title: Treatment of coronavirus disease 2019 in Shandong, China: a cost and affordability analysis

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is now a global public threat. Given the pandemic of COVID-19, the economic impact of COVID-19 is essential to add value to the policy-making process. We retrospectively conducted a cost and affordability analysis to determine the medical costs of COVID-19 patients in China, and also assess the factors affecting their costs. METHODS: This analysis was retrospectively conducted in Shandong Provincial Chest Hospital between 24 January and 16 March 2020. The total direct medical expenditures were analyzed by cost factors. We also assessed affordability by comparing the simulated out-of-pocket expenditure of COVID-19 cases relative to the per capita disposable income. Differences between groups were tested by student t test and Mann-Whitney test when appropriate. A multiple logistic regression model was built to determine the risk factors associated with high cost. RESULTS: A total of 70 COVID-19 patients were included in the analysis. The overall mean cost was USD 6827 per treated episode. The highest mean cost was observed in drug acquisition, accounting for 45.1% of the overall cost. Total mean cost was significantly higher in patients with pre-existing diseases compared to those without pre-existing diseases. Pre-existing diseases and the advanced disease severity were strongly associated with higher cost. Around USD 0.49 billion were expected for clinical manage of COVID-19 in China. Among rural households, the proportions of health insurance coverage should be increased to 70% for severe cases, and 80% for critically ill cases to avoid catastrophic health expenditure. CONCLUSIONS: Our data demonstrate that clinical management of COVID-19 patients incurs a great financial burden to national health insurance. The cost for drug acquisition is the major contributor to the medical cost, whereas the risk factors for higher cost are pre-existing diseases and severity of COVID-19. Improvement of insurance coverage will need to address the barriers of rural patients to avoid the occurrence of catastrophic health expenditure.


title: COVID-19 and Kawasaki syndrome: should we really be surprised?

text: A hyperinflammatory response to COVID-19 is being described in children. While this presents, and responds to management, similar to that of Kawasaki Disease it is being coined a new entity. But is it really? We explore how this phenomenon may be Kawasaki Disease with a new trigger.


Hidradenitis suppurativa: The importance of virtual outpatient care during COVID-19 pandemic


title: Effect of COVID-19 Pandemic on Oceans

text: The novel corona virus (COVID-19) has slowed down a lot of human activities in the world. A lockdown for a period of 2 months, due to the pandemic, was enough to cause a drop of 7% of the anthropogonic CO2 in the atmosphere. In addition to the world in general, the excess of the anthropogonic CO2 emission in the atmosphere has always been a threat to the oceans as well. Oceans play a key role to buffer the greenhouse effect, but in the process, it becomes warmer, more acidic, and less oxygenated. While there have already been investigations done on the effect of pandemic on atmosphere, the question what happens to oceans during the pandemic remains unanswered. The aim of this paper is to study the pandemic's effect and the resultant reduction in CO2 emissions on the productivity of the global oceans. Often Chlorophyll-a (Chl-a), Particulate organic and inorganic carbon (PIC:POC) and sea surface temperature(SST), are used to indicate the productivity of oceans. Herein, satellite-derived estimates of the aforementioned parameters are used. Based on these estimates, a drop in Chl-a (0.5 mgm-3) is observed off Alaska, North Europe,South China and Southeast USA during the pandemic. CO2 reduction of 123 MtCO2 during the pandemic in China might have caused reduction in mean Chl-a by around 5% (2.5 to 1.6 mgm-3). Reduction of Chl-a during the pandemic is mostly associated with the reduction of PIC:POC. The pandemic demonstrates noticeable effect on Chl-a and/or SST. A cooling response of 0.5 oC in mean SST is observed over most of the coastal areas, especially off Alaska,north Indian ocean and eastern Pacific. The decrease in the CO2 emissions in India by 30% during the pandemic translates into a drop of mean SST in the north Indian ocean by 5% (from 29.95 to 28.46 oC). All these suggest that maintaining global activities as sustainable as the pandemic period, can help to recover the oceans.


title: Cardiological Society of India: Document on acute MI care during COVID-19

text: The unprecedented and rapidly spreading Coronavirus Disease-19 (COVID-19) pandemic has challenged public health care systems globally. Based on worldwide experience, India has initiated a nationwide lockdown to prevent the exponential surge of cases. During COVID-19, management of cardiovascular emergencies like acute Myocardial Infarction (MI) may be compromised. Cardiological Society of India (CSI) has ventured in this moment of crisis to evolve a consensus document for care of acute MI. However, this care should be individualized, based on local expertise and governmental advisories.


title: Youth injury and parents' unemployment-the importance of socio-economic status and ethnicity context

text: BACKGROUND: Youth whose parents are unemployed have poorer health and well-being, including more injuries that result in hospitalization. The current study examined the possibility of an association of parents' employment status with youth injury and the interaction of this status with other socio-economic factors and ethnicity. METHODS: We distributed to adolescents aged 11-15 years, in class, the Israel Health Behavior in School-Aged Children Survey. We distinguished between any injury and severe injury, defining the latter as one necessitating the use of a cast, stitches and crutches or overnight hospitalization. RESULTS: Of 13 705 respondents, 6224 (45%) had an injury in the past year that required medical treatment and 1827 pupils (13.5%) reported severe injuries. The odds of any injury were 1.86 for boys as against girls (95% confidence interval [CI] 1.73-1.99), 0.80 for school grade (95% CI 0.78-0.82), 1.56 for Arabs vs. Jews (95% CI 1.43-1.70) and 1.10 for high Family Affluence Scale (FAS) vs. medium FAS (95% CI 1.01-1.21). Only in the low FAS group, when two parents were unemployed, the odds for severe injury was 1.36 (95% CI 1.03-1.78); when one or two parents were employed, the odds of severe child injury were the same (OR 1.13 and 95% CI 0.92-1.40). CONCLUSION: Factors that were found to increase the risk of injury among youth were parental unemployment, low socio-economic status and Arab ethnicity. The home environment was the most common place for injury.


title: Significant applications of virtual reality for COVID-19 pandemic

text: BACKGROUND AND AIMS: During COVID-19 pandemic, researchers are using innovative technologies for fast-tracking the development to end this menace. Virtual Reality (VR) also offers an imperative role for fighting this pandemic, through audiovisual-based virtual communication. METHODS: A brief study on Virtual Reality and its applications for the COVID-19 pandemic is carried out by employing keywords as Virtual reality or VR and COVID-19 from the databases of SCOPUS, Google Scholar, PubMed, Web of science Academia and ResearchGate. RESULTS: VR is beneficial for remote sites for exploring telemedicine, planning, treatment, and controlling of the infections by providing proper awareness to the people regarding this disease. CONCLUSIONS: VR technology develops a platform to reduce the face to face interaction of doctors with the infected COVID-19 patients. Through live video streaming, it helps to improve surveillance systems on the ongoing situation.


In Response to COVID-19 and the Otolaryngologist: Preliminary Evidence-Based Review


Trump claims public health warnings on covid-19 are a conspiracy against him


Covid-19: adverse mental health outcomes for healthcare workers


title: Managing COVID-19 Pandemic without Destructing the Economy

text: We analyze an approach to managing the COVID-19 pandemic without shutting down the economy while staying within the capacity of the healthcare system. We base our analysis on a detailed heterogeneous epidemiological model, which takes into account different population groups and phases of the disease, including incubation, infection period, hospitalization, and treatment in the intensive care unit (ICU). We model the healthcare capacity as the total number of hospital and ICU beds for the whole country. We calibrate the model parameters to data reported in several recent research papers. For high- and low-risk population groups, we calculate the number of total and intensive care hospitalizations, and deaths as functions of time. The main conclusion is that countries, which enforce reasonable hygienic measures on time can avoid lockdowns throughout the pandemic provided that the number of spare ICU beds per million is above the threshold of about 100. In countries where the total number of ICU beds is below this threshold, a limited period quarantine to specific high-risk groups of the population suffices. Furthermore, in the case of an inadequate capacity of the healthcare system, we incorporate a feedback loop and demonstrate that quantitative impact of the lack of ICU units on the death curve. In the case of inadequate ICU beds, full- and partial-quarantine scenarios outcomes are almost identical, making it unnecessary to shut down the whole economy. We conclude that only a limited-time quarantine of the high-risk group might be necessary, while the rest of the economy can remain operational.


COVID-19 pandemic, infodemic and the role of eHealth literacy


To consider or not antimalarials as a prophylactic intervention in the SARS-CoV-2 (COVID-19) pandemic


Serum IgA, IgM, and IgG responses in COVID-19


Coexistent COVID-19 pneumonia and pulmonary embolism: challenges in identifying dual pathology


title: Preliminary estimation of the novel coronavirus disease (COVID-19) cases in Iran: A modelling analysis based on overseas cases and air travel data

text: As of March 1, 2020, Iran had reported 987 novel coronavirus disease (COVID-19) cases, including 54 associated deaths. At least six neighboring countries (Bahrain, Iraq, Kuwait, Oman, Afghanistan, and Pakistan) had reported imported COVID-19 cases from Iran. In this study, air travel data and the numbers of cases from Iran imported into other Middle Eastern countries were used to estimate the number of COVID-19 cases in Iran. It was estimated that the total number of cases in Iran was 16 533 (95% confidence interval: 5925-35 538) by February 25, 2020, before the UAE and other Gulf Cooperation Council countries suspended inbound and outbound flights from Iran.


Letter to the editor regarding "How to avoid nosocomial spread during tracheostomy for Covid-19 patients"


Specific Considerations for Pediatric, Fetal, and Congenital Heart Disease Patients and Echocardiography Service Providers during the 2019 Novel Coronavirus Outbreak: Council on Pediatric and Congenital Heart Disease Supplement to the Statement of the American Society of Echocardiography: Endorsed by the Society of Pediatric Echocardiography and the Fetal Heart Society


title: A SARS-CoV-2 familial cluster infection reveals asymptomatic transmission to children

text: Information on SARS-CoV-2 asymptomatic infection and infectivity in children is limited. In this study, we aimed to report the epidemiological and clinical characteristics of a familial cluster infection including children with SARS-CoV-2. On February 1, 2020, two children(case 1 and case 2), an 8-year-old girl and a 9-year-old boy, were admitted to the isolation ward in Xiangyang Central Hospital, Hubei province, China, with the diagnosis of COVID-19. Before admission, they had been staying at home with their father and never contacted with any confirmed patients except their mother (case 3) who returned from Wuhan on January 22. Both case 1 and case 2 got mild symptoms. Case 3 did not develop any symptoms until February 6, 2020, with an asymptomatic period of 15 days. She was transferred to ICU and administered multiple treatment according to the disease progression and chest CT manifestations. Her nucleic acid test turned positive until Feb 21, 2020, 15 days after symptoms onset, 30 days after her return from Wuhan. Our data showed that patients with SARS-CoV-2 may have the ability to transmit during their asymptomatic period even with the negative of viral nucleic acid in pharyngeal swabs.


title: Sickle Cell Trait and The Potential Risk of Severe Coronavirus Disease 2019- A Mini-Review

text: Coronavirus Disease 2019 (COVID-19) pandemic is a rapidly evolving public health problem. The severity of COVID-19 cases reported hitherto has varied greatly from asymptomatic to severe pneumonia and thromboembolism with subsequent mortality. An improved understanding of risk factors for adverse clinical outcomes may shed some light on novel personalized approaches to optimize clinical care in vulnerable populations. Emerging trends in the United States suggest possibly higher mortality rates of COVID-19 amongst African Americans, although detailed epidemiological study data is pending. Sickle Cell Disease (SCD) disproportionately affect Black/African Americans in the United States as well as forebearers from sub-Saharan Africa, the Western Hemisphere (South America, the Caribbean, and Central America) and some Mediterranean countries. The carrier frequency for SCD is high amongst African Americans. This article underscores the putative risks that may be associated with COVID-19 pneumonia in sickle cell trait as well as potential opportunities for individualized medical care in the burgeoning era of personalized medicine.


title: Self-reported alteration of sense of smell or taste in patients with COVID-19: a systematic review and meta-analysis on 3563 patients

text: BACKGROUND: Emerging reports suggest that new onset of smell or taste loss are potential early clinical markers of SARS-CoV-2 infection, but it remains unclear as to what extent. Therefore, the purpose of this study is to systematically assess the prevalence of self-reported altered sense of smell or taste in patients with confirmed SARS-CoV-2 infection, overcoming the limitations of individual studies by meta-analysis of pooled data. METHODS: The databases Medline, Embase, Web of Science, Scopus and MedRxiv's set were searched from inception to the 4th May 2020. This study was conducted following the PRISMA checklist. RESULTS: 18 studies met the eligibility criteria out of the 171 initially screened citations. The overall prevalence of alteration of the sense of smell or taste was 47% , but estimates were 31% and 67% in severe and mild-to-moderate symptomatic patients, respec- tively. The loss of smell and taste preceded other symptoms in 20% of cases and it was concomitant in 28%. CONCLUSIONS: Based on this meta-analysis, we recommend self-isolation and testing, where possible, for patients complaining smell or taste impairment during COVID-19 pandemic in order to prevent spread of disease and propose the inclusion of loss of smell and taste as recognized symptoms of SARS-CoV-2 in the World Health Organization and other relevant regulatory body's lists.


docid: njsvkrkq

title: Successful intravenous immunoglobulin treatment in severe COVID-19 pneumonia

text: We describe a 42-year old woman, admitted to our Department after 15 days of persistence of respiratory failure and treated with infusion of intravenous immunoglobulin with a successful outcome.


title: COVID -19 and the state of African neurology

text: Expectations of Africa having high rates of infection and death from COVID-19 have, as yet, not materialised. At the time of writing, all 54 countries have officially reported COVID-19 cases; 123,724 people have tested positive for the disease and 3,668 people have died. The reasons for such low levels may be due, in part, to countries rapid responses: South Africa declared a national state of disaster and implemented a nationwide lockdown before even its first death was reported and likewise Uganda suspended all public gatherings before the country reported its first case. In Ethiopia-where the first case was reported March 13-the office of the Prime Minister announced that schools, sporting events, and public gatherings should be suspended for 15 days, on March 16. In Addis Ababa, on April 8, the Council of Ministers declared a 5-month long state of emergency.


docid: kvrbcmux

title: The impact of undetected cases on tracking epidemics: the case of COVID-19

text: One of the key indicators used in tracking the evolution of an infectious disease isthe reproduction number. This quantity is usually computed using the reportednumber of cases, but ignoring that many more individuals may be infected (e.g.asymptomatics). We propose a statistical procedure to quantify the impact of un-detected infectious cases on the determination of the effective reproduction number. Our approach is stochastic, data-driven and not relying on any compartmentalmodel. It is applied to the COVID-19 case in eight different countries and all Italianregions, showing that the effect of undetected cases leads to estimates of the effective reproduction numbers larger than those obtained only with the reported cases by factors ranging from two to ten. Our findings urge caution about deciding when and how to relax containment measures based on the value of the reproduction number.


title: Psychological health during the coronavirus disease 2019 pandemic outbreak

text: BACKGROUND: The current ongoing pandemic outbreak of COVID-19 (Coronavirus Disease 2019) has globally affected 213 countries and territories with more than 2.5 million confirmed cases and thousands of casualties. The unpredictable and uncertain COVID-19 outbreak has the potential of adversely affecting the psychological health on individual and community level. Currently all efforts are focused on the understanding of epidemiology, clinical features, mode of transmission, counteract the spread of the virus, and challenges of global health, while crucially significant mental health has been overlooked in this endeavor. METHOD: This review is to evaluate past outbreaks to understand the extent of adverse effects on psychological health, psychological crisis intervention, and mental health management plans. Published previous and current articles on PubMed, EMBASE, Google Scholar, and Elsevier about psychological impact of infectious diseases outbreaks and COVID-19 has been considered and reviewed. COMMENTS: COVID-19 is leading to intense psychosocial issues and comprising mental health marking a secondary health concern all around the world. Globally implementing preventive and controlling measures, and cultivating coping and resilience are challenging factors; modified lifestyle (lockdown curfew, self-isolation, social distancing and quarantine); conspiracy theories, misinformation and disinformation about the origin, scale, signs, symptoms, transmission, prevention and treatment; global socioeconomic crisis; travel restrictions; workplace hazard control; postponement and cancellation of religious, sports, cultural and entertainment events; panic buying and hoarding; incidents of racism, xenophobia, discrimination, stigma, psychological pressure of productivity, marginalization and violence; overwhelmed medical centers and health organizations, and general impact on education, politics, socioeconomic, culture, environment and climate - are some of the risk factors to aggravate further problems.


title: Corona virus versus existence of human on the earth: A computational and biophysical approach

text: SARS-CoV-2 has a positive sense RNA genome of 29.9 kb in size, showing high sequence similarity to the BAT-CoV, SARS-CoV, MERS-CoV. SARS-CoV-2 is composed of 14 open reading frames (ORFs), which encodes for a total of 27 proteins divided into structural and non-structural proteins (NSPs). The fundamental structural protein-encoding genes are a spike protein (S) gene, envelope protein (E) gene, a membrane protein (M) gene, and a nucleocapsid protein (N) gene. They make about 33% of the entire genome and are vital for the viral life cycle. Rest 67% is distributed among different NSPs (such as Mpro, helicase, and RNA-dependent RNA polymerase) encoding genes across the ORFs, which are involved in virus-cell receptor interactions during viral entry. Researchers are trying to formulate vaccines, therapeutic antibodies or protein-targeted antiviral drugs to control the spread. This review proceeds stepwise through the COVID-19 outbreak, structural and genomic organization, entry mechanism, pathogenesis, and finally highlighting the essential proteins involved at each step that might be potential targets for drug discovery. Currently, approved treatment modalities consist of only supportive care and oxygen supplementation. This review is established on the current knowledge that has expanded on structural motifs and topology of proteins and their functions.


Rethinking Regional Neurologic Care in the Coronavirus Disease 2019 Era


docid: vwergkpx

title: La pandemia de Coronavirus SARS-CoV-2 (COVID-19): Situación actual e implicaciones para México

text: The Coronavirus pandemic (COVID-19) is one of the most devastating in this century It originated in China in December 2019 caused by the SARS-Cov-2 virus, and in less than a month it had been classified as an "International Public Health Emergency" To date there are nearly 3 million people infected and more than 250,000 deaths caused by the disease worldwide Initially it affects the respiratory tract with atypical pneumonia and in severe cases it produces systemic inflammation with cytokine storm that can cause rapid deterioration with circulatory and respiratory failure, coagulopathy and a lethality rate of approximately 7% In Mexico, the first case was detected in February 2020, and to date there are 26,616 confirmed cases and 2,961 deaths throughout the country The low number of diagnostic tests conducted in our country clearly underestimates the real incidence and impact of the disease The most affected groups are those with risk factors such as age over 60, presence of hypertension, diabetes or cardiovascular disease Of the confirmed cases, 15% are healthcare workers There is no specific treatment or vaccine yet, so it is important to have hygiene, social isolation and personal protection measures Health, social and economic consequences could have great impact in the near future


title: Plasma from donors recovered from the new Coronavirus 2019 as therapy for critical patients with COVID-19 (COVID-19 plasma study): a multicentre study protocol

text: Since the end of 2019, a new coronavirus strain has been reported in the Chinese province of Wuhan, indicated as 2019-nCoV or SARS-CoV-2. In February 2020, the first case of transmission on Italian soil was reported. On March 09, 2020, at the time of protocol design, the Italian Ministry of Health reported 10,149 people who had contracted the virus; of these, 8514 were positive, of which 5038 were hospitalized with symptoms (59.2%) and 877 in intensive care (10.3%), while the remaining 2599 were in home isolation; 631 were deceased (6.2%) and 1004 healed (9.9%). To date there are no studies in the literature that demonstrate its feasibility and efficacy in the context of the worldwide SARS-CoV-2 epidemic. Based upon the little existing evidence, we planned to assess the efficacy of the infusion of hyperimmune plasma in COVID-19 patients in a one-arm proof-of-concept clinical trial. The primary objective of our study is to evaluate the efficacy of the administration of plasma taken from convalescent donors of COVID-19 to critically ill patients with COVID-19 in terms of their survival. Death from any cause will be considered. The main limit of this study is its one-arm proof-of-concept design with only 43 patients enrolled. However, in the absence of previous evidence, larger and/or randomized trials did not appear to be ethically acceptable. Moreover, the results from this study, if encouraging, will allow us to plan further informed large clinical trials. Trial registration: NCT04321421 March 23, 2020.


Hypofractionated radiotherapy in patients with non-melanoma skin cancer in the post COVID-19 era: Time to reconsider its role for most patients


title: Initial psychological impact of COVID-19 and its correlates in Indian Community: An online (FEEL-COVID) survey

text: BACKGROUND: The pandemic of Corona Virus (COVID-19) hit India recently; and the associated uncertainty is increasingly testing psychological resilience of the masses. When the global focus has mostly been on testing, finding a cure and preventing transmission; people are going through a myriad of psychological problems in adjusting to the current lifestyles and fear of the disease. Since there is a severe dearth of researches on this issue, we decided to conduct an online survey to evaluate its psychological impact. METHODS: From 26th to 29th March an online survey (FEEL-COVID) was conducted using principles of snowballing, and by invitation through text messages to participate. The survey collected data on socio-demographic and clinical variables related to COVID-19 (based on the current knowledge); along with measuring psychological impact with the help of Impact of Event-revised (IES-R) scale. RESULTS: There were a total of 1106 responses from around 64 cities in the country. Out of these 453 responses had at least one item missing; and were excluded from the analysis. The mean age of the respondents was around 41 years with a male female ratio of 3:1 and around 22% respondents were health care professionals. Overall approximately one third of respondents had significant psychological impact (IES-R score > 24). Higher psychological impact was predicted with younger age, female gender and comorbid physical illness. Presence of physical symptoms and contact history predicted higher psychological impact, but did not reach statistical significance. CONCLUSION: During the initial stages of COVID-19 in India, almost one-third respondents had a significant psychological impact. This indicates a need for more systematic and longitudinal assessment of psychological needs of the population, which can help the government in formulating holistic interventions for affected individuals.


Reply to "Vascular Changes Detected With Thoracic CT in Coronavirus Disease (COVID-19) Might Be Significant Determinants for Accurate Diagnosis and Optimal Patient Management"


docid: gswkidft

title: Insurance status and level of education predict disparities in receipt of treatment and survival for anal squamous cell carcinoma

text: INTRODUCTION: Anal squamous cell carcinoma (ASCC) is relatively rare, but its incidence and mortality have been steadily climbing in marginalized populations. We explored the impact of insurance status, education, and income on survival and receipt of chemoradiation therapy. METHODS: We included patients with ASCC from the Surveillance, Epidemiology, and End Results Program database from 2004 to 2016. Socioeconomic variables included insurance status, level of education, income, and unemployment rate. Cox proportional hazards and multivariate logistic regression were used to determine predictors of survival and receipt of chemoradiation. RESULTS: We included a total of 10,868 cases of ASCC. The median age was 55, 10.4 % were black, and 65.4 % were female. Overall, 74.1 % of patients received combination chemoradiation. In multivariate analysis, poorer survival was found for Medicaid (HR 1.52, 95 % CI 1.34-1.74) and uninsured (HR 1.68, 95 % CI 1.35-2.10) patients, and for communities with the lowest rates of high school education (HR 1.17, 95 % CI 1.02-1.38), lowest income (HR 1.29, 95 % CI 1.08-1.54), and highest unemployment (HR 1.21, 95 % CI 1.03-1.40). Patients were less likely to receive combination treatment if they were black (OR 0.76, 95 % CI 0.55-0.92), had Medicaid insurance (OR 0.54, 95 % CI 0.33-0.88) or lower education (OR 0.59, 95 % CI 0.46-0.76). CONCLUSION: Insurance status, level of education, income, and employment impact survival and receipt of treatment in patients with ASCC. Identifying high risk patients and developing targeted interventions to improve access to treatment is integral to reducing these disparities and improving cancer survival.


Covid-19: Doctors should be alert for signs of myocardial injury, says NICE


title: Usefulness and safety of remote continuous glucose monitoring for a severe COVID-19 patient with diabetes

text: Diabetes is associated with mortality and severity of COVID-19. Protecting against infection in healthcare workers at high risk of COVID-19 are critical. This report investigates the usefulness and safety of remote continuous glucose monitoring in a patient with diabetes and severe interstitial pneumonia caused by the coronavirus disease. The Dexcom G4 Platinum continuous glucose monitoring system® was used to monitor blood glucose levels from outside the patient's isolation room. Continuous insulin infusion rates and boluses were determined based on the patient's blood glucose levels. Real-time continuous glucose monitoring made it possible to track blood glucose trends and prevent dramatic variations in blood glucose, although the rate of insulin infusion changed dynamic. Furthermore, the need for healthcare workers to enter the isolation room was minimized because the Dexcom G4 Platinum continuous glucose monitoring system can evaluate from a distance of up to 6.0 meters.


title: Effective lockdown and role of hospital-based COVID-19 transmission in some Indian states: An outbreak risk analysis

text: There are several reports in India that indicate hospitals and quarantined centers are COVID-19 hotspots. In the absence of efficient contact tracing tools, Govt. and the policymakers may not be paying attention to the risk of hospital-based transmission. To explore more on this important route and its possible impact on lockdown effect, we developed a mechanistic model with hospital-based transmission. Using daily notified COVID-19 cases from six states (Maharashtra, Delhi, Madhya Pradesh, Rajasthan, Gujarat, and Uttar Pradesh) and overall India, we estimated several important parameters of the model. Moreover, we provided an estimation of the basic ($R_{0}$), the community ($R_{C}$), and the hospital ($R_{H}$) reproduction numbers for those seven locations. To obtain a reliable forecast of future COVID-19 cases, a BMA post-processing technique is used to ensemble the mechanistic model with a hybrid statistical model. Using the ensemble model, we forecast COVID-19 notified cases (daily and cumulative) from May 3, 2020, till May 20, 2020, under five different lockdown scenarios in the mentioned locations. Our analysis of the mechanistic model suggests that most of the new COVID-19 cases are currently undetected in the mentioned seven locations. Furthermore, a global sensitivity analysis of four epidemiologically measurable \&controllable parameters on $R_{0}$ and as well on the lockdown effect, indicate that if appropriate preventive measures are not taken immediately, a much larger COVID-19 outbreak may trigger from hospitals and quarantined centers. In most of the locations, our ensemble model forecast indicates a substantial percentage of increase in the COVID-19 notified cases in the coming weeks in India. Based on our results, we proposed a containment policy that may reduce the threat of a larger COVID-19 outbreak in the coming days.


title: Impact of Rumors and Misinformation on COVID-19 in Social Media

text: The coronavirus disease 2019 (COVID-19) pandemic has not only caused significant challenges for health systems all over the globe but also fueled the surge of numerous rumors, hoaxes, and misinformation, regarding the etiology, outcomes, prevention, and cure of the disease. Such spread of misinformation is masking healthy behaviors and promoting erroneous practices that increase the spread of the virus and ultimately result in poor physical and mental health outcomes among individuals. Myriad incidents of mishaps caused by these rumors have been reported globally. To address this issue, the frontline healthcare providers should be equipped with the most recent research findings and accurate information. The mass media, healthcare organization, community-based organizations, and other important stakeholders should build strategic partnerships and launch common platforms for disseminating authentic public health messages. Also, advanced technologies like natural language processing or data mining approaches should be applied in the detection and removal of online content with no scientific basis from all social media platforms. Furthermore, these practices should be controlled with regulatory and law enforcement measures alongside ensuring telemedicine-based services providing accurate information on COVID-19.


title: COViD-19: Face Mask Effectiveness, Hand Sanitizer Shortages, and Rapid Medication Therapy Trials

text: The COVID-19 pandemic is a rapidly evolving phenomenon that presents serious practical challenges and complex clinical considerations for health care workers, health care administrators, and policy formulators. The Senior Care Pharmacist carries periodic updates addressing matters relevant to pharmacotherapeutics and pharmacy practice as these relate to the care of older people in the time of the pandemic. The brief news items that are provided here are not intended to be substitutes for a careful and comprehensive consideration of the issues involved, but rather, they serve to provide initial awareness of concepts and to stimulate more complete situational analysis.


title: Marked T cell activation, senescence, exhaustion and skewing towards TH17 in patients with COVID-19 pneumonia

text: The immune system of patients infected by SARS-CoV-2 is severely impaired. Detailed investigation of T cells and cytokine production in patients affected by COVID-19 pneumonia are urgently required. Here we show that, compared with healthy controls, COVID-19 patients' T cell compartment displays several alterations involving naïve, central memory, effector memory and terminally differentiated cells, as well as regulatory T cells and PD1+CD57+ exhausted T cells. Significant alterations exist also in several lineage-specifying transcription factors and chemokine receptors. Terminally differentiated T cells from patients proliferate less than those from healthy controls, whereas their mitochondria functionality is similar in CD4+ T cells from both groups. Patients display significant increases of proinflammatory or anti-inflammatory cytokines, including T helper type-1 and type-2 cytokines, chemokines and galectins; their lymphocytes produce more tumor necrosis factor (TNF), interferon-Î³, interleukin (IL)-2 and IL-17, with the last observation implying that blocking IL-17 could provide a novel therapeutic strategy for COVID-19.


Anaesthesia preparedness for COVID-19 pandemic readiness: a medication preservation strategy


title: Measuring the effectiveness of an automated text messaging active surveillance system for COVID-19 in the south of Ireland, March to April 2020

text: We report the effectiveness of automated text messaging for active surveillance of asymptomatic close contacts of coronavirus disease (COVID-19) cases in the Cork/Kerry region of Ireland. In the first 7 weeks of the COVID-19 outbreak, 1,336 close contacts received 12,421 automated texts. Overall, 120 contacts (9.0%) reported symptoms which required referral for testing and 35 (2.6%) tested positive for COVID-19. Non-response was high (n = 2,121; 17.1%) and this required substantial clinical and administrative resources for follow-up.


title: [Significance and operation mode of moxibustion intervention for the group under quarantine after close contact with COVID-19]

text: On the base of the idea of traditional Chinese medicine as "disease prevention", the mode and the protocol of the moxibustion intervention for the group under quarantine after close contact with coronavirus disease 2019 (COVID-19) were explored. The group under quarantine after close contact with COVID-19 was taken as the subjects. By the non-contact physician-patient communication network platform co-developed by China Association of Acupuncture-Moxibustion, Hunan Provincial Association of Acupuncture-Moxibustion, Data Center of China Academy of Chinese Medical Sciences and Yuge Medicine Company, an exploratory randomized controlled trial was designed. A total of 100 cases were included and randomized into a moxibustion group and a conventional intervention group, 50 cases in each one. In the moxibustion group, moxibustion intervention was used. In the conventional intervention group, the conventional observation was adopted without moxibusiton intervention applied. The outcomes included the symptoms changes, e.g. anxiety, emotional disturbance, fatigue, headache and diarrhea, as well as whether quarantine release and the case confirmed or not, etc. The results were evaluated before intervention, in 14 days of intervention and 2 weeks after intervention separately. In this research, on the base of internet plus technology and with the internet communication platform adopted, through mobile phone WeChat App, it was to implement the subject screen, the random allocation and the instruction of moxibustion intervention as well as the quality control of patient's diary and data collection. It is anticipated that the significance and the implementation mode of moxibustion intervention can be assessed preliminarily for the group under quarantine after close contact with COVID-19.


title: A Conceptual Discussion about R0 of SARS-COV-2 in Healthcare Settings

text: To date, no specific estimate of R0 for SARS-CoV-2 is available for healthcare settings. Using inter-individual contact data, we highlight that R0 estimates from the community cannot translate directly to healthcare settings, with pre-pandemic R0 values ranging 1.3-7.7 in three illustrative healthcare institutions. This has implications for nosocomial Covid-19 control.


Paediatric ethical issues during the COVID-19 pandemic are not just about ventilator triage


Gustatory dysfunctions in COVID-19 patients: possible involvement of taste renin-angiotensin system (RAS)


title: National Outreach of Telepalliative Medicine Volunteers for a New York City Safety Net System COVID-19 Pandemic Response

text: The coronavirus disease 2019 surge in New York City created an increased demand for palliative care (PC) services. In staff-limited settings such as safety net systems, and amid growing reports of health care worker illness, leveraging help from less-affected areas around the country may provide an untapped source of support. A national social media outreach effort recruited 413 telepalliative medicine volunteers (TPMVs). After expedited credentialing and onboarding of 67 TPMVs, a two-week pilot was initiated in partnership with five public health hospitals without any previous existing telehealth structure. The volunteers completed 109 PC consults in the pilot period. Survey feedback from TPMVs and on-site PC providers was largely positive, with areas of improvement identified around electronic health record navigation and continuity of care. This was a successful, proof of concept, and quality improvement initiative leveraging TPMVs from across the nation for a PC pandemic response in a safety net system.


After the COVID 19 outbreak in Italy: What have we learnt?


title: An assessment of United States dermatology practices during the COVID-19 outbreak

text: Objectives: The COVID-19 outbreak is a serious threat to public health and social distancing on the part of individuals can help contain the epidemic. It is unknown if dermatologists are assisting with the public health officials' recommendations for social distancing by closing their practice or limiting their practice to the treatment of emergency conditions. This study examines the activity level of dermatology practices during the United States COVID-19 outbreak.Methods: We performed scripted phone calls to 60 dermatology practices in six different counties in the United Stated during the COVID-19 outbreak. We assessed if practices are open and if they are serving patients with urgent and non-urgent conditions.Results: Of the 60 dermatologists selected for the study, 55 were successfully contacted (92% contact rate). Of these practices, 29 (53%) were open, 17 (31%) were only seeing urgent patients and 9 (16%) were closed. New York, New York had 2 (20%) open offices which was the lowest proportion of any county (p = .04). Counties with higher prevalence had fewer open offices (p < .01, R2 = .7).Conclusions: Many practices have restricted their level of operation especially in higher areas of COVID-19 prevalence, likely to help facilitate social distancing.


title: Evaluation of the RealStar® SARS-CoV-2 RT-PCR kit RUO performances and limit of detection

text: BACKGROUND: The use of efficient, reliable and sensitive PCR assays is a cornerstone in the race to contain the SARS-CoV-2 pandemic. In this work we performed an independent evaluation of the RealStar® SARS-CoV-2 RT-PCR Kit Researh Use Only (Altona) for SARS-CoV-2 detection. METHODS: A comparative limit of detection (LoD) assessment was performed between RealStar® SARS-CoV-2 and the currently WHO recommended RT-PCR (WHO-PCR) workflow using a quantified clinical sample. Assessment of the RealStar® SARS-CoV-2 assay was also performed using 83 primary clinical samples in comparison with the WHO-PCR. RESULTS: The RealStar® SARS-CoV-2 demonstrated a slightly higher sensitivity than the WHO recommended assay with a limit of detection at 625 copies/mL instead of 1250 copies/mL for the WHO-PCR in our conditions. The overall percent agreement between RealStar® SARS-CoV-2 and WHO-PCR on 83 clinical samples was 97.6 % (81/83) with a sensitivity at 97.8 % (45/46) and specificity at 97.3 % (36/37). No cross reaction was encountered for the other human coronaviruses (HKU1, OC43, NL63, 229E). CONCLUSIONS: In this comparison of the RealStar® SARS-CoV-2 assay with the reference WHO assay, we observed a slightly better sensitivity of the RealStar® assay. It provides a robust option for all molecular biology laboratories, with a strong real-life LoD and is compatible with various real-time PCR platforms.


title: COVID-19 and the male susceptibility: the role of ACE2, TMPRSS2 and the androgen receptor

text: COVID-19 is the pandemic that hit the world starting December 2019. Recent studies and international statistics have shown an increased prevalence, morbidity as well as mortality of this disease in male patients compared to female patients. The aim of this brief communication is to describe the pathophysiology of this sex-discrepancy, based on the infectivity mechanism of the coronavirus including the Angiotensin-Converting Enzyme 2 (ACE2), the Type II transmembrane Serine Protease (TMPRSS2), and the androgen receptor. This could help understand the susceptibility of urological patients, especially those receiving androgen deprivation therapy for prostate cancer, and testosterone replacement therapy.


Letter to the editors in response to: Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may be harmful in patients with diabetes during COVID-19 pandemic (Cure et al.)


title: Neutrophil Extracellular Traps (NETs) Contribute to Immunothrombosis in COVID-19 Acute Respiratory Distress Syndrome

text: COVID-19 affects millions of patients worldwide with clinical presentation ranging from isolated thrombosis to acute respiratory distress syndrome (ARDS) requiring ventilator support. Neutrophil extracellular traps (NETs) originate from decondensed chromatin released to immobilize pathogens and can trigger immunothrombosis. We studied the connection between NETs and COVID-19 severity and progression. We conducted a prospective cohort study of COVID-19 patients (n=33) with age- and sex-matched controls (n=17). We measured plasma myeloperoxidase (MPO)-DNA complexes (NETs), Platelet Factor 4, RANTES, and selected cytokines. Three COVID-19 lung autopsies were examined for NETs and platelet involvement. We assessed NET formation ex vivo in COVID-19 neutrophils and in healthy neutrophils incubated with COVID-19 plasma. We also tested the ability of neonatal NET-Inhibitory Factor (nNIF) to block NET formation induced by COVID-19 plasma. Plasma MPO-DNA complexes increased in COVID-19 with intubation (P<0.0001) and death as outcome (P<0.0005). Illness severity correlated directly with plasma MPO-DNA complexes (P=0.0360), while PaO2/FiO2 correlated inversely(P=0.0340). Soluble and cellular factors triggering NETs were significantly increased in COVID-19 and pulmonary autopsies confirmed NET-containing microthrombi with neutrophil-platelet infiltration. Finally, COVID-19 neutrophils ex vivo displayed excessive NETs at baseline and COVID-19 plasma triggered NET formation which was blocked by nNIF. Thus, NETs triggering immunothrombosis may, in part, explain the prothrombotic clinical presentations in COVID-19 and NETs may represent targets for therapeutic intervention.


docid: ghdywizi

title: Incubation period of the coronavirus disease 2019 (COVID-19) in Busan, South Korea

text: The assessment of the incubation period, which is the period between the infection and the illness onset, is essential to identify the sufficient isolation period for infectious diseases. In South Korea, a few cases of the coronavirus disease 2019 (COVID-19) were identified after the 14-day self-quarantine program, and the length of this quarantine has raised controversial issues for the Korean public health professionals. We estimated the COVID-19 incubation period using the log-normal distribution from publicly available data. The data were obtained from the press release of the Busan city department of public health and news reports. We collected and analysed information for 47 patients with a median age of 30. We estimated that the median incubation period was three days (95% Confidence Interval, 0.6-8.2). We also did not find any significant difference in the incubation period between males and females. Our findings indicate that a 14-day self-quarantine program should be sufficient to prevent spreading in the infection of suspected individuals with COVID-19 in the community.


title: AI Surveillance during Pandemics: Ethical Implementation Imperatives

text: Artificial intelligence surveillance can be used to diagnose individual cases, track the spread of Covid-19, and help provide care. The use of AI for surveillance purposes (such as detecting new Covid-19 cases and gathering data from healthy and ill individuals) in a pandemic raises multiple concerns ranging from privacy to discrimination to access to care. Luckily, there exist several frameworks that can help guide stakeholders, especially physicians but also AI developers and public health officials, as they navigate these treacherous shoals. While these frameworks were not explicitly designed for AI surveillance during a pandemic, they can be adapted to help address concerns regarding privacy, human rights, and due process and equality. In a time where the rapid implementation of all tools available is critical to ending a pandemic, physicians, public health officials, and technology companies should understand the criteria for the ethical implementation of AI surveillance.


Impact of COVID-19 public health interventions on influenza incidence in Thailand


docid: cswpckme

title: Best interests versus resource allocation: could COVID-19 cloud decision-making for the cognitively impaired?

text: The COVID-19 pandemic is putting the NHS under unprecedented pressure, requiring clinicians to make uncomfortable decisions they would not ordinarily face. These decisions revolve primarily around intensive care and whether a patient should undergo invasive ventilation. Certain vulnerable populations have featured in the media as falling victim to an increasingly utilitarian response to the pandemic-primarily those of advanced years or with serious existing health conditions. Another vulnerable population potentially at risk is those who lack the capacity to make their own care decisions. Owing to the pandemic, there are increased practical and normative challenges to following the requirements of the Mental Capacity Act 2005. Both capacity assessments and best interests decisions may prove more difficult in the current situation. This may create a more paternalistic situation in decisions about the care of the cognitively impaired which is at risk of taking on a utilitarian focus. We look to these issues and consider whether there is a risk of patients who lack capacity to make their own care decisions being short-changed.


title: Examining the incubation period distributions of COVID-19 on Chinese patients with different travel histories

text: INTRODUCTION: Current studies estimated a general incubation period distribution of COVID-19 based on early-confirmed cases in Wuhan, and have not examined whether the incubation period distribution varies across population segments with different travel histories. We aimed to examine whether patients infected by community transmission had extended incubation periods than the early generation patients who had direct exposures to Wuhan. METHODOLOGY: Based on 4741 patient case reports from municipal centers of disease control by February 21, 2020, we calculated the incubation periods of 2555 patients with clear epidemiological survey information and illness development timeline. All patients were categorized into five groups by their travel histories. Incubation period distributions were modeled for each group by the method of the posterior Weibull distribution estimation. RESULTS: Adults aged 30 to 59 years had the most substantial proportion of confirmed cases in China. The incubation period distribution varied slightly across patient groups with different travel histories. Patients who regularly lived in Wuhan and left to other locations before January 23, 2020 had the shortest posterior median value of 7.57 days for the incubation period, while the incubation periods for persons affected by local community transmission had the largest posterior median of incubation periods, 9.31 days. CONCLUSIONS: The median incubation period for all patients infected outside Wuhan was 9 days, a bit of more extended than the early estimated 5-day incubation period that was based on patients in Wuhan. Our findings may imply the decreases of virulence of the COVID-19 virus along with intergenerational transmission.


Improved Prognosis in Cystic Fibrosis: Consideration for Intensive Care during the COVID-19 Pandemic


Culture and COVID-19: Observations From an Italian American Nurse


title: The psychological impact of COVID-19 pandemic on physicians in Saudi Arabia: A cross-sectional study

text: Background/Aim: COVID-19 pandemic exposed physicians to extraordinary stress and made them vulnerable to various types of psychological illnesses. The aim of this study was to evaluate the impact that the COVID-19 pandemic had on the psychological well-being of physicians. Materials and Methods: We performed a cross-sectional, survey-based study, targeting physicians in Saudi Arabia during the COVID-19 pandemic. The primary outcome was to assess the psychological impact that the pandemic had on physicians by using a questionnaire that was previously designed and used by Reynold's et al. to survey Canadians during the SARS outbreak in 2003. The questionnaire assessed respondents' understanding of the rationale for quarantine, quarantine behaviors (including difficulties and compliance), as well as socio-economic and psychological impacts through answers that are based on a Likert scale. We also assessed the possible risk factors for psychological disorders related to the pandemic. Results: The study included 529 physicians from various regions in Saudi Arabia. The enrolled physicians were practicing different specialties and branches in medicine. We classified them based on their workplace in relation to COVID-19 exposure to: COVID-19 designated center vs. non-COVID-19 designated centers. Furthermore, we subdivided the physicians who work in COVID-19 designated centers to those who work in high-risk areas such as ER, ICU and COVID-19 isolation wards and other areas as low-risk areas. The most common feelings reported by the physicians during the pandemic were: worry (357, 67.5%), isolation (301, 56.9%) and fear (263, 49.7%). According to logistic regression analysis, physicians older than age 60 were less likely to feel isolated (OR = 0.08, 95% CI = 0.01-0.96, P = 0.05), female physicians were more likely to experience fear (OR = 2.96, 95% CI = 1.20 - 7.27, P = 0.02) and worry (OR = 2.87,95% CI = 1.23 - 6.69, P = 0.02), while physicians with a previous exposure to similar traumatic events were less likely to experience fear (OR = 0.24, 0.10 - 0.64, P = 0.004) during the COVID-19 pandemic. Conclusions: The COVID-19 pandemic had a negative psychological effect on physicians in Saudi Arabia. Gender, age, and previous exposure to similar traumatic events were predictive of psychological reactions to the pandemic in this population.


title: Incorporating Video Visits into Ophthalmology Practice: A Retrospective Analysis and Patient Survey to Assess Initial Experiences and Patient Acceptability at an Academic Eye Center

text: INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has led to rapid adoption of teleophthalmology to deliver eyecare remotely. The purpose of our study was to assess the implementation and patient acceptability of video consultation for outpatient ophthalmic care at our institution. METHODS: We conducted a retrospective, cross-sectional analysis and patient survey of adult patients who completed a virtual video visit at our institution from 18 March 18 through to 27 April 2020. All video visit encounters were assessed for patient characteristics, diagnoses, management, and follow-up outcomes. Patients were surveyed for their feedback on acceptability and utility of their virtual video consultation. RESULTS: A total of 219 patients (mean age 55 years; range 21-89 years) completed 231 video visit encounters at our department over a 6-week period, of whom 118 were women (54%). About half of these encounters were acute visits (102 visits, 47%). The most common diagnosis of these visits was postoperative state (20 visits, 9% of the total), followed by conjunctivitis (16 visits, 7%), and keratitis (14 visits, 6%). The most common management decisions were medication prescription (102 visits, 46%) or reassurance (86 visits, 39%), while 17 video visit patients (8%) were escalated to an urgent, in-person evaluation. Ninety-two patients completed a follow-up survey (42% response rate), of whom 45 (49%) indicated that they might have delayed seeking care during this pandemic in the absence of a virtual video option. Seventy-two (78%) reported that they would consider participating in a video visit as an alternative to an office-based encounter in the future, and the overall video visit experience was rated highly, with a weighted mean Likert scale rating of 4.3 out of 5 (Cronbach's α = 0.88). CONCLUSION: Virtual video visits may be used to manage a range of ophthalmic complaints. Patients participating in this survey found such video visits acceptable and timesaving, and the majority would consider using video consultations for future eyecare encounters.


docid: kshjqsdj

title: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings: A Living Rapid Review

text: BACKGROUND: Recommendations on masks for preventing coronavirus disease 2019 (COVID-19) vary. PURPOSE: To examine the effectiveness of N95, surgical, and cloth masks in community and health care settings for preventing respiratory virus infections, and effects of reuse or extended use of N95 masks. DATA SOURCES: Multiple electronic databases, including the World Health Organization COVID-19 database and medRxiv preprint server (2003 through 14 April 2020; surveillance through 2 June 2020), and reference lists. STUDY SELECTION: Randomized trials of masks and risk for respiratory virus infection, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and observational studies of mask use and coronavirus infection risk were included. New evidence will be incorporated by using living review methods. DATA EXTRACTION: One reviewer abstracted data and assessed methodological limitations; a second reviewer provided verification. DATA SYNTHESIS: 39 studies (18 randomized controlled trials and 21 observational studies; 33 867 participants) were included. No study evaluated reuse or extended use of N95 masks. Evidence on SARS-CoV-2 was limited to 2 observational studies with serious limitations. Community mask use was possibly associated with decreased risk for SARS-CoV-1 infection in observational studies. In high- or moderate-risk health care settings, observational studies found that risk for infection with SARS-CoV-1 and Middle East respiratory syndrome coronavirus probably decreased with mask use versus nonuse and possibly decreased with N95 versus surgical mask use. Randomized trials in community settings found possibly no difference between N95 versus surgical masks and probably no difference between surgical versus no mask in risk for influenza or influenza-like illness, but compliance was low. In health care settings, N95 and surgical masks were probably associated with similar risks for influenza-like illness and laboratory-confirmed viral infection; clinical respiratory illness had inconsistency. Bothersome symptoms were common. LIMITATIONS: There were few SARS-CoV-2 studies, observational studies have methodological limitations, and the review was done by using streamlined methods. CONCLUSION: Evidence on mask effectiveness for respiratory infection prevention is stronger in health care than community settings. N95 respirators might reduce SARS-CoV-1 risk versus surgical masks in health care settings, but applicability to SARS-CoV-2 is uncertain. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.


COVID-19 pandemic in India: challenges and silver linings


title: Коронавирусная болезнь 2019 (COVID-19): размышления ревматолога

text: В декабре 2019 г в г Ухань (провинция Хубэй, расположенная в центральном регионе Китая) зарегистрирована вспышка новой инфекции, получившей рабочее название 2019-nCoV, которая быстро распространилась практически по всей территории земного шара и приняла характер пандемии Всемирная организация здравоохранения (ВОЗ) предложила новое название этого заболевания – коронавирусная болезнь (coronavirus disease, COVID-19), а Международный комитет по таксономии вирусов переименовал 2019-nCov в SARS-Cov-2 (severe acute respiratory syndrome Coronavirus-2) Развитие пандемии COVID-19 имеет не только огромное социальное значение, но и привлекает внимание медицинской общественности к принципиально новым клиническим и фундаментальным проблемам иммунопатологии заболеваний человека, которые еще предстоит сформулировать Уникальный опыт, накопленный в ревматологии в процессе изучения патогенетических механизмов и фармакотерапии иммуновоспалительных ревматических заболеваний (ИВРЗ), может иметь немаловажное значение для расшифровки природы патологических процессов, лежащих в основе тяжелых, потенциально смертельных осложнений COVID-19, и, возможно, будет способствовать совершенствованию их терапии Что касается перспектив пациентов с ИВРЗ, то, хотя развитие COVID-19 при них, к счастью, еще не описано, можно полагать, что инфицирование SARS-CoV-2 (как и другими вирусами) способно вызывать обострение патологического процесса, а тяжелая патология иммунной системы и сопутствующие коморбидные заболевания – утяжелять течение инфекции Поскольку, согласно современным представлениям, именно «гипериммунный» ответ, а не только действие самого вируса лежит в основе поражения легких и летальности при COVID-19, особое внимание привлекают эффекты «противоревматической» терапии, включающей нестероидные противовоспалительные препараты, глюкокортикоиды, базисные противовоспалительные препараты (БПВП), генно-инженерные биологические препараты и «таргетные» БПВП, которая могут оказывать разнонаправленное влияние на течение COVID-19 Имеются значительные теоретические предпосылки для «репозиционирования» (drug repurposing) некоторых широко применяемых в ревматологии лекарственных препаратов для лечения COVID-19 и его осложнений Рассматриваются перспективы изучения иммунопатологии COVID 19 и теоретические обоснования применения аминохинолиновых препаратов, моноклональных антител к ИЛ6, а также ингибиторов Янус-киназ для профилактики оcложнений и лечения COVID-19


title: The Australian Institute of Sport framework for rebooting sport in a COVID-19 environment

text: Sport makes an important contribution to the physical, psychological and emotional well-being of Australians. The economic contribution of sport is equivalent to 2-3% of Gross Domestic Product (GDP). The COVID-19 pandemic has had devastating effects on communities globally, leading to significant restrictions on all sectors of society, including sport. Resumption of sport can significantly contribute to the re-establishment of normality in Australian society. The Australian Institute of Sport (AIS), in consultation with sport partners (National Institute Network (NIN) Directors, NIN Chief Medical Officers (CMOs), National Sporting Organisation (NSO) Presidents, NSO Performance Directors and NSO CMOs), has developed a framework to inform the resumption of sport. National Principles for Resumption of Sport were used as a guide in the development of 'the AIS Framework for Rebooting Sport in a COVID-19 Environment' (the AIS Framework); and based on current best evidence, and guidelines from the Australian Federal Government, extrapolated into the sporting context by specialists in sport and exercise medicine, infectious diseases and public health. The principles outlined in this document apply to high performance/professional, community and individual passive (non-contact) sport. The AIS Framework is a timely tool of minimum baseline of standards, for 'how' reintroduction of sport activity will occur in a cautious and methodical manner, based on the best available evidence to optimise athlete and community safety. Decisions regarding the timing of resumption (the 'when') of sporting activity must be made in close consultation with Federal, State/Territory and/or Local Public Health Authorities. The priority at all times must be to preserve public health, minimising the risk of community transmission.


title: Global drug shortages due to COVID-19: Impact on patient care and mitigation strategies

text: Coronavirus disease 2019 (COVID-19) arising from Wuhan, China, is currently outbreaking worldwide. The World Health Organization (WHO) has declared COVID-19 to be a global pandemic. COVID-19 could cause a wide range of symptoms ranging from self-limiting fever, sore throat, and cough to more severe symptoms that could lead to acute respiratory distress syndrome. As a result of the lockdown and increased demand, drug shortages could become a growing global issue. This article aims to shed light on the potential impact of drug shortages as a result of this pandemic on patient outcomes and the role of pharmacists and pharmacy policymakers in alleviating this emerging problem.


Impact of the COVID-19 pandemic on therapeutic choices in thrombosis-hemostasis


title: Expressions and significances of the angiotensin-converting enzyme 2 gene, the receptor of SARS-CoV-2 for COVID-19

text: The ACE2 gene is a receptor of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) for COVID-19 (coronavirus disease 2019). To analyze the expression profiles and clinical significances for this gene in humans, RNA-seq data representing 27 different tissues were analyzed using NCBI; total RNA was extracted from different tissues of mouse and semi-quantitative reverse transcriptional-polymerase chain reaction (Q-RT-PCR) was carried out. Immunohistochemistry expression profiles in normal tissues and cancer tissues and TCGA survival analysis in renal and liver cancer were conducted. ACE2 was highly conserved in different species. In normal tissues, ACE2 expression distributions were organ-specific, mainly in the kidney, male testis and female breast, and cardiovascular and gastrointestinal systems. High level of expression in testis, cardiovascular and gastrointestinal system indicated that SARS-CoV-2 might not only attack the lungs, but also affect other organs, particularly the testes, thus it may severely damage male sexual development for younger male and lead to infertility in an adult male, if he contracted COVID-19. On the other side, high expression of ACE2 was correlated with increased survival rate in renal and liver cancer, indicating that ACE2 is a prognostic marker in both renal cancer and liver cancers. Thus, the ACE2 is a functional receptor for SARS-CoV-2 and has a potential anti-tumor role in cancer. Taken together, this study may not only provide potential clues for further medical pathogenesis of COVID-19 and male fertility, but also indicate the clinical significance of the role of the ACE2 gene in cancer.


The Need for Diabetes Care Customization in the ICU at the Time of SARS-CoV-2 Outbreak


COVID-19 in rheumatology outpatient clinics: Dutch mirror image to Lombardy, Italy


Changes in Pediatric Endoscopic Practice during the COVID-19 Pandemic: Results from an International Survey


title: Coronavirus disease 2019 (COVID-19) pandemic and pregnancy

text: The current coronavirus disease 2019 (COVID-19) pneumonia pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading globally at an accelerated rate, with a basic reproduction number (R0) of 2-2.5, indicating that 2-3 persons will be infected from an index patient. A serious public health emergency, it is particularly deadly in vulnerable populations and communities in which healthcare providers are insufficiently prepared to manage the infection. As of March 16, 2020, there are more than 180,000 confirmed cases of COVID-19 worldwide, with more than 7000 related deaths. The SARS-CoV-2 virus has been isolated from asymptomatic individuals, and affected patients continue to be infectious 2 weeks after cessation of symptoms. The substantial morbidity and socioeconomic impact have necessitated drastic measures across all continents, including nationwide lockdowns and border closures. Pregnant women and their fetuses represent a high-risk population during infectious disease outbreaks. To date, the outcomes of 55 pregnant women infected with COVID-19 and 46 neonates have been reported in the literature, with no definite evidence of vertical transmission. Physiological and mechanical changes in pregnancy increase susceptibility to infections in general, particularly when the cardiorespiratory system is affected, and encourage rapid progression to respiratory failure in the gravida. Furthermore, the pregnancy bias toward T-helper 2 (Th2) system dominance, which protects the fetus, leaves the mother vulnerable to viral infections, which are more effectively contained by the Th1 system. These unique challenges mandate an integrated approach to pregnancies affected by SARS-CoV-2. Here we present a review of COVID-19 in pregnancy, bringing together the various factors integral to the understanding of pathophysiology and susceptibility, diagnostic challenges with real-time reverse transcription polymerase chain reaction (RT-PCR) assays, therapeutic controversies, intrauterine transmission, and maternal-fetal complications. We discuss the latest options in antiviral therapy and vaccine development, including the novel use of chloroquine in the management of COVID-19. Fetal surveillance, in view of the predisposition to growth restriction and special considerations during labor and delivery, is addressed. In addition, we focus on keeping frontline obstetric care providers safe while continuing to provide essential services. Our clinical service model is built around the principles of workplace segregation, responsible social distancing, containment of cross-infection to healthcare providers, judicious use of personal protective equipment, and telemedicine. Our aim is to share a framework that can be adopted by tertiary maternity units managing pregnant women in the flux of a pandemic while maintaining the safety of the patient and healthcare provider at its core.


Auditoría inmunitaria de COVID-19 en el servicio de oftalmología de un hospital de tercer nivel antes del desconfinamiento./ Auditoría inmunitaria de COVID-19 en el servicio de oftalmología de un hospital de tercer nivel antes del desconfinamiento./ Immune audit of COVID-19 at the department of ophthalmology of a tertiary hospital before deconfinement


title: A temporal-spatial analysis and future trends of ammonia emissions in China

text: Excessive anthropogenic activities have led to high-level ammonia loss and volatilization, which is regarded as a key factor in Chinese haze formation. In this study, a comprehensive analysis of ammonia emission estimations is accomplished at both temporal (1980-2016) and spatial (provincial) scales using a mass-balanced model, and emission projections through 2030 are also studied in different development scenarios. The results show that the ammonia emissions increased from 4.7 Tg N yr-1 in 1980 to 11 Tg N yr-1 in 2016, which is an approximately 2.4-fold increase. The cropland and livestock emissions are the largest contributors, as most reports show approximately 80% contributions; however, nonagriculture sources of fuel combustion, waste treatment and ammonia escape have grown rapidly in recent years, accounting for 14% in 2016. The spatial differences also reveal the complex heterogeneity in Chinese provinces. In addition, the emission intensities of major agriculture and non-agriculture sources are 0-80 kg N ha-1 yr-1 and over 100 kg N ha-1 yr-1, respectively, indicating a higher degree of ammonia concentration from non-agriculture emissions, which should attract wide concern. In terms of scenario analysis, emissions would reach 12.8 Tg N yr-1 in 2030 under the currently developed model and 7.3 Tg N yr-1 under a series of reduction policies; the spatial analysis also shows that the North China Plain has a 2.1 Tg N yr-1 reduction potential. The results of this study provide new insights into ammonia emission estimations and a better understanding of the environmental impacts of ammonia emitted from different sources.


title: Management of transplant patients outside hospital during COVID-19 epidemic: A Chinese experience

text: Coronavirus disease 2019 (COVID-19) pandemic poses an increasing challenge for transplant community. Aggressive management measures are conductive to improve compliance and to lower the risk of intra-hospital infection. In this Personal Viewpoint essay, we shared experiences about management strategies of transplant patients outside hospital amid the epidemic. With the aid of Cloud Clinic service and telemedicine care, transplant patients could be regularly followed up and get medical consultation online. Furthermore, personal health education and mental health assistance are enrolled in our practice.


The struggle against the CoViD-19 pandemic in Macao


title: The COVID-19 Pandemic and Plastic Surgery: Literature Review, Ethical Analysis, and Proposed Guidelines

text: BACKGROUND: COVID-19, known as the "coronavirus", has spread to over 170 countries. In response, many organizations have spoken out and called to cancel all elective surgical procedures. OBJECTIVE: Our study aimed to provide clear recommendations for plastic surgeons to follow by addressing the following issues: 1) What defines elective surgery, and where does one draw the line between essential versus nonessential services? 2) How does this differ in the hospital versus private practice setting? 3) If called upon to operate on a patient with COVID-19, how do plastic surgeons protect themselves, while still providing excellent medical care? METHODS: A PRISMA systematic review of the literature on plastic surgery in the setting of a pandemic was performed on March 19, 2020. An ethical analysis was conducted using the four principles of medical ethics. RESULTS: The initial search yielded 118 articles. Eighteen articles were relevant and included for analysis. Only one editorial article was published in a plastic surgery journal. Accordingly, no peer-reviewed published COVID-19 guidelines exist for plastic surgery. Given that this pandemic may place healthcare systems under undue stress with an unpredictable trajectory, it is the responsibility of the plastic surgeon to assess and postpone cases whenever possible to properly contribute to adequate resource allocation and patient safety measures. CONCLUSION: This article fills an important gap in the literature by addressing COVID19 and providing guidelines for upholding ethics and responsible resource allocation. By upholding these standards, plastic surgeons can do their part to help minimize the spread of this virus.


No antibody response in acral cutaneous manifestations associated with COVID-19?


Determination of Length of Time for "Post-Aerosol Pause" for Patients Under Investigation or Positive for COVID-19


Coronavirus Disease 2019 (COVID-19): A critical care perspective beyond China


title: Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

text: INTRODUCTION: The COVID-19 pandemic has substantially impacted maternity care provision worldwide. Studies based on modelling estimated large indirect effects of the pandemic on services and health outcomes. The objective of this study was to prospectively document experiences of frontline maternal and newborn healthcare providers. METHODS: We conducted a global, cross-sectional study of maternal and newborn health professionals via an online survey disseminated through professional networks and social media in 12 languages. Information was collected between 24 March and 10 April 2020 on respondents' background, preparedness for and response to COVID-19 and their experience during the pandemic. An optional module sought information on adaptations to 17 care processes. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregating by low-income and middle-income countries (LMICs) and high-income countries (HICs). RESULTS: We analysed responses from 714 maternal and newborn health professionals. Only one-third received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, 47% of participants in LMICs and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based practices. CONCLUSIONS: Substantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information-sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations and support rapid development of effective responses.


title: Telemedicine is a useful tool to deliver care to patients with Amyotrophic Lateral Sclerosis during COVID-19 pandemic: results from Southern Italy

text: Background: Teleneurology is an effective tool for the rapid evaluation of patients in remote locations with a well-established use in stroke and epilepsy. To date its adoption for Amyotrophic Lateral Sclerosis (ALS) care is still in a preliminary stage. We evaluated the feasibility of multidisciplinary assessment of patients with ALS, using telememedicine during the emergency determined by the COVID-19 pandemic. Methods: All patients included in this survey had received a diagnosis of ALS according to international criteria after a complete clinical and paraclinical assessment during 2019. A structured questionnaire was used by the neurologist with the patient or the caregiver. A video interaction was offered but refused by all patients because they did not feel comfortable or did not have smartphone. Results: Out of 31 clinical interviews 8 were completed directly with the patients and 23 with patients' caregivers. In a successive survey, most of patients were satisfied with the neurological interview (85%), the possibility to interact directly with the clinician being at home (85%) and reduction of economic and time costs because they avoided unnecessary travel to the clinic. Most of subjects expressed their willingness to continue to be included in remote evaluation programs (90%). Notably, none of the patients presented index symptoms of Covid-19 infection. Conclusion: Our study indicates that telemedicine is a valid tool to triage patients with ALS to increase practice outreach and efficiency. Delivery of care via telemedicine was effective and successful in people with ALS in the dramatic and sudden crisis determined by Covid-19 outbreak.


docid: nedyccyw

title: Covid-19: Half of pregnant women in UK hospitals are from ethnic minorities


title: Consistent detection of 2019 novel coronavirus in saliva

text: The 2019-novel-coronavirus (2019-nCoV) was detected in the self-collected saliva of 91.7% (11/12) of patients. Serial saliva viral load monitoring generally showed a declining trend. Live virus was detected in saliva by viral culture. Saliva is a promising non-invasive specimen for diagnosis, monitoring, and infection control in patients with 2019-nCoV infection.


Anxiety and depression levels among pregnant women with COVID-19


Covid 2019 - Role of Faculty Members to Keep Mental Activeness of Students


After Covid-19


title: Responses of three urban U.S. Children's Hospitals to COVID-19: Seattle, New York and New Orleans

text: Since January 2020, there has been a worldwide pandemic of COVID-19, caused by a novel coronavirus-severe acute respiratory syndrome coronavirus 2. The United States has been particularly affected, with the largest number of confirmed cases in a single country in the world. Healthcare systems for adults as well as children have dealt with challenges. This article will reflect on the experiences of selected children's hospitals in Seattle, New York City, and New Orleans, three of the "hotspots" in the US and share common aspects and lessons learned from these experiences. This article discusses testing and cohorting of patients, personal protective equipment utilization, limiting workplace exposure, and information sharing.


title: Automatic Detection of Coronavirus Disease (COVID-19) in X-ray and CT Images: A Machine Learning-Based Approach

text: The newly identified Coronavirus pneumonia, subsequently termed COVID-19, is highly transmittable and pathogenic with no clinically approved antiviral drug or vaccine available for treatment. The most common symptoms of COVID-19 are dry cough, sore throat, and fever. Symptoms can progress to a severe form of pneumonia with critical complications, including septic shock, pulmonary edema, acute respiratory distress syndrome and multi-organ failure. While medical imaging is not currently recommended in Canada for primary diagnosis of COVID-19, computer-aided diagnosis systems could assist in the early detection of COVID-19 abnormalities and help to monitor the progression of the disease, potentially reduce mortality rates. In this study, we compare popular deep learning-based feature extraction frameworks for automatic COVID-19 classification. To obtain the most accurate feature, which is an essential component of learning, MobileNet, DenseNet, Xception, ResNet, InceptionV3, InceptionResNetV2, VGGNet, NASNet were chosen amongst a pool of deep convolutional neural networks. The extracted features were then fed into several machine learning classifiers to classify subjects as either a case of COVID-19 or a control. This approach avoided task-specific data pre-processing methods to support a better generalization ability for unseen data. The performance of the proposed method was validated on a publicly available COVID-19 dataset of chest X-ray and CT images. The DenseNet121 feature extractor with Bagging tree classifier achieved the best performance with 99% classification accuracy. The second-best learner was a hybrid of the a ResNet50 feature extractor trained by LightGBM with an accuracy of 98%.


Where Is the ID in COVID-19?


A twin challenge to handle: COVID-19 with pregnancy


title: Incidence and Clinical Course of COVID-19 in Patients with Connective Tissue Diseases: A Descriptive Observational Analysis

text: The outbreak of COVID-19 in December 2019 in China has very quickly become a global health emergency, with almost 2 million infected patients worldwide1 Along with the spread of the pandemic, there has been growing concern about the management of fragile patients with rheumatic conditions.


Preventing the transmission of COVID-19 amongst healthcare workers


Varicella-like exanthem as a specific COVID-19-associated skin manifestation: Multicenter case series of 22 patients


Comment on "Dermatology residents and the care of COVID-19 patients"


Journal Flexibility in the Troubling Times of COVID-19


Novel Coronavirus (COVID-19) Epidemic: What Are the Risks for Older Patients?


title: Platelet Gene Expression and Function in COVID-19 Patients

text: There is an urgent need to understand the pathogenesis of coronavirus disease 2019 (COVID-19). In particular, thrombotic complications in patients with COVID-19 are common and contribute to organ failure and mortality. Patients with severe COVID-19 present with hemostatic abnormalities that mimic disseminated intravascular coagulopathy associated with sepsis with the major difference being increased risk of thrombosis rather than bleeding. However, whether SARS-CoV-2 infection alters platelet function to contribute to the pathophysiology of COVID-19 remains unknown. In this study, we report altered platelet gene expression and functional responses in patients infected with SARS-CoV-2. RNA sequencing demonstrated distinct changes in the gene expression profile of circulating platelets of COVID-19 patients. Pathway analysis revealed differential gene expression changes in pathways associated with protein ubiquitination, antigen presentation and mitochondrial dysfunction. The receptor for SARS-CoV-2 binding, ACE2, was not detected by mRNA or protein in platelets. Surprisingly, mRNA from the SARS-CoV-2 N1 gene was detected in platelets from 2/25 COVID-19 patients, suggesting platelets may take-up SARS-COV-2 mRNA independent of ACE2. Resting platelets from COVID-19 patients had increased P-selectin expression basally and upon activation. Circulating platelet-neutrophil, -monocyte, and -T-cell aggregates were all significantly elevated in COVID-19 patients compared to healthy donors. Furthermore, platelets from COVID-19 patients aggregated faster and showed increased spreading on both fibrinogen and collagen. The increase in platelet activation and aggregation could partially be attributed to increased MAPK pathway activation and thromboxane generation. These findings demonstrate that SARS-CoV-2 infection is associated with platelet hyperreactivity which may contribute to COVID-19 pathophysiology.


We urgently need guidelines for managing COVID-19 in children with comorbidities


title: Staffing With Disease-Based Epidemiologic Indices May Reduce Shortage of Intensive Care Unit Staff During the COVID-19 Pandemic

text: BACKGROUND: Health care worker (HCW) safety is of pivotal importance during a pandemic such as coronavirus disease 2019 (COVID-19), and employee health and well-being ensure functionality of health care institutions. This is particularly true for an intensive care unit (ICU), where highly specialized staff cannot be readily replaced. In the light of lacking evidence for optimal staffing models in a pandemic, we hypothesized that staff shortage can be reduced when staff scheduling takes the epidemiology of a disease into account. METHODS: Various staffing models were constructed, and comprehensive statistical modeling was performed. A typical routine staffing model was defined that assumed full-time employment (40 h/wk) in a 40-bed ICU with a 2:1 patient-to-staff ratio. A pandemic model assumed that staff worked 12-hour shifts for 7 days every other week. Potential in-hospital staff infections were simulated for a total period of 120 days, with a probability of 10%, 25%, and 40% being infected per week when at work. Simulations included the probability of infection at work for a given week, of fatality after infection, and the quarantine time, if infected. RESULTS: Pandemic-adjusted staffing significantly reduced workforce shortage, and the effect progressively increased as the probability of infection increased. Maximum effects were observed at week 4 for each infection probability with a 17%, 32%, and 38% staffing reduction for an infection probability of 0.10, 0.25, and 0.40, respectively. CONCLUSIONS: Staffing along epidemiologic considerations may reduce HCW shortage by leveling the nadir of affected workforce. Although this requires considerable efforts and commitment of staff, it may be essential in an effort to best maintain staff health and operational functionality of health care facilities and systems.


title: Advanced "lab-on-a-chip" to detect viruses - Current challenges and future perspectives

text: Massive viral outbreaks draw attention to viruses that have not been thoroughly studied or understood. In recent decades, microfluidic chips, known as "lab-on-a-chip", appears as a promising tool for the detection of viruses. Here, we review the development of microfluidic chips that could be used in response to viral detection, specifically for viruses involved in more recent outbreaks. The advantages as well as the disadvantages of microfluidic systems are discussed and analyzed. We also propose ideas for future development of these microfluidic chips and we expect this advanced technology to be used in the future for viral outbreaks.


Mental health considerations for patients with epilepsy during COVID-19 crisis


title: Radiation therapy and the innate immune response: clinical implications for immunotherapy approaches

text: Radiation therapy is an essential component of cancer care, contributing up to 40% of curative cancer treatment regimens. It creates DNA double-strand breaks causing cell death in highly replicating tumour cells. However, tumours can develop acquired resistance to therapy. The efficiency of radiation treatment has been increased by means of combining it with other approaches such as chemotherapy, molecule-targeted therapies and, in recent years, immunotherapy. Cancer-cell apoptosis after radiation treatment causes an immunological reaction that contributes to eradicate the tumour via antigen presentation and subsequent T-cell activation. On the other hand, radiotherapy also contributes to the formation of an immunosuppressive environment that hinders the efficacy of the therapy. Innate immune cells from myeloid and lymphoid origin show a very active role in both acquired resistance and anti-tumorigenic mechanisms. Therefore, many efforts are being made in order to reach a better understanding of the innate immunity reactions after radiation therapy and the design of new combinatorial immunotherapy strategies focused in these particular populations.


title: [Management plan for prevention and control of novel coronavirus pneumonia among children in Xiangya Hospital of Central South University]

text: Since December 2019, an epidemic of novel coronavirus pneumonia (NCP) has occurred in China. How to effectively prevent and control NCP among children with limited resources is an urgent issue to be explored. Under the unified arrangement of the Xiangya Hospital of Central South University, the Department of Pediatrics has formulated an action plan with Xiangya unique model to prevent and control NCP among children according to the current epidemic situation and diagnostic and therapeutic program in China.


docid: rpamifoi

title: Early experience in Paris with the impact of the COVID-19 pandemic on vascular surgery


title: Targeting the Dimerization of the Main Protease of Coronaviruses: A Potential Broad-Spectrum Therapeutic Strategy

text: A new coronavirus (CoV) caused a pandemic named COVID-19, which has become a global health care emergency in the present time. The virus is referred to as SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2) and has a genome similar (â¼82%) to that of the previously known SARS-CoV (SARS coronavirus). An attractive therapeutic target for CoVs is the main protease (Mpro) or 3-chymotrypsin-like cysteine protease (3CLpro), as this enzyme plays a key role in polyprotein processing and is active in a dimeric form. Further, Mpro is highly conserved among various CoVs, and a mutation in Mpro is often lethal to the virus. Thus, drugs targeting the Mpro enzyme significantly reduce the risk of mutation-mediated drug resistance and display broad-spectrum antiviral activity. The combinatorial design of peptide-based inhibitors targeting the dimerization of SARS-CoV Mpro represents a potential therapeutic strategy. In this regard, we have compiled the literature reports highlighting the effect of mutations and N-terminal deletion of residues of SARS-CoV Mpro on its dimerization and, thus, catalytic activity. We believe that the present review will stimulate research in this less explored yet quite significant area. The effect of the COVID-19 epidemic and the possibility of future CoV outbreaks strongly emphasize the urgent need for the design and development of potent antiviral agents against CoV infections.


title: Intensifying vaccine production

text: The COVID-19 pandemic has started a race to develop new vaccines. Making sure enough is made to meet demand will require manufacturing innovation. Tatum Anderson reports.


Presenting prevalence, characteristics and outcome of asthmatic patients with T2 diseases in hospitalized subjects with COVID-19 in Madrid, Spain


title: Self-reported anosmia and dysgeusia as key symptoms of coronavirus disease 2019

text: OBJECTIVES: To slow down the transmission of coronavirus disease 2019 (COVID-19), it is important to identify specific symptoms for effective screening. While anosmia/hyposmia and dysgeusia/ageusia have been identified as highly prevalent symptoms, there are wide geographic variations, necessitating the regional evaluation of the prevalence of the symptoms. METHODS: A cross-sectional study was performed to evaluate the self-reported symptoms among adults (over 18 years old) who underwent COVID-19 tests at an ambulatory assessment centre. We identified 1,345 patients (102 positive and 1,243 negative) who visited the assessment centre between March 16 and April 15, 2020. We randomly sampled negative patients in a 1:3 ratio. The primary outcome was the prevalence of self-reported anosmia/hyposmia and dysgeusia/ageusia. Logistic regression was performed to evaluate the association between COVID-19 positivity and loss of smell and taste. RESULTS: Fifty-six of 102 (50%) positive patients and 72 of 306 (23.5%) negative patients completed the survey. Anosmia/hyposmia and dysgeusia/ageusia were more prevalent among COVID-19 positive patients (41.1% v. 4.2%, p < 0.001 for smell and 46.4% v. 5.6%, p < 0.001 for taste). Anosmia/hyposmia and dysgeusia/ageusia were independently highly associated with COVID-19 positivity (adjusted odds ratios 14.4 and 11.4 for smell and taste, respectively). CONCLUSION: In this Canadian study, smell and taste loss may be key symptoms of COVID-19. This evidence can be helpful in the clinical diagnosis of COVID-19, particularly settings of limited testing capacity.


title: Computed Tomography Manifestations of 5 Cases of the Novel Coronavirus Disease 2019 (COVID-19) Pneumonia From Patients Outside Wuhan

text: Clinical, laboratory, and computed tomography (CT) findings of 5 cases of the novel Coronavirus Disease 2019 (COVID-19) pneumonia from patients outside of Wuhan were reviewed. The human-to-human transmission of the virus may explain the infection of the disease outside of Wuhan. CT examination is important in the early detection and follow-up of the disease. With a history of exposure or travelling, symptoms of fever and cough, and the typical CT manifestation such as ground-glass opacity with a peripheral distribution, we should also think of the possibility of the COVID-19 pneumonia in patients outside of Wuhan.


Treatment considerations for coronavirus (COVID-19)


docid: sgfgixkj

title: The coronavirus (COVID-19) pandemic: Adaptations in medical education


Editorial - Nutritional Status Affects COVID-19 Patient Outcomes


Slowdown of urology residents' learning curve during the COVID-19 emergency


Targeting raised von Willebrand factor levels and macrophage activation in severe COVID-19: Consider low volume plasma exchange and low dose steroid


title: Don't forget shared decision-making in the COVID-19 crisis

text: Mechanical ventilation as a resource is limited and may lead to poor outcomes in at-risk populations. Critical care supports may not be preferred by those at risk of deterioration in the COVID-19 setting. Patient-centred communication and shared decision-making should continue to remain central to clinical practice.


docid: ryyqyzxy

title: Videolaryngoscopy Intubation in Patients with COVID-19: How to Minimize Risk of Aerosolization?


title: Ultra-High-Throughput Clinical Proteomics Reveals Classifiers of COVID-19 Infection

text: The COVID-19 pandemic is an unprecedented global challenge, and point-of-care diagnostic classifiers are urgently required. Here, we present a platform for ultra-high-throughput serum and plasma proteomics that builds on ISO13485 standardization to facilitate simple implementation in regulated clinical laboratories. Our low-cost workflow handles up to 180 samples per day, enables high precision quantification, and reduces batch effects for large-scale and longitudinal studies. We use our platform on samples collected from a cohort of early hospitalized cases of the SARS-CoV-2 pandemic and identify 27 potential biomarkers that are differentially expressed depending on the WHO severity grade of COVID-19. They include complement factors, the coagulation system, inflammation modulators, and pro-inflammatory factors upstream and downstream of interleukin 6. All protocols and software for implementing our approach are freely available. In total, this work supports the development of routine proteomic assays to aid clinical decision making and generate hypotheses about potential COVID-19 therapeutic targets.


Coronavirus disease 2019 (COVID-19): first indication of efficacy of Gene-Eden-VIR/Novirin in SARS-CoV-2 infection


title: COVID-19 Pandemic: Workforce Implications for Gerontological Social Work

text: The COVID-19 pandemic has been challenging for people of all ages but particularly devastating to adults 65 and older, which has highlighted the critical need for ensuring that all social workers gain the knowledge and skills necessary to work with this population. While there is a critical shortage of gerontological social workers and we must continue to increase that number, we cannot wait for this to occur. In this commentary, the authors call for infusing the current social work curricula with aging content; providing current social workers with trainings on aging practice; and all social work practitioners, faculty, and researchers to address four specific areas that have gained prominence due to the impact of COVID-19: ageism, loneliness and social isolation, technology, and interprofessional practice, in their respective areas.


Why your Patients' Believing Hydroxychloroquine and Chloroquine are 90% Effective for COVID-19 is 100% Dangerous


Why Your Patients' Believing Hydroxychloroquine and Chloroquine Are 90% Effective for COVID-19 Is 100% Dangerous


title: Kinetics of SARS-CoV-2 specific IgM and IgG responses in COVID-19 patients

text: The emerging COVID-19 caused by SARS-CoV-2 infection poses severe challenges to global public health. Serum antibody testing is becoming one of the critical methods for the diagnosis of COVID-19 patients. We investigated IgM and IgG responses against SARS-CoV-2 nucleocapsid (N) and spike (S) protein after symptom onset in the intensive care unit (ICU) and non-ICU patients. 130 blood samples from 38 COVID-19 patients were collected. The levels of IgM and IgG specific to N and S protein were detected by ELISA. A series of blood samples were collected along the disease course from the same patient, including 11 ICU patients and 27 non-ICU patients for longitudinal analysis. N and S specific IgM and IgG (N-IgM, N-IgG, S-IgM, S-IgG) in non-ICU patients increased after symptom onset. N-IgM and S-IgM in some non-ICU patients reached a peak in the second week, while N-IgG and S-IgG continued to increase in the third week. The combined detection of N and S specific IgM and IgG could identify up to 75% of SARS-CoV-2 infected patients in the first week. S-IgG was significantly higher in non-ICU patients than in ICU patients in the third week. In contrast, N-IgG was significantly higher in ICU patients than in non-ICU patients. The increase of S-IgG positively correlated with the decrease of C-reactive protein (CRP) in non-ICU patients. N and S specific IgM and IgG increased gradually after symptom onset and can be used for detection of SARS-CoV-2 infection. Analysis of the dynamics of S-IgG may help to predict prognosis.