title: Are Iranian Sulfur Mustard Gas-Exposed Survivors More Vulnerable to SARS-CoV-2? Some Similarity in Their Pathogenesis

text: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged as a health problem worldwide. It seems that COVID-19 is more lethal for Iranian veterans with a history of exposure to mustard gas. There are some similarities in the pathogenesis of SARS-CoV-2 and mustard gas in immune system disruption and pulmonary infection. SARS-CoV-2 and mustard gas inducing oxidative stress, immune system dysregulation, cytokine storm, and overexpression of angiotensin-converting enzyme II (ACE2) receptor in lungs that act as functional entry receptors for SARS-CoV-2. Moreover, Iranian survivors of mustard gas exposure are more susceptible and vulnerable to COVID-19. It is suggested that the principles of COVID-19 infection prevention and control be adhered to more stringently in Iranian survivors of mustard gas exposure than others who have not been exposed to mustard gas. Therefore, in this review, we discuss the different pathologic aspects of lung injury caused by mustard gas and also the relationship between this damage and the increased susceptibility of Iranian mustard gas exposed survivors to COVID-19.


Critical Need for Implementation of Clinical Pharmacology Principles in Developing Drugs for the Treatment or Prevention of COVID-19


title: Thrombotic complications of COVID-19 may reflect an upregulation of endothelial tissue factor expression that is contingent on activation of endosomal NADPH oxidase

text: The high rate of thrombotic complications associated with COVID-19 seems likely to reflect viral infection of vascular endothelial cells, which express the ACE2 protein that enables SARS-CoV-2 to invade cells. Various proinflammatory stimuli can promote thrombosis by inducing luminal endothelial expression of tissue factor (TF), which interacts with circulating coagulation factor VII to trigger extrinsic coagulation. The signalling mechanism whereby these stimuli evoke TF expression entails activation of NADPH oxidase, upstream from activation of the NF-kappaB transcription factor that drives the induced transcription of the TF gene. When single-stranded RNA viruses are taken up into cellular endosomes, they stimulate endosomal formation and activation of NADPH oxidase complexes via RNA-responsive toll-like receptor 7. It is therefore proposed that SARS-CoV-2 infection of endothelial cells evokes the expression of TF which is contingent on endosomal NADPH oxidase activation. If this hypothesis is correct, hydroxychloroquine, spirulina (more specifically, its chromophore phycocyanobilin) and high-dose glycine may have practical potential for mitigating the elevated thrombotic risk associated with COVID-19.


Comments on "Cross-species transmission of the newly identified coronavirus 2019-nCoV"


Sentiment analysis of nationwide lockdown due to COVID 19 outbreak: Evidence from India


Psycho-emotional Care in a Neonatal Unit during the Covid-19 Pandemic


Cancer population may be paradoxically protected from severe manifestations of COVID-19


title: COVID-19: Time for Post-Exposure Prophylaxis?

text: From a healthcare perspective, infection due to the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and the ensuing syndrome called COVID-19 (coronavirus disease 2019) represents the biggest challenge the world has faced in several decades. Particularly worrisome are the high contagiousness of the virus and the saturation of hospitals' capacity due to overwhelming caseloads. Non-pharmaceutical interventions such as quarantine and inter-personal distancing are crucial to limiting the spread of the virus in the general population, but more tailored interventions may be needed at an individual level on a case-by-case basis. In this perspective, the most insidious situation is when an individual has contact with a contagious subject without adequate protection. If rapidly recognized afterwards, this occurrence may be promptly addressed through a post-exposure chemoprophylaxis (PEP) with antiviral drugs. This strategy has been implemented for other respiratory viruses (influenza above all) and was successfully used in South Korea among healthcare workers against the Middle East respiratory syndrome (MERS) coronavirus, by providing people who were exposed to high-risk contacts with lopinavir-ritonavir plus ribavirin. Initial experiences with the use of hydroxychloroquine to prevent COVID-19 also seem promising. Post-exposure chemoprophylaxis might help mitigate the spread of SARS-CoV-2 in the current phase of the COVID-19 pandemic.


title: Acute Respiratory Distress Syndrome is a TH17-like and Treg immune disease

text: Acute Respiratory Distress Syndrome (ARDS) is a very severe syndrome leading to respiratory failure and subsequent mortality. Sepsis is one of the leading causes of ARDS. Thus, extracellular bacteria play an important role in the pathophysiology of ARDS. Overactivated neutrophils are the major effector cells in ARDS. Thus, extracellular bacteria triggered TH17-like innate immunity with neutrophil activation might accounts for the etiology of ARDS. Here, microarray analysis was employed to describe TH17-like innate immunity-related cytokine including TGF-{\beta} and IL-6 up-regulation in whole blood of ARDS patients. It was found that the innate TH17-related TLR1,2,4,5,8, HSP70, G-CSF, GM-CSF, complements, defensin, PMN chemokines, cathepsins, Fc receptors, NCFs, FOS, JunB, CEBPs, NFkB, and leukotriene B4 are all up-regulated. TGF-{\beta} secreting Treg cells play important roles in lung fibrosis. Up-regulation of Treg associated STAT5B and TGF-{\beta} with down-regulation of MHC genes, TCR genes, and co-stimulation molecule CD86 are noted. Key TH17 transcription factors, STAT3 and ROR{\alpha}, are down-regulated. Thus, the full adaptive TH17 helper CD4 T cells may not be successfully triggered. Many fibrosis promoting genes are also up-regulated including MMP8, MMP9, FGF13, TIMP1, TIMP2, PLOD1, P4HB, P4HA1, PDGFC, HMMR, HS2ST1, CHSY1, and CSGALNACT. Failure to induce successful adaptive immunity could also attribute to ARDS pathogenesis. Thus, ARDS is actually a TH17-like and Treg immune disorder.


title: A call for a gender-responsive, intersectional approach to address COVID-19

text: ABSTRACT The COVID-19 pandemic exacerbates existing health inequities, including gender disparities, and we must learn from previous global public health threats to build a gender-responsive, intersectional approach to address immediate and long-term consequences. While a narrow gender focus alone can reinforce binary and competing understandings of disease burden by gender, an intersectionality approach encourages understanding of the dimensions of power, historical structural inequalities, and the role of social determinants and lived experience to inform a multidimensional, gender-informed response to this and future emerging infectious diseases. We provide specific, actionable recommendations for critical healthcare, public health, and policy to use an intersectional approach to COVID-19 pandemic preparedness, response and resiliency.


RV Infections in Asthmatics Increase ACE2 Expression and Cytokine Pathways Implicated in COVID-19


title: Les effets de confinement SARS-CoV-2 sur le sommeil : enquête en ligne au cours de la quatrième semaine de confinement./ [The effects of quarantine for SARS-CoV-2 on sleep: An online survey]

text: OBJECTIVES: Explore the evolution of sleep during the SARS-CoV-2 quarantine period and define associated factors. METHODS: An online survey of patients in quarantine. Questions targeted the conditions of quarantine, sleep related behaviours and exposure to factors known to affect sleep and circadian rhythms (light exposure and sport). RESULTS: In all, 1777 participants were included: 77% women and 72% aged 25-54 years. Quarantine conditions were most frequently in couples with children (36%) and in a house with a garden (51%). Forty-seven percent of participants reported a decrease in sleep quality during quarantine. Factors associated with a reduction in sleep quality by logistic regression were sleep reduction (OR 15.52 P<0.001), going to bed later (OR 1.72 P<0.001), getting up earlier (2.18 P=0.01), an increase in sleep-wake irregularity (OR 2.29 P<0.001), reduced exposure to daylight (OR 1.46 P=0.01) and increased screen use in the evenings (OR 1.33 P=0.04). CONCLUSION: Sleep quality tended to reduce during quarantine and this was associated with changes in sleep behaviours and light exposure, especially in the evening. In order to optimise sleep during quarantine, regular sleep and wake times, at least 1hour exposure to daylight and a reduction of screen use in the evenings are suggested.


title: Sofosbuvir as a potential option for the treatment of COVID-19

text: Sofosbuvir may be a potential option in the treatment of COVID-19 based on the similarity between the replication mechanisms of the HCV and the coronavirus. According the limited experimental evidences, it is hypothesized that sofosbuvir might be a potential option to improve care of patients with COVID-19 especially at the start of the disease and before invasion of the virus into the lung parenchymal cells. Efficacy and safety of sofosbuvir in treatment of COVID-19 may be considered in future clinical studies.


title: Novel coronavirus, novel faculty development programs: rapid transition to eLearning during the pandemic

text: The novel coronavirus disease 2019 (COVID-19) has caused a rapid and massive transition to online education. We describe the response of our Office of Faculty Development at Texas Tech University Health Sciences Center El Paso (TTUHSC EP) to this unprecedented challenge during and after this post-pandemic crisis. The initiatives for emergency transition to eLearning and faculty development described in this paper may serve as a model for other academic health centers, schools, colleges and universities.


title: Evidence and possible mechanisms of rare maternal-fetal transmission of SARS-CoV-2

text: While SARS-CoV-2 infection has spread rapidly worldwide, data remains scarce about the natural history of infection in pregnant women and the risk of mother-to-fetal transmission. Current data indicates that viral RNA levels in maternal blood are low and there is no evidence of placental infection with SARS-CoV-2. Published reports to date suggest that perinatal transmission of SARSCoV- 2 can occur but is rare. Among 179 newborns tested for SARS-CoV2 at birth from mothers with COVID-19, transmission was suspected in 8 cases, 5 with positive nasopharyngeal SARS-CoV-2 RT-PCR and 3 with SARS-CoV-2 IgM. However, these cases arise from maternal infection close to childbirth and there are no information about exposition during first or second trimester of pregnancy. Welldesigned prospective cohort studies with rigorous judgement criteria are needed to determine the incidence and risk factors for perinatal transmission of SARS-CoV-2.


Epidermolysis bullosa and the COVID-19 pandemic: challenges and recommendations


title: The assessment of transmission efficiency and latent infection period on asymptomatic carriers of SARS-CoV-2 infection

text: Few studies aimed on the transmission efficiency of asymptomatic carriers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A follow-up study was performed on 147 asymptomatic carriers in Anhui Province. Of 147 asymptomatic carriers, 50.0% were male, 50.3% cases were older than 40 years, and 43.8% were farmers, 68.7% cases were from north of Anhui Province. There were 16 asymptomatic carriers developed illness in the following 14 days isolated observation, and diagnosed as confirmed cases. The possible latent infection period was evaluated ranged from one to five days before onset, and the median time was two days. The second attack rate of 16 confirmed cases whom transferred from asymptomatic carriers was 9.7% (23/236), while 131 asymptomatic carriers caused 2.6% (24/914) close contacts infection, there was a significant difference of second attack rate among two groups (Pï¼0.001). Our study indicated that COVID-19 cases are contagious during the incubation period, and the close contact screening should be covered the incubation period. Furthermore, the transmission efficiency of asymptomatic carriers was lower than that of confirmed cases.


Disrupt, innovate, and transform in the era of COVID-19


Should we mind for late neurologic manifestations from novel coronavirus?


title: COVID-19 in Children: Clinical Approach and Management

text: COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major public health crisis threatening humanity at this point in time. Transmission of the infection occurs by inhalation of infected droplets or direct contact with soiled surfaces and fomites. It should be suspected in all symptomatic children who have undertaken international travel in the last 14 d, all hospitalized children with severe acute respiratory illness, and asymptomatic direct and high-risk contacts of a confirmed case. Clinical symptoms are similar to any acute respiratory viral infection with less pronounced nasal symptoms. Disease seems to be milder in children, but situation appears to be changing. Infants and young children had relatively more severe illness than older children. The case fatality rate is low in children. Diagnosis can be confirmed by Reverse transcriptase - Polymerase chain reaction (RT-PCR) on respiratory specimen (commonly nasopharyngeal and oropharyngeal swab). Rapid progress is being made to develop rapid diagnostic tests, which will help ramp up the capacity to test and also reduce the time to getting test results. Management is mainly supportive care. In severe pneumonia and critically ill children, trial of hydroxychloroquine or lopinavir/ritonavir should be considered. As per current policy, children with mild disease also need to be hospitalized; if this is not feasible, these children may be managed on ambulatory basis with strict home isolation. Pneumonia, severe disease and critical illness require admission and aggressive management for acute lung injury and shock and/or multiorgan dysfunction, if present. An early intubation is preferred over non-invasive ventilation or heated, humidified, high flow nasal cannula oxygen, as these may generate aerosols increasing the risk of infection in health care personnel. To prevent post discharge dissemination of infection, home isolation for 1-2 wk may be advised. As of now, no vaccine or specific chemotherapeutic agents are approved for children.


title: [Understanding and prevention of D-dimer elevation in coronavirus disease 2019 in traditional Chinese medicine]

text: 2019 Novel coronavirus (2019-nCoV) infection caused a pandemic in the world. From the reported cases in the literatures, the level of D-dimer in patients with coronavirus disease 2019 (COVID-19) is positively correlated with the severity of illness, which needs the attention of clinical workers. According to Western medicine, the increase of D-dimer is related to the hyperactivity of fibrinolytic system and the shortening of prothrombin time (PT), resulting in excessive production and degradation of plasma fibrin and hypercoagulable state of blood, while traditional Chinese medicine (TCM) believes that the above syndromes belong to the pathogenesis of "blood stasis" according to TCM theories. Over the years, TCM has a significant effect on promoting blood circulation, removing blood stasis and improving microcirculation. This article reviews the mechanism, clinical significance, understanding of TCM and common methods of promoting blood circulation and removing blood stasis caused by 2019-nCoV, in order to provide ideas for the prevention and treatment of impaired blood coagulation in patients with COVID-19.


Low-cost production of handrubs and face shields in developing countries fighting the COVID19 pandemic


title: Potential inhibitors of the interaction between ACE2 and SARS-CoV-2 (RBD), to develop a drug

text: AIMS: The COVID-19 disease caused by the SARS-CoV-2 has become a pandemic and there are no effective treatments that reduce the contagion. It is urgent to propose new treatment options, which are more effective in the interaction between viruses and cells. In this study was to develop a search for new pharmacological compounds against the angiotensin-converting enzyme 2 (ACE2), to inhibit the interaction with SARS-CoV-2. MATERIALS AND METHODS: Docking, virtual screening using almost 500,000 compounds directed to interact in the region between the residues (Gln24, Asp30, His34, Tyr41, Gln42, Met82, Lys353, and Arg357) in ACE2. The average of ΔGbinding, the standard deviation value and the theoretical toxicity from compounds were analyzed. KEY FINDINGS: 20 best compounds directed to interact in ACE2 with a high probability to be safe in humans, validated by web servers of prediction of ADME and toxicity (ProTox-II and PreADMET), to difficult the interaction between ACE2 and region binding domain (RBD) of SARS-CoV-2. SIGNIFICANCE: In this study, 20 compounds were determined by docking focused on the region of interaction between ACE2 and RBD of SARS-CoV-2 was carried out. The compounds are publicly available to validate the effect in in vitro tests.


title: From Probability to Consilience: How Explanatory Values Implement Bayesian Reasoning

text: Recent work in cognitive science has uncovered a diversity of explanatory values, or dimensions along which we judge explanations as better or worse. We propose a Bayesian account of how these values fit together to guide explanation. The resulting taxonomy provides a set of predictors for which explanations people prefer and shows how core values from psychology, statistics, and the philosophy of science emerge from a common mathematical framework. In addition to operationalizing the explanatory virtues associated with, for example, scientific argument-making, this framework also enables us to reinterpret the explanatory vices that drive conspiracy theories, delusions, and extremist ideologies.


Precautions for Intubating Patients with COVID-19


title: COVID-19, obesity and undernutrition: A major challenge for Latin American countries

text: In March of 2020, the World Health Organization declared the SARS-Cov2 2019 (COVID-19) outbreak a global pandemic after documenting community scale transmission in every region, including Latin America. The risk factors associated with severity of disease include older age, diabetes, hypertension, cardiovascular and lung diseases, and immune suppression. Additional evidence strongly suggests that obesity is also a risk factor for severe forms of COVID-19 disease, while other types of malnutrition increase the risk of hospitalization from influenza-like diseases, regardless of the causative agent of the illness (1). Although detailed data are not yet available on the impact of undernutrition in the evolution of COVID-19, given the known inflammatory response caused by this condition, it is reasonable to expect a suboptimal immune response and higher risk of severity, as found with obesity (2).


title: Problematic online gaming and the COVID-19 pandemic

text: Stay-at-home mandates and quarantines related to the coronavirus (COVID-19) pandemic have led to greatly increased participation in online gaming. Initiatives such as #PlayApartTogether that promote gaming for socializing and stress reduction may achieve positive outcomes. Although gaming can be a healthy coping strategy for the majority, it can also pose risks to some vulnerable individuals. Protracted periods of social isolation and technology-based activity pose the danger of solidifying unhealthy lifestyle patterns, leading to difficulties to readaptation when the COVID-19 crisis has passed. Balanced and effective approaches to gaming during the COVID-19 pandemic are needed to support physical and psychological wellbeing.


Systematic infection control in Greek Physiotherapy Practices during the COVID-19 pandemic


This Special Issue of Chemistry-A European Journal is dedicated to the Chemical Functionalization of 2D Materials, and features some great contributions from experts in the field of 2D materials. This issue was originally assembled to support the Symposiumâ G "Chemical Functionalization of 2D Materials" at the European Materials Research Society (E-MRS) 2020 Spring Meeting, which was originally scheduled to be held in Strasbourg, France, from May 25th to 29th, 2020. Although the E-MRS 2020 Spring Meeting has been cancelled due to the COVID-19 outbreak, the publication of this Special Issue has proceeded and has become even more important as the contributors discuss diverse and timely research themes related to 2D materials. In this Editorial, a brief overview of the different types of 2D materials is given, together with the chemical functionalization schemes that can be applied to them to achieve new properties as well as enable improved performance in applications. Some of the articles featured in this Special Issue are also highlighted, with the hope that they will inspire readers and further advance the field.


Opinion: An Increase in Severe, Late Dental Complications Might Result From Reliance on Home Dental Remedies During the COVID-19 Pandemic


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title: Clinico-radiological Presentation of COVID-19 Patients at a Tertiary Care Center at Bhilwara Rajasthan, India

text: Background: COVID-19 has now become a pandemic. From Wuhan, China, in December 2019 to European countries, USA and now it seems to gain a strong foothold in India. The objective of this work is to report the initial experience with demographic and clinical features, and management of COVID-19 patients admitted in medical college Bhilwara, India. Methods: This is a descriptive case series of first 26 COVID-19 patients. Demographical, clinical, laboratory, and radiological characteristics and treatment and outcomes data were obtained with data collection forms and history given by 26 COVID-19 patients. Results and Discussion: During this study 26 COVID-19 positive patients were admitted in MG Hospital, Bhilwara. Male patients were 61.54% and majority (88.46%) were below 60 years of age. Approximately 30.76 % patients were asymptomatic. Fever was the most common symptom (61.54%) followed by sore throat (53.84 %), cough (42.30%) myalgia (38.46%)and dyspnea(23.07%). Six patients (23.07%) of total 26 had comorbidities. Leucopenia was seen in in 9 (34.61%) and leukocytosis was seen in 2 patient. Ten patient (38.46%) out of 26 shown increased lymphocyte/neutrophil ratio. Chest X- ray was normal in 20 patients (76.92%). Abnormalities in chest CT were detected among 10 (38.46%) patients. Typical findings were bilateral multifocal patchy peripheral subsegmental areas of consolidation more towards middle and lower zones and bilateral ground glass opacities involving multiple segments. Oseltamivir and chloroquine were given to all 26 patients. Azithromycin was given in 24 patients. Mean duration of conversion of COVID-19 patients was 6.83 days. All discharged patients advised home quarantine for 14 days as per guidelines. Conclusion: Patients often present without fever, and many may not have abnormal radiologic findings. Patients with older age and associated comorbid conditions (COPD and diabetes) seem to have greater risk for lung injury.


title: D-dimer in patients infected with COVID-19 and suspected pulmonary embolism

text: OBJECTIVE: To analyze the risk factors for pulmonary embolism (PE) in patients infected with COVID-19. METHODS: We conducted an observational, retrospective study. Patients with severe infection with COVID-19 and suspected PE were included. RESULTS: Patients with higher levels of D-dimer and those requiring intubation were at a higher risk of developing PE. Higher D-dimer levels were associated with a greater probability of PE 3, 6, 9 and 12 days after determining D-dimer levels with an OR of 1.7, 2.0, 2.4 and 2.4, respectively. CONCLUSION: In conclusion, patients infected with COVID-19 requiring OTI with higher levels of D-dimer have an increased risk of developing PE.


COVID-19: Herd immunity and convalescent plasma transfer therapy


title: Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020

text: The coronavirus disease 2019 (COVID-19) pandemic resulted in 5,817,385 reported cases and 362,705 deaths worldwide through May, 30, 2020, including 1,761,503 aggregated reported cases and 103,700 deaths in the United States.§ Previous analyses during February-early April 2020 indicated that age ≥65 years and underlying health conditions were associated with a higher risk for severe outcomes, which were less common among children aged <18 years (1-3). This report describes demographic characteristics, underlying health conditions, symptoms, and outcomes among 1,320,488 laboratory-confirmed COVID-19 cases individually reported to CDC during January 22-May 30, 2020. Cumulative incidence, 403.6 cases per 100,000 persons,¶ was similar among males (401.1) and females (406.0) and highest among persons aged ≥80 years (902.0). Among 599,636 (45%) cases with known information, 33% of persons were Hispanic or Latino of any race (Hispanic), 22% were non-Hispanic black (black), and 1.3% were non-Hispanic American Indian or Alaska Native (AI/AN). Among 287,320 (22%) cases with sufficient data on underlying health conditions, the most common were cardiovascular disease (32%), diabetes (30%), and chronic lung disease (18%). Overall, 184,673 (14%) patients were hospitalized, 29,837 (2%) were admitted to an intensive care unit (ICU), and 71,116 (5%) died. Hospitalizations were six times higher among patients with a reported underlying condition (45.4%) than those without reported underlying conditions (7.6%). Deaths were 12 times higher among patients with reported underlying conditions (19.5%) compared with those without reported underlying conditions (1.6%). The COVID-19 pandemic continues to be severe, particularly in certain population groups. These preliminary findings underscore the need to build on current efforts to collect and analyze case data, especially among those with underlying health conditions. These data are used to monitor trends in COVID-19 illness, identify and respond to localized incidence increase, and inform policies and practices designed to reduce transmission in the United States.


The shortage of skilled workers in Europe: its impact on geriatric medicine


title: COVID-19 and Multiorgan Response

text: Since the outbreak and rapid spread of COVID-19 starting late December 2019, it has been apparent that disease prognosis has largely been influenced by multiorgan involvement. Comorbidities such as cardiovascular diseases have been the most common risk factors for severity and mortality. The hyperinflammatory response of the body, coupled with the plausible direct effects of severe acute respiratory syndrome on body-wide organs via angiotensin-converting enzyme 2, has been associated with complications of the disease. Acute respiratory distress syndrome, heart failure, renal failure, liver damage, shock, and multiorgan failure have precipitated death. Acknowledging the comorbidities and potential organ injuries throughout the course of COVID-19 is therefore crucial in the clinical management of patients. This paper aims to add onto the ever-emerging landscape of medical knowledge on COVID-19, encapsulating its multiorgan impact.


title: SARS-CoV-2 RNA detection of hospital isolation wards hygiene monitoring during the Coronavirus Disease 2019 outbreak in a Chinese hospital

text: OBJECTIVES: The aim of this paper was to monitor the presence of SARS-Cov-2 among hospital environment surfaces, sewage, and personal protective equipment (PPE) of staffs in isolation wards in the First Affiliated Hospital of Zhejiang University, China. METHODS: Surfaces of objects were routinely wiped with 1000mg/L chlorine containing disinfectant. Air and sewage disinfection was proceeded routinely and strictly. Hospital environmental surfaces and PPE of staffs in isolation wards were sampled using swabs. The sewage from various inlet and outlets were sampled. The respiratory and stool specimens of patients were collected. The respiratory specimens of staffs in the isolation wards were also sampled once a week. Quantitative real-time reverse transcription PCR (qRT-PCR) methods were used to confirm the existence of SARS-Cov-2 RNA. Viral culture was done for the samples positive for SARS-Cov-2 RNA. RESULTS: During the study period, 33 laboratory-confirmed patients were hospitalized in isolation wards in the hospital. None of SARS-Cov-2 RNA was detected among the 36 objects surface samples and 9 staffs PPE samples in isolation wards. Though the 3 sewage samples from the inlet of preprocessing disinfection pool were positive for SARS-CoV-2 RNA and the sample from the outlet of preprocessing disinfection pool was weakly positive, the sewage sample from the outlet of the last disinfection pool was negative. All of the 5 sewage samples from various points were negative by viral culture of SARS-Cov-2. None of the respiratory specimens of staffs in the isolation wards were positive. CONCLUSIONS: Though SARS-Cov-2 RNA of the sewage samples were positive from inlets of the sewage disinfection pool and negative from the outlet of the last sewage disinfection pool, no viable virus was detected by culture. The monitoring data in this study suggested that the strict disinfection and hand hygiene could decrease the hospital-associated COVID-19 infection risk of the staffs in isolation wards.


title: [Analysis of 131 cases of COVID-19 treated with Ganlu Xiaodu Decoction]

text: In this study, Donghua Hospital information management system and Meikang clinical pharmacy management system were used to collect medical records of all inpatients diagnosed as coronavirus disease 2019(COVID-19) in Wuhan Third Hospital. The statistics was based on the data of the cases treated with Ganlu Xiaodu Decoction, including demographic statistics, clinical cha-racteristics before medication, outcome of after medication and efficacy of drug combination. Excel 2003 and SPSS Clementine 12.0 software were used to conduct statistics on the included cases, and Apriori algorithm and association rules were used for the association analysis on drug combination. A total of 131 cases of COVID-19 were treated with Ganlu Xiaodu Decoction combined with Chinese and Western medicine. All of the patients were cured and discharged. The drug combination mainly included Ganlu Xiaodu Decoction, abidor, Lianhua Qingwen, moxifloxacin, Qiangli Pipa Lu, vitamin C, glycyrrhizinate diammonium, pantoprazole and Shufeng Jiedu. There is a certain regularity and effectiveness in the treatment of COVID-19 infection patients with the combination of Ganlu Xiaodu Decoction and other drugs, but the rationality and safety still need to be further verified.


Lung Ultrasound in COVID-19 Pneumonia: Prospects and Limitations


title: The COVID-19 effect: number of patients presenting to The Mid Yorkshire Hospitals OMFS team with dental infections before and during The COVID-19 outbreak

text: This paper investigates the effect of the COVID-19 outbreak and closure of dental practices on the frequency and severity of dental infections presenting in our emergency department. We compared the mean number of daily emergency department referrals for dental abscesses in the two weeks prior to and following the Chief Dental Officer's statement advising general dental practitioners to cease routine appointments, the mean number decreased from 1 to 0.37. In contrast, the severity and requirement for admission of these infections rose from 35% to 80%. This highlights the importance of the provision of local urgent dental centres during the COVID-19 outbreak in order to reduce pressure on secondary and tertiary care centres.


Modelling Covid-19 under uncertainty: what can we expect?


docid: gizkeuwt

title: Paniculitis eosinofílica secundaria a infección por COVID-19./ Paniculitis eosinofílica secundaria a infección por COVID-19./ Eosinophilic Panniculitis Associated With COVID-19


title: Evaluation of COVID-19 RT-qPCR test in multi-sample pools

text: BACKGROUND: The recent emergence of SARS-CoV-2 lead to a current pandemic of unprecedented scale. Though diagnostic tests are fundamental to the ability to detect and respond, overwhelmed healthcare systems are already experiencing shortages of reagents associated with this test, calling for a lean immediately-applicable protocol. METHODS: RNA extracts of positive samples were tested for the presence of SARS-CoV-2 using RT-qPCR, alone or in pools of different sizes (2-, 4-, 8- ,16-, 32- and 64-sample pools) with negative samples. Transport media of additional 3 positive samples were also tested when mixed with transport media of negative samples in pools of 8. RESULTS: A single positive sample can be detected in pools of up to 32 samples, using the standard kits and protocols, with an estimated false negative rate of 10%. Detection of positive samples diluted in even up to 64 samples may also be attainable, though may require additional amplification cycles. Single positive samples can be detected when pooling either after or prior to RNA extraction. CONCLUSIONS: As it uses the standard protocols, reagents and equipment, this pooling method can be applied immediately in current clinical testing laboratories. We hope that such implementation of a pool test for COVID-19 would allow expanding current screening capacities thereby enabling the expansion of detection in the community, as well as in close organic groups, such as hospital departments, army units, or factory shifts.


title: An Overview on Audio, Signal, Speech,&Language Processing for COVID-19

text: Recently, there has been an increased attention towards innovating, enhancing, building, and deploying applications of speech signal processing for providing assistance and relief to human mankind from the Coronavirus (COVID-19) pandemic. Many AI with speech initiatives are taken to combat with the present situation and also to create a safe and secure environment for the future. This paper summarises all these efforts taken by the re-search community towards helping the individuals and the society in the fight against COVID-19 over the past 3-4 months using speech signal processing. We also summarise the deep techniques used in this direction to come up with capable solutions in a short span of time. This paper further gives an overview of the contributions from non-speech modalities that may complement or serve as inspiration for audio and speech analysis. In addition, we discuss our observations with respect to solution usability, challenges, and the significant technology achievements.


title: Advance in research of beta coronavirus receptors on ocular surface/ 中华实验眼科杂志

text: Novel coronavirus (2019-nCoV) caused an outbreak of corona virus disease 2019 (COVID-19) from December 2019 in China. 2019-nCoV which was identified is a kind of beta coronavirus belongs to one of four coronavirus genera. Except 2019-nCoV, two other beta coronavirus, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) are also quite harmful to human beings. 2019-nCoV uses the same cell entry receptor, angiotensin-converting enzyme 2 (ACE2), as SARS-CoV. And dipeptidyl peptidase 4 (DPP4) or CD26 is the cell receptor for MERS-CoV. The expression of ACE2 was found to have obvious positive expression in human corneal and conjunctival epithelium, and corneal endothelium. DPP4 activity was presented in normal animal conjunctival epithelium and fibroblasts of the subjacent connective tissue. It was also presented in the whole corneal epithelium and tear fluid of animal with severe injured corneas. The two receptors, ACE2 and DPP4, involve in many cellular signaling pathways and pathophysiological processes. Their expression in the cells of ocular surface may be an access route of corona virus in eye, which provides clues to elucidating the pathogenesis of corona virus in the eyeballs.


title: Caring for Bereaved Family Members During the COVID-19 Pandemic: Before and After the Death of a Patient

text: Bereavement care is considered an integral component of quality end-of-life care endorsed by the palliative care movement. However, few hospitals and health care institutions offer universal bereavement care to all families of patients who die. The current coronavirus disease 2019 pandemic has highlighted this gap and created a sense of urgency, from a public health perspective, for institutions to provide support to bereaved family members. In this article, drawing on the palliative care and bereavement literature, we offer suggestions about how to incorporate palliative care tools and psychological strategies into bereavement care for families during this pandemic.


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title: Wuhan COVID-19 data - An example to show the importance of public health interventions to fight against the pandemic


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title: Photopolarimetrical properties of coronavirus model particles: spike proteins number influence

text: Coronavirus virions have spherical shape surrounded by spike proteins. The coronavirus spike proteins are very effective molecular mechanisms, which provide the coronavirus entrance to the host cell. The number of these spikes is different; it dramatically depends on external conditions and determines the degree of danger of the virus. A larger number of spike proteins makes the virus infectivity stronger. This paper describes a mathematical model of the shape of coronavirus virions. Based on this model, the characteristics of light scattered by the coronavirus virions were calculated. It was found two main features of coronavirus model particles in the spectral region near 200nm: a minimum of intensity and a sharp leap of the linear polarization degree. The effect of the spike protein number on the intensity and polarization properties of the scattered light was studied. It was determined that when the number of spike proteins decreases, both the intensity minimum and the position of the linear polarization leap shift to shorter wavelengths. This allows us to better evaluate the shape of the coronavirus virion, and, therefore, the infectious danger of the virus. It was shown that the shorter the wavelength of scattered light, the more reliably one can distinguish viruses from non-viruses. The developed model and the light scattering simulations based on it can be applied not only to coronaviruses, but also to other objects of a similar structure, for example, pollen.


docid: fltadsjr

title: NAS letter suggests 'normal breathing' can expel coronavirus


docid: rhpxtlyz

title: Exploring On-site Biological Evidence Collection during the Epidemic Period of COVID-19


title: [Provisional guidelines on autopsy practice for deaths associated with COVID-19]

text: COVID-19 has been included in Category B infectious diseases and is prevented and controlled according to Category A infectious diseases. In order to establish a diagnosis or conduct further research, a post-mortem examination may be desired on a possible COVID-19 death. To guide the personnel engaged in the autopsy to carry out the correct operation, and ensure the safety of the pathologists and disease control staffs during the epidemic, the Chinese Pathological Society, the Chinese Pathologist Association and the Pathology and Pathophysiology national key discipline at Shantou University Medical College, formulated this guidance for the autopsy for deaths associated with COVID-19 during the prevention and control period of COVID-19 in China.


title: Individualizing Inpatient Diabetes Management During the Coronavirus Disease 2019 Pandemic

text: Diabetes is associated with poor clinical outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19). During this pandemic, many hospitals have already become overwhelmed around the world and are rapidly entering crisis mode. While there are global efforts to boost personal protective equipment (PPE) production, many centers are improvising care strategies, including the implementation of technology to prevent healthcare workers' exposures and reduce the waste of invaluable PPE. Not optimizing glycemic control due to clinical inertia driven by fear or lack of supplies may lead to poor outcomes in patients with diabetes and COVID-19. Individualized care strategies, novel therapeutic regimens, and the use of diabetes technology may reduce these barriers. However, systematic evaluation of these changes in care is necessary to evaluate both patient- and community-centered outcomes.


title: Exact and computationally efficient Bayesian inference for generalized Markov modulated Poisson processes

text: Statistical modeling of point patterns is an important and common problem in several areas. The Poisson process is the most common process used for this purpose, in particular, its generalization that considers the intensity function to be stochastic. This is called a Cox process and different choices to model the dynamics of the intensity gives raise to a wide range of models. We present a new class of unidimensional Cox processes models in which the intensity function assumes parametric functional forms that switch among them according to a continuous-time Markov chain. A novel methodology is proposed to perform exact Bayesian inference based on MCMC algorithms. The term exact refers to the fact that no discrete time approximation is used and Monte Carlo error is the only source of inaccuracy. The reliability of the algorithms depends on a variety of specifications which are carefully addressed, resulting in a computationally efficient (in terms of computing time) algorithm and enabling its use with large datasets. Simulated and real examples are presented to illustrate the efficiency and applicability of the proposed methodology. An specific model to fit epidemic curves is proposed and used to analyzed data from Dengue Fever in Brazil and COVID-19 in some countries.


title: Case report: A kidney transplant patient with mild COVID-19

text: Coronavirus Disease 2019 (COVID-19) is currently a pandemic with a mortality rate of 1%-6% in the general population. However, the mortality rate seems to be significantly higher in elderly patients, especially those hospitalized with comorbidities, such as hypertension, diabetes, or coronary artery diseases. Because viral diseases may have atypical presentations in immunosuppressed patients, the course of the disease in the transplant patient population is unknown. Hence, the management of these patients with COVID-19 is an area of interest, and a unique approach is warranted. Here, we report the clinical features and our treatment approach for a kidney transplant patient with a diagnosis of COVID-19. We believe that screening protocols for SARS-Cov-2 should be re-evaluated in patients with solid-organ transplants.


Impact of COVID-19 on oncology clinical trials


Community universal face mask use during the COVID 19 pandemic-from households to travellers and public spaces


title: Effect of ambient air pollutants and meteorological variables on COVID-19 incidence

text: OBJECTIVE: To determine whether ambient air pollutants and meteorological variables are associated with daily COVID-19 incidence. DESIGN: A retrospective cohort from January 25 to February 29, 2020. SETTING: Cities of Wuhan, Xiaogan, and Huanggang, China. PATIENTS: The COVID-19 cases detected each day. METHODS: We collected daily data of COVID-19 incidence, 8 ambient air pollutants (particulate matter of ≤2.5 µm [PM2.5], particulate matter ≤10 µm [PM10], sulfur dioxide [SO2], carbon monoxide [CO], nitrogen dioxide [NO2], and maximum 8-h moving average concentrations for ozone [O3-8h]) and 3 meteorological variables (temperature, relative humidity, and wind) in China's 3 worst COVID-19-stricken cities during the study period. The multivariate Poisson regression was performed to understand their correlation. RESULTS: Daily COVID-19 incidence was positively associated with PM2.5 and humidity in all cities. Specifically, the relative risk (RR) of PM2.5 for daily COVID-19 incidences were 1.036 (95% confidence interval [CI], 1.032-1.039) in Wuhan, 1.059 (95% CI, 1.046-1.072) in Xiaogan, and 1.144 (95% CI, 1.12-1.169) in Huanggang. The RR of humidity for daily COVID-19 incidence was consistently lower than that of PM2.5, and this difference ranged from 0.027 to 0.111. Moreover, PM10 and temperature also exhibited a notable correlation with daily COVID-19 incidence, but in a negative pattern The RR of PM10 for daily COVID-19 incidence ranged from 0.915 (95% CI, 0.896-0.934) to 0.961 (95% CI, 0.95-0.972, while that of temperature ranged from 0.738 (95% CI, 0.717-0.759) to 0.969 (95% CI, 0.966-0.973). CONCLUSIONS: Our data show that PM2.5 and humidity are substantially associated with an increased risk of COVID-19 and that PM10 and temperature are substantially associated with a decreased risk of COVID-19.


COVID-19: Recommended sampling sites at different stages of the disease


Prioritization on palliative radiotherapy during the COVID-19 pandemic (and beyond)


Evaluation and follow-up of pediatric COVID-19 in terms of cardiac involvement: A scientific statement from the Association of Turkish Pediatric Cardiology and Pediatric Cardiac Surgery


title: Incorporating social opinion in the evolution of an epidemic spread

text: Attempts to control the epidemic spread of COVID19 in the different countries often involve imposing restrictions to the mobility of citizens. Recent examples demonstrate that the effectiveness of these policies strongly depends on the willingness of the population to adhere them. And this is a parameter that it is difficult to measure and control. We demonstrate in this manuscript a systematic way to check the mood of a society and a way to incorporate it into dynamical models of epidemic propagation. We exemplify the process considering the case of Spain although the results and methodology can be directly extrapolated to other countries.


title: Fan therapy for cough: case report and literature review

text: This case report describes the care of a 59-year-old woman with metastatic small cell lung cancer and chronic obstructive pulmonary disease who was highly symptomatic with an intractable cough. The patient reported a subjective benefit from a table fan. The authors observed an objective improvement with a marked reduction in cough frequency when the fan was in use. A literature review was undertaken and identified one randomised controlled trial assessing the use of fan for cough. The proposed underlying mechanism of cough relief is stimulation of the trigeminal nerve, possibly by cooling. This mechanism is well described in breathlessness. It presents the possibility of a novel therapeutic approach to managing cough. Further studies of both the role of nasal receptors in cough pathophysiology and the role of fan therapy in cough, where there is no concern of an airborne infectious pathogen such as COVID-19, are warranted.


Laboratory haemostasis monitoring in COVID-19


Ensuring Access to Medications in the US During the COVID-19 Pandemic


COVID-19 and dermatology: a comprehensive guide for dermatologists


COVID-19: don't forget deaf people


title: From SARS-CoV to SARS-CoV-2: safety and broad-spectrum are important for coronavirus vaccine development

text: The global pandemic of COVID-19 caused by SARS-CoV-2 (also known as 2019-nCoV and HCoV-19) has posed serious threats to public health and economic stability worldwide, thus calling for development of vaccines against SARS-CoV-2 and other emerging and reemerging coronaviruses. Since SARS-CoV-2 and SARS-CoV have high similarity of their genomic sequences and share the same cellular receptor (ACE2), it is essential to learn the lessons and experiences from the development of SARS-CoV vaccines for the development of SARS-CoV-2 vaccines. In this review, we summarized the current knowledge on the advantages and disadvantages of the SARS-CoV vaccine candidates and prospected the strategies for the development of safe, effective and broad-spectrum coronavirus vaccines for prevention of infection by currently circulating SARS-CoV-2 and other emerging and reemerging coronaviruses that may cause future epidemics or pandemics.


title: Laparoscopic and Robotic Urology Surgery during Global Pandemic COVID19

text: Known laparoscopic and robotic assisted approaches and techniques for the surgical management of urological malignant and benign diseases are commonly used around the World. During the global pandemic COVID19, urology surgeons had to reorganize their daily surgical practice. A concern with the use of minimally invasive techniques arose due to a proposed risk of viral transmission of the coronavirus disease with the creation of pneumoperitoneum. Due to this, we reviewed the literature to evaluate the use of laparoscopy and robotics during the pandemic COVID19. A literature review of viral transmission in surgery and of the available literature regarding the transmission of the COVID19 virus was performed up to April 30, 2020. We additionally reviewed surgical society guidelines and recommendations regarding surgery during this pandemic. Few studies have been performed on viral transmission during surgery. No study has been made regarding this area during minimally invasive urology cases. To date there is no study that demonstrates or can suggest the ability for a virus to be transmitted during surgical treatment whether open, laparoscopic or robotic. There is no society consensus on restricting laparoscopic or robotic surgery. However, there is expert consensus on modification of standard practices to minimize any risk of transmission. During the pandemic COVID19 we recommend the use of specific personal protective equipment for the surgeon, anesthesiologist and nursing staff in the operating room. Modifications of standard practices during minimally invasive surgery such as using lowest intra-abdominal pressures possible, controlled smoke evacuation systems, and minimizing energy device usage are recommended.


title: Role of Non-Profit Organizations During COVID-19 for Diabetes Care: Health Care Inequities and Role of Virtual Specialty Clinic

text: Today, in the United States, we have a health care system that is designed to treat symptoms, not people-and to do so as cheaply as possible with the dual goals of minimizing costs and preventing hospital visits. We are failing on all fronts. We spend more money on health care per capita than our Organization for Economic Co-operation and Development (OECD) peers, and our outcomes are mediocre at best. Medicine is not personal, health care professionals often have their hands tied by payers, and geography has too much influence on the quality of care available. This has to end, especially since we have the technology to create a truly patient-focused, whole-person approach-one that treats physical and mental health equally and meets people where they are in every sense. Telemedicine can level the playing field and enable higher quality, decentralized care that-when needed-brings specialty care to the masses. Other technologies have an important role, too. For patients with insulin-dependent diabetes (type 1 diabetes), widespread uptake of continuous glucose monitors may be the game-changer we need right now that can facilitate telemedicine to remote places and remove health care disparities. Both health professionals and patients will win-and ultimately payers will, too.


Surgical intervention in patients with proximal femoral fractures confirmed positive for COVID-19-a report of 2 cases


title: Pancancer analysis of transmembrane protease serine 2 and cathepsin L that mediate cellular SARSCoV2 infection leading to COVID-19

text: Severe acute respiratory syndrome (SARS) coronavirus2 (SARSCoV2) is the cause of a new disease (COVID19) which has evolved into a pandemic during the first half of 2020. Older age, male sex and certain underlying diseases, including cancer, appear to significantly increase the risk for severe COVID19. SARSCoV2 infection of host cells is facilitated by the angiotensinconverting enzyme 2 (ACE2), and by transmembrane protease serine 2 (TMPRSS2) and other host cell proteases such as cathepsin L (CTSL). With the exception of ACE2, a systematic analysis of these two other SARSCoV2 infection mediators in malignancies is lacking. Here, we analysed genetic alteration, RNA expression, and DNA methylation of TMPRSS2 and CTSL across a wide spectrum of tumors and controls. TMPRSS2 was overexpressed in cervical squamous cell carcinoma and endocervical adenocarcinoma, colon adenocarcinoma, prostate adenocarcinoma (PRAD), rectum adenocarcinoma (READ), uterine corpus endometrial carcinoma and uterine carcinosarcoma, with PRAD and READ exhibiting the highest expression of all cancers. CTSL was upregulated in lymphoid neoplasm diffuse large Bcell lymphoma, oesophageal carcinoma, glioblastoma multiforme, head and neck squamous cell carcinoma, lower grade glioma, pancreatic adenocarcinoma, skin cutaneous melanoma, stomach adenocarcinoma, and thymoma. Hypomethylation of both genes was evident in most cases where they have been highly upregulated. We have expanded on our observations by including data relating to mutations and copy number alterations at pancancer level. The novel hypotheses that are stemming out of these data need to be further investigated and validated in large clinical studies.


Editor Responsibility and Scientific Integrity During the COVID-19 Outbreak


title: Why COVID-19 Silent Hypoxemia is Baffling to Physicians

text: Patients with COVID-19 are described as exhibiting oxygen levels incompatible with life without dyspnea. The pairing-dubbed happy hypoxia, but more precisely termed silent hypoxemia-is especially bewildering to physicians and is considered as defying basic biology. This combination has attracted extensive coverage in media but has not been discussed in medical journals. It is possible that coronavirus has an idiosyncratic action on receptors involved in chemosensitivity to oxygen, but well-established pathophysiological mechanisms can account for most, if not all, cases of silent hypoxemia. These mechanisms include how dyspnea and the respiratory centers respond to low levels of oxygen, how prevailing carbon dioxide tensions (PaCO2) blunt the brain's response to hypoxia, effects of disease and age on control of breathing, inaccuracy of pulse oximetry at low oxygen saturations, and temperature-induced shifts in the oxygen dissociation curve. Without knowledge of these mechanisms, physicians caring for hypoxemic patients free of dyspnea are operating in the dark-placing vulnerable COVID-19 patients at considerable risk. In conclusion, features about COVID-19 that physicians find baffling become less strange when viewed in the light of long-established principles of respiratory physiology; an understanding of these mechanisms will enhance patient care if the much-anticipated second wave emerges. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).


Interventional Radiology Preparedness in the Time of the COVID-19 Pandemic: Is there a Gold Standard?


COVID-19 Testing in South Korea: Current Status and the Need for Faster Diagnostics


title: Accelerating drug development through repurposed FDA approved drugs for COVID-19: speed is important, not haste

text: A life-threatening, emerging respiratory disease called Coronavirus Disease 2019 (COVID-19) 26 originated in the city of Wuhan in China's Hubei province in December, 2019 and has been classified as 27 an international pandemic by the World Health Organization. .


title: Investigation core emergency response competences of medical staff in public health outbreak of corona virus disease 2019/ 重庆医学

text: Objective To investigate the core emergency response capabilities of medical workers for corona virus disease 2019 (COVID-19) public health emergency, in order to provide references for improving emergency level. Methods By means of convenient sampling, the general information questionnaire and the medical staff's 2019-new coronavirus (2019-nCoV) core emergency capability questionnaire were used to conduct this survey, and the status of 2019-nCoV core emergency capability of 629 clinical medical staff was analysed. Results The score of core emergency response capability of medical staff for 2019-nCoV was (135.60±21.73)points, with a score rate of 73.3%; the score of preventive capability dimension was (11.69±1.96)points, with a score rate of 77.93%; the score of preparation ability dimension was (20.79±4.18)points, and the score rate was 69.30%; the score of rescue ability was (103.11±16.93)points, with a scoring rate of 73.57%. Conclusion The core emergency response capability of medical worker for 2019-nCoV and its dimensions are at a medium level. At the present stage, the training of core knowledge of medical personnel 2019-nCoV should be strengthened, effective measures should be taken to improve the alleviation of weakness in rescue, and the self-psychological adjustment of medical personnel should be strengthened to improve the core emergency response capability of medical worker.


title: TREC-COVID: Rationale and Structure of an Information Retrieval Shared Task for COVID-19

text: TREC-COVID is an information retrieval (IR) shared task initiated to support clinicians and clinical research during the COVID-19 pandemic. IR for pandemics breaks many normal assumptions, which can be seen by examining nine important basic IR research questions related to pandemic situations. TREC-COVID differs from traditional IR shared task evaluations with special considerations for the expected users, IR modality considerations, topic development, participant requirements, assessment process, relevance criteria, evaluation metrics, iteration process, projected timeline, and the implications of data use as a post-task test collection. This article describes how all these were addressed for the particular requirements of developing IR systems under a pandemic situation. Finally, initial participation numbers are also provided, which demonstrate the tremendous interest the IR community has in this effort.


Early adaptation of urology residency educational programs during COVID-19 clinical and gathering restrictions


title: Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China

text: Importance: Health care workers (HCWs) have high infection risk owing to treating patients with coronavirus disease 2019 (COVID-19). However, research on their infection risk and clinical characteristics is limited. Objectives: To explore infection risk and clinical characteristics of HCWs with COVID-19 and to discuss possible prevention measures. Design, Setting, and Participants: This single-center case series included 9684 HCWs in Tongji Hospital, Wuhan, China. Data were collected from January 1 to February 9, 2020. Exposures: Confirmed COVID-19. Main Outcomes and Measures: Exposure, epidemiological, and demographic information was collected by a structured questionnaire. Clinical, laboratory, and radiologic information was collected from electronic medical records. A total of 335 medical staff were randomly sampled to estimate the prevalence of subclinical infection among a high-risk, asymptomatic population. Samples from surfaces in health care settings were also collected. Results: Overall, 110 of 9684 HCWs in Tongji Hospital tested positive for COVID-19, with an infection rate of 1.1%. Of them, 70 (71.8%) were women, and they had a median (interquartile range) age of 36.5 (30.0-47.0) years. Seventeen (15.5%) worked in fever clinics or wards, indicating an infection rate of 0.5% (17 of 3110) among first-line HCWs. A total of 93 of 6574 non-first-line HCWs (1.4%) were infected. Non-first-line nurses younger than 45 years were more likely to be infected compared with first-line physicians aged 45 years or older (incident rate ratio, 16.1; 95% CI, 7.1-36.3; P < .001). The prevalence of subclinical infection was 0.74% (1 of 135) among asymptomatic first-line HCWs and 1.0% (2 of 200) among non-first-line HCWs. No environmental surfaces tested positive. Overall, 93 of 110 HCWs (84.5%) with COVID-19 had nonsevere disease, while 1 (0.9%) died. The 5 most common symptoms were fever (67 [60.9%]), myalgia or fatigue (66 [60.0%]), cough (62 [56.4%]), sore throat (55 [50.0%]), and muscle ache (50 [45.5%]). Contact with indexed patients (65 [59.1%]) and colleagues with infection (12 [10.9%]) as well as community-acquired infection (14 [12.7%]) were the main routes of exposure for HCWs. Conclusions and Relevance: In this case series, most infections among HCWs occurred during the early stage of disease outbreak. That non-first-line HCWs had a higher infection rate than first-line HCWs differed from observation of previous viral disease epidemics. Rapid identification of staff with potential infection and routine screening among asymptomatic staff could help protect HCWs.


Changes to Training Practices during a Pandemic - The Experience of the Irish National Trauma & Orthopaedic Training Scheme


The Next Wave of Health Care Strain Related to COVID-19: Heart Failure Patients Coming Back in Force-We Must Not Fail Them


Starting ADHD medications during the COVID-19 pandemic: recommendations from the European ADHD Guidelines Group


Are We Ready for Coronavirus Disease 2019 Arriving at Schools?


text: No abstract available.


title: Dutch General Public Reaction on Governmental COVID-19 Measures and Announcements in Twitter Data

text: Public sentiment (the opinion, attitude or feeling that the public expresses) is a factor of interest for government, as it directly influences the implementation of policies. Given the unprecedented nature of the COVID-19 crisis, having an up-to-date representation of public sentiment on governmental measures and announcements is crucial. While the staying-at-home policy makes face-to-face interactions and interviews challenging, analysing real-time Twitter data that reflects public opinion toward policy measures is a cost-effective way to access public sentiment. In this paper, we collect streaming data using the Twitter API starting from the COVID-19 outbreak in the Netherlands in February 2020, and track Dutch general public reactions on governmental measures and announcements. We provide temporal analysis of tweet frequency and public sentiment over the past four months. We also identify public attitudes towards the Dutch policy on wearing face masks in a case study. By presenting those preliminary results, we aim to provide visibility into the social media discussions around COVID-19 to the general public, scientists and policy makers. The data collection and analysis will be updated and expanded over time.


title: Moving Health Education and Behavior Upstream: Lessons From COVID-19 for Addressing Structural Drivers of Health Inequities

text: In this Perspective, we build on social justice and emancipatory traditions within the field of health education, and the field's long-standing commitment to building knowledge and shared power to promote health equity, to examine lessons and opportunities for health education emerging from the COVID-19 pandemic. Examining patterns that emerged as the pandemic unfolded in Metropolitan Detroit, with disproportionate impacts on African American and low-income communities, we consider conditions that contributed to excess exposure, mortality, and reduced access to critical health protective resources. Using a life course framework, we consider enduring impacts of the pandemic for health equity. Finally, we suggest several strategic actions in three focal areas-environment, occupation, and housing-that can be taken by health educators working in partnership with community members, researchers, and decision makers, using, for example, a community-based participatory research approach, to reduce adverse impacts of COVID-19 and promote long-term equity in health.


Ensuring continuity of care of hematologic patients during COVID-19 pandemic in a tertiary hospital in Lombardy (Italy)


COVID-19 in people with HIV


Experience of short-term hydroxychloroquine and azithromycin in COVID-19 patients and effect on QTc trend


One-Lung Ventilation: A Simple Technique to Reduce Air Contamination During the Coronavirus Disease 2019 (COVID-19) Pandemic


docid: awdzvxvf

title: Rapid Salivary Test suitable for a mass screening program to detect SARS-CoV-2: A diagnostic accuracy study


Planning and pandemics COVID 19 illuminates why urban planners should have listened to food advocates all along


title: An Approach to Teaching Psychiatry to Medical Students in the Time of Covid-19

text: In this time of Covid-19, life in healthcare has changed immeasurably. It has rapidly been injected with an 'all hands-on deck' approach, to facilitate the necessary adaptations required to reduce the spread of the virus and deliver frontline clinical care. Inevitably aspects of these changes have disrupted the delivery of medical education, notably clinical placements have been cancelled and social distancing guidelines prohibit face-to-face teaching. The training of future doctors is an essential part of this effort. Indeed, the emergence of a global health threat has underlined its continued importance. For medical educators and students alike, we have been presented with a challenge. Concurrently this presents us with an impetus and opportunity for innovation. For some time now, a transformation in medical education has been called for, with an increasing recognition of the need to prepare students for the changing landscape of healthcare systems. This has included a focus on the use of technology enhanced, and self-directed learning. As a team of educators and clinicians in psychiatry, working in the School of Medicine and Medical Sciences (SMMS) in University College Dublin (UCD), we will share how we have responded. We outline the adaptations made to our 'Psychiatry' module, and consider the influence this may have on its future delivery. These changes were informed by direct student input.


title: Can we use interleukin-6 (IL-6) blockade for coronavirus disease 2019 (COVID-19)-induced cytokine release syndrome (CRS)?

text: The emergent outbreak of coronavirus disease 2019 (COVID-19) has caused a global pandemic. Acute respiratory distress syndrome (ARDS) and multiorgan dysfunction are among the leading causes of death in critically ill patients with COVID-19. The elevated inflammatory cytokines suggest that a cytokine storm, also known as cytokine release syndrome (CRS), may play a major role in the pathology of COVID-19. However, the efficacy of corticosteroids, commonly utilized antiinflammatory agents, to treat COVID-19-induced CRS is controversial. There is an urgent need for novel therapies to treat COVID-19-induced CRS. Here, we discuss the pathogenesis of severe acute respiratory syndrome (SARS)-induced CRS, compare the CRS in COVID-19 with that in SARS and Middle East respiratory syndrome (MERS), and summarize the existing therapies for CRS. We propose to utilize interleukin-6 (IL-6) blockade to manage COVID-19-induced CRS and discuss several factors that should be taken into consideration for its clinical application.


title: An Efficient Index for Contact Tracing Query in a Large Spatio-Temporal Database

text: In this paper, we study a novel contact tracing query (CTQ) that finds users who have been in $direct$ $contact$ with the query user or $in$ $contact$ $with$ $the$ $already$ $contacted$ $users$ in subsequent timestamps from a large spatio-temporal database. The CTQ is of paramount importance in the era of new COVID-19 pandemic world for finding possible list of potential COVID-19 exposed patients. A straightforward way to answer the CTQ is using traditional spatio-temporal indexes. However, these indexes cannot serve the purpose as each user covers a large area within the time-span of potential disease spreading and thus they can hardly use efficient pruning techniques. We propose a multi-level index, namely QR-tree, that consider both space coverage and the co-visiting patterns to group users so that users who are likely to meet the query user are grouped together. More specifically, we use a quadtree to partition user movement traces w.r.t. space and time, and then exploit these space-time mapping of user traces to group users using an R-tree. The QR-tree facilitates efficient pruning and enables accessing only potential sets of user who can be the candidate answers for the CTQ. Experiments with real datasets show the effectiveness of our approach.


title: Inhibitory effects of glycopyrronium, formoterol, and budesonide on coronavirus HCoV-229E replication and cytokine production by primary cultures of human nasal and tracheal epithelial cells

text: BACKGROUND: Coronavirus 229E (HCoV-229E), one of the causes of the common cold, exacerbates chronic obstructive pulmonary disease (COPD) and bronchial asthma. Long-acting muscarinic antagonists and ß2-agonists and inhaled corticosteroids inhibit the exacerbation of COPD and bronchial asthma caused by infection with viruses, including HCoV-229E. However, the effects of these drugs on HCoV-229E replication and infection-induced inflammation in the human airway are unknown. METHODS: Primary human nasal (HNE) and tracheal (HTE) epithelial cell cultures were infected with HCoV-229E. RESULTS: Pretreatment of HNE and HTE cells with glycopyrronium or formoterol decreased viral RNA levels and/or titers, the expression of the HCoV-229E receptor CD13, the number and fluorescence intensity of acidic endosomes where HCoV-229E RNA enters the cytoplasm, and the infection-induced production of cytokines, including IL-6, IL-8, and IFN-ß. Treatment of the cells with the CD13 inhibitor 2'2'-dipyridyl decreased viral titers. Pretreatment of the cells with a combination of three drugs (glycopyrronium, formoterol, and budesonide) exerted additive inhibitory effects on viral titers and cytokine production. Pretreatment of HNE cells with glycopyrronium or formoterol reduced the susceptibility to infection, and pretreatment with the three drugs inhibited activation of nuclear factor-kappa B p50 and p65 proteins. Pretreatment with formoterol increased cAMP levels and treatment with cAMP decreased viral titers, CD13 expression, and the fluorescence intensity of acidic endosomes. CONCLUSIONS: These findings suggest that glycopyrronium, formoterol, and a combination of glycopyrronium, formoterol, and budesonide inhibit HCoV-229E replication partly by inhibiting receptor expression and/or endosomal function and that these drugs modulate infection-induced inflammation in the airway.


title: Postmortem swabs in the Sars-CoV-2 Pandemic: Report on 12 complete clinical autopsy cases

text: Context Clinical autopsies have historically provided a fundamental contribution in the definition of the clinico-pathological basis of infectious diseases. Even though we are witnessing the decline of the clinical autopsy, its importance remains unchanged as it is the most exhaustive way to investigate diseases. The identification of the virus in postmortem tissues is a fundamental step in the definition of its clinical features. Objective To investigate the presence of Sars-CoV-2 in the postmortem with swabs. Design We performed postmortem swabs in 12 autopsy cases of patients with a clinical diagnosis of Sars-CoV-2 related pneumonia. Our protocol, consisted of a rhino-pharingeal and a tracheal swab in order to search for the virus in the upper airways and of two swabs on the parenchyma of each lung. We also performed a fifth swab on the parenchyma of both lungs in order to search for other viruses that could evolve in a clinical picture of interstitial pneumonia Results Overall we found that 9 out of 12 cases had at least one postmortem swab to be positive for Sars-CoV-2. Moreover we evaluated the time lapse between the antemortem and the postmortem swabs, the time between death and the postmortem swabs, and the time lapse between the postmortem swabs and the acceptance to the microbiology laboratory. Interestingly we did not find a relation neither between the results of the swabs and the time lapsed from their collection, or with the time lapsed before their acceptance in the microbiology laboratory. Conclusions A thorough knowledge of the eventual persistence of pathogens in deaths related to infectious diseases is fundamental for the safety of the operators during the autopsy practice, especially when referring to emergent pathogens like Sars-Cov-2. Our study highlights the importance in performing multiple swabs in the postmortem, since Sars-CoV-2 swab positivity can be limited to only a single swab.


Clinical Decision Support Tools and the COVID-19 Pandemic


title: Living under the shadow of a pandemic: The psychological challenges underlying social distancing and awareness raising

text: The efforts of containing the novel virus (COVID-19) have now begun to show signs of psychological impact on societies across the globe. Social distancing and awareness campaigns can be double-edged sword, if handled inadequately. Herein, authors have shed light on the favorable and unfavorable aspects of living under lockdown. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: The Economic Costs of Containing a Pandemic

text: The coronavirus disease (COVID-19) has caused one of the most serious social and economic losses to countries around the world since the Spanish influenza pandemic of 1918 (during World War I). It has resulted in enormous economic as well as social costs, such as increased deaths from the spread of infection in a region. This is because public regulations imposed by national and local governments to deter the spread of infection inevitably involves a deliberate suppression of the level of economic activity. Given this trade-off between economic activity and epidemic prevention, governments should execute public interventions to minimize social and economic losses from the pandemic. A major problem regarding the resultant economic losses is that it unequally impacts certain strata of the society. This raises an important question on how such economic losses should be shared equally across the society. At the same time, there is some antipathy towards economic compensation by means of public debt, which is likely to increase economic burden in the future. However, as Paul Samuelson once argued, much of the burden, whether due to public debt or otherwise, can only be borne by the present generation, and not by future generations.


title: The coronavirus (COVID-19) fatality risk perception of US adult residents in March and April 2020

text: The study compares empirical results on the coronavirus SARS-CoV-2 (causing COVID-19) fatality risk perception of US adult residents stratified for age, gender, and race in mid-March 2020 (N1 = 1,182) and mid-April 2020 (N2 = 953). While the fatality risk perception has increased from March 2020 to April 2020, our findings suggest that many US adult residents severely underestimated their absolute and relative fatality risk (i.e., differentiated for subgroups defined by pre-existing medical conditions and age) at both time points compared to current epidemiological figures. These results are worrying because risk perception, as our study indicates, relates to actual or intended health-protective behaviour that can reduce SARS-CoV-2 transmission rates.


Coronavirus: global solutions to prevent a pandemic


title: Fractional-order SEIQRDP model for simulating the dynamics of COVID-19 epidemic

text: The novel coronavirus disease (COVID-19) is known as the causative virus of outbreak pneumonia initially recognized in the mainland of China, late December 2019. COVID-19 reaches out to many countries in the world, and the number of daily cases continues to increase rapidly. In order to simulate, track, and forecast the trend of the virus spread, several mathematical and statistical models have been developed. Susceptible-Exposed-Infected-Quarantined-Recovered-Death-Insusceptible (SEIQRDP) model is one of the most promising dynamic systems that has been proposed for estimating the transmissibility of the COVID-19. In the present study, we propose a Fractional-order SEIQRDP model to analyze the COVID-19 epidemic. The Fractional-order paradigm offers a flexible, appropriate, and reliable framework for pandemic growth characterization. In fact, fractional-order operator is not local and consider the memory of the variables. Hence, it takes into account the sub-diffusion process of confirmed and recovered cases growth. The results of the validation of the model using real COVID-19 data are presented, and the pertinence of the proposed model to analyze, understand, and predict the epidemic is discussed.


title: Prehospital Triage of Acute Stroke Patients During the COVID-19 Pandemic

text: The coronavirus disease 2019 (COVID-19) pandemic has broad implications on stroke patient triage. Emergency medical services providers have to ensure timely transfer of patients while minimizing the risk of infectious exposure for themselves, their co-workers, and other patients. This statement paper provides a conceptual framework for acute stroke patient triage and transfer during the COVID-19 pandemic and similar healthcare emergencies in the future.


docid: ygtzbfeq

title: Effects of altered photoperiod due to COVID-19 lockdown on pregnant women and their fetuses

text: Maternal circadian rhythms provide highly important input into the entrainment and programming of fetal and newborn circadian rhythms. The light-dark cycle is an important regulator of the internal biological clock. Even though pregnant women spend a greater part of the day at home during the latter stages of pregnancy, natural light exposure is crucial for the fetus. The current recommended COVID-19 lockdown might dramatically alter normal environmental lighting conditions of pregnant women, resulting in exposure to extremely low levels of natural daylight and high-intensity artificial light sources during both day and night. This article summarizes the potential effects on pregnant woman and their fetuses due to prolonged exposure to altered photoperiod and as consequence altered circadian system, known as chronodisruption, that may result from the COVID-19 lockdown.


title: The Delay in Confirming COVID-19 Cases Linked to a Religious Group in Korea

text: OBJECTIVES: As of March 3, 2020, the Shincheonji religious group accounted for the majority of Korean cases of coronavirus disease 2019 (COVID-19). Nonetheless, the most likely cause of the broad spread of COVID-19 among members of the Shincheonji religious group remains largely unknown. METHODS: We obtained data of laboratory-confirmed cases related to the Shincheonji religious group from press releases by Korean public health authorities and news reports. We measured the period from the date of illness onset to the date of COVID-19 confirmation. RESULTS: We analysed data from 59 cases (median age, 30 years). The estimated median period between the date of symptom onset and the date of COVID-19 confirmation was 4 days (95% confidence interval, 1-12). CONCLUSIONS: There was a delay in COVID-19 confirmation from the date of illness onset among the cases linked to the Shincheonji religious group. This delay likely contributed to the occurrence of many cases of COVID-19 in the group.


title: Consideration in the management of renal cell carcinoma during the COVID-19 Pandemic

text: INTRODUCTION: Recently the COVID-19 pandemic became the main global priority; main efforts and health infrastructures have been prioritized in favor of COVID-19 battle and the treatment of benign diseases has been postponed. Renal cell cancer (RCC) patients configure a heterogenous populations: some of them present indolent cases which can safely have postponed their treatments, others present aggressive tumors, deserving immediate care. These scenarios must be properly identified before a tailored therapeutic choice. Objectives We propose a risk- based approach for patients with RCC, to be used during this unprecedented viral infection time. MATERIALS AND METHODS: After a literature review focused in COVID-19 and current RCC treatments, we suggest therapeutic strategies of RCC in two sections: surgical approach and systemic therapy, in all stages of this malignance. RESULTS: Patients with cT1a tumors (and complex cysts, Bosniak III/IV), must be put under active surveillance and delayed intervention. cT1b-T2a/b cases must be managed by partial or radical nephrectomy, some selected T1b-T2a ((≤7cm) cases can have the surgery postponed by 60-90 days). Locally advanced tumors (≥cT3 and or N+) must be promptly resected. As possible, minimally invasive surgery and early hospital discharge are encouraged. Upfront cytoreduction, is not recommendable for low risk oligometastatic patients, which must start systemic treatment or even could be put under surveillance and delayed therapy. Intermediate and poor risk metastatic patients must start target therapy and/or immunotherapy (few good responders intermediate cases can have postponed cytoreduction). The recommendation about hereditary RCC syndromes are lacking, thus we recommend its usual care. Local or loco regional recurrence must have individualized approaches. For all cases, we suggest the application of a specific informed consent and a shared therapeutic choice. CONCLUSION: In the pandemic COVID -19 times, a tailored risk-based approach must be used for a safe management of RCC, aiming to not compromise the oncological outcomes of the patients.


title: Larger, but not better, motor adaptation ability inherent in medicated Parkinson's disease patients revealed by a smart-device-based study

text: Generating appropriate motor commands is an essential brain function. To achieve proper motor control in diverse situations, predicting future states of the environment and body and modifying the prediction are indispensable. The internal model is a promising hypothesis about brain function for generating and modifying the prediction. Although several findings support the involvement of the cerebellum in the internal model, recent results support the influence of other related brain regions on the internal model. A representative example is the motor adaptation ability in Parkinson's disease (PD) patients. Although this ability provides some hints about how dopamine deficits and other PD symptoms affect the internal model, previous findings are inconsistent; some reported a deficit in the motor adaptation ability in PD patients, but others reported that the motor adaptation ability of PD patients is comparable to that of healthy controls. A possible factor causing this inconsistency is the difference in task settings, resulting in different cognitive strategies in each study. Here, we demonstrate a larger, but not better, motor adaptation ability in PD patients than in healthy controls while reducing the involvement of cognitive strategies and concentrating on implicit motor adaptation abilities. This study utilizes a smart-device-based experiment that enables motor adaptation experiments anytime and anywhere with less cognitive strategy involvement. The PD patients showed a significant response to insensible environmental changes, but the response was not necessarily suitable for adapting to the changes. Our findings support compensatory cerebellar functions in PD patients from the perspective of motor adaptation.


docid: oqsrvxlz

title: Trombosis venosa cerebral e infección por SARS-CoV-2./ [Cerebral venous thrombosis and SARS-CoV-2 infection]


title: Vademecum for the treatment of people with COVID-19. Edition 2.0, 13 March 2020

text: The spread of COVID-19 epidemic in Italy, and particularly in Lombardy determined the need to standardize the therapeutic approach in order to offer the same indications for all hospitals in Lombardy. However, no specific drug has been previously approved for the COVID-19 treatment. The Lombardy Section of the Italian Society of Infectious and Tropical Diseases provided this «vademecum¼ with the aim to explore the current evidence about the drugs likely to be efficacious in the treatment of COVID-19. Moreover, a multidisciplinary group including critical care specialists has been created in order to provide indications about supporting measures and the use of steroids. A new grading scale has been proposed to help patients' stratification according to the severity of the respiratory conditions. Lastly, a collaborating group with immunologists and rheumatologists has been built with the aim of providing some guidance about the use of tocilizumab, a promising option for the treatment of the hyperinflammatory state occurring in most patients affected by COVID-19.


docid: hvskdppb

title: The Impact of COVID-19 Epidemic Declaration on Psychological Consequences: A Study on Active Weibo Users

text: COVID-19 (Corona Virus Disease 2019) has significantly resulted in a large number of psychological consequences. The aim of this study is to explore the impacts of COVID-19 on people's mental health, to assist policy makers to develop actionable policies, and help clinical practitioners (e.g., social workers, psychiatrists, and psychologists) provide timely services to affected populations. We sample and analyze the Weibo posts from 17,865 active Weibo users using the approach of Online Ecological Recognition (OER) based on several machine-learning predictive models. We calculated word frequency, scores of emotional indicators (e.g., anxiety, depression, indignation, and Oxford happiness) and cognitive indicators (e.g., social risk judgment and life satisfaction) from the collected data. The sentiment analysis and the paired sample t-test were performed to examine the differences in the same group before and after the declaration of COVID-19 on 20 January, 2020. The results showed that negative emotions (e.g., anxiety, depression and indignation) and sensitivity to social risks increased, while the scores of positive emotions (e.g., Oxford happiness) and life satisfaction decreased. People were concerned more about their health and family, while less about leisure and friends. The results contribute to the knowledge gaps of short-term individual changes in psychological conditions after the outbreak. It may provide references for policy makers to plan and fight against COVID-19 effectively by improving stability of popular feelings and urgently prepare clinical practitioners to deliver corresponding therapy foundations for the risk groups and affected people.


title: Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID-19: A multicentric prospective evaluation

text: AIMS: COVID-19 is especially severe for elderly subjects with cardiometabolic and respiratory comorbidities. Neck circumference (NC) has been shown to be strongly related to cardiometabolic and respiratory illnesses even after adjustment for body mass index (BMI). We performed a prospective study to investigate the potential of NC to predict the need for invasive mechanical ventilation (IMV) in adult COVID-19 inpatients. MATERIALS AND METHODS: We prospectively and consecutively enrolled COVID-19 adult patients admitted to dedicated medical wards of two Italian hospitals from 25 March to 7 April 2020. On admission, clinical, biochemical and anthropometric data, including BMI and NC were collected. As primary outcome measure, the maximum respiratory support received was evaluated. Follow-up time was 30 days from hospital admission. RESULTS: We enrolled 132 subjects (55.0-75.8 years, 32% female). During the study period, 26 (19.7%) patients underwent IMV. In multivariable logistic regression analyses, after adjusting for age, sex, diabetes, hypertension and COPD, NC resulted independently and significantly associated with IMV risk (adjusted OR 1.260-per 1 cm increase 95% CI:1.120-1.417; P < .001), with a stronger association in the subgroup with BMI ≤30 Kg/m2 (adjusted OR 1.526; 95% CI:1.243-1.874; P < .001). NC showed a good discrimination power in predicting patients requiring IMV (AUC 0.783; 95% CI:0.684-0.882; P < .001). In particular, NC > 40.5 cm (>37.5 for females and >42.5 for males) showed a higher and earlier IMV risk compared to subjects with lower NC (Log-rank test: P < .001). CONCLUSIONS: NC is an easy to measure parameter able to predict the need for IMV in adult COVID-19 inpatients.


title: Moral Obligation, Public Leadership, and Collective Action for Epidemic Prevention and Control: Evidence from the Corona Virus Disease 2019 (COVID-19) Emergency

text: To investigate the effect of villagers' moral obligation and village cadres' public leadership on villagers' collective action for epidemic prevention and control, against the background of the corona virus disease 2019 (COVID-19) emergency in China, we constructed models based on the institutional analysis and development (IAD) framework and employed principal component analysis (PCA) and ordered probit regression, drawing on survey data from 533 villagers in Henan province adjacent to the COVID-19 origin province, Hubei, China. The results indicate that: (1) generally, both moral obligation and public leadership as well as their constituent indicators contributed positively to collective action for COVID-19 prevention and control; (2) moreover, moral obligation and public leadership can strengthen each other's positive role in collective action for COVID-19 prevention and control. Based on the above findings, this paper suggests that villagers' moral obligation can be perfected through internalizing epidemic prevention and control norms into the villagers' moral norms by the way of villagers mastering the rural public health governance scheme. In addition, public leadership can be improved through professional training of village cadres and by motivating village elites to run for village cadres. With improved villagers' moral obligation and village cadres' public leadership, collective action for epidemic prevention and control could be more likely to be realized.


title: Covid-19: Symptomer, forløp og bruk av kliniske skåringsverktøy hos de 42 første pasientene innlagt på et norsk lokalsykehus./ Covid-19: Symptomer, forløp og bruk av kliniske skåringsverktøy hos de 42 første pasientene innlagt på et norsk lokalsykehus./ COVID-19: Symptoms, course of illness and use of clinical scoring systems for the first 42 patients admitted to a Norwegian local hospital

text: BACKGROUND: The COVID-19 outbreak is presenting the health system with new challenges, and there is a great need for knowledge about symptoms, clinical findings and course of illness in patients admitted to Norwegian hospitals with COVID-19. MATERIAL AND METHOD: In this observational qualitative study, all patients admitted to a Norwegian local hospital (Bærum Hospital) with proven COVID-19 infection were included consecutively from the start of the outbreak. We present here patient characteristics, symptoms, clinical findings, experience of using clinical scoring systems and course of illness based on data in medical records. RESULTS: In the period 9-31 March 2020, 42 patients, of whom 28 (67 %) were men, were admitted to hospital with COVID-19 infection. The median age was 72.5 years (range 30-95). Fever (79 %), reduced general condition (79 %), dyspnoea (69 %) and cough (67 %) were the most common symptoms. A total of nine patients (21 %) had a critical course of illness with treatment in the Intensive Care Department and/or death during their stay in hospital. Patients with a critical course had a higher average score on National Early Warning Score 2 (NEWS2) on admission (7.6 vs 3.3). Only one of the most severely ill patients scored ≥ 2 on the quick Sepsis-related Organ Failure Assessment (qSOFA) on admission. INTERPRETATION: Most patients admitted to our hospital with COVID-19 had a fever and respiratory tract symptoms. A high percentage of patients had a critical course of illness. A NEWS2 score of ≥ 5 on admission may be a useful aid in identifying patients at risk of a critical course of illness, while CRB-65 and qSOFA score ≥ 2 proved to be of little usefulness for this purpose in our material.


title: Selenium supplementation in the prevention of coronavirus infections (COVID-19)

text: Selenium (Se) is a ubiquitous element akin to sulfur (S) existing in the Earth crust in various organic and inorganic forms. Selenium concentration varies greatly depending on the geographic area. Consequently, the content of selenium in food products is also variable. It is known that low Se is associated with increased incidence of cancer and heart diseases. Therefore, it is advisable to supplement diet with this element albeit in a proper form. Although blood increased concentrations of Se can be achieved with various pharmacological preparations, only one chemical form (sodium selenite) can offer a true protection. Sodium selenite, but not selenate, can oxidize thiol groups in the virus protein disulfide isomerase rendering it unable to penetrate the healthy cell membrane. In this way selenite inhibits the entrance of viruses into the healthy cells and abolish their infectivity. Therefore, this simple chemical compound can potentially be used in the recent battle against coronavirus epidemic.


Editorial: the new normal for refractive surgery


title: Current status of treatment for 2019 novel coronavirus pneumonia/ 中华微生物学和免疫学杂志

text: 2019 novel coronavirus (2019-nCoV) is a new member of coronavirus family that can cause serious respiratory diseases after the emergence of severe acute respiratory syndrome-coronavirus (SARS-CoV) and middle east respiratory syndrome-coronavirus (MERS-CoV). At present, there is no specific antiviral drug targeting 2019-nCoV. In facing of the increasingly serious epidemic of 2019 novel coronavirus pneumonia and the urgent needs in drug treatment strategies, this paper reviewed the current research situation and progress in antiviral treatment for the newly identified disease.


Forced Choices: Ethical Challenges in Cardiology During the COVID-19 Pandemic


Post-lockdown management of oncological priorities and postponed radiation therapy following the COVID-19 pandemic: Experience of the Institut Curie


Mechanical Ventilation During the Coronavirus Disease 2019 Pandemic: Combating the Tsunami of Misinformation From Mainstream and Social Media


Ethical questions related to Covid-19 and ENT practice


docid: oubeywbn

title: Genomic analysis of SARS-CoV-2 strains among Indians returning from Italy, Iran & China, & Italian tourists in India


title: Psychological states of COVID-19 quarantine

text: The psychological effects of mass quarantine following the COVID-19 lockdown are likely to be significant. Emotional and behavioural responses to quarantine are related to a psychological state of anxiety. These and other emotions are normal and may even be adaptive. The exceptional circumstances of a national lockdown provide an opportunity to develop mental health literacy in the form of psychological first aid, to enable wider awareness of how individuals can contribute to listening and supporting others psychologically. This has potential implications for skilling clinicians and the public about responding to mental distress. As frontline health-care workers, general practitioners may themselves need to be recipients of psychological first aid and support as they deal with adverse consequences of the quarantine period.


Vaccine-Associated Posterior Uveitis


title: An Illustration of SARS-CoV-2 Dissemination Within a Skilled Nursing Facility Using Heat Maps

text: OBJECTIVES: To illustrate dissemination and asymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during a skilled nursing facility (SNF) outbreak. DESIGN: Case report. SETTING AND PARTICIPANTS: Residents of a 150-bed SNF. MEASUREMENTS: Heat maps generated by the SNF's infection prevention team to track staff and resident symptoms and SARS-CoV-2 test results to identify infection patterns. RESULTS: The SNF experienced a severe outbreak of SARS-CoV-2 early in the pandemic. The initial cluster of residents with symptoms and the first confirmed case occurred on the SNF's dementia care unit. The insufficient availability and prolonged turnaround time of testing for both residents and staff at the outset of the outbreak prevented timely and accurate identification and cohorting of cases. Despite extensive other infection control measures being in place, SARS-CoV-2 disseminated widely through the facility within 3 weeks of the first confirmed case, resulting in significant morbidity and mortality. CONCLUSION: Early, rapid, universal SARS-CoV-2 testing of both SNF residents and staff at the outset of an outbreak and then repeatedly thereafter is critical to mitigate viral transmission. This will become even more important as states relax stay-at-home orders and SNF staff intermingle with communities that are increasingly mobile. Increased testing will inevitably result in more staff testing positive and having to self-quarantine at home, meaning that states must partner with SNFs and other long-term care providers to coordinate and support strategic staffing reserves that can supplement current frontline staff.


Acute limb ischemia in COVID-19 patients: Could Aortic Floating Thrombus be the source of embolic complications?


title: Structure of the RNA-dependent RNA polymerase from COVID-19 virus

text: A novel coronavirus [severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2)] outbreak has caused a global coronavirus disease 2019 (COVID-19) pandemic, resulting in tens of thousands of infections and thousands of deaths worldwide. The RNA-dependent RNA polymerase [(RdRp), also named nsp12] is the central component of coronaviral replication and transcription machinery, and it appears to be a primary target for the antiviral drug remdesivir. We report the cryo-electron microscopy structure of COVID-19 virus full-length nsp12 in complex with cofactors nsp7 and nsp8 at 2.9-angstrom resolution. In addition to the conserved architecture of the polymerase core of the viral polymerase family, nsp12 possesses a newly identified ß-hairpin domain at its N terminus. A comparative analysis model shows how remdesivir binds to this polymerase. The structure provides a basis for the design of new antiviral therapeutics that target viral RdRp.