title: A Privacy-Preserving Solution for Proximity Tracing Avoiding Identifier Exchanging

text: Digital contact tracing is one of the actions useful, in combination with other measures, to manage an epidemic diffusion of an infection disease in an after-lock-down phase. This is a very timely issue, due to the pandemic of COVID-19 we are unfortunately living. Apps for contact tracing aim to detect proximity of users and to evaluate the related risk in terms of possible contagious. Existing approaches leverage Bluetooth or GPS, or their combination, even though the prevailing approach is Bluetooth-based and relies on a decentralized model requiring the mutual exchange of ephemeral identifiers among users' smartphones. Unfortunately, a number of security and privacy concerns exist in this kind of solutions, mainly due to the exchange of identifiers, while GPS-based solutions (inherently centralized) may suffer from threats concerning massive surveillance. In this paper, we propose a solution leveraging GPS to detect proximity, and Bluetooth only to improve accuracy, without enabling exchange of identifiers. Unlike related existing solutions, no complex cryptographic mechanism is adopted, while ensuring that the server does not learn anything about locations of users.


title: 81ª Semana Brasileira de Enfermagem e 1ª Semana Brasileira de Enfermagem em Tempos de Pandemia COVID-19

text: Iniciamos esse editorial dirigindo-nos aos profissionais de enfermagem que hoje já não estão entre nós Foram calados pela pandemia, sobretudo pela falta de recursos, de proteção, pela indiferença Justamente quando a Organização Mundial da Saúde declara 2020 como o Ano Internacional da Enfermagem, alertando que o mundo precisa de mais nove milhões de enfermeiros e parteiras para atingir a meta de cobertura universal de saúde até 2030;quando serão celebrados os 200 anos de Florence Nigthingale, a precursora da Enfermagem Moderna


What Should Gastroenterologists and Patients Know About COVID-19?


A wave of non-communicable diseases following the COVID-19 pandemic


Hypertonic saline nasal irrigation and gargling should be considered as a treatment option for COVID-19


title: Quantifying the Reach and Belief in COVID-19 Misinformation

text: The global COVID-19 pandemic has led to a startling rise in social-media fueled misinformation and conspiracies, leading to dangerous outcomes for our society and health. We quantify the reach and belief in COVID-19 related misinformation, revealing a troubling breadth and depth of misinformation that is highly partisan.


docid: gmsvzlpa

title: EDGE COVID-19: A Web Platform to generate submission-ready genomes for SARS-CoV-2 sequencing efforts

text: Genomics has become a pivotal technology for understanding emerging outbreaks of infectious diseases. A wide range of technologies and strategies for pathogen genome enrichment and sequencing are being used by laboratories and institutes, resulting in different analytical procedures for generating genome sequences and resulting in non-standard entries of varying quality into public repositories. A standardized analytical process for genome sequence generation, particularly for outbreaks such as the ongoing COVID-19 pandemic, are critical to provide scientists with a solid genomic basis for epidemiology analyses and for making well-informed decisions. To address this challenge, we have developed a web platform (EDGE COVID-19) to run standardized workflows for reference-based genome assembly and to perform further analysis of Illumina or Oxford Nanopore Technologies data for SARS-CoV-2 genome sequencing projects. Given a raw Illumina or Oxford Nanopore FASTQ read file, this web platform automates the production of a SARS-CoV-2 genome that is ready for submission to GISAID or GenBank. EDGE COVID-19 is open-source software that is available as a web application for public use at https://covid19.edgebioinformatics.org, and as a Docker container at https://hub.docker.com/r/bioedge/edge-covid19 for local installation.


title: Implementation of Obstetric Telehealth During COVID-19 and Beyond

text: PURPOSE: The purpose of this article is to illustrate and discuss the impact the 2019 novel Coronavirus (COVID-19) pandemic on the delivery of obstetric care, including a discussion on the preexisting barriers, prenatal framework and need for transition to telehealth. DESCRIPTION: The COVID-19 was first detected in China in December of 2019 and by March 2020 spread to the United States. As this virus has been associated with severe illness, it poses a threat to vulnerable populations-including pregnant women. The obstetric population already faces multiple barriers to receiving quality healthcare due to personal, environmental and economic barriers, now challenged with the additional risks of COVID-19 exposure and limited care in times much defined by social distancing. ASSESSMENT: The current prenatal care framework requires patients to attend multiple in-office prenatal visits that can exponentially multiply depending on maternal and fetal comorbidities. To decrease the rate of transmission of the COVID-19 and limit exposure to patients, providers in Hillsborough County, Florida (and nationwide) are rapidly transitioning to telehealth. The use of a virtual care model allows providers to reduce in-person visits and incorporate virtual visits into the schedule of prenatal care. CONCLUSION: Due to the COVID-19 pandemic, implementation of telehealth and telehealth have become crucial to ensure the safe and effective delivery of obstetric care. This implementation is one that will continue to require attention to planning, procedures and processes, and thoughtful evaluation to ensure the sustainability of telehealth and telehealth post COVID-19 pandemic.


The COVID-19 Pandemic: Experiences of a Geriatrician-Hospitalist Caring for Older Adults


title: Another Set of Coronavirus Vaccine Candidates

text: I surveyed the coronavirus vaccine landscape in this post, and then detailed some of the larger efforts in the field here (several updates have been added to that one since its initial posting) Now it’s time to look at several programs that aren’t in either of those, but still have plenty of serious science behind them For an example of a relatively new technology that’s now in use for human patients, there’s the VSV (vesicular stomatitis virus) platform, which was used to produce the Ebola vaccine now manufactured by Merck Stat has an excellent long-form article from earlier this year about how this came about, and it’s well worth a read, both for the history itself and as a look into the ups and downs of vaccine research in general The Yale team behind that one had developed a promising vaccine candidate for the SARS coronavirus during its epidemic, and they’re using those lessons in their current work If you look at that second link above on vaccine candidates, you will note that there are several using adenovirus vectors – this is conceptually the same sort of thing, but using a livestock virus (VSV) instead of human or primate-associated adenoviruses I don’t know if the Yale team has partnered with anyone yet, but I should also mention another connection of theirs, a spinoff company called CaroGen that has another engineered virus platform that is also being put to use against SARS-CoV-2 These projects are aiming at FDA approval for Phase I trials, but there’s no word yet on what such an application might go in


docid: svaxhbpm

title: Covid-19: 15 000 deregistered doctors are told, "Your NHS needs you"


Uncertainty surrounding the use of face masks in the community amid the COVID-19 pandemic


Lifestyle behaviours during the COVID-19 - time to connect


title: Impact of the State of Emergency Declaration for COVID-19 on Preventive Behaviors and Mental Conditions in Japan: Difference in Difference Analysis using Panel Data

text: During the COVID-19 epidemic in Japan between March and April 2020, Internet surveys were conducted to construct panel data to investigate changes at the individual level regarding preventive behaviors and mental conditions by surveying the same respondents at different times. Specifically, the difference-in-difference (DID) method was used to explore the impact of the COVID-19 state of emergency declared by the government. Key findings were: (1) the declaration led people to stay home, while also generating anger, fear, and anxiety. (2) The effect of the declaration on the promotion of preventive behaviors was larger than the detrimental effect on mental conditions. (3) Overall, the effect on women was larger than that on men.


The lurking scourge of multidrug resistant Candida auris in times of COVID-19 pandemic


Neurologic Involvement in COVID-19: Radiologists' Perspective


Ocular Signs of COVID-19 Suggested by Internet Search Term Patterns Worldwide


text: Online search data was used to explore a connection between COVID-19 and ocular symptoms. Compared to prior years, searches for sore and burning eyes increased and conjunctivitis search increases were variable based on language.


title: Otolaryngology during COVID-19: Preventive care and precautionary measures

text: Since the outbreak of novel coronavirus disease (COVID-19) in December 2019, it has spread to various regions and countries, forming a global pandemic. Reducing nosocomial infection is a new issue and challenge for all healthcare systems. Otolaryngology is a high-risk specialty as it close contact with upper respiratory tract mucous, secretions, droplets and aerosols during procedures and surgery. Therefore, infection prevention and control measures for this specialty are essential. Literatures on the epidemiology, clinical characteristics and infection control measures of COVID-19 were reviewed, practical knowledge from first-line otolaryngologists in China, the United States, and Brazil were reviewed and collated. It was recommended that otolaryngology professionals should improve screening in suspected patients with relevant nasal and pharyngeal symptoms and signs, suspend non-emergency consultations and examinations in clinics, and rearrange the working procedures in operating rooms. The guidelines of personal protective equipment for swab sampling, endoscopy and surgery were listed. Indications for tracheotomy during the pandemic should be carefully considered to avoid unnecessary airway opening and aerosol-generation; precautions during surgery to reduce the risk of exposure and infection were illustrated. This review aimed to provide recommendations for otolaryngologists to enhance personal protection against COVID-19 and reduce the risk of nosocomial infection.


Off the back burner: diverse and gender-inclusive decision-making for COVID-19 response and recovery


Neurological Involvement of COVID-19 Patients: Making the Most of MRI


title: Snowballing transmission of COVID-19 (SARS-CoV-2) through wastewater: Any sustainable preventive measures to curtail the scourge in low-income countries?

text: In this communication, we proposed sustainable preventive measures that may be adopted by the low-income countries to forestall the potential outbreak and transmission of COVID-19 (coronavirus disease 2019) through wastewater. Most low-income countries have poor sanitation and wastewater management policies, which create potential risks of COVID 19 spread. Hence, the proposed measures include decentralization of wastewater treatment facilities, community-wide monitoring and testing of SARS-CoV-2 in wastewater samples, improved sanitation, developing point-of-use devices for wastewater decontamination, and more focused policy interventions. Therefore, this paper adds useful insights into the monitoring and management of ongoing COVID-19 outbreak in low-income countries.


Another changing of the guard at OEM, this time during the COVID-19 pandemic


title: The role of initial chest X-ray in triaging patients with suspected COVID-19 during the pandemic

text: PURPOSE: The purpose of our research is to evaluate the usefulness of chest X-ray for triaging patients with suspected COVID-19 infection. METHODS: IRB approval was obtained to allow a retrospective review of adult patients who presented to the Emergency Department with a complaint of fever, cough, dyspnea or hypoxia and had a chest X-ray between 12 March 2020 and 26 March 2020. The initial chest X-ray was graded on a scale of 0-3 with grade 0 representing no alveolar opacities, grade 1: < 1/3 alveolar opacities of the lung, Grade 2: 1/3 to 2/3 lung with alveolar opacities and grade 3: > 2/3 alveolar opacities of the lung. Past medical history of diabetes and hypertension, initial oxygen saturation, COVID-19 testing results, intubation, and outcome were also collected. RESULTS: Four hundred ten patient chest X-rays were reviewed. Oxygen saturation and X-ray grade were both significantly associated with the length of stay in hospital, the hazard ratio (HR) of discharge was 1.05 (95% CI [1.01, 1.09], p = 0.017) and 0.61 (95% CI [0.51, 0.73], p < 0.001), respectively. In addition, oxygen saturation and X-ray grade were significant predictors of intubation (odds ratio (OR) of intubation is 0.88 (95% CI [0.81, 0.96], p = 0.004) and 3.69 (95% CI [2.25, 6.07], p < 0.001). CONCLUSIONS: Initial chest X-ray is a useful tool for triaging those subjects who might have poor outcomes with suspected COVID-19 infection and benefit most from hospitalization.


Evolving consensus on managing vitreo-retina and uvea practice in post-COVID-19 pandemic era


text: The COVID-19 pandemic has brought new challenges to the health care community. Many of the super-speciality practices are planning to re-open after the lockdown is lifted. However there is lot of apprehension in everyone's mind about conforming practices that would safeguard the patients, ophthalmologists, healthcare workers as well as taking adequate care of the equipment to minimize the damage. The aim of this article is to develop preferred practice patterns, by developing a consensus amongst the lead experts, that would help the institutes as well as individual vitreo-retina and uveitis experts to restart their practices with confidence. As the situation remains volatile, we would like to mention that these suggestions are evolving and likely to change as our understanding and experience gets better. Further, the suggestions are for routine patients as COVID-19 positive patients may be managed in designated hospitals as per local protocols. Also these suggestions have to be implemented keeping in compliance with local rules and regulations.


Ventilator Sharing: The Good, the Bad, and the Ugly


title: Hi Sigma, do I have the Coronavirus?: Call for a New Artificial Intelligence Approach to Support Health Care Professionals Dealing With The COVID-19 Pandemic

text: Just like your phone can detect what song is playing in crowded spaces, we show that Artificial Intelligence transfer learning algorithms trained on cough phone recordings results in diagnostic tests for COVID-19. To gain adoption by the health care community, we plan to validate our results in a clinical trial and three other venues in Mexico, Spain and the USA . However, if we had data from other on-going clinical trials and volunteers, we may do much more. For example, for confirmed stay-at-home COVID-19 patients, a longitudinal audio test could be developed to determine contact-with-hospital recommendations, and for the most critical COVID-19 patients a success ratio forecast test, including patient clinical data, to prioritize ICU allocation. As a challenge to the engineering community and in the context of our clinical trial, the authors suggest distributing cough recordings daily, hoping other trials and crowdsourcing users will contribute more data. Previous approaches to complex AI tasks have either used a static dataset or were private efforts led by large corporations. All existing COVID-19 trials published also follow this paradigm. Instead, we suggest a novel open collective approach to large-scale real-time health care AI. We will be posting updates at https://opensigma.mit.edu. Our personal view is that our approach is the right one for large scale pandemics, and therefore is here to stay - will you join?


Acute generalized exanthematous pustulosis after COVID-19 treatment with hydroxychloroquine


Challenges to scientific publishing in times of COVID-19


title: Smell and taste alterations in COVID-19: a cross-sectional analysis of different cohorts

text: BACKGROUND: Olfactory (OD) and gustatory (GD) dysfunction have been proven to be a typical symptom of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. However, their prevalence in different patient populations still needs to be clarified. METHODS: A cross-sectional study was performed from March 27 to April 1, 2020, in Northern Italy. Physicians administered a survey-based questionnaire to SARS-CoV-2-positive patients with the aim of assessing symptoms, focusing on OD and GD. Two groups were studied: group A, patients hospitalized at Azianda Socio Sanitaria Territoriale (ASST) Spedali Civili University Hospital of Brescia; and group B, home-quarantined subjects. RESULTS: A total of 508 patients were enrolled: 295 in group A and 213 in group B. Mean age ± standard deviation (SD) was 55 ± 15 years; 56% were men. Overall, OD and GD were present in 56% (95% confidence interval [CI], 51% to 60%) and 63% (95% CI, 59% to 67%) of cases, respectively. In group A, the prevalence of OD and GD was 44% (95% CI, 38% to 50%) and 52% (95% CI, 46% to 58%), respectively. In group B, the prevalence of OD and GD was 72% (95% CI, 65% to 79%) and 79% (95% CI, 73% to 84%), respectively. In the entire cohort, total loss of olfaction and taste was reported in 64% and 60% of cases, respectively. OD and GD occurred as the first symptom in 10% and 11% of cases, respectively; in the remaining cases, they occurred after a mean of 4 ± 3 days following the first symptom. At the time of the questionnaire, complete resolution of OD and GD was reported in 52% and 55% of cases, respectively (mean duration, 9 ± 5 days in both). CONCLUSION: OD and GD are more prevalent in home-quarantined subjects, and they are independently associated with younger age and female gender.


title: Protecting vulnerable patients with inherited anaemias from unnecessary death during the COVID-19 pandemic

text: With the developing COVID-19 pandemic, patients with inherited anaemias require specific advice regarding isolation and changes to usual treatment schedules. The National Haemoglobinopathy Panel (NHP) has issued guidance on the care of patients with sickle cell disease, thalassaemia, Diamond Blackfan anaemia (DBA), congenital dyserythropoietic anaemia (CDA), sideroblastic anaemia, pyruvate kinase deficiency and other red cell enzyme and membrane disorders. Cascading of accurate information for clinicians and patients is paramount to preventing adverse outcomes, such as patients who are at increased risk of fulminant bacterial infection due to their condition or its treatment erroneously self-isolating if their fever is mistakenly attributed to a viral cause, delaying potentially life-saving antibiotic therapy. Outpatient visits should be minimised for most patients, however some, such as first transcranial dopplers for children with sickle cell anaemia should not be delayed as known risk of stroke will outweigh the unknown risk from COVID-19 infection. Blood transfusion programmes should be continued, but specific changes to usual clinical pathways can be instituted to reduce risk of patient exposure to COVID-19, as well as contingency planning for possible reductions in blood available for transfusions. Bone marrow transplants for these disorders should be postponed until further notice. With the current lack of evidence on the risk and complications of COVID-19 infection in these patients, national data collection is ongoing to record outcomes and eventually to identify predictors of disease severity, particularly important if further waves of infection travel through the population.


title: Is subcutaneous insulin administration adequate for the management of hyperglycemic crisis in COVID-19?

text: There is a desperate need to explore different insulin administration strategies, particularly in coronavirus disease 2019 (COVID-19) patients with hyperglycemic crisis. Noteworthily, diabetes mellitus (DM) and poorly controlled blood glucose increase the risk of mortality and severity of COVID-19. Intravenous (IV) insulin administration with hourly monitoring of blood glucose is the ideal approach in managing patients with hyperglycemic crisis, but it is not judicious to be applied in developing countries where shortage of personal protective equipment (PPE) is a major issue. Furthermore, increasing the probability of "already greater risks" for doctors or other healthcare workers contracting COVID-19 seems inappropriate. Thus, an alternative administration strategy and more moderate glucose monitoring to reduce the contact exposure of healthcare workers with COVID-19 patients, by ensuring appropriate blood glucose levels, needs to be performed in this critical pandemic era. Subcutaneous (SC) rapid-acting insulin analog administration could presumably be a solution to this contentious issue.


Translating Science on COVID-19 to Improve Clinical Care and Support the Public Health Response


title: Sudden death due to acute pulmonary embolism in a young woman with COVID-19

text: Coronavirus disease 2019 (COVID-19) is an infectious disease that primarily affects the respiratory system, but it may cause cardiovascular complications such as thromboembolism. Rarely, pulmonary embolism may be encountered in patients with severe COVID-19 infection, especially in intensive care units. An asymptomatic young case of COVID-19 presenting with sudden death due to acute massive pulmonary embolism has not been previously described. We report a 41-year-old woman presented to emergency department with sudden death during physical activity. She had only history of diabetes mellitus and she was asymptomatic until sudden death. CT pulmonary angiography and chest CT scans revealed acute massive embolism and typical imaging findings of COVID-19 pneumonia, respectively. Interestingly, the patient had no symptoms or signs of infection and also had no risk factors for thromboembolism. COVID-19 infection appears to induce venous thromboembolism, especially pulmonary embolism. The case is remarkable in terms of showing how insidious and life-threatening COVID-19 infection can be.


title: European Association of Urology Guidelines Office Rapid Reaction Group: An Organisation-wide Collaborative Effort to Adapt the European Association of Urology Guidelines Recommendations to the Coronavirus Disease 2019 Era

text: The coronavirus disease 2019 (COVID-19) pandemic is unlike anything seen before by modern science-based medicine. Health systems across the world are struggling to manage it. Added to this struggle are the effects of social confinement and isolation. This brings into question whether the latest guidelines are relevant in this crisis. We aim to support urologists in this difficult situation by providing tools that can facilitate decision making, and to minimise the impact and risks for both patients and health professionals delivering urological care, whenever possible. We hope that the revised recommendations will assist urologist surgeons across the globe to guide the management of urological conditions during the current COVID-19 pandemic.


title: Evaluation of the Effectiveness of Surveillance and Containment Measures for the First 100 Patients with COVID-19 in Singapore - January 2-February 29, 2020

text: Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China, in December 2019, and has since spread globally, resulting in >95,000 confirmed COVID-19 cases worldwide by March 5, 2020 (1). Singapore adopted a multipronged surveillance strategy that included applying the case definition at medical consults, tracing contacts of patients with laboratory-confirmed COVID-19, enhancing surveillance among different patient groups (all patients with pneumonia, hospitalized patients in intensive care units [ICUs] with possible infectious diseases, primary care patients with influenza-like illness, and deaths from possible infectious etiologies), and allowing clinician discretion (i.e., option to order a test based on clinical suspicion, even if the case definition was not met) to identify COVID-19 patients. Containment measures, including patient isolation and quarantine, active monitoring of contacts, border controls, and community education and precautions, were performed to minimize disease spread. As of March 5, 2020, a total of 117 COVID-19 cases had been identified in Singapore. This report analyzes the first 100 COVID-19 patients in Singapore to determine the effectiveness of the surveillance and containment measures. COVID-19 patients were classified by the primary means by which they were detected. Application of the case definition and contact tracing identified 73 patients, 16 were detected by enhanced surveillance, and 11 were identified by laboratory testing based on providers' clinical discretion. Effectiveness of these measures was assessed by calculating the 7-day moving average of the interval from symptom onset to isolation in hospital or quarantine, which indicated significant decreasing trends for both local and imported COVID-19 cases. Rapid identification and isolation of cases, quarantine of close contacts, and active monitoring of other contacts have been effective in suppressing expansion of the outbreak and have implications for other countries experiencing outbreaks.


title: Interpretation of arrhythmogenic effects of COVID-19 disease through ECG

text: Objective: We aimed to detect the malignant arrhythmic potential of COVID-19 with surface electrocardiographic (ECG) markers.Material and method: Of the ECG parameters PR, QT, QTc, QTd, TPe, and Tpe/QTc were measured in 51 COVID-19 patients and 40 in control subjects.Results: Compared to control group mean QTc (410.8 ± 24.3 msec vs. 394.6 ± 20.3 msec, p < .001) and Tpe/QTc (0.19 ± 0.02 vs. 0.18 ± 0.04, p = .036) and median QTd (47.52 vs. 46.5) values were significantly higher in COVID-19 patients. Troponin levels were significantly correlated with heart rate (r = 0.387, p = .006) but not with ECG parameters.Conclusion: Several ventricular arrhythmia surface ECG predictors including QTc, QTd, and Tpe/QTc are increased in COVID-19 patients. Since medications used in COVID-19 patients have the potential to affect these parameters, giving importance to these ECG markers may have a significant contribution in decreasing disease-related arrhythmias.


Re: COVID-19 in Solid Organ Transplant Recipients: Initial Report from the US Epicenter


title: Explaining the Initial Spread of COVID-19 using Mobile Positioning Data: a Case Study

text: This work provides an analysis on the potential of aggregate and anonymised mobility data from mobile phones to explain the recent COVID-19 outbreak in Europe. The data were processed by the European Commission in collaboration with EU Mobile Network Operators (MNOs) to improve the quality of modelling and forecasting for the pandemic at EU level. Connectivity matrices derived from MNOs at EU scale can help the understanding of the initial dynamics of the spread. This work is expected to provide input to epidemiological modelling in informing policies on de-escalation of control measures and recovery. Connectivity data between administrative areas can also be used to estimate impacts and spread of future outbreaks. A case study of France shows that mobility alone can explain from 52% up to 92% of the initial spread of the virus, while there is no effect before the outbreak, and has a slow decay effect after lockdown measures are effective. It also emerges that internal mobility is more important than mobility across geographical departments.


Concerns Regarding the Article Entitled 'Safe Handling of Containers of Expressed Human Milk in all Settings During the SARS-CoV-2 (COVID-19)'


title: COVID-19 in persons with haematological cancers

text: Infection with SARS-CoV-2, the cause of coronavirus infectious disease-19 (COVID-19), has caused a pandemic with >850,000 cases worldwide and increasing. Several studies report outcomes of COVID-19 in predominately well persons. There are also some data on COVID-19 in persons with predominately solid cancer but controversy whether these persons have the same outcomes. We conducted a cohort study at two centres in Wuhan, China, of 128 hospitalised subjects with haematological cancers, 13 (10%) of whom developed COVID-19. We also studied 226 health care providers, 16 of whom developed COVID-19 and 11 of whom were hospitalised. Co-variates were compared with the 115 subjects with haematological cancers without COVID-19 and with 11 hospitalised health care providers with COVID-19. There were no significant differences in baseline co-variates between subjects with haematological cancers developing or not developing COVID-19. Case rates for COVID-19 in hospitalised subjects with haematological cancers was 10% (95% Confidence Interval [CI], 6, 17%) compared with 7% (4, 12%; P = 0.322) in health care providers. However, the 13 subjects with haematological cancers had more severe COVID-19 and more deaths compared with hospitalised health care providers with COVID-19. Case fatality rates were 62% (32, 85%) and 0 (0, 32%; P = 0.002). Hospitalised persons with haematological cancers have a similar case rate of COVID-19 compared with normal health care providers but have more severe disease and a higher case fatality rate. Because we were unable to identify specific risk factors for COVID-19 in hospitalised persons with haematological cancers, we suggest increased surveillance and possible protective isolation.


title: COVID-19: Financial Stress Test for Academic Medical Centers

text: The coronavirus pandemic (COVID-19) is having profound effects on the lives and well-being of the world's population. All levels of the nation's public health and health care delivery systems are rapidly adjusting to secure the health infrastructure to manage the pandemic in the United States. As the nation's safety net health care systems, academic medical centers (AMCs) are vital clinical and academic resources in managing the pandemic. COVID-19 may also risk the financial underpinnings of AMCs because their cost structures are high, and they may have incurred large amounts of debt over the last decade as they expanded their clinical operations and facilities. This Invited Commentary reviews existing data on AMC debt levels; summarizes relief provided in the Coronavirus Aid, Relief, and Economic Security Act; and suggests policy options to help mitigate risk.


Covid-19: Doctors launch judicial review over PPE failures


title: Short and long term impacts of COVID-19 on the pharmaceutical sector

text: BACKGROUND: The novel coronavirus disease 2019 (COVID-19) was characterized as a global pandemic by the WHO on March 11th, 2020. This pandemic had major effects on the health market, the pharmaceutical sector, and was associated with considerable impacts; which may appear in short and long-term time-horizon and need identification and appropriate planning to reduce their socio-economic burden. OBJECTIVES: Current short communication study assessed pharmaceutical market crisis during the COVID-19 era; discussing short- and long-term impacts of the pandemic on the pharmaceutical sector. RESULTS: Short-term impacts of COVID-19 pandemic includes demand changes, regulation revisions, research and development process changes and the shift towards tele-communication and tele-medicine. In addition, industry growth slow-down, approval delays, moving towards self-sufficiency in pharm-production supply chain and trend changes in consumption of health-market products along with ethical dilemma could be anticipated as long-term impacts of COVID-19 pandemic on pharmaceutical sector in both global and local levels. CONCLUSION: The pandemic of COVID-19 poses considerable crisis on the health markets, including the pharmaceutical sector; and identification of these effects, may guide policy-makers towards more evidence-informed planning to overcome accompanying challenges. Graphical abstract .


title: 5-Fluorouracil in combination with deoxyribonucleosides and deoxyribose as possible therapeutic options for the Coronavirus, COVID-19 infection

text: The recent global pandemic created by the Coronavirus SARS-CoV-2, started in Wuhan, China in December 2019, has generated panic, both in term of human death (4-5% of infected patients identified through testing) and the global economy. Human sufferings seem to be continuing, and it is not clear how long this will continue and how much more destruction it is going to cause until complete control is achieved. One of the most disturbing issues is Covid-19 treatment; although a large number of medications, previously used successfully with other viruses (including Chinese herbal medicines and anti-malaria drugs), are under consideration, there remain questions as to whether they can play a satisfactory role for this disease. Global attempts are ongoing to find the drugs for the treatment of this virus but none of the antiviral drugs used for treatment of other human viral infection is working and hence attempts to find new drugs are continuing. Here the author is proposing that 5-Fluorouracil (5-FU) which when used on its own is failing as an antiviral agent due to the removal of this compound by proof reading ability exceptionally found in Coronaviruses. The author here is proposing to test 5-FU in combination with a number of deoxynucleosides on animal models infected with this Covid-19. Should encouraging results ensue, therapies could then be tried on patients.


docid: bnlgkdhr

title: Positive result of Sars-Cov-2 in faeces and sputum from discharged patient with COVID-19 in Yiwu, China

text: BACKGROUND: With the effective prevention and control of COVID - 19 in China, the number of cured cases increased significantly. Further monitoring of the disease prognosis and effective control of the "relapse" of the epidemic become the next focus of work. To analyse the clinical prognosis of discharged COVID-19 patients by monitoring their SAR-CoV-2 nucleic acid status, which may provide evidence to establish discharge standards and follow-up management for COVID-19 patients. METHODS: We included 13 discharged COVID-19 patients who were quarantined for 4-week at home. The patient's daily clinical signs were recorded and sputum and faecal specimens were regularly sent for the detection of SARS-CoV-2 nucleic acid. RESULTS: The time between initial symptoms and meeting discharge criteria was 18 - 44 days with an average of 25 ± 6 days. The faecal samples of two patients still tested positive after meeting discharge criteria and the sputum samples of four patients returned positive 5 - 14 days after discharge. The rate of a recurring positive test result in samples from the respiratory system was 31%(4/13). CONCLUSION: Under the present discharge criteria, the high presence of SARS-CoV-2 nucleic acid in faecal and respiratory samples of discharged COVID-19 patients indicate potential infectivity. Therefore, we suggest that faecal virus nucleic acid should be tested as a routine monitoring index for COVID-19 and a negative result be added to the criteria. Simultaneously, we should strengthen the regular follow-up of discharged patients with continuous monitoring of the recurrence of viral nucleic acid. This article is protected by copyright. All rights reserved.


Neuroinfection may contribute to pathophysiology and clinical manifestations of COVID-19


docid: qsclxhuk

title: Post SARS-CoV-2 Guillain-Barré syndrome


title: Harnessing inflammation resolving-based therapeutic agents to treat pulmonary viral infections: What can the future offer to COVID-19?

text: Inflammation is generally accepted as a component of the host defence system and a protective response in the context of infectious diseases. However, altered inflammatory responses can contribute to disease in infected individuals. Many endogenous mediators that drive the resolution of inflammation are now known. Overall, mediators of resolution tend to decrease inflammatory responses and provide normal or greater ability of the host to deal with infection. In the lung, it seems that pro-resolution molecules, or strategies that promote their increase, tend to suppress inflammation and lung injury and facilitate control of bacterial or viral burden. Here, we argue that the demonstrated anti-inflammatory, pro-resolving, anti-thrombogenic and anti-microbial effects of such endogenous mediators of resolution may be useful in the treatment of the late stages of the disease in patients with COVID-19.


title: COVID-19 pandemic: a viewpoint from Asia

text: The expansion of severe acute respiratory syndrome (SARS) coronavirus 2 (SARSCoV-2) has now procured on epidemic percentages, affecting more than 190 nations in a matter of weeks. A widespread SARSCoV-2 contagion begun in Wuhan, Hubei Province, China, and circulate through China and beyond in December 2019. The containment events in China have lessened new instances by more than 90%, but this diminution is not the case to a different place. European countries like Italy and Spain have been the most affected. In Asia, the COVID-19 brings a catastrophe where after China mainland, countries like Iran and South Korea have been affected. There is now severe apprehension concerning the Asian health care system's ability to effectually counter to the necessities of patients who are infected and need rigorous precaution for COVID-19. The patient's ratio in special care reported in Iran has perpetually been between 6 and 8% who are rapidly infected. As about South Korea, the ratio is 3% and 4% who are rapidly infected. This analysis emphasizes the epidemiology of COVID-19, its effects in the Asia continent, and active case study of COVID-19 including the distinct countries.


Lack of Handwashing Access: A Widespread Deficiency in the Age of COVID-19


Accountability for SRHR in the context of the COVID-19 pandemic


title: Ethnic disparities in hospitalisation for COVID-19 in England: The role of socioeconomic factors, mental health, and inflammatory and pro-inflammatory factors in a community-based cohort study

text: BACKGROUND: Differentials in COVID-19 hospitalisations and mortality according to ethnicity have been reported but their origin is uncertain. We examined the role of socioeconomic, mental health, and pro-inflammatory factors in a community-based sample. METHODS: We used data on 340,966 men and women (mean age 56.2 years) from the UK Biobank study, a prospective cohort study with linkage to hospitalisation for COVID-19. Logistic regression models were used to estimate associations between ethnicity and hospitalisation for COVID-19. RESULTS: There were 640 COVID-19 cases (571/324,306 White, 31/4,485 Black, 21/5,732 Asian, 17/5,803 Other). Compared to the White study members and after adjusting for age and sex, Black individuals had over a 4-fold increased risk of COVID-19 infection (odds ratio; 95% confidence interval: 4.32; 3.00-6.23), and there was a doubling of risk in the Asian group (2.12; 1.37, 3.28) and the 'other' non-white group (1.84; 1.13, 2.99). After controlling for potential explanatory factors which included neighbourhood deprivation, household crowding, smoking, body size, inflammation, glycated haemoglobin, and mental illness, these effect estimates were attenuated by 33% for Blacks, 52% for Asians and 43% for Other, but remained raised for Blacks (2.66; 1.82, 3.91), Asian (1.43; 0.91, 2.26) and other non-white groups (1.41; 0.87, 2.31). CONCLUSIONS: There were clear ethnic differences in risk of COVID-19 hospitalisation and these do not appear to be fully explained by measured factors. If replicated, our results have implications for health policy, including the targeting of prevention advice and vaccination coverage.


title: COVID-19 Susceptibility Mapping Using Multicriteria Evaluation

text: OBJECTIVE: The purpose of this research was to investigate coronavirus disease (COVID-19) susceptibility in districts of Bangladesh using multicriteria evaluation techniques. METHODS: Secondary data were collected from different government organizations, 120 primary surveys were conducted for calculating weights, and results were validated through 12 key people's interviews. Pairwise comparison matrixes were calculated for 9 factors and subfactors. The analytic hierarchy process used for calculating the susceptibility index and map was prepared based on the results. RESULTS: According to the results, multiple causal factors might be responsible for COVID-19 spreading in Bangladesh. Dhaka might be vulnerable to COVID-19 due to a higher population, population density, and international collaboration. According to the pairwise comparison matrix, the consistency ratio for subfactors and factors was in the permissible limit (ie, less than 0.10). The highest factor weight of 0.2907 was found for the factors type of port. The maximum value for the susceptibility index was 0.435219362 for Chittagong, and the minimum value was 0.076174 for Naogaon. CONCLUSIONS: The findings of this research might help the communities and government agencies with effective decision-making.


title: How many can you infect? Simple (and naive) methods of estimating the reproduction number

text: This is a pedagogical paper on estimating the number of people that can be infected by one infectious person during an epidemic outbreak, known as the reproduction number. Knowing the number is crucial for developing policy responses. There are generally two types of such a number, i.e., basic and effective (or instantaneous). While basic reproduction number is the average expected number of cases directly generated by one case in a population where all individuals are susceptible, effective reproduction number is the number of cases generated in the current state of a population. In this paper, we exploit the deterministic susceptible-infected-removed (SIR) model to estimate them through three different numerical approximations. We apply the methods to the pandemic COVID-19 in Italy to provide insights into the spread of the disease in the country. We see that the effect of the national lockdown in slowing down the disease exponential growth appeared about two weeks after the implementation date. We also discuss available improvements to the simple (and naive) methods that have been made by researchers in the field. Authors of this paper are members of the SimcovID (Simulasi dan Pemodelan COVID-19 Indonesia) collaboration.


title: Trial of Chloroquines in the Treatment of COVID-19 and Its Research Progress in Forensic Toxicology

text: Abstract: Chloroquines are the long-established prescription drug, which are often used clinically to treat malaria and connective tissue diseases. Since December 2019, corona virus disease 2019 ï¼COVID-19ï¼ outbreaks caused by 2019 novel coronavirus ï¼2019-nCoVï¼ has occurred in China and many countries around the world. Due to the lack of drugs against COVID-19, the disease spreads rapidly and the mortality rate is relatively high. Therefore, specific drugs against 2019-nCoV need to be quickly screened. The antimalarial drug chloroquine phosphate which has already been approved is confirmed to have an anti-2019-nCoV effect and has been included in diagnostic and therapeutic guidelines. However, awareness of the risk of chloroquine phosphate causing acute poisoning or even death should be strengthened. The current dosage recommended in clinical treatment is larger than that in previous treatment of malaria and the period of treatment is longer. Many provinces have required close clinical monitoring of adverse reactions. This paper reviews the pharmacological effects, poisoning and toxicological mechanisms, in vivo metabolism and distribution, and forensic issues of chloroquine drugs, in order to provide help to forensic practice and clinical work.


title: Efficacy and safety of oral phosphodiesterase 5 inhibitors for erectile dysfunction: a network meta-analysis and multicriteria decision analysis

text: PURPOSE: To quantitatively assess the benefit-risk ratio on the efficacy and safety of all phosphodiesterase type 5 inhibitors (PDE5i) in men with erectile dysfunction. METHODS: A systematic review with network meta-analysis, surface under the cumulative ranking analysis and stochastic multicriteria acceptability analyses were performed. Searches were conducted in Pubmed, Scopus, Web of Science without limits for time-frame or language. Randomized controlled trials evaluating the efficacy or safety of any PDE5i compared to a placebo or to other PDE5i in males with erectile disfunction were included. RESULTS: Overall, 184 articles representing 179 randomized controlled trials (50,620 patients) were included. All PDE5i were significantly more efficient than placebo. Sildenafil 25 mg was statistically superior to all interventions in enhancing IIEF (with a 98% probability of being the most effective treatment), followed by sildenafil 50 mg (80% of probability). Taladafil 10 mg and 20 mg also presented good profiles (73% and 76%, respectively). Avanafil and lodenafil were less effective interventions. Mirodenafil 150 mg was the treatment that caused more adverse events, especially flushing and headaches. Sildenafil 100 mg was more related to visual disorders, while vardenafil and udenafil were more prone to cause nasal congestion. CONCLUSION: Sildenafil at low doses and tadalafil should be the first therapeutic options. Avanafil, lodenafil and mirodenafil use are hardly justified given the lack of expressive efficacy or high rates of adverse events.


COVID-19: the key to flattening the curve is health literacy


Letter in response to the article: Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers (Singh et al.)


title: From causes of aging to death from COVID-19

text: COVID-19 is not deadly early in life, but mortality increases exponentially with age, which is the strongest predictor of mortality. Mortality is higher in men than in women, because men age faster, and it is especially high in patients with age-related diseases, such as diabetes and hypertension, because these diseases are manifestations of aging and a measure of biological age. At its deepest level, aging (a program-like continuation of developmental growth) is driven by inappropriately high cellular functioning. The hyperfunction theory of quasi-programmed aging explains why COVID-19 vulnerability (lethality) is an age-dependent syndrome, linking it to other age-related diseases. It also explains inflammaging and immunosenescence, hyperinflammation, hyperthrombosis, and cytokine storms, all of which are associated with COVID-19 vulnerability. Anti-aging interventions, such as rapamycin, may slow aging and age-related diseases, potentially decreasing COVID-19 vulnerability.


docid: adiglhpj

title: Chronic pain management in COVID-19 era


title: Triaging Total Hip Arthroplasty During the COVID-19 Pandemic

text: PURPOSE OF REVIEW: The purpose of this review was to evaluate the available literature to determine what may be considered urgent indications for total hip arthroplasty, in the unprecedented setting of the worldwide COVID-19 pandemic. RECENT FINDINGS: SARS-CoV-2 is a novel coronavirus currently presenting in the form of a global pandemic, referred to as COVID-19. In this setting, multiple states have issued executive orders prohibiting "elective" surgery, including arthroplasty, in order to preserve healthcare resources. However, during this unprecedented reduction in elective surgery, there is likely to be some controversy as to what constitutes a purely "elective" procedure, versus an "urgent" procedure, particularly regarding hip arthroplasty. We reviewed the available literature for articles discussing the most commonly encountered indications for primary, conversion, and revision hip arthroplasty. Based upon the indications discussed in these articles, we further stratified these indications into "elective" versus "urgent" categories. In patients presenting with hip arthroplasty indications, the decision to proceed urgently with surgery should be based upon (a) the potential harm incurred by the patient if the surgery was delayed and (b) the potential risk incurred by the patient in the context of COVID-19 if surgery was performed. The authors present a decision-making algorithm for determining surgical urgency in three patients who underwent surgery in this context. Urgent total hip arthroplasty in the setting of the COVID-19 pandemic is a complex decision-making process, involving clinical and epidemiological factors. These decisions are best made in coordination with a multidisciplinary committee of one's peers. Region-specific issues such as hospital resources and availability of PPE may also inform the decision-making process.


title: Lanthanum content and effects on growth, gas exchanges, and chlorophyll index in maize plants/ Teor de lantânio e efeitos no crescimento, trocas gasosas e teor de clorofila em plantas de milho

text: Rare earth elements, such as lanthanum (La), have been applied to agriculture via fertilizers, aiming to increase the productivity and crop quality, such results observed mainly in China. However, the knowledge about the effect of La on maize growth, as well as for other species, despite the growing interest it is still limited. The aim of this study was to evaluate the effects of La on maize growth, La content,photosynthetic rate and chlorophyll content in maize plants in response to La treatment (0, 25, 50, 100, 150, 300 and 600 μM) in nutrient solution for three weeks. The plants were placed in geminated pots using a split-root technique. One of the pots in the geminated set was filled with a complete nutrient solution without La, while another was filled with a nutrient solution without phosphorus but containing different concentrations of La. It was verified that roots of maize plants can accumulate approximately sixty percent more La than shoots. Moreover, low La concentrations stimulated an increase in chlorophyll index,resulting in a slight increase in shoot biomass. At higher levels, La didnt reduce growth but caused adecrease in both photosynthetic rate and chlorophyll index.(AU)


title: Knowledge, attitude, and practice towards coronavirus disease 2019 (COVID-19) among medical students: A cross-sectional study

text: Objective: To assess knowledge, attitude, and practice of medical students towards coronavirus disease 2019 (COVID-19) Methods: A self-designed questionnaire was developed and given to the students of a government medical college in Uttarakhand The demographics, mean knowledge, attitude, and practice of the participants were investigated, and the scores were calculated t-test and ANOVA were used for statistical analysis Results: Out of the total participants (n=354), 50 3％ were male and 54 5％ were 21-23 years Almost all the participants (96 6％) increase the frequency of washing hands under the influence of COVID-19 Although no significant relationship was found between different religions, age-categories in terms of knowledge, the participants who were aged 21-23 years had higher knowledge In addition, gender had a significant impact on practice scores (P0 05) Conclusions: The majority of the participants had good knowledge, positive attitude, and sufficient practice Females and males have significantly different practices Although the results are very positive, it is suggested that people should continue to strengthen knowledge, attitude, and practice towards COVID-19, so that India can win the battle against the disease


The Coronavirus Pandemic: Public Health and American Values


COVID-19 in Singapore-Current Experience: Critical Global Issues That Require Attention and Action


Clinical characteristics of invasive pulmonary aspergillosis in patients with COVID-19 in Zhejiang, China: a retrospective case series


The care of patients through the lens of the fundamentals into times of the COVID-19 outbreak


Molecular characterization of SARS-CoV-2 from the first case of COVID-19 in Italy


title: Risk Factors for Mortality in Patients with COVID-19 in New York City

text: BACKGROUND: New York City emerged as an epicenter of the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: To describe the clinical characteristics and risk factors associated with mortality in a large patient population in the USA. DESIGN: Retrospective cohort study. PARTICIPANTS: 6493 patients who had laboratory-confirmed COVID-19 with clinical outcomes between March 13 and April 17, 2020, who were seen in one of the 8 hospitals and/or over 400 ambulatory practices in the New York City metropolitan area MAIN MEASURES: Clinical characteristics and risk factors associated with in-hospital mortality. KEY RESULTS: A total of 858 of 6493 (13.2%) patients in our total cohort died: 52/2785 (1.9%) ambulatory patients and 806/3708 (21.7%) hospitalized patients. Cox proportional hazard regression modeling showed an increased risk of in-hospital mortality associated with age older than 50 years (hazard ratio [HR] 2.34, CI 1.47-3.71), systolic blood pressure less than 90 mmHg (HR 1.38, CI 1.06-1.80), a respiratory rate greater than 24 per min (HR 1.43, CI 1.13-1.83), peripheral oxygen saturation less than 92% (HR 2.12, CI 1.56-2.88), estimated glomerular filtration rate less than 60 mL/min/1.73m2 (HR 1.80, CI 1.60-2.02), IL-6 greater than 100 pg/mL (HR 1.50, CI 1.12-2.03), D-dimer greater than 2 mcg/mL (HR 1.19, CI 1.02-1.39), and troponin greater than 0.03 ng/mL (HR 1.40, CI 1.23-1.62). Decreased risk of in-hospital mortality was associated with female sex (HR 0.84, CI 0.77-0.90), African American race (HR 0.78 CI 0.65-0.95), and hydroxychloroquine use (HR 0.53, CI 0.41-0.67). CONCLUSIONS: Among patients with COVID-19, older age, male sex, hypotension, tachypnea, hypoxia, impaired renal function, elevated D-dimer, and elevated troponin were associated with increased in-hospital mortality and hydroxychloroquine use was associated with decreased in-hospital mortality.


title: Coding in the World of COVID-19: Non-Face-to-Face Evaluation and Management Care

text: Almost all medical care in the United States is delivered with the provider and patient in immediate proximity; this model is referred to as face-to-face care. Medical services can be apportioned as procedural care (eg, surgery, radiology, or laboratory testing and others) or cognitive care, also known as Evaluation and Management (E/M) services, in which the provider formulates an assessment and plan after obtaining information from the patient's history, examination, and diagnostic tests.Providing a medical opinion and plan using the telephone as the technology that links the provider and the patient is an example of a non-face-to-face E/M service. Common Procedural Terminology (CPT) codes and the details for how to provide telephone services have been available for decades but have not been reimbursed and therefore were rarely used. In recent years, as new technologies have evolved, there has been slow and steady acceptance that non-face-to-face E/M care can be an adjunct to or replacement for some face-to-face E/M services. These technologies and the descriptors for associated CPT and Healthcare Common Procedure Coding System (HCPCS) codes were introduced over the past few years and have become known by the generic term telehealth. They have been slowly incorporated into medical practice. Most of these services were introduced in the consumer retail market, in which the cost was borne directly by the patient, or as private contract services, in which the cost was borne by the consulting hospital, such as with telestroke services. In both the consumer retail model and private contract model, the care delivered usually did not involve CPT or HCPCS coding. The adoption of telehealth has been slow, in part because of the initial costs and several regulatory constraints, as well as the reluctance of patients, providers, and the insurance industry to change the concept that medical care could only be delivered when the patient and their provider were in physical proximity.After the COVID-19 pandemic reached the United States, the US Department of Health & Human Services issued a public health emergency and declared a Section 1135 Waiver that lifted many of the administrative constraints. With the need for near-absolute social distancing, this perfect storm has resulted in the immediate adoption of telemedicine, at least for the duration of the pandemic, for cognitive care to be delivered using communication technologies that are already in place. This article discusses the most common forms of non-face-to-face E/M care and the proper coding elements necessary to provide these services.


title: A Preliminary Evaluation of the Public Risk Perception Related to the COVID-19 Health Emergency in Italy

text: Governments faced with the spread of COVID-19 pandemic are adopting strict and severe mitigation measures to influence people's behaviors. Public perception of health risk plays a key role in the adoption of these actions, in people's feelings, and in their daily habits. To support decision makers from international to local levels to face with future sanitary emergencies, this study aims at investigating Italian public perceptions of health risk. To this purpose, a questionnaire was designed and administered within the period of Italian COVID-19 lockdown and quarantine to almost 9000 citizens in Italy and abroad. The obtained results highlight a significative influence that mass media play on both the level of knowledge and the feelings of the respondents. The findings also point out future variations of some perceived behaviors consequent to the COVID-19 outbreak.


title: Helping doctors hasten COVID-19 treatment: Towards a rescue framework for the transfusion of best convalescent plasma to the most critical patients based on biological requirements via ml and novel MCDM methods

text: CONTEXT: People who have recently recovered from the threat of deteriorating coronavirus disease-2019 (COVID-19) have antibodies to the coronavirus circulating in their blood. Thus, the transfusion of these antibodies to deteriorating patients could theoretically help boost their immune system. Biologically, two challenges need to be surmounted to allow convalescent plasma (CP) transfusion to rescue the most severe COVID-19 patients. First, convalescent subjects must meet donor selection plasma criteria and comply with national health requirements and known standard routine procedures. Second, multi-criteria decision-making (MCDM) problems should be considered in the selection of the most suitable CP and the prioritisation of patients with COVID-19. OBJECTIVE: This paper presents a rescue framework for the transfusion of the best CP to the most critical patients with COVID-19 on the basis of biological requirements by using machine learning and novel MCDM methods. METHOD: The proposed framework is illustrated on the basis of two distinct and consecutive phases (i.e. testing and development). In testing, ABO compatibility is assessed after classifying donors into the four blood types, namely, A, B, AB and O, to indicate the suitability and safety of plasma for administration in order to refine the CP tested list repository. The development phase includes patient and donor sides. In the patient side, prioritisation is performed using a contracted patient decision matrix constructed between 'serological/protein biomarkers and the ratio of the partial pressure of oxygen in arterial blood to fractional inspired oxygen criteria' and 'patient list based on novel MCDM method known as subjective and objective decision by opinion score method'. Then, the patients with the most urgent need are classified into the four blood types and matched with a tested CP list from the test phase in the donor side. Thereafter, the prioritisation of CP tested list is performed using the contracted CP decision matrix. RESULT: An intelligence-integrated concept is proposed to identify the most appropriate CP for corresponding prioritised patients with COVID-19 to help doctors hasten treatments. DISCUSSION: The proposed framework implies the benefits of providing effective care and prevention of the extremely rapidly spreading COVID-19 from affecting patients and the medical sector.


title: Challenges of SARS-CoV-2 and lessons learnt from SARS in Guangdong Province, China

text: With lessons learnt from the SARS outbreak in 2003, Guangdong Province is taking the lead in bringing COVID-19 under control by multiple strict regulations in combination with effective healthcare provision.


title: Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases

text: Acute respiratory failure and a systemic coagulopathy are critical aspects of the morbidity and mortality characterizing infection with severe acute respiratory distress syndrome-associated coronavirus-2, the etiologic agent of Coronavirus disease 2019 (COVID-19). We examined skin and lung tissues from 5 patients with severe COVID-19 characterized by respiratory failure (n= 5) and purpuric skin rash (nâ¯=â¯3). COVID-19 pneumonitis was predominantly a pauci-inflammatory septal capillary injury with significant septal capillary mural and luminal fibrin deposition and permeation of the interalveolar septa by neutrophils. No viral cytopathic changes were observed and the diffuse alveolar damage (DAD) with hyaline membranes, inflammation, and type II pneumocyte hyperplasia, hallmarks of classic acute respiratory distress syndrome, were not prominent. These pulmonary findings were accompanied by significant deposits of terminal complement components C5b-9 (membrane attack complex), C4d, and mannose binding lectin (MBL)-associated serine protease (MASP)2, in the microvasculature, consistent with sustained, systemic activation of the complement pathways. The purpuric skin lesions similarly showed a pauci-inflammatory thrombogenic vasculopathy, with deposition of C5b-9 and C4d in both grossly involved and normally-appearing skin. In addition, there was co-localization of COVID-19 spike glycoproteins with C4d and C5b-9 in the interalveolar septa and the cutaneous microvasculature of 2 cases examined. In conclusion, at least a subset of sustained, severe COVID-19 may define a type of catastrophic microvascular injury syndrome mediated by activation of complement pathways and an associated procoagulant state. It provides a foundation for further exploration of the pathophysiologic importance of complement in COVID-19, and could suggest targets for specific intervention.


Ethical framework for head and neck endocrine surgery in the COVID-19 pandemic


title: Risk Factors for Mortality and Respiratory Support in Elderly Patients Hospitalized with COVID-19 in Korea

text: BACKGROUND: The mortality risk of coronavirus disease 2019 (COVID-19) is higher in patients with older age, and many elderly patients are reported to require advanced respiratory support. METHODS: We reviewed medical records of 98 patients aged ≥ 65 years who were hospitalized with COVID-19 during a regional outbreak in Daegu/Gyeongsangbuk-do province of Korea. The outcome measures were in-hospital mortality and the treatment with mechanical ventilation (MV) or high-flow nasal cannula (HFNC). RESULTS: The median age of the patients was 72 years; 55.1% were female. Most (74.5%) had at least one underlying condition. Overall case fatality rate (CFR) was 20.4%, and median time to death after admission was 8 days. The CFR was 6.1% among patients aged 65-69 years, 22.7% among those aged 70-79 years, and 38.1% among those aged ≥ 80 years. The CFR among patients who required MV was 43.8%, and the proportion of patients received MV/HFNC was 28.6%. Nosocomial acquisition, diabetes, chronic lung diseases, and chronic neurologic diseases were significant risk factors for both death and MV/HFNC. Hypotension, hypoxia, and altered mental status on admission were also associated with poor outcome. CRP > 8.0 mg/dL was strongly associated with MV/HFNC (odds ratio, 26.31; 95% confidence interval, 7.78-88.92; P < 0.001), and showed better diagnostic characteristics compared to commonly used clinical scores. CONCLUSION: Patients aged ≥ 80 years had a high risk of requiring MV/HFNC, and mortality among those severe patients was very high. Severe initial presentation and laboratory abnormalities, especially high CRP, were identified as risk factors for mortality and severe hospital course.


Message to the Food and Nutrition Bulletin Community


title: Decoding the evolution and transmissions of the novel pneumonia coronavirus (SARS-CoV-2 / HCoV-19) using whole genomic data

text: The outbreak of COVID-19 started in mid-December 2019 in Wuhan, China. Up to 29 February 2020, SARS-CoV-2 (HCoV-19 / 2019-nCoV) had infected more than 85 000 people in the world. In this study, we used 93 complete genomes of SARS-CoV-2 from the GISAID EpiFlu TM database to investigate the evolution and human-to-human transmissions of SARS-CoV-2 in the first two months of the outbreak. We constructed haplotypes of the SARS-CoV-2 genomes, performed phylogenomic analyses and estimated the potential population size changes of the virus. The date of population expansion was calculated based on the expansion parameter tau ( τ) using the formula t= τ/2 u. A total of 120 substitution sites with 119 codons, including 79 non-synonymous and 40 synonymous substitutions, were found in eight coding-regions in the SARS-CoV-2 genomes. Forty non-synonymous substitutions are potentially associated with virus adaptation. No combinations were detected. The 58 haplotypes (31 found in samples from China and 31 from outside China) were identified in 93 viral genomes under study and could be classified into five groups. By applying the reported bat coronavirus genome (bat-RaTG13-CoV) as the outgroup, we found that haplotypes H13 and H38 might be considered as ancestral haplotypes, and later H1 was derived from the intermediate haplotype H3. The population size of the SARS-CoV-2 was estimated to have undergone a recent expansion on 06 January 2020, and an early expansion on 08 December 2019. Furthermore, phyloepidemiologic approaches have recovered specific directions of human-to-human transmissions and the potential sources for international infected cases.


title: Clinical characteristics of coronavirus disease (COVID-19) early findings from a teaching hospital in Pavia, North Italy, 21 to 28 February 2020

text: We describe clinical characteristics, treatments and outcomes of 44 Caucasian patients with coronavirus disease (COVID-19) at a single hospital in Pavia, Italy, from 21-28 February 2020, at the beginning of the outbreak in Europe. Seventeen patients developed severe disease, two died. After a median of 6 days, 14 patients were discharged from hospital. Predictors of lower odds of discharge were age > 65 years, antiviral treatment and for severe disease, lactate dehydrogenase > 300 mg/dL.


Positive RT-PCR Test Results in Patients Recovered From COVID-19


Household COVID-19 Prevalence


COVID-19 and Crimean-Congo Hemorrhagic Fever: Similarities and Differences


"Pandemic fear" and COVID-19: mental health burden and strategies


As lockdowns lift, new hazards lurk in the water


Diagnosis of COVID-19 in children: the story evolves


title: Chinese herbal medicine for coronavirus disease 2019: A systematic review and meta-analysis

text: Currently, coronavirus disease 2019 (COVID-19), which can lead to severe respiratory failure and death, is now a global pandemic with no specific anti-viral drugs or vaccines. However, It is worth noting that traditional Chinese medicine (TCM), especially Chinese herbal medicine (CHM), has been widely applied in mainland China since outbreak, bringing new hope for the prevention and control of COVID-19. A comprehensive literature searching was conducted in 7 electronic databases from their inception up to June 21, 2020 to evaluate the efficacy and safety of CHM for COVID-19. Eighteen randomized controlled trials (RCTs) involving 2275 patients were enrolled. Most of CHMs were originated from classical Chinese herbal formulas. Liquoric Root (Gancao, Radix Glycyrrhizae), Baical Skullcap Root (Huangqin, Radix Scutellariae Baicalensis), Pinellia Rhizome (Banxia, Rhizoma Pinelliae Tematae), Forsythia Fruit (Lianqiao, Fructus Forsythiae Suspensae), and Bitter Apricot Seed (Kuxingren, Semen Armeniacae Amarum) were most frequently used Chinese herbs. The most commonly used dosage formulation was decoction. Our meta-analyses found that comparing CHM group and conventional western medicine group, CHM group has improvements in several clinical parameters including lung CT, clinical cure rate, ranging from mild to critical cases, length of hospital stay, total score of clinical symptoms, fever reduction time, symptom score of fever, number of cough reduction cases, symptom score of cough, number of fatigue reduction cases, symptom score of fatigue, disappearing time of fatigue, TCM syndrome, viral nucleic acid testing, and inflammatory biomarkers (C-reactive protein). Besides, no severe adverse effects was identified by CHM. CHM, especially classical Chinese herbal formulas, could be used as potential candidates for COVID-19 in this battle.


title: Compliance measurement and observed influencing factors of hand hygiene based on COVID-19 guidelines in China

text: BACKGROUND: Higher requirement is put forward in the measurement of hand hygiene (HH) during a pandemic. This study aimed to describe HH compliance measurement and explore observed influencing factors with respect to coronavirus disease 2019 (COVID-19) guidelines in China. METHODS: Compliance was measured as the percentage of compliant opportunities based on criteria for 17 moments. The criteria for compliance included HH behavior, procedure, duration, hand drying method, and the overall that counts them all. The observed influencing factors included different departments and areas and protection motivation. Descriptive analysis and logistic regression were performed. RESULTS: The compliance of overall criteria, HH behavior, procedure, duration, and hand drying method were 79.44%, 96.71%, 95.74%, 88.93%, and 88.42%, respectively, which were significantly different from each other (P < .001). Meanwhile, the overall and hand drying method compliance in semi-contaminated areas (odds ratio [OR]â¯=â¯1.829, P < .001; ORâ¯=â¯2.149, Pâ¯=â¯.001) and hygienic areas (ORâ¯=â¯1.689, Pâ¯=â¯.004; ORâ¯=â¯1.959, Pâ¯=â¯.015) were significantly higher than those in contaminated area. The compliance with HH behavior for the motivation of patient-protection (ORâ¯=â¯0.362, P < .001) was lower than that for the motivation of self-protection. CONCLUSIONS: HH compliance was firstly measured using different criteria for 17 moments according to COVID-19 guidelines in China. The measurement of HH compliance needs clearer definition and comprehensive practice. Contaminated areas and motivation of patient-protection contribute to lower compliance, which may be addressed by allocating more human resources and increasing supervision and education.


COVID-19 and the release of mafia bosses: The importance of medico-legal evaluations


title: Practical management of inflammatory bowel disease patients during the COVID-19 pandemic: expert commentary from the Gastroenterological Society of Australia Inflammatory Bowel Disease faculty

text: The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has emerged as a public health emergency and challenged healthcare systems globally. In a minority of patients, SARS-CoV-2 manifests with a severe acute respiratory illness and currently there is insufficient data regarding the virulence of COVID-19 in inflammatory bowel disease patients taking immunosuppressive therapy. This review aims to summarise the current literature and provide guidance on the management of inflammatory bowel disease patients in the context of the COVID-19 pandemic in the Australasian setting.


Characterization of eight novel full-length genomes of SARS-CoV-2 among imported COVID-19 cases from abroad in Yunnan, China


title: A Case Series of Five People Living with HIV Hospitalized with COVID-19 in Chicago, Illinois

text: The risk of COVID-19 among people living with HIV (PLWH) is largely unknown and there have been very few reported cases in the literature. We report a case series of five PLWH with COVID-19. We identified all patients with a diagnosis of HIV who tested positive for SARS-CoV-2 at University of Chicago Medicine between March 1, 2020, and April 7, 2020. We retrospectively collected data regarding demographics, comorbidities, medications, laboratory test results, radiology results, and outcomes associated with COVID-19. All five PLWH with COVID-19 were African American; 80% (4/5) were cisgender females. The mean age of patients was 48 years old (range 38-53). The majority of patients presented with cough, fever, and shortness of breath. Three patients had diarrhea. One patient presented with predominantly cardiac symptoms. All were taking antiretroviral therapy (ART) with CD4 count >200 cells/mm3 and suppressed HIV viral loads at the time of COVID-19 diagnosis. All five patients were hospitalized, two required supplemental oxygen, and none required mechanical ventilation. Four patients were treated with azithromycin and a cephalosporin and two were also treated with hydroxychloroquine. The median length of stay was 3 days (range 2-7). All patients recovered. More research is needed to understand the risks of COVID-19 among PLWH and the impact of ART on outcomes for patients with COVID-19.


title: A Deep Neural Network to Distinguish COVID-19 from other Chest Diseases using X-ray Images

text: BACKGROUND: Scanning patient's lungs to detect a Coronavirus 2019 (COVID-19) may lead to similar imaging with other chest diseases that strongly requires a multidisciplinary approach to confirm the diagnosis. There are only few works targeted pathological x-ray images. Most of the works targeted only single disease detection which is not good enough. Some works have provided for all classes however the results suffer due to lack of data for rare classes and data unbalancing problem. METHODS: Due to arise of COVID-19 virus medical facilities of many countries are overwhelmed and there is a need of intelligent system to detect it. There have been few works regarding detection of the coronavirus but there are many cases where it can be misclassified as some techniques do not provide any goodness if it can only identify type of diseases and ignore the rest. This work is a deep learning-based model to distinguish between cases of COVID-19 from other chest diseases which is need of today. RESULTS: A Deep Neural Network model provides a significant contribution in terms of detecting COVID-19 and provide effective analysis of chest related diseases with respect to age and gender. Our model achieves 87% accuracy in terms of Gan based synthetic data and four different types of deep learning- based models which provided state of the art comparable results. CONCLUSION: If the gap in identifying of all viral pneumonias is not filled with effective automation of chest disease detection the healthcare industry may have to bear unfavorable circumstances.


A proposed scoring system for triage of patients who require vascular access creation in times of COVID-19


A British Society of Thoracic Imaging statement: considerations in designing local imaging diagnostic algorithms for the COVID-19 pandemic


title: Development of a Portable, Ultra-Rapid and Ultra-Sensitive Cell-Based Biosensor for the Direct Detection of the SARS-CoV-2 S1 Spike Protein Antigen

text: One of the key challenges of the recent COVID-19 pandemic is the ability to accurately estimate the number of infected individuals, particularly asymptomatic and/or early-stage patients. We herewith report the proof-of-concept development of a biosensor able to detect the SARS-CoV-2 S1 spike protein expressed on the surface of the virus. The biosensor is based on membrane-engineered mammalian cells bearing the human chimeric spike S1 antibody. We demonstrate that the attachment of the protein to the membrane-bound antibodies resulted in a selective and considerable change in the cellular bioelectric properties measured by means of a Bioelectric Recognition Assay. The novel biosensor provided results in an ultra-rapid manner (3 min), with a detection limit of 1 fg/mL and a semi-linear range of response between 10 fg and 1 µg/mL. In addition, no cross-reactivity was observed against the SARS-CoV-2 nucleocapsid protein. Furthermore, the biosensor was configured as a ready-to-use platform, including a portable read-out device operated via smartphone/tablet. In this way, we demonstrate that the novel biosensor can be potentially applied for the mass screening of SARS-CoV-2 surface antigens without prior sample processing, therefore offering a possible solution for the timely monitoring and eventual control of the global coronavirus pandemic.


Shielding for patients using a single-use vinyl-box under continuous aerosol suction to minimize SARS-CoV-2 transmission during emergency endoscopy


title: Acute myocarditis associated with COVID-19 infection

text: We present the case of a 20-year-old male patient without previous history of cardiovascular disease who was admitted to our hospital with a new onset febrile sensation and chest pain. Chest computed tomography revealed a subpleural consolidation with a halo of ground-glass opacification. Blood tests revealed elevated levels of markers of myocyte necrosis (troponin I and creatine kinase-MB). Nasopharyngeal swab was positive for COVID-19. Cardiac MRI showed myocardial edema and late gadolinium enhancement compatible with myocarditis associated with COVID-19 infection. This case showed that acute myocarditis can be the initial presentation of patients with COVID-19 infection.


title: The pathogenesis and treatment of the `Cytokine Storm' in COVID-19

text: Cytokine storm is an excessive immune response to external stimuli. The pathogenesis of the cytokine storm is complex. The disease progresses rapidly, and the mortality is high. Certain evidence shows that, during the coronavirus disease 2019 (COVID-19) epidemic, the severe deterioration of some patients has been closely related to the cytokine storm in their bodies. This article reviews the occurrence mechanism and treatment strategies of the COVID-19 virus-induced inflammatory storm in attempt to provide valuable medication guidance for clinical treatment.


title: Management of primary hepatic malignancies during the COVID-19 pandemic: recommendations for risk mitigation from a multidisciplinary perspective

text: Around the world, recommendations for cancer treatment are being adapted in real time in response to the pandemic of COVID-19. We, as a multidisciplinary team, reviewed the standard management options, according to the Barcelona Clinic Liver Cancer classification system, for hepatocellular carcinoma. We propose treatment recommendations related to COVID-19 for the different stages of hepatocellular carcinoma (ie, 0, A, B, and C), specifically in relation to surgery, locoregional therapies, and systemic therapy. We suggest potential strategies to modify risk during the pandemic and aid multidisciplinary treatment decision making. We also review the multidisciplinary management of intrahepatic cholangiocarcinoma as a potentially curable and incurable diagnosis in the setting of COVID-19.


title: Connecting the Dots of COVID-19 Transmissions in India

text: Witnessing its first case in late January 2020 India has seen a sharp rise in the number of positive cases of COVID-19. 34 States/UT (s) of the country have been found to be affected by the pandemic to date. We in this work, study the progress of COVID-19 pandemic in India. We aim to create transmission network visualization (s) of COVID-19 in India and perform analysis upon them. Using the transmission networks obtained we attempt to find the possible Super Spreader Individual (s) and Super Spreader Events (SSE) responsible for the outbreak in their respective regions. We discuss the potentials of network analysis in mitigating the further spread of the disease. This is one of the initial studies of the outbreak in India and the first attempt to study the pandemic in the country from a transmission network perspective.


IBD in the Times of COVID-19


title: Prevalence of Asymptomatic SARS-CoV-2 Infection: A Narrative Review

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world since the first cases of coronavirus disease 2019 (COVID-19) were observed in December 2019 in Wuhan, China. It has been suspected that infected persons who remain asymptomatic play a significant role in the ongoing pandemic, but their relative number and effect have been uncertain. The authors sought to review and synthesize the available evidence on asymptomatic SARS-CoV-2 infection. Asymptomatic persons seem to account for approximately 40% to 45% of SARS-CoV-2 infections, and they can transmit the virus to others for an extended period, perhaps longer than 14 days. Asymptomatic infection may be associated with subclinical lung abnormalities, as detected by computed tomography. Because of the high risk for silent spread by asymptomatic persons, it is imperative that testing programs include those without symptoms. To supplement conventional diagnostic testing, which is constrained by capacity, cost, and its one-off nature, innovative tactics for public health surveillance, such as crowdsourcing digital wearable data and monitoring sewage sludge, might be helpful.


title: Coronavirus Disease 2019 (COVID-19) Information for Cardiologistsã- Systematic Literature Review and Additional Analysis

text: BACKGROUND: Despite the rapidly increasing attention being given to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, more commonly known as coronavirus disease 2019 (COVID-19), the relationship between cardiovascular disease and COVID-19 has not been fully described.MethodsâandâResults:A systematic review was undertaken to summarize the important aspects of COVID-19 for cardiologists. Protection both for patients and healthcare providers, indication for treatments, collaboration with other departments and hospitals, and regular update of information are essentials to front COVID-19 patients. CONCLUSIONS: Because the chief manifestations of COVID-19 infection are respiratory and acute respiratory distress syndrome, cardiologists do not see infected patients directly. Cardiologists need to be better prepared regarding standard disinfection procedures, and be aware of the indications for extracorporeal membrane oxygenation and its use in the critical care setting.


docid: oanaxfou

title: Mania Precipitated by COVID-19 Pandemic-Related Stress


title: Suppression of Groups Intermingling as Appealing Option For Flattening and Delaying the Epidemiological Curve While Allowing Economic and Social Life at Bearable Level During COVID-19 Pandemic

text: In this work, we simulate the COVID-19 pandemic dynamics in a population modeled as a network of groups wherein infection can propagate both via intra-group and via inter-group interactions. Our results emphasize the importance of diminishing the inter-group infections in the effort of substantial flattening and delaying of the epi(demiologic) curve with concomitant mitigation of disastrous economy and social consequences. To exemplify with a limiting case, splitting a population into m (say, 5 or 10) noninteracting groups while keeping intra-group interaction unchanged yields a stretched epidemiologic curve having the maximum number of daily infections reduced and postponed in time by the same factor $m$ (5 or 10). More generally, our study suggests a practical approach to fight against SARS-CoV-2 virus spread based on population splitting into groups and minimizing intermingling between them. This strategy can be pursued by large-scale infrastructure reorganization of activity at different levels in big logistic units (e.g., large productive networks, factories, enterprises, warehouses, schools, (seasonal) harvest work). Importantly, unlike total lockdwon strategy, the proposed approach prevents economic ruin and keeps social life at a more bearable level than distancing everyone from anyone. Last but not least, the declaration, for the first time in Europe, that COVID-19 epidemic ended in the two million people Slovenia may be taken as confirming the advantage of the strategy proposed in this paper.


title: Patient safety reports round-up during the COVID-19 pandemic

text: John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent patient safety reports, revealing that patient safety concerns continue during the current pandemic.


title: Tracing open data in emergencies: the case of the COVID-19 pandemic

text: BACKGROUND: The COVID-19 pandemic constitutes an ongoing, burning Public Health Emergency of International Concern (PHEIC). In 2015, the World Health Organization (WHO) adopted an open-data policy recommendation in such situations. OBJECTIVES: The present cross-sectional meta-research study aimed to assess the availability of open data and metrics and of articles pertaining to the COVID-19 outbreak in five high-impact journals. METHODS: All articles regarding the SARS-CoV-2, published in five high impact journals (Ann Intern Med, BMJ, JAMA, NEJM and Lancet) until March 14, 2020 were retrieved. Meta-data (namely the type of article, number of authors, number of patients, citations, errata, news and social media mentions) were extracted for each article in each journal in a systematic way. Google Scholar and Scopus were used for citations and author metrics respectively, and Altmetrics and PlumX were used for news and social media mentions retrieval. The degree of adherence to the PHEIC open data call was also evaluated. RESULTS: A total of 140 articles were published until March 14, 2020, mostly opinion papers. Sixteen errata followed these publications. The number of authors in each article ranged from 1 to 63, whereas the number of patients with a laboratory-confirmed SARS-CoV-2 infection reached 2,645. The impact of these publications reached a total of 4,210 cumulative crude citations and 342,790 news and social media mentions. Only one publication (0.7%) provided complete open data, while 32 (22.9%) included patient data. CONCLUSIONS: Even though a large number of manuscripts was produced since the pandemic, availability of open data remains restricted.


Falsely low fibrinogen levels in COVID-19 patients on direct thrombin inhibitors


Taking the right measures to control COVID-19


title: No current evidence supporting risk of using Ibuprofen in patients with COVID-19

text: SARS-CoV-2 is a novel RNA virus that infects cells expressing the angiotensin-converting enzyme (ACE2) receptor and is associated with an acute respiratory disease named COVID-19. It has been hypothesized that ACE2 expression can be increased by Ibuprofen leading to a higher risk for severe COVID-19 (1). Despite the reasonable mechanistic background and results from studies suggesting that Ibuprofen may be associated with complications of community-acquired pneumonia in children (2,3), there is no current evidence that this NSAID aggravates a SARS-CoV-2 infection in any age group.


title: COVID-19-Related Web Search Behaviors and Infodemic Attitudes in Italy: Infodemiological Study

text: BACKGROUND: Since the beginning of the novel coronavirus disease (COVID-19) outbreak, fake news and misleading information have circulated worldwide, which can profoundly affect public health communication. OBJECTIVE: We investigated online search behavior related to the COVID-19 outbreak and the attitudes of "infodemic monikers" (ie, erroneous information that gives rise to interpretative mistakes, fake news, episodes of racism, etc) circulating in Italy. METHODS: By using Google Trends to explore the internet search activity related to COVID-19 from January to March 2020, article titles from the most read newspapers and government websites were mined to investigate the attitudes of infodemic monikers circulating across various regions and cities in Italy. Search volume values and average peak comparison (APC) values were used to analyze the results. RESULTS: Keywords such as "novel coronavirus," "China coronavirus," "COVID-19," "2019-nCOV," and "SARS-COV-2" were the top infodemic and scientific COVID-19 terms trending in Italy. The top five searches related to health were "face masks," "amuchina" (disinfectant), "symptoms of the novel coronavirus," "health bulletin," and "vaccines for coronavirus." The regions of Umbria and Basilicata recorded a high number of infodemic monikers (APC weighted total >140). Misinformation was widely circulated in the Campania region, and racism-related information was widespread in Umbria and Basilicata. These monikers were frequently searched (APC weighted total >100) in more than 10 major cities in Italy, including Rome. CONCLUSIONS: We identified a growing regional and population-level interest in COVID-19 in Italy. The majority of searches were related to amuchina, face masks, health bulletins, and COVID-19 symptoms. Since a large number of infodemic monikers were observed across Italy, we recommend that health agencies use Google Trends to predict human behavior as well as to manage misinformation circulation in Italy.


title: Diagnostic efficacy of anti-SARS-CoV-2 IgG/IgM test for COVID-19: A meta-analysis

text: The serological testing of anti-SARS-CoV-2 immunoglobulin G (IgG) and/or IgM is widely used in the diagnosis of COVID-19. However, its diagnostic efficacy remains unclear. In this study, we searched for diagnostic studies from the Web of Science, PubMed, Embase, CNKI, and Wanfang databases to calculate the pooled diagnostic accuracy measures using bivariate random-effects model meta-analysis. As a result, 22 from a total of 1613 articles, including 2282 patients with SARS-CoV-2 and 1485 healthy persons or patients without SARS-CoV-2, were selected for a meta-analysis. Pooled sensitivity, specificity, and area under curve of the summary receiver operator curve (SROC) were: (a) 0.85 (95% confidence interval [CI]: 0.79-0.90), 0.99 (95% CI: 0.98-1.00), and 0.99 (95% CI: 0.97-0.99) for anti-SARS-CoV-2 IgG and (b) 0.74 (95% CI: 0.65-0.81), 0.99 (95% CI: 0.97-1.00), and 0.95 (95% CI: 0.93-0.97) for IgM. A subgroup analysis among detection methods indicated the sensitivity of IgG and IgM using enzyme-linked immunosorbent assay were slightly lower than those using gold immunochromatography assay (GICA) and chemiluminescence immunoassay (P > .05). These results showed that the detection of anti-SARS-CoV-2 IgG and IgM had high diagnostic efficiency to assist the diagnosis of SARS-CoV-2 infection. And, GICA might be used as the preferred method for its accuracy and simplicity.


title: Immuno-epidemiological model of two-stage epidemic growth

text: Epidemiological data on seasonal influenza show that the growth rate of the number of infected individuals can increase passing from one exponential growth rate to another one with a larger exponent. Such behavior is not described by conventional epidemiological models. In this work an immuno-epidemiological model is proposed in order to describe this two-stage growth. It takes into account that the growth in the number of infected individuals increases the initial viral load and provides a passage from the first stage of epidemic where only people with weak immune response are infected to the second stage where people with strong immune response are also infected. This scenario may be viewed as an increase of the effective number of susceptible increasing the effective growth rate of infected.


docid: sjenehbl

title: 'Masking the evidence': perspectives of the COVID-19 pandemic

text: The COVID-19 pandemic presents a severe and acute public health emergency around the world. The event of the pandemic has seen an upsurge in the general public wearing of disposable surgical masks (DSM) and other types of face masks. The World Health Organisation of mask wearing has been widely debated in the press a(WHO) have changed their advice, to now recommend the routine wearing of fabric masks by the general public as a means of preventing the spread of COVID-19 (WHO 2020a).


title: Response and role of palliative care during the COVID-19 pandemic: A national telephone survey of hospices in Italy

text: BACKGROUND: Palliative care is an important component of health care in pandemics, contributing to symptom control, psychological support, and supporting triage and complex decision making. AIM: To examine preparedness for, and impact of, the COVID-19 pandemic on hospices in Italy to inform the response in other countries. DESIGN: Cross-sectional telephone survey, in March 2020. SETTING: Italian hospices, purposively sampled according to COVID-19 regional prevalence categorised as high (>25), medium (15-25) and low prevalence (<15) COVID-19 cases per 100,000 inhabitants. A brief questionnaire was developed to guide the interviews. Analysis was descriptive. RESULTS: Seven high, five medium and four low prevalence hospices provided data. Two high prevalence hospices had experienced COVID-19 cases among both patients and staff. All hospices had implemented policy changes, and several had rapidly implemented changes in practice including transfer of staff from inpatient to community settings, change in admission criteria and daily telephone support for families. Concerns included scarcity of personal protective equipment, a lack of hospice-specific guidance on COVID-19, anxiety about needing to care for children and other relatives, and poor integration of palliative care in the acute planning response. CONCLUSION: The hospice sector is capable of responding flexibly and rapidly to the COVID-19 pandemic. Governments must urgently recognise the essential contribution of hospice and palliative care to the COVID-19 pandemic and ensure these services are integrated into the health care system response. Availability of personal protective equipment and setting-specific guidance is essential. Hospices may also need to be proactive in connecting with the acute pandemic response.


title: COVID-19: An update on diagnostic and therapeutic approaches

text: The unexpected pandemic set off by the novel coronavirus 2019 (COVID-19) has caused severe panic among people worldwide COVID-19 has created havoc, and scientists and physicians are urged to test the efficiency and safety of drugs used to treat this disease In such a pandemic situation, various steps have been taken by government to control and prevent the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) This pandemic situation has forced scientists to rework strategies to combat infectious diseases through drugs, treatment, and control measures COVID-19 treatment requires both limiting viral multiplication and neutralizing tissue damage induced by inappropriate immune reaction Currently, various diagnostic kits to test for COVID-19 are available, and repurposing therapeutics for COVID-19 has shown to be clinically effective As the global demand for diagnostics and therapeutics continues to rise, it is essential to rapidly develop various algorithms to successfully identify and contain the virus This review discusses the updates on specimens/samples, recent efficient diagnostics, and therapeutic approaches to control the disease and repurposed drugs mainly focusing on chloroquine/hydroxychloroquine and convalescent plasma (CP) More research is required for further understanding of the influence of diagnostics and therapeutic approaches to developing vaccines and drugs for COVID-19


Response to: 'Comparative analysis of synovial inflammation after SARS-CoV-2 infection' by Alivernini et al


title: The propagation of the economic impact through supply chains: The case of a mega-city lockdown against the spread of COVID-19

text: This study quantifies the economic effect of a possible lockdown of Tokyo to prevent spread of COVID-19. The negative effect of the lockdown may propagate to other regions through supply chains because of shortage of supply and demand. Applying an agent-based model to the actual supply chains of nearly 1.6 million firms in Japan, we simulate what would happen to production activities outside Tokyo when production activities that are not essential to citizens' survival in Tokyo were shut down for a certain period. We find that when Tokyo is locked down for a month, the indirect effect on other regions would be twice as large as the direct effect on Tokyo, leading to a total production loss of 27 trillion yen in Japan, or 5.3% of its annual GDP. Although the production shut down in Tokyo accounts for 21% of the total production in Japan, the lockdown would result in a reduction of the daily production in Japan by 86% in a month.


Building an "Army of Disease Detectives" to Trace COVID-19 Contacts


docid: cyneflql

title: Structural and Evolutionary Analysis Indicate That the SARS-CoV-2 Mpro Is a Challenging Target for Small-Molecule Inhibitor Design

text: The novel coronavirus whose outbreak took place in December 2019 continues to spread at a rapid rate worldwide. In the absence of an effective vaccine, inhibitor repurposing or de novo drug design may offer a longer-term strategy to combat this and future infections due to similar viruses. Here, we report on detailed classical and mixed-solvent molecular dynamics simulations of the main protease (Mpro) enriched by evolutionary and stability analysis of the protein. The results were compared with those for a highly similar severe acute respiratory syndrome (SARS) Mpro protein. In spite of a high level of sequence similarity, the active sites in both proteins showed major differences in both shape and size, indicating that repurposing SARS drugs for COVID-19 may be futile. Furthermore, analysis of the binding site's conformational changes during the simulation time indicated its flexibility and plasticity, which dashes hopes for rapid and reliable drug design. Conversely, structural stability of the protein with respect to flexible loop mutations indicated that the virus' mutability will pose a further challenge to the rational design of small-molecule inhibitors. However, few residues contribute significantly to the protein stability and thus can be considered as key anchoring residues for Mpro inhibitor design.