title: Host factor prioritization for pan-viral genetic perturbation screens using random intercept models and network propagation

text: Genetic perturbation screens using RNA interference (RNAi) have been conducted successfully to identify host factors that are essential for the life cycle of bacteria or viruses. So far, most published studies identified host factors primarily for single pathogens. Furthermore, often only a small subset of genes, e.g., genes encoding kinases, have been targeted. Identification of host factors on a pan-pathogen level, i.e., genes that are crucial for the replication of a diverse group of pathogens has received relatively little attention, despite the fact that such common host factors would be highly relevant, for instance, for devising broad-spectrum anti-pathogenic drugs. Here, we present a novel two-stage procedure for the identification of host factors involved in the replication of different viruses using a combination of random effects models and Markov random walks on a functional interaction network. We first infer candidate genes by jointly analyzing multiple perturbations screens while at the same time adjusting for high variance inherent in these screens. Subsequently the inferred estimates are spread across a network of functional interactions thereby allowing for the analysis of missing genes in the biological studies, smoothing the effect sizes of previously found host factors, and considering a priori pathway information defined over edges of the network. We applied the procedure to RNAi screening data of four different positive-sense single-stranded RNA viruses, Hepatitis C virus, Chikungunya virus, Dengue virus and Severe acute respiratory syndrome coronavirus, and detected novel host factors, including UBC, PLCG1, and DYRK1B, which are predicted to significantly impact the replication cycles of these viruses. We validated the detected host factors experimentally using pharmacological inhibition and an additional siRNA screen and found that some of the predicted host factors indeed influence the replication of these pathogens.


Vitamin C and coronavirus


docid: vaibbjjp

title: ASE Statement on Protection of Patients and Echocardiography Service Providers During the 2019 Novel Coronavirus Outbreak: Endorsed by the American College of Cardiology


title: The association between D-dimers in COVID-19 patients and mortality remains beset of uncertainties

text: We appreciated the response to our letter from Dr. Zhang and colleagues who actively support D-dimer level at admission as an effective and easy-to-perform laboratory predictor in patients with coronavirus disease 2019 (COVID-19) (1). We congratulate them for the work and thank them for the arguments they have provided. However, we still have many doubts, which observation of the cases we have managed in our university hospital do not dispel.


Practical implementation of COVID-19 patient flags into an antimicrobial stewardship program's prospective review


title: Details of a New Anti-Coronovirus Neutralizing Antibody

text: There’s a lot of work being done on antibodies for the coronavirus and on the protein domains they recognize This of course has bearing both on the idea of monoclonal antibody therapies and for the vaccines that are in development, so let’s have a look at the new data For reference, here’s a background post on some of the proteins that the virus makes and the mutations that have been spotted in them, here’s my post on the basics of antibodies and immunology as relating to the epidemic, with an update here, and here’s my earlier post on monoclonal antibodies as a treatment, now updated with some new items


title: Path Integral Approach to Uncertainties in SIR-type Systems

text: In this paper I show how path integral techniques can be used to put measures on histories in"susceptible-infectious-recovered"(SIR)-type systems. The standard SIR solution emerges as the classical saddle point of the action describing the measure. One can then expand perturbatively around the background solution, and this paper goes on to work out the covariance of fluctuations around the background solution. Using a Green's function type approach, one simply needs to solve additional ordinary differential equations; an explicit matrix inversion is not required. The computed covariance matrix should be useful in the construction of fast likelihoods for fitting the parameters of SIR-type models to data. A comparison of the predictions of the approach to an ensemble of simulations is presented.


title: Overview of The 2019 Novel Coronavirus (2019-nCoV): The Pathogen of Severe Specific Contagious Pneumonia (SSCP)

text: In late December 2019 a previous unidentified coronavirus, currently named as the 2019 novel coronavirus (2019-nCoV), emerged from Wuhan, China and resulted in a formidable outbreak in many cities in China and expanding globally, including Thailand, Republic of Korea, Japan, USA, Philippines, Viet Nam, and our country (as of 2/6/2020 at least 25 countries). The disease is officially named as the Severe Specific Contagious Pneumonia (SSCP) in 1/15/2019 and is a notifiable communicable disease of the 5 category by the Taiwan CDC, the Ministry of Health. SSCP is a potential zoonotic disease with low to moderate (estimated 2-5%) mortality rate. Person-to-person transmission may occur through droplet or contact transmission and jeopardized first-line healthcare workers if lack of stringent infection control or no proper personal protective equipment available. Currently, there is no definite treatment for SSCP although some drugs are under investigation. To promptly identify patients and prevent further spreading, physicians should be aware of travel or contact history for patients with compatible symptoms.


COVID-19: another infectious disease emerging at the animal-human interface


How to operationalise human rights for COVID-19 measures


title: Computational Design of ACE2-Based Peptide Inhibitors of SARS-CoV-2

text: Peptide inhibitors against the SARS-CoV-2 coronavirus, currently causing a worldwide pandemic, are designed and simulated. The inhibitors are mostly formed by two sequential self-supporting α-helices (bundle) extracted from the protease domain (PD) of angiotensin-converting enzyme 2 (ACE2), which bind to the SARS-CoV-2 receptor binding domains. Molecular dynamics simulations revealed that the α-helical peptides maintain their secondary structure and provide a highly specific and stable binding (blocking) to SARS-CoV-2. To provide a multivalent binding to the SARS-CoV-2 receptors, many such peptides could be attached to the surfaces of nanoparticle carriers. The proposed peptide inhibitors could provide simple and efficient therapeutics against the COVID-19 disease.


Frontline fighters: the continued fight against COVID-19


title: COVID-19: Disease, management, treatment, and social impact

text: COVID-19 was originated from Wuhan city of Hubei Province in China in December 2019. Since then it has spread in more than 210 countries and territories. It is a viral disease due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus. The patients show flu-like symptoms with a dry cough, sore throat, high fever, and breathing problems. The disease due to SARS-CoV-2 was named as COVID-19. About 2.2 million people have been infected with more than 0.15 million deaths globally. The United States of America is the most affected country with the highest patients of about 0.7 million. Despite great efforts, there is no treatment of this disease. However, prevention and management are the best options. This article describes SARS-CoV-2, disease, prevention and management, treatment and social impact on society. It was analyzed that a combination of antiviral drugs with hydroxyl-chloroquine and azithromycin (with the consultation of a medical practitioner) may be the best option to treat the patients, depending on the patient's conditions and symptoms. However, Unani therapy may be useful along with allopathic treatment. It is urgently advised and requested that all the persons should follow the preventive measures, managements and quarantine strictly without any religious discrepancy otherwise the situation may be the worst. Also, there is an urgent requirement to educate our new generation for science and technology to fight against any such disaster in future; if any. There is no need to be panic and proper prevention and management are essential to combat this disease. This article may be useful to create awareness among the public, to prevent, manage and treat COVID-19.


title: Monitoring and Management of Home-Quarantined Patients With COVID-19 Using a WeChat-Based Telemedicine System: Retrospective Cohort Study

text: BACKGROUND: Most patients with coronavirus disease (COVID-19) who show mild symptoms are sent home by physicians to recover. However, the condition of some of these patients becomes severe or critical as the disease progresses. OBJECTIVE: The aim of this study was to evaluate a telemedicine model that was developed to address the challenges of treating patients with progressive COVID-19 who are home-quarantined and shortages in the medical workforce. METHODS: A telemedicine system was developed to continuously monitor the progression of home-quarantined patients with COVID-19. The system was built based on a popular social media smartphone app called WeChat; the app was used to establish two-way communication between a multidisciplinary team consisting of 7 medical workers and 188 home-quarantined individuals (including 74 confirmed patients with COVID-19). The system helped patients self-assess their conditions and update the multidisciplinary team through a telemedicine form stored on a cloud service, based on which the multidisciplinary team made treatment decisions. We evaluated this telemedicine system via a single-center retrospective study conducted at Tongji Hospital in Wuhan, China, in January 2020. RESULTS: Among 188 individuals using the telemedicine system, 114 (60.6%) were not infected with COVID-19 and were dismissed. Of the 74 confirmed patients with COVID-19, 26 (35%) recovered during the study period and voluntarily stopped using the system. The remaining 48/76 confirmed patients with COVID-19 (63%) used the system until the end of the study, including 6 patients whose conditions progressed to severe or critical. These 6 patients were admitted to hospital and were stabilized (one received extracorporeal membrane oxygenation support for 17 days). All 74 patients with COVID-19 eventually recovered. Through a comparison of the monitored symptoms between hospitalized and nonhospitalized patients, we found prolonged persistence and deterioration of fever, dyspnea, lack of strength, and muscle soreness to be diagnostic of need for hospitalization. CONCLUSIONS: By continuously monitoring the changes in several key symptoms, the telemedicine system reduces the risks of delayed hospitalization due to disease progression for patients with COVID-19 quarantined at home. The system uses a set of scales for quarantine management assessment that enables patients to self-assess their conditions. The results are useful for medical staff to identify disease progression and, hence, make appropriate and timely treatment decisions. The system requires few staff to manage a large cohort of patients. In addition, the system can solicit help from recovered but self-quarantined medical workers to alleviate shortages in the medical workforce and free healthy medical workers to fight COVID-19 on the front line. Thus, it optimizes the usage of local medical resources and prevents cross-infections among medical workers and patients.


COVID 19 and brain crosstalks


title: COVID-19 pandemic: the first wave - an audit and guidance for paediatric dentistry

text: With the use of newly issued guidelines, King's College Hospital has developed new standard operating procedures specifically for the COVID-19 pandemic. Given the unprecedented nature of the current global pandemic, this paper highlights how paediatric dental emergencies can be managed safely and efficiently, as well as new measures which can help reduce transmission of the virus. Furthermore, an audit of the current paediatric dental emergencies attending the hospital is presented. Seventy-six percent of patients attending met the agreed local criteria for urgent treatment, with the most common presentation being irreversible pulpitis. This highlights the types of cases that practitioners enrolled in urgent dental care centres (UDCs) can expect to encounter and how to effectively manage this challenging group of patients.


Effects of age and sex on recovery from COVID-19: Analysis of 5769 Israeli patients


No significant correlation between ACE Ins/Del genetic polymorphism and COVID-19 infection


title: COVID-19 epidemic: Proposed alternatives in the management of digestive cancers: A French intergroup clinical point of view (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFR)

text: INTRODUCTION: Patients treated for malignancy are considered at risk of severe COVID-19. This exceptional pandemic has affected countries on every level, particularly health systems which are experiencing saturation. Like many countries, France is currently greatly exposed, and a complete reorganization of hospitals is ongoing. We propose here adaptations of diagnostic procedures, therapies and care strategies for patients treated for digestive cancer during the COVID-19 epidemic. METHODS: French societies of gastroenterology and gastrointestinal (GI) oncology carried out this study to answer two main questions that have arisen (i) how can we limit high-risk situations for GI-cancer patients and (ii) how can we limit contact between patients and care centers to decrease patients' risk of contamination while continuing to treat their cancer. All recommendations are graded as experts' agreement according to the level of evidence found in the literature until March 2020. RESULTS: A proposal to adapt treatment strategies was made for the main GI oncology situations. Considering the level of evidence and the heterogeneous progression of the COVID-19 epidemic, all proposals need to be considered by a multidisciplinary team and implemented with patient consent. CONCLUSION: COVID-19 epidemic may significantly affect patients treated for digestive malignancies. Healthcare teams need to consider adapting treatment sequences when feasible and according to the epidemic situation.


Ambulatory management of perianal Crohn's disease during the COVID-19 pandemic


The pandemic of social media panic travels faster than the COVID-19 outbreak


Pathways to COVID-19 'community protection'


[First case of neonate infected with novel coronavirus pneumonia in China]


docid: vgxnkfgz

title: Tocilizumab in the treatment of a critical COVID-19 patient: a case report

text: In December 2019, Coronavirus disease 2019 (COVID-19) emerged in Wuhan and rapidly spread throughout China and the rest of the world. COVID-19 is currently a global pandemic. There are cytokine storms in severe COVID-19 patients. Interleukin-6 plays an important role in cytokine storm. Tocilizumab is a blocker of interleukin-6 receptor, which is likely to become an effective drug for patients with severe COVID-19. Here, we reported a case in which tocilizumab was effective for a critical COVID-19 patient.


CoViD-19, containment and accidents in children's domestic life


Mental Health Status Among Children in Home Confinement During the Coronavirus Disease 2019 Outbreak in Hubei Province, China


A Novel Viral Epidemic Collides with an Ancient Scourge: COVID-19 Associated with Tuberculosis


title: CRISPR-Cas12-based detection of SARS-CoV-2

text: An outbreak of betacoronavirus severe acute respiratory syndrome (SARS)-CoV-2 began in Wuhan, China in December 2019. COVID-19, the disease associated with SARS-CoV-2 infection, rapidly spread to produce a global pandemic. We report development of a rapid (<40 min), easy-to-implement and accurate CRISPR-Cas12-based lateral flow assay for detection of SARS-CoV-2 from respiratory swab RNA extracts. We validated our method using contrived reference samples and clinical samples from patients in the United States, including 36 patients with COVID-19 infection and 42 patients with other viral respiratory infections. Our CRISPR-based DETECTR assay provides a visual and faster alternative to the US Centers for Disease Control and Prevention SARS-CoV-2 real-time RT-PCR assay, with 95% positive predictive agreement and 100% negative predictive agreement.


title: Fatal SARS-CoV-2 infection in a renal transplant recipient

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) caused a pandemic that first discovered in Wuhan, China. While 10% of the patients have asymptomatic infection, 15-20% have lung involvement, 5-10% have multiple organ failure, and macrophage activation syndrome. Chronic respiratory diseases, diabetes mellitus, hypertension, and cancer are risk factors for mortality. Prognosis or optimal treatment strategy for renal transplant recipients in SARS-CoV-2 infection is still unknown. Besides fatal cases, there were also milder case reports. In addition, COVID-19 treatment and the maintenance immunosuppression strategy is still under debate. Antiviral therapies and drug interactions are special topics for these patients. To the best of our knowledge, favipiravir and anti-cytokine treatments have not been previously reported in a kidney transplant recipient with SARS-CoV-2 infection before. We report a case of SARS-CoV-2 infection in a kidney transplant recipient with fatal outcomes.


title: Black Lives in a Pandemic: Implications of Systemic Injustice for End-of-Life Care

text: In recent months, Covid-19 has devastated African American communities across the nation, and a Minneapolis police officer murdered George Floyd. The agents of death may be novel, but the phenomena of long-standing epidemics of premature black death and of police violence are not. This essay argues that racial health and health care disparities, rooted as they are in systemic injustice, ought to carry far more weight in clinical ethics than they generally do. In particular, this essay examines palliative and end-of-life care for African Americans, highlighting the ways in which American medicine, like American society, has breached trust. In the experience of many African American patients struggling against terminal illness, health care providers have denied them a say in their own medical decision-making. In the midst of the Covid-19 pandemic, African Americans have once again been denied a say with regard to the rationing of scarce medical resources such as ventilators, in that dominant and ostensibly race-neutral algorithms sacrifice black lives. Is there such thing as a "good" or "dignified" death when African Americans are dying not merely of Covid-19 but of structural racism?


ACE2 Receptor Expression in Testes: Implications in COVID-19 Pathogenesis


title: Diagnosis and management of the drug hypersensitivity reactions in Coronavirus disease 19

text: Coronavirus disease 2019 (COVID-19), a respiratory tract infection caused by a novel human coronavirus, the severe acute respiratory syndrome coronavirus 2, leads to a wide spectrum of clinical manifestations ranging from asymptomatic cases to patients with mild and severe symptoms, with or without pneumonia. Given the huge influence caused by the overwhelming COVID-19 pandemic affecting over three million people worldwide, a wide spectrum of drugs is considered for the treatment in the concept of repurposing and off-label use. There is no knowledge about the diagnosis and clinical management of the drug hypersensitivity reactions that can potentially occur during the disease. This review brings together all the published information about the diagnosis and management of drug hypersensitivity reactions due to current and candidate off-label drugs and highlights relevant recommendations. Furthermore, it gathers all the dermatologic manifestations reported during the disease for guiding the clinicians to establish a better differential diagnosis of drug hypersensitivity reactions in the course of the disease.


Some thoughts on COVID-19


title: Liver transplantation and COVID-19 (Coronavirus) infection: guidelines of the liver transplant Society of India (LTSI)

text: The Liver Transplant Society of India (LTSI) has come up with guidelines for transplant centres across the country to deal with liver transplantation during this evolving pandemic of COVID-19 infection. The guidelines are applicable to both deceased donor as well as living donor liver transplants. In view of the rapidly changing situation of COVID-19 infection in India and worldwide, these guidelines will need to be updated according to the emerging data.


title: An Epidemiological Modelling Approach for Covid19 via Data Assimilation

text: The global pandemic of the 2019-nCov requires the evaluation of policy interventions to mitigate future social and economic costs of quarantine measures worldwide. We propose an epidemiological model for forecasting and policy evaluation which incorporates new data in real-time through variational data assimilation. We analyze and discuss infection rates in China, the US and Italy. In particular, we develop a custom compartmental SIR model fit to variables related to the epidemic in Chinese cities, named SITR model. We compare and discuss model results which conducts updates as new observations become available. A hybrid data assimilation approach is applied to make results robust to initial conditions. We use the model to do inference on infection numbers as well as parameters such as the disease transmissibility rate or the rate of recovery. The parameterisation of the model is parsimonious and extendable, allowing for the incorporation of additional data and parameters of interest. This allows for scalability and the extension of the model to other locations or the adaption of novel data sources.


title: Endovascular simulation as a supplemental training tool during the COVID-19 national emergency

text: The ongoing COVID pandemic raises many concerns as our healthcare system is pushed to its limits and as a consequence, Interventional Radiology training may be compromised. Endovascular simulators allow trainees many benefits to build and maintain endovascular skills in a safe environment. Our experience demonstrates a methodology to maintain IR training with use of didactic and simulation supplementation during the COVID-19 pandemic, which may be helpful for incorporation at other institutions facing similar challenges.


A patient with SARS-CoV-2 infection during pregnancy in Qingdao, China


Covid-19: Brazil's president rallies supporters against social distancing


title: Immune environment modulation in pneumonia patients caused by coronavirus: SARS-CoV, MERS-CoV and SARS-CoV-2

text: Currently, we are on a global pandemic of Coronavirus disease-2019 (COVID-19) which causes fever, dry cough, fatigue and acute respiratory distress syndrome (ARDS) that may ultimately lead to the death of the infected. Current researches on COVID-19 continue to highlight the necessity for further understanding the virus-host synergies. In this study, we have highlighted the key cytokines induced by coronavirus infections. We have demonstrated that genes coding interleukins (Il-1α, Il-1ß, Il-6, Il-10), chemokine (Ccl2, Ccl3, Ccl5, Ccl10), and interferon (Ifn-α2, Ifn-ß1, Ifn2) upsurge significantly which in line with the elevated infiltration of T cells, NK cells and monocytes in SARS-Cov treated group at 24 hours. Also, interleukins (IL-6, IL-23α, IL-10, IL-7, IL-1α, IL-1ß) and interferon (IFN-α2, IFN2, IFN-Î³) have increased dramatically in MERS-Cov at 24 hours. A similar cytokine profile showed the cytokine storm served a critical role in the infection process. Subsequent investigation of 463 patients with COVID-19 disease revealed the decreased amount of total lymphocytes, CD3+, CD4+, and CD8+ T lymphocytes in the severe type patients which indicated COVID-19 can impose hard blows on human lymphocyte resulting in lethal pneumonia. Thus, taking control of changes in immune factors could be critical in the treatment of COVID-19.


[Expert consensus on the use of corticosteroid in patients with 2019-nCoV pneumonia]


title: COVID-19 cytokine storm: The anger of inflammation

text: Patients with COVID-19 who require ICU admission might have the cytokine storm. It is a state of out-of-control release of a variety of inflammatory cytokines. The molecular mechanism of the cytokine storm has not been explored extensively yet. The attachment of SARS-CoV-2 spike glycoprotein with angiotensin-converting enzyme 2 (ACE2), as its cellular receptor, triggers complex molecular events that leads to hyperinflammation. Four molecular axes that may be involved in SARS-CoV-2 driven inflammatory cytokine overproduction are addressed in this work. The virus-mediated down-regulation of ACE2 causes a burst of inflammatory cytokine release through dysregulation of the renin-angiotensin-aldosterone system (ACE/angiotensin II/AT1R axis), attenuation of Mas receptor (ACE2/MasR axis), increased activation of [des-Arg9]-bradykinin (ACE2/bradykinin B1R/DABK axis), and activation of the complement system including C5a and C5b-9 components. The molecular clarification of these axes will elucidate an array of therapeutic strategies to confront the cytokine storm in order to prevent and treat COVID-19 associated acute respiratory distress syndrome.


title: The effects of social deprivation on adolescent development and mental health

text: Adolescence (the stage between 10 and 24 years) is a period of life characterised by heightened sensitivity to social stimuli and the increased need for peer interaction. The physical distancing measures mandated globally to contain the spread of COVID-19 are radically reducing adolescents' opportunities to engage in face-to-face social contact outside their household. In this interdisciplinary Viewpoint, we describe literature from a variety of domains that highlight how social deprivation in adolescence might have far-reaching consequences. Human studies have shown the importance of peer acceptance and peer influence in adolescence. Animal research has shown that social deprivation and isolation have unique effects on brain and behaviour in adolescence compared with other stages of life. However, the decrease in adolescent face-to-face contact might be less detrimental due to widespread access to digital forms of social interaction through technologies such as social media. The findings reviewed highlight how physical distancing might have a disproportionate effect on an age group for whom peer interaction is a vital aspect of development.


What should we ask patients with epilepsy on telemedicine during the COVID-19 crisis? A checklist for clinicians


Aggregated mobility data could help fight COVID-19


title: Rechtsfragen der Ressourcenzuteilung in der COVID-19-Pandemie  Zwischen Utilitarismus und Lebenswertindifferenz./ [Legal Issues of Resource Allocation in the COVID-19 Pandemic - Between Utilitarianism and Life Value Indifference]

text: The COVID-19 pandemic poses unprecedented challenges for the German health care system. What is already the case in some other countries, may occur in Germany in the near future also: Faced with limited ICU resources, doctors will be forced to decide which patients to treat and which to let die. This paper examines the legal implications of such decisions. It takes up arguments from the general discussion on prioritization in medicine. A constitutional hurdle for the application of utilitarian criteria (in particular patients' age or social role) comes from the principle that every human life is of equal value and must not be traded off against others ("life value indifference"). However, the limits that the Grundgesetz (German Basic Law) sets for state actions do not apply directly to doctors. According to the Musterberufsordnung (professional code of conduct), doctors act based on their conscience and the requirements of medical ethics and humanity. The implications of this normative standard for the prioritizing in an exceptional situation as the COVID 19 pandemic have not been sufficiently clarified. This uncertainty leads to emotional and moral burdens for doctors. The authors conclude that the German law grants a limited freedom of choice that allows physicians to apply utilitarian criteria in addition to purely medical decision algorithms.


title: Correction to: Esophageal Function Tests are Not Associated with Barium Swallow Findings in Advanced Lung Disease

text: The original version of this article unfortunately contained a mistake. The shared first authorship information was missing in the published article. It has been given below. The first authorship is shared between Dr. Shai Posner and Kurren Mehta.


Pandemia COVID-19. Un nuevo desafío para los servicios de farmacia hospitalaria./ COVID-19 Pandemic. New challenge for hospital pharmacy services


Reply: Practical experiences on the prevention and treatment strategies to fight against COVID-19 in hospital


Characteristics of ischaemic stroke associated with COVID-19


Immunology with Pam - lockdown silver lining


Thoracic Anesthesia in the COVID-19 Era


title: DNA vaccine protection against SARS-CoV-2 in rhesus macaques

text: The global COVID-19 pandemic caused by the SARS-CoV-2 virus has made the development of a vaccine a top biomedical priority. In this study, we developed a series of DNA vaccine candidates expressing different forms of the SARS-CoV-2 Spike (S) protein and evaluated them in 35 rhesus macaques. Vaccinated animals developed humoral and cellular immune responses, including neutralizing antibody titers comparable to those found in convalescent humans and macaques infected with SARS-CoV-2. Following vaccination, all animals were challenged with SARS-CoV-2, and the vaccine encoding the full-length S protein resulted in >3.1 and >3.7 log10 reductions in median viral loads in bronchoalveolar lavage and nasal mucosa, respectively, as compared with sham controls. Vaccine-elicited neutralizing antibody titers correlated with protective efficacy, suggesting an immune correlate of protection. These data demonstrate vaccine protection against SARS-CoV-2 in nonhuman primates.


Taipei Azalea - Supraglottic airways (SGA) preassembled with high-efficiency particulate air (HEPA) filters to simplify prehospital airway management for patients with out-of-hospital cardiac arrests (OHCA) during Coronavirus Disease 2019 (COVID-19) pandemic


SARS-CoV-2 vaccination-A plea for fast and coordinated action


docid: nwqwchui

title: Interleukin-1 receptor antagonist anakinra in association with remdesivir in severe Coronavirus disease 2019: A case report

text: We report the first successful treatment with the IL-1 receptor antagonist anakinra, in association with the most promising and available antiviral therapy, of a severe case of novel coronavirus disease 2019 (COVID-19). We describe the diagnosis, clinical course, and management of the case, including the respiratory failure at presentation, the progression to a scenario characterized by profound inflammatory dysregulation similar to that observed during macrophage activation syndrome, and the clinical improvement after treatment with the IL-1 receptor antagonist anakinra. This case highlights the high tolerability and the interesting immunomodulatory profile of the IL-1 receptor antagonist anakinra in the setting of severe COVID-19 associated with remdesivir therapy. Further studies are needed to confirm the safety and efficacy of this combination strategy in the treatment of this emerging infection.


No Detectable Surge in SARS-CoV-2 Transmission Attributable to the April 7, 2020 Wisconsin Election


text: The April 7, 2020, Wisconsin election produced a large natural experiment to help understand the transmission risks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of April 14, 2020, 1 551 711 total votes were cast (https://bit.ly/2yWPhlF),1 and 1 138 491 absentee ballots were returned as of April 21, 2020,1 suggesting that approximately 413 220 people voted in person. Waiting times in Milwaukee averaged 1.5 to 2 hours.2 Poll workers had surgical masks and latex gloves, hand sanitizer was made available to voters, isopropyl alcohol wipes were used to clean voting equipment, and painting tape and signs were used to facilitate social distancing.1 (Am J Public Health. Published online ahead of print June 18, 2020: e1-e2. doi:10.2105/AJPH.2020.305770).


Association of asthma and its genetic predisposition with the risk of severe COVID-19


docid: ibycqqes

title: COVIDGR dataset and COVID-SDNet methodology for predicting COVID-19 based on Chest X-Ray images

text: Currently, Coronavirus disease (COVID-19), one of the most infectious diseases in the 21st century, is diagnosed using RT-PCR testing, CT scans and/or Chest X-Ray (CXR) images. CT (Computed Tomography) scanners and RT-PCR testing are not available in most medical centers and hence in many cases CXR images become the most time/cost effective tool for assisting clinicians in making decisions. Deep learning neural networks have a great potential for building triage systems for detecting COVID-19 patients, especially patients with low severity. Unfortunately, current databases do not allow building such systems as they are highly heterogeneous and biased towards severe cases. This paper is three-fold: (i) we demystify the high sensitivities achieved by most recent COVID-19 classification models, (ii) under a close collaboration with Hospital Universitario Cl\'inico San Cecilio, Granada, Spain, we built COVIDGR-1.0, a homogeneous and balanced database that includes all levels of severity, from Normal with positive RT-PCR, Mild, Moderate to Severe. COVIDGR-1.0 contains 377 positive and 377 negative PA (PosteroAnterior) CXR views and (iii) we propose COVID Smart Data based Network (COVID-SDNet) methodology for improving the generalization capacity of COVID-classification models. Our approach reaches good and stable results with an accuracy of $97.37\% \pm 1.86 \%$, $88.14\% \pm 2.02\%$, $66.5\% \pm 8.04\%$ in severe, moderate and mild COVID severity levels. Our approach could help in the early detection of COVID-19. COVIDGR-1.0 dataset will be made available after the review process.


title: Bioinformatic analysis and identification of single-stranded RNA sequences recognized by TLR7/8 in the SARS-CoV-2, SARS-CoV, and MERS-CoV genomes

text: During virus infection, host toll-like receptors (TLRs) can recognize different pathogen-associated molecular patterns and trigger the innate immune response. TLR7/8 can identify the single-stranded RNA (ssRNA) of the virus. This study aimed to search ssRNA sequences recognized by TLR7/8 from the SARS-CoV-2, SARS-CoV, and MERS-CoV whole genomes by a bioinformatic technique. The immunoinformatic approach showed that the SARS-CoV-2 genome has more ssRNA fragments that could be recognized by TLR7/8 than the SARS-CoV genome. These findings suggest innate immune hyperactivation by SARS-CoV-2. This activity is possibly able to provoke a robust proinflammatory response via TLR7/8 recognition and cause acute lung injury.


docid: dlpoqoly

title: Social prescribing: a 'natural' community-based solution

text: This paper discusses social prescribing as part of the wider NHS England universal personalised care model, and it describes how community nurses can engage with social prescribing systems to support community resilience. A case study based on the example of gardening, as a nature-based social prescription provided by the RHS Bridgewater Wellbeing Garden, is provided to illustrate the scope, reach and impact of non-medical, salutogenic approaches for community practitioners. The authors argue that social prescribing and, in particular, nature-based solutions, such as gardening, can be used as a non-medical asset-based approach by all health professionals working in the community as a way to promote health and wellbeing. They consider how the negative impact of social distancing resulting from COVID-19 restrictions could be diluted through collaboration between a holistic, social prescribing system and community staff. The paper presents a unique perspective on how community nurses can collaborate with link workers through social prescribing to help combat social isolation and anxiety and support resilience.


Mental Health Care During and After the ICU: A Call to Action


title: Simulating synergies between climate change adaptation and disaster risk reduction stakeholders to improve management of transboundary disasters in Europe

text: Natural hazards and climate-related disasters disregard political borders, where additional barriers can complicate mitigation, response and recovery efforts within and between the sectors of Climate Change Adaptation (CCA) and Disaster Risk Reduction (DRR). The ESPREssO Project (Enhancing Synergies for Disaster Prevention in the European Union) aims to improve management of transboundary disasters by encouraging closer synergies between the CCA and DRR communities. Using targeted stakeholder interviews, questionnaires, Think Tank discussions and purpose-built serious games, ESPREssO draws on both CCA and DRR stakeholder experiences and informed perspectives in order to identify current gaps. Set within a fictitious border zone, ESPREssO's RAMSETE II serious game challenges CCA and DRR stakeholders in making coordinated decisions before, during and after a simulated disaster, in protection of population and critical infrastructure. Results highlight the essential role of local governance mechanisms as the sharp end of the policy wedge, with current examples of proactivity that require to be championed and supported at national level in order to thrive. These good practice examples reflect the fact that transboundary settings, despite their challenges, act as fertile ground for mutual growth, offering opportunities for CCA and DRR communities to find innovative ways to cooperate and unite in developing synergies and strengthening their mutual efforts towards resilience. Stakeholders emphasise a need to invest more resources in informal cooperation and call on policy makers to recognise that each border zone raises its own unique set of complex challenges that requires flexibility and special consideration by transboundary authorities in management of disasters.


Coronaviruses: Facts, Myths, and Hypotheses


Characteristics and outcomes of Behçet's syndrome patients with Coronavirus Disease 2019: a case series of 10 patients


title: The psychological impact of COVID-19 on the mental health in the general population

text: As a result of the emergence of coronavirus disease 2019 (COVID-19) outbreak caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Chinese city of Wuhan, a situation of socio-economic crisis and profound psychological distress rapidly occurred worldwide. Various psychological problems and important consequences in terms of mental health including stress, anxiety, depression, frustration, uncertainty during COVID-19 outbreak emerged progressively. This work aimed to comprehensively review the current literature about the impact of COVID-19 infection on the mental health in the general population. The psychological impact of quarantine related to COVID-19 infection has been additionally documented together with the most relevant psychological reactions in the general population related to COVID-19 outbreak. The role of risk and protective factors against the potential to develop psychiatric disorders in vulnerable individuals has been addressed as well. The main implications of the present findings have been discussed.


title: Evaluation of safety, efficacy, tolerability, and treatment-related outcomes of type I interferons for human coronaviruses (HCoVs) infection in clinical practice: An updated critical systematic review and meta-analysis

text: BACKGROUND: There is no vaccine or specific antiviral treatment for HCoVs infection. The use of type I interferons for coronavirus is still under great debate in clinical practice. MATERIALS AND METHODS: A literature search of all relevant studies published on PubMed, Cochrane library, Web of Science database, Science Direct, Wanfang Data, and China National Knowledge Infrastructure (CNKI) until February 2020 was performed. RESULTS: Of the 1081 identified articles, only 15 studies were included in the final analysis. Comorbidities and delay in diagnosis were significantly associated with case mortality. Type I interferons seem to improve respiratory distress, relieve lung abnormalities, present better saturation, reduce needs for supplemental oxygen support. Type I interferons seem to be well tolerated, and don't increase life threating adverse effects. Data on IFNs in HCoVs are limited, heterogenous and mainly observational. CONCLUSIONS: Current data do not allow making regarding robust commendations for the use of IFNs in HCoVs in general or in specific subtype. But we still recommend type I interferons serving as first-line antivirals in HCoVs infections within local protocols, and interferons may be adopted to the treatments of the SARS-CoV-2 as well. Well-designed large-scale prospective randomized control trials are greatly needed to provide more robust evidence on this topic.


title: Neurological complications in patients with SARS-CoV-2 infection: a systematic review

text: BACKGROUND: As the COVID-19 pandemic unfolds worldwide, different forms of reports have described its neurologic manifestations. OBJECTIVE: To review the literature on neurological complications of SARS-CoV-2 infection. METHODS: Literature search performed following systematic reviews guidelines, using specific keywords based on the COVID-19 neurological complications described up to May 10th, 2020. RESULTS: A total of 43 articles were selected, including data ranging from common, non-specific symptoms, such as hyposmia and myalgia, to more complex and life-threatening conditions, such as cerebrovascular diseases, encephalopathies, and Guillain-Barré syndrome. CONCLUSION: Recognition of neurological manifestations of SARS-CoV-2 should be emphasized despite the obvious challenges faced by clinicians caring for critical patients who are often sedated and presenting other concurrent systemic complications.


title: Using IL-2R/lymphocytes for predicting the clinical progression of patients with COVID-19

text: Effective laboratory markers for the estimation of disease severity and predicting the clinical progression of coronavirus disease-2019 (COVID-19) is urgently needed. Laboratory tests, including blood routine, cytokine profiles and infection markers, were collected from 389 confirmed COVID-19 patients. The included patients were classified into mild (n = 168), severe (n = 169) and critical groups (n = 52). The leukocytes, neutrophils, infection biomarkers [such as C-reactive protein (CRP), procalcitonin (PCT) and ferritin] and the concentrations of cytokines [interleukin (IL)-2R, IL-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α] were significantly increased, while lymphocytes were significantly decreased with increased severity of illness. The amount of IL-2R was positively correlated with the other cytokines and negatively correlated with lymphocyte number. The ratio of IL-2R to lymphocytes was found to be remarkably increased in severe and critical patients. IL-2R/lymphocytes were superior compared with other markers for the identification of COVID-19 with critical illness, not only from mild but also from severe illness. Moreover, the cytokine profiles and IL-2R/lymphocytes were significantly decreased in recovered patients, but further increased in disease-deteriorated patients, which might be correlated with the outcome of COVID-19. Lymphopenia and increased levels of cytokines were closely associated with disease severity. The IL-2R/lymphocyte was a prominent biomarker for early identification of severe COVID-19 and predicting the clinical progression of the disease.


docid: vptqgbbf

title: COVID-19, a viral endocrinological disease?


title: Chest computed tomography for severe acute respiratory syndrome coronavirus 2 infection screening for COVID-19 before emergency and elective upper endoscopy: a pilot study

text: The SARS-CoV-2 virus has spread worldwide and may present as an asymptomatic or subclinical infection1 . Upper gastrointestinal endoscopy is associated with a high risk of the coronavirus disease 2019 (COVID-19) owing to aerosol generation2 . Chest computed tomography (CT) can be undertaken in general clinical facilities and is as accurate in COVID-19 diagnosis as real-time reverse transcription-polymerase chain reaction (RT-PCR)3 . In April 2020, 31 patients underwent urgent or elective esophagogastroduodenoscopy at our institution. Among those, 21 patients experienced chest CT. None had fever, respiratory symptoms, or olfactory abnormalities. Patient characteristics are shown in Table 1. CT revealed possible COVID-19 findings in two patients (Figure 1A, 1B), and the endoscopic procedure was postponed. The first patient underwent RT-PCR twice, and the second patient also underwent LAMP test twice, all examinations showed negative results.


title: Blockchain-Based Healthcare Workflow for Tele-Medical Laboratory in Federated Hospital IoT Clouds

text: In a pandemic situation such as that we are living at the time of writing of this paper due to the Covid-19 virus, the need of tele-healthcare service becomes dramatically fundamental to reduce the movement of patients, thence reducing the risk of infection. Leveraging the recent Cloud computing and Internet of Things (IoT) technologies, this paper aims at proposing a tele-medical laboratory service where clinical exams are performed on patients directly in a hospital by technicians through IoT medical devices and results are automatically sent via the hospital Cloud to doctors of federated hospitals for validation and/or consultation. In particular, we discuss a distributed scenario where nurses, technicians and medical doctors belonging to different hospitals cooperate through their federated hospital Clouds to form a virtual health team able to carry out a healthcare workflow in secure fashion leveraging the intrinsic security features of the Blockchain technology. In particular, both public and hybrid Blockchain scenarios are discussed and assessed using the Ethereum platform.


title: COVID-19: lessons to date from China

text: The pandemic due to a novel coronavirus has been sweeping across different regions of the globe since January 2020. Early reports of this infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) consisted of mostly adult patients. As the outbreak spreads rapidly beyond the epicentre of Wuhan, it becomes clear that infants and children of all ages are susceptible to this infection. In China, there have been more than 1200 paediatric cases. Most paediatric patients acquire the infection through household contact with infected adults. The disease in children is usually self-limiting and most infected children will recover uneventfully within 7-10 days. Other than symptoms of the respiratory tract, many children may present with gastrointestinal symptoms. Older children are more likely to have asymptomatic infection. Although deaths related to SARS-CoV-2 are rarely reported in the paediatric age group, young children and those with underlying medical conditions are more likely to develop severe illness. Only a small fraction of neonates born to infected mother would acquire the virus by vertical transmission. Because a large proportion of children and adolescents may have asymptomatic or mildly symptomatic infection, children are likely to play an important role in community transmission of this infection. Screening of children who have a definitive contact history will facilitate early diagnosis and isolation of all infected children. This review summarises the lessons learned in China with regard to the current understanding of SARS-CoV-2 infection in the paediatric population.


title: Determining depression and related factors in a society affected by COVID-19 pandemic

text: BACKGROUND: Turkey has one of the highest death rates in the world due to COVID-19 pandemic. The pandemic caused anxiety and depression in individuals. However, there is insufficient information on the effects of COVID-19 on individuals and their coping methods. Therefore, mental problems associated with the pandemic need to be evaluated rapidly. AIMS: This study was carried out to determine depression levels and related factors in a society affected by COVID-19. METHOD: The study was planned using a descriptive cross-sectional design. The study started 2 weeks after the first diagnosis of COVID-19 in Turkey and was carried out between March 23 and April 3, 2020. The study included 1115 adult participants who were between 18 and 65 years of age and were citizens of the Turkish Republic. The study was carried out using online questionnaires, and data were collected with the Personal Information Form and the Beck Depression Inventory. The data were evaluated using IBM SPSS Statistics, version 20 software program. RESULTS: The depression scores of female participants who were between 18 and 29 years of age, single, students, and had less income than their expenses were found to be higher than others. People who experienced fear of being infected and infecting others, had a cleaning obsession, anxiety about the future, sadness, and anxiousness experienced depression at lower levels when compared to other participants. Participants who had to change their place of residence during the quarantine, experienced loneliness, fear of death, hopelessness, sleep problems, felt useless and worthless, started to smoke and drink alcohol, and experienced depression at moderate levels. Depression scores of those who spent time with their family, made time for themselves, were busy with home education or work were lower compared to others. CONCLUSION: The COVID-19 pandemic caused mild-level depression in the Turkish society.


title: Prediction Regions for Poisson and Over-Dispersed Poisson Regression Models with Applications to Forecasting Number of Deaths during the COVID-19 Pandemic

text: Motivated by the current Coronavirus Disease (COVID-19) pandemic, which is due to the SARS-CoV-2 virus, and the important problem of forecasting daily deaths and cumulative deaths, this paper examines the construction of prediction regions or intervals under the Poisson regression model and for an over-dispersed Poisson regression model. For the Poisson regression model, several prediction regions are developed and their performance are compared through simulation studies. The methods are applied to the problem of forecasting daily and cumulative deaths in the United States (US) due to COVID-19. To examine their performance relative to what actually happened, daily deaths data until May 15th were used to forecast cumulative deaths by June 1st. It was observed that there is over-dispersion in the observed data relative to the Poisson regression model. An over-dispersed Poisson regression model is therefore proposed. This new model builds on frailty ideas in Survival Analysis and over-dispersion is quantified through an additional parameter. The Poisson regression model is a hidden model in this over-dispersed Poisson regression model and obtains as a limiting case when the over-dispersion parameter increases to infinity. A prediction region for the cumulative number of US deaths due to COVID-19 by July 16th, given the data until July 2nd, is presented. Finally, the paper discusses limitations of proposed procedures and mentions open research problems, as well as the dangers and pitfalls when forecasting on a long horizon, with focus on this pandemic where events, both foreseen and unforeseen, could have huge impacts on point predictions and prediction regions.


title: Polish Society of Gynecology and Obstetrics statement on safety measures and performance of ultrasound examinations in obstetrics and gynecology during the SARS-CoV-2 pandemic

text: We present recommendations on performance and safety measures of ultrasound examinations in obstetrics and gynecology during the SARS COV-2 pandemic. The statement was prepared based on the current knowledge on the coronavirus by the Ultrasound Section of the Polish Society of Obstetrics and Gynecology. It has to be noted that the presented guidance is based on limited evidence and is primarily based on experiences published by authors from areas most affected by the virus thus far, such as China, Singapore, Hong Kong, and Italy. We realize that the pandemic situation is very dynamic. New data is published every day. Despite the imposed limitations related to the necessity of social distancing, it is crucial to remember that providing optimal care in safe conditions should remain the primary goal of healthcare providers. We plan to update the current guidelines as the situation develops.


Gangrenous cholecystitis during hospitalization for SARS-CoV2 infection


title: Structures of Human Antibodies Bound to SARS-CoV-2 Spike Reveal Common Epitopes and Recurrent Features of Antibodies

text: Neutralizing antibody responses to coronaviruses mainly target the receptor-binding domain (RBD) of the trimeric spike. Here, we characterized polyclonal immunoglobulin Gs (IgGs) and Fabs from COVID-19 convalescent individuals for recognition of coronavirus spikes. Plasma IgGs differed in their focus on RBD epitopes, recognition of alpha- and beta-coronaviruses, and contributions of avidity to increased binding/neutralization of IgGs over Fabs. Using electron microscopy, we examined specificities of polyclonal plasma Fabs, revealing recognition of both S1A and RBD epitopes on SARS-CoV-2 spike. Moreover, a 3.4 Å cryo-electron microscopy (cryo-EM) structure of a neutralizing monoclonal Fab-spike complex revealed an epitope that blocks ACE2 receptor binding. Modeling based on these structures suggested different potentials for inter-spike crosslinking by IgGs on viruses, and characterized IgGs would not be affected by identified SARS-CoV-2 spike mutations. Overall, our studies structurally define a recurrent anti-SARS-CoV-2 antibody class derived from VH3-53/VH3-66 and similarity to a SARS-CoV VH3-30 antibody, providing criteria for evaluating vaccine-elicited antibodies.


title: When patients refuse COVID-19 testing, quarantine, and social distancing in inpatient psychiatry: clinical and ethical challenges

text: The COVID-19 pandemic has introduced new ethical challenges in the care of patients with serious psychiatric illness who require inpatient treatment and who may have beeen exposed to COVID-19 or have mild to moderate COVID-19 but refuse testing and adherence to infection prevention protocols. Such situations increase the risk of infection to other patients and staff on psychiatric inpatient units. We discuss medical and ethical considerations for navigating this dilemma and offer a set of policy recommendations.


title: Infection and Rapid Transmission of SARS-CoV-2 in Ferrets

text: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China and rapidly spread worldwide. To prevent SARS-CoV-2 dissemination, understanding the in vivo characteristics of SARS-CoV-2 is a high priority. We report a ferret model of SARS-CoV-2 infection and transmission that recapitulates aspects of human disease. SARS-CoV-2-infected ferrets exhibit elevated body temperatures and virus replication. Although fatalities were not observed, SARS-CoV-2-infected ferrets shed virus in nasal washes, saliva, urine, and feces up to 8 days post-infection. At 2 days post-contact, SARS-CoV-2 was detected in all naive direct contact ferrets. Furthermore, a few naive indirect contact ferrets were positive for viral RNA, suggesting airborne transmission. Viral antigens were detected in nasal turbinate, trachea, lungs, and intestine with acute bronchiolitis present in infected lungs. Thus, ferrets represent an infection and transmission animal model of COVID-19 that may facilitate development of SARS-CoV-2 therapeutics and vaccines.


Anosmia in COVID-19 patients


COVID-19 screening of health-care workers in a London maternity hospital


title: Morfologia da bolsa cloacal de emas, Rhea americana americana Linnaeus, 1758/ Morphology of rhea's cloacal bursa, Rhea americana americana Linnaeus, 1758

text: A bolsa cloacal é o órgão das aves responsável pela maturação e transferência de linfócitos para outros tecidos. Apesar da importância deste órgão nos mecanismos imunológicos desses animais, são escassas as informações a respeito de sua morfologia em emas. Neste estudo, objetivou-se descrever o desenvolvimento morfológico da bolsa cloacal de emas jovens. Utilizou-se 12 animais de ambos os sexos (6 machos e 6 fêmeas) para a microscopia de luz, eletrônica de transmissão e varredura. Microscopicamente, a bolsa cloacal da ema apresentou, em todas as idades a mucosa interna pregueada composta por lóbulos linfoides de diversos tamanhos, organizados como estrutura alveolar. Em cada prega verificou-se quatro componentes histológicos: as camadas mucosa, submucosa, muscular e adventícia. Esses lóbulos eram compostos de uma zona cortical, uma zona corticomedular e uma zona medular. Verificou-se a existência de linfócitos de tamanhos variados, linfoblastos, capilares sanguíneos, células reticulares epiteliais e macrófagos. Pela microscopia eletrônica de varredura, verificou-se que a superfície da mucosa dos lóbulos bursais apresentaram projeções poligonais, com a presença de curtas microvilosidades em toda a superfície. A comparação nas idades de 0 e 15 semanas de vida demostrou o desenvolvimento dos lóbulos bursais. O padrão morfológico da bolsa cloacal de emas difere do padrão comumente reportado para outras aves tais como pato selvagem, galinha da angola, ganso nativo, peru, codorna japonesa e falcão.(AU)


COVID-19: A Singapore Orthopedic Resident's Musings in the Emergency Department


title: Mielodisplasia na peritonite infecciosa felina: 16 casos (2000-2017)/ Myelodysplasia in feline infectious peritonitis: 16 cases (2000-2017)

text: Apesar da prevalência da peritonite infecciosa felina (PIF) ser alta em praticamente o mundo todo, estudos anatomopatológicos recentes acerca dessa doença são escassos. Não obstante, as características microscópicas da medula óssea de gatos com PIF estão ausentes da literatura consultada. O objetivo deste artigo é descrever alterações medulares ósseas vistas em casos espontâneos de PIF. As medulas ósseas colhidas sistematicamente da região diafisária dos fêmures de 16 gatos necropsiados no Laboratório de Patologia Veterinária (LPV) da Universidade Federal de Santa Maria (UFSM), Rio Grande do Sul, entre janeiro de 2000 e junho de 2017, e que tiveram diagnóstico definitivo de PIF, foram avaliadas fenotípica (histopatologia - hematoxilina e eosina e histoquímica - reação de Perls) e imunofenotipicamente (utilizando marcadores mieloides (anti-MAC387) e de linfócitos (anti-CD79αcy e anti-CD3). Os resultados permitem afirmar que, independentemente da apresentação clinicopatológica da doença ocorrem as seguintes alterações: 1) hiperplasia mieloide; 2) hipoplasia eritroide, 3) displasia megacariocítica (dismegacariocitopoiese) e 4) plasmocitose medular. Exclusivamente nos casos de PIF seca há hemossiderose medular óssea e hepática. Essas alterações permitem estabelecer que gatos com PIF desenvolvem mielodisplasia, uma lesão mieloproliferativa muito semelhante àquela relatada em humanos infectados pelo HIV. Sugere-se que a partir dos achados aqui descritos, a mielodisplasia seja considerada a principal responsável pelas alterações hematológicas observadas na PIF, especialmente pela anemia e trombocitopenia arregenerativas frequentemente desenvolvidas pelos pacientes com essa doença.(AU)


title: Characterization of children younger than 5 Years of age with severe community-acquired alveolar pneumonia (CAAP) requiring Pediatric Intensive Care Unit (PICU) admission

text: BACKGROUND: The purpose of this study was to determine factors characterizing children admitted to the Pediatric Intensive Care Unit (PICU) with community-acquired alveolar pneumonia (CAAP) to help clinicians assess disease severity upon initial assessment in the emergency department. METHODS: We prospectively collected demographic, clinical, and laboratory data of children <5 years with radiologically confirmed CAAP referred to the Soroka University Medical Center during 2001-2011. Three groups of children were compared: 1) those hospitalized in the PICU (PICU-CAAP); 2) those treated in the emergency department and discharged (ED-CAAP); and 3) those hospitalized in a pediatric ward (Hosp-CAAP). RESULTS: Of 9722 CAAP episodes, 367 (3.8%) were PICU-CAAP, 5552 (57.1%) Hosp-CAAP and 3803 (39.1%) ED-CAAP. In a univariate analysis, respiratory syncytial virus (RSV) was detected more commonly among PICU-CAAP than in Hosp-CAAP (P = 0.02) and ED-CAAP patients (P < 0.001). In a multivariate analysis, several factors were associated with PICU hospitalization versus ED-CAAP and Hosp-CAAP: Younger age (ORs: 1.04, [95%CI: 1.02-1.05] and 0.97 [0.96-0.98], respectively); prematurity (ORs: 2.16 [1.28-3.64] and 1.61 [1.15-2.26], respectively), lower O2 saturation (ORs: 1.32 [1.25-1.41] and 0.94[0.92-0.96]), higher respiratory rate (ORs: 1.06 [1.04-1.07] and 1.00 [1-1.01], respectively). CONCLUSION: Children admitted to PICU were younger, had more respiratory syncytial virus (RSV) detection, were premature, had lower O2 saturation, and had a higher respiratory rate than those admitted to the general ward or those visiting the emergency department and subsequently discharged.


title: Obesity is the comorbidity more strongly associated for Covid-19 in Mexico. A case-control study

text: Some comorbidities are associated with severe coronavirus disease (Covid-19) but it is unclear whether some increase susceptibility to Covid-19. In this case-control Mexican study we found that obesity represents the strongest predictor for Covid-19 followed by diabetes and hypertension in both sexes and chronic renal failure in females only. Active smoking was associated with decreased odds of Covid-19. These findings indicate that these comorbidities are not only associated with severity of disease but also predispose for getting Covid-19. Future research is needed to establish the mechanisms involved in each comorbidity and the apparent "protective" effect of cigarette smoking.


title: Health belief model for coronavirus infection risk determinants

text: OBJECTIVE To use the advantages of a ratio scale with verbal anchors in order to measure the risk perception in the novel coronavirus infection, which causes covid-19, in a health belief model-based questionnaire, as well as its validity and reproducibility. METHOD We used the health belief model, which explores four dimensions: perceived susceptibility (five questions), perceived severity (five questions), perceived benefits (five questions), and perceived barriers (five questions). Additionally, we included a fifth dimension, called pro-health motivation (four questions). The questions composed an electronic questionnaire disseminated by social networks for an one-week period. Answers were quantitative values of subjective representations, obtained by a psychophysically constructed scale with verbal anchors ratio (CentiMax ® ). Mean time for total filling was 12 minutes (standard deviation = 1.6). RESULTS We obtained 277 complete responses to the form. One was excluded because it belonged to a participant under 18 years old. Reproducibility measures were significant for 22 of the 24 questions in our questionnaire (Cronbach's α = 0.883). Convergent validity was attested by Spearman-Brown's split half reliability coefficient (r = 0.882). Significant differences among groups were more intense in perceived susceptibility and severity dimensions, and less in perceived benefits and barriers. CONCLUSION Our health belief model-based questionnaire using quantitative measures enabled the confirmation of popular beliefs about covid-19 infection risks. The advantage in our approach lays in the possibility of quickly, directly and quantitatively identifying individual belief profiles for each dimension in the questionnaire, serving as a great ally for communication processes and public health education.


title: La batalla contra la enfermedad del Coronavirus 2019 (COVID-19): Manejo de Emergencia y Control de Infecciones en un Departamento de Radiología

text: OBJETIVO: Describir las estrategias, manejo de emergencias y los procedimientos de control de infecciones de nuestro departamento durante el brote de la enfermedad por coronavirus 2019 (COVID-19). MéTODOS: Creamos un equipo de manejo de emergencias. El equipo estableció varias medidas: Reconfiguración del flujo de trabajo en el departamento de radiología, distribución de material de protección personal y adiestramiento del personal, procedimientos para la obtención de imágenes en pacientes sospechosos o confirmados con COVID-19, así como para pacientes sin historial de exposición o síntomas. Aquellos con sospecha o confirmación de COVID-19 fueron escaneados en una unidad dedicada para ello. RESULTADOS: Del 21 de enero del 2020 hasta el 9 de marzo del 2020, 3,083 personas con sospecha o confirmación de COVID-19 recibieron CT de torax. Incluyendo los exámenes iniciales y repetidos, el número total de CT fue 3,340. Como resultado de nuestras medidas de precaución, ninguno de los miembros del personal del departamento de radiología fue infectado con COVID-19. CONCLUSIóN: Las estrategias de planificación y las protecciones adecuadas pueden ayudar a proteger a los pacientes y al personal contra una enfermedad altamente infecciosa. Y a la misma vez ayudar a mantener la capacidad de atender un volumen alto de pacientes.


title: Age-dependent effects in the transmission and control of COVID-19 epidemics

text: The COVID-19 pandemic has shown a markedly low proportion of cases among children1-4. Age disparities in observed cases could be explained by children having lower susceptibility to infection, lower propensity to show clinical symptoms or both. We evaluate these possibilities by fitting an age-structured mathematical model to epidemic data from China, Italy, Japan, Singapore, Canada and South Korea. We estimate that susceptibility to infection in individuals under 20 years of age is approximately half that of adults aged over 20 years, and that clinical symptoms manifest in 21% (95% credible interval: 12-31%) of infections in 10- to 19-year-olds, rising to 69% (57-82%) of infections in people aged over 70 years. Accordingly, we find that interventions aimed at children might have a relatively small impact on reducing SARS-CoV-2 transmission, particularly if the transmissibility of subclinical infections is low. Our age-specific clinical fraction and susceptibility estimates have implications for the expected global burden of COVID-19, as a result of demographic differences across settings. In countries with younger population structures-such as many low-income countries-the expected per capita incidence of clinical cases would be lower than in countries with older population structures, although it is likely that comorbidities in low-income countries will also influence disease severity. Without effective control measures, regions with relatively older populations could see disproportionally more cases of COVID-19, particularly in the later stages of an unmitigated epidemic.


Oral mucosa lesions in COVID-19


title: Oral mucosa lesions in COVID-19

text: SARS-CoV-2 marks a new era in the medical field. The literature has outlined several signs and symptoms of COVID-19 (Lake, 2020), but there are some manifestations not yet confirmed or not entirely described. There have been reported several dermatological conditions associated with COVID-19: rash, urticaria and chickenpox-like vesicles (Recalcati, 2020) and studies on cutaneous manifestations of COVID-19 have been announced (Fernandez-Nieto et al., 2020). The main path of COVID-19 transmission is through droplets (The Chinese Preventive Medicine Association, 2020) from the oral cavity. This is why dental professionals are widely exposed to be infected, but they could also be the first ones to identify SARS-CoV-2 positive patients. Carreras-Presas et al. published a paper presenting three case reports describing oral mucosa vesiculobullous lesions developed by COVID-19 positive or suspected to be positive patients.


docid: xcxbglem

title: COVID-19 and acute myocardial injury: the heart of the matter or an innocent bystander?


Acute kidney injury in SARS-CoV-2 infected patients


title: Managing Urology Consultations During COVID-19 Pandemic: Application of a Structured Care Pathway

text: OBJECTIVE: To describe and evaluate a risk-stratified triage pathway for inpatient urology consultations during the SARS-CoV-2 (COVID-19) pandemic. This pathway seeks to outline a urology patient care strategy that reduces the transmission risk to both healthcare providers and patients, reduces the healthcare burden, and maintains appropriate patient care. MATERIALS AND METHODS: Consultations to the urology service during a 3-week period (March 16 to April 2, 2020) were triaged and managed via one of 3 pathways: Standard, Telemedicine, or High-Risk. Standard consults were in-person consults with non COVID-19 patients, High-Risk consults were in-person consults with COVID-19 positive/suspected patients, and Telemedicine consults were telephonic consults for low-acuity urologic issues in either group of patients. Patient demographics, consultation parameters and consultation outcomes were compared to consultations from the month of March 2019. Categorical variables were compared using Chi-square test and continuous variables using Mann-Whitney U test. A P value <.05 was considered significant. RESULTS: Between March 16 and April 2, 2020, 53 inpatient consultations were performed. By following our triage pathway, a total of 19/53 consultations (35.8%) were performed via Telemedicine with no in-person exposure, 10/53 consultations (18.9%) were High-Risk, in which we strictly controlled the urology team member in-person contact, and the remainder, 24/53 consultations (45.2%), were performed as Standard in-person encounters. COVID-19 associated consultations represented 18/53 (34.0%) of all consultations during this period, and of these, 8/18 (44.4%) were managed successfully via Telemedicine alone. No team member developed COVID-19 infection. CONCLUSION: During the COVID-19 pandemic, most urology consultations can be managed in a patient and physician safety-conscious manner, by implementing a novel triage pathway.


title: A Conjectural Experiment to Observe the Effect of Conditional locked-down in an Epidemic

text: In a pandemic like Covid-19, there are many countries of lower-earning cannot provide a complete locked-down within the duration of the detected case. The locked-down may result in famine throughout the region of underdeveloped countries after the outbreak. So, a conjectural setup of an epidemic has been studied by applying specific period of locked-down (30 days) in 5 different scenarios. The stochastic approach to the SEIR (Susceptible, Exposed, Infected and Recovered) model has been used to evaluate the dynamics and the effects of locked-down. It is observed that there exist a suitable period to apply locked-down where more susceptible escape from the infection. The effect of the early (as soon as the infected case detected) and late (with respect to the estimated peak of detected cases for no locked-down) implementation of the locked-down has also been studied and found that the late implementation of locked-down will take the least time to end the epidemic. The CFR (Case Fatality Rate) has also been found to be varied from 7.55 to 8.02 for all the considered scenarios.


Neumonía bilateral por SARS-CoV2: evolución radiográfica./ Neumonía bilateral por SARS-CoV2: evolución radiográfica./ SARS-CoV2 bilateral pneumonia: chest X-ray evolution


title: Daily Situation Report on Coronavirus disease (COVID-19) in Iran;March 25, 2020

text: After detection of the first confirmed cases of COVID-19 in Iran, the National Committee on COVID-19 Epidemiology in Ministry of Health and Medical Education was established This Committee is official source of gathering, analyzing, and reporting the COVID-19 data in Iran The data of all sources in the country including, medical care monitoring center (MCMC), Hospitals' Information Systems (HIS), Laboratory portal, the data of the center for communicable disease control (MOH), as well as the data from community health centers are integrated and used in this regards This factsheet contain daily situation report on coronavirus disease (covid-19) in Iran;March 25, 2020


title: A joint action in times of pandemic: the German BioImaging recommendations for operating imaging core facilities during the SARS-Cov-2 emergency

text: Operating shared resource laboratories (SRL) in times of pandemic is a challenge for research institutions. In a multi-user, high-turnover working space, the transmission of infectious agents is difficult to control. To address this challenge, imaging core facility managers being members of German BioImaging discussed how shared microscopes could be operated with minimal risk of spreading SARS-CoV-2 between users and staff. Here, we describe the resulting guidelines and explain their rationale, with a focus on separating users in space and time, protective face masks, and keeping surfaces virus-free. These recommendations may prove useful for other types of SRLs.


COVID-19: How do you self-isolate in a refugee camp?


From Containment to Mitigation of COVID-19 in the US


title: Important Steps to Control COVID-19/SARS-CoV-2 Infection

text: Elderly patients are having high mortality rates from COVID-19/SARS-CoV-2 infection compared to younger patients. The SARS-CoV-2 virus uses the ACE2 receptor as the entry point to the host cells. ARBs/ACEIs which are widely used in elderly patients, have been found to be associated with overexpression of ACE2.To decrease the severity of COVID-19 infection, ARB/ACEI should be switched to another class drug not known to cause a rise in ACE2 until the COVID-19 infection subsides. Specific human immunoglobulin can be tried for COVID-19 patients with critical conditions under supervision.


The COVID-19 pandemic is a crisis and opportunity for bipolar disorder


docid: buxtklbx

title: Spotlight on Jails: COVID-19 Mitigation Policies Needed Now


title: The efficacy and safety of Jinhua Qinggan granule (JHQG) in the treatment of coronavirus disease 2019 (COVID-19): A protocol for systematic review and meta analysis

text: BACKGROUND: Currently, the global number of infected novel coronavirus has exceeded 2.6 million and the death toll has exceeded 170,000, but the specific drug for the treatment of COVID-19 has been not appears. In the process of fighting COVID-19 in China, JHQG has been promoted by the Chinese government and widely used in the treatment of COVID-19. The purpose of this study is to systematically evaluate the efficacy and safety of JHQG for COVID-19. METHODS: We are going to search the electronic databases: PubMed, EMBASE, Cochrane library, Web of Science (WOS), Google scholar, China National Knowledge Infrastructure (CNKI), Chinese Biomedical literature Database (CBM), Chinese Scientific and Journal Database (VIP), Wan Fang database (Wanfang) for published clinical trails and search clinical trials register platforms of Chinese Clinical Trial Registry (ChiCTR) and ClinicalTrials.gov (www.ClinicalTrials.gov/) for ongoing trials of Jinhua Qinggan granule for COVID-19. The primary outcomes of the included studies contain Clinical symptom disappearance rate and the secondary outcomes obtain: TCM syndrome scale score, Hamilton anxiety scale score, and adverse events. We will use RevMan V5.3 software to perform the calculations. PRISMA-P checklist was used in writing this report. RESULTS: The study results will be submitted to a peer-reviewed journal for publication. CONCLUSION: This study will provide a high-quality evidence of the efficacy and safety of Jinhua Qinggan granule on patients with COVID-19. PROSPERO REGISTRATION NUMBER: CRD42020181919.


title: Walk-Through Screening Center for COVID-19: an Accessible and Efficient Screening System in a Pandemic Situation

text: With the ongoing novel coronavirus disease 2019 (COVID-19) pandemic, the number of individuals that need to be tested for COVID-19 has been rapidly increasing. A walk-through (WT) screening center using negative pressure booths that is inspired by the biosafety cabinet has been designed and implemented in Korea for easy screening of COVID-19 and for safe and efficient consultation for patients with fever or respiratory symptoms. Here, we present the overall concept, advantages, and limitations of the COVID-19 WT screening center. The WT center increases patient access to the screening clinics and adequately protects healthcare personnel while reducing the consumption of personal protective equipment. It can also increase the number of people tested by 9-10 fold. However, there is a risk of cross-infection at each stage of screening treatment, including the booths, and adverse reactions with disinfection of the booths. These limitations can be overcome using mobile technology and increasing the number of booths to reduce congestion inside the center, reducing booth volume for sufficient and rapid ventilation, and using an effective, harmless, and certified environmental disinfectant. A WT center can be implemented in other institutions and countries and modified depending on local needs to cope with the COVID-19 pandemic.


COVID-19 associated pulmonary thrombosis


title: The Anxiety Status of Chinese Medical Workers During the Epidemic of COVID-19: A Meta-Analysis

text: OBJECTIVE: To analysis the anxiety status of Chinese medical workers during the epidemic of COVID-19 by meta-analysis method. METHODS: CNKI, VIP, WanFang Data, SinoMed, PubMed, Cochrane, EMBASE, MEDLINE, Scopus, Google Scholar and other databases were searched to collect literature on the anxiety status of Chinese medical workers during the epidemic of COVID-19. The retrieval time is from the database construction to 11/03/2020. Meta-analysis was performed on the included articles by using Stata 16.0 software. RESULTS: A total of 7 articles were included, with a total sample size of 7,741 people. Meta-analysis using the random effects model showed that the anxiety score of Chinese medical during the epidemic of COVID-19 was significantly higher than that of the national norm in each study, the difference was statistically significant [SMD (95% CI)=1.145 (0.705-1.584), p<0.001]. CONCLUSION: The anxiety level of Chinese medical workers has increased significantly during the epidemic of COVID-19.


title: "Closed Proportional-Integral-Derivative-Loop Model"Following Control

text: The proportional-integral-derivative (PID) control law is often overlooked as a computational imitation of the critic control in human decision. This paper provides a formulation to remedy this problem. Further, based on the characteristic settling-behaviour of dynamical systems, the"closed PID-loop model"following control (CPLMFC) method is introduced for automatic PID design. Also, a method for closed-loop settling-time identification is provided. The CPLMFC algorithm and some recommended guidelines are given for setting the critic weights of the PID. Finally, two representative case-studies are simulated. Both the theoretical results and simulation results (via performance indices) illustrate that the CPLMFC can guarantee both accurate and stable closed-loop adaptive PID control performance in real-time


title: Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis

text: BACKGROUND: Very little direct evidence exists on use of corticosteroids in patients with coronavirus disease 2019 (COVID-19). Indirect evidence from related conditions must therefore inform inferences regarding benefits and harms. To support a guideline for managing COVID-19, we conducted systematic reviews examining the impact of corticosteroids in COVID-19 and related severe acute respiratory illnesses. METHODS: We searched standard international and Chinese biomedical literature databases and prepublication sources for randomized controlled trials (RCTs) and observational studies comparing corticosteroids versus no corticosteroids in patients with COVID-19, severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS). For acute respiratory distress syndrome (ARDS), influenza and community-acquired pneumonia (CAP), we updated the most recent rigorous systematic review. We conducted random-effects meta-analyses to pool relative risks and then used baseline risk in patients with COVID-19 to generate absolute effects. RESULTS: In ARDS, according to 1 small cohort study in patients with COVID-19 and 7 RCTs in non-COVID-19 populations (risk ratio [RR] 0.72, 95% confidence interval [CI] 0.55 to 0.93, mean difference 17.3% fewer; low-quality evidence), corticosteroids may reduce mortality. In patients with severe COVID-19 but without ARDS, direct evidence from 2 observational studies provided very low-quality evidence of an increase in mortality with corticosteroids (hazard ratio [HR] 2.30, 95% CI 1.00 to 5.29, mean difference 11.9% more), as did observational data from influenza studies. Observational data from SARS and MERS studies provided very low-quality evidence of a small or no reduction in mortality. Randomized controlled trials in CAP suggest that corticosteroids may reduce mortality (RR 0.70, 95% CI 0.50 to 0.98, 3.1% lower; very low-quality evidence), and may increase hyperglycemia. INTERPRETATION: Corticosteroids may reduce mortality for patients with COVID-19 and ARDS. For patients with severe COVID-19 but without ARDS, evidence regarding benefit from different bodies of evidence is inconsistent and of very low quality.


COVID-19 tracheostomy Local Safety Standard for Invasive Procedures (LocSSIP): a single-centre experience


title: Does glycemic control rescue type 2 diabetes patients from COVID-19-related deaths?

text: COVID-19 patients with diabetes are reported to have higher mortality compared with non-diabetic COVID-19 patients. However, recent investigations showed the importance of better glycemic control among diabetes patients to avoid death from COVID-19.


Patient in hospital for over a year must leave for community care, says judge


title: COVID-19: Present and Future Challenges for Dental Practice

text: COVID-19 was declared a pandemic by the World Health Organization, with a high fatality rate that may reach 8%. The disease is caused by SARS-CoV-2 which is one of the coronaviruses. Realizing the severity of outcomes associated with this disease and its high rate of transmission, dentists were instructed by regulatory authorities, such as the American Dental Association, to stop providing treatment to dental patients except those who have emergency complaints. This was mainly for protection of dental healthcare personnel, their families, contacts, and their patients from the transmission of virus, and also to preserve the much-needed supplies of personal protective equipment (PPE). Dentists at all times should competently follow cross-infection control protocols, but particularly during this critical time, they should do their best to decide on the emergency cases that are indicated for dental treatment. Dentists should also be updated on how this pandemic is related to their profession in order to be well oriented and prepared. This overview will address several issues concerned with the COVID-19 pandemic that directly relate to dental practice in terms of prevention, treatment, and orofacial clinical manifestations.


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title: The psychological and cognitive impact of Covid-19 on individuals with neurocognitive impairments: research topics and remote intervention proposals


Sport in the tracks and fields of the corona virus: Critical issues during the exit from lockdown


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title: Impact of the SARS-CoV-2 outbreak on pediatric liver transplant recipients residing in Lombardy, Northern Italy

text: The novel Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) disease (COVID-19) represents an unprecedented public health issue for the general population and for patients with underlying chronic conditions. Compared to adults, children seem to have a milder course of the disease, with very few requiring medical attention.


COVID-19 in a Preterm- Leading to Remodelling of Care


title: COVID-19: a look into the modern age pandemic

text: Aim: COVID-19 presents as a pandemic requiring the utmost attention from the world, especially the healthcare sector. This review intends to discuss the symptoms, prevention, and management carried out related to the coronavirus, while also providing the healthcare provider strategies used by different countries in combating the disease. Subject and methods: This study was conducted over a period of 2 weeks where different sources were used to assess the ongoing situation regarding COVID-19. The data used in this study was verified and collected from authentic sources only. Results: Results show that there is at present no definite cure for the disease and that prevention is the best possible defense at our disposal at the moment. Data reviewed suggests that social distancing and isolation is the best possible option at the moment. Conclusion: This study provides an overview of the developments taking place in response to the pandemic. More research is required, especially in the treatment and prevention of the disease, so that we may progress towards finding a cure as well as creating a vaccine for the COVID-19.


Top EU scientist ousted over plans for coronavirus research


title: International comparison of guidelines for managing neonates at the early phase of the SARS-CoV-2 pandemic

text: BACKGROUND: The COVID-19 pandemic threatens global newborn health. We describe the current state of national and local protocols for managing neonates born to SARS-CoV-2-positive mothers. METHODS: Care providers from neonatal intensive care units on six continents exchanged and compared protocols on the management of neonates born to SARS-CoV-2-positive mothers. Data collection was between March 14 and 21, 2020. We focused on central protocol components, including triaging, hygiene precautions, management at delivery, feeding protocols, and visiting policies. RESULTS: Data from 20 countries were available. Disease burden varied between countries at the time of analysis. In most countries, asymptomatic infants were allowed to stay with the mother and breastfeed with hygiene precautions. We detected discrepancies between national guidance in particular regarding triaging, use of personal protection equipment, viral testing, and visitor policies. Local protocols deviated from national guidance. CONCLUSIONS: At the start of the pandemic, lack of evidence-based guidance on the management of neonates born to SARS-CoV-2-positive mothers has led to ad hoc creation of national and local guidance. Compliance between collaborators to share and discuss protocols was excellent and may lead to more consensus on management, but future guidance should be built on high-level evidence, rather than expert consensus. IMPACT: At the rapid onset of the COVID19 pandemic, all countries presented protocols in place for managing infants at risk of COVID19, with a certain degree of variations among regions.A detailed review of ad hoc guidelines is presented, similarities and differences are highlighted.We provide a broad overview of currently applied recommendations highlighting the need for international context-relevant coordination.


Failure modes and effect analysis to develop transfer protocols in the management of COVID-19 patients


Beneficial impact of Baricitinib in COVID-19 moderate pneumonia; multicentre study


title: Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline

text: PURPOSE: Traditional critical care dogma regarding the benefits of early tracheostomy during invasive ventilation has had to be revisited due to the risk of COVID-19 to patients and healthcare staff. Standard practises that have evolved to minimise the risks associated with tracheostomy must be comprehensively reviewed in light of the numerous potential episodes for aerosol generating procedures. We meet the urgent need for safe practise standards by presenting the experience of two major London teaching hospitals, and synthesise our findings into an evidence-based guideline for multidisciplinary care of the tracheostomy patient. METHODS: This is a narrative review presenting the extensive experience of over 120 patients with tracheostomy, with a pragmatic analysis of currently available evidence for safe tracheostomy care in COVID-19 patients. RESULTS: Tracheostomy care involves many potentially aerosol generating procedures which may pose a risk of viral transmission to staff and patients. We make a series of recommendations to ameliorate this risk through infection control strategies, equipment modification, and individualised decannulation protocols. In addition, we discuss the multidisciplinary collaboration that is absolutely fundamental to safe and effective practise. CONCLUSION: COVID-19 requires a radical rethink of many tenets of tracheostomy care, and controversy continues to exist regarding the optimal techniques to minimise risk to patients and healthcare workers. Safe practise requires a coordinated multidisciplinary team approach to infection control, weaning and decannulation, with integrated processes for continuous prospective data collection and audit.


title: SARS-CoV-2 RNA dependent RNA polymerase (RdRp) targeting: an in silico perspective

text: New treatment against SARS-CoV-2 now is a must. Nowadays, the world encounters a huge health crisis by the COVID-19 viral infection. Nucleotide inhibitors gave a lot of promising results in terms of its efficacy against different viral infections. In this work, molecular modeling, docking, and dynamics simulations are used to build a model for the viral protein RNA-dependent RNA polymerase (RdRp) and test its binding affinity to some clinically approved drugs and drug candidates. Molecular dynamics is used to equilibrate the system upon binding calculations to ensure the successful reproduction of previous results, to include the dynamics of the RdRp, and to understand how it affects the binding. The results show the effectiveness of Sofosbuvir, Ribavirin, Galidesivir, Remdesivir, Favipiravir, Cefuroxime, Tenofovir, and Hydroxychloroquine, in binding to SARS-CoV-2 RdRp. Additionally, Setrobuvir, YAK, and IDX-184, show better results, while four novel IDX-184 derivatives show promising results in attaching to the SARS-CoV-2 RdRp. There is an urgent need to specify drugs that can selectively bind and subsequently inhibit SARS-CoV-2 proteins. The availability of a punch of FDA-approved anti-viral drugs can help us in this mission, aiming to reduce the danger of COVID-19. The compounds 2 and 3 may tightly bind to the SARS-CoV-2 RdRp and so may be successful in the treatment of COVID-19.


Covid-19: MPs call on Public Health England to publish evidence for decision to drop community testing


Viral exanthem in COVID-19, a clinical enigma with biological significance


title: Clinical characteristics of severe acute respiratory syndrome coronavirus 2 reactivation

text: OBJECTIVES: Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. However, limited data was available for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reactivation. This study aimed to evaluate the clinical characteristics of the SARS-CoV-2 reactivation. METHODS: Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for 55 patients with laboratory-confirmed COVID-19 pneumonia (i.e., with throat swab samples that were positive for SARS-CoV-2) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan. 8 to Feb. 10, 2020. RESULTS: All 55 patients had a history of epidemiological exposure to COVID-19, and 5 (9%) patients who discharged from hospital presented with SARS-CoV-2 reactivation. Among the 5 reactivated patients, other symptoms were also observed, including fever, cough, sore throat, and fatigue. One of the 5 patients had progressive lymphopenia (from 1.3 to 0.56â¯×â¯109 cells per L) and progressive neutrophilia (from 4.5 to 18.28â¯×â¯109 cells per L). All 5 reactivated patients presented normal aminotransferase levels. Throat swab samples from the 5 reactivated patients were tested for SARS-CoV-2, indicating all positive for the virus. CONCLUSIONS: Findings from this small group of cases suggested that there was currently evidence for reactivation of SARS-CoV-2 and there might be no specific clinical characteristics to distinguish them.


title: Risk factors for death in 1859 subjects with COVID-19

text: We studied 1859 subjects with confirmed COVID-19 from seven centers in Wuhan 1651 of whom recovered and 208 died. We interrogated diverse covariates for correlations with risk of death from COVID-19. In multi-variable Cox regression analyses increased hazards of in-hospital death were associated with several admission covariates: (1) older age (HR = 1.04; 95% Confidence Interval [CI], 1.03, 1.06 per year increase; P < 0.001); (2) smoking (HR = 1.84 [1.17, 2.92]; P = 0.009); (3) admission temperature per °C increase (HR = 1.32 [1.07, 1.64]; P = 0.009); (4) Log10 neutrophil-to-lymphocyte ratio (NLR; HR = 3.30 [2.10, 5.19]; P < 0.001); (5) platelets per 10 E + 9/L decrease (HR = 0.996 [0.994, 0.998]; P = 0.001); (6) activated partial thromboplastin (aPTT) per second increase (HR = 1.04 [1.02, 1.05]; P < 0.001); (7) Log10 D-dimer per mg/l increase (HR = 3.00 [2.17, 4.16]; P < 0.001); and (8) Log10 serum creatinine per µmol/L increase (HR = 4.55 [2.72, 7.62]; P < 0.001). In piecewise linear regression analyses Log10NLR the interval from ≥0.4 to ≤1.0 was significantly associated with an increased risk of death. Our data identify covariates associated with risk of in hospital death in persons with COVID-19.


Bilateral lower limb weakness: a cerebrovascular consequence of covid-19 or a complication associated with it?


title: A County-level Dataset for Informing the United States' Response to COVID-19

text: As the coronavirus disease 2019 (COVID-19) becomes a global pandemic, policy makers must enact interventions to stop its spread. Data driven approaches might supply information to support the implementation of mitigation and suppression strategies. To facilitate research in this direction, we present a machine-readable dataset that aggregates relevant data from governmental, journalistic, and academic sources on the county level. In addition to county-level time-series data from the JHU CSSE COVID-19 Dashboard, our dataset contains more than 300 variables that summarize population estimates, demographics, ethnicity, housing, education, employment and in come, climate, transit scores, and healthcare system-related metrics. Furthermore, we present aggregated out-of-home activity information for various points of interest for each county, including grocery stores and hospitals, summarizing data from SafeGraph. By collecting these data, as well as providing tools to read them, we hope to aid researchers investigating how the disease spreads and which communities are best able to accommodate stay-at-home mitigation efforts. Our dataset and associated code are available at https://github.com/JieYingWu/COVID-19_US_County-level_Summaries.


Prescribing parenteral nutrition in acute hospital setting during COVID-19: The Singapore experience


title: Providing nutritional care to cancer patients during the COVID-19 pandemic: an Italian perspective

text: The COVID-19 outbreak has drastically changed practices inside hospitals, which include oncology routines. In oncology, malnutrition was and certainly still is a frequent problem associated with an increase in treatment-related toxicity, a reduced response to cancer treatment, an impaired quality of life, and a worse overall prognosis. Even in this situation of healthcare crisis, nutritional support in cancer care is an essential element. During the current COVID-19 pandemic, there is a concrete high risk to see a dramatic worsening of cancer patients' nutritional status, who are left without adequate clinical and nutritional support. The consequences are already reasonably foreseeable and will have a severe negative impact after the emergency. Therefore, we believe that it is essential to try to continue, as far as possible, the activity of clinical nutrition in oncology, by revolutionizing the setting and the approach to patients. For this purpose, the Clinical Nutrition and Dietetics Unit and the Medical Oncology Unit of our hospital, one of the largest community hospital in Lombardy that has been involved in the COVID-19 outbreak management since its inception, have reorganized the clinical routine activity in strict collaboration since the very beginning of the emergency, to better face up to the challenge, while preserving cancer patients' needs.


The 50th anniversary of reverse transcriptase-and its ironic legacy in the time of coronavirus


Social media WeChat infers the development trend of COVID-19


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title: Decreased utilization of mental health emergency service during the COVID-19 pandemic

text: During the rapid rise of the COVID-19 pandemic, a reduction of the numbers of patients presenting to emergency departments has been observed. We present an early study from a German psychiatric hospital to assess the dynamics of mental health emergency service utilization rates during the COVID-19 pandemic. Our results show that the numbers of emergency presentations decreased, and a positive correlation between these numbers and mobility of the general public suggests an impact of extended measures of social distancing. This finding underscores the necessity of raising and sustaining awareness regarding the threat to mental health in the context of the pandemic.