title: Registrerte meldingspliktige smittsomme sykdommer under covid-19-responsen./ Registrerte meldingspliktige smittsomme sykdommer under covid-19-responsen./ Reporting of notifiable infectious diseases during the COVID-19 response

text: BACKGROUND: The Norwegian Surveillance System for Communicable Diseases (MSIS) is based on reporting of cases of 72 mandatory notifiable diseases by clinical microbiological laboratories and diagnosing physicians. The aim of our study was to investigate a potential temporal association between measures against COVID-19 in February-April 2020 and incidence of other infectious diseases reported to MSIS. MATERIAL AND METHOD: We compared the number of disease cases reported to MSIS during weeks 6-14 in 2020 with the median of cases reported in corresponding weeks during three previous years (2017-2019). RESULTS: Compared to the median of cases reported during corresponding weeks in three previous years, physicians and laboratories reported 47 % fewer cases (159 vs. 301) in week 12, 50 % fewer cases (131 vs. 261) in week 13, and 69 % fewer cases (77 vs. 252) in week 14. There was a reduction in the number of notifications of all included disease groups. INTERPRETATION: The observed decline in reporting of diseases other than COVID-19 may indicate a reduced risk of communicable diseases due to comprehensive advice and the requirement for social distancing. However, it is also possible that the sensitivity of the surveillance system was affected by increased resource use on COVID-19 cases management.


title: Molecular Alterations Prompted by SARS-CoV-2 Infection: Induction of Hyaluronan, Glycosaminoglycan and Mucopolysaccharide Metabolism

text: BACKGROUND: The SARS-CoV-2 is the etiological agent causing COVID-19 which has infected more than 2 million people with more than 200000 deaths since its emergence in December 2019. In the majority of cases patients are either asymptomatic or show mild to moderate symptoms and signs of a common cold. A subset of patients, however, develop a severe atypical pneumonia, with the characteristic ground-glass appearance on chest x-ray and computerized tomography, which evolves into an acute respiratory distress syndrome, that requires mechanical ventilation and eventually results in multiple organ failure and death. The Molecular pathogenesis of COVID-19 is still unknown. AIM OF THE STUDY: In the present work we performed a stringent metanalysis from the publicly available RNAseq data from bronchoalveolar cells and peripheral blood mononuclear cells to elucidate molecular alterations and cellular deconvolution to identify immune cell profiles. RESULTS: Alterations in genes involved in hyaluronan, glycosaminoglycan and mucopolysaccharides metabolism were over-represented in bronchoalveolar cells infected by SARS-CoV-2, as well as potential lung infiltration with neutrophils, T CD4+ cell and macrophages. The blood mononuclear cells presented a proliferative state. Dramatic reduction of NK and T lymphocytes, whereas an exacerbated increase in monocytes. CONCLUSIONS: In summary our results revealed molecular pathogenesis of the SARS-CoV-2 infection to bronchoalveolar cells inducing the hyaluronan and glycosaminoglycan metabolism that could shape partially the components of the ground-glass opacities observed in CT. And the potential immune response profile in COVID-19.


Rapid publishing in the era of coronavirus disease 2019 (COVID-19)


docid: ivrcfwdq

title: Multi-Task Temporal Shift Attention Networks for On-Device Contactless Vitals Measurement

text: Telehealth and remote health monitoring have become increasingly important during the SARS-CoV-2 pandemic and it is widely expected that this will have a lasting impact on healthcare practices. These tools can help reduce the risk of exposing patients and medical staff to infection, make healthcare services more accessible, and allow providers to see more patients. However, objective measurement of vital signs is challenging without direct contact with a patient. We present a video-based and on-device optical cardiopulmonary vital sign measurement approach. It leverages a novel multi-task temporal shift convolutional attention network (MTTS-CAN) and enables real-time cardiovascular and respiratory measurements on mobile platforms. We evaluate our system on an ARM CPU and achieve state-of-the-art accuracy while running at over 150 frames per second which enables real-time applications. Systematic experimentation on large benchmark datasets reveals that our approach leads to substantial (20%-50%) reductions in error and generalizes well across datasets.


docid: lwhwxtiw

title: Structured thoracic computed tomography report for COVID-19 pandemic


title: Investigation and analysis of the psychological status of the clinical nurses in a class A hospital facing the novel coronavirus pneumonia/ 重庆医学

text: Objective To investigate the psychological status of clinical nurses in a class A hospital facing the novel coronavirus pneumonia (NCP), in order to provide effective psychological and social intervention. Methods A total of 867 clinical nurses were randomly selected from the Mianyang Central Hospital. The general information questionnaire, standard self-assessment anxiety scale (SAS) and crisis intervention classification assessment scale (TAF) were used to conduct self-assessment questionnaire survey. Then the data were analyzed by the SPSS22.0 software. Results 38.8% of the nurses had a low risk of infection, 18.0% of them had a medium risk, 29.6% had a medium high risk, and 13.6% had a high risk. The SAS scores of clinical nurses in this hospital were statistically significant different, compared with the Chinese norm value ( P <0.05). The difference between TAF score and the degree of crisis response of nursing students in SARS period was statistically significant ( P <0.05). The majority of clinical nurses had less crisis response to NCP, with 80.7% of them suffered mild cognitive, emotional and behavioral damage, and only 2.0% suffered severe damage. Analysis of related factors showed that department, self-test risk of infection, length of service had significant influence on SAS and TAF scores of clinical nurses ( P <0.05). Conclusion During the period of NCP prevalence, no obvious anxiety and crisis reaction among clinical nurses is found in the third grade hospital. However, the psychological changes of clinical nurses with middle-age, from key epidemic prevention departments and in high risk of self-test infection are more likely to produce anxiety and crisis reaction. Therefore, appropriate and timely psychological intervention should be given.


The Day the Earth Stood Still: COVID-19


Cardio-onco-hematology patients' management in the context of the current COVID-19 pandemic


Borderless collaboration is needed for COVID-19-A disease that knows no borders


title: Conducting exposure and response prevention treatment for contamination fears during COVID-19: The behavioral immune system impact on clinician approaches to treatment

text: The coronavirus disease 2019 (COVID-19) pandemic sparked significant anxiety regarding viral rates and means of transmission. Heightened concerns about contamination have prompted new hygienic strategies to vigilantly guard against infection, including hand washing immediately after touching foreign objects or suspected contaminants. This has presented a critical challenge for the delivery of exposure and response prevention (ERP) therapy to individuals with contamination fears due to Obsessive Compulsive Disorder (OCD), as providers must manage not only their clients' attitudes and reactions but their own as well. In this investigation, self-identified anxiety and OCD treatment specialists (N = 139) provided demographic information, including their anxiety and OCD caseloads, and completed measures related to intolerance of uncertainty (IUS-SF; Carlton et al., 2007), beliefs about exposure therapy (TBES; Deacon et al., 2013), and emotional reactions to physical sensations (The Chills; Maruskin et al., 2012). We tested the hypothesis that intolerance of uncertainty and activation of the behavioral immune system (BIS; Schaller & Park, 2011), a mechanism theoretically activated by the prominent emergence of pathogens to protect against illness would predict attitudes toward exposure. The Chills Scale was used to assess BIS activation, a broad assessment of vasoconstriction responses associated with different emotional reactions, and includes a subscale (coldness) that evaluates vasoconstriction associated with defense against pathogens. Both coldness and OCD caseload, but not anxiety caseload or subscales of intolerance of uncertainty, emerged as significant predictors of clinicians' beliefs about exposure; increases in OCD caseload were also related to decreases in negative beliefs about exposure. Findings are useful in determining methods for aiding clinicians in developing effective approaches to contamination fears during and post-pandemic that include addressing their own BIS-related concerns and mapping out means for social behavioral norms associated with engaging in exposure treatment.


title: Noncutaneous considerations of COVID-19 for dermatology practices

text: COVID-19 presents many pressing challenges to the global dermatological community and our patients with ongoing skin needs, which must be considered by every dermatology provider. Many of these are logistical and administrative, distinct from physical manifestations, and could be summarized by the acronym COVID (Consultations, Operations, Videoconferencing, Immunosuppressive medications, Drug and equipment shortages). While the pandemic may represent a threat to many parts of our existence, dermatologists can help the patients we care for by considering noncutaneous implications of COVID-19 upon our practice.


title: A combined oropharyngeal/nares swab is a suitable alternative to nasopharyngeal swabs for the detection of SARS-CoV-2

text: Given the global shortage of nasopharyngeal (NP) swabs typically used for respiratory virus detection, alternative collection methods were evaluated during the COVID-19 pandemic. This study showed that a combined oropharyngeal/nares swab is a suitable alternative to NP swabs for the detection of SARS-CoV-2, with sensitivities of 91.7% and 94.4%, respectively.


title: Recomendaciones prácticas para el manejo perioperatorio del paciente con sospecha o infección grave por coronavirus SARS-CoV-2./ Recomendaciones prácticas para el manejo perioperatorio del paciente con sospecha o infección grave por coronavirus SARS-CoV-2./ Practical recommendations for the perioperative management of the patient with suspection or serious infection by coronavirus SARS-CoV

text: In December 2019, the Wuhan Municipal Health and health Commission (Hubei Province, China) reported a series of cases of pneumonia of unknown etiology. On January 7, 2020, the Chinese authorities identified as a causative agent of the outbreak a new type of virus of the Coronaviridiae family, called SARS-CoV-2. Since then, thounsands of cases have been reported with global dissemination. Infections in humans cause a broad clinical spectrum ranging from mild upper respiratory tract infection, to severe acute respiratory distress syndrome and sepsis. There is not specific treatment for SARS-CoV-2, which is why the fundamental aspects are to establish adequate prevention measures and support treatment and management of complications.


COVID-19 phenotypes: leading or misleading?


docid: jgtsjcrd

title: Psychological distress among health professional students during the COVID-19 outbreak

text: BACKGROUND: Due to the drastic surge of COVID-19 patients, many countries are considering or already graduating health professional students early to aid professional resources. We aimed to assess outbreak-related psychological distress and symptoms of acute stress reaction (ASR) in health professional students and to characterize individuals with potential need for interventions. METHODS: We conducted a prospective cohort study of 1442 health professional students at Sichuan University, China. At baseline (October 2019), participants were assessed for childhood adversity, stressful life events, internet addiction, and family functioning. Using multivariable logistic regression, we examined associations of the above exposures with subsequent psychological distress and ASR in response to the outbreak. RESULTS: Three hundred and eighty-four (26.63%) participants demonstrated clinically significant psychological distress, while 160 (11.10%) met the criterion for a probable ASR. Individuals who scored high on both childhood adversity and stressful life event experiences during the past year were at increased risks of both distress (ORs 2.00-2.66) and probable ASR (ORs 2.23-3.10), respectively. Moreover, internet addiction was associated with elevated risks of distress (OR 2.05, 95% CI 1.60-2.64) and probable ASR (OR 2.15, 95% CI 1.50-3.10). By contrast, good family functioning was associated with decreased risks of distress (OR 0.43, 95% CI 0.33-0.55) and probable ASR (OR 0.48, 95% CI 0.33-0.69). All associations were independent of baseline psychological distress. CONCLUSIONS: Our findings suggest that COVID-19 related psychological distress and high symptoms burden of ASR are common among health professional students. Extended family and professional support should be considered for vulnerable individuals during these unprecedented times.


title: COVID-19 Blockchain Framework: Innovative Approach

text: The world is currently witnessing dangerous shifts in the epidemic of emerging SARS-CoV-2, the causative agent of (COVID-19) coronavirus. The infection, and death numbers reported by World Health Organization (WHO) about this epidemic forecasts an increasing threats to the lives of people and the economics of countries. The greatest challenge that most governments are currently suffering from is the lack of a precise mechanism to detect unknown infected cases and predict the infection risk of COVID-19 virus. In response to mitigate this challenge, this study proposes a novel innovative approach for mitigating big challenges of (COVID-19) coronavirus propagation and contagion. This study propose a blockchain-based framework which investigate the possibility of utilizing peer-to peer, time stamping, and decentralized storage advantages of blockchain to build a new system for verifying and detecting the unknown infected cases of COVID-19 virus. Moreover, the proposed framework will enable the citizens to predict the infection risk of COVID-19 virus within conglomerates of people or within public places through a novel design of P2P-Mobile Application. The proposed approach is forecasted to produce an effective system able to support governments, health authorities, and citizens to take critical decision regarding the infection detection, infection prediction, and infection avoidance. The framework is currently being developed and implemented as a new system consists of four components, Infection Verifier Subsystem, Blockchain platform, P2P-Mobile Application, and Mass-Surveillance System. This four components work together for detecting the unknown infected cases and predicting and estimating the infection Risk of Corona Virus (COVID-19).


title: Repurposed immunomodulatory drugs for Covid-19 in pre-ICu patients - mulTi-Arm Therapeutic study in pre-ICu patients admitted with Covid-19 - Repurposed Drugs (TACTIC-R): A structured summary of a study protocol for a randomised controlled trial

text: OBJECTIVES: To determine if a specific immunomodulatory intervention reduces progression of COVID-19-related disease to organ failure or death, compared to standard of care (SoC). TRIAL DESIGN: Randomised, parallel 3-arm (1:1:1 ratio), open-label, Phase IV platform trial of immunomodulatory therapies in patients with late stage 1 or stage 2 COVID-19-related disease, with a diagnosis based either on a positive assay or high suspicion of COVID-19 infection by clinical and/or radiological assessment. PARTICIPANTS: Patients aged 18 and over, with a clinical picture strongly suggestive of COVID-19-related disease (with/without a positive COVID-19 test) AND a Risk count (as defined below) >3 OR ≥3 if risk count includes "Radiographic severity score >3". A risk count is calculated by the following features on admission (1 point for each): radiographic severity score >3, male gender, non-white ethnicity, diabetes, hypertension, neutrophils >8.0 x109/L, age >40 years and CRP >40 mg/L. Patients should be considered an appropriate subject for intervention with immunomodulatory therapies in the opinion of the investigator and be able to be maintained on venous thromboembolism prophylaxis during the inpatient dosing period, according to local guidelines. The complete inclusion and exclusion criteria as detailed in the additional file 1 should be fulfilled. Patients will be enrolled prior to the need for invasive mechanical ventilation, cardiac or renal support. Participants will be recruited across multiple centres including initially at Cambridge University Hospitals NHS Foundation Trust, King's College Hospital NHS Foundation Trust, Guy's and St Thomas' NHS Foundation Trust, University Hospital of Wales, Gloucestershire Royal Hospitals NHS Foundation Trust and The Royal Wolverhampton NHS Trust. INTERVENTION AND COMPARATOR: Each active comparator arm will be compared against standard of care (SoC). The immunomodulatory drugs were selected from a panel of licenced candidates by a drug evaluation committee, which considered potential efficacy, potential toxicity, scalability and novelty of each strategy. The initial active arms comprise baricitinib and ravulizumab. Baricitinib will be given 4 mg orally (once daily (OD)) on days 1-14 or until day of discharge. The dose will be reduced to 2 mg OD for patients aged > 75 years and those with an estimated Cockcroft Gault creatinine clearance of 30-60 ml/min. Ravulizumab will be administered intravenously once according to the licensed weight-based dosing regimen (see Additional file 1). Each active arm will be compared with standard of care alone. No comparisons will be made between active arms in this platform trial. MAIN OUTCOMES: The primary outcome is the incidence (from baseline up to Day 14) of any one of the events (whichever comes first): death, invasive mechanical ventilation, extra corporeal membrane oxygenation, cardiovascular organ support (inotropes or balloon pump), or renal failure (estimated Cockcroft Gault creatinine clearance <15ml/min). RANDOMISATION: Eligible patients will be randomised using a central web-based randomisation service (Sealed Envelope) in a 1:1:1 ratio, stratified by site to one of the treatment arms or SoC. BLINDING (MASKING): This is an open-label trial. Data analysis will not be blinded. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): There is no fixed sample size for this study. Serial interim analyses will be triggered by an Independent Data Monitoring Committee (IDMC), including analysis after 125 patients are recruited to each arm, 375 in total assuming 3 arms. Additional interim analyses are projected after 229 patients per arm, and potentially then after 469 per arm, but additional analyses may be triggered by the IDMC. TRIAL STATUS: TACTIC-R Protocol version number 2.0 date May 20, 2020, recruitment began May 7, 2020 and the end trial will be the date 18 months after the last patient's last visit. The recruitment end date cannot yet be accurately predicted. TRIAL REGISTRATION: Registered on EU Clinical Trials Register EudraCT Number: 2020-001354-22 Registered: 6 May 2020 It was registered on ClinicalTrials.gov ( NCT04390464 ) and on ISRCTN (ISRCTN11188345) FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


title: Seroprevalence of MERS-CoV in healthy adults in western Saudi Arabia, 2011-2016

text: BACKGROUND: The Middle East respiratory syndrome coronavirus (MERS-CoV) is a newly recognized zoonotic coronavirus. Current evidence confirms the role of dromedaries in primary human infections but does not explain the sporadic community cases. However, asymptomatic or subclinical cases could represent a possible source of infection in the community. METHODS: Archived human sera (7461) collected between 2011 and 2016 from healthy adult blood donors from 50 different nationalities in the western part of Saudi Arabia were obtained for MERS-CoV seroprevalence investigation. Samples were tested for MERS-CoV S1-specific antibodies (Abs) by ELISA and confirmed by testing for neutralizing Abs (nAbs) using both pseudotyped and live virus neutralization assays. RESULTS: Out of 7461 samples, 174 sera from individuals with 18 different nationalities were ELISA positive (2.3%, 95% CI 2.0-2.7). Presence of nAbs was confirmed in 17 samples (0.23%, 95% CI 0.1-0.4) of which one sample exhibited positivity in both neutralization assays. Confirmed seropositivity was identified in young (15-44 years) men and women from Saudi Arabia, Egypt, Yemen, Pakistan, Palestine, Sudan, and India without significant preference. CONCLUSIONS: An increasing trend of MERS-CoV seroprevalence was observed in the general population in western Saudi Arabia, suggesting that asymptomatic or mild infections might exist and act as an unrecognized source of infection. Seropositivity of individuals from different nationalities underscores the potential MERS exportation outside of the Arabian Peninsula. Thus, enhanced and continuous surveillance is highly warranted.


title: COVID-19: $R_0$ is lower where outbreak is larger

text: We use daily data from Lombardy, the Italian region most affected by the COVID-19 outbreak, to calibrate a SIR model individually on each municipality. These are all covered by the same health system and, in the post-lockdown phase we focus on, all subject to the same social distancing regulations. We find that municipalities with a higher number of cases at the beginning of the period analyzed have a lower rate of diffusion, which cannot be imputed to herd immunity. In particular, there is a robust and strongly significant negative correlation between the estimated basic reproduction number ($R_0$) and the initial outbreak size, in contrast with the role of $R_0$ as a \emph{predictor} of outbreak size. We explore different possible explanations for this phenomenon and conclude that a higher number of cases causes changes of behavior, such as a more strict adoption of social distancing measures among the population, that reduce the spread. This result calls for a transparent, real-time distribution of detailed epidemiological data, as such data affects the behavior of populations in areas affected by the outbreak.


title: Mobile health clinic model in the COVID-19 pandemic: lessons learned and opportunities for policy changes and innovation

text: BACKGROUND: Mobile Clinics represent an untapped resource for our healthcare system. The COVID-19 pandemic has exacerbated its limitations. Mobile health clinic programs in the US already play important, albeit under-appreciated roles in the healthcare system. They provide access to healthcare especially for displaced or isolated individuals; they offer versatility in the setting of a damaged or inadequate healthcare infrastructure; and, as a longstanding community-based service delivery model, they fill gaps in the healthcare safety-net, reaching social-economically underserved populations in both urban and rural areas. Despite an increasing body of evidence of the unique value of this highly adaptable model of care, mobile clinics are not widely supported. This has resulted in a missed opportunity to deploy mobile clinics during national emergencies such as the COVID-19 pandemic, as well as using these already existing, and trusted programs to overcome barriers to access that are experienced by under-resourced communities. MAIN TEXT: In March, the Mobile Healthcare Association and Mobile Health Map, a program of Harvard Medical School's Family Van, hosted a webinar of over 300 mobile health providers, sharing their experiences, challenges and best practices of responding to COVID 19. They demonstrated the untapped potential of this sector of the healthcare system in responding to healthcare crises. A Call to Action: The flexibility and adaptability of mobile clinics make them ideal partners in responding to pandemics, such as COVID-19. In this commentary we propose three approaches to support further expansion and integration of mobile health clinics into the healthcare system: First, demonstrate the economic contribution of mobile clinics to the healthcare system. Second, expand the number of mobile clinic programs and integrate them into the healthcare infrastructure and emergency preparedness. Third, expand their use of technology to facilitate this integration. CONCLUSIONS: Understanding the economic and social impact that mobile clinics are having in our communities should provide the evidence to justify policies that will enable expansion and optimal integration of mobile clinics into our healthcare delivery system, and help us address current and future health crises.


The authors' response: Propofol and sedation in patients with coronavirus disease 2019


title: Placental Pathology in Covid-19 Positive Mothers: Preliminary Findings

text: This study describes the pathology and clinical information on 20 placentas whose mother tested positive for the novel Coronovirus (2019-nCoV) cases. Ten of the 20 cases showed some evidence of fetal vascular malperfusion or fetal vascular thrombosis. The significance of these findings is unclear and needs further study.


How COVID-19 lockdowns could lead to a kinder research culture


Preliminary recommendations of the German Society of Rheumatology (DGRh eV) for the management of patients with inflammatory rheumatic diseases during the SARS-CoV-2/COVID-19 pandemic


Acute pulmonary embolism mimicking COVID - 19 pneumonia


title: Acute Hemorrhage After Intracerebral Biopsy in COVID-19 Patients: Report of 3 Cases

text: BACKGROUND: When Belgium's coronavirus disease 2019 (COVID-19) outbreak began in March 2020, our neurosurgical department followed the protocol of most surgical departments in the world and postponed elective surgery. However, patients with tumor-like brain lesions requiring urgent surgery still received treatment as usual, in order to ensure ongoing neurooncologic care. From a series of 31 patients admitted for brain surgery, 3 were confirmed as infected by the novel severe acute respiratory syndrome coronavirus 2. CASE DESCRIPTION: We present the clinical outcomes of these 3 COVID-19 patients, who underwent an intracerebral biopsy in our department during April 2020. All suffered from a diffuse intraparenchymal hemorrhage postoperatively. Unfortunately, we were not able to identify a clear etiology of these postoperative complications. It could be hypothesized that an active COVID-19 infection status may be related to a higher bleeding risk. The remaining 28 neurooncologic non-COVID-19 patients underwent uneventful surgery during the same period. CONCLUSIONS: This case series reports the previously unreported and unexpected outcomes of COVID-19 patients suffering from acute hemorrhage after intracerebral biopsy procedures. Although no direct relation can yet be established, we recommend the neurosurgical community be cautious in such cases.


title: COVID-19: The Need for Rational Use of Face Masks in Nigeria

text: Because of the pandemic of COVID-19, the federal government of Nigeria has instituted a mandatory policy requiring everyone going out in public to wear face masks. Unfortunately, the Nigeria media is awash with images of misuse and abuse of face masks by the public, government officials, and healthcare workers. Medical masks are used widely in community settings amid reported scarcity within healthcare facilities. It is observed that some people wear face masks on their chin and neck, and mask wearers give no attention to covering their mouth and nose, especially when talking. Used face masks are kept with personal belongings or disposed indiscriminately in public spaces, leading to self and environmental contamination. Inappropriate use and disposal of face masks in Nigeria could promote the spread of the novel coronavirus in the country and negate the country's efforts to contain the COVID-19 pandemic. In the implementation of the universal masking policy in Nigeria, federal and state governments ought to consider local applicability, feasibility, and sustainability, as well as identify and mitigate all potential risks and unintended consequences. Also critical is the need for intensive public sensitization and education on appropriate use and disposal of face masks in the country.


Limits of Detection of 6 Approved RT-PCR Kits for the Novel SARS-Coronavirus-2 (SARS-CoV-2)


Covid-19: Scotland recommends face coverings, but England does not follow suit


title: How sustainable environments have reduced the diffusion of coronavirus disease 2019: the interaction between spread of COVID-19 infection, polluting industrialization, wind (renewable) energy

text: This study endeavors to explain the relation between air pollution and particulate compounds emissions, wind resources and energy, and the diffusion of COVID-19 infection to provide insights of sustainable policy to prevent future epidemics. The statistical analysis here focuses on case study of Italy, one of the countries to experience a rapid increase in confirmed cases and deaths. Results reveal two main findings: 1) cities in regions with high wind speed and a high wind energy production in MW have a lower number of infected individuals of COVID-19 infection and total deaths; 2) cities located in hinterland zones (mostly those bordering large urban conurbations) with high polluting industrialization, low wind speed and less cleaner production have a greater number of infected individuals and total deaths. Hence, cities with pollution industrialization and low renewable energy have also to consider low wind speed and other climatological factors that can increase stagnation of the air in the atmosphere with potential problems for public health in the presence of viral agents. Results here suggest that current pandemic of Coronavirus disease and future epidemics similar to COVID-19 infection cannot be solved only with research and practice of medicine, immunology and microbiology but also with a proactive strategy directed to interventions for a sustainable development. Overall, then, this study has to conclude that a strategy to prevent future epidemics similar to COVID-19 infection must also be based on sustainability science to support a higher level of renewable energy and cleaner production to reduce polluting industrialization and, as result, the factors determining the spread of coronavirus disease and other infections in society.


Reply to: 'Younger patients with MAFLD are at increased risk of severe COVID-19 illness: A multicenter preliminary analysis'


Declarations of pharma funding to doctors are hit by covid-19 crisis


title: [Several suggestion of operation for colorectal cancer under the outbreak of Corona Virus Disease 19 in China]

text: Pneumonia caused by SARS-Cov-2 infection has been reported in Wuhan since December 2019, and spread rapidly across the country. The radical operation of colorectal cancer is confine operation. Patients with colorectal cancer should receive operation as soon as possible after elective operation is resumed in each hospital. SARS-Cov-2 virus can be transmitted by asymptomatic infectors, and it has been confirmed to be transmitted by droplets and contact. However, fecal-oral transmission and aerosol transmission have not been excluded. Based onLaparoscopic colorectal operation experiences, the author suggests that the surgery strategy for colorectal cancer patients under the COVID-19 situation. Recommending laparoscopy-assisted radical surgery for colorectal cancer patients. The aerosols need to be strictly managed during operation. NOSES and TaTME should be carried out with cautious during the epidemic period. Protective stoma should be carried out scientifically and reasonably, and the protection of operating room personnel should be strengthened.


title: Pedagogical foundations to online lectures in health professions education

text: Professional and tertiary health professions education (HPE) has been markedly challenged by the current novel coronavirus (COVID-19). Mandates for training organisations to reduce social contact during the global pandemic, and make learning available online, provide an opportunity for regional, rural and remote clinicians and students to more easily access learning and professional development opportunities. Online lectures, while posing an opportunity for regional, rural and remote HPE, entail potential risks. Educators who are familiar with face-to-face pedagogies may find a transition to remote, digital interaction unfamiliar, disarming, and therefore they may not design maximally engaging lectures. The strategies used in a face-to-face lecture cannot be directly transferred into the online environment. This article proposes strategies to ensure the ongoing effectiveness, efficiency and engagement of lectures transitioning from face-to-face to online delivery. Cognitive learning theory, strategies to promote learner engagement and minimise distraction, and examples of software affordances to support active learning during the lecture are proposed. This enables lecturers to navigate the challenges of lecturing in an online environment and plan fruitful online lectures during this disruptive time. These suggestions will therefore enable HPE to better meet the existing and future needs of regional, rural and remote learners who may not be able to easily access face-to-face learning upon the relaxation of social distancing measures. Strategies to provide equitable HPE to learners who cannot access plentiful, fast internet are also discussed.


title: Corticosteroid therapy for patients with CoVID-19 pneumonia: a before-after study

text: BACKGROUND: Anti-inflammatory drugs such as corticosteroids may beneficially modulate the host inflammatory response to CoVID-19 pneumonia. AIMS: To evaluate the impact of addition of corticosteroids to the hospital protocol for treatment of suspected or confirmed CoVID-19 pneumonia on rates of death or intensive care unit (ICU) admission. METHODS: A before-after study was performed to evaluate the effect of addition of corticosteroids to our institution's COVID-19 treatment protocol on hospital mortality. RESULTS: Between March 3rd and April 14th 2020, 257 patients with CoVID-19 diagnosis were included. As corticosteroids were wide used since 27 March 2020, two periods were considered for the purposes of our study: the before period from March 3rd to 20th (n= 85) and the "after period" (n=172) from March 26th to April 14th 2020. The "after" period was associated with a lower risk of death (HR 0.47; 95% CI, 0.23 - 0.97; p=0.04), and a lower risk of intensive care admission or death before ICU admission (HR 0.37 95% CI 0.21 - 0.64; p=0.0005) by multivariate analysis adjusted for age, National Early Warning score and institutionalization status. CONCLUSIONS: In the "after period", the addition of corticosteroids to our institution's CoVID-19 treatment protocol was associated with a significant reduction in hospital mortality.


COVID-19, head and neck cancer, and the need of training of health students and practitioners regarding to tobacco control and patient counseling


title: Time scale for resolution of olfactory dysfunction in COVID-19

text: By now, the 2019 novel coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, is widely recognized around the world as a pandemic that has infected millions and claimed the lives of hundreds of thousands (1). Despite months of mitigation strategies, COVID-19 continues to spread and ascertainment of new knowledge about the disease process continues to be a priority of the medical community. Originally described by characteristic symptoms of fever, cough and/or shortness of breath that can rapidly progress to acute respiratory distress syndrome, it has become clear that COVID-19 has manifold clinical presentations (2-4). Notably, olfactory dysfunction (OD)-decreased sense of smell-has been reported to occur in up to 85.6% of COVID-19 patients (2,5).


Respiratory protection for healthcare workers caring for COVID-19 patients


title: Application-oriented mathematical algorithms for group testing

text: We have a large number of samples and we want to find the infected ones using as few number of tests as possible. We can use group testing which tells about a small group of people whether at least one of them is infected. Group testing is particularly efficient if the infection rate is low. The goal of this article is to summarize and extend the mathematical knowledge about the most efficient group testing algorithms, focusing on real-life applications instead of pure mathematical motivations and approaches.


title: Twitter as a Lifeline: Human-annotated Twitter Corpora for NLP of Crisis-related Messages

text: Microblogging platforms such as Twitter provide active communication channels during mass convergence and emergency events such as earthquakes, typhoons. During the sudden onset of a crisis situation, affected people post useful information on Twitter that can be used for situational awareness and other humanitarian disaster response efforts, if processed timely and effectively. Processing social media information pose multiple challenges such as parsing noisy, brief and informal messages, learning information categories from the incoming stream of messages and classifying them into different classes among others. One of the basic necessities of many of these tasks is the availability of data, in particular human-annotated data. In this paper, we present human-annotated Twitter corpora collected during 19 different crises that took place between 2013 and 2015. To demonstrate the utility of the annotations, we train machine learning classifiers. Moreover, we publish first largest word2vec word embeddings trained on 52 million crisis-related tweets. To deal with tweets language issues, we present human-annotated normalized lexical resources for different lexical variations.


title: School closure, COVID-19 and lunch programme: Unprecedented undernutrition crisis in low-middle income countries

text: The coronavirus disease 2019 pandemic has affected nearly 70% of children and teenagers around the world due to school closure policies. School closure is implemented widely in order to prevent viral transmission and its impact on the broader community, based on preliminary recommendations and evidence from influenza. However, there is debate with regard to the effectiveness of school closures. Growing evidence suggests that a child's SARS-CoV-2 infection is often mild or asymptomatic and that children may not be major SARS-CoV-2 transmitters; thus, it is questionable if school closures prevent transmission significantly. This question is important as a majority of children in low- and middle-income countries depend on free school meals; unexpected long-term school closure may adversely impact nutrition and educational outcomes. Food insecurity is expected to be higher during the pandemic. In this viewpoint, we argue for a more thorough exploration of potential adverse impacts of school closures in low- and middle-income countries and recommend actions to ensure that the health and learning needs of vulnerable populations are met in this time of crisis.


title: Social Distancing as a Network Population Game in a Socially Connected World

text: While social living is considered to be an indispensable part of human life in today's ever-connected world, social distancing has recently received much public attention on its importance since the outbreak of the coronavirus pandemic. In fact, social distancing has long been practiced in nature among solitary species, and been taken by human as an effective way of stopping or slowing down the spread of infectious diseases. Here we consider a social distancing problem for how a population, when in a world with a network of social sites, such as schools, restaurants, shopping centers, residential areas, etc., decides to visit or stay at some sites while avoiding or closing down others so that the social contacts across the network can be minimized. We model this problem as a network population game, where every individual tries to find some network sites to visit or stay so that he/she can minimize all his/her contacts. In the end, an optimal strategy can be found for every one, when the resulting distribution of the population over the network reaches an equilibrium. We show that a large class of equilibrium strategies can be obtained by selecting a set of network sites that forms a so-called maximal r-regular subnetwork. The latter includes many well studied network types, such as the maximal independent set (r=0), the maximal strong matching (r=1), the maximal set of independent cycles (r=2), etc. They are easy to identify or construct, and can be completely disconnected (with r = 0) for the most strict isolation, or allow certain degree of connectivities (with r>0) for more flexible distancing. We derive the equilibrium conditions of these strategies, and analyze their rigidity and flexibility on different types of r-regular subnetworks. We provide an overview on algorithms that can be used for computing maximal r-regular subnetworks and their associated distancing strategies.


title: Ocular Manifestations of COVID-19 (SARS-CoV-2): A Critical Review of Current Literature

text: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China in the city of Wuhan in December of 2019 and since then more than 5,000,000 people have been infected, with approximately 338,000 deaths worldwide. The virus causes the coronavirus disease 2019 (COVID-19), which is characterized by fever, myalgia and cough, with severe acute respiratory syndrome being the most fearsome complication. Nevertheless, the vast majority of cases present mild symptoms or none. Central nervous system and cardiovascular manifestations have been reported. The range of ocular manifestations, either as a result of the infection or as a result of the treatment, has not yet been discussed. In this study, a systematic review of current literature relevant to COVID-19 was performed with focus on modes of transmission, ocular manifestations related to infection and medications, as well as the control of infection in ophthalmic practice.


title: The changing course of the Amazon River in the Neogene: center stage for Neotropical diversification

text: We review geological evidence on the origin of the modern transcontinental Amazon River, and the paleogeographic history of riverine connections among the principal sedimentary basins of northern South America through the Neogene. Data are reviewed from new geochronological datasets using radiogenic and stable isotopes, and from traditional geochronological methods, including sedimentology, structural mapping, sonic and seismic logging, and biostratigraphy. The modern Amazon River and the continental-scale Amazon drainage basin were assembled during the late Miocene and Pliocene, via some of the largest purported river capture events in Earth history. Andean sediments are first recorded in the Amazon Fan at about 10.1-9.4 Ma, with a large increase in sedimentation at about 4.5 Ma. The transcontinental Amazon River therefore formed over a period of about 4.9-5.6 million years, by means of several river capture events. The origins of the modern Amazon River are hypothesized to be linked with that of mega-wetland landscapes of tropical South America (e.g. várzeas, pantanals, seasonally flooded savannahs). Mega-wetlands have persisted over about 10% northern South America under different configurations for >15 million years. Although the paleogeographic reconstructions presented are simplistic and coarse-grained, they are offered to inspire the collection and analysis of new sedimentological and geochronological datasets.(AU)


docid: gbfdwjxy

title: Collateral damage of the covid-19 pandemic: a Dutch perinatal perspective


Clinical determinants for fatality of 44,672 patients with COVID-19


Treading Lightly in a Pandemic: #Zentensivist Reflections on COVID-19


Kidney transplantation and the lockdown effect


Dilemma of organ donation in transplantation and the COVID-19 pandemic


title: Clinical analysis of nine cases with critical corona virus disease 2019 in Hainan province

text: Objective To explore the clinical features of critical cases of coronavirus disease 2019 (COVID-19) Methods The clinical data of nine patients who were diagnosed with critical COVID-19 in Hainan General Hospital from January 21, 2020 to February 6, 2020 were retrospectively analyzed RT-PCR testing for 2019 novel coronavirus (2019-nCoV) was performed with multi-sites synchronize specimens including pharyngeal swab, blood, excrement, and urine The serum levels of leucocyte, C-reactive protein, procalcitonin and lactic acid between the improved group (five cases) and the deteriorated group (four cases) were compared The t test was used for comparison of normally distributed continuous data between groups Results There were eight males (88 9%) and 1 female enrolled The patients aged 28-77 years old, with an age of (52 9±18 0) years By March 4, 2020, all five cases in improved group were cured and discharged, three cases in deteriorated group died and 1case remained in critical condition All multi-sites specimens of patients in improved group turned negative in 2-4 weeks of illness onset, while those of cases in deteriorated group showed sustained viral nucleic acid positive (up to 48th day of illness onset) The white blood cell counts ((13 52±8 24)×10 9 /L vs (10 49±4 46) ×10 9 /L), C-reactive protein ((139 71±87 46) mg/L vs (78 60±55 40) mg/L) and procalcitonin ((2 32±4 03) ng/mL vs (0 28±0 58) ng/mL) , lactic acid ((3 70±4 14) mmol/L vs (2 33±0 53) mmol/L) in deteriorated group were all significantly higher than those in improved group ( t =2 908, 5 009, 4 391 and 2 942, respectively, all P <0 01) A rapid rise of serum IL-6 level up to 8 500 pg/mL was observed in one patient three days prior to death Conclusion Among the patients with critical COVID-19, serum levels of inflammatory cytokines of the death cases are higher than those of improved and discharged cases


title: A model for treating COVID-19-related guilt, shame, and moral injury

text: During the unprecedented COVID-19 pandemic, people around the world have faced a myriad of heart-rending and ethically difficult scenarios (e.g., not being able to tend to a sick or dying loved one) that may lead to subsequent guilt, shame, or moral injury. Trauma-informed guilt reduction therapy is a brief intervention that helps clients accurately appraise their role in a stressful event (such as those experienced during the COVID-19 pandemic) and find positive ways to express important values going forward. Future studies of trauma-informed guilt reduction therapy with those affected by COVID-19 will be helpful for clarifying its effectiveness with this population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Community Mental Health Care Delivery During the COVID-19 Pandemic: Practical Strategies for Improving Care for People with Serious Mental Illness

text: The COVID-19 pandemic has presented a formidable challenge to care continuity for community mental health clients with serious mental illness and for providers who have had to quickly pivot the modes of delivering critical services. Despite these challenges, many of the changes implemented during the pandemic can and should be maintained. These include offering a spectrum of options for remote and in-person care, greater integration of behavioral and physical healthcare, prevention of viral exposure, increased collaborative decision-making related to long-acting injectable and clozapine use, modifying safety plans and psychiatric advance directives to include new technologies and broader support systems, leveraging natural supports, and integration of digital health interventions. This paper represents the authors' collaborative attempt to both reflect the changes to clinical practice we have observed in CMHCs across the US during this pandemic and to suggest how these changes can align with best practices identified in the empirical literature.


title: Suicidal ideation during the COVID-19 pandemic: The role of insomnia

text: There is growing concern over the potential for increased suicide risk in vulnerable populations as the COVID-19 pandemic unfolds. To contextualize this risk during the first weeks of the nationwide lockdown efforts, we had 1,013 U.S. adults complete questionnaires assessing worries over COVID-19, insomnia severity, and suicidal ideation. Anxiety about COVID-19 correlated positively with insomnia severity and suicidal ideation. Analysis revealed that the statistical association between pandemic fears and suicidal thinking was fully accounted for by insomnia severity, suggesting that interventions aimed at improving sleep may be useful in reducing suicide risk during the current pandemic.


Perforación intestinal en paciente COVID-19 en tratamiento con tocilizumab y corticoides. A propósito de un caso./ Perforación intestinal en paciente COVID-19 en tratamiento con tocilizumab y corticoides. A propósito de un caso./ Intestinal perforation in patient with COVID-19 infection treated with tocilizumab and corticosteroids. Report of a clinical case


Novel coronavirus and hospital infection prevention: Preparing for the impromptu speech


A case of Covid19 infection manifesting itself with only abdominal symptoms


Covid-19 and alcohol-a dangerous cocktail


title: Are non-vacuum states much relevant for retrieving shock wave memory of spacetime?

text: Shock wave gives back reaction to spacetime and the information is stored in the memory of background. Quantum memory effect of localised shock wave on Minkowski metric is investigated here. We find that the Wightman function for massless scalar field, on both sides of the wave location, turns out to be the same for usual Minkowski spacetime. Therefore the observables obtained from this, for any kind of observer, do not show the signature of the shock. Moreover, the vacuum states of field on both sides are equivalent. On the contrary, the correlator for the non-vacuum state does memorise the classical shock wave and hence the effect of it is visible in the observables, even for any frame. We argue that rather than vacuum state, the non-vacuum ones are relevant to retrieve the quantum information of classical memory.


docid: vosygxnp

title: COVID-19 pneumonia as a cause of acute chest syndrome in an adult sickle cell patient


Letter to the Editor: Survey of Academic U.S. Programs Regarding the Impact of the COVID-19 Pandemic on Clinical Practice, Education, and Research in Neurosurgery


COVID-19 and district and community nursing


Sex differences in immune responses in COVID-19


title: S2ORC: The Semantic Scholar Open Research Corpus

text: We introduce S2ORC, a large corpus of 81.1M English-language academic papers spanning many academic disciplines. The corpus consists of rich metadata, paper abstracts, resolved bibliographic references, as well as structured full text for 8.1M open access papers. Full text is annotated with automatically-detected inline mentions of citations, figures, and tables, each linked to their corresponding paper objects. In S2ORC, we aggregate papers from hundreds of academic publishers and digital archives into a unified source, and create the largest publicly-available collection of machine-readable academic text to date. We hope this resource will facilitate research and development of tools and tasks for text mining over academic text.


title: Evaluation of the Renal Arteries of 2,144 Living Kidney Donors Using Computed Tomography Angiography and Comparison with Intraoperative Findings

text: OBJECTIVES: A carefully chosen and suitably prepared kidney donor is essential in living-donor kidney transplantation. Computed tomography angiography (CTA) is an effective imaging method for evaluating the renovascular morphology of donor candidates. The aim of this study was to evaluate renal artery variations in kidney donors using CTA and compare the findings with the number of arteries detected during laparoscopic donor nephrectomy. MATERIALS AND METHODS: The study included 2,144 living donors who underwent pretransplant renovascular assessment using CTA and laparoscopic donor nephrectomy in our center between August 2012 and October 2018. The number of renal arteries to the donor kidney detected on CTA was compared with the number of arteries discovered intraoperatively. RESULTS: The mean age of the 2,144 living kidney donors included in the study was 47.19 ± 13.3 (18-87) years. According to CTA findings, 81.1% (n = 1,738) had a single renal artery, 17.2% (n = 369) had double renal arteries, 1.6% (n = 35) had triple renal arteries, and 0.1% (n = 2) had quadruple renal arteries. The same number of renal arteries were detected by CTA and in laparoscopic donor nephrectomy in 97.9% (n = 2,099) of the donors. In the other 2.1% (n = 45), fewer renal arteries were detected intraoperatively compared to their CTA findings. None of the donors included in the study had a greater number of renal arteries discovered during nephrectomy than by CTA. CONCLUSION: CTA is a highly accurate method for the evaluation of renovascular variations in donor candidates for living-donor kidney transplantation. However, it must be kept in mind that double or multiple renal artery variations may be detected on CTA in 18.9% of donor candidates.


title: Bacteriophage Based Biosensors: Trends, Outcomes and Challenges

text: Foodborne pathogens are one of the main concerns in public health, which can have a serious impact on community health and health care systems. Contamination of foods by bacterial pathogens (such as Staphylococcus aureus, Streptococci, Legionella pneumophila, Escherichia coli, Campylobacter jejuni and Salmonella typhimurium) results in human infection. A typical example is the current issue with Coronavirus, which has the potential for foodborne transmission and ruling out such concerns is often difficult. Although, the possible dissemination of such viruses via the food chain has been raised. Standard bacterial detection methods require several hours or even days to obtain the results, and the delay may result in food poisoning to eventuate. Conventional biochemical and microbiological tests are expensive, complex, time-consuming and not always reliable. Therefore, there are urgent demands to develop simple, cheap, quick, sensitive, specific and reliable tests for the detection of these pathogens in foods. Recent advances in smart materials, nanomaterials and biomolecular modeling have been a quantum leap in the development of biosensors in overcoming the limitations of a conventional standard laboratory assay. This research aimed to critically review bacteriophage-based biosensors, used for the detection of foodborne pathogens, as well as their trends, outcomes and challenges are discussed. The future perspective in the use of simple and cheap biosensors is in the development of lab-on-chips, and its availability in every household to test the quality of their food.


title: Nonparametric sequential change-point detection for multivariate time series based on empirical distribution functions

text: The aim of sequential change-point detection is to issue an alarm when it is thought that certain probabilistic properties of the monitored observations have changed. This work is concerned with nonparametric, closed-end testing procedures based on differences of empirical distribution functions that are designed to be particularly sensitive to changes in the comtemporary distribution of multivariate time series. The proposed detectors are adaptations of statistics used in a posteriori (offline) change-point testing and involve a weighting allowing to give more importance to recent observations. The resulting sequential change-point detection procedures are carried out by comparing the detectors to threshold functions estimated through resampling such that the probability of false alarm remains approximately constant over the monitoring period. A generic result on the asymptotic validity of such a way of estimating a threshold function is stated. As a corollary, the asymptotic validity of the studied sequential tests based on empirical distribution functions is proven when these are carried out using a dependent multiplier bootstrap for multivariate time series. Large-scale Monte Carlo experiments demonstrate the good finite-sample properties of the resulting procedures. The application of the derived sequential tests is illustrated on financial data.


Mental Health of Communities during the COVID-19 Pandemic


title: COVID-19 in teriflunomide-treated patients with multiple sclerosis

text: The outbreak of a severe acute respiratory syndrome caused by a novel coronavirus (COVID-19), has raised health concerns for patients with multiple sclerosis (MS) who are commonly on long-term immunotherapies. Managing MS during the pandemic remains challenging with little published experience and no evidence-based guidelines. We present five teriflunomide-treated patients with MS who subsequently developed active COVID-19 infection. The patients continued teriflunomide therapy and had self-limiting infection, without relapse of their MS. These observations have implications for the management of MS in the setting of the COVID-19 pandemic.


title: Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis

text: BACKGROUND AND OBJECTIVE: Knowledge about COVID-19 in children is limited due to the paucity of reported data. The pediatric age group comprises only less than 5% of total COVID-19 worldwide, therefore, large studies in this population are unlikely in the immediate future. Hence, we planned to synthesize the current data that will help in a better understanding of COVID-19 in children. METHODS: Four different electronic databases (MEDLINE, EMBASE, Web of Science, and CENTRAL) were searched for articles related to COVID-19 in the pediatric population. We included studies reporting disease characteristics and outcomes of COVID-19 in patients aged less than 19 years. We performed a random-effect meta-analysis to provide pooled estimates of various disease characteristics. RESULTS: 27 studies (4857 patients) fulfilling the eligibility criteria were included in this systematic review, from a total of 883 records. About half of the patients had each of fever and cough, 11% (6-17%) had fast breathing, and 6-13% had gastrointestinal manifestations. Most of the patients had mild to moderate disease, and only 4% had a severe or critical illness. Leukopenia was the commonest reported laboratory abnormality. CONCLUSION: Even among the symptomatic COVID-19 cases, severe manifestations are seen in very few children. Though fever and respiratory symptoms are most common, many children also have gastrointestinal manifestations.


Chinese Officials Investigate Cause of Pneumonia Outbreak in Wuhan


L'ennemi invisible./ [The invisible enemy]


Readaptation of surgical practice during COVID-19 outbreak: what has been done, what is missing and what to expect


Comment on: COVID-19 pandemic: perspectives on an unfolding crisis - a UK perspective


Correction to Considering the Effects of Microbiome and Diet on SARS-CoV-2 Infection: Nanotechnology Roles


title: Contraception and reproductive planning during the COVID-19 pandemic

text: INTRODUCTION: The coronavirus disease (COVID-19) is a global health emergency. Major disruption to healthcare services during the current COVID-19 pandemic will last even after its peak. Sexual and reproductive health (SRH), specially contraception, needs to be understood as an essential service. AREAS COVERED: This paper is a narrative review. Data from PubMed/MEDLINE, Scopus, and websites of scientific societies were screened during the months of April and May 2020. It addresses the main aspects related to contraception during the COVID-19 pandemic, with special emphasis on family planning services, extended use of long-acting reversible contraceptive (LARC) methods, drug interactions, and thromboembolism risk. We also specified some issues focused on the Brazilian reality. EXPERT OPINION: Ensuring proper contraception use in the COVID-19 time is very important. We encourage women, healthcare providers, policymakers, and the society to consider SRH services as priority.


title: COVID-19 Image Data Collection

text: This paper describes the initial COVID-19 open image data collection. It was created by assembling medical images from websites and publications and currently contains 123 frontal view X-rays.


title: Epidemiology of outpatient and inpatient eye injury in Taiwan: 2000, 2005, 2010, and 2015

text: PURPOSE: To estimate the incidence rate of eye injuries (EI) requiring inpatient and outpatient treatment in Taiwan and compare the epidemiologic characteristics of EI (age, sex, treatment setting, seasonality, occupation, external cause, diagnosis, and surgery) in the years 2000, 2005, 2010, and 2015. METHODS: We analyzed four random samples of 1,000,000 beneficiaries each from 2000, 2005, 2010, and 2015 of the Taiwan National Health Insurance Program. The direct age-standardized rate, with 95% confidence interval (CI), was used to compare EI rates for the four calendar years. The chi-square test and chi-square test for trend were used to compare data for the four calendar years. RESULTS: Annual EI incidence rates were between 2.57% in 2000 and 3.28% in 2015. The age-standardized rates were 2.73% (95% CI, 2.70%-2.76%) in 2000, 3.37% (95% CI, 3.33%-3.41%) in 2005, 3.31% (95% CI, 3.28%-3.35%) in 2010, and 3.02% (95% CI, 2.99%-3.06%) in 2015. Manual workers had the highest EI incidence rate, followed by non-manual workers and civil servants. The proportion of EI requiring inpatient treatment declined from 1.34% in 2000 to 0.63% in 2015 (P <0.0001). Analysis of seasonality showed a consistent decrease in February in the four sampling years; however, this decrease in EI was only seen in outpatients, not in EI requiring hospitalization. The proportion of outpatients requiring surgery significantly decreased, from 2.53% in 2000 to 1.2% in 2015 (P<0.0001). However, the proportion of inpatients requiring surgery for EI as the principal diagnosis increased from 69.32% in 2000 to 83.02% in 2015 (P = 0.29), and the proportion of inpatients requiring surgery for EI as a secondary diagnosis increased from 54.86% in 2000 to 71.6% in 2015 (P = 0.0019). Among inpatients with EI, the most common cause of EI was a traffic accident (44.79%, especially motorcycles), followed by falls (9.75%) and homicide (6.05%). CONCLUSION: In Taiwan, the annual EI incidence rate slightly increased from 2000 to 2005 and then decreased through 2015. The proportion of EI patients requiring hospitalization decreased from 1.34% in 2000 to 0.63% in 2015, but the percentage of inpatients requiring surgery increased. Traffic accidents (especially those involving motorcyclists) remained the predominant external cause of EI requiring hospitalization during the study period.


Coronavirus disease 2019 3 months after hematopoietic stem cell transplant: A pediatric case report


Call to Action for a US Nurse General: From Ebola to Corona


title: Impact of COVID-19 pandemic on people living with visual disability

text: People living with visual disabilities/impairment are more likely vulnerable to get contracted from the severe acute respiratory syndrome coronavirus-2 (SARS-CoV 2) than people without visual impairment. This means more than 253 million people globally will be at higher risk of affecting by the COVID-19. The current pandemic, followed by a nationwide emergency lockdown to slow the unprecedented spread of the virus, will have a serious impact on people living with visual disabilities and even endangers their lives in the long run. Many restrictive and control measures, including the adoption of new behavioural changes (for example, social distance during outdoor movement, limiting touch or tactile contact) recommended by the government will pose immense challenges to individuals with a visual loss. This serious impact, including challenges in healthcare access, can be minimized through inclusive service approaches, involving persons with visual disabilities, caregivers, family members, and healthcare providers, along with the community to a large extent, and finally, support to improve the overall outcomes. The government, along with profit or non-profit private sectors, should consider initiating such inclusive approaches while planning responses to the pandemic. Indeed, the present COVID-19 pandemic provides an opportunity for health care planners and decision-makers of various organizations across India for a reformation of disabilities care. Impacts due to the pandemic and lockdown can be reduced substantially if planning and policy are in place before any emergency happened in the future.


Tens of thousands of scientists are redeploying to fight coronavirus


title: Epidemiological investigation of the first reported case of coronavirus disease 2019（COVID-19）in Zhejiang Province/ 预防医学

text: Objective@# To conduct an epidemiological investigation on the first reported case of coronavirus disease 2019 （COVID-19） in Zhejiang Province, so as to provide reference for prevention and control of the disease.@*Methods @#According to the COVID-19 Diagnosis and Treatment Program （Trial） and the COVID-19 Prevention and Control Program （Trial） issued by National Health Commission of China, a field investigation was employed on a case of fever from Wuhan reported by Wenzhou in January 15, 2020; the real-time reverse transcription polymerase chain reaction （RT-PCR） assay was performed to detect the nucleic acid of severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） from the sputum specimens or throat swabs of the case; the close contacts of the case were tracked down; relevant prevention and control measures were implemented. @*Results @#The case had lived in Wuhan for long. On January 4 of 2020, he felt cold and uncomfortable without obvious inducement, and drove back to Wenzhou with his wife. He had fever （up to 39 ℃）, cough and expectoration on the next day. On January 9, the chest computed tomographic （CT） scan showed bilateral high-density patchy shadowing with blurred edges. On January 16, his throat swab and sputum samples were collected and sent to Zhejiang Provincial Center for Disease Control and Prevention （CDC） for detection of SARS-CoV-2. The result turned out to be positive on January 17, then was rechecked and confirmed by Chinese CDC on January 20. Two weeks before the onset of the disease, the patient was engaged in the door-to-door persuasion of installing elevators in an old residential area of Wuhan, and he denied any connection with other COVID-19 cases,markets,（sick or dead） poultry or poultry products. Totally 26 close contacts were identified and kept in quarantine. During this period,three of them developed fever or respiratory symptoms, but were excluded from COVID-19. On the afternoon of January 16,the health system of Zhejiang Province and Wenzhou City launched an emergency plan and implemented a series of prevention and control measures such as isolation and treatment of cases,screening and isolation of close contacts,and public health education. @*Conclusion @#According to the epidemiological history,clinical features and laboratory test Results,the patient was identified as the first reported case of COVID-19 in Zhejiang Province.


docid: ypokfutq

title: Structure of replicating SARS-CoV-2 polymerase

text: The coronavirus SARS-CoV-2 uses an RNA-dependent RNA polymerase (RdRp) for the replication of its genome and the transcription of its genes1-3. Here we present the cryo-electron microscopic structure of the SARS-CoV-2 RdRp in active form, mimicking the replicating enzyme. The structure comprises the viral proteins nsp12, nsp8, and nsp7, and over two turns of RNA template-product duplex. The active site cleft of nsp12 binds the first turn of RNA and mediates RdRp activity with conserved residues. Two copies of nsp8 bind to opposite sides of the cleft and position the second turn of RNA. Long helical extensions in nsp8 protrude along exiting RNA, forming positively charged 'sliding poles'. These sliding poles can account for the known processivity of the RdRp that is required for replicating the long coronavirus genome3. Our results enable a detailed analysis of the inhibitory mechanisms that underlie the antiviral activity of substances such as remdesivir, a drug for the treatment of coronavirus disease 2019 (COVID-19)4.


Covid-19: Don't apply advance care plans to groups of people, doctors' leaders warn


title: Stochastic Modeling of an Infectious Disease, Part I: Understand the Negative Binomial Distribution and Predict an Epidemic More Reliably

text: Why are the epidemic patterns of COVID-19 so different among different cities or countries which are similar in their populations, medical infrastructures, and people's behavior? Why are forecasts or predictions made by so-called experts often grossly wrong, concerning the numbers of people who get infected or die? The purpose of this study is to better understand the stochastic nature of an epidemic disease, and answer the above questions. Much of the work on infectious diseases has been based on"SIR deterministic models,"(Kermack and McKendrick:1927.) We will explore stochastic models that can capture the essence of the seemingly erratic behavior of an infectious disease. A stochastic model, in its formulation, takes into account the random nature of an infectious disease. The stochastic model we study here is based on the"birth-and-death process with immigration"(BDI for short), which was proposed in the study of population growth or extinction of some biological species. The BDI process model ,however, has not been investigated by the epidemiology community. The BDI process is one of a few birth-and-death processes, which we can solve analytically. Its time-dependent probability distribution function is a"negative binomial distribution"with its parameter $r$ less than $1$. The"coefficient of variation"of the process is larger than $\sqrt{1/r}>1$. Furthermore, it has a long tail like the zeta distribution. These properties explain why infection patterns exhibit enormously large variations. The number of infected predicted by a deterministic model is much greater than the median of the distribution. This explains why any forecast based on a deterministic model will fail more often than not.


COVID-19 pandemic and the quality of evidence synthesis


title: Priming reasoning increases intentions to wear a face covering to slow down COVID-19 transmission

text: Finding mechanisms to promote the use of face masks is fundamental during the second phase of the COVID-19 pandemic response, when shelter-in-place rules are relaxed and some segments of the population are allowed to circulate more freely. Here we report three pre-registered studies (total N = 1,920), using an heterogenous sample of people living in the USA, showing that priming people to"rely on their reasoning"rather than to"rely on their emotions"significantly increases their intentions to wear a face covering. Compared to the baseline, priming reasoning promotes intentions to wear a face covering, whereas priming emotion has no significant effect. These findings have theoretical and practical implications. Practically, they offer a simple and scalable intervention to promote intentions to wear a face mask. Theoretically, they shed light on the cognitive basis of intentions to wear a face covering.


Containing the spread of COVID-19 in Ethiopia


title: Poly(ADP-ribose) Polymerase Inhibition in Acute Lung Injury: A Re-emerging Concept

text: Poly(ADP-ribose) polymerase 1 (PARP1), the major isoform of a family of ADP-ribosylating enzymes, has been implicated in the regulation of various biological processes including DNA repair, gene transcription and cell death. The concept that PARP1 becomes activated in acute lung injury (ALI), and pharmacological inhibition or genetic deletion of this enzyme can provide therapeutic benefits has emerged over 20 years ago. The current article provides an overview of the cellular mechanisms involved in the pathogenetic roles of PARP1 in ALI, and overviews the preclinical data supporting the efficacy of PARP inhibitors. In recent years, several ultrapotent PARP inhibitors have been approved for clinical use (for the therapy of various oncological diseases): these newly-approved PARP inhibitors were recently reported to show efficacy in animal models of ALI. These observations offer the possibility of therapeutic repurposing of these inhibitors for patients with ALI. The current article lays out a potential roadmap for such repurposing efforts. In addition, the article also overviews the scientific basis of potentially applying PARP inhibitors for the experimental therapy of viral ALI, such as COVID-19-associated ARDS.


Show evidence that apps for COVID-19 contact-tracing are secure and effective


title: SARS-CoV-2 and myocardial injury: Few answers, many questions

text: Patients with COVID-19 and acute cardiac injury as measured by an elevated high-sensitivity troponin I or troponin T upon admission or during hospitalization have a mortality rate of over 50% in initial reports. The mechanism of SARS-CoV-2 and associated myocardial injury, whether SARS-CoV-2 patients with myocardial injury are a distinct population, and possible treatment options for myocardial injury associated with SARS-CoV-2 are unknown.


Profile and quality of published reviews on COVID-19


title: Technologies to optimize the care of severe COVID-19 patients for healthcare providers challenged by limited resources

text: Healthcare systems are belligerently responding to the new Coronavirus Disease 2019 (COVID-19). The severe acute respiratory syndrome (SARS co-V2) is a specific condition, whose distinctive features are severe hypoxemia associated with (>50% of cases) normal respiratory system compliance. When a patient requires intubation and invasive ventilation the outcome is poor and the length of stay in the intensive care unit (ICU) is usually two or three weeks. In this manuscript, authors will review several technological devices, which could support healthcare providers at the bedside to optimise the care for COVID-19 patients who are sedated, paralysed and ventilated. Particular attention is provided to the use of video-laryngoscopes (VL) because these can assist anaesthetists to perform a successful intubation outside the ICU while protecting healthcare providers from this viral infection. Authors will also review processed electroencephalographic (EEG) monitors which are used to better titrate sedation and the train of four monitors which are utilised to better titrate neuromuscular blocking agents in the view of sparing limited pharmacological resources. COVID-19 can rapidly exhaust human and technological resources too within the ICU. This review features a series of technological advancements that can significantly improve the care of patients requiring isolation. The working conditions in isolation could cause gaps or barriers in communication, fatigue and poor documentation of provided care. The available technology has several advantages including: a) facilitating appropriate paperless documentation and communication between all healthcare givers working in isolation rooms or large isolation areas; b) testing patients and staff at the bedside using smart point of care diagnostics (SPOCD) to confirm COVID-19 infection; c) allowing diagnostics and treatment at the bedside through point of care ultrasound (POCUS) and Thromboelastography (TEG); d) adapting the use of anaesthetic machines and the use of volatile anaesthetics. Implementing technologies for safeguarding healthcare providers as well as monitoring the limited pharmacological resources is paramount. Only by leveraging new technologies it will be possible to sustain and support healthcare systems during the expected long course of this pandemic.


docid: ywftexca

title: COVID-19 and Neonatal Respiratory Care: Current Evidence and Practical Approach

text: The novel coronavirus disease 2019 (COVID-19) pandemic has urged the development and implementation of guidelines and protocols on diagnosis, management, infection control strategies, and discharge planning. However, very little is currently known about neonatal COVID-19 and severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infections. Thus, many questions arise with regard to respiratory care after birth, necessary protection to health care workers (HCW) in the delivery room and neonatal intensive care unit (NICU), and safety of bag and mask ventilation, noninvasive respiratory support, deep suctioning, endotracheal intubation, and mechanical ventilation. Indeed, these questions have created tremendous confusion amongst neonatal HCW. In this manuscript, we comprehensively reviewed the current evidence regarding COVID-19 perinatal transmission, respiratory outcomes of neonates born to mothers with COVID-19 and infants with documented SARS-CoV-2 infection, and the evidence for using different respiratory support modalities and aerosol-generating procedures in this specific population. The results demonstrated that to date, neonatal COVID-19 infection is uncommon, generally acquired postnatally, and associated with favorable respiratory outcomes. The reason why infants display a milder spectrum of disease remains unclear. Nonetheless, the risk of severe or critical illness in young patients exists. Currently, the recommended respiratory approach for infants with suspected or confirmed infection is not evidence based but should include all routinely used types of support, with the addition of viral filters, proper personal protective equipment, and placement of infants in isolation rooms, ideally with negative pressure. As information is changing rapidly, clinicians should frequently watch out for updates on the subject. KEY POINTS: · Novel coronavirus disease 2019 (COVID-19) pandemic urged development of guidelines.. · Neonatal COVID-19 disease is uncommon.. · Respiratory outcomes in neonates seems favorable.. · Current neonatal respiratory care should continue.. · Clinicians should watch frequently for updates..


Reply to LTE: COVID-19 and pulmonary embolism: diagnostic imaging trends


Diagnosing Pulmonary Thromboembolism in COVID-19: A Stepwise Clinical and Imaging Approach


title: Aerosol and Surface Distribution of Severe Acute Respiratory Syndrome Coronavirus 2 in Hospital Wards, Wuhan, China, 2020

text: To determine distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards in Wuhan, China, we tested air and surface samples. Contamination was greater in intensive care units than general wards. Virus was widely distributed on floors, computer mice, trash cans, and sickbed handrails and was detected in air ≈4 m from patients.


title: Novel Coronavirus Disease 2019 (COVID-19): An Emerging Infectious Disease in the 21st Century

text: Background: At the beginning of the New Year 2020, China alerted the world health organization (WHO) to a cluster of unusual pneumonia cases in Wuhan After extensive speculation, eventually a new species of coronavirus introduced as the causative pathogen of the disease Coronavirus disease 2019 (COVID-19) is a name for the disease, and the virus that causes it is known SARS-CoV-2 The very rapid spread of the COVID-19 in China and in many other countries has caused fear among people across the world The novel coronavirus outbreak declared a Public Health Emergency of International Concern on 30 January 2020 Materials and Methods: Several databases such as PubMed, Scopus, Google scholar, and BioRxiv were searched for publications reporting on the novel coronavirus up to 29 February 2020 Literature searches were performed using keywords including “Coronavirus 2019”, “2019-nCoV”, “COVID-19”, and “SARS-CoV-2” Moreover, websites such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) were searched to retrieve updated data and statistics regarding the novel coronavirus We extracted data on the epidemiology, pathogenesis, virology, clinical manifestations, transmission routes, diagnosis, treatment, and prevention measures Results: From the 1416 articles identified in the initial search, 53 were remained after title and abstract screening After full-text review, 37 articles were eligible to include in our study Incubation period for COVID-19 is between 2-10 days, according to the World Health Organization (WHO) The case fatality rate in patients infected with SARC-CoV-2 is 4 3%, and the results indicate that the mortality is higher in elderly individuals and patients with chronic conditions including patients with coronary artery disease, diabetes, chronic pulmonary disease, and hypertension The mortality rate in healthy subjects is less than 1% Conclusion: The outbreak caused by the novel coronavirus is larger than the previous human coronaviruses, showing that the SARS-CoV-2 is an extremely contagious virus However, the mortality rate of COVID-19 is lower than that of other coronaviruses diseases such as SARS or MERS and other viruses like HIV and Ebola Currently, due to the lack of an effective treatment and vaccine, the best way to deal with the COVID-19 disease is to prevent transmission and spread of the virus and to execute personal protective measures


title: The Peru Approach against the COVID-19 Infodemic: Insights and Strategies

text: The COVID-19 epidemic has spawned an "infodemic," with excessive and unfounded information that hinders an appropriate public health response. This perspective describes a selection of COVID-19 fake news that originated in Peru and the government's response to this information. Unlike other countries, Peru was relatively successful in controlling the infodemic possibly because of the implementation of prison sentences for persons who created and shared fake news. We believe that similar actions by other countries in collaboration with social media companies may offer a solution to the infodemic problem.


title: COVID-19 Incidentally Detected on PET/CT During Work-up for Locally Advanced Head and Neck Cancer

text: AIM: To describe the incidental detection of COVID-19 disease on positron-emission tomography/computed tomography (PET/CT) in a patient with cancer despite initial negative swab by polymerase chain reaction (PCR). CASE REPORT: Clinical and radiographic data were obtained from the electronic medical record. Nasopharyngeal swabs were obtained and evaluated for COVID-19 by the Food and Drug Administration-approved reverse transcription-PCR assays. On radiographic examination, PET/CT was consistent with COVID-19-related pneumonia not seen on prior imaging. Initial nasopharyngeal swab 2 days after PET/CT imaging was negative for COVID-19. Subsequent repeat swab 10 days later was positive for COVID-19, while the patient was febrile on screening assessment. The patient remained COVID-19-positive until 1 month after abnormal PET/CT imaging. CONCLUSION: PET/CT can be sensitive for early COVID-19 detection, even in the setting of a negative confirmatory PCR test. This highlights the importance of continued patient surveillance and use of appropriate personal protective equipment to minimize COVID-19 transmission.


title: Deep Learning on Chest X-ray Images to Detect and Evaluate Pneumonia Cases at the Era of COVID-19

text: Coronavirus disease 2019 (COVID-19) is an infectious disease with first symptoms similar to the flu. COVID-19 appeared first in China and very quickly spreads to the rest of the world, causing then the 2019-20 coronavirus pandemic. In many cases, this disease causes pneumonia. Since pulmonary infections can be observed through radiography images, this paper investigates deep learning methods for automatically analyzing query chest X-ray images with the hope to bring precision tools to health professionals towards screening the COVID-19 and diagnosing confirmed patients. In this context, training datasets, deep learning architectures and analysis strategies have been experimented from publicly open sets of chest X-ray images. Tailored deep learning models are proposed to detect pneumonia infection cases, notably viral cases. It is assumed that viral pneumonia cases detected during an epidemic COVID-19 context have a high probability to presume COVID-19 infections. Moreover, easy-to-apply health indicators are proposed for estimating infection status and predicting patient status from the detected pneumonia cases. Experimental results show possibilities of training deep learning models over publicly open sets of chest X-ray images towards screening viral pneumonia. Chest X-ray test images of COVID-19 infected patients are successfully diagnosed through detection models retained for their performances. The efficiency of proposed health indicators is highlighted through simulated scenarios of patients presenting infections and health problems by combining real and synthetic health data.


title: Ethics in the Covid-19 emergency: Examining rationing decisions

text: Early last month, the Italian Society of Anaesthesia was forced to publish the above guideline (1) for the country's hospitals. Besides the rising cases of infection, the doctors realised that patients required up to 15-20 days of intensive care as the disease progressed (2). In the face of medical resource scarcities, the guideline established that everyone could not be saved from the coronavirus. And a massive death toll ensued.


The role of telemedicine during the COVID-19 epidemic in China-experience from Shandong province


National UK programme of community health workers for COVID-19 response


Novel coronavirus infection in newborn babies aged <28 days in China


Seeing COVID-19 through José Saramago's Blindness


title: Crise sanitaire liée au COVID-19 : modalités du traitement de l'appendicite aiguë non compliquée de l'adulte par antibiothérapie seule comme alternative à l'appendicectomie./ [Antibiotics alone as an alternative to appendectomy for uncomplicated acute appendicitis in adults: changes in treatment modalities related to the COVID-19 health crisis]

text: The massive inflow of patients with COVID-19 requiring urgent care has overloaded hospitals in France and impacts the management of other patients. Deferring hospitalization and non-urgent surgeries has become a priority for surgeons today in order to relieve the health care system.It is obviously not simple to reduce emergency surgery without altering the quality of care or leading to a loss of chance for the patient. Acute appendicitis is a very specific situation and the prevalence of this disease leads us to reconsider this particular disease in the context of the COVID-19 crisis. Indeed, while the currently recommended treatment for uncomplicated acute appendicitis is surgical appendectomy, the non-surgical alternative of medical management by antibiotic therapy alone has been widely evaluated by high-quality studies in the literature. Insofar as the main limitation of exclusively medical treatment of uncomplicated acute appendicitis is the risk of recurrent appendicitis, this treatment option represents an alternative of choice to reduce the intra-hospital overload in this context of health crisis.The aim of this work is therefore to provide physicians and surgeons with a practical guide based on a review of the literature on the medical treatment of uncomplicated acute appendicitis in adults, to offer this alternative treatment to the right patients and under good conditions, especially when access to the operating room is limited or impossible.


title: Molecular mechanisms of sex bias differences in COVID-19 mortality

text: More men than women have died from COVID-19. Genes encoded on X chromosomes, and sex hormones may explain the decreased fatality of COVID-19 in women. The angiotensin-converting enzyme 2 gene is located on X chromosomes. Men, with a single X chromosome, may lack the alternative mechanism for cellular protection after exposure to SARS-CoV-2. Some Toll-like receptors encoded on the X chromosomes can sense SARS-CoV-2 nucleic acids, leading to a stronger innate immunity response in women. Both estrogen and estrogen receptor-α contribute to T cell activation. Interventional approaches including estrogen-related compounds and androgen receptor antagonists may be considered in patients with COVID-19.


title: Hope as a Generative Force: Lifting Our Gaze to the Future

text: Pandemics are by nature "out of the blue." Their unpredictable nature and impact can leave nurses and support systems reeling. Nurses are physically and emotionally exhausted but also may be isolated from the physical and emotional support of families and other loved ones. As leaders concurrently manage the logistical and resource challenges of the COVID-19 epidemic, it is essential for leaders to also lift their gaze to the future. Leaders can be a force multiplier for supporting resilience in their teams. [J Contin Educ Nurs. 2020;51(5):203-204].


Early experiences of SARS-CoV-2 infection in severe asthmatics receiving biologic therapy


COVID-19 and individuals with mental illness in psychiatric facilities


Low prevalence of IgG antibodies to SARS-CoV-2 in cancer patients with COVID-19


Coronavirus Disease 2019 (COVID-19) and Pregnancy: Responding to a Rapidly Evolving Situation


title: "Off-label" use of hydroxychloroquine, azithromycin, lopinavir-ritonavir and chloroquine in COVID-19: A survey of cardiac adverse drug reactions by the French Network of Pharmacovigilance Centers

text: INTRODUCTION: COVID-19 is an unprecedented challenge for physicians and scientists. Several publicized drugs are being used with not much evidence of their efficacy such as hydroxychloroquine, azithromycin or lopinavir-ritonavir. Yet, the cardiac safety of these drugs in COVID-19 deserves scrutiny as they are known to foster cardiac adverse ADRs, notably QTc interval prolongation on the electrocardiogram and its arrhythmogenic consequences. METHODS: Since March 27th, 2020, the French Pharmacovigilance Network directed all cardiac adverse drug reactions associated with "off-label" use of hydroxychloroquine, azithromycin and lopinavir-ritonavir in COVID-19 to the Nice Regional Center of Pharmacovigilance. Each Regional Center of Pharmacovigilance first assessed causality of drugs. We performed a specific analysis of these cardiac adverse drug reactions amidst an array of risk factors, reassessed the electrocardiograms and estimated their incidence in coronavirus disease 2019. RESULTS: In one month, 120 reports of cardiac adverse drug reactions have been notified, 103 of which associated with hydroxychloroquine alone (86%), or associated with azithromycin (60%). Their estimated incidence is 0.77% to 1.54% of all patients, notwithstanding strong underreporting. Lopinavir-ritonavir came third with 17 reports (14%) and chloroquine fourth with 3 reports (2.5%). There were 8 sudden, unexplained or aborted deaths (7%), 8 ventricular arrhythmias (7%), 90 reports of prolonged QTc (75%) most of them "serious" (64%), 48 of which proved ≥ 500ms, 20 reports of severe conduction disorders (17%) and 5 reports of other cardiac causes (4%). Six reports derived from automedication. DISCUSSION AND CONCLUSION: "Off-label" use of treatments in COVID-19 increases the risk of cardiac ADRs, some of them avoidable. Even if these drugs are perceived as familiar, they are used in patients with added risk factors caused by infection. Precautions should be taken to mitigate the risk, even if they will be proven efficacious.


docid: jgwlorda

title: The emerging role of lung ultrasound in COVID-19 pneumonia

text: In the last decades lung ultrasound (LUS) has become of crucial importance in the evaluation and monitoring of a widely range of pulmonary diseases. One of the major benefits which favours this examination, is that this is a non-invasive, low-cost and radiation-free imaging modality which allows repeated imaging. LUS plays an important role in a wide range of pathologies, including cardiogenic oedema, acute respiratory distress syndrome and fibrosis. Specific LUS findings have proved useful and predictive of acute respiratory distress syndrome which is of particular relevance in the suspicion and monitoring of patients with lung disease. Furthermore, several studies have confirmed the role of LUS in the screening of interstitial lung diseases in connective tissue diseases. Given these data, LUS will likely play an important role in the management of COVID-19 patients from identification of specific abnormalities corresponding to definite pneumonia phases and CT scans findings. In addition, LUS could allow reduction in the exposure of health-care workers to potential infection. Herein, we provide a summary on emerging role of lung ultrasound in COVID-19 pneumonia.


docid: gexdgyfv

title: Ocular manifestations and clinical characteristics of 535 cases of COVID-19 in Wuhan, China: a cross-sectional study

text: PURPOSE: To investigate the ocular manifestations and clinical characteristics of COVID-19 patients caused by SARS-CoV-2 in Wuhan, China. METHODS: A total of 535 COVID-19 patients were recruited at Mobile Cabin Hospital and Tongji Hospital. Information on demographic characteristics, exposure history, ocular symptoms, eye drop medication, eye protections, chronic eye diseases, systemic concomitant symptoms, radiologic findings and SARS-CoV-2 detection in nasopharyngeal swabs by real-time PCR was collected from questionnaires and electronic medical records. RESULTS: Of 535 patients, 27 patients (5.0%) presented with conjunctival congestion and 4 patients had conjunctival congestion as the initial symptom. The average duration of conjunctival congestion was 5.9 ± 4.5 days (mean [SD]). The other ocular symptoms, including increased conjunctival secretion, ocular pain, photophobia, dry eye and tearing, were also found in patients with conjunctival congestion. Notably, hand-eye contact was independently correlated with conjunctival congestion in COVID-19 patients. We also found that some COVID-19 patients had chronic eye diseases, including conjunctivitis (33, 6.2%), xerophthalmia (24, 4.5%) and keratitis (14, 2.6%). Similar to the published studies, the most common clinical symptoms were fever, cough and fatigue. A total of 343 patients (64.1%) had positive SARS-CoV-2 detection in nasopharyngeal swabs. CONCLUSIONS: Conjunctival congestion is one of the COVID-19-related ocular symptoms, which could occur as the initial symptoms. Frequent hand-eye contact may be the risk factor for conjunctival congestion in COVID-19 patients. Screening of patients with conjunctival congestion by ophthalmologists is advocated during the outbreak of COVID-19. It is essential to provide eye-care equipment and strengthen education on eye protection.


docid: ladlgzef

title: One disease, different features: COVID-19 laboratory and radiological findings in three Italian patients


A Glimpse Into the Future


title: Generalized myoclonus in COVID-19

text: OBJECTIVE: To report 3 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed generalized myoclonus. METHODS: Patient data were obtained from medical records from the University Hospital "12 de Octubre," Madrid, Spain. RESULTS: Three patients (2 men and 1 woman, aged 63-88 years) presented with mild hypersomnia and generalized myoclonus following the onset of the so-called inflammatory phase of coronavirus disease 2019 (COVID-19). All of them had presented previously with anosmia. Myoclonus was generalized with both positive and negative jerks, predominantly involving the facial, trapezius, sternocleidomastoid, and upper extremities muscles. These myoclonic jerks occurred spontaneously and were extremely sensitive to multisensory stimuli (auditive and tactile) or voluntary movements, with an exaggerated startle response. Other causes of myoclonus were ruled out, and none of the patients had undergone respiratory arrest or significant prolonged hypoxia. All of them improved, at least partially, with immunotherapy. CONCLUSIONS: Our 3 cases highlight the occurrence of myoclonus during the COVID-19 pandemic as a post- or para-infectious immune-mediated disorder. However, we cannot rule out that SARS-CoV-2 may spread transneuronally to first- and second-order structures connected with the olfactory bulb. Further investigation is required to clarify the full clinical spectrum of neurologic symptoms and optimal treatment.


title: [Ichthyosis vulgaris]

text: Ichthyosis  also called fish scale disease  is a group of skin diseases, which are characterised by xerosis and scaling. Most commonly, the diseases are genetically inherited, but an acquired type also exists. Ichthyosis vulgaris (IV), is the most common type, affecting 1:250 individuals. Diagnosing IV can be challenging, because its clinical features are subject to great variation, ranging from mild cases with slight xerosis to severe cases with marked scaling and formation of fissures. In this review, IV and its most relevant differential diagnoses, X-linked ichthyosis, autosomal recessive congenital ichthyosis and acquired ichthyosis are reviewed.


COVID-19 will change MS care forever - Commentary