title: Content analysis of Persian/Farsi Tweets during COVID-19 pandemic in Iran using NLP

text: Iran, along with China, South Korea, and Italy was among the countries that were hit hard in the first wave of the COVID-19 spread. Twitter is one of the widely-used online platforms by Iranians inside and abroad for sharing their opinion, thoughts, and feelings about a wide range of issues. In this study, using more than 530,000 original tweets in Persian/Farsi on COVID-19, we analyzed the topics discussed among users, who are mainly Iranians, to gauge and track the response to the pandemic and how it evolved over time. We applied a combination of manual annotation of a random sample of tweets and topic modeling tools to classify the contents and frequency of each category of topics. We identified the top 25 topics among which living experience under home quarantine emerged as a major talking point. We additionally categorized broader content of tweets that shows satire, followed by news, is the dominant tweet type among the Iranian users. While this framework and methodology can be used to track public response to ongoing developments related to COVID-19, a generalization of this framework can become a useful framework to gauge Iranian public reaction to ongoing policy measures or events locally and internationally.


title: Whose life to save? Scarce resources allocation in the COVID-19 outbreak

text: After initially emerging in China, the coronavirus (COVID-19) outbreak has advanced rapidly. The World Health Organization (WHO) has recently declared it a pandemic, with Europe becoming its new epicentre. Italy has so far been the most severely hit European country and demand for critical care in the northern region currently exceeds its supply. This raises significant ethical concerns, among which is the allocation of scarce resources. Professionals are considering the prioritisation of patients most likely to survive over those with remote chances, and this news has triggered an intense debate about the right of every individual to access healthcare. The proposed analysis suggests that the national emergency framework in which prioritisation criteria are currently enforced should not lead us to perceive scarce resources allocation as something new. From an ethical perspective, the novelty of the current emergency is not grounded in the devastating effects of scarce resources allocation, which is rife in recent and present clinical practice. Rather, it has to do with the extraordinarily high number of people who find themselves personally affected by the implications of scarce resources allocation and who suddenly realise that the principle of 'equals should be treated equally' may no longer be applicable. Along with the need to allocate appropriate additional financial resources to support the healthcare system, and thus to mitigate the scarcity of resources, the analysis insists on the relevance of a medical ethics perspective that does not place the burden of care and choice solely on physicians.


Protocol for the development of a rapid advice guideline for prevention, management and care of children with 2019 novel coronavirus infection


title: COVID-19 and your rheumatology patients

text: The COVID-19 pandemic has caused a sense of unease in the rheumatology community about the risk to patients with immune-mediated diseases, given their predisposition to infection due to underlying disease states and immunosuppressive therapies. Thus far, there have been few cases of COVID-19 reported in patients with immune-mediated diseases and there have been no formal guidelines released on the management of patients with immune-mediated diseases in the setting of COVID-19. Results of clinical trials and data from the Global Rheumatology Alliance registry are eagerly awaited to gain further insight into the impact of this novel infection on our vulnerable patient population.


title: The changing landscape of SARS-CoV-2: Implications for the maternal-infant dyad

text: The COVID-19 pandemic represents the greatest challenge to date faced by the medical community in the 21st century. The rate of rapid dissemination, magnitude of viral contagiousness, person to person transmission at an asymptomatic phase of illness pose a unique and dangerous challenge for all patients, including neonatal and obstetric patients. Although scientific understanding of the pathophysiology of the disease, nature of transmission, and efficacy of mitigation strategies is growing, neither a cure or vaccine have been developed. While COVID-19 is primarily a disease of older patients, infection is now seen across all age demographics with reports of illness in pregnant patients and infants. Altered hormone status and predominance of Th-2 immune helper cells may result in increased predisposition to SARS-CoV-2. Case reports of pregnant patients demonstrate a clinical presentation comparable to non-pregnant adults, but evidence of vertical transmission to the fetus is controversial. Neonatal reports demonstrate an inconsistent and non-specific phenotype, and it is often difficult to separate COVID-19 from the underlying conditions of prematurity or bacterial infection. The development of international registries to enable risk profiling of COVID-19 positive pregnant mothers and/or their offspring may facilitate the development of enhanced mitigation strategies, medical treatments and effective vaccinations.


Gastrointestinal endoscopy during COVID-19 pandemic


Resuming Elective Orthopaedic Surgery During the COVID-19 Pandemic: Guidelines Developed by the International Consensus Group (ICM)


title: Retina assessment by optical coherence tomography of diabetic dogs/ Avaliação da retina de cães diabéticos pela tomografia de coerência óptica

text: Diabetes mellitus is one of the most common endocrine disorders characterized by relative or absolute lack of insulin; this can lead to several ocular manifestations, among them diabetic retinopathy and cataracts. Diabetic retinopathy (DR) is a microangiopathy that involves retinal precapillary arterioles, postcapillary venules, and large vessels, causing them to be functionally and anatomically incompetent. Hyperglycemia seems to be the most probable cause of damage to the retina due to interference in cellular metabolism and transduction processes. The aim of this study was to evaluate retinal thickness in eight diabetic dogs, four females and four males of different breeds and ages ranging from 6 to 15 years, by optical coherence tomography (OCT) and to compare them with non-diabetic dogs. Assessment provided by OCT in diabetic dogs showed retinal layers thinning and loss of stratification when compared to non-diabetic dogs (198μm versus 219μm respectively), with statistical significance (p=0.008). OCT images may suggest that diabetes mellitus causes retinal neuropathy in dogs, as also seen in diabetic humans.(AU)


Ethics in the time of COVID: What remains the same and what is different


title: Caring for adults with congenital heart disease in the era of Covid-19 pandemic: Early experience in an Italian tertiary centre

text: BACKGROUND: Adults with CHD are known to greatly benefit from a prompt access to continuous expert care. On the other hand, Covid-19 pandemic has determined a dramatic worldwide reconfiguration of the healthcare systems, with rapid redeployment of resources towards this emergency. Italy was the first western country affected by a large-scale spread of Covid-19. The aim of our study is to analyse the impact of the Covid-19 outbreak on in-hospital care of patients with CHD in an Italian tertiary centre. METHODS AND RESULTS: We retrospectively reviewed data on CHD hospital admissions in our centre since March 1st 2020, when the adoption of a strict infection containment policy throughout the country resulted in limited access of patients to routine hospital care and resources reallocation to the care of COVID-19 patients. Comparison with data from the previous year was performed in order to identify any relevant differences attributable to the outbreak. Despite cancellation of all elective procedures, the overall number of urgent hospital admission remained stable throughout the period of study. Patients admitted during the pandemic had greater disease complexity (p=0.001) with longer length on in-hospital stay (p=0.01). No adverse events or positive swabs were reported among CHD patients who were admitted to hospital or medical personnel caring for these patients. CONCLUSION: Data from our early experience suggest that Covid-19 pandemic did not impact significantly on the provision of urgent care to adult patients with CHD.


title: Understanding SARS-CoV-2-Mediated Inflammatory Responses: From Mechanisms to Potential Therapeutic Tools

text: Currently there is no effective antiviral therapy for SARS-CoV-2 infection, which frequently leads to fatal inflammatory responses and acute lung injury. Here, we discuss the various mechanisms of SARS-CoV-mediated inflammation. We also assume that SARS-CoV-2 likely shares similar inflammatory responses. Potential therapeutic tools to reduce SARS-CoV-2-induced inflammatory responses include various methods to block FcR activation. In the absence of a proven clinical FcR blocker, the use of intravenous immunoglobulin to block FcR activation may be a viable option for the urgent treatment of pulmonary inflammation to prevent severe lung injury. Such treatment may also be combined with systemic anti-inflammatory drugs or corticosteroids. However, these strategies, as proposed here, remain to be clinically tested for effectiveness.


Are subpleural consolidations indicators for segmental pulmonary embolism in COVID-19?


title: A Survey on Applications of Artificial Intelligence in Fighting Against COVID-19

text: The COVID-19 pandemic caused by the SARS-CoV-2 virus has spread rapidly worldwide, leading to a global outbreak. Most governments, enterprises, and scientific research institutions are participating in the COVID-19 struggle to curb the spread of the pandemic. As a powerful tool against COVID-19, artificial intelligence (AI) technologies are widely used in combating this pandemic. In this survey, we investigate the main scope and contributions of AI in combating COVID-19 from the aspects of disease detection and diagnosis, virology and pathogenesis, drug and vaccine development, and epidemic and transmission prediction. In addition, we summarize the available data and resources that can be used for AI-based COVID-19 research. Finally, the main challenges and potential directions of AI in fighting against COVID-19 are discussed. Currently, AI mainly focuses on medical image inspection, genomics, drug development, and transmission prediction, and thus AI still has great potential in this field. This survey presents medical and AI researchers with a comprehensive view of the existing and potential applications of AI technology in combating COVID-19 with the goal of inspiring researches to continue to maximize the advantages of AI and big data to fight COVID-19.


docid: voyrbonr

title: Application of Ordinal Logistic Regression Analysis to Identify the Determinants of Illness Severity of COVID-19 in China


Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis


Thinking of Risk in the Era of COVID-19


Application of fluorescence method in the process of personal protective equipment removal


Comment on: Coronavirus Disease 2019 in Geriatrics and Long-Term Care: The ABCDs of COVID-19


COVID-19 Immunity Passport to Ease Travel Restrictions?


title: Naive Forecast for COVID-19 in Utah Based on the South Korea and Italy Models-the Fluctuation between Two Extremes

text: Differences in jurisdictional public health actions have played a significant role in the relative success of local communities in combating and containing the COVID-19 pandemic. We forecast the possible COVID-19 outbreak in one US state (Utah) by applying empirical data from South Korea and Italy, two countries that implemented disparate public health actions. Forecasts were created by aligning the start of the pandemic in Utah with that in South Korea and Italy, getting a short-run forecast based on actual daily rates of spread, and long-run forecast by employing a log-logistic model with four parameters. Applying the South Korea model, the epidemic peak in Utah is 169 cases/day, with epidemic resolution by the end of May. Applying the Italy model, new cases are forecast to exceed 200/day by mid-April, with the potential for 250 new cases a day at the epidemic peak, with the epidemic continuing through the end of August. We identify a 3-month variation in the likely length of the pandemic, a 1.5-fold difference in the number of daily infections at outbreak peak, and a 3-fold difference in the expected cumulative cases when applying the experience of two developed countries in handling this virus to the Utah context.


Analysis of availability, types, and implementation of teledermatology services during COVID-19


How paediatric psycho-oncology is changing during the COVID-19 epidemic in Italy: New approaches


title: The Effect of the COVID-19 Pandemic on Electively Scheduled Hip and Knee Arthroplasty Patients in the United States

text: BACKGROUND: In response to the COVID-19 pandemic, hospitals in the United States were recommended to stop performing elective procedures. This stoppage has led to the cancellation of a large number of hip and knee arthroplasties. The effect of this on patients' physical mental and economic health is unknown. METHODS: A survey was developed by the AAHKS Research Committee to assess pain, anxiety, physical function, and economic ability of patients to undergo a delayed operation. Six institutions conducted the survey to 360 patients who had to have elective hip and knee arthroplasty cancelled between March and July of 2020. RESULTS: Patients were most anxious about the uncertainty of when their operation could be rescheduled. Although 85% of patients understood and agreed with the public health measures to curb infections, almost 90% of patients plan to reschedule as soon as possible. Age and geographic region of the patients affected their anxiety. Younger patients were more likely to have financial concerns and concerns about job security. Patients in the Northeast were more concerned about catching COVID-19 during a future hospitalization. CONCLUSIONS: Patients suffering from the pain of hip and knee arthritis continue to struggle with pain from their end-stage disease. They have anxiety about the COVID-19 pandemic. Few patients feel they will be limited financially and 90% want to have surgery as soon as possible. Age and physical location of the patients affect their causes for anxiety around their future surgery.


Cutaneous hyperesthesia: A novel manifestation of COVID-19


Coronavirus Disease 2019 in Children: An Invisible Threat Which We Cannot Ignore


Hipertensión y COVID-19: cuidados con los manguitos de presión arterial./ [Hypertension and COVID 19: Warnings regarding blood pressure cuffs]


title: Identifying and Interrupting Superspreading Events-Implications for Control of Severe Acute Respiratory Syndrome Coronavirus 2

text: It appears inevitable that severe acute respiratory syndrome coronavirus 2 will continue to spread. Although we still have limited information on the epidemiology of this virus, there have been multiple reports of superspreading events (SSEs), which are associated with both explosive growth early in an outbreak and sustained transmission in later stages. Although SSEs appear to be difficult to predict and therefore difficult to prevent, core public health actions can prevent and reduce the number and impact of SSEs. To prevent and control of SSEs, speed is essential. Prevention and mitigation of SSEs depends, first and foremost, on quickly recognizing and understanding these events, particularly within healthcare settings. Better understanding transmission dynamics associated with SSEs, identifying and mitigating high-risk settings, strict adherence to healthcare infection prevention and control measures, and timely implementation of nonpharmaceutical interventions can help prevent and control severe acute respiratory syndrome coronavirus 2, as well as future infectious disease outbreaks.


title: When is it safe to ease lockdowns?

text: Contact tracing and a low number of new cases are crucial before lifting coronavirus restrictions, reports Jessica Hamzelou.


COVID-19 and Its Impact on Nuclear Medicine


docid: yoqhglde

title: Enhancing workplace learning at the transition into practice. Lessons from a pandemic

text: Taking responsibility for prescribing is one of newly qualified doctors' greatest stressors.1 Despite being a routine task, prescribing insulin is particularly stress-inducing. The global pandemic has made it more important to minimise transitioning students' stress; yet there are fewer clinicians to support their accelerated transitions. We had planned an intervention during 9-week 'Clinical Assistantships' immediately before qualifying. Students would write insulin 'pre-prescriptions', which supervisors would endorse as prescriptions that were appropriate to dispense. A trained healthcare professional or person with diabetes ('debriefer') would conduct one-to-one Case Based discussions (CBDs) to help students learn reflectively from experience.


Enhancing workplace learning at the transition into practice: Lessons from a pandemic


title: Rapid and efficient detection methods of pathogenic swine enteric coronaviruses

text: Porcine enteric coronaviruses (CoVs) cause highly contagious enteric diarrhea in suckling piglets. These COV infections are characterized by clinical signs of vomiting, watery diarrhea, dehydration, and high morbidity and mortality, resulting in significant economic losses and tremendous threats to the pig farming industry worldwide. Because the clinical manifestations of pigs infected by different CoVs are similar, it is difficult to differentiate between the specific pathogens. Effective high-throughput detection methods are powerful tools used in the prevention and control of diseases. The immune system of piglets is not well developed, so serological methods to detect antibodies against these viruses are not suitable for rapid and early detection. This paper reviews various PCR-based methods used for the rapid and efficient detection of these pathogenic CoVs in swine intestines. KEY POINTS: 1. Swine enteric coronaviruses (CoVs) emerged and reemerged in past years. 2. Enteric CoVs infect pigs at all ages with high mortality rate in suckling pigs. 3. Rapid and efficient detection methods are needed and critical for diagnosis.


COVID-19: Needs-led implementation and the immediate potential of remote monitoring


Does hydroxychloroquine combat COVID-19? A timeline of evidence


title: [Pharmaceutical care for severe and critically ill patients with COVID-19]

text: Severe and critically ill patients with coronavirus disease 2019 (COVID-19) were usually with underlying diseases, which led to the problems of complicated drug use, potential drug-drug interactions and medication errors in special patients. Based on Diagnosis and treatment of novel coronavirus pneumonia (trial version 6), and Management of COVID-19: the Zhejiang experience, we summarized the experience in the use of antiviral drugs, corticosteroids, vascular active drugs, antibacterial, probiotics, nutrition support schemes in severe and critically ill COVID-19 patients. It is also suggested to focus on medication management for evaluation of drug efficacy and duration of treatment, prevention and treatment of adverse drug reactions, identification of potential drug-drug interactions, individualized medication monitoring based on biosafety protection, and medication administration for special patients.


2019 Novel Coronavirus-Important Information for Clinicians


Clinical course of COVID-19 in pulmonary arterial hypertension patients


title: High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice - Skagit County, Washington, March 2020

text: On March 17, 2020, a member of a Skagit County, Washington, choir informed Skagit County Public Health (SCPH) that several members of the 122-member choir had become ill. Three persons, two from Skagit County and one from another area, had test results positive for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Another 25 persons had compatible symptoms. SCPH obtained the choir's member list and began an investigation on March 18. Among 61 persons who attended a March 10 choir practice at which one person was known to be symptomatic, 53 cases were identified, including 33 confirmed and 20 probable cases (secondary attack rates of 53.3% among confirmed cases and 86.7% among all cases). Three of the 53 persons who became ill were hospitalized (5.7%), and two died (3.7%). The 2.5-hour singing practice provided several opportunities for droplet and fomite transmission, including members sitting close to one another, sharing snacks, and stacking chairs at the end of the practice. The act of singing, itself, might have contributed to transmission through emission of aerosols, which is affected by loudness of vocalization (1). Certain persons, known as superemitters, who release more aerosol particles during speech than do their peers, might have contributed to this and previously reported COVID-19 superspreading events (2-5). These data demonstrate the high transmissibility of SARS-CoV-2 and the possibility of superemitters contributing to broad transmission in certain unique activities and circumstances. It is recommended that persons avoid face-to-face contact with others, not gather in groups, avoid crowded places, maintain physical distancing of at least 6 feet to reduce transmission, and wear cloth face coverings in public settings where other social distancing measures are difficult to maintain.


Author response to: Ethics for surgeons during the COVID-19 pandemic


title: Gluten-free diet impact on dynamics of pancreatic islet-specific autoimmunity detected at celiac disease diagnosis

text: OBJECTIVE: Almost 6% of celiac disease (CD) patients at diagnosis are positive for at least one of the main pancreatic islet autoantibodies that characterize type 1 diabetes (T1D). Few information, dated back to almost two decades ago, exist as to whether a gluten-free diet (GFD) could reduce the islet-specific autoimmunity detected in patients at CD diagnosis. Aim of the study was to evaluate the impact of GFD on 31 patients who presented islet-specific autoimmunity at CD diagnosis. METHODS: CD patient sera collected at diagnosis and throughout the GFD were analyzed for the main humoral autoantibodies so far identified in T1D, directed against one or more among insulin, glutamic-acid decarboxylase, tyrosine-phosphatase 2 and zinc cation-efflux transporter autoantigens. RESULTS: GFD (median duration 39 months) was associated to a decrease or disappearance of the islet-specific autoantibodies in 71% of CD patients. Almost 80% of the patients who became autoantibody-negative during the GFD were positive for only one of the islet-specific autoimmune markers at CD diagnosis, with none of them developing diabetes. Conversely, 80% of the CD patients positive at diagnosis for ≥2 islet-specific autoantibodies were still positive after more than two years of GFD, with 25% of them developing T1D. CONCLUSIONS: Various factors appear to influence, individually or in combination, the effects of the GFD on pancreatic islet-specific autoimmune response detected at CD diagnosis. These factors include the number of diabetes autoantibodies found at CD diagnosis, the adherence to the GFD, its duration and an asymptomatic clinical presentation of CD. This article is protected by copyright. All rights reserved.


New preventative measures against coronavirus disease 2019 for home care aides in Taiwan


title: COVID-19: Management

text: Coronavirus disease (COVID-19) has grasped the world including Pakistan. Clinical features of this disease are variable, ranging from asymptomatic to critical disease. In this unprecedented global war, the Pakistan Chest Society has written a guideline for quick review for the specialists providing care to suspected or confirmed patients. This review highlights the approach to a patient with COVID-19, including definition of the various syndromes of the disease, the abnormal laboratory parameters and outlines the therapeutic measures which are currently under investigation.


title: COVID-19 in a designated infectious diseases hospital outside Hubei Province, China

text: BACKGROUND: The clinical characteristics of novel coronavirus disease (COVID-2019) patients outside the epicenter of Hubei Province are less understood. METHODS: We analyzed the epidemiological and clinical features of all COVID-2019 cases in the only referral hospital in Shenzhen City, China, from January 11, 2020, to February 6, 2020, and followed until March 6, 2020. RESULTS: Among the 298 confirmed cases, 233 (81.5%) had been to Hubei, while 42 (14%) did not have a clear travel history. Only 218 (73.15%) cases had a fever as the initial symptom. Compared with the nonsevere cases, severe cases were associated with older age, those with underlying diseases, and higher levels of C-reactive protein, interleukin-6, and erythrocyte sedimentation rate. Slower clearance of the virus was associated with a higher risk of progression to critical condition. As of March 6, 2020, 268 (89.9%) patients were discharged and the overall case fatality ratio was 1.0%. CONCLUSIONS: In a designated hospital outside Hubei Province, COVID-2019 patients could be effectively managed by properly using the existing hospital system. Mortality may be lowered when cases are relatively mild, and there are sufficient medical resources to care and treat the disease.


title: Emergency and essential surgical healthcare services during COVID-19 in low- and middle-income countries: A perspective

text: The COVID-19 pandemic resulted in significant changes in health care systems worldwide, with low- and middle-income countries (LMIC) sustaining important repercussions. Specifically, alongside cancellation and postponements of non-essential surgical services, emergency and essential surgical care delivery may become affected due to the shift of human and material resources towards fighting the pandemic. For surgeries that do get carried through, new difficulties arise in protecting surgical personnel from contracting SARS-CoV-2. This scarcity in LMIC surgical ecosystems may result in higher morbidity and mortality, in addition to the COVID-19 toll. This paper aims to explore the potential consequences of COVID-19 on the emergency and essential surgical care in LMICs, to offer recommendations to mitigate damages and to reflect on preparedness for future crises. Reducing the devastating consequences of the COVID-19 pandemic on LMIC emergency and essential surgical services can be achieved through empowering communities with accurate information and knowledge on prevention, optimizing surgical material resources, providing quality training of health care personnel to treat SARS-CoV-2, and ensuring adequate personal protection equipment for workers on the frontline. While LMIC health systems are under larger strain, the experience from previous outbreaks may aid in order to innovate and adapt to the current pandemic. Protecting LMIC surgical ecosystems will be a pivotal process in ensuring that previous health system strengthening efforts are preserved, comprehensive care for populations worldwide are ensured, and to allow for future developments beyond the pandemic.


Where have all the myocardial infarctions gone during lockdown? The answer is blowing in the less-polluted wind


title: Potential anti-viral activity of approved repurposed drug against main protease of SARS-CoV-2: an in silico based approach

text: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which was first reported in Wuhan province of China, has become a deadly pandemic causing alarmingly high morbidity and mortality. In the absence of new targeted drugs and vaccines against SARS-CoV-2 at present, the choices for effective treatments are limited. Therefore, considering the exigency of the situation, we focused on identifying the available approved drugs as potential inhibitor against the promising Coronavirus drug target, the Main Protease, using computer-aided methods. We created a library of U. S. Food and Drug Administration approved anti-microbial drugs and virtually screened it against the available crystal structures of Main Protease of the virus. The study revealed that Viomycin showed the highest -CDocker energy after docking at the active site of SARS-CoV-2 Main Protease. It is noteworthy that Viomycin showed higher -CDocker energy as compared to the drugs currently under clinical trial for SARS-CoV-2 treatment viz. Ritonavir and Lopinavir. Additionally, Viomycin formed higher number of H-bonds with SARS-CoV-2 Main Protease than its co-crystallised inhibitor compound N3. Molecular dynamics simulation further showed that Viomycin embedded deeply inside the binding pocket and formed robust binding with SARS-CoV-2 Main Protease. Therefore, we propose that Viomycin may act as a potential inhibitor of the Main Protease of SARS-CoV-2. Further optimisations with the drug may support the much-needed rapid response to mitigate the pandemic.Communicated by Ramaswamy H. Sarma.


Cancer survivorship care at the time of the COVID-19 pandemic


Investigating the social, economic and political consequences of the COVID-19 pandemic: A rolling cross-section approach Commentary


title: Covid-19 and diabetes mellitus: unveiling the interaction of two pandemics

text: A novel RNA betacoronavirus causing coronavirus disease 2019 (Covid-19) has now been declared pandemic disease by WHO. Guo et al published the first report of biochemical features in patients with diabetes and the further risk that this disease can determine to the progression of Covid-19. Among different cytokines found significantly higher in patients with diabetes compared to those without, Interleukin-6 (IL-6), which is already increased in conditions of chronic inflammation, may play a more deleterious role in Covid-19 infection. Targeting the overexpression of Il-6 effects with a monoclonal antibody against IL-6 receptor or using Janus Kinase inhibitors may be particularly helpful for treatment of Covid-19 pneumonia in diabetes.


COVID-19 testing and patients in mental health facilities


Author response to Letter to the Editor 'Liver impairment associated with disease progression in COVID-19 patients'


docid: onmqyvxu

title: Acute ischemic stroke in a patient with COVID-19


A Cruel COVID-19 Irony


title: Deep Learning for Automatic Pneumonia Detection

text: Pneumonia is the leading cause of death among young children and one of the top mortality causes worldwide. The pneumonia detection is usually performed through examine of chest X-ray radiograph by highly-trained specialists. This process is tedious and often leads to a disagreement between radiologists. Computer-aided diagnosis systems showed the potential for improving diagnostic accuracy. In this work, we develop the computational approach for pneumonia regions detection based on single-shot detectors, squeeze-and-excitation deep convolution neural networks, augmentations and multi-task learning. The proposed approach was evaluated in the context of the Radiological Society of North America Pneumonia Detection Challenge, achieving one of the best results in the challenge.


title: Antibody-based therapies for COVID-19: Can Europe move faster?

text: Michel Goldman and colleagues call on the European medical and scientific community to coordinate efforts on immunotherapy-based approaches to coronavirus.


COVID-2019 and pregnancy: A plea for transparent reporting of all cases


title: A library of nucleotide analogues terminate RNA synthesis catalyzed by polymerases of coronaviruses that cause SARS and COVID-19

text: SARS-CoV-2, a member of the coronavirus family, is responsible for the current COVID-19 worldwide pandemic. We previously demonstrated that five nucleotide analogues inhibit the SARS-CoV-2 RNA-dependent RNA polymerase (RdRp), including the active triphosphate forms of Sofosbuvir, Alovudine, Zidovudine, Tenofovir alafenamide and Emtricitabine. We report here the evaluation of a library of nucleoside triphosphate analogues with a variety of structural and chemical features as inhibitors of the RdRps of SARS-CoV and SARS-CoV-2. These features include modifications on the sugar (2' or 3' modifications, carbocyclic, acyclic, or dideoxynucleotides) or on the base. The goal is to identify nucleotide analogues that not only terminate RNA synthesis catalyzed by these coronavirus RdRps, but also have the potential to resist the viruses' exonuclease activity. We examined these nucleotide analogues for their ability to be incorporated by the RdRps in the polymerase reaction and to prevent further incorporation. While all 11 molecules tested displayed incorporation, 6 exhibited immediate termination of the polymerase reaction (triphosphates of Carbovir, Ganciclovir, Stavudine and Entecavir; 3'-OMe-UTP and Biotin-16-dUTP), 2 showed delayed termination (Cidofovir diphosphate and 2'-OMe-UTP), and 3 did not terminate the polymerase reaction (2'-F-dUTP, 2'-NH2-dUTP and Desthiobiotin-16-UTP). The coronaviruses possess an exonuclease that apparently requires a 2'-OH at the 3'-terminus of the growing RNA strand for proofreading. In this study, all nucleoside triphosphate analogues evaluated form Watson-Crick-like base pairs. The nucleotide analogues demonstrating termination either lack a 2'-OH, have a blocked 2'-OH, or show delayed termination. Thus, these nucleotide analogues are of interest for further investigation to evaluate whether they can evade the viral exonuclease activity. Prodrugs of five of these nucleotide analogues (Cidofovir, Abacavir, Valganciclovir/Ganciclovir, Stavudine and Entecavir) are FDA-approved medications for treatment of other viral infections, and their safety profiles are well established. After demonstrating potency in inhibiting viral replication in cell culture, candidate molecules can be rapidly evaluated as potential therapies for COVID-19.


title: The Role of Children in the Dynamics of Intra Family Coronavirus 2019 Spread in Densely Populated Area

text: We examined the dynamics of coronavirus 2019 (Covid-19) transmission within families. Our investigation demonstrated significantly lower rates of Covid-19 positivity in children compared with adults residing in the same household. Children of 5-17 years of age were 61% and children of 0-4 years of age were 47% less likely to have positive polymerase chain reaction results compared with adults residing in the same household.


docid: vnpjusrf

title: The perspective of surgical residents on current and future training in light of the COVID-19 pandemic


docid: ldgszgzw

title: Post mortem evaluation of spinal cord and protruded intervertebral discs in dogs without neurological abnormalities/ Avaliação post mortem da medula espinhal e de discos intervertebrais protrusos em cães sem alterações neurológicas

text: The aim of this study was to verify the presence of protrusion of the intervertebral disc (IVD) causing compression of the spinal cord and/or roots of cauda equina in 30 dogs above seven years of age with no evidence of previous neurological abnormalities. After the occurrence of death or euthanasia, a laminectomy was performed from C2 to the sacral vertebra to verify the presence of IVD protrusions. The protruded IVD were macroscopically graded according to the Thompson scale, and the corresponding spinal cord segment was histologically analyzed for nervous tissue compression. Of the 30 dogs, twelve (40%) presented disc protrusion, and of these 12 dogs, seven (58%) presented more than one protruded disc. Disc protrusion was observed in 3.2% (25/780) of all IVD evaluated. Of the six chondrodystrophic dogs, five (83%) presented disc protrusion. Of the 24 nonchondrodystrophic dogs, seven (29%) presented IVD protrusion. The site that showed the highest frequency of protrusion was L4-L5 (6/25) followed by the L6-L7 region (3/25) and C6-C7 (3/25). Only two of the medullary segments evaluated showed histological changes, with presence of focal lymphocytic infiltration and multifocal mild hemorrhage in the gray matter. Under the conditions of this study, 40% of dogs older than seven years old showed IVD protrusions without showing neurological signs, with no abnormality of the nervous tissue in 92% of the evaluated segments. Thus, the protrusion of the IVD in some dogs, can only be a finding of no clinical relevance.(AU)


title: Professionally responsible counseling about birth location during the COVID-19 pandemic

text: If the worries about the coronavirus disease 2019 (COVID-19) pandemic are not already enough, some pregnant women have been questioning whether the hospital is a safe or safe enough place to deliver their babies and therefore whether they should deliver out-of-hospital during the pandemic. In the United States, planned out-of-hospital births are associated with significantly increased risks of neonatal morbidity and death. In addition, there are obstetric emergencies during out-of-hospital births that can lead to adverse outcomes, partly because of the delay in transporting the woman to the hospital. In other countries with well-integrated obstetric services and well-trained midwives, the differences in outcomes of planned hospital birth and planned home birth are smaller. Women are empowered to make informed decisions when the obstetrician makes ethically justified recommendations, which is known as directive counseling. Recommendations are ethically justified when the outcomes of one form of management is clinically superior to another. The outcomes of morbidity and mortality and of infection control and prevention of planned hospital birth are clinically superior to those of out-of-hospital birth. The obstetrician therefore should recommend planned hospital birth and recommend against planned out-of-hospital birth during the COVID-19 pandemic. The COVID-19 pandemic has increased stress levels for all patients and even more so for pregnant patients and their families. The response in this difficult time should be to mitigate this stress and empower women to make informed decisions by routinely providing counseling that is evidence-based and directive.


COVID-19 Viral Load of an Infected Family in China


docid: halozxfr

title: Can Hypericum perforatum (SJW) prevent cytokine storm in COVID-19 patients?


Rescue fibrinolysis in suspected massive pulmonary embolism during SARS-CoV-2 pandemic


Images in Practice: Painful Cutaneous Vasculitis in a SARS-Cov-2 IgG-Positive Child


Recurrence of COVID-19 after recovery: a case report from Italy


title: Consensus statement of the Italian society of pediatric allergy and immunology for the pragmatic management of children and adolescents with allergic or immunological diseases during the COVID-19 pandemic

text: The COVID-19 pandemic has surprised the entire population. The world has had to face an unprecedented pandemic. Only, Spanish flu had similar disastrous consequences. As a result, drastic measures (lockdown) have been adopted worldwide. Healthcare service has been overwhelmed by the extraordinary influx of patients, often requiring high intensity of care. Mortality has been associated with severe comorbidities, including chronic diseases. Patients with frailty were, therefore, the victim of the SARS-COV-2 infection. Allergy and asthma are the most prevalent chronic disorders in children and adolescents, so they need careful attention and, if necessary, an adaptation of their regular treatment plans. Fortunately, at present, young people are less suffering from COVID-19, both as incidence and severity. However, any age, including infancy, could be affected by the pandemic.Based on this background, the Italian Society of Pediatric Allergy and Immunology has felt it necessary to provide a Consensus Statement. This expert panel consensus document offers a rationale to help guide decision-making in the management of children and adolescents with allergic or immunologic diseases.


title: Early virus clearance and delayed antibody response in a case of COVID-19 with a history of co-infection with HIV-1 and HCV

text: The effect of host immune status on SARS-CoV-2 infection remains unknown. Here, we report the first case of COVID-19 with HIV-1 and HCV co-infection, who showed a persistently negative SARS-CoV-2 RNA test, but delayed antibody response in the plasma. This case highlights the influence of HIV-1-induced immune dysfunction on the early SARS-CoV-2 clearance.


title: Demographic, clinical, and outcomes of confirmed cases of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in Najran, Kingdom of Saudi Arabia (KSA); A retrospective record based study

text: INTRODUCTION: MERS is caused by a viral infection, which was first identified in KSA, 2012. MERS-CoV infection consequences with either hospitalization or death. METHODS: All positive MERS-CoV cases that diagnosed in and reported to a referral hospital in Najran, KSA from March/2014 to December/2018 were revised retrospectively. We identified patients from infection control department and medical records. Demographic, clinical, and outcome data were collected. RESULTS: Of the 54 positive MERS-CoV cases, 3 cases were excluded because no available data. Therefore, the final number of the included cases in the study was 51 cases (94.4). Most of the patients were Saudi 36 (70.6%), and majority of cases were reported in the winter 18 (35.3) season. Fever 47 (92.2%), cough 44 (86.3%), and shortness of breath 37 (72.5%) were reported as most common symptoms. Most patients had diabetes mellitus and hypertension. Overall mortality rate was 37.3%, and interestingly the mortality rate dropped sharply over 5 years. In logistic regression analysis, Season and Chronic Kidney disease patients were the only two variables statistically significantly associated with death. The odds of death the patients infected by MERS-CoV during Autumn and Winter season were 4.09 times higher than those patients who infected during Spring and Summer season (OR = 4.09, CI 1.18-14.15, P < 0.026). Compared with MERS-CoV patients who had Non-Chronic kidney diseases, the odds of death the MERS-CoV patients who had chronic kidney diseases were 18.08 times higher (OR = 18.08, CI -2.01-162.99, P < 0.01). CONCLUSION: The case fatality rate of MERS-CoV infection was high. Further studies with large sample sizes are needed to explore the reasons behind the decrease in the mortality rate over the time period.


docid: rycxggeh

title: Advice regarding COVID-19 and use of immunomodulators, in patients with severe dermatological diseases


Myocardial injury in patients with COVID-19


Comorbidities and multi-organ injuries in the treatment of COVID-19


title: Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19)

text: BACKGROUND: The role of severe respiratory coronavirus virus 2 (SARS-CoV-2)-laden aerosols in the transmission of coronavirus disease 2019 (COVID-19) remains uncertain. Discordant findings of SARS-CoV-2 RNA in air samples were noted in early reports. METHODS: Sampling of air close to 6 asymptomatic and symptomatic COVID-19 patients with and without surgical masks was performed with sampling devices using sterile gelatin filters. Frequently touched environmental surfaces near 21 patients were swabbed before daily environmental disinfection. The correlation between the viral loads of patients' clinical samples and environmental samples was analyzed. RESULTS: All air samples were negative for SARS-CoV-2 RNA in the 6 patients singly isolated inside airborne infection isolation rooms (AIIRs) with 12 air changes per hour. Of 377 environmental samples near 21 patients, 19 (5.0%) were positive by reverse-transcription polymerase chain reaction (RT-PCR) assay, with a median viral load of 9.2 × 102 copies/mL (range, 1.1 × 102 to 9.4 × 104 copies/mL). The contamination rate was highest on patients' mobile phones (6 of 77, 7.8%), followed by bed rails (4 of 74, 5.4%) and toilet door handles (4 of 76, 5.3%). We detected a significant correlation between viral load ranges in clinical samples and positivity rate of environmental samples (P < .001). CONCLUSION: SARS-CoV-2 RNA was not detectable by air samplers, which suggests that the airborne route is not the predominant mode of transmission of SARS-CoV-2. Wearing a surgical mask, appropriate hand hygiene, and thorough environmental disinfection are sufficient infection control measures for COVID-19 patients isolated singly in AIIRs. However, this conclusion may not apply during aerosol-generating procedures or in cohort wards with large numbers of COVID-19 patients.


title: [Emergency management of prevention and control of the novel coronavirus infection in departments of stomatology]

text: Complying with overall requirements of the government and regulations on public health emergencies, as well as the clinical features of diagnosis and treatment of oral diseases, this article reviews previous guidelines and studies on the infection control in dental practices in China and foreign countries. The emergency management protocol for the prevention and control of COVID-19 has been implemented in Nanjing Stomatological Hospital, which mainly focuses on the implementation of the training programs for dental staff and the infection control project in the hospital environment. This article could be used as a reference for rapid response and emergency management for the prevention and control of COVID-19 in the departments of stomatology.


title: Emergency management of prevention and control of novel coronavirus pneumonia in departments of stomatology/ 中华口腔医学杂志

text: Complying with overall requirements of the government and regulations on public health emergences, as well as the clinical features of diagnosis and treatment of dental illness, this paper refers to previous guidelines and studies on the infection prevention and control in dental diagnosis and treatment in China and foreign countries. Nanjing Stomatological Hospital has implemented the emergency management practices for the prevention and control of novel coronavirus pneumonia (NCP), mainly focusing on the implementation of prevention and control training programs for medical staffs and the infection control projects on the hospital environment. This study could provide reference for rapid response and emergency management for the prevention and control of NCP in the departments of stomatology.


title: Potential for jaktinib hydrochloride to treat cytokine storms in patients with COVID-19

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become a serious public health threat to the whole world, and the number of infected is still rising dramatically at this moment. Several studies have confirmed that cytokine storms play a critical role in causing a case to worsen from mild to severe or critical. The current treatment for cytokine storms is limited, so the international medical community is focusing on a specific and effective remedy. Jaktinib hydrochloride is a broad spectrum JAK inhibitor. It can inhibit cytokine-induced immune activation by multiple mechanisms and also slow viral proliferation by inhibiting AAK1 without causing unacceptable toxicity. Jaktinib hydrochloride has great potential for the treatment of patients with coronavirus disease 2019 (COVID-19).


title: Mental health in the aftermath of COVID-19: A new normal

text: The COVID-19 pandemic with its subsequent mental health consequences has challenged the word view of most people. A genome typically of 26,000-32,000 bases long RNA has shut down the wheel of man made progress. The social isolation after the lock-down has not only led to economic difficulties but also adverse psychological reactions. The most common reaction is stress, anxiety and depression when faced with life-threatening circumstances. People have to deal with the imminent issue of death which is anxiety provoking in itself. This calls for dealing with the immediate mental health consequences with the aide of technological advancements as discussed in this write-up. A new inter-personal ethics need to emerge which is scientifically correct and in-line with age old values.


Comment on "Should anti-diabetic medications be reconsidered amid COVID-19 pandemic?"


title: Echocardiography during the coronavirus disease 2019 (COVID-19) pandemic: expert opinion of the Working Group on Echocardiography of the Polish Cardiac Society

text: Transthoracic and transesophageal echocardiography may be required in patients with coronavirus disease 2019 (COVID19), resulting in direct contact with the patient and risk of transmitting the infection from patients to medical personnel. Therefore, we recommend to perform problemoriented timelimited transthoracic examinations. Whenever possible, examinations should be analyzed offline, outside the isolation zones. Transesophageal echocardiography is considered an aerosolgenerating procedure and should be performed only as a lifesaving procedure. Personnel should use appropriate personal protection equipment in the immediate vicinity of the patients in accordance with the relevant guidelines.


Surgical safety


title: COVID-19: A Geriatric Emergency

text: The older Italian population is posing a challenge in the number of deaths for coronavirus disease 2019 (COVID-19). According to previous data from China, pre-existing health conditions dramatically increase the risk of dying from COVID-19. The presence of multiple diseases in older patients may be considered as a mark of frailty, which increases the person's vulnerability to stress and impairs the multisystemic compensatory effort to restore homeostasis. The clinical complexity associated with the management of frailty may increase the risk of complications during infection as well as the lack of the early recognition of atypical symptoms. There is an urgent need to share expertise and clinical management skills with geriatricians as well as the need for early diagnosis to start treatment at the earliest convenience in the community, with the aim to avoid the collapse of intensive care units.


title: Effectiveness of glucocorticoid therapy in patients with severe coronavirus disease 2019: protocol of a randomized controlled trial

text: BACKGROUND: At the end of 2019, a novel coronavirus outbreak causative organism has been subsequently designated the 2019 novel coronavirus (2019-nCoV). The effectiveness of adjunctive glucocorticoid therapy in the management of 2019-nCoV-infected patients with severe lower respiratory tract infections is not clear, and warrants further investigation. METHODS: The present study will be conducted as an open-labeled, randomized, controlled trial. We will enrol 48 subjects from Chongqing Public Health Medical Center. Each eligible subject will be assigned to an intervention group (methylprednisolone via intravenous injection at a dose of 1-2 mg/kg/day for 3 days) or a control group (no glucocorticoid use) randomly, at a 1:1 ratio. Subjects in both groups will be invited for 28 days of follow-up which will be scheduled at four consecutive visit points. We will use the clinical improvement rate as our primary endpoint. Secondary endpoints include the timing of clinical improvement after intervention, duration of mechanical ventilation, duration of hospitalization, overall incidence of adverse events, as well as rate of adverse events at each visit, and mortality at 2 and 4 weeks. DISCUSSION: The present coronavirus outbreak is the third serious global coronavirus outbreak in the past two decades. Oral and parenteral glucocorticoids have been used in the management of severe respiratory symptoms in coronavirus-infected patients in the past. However, there remains no definitive evidence in the literature for or against the utilization of systemic glucocorticoids in seriously ill patients with coronavirus-related severe respiratory disease, or indeed in other types of severe respiratory disease. In this study, we hope to discover evidence either supporting or opposing the systemic therapeutic administration of glucocorticoids in patients with severe coronavirus disease 2019. TRIAL REGISTRATION: ClinicalTrials.gov, ChiCTR2000029386, http://www.chictr.org.cn/showproj.aspx?proj=48777.


title: Challenges in Preparing and Managing the Critical Care Services for a Large Urban Area During COVID-19 Outbreak: Perspective From Delhi

text: The coronavirus disease-2019 (COVID-19) pandemic has put healthcare services all over the world into a challenging situation. The contagious nature of the disease and the respiratory failure necessitating ventilatory care of these patients have put extra burden on intensive care unit (ICU) services. India has been no exception; by March 2020, the number of COVID-19 patients started increasing in India. This article describes the measures taken and challenges faced in creating ample ICU bed capacity to cater to the anticipated load of patients in the state of Delhi, India, as a result of the COVID-19 pandemic. The main challenges faced, among others, were estimating the number of ICU beds to be created; deciding on dedicated hospitals to treat COVID-19 patients; procuring ventilators, personal protective equipment, and other related material; mobilizing human resources and providing their training; and providing isolated in-house accommodations to the staff on duty. The authors acknowledge and agree that the methodology proposed in this article is but one way of approaching this difficult scenario and that there could be other, perhaps better, methods of dealing with such a problem.


There may be virus in conjunctival secretion of patients with COVID-19


title: Public Health Is Essential: COVID-19's Learnable Moment for Medical Education

text: The COVID-19 pandemic, an unprecedented challenge for this generation of physicians and for the health care system, has re-awakened calls to strengthen the United States' public health systems. This global event is also a "learnable moment" for medical education-an opportunity to decisively incorporate public health, including public health systems, through the continuum of medical education. Although medical educators have made progress in integrating public health content into medical curricula, "public health" is not a phrase that is consistently used in curricular standards, and public health colleagues are not identified as unique and essential partners to improve and protect health. The COVID-19 crisis has demonstrated how a strong public health system is necessary to support the health of patients and populations, as well as the practice of medicine. Partnerships between medical and public health communities, through individual- and population-based interventions, can also more effectively combat more common threats to health, such as chronic diseases, health inequities, and substance abuse.To achieve a more effective medicine-public health relationship in practice, curricula across the continuum of medical education must include explanations of public health systems, the responsibilities of physicians to their local and state governmental public health agencies, and opportunities for collaboration. Medical education should also prepare physicians to advocate for public health policies, programs, and funding in order to improve and protect the health of their patients and communities. Pandemic COVID-19 demonstrates with laser focus that all physicians are part of public health systems, and that public health content has a distinct and critical place across the continuum of medical education to prepare physicians to participate in, collaborate with, and advocate for public health systems.


title: United but divided: Policy responses and people's perceptions in the EU during the COVID-19 outbreak

text: To understand the public sentiment toward the measures used by policymakers for COVID-19 containment, a survey among representative samples of the population in seven European countries was carried out in the first two weeks of April 2020. The study addressed people's support for containment policies, worries about COVID-19 consequences, and trust in sources of information. Citizens were overall satisfied with their government's response to the pandemic; however, the extent of approval differed across countries and policy measures. A north-south divide in public opinion was noticeable across the European states. It was particularly pronounced for intrusive policy measures, such as mobile data use for movement tracking, economic concerns, and trust in the information from the national government. Considerable differences in people's attitudes were noticed within countries, especially across individual regions and age groups. The findings suggest that the epidemic acts as a stressor, causing health and economic anxieties even in households that were not directly affected by the virus. At the same time, the burden of stress was unequally distributed across regions and age groups. Based on the data collected, we draw lessons from the containment stage and identify several insights that can facilitate the design of lockdown exit strategies and future containment policies so that a high level of compliance can be expected.


title: [Diagnostic and therapeutic strategies of lung cancer patients during the outbreak of 2019 novel coronavirus disease (COVID-19)]

text: With the increasing number of cases and widening geographical spread, the 2019 novel coronavirus disease (COVID-19) has been classified as one of the class B infectious diseases but prevented and controlled as class A infectious disease by the National Health Commission of China. The diagnosis and treatment of lung cancer patients have been challenged greatly because of extraordinary public health measures since the lung cancer patients are a high-risk population during the COVID-19 outbreak period. Strict protection for lung cancer patients is needed to avoid infection. Lung cancer patients are difficult to differentiate from patients with COVID-19 in terms of clinical symptoms, which will bring great trouble to the clinical work and physical and mental health of lung cancer patients. This review will demonstrate how to applicate appropriate and individual management for lung cancer patients to protect them from COVID-19.


Higher prevalence of asymptomatic or mild COVID-19 in children, claims and clues


title: Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children

text: Coronaviruses (CoVs) are a large family of enveloped, single-stranded, zoonotic RNA viruses. Four CoVs commonly circulate among humans: HCoV2-229E, -HKU1, -NL63 and -OC43. However, CoVs can rapidly mutate and recombine leading to novel CoVs that can spread from animals to humans. The novel CoVs severe acute respiratory syndrome coronavirus (SARS-CoV) emerged in 2002 and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012. The 2019 novel coronavirus (SARS-CoV-2) is currently causing a severe outbreak of disease (termed COVID-19) in China and multiple other countries, threatening to cause a global pandemic. In humans, CoVs mostly cause respiratory and gastrointestinal symptoms. Clinical manifestations range from a common cold to more severe disease such as bronchitis, pneumonia, severe acute respiratory distress syndrome, multi-organ failure and even death. SARS-CoV, MERS-CoV and SARS-CoV-2 seem to less commonly affect children and to cause fewer symptoms and less severe disease in this age group compared with adults, and are associated with much lower case-fatality rates. Preliminary evidence suggests children are just as likely as adults to become infected with SARS-CoV-2 but are less likely to be symptomatic or develop severe symptoms. However, the importance of children in transmitting the virus remains uncertain. Children more often have gastrointestinal symptoms compared with adults. Most children with SARS-CoV present with fever, but this is not the case for the other novel CoVs. Many children affected by MERS-CoV are asymptomatic. The majority of children infected by novel CoVs have a documented household contact, often showing symptoms before them. In contrast, adults more often have a nosocomial exposure. In this review, we summarize epidemiologic, clinical and diagnostic findings, as well as treatment and prevention options for common circulating and novel CoVs infections in humans with a focus on infections in children.


title: A Guide to Facial Trauma Triage and Precautions in the COVID-19 Pandemic

text: COVID-19 is an emerging viral illness that has rapidly transmitted throughout the world. Its impact on society and the health care system has compelled hospitals to quickly adapt and innovate as new information about the disease is uncovered. During this pandemic, essential medical and surgical services must be carried out while minimizing the risk of disease transmission to health care workers. There is an elevated risk of COVID-19 viral transmission to health care workers during surgical procedures of the head and neck due to potential aerosolization of viral particles from the oral cavity/naso-oropharynx mucosa. Thus, patients with facial fractures pose unique challenges to the variety of injuries and special considerations, including triaging injuries and protective measures against infection. The proximity to the oral cavity/naso-oropharyngeal mucosa, and potential for aerosolization of secretions containing viral particles during surgical procedures make most patients undergoing operative interventions for facial fractures high risk for COVID-19 transmission. Our proposed algorithm aims to balance patient care with patient/medical personnel protection as well as judicious health care utilization. It stratifies facial trauma procedures by urgency and assigns a recommended level of personal protective equipment, extreme or enhanced, incorporating current best practices and existing data on viral transmission. As this pandemic continues to evolve and more information is obtained, the protocol can be further refined and individualized to each institution.


title: Euglycemic diabetic ketoacidosis in a patient with type 1 diabetes and SARS-CoV-2 pneumonia: case report and review of the literature

text: OBJECTIVE: Recent publications on Coronavirus Disease-2019 (COVID-19) report that diabetic people with or without co-morbidities are at higher risk of developing severe and/or fatal illnesses. METHOD AND RESULT: We report the first case of a 60-year-old man with a 27-year history of type 1 diabetes mellitus, infected by SARS-CoV-2 presenting with an euglycaemic ketoacidosis and an acute respiratory distress syndrome. CONCLUSION: This case report reminds us of the importance of adjusting more recent glucose-lowering drugs, including sodium-glucose cotransporter 2 inhibitors, in the overall management of type 1 diabetic individuals during the ongoing COVID-19 outbreak. ABBREVIATIONS: COVID-19: Coronavirus disease 2019 (SARS-CoV-2) virus, T1DM: Type 1 diabetes mellitus, T2DM: Type 2 diabetes mellitus, SGLT2i: Sodium-glucose cotransporter 2 inhibitor, DKA: diabetic ketoacidosis, euDKA: euglycaemic diabetic ketoacidosis.


title: COVID-19, Australia: Epidemiology Report 6 (Reporting week ending 19:00 AEDT 7 March 2020)

text: This is the sixth epidemiological report for coronavirus disease 2019 (COVID-19), reported in Australia as at 19:00 Australian Eastern Daylight Time [AEDT] 7 March 2020. It includes data on COVID-19 cases diagnosed in Australia, the international situation and a review of current evidence.


Clare Gerada: Some good must come out of covid-19


COVID-19: Travel health and the implications for sub -Saharan Africa


Sixty seconds on . . . bubbles


title: Biodegradable and non-biodegradable fraction of municipal solid waste for multifaceted applications through a closed loop integrated refinery platform: Paving a path towards circular economy

text: An increase in population, rapid urbanization and industrialization has accelerated the rate of municipal solid waste generation. The current disposal of solid waste is a burgeoning issue and it's in immediate need to shift the existing disposal processes to a sustainable manner. Circular economy (CE) is a conceptual model which is been used for better use of resources and minimization of waste in a closed loop approach which could be appropriate for waste management. In this context, the present review illustrates the effective use of biodegradable and non-biodegradable fraction of solid waste in a closed loop integrated refinery platforms for the recovery of bioenergy resources and for the production of value added products. The biodegradable fraction of solid waste could be treated by advanced biological processes with the simultaneous production of bioenergy such as biohydrogen, biomethane, bioelectricity, etc., and other value added products like butanol, ethanol, methanol etc. The scheme illustrates the closed loop approach, the bioenergy generated from the biodegradable fraction of solid waste could be used for the operation of internal combustion engines and the energy could be further used for processing the waste. The non-biodegradable fraction of solid waste could be used for construction and pavement processes. Overall the study emphasizes the paradigm shift of solid waste management concepts from linear economy to a circular economy following the "Zero Waste" concept. The study also explains the circular economy policies practiced for solid waste management that stimulates the economy of the country and identify the pathways to maximize the local resources. In addition the review addresses the advanced information and communication technologies to unfold the issues and challenges faced in the solid waste management. The smart governance of managing waste using the "Internet of Things" (IoT) is one of the great precursors of technological development that could lead innovations in waste management.


Coronavirus response: a focus on containment is still apt


title: Plausible models for propagation of the SARS virus

text: Using daily infection data for Hong Kong we explore the validity of a variety of models of disease propagation when applied to the SARS epidemic. Surrogate data methods show that simple random models are insufficient and that the standard epidemic susceptible-infected-removed model does not fully account for the underlying variability in the observed data. As an alternative, we consider a more complex small world network model and show that such a structure can be applied to reliably produce simulations quantitative similar to the true data. The small world network model not only captures the apparently random fluctuation in the reported data, but can also reproduces mini-outbreaks such as those caused by so-called ``super-spreaders'' and in the Hong Kong housing estate Amoy Gardens.


Covid-19: the medical students responding to the pandemic


docid: hhijbeii

title: ST-Elevation Myocardial Infarction in Patients With COVID-19: Clinical and Angiographic Outcomes


title: Squalene-based multidrug nanoparticles for improved mitigation of uncontrolled inflammation in rodents

text: Uncontrolled inflammatory processes are at the root of numerous pathologies. Most recently, studies on confirmed COVID-19 cases have suggested that mortality might be due to virally induced hyperinflammation. Uncontrolled pro-inflammatory states are often driven by continuous positive feedback loops between pro-inflammatory signaling and oxidative stress, which cannot be resolved in a targeted manner. Here, we report on the development of multidrug nanoparticles for the mitigation of uncontrolled inflammation. The nanoparticles are made by conjugating squalene, a natural lipid, to adenosine, an endogenous immunomodulator, and then encapsulating α-tocopherol, as antioxidant. This resulted in high drug loading, biocompatible, multidrug nanoparticles. By exploiting the endothelial dysfunction at sites of acute inflammation, these multidrug nanoparticles delivered the therapeutic agents in a targeted manner, conferring survival advantage to treated animals in models of endotoxemia. Selectively delivering adenosine and antioxidants together could serve as a novel therapeutic approach for safe treatment of acute paradoxal inflammation.


title: Diagnostic performance of chest CT to differentiate COVID-19 pneumonia in non-high-epidemic area in Japan

text: PURPOSE: To evaluate the diagnostic performance of chest CT to differentiate coronavirus disease 2019 (COVID-19) pneumonia in non-high-epidemic area in Japan. MATERIALS AND METHODS: This retrospective study included 21 patients clinically suspected COVID-19 pneumonia and underwent chest CT more than 3 days after the symptom onset: six patients confirmed COVID-19 pneumonia by real-time reverse-transcription polymerase chain reaction (RT-PCR) and 15 patients proved uninfected. Using a Likert scale and its receiver operating characteristic curve analysis, two radiologists (R1/R2) evaluated the diagnostic performance of the five CT criteria: (1) ground glass opacity (GGO)-predominant lesions, (2) GGO- and peripheral-predominant lesions, (3) bilateral GGO-predominant lesions; (4) bilateral GGO- and peripheral-predominant lesions, and (5) bilateral GGO- and peripheral-predominant lesions without nodules, airway abnormalities, pleural effusion, and mediastinal lymphadenopathy. RESULTS: All patients confirmed COVID-19 pneumonia had bilateral GGO- and peripheral-predominant lesions without airway abnormalities, mediastinal lymphadenopathy, and pleural effusion. The five CT criteria showed moderate to excellent diagnostic performance with area under the curves (AUCs) ranging 0.77-0.88 for R1 and 0.78-0.92 for R2. The criterion (e) showed the highest AUC. CONCLUSION: Chest CT would play a supplemental role to differentiate COVID-19 pneumonia from other respiratory diseases presenting with similar symptoms in a clinical setting.


docid: juyamemg

title: Decrease in Hospital Admissions for Transient Ischemic Attack, Mild, and Moderate Stroke During the COVID-19 Era

text: BACKGROUND AND PURPOSE: Since the onset of the coronavirus 2019 (COVID-19) pandemic, doctors and public authorities have demonstrated concern about the reduction in quality of care for other health conditions due to social restrictions and lack of resources. Using a population-based stroke registry, we investigated the impact of the onset of the COVID-19 pandemic in stroke admissions in Joinville, Brazil. METHODS: Patients admitted after the onset of COVID-19 restrictions in the city (defined as March 17, 2020) were compared with those admitted in 2019. We analyzed differences between stroke incidence, types, severity, reperfusion therapies, and time from stroke onset to admission. Statistical tests were also performed to compare the 30 days before and after COVID-19 to the same period in 2019. RESULTS: We observed a decrease in total stroke admissions from an average of 12.9/100 000 per month in 2019 to 8.3 after COVID-19 (P=0.0029). When compared with the same period in 2019, there was a 36.4% reduction in stroke admissions. There was no difference in admissions for severe stroke (National Institutes of Health Stroke Scale score >8), intraparenchymal hemorrhage, and subarachnoid hemorrhage. CONCLUSIONS: The onset of COVID-19 was correlated with a reduction in admissions for transient, mild, and moderate strokes. Given the need to prevent the worsening of symptoms and the occurrence of medical complications in these groups, a reorganization of the stroke-care networks is necessary to reduce collateral damage caused by COVID-19.


title: Impact of Covid-19 on the urology service in United States: perspectives and strategies to face a Pandemic

text: Over the course of several weeks following the first diagnosed case of COVID-19 in the U.S., the virus rapidly spread across our communities. It became evident that the pandemic was going to place a severe strain on all components of the U.S. healthcare system, and we needed to adapt our daily practices, training and education. In the present paper we discuss four pillars to face a pandemic: surgical and outpatients service, tele-medicine and tele-education. In the face of unprecedented risks in providing adequate health care to our patients during this current, evolving public health crisis of COVID-19, alternative patient management tools such as telemedicine services, allow clinicians to maintain necessary patient rapport with their healthcare provider when required. As a subspecialty, urology should take full advantage of telehealth and tele-education at this juncture. As tele-urology and tele-education can obviate the potential drawbacks of "social distancing" as it pertains to healthcare, the platform can also reduce the risk of COVID-19 spread, without compromising quality urological care and educational efforts. Telehealth can bring urologists and their patients together, perhaps closer than ever.


Clear plastic drapes for aerosol-generating medical procedures in COVID-19 patients: questions still remain


First cases of COVID-19 in heart transplantation from China


docid: eypohzis

title: Impact of the COVID-19 Pandemic on Urologists in Germany

text: BACKGROUND: In order to contain the coronavirus disease 2019 (COVID-19) pandemic, Germany has implemented drastic restrictions on public or social life, while health institutions are invoked to postpone elective procedures. Although urologists are less involved in the direct treatment of COVID-19 patients, the current situation strongly affects the urological work routine. OBJECTIVE: To analyze the impact of the COVID-19 pandemic on various aspects of work and personal life among urologists in Germany. DESIGN, SETTING, AND PARTICIPANTS: A total of 589 urologists in Germany participated in an online survey between March 27 and April 11, 2020. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Participants were stratified into subgroups according to professional characteristics. RESULTS AND LIMITATIONS: Most urologists rated Germany as "well prepared" and the increasing restrictions of social life as "very positive." Routine operation was more restricted in hospitals than in the outpatient sector (p = 0.046). Moreover, urologists from the outpatient sector felt significantly less prepared for the COVID-19 pandemic (p = 0.001), reported a higher shortage of protective medical equipment (p < 0.001), and described a tendency toward a higher level of threat (p = 0.054). Although restrictions regarding telemedicine approaches were reported by 60% of participants, the outpatient sector used telehealth more frequently than hospitals (25.5% vs 17.0%, p < 0.001). Limitations include the national design and the restricted survey period. CONCLUSIONS: This survey systematically evaluates the impact of the COVID-19 pandemic on personal and professional aspects of German urologists. We identified several issues, such as a higher shortage of medical protective equipment in the outpatient sector that could trigger specific measures to further improve the quality of urological care in Germany. PATIENT SUMMARY: We evaluated a potential impact of the coronavirus disease 2019 (COVID-19) pandemic on professional and personal aspects of the urologists in Germany. Our results suggest that the outpatient sector should receive specific attention as, for example, shortage of protective equipment was more common.


Confinement is not sedentary


title: Clinical epidemiological analyses of overweight/obesity and abnormal liver function contributing to prolonged hospitalization in patients infected with COVID-19

text: BACKGROUND/OBJECTIVES: During the 2019 coronavirus disease (COVID-19) outbreak, obesity may contribute to COVID-19 transmission and deterioration. In addition, many patients with COVID-19 infection have suffered liver damage which might contribute to a worse prognosis. We conducted a clinical epidemiological analysis to investigate the association of overweight/obesity and abnormal liver function (ALF) with hospitalized duration in patients infected with COVID-19. SUBJECTS/METHODS: Fifty-eight patients with diagnosed COVID-19 (22 women & 36 men; average age: 49.2 ± 13.1 yr) were included, and their clinical data were collected at The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang. Overweight/obesity was determined as body mass index (BMI) ≥24 kg/m2, ALF was determined as alanine aminotransferase >40 U/L, and prolonged hospitalization was lasting more than the median value of the hospitalized days (19 days) in this population. RESULTS: The proportions of prolonged hospitalization were elevated in patients with overweight/obesity and ALF compared with those without overweight/obesity (62.1% versus 26.1%, P = 0.010) and those without ALF (70.6% versus 41.5%, P = 0.043). Kaplan-Meier analysis showed that the hospitalized duration was increased from the patients with neither overweight/obesity nor ALF to those with either overweight/obesity or ALF, and to those with both of overweight/obesity and ALF (mean with 95% confidence interval: 16.4 [14.5-18.3] versus 25.3 [21.6-29.1] versus 28.3 [24.6-32.0], P for trend = 0.001). Being discharged from hospital in time was inversely and independently associated with BMI (hazard ratio [HR] = 0.75, 95% CI: 0.63-0.90, P for trend = 0.002) and ALT (HR = 0.95, 95% CI: 0.92-0.99, P for trend = 0.007). CONCLUSIONS: Present findings suggested that overweight/obesity and/or ALF contributed to predicting a probability of prolonged hospitalization in patients with COVID-19 infection, to whom extra attentions and precautions should be paid during clinical treatments.


Why measles deaths are surging - and coronavirus could make it worse


title: Understanding the Influence Factors in Viral Nucleic Acid Test of 2019 novel Coronavirus (2019-nCoV)/ 中华检验医学杂志

text: At present, the prevention and control of new coronavirus has entered a critical period. However, the use of quantitative real-time PCR (qRT-PCR) assays for the detection of viral nucleic acid, as a crucial diagnostic approach, has been doubted in clinical practice. Herein, we have reviewed the current status of epidemic prevention and control, latest development of detection technologies, disease characteristics, clinical sampling and transport. We have also discussed the factors that may affect the performance of viral nucleic acid detection, and suggested some effective methods to improve the detection performance of the assays.


title: Seismic noise changes during COVID-19 pandemic: a case study of Shillong, India

text: The coronavirus pandemic has prompted several governments to take the major step of asking everyone to stay home except for essential needs. This has brought down the ground vibration significantly, in various frequency bands, particularly at higher frequencies related to anthropogenic seismic noise. The power is reduced by ~ 5 dB at 10 Hz in Shillong, India, post-lockdown (after 25 March 2020) in India. This is lower than the levels that are observed over the weekends. On the day of Janata Curfew (22 March 2020), the reduction in power is ~ 10 dB at 10 Hz.


Facing the COVID-19 outbreak: What should we know and what could we do?


title: ECIR 2020 Workshops: Assessing the Impact of Going Online

text: ECIR 2020 https://ecir2020.org/ was one of the many conferences affected by the COVID-19 pandemic. The Conference Chairs decided to keep the initially planned dates (April 14-17, 2020) and move to a fully online event. In this report, we describe the experience of organizing the ECIR 2020 Workshops in this scenario from two perspectives: the workshop organizers and the workshop participants. We provide a report on the organizational aspect of these events and the consequences for participants. Covering the scientific dimension of each workshop is outside the scope of this article.


Clinical Features and Treatment of 2019-nCov Pneumonia Patients in Wuhan: Report of A Couple Cases


title: Improving the quality of care in pregnancy and childbirth with coronavirus (COVID-19): a systematic review

text: In the context of serious coronavirus epidemic, it is critical that pregnant women not be ignored potentially life-saving interventions. So, this study was designed to improve the quality of care by health providers through what they need to know about coronavirus during pregnancy and childbirth. We conducted a systematic review of electronic databases was performed for published in English, before 25 March 2020. Finally, 29 papers which had covered the topic more appropriately were included in the study. The results of the systematic review of the existing literature are presented in the following nine sections: Symptoms of the COVID-19 in pregnancy, Pregnancy management, Delivery Management, Mode of delivery, Recommendations for health care provider in delivery, Neonatal outcomes, Neonatal care, Vertical Transmission, Breastfeeding. In conclusion, improving quality of care in maternal health, as well as educating, training, and supporting healthcare providers in infection management to be prioritized. Sharing data can help to countries that to prevent maternal and neonatal morbidity associated with the COVID-19.


title: Chest CT screening for COVID-19 in elective and emergency surgical patients: experience from a UK tertiary centre

text: AIM: To determine the incidence of possible COVID-19-related lung changes on preoperative screening computed tomography (CT) for COVID-19 and how their findings influenced decision-making. To also to determine whether the patients were managed as COVID-19 patients after their imaging findings, and the proportion who had SARS-CoV2 reverse transcriptionpolymerase chain reaction (RT-PCR) testing. MATERIALS AND METHODS: A retrospective study was undertaken of consecutive patients having imaging prior to urgent elective surgery (n=156) or acute abdominal imaging (n=283). Lung findings were categorised according to the British Society of Thoracic Imaging (BSTI) guidelines. RT-PCR testing, management, and outcomes were determined from the electronic patient records. RESULTS: 3% (13/439) of CT examinations demonstrated findings of classic/probable COVID-19 pneumonia, whilst 4% (19/439) had findings indeterminate for COVID-19. Of the total cohort, 1.6% (7/439) subsequently had confirmed RT-PCR-positive COVID-19. Importantly, all the patients with a normal chest or alternative diagnoses on CT who had PCR testing within the next 7 days, had a negative RT-PCR (92/407). There was a change in surgical outcome in 6% (10/156) of the elective surgical cohort with no change to surgical management was demonstrated in the acute abdominal emergency cohort requiring surgery (2/283). CONCLUSION: There was a 7% (32/439) incidence of potential COVID-19-related lung changes in patients having preoperative CT. Although this altered surgical management in the elective surgical cohort, no change to surgical management was demonstrated in the acute abdominal emergency cohort requiring surgery.


title: Familiarity with humans affect dogs' tendencies to follow human majority groups

text: Recently, copying others' behaviour has attracted attention among researchers. It aids individuals in reducing uncertainty about the knowledge of the environment and helps them in acquiring an adaptive behaviour at a lower cost than by learning it by themselves. Among the copying strategies, conformity, which is the copying of behavioural decisions presented by the majority, has been well studied and reported in many animals, including humans. The previous study showed that dogs did not conform to their multiple conspecific individuals; however, dogs have evolved to increase their adaptability while living with humans, and it is plausible that dogs have selected appropriate behaviour according to the behaviour of humans. Therefore, we investigated which factors influenced the choice of dogs in a situation where they have to choose one of two numerically unbalanced human groups. The results showed that the dogs followed the human majority group under certain conditions, depending on the familiarity with the human demonstrators. These results are important in considering the significance of groups for dogs and the factors of group formation, and will also provide a clue as to how dogs have penetrated into human society.


Testing Individuals for Coronavirus Disease 2019 (COVID-19)


docid: eolrahvl

title: Pandemic, panic, and psychiatrists - What should be done before, during, and after COVID-19?


[Pathological changes with novel coronavirus infection in lung cancer surgical specimen]


What Type of Face Mask Is Appropriate for Everyone-Mask-Wearing Policy amidst COVID-19 Pandemic?


title: Significance of serology testing to assist timely diagnosis of SARS-CoV-2 infections: implication from a family cluster

text: Confirmative diagnosis of SARS-CoV-2 infections has been challenged due to unsatisfactory positive rate of molecular assays. Here we identified a family cluster of SARS-CoV-2 infections, with five of six family members were SARS-CoV-2-specific immunoglobin serology testing positive, while molecular assays only detected two of this five patients even repeated twice. We comprehensively analyzed this familial cluster of cases based on the clinical characteristics, chest CT images, SARS-CoV-2 molecular detection results, and serology testing results. At last, two patients were diagnosed with COVID-19, two were suspected of COVID-19, and two were considered close contacts. Our results emphasized the significance of serology testing to assist timely diagnosis of SARS-CoV-2 infections, especially for COVID-19 close contacts screening.


title: Palliative Care Pandemic Pack: A Specialist Palliative Care Service Response to Planning the COVID-19 Pandemic

text: Specialist palliative care services (SPCS) have a vital role to play in the global coronavirus disease 2019 pandemic. Core expertise in complex symptom management, decision making in uncertainty, advocacy and education, and ensuring a compassionate response are essential, and SPCS are well positioned to take a proactive approach in crisis management planning. SPCS resource capacity is likely to be overwhelmed, and consideration needs to be given to empowering and supporting high-quality primary palliative care in all care locations. Our local SPCS have developed a Palliative Care Pandemic Pack to disseminate succinct and specific information, guidance, and resources designed to enable the rapid upskilling of nonspecialist clinicians needing to provide palliative care. It may be a useful tool for our SPCS colleagues to adapt as we face this global challenge collaboratively.


title: Incarceration and pandemic-related restrictions during COVID-19: An empathic understanding of two worlds

text: This paper explores parallels between experiences of confinement due to pandemic-related restrictions and confinement as a result of legal incarceration. We compare experiences of social isolation, lack of choice, and reduced access to resources while also acknowledging the existence of significant differences between the two situations. We describe the ways in which experiences of confinement as part of COVID-19 regulations can provide the general public with insight into difficulties associated with incarceration and the negative effect it can have on psychological health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


COVID-19 as a risk factor for obstetric violence


Letter regarding [High rates of 30-day mortality in patients with cirrhosis and COVID-19]


Response to 'Vitamin D concentrations and COVID-19 infection in UK Biobank'


docid: jedkxlsx

title: Screening FMT donors during the COVID-19 pandemic: a protocol for stool SARS-CoV-2 viral quantification


title: First Case of 2019 Novel Coronavirus in the United States

text: An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.


title: Guillain Barre syndrome associated with COVID-19 infection: A case report

text: Novel outbreak with coronavirus 2019 began since 31 December 2019. Coronaviruses can cause multiple systemic infections that respiratory complications are the most obvious symptoms. In this report, we describe the symptoms of Guillain Barre syndrome (GBS) in one infected patient with COVID-19, for the first time. We reported a 65-years- old male patient with complaints of acute progressive symmetric ascending quadriparesis. Two weeks prior to hospitalization, the patient suffered from cough, fever, and RT-PCR was reported positive for COVID-19 infection. The electrodiagnostic test showed that the patient is an AMSAN variant of GBS. COVID-19 stimulates inflammatory cells and produces various inflammatory cytokines and as a result, it creates immune-mediated processes. GBS is an immune-mediated disorder and molecular mimicry as a mechanism of autoimmune disorder plays an important role in creating it. It is unclear whether COVID-19 induces the production of antibodies against specific gangliosides. Further investigations should be conducted about the mechanism of GBS in patients with COVID-19, in the future.


Corona Virus Disease 2019 (COVID-19): the image tells the truth


title: Creating a Palliative Care Inpatient Response Plan for COVID-19-The UW Medicine Experience

text: CONTEXT: The coronavirus disease 2019 (COVID-19) pandemic is stressing health care systems throughout the world. Significant numbers of patients are being admitted to the hospital with severe illness, often in the setting of advanced age and underlying comorbidities. Therefore, palliative care is an important part of the response to this pandemic. The Seattle area and UW Medicine have been on the forefront of the pandemic in the U.S. METHODS: UW Medicine developed a strategy to implement a palliative care response for a multihospital health care system that incorporates conventional capacity, contingency capacity, and crisis capacity. The strategy was developed by our palliative care programs with input from the health care system leadership. RESULTS: In this publication, we share our multifaceted strategy to implement high-quality palliative care in the context of the COVID-19 pandemic that incorporates conventional, contingency, and crisis capacity and focuses on the areas of the hospital caring for the most patients: the emergency department, intensive care units, and acute care services. The strategy focuses on key content areas, including identifying and addressing goals of care, addressing moderate and severe symptoms, and supporting family members. CONCLUSION: Strategy planning for delivery of high-quality palliative care in the context of the COVID-19 pandemic represents an important area of need for our health care systems. We share our experiences of developing such a strategy to help other institutions conduct and adapt such strategies more quickly.


title: The effects of humic acid urea and polyaspartic acid urea on reducing nitrogen loss compared with urea

text: BACKGROUND: The utilization rate of urea-N in fertilizer plays a very important role in agricultural production and environmental protection. Humic acid urea (HAU) and polyaspartic acid urea (PAU) are two similar synergistic nitrogen fertilizers. METHODS: Fourier transform infrared spectroscopy (FT-IR), X-ray powder diffraction (XRD) and 13 C-nuclear magnetic resonance (13 CNMR) were used to determine the loading of urea-N into the humic acid (HA) and polyaspartic acid (PA). Thermal stability and physical adsorption properties of HAU and PAU were assessed by thermogravimetric analysis (TGA) and Brunauer Emmett Teller (BET) surface measurement. The soil incubation experiment was conducted to investigate the effects of HAU and PAU on nitrogen transformation and gaseous nitrogen loss compared with commercial urea. RESULTS: Nitrogen transformation from FAU and PAU was slowed down compared with urea. After 90 days of incubation, HAU and PAU reduced the cumulative NH3 volatilization (by 9.70% and 6.30%, respectively) and N2 O emission (by 40.48% and 43.00%, respectively) from soil compared with the urea-alone treatment. CONCLUSION: HAU and PAU could improve the nitrogen use efficiency. This article is protected by copyright. All rights reserved.


Open peer-review platform for COVID-19 preprints


COVID-19 and the state of food security in Africa


Audio Interview: Diagnosis and Early Treatment of Covid-19


title: [Health protection guideline of enterprises during COVID-19 outbreak]

text: This guideline is applicable to the disinfection and personal protection measures for enterprise employees from perspetives of taking the commuter shuttles, having meals, and office life during COVID-19 outbreak.


Detección de virus respiratorios en pacientes con sospecha de infección por SARS-CoV-2./ Detección de virus respiratorios en pacientes con sospecha de infección por SARS-CoV-2./ Detection of respiratory viruses in patients with suspected SARS-CoV-2 infection


COVID-19 outbreak and steroids administration: are patients treated for Sars-Cov-2 at risk of adrenal insufficiency?


title: Becoming a Faithful Defender: Traditional Chinese Medicine against Coronavirus Disease 2019 (COVID-19)

text: The outbreak caused by COVID-19 is causing a major challenge to clinical management and a worldwide threat to public health. So far, there is no specific anti-coronavirus therapy approved for the treatment of COVID-19. Recently, as the efficacy and safety of traditional Chinese medicine (TCM) is widely acknowledged, it has been brought to a crucial status by the public, governments, and World Health Organization (WHO). For a better popularization of TCM, governments have made several advances in regulations and policies for treatment and measures of novel coronavirus pneumonia (NCP). Therefore, on the basis of epidemiology and virology information, we reviewed relevant meta-analysis and clinical studies of anti-coronavirus therapeutics by TCM, in the aspect of mortality, symptom improvement, duration and dosage of corticosteroid, incidence of complications and the like. In addition, we also summarized preclinical rationale for anti-coronavirus activity by TCM in terms of virion assembly and release, as well as viral entry and replication, which could be a useful contribution for figuring out effective Chinese herbal medicine (CHM) for coronavirus, including ingredients from single monomeric compounds, Chinese herbs, Chinese herb extracts and Chinese herb formulas, or potential targets for medicine. We would like to see these relevant studies, ranging from basic researches to clinical application, could provide some idea on effects of CHM to combat COVID-19 or other coronaviruses, and also offer new thinking for the exploration of therapeutic strategies under the guidance of TCM.


Urology practice in the time of COVID-19


title: Estimation of Basic Reproduction Number of the COVID-19 Epidemic in Denmark using a Two-Step Model

text: Objective: To conduct an early estimation of the Basic Reproduction Number (BRN) induced by government interference, and to project resulting day to day number of in-patients, ICU-patients and cumulative number of deaths in a Danish setting. Method: We used the Kermack and McKendrick model with varying basic reproduction number to estimate number infected and age stratified percentages to estimate number of in-patients, ICU-patients and cumulative number of deaths. Changes in basic reproduction number was estimated based on current in-patient numbers. Results: The basic reproductive number in the time period of February 27th to March 18th was found to be 2.65, however, this number was reduced to 1.99 after March 18th. Keywords: COVID-19, basic reproduction number, Danish population


Covid-19: Nearly half of care homes in northeast England have had an outbreak


title: Correction: Toyocamycin attenuates free fatty acid-induced hepatic steatosis and apoptosis in cultured hepatocytes and ameliorates nonalcoholic fatty liver disease in mice

text: [This corrects the article DOI: 10.1371/journal.pone.0170591.].


Gynecological malignancies with asymptomatic SARS-CoV-2 infection during the convalescence of outbreak


title: Palpable Fear: COVID-19's Toll on Physician Morale and Mental Health

text: As COVID-19 ravaged human lives, it also took a toll on physician morale and mental health


Biologic agents in psoriasis: our experience during coronavirus infection


title: Stretching the Analytic Frame: Analytic Therapists' Experiences with Remote Therapy During COVID-19

text: Remote therapy has been used by analytic therapists for quite some time, though many have been reluctant to use it regularly, out of concern that it might distort analytic frame and relational dynamics. Now the Covid-19 pandemic has forced therapists to make a sudden, across-the-board transition to remote therapy. This study reports on survey responses from 190 analytic therapists on their transition to online therapy via videoconferencing during the pandemic and their previous experience with remote therapy (the majority had such experience). During the pandemic they prepared themselves and their patients for the transition in a variety of ways. The majority of those surveyed reported feeling as confident and as competent in their online sessions as in their earlier in-person work. Moreover, despite technical and relational challenges, they remained as strong, emotionally connected, and authentic in their online therapy sessions as they were in person. These experiences during the pandemic led to more positive views of online therapy than they held before, but a majority still considered online therapy less effective than in-person sessions.