BACKGROUND: On 23rd March 2020, the UK government released self-isolation/social distancing guidance to reduce the risk of transmission of SARS-CoV-2. The influence such guidance has on sexual activity is not known. AIM: To investigate levels and correlates of sexual activity during COVID-19 self-isolation/social distancing in a sample of the UK public. METHODS: This paper presents preplanned interim analyses of data from a cross-sectional epidemiological study, administered through an online survey. OUTCOMES: Sexual activity was measured using the following question: "On average after self-isolating how many times have you engaged in sexual activity weekly?" Demographic and clinical data were collected, including sex, age, marital status, employment, annual household income, region, current smoking status, current alcohol consumption, number of chronic physical conditions, number of chronic psychiatric conditions, any physical symptom experienced during self-isolation, and number of days of self-isolation/social distancing. The association between several factors (independent variables) and sexual activity (dependent variable) was studied using a multivariable logistic regression model. RESULTS: 868 individuals were included in this study. There were 63.1% of women, and 21.8% of adults who were aged between 25 and 34 years. During self-isolation/social distancing, 39.9% of the population reported engaging in sexual activity at least once per week. Variables significantly associated with sexual activity (dependent variable) were being male, a younger age, being married or in a domestic partnership, consuming alcohol, and a higher number of days of self-isolation/social distancing. CLINICAL IMPLICATIONS: In this sample of 868 UK adults self-isolating owing to the COVID-19 pandemic, the prevalence of sexual activity was lower than 40%. Those reporting particularly low levels of sexual activity included females, older adults, those not married, and those who abstain from alcohol consumption. STRENGTH AND LIMITATIONS: This is the first study to investigate sexual activity during the UK COVID-19 self-isolation/social distancing. Participants were asked to self-report their sexual activity potentially introducing self-reporting bias into the findings. Second, analyses were cross-sectional and thus it is not possible to determine trajectories of sexual activity during the current pandemic. CONCLUSION: Interventions to promote health and well-being during the COVID-19 pandemic should consider positive sexual health messages in mitigating the detrimental health consequences in relation to self-isolation/social distancing and should target those with the lowest levels of sexual activity. Jacob L, Smith L, Butler L, et al. Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United Kingdom. J Sex Med 2020;17:1229-1236.


title: Estimating the COVID-19 Infection Rate: Anatomy of an Inference Problem

text: As a consequence of missing data on tests for infection and imperfect accuracy of tests, reported rates of population infection by the SARS CoV-2 virus are lower than actual rates of infection. Hence, reported rates of severe illness conditional on infection are higher than actual rates. Understanding the time path of the COVID-19 pandemic has been hampered by the absence of bounds on infection rates that are credible and informative. This paper explains the logical problem of bounding these rates and reports illustrative findings, using data from Illinois, New York, and Italy. We combine the data with assumptions on the infection rate in the untested population and on the accuracy of the tests that appear credible in the current context. We find that the infection rate might be substantially higher than reported. We also find that the infection fatality rate in Italy is substantially lower than reported.


title: The effectiveness of contact tracing in heterogeneous networks

text: Case isolation and contact tracing is a widely-used intervention method for controlling epidemic outbreaks. Here, we argue that the effectiveness of contact tracing and isolation is likely underestimated by existing studies because they do not take into account the different forms of heterogeneity and sampling biases from the network structure. Specifically, we show that contact tracing can be even more effective than acquaintance sampling at locating hubs. Our results call for the need for contact tracing to go both backward and forward, in multiple steps, to leverage all forms of positive biases. Using simulations on networks with a power-law degree distribution, we show that this deep contact tracing can potentially prevent almost all further transmissions even at a small probability of detecting infected individuals. We also show that, when the number of traced contacts is small, the number of prevented transmission per traced node is even higher---although most traced individuals are healthy---than that from case isolation without contact tracing. Our results also have important consequences for new implementations of digital contact tracing and we argue backward and deep tracing can be incorporated without the important sacrificing privacy-preserving requirements of these new platforms.


Editorial: COVID-19: an opportunity to lead


title: Smoking Upregulates Angiotensin-Converting Enzyme-2 Receptor: A Potential Adhesion Site for Novel Coronavirus SARS-CoV-2 (Covid-19)

text: The epicenter of the original outbreak in China has high male smoking rates of around 50%, and early reported death rates have an emphasis on older males, therefore the likelihood of smokers being overrepresented in fatalities is high. In Iran, China, Italy, and South Korea, female smoking rates are much lower than males. Fewer females have contracted the virus. If this analysis is correct, then Indonesia would be expected to begin experiencing high rates of Covid-19 because its male smoking rate is over 60% (Tobacco Atlas). Smokers are vulnerable to respiratory viruses. Smoking can upregulate angiotensin-converting enzyme-2 (ACE2) receptor, the known receptor for both the severe acute respiratory syndrome (SARS)-coronavirus (SARS-CoV) and the human respiratory coronavirus NL638. This could also be true for new electronic smoking devices such as electronic cigarettes and "heat-not-burn" IQOS devices. ACE2 could be a novel adhesion molecule for SARS-CoV-2 causing Covid-19 and a potential therapeutic target for the prevention of fatal microbial infections, and therefore it should be fast tracked and prioritized for research and investigation. Data on smoking status should be collected on all identified cases of Covid-19.


COVID-19 exposes health worker shortages in the USA and UK, but nationalism and self-interest must not exploit medical workforces from low- and middle-income countries


Follow-Up Information About the Four Pregnant Patients With Coronavirus Disease (COVID-19) Pneumonia Who Were Still in the Hospital at the End of Our Study


Consensus statement for the management of acute coronary syndromes and the covid-19 pandemic.: Report of the ischemic heart disease committee. fac


Cerebral venous thrombosis associated with coronavirus infection: an underestimated entity?


title: Going to War on Covid19: Mobilizing an Academic Nephrology Group Practice

text: AIMS: The COVID-19 pandemic poses unprecedented operational challenges to nephrology divisions in every country as they cope with COVID-19-related kidney disease in addition to regular patient care. Although general approaches have been proposed, there is a lack of practical guidance for nephrology division response in a hospital facing a surge of cases. Here, we describe the specific measures that our division has taken in the hope that our experience in Singapore may be helpful to others METHODS: Descriptive narrative RESULTS: A compilation of operational responses to the COVID-19 pandemic taken by a nephrology division at a Singapore university hospital CONCLUSION: Nephrology operational readiness for COVID-19 requires a clinical mindset shift from usual standard of care to a crisis exigency model that targets best outcomes for available resources. Rapid multi-disciplinary efforts that evolve flexibly with the local dynamics of the outbreak are required. This article is protected by copyright. All rights reserved.


Managing patients with chronic pain during the COVID-19 outbreak: considerations for the rapid introduction of remotely supported (eHealth) pain management services


title: Dual-Functional Plasmonic Photothermal Biosensors for Highly Accurate Severe Acute Respiratory Syndrome Coronavirus 2 Detection

text: The ongoing outbreak of the novel coronavirus disease (COVID-19) has spread globally and poses a threat to public health in more than 200 countries. Reliable laboratory diagnosis of the disease has been one of the foremost priorities for promoting public health interventions. The routinely used reverse transcription polymerase chain reaction (RT-PCR) is currently the reference method for COVID-19 diagnosis. However, it also reported a number of false-positive or -negative cases, especially in the early stages of the novel virus outbreak. In this work, a dual-functional plasmonic biosensor combining the plasmonic photothermal (PPT) effect and localized surface plasmon resonance (LSPR) sensing transduction provides an alternative and promising solution for the clinical COVID-19 diagnosis. The two-dimensional gold nanoislands (AuNIs) functionalized with complementary DNA receptors can perform a sensitive detection of the selected sequences from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through nucleic acid hybridization. For better sensing performance, the thermoplasmonic heat is generated on the same AuNIs chip when illuminated at their plasmonic resonance frequency. The localized PPT heat is capable to elevate the in situ hybridization temperature and facilitate the accurate discrimination of two similar gene sequences. Our dual-functional LSPR biosensor exhibits a high sensitivity toward the selected SARS-CoV-2 sequences with a lower detection limit down to the concentration of 0.22 pM and allows precise detection of the specific target in a multigene mixture. This study gains insight into the thermoplasmonic enhancement and its applicability in the nucleic acid tests and viral disease diagnosis.


A treatment strategy for acute myocardial infarction and personal protection for medical staff during the COVID-19 epidemic: the Chinese experience


title: New type of corona virus induced acute otitis media in adult

text: Since late December 2019, a new type of coronavirus (CIVID-19) causing a cluster of respiratory infections was first identified in Wuhan-China. And it disseminated to all countries. Generally, COVID-19 cases have fever, cough, respiratory distress findings (dyspnoea, intercostal retraction, cyanosis etc.). In this paper, we have presented an adult otitis media case whom infected with COVID-19, but she have not any classical COVID-19 symptoms.


The Consequences of Ageist Language are upon us


title: Maximizing the Calm before the Storm: Tiered Surgical Response Plan for Novel Coronavirus (COVID-19)

text: The novel coronavirus (COVID-19) was first diagnosed in Wuhan, China in December 2019 and has now spread throughout the world, being verified by the World Health Organization as a pandemic on March 11. This had led to the calling of a national emergency on March 13 in the US. Many hospitals, healthcare networks, and specifically, departments of surgery, are asking the same questions about how to cope and plan for surge capacity, personnel attrition, novel infrastructure utilization, and resource exhaustion. Herein, we present a tiered plan for surgical department planning based on incident command levels. This includes acute care surgeon deployment (given their critical care training and vertically integrated position in the hospital), recommended infrastructure and transfer utilization, triage principles, and faculty, resident, and advanced care practitioner deployment.


Effect of recombinant human granulocyte colony-stimulating factor on lymphocyte subsets in patients with COVID-19


COVID-19: A personal perspective


docid: erddcuvg

title: How behavioural science data helps mitigate the COVID-19 crisis


title: Hyperbaric oxygen therapy may be effective to improve hypoxemia in patients with severe COVID-2019 pneumonia: two case reports

text: Objectives: To determine whether hyperbaric oxygen (HBO2) therapy be effective to improve hypoxemia for severe COVID-19 pneumonia patients Methods: Two male patients ages 57 and 64 years old were treated Each met at least one of the following criteria: shortness of breath;respiratory rate (RR) >/=30 breaths/minute;finger pulse oxygen saturation (SpO2) </=93% at rest;and oxygen index (P/F ratio: PaO2/FiO2 </=300 mmHg) Each case excluded any combination with pneumothorax, pulmonary bullae or other absolute contraindications to HBO2 Patients were treated with 1 5 atmospheres absolute HBO2 with an oxygen concentration of more than 95% for 60 minutes per treatment, once a day for one week Patients' self-reported symptoms, daily mean SpO2 (SO2), arterial blood gas analysis, D-dimer, lymphocyte, cholinesterase (che) and chest CT were conducted and measured Results: For both patients, dyspnea and shortness of breath were immediately alleviated after the first HBO2 treatment and remarkably relieved after seven days of HBO2 therapy The RR also decreased daily Neither patient became critically ill The decreasing trend of SO2 and P/F ratio was immediately reversed and increased day by day The lymphocyte count and ratio corresponding to immune function gradually recovered D-dimer corresponding to peripheral circulation disorders and serum cholinesterase, reflecting liver function had improved Follow-up chest CT showed that the pulmonary inflammation had clearly subsided Conclusion: Our preliminary uncontrolled case reports suggest that HBO2 therapy may promptly improve the progressive hypoxemia of patients with COVID-2019 pneumonia However, the limited sample size and study design preclude a definitive statement about the potential effectiveness of HBO2 therapy to COVID-2019 pneumonia It requires evaluation in randomized clinical trials in future


title: Simple Economical Solution for Personal Protection Equipment (Face Mask/Shield) for Health Care Staff During COVID 19

text: Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. It has taken a toll of lots of lives since its outbreak. Infection prevention at present is an appropriate control measure in addition to other measure like hand hygiene and personal protective equipment (PPE). In our country with a large population, supplying PPE to all the health care workers of all hospitals definitely is an economic burden. Hence we have come up with an economic and simple solution for face mask.


title: The use of ibuprofen to treat fever in COVID-19: A possible indirect association with worse outcome?

text: Fever has been reported as a common symptom occurring in COVID-19 illness. Over the counter antipyretics such as ibuprofen and acetaminophen are often taken by individuals to reduce the discomfort of fever. Recently, the safety of ibuprofen in COVID-19 patients has been questioned due to anecdotal reports of worsening symptoms in previously healthy young adults. Studies show that ibuprofen demonstrates superior efficacy in fever reduction compared to acetaminophen. As fever may have benefit in shortening the duration of viral illness, it is plausible to hypothesize that the antipyretic efficacy of ibuprofen may be hindering the benefits of a fever response when taken during the early stages of COVID-19 illness.


title: The effect of adaptive mobility policy to the spread of COVID-19 in urban environment: intervention analysis of Seoul, South Korea

text: Although severe mobility restrictions are recognized as the key enabler to contain COVID-19, there has been few scientific studies to validate such approach, especially in urban context. This study analyzes mobility pattern changes in Seoul, South Korea that adopted adaptive approach toward mobility. Intervention analyses reveal that major mobility reduction did occur two weeks before the city's case peak. Such voluntary adjustments exhibit strong preference shift toward private mode from public transit. Large reductions occurred in non-essential and high-contact activities of shopping and dining, while work and Starbucks trips were less affected. The collective evaluation reveal that major changes in epidemiology, mobility and policy occurred simultaneously, with no lagging nor leading contributors. Our study demonstrates that collective understanding the mutual aspects among mobility, epidemiology and policy is essential. Incremental and flexible mobility restriction is not only possible but necessary, especially for a pandemic of extensive spatial and temporal scales.


Resposta imediata da Vigilância em Saúde à epidemia da COVID-19./ Resposta imediata da Vigilância em Saúde à epidemia da COVID-19./ Immediate Health Surveillance Response to COVID-19 Epidemic


title: [Editorial] Possibility of transmission through dogs being a contributing factor to the extreme Covid19 outbreak in North Italy

text: Covid19 origin and transmission to humans. Covid19 infection began in Wuhan (Hubei, China) in December, 2019. Although to date it is considered that Covid19 originates from bats (96.2% overall genome sequence identity) (1), the type of intermediate animals that caused the transmission to humans remains unknown (2-4). Zhou et al (1) mentioned that 'Direct contact with intermediate host animals or consumption of wild animals was suspected to be the main route of SARSCoV2 transmission. However, the source(s) and transmission routine(s) of SARSCoV2 remain elusive' (1).


title: Molecular epidemiology of SARS-CoV-2 in Faisalabad, Pakistan: A real-world clinical experience

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-2019 is a new global health challenge which causes severe respiratory complications. As of May 17th, 2020, SARS-CoV-2 has infected 4.6 million people and caused 310,000 deaths, worldwide. In order to study potential impact of infection, complete epidemiological information should be reported on regular basis however, data from Pakistan has not yet been published. This retrospective study is the first report of epidemiological trends of COVID-19 in Faisalabad, Pakistan. On April 4th, 2020, 128 nasopharyngeal swabs collected from city Faisalabad were transported to Postgraduate Research Institute, Lahore for further processing. RNA was extracted using QIAsymphony DSP Virus/Pathogen Midi Kit and real-time PCR was performed to quantify COVID-19. Our finding showed that overall prevalence of COVID-19 in Faisalabad on April 4th was 17.18% (22 of 128). Prevalence was higher in males (n = 17; 77.2%) as compared to females (n = 5; 22.8%) but this gender-wise difference was not statistically significant. Patients belonging to age group 37-47 years were found to be most (45.5%) infected with COVID-19.


title: Combating COVID-19 with Mesenchymal Stem Cell therapy

text: The COVID-19 disease is caused by a positive stranded RNA virus called SARS-CoV-2. The virus mainly targets the pulmonary epithelial cells as it's initial site of infection by letting its surface spike protein interact and bind to the host ACE2 receptor. The internalization and gradual replication of the virus results in an exaggerated immune response triggering release of many pro-inflammatory cytokines and chemokines. This immune storm is responsible for multiple health hazards in the host ultimately leading to multiple organ failure. Mesenchymal stem cell therapy offers a promising approach towards mitigating the delirious effects of the infection in the COVID-19 patients. This therapy has shown to reduce the expression of pro-inflammatory cytokines as well as repair of damaged tissues in COVID-19 patients. This review has been organized to put forward the positive aruments and implications in support of mesenchymal stem cell therapy as a necessary approach for treating COVID-19 patients.


Fellowship in the Time of Coronavirus Disease 2019 (COVID-19): A Time to Adapt


title: Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China

text: BACKGROUND: Studies have reminded that cardiovascular metabolic comorbidities made patients more susceptible to suffer 2019 novel corona virus (2019-nCoV) disease (COVID-19), and exacerbated the infection. The aim of this analysis is to determine the association of cardiovascular metabolic diseases with the development of COVID-19. METHODS: A meta-analysis of eligible studies that summarized the prevalence of cardiovascular metabolic diseases in COVID-19 and compared the incidences of the comorbidities in ICU/severe and non-ICU/severe patients was performed. Embase and PubMed were searched for relevant studies. RESULTS: A total of six studies with 1527 patients were included in this analysis. The proportions of hypertension, cardia-cerebrovascular disease and diabetes in patients with COVID-19 were 17.1%, 16.4% and 9.7%, respectively. The incidences of hypertension, cardia-cerebrovascular diseases and diabetes were about twofolds, threefolds and twofolds, respectively, higher in ICU/severe cases than in their non-ICU/severe counterparts. At least 8.0% patients with COVID-19 suffered the acute cardiac injury. The incidence of acute cardiac injury was about 13 folds higher in ICU/severe patients compared with the non-ICU/severe patients. CONCLUSION: Patients with previous cardiovascular metabolic diseases may face a greater risk of developing into the severe condition and the comorbidities can also greatly affect the prognosis of the COVID-19. On the other hand, COVID-19 can, in turn, aggravate the damage to the heart.


title: Clinical characteristics and risk assessment of newborns born to mothers with COVID-19

text: BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is causing an outbreak of pneumonia in Wuhan, Hubei Province, China, and other international areas. OBJECTIVE: Here, we report the clinical characteristics of the newborns delivered by SARS-CoV-2 infected pregnant women. METHODS: We prospectively collected and analyzed the clinical features, laboratory data and outcomes of 7 newborns delivered by SARS-CoV-2 infected pregnant women in Zhongnan Hospital of Wuhan University during January 20 to January 29, 2020. RESULTS: 4 of the 7 newborns were late preterm with gestational age between 36 weeks and 37 weeks, and the other 3 were full-term infants. The average birth weight was 2096 ± 660 g. All newborns were born without asphyxia. 2 premature infants performed mild grunting after birth, but relieved rapidly with non-invasive continuous positive airway pressure (nCPAP) ventilation. 3 cases had chest X-ray, 1 was normal and 2 who were supported by nCPAP presented mild neonatal respiratory distress syndrome (NRDS). Samples of pharyngeal swab in 6 cases, amniotic fluid and umbilical cord blood in 4 cases were tested by qRT-PCR, and there was no positive result of SARS-CoV-2 nucleic acid in all cases. CONCLUSIONS: The current data show that the infection of SARS-CoV-2 in late pregnant women does not cause adverse outcomes in their newborns, however, it is necessary to separate newborns from mothers immediately to avoid the potential threats.


COVID-19, Clinical Trials, and QT-Prolonging Prophylactic Therapy in Healthy Subjects: First, Do No Harm


Recommendations to the government following the declaration of COVID-19 pandemic


docid: hxicmwis

title: Checkpoint inhibitor pneumonitis mimicking COVID-19 infection during the COVID-19 pandemic


title: Guidance on Short-Term Management of Atrial Fibrillation in Coronavirus Disease 2019

text: Atrial fibrillation is a common clinical manifestation in hospitalized patients with coronavirus disease 2019 (COVID-19). Medications used to treat atrial fibrillation, such as antiarrhythmic drugs and anticoagulants, may have significant drug interactions with emerging COVID-19 treatments. Common unintended nontherapeutic target effects of COVID-19 treatment include potassium channel blockade, cytochrome P 450 isoenzyme inhibition or activation, and P-glycoprotein inhibition. Drug-drug interactions with antiarrhythmic drugs and anticoagulants in these patients may lead to significant bradycardia, ventricular arrhythmias, or severe bleeding. It is important for clinicians to be aware of these interactions, drug metabolism changes, and clinical consequences when choosing antiarrhythmic drugs and anticoagulants for COVID-19 patients with atrial fibrillation. The objective of this review is to provide a practical guide for clinicians who are managing COVID-19 patients with concomitant atrial fibrillation.


docid: kuqkbcek

title: An Ethical Framework for Allocating Scarce Inpatient Medications for COVID-19 in the US


docid: budjcbej

title: Two linear epitopes on the SARS-CoV-2 spike protein that elicit neutralising antibodies in COVID-19 patients

text: Given the ongoing SARS-CoV-2 pandemic, identification of immunogenic targets against the coronavirus spike glycoprotein will provide crucial advances towards the development of sensitive diagnostic tools and potential vaccine candidate targets. In this study, using pools of overlapping linear B-cell peptides, we report two IgG immunodominant regions on SARS-CoV-2 spike glycoprotein that are recognised by sera from COVID-19 convalescent patients. Notably, one is specific to SARS-CoV-2, which is located in close proximity to the receptor binding domain. The other region, which is localised at the fusion peptide, could potentially function as a pan-SARS target. Functionally, antibody depletion assays demonstrate that antibodies targeting these immunodominant regions significantly alter virus neutralisation capacities. Taken together, identification and validation of these neutralising B-cell epitopes will provide insights towards the design of diagnostics and vaccine candidates against this high priority coronavirus.


Surgery Scheduling in a Crisis


A call from the European Academy of Neurology on COVID-19


title: COVID-19 and neuromuscular disorders

text: The coronavirus 2019 (COVID-19) pandemic has potential to disproportionately and severely affect patients with neuromuscular disorders. In a short period of time, it has already caused reorganization of neuromuscular clinical care delivery and education, which will likely have lasting effects on the field. This article reviews (1) potential neuromuscular complications of COVID-19, (2) assessment and mitigation of COVID-19-related risk for patients with preexisting neuromuscular disease, (3) guidance for management of immunosuppressive and immunomodulatory therapies, (4) practical guidance regarding neuromuscular care delivery, telemedicine, and education, and (5) effect on neuromuscular research. We outline key unanswered clinical questions and highlight the need for team-based and interspecialty collaboration. Primary goals of clinical research during this time are to develop evidence-based best practices and to minimize morbidity and mortality related to COVID-19 for patients with neuromuscular disorders.


title: Type I and III interferons disrupt lung epithelial repair during recovery from viral infection

text: Excessive cytokine signaling frequently exacerbates lung tissue damage during respiratory viral infection. Type I (IFN-α/ß) and III (IFN-λ) interferons are host-produced antiviral cytokines. Prolonged IFN-α/ß responses can lead to harmful proinflammatory effects, whereas IFN-λ mainly signals in epithelia, inducing localized antiviral immunity. Here we show that IFN signaling interferes with lung repair during influenza recovery, with IFN-λ driving these effects most potently. IFN-induced p53 directly reduces epithelial proliferation and differentiation, increasing disease severity, and susceptibility to bacterial superinfections. Thus, excessive or prolonged IFN-production aggravates viral infection by impairing lung epithelial regeneration. Therefore, timing and duration are critical parameters of endogenous IFN action and should be considered carefully for IFN therapeutic strategies against viral infections like influenza and coronavirus disease 2019 (COVID-19).


docid: shhkclam

title: Balanced diet is a major casualty in COVID-19


docid: oedadxeg

title: Personalized recovery of severe COVID19: Rehabilitation from the perspective of patient needs

text: After long term hospitalization or ICU treatment, COVID-19 patients are severe functionally impaired. They experience not only physical weakness but may also suffer from problems on the pulmonary, physical, psychosocial and cognitive domain. These domains interact and the impact on participation varies between patients. Therefore aftercare should be costumized to the patients individual needs. In this article we present a patient centered model to tailor treatment in the view of the Dutch health care system. This model can be helpful to determine the appropriate treatment for each patient at the right time in the right setting.


title: KGTK: A Toolkit for Large Knowledge Graph Manipulation and Analysis

text: Knowledge graphs (KGs) have become the preferred technology for representing, sharing and adding knowledge to modern AI applications. While KGs have become a mainstream technology, the RDF/SPARQL-centric toolset for operating with them at scale is heterogeneous, difficult to integrate and only covers a subset of the operations that are commonly needed in data science applications. In this paper, we present KGTK, a data science-centric toolkit to represent, create, transform, enhance and analyze KGs. KGTK represents graphs in tables and leverages popular libraries developed for data science applications, enabling a wide audience of developers to easily construct knowledge graph pipelines for their applications. We illustrate KGTK with real-world scenarios in which we have used KGTK to integrate and manipulate large KGs, such as Wikidata, DBpedia and ConceptNet, in our own work.


title: Standardized out-patient diagnosis and treatment process for osteoporosis clinics during the COVID-19 pandemic

text: Since the end of 2019, China and other regions around the world have been facing a pandemic of novel coronavirus pneumonia (COVID-19). The virus is highly transmissible, and the human population is generally susceptible. Most patients with osteoporosis are postmenopausal women or elderly people with hypoimmunity, so the osteoporosis clinic has become a new hotspot for corona virus infection. During the COVID-19 pandemic, it is necessary to establish standardized out-patient protocols to provide safe and effective treatment for osteoporosis patients and medical staff. In an osteoporosis clinic, we advocate the following suggestions to prevent and control osteoporosis during the pandemic period: (1) specialized diagnosis and treatment techniques for osteoporosis patients in the outpatient care, including enhancing the prevention for outpatient medical staff, strengthening awareness of COVID-19 prevention, strictly screening outpatients with COVID-19 infection, and insistent administration of anti-osteoporosis drugs during outbreaks; (2) home prevention for osteoporosis patients including keeping windows open, exposing them to sunlight, supplementing them with enough protein, exercising regularly, and administrating calcium supplements; and (3) simplifying the follow-up and evaluation of osteoporosis using online platforms.


title: The relationship between human mobility and viral transmissibility during the COVID-19 epidemics in Italy

text: We describe in this report our studies to understand the relationship between human mobility and the spreading of COVID-19, as an aid to manage the restart of the social and economic activities after the lockdown and monitor the epidemics in the coming weeks and months. We compare the evolution (from January to May 2020) of the daily mobility flows in Italy, measured by means of nation-wide mobile phone data, and the evolution of transmissibility, measured by the net reproduction number, i.e., the mean number of secondary infections generated by one primary infector in the presence of control interventions and human behavioural adaptations. We find a striking relationship between the negative variation of mobility flows and the net reproduction number, in all Italian regions, between March 11th and March 18th, when the country entered the lockdown. This observation allows us to quantify the time needed to"switch off"the country mobility (one week) and the time required to bring the net reproduction number below 1 (one week). A reasonably simple regression model provides evidence that the net reproduction number is correlated with a region's incoming, outgoing and internal mobility. We also find a strong relationship between the number of days above the epidemic threshold before the mobility flows reduce significantly as an effect of lockdowns, and the total number of confirmed SARS-CoV-2 infections per 100k inhabitants, thus indirectly showing the effectiveness of the lockdown and the other non-pharmaceutical interventions in the containment of the contagion. Our study demonstrates the value of"big"mobility data to the monitoring of key epidemic indicators to inform choices as the epidemics unfolds in the coming months.


COVID-19 and Orthopaedic Surgery: Experiences from Iran


title: Neurosurgery Services in Dr. Sardjito General Hospital, Yogyakarta, Indonesia, During the COVID-19 Pandemic: Experience from a Developing Country

text: BACKGROUND: Most articles describing the effect of the coronavirus disease 2019 (COVID-19) pandemic on neurosurgical services have been from developed countries. We report our experience in carrying out neurosurgical services at Dr. Sardjito General Hospital, Yogyakarta, Indonesia, during the time of the pandemic. METHODS: To collect information on the effect of the pandemic in Indonesia and Yogyakarta, we gathered data from the Indonesian Ministry of Health's online database for the national data and local government records for the local data (including records of Dr. Sardjito General Hospital Division of Neurosurgery). RESULTS: Compared with other countries, Indonesia has not been severely hit by the impact of COVID-19. To increase our understanding of the natural history of the pandemic, we divided the period into 4 phases: phase 1 (when there were confirmed cases in Indonesia but no cases in Yogyakarta), phase 2 (when the first case in Yogyakarta was detected), phase 3 (when the cumulative cases surpass their peak), and phase 4 (when the pandemic ends). At the time of this writing, we were still in phase 2 and in this phase, we experienced a decrease in the number of emergency surgical procedures, from an average of 4 to 2.4 per week. Moreover, the number of elective operations dropped from an average of 12 to 9 per week. CONCLUSIONS: A pandemic, such as COVID-19, reduces both inpatient and outpatient neurosurgical activities. A comprehensive plan can improve both utilization and safety of the neurosurgical staff.


title: Convalescent (immune) plasma treatment in a myelodysplastic COVID-19 patient with disseminated tuberculosis

text: During the ongoing COVID-19 pandemic due to the SARS-CoV-2 virus of which evidence-based medical paradigms cannot be easily applied; difficult clinical decisions shall be required particularly in the 'difficult-to-treat' cases of high risk group with associated comorbidities. Convalescent immune plasma therapy is a promising option as a sort of 'rescue' treatment in COVID-19 immune syndrome, where miraculous antiviral drugs are not available yet. In this report, we aim to convey our experience of multi-task treatment approach with convalescent immune plasma and anti-cytokine drug combination in a COVID-19 patient with extremely challenging comorbidities including active myeloid malignancy, disseminated tuberculosis and kidney failure.


title: Longitudinal laboratory testing tied to PCR diagnostics in COVID-19 patients reveals temporal evolution of distinctive coagulopathy signatures

text: Temporal inference from laboratory testing results and their triangulation with clinical outcomes as described in the associated unstructured text from the providers notes in the Electronic Health Record (EHR) is integral to advancing precision medicine. Here, we studied 181 COVIDpos and 7,775 COVIDneg patients subjected to 1.3 million laboratory tests across 194 assays during a two-month observation period centered around their SARS-CoV-2 PCR testing dates. We found that compared to COVIDneg at the time of clinical presentation and diagnostic testing, COVIDpos patients tended to have higher plasma fibrinogen levels and similarly low platelet counts, with approximately 25% of patients in both cohorts showing outright thrombocytopenia. However, these measures show opposite longitudinal trends as the infection evolves, with declining fibrinogen and increasing platelet counts to levels that are lower and higher compared to the COVIDneg cohort, respectively. Our EHR augmented curation efforts suggest a minority of patients develop thromboembolic events after the PCR testing date, including rare cases with disseminated intravascular coagulopathy (DIC), with most patients lacking the platelet reductions typically observed in consumptive coagulopathies. These temporal trends present, for the first time, fine-grained resolution of COVID-19 associated coagulopathy (CAC), via a digital framework that synthesizes longitudinal lab measurements with structured medication data and neural network-powered extraction of outcomes from the unstructured EHR. This study demonstrates how a precision medicine platform can help contextualize each patients specific coagulation profile over time, towards the goal of informing better personalization of thromboprophylaxis regimen.


Re-organising Junior Doctors During the COVID-19 Outbreak: A Single Centre Experience in the United Kingdom


JAK inhibitors in COVID-19: need for vigilance regarding increased inherent thrombotic risk


title: Describing the pattern of the COVID-19 epidemic in Vietnam

text: Given the rapid spread of the COVID-19 pandemic and the huge negative impacts it is causing, researching on COVID-19-related issues is very important for designing proactive and comprehensive public health interventions to fight against the pandemic. We describe the characteristics of COVID-19 patients detected in the two phases of the epidemic in Vietnam. Data used in this paper were mainly obtained from the official database of the Ministry of Health of Vietnam. Descriptive statistics were carried out using Stata 16 software. As of 18 May 2020, the cumulative number of COVID-19 cases detected in Vietnam was 324, 16 cases from 4 cities and provinces in the first phase (during 20 days, 0.8 cases detected per day) and 308 cases from 35 cities, provinces in the second phase (during 76 days, 4.1 cases detected per day). Vietnam has mobilized its entire political system to fight the COVID-19 and achieved some initial successes. We found both similarities and differences between the two phases of the COVID-19 epidemic in Vietnam. We demonstrated that the situation of the COVID-19 epidemic in Vietnam is getting more complicated and unpredictable.


title: Perspectives COVID-19 and PPE in context: an interview with China

text: The author aims to depict the current COVID-19 pandemic and personal protective equipment (PPE) crisis in the UK. The current situation is put into context exploring the history of global outbreaks of infectious disease and what has been learnt. These lessons are then applied and weighed against the recent response to coronavirus. An in depth interview with a UK biomedical SME based in Shanghai, China is reported in order to inform future procurement of PPE. It is hoped that an appreciation of the dynamic nature of the market will allow adaptations to be made in order to secure reliable supply chains moving forwards.


title: Treatment and preliminary outcomes of 150 acute care patients with COVID-19 in a rural health system in the Dakotas

text: The majority of available US-published reports present populations with community spread in urban areas. The objective of this report is to describe a rural healthcare system's utilisation of therapeutic options available to treat Coronavirus Disease 2019 (COVID-19) and subsequent patient outcomes. A total of 150 patients were treated for COVID-19 at three hospitals in the Dakotas from 21 March 2020 to 30 April 2020. The most common pharmacological treatment regimens administered were zinc, hydroxychloroquine plus azithromycin and convalescent plasma. Adjunctive treatments included therapeutic anticoagulation, tocilizumab and corticosteroids. As of 1 June 2020, 127 patients have survived to hospital discharge, 12 patients remain hospitalised and 11 patients have expired. The efficacy of hydroxychloroquine and azithromycin use has yet to be determined but was not without risks of corrected QT interval prolongation and arrhythmias in our cohort. We did not appreciate any adverse effects that appeared related to tocilizumab or convalescent plasma administration in those patient subsets. These findings may provide insight into disease severity and treatment options in the rural setting with limited resources to participate in clinical trials and encourage larger comparative studies evaluating treatment efficacy.


title: Tracking COVID-19 in Europe: Infodemiology Approach

text: BACKGROUND: Infodemiology (ie, information epidemiology) uses web-based data to inform public health and policy. Infodemiology metrics have been widely and successfully used to assess and forecast epidemics and outbreaks. OBJECTIVE: In light of the recent coronavirus disease (COVID-19) pandemic that started in Wuhan, China in 2019, online search traffic data from Google are used to track the spread of the new coronavirus disease in Europe. METHODS: Time series from Google Trends from January to March 2020 on the Topic (Virus) of "Coronavirus" were retrieved and correlated with official data on COVID-19 cases and deaths worldwide and in the European countries that have been affected the most: Italy (at national and regional level), Spain, France, Germany, and the United Kingdom. RESULTS: Statistically significant correlations are observed between online interest and COVID-19 cases and deaths. Furthermore, a critical point, after which the Pearson correlation coefficient starts declining (even if it is still statistically significant) was identified, indicating that this method is most efficient in regions or countries that have not yet peaked in COVID-19 cases. CONCLUSIONS: In the past, infodemiology metrics in general and data from Google Trends in particular have been shown to be useful in tracking and forecasting outbreaks, epidemics, and pandemics as, for example, in the cases of the Middle East respiratory syndrome, Ebola, measles, and Zika. With the COVID-19 pandemic still in the beginning stages, it is essential to explore and combine new methods of disease surveillance to assist with the preparedness of health care systems at the regional level.


docid: rwtdescy

title: Making transesophageal echocardiography safer during COVID-19: is there a role for probe protective equipment (pPE)?


docid: ggaeavcx

title: Safe doubling of ventilator capacity: a last resort proposal for last resorts


title: Brief report: International perspectives on the pediatric COVID-19 experience

text: The 2019 novel coronavirus (SARS-CoV-2) is endangering human health worldwide; scarcity of published pediatric cases and current literature and the absence of evidence-based guidelines necessitate international sharing of experience and personal communication. On 31 March 2020 the International Committee of the American Thoracic Society Pediatrics Assembly recorded an online podcast, during which pediatric pulmonologists worldwide shared their experience on the novel coronavirus disease (COVID-19) in children. The aim was to share personal experience in organizing pediatric care in different health care settings globally, protecting health care workers, and isolation practices. This manuscript summarizes the common themes of the podcast which centered around three main topics: more benign clinical disease and progression in pediatric cases compared to adults, a strong need for strategies to protect health care workers, and social or economic disparities as a barrier to successful pandemic control.


Recommendation and protocol compliance: "Yes, I do" may not be true; the complexity of measuring provider adherence


Ethnicity and COVID-19 in children with comorbidities


title: Iron oxide magnetic nanoparticles based low-field MR thermometry

text: This paper reports on a highly accurate approach of magnetic resonance (MR) thermometry using iron oxide magnetic nanoparticles (MNPs) as temperature sensors. An empirical model for the description of the temperature dependentR2relaxation rate is proposed by taking into account the temperature sensitivity of the MNP magnetization. The temperature sensitivity of the MNP magnetization (Î·) and the temperature sensitivity of theR2relaxation rate (κ) are simulated with the proposed empirical models to investigate their dependence on the magnetic field and the particle size. Simulation results show the existence of optimal magnetic fieldsHοÎ·andHοκthat maximize the temperature sensitivitiesÎ·andκ. Furthermore, simulations and experiments demonstrate that the optimal magnetic fieldHοÎ·(Hοκ) decreases with increasing the particle size. Experiments on temperature dependentR2relaxation rate are performed at different magnetic fields for MNP samples with different iron concentration. Experimental results show that the proposed MR thermometry using MNPs as temperature sensors allows a temperature estimation accuracy of about 0.05 °C. We believe that the achieved approach of highly accurate MR thermometry is of great interest and significance to biomedicine and biology.


title: COVID-19: Pulse oximeters in the spotlight

text: From home to intensive care units, innovations in pulse oximetry are susceptible to improve the monitoring and management of patients developing acute respiratory failure, and particularly those with the coronavirus disease 2019 (COVID-19). They include self-monitoring of oxygen saturation (SpO2) from home, continuous wireless SpO2 monitoring on hospital wards, and the integration of SpO2 as the input variable for closed-loop oxygen administration systems. The analysis of the pulse oximetry waveform may help to quantify respiratory efforts and prevent intubation delays. Tracking changes in the peripheral perfusion index during a preload-modifying maneuver may be useful to predict preload responsiveness and rationalize fluid therapy.


Telemedicine will not keep us apart in COVID-19 pandemic


COVID-19 in Europe: the Italian lesson


title: Diagnosis of Coronavirus Disease 2019 (COVID-19) with Structured Latent Multi-View Representation Learning

text: Recently, the outbreak of Coronavirus Disease 2019 (COVID-19) has spread rapidly across the world. Due to the large number of infected patients and heavy labor for doctors, computer-aided diagnosis with machine learning algorithm is urgently needed, and could largely reduce the efforts of clinicians and accelerate the diagnosis process. Chest computed tomography (CT) has been recognized as an informative tool for diagnosis of the disease. In this study, we propose to conduct the diagnosis of COVID-19 with a series of features extracted from CT images. To fully explore multiple features describing CT images from different views, a unified latent representation is learned which can completely encode information from different aspects of features and is endowed with promising class structure for separability. Specifically, the completeness is guaranteed with a group of backward neural networks (each for one type of features), while by using class labels the representation is enforced to be compact within COVID-19/community-acquired pneumonia (CAP) and also a large margin is guaranteed between different types of pneumonia. In this way, our model can well avoid overfitting compared to the case of directly projecting highdimensional features into classes. Extensive experimental results show that the proposed method outperforms all comparison methods, and rather stable performances are observed when varying the number of training data.


text: Recently, the outbreak of Coronavirus Disease 2019 (COVID-19) has spread rapidly across the world. Due to the large number of affected patients and heavy labor for doctors, computer-aided diagnosis with machine learning algorithm is urgently needed, and could largely reduce the efforts of clinicians and accelerate the diagnosis process. Chest computed tomography (CT) has been recognized as an informative tool for diagnosis of the disease. In this study, we propose to conduct the diagnosis of COVID-19 with a series of features extracted from CT images. To fully explore multiple features describing CT images from different views, a unified latent representation is learned which can completely encode information from different aspects of features and is endowed with promising class structure for separability. Specifically, the completeness is guaranteed with a group of backward neural networks (each for one type of features), while by using class labels the representation is enforced to be compact within COVID-19/community-acquired pneumonia (CAP) and also a large margin is guaranteed between different types of pneumonia. In this way, our model can well avoid overfitting compared to the case of directly projecting highdimensional features into classes. Extensive experimental results show that the proposed method outperforms all comparison methods, and rather stable performances are observed when varying the numbers of training data.


title: Impact of renal function on admission in COVID-19 patients: an analysis of the international HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID 19) Registry

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite its international aggressive extension, with a significant morbidity and mortality, the impact of renal function on its prognosis is uncertain. METHODS: Analysis from the international HOPE-Registry (NCT04334291). The objective was to evaluate the association between kidney failure severity on admission with the mortality of patients with SARS-CoV-2 infection. Patients were categorized in 3 groups according to the estimated glomerular filtration rate on admission (eGFR > 60 mL/min/1.73 m2, eGFR 30-60 mL/min/1.73 m2 and eGFR < 30 mL/min/1.73 m2). RESULTS: 758 patients were included: mean age was 66 ± 18 years, and 58.6% of patient were male. Only 8.5% of patients had a history of chronic kidney disease (CKD); however, 30% of patients had kidney dysfunction upon admission (eGFR < 60 mL/min/1.73 m2). These patients received less frequently pharmacological treatment with hydroxychloroquine or antivirals and had a greater number of complications such as sepsis (11.9% vs 26.4% vs 40.8%, p < 0.001) and respiratory failure (35.4% vs 72.2% vs 62.0%, p < 0.001) as well as a higher in-hospital mortality rate (eGFR > 60 vs eGFR 30-60 vs and eGFR < 30, 18.4% vs 56.5% vs 65.5%, p < 0.001). In multivariate analysis: age, hypertension, renal function, 02 saturation < 92% and lactate dehydrogenase elevation on admission independently predicted all-cause mortality. CONCLUSIONS: Renal failure on admission in patients with SARS-CoV-2 infection is frequent and is associated with a greater number of complications and in-hospital mortality. Our data comes from a multicenter registry and therefore does not allow to have a precise mortality risk assessment. More studies are needed to confirm these findings.


title: Effects of meteorological conditions and air pollution on COVID-19 transmission: Evidence from 219 Chinese cities

text: The spatial distribution of the COVID-19 infection in China cannot be explained solely by geographical distance and regulatory stringency. In this research we investigate how meteorological conditions and air pollution, as concurring factors, impact COVID-19 transmission, using data on new confirmed cases from 219 prefecture cities from January 24 to February 29, 2020. Results revealed a kind of nonlinear dose-response relationship between temperature and coronavirus transmission. We also found that air pollution indicators are positively correlated with new confirmed cases, and the coronavirus further spreads by 5-7% as the AQI increases by 10 units. Further analysis based on regional divisions revealed that in northern China the negative effects of rising temperature on COVID-19 is counteracted by aggravated air pollution. In the southern cities, the ambient temperature and air pollution have a negative interactive effect on COVID-19 transmission, implying that rising temperature restrains the facilitating effects of air pollution and that they jointly lead to a decrease in new confirmed cases. These results provide implications for the control and prevention of this disease and for the anticipation of another possible pandemic.


title: Recurrence of positive SARS-CoV-2 RNA in COVID-19: A case report

text: The ongoing outbreak of COVID-19 that began in Wuhan, China, has constituted a Public Health Emergency of International Concern, with cases confirmed in multiple countries. Currently, patients are the primary source of infection. We report a confirmed case of COVID-19 whose oropharyngeal swab test of SARS-CoV-2 RNA turned positive in convalescence. This case highlights the importance of active surveillance of SARS-CoV-2 RNA for infectivity assessment.


title: SARS-CoV-2 and Oral Ulcers; a Causative Agent or a Predisposing Factor?

text: Earlier reports on COVID-19 have reported certain orofacial manifestations like taste loss and salivary gland infection (Dar-Odeh et al, 2020). More recently, two studies from Spain and France reported oral ulcerative lesions in COVID-19 patients ( Chaux-Bodard et al, 2020; Carreras- Presas et al, 2020). The study from Spain included three patients. The first two cases (males) were suspected cases of COVID-19 as testing was not done for them. Intraorally, they had oral ulcers affecting the hard palate unilaterally in the anatomic area innervated by greater palatine nerve.


Cerebral venous thrombosis associated with COVID-19 infection: Causality or coincidence?


title: Essere cardiologo ai tempi del SARS-COVID-19: è tempo di riconsiderare il nostro modo di lavorare?/ [Being a cardiologist at the time of SARS-COVID-19: is it time to reconsider our way of working?]

text: The SARS-COVID-19 pandemic is bringing to light significant issues that require deliberations on how to manage patients at high cardiovascular risk or with proven heart disease. The evidence that the hospital can be a place where one might contract the infection and spread the disease has drastically reduced non-COVID-19 accesses to emergency rooms (ER) and to elective non-COVID-19 hospital activities. If this, on one hand, results in reducing improper access to the ER and hospital, on the other hand it substantiates the risk of underestimating problems not connected to COVID-19, such as an increased delay in the diagnosis and treatment of acute myocardial infarction and other cardiovascular emergencies. In addition, the need to reorganize hospital activities to treat patients suffering from serious COVID-19 disease forms forces us to reflect on how to safely manage patients who stay at home with milder COVID-19 disease forms and the need to keep the most vulnerable subjects, such as patients with chronic heart failure, away from the hospital. The problem is furtherly amplified by the uncertain trend of the epidemic, by the duration of forced isolation and limited mobility measures and by the inadequate integration between hospital and territory, especially in high-risk areas such as residences for the elderly or in socially and economically fragile environments. Our opinion is that a syndemic approach, which considers the complex interplay between social, economic, environmental and clinical problems, can be the most appropriate and achieved by means the contribution of telemedicine and telecardiology, intended as integration and not as an alternative to traditional management. A flexible use of telematic tools, now available for teleconsultation, and/or remote monitoring adapted to the needs of clinical, family and social-health contexts could allow the creation of integrated and personalized management programs that are effective and efficient for the care of patients.


Implications of respiratory pathogen transmission dynamics on prevention and testing


title: [Emergency department : COVID-19 crisis and organizational aspects]

text: Emergency departments are on the front line in the management of COVID-19 cases, from screening to the initial management of the most severe cases The clinical presentation of COVID-19 range from non-specific symptoms to adult acute respiratory distress syndrome (ARDS) Diagnosis is based on PCR from a nasopharyngeal swab and emergency treatment rely on oxygen therapy Patient's orientation (home, hospitalization, admission in intensive care unit) is a central aspect of emergency management The shift from a strategy of systematic recognition of potential cases to the one of epidemic mitigation required hospital emergency medicine services to implement crisis management measures, to guarantee admission and hospitalization capacity


title: Emergency department : COVID-19 crisis and organizational aspects/ Urgences hospitalieres : crise COVID-19 et aspects organisationnels

text: Emergency departments are on the front line in the management of COVID-19 cases, from screening to the initial management of the most severe cases The clinical presentation of COVID-19 range from non-specific symptoms to adult acute respiratory distress syndrome (ARDS) Diagnosis is based on PCR from a nasopharyngeal swab and emergency treatment rely on oxygen therapy Patient's orientation (home, hospitalization, admission in intensive care unit) is a central aspect of emergency management The shift from a strategy of systematic recognition of potential cases to the one of epidemic mitigation required hospital emergency medicine services to implement crisis management measures, to guarantee admission and hospitalization capacity Les services durgences sont en premiere ligne dans la gestion des cas de COVID-19, quil sagisse du depistage ou de la prise en charge des cas les plus severes La clinique associee au COVID-19 va de symptomes non specifiques au syndrome de detresse respiratoire aigue de ladulte Le diagnostic repose sur la PCR a partir dun frottis nasopharynge et le traitement durgence sur loxygenotherapie Lorientation du patient (retour a domicile, hospitalisation, indication aux soins intensifs) est un aspect central de la prise en charge aux urgences Le passage de la strategie de reconnaissance systematique des cas potentiels a celle de la mitigation de lepidemie a implique pour les services durgences hospitaliers la mise en place de mesures exceptionnelles afin de garantir une capacite daccueil et dhospitalisation


Usefulness of Telerehabilitation for Stroke Patients During the COVID-19 Pandemic


title: Challenges for medical education in Mexico in the time of COVID-19

text: By April 2, 2020, only 116 days after the description of the first case of SARS-CoV2 virus infection, which causes the COVID-19 disease, 1,014,673 cases and 50,030 deaths have been recorded in 181 countries.1 In the United States, there have been 244,678 cases and 5,911 deaths recorded (in New York State alone, there are 93,053 cases and 2,538 deaths), while in Mexico, 1,378 cases and 37 deaths have been recorded. This number is expected to keep on increasing in both countries. The health system in Mexico, as well as in the rest of the world, will face an enormous problem in the months to come.


Early Intervention of Palliative Care in the Emergency Department During the COVID-19 Pandemic


title: Clinical Guidance for the Management of Patients with Urothelial Cancers During the COVID-19 Pandemic - Rapid Review

text: The current COVID-19 pandemic presents a substantial obstacle to cancer patient care. Data from China as well as risk models suppose that cancer patients, particularly those on active, immunosuppressive therapies are at higher risks of severe infection from the illness. In addition, staff illness and restructuring of services to deal with the crisis will inevitably place treatment capacities under significant strain. These guidelines aim to expand on those provided by NHS England regarding cancer care during the coronavirus pandemic by examining the known literature and provide guidance in managing patients with urothelial and rarer urinary tract cancers. In particular, they address the estimated risk and benefits of standard treatments and consider the alternatives in the current situation. As a result, it is recommended that this guidance will help form a framework for shared decision making with patients. Moreover, they do not advise a one-size-fits-all approach but recommend continual assessment of the situation with discussion within and between centres.


Covid-19: A new challenge for forensic medicine


title: Reducing medical error during a pandemic

text: On 30 January 2020, the WHO declared the coronavirus disease 2019 (COVID-19) a public health emergency of international concern. By 11 March 2020, it was designated a pandemic owing to its rapid worldwide spread. In this short article we provide some information that might be useful and help equip colleagues to reduce medical error during a pandemic. We advocate a systems-based approach, rather than an individual's sole responsibility, and, look at ways to provide safer healthcare.


COVID-19: Are Spanish medicine and nursing students prepared?


Covid-19: Quarantine works when introduced early alongside other measures, finds review


title: Medical and Surgical Management of Hidradenitis Suppurativa: A Review of International Treatment Guidelines and Implementation in General Dermatology Practice

text: BACKGROUND: Hidradenitis suppurativa (HS) is a chronic painful skin disease that severely impairs patients' quality of life. While high-quality trials of HS therapies remain limited, medical knowledge of best treatment practices is rapidly evolving, leading to the recent publication of multiple international treatment guidelines for HS. SUMMARY: This review compares international HS treatment guidelines, describes evidence for effectiveness of common and emerging HS therapies, and provides guidance for integrating evidence-based HS care into practice. Although over 50 medical and procedural treatments are mentioned across international HS guidelines, only adalimumab and infliximab have grade B/weak recommendation or higher across all major guidelines. This review describes the appropriate patient selection and effectiveness of the most commonly used medical and procedural treatments for HS. It also includes recommendations for counseling, dosing, and duration of medical therapies as well as procedure videos for the practicing dermatologist.


Weathering COVID-19 storm: Successful control measures of five Asian countries


title: Knowledge Base Completion: Baseline strikes back (Again)

text: Knowledge Base Completion has been a very active area recently, where multiplicative models have generally outperformed additive and other deep learning methods -- like GNN, CNN, path-based models. Several recent KBC papers propose architectural changes, new training methods, or even a new problem reformulation. They evaluate their methods on standard benchmark datasets - FB15k, FB15k-237, WN18, WN18RR, and Yago3-10. Recently, some papers discussed how 1-N scoring can speed up training and evaluation. In this paper, we discuss how by just applying this training regime to a basic model like Complex gives near SOTA performance on all the datasets -- we call this model COMPLEX-V2. We also highlight how various multiplicative methods recently proposed in literature benefit from this trick and become indistinguishable in terms of performance on most datasets. This paper calls for a reassessment of their individual value, in light of these findings.


title: Is Handedness Associated with the Depth of the Olfactory Sulcus?

text: BACKGROUND: Structural and functional asymmetry is frequent in biological systems. The aim of the present study was to examine whether there is a relation between handedness and the depth of the olfactory sulcus (OS) and reinvestigate whether there is a lateralization of OS depth. METHODS: Forty-two healthy volunteers (mean age 24.1 years; 23 right-handed and 19 left-handed) participated. The subjects' brains were scanned using magnetic resonance imaging to assess OS depth. Normal olfactory function was ascertained using the Sniffin' Sticks odor identification test. RESULTS: There was no significant difference in OS depth between right- and left-handed participants (right-handed mean: right OS depth = 11.3 mm, left OS = 10.6 mm; left-handed mean: right OS = 11.3 mm, left OS = 11.0 mm). Across all subjects, OS depth was significantly larger on the right side compared to the left. CONCLUSION: Handedness has no major influence on OS depth. The present study confirmed that the right OS is deeper compared to the left OS, possibly indicating a right-sided lateralization of the olfactory system. IMPLICATIONS: The depth of the right OS is larger than that of the left OS. No major effect of handedness was observed.


title: Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) pandemic is a worldwide emergency. An increasing number of diarrhea cases is reported. Here we investigate the epidemiology, clinical presentation, molecular mechanisms, management, and prevention of SARS-CoV-2 associated diarrhea. We searched on PubMed, EMBASE, and Web of Science up to March 2020 to identify studies documenting diarrhea and mechanism of intestinal inflammation in patients with confirmed diagnosis of SARS-CoV-2 infection. Clinical studies show an incidence rate of diarrhea ranging from 2% to 50% of cases. It may precede or trail respiratory symptoms. A pooled analysis revealed an overall percentage of diarrhea onset of 10.4%. SARS-CoV uses the angiotensin-converting enzyme 2 (ACE2) and the serine protease TMPRSS2 for S protein priming. ACE2 and TMPRSS2 are not only expressed in lung, but also in the small intestinal epithelia. ACE2 is expressed furthermore in the upper esophagus, liver, and colon. SARS-CoV-2 binding affinity to ACE2 is significantly higher (10-20 times) compared with SARS-CoV. Several reports indicate viral RNA shedding in stool detectable longer time period than in nasopharyngeal swabs. Current treatment is supportive, but several options appear promising and are the subject of investigation. Diarrhea is a frequent presenting symptom in patients infected with SARS-CoV-2. Increasing evidence indicates possible fecal oral transmission, indicating the need for a rapid and effective modification of the screening and diagnostic algorithms. The optimal methods to prevent, manage, and treat diarrhea in COVID-19 infected patients are subjects of intensive research.


title: In vitro data of current therapies for SARS-CoV-2

text: BACKGROUND: In December 2019, a new coronavirus, named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has emerged from China causing pneumonia outbreaks first in the Wuhan region and currently worldwide. In the light of the lack of efficient and specific treatments and the need to contain the epidemic, drug repurposing appears to be the most efficient tool to find therapeutic solution. OBJECTIVES: The aim of this study was to summarize in vitro data of current agents used for the management of SARSCoV-2 all over the world. METHODS: A literature search of articles from January 2000 until April 2020 was performed using MEDLINE, EMBASE and the Cochrane Library to assess in vitro data of current or putative therapies for SARS-CoV-2. RESULTS: Although in vitro studies are scarce, data regarding chloroquine and hydroxychloroquine, remdesivir, nitazoxanide, teicoplanin, ivermectin, lopinavir, homoharringtonine and emetine seem promising. CONCLUSION: Scientist all over the world should work together and increase their efforts in order to find feasible and efficient solutions against this new global viral threat.


title: Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study

text: BACKGROUND: Since Dec 31, 2019, the Chinese city of Wuhan has reported an outbreak of atypical pneumonia caused by the 2019 novel coronavirus (2019-nCoV). Cases have been exported to other Chinese cities, as well as internationally, threatening to trigger a global outbreak. Here, we provide an estimate of the size of the epidemic in Wuhan on the basis of the number of cases exported from Wuhan to cities outside mainland China and forecast the extent of the domestic and global public health risks of epidemics, accounting for social and non-pharmaceutical prevention interventions. METHODS: We used data from Dec 31, 2019, to Jan 28, 2020, on the number of cases exported from Wuhan internationally (known days of symptom onset from Dec 25, 2019, to Jan 19, 2020) to infer the number of infections in Wuhan from Dec 1, 2019, to Jan 25, 2020. Cases exported domestically were then estimated. We forecasted the national and global spread of 2019-nCoV, accounting for the effect of the metropolitan-wide quarantine of Wuhan and surrounding cities, which began Jan 23-24, 2020. We used data on monthly flight bookings from the Official Aviation Guide and data on human mobility across more than 300 prefecture-level cities in mainland China from the Tencent database. Data on confirmed cases were obtained from the reports published by the Chinese Center for Disease Control and Prevention. Serial interval estimates were based on previous studies of severe acute respiratory syndrome coronavirus (SARS-CoV). A susceptible-exposed-infectious-recovered metapopulation model was used to simulate the epidemics across all major cities in China. The basic reproductive number was estimated using Markov Chain Monte Carlo methods and presented using the resulting posterior mean and 95% credibile interval (CrI). FINDINGS: In our baseline scenario, we estimated that the basic reproductive number for 2019-nCoV was 2·68 (95% CrI 2·47-2·86) and that 75â815 individuals (95% CrI 37â304-130â330) have been infected in Wuhan as of Jan 25, 2020. The epidemic doubling time was 6·4 days (95% CrI 5·8-7·1). We estimated that in the baseline scenario, Chongqing, Beijing, Shanghai, Guangzhou, and Shenzhen had imported 461 (95% CrI 227-805), 113 (57-193), 98 (49-168), 111 (56-191), and 80 (40-139) infections from Wuhan, respectively. If the transmissibility of 2019-nCoV were similar everywhere domestically and over time, we inferred that epidemics are already growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about 1-2 weeks. INTERPRETATION: Given that 2019-nCoV is no longer contained within Wuhan, other major Chinese cities are probably sustaining localised outbreaks. Large cities overseas with close transport links to China could also become outbreak epicentres, unless substantial public health interventions at both the population and personal levels are implemented immediately. Independent self-sustaining outbreaks in major cities globally could become inevitable because of substantial exportation of presymptomatic cases and in the absence of large-scale public health interventions. Preparedness plans and mitigation interventions should be readied for quick deployment globally. FUNDING: Health and Medical Research Fund (Hong Kong, China).


title: Clinical course of COVID-19 in patients with pre-existing decompensated cirrhosis: initial report from China

text: BACKGROUND: The clinical characteristics and disease course in COVID-19 patients with pre-existing decompensated cirrhosis has not been described so far. METHODS: In this case series, we report three patients with confirmed COVID-19 and pre-existing decompensated cirrhosis from three hospitals in Hubei, the epicenter of the outbreak in China. RESULT: Patient 1 was a 53-year-old man with hepatitis B virus-related cirrhosis, portal hypertension, and ascites. Though receiving intensive support, he died of irreversible multiple organ dysfunction syndrome 48 days after the onset of the illness. Patient 2 was a 75-year-old woman with a history of schistosomiasis-related cirrhosis, portal hypertension, and ascites. Her family members requested that invasive rescue measures not be undertaken, and she died of acute respiratory distress syndrome 40 days after presenting with COVID-19 infection. Patient 3 was an 87-year-old man with alcohol-related cirrhosis, portal hypertension, and esophageal variceal hemorrhage. He was discharged from the hospital 29 days after illness onset. CONCLUSION: The case series raise the possibility that decompensated cirrhosis may be a risk factor for a poor outcome in patients with COVID-19.


docid: zolodxub

title: How to protect operating room staff from COVID-19?


title: Impact of COVID-19 stay-at-home orders on weight-related behaviours among patients with obesity

text: How the impact of the COVID-19 stay-at-home orders is influencing physical, mental and financial health among vulnerable populations, including those with obesity is unknown. The aim of the current study was to explore the health implications of COVID-19 among a sample of adults with obesity. A retrospective medical chart review identified patients with obesity from an obesity medicine clinic and a bariatric surgery (MBS) practice. Patients completed an online survey from April 15, 2020 to May 31, 2020 to assess COVID-19 status and health behaviours during stay-at-home orders. Logistic regression models examined the impact of these orders on anxiety and depression by ethnic group. A total of 123 patients (87% female, mean age 51.2 years [SD 13.0]), mean BMI 40.2 [SD 6.7], 49.2% non-Hispanic white (NHW), 28.7% non-Hispanic black, 16.4% Hispanic, 7% other ethnicity and 33.1% completed MBS were included. Two patients tested positive for severe acute respiratory syndrome coronavirus 2 and 14.6% reported symptoms. Then, 72.8% reported increased anxiety and 83.6% increased depression since stay-at-home orders were initiated. Also 69.6% reported more difficultly in achieving weight loss goals, less exercise time (47.9%) and intensity (55.8%), increased stockpiling of food (49.6%) and stress eating (61.2%). Hispanics were less likely to report anxiety vs NHWs (adjusted odds ratios 0.16; 95% CI, 0.05-0.49; P = .009). Results here showed the COVID-19 pandemic is having a significant impact on patients with obesity regardless of infection status. These results can inform clinicians and healthcare professionals about effective strategies to minimize COVID-19 negative outcomes for this vulnerable population now and in post-COVID-19 recovery efforts.


docid: uajhziug

title: A cluster of pneumonia associated with the SARS-Cov-2 outside of Wuhan related to a house-warming banquet


title: Hospital capital budgeting during a public health crisis

text: This paper seeks to understand the current financial landscape in the context of hospital capital budgeting, as well as provide some guidance on how to navigate the capital markets in times of crisis The focus is on the general weighted average cost of capital formulation and the relationship of its components: the risk free rate and its relationship with the costs of equity and debt, the cost of debt, and the cost of equity We provide some practical implications for managing during the current crisis, as well as potential avenues that merit future research


title: Comparison of nasopharyngeal and oropharyngeal swabs for SARS-CoV-2 detection in 353 patients received tests with both specimens simultaneously

text: BACKGROUND: Since the outbreak of coronavirus disease (COVID-19) in Wuhan in December 2019, by March 10, 2020, a total of 80,932 confirmed cases have been reported in China. Two consecutively negative RT-PCR test results in respiratory tract specimens is required for the evaluation of discharge from hospital, and oropharyngeal swabs were the most common sample. However, false negative results occurred in the late stage of hospitalization, and avoiding false negative result is critical essential. METHODS: We reviewed the medical record of 353 patients who received tests with both specimens simultaneously, and compared the performance between nasopharyngeal and oropharyngeal swabs. RESULTS: Of the 353 patients (outpatients, 192; inpatients, 161) studied, the median age was 54 years, and 177 (50.1%) were women. Higher positive rate (positive tests/total tests) was observed in nasopharyngeal swabs than oropharyngeal swabs, especially in inpatients. Nasopharyngeal swabs from inpatients showed higher positive rate than outpatients. Nasopharyngeal swabs from male showed higher positive rate than female, especially in outpatients. Detection with both specimens slightly increased the positive rate than nasopharyngeal swab only. Moreover, the consistency between from nasopharyngeal and oropharyngeal swabs were poor (Kappa=0.308). CONCLUSION: In conclusion, our study suggests that nasopharyngeal swabs may be more suitable than oropharyngeal swab at this stage of COVID-19 outbreak.


Considering BCG vaccination to reduce the impact of COVID-19


Aerosol prevention box for regional anaesthesia for eye surgery in COVID times


title: Early Neonatal SARS-CoV-2 Infection Manifesting With Hypoxemia Requiring Respiratory Support

text: We describe a case of neonatal SARS-CoV-2 infection, in an infant diagnosed 3 days after birth, and manifesting with silent hypoxemia, requiring respiratory support.


title: Ethnic and socioeconomic differences in SARS-CoV-2 infection: prospective cohort study using UK Biobank

text: BACKGROUND: Understanding of the role of ethnicity and socioeconomic position in the risk of developing SARS-CoV-2 infection is limited. We investigated this in the UK Biobank study. METHODS: The UK Biobank study recruited 40-70-year-olds in 2006-2010 from the general population, collecting information about self-defined ethnicity and socioeconomic variables (including area-level socioeconomic deprivation and educational attainment). SARS-CoV-2 test results from Public Health England were linked to baseline UK Biobank data. Poisson regression with robust standard errors was used to assess risk ratios (RRs) between the exposures and dichotomous variables for being tested, having a positive test and testing positive in hospital. We also investigated whether ethnicity and socioeconomic position were associated with having a positive test amongst those tested. We adjusted for covariates including age, sex, social variables (including healthcare work and household size), behavioural risk factors and baseline health. RESULTS: Amongst 392,116 participants in England, 2658 had been tested for SARS-CoV-2 and 948 tested positive (726 in hospital) between 16 March and 3 May 2020. Black and south Asian groups were more likely to test positive (RR 3.35 (95% CI 2.48-4.53) and RR 2.42 (95% CI 1.75-3.36) respectively), with Pakistani ethnicity at highest risk within the south Asian group (RR 3.24 (95% CI 1.73-6.07)). These ethnic groups were more likely to be hospital cases compared to the white British. Adjustment for baseline health and behavioural risk factors led to little change, with only modest attenuation when accounting for socioeconomic variables. Socioeconomic deprivation and having no qualifications were consistently associated with a higher risk of confirmed infection (RR 2.19 for most deprived quartile vs least (95% CI 1.80-2.66) and RR 2.00 for no qualifications vs degree (95% CI 1.66-2.42)). CONCLUSIONS: Some minority ethnic groups have a higher risk of confirmed SARS-CoV-2 infection in the UK Biobank study, which was not accounted for by differences in socioeconomic conditions, baseline self-reported health or behavioural risk factors. An urgent response to addressing these elevated risks is required.


title: Use of Convalescent Plasma Therapy in Two COVID-19 Patients with Acute Respiratory Distress Syndrome in Korea

text: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 not yet has established its treatment, but convalescent plasma has been expected to increase survival rates as in the case with other emerging viral infections. We describe two cases of COVID-19 treated with convalescent plasma infusion. Both patients presented severe pneumonia with acute respiratory distress syndrome and showed a favorable outcome after the use of convalescent plasma in addition to systemic corticosteroid. To our knowledge, this is the first report of the use of convalescent plasma therapy for COVID-19 in Korea.


title: Antibodies in the breast milk of a maternal woman with COVID-19

text: A maternal woman was positive for SARS-CoV-2 tested in throat swabs but negative tested in other body fluids, and she had IgG and IgA detected in breast milk. Her infant negative for SARS-CoV-2 at birth had elevated IgG in serum but quickly decayed. These findings suggest that breastfeeding might have the potential benefit to the neonates.


title: Low prevalence and disease severity of COVID-19 in post-liver transplant recipients-A single centre experience

text: Coronavirus disease 2019 (COVID-19) caused by a novel coronavirus called severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is driving a present day global pandemic. Immunosuppressed patients are regarded as a high-risk cohort. The following is a short report on COVID-19 in liver transplant recipients (n = 5) from a high volume UK liver transplant unit with a large follow-up cohort (n = 4500). Based on this limited data, liver transplant recipients appear to have a low incidence of COVID-19, with less severe symptoms than expected, when compared with the general population and other solid organ recipients. This possibly could be related to self-isolation adherence and/or the 'ideal' level of immunosuppression that favourably modulates the immune response to COVID-19.


docid: yruugshg

title: Exhaled breath condensate as a potential specimen for diagnosing COVID-19


Pharynx gargle samples are suitable for SARS-CoV-2 diagnostic use and save personal protective equipment and swabs


title: COVID-19 and herpes zoster co-infection presenting with trigeminal neuropathy

text: BACKGROUND: Varicella-zoster virus (VZV) is a human neurotropic virus that remains in a latent state within ganglionic neurons throughout the entire neuroaxis after the primary infection. Whenever herpes zoster leads to trigeminal involvement, the ophthalmic division is the most implicated. COVID-19 emerged as a viral cause of severe acute respiratory syndrome that spread all over the world in the last months. Co-infection with COVID and other viruses has been registered, but sparsely and embracing the respiratory ones. METHODS: report a case of a co-infection of COVID-19 with VZV, and review the literature. RESULTS: 39-year-old immunocompetent man with oligosymptomatic infection by COVID-19 evolved to left facial herpes zoster affecting the three divisions of trigeminal nerve. The co-infection was remotely registered with other respiratory virus, being influenza the most mentioned. However, the present case is associated to the emergence of a latent virus infection, which might be related to the viral inflammatory response, especially ascending from the nasal cavity, where trigeminal branches are also placed. CONCLUSIONS: The emergence of the latent infection by VZV under a rare presentation might illustrate the impact at least locally of COVID-19, once retrograde reactivation of VZV was possibly induced in a young immunocompetent patient.


title: The tragedy of COVID-19 in Brazil: 124 maternal deaths and counting

text: Initial reports at the onset of the COVID-19 pandemic indicated that the obstetric population did not appear to be at higher risk of developing severe symptoms of COVID-19 than the general population.[1] However, following recent publications showing that pregnancy and the postpartum period might indeed pose additional risks for both women and babies, these preliminary observations urgently require review.[2] Explanations for heightened risk may include relative immunodeficiency associated with maternal physiological adaptations, as well as organic response to virus infections.


title: In vivo expressed biologics for infectious disease prophylaxis: rapid delivery of DNA-based antiviral antibodies

text: With increasing frequency, humans are facing outbreaks of emerging infectious diseases (EIDs) with the potential to cause significant morbidity and mortality. In the most extreme instances, such outbreaks can become pandemics, as we are now witnessing with COVID-19. According to the World Health Organization, this new disease, caused by the novel coronavirus SARS-CoV-2, has already infected more than 10 million people worldwide and led to 499,913 deaths as of 29 June, 2020. How high these numbers will eventually go depends on many factors, including policies on travel and movement, availability of medical support, and, because there is no vaccine or highly effective treatment, the pace of biomedical research. Other than an approved antiviral drug that can be repurposed, monoclonal antibodies (mAbs) hold the most promise for providing a stopgap measure to lessen the impact of an outbreak while vaccines are in development. Technical advances in mAb identification, combined with the flexibility and clinical experience of mAbs in general, make them ideal candidates for rapid deployment. Furthermore, the development of mAb cocktails can provide a faster route to developing a robust medical intervention than searching for a single, outstanding mAb. In addition, mAbs are well-suited for integration into platform technologies for delivery, in which minimal components need to be changed in order to be redirected against a novel pathogen. In particular, utilizing the manufacturing and logistical benefits of DNA-based platform technologies in order to deliver one or more antiviral mAbs has the potential to revolutionize EID responses.


title: SARS-CoV-2 Pandemic: Review of the Literature and Proposal for Safe Autopsy Practice

text: Context: The novel coronavirus disease 2019 (COVID-19) pandemic is significantly changing methodological approaches in all branches of the health system. From a forensic point of view, this event is partly changing the manner in which forensic pathologists and all those who work in autopsy services operate, but above all, it is changing the patterns established for years by which cadavers were analysed postmortem. Objective: To present a review of the literature and a proposal for COVID autopsy protocols. To contain the infection risk, a revision of all the protocols that until now have been applied to the examination of bodies that require autopsy services is required. Data source: Currently, the diagnosis and postmortem analysis of positive or suspected COVID-19 cases plays a crucial role in scientific research. A review of the main recommendations proposed by international scientific societies regarding the risk of infection during autopsy has been carried out. Scientific papers currently available via the PubMed NCBI search engine on COVID-19 postmortem diagnosis were also examined. Discussion: Throughout the history of medicine, the role of autopsy has been fundamental to the understanding of multiple pathogenic processes that are investigated postmortem through autopsy. The purpose of the study is to propose an operating protocol that can be useful for all clinical and forensic autopsies with particular reference to the correct methods to be applied to the examination of positive or suspected COVID-19 cases regarding both the autopsy procedure and the collection and analysis of biological samples.


title: Estimation of Covid-19 Prevalence from Serology Tests: A Partial Identification Approach

text: We propose a partial identification method for estimating disease prevalence from serology studies. Our data are results from antibody tests in some population sample, where the test parameters, such as the true/false positive rates, are unknown. Our method scans the entire parameter space, and rejects parameter values using the joint data density as the test statistic. The proposed method is conservative for marginal inference, in general, but its key advantage over more standard approaches is that it is valid in finite samples even when the underlying model is not point identified. Moreover, our method requires only independence of serology test results, and does not rely on asymptotic arguments, normality assumptions, or other approximations. We use recent Covid-19 serology studies in the US, and show that the parameter confidence set is generally wide, and cannot support definite conclusions. Specifically, recent serology studies from California suggest a prevalence anywhere in the range 0%-2% (at the time of study), and are therefore inconclusive. However, this range could be narrowed down to 0.7%-1.5% if the actual false positive rate of the antibody test was indeed near its empirical estimate (~0.5%). In another study from New York state, Covid-19 prevalence is confidently estimated in the range 13%-17% in mid-April of 2020, which also suggests significant geographic variation in Covid-19 exposure across the US. Combining all datasets yields a 5%-8% prevalence range. Our results overall suggest that serology testing on a massive scale can give crucial information for future policy design, even when such tests are imperfect and their parameters unknown.


Management of hepatocellular carcinoma in the time of COVID-19


Severe SARS-CoV-2 infections: practical considerations and management strategy for intensivists


title: Taste and Smell Impairment in SARS-CoV-2 Recovers Early and Spontaneously: Experimental Data Strongly Linked to Clinical Data

text: A growing body of literature indicates that smell and taste impairment has frequently occurred during the Severe Acute Respiratory Syndrome (SARS)-like Coronavirus (SARS-CoV-2) outbreak. Experimental studies have mostly found that non-neural-type cells are responsible for SARS-CoV-2-related taste and smell impairment. If this is the case, smell/taste impairment needs to recover early. Literature data from clinical studies indicated a strong correlation between experimental and clinical findings. This article presents clinical studies related to SARS-CoV-2-induced smell/taste impairment that reported recovery rates. Experimental researchers may use these data to observe the dynamics of smell impairment and implement these findings in their research (e.g., correct timing of sampling) to perform further studies.


Combination dose-escalated hydroxyurea and transfusion: an approach to conserve blood during the COVID-19 pandemic


title: Prognostic factors in patients with diabetes hospitalized for COVID-19: Findings from the CORONADO study and other recent reports

text: Diabetes mellitus is challenging in the context of the COVID-19 pandemic. The prevalence of diabetes patients hospitalized in intensive care units for COVID-19 is two- to threefold higher, and the mortality rate at least double, than that of non-diabetes patients. As the population with diabetes is highly heterogeneous, it is of major interest to determine the risk factors of progression to a more serious life-threatening COVID-19 infection. This brief review discusses the main findings of CORONADO, a prospective observational study in France that specifically addressed this issue as well as related observations from other countries, mainly China and the US. Some prognostic factors beyond old age have been identified: for example, an increased body mass index is a major risk factor for requiring respiratory assistance. Indeed, obesity combines several risk factors, including impaired respiratory mechanics, the presence of other comorbidities and inappropriate inflammatory responses, partly due to ectopic fat deposits. While previous diabetic microvascular (renal) and macrovascular complications also increase risk of death, the quality of past glucose control had no independent influence on hospitalized diabetes patient outcomes, but whether the quality of glucose control might modulate risk of COVID-19 in non-hospitalized diabetes patients is still unknown. In addition, no negative signs regarding the use of RAAS blockers and DPP-4 inhibitors and outcomes of COVID-19 could be identified. Hyperglycaemia at the time of hospital admission is associated with poor outcomes, but it may simply be considered a marker of severity of the infection. Thus, the impact of glucose control during hospitalization on outcomes related to COVID-19, which was not investigated in the CORONADO study, is certainly deserving of specific investigation.


title: The impact of COVID-19 on colorectal cancer disparities and the way forward

text: In response to the COVID-19 pandemic, the United States Surgeon General advised all hospitals and ambulatory care centers to delay nonurgent medical procedures and surgeries. This recommendation, echoed by a multigastroenterology society guideline, led to the suspension of colonoscopies for colorectal cancer (CRC) screening and surveillance. Although this temporary suspension was necessary to contain COVID-19 infections, we as gastroenterologists, patient advocates, and CRC researchers have witnessed the downstream impact of COVID-19 and this recommendation on CRC screening, research, and advocacy. These effects are particularly noticeable in medically underserved communities where CRC morbidity and mortality are highest. COVID-19 related pauses in medical care, as well as shifts in resource allocation and workforce deployment, threaten decades worth of work to improve CRC disparities in medically underserved populations. In this perspective, we present the unique challenges COVID-19 poses to health equity in CRC prevention and provide potential solutions as we navigate these uncharted waters.


Bee venom and SARS-CoV-2


title: Olfactory and gustatory dysfunctions in 100 patients hospitalized for COVID-19: sex differences and recovery time in real-life

text: PURPOSE: COVID-19 displays a variety of clinical manifestations; in pauci-symptomatic patients olfactory (OD) and gustatory dysfunctions (GD) may represent the first or only symptom. This topic is currently arousing great interest, and a growing number of papers are being published. Aim of this study is to investigate the timing of recovery from OD and GD in a real-life population hospitalized for COVID-19. METHODS: We followed up by a phone interview the first 100 patients discharged a month earlier from three Italian non-intensive care wards. RESULTS: All 100 patients were Caucasian, mean age was 65 years, 60% were males. Forty-two patients (mean age 63 years) experienced subjective chemosensory dysfunctions (29 OD and 41 GD): the male/female ratio was 2:1; 83% reported a complete or near complete recovery at follow-up. The recovery rate was not significantly different between males and females. The mean duration of OD and GD was 18 and 16 days, respectively. The mean recovery time from OD or GD resulted significantly longer for females than for males (26 vs 14 days, P = 0.009). Among the 42 symptomatic, the mean age of males was significantly higher than that of females (66 vs 57 years, P = 0.04), while the opposite was observed in the 58 asymptomatic patients (60 vs 73 years, P = 0.0018). CONCLUSIONS: Recovery from OD or GD was rapid, occurring within 4 weeks in most patients. Chemosensory dysfunctions in women was less frequent, but longer lasting. The value of our study is its focus on a population of hospitalized patients significantly older than those previously described, and the additional data on gender differences.


title: Small Area Estimation of Health Outcomes

text: Small area estimation (SAE) entails estimating characteristics of interest for domains, often geographical areas, in which there may be few or no samples available. SAE has a long history and a wide variety of methods have been suggested, from a bewildering range of philosophical standpoints. We describe design-based and model-based approaches and models that are specified at the area-level and at the unit-level, focusing on health applications and fully Bayesian spatial models. The use of auxiliary information is a key ingredient for successful inference when response data are sparse and we discuss a number of approaches that allow the inclusion of covariate data. SAE for HIV prevalence, using data collected from a Demographic Health Survey in Malawi in 2015-2016, is used to illustrate a number of techniques. The potential use of SAE techniques for outcomes related to COVID-19 is discussed.