Racial Health Disparities and Covid-19 - Caution and Context


Nonessential Research in the New Normal: The Impact of COVID-19


title: Passive immunization: Paradoxical and traditional method for new pandemic challenge COVID-19

text: World has been suffering from pandemic caused by mysterious Coronavirus. The novel member of Coronaviridae causing COVID-19 disease is named as SARS-Cov-2. Its first case was reported in China by the end of 2019, but its exponential spread has wrapped entire globe, suspended and is penalizing mankind. A retrospective meta-analysis study showed that outbreaks of Middle East Respiratory Syndrome (MERS) and SARS-Cov-1 (Coronaviridae), influenza infection H1N1 and West-African Ebola caused lower mortality than this new pandemic COVID-19. Virus has appeared as a new human pathogen so to counter COVID-19 no specific vaccine, monoclonal antibodies have been manufactured till day. The outbreak of novel Coronavirus is treated with antimicrobial drugs but they have their own mild side effects. But the drastic spread of COVID-19 compels us also to use other ways to counter pandemic. Thus, passive immunization can be opted to hold back this mysterious virus. Passive immunization has been in use since early 20th century and showed its effectiveness against all previous infectious outbreaks including MERS and SARS-Cov-1 members of Coronaviridae. The review argues that convalescent plasma is an explicit option for containment of COVID-19 disease.


We're Not All in This Together: On COVID-19, Intersectionality, and Structural Inequality


title: Protection of Healthcare Workers Against COVID-19 at a Large Teaching Hospital in Seoul, Korea

text: Thirteen patients with coronavirus disease 2019 (COVID-19) visited a university hospital in Seoul before recognizing their disease infections, causing contact with 184 hospital workers. We classified the patients into four risk levels and provided corresponding management measures. At 31 days after the last event, all screening laboratory results were negative, and no symptoms/signs were reported.


title: Coast-to-Coast Spread of SARS-CoV-2 during the Early Epidemic in the United States

text: The novel coronavirus SARS-CoV-2 was first detected in the Pacific Northwest region of the United States in January 2020, with subsequent COVID-19 outbreaks detected in all 50 states by early March. To uncover the sources of SARS-CoV-2 introductions and patterns of spread within the United States, we sequenced nine viral genomes from early reported COVID-19 patients in Connecticut. Our phylogenetic analysis places the majority of these genomes with viruses sequenced from Washington state. By coupling our genomic data with domestic and international travel patterns, we show that early SARS-CoV-2 transmission in Connecticut was likely driven by domestic introductions. Moreover, the risk of domestic importation to Connecticut exceeded that of international importation by mid-March regardless of our estimated effects of federal travel restrictions. This study provides evidence of widespread sustained transmission of SARS-CoV-2 within the United States and highlights the critical need for local surveillance.


title: Ethical Analysis on the Application of Neurotechnology for Human Augmentation in Physicians and Surgeons

text: With the shortage of physicians and surgeons and increase in demand worldwide due to situations such as the COVID-19 pandemic, there is a growing interest in finding solutions to help address the problem. A solution to this problem would be to use neurotechnology to provide them augmented cognition, senses and action for optimal diagnosis and treatment. Consequently, doing so can negatively impact them and others. We argue that applying neurotechnology for human enhancement in physicians and surgeons can cause injustices, and harm to them and patients. In this paper, we will first describe the augmentations and neurotechnologies that can be used to achieve the relevant augmentations for physicians and surgeons. We will then review selected ethical concerns discussed within literature, discuss the neuroengineering behind using neurotechnology for augmentation purposes, then conclude with an analysis on outcomes and ethical issues of implementing human augmentation via neurotechnology in medical and surgical practice.


Religious discrimination is hindering the covid-19 response


title: A case of improved oxygenation in SARS-CoV-2 positive patient on nasal cannula undergoing prone positioning

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality worldwide. It has placed societal and financial burden on the globe. Its rapid progressions from mild URI symptoms to severe acute respiratory distress syndrome (ARDS) in a matter of days is the underlying reason as to why the world is struggling to keep up with ventilator production. In this case report, we went about proning a corona virus positive patient for 6-8hrs as a potential early intervention to prevent progression to ARDS. Our patient was initially in acute hypoxemic respiratory failure and placed on nasal cannula. He was started on hydroxychloroquine and azithromycin with no improvement of symptoms. However within the span of few hours of proning he experienced significant symptomatic relief with improvement of oxygenation. His oxygen saturation improved drastically and eventually was taken off of nasal cannula and discharged within span of one day of proning.


Epidemiology of COVID-19 in Brazil: using a mathematical model to estimate the outbreak peak and temporal evolution


title: The development and deployment of formal methods in the UK

text: UK researchers have made major contributions to the technical ideas underpinning formal approaches to the specification and development of computer systems. Perhaps as a consequence of this, some of the significant attempts to deploy theoretical ideas into practical environments have taken place in the UK. The authors of this paper have been involved in formal methods for many years and both have tracked a significant proportion of the whole story. This paper both lists key ideas and indicates where attempts were made to use the ideas in practice. Not all of these deployment stories have been a complete success and an attempt is made to tease out lessons that influence the probability of long-term impact.


title: Suggestions for thoracic surgery clinical practice in non-epidemic area of coronavirus infected disease-19/ 中华外科杂志

text: In this paper, the mechanism of destroying human alveolar epithelial cells and pulmonary tissue by 2019 novel coronavirus (2019-nCoV) was discussed firstly. There may be multiple mechanisms including killing directly the target cells and hyperinflammatory responses. Secondly, the clinical features, CT imaging, short-term and long-term pulmonary function damage of the 2019 novel coronavirus pneumonia (COVID-19) was analyzed. Finally, some suggestions for thoracic surgery clinical practice in non-epidemic area during and after the epidemic of COVID-19 was provided, to help all the thoracic surgery patients receive active and effective treatment.


docid: zivtlgxd

title: Correction to: COVID-19 outbreak situation and its psychological impact among surgeons in training in France

text: In the original publication of the article, the first and last name of the first author were interchanged. The correct name of the author should be as given below.


COVID-19 outbreak situation and its psychological impact among surgeons in training in France


A case of COVID-19 infection presenting with a seizure following severe brain edema


title: Pulmonary Pathology of Early-Phase 2019 Novel Coronavirus (COVID-19) Pneumonia in Two Patients With Lung Cancer

text: There is currently a lack of pathologic data on the novel coronavirus (severe acute respiratory syndrome coronavirus 2) pneumonia, or coronavirus disease 2019 (COVID-19), from autopsy or biopsy. Two patients who recently underwent lung lobectomies for adenocarcinoma were retrospectively found to have had COVID-19 at the time of the operation. These two cases thus provide important first opportunities to study the pathology of COVID-19. Pathologic examinations revealed that apart from the tumors, the lungs of both patients exhibited edema, proteinaceous exudate, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells. Hyaline membranes were not prominent. Because both patients did not exhibit symptoms of pneumonia at the time of operation, these changes likely represent an early phase of the lung pathology of COVID-19 pneumonia.


Human Rights and Covid-19 pandemic


docid: hbuzwaym

title: Psychotic experiences in student population during the COVID-19 pandemic


Advances in direct optical detection


title: Misconceptions About Negative Pressure Rooms and Their Impact Aboard USNS Comfort in New York City

text: The outbreak of novel coronavirus disease 2019 (COVID-19) has had a momentous impact on the field of otolaryngology due to the high number of aerosol-generating procedures involving the upper aerodigestive tract. These procedures bear significant risk to the provider and clinical environment due to the possibility of viral aerosolization. While significant attention has been appropriately paid to personal protective equipment during this pandemic, an understanding of industrial hygiene is also necessary for the safe delivery of health care to mitigate the risk of exposure to other patients and health care workers. We provide a review of air ventilation practices and their role in reducing pathogen spread. In addition, we share our experiences with effectively treating COVID-19-positive patients aboard the USNS Comfort through proper environment control measures.


Adapting a Comfort Care Order Set in a Large Health System during the COVID-19 Pandemic


Suggestions for infection prevention and control in digestive endoscopy during current 2019-nCoV pneumonia outbreak in Wuhan, Hubei province, China


Occurrence of pulmonary embolism in a patient with mild clinical expression of COVID-19


title: Paediatric Inflammatory Multisystem Syndrome: Temporally Associated with SARS-CoV-2 (PIMS-TS): Cardiac Features, Management and Short-Term Outcomes at a UK Tertiary Paediatric Hospital

text: Children were relatively spared during COVID-19 pandemic. However, the recently reported hyperinflammatory syndrome with overlapping features of Kawasaki disease and toxic shock syndrome-"Paediatric Inflammatory Multisystem Syndrome-temporally associated with SARS-CoV-2" (PIMS-TS) has caused concern. We describe cardiac findings and short-term outcomes in children with PIMS-TS at a tertiary children's hospital. Single-center observational study of children with PIMS-TS from 10th April to 9th May 2020. Data on ECG and echocardiogram were retrospectively analyzed along with demographics, clinical features and blood parameters. Fifteen children with median age of 8.8 (IQR 6.4-11.2) years were included, all were from African/Afro-Caribbean, South Asian, Mixed or other minority ethnic groups. All showed raised inflammatory/cardiac markers (CRP, ferritin, Troponin I, CK and pro-BNP). Transient valve regurgitation was present in 10 patients (67%). Left Ventricular ejection fraction was reduced in 12 (80%), fractional shortening in 8 (53%) with resolution in all but 2. Fourteen (93%) had coronary artery abnormalities, with normalization in 6. ECG abnormalities were present in 9 (60%) which normalized in 6 by discharge. Ten (67%) needed inotropes and/or vasopressors. None needed extracorporeal life support. Improvement in cardiac biochemical markers was closely followed by improvement in ECG/echocardiogram. All patients were discharged alive and twelve (80%) have been reviewed since. Our entire cohort with PIMS-TS had cardiac involvement and this degree of involvement is significantly more than other published series and emphasizes the need for specialist cardiac review. We believe that our multi-disciplinary team approach was crucial for the good short-term outcomes.


title: Considerations in the evaluation and management of oral potentially malignant disorders during the COVID-19 pandemic

text: AIM: The COVID-19 pandemic has resulted in society experiencing unprecedented challenges for health care practitioners and facilities serving at the frontlines of this pandemic. With regard to oral cancer, there is a complete absence of literature regarding the long-term impact of pandemics on patients with oral potentially malignant disorders (OPMDs). The objective of this article is to put forth an institutional multidisciplinary approach for the evaluation and management of OPMDs. METHODS: A multidisciplinary approach was put formalized within our institution to risk stratify patients based on need for in-person assessment vs telehealth assessment during the COVID-19 pandemic. RESULTS: With judicious risk stratification of patients based on clinical features of their OPMD and with consideration of ongoing mitigation efforts and regional pandemic impact, providers are able to safely care for their patients. CONCLUSIONS: The COVID-19 pandemic has required health care practitioners to make novel decisions that are new to us with development of creative pathways of care that focused on patient safety, mitigation efforts, and clinical management of disease processes. The care of patients with OPMDs requires special considerations especially as patients at high risk for severe COVID-19 illness are also higher risk for the development of OPMDs.


Dapsone, colchicine and olanzapine as treatment adjuncts to prevent COVID-19 associated adult respiratory distress syndrome (ARDS)


title: Ethical framework for head and neck cancer care impacted by COVID-19

text: The COVID-19 pandemic has upended head and neck cancer care delivery in ways unforeseen and unprecedented. The impact of these changes parallels other fields in oncology, but is disproportionate due to protective measures and limitations on potentially aerosolizing procedures and related interventions specific to the upper aerodigestive tract. The moral and professional dimensions of providing ethically appropriate and consistent care for our patients in the COVID-19 crisis are considered herein for head and neck oncology providers.


title: Implications of SARS-CoV-2 Mutations for Genomic RNA Structure and Host microRNA Targeting

text: The SARS-CoV-2 virus is a recently-emerged zoonotic pathogen already well adapted to transmission and replication in humans. Although the mutation rate is limited, recently introduced mutations in SARS-CoV-2 have the potential to alter viral fitness. In addition to amino acid changes, mutations could affect RNA secondary structure critical to viral life cycle, or interfere with sequences targeted by host miRNAs. We have analysed subsets of genomes from SARS-CoV-2 isolates from around the globe and show that several mutations introduce changes in Watson-Crick pairing, with resultant changes in predicted secondary structure. Filtering to targets matching miRNAs expressed in SARS-CoV-2-permissive host cells, we identified ten separate target sequences in the SARS-CoV-2 genome; three of these targets have been lost through conserved mutations. A genomic site targeted by the highly abundant miR-197-5p, overexpressed in patients with cardiovascular disease, is lost by a conserved mutation. Our results are compatible with a model that SARS-CoV-2 replication within the human host is constrained by host miRNA defences. The impact of these and further mutations on secondary structures, miRNA targets or potential splice sites offers a new context in which to view future SARS-CoV-2 evolution, and a potential platform for engineering conditional attenuation to vaccine development, as well as providing a better understanding of viral tropism and pathogenesis.


First COVID-19 maternal mortality in the UK associated with thrombotic complications


Is Immuno-modulation the Key to COVID-19 Pandemic?


The role of IgA in COVID-19


title: A Potently Neutralizing Antibody Protects Mice against SARS-CoV-2 Infection

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for millions of infections and hundreds of thousands of deaths globally. There are no widely available licensed therapeutics against SARS-CoV-2, highlighting an urgent need for effective interventions. The virus enters host cells through binding of a receptor-binding domain within its trimeric spike glycoprotein to human angiotensin-converting enzyme 2. In this article, we describe the generation and characterization of a panel of murine mAbs directed against the receptor-binding domain. One mAb, 2B04, neutralized wild-type SARS-CoV-2 in vitro with remarkable potency (half-maximal inhibitory concentration of <2 ng/ml). In a murine model of SARS-CoV-2 infection, 2B04 protected challenged animals from weight loss, reduced lung viral load, and blocked systemic dissemination. Thus, 2B04 is a promising candidate for an effective antiviral that can be used to prevent SARS-CoV-2 infection.


title: Central nervous system involvement by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)

text: Neurologic sequelae can be devastating complications of respiratory viral infections. We report the presence of virus in neural and capillary endothelial cells in frontal lobe tissue obtained at postmortem examination from a patient infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Our observations of virus in neural tissue, in conjunction with clinical correlates of worsening neurologic symptoms, pave the way to a closer understanding of the pathogenic mechanisms underlying central nervous system involvement by SARS-CoV-2.


Reply to a Comment about the Article Published in Acta Med Port 2020; Apr 27; doi:10.20344/amp.13928


title: [Using the big data of internet to understand the characteristics of coronavirus disease 2019: a big data study]

text: Objective: To analyze the symptom characteristics of Coronavirus Disease 2019(COVID-19) and to improve its prevention by using big data. Methods: Using Baidu Index Platform (http://index.baidu.com) and the website of Chinese Center for Disease Control and Prevention as data resources, we obtained the search volume (SV) of keywords for symptoms associated with COVID-19 from January 1 to February 20 in each year from 2017 to 2020, in Hubei province and other top 10 impacted provinces in China and the epidemic data. Data of 2020 were compared with the previous three years. Data of Hubei province were compared with confirmed cases. The differences and characteristics of the SV of COVID-19-related symptoms, and the correlation between the SV of COVID-19 and new confirmed or suspected cases were analyzed and the hysteresis effects were discussed. R3.6.2 software was used to analyze the data. Results: Compared the data from January 1 to February 20, 2020, with the SV for the same period of previous three years, Hubei's SV for cough, fever, diarrhea, chest tightness, dyspnea and other symptoms were significantly increased. The total SV of lower respiratory symptoms was significantly higher than that of upper respiratory symptoms (P<0.001). The SV of COVID-19 in Hubei province was significantly correlated with new confirmed or suspected cases (r(confirmed)=0.723, r(suspected)=0.863, all P<0.001). The results of the distributed lag model suggested that the patients who retrieved relevant symptoms on the internet may begin to see a doctor in 2-3 days later and be diagnosed in 3-4 days later. Conclusions: The total SV of lower respiratory symptoms is higher than that of upper respiratory symptoms, and the SV of diarrhea also increases significantly. It warns us to pay attention to not only the symptoms of lower respiratory tract, but also the gastrointestinal symptoms, especially diarrhea in patients with COVID-19. There is a relationship between internet retrieval behavior and the number of new confirmed or suspected cases. Big data have a certain role in the early warning of infectious diseases.


title: COVID-19 and Avoiding Ibuprofen. How Good Is the Evidence?

text: Ibuprofen is an over-the-counter medication that is used widely for the treatment of pain and fever during COVID-19 pandemic. A concern was raised regarding the safety of ibuprofen use because of its role in increasing ACE2 levels within the Renin-Angiotensin-Aldosterone system. ACE2 is the coreceptor for the entry of SARS-CoV-2 into cells, and so, a potential increased risk of contracting COVID-19 disease and/or worsening of COVID-19 infection was feared with ibuprofen use. However, available data from limited studies show administration of recombinant ACE2 improves lung damage caused by respiratory viruses, suggesting ibuprofen use may be beneficial in COVID-19 disease. At this time, there is no supporting evidence to discourage the use of ibuprofen.


title: British Society of Gastroenterology guidance for management of inflammatory bowel disease during the COVID-19 pandemic

text: The COVID-19 pandemic is putting unprecedented pressures on healthcare systems globally. Early insights have been made possible by rapid sharing of data from China and Italy. In the UK, we have rapidly mobilised inflammatory bowel disease (IBD) centres in order that preparations can be made to protect our patients and the clinical services they rely on. This is a novel coronavirus; much is unknown as to how it will affect people with IBD. We also lack information about the impact of different immunosuppressive medications. To address this uncertainty, the British Society of Gastroenterology (BSG) COVID-19 IBD Working Group has used the best available data and expert opinion to generate a risk grid that groups patients into highest, moderate and lowest risk categories. This grid allows patients to be instructed to follow the UK government's advice for shielding, stringent and standard advice regarding social distancing, respectively. Further considerations are given to service provision, medical and surgical therapy, endoscopy, imaging and clinical trials.


title: Antithrombotic Therapies in COVID-19 Disease: a Systematic Review

text: BACKGROUND: Infection with coronavirus SARS-CoV-2, causing COVID-19 disease, leads to inflammation and a prothrombotic state. OBJECTIVE: This rapid systematic review aims to synthesize evidence on thromboembolism incidence and outcomes with antithrombotic therapies in COVID-19. DATA SOURCES: We searched MEDLINE (Ovid), Cochrane Rapid Reviews, PROSPERO, and the WHO COVID-19 Database from January 1, 2003, to April 22, 2020, for studies meeting pre-specified inclusion criteria. STUDY SELECTION, DATA EXTRACTION, AND SYNTHESIS: One investigator identified articles for inclusion, abstracted data, and performed quality assessment, with second reviewer checking. RESULTS: Incidence of thromboembolism among hospitalized patients with COVID-19 ranged from 25 to 53% in 4 retrospective series. We identified 3 studies (1 retrospective cohort study, 1 prospective uncontrolled observational study, and 1 case series) examining outcomes among COVID-19 patients who received antithrombotic therapies. These studies all included different interventions (thromboprophylaxis with unfractionated heparin (UFH) or low molecular-weight heparin (LMWH); an intensive thromboprophylaxis protocol with LMWH, antithrombin, and clopidogrel; and salvage therapy with tissue plasminogen activator and heparin). These studies are overall poor quality due to methodological limitations including unclear patient selection protocols, lack of reporting or adjustment for patient baseline characteristics, inadequate duration of follow-up, and partial reporting of outcomes. CONCLUSIONS: New evidence on thromboembolism in COVID-19 does not warrant a change in current guidance on thromboprophylaxis among hospitalized patients. Prospective trials of antithrombotic treatment strategies among patients with COVID-19 are urgently needed.


Neurology and the COVID-19 emergency


title: COVID-19 in a Patient Presenting with Syncope and a Normal Chest X-ray

text: SARS-CoV-2 is a novel virus that has now affected hundreds of thousands of individuals across the world. Amidst this global pandemic, maintaining a high index of suspicion, rapid testing capacity, and infection control measures are required to curtail the virus' rapid spread. While fever and respiratory symptoms have been commonly used to identify COVID-19 suspects, we present an elderly female who arrived to the hospital after a syncopal episode. She was afebrile with a normal chest X-ray and there was no suspicion of COVID-19. She then developed a fever and tested positive for COVID-19. Our unique case underscores the increasing diversity of COVID-19 presentations and potential for initial mis- diagnosis and delay in implementing proper precautions.


title: An intent-based approach for creating assistive robots' control systems

text: The current research standards in robotics demand general approaches to robots' controllers development. In the assistive robotics domain, the human-machine interaction plays a~substantial role. Especially, the humans generate intents that affect robot control system. In the article an approach is presented for creating control systems for assistive robots, which reacts to users' intents delivered by voice commands, buttons, or an operator console. The whole approach was applied to the real system consisting of customised \tiago{} robot and additional hardware components. The exemplary experiments performed on the platform illustrate the motivation for diversification of human-machine interfaces in assistive robots.


title: Radiographic and chest CT imaging presentation and follow-up of COVID-19 pneumonia: a multicenter experience from an endemic area

text: COVID-19 has infected more than 2 million people in the world in less than 5 months outbreak. Chest imaging is recommended for triage of suspected cases of COVID-19 with moderate-severe clinical features and high pre-test probability of disease, and may help for patient follow-up and to identify patients at higher risk of disease worsening. This pictorial essay illustrates typical and uncommon imaging findings of COVID-19 pneumonia and the role of imaging for patient management.


docid: ahwnezdn

title: Headache as the Presenting Symptom in 2 Patients With COVID-19 and a History of Migraine: 2 Case Reports

text: The coronavirus disease 2019 (COVID-19) pandemic has now affected more than 5 million people globally. Typical symptoms include fever, cough, and shortness of breath. Patients with underlying medical comorbidities such as cardiovascular disease and diabetes are more likely to become severely ill. To date there is limited information on how COVID-19 affects patients with a history migraine. Here, we present the cases of 2 women with a history of migraine whose first symptom of COVID-19 was a severe persistent headache.


title: Partially-Latent Class Models (pLCM) for Case-Control Studies of Childhood Pneumonia Etiology

text: In population studies on the etiology of disease, one goal is the estimation of the fraction of cases attributable to each of several causes. For example, pneumonia is a clinical diagnosis of lung infection that may be caused by viral, bacterial, fungal, or other pathogens. The study of pneumonia etiology is challenging because directly sampling from the lung to identify the etiologic pathogen is not standard clinical practice in most settings. Instead, measurements from multiple peripheral specimens are made. This paper introduces the statistical methodology designed for estimating the population etiology distribution and the individual etiology probabilities in the Pneumonia Etiology Research for Child Health (PERCH) study of 9; 500 children for 7 sites around the world. We formulate the scientific problem in statistical terms as estimating the mixing weights and latent class indicators under a partially-latent class model (pLCM) that combines heterogeneous measurements with different error rates obtained from a case-control study. We introduce the pLCM as an extension of the latent class model. We also introduce graphical displays of the population data and inferred latent-class frequencies. The methods are tested with simulated data, and then applied to PERCH data. The paper closes with a brief description of extensions of the pLCM to the regression setting and to the case where conditional independence among the measures is relaxed.


title: Erfahrungen und Belastungserleben niedergelassener Neurologen und Psychiater während der COVID-19-Pandemie./ [Experience of Practice-Based Psychiatrists and Neurologists During the COVID-19 Pandemic]

text: AIM: To date, to our knowledge there are no studies regarding attitudes and experiences of outpatient medical personnel during a pandemic. This study's aim was to evaluate the impact of the COVID-19 pandemic in March 2020 on German psychiatrists and neurologists. METHODS: An e-mail and fax-based short survey of 2,072 practice-based psychiatrists and neurologists was performed including Likert-type questions on personal burden and concerns, anticipated risk of infection, practice management as well as anxiety and sleep problems. RESULTS: 396 physicians returned the questionnaire (19â%). More than 60â% of the participants felt restricted strongly or very strongly, more than 30â% were strongly and very strongly concerned. They anticipated a high own risk of infection. However, 91â% did not report any contact with patients positively screened for COVID-19, which they were aware of. One third felt financially threatened and loss of business volume was anticipated. 18â% reported, that the pandemic triggers substantial anxiety. Sleep problems, which occur at least almost every night, were rarely reported (9â%). CONCLUSION: Practice-based psychiatrists and neurologists are negatively affected by the COVID-19 pandemic.


COVID-19 and the Social Determinants of Health


title: Hydroxychloroquine use during the COVID-19 pandemic 2020

text: At present, there are no studies demonstrating the clinical efficacy of hydroxychloroquine for the prophylaxis or treatment of COVID-19 infection.


Mass Drug Administration and Worms Experience in Africa: Envisage Repurposing Ivermectin for SARS-COV-2


title: Coronavirus disease of 2019 (COVID-19) in the Gulf Cooperation Council (GCC) countries: Current status and management practices

text: Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently a global threat to human population. The numbers of cases and deaths due to COVID-19 are escalating daily, putting health care systems worldwide under tremendous pressure. Policymakers in the affected countries have adopted varying strategies to deal with this crisis. As a result, the current COVID-19 status in terms of number of cases and deaths hugely varies between countries. The Gulf Cooperation Council (GCC) countries have managed to limit the massive spread of the infection among their populations by implementing proactive plans and timely decisions in response to COVID-19 outbreak; measures taken included suspension of flights, closure of educational institutes, curfew and lockdown of major cities, and provision of free-of-charge healthcare to patients. This review summarizes the COVID-19 status as of 18 May 2020 and highlights prevention and control measures applied in the GCC countries.


Editorial. Innovations in neurosurgical education during the COVID-19 pandemic: is it time to reexamine our neurosurgical training models?


docid: qpkdlijj

title: Genesis of an emergency public drug information website by the French Society of Pharmacology and Therapeutics during the COVID-19 pandemic

text: On March 16, 2020, the French Society of Pharmacology and Therapeutics put online a national Question and Answer (Q&A) website, https://sfpt-fr.org/covid19 on the proper use of drugs during the COVID-19 pandemic. The working group 'Drugs and COVID-19' was composed of a scientific council, an editorial team, and experts in the field. The first questions were posted online during the first evening of home-confinement in France, March 17, 2020. Six weeks later, 140 Q&As have been posted. Questions on the controversial use of hydroxychloroquine and to a lesser extent concerning azithromycin have been the most consulted Q&As. Q&As have been consulted 226 014 times in 41 days. This large visibility was obtained through an early communication on Twitter, Facebook, traditional print, and web media. In addition, an early communication through the French Ministry of Health and the French National Agency for Medicines and Health Products Safety ANSM had a large impact in terms of daily number of views. There is a pressing need to sustain a public drug information service combining the expertise of scholarly pharmacology societies, pharmacovigilance network, and the Ministry of Health to quickly provide understandable, clear, expert answers to the general population's concerns regarding COVID-19 and drug use and to counter fake news.


title: Future Evolution of COVID-19 Pandemic in North Carolina: Can We Flatten the Curve?

text: On June 24th, Governor Cooper announced that North Carolina will not be moving into Phase 3 of its reopening process at least until July 17th. Given the recent increases in daily positive cases and hospitalizations, this decision was not surprising. However, given the political and economic pressures which are forcing the state to reopen, it is not clear what actions will help North Carolina to avoid the worst. We use a compartmentalized model to study the effects of social distancing measures and testing capacity combined with contact tracing on the evolution of the pandemic in North Carolina until the end of the year. We find that going back to restrictions that were in place during Phase 1 will slow down the spread but if the state wants to continue to reopen or at least remain in Phase 2 or Phase 3 it needs to significantly expand its testing and contact tracing capacity. Even under our best-case scenario of high contact tracing effectiveness, the number of contact tracers the state currently employs is inadequate.


Acute Myocarditis With Ventricular Noncompaction in a COVID-19 Patient


docid: gqiapgiv

title: Visualising the Evolution of English Covid-19 Cases with Topological Data Analysis Ball Mapper

text: Understanding disease spread through data visualisation has concentrated on trends and maps. Whilst these are helpful, they neglect important multi-dimensional interactions between characteristics of communities. Using the Topological Data Analysis Ball Mapper algorithm we construct an abstract representation of NUTS3 level economic data, overlaying onto it the confirmed cases of Covid-19 in England. In so doing we may understand how the disease spreads on different socio-economical dimensions. It is observed that some areas of the characteristic space have quickly raced to the highest levels of infection, while others close by in the characteristic space, do not show large infection growth. Likewise, we see patterns emerging in very different areas that command more monitoring. A strong contribution for Topological Data Analysis, and the Ball Mapper algorithm especially, in comprehending dynamic epidemic data is signposted.


Covid-19: Cases rise in Russia as health workers pay the price for PPE shortage


title: Atención de los síndromes coronarios agudos durante la contingencia sanitaria por brote de SARS-CoV-2

text: The communications accumulated in the last weeks make it clear that there is no agreement to define the best treatment strategy in patients with acute coronary syndrome (SICA) In patients presenting with an acute myocardial infarction with ST-segment elevation (IAMCESST), it has been suggested to favor fibrinolysis (FL) over primary percutaneous coronary intervention (PCI), reserving ICP for cases of failed FL1,2;however, some societies have maintained the indication of the ICPp as the repercussion method of choice3 In SICAs without ST segment elevation (SICASESST) the recommendations are very similar, favoring medical treatment over percutaneous coronary intervention in this subgroup of patients1 Several companies consider the contagion status, particularly in the SICASESST, to decide which repercussion follow3 Anticipating that the epidemiological curve in Mexico will be similar to that observed in most countries, we recommend continuing the care of patients with SICA, the catheterization rooms must maintain their operation


Call for Special Issue Papers: Digital Romance and Dating, Including COVID-19 Pandemic-Related Impacts


title: Principalism in public health decision making in the context of the COVID-19 pandemic

text: BACKGROUND: The COVID-19 pandemic lead scientists and governmental authorities to issue clinical and public health recommendations based on progressively emerging evidence and expert opinions and many of these fast-tracked to peer-reviewed publications. Concerns were raised on scientific quality and generalizability of this emerging evidence. MAIN ARGUMENT: However, this way acting is not entirely new and often public health decisions are based on flawed and ambiguous evidence. Thus, to better guide decisions in these circumstances, in this article we argue that there is a need to follow fundamental principles in order to guide best public health practices. We purpose the usefulness of the framework of principalism in public which has been proved useful in real life conditions as a guide in the absence of reliable evidence. CONCLUSIONS: It is recommended the implementation of these principles in an integrated manner adopting an holistic system approach to health policies adapted to specificities of local contexts.


docid: twusowzh

title: Global Neurosurgery in the Time of COVID-19


Manifestaciones cutáneas en contexto del brote actual de enfermedad por coronavirus 2019./ [Cutaneous manifestations in the current pandemic of coronavirus infection disease (COVID 2019)]


Correction: Clinicopathological characteristics of 8697 patients with COVID-19 in China: a meta-analysis


Hitting the reset button for hospitality research in times of crisis: Covid19 and beyond


Diagnosis and Treatment Plan for COVID-19 (Trial Version 6)


Unconventional approaches to mechanical ventilation-step-by-step through the COVID-19 crisis


title: Prevalence of novel coronavirus pneumonia in the early stage of transmission and responding strategies in Japan/ 上海预防医学

text: Novel coronavirus pneumonia disease (COVID-19) caused by SARS-CoV-2 began to emerge in Wuhan, Hubei, China in December 2019. It is currently spreading globally including Japan. The COVID-19 case in Japan began to appear in middle January 2020 and continued to increase over time. The period from middle January to the end of February is considered to be the initial stage of domestic transmission in Japan. This article described the spread of 935 COVID-19 cases related to Japan by the end of February 2020, including the 15 infected Japanese returned from Wuhan, the 696 infected individuals in the large-scale cruise ship 'Diamond Princess' and the 224 infected individuals in Japan. This paper summarizes the measures to control the spread of SARS-CoV-2 in Japan, such as limiting RT-PCR detection for SARS-CoV-2, reducing the number of patients with mild illness who go to medical institutions unnecessarily, formulating guidelines for SARS-CoV-2 infection consultation, canceling large gatherings and temporarily closing schools. This paper further points out the problems encountered in the prevention and control of the spread of SARS-CoV-2 in Japan, such as the slow detection of RT-PCR, the risk of infection faced by medical staff, the regional differences in the domestic health care service system, the confusion of information disclosure and management. The above introduction as allows us to acquire a better understanding of the new coronavirus pneumonia in Japan and the world and may provide reference for the control the epidemic of COVID-19 in worldwide.


title: A new normal with cataract surgery during COVID-19 pandemic

text: Cataract is the second leading cause of preventable blindness on the globe. Several programs across the country have been running efficiently to increase the cataract surgical rates and decrease blindness due to cataract. The current COVID-19 pandemic has led to a complete halt of these programs and thus accumulating all the elective cataract procedures. At present with the better understanding of the safety precautions among the health care workers and general population the Government of India (GoI) has given clearance for functioning of eye care facilities. In order to facilitate smooth functioning of every clinic, in this paper, we prepared preferred practice pattern based on consensus discussions between leading ophthalmologists in India including representatives from major governmental and private institutions as well as the All India Ophthalmological Society leadership. These guidelines will be applicable to all practice settings including tertiary institutions, corporate and group practices and individual eye clinics. The guidelines include triage, use of personal protective equipment, precautions to be taken in the OPD and operating room as well for elective cataract screening and surgery. These guidelines have been prepared based on current situation but are expected to evolve over a period of time based on the ongoing pandemic and guidelines from GoI.


title: COVID-19 and immunomodulation treatment for women with reproductive failures

text: COVID-19 pandemic is affecting various areas of health care, including human reproduction. Many women with reproductive failures, during the peri-implantation period and pregnancy, are on the immunotherapy using immune modulators and immunosuppressant due to underlying autoimmune diseases, cellular immune dysfunction, and rheumatic conditions. Many questions have been raised for women with immunotherapy during the COVID-19 pandemic, including infection susceptibility, how to manage women with an increased risk of and active COVID-19 infection. SARS-CoV-2 is a novel virus, and not enough information exists. Yet, we aim to review the data from previous coronavirus outbreaks and current COVID-19 and provide interim guidelines for immunotherapy in women with reproductive failures.


docid: jdfwchpo

title: Assessing the relationship between surface levels of PM2.5 and PM10 particulate matter impact on COVID-19 in Milan, Italy

text: The novel coronavirus disease (COVID-19) is a highly pathogenic, transmittable and invasive pneumococcal disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which emerged in December 2019 and January 2020 in Wuhan city, Hubei province, China and fast spread later on the middle of February 2020 in the Northern part of Italy and Europe. This study investigates the correlation between the degree of accelerated diffusion and lethality of COVID-19 and the surface air pollution in Milan metropolitan area, Lombardy region, Italy. Daily average concentrations of inhalable particulate matter (PM) in two size fractions PM2.5, PM10 and maxima PM10 ground level atmospheric pollutants together air quality and climate variables (daily average temperature, relative humidity, wind speed, atmospheric pressure field and Planetary Boundary Layer-PBL height) collected during 1 January-30 April 2020 were analyzed. In spite of being considered primarily transmitted by indoor bioaerosols droplets and infected surfaces, or direct human-to-human personal contacts, it seems that high levels of urban air pollution, weather and specific climate conditions have a significant impact on the increased rates of confirmed COVID-19 Total number, Daily New and Total Deaths cases, possible attributed not only to indoor but also to outdoor airborne bioaerosols distribution. Our analysis demonstrates the strong influence of daily averaged ground levels of particulate matter concentrations, positively associated with average surface air temperature and inversely related to air relative humidity on COVID-19 cases outbreak in Milan. Being a novel pandemic coronavirus (SARS-CoV-2) version, COVID-19 might be ongoing during summer conditions associated with higher temperatures and low humidity levels. Presently is not clear if this protein "spike" of the new coronavirus COVID-19 is involved through attachment mechanisms on indoor or outdoor airborne aerosols in the infectious agent transmission from a reservoir to a susceptible host in some agglomerated urban areas like Milan is.


Back to the Future: Shortcomings of an Archaic Model for Radiology Lectures


title: Are women still "the other"? Gendered mental health interventions for health care workers in Spain during COVID-19

text: During the COVID-19 pandemic, Spain ranked 1st in number of infected health workers. Despite the fact that up to 75% of them were women, psychological interventions to prevent distress usually lacked a gender perspective and a biopsychosocial approach. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Hepatic complications of COVID-19 and its treatment

text: Coronavirus disease 2019 (COVID-19) is highly contagious and has a variety of clinical manifestations, it can affect a number of other organs in addition to the lungs, and liver injury may occur. Severe acute respiratory syndrome coronavirus 2 can cause liver injury through systemic inflammatory response syndrome, cytokine storms, ischemia-reperfusion injury, side effects of treatment drugs, and underlying liver disease and can attack liver cells directly via angiotensin-converting enzyme 2. Clinical studies have found that liver injury in COVID-19 patients mainly manifests as abnormal liver biochemical indicators, but there have been no reports of liver failure caused by this disease. The number of COVID-19 patients with liver injury is increasing, and the incidence of liver injury in COVID-19 patients with severe disease are higher than in patients with mild disease. Liver injury may be a risk factor, which worsens in patients with COVID-19, and hence it is necessary to pay attention to the occurrence of liver injury in the diagnosis and treatment of COVID-19.


docid: bfuqquhx

title: Urology in the time of corona


title: A Privacy-preserving Mobile and Fog Computing Framework to Trace and Prevent COVID-19 Community Transmission

text: To slow down the spread of COVID-19, governments around the world are trying to identify infected people and to contain the virus by enforcing isolation and quarantine. However, it is difficult to trace people who came into contact with an infected person, which causes widespread community transmission and mass infection. To address this problem, we develop an e-government Privacy Preserving Mobile and Fog computing framework entitled PPMF that can trace infected and suspected cases nationwide. We use personal mobile devices with contact tracing app and two types of stationary fog nodes, named Automatic Risk Checkers (ARC) and Suspected User Data Uploader Node (SUDUN), to trace community transmission alongside maintaining user data privacy. Each user's mobile device receives a Unique Encrypted Reference Code (UERC) when registering on the central application. The mobile device and the central application both generate Rotational Unique Encrypted Reference Code (RUERC), which broadcasted using the Bluetooth Low Energy (BLE) technology. The ARCs are placed at the entry points of buildings, which can immediately detect if there are positive or suspected cases nearby. If any confirmed case is found, the ARCs broadcast pre-cautionary messages to nearby people without revealing the identity of the infected person. The SUDUNs are placed at the health centers that report test results to the central cloud application. The reported data is later used to map between infected and suspected cases. Therefore, using our proposed PPMF framework, governments can let organizations continue their economic activities without complete lockdown.


docid: klprrzhk

title: Can dried blood spots (DBS) contribute to conducting comprehensive SARS-CoV-2 antibody tests?


The negative impact of wearing personal protective equipment on communication during coronavirus disease 2019


Improving staff safety during tracheostomy in COVID-19 patients


Is innate immunity our best weapon for flattening the curve?


Managing patients with hematological malignancies during COVID-19 pandemic


title: A comparison of Monte Carlo sampling methods for metabolic network models

text: Reaction rates (fluxes) in a metabolic network can be analyzed using constraint-based modeling which imposes a steady state assumption on the system. In a deterministic formulation of the problem the steady state assumption has to be fulfilled exactly, and the observed fluxes are included in the model without accounting for experimental noise. One can relax the steady state constraint, and also include experimental noise in the model, through a stochastic formulation of the problem. Uniform sampling of fluxes, feasible in both the deterministic and stochastic formulation, can provide us with statistical properties of the metabolic network, such as marginal flux probability distributions. In this study we give an overview of both the deterministic and stochastic formulation of the problem, and of available Monte Carlo sampling methods for sampling the corresponding solution space. We apply the ACHR, OPTGP, CHRR and Gibbs sampling algorithms to ten metabolic networks and evaluate their convergence, consistency and efficiency. The coordinate hit-and-run with rounding (CHRR) is found to perform best among the algorithms suitable for the deterministic formulation. A desirable property of CHRR is its guaranteed distributional convergence. Among the three other algorithms, ACHR has the largest consistency with CHRR for genome scale models. For the stochastic formulation, the Gibbs sampler is the only method appropriate for sampling at genome scale. However, our analysis ranks it as less efficient than the samplers used for the deterministic formulation.


Caution: Wit and Humor During the COVID-19 Pandemic


docid: vdmjvuxd

title: Rapid Deployment of a Statewide COVID-19 ECHO Program for Frontline Clinicians: Early Results and Lessons Learned


Should we deny ICU admission to the elderly? Ethical considerations in times of COVID-19


COVID-19 and the history of antiseptic surgery: how to tackle these little beasts


title: Psychosocial Vulnerabilities to Upper Respiratory Infectious Illness: Implications for Susceptibility to Coronavirus Disease 2019 (COVID-19)

text: For 35 years, our laboratory has been involved in identifying psychosocial factors that predict who becomes ill when they are exposed to a virus affecting the upper respiratory tract. To pursue this question, we used a unique viral-challenge design in which we assessed behavioral, social, and psychological factors in healthy adults. We subsequently exposed these adults to a cold or influenza virus and then monitored them in quarantine for 5 to 6 days for onset of respiratory illness. Factors we found to be associated with greater risk of respiratory illnesses after virus exposure included smoking, ingesting an inadequate level of vitamin C, and chronic psychological stress. Those associated with decreased risk included social integration, social support, physical activity, adequate and efficient sleep, and moderate alcohol intake. We cautiously suggest that our findings could have implications for identifying who becomes ill when exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). This argument is based on evidence that the associations we report are replicable across multiple respiratory viruses and that the pathways found to link psychosocial factors to colds and influenza may play similar roles in COVID-19.


Homocysteine as a potential predictor of cardiovascular risk in patients with COVID-19


title: Population flow drives spatio-temporal distribution of COVID-19 in China

text: Sudden, large-scale and diffuse human migration can amplify localized outbreaks of disease into widespread epidemics1-4. Rapid and accurate tracking of aggregate population flows may therefore be epidemiologically informative. Here we use 11,478,484 counts of mobile phone data from individuals leaving or transiting through the prefecture of Wuhan between 1 January and 24 January 2020 as they moved to 296 prefectures throughout mainland China. First, we document the efficacy of quarantine in ceasing movement. Second, we show that the distribution of population outflow from Wuhan accurately predicts the relative frequency and geographical distribution of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) until 19 February 2020, across mainland China. Third, we develop a spatio-temporal 'risk source' model that leverages population flow data (which operationalize the risk that emanates from epidemic epicentres) not only to forecast the distribution of confirmed cases, but also to identify regions that have a high risk of transmission at an early stage. Fourth, we use this risk source model to statistically derive the geographical spread of COVID-19 and the growth pattern based on the population outflow from Wuhan; the model yields a benchmark trend and an index for assessing the risk of community transmission of COVID-19 over time for different locations. This approach can be used by policy-makers in any nation with available data to make rapid and accurate risk assessments and to plan the allocation of limited resources ahead of ongoing outbreaks.


title: The Potential of Various Nanotechnologies for Coronavirus Diagnosis/Treatment Highlighted through a Literature Analysis

text: With the current COVID-19 outbreak, it has become essential to develop efficient methods for the treatment and detection of this virus. Among the new approaches that could be tested, that relying on nanotechnology finds one of its main grounds in the similarity between nanoparticle (NP) and coronavirus (COV) sizes, which promotes NP-COV interactions. Since COVID-19 is very recent, most studies in this field have focused on other types of coronavirus than COVID-19, such as those involved in MERS or SARS diseases. Although their number is limited, they have led to promising results on various COV using a wide range of different types of nanosystems, e.g., nanoparticles, quantum dos, or nanoassemblies of polymers/proteins. Additional efforts deserve to be spent in this field to consolidate these findings. Here, I first summarize the different nanotechnology-based methods used for COV detection, i.e., optical, electrical, or PCR ones, whose sensitivity was improved by the presence of nanoparticles. Furthermore, I present vaccination methods, which comprise nanoparticles used either as adjuvants or as active principles. They often yield a better-controlled immune response, possibly due to an improved antigen presentation/processing than in non-nanoformulated vaccines. Certain antiviral approaches also took advantage of nanoparticle uses, leading to specific mechanisms such as the blocking of virus replication at the cellular level or the reduction of a COV induced apoptotic cellular death.


title: Community pharmacist in public health emergencies: Quick to action against the coronavirus 2019-nCoV outbreak

text: The 2019-nCoV infection that is caused by a novel strain of coronavirus was first detected in China in the end of December 2019 and declared a public health emergency of international concern by the World Health Organization on January 30, 2020. Community pharmacists in one of the first areas that had confirmed cases of the viral infection, Macau, joined the collaborative force in supporting the local health emergency preparedness and response arrangements. This paper aimed to improve the understanding of community pharmacists' role in case of 2019-CoV outbreak based on the practical experiences in consultation with the recommendations made by the International Pharmaceutical Federation on the Coronavirus 2019-nCoV outbreak.


COVID-19 and Semen: An Unanswered Area of Research


title: Clinical evaluation of a rapid colloidal gold immunochromatography assay for SARS-Cov-2 IgM/IgG

text: BACKGROUND: Since December 2019, there had been an outbreak of COVID-19 in Wuhan, China At present, diagnosis COVID-19 were based on real-time RT-PCR, which have to be performed in biosafe laboratory and is unsatisfactory for suspect case screening Therefore, there is an urgent need for rapid diagnostic test for COVID-19 OBJECTIVE: To evaluate the diagnostic performance and clinical utility of the colloidal gold immunochromatography assay for SARS-Cov-2 specific IgM/IgG anti-body detection in suspected COVID-19 cases METHODS: In the prospective cohort, 150 patients with fever or respiratory symptoms were enrolled in Taizhou Public Health Medical Center, Taizhou Hospital, Zhejiang province, China, between January 20 to February 2, 2020 All patients were tested by the colloidal gold immunochromatography assay for COVID-19 At least two samples of each patient were collected for RT-PCR assay analysis, and the PCR results were performed as the reference standard of diagnosis Meanwhile 26 heathy blood donor were recruited The sensitivity and specificity of the immunochromatography assay test were evaluated Subgroup analysis were performed with respect to age, sex, period from symptom onset and clinical severity RESULTS: The immunochromatography assay test had 69 positive result in the 97 PCR-positive cases, achieving sensitivity 71 1% [95% CI 0 609-0 797], and had 2 positive result in the 53 PCR-negative cases, achieving specificity 96 2% [95% CI 0 859-0 993] In 26 healthy donor blood samples, the immunochromatography assay had 0 positive result In subgroup analysis, the sensitivity was significantly higher in patients with symptoms more than 14 days 95 2% [95% CI 0 741-0 998] and patients with severe clinical condition 86 0% [95% CI 0 640-0 970] CONCLUSIONS: The colloidal gold immunochromatography assay for SARS-Cov-2 specific IgM/IgG anti-body had 71 1% sensitivity and 96 2% specificity in this population, showing the potential for a useful rapid diagnosis test for COVID-19 Further investigations should be done to evaluate this assay in variety of clinical settings and populations


Urgent dental care for patients during the COVID-19 pandemic


title: The mystery of "missing" visits in an emergency cardiology department, in the era of COVID-19.; a time-series analysis in a tertiary Greek General Hospital

text: BACKGROUND: In the era of the current COVID-19 health crisis, the aim of the present study was to explore population behavior as regards the visits in the Εmergency Cardiology department (ECD) of a tertiary General Hospital that does not hospitalize SARS-CoV-2 infected patients METHODS AND RESULTS: Daily number of visits at the EDC and admissions to Cardiology Wards and Intensive Care Unit of a tertiary General Hospital, in Athens, Greece, were retrieved from hospital's database (January 1st-April 30th 2018, 2019 and 2020). A highly significant reduction in the visits at ECD of the hospital during March and April 2020 was observed as compared with January and February of the same year (p for linear trend < ·001); in particular the number of visits was 41.1% lower in March 2020 and 32.7% lower in April 2020, as compared to January 2020. As the number of confirmed COVID-19 cases throughout the country increased (i.e., from February 26th to April 2nd) the number of visits at ECD decreased (p = 0.01), whereas, the opposite was observed in the period afterwards (p = 0.01).The number of acute Myocardial infarctions (MI) cases in March 2020 was the lowest compared to the entire three year period (p < 0·001); however, the number of acute MI cases in April 2020 was doubled as compared to March 2020, but still was lower than the preceding years (p < 0·001). CONCLUSIONS: It is hard to explain the mystery of the "missing" emergency hospital visits. However, if this decline in cardiovascular disease related hospital visits is "true", it is something that needs to be rigorously studied, to learn how to keep these rates down.


title: The COVID-19 pandemic's impact on U.S. electricity demand and supply: an early view from the data

text: After the onset of the recent COVID-19 pandemic, a number of studies reported on possible changes in electricity consumption trends. The overall theme of these reports was that ``electricity use has decreased during the pandemic, but the power grid is still reliable''---mostly due to reduced economic activity. In this paper we analyze electricity data upto end of May 2020, examining both electricity demand and variables that can indicate stress on the power grid, such as peak demand and demand ramp-rate. We limit this study to three states in the USA: New York, California, and Florida. The results indicate that the effect of the pandemic on electricity demand is not a simple reduction from comparable time frames, and there are noticeable differences among regions. The variables that can indicate stress on the grid also conveyed mixed messages: some indicate an increase in stress, some indicate a decrease, and some do not indicate any clear difference. A positive message is that some of the changes that were observed around the time stay-at-home orders were issued appeared to revert back by May 2020. A key challenge in ascribing any observed change to the pandemic is correcting for weather. We provide a weather-correction method, apply it to a small city-wide area, and discuss the implications of the estimated changes in demand. The weather correction exercise underscored that weather-correction is as challenging as it is important.


COVID-19; beyond the obvious: how do we move forward?


Psychogeriatric research during COVID-19 pandemic: qualitative analysis of participant views


title: Ethical and Logistical Considerations of Caring for Older Adults on Inpatient Psychiatry During the COVID-19 Pandemic

text: The coronavirus disease 2019 (COVID-19) pandemic has brought challenges to delivery of care for older adults on inpatient psychiatry. We describe two cases: patient A, a 62-year-old woman who initially refused screening for potential COVID-19, bringing up questions about threshold for capacity when public health is at risk and questions about whether screening for infection should be different in older adults. The other case, patient B, is that of an 83-year-old man who was on the unit when patient A tested positive, and brought up concerns for risk of dissemination in the context of wandering, spitting behaviors, and inability to adhere to room isolation or masking measures. We review measures taken to decrease risk of transmission and improve screening for infection in older adults.


title: Survival Analysis meets Counterfactual Inference

text: There is growing interest in applying machine learning methods for counterfactual inference from observational data. However, approaches that account for survival outcomes are relatively limited. Survival data are frequently encountered across diverse medical applications, \textit{i.e.}, drug development, risk profiling, and clinical trials, and such data are also relevant in fields like manufacturing (for equipment monitoring). When the outcome of interest is time-to-event, special precautions for handling censored events need to be taken, as ignoring censored outcomes may lead to biased estimates. We propose a theoretically grounded unified framework for counterfactual inference applicable to survival outcomes. Further, we formulate a nonparametric hazard ratio metric for evaluating average and individualized treatment effects. Experimental results on real-world and semi-synthetic datasets, the latter which we introduce, demonstrate that the proposed approach significantly outperforms competitive alternatives in both survival-outcome predictions and treatment-effect estimation.


Preventing Suicide in Rural Communities During the COVID-19 Pandemic


title: COVID-19, Health, Conservation, and Shared Wellbeing: Details Matter

text: Many have stridently recommended banning markets like the one where coronavirus disease 2019 (COVID-19) originally spread. We highlight that millions of people around the world depend on markets for subsistence and the diverse use of animals globally defies uniform bans. We argue that the immediate and fair priority is critical scrutiny of wildlife trade.


Insuficiencia respiratoria COVID-19: soporte con ECMO para niños y adultos jóvenes./ [COVID-19 respiratory failure: ECMO support for children and young adult patients]


title: SARS-CoV-2 Laboratory Testing in India's Pandemic Response: A Public Health Perspective

text: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted (at the time of writing) in over 3.3 million cases and 233,000 deaths globally and ~33,000 cases and ~1,100 deaths in India. The mainstay of the diagnosis is a reverse-transcription polymerase chain reaction assay to detect SARS-CoV-2 RNA. The accurate diagnosis is contingent on appropriate specimen choice, time of collection, and assay employed. In this commentary, we highlight the role of laboratory diagnostic tests used in the different stages of India's COVID-19 pandemic response.


docid: klnslurz

title: The Centers for Disease Control and Prevention and State Health Departments should include Blood-Type Variables in their Babesiosis Case Reports


Asymptomatic COVID-19 Infection in a Patient Evaluated for Ureteric Colic: Radiological Findings and Impact on Management


Clinical Insights and Management Recommendations for COVID-19 Patients Hospitalized in Internal Medicine Departments: Recommendations by the Corona Department Heads in Israel


Dry eye in the COVID-19 era: how the measures for controlling pandemic might harm ocular surface


docid: qqdnwfdb

title: Spatial Statistics and Influencing Factors of the COVID-19 Epidemic at Both Prefecture and County Levels in Hubei Province, China

text: The coronavirus disease 2019 (COVID-19) epidemic has had a crucial influence on people's lives and socio-economic development throughout China and across the globe since December 2019. An understanding of the spatiotemporal patterns and influencing factors of the COVID-19 epidemic on multiple scales could benefit the control of the outbreak. Therefore, we used spatial autocorrelation and Spearman's rank correlation methods to investigate these two topics, respectively. The COVID-19 epidemic data reported publicly and relevant open data in Hubei province were analyzed. The results showed that (1) at both prefecture and county levels, the global spatial autocorrelation was extremely significant for the cumulative confirmed COVID-19 cases (CCC) in Hubei province from 30 January to 18 February 2020. Further, (2) at both levels, the significant hotspot and cluster/outlier area was observed solely in Wuhan city and most of its districts/sub-cities from 30 January to 18 February 2020. (3) At the prefecture level in Hubei province, the number of CCC had a positive and extremely significant correlation (p < 0.01) with the registered population (RGP), resident population (RSP), Baidu migration index (BMI), regional gross domestic production (GDP), and total retail sales of consumer goods (TRS), respectively, from 29 January to 18 February 2020 and had a negative and significant correlation (p < 0.05) with minimum elevation (MINE) from 2 February to 18 February 2020, but no association with the land area (LA), population density (PD), maximum elevation (MAXE), mean elevation (MNE), and range of elevation (RAE) from 23 January to 18 February 2020. (4) At the county level, the number of CCC in Hubei province had a positive and extremely significant correlation (p < 0.01) with PD, RGP, RSP, GDP, and TRS, respectively, from 27 January to 18 February 2020, and was negatively associated with MINE, MAXE, MNE, and RAE, respectively, from 26 January to 18 February 2020, and negatively associated with LA from 30 January to 18 February 2020. It suggested that (1) the COVID-19 epidemic at both levels in Hubei province had evident characteristics of significant global spatial autocorrelations and significant centralized high-risk outbreaks, and had an extremely significant association with social and economic factors. (2) The COVID-19 epidemics were significantly associated with the natural factors, such as LA, MAXE, MNE, and RAE, -only at the county level, not at the prefecture level, from 2 February to 18 February 2020. (3) The COVID-19 epidemics were significantly related to the socioeconomic factors, such as RGP, RSP, TRS, and GDP, at both levels from 26 January to 18 February 2020. It is desired that this study enrich our understanding of the spatiotemporal patterns and influencing factors of the COVID-19 epidemic and benefit classified prevention and control of the COVID-19 epidemic for policymakers.


docid: jnyvwnri

title: COVID-19 and Antimicrobial Resistance: Parallel and Interacting Health Emergencies

text: The COVID-19 pandemic and antimicrobial resistance are parallel and interacting health emergencies with opportunity for mutual learning. As their measures and consequences are comparable, the COVID-19 pandemic helps to illustrate the potential long-term impact of AMR, which is less acute but not less crucial. They may also impact each other as there is a push to resort to existing antimicrobials in critically ill COVID-19 patients in the absence of specific treatments, while attempts to manage the spread of COVID-19 may also lead to a slow down AMR. Understanding how COVID-19 affects AMR trends and what we can expect if these remain the same or worsen, will help us plan next steps to tackle AMR. Researchers should now start collecting data to measure the impact of current COVID-19 policies and programs on AMR.


title: Cohort of Four Thousand Four Hundred Four Persons Under Investigation for COVID-19 in a New York Hospital and Predictors of ICU Care and Ventilation

text: STUDY OBJECTIVE: Most coronavirus disease 2019 (COVID-19) reports have focused on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients. However, at initial presentation, most patients' viral status is unknown. Determination of factors that predict initial and subsequent need for ICU and invasive mechanical ventilation is critical for resource planning and allocation. We describe our experience with 4,404 persons under investigation and explore predictors of ICU care and invasive mechanical ventilation at a New York COVID-19 epicenter. METHODS: We conducted a retrospective cohort study of all persons under investigation and presenting to a large academic medical center emergency department (ED) in New York State with symptoms suggestive of COVID-19. The association between patient predictor variables and SARS-CoV-2 status, ICU admission, invasive mechanical ventilation, and mortality was explored with univariate and multivariate analyses. RESULTS: Between March 12 and April 14, 2020, we treated 4,404 persons under investigation for COVID-19 infection, of whom 68% were discharged home, 29% were admitted to a regular floor, and 3% to an ICU. One thousand six hundred fifty-one of 3,369 patients tested have had SARS-CoV-2-positive results to date. Of patients with regular floor admissions, 13% were subsequently upgraded to the ICU after a median of 62 hours (interquartile range 28 to 106 hours). Fifty patients required invasive mechanical ventilation in the ED, 4 required out-of-hospital invasive mechanical ventilation, and another 167 subsequently required invasive mechanical ventilation in a median of 60 hours (interquartile range 26 to 99) hours after admission. Testing positive for SARS-CoV-2 and lower oxygen saturations were associated with need for ICU and invasive mechanical ventilation, and with death. High respiratory rates were associated with the need for ICU care. CONCLUSION: Persons under investigation for COVID-19 infection contribute significantly to the health care burden beyond those ruling in for SARS-CoV-2. For every 100 admitted persons under investigation, 9 will require ICU stay, invasive mechanical ventilation, or both on arrival and another 12 within 2 to 3 days of hospital admission, especially persons under investigation with lower oxygen saturations and positive SARS-CoV-2 swab results. This information should help hospitals manage the pandemic efficiently.


title: Estimated effectiveness of symptom and risk screening to prevent the spread of COVID-19

text: Traveller screening is being used to limit further spread of COVID-19 following its recent emergence, and symptom screening has become a ubiquitous tool in the global response. Previously, we developed a mathematical model to understand factors governing the effectiveness of traveller screening to prevent spread of emerging pathogens (Gostic et al., 2015). Here, we estimate the impact of different screening programs given current knowledge of key COVID-19 life history and epidemiological parameters. Even under best-case assumptions, we estimate that screening will miss more than half of infected people. Breaking down the factors leading to screening successes and failures, we find that most cases missed by screening are fundamentally undetectable, because they have not yet developed symptoms and are unaware they were exposed. Our work underscores the need for measures to limit transmission by individuals who become ill after being missed by a screening program. These findings can support evidence-based policy to combat the spread of COVID-19, and prospective planning to mitigate future emerging pathogens.


Who Was the First Doctor to Report the COVID-19 Outbreak in Wuhan, China?


May the Central Nervous System Be Fogged by the Cytokine Storm in COVID-19?: an Appraisal


title: Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine

text: The epidemic of coronavirus disease 2019 (COVID-19), originating in Wuhan, China, has become a major public health challenge for not only China but also countries around the world. The World Health Organization announced that the outbreaks of the novel coronavirus have constituted a public health emergency of international concern. As of February 26, 2020, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed cases and 2,700 deaths. Infection control measures are necessary to prevent the virus from further spreading and to help control the epidemic situation. Due to the characteristics of dental settings, the risk of cross infection can be high between patients and dental practitioners. For dental practices and hospitals in areas that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in (potentially) affected areas.


title: Buying Time with COVID-19 Outbreak Response, Israel

text: Israel's response during the containment phase of the COVID-19 outbreak in early 2020 led to a delay in sustained community transmission and effective mitigation. During February-April 2020, a total of 15,981 confirmed cases resulted in 223 deaths. A total of 179,003 persons reported electronically to self-quarantine and were entitled to paid sick leave.


title: Co-infection with SARS-CoV-2 and Human Metapneumovirus

text: The novel coronavirus (now called SARS-CoV-2) initially discovered in Wuhan, China, has now become a global pandemic. We describe a patient presenting to an Emergency Department in Rhode Island on March 12, 2020 with cough and shortness of breath after a trip to Jamaica. The patient underwent nasopharyngeal swab for a respiratory pathogen panel as well as SARS-CoV-2 RT-PCR. When the respiratory pathogen panel was positive for human metapneumovirus, the patient was treated and discharged. SARS-CoV-2 RT-PCR came back positive 24 hours later. Although respiratory viral co-infection is thought to be relatively uncommon in adults, this case reflects that SARS-CoV-2 testing algorithms that exclude patients who test positive for routine viral pathogens may miss SARS-CoV-2 co-infected patients.


title: Balancing evidence and frontline experience in the early phases of the COVID-19 pandemic: current position of the Italian Society of Anti-infective Therapy (SITA) and the Italian Society of Pulmonology (SIP)

text: BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19), which has rapidly become epidemic in Italy and other European countries. The disease spectrum ranges from asymptomatic/mildly symptomatic presentations to acute respiratory failure. At the present time the absolute number of severe cases requiring ventilator support is reaching or even surpassing the intensive care unit bed capacity in the most affected regions and countries. OBJECTIVES: To narratively summarize the available literature on the management of COVID-19 in order to combine current evidence and frontline opinions and to provide balanced answers to pressing clinical questions. SOURCES: Inductive PubMed search for publications relevant to the topic. CONTENT: The available literature and the authors' frontline-based opinion are summarized in brief narrative answers to selected clinical questions, with a conclusive statement provided for each answer. IMPLICATIONS: Many off-label antiviral and anti-inflammatory drugs are currently being administered to patients with COVID-19. Physicians must be aware that, as they are not supported by high-level evidence, these treatments may often be ethically justifiable only in those worsening patients unlikely to improve only with supportive care, and who cannot be enrolled onto randomized clinical trials. Access to well-designed randomized controlled trials should be expanded as much as possible because it is the most secure way to change for the better our approach to COVID-19 patients.


docid: ekxyxigk

title: Remote patient management of peritoneal dialysis during COVID-19 pandemic


Reply to the Letter to the Editor: The Incidence and Outcomes of COVID-19 in Patients With IBD: A Rapid Review and Meta-Analysis


docid: lwvlajry

title: Promoting Community Health Worker Leadership in Policy Development: Results from a Louisiana Workforce Study

text: Community health workers (CHWs) are effective in improving public health, and many states are developing policy to support the workforce. In 2019, the Louisiana legislature created the CHW Workforce Study Committee (Committee) of at least half CHWs to study the workforce and provide the state with policy recommendations. The Committee followed national best practices in CHW engagement. A CHW and an academic team identified CHWs and employers statewide, administered a survey in partnership with a CHW professional association, and conducted in-depth interviews with CHWs and employers. Descriptive statistics were used to summarize survey data and applied thematic analysis was used to interpret interview transcripts. Sixty-five CHWs and 37 employers participated in the survey. Twenty-one CHWs and 15 employers completed interviews. Survey data indicated that Louisiana CHW roles and activities are consistent with national research. Interviews revealed a lack of knowledge about CHWs among key stakeholders, CHW workforce challenges including lack of community and professional resources, and differing ideas about the value of common workforce development practices such as standardized training and credentialing. Findings suggest a need for widespread education about CHWs and support for CHW participation in professional associations to address common workforce challenges. CHW co-leadership and partnering with a CHW professional association enabled successful study execution and full participation of CHWs in the formation of Committee recommendations. A subset of Committee members, made up of at least half CHWs, continues to meet to expand and support the workforce.


title: [Suggestions on design of evidence-based traditional Chinese medicine clinical study for new public health emergencies]

text: 2019 novel coronavirus(2019-nCoV) has occurred for 2 months, and seriously affected the people's health in the world. Therefore, scientific prevention and control strategies and effective intervention measures are the only ways to solve the world problem. In the determination of intervention measures, not only the effectiveness evaluation, but also accessibility, treatment cost, inventory and production capacity and other relevant sociological issues shall be considered, especially in low and middle-income countries and regions. With the introduction of clinical epidemiological experiment design and evidence-based medicine evidence evaluation into the evaluation of curative effect of traditional Chinese medicine(TCM), TCM has officially entered the studies of syndrome regularity of new public health emergencies(such as SARS and influenza) clearly diagnosed by modern medicine for many years, as well as the development of relevant guidelines, consensus and paths. The results of curative effect show that TCM could significantly alleviate symptoms, control disease and tendency, reduce the occurrence of critical illness, and improve the clinical efficacy and the prognosis and quality of life of patients, which fully reflects the consciousness and self-confidence of traditional Chinese medicine workers. For the evidence-based evaluation of TCM intervention in new public health emergencies, the basic principles and general methods of clinical epidemiology and evidence-based medicine shall be followed to obtain high-quality evidence; besides, we shall also fully realize that clinical scientific study is carried out with the epidemic treatment as the primary task. The scientific hypothesis comes from the clinical problems unsolved. The scientific study conclusions aim to give feedbacks to clinical diagnosis and treatment regimens. The core elements of clinical trials are population(P), intervention(I), control(C), outcome(O), which are abbreviated as "PICO". The evaluation of intervention measures for new public health emergencies with traditional Chinese medicine shall have clear study objectives and a high quality, with a correct analysis method as the guarantee of real and reliable results. Then, the selection of patients, the de-finition of intervention measures and control measures, the development of end-point indicators, the clinical quality control under special epidemics, the data verification, and the data analysis methods to be adopted are all characteristics and key points that need special consideration. It is suggested that scientific experimental design, rigorous collection and scientific data analysis shall be conducted to reflect the therapeutic value of traditional Chinese medicine, so that the study results could be adopted and shared, and become the scientific evidence for China and even the global to republish the diagnosis and treatment regimens.


Errata corrige relativa al lavoro "Nuove acquisizioni sulla gravità del danno cardiaco acuto in corso di COVID-19" [G Ital Cardiol 2020;21(5):328-331]./ [Corrigendum to "New insights into the seriousness of acute myocardial injury during COVID-19" [G Ital Cardiol 2020;21(5):328-331]]


title: COVID-19 detection using deep learning models to exploit Social Mimic Optimization and structured chest X-ray images using fuzzy color and stacking approaches

text: Coronavirus causes a wide variety of respiratory infections and it is an RNA-type virus that can infect both humans and animal species. It often causes pneumonia in humans. Artificial intelligence models have been helpful for successful analyses in the biomedical field. In this study, Coronavirus was detected using a deep learning model, which is a sub-branch of artificial intelligence. Our dataset consists of three classes namely: coronavirus, pneumonia, and normal X-ray imagery. In this study, the data classes were restructured using the Fuzzy Color technique as a preprocessing step and the images that were structured with the original images were stacked. In the next step, the stacked dataset was trained with deep learning models (MobileNetV2, SqueezeNet) and the feature sets obtained by the models were processed using the Social Mimic optimization method. Thereafter, efficient features were combined and classified using Support Vector Machines (SVM). The overall classification rate obtained with the proposed approach was 99.27%. With the proposed approach in this study, it is evident that the model can efficiently contribute to the detection of COVID-19 disease.


Recommendations to Manage Patients for Bariatric Surgery in the COVID-19 Pandemic: Experience from China


title: Five genetic polymorphisms of cytochrome P450 enzymes in the Czech non-Roma and Czech Roma population samples

text: Objectives Cytochromes P450 play a role in human drugs metabolic pathways and their genes are among the most variable in humans. The aim of this study was to analyze genotype frequencies of five common polymorphisms of cytochromes P450 in Roma/Gypsy and Czech (non-Roma) population samples with Czech origin. Methods Roma/Gypsy (n=302) and Czech subjects (n=298) were genotyped for CYP1A2 (rs762551), CYP2A6 (rs4105144), CYP2B6 (rs3745274) and CYP2D6 (rs3892097; rs1065852) polymorphisms using PCR-RFLP or Taqman assay. Results We found significant allelic/genotype differences between ethnics in three genes. For rs3745274 polymorphism, there was increased frequency of T allele carriers in Roma in comparison with Czech population (53.1 vs. 43.7%; p=0.02). For rs4105144 (CYP2A6) there was higher frequency of T allele carriers in Roma in comparison with Czech population (68.7 vs. 49.8%; p<0.0001). For rs3892097 (CYP2D6) there was more carriers of the A allele between Roma in comparison with Czech population (39.2 vs. 38.2%; p=0.048). Genotype/allelic frequencies of CYP2D6 (rs1065852) and CYP1A2 (rs762551) variants did not significantly differ between the ethnics. Conclusions There were significant differences in allelic/genotype frequencies of some, but not all cytochromes P450 polymorphisms between the Czech Roma/Gypsies and Czech non-Roma subjects.


Angiotensin-converting enzyme inhibitors, angiotensin II type 1 receptor blockers and risk of COVID 19: information from Bartter's and Gitelman's syndromes patients


DRC faces new Ebola outbreak, covid-19, and measles all at once


title: Imaging features of the initial chest thin-section CT scans from 110 patients after admission with suspected or confirmed diagnosis of COVID-19

text: BACKGROUND: In December 2019, an outbreak of a novel coronavirus pneumonia, now called COVID-19, occurred in Wuhan, Hubei Province, China. COVID-19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread quickly across China and the rest of the world. This study aims to evaluate initial chest thin-section CT findings of COVID-19 patients after their admission at our hospital. METHODS: Retrospective study in a tertiary referral hospital in Anhui, China. From January 22, 2020 to February 16, 2020, 110 suspected or confirmed COVID-19 patients were examined using chest thin-section CT. Patients in group 1 (n = 51) presented with symptoms of COVID-19 according to the diagnostic criteria. Group 2 (n = 29) patients were identified as a high degree of clinical suspicion. Patients in group 3 (n = 30) presented with mild symptoms and normal chest radiographs. The characteristics, positions, and distribution of intrapulmonary lesions were analyzed. Moreover, interstitial lesions, pleural thickening and effusion, lymph node enlargement, and other CT abnormalities were reviewed. RESULTS: CT abnormalities were found only in groups 1 and 2. The segments involved were mainly distributed in the lower lobes (58.3%) and the peripheral zone (73.8%). The peripheral lesions, adjacent subpleural lesions, accounted for 51.8%. Commonly observed CT patterns were ground-glass opacification (GGO) (with or without consolidation), interlobular septal thickening, and intralobular interstitial thickening. Compared with group 1, patients in group 2 presented with smaller lesions, and all lesions were distributed in fewer lung segments. Localized pleural thickening was observed in 51.0% of group 1 patients and 48.2% of group 2 patients. The prevalence of lymph node enlargement in groups 1 and 2 combined was extremely low (1 of 80 patients), and no significant pleural effusion or pneumothorax was observed (0 of 80 patients). CONCLUSION: The common features of chest thin-section CT of COVID-19 are multiple areas of GGO, sometimes accompanied by consolidation. The lesions are mainly distributed in the lower lobes and peripheral zone, and a large proportion of peripheral lesions are accompanied by localized pleural thickening adjacent to the subpleural region.


COVID-19: should we continue to cryopreserve sperm during the pandemic?


title: New paths for sustainable solutions to tackle global and emerging infectious threats

text: With the dramatic background of a newly emerged virus (SARS-CoV-2) spreading around the world, Coronavirus and other infectious health threats for the human and animal populations were illustrated and debated in excellent presentations at the IABS meeting 26-28 of February 2020. Historical evidence of pandemics and lessons learned from recent epidemics or epizootics caused by many pathogens (e.g., Ebola, Zika, and African Swine Fever viruses) illustrated the overarching need for close international cooperation. New and old technologies in vaccine development and their use were presented, resulting in a call for greater interaction between the human and the veterinary fields in order to leverage the expertise and knowledge in both human and animal medicine. The One Health concept was also emphasized for eliminating the 59,000 fatal human rabies cases annually attributed to unvaccinated dogs. For preventable, infectious diseases commonly spreading in the poorer regions of the world, a new regulatory approach and governance structure was called for to give access to affordable vaccines. Vaccines were touted as one of the most successful health invention ever introduced; on a similar level to health improvements due to clean water.


title: Viral kinetics and factors associated with rapid viral clearance during lopinavir/ritonavir-based combination therapy in non-severe COVID-19 patients

text: OBJECTIVE: Lopinavir/ritonavir has modest antiviral activity against severe acute respiratory syndrome coronavirus 2. The aim was to investigate the viral kinetics and factors associated with viral clearance during lopinavir/ritonavir-based combination treatment in non-severe patients. PATIENTS AND METHODS: Sixty-four patients were retrospectively enrolled. Viral RNA was detected by real-time RT-PCR assay from sputum or throat swab samples at different time points. The patterns of viral kinetics were characterized, and factors associated with rapid viral clearance, which was defined as viral RNA undetectable within two weeks, were analyzed using multivariate logistic regression analyses. RESULTS: All patients achieved viral RNA negativity and were discharged from the hospital. Furthermore, 48 (75%) and 16 (25%) patients achieved rapid and delayed viral clearance, respectively. The lymphocyte counts of rapid viral clearance patients (1.40 [1.20-1.80] × 109/L) were higher, when compared to delayed viral clearance patients (1.00 [0.70-1.47] × 109/L) (p=0.024). The multivariate logistic analysis revealed that high lymphocyte count (≥1.3×109/L) is an independent factor associated with rapid viral clearance (OR=7.62, 95% CI=1.15-50.34, p=0.035). CONCLUSIONS: The viral shedding exhibited different patterns during treatment. Immune insufficiency is responsible for the delayed viral clearance, suggesting that an immunomodulator should be considered to promote viral clearance in patients with low lymphocyte counts.


title: Pandemics, Protocols, and the Plague of Athens: Insights from Thucydides

text: When confronted by the novel ethical challenges posed by a pandemic, it is helpful to turn to history for guidance and direction. In this essay, the author revisits Thucydides's description of the Plague of Athens from The Peloponnesian War as he considers the New York State Task Force on Life and the Law's 2015 guidelines on ventilator allocation. Confronted by the exigencies of the Covid-19 surge that struck New York, he questions the task force's decision not to give any degree of preference to health care workers who might become ill. He posits that they are due a compensatory ethic and some deference given the risks they have assumed, often with inadequate protective gear. Reflecting on his ambivalence, he asks if his change of heart reflects the impact of experiential learning or the erosion of nomos-or governing norms-described by Thucydides when the plague struck Athens.


Oral submucous fibrosis and COVID-19: Perspective on comorbidity


Pulmonary Artery Embolism in COVID-19 Despite Thrombosis Prophylaxis


title: Knowledge synthesis of 100 million biomedical documents augments the deep expression profiling of coronavirus receptors

text: The COVID-19 pandemic demands assimilation of all biomedical knowledge to decode mechanisms of pathogenesis. Despite the recent renaissance in neural networks, a platform for the real-time synthesis of the exponentially growing biomedical literature and deep omics insights is unavailable. Here, we present the nferX platform for dynamic inference from 45 quadrillion+ possible conceptual associations from unstructured text and triangulation with insights from Single Cell RNA-sequencing, bulk RNAseq and proteomics from diverse tissue types. A hypothesis-free profiling of ACE2 suggests tongue keratinocytes, olfactory epithelial cells, airway club cells and respiratory ciliated cells as potential reservoirs of the SARS-CoV-2 receptor. We find the gut as the putative hotspot of COVID-19, where a maturation correlated transcriptional signature is shared in small intestine enterocytes among coronavirus receptors(ACE2, DPP4, ANPEP). A holistic data science platform triangulating insights from structured and unstructured data holds potential for accelerating the generation of impactful biological insights and hypotheses.


docid: xnywgipn

title: Dysregulation of type I interferon responses in COVID-19


Did Whatsapp® reveal a new cutaneous COVID-19 manifestation?


docid: rckuwjyj

title: Conquest of COVID-19. Publish it to death?


Kampf gegen COVID-19


Cling film for mobile phone to prevent cross-infection during COVID-19 pandemic


COVID-19, leadership and lessons from physics


title: Currently available intravenous immunoglobulin contains antibodies reacting against severe acute respiratory syndrome coronavirus 2 antigens

text: Aim: There is a critical need for effective therapies that are immediately available to control the spread of COVID-19 disease. Material & methods: Gamunex®-C and Flebogamma® DIF (Grifols) intravenous immunoglobulin (IVIG) products were tested using ELISA techniques for antibodies against several antigens of human common betacoronaviruses that may crossreact with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Results: Both IVIGs showed consistent reactivity to components of the tested viruses. Positive crossreactivity was seen in SARS-CoV, middle east respiratory syndrome-CoV and SARS-CoV-2. For SARS-CoV-2, positive reactivity was observed at IVIG concentrations ranging from 100 µg/ml with Gamunex-C to 1 mg/ml with Flebogamma 5% DIF. Conclusion: Gamunex-C and Flebogamma DIF contain antibodies reacting against SARS-CoV-2 antigens. Studies to confirm the utility of IVIG preparations for COVID-19 management may be warranted.


title: Psychosoziale Folgen von Quarantänemaßnahmen bei schwerwiegenden Coronavirus-Ausbrüchen: ein Rapid Review./ [Psychosocial Impact of Quarantine Measures During Serious Coronavirus Outbreaks: A Rapid Review]

text: OBJECTIVE: Review of the evidence on the psychosocial impact of quarantine measures during serious coronavirus outbreaks before COVID-19.âSuch information is highly relevant in regard to the COVID-19 pandemic. METHODS: Search of the MEDLINE database for relevant studies related to SARS-CoV and MERS-CoV outbreaks. RESULTS: Across 13 identified studies, quarantine measures were consistently associated with negative psychosocial outcomes, including depressive symptoms, anxiety, anger, stress, posttraumatic stress, social isolation, loneliness and stigmatization. Determinants comprised duration of quarantine measures and income losses. Health care workers constituted a particularly vulnerable group. CONCLUSION: Quarantine measures during serious coronavirus outbreaks have extensive negative consequences for mental health. Prevention and intervention approaches to attenuate the psychosocial impact should be an integral component of crisis response during pandemic conditions.


Countries test tactics in 'war' against COVID-19