title: Guidelines for Resident Participation in Otolaryngology Telehealth Clinics During the COVID-19 Pandemic

text: The practice of otolaryngology has changed drastically since the start of the COVID-19 pandemic. To limit exposure and maintain a reserve of caregivers, residency education ceased most clinical activities and shifted to remote lecture consortiums hosted online across the country in lieu of ambulatory and operative experiences. Many practicing university otolaryngologists have transitioned their clinics to telehealth medicine to maintain access to clinical care during the pandemic. The participation of residents in telemedicine visits has not been described. Here we present guidelines and experience-based suggestions for successful resident involvement in telemedicine. While it is unclear what role telehealth medicine may play within the field of otolaryngology beyond the pandemic, our experiences suggest better patient outreach and access. Expanding residents' skill set with telehealth medicine can enhance their education and better prepare them for future practice.


Induced Pluripotent Stem Cells (iPSCs) Derived 3D Human Lung Organoids from Different Ethnicities to Understand the SARS-CoV2 Severity/Infectivity Percentage


Ventilatory Ratio in Hypercapnic Mechanically Ventilated Patients with COVID-19-associated Acute Respiratory Distress Syndrome


Routine childhood immunization may protect against COVID-19


"Keep It Going if You Can": HIV Service Provision for Priority Populations During the COVID-19 Pandemic in Seattle, WA


title: Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia

text: OBJECTIVE. The purpose of this study was to investigate early clinical and CT manifestations of coronavirus disease (COVID-19) pneumonia. MATERIALS AND METHODS. Patients with COVID-19 pneumonia confirmed by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test (reverse transcription-polymerase chain reaction) were enrolled in this retrospective study. The clinical manifestations, laboratory results, and CT findings were evaluated. RESULTS. One hundred eight patients (38 men, 70 women; age range, 21-90 years) were included in the study. The clinical manifestations were fever in 94 of 108 (87%) patients, dry cough in 65 (60%), and fatigue in 42 (39%). The laboratory results were normal WBC count in 97 (90%) patients and normal or reduced lymphocyte count in 65 (60%). High-sensitivity C-reactive protein level was elevated in 107 (99%) patients. The distribution of involved lobes was one lobe in 38 (35%) patients, two or three lobes in 24 (22%), and four or five lobes in 46 (43%). The major involvement was peripheral (97 patients [90%]), and the common lesion shape was patchy (93 patients [86%]). Sixty-five (60%) patients had ground-glass opacity (GGO), and 44 (41%) had GGO with consolidation. The size of lesions varied from smaller than 1 cm (10 patients [9%]) to larger than 3 cm (56 patients [52%]). Vascular thickening (86 patients [80%]), crazy paving pattern (43 patients [40%]), air bronchogram sign (52 patients [48%]), and halo sign (69 [64%]) were also observed in this study. CONCLUSION. The early clinical and laboratory findings of COVID-19 pneumonia are low to midgrade fever, dry cough, and fatigue with normal WBC count, reduced lymphocyte count, and elevated high-sensitivity C-reactive protein level. The early CT findings are patchy GGO with or without consolidation involving multiple lobes, mainly in the peripheral zone, accompanied by halo sign, vascular thickening, crazy paving pattern, or air bronchogram sign.


title: Characterizing and monitoring student discomfort in upper-division quantum mechanics

text: We investigate student comfort with the material in an upper-division spins-first quantum mechanics course. Pre-lecture surveys probing students' comfort were administered weekly, in which students assigned themselves a"discomfort level"on a scale of 0--10 and provided a written explanation for their choice. The weekly class-wide average discomfort level was effectively constant over the semester, suggesting that the class found no single unit especially jarring nor especially easy. Student written responses were coded according to their reported source of discomfort---math, math-physics connection, physics, and notation. The relative prevalence of these categories varied significantly over the semester, indicating that students find that different units present different challenges, and also that some of these challenges fade in importance as the semester progresses. Semi-structured interviews with students in a similar quantum mechanics course at a different institution provided additional context and insight into these results.


docid: qtqhrpbp

title: Forgetting "routine" deep venous thrombosis and stroke during COVID-19 is a parallel pandemic that will be costly if ignored


Remaining Academically Connected While Socially Distant: Leveraging Technology to Support Dispersed Radiology and Nuclear Medicine Training Programs in the Era of COVID-19


title: Home delivery of medication during Coronavirus disease 2019, Cape Town, South Africa: Short report

text: The public sector primary care facilities in Cape Town serve a large number of patients with chronic diseases such as human immunodeficiency virus, tuberculosis, diabetes, hypertension, asthma and chronic obstructive pulmonary disease. Prior to the Coronavirus disease 2019 (COVID-19) epidemic, stable patients with chronic conditions attended the facility or support groups to obtain their medication. During the COVID-19 epidemic, these patients would be put at risk if they had to travel and gather in groups to receive medication. The Metropolitan Health Services, therefore, decided to offer home delivery of medication. A system of home delivery was rapidly established by linking the existing chronic dispensing unit system with the emerging approach to community-orientated primary care in the Metro. Medication was delivered as usual to primary care pharmacies, but then a variety of means were used to disseminate the parcels to local non-profit organisations, where they could be delivered by a city-wide network of community health workers (CHWs). Innovations included various ways of delivering the parcels, including via Uber, bicycles and electric scooters, as well as Google forms to monitor the success of the initiative. It was estimated that up to 200 000 parcels per month could be delivered in this way via 2500 CHWs. The new system was established throughout the Metropole, and its strengths, weaknesses, opportunities and threats are further discussed. The initiative may prevent COVID-19 amongst people with comorbidities who would be at risk of more severe diseases. It may also have de-congested primary care facilities ahead of the expected surge in COVID-19 cases.


title: Comparison of Estimated Rates of Coronavirus Disease 2019 (COVID-19) in Border Counties in Iowa Without a Stay-at-Home Order and Border Counties in Illinois With a Stay-at-Home Order

text: Importance: Iowa is 1 of 5 states in the US that have not issued a stay-at-home order during the coronavirus disease 2019 (COVID-19) pandemic. There is no empirical evidence on whether issuing a stay-at-home order in Iowa could have been associated with a reduced rate of COVID-19 infections in the state. Objective: To compare COVID-19 cases in border counties in Iowa, which did not issue a stay-at-home order, with cases in border counties in Illinois, which did issue a stay-at-home order. Design, Setting, and Participants: This cross-sectional study with a difference-in-differences design compared daily changes in COVID-19 cases per 10â¯000 residents in 8 Iowa counties bordering Illinois with those in the 7 Illinois counties bordering Iowa before and after Illinois issued a stay-at-home order on March 21, 2020. Additional sensitivity analyses were conducted to account for differences in timing of closing schools and nonessential businesses between the 2 states and differential trends in COVID-19 cases by county population density and poverty rates. Exposures: Issuing a stay-at-home order. Main Outcomes and Measures: Comparison of cumulative cases of COVID-19 per 10â¯000 residents in border counties in Iowa and Illinois. Results: The total populations were 462â¯445 in the Iowa border counties and 272â¯385 in the Illinois border counties. Population density was higher in the Iowa counties (114.2 people per square mile) than in the Illinois counties (78.2 people per square mile). Trends of cumulative COVID-19 cases per 10â¯000 residents for the Iowa and Illinois border counties were comparable before the Illinois stay-at-home order, which went into effect at 5:00 pm on March 21 (March 15 to March 21: 0.024 per 10â¯000 residents vs 0.026 per 10â¯000 residents). After that, cases increased more quickly in Iowa and more slowly in Illinois. Within 10, 20, and 30 days after the enactment of the stay-at-home order in Illinois, the difference in cases was -0.51 per 10â¯000 residents (SE, 0.09; 95% CI, -0.69 to -0.32; P < .001), -1.15 per 10â¯000 residents (SE, 0.49; 95% CI, -2.12 to -0.18; P = .02), and -4.71 per 10â¯000 residents (SE, 1.99; 95% CI, -8.64 to -0.78; P = .02), respectively. The estimates indicate excess cases in the border Iowa counties by as many as 217 cases after 1 month without a stay-at-home order. This estimate of excess cases represents 30.4% of the 716 total cases in those Iowa counties by that date. Sensitivity analyses addressing differences in timing of closing schools and nonessential businesses and differences in county population density and poverty rates between the 2 states supported these findings. Conclusions and Relevance: This cross-sectional study with a difference-in-differences design found an increase in estimated rates of COVID-19 cases per 10â¯000 residents in the border counties in Iowa compared with the border counties in Illinois following a stay-at-home order that was implemented in Illinois but not in Iowa.


title: The dynamics of Recurrent Neural Networks trained for temporal tasks and the eigenvalue spectrum

text: Different areas of the brain such as the cortex and the prefrontal cortex show great recurrence in their connections, even in early sensory areas. Several approaches and methods based on trained networks have been proposed to model and describe these systems. It is essential to understand the dynamics behind the models because they are used to build different hypotheses about the functioning of brain areas and to explain experimental results. Present work focuses on the study of the dynamics of recurrent neural networks trained to perform Boolean-like tasks with temporal stimuli that emulate being sensory signals. The contribution here is the description of the dynamics through the classification and interpretation carried out with a set of numerical simulations corresponding to networks trained to process time stimuli with AND, OR, XOR, and Flip Flop tasks. The patterns in the distribution of the eigenvalues of the recurrent weight matrix ware studied and properly related to the dynamics.


Our thanks to ALL healthcare workers on the frontlines caring for our most vulnerable


title: Acute encephalopathy with elevated CSF inflammatory markers as the initial presentation of COVID-19

text: BACKGROUND: COVID-19 is caused by the severe acute respiratory syndrome virus SARS-CoV-2. It is widely recognized as a respiratory pathogen, but neurologic complications can be the presenting manifestation in a subset of infected patients. CASE PRESENTATION: We describe a 78-year old immunocompromised woman who presented with altered mental status after witnessed seizure-like activity at home. She was found to have SARS-CoV-2 infection and associated neuroinflammation. In this case, we undertake the first detailed analysis of cerebrospinal fluid (CSF) cytokines during COVID-19 infection and find a unique pattern of inflammation in CSF, but no evidence of viral neuroinvasion. CONCLUSION: Our findings suggest that neurologic symptoms such as encephalopathy and seizures may be the initial presentation of COVID-19. Central nervous system inflammation may associate with neurologic manifestations of disease.


title: Symptom Cluster of ICU Nurses Treating COVID-19 Pneumonia Patients in Wuhan, China

text: BACKGROUND: In treating highly infectious coronavirus disease-19 (COVID-19) pneumonia, intensive care unit (ICU) nurses face a high risk of developing somatic symptom disorder (SSD).The symptom clusters in one population may show overlaps and involvements, a phenomenon that should be deliberately resolved to improve the management efficiency. OBJECTIVES: The present study aims to investigate the symptoms and causes of SSD of ICU nurses treating COVID-19 pneumonia. The research results are expected to provide evidence for the establishment of a better management strategy. METHODS: This study enrolled a total of 140 ICU nurses who were selected by Jiangsu Province Hospital to work in Wuhan (the epicenter of the COVID-19 epidemic in China) on February 3, 2020. A questionnaire, Somatic symptom disorders for ICU nurses in Wuhan No. 1 Hospital, was designed based on the International Classification of Functioning, Disability and Health. Exploratory factor analysis was performed to cluster the symptoms and logistic regression analysis to find the risk factors of the symptoms. RESULTS: Five major symptoms were chest discomfort and palpitation (31.4%), dyspnea (30.7%), nausea (21.4%), headache (19.3%), and dizziness (17.9%). In exploratory factor analysis, the symptoms were classified into three clusters: Cluster A of breathing and sleep disturbances (dizziness, sleepiness, and dyspnea); Cluster B of gastrointestinal complaints and pain (nausea and headache), and Cluster C of general symptoms (xerostomia, fatigue, as well as chest discomfort and palpitation). In Cluster A, urine/feces splash, sex, and sputum splash were independent predictive factors. In Cluster B, fall of protective glasses and urine/feces splash were independent predictive factors. In Cluster C, urine/feces splash and urine/feces clearance were independent predictive factors. CONCLUSION: The ICU nurses in Wuhan showed varying and overlapping SSDs. These SSDs could be classified into three symptom clusters. Based on the characteristics of their SSDs, specific interventions could be implemented to safeguard the health of ICU nurses.


Pandemic as Teacher - Forcing Clinicians to Inhabit the Experience of Serious Illness


Infectious Disease Transmission Models to Predict, Evaluate, and Improve Understanding of SARS-COV-2 Trajectory and Interventions


title: The role of PARP inhibitors in germline BRCA-associated pancreatic ductal adenocarcinoma

text: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy that remains a challenge to treat. In pursuit of personalized medicine, researchers continue active exploration of the genetic and molecular framework of PDAC to apply novel therapeutics and enhance outcomes. In patients who have PDAC, germline mutations-such as those in the BRCA1/2 and PALB2 genes-are predominantly associated with the DNA damage response and repair pathway. On the basis of studies completed in patients with BRCA-mutated advanced breast and ovarian cancer, the poly(ADP-ribose) polymerase (PARP) inhibitors have been evaluated for safety, tolerability, and efficacy in patients with advanced PDAC who are carrying germline BRCA gene mutations. Results have demonstrated meaningful activity and identified BRCA as a predictive and targetable biomarker in PDAC, and have also identified the role of olaparib as a maintenance therapy in PDAC. On the basis of the principle of synthetic lethality, and to avert resistance to PARP inhibitors, clinical trials of combination therapy with PARP inhibitors and platinum-based chemotherapy have been conducted with an early signal. As we continue to explore the role of PARP inhibitors in the management of PDAC, recent clinical trials are studying the effectiveness of PARP inhibitors in combination with immunotherapy, targeted inhibitors, and angiogenesis inhibitors. The next steps are to understand the role of PARP inhibitors beyond germline BRCA in other homologous recombination repair gene mutations and in other subgroups of patients with PDAC.


docid: kjxietjx

title: Letter to the editor in response to article: "Clinical considerations for patients with diabetes in times of COVID-19 epidemic (Gupta et al.)


title: High EREG Expression Is Predictive of Better Outcomes in Rectal Cancer Patients Receiving Neoadjuvant Concurrent Chemoradiotherapy

text: BACKGROUND/AIM: A great proportion of patients with rectal cancer initially present with locally advanced disease and can potentially benefit from neoadjuvant concurrent chemoradiotherapy (CCRT) for downstaging before surgery. However, risk and clinical outcome stratification remain a great challenge. We aimed to find the potential biomarker to predict the effect of neoadjuvant CCRT on rectal cancer. METHODS: We identified epiregulin (EREG) as the most significant predictive marker for neoadjuvant CCRT response from the published rectal cancer transcriptome data set GSE35452. We collected 172 biopsy specimens from rectal cancer patients who received neoadjuvant CCRT followed by radical proctectomy, performed EREG immunohistochemistry, and analyzed the H-scores. We further examined the correlations between the expression level of EREG and clinicopathological features, tumor regression grade, and survival, including disease-specific survival (DSS), locoregional recurrence-free survival (LRFS), and metastasis-free survival (MeFS). RESULTS: High EREG expression was significantly related to early pretreatment (pre-Tx) and posttreatment (post-Tx) tumor status (T1, T2, p = 0.047 and p < 0.001), pre-Tx and post-Tx negative nodal status (N0, p < 0.001 and p = 0.004), less vascular and perineurial invasion (p = 0.015 and p = 0.023), and higher tumor regression grade (p < 0.001). In the survival analysis, high EREG expression was significantly associated with better DSS (p < 0.0001), LRFS (p = 0.0004), and MeFS (p < 0.0001). In the multivariate analysis, high EREG expression remained prognostically significant for better DSS (p = 0.003; hazard ratio: 5.599). CONCLUSION: These data suggest that EREG is a potential predictive marker and therapeutic target in rectal cancer patients receiving neoadjuvant CCRT.


Mental health of health-care workers in the COVID-19 era


We Need to Rethink on Medical Education for Pandemic Preparedness: Lessons Learnt From COVID-19


Coronavirus disease 2019 (COVID-19) outbreak in Afghanistan: Measures and challenges


title: CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients

text: OBJECTIVE: The objective of this systematic review was to evaluate the key imaging manifestations of COVID-19 on chest CT in adult patients by providing a comprehensive review of the published literature. METHODS: We performed a systematic literature search from the PubMed, Google Scholar, Embase, and WHO databases for studies mentioning the chest CT imaging findings of adult COVID-19 patients. RESULTS: A total of 45 studies comprising 4410 patients were included. Ground glass opacities (GGO), in isolation (50.2%) or coexisting with consolidations (44.2%), were the most common lesions. Distribution of GGOs was most commonly bilateral, peripheral/subpleural, and posterior with predilection for lower lobes. Common ancillary findings included pulmonary vascular enlargement (64%), intralobular septal thickening (60%), adjacent pleural thickening (41.7%), air bronchograms (41.2%), subpleural lines, crazy paving, bronchus distortion, bronchiectasis, and interlobular septal thickening. CT in early follow-up period generally showed an increase in size, number, and density of GGOs, with progression into mixed areas of GGOs plus consolidations and crazy paving, peaking at 10-11 days, before gradually resolving or persisting as patchy fibrosis. While younger adults more commonly had GGOs, extensive/multilobar involvement with consolidations was prevalent in the older population and those with severe disease. CONCLUSION: This review describes the imaging features for diagnosis, stratification, and follow-up of COVID-19 patients. The most common CT manifestations are bilateral, peripheral/subpleural, posterior GGOs with or without consolidations with a lower lobe predominance. It is pertinent to be familiar with the various imaging findings to positively impact the management of these patients. KEY POINTS: â¢ Ground glass opacities (GGOs), whether isolated or coexisting with consolidations, in bilateral and subpleural distribution, are the most prevalent chest CT findings in adult COVID-19 patients. â¢ Follow-up CT shows a progression of GGOs into a mixed pattern, reaching a peak at 10-11 days, before gradually resolving or persisting as patchy fibrosis. â¢ Younger people tend to have more GGOs. Older or sicker people tend to have more extensive involvement with consolidations.


title: Aerosol Filtration Efficiency of Common Fabrics Used in Respiratory Cloth Masks

text: The emergence of a pandemic affecting the respiratory system can result in a significant demand for face masks. This includes the use of cloth masks by large sections of the public, as can be seen during the current global spread of COVID-19. However, there is limited knowledge available on the performance of various commonly available fabrics used in cloth masks. Importantly, there is a need to evaluate filtration efficiencies as a function of aerosol particulate sizes in the 10 nm to 10 µm range, which is particularly relevant for respiratory virus transmission. We have carried out these studies for several common fabrics including cotton, silk, chiffon, flannel, various synthetics, and their combinations. Although the filtration efficiencies for various fabrics when a single layer was used ranged from 5 to 80% and 5 to 95% for particle sizes of <300 nm and >300 nm, respectively, the efficiencies improved when multiple layers were used and when using a specific combination of different fabrics. Filtration efficiencies of the hybrids (such as cotton-silk, cotton-chiffon, cotton-flannel) was >80% (for particles <300 nm) and >90% (for particles >300 nm). We speculate that the enhanced performance of the hybrids is likely due to the combined effect of mechanical and electrostatic-based filtration. Cotton, the most widely used material for cloth masks performs better at higher weave densities (i.e., thread count) and can make a significant difference in filtration efficiencies. Our studies also imply that gaps (as caused by an improper fit of the mask) can result in over a 60% decrease in the filtration efficiency, implying the need for future cloth mask design studies to take into account issues of "fit" and leakage, while allowing the exhaled air to vent efficiently. Overall, we find that combinations of various commonly available fabrics used in cloth masks can potentially provide significant protection against the transmission of aerosol particles.


title: Critical Role of Type III Interferon in Controlling SARS-CoV-2 Infection in Human Intestinal Epithelial Cells

text: Severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) is an unprecedented worldwide health problem that requires concerted and global approaches to stop the coronavirus 2019 (COVID-19) pandemic. Although SARS-CoV-2 primarily targets lung epithelium cells, there is growing evidence that the intestinal epithelium is also infected. Here, using both colon-derived cell lines and primary non-transformed colon organoids, we engage in the first comprehensive analysis of the SARS-CoV-2 life cycle in human intestinal epithelial cells (hIECs). Our results demonstrate that hIECs fully support SARS-CoV-2 infection, replication, and production of infectious de novo virus particles. We found that viral infection elicits an extremely robust intrinsic immune response where interferon-mediated responses are efficient at controlling SARS-CoV-2 replication and de novo virus production. Taken together, our data demonstrate that hIECs are a productive site of SARS-CoV-2 replication and suggest that the enteric phase of SARS-CoV-2 may participate in the pathologies observed in COVID-19 patients by contributing to increasing patient viremia and fueling an exacerbated cytokine response.


docid: noabikqq

title: Creating Backup Management Resources for Spine Care during the Coronavirus Disease 2019 Pandemic

text: During this unprecedented time of the coronavirus disease 2019 (COVID 19) pandemic, most countries are struggling to optimize their healthcare resources. Although the prevention and treatment of COVID 19 has become the priority for the majority of the population, most medical professionals are facing the challenge of balancing the management of this pandemic and treating patients with other diseases. Healthcare professionals from all specialties are facing this situation and designing guidelines and recommendations that are contributing to the literature that is crucial for disease management at the current time. We share our experience with two ends of the spectra that we currently observe in spine patients. One group of patients included the non-operative cases that presented with back pain. Further, we discuss our experience with operative precautions and digitally assisted discharge.


Covid-19: Doctors "face difficulties" getting life insurance after exposure to disease


title: Percepción de la pandemia COVID-19 en los servicios de cirugía en Colombia

text: Introducción La pandemia por COVID-19 ha llevado a modificar la estructura asistencial en los hospitales alrededor del mundo, buscando la mejor forma de adaptarse para responder al incremento de pacientes infectados por el virus, sin desatender las necesidades de los pacientes no afectados por el mismo El objetivo de este trabajo es describir la percepción de la comunidad quirúrgica sobre el impacto que ha tenido la pandemia COVID-19 en los servicios de cirugía en Colombia Métodos Estudio de corte transversal descriptivo mediante encuesta estructurada compuesta por 10 preguntas de selección múltiple y 8 preguntas con ítems tipo Likert Se distribuyó electrónicamente a residentes de cirugía general, cirujanos generales o sub-especialistas que tuvieran práctica clínica en Colombia Resultados Se incluyeron 464 participantes, 27 8 % fueron mujeres y 45 3 % cirujanos generales Alrededor de la mitad residían en Bogotá (51 4 %) o trabajaban en un hospital universitario privado (48 3 %) El 78 8% de los encuestados consideraron que las recomendaciones de seguridad son efectivas y 76 6% se sienten seguros realizando procedimientos con ellas Sin embargo, el 63% consideran que estas se cumplen parcialmente Hasta el momento, 20% de los participantes reportó haber tenido contacto directo con pacientes COVID-19 positivos Finalmente, la mayoría (93%) están de acuerdo con la cancelación de procedimientos electivos y están dispuestos a ser reubicados en otros servicios en caso de ser necesario Conclusiones Para el inicio de la fase de mitigación en Colombia existe consenso en la percepción del impacto de la pandemia COVID-19 en los servicios de cirugía No se observó una variabilidad significativa respecto al nivel de entrenamiento ni al tipo de institución hospitalariaIntroduction: The COVID-19 pandemic has led to changes in the care structure in hospitals around the world, seeking the best way to adapt in response to the increase in patients infected with the virus, without neglecting the needs of patients not affected by it The objective of this study is to describe the perception of the surgical community on the impact that the COVID-19 pandemic has had on the surgical services in Colombia Methods: Descriptive cross-sectional study using a structured survey consisting of 10 multiple-choice questions and 8 questions with Likert-type items It was distributed electronically to residents of general surgery, general surgeons, or sub-specialists who had clinical practice in Colombia Results: 464 participants were included, 27 8% were women and 45 3% were general surgeons About half resided in Bogotá (51 4%) or worked in a private university hospital (48 3%) 78 8% of the respondents considered that the safety recommendations are effective and 76 6% feel safe performing procedures with them However, 63% con-sider that these are partially met So far, 20% of participants reported having had direct contact with COVID-19 positive patients Finally, the majority (93%) agree to the cancellation of elective procedures and are willing to be relocated to other services if necessary Conclusions: There is a consensus in the perception of the COVID-19 pandemic impact in the surgery services without observing significant variability regarding the level of training or the type of hospital institution


Venous Thrombosis Among Critically Ill Patients With Coronavirus Disease 2019 (COVID-19)


The COVID-19 Intubation and Ventilation Pathway (CiVP);a Commentary


title: An analytical study on the awareness, attitude and practice during the COVID-19 pandemic in Riyadh, Saudi Arabia

text: BACKGROUND: Coronavirus disease (COVID-19) is an infectious disease caused by a new variable of the Coronaviridae family. COVID-19 spreads primarily by contacting the virus either from a COVID-19-infected individual through coughing or sneezing or from COVID-19-contaminated surfaces. On March 12, 2020, the World Health Organization (WHO) announced COVID-19 as a pandemic. The government of Saudi Arabia was among the first countries in the world to take quick and serious precautions. The Ministry of Health (MOH) has made the public aware of the virus transmission patterns and the importance of quarantine and curfew. Despite strict measures taken, the awareness of people towards infectious viruses remains the most important factor in limiting the widespread of diseases. METHOD: A cross-sectional survey of 1767 participants, was conducted to explore the awareness, attitude and practice of COVID-19 in relation to socioeconomic data among residents in the city of Riyadh. RESULTS: Of all the participants, 58% showed a moderate level of awareness, 95% presented a high attitude and 81% presented an adequate practice regarding COVID-19. Significant positive correlation between awareness-attitude (r = 0.132, p-value < 0.001) and attitude-practice (r = 0.149, p-value < 0.001) were found. The gender of the participants was the only common characteristic significantly associated with both awareness and practice. This study revealed that males showed a slight increase (60%) in the level of awareness compared to female participants (57%), however, when it comes to the practice towards COVID-19, females showed slightly better practice (82%) than males (80%). The World health organization (WHO) and the Ministry of Health (MOH) were the main sources of information. CONCLUSION: Despite the moderate public awareness, their attitude and practice were better. Therefore, public awareness must be improved to be prepared for epidemic and pandemic situations. A comprehensive public health education program is important to increase awareness and to reach sufficient knowledge.


title: Crucial laboratory parameters in COVID-19 diagnosis and prognosis: An updated meta-analysis

text: INTRODUCTION AND OBJECTIVES: Common laboratory parameters are crucial in aiding coronavirus disease 2019 (COVID-19) case detection. This study aimed to determine the differences between laboratory parameters in (1) COVID-19 versus non-COVID-19 pneumonia, and (2) severe versus non-severe COVID-19 cases. METHODS: Studies were collected until March 2020, and retrieved parameters include leukocyte, neutrophil, thrombocyte, and lymphocyte counts in addition to C-reactive protein (CRP), procalcitonin (PCT) and D-dimer levels. In the presence of heterogeneity, the random-effect model (REM) was used instead of the fixed-effect model (FEM). RESULTS: Seven studies in the first analysis showed significantly lower leukocyte, neutrophil and platelet counts in COVID-19 pneumonia (SMD=-0.42, 95%CI -0.60 to -0.25, p<0.00001, SMD=-0.23, 95%CI -0.41 to -0.06, p=0.01, SMD=-0.54, 95%CI -0.91 to -0.16, p=0.0005) compared to non-COVID-19 pneumonia. Twenty-six studies in the second analysis showed significantly lower lymphocyte and thrombocyte counts (SMD=-0.56, 95%CI -0.71 to -0.40, p<0.0001, SMD=-0.32, 95%CI -0.49 to -0.15, p=0.0002) and significantly higher leukocyte, neutrophil, D-dimer, and CRP (SMD=0.31, 95%CI 0.07-0.56, p=0.01; SMD=0.44, 95%CI 0.24-0.64, p<0.0001; SMD=0.53, 95%CI 0.31-0.75, p<0.00001; SMD=0.97, 95%CI 0.70-1.24, p<0.00001) in severe COVID-19 compared to non-severe COVID-19. CONCLUSIONS: In conclusion, thrombocyte count is key in both diagnosis and prognosis. Low leukocyte and neutrophil counts are markers of COVID-19 infection, but contrastingly higher counts indicate progressive COVID-19. And although lymphocyte, D-dimer and CRP levels did not demonstrate diagnostic value, all indicate severity of COVID-19. Confirmation of these findings should be performed in future studies.


title: Conflict in Africa during COVID-19: social distancing, food vulnerability and welfare response

text: We study the effect of social distancing, food vulnerability, welfare and labour COVID-19 policy responses on riots, violence against civilians and food-related conflicts. Our analysis uses georeferenced data for 24 African countries with monthly local prices and real-time conflict data reported in the Armed Conflict Location and Event Data Project (ACLED) from January 2015 until early May 2020. Lockdowns and recent welfare policies have been implemented in light of COVID-19, but in some contexts also likely in response to ongoing conflicts. To mitigate the potential risk of endogeneity, we use instrumental variables. We exploit the exogeneity of global commodity prices, and three variables that increase the risk of COVID-19 and efficiency in response such as countries colonial heritage, male mortality rate attributed to air pollution and prevalence of diabetes in adults. We find that the probability of experiencing riots, violence against civilians, food-related conflicts and food looting has increased since lockdowns. Food vulnerability has been a contributing factor. A 10% increase in the local price index is associated with an increase of 0.7 percentage points in violence against civilians. Nonetheless, for every additional anti-poverty measure implemented in response to COVID-19 the probability of experiencing violence against civilians, riots and food-related conflicts declines by approximately 0.2 percentage points. These anti-poverty measures also reduce the number of fatalities associated with these conflicts. Overall, our findings reveal that food vulnerability has increased conflict risks, but also offer an optimistic view of the importance of the state in providing an extensive welfare safety net.


Putting some context to the aerosolization debate around SARS-CoV-2


COVID-19 putting patients at risk of unplanned extubation and airway providers at increased risk of contamination


title: Distribution of ACE2, CD147, CD26 and other SARS-CoV-2 associated molecules in tissues and immune cells in health and in asthma, COPD, obesity, hypertension, and COVID-19 risk factors

text: BACKGROUND: Morbidity and mortality from COVID-19 caused by novel coronavirus SARS-CoV-2 is accelerating worldwide and novel clinical presentations of COVID-19 are often reported. The range of human cells and tissues targeted by SARS-CoV-2, its potential receptors and associated regulating factors are still largely unknown. The aim of our study was to analyze the expression of known and potential SARS-CoV-2 receptors and related molecules in the extensive collection of primary human cells and tissues from healthy subjects of different age and from patients with risk factors and known comorbidities of COVID-19. METHODS: We performed RNA sequencing and explored available RNA-Seq databases to study gene expression and co-expression of ACE2, CD147 (BSG), CD26 (DPP4) and their direct and indirect molecular partners in primary human bronchial epithelial cells, bronchial and skin biopsies, bronchoalveolar lavage fluid, whole blood, peripheral blood mononuclear cells (PBMCs), monocytes, neutrophils, DCs, NK cells, ILC1, ILC2, ILC3, CD4+ and CD8+ T cells, B cells and plasmablasts. We analyzed the material from healthy children and adults, and from adults in relation to their disease or COVID-19 risk factor status. RESULTS: ACE2 and TMPRSS2 were coexpressed at the epithelial sites of the lung and skin, whereas CD147 (BSG), cyclophilins (PPIA and PPIB), CD26 (DPP4) and related molecules were expressed in both, epithelium and in immune cells. We also observed a distinct age-related expression profile of these genes in the PBMCs and T cells from healthy children and adults. Asthma, COPD, hypertension, smoking, obesity, and male gender status generally led to the higher expression of ACE2- and CD147-related genes in the bronchial biopsy, BAL or blood. Additionally, CD147-related genes correlated positively with age and BMI. Interestingly, we also observed higher expression of ACE2- and CD147-related genes in the lesional skin of patients with atopic dermatitis. CONCLUSIONS: Our data suggest different receptor repertoire potentially involved in the SARS-CoV-2 infection at the epithelial barriers and in the immune cells. Altered expression of these receptors related with age, gender, obesity and smoking, as well as with the disease status might contribute to COVID-19 morbidity and severity patterns.


title: Outbreak of SARS-CoV2: Pathogenesis of infection and cardiovascular involvement

text: Since the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has emerged from China, the infection (novel corona virus disease-2019, COVID-19) has affected many countries and led to many deaths worldwide. Like SARS-CoV, angiotencin converting enzyme (ACE)2 as a functional receptor for SARS-CoV2 is essential for the virus to make an entry into the cell. ACE2 is a part of Renin-Angiotensin-Aldosterone System, which is expressed in several organs that opposes the angiotensin (Ang) II functions by converting Ang II to Ang (1-7), the one with vasodilation effects. The death rate of COVID-19 is estimated to be approximately 3.4%; however, some comorbid conditions like underlying cardiovascular disease, hypertension, and diabetes increase the risk of mortality. In addition, cardiovascular involvement as a complication of SARS-CoV2 could be direct through either ACE2 receptors that are expressed tremendously in the heart, or by the surge of different cytokines or by acute respiratory distress syndrome-induced hypoxia. Traditional risk factors could aggravate the process of COVID-19 infection that urges the triage of these high-risk patients for SARS-CoV2. Currently, there is no effective, proven treatment or vaccination for COVID-19, but many investigators are struggling to find a treatment strategy as soon as possible. Some potential medications like chloroquine by itself or in combination with azithromycin and some protease inhibitors used for the treatment of COVID-19 have cardiovascular adverse effects, which should be kept in mind while the patients taking these medications are being closely monitored.


title: [Individualized treatment recommendations for lung cancer patients at different stages of treatment during the outbreak of 2019 novel coronavirus disease]

text: In order to achieve the overall victory over 2019 novel coronavirus disease epidemic, especially to prevent the disease recurrence from rebounding during the resumption of labor, the government has not loosened any control of personnel mobility, which has obviously affected the normal examination and treatment of lung cancer patients under the influence of this epidemic. During the epidemic period, cancer patients with low immunity levels face the double ordeals of disease and epidemic situation. Compared with the general population, they are more likely to be infected with the new coronavirus. Among the infected cancer patients, lung cancer is the most common type. It is necessary to provide more appropriate individualized treatment recommendations for patients with lung cancer based on the epidemic situation of the patient's location and in combination with the patient's own condition. Through active prevention of infection, timely conversion of treatment strategies, online and offline joint control, and positive psychological counseling, we do our best to help patients with lung cancer to survive this difficult period.


title: Masked Face Recognition Dataset and Application

text: In order to effectively prevent the spread of COVID-19 virus, almost everyone wears a mask during coronavirus epidemic. This almost makes conventional facial recognition technology ineffective in many cases, such as community access control, face access control, facial attendance, facial security checks at train stations, etc. Therefore, it is very urgent to improve the recognition performance of the existing face recognition technology on the masked faces. Most current advanced face recognition approaches are designed based on deep learning, which depend on a large number of face samples. However, at present, there are no publicly available masked face recognition datasets. To this end, this work proposes three types of masked face datasets, including Masked Face Detection Dataset (MFDD), Real-world Masked Face Recognition Dataset (RMFRD) and Simulated Masked Face Recognition Dataset (SMFRD). Among them, to the best of our knowledge, RMFRD is currently theworld's largest real-world masked face dataset. These datasets are freely available to industry and academia, based on which various applications on masked faces can be developed. The multi-granularity masked face recognition model we developed achieves 95% accuracy, exceeding the results reported by the industry. Our datasets are available at: https://github.com/X-zhangyang/Real-World-Masked-Face-Dataset.


title: [The Management of Blood Glucose Should be Emphasized in the Treatment of COVID-19]

text: Based on the higher mortality and the higher proportion of critically ill adults in coronavirus disease 2019 (COVID-19) patients with diabetes, good inpatient glycemic control is particularly important in the comprehensive treatment of COVID-19. Individualized blood glucose target goals and treatment strategies should be made according to specific circumstances of COVID-19 inpatients with diabetes. For mild patients, a strict glycemic control target (fasting plasma glucose (FPG) 4.4-6.1 mmol/L, 2-hour postprandial plasma glucose (2 h PG) 6.1-7.8 mmol/L) are recommended; a target for the glycemic control of common type patients (FPG 6.1-7.8 mmol/L, 2 h PG 7.8-10.0 mmol/L) and subcutaneous insulin deliver therapy are recommended; a target nonfasting blood glucose range of 10.0 mmol or less per liter for severe-type COVID-19 patients, a relatively Less stringent blood glucose control target (FPG 7.8-10.0 mmol/L, 2 h PG 7.8-13.9 mmol/L) for critically ill patients and intravenous insulin infusion therapy are recommended. Due to the rapid changes in the condition of some patients, the risk of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar status (HHS) maybe occur during the treatment. Blood glucose monitoring, dynamic evaluation and timely adjustment of strategies should be strengthened to ensure patient safety and promote early recovery of patients.


Rural Healthcare Center Preparation and Readiness Response to Threat of COVID-19


title: Correlation Between Relative Nasopharyngeal Virus RNA Load and Lymphocyte Count Disease Severity in Patients with COVID-19

text: The aim of this study was to analyze the correlation between dynamic changes in the nasopharyngeal viral load of patients infected with the new coronavirus causing pneumonia and lymphocyte count disease severity. Cases newly diagnosed with COVID-19 at the First Affiliated Hospital of Nanchang University from January 2020 to February 2020 were analyzed retrospectively. Quantitative real-time polymerase chain reaction was used to determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from throat swab sample ΔCT values; lymphocyte and lymphocyte subset counts, coagulation system factor levels, myocardial injury indexes, and laboratory biochemical indicators were compared between the mild group and the severe group. The correlation between the relative load of nasopharyngeal SARS-CoV-2 RNA and severe disease symptoms was analyzed. Of the 76 patients, 49 were male and 27 were female. The lymphocyte, CD4+ T lymphocyte, and CD8+ T lymphocyte counts all differed significantly between the two groups (p < 0.001), as did differences in interleukin (IL)-2R, IL-6, and IL-8 levels (p = 0.022, 0.026, and 0.012, respectively). Moreover, there were significant differences in prothrombin time, D-dimer, and fibrinogen levels between the mild group and the severe group (p = 0.029, 0.006, and <0.001, respectively), and in lactate dehydrogenase and troponin (p < 0.001 and p = 0.007, respectively). SARS-CoV-2 RNA load and lymphocyte count, CD4+ T lymphocyte count, and CD8+ T lymphocyte count were linearly negatively correlated (p < 0.001). SARS-CoV-2 RNA load was positively correlated with IL-2R, prothrombin time, lactate dehydrogenase, and hypersensitive troponin T (p = 0.002, p = 0.009, and p < 0.001, respectively). In addition, the time that it took for the nucleic acid test to turn negative was significantly shorter for patients in the mild group than for those in the severe group (Z = -6.713, p < 0.001). In conclusion, relative SARS-CoV-2 RNA load in the nasopharynx is closely related to COVID-19 severity. If the relative RNA load was higher, the lymphocyte count was lower, organ damage was greater, and the time it took for the nucleic acid test to turn negative was longer.


title: [A COVID19-vírusfertozés klinikai felismerését szolgáló új információk és a fej-nyaki régióban dolgozó egészségügyi személyzet védekezésének lehetoségei]/ Essential new informations for the clinical recognition of COVID-19 infection and the prevention possibilities of healthcare personnel working in the head and neck region

text: The coronavirus (COVID-19) pandemic probably started in China in 2019 and is influencing the whole healthcare system worldwide. As several healthcare interventions are essential even during pandemics, it is necessary for professionals working in such fields to get up-to-date information about the virus and its aspects that can influence patient care and suggested actions. The current article is a literature review, in which the authors elaborated the recently available scientific articles with their relevancy for clinical interventions as primary factor. The processed articles emphasize that during interventions in the head and neck region, especially when using rotating instruments, it is of utmost importance for all personnel being present at the time of intervention to wear full protection, including disposable medical uniforms, glasses and special masks. These single-use items have to be changed after each intervention and the whole team has to be educated for this process in advance. In order to avoid cross-contamination and infection of personnel during intervention, it is essential to keep all work-safety and infection-control precautions extremely strictly. Orv Hetil. 2020; 161(17): 660666.


title: IL-15 immunotherapy is a viable strategy for COVID-19

text: Coronavirus disease 2019 (COVID-19) is a pulmonary inflammatory disease induced by a newly recognized coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 infection was detected for the first time in the city of Wuhan in China and spread all over the world at the beginning of 2020. Several millions of people have been infected with SARS-CoV-2, and almost 382,867 human deaths worldwide have been reported so far. Notably, there has been no specific, clinically approved vaccine or anti-viral treatment strategy for COVID-19. Herein, we review COVID-19, the viral replication, and its effect on promoting pulmonary fibro-inflammation via immune cell-mediated cytokine storms in humans. Several clinical trials are currently ongoing for anti-viral drugs, vaccines, and neutralizing antibodies against COVID-19. Viral clearance is the result of effective innate and adaptive immune responses. The pivotal role of interleukin (IL)-15 in viral clearance involves maintaining the balance of induced inflammatory cytokines and the homeostatic responses of natural killer and CD8+ T cells. This review presents supporting evidence of the impact of IL-15 immunotherapy on COVID-19.


title: Antigen Capture Enzyme-Linked Immunosorbent Assay for Detecting Middle East Respiratory Syndrome Coronavirus in Humans

text: The Middle East respiratory syndrome (MERS) is the second novel zoonotic disease infecting humans caused by coronavirus (CoV) in this century. To date, more than 2200 laboratory-confirmed human cases have been identified in 27 countries, and more than 800 MERS-CoV associated deaths have been reported since its outbreak in 2012. Rapid laboratory diagnosis of MERS-CoV is the key to successful containment and prevention of the spread of infection. Though the gold standard for diagnosing MERS-CoV infection in humans is still nucleic acid amplification test (NAAT) of the up-E region, an antigen capture enzyme-linked immunosorbent assay (ELISA) could also be of use for early diagnosis in less developed locations. In the present method, a step-by-step guide to perform a MERS-CoV nucleocapsid protein (NP) capture ELISA using two NP-specific monoclonal antibodies is provided for readers to develop their in-house workflow or diagnostic kit for clinical use and for mass-screening project of animals (e.g., dromedaries and bats) to better understand the spread and evolution of the virus.


title: The Brain Retains: Nonhuman Primate Models for Pediatric HIV-1 in the CNS

text: PURPOSE OF REVIEW: Perinatal HIV-1 infection is associated with an increased risk for neurologic impairments. With limited access to clinical specimens, animal models could advance our understanding of pediatric central nervous system (CNS) disease and viral persistence. Here, we summarize current findings on HIV-1 CNS infection from nonhuman primate (NHP) models and discuss their implications for improving pediatric clinical outcomes. RECENT FINDINGS: SIV/SHIV can be found in the CNS of infant macaques within 48 h of challenge. Recent studies show an impermeable BBB during SIV infection, suggesting neuroinvasion in post-partum infection is likely not wholly attributed to barrier dysfunction. Histopathological findings reveal dramatic reductions in hippocampal neuronal populations and myelination in infected infant macaques, providing a link for cognitive impairments seen in pediatric cases. Evidence from humans and NHPs support the CNS as a functional latent reservoir, harbored in myeloid cells that may require unique eradication strategies. Studies in NHP models are uncovering early events, causes, and therapeutic targets of CNS disease as well as highlighting the importance of age-specific studies that capture the distinct features of pediatric HIV-1 infection.


title: Clinical outcomes in COVID-19 patients treated with tocilizumab: An individual patient data systematic review

text: BACKGROUND: Current evidence suggests an important role of the interleukin-6 (IL-6) pathway in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related cytokine release storm in severely ill coronavirus disease 2019 (COVID-19) patients. Inhibition of the IL-6 pathway with tocilizumab has been employed successfully in some of these patients but the data is mostly consistent of case reports and series. METHODS: We performed a systematic search of PubMed, Embase, and Medline from 22nd April 2020 and again on 27th April 2020 using the following search terms alone or in combination: "COVID-19," "coronavirus," "SARS-CoV-2," "COVID," "anti-interleukin-6 receptor antibodies," "anti-IL-6," "tocilizumab," "sarilumab," "siltuximab." We included studies that reported individual patient data. We extracted and analyzed individual level data on baseline characteristics, laboratory findings, and clinical outcomes. The primary endpoint was in-hospital mortality. Secondary endpoints included in-hospital complications, recovery rates, effect of patient characteristics on the primary outcome and changes in levels of inflammatory markers. RESULTS: Three hundred fifty-two records were identified through a systematic search, of which 10 studies met the inclusion criteria. A single study currently under review was also added. Eleven observational studies encompassing 29 patients were included in the present review. There were more males (24 [82.8%]), and hypertension was the most common comorbidity (16 [48.3%]). Over an average of 5.4 hospital days, the primary endpoint occurred in 6 (20.7%) patients. Among surviving patients, about 10% had worsened disease and 17% recovered. The most common complication was acute respiratory distress syndrome (8 [27.6%]). The IL-6 level was significantly higher after the initiation of tocilizumab with median (interquartile range) of 376.6 (148-900.6) pg/mL compared to the baseline of 71.1 (31.9-122.8) pg/mL (P = .002). Mean (standard deviation) levels of C-reactive protein (CRP) were significantly decreased following treatment 24.6 (26.9) mg/L compared to baseline 140.4 (77) mg/L (P < .0001). Baseline demographics were not significantly different among survivors and nonsurvivors by Fisher's exact test. CONCLUSION: In COVID-19 patients treated with tocilizumab, IL-6 levels are significantly elevated, which are supportive of cytokine storm. Following initiation of tocilizumab, there is elevation in the IL-6 levels and CRP levels dramatically decrease, suggesting an improvement in this hyperinflammatory state. Ongoing randomized control trials will allow for further evaluation of this promising therapy. IMPORTANCE: Recent data indicate that severe COVID-19 causes a cytokine release storm and is associated with worse clinical outcomes and IL-6 plays an important role. It is suggestive that anti-IL-6 results in the improvement of this hyperinflammatory state. However, to our knowledge, there is no individual patient data systematic review performed to summarize baseline characteristics and clinical outcomes of COVID-19 patients who received tocilizumab.


docid: ejskxpsu

title: COVID-19 pandemic: Lessons learned and future directions

text: Emerging pandemics show that humans are not infallible and communities need to be prepared. Coronavirus outbreak was first reported towards the end of 2019 and has now been declared a pandemic by the World Health Organization. Worldwide countries are responding differently to the virus outbreak. A delay in detection and response has been recorded in China, as well as in other major countries, which led to an overburdening of the local health systems. On the other hand, some other nations have put in place effective strategies to contain the infection and have recorded a very low number of cases since the beginning of the pandemics. Restrictive measures like social distancing, lockdown, case detection, isolation, contact tracing, and quarantine of exposed had revealed the most efficient actions to control the disease spreading. This review will help the readers to understand the difference in response by different countries and their outcomes. Based on the experience of these countries, India responded to the pandemic accordingly. Only time will tell how well India has faced the outbreak. We also suggest the future directions that the global community should take to manage and mitigate the emergency.


COVID-19, sweat, tears and myopia?


Psychiatric burdens or stress during hospitalization and concerns after discharge in patients with severe acute respiratory syndrome coronavirus-2 isolated in a tertiary care hospital


title: Bracing for the Big Ones: Novel Diseases like COVID-19 Could Test Texas' Public Health System

text: Novel diseases like COVID-19 could be a tough test for Texas' public health system.


Chest-X-ray is a mainstay for follow-up in critically ill patients with covid-19 induced pneumonia


title: Au-decorated BN nanotube as a breathalyzer for potential medical applications

text: Respiratory viral infections such as coronavirus (COVID-19) will cause a great mortality, especially in people who underly lung diseases such as chronic obstructive pulmonary and asthma. Very recently, the COVID-19 outbreak has exposed the lack of quick approaches for screening people who may have risen risk of pathogen contact. One proposed non-invasive potential approach to recognize the viral infection is analysis of exhaled gases. It has been indicated that the nitric oxide is one of most important biomarkers which might be emanated by respiratory epithelial cells. Using density functional theory calculations, here, we introduced a novel Au-decorated BN nanotube-based breathalyzer for probable recognition of NO gas released from the respiratory epithelial cells in the presence of interfering CO2 and H2O gases. This breathalyzer benefits from different advantages including high sensitivity (sensing responseâ¯=â¯101.5), high selectivity, portability, short recovery time (1.8â¯µs at 298â¯K), and low cost.


Clinical Insights for Gastroenterology and Hepatology Providers during the COVID-19 Pandemic


title: COVID-19: Immunology and treatment options

text: The novel coronavirus SARS-CoV2 causes COVID-19, a pandemic threatening millions. As protective immunity does not exist in humans and the virus is capable of escaping innate immune responses, it can proliferate, unhindered, in primarily infected tissues. Subsequent cell death results in the release of virus particles and intracellular components to the extracellular space, which result in immune cell recruitment, the generation of immune complexes and associated damage. Infection of monocytes/macrophages and/or recruitment of uninfected immune cells can result in massive inflammatory responses later in the disease. Uncontrolled production of pro-inflammatory mediators contributes to ARDS and cytokine storm syndrome. Antiviral agents and immune modulating treatments are currently being trialled. Understanding immune evasion strategies of SARS-CoV2 and the resulting delayed massive immune response will result in the identification of biomarkers that predict outcomes as well as phenotype and disease stage specific treatments that will likely include both antiviral and immune modulating agents.


The effects of the COVID-19 virus on mental healthcare for older people in The Netherlands


COVID-19: the use of immunotherapy in metastatic lung cancer


title: Review of Artificial Intelligence Techniques in Imaging Data Acquisition, Segmentation and Diagnosis for COVID-19

text: The pandemic of coronavirus disease 2019 (COVID-19) is spreading all over the world. Medical imaging such as X-ray and computed tomography (CT) plays an essential role in the global fight against COVID-19, whereas the recently emerging artificial intelligence (AI) technologies further strengthen the power of the imaging tools and help medical specialists. We hereby review the rapid responses in the community of medical imaging (empowered by AI) toward COVID-19. For example, AI-empowered image acquisition can significantly help automate the scanning procedure and also reshape the workflow with minimal contact to patients, providing the best protection to the imaging technicians. Also, AI can improve work efficiency by accurate delineation of infections in X-ray and CT images, facilitating subsequent quantification. Moreover, the computer-aided platforms help radiologists make clinical decisions, i.e., for disease diagnosis, tracking, and prognosis. In this review paper, we thus cover the entire pipeline of medical imaging and analysis techniques involved with COVID-19, including image acquisition, segmentation, diagnosis, and follow-up. We particularly focus on the integration of AI with X-ray and CT, both of which are widely used in the frontline hospitals, in order to depict the latest progress of medical imaging and radiology fighting against COVID-19.


title: Effect of Underlying Comorbidities on the Infection and Severity of COVID-19 in Korea: a Nationwide Case-Control Study

text: BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is an emerging threat worldwide. It remains unclear how comorbidities affect the risk of infection and severity of COVID-19. METHODS: This is a nationwide retrospective case-control study of 219,961 individuals, aged 18 years or older, whose medical costs for COVID-19 testing were claimed until May 15, 2020. COVID-19 diagnosis and infection severity were identified from reimbursement data using diagnosis codes and on the basis of respiratory support use, respectively. Odds ratios (ORs) were estimated using multiple logistic regression, after adjusting for age, sex, region, healthcare utilization, and insurance status. RESULTS: The COVID-19 group (7,341 of 219,961) was young and had a high proportion of female. Overall, 13.0% (954 of 7,341) of the cases were severe. The severe COVID-19 group had older patients and a proportion of male ratio than did the non-severe group. Diabetes (odds ratio range [ORR], 1.206-1.254), osteoporosis (ORR, 1.128-1.157), rheumatoid arthritis (ORR, 1.207-1.244), substance use (ORR, 1.321-1.381), and schizophrenia (ORR, 1.614-1.721) showed significant association with COVID-19. In terms of severity, diabetes (OR, 1.247; 95% confidential interval, 1.009-1.543), hypertension (ORR, 1.245-1.317), chronic lower respiratory disease (ORR, 1.216-1.233), chronic renal failure, and end-stage renal disease (ORR, 2.052-2.178) were associated with severe COVID-19. CONCLUSION: We identified several comorbidities associated with COVID-19. Health care workers should be more careful while diagnosing and treating COVID-19 when patients have the abovementioned comorbidities.


Child poverty, food insecurity, and respiratory health during the COVID-19 pandemic


title: Changes to management of a non-pandemic illness during the COVID-19 pandemic: case study of invasive management of acute coronary syndrome

text: The coronavirus 2019 (COVID-19) pandemic requires significant changes to standard operating procedures for non-COVID-19 related illnesses Balancing the benefit from standard evidence-based treatments with the risks posed by COVID-19 to patients, healthcare workers and to the population at large is difficult due to incomplete and rapidly changing information In this article, we use management of acute coronary syndromes as a case study to show how these competing risks and benefits can be resolved, albeit incompletely While the risks due to COVID-19 in patients with acute coronary syndromes is unclear, the benefits of standard management are well established in this condition As an aid to decision making, we recommend systematic estimation of the risks and benefits for management of any condition where there is likely to be an increase in non-COVID-19 related mortality and morbidity due to changes in routine care


title: SARS-CoV-2 spike protein favors ACE2 from Bovidae and Cricetidae

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the recent COVID-19 public health crisis. Bat is the widely believed original host of SARS-CoV-2. However, its intermediate host before transmitting to humans is not clear. Some studies proposed pangolin, snake, or turtle as the intermediate hosts. Angiotensin-converting enzyme 2 (ACE2) is the receptor for SARS-CoV-2, which determines the potential host range for SARS-CoV-2. On the basis of structural information of the complex of human ACE2 and SARS-CoV-2 receptor-binding domain (RBD), we analyzed the affinity to S protein of the 20 key residues in ACE2 from mammal, bird, turtle, and snake. Several ACE2 proteins from Primates, Bovidae, Cricetidae, and Cetacea maintained the majority of key residues in ACE2 for associating with SARS-CoV-2 RBD. The simulated structures indicated that ACE2 proteins from Bovidae and Cricetidae were able to associate with SARS-CoV-2 RBD. We found that nearly half of the key residues in turtle, snake, and bird were changed. The simulated structures showed several key contacts with SARS-CoV-2 RBD in turtle and snake ACE2 were abolished. This study demonstrated that neither snake nor turtle was the intermediate hosts for SARS-CoV-2, which further reinforced the concept that the reptiles are resistant against infection of coronavirus. This study suggested that Bovidae and Cricetidae should be included in the screening of intermediate hosts for SARS-CoV-2.


The prominence of asymptomatic superspreaders in transmission mean universal face masking should be part of COVID-19 de-escalation strategies


Ventilators by Lottery: The Least Unjust Form of Allocation in the COVID-19 Pandemic


title: The psychosocial impact of COVID-19 pandemic in Italy: A lesson for mental health prevention in the first severely hit European country

text: Italy was the first European country severely hit by the COVID-19 pandemic. While the containment measures were relatively effective in the acute phase, the current postemergency phase addressing the long-term psychosocial consequences is the key challenge for our healthcare system, where the importance of mental health prevention is not sufficiently recognized. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


COVID-19 and the 'Spanish' flu


A "paper diaper" in N95 respirator


title: Manejo Emocional De La Crisis Sanitaria Ante El Coronavirus: Una Revisión Narrativa./ [Emotional management of the health crisis by coronavirus: A narrative review]

text: OBJECTIVE: To make a synthesis of the available scientific evidence in the emotional management of the declared health crisis in the face of coronavirus. METHODS: A bibliographic search was made, without date limit, in Medline, CINAHL, PsycINFO, Scopus and Web of Science databases using the following keywords: "emotional management"; "health crisis" and "health crisis response". Initially; 73 studies were identified and; after selecting them according to eligibility criteria; 10 were included. RESULTS: The main recommendations based on the available evidence indicate emotional management measures such as offering support groups to professionals, ensuring their social non-discrimination, strengthening their confidence and control capacity through training actions, as well as reinforcing the recognition of nurses by the community. DISCUSSION AND CONCLUSIONS: The accumulated evidence comes from experience with previous outbreaks of SARS-CoV-1 and MERS-CoV. Stress was the most studied aspect, concerning issues such as social stigma, professionalism, intention to care, burnout, ethical conflicts, anxiety, depression or guilt. The emotional management of health crises in the face of the coronavirus requires an individual, collective, social and institutional strategy to reinforce security on all fronts and reduce fear through effective control measures using sufficient and adequate material and human resources.


title: Improved Clinical Symptoms and Mortality on Severe/Critical COVID-19 Patients Utilizing Convalescent Plasma Transfusion

text: Coronavirus disease 2019 (COVID-19) is causing worldwide pandemic with no specific therapeutic agents, especially for severe or critical patients. To comprehensively evaluate the effectiveness, safety, and indications of convalescent plasma transfusion (CPT) therapy for severe or critical COVID-19 patients, we analyzed the clinical, laboratory, and radiologic characteristics of 1,568 patients from a single center, in which 138 patients received ABO-compatible CPT. The median time from the first symptom to CPT was 45 days. 2.2% and 4.1% of cases died in the CPT group and in the standard-treatment group, respectively. 2.4% and 5.1% of patients in the CPT and the standard-treatment group have been admitted to ICU eventually. 70% of the patients who had severe respiratory symptoms got improved and removed oxygen supports within 7 days after CPT. The viral loads and C-reactive protein (CRP) concentration significantly decreased (P<0.001), and the percentage of lymphocytes increased (P=0.006), 76.8% of cases received radiological improvements within 14 days after CPT. Patients with a higher percentage of lymphocytes and a lower percentage of neutrophils and CRP concentration respond better to CPT (P<0.05). Notably, for the patients who received CPT within 7 weeks after symptom onset, the median time from CPT to clinical improvements was approximately 10 days. But the time to clinical improvements was significantly prolonged for patients who received CPT later than 7 weeks after onset. Our study will provide important information for the clinical practice in COVID-19 treatment, as well as provide real-world observations and clinical data for the development of monoclonal antibodies.


title: Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19

text: The role of clinical laboratory data in the differential diagnosis of the severe forms of COVID-19 has not been definitely established. The aim of this study was to look for the warning index in severe COVID-19 patients. We investigated 43 adult patients with COVID-19. The patients were classified into mild group (28 patients) and severe group (15 patients). A comparison of the hematological parameters between the mild and severe groups showed significant differences in interleukin-6 (IL-6), d-dimer (d-D), glucose, thrombin time, fibrinogen, and C-reactive protein (P < .05). The optimal threshold and area under the receiver operator characteristic curve (ROC) of IL-6 were 24.3 and 0.795 µg/L, respectively, while those of d-D were 0.28 and 0.750 µg/L, respectively. The area under the ROC curve of IL-6 combined with d-D was 0.840. The specificity of predicting the severity of COVID-19 during IL-6 and d-D tandem testing was up to 93.3%, while the sensitivity of IL-6 and d-D by parallel test in the severe COVID-19 was 96.4%. IL-6 and d-D were closely related to the occurrence of severe COVID-19 in the adult patients, and their combined detection had the highest specificity and sensitivity for early prediction of the severity of COVID-19 patients, which has important clinical value.


title: Challenges of diabetes care management in developing countries with a high incidence of COVID-19: A brief report

text: BACKGROUND AND AIMS: Diabetes mellitus (DM) is one of the most critical risk factors for complications and death in COVID-19 patients. The present study aims to highlight challenges in the management of diabetic patients during the COVID-19 outbreak in developing countries. METHODS: We reviewed the literature to obtain information about diabetic care during the Covid-19 crisis. We also seek opinions of clinicians working in undeveloped countries. RESULTS: Current challenges faced by clinicians in the management of diabetic patients in developing countries are as follows: lack of preventive measures, inadequate number of visits, loss of the traditional method of communication with the patient, shortage of medications, impaired routine diabetic care, and absence of telehealth services. CONCLUSIONS: Developing countries are faced with many challenges in diabetes management due to a lack of resources.


The key role of palliative care in response to the COVID-19 tsunami of suffering


title: Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study

text: BACKGROUND: In December, 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The number of affected pregnant women is increasing, but scarce information is available about the clinical features of COVID-19 in pregnancy. This study aimed to clarify the clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19. METHODS: In this retrospective, single-centre study, we included all pregnant women with COVID-19 who were admitted to Tongji Hospital in Wuhan, China. Clinical features, treatments, and maternal and fetal outcomes were assessed. FINDINGS: Seven patients, admitted to Tongji Hospital from Jan 1, to Feb 8, 2020, were included in our study. The mean age of the patients was 32 years (range 29-34 years) and the mean gestational age was 39 weeks plus 1 day (range 37 weeks to 41 weeks plus 2 days). Clinical manifestations were fever (six [86%] patients), cough (one [14%] patient), shortness of breath (one [14%] patient), and diarrhoea (one [14%] patient). All the patients had caesarean section within 3 days of clinical presentation with an average gestational age of 39 weeks plus 2 days. The final date of follow-up was Feb 12, 2020. The outcomes of the pregnant women and neonates were good. Three neonates were tested for SARS-CoV-2 and one neonate was infected with SARS-CoV-2 36 h after birth. INTERPRETATION: The maternal, fetal, and neonatal outcomes of patients who were infected in late pregnancy appeared very good, and these outcomes were achieved with intensive, active management that might be the best practice in the absence of more robust data. The clinical characteristics of these patients with COVID-19 during pregnancy were similar to those of non-pregnant adults with COVID-19 that have been reported in the literature. FUNDING: National Natural Science Foundation of China, Hubei Provincial Natural Science Foundation of China.


Providing equitable care to patients with limited dominant language proficiency amid the COVID-19 pandemic


title: Cross Hashing: Anonymizing encounters in Decentralised Contact Tracing Protocols

text: During the COVID-19 (SARS-CoV-2) epidemic, Contact Tracing emerged as an essential tool for managing the epidemic. App-based solutions have emerged for Contact Tracing, including a protocol designed by Apple and Google (influenced by an open-source protocol known as DP3T). This protocol contains two well-documented de-anonymisation attacks. Firstly that when someone is marked as having tested positive and their keys are made public, they can be tracked over a large geographic area for 24 hours at a time. Secondly, whilst the app requires a minimum exposure duration to register a contact, there is no cryptographic guarantee for this property. This means an adversary can scan Bluetooth networks and retrospectively find who is infected. We propose a novel"cross hashing"approach to cryptographically guarantee minimum exposure durations. We further mitigate the 24-hour data exposure of infected individuals and reduce computational time for identifying if a user has been exposed using k-Anonymity buckets of hashes and Private Set Intersection.


Long-Term Care Policy after Covid-19 - Solving the Nursing Home Crisis


The place of early rehabilitation in ICU for Covid-19


title: [Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia]

text: At the end of December 2019, a novel coronavirus (COVID-19) caused an outbreak in Wuhan, and has quickly spread to all provinces in China and 26 other countries around the world, leading to a serious situation for epidemic prevention. So far, there is still no specific medicine. Previous studies have shown that chloroquine phosphate (chloroquine) had a wide range of antiviral effects, including anti-coronavirus. Here we found that treating the patients diagnosed as novel coronavirus pneumonia with chloroquine might improve the success rate of treatment, shorten hospital stay and improve patient outcome. In order to guide and regulate the use of chloroquine in patients with novel coronavirus pneumonia, the multicenter collaboration group of Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province for chloroquine in the treatment of novel coronavirus pneumonia developed this expert consensus after extensive discussion. It recommended chloroquine phosphate tablet, 500mg twice per day for 10 days for patients diagnosed as mild, moderate and severe cases of novel coronavirus pneumonia and without contraindications to chloroquine.


title: Awareness, Attitudes, and Actions Related to COVID-19 Among Adults With Chronic Conditions at the Onset of the U.S. Outbreak: A Cross-sectional Survey

text: Background: The evolving outbreak of coronavirus disease 2019 (COVID-19) is requiring social distancing and other measures to protect public health. However, messaging has been inconsistent and unclear. Objective: To determine COVID-19 awareness, knowledge, attitudes, and related behaviors among U.S. adults who are more vulnerable to complications of infection because of age and comorbid conditions. Design: Cross-sectional survey linked to 3 active clinical trials and 1 cohort study. Setting: 5 academic internal medicine practices and 2 federally qualified health centers. Patients: 630 adults aged 23 to 88 years living with 1 or more chronic conditions. Measurements: Self-reported knowledge, attitudes, and behaviors related to COVID-19. Results: A fourth (24.6%) of participants were "very worried" about getting the coronavirus. Nearly a third could not correctly identify symptoms (28.3%) or ways to prevent infection (30.2%). One in 4 adults (24.6%) believed that they were "not at all likely" to get the virus, and 21.9% reported that COVID-19 had little or no effect on their daily routine. One in 10 respondents was very confident that the federal government could prevent a nationwide outbreak. In multivariable analyses, participants who were black, were living below the poverty level, and had low health literacy were more likely to be less worried about COVID-19, to not believe that they would become infected, and to feel less prepared for an outbreak. Those with low health literacy had greater confidence in the federal government response. Limitation: Cross-sectional study of adults with underlying health conditions in 1 city during the initial week of the COVID-19 U.S. outbreak. Conclusion: Many adults with comorbid conditions lacked critical knowledge about COVID-19 and, despite concern, were not changing routines or plans. Noted disparities suggest that greater public health efforts may be needed to mobilize the most vulnerable communities. Primary Funding Source: National Institutes of Health.


title: Predicting infectious SARS-CoV-2 from diagnostic samples

text: BACKGROUND: RT-PCR has become the primary method to diagnose viral diseases, including SARS-CoV-2. RT-PCR detects RNA, not infectious virus, thus its ability to determine duration of infectivity of patients is limited. Infectivity is a critical determinant in informing public health guidelines/interventions. Our goal was to determine the relationship between E gene SARS-CoV-2 RT-PCR cycle threshold (Ct) values from respiratory samples, symptom onset to test (STT) and infectivity in cell culture. METHODS: In this retrospective cross-sectional study, we took SARS-CoV-2 RT-PCR confirmed positive samples and determined their ability to infect Vero cell lines. RESULTS: Ninety RT-PCR SARS-CoV-2 positive samples were incubated on Vero cells. Twenty-six samples (28.9%) demonstrated viral growth. Median TCID50/ml was 1780 (282-8511). There was no growth in samples with a Ct > 24 or STT > 8 days. Multivariate logistic regression using positive viral culture as a binary predictor variable, STT and Ct demonstrated an odds ratio for positive viral culture of 0.64 (95% CI 0.49-0.84, p<0.001) for every one unit increase in Ct. Area under the receiver operating characteristic curve for Ct vs. positive culture was OR 0.91 (95% CI 0.85-0.97, p<0.001), with 97% specificity obtained at a Ct of >24. CONCLUSIONS: SARS-CoV-2 Vero cell infectivity was only observed for RT-PCR Ct < 24 and STT < 8 days. Infectivity of patients with Ct >24 and duration of symptoms >8 days may be low. This information can inform public health policy and guide clinical, infection control and occupational health decisions. Further studies of larger size are needed.


title: Ischemic stroke associated with novel coronavirus 2019: a report of three cases

text: Introduction: There is limited evidence about the neurological manifestations of COVID-19 in infected patients. In this report, we describe three patients with ischemic stroke associated with COVID-19 infection.Methods: We report 3 cases of adult patients with ischemic stroke and novel coronavirus 2019 infection. Case 1 is an 88-year-old female with acute left hemiplegia and right peripheral facial paresis that she had a fever along with stroke symptoms. Case 2 is an 85-year-old female with left hemiplegia and drowsiness who had a weakness, asthenia, and dry cough 3 days before appearing stroke signs. Case 3 is a 55-year-old male with acute Broca's aphasia and right hemiplegia who experience fever and respiratory problems 3 days after admission.Results: The clinical symptoms of infected patients with COVID-19 have been associated with severe symptoms of ischemic stroke. Two patients were admitted to the ICU. RT-PCR of the oropharyngeal sample was positive in three cases. All patients had the involvement of large cerebral arteries.Conclusion: The mechanism by which COVID-19 causes ischemic stroke is unknown but it is likely by production inflammatory cytokines or direct infection of cerebral arteries. Therefore, regarding the current situation of the COVID-19 pandemic, it is indispensable that the possible diagnosis of COVID-19 vasculopathy is considered in all ischemic strokes of unclear etiology.


title: Obstetric and perinatal care units functioning during the COVID-19 pandemic ;О принципах работы перинатального стационара в условиях пандемии коронавируса

text: The rapid spread of COVID-19 and the large number of cases put a significant burden on the health systems of any developed country Specialists in natural disasters and military medicine should be involved in the provision of medical care and observance of anti-epidemic measures In some countries, including Italy, they were involved only after the situation was dramatically worsening with many clinical units and hospitals overloaded by infected patients To curb the spread of COVID-19, most countries declared a state of emergency, and unprecedented measures have been taken to strengthen quarantine in suspected or positive symptomatic subjects Nevertheless, the crisis associated with the unexpectedly global scale and tragedy of the pandemic and the inconsistency of actions of both society and individuals and specialized medical services, lead to insufficient effectiveness of the measures taken in a number of regions In the present day, it is vital for every person to change its mindset â€• relying on personal responsibility to comply with all recommendations of quarantine and anti-epidemic measures, and to reorganize departments and resources of medical institutions at all levels in order to withstand the spread of infection and at the same time provide all those in need with the necessary and appropriate medical care Particular attention should be paid to the obstetric care service, given that even in normal times, the obstetric hospital is an area of increased responsibility for the life and health of mother and child and future mankind Fulfillment of existing orders, instructions of national and regional committees, international and national protocols and clinical protocols should undoubtedly lead to a positive result, but this requires additional training of medical personnel at all levels The purpose of this review is to propose quick key strategies for reassessing the maternity and neonatal wards/ hospitals based on the experience of health systems and 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Ð¾Ð±ÑÐ·Ð°Ñ‚ÐµÐ»ÑŒÐ½Ñ‹Ð¼Ð¸ Ðº Ð¸ÑÐ¿Ð¾Ð»Ð½ÐµÐ½Ð¸ÑŽ Ð´ÐµÐ¹ÑÑ‚Ð²ÑƒÑŽÑ‰Ð¸Ð¼Ð¸ Ð¿Ñ€Ð¸ÐºÐ°Ð·Ð°Ð¼Ð¸ Ð¸ Ñ€Ð°ÑÐ¿Ð¾Ñ€ÑÐ¶ÐµÐ½Ð¸ÑÐ¼Ð¸ Ð² Ð°ÐºÑƒÑˆÐµÑ€ÑÐºÐ¸Ñ… ÑÑ‚Ð°Ñ†Ð¸Ð¾Ð½Ð°Ñ€Ð°Ñ…, Ñ‡Ñ‚Ð¾Ð±Ñ‹ Ð¿Ñ€ÐµÐ²ÐµÐ½Ñ‚Ð¸Ð²Ð½Ð¾ Ð¾Ñ‚Ñ€ÐµÐ°Ð³Ð¸Ñ€Ð¾Ð²Ð°Ñ‚ÑŒ Ð½Ð° Ð²ÐµÑ€Ð¾ÑÑ‚Ð½ÑƒÑŽ Ð²Ð¾Ð»Ð½Ñƒ Ñ€Ð¾ÑÑ‚Ð° Ð·Ð°Ð±Ð¾Ð»ÐµÐ²Ð°ÐµÐ¼Ð¾ÑÑ‚Ð¸ Ð¸ Ð½Ð¾ÑÐ¸Ñ‚ÐµÐ»ÑŒÑÑ‚Ð²Ð° COVID-19


Superspreaders and the spread pattern of COVID-19: Response to: "Do superspreaders generate new superspreaders? A hypothesis to explain the propagation pattern of COVID-19", International Journal of Infectious Diseases 96 (2020) 461-463


title: Recommendations on Management of Locally Advanced Rectal Cancer During the COVID-19 Pandemic: an Iranian Consensus

text: PURPOSE: Today, the rapid outbreak of COVID-19 is the leading health issue. Patients with cancer are at high risk for the development of morbidities of COVID-19. Hence, oncology centers need to provide organ-based recommendations for optimal management of cancer in the COVID-19 era. METHODS: In this article, we have provided the recommendations on management of locally advanced rectal cancer during the COVID-19 pandemic based on our experience in Shohada-e Tajrish Hospital, Iran. RESULTS: We recommend that patients with locally advanced rectal cancer should be managed in an individualized manner in combination with local conditions related to COVID-19. CONCLUSION: Our recommendation may provide a guide for oncology centers of developing countries for better management of locally advanced rectal cancer.


title: [Analysis on the theory and clinical ideas of acupuncture and moxibustion for the prevention and treatment of coronavirus disease 2019]

text: Acupuncture and moxibustion has a wealth of experience in the prevention and control of epidemic disease since ancient times, which was used for all kinds of acute infectious diseases in modern times and its efficacy has been clearly and reliably reported. This article proposes the theoretical feasibility and reliability of acupuncture and moxibustion interventional prevention and treatment by discussing the recognition of coronavirus disease 2019 (COVID-19) from the perspective of acupuncture and moxibustion. The unique "acupuncture and moxibustion program" for COVID-19 is presented including treatment in different stages, selecting acupoints by distinguishing meridians, applying needle technique by various methods. The article also proposes a new understanding of acupuncture and moxibustion at related acupoints on the surface of the body that can directly affect the "moyuan" to treat the disease.


Transforming graduate nursing education during an era of social distancing: Tools from the field


title: Coswara -- A Database of Breathing, Cough, and Voice Sounds for COVID-19 Diagnosis

text: The COVID-19 pandemic presents global challenges transcending boundaries of country, race, religion, and economy. The current gold standard method for COVID-19 detection is the reverse transcription polymerase chain reaction (RT-PCR) testing. However, this method is expensive, time-consuming, and violates social distancing. Also, as the pandemic is expected to stay for a while, there is a need for an alternate diagnosis tool which overcomes these limitations, and is deployable at a large scale. The prominent symptoms of COVID-19 include cough and breathing difficulties. We foresee that respiratory sounds, when analyzed using machine learning techniques, can provide useful insights, enabling the design of a diagnostic tool. Towards this, the paper presents an early effort in creating (and analyzing) a database, called Coswara, of respiratory sounds, namely, cough, breath, and voice. The sound samples are collected via worldwide crowdsourcing using a website application. The curated dataset is released as open access. As the pandemic is evolving, the data collection and analysis is a work in progress. We believe that insights from analysis of Coswara can be effective in enabling sound based technology solutions for point-of-care diagnosis of respiratory infection, and in the near future this can help to diagnose COVID-19.


docid: mmvcfsth

title: Response to Kim et al. re: "Exosomes Derived from Bone Marrow Mesenchymal Stem Cells as Treatment for Severe COVID-19"


title: The Emerging Threat of (Micro)Thrombosis in COVID-19 and Its Therapeutic Implications

text: The recent emergence of SARS-CoV-2 and the ensuing global pandemic has presented a health emergency of unprecedented magnitude. Recent clinical data has highlighted that COVID-19 is associated with a significant risk of thrombotic complications ranging from microvascular thrombosis, venous thromboembolic disease and stroke. Importantly, thrombotic complications are markers of severe COVID-19 and are associated with multi-organ failure and increased mortality. The evidence to date supports the concept that the thrombotic manifestations of severe COVID-19 is due to the ability of SARS-CoV-2 to invade endo¬thelial cells via angiotensin-converting enzyme 2 (ACE2), which is expressed on the endothelial cell surface. However, in patients with COVID-19 the subsequent endothelial inflammation, complement activation, thrombin generation, platelet and leukocyte recruitment, and the initiation of innate and adaptive immune responses culminate in immunothrombosis, ultimately causing (micro)thrombotic compli¬cations such as deep vein thrombosis, pulmonary embolism and stroke. Accordingly, the activation of coagulation (e.g. as measured with plasma D-dimer) and thrombocytopenia have emerged as prognostic markers in COVID-19. Given thrombotic complications are central determinants of the high mortality rate in COVID-19, strategies to prevent thrombosis are of critical importance. A number of antithrombotic drugs have been proposed as potential therapies to prevent COVID-19-associated thrombosis, including, heparin, FXII inhibitors, fibrinolytic drugs, nafamostat and dipyridamole, many of which also possess pleiotropic anti-inflammatory or anti-viral effects. The growing awareness and mechanistic understanding of the prothrombotic state of COVID-19 patients is driving efforts to more stringent diagnostic screening for thrombotic compli¬cations and to the early institution of antithrombotic drugs, for both the prevention and therapy of thrombotic complications. The shifting paradigm of diagnostic and treatment strategies holds significant promise to reduce the burden of thrombotic complications and ultimately improve the prognosis for patients with COVID-19.


title: [Be alert to superposed effect of seasonal influenza while fighting against novel coronavirus pneumonia]

text: The novel coronavirus pneumonia (NCP) continues to spread throughout the country, and the prevention and control of the epidemic has entered a critical period. However, southern cities with severe outbreaks are about to enter the seasonal influenza season. We should strengthen the epidemiological investigation, optimize the laboratory testing strategy, take effective measures, strengthen the prevention and control of influenza epidemic, and minimize the interference to the new coronavirus epidemic.


Pandemia por COVID-19: el mayor reto de la historia del intensivismo./ Pandemia por COVID-19: el mayor reto de la historia del intensivismo./ COVID-19 Pandemic: the greatest challenge in the history of critical care


Vertical Transmission of SARS-CoV-2: What is the Optimal Definition?


The potential danger of suboptimal antibody responses in COVID-19


title: Osteoporosis in the age of COVID-19

text: As the world grapples with the crisis of COVID-19, established economies and healthcare systems have been brought to their knees. Tough decisions regarding redirection of resources away from the management of conditions deemed "nonessential" are being made. How can we balance urgent resourcing of our acute crisis while not abandoning the real need of patients with osteoporosis? This article offers a few practical solutions.


title: Detecting fake news for the new coronavirus by reasoning on the Covid-19 ontology

text: In the context of the Covid-19 pandemic, many were quick to spread deceptive information. I investigate here how reasoning in Description Logics (DLs) can detect inconsistencies between trusted medical sources and not trusted ones. The not-trusted information comes in natural language (e.g."Covid-19 affects only the elderly"). To automatically convert into DLs, I used the FRED converter. Reasoning in Description Logics is then performed with the Racer tool.


title: CORDITE: The Curated CORona Drug InTERactions Database for SARS-CoV-2

text: Since the outbreak in 2019, researchers are trying to find effective drugs against the SARS-CoV-2 virus based on de novo drug design and drug repurposing. The former approach is very time consuming and needs extensive testing in humans, whereas drug repurposing is more promising, as the drugs have already been tested for side effects, etc. At present, there is no treatment for COVID-19 that is clinically effective, but there is a huge amount of data from studies that analyze potential drugs. We developed CORDITE to efficiently combine state-of-the-art knowledge on potential drugs and make it accessible to scientists and clinicians. The web interface also provides access to an easy-to-use API that allows a wide use for other software and applications, e.g., for meta-analysis, design of new clinical studies, or simple literature search. CORDITE is currently empowering many scientists across all continents and accelerates research in the knowledge domains of virology and drug design.


Correspondence regarding research letter to the editor by Mathian et al, 'Clinical course of coronavirus disease 2019 (COVID-19) in a series of 17 patients with systemic lupus under long-term treatment with hydroxychloroquine'