title: Deep learning-based multi-view fusion model for screening 2019 novel coronavirus pneumonia: A multicentre study

text: PURPOSE: To develop a deep learning-based method to assist radiologists to fast and accurately identify patients with COVID-19 by CT images. METHODS: We retrospectively collected chest CT images of 495 patients from three hospitals in China. 495 datasets were randomly divided into 395 cases (80%, 294 of COVID-19, 101 of other pneumonia) of the training set, 50 cases (10%, 37 of COVID-19, 13 of other pneumonia) of the validation set and 50 cases (10%, 37 of COVID-19, 13 of other pneumonia) of the testing set. We trained a multi-view fusion model using deep learning network to screen patients with COVID-19 using CT images with the maximum lung regions in axial, coronal and sagittal views. The performance of the proposed model was evaluated by both the validation and testing sets. RESULTS: The multi-view deep learning fusion model achieved the area under the receiver-operating characteristics curve (AUC) of 0.732, accuracy of 0.700, sensitivity of 0.730 and specificity of 0.615 in validation set. In the testing set, we can achieve AUC, accuracy, sensitivity and specificity of 0.819, 0.760, 0.811 and 0.615 respectively. CONCLUSIONS: Based on deep learning method, the proposed diagnosis model trained on multi-view images of chest CT images showed great potential to improve the efficacy of diagnosis and mitigate the heavy workload of radiologists for the initial screening of COVID-19 pneumonia.


Clinical considerations for patients with diabetes in times of COVID-19 pandemic


Letter from China


Telepsychiatry in the age of COVID: Some ethical considerations


To alert coinfection of COVID-19 and dengue virus in developing countries in the dengue-endemic area


title: Psychiatrist experience of remote consultations by telephone in an outpatient psychiatric department during the COVID-19 pandemic

text: OBJECTIVE: In response to the COVID-19 pandemic, there has been a shift globally from face-to-face consultations to remote consultations. In our department, remote consultations have taken in the form of telephone consultations. In this paper, we set out to study a group of Irish psychiatrists' experience of these consultations. METHODS: We identified recurrent themes in the existing literature on doctors' experience of telephone consultations with a view to determining the applicability of these themes to a group of Irish psychiatrists. A questionnaire was developed based on themes in the literature. This was sent to all psychiatrists working in a busy psychiatric service in Dublin. RESULTS: The questionnaire response rate was 72% (n = 26/35). Diagnostic challenges, the effect of phone consultation on the therapeutic alliance, challenges associated with the use of technology and ethical concerns were identified as issues. Flexibility in the working day and convenience were identified as possible benefits to telephone consultations. CONCLUSIONS: The group that participated in this research study identified a number of challenges to carrying out successful phone consultations. This study highlights the need at our clinical site for interventions to address the issues identified by staff. The findings also highlight the requirement for larger studies with stronger methodologies to determine the generalisability of our results.


title: Low- dose systemic steroids, an emerging therapeutic option for COVID-19 related urticaria

text: Dermatologists around the world are still doing their best to report more cutaneous manifestations of the emerging COVID-19 infection. New-onset acute or relapsing chronic urticaria may result from the body's overreacting inflammatory response to infection. The cytokine storm hits different organs in the body, including the skin, leading to activation and degranulation of mast cells with resultant urticaria. Low-dose systemic steroids combined with antihistamines can combat the COVID-19 inflammatory insult and play a role in the control of COVID-19 related severe urticarial attack.


title: The impact of respiratory protective equipment on difficult airway management: a randomised, crossover, simulation study

text: The current international COVID-19 health crisis underlines the importance of adequate and suitable personal protective equipment for clinical staff during acute airway management. This study compares the impacts of standard air-purifying respirators and powered air-purifying respirators during simulated difficult airway scenarios. Twenty-five anaesthetists carried out four different standardised difficult intubation drills, either unprotected (control), or wearing a standard or a powered respirator. Treatment times and wearer comfort were determined and compared. In the wearer comfort evaluation form, operators rated mobility, noise, heat, vision and speech intelligibility. All anaesthetists accomplished the treatment objectives of all study arms without adverse events. Total mean (SD) intubation times for the four interventions did not show significant differences between the powered and the standard respirator groups, being 16.4 (8.6) vs. 19.2 (5.2) seconds with the Airtraq™; 11.4 (3.4) vs. 10.0 (2.1) seconds with the videolaryngoscope; 39.2 (4.5) vs. 40.1 (4.8) seconds with the fibreoptic bronchoscope scope; and 15.4 (5.7) vs. 15.1 (5.0) seconds for standard tracheal intubation by direct laryngoscopy, respectively. Videolaryngoscopy allowed the shortest intubation times regardless of the respiratory protective device used. Anaesthetists rated heat and vision significantly higher in the powered respirator group; however, noise levels were perceived to be significantly lower than in the standard respirator group. We conclude that standard and powered respirators do not significantly prolong simulated advanced intubation procedures.


Re: Karl H. Pang, Diego M. Carrion, Juan Gomez Rivas, et al. The Impact of COVID-19 on European Health Care and Urology Trainees. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2020.04.042


title: Pulmonary Rehabilitation for Patients with Coronavirus Disease 2019 (COVID-19)

text: As a highly infectious respiratory tract disease, coronavirus disease 2019 (COVID-19) can cause respiratory, physical, and psychological dysfunction in patients. Therefore, pulmonary rehabilitation is crucial for both admitted and discharged patients of COVID-19. In this study, based on the newly released pulmonary rehabilitation guidelines for patients with COVID-19, as well as evidence from the pulmonary rehabilitation of patients with severe acute respiratory syndrome, we investigated pulmonary rehabilitation for patients with COVID-19 having complications, such as chronic pulmonary disease, and established an intelligent respiratory rehabilitation model for these patients.


Third year Dermatology Resident Anxiety in the Era of COVID-19


title: Criminal Justice-Involved Women Navigate COVID-19: Notes From the Field

text: In March-April, 2020, we communicated with a cohort of criminal justice-involved (CJI) women to see how they were navigating COVID-19, chronic illness, homelessness, and shelter-in-place orders in Oakland, Birmingham, and Kansas City. We report on conversations with N = 35 women (out of the cohort of 474 women) and our own observations from ongoing criminal justice involvement studies. Women reported barriers to protecting themselves given widespread unstable housing and complex health needs, though many tried to follow COVID-19 prevention recommendations. Women expressed dissatisfaction with the suspension of research activities, as the pandemic contributed to a heightened need for study incentives, such as cash, emotional support, and other resources. COVID-19 is illuminating disparities between those who can follow recommended actions to prevent infection and those who lack resources to do so. Concerted efforts are required to reduce inequities that put the 1.3 million U.S. women under criminal justice supervision at risk for infection and mortality.


title: Situación de la infección por SARS-CoV-2 en pacientes en tratamiento renal sustitutivo. Informe del Registro COVID-19 de la Sociedad Española de Nefrología (SEN)./ Situación de la infección por SARS-CoV-2 en pacientes en tratamiento renal sustitutivo. Informe del Registro COVID-19 de la Sociedad Española de Nefrología (SEN)./ [SARS-CoV-2 infection in patients on renal replacement therapy. Report of the COVID-19 Registry of the Spanish Society of Nephrology (SEN)]

text: INTRODUCTION: The recent appearance of the SARS-CoV-2 coronavirus pandemic has had a significant impact on the general population. Patients on renal replacement therapy (RRT) have not been unaware of this situation and due to their characteristics they are especially vulnerable. We present the results of the analysis of the COVID-19 Registry of the Spanish Society of Nephrology. MATERIAL AND METHODS: The Registry began operating on March 18th, 2020. It collects epidemiological variables, contagion and diagnosis data, signs and symptoms, treatments and outcomes. It is an online registry. Patients were diagnosed with SARS-CoV-2 infection based on the results of the PCR of the virus, carried out both in patients who had manifested compatible symptoms or had suspicious signs, as well as in those who had undergone screening after some contact acquainted with another patient. RESULTS: As of April 11, the Registry had data on 868 patients, from all the Autonomous Communities. The most represented form of RRT is in-center hemodialysis (ICH) followed by transplant patients. Symptoms are similar to the general population. A very high percentage (85%) required hospital admission, 8% in intensive care units. The most used treatments were hydroxychloroquine, lopinavir-ritonavir, and steroids. Mortality is high and reaches 23%; deceased patients were more frequently on ICH, developed pneumonia more frequently, and received less frequently lopinavir-ritonavir and steroids. Age and pneumonia were independently associated with the risk of death. CONCLUSIONS: SARS-CoV-2 infection already affects a significant number of Spanish patients on RRT, mainly those on ICH, hospitalization rates are very high and mortality is high; age and the development of pneumonia are factors associated with mortality.


title: Addressing inequities in COVID-19 morbidity and mortality: research and policy recommendations

text: The COVID-19 pandemic is the greatest global public health crisis since the 1918 influenza outbreak. As of early June, the novel coronavirus has infected more than 6.3 million people worldwide and more than 1.9 million in the United States (US). The total number of recorded deaths due to COVID-19 are growing at an alarming rate globally (³383,000) and nationally (³109,000) Evidence is mounting regarding the heavier burden of COVID-19 infection, morbidity, and mortality on the underserved populations in the US. This commentary focuses on this global health pandemic and how mitigation of the virus relies heavily on health behavior change to slow its spread, highlighting how the pandemic specifically affects the most socially and economically disadvantaged populations in the US. The commentary also offers short, intermediate and long-term research and policy focused recommendations. Both the research and policy recommendations included in this commentary emphasize equity-driven: (1) research practices, including applying a social determinants and health equity lens on monitoring, evaluation, and clinical trials activities on COVID-19; and (2) policy actions, such as dedicating resources to prioritize high-risk communities for testing, treatment, and prevention approaches and implementing organizational, institutional, and legislative policies that address the social and economic barriers to overall well-being that these populations face during a pandemic. It is our hope that these recommendations will generate momentum in delivering timely, effective, and lifesaving changes.


title: A retrospective study on the epidemiological characteristics and establishment of an early warning system of severe COVID-19 patients

text: This paper estimates the magnitude of an informational friction limiting credit reallocation to firms during the 2007-2009 financial crisis. Because lenders rely on private information when deciding which relationship to end, borrowers looking for a new lender are adversely selected. I show how to identify private information separately from information common to all lenders but unobservable to the econometrician by using bank shocks within a discrete choice model of relationships. Quantitatively, these informational frictions seem too small to explain the credit crunch in the U.S. syndicated corporate loan market.


Coronavirus misinformation, and how scientists can help to fight it


title: A reaction-diffusion system to better comprehend the unlockdown: Application of SEIR-type model with diffusion to the spatial spread of COVID-19 in France

text: A reaction-diffusion model was developed describing the spread of the COVID-19 virus considering the mean daily movement of susceptible, exposed and asymptomatic individuals. The model was calibrated using data on the confirmed infection and death from France as well as their initial spatial distribution. First, the system of partial differential equations is studied, then the basic reproduction number, R0 is derived. Second, numerical simulations, based on a combination of level-set and finite differences, shown the spatial spread of COVID-19 from March 16 to June 16. Finally, scenarios of unlockdown are compared according to variation of distancing, or partially spatial lockdown.


title: Nanofiltration of growth media supplemented with human platelet lysates for pathogen-safe xeno-free expansion of mesenchymal stromal cells

text: BACKGROUND AIMS: Human platelet lysate can replace fetal bovine serum (FBS) for xeno-free ex vivo expansion of mesenchymal stromal cells (MSCs), but pooling of platelet concentrates (PCs) increases risks of pathogen transmission. We evaluated the feasibility of performing nanofiltration of platelet lysates and determined the impact on expansion of bone marrow-derived MSCs. METHODS: Platelet lysates were prepared by freeze-thawing of pathogen-reduced (Intercept) PCs suspended in 65% storage solution (SPP+) and 35% plasma, and by serum-conversion of PCs suspended in 100% plasma. Lysates were added to the MSC growth media at 10% (v/v), filtered and subjected to cascade nanofiltration on 35- and 19-nm Planova filters. Media supplemented with 10% starting platelet lysates or FBS were used as the controls. Impacts of nanofiltration on the growth media composition, removal of platelet extracellular vesicles (PEVs) and MSC expansion were evaluated. RESULTS: Nanofiltration did not detrimentally affect contents of total protein and growth factors or the biochemical composition. The clearance factor of PEVs was >3 log values. Expansion, proliferation, membrane markers, differentiation potential and immunosuppressive properties of cells in nanofiltered media were consistently better than those expanded in FBS-supplemented media. Compared with FBS, chondrogenesis and osteogenesis genes were expressed more in nanofiltered media, and there were fewer senescent cells over six passages. CONCLUSIONS: Nanofiltration of growth media supplemented with two types of platelet lysates, including one prepared from pathogen-reduced PCs, is technically feasible. These data support the possibility of developing pathogen-reduced xeno-free growth media for clinical-grade propagation of human cells.


AGS COVID-19 Policy Brief Offers Roadmap to Government Action for a Critical Group During Pandemics: Older Adults in Nursing Homes


docid: dwawjone

title: The COVID-19 pandemic, personal protective equipment and respirator: A narrative review

text: INTRODUCTION: The coronavirus disease 2019 pandemic has touched almost every continent. Personal protective equipment (PPE) is the final line of protection of healthcare workers (HCW). There is variation as well as controversy of infection control recommendation with regards to the use of PPE for HCW between institutions. The aim of this narrative review is to of examine and summarise the available evidence to guide recommendation for the safety of HCW. METHOD: A literature search was conducted on the PubMed, MedLine and Embase databases with the keywords "personal protective equipment," "COVID 19," "n95," "health care worker" and "mortality." RESULTS: SARS-nCoV-2 is highly contagious. About 3.5%-20% of HCW has been reported to be infected. The mortality ranges from 0.53% to 1.94%. PPE is part of the measure within a package of prevention and control of pandemic, rather than a replacement of. Respirators are more effective than masks in preventing aerosol transmission to HCWs. Extended use may be considered if guidelines are adhered. Powered air-purifying respirators if available should be used in high-risk procedures. CONCLUSION: Transmission of viruses is multimodal and in the setting of a novel pathogen with high case fatality with no proven effective interventions, PPE that affords the best protection should be available to HCWs.


docid: kqqantwg

title: Possible Bat Origin of Severe Acute Respiratory Syndrome Coronavirus 2

text: We showed that severe acute respiratory syndrome coronavirus 2 is probably a novel recombinant virus. Its genome is closest to that of severe acute respiratory syndrome-related coronaviruses from horseshoe bats, and its receptor-binding domain is closest to that of pangolin viruses. Its origin and direct ancestral viruses have not been identified.


title: Emergency Response to COVID-19 in Canada: Platform Development and Implementation for eHealth in Crisis Management

text: BACKGROUND: Public health emergencies like epidemics put enormous pressure on health care systems while revealing deep structural and functional problems in the organization of care. The current coronavirus disease (COVID-19) pandemic illustrates this at a global level. The sudden increased demand on delivery systems puts unique pressures on pre-established care pathways. These extraordinary times require efficient tools for smart governance and resource allocation. OBJECTIVE: The aim of this study is to develop an innovative web-based solution addressing the seemingly insurmountable challenges of triaging, monitoring, and delivering nonhospital services unleashed by the COVID-19 pandemic. METHODS: An adaptable crisis management digital platform was envisioned and designed with the goal of improving the system's response on the basis of the literature; an existing shared health record platform; and discussions between health care providers, decision makers, academia, and the private sector in response to the COVID 19 epidemic. RESULTS: The Crisis Management Platform was developed and offered to health authorities in Ontario on a nonprofit basis. It has the capability to dramatically streamline patient intake, triage, monitoring, referral, and delivery of nonhospital services. It decentralizes the provision of services (by moving them online) and centralizes data gathering and analysis, maximizing the use of existing human resources, facilitating evidence-based decision making, and minimizing the risk to both users and providers. It has unlimited scale-up possibilities (only constrained by human health risk resource availability) with minimal marginal cost. Similar web-based solutions have the potential to fill an urgent gap in resource allocation, becoming a unique asset for health systems governance and management during critical times. They highlight the potential effectiveness of web-based solutions if built on an outcome-driven architecture. CONCLUSIONS: Data and web-based approaches in response to a public health crisis are key to evidence-driven oversight and management of public health emergencies.


title: The COVID-19 pandemic

text: In December 2019, an outbreak of pneumonia of unknown origin was reported in Wuhan, Hubei Province, China. Pneumonia cases were epidemiologically linked to the Huanan Seafood Wholesale Market. Inoculation of respiratory samples into human airway epithelial cells, Vero E6 and Huh7 cell lines, led to the isolation of a novel respiratory virus whose genome analysis showed it to be a novel coronavirus related to SARS-CoV, and therefore named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is a betacoronavirus belonging to the subgenus Sarbecovirus. The global spread of SARS-CoV-2 and the thousands of deaths caused by coronavirus disease (COVID-19) led the World Health Organization to declare a pandemic on 12 March 2020. To date, the world has paid a high toll in this pandemic in terms of human lives lost, economic repercussions and increased poverty. In this review, we provide information regarding the epidemiology, serological and molecular diagnosis, origin of SARS-CoV-2 and its ability to infect human cells, and safety issues. Then we focus on the available therapies to fight COVID-19, the development of vaccines, the role of artificial intelligence in the management of the pandemic and limiting the spread of the virus, the impact of the COVID-19 epidemic on our lifestyle, and preparation for a possible second wave.


The role of serology for COVID-19 control: Population, kinetics and test performance do matter


Reproductive health under COVID-19 - challenges of responding in a global crisis


title: Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS): an atypical acute respiratory distress syndrome working hypothesis

text: We suggest the use of MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome) as a new name for severe pulmonary coronavirus disease 2019 (COVID-19) We hypothesise that, in predisposed individuals, alveolar viral damage is followed by an inflammatory reaction and by microvascular pulmonary thrombosis This progressive endothelial thromboinflammatory syndrome may also involve the microvascular bed of the brain and other vital organs, leading to multiple organ failure and death Future steps in the understanding of the disease and in the identification of treatments may benefit from this definition and hypothesised sequence of events


title: How Are Orthopaedic Surgery Residencies Responding to the COVID-19 Pandemic? An Assessment of Resident Experiences in Cities of Major Virus Outbreak

text: BACKGROUND: In response to COVID-19, American medical centers have enacted elective case restrictions, markedly affecting the training of orthopaedic residents. Residencies must develop new strategies to provide patient care while ensuring the health and continued education of trainees. We aimed to describe the evolving impact of COVID-19 on orthopaedic surgery residents. METHODS: We surveyed five Accreditation Council for Graduate Medical Education-accredited orthopaedic residency programs within cities highly affected by the COVID-19 pandemic about clinical and curricular changes. An online questionnaire surveyed individual resident experiences related to COVID-19. RESULTS: One hundred twenty-one resident survey responses were collected. Sixty-five percent of the respondents have cared for a COVID-19-positive patient. One in three reported being unable to obtain institutionally recommended personal protective equipment during routine clinical work. All programs have discontinued elective orthopaedic cases and restructured resident rotations. Most have shifted schedules to periods of active clinical duty followed by periods of remote work and self-isolation. Didactic education has continued via videoconferencing. DISCUSSION: COVID-19 has caused unprecedented changes to orthopaedic training; however, residents remain on the front lines of inpatient care. Exposures to COVID-19 are prevalent and residents have fallen ill. Programs currently use a variety of strategies to provide essential orthopaedic care. We recommend continued prioritization of resident safety and necessary training accommodations.


Case 22-2020: A 62-Year-Old Woman with Early Breast Cancer during the Covid-19 Pandemic


A pilot study on the perspectives of pediatric ophthalmologists and their patients towards online consultation during COVID-19 lockdown in India


title: COVID-19 Infection: Implications for Perioperative and Critical Care Physicians

text: Healthcare systems worldwide are responding to Coronavirus Disease 2019 (COVID-19), an emerging infectious syndrome caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus. Patients with COVID-19 can progress from asymptomatic or mild illness to hypoxemic respiratory failure or multisystem organ failure, necessitating intubation and intensive care management. Healthcare providers, and particularly anesthesiologists, are at the frontline of this epidemic, and they need to be aware of the best available evidence to guide therapeutic management of patients with COVID-19 and to keep themselves safe while doing so. Here, the authors review COVID-19 pathogenesis, presentation, diagnosis, and potential therapeutics, with a focus on management of COVID-19-associated respiratory failure. The authors draw on literature from other viral epidemics, treatment of acute respiratory distress syndrome, and recent publications on COVID-19, as well as guidelines from major health organizations. This review provides a comprehensive summary of the evidence currently available to guide management of critically ill patients with COVID-19.


title: Management strategy of Novel coronavirus pneumonia in burn and wound care ward/ 中华烧伤杂志

text: The prevention and control of novel coronavirus pneumonia (NCP) has already entered a key period . The patients treated in the burn and wound care ward are susceptible to viral infection because of disease, age and other factors, so it is very important to manage the burn and wound care ward during the prevention and control of NCP epidemic. In this paper, combining with the key clinical problems of prevention and control in hospital during the epidemic period of NCP infection, medical evidence, and clinical and management experience, the author formulates prevention and control management strategy of the author’s unit in order to provide reference for prevention and control of burn and wound care ward.


title: Staffing Up For The Surge: Expanding The New York City Public Hospital Workforce During The COVID-19 Pandemic

text: Ascending to the peak of the novel coronavirus disease (COVID-19) pandemic in New York City, NYC Health + Hospitals (NYC H+H), the City's public health care system, rapidly expanded capacity across its 11 acute-care hospitals and three new field hospitals. To meet the unprecedented demand for patient care, NYC H+H redeployed staff to the areas of greatest need and redesigned recruiting, onboarding, and training processes. The hospital system engaged private staffing agencies, partnered with the U.S Department of Defense, and recruited volunteers throughout the country. A centralized onboarding team created a single-source portal for medical providers requiring credentialing and established new staff positions to increase efficiency. Using new educational tools focused on COVID-19 content, the hospital system trained 20,000 staff, including nearly 9,000 nurses, within a two-month period. Creation of multidisciplinary teams, frequent enterprise-wide communication, willingness to shift direction in response to changing needs, and innovative use of technology were the key factors that enabled the hospital system to meet its goals. [Editor's Note: This Fast Track Ahead Of Print article is the accepted version of the manuscript. The final edited version will appear in an upcoming issue of Health Affairs.].


title: On the nonlinearity of a tuning fork

text: Tuning fork experiments at the undergraduate level usually only demonstrate a tuning fork's linear resonance. In this paper, we introduce an experiment that can be used to measure the nonlinear tuning curve of a regular tuning fork. Using double-grating Doppler interferometry, we achieve measurement accuracy within ten microns. With this experiment setup, we observe typical nonlinear behaviors of the tuning fork such as the softening tuning curve and jump phenomena. Our experiment is inexpensive and easy to operate. It provides an integrated experiment for intermediate-level students and a basis for senior research projects.


title: Neural Network aided quarantine control model estimation of COVID spread in Wuhan, China

text: In a move described as unprecedented in public health history, starting 24 January 2020, China imposed quarantine and isolation restrictions in Wuhan, a city of more than 10 million people. This raised the question: is mass quarantine and isolation effective as a social tool in addition to its scientific use as a medical tool? In an effort to address this question, using a epidemiological model driven approach augmented by machine learning, we show that the quarantine and isolation measures implemented in Wuhan brought down the effective reproduction number R(t) of the CoVID-19 spread from R(t)>1 to R(t)<1 within a month after the imposition of quarantine control measures in Wuhan, China. This ultimately resulted in a stagnation phase in the infected case count in Wuhan. Our results indicate that the strict public health policies implemented in Wuhan may have played a crucial role in halting down the spread of infection and such measures should potentially be implemented in other highly affected countries such as South Korea, Italy and Iran to curtail spread of the disease. Finally, our forecasting results predict a stagnation in the quarantine control measures implemented in Wuhan towards the end of March 2020; this would lead to a subsequent stagnation in the effective reproduction number at R(t)<1. We warn that immediate relaxation of the quarantine measures in Wuhan may lead to a relapse in the infection spread and a subsequent increase in the effective reproduction number to R(t)>1. Thus, it may be wise to relax quarantine measures after sufficient time has elapsed, during which maximum of the quarantined/isolated individuals are recovered.


Schutz von Patienten und medizinischem Personal vor COVID-19: Überlegungen für Praxis und ambulante Versorgung in der Kardiologie./ Protecting patients and healthcare personnel from COVID-19: considerations for practice and outpatient care in cardiology


Traqueobronquitis necrotizante con obstrucción del tubo endotraqueal en pacientes COVID-19./ [Necrotizing tracheobronchitis with endotracheal tube obstruction in COVID-19 patients]


#SendHelpNow: Mental wellness and virtual connection in the age of coronavirus


Approaching COVID-19-Bedside strategies for intensive care


title: How We Do It: Lessons on Outbreak Preparedness from the Cleveland Clinic

text: Disasters, including infectious disease outbreaks, are inevitable. Hospitals need to plan in advance to ensure that their systems can adapt to a rapidly changing environment if necessary. This review provides an overview of ten general principles that hospitals and healthcare systems should consider when developing disaster plans. The principles are consistent with an "all-hazards" approach to disaster mitigation. This approach is adapted to planning for a multiplicity of threats, but emphasizes highly relevant scenarios, such as the COVID-19 pandemic. We also describe specific ways these principles helped prepare our hospital for this pandemic. Key points include acting quickly, identifying and engaging key stakeholders early, providing accurate information, prioritizing employee safety and mental health, promoting a fully integrated clinical response, developing surge plans, preparing for ethical dilemmas, and having a cogent exit strategy for post disaster recovery.


La práctica de la Cardiología ante la pandemia por COVID-19. Recomendaciones de la comunidad cardiológica mexicana./ Practice of Cardiology during COVID 19 pandemic. Recommendations of the Mexican Cardiology Community


title: Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia

text: BACKGROUND: Three months ago, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out in Wuhan, China, and spread rapidly around the world. Severe novel coronavirus pneumonia (NCP) patients have abnormal blood coagulation function, but their venous thromboembolism (VTE) prevalence is still rarely mentioned. OBJECTIVES: To determine the incidence of VTE in patients with severe NCP. METHODS: In this study, 81 severe NCP patients in the intensive care unit (ICU) of Union Hospital (Wuhan, China) were enrolled. The results of conventional coagulation parameters and lower limb vein ultrasonography of these patients were retrospectively collected and analyzed. RESULTS: The incidence of VTE in these patients was 25% (20/81), of which 8 patients with VTE events died. The VTE group was different from the non-VTE group in age, lymphocyte counts, activated partial thromboplastin time (APTT), D-dimer, etc. If 1.5 µg/mL was used as the D-dimer cut-off value to predicting VTE, the sensitivity was 85.0%, the specificity was 88.5%, and the negative predictive value (NPV) was 94.7%. CONCLUSIONS: The incidence of VTE in patients with severe NCP is 25% (20/81), which may be related to poor prognosis. The significant increase of D-dimer in severe NCP patients is a good index for identifying high-risk groups of VTE.


title: [Large differences in excess mortality in March-May 2020 by country of birth in Sweden]

text: The Swedish strategy for dealing with covid-19 has been criticized for not accounting for difficulties of conducting voluntary social distancing in settings with household overcrowding, dependence on public transport and large proportion of service sector workers In such neighbourhoods there is typically a larger proportion of immigrants We compared all-cause-mortality data in Sweden by country of origin from 2020 and 2016-2019 and found large disparities The number of deaths among persons born in countries from which many refugees have migrated to Sweden in the last decades was 220% higher in March-May 2020 compared to the mean in 2016-2019 In contrast, there was no increased mortality among persons aged 40-64 years and a 19% increased number of deaths of those aged above 65 years born in Sweden, EU or North America during these three months These observations further illustrate the need for a dedicated and more diverse strategy in dealing with the covid-19 pandemic


title: SARS-CoV-2 and viral sepsis: observations and hypotheses

text: Since the outbreak of coronavirus disease 2019 (COVID-19), clinicians have tried every effort to understand the disease, and a brief portrait of its clinical features have been identified. In clinical practice, we noticed that many severe or critically ill COVID-19 patients developed typical clinical manifestations of shock, including cold extremities and weak peripheral pulses, even in the absence of overt hypotension. Understanding the mechanism of viral sepsis in COVID-19 is warranted for exploring better clinical care for these patients. With evidence collected from autopsy studies on COVID-19 and basic science research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and SARS-CoV, we have put forward several hypotheses about SARS-CoV-2 pathogenesis after multiple rounds of discussion among basic science researchers, pathologists, and clinicians working on COVID-19. We hypothesise that a process called viral sepsis is crucial to the disease mechanism of COVID-19. Although these ideas might be proven imperfect or even wrong later, we believe they can provide inputs and guide directions for basic research at this moment.


title: A Robust Stochastic Method of Estimating the Transmission Potential of 2019-nCoV

text: The recent outbreak of a novel coronavirus (2019-nCoV) has quickly evolved into a global health crisis. The transmission potential of 2019-nCoV has been modelled and studied in several recent research works. The key factors such as the basic reproductive number, $R_{0}$, of the virus have been identified by fitting contagious disease spreading models to aggregated data. The data include the reported cases both within China and in closely connected cities over the world. In this paper, we study the transmission potential of 2019-nCoV from the perspective of the robustness of the statistical estimation, in light of varying data quality and timeliness in the initial stage of the outbreak. Sample consensus algorithm has been adopted to improve model fitting when outliers are present. The robust estimation enables us to identify two clusters of transmission models, both are of substantial concern, one with $R_0:8\sim14$, comparable to that of measles and the other dictates a large initial infected group.


title: Exploration and Discovery of the COVID-19 Literature through Semantic Visualization

text: We are developing semantic visualization techniques in order to enhance exploration and enable discovery over large datasets of complex networks of relations. Semantic visualization is a method of enabling exploration and discovery over large datasets of complex networks by exploiting the semantics of the relations in them. This involves (i) NLP to extract named entities, relations and knowledge graphs from the original data; (ii) indexing the output and creating representations for all relevant entities and relations that can be visualized in many different ways, e.g., as tag clouds, heat maps, graphs, etc.; (iii) applying parameter reduction operations to the extracted relations, creating"relation containers", or functional entities that can also be visualized using the same methods, allowing the visualization of multiple relations, partial pathways, and exploration across multiple dimensions. Our hope is that this will enable the discovery of novel inferences over relations in complex data that otherwise would go unnoticed. We have applied this to analysis of the recently released CORD-19 dataset.


title: Two clinical cases of Novel coronavirus pneumonia (NCP) in renal transplant recipients/ 中华器官移植杂志

text: Objective@#To explore the clinical features, diagnosis and prognosis of renal transplant recipients with NCP.@*Method@#The clinical data of 2 cases of kidney transplant recipients with NCP were retrospectively analyzed. Based onclinical manifestations, blood routine, inflammatory factors, cell immunity, chest CT andtherapeutic effects, the diagnosis and treatment of NCP in kidney transplant recipients (5th edition) were compared to that ofordinary NCP patients. Both recipients developed onset of low andmoderate fever, with no cough or fatigue at the initial stage. Blood routine indicated a normal range of leukocytes,buta significant decrease in lymphocyte counts, increased C-reactive protein (CRP) , and slightly higher procalcitonin (PCT) . The cellular immunity was extremely low, and the chest CT showed multiple patchy ground glass shadows in both lungs.@*Result@#After 1 week of onset, both patients had significant disease progression. The pathogenesis and imaging changes were highly similar tothatreported in ordinary NCP patients.Two patients were givensymptomatic supportive treatment by antiviral agents, stop uses ofimmunosuppression agents, small amount of hormone maintenance, intravenous drip of gamma globulin andrespiratory support toavoid secondary infections. At present, the condition of both patients is obviously improved, and renal function is stable. One of them has recovered and was discharged.@*Conclusion@#The clinical manifestations of NCP in renal transplant recipients were generally consistent with that of ordinary NCP patients. Although there is no established method for the treatment of NCP, it is effective by stopping uses of immunosuppressive agents, maintaining small and medium doses of hormones, actively restoring immunity, and providing respiratory support in a timely manner.


COVID-19: towards understanding of pathogenesis


title: Academic Emergency Medicine Physicians' Anxiety Levels, Stressors and Potential Stress Mitigation Measures during the Acceleration Phase of the COVID-19 Pandemic

text: OBJECTIVE: To assess anxiety and burnout levels, home life changes and measures to relieve stress of United States academic emergency medicine (EM) physicians during the COVID-19 pandemic acceleration phase. METHODS: We sent a cross-sectional email survey to all EM physicians at seven academic emergency departments. The survey incorporated items from validated stress scales and assessed perceptions and key elements in the following domains: numbers of suspected COVID-19 patients, availability of diagnostic testing, levels of home and workplace anxiety, severity of work burnout, identification of stressors, changes in home behaviors, and measures to decrease provider anxiety. RESULTS: 426 (56.7%) EM physicians responded. On a scale of 1-7 (1= not at all, 4 = somewhat, and 7=extremely), the median (interquartile range) reported effect of the pandemic on both work and home stress levels was 5 (4,6). Reported levels of emotional exhaustion/burnout increased from pre-pandemic median 3 (2,4) to since the pandemic started median 4 (3,6); difference in medians = 1.8 (95% confidence interval 1.7-1.9). Most physicians (90.8%) reported changing their behavior towards family and friends, especially by decreasing signs of affection (76.8%). The most commonly cited measures cited to alleviate stress/anxiety were increasing personal protective equipment availability (PPE), offering rapid COVID-19 testing at physician discretion, providing clearer communication about COVID-19 protocol changes, and assuring that physicians can take leave for care of family and self. CONCLUSIONS: During the acceleration phase, the COVID-19 pandemic has induced substantial workplace and home anxiety in academic EM physicians and their exposure during work has had a major impact on their home lives. Measures cited to decrease stress include enhanced availability of PPE, rapid turnaround testing at provider discretion, and clear communication about COVID-19 protocol changes.


The Crucible of War: Innovation in a Pandemic


Reply to Siniorakis et al., "COVID-19 Interference with Renin-Angiotensin System in the Context of Heart Failure"


title: mEBAL: A Multimodal Database for Eye Blink Detection and Attention Level Estimation

text: This work presents mEBAL, a multimodal database for eye blink detection and attention level estimation. The eye blink frequency is related to the cognitive activity and automatic detectors of eye blinks have been proposed for many tasks including attention level estimation, analysis of neuro-degenerative diseases, deception recognition, drive fatigue detection, or face anti-spoofing. However, most existing databases and algorithms in this area are limited to experiments involving only a few hundred samples and individual sensors like face cameras. The proposed mEBAL improves previous databases in terms of acquisition sensors and samples. In particular, three different sensors are simultaneously considered: Near Infrared (NIR) and RGB cameras to capture the face gestures and an Electroencephalography (EEG) band to capture the cognitive activity of the user and blinking events. Regarding the size of mEBAL, it comprises 6,000 samples and the corresponding attention level from 38 different students while conducting a number of e-learning tasks of varying difficulty. In addition to presenting mEBAL, we also include preliminary experiments on: i) eye blink detection using Convolutional Neural Networks (CNN) with the facial images, and ii) attention level estimation of the students based on their eye blink frequency.


Olfactory and gustatory dysfunction caused by SARS-CoV-2: Comparison with cases of infection with influenza and other viruses


Acute Kidney Injury in COVID-19 Pandemic


title: The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2

text: BACKGROUND: Face mask usage by the healthy population in the community to reduce risk of transmission of respiratory viruses remains controversial. We assessed the effect of community-wide mask usage to control coronavirus disease 2019 (COVID-19) in Hong Kong Special Administrative Region (HKSAR). METHODS: Patients presenting with respiratory symptoms at outpatient clinics or hospital wards were screened for COVID-19 per protocol. Epidemiological analysis was performed for confirmed cases, especially persons acquiring COVID-19 during mask-off and mask-on settings. The incidence of COVID-19 per million population in HKSAR with community-wide masking was compared to that of non-mask-wearing countries which are comparable with HKSAR in terms of population density, healthcare system, BCG vaccination and social distancing measures but not community-wide masking. Compliance of face mask usage in the HKSAR community was monitored. FINDINGS: Within first 100 days (31 December 2019 to 8 April 2020), 961 COVID-19 patients were diagnosed in HKSAR. The COVID-19 incidence in HKSAR (129.0 per million population) was significantly lower (p<0.001) than that of Spain (2983.2), Italy (2250.8), Germany (1241.5), France (1151.6), U.S. (1102.8), U.K. (831.5), Singapore (259.8), and South Korea (200.5). The compliance of face mask usage by HKSAR general public was 96.6% (range: 95.7% to 97.2%). We observed 11 COVID-19 clusters in recreational 'mask-off' settings compared to only 3 in workplace 'mask-on' settings (pâ¯=â¯0.036 by Chi square test of goodness-of-fit). CONCLUSION: Community-wide mask wearing may contribute to the control of COVID-19 by reducing the amount of emission of infected saliva and respiratory droplets from individuals with subclinical or mild COVID-19.


title: Recommendations for the organization of electrophysiology and cardiac pacing services during the COVID-19 pandemic : Latin American Heart Rhythm Society (LAHRS) in collaboration with: Colombian College Of Electrophysiology, Argentinian Society of Cardiac Electrophysiology (SADEC), Brazilian Society Of Cardiac Arrhythmias (SOBRAC), Mexican Society Of Cardiac Electrophysiology (SOMEEC)

text: COVID-19 is a rapidly evolving public health emergency that has largely impacted the provision of healthcare services around the world. The challenge for electrophysiology teams is double; on one side preventing disease spread by limiting all nonessential face-to-face interactions, but at the same time ensuring continued care for patients who need it. These guidelines contain recommendations regarding triaging in order to define what procedures, device checks and clinic visits can be postponed during the pandemic. We also discuss best practices to protect patients and healthcare workers and provide guidance for the management of COVID-19 patients with arrhythmic conditions.


Understanding pathophysiology of hemostasis disorders in critically ill patients with COVID-19


title: Mobilidade urbana e o acesso ao Sistema Único de Saúde para casos suspeitos e graves de Covid-19 nas vinte maiores cidades do Brasil

text: A iminência da crise do sistema de saúde causada pela Covid-19 exige inúmeras ações emergenciais Entre estas, é essencial para o planejamento dos serviços de saúde ter um diagnóstico de quais áreas das cidades têm menos acesso a equipamentos de saúde, e quais são os hospitais que poderão ter maior sobrecarga de demanda por internações Esta nota técnica tem como objetivos: (1) estimar quantas são e onde moram as pessoas mais vulneráveis com maior dificuldade de acessar equipamentos de saúde;e (2) apontar quais são os estabelecimentos de saúde que poderão ter maior estrangulamento de demanda, considerando-se sua capacidade de oferta de leitos de unidades de tratamento intensivo (UTIs) Este trabalho analisou a capacidade de suporte do SUS, apresentando estimativas da quantidade de leitos de UTI/respiradores por pessoa de cada hospital nos maiores municípios do Brasil Os resultados apontam que os maiores municípios do Brasil têm um número de leitos de UTI adulto com respiradores disponíveis ao SUS muito próximo do mínimo desejável, segundo o Ministério da Saúde No entanto, esse valor pode ficar muito abaixo do necessário para lidar com um grande crescimento da demanda de internações, mesmo caso os cenários mais otimistas de propagação da Covid-19 no Brasil se confirmem Os resultados apontam uma situação ainda mais preocupante nas periferias dos grandes centros urbanos, onde, via de regra, a baixa oferta de equipamentos de saúde, combinada com piores condições de urbanização e de renda, aumentam o potencial de propagação da Covid-19 diante de uma baixa capacidade de atendimento do sistema de saúde Esses resultados podem ajudar a identificar quais unidades de saúde poderiam receber aportes de recursos suplementares para ampliação de sua capacidade Uma análise mais detalhada desses resultados poderia apontar também quais são os bairros das cidades onde a construção de hospitais de campanha seria mais eficaz quanto ao aumento do acesso da população aos serviços de saúde


title: The spike glycoprotein of the new coronavirus 2019-nCoV contains a furin-like cleavage site absent in CoV of the same clade

text: In 2019, a new coronavirus (2019-nCoV) infecting Humans has emerged in Wuhan, China. Its genome has been sequenced and the genomic information promptly released. Despite a high similarity with the genome sequence of SARS-CoV and SARS-like CoVs, we identified a peculiar furin-like cleavage site in the Spike protein of the 2019-nCoV, lacking in the other SARS-like CoVs. In this article, we discuss the possible functional consequences of this cleavage site in the viral cycle, pathogenicity and its potential implication in the development of antivirals.


title: Pandemics and psychiatry: Repositioning research in context of COVID-19

text: The current Covid-19 pandemic is posing an unprecedented threat to global well-being and its mental health consequences are just becoming understood. While the crisis has led to a temporary halt in a lot of ongoing or planned psychiatric research, this pandemic is a natural experiment that can help the field to repurpose research to better understand the causes, presentations and outcome trajectories as well as treatments in psychiatry. Inter-disciplinary collaborations between researchers are needed to rapidly develop and share the emerging new knowledge of the mental health implications of Covid-19, This will help mount an effective response to the current as well as future pandemics.


title: Prediction of repurposed drugs for treating lung injury in COVID-19

text: Coronavirus disease (COVID-19) is an infectious disease discovered in 2019 and currently in outbreak across the world. Lung injury with severe respiratory failure is the leading cause of death in COVID-19, brought by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, there still lacks efficient treatment for COVID-19 induced lung injury and acute respiratory failure. Inhibition of Angiotensin-converting enzyme 2 (ACE2) caused by spike protein of SARS-CoV-2 is the most plausible mechanism of lung injury in COVID-19. We propose two candidate drugs, COL-3 (a chemically modified tetracycline) and CGP-60474 (a cyclin-dependent kinase inhibitor), for treating lung injuries in COVID-19, based on their abilities to reverse the gene expression patterns in HCC515 cells treated with ACE2 inhibitor and in human COVID-19 patient lung tissues. Further bioinformatics analysis shows that twelve significantly enriched pathways (P-value<0.05) overlap between HCC515 cells treated with ACE2 inhibitor and human COVID-19 patient lung tissues, including signaling pathways known to be associated with lung injury such as TNF signaling, MAPK signaling and Chemokine signaling pathways. All these twelve pathways are targeted in COL-3 treated HCC515 cells, in which genes such as RHOA, RAC2, FAS, CDC42 have reduced expression. CGP-60474 shares eleven of twelve pathways with COL-3 with common target genes such as RHOA. It also uniquely targets genes related to lung injury, such as CALR and MMP14. In summary, this study shows that ACE2 inhibition is likely part of the mechanisms leading to lung injury in COVID-19, and that compounds such as COL-3 and CGP-60474 have the potential as repurposed drugs for its treatment.


Non-evidence-based platelet transfusions for protocol eligibility


We must not forget the most disadvantaged people facing the COVID-19 crisis


Kidney Involvement in COVID-19: Need for Better Definitions


title: Early recovery following new onset anosmia during the COVID-19 pandemic - an observational cohort study

text: BACKGROUND: A rapidly evolving evidence suggests that smell and taste disturbance are common symptoms in COVID-19 infection. As yet there are no reports on duration and recovery rates. We set out to characterise patients reporting new onset smell and taste disturbance during the COVID-19 pandemic and report on early recovery rates. METHODS: Online Survey of patients reporting self-diagnosed new onset smell and taste disturbance during the COVID-19 pandemic, with 1 week follow-up. RESULTS: Three hundred eighty-two patents completed bot an initial and follow-up survey. 86.4% reported complete anosmia and a further 11.5% a very severe loss of smell at the time of completing the first survey. At follow-up 1 week later, there is already significant improvement in self-rating of severity of olfactory loss. 80.1% report lower severity scores at follow-up, 17.6% are unchanged and 1.9% are worse. 11.5% already report compete resolution at follow up, while 17.3% report persistent complete loss of smell, with reported duration being 1 to over 4 weeks. This is reflected in the overall cumulative improvement rate of 79% patients overall in the interval between surveys. CONCLUSIONS: A review of the growing evidence base supports the likelihood that out cohort have suffered olfactory loss as part of COVID-19 infection. While early recovery rates are encouraging, long term rates will need to be further investigated and there may be an increase in patients with persistent post-viral loss as a result of the pandemic. We further call for loss of sense of smell to be formerly recognised as a marker of COVID-19 infection.


title: Robot assisted surgery during the COVID-19 pandemic, especially for gynecological cancer: a statement of the Society of European Robotic Gynaecological Surgery (SERGS)

text: All surgery performed in an epicenter of the coronavirus disease 2019 (COVID-19) pandemic, irrespective of the known or suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) status of the patient, should be regarded as high risk and protection of the surgical team at the bedside should be at the highest level. Robot assisted surgery (RAS) may help to reduce hospital stay for patients that urgently need complex-oncological-surgery, thus making room for COVID-19 patients. In comparison to open or conventional laparoscopic surgery, RAS potentially reduces not only contamination with body fluids and surgical gasses of the surgical area but also the number of directly exposed medical staff. A prerequisite is that general surgical precautions under COVID-19 circumstances must be taken, with the addition of prevention of gas leakage: â¢ Use highest protection level III for bedside assistant, but level II for console surgeon. â¢ Reduce the number of staff at the operation room. â¢ Ensure safe and effective gas evacuation. â¢ Reduce the intra-abdominal pressure to 8 mmHg or below. â¢ Minimize electrocautery power and avoid use of ultrasonic sealing devices. â¢ Surgeons should avoid contact outside theater (both in and out of the hospital).


title: HIV care in times of the COVID-19 crisis - Where are we now in Central and Eastern Europe?

text: INTRODUCTION: The SARS-CoV-2 pandemic has hit the European region disproportionately. Many HIV clinics share staff and logistics with infectious disease facilities, which are now on the frontline in tackling COVID-19. Therefore, this study investigated the impact of the current pandemic situation on HIV care and continuity of antiretroviral treatment (ART) supplies in CEE countries. METHODS: The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was established in February 2016 to review standards of care for HIV in the region. The group consists of professionals actively involved in HIV care. On March 19, 2020 we decided to review the status of HIV care sustainability in the face of the emerging SARS-CoV-2 pandemic in Europe. For this purpose, we constructed an online survey consisting of 23 questions. Respondents were recruited from ECEE members in 22 countries, based on their involvement in HIV care, and contacted via email. RESULTS: In total, 19 countries responded: Albania, Armenia, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Georgia, Greece, Hungary, Lithuania, Macedonia, Poland, Republic of Moldova, Russia, Serbia, Turkey, and Ukraine. Most of the respondents were infectious disease physicians directly involved in HIV care (17/19). No country reported HIV clinic closures. HIV clinics were operating normally in only six countries (31.6%). In 11 countries (57.9%) physicians were sharing HIV and COVID-19 care duties. None of the countries expected shortage of ART in the following 2 weeks; however, five physicians expressed uncertainty about the following 2 months. At the time of providing responses, ten countries (52.6%) had HIV-positive persons under quarantine. CONCLUSIONS: A shortage of resources is evident, with an impact on HIV care inevitable. We need to prepare to operate with minimal medical resources, with the aim of securing constant supplies of ART. Non-governmental organizations should re-evaluate their earlier objectives and support efforts to ensure continuity of ART delivery.


title: Abdominal presentation of covid-19

text: A 64-year-old with hypertension, hypercholesterolemia, and recent expo-sure to a family member with coronavi-rus disease 2019 (COVID-19) presented to the emergency department with a two-day history of abdominal pain, nau-sea, vomiting, diarrhea, and low-grade fever The patient denied fatigue, myal-gia, headache, cough, sore throat, short-ness of breath, and chest pain/ tightness Physical examination was remarkable for a temperature of 101°F, oxygen sat-uration of 98%, and generalized abdominal tenderness Laboratory values were remarkable for slightly elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) An abdominal– pelvic CT scan with intravenous contrast was subsequently performed to assess for acute pathology Based upon CT observations at the imaged lung bases, an anterior–posterior chest radiograph was obtained


title: Correction to: Ultra-high-resolution computed tomography can demonstrate alveolar collapse in novel coronavirus (COVID-19) pneumonia

text: The correct caption is given below.


title: Clinical trials for inflammatory bowel disease: a global guidance during COVID-19 pandemic

text: The severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]-causing coronavirus disease [COVID]-19 pandemic poses major challenges for patients with inflammatory bowel disease to be recruited and maintained in clinical trials. However, clinical trials offer patients who have failed multiple drugs access to study medications with alternative mode of action and the potential for relief from inflammation-mediated symptoms. Therefore, the continuation of clinical trials in IBD during the COVID-19 pandemic is important both for participants and the community of IBD patients, due to the dire need of an expanded therapeutic armamentarium. As the safety of patients in clinical trials is the leading principle, we are providing ten specific rules to guide patients and principal investigators safely through the challenging time.


title: Coronavirus disinfection in histopathology

text: The 2019 Coronavirus epidemic, provisionally called 2019-nCoV, was first identified in Wuhan, China, in persons exposed to a seafood or wet market. There is an international push to contain the virus and prevent its spread. It is feasible that potentially infectious samples may be received in histopathology laboratories for diagnosis. This technical note presents disinfection procedures and histotechnology processes that should alleviate the risk of infection to laboratory staff. Using data obtained from similar coronaviruses, e.g. severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), experts are confident that 70% ethanol and 0.1% sodium hypochlorite should inactivate the virus. Formalin fixation and heating samples to 56oC, as used in routine tissue processing, were found to inactivate several coronaviruses and it is believed that 2019-nCoV would be similarly affected.


title: When basic supplies are missing, what to do? Specific demands of the local street population in times of coronavirus - a concern of social psychiatry

text: BACKGROUND: Homeless experts and some federal housing officials are sounding the alarm that the patchwork of government efforts to address the coronavirus outbreak risks leaving out one group of acutely vulnerable people: the homeless. In terms of isolation, it is too unclear what that looks like if you normally sleep on the streets. In this tough moment, when people should be turned away, not only it feels inhumane, but it is also a big public health risk, because where are they going to go? METHOD: The studies were identified using large-sized newspapers with international circulation RESULTS: With more cities suspecting community transmission of the novel coronavirus, people who sleep in shelters or hunker down outside already have a lower life expectancy and often have underlying health conditions that put them at greater risk if they develop COVID-19 (Global News, 2020). These people face lack of sleep, malnutrition, and "extreme stress levels just to meet their daily needs", all of which weakens the immune system. Along with mental illness or substance abuse disorders, they are "incredibly vulnerable to this virus". CONCLUSIONS: Health organizations are well aware of the risks involved in mental health. A large population of homeless people experience their pain and psychological distress intermittently. For low-income patients, the various borderline situations related to health/illness involve growing expectations regarding the basic needs. This is a serious concern when linked to the pandemic.


The search for a COVID-19 animal model


title: Coagulopathy, thromboembolic complications and the use of heparin in COVID-19 Pneumonia

text: The SARS-CoV-2 (COVID-19) is causing a pandemic and potentially fatal disease, actually of global public health concern. Viral infections are known to be associated with coagulation impairment thus thrombosis, hemorrhage, or both, may occur. Understanding the pathophysiological mechanisms underlying the development of coagulation disorders during viral infection is essential for the development of therapeutic strategies. Coagulopathy in COVID-19 infection is emerging as a precipitant factor for severe respiratory complications and death. An increase in coagulation markers such as fibrinogen and D-Dimer has been found in severe COVID-19 cases. Heparin, clinically used as an anticoagulant, has also anti-inflammatory properties including binding of inflammatory cytokines, inhibition of neutrophil chemotaxis, protection of endothelial cells and a potential antiviral effect. We hypothesized that low molecular weight heparin (LMWH) may attenuate cytokine storm in COVID-19 patients therefore LMWH could be a valid adjunctive therapeutic drug for the treatment of COVID-19 pneumopathy. In this paper we review potential mechanisms involved in coagulation impairment following viral infection and the possible role of heparin in the treatment of COVID-19 patients.


docid: ezirpmbd

title: Projecting demand for critical care beds during COVID-19 outbreaks in Canada

text: BACKGROUND: Increasing numbers of coronavirus disease 2019 (COVID-19) cases in Canada may create substantial demand for hospital admission and critical care. We evaluated the extent to which self-isolation of mildly ill people delays the peak of outbreaks and reduces the need for this care in each Canadian province. METHODS: We developed a computational model and simulated scenarios for COVID-19 outbreaks within each province. Using estimates of COVID-19 characteristics, we projected the hospital and intensive care unit (ICU) bed requirements without self-isolation, assuming an average number of 2.5 secondary cases, and compared scenarios in which different proportions of mildly ill people practised self-isolation 24 hours after symptom onset. RESULTS: Without self-isolation, the peak of outbreaks would occur in the first half of June, and an average of 569 ICU bed days per 10 000 population would be needed. When 20% of cases practised self-isolation, the peak was delayed by 2-4 weeks, and ICU bed requirement was reduced by 23.5% compared with no self-isolation. Increasing self-isolation to 40% reduced ICU use by 53.6% and delayed the peak of infection by an additional 2-4 weeks. Assuming current ICU bed occupancy rates above 80% and self-isolation of 40%, demand would still exceed available (unoccupied) ICU bed capacity. INTERPRETATION: At the peak of COVID-19 outbreaks, the need for ICU beds will exceed the total number of ICU beds even with self-isolation at 40%. Our results show the coming challenge for the health care system in Canada and the potential role of self-isolation in reducing demand for hospital-based and ICU care.


Potential benefit of angiotensin II in COVID-19 patients: beyond reasonable doubt?


title: A comparison of group testing architectures for COVID-19 testing

text: An important component of every country's COVID-19 response is fast and efficient testing -- to identify and isolate cases, as well as for early detection of local hotspots. For many countries, producing a sufficient number of tests has been a serious limiting factor in their efforts to control COVID-19 infections. Group testing is a well-established mathematical tool, which can provide a serious and rapid improvement to this situation. In this note, we compare several well-established group testing schemes in the context of qPCR testing for COVID-19. We include example calculations, where we indicate which testing architectures yield the greatest efficiency gains in various settings. We find that for identification of individuals with COVID-19, array testing is usually the best choice, while for estimation of COVID-19 prevalence rates in the total population, Gibbs-Gower testing usually provides the most accurate estimates given a fixed and relatively small number of tests. This note is intended as a helpful handbook for labs implementing group testing methods.


Depression and anxiety among adolescents during COVID-19: A cross-sectional study


title: Protection Challenges of Pregnant Women against Vertical Transmission during COVID-19 Epidemic: A Narrative Review

text: This paper presents a narrative review study of five popular data repositories focusing on challenges of pregnant women protection during the COVID-19 pandemic. The study concludes that the likelihood of a vertical transmission of COVID-19 infection from pregnant women to neonates was not observed. Nevertheless, it remains a serious risk for them during their earlier stage of pregnancy, thus, special attention from health professionals has been recommended.


title: Unmet healthcare needs among migrants without medical insurance in Montreal, Canada

text: While access to healthcare for permanent residents in Canada is well known, this is not the case for migrants without healthcare coverage. This is the first large-scale study that examines the unmet healthcare needs of migrants without healthcare coverage in Montreal. 806 participants were recruited: 436 in the community and 370 at the NGO clinic. Proportions of individuals reporting unmet healthcare needs were similar (68.4% vs. 69.8%). The main reason invoked for these unmet needs was lacking money (80.6%). Situations of not working or studying, not having had enough food in the past 12 months, not having a medical prescription to get medication and having had a workplace injury were all significantly associated with higher odds of having unmet healthcare needs. Unmet healthcare needs were more frequent among migrants without healthcare coverage than among recent immigrants or the citizens with health healthcare coverage (69%, 26%, 16%). Canada must take measures to enable these individuals to have access to healthcare according to their needs in order to reduce the risk of worsening their health status, something that may have an impact on the healthcare system and population health. The Government of Quebec announced that all individuals without any healthcare coverage will have access to COVID-19 related health care. We hope that this right, the application of which is not yet obvious, can continue after the pandemic for all health care.


COVID 19: Frontline experience at a tertiary care hospital in UK


title: Unexpected Findings of Coronavirus Disease (COVID-19) at the Lung Bases on Abdominopelvic CT

text: OBJECTIVE. The purpose of this study is to report unanticipated lung base findings on abdominal CT in 23 patients concerning for coronavirus disease (COVID-19). In these patients, who were not previously suspected of having COVID-19, abdominal pain was the most common indication for CT (n = 19), and 11 patients had no extrapulmonary findings. Seventeen patients underwent polymerase chain reaction testing, which returned positive results for all 17. CONCLUSION. Unsuspected coronavirus disease may be strongly suggested on the basis of lung findings on abdominopelvic CT.


Olfactory Dysfunction in Recovered Coronavirus Disease 2019 (COVID-19) Patients


title: The Epidemiology of COVID-19 cases and the Successful Containment Strategy in Hong Kong - January to May 2020

text: BACKGROUND: Hong Kong, a Special Administrative Region of China, recorded its first confirmed Coronavirus disease 2019 (COVID-19) case on 23 January 2020. We reviewed the case epidemiology and the various public health measures implemented from January to May 2020. METHOD: We described and compared the epidemiological and clinical characteristics of the cases recorded in different phases of the epidemic and reviewed the effectiveness of the public health measures implemented using the changes in the daily number of confirmed cases and the interval from symptom onset to hospital admission. RESULTS: Between January and May 2020, 1084 confirmed COVID-19 cases were reported, about 70% of which had travel history during the incubation period. The case fatality ratio was 0.4%. The local epidemic progressed through four phases: (i) preparedness and imported infection from mainland China, (ii) local transmission, (iii) imported infection from overseas countries associated with local transmission, and (iv) controlled imported infection with limited local transmission, with an eventual reduction of daily case number and minimization of onset-to-admission interval. Various public health measures, including enhanced surveillance, border control and social distancing, were introduced in phases in response to the prevailing local and global situations. DISCUSSION: Hong Kong's overall containment strategy has led to a stabilization of number of cases and absence of community-wide outbreak in the 4.5 months since the reporting of the first case. Hong Kong's strategy of containment might serve as an example for future planning of preparedness and response against novel infectious agents.


docid: tecnmybz

title: Denominator matters in estimating COVID-19 mortality rates


title: The Orthopaedic Trauma Service and COVID-19: Practice Considerations to Optimize Outcomes and Limit Exposure

text: The COVID-19 pandemic has presented challenges to healthcare systems, including the cancellation and then staged resumption of elective procedures. The orthopaedic trauma community has continued to provide care to patients with acute musculoskeletal injuries that cannot be delayed in all scenarios. This article summarizes and provides relevant information (orthopaedic trauma service, outpatient fracture clinic, inpatient surgery) to the practicing orthopaedic traumatologist on maximizing outcomes while limiting exposure during the pandemic. LEVEL OF EVIDENCE:: Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.


title: [Therapeutic effect of Compound Qinlan Oral Liquid on treating combining disease with syndrome of human coronavirus pneumonia with pestilence attacking lung syndrome]

text: The aim of this paper was to investigate the therapeutic effect of Compound Qinlan Oral Liquid recommended by Provincial Novel Coronary Virus Pneumonia Treatment Scheme on the treatment of BALB/c mice with combining disease with syndrome of human coronavirus pneumonia with pestilence attacking lung syndrome and to explore its clinical application in the treatment of novel coronavirus pneumonia, and to provide laboratory data support for clinical Chinese medicine. According to the classification of syndromes of novel coronavirus pneumonia by the national competent department of traditional Chinese medicine, this study determined that human coronavirus 229 E(HCoV-229 E)-infected mouse model of cold and dampness syndrome can be used to study human coronavirus pneumonia combined with pestilence attacking the lung syndrome model. This model is suitable for simulating traditional Chinese medicine treatment of common disease syndromes in Novel Coronavirus Pneumonia Diagnosis and Treatment program(trial implementation of the sixth edition). Specific steps are as follows. BALB/c mice of cold and dampness syndrome is infected with HCoV-229 E virus, and were divided into normal control group, infection control group, cold-dampness control group, cold-dampness infection group(the model group), and Compound Qilan Oral Liquid high dose group(22 mL·kg~(-1)·d~(-1)) and low dose group(11 mL·kg~(-1)·d~(-1)). On the day of infection, the Compound Qilan Oral Liquid was administered for three consecutive days. On the last dosing day, the lung tissue was dissected, and the lung index and inhibition rate were calculated. The nucleic acid of lung tissue was extracted and the HCoV-229 E virus load was detected by RT-PCR. Blood leukocytes were separated and the percentage of T and B lymphocytes was detected by flow cytometry. Lung tissue protein was extracted and the contents of IL-6, IL-10, TNF-α and IFN-Î³ were detected by ELISA. Serum was separated and the contents of gastrin(GAS) and motilin(MTL) were detected by ELISA. Histopathological analysis was performed with lung tissue. The high and low doses of Compound Qinlan Oral Liquid significantly reduced the lung index(P<0.01) of mice with combining disease with syndrome of human coronavirus pneumonia with pestilence attacking lung syndrome, and the inhibition rates were 59.01% and 47.72%, respectively. Compared with the model control group, the high and low doses of Compound Qinlan Oral Liquid significantly reduced lung tissue viral load(P<0.01), increased cross blood CD4~+ T lymphocytes, CD8~+ T lymphocytes and total B lymphocyte percentage(P<0.01), reduced serum motilin content(P<0.01), reduced IL-6, IL-10, TNF-α and IFN-Î³ levels in lungs(P<0.01) and reduced lung tissue inflammation. Compound Qinlan Oral Liquid has a better effect on the mouse model with combining disease with syndrome of human coronavirus pneumonia with pestilence attacking lung syndrome, which may attribute to its function of in virus replication inhibition, gastrointestinal function improvement, immunity enhancement, and inflammatory factor reduction.


title: Korean clinical practice guidelines for preventing transmission of coronavirus disease 2019 (COVID-19) in hemodialysis facilities

text: Coronavirus disease 2019 (COVID-19) is a highly contagious viral disease that is caused by the novel virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). COVID-19 has become pandemic since December 2019, when the first case developed in Wuhan, China. Patients receiving hemodialysis are more vulnerable to viral transmission because their immune functions are impaired and they receive treatment within a narrow space. Calling on previous experience with Middle East Respiratory Syndrome during the 2015 outbreak, the joint committee of the Korean Society of Nephrology and the Korean Society of Dialysis Therapy quickly formed a COVID-19 task force team to develop a manual before the first index case was diagnosed in the hemodialysis unit. This special article introduces clinical practice guidelines to prevent secondary transmission of COVID-19 within hemodialysis facilities, which were developed to protect patients, healthcare workers, and caregivers from this highly transmissible virus. The areas of infection control covered by these guidelines include standard precautions, performing dialysis therapy for confirmed or suspected cases, performing cohort isolation for contact patients, and disease monitoring and contact surveillance. We hope these guidelines help healthcare workers and hemodialysis patients around the world cope with the COVID-19 pandemic.


COVID-19: A Chimera of Two Pandemics


title: How Big Data and Artificial Intelligence Can Help Better Manage the COVID-19 Pandemic

text: SARS-CoV2 is a novel coronavirus, responsible for the COVID-19 pandemic declared by the World Health Organization. Thanks to the latest advancements in the field of molecular and computational techniques and information and communication technologies (ICTs), artificial intelligence (AI) and Big Data can help in handling the huge, unprecedented amount of data derived from public health surveillance, real-time epidemic outbreaks monitoring, trend now-casting/forecasting, regular situation briefing and updating from governmental institutions and organisms, and health facility utilization information. The present review is aimed at overviewing the potential applications of AI and Big Data in the global effort to manage the pandemic.


The C-Cube: an endoscopic solution in the time of COVID-19


Why Fibrinolytic Therapy for ST-Segment-Elevation Myocardial Infarction in the COVID-19 Pandemic Is Not Your New Best Friend


title: CT Scans of Patients with 2019 Novel Coronavirus (COVID-19) Pneumonia

text: Rationale: The increasing speed of confirmed 2019 novel coronavirus (COVID-19) cases is striking in China. The purpose of this study is to summarize the outcomes of patients with novel COVID-19 pneumonia (NCP) at our institution. Methods: In this single-center study, we retrospectively included 118 cases of NCP, from January 16, 2020 to February 4, 2020. The clinical outcomes were monitored up to February 11, 2020. The outcomes of NCP patients were phase summarized at our institution. Three kinds of responses to clinical treatment were defined and evaluated: 1) good, symptoms continually improved; 2) fair, symptoms not improved or relapsed; 3) poor, symptoms aggravated. The risk factors, including basal clinical characteristics, CT imaging features, and follow-up CT changes (no change, progress, and improvement) related to poor/fair outcomes, were also investigated. Results: Six patients were improved to no-emergency type, 2 remained the same, and 2 progressed to fatal type. Besides, 13 patients progressed from the common type group to the emergency group (3 in fatal type and 10 in severe type). Forty-two (35.6%) patients were discharged with a median hospital stay of 9.5 days (range, 4.0-15.0 days). Thus, the numbers in different responses were, 73 patients in good response group (4 emergency cases, 69 no-emergency cases), 28 in fair response group (3 emergency cases, 25 no-emergency cases), and 17 in poor response group (3 emergency cases, 14 no-emergency cases). No patient has died in our hospital to date. The median duration of progress observed from CT scans was 6 days (range, 2-14 days). The progression in abnormal imaging findings indicate a poor/fair response, whereas the alleviated symptoms seen from CT suggest a good response. Conclusion: Most cases are no-emergency type and have a favorable response to clinical treatment. Follow-up CT changes during the treatment can help evaluate the treatment response of patients with NCP.


title: Older Workers on the COVID-19-Frontlines without Paid Sick Leave

text: The rapid spread of COVID-19 has left many workers around the world - workers in food distribution, truckers, janitors, and home and personal health care workers - deeply concerned about contracting the virus from exposure at work. In particular, older workers in frontline occupations are vulnerable to illness and to the deadly and debilitating effects of COVID-19, especially with inadequate protective gear and inadequate sick leave. In the absence of strong unions, which ensure that employers provide workers with accurate information, robust training, adequate equipment, and paid leave in the event of quarantines or illness, the COVID-19 pandemic highlights the need for additional legislation to shore up worker protections and provide paid sick leave.


The Impact of the COVID-19 Pandemic on Disabled and Hospice Home Care Patients


title: A Spatiotemporal Epidemic Model to Quantify the Effects of Contact Tracing, Testing, and Containment

text: Motivated by the current COVID-19 outbreak, we introduce a novel epidemic model based on marked temporal point processes that is specifically designed to make fine-grained spatiotemporal predictions about the course of the disease in a population. Our model can make use and benefit from data gathered by a variety of contact tracing technologies and it can quantify the effects that different testing and tracing strategies, social distancing measures, and business restrictions may have on the course of the disease. Building on our model, we use Bayesian optimization to estimate the risk of exposure of each individual at the sites they visit, the percentage of symptomatic individuals, and the difference in transmission rate between asymptomatic and symptomatic individuals from historical longitudinal testing data. Experiments using real COVID-19 data and mobility patterns from T\"{u}bingen, a town in the southwest of Germany, demonstrate that our model can be used to quantify the effects of tracing, testing, and containment strategies at an unprecedented spatiotemporal resolution. To facilitate research and informed policy-making, particularly in the context of the current COVID-19 outbreak, we are releasing an open-source implementation of our framework at https://github.com/covid19-model.


title: Türk Kardiyoloji Dernegi Uzlasi Raporu: COVID-19 Pandemisi ve Kardiyovasküler Hastaliklar Konusunda Bilinmesi Gerekenler (25 Mart 2020)./ [Consensus Report from Turkish Society of Cardiology: COVID-19 and Cardiovascular Diseases. What cardiologists should know. (25th March 2020)]

text: In December 2019, in the city of Wuhan, in the Hubei province of China, treatment-resistant cases of pneumonia emerged and spread rapidly for reasons unknown. A new strain of coronavirus (severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]) was identified and caused the first pandemic of the 21st century. The virus was officially detected in our country on March 11, 2020, and the number of cases increased rapidly; the virus was isolated in 670 patients within 10 days. The rapid increase in the number of patients has required our physicians to learn to protect both the public and themselves when treating patients with this highly infectious disease. The group most affected by the outbreak and with the highest mortality rate is elderly patients with known cardiovascular disease. Therefore, it is necessary for cardiology specialists to take an active role in combating the epidemic. The aim of this article is to make a brief assessment of current information regarding the management of cardiovascular patients affected by COVID-19 and to provide practical suggestions to cardiology specialists about problems and questions they have frequently encountered.


Europe's migrant containment policies threaten the response to covid-19


Coronavirus disease 2019 and Pneumocystis jirovecii pneumonia: a diagnostic dilemma in HIV


Obesity is Associated with Severe Forms of COVID-19


COVID-19 update: Covid-19-associated coagulopathy


title: Comparing the analytical performance of three SARS-CoV-2 molecular diagnostic assays

text: In December 2019, a novel coronavirus (SARS-CoV-2) was first isolated from Wuhan city, China and within three months, the global community was challenged with a devastating pandemic. The rapid spread of the virus challenged diagnostic laboratories to rapidly develop molecular diagnostic methods. As SARS CoV-2 assays became available for testing on existing molecular platforms, laboratories devoted unprecedented energy and resources into evaluating the analytical performance of the new tests and in some cases developed their own diagnostic assays under FDA-EUA guidance. This study compares the validation of three different molecular assays at the Johns Hopkins Molecular Virology laboratory: the RealStar® SARS-CoV-2 RT-PCR, ePlex® SARS-CoV-2, and the CDC COVID-19 RT-PCR tests. Overall, our studies indicate a comparable analytical performance of the three assays for the detection of SARS-CoV-2.


COVID-19 and the eye


title: Towards Seamless Authentication for Zoom-Based Online Teaching and Meeting

text: The lockdowns and travel restrictions in current coronavirus pandemic situation has replaced face-to-face teaching and meeting with online teaching and meeting. Recently, the video conferencing tool Zoom has become extremely popular for its simple-to-use feature and low network bandwith requirement. However, Zoom has serious security and privacy issues. Due to weak authentication mechanisms, unauthorized persons are invading Zoom sessions and creating disturbances (known as Zoom bombing). In this paper, we propose a preliminary work towards a seamless authentication mechanism for Zoom-based teaching and meeting. Our method is based on PRNU (Photo Response Non Uniformity)-based camera authentication, which can authenticate the camera of a device used in a Zoom meeting without requiring any assistance from the participants (e.g., needing the participant to provide biometric). Results from a small-scale experiment validates the proposed method.


title: Outcome of Oncology Patients Infected With Coronavirus

text: PURPOSE: This study investigated the features of oncology patients with confirmed Middle East respiratory syndrome (MERS) at the Ministry of National Guard Health Affairs-Riyadh during the outbreak of June 2015 to determine the clinical course and outcome of affected patients. METHODS: The patients' demographic information, cancer history, treatment pattern, information about MERS-coronavirus (CoV) infection, history of travel, clinical symptoms, test results, and outcome were collected and analyzed as part of a quality improvement project to improve the care and safety of our patients. Only patients with confirmed infection were included. RESULTS: A total of 19 patients were identified, with a median age of 66 years (range, 16-88 years), and 12 patients (63%) were males. The most common underlying disease was hematologic malignancies (47.4%), followed by colorectal cancer (21%) and lung cancer (15.8%). Hypertension and diabetes mellitus were the most common comorbidities (57.9% and 52.6%, respectively). Infection was diagnosed by nasopharyngeal swab in all patients. All patients contracted the infection during their hospitalization for other reasons. Sixteen patients (80%) were admitted to the intensive care unit; 13 patients (81%) had acute respiratory distress syndrome, 11 were intubated (68.75%), 9 had acute renal injury (56.25%), and 3 required dialysis (18.75%). Only 3 patients (15.8%) with early-stage cancers survived. Patients with hematologic malignancies and advanced solid tumors had a 100% case fatality rate. The majority of the causes of death were due to multi-organ failure and septic shock. CONCLUSION: MERS-CoV infection resulted in a high case fatality rate in patients with malignancy. Therefore, it is critical to implement effective primary preventive measures to avoid exposure of patients with cancer to the virus.


Implications for Design and Analyses of Oncology Clinical Trials During the COVID-19 Pandemic


No double-edged sword and no doubt about the relation between smoking and COVID-19 severity


title: COVID-19-associated pneumomediastinum

text: A case is presented highlighting the emerging association of COVID-19 with pneumomediastinum, even in patients who have never received mechanical ventilation or positive airway pressure.


Use of antiviral drugs to reduce COVID-19 transmission


title: Evaluation of the COVID19 ID NOW EUA assay

text: BACKGROUND: The SARS-CoV-2 pandemic caused a major surge in needed diagnostic capacity. In response, many EUA assays have become available for clinical laboratories, and more recently, the point of care device, Abbott ID NOW. OBJECTIVES: To determine the analytical performance of the ID NOW assay for detecting SARS-CoV-2. STUDY DESIGN: Residual NP samples collected in viral transport media were tested by the ID NOW platform in two independent laboratories. Results were compared to either the CDC or New York EUA assays, which served as reference methods. RESULTS: Overall agreement of ID NOW was 78.7%. Sensitivity was 71.7% and specificity was 100%. Notably, all false-negative results correlated to those samples that were weakly positive. CONCLUSIONS: ID NOW performs well for strong and moderately positive samples but has reduced sensitivity for weakly positive samples. This sensitivity, among other concerns, should be taken into consideration when using this test for patients with a low suspicion for COVID-19 disease.


Tromboembolismo pulmonar y COVID-19: un cambio de paradigma./ Tromboembolismo pulmonar y COVID-19: un cambio de paradigma./ Pulmonary embolism and COVID-19: A paradigm change


Coronavirus disease 2019 is delaying the diagnosis and management of chest pain, acute coronary syndromes, myocarditis and heart failure


title: Perspectives of patients with rheumatic diseases in the early phase of COVID-19

text: OBJECTIVE: To determine health perceptions of patients with rheumatic diseases in the early phase of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Rheumatology patients at a single centre received via text message the national Rheumatology Association COVID-19 information sheet and an invitation to participate in a de-identified survey. Patient concerns regarding risks conferred by their rheumatological disease or medications, impact of receiving the information sheet on the likelihood of staying on medication, and acceptance of telehealth, were ascertained. RESULTS: 2,630 patients received the message and the survey response rate was 21% (n=550). Mean (±SD) age was 52 (±15.2) years and 75% were female. Participants' highest ranked concern was that their medications would increase their severity of COVID-19 (76.1%). The highest levels of concern were seen in patients on combination conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and/or a biologic/targeted synthetic disease-modifying anti-rheumatic drug (b/tsDMARD). There was no association between prednisolone dose and concern. While 63% of patients planned to continue their anti-rheumatic medications, a further 30% were more likely to stay on their medications as a result of receiving the information. Telehealth was acceptable to 98.4% of patients, but 28.1% felt this was only appropriate while infection control measures were in place. CONCLUSION: Concerns regarding the risk of COVID-19 among patients on anti-rheumatic drugs are common. Proactive dissemination of information is needed to address misconceptions relating to medication risk, improve medication adherence and minimise the risk of flares. Telehealth is acceptable to a majority of patients during the COVID-19 pandemic.


docid: qxwtggpz

title: Co-infections in COVID-19 critically ill and antibiotic management: a prospective cohort analysis


COVID-19 Infection Among Medical Staff in Wuhan: A Retrospective Study From a Single Center


title: Produção e caracterização físico-química e microbiológica da geleia de jambo vermelho (Syzygium malaccense)

text: Por possuir um sabor adocicado suavemente ácido, o Syzygium malaccense Merr. & Perry é muito consumido e apreciado pela população. Por esse motivo, objetivou-se neste estudo a produção da geleia de jambo, com o intuito de avaliar se a geleia manterá as características fisico-químicas e nutricionais presentes no jambo vermelho in natura, além de verificar sua conformidade com os padrões microbiológicos vigentes. A geleia foi produzida a partir de 800g de polpa de jambo adicionados a 400 mL de água potável sob aquecimento por 40 minutos. Após a peneiração, ao filtrado foram adicionados 275 g de açúcar e 5 mL de ácido cítrico e aquecido por mais 20 minutos até alcançar a consistência desejada. Foram realizadas as determinações de proteínas, lipídios, cinzas, umidade, carboidratos e valor calórico. O doseamento de antocianinas e flavonoides foi utilizado por meio do método descrito por Francis (1982). A geleia apresentou menor porcentagem de umidade (57,5±0,35), proteínas (2,39±0,2), cinzas (0,33±0,03) e lipídios (0,49±0,00), e maior porcentagem de carboidratos (39,29±0,42) quando comparados ao jambo in natura que teve umidade de 91,07±0,22, proteínas de 2,41±0,19, cinzas 0,42±0,07, lipídios 1,12±0,05 e carboidratos 4,97±0,22. Observou-se também que, após o processo de produção da geleia, houve aumento nos percentuais de flavonóides (26,4±0,7) e antocianinas (29±0,78) quando comparado ao fruto in natura que teve antocianinas de 19,37±4,82 e flavonoides de 11,30±3,73. Quanto aos padrões microbiológicos, a geleia de jambo vermelho estava de acordo com os padrões microbiológicos para geleia de frutas determinados pela ANVISA, estando apta para o consumo.(AU)


Psoriasis and risk of the COVID-19: is there a role for angiotensin converting enzyme (ACE)?


title: A Guide for Oncologic Patient Management during Covid-19 Pandemic: The Initial Experience of an Italian Oncologic Hub with Exemplificative Focus on Uro-Oncologic Patients

text: The recent exponential increase in the number of COVID-19 patients in Italy led to the adoption of specific extraordinary measures, such as the need to convey treatment of all non-deferrable cancer patients to specialized centres (hubs). We reported a comprehensive summary of guidelines to create and run an oncologic hub during the COVID-19 pandemic. Oncologic hubs must fulfil some specific requirements such as a high experience in oncologic patient treatment, strict strategies applied to remain a "COVID-19-free" centre, and the creation of a dedicated multidisciplinary "hub team". Cancer treatment of patients who belong to external centres, namely spoke centres, could be organized in different pathways according to the grade of involvement and/or availability of the medical team of the spoke centre. Moreover, dedicated areas should be created for the management and treatment of patients who developed COVID-19 symptoms after hospitalization (i.e., dedicated wards, operation rooms and intensive care beds). Lastly, hospital staff must be highly trained for both preventing COVID-19 contagion and treating patients who develop the infection. We provided a simplified, but complete and easily applicable guide. We believe that this guide could help those clinicians who have to treat oncologic patients during the COVID-19 pandemic.


title: Ten-Year Research Update Review: Antiviral Activities from Marine Organisms

text: Oceans cover more than 70 percent of the surface of our planet and are characterized by huge taxonomic and chemical diversity of marine organisms. Several studies have shown that marine organisms produce a variety of compounds, derived from primary or secondary metabolism, which may have antiviral activities. In particular, certain marine metabolites are active towards a plethora of viruses. Multiple mechanisms of action have been found, as well as different targets. This review gives an overview of the marine-derived compounds discovered in the last 10 years. Even if marine organisms produce a wide variety of different compounds, there is only one compound available on the market, Ara-A, and only another one is in phase I clinical trials, named Griffithsin. The recent pandemic emergency caused by SARS-CoV-2, also known as COVID-19, highlights the need to further invest in this field, in order to shed light on marine compound potentiality and discover new drugs from the sea.


Orthopaedics in Times of COVID 19


So far so close: an insight into smart working and telehealth reorganization of a Language and Learning Disorders Service in Milan during COVID-19 pandemic


Considerations for Assessing Risk of Provider Exposure to SARS-CoV-2 after a Negative Test


COVID-19, chronic inflammatory respiratory diseases and eosinophils-Observations from reported clinical case series