title: A Feasibility Study of Urgent Implementation of Cystic Fibrosis Multidisciplinary Telemedicine Clinic in the Face of COVID-19 Pandemic: Single-Center Experience

text: Introduction: The coronavirus 2019 (COVID-19) pandemic has become a major world health problem. All U.S. states have advised their cystic fibrosis (CF) populations to socially isolate. Major health care payors such as Medicare and most private insurance companies have agreed to reimburse health care providers for telemedicine and telephone visits. Methods: The CF adult team at the University of Virginia (UVA) transitioned from face-to-face clinics to multidisciplinary telemedicine clinics by using WebEx® (Cisco Systems, San Jose, CA), a Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliant platform. Interventions: Patients were contacted before scheduled visits and triaged into: (1) patients eligible for the multidisciplinary telemedicine clinic, (2) patients to be seen in clinic urgently due to acute needs, and (3) stable patients who can be rescheduled at a later time. Ineligible patients for the telemedicine clinic due to lack of access to technology were followed up via telephone. Results: A total of 63 patients were scheduled to be seen in the UVA clinic over 4 weeks, 10 clinic days. Of these patients, 20 (32%) rescheduled their appointment. In addition, 2 patients (3%) were seen in clinic for acute needs and 38 (60%) were seen by the multidisciplinary team through telemedicine. Conclusions: In the context of the COVID-19 pandemic, implementing a telemedicine clinic process that serves the needs of a multidisciplinary care team is paramount to preserving the CF care model. Through a systematic design and test process, a feasible and sustainable program was created that can be utilized by other multidisciplinary programs to adapt to their context.


Maintaining HIV care during the COVID-19 pandemic


title: Clinical Characteristics and Outcomes of Community- and Hospital-Acquired Acute Kidney Injury with COVID-19 in a US Inner City Hospital System

text: INTRODUCTION: Emerging data have described poor clinical outcomes from infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) among African American patients and those from underserved socioeconomic groups. We sought to describe the clinical characteristics and outcomes of acute kidney injury (AKI) in this special population. METHODS: This is a retrospective study conducted in an underserved area with a predominance of African American patients with coronavirus disease 2019 (COVID-19). Descriptive statistics were used to characterize the sample population. The onset of AKI and relation to clinical outcomes were determined. Multivariate logistic regression was used to determine factors associated with AKI. RESULTS: Nearly half (49.3%) of the patients with COVID-19 had AKI. Patients with AKI had a significantly lower baseline estimated glomerular filtration rate (eGFR) and higher FiO2 requirement and D-dimer levels on admission. More subnephrotic proteinuria and microhematuria was seen in these patients, and the majority had a pre-renal urine electrolyte profile. Patients with hospital-acquired AKI (HA-AKI) as opposed to those with community-acquired AKI (CA-AKI) had higher rates of in-hospital death (52 vs. 23%, p = 0.005), need for vasopressors (42 vs. 25%, p = 0.024), and need for intubation (55 vs. 25%, p = 0.006). A history of heart failure was significantly associated with AKI after adjusting for baseline eGFR (OR 3.382, 95% CI 1.121-13.231, p = 0.032). CONCLUSION: We report a high burden of AKI among underserved COVID-19 patients with multiple comorbidities. Those who had HA-AKI had worse clinical outcomes compared to those who with CA-AKI. A history of heart failure is an independent predictor of AKI in patients with COVID-19.


title: Reduced Physical Activity During COVID-19 Pandemic in Children With Congenital Heart Disease

text: Children with congenital heart disease (CHD) are at risk for both COVID-19 and secondary cardiovascular outcomes. Their increased cardiovascular risk may be mitigated through physical activity, but public health measures implemented for COVID-19 can make physical activity challenging. We objectively measured the impact of the COVID-19 pandemic on physical activity, continuously measured by Fitbit step counts, in children with CHD. Step counts were markedly lower in late March and early April 2020, compared with 2019 and early March 2020. It is vital to understand how precautions for COVID-19 will affect the health of children with CHD, especially if they persist long term.


docid: docjxewt

title: Pancreatic Cancer During COVID-19 Pandemic: Treat or Not to Treat?

text: Pancreatic cancer is a very aggressive disease and survival remains dismal even with treatment Currently, management of patients with pancreatic cancer has been complicated by the ongoing COVID-19 pandemic Medical oncologists face the dilemma of whether to treat or to not treat these patients who are at high-risk of complications and even death from COVID-19 No current guidelines are available and our limited experience at this time makes it more difficult to manage these patients Although we have general strategies available from experience in Italy, we need more treatment specific strategies to help mitigate risks of complications and toxicities from chemotherapy in order to protect our patients from COVID-19 as much as possible


title: Generalized Multivariate Hawkes Processes

text: This work contributes to the theory and applications of Hawkes processes. We introduce and examine a new class of Hawkes processes that we call generalized Hawkes processes, and their special subclass -- the generalized multivariate Hawkes processes (GMHPs). GMHPs are multivariate marked point processes that add an important feature to the family of the (classical) multivariate Hawkes processes: they allow for explicit modelling of simultaneous occurrence of excitation events coming from different sources, i.e. caused by different coordinates of the multivariate process. We study the issue of existence of a generalized Hawkes process, and we provide a construction of a specific generalized multivariate Hawkes process. We investigate Markovian aspects of GMHPs, and we indicate some plausible important applications of GMHPs.


title: [Clinical experience of high-flow nasal cannula oxygen therapy in severe COVID-19 patients]

text: Acute respiratory failure due to acute hypoxemia is the major manifestation in severe coronavirus disease 2019 (COVID-19). Rational and effective respiratory support is crucial in the management of COVID-19 patients. High-flow nasal cannula (HFNC) has been utilized widely due to its superiority over other non-invasive respiratory support techniques. To avoid HFNC failure and intubation delay, the key issues are proper patients, timely application and improving compliance. It should be noted that elder patients are vulnerable for failed HFNC. We applied HFNC for oxygen therapy in severe and critical ill COVID-19 patients and summarized the following experiences. Firstly, to select the proper size of nasal catheter, to locate it at suitable place, and to confirm the nose and the upper respiratory airway unobstructed. Secondly, an initial îow of 60 L/min and 37â should be given immediately for patients with obvious respiratory distress or weak cough ability; otherwise, low-level support should be given first and the level gradually increased. Thirdly, to avoid hypoxia or hypoxemia, the treatment goal of HFNC should be maintained the oxygen saturation (SpO2) above 95% for patients without chronic pulmonary disease. Finally, patients should wear a surgical mask during HFNC treatment to reduce the risk of virus transmission through droplets or aerosols.


La alteración del olfato y el gusto en pacientes COVID-19. Un recurso diagnóstico en atención primaria./ [The alteration of smell and taste in COVID-19 patients. A diagnostic resource in primary care]


Outpatient Teledermatology Implementation During the COVID-19 Pandemic: Challenges and Lessons Learned


title: Could autism spectrum disorders be a risk factor for COVID-19?

text: The coronavirus SARS-CoV-2 pandemia is infecting millions of people and some studies relate conditions that might increase the risk of developing a fatal course for the disease, such as diabetes, cardiovascular diseases and obesity. In COVID-19 physiopathology, one of the main inflammation mechanisms is the "cytokine storm", causing a pro-inflammatory state, related to cardiac and pulmonary damage. There is also a less effective role of lymphocyte B and T in the humoral immunity due to the reduction of their proliferative response. The physiopathology of ASD (Autism Spectrum Disorder) involves several modifications at the genetic and at the immune level, such as the increase of inflammatory cytokines and abnormal immune response in several levels. We hypothesize that ASD could be a risk-factor as the other conditions are.


COVID-19: Fever syndrome and neurological symptoms in a neonate


docid: vexdpths

title: Throat Wash Testing and COVID-19 Disease: Should We Put Our Money Where Our Mouth Is?


Retroauricular dermatitis with vehement use of ear loop face masks during COVID-19 pandemic


Old Weapon for New Enemy: Drug Repurposing for Treatment of Newly Emerging Viral Diseases


title: Establishing Mayo Clinic's Coronavirus Disease 2019 Virtual Clinic: A Preliminary Communication

text: The coronavirus disease 2019 (COVID-19) pandemic is taking a massive toll on health care systems globally. We developed the COVID-19 virtual clinic (CVC) in conjunction with drive through testing to cope with this situation. There are two arms of the CVC: (1) a screening arm and (2) positive patient arm. Screening is performed over the phone based on the Centers for Disease Control and Prevention screening guideline. Positive patients are followed at regular intervals by video appointments where concerns can be addressed by a provider while also tracking symptom progression. We enrolled 63 positive patients out of 1,153 screened for COVID-19 as of this writing. The CVC continues to address patients' concerns and symptoms in an effort to minimize emergency department and hospital patient volumes, as incidence increases. Drive through testing in conjunction with a virtual clinic allows us to provide high-quality care in an anxious time without consuming excessive personal protective equipment or unnecessarily exposing health care workers. This article could serve as a model to guide other practices to cope with this and future pandemics.


title: When SARS-CoV-2 comes knocking on your lab door: Individual scientists' experiences during the pandemic

text: A snapshot of how scientists are personally affected by the global Covid-19 pandemic.


Covid-19: Important potential side effects of wearing face masks that we should bear in mind


title: The clinical characteristic of eight patients of COVID-19 with positive RT-PCR test after discharge

text: Corona virus disease 2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The phenomenon of positive real time reverse transcription polymerase chain reaction (RT-PCR) result of SARS-CoV-2 in recovered patients had occurred and the research about these patients was rare. In our study, we did a retrospective review of medical records from COVID-19 patients admitted to one ward of Tongji Hospital of Hua Zhong University of Science and Technology from 10 February to 13 April 2020. From 10 February to 13 April 2020, there were 108 patients of COVID-19 admitted in the one ward of Tongji Hospital. Among them, eight cases were readmission patients because the RT-PCR result of SARS-CoV-2 was positive again after discharge. On the second admission, they had no symptoms and their chest computed tomography was almost normal. Data from laboratory tests of the readmission patients showed that all eight patients had normal white blood cell count, lymphocyte count. The inflammatory factors like procalcitonin and interleukin 6 were normal. After treatment, two patients met the standard and were discharged. The other six patients were still in the hospital because their RT-PCR of SARS-CoV-2 did not get three consecutive negative results and the course of two patients had persisted more than 90 days. We still needed to be alert that these patients could infect other people as a source of infection, and we also needed to be alert that these patients become chronic virus carriers. It also aroused our concern about the discharge standard of COVID-19.


Commentary: Origin and evolution of pathogenic coronaviruses


Chloroquine and COVID-19, where do we stand?


title: Epidemic characteristics of emerging respiratory infectious diseases and coping strategies/ 重庆医学

text: The prevention and control of emerging respiratory infectious diseases is an arduous task. The current outbreak of the new coronavirus pneumonia (COVID-19) is severe and seriously endangers people's health. In order to better guide the clinical work, this article briefly expounded the epidemic characteristics and corresponding coping strategies of the main emerging respiratory infectious diseases in recent years.


title: Partial characterization of digestive proteases in sheepshead, Archosargus probatocephalus (Spariformes: Sparidae)

text: Digestive proteases were partially characterized in sheepshead juveniles, using biochemical and electrophoretic techniques. Results showed higher activity level of the stomach proteases (2.39 ± 0.02 U mg protein-1) compared to the intestinal proteases (1.6 ± 0.1 U mg protein-1). The activity of trypsin, chymotrypsin, leucine aminopeptidase and carboxypeptidase A was also recorded. The optimum temperature of the stomach proteases was recorded at 45 °C, while for intestinal proteases was recorded at 55 °C. Stomach proteases showed less stability to temperature changes than intestinal proteases. An optimum pH of 2 was recorded for stomach proteases with high stability under acidic conditions, while an optimum pH of 9 was recorded for intestinal proteases showing high stability under alkaline conditions. Stomach proteases were inhibited around 78% with Pepstatin A, indicating the presence of pepsin as the main protease. The stomach proteases zymogam revealed one active band with Rf of 0.49, this enzyme was completely inhibited by Pepstatin A. The intestinal proteases zymogram revealed four active proteases (51.3, 34.9, 27.8 and 21.2 kDa) that were inhibited by TLCK, which mainly represent a trypsin-like serine proteases. It can be conclude that digestion in sheepshead can be considered as a carnivorous species with an omnivorous tendency.(AU)


Respiratory failure and non-invasive respiratory support during the covid-19 pandemic: an update for re-deployed hospital doctors and primary care physicians


A report of clustered COVID-19 in a hematology ward


title: Clinicopathological evaluation of clear cell hidradenoma (acrospiroma) within multiple tumor complex in a dog

text: Background: Clear cell hidradenoma (acrospiroma) is adnexal tumors that arise from the distal excretory duct of eccrine sweat glands. It is generally defined in humanbeings. It presents solitary structure in firmness nodule. Most frequently are encountered in head, face, and upper extremities in humans. Hidradenomas are called generally by definition benign. Their malignant transformations and metastasis are seen very rarely. In veterinary literature database, the malignant form of tumor has been defined as an unique report in four dogs. They are extremely rare tumors in dogs. It is not documented within multiple tumor complex up to now.Case: In the case, three tumors were detected in a 9-year-old neutered female German shepherd dog. After clinical examination, a complete surgical resection of all masses was performed and masses were sent to Pathology for diagnosis. A mass on the right last rib was a 8x6 cm in diameters with severe ulceration. The mass had a hard texture, immobility and irregular borders. Other masses were localized on the back and left caudo-abdominal mammary lobe. Tumors on the back and the mammary lobe did not invade muscle layer, but the tumor on the last rib aggressively invaded surrounding tissue and were very difficult to remove surgically After macroscopy, all the masses were stained with hematoxylin-eosin (H&E), Mayers mucicarmine and Periodic Acid Shiff (PAS) stainings. In the first mass, there were multilobular epithelial islands between prominent fibrous septa from the upper to deep of dermis. The neoplastic cells were generally round or polyhedral in shape. Some of cytoplasms were eosinophilic at different degree. But cytoplasms were generally finely granular and vesicular or clear in appearance. Some cells had possible glycogen deposits. Nucleus was oval to round and had fine reticular chromatin and a distinct nucleolus.[...](AU)


Consideration of Pannexin 1 channels in COVID-19 pathology and treatment


docid: yolnslsr

text: Pannexin1 (PANX1) is a ubiquitously expressed, channel-forming protein found in a number of tissues thoughout the body (e.g. lung, vasculature, liver, central nervous system, immune system) that is important in many key physiological and immune responses. PANX1 channels passively flux ATP (predominantly), multiple metabolites, and likely other small anions. PANX1 channels regulate inflammation and host responses to several pathogens, including viruses. While there is currently no evidence suggesting novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and PANX1 directly interact, there is an urgent need for therapeutic strategies, especially those targeting the hyper-inflammation and cytokine storm that occurs in severe cases of COVID-19. Here we argue that PANX1, and drugs known to target PANX1 (including the FDA-approved drug probenecid), should be the focus of further investigation in the context of SARS-CoV-2 infection and its associated pathology in COVID-19 patients.


title: The COVID-19 outbreak in Italy: Initial implications for organ transplantation programs

text: The spread of Coronavirus Disease 2019 (COVID-19) has already reached a pandemic dimension within a few weeks. Italy has been one of the first countries dealing with the outbreak of COVID-19, and severe measures have been adopted to limit viral transmission. The spread of COVID-19 may have several implications in organ transplant activity that physicians should be aware of. The initial experience gained during the COVID-19 outbreak shows that around 10% of infected patients in Italy need intensive care management to overcome the acute respiratory distress syndrome. Due to the exponential rise of infected patients we are now facing an actual risk of saturation of intensive care unit (ICU) beds. A restriction in the number of ICU beds available for both donors and transplant recipients may unfavorably influence the overall donation activity, and eventually lead to a reduced number of transplants. Preliminary Italian data show that a 25% reduction of procured organs has already occurred during the first 4 weeks of COVID-19 outbreak. This underlines the need to closely monitor what will be further happening in ICUs due to the COVID-19 spread in the attempt to preserve transplant activity, especially in Western countries where deceased donors represent the major organ resource.


title: SARS-CoV-2 and Coronavirus Disease 2019: What We Know So Far

text: In December 2019, a cluster of fatal pneumonia cases presented in Wuhan, China. They were caused by a previously unknown coronavirus. All patients had been associated with the Wuhan Wholefood market, where seafood and live animals are sold. The virus spread rapidly and public health authorities in China initiated a containment effort. However, by that time, travelers had carried the virus to many countries, sparking memories of the previous coronavirus epidemics, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and causing widespread media attention and panic. Based on clinical criteria and available serological and molecular information, the new disease was called coronavirus disease of 2019 (COVID-19), and the novel coronavirus was called SARS Coronavirus-2 (SARS-CoV-2), emphasizing its close relationship to the 2002 SARS virus (SARS-CoV). The scientific community raced to uncover the origin of the virus, understand the pathogenesis of the disease, develop treatment options, define the risk factors, and work on vaccine development. Here we present a summary of current knowledge regarding the novel coronavirus and the disease it causes.


docid: enlydped

title: Discrimination, Skin Color Satisfaction, and Adjustment among Latinx American Youth

text: Race-related biases and discrimination and easily observable race-related characteristics, such as skin color, appear to go hand and hand, but it remains unclear how these factors work together to shape youth development. The current study addresses this gap by investigating skin color satisfaction as a mediator between perceptions of discrimination and adjustment. Data are from a cross-sectional sample of Latinx youth (N = 175; Mage = 12.86; 51.4% female; 86.9% US-born) who completed measures of foreigner-based objectification, peer discrimination, adult discrimination, self-esteem, depressive symptoms, and the importance or value attributed to academic success. Evidence of significant indirect effects of skin color satisfaction in the links between foreigner-based objectification and self-esteem as well as academic importance was found. Skin color satisfaction did not mediate links between either peer or adult discrimination and self-esteem, depression, and academic importance. The results provide support that being perceived as a foreigner has negative implications for Latinx youth adjustment through skin color satisfaction. The present study expands understanding of how different forms of differential treatment may affect minoritized youth. Implications and future research ideas are discussed.


An increased severity of peripheral arterial disease in the COVID-19 era


COVID-19 Severity Correlates with Weaker T Cell Immunity, Hypercytokinemia and Lung Epithelium Injury


Malaria prophylaxis approach during COVID-19 pandemic


docid: iltfvwty

title: Community-based Cancer Care Quality and Expertise in a COVID-19 Era and Beyond


title: [Liquid chromatography tandem mass spectrometry for therapeutic drug monitoring of voriconazole in heat-inactivated blood samples: its application during COVID-19 pandemic]

text: OBJECTIVE: To investigate the effect of heat inactivation (56âfor 30 min) of SARS-CoV-2 on the results of therapeuticdrug monitoring (TDM) of voriconazole by liquid chromatography tandem mass spectrometry (LC-MS/MS). METHODS: We collected clinical blood samples from voriconazole-treated patients in heparinized tubes and sterilized the surface of the tubes with 75% ethanol. The whole blood samples were centrifuged to separate the plasma with or without prior heat inactivation, or only the separated plasma was heat inactivated. Heat inactivation of the samples was carried out at 56 â for 30 min followed by protein precipitation with acetonitrile or ethanol. The plasma standard and quality control samples were inactivated in an identical manner and tested with LC-MS/MS along with the treated samples. RESULTS: The optimized method showed a high imprecision (with mean intra- and inter-day imprecisions of 3.59% and 2.81%, respectively) and a high accuracy (mean 97.37%) for detecting voriconazole in the inactivated samples at different concentration levels. Sample preparation with acetonitrile or ethanol resulted in a high mean recovery (100.56% or 95.90%) with minimal mean matrix effect (102.85% or 93.62%). The measured voriconazole concentrations in inactivated whole blood, inactivated plasma and the samples without inactivation all showed good linear correlations with correlation coefficients all greater than 0.99. CONCLUSIONS: Heat inactivation at 56 â for 30 min combined with ethanol sample preparation only has limited effects to affect LC-MS-based voriconazole concentration measurement in whole blood samples collected in heparinized tubes, and can be used for therapeutic drug monitoring of voriconazole during the ongoing COVID-19 pandemic.


title: COVID-19: The New Caledonia experience

text: New Caledonia is a French associated territory in the South Pacific Ocean. While COVID-19 is expanding over the world, we seem to be well preserved with a total of 18 documented cases. We report the measures implemented on our island that probably helped containing an epidemic spread.


COVID-19 pandemic and the Olympic Games


title: In the Aftermath

text: After the initial surge of COVID-19, it's time for nurses to look inward and ahead.


title: Safety management of nasopharyngeal specimen collection from suspected cases of coronavirus disease 2019

text: This article introduces safety management strategies of nasopharyngeal specimen collection from suspected cases of coronavirus disease 2019 in a tertiary designated hospital. The key points includes establishing a special sampling room, strict sterilization of the entire environment, training of professional nurses, enhancement of personal protection, standardization of methods and processes for swab collection, and a timely and safety sample submission. More than 11,000 nasopharyngeal specimens were collected by eight nurses, with an average of 1375 specimen swab collections each nurse, and no one was infected.


Comparing the impact of various interventions to control the spread of COVID-19 in 12 countries


title: Dead body management amidst global pandemic of Covid-19

text: Covid-19 has reached almost all the nations in the world. More and more people are dying from it and in some countries, even the army has been called upon to help dispose of the dead as there is a shortage of coffins, and undertakers are overwhelmed. Therefore, it is essential to have measures in place to contain the spread of infection while handling dead bodies. In view of this, different guidelines and protocols have been proposed bearing in mind the limited information we have about the virus. This review article sets them out for better reference.


title: Infection control practices in children during COVID-19 pandemic: Differences from adults

text: BACKGROUND: Limited studies have been published on practices and management of Coronavirus Disease 2019 (COVID-19) in children. Despite the fact that COVID-19 rarely caused any severe disease in children, the asymptomatic children might be playing an important role for spreading COVID-19 in healthcare facilities. This review aimed at sharing our experience of how to handle patients with COVID-19 in a pediatric referral and tertiary care hospital to prevent the possible transmissions to the healthcare workers (HCWs). METHODS: This review sought to identify infection control practices measures during COVID-19 pandemic comes from our daily practice combined with the most recent guidelines with the new experience and information. RESULTS: Prevention the transmission of COVID-19 to the HCWs, 4 primary themes should be taken into consideration; (1) ongoing education and importance of the organization of the healthcare facility, (2) proper clinical triage and isolation of the suspected or confirmed COVID-19 patients in the outpatient clinics and in the emergency departments, (3) necessity of the organization of the COVID-19 wards, and (4) utilization of personal protective equipment. CONCLUSIONS: Infection control precautions to prevent the possible transmissions to HCWs as well as the other patients and their caregivers from children with COVID-19 are very critical. If sufficient precautions are not taken, healthcare settings may serve as additional source of transmission and spread of COVID-19 in the society.


Coronavirus Disease 2019, Prothrombotic Factors, and Venous Thromboembolism


Protecting health-care workers from subclinical coronavirus infection


CT screening for early diagnosis of SARS-CoV-2 infection


title: Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults

text: The novel coronavirus (COVID-19) has enforced dramatic changes to daily living including economic and health impacts. Evidence for the impact of these changes on our physical and mental health and health behaviors is limited. We examined the associations between psychological distress and changes in selected health behaviors since the onset of COVID-19 in Australia. An online survey was distributed in April 2020 and included measures of depression, anxiety, stress, physical activity, sleep, alcohol intake and cigarette smoking. The survey was completed by 1491 adults (mean age 50.5 ± 14.9 years, 67% female). Negative change was reported for physical activity (48.9%), sleep (40.7%), alcohol (26.6%) and smoking (6.9%) since the onset of the COVID-19 pandemic. Significantly higher scores in one or more psychological distress states were found for females, and those not in a relationship, in the lowest income category, aged 18-45 years, or with a chronic illness. Negative changes in physical activity, sleep, smoking and alcohol intake were associated with higher depression, anxiety and stress symptoms. Health-promotion strategies directed at adopting or maintaining positive health-related behaviors should be utilized to address increases in psychological distress during the pandemic. Ongoing evaluation of the impact of lifestyle changes associated with the pandemic is needed.


title: [Feasibility analysis on acupuncture therapy for the treatment of Corona Virus Disease 2019 and the exploration on the application scheme]

text: The situation of Corona Virus Disease 2019 (COVID-19) is still severe at present. In order to better fight against the epidemic and give full play to the advantages of traditional Chinese medicine, we explored the feasibility of acupuncture therapy in the intervention of COVID-19 through analyzing the relevant literature in both ancient and modern time. Additionally, we analyzed the intervention scheme of acupuncture for COVID-19 developed by China Association of Acupuncture and Moxibustion and supplemented the protocol of the intervention with auricular acupuncture. It was proposed that the advantages of acupuncture and moxibustion should be fully displayed while Chinese herbal medications have been applied in the treatment of COVID-19. During treatment, acupuncture physicians should be rationally allocated to a certain proportion so as to adequately utilize comprehensive therapeutic approaches and guarantee people's safety to the greatest extent. Eventually, the clinical therapeutic effect may be improved, the national resources be economized on and the COVID-19 epidemic be conquered early.


Genomic search for COVID-19 severity clues


Clinical course of COVID-19 in 41 patients with immune-mediated inflammatory diseases: experience from Humanitas Center, Milan


Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment-Elevation Myocardial Infarction Care in Hong Kong, China


title: Clinical Trial Drug Safety Assessment for Studies and Submissions Impacted by COVID-19

text: In this paper, we provide guidance on how standard safety analyses and reporting of clinical trial safety data may need to be modified, given the potential impact of the COVID-19 pandemic. The impact could include missed visits, alternative methods for assessments (such as virtual visits), alternative locations for assessments (such as local labs), and study drug interruptions. We focus on safety planning for Phase 2-4 clinical trials and integrated summaries for submissions. Starting from the recommended safety analyses proposed in white papers and a workshop, created as part of an FDA/PHUSE collaboration (PHUSE 2013, 2015, 2017, 2019), we assess what modifications might be needed. Impact from COVID-19 will likely affect treatment arms equally, so analyses of adverse events from controlled data can, to a large extent, remain unchanged. However, interpretation of summaries from uncontrolled data (summaries that include open-label extension data) will require even more caution than usual. Special consideration will be needed for safety topics of interest, especially events expected to have a higher incidence due to a COVID-19 infection or due to quarantine or travel restrictions (e.g., depression). Analyses of laboratory measurements may need to be modified to account for the combination of measurements from local and central laboratories.


Decline in child vaccination coverage during the COVID-19 pandemic - Michigan Care Improvement Registry, May 2016-May 2020


Pragmatic recommendations for intubating critically ill patients with suspected COVID-19


title: Experiencias del farmacéutico de hospital en el equipo pluridisciplinar en unidades especiales./ Hospital pharmacist experience in a multidisciplinary team in special care settings

text: The COVID-19 pandemic is placing huge strain on health systems and professionals. Emergency departments and their pharmacy services have been the first to face this challenge before any other pharmacy units. This article provides a description of the experience of two public hospitals located in the Autonomous Community of Madrid, Spain. Team working and reciprocal trust have made it possible to meet the unprecedented demand for health services and has facilitated rapid decision making. Strategies have been developed to guarantee the availability, distribution and safe use of medications. Other strategies have included favoring communication within Emergency Departments pharmacy services, and between these services and Emergency Departments during the pandemic. Multidisciplinary cooperation and information sharing have traditionally formed the base for efficient and quality work, along with solid technologies that guarantee a safe use of medications. The crucial role of information and communication technologies during the pandemic may give rise to a new model of pharmaceutical care, which should not replace face-to- face Emergency Department pharmacist support and advice. Promoting the re- humanization of healthcare and pharmacy services is essential. An adequate technical training and the development of abilities such as flexibility, planning and coordination skills, and an assertive communication and management of emotions will be key to the successful management of unimaginable settings in the future.


title: The role of echocardiography in SARS-CoV-2 pandemic: a compromise among appropriateness, safety and clinical impact

text: SARS-CoV-2 infection, responsible for COVID-19, can determine cardiac events, which require a quick diagnosis and management, and should not be overlooked due to the presence of COVID-19 infection. In some cases, cardiovascular symptoms can also be the first and only manifestation of SARS-CoV-2 infection. In patients with COVID-19, the full cardiovascular disease diagnostic algorithm can be hindered by logistic restrain mainly derived from the difficulty of transporting patients in critical conditions to Radiology or Hemodynamics wards. The echocardiography in SARS-CoV-2 pandemic can help for differential diagnosis of cardiac events, which can be related or unrelated by the infection and can likely impact on short-term prognosis. Indeed, transthoracic echocardiography plays a key role in the screen for CV complications of COVID-19 infection: it must be focused cardiac ultrasound study (FoCUS) performed at bedside. All transthoracic, transesophageal and stress echocardiograms in patients in which test results are unlikely to change the management strategy should be postponed.


title: Novel approach to Room Temperature Superconductivity problem

text: A long-standing problem of observing Room Temperature Superconductivity is finally solved by a novel approach. Instead of increasing the critical temperature Tc of a superconductor, the temperature of the room was decreased to an appropriate Tc value. We consider this approach more promising for obtaining a large number of materials possessing Room Temperature Superconductivity in the near future.


Store-and-forward teledermatology in the era of COVID-19: A pilot study


Coronavirus Disease 2019 (COVID-19) and Your Radiology Practice: Case Triage, Staffing Strategies, and Addressing Revenue Concerns


Psychoanalysis and the pandemic: Editor's Introduction


docid: zztydksw

title: Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes

text: In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.


title: COVID-19 and the Global Impact on Colorectal Practice and Surgery

text: BACKGROUND: The novel severe acute respiratory syndrome coronavirus 2 virus that emerged in December 2019 causing coronavirus disease 2019 (COVID-19) has led to the sudden national reorganization of health care systems and changes in the delivery of health care globally. The purpose of our study was to use a survey to assess the global effects of COVID-19 on colorectal practice and surgery. MATERIALS AND METHODS: A panel of International Society of University Colon and Rectal Surgeons (ISUCRS) selected 22 questions, which were included in the questionnaire. The questionnaire was distributed electronically to ISUCRS fellows and other surgeons included in the ISUCRS database and was advertised on social media sites. The questionnaire remained open from April 16 to 28, 2020. RESULTS: A total of 287 surgeons completed the survey. Of the 287 respondents, 90% were colorectal specialists or general surgeons with an interest in colorectal disease. COVID-19 had affected the practice of 96% of the surgeons, and 52% were now using telemedicine. Also, 66% reported that elective colorectal cancer surgery could proceed but with perioperative precautions. Of the 287 respondents, 19.5% reported that the use of personal protective equipment was the most important perioperative precaution. However, personal protective equipment was only provided by 9.1% of hospitals. In addition, 64% of surgeons were offering minimally invasive surgery. However, 44% reported that enough information was not available regarding the safety of the loss of intra-abdominal carbon dioxide gas during the COVID-19 pandemic. Finally, 61% of the surgeons were prepared to defer elective colorectal cancer surgery, with 29% willing to defer for ≤ 8 weeks. CONCLUSION: The results from our survey have demonstrated that, globally, COVID-19 has affected the ability of colorectal surgeons to offer care to their patients. We have also discussed suggestions for various practical adaptation strategies for use during the recovery period.


COVID-19 impact on early career investigators: a call for action


title: Coronavirus (COVID-19) Outbreak: What the Department of Radiology Should Know

text: In December 2019, a novel coronavirus (COVID-19) pneumonia emerged in Wuhan, China. Since then, this highly contagious COVID-19 has been spreading worldwide, with a rapid rise in the number of deaths. Novel COVID-19-infected pneumonia (NCIP) is characterized by fever, fatigue, dry cough, and dyspnea. A variety of chest imaging features have been reported, similar to those found in other types of coronavirus syndromes. The purpose of the present review is to briefly discuss the known epidemiology and the imaging findings of coronavirus syndromes, with a focus on the reported imaging findings of NCIP. Moreover, the authors review precautions and safety measures for radiology department personnel to manage patients with known or suspected NCIP. Implementation of a robust plan in the radiology department is required to prevent further transmission of the virus to patients and department staff members.


title: Between fear and courage: Attitudes, beliefs, and behavior of liver transplantation recipients and waiting list candidates during the COVID-19 pandemic

text: Patients with chronic liver disease and patients after solid organ transplantation (SOT) are vulnerable to severe coronavirus disease 2019 (COVID-19). We evaluated fears, attitudes, and opinions associated with COVID-19 in 365 SOT recipients (95% liver, 5% pancreas/kidney), 112 SOT candidates, and 394 immediate household contacts in 2 German transplant centers. Seven (1.5%) patients and 10 (2.5%) controls had contact with confirmed COVID-19 cases. Fear of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was expressed by 65% of SOT recipients and by 55% of SOT candidates. SOT recipients had higher levels of fear of infection and more often wore personal protective gear than household controls. Female sex, steroid treatment, and using the local newspaper as a primary source of information were independently associated with expressed fear of infection in SOT recipients. Younger age and more recent transplantation correlated with concerns about severe COVID-19 expressed by patients and with concerns about worse medical care expressed by household controls. One third of the patients expressed fear that immunosuppression could worsen COVID-19 but only 15% used the transplantation center as a source of information. These data show that fears associated with the SARS-CoV-2 pandemic are frequently expressed but measures to prevent infection are regularly followed by patients before and after SOT.


Embracing the Landscape of Therapeutics


title: A note on 'Collider bias undermines our understanding of COVID-19 disease risk and severity' and how causal Bayesian networks both expose and resolve the problem

text: An important recent preprint by Griffith et al highlights how 'collider bias' in studies of COVID19 undermines our understanding of the disease risk and severity. This is typically caused by the data being restricted to people who have undergone COVID19 testing, among whom healthcare workers are overrepresented. For example, collider bias caused by smokers being underrepresented in the dataset may (at least partly) explain empirical results that suggest smoking reduces the risk of COVID19. We extend the work of Griffith et al making more explicit use of graphical causal models to interpret observed data. We show that their smoking example can be clarified and improved using Bayesian network models with realistic data and assumptions. We show that there is an even more fundamental problem for risk factors like 'stress' which, unlike smoking, is more rather than less prevalent among healthcare workers; in this case, because of a combination of collider bias from the biased dataset and the fact that 'healthcare worker' is a confounding variable, it is likely that studies will wrongly conclude that stress reduces rather than increases the risk of COVID19. Indeed,"being in close contact with COVID19 people"reduces the risk of COVID19. To avoid such potentially erroneous conclusions, any analysis of observational data must take account of the underlying causal structure including colliders and confounders. If analysts fail to do this explicitly then any conclusions they make about the effect of specific risk factors on COVID19 are likely to be flawed.


A potential protective role of losartan against coronavirus-induced lung damage


Advance of promising targets and agents against COVID-19 in China


title: Cannabinoid Receptor Type 2: A Possible Target in SARS-CoV-2 (CoV-19) Infection?

text: In late December 2019, a novel coronavirus (SARS-CoV-2 or CoV-19) appeared in Wuhan, China, causing a global pandemic. SARS-CoV-2 causes mild to severe respiratory tract inflammation, often developing into lung fibrosis with thrombosis in pulmonary small vessels and causing even death. COronaVIrus Disease (COVID-19) patients manifest exacerbated inflammatory and immune responses, cytokine storm, prevalence of pro-inflammatory M1 macrophages and increased levels of resident and circulating immune cells. Men show higher susceptibility to SARS-CoV-2 infection than women, likely due to estrogens production. The protective role of estrogens, as well as an immune-suppressive activity that limits the excessive inflammation, can be mediated by cannabinoid receptor type 2 (CB2). The role of this receptor in modulating inflammation and immune response is well documented in fact in several settings. The stimulation of CB2 receptors is known to limit the release of pro-inflammatory cytokines, shift the macrophage phenotype towards the anti-inflammatory M2 type and enhance the immune-modulating properties of mesenchymal stromal cells. For these reasons, we hypothesize that CB2 receptor can be a therapeutic target in COVID-19 pandemic emergency.


title: A Possible Scenario for the Covid-19 Epidemic, Based on the SI(R) Model

text: Many attempts to build epidemic models of the current Covid-19 epidemic have been made in the recent past. However, only models postulating permanent immunity have been proposed. In this paper, we propose a SI(R) model in order to forecast the evolution of the epidemic under the hypothesis of not permanent immunity. This model offers an analytical solution to the problem of finding possible steady states, providing the following equilibrium values: Susceptible about 17%, Recovered (including deceased and healed) ranging from 79 to 81%, and Infected ranging from 2 to 4%. However, it is crucial to consider that the results concerning the recovered, which at first glance are particularly impressive, include the huge proportion of asymptomatic subjects. On the basis of these considerations, we analyse the situation in the province of Pesaro-Urbino, one of the main outbreaks of the epidemic in Italy.


Doubtful precipitation of hemolysis by hydroxychloroquine in glucose-6-phosphate dehydrogenase-deficient patient with COVID-19 infection


title: Doubtful precipitation of hemolysis by hydroxychloroquine in glucose-6-phosphate dehydrogenase deficient patient with COVID-19 infection

text: We read with great interest the recent article by Beauverd et al.1 on an interesting case of severe hemolysis in a patient with COVID-19 treated with hydroxychloroquine. The authors concluded that COVID-19 infection was possibly the initial trigger for hemolysis. However, the article also suggested that hydroxychloroquine possibly worsened the hemolysis, and further cautioned the use of hydroxychloroquine in glucose-6-phosphate dehydrogenase (G6PD)-deficient patients. We would like to comment on the authors' attribution of accentuated hemolysis to the use of hydroxychloroquine.


title: Hot Topic Commentary on COVID-19

text: The recent pandemic outbreak of COVID-19 (severe acute respiratory syndrome coronavirus 2; SARS-CoV-2) worldwide caught the health care systems in every country around the world by storm and without a proper defense mechanism to cope and control such a pandemic. In this special Theme issue, we would like to discuss the latest treatment modalities available around the world in tackling this dreadful disease.


title: COVID 19: Diabetes and Obesity API-ICP Recommendations

text: Diabetes and Obesity are major risk factors which confer vulnerability to Covid 19 . Diabetes has immune defects which makes the individual susceptible to infections and covid 19 is no exception . Also covid 19 can cause pancreatic damage as well as stress hyperglycaemia in hospitals which may need Insulin . Among diabetes male gender,elderly,hypertension ,heart disease and chronic renal disease are more vulbwdvale to covid 19 and need strict supervision . Diabetes management in hospitalised situation merits early diabetes specific nutrition with Insulin. Adherence to lifestyle with self monitoring of blood glucose and adequate supply of Insulin and Oral antidiabetic agents is encouraged.


title: Transient Dynamics of Infection Transmission in a Simulated Intensive Care Unit

text: Healthcare-associated infections (HAIs) remain a public health problem. Previous work showed intensive care unit (ICU) population structure impacts methicillin-resistant Staphylococcus aureus (MRSA) rates. Unexplored in that work was the transient dynamics of this system. We consider the dynamics of MRSA in an ICU in three different models: 1) a Ross-McDonald model with a single healthcare staff type, 2) a Ross-McDonald model with nurses and doctors considered as separate populations and 3) a meta-population model that segments patients into smaller groups seen by a single nurse. The basic reproduction number, R0 is derived using the Next Generation Matrix method, while the importance of the position of patients within the meta-population model is assessed via stochastic simulation. The single-staff model had an R0 of 0.337, while the other two models had R0s of 0.278. The meta-population model's R0 was not sensitive to the time nurses spent with their assigned patients vs. unassigned patients. This suggests previous results showing that simulated infection rates are dependent on this parameter are the result of differences in the transient dynamics between the models, rather than differing long-term equilibria.


title: In Silico Screening of Potential Chinese Herbal Medicine Against COVID-19 by Targeting SARS-CoV-2 3CLpro and Angiotensin Converting Enzyme II Using Molecular Docking

text: OBJECTIVE: To seek potential Chinese herbal medicine (CHM) for the treatment of coronavirus disease 2019 (COVID-19) through the molecular docking of the medicine with SARS-CoV-2 3CL hydrolytic enzyme and the angiotensin converting enzyme II(ACE2) as receptors, using computer virtual screening technique, so as to provide a basis for combination forecasting. METHODS: The molecular docking of CHM with the SARS-Cov-2 3CL hydrolase and the ACE2 converting enzyme, which were taken as the targets, was achieved by the Autodock Vina software. The CHM monomers acting on 3CLpro and ACE2 receptors were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, the active ingredients were selected, and the key CHMs and compounds were speculated. Based on the perspective of network pharmacology, the chemical-target network was constructed, and the functional enrichment analysis of gene ontology and the pathway enrichment analysis of Kyoto encyclopedia of genes and genomes were carried out by DAVID to speculate about the mechanism of action of the core drug pairs. RESULTS: There are 6 small molecule compounds that have the optimal binding energy with the two target proteins. Among 238 potential anti-COVID-19 herbs screened in total, 16 kinds of CHM containing the most active ingredients, and 5 candidate anti-COVID-19 herbs that had been used in high frequency, as well as a core drug pair, namely, Forsythiae Fructus-Lonicerae Japonicae Flos were selected. CONCLUSION: The core drug pair of Forsythiae Fructus-Lonicerae Japonicae Flos containing multiple components and targets is easy to combine with 3CLpro and ACE2, and exerts an anti-COVID-19 pneumonia effect through multi-component and multi-target, and plays the role of anti-COVID-19 pneumonia in multi-pathway.


docid: oldorods

title: Platelets in Coronavirus Disease 2019


title: The EuroSys 2020 Online Conference: Experience and lessons learned

text: The 15th European Conference on Computer Systems (EuroSys'20) was organized as a virtual (online) conference on April 27-30, 2020. The main EuroSys'20 track took place April 28-30, 2020, preceded by five workshops (EdgeSys'20, EuroDW'20, EuroSec'20, PaPoC'20, SPMA'20) on April 27, 2020. The decision to hold a virtual (online) conference was taken in early April 2020, after consultations with the EuroSys community and internal discussions about potential options, eventually allowing about three weeks for the organization. This paper describes the choices we made to organize EuroSys'20 as a virtual (online) conference, the challenges we addressed, and the lessons learned.


title: Spring Festival points the way to cleaner air in China

text: Human migration during the Chinese Spring Festival (SF) is the largest collective human activity of its kind in the modern era-involving about one-tenth of the world population and over six percent of the earth's land surface area. The festival results in a drop of air pollutant emissions that causes dramatic changes of atmospheric composition over China's most polluted regions. Based on satellite and in-situ measurements for the years 2005-2019 over 50 cities in eastern China, we find that the atmospheric NO2 pollution dropped by ~40% during the SF week, and fine particulate matter (PM2.5) decreased by ~30% in the following week, reflecting the effectiveness of precursor emission controls on the mitigation of secondary PM2.5 formation. However, although human activity and emissions are at the lowest level, air pollution over eastern China during the SF still far exceeds that over other worldwide pollution hotspots. Our analyses suggest that measures based solely on end-of-pipe controls and industry upgrades may not suffice to meet air quality goals. Further cleaning of the air in China depends fundamentally on sustainable advances in both heavy industry upgrades and clean energy transition.


title: The Area of a Rough Black Hole

text: We investigate the consequences for the black hole area of introducing fractal structure for the horizon geometry. We create a three-dimensional spherical analogue of a 'Koch Snowflake' using a infinite diminishing hierarchy of touching spheres around the Schwarzschild event horizon. We can create a fractal structure for the horizon with finite volume and infinite (or finite) area. This is a toy model for the possible effects of quantum gravitational spacetime foam, with significant implications for assessments of the entropy of black holes and the universe, which is generally larger than in standard picture of black hole structure and thermodynamics, potentially by very considerable factors. The entropy of the observable universe today becomes log(S) is approximately 120(1+D/2) with D = 0 for a smooth spacetime structure and D = 1 for the most intricate. The Hawking lifetime of black holes is also reduced.


title: What are we weighting for? A mechanistic model for probability weighting

text: Behavioural economics provides labels for patterns in human economic behaviour. Probability weighting is one such label. It expresses a mismatch between probabilities used in a formal model of a decision (i.e. model parameters) and probabilities inferred from real people's decisions (the same parameters estimated empirically). The inferred probabilities are called"decision weights."It is considered a robust experimental finding that decision weights are higher than probabilities for rare events, and (necessarily, through normalisation) lower than probabilities for common events. Typically this is presented as a cognitive bias, i.e. an error of judgement by the person. Here we point out that the same observation can be described differently: broadly speaking, probability weighting means that a decision maker has greater uncertainty about the world than the observer. We offer a plausible mechanism whereby such differences in uncertainty arise naturally: when a decision maker must estimate probabilities as frequencies in a time series while the observer knows them a priori. This suggests an alternative presentation of probability weighting as a principled response by a decision maker to uncertainties unaccounted for in an observer's model.


title: Spread and dynamics of the COVID-19 epidemic in Italy: Effects of emergency containment measures

text: The spread of coronavirus disease 2019 (COVID-19) in Italy prompted drastic measures for transmission containment. We examine the effects of these interventions, based on modeling of the unfolding epidemic. We test modeling options of the spatially explicit type, suggested by the wave of infections spreading from the initial foci to the rest of Italy. We estimate parameters of a metacommunity Susceptible-Exposed-Infected-Recovered (SEIR)-like transmission model that includes a network of 107 provinces connected by mobility at high resolution, and the critical contribution of presymptomatic and asymptomatic transmission. We estimate a generalized reproduction number ([Formula: see text] = 3.60 [3.49 to 3.84]), the spectral radius of a suitable next-generation matrix that measures the potential spread in the absence of containment interventions. The model includes the implementation of progressive restrictions after the first case confirmed in Italy (February 21, 2020) and runs until March 25, 2020. We account for uncertainty in epidemiological reporting, and time dependence of human mobility matrices and awareness-dependent exposure probabilities. We draw scenarios of different containment measures and their impact. Results suggest that the sequence of restrictions posed to mobility and human-to-human interactions have reduced transmission by 45% (42 to 49%). Averted hospitalizations are measured by running scenarios obtained by selectively relaxing the imposed restrictions and total about 200,000 individuals (as of March 25, 2020). Although a number of assumptions need to be reexamined, like age structure in social mixing patterns and in the distribution of mobility, hospitalization, and fatality, we conclude that verifiable evidence exists to support the planning of emergency measures.


docid: lxsdhsmt

title: Nuclear Medicine Operations in the Times of COVID-19: Strategies, Precautions, and Experiences


title: Procedural sedation in the COVID-19 era

text: Resuming procedural sedation services for elective procedures during the COVID-19 pandemic requires unique considerations to ensure safety for patients and providers. Guidelines for resuming these procedures, including timing, screening and testing, use of personal protective equipment, and case planning are discussed. Approaches to procedural sedation can be modified to reduce the risk of droplet or aerosol transmission by decreasing nasal cannula oxygen supplementation flows. Decreasing the need for oxygen supplement can be accomplished by opioid and sedative sparing strategies, including the use of multimodal analgesia and non-pharmacologic analgesic and anxiolytic interventions. Recommendations are made for patients who are COVID-19 positive and require procedural sedation.


title: Coronavirus Disease-2019 (COVID-19) and Cardiovascular Complications

text: The coronavirus disease-2019 (COVID-19) has become a global pandemic. It has spread to more than 100 countries, and more than 1 million cases have been confirmed. Although coronavirus causes severe respiratory infections in humans, accumulating data have demonstrated cardiac complications and poor outcome in patients with COVID-19. A large percent of patients have underlying cardiovascular disease, and they are at a high risk of developing cardiac complications. The basics of the virus, the clinical manifestations, and the possible mechanisms of cardiac complications in patients with COVID-19 are reviewed. Before an effective vaccine or medicine is available, supportive therapy and identifying patients who are at high risk of cardiac complications are important.


In these difficult times of COVID-19, urologic research cannot stop: COVID-19 pandemic and reconstructive urology highlighted in International Brazilian Journal of Urology


title: Automatic Textual Evidence Mining in COVID-19 Literature

text: We created this EVIDENCEMINER system for automatic textual evidence mining in COVID-19 literature. EVIDENCEMINER is a web-based system that lets users query a natural language statement and automatically retrieves textual evidence from a background corpora for life sciences. It is constructed in a completely automated way without any human effort for training data annotation. EVIDENCEMINER is supported by novel data-driven methods for distantly supervised named entity recognition and open information extraction. The named entities and meta-patterns are pre-computed and indexed offline to support fast online evidence retrieval. The annotation results are also highlighted in the original document for better visualization. EVIDENCEMINER also includes analytic functionalities such as the most frequent entity and relation summarization.


title: [Recommendations for respiratory rehabilitation of coronavirus disease 2019 in adult]

text: COVID-19 is a highly infectious respiratory infection disease, which leads to dysfunction of respiratory, physical, and psychological of the patients. pulmonary rehabilitation is an important intervention for clinical patients as well as cure patients. With the deeper cognition of COVID-19 and accumulation of clinical experience, we proposed the recommendations for pulmonary rehabilitation of COVID-19 in adults based on the opinions of front-line clinical experts involved in the management of this epidemic and a review of the relevant literature and evidences: (1)for the inpatients with COVID-19, pulmonary rehabilitation would relieve the symptoms of dyspnea, anxiety, and depression; eventually improve physical function and the quality of life; (2)For severe/critical inpatients, the early performance of pulmonary rehabilitation is not suggested. (3)For isolating patients, the pulmonary rehabilitation guidence should be conducted through education video, instruction manual or remote consultation. (4)Assessment and monitor should be performed throughout the entire pulmonary rehabilitation process.(5)Taking proper grading protection following the guideline. These recommendations can serve as a clinical practice guidence and basis for pulmonary rehabilitation of COVID-19.


title: The Effect of Social Distancing on the Reach of an Epidemic in Social Networks

text: How does social distancing affect the reach of an epidemic in social networks? We present Monte Carlo simulation results of a Susceptible- Infected-Removed (SIR) model on a network, where individuals are limited in the number of other people they can interact with. While increased social distancing always reduces the spread of an infectious disease, the magnitude varies greatly depending on the topology of the social network. Our results also reveal the importance of coordination at the global level. In particular, the public health benefits from social distancing to a group (e.g., a country) may be completely undone if that group maintains connections with outside groups that are not social distancing.


No Need of Transforming Gastroenterology Units to COVID Units at the Time of SARS-COV2 Infection - A Single-Center Analysis from Northern Italy


Azithromycin for COVID-19: More Than Just an Antimicrobial?


The globe on the spotlight: Coronavirus disease 2019 (Covid-19)


Societal pandemic burnout: A COVID legacy


title: Disappearance of SARS-CoV-2 Antibodies in Infants Born to Women with COVID-19, Wuhan, China

text: We report the detection and decline over time of severe acute respiratory syndrome coronavirus 2 antibodies in infants born to women with coronavirus disease. Among 11 infants tested at birth, all had detectable IgG and 5 had detectable IgM. IgG titers with positive IgM declined more slowly than those without.


Appearance of skin rash in pediatric patients with COVID-19: Three case presentations


title: Coronavirus disease (COVID-19): An updated review based on current knowledge and existing literature for dermatologists

text: The world entered the year 2020 with reports of the emergence of a new viral illness in Wuhan city, Hubei province, China. In January 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified to be the causative novel coronavirus for the cluster of patients suffering from pneumonia in China. The disease was later named as coronavirus disease (COVID-19) and was declared a pandemic by the World Health Organization on March 11, 2020. Several studies, since then, have tried to study and explain the origin of SARS-CoV-2, its structure and pathogenicity, epidemiology, modes of transmission, spectrum of illness and causes of mortality and morbidity. The current management strategies focus on supportive care and prevention of complications. With no definite treatment, as of now, encouraging reports of some anti-viral and anti-malarial drugs in the management of COVID-19 generate some hope. This review intends to cover the current known aspects of COVID-19 and SARS-CoV-19, based on the available literature.


Intensive care during the coronavirus epidemic


COVID-19: Facemask use prevalence in international airports in Asia, Europe and the Americas, March 2020


title: Clinical Course and Outcomes of Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a Preliminary Report of the First 28 Patients from the Korean Cohort Study on COVID-19

text: BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pneumonia emerged in Wuhan, China in December 2019. In this retrospective multicenter study, we investigated the clinical course and outcomes of novel coronavirus disease 2019 (COVID-19) from early cases in Republic of Korea. METHODS: All of the cases confirmed by real time polymerase chain reaction were enrolled from the 1st to the 28th patient nationwide. Clinical data were collected and analyzed for changes in clinical severity including laboratory, radiological, and virologic dynamics during the progression of illness. RESULTS: The median age was 40 years (range, 20-73 years) and 15 (53.6%) patients were male. The most common symptoms were cough (28.6%) and sore throat (28.6%), followed by fever (25.0%). Diarrhea was not common (10.7%). Two patients had no symptoms. Initial chest X-ray (CXR) showed infiltration in 46.4% of the patients, but computed tomography scan confirmed pneumonia in 88.9% (16/18) of the patients. Six patients (21.4%) required supplemental oxygen therapy, but no one needed mechanical ventilation. Lymphopenia was more common in severe cases. Higher level of C-reactive protein and worsening of chest radiographic score was observed during the 5-7 day period after symptom onset. Viral shedding was high from day 1 of illness, especially from the upper respiratory tract (URT). CONCLUSION: The prodromal symptoms of COVID-19 were mild and most patients did not have limitations of daily activity. Viral shedding from URT was high from the prodromal phase. Radiological pneumonia was common from the early days of illness, but it was frequently not evident in simple CXR. These findings could be plausible explanations for the easy and rapid spread of SARS-CoV-2 in the community.


title: The Demographics and Economics of Direct Care Staff Highlight Their Vulnerabilities Amidst the COVID-19 Pandemic

text: An estimated 3.5 million direct care staff working in facilities and people's homes play a critical role during the COVID-19 pandemic. They allow vulnerable care recipients to stay at home and they provide necessary help in facilities. Direct care staff, on average, have decades of experience, often have certifications and licenses, and many have at least some college education to help them perform the myriad of responsibilities to properly care for care recipients. Yet, they are at heightened health and financial risks. They often receive low wages, limited benefits, and have few financial resources to fall back on when they get sick themselves and can no longer work. Furthermore, most direct care staff are parents with children in the house and almost one-fourth are single parents. If they fall ill, both they and their families are put into physical and financial risk.


title: COVID-19 Emergency Reforms in Massachusetts to Support Behavioral Health Care and Reduce Mortality of People With Serious Mental Illness

text: People with serious mental illness are at disproportionate risk of COVID-19 morbidity and mortality because of high rates of risk factors that directly parallel those related to poor coronavirus outcomes, including smoking, chronic obstructive pulmonary disease, cardiovascular disease, and diabetes, along with housing instability, homelessness, food insecurity, and poverty. Community-based behavioral health organizations are also at risk of adverse outcomes because of dramatic declines in revenues and a diminished workforce. The State of Massachusetts has responded to this crisis by rapidly implementing a variety of policy, regulatory, and payment reforms. This column describes some of these reforms, which are designed to enhance remote telehealth delivery of care, ensure access to needed medications and residential care staff, and support the financial livelihood of community-based behavioral health services.


Incoming International Medical Graduates and the COVID-19 Pandemic: More Than Meets the Eye


Covid-19 mortality in Italian doctors


title: Fatal Invasive Aspergillosis and Coronavirus Disease in an Immunocompetent Patient

text: Invasive pulmonary aspergillosis is a complication in critically ill patients with acute respiratory distress syndrome, especially those with severe influenza pneumonia. We report a fatal case of invasive pulmonary aspergillosis in an immunocompetent patient in France who had severe coronavirus disease-associated pneumonia.


title: What about COVID-19 and arachidonic acid pathway?

text: BACKGROUND AND OBJECTIVE: COVID-19 is a highly contagious viral disease. In this study, we tried to define and discuss all the findings on the potential association between arachidonic acid (AA) pathway and COVID-19 pathophysiology. METHODS: A literature search across PubMed, Scopus, Embase, and Cochrane database was conducted. A total of 25 studies were identified. RESULTS: The data elucidated that COX-2 and prostaglandins (PGs), particularly PGE2, have pro-inflammatory action in COVID-19 pathophysiology. Arachidonic acid can act as endogenous antiviral compound. A deficiency in AA can make humans more susceptible to COVID-19. Targeting these pro-inflammatory mediators may help in decreasing the mortality and morbidity rate in COVID-19 patients. CONCLUSIONS: PGE2 levels and other PGs levels should be measured in patients with COVID-19. Lowering the PGE2 levels through inhibition of human microsomal prostaglandin E synthase-1 (mPGES-1) can enhance the host immune response against COVID-19. In addition, the hybrid compounds, such as COX-2 inhibitors/TP antagonists, can be an innovative treatment to control the overall balance between AA mediators in patients with COVID-19.


Covid-19 pandemic experience: can it serve as a clarion call to establish or revamp a specialty known as 'Infectious Diseases Physiotherapy'?


title: The Anticoagulant Nafamostat Potently Inhibits SARS-CoV-2 S Protein-Mediated Fusion in a Cell Fusion Assay System and Viral Infection In Vitro in a Cell-Type-Dependent Manner

text: Although infection by SARS-CoV-2, the causative agent of coronavirus pneumonia disease (COVID-19), is spreading rapidly worldwide, no drug has been shown to be sufficiently effective for treating COVID-19. We previously found that nafamostat mesylate, an existing drug used for disseminated intravascular coagulation (DIC), effectively blocked Middle East respiratory syndrome coronavirus (MERS-CoV) S protein-mediated cell fusion by targeting transmembrane serine protease 2 (TMPRSS2), and inhibited MERS-CoV infection of human lung epithelium-derived Calu-3 cells. Here we established a quantitative fusion assay dependent on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) S protein, angiotensin I converting enzyme 2 (ACE2) and TMPRSS2, and found that nafamostat mesylate potently inhibited the fusion while camostat mesylate was about 10-fold less active. Furthermore, nafamostat mesylate blocked SARS-CoV-2 infection of Calu-3 cells with an effective concentration (EC)50 around 10 nM, which is below its average blood concentration after intravenous administration through continuous infusion. On the other hand, a significantly higher dose (EC50 around 30 mM) was required for VeroE6/TMPRSS2 cells, where the TMPRSS2-independent but cathepsin-dependent endosomal infection pathway likely predominates. Together, our study shows that nafamostat mesylate potently inhibits SARS-CoV-2 S protein-mediated fusion in a cell fusion assay system and also inhibits SARS-CoV-2 infection in vitro in a cell-type-dependent manner. These findings, together with accumulated clinical data regarding nafamostat's safety, make it a likely candidate drug to treat COVID-19.


A Case of HIV and SARS-CoV-2 Co-infection in Singapore


title: Well-aerated Lung on Admitting Chest CT to Predict Adverse Outcome in COVID-19 Pneumonia

text: Background Computed tomography (CT) of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease depicts the extent of lung involvement in COVID-19 pneumonia. Purpose The aim of the study was to determine the value of quantification of the well-aerated lung obtained at baseline chest CT for determining prognosis in patients with COVID-19 pneumonia. Materials and Methods Patients who underwent chest CT suspected for COVID-19 pneumonia at the emergency department admission between February 17 to March 10, 2020 were retrospectively analyzed. Patients with negative reverse-transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 in nasal-pharyngeal swabs, negative chest CT, and incomplete clinical data were excluded. CT was analyzed for quantification of well aerated lung visually (%V-WAL) and by open-source software (%S-WAL and absolute volume, VOL-WAL). Clinical parameters included demographics, comorbidities, symptoms and symptom duration, oxygen saturation and laboratory values. Logistic regression was used to evaluate relationship between clinical parameters and CT metrics versus patient outcome (ICU admission/death vs. no ICU admission/ death). The area under the receiver operating characteristic curve (AUC) was calculated to determine model performance. Results The study included 236 patients (females 59/123, 25%; median age, 68 years). A %V-WAL<73% (OR, 5.4; 95% CI, 2.7-10.8; P<0.001), %S-WAL<71% (OR, 3.8; 95% CI, 1.9-7.5; P<0.001), and VOL-WAL<2.9 L (OR, 2.6; 95% CI, 1.2-5.8; P<0.01) were predictors of ICU admission/death. In comparison with clinical model containing only clinical parameters (AUC, 0.83), all three quantitative models showed higher diagnostic performance (AUC 0.86 for all models). The models containing %V-WAL<73% and VOL-WAL<2.9L were superior in terms of performance as compared to the models containing only clinical parameters (P=0.04 for both models). Conclusion In patients with confirmed COVID-19 pneumonia, visual or software quantification the extent of CT lung abnormality were predictors of ICU admission or death.


Online Neuroanatomy Education and Its Role During the Coronavirus Disease 2019 (COVID-19) Lockdown


Placental abruption in a twin pregnancy at 32 weeks' gestation complicated by COVID-19, without vertical transmission to the babies


Coronavirus breakthrough: dexamethasone is first drug shown to save lives


title: Androgen-deprivation therapies for prostate cancer and risk of infection by SARS-CoV-2: a population-based study (N = 4532)

text: BACKGROUND: Cell entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) depends on binding of the viral spike (S) proteins to angiotensin-converting enzyme 2 and on S protein priming by TMPRSS2. Inhibition of TMPRSS2 may work to block or decrease the severity of SARS-CoV-2 infections. Intriguingly, TMPRSS2 is an androgen-regulated gene that is up-regulated in prostate cancer where it supports tumor progression and is involved in a frequent genetic translocation with the ERG gene. First- or second-generation androgen-deprivation therapies (ADTs) decrease the levels of TMPRSS2. Here we put forward the hypothesis that ADTs may protect patients affected by prostate cancer from SARS-CoV-2 infections. MATERIALS AND METHODS: We extracted data regarding 9280 patients (4532 males) with laboratory-confirmed SARS-CoV-2 infection from 68 hospitals in Veneto, one of the Italian regions that was most affected by the coronavirus disease 2019 (COVID-19) pandemic. The parameters used for each COVID-19-positive patient were sex, hospitalization, admission to intensive care unit, death, tumor diagnosis, prostate cancer diagnosis, and ADT. RESULTS: There were evaluable 9280 SARS-CoV-2-positive patients in Veneto on 1 April 2020. Overall, males developed more severe complications, were more frequently hospitalized, and had a worse clinical outcome than females. Considering only the Veneto male population (2.4 million men), 0.2% and 0.3% of non-cancer and cancer patients, respectively, tested positive for SARS-CoV-2. Comparing the total number of SARS-CoV-2-positive cases, prostate cancer patients receiving ADT had a significantly lower risk of SARS-CoV-2 infection compared with patients who did not receive ADT (OR 4.05; 95% CI 1.55-10.59). A greater difference was found comparing prostate cancer patients receiving ADT with patients with any other type of cancer (OR 4.86; 95% CI 1.88-12.56). CONCLUSION: Our data suggest that cancer patients have an increased risk of SARS-CoV-2 infections compared with non-cancer patients. However, prostate cancer patients receiving ADT appear to be partially protected from SARS-CoV-2 infections.


A propos de chirurgie et Covid-19: quelques précautions complémentaires./ [Surgery and the Covid-19 epidemic: some additional precautions]


Association between low vitamin D and COVID-19: don't forget the vitamin D binding protein


Choices for the "New Normal"


docid: ejewqzcs

title: Need for Caution in the Diagnosis of Radiation Pneumonitis in the COVID-19 Pandemic

text: Introduction: Patients with cancer are at high-risk for mortality from coronavirus-disease 2019 (COVID-19). Radiation pneumonitis (RP) is a common toxicity of thoracic radiotherapy with overlapping clinical and imaging features with COVID-19, however, RP is treated with high-dose corticosteroids, which may exacerbate COVID-19-associated lung injury. We reviewed patients who presented with symptoms of RP during the intensification of a regional COVID-19 epidemic to report on their clinical course and COVID-19 testing results. Methods: The clinical course and chest computed tomography (CT) imaging findings of consecutive patients who presented with symptoms of RP in March 2020 were reviewed. The first regional COVID-19 case was diagnosed on 3/1/2020. All patients underwent COVID-19 qualitative RNA testing. Results: Four patients with clinical suspicion for RP were assessed. Three out of four patients tested positive for COVID-19. All patients presented with symptoms of cough and dyspnea. Two patients had a fever, of whom only one tested positive for COVID-19. Two patients started on an empiric high-dose corticosteroid taper for presumed RP, but both had clinical deterioration, and ultimately tested positive for COVID-19 and required hospitalization. Chest CT findings in patients suspected of RP, but ultimately diagnosed with COVID-19 showed ground-glass opacities mostly pronounced outside the radiation field. Conclusions: As this pandemic continues, patients with symptoms of RP require diagnostic attention. We recommend that patients suspected of RP be tested for COVID-19 before starting empiric corticosteroids and for careful attention be paid to chest CT imaging in order to prevent potential exacerbation of COVID-19 in these high-risk patients.


title: Prediction of the rehabilitation duration and risk management for mild-moderate COVID-19

text: BACKGROUND: More than 80% COVID-19 cases are mild or moderate. In this study, a risk model was developed for predicting rehabilitation duration of the mild-moderate COVID-19 cases, thereby conducting refined risk management for different risk population. METHODS: 90 consecutive mild-moderate COVID-19 cases were enrolled. Large-scale datasets were extracted from clinical practices. Through the multivariable linear regression analysis, the model was based on significant risk factors and was developed for predicting the rehabilitation duration of mild-moderate COVID-19. According to the local epidemic situation, risk management was conducted by weighing the risk assessment for different risk populations. RESULTS: Ten risk factors from 44 high-dimensional clinical datasets were significantly correlated to rehabilitation duration (P < 0.05). Among these, five risk predictors were incorporated into a risk model. Individual rehabilitation durations were effectively calculated. Weighing the local epidemic situation, threshold probability was classified for low risk, intermediate risk, and high risk. According to this classification, risk management was based on a treatment flowchart for tailored clinical decisions-making. CONCLUSIONS: The proposed model is a useful tool for the individualized risk management of mild-moderate COVID-19 cases for the first time, and it may readily facilitate dynamic clinical decision-making for different risk populations.


Prevalence, risk factors and clinical outcomes of COVID-19 in patients with a history of pancreatitis in Northern California


docid: jtdtctjb

title: Transplant programs during COVID-19: Unintended consequences for health inequality


Pandemic Palliative Care Consultations Spanning State and Institutional Borders


Novel Approach to Reduce Transmission of COVID-19 During Tracheostomy


title: COVID-19 Pandemic: A Big Challenge in Iran and the World

text: No abstract!


title: COVID-19, SARS and MERS: A neurological perspective

text: Central to COVID-19 pathophysiology is an acute respiratory infection primarily manifesting as pneumonia. Two months into the COVID-19 outbreak, however, a retrospective study in China involving more than 200 participants revealed a neurological component to COVID-19 in a subset of patients. The observed symptoms, the cause of which remains unclear, included impaired consciousness, skeletal muscle injury and acute cerebrovascular disease, and appeared more frequently in severe disease. Since then, findings from several studies have hinted at various possible neurological outcomes in COVID-19 patients. Here, we review the historical association between neurological complications and highly pathological coronaviruses including SARS-CoV, MERS-CoV and SARS-CoV-2. We draw from evidence derived from past coronavirus outbreaks, noting the similarities and differences between SARS and MERS, and the current COVID-19 pandemic. We end by briefly discussing possible mechanisms by which the coronavirus impacts on the human nervous system, as well as neurology-specific considerations that arise from the repercussions of COVID-19.


title: [Correlation between clinical classification of COVID-19 and imaging characteristics of MSCT volume scanning of the lungs]

text: OBJECTIVE: To investigate the correlation between the clinical classification of coronavirus disease 2019 (COVID-19) and the imaging characteristics of multislice spiral computed tomography (MSCT) volume scanning of the lungs. METHODS: The clinical data and thoracic MSCT volume scanning data were analyzed retrospectively for 102 patients with COVID-19 diagnosed and hospitalized in the First Affiliated Hospital of Bengbu Medical College between January 18 and February 26, 2020. According to the Fifth Edition of the Diagnosis and Treatment Guidelines by the National Health Commission, the patients were divided into common type, severe type and critical type. The imaging characteristics including the lung sides of the lesions, lung segment involved, lesion distribution, and lesion number and density were compared among the patients with different clinical types of COVID-19. RESULTS: Seventy-seven of the patients had common type, 18 had severe type and 7 had critical type of COVID-19. The main clinical manifestations included fever, cough and fatigue. Severe and critical types were more frequently seen in elderly patients, who were more prone to show such symptoms as asthenia, breathing difficulty and dyspnea. Two patients presented with no obvious abnormality in the first CT examinations; in the remaining 100 patients, 89.0% had bilateral lung lesions, 16.0% had diffuse lesions, involving a mean of 6.56±4.22 lung segments. Compared with the patients with the common type, the severe and critical patients had a significantly greater number of lung segments involved (P < 0.05), and were also more likely to show diffuse lesions (P < 0.05). The lesion side, lesion number or lesion density did not differ significantly among the patients with different clinical types of COVID-19 (P > 0.05). CONCLUSIONS: MSCT volume scanning not only allows early diagnosis of COVID-19 but also provides evidence for evaluating the severity of COVID-19 to assist in the clinical treatment of the patients.


Pandemic Surge Models in the Time of Severe Acute Respiratory Syndrome Coronavirus-2: Wrong or Useful?


Anti-protease Treatments Targeting Plasmin(ogen) and Neutrophil Elastase May Be Beneficial in Fighting COVID-19


title: Deposition distribution of the new coronavirus (SARS-CoV-2) in the human airways upon exposure to cough-generated aerosol

text: The new coronavirus disease 2019 (COVID-19) has been emerged as a rapidly spreading pandemic. The disease is thought to spread mainly from person-to-person through respiratory droplets produced when an infected person coughs, sneezes, or talks. The pathogen of COVID-19 is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It infects the cells binding to the angiotensin-converting enzyme 2 receptor (ACE2) which is expressed by cells throughout the airways as targets for cellular entry. Although the majority of persons infected with SARS-CoV-2 experience symptoms of mild upper respiratory tract infection, in some people infections of the peripheral airways result in severe, potentially fatal pneumonia. However, the induction of COVID-19 pneumonia requires that SARS-CoV-2 reaches the peripheral airways. While huge efforts have been made to understand the spread of the disease as well as the pathogenesis following cellular entry, much less attention is paid how SARS-CoV-2 from the environment reach the receptors of the target cells. The aim of the present study is to characterize the deposition distribution of SARS-CoV-2 in the airways upon exposure to cough-generated aerosol. For this purpose, the Stochastic Lung Deposition Model has been applied. Aerosol size distribution and breathing parameters were taken from the literature supposing normal breathing through the nose. We found that the probability of direct infection of the peripheral airways due to inhalation of aerosol generated by a bystander cough is very low. As the number of pathogens deposited in the extrathoracic airways is ~10 times higher than in the peripheral airways, we concluded that in most cases COVID-19 pneumonia must be preceded by SARS-CoV-2 infection of the upper airways. Our results suggest that without the enhancement of viral load in the upper airways, COVID-19 would be much less dangerous...


Emergence of a novel human coronavirus threatening human health


title: The SARS-CoV-2/COVID-19 pandemic and challenges in stroke care in India

text: Stroke care in India has evolved rapidly in the last decade with a focus on stroke awareness, prevention, rapid triage, treatment, and rehabilitation. But acute stroke care and poststroke rehabilitation in the country have limitations owing to the economic constraints and poor access to health care. The SARS-CoV-2/COVID-19 pandemic has made stroke care even more challenging. We outline the unfavorable circumstances in stroke care induced by the pandemic; propose mitigating measures; crisis management; and provide a comparative evaluation of stroke care between India and the United States during the pandemic. There is a need for public health systems in both developed and developing countries to improve awareness, implement proper strategies of triage, acute treatment, well-defined rehabilitation plans, telemedicine services, and virtual check-ins.


title: Israel Ad Hoc COVID-19 Committee: Guidelines for Care of Older Persons During a Pandemic

text: Early on, geriatricians in Israel viewed with increasing alarm the spread of coronavirus disease 2019 (COVID-19). It was clear that this viral disease exhibited a clear predilection for and danger to older persons. Informal contacts began with senior officials from the country's Ministry of Health, the Israel Medical Association, and the country's largest health fund; this was done to plan an approach to the possible coming storm. A group was formed, comprising three senior geriatricians, a former dean, a palliative care specialist, and a lawyer/ethicist. The members made every effort to ensure that their recommendations would be practical while at the same time taking into account the tenets of medical ethics. The committee's main task was to think through a workable approach because intensive care unit/ventilator resources may be far outstripped by those requiring such care. Recommendations included the approach to older persons both in the community and in long-term care institutions, a triage instrument, and palliative care. Patient autonomy was emphasized, with a strong recommendation for people of all ages to update their advance directives or, if they did not have any, to quickly draw them up. Considering the value of distributive justice, with respect to triage, a "soft utilitarian" approach was advocated with the main criteria being function and comorbidity. Although chronological age was rejected as a sole criterion, in the case of an overwhelming crisis, "biological age" would enter into the triage considerations, but only in the case of distinguishing between people with equal non-age-related deficits. The guideline emphasized that no matter what, in the spirit of beneficence, anyone who fell ill must receive active palliative care throughout the course of a COVD-19 infection but especially at the end of life. Furthermore, in the spirit of nonmaleficence, the frail, very old, and severely demented would be actively protected from dying on ventilation. J Am Geriatr Soc 68:1370-1375, 2020.


docid: ontjgjwv

title: Anchoring BODIPY photosensitizers enable pan-microbial photoinactivation

text: Photodynamic antimicrobial chemotherapy (PACT) is an effective strategy to inactivate pathogenic and resistant microbes. However, pan-microbial photoinactivation has hardly achieved. In this manuscript, we built anti-microbial PSs based on 2,6-diiodo-1,3,5,7-tetramethyl BODIPY (2I-BDP) using anchoring strategy through modifications on boron atom with bis-cationic moieties. With appropriate bis-cationic anchoring, we could achieve effective PACT for pan-microbial photoinactivation via straight forward modifications. Our studies suggested that integration of an efficient photosensitizer, good amphiphilicity, as well as tight interaction with microbial membrane could be essential for effective PACT.


title: Rapid response to COVID-19: health informatics support for outbreak management in an academic health system

text: OBJECTIVE: To describe the implementation of technological support important for optimizing clinical management of the COVID-19 pandemic. MATERIALS AND METHODS: Our health system has confirmed prior and current cases of COVID-19. An Incident Command Center was established early in the crisis and helped identify electronic health record (EHR)-based tools to support clinical care. RESULTS: We outline the design and implementation of EHR-based rapid screening processes, laboratory testing, clinical decision support, reporting tools, and patient-facing technology related to COVID-19. DISCUSSION: The EHR is a useful tool to enable rapid deployment of standardized processes. UC San Diego Health built multiple COVID-19-specific tools to support outbreak management, including scripted triaging, electronic check-in, standard ordering and documentation, secure messaging, real-time data analytics, and telemedicine capabilities. Challenges included the need to frequently adjust build to meet rapidly evolving requirements, communication, and adoption, and to coordinate the needs of multiple stakeholders while maintaining high-quality, prepandemic medical care. CONCLUSION: The EHR is an essential tool in supporting the clinical needs of a health system managing the COVID-19 pandemic.


docid: rowjplsk

title: COVID-19: maintaining essential rehabilitation services across the care continuum


COVID-19 targets the right lung


Revisiting the 1957 and 1968 influenza pandemics


Antibody profiles in mild and severe cases of COVID-19


docid: tktftsfl

title: T cell renaissance in COVID-19


Response to: Broadbent 2020, Better the drug you know: Commentary on "Daughton 2020, Natural experiment concept to accelerate the re-purposing of existing therapeutics for Covid-19"


title: Management of neurourological patients during the COVID-19 pandemic./ Manejo del paciente neurourologico durante la pandemia COVID-19

text: OBJECTIVES: To report the recommendations of an expert panel to reorganize Neurourology units and to prioritize examinations and both conservative and surgical treatments during the COVID-19 pandemic MATERIALS AND METHODS: Non-systematic review of the literature and national experts' opinion summarizing the recommendations in the diagnosis, management, and follow-up of neurourological patients during the COVID-19 pandemic A modified nominal group technique was used due to extraordinary meeting and mobility restrictions during COVID-19 pandemic RESULTS: Neurourological patients have special physiological and pathological characteristics that make them more vulnerable to SARS-CoV-2 infection For prioritization purposes, they encompass in Functional Urology patients and their management is considered non-urgentor delayable with no specific deadline of recovery from normality However, it is important to identify individual situations jeopardising the upper urinary tract, urinary retention or predisposing to urinary infections/sepsis A classification is provided prioritizing conservative/outpatient management and the surgical treatment of the events occurring in neurourological patients during the COVID-19 pandemic CONCLUSIONS: In neurourological patients we can find exceptional clinical situations in which a delayed treatment could develop irreversible changes in the upper urinary tract, advocating a more urgent treatment inspecific scenarios OBJETIVOS: Exponer las recomendaciones de un comite de expertos para la reorganizacion de las unidades de neurourologia y la priorizacion de estudios y tratamientos durante la pandemia COVID-19 MATERIAL Y METODOS: Revision no sistematica de la literatura cientifica y opinion de expertos nacionalespara resumir las recomendaciones en el diagnostico, tratamiento y seguimiento de los pacientes neurourologicos durante la pandemia COVID-19 Se utiliza una tecnica de grupo nominal modificada debido a las restricciones extraordinarias de reunion y movilidad durante la pandemia COVID-19 RESULTADOS: Los pacientes neurourologicos poseen caracteristicas fisiopatologicas especiales que les hace mas vulnerables frente a la infeccion por SARS-CoV-2 Han sido englobados en general en el grupo de la Urologia Funcional, relegando su manejo al de las situaciones no urgentes y demorables sin plazo concreto de recuperacion de la normalidad Sin embargo, es importante identificar situaciones especificas en las que exista compromiso funcional del aparato urinario superior, retencion urinaria, o desarrollo de infecciones/sepsis urinaria Se realiza una clasificacion segun el nivel de prioridad tanto del manejo ambulatorio y conservador como del tratamiento quirurgico de eventos relacionados con pacientes neurourologicos durante la pandemia COVID-19 CONCLUSIONES: En los pacientes neurourologicos encontramos situaciones clinicas excepcionales en las que un retraso de su tratamiento puede conllevar alteraciones irreversibles en el tracto urinario superior, dada su condicion de vejiga de riesgo funcional, por lo que debe individualizarse un manejo mas precoz en ciertos escenarios


title: [Management of neurourological patients during the COVID-19 pandemic.]

text: OBJECTIVES: To report the recommendations of an expert panel to reorganize Neurourology units and to prioritize examinations and both conservative and surgical treatments during the COVID-19 pandemic MATERIALS AND METHODS: Non-systematic review of the literature and national experts' opinion summarizing the recommendations in the diagnosis, management, and follow-up of neurourological patients during the COVID-19 pandemic A modified nominal group technique was used due to extraordinary meeting and mobility restrictions during COVID-19 pandemic RESULTS: Neurourological patients have special physiological and pathological characteristics that make them more vulnerable to SARS-CoV-2 infection For prioritization purposes, they encompass in Functional Urology patients and their management is considered non-urgentor delayable with no specific deadline of recovery from normality However, it is important to identify individual situations jeopardising the upper urinary tract, urinary retention or predisposing to urinary infections/sepsis A classification is provided prioritizing conservative/outpatient management and the surgical treatment of the events occurring in neurourological patients during the COVID-19 pandemic CONCLUSIONS: In neurourological patients we can find exceptional clinical situations in which a delayed treatment could develop irreversible changes in the upper urinary tract, advocating a more urgent treatment inspecific scenarios