title: A climatologic investigation of the SARS-CoV outbreak in Beijing, China

text: The first cases of severe acute respiratory syndrome (SARS) were identified in November 2002, in Guangdong Province, China. The epidemic spread rapidly within China and internationally, with 8454 recorded infections and 792 deaths by June 15, 2003. Temperature, relative humidity, and wind velocity were the three key meteorological determinants affecting the transmission of SARS. The peak spread of SARS occurred at a mean temperature of 16.9 degrees C (95% CI, 10.7 degrees C to 23.1 degrees C), with a mean relative humidity of 52.2% (95% CI, 33.0% to 71.4%) and wind speed of 2.8 ms(-1) (95% CI, 2.0 to 3.6 ms(-1)). In northern China, these conditions are most likely to occur in the spring and suggest that SARS has a seasonal nature akin to viruses such as influenza and the common cold. A regression equation (Y=218.692-0.698X(t)-2.043X(h)+2.282X(w)) was derived to represent the optimal climatic conditions for the 2003 SARS epidemic. Further investigations in other regions are necessary to verify these results.


Making Decisions in a COVID-19 World


title: Case Report: Right Bundle Brunch Block and QTc Prolongation in a Patient with COVID-19 Treated with Hydroxychloroquine

text: Novel coronavirus disease (COVID-19) is a highly contagious disease caused by severe acute respiratory distress syndrome coronavirus-2 that has resulted in the current global pandemic. Currently, there is no available treatment proven to be effective against COVID-19, but multiple medications, including hydroxychloroquine (HCQ), are used off label. We report the case of a 60-year-old woman without any cardiac history who developed right bundle brunch block and critically prolonged corrected electrocardiographic QT interval (QTc 631 ms) after treatment for 3 days with HCQ, which resolved on discontinuation of the medication. This case highlights a significant and potentially life-threatening complication of HCQ use.


title: PAP therapy increases the risk of transmission of COVID-19

text: Positive airway pressure (PAP) therapy is an open system that can generate contact, droplet, and airborne COVID-19 thereby increasing the risk of transmission of COVID-19 like other procedures such as tracheal intubation, noninvasive ventilation, and cardiopulmonary resuscitation. Medically prudent recommendations have been established for home use of PAP therapy in asymptomatic patients and patients with suspected or confirmed COVID-19. Recommendations for sleep clinics and sleep laboratory activities are also discussed as well as the emergency use of PAP devices as a substitute for ventilation.


Rapid Development of Resident-Led Procedural Response Teams to Support Patient Care During the Coronavirus Disease 2019 Epidemic: A Surgical Workforce Activation Team


Author's reply to "To the editor - Is it really COVID-19 infection?"


Is low sodium intake a risk factor for severe and fatal COVID-19 infection?


title: Heat-Related Deaths - United States, 2004-2018

text: Deaths attributable to natural heat exposure, although generally considered preventable (1), represent a continuing public health concern in the United States. During 2004-2018, an average of 702 heat-related deaths occurred in the United States annually. To study patterns in heat-related deaths by age group, sex, race/ethnicity, and level of urbanization, and to explore comorbid conditions associated with deaths resulting from heat exposure, CDC analyzed nationally comprehensive mortality data from the National Vital Statistics System (NVSS).* The rate of heat-related mortality tended to be higher among males, persons aged ≥65 years, non-Hispanic American Indian/Alaska Natives, and persons living in noncore nonmetropolitan and large central metropolitan counties. Natural heat exposure was a contributing cause of deaths attributed to certain chronic medical conditions and other external causes. Preparedness and response initiatives directed toward extreme heat events, currently underway at local, state, and national levels, can contribute to reducing morbidity and mortality associated with natural heat exposure. Successful public health interventions to mitigate heat-related deaths include conducting outreach to vulnerable communities to increase awareness of heat-related symptoms and provide guidance for staying cool and hydrated, particularly for susceptible groups at risk such as young athletes and persons who are older or socially isolated (2). Improved coordination across various health care sectors could inform local activities to protect health during periods of high heat. For instance, jurisdictions can monitor weather conditions and syndromic surveillance data to guide timing of risk communication and other measures (e.g., developing and implementing heat response plans, facilitating communication and education activities) to prevent heat-related mortality in the United States. CDC also recommends that federal, state, local, and tribal jurisdictions open cooling centers or provide access to public locations with air conditioning for persons in need of a safe, cool, environment during hot weather conditions. In light of the coronavirus disease 2019 (COVID-19) pandemic, CDC updated its guidance on the use of cooling centers to provide best practices (e.g., potential changes to staffing procedures, separate areas for persons with symptoms of COVID-19, and physical distancing) to reduce the risk for introducing and transmitting SARS COV-2, the virus that causes COVID-19, into cooling centers.§.


Adrenal Vascular Changes in COVID-19 Autopsies


title: Case series of coronavirus (SARS-CoV-2) in a military recruit school: clinical, sanitary and logistical implications

text: INTRODUCTION: A new coronavirus, called Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2), has emerged from China in late 2019 and has now caused a worldwide pandemic. The impact of COVID-19 has not been described so far in a military setting. We therefore report a case series of infected patients in a recruit school in Switzerland and the herein associated challenges. METHODS: Retrospective review of COVID-19 cases among Swiss Armed Forces recruits in the early weeks of SARS-CoV-2 pandemic in the canton of Ticino, the southernmost canton of Switzerland. Positive cases were defined with two positive PCR testing for SARS-CoV-2 from nasopharyngeal swabs. Serological testing was performed with a commercially available kit according to manufacturers' instructions. RESULTS: The first case was likely contaminated while skiing during weekend permission. He became symptomatic 4 days later, tested positive for SARS-CoV-2 and was put into isolation. He showed complete symptom resolution after 48 hours. Quarantine was ordered for all recruits with close contact in the past 2 days, a total of 55 persons out of 140 in the company. Seven out of nine recruits in one particular quarantine room became mildly symptomatic. SARS-CoV-2 PCR was positive in one of them. Seven days after initial diagnosis, the index patient and the other one from the quarantine retested positive for SARS-CoV-2, although they had been completely asymptomatic for over 96 hours. Serological testing revealed positive for both patients. All others showed negative IgM and IgG. CONCLUSIONS: Young healthy recruits often showed a mild course of COVID-19 with rapid symptom decline but were persistent SARS-CoV-2 carriers. This illustrates how asymptomatic patients may be responsible for covert viral transmission. An early and prolonged establishment of isolation and quarantine for patients and close contacts is essential to slow down the spread of SARS-CoV-2, especially in the confined space of a military environment.


Policy opportunities to enhance sharing for pandemic research


title: Spectrum of COVID-19 in Children

text: The prevalence of coronavirus disease 2019 (COVID-19) is lower in children compared to adults. Children contribute to 1-5% of all COVID-19 cases (1) . A recent study from China reported that 171(12.3%) of 1391 children with suspected disease had confirmed COVID-19 infection (2) . As of May 15, 2020, there are 33,241 children with COVID-19 in the United States (3) . The most common symptoms in children with confirmed and suspected COVID-19 include fever and cough followed by diarrhea, and abdominal pain.


A plea for avoiding systematic intubation in severely hypoxemic patients with COVID-19-associated respiratory failure


Creating a COVID-19 surge clinic to offload the emergency department


title: The potential of drug repositioning as a short-term strategy for the control and treatment of COVID-19 (SARS-CoV-2): a systematic review

text: The novel human coronavirus (SARS-CoV-2), the causative agent of COVID-19, has quickly become a threat to the public health and economy worldwide. Despite the severity of some cases, there are no current pathogen-specific antivirals available to treat the disease. Therefore, many studies have focused on the evaluation of the anti-SARS-CoV-2 activity of clinically available drugs. Here, we conducted a systematic review to describe the drug repositioning strategy against SARS-CoV-2 and to discuss the clinical impact of this approach in the current pandemic context. The systematic review was performed on March 23, 2020, using PubMed/MEDLINE, Scopus, Cochrane Library, and Biblioteca Virtual de Saúde (BVS). The data were summarized in tables and critically analyzed. After the database search, 12 relevant studies were identified as eligible for the review. Among the drugs reported in these studies, 57 showed some evidence of antiviral activity. Antivirals, especially antiretrovirals, are the main class of therapeutic agents evaluated against COVID-19. Moreover, studies have reported the anti-SARS-CoV-2 activity of antitumor (16%; 9/57), antimalarial (7%, 4/57), and antibacterial (5%; 3/57) agents. Additionally, seven pharmacological agents (chloroquine, tetrandrine, umifenovir (arbidol), carrimycin, damageprevir, lopinavir/ritonavir) are in phase IV of clinical trials. Due to the evidence of the anti-SARS-CoV-2 activity of various clinically available agents, drug repositioning stands out as a promising strategy for a short-term response in the fight against the novel coronavirus.


Invited commentary on the letter "The COVID-19 crisis: A unique opportunity to expand dermatology to underserved populations"


title: Robotics Utilization for Healthcare Digitization in Global COVID-19 Management

text: This paper describes the evolving role of robotics in healthcare and allied areas with special concerns relating to the management and control of the spread of the novel coronavirus disease 2019 (COVID-19). The prime utilization of such robots is to minimize person-to-person contact and to ensure cleaning, sterilization and support in hospitals and similar facilities such as quarantine. This will result in minimizing the life threat to medical staff and doctors taking an active role in the management of theCOVID-19 pandemic. The intention of the present research is to highlight the importance of medical robotics in general and then to connect its utilization with the perspective of COVID-19 management so that the hospital management can direct themselves to maximize the use of medical robots for various medical procedures. This is despite the popularity of telemedicine, which is also effective in similar situations. In essence, the recent achievement of the Korean and Chinese health sectors in obtaining active control of the COVID-19 pandemic was not possible without the use of state of the art medical technology.


Traditional Chinese and Western Medicines Jointly Beat COVID-19 Pandemic


docid: wfnsibyg

title: Oncology Nursing During a Pandemic: Critical Reflections in the Context of COVID-19

text: OBJECTIVES: To provide a critical reflection of COVID-19 in the context of oncology nursing and provide recommendations for caring for people affected by cancer during this pandemic. DATA SOURCES: Electronic databases, including CINAHL, MEDLINE, PsychINFO, Scopus, professional web sites, and grey literature were searched using Google Scholar. CONCLUSION: Nurses are key stakeholders in developing and implementing policies regarding standards of care during the COVID-19 pandemic. This pandemic poses several challenges for oncology services. Oncology nurses are providing a pivotal role in the care and management of the novel COVID-19 in the year landmarked as the International Year of the Nurse. IMPLICATIONS FOR NURSING PRACTICE: It is too early to tell what shape this pandemic will take and its impact on oncology care. However, several important clinical considerations have been discussed to inform oncology nursing care and practice.


title: Telemedicine Platforms and Their Use in the Coronavirus Disease-19 Era to Deliver Comprehensive Vascular Care

text: Implementation of telemedicine for patient encounters optimizes personal safety and allows for continuity of patient care. Embracing telehealth reduces the use of personal protective equipment (PPE) and other resources consumed during in-person visits. The use of telehealth has increased to historic levels in response to the coronavirus disease 2019 (COVID-19) pandemic. Telehealth may be a key modality to fight against COVID-19, allowing us to take care of patients, conserve PPE, and protect healthcare workers all while minimizing the risk of viral spread. We must not neglect vascular health issues while the coronavirus pandemic continues to flood many hospitals and keep people confined to their homes. Patients are not immune to diseases and illnesses such as stroke, critical limb ischemia, and deep vein thrombosis while being confined to their homes and afraid to visit hospitals. Emerging from the COVID-19 crisis, incorporating telemedicine into routine medical care is transformative. By leveraging digital technology, the authors discuss their experience with the implementation, workflow, coding, and reimbursement issues of telehealth during the COVID-19 era.


Ethics and Resource Scarcity: ASCO Recommendations for the Oncology Community During the COVID-19 Pandemic


Applying the Popular Opinion Leader Intervention for HIV to COVID-19


title: Predicting Dynamics on Networks Hardly Depends on the Topology

text: Processes on networks consist of two interdependent parts: the network topology, consisting of the links between nodes, and the dynamics, specified by some governing equations. This work considers the prediction of the future dynamics on an unknown network, based on past observations of the dynamics. For a general class of governing equations, we propose a prediction algorithm which infers the network as an intermediate step. Inferring the network is impossible in practice, due to a dramatically ill-conditioned linear system. Surprisingly, a highly accurate prediction of the dynamics is possible nonetheless: Even though the inferred network has no topological similarity with the true network, both networks result in practically the same future dynamics.


title: Culture Matters in Communicating the Global Response to COVID-19

text: Current communication messages in the COVID-19 pandemic tend to focus more on individual risks than community risks resulting from existing inequities. Culture is central to an effective community-engaged public health communication to reduce collective risks. In this commentary, we discuss the importance of culture in unpacking messages that may be the same globally (physical/social distancing) yet different across cultures and communities (individualist versus collectivist). Structural inequity continues to fuel the disproportionate impact of COVID-19 on black and brown communities nationally and globally. PEN-3 offers a cultural framework for a community-engaged global communication response to COVID-19.


title: The potential impacts of obesity on COVID-19

text: Obese patients are at increased risk of exacerbations from viral respiratory infections. During the H1N1 pandemic, obesity was associated with an increased risk of influenza-associated intensive care unit (ICU) admission and death, longer duration of mechanical ventilation, and longer duration of ICU and hospital length of stay compared with the non-obese. These observations have raised a concern about the correlation between obesity and the current COVID-19 pandemic. In this review, we have outlined the potential impacts of obesity on respiratory physiology and the function of both innate and adaptive immune responses. Also, it has been clearly illustrated that obese patients are potentially more vulnerable to COVID-19 and more contagious than lean patients. The comorbidities associated with obesity were found to be correlated with a severe clinical course of COVID-19 and increased mortality and high BMI has been shown to be correlated with hospitalisation, the need for mechanical ventilation and non-survival. The review also sheds light on the challenges that obese patients pose for healthcare providers inside and outside ICUs.


title: Novel Coronavirus Pneumonia (COVID-19) Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section CT Features During Recovery

text: BACKGROUND: To retrospectively analyze the evolution of clinical features and thin-section CT imaging of novel coronavirus pneumonia (COVID-19) in 17 discharged patients. METHODS: Serial thin-section CT scans of 17 discharged patients with COVID-19 were obtained during recovery. Longitudinal changes of clinical parameters and CT pattern were documented in all patients during 4 weeks since admission. CT score was used to evaluate the extent of the disease. RESULTS: There was a marked improvement of fever, lymphocytes count, C-reactive protein and erythrocyte sedimentation rate within the first two weeks since admission. However, the mean CT score rapidly increased from the 1st to 3rd week, with a top score of 8.2 obtained in the 2nd week. During the 1st week, the main CT pattern was ground-glass opacities (GGO,76.5%). The frequency of GGO (52.9%) decreased in the 2nd week. Consolidation and mixed patterns (47.0%) were noted in the 2nd week. Thereafter, consolidations generally dissipated into GGO and the frequency of GGO increased in the 3rd week (76.5%) and 4th week (71.4%). Opacities were mainly located in the peripheral (76.5%), subpleural (47.1%) zones of the lungs, and presented as focal (35.3%) or multifocal (29.4%) in the 1st week and became more diffuse in the 2nd (47.1%) and 3rd week (58.8%), then showed reduced extent in 4th week (50%). CONCLUSIONS: The progression course of CT pattern was later than the clinical parameters within the first two weeks since admission; however, there was a synchronized improvement in both clinical and radiologic features in the 4th week.


title: Which curve provides the best explanation of the growth in confirmed COVID-19 cases in Chile?

text: OBJECTIVE: to explore the best type of curve or trend model that could explain the epidemiological behavior of the infection by COVID-19 and derive the possible causes that contribute to explain the corresponding model and the health implications that can be inferred. METHOD: data were collected from the COVID-19 reports of the Department of Epidemiology, Ministry of Health, Chile. Curve adjustment studies were developed with the data in four different models: quadratic, exponential, simple exponential smoothing, and double exponential smoothing. The significance level used was α≤0.05. RESULTS: the curve that best fits the evolution of the accumulated confirmed cases of COVID-19 in Chile is the doubly-smoothed exponential curve. CONCLUSION: the number of infected patients will continue to increase. Chile needs to remain vigilant and adjust the strategies around the prevention and control measures. The behavior of the population plays a fundamental role. We suggest not relaxing restrictions and further improving epidemiological surveillance. Emergency preparations are needed and more resource elements need to be added to the current health support. This prediction is provisional and depends on keeping all intervening variables constant. Any alteration will modify the prediction.


Attitude to telemedicine in the times of COVID 19 pandemic: Opinion of medical practitioners from India


title: Potential risks of SARS-CoV-2 infection on reproductive health

text: The outbreak of 2019 novel coronavirus disease (COVID-19) has become a major pandemic threat worldwide. Such a public health emergency can greatly impact various aspects of people's health and lives. This paper focuses on its potential risks for reproductive health, including the reproductive system and its functioning, as well as gamete and embryo development, which could be affected by the virus itself, drug treatments, chemical disinfectants and psychological effects related to panic during the COVID-19 outbreak.


Alert for SARS-CoV-2 infection caused by fecal aerosols in rural areas in China


Funders' Efforts: Aging And Health, COVID-19


title: Serology for SARS-CoV-2: Apprehensions, opportunities, and the path forward

text: Serological testing for SARS-CoV-2 has enormous potential to contribute to COVID-19 pandemic response efforts. However, the required performance characteristics of antibody tests will critically depend on the use case (individual-level vs. population-level).


CIDO, a community-based ontology for coronavirus disease knowledge and data integration, sharing, and analysis


title: Estimation of Renin-Angiotensin-Aldosterone-System (RAAS)-Inhibitor effect on COVID-19 outcome: A Meta-analysis

text: BACKGROUND AND RATIONALE: Some studies of hospitalized patients suggested that the risk of death and/or severe illness due to COVID-19 is not associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin II receptor type 1 blockers (ARBs). Nevertheless, some controversy still exists and there is limited information of the ACEIs/ARBs effect size on COVID-19 prognosis. AIM AND METHODS: We aimed to measure the effect of ACEIs and/or ARBs on COVID-19 severe clinical illness by a meta-analysis. Literature search included all studies published since the COVID-19 outbreak began (December 2019) until May 9, 2020. We analyzed information from studies that included tested COVID-19 patients with arterial hypertension as comorbidity prior to hospital admission and history of taking ACEIs, ARBs, or ACEIs/ARBs. RESULTS: We included 16 studies that involved 24,676 COVID-19 patients, and we compared patients with critical (nâ¯=â¯4134) vs. non-critical (nâ¯=â¯20,542) outcomes. The overall assessment by estimating random effects shows that the use of ACEIs/ARBs is not associated with higher risk of in-hospital-death and/or severe illness among hypertensive patients with COVID-19 infection. On the contrary, effect estimate shows an overall protective effect of RAAS inhibitors/blockers (ACEIs, ARBs, and/or ACEIs/ARBs) with â¼ 23 % reduced risk of death and/or critical disease (OR: 0.768, 95%CI: 0.651-0.907, p=0.0018). The use of ACEIs (OR:0.652, 95%CI:0.478-0.891, p=0.0072) but not ACEIs/ARBs (OR:0.867, 95%CI:0.638-1.179, p =NS) or ARBs alone (OR:0.810, 95%CI:0.629-1.044, p=NS) may explain the overall protection displayed by RAAS intervention combined. CONCLUSION: RAAS inhibitors might be associated with better COVID-19 prognosis.


title: Public Willingness to Get Vaccinated Against COVID-19: How AI-Developed Vaccines Can Affect Acceptance

text: Vaccines for COVID-19 are currently under clinical trials. These vaccines are crucial for eradicating the novel coronavirus. Despite the potential, there exist conspiracies related to vaccines online, which can lead to vaccination hesitancy and, thus, a longer-standing pandemic. We used a between-subjects study design (N=572 adults in the US and UK) to understand the public willingness towards vaccination against the novel coronavirus under various circumstances. Our survey findings suggest that people are more reluctant to vaccinate their children compared to themselves. Explicitly stating the high effectiveness of the vaccine against COVID-19 led to an increase in vaccine acceptance. Interestingly, our results do not indicate any meaningful variance due to the use of artificial intelligence (AI) in developing vaccines, if these systems are described to be in use alongside human researchers. We discuss the public's expectation of local governments in assuring the safety and effectiveness of a future COVID-19 vaccine.


Letter to the Editor regarding "COVID-19 and Neurosurgical Education in Africa"; How the pandemic is changing neurosurgical education in Morocco


title: Test Agreement Between Roche Cobas 6800 and Cepheid GeneXpert Xpress SARS-CoV-2 Assays at High Cycle Threshold Ranges

text: The SARS-CoV-2 pandemic has changed the face of the globe and upended the daily lives of billions. .


title: Maintaining comprehensive pharmacy services during a pandemic: recommendations from a designated COVID-19 facility

text: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.


Hearing the Call of Duty: What We Must Do to Allow Medical Students to Respond to the COVID-19 Pandemic


title: On the Pharmacy Radar: COViD-19 and Older People

text: The COVID-19 pandemic presents many medical and social issues for older people. Presented here is a range of information arising from related areas that have impact upon the safety and efficacy of drug therapy in the context of COVID-19. Issues include pharmacy practice, clinical therapeutics, and possible new treatments for the virus. More information will be published in coming issues of The Senior Care Pharmacist.


title: Arterial and venous abdominal thrombosis in a 79-year-old woman with COVID-19 pneumonia

text: As coronavirus pandemic continue to spread over the world, we have to be aware of potential complications on hospitalized patients. We report a case of a 79-year-old woman with COVID-19 pneumonia complicated by combined arterial and venous thrombosis of upper mesenteric vessels. As unenhanced chest-CT scan plays a key-role in managing the COVID-19 pandemic we should pay attention to indirect signs of thrombosis.


Optimizing provision of extracorporeal life support during the COVID-19 pandemic: practical considerations for Canadian jurisdictions


title: Challenges and recommendations for mental health providers during the COVID-19 pandemic: the experience of China's First University-based mental health team

text: Coronavirus Disease is impacting the entire world. As the first country that has needed to confront this disease, China has responded with unprecedented and hugely successful public health initiatives. Almost simultaneous with the awareness of the potential for widespread loss of life, the first Chinese university recognizing the likely psychological impacts of COVID-19, assembled the first university-based professional team to offer pandemic-related mental health services to the Chinese public. This paper describes the work that we provided and the challenges encountered. The challenges are described in four contexts: the organizational/systemic level, the technical perspective, the therapeutic process, and the ethical aspects. We also provide recommendations on what we can do in the short term, and future improvements that can be made.


Money injection for public services


Striving as a nation to become an academic leader in the COVID-19 crisis


title: Restructuring Electrophysiology During the COVID-19 Pandemic: A Practical Guide from a New York City Hospital Network

text: The COVID-19 crisis is a global pandemic of a novel infectious disease with far-ranging public health implications. With regard to cardiac electrophysiology (EP) services, we discuss the "real-world" challenges and solutions that have been essential for efficient and successful (i) ramping down of standard clinical practice patterns and (ii) pivoting of workflow processes to meet the demands of this pandemic. The aims of these recommendations are to outline: (1) essential practical steps to approaching procedures, as well as outpatient and inpatient care of EP patients, with relevant examples, (2) successful strategies to minimize exposure risk to patients and clinical staff while also balancing resource utilization, (3) challenges related to redeployment and restructuring of clinical and support staff, and (4) considerations regarding continued collaboration with clinical and administrative colleagues in order to implement these changes. While process changes will vary across practices and hospital systems, we believe that these experiences from four different EP sections in a large New York city hospital network currently based in the global epicenter of the COVID-19 pandemic will prove useful for other EP practices adapting their own practices in preparation for local surges.


Addressing COVID-19 fear to improve clinic attendance for patients with wet age-related macular degeneration


title: Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry

text: This study aimed to assess and compare the immediate stress and psychological impact experienced by people with and without psychiatric illnesses during the peak of 2019 coronavirus disease (COVID-19) epidemic with strict lockdown measures. Seventy-six psychiatric patients and 109 healthy control subjects were recruited from Chongqing, China and completed a survey on demographic data, physical symptoms during the past 14 days and a range of psychiatric symptoms using the Impact of Event Scale-Revised (IES-R), Depression, Anxiety and Stress Scale (DASS-21) and Insomnia Severity Index (ISI). IES-R measures PTSD symptoms in survivorship after an event. DASS-21 is based on tripartite model of psychopathology that comprise a general distress construct with distinct characteristics. The mean IES-R, DASS-21 anxiety, depression and stress subscale and ISI scores were higher in psychiatric patients than healthy controls (p < 0.001). Serious worries about their physical health, anger and impulsivity and intense suicidal ideation were significantly higher in psychiatric patients than healthy controls (p < 0.05). More than one-third of psychiatric patients might fulfil the diagnostic criteria post-traumatic stress disorder (PTSD). More than one-quarter of psychiatric patients suffered from moderately severe to severe insomnia. Respondents who reported no change, poor or worse physical health status and had a psychiatric illness were significantly more likely to have higher mean IES-R, DASS depression, anxiety and stress subscale scores and ISI scores (p < 0.05). This study confirms the severity of negative psychological impact on psychiatric patients during the COVID-19 epidemic with strict lockdown measures. Understanding the psychological impact on psychiatric patients during the COVID-19 pandemic has the potential to provide insight into how to develop a new immunopsychiatry service. Further research is required to compare pro-inflammatory cytokines between psychiatric patients and healthy controls during the pandemic.


Five recommendations for loco-regional treatments of hepatocellular carcinoma during the COVID-19 pandemic


title: Otolaryngology Community Operating With Collaboration and Productive Resolve During the COVID-19 Pandemic

text: In the wake of the tremendous fallout from the COVID-19 pandemic that was mostly negative, I find great optimism and encouragement from the ability of society at all levels to focus on a common problem with a collaborative and productive resolve to address this millennial event. The rapid response was made possible by marshaling the resources available from many sources, not the least of which was the medical association community. It has been particularly gratifying to work hand-in-hand with our specialty societies within and outside the otolaryngology family to produce educational and scientific information that is consistent and that has and will continue to affect policy favorably. The groups that enable these inspirational collaborative accomplishments through their dedication, innovation, and imagination are the practicing physicians who have given freely and generously of their time and talents to help the whole health care community provide the most up-to-date care possible.


title: Guillain-Barré syndrome in a patient with antibodies against SARS-COV-2

text: There are now several reports on neurologic features of SARS-CoV-2 infection.1 2 In a recent study of 214 patients with COVID-19, 78 (36.4%) patients had neurological manifestations, including headache, dizziness, acute cerebrovascular diseases, and impaired consciousness.2.


title: Diagnosis and treatment of coronavirus disease 2019 (COVID-19): Laboratory, PCR, and chest CT imaging findings

text: Since December 2019, more than 3 million cases of coronavirus disease 2019 (COVID-19) and about 200,000 deaths have been reported worldwide. The outbreak of this novel disease has become a global health emergency and continues to rapidly spread around the world. Based on the clinical data, approved cases are divided into four classes including mild, moderate, severe, and critical. About 5% of cases were considered critically ill and 14% were considered to have the severe classification of the disease. In China, the fatality rate of this infection was about 4%. This review focuses on currently available information on the etiology, clinical symptoms, diagnosis, and mechanism of action of COVID-19. Furthermore, we present an overview of diagnostic approaches and treatment of this disease according to available findings. This review paper will help the physician to diagnose and successfully treat COVID-19.


Breaking Social Isolation Amidst COVID-19: A Viewpoint on Improving Access to Technology in Long-Term Care Facilities


title: Immune-related factors associated with pneumonia in 127 children with coronavirus disease 2019 in Wuhan

text: OBJECTIVE: Information regarding the association of immune-related factors with pneumonia in children with coronavirus disease 2019 (COVID-19) is scarce. This study aims to summarize the immune-related factors and their association with pneumonia in children with COVID-19. METHODS: Children with COVID-19 at Wuhan Children's Hospital from 28 January to 12 March 2020 were enrolled. Pneumonia due to causes other than COVID-19 were excluded. The clinical and laboratory information including routine blood tests, blood biochemistry, lymphocyte subsets, immunoglobulins, cytokines, and inflammatory factors were analyzed retrospectively in 127 patients. Normal ranges and mean values of laboratory markers were applied as parameters for logistic regression analyses of their association with pneumonia. RESULTS: In nonintensive care unit patients, 48.8% and 22.4% of patients had increased levels of procalcitonin and hypersensitive C-reactive protein (hs-CRP) respectively. A total 12.6% and 18.1% of patients had decreased levels of immunoglobulin A (IgA) and interleukin 10 (IL-10), respectively. Approximately 65.8% of patients had pneumonia. These patients had decreased levels of globulin (odds ratio [OR], 3.13; 95% confidence interval [CI] 1.41-6.93; P = .005), IgA (OR, 4.00; 95% CI, 1.13-14.18; P = .032), and increased levels of hs-CRP (OR, 3.14; 95% CI, 1.34-7.36; P = .008), procalcitonin (OR, 3.83; 95% CI, 2.03-7.24; P < .001), IL-10 (OR, 7.0; 95% CI, 1.59-30.80; P = .010), and CD4+ CD25+ T lymphocyte less than 5.0% (OR, 1.93; 95% CI, 1.04-3.61; P = 0.038). CONCLUSION: Decreased IgA and CD4+ CD25+ T lymphocyte percentage, and increased hs-CRP, procalcitonin, and IL-10 were associated with pneumonia, suggesting that the immune-related factors may participate in the pathogenesis of pneumonia in children with COVID-19.


title: Understanding the age divide in COVID-19: why are children overwhelmingly spared?

text: The rapid emergence and subsequent global dissemination of SARS-CoV-2 disease (COVID-19) has resulted in over 4 million cases worldwide. The disease has a marked predilection for adults, and children are relatively spared. Understanding the age-based differences in pathophysiological pathways and processes relevant to the onset and progression of disease both in the clinical course and in experimental disease models may hold the key to the identification of therapeutic targets. The differences in the clinical course are highlighted by the lack of progression of the SARS-CoV-2 infection beyond mild symptoms in a majority of children, whereas in adults the disease progresses to acute lung injury and an acute respiratory distress syndrome (ARDS)-like phenotype with high mortality. The pathophysiological mechanisms leading to decreased lung injury in children may involve the decreased expression of the mediators necessary for viral entry into the respiratory epithelium and differences in the immune system responses in children. Specifically, decreased expression of proteins, including angiotensin-converting enzyme 2 (ACE2) and Transmembrane Serine Protease 2 (TMPRSS2) in the airway epithelium in children may prevent viral entry. The immune system differences may include a relative preponderance of CD4+ T cells, decreased neutrophil infiltration, decreased production of proinflammatory cytokines, and increased production of immunomodulatory cytokines in children compared with adults. Notably, the developing lung in children may have a greater capacity to recover and repair after viral infection. Understanding the relative contributions of the above processes to the protective phenotype in the developing lung can guide the trial of the appropriate therapies in adults.


Personal protective equipment (PPE) for vitreoretinal surgery during COVID-19


title: Quantifying the Impact of Making and Breaking Interface Habits

text: The frequency with which people interact with technology means that users may develop interface habits, i.e. fast, automatic responses to stable interface cues. Design guidelines often assume that interface habits are beneficial. However, we lack quantitative evidence of how the development of habits actually affect user performance and an understanding of how changes in the interface design may affect habit development. Our work quantifies the effect of habit formation and disruption on user performance in interaction. Through a forced choice lab study task (n=19) and in the wild deployment (n=18) of a notificationdialog experiment on smartphones, we show that people become more accurate and faster at option selection as they develop an interface habit. Crucially this performance gain is entirely eliminated once the habit is disrupted. We discuss reasons for this performance shift and analyse some disadvantages of interface habits, outlining general design patterns on how to both support and disrupt them.Keywords: Interface habits, user behaviour, breaking habit, interaction science, quantitative research.


title: Reconfiguring health services to reduce the workload of caregivers during the COVID-19 outbreak using an open-source scalable platform for remote digital monitoring and coordination of care in hospital Command Centres

text: The Covid-19 outbreak threatens to saturate healthcare systems in most Western countries. We describe how digital technologies may be used to automatically and remotely monitor patients at home. Patients answer simple self-reported questionnaires and their data is transmitted, in real time, to a Command Centre in the nearest reference hospital. Patient reported data are automatically filtered by algorithms to identify those with early warning signs. Open-source code of all software components required to deploy the remote digital monitoring platform and Command Centres is available.


title: Statewide Interventions and Covid-19 Mortality in the United States: An Observational Study

text: BACKGROUND: Social distancing is encouraged to mitigate viral spreading during outbreaks. However, the association between distancing and patient-centered outcomes in Covid-19 has not been demonstrated. In the United States social distancing orders are implemented at the state level with variable timing of onset. Emergency declarations and school closures were two early statewide interventions. METHODS: To determine whether later distancing interventions were associated with higher mortality, we performed a state-level analysis in 55,146 Covid-19 non-survivors. We tested the association between timing of emergency declarations and school closures with 28-day mortality using multivariable negative binomial regression. Day 1 for each state was set to when they recorded ≥ 10 deaths. We performed sensitivity analyses to test model assumptions. RESULTS: At time of analysis, 37 of 50 states had ≥ 10 deaths and 28 follow-up days. Both later emergency declaration (adjusted mortality rate ratio [aMRR] 1.05 per day delay, 95% CI 1.00 to 1.09, p=0.040) and later school closure (aMRR 1.05, 95% CI 1.01 to 1.09, p=0.008) were associated with more deaths. When assessing all 50 states and setting day 1 to the day a state recorded its first death, delays in declaring an emergency (aMRR 1.05, 95% CI 1.01 to 1.09, p=0.020) or closing schools (aMRR 1.06, 95% CI 1.03 to 1.09, p<0.001) were associated with more deaths. Results were unchanged when excluding New York and New Jersey. CONCLUSIONS: Later statewide emergency declarations and school closure were associated with higher Covid-19 mortality. Each day of delay increased mortality risk 5 to 6%.


title: Zinc Iodide in combination with Dimethyl Sulfoxide for treatment of SARS-CoV-2 and other viral infections

text: Zinc Iodide and Dimethyl Sulfoxide compositions are proposed as therapeutic agents to treat and prevent chronic and acute viral infections including SARS-CoV-2 infected patients. The therapeutic combinations have a wide range of virucidal effects on DNA and RNA containing viruses. The combinations also exhibit anti-inflammatory, immunomodulating, antifibrotic, antibacterial, antifungal and antioxidative effects. Given the fact that Zinc Iodide has been used as an oral antiseptic agent and DMSO has been already proven as a safe pharmaceutical solvent and therapeutic agent, we hypothesize that the combination of these two agents can be applied as an effective, safe and inexpensive treatment for SARS-CoV-2 and other viral infection. The therapeutic compound can be applied as both etiological and pathogenesis therapy and used as an effective and safe antiseptic (disinfectant) for human and animals as well.


title: Corona virus-An upadated review

text: Emerging of infectious diseases such as severe acute respiratory syndrome (SARS) which is a present major menace to public health, although intense research efforts, how, when, and where new diseases are appearing which still a source of considerable uncertainty is A serious respiratory disease was recently reported in Wuhan, Hubei province, china At least 1,975cases had been reported till 25 January 2020, since the patient was hospitalized on 12 December 2019 Epidemiology research has suggested that the beginning of the virus was associated with seafood contact in Wuhan Here we considered a single patient who was one of the workers in the market and was admitted to Central Hospital of Wuhan on 26 December of 2019 He was experiencing severe respiratory syndrome which is included with dizziness and cough After analysis, it was identified as a new RNA virus strain, from the family Coronaviridae, which is generally designated as WH-Human 1’ Corona virus is also referred to 2019 –nCoV The phylogenetic analysis started that this virus was mostly closely selected to a group of SARS and MERS like corona virus these are previously been found in bats in China


title: Stroke priorities during COVID-19 outbreak: acting both fast and safe

text: While the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) spreads all over the world, the healthcare systems are facing the dramatic challenge of simultaneously fight against the outbreak and life-threating emergencies. In this biological setting, emergency departments and neurovascular teams are exposed to high risk of infection and should therefore be prepared to deal with neurological emergencies safely. The purpose of this article is to analyze the current evidence on COVID-19 in the context of acute ischemic stroke and to describe the model of behavior we are putting into action to maintain the stroke pathway both rapid for the patient and safe for the healthcare professionals. We reserve a specific focus on personal protection equipment, dress code and healthcare professional behavior.


title: Does COVID-19 really call for an overhaul of nursing curricula or promoting the power, status and representation of nursing?

text: The COVID-19 pandemic has presented us with many well documented challenges as well as causing death, disability and economic devastation. All around the globe people were caught unprepared for the pandemic despite the warnings of public health experts. Many of these warnings were not considered serious and moves towards nationalism and populism have challenged global collaboration.


A year without conferences? How the coronavirus pandemic could change research


Covid-19: hospitals brace for disaster as US surpasses China in number of cases


Audio Interview: Studying Potential Covid-19 Therapies


Letter from Switzerland


Early COVID-19 Impact on Adolescent Health and Medicine Programs in the United States: LEAH Program Leadership Reflections


Strategies and recommendations for the safe implementation of vascular surgery during the pandemic period of novel coronavirus pneumonia


Covid-19 in Italy: A Lesson to be Learned


title: Amelioration of COVID-19 related cytokine storm syndrome: Parallels to chimeric antigen receptor-T cell cytokine release syndrome

text: Coronavirus disease-2019 (COVID-19) severity appears to parallel the host immune response, with a subset of patients developing COVID-19 cytokine storm syndrome (CSS).(1) Serum inflammatory cytokines are elevated in COVID-19,(2-5) and interleukin (IL)-6 appears to play a central role in COVID-19 related CSS.(6-8) Based on the success of IL-6 receptor blockade for chimeric antigen receptor T-cell therapy associated cytokine release syndrome (CAR T-cell CRS), similar strategies using tocilizumab are being investigated in COVID-19.


Extracorporeal membrane oxygenation for respiratory failure in COVID-19 patients: outcome and time-course of clinical and biological parameters


title: Effect of amino acids on IGF1 gene expression in human myotubes and skeletal muscle

text: OBJECTIVE: Insulin-like growth factor I (IGF1) is an important regulator of collagen and extracellular matrix protein expression. We aimed to evaluate the effect of amino acids (AAs) on expression of IGF1 and IGF1-dependent genes in human myotubes and skeletal muscle and supposed that AAs administration increases IGF1 levels in blood and expression of IGF1 and IGF1-dependent genes in trained skeletal muscle, thereby reducing training-induced muscle damage. DESIGN: Human myotubes were incubated with Arg and Leu for 24 h. Then, the effects of long-term branched chain AAs administration (10 weeks, 0.1 g/kg body mass/day) to volunteers (six subjects per AAs and placebo groups) performing large training volumes regularly (cross country skiers, training twice a day) were examined. RESULTS: Incubating the myotubes with AAs increases expression of IGF1 mRNA isoforms and IGF1 secretion by 2-3 times. In athletes, long-term AAs administration increased basal blood levels of IGF1 (~50%) and expression of IGF1Ea mRNA slightly in skeletal muscle. There is no marked increase in expression of COL1A1, COL3A1, COL5A1, and LOX genes in skeletal muscle after AAs administration. However, expression of these genes in the combined group (placebo + AAs; n = 12) significantly correlated with the expression of IGF1Ea mRNA in muscle and did not correlate with IGF1 levels in the blood. CONCLUSIONS: AAs administration increases IGF1 expression in vitro and in vivo. To obtain more pronounced changes in expression of IGF1 and IGF1-dependent genes in skeletal muscle, it may be necessary to increase the dose and/or duration of AAs administration.


Too many children miss out on education - but better data can help


title: Early forecasts of the evolution of the COVID-19 outbreaks and quantitative assessment of the effectiveness of countering measures

text: We discovered that the time evolution of the inverse fractional daily growth of new infections, N/dN, in the current outbreak of COVID-19 is accurately described by a universal function, namely the two-parameter Gumbel cumulative function, in all countries that we have investigated. While the two Gumbel parameters, as determined bit fits to the data, vary from country to country (and even within different regions of the same country), reflecting the diversity and efficacy of the adopted containment measures, the functional form of the evolution of N/dN appears to be universal. The result of the fit in a given region or country appears to be stable against variations of the selected time interval. This makes it possible to robustly estimate the two parameters from the data data even over relatively small time periods. In turn, this allows one to predict with large advance and well-controlled confidence levels, the time of the peak in the daily new infections, its magnitude and duration (hence the total infections), as well as the time when the daily new infections decrease to a pre-set value (e.g. less than about 2 new infections per day per million people), which can be very useful for planning the reopening of economic and social activities. We use this formalism to predict and compare these key features of the evolution of the COVID-19 disease in a number of countries and provide a quantitative assessment of the degree of success in in their efforts to countain the outbreak.


title: Evaluating the Effectiveness of Social Distancing Interventions to Delay or Flatten the Epidemic Curve of Coronavirus Disease

text: By April 2, 2020, >1 million persons worldwide were infected with severe acute respiratory syndrome coronavirus 2. We used a mathematical model to investigate the effectiveness of social distancing interventions in a mid-sized city. Interventions reduced contacts of adults >60 years of age, adults 20-59 years of age, and children <19 years of age for 6 weeks. Our results suggest interventions started earlier in the epidemic delay the epidemic curve and interventions started later flatten the epidemic curve. We noted that, while social distancing interventions were in place, 20% of new cases and most hospitalizations and deaths were averted, even with modest reductions in contact among adults. However, when interventions ended, the epidemic rebounded. Our models suggest that social distancing can provide crucial time to increase healthcare capacity but must occur in conjunction with testing and contact tracing of all suspected cases to mitigate virus transmission.


title: Mortality Rates of Patients with Proximal Femoral Fracture in a Worldwide Pandemic: Preliminary Results of the Spanish HIP-COVID Observational Study

text: BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), in December 2019 in Wuhan, People's Republic of China, has developed into an unprecedented pandemic with enormous pressure on health-care providers around the world. A higher mortality rate has been described in older infected individuals. Patients with hip fracture are a particularly vulnerable population during this pandemic because older age is associated with a higher mortality rate. Our aim was to describe the early mortality rate and demographic variables in a hip fracture sample population in Spain during the coronavirus pandemic. METHODS: This is a multicenter, observational, retrospective, descriptive study. We collected data from 13 major hospitals in Spain from the beginning of the national state of alarm (declared on March 14, 2020, by the Spanish government) until the end of our study period on April 4, 2020. All patients who were ≥65 years of age, presented to the Emergency Department of the participating hospitals during this period with a diagnosis of proximal femoral fracture, and had a minimum follow-up of 10 days were included in the cohort. In addition to mortality, demographic and other potential prognostic variables were also collected. RESULTS: In this study, 136 patients with a hip fracture were included. Of these patients, 124 underwent a surgical procedure and 12 were managed nonoperatively. The total mortality rate was 9.6%. Sixty-two patients were tested for COVID-19, with 23 patients being positive. The mortality rate for these 23 patients was 30.4% (7 of 23 patients) at a mean follow-up of 14 days. The mortality rate was 10.3% (4 of 39) for patients who had been tested and had a negative result and 2.7% (2 of 74) for patients who had not been tested. Of the 12 patients who were managed nonoperatively, 8 (67%) died, whereas, of the 124 patients who were surgically treated, 5 (4%) died. Results differed among centers. CONCLUSIONS: There is a higher mortality rate in patients with a hip fracture and an associated positive test for COVID-19. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.


title: Epidemiological and clinical characteristics of 46 newly-admitted coronavirus disease 2019 cases in Beijing/ 中华传染病杂志

text: Objective@#To investigate and analyze the epidemiological and clinical characteristics of some cases of coronavirus disease 2019 (COVID-19) in Beijing.@*Methods@#A retrospective study was conducted to analyze the data of 46 patients with COVID-19 in Beijing from 20th January 2020 to 8th February 2020 at the Fifth Medical Center of the PLA General Hospital. Features of clinical symptoms, laboratory inspections and imaging inspections were analyzed. Statistical analysis used Fisher exact test. If P<0.05, post-hoc test was used for pairwise comparison, and the statistics were corrected by Bonferroni test.@*Results@#Among the 46 patients included in this study, 27 were male and 19 were female. The age range was between 3 - 79 years old, and the mean age was (41.8 ± 16.3) years old. The average incubation period was (4.85 ± 3.00) days. A total of 26 cases (56.5%) were clustered patients, and 12 (26.1%), 23 (50.0%) and 11 patients (23.9%)were assigned to the mild group, common group, and sever group, respectively. Fever (39.8%), cough (27.6%), and fatigue (25.3%) was the main clinical symptom for these patients. The decrease in white blood cell counts occurred in 12 patients, four had the decrease in T lymphocyte counts, 17 had the decrease in CD4 + T lymphocyte counts, seven had the decrease in CD8 + T lymphocyte counts, 21 had the increase level of C-reactive protein (45.7%), and IL-6 level increased in 32 cases (69.6%), erythrocyte sedimentation rate increased in 20 cases(50.0%), serum ferritin level increased in 26 cases (56.5%), and blood lactate level increased in nine cases. There was a statistically significant difference in the number of cases in which the absolute value of T lymphocytes and of CD8 + T lymphocytes decreased among the mild, common and severe groups (all P<0.05). Comparing the number of cases in the three groups with elevated C-reactive protein, interleukin-6, erythrocyte sedimentation rate, serum ferritin and blood lactate levels, the differences were statistically significant (all P<0.05). The number of cases with elevated C-reactive protein levels was higher in severe group than that in mild and common group. The number of cases with elevated interleukin-6, erythrocyte sedimentation rate, and serum ferritin levels were higher in severe group than in mild group. The number of cases with elevated blood lactic acid levels was higher in severe group than in mild group. The differences between the above groups were statistically significant (both adjusted P<0.017). Analysis of chest X-rays showed that 34 patients (73.9%) had inflammation in the lungs.@*Conclusions@#The epidemiological characteristics of cases with COVID-19 in Beijing are mainly imported cases and clustered cases. The clinical manifestations are mainly fever , fatigue and cough. C-reactive protein, interleukin-6, red blood cell sedimentation rate, serum ferritin and blood lactate levels are higher in severe patients.


title: [Guide for the prevention and treatment of coronavirus disease 2019]

text: In December 2019, a novel coronavirus was identified in Wuhan City, Hubei Province, China and later the disease was named coronavirus disease 2019 (COVID-19) . On March 11, 2020, the World Health Organization (WHO) officially announced that COVID-19 had reached global pandemic status. This article summarized the understanding of the etiology, pathogenesis, epidemiology, clinical characteristics, diagnosis, treatment, rehabilitation, and prevention and control measures of COVID-19 based on the available data and anti-epidemic experience in China.


COVID-19 With Limb Ischemic Necrosis


COVID-19, Urologists and Hospitals


title: Prevention and treatment of COVID-19 disease by controlled modulation of innate immunity

text: The recent outbreak of coronavirus disease 2019 (COVID-19), triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses an enormous threat to global public health and economies. Human coronaviruses normally cause no or mild respiratory disease but in the past two decades, potentially fatal coronavirus infections have emerged, causing respiratory tract illnesses such as pneumonia and bronchitis. These include severe acute respiratory syndrome coronavirus (SARS-CoV), followed by the Middle East respiratory syndrome coronavirus (MERS-CoV), and recently the SARS-CoV-2 coronavirus outbreak that emerged in Wuhan, China, in December 2019. Currently, most COVID-19 patients receive traditional supportive care including breathing assistance. To halt the ongoing spread of the pandemic SARS-CoV-2 coronavirus and rescue individual patients, established drugs and new therapies are under evaluation. Since it will be some time until a safe and effective vaccine will be available, the immediate priority is to harness innate immunity to accelerate early antiviral immune responses. Second, since excessive inflammation is a major cause of pathology, targeted anti-inflammatory responses are being evaluated to reduce inflammation-induced damage to the respiratory tract and cytokine storms. Here, we highlight prominent immunotherapies at various stages of development that aim for augmented anti-coronavirus immunity and reduction of pathological inflammation.


Chloroquine as a prophylactic agent against COVID-19?


Patients with lupus are not protected from COVID-19


Hydroxychloroquine, Coronavirus Disease 2019, and QT Prolongation


title: Management of a patient presenting with anterior STEMI with concomitant COVID-19 infection early in the course of the U.S. pandemic

text: The coronavirus disease-2019 (COVID-19) is a viral illness with heterogenous clinical manifestations, ranging from mild symptoms to severe acute respiratory distress syndrome and shock caused by the severe acute respiratory syndrome coronavirus-2. The global healthcare community is rapidly learning more about the effects of COVID-19 on the cardiovascular system, as well as the strategies for management of infected patients with cardiovascular disease. There is minimal literature available surrounding the relationship between COVID-19 infection and acute coronary syndrome. We describe the case of a woman who presented with an acute anterior ST-elevation myocardial infarction managed by primary percutaneous coronary intervention, who subsequently developed severe COVID-19 infection and ultimately succumbed to multisystem organ failure.


title: Specific coagulation markers may provide more therapeutic targets in COVID-19 patients receiving prophylactic anticoagulant

text: I read with interest the recent published article from Professor Robert L. Medcalf, entitled "Fibrinolysis and COVID-19: a plasmin paradox" [1]. As an indirect marker of thrombin and plasmin activation, D-dimer has been suggested to guide anticoagulant treat in COVID-19 patients [2, 3]. However, D-dimer may not be able to reflect accurate fibrinolysis status of COVID-19 patients, and therefore can't guide the possible antifibrinolysis or thrombolytic therapy in different stages of COVID-19, as Professor Robert L. Medcalf discussed. Hence, we speculated that measuring direct markers of thrombin, plasmin and so on, may provide more therapeutic targets in COVID-19 patients with coagulopathy.


docid: ozesvnqu

title: Treatments Administered to the First 9152 Reported Cases of COVID-19: A Systematic Review

text: The emergence of SARS-CoV-2/2019 novel coronavirus (COVID-19) has created a global pandemic with no approved treatments or vaccines. Many treatments have already been administered to COVID-19 patients but have not been systematically evaluated. We performed a systematic literature review to identify all treatments reported to be administered to COVID-19 patients and to assess time to clinically meaningful response for treatments with sufficient data. We searched PubMed, BioRxiv, MedRxiv, and ChinaXiv for articles reporting treatments for COVID-19 patients published between 1 December 2019 and 27 March 2020. Data were analyzed descriptively. Of the 2706 articles identified, 155 studies met the inclusion criteria, comprising 9152 patients. The cohort was 45.4% female and 98.3% hospitalized, and mean (SD) age was 44.4 years (SD 21.0). The most frequently administered drug classes were antivirals, antibiotics, and corticosteroids, and of the 115 reported drugs, the most frequently administered was combination lopinavir/ritonavir, which was associated with a time to clinically meaningful response (complete symptom resolution or hospital discharge) of 11.7 (1.09) days. There were insufficient data to compare across treatments. Many treatments have been administered to the first 9152 reported cases of COVID-19. These data serve as the basis for an open-source registry of all reported treatments given to COVID-19 patients at www.CDCN.org/CORONA. Further work is needed to prioritize drugs for investigation in well-controlled clinical trials and treatment protocols.


title: Building Mean Field State Transition Models Using The Generalized Linear Chain Trick and Continuous Time Markov Chain Theory

text: The well-known Linear Chain Trick (LCT) allows modelers to derive mean field ODEs that assume gamma (Erlang) distributed passage times, by transitioning individuals sequentially through a chain of sub-states. The time spent in these states is the sum of $k$ exponentially distributed random variables, and is thus gamma (Erlang) distributed. The Generalized Linear Chain Trick (GLCT) extends this technique to the much broader phase-type family of distributions, which includes exponential, Erlang, hypoexponential, and Coxian distributions. Intuitively, phase-type distributions are the absorption time distributions for continuous time Markov chains (CTMCs). Here we review CTMCs and phase-type distributions, then illustrate how to use the GLCT to efficiently build mean field ODE models from underlying stochastic model assumptions. We generalize the Rosenzweig-MacArthur and SEIR models and show the benefits of using the GLCT to compute numerical solutions. These results highlight some practical benefits, and the intuitive nature, of using the GLCT to derive ODE models from first principles.


docid: wnesrpmm

title: [Clinical outcomes of COVID-19 cases and influencing factors in Guangdong province]

text: Objective: To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods: We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results: Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days (P(25)-P(75): 18-31 days) and the median length of hospitalization were 20 days (P(25)-P(75): 15-27 days). For severe cases, the median time of showing severe manifestations was on the 12th day after onset (P(25)-P(75): 9th to 15th days), and the median time of severe manifestation lasted for 8 days P(25)-P(75): 4-14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (aHR=1.87, 95%CI: 1.43-2.46), older age (aHR=1.67, 95%CI: 1.51-1.85), seeking medical care on day 2-3 after onset (aHR=1.73, 95%CI: 1.20-2.50) pre-existing diabetes (aHR=1.75, 95%CI: 1.12-2.73) and hypertension (aHR=1.49, 95%CI: 1.06-2.09). Conclusions: The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.


Role of serology in the COVID-19 pandemic


COVID-19 and Working Conditions in Health Care


Retraction-Chinese medical staff request international medical assistance in fighting against COVID-19


title: Universal Testing for COVID-19 in Essential Orthopaedic Surgery Reveals a High Percentage of Asymptomatic Infections

text: BACKGROUND: The long incubation period and asymptomatic spread of COVID-19 present considerable challenges for health-care institutions. The identification of infected individuals is vital to prevent the spread of illness to staff and other patients as well as to identify those who may be at risk for disease-related complications. This is particularly relevant with the resumption of elective orthopaedic surgery around the world. We report the results of a universal testing protocol for COVID-19 in patients undergoing orthopaedic surgery during the coronavirus pandemic and to describe the postoperative course of asymptomatic patients who were positive for COVID-19. METHODS: A retrospective review of adult operative cases between March 25, 2020, and April 24, 2020, at an orthopaedic specialty hospital in New York City was performed. Initially, a screening questionnaire consisting of relevant signs and symptoms (e.g., fever, cough, shortness of breath) or exposure dictated the need for nasopharyngeal swab real-time quantitative polymerase chain reaction (RT-PCR) testing for all admitted patients. An institutional policy change occurred on April 5, 2020, that indicated nasopharyngeal swab RT-PCR testing for all orthopaedic admissions. Screening and testing data for COVID-19 as well as relevant imaging, laboratory values, and postoperative complications were reviewed for all patients. RESULTS: From April 5, 2020, to April 24, 2020, 99 patients underwent routine nasopharyngeal swab testing for COVID-19 prior to their planned orthopaedic surgical procedure. Of the 12.1% of patients who tested positive for COVID-19, 58.3% were asymptomatic. Three asymptomatic patients developed postoperative hypoxia, with 2 requiring intubation. The negative predictive value of using the signs and symptoms of disease to predict a negative test result was 91.4% (95% confidence interval [CI], 81.0% to 97.1%). Including a positive chest radiographic finding as a screening criterion did not improve the negative predictive value of screening (92.5% [95% CI, 81.8% to 97.9%]). CONCLUSIONS: A protocol for universal testing of all orthopaedic surgery admissions at 1 hospital in New York City during a 3-week period revealed a high rate of COVID-19 infections. Importantly, the majority of these patients were asymptomatic. Using chest radiography did not significantly improve the negative predictive value of screening. These results have important implications as hospitals anticipate the resumption of elective surgical procedures. LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.


title: COVID-19 highlights risks of healthcare and social care workers attending work while ill

text: As COVID-19 affects healthcare and social care systems around the world, reports of infection among healthcare and social care workers continue to accumulate.


The virus crisis affects Orthopaedic surgery and scientific activities worldwide


title: Changes in testing rates could mask the novel coronavirus disease (COVID-19) growth rate

text: Since the novel coronavirus disease (COVID-19) emerged in December 2019 in China, it has rapidly spread around the world, leading to one of the most significant pandemic events of recent history. Deriving reliable estimates of the COVID-19 epidemic growth rate is quite important to guide the timing and intensity of intervention strategies. Indeed, many studies have quantified the epidemic growth rate using time-series of reported cases during the early phase of the outbreak to estimate the basic reproduction number, R0. Using daily time series of COVID-19 incidence, we illustrate how epidemic curves of reported cases may not always reflect the true epidemic growth rate due to changes in testing rates, which could be influenced by limited diagnostic testing capacity during the early epidemic phase.


title: When to Operate, Hesitate and Reintegrate: Society of Gynecologic Oncology Surgical Considerations during the COVID-19 Pandemic

text: The COVID-19 pandemic has challenged our ability to provide timely surgical care for our patients. In response, the U.S. Surgeon General, the American College of Srugeons, and other surgical professional societies recommended postponing elective surgical procedures and proceeding cautiously with cancer procedures that may require significant hospital resources and expose vulnerable patients to the virus. These challenges have particularly distressing for women with a gynecologic cancer diagnosis and their providers. Currently, circumstances vary greatly by region and by hospital, depending on COVID-19 prevalence, case mix, hospital type, and available resources. Therefore, COVID-19-related modifications to surgical practice guidelines must be individualized. Special consideration is necessary to evaluate the appropriateness of procedural interventions, recognizing the significant resources and personnel they require. Additionally, the pandemic may occur in waves, with patient demand for surgery ebbing and flowing accordingly. Hospitals, cancer centers and providers must prepare themselves to meet this demand. The purpose of this white paper is to highlight all phases of gynecologic cancer surgical care during the COVID-19 pandemic and to illustrate when it is best to operate, to hestitate, and reintegrate surgery. Triage and prioritization of surgical cases, preoperative COVID-19 testing, peri-operative safety principles, and preparations for the post-COVID-19 peak and surgical reintegration are reviewed.


docid: cljccfpc

title: The association between international and domestic air traffic and the coronavirus (COVID-19) outbreak

text: BACKGROUND: The World Health Organization (WHO) has declared the current outbreak of the novel coronavirus (COVID-19) a global pandemic. Many countries are facing increasing numbers of COVID-19 cases, which are, in their origin mostly attributed to regular international flight connections with China. This study aims to investigate this relation by analyzing available data on air traffic volume and the spread of COVID-19 cases. METHODS: and findings: We analyzed available data on current domestic and international passenger volume and flight routes and compared these to the distribution of domestic and international COVID-19 cases. RESULTS: Our data indicate a strong linear correlation between domestic COVID-19 cases and passenger volume for regions within China (r2 = 0.92, p = 0.19) and a significant correlation between international COVID-19 cases and passenger volume (r2 = 0.98, p < 0.01). CONCLUSIONS: The number of flight routes as well as total passenger volume are highly relevant risk factors for the spread of current COVID-19. Multiple regions within Asia, as well as some in North America and Europe are at serious risk of constant exposure to COVID-19 from China and other highly infected countries. Risk for COVID-19 exposure remains relatively low in South America and Africa. If adequate measures are taken, including on-site disease detection and temporary passenger quarantine, limited but not terminated air traffic can be a feasible option to prevent a long-term crisis. Reasonable risk calculations and case evaluations per passenger volume are crucial aspects which must be considered when reducing international flights.


title: COVID-19 infection during pregnancy: fetus as a patient deserves more attention

text: The novel coronavirus disease 2019 (COVID-19) pandemic is causing concern also for the management and outcome of COVID-19-positive pregnant women and their offspring, as reported cases are rare. Current evidence suggests the association of COVID-19 infection in pregnancy with both severe maternal morbidity requiring intensive care and perinatal complications (preterm birth with consequent neonatal morbidity and even perinatal death). Most of the reported cases focused specifically on the maternal outcomes and possible vertical transmission, but less attention has been paid to fetus as a patient in such pregnancies. The use of antenatal steroids and fetal neuroprotection with magnesium sulfate is clearly underreported. Several recently issued guidelines suggest lowering the upper gestational age for antenatal steroid administration and also advocate extreme caution or even restraining from the use of magnesium sulfate. Also, the rate of cesarean deliveries among COVID-19 women is unacceptably high. Here we provide arguments for NOT changing the existing guidelines and caution against cesarean delivery that was the prevalent delivery mode in the reported cases and case series.


title: Future of COVID-19 in Italy: A mathematical perspective

text: We have proposed an SEIR compartmental mathematical model. The prime objective of this study is to analyze and forecast the pandemic in Italy for the upcoming months. The basic reproduction number has been calculated. Based on the current situation in Italy, in this paper, we will estimate the possible time for the end of the pandemic in the country. The impact of lockdown and rapid isolation on the spread of the pandemic are also discussed. Further, we have studied four of the most pandemic affected regions in Italy. Using the proposed model, a prediction has been made about the duration of pandemic in these regions. The variation in the basic reproduction number corresponding to the sensitive parameters of the model is also examined.


Meeting the challenge of the 2019 novel coronavirus disease in patients with cancer


title: Saliva is a non-negligible factor in the spread of COVID-19

text: SARS-CoV-2, a novel emerging coronavirus, has caused severe disease (COVID-19), and rapidly spread worldwide since the beginning of 2020. SARS-CoV-2 mainly spreads by coughing, sneezing, droplet inhalation, and contact. SARS-CoV-2 has been detected in saliva samples, making saliva a potential transmission route for COVID-19. The participants in dental practice confront a particular risk of SARS-CoV-2 infection due to close contact with the patients and potential exposure to saliva-contaminated droplets and aerosols generated during dental procedures. In addition, saliva-contaminated surfaces could lead to potential cross-infection. Hence, the control of saliva-related transmission in the dental clinic is critical, particularly in the epidemic period of COVID-19. Based on our experience of the COVID-19 epidemic, some protective measures that can help reduce the risk of saliva-related transmission are suggested, in order to avoid the potential spread of SARS-CoV-2 among patients, visitors, and dental practitioners.


Catheterization Laboratory Considerations During the Coronavirus (COVID-19) Pandemic: From the ACC's Interventional Council and SCAI


SARS-CoV-2 pandemics: The lack of critical reflection addressing short- and long-term challenges


Remdesivir in Patients with Acute or Chronic Kidney Disease and COVID-19


title: The impact of nutrition on COVID-19 susceptibility and long-term consequences

text: While all groups are affected by the COVID-19 pandemic, the elderly, underrepresented minorities, and those with underlying medical conditions are at the greatest risk. The high rate of consumption of diets high in saturated fats, sugars, and refined carbohydrates (collectively called Western diet, WD) worldwide, contribute to the prevalence of obesity and type 2 diabetes, and could place these populations at an increased risk for severe COVID-19 pathology and mortality. WD consumption activates the innate immune system and impairs adaptive immunity, leading to chronic inflammation and impaired host defense against viruses. Furthermore, peripheral inflammation caused by COVID-19 may have long-term consequences in those that recover, leading to chronic medical conditions such as dementia and neurodegenerative disease, likely through neuroinflammatory mechanisms that can be compounded by an unhealthy diet. Thus, now more than ever, wider access to healthy foods should be a top priority and individuals should be mindful of healthy eating habits to reduce susceptibility to and long-term complications from COVID-19.


There is a Relationship Between Obesity and Coronavirus Disease 2019 but More Information is Needed


title: Taking care of systemic sclerosis patients during COVID-19 pandemic: rethink the clinical activity

text: COVID-19 outbreak has quickly spread worldwide, causing a high pressure on the health-care system. In Italy, from March 8, 2020, all the deferrable clinical activities have been suspended to increase the health care offer for COVID-19 patients. The hospital organization has been modified also in order to assure non-COVID-19 patients assistance. The Scleroderma Unit of ASST Pini-CTO Hospital, in Milan, in the region mostly hit by SARS-CoV-2 in Italy, follows more than 600 patients affected by systemic sclerosis (SSc). Patients with SSc need a close follow-up with a regular screening of organ involvement and frequent intravenous treatments. All SSc patients have been educated about ministerial directives to limit COVID-19 spread. The organization of our Scleroderma Unit has been quickly rethought to assure SSc patients assistance in safety for them and for health-care workers during urgent visits or infusion therapies. Using electronic way of communication with frequent virtual contact and guarantying home deliveries of some therapies, we allowed a continuity of care also outside the Hospital.


title: Promising inhibitors of main protease of novel corona virus to prevent the spread of COVID-19 using docking and molecular dynamics simulation

text: Coronavirus disease-2019 (COVID-19) is a global health emergency and the matter of serious concern, which has been declared a pandemic by WHO. Till date, no potential medicine/ drug is available to cure the infected persons from SARS-CoV-2. This deadly virus is named as novel 2019-nCoV coronavirus and caused coronavirus disease, that is, COVID-19. The first case of SARS-CoV-2 infection in human was confirmed in the Wuhan city of the China. COVID-19 is an infectious disease and spread from man to man as well as surface to man . In the present work, in silico approach was followed to find potential molecule to control this infection. Authors have screened more than one million molecules available in the ZINC database and taken the best two compounds based on binding energy score. These lead molecules were further studied through docking against the main protease of SARS-CoV-2. Then, molecular dynamics simulations of the main protease with and without screened compounds were performed at room temperature to determine the thermodynamic parameters to understand the inhibition. Further, molecular dynamics simulations at different temperatures were performed to understand the efficiency of the inhibition of the main protease in the presence of the screened compounds. Change in energy for the formation of the complexes between the main protease of novel coronavirus and ZINC20601870 as well ZINC00793735 at room temperature was determined on applying MM-GBSA calculations. Docking and molecular dynamics simulations showed their antiviral potential and may inhibit viral replication experimentally. Communicated by Ramaswamy H. Sarma.


Changes in Gastroenterology and Endoscopy Practices in Response to the Coronavirus Disease 2019 Pandemic: Results From a North American Survey


docid: ishxtpme

title: Adjusting to the new reality: Evaluation of early practice pattern adaptations to the COVID-19 pandemic

text: OBJECTIVE: We aim to define national practice patterns to assess current clinical practice, anticipated delays and areas of concern that potentially could lead to deviations from the normal standard of care. METHODS: Anonymous surveys were emailed to members of the Society of Gynecologic Oncology (SGO). The spread of COVID-19 and its impact on gynecologic oncology care in terms of alterations to normal treatment patterns and anticipated challenges were assessed. The Wilcoxon rank sum test was performed to determine risk factors for COVID-19 infection. RESULTS: We analyzed the responses of 331 gynecologic oncology providers. COVID-19 is present in 99.1% of surveyed communities with 99.7% reporting mitigation efforts in effect. The infection rate differs significantly between regions (pâª0.001) with the Northeast reporting the highest number of COVID-19 cases. Practice volume has dropped by 61.6% since the start of the pandemic with most cancellations being provider initiated. A majority of responders (52.8%) believed that ovarian cancer will be the most affected cancer by COVID-19. >94% of responders are proceeding with gynecologic cancer surgeries with exception of grade 1, endometrioid endometrial adenocarcinoma (36.3%). Surgical backlog (58.6%), delayed cancer diagnosis (43.2%) and re-establishing normal care with delayed patient (37.8%) were identified as the top 3 challenges after COVID-19 has abated. CONCLUSIONS: COVID-19 is widespread and has radically altered normal practice patterns. Despite COVID-19 related concerns, most gynecologic oncology care is proceeding. However, the steep decline in clinical volume shows there is a large group of patients who are not being diagnosed or are deferring care.


title: Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19)

text: Coronavirus has emerged as a global health threat due to its accelerated geographic spread over the last two decades. This article reviews the current state of knowledge concerning the origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Historically, it has caused two pandemics: severe acute respiratory syndrome and Middle East respiratory syndrome followed by the present COVID-19 that emerged from China. The virus is believed to be acquired from zoonotic source and spreads through direct and contact transmission. The symptomatic phase manifests with fever, cough and myalgia to severe respiratory failure. The diagnosis is confirmed using reverse transcriptase PCR. Management of COVID-19 is mainly by supportive therapy along with mechanical ventilation in severe cases. Preventive strategies form the major role in reducing the public spread of virus along with successful disease isolation and community containment. Development of a vaccine to eliminate the virus from the host still remains an ongoing challenge.


title: Medical waste management practice during the 2019-2020 novel coronavirus pandemic: Experience in a general hospital

text: It is currently a critical period for the prevention and control of the COVID-19 pandemic. Since the medical waste disposal could be an important way to control the source of infection, standardization, and strict implementation of the management of COVID-19 related medical waste should be with careful consideration to reduce the risk of epidemic within hospitals. This study illustrates the practice of medical waste disposal responding to the 2019-2020 novel coronavirus pandemic.


title: Identification of a druggable binding pocket in the spike protein reveals a key site for existing drugs potentially capable of combating Covid-19 infectivity

text: BACKGROUND: Following the recent outbreak of the new coronavirus pandemic (Covid-19), the rapid determination of the structure of the homo-trimeric spike glycoprotein has prompted the study reported here. The aims were to identify potential "druggable" binding pockets in the protein and, if located, to virtual screen pharmaceutical agents currently in use for predicted affinity to these pockets which might be useful to restrict, reduce, or inhibit the infectivity of the virion. RESULTS: Our analyses of this structure have revealed a key potentially druggable pocket where it might be viable to bind pharmaceutical agents to inhibit its ability to infect human cells. This pocket is found at the inter-chain interface that exists between two domains prior to the virion binding to human Angiotensin Converting Enzyme 2 (ACE2) protein. One of these domains is the highly mobile receptor binding domain, which must move into position to interact with ACE2, which is an essential feature for viral entry to the host cell. Virtual screening with a library of purchasable drug molecules has identified pharmaceuticals currently in use as prescription and over the counter medications that, in silico, readily bind into this pocket. CONCLUSIONS: This study highlights possible drugs already in use as pharmaceuticals that may act as agents to interfere with the movements of the domains within this protein essential for the infectivity processes and hence might slow, or even halt, the infection of host cells by this new coronavirus. As these are existing pharmaceuticals already approved for use in humans, this knowledge could accelerate their roll-out, through repurposing, for affected individuals and help guide the efforts of other researchers in finding effective treatments for the disease.


title: From Hard Spheres and Cubes to Nonequilibrium Maps with Thirty-Some Years of Thermostatted Molecular Dynamics

text: This is our current research perspective on models providing insight into statistical mechanics. It is necessarily personal, emphasizing our own interest in simulation as it developed from the National Laboratories' work to the worldwide explosion of computation of today. We contrast the past and present in atomistic simulations, emphasizing those simple models which best achieve reproducibility and promote understanding. Few-body models with pair forces have led to today's"realistic"simulations with billions of atoms and molecules. Rapid advances in computer technology have led to change. Theoretical formalisms have largely been replaced by simulations incorporating ingenious algorithm development. We choose to study particularly simple, yet relevant, models directed toward understanding general principles. Simplicity remains a worthy goal, as does relevance. We discuss hard-particle virial series, melting, thermostatted oscillators with and without heat conduction, chaotic dynamics, fractals, the connection of Lyapunov spectra to thermodynamics, and finally simple linear maps. Along the way we mention directions in which additional modelling could provide more clarity and yet more interesting developments in the future.


title: Onkológiai beteg tervezett PET/CT vizsgálata során véletlenszeruen felfedezett COVID-19-betegség/ Oncologic patient with COVID-19 discovered incidentally by PET/CT examination: (A COVID19-pandémia orvosszakmai kérdései)

text: The scientific literature of coronavirus-disease 2019 (COVID-19) is rapidly expanding. There is a growing evidence on the discrepancy between clinical symptoms and radiologic findings in many patients. This case report gives details about a patient with only mild symptoms but relatively severe radiological findings. The 75-year-old patient suffering from oncologic disease had a planned a F18-fluoro-deoxy-glucose positron-emission tomography/computer tomography scan with a routine oncological indication where incidental radiomorphologic findings of pneumonia suspect for COVID-19 were detected. After immediate isolation, the patient was transferred to the corresponding medical department, where further investigations verified the diagnosis of COVID-19. With this case, our aim is to raise the awareness for the importance of the instant evaluation of chest computer tomography series when performing planned imaging examination, especially in frail patients. With this practice, potential radiomorphologic findings of pneumonia suspect for COVID-19 could be identified in time, which fundamentally determines further patient management steps. Orv Hetil. 2020; 161(23): 971-976.


title: Análise da tendência de casos e óbitos por Coronavirus Disease-2019 (COVID-19) nos principais países afetados e no Brasil: uma análise dos primeiros 50 dias da pandemia

text: Objetivo: analisar a tendência de casos e óbitos pelo COVID-19 Métodos: foram analisados os óbitos e os casos confirmados até o dia 15 de março de 2020, informados pela Organização Mundial da Saúde, utilizando-se Regressão Joinpoint Resultados: a partir de 6 de fevereiro, os casos globais de COVID-19 apresentaram aumento de 8,2% e relacionavam-se com os casos registrados na Europa, e o incremento no número de óbitos, a partir de 20 de fevereiro, coincidiu com o aumento dos registros na Itália e Irã Conclusão: na China, houve tendência de redução de casos e óbitos, enquanto a Europa apresentou transmissão sustentada (AU)Objective: to analyze the trend of cases and deaths by COVID-19 Methods: the deaths and confirmed cases until March 15th, 2020 were analyzed, reported by the World Health Organization, using Joinpoint Regression Results: From February 6th, the global cases of COVID-19 presented an increase of 8 2% and were related to cases recorded in Europe, and the increase in the number of deaths, from February 20th, coincided with the increase of registrations in Italy and Iran Conclusion: in China, there was a tendency of reduction of cases and deaths, while Europe showed sustained transmission (AU)


title: Could nutritional and functional status serve as prognostic factors for COVID-19 in the elderly?

text: Geriatric patients seem to be the most vulnerable group in COVID-19. These patients are usually characterized by impaired mobilization and malnutrition. In addition, obesity has been correlated with increased mortality rates after COVID-19 infection, highlighting the role of nutrition in prognosis of COVID-19 as well. In the past, several indices of nutritional status (GNRI) and functional status (ECOG performance status, Barthel Index, Handgrip Strength) have demonstrated a prognostic ability for hospitalized patients with influenza-like respiratory infections from coronavirus, metapneumovirus, parainfluenza and rhinovirus. Our hypothesis suggests that the previously mentioned nutritional and functional status indices, combined with the pneumonia severity index (CRB-65), could be useful in prognosis of morbidity and mortality of the elderly after the novel COVID-19 infection. Our hypothesis, is the first in the literature, which suggests a prognostic association between nutritional status of patients and COVID-19 infection, offering a quick and low-cost prognostic tool for COVID-19 in the elderly.


docid: ryraplpe

title: Distribution and growth rate of COVID-19 outbreak in Tamil Nadu: A log-linear regression approach

text: Background: Most of the countries are affected with the pandemic outbreak of the coronavirus infection. Understanding the severity and distribution in various regions will help in planning the controlling measures. Objectives: The objective was to assess the distribution and growth rate of COVID-19 infection in Tamil Nadu, India. Methods: The data on the number of infections of COVID-19 have been obtained from the media reports released by the Government of Tamil Nadu. The data contain information on the incidence of the disease for the first 41 days of the outbreak started on March 7, 2020. Log-linear model has been used to estimate the progression of the COVID-19 infection in Tamil Nadu. Separate models were employed to model the growth rate and decay rate of the disease. Spatial Poisson regression was used to identify the high-risk areas in the state. Results: : The models estimated the doubling time for the number of cases in growth phase as 3.96 (95% confidence interval [CI]: 2.70, 9.42) days and halving time in the decay phase as 12.08 (95% CI: 6.79, 54.78) days. The estimated median reproduction numbers were 1.88 (min = 1.09, max = 2.51) and 0.76 (min = 0.56, max = 0.99) in the growth and decay phases, respectively. The spatial Poisson regression identified 11 districts as high risk. Conclusion: The results indicate that the outbreak is showing decay in the number of infections of the disease which highlights the effectiveness of controlling measures.


title: Biosafety measures for preventing infection from COVID-19 in clinical laboratories: IFCC Taskforce Recommendations

text: Coronavirus disease 2019 (COVID-19) is the third coronavirus outbreak that has emerged in the past 20 years, after severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). One important aspect, highlighted by many global health organizations, is that this novel coronavirus outbreak may be especially hazardous to healthcare personnel, including laboratory professionals. Therefore, the aim of this document, prepared by the COVID-19 taskforce of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), is to provide a set of recommendations, adapted from official documents of international and national health agencies, on biosafety measures for routine clinical chemistry laboratories that operate at biosafety levels 1 (BSL-1; work with agents posing minimal threat to laboratory workers) and 2 (BSL-2; work with agents associated with human disease which pose moderate hazard). We believe that the interim measures proposed in this document for best practice will help minimazing the risk of developing COVID-19 while working in clinical laboratories.


COVID umbrella trials multiply


The Impact of COVID-19 on Radiation Oncology Clinics and Cancer Patients in the U.S


title: The synthetic LPS binding peptide 19-2.5 interferes with clotting and prevents degradation of high molecular weight kininogen in plasma

text: Sepsis and septic shock are life-threatening conditions and remain an important medical problem, emphasizing the need to identify novel therapeutic approaches. Coagulation dysfunction, hypotension, disturbed microcirculation and multiorgan failure occur frequently. These severe conditions result from an overwhelming inflammatory response, induced by pathogen and damage associated molecular patterns (PAMPs and DAMPs) released into the bloodstream. In the present study, we demonstrated that the synthetic Lipopolysaccharid (LPS)-binding peptide 19-2.5 interferes with the activation of the coagulation and contact system. Moreover, binding of LPS to high molecular weight kininogen (HK), one of the major LPS carrier in blood, could be prevented by the peptide. Thus, peptide 19-2.5 might represent a promising target in the treatment of endotoxemia and sepsis, not only by its anti-inflammatory potential, but also by the anticoagulant effect, together with its ability to prevent degradation of HK.


docid: zfwwqhxq

title: A Global Effort to Define the Human Genetics of Protective Immunity to SARS-CoV-2 Infection

text: SARS-CoV-2 infection displays immense inter-individual clinical variability, ranging from silent infection to lethal disease. The role of human genetics in determining clinical response to the virus remains unclear. Studies of outliers-individuals remaining uninfected despite viral exposure and healthy young patients with life-threatening disease-present a unique opportunity to reveal human genetic determinants of infection and disease.


Comment on "Is the type of diabetes treatment relevant to outcome of COVID-19?"


Pérdida del sentido del olfato durante la pandemia COVID-19./ Pérdida del sentido del olfato durante la pandemia COVID-19./ Olfactory dysfunction during COVID-19 pandemic