title: Impact of the COVID-19 Pandemic on the Urologist's clinical practice in Brazil: a management guideline proposal for low- and middle-income countries during the crisis period

text: This letter to the Editor aims to provide suggestions and recommendations for the management of urological conditions in times of COVID-19 crisis in Brazil and other low- and middle-income countries. It is important to highlight that one of the main characteristics of this pandemic is the oversaturation of the health system capacity, mostly due to a high demand for personal protective equipment (PPE), Hospital/ICU beds, as well as ventilators. In places with limited resources and where the health care systems are already saturated, such consideration is even more worrisome. Therefore, most worldwide authorities are recommending to avoid, as much as possible, patient's elective visits to hospitals, as well as a judicious use of the operating room in order to mitigate the strain put on the health system. While efforts should be directed to the care of COVID-19 patients, other conditions (especially urgencies and oncological cases) must continue to be assisted. Thus, through a panel of experts, we have prepared a practical guide for Thus, through a panel of experts, we have prepared a practical guide for urologists based on the recommendations from the main Urologic Associations, as well as data from the literature to support the suggested management. We will try to follow the standard guideline recommendations from the American Urological Association (AUA) and European Association of Urology (EAU), with the aim of pursuing the best outcomes possible. However, some recommendations were based on the consensus of the panel, taking into consideration the reality of developing countries and the unprecedented situation caused by the COVID-19 crisis. Most importantly, all recommendations on this manuscript are based on the expectancy of a maximum 3-month duration of the crisis. If this period shall extended, these recommendations will be revised and updated.


Covid-19 and Namaste


title: Early experience of an infectious and tropical diseases unit during the coronavirus disease (COVID-19) pandemic, Florence, Italy, February to March 2020

text: We analysed the first 84 coronavirus disease (COVID-19) patients hospitalised in an infectious and tropical disease unit in Florence, Italy, over 30 days after the start of the COVID-19 outbreak in Italy. A 12% reduction in the rate of intensive care unit transfer was observed after the implementation of intensity care measures in the regular ward such as increasing the nurse/patient ratio, presence of critical care physicians and using high flow nasal cannulae oxygenation.


Time for coordinated action in waste management under lockdown challenges


title: Expert recommendations on blood purification treatment protocol for patients with severe COVID-19: Recommendation and consensus

text: Coronavirus disease (COVID-19) was first diagnosed in Wuhan in December 2019. The World Health Organization defined the subsequent outbreak of COVID-19 worldwide as a public health emergency of international concern. Epidemiological data indicate that at least 20% of COVID-19 patients have severe disease. In addition to impairment of the respiratory system, acute kidney injury (AKI) is a major complication. Immune damage mediated by cytokine storms and concomitant AKI is a key factor for poor prognosis. Based on previous experience of blood purification for patients with severe acute respiratory syndrome and Middle East respiratory syndrome combined with clinical front-line practice, we developed a blood purification protocol for patients with severe COVID-19. This protocol is divided into four major steps. The first step is to assess whether patients with severe COVID-19 require blood purification. The second step is to prescribe a blood purification treatment for patients with COVID-19. The third step is to monitor and adjust parameters of blood purification. The fourth step is to evaluate the timing of discontinuation of blood purification. It is expected that blood purification will play a key role in effectively reducing the mortality of patients with severe COVID-19 through the standardized implementation of the present protocol.


Reconsidering the immediate release of prisoners during COVID-19 community restrictions


COVID-19: An Overview of Worldwide Recommendations for Management of Patients With Liver Diseases or Liver Transplantation


Fighting 2 Enemies: Cancer and COVID-19


Essential care of critical illness must not be forgotten in the COVID-19 pandemic


New guidance for treating patients with lung cancer and COVID-19


Hypothesis: angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19


Comments on "Preliminary estimation of the basic reproduction number of novel Coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven Analysis in the early phase of the outbreak"


docid: iabithts

title: Air Microbiome and Pollution: Composition and Potential Effects on Human Health, Including SARS Coronavirus Infection

text: Polluted air poses a significant threat to human health. Exposure to particulate matter (PM) and harmful gases contributes to cardiovascular and respiratory diseases, including allergies and obstructive lung disease. Air pollution may also be linked to cancer and reduced life expectancy. Uptake of PM has been shown to cause pathological changes in the intestinal microbiota in mice and humans. Less is known about the effects of pollution-associated microbiota on human health. Several recent studies described the microbiomes of urban and rural air samples, of the stratosphere and sand particles, which can be transported over long distances, as well as the air of indoor environments. Here, we summarize the current knowledge on airborne bacterial, viral, and fungal communities and discuss their potential consequences on human health. The current data suggest that bacterial pathogens are typically too sparse and short-lived in air to pose a significant risk for infecting healthy people. However, airborne fungal spores may exacerbate allergies and asthma. Little information is available on viruses including phages, and future studies are likely to detect known and novel viruses with a yet unknown impact on human health. Furthermore, varying experimental protocols have been employed in the recent microbiome and virome studies. Therefore, standardized methodologies will be required to allow for better comparisons between studies. Air pollution has been linked to more severe outcomes of SARS (severe acute respiratory syndrome) coronavirus (SARS-CoV) infections. This may have contributed to severe SARS-CoV-2 outbreaks, especially those in China, Northern Italy, Iran, and New York City.


Long-Term Hemodialysis during the COVID-19 Pandemic


Follow-up study on pulmonary function and radiological changes in critically ill patients with COVID-19


title: SODA: Detecting Covid-19 in Chest X-rays with Semi-supervised Open Set Domain Adaptation

text: The global pandemic of COVID-19 has infected millions of people since its first outbreak in last December. A key challenge for preventing and controlling COVID-19 is how to quickly, widely, and effectively implement the test for the disease, because testing is the first step to break the chains of transmission. To assist the diagnosis of the disease, radiology imaging is used to complement the screening process and triage patients into different risk levels. Deep learning methods have taken a more active role in automatically detecting COVID-19 disease in chest x-ray images, as witnessed in many recent works. Most of these works first train a CNN on an existing large-scale chest x-ray image dataset and then fine-tune it with a COVID-19 dataset at a much smaller scale. However, direct transfer across datasets from different domains may lead to poor performance due to visual domain shift. Also, the small scale of the COVID-19 dataset on the target domain can make the training fall into the overfitting trap. To solve all these crucial problems and fully exploit the available large-scale chest x-ray image dataset, we formulate the problem of COVID-19 chest x-ray image classification in a semi-supervised open set domain adaptation setting, through which we are motivated to reduce the domain shift and avoid overfitting when training on a very small dataset of COVID-19. In addressing this formulated problem, we propose a novel Semi-supervised Open set Domain Adversarial network (SODA), which is able to align the data distributions across different domains in a general domain space and also in a common subspace of source and target data. In our experiments, SODA achieves a leading classification performance compared with recent state-of-the-art models, as well as effectively separating COVID-19 with common pneumonia.


Publishing in a Pandemic: The View from Cell Reports


The psychological impact of COVID-19 on medical students [Letter]


Maximising application of the aerosol box in protecting healthcare workers during the COVID-19 pandemic


Letter to the Editor: Variability but not admission or trends in NEWS2 score predicts clinical outcome in elderly hospitalised patients with COVID-19


title: COVID-19 and careers: On the futility of generational explanations

text: It is common to broadly group people of different ages into "generations" and to speak of distinctions between such groups in terms of "generational differences." The problem with this practice, is that there exists no credible scientific evidence that (a) generations exist, (b) that people can be reliably classified into generational groups, and (c) that there are demonstrable differences between such groups. We have already noted an emerging generationalized rhetoric that has characterized how people of different ages have been affected by and reacted to the COVID-19 pandemic. These narratives have been especially present in discussions of how work and careers will be affected by this crisis. In this essay, we outline problems with applying the concept of generations, especially for researchers seeking explanations for how COVID-19 will affect careers and career development. We urge researchers to eschew the notion of generations and generational differences and consider alternative lifespan development theoretical frameworks that better capture age-graded processes.


title: Immunologic aspects of characteristics, diagnosis, and treatment of coronavirus disease 2019 (COVID-19)

text: On March 11, 2020, the World Health Organization declared the worldwide spread of the infectious disease COVID-19, caused by a new strain of coronavirus, SARS-CoV-2, as a pandemic. Like in all other infectious diseases, the host immune system plays a key role in our defense against SARS-CoV-2 infection. However, viruses are able to evade the immune attack and proliferate and, in susceptible individuals, cause severe inflammatory response known as cytokine storm, particularly in the lungs. The advancement in our understanding of the mechanisms underlying the host immune responses promises to facilitate the development of approaches for prevention or treatment of diseases. Components of immune system, such as antibodies, can also be used to develop sensitive and specific diagnostic methods as well as novel therapeutic agents. In this review, we summarize our knowledge about how the host mounts immune responses to infection by SARS-CoV-2. We also describe the diagnostic methods being used for COVID-19 identification and summarize the current status of various therapeutic strategies, including vaccination, being considered for treatment of the disease.


SARS-CoV-2 Infection Results in Serious Kidney Impairment: More Studies Need to Be Explored


title: [A koronavírus okozta COVID19-pandémia. Korábbi tapasztalatok és tudományos evidenciák 2020. március végén]/ The coronavirus-induced COVID-19 pandemic. Previous experiences and scientific evidences at the end of March, 2020

text: The COVID-19 epidemic hit everyone, professionals and civilians alike. The possibility of a worldwide pandemic has long been theorized by epidemiologists, infectologists on the one hand, and sociologists and behavioral scientists dealing with communication and social habits on the other. Yet, faced with real-time events, daily infections and mortality statistics, almost everyone feels uninformed or disturbingly inexperienced. This summary aims to provide an overview of the latest scientific evidences. Of course, the incomplete material, compiled in late March 2020, will certainly contain a few elements that likely will be outdated in a few weeks. The authors hope that in the next publication we will all read much better and more hopeful prospects. Orv Hetil. 2020; 161(17): 644651.


title: Refusal of viral testing during the SARS-CoV-2 pandemic

text: Widespread testing for the respiratory syndrome coronavirus-2 (SARS-CoV-2) will represent an important part of any strategy designed to safely reopen societies from lockdown. Healthcare settings have the potential to become reservoirs of infectivity, and therefore many hospital trusts are beginning to carry out routine screening of staff and patients. This could promote the effective cohorting of patients and reduce the rate of nosocomial infection. However, for various reasons, some individuals may refuse this testing. Here we highlight this as an emergent ethicolegal issue which we expect to become increasingly relevant as testing becomes ubiquitous. We explore this position from an ethical and legal perspective, determining whether refusal of testing is acceptable under UK law. Individual patients refusing testing could undermine a hospital's testing strategy; therefore clinicians and policy makers must prospectively determine the best course of action if this were to occur.


docid: lablhoni

title: Azithromycin and SARS-CoV-2 infection: where we are now and where we are going


title: Fecal-Oral Transmission of COVID-19: Could Hypochlorhydria Play a Role?

text: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) which emerged in Wuhan, China in 2019 (1). Respiratory symptoms remain the most common clinical manifestations of COVID-19. However, non-respiratory symptoms are increasingly being recognized. Gastrointestinal (GI) symptoms such as anorexia, nausea, vomiting, diarrhea, and abdominal pain are noted in COVID-19 patients either alone or in association with respiratory manifestations (2). Stool viral RNA can be detected by up to 50% in patients with diarrhea (3). This article is protected by copyright. All rights reserved.


COVID-19: Impact on health of people & wealth of nations


title: Investigating the genomic landscape of novel coronavirus (2019-nCoV) to identify non-synonymous mutations for use in diagnosis and drug design

text: Novel coronavirus has wrecked medical and health care facilities claiming â¼5% death tollsglobally. All efforts to contain the pathogenesis either using inhibitory drugs or vaccines largelyremained futile due to a lack of better understanding of the genomic feature of this virus. In thepresent study, we compared the 2019-nCoV with other coronaviruses, which indicated that batSARS like coronavirus could be a probable ancestor of the novel coronavirus. The proteinsequence similarity of pangolin-hCoV and bat-hCoV with human coronavirus was higher ascompared to their nucleotide similarity denoting the occurrence of more synonymous mutationsin the genome. Phylogenetic and alignment analysis of 591 novel coronaviruses of differentclades from Group I to Group V revealed several mutations and concomitant amino acidchanges. Detailed investigation on nucleotide substitution unfolded 100 substitutions in thecoding region of which 43 were synonymous and 57 were of non-synonymous type. The nonsynonymous substitutions resulting into 57 amino acid changes were found to be distributed overdifferent hCoV proteins with maximum on spike protein. An important di-amino acid change RGto KR was observed in ORF9 protein. Additionally, several interesting features of the novelcoronavirus genome have been highlighted in respect to various other human infecting viruseswhich may explain extreme pathogenicity, infectivity and simultaneously the reason behindfailure of the antiviral therapies. SUMMARY: This study presents a comprehensive phylogenetic analysis of SARS-CoV2 isolates to understand discrete mutations that are occurring between patient samples. The analysis unravel various amino acid mutations in the viral proteins which may provide an explanation for varying treatment efficacies of different inhibitory drugs and a future direction towards a combinatorial treatment therapies based on the kind of mutation in the viral genome.


docid: ezdeohsj

title: Advances in Telemedicine in Ophthalmology

text: Telemedicine is the provision of healthcare-related services from a distance and is poised to move healthcare from the physician's office back into the patient's home. The field of ophthalmology is often at the forefront of technological advances in medicine including telemedicine and the use of artificial intelligence. Multiple studies have demonstrated the reliability of tele-ophthalmology for use in screening and diagnostics and have demonstrated benefits to patients, physicians, as well as payors. There remain obstacles to widespread implementation, but recent legislation and regulation passed due to the devastating COVID-19 pandemic have helped to reduce some of these barriers. This review describes the current status of tele-ophthalmology in the United States including benefits, hurdles, current programs, technology, and developments in artificial intelligence. With ongoing advances patients may benefit from improved detection and earlier treatment of eye diseases, resulting in better care and improved visual outcomes.


Cardiac surgery model during COVID-19 pandemic: now it's time to ramp up


Can thrombotic events be a major concern in hepatocellular carcinoma patients under systemic treatment during SARS-Cov-2?


Obesity and covid-19: the role of the food industry


The ethics of scare: COVID-19 and the Philippines' fear appeals


title: Modelling transmission and control of the COVID-19 pandemic in Australia

text: We develop an agent-based model for a fine-grained computational simulation of the ongoing COVID-19 pandemic in Australia. This model is calibrated to reproduce key characteristics of COVID-19 transmission. An important calibration outcome is the age-dependent fraction of symptomatic cases, with this fraction for children found to be one-fifth of such fraction for adults. We apply the model to compare several intervention strategies, including restrictions on international air travel, case isolation, home quarantine, social distancing with varying levels of compliance, and school closures. School closures are not found to bring decisive benefits, unless coupled with high level of social distancing compliance. We report several trade-offs, and an important transition across the levels of social distancing compliance, in the range between 70% and 80% levels, with compliance at the 90% level found to control the disease within 13--14 weeks, when coupled with effective case isolation and international travel restrictions.


Potential therapeutic options for coronavirus disease 2019: using knowledge of past outbreaks to guide future treatment


Renin-angiotensin-aldosterone system inhibitors impact on COVID-19 mortality: What's next for ACE2?


title: COVID-19 pandemic predictions using the modified Bateman SIZ model and observational data for Heidelberg, Germany: Effect of vaccination with a SARS-CoV-2 vaccine, coronavirus testing and application of the Corona-Warn-App

text: AIMS OF THE STUDY: Published data show that the current progression of the COVID-19 pandemic in Heidelberg, Germany, despite the current lockdown, could continue into 2021 and become more severe. We have used the modified Bateman SIZ algorithm to predict the effects of interventional measures to control the COVID-19 pandemic. MATERIALS AND METHODS: Model parameters, e.g., doubling time and rate of decrease in the number of infectious persons were obtained from published reports. Predictions were made for the status quo on June 1, 2020, and for interventional measures obtained for 4 scenarios. These included vaccination of the whole population using a SARS-CoV-2 vaccine having an efficacy of 50% and 100%, mass-testing for COVID-19 coronavirus and application of the Corona-Warn-App. RESULTS: The principle findings were 1) without new measures to control the pandemic, the daily number of infectious persons could reach a peak of > 4,500 daily within 18 months when > 67,000 persons would have been infected. This could be prevented by using a vaccine with 50% efficacy which was almost equally effective as a vaccine with 100% efficacy. Application of the Corona-Warn-App was the most effective method and more effective than testing for COVID-19. The methodology used has been described in detail to enable other researchers to apply the modified Bateman SIZ model to obtain predictions for COVID-19 outbreaks in other regions. Application of the model has been verified by independent investigators using different commercial software packages. CONCLUSION: The modified Bateman SIZ model has been verified and used to predict the course of the COVID-19 pandemic in Heidelberg. Lockdown measures alone are insufficient to control the pandemic during 2021. Vaccination, diagnostic tests, and use of the Corona-Warn-App with quarantine could successfully control the spread of the coronavirus infection in the community. The Corona-Warn-App applied correctly may be the most effective. The model showed that vaccination with 50% efficacy is almost as effective as vaccination with 100% efficacy.


False Negative Tests for SARS-CoV-2 Infection - Challenges and Implications


docid: vygsubve

title: Face masks and containment of COVID-19: experience from South Korea


title: COVID-19 and arterial hypertension: Hypothesis or evidence?

text: Investigations reported that hypertension, diabetes, and cardiovascular diseases were the most prevalent comorbidities among the patients with coronavirus disease 2019 (COVID-19). Hypertension appeared consistently as the most prevalent risk factors in COVID-19 patients. Some investigations speculated about the association between renin-angiotensin-aldosterone system (RAAS) and susceptibility to COVID-19, as well as the relationship between RAAS inhibitors and increased mortality in these patients. This raised concern about the potential association between hypertension (and its treatment) and propensity for COVID-19. There are only a few follow-up studies that investigated the impact of comorbidities on outcome in these patients with conflicting findings. Hypertension has been proven to be more prevalent in patients with an adverse outcome (admission in intensive care unit, use of mechanical ventilation, or death). So far, there is no study that demonstrated independent predictive value of hypertension on mortality in COVID-19 patients. There are many speculations about this coronavirus and its relation with different risk factors and underlying diseases. The aim of this review was to summarize the current knowledge about the relationship between hypertension and COVID-19 and the role of hypertension on outcome in these patients.


Perfusion SPECT/CT to diagnose pulmonary embolism during COVID-19 pandemic


Nicaragua's surprising response to COVID-19


title: Mission impossible? WHO director fights to prevent a pandemic without offending China ;Science ;AAAS

text: New outbreak comes as Tedros Adhanom Ghebreyesus struggles to raise more money, thwart Ebola, and fight health misinformation


title: Minimizing the Risk of Aerosol Contamination During Elective Lung Resection Surgery

text: BACKGROUND: In the setting of the COVID-19 pandemic, the conduct of elective cancer surgery has become an issue because of the need to balance the requirement to treat patients with the possibility of transmission of the virus by asymptomatic carriers. A particular concern is the potential for viral transmission by way of aerosol which may be generated during perioperative care. There are currently no guidelines for the conduct of elective lung resection surgery in this context. METHODS: A working group composed of 1 thoracic surgeon, 2 anesthesiologists and 1 critical care specialist assessed the risk for aerosol during lung resection surgery and proposed steps for mitigation. After external review, a final draft was approved by the Committee for the Governance of Perioperative and Surgical Activities of the Hôpital Maisonneuve-Rosemont, in Montreal, Canada. RESULTS: The working group divided the risk for aerosol into 6 time-points: (1) intubation and extubation; (2) Lung isolation and patient positioning; (3) access to the chest; (4) conduct of the surgical procedure; (5) procedure termination and lung re-expansion; (6) chest drainage. Mitigating strategies were proposed for each time-point. CONCLUSIONS: The situation with COVID-19 is an opportunity to re-evaluate operating room protocols both for the purposes of this pandemic and similar situations in the future. In the context of lung resection surgery, specific time points during the procedure seem to pose specific risks for the genesis of aerosol and thus should be the focus of attention.


title: Severe SARS-CoV-2 Infection in Children With Suspected Acute Abdomen: A Case Series From a Tertiary Hospital in Spain

text: We describe 5 children with severe SARS-CoV-2 infection, hemodynamic instability and suspected acute abdomen. This form of the disease has not been previously documented. Four of the cases were confirmed SARS-CoV-2 infection and 1 probable. All of them were previously healthy and needed a pediatric critical care unit admission. The respiratory symptoms were not dominant or were absent. Also, fever was observed. Laboratory testing revealed lymphopenia and high levels of C-reactive protein and procalcitonin with D-dimer, ferritin and interleukin-6 usually elevated. Respiratory support and inotropic support were almost always necessary. In all of them, deterioration occurred on the day of admission.


title: Mobilization of Telepsychiatry in Response to COVID-19-Moving Toward 21st Century Access to Care

text: The COVID-19 pandemic threatens to disrupt the provision of mental health services. In response, policymakers, administrators, and providers have taken bold steps toward enabling telepsychiatry to bridge this sudden gap in care for our most vulnerable populations. With rapid deregulation and adoption of this modality of care, careful consideration of issues related to policy and implementation is essential to maximize its effectiveness and mitigate unintended consequences. Though the crisis places the healthcare system under strain, it sets the stage for a lasting shift in not only how care is delivered, but also our beliefs around the system's capacity for rapid, innovative change.


Reactions to COVID-19: actions of nuclear medicine healthcare personnel in China


Calculating an institutional personal protective equipment (PPE) burn rate to project future usage patterns during the 2020 COVID-19 pandemic


title: Six Propositions against Ageism in the COVID-19 Pandemic

text: The risk of developing severe illness from COVID-19 and of dying from it increases with age. This statistical association has led to numerous highly problematic policy suggestions and comments revealing underlying ageist attitudes and promoting age discrimination. Such attitudes are based on negative stereotypes on the health and functioning of older adults. As a result, the lives of older people are disvalued, including in possible triage situations and in the potential limitation of some measures against the spread of the pandemic to older adults. These outcomes are unjustified and unethical. We develop six propositions against the ageism underlying these suggestions to spur a more adequate response to the current pandemic in which the needs and dignity of older people are respected.


Letter to editor - Can universal masking help with our recovery from the COVID-19 pandemic?


Cutaneous manifestation of COVID-19 in images: a case report


title: Clarification of Misleading Perceptions of COVID-19 Fatality and Testing Rates in Italy: Data Analysis

text: BACKGROUND: The fatality rate of coronavirus disease (COVID-19) in Italy is controversial and is greatly affecting discussion on the impact of containment measures that are straining the world's social and economic fabric, such as instigating large-scale isolation and quarantine, closing borders, imposing limits on public gatherings, and implementing nationwide lockdowns. OBJECTIVE: The scientific community, citizens, politicians, and mass media are expressing concerns regarding data suggesting that the number of COVID-19-related deaths in Italy is significantly higher than in the rest of the world. Moreover, Italian citizens have misleading perceptions related to the number of swab tests that have actually been performed. Citizens and mass media are denouncing the coverage of COVID-19 swab testing in Italy, claiming that it is not in line with that in other countries worldwide. METHODS: In this paper, we attempt to clarify the aspects of COVID-19 fatalities and testing in Italy by performing a set of statistical analyses that highlight the actual numbers in Italy and compare them with official worldwide data. RESULTS: The analysis clearly shows that the Italian COVID-19 fatality and mortality rates are in line with the official world scenario, as are the numbers of COVID-19 tests performed in Italy and in the Lombardy region. CONCLUSIONS: This up-to-date analysis may elucidate the evolution of the COVID-19 pandemic in Italy.


JAK Inhibition with Methotrexate as Treatment for COVID-19 Is a Double-Edged Sword


Validation: The Use of Google Trends as an Alternative Data Source for COVID-19 Surveillance in Indonesia


docid: zdbcuamm

title: Validation of the Hologic's Aptima Unisex and Multitest Specimen collection kits used for Endocervical and Male Urethral Swab Specimen (Aptima Swab) for sample collection of SARS-CoV-2

text: Recent events have seen the rise of SARS-CoV-2 all across the world affecting the lives and economies of every nation. .


title: Liver injury during highly pathogenic human coronavirus infections

text: The severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), the pathogen of 2019 novel coronavirus disease (COVID-19), has posed a serious threat to global public health. The WHO has declared the outbreak of SARS-CoV-2 infection an international public health emergency. Lung lesions have been considered as the major damage caused by SARS-CoV-2 infection. However, liver injury has also been reported to occur during the course of the disease in severe cases. Similarly, previous studies have shown that liver damage was common in the patients infected by the other two highly pathogenic coronavirus - severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), and associated with the severity of diseases. In this review, the characteristics and mechanism of liver injury caused by SARS-CoV, MERS-CoV as well as SARS-CoV-2 infection were summarized, which may provide help for further studies on the liver injury of COVID-19.


title: Help-Seeking Behavior of Returning to Work in Healthcare Workers and its Influencing Factors During COVID-19 Subsiding

text: OBJECTIVES: To explore the level and influencing factors of help-seeking behavior of returning to work in healthcare Workers (HCWs). METHODS: A total of 861 HCWs were surveyed. A structured self-administered questionnaire was used to collect data. Multivariable logistic regression was performed to examine the influencing factors of help-seeking behavior. RESULTS: HCWs sought help with respect to COVID-19-diagnosised problem most. Help-seeking intention, problems encountered after return, test for return, work condition during COVID-19, relatives or friends diagnosed or suspected as COVID-19 and socio-demographic characteristics such as occupation, education, title and marriage status are predictors of help-seeking behavior. CONCLUSIONS: Education and intervention should lay particular stress on HCWs featured rest at home before return, doctor, lower education and lower title to ensure the safety, accuracy and quality of work after they return to work for a better occupational environment.


Impact of COVID-19 on Peripheral Arterial Disease Treatment


Perspectives on personal protective equipment in acute-care facilities during the COVID-19 pandemic


title: Persistent viral RNA positivity during the recovery period of a patient with SARS-CoV-2 infection

text: As an emerging infectious disease, the clinical course and virological course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remain to be further investigated. In this case report, we described a case of SARS-CoV-2 infection with the clinical course for more than 2 months. This patient had recovered from pneumonia after treatment. The viral RNA of throat swabs became negative and the viral-specific antibodies were produced during the recovery period. However, the viral RNA reappeared and additionally persisted in throat swabs for more than 40 days. In addition, the viral RNA was detected in multiple types of specimens with extremely high titers in the saliva. In conclusion, these findings indicate that SARS-CoV-2 can cause a long clinical course. The coexistence of viral RNA and viral-specific antibodies may imply an immune evasion of SARS-CoV-2 from the host's immune system.


title: Highly asymmetric optical properties of \b{eta}-Ga2O3 as probed by linear and nonlinear optical excitation spectroscopy

text: Highly asymmetric optical properties of b-Ga2O3 are investigated by polarization-dependent photoluminescence (PL) excitation spectroscopy for assessing its potential use for a novel ultraviolet emitter and nonlinear optical material. Based on power-dependent excitation and two-photon depth scan, it is demonstrated that the underlying mechanism for the PL occurring far below the bandgap is not caused by intrinsic polaron effects, but by excitonic recombination at extrinsic defect sites.


title: Characteristics of COVID-19 infection in Beijing

text: BACKGROUND: Since the first case of a novel coronavirus (COVID-19) infection pneumonia was detected in Wuhan, China, a series of confirmed cases of the COVID-19 were found in Beijing. We analyzed the data of 262 confirmed cases to determine the clinical and epidemiological characteristics of COVID-19 in Beijing. METHODS: We collected patients who were transferred by Beijing Emergency Medical Service to the designated hospitals. The information on demographic, epidemiological, clinical, laboratory test for the COVID-19 virus, diagnostic classification, cluster case and outcome were obtained. Furthermore we compared the characteristics between severe and common confirmed cases which including mild cases, no-pneumonia cases and asymptomatic cases, and we also compared the features between COVID-19 and 2003 SARS. FINDINGS: By Feb 10, 2020, 262 patients were transferred from the hospitals across Beijing to the designated hospitals for special treatment of the COVID-19 infected by Beijing emergency medical service. Among of 262 patients, 46 (17.6%) were severe cases, 216 (82.4%) were common cases, which including 192 (73.3%) mild cases, 11(4.2%) non-pneumonia cases and 13 (5.0%) asymptomatic cases respectively. The median age of patients was 47.5 years old and 48.5% were male. 192 (73.3%) patients were residents of Beijing, 50 (26.0%) of which had been to Wuhan, 116 (60.4%) had close contact with confirmed cases, 21 (10.9%) had no contact history. The most common symptoms at the onset of illness were fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%) and headache (6.5%). The median incubation period was 6.7 days, the interval time from between illness onset and seeing a doctor was 4.5 days. As of Feb 10, 17.2% patients have discharged and 81.7% patients remain in hospital in our study, the fatality of COVID-19 infection in Beijing was 0.9%. INTERPRETATION: On the basis of this study, we provided the ratio of the COVID-19 infection on the severe cases to the mild, asymptomatic and non-pneumonia cases in Beijing. Population was generally susceptible, and with a relatively low fatality rate. The measures to prevent transmission was very successful at early stage, the next steps on the COVID-19 infection should be focused on early isolation of patients and quarantine for close contacts in families and communities in Beijing. FUNDING: Beijing Municipal Science and Technology Commission and Ministry of Science and Technology.


title: Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic

text: Burnout is a state of physical or mental collapse caused by overwork or stress. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. The new COVID-19 pandemic has raised public health problems around the world and required a reorganization of health services. In this context, burnout syndrome and physical exhaustion have become even more pronounced. Resident doctors, and especially those in certain specialties, seem even more exposed due to the higher workload, prolonged exposure and first contact with patients. This article is a short review of the literature and a presentation of some considerations regarding the activity of the medical residents in a non-Covid emergency hospital in Romania, based on the responses obtained via a questionnaire. Burnout prevalence is not equal in different specialties. We studied its impact and imagine the potential steps that can be taken in order to reduce the increasing rate of burnout syndrome in the pandemics.


The impact of COVID-19 on mental health in the Hispanic Caribbean region


title: tbiExtractor: A framework for extracting traumatic brain injury common data elements from radiology reports

text: BACKGROUND: The manual extraction of valuable data from electronic medical records is cumbersome, error-prone, and inconsistent. By automating extraction in conjunction with standardized terminology, the quality and consistency of data utilized for research and clinical purposes would be substantially improved. Here, we set out to develop and validate a framework to extract pertinent clinical conditions for traumatic brain injury (TBI) from computed tomography (CT) reports. METHODS: We developed tbiExtractor, which extends pyConTextNLP, a regular expression algorithm using negation detection and contextual features, to create a framework for extracting TBI common data elements from radiology reports. The algorithm inputs radiology reports and outputs a structured summary containing 27 clinical findings with their respective annotations. Development and validation of the algorithm was completed using two physician annotators as the gold standard. RESULTS: tbiExtractor displayed high sensitivity (0.92-0.94) and specificity (0.99) when compared to the gold standard. The algorithm also demonstrated a high equivalence (94.6%) with the annotators. A majority of clinical findings (85%) had minimal errors (F1 Score ≥ 0.80). When compared to annotators, tbiExtractor extracted information in significantly less time (0.3 sec vs 1.7 min per report). CONCLUSION: tbiExtractor is a validated algorithm for extraction of TBI common data elements from radiology reports. This automation reduces the time spent to extract structured data and improves the consistency of data extracted. Lastly, tbiExtractor can be used to stratify subjects into groups based on visible damage by partitioning the annotations of the pertinent clinical conditions on a radiology report.


docid: xvztqshw

title: Reporting of all cardiac medications and their outcome in COVID-19


Tuberculosis and type 2 Diabetes Mellitus: an inflammatory danger signal in the time of COVID-19


title: [Progress and challenge of vaccine development against 2019 novel coronavirus (2019-nCoV)]

text: The outbreak of 2019 novel coronavirus (2019-nCoV) infection poses a serious threat to global public health. Vaccination is an effective way to prevent the epidemic of the virus. 2019-nCoV along with severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) belong to the same ß-genus of coronavirus family. Base on the previous experience and the technical platform of developing SARS-CoV and MERS-CoV vaccines, scientists from all over the world are working hard and quickly on the related fields. There are substantial progress in these fields including the characterizing the 2019-nCoV virus, identification of candidate antigens and epitopes, establishment of animal models, characterizing the immune responses, and the design of vaccines. The development of 2019-nCoV vaccines cover all types: inactivated virus vaccine, recombinant protein vaccine, viral vector-based vaccine, mRNA vaccine, and DNA vaccine, et al. As of March 2020, two 2019-nCoV vaccines have entered phase I clinical trials. One is named as Ad5-nCoV developed by the Chinese Institute of Biotechnology of the Academy of Military Medical Sciences and Tianjin Cansino Biotechnology Inc. Ad5-nCoV is based on the replication-defective adenovirus type 5 as the vector to express 2019-nCoV spike protein. The another vaccine is mRNA-1273 developed by the National Institute of Allergy and Infectious Diseases and Moderna, Inc.. RNA-1273 is an mRNA vaccine expressing 2019-nCoV spike protein. Although the rapid development of 2019-nCoV vaccine, it still faces many challenges with unknown knowledge, including the antigenic characteristics of the 2019-nCoV, the influence of antigenic variation, the protective immune response of host, the protection of the elderly population, and the downstream manufacturing process of the new vaccine. The safety and efficacy of vaccines are the first priority for vaccine development and should be carefully evaluated.


title: Caring for the carers: Advice for dealing with sleep problems of hospital staff during the COVID-19 outbreak

text: Hospital staff are at the frontline in the COVID-19 outbreak. The stressors they experience may induce sleep problems in a population already at risk. Sleep deprivation, long shifts and insomnia in hospital staff have been associated with individual, organizational and public health hazards. These include increased risk of mental and somatic disorders, altered immune responses, medical errors, misunderstandings, drowsy driving and burnout. In March 2020, the World Health Organization called for providing access to mental health and counselling for health professionals involved in the COVID-19 outbreak. To answer this call, we propose practical advice for the management of sleep problems (sleep deprivation, insomnia and shift work) that can be included in supportive interventions. The advice is based on psychobiological principles of sleep regulation and on guidelines for the treatment of insomnia and was implemented within an initiative offering psychological support to the staff of three university hospitals in Rome.


title: Prediction of the COVID-19 Pandemic for the Top 15 Affected Countries: Advanced Autoregressive Integrated Moving Average (ARIMA) Model

text: BACKGROUND: The coronavirus disease (COVID-19) pandemic has affected more than 200 countries and has infected more than 2,800,000 people as of April 24, 2020. It was first identified in Wuhan City in China in December 2019. OBJECTIVE: The aim of this study is to identify the top 15 countries with spatial mapping of the confirmed cases. A comparison was done between the identified top 15 countries for confirmed cases, deaths, and recoveries, and an advanced autoregressive integrated moving average (ARIMA) model was used for predicting the COVID-19 disease spread trajectories for the next 2 months. METHODS: The comparison of recent cumulative and predicted cases was done for the top 15 countries with confirmed cases, deaths, and recoveries from COVID-19. The spatial map is useful to identify the intensity of COVID-19 infections in the top 15 countries and the continents. The recent reported data for confirmed cases, deaths, and recoveries for the last 3 months was represented and compared between the top 15 infected countries. The advanced ARIMA model was used for predicting future data based on time series data. The ARIMA model provides a weight to past values and error values to correct the model prediction, so it is better than other basic regression and exponential methods. The comparison of recent cumulative and predicted cases was done for the top 15 countries with confirmed cases, deaths, and recoveries from COVID-19. RESULTS: The top 15 countries with a high number of confirmed cases were stratified to include the data in a mathematical model. The identified top 15 countries with cumulative cases, deaths, and recoveries from COVID-19 were compared. The United States, the United Kingdom, Turkey, China, and Russia saw a relatively fast spread of the disease. There was a fast recovery ratio in China, Switzerland, Germany, Iran, and Brazil, and a slow recovery ratio in the United States, the United Kingdom, the Netherlands, Russia, and Italy. There was a high death rate ratio in Italy and the United Kingdom and a lower death rate ratio in Russia, Turkey, China, and the United States. The ARIMA model was used to predict estimated confirmed cases, deaths, and recoveries for the top 15 countries from April 24 to July 7, 2020. Its value is represented with 95%, 80%, and 70% confidence interval values. The validation of the ARIMA model was done using the Akaike information criterion value; its values were about 20, 14, and 16 for cumulative confirmed cases, deaths, and recoveries of COVID-19, respectively, which represents acceptable results. CONCLUSIONS: The observed predicted values showed that the confirmed cases, deaths, and recoveries will double in all the observed countries except China, Switzerland, and Germany. It was also observed that the death and recovery rates were rose faster when compared to confirmed cases over the next 2 months. The associated mortality rate will be much higher in the United States, Spain, and Italy followed by France, Germany, and the United Kingdom. The forecast analysis of the COVID-19 dynamics showed a different angle for the whole world, and it looks scarier than imagined, but recovery numbers start looking promising by July 7, 2020.


COVID19 -Nuclear Medicine Departments, be prepared!


Evaluation of endodontic competency in the COVID-19 era: Problem, solution and results


title: Influence of diabetes mellitus on the severity and fatality of SARS-CoV-2 (COVID-19) infection

text: AIM: To evaluate the influence of diabetes on the severity and fatality of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. MATERIALS AND METHODS: The medical records of 66 hospitalized coronavirus disease 2019 (COVID-19) patients were collected and classified into non-severe (mild/moderate cases) and severe (severe/critical cases) groups. Logistic regression analysis was used to estimate the risk of severe COVID-19 (severe/critical infection). In addition, a meta-analysis including published studies reported the impact of diabetes on the severity and fatality of COVID-19. The current study was conducted using fixed effects models. RESULTS: There were 22 diabetes and 44 non-diabetes cases among the 66 hospitalized COVID-19 patients. Seven patients with diabetes (31.82%) were diagnosed as severe COVID-19 cases, which was significantly higher than that in the non-diabetes group (4/44, 9.09%, P = .033). After adjustment for age and gender, diabetes was significantly associated with COVID-19 severity (OR: 5.29, 95% CI: 1.07-26.02). A meta-analysis further confirmed the positive association between diabetes and COVID-19 severity (pooled OR = 2.58, 95% CI: 1.93-3.45). Moreover, the patients with diabetes infected with SARS-CoV-2 had a 2.95-fold higher risk of fatality compared with those patients without diabetes (95% CI: 1.93-4.53). CONCLUSIONS: Our findings provide new evidence that diabetes is associated with a higher risk of severity and fatality of COVID-19. Therefore, intensive monitoring and antidiabetic therapy should be considered in patients with diabetes with SARS-CoV-2 infection.


The severity of COVID-19 in children on immunosuppressive medication


Letter to the Editor: Three cases of redetectable positive SARS-CoV-2 RNA in recovered COVID-19 patients with antibodies


title: Coagulation dysfunction: A hallmark in COVID-19

text: Context: The coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coagulation dysfunction is a hallmark in patients with COVID-19. Fulminant thrombotic complications emerge as critical issues in patients with severe COVID-19. Objective: To present a review of the literature and discuss the mechanisms of COVID-19 underlying coagulation activation and the implications for anticoagulant and thrombolytic treatment in the management of COVID-19. Data Sources: We performed a systemic review of scientific papers on the topic of COVID-19, online available via the PubMed NCBI, medRxiv, and Preprints as of May 15, 2020. We also shared our experience on the management of thrombotic events in patients with COVID-19. Conclusions: COVID-19-associated coagulopathy ranges from mild laboratory alterations to disseminated intravascular coagulation (DIC) with a predominant phenotype of thrombotic/multiple organ failure. Characteristically, high D-dimer levels on admission and/or continuously increasing concentrations of D-dimer is associated with disease progression and poor overall survival. SARS-CoV-2 infection triggers the immune-hemostatic response. Drastic inflammatory responses including, but not limited to, cytokine storm, vasculopathy, and NETosis may contribute to an overwhelming activation of coagulation. Hypercoagulability and systemic thrombotic complications necessitate anticoagulant and thrombolytic interventions, which provide opportunities to prevent or reduce "excessive" thrombin generation, while preserving "adaptive" hemostasis and bring additional benefit via their anti-inflammatory effect in the setting of COVID-19.


title: Neurosurgical activity during COVID-19 pandemic: an expert opinion from China, South Korea, Italy, United Stated of America, Colombia and United Kingdom

text: BACKGROUND: More than a million and a half people are infected worldwide with more than 90.000 casualties. The ongoing COVID-19 pandemic is radically altering both socio-economic and health care scenarios. METHODS: On April 4, 2020, at 13.30 CET, a webinar was broadcasted, organized by Global Neuro and supported by WFNS. Expert neurosurgeons from 6 different countries (China, Italy, South Korea, USA, Colombia and United Kingdom) reported on the impact of the COVID-19 pandemic on their health care systems and neurosurgical activity. RESULTS: The first part focused on the epidemiology until that date. The USA were the most affected State with 450.000 cases, followed by Italy (140.000 cases and 19.000 casualties), China (83.305 cases and 3.345 had died), South Korea (10.156 cases with 177 casualties), the UK (38.168 cases and 3.605 deaths) and Colombia (1.267 cases and 25 deaths). The second part concerned Institution and staff reorganization. In every country all surgical plans have been modified. In Wuhan the staff was enrolled in COVID-units. In New York, the Mount Sinai Health System was in lockdown mode. In South Korea, sterilizing chambers have been placed. In Italy some Departments were reorganized in a Hub and Spoke fashion. In the Latin American region, they adopted special measures for every case. In the UK a conference center has been used to accommodate intensive care unit (ICU) beds. The third part was about neurosurgical practice during the COVID-19 pandemic. In Wuhan the main hospital was used for urgent non-COVID patients. In New York the neurosurgeon staff work in ICU as advanced practitioner (APP). In South Korea every patient is screened. In Italy the on-duty Hub neurosurgeons have been doubled. In the Latin American region recommendations have been developed by some neurosurgical societies. In the UK local non-specialists and traumatologists neurosurgical experts are collaborating in terms of best practice. The final part touched upon how to perform safe surgery and re-start after the pandemic. In China elective surgical procedures are performed very carefully. In New York, surgery planning will be based on patient's viral load. In South Korea and in Italy disinfection plans and negative-pressure O.R. were created. In the Latin American region, the aim is to have a rapid testing system. In the UK they have developed flowcharts to guide trauma patient management. CONCLUSIONS: In general, the pandemic scenario was presented as a thought-provoking challenge in all countries which requires tireless efforts for both maintaining emergency and elective neurosurgical procedures.


Health Insurance Status and Risk Factors for Poor Outcomes With COVID-19 Among U.S. Health Care Workers: A Cross-sectional Study


docid: btixbxvm

title: Coronavirus in charts: are virtual conferences here to stay?


Novel coronavirus SARS-CoV-2: familial spread resulting in COVID-19 pneumonia in a pediatric patient


The hearth of mathematical and statistical modelling during the Coronavirus pandemic


Screening for COVID-19 at childbirth: is it effective?


Insights from Italy: the Novara-COVID score for rapid destination of COVID-19 patients at emergency department presentation


Covid-19 fatality is likely overestimated


title: Fecal specimen diagnosis 2019 novel coronavirus-infected pneumonia

text: The emergence and spread of 2019 novel coronavirus-infected pneumonia (COVID-19) from Wuhan, China, it has spread globally. We extracted the data on 14 patients with laboratory-confirmed COVID-19 from Jinhua Municipal Central hospital through 27 January 2020. We found that compared to pharyngeal swab specimens, nucleic acid detection of COVID-19 in fecal specimens was equally accurate. And we found that patients with a positive stool test did not experience gastrointestinal symptoms and had nothing to do with the severity of the lung infection. These results may help to understand the clinical diagnosis and the changes in clinical parameters of COVID-19.


A COVID-19 outbreak's lesson: Best use of the paediatric emergency department


Serum antibody response in critically ill patients with COVID-19


title: Graft Cryopreservation Does Not Impact Overall Survival after Allogeneic Hematopoietic Cell Transplantation Using Post-Transplantation Cyclophosphamide for Graft-versus-Host Disease Prophylaxis

text: The COVID-19 pandemic has created significant barriers to timely donor evaluation, cell collection, and graft transport for allogeneic hematopoietic stem cell transplantation (allo-HCT). To ensure availability of donor cells on the scheduled date of infusion, many sites now collect cryopreserved grafts before the start of pretransplantation conditioning. Post-transplantation cyclophosphamide (ptCY) is an increasingly used approach for graft-versus-host disease (GVHD) prophylaxis, but the impact of graft cryopreservation on the outcomes of allo-HCT using ptCY is not known. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we compared the outcomes of HCT using cryopreserved versus fresh grafts in patients undergoing HCT for hematologic malignancy with ptCY. We analyzed 274 patients with hematologic malignancy undergoing allo-HCT between 2013 and 2018 with cryopreserved grafts and ptCY. Eighteen patients received bone marrow grafts and 256 received peripheral blood stem cell grafts. These patients were matched for age, graft type, disease risk index (DRI), and propensity score with 1080 patients who underwent allo-HCT with fresh grafts. The propensity score, which is an assessment of the likelihood of receiving a fresh graft versus a cryopreserved graft, was calculated using logistic regression to account for the following: disease histology, Karnofsky Performance Score (KPS), HCT Comorbidity Index, conditioning regimen intensity, donor type, and recipient race. The primary endpoint was overall survival (OS). Secondary endpoints included acute and chronic graft-versus-host disease (GVHD), non-relapse mortality (NRM), relapse/progression and disease-free survival (DFS). Because of multiple comparisons, only P values <.01 were considered statistically significant. The 2 cohorts (cryopreserved and fresh) were similar in terms of patient age, KPS, diagnosis, DRI, HCT-CI, donor/graft source, and conditioning intensity. One-year probabilities of OS were 71.1% (95% confidence interval [CI], 68.3% to 73.8%) with fresh grafts and 70.3% (95% CI, 64.6% to 75.7%) with cryopreserved grafts (P = .81). Corresponding probabilities of OS at 2 years were 60.6% (95% CI, 57.3% to 63.8%) and 58.7% (95% CI, 51.9% to 65.4%) (P = .62). In matched-pair regression analysis, graft cryopreservation was not associated with a significantly higher risk of mortality (hazard ratio [HR] for cryopreserved versus fresh, 1.05; 95% CI, .86 to 1.29; P = .60). Similarly, rates of neutrophil recovery (HR, .91; 95% CI, .80 to 1.02; P = .12), platelet recovery (HR, .88; 95% CI, .78 to 1.00; P = .05), grade III-IV acute GVHD (HR, .78; 95% CI, .50 to 1.22; P = .27), NRM (HR, 1.16; 95% CI, .86 to 1.55; P = .32) and relapse/progression (HR, 1.21; 95% CI, .97 to 1.50; P = .09) were similar with cryopreserved grafts versus fresh grafts. There were somewhat lower rates of chronic GVHD (HR, 78; 95% CI, .61 to .99; P = .04) and DFS (HR for treatment failure, 1.19; 95% CI, 1.01 to 1.29; P = .04) with graft cryopreservation that were of marginal statistical significance after adjusting for multiple comparisons. Overall, our data indicate that graft cryopreservation does not significantly delay hematopoietic recovery, increase the risk of acute GVHD or NRM, or decrease OS after allo-HCT using ptCY.


title: Clinical Characteristics of Coronavirus Disease 2019 in China

text: BACKGROUND: Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. METHODS: We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. RESULTS: The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. CONCLUSIONS: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.).


Neurologists and COVID-19: A note on courage in a time of uncertainty


title: Procoagulatio, hypercoagulatio és fibrinolysis "shut down" kimutatása ClotPro® viszkoelasztikus tesztek segítségével COVID-19-betegekben./ Procoagulation, hypercoagulation and fibrinolytic "shut down" detected with ClotPro® viscoelastic tests in COVID-19 patients

text: INTRODUCTION: International data indicate that arterial, venous and microvascular thrombosis or disseminated intravascular coagulation occur in more than 30% of hospitalized patients with COVID-19. This condition is characterized by high levels of D-dimer and fibrinogen, prolonged prothrombin time and activated partial thromboplastin time. METHOD: Blood samples from three COVID-19 patients treated in a Hungarian intensive care unit were collected and analyzed with ClotPro® tests. EX-tests, IN-test, FIB-tests, RVV-tests, and TPA-tests were performed. The results were interpreted with respect to the clinical condition of the patients. RESULTS: Procoagulation, hypercoagulation and either fibrinolysis or a "shut down" phenomenon of the fibrinolytic process were found with ClotPro®. The ClotPro® parameters were consistent with the conventional coagulation tests and corresponded with the criteria of non-overt disseminated intravascular coagulation. CONCLUSION: These findings encourage further investigations to elucidate the underlying pathophysiology of thromboembolic events in COVID-19 patients and may support the introduction of full dose anticoagulation with or without antiplatelet therapy. Interventional clinical trials may be helpful in defining the appropriate drug(s), for this purpose, the algorithms of administration, and the optimal duration of therapy. At present, the authorization of a clinical trial that attempts to answer these questions is in progress. Orv Hetil. 2020; 161(22): 899-907.


Video consultations for triage of patients with covid-19


COVID-19 CRISIS: we must care for ourselves as we care for others


Ocular Findings and Proportion with Conjunctival SARS-COV-2 in COVID-19 Patients


title: Long-Term Care Facilities as a Risk Factor for Death Due to COVID-19

text: A large percentage of the deaths from COVID-19 occur among residents of long-term care facilities. There are two possible reasons for this phenomenon. First, the structural features of such settings may lead to death. Alternatively, it is possible that individuals in these facilities are in poorer health than those living elsewhere, and that these individuals would have died even if they had not been in these facilities. Our findings show that, controlling for the population density and the percentage of older adults in the population, there is a significant positive association between the number of long-term care beds per capita and COVID-19 mortality rates. This finding provides support for the claim that long-term care living arrangements (of older people) are a significant risk factor for dying from COVID-19.


title: Vulnerabilidade a formas graves de COVID-19: uma análise intramunicipal na cidade do Rio de Janeiro, Brasil./ Vulnerabilidade a formas graves de COVID-19: uma análise intramunicipal na cidade do Rio de Janeiro, Brasil./ Vulnerability to severe forms of COVID-19: an intra-municipal analysis in the city of Rio de Janeiro, Brazil

text: Given the characteristics of the COVID-19 pandemic and the limited tools for orienting interventions in surveillance, control, and clinical care, the current article aims to identify areas with greater vulnerability to severe cases of the disease in Rio de Janeiro, Brazil, a city characterized by huge social and spatial heterogeneity. In order to identify these areas, the authors prepared an index of vulnerability to severe cases of COVID-19 based on the construction, weighting, and integration of three levels of information: mean number of residents per household and density of persons 60 years or older (both per census tract) and neighborhood tuberculosis incidence rate in the year 2018. The data on residents per household and density of persons 60 years or older were obtained from the 2010 Population Census, and data on tuberculosis incidence were taken from the Brazilian Information System for Notificable Diseases (SINAN). Weighting of the indicators comprising the index used analytic hierarchy process (AHP), and the levels of information were integrated via weighted linear combination with map algebra. Spatialization of the index of vulnerability to severe COVID-19 in the city of Rio de Janeiro reveals the existence of more vulnerable areas in different parts of the city's territory, reflecting its urban complexity. The areas with greatest vulnerability are located in the North and West Zones of the city and in poor neighborhoods nested within upper-income parts of the South and West Zones. Understanding these conditions of vulnerability can facilitate the development of strategies to monitor the evolution of COVID-19 and orient measures for prevention and health promotion.


title: COVID-19 outbreak in Malaysia: Actions taken by the Malaysian government

text: BACKGROUND: Coronavirus disease 2019 (COVID-19), a novel pneumonia disease originating in Wuhan, was confirmed by the World Health Organization on January 12, 2020 before becoming an outbreak in all countries. OUTBREAK SITUATION: A stringent screening process at all airports in Malaysia was enforced after the first case outside China was reported in Thailand. Up to April 14, 2020, Malaysia had reported two waves of COVID-19 cases, with the first wave ending successfully within less than 2 months. In early March 2020, the second wave occurred, with worrying situations. ACTIONS TAKEN: The Government of Malaysia enforced a Movement Control Order starting on March 18, 2020 to break the chain of COVID-19. The media actively spread the hashtag #stayhome. Non-governmental organizations, as well as prison inmates, started to produce personal protective equipment for frontliners. Various organizations hosted fundraising events to provide essentials mainly to hospitals. A provisional hospital was set up and collaborations with healthcare service providers were granted, while additional laboratories were assigned to enhance the capabilities of the Ministry of Health. ECONOMIC DOWNTURN: An initial financial stimulus amounting to RM 20.0 billion was released in February 2020, before the highlighted PRIHATIN Package, amounting to RM 250 billion, was announced. The PRIHATIN Package has provided governmental support to society, covering people of various backgrounds from students and families to business owners.


title: Kawasaki-like diseases and thrombotic coagulopathy in COVID-19: delayed over-activation of the STING pathway?

text: We previously made the hypothesis that STING contributes to COVID-19. The present review detail new arguments for over-activation of STING pathways in COVID-19, following the description of hyper-coagulability and Kawasaki-like diseases in children. Indeed, Kawasaki disease is induced by overreaction of innate cells following exposition to various viruses, including herpes viruses which trigger STING. It predisposes to diffuse vasculitis and aneurysms, whereas STING is over-expressed in arterial aneurisms. The redness at the inoculation site of bacillus Calmette-Guérin, a specific feature of Kawasaki disease, is reproduced by activation of the STING pathway, which is inhibited upstream by aspirin, intravenous immunoglobulins, and Vitamin-D. SARS-CoV2 binding to ACE2 can lead to excessive angiotensin II signaling, which activates the STING pathway in mice. Over-activation of the STING-pathway promotes hyper-coagulability through release of interferon-ß and tissue factor by monocytes-macrophages. Aspirin and dipyridamole, besides their anti-platelet activity, also reduce tissue factor procoagulant activity, and aspirin inhibits the STING pathway upstream of STING. Aspirin and dipyridamole may be used, in combination with drugs blocking downstream the activation of the STING pathway, like inhibitors of IL-6R and JAK/STAT pathways. The risk of bleeding should be low as bleeding has not been reported in severe COVID-19 patients.


"Urinary Tract Infection" in the Era of COVID-19


title: Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019-Induced Acute Respiratory Distress Syndrome: A Multicenter Descriptive Study

text: OBJECTIVES: Severe acute respiratory distress syndrome is complicated with coronavirus disease 2019 and extracorporeal membrane oxygenation support may be necessary in severe cases. This study is to summarize the clinical features, extracorporeal membrane oxygenation characteristics, and outcomes of patients with severe acute respiratory syndrome coronavirus 2 pneumonia received extracorporeal membrane oxygenation. DESIGN: Descriptive study from two hospitals. SETTING: The ICUs from university hospitals. PATIENTS: Patients with severe acute respiratory syndrome coronavirus 2 pneumonia received mechanical ventilation, including those underwent extracorporeal membrane oxygenation from Zhongnan Hospital of Wuhan University and Wuhan Pulmonary Hospital from January 8, 2020, to March 31, 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Clinical records, laboratory results, ventilator parameters, and extracorporeal membrane oxygenation-related data were abstracted from the medical records. One-hundred twenty-nine critically ill patients with severe acute respiratory syndrome coronavirus 2 pneumonia were admitted to ICU of the two referral hospitals. Fifty-nine patients received mechanical ventilation and 21 of them received extracorporeal membrane oxygenation support (fourteen from Zhongnan hospital and seven from Wuhan pulmonary hospital). Compared to mechanical ventilation patients without extracorporeal membrane oxygenation support, there was a tendency of decline in mortality but with no significant difference (no-extracorporeal membrane oxygenation group 24/38 [63.2%] vs extracorporeal membrane oxygenation group 12/21 [57.1%]; p = 0.782). For those patients with extracorporeal membrane oxygenation, 12 patients died and nine survived by April 7, 2020. Among extracorporeal membrane oxygenation patients, the PaCO2 prior to extracorporeal membrane oxygenation was lower (54.40 mm Hg [29.20-57.50 mm Hg] vs 63.20 mm Hg [55.40-72.12 mm Hg]; p = 0.006), and pH prior to extracorporeal membrane oxygenation was higher (7.38 [7.28-7.48] vs 7.23 [7.16-7.33]; p = 0.023) in survivors than nonsurvivors. CONCLUSIONS: Extracorporeal membrane oxygenation might be an effective salvage treatment for patients with severe acute respiratory syndrome coronavirus 2 pneumonia associated with severe acute respiratory distress syndrome. Severe CO2 retention and acidosis prior to extracorporeal membrane oxygenation indicated a poor prognosis.


Immunosuppression in hematological cancer patients with Covid-19 -Uncomplicated infections but delayed viral clearance?


Ethnicity and COVID-19 infection: are the pieces of the puzzle falling into place?


title: Risks of Novel Coronavirus Disease (COVID-19) in Pregnancy;a Narrative Review

text: Introduction: The outbreak of the new Coronavirus in China in December 2019 and subsequently in various countries around the world has raised concerns about the possibility of vertical transmission of the virus from mother to fetus The present study aimed to review published literature in this regard Methods: In this narrative review, were searched for all articles published in various databases including PubMed, Scopus, Embase, Science Direct, and Web of Science using MeSH-compliant keywords including COVID-19, Pregnancy, Vertical transmission, Coronavirus 2019, SARS-CoV-2 and 2019-nCoV from December 2019 to March 18, 2020 and reviewed them All type of articles published about COVID-19 and vertical transmission in pregnancy were included Results: A review of 13 final articles published in this area revealed that COVID-19 can cause fetal distress, miscarriage, respiratory distress and preterm delivery in pregnant women but does not infect newborns There has been no report of vertical transmission in pregnancy, and it has been found that clinical symptoms of COVID-19 in pregnant women are not different from those of non-pregnant women Conclusion: Overall, due to lack of appropriate data about the effect of COVID-19 on pregnancy, it is necessary to monitor suspected pregnant women before and after delivery For confirmed cases both the mother and the newborn child should be followed up comprehensively


Beyond COVID-19: five actions which would improve the health of all New Zealanders


title: COVID-19 Pandemic Hemoperfusion Therapy Versus Plasma Exchange Therapy in Intensive Care

text: No abstract.


title: Correction to: Influence of population mobility on the novel coronavirus disease (COVID-19) epidemic: based on panel data from Hubei, China

text: [This corrects the article DOI: 10.1186/s41256-020-00151-6.].


title: Scoping review of prevalence of neurologic comorbidities in patients hospitalized for COVID-19

text: OBJECTIVE: The emergence of coronavirus disease 2019 (COVID-19) presents a challenge for neurologists caring for patients with preexisting neurologic conditions hospitalized for COVID-19 or for evaluation of patients who have neurologic complications during COVID-19 infection. We conducted a scoping review of the available literature on COVID-19 to assess the potential effect on neurologists in terms of prevalent comorbidities and incidence of new neurologic events in patients hospitalized with COVID-19. METHODS: We searched MEDLINE/PubMed, CINAHL (EBSCO), and Scopus databases for adult patients with preexisting neurologic disease who were diagnosed and hospitalized for COVID-19 or reported incidence of secondary neurologic events following diagnosis of COVID-19. Pooled descriptive statistics of clinical data and comorbidities were examined. RESULTS: Among screened articles, 322 of 4,014 (8.0%) of hospitalized patients diagnosed and treated for COVID-19 had a preexisting neurologic illness. Four retrospective studies demonstrated an increased risk of secondary neurologic complications in hospitalized patients with COVID-19 (incidence of 6%, 20%, and 36.4%, respectively). Inconsistent reporting and limited statistical analysis among these studies did not allow for assessment of comparative outcomes. CONCLUSION: Emerging literature suggests a daunting clinical relationship between COVID-19 and neurologic illness. Neurologists need to be prepared to reorganize their consultative practices to serve the neurologic needs of patients during this pandemic.


title: The old but new: Can unfractioned heparin and low molecular weight heparins inhibit proteolytic activation and cellular internalization of SARS-CoV2 by inhibition of host cell proteases?

text: Currently, our world is facing the 2019 Novel Coronavirus (COVID-19) outbreak and tremendous efforts are made for developing drugs to treat and vaccines to prevent the disease. At present, there is no specific antiviral drug or vaccine for COVID-19. The pathogenic infectivity of the virus requires the S1 subunit of the spike (S) protein to bind the host cell receptor, angiontensin converting enzyme (ACE2). While the binding to host cell receptor is the first step of infection, the entrance of the virus into the cell needs the cleavage of S1-S2 subunits to expose S2 for fusion to cell membrane via host proteases including cathepsins, cell surface transmembrane protease/serine (TMPRSS) proteases, furin, trypsin and factor Xa. Previous in vitro studies have shown that factor Xa inhibition can decrease viral infectivity. We suppose that host cell proteases including furin (as expressed highly in lungs), factor Xa and cathepsin are possible targets to decrease viral burden, therefore unfractioned heparin and low molecular weight heparin-LMWH (specifically dalteparin and tinzaparin for their anti inflammatory action) can be potential inhibitors of multiple endoproteases involved in virus infectivity. Our hypothesis needs to be tested in in vitro and clinical studies, however as we are in an urgent situation as the burden of SARS-CoV2 is increasing all around the world, we recommend the usage of unfractioned heparin or LMWH in intensive care unit (ICU) and non-ICU hospitalized patients with the risk-benefit judgement of the clinician. Whether our hypothesis is clinically applicable and successful in decreasing viral infection will be evaluated for further studies.


title: Identifying the measurements required to estimate rates of COVID-19 transmission, infection, and detection, using variational data assimilation

text: We demonstrate the ability of statistical data assimilation to identify the measurements required for accurate state and parameter estimation in an epidemiological model for the novel coronavirus disease COVID-19. Our context is an effort to inform policy regarding social behavior, to mitigate strain on hospital capacity. The model unknowns are taken to be: the time-varying transmission rate, the fraction of exposed cases that require hospitalization, and the time-varying detection probabilities of new asymptomatic and symptomatic cases. In simulations, we obtain accurate estimates of undetected (that is, unmeasured) infectious populations, by measuring the detected cases together with the recovered and dead - and without assumed knowledge of the detection rates. These state estimates require a measurement of the recovered population, and are tolerant to low errors in that measurement. Further, excellent estimates of all quantities are obtained using a temporal baseline of 112 days, with the exception of the time-varying transmission rate at times prior to the implementation of social distancing. The estimation of this transmission rate is sensitive to contamination in the data, highlighting the need for accurate and uniform methods of reporting. Finally, we employ the procedure using real data from Italy reported by Johns Hopkins. The aim of this paper is not to assign extreme significance to the results of these specific experiments \textit{per se}. Rather, we intend to exemplify the power of SDA to determine what properties of measurements will yield estimates of unknown model parameters to a desired precision - all set within the complex context of the COVID-19 pandemic.


title: Kidney transplant patients with SARS-CoV-2 infection: the brescia renal COVID task force experience

text: The outcome of kidney transplant patients with SARS-CoV-2 infection is still unclear. Here we describe the clinical characteristics, disease outcome and risk factors for ARDS and death of a cohort of 53 kidney transplant patients with COVID-19. 8/53 have been handled as outpatients due to mild disease, on average with immunosuppression reduction and the addiction of hydroxychloroquine and azithromycin; no patients required admission, developed ARDS or died. 45/53 required admission due to severe symptoms: this cohort has been managed with immunosuppression withdrawal, methylprednisolone 16 mg/day, hydroxychloroquine and antiviral drugs. Dexamethasone and tocilizumab were considered in case of ARDS. 33% of the patients developed AKI, 60% ARDS and 33% died. In this group, thrombocytopenia was associated to ARDS while lymphopenia at the baseline, higher D-dimer and lack of CRP reduction with risk of death. In the overall population, dyspnoea was associated with the risk of ARDS while age older than 60 years and dyspnoea with the risk of death with only a trend towards an increased risk of death for patients on tacrolimus. In conclusion, SARS-CoV-2 infection may have a variable outcome in renal transplant patients, with higher risk of ARDS and death in the ones requiring admission.


Covid-19: NHS bosses told to assess risk to ethnic minority staff who may be at greater risk


title: The Impact of the Pandemic on Otolaryngology Patients With Negative COVID-19 Status: Commentary and Insights From Orbital Emergencies

text: Efforts aimed at minimizing the spread of COVID-19 and "flattening the curve" may be affecting clinical care delivery for non-COVID-19 cases that include otolaryngologic and orbital conditions. We are witnessing changes in the manner that patients present, as well as modifications in clinical management strategies. An improved understanding of these phenomena and the contributing factors is essential for otolaryngologists to provide sound clinical care during this unprecedented pandemic.


title: Limited containment options of COVID-19 outbreak revealed by regional agent-based simulations for South Africa

text: COVID-19 has spread from China across Europe and the United States and has become a global pandemic. In countries of the Global South, due to often weaker socioeconomic options and health care systems, effective local countermeasures remain debated. We combine large-scale socioeconomic and traffic survey data with detailed agent-based simulations of local transportation to analyze COVID-19 spreading in a regional model for the Nelson Mandela Bay Municipality in South Africa under a range of countermeasure scenarios. The simulations indicate that any realistic containment strategy, including those similar to the one ongoing in South Africa, may yield a manifold overload of available intensive care units (ICUs). Only immediate and the most severe countermeasures, up to a complete lock-down that essentially inhibits all joint human activities, can contain the epidemic effectively. As South Africa exhibits rather favorable conditions compared to many other countries of the Global South, our findings constitute rough conservative estimates and may support identifying strategies towards containing COVID-19 as well as any major future pandemics in these countries.


Wound care during COVID-19 pandemic


title: Development and validation a nomogram for predicting the risk of severe COVID-19: A multi-center study in Sichuan, China

text: BACKGROUND: Since December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan and spread across the globe. The objective of this study is to build and validate a practical nomogram for estimating the risk of severe COVID-19. METHODS: A cohort of 366 patients with laboratory-confirmed COVID-19 was used to develop a prediction model using data collected from 47 locations in Sichuan province from January 2020 to February 2020. The primary outcome was the development of severe COVID-19 during hospitalization. The least absolute shrinkage and selection operator (LASSO) regression model was used to reduce data size and select relevant features. Multivariable logistic regression analysis was applied to build a prediction model incorporating the selected features. The performance of the nomogram regarding the C-index, calibration, discrimination, and clinical usefulness was assessed. Internal validation was assessed by bootstrapping. RESULTS: The median age of the cohort was 43 years. Severe patients were older than mild patients by a median of 6 years. Fever, cough, and dyspnea were more common in severe patients. The individualized prediction nomogram included seven predictors: body temperature at admission, cough, dyspnea, hypertension, cardiovascular disease, chronic liver disease, and chronic kidney disease. The model had good discrimination with an area under the curve of 0.862, C-index of 0.863 (95% confidence interval, 0.801-0.925), and good calibration. A high C-index value of 0.839 was reached in the interval validation. Decision curve analysis showed that the prediction nomogram was clinically useful. CONCLUSION: We established an early warning model incorporating clinical characteristics that could be quickly obtained on admission. This model can be used to help predict severe COVID-19 and identify patients at risk of developing severe disease.


title: COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression ;Journal of Antimicrobial Chemotherapy ;Oxford Academic

text: A novel coronavirus disease (COVID-19), caused by infection with SARS-CoV-2, has swept across 31 provinces in China and over 40 countries worldwide The transition from first symptoms to acute respiratory distress syndrome (ARDS) is highly likely to be due to uncontrolled cytokine release There is an urgent need to identify safe and effective drugs for treatment Chloroquine (CQ) exhibits a promising inhibitory effect However, the clinical use of CQ can cause severe side effects We propose that hydroxychloroquine (HCQ), which exhibits an antiviral effect highly similar to that of CQ, could serve as a better therapeutic approach HCQ is likely to attenuate the severe progression of COVID-19, inhibiting the cytokine storm by suppressing T cell activation It has a safer clinical profile and is suitable for those who are pregnant It is cheaper and more readily available in China We herein strongly urge that clinical trials are performed to assess the preventive effects of HCQ in both disease infection and progression


title: COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression

text: A novel coronavirus disease (COVID-19), caused by infection with SARS-CoV-2, has swept across 31 provinces in China and over 40 countries worldwide. The transition from first symptoms to acute respiratory distress syndrome (ARDS) is highly likely to be due to uncontrolled cytokine release. There is an urgent need to identify safe and effective drugs for treatment. Chloroquine (CQ) exhibits a promising inhibitory effect. However, the clinical use of CQ can cause severe side effects. We propose that hydroxychloroquine (HCQ), which exhibits an antiviral effect highly similar to that of CQ, could serve as a better therapeutic approach. HCQ is likely to attenuate the severe progression of COVID-19, inhibiting the cytokine storm by suppressing T cell activation. It has a safer clinical profile and is suitable for those who are pregnant. It is cheaper and more readily available in China. We herein strongly urge that clinical trials are performed to assess the preventive effects of HCQ in both disease infection and progression.


Views of patients with inflammatory bowel disease on the COVID-19 pandemic: a global survey


Letter to the editor: Plenty of coronaviruses but no SARS-CoV-2


Electroconvulsive therapy for geriatric depression in the COVID-19 era: reflection on the ethics


The scandal of modern slavery in the trade of masks and gloves


The first infant case of COVID-19 acquired from a secondary transmission in Vietnam


The DOSMD challenge and the COVID-19 conundrum


Clinical features and the treatment of children with COVID-19: A case series from Wenzhou, China


title: Mental Health in the Coronavirus Disease 2019 Emergency-The Italian Response

text: Importance: This article briefly reports the experience of mental health services and the lessons learned during the coronavirus disease 2019 (COVID-19) crisis. In particular, this report offers opportunities to build on experience gained in managing the COVID-19 emergency in the Departments of Mental Health and Addiction (DMHAs) in Lombardy, the wealthiest Italian region, which has approximately 10 million inhabitants. Observations: Italy has a National Mental Health System divided into 134 DMHAs, 27 of which are in Lombardy. In the 4 weeks after the epidemic started, important changes occurred in the management of DMHAs in Lombardy. Many challenges have occurred in the management of health services. In many hospitals, entire wards, including some psychiatric wards, have been reorganized to admit patients with COVID-19, and many physicians and nurses have been diverted to wards managing patients with COVID-19. Most day facilities for patients with psychiatric needs have been temporarily closed, whereas in residential facilities, patients who usually are free to come and go during the day have had to be confined in the facilities with very limited or no leave. These changes have produced considerable stresses on people with severe mental disorders. Many outpatient clinics have limited appointments to those with the most urgent cases, and home visits, a common practice in most DMHAs, have been drastically reduced with potentially detrimental consequences for patients' well-being. Another potential detrimental consequence of being forced to stay at home has been an increase in the hours spent face to face with families with high amounts of conflict. Conclusions and Relevance: Departments of Mental Health need to be equipped with appropriate e-health technologies and procedures to cope with situations such as the COVID-19 pandemic. Additionally, interventions are needed to mitigate the potentially harmful consequences of quarantine. Departments of Mental Health should be able to assume a leadership position in the psychosocial management of disasterlike situations, and this requires the acquisition of new skills, notably how to correctly inform the population about risk, train and disseminate effective preventive and management procedures for disasters, support health personnel and rescuers, and support those experiencing bereavement.


COVID-19 and smoking


High-flow nasal cannula for COVID-19 patients: low risk of bio-aerosol dispersion


A quick "Can I donate blood" self-assessment tool amid the COVID-19 outbreak


title: Clinical Characteristics of and Medical Interventions for COVID-19 in Hemodialysis Patients in Wuhan, China

text: BACKGROUND: Reports indicate that those most vulnerable to developing severe coronavirus disease 2019 (COVID-19) are older adults and those with underlying illnesses, such as diabetes mellitus, hypertension, or cardiovascular disease, which are common comorbidities among patients undergoing maintenance hemodialysis. However, there is limited information about the clinical characteristics of hemodialysis patients with COVID-19 or about interventions to control COVID-19 in hemodialysis centers. METHODS: We collected data retrospectively through an online registration system that includes all patients receiving maintenance hemodialysis at 65 centers in Wuhan, China. We reviewed epidemiologic and clinical data of patients with laboratory-confirmed COVID-19 between January 1, 2020 and March 10, 2020. RESULTS: Of 7154 patients undergoing hemodialysis, 154 had laboratory-confirmed COVID-19. The mean age of the 131 patients in our analysis was 63.2 years; 57.3% were men. Many had underlying comorbidities, with cardiovascular disease (including hypertension) being the most common (68.7%). Only 51.9% of patients manifested fever; 21.4% of infected patients were asymptomatic. The most common finding on chest computed tomography (CT) was ground-grass or patchy opacity (82.1%). After initiating comprehensive interventions-including entrance screening of body temperature and symptoms, universal chest CT and blood tests, and other measures-new patients presenting with COVID-19 peaked at 10 per day on January 30, decreasing to 4 per day on February 11. No new cases occurred between February 26 and March 10, 2020. CONCLUSIONS: We found that patients receiving maintenance hemodialysis were susceptible to COVID-19 and that hemodialysis centers were high-risk settings during the epidemic. Increasing prevention efforts, instituting universal screening, and isolating patients with COVID-19 and directing them to designated hemodialysis centers were effective in preventing the spread of COVID-19 in hemodialysis centers.


Mild Pancreatic Enzyme Elevations in COVID-19 Pneumonia: Synonymous with Injury or Noise?


title: Assessing the impact of the coronavirus lockdown on unhappiness, loneliness, and boredom using Google Trends

text: The COVID-19 pandemic has led many governments to implement lockdowns. While lockdowns may help to contain the spread of the virus, it is possible that substantial damage to population well-being will result. This study relies on Google Trends data and tests whether the lockdowns implemented in Europe and America led to changes in well-being related topic search terms. Using different methods to evaluate the causal effects of lockdown, we find a substantial increase in the search intensity for boredom in Europe and the US. We also found a significant increase in searches for loneliness, worry and sadness, while searches for stress, suicide and divorce on the contrary fell. Our results suggest that people's mental health may have been severely affected by the lockdown.


docid: drcxrbxy

title: Serological immunochromatographic approach in diagnosis with SARS-CoV-2 infected COVID-19 patients

text: An outbreak of new coronavirus SARS-CoV-2 was occurred in Wuhan, China and rapidly spread to other cities and nations. The standard diagnostic approach that widely adopted in the clinic is nucleic acid detection by real-time RT-PCR. However, the false-negative rate of the technique is unneglectable and serological methods are urgently warranted. Here, we presented the colloidal gold-based immunochromatographic (ICG) strip targeting viral IgM or IgG antibody and compared it with real-time RT-PCR. The sensitivity of ICG assay with IgM and IgG combinatorial detection in nucleic acid confirmed cases were 11.1%, 92.9% and 96.8% at the early stage (1-7 days after onset), intermediate stage (8-14 days after onset), and late stage (more than 15 days), respectively. The ICG detection capacity in nucleic acid-negative suspected cases was 43.6%. In addition, the concordance of whole blood samples and plasma showed Cohen's kappa value of 0.93, which represented the almost perfect agreement between two types of samples. In conclusion, serological ICG strip assay in detecting SARS-CoV-2 infection is both sensitive and consistent, which is considered as an excellent supplementary approach in clinical application.


Fatality rate of COVID-19 in patients with malignancies: a sytematic review and meta-analysis


The database-based strategy may overstate the potential effects of traditional Chinese medicine against COVID-19


title: Will environmental changes in temperature affect the course of COVID-19?

text: While the outbreak has reached every region of the world, it is undeniable that countries in the southern hemisphere seem to be less affected, where cases have been reported, these have been imported and travel related. We analyzed the climate temperature from various regions according to their current ongoing human-to-human transmission status. We studied 3 groups; Group 1, 10 provinces from China with majority of COVID-19 cases; Group 2, areas where continuous horizontal transmission outside of China had been reported; and group 3, areas where imported cases had been detected and no horizontal transmission had been documented after at least seven days since the first case was reported. The regions without ongoing human-to-human transmission showed significantly higher temperatures when compared to China and countries with ongoing human-to-human transmission, with over an 11-degree difference. The average rainfall during the study period was significantly higher in those regions without OHHT when compared to the Chinese provinces with ongoing human-to-human transmission and the regions with active transmission of SARS-CoV-2. Our findings show statistically significant differences between regions with ongoing human-to-human transmission of COVID-19 cases compared to those regions without horizontal transmission. This phenomenon could have implications in the behavior of the ongoing COVID-19 outbreak in the following months.


New-onset psychosis in COVID-19 pandemic: a case series in Madrid


title: Predictors of in-hospital mortality in patients with left ventricular assist device

text: BACKGROUND: A left ventricular assist device (LVAD) is used to support patients with end-stage heart failure. AIMS: To examine the role of comorbidities and complications in predicting in-hospital mortality since the introduction of continuous flow (CF)-LVAD. METHODS: The Nationwide Inpatient Sample was queried from 2010 to 2014 using International Classification of Disease-9 code for LVAD among patients 18 years or older. The sample consisted of 2,359 patients (mean age = 55 ± 13.7 years, 76.8% men, 59.3% Caucasian). RESULTS: Comparative analysis revealed mortality did not differ from 2010 to 2014 (p = 0.653). Increases in comorbidities of atrial fibrillation, acute kidney injury, mechanical ventilation, body mass index ≥ 25, cerebrovascular disease, and mild liver disease were evidenced over the 5-year period (p values ≤ 0.049). Multivariate analysis showed that significant predictors of mortality were comorbid hemodialysis (AOR = 7.62, 95% CI [4.78, 12.27]), cerebrovascular disease (AOR = 5.38, 95% CI [3.49, 8.26]), mechanical ventilation (AOR = 3.83, 95% CI [2.84, 5.18]), mild liver disease (AOR = 1.96, 95% CI [1.38, 2.76]), and acute kidney injury (AOR = 1.62, 95% CI [1.16, 2.28]). Predictive complications included disseminated intravascular coagulation (AOR = 6.41, 95% CI [2.79, 6.84]), sepsis (AOR = 4.37, 95% CI [2.79, 6.84]), septic shock (AOR = 3.9, 95% CI [2.11, 7.59]), and gastrointestinal bleed (AOR = 1.81, 95% CI [1.11, 2.93]). CONCLUSIONS: CF-LVADs have not reduced mortality, possibly due to utilization in patients with comorbid conditions. Future trials are necessary for improved patient selection and reduced post-procedural complications.


title: Asymptomatic novel coronavirus pneumonia presenting as acute cerebral infarction:case report and review of the literature/ 中华急诊医学杂志

text: An outbreak of novel coronavirus pneumonia that began in Wuhan, China, has spread rapidly in December 2019, with cases now confirmed in multiple countries. As the number of cases increases, we pay more and more attention to asymptomatic novel coronavirus pneumonia,We report the first case of Asymptomatic novel coronavirus pneumonia presenting as acute cerebral infarction and describe the identification, diagnosis, clinical course, and emergency treatment, including. This case highlights the the importance of emergency medical teams in initial assessment of emergency public health emergencies, as well as the necessary of the emergency chest CT for screening asymptomatic novel coronavirus pneumonia.