title: Comparison of chest CT imaging between confirmed and suspected cases of COVID-19/ 新型冠状病毒肺炎确诊与疑似患者的临床和胸部CT影像比较

text: Objective: To explore the value of chest CT features and clinical indexes in the differential diagnosis between suspected COVID-19 with two or more negative nucleic acid tests and confirmed COVID-19. Methods: The clinical data and chest CT images of 105 cases with confirmed COVID-19 (55 males and 50 females, aged from 2 month to 88 years) and 97 cases with suspected COVID-19 (59 males and 38 females, aged from 1 month to 93 years) were analyzed retrospectively in Shiyan Taihe Hospital from January 21 to February 10, 2020. χ2test and two independent sample t test were used to analyze the clinical data and CT signs of the two group cases, with P<0.05 for statistically significant difference. Results: Compared with the suspected patients, the average age of confirmed ones was higher (t=2.460, P=0.01). The main pathological changes were pure ground glass (68 cases) and mixed ground glass density (53 cases) (χ2=50.016, P<0.01). Interstitial thickening (83 cases) (χ2=55.395, P<0.01), vascular widening (73 cases) (χ2=57.527, P<0.01), air bronchogram sign or bronchiectasis (67 cases) (χ2=17.899, P<0.01), fibrous streak shadow (54 cases) (χ2=5.500, P=0.02), commonly distributed under the pleura and the long axis of the lesion was parallel to the pleura (89 cases) (χ2=23.597, P<0.01), most of them had no pleural effusion (χ2= 7.017, P<0.01); both lesions were mainly distributed in patches (89 confirmed cases, 87 suspected cases) (χ2=19.573, P< 0.01). In addition, the lesions of patients with confirmed COVID-19 showed progress in short term (72/87, 82.76%), and those with suspected COVID-19 showed remission in short term (63/89, 70.78%). The difference was statistically significant (χ2=51.114, P< 0.01). There was no significant difference in gender and distribution of pulmonary lobes (χ2=1.462, P=0.23; χ2= 7.381, P=0.19). The number of white blood cells (χ2=17.891, P<0.01) and the percentage of lymphocytes (χ2=11.151, P<0.01) of COVID-19 were mostly normal or decreased, creatine kinase (χ2=9.589, P<0.01) was mostly normal, and erythrocyte sedimentation rate was mostly normal or increased (χ2=4.240, P=0.04). Conclusions: The imaging features and biochemical indexes of diagnosed COVID-19 are different from those of suspected ones. The comparative analysis of imaging features, clinical indexes and follow up examination are helpful for the differential diagnosis of COVID-19.


title: Understanding the psychological impact of the COVID-19 pandemic and containment measures: an empirical model of stress.

text: Research suggests that epidemics and corresponding containment measures have negative consequences to the individual and cause stress. The psychological mechanisms that determine stress, caused by the COVID-19 pandemic and containment measures, are not yet clear. In a survey during the lockdown in Switzerland (n=1565), we found substantially increased levels of stress in the population. In particular, individuals who did not agree with the containment measures, as well as those who saw nothing positive in the crisis, experienced even higher levels of stress. In contrast, individuals who are part of a risk group or who are working in healthcare or in essential shops experienced similar stress levels as the general public. We conducted a path analysis to gain a deeper understanding of the psychological mechanisms during lockdown. Experiencing fear of the disease is a key driver for being worried. Our model further shows that worries about the individual, social, and economic consequences of the crisis, strongly boost stress. The infection rate in the canton (i.e. state) of residence also contributes to stress. Positive thinking and perceived social, organizational, and governmental support mitigate worries and stress. To prevent stress, authorities should explain containment measures well, highlight positive aspects of the crisis, address worries, and facilitate support.


docid: acmfhbtm

title: Highland of COVID-19 outside Hubei: epidemic characteristics, control and projections of Wenzhou, China

text: In late December 2019, Chinese authorities reported a cluster of pneumonia cases of unknown aetiology in Wuhan, China. Wenzhou, as a southeast coastal city with the most cases outside Hubei Province, its policy control and epidemic projections have certain references for national and worldwide epidemic prevention and control. The maximum number of illness onset in Wenzhou appeared on January 26 (38 cases). Since January 27, the incidence per day in Wenzhou has continued to decline is likely to be due to isolation of people return to Wenzhou, implementation of region quarantine and suspension of public transportation system. Under the current control efforts, we estimate that the daily incidence by March 3-9, 2020 will drop to 0 in Wenzhou using SEIR model. The total number of affected people is 538.


title: Internet-based tool for visualizing county and state level COVID-19 trends in the United States.

text: The novel COVID-19 outbreak started in 2019 in Wuhan China and quickly spread to at least 185 countries. We developed an interactive web application that allows users to visualize the spread of COVID-19 in the Unites States at state and county levels. This tool allows visualization of how the virus spreads over time and how state-wide efforts to reduce transmissions have affected the curve in local areas. The downloadable application data allows users to conduct additional analyses. We demonstrate exemplars of trend analyses comparing the daily infection and death rates before and after safer at home orders were implemented per state. The goal was to develop a COVID-19 tracking tool that informs users about the spread of the virus to enable them to make informed decisions after better understanding the presented data.


title: Novel surrogate virus neutralization test reveals low serum neutralizing anti-SARS-CoV-2-S antibodies levels in mildly affected COVID-19 convalescents

text: Neutralizing antibodies targeting the receptor-binding domain (RBD) of the SARS-CoV-2 spike (S) block severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry into cells using surface-expressed angiotensin-converting enzyme 2 (ACE2). We developed a surrogate neutralization test (sVNT) to assess at what degree serum antibodies interfere with the binding of SARS-CoV-2-S-RBD to ACE2. The sVNT revealed neutralizing anti-SARS-CoV-2-S antibodies in the sera of 90% of mildly and 100% of severely affected coronavirus-disease-2019 (COVID-19) convalescent patients. Importantly, sVNT results correlated strongly to the results from pseudotyped-vesicular stomatitis virus-vector-based neutralization assay and to levels of anti-SARS-CoV-2-S1 IgG and IgA antibodies. Moreover, levels of neutralizing antibodies also correlated to duration and severity of clinical symptoms, but not patient age or gender. These findings together with the sVNT will not only be important for evaluating the prevalence of neutralizing antibodies in a population but also for identifying promising plasma donors for successful passive antibody therapy.


title: Modeling and Dynamics in Epidemiology, COVID19 withLockdown and Isolation Effect : Application to Moroccan Case

text: In this paper, we present a SIR mathematical model in order to study the dynamics and propagation of Covid19 and the effect of lockdown of susceptible population and isolation of infectious population. The basic reproduction number R0 depends on the lockdown and isolation rates. We prove that, R0 becomes smaller than one if the lockdown and isolation rates are higher and in this case, we have the extinction of the infectious population. We apply our results to the case of Morocco country. In the end we carried out some numerical simulations illustrating our results.


title: Patterns of COVID-19 related excess mortality in the municipalities of Northern Italy

text: The Coronavirus Disease 2019 (COVID-19) spatial distribution in Italy is inhomogeneous, because of its ways of spreading from the initial hotspots. The impact of COVID-19 on mortality has been described at the regional level, while less is known about mortality in demographic subgroups within municipalities. We aimed to describe the excess mortality (EM) due to COVID-19 in the three most affected Italian regions, by estimating EM in subgroups defined by gender and age classes within each municipality from February 23 to March 31, 2020. EM varied widely among municipalities even within the same region; it was similar between genders for the [≥]75 age group, while in the other age groups it was higher in males. Thus, nearby municipalities may show a different mortality burden despite being under common regional health policies, possibly as a result of policies adopted both at the regional and at the municipality level.


title: COVID-19 in Great Britain: epidemiological and clinical characteristics of the first few hundred (FF100) cases: a descriptive case series and case control analysis

text: Objectives: Following detection of the first virologically-confirmed cases of COVID-19 in Great Britain, an enhanced surveillance study was initiated by Public Health England to describe the clinical presentation, course of disease and identify risk factors for infection of the first few hundred cases. Methods: Information was collected on the first COVID-19 cases according to the First Few X WHO protocol. Case-control analyses of the sensitivity, specificity and predictive value of symptoms and risk factors for infection were conducted. Point prevalences of underlying health conditions among the UK general population were presented. Findings: The majority of FF100 cases were imported (51.4%), of which the majority had recent travel to Italy (71.4%). 24.7% were secondary cases acquired mainly through household contact (40.4%). Children had lower odds of COVID-19 infection compared with the general population. The clinical presentation of cases was dominated by cough, fever and fatigue. Non-linear relationships with age were observed for fever, and sensitivity and specificity of symptoms varied by age. Conditions associated with higher odds of COVID-19 infection (after adjusting for age and sex) were chronic heart disease, immunosuppression and multimorbidity. Conclusion: This study presents the first epidemiological and clinical summary of COVID-19 cases in Great Britain. The FFX study design enabled systematic data collection. The study was able to characterize the risk factors for infection with population prevalence estimates setting these relative risks into a public health context. It also provides important evidence for generating case definitions to support public health risk assessment, clinical triage and diagnostic algorithms.


title: Increasing testing throughput and case detection with a pooled-sample Bayesian approach in the context of COVID-19

text: Rapid and widespread implementation of infectious disease surveillance is a critical component in the response to novel health threats. Molecular assays are the preferred method to detect a broad range of pathogens with high sensitivity and specificity. The implementation of molecular assay testing in a rapidly evolving public health emergency can be hindered by resource availability or technical constraints. In the context of the COVID-19 pandemic, the applicability of a pooled-sample testing protocol to screen large populations more rapidly and with limited resources is discussed. A Bayesian inference analysis in which hierarchical testing stages can have different sensitivities is implemented and benchmarked against early COVID-19 testing data. Optimal pool size and increases in throughput and case detection are calculated as a function of disease prevalence. Even for moderate losses in test sensitivity upon pooling, substantial increases in testing throughput and detection efficiency are predicted, suggesting that sample pooling is a viable avenue to circumvent current testing bottlenecks for COVID-19.


title: Crystallographic and electrophilic fragment screening of the SARS-CoV-2 main protease

text: COVID-19, caused by SARS-CoV-2, lacks effective therapeutics. Additionally, no antiviral drugs or vaccines were developed against the closely related coronavirus, SARS-CoV-1 or MERS-CoV, despite previous zoonotic outbreaks. To identify starting points for such therapeutics, we performed a large-scale screen of electrophile and non-covalent fragments through a combined mass spectrometry and X-ray approach against the SARS-CoV-2 main protease, one of two cysteine viral proteases essential for viral replication. Our crystallographic screen identified 71 hits that span the entire active site, as well as 3 hits at the dimer interface. These structures reveal routes to rapidly develop more potent inhibitors through merging of covalent and non-covalent fragment hits; one series of low-reactivity, tractable covalent fragments was progressed to discover improved binders. These combined hits offer unprecedented structural and reactivity information for on-going structure-based drug design against SARS-CoV-2 main protease.


title: Prolonged SARS-CoV-2 Viral Shedding in Patients with COVID-19 was Associated with Delayed Initiation of Arbidol Treatment: a retrospective cohort study

text: Abstract Objectives: Evaluate the risk factors of prolonged SARS-CoV-2 virus shedding and the impact of arbidol treatment on SARS-CoV-2 virus shedding. Methods: Data were retrospective collected from adults hospitalized with COVID-19 in Wuhan Union Hospital. We described the clinical features and SARS-CoV-2 RNA shedding of patients with COVID-19 and evaluated factors associated with prolonged virus shedding by multivariate regression analysis. Results: Among 238 patients, the median age was 55.5 years, 57.1% were female, 92.9% (221/238) used arbidol, 58.4% (139/238) used arbidol combination with interferon. The median time from illness onset to start arbidol was 8 days (IQR, 5-14 days) and the median duration of SARS-CoV-2 virus shedding was 23 days (IQR, 17.8-30 days). SARS-CoV-2 RNA clearance was significantly delayed in patients who received arbidol >7 days after illness onset, compared with those in whom arbidol treatment was started less than or equal to7 days after illness onset (HR, 1.738 [95% CI, 1.339-2.257], P < .001). Multivariate regression analysis revealed that prolonged viral shedding was significantly associated with initiation arbidol more than seven days after symptom onset (OR 2.078, 95% CI [1.114-3.876], P .004), more than 7 days from onset of symptoms to first medical visitation (OR 3.321, 95% CI[1.559-7.073], P .002), illness onset before Jan.31, 2020 (OR 3.223, 95% CI[1.450-7.163], P .021). Arbidol combination with interferon was also significantly associated with shorter virus shedding (OR .402, 95% CI[.206-.787], P .008). Conclusions: Early initiation of arbidol and arbidol combination with interferon as well as consulting doctor timely after illness onset were helpful for SARS-CoV-2 clearance.


title: Correlating Covid-19 mortality and infection levels

text: Covid-19 deaths and positive cases show a remarkable heterogeneity across countries which cannot be easily explained on the basis of similarities or differences in the quality of healthcare, access to healthcare, testing facilities, or preventive measures such as lockdowns. Here we show that there is a distinct correlation between the mortality level and the infection level across countries, which can explain the mortality levels for a wide spectrum of countries. This implies that the number of deaths per 100 infected individuals is approximately the same across diverse countries and can be estimated from the slope of the mortality level-infection level plot. The correlation presented here can potentially be combined with estimates of infection spread to forecast future mortality levels and therefore future needs in terms of healthcare and other resources. Tracking of an individual locations temporal path on this plot can potentially serve as a visual assessment of the nature of the epidemic. Methods presented here are not specific to the current epidemic. This is a preliminary report and uses data from a single source at a single time-point to demonstrate the capability of such an analysis.


title: Optimal Control Measures to Combat COVID19 Spread in Sri Lanka: A Mathematical ModelConsidering the Heterogeneity of Cases

text: The COVID 19 pandemic caused by the novel corona virus (SARS-CoV-2) has been one of the major public health concerns across the globe, currently more than 3.5 million individuals have been infected, and the number of deaths has passed 250,000. The world wide burden of the disease has been massive, and the governments are in dilemma to protect the health system of the country while safeguarding the economy. There is no vaccine or antivirus drug found against this virus while multiple research groups are actively working on a suitable candidate. The only available mode of minimizing the disease burden has been to control its transmission among the population. Since the occurrence of first COVID 19 local case on 11 March 2020, the government of Sri Lanka introduced serious social distancing and public health interventions in its fullest capacity as a developing nation to effectively combat with the disease spread. This study focuses to develop a mathematical model to investigate the dynamic of this novel disease using an extended version of an SEIR compartmental structure considering the heterogeneity of cases such as asymptomatic, symptomatic with mild indications and the cases required intensive care treatments. All the measures and interventions are in progress with a significantly large social and economic cost, thus, optimal control techniques are used to identify the most appropriate strategies to minimize this cost. The results of the simulations prove that optimal control measures can be worked out as the epidemic curves are flattened while delaying the outbreak so that the health system might not be under pressure to treat and care the patients.


docid: uipazeve

title: Genetic polymorphisms mediating behavioural and immune response to pathogens may moderate the impact of the COVID-19 pandemic: a pilot study

text: Background: The COVID-19 pandemic has affected the entire world, but there are wide variations in prevalence and mortality across nations. Genetic variants which influence behavioural or immune responses to pathogens, selected for by pathogen pressure, may influence this variability. Two relevant polymorphisms in this context are the s allele of the serotonin transporter promoter (5-HTTLPR) and the G allele of the interleukin-6 gene (IL-6 rs1800795). Methods: The frequencies of the 5-HTTLPR s allele and IL-6 rs1800795 G allele were obtained from published data. The correlations between these allele frequencies and the prevalence and mortality rates of COVID-19 were examined across 44 nations. Results: The IL-6 rs1800795 G allele was negatively correlated with COVID-19 prevalence ({rho} = -0.466, p < 0.01) and mortality ({rho} = -0.591, p<0.001) across nations. The 5-HTTLPR s allele was negatively correlated with COVID-19 mortality rates ({rho} = -0.437, p = 0.023). Conclusions: These results suggest that a significant relationship exists between genetic variants that influence behavioural and immune responses to pathogens and indices of the impact of COVID-19 across nations. Further investigation of these variants and their correlates may permit the development of better preventive or therapeutic strategies in the management of the COVID-19 pandemic.


title: Estimating the seroprevalence of SARS-CoV-2 infections: systematic review

text: Abstract Background: Accurate seroprevalence estimates of SARS-CoV-2 in different populations could help gauge the true magnitude and spread of the infection seroprevalence. Reported estimates have varied greatly, but many have derived from biased samples, and inadequate testing methods. Objective: To estimate the range of valid seroprevalence rates of SARS-CoV-2 in different populations, and compare these seroprevalence estimates with the cumulative cases seen in the same population. Methods: We searched PubMed, Embase, the Cochrane COVID-19 trials, and Europe-PMC for published studies and pre-prints from January 2020 to 25 May 2020 that reported anti-SARS-CoV-2 IgG, IgM and/or IgA antibodies for serosurveys of either the general community or of defined sub-populations, such healthcare workers and other organizations. Results: Of the 837 studies identified, 49 were assessed and 14 were includable. Included studies represented 10 countries and 100,557 subjects: 9 from randomly selected populations, 2 from healthcare workers, 2 from industry populations, and 1of parturient women. The seroprevalence proportions in 10 studies ranged between 1%-10%, and 2 study estimates under 1%, and 2 over 10% - from the notably hard-hit regions of Gangelt in Germany and from Northwest Iran. The two studies in healthcare workers, in Italy and Spain, had seroprevalence rates at higher range of estimates, with the Barcelona hospitals having a higher rate than the Spanish national survey. For only one study was the seroprevalence estimate higher than the cumulative incidence, though these were proximate for several studies. In five studies, the seroprevalence was similar to the cumulative case numbers in the same population. For seropositive cases not previously detected as COVID-19 cases, the majority had prior COVID-like symptoms. Conclusion: The seroprevalence of SARS-CoV-2 mostly less than 10% with the level of infection lower in the general community, suggesting levels well below herd immunity. The similarity of seroprevalence and reported cases is several studies, and high symptom rates in seropositive cases suggest that gaps between seroprevalence rates and reported cases are likely due to undertesting of symptomatic people.


title: New coronavirus pneumonia and outbreak epidemic virus and eye disease/ 暴发性流行性疾病病毒传播途径与眼病

text: Since the outbreak of the new coronavirus pneumonia (NCP) in Wuhan City, China, the main transmission mode as well as the diagnosis and treatment of NCP have become a focus of research in China and World Health Organization.Understanding the mode of infection, transmission and biological behavior of the novel coronavirus (2019-nCoV) is undoubtedly a key of cutting off the spread and prevention of the disease which doctors are fearing to be a worldwide epidemic.In February 2020, Lancet published a correspondence paper, which reviewed a case of NCP patient who first started with conjunctivitis, and raised the issue that the transmission of 2019-nCoV through the ocular surface must not be ignored, causing widespread concern.However, due to a lack of clinical observation data and laboratory research at present, the relationship between NCP pathogen infection and ocular surface infection is not completely clear.So far, there have been many studies and reports on the observation of large-scale epidemic virus infections and eye diseases.This article reviews the eye performance of various types of epidemic virus infections and provides a reference for NCP prevention and control.


title: Psychiatric Predictors of COVID-19 Outcomes in a Skilled Nursing Facility Cohort

text: Several medical risk factors for COVID-19 have been identified. However, additional factors likely account for some of the observed variability in COVID-19 outcomes. We examined the relationships between chronic psychiatric disorders and COVID-19 morbidity and mortality. Medical records from a cohort of 141 skilled nursing facility residents were reviewed. Multivariate logistic regression modeling determined psychiatric predictors for hospital admission, intensive care unit (ICU) admission, and mortality after controlling for medical risk factors. After controlling for all medical risk, altered mental status (AMS) was a predictor of hospital admission (p = .005), ICU admission (p = .015), and mortality (p = .006). Anxiety (p = .008) and dementia (p = .040) were also associated with an elevated risk of death. A simplified model yielded comparable findings. AMS was associated with a greater risk of hospital admission (p = .002), ICU admission (p = .024), and mortality (p = .006); anxiety (p = .002) was also a powerful predictor of mortality. After accounting for medical risk, morbidity and mortality due to COVID-19 are higher than expected in patients with chronic anxiety disorders, dementia, and AMS. Mechanisms underlying adverse outcomes remain to be determined. Links to neuroendocrine modulation, inflammation, and immune functioning are considered. Furthermore, outcomes in patients with dementia and AMS suggest COVID-19 poses substantial risk to the brain.


title: Children and covid-19

text: Children will face many hidden negative effects from the new coronavirus– it's not too late to avert them, says Paul Ramchandani


title: Evaluation of the number of COVID-19 undiagnosed infected using source of infection measurements

text: Multiple studies have been conducted to predict the impact and duration of the current COVID-19 epidemics. Most of those studies rely on parameter calibration using the published number of confirmed cases. Unfortunately, this number is usually incomplete and biased due to the lack of testing capacities, and varying testing protocols. An essential requirement for better monitoring is the evaluation of the number of undiagnosed infected individuals. This number is crucial for the determination of transmission prevention strategies and it provides statistics on the epidemic dynamics. To estimate the number of undiagnosed infected individuals, we studied the relation between the fraction of diagnosed infected out of all infected, and the fraction of infected with known contaminator out of all diagnosed infected. We simulated multiple models currently used to study the COVID-19 pandemic and computed the relation between these two fractions in all those models. Across most models currently used and for most realistic model parameters, the relation between the two fractions is consistently linear and model independent. This relation can be used to estimate the number of undiagnosed infected, with no explicit epidemiological model. We apply this method to measure the number of undiagnosed infected in Israel. Since the fraction of confirmed cases with a known source can be obtained from epidemiological investigations in any country, one can estimate the total number of infected individuals in the same country.


title: Transmission onset distribution of COVID-19 in South Korea

text: Background The distribution of the transmission onset of COVID-19 relative to the symptom onset is a key parameter for infection control. It is often not easy to study the transmission onset time, as is difficult to know who infected whom exactly when. Methods We inferred transmission onset time from 72 infector-infectee pairs in South Korea, either with known or inferred contact dates by means of incubation period. Combining this data with known information of infector's symptom onset, we could generate the transmission onset distribution of COVID-19, using Bayesian methods. Findings We estimated the median transmission onset to be 1.31 days (standard deviation, 2.64 days) after symptom onset with peak at 0.72 days before symptom onset. The pre-symptomatic transmission proportion was 37% (95% credible interval [CI], 16-52%). The median incubation period was estimated to be 2.87 days (95% CI, 2.33-3.50 days) and the median serial interval to be 3.56 days (95% CI, 2.72-4.44 days). Interpretation Considering the transmission onset distribution peaked with the symptom onset and the pre-symptomatic transmission proportion is substantial, the usual preventive measure might be too late to prevent SARS-CoV-2 transmission.


title: Selectomic and Evolvability Analyses of the Highly Pathogenic Betacoronaviruses SARS-CoV-2, SARS-CoV, and MERS-CoV

text: SARS-CoV-2, the causative agent of COVID-19, is widespread in several countries around the world following its late-2019 emergence in the human population. Rapid development of molecular diagnostic tests and subunit vaccines have been prioritized, and as such evaluating the SARS-CoV-2 genomic plasticity and evolutionary dynamics is an urgent need. We determined the SARS-CoV-2 selectome by calculating rates of pervasive and episodic diversifying selection for every amino acid coding position in the SARS-CoV-2 genome. To provide context for evolutionary dynamics of a highly pathogenic betacoronavirus following a zoonotic spillover into human hosts, we also determined the selectomes of SARS-CoV and MERS-CoV, and performed evolvability calculations for SARS-CoV-2 based on SARS-CoV. These analyses identify the amino acid sites within each coding sequence that have been subjected to pervasive diversifying selection or episodic diversifying selection, and report significantly evolvable sites in the ORF1a polyprotein, the spike protein, and the membrane protein of SARS-CoV-2. These findings provide a comprehensive view of zoonotic, highly pathogenic betacoronavirus evolutionary dynamics that can be directly applied to diagnostic assay and vaccine design for SARS-CoV-2.


title: A Multicenter, randomized, open-label, controlled trial to evaluate the efficacy and tolerability of hydroxychloroquine and a retrospective study in adult patients with mild to moderate Coronavirus disease 2019 (COVID-19)

text: Objective In this study, we evaluated the efficacy of hydroxychloroquine (HCQ) against coronavirus disease 2019 (COVID-19) via a randomized controlled trial (RCT) and a retrospective study. Methods Subjects admitted to 11 designated public hospitals in Taiwan between April 1 and May 31, 2020, with COVID-19 diagnosis confirmed by pharyngeal real-time RT-PCR for SARS-CoV-2, were randomized at a 2:1 ratio and stratified by mild or moderate illness. HCQ 400 mg twice for 1 d and HCQ 200 mg twice daily for 6 days were administered. Both study group and controlled group received standard of care (SOC). Pharyngeal swabs and sputum were collected every other day. The proportion and time to negative viral PCR were assessed on day 14. In the retrospective study, medical records were reviewed for patients admitted before March 31, 2020. Results There were 33 and 37 cases in the RCT and retrospective study, respectively. In the RCT, the median times to negative rRT-PCR from randomization to hospital day 14 were 5 days (95% CI; 1-9 days) and 10 days (95% CI; 2-12 days) for the HCQ and SOC groups, respectively (p = 0.40). On day 14, 81.0% (17/21) and 75.0% (9/12) of the subjects in the HCQ and SOC groups, respectively, had undetected virus (p = 0.36). In the retrospective study, 12 (42.9%) in the HCQ group and 5 (55.6%) in the control group had negative rRT-PCR results on hospital day 14 (p = 0.70). Conclusions Neither study demonstrated that HCQ shortened viral shedding in mild to moderate COVID-19 subjects.


title: Profiling the positive detection rate of SARS-CoV-2 using polymerase chain reaction in different types of clinical specimens: a systematic review and meta-analysis

text: Background: Testing is one of the commendable preventive measures against coronavirus disease (COVID_19), and needs to be done using both most appropriate specimen and an accurate diagnostic test like real time reverse transcription polymerase chain reaction (qRT_PCR). However, the detection rate of severe acute respiratory syndrome coronavirus 2 (SARS_CoV_2) RNA from different clinical specimens after onset of symptoms is not yet well established. For guiding the selection of specimens for clinical diagnosis of COVID-19, a systematic review aiming at profiling the positive detection rate from different clinical specimens using PCR was conducted. Methods: The systematic search was done using PubMed/MEDLINE, Science direct, Google Scholar, among others. The search included studies on laboratory diagnosis of SARS_CoV_2 from different clinical specimens using PCR. Data extraction was done using Microsoft Excel spread sheet 2010 and reported according to PRISMA_P guidelines. Using Open Meta Analyst software, DerSimonian_Laird random effects analysis was performed to determine a summary estimate (positive rate [PR]/proportions) and their 95% confidence interval (95%CI). Results: A total of 8136 different clinical specimens were analyzed to detect SARS_CoV_2, with majority being nasopharyngeal swabs (69.6%). Lower respiratory tract (LRT) specimens had a PR of 71.3% (95%CI:60.3%-82.3%) while no virus was detected from the urinogenital specimens. Bronchoalveolar lavage fluid (BLF) specimen had the PR of 91.8% (95%CI:79.9-103.7%), followed by rectal swabs, 87.8 % (95%CI:78.6%-96.9%) then sputum, 68.1% (95%CI:56.9%-79.4%). Low PR was observed in oropharyngeal swabs, 7.6% (95%CI:5.7%-9.6%) and blood samples, 1.0% (95%CI: -0.1%-2.1%), whilst no SARS-CoV-2 was detected in urine samples. Nasopharyngeal swab, a widely used specimen had a PR of 45.5% (95%CI:31.2%-59.7%). Conclusion: In this study, SARS-CoV-2 was highly detected in lower respiratory tract specimens while there was no detected virus in urinogenital specimens. Regarding the type of clinical specimens, bronchoalveolar lavage fluid had the highest positive rate followed by rectal swab then sputum. Nasopharyngeal swab which is widely used had a moderate detection rate. Low positive rate was recorded in oropharyngeal swab and blood sample while no virus was found in urine samples. More importantly, the virus was detected in feces, suggesting SARS-CoV-2 transmission by the fecal route.


New coronavirus pandemic: An analysis paralysis?


title: Unveiling diffusion pattern and structural impact of the most invasive SARS-CoV-2 spike mutation

text: Starting in Wuhan, China, SARS-CoV-2 epidemics quickly propagated worldwide in less than three months, geographically sorting genomic variants in newly established propagules of infections. Stochasticity in transmission within and between countries and/or actual advantage in virus transmissibility could explain the high frequency reached by some genomic variants during the course of the outbreak. Using a suite of statistical, population genetics, and theoretical approaches, we show that the globally most represented spike protein variant (i.e., the G clade, A → G nucleotide change at genomic position 23,403; D → G amino acid change at spike protein position 614) i) underwent a significant demographic expansion in most countries not explained by stochastic effects or enhanced pathogenicity; ii) affects the spike S1/S2 furin-like site increasing its conformational plasticity (short range effect), and iii) modifies the internal motion of the receptor-binding domain affecting its cross-connection with other functional domains (long-range effect). Our study unambiguously links the spread of the G614 with a non-random process, and we hypothesize that this process is related to the selective advantage produced by a specific structural modification of the spike protein. We conclude that the different conformation of the S1/S2 proteolytic site is at the basis of the higher transmission rate of this invasive SARS-CoV-2 variant, and provide structural information to guide the design of selective and efficient drugs.


title: RdRp mutations are associated with SARS-CoV-2 genome evolution

text: COVID-19, caused by the novel SARS-CoV-2 virus, started in China in late 2019, and soon became a global pandemic. With the help of thousands of viral genome sequences that have been accumulating, it has become possible to track the evolution of viral genome over time as it spread across the world. An important question that still needs to be answered is whether any of the common mutations affect the viral properties, and therefore the disease characteristics. Therefore, we sought to understand the effects of mutations in RNA-dependent RNA polymerase (RdRp), particularly the common 14408C>T mutation, on mutation rate and viral spread. By focusing on mutations in the slowly evolving M or E genes, we aimed to minimize the effects of selective pressure. Our results indicate that 14408C>T mutation increases the mutation rate, while the third-most common RdRp mutation, 15324C>T, has the opposite effect. It is possible that 14408C>T mutation may have contributed to the dominance of its co-mutations in Europe and elsewhere.


title: Kafka and the COVID-19 epidemic: Why the Sirens’ silence is more deadly than their song

text: Seeking to examine the implications of social distancing, isolation and the silencing of public spaces brought about by the COVID-19 epidemic, I offer an interpretation of Kafka’s short story ‘The Silence of the Sirens’ contrasting it to the Homeric original. In Homer’s story, Odysseus resists the temptation of the Sirens’ deadly song by having himself tied to the mast of his ship, while his oarsmen, ears blocked with beeswax, sail quickly by. By contrast, in Kafka’s telling of the story, the Sirens fall silent. A solitary Odysseus, indifferent to them, sails by peacefully, his ears blocked, his ‘great eyes’ staring in the distance. Homer’s story has long been seen as a warning against the seductions of Siren voices like those of opportunist demagogues. Throughout the Odyssey, Odysseus himself offers a complex archetype of heroic leadership, navigating adroitly and prudently the dangers of stormy seas. Kafka’s character, by contrast, proposes a different archetype, one akin to the Stoics’ homo viator, the individual who sails through life’s adversities by accepting them and turning them into a source of inner strength and wisdom. In this way, Kafka offers two things: first, an insightful explanation of why silence and isolation can be deadly when they leaving us alone with our darkest fears and fantasies, and second, an archetype of hope that is attuned to our times on how to cope with pain and anxiety.


docid: nbamgloi

title: This COVID-19 Life: How These Neurologists Achieve That Work-Family Balance


docid: lgwndlfq

title: COVID-19: hommage aux combattants, à leur service de santé et leurs stratèges


title: Psychological Distress during the COVID-19 pandemic in France: a national assessment of at-risk populations

text: Introduction More than 2.5 billion people in the world are currently in lockdowns to limit the spread of the novel coronavirus disease 2019 (COVID-19). Psychological Distress (PD) and Post-Traumatic Stress Disorder have been reported after traumatic events, but the specific effect of pandemics is not well known. The aim of this study was to assess PD in France, a country where COVID-19 had such a dramatic impact that it required a country-wide lockdown. Patients and methods We recruited patients in 4 groups of chatbot users followed for breast cancer, asthma, depression and migraine. We used the Psychological Distress Index (PDI), a validated scale to measure PD during traumatic events, and correlated PD risk with patients characteristics in order to better identify the one who were the most at-risk. Results The study included 1771 participants. 91.25% (1616) were female with a mean age of 32.8 years (SD=13,71), 7.96% (141) were male with a mean age of 28.0 years (SD=8,14). In total, 38.06% (674) of the respondents had psychological distress (PDI [≥]15). An ANOVA analysis showed that sex (p=0.00132), unemployment (p=7.16x10-6) and depression (p=7.49x10-7) were significantly associated with a higher PDI score. Patients using their smartphone or computer more than one hour a day also had a higher PDI score (p=0.02588). Conclusion Prevalence of PD in at-risk patients is high. These patients are also at increased risk to develop Post-Traumatic Stress Disorder. Specific steps should be implemented to monitor and prevent PD through dedicated mental health policies if we want to limit the public health impact of COVID-19 in time.


title: Comparison of the clinical characteristics and outcomes of hospitalized adult COVID-19 and influenza patients: a prospective observational study

text: Objective We compared the clinical characteristics, findings and outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19) or influenza to detect relevant differences. Methods From December 2019 to April 2020, we recruited all eligible hospitalized adults with respiratory infection to a prospective observational study at the HUS Jorvi Hospital, Finland. Influenza and SARS-CoV-2 infections were confirmed by RT-PCR. Follow-up lasted for at least 30 days from admission. Results We included 61 patients, of whom 28 were COVID-19 and 33 influenza patients with median ages of 53 and 56 years. Majority of both COVID-19 and influenza patients were men (61% vs 67%) and had at least one comorbidity (68% vs 85%). Pulmonary diseases and current smoking were less common among COVID-19 than influenza patients (5 [18%] vs 15 [45%], P=0.03 and 1 [4%] vs 10 [30%], P=0.008). In chest x-ray at admission, ground-glass opacities and consolidations were more frequent among COVID-19 than influenza patients (19 [68%] and 7 [21%], P < 0.001). Severe disease and intensive care unit (ICU) admission occurred more often among COVID-19 than influenza patients (26 [93%] vs 19 [58%], P=0.003 and 8 [29%] vs 2 [6%], P=0.034). COVID-19 patients were hospitalized longer than influenza patients (6 days [IQR 4-21] vs 3 [2-4], P<0.001). Conclusion Bilateral ground-glass opacities and consolidations in chest X-ray may help to differentiate COVID-19 from influenza. Hospitalized COVID-19 patients had more severe disease, required longer hospitalization and were admitted to ICU more often than influenza patients, which has important implications for public health policies.


Education for Students with Visual Impairments in the Time of Coronavirus: An Approach to Education Through Videoconferencing


title: Bariatric Surgical Practice and Patient Care During the COVID-19 Pandemic

text: Bariatric patients are unique from other surgical patients due to their higher prevalence of hypertension, type 2 diabetes, cardiovascular disease, and respiratory illnesses The outbreak of the No


title: Highly ACE2 Expression in Pancreas May Cause Pancreas Damage After SARS-CoV-2 Infection

text: The ongoing outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started in the end of 2019 in China has triggered a global public health crisis. Previous studies have shown that SARS-CoV-2 infects cells by binding angiotensin-converting enzyme 2 (ACE2), which is the same as SARS-CoV. The expression and distribution of ACE2 in the pancreas are unknown. At the same time, the injury of pancreas after SARS-CoV-2 infection has not been concerned. Here, we collected public datasets (bulk RNA-seq and single-cell RNA-seq) to indicate the expression and the distribution of ACE2 in pancreas (in both exocrine glands and islets). And further, clinical data including mild and severe patients with COVID-19 demonstrated there existed mild pancreatitis. In the 67 severe cases, 11 patients (16.41%) showed elevated levels of both amylase and lipase, and 5 patients (7.46%) showed imaging alterations. Only one patient (1.85%) showed elevated levels of both amylase and lipase in 54 mild cases, without imaging changes. Our study revealed the phenomenon and possible cause of mild pancreatic injury in patients with COVID-19. This suggests that pancreatitis after SARS-CoV-2 infection should also be paid attention in clinical work.


title: Progression of COVID-19 in Indian States - Forecasting Endpoints Using SIR and Logistic Growth Models

text: COVID-19 has led to the most widespread public health crisis in recent history. The first case of the disease was detected in India on 31 January 2019, and confirmed cases stand at 74,281 as of 13 May 2020. Mathematical modeling can be utilized to forecast the final numbers as well as the endpoint of the disease in India and its states, as well as assess the impact of social distancing measures. In the present work, the Susceptible-Infected-Recovered (SIR) model and the Logistic Growth model have been implemented to predict the endpoint of COVID-19 in India as well as three states accounting for over 55% of the total cases - Maharashtra, Gujarat and Delhi. The results using the SIR model indicate that the disease will reach an endpoint in India on 12 September, while Maharashtra, Gujarat and Delhi will reach endpoints on 20 August, 30 July and 9 September respectively. Using the Logistic Regression model, the endpoint for India is predicted on 23 July, while that for Maharashtra, Gujarat and Delhi is 5 July, 23 June and 10 August respectively. It is also observed that the case numbers predicted by the SIR model are greater than those for the Logistic Growth model in each case. The results suggest that the lockdown enacted by the Government of India has had only a moderate impact on the spread of COVID-19, and emphasize the need for firm implementation of social distancing guidelines.


title: A model to forecast regional demand for COVID-19 related hospital beds

text: COVID-19 threatens to overwhelm hospital facilities throughout the United States. We created an interactive, quantitative model that forecasts demand for COVID-19 related hospitalization based on county-level population characteristics, data from the literature on COVID-19, and data from online repositories. Using this information as well as user inputs, the model estimates a time series of demand for intensive care beds and acute care beds as well as the availability of those beds. The online model is designed to be intuitive and interactive so that local leaders with limited technical or epidemiological expertise may make decisions based on a variety of scenarios. This complements high-level models designed for public consumption and technically sophisticated models designed for use by epidemiologists. The model is actively being used by several academic medical centers and policy makers, and we believe that broader access will continue to aid community and hospital leaders in their response to COVID-19. Link to online model: https://surf.stanford.edu/covid-19-tools/covid-19/


title: Age-stratified Infection Probabilities Combined with Quarantine-Modified SEIR Model in the Needs Assessments for COVID-19

text: We use the age-stratified COVID-19 infection and death distributions from China (more than 44,672 infectious as of February 11, 2020) as an estimate for a study area infection and morbidity probabilities at each age group. We then apply these probabilities into the actual age-stratified population to predict infectious individuals and deaths at peak. Testing with different countries shows the predicted infectious skewing with the country median age and age stratification, as expected. We added a Q parameter to the classic SEIR compartmental model to include the effect of quarantine (Q-SEIR). The projections from the age-stratified probabilities give much lower predicted incidences of infection than the Q-SEIR model. As expected, quarantine tends to delay the peaks for both Exposed and Infectious, and to flatten the curve or lower the predicted values for each compartment. These two estimates were used as a range to inform planning and response to the COVID-19 threat.


title: A possible role of immunopathogenesis in COVID-19 progression

text: Background: The efficacy of the humoral and cellular immunity determines the outcome of viral infections. An appropriate immune response mediates protection, whereas an overwhelming immune response has been associated with immune-mediated pathogenesis in viral infections. The current study explored the general and SARS-CoV-2 specific cellular and humoral immune status in patients with different COVID-19 severities. Methods: In this prospective study, we included 53 patients with moderate, severe, and critical COVID-19 manifestations comparing their quantitative, phenotypic, and functional characteristics of circulating immune cells, SARS-CoV-2 antigen specific T-cells, and humoral immunity. Results: Significantly diminished frequencies of CD8+T-cells, CD4+ and CD8+T-cell subsets with activated differentiated memory/effector phenotype and migratory capacity were found in circulation in patients with severe and/or critical COVID-19 as compared to patients with moderate disease. Importantly, the improvement of the clinical courses from severe to moderate was accompanied by an improvement in the T-cell subset alterations. Furthermore, we surprisingly observed a detectable SARS-CoV-2-reactive T-cell response in all three groups after stimulation with SARS-CoV-2 S-protein overlapping peptide pool already at the first visit. Of note, patients with a critical COVID-19 demonstrated a stronger response of SARS-CoV-2-reactive T-cells producing Th1 associated inflammatory cytokines. Furthermore, clear correlation between antibody titers and SARS-CoV-2-reactive CD4+ frequencies underscore the role of specific immunity in disease progression. Conclusion: Our data demonstrate that depletion of activated memory phenotype circulating T-cells and a strong SARS-CoV-2-specific cellular and humoral immunity are associated with COVID-19 disease severity. This counter-intuitive finding may have important implications for diagnostic, therapeutic and prophylactic COVID-19 management.


title: Telemedicine for chronic pain management during COVID-19 pandemic

text: Treatment of chronic pain is an essential service. Due to lockdown, travel restrictions, social and physical distancing requirements or fear that health care facilities may be infected; patients may avoid visiting health care facilities in person. It is also imperative to decrease the risk of exposure of the health care workers (HCWs) to severe acute respiratory syndrome corona virus 2 (SARS CoV2) and to ease the overtly burdened health care system. But any disruption in pain practice will have alarming consequences for individuals, society, and whole of health care system and providers. In the current scenario of COVID-19 pandemic, telemedicine is emerging as a key technology for efficient communication and sustainable solution to provide essential health care services and should be considered for chronic pain patients (CPPs). Recently, Board of Governors in supersession of Medical Council of India along with National Institution for Transforming India (NITI Aayog) released 'Telemedicine Practice Guidelines' enabling registered medical practitioners to provide healthcare using telemedicine. This article describes the challenges in CPPs during COVID-19 pandemic and the use of telemedicine as the rescue management vehicle for CPPs in current scenario.


title: COVID-19 DYNAMICS: A HETEROGENEOUS MODEL

text: The ongoing Coronavirus disease 2019 (COVID-19) epidemic is different from the previous epidemic of severe acute respiratory syndrome (SARS), which demands a rigorous analysis for the selection of anti-epidemic measures and their lifting when the epidemic subsides. Here we estimate the basic reproductive number for COVID-19 and propose a dynamical model for the time course of infection number. With this model, we assessed the effects of different measures for infection risk control. The model is different from the previous ones as it models the population as heterogeneous, with subpopulations having different infection risks. Our analyses showed that after this heterogeneity is incorporated in the model, several characteristics of the epidemic are estimated more accurately: the total number of cases and peak number of cases are lower compared to the homogeneous case, the early-stage growth rate in the number of infection cases is little affected, and the decrease in the number of infections slows down during the epidemic late stage. The comparison of our model results with the available data for COVID-19 indicates that the anti-epidemic measures undertaken in China and the rest of the world managed to decrease the basic reproductive number but did not assure an accumulation of sufficient collective immunity. Thus, the epidemic has a high likelihood to restart, which necessitates a careful approach to lifting the quarantine measures.


title: Viral modernity? epidemics, infodemics, and the ‘bioinformational’ paradigm

text: Viral modernity is a concept based upon the nature of viruses, the ancient and critical role they play in evolution and culture, and the basic application to understanding the role of information and forms of bioinformation in the social world. The concept draws a close association between viral biology on the one hand, and information science on the other–it is an illustration and prime example of bioinformationalism that brings together two of the most powerful forces that now drive cultural evolution. The concept of viral modernity applies to viral technologies, codes and ecosystems in information, publishing, education and emerging knowledge (journal) systems. This paper traces the relationship between epidemics, quarantine, and public health management and outlines elements of viral-digital philosophy (VDP) based on the fusion of living and technological systems. We discuss Covid-19 as a ‘bioinformationalist’ response that represents historically unprecedented level of sharing information from the sequencing of the genome to testing for a vaccination. Finally, we look at the US response to Covid-19 through the lens of infodemics and post-truth. The paper is followed by three open reviews, which further refine its conclusions as they relate to (educational) philosophy and the notion of the virus as Pharmakon.


title: Assessment of service availability and Infection prevention measures in hospitals of Nepal during the transition phase of COVID-19 case surge

text: As with other coronavirus-affected countries, Nepalese medical fraternity also expressed concerns regarding public health strategies of government and hospital readiness in response to upgoing case surge. To gauge such response, we assessed service availability and Infection prevention and control (IPC) status in 110 hospitals situated across seven provinces. An electronic survey was sent out to the frontline clinicians working on those hospitals between 24th March and 7th April 2020; one response per hospital was analyzed. Hospitals were divided into small, medium, and large based on the total number of beds (small:<=15; medium:16-50; large:>50), and further categorized into public, private, and mixed based on the ownership. Out of 110 hospitals, 81% (22/27) of small, 39% (11/28) of medium, and 33% (18/55) of large hospitals had not allocated isolation beds for COVID-19 suspects. All small, majority of medium (89%; 25/28), and 50% of large hospitals did not have a functional intensive care unit (ICU) at the time of study. Nasopharyngeal (NP)/throat swab kits were available in one-third (35/110), whereas viral transport media (VTM), portable fridge box, and refrigerator were available in one-fifth (20%) of hospitals. Only one hospital (large/tertiary) had a functional PCR machine. Except for General practitioners, other health cadres- crucial during pandemics, were low in number. On IPC measures, the supplies of simple face masks, gloves, and hand sanitizers were adequate in the majority of hospitals, however, N95-respirators, Filter masks, and PPE-suits were grossly lacking. Government COVID-19 support was unevenly distributed across provinces; health facilities in Province 2, Gandaki, and Province 5 received fewer resources than others. Our findings alert the Nepalese and other governments to act early and proactively during health emergencies and not wait until the disease disrupts their health systems. Other countries of similar economic levels may undertake similar surveys to measure and improve their pandemic response.


title: Methodological Issues with Search in MEDLINE: A Longitudinal Query Analysis

text: This study compares the results of data collected from a longitudinal query analysis of the MEDLINE database hosted on multiple platforms that include PubMed, EBSCOHost, Ovid, ProQuest, and Web of Science in order to identify variations among the search results on the platforms after controlling for search query syntax. We devised twenty-nine sets of search queries comprised of five queries per set to search against the five MEDLINE database platforms. We ran our queries monthly for a year and collected search result count data to observe changes. We found that search results vary considerably depending on MEDLINE platform, both within sets and across time. The variation is due to trends in scholarly publication that include publishing online first versus publishing in journal issues, which leads to metadata differences in the bibliographic record; to differences in the level of specificity among search fields provided by the platforms; to database integrity issues that lead to large fluctuations in monthly search results based on the same query; and to database currency issues that arise due to when each platform updates its MEDLINE file. Specific bibliographic databases, like PubMed and MEDLINE, are used to inform clinical decision-making, create systematic reviews, and construct knowledge bases for clinical decision support systems. Since they serve as essential information retrieval and discovery tools that help identify and collect research data and are used in a broad range of fields and as the basis of multiple research designs, this study should help clinicians, researcher, librarians, informationalists, and others understand how these platforms differ and inform future work in their standardization.


title: Video Consultation in Lung Transplant Recipients during the COVID-19 Pandemic

text: Background: The COVID-19 pandemic has disrupted health care systems worldwide. This is due to the demand for medical resources in other areas as well as concern for the risk of nosocomial SARS-CoV-2 exposure. The interruption of routine care is especially problematic for patients with chronic conditions requiring regular follow-up, such as lung transplant recipients. New methods like telemedicine are needed to provide care to these patients. Methods: A retrospective analysis of video consultations (VC) in comparison to on-site visits (OSV) was performed during a six-week period in a lung transplant center in Germany. VC included a structured work-up questionnaire and vital sign documentation. Results: During the 6-week study period, 75 VC were performed for 53 patients and 75 OSV by 51 patients occurred. By the end of our study period, 77% of physician-patient contacts occurred via VC. Overall, physician-patient consultations were reduced by 47% in comparison to an equivalent time frame in 2019. In 62% of cases, VC resulted in a concrete clinical decision. For two VC patients, the indication for inpatient admission was established during the consultation. One COVID-19 patient in home quarantine was admitted due to respiratory failure detected by VC. Patient satisfaction with VC was high. Conclusions: By transitioning to VC, OSV for lung transplant patients during the COVID-19 pandemic was reduced. VC was well received by the majority of patients. This technology can be adopted to provide care for a wide range of chronic illnesses.


title: The anticoagulant nafamostat potently inhibits SARS-CoV-2 infection in vitro: an existing drug with multiple possible therapeutic effects

text: Although infection by SARS-CoV-2, the causative agent of COVID-19, is spreading rapidly worldwide, no drug has been shown to be sufficiently effective for treating COVID-19. We previously found that nafamostat mesylate, an existing drug used for disseminated intravascular coagulation (DIC), effectively blocked MERS-CoV S protein-initiated cell fusion by targeting TMPRSS2, and inhibited MERS-CoV infection of human lung epithelium-derived Calu-3 cells. Here we established a quantitative fusion assay dependent on SARS-CoV-2 S protein, ACE2 and TMPRSS2, and found that nafamostat mesylate potently inhibited the fusion while camostat mesylate was about 10-fold less active. Furthermore, nafamostat mesylate blocked SARS-CoV-2 infection of Calu-3 cells with an EC50 around 10 nM, which is below its average blood concentration after intravenous administration through continuous infusion. These findings, together with accumulated clinical data regarding its safety, make nafamostat a likely candidate drug to treat COVID-19.


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title: The therapeutic effectiveness of Convalescent plasma therapy on treating COVID-19 patients residing in respiratory care units in hospitals in Baghdad, Iraq

text: Objectives: The current COVID-19 pandemic needs unconventional therapies to tackle the resulted high morbidity and mortality. Convalescent plasma is one of the therapeutic approaches that might be of benefit. Methods: Forty nine early-stage critically-ill COVID-19 patients residing in RCU of three hospitals in Baghdad, Iraq were included, 21 received convalescent plasma while 28 did not receive, namely control group. Recovery or death, length of stay in hospital, and improvement in the clinical course of the disease were monitored clinically along with laboratory monitoring through SARS-CoV-2 RNA detection via PCR, and SARS-CoV-2 IgG and IgM serological monitoring. Results: Patients received convalescent plasma showed reduced duration of infection in about 4 days, and showed less death rate, 1/21 versus 8/28 in control group. In, addition, all of the patients received convalescent plasma showed high levels of SARS-CoV-2 IgG and IgM 3 days after plasma transfusion. Plasma from donors with high levels of SARS-CoV-2 IgG and donors with positive SRAS-CoV-2 IgM showed better therapeutic results than other donors. Conclusions: Convalescent plasma therapy is an effective mode of therapy if donors with high level of SARS-Cov2 antibodies are selected and if recipients were at their early stage of critical illness, being no more than 3 days in RCU.


title: Evaluation of the clinical characteristics of suspected or confirmed cases of COVID-19 during home care with isolation: A new retrospective analysis based on O2O

text: Summary Background The recent outbreak of the novel coronavirus in December 2019 (COVID-19) has activated top-level response nationwide. We developed a new treatment model based on the online-to-offline (O2O) model for the home isolated patients, because in the early stages the medical staff were insufficient to cope with so many patients. Methods In this single-centered, retrospective study, we enrolled 48 confirmed/suspected COVID-19 patients who underwent home isolation in Wuhan between January 6 and January 31, 2020. By WeChat and online document editing all patients were treated with medical observation scale. The clinical indications such as Fever, Muscle soreness, Dyspnea and Lack of strength were collected with this system led by medical staff in management, medicine, nursing, rehabilitation and psychology. Findings The mean(SD) age of 48 patients was 39.08(13.88) years, 35(72.9%) were women. Compared with non-hospitalized patients, inpatients were older(≥8805;70years, 2.4% vs 33.3%, P<0.04). All inpatients had fever, 50% inpatients had coughs and showed infiltration in both lungs at the time of diagnosis. 33.3% inpatients exhibited negative changes in their CT results at initial diagnosis. The body temperature of non-hospitalized patients with mild symptoms returned to normal by day 4-5. While dyspnea peaked on day 6 for non-hospitalized patients with mild symptoms, it persisted in hospitalized patients and exacerbated over time. The lack of strength and muscle soreness were both back to normal by day 4 for non-hospitalized patients. Interpretation Monitoring the trends of symptoms is more important for identifying severe cases. Excessive laboratory data and physical examination are not necessary for the evaluation of patients with mild symptoms. The system we developed is the first to convert the subjective symptoms of patients into objective scores. This type of O2O, subjective-to-objective strategy may be used in regions with similar highly infectious diseases to minimize the possibility of infection among medical staff.


title: Patient trajectories and risk factors for severe outcomes among persons hospitalized for COVID-19 in the Maryland/DC region

text: Background: Risk factors for poor outcomes from COVID-19 are emerging among US cohorts, but patient trajectories during hospitalization ranging from mild-moderate, severe, and death and the factors associated with these outcomes have been underexplored. Methods: We performed a cohort analysis of consecutive COVID-19 hospital admissions at 5 Johns Hopkins hospitals in the Baltimore/DC area between March 4 and April 24, 2020. Disease severity and outcomes were classified using the WHO COVID-19 disease severity ordinal scale. Cox proportional-hazards regressions were performed to assess relationships between demographics, clinical features and progression to severe disease or death. Results: 832 COVID-19 patients were hospitalized; 633 (76.1%) were discharged, 113 (13.6%) died, and 85 (10.2%) remained hospitalized. Among those discharged, 518 (82%) had mild/moderate and 116 (18%) had severe illness. Mortality was statistically significantly associated with increasing age per 10 years (adjusted hazard ratio (aHR) 1.54; 95%CI 1.28-1.84), nursing home residence (aHR 2.13, 95%CI 1.41-3.23), Charlson comorbidity index (1.13; 95% CI 1.02-1.26), respiratory rate (aHR 1.13; 95%CI 1.09-1.17), D-dimer greater than 1mg/dL (aHR 2.79; 95% 1.53-5.09), and detectable troponin (aHR 2.79; 95%CI 1.53-5.09). In patients under 60, only male sex (aHR 1.7;95%CI 1.11-2.58), increasing body mass index (BMI) (aHR1.25 1.14-1.37), Charlson score (aHR 1.27; 1.1-1.46) and respiratory rate (aHR 1.16; 95%CI 1.13-1.2) were associated with severe illness or death. Conclusions: A combination of demographic and clinical features on admission is strongly associated with progression to severe disease or death in a US cohort of COVID-19 patients. Younger patients have distinct risk factors for poor outcomes.


title: Early Real-time Estimation of Infectious Disease Reproduction Number

text: When an infectious disease strikes a population, the number of newly reported cases is often the only available information that one can obtain during early stages of the outbreak. An important goal of early outbreak analysis is to obtain a reliable estimate for the basic reproduction number, $R_{0}$, from the limited information available. We present a novel method that enables us to make a reliable real-time estimate of the reproduction number at a much earlier stage compared to other available methods. Our method takes into account the possibility that a disease has a wide distribution of infectious period and that the degree distribution of the contact network is heterogeneous. We validate our analytical framework with numerical simulations.


COVID-19: disease pathways and gene expression changes predict methylprednisolone can improve outcome in severe cases


title: Integrate Structural Analysis, Isoform Diversity, and Interferon-Inductive Propensity of ACE2 to Refine SARS-CoV2 Susceptibility Prediction in Vertebrates

text: The current new coronavirus disease (COVID-19) has caused globally near 0.4/6 million confirmed deaths/infected cases across more than 200 countries. As the etiological coronavirus (a.k.a. SARS-CoV2) may putatively have a bat origin, our understanding about its intermediate reservoir between bats and humans, especially its tropism in wild and domestic animals, are mostly unknown. This constitutes major concerns in public health for the current pandemics and potential zoonosis. Previous reports using structural analysis of the viral spike protein (S) binding its cell receptor of angiotensin-converting enzyme 2 (ACE2), indicate a broad SARS-CoV2 susceptibility in wild and particularly domestic animals. Through integration of key immunogenetic factors, including the existence of S-binding-void ACE2 isoforms and the disparity of ACE2 expression upon early innate immune response, we further refine the SARS-CoV2 susceptibility prediction to fit recent experimental validation. In addition to showing a broad susceptibility potential across mammalian species based on structural analysis, our results also reveal that domestic animals including dogs, pigs, cattle and goats may evolve ACE2-related immunogenetic diversity to restrict SARS-CoV2 infections. Thus, we propose that domestic animals may be unlikely to play a role as amplifying hosts unless the virus has further species-specific adaptation. These findings may relieve relevant public concerns regarding COVID-19-like risk in domestic animals, highlight virus-host coevolution, and evoke disease intervention through targeting ACE2 molecular diversity and interferon optimization.


title: Estimation of the Final Size of the COVID-19 Epidemic in Pakistan

text: The COVID-19 infections in Pakistan are spreading at an exponential rate and a point may soon be reached where rigorous prevention measures would need to be adopted. Mathematical models can help define the scale of an epidemic and the rate at which an infection can spread in a community. We used an SIR model to predict the magnitude of the COVID-19 epidemic in Pakistan and compared the numbers with the reported cases on the national database. Our results indicate that Pakistan could hit peak number of infectious cases on May 26th, 2020 and by June 24th, 2020, 90% of the population will have become infected with the virus if policy interventions seeking to curb this infection are not adopted aggressively.


title: Application-oriented mathematical algorithms for group testing

text: Group testing is a widely used protocol which aims to test a small group of people to identify whether at least one of them is infected. It is particularly efficient if the infection rate is low, because it only requires a single test if everybody in the group is negative. The most efficient use of group testing is a complex mathematical question. However, the answer highly depends on practical parameters and restrictions, which are partially ignored by the mathematical literature. This paper aims to offer practically efficient group testing algorithms, focusing on the current COVID-19 epidemic.


title: Clinical characteristics of 2019 novel coronavirus infection in China

text: Background: Since December 2019, acute respiratory disease (ARD) due to 2019 novel coronavirus (2019-nCoV) emerged in Wuhan city and rapidly spread throughout China. We sought to delineate the clinical characteristics of these cases. Methods: We extracted the data on 1,099 patients with laboratory-confirmed 2019-nCoV ARD from 552 hospitals in 31 provinces/provincial municipalities through January 29th, 2020. Results: The median age was 47.0 years, and 41.90% were females. Only 1.18% of patients had a direct contact with wildlife, whereas 31.30% had been to Wuhan and 71.80% had contacted with people from Wuhan. Fever (87.9%) and cough (67.7%) were the most common symptoms. Diarrhea is uncommon. The median incubation period was 3.0 days (range, 0 to 24.0 days). On admission, ground-glass opacity was the typical radiological finding on chest computed tomography (50.00%). Significantly more severe cases were diagnosed by symptoms plus reverse-transcriptase polymerase-chain-reaction without abnormal radiological findings than non-severe cases (23.87% vs. 5.20%, P<0.001). Lymphopenia was observed in 82.1% of patients. 55 patients (5.00%) were admitted to intensive care unit and 15 (1.36%) succumbed. Severe pneumonia was independently associated with either the admission to intensive care unit, mechanical ventilation, or death in multivariate competing-risk model (sub-distribution hazards ratio, 9.80; 95% confidence interval, 4.06 to 23.67). Conclusions: The 2019-nCoV epidemic spreads rapidly by human-to-human transmission. Normal radiologic findings are present among some patients with 2019-nCoV infection. The disease severity (including oxygen saturation, respiratory rate, blood leukocyte/lymphocyte count and chest X-ray/CT manifestations) predict poor clinical outcomes.


title: Regulation of angiotensin converting enzyme 2 (ACE2) in obesity: implications for COVID-19

text: The ongoing COVID-19 pandemic is caused by the novel coronavirus SARS-CoV-2. Age, smoking, obesity, and chronic diseases such as cardiovascular disease and diabetes have been described as risk factors for severe complications and mortality in COVID-19. Obesity and diabetes are usually associated with dysregulated lipid synthesis and clearance which can initiate or aggravate pulmonary inflammation and injury. It has been shown that for viral entry into the host cell, SARS-CoV-2 utilizes the angiotensin converting enzyme 2 (ACE2) receptors present on the cells. We aimed to characterize how SARS-CoV-2 dysregulates lipid metabolism pathways in the host and the effect of dysregulated lipogenesis on the regulation of ACE2, specifically in obesity. In our study, through the re-analysis of publicly available transcriptomic data, we first found that lung epithelial cells infected with SARS-CoV-2 showed upregulation of genes associated with lipid metabolism, including the SOC3 gene which is involved in regulation of inflammation and inhibition of leptin signaling. This is of interest as viruses may hijack host lipid metabolism to allow completion of their viral replication cycles. Furthermore, a mouse model of diet-induced obesity showed a significant increase in Ace2 expression in the lungs which negatively correlated with the expression of genes that code for sterol response element binding proteins 1 and 2 (SREBP). Suppression of Srebp1 showed a significant increase in Ace2 expression in the lung. Together our results suggest that the dysregulated lipogenesis and the subsequently high ACE2 expression in obese patients might be the mechanism underlying the increased risk for severe complications in those patients when infected by SARS-CoV-2.


title: Assessment of the use and quick preparation of saliva for rapid microbiological diagnosis of COVID-19

text: The objective of this study was to assess the performance of direct real time RT-PCR detection of SARS-CoV-2 in heated saliva samples, avoiding the RNA isolation step. Oropharyngeal and nasopharyngeal swabs together with saliva samples were obtained from 51 patients clinically diagnosed as potentially having COVID-19. Two different methods were compared: 1. RNA was extracted from 500 μl of sample using a MagNA Pure Compact Instrument with an elution volume of 50μl and 2. 700µL of saliva were heat-inactivated at 96°C for 15 minutes, and directly subjected to RT-PCR. One step real time RT-PCR was performed using 5 μl of extracted RNA or directly from 5 μl of heated sample. RT-PCR was performed targeting the SARS-CoV-2 envelope (E) gene region. Diagnostic performance was assessed using the results of the RT-PCR from nasopharyngeal and oropharyngeal swabs as the gold standard. The overall sensitivity, specificity, positive and negative predictive values were 81.08%, 92.86%, 96.77% and 65.00%, respectively when RNA extraction was included in the protocol with saliva, whereas sensitivity, specificity, positive and negative predictive values were 83.78%, 92.86%, 68.42% and 96.88%, respectively, for the heat-inactivation protocol. However, when the analysis was performed exclusively on saliva samples with a limited time from the onset of symptoms (<9 days, N=28), these values were 90%, 87.5%, 44% and 98.75% for the heat-inactivation protocol. The study showed that RT-PCR can be performed using saliva in an RNA extraction free protocol, showing good sensitivity and specificity.


COVID-19 and lockdown: Delayed effects on health


title: Stratégies de gestion de l’impact du confinement sur le sommeil : une synthèse d’experts

text: Résumé En plus de l’impact psychologique du confinement et de l’épidémie, il existe des répercussions sur le sommeil qu’il faut prendre en compte par la mise en place de stratégies adaptées afin de maintenir un bon état de santé mental et de santé général. Le confinement peut désorganiser le sommeil en impactant, d’une part, les rythmes circadiens par une diminution de l’intensité des synchroniseurs extérieurs et, d’autre part, peut favoriser l’insomnie dans cette période de stress aigu. Enfin, le confinement peut être source d’une privation de sommeil chez ceux qui sont en première ligne et qui gèrent la crise. De plus, chez les enfants/adolescents le confinement peut également déstructurer les journées et ainsi avoir un impact sur la santé en générale. Pour cela, il est important de mettre en place certaines stratégies de préventions de ces perturbations de sommeil afin d’atténuer l’impact psychologique, infectieux et faire face de manière optimale à cette situation que nous vivons tous. Summary In addition to the psychological impact of quarantine, there are sleep disturbances that must be taken into account by implementing appropriate strategies in order to maintain good mental and general health. Quarantine can disrupt sleep first in impacting circadian rhythms by decreasing the intensity of zeitgebers, second can promote insomnia in this period of acute stress and third can be a source of sleep deprivation in those on the front line and managing the crisis. In addition, in children/adolescents, confinement can also destructure the days and thus have an impact on overall health. For this, it is important to put in place strategies to prevent these sleep disturbances in order to reduce the psychological, infectious impact and deal optimally with this situation that we are all experiencing.


docid: cijoegsa

title: COVID‐19 pneumonia as a cause of acute chest syndrome in an adult sickle cell patient


The Role of a Geriatrician has Become Even More Important in an Academic Institution during COVID-19


title: A Comprehensive Approach Is Vital for Diagnosing COVID-19: A Case of False Negative

text: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading at a rapid pace throughout the world, and the World Health Organization (WHO) declared it as pandemic on March 11, 2020. We present a case of COVID-19 patient whose reverse transcription-polymerase chain reaction (RT-PCR) initially was false negative and later turned positive, which will stress the importance of a comprehensive approach while evaluating a patient with a differential of COVID-19. The clinicians should be aware of the sensitivity and specificities of these tests which can have grave implications on the patient and community if the diagnosis is missed just based on the laboratory tests due to the highly contagious nature of the disease.


title: COVID-19 Trend Estimation in the Elderly Italian Region of Sardinia

text: December 2019 saw a novel coronavirus (COVID-19) from China quickly spread globally. Currently, COVID-19, defined as the new pandemic by the World Health Organization (WHO), has reached over 750,000 confirmed cases worldwide. The virus began to spread in Italy from the 22nd February, and the number of related cases is still increasing. Furthermore, given that a relevant proportion of infected people need hospitalization in Intensive Care Units, this may be a crucial issue for National Healthcare System's capacity. WHO underlines the importance of specific disease regional estimates. Because of this, Italy aimed to put in place proportioned and controlled measures, and to guarantee adequate funding to both increase the number of ICU beds and increase production of personal protective equipment. Our aim is to investigate the current COVID-19 epidemiological context in Sardinia region (Italy) and to estimate the transmission parameters using a stochastic model to establish the number of infected, recovered, and deceased people expected. Based on available data from official Italian and regional sources, we describe the distribution of infected cases during the period between 2nd and 15th March 2020. To better reflect the actual spread of COVID-19 in Sardinia based on data from 15th March (first Sardinian declared outbreak), two Susceptible-Infectious-Recovered-Dead (SIRD) models have been developed, describing the best and worst scenarios. We believe that our findings represent a valid contribution to better understand the epidemiological context of COVID-19 in Sardinia. Our analysis can help health authorities and policymakers to address the right interventions to deal with the rapidly expanding health emergency.


title: Sociodemographic predictors of outcomes in COVID-19: examining the impact of ethnic disparities in Northern Nevada

text: Background: On March 11, 2020, the World Health Organization declared coronavirus disease-19 (COVID-19) a pandemic. Nearly five million individuals have since been diagnosed with this increasingly common and potentially lethal viral infection. Emerging evidence suggests a disproportionate burden of illness and death among minority communities. We aimed to evaluate the effect of ethnicity on outcomes among patients diagnosed with COVID-19 in Northern Nevada. Design: Single-center, retrospective observational study Materials and methods: The electronic health records of 172 patients diagnosed with COVID-19 were obtained from a 946-bed tertiary referral center serving Northern Nevada. Demographic and clinical characteristics were compared by ethnic group (Hispanic versus non-Hispanic). Logistic regression was used to determine predictors of mortality. Results: Among 172 patients who were diagnosed with COVID-19 between March 12th and May 8th, 2020, 87 (50.6%) identified as Hispanic and 81 (47.1%) as non-Hispanic. The mean age was 46.0 among Hispanics and 55.8 among non-Hispanics. Comorbidities linked to increased COVID-19-related mortality - hypertension, obesity, and chronic obstructive pulmonary disease - were more common among the non-Hispanic population. Hispanic individuals were significantly more likely to be uninsured and to live in low-income communities as compared to their non-Hispanic counterparts (27.6% versus 8.2% and 52.9% versus 30.6%, respectively). Hispanic patients were also less likely than non-Hispanics to have a primary care provider (42.5% versus 61.2%). However, mortality was significantly higher among the non-Hispanic population (15.3% versus 5.8%). Conclusion: The COVID-19 pandemic has disproportionately affected Hispanic individuals in Northern Nevada, who account for only 25.7% of the population but over half of the confirmed cases. Hispanic individuals were younger and had fewer comorbidities than their non-Hispanic counterparts; consequently, despite considerable socioeconomic disadvantage, mortality was lower among the Hispanic population. The underlying causes of ethnic disparities in COVID-19 incidence remain to be established, but further investigation may lead to more effective community- and systems-based interventions.


title: Mortality Attributed to COVID-19 in High-Altitude Populations

text: Background: Since partial oxygen pressure decreases as altitude increases, environmental hypoxia could worsen COVID-19 patient's hypoxemia. We compared COVID-19 mortality at different altitudes. Methods: Retrospective analysis of population-level data on COVID-19 deaths in the U.S. (1,016 counties) and Mexico (567 municipalities). Mixed-model Poisson regression analysis of the association between altitude and COVID-19 mortality using individual-level data from 40,168 Mexican subjects with COVID-19, adjusting for multiple covariates. Results: Between January 20 and April 13, 2020, mortality rates were higher in U.S. counties located at [≥]2,000 m elevation vs. those located below 1,500 m (12.3 vs. 3.2 per 100,000; P<0.001). In Mexico, between March 13 and May 13, 2020, mortality rates were higher in municipalities located at [≥]2,000 m vs. <1,500 m (5.3 vs. 3.9 per 100,000; P<0.001). Among Mexican subjects <65 years old, the risk of death was 36% higher in those living at [≥]2,000 m vs. <1,500 m (adjusted incidence rate ratio: 1.36; 95% CI, 1.05-1.78; P=0.022). Among men, the risk of death was 31% higher at [≥]2,000 m vs. <1,500 m (adjusted IRR: 1.31; 95% CI, 1.03-1.66; P=0.025). No association was found among women. Conclusion: Altitude is associated with COVID-19 mortality in men younger than 65 years.


title: When strong mitigation against a pandemic backfires

text: I introduce social feasibility constraints in a SIR epidemiological model: at any point in time, the ability of a social planner to impose mitigation measures is limited, but it is increasing in the proportion of infected individuals. When considering threshold policies with constant levels of mitigation for a time period, the overall fatality rate in the population is non-monotonic in the levels of mitigation: higher levels of mitigation can increase the overall fatality rate. Intuitively, strong mitigation at a point in time can undermine the social feasibility of future mitigation.


title: Identification of novel mechanistically distinct endotypes of pandemic influenza-associated acute respiratory failure

text: Respiratory viral pandemics result in large numbers of cases of acute respiratory failure arising from a single etiology, thus reducing the heterogeneity of precepting insult and allowing improved insight into the variation of host responses. In 2009-2011, an influenza pandemic occurred, with pH1N1 infecting millions of people worldwide. Here, we have used novel bioinformatic methods to combine clinical, protein biomarker, and genomic data from patients with influenza-associated acute respiratory failure to identify three mechanistically discrete sub-types with significantly different clinical outcomes. The three endotypes identified can be described as neutrophil-driven (16.3%), adaptive (51.9%), and endothelial leak (31.7%). The neutrophil driven patients display evidence of innate immune activation with associated multi-organ dysfunction and reduced 30-day survival. These patients could be differentiated from the adaptive endotype by an alteration in the GAIT-mechanism, a late transcriptional regulatory response to IFN-gamma; that acts to suppress innate immunity by reducing caeruloplasmin mRNA translation. Patients with the neutrophil-driven endotype had significantly increased IFN-gamma; levels but appeared unable to suppress their innate immune response. The endothelial leak endotype could be distinguished from both the neutrophil driven and adaptive endotypes by alterations in Slit-Robo signalling, a pathway important in the maintenance of endothelial barrier integrity; Although patients with this endotype required mechanical ventilation, they did not develop multi-organ failure in the manner of the neutrophil-driven endotype patients, and had significantly better clinical outcomes. Importantly, the endotypes identified were stable over 48 hours opening up the possibility of stratified interventional clinical trials in the future.


title: Assessment of ACE2, CXCL10 and Their co-expressed Genes: An In-silico Approach to Evaluate the Susceptibility and Fatality of Lung Cancer Patients towards COVID-19 Infection

text: Background COVID-19 is a recent pandemic that started to spread out worldwide from Wuhan, China. This disease is caused by a newly discovered strain of the coronavirus, namely SARS CoV-2. Lung cancer patients are reported to be more susceptible to COVID-19 infection. To evaluate the probable reasons behind the excessive susceptibility and fatality of lung cancer patients to COVID-19 infection, we targeted two most crucial biomarkers of COVID-19, ACE2 and CXCL10. ACE2 plays a vital role in the SARS CoV-2 entry into the host cell while CXCL10 is a cytokine mainly responsible for the lung cell damage involving in a cytokine storm. Methods Firstly, we used the TIMER, UALCAN and GEPIA2 databases to analyze the expression and correlation of ACE2 and CXCL10 in LUAD and LUSC. After that, using the cBioPortal database, we performed an analytical study to determine the genetic changes in ACE2 and CXCL10 protein sequences that are responsible for lung cancer development. Finally, we analyzed different functional approaches of ACE2, CXCL10 and their co-expressed genes associated with lung cancer and COVID-19 development by using the PANTHER database. Results Initially, we observed that ACE2 and CXCL10 are mostly overexpressed in LUAD and LUSC. We also found the functional significance of ACE2 and CXCL10 in lung cancer development by determining the genetic alteration frequency in their amino acid sequences. Lastly, by doing the functional assessment of the targeted genes, we identified that ACE2 and CXCL10 along with their commonly co-expressed genes are respectively involved in the binding activity and immune responses in case of lung cancer and COVID-19 infection. Conclusions Finally, on the basis of this systemic analysis, we came to the conclusion that ACE2 and CXCL10 are possible biomarkers responsible for the higher susceptibility and fatality of lung cancer patients towards the COVID-19.


title: Modeling the Covid-19 Pandemic Response of the US States

text: Background: The United States of America (USA) has been the country worst affected, in absolute terms, by the Covid-19 pandemic. The country comprises 50 states under a federal system. The impact of the pandemic has resulted in different responses at the state level, which are driven by differing intervention policies, demographics, connectedness and other factors. Understanding the dynamics of the Covid-19 pandemic at the state level is essential in predicting its future evolution. Objective: Our objective is to identify and characterize multiple waves of the pandemic by analyzing the reported infected population curve in each of the 50 US states. Based on the intensity of the waves, characterized by declining, stationary, or increasing strengths, each state's response can be inferred and quantified. Methods: We apply a recently proposed multiple-wave model to fit the infected population data for each state in USA, and use the proposed Pandemic Response Index to quantify their response to the Covid-19 pandemic. Results: We have analyzed reported infected cases from each one of the 50 USA states and the District of Columbia, based on the multiple-wave model, and present the relevant parameters. Multiple waves have been identified and this model is found to describe the data better. Each of the states can be classified into one of three distinct classes characterized by declining, increasing, or stationary strength of the waves following the initial one. The effectiveness of intervention measures can be inferred by the peak intensities of the waves, and states with similar population characteristics can be directly compared. We estimate how much lower the number of infections might have been, if early and strict intervention measures had been imposed to stop the disease spread at the first wave, as was the case for certain states. Based on our model's results, we compute the value of the Pandemic Response Index, a recently introduced metric for quantifying in an objective manner the response to the pandemic. Conclusions: Our results reveal a series of epidemic waves, characterizing USA's pandemic response at the state level, and also infer to what extent the imposition of early intervention measures could have had on the spread and impact of the disease. As of June 11, 2020, only 19 states and the District of Columbia (40% of the total) clearly exhibit declining trends in the numbers of reported infected cases, while 13 states exhibit stationary and 18 states increasing trends in the numbers of reported cases.


title: Predict the next moves of COVID-19: reveal the temperate and tropical countries scenario

text: The spread of COVID-19 engulfs almost all the countries and territories of the planet, and infections and fatality are increasing rapidly. The first epi-center of its' massive spread was in Wuhan, Hubei province, China having a temperate weather, but the spread has got an unprecedented momentum in European temperate countries mainly in Italy and Spain (as of March 30, 2020). However, Malaysia and Singapore and the neighboring tropical countries of China got relatively low spread and fatality that created a research interest on whether there are potential impacts of weather condition on COVID-19 spread. Adopting the SIR (Susceptible Infected Removed) deviated model to predict potential cases and death in the coming days from COVID-19 was done using the secondary and official sources of data. This study shows that COVID-19 spread and fatality tend to be high across the world but compared to tropical countries, it is going to be incredibly high in the temperate countries having lower temperature (7-16°C) and humidity (80-90%) in last March. However, some literature predicted that this might not to be true, rather irrespective of weather conditions there might be a continuous spread and death. Moreover, a large number of asymptotic COVID-19 carrier in both temperate and tropical countries may re-outbreak in the coming winter. Therefore, a comprehensive global program with the leadership of WHO for testing of entire population of the world is required, which will be very useful for the individual states to take proper political action, social movement and medical services.


title: The effect of reopening policy on COVID-19 related cases and deaths

text: By May 29, 2020, all 50 states in the United States had reopened their economies to some extent after the coronavirus lockdown. Although there are many debates about whether states reopened their economies too early, no study has examined this effect quantitatively. This paper takes advantage of the daily cases, deaths, and test data at the state level, and uses the synthetic control method to address this question. I find that reopening the economy caused an additional 2000 deaths in the 6 states (Alabama, Colorado, Georgia, Mississippi, Tennessee, and Texas) that reopened before May 1st by three weeks after reopening. It also increased daily confirmed cases by 40%, 52%, and 53% after the first, second, and third week of reopening, respectively. Moreover, contrary to scientists' prescription that expanding tests is a necessary condition for reopening, these states witnessed a decline in daily tests by 17%, 47%, and 31% after the first, second, and third week of reopening, respectively.


Die Versorgung und Reanimation des Neugeborenen: COVID-19-Leitlinien des European Resuscitation Council


title: Data driven inference of the reproduction number (R0) for COVID-19 before and after interventions for 51 European countries

text: The reproduction number (R0) is broadly considered as a key indicator for the spreading of the COVID-19 pandemic. The estimation of its value with respect to the key threshold of 1.0 is a measure of the need, and eventually effectiveness, of interventions imposed in various countries. Here we present an online tool for the data driven inference and quantification of uncertainties for R0 as well as the time points of interventions for 51 European countries. The study relies on the Bayesian calibration of the simple and well established SIR model with data from reported daily infections. The model is able to fit the data for most countries without individual tuning of parameters. We deploy an open source Bayesian inference framework and efficient sampling algorithms to present a publicly available GUI (https://www.cse-lab.ethz.ch/coronavirus/) that allows the user to assess custom data and compare predictions for pairs of European countries. The results provide a ranking based on the rate of the disease's spread suggesting a metric for the effectiveness of social distancing measures. They also serve to demonstrate how geographic proximity and related times of interventions can lead to similarities in the progression of the epidemic.


A case of novel coronavirus (COVID-19)-induced viral myocarditis mimicking a Takotsubo cardiomyopathy


title: Analysis and forecast of COVID-19 spreading in China, Italy and France

text: Abstract In this note we analyze the temporal dynamics of the coronavirus disease 2019 outbreak in China, Italy and France in the time window 22 / 01 − 15 / 03 / 2020 . A first analysis of simple day-lag maps points to some universality in the epidemic spreading, suggesting that simple mean-field models can be meaningfully used to gather a quantitative picture of the epidemic spreading, and notably the height and time of the peak of confirmed infected individuals. The analysis of the same data within a simple susceptible-infected-recovered-deaths model indicates that the kinetic parameter that describes the rate of recovery seems to be the same, irrespective of the country, while the infection and death rates appear to be more variable. The model places the peak in Italy around March 21st 2020, with a peak number of infected individuals of about 26000 (not including recovered and dead) and a number of deaths at the end of the epidemics of about 18,000. Since the confirmed cases are believed to be between 10 and 20% of the real number of individuals who eventually get infected, the apparent mortality rate of COVID-19 falls between 4% and 8% in Italy, while it appears substantially lower, between 1% and 3% in China. Based on our calculations, we estimate that 2500 ventilation units should represent a fair figure for the peak requirement to be considered by health authorities in Italy for their strategic planning. Finally, a simulation of the effects of drastic containment measures on the outbreak in Italy indicates that a reduction of the infection rate indeed causes a quench of the epidemic peak. However, it is also seen that the infection rate needs to be cut down drastically and quickly to observe an appreciable decrease of the epidemic peak and mortality rate. This appears only possible through a concerted and disciplined, albeit painful, effort of the population as a whole.