title: COVID-19 and diabetes mellitus: implications for prognosis and clinical management

text: INTRODUCTION: COVID-19 is a novel coronavirus that emerged from Wuhan, China in December 2019, and within 3 months became a global pandemic. AREAS COVERED: PubMed search of published data on COVID-19, respiratory infections, and diabetes mellitus (DM). DM associates with impairments of both cellular and humoral immunity. Early emergent global data reveal that severity of clinical outcome from COVID-19 infection (including hospitalization and admission to Intensive Care Unit [ICU]), associate with co-morbidities, prominently DM. The key principles of management of COVID-19 in patients with DM include ongoing focused outpatient management (remotely where necessary) and maintenance of good glycemic control. EXPERT OPINION: We will remember the dawn of the third decade of the twenty-first century as a time when the world changed, the true scale and impact of which is hard for us to imagine. Like a phoenix from the ashes though, COVID-19 provides us with a great learning opportunity to renew insights into ourselves as individuals, our clinical teams, and the optimized provision of care for our patients. COVID-19 has re-shaped and re-focused our collective societal values, with a sea-changed shift from materialistic to human-centric, from self-centredness to altruism, ultimately for the betterment of patient care and the whole of society.


Atividade Física e Redução do Comportamento Sedentário durante a Pandemia do Coronavírus./ Atividade Física e Redução do Comportamento Sedentário durante a Pandemia do Coronavírus./ Physical Activity And Reducing Sedentary Behavior During The Coronavirus Pandemic


title: Anomalous $Wtb$ couplings from $B$-physics

text: We revisit constraints on anomalous $Wtb$ couplings from $B$-physics experiments, performing a correlated analysis allowing all anomalous couplings to differ simultaneously from their Standard-Model (SM) values. The $B$-physics observables allow one to probe the three linear combinations out of the four anomalous couplings, which parameterize the $Wtb$ vertex under the assumption that the SM symmetries remain the symmetries of the effective theory. We take into account constraints coming from the inclusive $B\to X_s\gamma$, $B\to X_s \mu^+ \mu^-$ decays, the $\bar B^{0}-B^0$ oscillations, the leptonic $B\to \mu^+\mu^-$ decays, and the exclusive $B\to K^*\mu^+\mu^-$ decays at low $q^2$. We find that the SM values belong to the 95% CL allowed region obtained this way; however, the SM values are not the most probable values given by the fit. We also report that the distributions of the anomalous couplings obtained within our 3D scenario differ noticeably from the 1D scenario, when only one of the couplings is allowed to deviate from its SM value.


Lung Herniation Mimicking COVID-19


title: Service-learning in response to the coronavirus disease 2019 pandemic: Emerging lessons from the Department of Family Medicine and Public Health at the University of Botswana

text: The novel coronavirus disease 2019 (COVID-19) pandemic has disrupted many lives worldwide. Training programmes in academic institutions have also been affected by the pandemic. Teaching and learning family medicine and public health medicine in the COVID-19 era require adjustments to training activities. At the University of Botswana, the pandemic presented an opportunity to steer training programmes in the Department of Family Medicine and Public Health Medicine more towards service-learning. The department collaborated with the Ministry of Health and Wellness as well as the District Health Management teams in the national response to the pandemic as essential service providers. The increased demands for service provision were balanced with educational opportunities for trainees during the COVID-19 public health emergency. Including structured ongoing reflections for trainees involved in the COVID-19 response helps to connect service and the academic curriculum.


title: Increases in Health-Related Workplace Absenteeism Among Workers in Essential Critical Infrastructure Occupations During the COVID-19 Pandemic - United States, March-April 2020

text: During a pandemic, syndromic methods for monitoring illness outside of health care settings, such as tracking absenteeism trends in schools and workplaces, can be useful adjuncts to conventional disease reporting (1,2). Each month, CDC's National Institute for Occupational Safety and Health (NIOSH) monitors the prevalence of health-related workplace absenteeism among currently employed full-time workers in the United States, overall and by demographic and occupational subgroups, using data from the Current Population Survey (CPS).* This report describes trends in absenteeism during October 2019-April 2020, including March and April 2020, the period of rapidly accelerating transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Overall, the prevalence of health-related workplace absenteeism in March and April 2020 were similar to their 5-year baselines. However, compared with occupation-specific baselines, absenteeism among workers in several occupational groups that define or contain essential critical infrastructure workforce categories was significantly higher than expected in April. Significant increases in absenteeism were observed in personal care and service§ (includes child care workers and personal care aides); healthcare support¶; and production** (includes meat, poultry, and fish processing workers). Although health-related workplace absenteeism remained relatively unchanged or decreased in other groups, the increase in absenteeism among workers in occupational groups less able to avoid exposure to SARS-CoV-2 (3) highlights the potential impact of COVID-19 on the essential critical infrastructure workforce because of the risks and concerns of occupational transmission of SARS-CoV-2. More widespread and complete collection of occupational data in COVID-19 surveillance is required to fully understand workers' occupational risks and inform intervention strategies. Employers should follow available recommendations to protect workers' health.


Feasibility of Therapeutic Effects of the Cholinergic Anti-Inflammatory Pathway on COVID-19 Symptoms


title: Ruxolitinib for tocilizumab-refractory severe COVID-19 infection

text: Whilst the majority of patients with COVID-19 infection have mild self-limiting symptoms, for some the SARS-CoV2 virus can trigger a severe hyperinflammatory syndrome which is life threatening. Anti-IL6 therapy has shown promise in restraining the hyperinflammatory syndrome and while IL-6 is a pleiotropic mediatory of the inflammatory response, redundancy within inflammatory pathways means that the use of such targeted monoclonal therapy may have too restricted a repertoire in some patients. We present the case of a 53-year-old haematopoetic stem cell transplant recipient who developed a severe COVID-19 that was refractory to anti-IL6 therapy, but responded to Jak-Stat inhibition with ruxolitinib, demonstrating its safety and efficacy in this setting.


docid: cdkdymfz

title: Die Auswirkung der COVID-19-Pandemie auf Operationen bei malignen Erkrankungen./ [The impact of the COVID-19 pandemic on surgery for malignant diseases]


Materials Science in the time of Coronavirus


title: Buying Time: Using OMM to Potentially Reduce the Demand for Mechanical Ventilation in Patients With COVID-19

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) pandemic is causing an increased need for mechanical ventilation for a significant percentage of people who present to the hospital for treatment. This increase in demand could surpass the supply of ventilators and lead to an increase in mortality due to a lack of ventilator vacancies. There is significant evidence that osteopathic manipulative medicine (OMM) can alleviate pulmonary symptoms and aid in quicker recoveries from various respiratory ailments. OMM has the potential to play a significant role in helping reduce a patient's need for mechanical ventilation by delaying the onset of acute respiratory distress syndrome stemming from SARS-Cov2 infections.


Medical education in the COVID-19 era: Impact on anesthesiology trainees


title: COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition

text: Coronavirus disease 2019 (COVID-19) continues to ravage health and economic metrics globally, including progress in maternal and child nutrition. Although there has been focus on rising rates of childhood wasting in the short term, maternal and child undernutrition rates are also likely to increase as a consequence of COVID-19 and its impacts on poverty, coverage of essential interventions, and access to appropriate nutritious foods. Key sectors at particular risk of collapse or reduced efficiency in the wake of COVID-19 include food systems, incomes, and social protection, health care services for women and children, and services and access to clean water and sanitation. This review highlights key areas of concern for maternal and child nutrition during and in the aftermath of COVID-19 while providing strategic guidance for countries in their efforts to reduce maternal and child undernutrition. Rooted in learnings from the exemplars in Global Health's Stunting Reduction Exemplars project, we provide a set of recommendations that span investments in sectors that have sustained direct and indirect impact on nutrition. These include interventions to strengthen the food-supply chain and reducing food insecurity to assist those at immediate risk of food shortages. Other strategies could include targeted social safety net programs, payment deferrals, or tax breaks as well as suitable cash-support programs for the most vulnerable. Targeting the most marginalized households in rural populations and urban slums could be achieved through deploying community health workers and supporting women and community members. Community-led sanitation programs could be key to ensuring healthy household environments and reducing undernutrition. Additionally, several COVID-19 response measures such as contact tracing and self-isolation could also be exploited for nutrition protection. Global health and improvements in undernutrition will require governments, donors, and development partners to restrategize and reprioritize investments for the COVID-19 era, and will necessitate data-driven decision making, political will and commitment, and international unity.


title: Lung ultrasound monitoring in patients with COVID-19 on home isolation

text: Many patients with COVID-19, the clinical illness caused by SARS-CoV-2 infection, exhibit mild symptoms and do not require hospitalization. Instead, these patients are often referred for 14-days of home isolation as symptoms resolve. Lung ultrasound is well-established as an important means of evaluating lung pathology in patients in the emergency department and in intensive care units. Ultrasound is also being used to assess admitted patients with COVID-19. However, data on the progression of sonographic findings in patients with COVID-19 on home isolation is lacking. Here we present a case series of a group of physician patients with COVID-19 who monitored themselves daily while in home isolation using lung point-of-care ultrasound (POCUS). Lung POCUS findings corresponded with symptom onset and resolution in all 3 patients with confirmed COVID-19 during the 14-day isolation period. Lung POCUS may offer a feasible means of monitoring patients with COVID-19 who are on home isolation. Further studies correlating sonographic findings to disease progression and prognosis will be valuable.


COVID-19 Pandemic: Saudi Arabia's Role at National and International Levels


The Parallel Pandemic: Medical Misinformation and COVID-19 : Primum non nocere


title: Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context

text: In the context of SARS-CoV-2 pandemic, the hospital management of mother-infant pairs poses to obstetricians and neonatologists previously unmet challenges. In Lombardy, Northern Italy, 59 maternity wards networked to organise the medical assistance of mothers and neonates with suspected or confirmed SARS-CoV-2 infection. Six "COVID-19 maternity centres" were identified, the architecture and activity of obstetric and neonatal wards of each centre was reorganised, and common assistance protocols for the management of suspected and proven cases were formulated. Here, we present the key features of this reorganization effort, and our current management of the mother-infant dyad before and after birth, including our approach to rooming-in practice, breastfeeding and neonatal follow-up, based on the currently available scientific evidence. Considered the rapid diffusion of COVID-19 all over the world, we believe that preparedness is fundamental to assist mother-infant dyads, minimising the risk of propagation of the infection through maternity and neonatal wards.


title: Eco-epidemiological assessment of the COVID-19 epidemic in China, January-February 2020

text: Background: The outbreak of COVID-19 in China in early 2020 provides a rich data source for exploring the ecological determinants of this new infection, which may be of relevance as the pandemic develops.Objectives: Assessing the spread of the COVID-19 across China, in relation to associations between cases and ecological factors including population density, temperature, solar radiation and precipitation.Methods: Open-access COVID-19 case data include 18,069 geo-located cases in China during January and February 2020, which were mapped onto a 0.25° latitude/longitude grid together with population and weather data (temperature, solar radiation and precipitation). Of 15,539 grid cells, 559 (3.6%) contained at least one case, and these were used to construct a Poisson regression model of cell-weeks. Weather parameters were taken for the preceding week given the established 5-7 day incubation period for COVID-19. The dependent variable in the Poisson model was incident cases per cell-week and exposure was cell population, allowing for clustering of cells over weeks, to give incidence rate ratios.Results: The overall COVID-19 incidence rate in cells with confirmed cases was 0.12 per 1,000. There was a single confirmed case in 113/559 (20.2%) of cells, while two grid cells recorded over 1,000 confirmed cases. Weekly means of maximum daily temperature varied from -28.0°C to 30.1°C, minimum daily temperature from -42.4°C to 23.0°C, maximum solar radiation from 0.04 to 2.74 MJm-2 and total precipitation from 0 to 72.6 mm. Adjusted incidence rate ratios suggested brighter, warmer and drier conditions were associated with lower incidence.Conclusion: Though not demonstrating cause and effect, there were appreciable associations between weather and COVID-19 incidence during the epidemic in China. This does not mean the pandemic will go away with summer weather but demonstrates the importance of using weather conditions in understanding and forecasting the spread of COVID-19.


docid: tjgjginv

title: Mascarillas quirúrgicas a propósito del COVID-19: Algunos aspectos técnicos


COVID-19: the medium is the message


title: Practice and thinking of the informationized cabin hospitals during the novel coronavirus pneumonia period/ 中华医院管理杂志

text: Novel coronavirus pneumonia, which has emerged in Wuhan since the end of 2019, has posed a huge challenge for medical institutions in the city. Rapid completion of a number of cabin hospitals plays a vital role in preventing further spreading of the epidemic, by means of collecting and treating mild patients of the disease. This paper presents the key process of Tongji Hospital in its rapid informatization since it took over a cabin hospital. Based on the network architecture of the Tongji cloud platform, the shared service center is used to share data and integrate services between the cabin hospital and Tongji hospital. This practice can prevent cross-infection and improve service efficiency as well, hence offering a reference for future information infrastructure development of cabin hospitals.


title: Coronavirus Disease 2019 and Viral Hepatitis coinfection: Provide guidelines for integrated screening and treatment

text: The rapid spread of severe acute respiratory syndrome coronavirus 2, the virus, that causes Coronavirus disease 2019 (COVID-19) threatens global health. Emerging evidence and past experience from other coronaviruses suggests that people with underlying liver disease including viral hepatitis could be at risk of disease severity and mortality. However, with the present relatively low screening rates for the most prevalent viral hepatitis - Hepatitis B and C, many COVID-19 cases especially in low middle income countries are unlikely to be screened for viral hepatitis coinfection. Without active screening, little will be known about the clinical and epidemiological manifestations which could negatively impact public health efforts. In this commentary, we call for systematic and integrated screening of Hepatitis B and C for COVID-19 confirmed patients. We also call for guidelines for management and treatment as well as research to understand the epidemiology of coinfection This article is protected by copyright. All rights reserved.


title: COVID-19 Impact on People with Diabetes in the South and Central America

text: AIMS: The present observational study aims to describe the political actions in place to fight COVID-19 in the South and Central America region (SACA) while protecting individuals with diabetes. METHODS: A survey with 12 questions was shared with all IDF-SACA member organizations, in 18 countries. A descriptive analysis was performed and a multivariate cluster analysis technique pam (partitioning around medoids) was applied. RESULTS: Two groups of countries were identified. The first group reported more difficulties (limitations in accessing basic or health needs) and fears (concerns regarding the impact of the pandemic), mostly countries with stricter measures to contain the spread of the virus, whereas most of the second group consisted of countries with less restrictive measures, and reported fewer difficulties. Only 37% responded that a policy was put into place to protect individuals with diabetes delivering their medicines and supplies at home (16%) or receiving at once medicine and supplies enough for 2-3 months (21%). All respondents reported as one of the main fears "be infected and do not receive adequate treatment" and/or "getting infected if going to the hospital or medical appointments". CONCLUSIONS: Most of the SACA countries lack timely implemented measures to protect individuals with diabetes, which may lead to present and future severe impact on the individuals, health system and economy.


title: Cerebellar degeneration in adult spinal muscular atrophy patients

text: BACKGROUND: Spinal muscular atrophy (SMA) is a genetic motor neuron disease related to deletions in the SMN1 gene. There is mounting evidence that the disease is not restricted to motor neurons. In this neuroimaging study, we aimed to investigate the presence of in-vivo cerebellar damage in adult SMA patients not treated with disease-modifying treatment. METHODS: Twenty-five molecularly confirmed patients with SMA type III or IV and 25 healthy controls underwent MRI with cerebellar focused structural analysis by the CERES automated pipeline. Volumetry (total and gray matter-GM) as well as cortical thickness of the cerebellar lobules were compared in both groups. Full clinical and demographic data were then assessed for correlations with cerebellar imaging findings. RESULTS: Volumes of cerebellar lobules VIIIB (right), IX and X were significantly smaller in patients with SMA. Lobule IX also had GM atrophy in comparison to controls. We found no significant correlation between clinical findings and cerebellar damage. CONCLUSIONS: Neuroimaging detects cerebellar structural changes in adult SMA patients, suggesting that neurodegeneration is not confined to the lower motor neurons in the disease.


Acral findings during the COVID-19 outbreak: Chilblain-like lesions should be preferred to acro-ischemic lesions


title: Genomic Epidemiology of SARS-CoV-2 in Guangdong Province, China

text: Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2 infection and was first reported in central China in December 2019. Extensive molecular surveillance in Guangdong, China's most populous province, during early 2020 resulted in 1,388 reported RNA-positive cases from 1.6 million tests. In order to understand the molecular epidemiology and genetic diversity of SARS-CoV-2 in China, we generated 53 genomes from infected individuals in Guangdong using a combination of metagenomic sequencing and tiling amplicon approaches. Combined epidemiological and phylogenetic analyses indicate multiple independent introductions to Guangdong, although phylogenetic clustering is uncertain because of low virus genetic variation early in the pandemic. Our results illustrate how the timing, size, and duration of putative local transmission chains were constrained by national travel restrictions and by the province's large-scale intensive surveillance and intervention measures. Despite these successes, COVID-19 surveillance in Guangdong is still required, because the number of cases imported from other countries has increased.


Shifting Sands - Molecular Coronavirus Testing During a Time of Inconsistent Resources


The impact of COVID-19 on Head and Neck surgery, education, and training


Clinical course, severity and mortality in a cohort of patients with COVID-19 with rheumatic diseases


title: An update on our response to Covid-19

text: BVA is working hard to keep the veterinary profession informed and supported during these challenging and unpredictable times.


docid: nvpldzwl

title: An open-label cluster-randomized controlled trial of chloroquine, hydroxychloroquine or only supportive care in patients admitted with moderate to severe COVID-19 (ARCHAIC)-Protocol publication


COVID-19 may transmit through aerosol


docid: lssilsje

title: Acute pulmonary embolism in COVID-19 related hypercoagulability

text: Since December 2019, a novel Coronavirus (SARS-CoV-2) was confirmed as the etiologic agent of a worldwide outbreak of a pneumonia that can result in severe respiratory failure. This clinical entity seems to be associated with a marked hypercoagulable state that causes both arterial and venous thromboembolic complications. Therefore, an adequate anti-thrombotic prophylaxis is recommended in hospitalized COVID-19 patients. Although rapidly worsening respiratory symptoms in a patient with SARS-CoV-2 respiratory infection may correlate with worsening pneumonia itself, it may also mask a pulmonary embolism. We report the case of a 50-year-old man affected by SARS-CoV-2 pneumonia, who developed acute pulmonary embolism.


Reply to: Cigarette Smoking and COVID-19: A Complex Interaction


Social media for rapid knowledge dissemination: early experience from the COVID-19 pandemic


title: Epidemic parameters for COVID-19 in several regions of India

text: Bayesian analysis of publicly available time series of cases and fatalities in different geographical regions of India during April 2020 is reported. It is found that the initial apparent rapid growthin infections could be partly due to confounding factors such as initial rapid ramp-up of disease surveillance. A brief discussion is given of the fallacies which arise if this possibility is neglected. The growth after April 10 is consistent with a time independent but region dependent exponential. From this, R0 is extracted using both known cases and fatalities. The two estimates are seen to agree in many cases; for these CFR is reported. It is seen that CFR and R0 increase together. Some public health implications of this observation are discussed, including a target doubling interval if medical facilities are to remain adequate.


title: HLA predictions from the bronchoalveolar lavage fluid samples of five patients at the early stage of the Wuhan seafood market COVID-19 outbreak

text: We are in the midst of a global viral pandemic, one with no cure and a high mortality rate. The Human Leukocyte Antigen (HLA) gene complex plays a critical role in host immunity. We predicted HLA class I and II alleles from the transcriptome sequencing data prepared from the bronchoalveolar lavage fluid samples of five patients at the early stage of the COVID-19 outbreak. We identified the HLA-I allele A*24:02 in four out of five patients, which is higher than the expected frequency (17.2%) in the South Han Chinese population. The difference is statistically significant with a p-value less than $10^{-4}$. Our analysis results may help provide future insights on disease susceptibility.


title: The Question of Whether to Remain on Therapy for Chronic Rheumatic Diseases in the Setting of the Covid-19 Pandemic

text: We appreciate our Italian colleagues' interest in our editorial denoting the rheumatologist's role in helping to diagnose and treat cytokine storm syndrome (CSS) in the setting of the Covid-19 panemic (1). It is encouraging that none of the 123 pediatric rheumatology patients (primarily juvenile idiopathic arthritis) on background biological disease modifying anti-rheumatic drug (bDMARD) therapies in Milan, Italy surveyed over a 7-week period from February 25 through April 14, 2020 (during which time Covid-19 was hyper-endemic there) had either confirmed or suspected Covid-19 (2).


title: Persistent Viral Presence Determines the Clinical Course of the Disease in COVID-19

text: BACKGROUND: The clinical management of coronavirus disease 2019 (COVID-19) is dependent on understanding the underlying factors that contribute to the disease severity. In the absence of effective antiviral therapies, other host immunomodulatory therapies such as targeting inflammatory response are currently being used without clear evidence of their effectiveness. Because inflammation is an essential component of host antiviral mechanisms, therapies targeting inflammation may adversely affect viral clearance and disease outcome. OBJECTIVE: To understand whether the persistent presence of the virus is a key determinant in the disease severity during COVID-19 and to determine whether the viral reactivation in some patients is associated with infectious viral particles. METHODS: The data for patients were available including the onset of the disease, duration of viral persistence, measurements of inflammatory markers such as IL-6 and C-reactive protein, chest imaging, disease symptoms, and their durations among others. Follow-up tests were performed to determine whether the viral negative status persists after their recovery. RESULTS: Our data show that patients with persistent viral presence (>16 days) have more severe disease outcomes including extensive lung involvement and requirement of respiratory support. Two patients who died of COVID-19 were virus-positive at the time of their death. Four patients demonstrated virus-positive status on the follow-up tests, and these patient samples were sent to viral culture facility where virus culture could not be established. CONCLUSIONS: These data suggest that viral persistence is the key determining factor of the disease severity. Therapies that may impair the viral clearance may impair the host recovery from COVID-19.


title: Effect of the Coronavirus Disease 2019 (COVID-19) Pandemic on the U.S. Emergency Medical Services System: A Preliminary Report

text: BACKGROUND: Our objective was to quantify trends in emergency medical services (EMS) incidents as the effects of the COVID-19 pandemic spread across the United States and to determine if there was an increase in EMS-attended deaths. METHODS: We conducted a 3-year comparative retrospective cohort analysis of data from the National EMS Information System. Data were included if care was provided between the 40th and 21st weeks of the next year and compared over 3 years. We included incidents identified through 9-1-1 where patient contact was made. The total number of EMS incidents per week was used as the denominator to calculate the rate of patient deaths and possible injury. We assessed for temporal and seasonal trends. RESULTS: Starting in the 10th week of 2020 there was a decrease in the number of EMS activations in the United States compared to the prior weeks and the same time period in previous years. The number of activations between week 10 and week 16 decreased by 140,292 or 26.1%. The portion of EMS activations reporting a patient disposition of death nearly doubled between the 11th and 15th weeks of 2020 (1.49%-2.77% of all activations). The number of EMS activations documenting a possible injury decreased from 18.43% to 15.27% between weeks 10 and 13. CONCLUSION: We found that early in the COVID-19 outbreak there was a significant decrease in the number of EMS responses across the United States. Simultaneously the rate of EMS-attended death doubled, while the rate of injuries decreased.


Safety of Ibuprofen in Patients With COVID-19: Causal or Confounded?


title: Review of practical recommendations for otolaryngologists and head and neck surgeons during the COVID-19 pandemic

text: INTRODUCTION: Otolaryngologists are at very high risk of COVID-19 infection while performing examination or surgery. Strict guidelines for these specialists have not already been provided, while currently available recommendations could presumably change in course of COVID-19 pandemic as the new data increases. OBJECTIVES: This study aimed to synthesize evidence concerning otolaryngology during COVID-19 pandemic. It presents a review of currently existing guidelines and recommendations concerning otolaryngological procedures and surgeries during COVID-19 pandemic, and provides a collective summary of all crucial information for otolaryngologists. It summarizes data concerning COVID-19 transmission, diagnosis, and clinical presentation highlighting the information significant for otolaryngologists. METHODS: The Medline and Web of Science databases were searched without time limit using terms ''COVID-19", "SARS-CoV-2" in conjunction with "head and neck surgery", "otorhinolaryngological manifestations". RESULTS: Patients in stable condition should be consulted using telemedicine options. Only emergency consultations and procedures should be performed during COVID-19 pandemic. Mucosa-involving otolaryngologic procedures are considered high risk procedures and should be performed using enhanced PPE (N95 respirator and full face shield or powered air-purifying respirator, disposable gloves, surgical cap, gown, shoe covers). Urgent surgeries for which there is not enough time for SARS-CoV-2 screening are also considered high risk procedures. These operations should be performed in a negative pressure operating room with high-efficiency particulate air filtration. Less urgent cases should be tested for COVID-19 twice, 48 h preoperatively in 24 h interval. CONCLUSIONS: This review serves as a collection of current recommendations for otolaryngologists for how to deal with their patients during COVID-19 pandemic.


title: Using Telemedicine During the COVID-19 Pandemic

text: Telemedicine is the delivery of health care services using information or communication technology. In the current pandemic scenario, telemedicine can supplement health-care delivery in the absence of in-person visit. The Government of India has recently launched the e-sanjeevani OPD, a National teleconsultation service, which has been adopted by many state governments as mandatory for health-care providers. With Indian Medical Association issuing an advisory against the use of telemedicine except in few situations, a lot of confusion exists in the mind of a pediatrician. Despite the uncertain situation, we have to remember that other diseases shall not stall in the face of a pandemic. Since telemedicine is an evolving subject, training of medical professionals, clear guidelines and good quality internet service systems will go a long way in increasing the acceptability of telemedicine in the Indian population. We herein discuss issues related to using telemedicine during the SARS-CoV-2 pandemic.


title: Community quarantine strategy against coronavirus disease 2019 in Anhui: An evaluation based on trauma center patients

text: OBJECTIVE: The objective of our study was to introduce community quarantine strategy against coronavirus disease 2019 (COVID-19) in Anhui and evaluate the effectiveness of community quarantine based on trauma center (TC) patients. METHOD: The structure of community quarantine strategy was illustrated. Distribution of injuries among patients in two TCs between January 24, 2020 and February 24, 2020 was described. Multiple linear regression was used to analyze the correlation between the distribution of Injuries in TCs and the number of COVID-19-associated cases. RESULTS: A total of 757 TC patients in the two hospitals were enrolled. The number of traffic injuries and outdoor injuries showed a significant decrease in the early stage and began to increase on February 17. The number of indoor injuries neither decreased nor increased. Multiple linear regression analysis revealed a significant correlation between COVID-19-associated cases and traffic and outdoor injuries. CONCLUSION: From the perspective of the injuries in TCs, community quarantine strategy was effectively implemented and significantly slowed the outbreak of COVID-19 in Anhui. However, the implementation and maintenance of the strategy is costly and requires the participation of the entire population.


title: The effect of messaging and gender on intentions to wear a face covering to slow down COVID-19 transmission

text: Now that various countries are or will soon be moving towards relaxing shelter-in-place rules, it is important that people use a face covering, to avoid an exponential resurgence of the spreading of the coronavirus disease (COVID-19). Here we report a pre-registered online experiment (N=2,459) using a heterogenous, although not representative, sample of people living in the USA, where we test the relative effect of messages highlighting that the coronavirus is a threat to"you"vs"your family"vs"your community"vs"your country"on self-reported intentions to wear a face covering. Results show that focusing on"your community"promotes intentions to wear a face covering relative to the baseline; the trend is the same when comparing"your community"to the other conditions, but not significant. We also conducted pre-registered analyses of gender differences on intentions to wear a face covering. We find that men less than women intend to wear a face covering, but this difference almost disappears in counties where wearing a face covering is mandatory. We also find that men less than women believe that they will be seriously affected by the coronavirus, and this partly mediates gender differences in intentions to wear a face covering (this is particularly ironic because official statistics actually show that men are affected by the COVID-19 more seriously than women). Finally, we also find gender differences in self-reported negative emotions felt when wearing a face covering. Men more than women agree that wearing a face covering is shameful, not cool, a sign of weakness, and a stigma; and these gender differences also mediate gender differences in intentions to wear a face covering.


docid: rosqbqcl

title: Chemical-bromatological composition and in vitro ruminal kinetics of sugar cane silage with maniçoba/ Composição químico bromatológica e cinética ruminal in vitro em silagens de cana de açúcar com maniçoba

text: The objective this study was to evaluate the effect of maniçoba supplementation in sugar cane silage with respect to chemical-bromatological composition and the in vitro degradation kinetics of the silage. This experiment was conducted in a completely randomized design with four treatments (maniçoba levels: 0, 20, 30, and 40%) and six repetitions. Silage samples were analyzed for their chemical-bromatological composition, digestible energy, metabolizable energy, total digestible nutrients, in vitro gas production and degradability parameters. The silage with higher inclusion level had better bromatological composition (p < 0.05) than the silage without maniçoba for CP, NDF, ADF and MM (6.49, 56.64, 38.66 and 4.52% versus 2.21, 70.96, 49.95 and 2.78%). Higher ME content (2.35 MJ kg-1 MS versus 1.85 MJ kg-1 MS), DE (2.87 Mcal kg-1 MS versus 2.25 Mcal kg-1 MS) and TDN (65.16% versus 51.11%), respectively. The highest values for gas production were also observed in silage with added maniçoba due to higher NFC content (34.87%). With an increase in the proportion of maniçoba, there was an increase in the soluble a fraction, b fraction, and thus a higher effective degradability of dry matter (46.56%). The addition of maniçoba improves the nutritive value of sugarcane silage.(AU)


What Does COVID-19 Mean for the Pathology-Urology Interaction?


Lack of protective gear disrupts oncology care


title: Macrolides and viral infections: focus on azithromycin in COVID-19 pathology

text: The emergence of the new COVID-19 virus is proving to be a challenge in seeking effective therapies. Since the most severe clinical manifestation of COVID-19 appears to be a severe acute respiratory syndrome, azithromycin has been proposed as a potential treatment. Azithromycin is known to have immunomodulating and antiviral properties. In vitro studies have demonstrated the capacity of azithromycin in reducing production of pro-inflammatory cytokines such as IL-8, IL-6, TNF alpha, reduce oxidative stress, and modulate T-helper functions. At the same time there are multiple clinical evidences of the role of azithromycin in acute respiratory distress syndrome and against Middle East Respiratory syndrome (MERS). Some preliminary evidence has demonstrated controversial results regarding efficacy of azithromycin in combination with hydroxychloroquine in COVID-19. First, a French trial demonstrated 100% virological negativizing of six patients treated with azithromycin plus hydroxychloroquine vs. 57.1% of patients treated with only hydroxychloroquine and 12.5% of the control group (P < 0.05). On the other hand, another case series revealed no efficacy at all on 11 patients treated with the same combination and doses. Furthermore, there are some concerns regarding the association of azithromycin and hydroxychloroquine because of potential QT prolongation. In fact, both drugs have this as a potential side effect and evidence regarding the safe use of this combination is controversial. Despite the necessity to quickly find solutions for COVID-19, extreme caution must be used in evaluating the risk-benefit balance. However, based on preclinical and clinical evidence and some preliminary results in COVID-19, azithromycin could have potential in the fight against this new disease.


title: [Materialism and dialectics of epidemic prevention and control: only by respecting science can we do more with less]

text: The epidemic caused by COVID-19 has been highly concerned by the international community including World Health Organization (WHO). This is an ongoing battle for human life and health. We should always remember and learn lessons from the past, which could be promoted to all over the country, even the world. Many phenomena and problems in the work of epidemic prevention, control and treatment are worthy of our deep reflection. We should use scientific approach and dialectical materialism to make a practical and realistic summary. The purpose is to win the battle as soon as possible, and more importantly, to avoid repeating the same mistakes and prevent pestilence before it happens.


Olfactory Dysfunction in COVID-19


Biologic therapy for psoriasis during the COVID-19 outbreak: The choice is to weigh risks and benefits


title: Coronavirus (COVID-19): Patient experience-Administrative services on the frontline during crisis

text: The COVID-19 pandemic has had a dramatic impact on care delivery among health care institutions and providers in the United States. As a categorical cancer center, MD Anderson has prioritized care for our patients based on acuity of their disease. We continue to implement measures to protect patients and employees from acquiring the infection within our facilities, and to provide acute management of cancer patients with concomitant COVID-19 infections who are considered at high risk of death. The Division of Patient Experience, formerly established in October 2016, has played an integral role in the institution's pandemic response from its inception. The team actively supported programs and processes in anticipation of the pandemic's effect on our patients and employees. We will describe how the team continues to serve in the ever-dynamic environment as we approach the expected surge in COVID-19 cases among our patient population, our employees, and in our community.


Primary and Secondary Prevention of Cardiovascular Disease in the Era of the Coronavirus Pandemic


Mitigating the psychological effects of social isolation during the covid-19 pandemic


Screams on a Zoom call: the theory of homeworking with kids meets reality


Corticosteroids for Common Palliative Care Symptoms #395


title: Liver Biochemistries in Hospitalized Patients With COVID-19

text: Coronavirus disease 2019 (COVID-19) leads to elevated liver biochemistries in approximately half of patients on presentation. To date, data are limited regarding the trend of liver biochemistries over the course of illness. We aimed to evaluate the trend, etiology, and outcomes associated with liver biochemistries in COVID-19. A total of 60 patients with COVID-19 were admitted between March 21 and March 28, 2020. Mean age was 57 years, 65% were male and 28% were Hispanic. At study conclusion, 6 patients were deceased, 28 discharged, and 26 remained admitted. Patients who remained admitted were followed for median 12 days. Of 60 patients, 41 (69%) had at least one abnormal liver biochemistry on admission. Median aspartate aminotransferase (AST) was higher than alanine aminotransferase (ALT) at admission (46 vs. 30 U/L) and during the hospital course. Aminotransferases rose above normal in 54 (93%) patients, while alkaline phosphatase and total bilirubin elevations were rare. Ten (17%) patients developed aminotransferases more than 5 times the upper limit of normal. AST highly correlated with ALT throughout the illness course (r = 0.97; P < 0.0001), whereas correlations with markers of muscle injury and inflammation were weak. Statin use was common prior to (40%) and during admission (80%) at our center, with no difference in peak liver biochemistries between users and non-users. No demographic or comorbid illness was associated with liver injury. Admission AST (69 vs. 49; P < 0.05), peak AST (364 vs. 77; P = 0.003), and peak ALT (220 vs. 52; P = 0.002) were higher in intubated patients. Conclusion: AST-dominant aminotransferase elevation is common in COVID-19, mirrors disease severity, and appears to reflect true hepatic injury.


Daily Situation Report on Coronavirus disease (COVID-19) in Iran;March 13, 2020


title: Relative contributions of transmission routes for COVID-19 among healthcare personnel providing patient care

text: The routes of COVID-19 transmission to healthcare personnel from infected patients is the subject of debate, but is critical to the selection of personal protective equipment. The objective of this paper was to explore the contributions of three transmission routes-contact, droplet, and inhalation-to the risk of occupationally acquired COVID-19 infection among healthcare personnel (HCP). The method was quantitative microbial risk assessment, and an exposure model, where possible model parameters were based on data specific to the SARS-CoV-2 virus when available. The key finding was that droplet and inhalation transmission routes predominate over the contact route, contributing 35%, 57%, and 8.2% of the probability of infection, on average, without use of personal protective equipment. On average, 80% of inhalation exposure occurs when HCP are near patients. The relative contribution of droplet and inhalation depends upon the emission of SARS-CoV-2 in respirable particles (<10 µm) through exhaled breath, and inhalation becomes predominant, on average, when emission exceeds five gene copies per min. The predicted concentration of SARS-CoV-2 in the air of the patient room is low (< 1 gene copy per m3 on average), and likely below the limit of quantification for many air sampling methods. The findings demonstrate the value of respiratory protection for HCP, and that field sampling may not be sensitive enough to verify the contribution of SARS-CoV-2 inhalation to the risk of occupationally acquired COVID-19 infection among healthcare personnel. The emission and infectivity of SARS-CoV-2 in respiratory droplets of different sizes is a critical knowledge gap for understanding and controlling COVID-19 transmission.


Viewpoint: Impact of the Covid-19 Outbreak on the Clinical and Research Activities of Memory Clinics: An Alzheimer's Disease Center Facing the Covid-19 Crisis


Practical experiences and suggestions for the 'eagle-eyed observer': a novel promising role for controlling nosocomial infection in the COVID-19 outbreak


title: The management of coronavirus disease 2019 (COVID-19)

text: In December 2019, a novel coronavirus causing severe acute respiratory disease occurred in Wuhan, China. It is an emerging infectious disease with widespread and rapid infectiousness. The World Health Organization declared the coronavirus outbreak to be a public health emergency of international concern on 31 January 2020. Severe COVID-19 patients should be managed and treated in a critical care unit. Performing a chest X-ray/CT can judge the severity of the disease. The management of COVID-19 patients includes epidemiological risk and patient isolation; treatment entails general supportive care, respiratory support, symptomatic treatment, nutritional support, psychological intervention, etc. The prognosis of the patients depends upon the severity of the disease, the patient's age, the underlying diseases of the patients, and the patient's overall medical condition. The management of COVID-19 should focus on early diagnosis, immediate isolation, general and optimized supportive care, and infection prevention and control.


title: Fomite transmission and disinfection strategies for SARS-CoV-2 and related viruses

text: Contaminated objects or surfaces, referred to as fomites, play a critical role in the spread of viruses, including SARS-CoV-2, the virus responsible for the COVID-19 pandemic. The long persistence of viruses (hours to days) on surfaces calls for an urgent need for surface disinfection strategies to intercept virus transmission and the spread of the disease. Elucidating the physicochemical processes and surface science underlying the adsorption and transfer of virus between surfaces, as well as their inactivation, are important in understanding how the disease is transmitted, and in developing effective interception strategies. This review aims to summarize the current knowledge and underlying physicochemical processes of virus transmission, in particular via fomites, and common disinfection approaches. Gaps in knowledge and needs for further research are also identified. The review focuses on SARS-CoV-2, but will supplement the discussions with related viruses.


title: CovidChain: An Anonymity Preserving Blockchain Based Framework for Protection Against Covid-19

text: Today, the entire world is facing incredible health and economic challenges due to the rapid spread of the life threatening novel Coronavirus Disease - 2019 (COVID-19). In the prevailing situation when a vaccine is many months away, the way forward seems to be a controlled exit from the lockdown - where, infected/exposed people are strictly quarantined and recovered/unexposed people are allowed to carry on with their day to day business activities. However, appropriate physical distancing norms will have to be strictly followed for such relaxations. Therefore, mechanisms are required that will assist people in following the social and physical distancing norms in public places. In this paper, we propose an anonymity preserving blockchain based framework that allows people, through use of their smart phones and other communication devices, to protect themselves from infections as they conduct their daily business activities.


title: COVID-19: Prevention and control measures in community

text: On January 30, 2020, the WHO declared the COVID-19 outbreak a public health emergency of international concern and, in March 2020, began to characterize it as a pandemic in order to emphasize the gravity of the situation and urge all countries to take action in detecting infection and preventing spread. Unfortunately, there is no medication that has been approved by the FDA, gone through controlled studies and demonstrated an effect on the virus for this global pandemic. Although there are cures for illnesses and developments made by leaps and bounds in our day, the strongest and most effective weapon that society has against this virus that is affecting not just health but also economics, politics, and social order, is the prevention of its spread. The main points in preventing the spread in society are hand hygiene, social distancing and quarantine. With increased testing capacity, detecting more COVID-19 positive patients in the community will also enable the reduction of secondary cases with stricter quarantine rules.


Is Coronavirus Disease 2019 (COVID-19) seen less in countries more exposed to Malaria?


title: Correction to: Sargramostim to treat patients with acute hypoxic respiratory failure due to COVID-19 (SARPAC): A structured summary of a study protocol for a randomised controlled trial

text: An amendment to this paper has been published and can be accessed via the original article.


The WHO we want


Early Observation and Mitigation of Challenges in Diabetes Management of COVID-19 Patients in Critical Care Units


title: The perils of practicum in the time of COVID-19: A graduate student's perspective

text: The COVID-19 pandemic has placed competing demands on many graduate students working at practica. Though graduate programs seek to minimize potential sources of exposure to the virus, some practicum sites rely on students as essential staff. At the same time, although some students may wish to eliminate this source of potential exposure to the virus, other students may consider the opportunity to fulfill their practicum duties at a time of crisis an important part of their educational experience. Guidance published by the Association of Psychology Postdoctoral and Internship Centers regarding internship students provides at least a starting point for programs to develop policies that allow students to make informed decisions about their practicum training. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Consideration on TMPRSS2 and the risk of COVID-19 infection in Cushing's syndrome


title: Study on the relationship between the 2019 Novel Coronavirus Disease epidemic in China and population migration from Wuhan/ 中华医学科研管理杂志

text: Objective@#To investigate the relationship between the epidemic of Coronavirus Disease in 2019 (COVID-19) in China and population migration from Wuhan before the city implemented strict migration restrictions.@*Methods@#We collected the cumulative number of confirmed cases with COVID-19 up to January 31, 2020 from the official website of the health administrative departments, and information on population migration out of Wuhan during January 10, 2020 and January 24, 2020, approximately half months prior to the implementation of strict migration restrictions by the city, from Baidu population-migration big data platform. Population migration data were provided for the top 100 cities in the form of percentage values, calculated as the number of migrants from Wuhan into these cities divided by the total number of migrants out of Wuhan during the same period multiplied by 100%. The two-independent sample non-parametric Wilcoxon rank-sum test was used to compare the distribution of cumulative number of cases between the top 100 cities and the remaining 205 non-top 100 cities of China. The relationship between the cumulative number of cases and the percentage of migrants from Wuhan into the top 100 cities were further assessed by Pearson correlation and by multiple linear regression with adjustment for population size, population density, and GDP per capita.@*Results@#The top 100 cities accounted for 91.6% of total migrants out of Wuhan, and the top 14 cities were all in Hubei province. There were a total of 5,869 cases in the top 100 cities, with a median (interquartile range) of 21.5 (12~55) cases, whereas in the 205 non-top 100 cities there were a total of 1,063 cases, with a median (interquartile range) of 4 (2~7) cases. The median cumulative number of cases differed significantly between the two types of cities (P<0.001). Among the top 100 cities, there was a strong correlation between the percentage of migrants from Wuhan and the cumulated number of cases (Pearson correlation coefficient=0.92), and for every 1 percentage point increase in migrants from Wuhan the cumulative number of cases increased by approximately 42 (95%CI, 39 to 45). The number of cumulative number of cases in Wenzhou and Chongqing was detected as potential outliers in regression diagnosis (P<0.001, corresponding standardized residuals were 5.2 and 3.5, respectively), suggesting that the number of cases in these two cities was substantially higher than others with similar amount of migrants from Wuhan.@*Conclusions@#There is a strong positive association between the percentage of migrants from Wuhan and the epidemic status of COVID-19 infections in cities in China.


SARS-CoV-2 infection in beta thalassemia: Preliminary data from the Italian experience


title: Social-economic impact of COVID-19 pandemic on aesthetic centers in Greece

text: BACKGROUND: Epidemics are a major cause of health problems in developing countries, preventing the accumulation of human capital and economic growth. On the appearance of the pandemic of the new coronavirus COVID-19 worldwide, this survey was carried out in the 4th week of the occurrence of the cases in Greece. OBJECTIVES: The investigation was aimed at the social and economic impact caused by this COVID-19 pandemic and the state's decision to suspend the operation of businesses and stores in Greece. MATERIALS AND METHODS: One hundred and fifty-eight esthetic centers from various areas of Greece were participated in this study, and the questionnaires were sent electronically to the business owners. Statistical analyzes were conducted using Google Forms and the questionnaires analyzed through PSPP software. RESULTS: Based on their answers and the statistical analyzes, it was calculated the reduction of the monthly income for the first month of suspension of the operation of their companies. Additionally, social-related matters were examined as, how they experience this period, psychologically, financially, what problems they believe that they will face, and what changes in their work that could result from the pandemic. DISCUSSION: There is no similar study and experience for esthetic centers from a viral pandemic in literature. The suspension of operations provoked serious financial problems and significant psychological burden about what "tomorrow will bring" with returning to "normalcy."


These cancer scientists turned their lab into a coronavirus-testing facility


Impact of a 10 Rules Protocol on COVID-19 Hospital-Related Transmission: Insights From Padua University Hospital, Italy


Deploying Medical Students to Combat Misinformation During the COVID-19 Pandemic


Getting back on track: control of covid-19 outbreaks in the community


Perspectives From the Foot and Ankle Department at an Academic Orthopedic Hospital During the Surge Phase of the COVID-19 Pandemic in New York City


title: Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II): protocol for an observational study using linked Scottish national data

text: INTRODUCTION: Following the emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 and the ensuing COVID-19 pandemic, population-level surveillance and rapid assessment of the effectiveness of existing or new therapeutic or preventive interventions are required to ensure that interventions are targeted to those at highest risk of serious illness or death from COVID-19. We aim to repurpose and expand an existing pandemic reporting platform to determine the attack rate of SARS-CoV-2, the uptake and effectiveness of any new pandemic vaccine (once available) and any protective effect conferred by existing or new antimicrobial drugs and other therapies. METHODS AND ANALYSIS: A prospective observational cohort will be used to monitor daily/weekly the progress of the COVID-19 epidemic and to evaluate the effectiveness of therapeutic interventions in approximately 5.4 million individuals registered in general practices across Scotland. A national linked dataset of patient-level primary care data, out-of-hours, hospitalisation, mortality and laboratory data will be assembled. The primary outcomes will measure association between: (A) laboratory confirmed SARS-CoV-2 infection, morbidity and mortality, and demographic, socioeconomic and clinical population characteristics; and (B) healthcare burden of COVID-19 and demographic, socioeconomic and clinical population characteristics. The secondary outcomes will estimate: (A) the uptake (for vaccines only); (B) effectiveness; and (C) safety of new or existing therapies, vaccines and antimicrobials against SARS-CoV-2 infection. The association between population characteristics and primary outcomes will be assessed via multivariate logistic regression models. The effectiveness of therapies, vaccines and antimicrobials will be assessed from time-dependent Cox models or Poisson regression models. Self-controlled study designs will be explored to estimate the risk of therapeutic and prophylactic-related adverse events. ETHICS AND DISSEMINATION: We obtained approval from the National Research Ethics Service Committee, Southeast Scotland 02. The study findings will be presented at international conferences and published in peer-reviewed journals.


Recommendations for general surgery activities in a pandemic scenario (SARS-CoV-2)


title: How can dentistry get back to work safely?

text: Data sources Narrative reviewStudy abstract This review provides a synopsis of our understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated coronavirus disease, COVID-19. The virus is shed in the nasopharyngeal and salivary secretions of carriers, and this puts dental professionals at risk for increased exposure of SARS-CoV-2. The paper summarises the current guidelines outlined by the CDC and presents the triaging protocols to identify potential carriers and how to safely limit treatment to low-risk patients.


title: Evolutionary history, potential intermediate animal host, and cross-species analyses of SARS-CoV-2

text: To investigate the evolutionary history of the recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China, a total of 70 genomes of virus strains from China and elsewhere with sampling dates between 24 December 2019 and 3 February 2020 were analyzed. To explore the potential intermediate animal host of the SARS-CoV-2 virus, we reanalyzed virome data sets from pangolins and representative SARS-related coronaviruses isolates from bats, with particular attention paid to the spike glycoprotein gene. We performed phylogenetic, split network, transmission network, likelihood-mapping, and comparative analyses of the genomes. Based on Bayesian time-scaled phylogenetic analysis using the tip-dating method, we estimated the time to the most recent common ancestor and evolutionary rate of SARS-CoV-2, which ranged from 22 to 24 November 2019 and 1.19 to 1.31 × 10-3 substitutions per site per year, respectively. Our results also revealed that the BetaCoV/bat/Yunnan/RaTG13/2013 virus was more similar to the SARS-CoV-2 virus than the coronavirus obtained from the two pangolin samples (SRR10168377 and SRR10168378). We also identified a unique peptide (PRRA) insertion in the human SARS-CoV-2 virus, which may be involved in the proteolytic cleavage of the spike protein by cellular proteases, and thus could impact host range and transmissibility. Interestingly, the coronavirus carried by pangolins did not have the RRAR motif. Therefore, we concluded that the human SARS-CoV-2 virus, which is responsible for the recent outbreak of COVID-19, did not come directly from pangolins.


title: COVID-19 Diagnostic and Management Protocol for Pediatric Patients

text: This review aims to verify the main epidemiologic, clinical, laboratory-related, and therapeutic aspects of coronavirus disease 2019 (COVID-19) in critically ill pediatric patients. An extensive review of the medical literature on COVID-19 was performed, mainly focusing on the critical care of pediatric patients, considering expert opinions and recent reports related to this new disease. Experts from a large Brazilian public university analyzed all recently published material to produce a report aiming to standardize the care of critically ill children and adolescents. The report emphasizes on the clinical presentations of the disease and ventilatory support in pediatric patients with COVID-19. It establishes a flowchart to guide health practitioners on triaging critical cases. COVID-19 is essentially an unknown clinical condition for the majority of pediatric intensive care professionals. Guidelines developed by experts can help all practitioners standardize their attitudes and improve the treatment of COVID-19.


title: The geographic spread of COVID-19 correlates with structure of social networks as measured by Facebook

text: We use anonymized and aggregated data from Facebook to show that areas with stronger social ties to two early COVID-19"hotspots"(Westchester County, NY, in the U.S. and Lodi province in Italy) generally have more confirmed COVID-19 cases as of March 30, 2020. These relationships hold after controlling for geographic distance to the hotspots as well as for the income and population density of the regions. These results suggest that data from online social networks may prove useful to epidemiologists and others hoping to forecast the spread of communicable diseases such as COVID-19.


title: A pharmacological perspective of Chloroquine in SARS-CoV-2 infection

text: The pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is having serious consequences on health and the economy worldwide. All evidence-based treatment strategies need to be considered to combat this new virus. Drugs need to be considered on scientific grounds of efficacy, safety and cost. Chloroquine (CQ) and hydroxychloroquine (HCQ) are old drugs used in the treatment of malaria; in addition, their antiviral properties have been previously studied, including in coronaviruses, where evidence of efficacy has been found. The safety of CQ and HCQ has been studied for over 50 years. In the current race against time triggered by the SARS-CoV-2 pandemic, the search for new antivirals is very important. However, consideration should be given to old drugs with known anti-coronavirus activity, such as CQ and HCQ; these could be integrated into current treatment strategies while novel treatments are awaited, also in light of the fact that they display an anticoagulant effect that facilitates the activity of low MW heparin, aimed at preventing ARDS-associated thrombotic events. The safety of CQ and HCQ has been studied for over 50 years, however, recently published data raise concerns for cardiac toxicity of CQ/HCQ in patients with COVID-19. The review that we here provide also reexamines the real information provided by some of the published alarming reports although concluding that cardiac toxicity should in any case be stringently monitored with patients with CQ/HCQ.


Cyclosporine A: a valid candidate to treat COVID-19 patients with acute respiratory failure?


title: Use Stones from Another Mountain to Polish One’s Jade: Learn from MERS Studies toexplore potential mechanisms underlying the effect of diabetes mellitus on COVID-19/ 中华内分泌代谢杂志

text: Epidemiology studies suggest that comorbid diabetes may have negative impact on the progression and severity of the coronavirus disease 2019 (COVID-19), which first occurred in Wuhan. However, the exact mechanism remains unclear. A recent study on another type of coronavirus infection, Middle East Respiratory Syndrome (MERS), investigated its relationship with diabetes. This essay aims to give a brief introduction to this report and related studies, and to propose suggestions on what we can learn from these investigations to conduct further studies on the potential mechanisms underlying the effect of diabetes mellitus on COVID-19.


The importance of preventing COVID-19 in surgical wards cannot be overemphasized


title: COVID-19, Australia: Epidemiology Report 17 (Fortnightly reporting period ending 24 May 2020)

text: Confirmed cases in Australia notified up to 24 May 2020: notifications = 7,135; deaths = 102. The incidence of COVID-19 has markedly reduced since a peak in mid-March. There have been no cases reported in SA, the NT or the ACT in the last four weeks. The numbers of new cases reported from other jurisdictions continue to be very low. Testing rates have been higher across all jurisdictions, with Victoria reporting an 85% testing rate increase and NSW a 40% increase over this period. The positivity rate nationally continues to remain very low at less than 0.1% over the reporting period. Continued high rates of testing are necessary to detect and mitigate the spread of COVID-19 in the community. Over the past fortnight, 45% of cases acquired their infection overseas. Of cases considered to be locally acquired over this period, most were associated with contacts of confirmed cases or were associated with known outbreaks. The highest rate of COVID-19 continues to be among people aged 65-79 years. Three-quarters of all cases in this age group have been associated with overseas travel, including several outbreaks linked to cruise ships. The lowest rate of disease is in children under 18, a pattern reflected in international reports. A small proportion of cases overall have experienced severe disease, requiring hospitalisation or intensive care with some fatalities. The crude case fatality rate amongst Australian cases is 1.4%. People who are older and have one or more comorbidities are more likely to experience severe disease. A combination of early case identification, physical distancing, public health measures and a reduction in international travel have likely been effective in slowing the spread of the disease in Australia. In addition, the median number of days between symptom onset and diagnostic testing has improved considerably from 7 days in the early phase of the outbreak to 1 day in the latest phase of the epidemic. Internationally, as at 24 May 2020, there have been recent increases in the number of daily cases reported globally. The largest numbers of both cases and deaths have been reported in the United States. Of the confirmed cases reported globally, the case fatality rate is approximately 6.5%. Countries in South America are starting to see rapid acceleration, while the United States is seeing a very slow decline in its daily new case numbers. In the South East Asia region, India and Bangladesh are seeing accelerating epidemics, compounded by the recovery from Cyclone Amphan. Increasing numbers of cases are also being reported in Africa, although the numbers are much smaller. In the Pacific there are very few daily new cases reported.


The Ethics of COVID-19 Clinical Trials: New Considerations in a Controversial Area


Presenting symptoms of COVID-19 in children: a meta-analysis of published studies


title: Fatal outcome in a liver transplant recipient with COVID-19

text: Liver injury is common in patients with COVID-19, but little is known about its clinical presentation and severity in the context of liver transplant. We describe a case of COVID-19 in a patient who underwent transplant 3 years ago for hepatocellular carcinoma. The patient came to clinic with symptoms of respiratory disease; pharyngeal swabs for severe acute respiratory syndrome coronavirus 2 were positive. His disease progressed rapidly from mild to critical illness and was complicated by several nosocomial infections and multiorgan failure. Despite multiple invasive procedures and rescue therapies, he died from the disease. The management of COVID-19 in the posttransplant setting presents complex challenges, emphasizing the importance of strict prevention strategies.


Virusinfektion und fehlende Beatmungsgeräte  ein Déjà-vu?/ [Viral infection and lack of ventilators-déjà vu?]


title: Is Lockdown Bad for Social Anxiety in COVID-19 Regions?: A National Study in The SOR Perspective

text: Lockdown measures have been widely used to control and prevent virus transmission in pandemic regions. However, the psychological effects of lockdown measures have been neglected, and the related theoretical research lags behind the practice. The present study aimed to better understand the mechanism of social anxiety in pandemic regions where the lockdown measures were imposed, based on the conceptual framework of the Stimulus-Organism-Response (SOR). For that, this research investigated how lockdown measures and psychological distance influenced social anxiety in the pandemic region. The Chinese national data was analyzed for the outcome. The results showed that (1) psychological distance mediated the relationship between pandemic COVID-19 severity and social anxiety, (2) lockdown measures buffered the detrimental effect of the COVID-19 pandemic severity on social anxiety, (3) lockdown measures moderated the mediation effect of psychological distancing on social anxiety caused by the COVID-19 pandemic. In conclusion, under the SOR framework, the lockdown measures had a buffer effect on social anxiety in pandemic regions, with the mediating role of psychological distancing.


Income security during public health emergencies: the COVID-19 poverty trap in Vietnam


title: Alternative management of Covid-19 infection

text: Cytokine storm is a life-threatening complication of Covid-19 infection. Excessive cytokines are the products of hyperactive immune inflammatory response mounted by the host against the virus. There is no agreed treatment for cytokine storm. Three therapeutic agents with proven immune-modulatory properties in regular use in a wide range of inflammatory disorders (high dose intravenous immunoglobulin, Rituximab and thalidomide) are proposed for the treatment of cytokine storm. Safety and efficacy of the proposed treatment should be assessed by randomised controlled clinical trials. The use of the proposed treatment is expected to reduce the mortality rate and alter the overall management of the pandemic.


Capturing the Impact of Children's Nurse Clinical Academics during the COVID-19 Pandemic


Telemedicine in nursing homes during the COVID-19 outbreak: A star is born (again)


Vulnerability of nurse and physicians with COVID-19: Monitoring and surveillance needed


Emergency Caesarean delivery in a patient with confirmed COVID-19 under spinal anaesthesia


title: A Systematic Media Frame Analysis of 1.5 Million New York Times Articles from 2000 to 2017

text: Framing is an indispensable narrative device for news media because even the same facts may lead to conflicting understandings if deliberate framing is employed. Therefore, identifying media framing is a crucial step to understanding how news media influence the public. Framing is, however, difficult to operationalize and detect, and thus traditional media framing studies had to rely on manual annotation, which is challenging to scale up to massive news datasets. Here, by developing a media frame classifier that achieves state-of-the-art performance, we systematically analyze the media frames of 1.5 million New York Times articles published from 2000 to 2017. By examining the ebb and flow of media frames over almost two decades, we show that short-term frame abundance fluctuation closely corresponds to major events, while there also exist several long-term trends, such as the gradually increasing prevalence of the ``Cultural identity'' frame. By examining specific topics and sentiments, we identify characteristics and dynamics of each frame. Finally, as a case study, we delve into the framing of mass shootings, revealing three major framing patterns. Our scalable, computational approach to massive news datasets opens up new pathways for systematic media framing studies.


title: [Analysis on cluster cases of COVID-19 in Tianjin]

text: Objective: To understand the characteristics of clusters of COVID-19 cases in Tianjin, and provide epidemiological evidence for the prevention and control of COVID-19. Methods: The data of all the COVID-19 cluster cases in Tianjin, reported by 22 February 2020, were collected to analyze the characteristics of different types of the clusters. Results: A total of 115 COVID-19 cases were reported in 33 clusters in Tianjin included 28 family clusters (71 cases), 1 work place cluster (10 cases), 3 transport vehicle clusters (8 cases) and 1 public place cluster (26 cases). Family clusters were caused by the cases from the working place or public place clusters. Numbers of secondary cases of family clusters was between 1 to 7, the median number was 2. The interval from onset to diagnosis for the first case was longer than those of other cases in the familial clusters (Z=-2.406, P=0.016). The median of incubation period of the public place clusters was 2 days. The intervals from onset to diagnosis were significant different among the family, working place and public place clusters (H=8.843, P=0.012), and also significant differences in onset time among the secondary cases (H=16.607, P=0.000). Conclusions: In the surveillance of COVID-19 epidemic, special attention should be paid to places where clustering are prone to occur, and the epidemiological investigation should be carried out timely to confirm the cluster. To prevent the transmission of COVID-19, the close contacts of the patients should be transferred to an assigned observation place on time for single room isolation. The awareness of COVID-19 prevention is low in some rural areas, reflected by many mass gathering activities and delayed medical care seeking after onset. It is necessary to strengthen the health education and take control measures in early period of epidemic.


Cluster-based approach to Coronavirus Disease 2019 (COVID-19) response in Japan-February-April 2020


Quelle conduite à tenir adopter vis à vis des injections intravitréennes (IVT) dans cette période d'épidémie au Covid-19  SARS-CoV-2 ?/ [How to approach intravitreal injections during this COVID-19 pandemic ?]


title: Prophylactic and therapeutic remdesivir (GS-5734) treatment in the rhesus macaque model of MERS-CoV infection

text: The continued emergence of Middle East Respiratory Syndrome (MERS) cases with a high case fatality rate stresses the need for the availability of effective antiviral treatments. Remdesivir (GS-5734) effectively inhibited MERS coronavirus (MERS-CoV) replication in vitro, and showed efficacy against Severe Acute Respiratory Syndrome (SARS)-CoV in a mouse model. Here, we tested the efficacy of prophylactic and therapeutic remdesivir treatment in a nonhuman primate model of MERS-CoV infection, the rhesus macaque. Prophylactic remdesivir treatment initiated 24 h prior to inoculation completely prevented MERS-CoV-induced clinical disease, strongly inhibited MERS-CoV replication in respiratory tissues, and prevented the formation of lung lesions. Therapeutic remdesivir treatment initiated 12 h postinoculation also provided a clear clinical benefit, with a reduction in clinical signs, reduced virus replication in the lungs, and decreased presence and severity of lung lesions. The data presented here support testing of the efficacy of remdesivir treatment in the context of a MERS clinical trial. It may also be considered for a wider range of coronaviruses, including the currently emerging novel coronavirus 2019-nCoV.


Response to the letter of L. Santacroce regarding article "Enhancing immunity in viral infections, with special emphasis on COVID-19: A review" (Jayawardena et al.)


title: Multisystem Inflammatory Syndrome with Features of Atypical Kawasaki Disease during COVID-19 Pandemic

text: There is a global concern of increasing number of children presenting with inflammatory syndrome with clinical features simulating Kawasaki disease, during ongoing COVID-19 pandemic. The authors report a very similar case of 5-y-old boy from a COVID-19 hotspot area who presented in late April 2020 with acute febrile illness with abdominal pain and loose stools followed by shock. On examination, child had bulbar conjunctivitis and extremity edema. Initial investigations showed high inflammatory parameters, elevated serum creatinine and liver enzymes. Echocardiography showed moderate LV dysfunction and normal coronaries. Cardiac enzymes were also elevated, suggesting myocarditis. He was treated with inotropic support, respiratory support with high flow nasal cannula, IV immunoglobulins, aspirin, steroids and diuretics. RT PCR for SARS-CoV-2 was negative twice. His clinical condition improved rapidly, was afebrile from day 2, inflammatory parameters decreased, left ventricular function improved and was discharged after 6 d of hospital stay.


title: Advancing computerized cognitive training for early Alzheimer's disease in a Covid-19 pandemic and post-pandemic world

text: The COVID-19 pandemic has transformed mobile health applications and telemedicine from nice to have tools into essential healthcare infrastructure. This need is particularly great for the elderly who, due to their greater risk for infection, may avoid medical facilities or be required to self-isolate. These are also the very groups at highest risk for cognitive decline. For example, during the COVID-19 pandemic artificially intelligent conversational agents were employed by hospitals and government agencies (such as the CDC) to field queries from patients about symptoms and treatments. Digital health tools also proved invaluable to provide neuropsychiatric and psychological self-help to people isolated at home or in retirement centers and nursing homes.


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title: Low risk for SARS-CoV2 symptomatic infection and early complications in paediatric patients during the ongoing CoVID19 epidemics in Lombardy


title: Sustainability of Coronavirus on different surfaces

text: COVID-19 is the name of the disease supposedly manifested in December 2019 from Wuhan, because of virus named as SARS-CoV-2. Now this disease has spread to almost all other parts of the world. COVID-19 pandemic has various reasons for its dramatic worldwide increase. Here, we have studied Coronavirus sustainability on various surfaces. Various disinfectants and their roles are discussed from the available literature. The infection capabilities of SARS-CoV-1 and SARS-CoV-2 for different materials are discussed and finally studies infection decay for SARS-CoV-1 and SARS-CoV-2.


title: The Impacts of Young Consumers' Health Values on Functional Beverages Purchase Intentions

text: Internationally, there is increasing recognition of the importance of proper diet values and habits, a balanced intake of healthy food products, and rates of obesity control encompassing information on fat content and calories. In this context, some beverage manufacturers have shifted to marketing their products as having fewer calories and more functional benefits. This study aims to develop an extended value-attitude-behavior (VAB) research model that includes three constructs, namely, cue to action, self-efficacy, and health orientation, to explore the impacts of university students' health values on their purchase intentions concerning functional beverages. The results indicated that university students' interest in functional beverages was significantly affected by their health values. Besides, both interests in functional beverages and health orientation were significant predictors of purchase intention, while cue to action and self-efficacy were not. Based on these results, enhancing consumers' education about food security is suggested. Furthermore, the findings provide crucial insights for marketing channels, suggesting the beverage industry can target consumers' health values concerning health beverages as the key to purchase intention and attract business by developing practical marketing strategies.


title: Soroprevalência de Toxoplasma gondii em equídeos do Nordeste do Brasil/ Seroprevalence of Toxoplasma gondii in equidae from Northeast Brazil

text: Este estudo teve como objetivo determinar a soroprevalência da toxoplasmose em equídeos mantidos em diferentes formas de manejo no estado de Pernambuco. Para tanto, um total de 400 amostras de soro sanguíneo de equídeos clinicamente saudáveis foram analisados através do teste de aglutinação modificado (MAT) considerando-se cut-off de 1:25. Dados referentes às características dos animais e dos rebanhos, sistema de criação, presença de outros animais, idade, sexo, raça, aptidão, condição física foram coletados por meio de questionários investigativos. Anticorpos IgG anti-Toxoplasma gondii foram detectados em 12,5% (50/400) dos animais analisados. Dos 12 municípios estudados, houve positividade em 91,67% (11/12) com variação entre 4,4% e 33,3%. Quando avaliados os fatores de risco, apenas o fator mesorregião (p=0,029) apresentou associação com a infecção, particularmente Zona da Mata (OR=3), seguida de Região Metropolitana do Recife (OR=2,2), Agreste (OR=1,7) e Sertão (OR=1). Os resultados revelam a presença do parasito na área estudada, o que pode representar um elo na cadeia de transmissão da toxoplasmose a qual tem repercussão em saúde pública tendo em vista que o Brasil é o oitavo maior exportador de carne equina do mundo.(AU)


RT-PCR for SARS-CoV-2: quantitative versus qualitative


docid: comwweus

title: Managing cancer during a pandemic


In Reply to 'Is SARS-CoV-2 Serology Relevant for Hemodialysis Patients With COVID-19?'


docid: mzzjktto

title: COVID-19 in kidney transplant recipients: A multicenter experience in Istanbul

text: INTRODUCTION: Management of COVID-19 in kidney transplant recipients should include treatment of the infection, regulation of immunosuppression, and supportive therapy. However, there is no consensus on this issue yet. This study aimed to our experiences with kidney transplant recipients diagnosed with COVID-19. MATERIAL AND METHODS: Kidney transplant recipients diagnosed with COVID-19 from five major transplant centers in Istanbul, Turkey, were included in this retrospective cohort study. Patients were classified as having moderate or severe pneumonia for the analysis. The primary endpoint was all-cause mortality. The secondary endpoints were acute kidney injury, the average length of hospital stay, admission to intensive care, and mechanical ventilation. RESULTS: Forty patients were reviewed retrospectively over a follow-up period of 32 days after being diagnosed with COVID-19. Cough, fever, and dyspnea were the most frequent symptoms in all patients. The frequency of previous induction and rejection therapy was significantly higher in the group with severe pneumonia compared to the moderate pneumonia group. None of the patients using cyclosporine A developed severe pneumonia. Five patients died during follow-up in the intensive care unit. None of the patients developed graft loss during follow-up. DISCUSSION: COVID-19 has been seen to more commonly cause moderate or severe pneumonia in kidney transplant recipients. Immunosuppression should be carefully reduced in these patients. Induction therapy with lymphocyte-depleting agents should be carefully avoided in kidney transplant recipients during the pandemic period.


Gastrointestinal endoscopy operation-A potential transmission risk for SARS-CoV-2


'Shielded' anaesthetists and intensivists during the COVID-19 pandemic


title: Graphene-enhanced differentiation of neuroblastoma mouse cells mediated by poly-D-lysine

text: We compared the proliferation and differentiation of mouse neuroblastoma Neuro 2A cell line on single layer graphene and glass substrates. Quantitative and qualitative analysis of the cell proliferation and differentiation were performed, considering also the effect of a common adhesion factor, namely polylysine. We observed that on graphene substrates the cells proliferate faster with respect to glass; additionally, the presence of the adhesion factor enhances the difference and, remarkably, boosts the cell differentiation on the graphene-based interface. To understand the mechanism underlying a different cell behavior on the same adhesion coating, we carried out a physicochemical investigation of the studied interfaces (glass and graphene, bare and polylysine coated) by several techniques. In particular, we employed infrared spectroscopy to gain information on polylysine conformation, and atomic force microscopy force-distance curves to study adhesion properties at the surface. The results indicate that polylysine has an enhanced binding affinity for graphene, as well as a different molecular arrangement on graphene with respect to glass. These properties act as surface cues to trigger the cell response.


title: Covid-19 and Post Intensive Care Syndrome: A Call for Action

text: Although we are currently overwhelmed by the astonishing speed of infection of the Covid-19 pandemic, and the daily onslaught of new, and ever-worsening predictions, it is vital that we begin to prepare for the aftershocks of the pandemic. Prominent among this will be the cohort of post-intensive case survivors who have been mechanically ventilated and will like experience short- and medium-term consequences. The notion that patients surviving intensive care and mechanical ventilation for several weeks can be discharged home without further medical attention is a dangerous illusion. Post Intensive Care Syndrome and other severe conditions will require not only adequate screening but early rehabilitation and other interventions. Action must be taken now to prepare for this inevitable aftershock to the healthcare system.


COVID-19 and Rural Harm Reduction Challenges in the U.S. Southern Mountains


title: COVID-19 Collaborative Model for an Academic Hospital and Long-Term Care Facilities

text: The COVID-19 pandemic is devastating post-acute and long-term care (PA/LTC). As geriatricians practicing in PA/LTC and a regional academic medical center, we created this program for collaboration between academic medical centers and regional PA/LTC facilities. The mission of the Geriatric Engagement and Resource Integration in Post-Acute and Long-Term Care Facilities (GERI-PaL) program is to support optimal care of residents in PA/LTC facilities during the COVID-19 pandemic. There are 5 main components of our program: (1) Project ECHO; (2) nursing liaisons; (3) infection advisory consultation; (4) telemedicine consultation; and (5) resident social contact remote connections. Implementation of this program has had positive response from our local PA/LTC facilities. A key component of our program is our interprofessional team, which includes physicians and nursing, emergency response, and public health experts. With diverse professional backgrounds, our team members have created a new model for academic medical centers to collaborate with local PA/LTC facilities.


title: Automatic Text Summarization of COVID-19 Medical Research Articles using BERT and GPT-2

text: With the COVID-19 pandemic, there is a growing urgency for medical community to keep up with the accelerating growth in the new coronavirus-related literature. As a result, the COVID-19 Open Research Dataset Challenge has released a corpus of scholarly articles and is calling for machine learning approaches to help bridging the gap between the researchers and the rapidly growing publications. Here, we take advantage of the recent advances in pre-trained NLP models, BERT and OpenAI GPT-2, to solve this challenge by performing text summarization on this dataset. We evaluate the results using ROUGE scores and visual inspection. Our model provides abstractive and comprehensive information based on keywords extracted from the original articles. Our work can help the the medical community, by providing succinct summaries of articles for which the abstract are not already available.


docid: hilumpjw

title: "Building the plane as you fly": Simulation during the COVID-19 pandemic


title: Bedside Focused Cardiac Ultrasound in COVID-19 from the Wuhan Epicenter: The Role of Cardiac Point-of-Care Ultrasound, Limited Transthoracic Echocardiography, and Critical Care Echocardiography

text: BACKGROUND: Three cases of the application of focused cardiac ultrasound in patients with coronavirus disease 2019 are presented. METHODS: Cardiac point-of-care ultrasound, limited transthoracic echocardiography, and critical care echocardiography were applied in cases of heart failure, pulmonary embolism, and myocarditis with thrombus respectively. RESULTS: The impact on patient management and the global context of each presentation are discussed. CONCLUSIONS: Focused cardiac point-of-care ultrasound played an important, front-line role in the bedside management of patients during the COVID-19 pandemic in Wuhan, China.


title: COVID-19: how prepared are front-line healthcare workers in England?

text: National efforts are underway to prepare the UK National Health Service (NHS) for the COVID-19 pandemic; however, the efficacy of these interventions is unknown. In view of this, a cross-sectional survey of front-line healthcare workers (HCWs) at two large acute NHS hospital trusts in England was undertaken to assess their confidence and perceived level of preparedness for the virus. The survey found that there has been moderate success in readying HCWs to manage COVID-19, but that more still needs to be done, particularly in relation to educating HCWs about laboratory diagnostics.


docid: ylopbepi

title: The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention


title: Addressing Health Inequities Exacerbated by COVID-19 Among Youth With HIV: Expanding Our Toolkit

text: Adolescents and young adults, aged 13-24 years, are disproportionately affected by HIV in the United States. Youth with HIV (YHIV) face many psychosocial and structural challenges resulting in poor clinical outcomes including lower rates of medication adherence and higher rates of uncontrolled HIV. The Johns Hopkins Intensive Primary Care clinic, a longstanding HIV care program in Baltimore, Maryland, cares for 76 YHIV (aged 13-24 years). The multidisciplinary team provides accessible, evidenced-based, culturally sensitive, coordinated and comprehensive patient and family-centered HIV primary care. However, the ability to provide these intensive, in-person services was abruptly disrupted by the necessary institutional, state, and national coronavirus disease 2019 (COVID-19) mitigation strategies. As most of our YHIV are from marginalized communities (racial/ethnic, sexual, and gender minorities) with existing health and social inequities that impede successful clinical outcomes and increase HIV disparities, there was heightened concern that COVID-19 would exacerbate these inequities and amplify the known HIV disparities. We chronicle the structural and logistic approaches that our team has taken to proactively address the social determinants of health that will be negatively impacted by the COVID-19 pandemic, while supporting YHIV to maintain medication adherence and viral suppression.


title: Takotsubo cardiomyopathy triggered by SARS-CoV-2 infection in a critically ill patient

text: COVID-19 became a global pandemic in early 2020. While well known for its pulmonary manifestations, the virus also has a number of cardiac manifestations as well. Takotsubo syndrome has scarcely been reported in patients with COVID-19, but it is possible that the cytokine storm associated with the infection can trigger Takotsubo syndrome in patients with underlying risk factors for Takotsubo (emotional distress, physical distress, history of psychiatric disorders).


title: An Insight into the Sex Differences in COVID-19 Patients: What are the Possible Causes?

text: Studies have reported a sex bias in case fatalities of COVID-19 patients. Moreover, it is observed that men have a higher risk of developing a severe form of the disease compared to women, highlighting the importance of disaggregated data of male and female COVID-19 patients. On the other hand, other factors (eg, hormonal levels and immune functions) also need to be addressed due to the effects of sex differences on the outcomes of COVID-19 patients. An insight into the underlying causes of sex differences in COVID-19 patients may provide an opportunity for better care of the patients or prevention of the disease. The current study reviews the reports concerning with the sex differences in COVID-19 patients. It is explained how sex can affect angiotensin converting enzyme-2 (ACE2), that is a key component for the pathogenesis of COVID-19, and summarized the gender differences in immune responses and how sex hormones are involved in immune processes. Furthermore, the available data about the impact of sex hormones on the immune functions of COVID-19 cases are looked into.


title: Managing haematology and oncology patients during the COVID-19 pandemic: interim consensus guidance

text: INTRODUCTION: A pandemic coronavirus, SARS-CoV-2, causes COVID-19, a potentially life-threatening respiratory disease. Patients with cancer may have compromised immunity due to their malignancy and/or treatment, and may be at elevated risk of severe COVID-19. Community transmission of COVID-19 could overwhelm health care services, compromising delivery of cancer care. This interim consensus guidance provides advice for clinicians managing patients with cancer during the pandemic. MAIN RECOMMENDATIONS: During the COVID-19 pandemic: In patients with cancer with fever and/or respiratory symptoms, consider causes in addition to COVID-19, including other infections and therapy-related pneumonitis. For suspected or confirmed COVID-19, discuss temporary cessation of cancer therapy with a relevant specialist. Provide information on COVID-19 for patients and carers. Adopt measures within cancer centres to reduce risk of nosocomial SARS-CoV-2 acquisition; support population-wide social distancing; reduce demand on acute services; ensure adequate staffing; and provide culturally safe care. Measures should be equitable, transparent and proportionate to the COVID-19 threat. Consider the risks and benefits of modifying cancer therapies due to COVID-19. Communicate treatment modifications, and review once health service capacity allows. Consider potential impacts of COVID-19 on the blood supply and availability of stem cell donors. Discuss and document goals of care, and involve palliative care services in contingency planning. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT: This interim consensus guidance provides a framework for clinicians managing patients with cancer during the COVID-19 pandemic. In view of the rapidly changing situation, clinicians must also monitor national, state, local and institutional policies, which will take precedence. ENDORSED BY: Australasian Leukaemia and Lymphoma Group; Australasian Lung Cancer Trials Group; Australian and New Zealand Children's Haematology/Oncology Group; Australia and New Zealand Society of Palliative Medicine; Australasian Society for Infectious Diseases; Bone Marrow Transplantation Society of Australia and New Zealand; Cancer Council Australia; Cancer Nurses Society of Australia; Cancer Society of New Zealand; Clinical Oncology Society of Australia; Haematology Society of Australia and New Zealand; National Centre for Infections in Cancer; New Zealand Cancer Control Agency; New Zealand Society for Oncology; and Palliative Care Australia.


title: A realistic two-strain model for MERS-CoV infection uncovers the high risk for epidemic propagation

text: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) causes severe acute respiratory illness with a case fatality rate (CFR) of 35,5%. The highest number of MERS-CoV cases are from Saudi-Arabia, the major worldwide hotspot for this disease. In the absence of neither effective treatment nor a ready-to-use vaccine and with yet an incomplete understanding of its epidemiological cycle, prevention and containment measures can be derived from mathematical models of disease epidemiology. We constructed 2-strain models to predict past outbreaks in the interval 2012-2016 and derive key epidemiological information for Macca, Madina and Riyadh. We approached variability in infection through three different disease incidence functions capturing social behavior in response to an epidemic (e.g. Bilinear, BL; Non-monotone, NM; and Saturated, SAT models). The best model combination successfully anticipated the total number of MERS-CoV clinical cases for the 2015-2016 season and accurately predicted both the number of cases at the peak of seasonal incidence and the overall shape of the epidemic cycle. The evolution in the basic reproduction number (R0) warns that MERS-CoV may easily take an epidemic form. The best model correctly captures this feature, indicating a high epidemic risk (1≤R0≤2,5) in Riyadh and Macca and confirming the alleged co-circulation of more than one strain. Accurate predictions of the future MERS-CoV peak week, as well as the number of cases at the peak are now possible. These results indicate public health agencies should be aware that measures for strict containment are urgently needed before new epidemics take off in the region.