title: Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma

text: Importance: Coronavirus disease 2019 (COVID-19) is a pandemic with no specific therapeutic agents and substantial mortality. It is critical to find new treatments. Objective: To determine whether convalescent plasma transfusion may be beneficial in the treatment of critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Design, Setting, and Participants: Case series of 5 critically ill patients with laboratory-confirmed COVID-19 and acute respiratory distress syndrome (ARDS) who met the following criteria: severe pneumonia with rapid progression and continuously high viral load despite antiviral treatment; Pao2/Fio2 <300; and mechanical ventilation. All 5 were treated with convalescent plasma transfusion. The study was conducted at the infectious disease department, Shenzhen Third People's Hospital in Shenzhen, China, from January 20, 2020, to March 25, 2020; final date of follow-up was March 25, 2020. Clinical outcomes were compared before and after convalescent plasma transfusion. Exposures: Patients received transfusion with convalescent plasma with a SARS-CoV-2-specific antibody (IgG) binding titer greater than 1:1000 (end point dilution titer, by enzyme-linked immunosorbent assay [ELISA]) and a neutralization titer greater than 40 (end point dilution titer) that had been obtained from 5 patients who recovered from COVID-19. Convalescent plasma was administered between 10 and 22 days after admission. Main Outcomes and Measures: Changes of body temperature, Sequential Organ Failure Assessment (SOFA) score (range 0-24, with higher scores indicating more severe illness), Pao2/Fio2, viral load, serum antibody titer, routine blood biochemical index, ARDS, and ventilatory and extracorporeal membrane oxygenation (ECMO) supports before and after convalescent plasma transfusion. Results: All 5 patients (age range, 36-65 years; 2 women) were receiving mechanical ventilation at the time of treatment and all had received antiviral agents and methylprednisolone. Following plasma transfusion, body temperature normalized within 3 days in 4 of 5 patients, the SOFA score decreased, and Pao2/Fio2 increased within 12 days (range, 172-276 before and 284-366 after). Viral loads also decreased and became negative within 12 days after the transfusion, and SARS-CoV-2-specific ELISA and neutralizing antibody titers increased following the transfusion (range, 40-60 before and 80-320 on day 7). ARDS resolved in 4 patients at 12 days after transfusion, and 3 patients were weaned from mechanical ventilation within 2 weeks of treatment. Of the 5 patients, 3 have been discharged from the hospital (length of stay: 53, 51, and 55 days), and 2 are in stable condition at 37 days after transfusion. Conclusions and Relevance: In this preliminary uncontrolled case series of 5 critically ill patients with COVID-19 and ARDS, administration of convalescent plasma containing neutralizing antibody was followed by improvement in their clinical status. The limited sample size and study design preclude a definitive statement about the potential effectiveness of this treatment, and these observations require evaluation in clinical trials.


Opportunities and challenges of traditional Chinese medicine going abroad for COVID-19 treatment


title: Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists

text: Severe acute respiratory syndrome-corona virus-2, which causes coronavirus disease 2019 (COVID-19), is highly contagious. Airway management of patients with COVID-19 is high risk to staff and patients. We aimed to develop principles for airway management of patients with COVID-19 to encourage safe, accurate and swift performance. This consensus statement has been brought together at short notice to advise on airway management for patients with COVID-19, drawing on published literature and immediately available information from clinicians and experts. Recommendations on the prevention of contamination of healthcare workers, the choice of staff involved in airway management, the training required and the selection of equipment are discussed. The fundamental principles of airway management in these settings are described for: emergency tracheal intubation; predicted or unexpected difficult tracheal intubation; cardiac arrest; anaesthetic care; and tracheal extubation. We provide figures to support clinicians in safe airway management of patients with COVID-19. The advice in this document is designed to be adapted in line with local workplace policies.


Scientific Response to the Coronavirus Crisis in Spain: Collaboration and Multidisciplinarity


Coronavirus: why a permanent ban on wildlife trade might not work in China


Optimising influenza vaccination during a SARS-CoV-2 epidemic in South Africa could help maintain the integrity of our healthcare system


Adaption of the emergency department decontamination room for airway management during COVID-19


title: Data Quality of Chinese Surveillance of COVID-19: Objective Analysis Based on WHO's Situation Reports

text: Was there quality in the Chinese epidemiological surveillance system during the COVID-19 pandemic? Using data of World Health Organization's situation reports (until situation report 55), an objective analysis was realized to answer this important question. Fulfillment of Benford's law (first digit law) is a rapid tool to suggest good data quality. Results suggest that China had an acceptable quality in its epidemiological surveillance system. Furthermore, more detailed and complete analyses could complement the evaluation of the Chinese surveillance system.


Drama out of a crisis: the cultural sector responds to healthcare professionals impacted by COVID-19


The Novel Coronavirus 2019 epidemic and kidneys


title: Epidemiology and clinical features of emergency department patients with suspected COVID-19: Initial results from the COVID-19 Emergency Department Quality Improvement Project (COVED-1)

text: OBJECTIVE: The COVID-19 Emergency Department (COVED) Quality Improvement Project aims to provide regular and real-time clinical information to ED clinicians caring for patients with suspected and confirmed COVID-19. The present study summarises data from the first 2 weeks of the study. METHODS: COVED is an ongoing prospective cohort study that commenced on 1 April 2020. It includes all adult patients presenting to a participating ED who undergo testing for SARS-CoV-2. Data are collected prospectively and entered into a bespoke registry. Outcomes include a positive SARS-CoV-2 polymerase chain reaction test result and requirement for intensive respiratory support. RESULTS: In the period 1-14 April 2020, 240 (16%) of 1508 patients presenting to The Alfred Emergency and Trauma Centre met inclusion criteria. Of these, 11 (5%) tested positive for SARS-CoV-2. The mean age of patients was 60 years and the commonest symptoms were acute shortness of breath (n = 122 [67%]), cough (n = 108 [56%]) or fever (n = 98 [51%]). Overseas travel or known contact with a confirmed case was reported by 24 (14%) and 16 (10%) patients, respectively. Fever or hypoxia was recorded in 23 (10%) and 11 (5%) patients, respectively. Eleven (5%) patients received mechanical ventilation in the ED, of whom none tested positive for SARS-CoV-2. CONCLUSIONS: Among patients presenting to a tertiary ED with suspected COVID-19, only a small proportion tested positive for SARS-CoV-2. Although the low incidence of positive cases currently precludes the development of predictive tools, the COVED Project demonstrates that the rapid establishment of an agile clinical registry for emergency care is feasible.


title: The Outcome and Implications of Public Precautionary Measures in Taiwan-Declining Respiratory Disease Cases in the COVID-19 Pandemic

text: With the rapid development of the COVID-19 pandemic, countries are trying to cope with increasing medical demands, and, at the same time, to reduce the increase of infected numbers by implementing a number of public health measures, namely non-pharmaceutical interventions (NPIs). These public health measures can include social distancing, frequent handwashing, and personal protective equipment (PPE) at the personal level; at the community and the government level, these measures can range from canceling activities, avoiding mass gatherings, closing facilities, and, at the extreme, enacting national or provincial lockdowns. Rather than completely stopping the infectious disease, the major purpose of these NPIs in facing an emerging infectious disease is to reduce the contact rate within the population, and reduce the spread of the virus until the time a vaccine or reliable medications become available. The idea is to avoid a surge of patients with severe symptoms beyond the capacity of the hospitals' medical resources, which would lead to more mortality and morbidity. While many countries have experienced steep curves in new cases, some, including Hong Kong, Vietnam, South Korea, New Zealand, and Taiwan, seem to have controlled or even eliminated the infection locally. From its first case of COVID-19 on the 21 January until the 12 May, Taiwan had 440 cases, including just 55 local infections, and seven deaths in total, representing 1.85 cases per 100,000 population and a 1.5% death rate (based on the Worldometer 2020 statistics of Taiwan's population of 23.8 million). This paper presents evidence that spread prevention involving mass masking and universal hygiene at the early stage of the COVID-19 pandemic resulted in a 50% decline of infectious respiratory diseases, based on historical data during the influenza season in Taiwan. These outcomes provide potential support for the effectiveness of widely implementing public health precaution measures in controlling COVID-19 without a lockdown policy.


docid: itpizzzh

title: Implications of the lack of a unified research project framework: an investigation into the registration of clinical trials of COVID-19

text: Objective: The aim of this study was to provide recommendations for improving the design of subsequent studies through analysis of the registered coronavirus disease 2019 (COVID-19) clinical trials.Methods: A retrospective analysis of 189 trial retrievals achieved on 20 February 2020.Results: A total of 189 trials are included in the study. There were 69.3% interventional studies, 21.7% observational studies, 5.3% diagnostic tests and 3.7% other studies. The following statistics are provided only for the interventional studies. Severity of disease: 5.3% light and common type, 17.6% severe and critically ill and 59.6% with no restricted classification. Medication use: 51.1% Western medicine, 32.1% Chinese medicine, 10.7% blood related product and 6.1% non-drug therapy. The median and inner quantile range of the sample sizes included in these studies: 104 (IQR: 60, 200). Primary outcome type most used: 45.8% with clinical characteristics and 21.4% with virological. Study design characteristics: 71% of all studies were randomized, 5% of all studies were blinded, 18% of all studies were multicenter and 76% of all studies were single center.Conclusion: Although many COVID-19 studies include randomization in their design, the lack of additional double-blind and placebo-controlled elements in their designs result in a less robust evaluation of intervention safety and efficacy. Furthermore, similar or repeated research and small sample studies that have less promise in gains of new information have possibly led to a shortage of recruitable patients and become a barrier to the completion of large multicenter clinical trial studies.


title: COVID-19 infections among HCWs exposed to a patient with a delayed diagnosis of COVID-19

text: We report on COVID-19 risk among HCWs exposed to a patient diagnosed with COVID-19 on day 13 of hospitalization. There were 44 HCWs exposed to the patient before contact and droplet precautions were implemented: of these, 2 of 44 (5%) developed COVID-19 potentially attributable to the exposure.


Converting gas-driven ventilators from oxygen to air


title: Virological and clinical cure in COVID-19 patients treated with hydroxychloroquine: A systematic review and meta-analysis

text: Following the demonstration of the efficacy of hydroxychloroquine against severe acute respiratory syndrome coronavirus 2 in vitro, many trials started to evaluate its efficacy in clinical settings. However, no systematic review and meta-analysis have addressed the issue of the safety and efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019. We conducted a systematic review and meta-analysis with the objectives of evaluation of safety and efficacy of HCQ alone or in combination in terms of "time to clinical cure," "virological cure," "death or clinical worsening of disease," "radiological progression," and safety. RevMan was used for meta-analysis. We searched 16 literature databases out of which seven studies (n = 1358) were included in the systematic review. In terms of clinical cure, two studies reported possible benefit in "time to body temperature normalization" and one study reported less "cough days" in the HCQ arm. Treatment with HCQ resulted in less number of cases showing the radiological progression of lung disease (odds ratio [OR], 0.31, 95% confidence interval [CI], 0.11-0.9). No difference was observed in virological cure (OR, 2.37, 95% CI, 0.13-44.53), death or clinical worsening of disease (OR, 1.37, 95% CI, 1.37-21.97), and safety (OR, 2.19, 95% CI, 0.59-8.18), when compared with the control/conventional treatment. Five studies reported either the safety or efficacy of HCQ + azithromycin. Although seems safe and effective, more data are required for a definitive conclusion. HCQ seems to be promising in terms of less number of cases with radiological progression with a comparable safety profile to control/conventional treatment. We need more data to come to a definite conclusion.


COVID-19 and spinal cord injury professionals: Maintaining a scholarly perspective


title: A review of information security aspects of the emerging COVID-19 contact tracing mobile phone applications

text: This paper discusses the aspects of data reliability and user privacy for the emerging practice of mobile phone based contact tracing for the COVID-19 pandemic. Various countries and large technology companies have already used or plan to design and use mobile phone based solutions, in an effort to urgently expedite the process of identifying people who may have been exposed to the disease and limit its spread to the general population. However, serious concerns have been raised both in terms of the validity of the collected data as well as the extent to which implemented approaches can breach the privacy of the mobile phone users. This review examines the weaknesses of existing implementations and concludes with specific recommendations that can contribute towards increasing the safety of infrastructures that collect and process this kind of information, as well as the adoption and acceptance of these solutions from the public.


title: Acute Kidney Injury in Coronavirus Disease 2019 Infected Patients: A Meta-Analytic Study

text: INTRODUCTION: In clinical reports on coronavirus disease 2019 (COVID-19), the incidence of acute kidney injury (AKI) is extremely variable, although AKI is described as an independent risk factor for mortality. A meta-analysis was performed to clarify the incidence and the impact of COVID-19-related AKI on mortality. METHODS: All trials reporting the incidence of AKI in COVID-19 patients were searched using MEDLINE, the Cochrane Library, and EMBASE databases (last update April 26, 2020). RESULTS: Ten trials with a sample of 5,166 patients were included. AKI occurred in 947 out of 5,166 (18.3%) patients. AKI incidence was higher in severe cases: 62/305 severe patients developed AKI (20%) versus 27/1,268 nonsevere patients (2%) (p = 0.00001). AKI occurred in 475 out of 915 (52%) deceased patients versus 183 out of 2,678 (7%) survivors (p = 0.00001). Continuous renal replacement therapy was significantly more frequent in severe cases and in dead patients. CONCLUSION: A significant increase in mortality rate was observed in COVID patients who developed AKI, and AKI incidence was also higher in severe cases. Any supportive strategies to protect kidney could represent valuable intervention to reduce mortality in severe COVID-19 patients.


title: Risk factors associated with disease progression in a cohort of patients infected with the 2019 novel coronavirus

text: BACKGROUND: The emerging infection of the 2019 novel coronavirus (2019-nCoV) in late December, 2019 in Wuhan, China, has caused an extreme health concern, with many patients having progressed to acute respiratory disease or other complications in a short period. Meanwhile, the risk factors associated with the disease progression still remain elusive. METHODS: A cohort of 17 patients with laboratory-confirmed 2019-nCoV infections who were admitted to the Ninth Hospital of Nanchang between January 28 and February 6, 2020, were enrolled in this study. All the patients received standardized treatment. The disease progression was evaluated every 7 days after admission. The clinical, radiologic, and laboratory characteristics were retrospectively analyzed, and the factors associated with the disease progression were screened by binary logistic regression analysis. RESULTS: The cohort comprised 11 women (64.7%) and 6 men (35.3%) between the ages of 18 to 70 years old. All patients had a reported history of contact with infection-confirmed patients. Fever (11/64.7%) and cough (8/47.1%) were the most common symptoms, whereas dyspnea (2/11.8%) and fatigue (3/17.6%) were rare, and there was no patient with diarrhea symptoms. There were 5 patients with aggravated disease at the first disease progression evaluation, and no patient received mechanical ventilation, transferred to the intensive care unit (ICU), or progressed to acute respiratory distress syndrome, septic shock, refractory metabolic acidosis, coagulation dysfunction, or death. Based on the disease progression, patients were divided into the non-aggravation group (12 cases) and the aggravation group (5 cases). There were no significant differences between the 2 groups with respect to their clinical characteristics. Chest computed tomography (CT) on admission revealed there were 8 patients (47.1%) with invasive lesions found bilaterally on the lungs on multiple lobes, 4 patients (23.5%) with invasive lesions on 1 lobe, and 5 patients (29.4%) with normal chest CT. The aggravation group had1 patient (20.0%) with invasive lesions on one lobe, 3 (60.0%) with invasive lesions on multiple lobes, bilaterally, and 1 (20.0%) with normal chest CT; meanwhile, the nonaggravation group had 3 patients (25.0%) with invasive lesions on one lobe, 5 (41.7%) with invasive lesions on multiple lobes, bilaterally, and 4 (33.3%) with normal chest CT. No significant difference was found between the 2 groups. In the aggravation group, the total lymphocyte counts significantly decreased in comparison to that in the non-aggravation group. Further analysis showed that the CD4+ T cell count but not the CD8+ T cell count of the aggravation group was significantly lower than that of the non-aggravation group. Correlation analysis indicated total lymphocyte count was positively correlated with CD4+ T cell count, and no significant differences were found between the 2 groups in other laboratory measurements, including those of white blood cell (WBC) count, C-reactive protein (CRP), albumin, lactate dehydrogenase (LDH), and D-dimer. Finally, a binary logistic regression model was used to identify the factors associated with the disease progression. It was found that total lymphocyte count was a risk factor associated with disease progression in patients infected with 2019-nCoV. CONCLUSIONS: A higher cell count of total lymphocytes may indicate a better outcome of the disease, and immune response may be a vital factor for directing disease progression in the early stage of 2019-nCoV infection.


docid: xamayhqq

title: Thrombotic microangiopathy in a patient with COVID-19


title: Evaluation of novel antigen-based rapid detection test for the diagnosis of SARS-CoV-2 in respiratory samples

text: OBJECTIVES: In the context of the Covid-19 pandemic, the development and validation of rapid and easy-to-perform diagnostic methods are of high priority. We evaluated a novel rapid antigen detection test (RDT) for SARS-CoV-2 in respiratory samples. METHODS: The fluorescence immunochromatographic SARS-CoV-2 antigen test (Bioeasy Biotechnology Co., Shenzhen, China) was evaluated using universal transport medium with nasopharyngeal (NP) and oropharyngeal (OP) swabs from suspected Covid-19 cases. Diagnostic accuracy was determined in comparison to SARS-CoV-2 real time (RT)-PCR. RESULTS: A total of 127 samples were included; 82 were RT-PCR positive. Median patients' age was 38 years, 53.5% were male, and 93.7% were from the first week after symptom onset. Overall sensitivity and specificity were 93.9% (CI95% 86.5-97.4) and 100% (CI95% 92.1-100), respectively, with a diagnostic accuracy of 96.1% and Kappa coefficient of 0.9. Sensitivity was significantly higher in samples with high viral loads. CONCLUSIONS: The evaluated RDT showed a high sensitivity and specificity in samples mainly obtained during the first week of symptoms and with high viral loads, despite the use of a non-validated sample material. The assay has the potential to become an important tool for early diagnosis of SARS-CoV-2, particularly in situations with limited access to molecular methods.


title: Characteristics of patients with coronavirus disease (COVID-19) confirmed using an IgM-IgG antibody test

text: Coronavirus disease (COVID-19), caused by a novel betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly developed into a pandemic since it was first reported in December 2019. Nucleic acid testing is the standard method for the diagnosis of viral infections. However, this method reportedly has a low positivity rate. To increase the sensitivity of COVID-19 diagnoses, we developed an IgM-IgG combined assay and tested it in patients with suspected SARS-CoV-2 infection. In total, 56 patients were enrolled in this study and SARS-CoV-2 was detected by using both IgM-IgG antibody and nucleic acid tests. Clinical and laboratory data were collected and analyzed. Our findings suggest that patients who develop severe illness might experience longer virus exposure times and develop a more severe inflammatory response. The IgM-IgG test is an accurate and sensitive diagnostic method. A combination of nucleic acid and IgM-IgG testing is a more sensitive and accurate approach for diagnosis and early treatment of COVID-19.


Utility of hyposmia and hypogeusia for the diagnosis of COVID-19


title: History is repeating itself: Probable zoonotic spillover as the cause of the 2019 novel Coronavirus Epidemic

text: Pathogen transmission from a vertebrate animal to a human, also known as zoonotic spillover, represents a global public health burden, which while associated with multiple outbreaks, still remains a poorly understood phenomenon. Coronaviruses, like influenza viruses, circulate in nature in various animal species. Alpha-coronaviruses and beta-coronaviruses can infect mammals and gamma-coronaviruses and delta-coronaviruses tend to infect birds, but some of them can also be transmitted to mammals. Although still preliminary, current data suggest that bats are the most probable initial source of the current 2019 novel CoV (2019nCoV) outbreak, that begun on December 2019 in Wuhan, China, apparently spreading from a "wet market" to multiple cities and provinces in China. This epidemic of 2019nCoV, already reaching more than 6,000 cases to-day (end of January 2020) (>90% in China), will not be the last one linked to zoonotic spillover events.


History is repeating itself: Probable zoonotic spillover as the cause of the 2019 novel coronavirus epidemic


The COVID-19 pandemic requires a unified global response


Breaking Bad News via Telemedicine: A New Challenge at Times of an Epidemic


title: Implicaciones hepáticas en la pandemia por COVID-19

text: La infección generada por el coronavirus, denominado SARS-CoV-2, llamada coronavirus disease 2019(COVID-19), surgió en China a finales de diciembre de 2019 Actualmente ha sido categorizada como una pandemia por la Organización Mundial de la Salud (OMS) Se han documentado alteraciones de pruebas hepáticas, sin embargo, los estudios se han enfocado en los efectos cardíacos, pulmonares y renales de esta infección La alteración de pruebas hepáticas en el contexto de COVID-19 puede ser consecuencia de hepatitis viral, toxicidad farmacológica, inflamación o choque También se considera como un marcador de pronóstico y gravedad de la enfermedad El impacto de la infección por SARS-CoV-2 en pacientes con enfer-medad hepática preexistente o receptores de trasplante hepático no es claro, y se plantean distintas hipótesis sobre mayor o menor riesgo de enfermedad grave y de descompensación de la enfermedad de base (AU)The infection generated by the novel coronavirus SARS-CoV-2, named Coronavirus Disease 2019 (COVID-19) emerged late December of 2019 in China It is currently categorized as a pandemic by the World Health Organization Studies have focused on cardiac, pulmonary, and renal effects of this infection, but liver test abnormalities have also been documented This alteration may be a consequence of viral hepatitis, phar-macological toxicity, inflammation, or shock It is also considered a marker of prognosis and severity of the disease The impact of SARS-CoV-2 infection in patients with pre-existing liver disease or liver transplant recipients is unclear, and different hypotheses exist regarding the higher or lower risk of severe disease and decompensation of the underlying disease


title: Precautions for Operating Room Team Members During the COVID-19 Pandemic

text: BACKGROUND: The novel coronavirus SARS-CoV-2 (COVID-19) can infect healthcare workers. We developed an institutional algorithm to protect operating room team members during the COVID-19 pandemic and rationally conserve personal protective equipment (PPE). STUDY DESIGN: An interventional platform (operating room, interventional suite, and endoscopy) PPE taskforce was convened by the hospital and medical school leadership and tasked with developing a common algorithm for PPE use, to be used throughout the interventional platform. In conjunction with our infectious disease experts, we developed our guidelines based on potential patterns of spread, risk of exposure, and conservation of PPE. RESULTS: A decision tree algorithm describing our institutional guidelines for precautions for operating room team members was created. This algorithm is based on urgency of operation, anticipated viral burden at the surgical site, opportunity for a procedure to aerosolize virus, and likelihood a patient could be infected based on symptoms and testing. CONCLUSIONS: Despite COVID-19 being a new threat, we have shown that by developing an easy-to-follow decision tree algorithm for the interventional platform teams, we can ensure optimal health care worker safety.


Straining the System: Novel Coronavirus (COVID-19) and Preparedness for Concomitant Disasters


Acral edema during the COVID-19 pandemic


Precision medicine for COVID-19: a call for better clinical trials


docid: zhncseof

title: Clinically significant portal hypertension in cirrhosis patients with COVID-19: Clinical characteristics and outcomes


Clinically significant portal hypertension in cirrhosis patients with COVID-19: clinical characteristics and outcomes


title: Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019

text: BACKGROUND: The novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patient remains largely unknown, and the clinical values of antibody testing have not been fully demonstrated. METHODS: A total of 173 patients with SARS-CoV-2 infection were enrolled. Their serial plasma samples (n=535) collected during the hospitalization were tested for total antibodies (Ab), IgM and IgG against SARS-CoV-2. The dynamics of antibodies with the disease progress was analyzed. RESULTS: Among 173 patients, the seroconversion rate for Ab, IgM and IgG was 93.1%, 82.7% and 64.7%, respectively. The reason for the negative antibody findings in 12 patients might due to the lack of blood samples at the later stage of illness. The median seroconversion time for Ab, IgM and then IgG were day-11, day-12 and day-14, separately. The presence of antibodies was <40% among patients within 1-week since onset, and rapidly increased to 100.0% (Ab), 94.3% (IgM) and 79.8% (IgG) since day-15 after onset. In contrast, RNA detectability decreased from 66.7% (58/87) in samples collected before day-7 to 45.5% (25/55) during day 15-39. Combining RNA and antibody detections significantly improved the sensitivity of pathogenic diagnosis for COVID-19 (p<0.001), even in early phase of 1-week since onset (p=0.007). Moreover, a higher titer of Ab was independently associated with a worse clinical classification (p=0.006). CONCLUSIONS: The antibody detection offers vital clinical information during the course of SARS-CoV-2 infection. The findings provide strong empirical support for the routine application of serological testing in the diagnosis and management of COVID-19 patients.


title: Risk estimation of the SARS-CoV-2 acute respiratory disease outbreak outside China

text: BACKGROUND: On December 31, 2019, the World Health Organization was alerted to the occurrence of cases of pneumonia in Wuhan, Hubei Province, China, that were caused by an unknown virus, which was later identified as a coronavirus and named the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to estimate the reproductive number of SARS-CoV-2 in the Hubei Province and evaluate the risk of an acute respiratory coronavirus disease (COVID-19) outbreak outside China by using a mathematical model and stochastic simulations. RESULTS: We constructed a mathematical model of SARS-CoV-2 transmission dynamics, estimated the rate of transmission, and calculated the reproductive number in Hubei Province by using case-report data from January 11 to February 6, 2020. The possible number of secondary cases outside China was estimated by stochastic simulations in various scenarios of reductions in the duration to quarantine and rate of transmission. The rate of transmission was estimated as 0.8238 (95% confidence interval [CI] 0.8095-0.8382), and the basic reproductive number as 4.1192 (95% CI 4.0473-4.1912). Assuming the same rate of transmission as in Hubei Province, the possibility of no local transmission is 54.9% with a 24-h quarantine strategy, and the possibility of more than 20 local transmission cases is 7% outside of China. CONCLUSION: The reproductive number for SARS-CoV-2 transmission dynamics is significantly higher compared to that of the previous SARS epidemic in China. This implies that human-to-human transmission is a significant factor for contagion in Hubei Province. Results of the stochastic simulation emphasize the role of quarantine implementation, which is critical to prevent and control the SARS-CoV-2 outbreak outside China.


Early tocilizumab treatment could improve survival among COVID-19 patients


title: Concerns and Fears of Indian Dentists on Professional Practice During the Coronavirus Disease-2019 (COVID-19) Pandemic

text: The Coronavirus disease-2019 (COVID-19) pandemic, due to the Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) was declared a public health emergency of international concern by the World Health Organization on 30th of January 2020 (World Health Organization, 2020). The first case of COVID-19 was reported in India on the same day, and at the time of writing, on 20th May 2020, India has reported over 106,000 patients, with over 3,300 related deaths. The country is under a state of lockdown since 25th March, 2020, and over 600 health care providers have been infected.


Concerns and fears of Indian dentists on professional practice during the coronavirus disease 2019 (COVID-19) pandemic


Untapped potential: More US labs could be providing tests for coronavirus


SARS-CoV-2 and COVID-19: What are our options? Where should we focus our attention on to find new drugs and strategies?


title: [The risk and prevention of bio-aerosol transmission in dental clinics]

text: Corona virus disease 2019 (COVID-19) has become a Public Health Emergency of International Concern since its outbreak, and whether COVID-19 can transmit by aerosol remains controversial The problem of bio-aerosol transmission in the relatively confined dental clinics has aroused wide attention in the field of dentistry This review provided a most updated summary on the relation between bio-aerosols and dental clinics, which included the microorganisms in bio-aerosols, the bio-aerosol transmission and the sources testing methods, temporal and spatial distribution of dental bio-aerosols and summarized how to reduce the exposure to bio-aerosols in dental clinics


title: Contaminação microbiológica da ração e água fornecida a frangos em granja avícola da cidade de Januária, MG

text: A qualidade da água e das rações são fatores importantes para o desempenho da atividade avícola. A cadeia de produção de frangos pode proporcionar variadas fontes de contaminação, incluindo a ração e a água utilizada. O presente estudo teve como objetivo avaliar a incidência de indicadores de contaminação microbiológica em ração e água fornecida a frangos de corte em uma granja avícola do município de Januária-MG. Foram realizadas análises microbiológicas da água e ração fornecidas aos frangos, avaliando a contagem de bactérias coliformes totais, coliformes a 45°C e enterobactérias. A elevada contagem de coliformes totais e coliformes a 45°C na água e na ração, assim como, a elevada contagem de enterobactérias na ração pode representar a possibilidade da presença de bactérias patogênicas e consequente risco à saúde dos consumidores das aves comercializadas pela granja pesquisada.(AU)


title: Current pharmacological treatments for SARS-COV-2: A narrative review

text: The novel coronavirus, later identified as SARS-CoV-2, originating from Wuhan in China in November 2019, quickly spread around the world becoming a pandemic. Despite the knowledge of previous coronaviruses, such as those responsible for the SARS and MERS-CoV epidemic, there is no drug or prophylaxis treatment to this day. The rapid succession of scientific findings on SARS-CoV-2 provides a significant number of potential drug targets. Nevertheless, at the same time, the high quantity of clinical data, generated by a large number of rapidly infected people, require accurate tests regarding effective medical treatments. Several in vitro and in vivo studies were rapidly initiated after the outbreak of the pandemic COVID-19. Initial clinical studies revealed the promising potential of remdesivir that demonstrated a powerful and specific in vitro antiviral activity for COVID-19. Promising effects appear to be attributable to hydroxychloroquine. Remdesivir and hydroxychloroquine are being tested in ongoing randomized trials. In contrast, oseltamivir was not effective and corticosteroids are not currently recommended. However, few data from ongoing clinical trials are identifying low molecular weight heparins, innate immune system stimulating agents, and inflammatory modulating agents as potential effective agents. The authors assume that the current pandemic will determine the need for a systematic approach based on big data analysis for identifying effective drugs to defeat SARS-Cov-2. This work is aimed to be a general reference point and to provide an overview as comprehensive as possible regarding the main clinical trials in progress at the moment.


COVID-19 in the community


Tackling the Burden of Neurological Diseases in Canada with Virtual Care During the COVID-19 Pandemic and Beyond


Universal screening for SARS-CoV-2 in asymptomatic obstetric patients in Tokyo, Japan


title: Adapting to the Coronavirus Disease 2019 Pandemic in New York City

text: The coronavirus disease 2019 has and continues to overwhelm the medical establishment in New York City. It has moved faster and had rates of mortality higher than what were initially forecast. All departments within large hospital systems have had to learn lessons and adapt in real time to the crisis. We share our experience and what we have learned as it pertains to this pandemic and hope that it aides, guides, and influences other departments of physical medicine and rehabilitation regarding their potential roles and areas of growth during this time.


The Rheumatology Community responds to the COVID-19 pandemic: the establishment of the COVID-19 global rheumatology alliance


title: Dietary Choices and Habits during COVID-19 Lockdown: Experience from Poland

text: The outbreak of coronavirus disease (COVID-19) in late December 2019 in China, which later developed into a pandemic, has forced different countries to implement strict sanitary regimes and social distancing measures. Globally, at least four billion people were under lockdown, working remotely, homeschooling children, and facing challenges coping with quarantine and the stressful events. The present cross-sectional online survey of adult Poles (n = 1097), conducted during a nationwide quarantine, aimed to assess whether nutritional and consumer habits have been affected under these conditions. Over 43.0% and nearly 52% reported eating and snacking more, respectively, and these tendencies were more frequent in overweight and obese individuals. Almost 30% and over 18% experienced weight gain (mean ± SD 3.0 ± 1.6 kg) and loss (-2.9 ± 1.5 kg), respectively. Overweight, obese, and older subjects (aged 36-45 and >45) tended to gain weight more frequently, whereas those with underweight tended to lose it further. Increased BMI was associated with less frequent consumption of vegetables, fruit, and legumes during quarantine, and higher adherence to meat, dairy, and fast-foods. An increase in alcohol consumption was seen in 14.6%, with a higher tendency to drink more found among alcohol addicts. Over 45% of smokers experienced a rise in smoking frequency during the quarantine. The study highlights that lockdown imposed to contain an infectious agent may affect eating behaviors and dietary habits, and advocates for organized nutritional support during future epidemic-related quarantines, particularly for the most vulnerable groups, including overweight and obese subjects.


title: Variance of Longest Run Duration in a Random Bitstring

text: We continue an earlier study, starting with unconstrained $n$-bitstrings, focusing now less on average behavior and more on uncertainty. The interplay between $\bullet$ longest runs of 0s and of 1s, when bitstrings are multus $\bullet$ longest runs of 0s and bitsums (# of 1s), when bitstrings are solus $\\$ is examined. While negative correlations approach zero as $n \rightarrow \infty$ in the former (for clumped 1s), the limit is evidently nonzero in the latter (for separated 1s). Similar analysis is possible when both 0s and 1s are clumped (bimultus), and when 0s are clumped but 1s are separated (persolus). Our methods are experimentally-based.


All that's fit to preprint


title: Pandemie post-normali. Perché CoViD-19 richiede un nuovo approccio alla scienza./ [Post-Normal Pandemics: why CoViD-19 requires a new approach to science.]

text: In addressing pandemics, science has never seemed more needed and useful, while at the same time limited and powerless. The existing contract between science and society is falling apart. A new covenant is urgently needed to navigate the days ahead.


title: Passengers' destinations from China: low risk of Novel Coronavirus (2019-nCoV) transmission into Africa and South America

text: Novel Coronavirus (2019-nCoV [SARS-COV-2]) was detected in humans during the last week of December 2019 at Wuhan city in China, and caused 24 554 cases in 27 countries and territories as of 5 February 2020. The objective of this study was to estimate the risk of transmission of 2019-nCoV through human passenger air flight from four major cities of China (Wuhan, Beijing, Shanghai and Guangzhou) to the passengers' destination countries. We extracted the weekly simulated passengers' end destination data for the period of 1-31 January 2020 from FLIRT, an online air travel dataset that uses information from 800 airlines to show the direct flight and passengers' end destination. We estimated a risk index of 2019-nCoV transmission based on the number of travellers to destination countries, weighted by the number of confirmed cases of the departed city reported by the World Health Organization (WHO). We ranked each country based on the risk index in four quantiles (4th quantile being the highest risk and 1st quantile being the lowest risk). During the period, 388 287 passengers were destined for 1297 airports in 168 countries or territories across the world. The risk index of 2019-nCoV among the countries had a very high correlation with the WHO-reported confirmed cases (0.97). According to our risk score classification, of the countries that reported at least one Coronavirus-infected pneumonia (COVID-19) case as of 5 February 2020, 24 countries were in the 4th quantile of the risk index, two in the 3rd quantile, one in the 2nd quantile and none in the 1st quantile. Outside China, countries with a higher risk of 2019-nCoV transmission are Thailand, Cambodia, Malaysia, Canada and the USA, all of which reported at least one case. In pan-Europe, UK, France, Russia, Germany and Italy; in North America, USA and Canada; in Oceania, Australia had high risk, all of them reported at least one case. In Africa and South America, the risk of transmission is very low with Ethiopia, South Africa, Egypt, Mauritius and Brazil showing a similar risk of transmission compared to the risk of any of the countries where at least one case is detected. The risk of transmission on 31 January 2020 was very high in neighbouring Asian countries, followed by Europe (UK, France, Russia and Germany), Oceania (Australia) and North America (USA and Canada). Increased public health response including early case recognition, isolation of identified case, contract tracing and targeted airport screening, public awareness and vigilance of health workers will help mitigate the force of further spread to naïve countries.


title: Performance of the nasal photoplethysmographic index as an analgesic index during surgery under general anaesthesia

text: In a previous study, we developed a new analgesic index using nasal photoplethysmography (nasal photoplethysmographic index, NPI) and showed that the NPI was superior to the surgical pleth index (SPI) in distinguishing pain above numerical rating scale 3. Because the NPI was developed using data obtained from conscious patients with pain, we evaluated the performance of NPI in comparison with the SPI and the analgesia nociception index (ANI) in patients under general anaesthesia with target-controlled infusion of propofol and remifentanil. The time of nociception occurrence was defined as when the signs of inadequate anaesthesia occurred. The median values of NPI, SPI, and ANI for 1 minute from the time of the sign of inadequate anaesthesia were determined as the value of each analgesic index that represents inadequate anaesthesia. The time of no nociception was determined as 2 minutes before the onset of skin incision, and the median value for 1 minute from that time was defined as the baseline value. In total, 81 patients were included in the analysis. NPI showed good performance in distinguishing inadequate anaesthesia during propofol-remifentanil based general anaesthesia. NPI had the highest value in terms of area under the receiver operating characteristic curve, albeit without statistical significance (NPI: 0.733, SPI: 0.722, ANI: 0.668). The coefficient of variations of baseline values of NPI, SPI, and ANI were 27.5, 47.2, and 26.1, respectively. Thus, the NPI was effective for detecting inadequate anaesthesia, showing similar performance with both indices and less baseline inter-individual variability than the SPI.


title: Pregnancy and COVID-19: a systematic review of maternal, obstetric and neonatal outcomes

text: BACKGROUND: There is limited information related to COVID-19 in pregnancy. OBJECTIVES: Evaluate the impact of COVID-19 during pregnancy. Search strategy: Searches were systematically carried out in PubMed, Scopus database and WHO database. Selection criteria: Studies with information related to the effects of COVID-19 in pregnancy, concerning maternal, obstetric, and neonatal outcomes were included. Data collection and analysis: Data were extracted for systematic review following PRISMA guidelines. CARE and STROBE were used to evaluate the quality of data. Main Results: A total of 8 studies involving 95 pregnant women and 51 neonates were included. Overall, the quality was considered good in four studies, moderate in three and poor in one. Among pregnant women, 26% had a history of epidemiological exposure to SARS-CoV-2. The most common symptoms presented were fever (55%), cough (38%) and fatigue (11%). In 50 deliveries, 94% were cesarean sections and 35% were preterm births. Of the 51 neonates, 20% had low birth weight and 1 tested positive for Sars-CoV-2. There was 1 neonatal death, not related to the viral infection, and no cases of severe neonatal asphyxia. CONCLUSIONS: The information compiled in this systematic review may help healthcare providers administer the best possible care.


title: Developing and testing a measure of COVID-19 organizational support of healthcare workers - results from Peru, Ecuador, and Bolivia

text: During the COVID-19 pandemic, healthcare workers are facing high workloads with resource constraints and risk of virus exposure, and healthcare organizations need to support their healthcare workers to reduce their anxiety. Based on a recent 8-point framework of COVID-19 specific organization support, we devised a measure of COVID-19 Organizational Support (COVID-OS). We tested the new measure with 712 healthcare workers in Bolivia, Ecuador, and Peru and found the new measure formed three factors to predict healthcare workers' anxiety and life satisfaction during the COVID-19 pandemic. We call for further studies to test COVID-OS in other countries and settings.


Continuing Professional Development in the Era of COVID-19


title: Thoughts and Advices on Performing Procedures in Surgery During the Outbreak of Novel Coronavirus Pneumonia/ 中山大学学报(医学科学版)

text: @#Since the outbreak of novel coronavirus pneumonia（coronavirus disease 2019，COVID- 19）in 2019，it has had a serious impact on the normal work and life of the people because of its strong infectivity，high susceptibility，long incubation period and diversified clinical manifestations. In this epidemic situation，clinicians should master the clinical manifestations and epidemiological characteristics of novel coronavirus pneumonia ，comply with the diagnosis and treatment guidelines of novel coronavirus pneumonia，carry out the diagnosis and treatment classification of surgical diseases well，reasonably select surgical methods；while optimizing the process of diagnosis，treatment and nursing，the protective measures should be taken according to different risk grades.


docid: ycumcmqu

title: Academic Community's Efforts to Guide the Fight Against Coronavirus Disease 2019 (COVID-19) Epidemic in Korea


title: Artificial Intelligence Distinguishes COVID-19 from Community Acquired Pneumonia on Chest CT

text: Background Coronavirus disease has widely spread all over the world since the beginning of 2020. It is desirable to develop automatic and accurate detection of COVID-19 using chest CT. Purpose To develop a fully automatic framework to detect COVID-19 using chest CT and evaluate its performances. Materials and Methods In this retrospective and multi-center study, a deep learning model, COVID-19 detection neural network (COVNet), was developed to extract visual features from volumetric chest CT exams for the detection of COVID-19. Community acquired pneumonia (CAP) and other non-pneumonia CT exams were included to test the robustness of the model. The datasets were collected from 6 hospitals between August 2016 and February 2020. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC), sensitivity and specificity. Results The collected dataset consisted of 4356 chest CT exams from 3,322 patients. The average age is 49±15 years and there were slightly more male patients than female (1838 vs 1484; p-value=0.29). The per-exam sensitivity and specificity for detecting COVID-19 in the independent test set was 114 of 127 (90% [95% CI: 83%, 94%]) and 294 of 307 (96% [95% CI: 93%, 98%]), respectively, with an AUC of 0.96 (p-value<0.001). The per-exam sensitivity and specificity for detecting CAP in the independent test set was 87% (152 of 175) and 92% (239 of 259), respectively, with an AUC of 0.95 (95% CI: 0.93, 0.97). Conclusions A deep learning model can accurately detect COVID-19 and differentiate it from community acquired pneumonia and other lung diseases.


title: [Preliminary clinical study of direct renin inhibitor aliskiren in the treatment of severe COVID-19 patients with hypertension]

text: Objective: To explore the feasibility of direct renin inhibitor aliskiren for the treatment of severe patients of COVID-19 with hypertension. Methods: A retrospective case analysis of effectiveness and safety of aliskiren treatment to lower blood pressure in three severe and one critically ill patients of COVID-19 with hypertension. Results: Four patients, two males and two females, with an average age of 78 years (66-87 years), were referred to hospital mainly because of respiratory symptoms. Three cases were confirmed by 2019-nCoV nucleic acid and antibody detection (severe type), and one with cardiac insufficiency was clinically determined (critically ill type). The previous diagnosis of hypertension was clear. Two patients took calcium channel antagonist (CCB), one patient took angiotensin converting enzyme inhibitor (ACEI), and one patient took angiotensin II receptor antagonist (ARB). After admission, ACEI or ARB were discontinued, one patient with heart failure patient was treated by aliskiren combined with diuretic; 3 patients were treated with aliskiren combined with CCB. Two patients were stopped to use CCB due to low blood pressure after 1 to 2 weeks of using CCB and aliskiren. On the basis of comprehensive therapy combined with antiviral and oxygenation treatment, aliskiren antihypertensive treatment was taken for three to four weeks. The blood pressure control of four patients was satisfactory and there was no complaint of discomfort. The condition improved, and all patients had reached the discharge standard and were discharged. Conclusion: Our preliminary clinical data shows that aliskiren's antihypertensive therapy is effective and safe for severe COVID-19 patients complicated with hypertension. Further clinical aliskiren therapy study is required with more COVID-19 patients..


Child Health and Delivery of Care During the COVID-19 Pandemic and Beyond


title: Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

text: PURPOSE OF REVIEW: Coronavirus disease of 2019 (COVID-19) is a cause of significant morbidity and mortality worldwide. While cardiac injury has been demonstrated in critically ill COVID-19 patients, the mechanism of injury remains unclear. Here, we review our current knowledge of the biology of SARS-CoV-2 and the potential mechanisms of myocardial injury due to viral toxicities and host immune responses. RECENT FINDINGS: A number of studies have reported an epidemiological association between history of cardiac disease and worsened outcome during COVID infection. Development of new onset myocardial injury during COVID-19 also increases mortality. While limited data exist, potential mechanisms of cardiac injury include direct viral entry through the angiotensin-converting enzyme 2 (ACE2) receptor and toxicity in host cells, hypoxia-related myocyte injury, and immune-mediated cytokine release syndrome. Potential treatments for reducing viral infection and excessive immune responses are also discussed. COVID patients with cardiac disease history or acquire new cardiac injury are at an increased risk for in-hospital morbidity and mortality. More studies are needed to address the mechanism of cardiotoxicity and the treatments that can minimize permanent damage to the cardiovascular system.


title: Advances in Collaborative Filtering and Ranking

text: In this dissertation, we cover some recent advances in collaborative filtering and ranking. In chapter 1, we give a brief introduction of the history and the current landscape of collaborative filtering and ranking; chapter 2 we first talk about pointwise collaborative filtering problem with graph information, and how our proposed new method can encode very deep graph information which helps four existing graph collaborative filtering algorithms; chapter 3 is on the pairwise approach for collaborative ranking and how we speed up the algorithm to near-linear time complexity; chapter 4 is on the new listwise approach for collaborative ranking and how the listwise approach is a better choice of loss for both explicit and implicit feedback over pointwise and pairwise loss; chapter 5 is about the new regularization technique Stochastic Shared Embeddings (SSE) we proposed for embedding layers and how it is both theoretically sound and empirically effectively for 6 different tasks across recommendation and natural language processing; chapter 6 is how we introduce personalization for the state-of-the-art sequential recommendation model with the help of SSE, which plays an important role in preventing our personalized model from overfitting to the training data; chapter 7, we summarize what we have achieved so far and predict what the future directions can be; chapter 8 is the appendix to all the chapters.


title: Learning from a Pandemic

text: The Covid-19 pandemic has highlighted connections between health and social structural phenomena that have long been recognized in bioethics but have never really been front and center-not just access to health care, but fundamental conditions of living that affect public health, from income inequality to political and environmental conditions. In March, as the pandemic spread globally, the field's traditional focus on health care and health policy, medical research, and biotechnology no longer seemed enough. The adequacy of bioethics seemed even less certain after the killing of George Floyd, whose homicide showed in an especially agonizing way how social institutions are in effect (and often intentionally) designed to make the lives of black people go poorly and end early. Whether bioethics needs to be expanded, redirected, and even reconceived is at the heart of the May-June 2020 issue of the Hastings Center Report, which is devoted to questions provoked by and lessons emerging during this pandemic.


title: Overdose and risk factors for coronavirus disease 2019

text: BACKGROUND: There have been significant efforts to respond to the two public health emergencies of coronavirus disease 2019 (COVID-19) and overdose in British Columbia (BC), Canada. The purpose of this study was to quantify the prevalence of known risk factors associated with mortality due to COVID-19 for persons who have had a non-fatal overdose during 2015-2017 in comparison to persons who have not had an overdose. METHODS: Data were extracted from the BC Provincial Overdose Cohort which includes a 20 % random sample of BC residents and persons who have had a non-fatal overdose in BC from January 2015 to December 2017. Chi-square tests and logistic regression were used to compare risk factors by overdose history. RESULTS: Persons who had a non-fatal overdose were significantly more likely to have three (chronic pulmonary disease, diabetes, coronary heart disease) of the four known chronic conditions associated with the development of severe illness due to COVID-19 compared to persons who did not have a previous non-fatal overdose event. CONCLUSION: Persons who had an overdose were more likely to have several chronic conditions associated with the development of severe illness due to COVID-19. The increased likelihood of having these risk factors is reflective of the social and health inequities experienced by persons who have a history of overdose.


docid: ixrgejiy

title: The #ASRASpring20 conference was canceled due to COVID-19 but the science survives and thrives


title: Soluble Urokinase Plasminogen Activator Receptor: A Biomarker for Predicting Complications and Critical Care Admission of COVID-19 Patients

text: The novel coronavirus infection has spread worldwide, causing a wide spectrum of clinical manifestations. Most patients develop moderate clinical illness, but a substantial number will experience severe pneumonia, which may rapidly progress to acute respiratory distress syndrome and multiple organ failure. In this population, soluble urokinase plasminogen activator receptor (suPAR) could serve as a quick triage test and independent marker of clinical severity, hospital and intensive care unit admission, complications, and mortality.


Inpatient care for dermatological patients during SARS-CoV-2 - a case report from Portugal


docid: yugugrfj

title: The Natural history of Epicardial Adipose Tissue Volume and Attenuation: A long-term prospective cohort follow-up study

text: Epicardial adipose tissue (EAT) is associated with cardiovascular risk. The longitudinal change in EAT volume (EATv) and density (EATd), and potential modulators of these parameters, has not been described. We prospectively recruited 90 patients with non-obstructive coronary atherosclerosis on baseline computed tomography coronary angiography (CTCA) performed for suspected coronary artery disease to undergo a repeat research CTCA. EATv in millilitres (mL) and EATd in Hounsfield units (HU) were analysed and multivariable regression analysis controlling for traditional cardiovascular risk factors (CVRF) performed to assess for any predictors of change. Secondary analysis was performed based on statin therapy. The median duration between CTCA was 4.3years. Mean EATv increased at follow-up (72 ± 33 mL to 89 ± 43 mL, p < 0.001) and mean EATd decreased (baseline -76 ± 6 HU vs. -86 ± 5 HU, p < 0.001). There were no associations between baseline variables of body mass index, age, sex, hypertension, hyperlipidaemia, diabetes or smoking on change in EATv or EATd. No difference in baseline, follow-up or delta EATv or EATd was seen in patients with (60%) or without baseline statin therapy. In this select group of patients, EATv consistently increased and EATd consistently decreased at long-term follow-up and these changes were independent of CVRF, age and statin use. Together with the knowledge of strong associations between EAT and cardiac disease, these findings may suggest that EAT is an independent parameter rather than a surrogate for cardiovascular risk.


Extracorporeal membrane oxygenation in COVID-19


title: Highly sensitive detection of SARS-CoV-2 RNA by multiplex rRT-PCR for molecular diagnosis of COVID-19 by clinical laboratories

text: BACKGROUND: The detection of SARS-CoV-2 RNA by real-time reverse transcription-polymerase chain reaction (rRT-PCR) is used to confirm the clinical diagnosis of COVID-19 by molecular diagnostic laboratories. We developed a multiplex rRT-PCR methodology for the detection of SARS-CoV-2 RNA. METHODS: Three genes were used for multiplex rRT-PCR: the Sarbecovirus specific E gene, the SARS-CoV-2 specific N gene, and the human ABL1 gene as an internal control. RESULTS: Good correlation of Cq values was observed between the simplex and multiplex rRT-PCR methodologies. Low copies (<25 copies/reaction) of SARS-CoV-2 RNA were detected by the novel multiplex rRT-PCR method. CONCLUSION: The proposed multiplex rRT-PCR methodology will enable highly sensitive detection of SARS-CoV-2 RNA, reducing reagent use and cost, and time required by clinical laboratory technicians.


title: COVID-19 autopsy in people who died in community settings: the first series

text: Here, we report the pathological findings of nine complete autopsies of individuals who died in community settings in the UK, three of which were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), three tested negative for SARS-CoV-2 but are likely false negatives, and three died of other respiratory infections. Autopsy revealed firm, consolidated lungs or lobar pneumonia. Histology of the lungs showed changes of diffuse alveolar damage with fibrin membrane formation, thickened alveolar walls and interstitium with lymphocytic infiltrate, and type 2 pneumocyte hyperplasia with shedding into the alveolar space. This series is the first in the world to describe autopsy findings in individuals dying suddenly in the community, not previously known to have COVID-19 infection, and the first autopsy series in the UK. During a time when testing in the UK is currently primarily offered to patients in hospital or symptomatic key workers, with limited testing available in community settings, it highlights the importance of testing for COVID-19 at autopsy. Two deaths occurred in care homes where a diagnosis of COVID-19 allowed the health protection team to provide support in that 'closed setting' to reduce the risks of onward transmission. This work highlights the need for frequent COVID-19 testing in the management of patients in community settings. Comprehensive virology and microbiology assessment is pivotal to correctly identify the cause of death, including those due to COVID-19 infection, and to derive accurate death statistics.


docid: mfwfibki

title: SARS-CoV-2, where to now?


Lack of dyspnea in patients with Covid-19: another neurological conundrum?


docid: zbqpsrol

title: Minimising droplet and virus spread during and after tracheal extubation


title: Mucous membrane pemphigoid and COVID-19 treated with high-dose intravenous immunoglobulins: a case report

text: This is a report of a case with mucous membrane pemphigoid (MMP) with severe eye involvement and concurrent COVID-19 treated successfully using simultaneous high dose intravenous immunoglobulin (IVIg) and anti-viral treatment as hydroxychloroquine, lopinavir/ritonavir, and ribavirin. He had finished a 2-g cycle of rituximab (RTX) in late January. He was receiving mycophenolate mofetil (MMF) for one month and 30 mg prednisolone for three months until his hospitalization. Prednisolone was tapered to 15 mg when current COVID-19 was suspected, considering his recent cough, dyspnea, and fever.


SARS-CoV-2-reactive T cells in patients and healthy donors


docid: cloeomqq

title: Searching inhibitors for three important proteins of COVID-19 through molecular docking studies

text: After the first infected patient detected in Wuhan, China in December, 2019 with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, the COVID-19 (CO means corona, VI is virus, D is disease, 19 is the year of discovery) disease spread globally due to its high contagious nature and became an ongoing pandemic. Also, the lack of vaccines and efficacious drugs to treat infected patients is a great problem to cope this pandemic. The approved drugs for similar health problems, reported potential drugs but not yet approved clinically or under clinical trial, and molecules from medicinal plants extracts are investigated randomly to deal with the COVID-19 infection. Molecular docking, one of the best approach to search therapeutically potent drugs/molecules in real time with possible hope to apply on COVID-19. In this communication, molecular docking studies of 18 ligands were carried out with the three important proteins of SARS-CoV-2, i.e., RNA-dependent RNA polymerase (RdRp), angiotensin-converting enzyme 2 (ACE2) and spike glycoprotein (SGp). From the obtained results, we observed that all the tested molecules showed better dock score in compared to the hydroxychloroquine claimed to be effective against COVID-19. Combining the dock score and other medicinal properties, we believe the limonin can be further explored for potential use against COVID-19.


title: Federated Learning's Blessing: FedAvg has Linear Speedup

text: Federated learning (FL) learns a model jointly from a set of participating devices without sharing each other's privately held data. The characteristics of non-iid data across the network, low device participation, and the mandate that data remain private bring challenges in understanding the convergence of FL algorithms, particularly in regards to how convergence scales with the number of participating devices. In this paper, we focus on Federated Averaging (FedAvg)--the most widely used and effective FL algorithm in use today--and provide a comprehensive study of its convergence rate. Although FedAvg has recently been studied by an emerging line of literature, it remains open as to how FedAvg's convergence scales with the number of participating devices in the FL setting--a crucial question whose answer would shed light on the performance of FedAvg in large FL systems. We fill this gap by establishing convergence guarantees for FedAvg under three classes of problems: strongly convex smooth, convex smooth, and overparameterized strongly convex smooth problems. We show that FedAvg enjoys linear speedup in each case, although with different convergence rates. For each class, we also characterize the corresponding convergence rates for the Nesterov accelerated FedAvg algorithm in the FL setting: to the best of our knowledge, these are the first linear speedup guarantees for FedAvg when Nesterov acceleration is used. To accelerate FedAvg, we also design a new momentum-based FL algorithm that further improves the convergence rate in overparameterized linear regression problems. Empirical studies of the algorithms in various settings have supported our theoretical results.


Failure of hydroxychloroquine pre-exposure prophylaxis in COVID-19 infection? A case report


COVID-19 and vaping: risk for increased susceptibility to SARS-CoV-2 infection?


title: Plastic Surgery and the COVID-19 Pandemic: A Review of Clinical Guidelines

text: BACKGROUND: A novel coronavirus disease (COVID-19) was first reported in December 2019 in China and was soon declared a pandemic by the World Health Organization. Many elective and nonessential surgeries were postponed worldwide in an effort to minimize spread of disease, as well as to conserve resources. Our goal with this article is to review current practice guidelines in setting of the COVID-19 pandemic, based on available data and literature. METHODS: Websites pertaining to surgical and medical societies, and government agencies were reviewed, along with recently published literature to identify recommendations related to COVID-19 and plastic surgery procedures. RESULTS: Clinical practice modifications are recommended during the pandemic in outpatient and perioperative settings. Use of personal protective equipment is critical for aerosol-generating procedures, such as surgery in the head and neck area. Care for trauma and malignancy should continue during the pandemic; however, definitive reconstruction could be delayed for select cases. Specific recommendations were made for surgical treatment of cancer, trauma, and semiurgent reconstructive procedures based on available data and literature. CONCLUSIONS: The risk and benefit of each reconstructive procedure should be carefully analyzed in relation to necessary patient care, minimized COVID-19 spread, protection of health care personnel, and utilization of resources. Recommendations in this article should be taken in the context of each institute's resources and prevalance of COVID-19 in the region. It should be emphasized that the guidelines provided are a snapshot of current practices and are subject to change as the pandemic continues to evolve.


title: The use of radiological imaging alongside reverse transcriptase PCR in diagnosing novel coronavirus disease 2019: a narrative review

text: The diagnosis of novel coronavirus disease 2019 (COVID-19) has been a challenge in many countries due to nonspecific symptoms and variable incubation period. The current reference test is reverse transcriptase PCR. Many studies have reported high sensitivities of CT scans and suggested that they can be used in the diagnosis of COVID-19 alongside reverse transcriptase PCR. The current data about CT scans are highly variable and incoherent. Therefore, new multicentric studies in different countries are needed to better understand the role of CT scans in COVID-19 diagnosis. In this report, we will discuss the clinical relevance of each test and the current Centers for Disease Control and Prevention and American College of Radiology recommendations regarding the use of imaging in the diagnosis of COVID-19.


Anti-Asian sentiment in the United States - COVID-19 and history


Autoimmune and inflammatory diseases following COVID-19


How we have protected our patients: The Italian pediatric onco-hematology units' response to the COVID-19 pandemic


title: Observed and Potential Impacts of the COVID-19 Pandemic on the Environment

text: Various environmental factors influence the outbreak and spread of epidemic or even pandemic events which, in turn, may cause feedbacks on the environment. The novel coronavirus disease (COVID-19) was declared a pandemic on 13 March 2020 and its rapid onset, spatial extent and complex consequences make it a once-in-a-century global disaster. Most countries responded by social distancing measures and severely diminished economic and other activities. Consequently, by the end of April 2020, the COVID-19 pandemic has led to numerous environmental impacts, both positive such as enhanced air and water quality in urban areas, and negative, such as shoreline pollution due to the disposal of sanitary consumables. This study presents an early overview of the observed and potential impacts of the COVID-19 on the environment. We argue that the effects of COVID-19 are determined mainly by anthropogenic factors which are becoming obvious as human activity diminishes across the planet, and the impacts on cities and public health will be continued in the coming years.


title: Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV

text: Middle East respiratory syndrome coronavirus (MERS-CoV) is the causative agent of a severe respiratory disease associated with more than 2468 human infections and over 851 deaths in 27 countries since 2012. There are no approved treatments for MERS-CoV infection although a combination of lopinavir, ritonavir and interferon beta (LPV/RTV-IFNb) is currently being evaluated in humans in the Kingdom of Saudi Arabia. Here, we show that remdesivir (RDV) and IFNb have superior antiviral activity to LPV and RTV in vitro. In mice, both prophylactic and therapeutic RDV improve pulmonary function and reduce lung viral loads and severe lung pathology. In contrast, prophylactic LPV/RTV-IFNb slightly reduces viral loads without impacting other disease parameters. Therapeutic LPV/RTV-IFNb improves pulmonary function but does not reduce virus replication or severe lung pathology. Thus, we provide in vivo evidence of the potential for RDV to treat MERS-CoV infections.


COVID-19 pandemic: triage for intensive-care treatment under resource scarcity


Los servicios de urgencias y emergencias ante la pandemia por SARS-CoV-2./ Los servicios de urgencias y emergencias ante la pandemia por SARS-CoV-2./ Emergency services and the fight against the SARS-CoV-2 pandemic


title: Dementia care and COVID-19 pandemic: a necessary digital revolution

text: Due to the COVID-19 pandemic, most memory clinics have had to suspend their activities. On the other hand, international dementia experts have recommended to provide urgently worldwide support for people living with dementia. This situation urges to play out new strategies to guarantee adequate care. Telemedicine and digital technology (DT) devices, such as smartphones, can be very helpful in remote monitoring and care. Technological devices such as videoconference or smartphone apps might be used for follow-up visits and support to patients and caregivers and to acquire digital markers of clinical progression. Hopefully, this dramatic situation would facilitate the process of progressive familiarization of neurologists with telemedicine and DT approach.


COVID-19 and the General Surgical Department - Measures to Reduce Spread of SARS-COV-2 Among Surgeons


Re: Respirators and surgical facemasks for COVID-19: implications for MRI


title: Early CT Findings of Coronavirus Disease 2019 (COVID-19) in Asymptomatic Children: A Single-Center Experience

text: OBJECTIVE: The current study reported a case series to illustrate the early computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) in pediatric patients. MATERIALS AND METHODS: All pediatric patients who were diagnosed with COVID-19 and who underwent CT scan in Zhongnan Hospital of Wuhan University from January 20, 2020 to February 28, 2020 were included in the current study. Data on clinical and CT features were collected and analyzed. RESULTS: Four children were included in the current study. All of them were asymptomatic throughout the disease course (ranging from 7 days to 15 days), and none of them showed abnormalities in blood cell counts. Familial cluster was the main transmission pattern. Thin-section CT revealed abnormalities in three patients, and one patient did not present with any abnormal CT findings. Unilateral lung involvement was observed in two patients, and one patient showed bilateral lung involvement. In total, five small lesions were identified, including ground-glass opacity (n = 4) and consolidation (n = 1). All lesions had ill-defined margins with peripheral distribution and predilection of lower lobe. CONCLUSION: Small patches of ground-glass opacity with subpleural distribution and unilateral lung involvement were common findings on CT scans of pediatric patients in the early stage of the disease.


title: Serologic Detection of Middle East Respiratory Syndrome Coronavirus Functional Antibodies

text: We developed and validated 2 species-independent protein-based assays to detect Middle East respiratory syndrome coronavirus functional antibodies that can block virus receptor-binding or sialic acid-attachment. Antibody levels measured in both assays correlated strongly with virus-neutralizing antibody titers, proving their use for serologic confirmatory diagnosis of Middle East respiratory syndrome.


Initial Experience with a COVID-19 Web-Based Patient Self-assessment Tool


title: ISIDOG Recommendations Concerning COVID-19 and Pregnancy

text: Providing guidelines to health care workers during a period of rapidly evolving viral pandemic infections is not an easy task, but it is extremely necessary in order to coordinate appropriate action so that all patients will get the best possible care given the circumstances they are in. With these International Society of Infectious Disease in Obstetrics and Gynecology (ISIDOG) guidelines we aim to provide detailed information on how to diagnose and manage pregnant women living in a pandemic of COVID-19. Pregnant women need to be considered as a high-risk population for COVID-19 infection, and if suspected or proven to be infected with the virus, they require special care in order to improve their survival rate and the well-being of their babies. Both protection of healthcare workers in such specific care situations and maximal protection of mother and child are envisioned.


Humans, Viruses, and the Eye-An Early Report From the COVID-19 Front Line


title: Service Needs of Older Adults with Serious Mental Illness

text: The COVID-19 pandemic places older adults with serious mental illness with medical comorbidity at greater risk for poor physical and mental health outcomes. Social workers can play an important role in promoting well-being by working collaboratively with clients to address loneliness and to develop chronic disease self-management skills. Integration of physical and behavioral healthcare is even more essential now for promoting well-being among older adults with schizophrenia spectrum, bipolar, and major depressive disorders.


title: Recurrence in the evolution of air transport networks

text: Changes in air transport networks over time may be induced by competition among carriers, changes in regulations on airline industry, and socioeconomic events such as terrorist attacks and epidemic outbreaks. Such network changes may reflect corporate strategies of each carrier. In the present study, we propose a framework for analyzing evolution patterns in temporal networks in discrete time from the viewpoint of recurrence. Recurrence implies that the network structure returns to one relatively close to that in the past. We applied the proposed methods to four major carriers in the US from 1987 to 2019. We found that the carriers were different in terms of speed of network evolution, strength of periodicity, and changes in these quantities across decades. We also found that the network structure of the individual carriers abruptly changes from time to time. Such a network change reflects changes in their operation at their hub airports rather than famous socioeconomic events that look closely related to airline industry. The proposed methods are expected to be useful for revealing, for example, evolution of airline alliances and responses to natural disasters or infectious diseases, as well as characterizing evolution of social, biological, and other networks over time.


title: Distribution of graph-distances in Boltzmann ensembles of RNA secondary structures

text: Large RNA molecules often carry multiple functional domains whose spatial arrangement is an important determinant of their function. Pre-mRNA splicing, furthermore, relies on the spatial proximity of the splice junctions that can be separated by very long introns. Similar effects appear in the processing of RNA virus genomes. Albeit a crude measure, the distribution of spatial distances in thermodynamic equilibrium therefore provides useful information on the overall shape of the molecule can provide insights into the interplay of its functional domains. Spatial distance can be approximated by the graph-distance in RNA secondary structure. We show here that the equilibrium distribution of graph-distances between arbitrary nucleotides can be computed in polynomial time by means of dynamic programming. A naive implementation would yield recursions with a very high time complexity of O(n^11). Although we were able to reduce this to O(n^6) for many practical applications a further reduction seems difficult. We conclude, therefore, that sampling approaches, which are much easier to implement, are also theoretically favorable for most real-life applications, in particular since these primarily concern long-range interactions in very large RNA molecules.


title: COVID19: potential cardiovascular issues in pediatric patients

text: The novel severe acute respiratory syndrome coronavirus 2 (SARS-COV 2) has rapidly spread worldwide with increasing hospitalization and mortality rate. Ongoing studies and accumulated data are de- tailing the features and the effects of the new coronavirus disease 19 (COVID 19) in the adult population, and cardiovascular involvement is emerging as the most significant and life-threatening complication, with an in- creased risk of morbidity and mortality in patients with underlying cardiovascular disease. At present, though the limited data on the effects of COVID 19 in pediatric patients, children seem to count for a little proportion of SARS-COV 2 infection, and present with less severe disease and effects However infants and toddlers are at risk of developing critical course. The disease has a range of clinical presentations in children, for which the potential need for further investigation of myocardial injury and cardiovascular issues should be kept in mind to avoid misdiagnosing severe clinical entities. Overlapping with Kawasaki disease is a concern, particularly the incomplete and atypical form. We aim to summarize the initial considerations and potential cardiovascular implications of COVID-19 for children and patients with congenital heart disease.


title: Rapidly Deploying a Neural Search Engine for the COVID-19 Open Research Dataset: Preliminary Thoughts and Lessons Learned

text: We present the Neural Covidex, a search engine that exploits the latest neural ranking architectures to provide information access to the COVID-19 Open Research Dataset curated by the Allen Institute for AI. This web application exists as part of a suite of tools that we have developed over the past few weeks to help domain experts tackle the ongoing global pandemic. We hope that improved information access capabilities to the scientific literature can inform evidence-based decision making and insight generation. This paper describes our initial efforts and offers a few thoughts about lessons we have learned along the way.


Lung ultrasound in pregnant women with suspicion of COVID-19


World Federation for Ultrasound in Medicine and Biology Position Statement: How to Perform a Safe Ultrasound Examination and Clean Equipment in the Context of COVID-19


title: Evaluating Transmission Heterogeneity and Super-Spreading Event of COVID-19 in a Metropolis of China

text: COVID-19 caused rapid mass infection worldwide. Understanding its transmission characteristics, including heterogeneity and the emergence of super spreading events (SSEs) where certain individuals infect large numbers of secondary cases, is of vital importance for prediction and intervention of future epidemics. Here, we collected information of all infected cases (135 cases) between 21 January and 26 February 2020 from official public sources in Tianjin, a metropolis of China, and grouped them into 43 transmission chains with the largest chain of 45 cases and the longest chain of four generations. Utilizing a heterogeneous transmission model based on branching process along with a negative binomial offspring distribution, we estimated the reproductive number R and the dispersion parameter k (lower value indicating higher heterogeneity) to be 0.67 (95% CI: 0.54-0.84) and 0.25 (95% CI: 0.13-0.88), respectively. A super-spreader causing six infections was identified in Tianjin. In addition, our simulation allowing for heterogeneity showed that the outbreak in Tianjin would have caused 165 infections and sustained for 7.56 generations on average if no control measures had been taken by local government since 28 January. Our results highlighted more efforts are needed to verify the transmission heterogeneity of COVID-19 in other populations and its contributing factors.


title: Performance analysis of Zero Black-Derman-Toy interest rate model in catastrophic events: COVID-19 case study

text: In this paper we continue the research of our recent interest rate tree model called Zero Black-Derman-Toy (ZBDT) model, which includes the possibility of a jump at each step to a practically zero interest rate. This approach allows to better match to risk of financial slowdown caused by catastrophic events. We present how to valuate a wide range of financial derivatives for such a model. The classical Black-Derman-Toy (BDT) model and novel ZBDT model are described and analogies in their calibration methodology are established. Finally two cases of applications of the novel ZBDT model are introduced. The first of them is the hypothetical case of an S-shape term structure and decreasing volatility of yields. The second case is an application of the ZBDT model in the structure of United States sovereign bonds in the current $2020$ economic slowdown caused by the Coronavirus pandemic. The objective of this study is to understand the differences presented by the valuation in both models for different derivatives.


docid: fnedlhdy

title: Ventilator management in the age of COVID-19: response to "Logistic and organizational aspects of a dedicated intensive care unit for COVID-19 patients"


Coronavirus Disease 2019 as an Opportunity to Move toward Transdisciplinary Palliative Care


title: Deep Learning COVID-19 Features on CXR using Limited Training Data Sets

text: Under the global pandemic of COVID-19, the use of artificial intelligence to analyze chest X-ray (CXR) image for COVID-19 diagnosis and patient triage is becoming important. Unfortunately, due to the emergent nature of the COVID-19 pandemic, a systematic collection of CXR data set for deep neural network training is difficult. To address this problem, here we propose a patch-based convolutional neural network approach with a relatively small number of trainable parameters for COVID-19 diagnosis. The proposed method is inspired by our statistical analysis of the potential imaging biomarkers of the CXR radiographs. Experimental results show that our method achieves state-of-the-art performance and provides clinically interpretable saliency maps, which are useful for COVID-19 diagnosis and patient triage.


text: Under the global pandemic of COVID-19, the use of artificial intelligence to analyze chest X-ray (CXR) image for COVID-19 diagnosis and patient triage is becoming important. Unfortunately, due to the emergent nature of the COVID-19 pandemic, a systematic collection of the CXR data set for deep neural network training is difficult. To address this problem, here we propose a patch-based convolutional neural network approach with a relatively small number of trainable parameters for COVID-19 diagnosis. The proposed method is inspired by our statistical analysis of the potential imaging biomarkers of the CXR radiographs. Experimental results show that our method achieves state-of-the-art performance and provides clinically interpretable saliency maps, which are useful for COVID-19 diagnosis and patient triage.


title: CONTAIN: Privacy-oriented Contact Tracing Protocols for Epidemics

text: Pandemic and epidemic diseases such as CoVID-19, SARS-CoV2, and Ebola have spread to multiple countries and infected thousands of people. Such diseases spread mainly through person-to-person contacts. Health care authorities recommend contact tracing procedures to prevent the spread to a vast population. Although several mobile applications have been developed to trace contacts, they typically require collection of privacy-intrusive information such as GPS locations, and the logging of privacy-sensitive data on a third party server, or require additional infrastructure such as WiFi APs with known locations. In this paper, we introduce CONTAIN, a privacy-oriented mobile contact tracing application that does not rely on GPS or any other form of infrastructure-based location sensing, nor the continuous logging of any other personally identifiable information on a server. The goal of CONTAIN is to allow users to determine with complete privacy if they have been within a short distance, specifically, Bluetooth wireless range, of someone that is infected, and potentially also when. We identify and prove the privacy guarantees provided by our approach. Our simulation study utilizing an empirical trace dataset (Asturies) involving 100 mobile devices and around 60000 records shows that users can maximize their possibility of identifying if they were near an infected user by turning on the app during active times.


Letter to the Editor: Repurposing of an Antisepsis Drug in COVID-19 Patients


Decontamination of respirators in the covid-19 pandemic


Helen Salisbury: Battening down the hatches for a second wave


title: Controlling the COVID-19 Pandemic in Vietnam: Lessons From a Limited Resource Country

text: The lessons learned from Vietnam, a country that the world acclaimed for its management of the fight against COVID-19, could stand out as an example of how to do more with less. The Vietnamese government has acted swiftly at the very early stage of the pandemic with a focus on containment efforts and extensive public health measures, particularly (1) the commitment from the government with a multisectoral approach; (2) a timely, accurate, and transparent risk communication; (3) active surveillance and intensive isolation/quarantine operation, case management with tracing all new arrivals and close contact up to 3 clusters; and (4) suspension of flights, shutting schools, and all nonessential services.


title: Dynamic Graph Streaming Algorithm for Digital Contact Tracing

text: Digital contact tracing of an infected person, testing the possible infection for the contacted persons, and isolation play a crucial role in alleviating the outbreak. Here, we design a dynamic graph streaming algorithm that can trace the contacts under the control of the Public Health Authorities (PHA). The algorithm can work as the augmented part of the PHA for the crisis period. Our algorithm receives proximity data from the mobile devices as contact data streams and uses a sliding window model to construct a dynamic contact graph sketch. Prominently, we introduce the edge label of the contact graph as a contact vector, which acts like a sliding window and holds the latest D days of social interactions. Importantly, the algorithm prepares the direct and indirect (multilevel) contact list from the contact graph sketch for a given set of infected persons. The algorithm also uses a disjoint set data structure to construct the infectious trees for the trace list. The present study offers the design of algorithms with underlying data structures for digital contact trace relevant to the proximity data produced by Bluetooth enabled mobile devices. Our analysis reveals that for COVID-19 close contact parameters, the storage space requires maintaining the contact graph of ten million users having 14 days close contact data in PHA server takes 55 Gigabytes of memory and preparation of the contact list for a given set of the infected person depends on the size of the infected list.


The emergency department in the COVID-19 era. Who are we missing?


title: Recommendations for the use of radiation therapy in managing patients with gastrointestinal malignancies in the era of COVID-19

text: As of April 6, 2020, there are over 1,200,000 reported cases and 70,000 deaths worldwide due to COVID-19, the disease caused by the SARS-CoV-2 virus, and these numbers rise exponentially by the day [1]. According to the Centers for Disease Control (CDC), the most effective means of minimizing the spread of the virus is through reducing interactions between individuals [2]. We performed a review of the literature, as well as national and international treatment guidelines, seeking data in support of the RADS principle (Remote visits, Avoid radiation, Defer radiation, Shorten radiation) [3] as it applies to gastrointestinal cancers. The purpose of the present work is to guide radiation oncologists managing patients with gastrointestinal cancers during the COVID-19 crisis in order to maintain the safety of our patients, while minimizing the impact of the pandemic on cancer outcomes.


title: The CoV-2 outbreak: how hematologists could help to fight Covid-19

text: COVID-19 is a medical emergency, with 20 % of patients presenting with severe clinical manifestations. From the pathogenetic point of view, COVID-19 mimics two other well-known diseases characterized by cytokine storm and hyper-activation of the immune response, with consequent organ damage: acute graft-versus-host disease (aGVHD) and macrophage activation syndrome (MAS). Hematologists are confident with these situations requiring a prompt therapeutic approach for switching off the uncontrolled cytokine release; here, we discuss pros and cons of drugs that are already employed in hematology in the light of their possible application in COVID-19. The most promising drugs might be: Ruxolitinib, a JAK1/2 inhibitor, with a rapid and powerful anti-cytokine effect, tyrosine kinase inhibitors (TKIs), with their good anti-inflammatory properties, and perhaps the anti-Cd26 antibody Begelomab. We also present immunological data from gene expression experiments where TKIs resulted effective anti-inflammatory and pro-immune drugs. A possible combined treatment algorithm for COVID-19 is here proposed.


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title: COVID-19 Anosmia Reporting Tool: Initial Findings

text: There is accumulating anecdotal evidence that anosmia and dysgeusia are associated with the COVID-19 pandemic. To investigate their relationship to SARS-CoV2 infection, the American Academy of Otolaryngology-Head and Neck Surgery developed the COVID-19 Anosmia Reporting Tool for Clinicians for the basis of this pilot study. This tool allows health care providers to confidentially submit cases of anosmia and dysgeusia related to COVID-19. We analyzed the first 237 entries, which revealed that anosmia was noted in 73% of patients prior to COVID-19 diagnosis and was the initial symptom in 26.6%. Some improvement was noted in 27% of patients, with a mean time to improvement of 7.2 days in this group (85% of this group improved within 10 days). Our findings suggest that anomia can be a presenting symptom of COVID-19, consistent with other emerging international reports. Anosmia may be critical in timely identification of individuals infected with SARS-CoV2 who may be unwittingly transmitting the virus.


title: Heterogeneous mental health consequences of COVID-19: Costs and benefits

text: In this commentary, I argue that the mental health impact of COVID-19 will show substantial variation across individuals, contexts, and time. Further, one key contributor to this variation will be the proximal and long-term impact of COVID-19 on the social environment. In addition to the mental health costs of the pandemic, it is likely that a subset of people will experience improved social and mental health functioning. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


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title: Alone Together in Our Fear: Perspectives From the Early Days of Lockdown Due to COVID-19


title: Has COVID-19 played an unexpected "stroke" on the chain of survival?

text: BACKGROUND: The COVID-19 pandemics required several changes in stroke management and it may have influenced some clinical or functional characteristics. We aimed to evaluate the effects of the COVID-19 pandemics on stroke management during the first month of Italy lockdown. In addition, we described the emergency structured pathway adopted by an Italian University Hub Stroke Unit in the cross-border Italy-Slovenia area. METHODS: We analyzed admitted patients' clinical features and outcomes between 9th March 2020 and 9th April 2020 (first month of lockdown), and compared them with patients admitted during the same period in 2019. RESULTS: Total admissions experienced a reduction of 45% during the lockdown compared to the same period in 2019 (16 vs 29, respectively), as well as a higher prevalence of severe stroke (NIHSS>10) at admission (n = 8, 50% vs n = 8, 28%). A dramatic prevalence of stroke of unknown symptom onset was observed in 2020 (n = 8, 50% vs n = 3, 10%). During lockdown, worse functional and independence outcomes were found, despite the similar proportion of reperfused patients. Similar 'symptoms alert-to-admission' and 'door-to-treatment' times were observed. During lockdown hospitalization was shorter and fewer patients completed the stroke work-up. CONCLUSION: In conclusion, the adopted strategies for stroke management during the COVID-19 emergency have suggested being effective, while suffering a reduced and delayed reporting of symptoms. Therefore, we recommend raising awareness among the population against possible stroke symptoms onset. Thus, think F.A.S.T. and do not stay-at-home at all costs.


Covid-19: NHS leaders braced for longer waiting times as service deals with fallout


Rehab facilities face COVID-19 crunch as more patients recover


title: Robustification of Elliott's on-line EM algorithm for HMMs

text: In this paper, we establish a robustification of an on-line algorithm for modelling asset prices within a hidden Markov model (HMM). In this HMM framework, parameters of the model are guided by a Markov chain in discrete time, parameters of the asset returns are therefore able to switch between different regimes. The parameters are estimated through an on-line algorithm, which utilizes incoming information from the market and leads to adaptive optimal estimates. We robustify this algorithm step by step against additive outliers appearing in the observed asset prices with the rationale to better handle possible peaks or missings in asset returns.


Syringe services program (SSP) operational changes during the COVID-19 global outbreak


title: Effects of weather and policy intervention on COVID-19 infection in Ghana

text: Even though laboratory and epidemiological studies have demonstrated the effects of ambient temperature on the transmission and survival of coronaviruses, not much has been done on the effects of weather on the spread of COVID-19. This study investigates the effects of temperature, humidity, precipitation, wind speed and the specific government policy intervention of partial lockdown on the new cases of COVID-19 infection in Ghana. Daily data on confirmed cases of COVID-19 from March 13, 2020 to April 21, 2020 were obtained from the official website of Our World in Data (OWID) dedicated to COVID-19 while satellite climate data for the same period was obtained from the official website of NASA's Prediction of Worldwide Energy Resources (POWER) project. Considering the nature of the data and the objectives of the study, a time series generalized linear model which allows for regressing on past observations of the response variable and covariates was used for model fitting. The results indicate significant effects of maximum temperature, relative humidity and precipitation in predicting new cases of the disease. Also, results of the intervention analysis indicate that the null hypothesis of no significant effect of the specific policy intervention of partial lockdown should be rejected (p-value=0.0164) at a 5\% level of significance. These findings provide useful insights for policymakers and the public.