title: Global Short-Term Forecasting of Covid-19 Cases

text: The continuously growing number of COVID-19 cases pressures healthcare services worldwide. Accurate short-term forecasting is thus vital to support country-level policy making. The strategies adopted by countries to combat the pandemic vary, generating different uncertainty levels about the actual number of cases. Accounting for the hierarchical structure of the data and accommodating extra-variability is therefore fundamental. We introduce a new modelling framework to describe the course of the pandemic with great accuracy, and provide short-term daily forecasts for every country in the world. We show that our model generates highly accurate forecasts up to six days ahead, and use estimated model components to cluster countries based on recent events. We introduce statistical novelty in terms of modelling the autoregressive parameter as a function of time, increasing predictive power and flexibility to adapt to each country. Our model can also be used to forecast the number of deaths, study the effects of covariates (such as lockdown policies), and generate forecasts for smaller regions within countries. Consequently, it has strong implications for global planning and decision making. We constantly update forecasts and make all results freely available to any country in the world through an online Shiny dashboard.


COVID and the convergence of three crises in Europe


title: Transfer Learning or Self-supervised Learning? A Tale of Two Pretraining Paradigms

text: Pretraining has become a standard technique in computer vision and natural language processing, which usually helps to improve performance substantially. Previously, the most dominant pretraining method is transfer learning (TL), which uses labeled data to learn a good representation network. Recently, a new pretraining approach -- self-supervised learning (SSL) -- has demonstrated promising results on a wide range of applications. SSL does not require annotated labels. It is purely conducted on input data by solving auxiliary tasks defined on the input data examples. The current reported results show that in certain applications, SSL outperforms TL and the other way around in other applications. There has not been a clear understanding on what properties of data and tasks render one approach outperforms the other. Without an informed guideline, ML researchers have to try both methods to find out which one is better empirically. It is usually time-consuming to do so. In this work, we aim to address this problem. We perform a comprehensive comparative study between SSL and TL regarding which one works better under different properties of data and tasks, including domain difference between source and target tasks, the amount of pretraining data, class imbalance in source data, and usage of target data for additional pretraining, etc. The insights distilled from our comparative studies can help ML researchers decide which method to use based on the properties of their applications.


Management of patients with hidradenitis suppurativa during the COVID-19 pandemic


Management of patients with Hidradenitis Suppurativa during the COVID-19 pandemic


title: Crystallization and Structural Determination of the Receptor-Binding Domain of MERS-CoV Spike Glycoprotein

text: Three-dimensional structures of the receptor-binding domain (RBD) of MERS-CoV spike glycoprotein bound to cellular receptor and monoclonal antibodies (mAbs) have been determined by X-ray crystallography, providing structural information about receptor recognition and neutralizing mechanisms of mAbs at the atomic level. In this chapter, we describe the purification, crystallization, and structure determination of the MERS-CoV RBD.


title: Social Distancing and Incarceration: Policy and Management Strategies to Reduce COVID-19 Transmission and Promote Health Equity Through Decarceration

text: Incarcerated people are at disproportionately high risk of contracting COVID-19. Prisons are epicenters for COVID-19 transmission, including to the community. High rates of preexisting health conditions, limited access to quality health care, and inability to social distance make it impossible to reduce the impact of COVID-19 in prisons. Due to a history of compounded social determinants, incarcerated populations are disproportionately composed of people of color and people with stigmatized behavioral health disorders. Rapid decarceration is needed to promote health equity. Historical mass decarceration events demonstrate feasibility to rapidly release large groups of people while maintaining public safety. Iran and Ireland have released substantial portions of their prison populations by transitioning people to home confinement. In the United States and Uganda, some jurisdictions have reduced new incarcerations through policies that decrease arrests. These policies must be globally expanded to contain the epidemic, and its potential health consequences, while addressing health equity.


title: Identifying and managing osteoporosis before and after COVID-19: rise of the remote consultation?

text: The COVID-19 pandemic is influencing methods of healthcare delivery. In this short review, we discuss the evidence for remote healthcare delivery in the context of osteoporosis. INTRODUCTION: The COVID-19 pandemic has undoubtedly had, and will continue to have, a significant impact on the lives of people living with, and at risk of, osteoporosis and those caring for them. With osteoporosis outpatient and Fracture Liaison Services on pause, healthcare organisations have already moved to delivering new and follow-up consultations remotely, where staffing permits, by telephone or video. METHODS: In this review, we consider different models of remote care delivery, the evidence for their use, and the possible implications of COVID-19 on osteoporosis services. RESULTS: Telemedicine is a global term used to describe any use of telecommunication systems to deliver healthcare from a distance and encompasses a range of different scenarios from remote clinical data transfer to remote clinician-patient interactions. Across a range of conditions and contexts, there remains unclear evidence on the acceptability of telemedicine and the effect on healthcare costs. Within the context of osteoporosis management, there is some limited evidence to suggest telemedicine approaches are acceptable to patients but unclear evidence on whether telemedicine approaches support informed drug adherence. Gaps in the evidence pertain to the acceptability and benefits of using telemedicine in populations with hearing, cognitive, or visual impairments and in those with limited health literacy. CONCLUSION: There is an urgent need for further health service evaluation and research to address the impact of remote healthcare delivery during COVID-19 outbreak on patient care, and in the longer term, to identify acceptability and cost- and clinical-effectiveness of remote care delivery on outcomes of relevance to people living with osteoporosis.


The Italian NHS: What Lessons to Draw from COVID-19?


Hydroxychloroquine: A Potential Ethical Dilemma for Rheumatologists during the COVID-19 Pandemic


Testing animals for SARS-CoV-2


Coronavirus Disease 2019 Coagulopathy: Disseminated Intravascular Coagulation and Thrombotic Microangiopathy-Either, Neither, or Both


title: Autoregressive Mixture Models for Serial Correlation Clustering of Time Series Data

text: Clustering individuals into similar groups in longitudinal studies can improve time series models by combining information across like individuals. While there is a well developed literature for clustering of time series, these approaches tend to generate clusters independently of the model training procedure which can lead to poor model fit. We propose a novel method that simultaneously clusters and fits autoregression models for groups of similar individuals. We apply a Wishart mixture model so as to cluster individuals while modeling the corresponding autocorrelation matrices at the same time. The fitted Wishart scale matrices map to cluster-level autoregressive coefficients through the Yule-Walker equations, fitting robust parsimonious autoregressive mixture models. This approach is able to discern differences in underlying serial variation of time series while accounting for an individual's intrinsic variability. We prove consistency of our cluster membership estimator and compare our approach against competing methods through simulation as well as by modeling regional COVID-19 infection rates.


title: Chloroquine and Hydroxychloroquine for the Prevention or Treatment of COVID-19 in Africa: Caution for Inappropriate Off-label Use in Healthcare Settings

text: The novel severe acute respiratory syndrome-coronavirus-2 pandemic has spread to Africa, where nearly all countries have reported laboratory-confirmed cases of novel coronavirus disease (COVID-19). Although there are ongoing clinical trials of repurposed and investigational antiviral and immune-based therapies, there are as yet no scientifically proven, clinically effective pharmacological treatments for COVID-19. Among the repurposed drugs, the commonly used antimalarials chloroquine (CQ) and hydroxychloroquine (HCQ) have become the focus of global scientific, media, and political attention despite a lack of randomized clinical trials supporting their efficacy. Chloroquine has been used worldwide for about 75 years and is listed by the WHO as an essential medicine to treat malaria. Hydroxychloroquine is mainly used as a therapy for autoimmune diseases. However, the efficacy and safety of CQ/HCQ for the treatment of COVID-19 remains to be defined. Indiscriminate promotion and widespread use of CQ/HCQ have led to extensive shortages, self-treatment, and fatal overdoses. Shortages and increased market prices leave all countries vulnerable to substandard and falsified medical products, and safety issues are especially concerning for Africa because of its healthcare system limitations. Much needed in Africa is a cross-continental collaborative network for coordinated production, distribution, and post-marketing surveillance aligned to low-cost distribution of any approved COVID-19 drug; this would ideally be piggybacked on existing global aid efforts. Meanwhile, African countries should strongly consider implementing prescription monitoring schemes to ensure that any off-label CQ/HCQ use is appropriate and beneficial during this pandemic.


title: Inf-Net: Automatic COVID-19 Lung Infection Segmentation from CT Images

text: Coronavirus Disease 2019 (COVID-19) spread globally in early 2020, causing the world to face an existential health crisis. Automated detection of lung infections from computed tomography (CT) images offers a great potential to augment the traditional healthcare strategy for tackling COVID-19. However, segmenting infected regions from CT slices faces several challenges, including high variation in infection characteristics, and low intensity contrast between infections and normal tissues. Further, collecting a large amount of data is impractical within a short time period, inhibiting the training of a deep model. To address these challenges, a novel COVID-19 Lung Infection Segmentation Deep Network (Inf-Net) is proposed to automatically identify infected regions from chest CT slices. In our Inf-Net, a parallel partial decoder is used to aggregate the high-level features and generate a global map. Then, the implicit reverse attention and explicit edge-attention are utilized to model the boundaries and enhance the representations. Moreover, to alleviate the shortage of labeled data, we present a semi-supervised segmentation framework based on a randomly selected propagation strategy, which only requires a few labeled images and leverages primarily unlabeled data. Our semi-supervised framework can improve the learning ability and achieve a higher performance. Extensive experiments on our COVID-SemiSeg and real CT volumes demonstrate that the proposed Inf-Net outperforms most cutting-edge segmentation models and advances the state-of-the-art performance.


title: Hypoxemia in COVID-19; Comment on: "The neuroinvasive potential of SARS - CoV2 may play a role in the respiratory failure of COVID-19 patients"

text: Patients with coronavirus disease 2019 (COVID-19) seldom complain of dyspnea. It has been suggested that the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) targets the brainstem and plays a role COVID-19 respiratory failure. We hypothesise that asymptomatic hypoxemia presented by COVID-19 patients with severe pneumonia is related to a dysfunction of cortical rather than of subcortical structures, and is linked to SARS-CoV-2 neuroinvasiveness. This article is protected by copyright. All rights reserved.


Hydroxychloroquine and ritonavir for COVID-19 infection: a possible synergic toxicity for retinal pigmented epithelium


title: Containing COVID-19 outside the isolation ward: the impact of an infection control bundle on environmental contamination and transmission in a cohorted general ward

text: BACKGROUND: During an ongoing outbreak of COVID-19, unsuspected cases may be housed outside of dedicated isolation wards. AIM: At a Singaporean tertiary hospital, individuals with clinical syndromes compatible with COVID-19 but no epidemiologic risk were placed in cohorted general wards for COVID-19 testing. To mitigate risk, an infection control bundle was implemented comprising infrastructural enhancements, improved personal-protective-equipment (PPE), and social distancing. We assessed the impact on environmental contamination and transmission. METHOD: Upon detection of a case of COVID-19 in the dedicated general ward, patients and healthcare workers (HCWs) contacts were identified. All patient and staff-close contacts were placed on 14-day phone surveillance and followed-up for 28 days; symptomatic contacts were tested. Environmental samples were also obtained. FINDINGS: Over a 3-month period, 28 unsuspected cases of COVID-19 were contained in the dedicated general ward. In 5 of the 28 cases, sampling of the patient's environment yielded SARS-CoV-2; index cases who required supplemental oxygen had higher odds of environmental contamination (p=0.01). A total of 253 staff close-contacts and 45 patient close-contacts were identified; only 3 HCWs (1.2%, 3/253) required quarantine. On 28-day follow-up, no patient-to-HCW transmission was documented; only one symptomatic patient close-contact tested positive. CONCLUSION: Our institution successfully implemented an intervention bundle to mitigate COVID-19 transmission in a multi-bedded cohorted general ward setting.


False negative of RT-PCR and prolonged nucleic acid conversion in COVID-19: Rather than recurrence


title: Are single-donor red blood cell transfusions still relevant for preterm infants?

text: OBJECTIVE: To explore the worth of a single-donor program for preterm infants through the recipient profile and the impact on donor exposure, red blood cell (RBC) pack waste, storage duration, and transfusion performance. STUDY DESIGN: Patients and transfusion characteristics were collected for 3 years (2015-2017) in preterm infants according to single-donor program prescription in a unit not practicing placental transfusion or erythropoietin supplementation. RESULTS: Among 1048 eligible preterm infants, 161 met the inclusion criteria, and 51 received single-donor packs. Our single-donor program induced a donor number reduction (34% less than the transfusion number) and an extension of storage duration (median: 9 versus 7 days, p < 0.0001) without altering the transfusion performance. However, 41% of small packs were not used. CONCLUSION: A single-donor program partially reduced donor exposure but led to drastic RBC pack waste. Optimization of transfusion alternatives may increase this phenomenon, calling into question the rationale of this practice.


Unequal Distribution of COVID-19 Risk Among Rural Residents by Race and Ethnicity


title: Infección por SARS-CoV2 en pacientes con trasplante de órgano sólido: Cinco preguntas importantes

text: Es grande la expectativa que genera en todos los servicios de salud del mundo la rápida expansión del SARS-CoV2 (Coronavirus 2 del Síndrome Respiratorio Agudo y Grave), agente etiológico de la Enfermedad Infec-ciosa por Coronavirus del año 2019, COVID-19 Por tratarse de una enfermedad emergente es poco lo que se conoce sobre su comportamiento en los humanos, lo que lleva a múltiples interrogantes al momento de tomar decisiones en la práctica clínica Hasta el momento, las estrategias para enfrentar esta pandemia se basan en la experiencia de los países que han sido epicentro del brote infeccioso y en la evidencia recopilada durante el manejo de otros coronavirus en años anteriores (SARS-CoV en el año 2002 y MERS-CoV en 2012) La falta de información contundente y unificada ha dado lugar a especulaciones y a suposiciones, especialmente relacionadas con la atención del COVID-19 en poblaciones consideradas de alto riesgo, como son los pacientes crónicamente inmunosuprimidos postrasplante A través de esta revisión narrativa de la literatura, más allá de dar la opinión de los autores, se pretende organizar de manera juiciosa los documentos hasta el momento publicados, y responder, basados en datos reales, cinco de las preguntas más importantes que surgen en el día a día durante el manejo de los pacientes trasplantadosThere is a high expectation generated by the rapid expansion of SARS-CoV2 (Severe Acute Respira-tory Syndrome related to Coronavirus 2), which is the etiological agent of the Coronavirus Infectious Disease 2019, COVID-19 As an emerging disease, little is known about its behavior in humans, which generates multiple questions when making decisions in clinical practice So far, the strategies to face this pandemic are based on the experience of the countries that have been the epicenter of the infectious outbreak and on the evidence collected during the management of other past coronavirus infections such as (SARS-CoV in 2002 and MERS-CoV in 2012) The lack of unified and robust information has given rise to speculation and assumptions primarily related to the care and management of COVID-19 in populations considered at high risk of infection, such as chronically immunosuppressed patients after transplantation Beyond giving the opinion from the authors, this narrative review tries to organize the documents published so far and to answer five of the most critical questions that arise every day during the management of transplant patients based on real data


title: Safety, Tolerability, and Pharmacokinetics of Remdesivir, an Antiviral for Treatment of COVID-19, in Healthy Subjects

text: Remdesivir (RDV), a single diastereomeric monophosphoroamidate prodrug that inhibits viral RNA polymerases, has potent in vitro antiviral activity against SARS-CoV2. RDV received FDA's emergency use authorization in United States and approval in Japan for treatment of severe COVID-19 patients. This report describes two phase 1 studies that evaluated the safety and pharmacokinetics (PK) of single escalating and multiple intravenous (IV) doses of RDV (solution or lyophilized formulation) in healthy subjects. Lyophilized formulation was evaluated for potential future use in clinical trials due to its storage stability in resource-limited settings. All adverse events were Grade 1 or 2 in severity. Overall, RDV exhibited a linear profile following single-dose IV administration over 2 hours of RDV solution formulation across the dose range of 3 to 225mg. Both lyophilized and solution formulations provided comparable PK parameters. High intracellular concentrations of the active triphosphate (approximately 220 to 370- fold higher than the in vitro EC50 against SARS-CoV-2 clinical isolate) were achieved following infusion of 75 mg or 150 mg lyophilized formulation over 30 minutes or 2 hours. Following multiple-doses of RDV 150mg once daily for 7 or 14 days, RDV exhibited a PK profile similar to single-dose administration. Metabolite GS-441524 accumulated approximately 1.9-fold after daily dosing. Overall, RDV exhibited favorable safety and PK profiles that supported once-daily dosing.


Beat COVID-19 through innovation


title: Centralized medical quarantine for imported COVID-19 in Shanghai, China

text: A mandatory 14-day 'centralized medical quarantine' has been instituted in Shanghai, China, to prevent secondary transmission of imported COVID-19. Here we summarize our experiences and describe the work flow and disinfection measures in our quarantine centre.


Full spectrum of COVID-19 severity still being depicted


Advances in the relationship between coronavirus infection and coagulation function


title: Studies of Novel Coronavirus Disease 19 (COVID-19) Pandemic: A Global Analysis of Literature

text: Novel coronavirus disease 19 (COVID-19) is a global threat to millions of lives. Enormous efforts in knowledge production have been made in the last few months, requiring a comprehensive analysis to examine the research gaps and to help guide an agenda for further studies. This study aims to explore the current research foci and their country variations regarding levels of income and COVID-19 transmission features. This textual analysis of 5780 publications extracted from the Web of Science, Medline, and Scopus databases was performed to explore the current research foci and propose further research agenda. The Latent Dirichlet allocation was used for topic modeling. Regression analysis was conducted to examine country variations in the research foci. Results indicate that publications are mainly contributed by the United States, China, and European countries. Guidelines for emergency care and surgical, viral pathogenesis, and global responses in the COVID-19 pandemic are the most common topics. There is variation in the research approaches to mitigate COVID-19 problems in countries with different income and transmission levels. Findings highlighted the need for global research collaborations among high- and low/middle-income countries in the different stages of pandemic prevention and control.


title: Bioactive compounds from marine resources against novel corona virus (2019-nCoV): in silico study for corona viral drug

text: Present research reports the molecular docking analysis of 2019-nCoV inhibition by antiviral compounds from marine natural resources. For this study, the structure of ligand (antiviral compound) and 2019-nCoV main protease (Mpro) was received from the databases of PubChem and Protein Data Bank (PDB), respectively. Molecular Docking was performed by Autodock version 4.2.6 software. Eight antiviral compounds identified showed inhibitory activities against novel 2019-nCoV protease. Of these compounds, Esculetin ethyl ester (-8.42 kcal/mol) from Marine Sponges Axinella cf. corrugata, has the strongest interaction with the protease enzyme of 2019-nCoV and it may be considered as an effective 2019-nCoV antiprotease drug.


title: Impact of quarantine due to COVID infection on migraine: a survey in Genova, Italy

text: Quarantine is a well-known risk factor for psychological and psychiatric disturbances. We evaluated burden of migraine during lockdown due to COVID 19 pandemia. Forty-nine subjects followed in our headache clinic for migraine were evaluated for migraine burden by means of global assessment of migraine severity (GAMS) and visual analogue scale (VAS) by phone interview. Moreover, depression and anxiety were quantified by Beck depression inventory (BDI) and Zung Self-Rating Anxiety Scale (SAS). We evaluated changes in the value of migraine score from the 2 months immediately before lockdown (from January 1 to March 9) to the 2 months of quarantine (from March 10 to May 3). Value of GAMS was 5.61 ± 0.76 before and 4.16 ± 1.46 during quarantine (p < .001). VAS was 7.49 ± 1.10 before and 5.47 ± 1.88 during quarantine (p < .001). We also found a time by depression level interaction, F(1,47) = 6.21, p = .016, F(1,47) = 14.52, p < .006, respectively, showing that subjects with lower level of depression had better course of migraine. In conclusion, we showed that, during quarantine due to COVID pandemia, subjects with migraine had fewer migraine attacks and lesser pain and show moderate level of depression, correlated to migraine burden.


title: Exploring the roles of high-speed train, air and coach services in the spread of COVID-19 in China

text: To understand the roles of different transport modes in the spread of COVID-19 pandemic across Chinese cities, this paper looks at the factors influencing the number of imported cases from Wuhan and the spread speed and pattern of the pandemic. We find that frequencies of air flights and high-speed train (HST) services out of Wuhan are significantly associated with the number of COVID-19 cases in the destination cities. The presence of an airport or HST station at a city is significantly related to the speed of the pandemic spread, but its link with the total number of confirmed cases is weak. The farther the distance from Wuhan, the lower number of cases in a city and the slower the dissemination of the pandemic. The longitude and latitude coordinates do not have a significant relationship with the number of total cases but can increase the speed of the COVID-19 spread. Specifically, cities in the higher longitudinal region tended to record a COVID-19 case earlier than their counterparties in the west. Cities in the north were more likely to report the first case later than those in the south. The pandemic may emerge in large cities earlier than in small cities as GDP is a factor positively associated with the spread speed.


Neuropathological Features of Covid-19


title: COVID-19 Is Distinct From SARS-CoV-2-Negative Community-Acquired Pneumonia

text: Background: Corona virus disease (COVID-19) is an infectious respiratory disease that has spread rapidly across the world. Many studies have already evaluated the clinical features of COVID-19, but how it compares with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative community-acquired pneumonia (SN-CAP) is still unclear. Moreover, COVID-19 mortality is correlated with disease severity, but indicators for severity grading have not been specified. We aimed to analyze the clinical characteristics of COVID-19 in comparison with SN-CAP and find indicators for disease severity in COVID-19. Methods: Patients diagnosed with COVID-19 and SN-CAP were enrolled. Clinical, radiological, and laboratory data were analyzed. Results: The numbers of COVID-19 and SN-CAP patients enrolled were 304 and 138, respectively. The age of the patients was not significantly different between the groups. Compared with SN-CAP, COVID-19 patients had more symptoms of fever and dyspnea; and showed significant difference in blood count results. Computed tomography (CT) imaging of COVID-19 patients showed patchy ground-glass opacities that correlated with disease severity, whereas the CT imaging of SN-CAP patients showed patchy high-density shadows. COVID-19 patients were classified into moderate, severe, and critically severe groups. The severe and critically severe groups had elevated levels of white blood cells (WBC), neutrophils, platelets, C-reaction protein (CRP), lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), troponin-I, creatinine, and blood urea nitrogen (BUN). However, they had decreased levels of lymphocytes, lymphocyte ratio, and albumin. Compared with the younger patients, the older COVID-19 individuals had more chronic diseases and significantly elevated levels of WBC, neutrophil, and CRP levels. Conclusion: SN-CAP showed more inflammatory reaction than COVID-19. Old people with chronic diseases are more susceptible to COVID-19 and have a high likelihood of developing severe and critically severe infection. Levels of WBC, lymphocytes, neutrophils, CRP, NLR, PLR, troponin-I, creatinine, and BUN are important indicators for severity grading in COVID-19.


title: A Multibasic Cleavage Site in the Spike Protein of SARS-CoV-2 Is Essential for Infection of Human Lung Cells

text: The pandemic coronavirus SARS-CoV-2 threatens public health worldwide. The viral spike protein mediates SARS-CoV-2 entry into host cells and harbors a S1/S2 cleavage site containing multiple arginine residues (multibasic) not found in closely related animal coronaviruses. However, the role of this multibasic cleavage site in SARS-CoV-2 infection is unknown. Here, we report that the cellular protease furin cleaves the spike protein at the S1/S2 site and that cleavage is essential for S-protein-mediated cell-cell fusion and entry into human lung cells. Moreover, optimizing the S1/S2 site increased cell-cell, but not virus-cell, fusion, suggesting that the corresponding viral variants might exhibit increased cell-cell spread and potentially altered virulence. Our results suggest that acquisition of a S1/S2 multibasic cleavage site was essential for SARS-CoV-2 infection of humans and identify furin as a potential target for therapeutic intervention.


IJCARS - IPCAI 2020 special issue: 11th conference on information processing for computer-assisted interventions - part 1


title: The Future of Bioethics: It Shouldn't Take a Pandemic

text: The Covid-19 pandemic has concentrated bioethics attention on the "lifeboat ethics" of rationing and fair allocation of scarce medical resources, such as testing, intensive care unit beds, and ventilators. This focus drives ethics resources away from persistent and systemic problems-in particular, the structural injustices that give rise to health disparities affecting disadvantaged communities of color. Bioethics, long allied with academic medicine and highly attentive to individual decision-making, has largely neglected its responsibility to address these difficult "upstream" issues. It is time to broaden our teaching, research, and practice to match the breadth of the field in order to help address these significant societal inequities and unmet health needs.


A hybrid approach to tracheostomy in COVID-19 patients ensuring staff safety


Crisis Standard of Care: Management of Infantile Spasms during COVID-19


Get the facts first


title: Novel coronavirus disease pandemic and ophthalmologist's perspectives

text: Ophthalmologists are among those healers facing a higher risk of acquiring novel coronavirus disease 2019, called COVID-19, during their professional duties since they have close physical contact with their patients. Some patients with COVID-19 may present with or may develop conjunctivitis during the course of the illness. The ocular secretions and tears have been identified to have positive results to COVID-19 tests and as such could be a source of spread. This review aims at providing the useful guidelines to ophthalmic professionals for their own safety, and safety of their patients based on the available current literature, and also based on personal experience and observations. Literature search was made on PubMed for COVID-19 in relation to ophthalmology in the limited period of the last quarter of 2019 and first quarter of 2020. Research also included access to current guidelines published by various ophthalmic societies. Accordingly, present and future ophthalmic practice patterns need to be modified.


title: Protecting prone positioned patients from facial pressure ulcers using prophylactic dressings: A timely biomechanical analysis in the context of the COVID-19 pandemic

text: Prone positioning is used for surgical access and recently in exponentially growing numbers of coronavirus disease 2019 patients who are ventilated prone. To reduce their facial pressure ulcer risk, prophylactic dressings can be used; however, the biomechanical efficacy of this intervention has not been studied yet. We, therefore, evaluated facial soft tissue exposures to sustained mechanical loads in a prone position, with versus without multi-layered silicone foam dressings applied as tissue protectors at the forehead and chin. We used an anatomically realistic validated finite element model of an adult male head to determine the contribution of the dressings to the alleviation of the sustained tissue loads. The application of the dressings considerably relieved the tissue exposures to loading. Specifically, with respect to the forehead, the application of a dressing resulted in 52% and 71% reductions in soft tissue exposures to effective stresses and strain energy densities, respectively. Likewise, a chin dressing lowered the soft tissue exposures to stresses and strain energy densities by 78% and 92%, respectively. While the surgical context is clear and there is a solid, relevant need for biomechanical information regarding prophylaxis for the prone positions, the projected consequences of the coronavirus pandemic make the present work more relevant than ever before.


title: Clinical features of familial clustering in patients infected with 2019 novel coronavirus in Wuhan, China

text: An epidemic caused by SARS-Coronavirus-2 (SARS-CoV-2) infection has appeared in Wuhan City in December 2019. The disease has shown a "clustering epidemic" pattern, and family-clustered onset has been the main characteristic. We collected data about 130 cases from 35 cluster-onset families (COFs) and 41 cases from 16 solitary-onset families (SOFs). The incidence of 2019 coronavirus disease (COVID-19) in COFs was significantly higher than that of SOFs. Our study also showed that patients with exposure to high-risk factors (respiratory droplets and close contact), advanced age, and comorbidities were more likely to develop COVID-19 in the COFs. In addition, advanced age and elevated neutrophil/lymphocyte ratio (NLR) were risk factors for death in patients with SARS-CoV-2 infection in the COFs.


What Is the Role of Angiotensin-Converting Enzyme 2 (ACE2) in COVID-19 Infection in Hypertensive Patients With Diabetes?


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title: Activation of the renin-angiotensin-aldosterone system is associated with Acute Kidney Injury in COVID-19

text: The pathophysiology of acute kidney injury (AKI) in COVID-19 patients is still poorly understood. SARS-CoV-2 has been suggested to modulate the renin-angiotensin-aldosterone system (RAAS). In this series of COVID-19 critically ill patients, we report evidence of activation of the RAAS in COVID-19 patients with AKI.


COVID-19 will severely impact older people's lives, and in many more ways than you think!


title: Detection of Listeria spp. in cattle and environment of pasture-based dairy farms/ Detecção de Listeria spp. em gados leiteiros no meio ambiente com base na pastagem

text: The aim of the study was to detect Listeria spp., particularly Listeria monocytogenes, in cattle and environment of pasture based dairy farms in Paysandú, Uruguay. A two-stage sampling was conducted, 10 farms were selected by probability proportional to size. A single visit was made to each farm. Samples from bovine faeces, feedstuffs, bulk tank milk, drinking water and soil from the entry and exit pens of the milking parlour were collected for bacteriological studies. PCR assays were used to confirm species and determine the serotype profile of L. monocytogenes isolates. AscI-pulsed-field gel electrophoresis was done to genetically compare them. Listeria spp. were isolated from eight of ten dairy farms, whereas L. monocytogenes in three of them. Serotype distribution in L. monocytogenes was as follows: 1/2a, three isolates; 4b, one isolate. L. monocytogenes or L. innocua excreted from clinically healthy milking cows was detected via faeces. In feedstuffs, only one L. monocytogenes 1/2a isolate from a pasture was obtained. The strain was identical by PFGE to an isolate 1/2a obtained from a pool of milking cow feces that grazed on this farm. No isolation of Listeria spp. was retrieved from the bulk tank milk or drinking water from any of the farms. Listeria innocua was detected in 13 feedstuffs and seven samples of soil from the entry and exit pens of the milking parlour. This is a first local study that confirms the presence of Listeria spp. including L. monocytogenes in healthy cattle and environment of pasture-based dairy farms. These results suggest the potential role that healthy cattle and their sub-products would play as a source of these agents for humans and/or others animals. More detailed studies that include genetic comparison of human and animal isolates are required in order to clearly establish the epidemiological relationship.(AU)


title: COVID-19 and Income Profile: How People in Different Income Groups Responded to Disease Outbreak, Case Study of the United States

text: Due to immature treatment and rapid transmission of COVID-19, mobility interventions play a crucial role in containing the outbreak. Among various non-pharmacological interventions, community infection control is considered to be a quite promising approach. However, there is a lack of research on improving community-level interventions based on a community's real conditions and characteristics using real-world observations. Our paper aims to investigate the different responses to mobility interventions between communities in the United States with a specific focus on different income levels. We produced six daily mobility metrics for all communities using the mobility location data from over 100 million anonymous devices on a monthly basis. Each metric is tabulated by three performance indicators:"best performance,""effort,"and"consistency."We found that being high-income improves social distancing behavior after controlling multiple confounding variables in each of the eighteen scenarios. In addition to the reality that it is more difficult for low-income communities to comply with social distancing, the comparisons between scenarios raise concerns on the employment status, working condition, accessibility to life supplies, and exposure to the virus of low-income communities.


Twitter as a powerful tool for communication between pain physicians during COVID-19 pandemic


Critical Care During the Coronavirus Crisis: Challenges and Considerations for the Cardiothoracic and Vascular Anesthesia Community


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title: Correspondence-COVID-19: Initial experience of hand surgeons in Northern Italy


title: ACE2 correlated with immune infiltration serves as a prognostic biomarker in endometrial carcinoma and renal papillary cell carcinoma: implication for COVID-19

text: Angiotensin-converting enzyme 2 (ACE2) is a member of the renin-angiotension system, however, the correlation between ACE2 and prognosis in UCEC (Uterine Corpus Endometrial Carcinoma) and KIRP (Kidney Renal Papillary Cell Carcinoma) is not clear. We analyzed the expression levels of ACE2 in the Oncomine and TIMER databases, the correlation between ACE2 and overall survival in the PrognoScan, GEPIA and Kaplan-Meier plotter databases. The correlation between ACE2 and immune infiltration level and the type markers of immune cells was investigated in TIMER database. A prognosis analysis based on the expression levels of ACE2 was further performed in related immune cells subgroup. The ACE2 promoter methylation profile was tested in the UALCAN database. In addition, we used GSE30589 and GSE52920 databases to elucidate the changes of ACE2 expression in vivo and in vitro after SARS-CoV infection. ACE2 was elevated in UCEC and KIRP, and high ACE2 had a favorable prognosis. The expression of ACE2 was positively correlated with the level of immune infiltration of macrophage in KIRP, B cell, CD4+T cell, neutrophil and dendritic cell immune infiltration levels in UCEC. ACE2 was significantly positively correlated with the type markers of B cells and neutrophils, macrophages in UCEC, while ACE2 in KIRP was positively correlated with the type markers of macrophages. High ACE2 expression level had a favorable prognosis in different enriched immune cells subgroups in UCEC and KIRP. And the promoter methylation levels of ACE2 in UCEC and KIRP were significantly reduced. What's more, we found that the expression of ACE2 decreased in vivo and in vitro after SARS-CoV infection. In conclusion, ACE2 expression increased significantly in UCEC and KIRP, elevated ACE2 was positively correlated with immune infiltration and prognosis. Moreover, tumor tissues may be more susceptible to SARS-CoV-2 infection in COVID-19 patients with UCEC and KIRP, which may worsen the prognosis.


The Synergistic Effect of Social Media Use and Psychological Distress on Depression in China During the COVID-19 Epidemic


title: The clinical data from 19 critically ill patients with coronavirus disease 2019: a single-centered, retrospective, observational study

text: Background: The objectives of this study were to analyze the clinical features of coronavirus disease 2019 (COVID-19) and evaluate the diagnosis and treatment. Methods: A retrospective analysis of the clinical manifestation and auxiliary examination of 19 patients with COVID-19 from the Liyuan Hospital intensive care unit (ICU) between January 16, 2020 and February 20, 2020 was undertaken. Results: There were 11 male and 8 female cases among the patients. The median (range) age was 73 (38-91) years. Of these patients, 8 (42.1%) had died and the median duration from ICU admission to death was 2 (interquartile range (IQR): 1-10.75) days. Seven of these 8 patients had underlying diseases. The auxiliary examination showed fever (68.4%), dry cough (15.8%), dyspnea (10.5%), and diarrhea (5.3%). All 19 cases showed ground-glass changes on chest computed tomography. Serum hypersensitive C-reactive protein (hs-CRP) and serum amylase A (SAA) were clearly increased in all of the cases. Among the 19 cases, there were 16 (84.2%) cases in which the total number of lymphocytes decreased, 12 cases (63%) had reduced liver function, and 11 cases (58%) had deviant results for fibrinogen (FIB) and D-dimer, in particular, the D-dimer level was significantly higher in the non-survivors compared with the survivors. Conclusion: There were more men than women among critically ill patients. All of the cases showed ground-glass changes on chest computed tomography and the vast majority of patients displayed fever and dry cough. The clinical laboratory indices change significantly, especially the D-dimer level among non-survivors.


docid: cfnclzuo

title: Selecting the Most Appropriate Oncological Treatment for Patients with Renal Masses During the COVID-19 Pandemic: Recommendations from a Referral Center


title: Vitamin D: A simpler alternative to tocilizumab for trial in COVID-19?

text: There is anecdotal evidence that tocilizumab, an immunosuppressant drug, may be a potential therapeutic option for patients with severe manifestations of coronavirus disease 2019 (COVID-19). Like tocilizumab, Vitamin D appears to modulate the activity of an interleukin (IL-6), which may explain the seasonal variation in prevalence of influenza. While most cases of COVID-19 have, thus far, occurred in the Northern Hemisphere winter, limiting the ability to assess seasonal variation, there remains substantial variation in the severity of this condition that has yet to be explained. A retrospective comparison of Vitamin D levels in previously obtained blood samples between survivors and confirmed fatalities could establish a rationale for implementation of widespread Vitamin D supplementation. This would be far cheaper and simpler than tocilizumab as a therapeutic option to trial.


title: Novel coronavirus disease with conjunctivitis and conjunctivitis as first symptom: Two cases report/ 中华实验眼科杂志

text: As the frontline health care workers at the center of the novel coronavirus disease (COVIN-19) outbreak, we have found many asymptomatic COVIN-19 patients or patients with mild symptoms since December 2019. A number of COVIN-19 cases with conjunctivitis or conjunctivitis as the first symptom have been observed in our clinical work. This paper reports the diagnosis and treatment of one COVIN-19 patient with conjunctivitis as the first symptom and one COVIN-19 patient with conjunctivitis. Case one occurred conjunctivitis at the third day after closely contacted with determined COVID-19 patient and visited to eye doctor, and the symptom of conjunctivitis following the topical administration of anti-virual eyedrops for 1 week, followed by COVID-19. Her 2019-nCoV RNA detection of nasopharynx swab was positive but that of conjunctival sac swab was a negative result. Case two had a positive epidemiological history and simultaneous onset of COVID-19 and conjunctivitis.She presented positive results of 2019-nCoV RNA detection in both nasopharynx and conjunctival sac swabs, and other lab results supported the diagnosis of COVID-19 but she had a normal CT findings of the chest. The ocular symptoms were disappeared after topical administration of anti-virual eyedrops for 1 week.


title: Pediatric Resuscitation Practices During the Coronavirus Disease 2019 Pandemic

text: OBJECTIVES: While most pediatric coronavirus disease 2019 cases are not life threatening, some children have severe disease requiring emergent resuscitative interventions. Resuscitation events present risks to healthcare provider safety and the potential for compromised patient care. Current resuscitation practices and policies for children with suspected/confirmed coronavirus disease 2019 are unknown. DESIGN: Multi-institutional survey regarding inpatient resuscitation practices during the coronavirus disease 2019 pandemic. SETTING: Internet-based survey. SUBJECTS: U.S. PICU representatives (one per institution) involved in resuscitation system planning and oversight. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 130 institutions surveyed, 78 (60%) responded. Forty-eight centers (62%) had admitted coronavirus disease 2019 patients; 26 (33%) reported code team activation for patients with suspected/confirmed coronavirus disease 2019. Sixty-seven respondents (86%) implemented changes to inpatient emergency response systems. The most common changes were as follows: limited number of personnel entering patient rooms (75; 96%), limited resident involvement (71; 91%), and new or refined team roles (74; 95%). New or adapted technology is being used for coronavirus disease 2019 resuscitations in 58 centers (74%). Most institutions (57; 73%) are using enhanced personal protective equipment for all coronavirus disease 2019 resuscitation events; 18 (23%) have personal protective equipment policies dependent on the performance of aerosol generating procedures. Due to coronavirus disease 2019, most respondents are intubating earlier during cardiopulmonary resuscitation (56; 72%), utilizing video laryngoscopy (67; 86%), pausing chest compressions during laryngoscopy (56; 72%), and leaving patients connected to the ventilator during cardiopulmonary resuscitation (56; 72%). Responses were varied regarding airway personnel, prone cardiopulmonary resuscitation, ventilation strategy during cardiopulmonary resuscitation without an airway in place, and extracorporeal cardiopulmonary resuscitation. Most institutions (46; 59%) do not have policies regarding limitations of resuscitation efforts in coronavirus disease 2019 patients. CONCLUSIONS: Most U.S. pediatric institutions rapidly adapted their resuscitation systems and practices in response to the coronavirus disease 2019 pandemic. Changes were commonly related to team members and roles, personal protective equipment, and airway and breathing management, reflecting attempts to balance quality resuscitation with healthcare provider safety.


title: A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection

text: The SARS-CoV-2 epidemic is pressuring healthcare systems worldwide. Disease outcomes in certain subgroups of patients are still scarce, and data are needed. Therefore, we describe here the experience of four dialysis centers of the Brescia Renal COVID Task Force. During March 2020, within an overall population of 643 hemodialysis patients, SARS-CoV-2 RNA positivity was detected in 94 (15%). At disease diagnosis, 37 of the 94 (39%) patients (group 1) were managed on an outpatient basis, whereas the remaining 57 (61%) (group 2) required hospitalization. Choices regarding management strategy were made based on disease severity. In group 1, 41% received antivirals and 76% hydroxychloroquine. Eight percent died and 5% developed acute respiratory distress syndrome (ARDS). In group 2, 79% received antivirals and 77% hydroxychloroquine. Forty two percent died and 79% developed ARDS. Overall mortality rate for the entire cohort was 29%. History of ischemic cardiac disease, fever, older age (over age 70), and dyspnea at presentation were associated with the risk of developing ARDS, whereas fever, cough and a C-reactive protein higher than 50 mg/l at disease presentation were associated with the risk of death. Thus, in our population of hemodialysis patients with SARS-CoV-2 infection, we documented a wide range of disease severity. The risk of ARDS and death is significant for patients requiring hospital admission at disease diagnosis.


title: Innovative Use of High-Fidelity Lung Simulators to Test a Ventilator Splitter Device

text: The coronavirus disease 2019 (COVID-19) pandemic has rapidly exposed health care system inadequacies. Hospital ventilator shortages in Italy compelled US physicians to consider creative solutions, such as using Y-pieces or T-pieces, to preclude the need to make decisions of life or death based on medical equipment availability. We add to current knowledge and testing capacity for ventilator splitters by reporting the ability to examine the functionality of ventilator splitters by using 2 high-fidelity lung simulators. Data obtained by the high-fidelity lung simulators included: tidal volume, respiratory rate, minute ventilation, peak inspiratory pressure, peak plateau pressure, and positive end-expiratory pressure.


title: Paying the Price for PPE

text: The early days of the COVID-19 pandemic threw the market for personal protective equipment (PPE) into chaos So physicians and county medical societies across Texas found they had to go big or go home when it came to obtaining those critical supplies


title: COVID-19: La visión del residente de reumatología./ COVID-19: La visión del residente de reumatología./ COVID-19: Overview of Rheumatology Fellows

text: SARS-CoV-2 infection has spread worldwide since it originated in December 2019, in Wuhan, China. The pandemic has largely demonstrated the resilience of the world's health systems and is the greatest health emergency since World War II. There is no single therapeutic approach to the treatment of COVID-19 and the associated immune disorder. The lack of randomised clinical trials (RCTs) has led different countries to tackle the disease based on case series, or from results of observational studies with off-label drugs. We as rheumatologists in general, and specifically rheumatology fellows, have been on the front line of the pandemic, modifying our activities and altering our training itinerary. We have attended patients, we have learned about the management of the disease and from our previous experience with drugs for arthritis and giant cell arteritis, we have used these drugs to treat COVID-19.


Management of SARS-CoV-2 infection: recommendations of the Polish Association of Epidemiologists and Infectiologists as of March 31, 2020


title: Daily Situation Report on Coronavirus disease (COVID-19) in Iran;March 23, 2020

text: After detection of the first confirmed cases of COVID-19 in Iran, the National Committee on COVID-19 Epidemiology in Ministry of Health and Medical Education was established This Committee is official source of gathering, analyzing, and reporting the COVID-19 data in Iran The data of all sources in the country including, medical care monitoring center (MCMC), Hospitals' Information Systems (HIS), Laboratory portal, the data of the center for communicable disease control (MOH), as well as the data from community health centers are integrated and used in this regards This factsheet contain daily situation report on coronavirus disease (covid-19) in Iran;March 23, 2020


title: Assessing Differential Impacts of COVID-19 on Black Communities

text: Purpose: Given incomplete data reporting by race, we used data on COVID-19 cases and deaths in US counties to describe racial disparities in COVID-19 disease and death and associated determinants. Methods: Using publicly available data (accessed April 13, 2020), predictors of COVID-19 cases and deaths were compared between disproportionately (>13%) black and all other (<13% black) counties. Rate ratios were calculated and population attributable fractions (PAF) were estimated using COVID-19 cases and deaths via zero-inflated negative binomial regression model. National maps with county-level data and an interactive scatterplot of COVID-19 cases were generated. Results: Nearly ninety-seven percent of disproportionately black counties (656/677) reported a case and 49% (330/677) reported a death versus 81% (1987/2,465) and 28% (684/ 2465), respectively, for all other counties. Counties with higher proportions of black people have higher prevalence of comorbidities and greater air pollution. Counties with higher proportions of black residents had more COVID-19 diagnoses (RR 1.24, 95% CI 1.17-1.33) and deaths (RR 1.18, 95% CI 1.00-1.40), after adjusting for county-level characteristics such as age, poverty, comorbidities, and epidemic duration. COVID-19 deaths were higher in disproportionally black rural and small metro counties. The PAF of COVID-19 diagnosis due to lack of health insurance was 3.3% for counties with <13% black residents and 4.2% for counties with >13% black residents. Conclusions: Nearly twenty-two percent of US counties are disproportionately black and they accounted for 52% of COVID-19 diagnoses and 58% of COVID-19 deaths nationally. County-level comparisons can both inform COVID-19 responses and identify epidemic hot spots. Social conditions, structural racism, and other factors elevate risk for COVID-19 diagnoses and deaths in black communities.


title: Remote video auditing in the endoscopy unit for evaluation of duodenoscope reprocessing in a tertiary care center

text: BACKGROUND : A significant proportion of duodenoscope-transmitted infections have resulted from errors related to reprocessing. Remote video auditing (RVA) is a tool that can monitor reprocessing compliance but it has not been previously evaluated in a tertiary care setting. The aims of this study were to evaluate: 1) RVA feasibility in a tertiary care setting (defined as the ability to audit every step of duodenoscope reprocessing without delaying the next procedure due to unavailability of duodenoscopes); and 2) the use of RVA as a compliance monitoring tool. METHODS : This was a prospective study at a tertiary care center. A video camera with offsite monitoring was installed in March 2018.âAuditors delivered a compliance score after each procedure. The duodenoscope was not used until it passed the audit. Feasibility and compliance data were collected from April 2018 to August 2019 after a 1-month run-in phase. Both per-step compliance and overall 100â% compliance rates were measured. RESULTS : Of 743 duodenoscope reprocessing procedures, 32â 666 individual steps were audited and 99.9â% of the steps were fully viewable. The mean time per audit was 38.3 minutes, the mean duodenoscope turnover time was 76.1 minutes, and there were no delays to the next procedure due to unavailability of duodenoscopes. The per-step compliance rate was 99.5â% but the overall 100â% compliance rate was 90.3â%. CONCLUSIONS : The use of RVA in duodenoscope reprocessing was feasible and promoted sustained high-level compliance in a tertiary care center.


title: In silico screening of natural compounds against COVID-19 by targeting Mpro and ACE2 using molecular docking

text: OBJECTIVE: Currently, Coronavirus COVID-19 is spreading worldwide very rapidly and its control is very difficult because there is no effective vaccine or drugs available in markets. This virus can infect both animals and people and cause illnesses of the respiratory tract. WHO has declared Coronavirus as pandemic and the whole world is fighting against Coronavirus. Globally, more than 199,478 people have been diagnosed with COVID-19. As of March 18, 2020, more than 167 countries have been affected and more than 8000 deaths have been reported. The main country being affected is China followed by Italy, Iran, Spain, France, and the USA. MATERIALS AND METHODS: Since there are no effective drugs available against Coronavirus, we conducted virtual screening of phytochemicals to find novel compounds against this virus. Hence, we created a phytochemical library of 318 phytochemicals from 11 plants which have been reported as antiviral, antibacterial and antifungal activity. The phytochemical library was subjected to virtual screening against molecular targets; Main protease (Mpro) and Angiotensin-Converting Enzyme 2 (ACE2). RESULTS: Top 10 compounds were selected from each target which had better and significantly low binding energy as compared to the reference molecule. CONCLUSIONS: Based on the binding energy score, we suggest that these compounds can be tested against Coronavirus and used to develop effective antiviral drugs.


COVID-19 contact tracing apps: the 'elderly paradox'


title: SEIAR model with asymptomatic cohort and consequences to efficiency of quarantine government measures in COVID-19 epidemic

text: We present a compartmental SEIAR model of epidemic spread as a generalization of the SEIR model. We believe that the asymptomatic infectious cohort is an omitted part of the understanding of the epidemic dynamics of disease COVID-19. We introduce and derive the basic reproduction number as the weighted arithmetic mean of the basic reproduction numbers of the symptomatic and asymptomatic cohorts. Since the asymptomatic subjects people are not detected, they can spread the disease much longer, and this increases the COVID-19 $R_0$ up to around 9. We show that European epidemic outbreaks in various European countries correspond to the simulations with commonly used parameters based on clinical characteristics of the disease COVID-19, but $R_0$ is around three times bigger if the asymptomatic cohort is taken into account. Many voices in the academic world are drawing attention to the asymptomatic group of infectious subjects at present. We are convinced that the asymptomatic cohort plays a crucial role in the spread of the COVID-19 disease, and it has to be understood during government measures.


title: Systematic rapid "living" review on rehabilitation needs due to covid-19: update to march 31st 2020

text: BACKGROUND: The outbreak of Covid-19 epidemics has challenged the provision of health care worldwide, highlighting the main flaws of some national health systems with respect to their capacity to cope with the needs of frail subjects. People experiencing disability due to Covid-19 express specific rehabilitation needs that deserve a systematic evidence-based approach. OBJECTIVES: To provide the rehabilitation community with updates on the latest scientific literature on rehabilitation needs due to Covid-19. The first rapid "living" review will present the results of a systematic search performed up to March 31st, 2020. METHODS: A systematic search on PubMed, Pedro and Google Scholar was performed using the search terms: "Covid-19", "Coronavirus", "severe acute respiratory syndrome coronavirus 2", "rehabilitation", "physical therapy modalities", "exercise", "occupational therapy", and "late complications". Papers published up to March 31st, 2020, in English, were included. RESULTS: Out of the 2758 articles retrieved, 9 were included in the present review. Four of them are "calls for action", 3 provide recommendations about rehabilitation interventions in the acute phase, 2 address the needs of people quarantined at home or with restricted mobility due to the lockdown, and 1 provides a Core Outcome Set to be used in clinical trials to test the efficacy of health strategies in managing Covid-19 patients. CONCLUSIONS: All selected papers were based on previous literature and not on the current Covid-19 pandemic. Main messages included: 1) early rehabilitation should be granted to inpatients with Covid-19; 2) people with restricted mobility due to quarantine or lockdown should receive exercise programs to reduce the risk of frailty, sarcopenia, cognitive decline and depression; 3) telerehabilitation may represent the first option for people at home. Further updates are warranted in order to characterize the emerging disability in Covid-19 survivors and the adverse effects on the health of chronically disabled people.


title: Caracterização das lesões parasitárias de ovinos observadas na linha de abate/ Characterization of parasitic lesions of sheep observed at slaughter line

text: Considerando a possibilidade de erros na identificação das lesões e a necessidade de melhorar o diagnóstico, o objetivo desse trabalho foi caracterizar macroscopicamente e microscopicamente as principais lesões parasitárias observadas em ovinos na linha de abate. Os materiais foram colhidos durante duas visitas a um matadouro frigorífico de ovinos no estado do Rio Grande do Sul. Totalizaram-se 161 amostras com lesões parasitárias de ovinos em diferentes órgãos. As alterações observadas incluíam hidatidose, cisticercose por Cysticercus ovis, cisticercose por Cysticercus tenuicollis, sarcocistose (morfologia compatível com Sarcocystis gigantea), fasciolose (Fasciola hepatica) e esofagostomose. Das 161 amostras, 25,5% correspondiam a hidatidose, e os cistos hidáticos foram observados, predominantemente, nos pulmões (46,3%) e fígado (41,5%). Ao corte, os cistos demonstraram três padrões morfológicos: cistos uniloculares viáveis (34%); cistos multivesiculares viáveis (31,7%); e cistos hidáticos (uniloculares e multivesiculares) degenerados (34%). As lesões de cisticercose por C. ovis (22,4%) foram visualizadas no coração (63,9%), língua (13,9%), músculo masseter (11,1%) e diafragma (11,1%). Morfologicamente os cisticercos foram classificados em vivos (viáveis), degenerados e mineralizados. Lesões provocadas por S. gigantea (19,2%) estavam presentes na túnica muscular do esôfago, na língua e na laringe. Macroscopicamente, observaram-se múltiplas estruturas nodulares brancas que continham uma cápsula fibrosa e lúmen preenchido por material gelatinoso translúcido. Cisticercose por C. tenuicollis representaram 18,6% das lesões. Os cistos foram observados aderidos no omento, no mesentério, na cápsula do fígado e na vesícula biliar. Morfologicamente os cistos foram classificados como vivos (viáveis) e degenerados. Os cistos vivos apresentavam a parede translúcida ou levemente opaca, contendo um escólex no seu interior.(AU)


title: Practical guide for pediatric pulmonologists on imaging management of pediatric patients with COVID-19

text: Understanding of coronavirus disease 2019 is rapidly evolving with new articles on the subject daily. This flood of articles can be overwhelming for busy practicing clinicians looking for key pieces of information that can be applied in daily practice. This review article synthesizes the reported imaging findings in pediatric Coronavirus disease 2019 (COVID-19) across the literature, offers imaging differential diagnostic considerations and useful radiographic features to help differentiate these entities from COVID-19, and provides recommendations for requesting imaging studies to evaluate suspected cases of pediatric COVID-19.


COVID-19 and the need of targeted inverse quarantine


title: Coronavirus Disease 2019 in a Hemodialysis Patient

text: There has been a global outbreak of the coronavirus disease 2019 (COVID-19) since December 2019. Here, we describe the case of a 49-year-old male undergoing maintenance hemodialysis (HD) who got infected with COVID-19 and our experience in performing HD for him. The patient's symptoms and lung imaging changes were atypical. However, his lymphocyte range decreased upon admission and the polymerase chain reaction of the pharyngeal swab for the -COVID-19 nucleic acid was positive. The patient developed respiratory failure and required mechanical ventilation 8 days after admission. In the end, he died from multiple organ dysfunction syndrome. The difficulties in diagnosis, infection control, and treatment of COVID-19 in maintenance HD patients are discussed in this report.


title: Efficient GAN-based Chest Radiographs (CXR) augmentation to diagnose coronavirus disease pneumonia

text: Background: As 2019 ends coronavirus disease start expanding all over the world. It is highly transmissible disease that can affect respiratory tract and can leads to organ failure. In 2020 it is declared by world health organization as "Public health emergency of international concerns". The current situation of Covid-19 and chest related diseases have already gone through radical change with the advancements of image processing tools. There is no effective method which can accurately identify all chest related diseases and tackle the multiple class problems with reliable results. Method: There are many potentially impactful applications of Deep Learning to fighting the Covid-19 from Chest X-Ray/CT Images, however, most are still in their early stages due to lack of data sharing as it continues to inhibit overall progress in a variety of medical research problems. Based on COVID-19 radiographical changes in CT images, this work aims to detect the possibility of COVID-19 in the patient. This work provides a significant contribution in terms of Gan based synthetic data and four different types of deep learning- based models which provided state of the art comparable results. Results: A Deep Neural Network model provides a significant contribution in terms of detecting COVID-19 and provides effective analysis of chest related diseases with respect to age and gender. Our model achieves 89% accuracy in terms of Gan based synthetic data and four different types of deep learning- based models which provided state of the art comparable results. Conclusion: If the gap in identifying of all viral pneumonias is not filled with effective automation of chest disease detection the healthcare industry may have to bear unfavorable circumstances.


COVID-19: mitigating transmission via wastewater plumbing systems


title: What Can We Estimate from Fatality and Infectious Case Data using the Susceptible-Infected-Removed (SIR) model? A case Study of Covid-19 Pandemic

text: The rapidly spreading Covid-19 that affected almost all countries, was first reported at the end of 2019. As a consequence of its highly infectious nature, countries all over the world have imposed extremely strict measures to control its spread. Since the earliest stages of this major pandemic, academics have done a huge amount of research in order to understand the disease, develop medication, vaccines and tests, and model its spread. Among these studies, a great deal of effort has been invested in the estimation of epidemic parameters in the early stage, for the countries affected by Covid-19, hence to predict the course of the epidemic but the variability of the controls over the course of the epidemic complicated the modeling processes. In this article, the determination of the basic reproduction number, the mean duration of the infectious period, the estimation of the timing of the peak of the epidemic wave is discussed using early phase data. Daily case reports and daily fatalities for ten countries over the period January 22, 2020 - April 18, 2020 are evaluated using the Susceptible-Infected-Removed (SIR) model. For each country, the SIR models fitting cumulative infective case data within 5% error are analysed. It is observed that the basic reproduction number and the mean duration of the infectious period can be estimated only in cases where the spread of the epidemic is over (for China and South Korea in the present case). Nevertheless, it is shown that the timing of the maximum and timings of the inflection points of the proportion of infected individuals can be robustly estimated from the normalized data. The validation of the estimates by comparing the predictions with actual data has shown that the predictions were realised for all countries except USA, as long as lock-down measures were retained.


title: A highly pathogenic GI-19 lineage infectious bronchitis virus originated from multiple recombination events with broad tissue tropism

text: In the present study, an IBV strain I0305/19 was isolated from a diseased commercial broiler flock in 2019 in China with high morbidity and mortality. The isolate I0305/19 was clustered together with viruses in sublineage D of GI-19 lineage on the basis of the complete S1 sequence analysis. Isolate I0305/19 and other GI-19 viruses isolated in China have the amino acid sequence MIA at positions 110-112 in the S protein. Further analysis based on the complete genomic sequence showed that the isolate emerged through at least four recombination events between GI-19 ck/CH/LJS/120848- and GI-13 4/91-like strains, in which the S gene was found to be similar to that of the GI-19 ck/CH/LJS/120848-like strain. Pathological assessment showed the isolate was a nephropathogenic IBV strain that caused high morbidity of 100 % and mortality of 80 % in 1-day-old specific-pathogen-free (SPF) chicks. The isolate I0305/19 exhibited broader tropisms in different tissues, including tracheas, lungs, bursa of Fabricius, spleen, liver, kidneys, proventriculus, small intestines, large intestines, cecum, and cecal tonsils. Furthermore, subpopulations of the virus were found in tissues of infected chickens; this finding is important in understanding how the virulent IBV strains can potentially replicate and evolve to cause disease. This information is also valuable for understanding the mechanisms of replication and evolution of other coronaviruses such as the newly emerged SARS-CoV-2.


Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19


Exercising in times of COVID-19: what do experts recommend doing within four walls?


Acute coronary syndromes during COVID-19


title: The need to manage the risk of thromboembolism in COVID-19 patients

text: COVID-19 first appeared in Wuhan, Hubei Province, China, in December 2019. Thought to be of zoonotic origin, it has been named SARS-CoV-2 (COVID-19) and has spread rapidly. As of April 20, 2020, there have been >2.4 million cases recorded worldwide. The inflammatory process, cytokine storm, and lung injury that are associated with COVID-19 can put patients at an increased risk of thrombosis. The total incidence of thrombotic events in COVID-19 patients is currently uncertain. Those with more severe disease and with other risk factors, including increasing age, male sex, obesity, cancer, comorbidities, and intensive care unit admission, are at higher risk of these events. However, there is little international guidance on managing these risks in COVID-19 patients. In this paper, we explore the current evidence and theories surrounding thrombosis in these unique patients and reflect on experience from our center.


Far from the eyes, close to the heart: Psychological Impact of COVID-19 in a Sample of Italian foreign workers


title: Coagulation modifiers targeting SARS-CoV-2 main protease Mpro for COVID-19 treatment: an in silico approach

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection depends on viral polyprotein processing, catalysed by the main proteinase (Mpro). The solution of the SARS-CoV-2 Mpro structure allowed the investigation of potential inhibitors. This work aims to provide first evidences of the applicability of commercially approved drugs to treat coronavirus disease-19 (COVID-19). We screened 4,334 compounds to found potential inhibitors of SARS-CoV-2 replication using an in silico approach. Our results evidenced the potential use of coagulation modifiers in COVID-19 treatment due to the structural similarity of SARS-CoV-2 Mpro and human coagulation factors thrombin and Factor Xa. Further in vitro and in vivo analysis are needed to corroborate these results.


title: Inferring proximity from Bluetooth Low Energy RSSI with Unscented Kalman Smoothers

text: The Covid-19 pandemic has resulted in a variety of approaches for managing infection outbreaks in international populations. One example is mobile phone applications, which attempt to alert infected individuals and their contacts by automatically inferring two key components of infection risk: the proximity to an individual who may be infected, and the duration of proximity. The former component, proximity, relies on Bluetooth Low Energy (BLE) Received Signal Strength Indicator(RSSI) as a distance sensor, and this has been shown to be problematic; not least because of unpredictable variations caused by different device types, device location on-body, device orientation, the local environment and the general noise associated with radio frequency propagation. In this paper, we present an approach that infers posterior probabilities over distance given sequences of RSSI values. Using a single-dimensional Unscented Kalman Smoother (UKS) for non-linear state space modelling, we outline several Gaussian process observation transforms, including: a generative model that directly captures sources of variation; and a discriminative model that learns a suitable observation function from training data using both distance and infection risk as optimisation objective functions. Our results show that good risk prediction can be achieved in $\mathcal{O}(n)$ time on real-world data sets, with the UKS outperforming more traditional classification methods learned from the same training data.


docid: rhwihzrx

title: Is Samoa Prepared for an Outbreak of COVID-19?

text: The global pandemic of COVID-19 poses a public health danger to the Pacific island countries. Due to the imminent threat of the SARS-COV-2, the World Health Organization in collaboration with other regional stakeholders had initiated a joint task force on epidemic preparedness and management. Since Samoa is a tourism destination in the south pacific, it is highly prone to an outbreak of COVID-19 if stringent public health measures and regulations are not enforced. This article, thus, highlights different opinions and various stand points regarding epidemic preparedness and emergency response in case there is an outbreak of COVID-19 in Samoa.


title: Differences in Preventive Behaviors of COVID-19 between Urban and Rural Residents: Lessons Learned from A Cross-Sectional Study in China

text: Purpose: The purpose of this study is to examine the differences in preventive behaviors of COVID-19 between urban and rural residents, as well as identify the factors that might contribute to such differences. Methods: Our online survey included 1591 participants from 31 provinces of China with 87% urban and 13% rural residents. We performed multiple linear regressions and path analysis to examine the relationship between rural status and behavioral intention, attitude, subjective norms, information appraisal, knowledge, variety of information source use, and preventive behaviors against COVID-19. Findings: Compared with urban residents, rural residents were less likely to perform preventive behaviors, more likely to hold a negative attitude toward the effectiveness of performing preventive behaviors, and more likely to have lower levels of information appraisal skills. We identified information appraisal as a significant factor that might contribute to the rural/urban differences in preventive behaviors against COVID-19 through attitude, subjective norms, and intention. We found no rural/urban differences in behavioral intention, subjective norms, knowledge about preventive behaviors, or the variety of interpersonal/media source use. Conclusions: As the first wave of the pandemic inundated urban areas, the current media coverage about COVID-19 prevention may not fully satisfy the specific needs of rural populations. Thus, rural residents were less likely to engage in a thoughtful process of information appraisal and adopt the appropriate preventive measures. Tailoring health messages to meet rural populations' unique needs can be an effective strategy to promote preventive health behaviors against COVID-19.


What will we learn from covid-19? That we live in an uncertain world


Mental health characteristics associated with dysfunctional coronavirus anxiety


title: Genomic Profiling of Stage II Colorectal Cancer Identifies Candidate Genes Associated with Recurrence-Free Survival, Tumor Location, and Differentiation Grade

text: BACKGROUND: Identification of high-risk stage II colorectal cancer (CRC) patients, potential candidates for adjuvant chemotherapy, is challenging. Current clinical guidelines rely mainly on histopathological markers with relatively weak prognostic value. This motivates further search for prognostic markers. METHODS: This explorative study aimed to identify potential candidate gene mutations to facilitate differentiation between subgroups of patients with CRC stage II. Panel-based massive parallel sequencing was used to genetically characterize tumor tissues from 85 patients radically operated for CRC stage II, of which 12 developed recurrent cancer during follow-up. Genetic data was compared between patients with or without cancer recurrence, between tumors located in colon and in rectum, and for association with tumor differentiation grade. RESULTS: Genetic variation in ATM, C11ORF65 was associated with recurrence-free survival. Previous reports regarding the association between BRAF mutation and a higher age at diagnosis, and tumor location in colon were confirmed. APC, BRAF, or KRAS mutation was associated with tumor differentiation grade. Multiple correspondence analyses revealed no obvious clustering of patients with the studied clinical characteristics, indicating that the genetic signatures observed here were unique for each individual. CONCLUSIONS: Taken together, we have demonstrated the utility of panel-based massive parallel sequencing to explore the pathogenesis of CRC stage II. We have identified promising candidate gene mutations associated with cancer recurrence, tumor location, and differentiation grade in patients with CRC stage II, which merit further investigation.


title: Social Media and COVID-19: Can Social Distancing be Quantified without Measuring Human Movements?

text: The COVID-19 outbreak has posed significant threats to international health and the economy. In the absence of treatment for this virus, public health officials asked the public to practice social distancing to reduce the number of physical contacts. However, quantifying social distancing is a challenging task and current methods are based on human movements. We propose a time and cost-effective approach to measure how people practice social distancing. This study proposes a new method based on utilizing the frequency of hashtags supporting and encouraging social distancing for measuring social distancing. We have identified 18 related hashtags and tracked their trends between Jan and May 2020. Our evaluation results show that there is a strong correlation (P<0.05) between our findings and the Google social distancing report.


title: Meta-analysis of diagnostic performance of serological tests for SARS-CoV-2 antibodies up to 25 April 2020 and public health implications

text: We reviewed the diagnostic accuracy of SARS-CoV-2 serological tests. Random-effects models yielded a summary sensitivity of 82% for IgM, and 85% for IgG and total antibodies. For specificity, the pooled estimate were 98% for IgM and 99% for IgG and total antibodies. In populations with ≤ 5% of seroconverted individuals, unless the assays have perfect (i.e. 100%) specificity, the positive predictive value would be ≤ 88%. Serological tests should be used for prevalence surveys only in hard-hit areas.


title: Natural brominated phenoxyphenols kill persistent and biofilm-incorporated cells of MRSA and other pathogenic bacteria

text: Due to a high unresponsiveness to chemotherapy, biofilm formation is an important medical problem that frequently occurs during infection with many bacterial pathogens. In this study, the marine sponge-derived natural compounds 4,6-dibromo-2-(2',4'-dibromophenoxy)phenol and 3,4,6-tribromo-2-(2',4'-dibromophenoxy)phenol were found to exhibit broad antibacterial activity against medically relevant gram-positive and gram-negative pathogens. The compounds were not only bactericidal against both replicating and stationary phase-persistent planktonic cells of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa; they also killed biofilm-incorporated cells of both species while not affecting biofilm structural integrity. Moreover, these compounds were active against carbapenemase-producing Enterobacter sp. This simultaneous activity of compounds against different growth forms of both gram-positive and gram-negative bacteria is rare. Genome sequencing of spontaneous resistant mutants and proteome analysis suggest that resistance is mediated by downregulation of the bacterial EIIBC phosphotransferase components scrA and mtlA in MRSA likely leading to a lower uptake of the molecules. Due to their only moderate cytotoxicity against human cell lines, phenoxyphenols provide an interesting new scaffold for development of antimicrobial agents with activity against planktonic cells, persisters and biofilm-incoporated cells of ESKAPE pathogens. KEY POINTS: â¢ Brominated phenoxyphenols kill actively replicating and biofilm-incorporated bacteria. â¢ Phosphotransferase systems mediate uptake of brominated phenoxyphenols. â¢ Downregulation of phosphotransferase systems mediate resistance.


[18F]-FDG PET/CT for suspected lymphoma relapse in a patient with concomitant pneumococcal pneumonia during COVID-19 outbreak: unexpected SARS-Cov-2 co-infection despite double RT-PCR negativity


title: Interactions of coronaviruses with ACE2, angiotensin II, and RAS inhibitors-lessons from available evidence and insights into COVID-19

text: The rapid spread of a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to an ongoing pandemic of coronavirus disease 2019 (COVID-19). Recently, angiotensin-converting enzyme 2 (ACE2) has been shown to be a functional receptor for SARS-CoV-2 to enter host target cells. Given that angiotensin receptor blockers (ARBs) and an ACE inhibitor (ACEI) upregulated ACE2 expression in animal studies, the concern might arise regarding whether ARBs and ACEIs would increase the morbidity and mortality of COVID-19. On the other hand, animal data suggested a potential protective effect of ARBs against COVID-19 pneumonia because an ARB prevented the aggravation of acute lung injury in mice infected with SARS-CoV, which is closely related to SARS-CoV-2. Importantly, however, there is no clinical or experimental evidence supporting that ARBs and ACEIs either augment the susceptibility to SARS-CoV-2 or aggravate the severity and outcomes of COVID-19 at present. Until further data are available, it is recommended that ARB and ACEI medications be continued for the treatment of patients with cardiovascular disease and hypertension, especially those at high risk, according to guideline-directed medical therapy based on the currently available evidence.


What ENT doctors should know about COVID-19 contagion risks


title: Crystal Structure of the SARS-CoV-2 Non-structural Protein 9, Nsp9

text: Many of the SARS-CoV-2 proteins have related counterparts across the Severe Acute Respiratory Syndrome (SARS-CoV) family. One such protein is non-structural protein 9 (Nsp9), which is thought to mediate viral replication, overall virulence, and viral genomic RNA reproduction. We sought to better characterize the SARS-CoV-2 Nsp9 and subsequently solved its X-ray crystal structure, in an apo form and, unexpectedly, in a peptide-bound form with a sequence originating from a rhinoviral 3C protease sequence (LEVL). The SARS-CoV-2 Nsp9 structure revealed the high level of structural conservation within the Nsp9 family. The exogenous peptide binding site is close to the dimer interface and impacted the relative juxtapositioning of the monomers within the homodimer. We have established a protocol for the production of SARS-CoV-2 Nsp9, determined its structure, and identified a peptide-binding site that warrants further study to understanding Nsp9 function.


title: Understanding the role that 'COVID toe' has in recognizing the potential extent of COVID-19 infections: a case study

text: Dermatological manifestations have shown to be associated with COVID-19 infections. The numbers of papers have quadrupled within May 2020 alone. One particular cutaneous manifestation named pseudo chilblains (COVID toe), expressed mostly in otherwise asymptomatic younger patients, has had particular media attention. Public health bodies, on the other hand, have been slow to recognize it as a symptom. This article will be discussing two case studies to demonstrate the lack of public knowledge and of public health guidance associated with this symptom. We will further explore the use of COVID toe in the epidemiology of COVID-19 and its utility as a sign for total cases and contact tracing.


title: Robust inference for nonlinear regression models from the Tsallis score: application to Covid-19 contagion in Italy

text: We discuss an approach for fitting robust nonlinear regression models, which can be employed to model and predict the contagion dynamics of the Covid-19 in Italy. The focus is on the analysis of epidemic data using robust dose-response curves, but the functionality is applicable to arbitrary nonlinear regression models.


Ongoing Lessons During the COVID-19 Pandemic


Keep older healthcare workers off the covid-19 front line


Monitoring for post-injection delirium/sedation syndrome with long-acting olanzapine during the COVID-19 pandemic


title: COVID-19-Cluster-Studie an einem Lehrkrankenhaus : Corona-Pandemie 2020./ [COVID-19 cluster study at a teaching hospital]

text: On Mar 11th, 2020, the World Health Organization (WHO) stated in its Situation Report - 51 Coronavirus disease 2019 (COVID-19) as a pandemic. In early April 2020, a teaching hospital underwent shutdown and quarantine due to an outbreak of infection in accordance with Section 6 of the Infection Protection Act (index patient and 5 infected nursing staff). The complete staff (physicians, nurses and nonmedical personnel [NMP]) underwent COVID-19 testing within two phases: (1) between Apr 3rd and 5th, 2020 [n=1170], followed by (2) between Apr 8th and 9th, 2020 [n=953] with COVID-19 silent carrier positivity rates in accordance to testing phases of (1) n=19 (1.6%) and (2) n=25 (2.6%). The cumulative infection rate for NMP (1.6%), doctors (3.8%) and nurses (9.7%) was connected to type and extent of COVID-19 patient contact. Despite COVID-19 positivity of 34.8% (46 of 132 beds), a risk-free management of hospital operation is possible to a certain extent if hygiene regulations and strict patient selection are followed. However, a COVID-19-free clinic cannot be expected due to silent carriers.


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title: Acute Myopericarditis with Pericardial Effusion and Cardiac Tamponade in a Patient with COVID-19

text: BACKGROUND Coronavirus disease 2019 (COVID-19) is primarily a respiratory illness. However, with rising numbers of cases, multiple reports of cardiovascular manifestations have emerged. We present a case of COVID-19 infection complicated by myopericarditis and tamponade requiring drainage. CASE REPORT An 82-year-old woman with multiple comorbidities presented with five days of productive cough, fever with chills, and intermittent diarrhea. She tested positive for COVID-19. Index EKG revealed new diffuse T-wave inversions and a prolonged QT interval (>500 ms). Troponin was mildly elevated without any anginal symptoms. Hydroxychloroquine and azithromycin were not initiated due to concerns about QT prolongation. The echocardiogram revealed preserved left ventricular (LV) function, a small global pericardial effusion, and apical hypokinesis. Serial echocardiograms revealed an enlarging circumferential pericardial effusion with pacemaker wire reported as 'piercing' the right ventricular (RV) apex alongside early diastolic collapse of the right ventricle, suggesting echocardiographic tamponade. Chest CT revealed extension of the RV pacemaker lead into the pericardial fat. Interestingly, on comparison with a previous chest CT from 2019, similar lead positions were confirmed. Pericardiocentesis was performed with removal of 400 cc exudate. CONCLUSIONS Acute myopericarditis and pericardial effusion can occur in COVID-19 infection, even in the absence of severe pulmonary disease. This case highlights the importance of awareness of rare cardiac manifestations of COVID-19 in the form of acute myopericarditis and cardiac tamponade and their early diagnosis and management.


title: Prediction of the Number of Patients Infected with COVID-19 Based on Rolling Grey Verhulst Models

text: The outbreak of a novel coronavirus (SARS-CoV-2) has caused a large number of residents in China to be infected with a highly contagious pneumonia recently. Despite active control measures taken by the Chinese government, the number of infected patients is still increasing day by day. At present, the changing trend of the epidemic is attracting the attention of everyone. Based on data from 21 January to 20 February 2020, six rolling grey Verhulst models were built using 7-, 8- and 9-day data sequences to predict the daily growth trend of the number of patients confirmed with COVID-19 infection in China. The results show that these six models consistently predict the S-shaped change characteristics of the cumulative number of confirmed patients, and the daily growth decreased day by day after 4 February. The predicted results obtained by different models are very approximate, with very high prediction accuracy. In the training stage, the maximum and minimum mean absolute percentage errors (MAPEs) are 4.74% and 1.80%, respectively; in the testing stage, the maximum and minimum MAPEs are 4.72% and 1.65%, respectively. This indicates that the predicted results show high robustness. If the number of clinically diagnosed cases in Wuhan City, Hubei Province, China, where COVID-19 was first detected, is not counted from 12 February, the cumulative number of confirmed COVID-19 cases in China will reach a maximum of 60,364-61,327 during 17-22 March; otherwise, the cumulative number of confirmed cases in China will be 78,817-79,780.


docid: boyqqbpx

title: Peer-to-Peer Contact Tracing: Development of a Privacy-Preserving Smartphone App

text: BACKGROUND: The novel coronavirus disease 2019 (COVID-19) pandemic is an urgent public health crisis, with epidemiologic models predicting severe consequences, including high death rates, if the virus is permitted to run its course without any intervention or response. Contact tracing using smartphone technology is a powerful tool that may be employed to limit disease transmission during an epidemic or pandemic; yet, contact tracing apps present significant privacy concerns regarding the collection of personal data such as location. OBJECTIVE: The aim of this study is to develop an effective contact tracing smartphone app that respects user privacy by not collecting location information or other personal data. METHODS: We propose the use of an anonymized graph of interpersonal interactions to conduct a novel form of contact tracing and have developed a proof-of-concept smartphone app that implements this approach. Additionally, we developed a computer simulation model that demonstrates the impact of our proposal on epidemic or pandemic outbreak trajectories across multiple rates of adoption. RESULTS: Our proof-of-concept smartphone app allows users to create "checkpoints" for contact tracing, check their risk level based on their past interactions, and anonymously self-report a positive status to their peer network. Our simulation results suggest that higher adoption rates of such an app may result in a better controlled epidemic or pandemic outbreak. CONCLUSIONS: Our proposed smartphone-based contact tracing method presents a novel solution that preserves privacy while demonstrating the potential to suppress an epidemic or pandemic outbreak. This app could potentially be applied to the current COVID-19 pandemic as well as other epidemics or pandemics in the future to achieve a middle ground between drastic isolation measures and unmitigated disease spread.


The presence and distribution of novel coronavirus in medical environment


The Italian Outbreak of COVID-19: Conditions, Contributors, and Concerns


title: The role of interleukin-6 in monitoring severe case of coronavirus disease 2019

text: Progression to severe disease is a difficult problem in treating coronavirus disease 2019 (COVID-19). The purpose of this study is to explore changes in markers of severe disease in COVID-19 patients. Sixty-nine severe COVID-19 patients were included. Patients with severe disease showed significant lymphocytopenia. Elevated level of lactate dehydrogenase (LDH), C-reactive protein (CRP), ferritin, and D-dimer was found in most severe cases. Baseline interleukin-6 (IL-6) was found to be associated with COVID-19 severity. Indeed, the significant increase of baseline IL-6 was positively correlated with the maximal body temperature during hospitalization and with the increased baseline of CRP, LDH, ferritin, and D-dimer. High baseline IL-6 was also associated with more progressed chest computed tomography (CT) findings. Significant decrease in IL-6 and improved CT assessment was found in patients during recovery, while IL-6 was further increased in exacerbated patients. Collectively, our results suggest that the dynamic change in IL-6 can be used as a marker for disease monitoring in patients with severe COVID-19.


The Impact of the COVID-19 Pandemic on the Biotech Industry


title: Novel Percutaneous Tracheostomy for Critically Ill Patients With COVID-19

text: BACKGROUND: Coronavirus 2019 (COVID-19) is a worldwide pandemic, with many patients requiring prolonged mechanical ventilation. Tracheostomy is not recommended by current guidelines as it is considered a superspreading event owing to aerosolization that unduly risks health care workers. METHODS: Patients with severe COVID-19 who were on mechanical ventilation for 5 days or longer were evaluated for percutaneous dilational tracheostomy. We developed a novel percutaneous tracheostomy technique that placed the bronchoscope alongside the endotracheal tube, not inside it. That improved visualization during the procedure and continued standard mechanical ventilation after positioning the inflated endotracheal tube cuff in the distal trachea. This technique offers a significant mitigation for the risk of virus aerosolization during the procedure. RESULTS: From March 10 to April 15, 2020, 270 patients with COVID-19 required invasive mechanical ventilation at New York University Langone Health Manhattan's campus; of those, 98 patients underwent percutaneous dilational tracheostomy. The mean time from intubation to the procedure was 10.6 ± 5 days. Currently, 32 patients (33%) do not require mechanical ventilatory support, 19 (19%) have their tracheostomy tube downsized, and 8 (8%) were decannulated. Forty patients (41%) remain on full ventilator support, and 19 (19%) are weaning from mechanical ventilation. Seven patients (7%) died as a result of respiratory and multiorgan failure. Tracheostomy-related bleeding was the most common complication (5 patients). None of health care providers has had symptoms or tested positive for COVID-19. CONCLUSIONS: Our percutaneous tracheostomy technique appears to be safe and effective for COVID-19 patients and safe for health care workers.


title: Case-Initiated COVID-19 Contact Tracing Using Anonymous Notifications

text: We discuss the concept of a participatory digital contact notification approach to assist tracing of contacts who are exposed to confirmed cases of coronavirus disease (COVID-19); the approach is simple and affordable for countries with limited access to health care resources and advanced technology. The proposed tool serves as a supplemental contract tracing approach to counteract the shortage of health care staff while providing privacy protection for both cases and contacts. This tool can be deployed on the internet or as a plugin for a smartphone app. Confirmed cases with COVID-19 can use this tool to provide contact information (either email addresses or mobile phone numbers) of close contacts. The system will then automatically send a message to the contacts informing them of their contact status, what this status means, the actions that should follow (eg, self-quarantine, respiratory hygiene/cough etiquette), and advice for receiving early care if they develop symptoms. The name of the sender of the notification message by email or mobile phone can be anonymous or not. The message received by the contact contains no disease information but contains a security code for the contact to log on the platform to retrieve the information.


Chloroquine and hydroxychloroquine to treat COVID-19: between hope and caution


Critical Illness in Patients With COVID-19: Mounting an Effective Clinical and Research Response