title: The value of clinical parameters in predicting the severity of COVID-19

text: To study the relationship between clinical indexes and the severity of coronavirus disease 2019 (COVID-19), and to explore its role in predicting the severity of COVID-19. Clinical data of 443 patients with COVID-19 admitted to our hospital were retrospectively analyzed, which were divided into nonsevere group (n = 304) and severe group (n = 139) according to their condition. Clinical indicators were compared between different groups. The differences in sex, age, the proportion of patients with combined heart disease, leukocyte, neutrophil-to-lymphocyte ratio (NLR), neutrophil, lymphocyte, platelet, D-dimer, C-reactive protein (CRP), procalcitonin, lactate dehydrogenase, and albumin on admission between the two groups were statistically significant (P < .05). Multivariate logistic regression analysis showed NLR and CRP were independent risk factors for severe COVID-19. Platelets were independent protective factors for severe COVID-19. The receiver operating characteristic (ROC) curve analysis demonstrated area under the curve of NLR, platelet, CRP, and combination was 0.737, 0.634, 0.734, and 0.774, respectively. NLR, CRP, and platelets can effectively assess the severity of COVID-19, among which NLR is the best predictor of severe COVID-19, and the combination of three clinical indicators can further predict severe COVID-19.


The Airway Lead: opportunities to improve institutional and personal preparedness for airway management


title: Getting Insights from a Large Corpus of Scientific Papers on Specialisted Comprehensive Topics -- the Case of COVID-19

text: COVID-19 is one of the most important topic these days, specifically on search engines and news. While fake news are easily shared, scientific papers are reliable sources where information can be extracted. With about 24,000 scientific publications on COVID-19 and related research on PUBMED, automatic computer-assisted analysis is required. In this paper, we develop two methodologies to get insights on specific sub-topics of interest and latest research sub-topics. They rely on natural language processing and graph-based visualizations. We run these methodologies on two cases: the virus origin and the uses of existing drugs.


title: A snapshot of the Covid-19 pandemic among pregnant women in France

text: OBJECTIVE: To describe the course over time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in French women from the beginning of the pandemic until mid-April, the risk profile of women with respiratory complications, and short-term pregnancy outcomes. METHODS: We collected a case series of pregnant women with COVID-19 in a research network of 33 French maternity units between March 1 and April 14, 2020. All cases of SARS-CoV-2 infection confirmed by a positive result on real-time reverse transcriptase polymerase chain reaction tests of a nasal sample and/or diagnosed by a computed tomography chest scan were included and analyzed. The primary outcome measures were COVID-19 requiring oxygen (oxygen therapy or noninvasive ventilation) and critical COVID-19 (requiring invasive mechanical ventilation or extracorporeal membrane oxygenation, ECMO). Demographic data, baseline comorbidities, and pregnancy outcomes were also collected. RESULTS: Active cases of COVID-19 increased exponentially during March 1-31, 2020; the numbers fell during April 1-14, after lockdown was imposed on March 17. The shape of the curve of active critical COVID-19 mirrored that of all active cases. By April 14, among the 617 pregnant women with COVID-19, 93 women (15.1 %; 95 %CI 12.3-18.1) had required oxygen therapy and 35 others (5.7 %; 95 %CI 4.0-7.8) had had a critical form of COVID-19. The severity of the disease was associated with age older than 35 years and obesity, as well as preexisting diabetes, previous preeclampsia, and gestational hypertension or preeclampsia. One woman with critical COVID-19 died (0.2 %; 95 %CI 0-0.9). Among the women who gave birth, rates of preterm birth in women with non-severe, oxygen-requiring, and critical COVID-19 were 13/123 (10.6 %), 14/29 (48.3 %), and 23/29 (79.3 %) before 37 weeks and 3/123 (2.4 %), 4/29 (13.8 %), and 14/29 (48.3 %) before 32 weeks, respectively. One neonate (0.5 %; 95 %CI 0.01-2.9) in the critical group died from prematurity. CONCLUSION: COVID-19 can be responsible for significant rates of severe acute, potentially deadly, respiratory distress syndromes. The most vulnerable pregnant women, those with comorbidities, may benefit particularly from prevention measures such as a lockdown.


Four Strategies for Plastic Surgery Education Amidst the COVID-19 Pandemic


Two consecutive myocardial tissue insults for inpatients with COVID-19


A novel COVID-19 and its effects on cardiovascular disease


Coronavirus modelling - boost developing world capacity


Iran Without Mandatory Quarantine and with Social Distancing Strategy Against Coronavirus Disease (COVID-19)


Urgent Pacemaker Implantation Rates in the Veneto Region of Italy After the COVID-19 Outbreak


The Brazilian slums hiring their own doctors to fight covid-19


title: Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms

text: Coronavirus disease 2019 (COVID-19), a disease caused by the novel betacoronavirus (SARS-CoV-2), has become a global pandemic threat. The potential involvement of COVID-19 in central nervous system (CNS) has attracted considerable attention due to neurological manifestations presented throughout the disease process. In addition, SARS-CoV-2 is structurally similar to SARS-CoV, and both bind to the angiotensin-converting enzyme 2 (ACE2) receptor to enter human cells. Thus, cells expressing ACE2, such as neurons and glial cells may act as targets and are thus vulnerable to SARS-CoV-2 infection. Here, we have reviewed the neurological characteristics of COVID-19 and summarized possible mechanisms of SARS-CoV-2 invasion of the CNS. COVID-19 patients have presented with a number of different neurological symptoms such as headache, dizziness, hyposmia, and hypogeusia during the course of illness. It has also been reported recently that some cases of COVID-19 have presented with concurrent acute cerebrovascular disease (acute ischemic stroke, cerebral venous sinus thrombosis, cerebral hemorrhage, subarachnoid hemorrhage), meningitis/encephalitis, acute necrotizing hemorrhagic encephalopathy, and acute Guillain-Barré syndrome. Furthermore, SARS-CoV-2 RNA detected in a cerebrospinal fluid specimen of a patient with COVID-19 have provided direct evidence to support the theory of neurotropic involvement of SARS-CoV-2. However, the underlying neurotropic mechanisms of SARS-CoV-2 are yet to be established. SARS-CoV-2 may affect CNS through two direct mechanisms (hematogenous dissemination or neuronal retrograde dissemination) or via indirect routes. The underlying mechanisms require further elucidation in the future.


title: Divergent modes of online collective attention to the COVID-19 pandemic are associated with future caseload variance

text: Using a random 10% sample of tweets authored from 2019-09-01 through 2020-04-30, we analyze the dynamic behavior of words (1-grams) used on Twitter to describe the ongoing COVID-19 pandemic. Across 24 languages, we find two distinct dynamic regimes: One characterizing the rise and subsequent collapse in collective attention to the initial Coronavirus outbreak in late January, and a second that represents March COVID-19-related discourse. Aggregating countries by dominant language use, we find that volatility in the first dynamic regime is associated with future volatility in new cases of COVID-19 roughly three weeks (average 22.49 $\pm$ 3.26 days) later. Our results suggest that surveillance of change in usage of epidemiology-related words on social media may be useful in forecasting later change in disease case numbers, but we emphasize that our current findings are not causal or necessarily predictive.


docid: qznrjflx

title: Active and inactive quarantine in epidemic spreading on adaptive activity-driven networks

text: We consider an epidemic process on adaptive activity-driven temporal networks, with adaptive behaviour modelled as a change in activity and attractiveness due to infection. By using a mean-field approach, we derive an analytical estimate of the epidemic threshold for SIS and SIR epidemic models for a general adaptive strategy, which strongly depends on the correlations between activity and attractiveness in the susceptible and infected states. We focus on a strong adaptive behaviour, implementing two types of quarantine inspired by recent real case studies: an active quarantine, in which the population compensates the loss of links rewiring the ineffective connections towards non-quarantining nodes, and an inactive quarantine, in which the links with quarantined nodes are not rewired. Both strategies feature the same epidemic threshold but they strongly differ in the dynamics of active phase. We show that the active quarantine is extremely less effective in reducing the impact of the epidemic in the active phase compared to the inactive one, and that in SIR model a late adoption of measures requires inactive quarantine to reach containment.


title: ESGE and ESGENA Position Statement on gastrointestinal endoscopy and COVID-19: An update on guidance during the post-lockdown phase and selected results from a membership survey

text: N/A.


title: å¿ç«¥2019å ç¶ç æ¯ç æ£è çè¸é¨CTè¡¨ç°åä¸´åºç¹å¾./ å¿ç«¥2019å ç¶ç æ¯ç æ£è çè¸é¨CTè¡¨ç°åä¸´åºç¹å¾./ Chest CT findings and clinical features of coronavirus disease 2019 in children

text: OBJECTIVES: To describe the CT features and clinical characteristics of pediatric patients with coronavirus disease 2019 (COVID-19). METHODS: A total of 9 COVID-19 infected pediatric patients were included in this study. Clinical history, laboratory examination, and detailed CT imaging features were analyzed. All patients underwent the first CT scanning on the same day of being diagnosed by real-time reverse-transcription polymerase chain reaction (rRT-PCR). A low-dose CT scan was performed during follow-up. RESULTS: All the child patients had positive results. Four patients had cough and one patient had fever. One patient presented both cough and fever. Two children presented other symptoms like sore throat and stuffy nose. One child showed no clinical symptom. Five patients had positive initial CT findings with subtle lesions like ground-glass opacity (GGO) or spot-like mixed consolidation. Three patients were reported with negative results in the initial and follow-up CT examination. One patient was reported with initial negative CT findings but turning positive during the first follow-up. All patients had absorbed lesions on follow-up CT images after treatment. CONCLUSIONS: Pediatric COVID-19 patients have certain imaging and clinical features as well as disease prognosis. Children with COVID-19 tend to have normal or subtle CT findings and relatively better outcome.


Aquagenic Syringeal Acrokeratoderma from Extensive Water Immersion during the COVID-19 Pandemic Outbreak


docid: kyhvaqyy

title: A Proposed Lottery System to Allocate Scarce COVID-19 Medications: Promoting Fairness and Generating Knowledge


title: Comparing the process of early control of government between H7N9 avian influenza in Shanghai in 2013 and COVID-19 in Wuhan in 2019/ 上海预防医学

text: [Objective] To analyze and judge the possibility of early control in Shanghai if COVID-19 begins in Shanghai. [Methods] Compare the process of early control of H7N9 avian influenza in Shanghai in 2013 and Wuhan COVID-19 in 2019. The early incidence data of Korean COVID-19 was simulated and analyzed to predict whether the medical resources needed in Shanghai were available. [Results] (1) It would take 22 days from the first case to the government's emergency response in terms of Shanghai. (2) It is estimated that there would be 602-763 patients with cumulative onset and onset after incubation period. (3) At least 500 beds of infectious diseases can be allocated in Shanghai in case of emergency. Through adding beds and resources reallocation in the whole city, patients can be fully admitted and treated. [Conclusion] If COVID-19 epidemic occurs in Shanghai, early control is possible.


title: Modeling the Epidemic Outbreak and Dynamics of COVID-19 in Croatia

text: The paper deals with a modeling of the ongoing epidemic caused by Coronavirus disease 2019 (COVID-19) on the closed territory of the Republic of Croatia. Using the official public information on the number of confirmed infected, recovered and deceased individuals, the modified SEIR compartmental model is developed to describe the underlying dynamics of the epidemic. Fitted modified SEIR model provides the prediction of the disease progression in the near future, considering strict control interventions by means of social distancing and quarantine for infected and at-risk individuals introduced at the beginning of COVID-19 spread on February, 25th by Croatian Ministry of Health. Assuming the accuracy of provided data and satisfactory representativeness of the model used, the basic reproduction number is derived. Obtained results portray potential positive developments and justify the stringent precautionary measures introduced by the Ministry of Health.


Coronavirus disease 2019 in Italy: The Veneto model


title: The impact of coronavirus infectious disease 19 (COVID-19) on oral health

text: Health services across the world face an unprecedented situation as a result of a global COVID-19 outbreak. Urgent joined research efforts regarding the SARS-COV-2 rapid tests, accurate diagnosis, especially early recognition, and effective treatment of life-threatening complications would be highly desirable for humanity and medical workforce all over the world that try to combat a current global pandemic threat. Due to indirect complex effect, intensified COVID-19 therapies and multi-drug treatment, it is believed that some oral conditions could be aggravated by COVID-19 disease, particularly those with autoimmune aetiology, linked to compromised immune system or long-term pharmacotherapy.


COVID-19 Pandemic-Induced Panic Disorder


title: Exploring the young demographic profile of COVID-19 cases in Hong Kong: Evidence from migration and travel history data

text: This paper investigates the profile of COVID-19 cases in Hong Kong, highlighting the unique age structure of confirmed cases compared to other territories. While the majority of cases in most territories around the world have fitted an older age profile, our analysis shows that positive cases in Hong Kong have been concentrated among younger age groups, with the largest incidence of cases reported in the 15-24 age group. This is despite the population's rapidly aging structure and extremely high levels of population density. Using detailed case data from Hong Kong's Centre for Health Department and Immigration Department, we analyze the sex and age distribution of the confirmed cases along with their recent travel histories and immigration flows for the period January to April 2020. Our analysis highlights Hong Kong's high proportion of imported cases and large overseas student population in developing COVID-19 hotspot areas such as the United Kingdom. Combined with community action and targeted and aggressive early policy measures taken to contain the virus, these factors may have contributed to the uniquely younger age structure of COVID-19 cases in the city. Consequently, this young profile of confirmed cases may have prevented fatalities in the territory. Recent research has highlighted the importance of a demographic approach to understanding COVID-19 transmission and fatality rates. The experience in Hong Kong shows that while an older population age structure may be important for understanding COVID-19 fatality, it is not a given. From a social science perspective at least, there is 'no easy answer' to why one area should experience COVID-19 differently from another.


Updates on Wuhan 2019 novel coronavirus epidemic


Functional prediction and frequency of coding variants in human ACE2 at binding sites with SARS-CoV-2 spike protein on different populations


Neurosurgical Practice at the Time of COVID-19


title: Pituitary germinomas: a multi-institutional study analyzing patient demographics and management patterns

text: PURPOSE: Intracranial germinomas are exceedingly rare tumors found in the pineal and suprasellar regions. The extremely low incidence of pituitary germinoma has resulted in a significant gap in knowledge regarding its demographics, management, and treatment outcomes. We present the largest multicenter analysis of pituitary germinomas to date, focused on analyzing demographic and management patterns. METHODS: This study utilizes the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program (2004-2016) to study patients with a primary intracranial germinoma of the pituitary gland. We analyzed demographic information and management strategies among adult and pediatric populations and conducted a 20-year overall survival analysis using Kaplan-Meier curve for a descriptive evaluation of survival outcomes between age groups and treatment groups. RESULTS: 92 patients were included in the study, consisting of 58% pediatric patients and 42% adults, with overall 60% males. 82% patients received radiation as part of the treatment, with no significant difference between pediatric and adult groups. Chemotherapy was used significantly more in pediatrics (p = 0.0002) while surgery was significantly more common in adults (p = 0.0117). The most common treatment in pediatrics was radiation + chemotherapy (47%), while the most common treatment in adults was radiation + gross total resection + chemotherapy (23%) followed by radiation + gross total resection (19%). Younger age, radiotherapy, and chemotherapy were associated with increased 20-year survival on Kaplan-Meier curves. CONCLUSIONS: There exist significant differences in the management of pediatric and adult populations with pituitary germinomas. The low incidence of these tumors makes them challenging to study, but also highlights the importance of national cancer registries in amassing sufficient patient data from which to draw evidence-based conclusions.


title: Clinical characteristics of 25 death cases with COVID-19: A retrospective review of medical records in a single medical center, Wuhan, China

text: OBJECTIVES: This study aims to summarize the clinical characteristics of death cases with COVID-19 and to identify critically ill patients of COVID-19 early and reduce their mortality. METHODS: The clinical records, laboratory findings and radiological assessments included chest X-ray or computed tomography were extracted from electronic medical records of 25 died patients with COVID-19 in Renmin Hospital of Wuhan University from Jan 14 to Feb 13, 2020. Two experienced clinicians reviewed and abstracted the data. RESULTS: The age and underlying diseases (hypertension, diabetes, etc.) were the most important risk factors for death of COVID-19 pneumonia. Bacterial infections may play an important role in promoting the death of patients. Malnutrition was common to severe patients. Multiple organ dysfunction can be observed, the most common organ damage was lung, followed by heart, kidney and liver. The rising of neutrophils, SAA, PCT, CRP, cTnI, D-dimer, LDH and lactate levels can be used as indicators of disease progression, as well as the decline of lymphocytes counts. CONCLUSIONS: The clinical characteristics of 25 death cases with COVID-19 we summarized, which would be helpful to identify critically ill patients of COVID-19 early and reduce their mortality.


title: The role of environmental factors to transmission of SARS-CoV-2 (COVID-19)

text: The current outbreak of the novel coronavirus disease 2019 (COVID-19) in more than 250 countries has become a serious threat to the health of people around the world. Human-to-human transmission of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurs most often when people are in the incubation stage of the disease or are carriers and have no symptoms. Therefore, in this study, was discussed the role of environmental factors and conditions such as temperature, humidity, wind speed as well as food, water and sewage, air, insects, inanimate surfaces, and hands in COVID-19 transmission. The results of studies on the stability of the SARS-CoV-2 on different levels showed that the resistance of this virus on smooth surfaces was higher than others. Temperature increase and sunlight can facilitate the destruction of SARS-COV-2 and the stability of it on surfaces. When the minimum ambient air temperature increases by 1 °C, the cumulative number of cases decreases by 0.86%. According to the latest evidence, the presence of coronavirus in the sewer has been confirmed, but there is no evidence that it is transmitted through sewage or contaminated drinking water. Also, SARS-COV-2 transmission through food, food packages, and food handlers has not been identified as a risk factor for the disease. According to the latest studies, the possibility of transmitting SARS-COV-2 bioaerosol through the air has been reported in the internal environment of ophthalmology. The results additionally show that infectious bio-aerosols can move up to 6 feet. There have been no reports of SARS-COV-2 transmission by blood-feeding arthropods such as mosquitoes.


docid: yzckofuk

title: Ocular Surface Expression of SARS-CoV-2 Receptors

text: PURPOSE: The spike proteins of SARS-CoV-2 interact with ACE2 or basigin/CD147 receptors, regulating human-to-human transmissions of COVID-19 together with serine protease TMPRSS2. The expression of these receptors on the ocular surface is unknown. MATERIAL AND METHODS: Gene expression of SARS-CoV-2 receptors was investigated in conjunctival epithelial cell samples and in ex-vivo cornea samples using microarray or transcriptome sequencing. RESULTS: ACE2 is expressed in conjunctival samples at a low level, while BSG and TMPRSS2 are expressed at intermediate levels in both conjunctiva and cornea. Other receptors such as ANPEP, AGTR2 are expressed at low level in the conjunctiva. Two RNA editing enzymes involved in antiviral responses, APOBEC3A, and ADAR-1 were also highly expressed. CONCLUSIONS: The ocular surface may represent an entry point for the SARS-CoV-2 in the human body. The conjunctiva and the cornea can adopt antiviral countermeasures which may explain the low prevalence of eye involvement.


docid: fskfnmig

title: Renin-Angiotensin-Aldosterone System Inhibitors and Risk of Covid-19

text: BACKGROUND: There is concern about the potential of an increased risk related to medications that act on the renin-angiotensin-aldosterone system in patients exposed to coronavirus disease 2019 (Covid-19), because the viral receptor is angiotensin-converting enzyme 2 (ACE2). METHODS: We assessed the relation between previous treatment with ACE inhibitors, angiotensin-receptor blockers, beta-blockers, calcium-channel blockers, or thiazide diuretics and the likelihood of a positive or negative result on Covid-19 testing as well as the likelihood of severe illness (defined as intensive care, mechanical ventilation, or death) among patients who tested positive. Using Bayesian methods, we compared outcomes in patients who had been treated with these medications and in untreated patients, overall and in those with hypertension, after propensity-score matching for receipt of each medication class. A difference of at least 10 percentage points was prespecified as a substantial difference. RESULTS: Among 12,594 patients who were tested for Covid-19, a total of 5894 (46.8%) were positive; 1002 of these patients (17.0%) had severe illness. A history of hypertension was present in 4357 patients (34.6%), among whom 2573 (59.1%) had a positive test; 634 of these patients (24.6%) had severe illness. There was no association between any single medication class and an increased likelihood of a positive test. None of the medications examined was associated with a substantial increase in the risk of severe illness among patients who tested positive. CONCLUSIONS: We found no substantial increase in the likelihood of a positive test for Covid-19 or in the risk of severe Covid-19 among patients who tested positive in association with five common classes of antihypertensive medications.


title: Analysis of the susceptibility of lung cancer patients to SARS-CoV-2 infection

text: Recent studies have reported that COVID-19 patients with lung cancer have a higher risk of severe events than patients without cancer. In this study, we investigated the gene expression of angiotensin I-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) with prognosis in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC). Lung cancer patients in each age stage, subtype, and pathological stage are susceptible to SARS-CoV-2 infection, except for the primitive subtype of LUSC. LUAD patients are more susceptible to SARS-CoV-2 infection than LUSC patients. The findings are unanimous on tissue expression in gene and protein levels.


New insights into the neurological effects of COVID-19


title: COVID-19 infection in solid organ transplant recipients: A single-center experience with patients immediately after transplantation

text: In our transplant center, infection with SARS-CoV-2 virus was confirmed in 4 organ transplant recipients (3 kidney and 1 liver transplant recipients) during their early post-transplant hospital stay. In this paper, we report the basic characteristics, management, clinical course, and outcomes of these patients.


title: Current Perspectives on Coronavirus Disease 2019 and Cardiovascular Disease: A White Paper by the JAHA Editors

text: Coronavirus Disease 2019 (COVID-19) has infected more than 3.0 million people worldwide and killed more than 200,000 as of April 27, 2020. In this White Paper, we address the cardiovascular co-morbidities of COVID-19 infection; the diagnosis and treatment of standard cardiovascular conditions during the pandemic; and the diagnosis and treatment of the cardiovascular consequences of COVID-19 infection. In addition, we will also address various issues related to the safety of healthcare workers and the ethical issues related to patient care in this pandemic.


Peripheral Blood Smear Findings in COVID-19


title: Aminoglycosides can be a better choice over macrolides in COVID-19 regimen: Plausible mechanism for repurposing strategy

text: In the current COVID-19 pandemic, prioritizing the immunity enhancers is equally important to anti-virals. Defensins are the forgotten molecules that enhance the innate immunity against various microbes. Although macrolides like azithromycin and clarithromycin etc., have been reported to act against respiratory infections but they lack the ability of immunity enhancement through defensins. The aminoglycosides were proved to have defensin mediated antiviral activity, that could enhance the immunity. So, Consideration of aminoglycosides can be a double edge sword viz., against respiratory infection as well as Immunity enhancer (along with anti-virals) for COVID-19 regimen.


docid: hczmytse

title: COVID-19 as an Acute Inflammatory Disease

text: The 2019 coronavirus disease (COVID-19) pandemic caused by the virus severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has created an unprecedented global crisis for the infrastructure sectors, including economic, political, healthcare, education, and research systems. Although over 90% of infected individuals are asymptomatic or manifest noncritical symptoms and will recover from the infection, those individuals presenting with critical symptoms are in urgent need of effective treatment options. Emerging data related to mechanism of severity and potential therapies for patients presenting with severe symptoms are scattered and therefore require a comprehensive analysis to focus research on developing effective therapeutics. A critical literature review suggests that the severity of SARS-CoV-2 infection is associated with dysregulation of inflammatory immune responses, which in turn inhibits the development of protective immunity to the infection. Therefore, the use of therapeutics that modulate inflammation without compromising the adaptive immune response could be the most effective therapeutic strategy.


COVID-19 and Antiretroviral Therapies: South Africa's Charge Towards 90-90-90 in the Midst of a Second Pandemic


2019 Novel Coronavirus Is Undergoing Active Recombination


title: Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020

text: BACKGROUND: There's an outbreak of a novel coronavirus (SARS-CoV-2) infection since December 2019, first in China, and currently with more than 80 thousand confirmed infection globally in 29 countries till March 2, 2020. Identification, isolation and caring for patients early are essential to limit human-to-human transmission including reducing secondary infections among close contacts and health care workers, preventing transmission amplification events. The RT-PCR detection of viral nucleic acid test (NAT) was one of the most quickly established laboratory diagnosis method in a novel viral pandemic, just as in this COVID-19 outbreak. METHODS: 4880 cases that had respiratory infection symptoms or close contact with COVID-19 patients in hospital in Wuhan, China, were tested for SARS-CoV-2 infection by use of quantitative RT-PCR (qRT-PCR) on samples from the respiratory tract. Positive rates were calculated in groups divided by genders or ages. RESULTS: The positive rate was about 38% for the total 4880 specimens. Male and older population had a significant higher positive rates. However, 57% was positive among the specimens from the Fever Clinics. Binary logistic regression analysis showed that age, not gender, was the risk factor for SARS-CoV-2 infection in fever clinics. CONCLUSIONS: Therefore, we concluded that viral NAT played an important role in identifying SARS-CoV-2 infection.


docid: dkezjatc

title: Recomendaciones para el manejo de los pacientes quirúrgicos urgentes durante la pandemia COVID-19


title: Deleterious effects of viral pneumonia on cardiovascular system

text: Viral pneumonia has a significant effect on the cardiovascular system through various mechanisms; even though it is traditionally regarded as a pulmonary disease characterized by dyspnoea and hypoxaemia. Recent research works have shown that cardiovascular events outweigh all other causes of death in various influenza pandemics. Therefore, the exploration of the effects of viral pneumonia on cardiovascular system becomes increasingly essential. The objective of this review is three-fold: first, to summarize the knowledge about the epidemiological characteristics and clinical manifestations of viral infections that are the recent causes of global pandemics; second, to explore the cardiovascular response to these infections; and third, to attempt in identifying the possible coping strategies of the Wuhan epidemic and the future viral infection pandemics.


Recurrence of immune thrombocytopenia at the time of SARS-CoV-2 infection


Recent Advances in Molecular diagnosis curbing the COVID-19


The perils of premature phenotyping in COVID: a call for caution


The New Normal: An approach to optimizing and combining in-person and telemedicine visits to maximize patient care


title: Cardiac Rehabilitation During COVID-19 Pandemic: Highlighting the Value of Home-Based Programs

text: Cardiac rehabilitation (CR) is a class I treatment for cardiovascular disease, however, underutilization of these services remains. Home-based CR (HBCR) models have been implemented as a potential solution to addressing access barriers to CR services. Home-based models have been shown to be effective, however, there continues to be large variation of protocols and minimal evidence of effectiveness in higher risk populations. In addition, lack of reimbursement models has discouraged the widespread adoption of HBCR. During the coronavirus 2019 (COVID-19) pandemic, an even greater gap in CR care has been present due to decreased availability of on-site services. The COVID-19 pandemic presents a time to highlight the value and experiences of home-based models as clinicians search for ways to continue to provide care. Continued review and standardization of HBCR models are essential to provide care for a wider range of patients and circumstances.


N95 respirator, COVID-19, and health care worker


Roles and challenges of traditional Chinese medicine in COVID-19 in Hong Kong


COVID-19: where is the national ethical guidance?


COVID-19 and racial disparities


title: A human monoclonal antibody blocking SARS-CoV-2 infection

text: The emergence of the novel human coronavirus SARS-CoV-2 in Wuhan, China has caused a worldwide epidemic of respiratory disease (COVID-19). Vaccines and targeted therapeutics for treatment of this disease are currently lacking. Here we report a human monoclonal antibody that neutralizes SARS-CoV-2 (and SARS-CoV) in cell culture. This cross-neutralizing antibody targets a communal epitope on these viruses and may offer potential for prevention and treatment of COVID-19.


Personal protective equipment during COVID-19 outbreak at the First Affiliated Hospital of Wenzhou Medical University, China


At the center of the COVID-19 pandemic: Lessons learned for otolaryngology-head and neck surgery in China


docid: fhnfolyg

title: Preventing COVID-19 in Assisted Living Facilities-A Balancing Act


title: The Era of COVID-19 and the Rise of Science Collectivism in Cancer Research

text: The coronavirus SARS-CoV-2 has created a global pandemic that has killed more than a quarter million people since December 2019, halted commerce, and disrupted our ability to research cancer in the laboratory and clinic and care for our patients. A return to a functioning society can be facilitated by the active participation of cancer researchers to diagnose and treat SARS-CoV-2-infected patients, and the direct and indirect benefits of our involvement cannot be overstated.


Bronchoscopy in the Age of COVID-19


Disparities in the Luxury of Distance for COVID-19 Care


Recommendations for Minimal Laboratory Testing Panels in Patients with COVID-19: Potential for Prognostic Monitoring


Surgical Case Deferment During a Global Pandemic


On the Question of Resource Constraints During the COVID-19 Pandemic, Thinking Globally


Swivel-HEPA-ETT (SHE) bougie and HEPA-ETT (HE) methods for safe intubation while managing patients with COVID-19


docid: eorodjey

title: Structural plasticity of SARS-CoV-2 3CL Mpro active site cavity revealed by room temperature X-ray crystallography

text: The COVID-19 disease caused by the SARS-CoV-2 coronavirus has become a pandemic health crisis. An attractive target for antiviral inhibitors is the main protease 3CL Mpro due to its essential role in processing the polyproteins translated from viral RNA. Here we report the room temperature X-ray structure of unliganded SARS-CoV-2 3CL Mpro, revealing the ligand-free structure of the active site and the conformation of the catalytic site cavity at near-physiological temperature. Comparison with previously reported low-temperature ligand-free and inhibitor-bound structures suggest that the room temperature structure may provide more relevant information at physiological temperatures for aiding in molecular docking studies.


docid: qjpbgglu

title: Modelling SARS-COV2 Spread in London: Approaches to Lift the Lockdown

text: OBJECTIVE: To use mathematical models to predict the epidemiological impact of lifting the lockdown in London, UK, and alternative strategies to help inform policy in the UK. METHODS: A mathematical model for the transmission of SARS-CoV2 in London. The model was parametrised using data on notified cases, deaths, contacts, and mobility to analyse the epidemic in the UK capital. We investigated the impact of multiple non pharmaceutical interventions (NPIs) and combinations of these measures on future incidence of COVID-19. RESULTS: Immediate action at the early stages of an epidemic in the affected districts would have tackled spread. While an extended lockdown is highly effective, other measures such as shielding older populations, universal testing and facemasks can all potentially contribute to a reduction of infections and deaths. However, based on current evidence it seems unlikely they will be as effective as continued lockdown. In order to achieve elimination and lift lockdown within 5 months, the best strategy seems to be a combination of weekly universal testing, contact tracing and use of facemasks, with concurrent lockdown. This approach could potentially reduce deaths by 48% compared with continued lockdown alone. CONCLUSIONS: A combination of NPIs such as universal testing, contact tracing and mask use while under lockdown would be associated with least deaths and infections. This approach would require high uptake and sustained local effort but it is potentially feasible as may lead to elimination in a relatively short time scale.


title: COVID-19: Consider IL-6 receptor antagonist for the therapy of cytokine storm syndrome in SARS-CoV-2 infected patients

text: COVID-19 leads to mortality of several patients and the cytokine storm is reportedly critical in the patients. To reduce the cytokine storm, we would like to propose the interleukin (IL) 6 receptor (IL-6R) antagonist therapy for the COVID-19 patients. Two humanized monoclonal antibodies are in clinical trial following IL-6R antagonist therapies namely tocilizumab and sarilumab. However, researchers and physicians should look for more IL-6R antagonists for the therapy of cytokine storm syndrome severe acute respiratory syndrome coronavirus 2 infected persons to enhance the therapeutic options for cytokine storm.


Impact of COVID-19 on Children and Pediatricians


title: N-Acetylcysteine: A potential therapeutic agent for SARS-CoV-2

text: COVID-19, a respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread across the globe. Predisposing factors such as age, diabetes, cardiovascular disease, and lowered immune function increase the risk of disease severity. T cell exhaustion, high viral load, and high levels of TNF-É, IL1ß, IL6, IL10 have been associated with severe SARS-CoV-2. Cytokine and antigen overstimulation are potentially responsible for poor humoral response to the virus. Lower cellular redox status, which leads to pro-inflammatory states mediated by TNF-É is also potentially implicated. In vivo, in vitro, and human clinical trials have demonstrated N-acetylcysteine (NAC) as an effective method of improving redox status, especially when under oxidative stress. In human clinical trials, NAC has been used to replenish glutathione stores and increase the proliferative response of T cells. NAC has also been shown to inhibit the NLRP3 inflammasome pathway (IL1ß and IL18) in vitro, and decrease plasma TNF-É in human clinical trials. Mediation of the viral load could occur through NAC's ability to increase cellular redox status via maximizing the rate limiting step of glutathione synthesis, and thereby potentially decreasing the effects of virally induced oxidative stress and cell death. We hypothesize that NAC could act as a potential therapeutic agent in the treatment of COVID-19 through a variety of potential mechanisms, including increasing glutathione, improving T cell response, and modulating inflammation. In this article, we present evidence to support the use of NAC as a potential therapeutic agent in the treatment of COVID-19.


title: Back to Normal: An Old Physics Route to Reduce SARS-CoV-2 Transmission in Indoor Spaces

text: We advocate the widespread use of UV-C light as a short-term, easily deployable, and affordable way to limit virus spread in the current SARS-CoV-2 pandemic. Radical social distancing with the associated shutdown of schools, restaurants, sport clubs, workplaces, and traveling has been shown to be effective in reducing virus spread, but its economic and social costs are unsustainable in the medium term. Simple measures like frequent handwashing, facial masks, and other physical barriers are being commonly adopted to prevent virus transmission. However, their efficacy may be limited, particularly in shared indoor spaces, where, in addition to airborne transmission, elements with small surface areas such as elevator buttons, door handles, and handrails are frequently used and can also mediate transmission. We argue that additional measures are necessary to reduce virus transmission when people resume attending schools and jobs that require proximity or some degree of physical contact. Among the available alternatives, UV-C light satisfies the requirements of rapid, widespread, and economically viable deployment. Its implementation is only limited by current production capacities, an increase of which requires swift intervention by industry and authorities.


title: The Appropriate Use of Testing for COVID-19

text: Many public officials are calling for increased testing for the 2019 novel coronavirus disease (COVID-19), and some governments have taken extraordinary measures to increase the availability of testing. However, little has been published about the sensitivity and specificity of the reverse transcriptase-polymerase chain reaction (RT-PCR) nasopharyngeal swabs that are commonly used for testing. This narrative review evaluates the literature regarding the accuracy of these tests, and makes recommendations based on this literature. In brief, a negative RT-PCR nasopharyngeal swab test is insufficient to rule out COVID-19. Thus, over-reliance on the results of the test may be dangerous, and the push for widespread testing may be overstated.


title: Preventing adverse cutaneous reactions from amplified hygiene practices during the COVID-19 pandemic: how dermatologists can help through anticipatory guidance

text: The COVID-19 pandemic has swept the globe with more than 2,000,000 confirmed cases of SARS-CoV-2 infection in 184 countries and territories. According to the Centers for Disease Control and Prevention (CDC), two crucial actions can reduce the risk of person-to-person viral transmission: frequent hand washing and surface decontamination with specific environmental protection agency (EPA)-registered disinfectants. As hygiene recommendations evolve during the COVID-19 pandemic and community members adopt changing practices, dermatologists are likely to see a rise in adverse cutaneous reactions from prolonged irritant exposures and widespread use of antimicrobials. The purposes of this report are to familiarize dermatologists with the hygiene practices recommended for COVID-19 prevention, to highlight adverse cutaneous reactions associated with repeated exposures to detergents and disinfectants, and to discuss strategies which patients can implement during the COVID-19 pandemic to minimize skin irritation white still performing hygiene practices effectively.


To test or not to test? An opportunity to restart dentistry sustainably in the 'COVID-19 era'


title: Infection of bat and human intestinal organoids by SARS-CoV-2

text: A novel coronavirus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-emerged in humans in Wuhan, China, in December 2019 and has since disseminated globally1,2. As of April 16, 2020, the confirmed case count of coronavirus disease 2019 (COVID-19) had surpassed 2 million. Based on full-genome sequence analysis, SARS-CoV-2 shows high homology to SARS-related coronaviruses identified in horseshoe bats1,2. Here we show the establishment and characterization of expandable intestinal organoids derived from horseshoe bats of the Rhinolophus sinicus species that can recapitulate bat intestinal epithelium. These bat enteroids are fully susceptible to SARS-CoV-2 infection and sustain robust viral replication. Development of gastrointestinal symptoms in some patients with COVID-19 and detection of viral RNA in fecal specimens suggest that SARS-CoV-2 might cause enteric, in addition to respiratory, infection3,4. Here we demonstrate active replication of SARS-CoV-2 in human intestinal organoids and isolation of infectious virus from the stool specimen of a patient with diarrheal COVID-19. Collectively, we established the first expandable organoid culture system of bat intestinal epithelium and present evidence that SARS-CoV-2 can infect bat intestinal cells. The robust SARS-CoV-2 replication in human intestinal organoids suggests that the human intestinal tract might be a transmission route of SARS-CoV-2.


title: Real-time tracking of self-reported symptoms to predict potential COVID-19

text: A total of 2,618,862 participants reported their potential symptoms of COVID-19 on a smartphone-based app. Among the 18,401 who had undergone a SARS-CoV-2 test, the proportion of participants who reported loss of smell and taste was higher in those with a positive test result (4,668 of 7,178 individuals; 65.03%) than in those with a negative test result (2,436 of 11,223 participants; 21.71%) (odds ratio = 6.74; 95% confidence interval = 6.31-7.21). A model combining symptoms to predict probable infection was applied to the data from all app users who reported symptoms (805,753) and predicted that 140,312 (17.42%) participants are likely to have COVID-19.


title: Filtration Efficiencies of Nanoscale Aerosol by Cloth Mask Materials Used to Slow the Spread of SARS-CoV-2

text: Filtration efficiency (FE), differential pressure (ΔP), quality factor (QF), and construction parameters were measured for 32 cloth materials (14 cotton, 1 wool, 9 synthetic, 4 synthetic blends, and 4 synthetic/cotton blends) used in cloth masks intended for protection from the SARS-CoV-2 virus (diameter 100 ± 10 nm). Seven polypropylene-based fiber filter materials were also measured including surgical masks and N95 respirators. Additional measurements were performed on both multilayered and mixed-material samples of natural, synthetic, or natural-synthetic blends to mimic cloth mask construction methods. Materials were microimaged and tested against size selected NaCl aerosol with particle mobility diameters between 50 and 825 nm. Three of the top five best performing samples were woven 100% cotton with high to moderate yarn counts, and the other two were woven synthetics of moderate yarn counts. In contrast to recently published studies, samples utilizing mixed materials did not exhibit a significant difference in the measured FE when compared to the product of the individual FE for the components. The FE and ΔP increased monotonically with the number of cloth layers for a lightweight flannel, suggesting that multilayered cloth masks may offer increased protection from nanometer-sized aerosol with a maximum FE dictated by breathability (i.e., ΔP).


title: Filtration Efficiencies of Nanoscale Aerosol by Cloth Mask Materials Used to Slow the Spread of SARS CoV-2

text: Filtration efficiency (FE), differential pressure (ΔP), quality factor (QF) and construction parameters were measured for 32 cloth materials (14 cotton, 1 wool, 9 synthetic, 4 synthetic blends, and 4 synthetic/cotton blends) used in cloth masks intended for protection from the SARS CoV-2 virus (diameter 100 ± 10 nm). Seven polypropylene-based fiber filter materials were also measured, including surgical masks and N95 respirators. Additional measurements were performed on both multi-layered and mixed-material samples of natural, synthetic, or natural-synthetic blends to mimic cloth mask construction methods. Materials were micro-imaged and tested against size selected NaCl aerosol with particle mobility diameters between 50 nm and 825 nm. Three of the top five best performing samples were woven 100% cotton with high to moderate yarn counts and the other two were woven synthetics of moderate yarn counts. In contrast to recently published studies, samples utilizing mixed materials did not exhibit a significant difference in the measured FE when compared to the product of the individual FE for the components. The FE and ΔP increased monotonically with the number of cloth layers for a lightweight flannel, suggesting that multi-layered cloth masks may offer increased protection from nanometer-sized aerosol with a maximum FE dictated by breathability (i.e. ΔP).


title: Registries Offer Insights on COVID-19-Cancer Connection

text: Findings from CCC19 and TERAVOLT suggest that patients with cancer may be more likely to die from COVID-19 than people in the general population. Additional mortality risk factors may include age, performance status, treatment with chemotherapy, and exposure to hydroxychloroquine plus azithromycin.


title: "We're staying at home". Association of self-perceptions of aging, personal and family resources and loneliness with psychological distress during the lock-down period of COVID-19

text: OBJECTIVES: Families are going through a very stressful time because of the COVID-19 outbreak, with age being a risk factor for this illness. Negative self-perceptions of aging, among other personal and relational variables may be associated with loneliness and distress caused by the pandemic crisis. METHOD: Participants are 1310 Spanish people (age range: 18-88 years) during a lock-down period at home. In addition to specific questions about risk for COVID-19, self-perceptions of aging, family and personal resources, loneliness and psychological distress were measured. Hierarchical regression analyses were done for assessing the correlates of loneliness and psychological distress. RESULTS: The measured variables allow for an explanation of 48% and 33% of the variance of distress and loneliness, respectively. Being female, younger, having negative self-perceptions about aging, more time exposed to news about COVID-19, more contact with relatives different to those that co-reside, fewer positive emotions, less perceived self-efficacy, lower quality of sleep, higher expressed emotion and higher loneliness were associated with higher distress. Being female, younger, having negative self-perceptions about aging, more time exposed to news about COVID-19, lower contact with relatives, higher self-perception as a burden, fewer positive emotions, lower resources for entertaining oneself, lower quality of sleep and higher expressed emotion were associated with higher loneliness.


Pediatric COVID-19: An Update on the Expanding Pandemic


title: Assessing Knowledge, Attitudes and Practices of dental practitioners regarding the COVID-19 pandemic: A multinational study

text: BACKGROUND: Coronavirus Disease 2019 (COVID-19) has been declared a global public health emergency that is affecting people across the globe. OBJECTIVES: The aim of this study was to assess the Knowledge, Attitudes and Practices (KAP) of dental practitioners regarding the Coronavirus Disease 2019 (COVID-2019) pandemic. MATERIAL AND METHODS: An online questionnaire was distributed among dentists across the globe using a combination of convenience and snowball sampling. The questionnaire was divided into 4 sections: the 1st one contained personal information, whereas the 2nd, 3rd and 4th sections assessed knowledge (11 questions), attitudes (6 questions) and practices (7 questions) of the dentists. The data was subjected to the Shapiro-Wilk test, one-way analysis of variance (ANOVA), multivariate linear regression, and Pearson's correlation; 95% confidence interval (CI) was calculated and odds ratio (OR) was obtained. The analysis was done using IBM SPSS for Windows, v. 21.0. RESULTS: The total number of the responses received (860) was divided with regard to various continents (Asia, Americas - North and South, Europe, Africa, and other - Australia and Antarctica). The largest number of dentists came from the Asian continent (264; 30.7%). Most dentists had a degree of MDS (Master of Dental Science) (301; 35.0%), followed by BDS (Bachelor of Dental Surgery) (282; 32.8%) and DDS (Doctor of Dental Surgery) (226; 26.3%). High/Good knowledge and practice scores were observed among 92.7% and 79.5 % of the dentists, respectively. Good knowledge scores were significantly associated with qualifications (p = 0.04) and years of practice (p = 0.02); good practice scores were associated with qualifications only (p = 0.03). CONCLUSIONS: The dentists were found to have good knowledge and practice scores, which is important to combat COVID-19. They are advised to follow the Centers of Disease Control and Prevention (CDC) and World Health Organization (WHO) guidelines in their clinics, and sensitize their staff so that no stone is left unturned in defeating this pandemic.


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title: Effectiveness of N95 Respirator Decontamination and Reuse against SARS-CoV-2 Virus

text: The coronavirus pandemic has created worldwide shortages of N95 respirators. We analyzed 4 decontamination methods for effectiveness in deactivating severe acute respiratory syndrome coronavirus 2 virus and effect on respirator function. Our results indicate that N95 respirators can be decontaminated and reused, but the integrity of respirator fit and seal must be maintained.


Dermatology patients' knowledge and concerns regarding their immunomodulatory medication during the COVID-19 pandemic


Tough times call for rapid techniques: combating the novel coronavirus


Could Patients With Inflammatory Bowel Disease Treated with Immunomodulators or Biologics Be at Lower Risk for Severe Forms of Covid-19?


title: The Performance of Chest CT in Evaluating the Clinical Severity of COVID-19 Pneumonia: Identifying Critical Cases Based on CT Characteristics

text: OBJECTIVES: The aim of this study was to assess the clinical severity of COVID-19 pneumonia using qualitative and/or quantitative chest computed tomography (CT) indicators and identify the CT characteristics of critical cases. MATERIALS AND METHODS: Fifty-one patients with COVID-19 pneumonia including ordinary cases (group A, n = 12), severe cases (group B, n = 15), and critical cases (group C, n = 24) were retrospectively enrolled. The qualitative and quantitative indicators from chest CT were recorded and compared using Fisher exact test, one-way analysis of variance, Kruskal-Wallis H test, and receiver operating characteristic analysis. RESULTS: Depending on the severity of the disease, the number of involved lung segments and lobes, the frequencies of consolidation, crazy-paving pattern, and air bronchogram increased in more severe cases. Qualitative indicators including total severity score for the whole lung and total score for crazy-paving and consolidation could distinguish groups B and C from A (69% sensitivity, 83% specificity, and 73% accuracy) but were similar between group B and group C. Combined qualitative and quantitative indicators could distinguish these 3 groups with high sensitivity (B + C vs A, 90%; C vs B, 92%), specificity (100%, 87%), and accuracy (92%, 90%). Critical cases had higher total severity score (>10) and higher total score for crazy-paving and consolidation (>4) than ordinary cases, and had higher mean lung density (>-779 HU) and full width at half maximum (>128 HU) but lower relative volume of normal lung density (â¦50%) than ordinary/severe cases. In our critical cases, 8 patients with relative volume of normal lung density smaller than 40% received mechanical ventilation for supportive treatment, and 2 of them had died. CONCLUSIONS: A rapid, accurate severity assessment of COVID-19 pneumonia based on chest CT would be feasible and could provide help for making management decisions, especially for the critical cases.


Sensitivity of the Wondfo One Step COVID-19 test using serum samples


Letter: Emergency Response Plan During the COVID-19 Pandemic: The University of Alabama at Birmingham Experience


title: Quest: Practical and Oblivious Mitigation Strategies for COVID-19 using WiFi Datasets

text: Contact tracing has emerged as one of the main mitigation strategies to prevent the spread of pandemics such as COVID-19. Recently, several efforts have been initiated to track individuals, their movements, and interactions using technologies, e.g., Bluetooth beacons, cellular data records, and smartphone applications. Such solutions are often intrusive, potentially violating individual privacy rights and are often subject to regulations (e.g., GDPR and CCPR) that mandate the need for opt-in policies to gather and use personal information. In this paper, we introduce Quest, a system that empowers organizations to observe individuals and spaces to implement policies for social distancing and contact tracing using WiFi connectivity data in a passive and privacy-preserving manner. The goal is to ensure the safety of employees and occupants at an organization, while protecting the privacy of all parties. Quest incorporates computationally- and information-theoretically-secure protocols that prevent adversaries from gaining knowledge of an individual's location history (based on WiFi data); it includes support for accurately identifying users who were in the vicinity of a confirmed patient, and then informing them via opt-in mechanisms. Quest supports a range of privacy-enabled applications to ensure adherence to social distancing, monitor the flow of people through spaces, identify potentially impacted regions, and raise exposure alerts. We describe the architecture, design choices, and implementation of the proposed security/privacy techniques in Quest. We, also, validate the practicality of Quest and evaluate it thoroughly via an actual campus-scale deployment at UC Irvine over a very large dataset of over 50M tuples.


title: Coronavirus infection and pregnancy (Covid-19)

text: Guidelines The Czech Society for Ultrasound in Obstetrics and Gynecology of the Czech Medical Association of J E Purkyně issues this opinion in connection with statements of the World Health Organization (WHO) and other international authorities regarding the concerns about COVID-19 infection in pregnancy The impact of this year‘s coronavirus COVID-19 infection on pregnant women seems to be less severe than in previous years of H1N1 influenza type A, SARS-CoV or MERS-CoV From the information published so far it was not possible to prove the transmission of infection from mother to fetus It also seems that there is no risk of vertical transmission during breastfeeding This opinion does not replace the recommendations and opinions issued by governmental bodies such as the Ministry of Health and others, and concerns solely consultation of pregnant women


title: In-hospital airway management of COVID-19 patients

text: Those involved in the airway management of COVID-19 patients are particularly at risk. Here, we describe a practical, stepwise protocol for safe in-hospital airway management in patients with suspected or confirmed COVID-19 infection.


COVID-19 and access to labour epidural analgesia in UK hospitals


COVID-19 and Neonatal Resuscitation


Use of systemic immunomodulatory therapies during the coronavirus disease 2019 (COVID-19) pandemic


title: Elevated Serum Endothelial Cell Adhesion Molecules Expression in COVID-19 Patients

text: In a retrospective study of 39 COVID-19 patients and 32 control participants in China, we collected clinical data and examined the expression of endothelial cell adhesion molecules by enzyme-linked immunosorbent assays. Serum levels of fractalkine, vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and vascular adhesion protein-1 (VAP-1) elevated in mild patients, dramatically in severe cases, while decreased in the convalescence phase. In conclusion, the increased expression of endothelial cell adhesion molecules is related to COVID-19 and disease severity and may contribute to coagulation dysfunction.


title: Comparative in silico design and validation of GPS™ CoVID-19 dtec-RT-qPCR Test

text: AIMS: Providing a ready-to-use RT-qPCR method fully validated to detect the SARS-CoV-2 with a higher exclusivity than this shown by early published RT-qPCR designs. METHODS AND RESULTS: The specificity of the GPS™ CoVID-19 dtec-RT-qPCR Test by analysis of sequence alignments was approached and compared with other RT-qPCR designs. The GPS™ CoVID-19 dtec-RT-qPCR Test was validated following criteria of UNE/EN ISO 17025:2005 and ISO/IEC 15189:2012. Diagnostic validation was achieved by two independent reference laboratories, the Instituto de Salud Carlos III, (Madrid, Spain), the Public Health England (Colindale, London, UK), and received the label CE-IVD. The GPS™ design showed the highest exclusivity and passed all parameters of validation with strict acceptance criteria. Results from reference laboratories 100 % correlated with these obtained by using reference methods and showed 100 % of diagnostic sensitivity and specificity. CONCLUSIONS: The CE-IVD GPS™ CoVID-19 dtec-RT-qPCR Test, available worldwide with full analytical and diagnostic validation, is the more exclusive for SARS-CoV-2 by far. SIGNIFICANCE: Considering the CoVID-19 pandemic status, the exclusivity of RT-qPCR tests is crucial to avoid false positives due to related coronaviruses. IMPACT OF STUDY: This work provides of a highly specific and validated RT-qPCR method for detection of SARS-CoV-2, which represents a case of efficient transfer of technology successfully used since the pandemic was declared.


Hydroxychloroquine for Treatment of SARS-CoV-2 Infection? Improving Our Confidence in a Model-Based Approach to Dose Selection


title: La gestione del paziente cardiologico nella fase post-pandemia COVID-19: la proposta dell'ANMCO Regionale Veneto./ [Managing cardiac patients post-COVID-19 pandemic: a proposal by the ANMCO Veneto Region]

text: The COVID-19 post-lockdown period and the subsequent progressive withdrawal of the quarantine measures are currently allowing the gradual resumption of the ordinary clinical activities, which have been suppressed during the COVID-19 pandemic. In this phase, it is crucial to minimize the risk of infection to limit COVID-19-related morbidity and mortality and the number of new cases. Indeed, COVID-19 manifestations may be equivocal, including asymptomatic or mildly symptomatic patients. In order to ensure the safety of patients and healthcare providers, therefore, it is mandatory to stratify the risk of post-COVID-19 pandemic infection during the clinical and instrumental evaluation of cardiac patients, who are at low risk for COVID-19. Here we discuss the most common diagnostic procedures and therapeutic activities, the type of personal protective equipment according to the different tests, the timetable of the different diagnostic examinations, the tele-health services or alternative strategies, and the structural and management requirements, that should be applied to protect patients and healthcare providers in the post-COVID-19 era.


Covid-19: ensuring equality of access to testing for ethnic minorities


title: Mobile smartphone tracing can detect almost all SARS-CoV-2 infections

text: Currently, many countries are considering the introduction of tracing software on mobile smartphones with the main purpose to inform and alarm the mobile app user. Here, we demonstrate that, in addition to alarming and informing, mobile tracing can detect nearly all individuals that are infected by SARS-CoV-2, including the notorious asymptomatic infections. Besides voluntary reports of the infectious health status, our algorithm requires the location information of an overwhelming part of the population and then guarantees that almost all SARS-CoV-2 infections in that closed population can be detected. Our algorithm is based on a hidden Markov epidemic model and recursive Bayesian filtering. The potential that mobile tracing apps, in addition to medical testing and quarantining, can eradicate COVID-19 may persuade citizens to trade-off privacy against public health.


The ORF3a protein of SARS-CoV-2 induces apoptosis in cells


title: Amantadine as a drug to mitigate the effects of COVID-19

text: The SARS-CoV-2 virus has spread around the world. At this time, there is no vaccine that can help people prevent the spread of coronavirus. We are proposing amantadine as a drug that can be used to mitigate the effects of the virus. It is demonstrated by docking models how amantadine can exert its action on Coronavirus viroporin E.


title: Evaluating the national PPE guidance for NHS healthcare workers during the COVID-19 pandemic

text: Tragically, many of the infections and deaths recorded in the global coronavirus disease 2019 (COVID-19) pandemic have occurred in healthcare workers. Some have attributed this to inadequate provision of personal protective equipment (PPE). In the UK, several organisations have voiced their concerns that the national PPE guidance issued by Public Health England is inadequate. Despite recent revisions to these guidelines, concerns remain that they offer insufficient protection to frontline NHS healthcare workers. In this report, we evaluate whether these concerns are merited, through critical appraisal of the available evidence, review of international PPE guidance, and consideration of the ethical implications.


title: Anesthetic concerns for pediatric patients in the era of COVID-19

text: After a novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was reported in China in December 2019, the disease quickly reached pandemic level. On January 30, 2020, the World Health Organization (WHO) declared that the SARS-CoV-2 outbreak constituted a Public Health Emergency of International Concern. The caseload has increased exponentially, with WHO reporting 182 000 global cases by March 17, 2020, and over 2.6 million by 23 April. The clinical situation is complex, with children presenting different clinical features compared to adults. Several articles with recommendations on the anesthetic management of adult patients with COVID-19 have been published, but no specific recommendations for pediatric anesthesiologists have been made yet. This article addresses specific concerns for the anesthetic management of the pediatric population with COVID-19.


Pooling of nasopharyngeal swab specimens for SARS-CoV-2 detection by RT-PCR


title: Why are pregnant women susceptible to COVID-19? An immunological viewpoint

text: The 2019 novel coronavirus disease (COVID-19) was first detected in December 2019 and became epidemic in Wuhan, Hubei Province, China. COVID-19 has been rapidly spreading out in China and all over the world. The virus causing COVID-19, SARS-CoV-2 has been known to be genetically similar to severe acute respiratory syndrome coronavirus (SARS-CoV) but distinct from it. Clinical manifestation of COVID-19 can be characterized by mild upper respiratory tract infection, lower respiratory tract infection involving non-life threatening pneumonia, and life-threatening pneumonia with acute respiratory distress syndrome. It affects all age groups, including newborns, to the elders. Particularly, pregnant women may be more susceptible to COVID-19 since pregnant women, in general, are vulnerable to respiratory infection. In pregnant women with COVID-19, there is no evidence for vertical transmission of the virus, but an increased prevalence of preterm deliveries has been noticed. The COVID-19 may alter immune responses at the maternal-fetal interface, and affect the well-being of mothers and infants. In this review, we focused on the reason why pregnant women are more susceptible to COVID-19 and the potential maternal and fetal complications from an immunological viewpoint.


Refugees besieged: The lurking threat of COVID-19 in Syrian war refugee camps


Could MEFV mutation carriage status have a protective role for COVID-19 pandemic?


title: Clinical characteristics of 34 COVID-19 patients admitted to intensive care unit in Hangzhou, China

text: OBJECTIVE: This study summarizes and compares clinical and laboratory characteristics of 34 patients admitted to the intensive care unit (ICU) for complications from coronavirus disease 2019 (COVID-19) at the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China from Jan. 22 to Mar. 5, 2020. METHODS: A total of 34 patients were divided into two groups, including those who required noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) with additional extracorporeal membrane oxygenation (ECMO) in 11 patients. Clinical features of COVID-19 patients were described and the parameters of clinical characteristics between the two groups were compared. RESULTS: The rates of the acute cardiac and kidney complications were higher in IMV cases than those in NIV cases. Most patients had lymphocytopenia on admission, with lymphocyte levels dropping progressively on the following days, and the more severe lymphopenia developed in the IMV group. In both groups, T lymphocyte counts were below typical lower limit norms compared to B lymphocytes. On admission, both groups had higher than expected amounts of plasma interleukin-6 (IL-6), which over time declined more in NIV patients. The prothrombin time was increased and the levels of platelet, hemoglobin, blood urea nitrogen (BUN), D-dimer, lactate dehydrogenase (LDH), and IL-6 were higher in IMV cases compared with NIV cases during hospitalization. CONCLUSIONS: Data showed that the rates of complications, dynamics of lymphocytopenia, and changes in levels of platelet, hemoglobin, BUN, D-dimer, LDH and IL-6, and prothrombin time in these ICU patients were significantly different between IMV and NIV cases.


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title: Limiting the spread of COVID-19 in Africa: one size mitigation strategies do not fit all countries


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title: From bench to bedside - Development of an integrated COVID-19 patient flow management system


title: COVID-19 in the UK and Occupational Health and Safety: Predictable not Inevitable Failures by Government, and Trade Union and Nongovernmental Organization Responses

text: This commentary examines the occupational health and safety issues faced by the UK workers in the COVID-19 pandemic, against the background of government cuts in health care and in occupational health and safety budgets, and a deregulatory climate. The UK government has been obsessed, blinkered, and distracted by the desire to leave the European Union (Brexit). The state of knowledge about the virus, especially from international agencies that identified pandemic threats and strategies to combat it, is outlined. UK politicians, government bodies, medical and scientific advisors, and employers periodically ignored or abused that knowledge. Regulatory and ministerial inaction and errors on the workplace virus risks emerged. In contrast, several trade unions, health professional bodies, and nongovernmental organizations identified COVID-19 threats from poor personal protection equipment, working practices, and knowledge gaps and offered solutions for health care workers, social care workers, production workers, and service workers in "essential" occupations.


title: Security Survey and Analysis of Vote-by-Mail Systems

text: Voting by mail has been gaining traction for decades in the United States and has emerged as the preferred voting method during the COVID-19 pandemic. In this paper, we examine the security of electronic systems used in the process of voting by mail, including online voter registration and online ballot tracking systems. The goals of these systems, to facilitate voter registration and increase public confidence in elections, are laudable. They indisputably provide a critical public good. It is for these reasons that understanding the security and privacy posture of the mail-in voting process is paramount. We find that online voter registration systems in some states have vulnerabilities that allow adversaries to alter or effectively prevent a voter's registration. We additionally find that ballot tracking systems raise serious privacy questions surrounding ease of access to voter data. While the vulnerabilities discussed here are unlikely to enable an adversary to modify votes, several could have the effect of disenfranchising voters and reducing voter confidence in U.S. elections infrastructure, thereby undermining the very purpose of these systems.


title: Positive Public Health Ethics: Toward Flourishing and Resilient Communities and Individuals

text: The COVID-19 pandemic is a global contagion of unprecedented proportions and health, economic, and social consequences. As with many health problems, its impact is uneven. This article argues the COVID-19 pandemic is a global health injustice due to moral failures of national governments and international organizations to prepare for, prevent and control it. Global and national health communities had a moral obligation to act in accordance with the current state of knowledge of pandemic preparedness. This obligation-a positive duty to develop and implement systems to reduce threats to and safeguard individuals' and, communities' abilities to flourish-stems from theories of global health justice and governance. The COVID-19 pandemic revealed and amplified the fragility and deficiencies in our global and domestic health institutions and systems. Moving forward, positive public health ethics is needed to set ethical standards for building and operating robust public health systems for resilient individuals and communities.


title: Validating a low-cost laser speckle contrast imaging system as a quantitative tool for assessing retinal vascular function

text: The ability to monitor progression of retinal vascular diseases like diabetic retinopathy in small animal models is often complicated by their failure to develop the end-stage complications which characterize the human phenotypes in disease. Interestingly, as micro-vascular dysfunction typically precedes the onset of retinal vascular and even some neurodegenerative diseases, the ability to visualize and quantify hemodynamic changes (e.g. decreased flow or occlusion) in retinal vessels may serve as a useful diagnostic indicator of disease progression and as a therapeutic outcome measure in response to treatment. Nevertheless, the ability to precisely and accurately quantify retinal hemodynamics remains an unmet challenge in ophthalmic research. Herein we demonstrate the ability to modify a commercial fundus camera into a low-cost laser speckle contrast imaging (LSCI) system for contrast-free and non-invasive quantification of relative changes to retinal hemodynamics over a wide field-of-view in a rodent model.


Feasibility Study of Mixing Throat Swab Samples for Severe Acute Respiratory Syndrome Coronavirus-2 Screening


Convalescent plasma therapy: A passive therapy for an aggressive COVID-19


COVID-19: differences de symptomatologie entre la Chine et lEurope


Defining causality in COVID-19 and neurological disorders


title: COVID-19-Related Factors Associated with Sleep Disturbance and Suicidal Thoughts among the Taiwanese Public: A Facebook Survey

text: Coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of people's lives all over the world. This Facebook survey study aimed to investigate the COVID-19-related factors that were associated with sleep disturbance and suicidal thoughts among members of the public during the COVID-19 pandemic in Taiwan. The online survey recruited 1970 participants through a Facebook advertisement. Their self-reported experience of sleep disturbance and suicidal thoughts in the previous week were collected along with a number of COVID-19-related factors, including level of worry, change in social interaction and daily lives, any academic/occupational interference, levels of social and specific support, and self-reported physical health. In total, 55.8% of the participants reported sleep disturbance, and 10.8% reported having suicidal thoughts in the previous week. Multiple COVID-19-related factors were associated with sleep disturbance and suicidal thoughts in the COVID-19 pandemic. Increased worry about COVID-19, more severe impact of COVID-19 on social interaction, lower perceived social support, more severe academic/occupational interference due to COVID-19, lower COVID-19-specified support, and poorer self-reported physical health were significantly associated with sleep disturbance. Less handwashing, lower perceived social support, lower COVID-19-specified support, poorer self-reported physical health, and younger age were significantly associated with suicidal thoughts. Further investigation is needed to understand the changes in mental health among the public since the mitigation of the COVID-19 pandemic.


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title: Association of viral load with serum biomakers among COVID-19 cases

text: Since SARS-CoV-2 spreads rapidly around the world, data have been needed on the natural fluctuation of viral load and clinical indicators associated with it. We measured and compared viral loads of SARS-CoV-2 from pharyngeal swab, IgM anti-SARS-CoV-2, CRP and SAA from serum of 114 COVID-19 patients on admission. Positive rates of IgM anti-SARS-CoV-2, CRP and SAA were 80.7%, 36% and 75.4% respectively. Among IgM-positive patients, viral loads showed different trends among cases with different severity, While viral loads of IgM-negative patients tended to increase along with the time after onset. As the worsening of severity, the positive rates of CRP and SAA also showed trends of increase. Different CRP/SAA type showed associations with viral loads in patients in different severity and different time after onset. Combination of the IgM and CRP/SAA with time after onset and severity may give suggestions on the viral load and condition judgment of COVID-19 patients.


title: Forecasting COVID-19 Transmission and Healthcare Capacity in Bali, Indonesia

text: OBJECTIVES: In the current early phase of the coronavirus disease 2019 (COVID-19) outbreak, Bali needs to prepare to face the escalation of cases, with a particular focus on the readiness of healthcare services. We simulated the future trajectory of the epidemic under current conditions, projected the impact of policy interventions, and analyzed the implications for healthcare capacity. METHODS: Our study was based on the first month of publicly accessible data on new confirmed daily cases. A susceptible, exposed, infected, recovered (SEIR) model for COVID-19 was employed to compare the current dynamics of the disease with those predicted under various scenarios. RESULTS: The fitted model for the cumulative number of confirmed cases in Bali indicated an effective reproduction number of 1.4. Interventions have decreased the possible maximum number of cases from 71 125 on day 86 to 22 340 on day 119, and have prolonged the doubling time from about 9 days to 21 days. This corresponds to an approximately 30% reduction in transmissions from cases of mild infections. There will be 2780 available hospital beds, and at the peak (on day 132), the number of severe cases is estimated to be roughly 6105. Of these cases, 1831 will need intensive care unit (ICU) beds, whereas the number of currently available ICU beds is roughly 446. CONCLUSIONS: The healthcare system in Bali is in danger of collapse; thus, serious efforts are needed to improve COVID-19 interventions and to prepare the healthcare system in Bali to the greatest extent possible.


title: The CREST-2 experience with the evolving challenges of COVID-19: A clinical trial in a pandemic

text: The coronavirus disease 2019 pandemic has disrupted the lives of whole communities and nations. The multinational multicenter National Institute of Neurological Disorders and Stroke Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial stroke prevention trial rapidly experienced the effects of the pandemic and had to temporarily suspend new enrollments and shift patient follow-up activities from in-person clinic visits to telephone contacts. There is an ethical obligation to the patients to protect their health while taking every feasible step to ensure that the goals of the trial are successfully met. Here, we describe the effects of the pandemic on the trial and steps that are being taken to mitigate the effects of the pandemic so that trial objectives can be met.


Virtual clinics: Need of the hour, a way forward in the future. Adapting practice during a healthcare crisis


docid: xlzrknzu

title: Will the Current COVID-19 Pandemic Impact on Long-Term Cannabis Buying Practices?

text: The COVID-19 pandemic and the response to have resulted in an increase in sales activity levels on darknet markets during the first three months of 2020, mainly related to cannabis products. One key question is whether more people will become used to this form of purchasing their drugs and will they continue with it post COVID-19 lockdown. As one-to-one encrypted communication services or social media apps are increasingly being used, monitoring and interdiction will become much more challenging.


Nursing homes and COVID-19: We can and should do better


Effective strategies to prevent in-hospital infection in the emergency department during the novel coronavirus disease 2019 pandemic


title: Ly6cLo non-classical monocytes promote resolution of rhesus rotavirus-mediated perinatal hepatic inflammation

text: Perinatal hepatic inflammation can have devastating consequences. Monocytes play an important role in the initiation and resolution of inflammation, and their diverse functions can be attributed to specific cellular subsets: pro-inflammatory or classical monocytes (Ly6cHi) and pro-reparative or non-classical monocytes (Ly6cLo). We hypothesized that inherent differences in Ly6cHi classical monocytes and Ly6cLo non-classical monocytes determine susceptibility to perinatal hepatic inflammation in late gestation fetuses and neonates. We found an anti-inflammatory transcriptional profile expressed by Ly6cLo non-classical monocytes, and a physiologic abundance of these cells in the late gestation fetal liver. Unlike neonatal pups, late gestation fetuses proved to be resistant to rhesus rotavirus (RRV) mediated liver inflammation. Furthermore, neonatal pups were rendered resistant to RRV-mediated liver injury when Ly6cLo non-classical monocytes were expanded. Pharmacologic inhibition of Ly6cLo non-classical monocytes in this setting restored susceptibility to RRV-mediated disease. These data demonstrate that Ly6cLo monocytes promote resolution of perinatal liver inflammation in the late gestation fetus, where there is a physiologic expansion of non-classical monocytes, and in the neonatal liver upon experimental expansion of these cells. Therapeutic strategies directed towards enhancing Ly6cLo non-classical monocyte function may mitigate the detrimental effects of perinatal liver inflammation.


title: Epidemiological and clinical features of asymptomatic patients with SARS-CoV-2 infection

text: Few studies reported the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients with completely asymptomatic throughout the disease course. We investigated the epidemiological and clinical features of patients infected by SARS-CoV-2 without any symptoms. Patients with confirmed SARS-CoV-2 infection were retrospectively recruited. The demographic characteristics, clinical data, treatment, and outcomes of SARS-CoV-2 infected patients without any symptoms were analyzed. Fifteen (4.4%) of 342 SARS-CoV-2 infected patients did not develop any symptom during the course of the disease. The median time from exposure to diagnosis was 7.0 days (interquartile range [IQR]: 1.0-15.0 days). Of the 15 patients, 14 patients were diagnosed by tested positive for SARS-CoV-2 in throat swabs, while one patient was only tested positive for SARS-CoV-2 in anal swabs. During hospitalization, only 1 (6.7%) patient developed lymphopenia. Abnormalities of chest computed tomography examinations were detected in 8 (53.4%) patients on admission. As of 8 March 2020, all patients have been discharged. The median time of SARS-CoV-2 tested negative from admission was 7.0 days (IQR: 4.0-9.0 days). Patients without any symptoms but with SARS-CoV-2 exposure should be closely monitored and tested for SARS-CoV-2 both in anal and throat swabs to excluded the infection. Asymptomatic patients infected by SARS-CoV-2 have favorable outcomes.


The COVID-19 pandemic will redefine the future delivery of glaucoma care


title: Prognostic value of NT-proBNP in patients with severe COVID-19

text: BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China has been declared a public health emergency of international concern. The cardiac injury is a common condition among the hospitalized patients with COVID-19. However, whether N terminal pro B type natriuretic peptide (NT-proBNP) predicted outcome of severe COVID-19 patients was unknown. METHODS: The study initially enrolled 102 patients with severe COVID-19 from a continuous sample. After screening out the ineligible cases, 54 patients were analyzed in this study. The primary outcome was in-hospital death defined as the case fatality rate. Research information and following-up data were obtained from their medical records. RESULTS: The best cut-off value of NT-proBNP for predicting in-hospital death was 88.64 pg/mL with the sensitivity for 100% and the specificity for 66.67%. Patients with high NT-proBNP values (> 88.64 pg/mL) had a significantly increased risk of death during the days of following-up compared with those with low values (≤88.64 pg/mL). After adjustment for potential risk factors, NT-proBNP was independently correlated with in-hospital death. CONCLUSION: NT-proBNP might be an independent risk factor for in-hospital death in patients with severe COVID-19. TRIAL REGISTRATION: ClinicalTrials, NCT04292964. Registered 03 March 2020.


title: Impact of new coronavirus epidemics on HIV-infected patients

text: Since the first report of a cluster of pneumonia cases in Wuhan (China) at the end of 2019 due to a new airborne highly transmissible coronavirus known as SARS-CoV-2, large-scale spreading has rapidly become a global concern Up to the end of February 2020, more than 85,000 cases had been confirmed worldwide, mostly in China, with more than 3,000 deaths Figures are increasing on a daily basis, being unpredictable what will happen next Table 1 summarizes figures for major outbreaks due to acute viral infections recorded during the past 50 years


docid: gtmsgili

title: Covid-19: Doctors performing resuscitation need higher level of PPE, says royal college


Reshaping the future of ethnobiology research after the COVID-19 pandemic


title: Direct Comparison of SARS-CoV-2 Analytical Limits of Detection across Seven Molecular Assays

text: Analytical sensitivity for SARS-CoV-2 detection is a key performance metric for evaluation of viral detection assays. We determined analytical limits of detection for seven SARS-CoV-2 assays using serial dilutions of pooled patient material quantified with droplet digital PCR. Limits of detection ranged from ≤10-74 copies/mL for commercial high-throughput laboratory analyzers (Roche Cobas, Abbott m2000, Hologic Panther Fusion) and 167-511 copies/mL for sample to answer (Diasorin Simplexa, Genmark ePlex) and point of care instruments (Abbott ID NOW). The CDC assay yielded limits of detection ranging from 85-499 copies/mL, depending on the extraction method and thermocycler used. These results can help to inform the assay choice for testing approaches to manage the current COVID-19 outbreak.


Radiology Department Preparedness for COVID-19: Radiology Scientific Expert Panel


title: The management of surgical patients during the coronavirus disease 2019 (COVID-19) pandemic

text: BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has raised several issues regarding the management of surgical patients. The aim of the current study was to clarify the management of oncologic and surgical patients during the pandemic. METHODS: Relevant publications reporting on the epidemiology of the pandemic, the diagnosis of the severe acute respiratory syndrome coronavirus 2 infection, and the clinical management of cancer and surgical patients, as well as studies concerning health care workers' safety, were included. The last date of research for this study was April 4, 2020. RESULTS: We analyzed 28 papers. Real-time polymerase chain reaction was considered the gold standard for the diagnosis of COVID-19, and computed tomography scans were considered useful for cases of diagnostic uncertainty. Cancer patients and surgical patients were confirmed to be particularly at risk of infection and negative outcome. To guarantee adequate care to these patients, while minimizing the risk for infection, the early postponing of elective surgery, the creation of COVID-free facilities and the identification of COVID- dedicated operating theaters and teams have been proposed. The correct use of personal protective equipment was also strongly advocated, along with the institution of facilities for the psychologic support of health care workers. CONCLUSION: Clinicians should be aware of the importance of providing adequate care to patients with urgent and nondeferrable clinical issues, such as cancer. Every effort should be made to contain the virus spread in the hospital setting. Also, clinicians should value the importance of self-protection and mental health care.


title: Serum Hydrogen Sulfide and Outcome Association in Pneumonia by the SARS-CoV-2 Corona virus

text: BACKGROUND: The pneumonia of COVID-19 illness has often a subtle initial presentation making mandatory the use of biomarkers for evaluation of severity and prediction of final patient disposition. We evaluated the use of hydrogen sulfide (H2S) for the outcome of COVID-19 pneumonia. MATERIALS & METHODS: We studied 74 patients with COVID-19. Clinical data were collected, and survival predictors were calculated. Blood was collected within 24âhours after admission (day 1) and on day 7. H2S was measured in sera by monobromobimane derivation (MBB) followed by high performance liquid chromatography and correlated to other markers like procalcitonin (PCT) and C- reactive protein (CRP). Tumor necrosis factor alpha (TNFα) and interleukin (IL)-6 were also measured in serum. RESULTS: Survivors had significantly higher H2S levels on day 1 and 7 after admission. A cut-off point of 150.44âµM could discriminate survivors from non-survivors with 80% sensitivity, 73.4% specificity and negative predictive value 95.9%. Mortality after 28 days was 32% with admission levels lower or equal to 150.44âµΜ and 4.1% with levels above 150.44âµΜ (p: 0.0008). Mortality was significantly greater among patients with a decrease of H2S levels from day 1 to day 7 greater or equal to 36% (p: 0.0005). Serum H2S on day 1 was negatively correlated with IL- 6 and CRP and positively correlated with the absolute lymphocyte count in peripheral blood. CONCLUSION: It is concluded that H2S is a potential marker for severity and final outcome of pneumonia by the SARS-CoV-2 coronavirus. Its correlation with IL- 6 suggests anti-inflammatory properties.


title: Severe air pollution links to higher mortality in COVID-19 patients: The "double-hit" hypothesis

text: OBJECTIVES: In areas of SARS-CoV-2 outbreak worldwide mean air pollutants concentrations vastly exceed the maximum limits. Chronic exposure to air pollutants have been associated with lung ACE-2 over-expression which is known to be the main receptor for SARS-CoV-2. The aim of this study was to analyse the relationship between air pollutants concentration (PM 2.5 and NO2) and COVID-19 outbreak, in terms of transmission, number of patients, severity of presentation and number of deaths. METHODS: COVID-19 cases, ICU admissions and mortality rate were correlated with severity of air pollution in the Italian regions. RESULTS: The highest number of COVID-19 cases were recorded in the most polluted regions with patients presenting with more severe forms of the disease requiring ICU admission. In these regions, mortality was two-fold higher than the other regions. CONCLUSIONS: From the data available we propose a "double-hit hypothesis": chronic exposure to PM 2.5 causes alveolar ACE-2 receptor overexpression. This may increase viral load in patients exposed to pollutants in turn depleting ACE-2 receptors and impairing host defences. High atmospheric NO2 may provide a second hit causing a severe form of SARS-CoV-2 in ACE-2 depleted lungs resulting in a worse outcome.


title: Ethical dilemmas in clinical care during COVID-19 pandemic

text: In a short span of a few weeks, the COVID-19 pandemic has affected the entire world like no other event in modern history. Healthcare institutions and providers have been at the forefront of containing the ravages of this disease, and are experiencing unprecedented challenges. Medical decision making has become all the more complex because of the moral weight of difficult decisions that need to be made. This paper discusses three areas where ethical decision making is extremely important: dealing with those patients with COVID-19 who no longer have access to their doctors; following ethical criteria for assigning risky duties to healthcare professionals; and in making life and death decisions while allocating scarce resources. This paper describes a national level guidance document for the COVID-19 pandemic that is designed to facilitate ethical decision-making.


title: Using Patient Engagement Platforms in the Postoperative Management of Patients

text: PURPOSE OF REVIEW: The purpose of this review is to contextualize the topic of patient engagement in orthopedic surgery. There will be a specific focus on patient engagement platforms and the impact on outcomes and orthopedic clinical workflows. RECENT FINDINGS: In an attempt to engage patients and optimize the orthopedic perioperative surgical home, patient engagement platforms have emerged in the form of portals, mobile health applications, and chatbots. Collectively, these platforms have improved patient satisfaction scores and outcomes. Patient portals, mobile health applications, and chatbots can engage orthopedic patients and improve the effectiveness of the perioperative orthopedic surgical home. There are specific differences in these applications that should be noted and accounted for. When deciding to incorporate one of these systems into your practice, it is paramount to identify what you are looking to improve upon within your health system and choose a platform accordingly.


The other side of novel coronavirus outbreak: Fear of performing cardiopulmonary resuscitation


title: Relational lockdown and relational trauma* in the time of Coronavirus: a reflection from a UK family therapist

text: Like a meteor hitting the earth's surface, 41,698* unexpected deaths have shaken, disturbed and saddened the core of our Nation. This reflection considers the consequences of the Coronavirus crisis on the UK with particular reference to the impact on families and on the practice of family therapists. The perspective presented can only be partial because of the fast changing situation and the limited access to alternative perspectives that is available during this period of relational lockdown. The author provides a systemic understanding of what has happened and what is happening.


Recommendations for diagnosis and treatment of onychomycosis during the COVID-19 pandemic


Looking at intra-hospital non COVID-19 mortality among elderly patients during COVID-19 pandemic


title: Lymphopenia in COVID-19: Therapeutic opportunities

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is uncontrollably spread all over the world. The host immune responses strongly try to confront it with all the potential cells and cytokines. With chronically condition of SARS-CoV-2, natural killer cells and T cells become exhausted and decreasing their count leads to lymphopenia. Inability to eradicate the infected organ makes hyperinitiation of the immune system, which releases the excessive inflammatory cytokines to compensate the exhausted one as well as the low lymphocytes counts; it consequently leads to the cytokine storm syndrome. These mechanisms and the potential therapeutic targeting are discussed in this paper.


title: COVID-19 and clinical mimics. Correct diagnosis is the key to appropriate therapy

text: As of 29 April 2020, across the globe, there are 3,216,353 confirmed Coronavirus disease 2019 (COVID-19 disease) with 227,894 deaths. The health care infrastructure of most of the countries is overwhelmed due to the gigantic upsurge of the new cases within a short time period. Most of the beds in the regular wards and critical care units are currently occupied by either people under investigation (PUI) or COVID-19 confirmed cases. We hereby discuss the challenges faced while approaching any case of shortness of breath, or other common upper respiratory symptoms during the current COVID-19 pandemic era.


Operational protocol for donation of anti-COVID-19 convalescent plasma in Italy