title: Assessing the risk of spread of COVID-19 to the Asia Pacific region

text: During the early stages of an emerging disease outbreak, governments are required to make critical decisions on how to respond appropriately, despite limited data being available to inform these decisions. Analytical risk assessment is a valuable approach to guide decision-making on travel restrictions and border measures during the early phase of an outbreak, when transmission is primarily contained within a source country. Here we introduce a modular framework for estimating the importation risk of an emerging disease when the direct travel route is restricted and the risk stems from indirect importation via intermediary countries. This was the situation for Australia in February 2020. The framework was specifically developed to assess the importation risk of COVID-19 into Australia during the early stages of the outbreak from late January to mid-February 2020. The dominant importation risk to Australia at the time of analysis was directly from China, as the only country reporting uncontained transmission. However, with travel restrictions from mainland China to Australia imposed from February 1, our framework was designed to consider the importation risk from China into Australia via potential intermediary countries in the Asia Pacific region. The framework was successfully used to contribute to the evidence base for decisions on border measures and case definitions in the Australian context during the early phase of COVID-19 emergence and is adaptable to other contexts for future outbreak response.


title: An exploratory Integrated Moving Average Time Series Model of the initial outbreak of COVID-19 in six (6) significantly impacted Countries

text: The 2019 Novel Coronavirus SARS-CoV-2 (COVID-19) is a single-stranded RNA virus that has threatened the lives of humans all over the globe. Government officials, policy makers and public health officials have been scrambling and struggling to flatten the curve to decelerate the prevalence and spread of COVID-19 given the significant economic destruction of the spread of the virus. Most flatten the curve models are based on Compartmental Models. This preliminary research is based on six (6) selected countries significantly impacted by COVID-19 and endeavors to build a new model based on moving averages lagged at different time periods to better hone in on the time the COVID-19 begins to decelerate using the date of first reported case and date of first reported death. This new model, the Consistent Deceleration Model (CDM) is based on each individual countrys date of Peak Increase in Mortality Rate (PINC MR) and the Moving Average since the peak increase in mortality rate (MA POSTINC). The CDM can be utilized of one of many quantitative tools to determine the strength of the deceleration of an infectious outbreak.


docid: kehnbcqm

title: A single dose of recombinant VSV-ΔG-spike vaccine provides protection against SARS-CoV-2 challenge

text: The COVID-19 pandemic caused by SARS-CoV-2 that emerged in December 2019 in China resulted in over 7.8 million infections and over 430,000 deaths worldwide, imposing an urgent need for rapid development of an efficient and cost-effective vaccine, suitable for mass immunization. Here, we generated a replication competent recombinant VSV-ΔG-spike vaccine, in which the glycoprotein of VSV was replaced by the spike protein of the SARS-CoV-2. In vitro characterization of the recombinant VSV-ΔG-spike indicated expression and presentation of the spike protein on the viral membrane with antigenic similarity to SARS-CoV-2. A golden Syrian hamster in vivo model for COVID-19 was implemented. We show that vaccination of hamsters with recombinant VSV-ΔG-spike results in rapid and potent induction of neutralizing antibodies against SARS-CoV-2. Importantly, single-dose vaccination was able to protect hamsters against SARS-CoV-2 challenge, as demonstrated by the abrogation of body weight loss of the immunized hamsters compared to unvaccinated hamsters. Furthermore, whereas lungs of infected hamsters displayed extensive tissue damage and high viral titers, immunized hamsters’ lungs showed only minor lung pathology, and no viral load. Taken together, we suggest recombinant VSV-ΔG-spike as a safe, efficacious and protective vaccine against SARS-CoV-2 infection.


title: Impact of Surface Roughness and Porosity on Lattice Structures Fabricated by Additive Manufacturing- A Computational Study

text: Abstract Research in this article presents a computational analysis of effects of defects in 2.5D lattice structures fabricated by Additive Manufacturing (AM). Components resulting from AM often suffer from rough surfaces and porosity defects. This complicates their response which must be understood for their service deployment. The core of the methodology used in this research is a workflow for generating various defects such as surface roughness and porosity analogous to those that naturally result from AM-fabricated lattices. Surface roughness is introduced by either discretizing a sinusoidal function or fitting experimental roughness data by Fourier Transforms. Porosity defects are implemented by drawing ellipses with assigned center position, radius and aspect ratio. A plane stress Finite Element Method (FEM) model is used under a uniform displacement boundary condition. Stress-strain and stiffness of the lattices are characterized as a function of the implanted defect. This methodology enables characterization of the effect of: (i) surface roughness, (ii) porosity defect density, (iii) porosity defect size, and (iv) algorithms with which random defects can be generated in simulated specimens. Effectiveness of this workflow also provides an efficient way to generate an adequate data pool for future machine learning and other data processing work.


title: Dangers of ACE inhibitor and ARB usage in COVID-19: evaluating the evidence

text: Background: Concerns have been raised regarding the safety of Angiotensin Converting Enzyme Inhibitors (ACEIs) and Angiotensin Receptor Blockers (ARBs) in patients with COVID-19, based on the hypothesis that such medications may raise expression of ACE2, the receptor for SARS-CoV-2. Methods: We conducted a literature review of studies (n=12) in experimental animals and human subjects (n=11) and evaluated the evidence regarding the impact of administration of ACEIs and ARBs on ACE2 expression. We prioritized studies that assessed ACE2 protein expression data, measured directly or inferred from ACE2 activity assays. Results: The findings in animals are inconsistent with respect to an increase in ACE2 expression in response to treatment with ACEIs or ARBs. Control/sham animals show little to no effect in the plurality of studies. Those studies that report increases in ACE2 expression tend to involve acute injury models and/or higher doses than typically administered to patients. Data from human studies overwhelmingly imply that administration of ACEIs/ARBs does not increase ACE2 expression. Conclusion: Available evidence, in particular, data from human studies, does not support the hypothesis that ACEI/ARB use increases ACE2 expression and the risk of complications from COVID-19. We conclude that patients being treated with ACEIs and ARBs should continue their use for approved indications.


title: Comparative genomics provides an operational classification system and reveals early emergence and biased spatio-temporal distribution of SARS-CoV-2

text: Effective systems for the analysis of molecular data are of fundamental importance for real-time monitoring of the spread of infectious diseases and the study of pathogen evolution. While the Nextstrain and GISAID portals offer widely used systems for the classification of SARS-CoV-2 genomes, both present relevant limitations. Here we propose a highly reproducible method for the systematic classification of SARS-CoV-2 viral types. To demonstrate the validity of our approach, we conduct an extensive comparative genomic analysis of more than 20,000 SARS-CoV-2 genomes. Our classification system delineates 12 clusters and 4 super-clusters in SARS-CoV-2, with a highly biased spatio-temporal distribution worldwide, and provides important observations concerning the evolutionary processes associated with the emergence of novel viral types. Based on the estimates of SARS-CoV-2 evolutionary rate and genetic distances of genomes of the early pandemic phase, we infer that SARS-CoV-2 could have been circulating in humans since August-November 2019. The observed pattern of genomic variability is remarkably similar between all clusters and super-clusters, being UTRs and the s2m element, a highly conserved secondary structure element, the most variable genomic regions. While several polymorphic sites that are specific to one or more clusters were predicted to be under positive or negative selection, overall, our analyses also suggest that the emergence of novel genome types is unlikely to be driven by widespread convergent evolution and independent fixation of advantageous substitutions. While, in the absence of rigorous experimental validation, several questions concerning the evolutionary processes and the phenotypic characteristics (increased/decreased virulence) remain open, we believe that the approach outlined in this study can be of relevance for the tracking and functional characterization of different types of SARS-CoV-2 genomes.


title: Time-series plasma cell-free DNA analysis reveals disease severity of COVID-19 patients

text: Symptoms of coronavirus disease 2019 (COVID-19) range from asymptomatic to severe pneumonia and death. Detection of individuals at high risk for critical condition is crucial for control of the disease. Herein, for the first time, we profiled and analyzed plasma cell-free DNA (cfDNA) of mild and severe COVID-19 patients. We found that in comparison between mild and severe COVID-19 patients, Interleukin-37 signaling was one of the most relevant pathways; top significantly altered genes included POTEH, FAM27C, SPATA48, which were mostly expressed in prostate and testis; adrenal glands, small intestines and liver were tissues presenting most differentially expressed genes. Our data thus revealed potential tissue involvement, provided insights into mechanism on COVID-19 progression, and highlighted utility of cfDNA as a noninvasive biomarker for disease severity inspections.


title: Implementation of a Novel Remote Physician SBRT Coverage Process during the Coronavirus Pandemic

text: INTRODUCTION: During the COVID-19 pandemic, alternative methods of care are needed to reduce the relative risk of transmission in departments. Also needed is the ability to provide vital radiation oncological care if radiation oncologists (RO) are reallocated to other departments. We implemented a novel remote RO SBRT coverage practice, requiring it to be reliable, of high audio and visual quality, timely, and the same level of specialty care as our current in-person treatment coverage practice. METHODS: All observed failure modes were recorded during implementation over the first 15 sequential fractions. The time from CBCT to treatment was calculated before and after implementation to determine timeliness of remote coverage. Image quality metrics were calculated between the imaging console screen and the RO's shared screen. Comfort levels with audio/visual communication as well as overall comfort in comparison to in-person RO coverage was evaluated using Likert scale surveys after treatment. RESULTS: Remote RO SBRT coverage was successfully implemented in 14/15 fractions with 3 observed process failures that were all corrected before treatment. Average times of pre-treatment coverage before and after implementation were 8.74 and 8.51min, respectively. The cross correlation between the imaging console screen and RO's shared screen was r=0.96 and lag was 0.05s. The average value for all survey questions was above 4.5, approaching in-person RO coverage comfort levels. CONCLUSIONS: Our novel method of remote RO SBRT coverage permits reduced personnel and patient interactions surrounding RT procedures. This may help to reduce transmission of COVID-19 in our department and provides a means for SBRT coverage if ROs are reallocated to other areas of the hospital for COVID-19 support.


title: Appealing for Efficient, Well Organized Clinical Trials on COVID-19

text: The rapid emergence of clinical trials on COVID-19 stimulated a wave of discussion in scientific community. We reviewed the characteristics of interventional trials from Chinese Clinical Trial Registration (ChiCTR) and ClinicalTrials.gov. A total of 171 COVID-19-related interventional trials were identified on Feb 22nd, 2020. These trials are classified into 4 categories based on treatment modalities, including chemical drugs, biological therapies, traditional Chinese medicine treatments and other therapies. Our analysis focused on the issues of stage, design, randomization, blinding, primary endpoints definition and sample size of these trials. We found some studies with potential defects including unreasonable design, inappropriate primary endpoint definition, insufficient sample size and ethical issue. Clinical trials on COVID-19 should be designed based on scientific rules, ethics and benefits for patients.


title: Model of a Testing-and-Quarantine Strategy to Slow-Down the COVID-19 Outbreak in Guadeloupe

text: Using a stochastic epidemic model explicitly considering the entire population of Guadeloupe (1), we explore the domain of solutions presenting an efficient slowing down of the COVID-19 epidemic spread during the post-containment period. The considered model parameters are the basic reproduction number R0 to simulate the effects of social distancing, the time delay {delta}TQ elapsed between the detection of a symptomatic person and her/his placement in quarantine to suppress her/his contagiousness, and the number Na of asymptomatic people tested positively and isolated. We show that acceptable solutions are obtained for a wide range of parameter values. Thanks to a good control of the initial epidemic spread resulting from an early containment and efficient communication by the sanitary and administrative authorities, the present situation corresponds to a pre-epidemic state. The most safe solutions are a combinations of social distancing, numerous testing to perform a systematic isolation of symptomatic patients and guided detection of asymptomatic people in the entourage of localised symptomatic patients.


Use of Spironolactone in SARS-CoV-2 ARDS Patients


title: COVID-19. Transport of respiratory droplets in a microclimatologic urban scenario

text: Although there are some recent studies which intent to address the spread of respiratory droplets through the air, these correspond to indoor conditions or outdoor situations which not take into account realistic scenario. Less attention has been paid to the spread of respiratory droplets in outdoor environments under microclimatologic turbulent wind and which is of growing importance given the current COVID19 epidemic. We implement a computational model describing a sneezing person in an urban scenario under a medium intensity climatological wind. Turbulence was described with a wall-modeled Large Eddy Simulation model and the spread of respiratory droplets by using a lagrangian approach. Results show the spread of respiratory droplets is characterized by the dynamics of two groups of droplets of different sizes: larger droplets (400 – 900 μm) are spread between 2–5 m during 2.3 s while smaller (100 – 200 μm) droplets are transported a larger range between 8–11 m by the action of the turbulent wind in 14.1 s average. Given the uncertainty of potential contagion over this way and with this reach, these efforts are an intent to contribute to shine a light on the possibility of adopting stricter self-care and distancing measures.


title: Comparison of Transgenic and Adenovirus hACE2 Mouse Models for SARS-CoV-2 Infection

text: Severe acute respiratory syndrome CoV-2 (SARS-CoV-2) is currently causing a worldwide pandemic with high morbidity and mortality. Development of animal models that recapitulate important aspects of coronavirus disease 2019 (COVID-19) is critical for the evaluation of vaccines and antivirals, and understanding disease pathogenesis. SARS-CoV-2 has been shown to use the same entry receptor as SARS-CoV-1, human angiotensin-converting enzyme 2 (hACE2)(1-3). Due to amino acid differences between murine and hACE2, inbred mouse strains fail to support high titer viral replication of SARS-CoV-2 virus. Therefore, a number of transgenic and knock-in mouse models, as well as viral vector-mediated hACE2 delivery systems have been developed. Here we compared the K18-hACE2 transgenic model to adenovirus-mediated delivery of hACE2 to the mouse lung. We show that K18-hACE2 mice replicate virus to high titers in both the lung and brain leading to lethality. In contrast, adenovirus-mediated delivery results in viral replication to lower titers limited to the lung, and no clinical signs of infection with a challenge dose of 104 plaque forming units. The K18-hACE2 model provides a stringent model for testing the ability of vaccines and antivirals to protect against disease, whereas the adenovirus delivery system has the flexibility to be used across multiple genetic backgrounds and modified mouse strains.


docid: mmvbkbjw

title: Air Pollution Reduction and Mortality Benefit during the COVID-19 Outbreak in China

text: To control the novel coronavirus disease (COVID-19) outbreak, China undertook stringent traffic restrictions and self-quarantine measures. We herein examine the change in air pollution levels and the potentially avoided cause-specific mortality during this massive population quarantine episode. We found that, due to the quarantine, NO2 dropped by 22.8 μg/m3 and 12.9 μg/m3 in Wuhan and China, respectively. PM2.5 dropped by 1.4 μg/m3 in Wuhan but decreased by 18.9 μg/m3 across 367 cities. Our findings show that interventions to contain the COVID-19 outbreak led to air quality improvements that brought health benefits which outnumbered the confirmed deaths due to COVID-19 in China


title: Tracing DAY-ZERO and Forecasting the Fade out of the COVID-19 Outbreak in Lombardy, Italy: A Compartmental Modelling and Numerical Optimization Approach.

text: Italy currently constitutes the epicenter of the novel coronavirus disease (COVID-19) pandemic, having surpassed China's death toll. The disease is sweeping through Lombardy, which remains in lockdown since the 8th of March. As of the same day, the isolation measures taken in Lombardy have been extended to the entire country. Here, we provide estimates for: (a) the DAY-ZERO of the outbreak in Lombardy, Italy; (b) the actual number of exposed/infected cases in the total population; (c) the basic reproduction number (R0); (d) the "effective" per-day disease transmission; and, importantly, (e) a forecast for the fade out of the outbreak, on the basis of the COVID-19 Community Mobility Reports released by Google on March 29. Methods. To deal with the uncertainty in the number of actual exposed/ infected cases in the total population, we address a compartmental Susceptible/ Exposed/ Infectious/ Recovered/ Dead (SEIRD) model with two compartments of infectious persons: one modelling the total cases in the population and another modelling the confirmed cases. The parameters of the model corresponding to the recovery period, the time from the onset of symptoms to death, the case fatality ratio, and the time from exposure to the time that an individual starts to be infectious, have been set as reported from clinical studies on COVID-19. For the estimation of the DAY-ZERO of the outbreak in Lombardy, as well as of the ``effective" per-day transmission rate for which no clinical data are available, we have used the SEIRD simulator to fit the numbers of new daily cases from February 21 to the 8th of March, the lockdown day of Lombardy and of all Italy. This was accomplished by solving a mixed-integer optimization problem with the aid of genetic algorithms. Based on the computed values, we also provide an estimation of the basic reproduction number $R_0$. Furthermore, based on an estimation for the reduction in the "effective" transmission rate of the disease as of March 8 that reflects the suspension of almost all activities in Italy, we ran the simulator to forecast the fade out of the epidemic. For this purpose, we considered the reduction in mobility in Lombardy as released on March 29 by Google COVID-19 Community Mobility Reports, the effect of social distancing, and the draconian measures taken by the government on March 20 and March 21, 2020. Results. Based on the proposed methodological procedure, we estimated that the DAY-ZERO was most likely between January 5 and January 23 with the most probable date the 15th of January 2020. The actual cumulative number of exposed cases in the total population in Lombardy on March 8 was of the order of 15 times the confirmed cumulative number of infected cases. The "effective" per-day disease transmission rate for the period until March 8 was found to be 0.686 (95% CI:0.660, 0.713), while the basic reproduction number R0 was found to be 4.51 (95% CI: 4.14, 4.90). Importantly, simulations show that the COVID-19 pandemic in Lombardy is expected to fade out by the end of May - early June, 2020, if the draconian, as of March 20 and March 21, measures are maintained.


title: Psychological Stress and Gender Differences during COVID-19 Pandemic in Chinese Population

text: Background The COVID-19 disease has been spreading for more than four months in China and been pronounced as a pandemic by the World Health Organization (WHO). As an urgent public health crisis, it has severe physical and psychological impacts on human. The related experience and mental health on individuals and society during the pandemic can be devastating and has lasting impact. Objective To investigate the psychological stress and gender difference responding to the threat of COVID-19 and relevant factors. Methods A cross-sectional population-based study using online questionnaires via a social media software, WeChat, from 20th to 27th Feb, 2020. Psychological stress was measured by visual analogue scale (VAS). The relevant factors included demographics, the epidemic and living status characteristics related to COVID-19, psychological status, the needs of psychological support services, and psychological resilience. Psychological responses to depression, anxiety were also measured. Results Total 3088 questionnaires from 32 provinces in China were collected online. The average score of psychological stress was 3.4. The risk factors related to psychological stress included: female, [≤]45 years old, higher education, farmer/worker/clerical and business/service, unemployed, more diseases, uncertainty local epidemic status, close contact or completed a medical observation, higher desire for knowledge about the COVID-19, the diseases, psychological, economic difficulties during the epidemic. The protect factors included: frequently contacting with colleagues, calm mood, and high psychological resilience. There were gender differences on stress, the adaption to current living/working status, the coping strategy for heating, and the psychological support service needs. Conclusion The stress, anxiety and depression were mainly related to gender, age, education, and occupation during the epidemic of COVID-19. It suggested that we should make appropriate control measures and provide different psychological supports according to different population characteristics.


title: Losing ground at the wrong time: Trends in self-reported influenza vaccination uptake in Switzerland, Heath Survey 2007-2017

text: Objectives We studied time trends in seasonal influenza vaccination and associations with socioeconomic and health-related determinants in Switzerland, overall and in people aged [≥]65 years. Design Three cross-sectional surveys. Participants Individuals who participated in the Swiss Health Surveys 2007, 2012, and 2017. We calculated the proportion reporting influenza vaccination in the last 12 months, and performed multivariable logistic regression analyses. Results: The proportion of reporting a history of influenza vaccination overall was 31.9% (95% confidence intervals [95% CI] 31.4-32.4); and dropped from 34.5% in 2007 to 28.8% in 2017. The uptake of vaccination within the past 12 months was 16% in 2007 and similar in 2012 and 2017 (around 14%). In people with chronic disease, uptake dropped from 43.8% in 2007 to 37.1% in 2012 and to 31.6% in 2017 (p<0.001). In people aged [≥]65 years, uptake dropped from 47.8% in 2007 to 38.5% in 2012 to 36.2% in 2017 (p<0.001). Similarly, a decrease in vaccine uptake was seen in people with poor self-reported health status (39.4%, 33.1%, and 27.0%). In logistic regression, self-reported vaccination coverage decreased in the 65 to 75 years old (adjusted odds ratio (aOR) aOR 0.56, 95% Cl 0.48-0.66 between 2007 and 2012; aOR 0.89, 95% CI 0.77-1.03). Uptake was positively associated with the [≥]65 age group, living in French-speaking and urban areas, history of smoking, bad self-reported health status, private/semiprivate health insurance, having a medical profession, and having any underlying chronic disease. Use of any alternative medicine therapy was negatively associated with influenza vaccination (aOR 0.72, 95% CI 0.67-0.80). Conclusion: Influenza vaccination coverage was low in older and chronically ill persons. Significant efforts are required in preparing for the flu season 2020/21 to reduce the double burden of COVID-19 and seasonal influenza. These efforts should include campaigns but also novel approaches using social media.


title: Urological surgery in the COVID-19 era: Patient counselling and informed consent

text: The current coronavirus disease 2019 (COVID-19) pandemic is massively affecting our daily practice. Elective surgical service has been significantly altered, i.e. reduced overall service provision, special operating theatres’ precautions, as well as considerations for testing patients before surgery. The process of counselling patients and obtaining their consent is a must before any surgical intervention. Several factors can affect this process particularly amid the current pandemic crisis. Only with a full understanding of all the relevant facts, including risks and available alternatives, can patients give an ‘informed consent’. Therefore, we urologists need to be aware of the impact of the current COVID-19 situation on how to consent our patients. Abbreviations: COVID-19: coronavirus disease 2019; PPE: personal protective equipment.


Physical activity, health and well-being in an imposed social distanced world*


docid: mmruskuv

title: Performance evaluation and clinical application of three antibody test kits for novel coronavirus/ 新型冠状病毒3种抗体试剂盒的性能评估及临床应用初探

text: Objective: To evaluate the performance of three antibody kits for novel coronavirus (SARS-CoV-2) and to investigate the feasibility and advantages of them in clinical application. Methods: A total of 104 patients who were admitted to Guangzhou Eighth People's Hospital with COVID-19 from January to February 2020 were selected as research group. Fifty-one healthy subjects were selected during the same period as negative control group. Serum antibodies (IgM/IgG) against SARS-CoV-2 were detected using two kinds of colloidal gold kits (A and B kits) and one chemiluminescence kit (C kit). The positive rates of SARS-CoV-2 nucleic acid in different samples from patients with COVID-19 were retrospectively analyzed. Results: The clinical sensitivity of A kit to detect SARS-CoV-2-specific IgM and IgG was 77.88% (81/104) and 65.38% (68/104), respectively, and the clinical specificity was 70.59% (36/51) and 100.00% (51/51). However, the false positive rate in IgM detection was as high as 29.41% (15/51). The sensitivity of B kit to test total antibodies to SARS-CoV-2 was 63.46% (66/104), and the clinical specificity was 94.12% (48/51). The clinical sensitivity of C kit to detect SARS-CoV-2-specific IgM and IgG were respectively 31.73% (33/104) and 64.42% (67/104), and the clinical specificity were both 98.04% (50/51). There was a moderate correlation between the detection results of two colloidal gold kits and the chemiluminescence kit with the Kappa values of 0.462 and 0.587 (Z=6.157, P<0.01; Z=7.345, P<0.01). C kit had the highest positive detection rate for IgG, and would be more reliable to be used for IgG detection in COVID-19 patients 14 d after onset. The total positive detection rate of nucleic acid in all types of samples was 63.46% (66/104). The highest positive detection rate was in throat swabs or sputum samples, followed by those in blood samples and anal swabs. No viral nucleic acid was detected in urine samples for the time being. Conclusions: SARS-CoV-2-specific antibodies could be detected in the early or late stage of COVID-19. The method of antibody detection has the advantages of shorter detection time, simple operation and high biological safety, indicating that it could be used as a supplementary or auxiliary detection for the diagnosis of suspected COVID-19 cases with negative nucleic acid test results. The chemiluminescence kit has good sensitivity and specificity, and is well recommended for clinical laboratories.


title: On the role of reduced wind mass-loss rate in enabling exoplanets to shape planetary nebulae

text: We use the stellar evolution code MESA-binary and follow the evolution of three exoplanets and two brown dwarfs (BDs) to determine their potential role in the future evolution of their parent star on the red giant branch (RGB) and on the asymptotic giant branch (AGB). We limit this study to exoplanets and BDs with orbits that have semi-major axis of 1AU0.25, and having a parent star of mass M>1Mo. We find that the star HIP 75458 will engulf its planet HIP 75458 b during its RGB phase. The planet will remove the envelope and terminate the RGB evolution, leaving a bare helium core of mass 0.4Mo that will evolve to form a helium white dwarf. Only in one system out of five, the planet beta Pic c will enter the envelope of its parent star during the AGB phase. For that to occur, we have to reduce the wind mass-loss rate by a factor of about four from its commonly used value. This strengthens an early conclusion, which was based on exoplanets with circular orbits, that states that to have a non-negligible fraction of AGB stars that engulf planets we should consider lower wind mass-loss rates of isolated AGB stars (before they are spun-up by a companion). Such an engulfed planet might lead to the shaping of the AGB mass-loss geometry to form an elliptical planetary nebula.


title: Modal interactions for spindle, holders, and tools

text: Abstract This paper describes the interaction between vibration modes associated with the machine-spindle and those associated with the holder-tool when the holder-tool combination is inserted in the milling machine spindle. It is shown that when the bending natural frequency of the holder-tool is near a machine-spindle natural frequency, there is a combined two mode frequency response (similar to a dynamic absorber) for the assembly that exhibits increased dynamic stiffness over those situations when the interaction is absent. Experimental results are provided. The variation in tool point frequency response with tool extension length is then used to calculate the corresponding stability maps. These maps are evaluated to determine the effect of interactions between machine-spindle and holder-tool modes on milling stability. Conclusions are presented.


title: Epidemiological characteristics of new coronavirus diseases (COVID-19): Features of risk factors and clinical features of the child population

text: The article presents features of epidemiology and clinical picture of a new virus-COVID-2019 in Kazakhstan, features of dynamics among the child population. As of April 15, 2020, there are 1,295 cases of COVID-19. In total, the infection was confirmed in 80 children. Among them, one newborn, two children under one year old and this has allowed to limit the spread of this serious disease with the cooperation of all citizens in terms of containment and individual protection measures. Objective: to evaluate the prevalence, clinical and epidemiological features and risk factors of COVID-19 in children of different ages. The design of the study corresponded to the observational analytical one. The COVID-19 pandemic has spread very quickly, so it is children of all ages who should be the focus of special attention, as they play a huge role in the spread of the disease.


The 2019/2020 novel corona virus outbreak: An international health management perspective


title: Backcalculating the Incidence of Infection with COVID-19 on the Diamond Princess

text: To understand the time-dependent risk of infection on a cruise ship, the Diamond Princess, I estimated the incidence of infection with novel coronavirus (COVID-19). The epidemic curve of a total of 199 confirmed cases was drawn, classifying individuals into passengers with and without close contact and crew members. A backcalculation method was employed to estimate the incidence of infection. The peak time of infection was seen for the time period from 2 to 4 February 2020, and the incidence has abruptly declined afterwards. The estimated number of new infections among passengers without close contact was very small from 5 February on which a movement restriction policy was imposed. Without the intervention from 5 February, it was predicted that the cumulative incidence with and without close contact would have been as large as 1373 (95% CI: 570, 2176) and 766 (95% CI: 587, 946) cases, respectively, while these were kept to be 102 and 47 cases, respectively. Based on an analysis of illness onset data on board, the risk of infection among passengers without close contact was considered to be very limited. Movement restriction greatly reduced the number of infections from 5 February onwards.


COVID-19 testing before endoscopy safe, effective in the US


The COVID-19 pandemic preparedness or lack thereof: from China to Italy


docid: imkeghfd

title: Computational Design of Peptides to Block Binding of the SARS-CoV-2 Spike Protein to Human ACE2

text: The outbreak of COVID-19 has now become a global pandemic and it continues to spread rapidly worldwide, severely threatening lives and economic stability. Making the problem worse, there is no specific antiviral drug that can be used to treat COVID-19 to date. SARS-CoV-2 initiates its entry into human cells by binding to angiotensin-converting enzyme 2 (hACE2) via the receptor binding domain (RBD) of its spike protein. Therefore, molecules that can block SARS-CoV-2 from binding to hACE2 may potentially prevent the virus from entering human cells and serve as an effective antiviral drug. Based on this idea, we designed a series of peptides that can strongly bind to SARS-CoV-2 RBD in computational experiments. Specifically, we first constructed a 31-mer peptidic scaffold by linking two fragments grafted from hACE2 (a.a. 22-44 and 351-357) with a linker glycine, and then redesigned the peptide sequence to enhance its binding affinity to SARS-CoV-2 RBD. Compared with several computational studies that failed to identify that SARS-CoV-2 shows higher binding affinity for hACE2 than SARS-CoV, our protein design scoring function, EvoEF2, makes a correct identification, which is consistent with the recently reported experimental data, implying its high accuracy. The top designed peptide binders exhibited much stronger binding potency to hACE2 than the wild-type (−53.35 vs. −46.46 EvoEF2 energy unit for design and wild-type, respectively). The extensive and detailed computational analyses support the high reasonability of the designed binders, which not only recapitulated the critical native binding interactions but also introduced new favorable interactions to enhance binding. Due to the urgent situation created by COVID-19, we share these computational data to the community, which should be helpful to develop potential antiviral peptide drugs to combat this pandemic.


title: Suppression of COVID-19 outbreak in the municipality of Vo, Italy

text: On the 21st of February 2020 a resident of the municipality of Vo, a small town near Padua, died of pneumonia due to SARS-CoV-2 infection. This was the first COVID-19 death detected in Italy since the emergence of SARS-CoV-2 in the Chinese city of Wuhan, Hubei province. In response, the regional authorities imposed the lockdown of the whole municipality for 14 days. We collected information on the demography, clinical presentation, hospitalization, contact network and presence of SARS-CoV-2 infection in nasopharyngeal swabs for 85.9% and 71.5% of the population of Vo at two consecutive time points. On the first survey, which was conducted around the time the town lockdown started, we found a prevalence of infection of 2.6% (95% confidence interval (CI) 2.1-3.3%). On the second survey, which was conducted at the end of the lockdown, we found a prevalence of 1.2% (95% CI 0.8-1.8%). Notably, 43.2% (95% CI 32.2-54.7%) of the confirmed SARS-CoV-2 infections detected across the two surveys were asymptomatic. The mean serial interval was 6.9 days (95% CI 2.6-13.4). We found no statistically significant difference in the viral load (as measured by genome equivalents inferred from cycle threshold data) of symptomatic versus asymptomatic infections (p-values 0.6 and 0.2 for E and RdRp genes, respectively, Exact Wilcoxon-Mann-Whitney test). Contact tracing of the newly infected cases and transmission chain reconstruction revealed that most new infections in the second survey were infected in the community before the lockdown or from asymptomatic infections living in the same household. This study sheds new light on the frequency of asymptomatic SARS-CoV-2 infection and their infectivity (as measured by the viral load) and provides new insights into its transmission dynamics, the duration of viral load detectability and the efficacy of the implemented control measures.


title: Determination of COVID-19 parameters for an agent-based model: Easing or tightening control strategies

text: Different agent-based models have been developed to estimate the spread progression of coronavirus disease 2019 (COVID-19) and to evaluate different control strategies to control outbreak of the infectious disease. While there are several estimation methods for the disease-specific parameters of COVID-19, they have been used for aggregate level models such as SIR and not for agent-based models. We propose a mathematical structure to determine parameter values of agent-based models considering the mutual effects of parameters. Then, we assess the extent to which different control strategies can intervene the transmission of COVID-19. Accordingly, we consider scenarios of easing social distancing restrictions, opening businesses, speed of enforcing control strategies and quarantining family members of isolated cases on the disease progression. We find the social distancing compliance level in the Sydney greater metropolitan area to be around 85%. Then we elaborate on consequences of easing the compliance level in the disease suppression. We also show that tight social distancing levels should be considered when the restrictions on businesses and activity participations are easing.


title: Effects of the COVID-19 lockdown on urban mobility: Empirical evidence from the city of Santander (Spain)

text: This article analyses the impact that the confinement measures or quarantine imposed in Spain on 15 March 2020 had on urban mobility in the northern city of Santander. Data have been collected from traffic counters, public transport ITS, and recordings from traffic control cameras and environmental sensors to make comparisons between journey flows and times before and during the confinement. This data has been used to re-estimate Origin-Destination trip matrices to obtain an initial diagnostic of how daily mobility has been reduced and how the modal distribution and journey purposes have changed. The impact on externalities such as NO2 emissions and traffic accidents have also been quantified. The analysis revealed an overall mobility fall of 76%, being less important in the case of the private car. Public transport users dropped by up to 93%, NO2 emissions were reduced by up to 60%, and traffic accidents were reduced by up to 67% in relative terms.


title: SYBR green one-step qRT-PCR for the detection of SARS-CoV-2 RNA in saliva

text: We describe our efforts at developing a one-step quantitative reverse-transcription (qRT)-PCR protocol to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA directly from saliva samples, without RNA purification. We find that both heat and the presence of saliva impairs the ability to detect synthetic SARS-CoV-2 RNA. Buffer composition (for saliva dilution) was also crucial to effective PCR detection. Using the SG2 primer pair, designed by Sigma-Aldrich, we were able to detect the equivalent of 1.7×106 viral copies per mL of saliva after heat inactivation; approximately equivalent to the median viral load in symptomatic patients. This would make our assay potentially useful for rapid detection of high-shedding infected individuals. We also provide a comparison of the PCR efficiency and specificity, which varied considerably, across 9 reported primer pairs for SARS-CoV-2 detection. Primer pairs SG2 and CCDC-N showed highest specificity and PCR efficiency. Finally, we provide an alternate primer pair to use as a positive control for human RNA detection in SARS-CoV-2 assays, as we found that the widely used US CDC primers (targeting human RPP30) do not span an exon-exon junction and therefore does not provide an adequate control for the reverse transcription reaction.


title: A Gaussian Model for the Time Development of the Sars-Cov-2 Corona Pandemic Disease. Predictions for Germany Made on 30 March 2020

text: For Germany, it is predicted that the first wave of the corona pandemic disease reaches its maximum of new infections on 11 April 2020 −3 4 + 5 4 days with 90% confidence With a delay of about 7 days the maximum demand on breathing machines in hospitals occurs on 18 April 2020 −3 4 + 5 4 days The first pandemic wave ends in Germany end of May 2020 The predictions are based on the assumption of a Gaussian time evolution well justified by the central limit theorem of statistics The width and the maximum time and thus the duration of this Gaussian distribution are determined from a statistical χ2 -fit to the observed doubling times before 28 March 2020


docid: ufnwertb

title: CT-patterns in COVID-19 associated pneumonia-unification of radiological reports based on glossary of fleischner society

text: According to most recent publications, computed tomography (CT) plays the central role in diagnostic, evaluation of severity and follow-up of COVID-19 associated pneumonias. The aim of this article is to unify the assessment of the lung and thorax CT-studies in patients with COVID-19 associated pneumonias based on the glossary of Fleischner Society. The results of CT-studies of verified COVID-19 associated pneumonias are demonstrated in this article. The terminology of Fleischner Society glossary is suggested for the description of CT-studies. The value of different CT-patterns in evaluation of presen-tation, severity grade and prognosis in COVID-19 pneumonias is highlighted. This article was supported by the Medical Faculty of Heidelberg University.


title: Epidemiology of SARS-CoV-2 Emergence Amidst Community-Acquired Respiratory Viruses

text: Background. SARS-CoV-2 emerged in China in December 2019 as new cause of severe viral pneumonia (CoVID-19) reaching Europe by late January 2020. We validated the WHO-recommended assay and describe the epidemiology of SARS-CoV-2 and community-acquired respiratory viruses (CARVs). Methods. Naso-oropharyngeal swabs (NOPS) from 7663 individuals were prospectively tested by the Basel-S-gene and the WHO-based E-gene-assay (Roche) using Basel-N-gene-assay for confirmation. CARVs were tested in 2394 NOPS by multiplex-NAT, including 1816 together with SARS-CoV-2. Results. Basel-S-gene and Roche-E-gene-assays were concordant in 7475 cases (97.5%) including 825 (11%) positive samples. In 188 (2.5%) discordant cases, SARS-CoV-2 loads were significantly lower than in concordant positive ones and confirmed in 105 NOPS. Adults were more likely to test positive for SARS-CoV-2, while children were more likely to test CARV-positive. CARV co-infections with SARS-CoV-2 occurred in 1.8%. SARS-CoV-2 replaced other CARVs within 3 weeks reaching 48% of all detected respiratory viruses followed by rhino/enterovirus (13%), influenzavirus (12%), coronavirus (9%), respiratory syncytial (6%) and metapneumovirus (6%). Conclusions. The differential diagnosis for respiratory infections was broad during the early pandemic, affecting infection control and treatment decisions. We discuss the role of pre-existing immunity and competitive CARV replication for the epidemiology of SARS-CoV-2 infection among adults and children.


title: E-cigarette use frequency by smoking status among youth in the United States, 2014-2019

text: Aims: To report annual 2014-2019 youth estimates of past 30-day e-cigarette use frequency by smoking status in the United States (US). Design: Weighted prevalence estimates of students e-cigarette use using the 2014-2019 National Youth Tobacco Surveys (NYTS). For each year, t-tests for significance were used to compare estimates with those from the preceding year; t-tests were not performed on data for 2019 due to the change in survey format from paper to electronic. Setting: The NYTS is an annual school-based cross-sectional survey of US middle school (MS) and high school (HS) students. Participants: 117,472 students. Measurements: Self-report of past 30 day e-cigarette use based on students smoking status. Smoking status is assessed by asking if students have ever tried smoking, even one or two puffs, with never smokers responding no. Former smokers respond yes but have not smoked at all in the past 30 days. Current smokers used cigarettes at least once in the past 30 days. Frequent e-cigarette use is defined as use on 20 or more days in the past month. Findings: Past 30-day and frequent e-cigarette use increased among never, former, and current smoker youth from 2014-2019. In 2019, a greater proportion of current smokers used e-cigarettes frequently (HS = 46.1%, 95% CI: 39.1, 53.2; MS = 27.4%, 95% CI: 21.1, 33.6) compared to former smokers (HS = 23.2%, 95% CI: 18.1, 28.2; MS = 10.9%, 95% CI: 6.1, 15.7) and never smokers (HS = 3.7%, 95% CI: 3.0, 4.3; MS = 0.7%, 95% CI: 0.4, 0.9). From 2018 to 2019, the total number of youth using e-cigarettes frequently who were never smokers (2018: 180,000; 2019: 490,000) or former smokers (2018: 260,000; 2019: 640,000) surpassed that of current smokers (2018: 420,000; 2019: 460,000). Conclusions: The proportion and number of never smoker youth using e-cigarettes frequently increased greatly since 2014.


title: The COVID-19 Distance Learning: Insight from Ukrainian students

text: Although distance learning has become an essential part of everyday life of most students during quarantine, there is little evidence regarding its effectiveness among Ukrainian students The objective of the research is to estimate the effectiveness of current distance learning process in Ukrainian higher educational institutions;outline types of distance education provided;highlight the negative and positive aspects of introducing distance learning;describe the perspectives and approaches to solving the problems of distance education in universities The study sought to collect data on students' attitudes and needs for distance learning during quarantine by means of the on-line survey - Covid-19 Distance Learning Questionnaire, which involved 540 respondents Prerequisites for the development of distance education in Ukraine are considered The findings reveal the most used distance learning tools, duration of learning, types of leisure activities, readiness of participants of educational process for distance learning, factors that affect distance learning (skills, internet speed, emotions) etc The results obtained in the research can be provided to the governmental agencies, educational institutions and other stakeholders to further improve the process of distance learning


title: Prediction of the COVID-19 Epidemic Trends Based on SEIR and AI Models

text: The outbreak of novel coronavirus-caused pneumonia (COVID-19) in Wuhan has attracted worldwide attention. To contain its spread, China adopted unprecedented nationwide interventions on January 23. We sought to show how these control measures impacted the containment of the epidemic. We proposed an SEIR(Susceptible-Exposed- Infectious-Removed) model to analyze the epidemic trend in Wuhan and use the AI model to analyze the epidemic trend in non-Wuhan areas. We found that if the closure was lifted, the outbreak in non-Wuhan areas of mainland China would double in size. Our SEIR and AI model was effective in predicting the COVID-19 epidemic peaks and sizes. The implementation of control measures on January 23, 2020, was indispensable in reducing the eventual COVID-19 epidemic size.


title: Neutralizing Antibody Responses in COVID-19 Convalescent Sera

text: Passive transfer of antibodies from COVID-19 convalescent patients is being used as an experimental treatment for eligible patients with SARS-CoV-2 infections. The United States Food and Drug Administration's (FDA) guidelines for convalescent plasma recommends target antibody titers of 160. We evaluated SARS-CoV-2 neutralizing antibodies in sera from recovered COVID-19 patients using plaque reduction neutralization tests (PRNT) at low (PRNT50) and high (PRNT90) stringency thresholds. We found that neutralizing activity increased with time post symptom onset (PSO), reaching a peak at 31-35 days PSO. At this point, the number of sera having neutralizing titers of at least 160 was ~93% (PRNT50) and ~54% (PRNT90). Sera with high SARS-CoV-2 antibody levels ([≥]960 ELISA titers) showed maximal activity, but not all high titer sera contained neutralizing antibody at FDA recommended levels, particularly at high stringency. These results underscore the value of serum characterization for neutralization activity.


title: To streamline coronavirus vaccine and drug efforts, NIH and firms join forces

text: More than 100 treatments and vaccines are in development to stem the COVID-19 pandemic, and some onlookers have worried that this sprawling and potentially duplicative effort is wasting time and resources Hoping to bring order to the chaos, the National Institutes of Health (NIH) and major drug companies today announced a plan to stage carefully designed clinical trials of the drugs and vaccines they have decided are the highest priorities for testing and development The public-private partnership involves NIH, other U S government agencies, 16 pharma companies and biotechs, and the nonprofit Foundation for the National Institutes of Health (FNIH) It aims to develop “an international strategy” for COVID-19 research, a press release states However, NIH Director Francis Collins told reporters during a press call today that “it is primarily a U S -focused effort ”


title: Perceptions of the Adult US Population regarding the Novel Coronavirus Outbreak

text: Background: COVID-19 outbreak is spreading globally. Although the risk of infection in the US is currently low, it is important to understand the public perception of risk and trust in sources of information to better inform public health messaging. In this study, we surveyed the adult US population to understand their risk perceptions about the COVID-19 outbreak. Methods and Findings: We used an online platform to survey 718 adults in the US in early February 2020 using a questionnaire that we developed. Our sample was fairly similar to the general adult US population in terms of age, gender, race, ethnicity and education. We found that 69% of the respondents wanted the scientific/public health leadership (either the CDC Director or NIH Director) to lead the US response to COVID-19 outbreak as compared to 14% who wanted the political leadership (either the president or the Congress) to lead the response. Risk perception was low (median score of 5 out of 10) with the respondents trusting health professionals and health officials for information on COVID-19. Majority of the respondents were in favor of strict infection prevention policies to control the outbreak. Conclusion: Given our results, the public health/scientific leadership should be at the forefront of the COVID-19 response to promote trust.


title: Perioperative Anaesthetic Management of Confirmed or Suspected COVID-19 Patients

text: The outbreak of coronavirus disease (COVID-19) that started in Wuhan, China, has spread to 210 countries, infecting 2,726,274 patients and causing 191,075 deaths by April 24, 2020, and has turned into a global threat. Although various measures have been taken to stop human-to-human transmission in many countries, health care workers are in the high-risk zone for transmission as they deliver patient care. It is evident that anaesthesiologists will keep encountering patients with confirmed or suspected COVID-19 infection who will undergo emergency surgeries. Anaesthesiologists carry a higher risk of being infected during aerosol-creating procedures, hence appropriate protective measures should be taken, both during preoperative evaluation and management anaesthesia. Anaesthesia management of patients with COVID-19 also is a challenge for anaesthesiologists as it is an infection that may affect not only the respiratory system but also other vital organs. The aims of this review are to provide prudent safety measures to protect anaesthesiologists and other health care workers in the operating theatre and recommendations or the safest anaesthesia management of patients with suspected or confirmed COVID-19 undergoing surgery.


title: A Continuously Active Antimicrobial Coating effective against Human Coronavirus 229E

text: The disinfection of high-contact surfaces is seen as an infection control practice to prevent the spread of pathogens by fomites. Unfortunately, recontamination of these surfaces can occur any time after the use of common disinfectants. We recently reported on a novel continuously active antimicrobial coating which was shown to reduce the spread of healthcare acquired infections in hospitals. We evaluated a modified coating that demonstrated a residual efficacy against viruses. The coated surfaces were found to be effective against human coronavirus (HCoV) 229E, reducing the concentration of these viruses by greater than 90% in 10 minutes and by greater than 99.9% after two hours of contact. The coating formulation when tested in suspension yielded a greater than 99.99% reduction of HCoV 229E within ten minutes of contact. This outcome presents an opportunity for controlling the transmission of COVID-19 from contaminated fomites.


title: Dynamics of Interacting Hotspots -- I

text: The worldwide spread of COVID-19 has called for fast advancement of new modelling strategies to estimate its unprecedented spread. Here, we introduce a model based on the fundamental SIR equations with a stochastic disorder by a random exchange of infected populations between cities to study dynamics in an interacting network of epicentres in a model state. Although each stochastic exchange conserves populations pair-wise, the disorder drives the global system towards newer routes to dynamic equilibrium. Upon controlling the range of the exchange fraction, we show that it is possible to control the heterogeneity in the spread and the co-operativity among the interacting hotspots. Data of collective temporal evolution of the infected populations in federal states of Germany validate the qualitative features of the model.


title: Risk factors for clinical progression in patients with COVID-19: a retrospective study of electronic health record data in the United Kingdom

text: Background: The novel coronavirus disease 2019 (COVID-19) outbreak presents a significant threat to global health. A better understanding of patient clinical profiles is essential to drive efficient and timely health service strategies. In this study, we aimed to identify risk factors for a higher susceptibility to symptomatic presentation with COVID-19 and a transition to severe disease. Methods: We analysed data on 2756 patients admitted to Chelsea & Westminster Hospital NHS Foundation Trust between 1st January and 23rd April 2020. We compared differences in characteristics between patients designated positive for COVID-19 and patients designated negative on hospitalisation and derived a multivariable logistic regression model to identify risk factors for predicting risk of symptomatic COVID-19. For patients with COVID-19, we used univariable and multivariable logistic regression to identify risk factors associated with progression to severe disease defined by: 1) admission to the hospital AICU, 2) the need for mechanical ventilation, 3) in-hospital mortality, and 4) at least one measurement of elevated D-dimer (equal or superior to 1,000 ug/L) indicative of increased risk of venous thromboembolism. Results: The patient population consisted of 1148 COVID-19 positive and 1608 COVID-19 negative patients. Age, sex, self-reported ethnicity, C-reactive protein, white blood cell count, respiratory rate, body temperature, and systolic blood pressure formed the most parsimonious model for predicting risk of symptomatic COVID-19 at hospital admission. Among 1148 patients with COVID-19, 116 (10.1%) were admitted to the AICU, 71 (6.2%) required mechanical ventilation, 368 (32.1%) had at least one record of D-dimer levels [≥]1,000 g/L, and 118 patients died. In the multivariable logistic regression, age (OR = 0.953 per 1 year, 95% CI: 0.937-0.968) C-reactive protein (OR = 1.004 per 1 mg/L, 95% CI: 1.002-1.007), and white blood cell counts (OR = 1.059 per 109/L, 95% CI: 1.010-1.111) were found to be associated with admission to the AICU. Age (OR = 0.973 per 1 year, 95% CI: 0.955-0.990), C-reactive protein (OR = 1.003 per 1 mg/L, 95% CI: 1.000-1.006) and sodium (OR = 0.915 per 1 mmol/L, 0.868-0.962) were associated with mechanical ventilation. Age (OR = 1.023 per 1 year, 95% CI: 1.004-1.043), CRP (OR = 1.004 per 1 mg/L, 95% CI: 1.002-1.006), and body temperature (OR = 0.723 per 1oC, 95% CI: 0.541-0.958) were associated with elevated D-dimer. For mortality, we observed associations with age (OR = 1.060 per 1 year, 95% CI: 1.040-1.082), female sex (OR = 0.442, 95% CI: 0.442, 95% CI: 0.245-0.777), Asian ethnic background (OR = 2.237 vs White ethnic background, 95% CI: 1.111-4.510), C-reactive protein (OR = 1.004 per 1 mg/L, 95% CI: 1.001-1.006), sodium (OR = 1.038 per 1 mmol/L, 95% CI: 1.001-1.006), and respiratory rate (OR = 1.054 per 1 breath/min, 95% CI: 1.024-1.087). Conclusion: Our analysis suggests there are several demographic, clinical and laboratory findings associated with a symptomatic presentation of COVID-19. Moreover, significant associations between patient deterioration were found with age, sex and specific blood markers, chiefly C-reactive protein, and could help early identification of patients at risk of poorer prognosis. Further work is required to clarify the extent to which our observations are relevant beyond current settings.


Otorhinolaryngologists and Coronavirus Disease 2019 (COVID-19)


title: Neuromechanisms of SARS-CoV-2: A Review

text: Recent studies have suggested the neuroinvasive potential of severe acute respiratory coronavirus 2 (SARS-CoV-2). Notably, neuroinvasiveness might be involved in the pathophysiology of coronavirus disease 2019 (COVID-19). Some studies have demonstrated that synapse-connected routes may enable coronaviruses to access the central nervous system (CNS). However, evidence related to the presence of SARS-CoV-2 in the CNS, its direct impact on the CNS, and the contribution to symptoms suffered, remain sparse. Here, we review the current literature that indicates that SARS-CoV-2 can invade the nervous system. We also describe the neural circuits that are potentially affected by the virus and their possible role in the progress of COVID-19. In addition, we propose several strategies to understand, diagnose, and treat the neurological symptoms of COVID-19.


title: Predicting the number of reported and unreported cases for the COVID-19 epidemics in China, South Korea, Italy, France, Germany and United Kingdom

text: The novel coronavirus (SARS-CoV-2) is currently causing concern in the medical, epidemiological and mathematical communities as the virus is rapidly spreading around the world. Internationally, there are more than 1,200,000 cases detected and confirmed in the world on April 6. The asymptomatic and mild symptomatic cases are just going to be really crucial for us to understand what is driving this epidemic to transmit rapidly. Combining a mathematical model of severe (SARS-CoV-2) transmission with data from China, South Korea, Italy, France, Germany and United Kingdom, we provide the epidemic predictions of the number of reported and unreported cases for the SARS-CoV-2 epidemics and evaluate the effectiveness of control measures for each country.


title: COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants

text: Background Frailty and multimorbidity have been suggested as risk factors for severe COVID-19 disease. Aims We investigated whether frailty and multimorbidity were associated with risk of hospitalisation with COVID-19 in the UK Biobank. Methods 502,640 participants aged 40-69 years at baseline (54-79 years at COVID-19 testing) were recruited across UK 2006-10. A modified assessment of frailty using Fried's classification was generated from baseline data. COVID-19 test results (England) were available 16/03/2020-01/06/2020, mostly taken in hospital settings. Logistic regression was used to discern associations between frailty, multimorbidity and COVID-19 diagnoses, adjusting for sex, age, BMI, ethnicity, education, smoking and number of comorbidity groupings, comparing COVID-19 positive, COVID-19 negative and non-tested groups. Results 4,510 participants were tested for COVID-19 (positive=1,326, negative=3,184). 497,996 participants were not tested. Compared to the non-tested group, after adjustment, COVID-19 positive participants were more likely to be frail (OR=1.3 [95% CI=1.1, 1.7]), report slow walking speed (OR=1.3 [1.1, 1.6]), report two or more falls in the past year (OR=1.3 [1.0, 1.5]) and be multimorbid ([≥]4 comorbidity groupings vs 0-1: OR=1.9 [1.5, 2.3]). However, similar strength of associations were apparent when comparing COVID-19 negative and non-tested groups. Furthermore, frailty and multimorbidity were not associated with COVID-19 diagnoses, when comparing COIVD-19 positive and COVID-19 negative participants. Discussion and conclusions Frailty and multimorbidity do not appear to aid risk stratification, in terms of a positive versus negative results of COVID-19 testing. Investigation of the prognostic value of these markers for adverse clinical sequelae following COVID-19 disease is urgently needed.


docid: rzrrnypq

title: Analysis of the impact of lockdown on the evolution Covid-19 epidemics in Spain

text: Objective: The late 2019 Covid-19 disease outbreak has put the health systems of many countries to the limit of their capacity. The most affected European countries are, so far, Italy and Spain. In both countries (and others), the authorities decreed a lockdown, with local specificities. The objective of this work is to evaluate the impact of the measures undertaken in Spain to deal with the pandemic. Method: We estimated the number of cases and the impact of lockdown on the reproducibility number based on the hospitalization reports. Results: The estimated number of cases shows a sharp increase until the lockdown, followed by a slowing down and then a decrease after full quarantine was implemented. Differences in the basic reproduction ratio are also very significant, dropping from de 5.89 (95% CI: 5.46-7.09) before the lockdown to 0.48 (95% CI: 0.15-1.17) afterwards. Conclusions: Handling a pandemic like Covid-19 is very complex and requires quick decision making. The large differences found in the speed of propagation of the disease show us that being able to implement interventions at the earliest stage is crucial to minimise the impact of a potential infectious threat. Our work also stresses the importance of reliable up to date epidemiological data in order to accurately assess the impact of Public Health policies on viral outbreak.


title: Occupational Exposures and Programmatic Response to COVID-19 Pandemic: An Emergency Medical Services Experience

text: Background Rigorous assessment of occupational COVID-19 risk and personal protective equipment (PPE) use are not well-described. We evaluated 9-1-1 emergency medical services (EMS) encounters for patients with COVID-19 to assess occupational exposure, programmatic strategies to reduce exposure, and PPE use. Methods We conducted a retrospective cohort investigation of lab-confirmed COVID-19 patients in King County, WA who received 9-1-1 EMS responses from February 14, 2020 to March 26, 2020. We reviewed dispatch, EMS, and public health surveillance records to evaluate the temporal relationship between exposure and programmatic changes to EMS operations designed to identify high-risk patients, protect the workforce, and conserve PPE. Results There were 274 EMS encounters for 220 unique COVID-19 patients involving 700 unique EMS providers with 988 EMS person-encounters. Use of full PPE including mask, eye protection, gown and gloves (MEGG) was 67%. There were 151 person-exposures among 129 individuals, who required 981 quarantine days. Of the 700 EMS providers, 3 (0.4%) tested positive within 14 days of encounter. Programmatic changes were associated with a temporal reduction in exposures. When stratified at the study encounters midpoint, 94% (142/151) of exposures occurred during the first 137 EMS encounters compared to 6% (9/151) during the second 137 EMS encounters (p<0.01). By the final week of the study period, EMS deployed MEGG PPE in 34% (3579/10,468) of all EMS person-encounters. Conclusion Less than 0.5% of EMS providers experienced COVID-19 illness within 14 days of occupational encounter. Programmatic strategies were associated with a reduction in exposures, while achieving a measured use of PPE.


title: Aging imparts cell-autonomous dysfunction to regulatory T cells during recovery from influenza pneumonia

text: Regulatory T (Treg) cells orchestrate resolution and repair of acute lung inflammation and injury following viral pneumonia. Compared with younger patients, older individuals experience impaired recovery and worse clinical outcomes after severe viral infections, including influenza and the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Whether age is a key determinant of Treg cell pro-repair function following lung injury remains unknown. Here, we show that aging results in a cell-autonomous impairment of reparative Treg cell function following experimental influenza pneumonia. Transcriptional and DNA methylation profiling of sorted Treg cells provide insight into the mechanisms underlying their age-related dysfunction, with Treg cells from aged mice demonstrating both loss of reparative programs and gain of maladaptive programs. Novel strategies that restore youthful Treg cell functional programs could be leveraged as therapies to improve outcomes among older individuals with severe viral pneumonia.


docid: vodwptdo

title: Capturing limbal epithelial stem cell population dynamics, signature, and their niche

text: Stem cells (SCs) are traditionally viewed as rare, slow-cycling cells that follow deterministic rules dictating their self-renewal or differentiation. It was several decades ago, when limbal epithelial SCs (LSCs) that regenerate the corneal epithelium were one of the first sporadic, quiescent SCs ever discovered. However, LSC dynamics, heterogeneity and genetic signature are largely unknown. Moreover, recent accumulating evidence strongly suggested that epithelial SCs are actually abundant, frequently dividing cells that display stochastic behavior. In this work, we performed an in-depth analysis of the murine limbal epithelium by single-cell RNA sequencing and quantitative lineage tracing. The generated data provided an atlas of cell states of the corneal epithelial lineage, and particularly, revealed the co-existence of two novel LSC populations that reside in separate and well-defined sub-compartments. In the “outer” limbus, we identified a primitive widespread population of quiescent LSCs (qLSCs) that uniformly express Krt15/Gpha2/Ifitm3/Cd63 proteins, while the “inner” limbus host prevalent active LSCs (aLSCs) co-expressing Krt15-GFP/Atf3/Mt1-2/Socs3. Analysis of LSC population dynamics suggests that while qLSCs and aLSCs possess different proliferation rates, they both follow similar stochastic rules that dictate their self-renewal and differentiation. Finally, T cells were distributed in close proximity to qLSCs. Indeed, their absence or inhibition resulted in the loss of quiescence and delayed wound healing. Taken together, we propose that divergent regenerative strategies are tailored to properly support tissue-specific physiological constraints. The present study suggests that in the case of the cornea, quiescent epithelial SCs are abundant, follow stochastic rules and neutral drift dynamics.


title: Surveying Tenants of Permanent Supportive Housing in Skid Row about COVID-19

text: Permanent supportive housing (PSH) targets highly vulnerable homeless adults who exhibit early onset of geriatric conditions and require in-home supports. This suggests potentially high risk for COVID-19 within PSH and the need for tenants to take protective measures. This study reports on survey results collected from 532 PSH tenants in Los Angeles, California during the 4th week of March in 2020. Results show that nearly all tenants were aware of COVID-19 and 65% considered it to be a very serious health threat, which was a strong predictor of taking protective measures (i.e. handwashing and social distancing). Tenants in units with shared bathroom facilities had lower odds of social distancing than those in studio apartments. Tenants with mental health diagnoses had lower odds of consistent handwashing. Lack of access to food, hygiene items, and medication delivery were common barriers to sheltering in place.


title: Urinalysis, but not blood biochemistry, detects the early renal-impairment in patients with COVID-19

text: Background: In December 2019, a novel coronavirus (SARS-CoV-2) caused infectious disease, termed COVID-19, outbroke in Wuhan, China. COVID-19 patients manifested as lung injury with complications in other organs, such as liver, heart, gastrointestinal tract, especially for severe cases. However, whether COVID-19 causes significant acute kidney injury (AKI) remained controversial. Methods: We retrospectively analyzed the clinical characteristics, urine and blood routine tests and other laboratory parameters of hospitalized COVID-19 patients in Wuhan Union Hospital. Findings: 178 patients, admitted to Wuhan Union hospital from February 02 to February 29, 2020, were included in this study. No patient (0 [0%]) presented increased serum creatinine (Scr), and 5 (2.8%) patients showed increased blood urea nitrogen (BUN), indicating few cases with kidney dysfunction. However, for patients (83) with no history of kidney disease who received routine urine test upon hospitalization, 45 (54.2%) patients displayed abnormality in urinalysis, such as proteinuria, hematuria and leukocyturia, while none of the patients was recorded to have acute kidney injury (AKI) throughout the study. Meanwhile, the patients with abnormal urinalysis usually had worse disease progression reflecting by laboratory parameters presentations, including markers of liver injury, inflammation, and coagulation. Conclusion: Many patients manifested by abnormal urinalysis on admission, including proteinuria or hematuria. Our results revealed that urinalysis is better in unveiling potential kidney impairment of COVID-19 patients than blood chemistry test and urinalysis could be used to reflect and predict the disease severity. We therefore recommend pay more attention in urinalysis and kidney impairment in COVID-19 patients.


title: Public Health Aspects of COVID-19 Infection with Focus on Cardiovascular Diseases

text: INTRODUCTION: COVID-19 is the disease caused by an infection of the SARS-CoV-2 virus, first identified in the city of Wuhan, in China’s Hubei province in December 2019. COVID-19 was previously known as 2019 Novel Coronavirus (2019-nCoV) respiratory disease before the World Health Organization (WHO) declared the official name as COVID-19 in February 2020. AIM: The aim of this study is to search scientific literature in the biomedicine and analyzed current results of investigations regarding morbidity and mortality rates as consequences of COVID-19 infection of Cardiovascular diseases (CVD), and other most common chronic diseases which are on the top mortality and morbidity rates in almost all countries in the world. Also, to propose most useful measures how to prevent patients to keep themselves against COVID-19 infection. METHODS: We used method of descriptive analysis of the published papers with described studies about Corona virus connected with CVD, and, also, Guidelines proposed by World Health Organization (WHO) and European Society of Cardiology (ESC), and some other international associations which are included in global fighting against COVID-19 infection. RESULTS: After searching current scientific literature we have acknowledged that not any Evidence Based Medicine (EBM) study in the world during last 5 months from the time when first cases of COVID-10 infection was detected. Also, there is no unique proposed ways of treatments and drugs to protect patients, especially people over 65 years old, who are very risk group to be affected with COVID-19. Expectations that vaccine against COVID-19 will be produced optimal during at least 10 months to 2 years, and in all current Guidelines most important proposed preventive measures are the same like which one described in Strategic documents of WHO, in statements of Declaration of Primary Health Care in Alma Ata in 1978. CONCLUSION: WHO proposed preventive measures can be helpful to everybody. Physicians who work at every level of Health Care Systems, but especially at primary health care level, must follow those recommendations and teach their patients about it. But, the fact is that current focus of COVID-19 epidemic has targeted on protection of physical health of population in global, however, the influence on mental health which will be one of the important consequences of COVID-19 pandemic in the future, and which could be declared as «Post-coronavirus Stress Syndrome„ (PCSS) could be bigger challenge for Global Public Health.


title: Knowledge and practices towards COVID-19 during its outbreak: a multinational cross-sectional study

text: Background: The emergence of COVID-19 globally coupled with its unknown aetiology and its high transmission rate has created an unprecedented state of emergency worldwide. Public knowledge and awareness about COVID-19 are essential in suppressing its pandemic status. Method: A cross-sectional study using an online survey was conducted between 19th of March and 6th of April 2020 in three Middle Eastern countries (Jordan, Saudi Arabia and Kuwait) to explore the knowledge and practices of Middle Eastern population towards COVID-19. A previously developed questionnaire was used. Multiple linear regression analysis was used to identify predictors of COVID-19 knowledge. Results: A total of 1,208 participants were involved in this study from the three countries (Jordan = 389, Saudi Arabia = 433, and Kuwait = 386). The majority of participants (n = 810, 67.2%) were females and aged 30 to 49 years (n = 501, 41.5%). Participants had moderate overall COVID-19 knowledge with a mean score of 7.93 (SD = 1.72) out of 12, 66.1%. Participants had better knowledge about disease prevention and control with 83.0%, whereas the lowest sub-scale scores were for questions about disease transmission routes (43.3%). High education level was an important predictor of greater COVID-19 knowledge scores (p<0.01). Conclusion: Middle Eastern participants are of a relatively low level of knowledge about COVID-19, particularly regarding its transmission routes. Policymakers are recommended to develop informative COVID-19 related campaigns targeted specifically towards university students, unemployed individuals and those with lower levels of education.


The Coronavirus crisis: What will the post-pandemic city look like?


title: Sweden backcasting, now?-Strategic planning for Covid-19 mitigation in a liberal democracy

text: Sweden is applying the herd-immunity as its main natural science strategy to combat the Covid-19 pandemic. This has been communicated in a transparent manner. Small groups of young(er) people of up to approximately 50 individuals are subject to a bigger risk of infection than others. The objective of this paper is to make a case for the argument, that alongside herd-immunity, Sweden is using the social science originated planning approach: backcasting. The government has not been transparent on backcasting. The authors present the use of backcasting only as an argument based on available data and authors' reasoning. A backcasting exercise for the case of the Swedish economy is constructed. This frame outlines five interdependent levels with which a national economy can apply what this paper calls a backcasting herd-immunity approach in its COVID-19 policy. The authors further suggest how it is possible to use social science, natural science and political ideology as complementary in COVID-19 mitigation in particular and in sustainability strategies in general.


title: Sybodies targeting the SARS-CoV-2 receptor-binding domain

text: The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has resulted in a global health and economic crisis of unprecedented scale. The high transmissibility of SARS-CoV-2, combined with a lack of population immunity and prevalence of severe clinical outcomes, urges the rapid development of effective therapeutic countermeasures. Here, we report the generation of synthetic nanobodies, known as sybodies, against the receptor-binding domain (RBD) of SARS-CoV-2. In an expeditious process taking only twelve working days, sybodies were selected entirely in vitro from three large combinatorial libraries, using ribosome and phage display. We obtained six strongly enriched sybody pools against the isolated RBD and identified 63 unique anti-RBD sybodies which also interact in the context of the full-length SARS-CoV-2 spike ectodomain. Among the selected sybodies, six were found to bind to the viral spike with double-digit nanomolar affinity, and five of these also showed substantial inhibition of RBD interaction with human angiotensin-converting enzyme 2 (ACE2). Additionally, we identified a pair of anti-RBD sybodies that can simultaneously bind to the RBD. It is anticipated that compact binders such as these sybodies could feasibly be developed into an inhalable drug that can be used as a convenient prophylaxis against COVID-19. Moreover, generation of polyvalent antivirals, via fusion of anti-RBD sybodies to additional small binders recognizing secondary epitopes, could enhance the therapeutic potential and guard against escape mutants. We present full sequence information and detailed protocols for the identified sybodies, as a freely accessible resource.


title: Management and Outcomes of ST-segment Elevation Myocardial Infarction During Coronavirus 2019 Pandemic in a Center with 24/7 Primary Angioplasty Capability: Should We Change Our Practice During Outbreak?

text: Background: ST-Elevation Myocardial Infarction (STEMI) is associated with high mortality and morbidity. In order to minimize cardiac tissue injury, primary per-cutaneous coronary intervention (PPCI) as treatment of choice should be performed as soon as possible. Coronavirus Disease 2019 (COVID-19) as an ongoing major global concern affects the other parts of health care system. Applying preventive strategies during this outbreak is necessary. However, critical times in STEMI management and outcomes may be influenced by infection control protocols implementation. The aim of this study is to investigate the differences in time intervals related to STEMI care and 15-day major adverse cardiac events (MACE) during this outbreak compared with the same period in last year and to determine whether the STEMI protocol should be changed to thrombolytic therapy during COVID-19 outbreak or not. Methods and results: The patients with STEMI who underwent PPCI in Tehran Heart Center were included. Chest Computed tomography (CT) imaging and real time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) were only performed for COVID-19 suspected patients. Seventy-seven patients from 29th February to 29th March 2020 were compared with 62 patients from 1st to 30th March 2019. COVID-19 infection was confirmed by rRT-PCR in 5 cases. CT imaging in 4 out of 5 patients was in favor of COVID-19. The median of door-to-device time was reduced 13 minutes during this outbreak (p :0.007). In-hospital mortality before and during outbreak was 3.22% and 5.19%, respectively (p: 0.57). Confirmed infection with COVID-19 was only reported in one of expired cases. The difference in 15-day MACE between two time periods was not statistically significant. Conclusion: Given that 15-day outcome in acute STEMI patients is not affected by COVID-19 outbreak, we did not find it reasonable to change our protocol. However, further studies are needed to determine a standard protocol for emergency management


title: The impact of movement control order (MCO) during pandemic COVID-19 on local air quality in an urban area of Klang valley, Malaysia

text: The world is currently going through the COVID-19 pandemic which has caused hundreds of thousands of deaths in just a few months. Considering the need for lockdown measures, most countries, including Malaysia, have implemented ‘Movement Control Orders’ (MCOs) as a prevention step to reduce the deadly spread of this disease. Local and worldwide media have reported the immediate improvement of air quality due to this event. Nevertheless, data on the effects of MCOs on air quality at local scales are still sparse. Here, we investigate changes in air quality during the MCO at an urban area using the air sensor network AiRBOXSense which measures monoxide (CO) and particulate matter (PM2.5and PM10). In this study, air pollutant data during normal days were compared with MCO days using a reference analyser and AiRBOXSense. The results showed that the levels of the measured pollutants dropped by ~20 to 60% during the MCO days at most locations. However, CO in Kota Damansara (KD) dropped to 48.7%, but PM2.5and PM10increased up to 60% and 9.7% respectively during MCO days. Local burning activities in the residential area of KD are believed to be the main cause of the increased PM levels. This study has proven that air pollutant levels have significantly fallen due to the MCO. This air quality level information showed that the reduction of air pollutants can be achieved if traffic and industry emissions are strictly controlled.


title: Comparisons of Staphylococcus aureus infection and other outcomes between users of angiotensin-converting-enzyme inhibitors and angiotensin II receptor blockers: lessons for COVID-19 from a nationwide cohort study

text: Background: Mice receiving angiotensin converting enzyme inhibitor (ACEI) drugs show increased susceptibility to infection by Staphylococcus aureus ( S. aureus). We sought to investigate whether humans using ACEI were at increased risk of S. aureus infection, comparing them to users of Angiotensin II Receptor Blockers (ARB) with multiple control outcomes to assess the potential for residual confounding. Methods: Using the UK Clinical Practice Research Datalink linked to Hospital Episode Statistics between 1997 and 2017, we identified adults starting ACEI or ARB (as an active comparator drug). We regarded prescription of ACEI or ARB as time-dependent exposure and used a Cox regression model to compare incidence of first hospitalisation with infection due to S. aureus in periods with ACEI to periods with ARB prescriptions. We repeated the analysis using control outcomes that we did not expect to be associated with use of ACEI versus ARB (Gram-negative sepsis, hip fracture and herpes zoster) and one that we did (dry cough). Results: We identified 445,341 new users of ACEI (mean age 64.0±14.0, male 51.7%) and 41,824 new users of ARB (mean age 64.1±14.0, male 45.5%). The fully adjusted hazard ratio for S. aureus infection (ACEI vs. ARB) was 1.18 (95% CI 1.10–1.27), consistent across sensitivity analyses. However, we also found associations with all control outcomes; rates of Gram-negative sepsis, hip fracture and dry cough were also increased during periods of time treated with ACEI compared to ARB while herpes zoster was more common during time treated with ARB. Conclusions: Our results suggest that although ARB users appear an ideal control for analyses of ACEI effects, there is residual confounding even after multivariable adjustment. This has implications for observational analyses comparing users of these drug classes, in particular the effect of these drugs in relation to COVID-19 infection.


docid: zgehbwve

title: FACT- Frankfurt adjusted COVID-19 testing- a novel method enables high-throughput SARS-CoV-2 screening without loss of sensitivity

text: Background: In the pandemic, testing for SARS-CoV-2 by RT-PCR in one of the pillars on which countermeasures are based. Factors limiting the output of laboratories interfere with the effectiveness of public health measures. Conserving reagents by pooling samples in low-probability settings is proposed, but may cause dilution and loss of sensitivity. Methods: We tested an alternate approach (FACT) by simultaneously incubating multiple respiratory swabs in a single tube. This protocol was evaluated by serial incubation of a respiratory swab in up to 10 tubes. The analytics validity of this concept was demonstrated in a five-sample mini pool set-up. It was consequently applied in the testing of 50 symptomatic patients (five-sample pools) as well as 100 asymptomatic residents of a nursing home (ten-sample pools). Results: Serial incubation of a respiratory swab in up to 10 tubes did not lead to a significant decline in viral concentration. The novel FACT-protocol did not cause a false negative result in a five-sample mini-pool setup, with non-significantly differing Ct values between single sample and mini-pool NAT. In two routine applications, all mini pools containing positive patient samples were correctly identified. Conclusions: Our proposed FACT- protocol did not cause a significant loss in analytic or diagnostic sensitivity compared to single sample testing in multiple setups. It reduced the amount of reagents needed by up to 40%, and also reduced hands-on time. This method could enhance testing efficiency, especially in groups with a low pretest-probability, such as systemically relevant professional groups.


title: COVID-19 Infections and Outcomes in a Live Registry of Heart Failure Patients Across an Integrated Health Care System

text: Background: Patients with comorbid conditions have a higher risk of mortality with SARS-CoV-2 (COVID-19) infection, but the impact on heart failure patients living near a disease hotspot is unknown. Therefore, we sought to characterize the prevalence and outcomes of COVID-19 in a live registry of heart failure patients across an integrated health care system in Connecticut. Methods: In this retrospective analysis, the Yale Heart Failure Registry (NCT04237701) that includes 26,703 patients with heart failure across a 6-hospital integrated health care system in Connecticut, was queried on April 16th, 2020 for all patients tested for COVID-19. Sociodemographic and geospatial data as well as, clinical management, respiratory failure, and patient mortality were obtained via the real-time registry. Data on COVID-19 specific care was extracted by retrospective chart review. Results: COVID-19 testing was performed on 900 symptomatic patients, comprising 3.4% of the Yale Heart Failure Registry (N=26,703). Overall, 206 (23%) were COVID-19+. As compared to COVID-19-, these patients were more likely to be older, black, have hypertension, coronary artery disease, and were less likely to be on renin angiotensin blockers (P<0.05, all). COVID-19- patients tended to be more diffusely spread across the state whereas COVID-19+ were largely clustered around urban centers. 20% of COVID-19+ patients died, and age was associated with increased risk of death [OR 1.92 95% CI (1.33-2.78); P<0.001]. Among COVID-19+ patients who were [≥]85 years of age rates of hospitalization were 87%, rates of death 36%, and continuing hospitalization 62% at time of manuscript preparation. Conclusions: In this real-world snapshot of COVID-19 infection among a large cohort of heart failure patients, we found that a small proportion had undergone testing. Patients found to be COVID-19+ tended to be black with multiple comorbidities and clustered around lower socioeconomic status communities. Elderly COVID-19+ patients were very likely to be admitted to the hospital and experience high rates of mortality.


title: Persistence of viral RNA, widespread thrombosis and abnormal cellular syncytia are hallmarks of COVID-19 lung pathology

text: COVID-19 is a deadly pulmonary disease with unique clinical features. A thorough understanding of the molecular and histological correlates of the disease is still missing, especially because post-mortem analysis of COVID-19-affected organs has been so far scant and often anecdotical. Here we report the results of the systematic analysis of 41 consecutive post-mortem samples from individuals who died of COVID-19. We found that the disease is characterized by extensive alveolar damage and thrombosis of the lung micro- and macro-vasculature. Thrombi were in different stages of organization, consistent with an ongoing, endogenous thrombotic process. In all the analyzed samples, in situ RNA hybridization showed that pneumocytes and vascular endothelial cells had massive presence of viral RNA even at the later stages of the disease. An additional feature of the disease was the presence, in the vast majority of patients, of a large number of dysmorphic pneumocytes, often forming large syncytial elements, a consequence of the fusogenic activity of the viral Spike protein, detected with specific antibodies. Despite occasional presence of virus-positive cells in the heart, no overt signs of viral infection were detected in other organs, which showed common alterations compatible with prolonged hypoxia, multifocal organ disease or previous comorbidities. In summary, COVID-19 is a unique interstitial pneumonia with extensive lung thrombosis, long-term persistence of viral replication in pneumocytes and endothelial cells, along with the presence of infected cellular syncytia in the lung. We propose that several of the COVID-19 disease features are due to the persistence of virus-infected cells in the lungs of the infected individuals for the duration of the disease.


title: Curve-fitting approach for COVID-19 data and its physical background

text: Forecast of the peak-out and settling timing of COVID-19 at an early stage should help the people how to cope with the situation. Curve-fitting method with an asymmetric log-normal function has been applied to daily confirmed cases data in various countries. Most of the curve-fitting could show good forecasts, while the reason has not been clearly shown. The K value has recently been proposed which can provide good reasoning of curve-fitting mechanism by corresponding a long and steep slope on the K curve with fitting stability. Since K can be expressed by a time differential of logarithmic total cases, the physical background of the above correspondence was discussed in terms of the growth rate in epidemic entropy.


title: COVID-19: A Resident's Perspective

text: My shifts all start the same way these last few weeks with the collection of my allocated face shield and N95. The same shifts where it feels like the only patients I treat are those with COVID-19. Faces sometimes not much older than mine. Patients who are tachycardic, hypoxic, and ill. But these interactions are different; physical exams completed under the supervision of a colleague just outside the room, charged to watch my every movement. Vigilance not just for me but for everyone else I could and would come into contact with over the course of my shift. COVID19 lingers on carboard, steel, plastic, and other surfaces. Even the simplest of acts are dangerous without appropriate precautions.


title: COVID-19 receptor ACE2 is expressed in human conjunctival tissue, expecially in diseased conjunctival tissue

text: COVID-19 virus has currently caused major outbreaks worldwide. ACE2 is a major cellular-entry receptor for the COVID-19 virus. Although ACE2 is known to be expressed in many organs, whether it is expressed by the conjunctival tissue is largely unknown. Human conjunctival tissues from 68 subjects were obtained, which included 10 subjects with conjunctival nevi, 20 subjects with conjunctivitis, 9 subjects with conjunctival papilloma, 16 subjects with conjunctival cyst, 7 subjects with conjunctival polyps, and 6 ocular traumas as normal subjects. Expression of ACE2 was evaluated by immunohistochemistry, immunofluorescence, reverse transcriptase-quantitative polymerase chain reaction, and western blot assay. We observed the expression of ACE2 by conjunctival tissues, expecially in conjunctival epithelial cells. ACE2 was significantly (p<0.001) overexpressed in conjunctival cells obtained from subjects with conjunctivitis, conjunctival nevi, conjunctival papilloma, conjunctival cyst, and conjunctival polyps epithelial cells when compared to that in conjunctival epithelial cells obtained from control subjects. Collectively, clinical features of reported COVID-19 patients combined with our results indicate that COVID-19 is likely to be transmitted through the conjunctiva.


title: Several FDA-approved drugs effectively inhibit SARS-CoV-2 infection in vitro

text: To identify drugs that are potentially used for the treatment of COVID-19, the potency of 1403 FDA-approved drugs were evaluated using a robust pseudovirus assay and the candidates were further confirmed by authentic SARS-CoV-2 assay. Four compounds, Clomiphene (citrate), Vortioxetine, Vortioxetine (hydrobromide) and Asenapine (hydrochloride), showed potent inhibitory effects in both pseudovirus and authentic virus assay. The combination of Clomiphene (citrate), Vortioxetine and Asenapine (hydrochloride) is much more potent than used alone, with IC50 of 0.34 μM.


title: Caring for the carers: safeguarding oncologists’ mental health in the time of COVID-19

text: Taking care of patients with chronic, terminal diseases presents unique challenges to the mental health of medical oncologists. The current coronavirus disease 2019 (COVID-19) pandemic has exacerbated these mental health risks brought about by isolation and exhaustion. Delegated to be a national COVID-19 referral centre, the University of the Philippines—Philippine General Hospital faced many challenges, including the increased workload in a perilous and anxiety-inducing national crisis which placed the entire healthcare team in an unprecedented situation. To adapt to these challenges, the Division of Medical Oncology employed the following measures to safeguard the mental health of its faculty and fellows: 1) use of psychological support materials; 2) initiation of a psychological intervention programme and 3) establishment of peer support programmes. Caring for the carers through evidence-based interventions ensures the delivery of quality care to our cancer patients despite the challenges during these trying times.


title: Households at Higher Risk of Losing at Least One Individual in India: if COVID-19 is a new normal

text: After the outbreak of COVID-19 and the passing of a few months with this pandemic; the world has started to adopt strategies to live with the virus. The WHO has also accepted that the pandemic caused by the novel coronavirus is going to last longer, and suggested that one needs to learn to live with this virus. Accepting this bitter truth that this pandemic is going to be a new normal and people of all ages can be infected by the new coronavirus; however, older people and those with chronic diseases are more vulnerable to the virus. The study tries to access the household with at least one patient with few selected chronic diseases in India, which are presumed to be at a higher risk of losing at least one individual if this pandemic scenario is going to last long and spread is wider. The study used nationally representative data (NSSO) for information on morbidity and other health-related issues. Data from the official website of the Ministry of Health and Family Welfare dedicated to COVID-19 reports have been used to look into the recent happenings caused by COVID-19 pandemic in India. Bivariate analysis has been used to calculate household at risk, and binary logistic regression has been used for the likelihood of household at risk. The case-fatality ratio is calculated using the number of confirmed cases and the number deceased due to the same. The study found that about 9.4% of Indian households are at a higher risk of losing at least one individual. Older people (60+), males and households with better economic status are at a higher risk. The chronic condition varies by states and social-economic and demographic status. The share of households at higher risk was highest in Kerala (33.19%), followed by Andhra Pradesh (19.85%) and Chandigarh (19.05%).


COVID-19 and the pulmonary vasculature