title: SARS-CoV-2 (COVID-19) structural and evolutionary dynamicome: Insights into functional evolution and human genomics

text: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has challenged the speed at which laboratories discover the viral composition and study health outcomes. The small ~30-kb ssRNA genome of coronaviruses makes them adept at cross-species spread, but also enable a robust understanding of all the proteins the viral genome encodes. We have employed protein modeling, molecular dynamic simulations, evolutionary mapping, and 3D printing to gain a full proteome- and dynamicome-level understanding of SARS-CoV-2. We established the Viral Integrated Structural Evolution Dynamic Database (VIStEDD at prokoplab.com/vistedd) to facilitate future discoveries and educational use. Here, we highlight the use of VIStEDD for nsp6, nucleocapsid (N), and spike (S) surface glycoprotein. For both nsp6 and N, we found highly conserved surface amino acids that likely drive protein-protein interactions. In characterizing viral S protein, we developed a quantitative dynamics cross-correlation matrix to gain insights into its interactions with the angiotensin I-converting enzyme 2 (ACE2)-solute carrier family 6 member 19 (SLC6A19) dimer. Using this quantitative matrix, we elucidated 47 potential functional missense variants from genomic databases within ACE2/SLC6A19/transmembrane serine protease 2 (TMPRSS2), warranting genomic enrichment analyses in SARS-CoV-2 patients. These variants had ultralow frequency but existed in males hemizygous for ACE2. Two ACE2 noncoding variants (rs4646118 and rs143185769) present in ~9% of individuals of African descent may regulate ACE2 expression and may be associated with increased susceptibility of African Americans to SARS-CoV-2. We propose that this SARS-CoV-2 database may aid research into the ongoing pandemic.


title: A Comprehensive Updated Review on SARS-CoV-2 and COVID-19

text: This literature review aims to provide a comprehensive current summary of the pathogenesis, clinical features, disease course, host immune responses, and current investigational antiviral and immunomodulatory pharmacotherapies to facilitate the development of future therapies and measures for prevention and control.


COVID-19 and ischemic heart disease emergencies: What cardiac surgery should expect?


title: Predicting turning point, duration and attack rate of COVID-19 outbreaks in major Western countries

text: In this paper, we employed a segmented Poisson model to analyze the available daily new cases data of the COVID-19 outbreaks in the six Western countries of the Group of Seven, namely, Canada, France, Germany, Italy, UK and USA. We incorporated the governments' interventions (stay-at-home advises/orders, lockdowns, quarantines and social distancing) against COVID-19 into consideration. Our analysis allowed us to make a statistical prediction on the turning point (the time that the daily new cases peak), the duration (the period that the outbreak lasts) and the attack rate (the percentage of the total population that will be infected over the course of the outbreak) for these countries.


title: Aerosol formation during non-contact "air-puff"tonometry and its significance for prevention of COVID-19

text: To evaluate the aerosol concentration(PM2 5,PM10 0 and aerosol particle number) formation in non-contact "air-puff"tonometry and provide suggestions for medical workers to take appropriate daily protection during the prevalence of 2019-nCoV ;;Methods;A cross-sectional study was carried out in this study Thirty healthy subjects were enrolled on February 22, 2020 at Eye Hospital of Wenzhou Medical University The intraocular pressure (IOP) was measured by non-contact "air-puff"tonometer in the ophthalmic consulting room and the hall with or without masks PM2 5, PM10 0 and aerosol particles were recorded by air quality detector The cumulative effects of IOP measurement, PM2 5, PM10 0 and aerosol particle number were analyzed, and the aerosol density of subjects with and without masks was compared ;;Results;The PM2 5, PM10 0 and aerosol particles produced by the non-contact "air-puff"tonometry and increased with the increase of spray times The IOP curves of 60 eyes of 30 subjects were measured respectively in two environments of medical consulting room and medical institution hall It was found that PM2 5, pm10 0 and particle number fluctuated and increased with the increase of IOP measurement person times, showing cumulative effect, and the accumulation speed of aerosol density in hall was faster than that in consulting room The density of PM2 5 and PM10 0 produced without gauze mask were (53 417±2 306) and (85 350±3 488) μg/m3, which were higher than those of (50 567±0 862) and (80 617±1 463) μg/m3with gauze mask The differences were statistically significant (<italic>P</italic>=0 028, 0 019) ;;Conclusions;Aerosol can be produced by non-contact "air-puff"tonometer spraying, and it fluctuates with the increase of spraying times, showing a cumulative effect The aerosol accumulation is higher in the hall with insufficient air circulation And more aerosol can be produced without gauze mask ;


title: Aerosol formation during non-contact 'air-puff' tonometry and its significance for prevention of COVID-19

text: Objective To evaluate the aerosol concentration(PM2 5,PM10 0 and aerosol particle number) formation in non-contact 'air-puff' tonometry and provide suggestions for medical workers to take appropriate daily protection during the prevalence of 2019-nCoV Methods A cross-sectional study was carried out in this study Thirty healthy subjects were enrolled on February 22, 2020 at Eye Hospital of Wenzhou Medical University The intraocular pressure (IOP) was measured by non-contact 'air-puff' tonometer in the ophthalmic consulting room and the hall with or without masks PM2 5, PM10 0 and aerosol particles were recorded by air quality detector The cumulative effects of IOP measurement, PM2 5, PM10 0 and aerosol particle number were analyzed, and the aerosol density of subjects with and without masks was compared Results The PM2 5, PM10 0 and aerosol particles produced by the non-contact 'air-puff' tonometry and increased with the increase of spray times The IOP curves of 60 eyes of 30 subjects were measured respectively in two environments of medical consulting room and medical institution hall It was found that PM2 5, pm10 0 and particle number fluctuated and increased with the increase of IOP measurement person times, showing cumulative effect, and the accumulation speed of aerosol density in hall was faster than that in consulting room The density of PM2 5 and PM10 0 produced without gauze mask were (53 417±2 306) and (85 350±3 488) μg/m 3 , which were higher than those of (50 567±0 862) and (80 617±1 463) μg/m 3 with gauze mask The differences were statistically significant ( P =0 028, 0 019) Conclusions Aerosol can be produced by non-contact 'air-puff' tonometer spraying, and it fluctuates with the increase of spraying times, showing a cumulative effect The aerosol accumulation is higher in the hall with insufficient air circulation And more aerosol can be produced without gauze mask


text: Objective@#To evaluate the aerosol concentration(PM2 5,PM10 0 and aerosol particle number) formation in non-contact &quot;air-puff&quot;tonometry and provide suggestions for medical workers to take appropriate daily protection during the prevalence of 2019-nCoV @*Methods@#A cross-sectional study was carried out in this study Thirty healthy subjects were enrolled on February 22, 2020 at Eye Hospital of Wenzhou Medical University The intraocular pressure (IOP) was measured by non-contact &quot;air-puff&quot;tonometer in the ophthalmic consulting room and the hall with or without masks PM2 5, PM10 0 and aerosol particles were recorded by air quality detector The cumulative effects of IOP measurement, PM2 5, PM10 0 and aerosol particle number were analyzed, and the aerosol density of subjects with and without masks was compared @*Results@#The PM2 5, PM10 0 and aerosol particles produced by the non-contact &quot;air-puff&quot;tonometry and increased with the increase of spray times The IOP curves of 60 eyes of 30 subjects were measured respectively in two environments of medical consulting room and medical institution hall It was found that PM2 5, pm10 0 and particle number fluctuated and increased with the increase of IOP measurement person times, showing cumulative effect, and the accumulation speed of aerosol density in hall was faster than that in consulting room The density of PM2 5 and PM10 0 produced without gauze mask were (53 417±2 306) and (85 350± 3 488) &#x03BC;g/m3, which were higher than those of (50 567±0 862) and (80 617±1 463) &#x03BC;g/m3 with gauze mask The differences were statistically significant (P=0 028, 0 019) @*Conclusions@#Aerosol can be produced by non-contact &quot;air-puff&quot;tonometer spraying, and it fluctuates with the increase of spraying times, showing a cumulative effect The aerosol accumulation is higher in the hall with insufficient air circulation And more aerosol can be produced without gauze mask


Redeployment of Dermatologists During COVID-19: Implementation of a Large-Scale, Centralized Results Management Infrastructure


title: Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia

text: OBJECTIVE: We aimed to investigate the relationship between clinical characteristics, outcomes and the severity of severe acute respiratory syndrome coronavirus 2 pneumonia. METHODS: We performed a systematic review and meta-analysis using PubMed, Embase, and Cochrane Library databases to assess the clinical characteristics and outcomes of confirmed COVID-19 cases and compared severe (ICU) and nonsevere (non-ICU) groups. RESULTS: We included 12 cohort studies including 2,445 patients with COVID-19. Compared with nonsevere (non-ICU) patients, severe (ICU) disease was associated with a smoking history (Pâ¯=â¯.003) and comorbidities including chronic obstructive pulmonary disease (ORâ¯=â¯5.08, P < .001), diabetes (ORâ¯=â¯3.17, P < .001), hypertension (ORâ¯=â¯2.40, P < .001), coronary heart disease (ORâ¯=â¯2.66, P < .001), cerebrovascular diseases (ORâ¯=â¯2.68, Pâ¯=â¯.008), and malignancy (OR=2.21, Pâ¯=â¯.040). We found significant differences between the 2 groups for fever, dyspnea, decreased lymphocyte and platelet counts, and increased leukocyte count, C-creative protein, procalcitonin, lactose dehydrogenase, aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and creatinine levels (P < .05). Significant differences were also observed for multiple treatments (P < .05). Patients in the severe (ICU) group were more likely to have complications and had a much higher mortality rate and lower discharge rate than those with nonsevere (non-ICU) disease (P < .05). CONCLUSIONS: Investigation of clinical characteristics and outcomes of severe cases of COVID-19 will contribute to early prediction, accurate diagnosis, and treatment to improve the prognosis of patients with severe illness.


Deep impact of COVID-19 in the healthcare of Latin America: the case of Brazil


title: Can orthodontic care be safely delivered during the COVID-19 pandemic? Recommendations from a literature review

text: Data sources Five electronic databases were searched: COVID-19 Open Research Dataset (CORD-19-2020); PubMed; MEDLINE; Scopus; and Google Scholar.Study selection Titles of articles and abstracts were identified during the electronic database searches and then screened for relevance. Publications up until the date of the literature search, 19th March 2020, were used. All articles with the appropriate topics pertaining to COVID-19, dentistry, orthodontics, and infection control were used irrespective of language. The author did not state whether they were selective about the study type or design of articles screened. References of these articles were also screened, via the 'snowballing technique', to obtain as much relevant literature as possible.Data extraction and synthesis Articles were reviewed by the cited author, and one research assistant. Data was extracted from each study by this author. The data obtained was combined and discussed narratively, in a qualitative manner. Due to the broad scope of studies included, it was not possible to conduct a meta-analysis.Results This literature review describes ways to reduce COVID-19 transmission in orthodontic practice. Overview of the literature discusses how the virus may be transmitted in the orthodontic setting: by human-human contact; saliva; aerosols; and use of orthodontic instruments. The literature review illustrates the need for optimum infection control and strict cleaning, detailing surface disinfection and sterilisation protocols. It highlights the need for optimal hand hygiene, use of high standard personal protective equipment, controlling aerosol use, appropriate ventilation, and treating emergency cases only.Conclusions While there are no known cases of COVID-19 cross-transmission within the dental setting currently reported, utmost vigilance is required by orthodontic professionals to reduce risk of transmission. The review reinforces crucial measures required to reduce infection, as outlined in the Results section above. While the virus is still emerging, knowledge is limited and as such it is difficult to provide robust and complete recommendations for best practice. Further studies to inform future practice are required.


Aerosol Barrier Hood for Use in the Management of Critically Ill Adults With COVID-19


COVID-19 Reveals Urgent Need to Strengthen the World Health Organization


COVID-19 affecting our world


title: Aspectos epidemiológicos, clínicos e anatomopatológicos do linfoma folicular em cães/ Epidemiological, clinical and pathological aspects of follicular lymphoma in dogs

text: Linfomas foliculares são uma rara forma de distúrbio linfoproliferativo descrita em medicina veterinária. Juntamente com a não reconhecida ocorrência dos linfomas de Hodgkin em cães, essa é a maior diferença acerca de linfoma entre humanos e cães. O objetivo deste artigo é descrever os achados epidemiológicos, clínicos e anatomopatológicos vistos em cinco cães com linfoma folicular. Destes, dois eram machos (40%) e três eram fêmeas (60%). A idade dos cães afetados variou de 11 a 13 anos. Quatro dos cinco (80%) cães eram de raça pura e um (20%) não tinha raça definida. Todos os cães apresentaram linfadenomegalia generalizada e esplenomegalia, o que incluiu os casos como linfoma multicêntrico. Na necropsia, os linfonodos e o baço demonstraram um padrão nodular à superfície de corte, caracterizado por dezenas a centenas de nódulos brancos, multifocais ou coalescentes e de tamanhos variáveis. Na superfície natural do baço, frequentemente (4/5, 80%), havia miríades de pontos brancos, multifocais ou coalescentes, de tamanhos variáveis. Na histopatologia, os tumores foram confirmados como linfomas foliculares. Todos os casos eram Grau III, sendo dois (40%) incluídos como IIIa e outros três (60%) como IIIb. Em um caso (1/5, 20%), o linfoma folicular foi considerado como IIIb variante de pequenos centroblastos semelhantes aos linfócitos neoplásicos vistos no linfoma de Burkitt. Os linfomas foram validados como tendo origem em células B através da imuno-histoquímica, utilizando anticorpos anti-CD20. Os casos de linfomas foliculares descritos comportaram-se de forma agressiva e levaram os pacientes à morte.(AU)


title: Preparedness and Best Practice in Radiology Department for COVID-19 and Other Future Pandemics of Severe Acute Respiratory Infection

text: The COVID-19 global pandemic has emerged as an unprecedented health care crisis. To reduce risks of severe acute respiratory syndrome coronavirus 2 transmission in the Radiology Department, this article describes measures to increase the preparedness of Radiology Department, such as careful screening of staff and patients, thorough disinfection of equipments and rooms, appropriate use of personal protection equipment, and early isolation of patients with incidentally detected computed tomography findings suspicious for COVID-19. The familiarity of radiologists with clinical and imaging manifestations of COVID-19 pneumonia and their prognostic implications is essential to provide optimal care to patients.


Metabolomics to Predict Antiviral Drug Efficacy in COVID-19


Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in Portugal


title: Pharmacologic Therapy for COVID-19 Infection

text: The COVID-19 pandemic has focused attention on issues of epidemiology, public health, and vaccine design. I submit that attention to COVID-19 pharmacologic therapy needs similar emphasis, including identifying any existing medications that can be repurposed to treat COVID-19 patients.


Weathering the Cytokine Storm in Susceptible Patients with Severe SARS-CoV-2 Infection


Prevalence and fatality rates of COVID-19: What are the reasons for the wide variations worldwide?


Sexually transmitted infections during the COVID-19 outbreak: comparison of patients referring to the service of sexually transmitted diseases during the sanitary emergency with those referring during the common practice


Covid-19: Medical leaders call for urgent action to make hospitals safe


Decrease in Neurosurgical Program Volume During COVID-19: Residency Programs Must Adapt


Implications of social distancing in Brazil in the COVID-19 pandemic


The pros and cons of traditional Chinese medicines in the treatment of COVID-19


Low incidence of COVID-19 in children and adolescent post-liver transplant at a Latin American reference center


Performing abdominal surgery during the COVID-19 epidemic in Wuhan, China: a single-centred, retrospective, observational study


title: Special considerations for elderly patients with head and neck cancer during the COVID-19 pandemic

text: Elderly patients with head and neck cancer are at increased risk of adverse outcomes during and after treatment of head and neck cancer. COVID-19 severity and mortality can be expected to be significantly greater in elderly patients with head and neck cancer, given that increased age, comorbidities, and presence of malignancy are known risk factors for disease severity and mortality in patients with COVID-19. Therefore, their management requires multidisciplinary consensus and patient input. A thorough geriatric assessment, which has been shown to be beneficial prior to the COVID-19 pandemic, could be particularly helpful in this patient population with the added dimension of COVID-19 risk. In many cases, prudent treatment plan modification may allow for overall best outcomes. Furthermore, recruitment of social services and, when appropriate, palliative care, may allow for optimal management of these patients.


title: Isolation, characterization and anti-inflammatory mechanism of probiotics in lipopolysaccharide-stimulated RAW 264.7 macrophages

text: Probiotics are known to modulate gut microbiota, intestinal barrier function and host immune response, but due to the species and strain specific response their mechanisms are not clearly understood. Thus, the present study was designed to isolate, assess the anti-inflammatory potential and underlying modulatory mechanisms of indigenous probiotics in murine macrophage cell line, RAW 264.7. Forty lactic acid bacteria (LAB) were isolated from different sources and monitored for their anti-inflammatory potential against lipopolysaccharide (LPS) induced inflammatory stress employing RAW 264.7 cells. Among these isolates, only four LAB isolates exhibited more than 90% nitric oxide inhibition and possessed the probiotic attributes. Further, these selected LAB isolates reduced the level of pro-inflammatory cytokines, TNF-α, IL-1ß and IL-6, inhibited the phosphorylation of Mitogen Activated Protein Kinases (MAPKs) i.e. p38 MAPK, ERK1/2 and SAPK/JNK and expression of cyclooxygenase-2 (COX-2) in LPS stimulated RAW 264.7 cells. The in vitro analysis suggested that the selected probiotic isolates attenuated the LPS-induced inflammation by downregulating MAPK pathway vis-a-vis inhibiting COX-2 and can be employed as anti-inflammatory agents in various inflammatory diseases.


title: Fighting the COVID-19 Infodemic: Modeling the Perspective of Journalists, Fact-Checkers, Social Media Platforms, Policy Makers, and the Society

text: With the emergence of the COVID-19 pandemic, the political and the medical aspects of disinformation merged as the problem got elevated to a whole new level to become the first global infodemic. Fighting this infodemic is ranked second in the list of the most important focus areas of the World Health Organization, with dangers ranging from promoting fake cures, rumors, and conspiracy theories to spreading xenophobia and panic. Addressing the issue requires solving a number of challenging problems such as identifying messages containing claims, determining their check-worthiness and factuality, and their potential to do harm as well as the nature of that harm, to mention just a few. Thus, here we design, annotate, and release to the research community a new dataset for fine-grained disinformation analysis that (i)focuses on COVID-19, (ii) combines the perspectives and the interests of journalists, fact-checkers, social media platforms, policy makers, and society as a whole, and (iii) covers both English and Arabic. Finally, we show strong evaluation results using state-of-the-art Transformers, thus confirming the practical utility of the annotation schema and of the dataset.


Challenges for Child and Adolescent Psychiatric Research in the Era of COVID-19


docid: ahdefbbn

title: An epidemiological study of laboratory confirmed COVID-19 cases admitted in a tertiary care hospital of Pune, Maharashtra

text: Background: India has reported more than 70,000 cases and 2000 deaths. Pune is the second city in the Maharashtra state after Mumbai to breach the 1000 cases. Total deaths reported from Pune were 158 with a mortality of 5.7%. To plan health services, it is important to learn lessons from early stage of the outbreak on course of the disease in a hospital setting. Objectives: To describe the epidemiological characteristics of the outbreak of COVID-19 in India from a tertiary care hospital. Methods: This was a hospital-based cross-sectional study which included all admitted laboratory confirmed COVID19 cases from March 31, to April 24, 2020. The information was collected in a predesigned pro forma which included sociodemographic data, duration of stay, family background, outcome, etc., by trained staff after ethics approval. Epi Info7 was used for data analysis. Results: Out of the total 197 cases, majority cases were between the ages of 31-60 years with slight male preponderance. Majority of these cases were from the slums. Breathlessness was the main presenting symptom followed by fever and cough. More than 1/5th of patients were asymptomatic from exposure to admission. The case fatality rate among the admitted cases was 29.4%. Comorbidity was one of the significant risk factors for the progression of disease and death (odds ratio [OR] = 16.8, 95% confidence interval [CI] = 7.0 - 40.1, P < 0.0001). Conclusion: Mortality was higher than the national average of 3.2%; comorbidity was associated with bad prognosis.


title: A First Look at Android Applications in Google Play related to Covid-19

text: Due to the convenience of access-on-demand to information and business solutions, mobile apps have become an important asset in the digital world. In the context of the Covid-19 pandemic, app developers have joined the response effort in various ways by releasing apps that target different user bases (e.g., all citizens or journalists), offer different services (e.g., location tracking or diagnostic-aid), provide generic or specialized information, etc. While many apps have raised some concerns by spreading misinformation or even malware, the literature does not yet provide a clear landscape of the different apps that were developed. In this study, we focus on the Android ecosystem and investigate Covid-related Android apps. In a best-effort scenario, we attempt to systematically identify all relevant apps and study their characteristics with the objective to provide a first taxonomy of Covid-related apps, broadening the relevance beyond the implementation of contact tracing. Overall, our study yields a number of empirical insights that contribute to enlarge the knowledge on Covid-related apps: (1) Developer communities contributed rapidly to the Covid-19, with apps released as early as February 2020; (2) Covid-related apps deliver digital tools to users (e.g., health diaries), serve to broadcast information to users (e.g., spread statistics), and collect data from users (e.g., for tracing); (3) Covid-related apps are less complex than standard apps; (4) they generally do not seem to leak sensitive data; (5) in the majority of cases, Covid-related apps are released by entities with past experience on the market, mostly official government entities or public health organizations.


title: Impact of the COVID-19 Pandemic on Orthopaedic and Trauma Surgery in University Hospitals in Germany: Results of a Nationwide Survey

text: BACKGROUND: The purpose of the present study was to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on orthopaedic and trauma surgery departments in university hospitals in Germany in order to clarify current challenges. METHODS: In this cross-sectional study, an online-based anonymous survey was conducted within the Convention of University Professors of Orthopaedic and Trauma Surgery in Germany from April 3 to April 11, 2020. A bipolar 5-point Likert scale (with possible responses of "totally disagree," "rather disagree," "neutral," "rather agree," and "totally agree") was applied. Fifty-two (69.3%) of 75 clinic directors participated. RESULTS: Communication and cooperation with the government, hospital administration, and other departments during the COVID-19 pandemic were mainly perceived as appropriate. However, only 7 respondents (13.7%) totally agreed or rather agreed with the statement that the authorities are supporters of orthopaedic and trauma surgery departments. Substantial financial and personnel changes in orthopaedic and trauma surgery departments of university hospitals were reported, resulting in an average reduction of 49.4% in operating room capacity and an expected 29.3% loss of revenue. In addition, 14.7% of physicians were reallocated from orthopaedic and trauma surgery to other care-delivery environments. CONCLUSIONS: Our study demonstrated that the COVID-19 pandemic has had a substantial impact on orthopaedic and trauma surgery departments in German university hospitals. Distinct structural and financial effects were noted. Nevertheless, the present study demonstrates the commitment of our specialty to overcome the pandemic by providing competent personnel as well as close cooperation with the hospital administration and other departments. CLINICAL RELEVANCE: To our knowledge, this is the first Germany-wide survey among the heads of orthopaedic and trauma surgery departments in university hospitals on the impact of the COVID-19 pandemic. The survey results may help to inform system-wide decision-making in Germany, in Europe, and beyond.


title: Predicting financial markets with Google Trends and not so random keywords

text: We check the claims that data from Google Trends contain enough data to predict future financial index returns. We first discuss the many subtle (and less subtle) biases that may affect the backtest of a trading strategy, particularly when based on such data. Expectedly, the choice of keywords is crucial: by using an industry-grade backtesting system, we verify that random finance-related keywords do not to contain more exploitable predictive information than random keywords related to illnesses, classic cars and arcade games. We however show that other keywords applied on suitable assets yield robustly profitable strategies, thereby confirming the intuition of Preis et al. (2013)


title: COVID-19 and the 5G Conspiracy Theory: Social Network Analysis of Twitter Data

text: BACKGROUND: Since the beginning of December 2019, the coronavirus disease (COVID-19) has spread rapidly around the world, which has led to increased discussions across online platforms. These conversations have also included various conspiracies shared by social media users. Amongst them, a popular theory has linked 5G to the spread of COVID-19, leading to misinformation and the burning of 5G towers in the United Kingdom. The understanding of the drivers of fake news and quick policies oriented to isolate and rebate misinformation are keys to combating it. OBJECTIVE: The aim of this study is to develop an understanding of the drivers of the 5G COVID-19 conspiracy theory and strategies to deal with such misinformation. METHODS: This paper performs a social network analysis and content analysis of Twitter data from a 7-day period (Friday, March 27, 2020, to Saturday, April 4, 2020) in which the #5GCoronavirus hashtag was trending on Twitter in the United Kingdom. Influential users were analyzed through social network graph clusters. The size of the nodes were ranked by their betweenness centrality score, and the graph's vertices were grouped by cluster using the Clauset-Newman-Moore algorithm. The topics and web sources used were also examined. RESULTS: Social network analysis identified that the two largest network structures consisted of an isolates group and a broadcast group. The analysis also revealed that there was a lack of an authority figure who was actively combating such misinformation. Content analysis revealed that, of 233 sample tweets, 34.8% (n=81) contained views that 5G and COVID-19 were linked, 32.2% (n=75) denounced the conspiracy theory, and 33.0% (n=77) were general tweets not expressing any personal views or opinions. Thus, 65.2% (n=152) of tweets derived from nonconspiracy theory supporters, which suggests that, although the topic attracted high volume, only a handful of users genuinely believed the conspiracy. This paper also shows that fake news websites were the most popular web source shared by users; although, YouTube videos were also shared. The study also identified an account whose sole aim was to spread the conspiracy theory on Twitter. CONCLUSIONS: The combination of quick and targeted interventions oriented to delegitimize the sources of fake information is key to reducing their impact. Those users voicing their views against the conspiracy theory, link baiting, or sharing humorous tweets inadvertently raised the profile of the topic, suggesting that policymakers should insist in the efforts of isolating opinions that are based on fake news. Many social media platforms provide users with the ability to report inappropriate content, which should be used. This study is the first to analyze the 5G conspiracy theory in the context of COVID-19 on Twitter offering practical guidance to health authorities in how, in the context of a pandemic, rumors may be combated in the future.


title: COVID-19 and Iranian Medical Students; A Survey on Their Related-Knowledge, Preventive Behaviors and Risk Perception

text: BACKGROUND: Since December 2019, a novel coronavirus disease (COVID-19) began its journey around the world. Medical students, as frontline healthcare workers, are more susceptible to be infected by the virus. The aim of this study was to assess COVID-19 related knowledge, self-reported preventive behaviors and risk perception among Iranian medical students within the first week after the onset of the outbreak in Iran. METHODS: This cross-sectional study was conducted from 26th to 28th of February, 2020. Participants were Iranian medical students (5th-7th year) whose knowledge, preventive behaviors and risk perceptions of COVID-19 were assessed using an online questionnaire. The questionnaire consisted of 26 questions including 15 items about COVID-19 related knowledge, 9 items regarding preventive measures and 2 items about COVID-19 risk perception. The validity and reliability of the questionnaire were shown to be satisfactory. RESULTS: A total of 240 medical students completed the questionnaire. The mean age of participants was 23.67 years. The average of correct answers of knowledge was 86.96%; and 79.60% had high level of related knowledge. The average rate of practicing preventive behaviors was 94.47%; and 94.2% had high level of performance in preventive behaviors. The cumulative score of risk perception was 4.08 out of 8 which was in moderate range. Risk perception was significantly different between stagers and interns and between those being trained in emergency room (ER) and non-ER wards. There was a significant negative correlation between preventive behaviors and risk perception. CONCLUSION: We found a high level of COVID-19 related knowledge and self-reported preventive behaviors and moderate risk perception among Iranian medical students.


title: Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2

text: INTRODUCTION: Cytokine storm syndrome (CSS) is a serious complication of COVID-19 patients Treatment is tocilizumab The use of glucocorticoids (GC) is controversial In other very similar CSS, such as macrophage activation syndrome (MAS) and hemophagocytic syndrome (HFS), the main treatment are corticosteroids Our objective is to evaluate the efficacy of GC in the CSS by COVID-19 PATIENTS: We included 92 patients with CSS associated to COVID-19 who received GC, GC, and tocilizumab and only tocilizumab We determine CSS markers We evaluated mortality, intubation, and a combined variable RESULTS: In all cases the percentages of events were lower in the group of patients with GC was administered The hazard ratio of the final variables with GC versus the group in which only tocilizumab was administered was lower as CGs were considered, with statistical significance for survival DISCUSSION: The early use of GC pulses could control SLC, with a lower requirement to use tocilizumab and a decrease in events such as intubation and death


title: Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2./ Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2./ Effectiveness of corticoid pulses in patients with cytokine storm syndrome induced by SARS-CoV-2 infection

text: INTRODUCTION: Cytokine storm syndrome (CSS) is a serious complication of COVID-19 patients. Treatment is tocilizumab. The use of glucocorticoids (GC) is controversial. In other very similar CSS, such as macrophage activation syndrome (MAS) and hemophagocytic syndrome (HFS), the main treatment are corticosteroids. Our objective is to evaluate the efficacy of GC in the CSS by COVID-19. PATIENTS: We included 92 patients with CSS associated to COVID-19 who received GC, GC, and tocilizumab and only tocilizumab. We determine CSS markers. We evaluated mortality, intubation, and a combined variable. RESULTS: In all cases the percentages of events were lower in the group of patients with GC was administered. The hazard ratio of the final variables with GC versus the group in which only tocilizumab was administered was lower as CGs were considered, with statistical significance for survival. DISCUSSION: The early use of GC pulses could control SLC, with a lower requirement to use tocilizumab and a decrease in events such as intubation and death.


docid: qqbokruo

title: [Application and thinking of health standards related to public health in prevention and control of coronavirus disease 2019]

text: Objective: To systematically analyze the basic characteristics and contents of the current health standards for infectious disease, environmental health, school health and disinfection in the context of COVID-19 prevention and control, and provide support for the further optimization of epidemic prevention and control guidelines and reference for the revision and improvement of related health standards. Methods: Public health standards used in COVID-19 prevention and control were selected for a systematic comparison with "The Plan of COVID19 Prevention and Control" (the 6th Edition) and other epidemic prevention and control guidelines from the perspectives of application scope and technical elements. Results: The current standards of public health are with scientificity, timeliness and feasibility. The application scope and technical elements of the current public health standards basically meet the needs of the prevention and control of COVID-19 epidemic, but the public health standardization system still needs improvement, and some public health standards need to be revised. Conclusions: The implementation of current public health standards can provide strong technical support for the prevention and control of COVID-19 epidemic. The experience obtained from COVID-19 epidemic prevention and control might promote the further improvement of the health standardization system.


title: Coronavirus disease 2019 among pregnant Chinese women: case series data on the safety of vaginal birth and breastfeeding

text: OBJECTIVE: To assess whether vaginal secretions and breast milk of women with coronavirus disease 2019 (COVID-19) contain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). DESIGN: Single centre cohort study. SETTING: Renmin Hospital of Wuhan University, Wuhan, Hubei province, China. POPULATION: We studied 13 SARS-CoV-2-infected pregnant women diagnosed between 31 January and 9 March 2020. METHODS: We collected clinical data, vaginal secretions, stool specimens and breast milk from SARS-CoV-2-infected women during different stages of pregnancy and collected neonatal throat and anal swabs. MAIN OUTCOMES AND MEASURES: We assessed viral presence in different biosamples. RESULTS: Of the 13 women with COVID-19, five were in their first trimester, three in their second trimester and five in their third trimester. Of the five women in their third trimester who gave birth, all delivered live newborns. Among these five deliveries, the primary adverse perinatal outcomes included premature delivery (n = 2) and neonatal pneumonia (n = 2). One of nine stool samples was positive; all 13 vaginal secretion samples, and five throat swabs and four anal swabs collected from neonates, were negative for the novel coronavirus. However, one of three samples of breast milk was positive by viral nucleic acid testing. CONCLUSIONS: In this case series of 13 pregnant women with COVID-19, we observed negative viral test results in vaginal secretion specimens, suggesting that a vaginal delivery may be a safe delivery option. However, additional research is urgently needed to examine breast milk and the potential risk for viral contamination. TWEETABLE ABSTRACT: New evidence for the safety of vaginal delivery and breastfeeding in pregnant women infected with SARS-CoV-2, positive viral result in a breast-milk sample.


title: A mathematical model reveals the influence of population heterogeneity on herd immunity to SARS-CoV-2

text: Despite various levels of preventive measures, in 2020 many countries have suffered severely from the coronavirus 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. We show that population heterogeneity can significantly impact disease-induced immunity as the proportion infected in groups with the highest contact rates is greater than in groups with low contact rates. We estimate that if R 0 = 2.5 in an age-structured community with mixing rates fitted to social activity then the disease-induced herd immunity level can be around 43%, which is substantially less than the classical herd immunity level of 60% obtained through homogeneous immunization of the population. Our estimates should be interpreted as an illustration of how population heterogeneity affects herd immunity, rather than an exact value or even a best estimate.


Covid-19: medical students and FY1 doctors to be given early registration to help combat covid-19


docid: khawtgub

title: Is the gingival sulcus a potential niche for SARS-Corona virus-2?


International Expansion of a Novel SARS-CoV-2 Mutant


title: COVID-19's impact on the atmospheric environment in the Southeast Asia region

text: Since its first appearance in Wuhan, China at the end of 2019, the new coronavirus (COVID-19) has evolved a global pandemic within three months, with more than 4.3 million confirmed cases worldwide until mid-May 2020. As many countries around the world, Malaysia and other southeast Asian (SEA) countries have also enforced lockdown at different degrees to contain the spread of the disease, which has brought some positive effects on natural environment. Therefore, evaluating the reduction in anthropogenic emissions due to COVID-19 and the related governmental measures to restrict its expansion is crucial to assess its impacts on air pollution and economic growth. In this study, we used aerosol optical depth (AOD) observations from Himawari-8 satellite, along with tropospheric NO2 column density from Aura-OMI over SEA, and ground-based pollution measurements at several stations across Malaysia, in order to quantify the changes in aerosol and air pollutants associated with the general shutdown of anthropogenic and industrial activities due to COVID-19. The lockdown has led to a notable decrease in AOD over SEA and in the pollution outflow over the oceanic regions, while a significant decrease (27% - 30%) in tropospheric NO2 was observed over areas not affected by seasonal biomass burning. Especially in Malaysia, PM10, PM2.5, NO2, SO2, and CO concentrations have been decreased by 26-31%, 23-32%, 63-64%, 9-20%, and 25-31%, respectively, in the urban areas during the lockdown phase, compared to the same periods in 2018 and 2019. Notable reductions are also seen at industrial, suburban and rural sites across the country. Quantifying the reductions in major and health harmful air pollutants is crucial for health-related research and for air-quality and climate-change studies.


SARS-CoV-2-Induced Vomiting as Onset Symptom in a Patient with COVID-19


title: How does Working from Home Affect Developer Productivity? -- A Case Study of Baidu During COVID-19 Pandemic

text: Nowadays, working from home (WFH) has become a popular work arrangement due to its many potential benefits for both companies and employees (e.g., increasing job satisfaction and retention of employees). Many previous studies have investigated the impact of working from home on the productivity of employees. However, most of these studies usually use a qualitative analysis method such as survey and interview, and the studied participants do not work from home for a long continuing time. Due to the outbreak of coronavirus disease 2019 (COVID-19), a large number of companies asked their employees to work from home, which provides us an opportunity to investigate whether working from home affects their productivity. In this study, to investigate the difference of developer productivity between working from home and working onsite, we conduct a quantitative analysis based on a dataset of developers' daily activities from Baidu Inc, one of the largest IT companies in China. In total, we collected approximately four thousand records of 139 developers' activities of 138 working days. Out of these records, 1,103 records are submitted when developers work from home due to COVID-19 pandemic. We find that WFH has both positive and negative impacts on developer productivity in terms of different metrics, e.g., the number of builds/commits/code reviews. We also notice that working from home has different impacts on projects with different characteristics including programming language, project type/age/size. For example, working from home has a negative impact on developer productivity for large projects. Additionally, we find that productivity varies for different developers. Based on these findings, we get some feedbacks from developers of Baidu and understand some reasons why WFH has different impacts on developer productivity.


Spinal anesthesia in COVID-19 patients, more research is needed


title: Non-conservative Boltzmann-type kinetic equations for multi-agent systems with label switching

text: In this paper, we propose a Boltzmann-type kinetic description of mass-varying interacting multi-agent systems. Our agents are characterised by a microscopic state, which changes due to their mutual interactions, and by a label, which identifies a group to which they belong. Besides interacting within and across the groups, the agents may change label according to a state-dependent Markov-type jump process. Hence the mass of each group is not conserved. We derive general kinetic equations for the joint interaction/label switching processes in each group. Moreover, for prototypical birth/death dynamics we characterise the transient and equilibrium kinetic distributions of the groups via a Fokker-Planck asymptotic analysis. Finally, we introduce and discuss, both analytically and numerically, a new model for the contagion of infectious diseases with quarantine based on this non-conservative kinetic framework.


title: Simulated Sunlight Rapidly Inactivates SARS-CoV-2 on Surfaces

text: Previous studies have demonstrated that SARS-CoV-2 is stable on surfaces for extended periods under indoor conditions. In the present study, simulated sunlight rapidly inactivated SARS-CoV-2 suspended in either simulated saliva or culture media and dried on stainless steel coupons. Ninety percent of infectious virus was inactivated every 6.8 minutes in simulated saliva and every 14.3 minutes in culture media when exposed to simulated sunlight representative of the summer solstice at 40°N latitude at sea level on a clear day. Significant inactivation also occurred, albeit at a slower rate, under lower simulated sunlight levels. The present study provides the first evidence that sunlight may rapidly inactivate SARS-CoV-2 on surfaces, suggesting that persistence, and subsequently exposure risk, may vary significantly between indoor and outdoor environments. Additionally, these data indicate that natural sunlight may be effective as a disinfectant for contaminated nonporous materials.


title: Use of a portable computed tomography scanner for chest imaging of COVID-19 patients in the urgent care at a tertiary cancer center

text: To present a novel use of a portable computed tomography (CT) for evaluation of COVID-19 patients presenting to an urgent care center (UCC). Infection control is imperative for hospitals treating patients with COVID-19, even more so in cancer centers, where the majority of the patient population is susceptible to adverse outcomes from the infection. Over the past several weeks, our department has worked to repurpose a portable CT scanner from our surgical colleagues that operates with fixed-parameters to perform non-contrast, helical, thin-slice chest imaging to address the known pulmonary complications of COVID-19. Despite the technical limitations of the portable CT unit that was repurposed for the UCC, diagnostic-quality images in an acute care setting were successfully obtained. Repurposing of a portable CT scanner for use in COVID-19 patients offers a feasible option to obtain diagnostic quality images while minimizing the risk of exposing other patients and hospital staff to an infected patient.


Iranian Emotional Experience and Expression During the COVID-19 Crisis


Poor survival with extracorporeal membrane oxygenation in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19): Pooled analysis of early reports


title: Air quality during the COVID-19: PM2.5 analysis in the 50 most polluted capital cities in the world

text: On December 31, 2019, the Chinese authorities reported to the World Health Organization (WHO) the outbreak of a new strain of coronavirus that causes a serious disease in the city of Wuhan, China. This outbreak was classified as SARS-CoV2 and is the cause of the COVID-19 disease. On March 11, 2020, the WHO declares it a Pandemic and today it is considered the greatest challenge in global health that humanity has faced since World War II and it is estimated that between 40 and 60% of the population worldwide will catch the virus. This has caused enormous challenges in countries around the world in social, economic, environmental and obviously health issues. These challenges are mainly due to the effects of the established quarantines in almost all capitals and major cities around the world, from Asia, Europe to America. However, these lockdown which began worldwide from January 23, have had a significant impact on the environment and on the air quality of cities as recently reported by NASA (National Aeronautics and Space Administration) and ESA (European Space Agency), with reductions according to them of up to 30% in some of the epicenters such as the case of Wuhan. Knowing that air pollution causes approximately 29% of lung cancer deaths, 43% of COPD deaths, and 25% of ischemic heart disease deaths, it is important to know the effects of quarantines in cities regarding air quality to take measures that favor populations and urban ecosystems when the emergency ends. Therefore, this paper describes the behavior of PM2.5 emissions particulate matter from the 50 most polluted capital cities in the world according to the WHO, measured before-after the start of the quarantine. Likewise, the impact at the local and global level of this emissions behavior, which averaged 12% of PM2.5 decrease in these cities.


Lack of efficacy of hydroxychloroquine in covid-19


title: Bat coronavirus phylogeography in the Western Indian Ocean

text: Bats provide key ecosystem services such as crop pest regulation, pollination, seed dispersal, and soil fertilization. Bats are also major hosts for biological agents responsible for zoonoses, such as coronaviruses (CoVs). The islands of the Western Indian Ocean are identified as a major biodiversity hotspot, with more than 50 bat species. In this study, we tested 1,013 bats belonging to 36 species from Mozambique, Madagascar, Mauritius, Mayotte, Reunion Island and Seychelles, based on molecular screening and partial sequencing of the RNA-dependent RNA polymerase gene. In total, 88 bats (8.7%) tested positive for coronaviruses, with higher prevalence in Mozambican bats (20.5% ± 4.9%) as compared to those sampled on islands (4.5% ± 1.5%). Phylogenetic analyses revealed a large diversity of α- and ß-CoVs and a strong signal of co-evolution between CoVs and their bat host species, with limited evidence for host-switching, except for bat species sharing day roost sites. These results highlight that strong variation between islands does exist and is associated with the composition of the bat species community on each island. Future studies should investigate whether CoVs detected in these bats have a potential for spillover in other hosts.


Mental health of scientists in the time of COVID-19


title: Psychological Practice and the COVID-19 Crisis: A Rapid Response Survey

text: Psychological practice has changed dramatically over the past 125 years. The two world wars both served to stimulate and change the scope of practice for psychologists. We surveyed over 3,000 doctoral psychologists about the impact of the COVID-19 health crisis on their clinical practices. Practice changed from primarily in-office to mostly telepsychology practice over the course of 2 weeks in March of 2020. The long-term effect on professional practice in psychology is not known.


Airborne precautions recommended in Wuhan, China for bedside fiberoptic bronchoscopy examination of patients with COVID-19


Beatmung von COVID-19-Patienten auf Intensivstationen./ Ventilation of COVID-19 patients in intensive care units


Telemedicine-Enabled Accelerated Discharge of Hospitalized COVID-19 Patients to Isolation in Repurposed Hotel Rooms


docid: yeekwlzs

title: COVID-19 and the death of older people in Italy's rest homes. Is a judicial turmoil the answer?


title: [Effect of Xuebijing injection on inflammatory markers and disease outcome of coronavirus disease 2019]

text: OBJECTIVE: To observe the influence of Xuebijing injection on the inflammatory markers and prognosis of coronavirus disease 2019 (COVID-19) patients. METHODS: Sixty severe COVID-19 patients admitted to Changsha Public Health Treatment Center (North Hospital of the First Hospital of Changsha City) from January to March in 2020 were randomly divided into routine treatment group, Xuebijing 50 mL group and Xuebijing 100 mL group, with 20 cases in each group. The routine treatment group was treated according to the National Health Commission's guide for COVID-19. On the basis of conventional treatment, Xuebijing injection was injected by 50 mL twice a day for 7 days in Xuebijing 50 mL group, while by 100 mL twice a day for 7 days in Xuebijing 100 mL group. The blood routine test, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), acute physiology and chronic health evaluation II (APACHE II) score, 2019 novel coronavirus (2019-nCoV) nucleic acid test and disease classification of three groups before and 8 days after treatment were observed. RESULTS: (1) After treatment, the white blood cell count (WBC) and lymphocyte count (LYM) of three groups increased, meanwhile CRP and ESR decreased. Compared with routine treatment group, the WBC count of Xuebijing 100 mL group after treatment significantly increased (×109/L: 7.12±0.55 vs. 5.67±0.51, P < 0.05), and the levels of CRP and ESR in Xuebijing 50 mL and 100 mL groups significantly decreased [CRP (mg/L): 32.3±4.6, 28.0±6.2 vs. 37.3±5.9; ESR (mm/1 h): 45.9±5.7, 40.5±7.4 vs. 55.3±6.6, all P < 0.05]. Compared with Xuebijing 50 mL group, the increase of WBC, and the decrease of CRP and ESR were more significant in Xuebijing 100 mL group [WBC (×109/L): 7.12±0.55 vs. 5.82±0.49, CRP (mg/L): 28.0±6.2 vs. 32.3±4.6, ESR (mm/1 h): 40.5±7.4 vs. 45.9±5.7, all P < 0.05]. (2) After treatment, the APACHE II score of three groups decreased. In Xuebijing 100 mL group, the APACHE II score after treatment was significantly lower than those in routine treatment and Xuebijing 50 mL groups (12.3±1.5 vs. 16.5±1.6, 15.9±1.4, both P < 0.05). After treatment, the 2019-nCoV nucleic acid test in three groups partly turned negative, with 9 cases in routine treatment group, 8 cases in Xuebijing 50 mL group and 9 cases in Xuebijing 100 mL group, without significant difference (P > 0.05). The conditions of patients in the three groups were improved after treatment, among them, 8 cases in the routine treatment group were transformed into common type, 1 case into critical type; 9 cases and 12 cases of Xuebijing 50 mL group and 100 mL group were transformed into common type respectively. Xuebijing 100 mL group was improved more obviously than Xuebijing 50 mL group and routine treatment group (both P < 0.05). CONCLUSIONS: The Xuebijing injection can effectively improve the inflammatory markers and prognosis of severe COVID-19 patients.


title: The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2

text: A new type of pneumonia caused by a novel coronavirus SARS-CoV-2 outbreaks recently in China and spreads into many other countries. This disease, named as COVID-19, is similar to patients infected by SARS-CoV and MERS-CoV, and nearly 20% of patients developed severe condition. Cardiac injury is a prevalent complication of severe patients, exacerbating the disease severity in coronavirus disease 2019 (COVID-19) patients. Angiotensin-converting enzyme 2 (ACE2), the key host cellular receptor of SARS-CoV-2, has been identified in multiple organs, but its cellular distribution in human heart is not illuminated clearly. This study performed the first state-of-art single cell atlas of adult human heart, and revealed that pericytes with high expression of ACE2 might act as the target cardiac cell of SARS-CoV-2. The pericytes injury due to virus infection may result in capillary endothelial cells dysfunction, inducing microvascular dysfunction. And patients with basic heart failure disease showed increased ACE2 expression at both mRNA and protein levels, meaning that if infected by the virus these patients may have higher risk of heart attack and critically ill condition. The finding of this study explains the high rate of severe cases among COVID-19 patients with basic cardiovascular disease; and these results also perhaps provide important reference to clinical treatment of cardiac injury among severe patients infected by SARS-CoV-2.


docid: hybvicad

title: Monitoring of patients with systemic lupus erythematosus during the COVID-19 outbreak


title: Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy

text: Importance: In December 2019, a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) emerged in China and has spread globally, creating a pandemic. Information about the clinical characteristics of infected patients who require intensive care is limited. Objective: To characterize patients with coronavirus disease 2019 (COVID-19) requiring treatment in an intensive care unit (ICU) in the Lombardy region of Italy. Design, Setting, and Participants: Retrospective case series of 1591 consecutive patients with laboratory-confirmed COVID-19 referred for ICU admission to the coordinator center (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy) of the COVID-19 Lombardy ICU Network and treated at one of the ICUs of the 72 hospitals in this network between February 20 and March 18, 2020. Date of final follow-up was March 25, 2020. Exposures: SARS-CoV-2 infection confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasal and pharyngeal swabs. Main Outcomes and Measures: Demographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality. Data were recorded by the coordinator center on an electronic worksheet during telephone calls by the staff of the COVID-19 Lombardy ICU Network. Results: Of the 1591 patients included in the study, the median (IQR) age was 63 (56-70) years and 1304 (82%) were male. Of the 1043 patients with available data, 709 (68%) had at least 1 comorbidity and 509 (49%) had hypertension. Among 1300 patients with available respiratory support data, 1287 (99% [95% CI, 98%-99%]) needed respiratory support, including 1150 (88% [95% CI, 87%-90%]) who received mechanical ventilation and 137 (11% [95% CI, 9%-12%]) who received noninvasive ventilation. The median positive end-expiratory pressure (PEEP) was 14 (IQR, 12-16) cm H2O, and Fio2 was greater than 50% in 89% of patients. The median Pao2/Fio2 was 160 (IQR, 114-220). The median PEEP level was not different between younger patients (n = 503 aged ≤63 years) and older patients (n = 514 aged ≥64 years) (14 [IQR, 12-15] vs 14 [IQR, 12-16] cm H2O, respectively; median difference, 0 [95% CI, 0-0]; P = .94). Median Fio2 was lower in younger patients: 60% (IQR, 50%-80%) vs 70% (IQR, 50%-80%) (median difference, -10% [95% CI, -14% to 6%]; P = .006), and median Pao2/Fio2 was higher in younger patients: 163.5 (IQR, 120-230) vs 156 (IQR, 110-205) (median difference, 7 [95% CI, -8 to 22]; P = .02). Patients with hypertension (n = 509) were older than those without hypertension (n = 526) (median [IQR] age, 66 years [60-72] vs 62 years [54-68]; P < .001) and had lower Pao2/Fio2 (median [IQR], 146 [105-214] vs 173 [120-222]; median difference, -27 [95% CI, -42 to -12]; P = .005). Among the 1581 patients with ICU disposition data available as of March 25, 2020, 920 patients (58% [95% CI, 56%-61%]) were still in the ICU, 256 (16% [95% CI, 14%-18%]) were discharged from the ICU, and 405 (26% [95% CI, 23%-28%]) had died in the ICU. Older patients (n = 786; age ≥64 years) had higher mortality than younger patients (n = 795; age ≤63 years) (36% vs 15%; difference, 21% [95% CI, 17%-26%]; P < .001). Conclusions and Relevance: In this case series of critically ill patients with laboratory-confirmed COVID-19 admitted to ICUs in Lombardy, Italy, the majority were older men, a large proportion required mechanical ventilation and high levels of PEEP, and ICU mortality was 26%.


title: Response to the COVID-19 Pandemic: Practical Guide to Rapidly Deploying Home Workstations to Guarantee Radiology Services During Quarantine, Social Distancing, and Stay Home Orders

text: OBJECTIVE. The purpose of this article is to share an experience in the rapid deployment of home workstations that illustrates a creative solution that transcended typical administrative barriers. CONCLUSION. In response to the global coronavirus disease (COVID-19) pandemic, radiology departments need to rapidly deploy home PACS workstations to facilitate physical distancing and to guarantee radiologic expertise despite possible home quarantining or stay home, work safe orders.


Triaging Spine Surgery in the COVID-19 Era


SARS-Coronavirus-2 and acute urticaria


Suggestions from Cremona, Italy: 2 months into the pandemic at the frontline of COVID-19 in Europe


title: Hajj in the Time of COVID-19

text: The recent outbreak of the novel COVID-19 is posing a severe public health risk across the globe. The Kingdom of Saudi Arabia (KSA) is one of the greatest destinations of religious congregations of Muslims. One of the largest religious gatherings is the Hajj that is anticipated to produce serious challenges of mass level exposures and spread to every corner of the world. Therefore, it is highly recommended that the Ministry of Hajj and Umrah (KSA), must regularly analyze the prevailing situation of COVID-19, and involve the religious scholars to make appropriate decisions about Hajj 2020. Although the Saudi government has been continuously taking all possible measures to contain the pandemic, people's cooperation is crucial in the fight against COVID-19.


How covid-19 is accelerating the threat of antimicrobial resistance


COVID-19 and Educational Engagement


title: Effectiveness of preventive measures against COVID-19: A systematic review of In Silico modeling studies in indian context

text: Background: In the absence of any approved treatment or vaccine against novel Severe Acute Respiratory Syndrome Coronavirus -2 (SARS-CoV-2) infection, Non-Pharmaceutical Interventions (NPIs) are the cornerstone to prevent the disease, especially in a populous country like India. Objectives: To understand the effectiveness of NPIs reported in the contemporary literatures describing prediction models for prevention of the ongoing pandemic of SARS-CoV-2 specifically in Indian population. Methods: Original research articles in English obtained through keyword search in PubMed, WHO Global Database for COVID19, and pre-print servers were included in the review. Thematic synthesis of extracted data from articles were done. Results: Twenty-four articles were found eligible for the review - four published articles and twenty pre-print articles. Compartmental model was found to be the most commonly used mathematical model; along with exponential, time varying, neural network and cluster kinetic models. Social distancing, specifically lockdown, was the most commonly modelled intervention strategy. Additionally, contact tracing using smartphone application, international travel restriction, increasing hospital/ICU beds, changes in testing strategy were also dealt with. Social distancing along with increasing testing seemed to be effective in delaying the peak of the epidemic and reducing the peak prevalence. Conclusion: Although there is mathematical rationality behind implementation of social distancing measures including lockdown, this study also emphasised the importance of other associated measures like increasing tests and increasing the number of hospital and ICU beds. The later components are particularly important during the social mixing period to be observed after lifting of lockdown.


docid: ztvquckn

title: A hypothesized role for dysregulated bradykinin signaling in COVID-19 respiratory complications

text: As of April 20, 2020, over time, the COVID-19 pandemic has resulted in 157 970 deaths out of 2 319 066 confirmed cases, at a Case Fatality Rate of ~6.8%. With the pandemic rapidly spreading, and health delivery systems being overwhelmed, it is imperative that safe and effective pharmacotherapeutic strategies are rapidly explored to improve survival. In this paper, we use established and emerging evidence to propose a testable hypothesis that, a vicious positive feedback loop of des-Arg(9)-bradykinin- and bradykinin-mediated inflammation â injury â inflammation, likely precipitates life threatening respiratory complications in COVID-19. Through our hypothesis, we make the prediction that the FDA-approved molecule, icatibant, might be able to interrupt this feedback loop and, thereby, improve the clinical outcomes. This hypothesis could lead to basic, translational, and clinical studies aimed at reducing COVID-19 morbidity and mortality.


title: Correction to: SARS-CoV-2 and COVID-19 in older adults: what we may expect regarding pathogenesis, immune responses, and outcomes

text: The affiliation of the second author (Kenneth S. Knox) should have been Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine-Phoenix, Phoenix, AZ 85004, USA instead of Department of Medicine, University of Arizona-Phoenix, Phoenix, AZ 85004, USA.


Risk of COVID-19 in young kidney transplant recipients. Results from a single-center observational study


title: [Early containment strategies and core measures for prevention and control of novel coronavirus pneumonia in China]

text: In December 2019, novel coronavirus pneumonia epidemic occurred in Wuhan, Hubei Province, and spread rapidly across the country. In the early stages of the epidemic, China adopted the containment strategy and implemented a series of core measures around this strategic point, including social mobilization, strengthening case isolation and close contacts tracking management, blocking epidemic areas and traffic control to reduce personnel movements and increase social distance, environmental measures and personal protection, with a view to controlling the epidemic as soon as possible in limited areas such as Wuhan. This article summarizes the background, key points and core measures in the country and provinces. It sent prospects for future prevention and control strategies.


title: [A specifikus IgM- és IgG-antitesteket detektáló gyorstesztek értéke a SARS CoV-2 vírusfertozés kimutatásában (A COVID-19-pandémia orvosszakmai kérdései)]/ The diagnostic value of rapid anti IgM and IgG detecting tests in the identification of patients with SARS CoV-2 virus infection

text: Introduction: At the end of March, 2020, rapid tests detecting the presence of antiviral IgM and IgG antibodies against SARS-CoV-2 virus were introduced in Hungary for the identification of SARS-CoV-2 infection (COVID-19 disease). Aim: We evaluated two rapid tests (Anhui and Clungene) in comparison with those of real-time PCR tests considered as the gold standard in the detection of infection. Method: Between 16, March and 14, April, 2020, we performed rapid IgM and IgG detecting tests without PCR; PCR without rapid tests; and PCR WITH rapid tests in 4140, 3210 and 1654 patients, respectively. (Out of these 1654 patients, Anhui and Clungene tests were used for testing in 625 and 1029 patients, respectively.) Patients were considered as positive in PCR and rapid tests when PCR positivity and IgM or IgG positivity occurred at any time, respectively. (Note: Clungene test is also marketed as 'Lungene'.) Results: The prevalence of PCR positivity in 4864 patients tested with PCR was 6.3%. The sensitivity and specificity of Anhui and Clungene tests were 33.3% and 72.85%, and 35.48% and 85.02%, respectively. At 6% PCR positivity, the positive and negative predictive values of Anhui and Clungene were 7.28%, 94.48%, 13.13%, and 95.38%, respectively. Conclusion: The low positive predictive values indicate that Anhui and Clungene rapid tests detecting the presence of anti-IgM and anti-IgG against SARS-CoV-2 virus infection are not suitable for screening SARS-CoV-2 vírus infection in the general population. These results strongly support that Anhui and Clungene rapid tests detecting IgM and IgG antibodies against SARS-CoV-2 virus should not be used in the differential diagnosis of infection. Orv Hetil. 2020; 161(20): 807-812.


title: COVID-19 Pandemic: What Every Otolaryngologist-Head and Neck Surgeon Needs to Know for Safe Airway Management

text: The novel coronavirus disease 2019 (COVID-19) pandemic has unfolded with remarkable speed, posing unprecedented challenges for health care systems and society. Otolaryngologists have a special role in responding to this crisis by virtue of expertise in airway management. Against the backdrop of nations struggling to contain the virus's spread and to manage hospital strain, otolaryngologists must partner with anesthesiologists and front-line health care teams to provide expert services in high-risk situations while reducing transmission. Airway management and airway endoscopy, whether awake or sedated, expose operators to infectious aerosols, posing risks to staff. This commentary provides background on the outbreak, highlights critical considerations around mitigating infectious aerosol contact, and outlines best practices for airway-related clinical decision making during the COVID-19 pandemic. What otolaryngologists need to know and what actions are required are considered alongside the implications of increasing demand for tracheostomy. Approaches to managing the airway are presented, emphasizing safety of patients and the health care team.


docid: vingrzbx

title: Characteristics of laboratory indexes in COVID-19 patients with non-severe symptoms in Hefei City, China: diagnostic value in organ injuries

text: This study compared the laboratory indexes in 40 non-severe COVID-19 patients with those in 57 healthy controls. In the peripheral blood system of non-severe symptom COVID-19 patients, lymphocytes, eosinophils, basophils, total procollagen type 1 amino-terminal propeptide, osteocalcin N-terminal, thyroid-stimulating hormone, growth hormone, and insulin-like growth factor-binding protein 3 significantly decreased, and total protein, albumin, alanine transaminase, alkaline phosphatase, Î³-glutamyl transferase, activated partial thromboplastin time, prothrombin time, fibrinogen, D-dimer, fibrinogen degradation products, human epididymal protein 4, serum ferritin, and C-reactive protein were elevated. SARS-CoV-2 infection can affect hematopoiesis, hemostasis, coagulation, fibrinolysis, bone metabolism, thyroid, parathyroid glands, the liver, and the reproductive system.


title: COVID-19 More Frequent, Severe in Cancer Patients

text: Using data from China, two studies suggest that people with cancer are more likely than the general population to contract COVID-19 and to develop more severe disease or die from it.


Covid-19: Papers justifying government's plans to reopen schools are "inconclusive," say union bosses


docid: ucqdhszq

title: The novel coronavirus (COVID-19) and the risk of Kawasaki disease in children


title: Risk of Virus Contamination Through Surgical Smoke During Minimally Invasive Surgery: A Systematic Review of the Literature on a Neglected Issue Revived in the COVID-19 Pandemic Era

text: CONTEXT: The coronavirus disease 2019 (COVID-19) pandemic raised concerns about the safety of laparoscopy due to the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diffusion in surgical smoke. Although no case of SARS-CoV-2 contagion related to surgical smoke has been reported, several international surgical societies recommended caution or even discouraged the use of a laparoscopic approach. OBJECTIVE: To evaluate the risk of virus spread due to surgical smoke during surgical procedures. EVIDENCE ACQUISITION: We searched PubMed and Scopus for eligible studies, including clinical and preclinical studies assessing the presence of any virus in the surgical smoke from any surgical procedure or experimental model. EVIDENCE SYNTHESIS: We identified 24 studies. No study was found investigating SARS-CoV-2 or any other coronavirus. About other viruses, hepatitis B virus was identified in the surgical smoke collected during different laparoscopic surgeries (colorectal resections, gastrectomies, and hepatic wedge resections). Other clinical studies suggested a consistent risk of transmission for human papillomavirus (HPV) in the surgical treatments of HPV-related disease (mainly genital warts, laryngeal papillomas, or cutaneous lesions). Preclinical studies showed conflicting results, but HPV was shown to have a high risk of transmission. CONCLUSIONS: Although all the available data come from different viruses, considering that the SARS-CoV-2 virus has been shown in blood and stools, the theoretical risk of virus diffusion through surgical smoke cannot be excluded. Specific clinical studies are needed to understand the effective presence of the virus in the surgical smoke of different surgical procedures and its concentration. Meanwhile, adoption of all the required protective strategies, including preoperative patient nasopharyngeal swab for COVID-19, seems mandatory. PATIENT SUMMARY: In this systematic review, we looked at the risk of virus spread from surgical smoke exposure during surgery. Although no study was found investigating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or any other coronavirus, we found that the theoretical risk of virus diffusion through surgical smoke cannot be excluded.


Learning from history: Coronavirus outbreaks in the past


title: COVID-19: what has been learned and to be learned about the novel coronavirus disease

text: The outbreak of Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), has thus far killed over 3,000 people and infected over 80,000 in China and elsewhere in the world, resulting in catastrophe for humans. Similar to its homologous virus, SARS-CoV, which caused SARS in thousands of people in 2003, SARS-CoV-2 might also be transmitted from the bats and causes similar symptoms through a similar mechanism. However, COVID-19 has lower severity and mortality than SARS but is much more transmissive and affects more elderly individuals than youth and more men than women. In response to the rapidly increasing number of publications on the emerging disease, this article attempts to provide a timely and comprehensive review of the swiftly developing research subject. We will cover the basics about the epidemiology, etiology, virology, diagnosis, treatment, prognosis, and prevention of the disease. Although many questions still require answers, we hope that this review helps in the understanding and eradication of the threatening disease.


The Dermatologist's Perspective: Why is COVID-19 mortality lower in females than males?


title: Coronavirus: a clinical update of Covid-19

text: A covid-19 pandemic decreed by WHO has raised greater awareness of it. The infection reached the mark of 350,000 patients in 33 countries and affected as comorbidities the presence of comorbidities and advanced age. The transmissibility calculated so far is similar to the H1N1 epidemic, but with lower mortality rates. The SARS-CoV-2 virus, of the Coronaviridae family, has the capacity for cellular invasion through the angiotensin-converting enzyme 2 does not have a lower respiratory epithelium and in the cells of the small intestine mucosa. A presentation can be divided into mild (fever, fatigue, cough, myalgia, and sputum) and severe (cyanosis, dyspnoea, tachypnea, chest pain, hypoxemia and need for clinical measurement) and has an estimated estimate of 2%.allows the detection of viral load in CRP-TR of patients with high clinical suspicion. Based on supportive measures and infection control. In severe cases, the use of medications such as hydroxychloroquine and azithromycin or medication can be promising. Take care to avoid the use of corticosteroids. There are no restrictions on the use of resources and ACEIs / ARBs.


title: The Semester COVID-19 Stole the Joy

text: A nursing faculty member describes how the COVID-19 pandemic disrupted nursing education.


title: Genetic and epigenetic analyses of panic disorder in the post-GWAS era

text: Panic disorder (PD) is a common and debilitating neuropsychiatric disorder characterized by panic attacks coupled with excessive anxiety. Both genetic factors and environmental factors play an important role in PD pathogenesis and response to treatment. However, PD is clinically heterogeneous and genetically complex, and the exact genetic or environmental causes of this disorder remain unclear. Various approaches for detecting disease-causing genes have recently been made available. In particular, genome-wide association studies (GWAS) have attracted attention for the identification of disease-associated loci of multifactorial disorders. This review introduces GWAS of PD, followed by a discussion about the limitations of GWAS and the major challenges facing geneticists in the post-GWAS era. Alternative strategies to address these challenges are then proposed, such as epigenome-wide association studies (EWAS) and rare variant association studies (RVAS) using next-generation sequencing. To date, however, few reports have described these analyses, and the evidence remains insufficient to confidently identify or exclude rare variants or epigenetic changes in PD. Further analyses are therefore required, using sample sizes in the tens of thousands, extensive functional annotations, and highly targeted hypothesis testing.


The SARS-CoV-2 epidemic: how the Italian public is being informed


Tele-health in neurology: an indispensable tool in the management of the SARS-CoV-2 epidemic


How to manage rheumatic patients during the coronavirus pandemic


title: Rapid and visual detection of porcine deltacoronavirus by recombinase polymerase amplification combined with a lateral flow dipstick

text: BACKGROUND: Porcine Deltacoronavirus (PDCoV) is a newly emerging Coronavirus that was first identified in 2012 in Hong Kong, China. Since then, PDCoV has subsequently been reported worldwide, causing a high number of neonatal piglet deaths and significant economic losses to the swine industry. Therefore, it is necessary to establish a highly sensitive and specific method for the rapid diagnosis of PDCoV. RESULTS: In the present study, a highly sensitive and specific diagnostic method using recombinase polymerase amplification combined with a lateral flow dipstick (LFD-RPA) was developed for rapid and visual detection of PDCoV. The system can be performed under a broad range of temperature conditions from 10 to 37 °C, and the detection of PDCoV can be completed in 10 min at 37 °C. The sensitivity of this assay was 10 times higher than that of conventional PCR with a lower detection limit of 1 × 102 copies/µl of PDCoV. Meanwhile, the LFD-RPA assay specifically amplified PDCoV, while there was no cross-amplification with other swine-associated viruses, including Porcine epidemic diarrhea virus (PEDV), Transmissible gastroenteritis virus (TGEV), Porcine kobuvirus (PKoV), Foot and mouth disease virus (FMDV), Porcine reproductive and respiratory syndrome virus (PRRSV), Porcine circovirus type 2 (PCV2), Classical swine fever virus (CSFV) and Seneca valley virus (SVV). The repeatability of the test results indicated that this assay had good repeatability. In addition, 68 clinical samples (48 fecal swab specimens and 20 intestinal specimens) were further tested by LFD-RPA and RT-PCR assay. The positive rate of LFD-RPA clinical samples was 26.47% higher than that of conventional PCR (23.53%). CONCLUSIONS: The LFD-RPA assay successfully detected PDCoV in less than 20 min in this study, providing a potentially valuable tool to improve molecular detection for PDCoV and to monitor the outbreak of PDCoV, especially in low-resource areas and laboratories.


Myopericarditis, Rhabdomyolysis, and Acute Hepatic Injury: Sole Expression of a SARS-CoV-2 Infection


Surgical strategies during the COVID-19 crisis: The Salzburg concept


title: MeSH descriptors indicate the knowledge growth in the SARS-CoV-2/COVID-19 pandemic

text: The scientific papers dealing with the novel betacoronavirus SARS-CoV-2 and the coronavirus disease 2019 (COVID-19) caused by this virus, published in 2020 and recorded in the database PUBMED, were retrieved on April 27, 2020. About 20\% of the records contain Medical Subject Headings (MeSH), keywords assigned to records in the course of the indexing process in order to summarise the articles' contents. The temporal sequence of the first occurrences of the keywords was determined, thus giving insight into the growth of the knowledge base of the pandemic.


Integrating Telemedicine for Medication Treatment for Opioid Use Disorder in Rural Primary Care: Beyond the COVID Pandemic


COVID-19: Finding silver linings for dental education


title: Intubation and Ventilation amid the COVID-19 Outbreak: Wuhan's Experience

text: The COVID-19 outbreak has led to 80,409 diagnosed cases and 3,012 deaths in mainland China based on the data released on March 4, 2020. Approximately 3.2% of patients with COVID-19 required intubation and invasive ventilation at some point in the disease course. Providing best practices regarding intubation and ventilation for an overwhelming number of patients with COVID-19 amid an enhanced risk of cross-infection is a daunting undertaking. The authors presented the experience of caring for the critically ill patients with COVID-19 in Wuhan. It is extremely important to follow strict self-protection precautions. Timely, but not premature, intubation is crucial to counter a progressively enlarging oxygen debt despite high-flow oxygen therapy and bilevel positive airway pressure ventilation. Thorough preparation, satisfactory preoxygenation, modified rapid sequence induction, and rapid intubation using a video laryngoscope are widely used intubation strategies in Wuhan. Lung-protective ventilation, prone position ventilation, and adequate sedation and analgesia are essential components of ventilation management.


title: Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis

text: BACKGROUND: The prevalence and prognosis of digestive system involvement, including gastrointestinal symptoms and liver injury, in patients with COVID-19 remains largely unknown. We aimed to quantify the effects of COVID-19 on the digestive system. METHODS: In this systematic review and meta-analysis, we systematically searched PubMed, Embase, and Web of Science for studies published between Jan 1, 2020, and April 4, 2020. The websites of WHO, CDC, and major journals were also searched. We included studies that reported the epidemiological and clinical features of COVID-19 and the prevalence of gastrointestinal findings in infected patients, and excluded preprints, duplicate publications, reviews, editorials, single case reports, studies pertaining to other coronavirus-related illnesses, and small case series (<10 cases). Extracted data included author; date; study design; country; patient demographics; number of participants in severe and non-severe disease groups; prevalence of clinical gastrointestinal symptoms such as vomiting, nausea, diarrhoea, loss of appetite, abdominal pain, and belching; and digestive system comorbidities including liver disease and gastrointestinal diseases. Raw data from studies were pooled to determine effect estimates. FINDINGS: We analysed findings from 35 studies, including 6686 patients with COVID-19, that met inclusion criteria. 29 studies (n=6064) reported gastrointestinal symptoms in patients with COVID-19 at diagnosis, and the pooled prevalence of digestive system comorbidities was 4% (95% CI 2-5; range 0-15; I2=74%). The pooled prevalence of digestive symptoms was 15% (10-21; range: 2-57; I2=96%) with nausea or vomiting, diarrhoea, and loss of appetite being the three most common symptoms. The pooled prevalence of abnormal liver functions (12 studies, n=1267) was 19% (9-32; range 1-53; I2=96%). Subgroup analysis showed patients with severe COVID-19 had higher rates of abdominal pain (odds ratio [OR] 7·10 [95% CI 1·93-26·07]; p=0·003; I2=0%) and abnormal liver function including increased ALT (1·89 [1·30-2·76]; p=0·0009; I2=10%) and increased AST (3·08 [2·14-4·42]; p<0·00001; I2=0%) compared with those with non-severe disease. Patients in Hubei province, where the initial COVID-19 outbreak occurred, were more likely to present with abnormal liver functions (p<0·0001) compared with those outside of Hubei. Paediatric patients with COVID-19 had a similar prevalence of gastrointestinal symptoms to those of adult patients. 10% (95% CI 4-19; range 3-23; I2=97%) of patients presented with gastrointestinal symptoms alone without respiratory features. Patients who presented with gastrointestinal system involvement had delayed diagnosis (standardised mean difference 2·85 [95% CI 0·22-5·48]; p=0·030; I2=73%). Patients with gastrointestinal involvement tended to have a poorer disease course (eg, acute respiratory distress syndrome OR 2·96 [95% CI 1·17-7·48]; p=0·02; I2=0%). INTERPRETATION: Our study showed that digestive symptoms and liver injury are not uncommon in patients with COVID-19. Increased attention should be paid to the care of this unique group of patients. FUNDING: None.


docid: autcieed

title: Covid-19: Cancer mortality could rise at least 20% because of pandemic, study finds


Covid-19: UK lockdown is "crucial" to saving lives, say doctors and scientists


Síndrome de Guillain-Barré asociado a infección por SARS-CoV-2


title: Upholding the Tripartite Mission in Times of Crisis: Purpose and Perseverance in the COVID-19 Pandemic

text: Academic otolaryngology has historically comprised a tripartite mission of research, education, and clinical care. This mission is greatly strained by the COVID-19 pandemic. Research laboratories are fallow, surgical cases are deferred, and clerkships are canceled. Otolaryngologists are adapting to new circumstances ranging from virtual patient care to urgent procedures in protective gear to deployment to provisional field hospitals. Amid these operational challenges, the specialty is demonstrating extraordinary resilience and grit, discovering new ways to serve learners, colleagues, and communities. Statements from leaders in otolaryngology reveal selfless acts and purposefulness. Necessity has spurred innovation in education, science, and novel models of care. Paragons strike notes of hope, inspiring us to persevere and serve. This commentary explores the present challenges and offers a vision for upholding the academic mission.


title: Translating IL-6 biology into effective treatments

text: In 1973, IL-6 was identified as a soluble factor that is secreted by T cells and is important for antibody production by B cells. Since its discovery more than 40 years ago, the IL-6 pathway has emerged as a pivotal pathway involved in immune regulation in health and dysregulation in many diseases. Targeting of the IL-6 pathway has led to innovative therapeutic approaches for various rheumatic diseases, such as rheumatoid arthritis, juvenile idiopathic arthritis, adult-onset Still's disease, giant cell arteritis and Takayasu arteritis, as well as other conditions such as Castleman disease and cytokine release syndrome. Targeting this pathway has also identified avenues for potential expansion into several other indications, such as uveitis, neuromyelitis optica and, most recently, COVID-19 pneumonia. To mark the tenth anniversary of anti-IL-6 receptor therapy worldwide, we discuss the history of research into IL-6 biology and the development of therapies that target IL-6 signalling, including the successes and challenges and with an emphasis on rheumatic diseases.


title: What healthcare professionals owe us: why their duty to treat during a pandemic is contingent on personal protective equipment (PPE)

text: Healthcare professionals' capacity to protect themselves, while caring for infected patients during an infectious disease pandemic, depends on their ability to practise universal precautions. In turn, universal precautions rely on the availability of personal protective equipment (PPE). During the SARS-CoV2 outbreak many healthcare workers across the globe have been reluctant to provide patient care because crucial PPE components are in short supply. The lack of such equipment during the pandemic was not a result of careful resource allocation decisions in the global north, where the short supply could be explained through their high cost. Instead, they were the result of democratically elected governments prioritising low tax regimes over an adequate resourcing of their healthcare delivery systems. Such decisions were made despite global health experts warning about the high probability of pandemics like SARS-CoV2 occurring during our lifetimes. Avoidable allocation decisions by democratically elected political leaders resulted in a lack of sufficient PPE for healthcare professionals. After discussing and discounting various ethical arguments in support of a professional obligation to treat, even without or with suboptimal PPE, I conclude that these policy decisions were sufficiently grave that they provide a sound ethical rationale to justify healthcare workers' refusal to provide care to infected patients.


title: Attitude and beliefs about the social environment associated with chemsex among MSM visiting STI clinics in the Netherlands: An observational study

text: BACKGROUND: Drug use during sex, 'chemsex', is common among men who have sex with men (MSM) and related to sexual and mental health harms. This study assessed associations between chemsex and a wide range of determinants among MSM visiting STI clinics to increase understanding of characteristics and beliefs of MSM practicing chemsex. METHODS: In 2018, 785 MSM were recruited at nine Dutch STI clinics; 368 (47%) fully completed the online questionnaire. All participants reported to have had sex in the past six months. Chemsex was defined as using cocaine, crystal meth, designer drugs, GHB/GBL, ketamine, speed or XTC/MDMA during sex in the past six months. Associations between chemsex and psychosocial determinants, socio-demographics, sexual behaviour and using tobacco or alcohol were assessed by multivariable logistic regression analyses. RESULTS: Chemsex was reported by 44% of MSM (161/368) and was not associated with socio-demographics. Independent determinants were 'believing that the majority of friends/sex partners use drugs during sex' (descriptive norm) (aOR: 1.95, 95%CI: 1.43-2.65), 'believing that sex is more fun when using drugs' (attitude) (aOR: 2.06, 95%CI: 1.50-2.84), using tobacco (aOR: 2.65, 95%CI: 1.32-5.32), multiple sex partners (aOR: 2.69, 95%CI: 1.21-6.00), group sex (aOR: 4.65, 95%CI: 1.54-14.05) and using online dating platforms (aOR: 2.73, 95%CI: 1.13-6.62). CONCLUSION: MSM are likely to find themselves in distinct social networks where it is the norm to use drugs when having sex and pleasure is linked to chemsex. Health services should acknowledge the social influence and pleasurable experiences to increase acceptability of strategies aimed at minimizing the possible harms of chemsex.


title: COVID-19 and the policy sciences: initial reactions and perspectives

text: The world is in the grip of a crisis that stands unprecedented in living memory. The COVID-19 pandemic is urgent, global in scale, and massive in impacts. Following Harold D. Lasswell's goal for the policy sciences to offer insights into unfolding phenomena, this commentary draws on the lessons of the policy sciences literature to understand the dynamics related to COVID-19. We explore the ways in which scientific and technical expertise, emotions, and narratives influence policy decisions and shape relationships among citizens, organizations, and governments. We discuss varied processes of adaptation and change, including learning, surges in policy responses, alterations in networks (locally and globally), implementing policies across transboundary issues, and assessing policy success and failure. We conclude by identifying understudied aspects of the policy sciences that deserve attention in the pandemic's aftermath.


title: From the Eye of the Storm: Multi-Institutional Practical Perspectives on Neuroradiology from the COVID-19 Outbreak in New York City

text: During the Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) pandemic, neuroradiology practices have experienced a paradigm shift in practice, which affected everything from staffing, workflow, work volumes, conferences, resident and fellowship education, and research. This article highlights adaptive strategies that were undertaken at the epicenter of the outbreak in New York City during the past 4-6 weeks, as experienced by 5 large neuroradiology academic departments.


Preparedness is key - the challenge of COVID-19 in low resource settings: 4 checklists from Doctors Worldwide to prepare for COVID-19


title: A Novel Coronavirus from Patients with Pneumonia in China, 2019

text: In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.).


May we target double-membrane vesicles and oxysterol-binding protein to combat SARS-CoV-2 infection?


Depression and Anxiety Changes Among Sexual and Gender Minority People Coinciding with Onset of COVID-19 Pandemic


title: "Transition to on-line is possible: solution for simulation-based teaching during pandemic"

text: In March 2020, Polish universities had to suspend all on-site activities due to the SARS-CoV-2 pandemic. As a result, we were faced with the problem of how to convert a simulation-based course in geriatrics into distance-learning. The main focus of the original course (30 academic hours) is to expose fourth-year medical students, working in teams of three, to eight simulated cases including acute dyspnea (pneumonia), behavior change (somatic delirium), and cardio-pulmonary deterioration.


Transition to online is possible: Solution for simulation-based teaching during the COVID-19 pandemic


title: 18F-FDG PET/CT findings of COVID-19: a series of four highly suspected cases

text: PURPOSE: The aim of this case series is to illustrate the 18F-FDG PET/CT findings of patients with acute respiratory disease caused by COVID-19 in Wuhan, Hubei province of China. METHODS: We describe the 18F-FDG PET/CT results from four patients who were admitted to the hospital with respiratory symptoms and fever between January 13 and January 20, 2020, when the COVID-19 outbreak was still unrecognized and the virus infectivity was unknown. A retrospective review of the patients' medical history, clinical and laboratory data, as well as imaging findings strongly suggested a diagnosis of COVID-19. RESULTS: All patients had peripheral ground-glass opacities and/or lung consolidations in more than two pulmonary lobes. Lung lesions were characterized by a high 18F-FDG uptake and there was evidence of lymph node involvement. Conversely, disseminated disease was absent, a finding suggesting that COVID-19 has pulmonary tropism. CONCLUSIONS: Although 18F-FDG PET/CT cannot be routinely used in an emergency setting and is generally not recommended for infectious diseases, our pilot data shed light on the potential clinical utility of this imaging technique in the differential diagnosis of complex cases.


Clinicians are leading service reconfiguration to cope with covid-19


[Interim Guidelines for Prevention and Control of COVID-19 for Oversea Returnees]


title: What We Need to Consider During and After the SARS-CoV-2 Pandemic

text: Even though extreme containment and mitigation strategies were implemented by numerous governments around the world to slow down the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the number of critically ill patients and fatalities keeps rising. This crisis has highlighted the socioeconomic disparities of health care systems within and among countries. As new CoVID policies and responses are implemented to lessen the impact of the virus, it is imperative (1) to consider additional mitigation strategies critical for the development of effective countermeasures, (2) to promote long-term policies and strict regulations of the trade of wildlife and live animal markets, and (3) to advocate for necessary funding and investments in global health, specifically for the prevention of and response to natural and manmade pandemics. This document considers some of these challenges.


title: Press on COVID-19 and 2019-nCov in Spanish media: The role of digital media in times of confinement

text: This paper analyses the publications on Covid-19 and 2019-nCov in the Spanish media This is done by using news retrieved from My News database The analysis includes the total amount of news in Spanish media by type of media;the evolution of the publication in digital media considering various periods of time, and the volume of news in the most used Spanish digital media The results show that digital media are the most used among other types to publish on the topic, with a significant increase since the beginning of the alarm state In this sense, some arguments on the function and utility of this type of media during the confinement are exposed Also, the essential role of digital media covering the population's information needs is discussed The digital media with the largest number publications are abc es, 20minutos es, and elconfidencial com The value of this work is that it can serve as starting point for others in order to carry out content analysis on the subject considering different channels and digital media