title: A systematic review on COVID-19: urological manifestations, viral RNA detection and special considerations in urological conditions

text: PURPOSE AND OBJECTIVE: We performed a systematic review on COVID-19 and its potential urological manifestations. METHODS: A literature search was performed using combination of keywords (MeSH terms and free text words) relating to COVID-19, urology, faeces and stool on multiple databases. Primary outcomes were the urological manifestations of COVID-19, and SARS-CoV-2 viral RNA detection in urine and stool samples. Meta-analyses were performed when there were two or more studies reporting on the same outcome. Special considerations in urological conditions that were relevant in the pandemic of COVID-19 were reported in a narrative manner. RESULTS: There were a total of 21 studies with 3714 COVID-19 patients, and urinary symptoms were absent in all of them. In patients with COVID-19, 7.58% (95% CI 3.30-13.54%) developed acute kidney injury with a mortality rate of 93.27% (95% CI 81.46-100%) amongst them. 5.74% (95% CI 2.88-9.44%) of COVID-19 patients had positive viral RNA in urine samples, but the duration of viral shedding in urine was unknown. 65.82% (95% CI 45.71-83.51%) of COVID-19 patients had positive viral RNA in stool samples, which were detected from 2 to 47 days from symptom onset. 31.6% of renal transplant recipients with COVID-19 required non-invasive ventilation, and the overall mortality rate was 15.4%. CONCLUSIONS: Acute kidney injury leading to mortality is common amongst COVID-19 patients, likely as a result of direct viral toxicity. Viral RNA positivity was detected in both urine and stool samples, so precautions are needed when we perform transurethral or transrectal procedures.


Bilateral carotid artery dissection in a SARS-CoV-2 infected patient: causality or coincidence?


"We Signed Up for This!" - Student and Trainee Responses to the Covid-19 Pandemic


title: Digital Approaches to Remote Pediatric Health Care Delivery During the COVID-19 Pandemic: Existing Evidence and a Call for Further Research

text: The global spread of the coronavirus disease (COVID-19) outbreak poses a public health threat and has affected people worldwide in various unprecedented ways, both personally and professionally. There is no question that the current global COVID-19 crisis, now more than ever, is underscoring the importance of leveraging digital approaches to optimize pediatric health care delivery in the era of this pandemic. In this perspective piece, we highlight some of the available digital approaches that have been and can continue to be used to streamline remote pediatric patient care in the era of the COVID-19 pandemic, including but not limited to telemedicine. JMIR Pediatrics and Parenting is currently publishing a COVID-19 special theme issue in which investigators can share their interim and final research data related to digital approaches to remote pediatric health care delivery in different settings. The COVID-19 pandemic has rapidly transformed health care systems worldwide, with significant variations and innovations in adaptation. There has been rapid expansion of the leveraging and optimization of digital approaches to health care delivery, particularly integrated telemedicine and virtual health. Digital approaches have played and will play major roles as invaluable and reliable resources to overcome restrictions and challenges imposed during the COVID-19 pandemic and to increase access to effective, accessible, and consumer-friendly care for more patients and families. However, a number of challenges remain to be addressed, and further research is needed. Optimizing digital approaches to health care delivery and integrating them into the public health response will be an ongoing process during the current COVID-19 outbreak and during other possible future pandemics. Regulatory changes are essential to support the safe and wide adoption of these approaches. Involving all relevant stakeholders in addressing current and future challenges as well as logistical, technological, and financial barriers will be key for success. Future studies should consider evaluating the following research areas related to telemedicine and other digital approaches: cost-effectiveness and return on investment; impact on quality of care; balance in use and number of visits needed for the management of both acute illness and chronic health conditions; system readiness for further adoption in other settings, such as inpatient services, subspecialist consultations, and rural areas; ongoing user-centered evaluations, with feedback from patients, families, and health care providers; strategies to optimize health equity and address disparities in access to care related to race and ethnicity, socioeconomic status, immigration status, and rural communities; privacy and security concerns for protected health information with Health Insurance Portability and Accountability Act (HIPAA)-secured programs; confidentiality issues for some specific populations, especially adolescents and those in need of mental health services; early detection of exposure to violence and child neglect; and integration of training into undergraduate and graduate medical education and subspecialty fellowships. Addressing these research areas is essential to understanding the benefits, sustainability, safety, and optimization strategies of telemedicine and other digital approaches as key parts of modern health care delivery. These efforts will inform long-term adoption of these approaches with expanded dissemination and implementation efforts.


[Diagnosis and treatment of COVID-19: acute kidney injury cannot be ignored]


title: The Pandemic from COVID 19: a Lesson that we must not forget

text: This issue of the Acta Biomedica for Health Professions magazine was prepared during the lockdown, imposed by the Italian government, for the contain- ment of COVID 19. This acute syndrome was initially thought to concern only the respiratory system and for this reason it has been defined as SARS CoV-2. To date, however, we know that COVID 19 affects numerous areas of the body (1,2). In Italy, the first western country where the infection manifested itself in the form of an epidemic, we listened to health bulletins that resembled war bulletins, which reported on thousands of people affected by the virus and hundreds of dead people. [...].


Recommendations for emergency departments receiving patients with vital signs absent from paramedics during COVID-19


title: Why does COVID-19 disproportionately affect older people?

text: The severity and outcome of coronavirus disease 2019 (COVID-19) largely depends on a patient's age. Adults over 65 years of age represent 80% of hospitalizations and have a 23-fold greater risk of death than those under 65. In the clinic, COVID-19 patients most commonly present with fever, cough and dyspnea, and from there the disease can progress to acute respiratory distress syndrome, lung consolidation, cytokine release syndrome, endotheliitis, coagulopathy, multiple organ failure and death. Comorbidities such as cardiovascular disease, diabetes and obesity increase the chances of fatal disease, but they alone do not explain why age is an independent risk factor. Here, we present the molecular differences between young, middle-aged and older people that may explain why COVID-19 is a mild illness in some but life-threatening in others. We also discuss several biological age clocks that could be used in conjunction with genetic tests to identify both the mechanisms of the disease and individuals most at risk. Finally, based on these mechanisms, we discuss treatments that could increase the survival of older people, not simply by inhibiting the virus, but by restoring patients' ability to clear the infection and effectively regulate immune responses.


Obesity and COVID-19: The mTOR pathway as a possible culprit


title: Discovery of G-quadruplex-forming sequences in SARS-CoV-2

text: The outbreak caused by the novel coronavirus SARS-CoV-2 has been declared a global health emergency. G-quadruplex structures in genomes have long been considered essential for regulating a number of biological processes in a plethora of organisms. We have analyzed and identified 25 four contiguous GG runs (G2NxG2NyG2NzG2) in the SARS-CoV-2 RNA genome, suggesting putative G-quadruplex-forming sequences (PQSs). Detailed analysis of SARS-CoV-2 PQSs revealed their locations in the open reading frames of ORF1 ab, spike (S), ORF3a, membrane (M) and nucleocapsid (N) genes. Identical PQSs were also found in the other members of the Coronaviridae family. The top-ranked PQSs at positions 13385 and 24268 were confirmed to form RNA G-quadruplex structures in vitro by multiple spectroscopic assays. Furthermore, their direct interactions with viral helicase (nsp13) were determined by microscale thermophoresis. Molecular docking model suggests that nsp13 distorts the G-quadruplex structure by allowing the guanine bases to be flipped away from the guanine quartet planes. Targeting viral helicase and G-quadruplex structure represents an attractive approach for potentially inhibiting the SARS-CoV-2 virus.


docid: sgcujdme

title: Saving Lives Versus Saving Dollars: The Acceptable Loss for Coronavirus Disease 2019


Considerations for Telepsychiatry Service Implementation in the Era of COVID-19


title: Can mathematical modelling solve the current Covid-19 crisis?

text: Since COVID-19 transmission started in late January, mathematical modelling has been at the forefront of shaping the decisions around different non-pharmaceutical interventions to confine its' spread in the UK and worldwide. This Editorial discusses the importance of modelling in understanding Covid-19 spread, highlights different modelling approaches and suggests that while modelling is important, no one model can give all the answers.


title: Social distancing, social justice, and risk during the COVID-19 pandemic

text: Social distancing is an important and necessary measure to help arrest the spread of SARS-CoV-2 during the COVID-19 pandemic. However, it does place persons who are socially or politically marginalized, including those who are of lower socio-economic status, at risk of further harms. In other words, marginalized or disadvantaged persons are at risk of both contracting SARS-CoV-2 and the risk of harms that may come about because of the social distancing measures themselves. Finally, a third layer of risk faced by marginalized persons would be the overuse of utility (i.e., maximize the benefit of resource x) as the primary ethics principle upon which to make allocation decisions, since oftentimes it is resource-intensive to help those in positions of social marginality. This three-fold risk of harm to which marginalized persons are subjected runs counter to the very notion of social justice that underpins public health. Social distancing in a socially just manner requires dialoguing with affected populations and providing social supports to marginalized persons, regardless of the associated costs.


title: Therapy with agents acting on the renin-angiotensin system and risk of SARS-CoV-2 infection

text: Exposure to agents acting on the renin-angiotensin system was not associated to a risk increase of COVID-19 infection in two Italian matched case-control studies, one nested in hypertensive patients and the other in patients with cardiovascular diseases or diabetes.


The official French guidelines to protect patients with cancer against SARS-CoV-2 infection


title: Mitigating the Psychological Impact of COVID-19 on Healthcare Workers: A Digital Learning Package

text: The coronavirus pandemic (COVID-19) will undoubtedly have psychological impacts for healthcare workers, which could be sustained; frontline workers will be particularly at risk. Actions are needed to mitigate the impacts of COVID-19 on mental health by protecting and promoting the psychological wellbeing of healthcare workers during and after the outbreak. We developed and evaluated a digital learning package using Agile methodology within the first three weeks of UK outbreak. This e-package includes evidence-based guidance, support and signposting relating to psychological wellbeing for all UK healthcare employees. A three-step rapid development process included public involvement activities (PPIs) (STEP 1), content and technical development with iterative peer review (STEP 2), and delivery and evaluation (STEP 3). The package outlines the actions that team leaders can take to provide psychologically safe spaces for staff, together with guidance on communication and reducing social stigma, peer and family support, signposting others through psychological first aid (PFA), self-care strategies (e.g., rest, work breaks, sleep, shift work, fatigue, healthy lifestyle behaviours), and managing emotions (e.g., moral injury, coping, guilt, grief, fear, anxiety, depression, preventing burnout and psychological trauma). The e-package includes advice from experts in mental wellbeing as well as those with direct pandemic experiences from the frontline, as well as signposting to public mental health guidance. Rapid delivery in STEP 3 was achieved via direct emails through professional networks and social media. Evaluation included assessment of fidelity and implementation qualities. Essential content was identified through PPIs (n = 97) and peer review (n = 10) in STEPS 1 and 2. The most important messages to convey were deemed to be normalisation of psychological responses during a crisis, and encouragement of self-care and help-seeking behaviour. Within 7 days of completion, the package had been accessed 17,633 times, and healthcare providers had confirmed immediate adoption within their health and wellbeing provisions. Evaluation (STEP 3, n = 55) indicated high user satisfaction with content, usability and utility. Assessment of implementation qualities indicated that the package was perceived to be usable, practical, low cost and low burden. Our digital support package on 'psychological wellbeing for healthcare workers' is free to use, has been positively evaluated and was highly accessed within one week of release. It is available here: Supplementary Materials. This package was deemed to be appropriate, meaningful and useful for the needs of UK healthcare workers. We recommend provision of this e-package to healthcare workers alongside wider strategies to support their psychological wellbeing during and after the COVID-19 pandemic.


title: Correction to: Population vulnerability to COVID-19 in Europe: a burden of disease analysis

text: [This corrects the article DOI: 10.1186/s13690-020-00433-y.].


title: Coronavirus Disease 2019 and Diabetes: The Epidemic and the Korean Diabetes Association Perspective

text: Diabetes has been associated with more severe outcomes and higher mortality in coronavirus disease 2019 (COVID-19) patients compare to morbidity and mortality in patients without diabetes. Several mechanisms may play a role in this greater morbidity and mortality, especially uncontrolled hyperglycemia, an impaired immune system, pre-existing proinflammatory states, multiple comorbidities, and dysregulated angiotensin-converting enzyme 2 signaling. Thus, the diabetes medical community emergently needs to know about COVID-19 and its effects on patients with diabetes, as they must take precautions to carefully manage these patients during the COVID-19 pandemic. The Korean Diabetes Association provides some guidance and practical recommendations for the management of diabetes during the pandemic. This report provides insight into the association between diabetes and COVID-19, proper management of diabetes in patients with COVID-19 and an official suggestion by the Korean Diabetes Association for managing the COVID-19 outbreak.


Autopsy slowdown hinders quest to determine how coronavirus kills


title: [Dandelion clock-like sign on CT for diagnose of COVID-19]

text: OBJECTIVE: To explore the value of the "dandelion clock-like" sign on chest CT for diagnosis of SARS-CoV-2-associated pneumonia. METHODS: This retrospective analysis was conducted based on the data of 119 cases from the Department of Fever and the Department of Infection undergoing chest high-resolution CT examinations in Sanshui District People's Hospital between January, 24 and February 10, 2020. The cases with no abnormality on chest CT were excluded. Twenty-three patients were diagnosed to have pneumonia, including 9 with SARS-CoV-2-associated pneumonia and 14 with other types of pneumonia. We comparatively analyzed the CT signs, location of the lesions and the dandelion clock-like sign among different types of pneumonia. RESULTS: Among the 23 patients with pneumonia, 9 (39.1%) had common or severe SARS-CoV-2- associated pneumonia with a positive epidemiological history and corresponding respiratory symptoms. Seven of the SARSCoV-2-associated pneumonia patients had multiple lesions in bilateral lungs, compromising mainly the lung field and the subpleural area and showing patchy, lumpy, and umbrella-shaped ground glass opacity, often accompanied by pulmonary vascular thickening and increased microvessels, interlobular septal thickening and fibrosis and lined with grid-like and small-bubble-like "crazy-paving" patterns. The dandelion clock-like sign was found in all the 9 patients with SARSCoV-2-associated pneumonia, with a total of 46 lesions (60.5%, 76 total lesions); 9 of the lesions presented with a "dandelion clek-like" sign and 37 with a "dandelion seed sign". These signs were not found in the 14 patients with other types of pneumonia. CONCLUSIONS: The dandelion clock-like sign is a common and characteristic chest CT finding in patients with SARS-CoV-2-associated pneumonia, and can help to distinguish SARS-CoV-2-associated pneumonia from other types of pneumonia.


title: Chloroquine and hydroxychloroquine in the management of COVID-19: Much kerfuffle but little evidence

text: Chloroquine and hydroxychloroquine are drugs that have shown in vitro activity on the replication of certain coronaviruses. In the context of the SARS-Cov-2 epidemic, the virus responsible for the novel coronavirus disease (COVID-19), these two drugs have been proposed as possible treatments. The results of the first clinical studies evaluating the effect of hydroxychloroquine do not support any efficacy of this drug in patients with COVID-19, due to major methodological weaknesses. Yet, these preliminary studies have aroused considerable media interest, raising fears of massive and uncontrolled use. In the absence of evidence of clinical benefits, the main risk is of exposing patients unnecessarily to the well-known adverse effects of hydroxychloroquine, with a possibly increased risk in the specific setting of COVID-19. In addition, widespread use outside of any recommendation risks compromising the completion of good quality clinical trials. The chloroquine hype, fueled by low-quality studies and media announcements, has yielded to the implementation of more than 150 studies worldwide. This represents a waste of resources and a loss of opportunity for other drugs to be properly evaluated. In the context of emergency, rigorous trials are more than ever needed in order to have, as soon as possible, reliable data on drugs that are possibly effective against the disease. Meanwhile, serious adverse drug reactions have been reported in patients with COVID-19 receiving hydroxychloroquine, justifying to limit its prescription, and to perform suitable cardiac and therapeutic drug monitoring.


docid: dratashk

title: COVID-19 and pulmonary embolism: Do not forget the association!


Response to COVID-19 and diabetes: Can DPP4 inhibition play a role? - GLP-1 might play one too


SARS-CoV-2 & Covid-19: Key-Roles of the 'Renin-Angiotensin' System / Vitamin D Impacting Drug and Vaccine Developments


title: Time for a culture change: understanding and reducing risk, morbidity and mortality from COVID-19 in those of black and minority ethnicity

text: Following a number of epidemics in the 21st century, including Ebola and Middle East respiratory syndrome, the SARS-COV-2 virus, causing COVID-19 disease, was declared a pandemic health emergency of international concern in January 2020.


title: Intervention effects in the transmission of COVID-19 depending on the detection rate and extent of isolation

text: Objectives: In 2020, the COVID-19 respiratory infection is spreading in Korea. In order to prevent the spread of an infectious disease, infected people must be quickly identified and isolated, and contact with the infected must be blocked early. This study attempted to verify the intervention effects on the spread of an infectious disease by using these measures in a mathematical model. Methods: We used the Susceptible-Infectious-Recovery (SIR) model for a virtual population group connected by a special structured network. In the model, the infected state (I) was divided into I in which the infection is undetected and I_x in which the infection is detected. The probability of transitioning from an I state to I_x can be viewed as the rate at which an infected person is found. We assumed that only those connected to each other in the network can cause infection. In addition, this study attempted to evaluate the effects of isolation by temporarily removing the connection among these people. Results: In Scenario 1, only the infected are isolated; in Scenario 2, those who are connected to an infected person and are also found to be infected are isolated as well. In Scenario 3, everyone connected to an infected person are isolated. In Scenario 3, it was possible to effectively suppress the infectious disease even with a relatively slow rate of diagnosis and relatively high infection rate. Conclusion: During the epidemic, quick identification of the infected is helpful. In addition, it was possible to quantitatively show through a simulation evaluation that the management of infected individuals as well as those who are connected greatly helped to suppress the spread of infectious diseases.


Out-of-hospital Cardiac Arrest and Donation after Circulatory Death during the Covid-19 Pandemia


title: The patient's pathway for breast cancer in the COVID-19 era: An Italian single-center experience

text: COVID-19 has been declared a pandemic by the World Health Organization. As of April 1, 2020, Italy was the country with the second highest number of cases in the world. The spread of COVID-19 has required a rapid reorganization of health service delivery in face of the pandemic. Breast cancer units have reprioritized their workload to guarantee the health of oncologic patients at the highest risk and regular screening activities. However, at the end of the pandemic emergency, many benign and reconstructive cases will return to our attention and their surgical treatment will be necessary as soon as possible.


Response to: Eosinophil count in severe coronavirus disease 2019


title: COVID-19 and Bacillus Calmette-Guérin: What is the Link?

text: The debate around the role of vaccination with Bacillus Calmette-Guérin has revived right in the time of the Coronavirus disease 19 pandemic. Since Bacillus Calmette-Guérin is one of the most commonly delivered therapies in urology, in this editorial we discuss some points that we think will be of interest and guidance to practicing urologists during this public health emergency.


docid: apgyvixr

title: Global coronavirus disease 2019: What has daily cumulative index taught us?

text: In addition to the absolute case number, a rapid increase in the number of COVID-19 cases within a short time results in insufficiency of healthcare systems and further negatively affects patient outcomes. This study was conducted to investigate the association between the outcomes of COVID-19 patients and daily cumulative index (DCI), which was defined as the average daily number of new cases of COVID-19 and calculated by cumulative cases/number of days between the first reported case and March 6, 2020, by country. Spearman's rank correlation analyses were conducted to evaluate the relationship between mortality, incidence, and DCI. In this study, DCI was positively correlated with incidence (adjusted risk ratio [aRR] = 1.01, 95% confidence interval [CI] = 1.00-1.02, P < 0.01). Higher correlation was observed between mortality and DCI (mortality rate: r = 0.397, P = 0.018; mortality per 1 000 000 people: r = 0.0.428, P = 0.004) than between disease incidence and DCI. DCI remained statistically significantly associated with mortality per 1 000 000 people after adjustment of Health Care Index (aRR = 1.02, 95% CI = 1.01-1.03, P < 0.001) or Healthcare Access and Quality Index (aRR = 1.02, 95% CI = 1.01-1.04, P < 0.01. Reducing DCI through strict infection control measures can help slow the number of new COVID-19 cases and further improve outcomes in COVID-19 patients.


title: Bacterial protein azurin and derived peptides as potential anti-SARS-CoV-2 agents: insights from molecular docking and molecular dynamics simulations

text: The current pandemic SARS-CoV-2 has wreaked havoc in the world, and neither drugs nor vaccine is available for the treatment of this disease. Thus, there is an immediate need for novel therapeutics that can combat this deadly infection. In this study, we report the therapeutic assessment of azurin and its peptides: p18 and p28 against the viral structural S-protein and non-structural 3CLpro and PLpro proteins. Among the analyzed complexes, azurin docked relatively well with the S2 domain of S-protein compared to the other viral proteins. The derived peptide p18 bound to the active site domain of the PLpro protein; however, in other complexes, lesser interactions were recorded. The second azurin derived peptide p28, fared the best among the docked proteins. p28 interacted with all the three viral proteins and the host ACE-2 receptor by forming several electrostatic and hydrogen bonds with the S-protein, 3CLpro, and PLpro. MD simulations indicated that p28 exhibited a strong affinity to S-protein and ACE-2 receptor, indicating a possibility of p28 as a protein-protein interaction inhibitor. Our data suggest that the p28 has potential as an anti-SARS-CoV-2 agent and can be further exploited to establish its validity in the treatment of current and future SARS-CoV crisis.Communicated by Ramaswamy H. Sarma.


Brief Report of Co-infections with SARS-CoV-2 and Other Respiratory Pathogens


Beyond handwashing: Water insecurity undermines COVID-19 response in developing areas


A history of the medical mask and the rise of throwaway culture


COVID-19 and hand surgery


title: Lung under attack by COVID-19-induced cytokine storm: pathogenic mechanisms and therapeutic implications

text: The lung is a key target of the cytokine storm that can be triggered by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), responsible for the widespread clinical syndrome known as coronavirus disease 2019 (COVID-19). Indeed, in some patients, SARS-CoV-2 promotes a dysfunctional immune response that dysregulates the cytokine secretory pattern. Hypercytokinemia underlies the hyperinflammatory state leading to injury of alveolar epithelial cells and vascular endothelial cells, as well as to lung infiltration sustained by neutrophils and macrophages. Within such a pathogenic context, interleukin-6 (IL-6) and other cytokines/chemokines play a pivotal pro-inflammatory role. Therefore, cytokines and their receptors, as well as cytokine-dependent intracellular signalling pathways can be targeted by potential therapies aimed to relieve the heavy burden of cytokine storm. In particular, the anti-IL-6-receptor monoclonal antibody tocilizumab is emerging as one of the most promising pharmacologic treatments. The reviews of this paper are available via the supplemental material section.


title: Reshaping ophthalmology training after COVID-19 pandemic

text: BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on practical activities and didactic teaching of residents and fellows. This survey aimed to propose long-term changes for ophthalmology training based on the changes experienced by trainees and their perception of new training opportunities. METHODS: An online survey was distributed to ophthalmology trainees in multiple countries. Descriptive statistics were used to analyse the data. RESULTS: A total of 504 analyzable responses were collected from 32 different countries. The current impact of COVID-19 pandemic was described as "severe" by most trainees (55.2%); however, the future perspective was more optimistic as demonstrated by the greater number of responses reporting a presumed "moderate" (37.3%), "mild" (14.1%) or "slight" (4.2%) long-term impact. The vast majority of trainees reported a decrease ≥50% of clinical activity (76.4%) and >75% of surgical activity (74.6%). Although an initial gap in didactic teaching has been experienced by many (55.4%), regular web-based teaching was reportedly attended by 67.7% of the respondents. A strong agreement was found regarding the worthwhile role of web-based case-presentations in clinical training (91.7%), web-based discussion of edited surgical videos (85.7%) and simulation-based practice (86.9%) in surgical training. CONCLUSIONS: This survey, focusing on trainees' perspective, strongly reinforces the need to promptly include new technology-based training tools, such as web-based teaching, virtual surgical simulators, and telementoring, in long-term reorganisation of ophthalmology training to ensure its continuity and effectiveness, which would remain available even in the face of another unpredictable crisis within the health system.


Tocilizumab not associated with increased infection risk after CAR T-cell therapy: implications for COVID-19?


Angioedema in COVID-19


Identification of pathophysiological patterns for triage and respiratory support in COVID-19


docid: hvafziof

title: Ethics guidelines on COVID-19 triage-an emerging international consensus


Protecting Chinese healthcare workers while combating the 2019 novel coronavirus


What is our threshold: Departmental planning for radiation oncology's future in the time of COVID-19


Timely blood glucose management for the outbreak of 2019 novel coronavirus disease (COVID-19) is urgently needed


docid: aqbtnfcs

title: Clinical characteristics of 161 cases of corona virus disease 2019 (COVID-19) in Changsha

text: OBJECTIVE: In December 2019, a new type of coronavirus-infected pneumonia broke out in Wuhan and spread rapidly to other parts of the country. The purpose of this study was to investigate the clinical features of coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: A retrospective analysis was performed on the confirmed cases of COVID-19, who were admitted to the North Hospital of Changsha first Hospital (Changsha Public Health treatment Center) from January 17 to February 7, 2020. RESULTS: The median age of COVID-19 patients was 45 years (range 33.5-57). The male patients accounted for 49.7%, 64.6% of the patients had a history of exposure in Wuhan, and 31.7% had family aggregation. The median days of onset were six, and the incidence of severe illness was 18.6%. Compared with the non-severe group, the severe group showed statistical significance in older age, hypertension, bilateral lung plaque shadow, decrease in lymphocyte count, increase in C-reactive protein (CRP), aspartate aminotransferase (AST), lactate dehydrogenase, and creatine kinase. CONCLUSIONS: Age, combined hypertension, oxygenation index, double lung patch, decreased lymphocyte count, and elevated levels of C-reactive protein, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase can be used as predictors of the disease severity.


title: Ayurvedic clinical profile of COVID-19 - A preliminary report

text: BACKGROUND: Ayurvedic clinical profiling of COVID-19 is a pre-requisite to develop standalone and integrative treatment approaches. At present, Ayurvedic clinicians do not have access to COVID-19 patients in clinical settings. In these circumstances, a preliminary clinical profiling of COVID-19 based on review of modern medical and classical Ayurvedic literature with inputs from Allopathic clinicians treating COVID-19 patients assumes significance. OBJECTIVES: This paper aims to develop an Ayurvedic clinical profile of COVID-19 by literature review supported by analysis of clinical data of a cohort of COVID-19 patients. METHODS: The typical clinical presentation of COVID-19 was categorized based on a cluster of symptoms with reference to "Interim Clinical Guidance for Management of Patients with confirmed corona virus disease (COVID-19)" released by the US CDC. As the clinical presentation is found to vary widely, research papers reporting clinical symptoms of patient samples from different parts of the world were also reviewed to identify outliers and atypical presentations. Case records of fourteen COVID-19 patients treated at Medanta Hospital, Gurgaon were analyzed to compare symptomatology with data obtained from published literature. Further, a careful correlation was done with the data collected from selected Ayurvedic classical texts and expert views of clinical practitioners to arrive at a preliminary Ayurvedic clinical profile of COVID-19. RESULTS: COVID-19 can be understood from the Ayurvedic perspective as vatakapha dominant sannipatajvara of agantu origin with pittanubandha. The asymptomatic, presymptomatic, mild, moderate, severe and critical stages of COVID-19 with varying clinical presentations have been analysed on the basis of nidana, dosa, dusya, nidanapañcaka and satkriyakala to present a preliminary clinical profile of the disease. CONCLUSION: In this paper, we have demonstrated that a preliminary clinical profiling of COVID-19 from the Ayurvedic perspective is possible through literature review supported by discussions with Allopathic clinicians as well as examination of patient case records. The provisional diagnosis proposed can be further developed with continued review of literature, wider cooperation and teamwork with Allopathic physicians and access to clinical data as well as direct clinical assessment of COVID-19 patients.


Distinct stem/progenitor cells proliferate to regenerate the trachea, intrapulmonary airways and alveoli in COVID-19 patients


title: Role of vitamin D in preventing of COVID-19 infection, progression and severity

text: The outbreak of COVID-19 has created a global public health crisis. Little is known about the protective factors of this infection. Therefore, preventive health measures that can reduce the risk of infection, progression and severity are desperately needed. This review discussed the possible roles of vitamin D in reducing the risk of COVID-19 and other acute respiratory tract infections and severity. Moreover, this study determined the correlation of vitamin D levels with COVID-19 cases and deaths in 20 European countries as of 20 May 2020. A significant negative correlation (p=0.033) has been observed between mean vitamin D levels and COVID-19 cases per one million population in European countries. However, the correlation of vitamin D with COVID-19 deaths of these countries was not significant. Some retrospective studies demonstrated a correlation between vitamin D status and COVID-19 severity and mortality, while other studies did not find the correlation when confounding variables are adjusted. Several studies demonstrated the role of vitamin D in reducing the risk of acute viral respiratory tract infections and pneumonia. These include direct inhibition with viral replication or with anti-inflammatory or immunomodulatory ways. In the meta-analysis, vitamin D supplementation has been shown as safe and effective against acute respiratory tract infections. Thus, people who are at higher risk of vitamin D deficiency during this global pandemic should consider taking vitamin D supplements to maintain the circulating 25(OH)D in the optimal levels (75-125nmol/L). In conclusion, there is not enough evidence on the association between vitamin D levels and COVID-19 severity and mortality. Therefore, randomized control trials and cohort studies are necessary to test this hypothesis.


Will financial innovation transform pandemic response?


title: ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of hyperthyroidism and hypothyroidism

text: This manuscript provides guidance on the management of thyroid dysfunction during the COVID-19 pandemic. Autoimmune thyroid diseases are not linked to increased risks of COVID-19. Uncontrolled thyrotoxicosis may result in more severe complications from SARS-CoV-2 infection, including thyroid storm. The management of patients with a new diagnosis of hyperthyroidism is best undertaken with a block-and-replace regimen due to limited biochemical testing availability. Antithyroid drug (ATD)-induced neutropenia may favour the progression of COVID-19 and symptoms of infection may be confused with SARS-CoV-2 infection. The withdrawal of ATDs and urgent measurement of neutrophils should be considered in case of flu-like manifestations occurring in the initial months of treatment. Urgent surgery or 131-I may be undertaken in selected cases of uncontrolled thyrotoxicosis. Patients with COVID-19 infection may present with conjunctivitis, which could cause diagnostic difficulties in patients with new or existing Graves' ophthalmopathy. Patients who are on replacement treatment with thyroid hormones should ensure they have sufficient supply of medication. The usual advice to increase dosage of levothyroxine during pregnancy should be adhered to. Many newly presenting and previously diagnosed patients with thyroid dysfunction can be managed through virtual telephone or video clinics supported by a dedicated nurse-led service, depending on available facilities.


docid: kazmcqih

title: Serial bedside lung ultrasonography in a critically ill COVID-19 patient


title: Blueprint for Restructuring a Department of Surgery in Concert With the Health Care System During a Pandemic: The University of Wisconsin Experience

text: The current health care environment is complex. Systems often cross US state boundaries to provide care to patients with a wide variety of medical needs. The coronavirus disease 2019 pandemic is challenging health care systems across the globe. Systems face varying levels of complexity as they adapt to the new reality. This pandemic continues to escalate in hot spots nationally and internationally, and the worst strain on health care systems may be yet to come. The purpose of this article is to provide a road map developed from lessons learned from the experience in the Department of Surgery at the University of Wisconsin School of Medicine and Public Health and University of Wisconsin Health, based on past experience with incident command structures in military combat operations and Federal Emergency Management Agency responses. We will discuss administrative restructuring leveraging a team-of-teams approach, provide a framework for deploying the workforce needed to deliver all necessary urgent health care and critical care to patients in the system, and consider implications for the future.


SARS-CoV-2 outbreak and lockdown in a Northern Italy hospital. Comparison with Scandinavian no-lockdown country


text: The ongoing SARS-CoV-2 pandemic has evolved with cases of local transmission soon after the detection of imported cases in affected countries. However, the pandemic did not reach all countries at the same time and our country (Italy) had to act as forerunners.


title: Prediction of Number of Cases of 2019 Novel Coronavirus (COVID-19) Using Social Media Search Index

text: Predicting the number of new suspected or confirmed cases of novel coronavirus disease 2019 (COVID-19) is crucial in the prevention and control of the COVID-19 outbreak. Social media search indexes (SMSI) for dry cough, fever, chest distress, coronavirus, and pneumonia were collected from 31 December 2019 to 9 February 2020. The new suspected cases of COVID-19 data were collected from 20 January 2020 to 9 February 2020. We used the lagged series of SMSI to predict new suspected COVID-19 case numbers during this period. To avoid overfitting, five methods, namely subset selection, forward selection, lasso regression, ridge regression, and elastic net, were used to estimate coefficients. We selected the optimal method to predict new suspected COVID-19 case numbers from 20 January 2020 to 9 February 2020. We further validated the optimal method for new confirmed cases of COVID-19 from 31 December 2019 to 17 February 2020. The new suspected COVID-19 case numbers correlated significantly with the lagged series of SMSI. SMSI could be detected 6-9 days earlier than new suspected cases of COVID-19. The optimal method was the subset selection method, which had the lowest estimation error and a moderate number of predictors. The subset selection method also significantly correlated with the new confirmed COVID-19 cases after validation. SMSI findings on lag day 10 were significantly correlated with new confirmed COVID-19 cases. SMSI could be a significant predictor of the number of COVID-19 infections. SMSI could be an effective early predictor, which would enable governments' health departments to locate potential and high-risk outbreak areas.


Orthopaedic resident management during the COVID-19 pandemic - AIIMS model


Trombosis y COVID-19: Atención Primaria clave en el abordaje interdisciplinar./ [Thrombosis and COVID-19: Key primary care in the interdisciplinary approach]


title: Estimating COVID-19 outbreak risk through air travel

text: BACKGROUND: Substantial limitations have been imposed on passenger air travel to reduce transmission of SARS-CoV-2 between regions and countries. However, as case numbers decrease, air travel will gradually resume. We considered a future scenario in which case numbers are low and air travel returns to normal. Under that scenario, there will be a risk of outbreaks in locations worldwide due to imported cases. We estimated the risk of different locations acting as sources of future COVID-19 outbreaks elsewhere. METHODS: We use modelled global air travel data and population density estimates from locations worldwide to analyse the risk that 1364 airports are sources of future COVID-19 outbreaks. We use a probabilistic, branching-process based approach that considers the volume of air travelers between airports and the reproduction number at each location, accounting for local population density. RESULTS: Under the scenario we model, we identify airports in East Asia as having the highest risk of acting as sources of future outbreaks. Moreover, we investigate the locations most likely to cause outbreaks due to air travel in regions that are large and potentially vulnerable to outbreaks: India, Brazil and Africa. We find that outbreaks in India and Brazil are most likely to be seeded by individuals travelling from within those regions. We find that this is also true for less vulnerable regions, such as the United States, Europe, and China. However, outbreaks in Africa due to imported cases are instead most likely to be initiated by passengers travelling from outside the continent. CONCLUSIONS: Variation in flight volumes and destination population densities create a non-uniform distribution of the risk that different airports pose of acting as the source of an outbreak. Accurate quantification of the spatial distribution of outbreak risk can therefore facilitate optimal allocation of resources for effective targeting of public health interventions.


title: Diabetes or endocrinopathy admitted in the COVID-19 ward

text: The Covid-19 pandemic confronted us with unknown clinical pictures, also in diabetology and endocrinology. Sharing clinical experiences is therefore of enormous importance. Actually, information about the care given in the Covid-19 ward (in contrast to that provided in the Emergency Room/ICU) is still sparse. The last weeks we built experience and gathered knowledge while giving hospital care to patients who had a pre-existent endocrine disease (and diabetes; most patients suffered from a type two diabetes). In our contribution we presented our insights obtained from this intensive period obtained in the Covid-19 ward.


title: Potential utilities of mask-wearing and instant hand hygiene for fighting SARS-CoV-2

text: The surge of patients in the pandemic of COVID-19 caused by the novel coronavirus SARS-CoV-2 may overwhelm the medical systems of many countries. Mask-wearing and handwashing can slow the spread of the virus, but currently, masks are in shortage in many countries, and timely handwashing is often impossible. In this study, the efficacy of three types of masks and instant hand wiping was evaluated using the avian influenza virus to mock the coronavirus. Virus quantification was performed using real-time reverse transcription-polymerase chain reaction. Previous studies on mask-wearing were reviewed. The results showed that instant hand wiping using a wet towel soaked in water containing 1.00% soap powder, 0.05% active chlorine, or 0.25% active chlorine from sodium hypochlorite removed 98.36%, 96.62%, and 99.98% of the virus from hands, respectively. N95 masks, medical masks, and homemade masks made of four-layer kitchen paper and one-layer cloth could block 99.98%, 97.14%, and 95.15% of the virus in aerosols. Medical mask-wearing which was supported by many studies was opposed by other studies possibly due to erroneous judgment. With these data, we propose the approach of mask-wearing plus instant hand hygiene (MIH) to slow the exponential spread of the virus. This MIH approach has been supported by the experiences of seven countries in fighting against COVID-19. Collectively, a simple approach to slow the exponential spread of SARS-CoV-2 was proposed with the support of experiments, literature review, and control experiences.


title: Potential therapeutic effects of dipyridamole in the severely ill patients with COVID-19

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause acute respiratory distress syndrome, hypercoagulability, hypertension, and multiorgan dysfunction. Effective antivirals with safe clinical profile are urgently needed to improve the overall prognosis. In an analysis of a randomly collected cohort of 124 patients with Corona Virus Disease 2019 (COVID-19), we found that hypercoagulability as indicated by elevated concentrations of D-dimers was associated with disease severity. By virtual screening of a U.S. Food and Drug Administration (FDA) approved drug library, we identified an anticoagulation agent dipyridamole (DIP) in silico, which suppressed SARS-CoV-2 replication in vitro. In a proof-of-concept trial involving 31 patients with COVID-19, DIP supplementation was associated with significantly decreased concentrations of D-dimers (P<0.05), increased lymphocyte and platelet recovery in the circulation, and markedly improved clinical outcomes in comparison to the control patients. In particular, all 8 of the DIP-treated severely ill patients showed remarkable improvement: 7 patients (87.5%) achieved clinical cure and were discharged from the hospitals while the remaining 1 patient (12.5%) was in clinical remission.


Radiotherapy and COVID-19: Practical recommendations from iran


Microthrombotic Complications of COVID-19 Are Likely Due to Embolism of Circulating Endothelial Derived Ultralarge Von Willebrand Factor (eULVWF) Decorated-Platelet Strings


title: Ruptured Abdominal Aortic Aneurysm Treated with Endovascular Repair in a Patient with Active COVID-19 Infection during the Pandemic

text: We report a patient who presented with acute abdominal pain during the COVID-19 pandemic. His work-up revealed rupture of a 5.8 cm abdominal aortic aneurysm. He also had fever, cough, and shortness of breath and radiologic evidence of COVID-19 infection. After careful consideration, he underwent successful endovascular repair under local anesthesia with good short-term results.


title: [Pulmonary rehabilitation guidelines in the principle of 4S for patients infected with 2019 novel coronavirus (2019-nCoV)]

text: A recent epidemic of pneumonia cases in Wuhan China was caused by a novel coronavirus with strong infectivity, the 2019 novel coronavirus (2019-nCoV). The article provides the pulmonary rehabilitation (PR) methods in the principle of 4S (simple, safe, satisfy, save) for patients with pneumonia caused by the novel coronavirus, shows how to establish a ventilative and convectional PR environment to prevent the spread of virus through droplets, how to guide the patients to carry out PR, how to carry out respiratory muscle training, effective cough, expectoration, sneeze, general exercise, digestive function rehabilitation and psychological rehabilitation, and how to clean and disinfect the PR environment.


title: Prevention of COVID-19 infection in the medical population: a possible help from anosmia?

text: COVID-19 asymptomatic cases increases the risks of disease dissemination with even greater risk for physicians given the shortage of personal protective equipment. Here we report on the consistent finding of frequent presentation of anosmia or hyposmia in COVID-19 patients, even in the absence of other symptoms and without other olfactory or nasal findings. In the uncertainty of the clinical characteristics of these patients, this symptom can be a tool to reduce the spread of the infection between medical population.


A UK-wide British Society of Thoracic Imaging COVID-19 imaging repository and database: design, rationale and implications for education and research


Response to: Cardiac drugs and outcome in COVID-19


Taste Changes (Dysgeusia) in COVID-19: A systematic review and metaanalysis


title: Assessing changes in US public trust in science amid the COVID-19 pandemic

text: OBJECTIVES: The emergence of the coronavirus disease 2019 (COVID-19) and subsequent pandemic has led to the most substantive large-scale, open, and public social discussion of epidemiology and science in recent history. In the United States (US), extensive debate has ensued as to the risk posed by the disease, whether the health system is prepared to manage a high volume of critical cases, whether any number of public health responses are necessary and appropriate, and the appropriate ways to prevent, manage, and treat the pandemic. I hypothesized that the interplay between scientists, policymakers, and the public in an open forum was associated with increased overall public trust in science and scientists, but that this was moderated by political orientation and/or religious commitment. In the context of a public health emergency, it is important to understand the degree to which science and scientists are trusted to produce information that can provide reassurance and also can explain the details of a highly complex event such as a viral pandemic while providing actionable recommendations. STUDY DESIGN: The study design was analytic cross-sectional. METHODS: Data were obtained on March 17-18, 2020, from a sample of 242 US-based Amazon Mechanical Turk users. Respondents completed a 49-question survey consisting of key sociodemographic variables, political affiliation, religious commitment, and two iterations of the Trust in Science and Scientist Inventory (one for March 2020, and one for December 2019 using retrospective recall). Changes in mean level of trust and interaction with political affiliation and/or religious commitment were assessed using mixed ANOVA via the general linear model. RESULTS: On a scale from 1 (low trust) to 5 (high trust), the mean level of trust in science and scientists was static; 3.82 in December 2019 and 3.81 in March 2020. Conservative political orientation and high religious commitment were associated with significantly less overall trust in science; the interaction effect suggested that liberal trust in science decreased slightly from December 2019 to March 2020, whereas conservative trust increased slightly. CONCLUSIONS: Counter to my expectations, the overall level of trust in science remained static after the first several months of COVID-19 in the US, although there is some evidence that political orientation was associated with magnitude and directionality of change in trust. Continued examination of these trends is important for understanding public response to epidemiologic recommendations.


Gastric Occlusion due to the Intragastric Balloon Displacement in the Era of Coronavirus Disease-19 (COVID-19) Pandemic, Operative Management: a Case Report


Acute coronary syndromes in developing countries during the COVID-19 pandemic


Social stigma in the time of Coronavirus


Patients with respiratory symptoms are at greater risk of COVID-19 transmission


Association of respiratory allergy, asthma, and expression of the SARS-CoV-2 receptor ACE2


COVID-19: Peer Support and Crisis Communication Strategies to Promote Institutional Resilience


A rapid transition to voluntary breath hold from device-assisted moderate deep inspiration breath hold for patients receiving breast radiotherapy during the COVID-19 pandemic


title: Emergency Department and Out-of-Hospital Emergency System (112-AREU 118) integrated response to Coronavirus Disease 2019 in a Northern Italy centre

text: Since December 2019, the world has been facing the life-threatening disease, named Coronavirus disease-19 (COVID-19), recognized as a pandemic by the World Health Organization. The response of the Emergency Medicine network, integrating "out-of-hospital" and "hospital" activation, is crucial whenever the health system has to face a medical emergency, being caused by natural or human-derived disasters as well as by a rapidly spreading epidemic outbreak. We here report the Pavia Emergency Medicine network response to the COVID-19 outbreak. The "out-of-hospital" response was analysed in terms of calls, rescues and missions, whereas the "hospital" response was detailed as number of admitted patients and subsequent hospitalisation or discharge. The data in the first 5 weeks of the Covid-19 outbreak (February 21-March 26, 2020) were compared with a reference time window referring to the previous 5 weeks (January 17-February 20, 2020) and with the corresponding historical average data from the previous 5 years (February 21-March 26). Since February 21, 2020, a sudden and sustained increase in the calls to the AREU 112 system was noted (+ 440%). After 5 weeks, the number of calls and missions was still higher as compared to both the reference pre-Covid-19 period (+ 48% and + 10%, respectively) and the historical control (+ 53% and + 22%, respectively). Owing to the overflow from the neighbouring hospitals, which rapidly became overwhelmed and had to temporarily close patient access, the population served by the Pavia system more than doubled (from 547.251 to 1.135.977 inhabitants, + 108%). To minimize the possibility of intra-hospital spreading of the infection, a separate "Emergency Department-Infective Disease" was created, which evaluated 1241 patients with suspected infection (38% of total ED admissions). Out of these 1241 patients, 58.0% (n = 720) were admitted in general wards (n = 629) or intensive care unit (n = 91). To allow this massive number of admissions, the hospital reshaped many general ward Units, which became Covid-19 Units (up to 270 beds) and increased the intensive care unit beds from 32 to 60. In the setting of a long-standing continuing emergency like the present Covid-19 outbreak, the integration, interaction and team work of the "out-of-hospital" and "in-hospital" systems have a pivotal role. The present study reports how the rapid and coordinated reorganization of both might help in facing such a disaster. AREU-112 and the Emergency Department should be ready to finely tune their usual cooperation to respond to a sudden and overwhelming increase in the healthcare needs brought about by a pandemia like the current one. This lesson should shape and reinforce the future.


title: Clostridioides difficile in COVID-19 Patients, Detroit, Michigan, USA, March-April 2020

text: We describe 9 patients at a medical center in Detroit, Michigan, USA, with severe acute respiratory syndrome coronavirus 2 and Clostridioides difficile. Both infections can manifest as digestive symptoms and merit screening when assessing patients with diarrhea during the coronavirus disease pandemic. These co-infections also highlight the continued importance of antimicrobial stewardship.


title: Implicações Cardiovasculares em Pacientes Infectados com Covid-19 e a Importância do Isolamento Social para Reduzir a Disseminação da Doença./ Implicações Cardiovasculares em Pacientes Infectados com Covid-19 e a Importância do Isolamento Social para Reduzir a Disseminação da Doença./ Cardiovascular Implications in Patients Infected with Covid-19 and the Importance of Social Isolation to Reduce Dissemination of the Disease

text: Respiratory symptoms, especially the development of severe acute respiratory distress syndrome, dominate the discussion and initial concerns of the population and health professionals. However, the cardiovascular system is greatly affected by these conditions and is often responsible for complications and mortality of these patients. In order to show the cardiovascular implications in patients infected with COVID-19 and the importance of social isolation as an alternative to curb the spread of the disease, a literature review was carried out based on 37 articles, in English, Portuguese and Spanish, available on Scielo and PubMed. The findings showed that cardiac complications associated with COVID-19 infection are similar to those produced by: severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and influenza. However, COVID-19 has a much greater and faster contamination and, unlike influenza, there is no vaccine or treatment available yet. In view of this, social isolation becomes a tool that can reduce and flatten the curve of cases and thus protect the people at higher risk, decreasing the chances of serious conditions related to the disease, potential deaths and the collapse of the country's health system.


Coronavirus y personal de la salud


The Urgency of Care during the Covid-19 Pandemic - Learning as We Go


title: Universal Masking during Covid-19 Pandemic - Current Evidence and Controversies

text: The emergence of coronavirus disease 19 pandemic and novel research on the high transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised controversies over the use of face masks to prevent community transmission. Specific regulations need to be fulfilled to use a face mask as part of the personal protective equipment and high quality of evidence supporting its use to prevent respiratory viral infections, including SARS-CoV-2, is lacking. However, its widespread use is becoming a standard practice in some countries and discrepancies between health authorities on their policy have led to controversy. The aim of this review is to provide an outlook on recent research in this matter and areas of opportunity.


The need for neurologists in the care of COVID-19 patients


title: The Exponential Phase of the Covid-19 Pandemic in Central Italy: An Integrated Care Pathway

text: The Coronavirus Disease (Covid-19) pandemic is rapidly spreading across the world, representing an unparalleled challenge for health care systems. There are differences in the estimated fatality rates, which cannot be explained easily. In Italy, the estimated case fatality rate was 12.7% in mid-April, while Germany remained at 1.8%. Moreover, it is to be noted that different areas of Italy have very different lethality rates. Due to the complexity of Covid-19 patient management, it is of paramount importance to develop a well-defined clinical workflow in order to avoid the inconsistent management of patients. The Integrated Care Pathway (ICP) represents a multidisciplinary outline of anticipated care to support patient management in the Sant'Andrea Hospital, Rome. The main objective of this pilot study was to develop a new ICP evaluated by care indicators, in order to improve the COVID-19 patient management. The suggested ICP was developed by a multi-professional team composed of different specialists and administrators already involved in clinical and management processes. After a review of current internal practices and published evidences, we identified (1) the activities performed during care delivery, (2) the responsibilities for these activities, (3) hospital structural adaptation needs and potential improvements, and (4) ICP indicators. The process map formed the basis of the final ICP document; 160 COVID-19 inpatients were considered, and the effect of the ICP implementation was evaluated over time during the exponential phase of the COVID-19 pandemic. In conclusion, a rapid adoption of ICP and regular audits of quality indicators for the management of COVID-19 patients might be important tools to improve the quality of care and outcomes.


title: Assessing ACE2 expression patterns in lung tissues in the pathogenesis of COVID-19

text: It has been reported that SARS-CoV-2 may use ACE2 as a receptor to gain entry into human cells, in a way similar to that of SARS-CoV. Analyzing the distribution and expression level of ACE2 may therefore help reveal underlying mechanisms of viral susceptibility and post-infection modulation. In this study, we utilized previously uploaded information on ACE2 expression in various conditions including SARS-CoA to evaluate the role of ACE2 in SARS-CoV and extrapolate that to COVID-19. We found that the expression of ACE2 in healthy populations and patients with underlying diseases was not significantly different. However, based on the elevated expression of ACE2 in cigarette smokers, we speculate that long-term smoking may be a risk factor for COVID-19. Analysis of ACE2 in SARS-CoV infected cells suggests that ACE2 is not only a receptor but is also involved in post-infection regulation, including immune response, cytokine secretion, and viral genome replication. Moreover, we constructed Protein-protein interaction (PPI) networks and identified hub genes in viral activity and cytokine secretion. Our findings may help clinicians and researchers gain more insight into the pathogenesis of SARS-CoV-2 and design therapeutic strategies for COVID-19.


Lidocaine during intubation and extubation in patients with coronavirus disease (COVID-19)


N95 respirator associated pressure ulcer amongst COVID-19 health care workers


EHRA 2020 during COVID-19 days


title: Coronavirus: una amplia familia de virus no tan nueva

text: Empiezo esta comunicación, invitándolos a una breve reflexión acerca del manejo de la información que se recibe y difunde en estos tiempos de pandemia Ante la emergencia sanitaria que se vive en el mundo por la expansión de la Covid-19, uno de los aspectos que se pro-paga rápidamente y es igual de peligroso que el propio virus son las noticias falsas y la desinformación, lo cual ha generado un fenómeno que la Organización Mundial de la Salud (OMS) nombró como infodemia Otro fenómeno que acompaña a la pandemia de la covid-19 es la infoxicación Es decir, la sobrecarga informativa Por ejemplo, realizando una búsqueda el dia 6 de mayo de 2020 en google empleando las palabras coronavirus covid-19, el buscador nos arroja 2,800,000,000 de resultados asocia-dos a la búsqueda, lo cual representa un cúmulo de información y ello se magnifica en importancia si se tiene en cuenta lo relativamente nueva que es la pandemia


docid: ytrzvjhe

title: Keeping up with studies on covid-19: systematic search strategies and resources


title: Proposed Intranasal Route for Drug Administration in the Management of Central Nervous System Manifestations of COVID-19

text: There is mounting evidence of the central nervous system manifestations associated with COVID-19, particularly in severe cases. Up to 25% of COVID-19 cases exhibit neurological manifestations associated with COVID-19. In view of the devastating nature of the disease due to severe acute respiratory syndrome coronavirus 2, here we debate intranasal drug delivery, in addition to intravenous delivery, as a therapeutic strategy in the management of COVID-19 cases with central nervous system involvement.


Covid-19: Don't forget the impact on US family physicians


Risk factors for facial pressure sore of healthcare workers during the outbreak of COVID-19


[Detection of 2019-nCoV in the pathological paraffin embedded tissue]


title: Varying Presentations and Favourable Outcomes of COVID-19 Infection in Children and Young Adults with Sickle Cell Disease: An Additional Case Series with Comparisons to Published Cases

text: Patients with sickle cell disease (SCD) are theoretically at greater risk for serious illness from COVID 19 due to the underlying pathophysiology of chronic inflammation with an increased risk of thrombosis, especially at the time of a vaso-occlusive event (1). Individuals living with SCD are also considered to be immunocompromised due to autoinfarction of their spleen or surgical splenectomy, often as a result of red cell splenic sequestration (2). In addition, patients with SCD often have comorbidities and secondary organ dysfunction that can put them at risk of significant morbidity and or mortality from the severe acute respiratory coronavirus 2 (SARS-CoV-2), and its subsequent disease COVID-19.


The COVID-19 Pandemic: Setting the Mental Health Research Agenda


title: Impact of VOCs emission from iron and steel industry on regional O3 and PM2.5 pollutions

text: Iron and steel industry emission is an important industrial source of air pollution. However, little is known about the relationship between volatile organic compounds (VOCs) emitted and regional air pollution. In this study, VOCs emissions from a typical iron and steel plant in Yangtze River Delta (YRD, China) were monitored from April 2018 to March 2019. The ozone formation potential (OFP) and secondary organic aerosol (SOA) formation of VOCs were calculated to reveal the influence of VOCs emissions on regional ozone and particulate pollution, and the sensitivity analysis approach was performed to explore the qualitative and quantitative relationships between VOCs and O3, as well as VOCs and PM2.5. The VOCs concentration was 93.76 ± 266.97 ppbv during the study. The OFP was 760.08 ± 2391.90 µg m-3, and aromatics were the predominant precursors, contributing 54.05% of the total OFP. Furthermore, the SOA estimated by fractional aerosol coefficient (FAC) and time-resolved (TR) methods were 6.032 ± 13.347 µg m-3 and 0.971 ± 4.650 µg m-3, accounting for 8.65-26.39% (13.78 ± 7.46%) and 1.55-4.20% (2.22 ± 1.23%) of the PM2.5 concentrations, respectively. The results indicated that VOCs were more sensitive to O3 pollution in high pollution domains, whereas VOCs were more sensitive to PM2.5 pollution in low pollution domains. We concluded that reducing VOCs emissions might be effective in alleviating photochemical pollution episodes in areas around iron and steel industry, and the haze pollution occurred in these regions may be caused by the primary emission of PM, and the contribution of SOA was relatively small.


Balancing the need for rapid and rigorous scientific data during early phase of the COVID-19 pandemic: A further role for the scientific community


title: Telemedicine and the 2019 coronavirus (SARS-CoV-2)

text: In 2020 during the CoronaVirus Disease19 (COVID19) pandemic caused by da SARS-CoV-2, the weakness of e-health (electronic health) (ie the lack of direct contact between physician and patient) may prove to be a strength, given the high contagiousness and relative lethality of the virus. In Italy the lack of preparation for supporting the patient load (shortage of personal protection devices, shortage of Intensive Care Unit) beds in comparison with other European Countries, and the poor early diagnostic and therapeutic activity has led us to suggest a project that uses an online platform between General Practitioners and patients in order to reduce moving infected individuals and to perform the diagnosis and treatment early on.


title: Telemedicine and the 2019 Coronavirus (SARS-CoV-2)

text: In 2020 during the CoronaVirus Disease19 (COVID19) pandemic caused by da SARS-CoV-2, the weakness of e-health (electronic health) (i.e. the lack of direct contact between physician and patient) may prove to be a strength, given the high contagiousness and relative lethality of the virus. In Italy the lack of preparation for supporting the patient load (shortage of personal protection devices, shortage of Intensive Care Unit (ICU) beds in comparison to other European Countries, and the poor early diagnostic and therapeutic activity) has led us to suggest a project that uses an online platform between General Practitioners and patients, in order to reduce moving infected individuals and to perform the diagnosis and treatment early on.


Susceptibility and severity of COVID-19 in patients treated with bDMARDS and tsDMARDs: a population-based study


title: Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Exam, Labs, Imaging Accuracy and Biases

text: In December 2019 a novel viral respiratory pathogen emerged in China, ultimately named severe acute respiratory syndrome coronavirus 2 (SARS-Co-V-2) with the clinical illness dubbed coronavirus disease (COVID-19). COVID-19 became a global pandemic in early 2020 forcing governments worldwide to enact social isolation policies with dire economic ramifications. Emergency departments (ED) encountered decreased patient volumes before some in Seattle, New York City, New Orleans, and Detroit experienced waves of COVID-19 patients mixed with asymptomatic patients or those concerned about potential exposures. Diagnosing COVID-19 was hampered by inadequate supplies of reagents and kits, which was compounded by clinical and radiographic features that overlap with numerous seasonal viral respiratory infections.


title: Epidemiological characteristics of and containment measures for coronavirus disease 2019 in Busan Metropolitan City, South Korea

text: Objectives: To describe and evaluate epidemiological investigation. Results: and containment measures implemented in Busan, where 108 cases were confirmed with coronavirus disease 2019 (COVID-19) between February 21 and March 24, 2020. Methods: Any individual who tested positive for COVID-19 was classified as a confirmed case. Measures were taken to identify the source of infection and trace and quarantine contacts. Serial intervals were estimated and the effective reproduction number (R_t) was computed. Results: Of the total 18,303 COVID-19 tests performed between January 16 and March 24 in Busan, 108 yielded positive. Results: (positive test rate: 0.6%). All confirmed cases were placed in isolation at hospitals. Of the 108 confirmed cases, 59 (54.6%) were female. The most common age group was 20-29 years with 37 cases (34.3%). Regarding symptoms at the time of diagnosis, cough (n=38, 35.2%) and fever (n=34, 31.5%) were most common; 12 cases (11.1%) were asymptomatic. The source of infection was identified in 99 cases (91.7%). A total of 3,223 contacts were identified and quarantined. Household contacts accounted for 196, and the household secondary attack rate (SAR) was 8.2% (95% confidence interval [CI] 4.7-12.9%). The mean serial interval was estimated to be 5.54 days (95% CI 4.08-7.01 days). After February 26, R_t remained below 1 in Busan. Conclusion: : The early containment strategy implemented in Busan shows that control is possible if outbreaks are of limited scope. In preparation for future outbreaks, public health and healthcare systems should be re-examined and put in a ready state.


title: ICT Intervention in the Containment of the Pandemic Spread of COVID-19: An Exploratory Study

text: The objective of this article is to explore the Information and Communication Technology (ICT) interventions and its strengths, weaknesses, opportunities and threats for the containment of the pandemic spread of novel Coronavirus. The research adopted a qualitative research approach, while the study data were collected through online content review and Focus Group Discussion (FGD). Starting with a preliminary set of about 1200 electronic resources or contents, 56 were selected for review study, applying an inclusion and exclusion criteria. The review study revealed ICT interventions that include websites and dashboards, mobile applications, robotics and drones, artificial intelligence (AI), data analytic, wearable and sensor technology, social media and learning tools, and interactive voice response (IVR) as well as explored their respective usages to combat the pandemic spread of COVID-19. Later, the FGD was replicated with 22 participants and explored the possible strengths, weaknesses, opportunities, and threats (SWOT) of deploying such technologies to fight against the COVID-19 pandemic. This research not only explores the exiting status of ICT interventions to fight with the COVID-19 pandemic but also provides a number of implications for the government, practitioners, doctors, policymakers and researchers for the effective utilization of the existing ICT interventions and for the future potential research and technological development to the containment of the pandemic spread of COVID-19 and future pandemics.


title: Using random testing to manage a safe exit from the COVID-19 lockdown

text: We argue that frequent sampling of the fraction of infected people (either by random testing or by analysis of sewage water), is central to managing the COVID-19 pandemic because it both measures in real time the key variable controlled by restrictive measures, and anticipates the load on the healthcare system due to progression of the disease. Knowledge of random testing outcomes will (i) significantly improve the predictability of the pandemic, (ii) allow informed and optimized decisions on how to modify restrictive measures, with much shorter delay times than the present ones, and (iii) enable the real-time assessment of the efficiency of new means to reduce transmission rates. Here we suggest, irrespective of the size of a suitably homogeneous population, a conservative estimate of 15000 for the number of randomly tested people per day which will suffice to obtain reliable data about the current fraction of infections and its evolution in time, thus enabling close to real-time assessment of the quantitative effect of restrictive measures. Still higher testing capacity permits detection of geographical differences in spreading rates. Furthermore and most importantly, with daily sampling in place, a reboot could be attempted while the fraction of infected people is still an order of magnitude higher than the level required for a relaxation of restrictions with testing focused on symptomatic individuals. This is demonstrated by considering a feedback and control model of mitigation where the feed-back is derived from noisy sampling data.


title: Potential therapeutic targets for combating SARS-CoV-2: Drug repurposing, clinical trials and recent advancements

text: The present pandemic of SARS-CoV-2 has been a tough task for the whole world to deal with. With the absence of specific drugs or vaccines against SARS-CoV-2, the situation is very difficult to control. Apart from the absence of specific therapies, the lack of knowledge about potential therapeutic targets and individual perception is adding to the complications. The present review describes the novel SARS-CoV-2 structure, surface proteins, asymptomatic and symptomatic transmission in addition to the genotype and phenotype of SARS-CoV-2 along with genetic strains and similarity between SARS, MERS and SARS-CoV-2. Therapeutic strategies such as inhibition of the endocytic pathway and suppressing RNA polymerase activity by metal ions, which could be quite beneficial for controlling COVID-19, are outlined. The drug repurposing for SARS-CoV-2 is discussed in detail along with therapeutic classes such as antivirals, antibiotics, and amino quinolones and their probable role in suppressing SARS-CoV-2 with reference to case studies. The ongoing clinical trials both with respect to drug repurposing and vaccines are summarized along with a brief description. The recent advancements and future perspective of ongoing research for therapy and detection of SARS-CoV-2 are provided. The review, in brief, summarizes epidemiology, therapy and the current scenario for combating SARS-CoV-2.


Angiotensin II for the Treatment of COVID-19-Related Vasodilatory Shock


docid: bwonzoby

title: The COVID-19 pandemic and tuberculosis in Taiwan


COVID-19 and the Inpatient Dialysis Unit: Managing Resources during Contingency Planning Pre-Crisis


title: Gene expression network analysis of lymph node involvement in colon cancer identifies AHSA2, CDK10, and CWC22 as possible prognostic markers

text: Colon cancer has been well studied using a variety of molecular techniques, including whole genome sequencing. However, genetic markers that could be used to predict lymph node (LN) involvement, which is the most important prognostic factor for colon cancer, have not been identified. In the present study, we compared LN(+) and LN(-) colon cancer patients using differential gene expression and network analysis. Colon cancer gene expression data were obtained from the Cancer Genome Atlas and divided into two groups, LN(+) and LN(-). Gene expression networks were constructed using LASSO (Least Absolute Shrinkage and Selection Operator) regression. We identified hub genes, such as APBB1, AHSA2, ZNF767, and JAK2, that were highly differentially expressed. Survival analysis using selected hub genes, such as AHSA2, CDK10, and CWC22, showed that their expression levels were significantly associated with the survival rate of colon cancer patients, which indicates their possible use as prognostic markers. In addition, protein-protein interaction network, GO enrichment, and KEGG pathway analysis were performed with selected hub genes from each group to investigate the regulatory relationships between hub genes and LN involvement in colon cancer; these analyses revealed differences between the LN(-) and LN(+) groups. Our network analysis may help narrow down the search for novel candidate genes for the treatment of colon cancer, in addition to improving our understanding of the biological processes underlying LN involvement. All R implementation codes are available at journal website as Supplementary Materials.


docid: nfvswoto

title: Rapid immunoglobulin test confirms a suspected case of COVID-19


Overcoming post-surgery challenges in lockdown


title: COVID-19-CT-CXR: a freely accessible and weakly labeled chest X-ray and CT image collection on COVID-19 from biomedical literature

text: The latest threat to global health is the COVID-19 outbreak. Although there exist large datasets of chest X-rays (CXR) and computed tomography (CT) scans, few COVID-19 image collections are currently available due to patient privacy. At the same time, there is a rapid growth of COVID-19-relevant articles in the biomedical literature. Here, we present COVID-19-CT-CXR, a public database of COVID-19 CXR and CT images, which are automatically extracted from COVID-19-relevant articles from the PubMed Central Open Access (PMC-OA) Subset. We extracted figures, associated captions, and relevant figure descriptions in the article and separated compound figures into subfigures. We also designed a deep-learning model to distinguish them from other figure types and to classify them accordingly. The final database includes 1,327 CT and 263 CXR images (as of May 9, 2020) with their relevant text. To demonstrate the utility of COVID-19-CT-CXR, we conducted four case studies. (1) We show that COVID-19-CT-CXR, when used as additional training data, is able to contribute to improved DL performance for the classification of COVID-19 and non-COVID-19 CT. (2) We collected CT images of influenza and trained a DL baseline to distinguish a diagnosis of COVID-19, influenza, or normal or other types of diseases on CT. (3) We trained an unsupervised one-class classifier from non-COVID-19 CXR and performed anomaly detection to detect COVID-19 CXR. (4) From text-mined captions and figure descriptions, we compared clinical symptoms and clinical findings of COVID-19 vs. those of influenza to demonstrate the disease differences in the scientific publications. We believe that our work is complementary to existing resources and hope that it will contribute to medical image analysis of the COVID-19 pandemic. The dataset, code, and DL models are publicly available at https://github.com/ncbi-nlp/COVID-19-CT-CXR.


Systematic analysis of COVID-19 infection and symptoms in a systemic lupus erythematosus population: correlation with disease characteristics, hydroxychloroquine use and immunosuppressive treatments


title: Youth Mental Health in the time of COVID-19

text: Youth Mental Health is a rapidly developing field with a focus on prevention, early identification, treatment innovation and service development. In this perspective piece, we discuss the effects of COVID-19 on young people's mental health. The psychosocial effects of COVID-19 disproportionately affect young people. Both immediate and longer-term factors through which young people are affected include social isolation, changes to the delivery of therapeutic services and almost complete loss of all structured occupations (school, work and training) within this population group. Longer-term mechanisms include the effects of the predicted recession on young people's mental health. Opportunities within this crisis exist for service providers to scale up telehealth and digital services that may benefit service provision for young people's mental health in the future.


Innovative strategies to support physical distancing among individuals with active addiction


title: Impact of COVID-19 related healthcare crisis on treatments for patients with lysosomal storage disorders, the first Italian experience

text: The direct and indirect effects of Coronavirus Disease-19 (COVID-19) pandemic, on Italian patients with lysosomal storage disorders receiving therapy, were analyzed by a phone questionnaire. No proved COVID-19 emerged among 102 interviewed. No problems were reported by patients receiving oral treatments. Forty-nine% of patients receiving enzyme replacement therapy in hospitals experienced disruptions, versus 6% of those home-treated. The main reasons of missed infusions were fear of infection (62.9%) and re-organization of the infusion centers (37%).


title: Analysis of Psychological and Sleep Status and Exercise Rehabilitation of Front-Line Clinical Staff in the Fight Against COVID-19 in China

text: BACKGROUND The aim of this study was to understand the changes in psychological factors and sleep status of front-line medical staff in the fight against COVID-19 and provide evidence of exercise interventions to relieve psychological stress and improve sleep status for medical staff. MATERIAL AND METHODS A survey study was conducted among 120 front-line medical staff in the fight against COVID-19, of which 60 medical staff worked at the designated hospital (experimental group) and 60 medical staff worked at the non-designated hospital (control group). The Symptom Checklist 90 (SCL-90), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and PTSD Checklist-Civilian Version (PCL-C) were used to assess mental status. Sleep status was assessed using the Pittsburgh Sleep Quality Index (PSQI). RESULTS SCL-90 scores of somatization, depression, anxiety, and terror were higher than normal in front-line medical staff at the designated hospital. The SAS (45.89±1.117), SDS (50.13±1.813), and PCL-C (50.13±1.813) scores in the experimental group were higher than the normal control group, and were significantly different from those in the control group on SDS and PCL-C scales (P<0.05). The total average PSQI of the experimental group was 16.07±3.761, indicating that the sleep quality was poor. Among them, participants with moderate insomnia reached 61.67%, and participants with severe insomnia reached 26.67%. CONCLUSIONS There are psychological symptoms and sleep symptoms in front-line medical staff who participate in the fight against COVID-19, and they affect each other. Hospitals should improve emergency management measures, strengthen psychological counseling for clinical front-line medical staff, strengthen exercise intervention, and improve their sleep quality and mental health.


Shielding from covid-19 should be stratified by risk


docid: sjiaotil

title: Letter to the Editor on "Rehabilitation following critical illness in people with COVID-19 infection"


title: Detection of SARS-CoV-2-Specific Humoral and Cellular Immunity in COVID-19 Convalescent Individuals

text: The World Health Organization has declared SARS-CoV-2 virus outbreak a worldwide pandemic. However, there is very limited understanding on the immune responses, especially adaptive immune responses to SARS-CoV-2 infection. Here, we collected blood from COVID-19 patients who have recently become virus-free, and therefore were discharged, and detected SARS-CoV-2-specific humoral and cellular immunity in eight newly discharged patients. Follow-up analysis on another cohort of six patients 2 weeks post discharge also revealed high titers of immunoglobulin G (IgG) antibodies. In all 14 patients tested, 13 displayed serum-neutralizing activities in a pseudotype entry assay. Notably, there was a strong correlation between neutralization antibody titers and the numbers of virus-specific T cells. Our work provides a basis for further analysis of protective immunity to SARS-CoV-2, and understanding the pathogenesis of COVID-19, especially in the severe cases. It also has implications in developing an effective vaccine to SARS-CoV-2 infection.


title: Case-Fatality Risk Estimates for COVID-19 Calculated by Using a Lag Time for Fatality

text: We estimated the case-fatality risk for coronavirus disease cases in China (3.5%); China, excluding Hubei Province (0.8%); 82 countries, territories, and areas (4.2%); and on a cruise ship (0.6%). Lower estimates might be closest to the true value, but a broad range of 0.25%-3.0% probably should be considered.


title: Optimized lockdown strategies for curbing the spread of COVID-19: A South African case study

text: To curb the spread of COVID-19, many governments around the world have implemented tiered lockdowns with varying degrees of stringency. Lockdown levels are typically increased when the disease spreads and reduced when the disease abates. A predictive control approach is used to develop optimized lockdown strategies for curbing the spread of COVID-19. These strategies are then applied to South African data. The South African case is of immediate interest as the number of confirmed infectious cases does not appear to have peaked yet (at the time of writing), while at the same time the South African government is busy reducing the degree of lockdown. An epidemiological model for the spread of COVID-19 in South Africa was previously developed, and is used in conjunction with a hybrid model predictive controller to optimize lockdown management under different policy scenarios. Scenarios considered include how flatten the curve to a level that the healthcare system can cope with, how to balance lives and livelihoods, and what impact the compliance of the population to the lockdown measures has on the spread of COVID-19.


title: Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan

text: A mysterious outbreak of atypical pneumonia in late 2019 was traced to a seafood wholesale market in Wuhan of China Within a few weeks, a novel coronavirus tentatively named as 2019 novel coronavirus (2019-nCoV) was announced by the World Health Organization We performed bioinformatics analysis on a virus genome from a patient with 2019-nCoV infection and compared it with other related coronavirus genomes Overall, the genome of 2019-nCoV has 89% nucleotide identity with bat SARS-like-CoVZXC21 and 82% with that of human SARS-CoV The phylogenetic trees of their orf1a/b, Spike, Envelope, Membrane and Nucleoprotein also clustered closely with those of the bat, civet and human SARS coronaviruses However, the external subdomain of Spike's receptor binding domain of 2019-nCoV shares only 40% amino acid identity with other SARS-related coronaviruses Remarkably, its orf3b encodes a completely novel short protein Furthermore, its new orf8 likely encodes a secreted protein with an alpha-helix, following with a beta-sheet(s) containing six strands Learning from the roles of civet in SARS and camel in MERS, hunting for the animal source of 2019-nCoV and its more ancestral virus would be important for understanding the origin and evolution of this novel lineage B betacoronavirus These findings provide the basis for starting further studies on the pathogenesis, and optimizing the design of diagnostic, antiviral and vaccination strategies for this emerging infection FAU - Chan, Jasper Fuk-Woo


title: Survey Says: "COVID-19 Lockdown Hits Young Faculty and Clinical Trials"

text: COVID-19 has severely impacted laboratory research. Analysis of the International Society for Stem Cell Research (ISSCR) member survey has highlighted a particular impact on clinical trials and early-career investigators. The stem cell community needs to support young researchers and ensure that stem cell medicine does not lose its momentum.


title: Thyroid disease in the time of COVID-19

text: The novel coronavirus disease COVID-19 is produced by SARS-CoV-2. WHO has declared COVID-19 as a public health emergency, with the most susceptible populations (requiring ventilation) being the elderly, pregnant women and people with associated co-morbidities including heart failure, uncontrolled diabetes, chronic obstructive pulmonary disease, asthma and cancer. However, such general guidance does not provide information regarding COVID-19 risks in patients with suffering from pre-existing thyroid problems, and furthermore, we do not know whether patients with COVID-19 (symptomatic or without symptoms), who have not previously had thyroid issues develop endocrine thyroid dysfunction after infection. The European Society for Endocrinology recently published a statement on COVID-19 and endocrine diseases (Endocrine, 2020); however, thyroid diseases were not mentioned specifically. We have therefore reviewed the current literature on thyroid diseases (excluding cancer) and COVID-19, including data from the previous coronavirus pandemic caused by the SARS-associated coronavirus (SARS-CoV), a member of the same family Coronaviridae leading to severe acute respiratory syndrome (SARS). At the moment there are no data suggesting that thyroid patients are at higher risk of COVID-19, but this requites further research and data analysis.


COVID-19 mental-health responses neglect social realities


title: A technical report from the Italian SARS-CoV-2 outbreak. Postmortem sampling and autopsy investigation in cases of suspected or probable COVID-19

text: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a coronavirus responsible for COVID-19 (coronavirus disease 2019) which resulted in a cluster of cases of pneumonia that originated in China around 31 December 2019 and has subsequently spread across the globe. Currently, COVID-19 represents a health emergency worldwide, leading, in severe cases, to pneumonia, severe acute respiratory syndrome, multiorgan dysfunction or failure, and death. In the context of limited scientific knowledge and evidence of SARS-CoV-2 infection, guidance is becoming increasingly necessary for pathologists who have to perform postmortem investigations on COVID-19 cases. The aim of the present report is to share a procedure applicable to cases of COVID-19-related death, particularly in cases of death without medical intervention and in the absence of an ascertained SARS-CoV-2 infection and/or COVID-19 diagnosis, therefore providing support for diagnostic activity in the present COVID-19 pandemic. For this purpose, a standard operating procedure for correct swab collection, autopsy investigation and tissue sampling is provided.


title: Viral RNA Load in Mildly Symptomatic and Asymptomatic Children with COVID-19, Seoul

text: Along with positive SARS-CoV-2 RNA in nasopharyngeal swabs, viral RNA was detectable at high concentration for >3 weeks in fecal samples from 12 mildly symptomatic and asymptomatic children with COVID-19. Saliva also tested positive during the early phase of infection. If proven infectious, feces and saliva could serve as transmission sources.


Covid-19 worldwide: we need precise data by age group and sex urgently


docid: emmpoaks

title: The use of continuous perineural catheters and other practices to optimize regional anesthesia in COVID-19 patients


title: An international comparison analysis of reserve and supply system for emergency medical supplies between China, the United States, Australia, and Canada

text: Coronavirus disease 19 (COVID-19) has become a pandemic around the world. With the explosive growth of confirmed cases, emergency medical supplies are facing global shortage, which restricts the treatment of seriously ill patients and protection of medical staff. Taking China, the United States, Australia, and Canada as examples, this study compares and analyzes the reserve and supply systems of emergency medical supplies and problems exposed in response to the COVID-19 epidemic. Some common problems were found, such as insufficient types and quantities of emergency medical supplies in reserve, insufficient emergency production capacity, and imperfect command mechanism for emergency supplies deployment and transportation. A sound reserve system of emergency medical supplies is the basis and guarantee for dealing with public health emergencies such as major outbreaks. Based on the comparison of systems and practical experience, countries around the world should further improve the reserve and supply system of emergency medical supplies, and improve the coordination and cooperation mechanism for emergency supplies for international public health emergencies, so as to cope with increasingly severe public health emergencies in the context of globalization.


docid: dhpgchjk

title: Re: Kristian D. Stensland, Todd M. Morgan, Alireza Moinzadeh, et al. Considerations in the Triage of Urologic Surgeries During the COVID-19 Pandemic. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2020.03.027: The Forgotten Urological Patient During the COVID-19 Pandemic: Patient Safety Safeguards


title: 'What is Inconvenient for You is Life-saving for Me': How Health Inequities are playing out during the COVID-19 Pandemic

text: The COVID-19 pandemic has had a significant impact globally. Most affected, however, are those individuals and groups routinely disadvantaged by the social injustice created by the misdistribution of power, money, and resources. Simple measures that prevent the spread of COVID-19, such as frequent hand washing and social distancing, are unavailable to millions of people in the wealthiest of nations and in the poorest of nations. Disadvantaged groups are impacted more directly and in disproportionately higher numbers due to existing poor health, and the disruption of services central to securing an income and an education will have lasting consequences for their futures. The unintended effect of exclusionary government policies is that privileged citizens and healthcare systems are also at greater risk. This paper seeks to highlight the impact of COVID-19 on those already suffering health inequities through consideration of some of the social determinants of health on groups in affluent and poorer nations. It also highlights some of the factors that may assist in tackling health inequities as we emerge from this pandemic.


The robot recruits in China's health-care system


title: Facial diplegia, a possible atypical variant of Guillain-Barré Syndrome as a rare neurological complication of SARS-CoV-2

text: We present a case of facial diplegia after 10 days of SARS-CoV-2 confirmed infection symptoms in a 61 year old patient without prior clinically relevant background. There are few known cases of Guillain-Barré Syndrome (GBS) related to SARS-CoV-2 infection; we propose this case as a rare variant of GBS in COVID-19 infection context, due to Its chronology, clinical manifestations and cerebrospinal fluid (CSF) findings.


title: Lockdown contained the spread of 2019 novel coronavirus disease in Huangshi city, China: Early epidemiological findings

text: BACKGROUND: To control the spread of 2019 novel coronavirus disease (COVID-19), China sealed Wuhan on Jan 23, 2020 and soon expanded lockdown to other twelve cities in Hubei province. We aimed to describe the epidemiological characteristics in one of the cities and highlight the effect of current implemented lockdown and nonpharmaceutical interventions. METHODS: We retrieved data of reported cases in Huangshi and Wuhan from publicly available disease databases. Local epidemiological data on suspected or confirmed cases in Huangshi were collected through field investigation. Epidemic curves were constructed with data on reported and observed cases. RESULTS: The accumulated confirmed COVID-19 cases and fatality in Huangshi were reported to be 1015 and 3.74% respectively, compared with 50006 and 5.08% in Wuhan till Mar 27, 2020. Right after Jan 24, the epidemic curve based on observed cases in Huangshi became flattened. Feb 1, 2020 was identified as the "turning point" as the epidemic in Huangshi faded soon afterwards. COVID-19 epidemic was characterized by mild cases in Huangshi, accounting for 82.66% of total cases. Moreover, 50 asymptomatic infections were identified in adults and children. Besides, we found confirmed cases in 19 familial clusters and 21 health care workers, supporting inter-human transmission. CONCLUSIONS: Our study reported the temporal dynamics and characteristics of the COVID-19 epidemic in Huangshi city, China, across the unprecedented intervention. Such new epidemiological inference might provide further guidance on current lockdown measures in high-risk cities and, subsequently, help improve public health intervention strategies against the pandemic on the country and global levels.


Original TitleCovid-19 : et notre monde se referma comme une huître…


Cancer, COVID-19 and the precautionary principle: prioritizing treatment during a global pandemic