CoV-2 mediated pathological impact on the lungs, heart and brain, 2) signifies the therapeutic uses of BoNTs against pulmonary failure, cardiac arrest and neurological deficits, and 3) emphasize the rationality for the possible use of BoNT to prevent SARS-CoV-2 infection and manage COVID-19.


title: Saving the Diabetic Foot During the COVID-19 Pandemic: A Tale of Two Cities

text: Of all the late complications of diabetes, those involving the foot have traditionally required more face-to-face patient visits to clinics to treat wounds by debridement, offloading, and many other treatment modalities. The advent of the coronavirus disease 2019 (COVID-19) pandemic has resulted not only in the closing of most outpatient clinics for face-to-face consultations but also in the inability to perform most laboratory and imaging investigations. This has resulted in a paradigm shift in the delivery of care for those with diabetic foot ulcers. The approaches to this challenge in two centers with an interest in diabetic foot disease, including virtual consultations using physician-to-patient and physician-to-home nurse telemedicine as well as home podiatry visits, are described in this review and are illustrated by several case vignettes. The outcomes from these two centers suggest that we may be witnessing new possibilities in models of care for the diabetic foot.


Lack of supporting data make the risks of a clinical trial of radiation therapy as a treatment for COVID-19 pneumonia unacceptable


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title: A Word from OLAW: COVID-19 guidance


docid: tvslcuqq

title: Managing Oncology Services During a Major Coronavirus Outbreak: Lessons From the Saudi Arabia Experience

text: Outbreaks of infectious etiology, particularly those caused by a novel virus that has no known treatment or vaccine, may result in the interruption of medical care provided to patients with cancer and put them at risk for undertreatment in addition to the risk of being exposed to infection, a life-threatening event among patients with cancer. This article describes the approach used to manage patients with cancer during a large-scale Middle East respiratory syndrome-coronavirus hospital outbreak in Saudi Arabia to ensure continuity of care and minimize harm from treatment interruption or acquiring infection. The approach taken toward managing this high-risk situation (COVID-19) could be easily adopted by health care organizations and would be helpful to ensure readiness for the occurrence of future outbreaks of different infectious etiologies like those recent episodes of new coronavirus.


Epidemiology of Coronavirus Disease Outbreak: The Italian Trends


How the coronavirus pandemic has affected the clinical management of Philadelphia-negative chronic myeloproliferative neoplasms in Italy-a GIMEMA MPN WP survey


title: The role of natriuretic peptide estimation in severe COVID-19

text: Since its inception in Wuhan in December 2019, Coronavirus disease 2019 (COVID-19) has shattered the economies and health-care infrastructures worldwide. Even the best of health-care systems (United States, Italy) have been overwhelmed and collapsed because of this unprecedented pandemic. India is preparing itself for the onslaught of Coronavirus. After recording its first case on January 30th, 2020, the rise was slow until the last week of March. However, since then, the number of cases has increased exponentially, and as on April 14th, 2020, there have been more than 10,000 cases of coronavirus disease (COVID-19) in India, which has resulted in more than 350 deaths.


title: The novel coronavirus (COVID-19) pneumonia with negative detection of viral ribonucleic acid from nasopharyngeal swabs: a case report

text: BACKGROUND: The novel coronavirus disease 2019 (COVID-19) outbreak started in Wuhan, Hubei, China since Dec 2019 and cases of infection have been continuously reported in various countries. It is now clear that the SARS-COV-2 coronavirus is transmissible from human to human. Nucleic acid detection is considered as the gold standard for the diagnosis of COVID-19. In this case report, we describe our experience in detection of SARS-COV-2 from a confirmed patient using nucleic acid test of bronchoalveolar-lavage fluid (BALF) samples but not nasopharyngeal swabs. CASE PRESENTATION: We present a case of severely ill SARS-COV-2 infected 46-year-old man with fever, coughing and chest tightness. We performed viral detection using his BALF samples and imaging method (CT) for confirmation. The patient received combination of interferonalfa-1b and ribavirin, lopinavir and ritonavir for antiviral treatment at different stages. Other medication was also given to him in combination for anti-inflammation, intestinal microbial regulation, phlegm elimination, liver protection and pulmonary fibrosis prevention purposes. We provided oxygen supply to him using BIPAP ventilator and high-flow humidification oxygen therapy instrument to facilitate respiration. The patient was cured and discharged. CONCLUSION: This case report described an effective supportive medication scheme to treat SARS-COV-2 infected patient and emphasized the necessity of detection of the viral genome using BALF samples and its significance in the diagnosis and prognosis of the disease.


title: Structure-based design of antiviral drug candidates targeting the SARS-CoV-2 main protease

text: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is the etiological agent responsible for the global COVID-19 (coronavirus disease 2019) outbreak. The main protease of SARS-CoV-2, Mpro, is a key enzyme that plays a pivotal role in mediating viral replication and transcription. We designed and synthesized two lead compounds (11a and 11b) targeting Mpro Both exhibited excellent inhibitory activity and potent anti-SARS-CoV-2 infection activity. The x-ray crystal structures of SARS-CoV-2 Mpro in complex with 11a or 11b, both determined at a resolution of 1.5 angstroms, showed that the aldehyde groups of 11a and 11b are covalently bound to cysteine 145 of Mpro Both compounds showed good pharmacokinetic properties in vivo, and 11a also exhibited low toxicity, which suggests that these compounds are promising drug candidates.


title: COVID-19 pathophysiology: A review

text: In December 2019, a novel coronavirus, now named as SARS-CoV-2, caused a series of acute atypical respiratory diseases in Wuhan, Hubei Province, China. The disease caused by this virus was termed COVID-19. The virus is transmittable between humans and has caused pandemic worldwide. The number of death tolls continues to rise and a large number of countries have been forced to do social distancing and lockdown. Lack of targeted therapy continues to be a problem. Epidemiological studies showed that elder patients were more susceptible to severe diseases, while children tend to have milder symptoms. Here we reviewed the current knowledge about this disease and considered the potential explanation of the different symptomatology between children and adults.


Infodemic and the spread of fake news in the COVID-19-era