title: SARS-CoV-2 in the context of past coronaviruses epidemics: Consideration for prenatal care

text: Since December 2019, the novel SARS-CoV-2 outbreak has resulted in millions of cases and more than 200 000 deaths worldwide. The clinical course among nonpregnant women has been described, but data about potential risks for women and their fetus remain scarce. The SARS and MERS epidemics were responsible for miscarriages, adverse fetal and neonatal outcomes, and maternal deaths. For COVID-19 infection, only nine cases of maternal death have been reported as of 22 April 2020, and pregnant women seem to develop the same clinical presentation as the general population. However, severe maternal cases, as well as prematurity, fetal distress, and stillbirth among newborns have been reported. The SARS-CoV-2 pandemic greatly impacts prenatal management and surveillance and raise the need for clear unanimous guidelines. In this narrative review, we describe the current knowledge about coronaviruses (SARS, MERS, and SARS-CoV-2) risks and consequences on pregnancies, and we summarize available current candidate therapeutic options for pregnant women. Finally, we compare current guidance proposed by The Royal College of Obstetricians and Gynaecologists, The American College of Obstetricians and Gynecologists, and the World Health Organization to give an overview of prenatal management which should be utilized until future data appear.


docid: ahompluy

title: Fighting COVID-19, a place for artificial intelligence


Estimating the risk of an anaesthetist acquiring COVID-19 by anaesthetising an asymptomatic patient


Regulatory T Cells for Treating Patients With COVID-19 and Acute Respiratory Distress Syndrome: Two Case Reports


Science in the Wake of the Pandemic: How Will COVID-19 Change the Way We Do Research?


title: The curative effects of shortwave diathermy on treating Novel coronavirus (COVID-19) pneumonia: A structured summary of a study protocol for a randomised controlled trial

text: OBJECTIVES: To evaluate the therapeutic effects of ultra-short-wave diathermy (SWD) on COVID-19 pneumonia. The hypothesis is that SWD may minimise pneumonic inflammation and shorten the duration of the time to positive-to-negative conversion of COVID-19 nucleic acid test. TRIAL DESIGN: This is a single centre, 2-arm (1:1 ratio), evaluator blinded, parallel group design superiority randomised, controlled clinical trial. PARTICIPANTS: The inclusion criteria were: (1) Age 18-65 years, (2) COVID-19 nucleic acid test is positive, (3) Lung CT showed multiple patchy ground glass shadows or other typical manifestations of both lungs. The exclusion criteria were: (1) Patients who need ICU management, (2) Positive tests for other pathogens such as Tuberculosis, Mycoplasma, (3) Patients with respiratory failure or requiring mechanical ventilation, (4) Patients with metal implants or pacemakers, (5) Those with shock (6) Those that have bleeding tendency or active bleeding in the lungs, (7) Patients with multiple organ failure who need ICU monitoring and treatment, (8) Cancer patients and those with severe underlying diseases, (9) Pregnant or lactating women, (10) Patients with severe cognitive impairment who cannot follow the instructions to complete the treatment, (11) Those without signed informed consent and (12) Those with other contraindications to short wave. This study will be conducted in Tongji Hospital, Caidian, Wuhan, People's Republic of China. INTERVENTION AND COMPARATOR: The experimental group will be given the nationally recommended standard medical treatment + ultra-short-wave diathermy treatment. Ultra-short-wave therapy treatment will be performed through application of ultra-short-wave therapy machine electrodes on the anterior and posterior parts of the trunk for 10 minutes, twice a day for 12 consecutive days. The comparator will be the control, not receiving ultra-short-wave therapy, and will be given only the nationally recommended standard medical treatment. MAIN OUTCOMES: The primary outcome measures will be time to positive-to-negative conversion of COVID-19 nucleic acid test by pharyngeal swab, in days assessed at 7th, 14th ,21st and 28th days. The secondary outcome measures include nucleic acid test rate and recovery from symptoms, Vital signs assessment, Computed Tomography, Complete blood count, serum analysis and SIRS scale scores. Blinded evaluation will be at baseline (the day of starting ultra-short-wave diathermy) and after 28 days following the interventions. RANDOMISATION: A Randomization plan will be generated online on www.randomization.com using permuted blocks method, by a statistician who will not be part of the study. Small blocks of various sizes will be used. Patients will be randomized (1:1) between the experimental and control groups BLINDING (MASKING): This will be an evaluator blinded study. Due to the nature of the intervention, blinding of patients and healthcare workers is not possible. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): A total of 410 patients will be randomised in 1:1 ratio to two groups: experimental group (n=205) and control group (n=205). TRIAL STATUS: Protocol version 1 was approved on 02/12/2020. Recruitment for this trial began on 02/18/2020 and will be ongoing till the required sample size is reached. The analysis deadline is August 2020. TRIAL REGISTRATION: This randomised controlled trial has been prospectively registered with the Chinese Clinical Trials ( ChiCTR2000029972 ) on 17 February 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol." The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).


Simultaneous ventilation of two simulated ARDS patients in COVID-19 pandemic


title: Characteristics of Hospitalized Pediatric COVID-19 Cases - Chicago, Illinois, March - April 2020

text: BACKGROUND: To date, no report on COVID-19 pediatric patients in a large urban center with data on underlying comorbidities and co-infection for hospitalized cases has been published. METHODS: Case series of Chicago COVID-19 patients aged 0-17 years reported to Chicago Department of Public Health (CDPH) from 3/5/20-4/8/20. Enhanced case investigation performed. Chi-square and Wilcoxon two-sample tests to compare characteristics among hospitalized and non-hospitalized cases. RESULTS: During March 5-April 8, 2020, 6369 lab-confirmed cases of COVID-19 were reported to CDPH; 64 (1.0%) were among children 0-17 years. Ten patients (16%) were hospitalized, seven (70%) required intensive care (ICU); median length of hospitalization 4 days (range: 1-14). Reported fever and dyspnea were significantly higher in hospitalized patients compared to non-hospitalized patients (9/10 vs. 28/54, p = 0.04 and 7/10 vs. 10/54, p = 0.002, respectively). Hospitalized patients were significantly younger than non-hospitalized patients (median, 3.5 years vs. 12 years; p = 0.03) and all either had an underlying comorbidity or co-infection. Among the 34 unique households with multiple laboratory-confirmed infections, median number of laboratory-confirmed infections was 2 (range: 2-5), and 31 (91%) households had at least one COVID-19 infected adult. For 15 households with available data to assess transmission, 11 (73%) were adult-to-child, 2 (13%) child-to-child, and 2 (13%) child-to-adult. CONCLUSIONS: Enhanced case investigation of hospitalized patients revealed that underlying comorbidities and co-infection might have contributed to severe disease. Given frequency of household transmission, healthcare providers should consider alternative dispositional planning for affected families of children living with comorbidities.


Nurses as heroes, warriors and political activists


COVID-19: The Importance of Multidisciplinary Approach


title: Exploitation of Human Trust, Curiosity and Ignorance by Malware

text: Despite defensive advances in the Internet realm, Malware (malicious software) remains a Cybersecurity threat. These days, Malware can be purchased and licensed on the Internet to further customize and deploy. With hundreds of Malware variants discovered every day, organizations and users experience enormous financial losses as cybercriminals steal financial and user data. In this article surveys the human characteristics that are key to the defense chain against Malware. The article starts with the attack models/vectors that humans often fall prey to and their fallouts. Next, analysis of their root cause and suggest preventive measures that may be employed is detailed. The article concludes that while Internet user education, training, awareness can reduce the chances of Malware attacks,it cannot entirely eliminate them.


Releasing Migrants from Detention During the Covid-19 Pandemic


title: Spatial-temporal characteristics of AIDS incidences in Mainland China

text: OBJECT: Revealed the spatial-temporal patterns of acquired immune deficiency syndrome (AIDS) incidences in Mainland China. METHODS: Empirical orthogonal function (EOF) technique was applied to analyze the major spatial distribution modes and the temporal changes of AIDS incidences in Mainland China during 2002-2017. RESULTS: The annual average AIDS incidences increased from 0.06 per 100 000 in 2002 to 4.15 per 100 000 in 2017, with an annual average increase of 0.31 per 100 000. The southwest regions were high-incidence areas, as well as Xinjiang province in the northwest. There were two typical spatial modes. EOF 1 represented an isodirectional spatial pattern that the incidences were relatively high in general, and the fluctuation ranges were relatively high in the southwest and northeast. EOF 2 represented a reverse spatial pattern that the incidences were relatively high (or low) in Guangxi, Yunnan, Xinjiang, Shanghai, and Henan, yet were relatively low (or high) in the remaining regions. CONCLUSION: The AIDS incidences in Mainland China were relatively low during 2002-2010, yet were kept in a relatively high level since 2012. The prevention and control of AIDS need further development, especially in the southwest regions.


title: [Nationwide survey on clinical treatment of coronavirus disease 2019 in 9 provinces and municipalities]

text: OBJECTIVE: To investigate the clinical treatment and assess the knowledge and use of the coronavirus disease 2019 (COVID-19) treatment plan issued by the nation. METHODS: A nationwide questionnaire survey on line was administered to medical staffs involved in COVID-19 treatment on February 28th, 2020. The questionnaire included drug treatment, respiratory support therapy, sedation and analgesia, continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (ECMO), etc. RESULTS: There were 1 103 respondents, of whom 699 (504 doctors and 195 nurses) participated in the treatment of COVID-19. Finally, 432 doctors and 170 nurses from 9 provinces submitted valid questionnaires. The results of the questionnaire surveys of doctors and nurses were basically the same. Considering that doctors dominated in the diagnosis and treatment of COVID-19, the results of the questionnaires of doctors were mainly analyzed. The doctors participating in the survey were mainly from Hubei (29.2%), followed by Henan (24.5%), Guizhou (22.7%), and Guangxi (14.6%), etc. 55.4% of the doctors came from tertiary three hospitals, and most of them have senior titles (56.4%). 232 doctors (53.7%) participated in the treatment of mild COVID-19, and 200 doctors (46.3%) participated in the treatment of severe and critically ill patients. More than 95% of the doctors expressed that they would carry out antiviral treatment for patients with COVID-19 regardless of disease severity. The main antiviral drugs included α-interferon (69.5%), lopinavir/ritonavir (65.0%), abidol (60.0%), and ribavirin (55.7%). The choice of antiviral drugs was highly consistent with the national treatment programs of COVID-19. At the same time, 95.5% of doctors would routinely prescribe antibiotics to severe and critically ill patients. 94.0% of doctors agreed to prescribe low-dose glucocorticoid therapy to severe and critically ill patients. About 2/3 of doctors would perform lung recruitment or prone position treatment for critical patients with invasive ventilation. 79.0% of doctors preferred to use deep sedation for patients with invasive ventilation. About 1/3 of doctors believed that CRRT should be initiated early, and nearly 1/3 of doctors suggested that ECMO should be used more aggressively in critically ill patients. CONCLUSIONS: Medical staffs are familiar with the national treatment plan of COVID-19 and willing to follow it. However, as a new disease, we have limited knowledge about COVID-19 and there are still many controversies. Further practical training is needed to make clinicians more aware of the disease, and more evidence-based evidence is needed to guide clinical treatment.


title: Covid-19: la nueva enfermedad causada por un coronavirus./ [Covid-19: the new pathology caused by a coronavirus]

text: In this special communication, a brief description is made of the main events of the new pathology (that WHO has named Covid-19) caused by coronavirus. The cases of Covid-19 occurred in mainland China and the rest of the world are mentioned. It is also emphasized the effort that China and other countries around the world are making to contain the epidemic. Also, it highlights the role that WHO and other international organizations are playing to prevent and control the epidemic.


American Association for Thoracic Surgery: Maintaining the Mission during the COVID-19 Pandemic


title: Managing common endocrine disorders amid COVID-19 pandemic

text: BACKGROUND AND AIMS: The novel coronavirus disease (COVID-19) pandemic and the resulting nationwide lockdowns have posed a major challenge to the management of pre-existing and newly diagnosed endocrine disorders. Herein, we have summarized the management approaches of common endocrine disorders amid the ongoing pandemic. METHODS: We have performed an extensive literature search for articles in PubMed, EMBASE and Google Scholar databases till 25 May 2020, with the following keywords: "COVID-19", "diabetes mellitus", "thyroid disorders", "primary adrenal insufficiency", "Cushing's syndrome", "pituitary tumors", "vitamin Dâ³", "osteoporosis", "primary hyperparathyroidism", "hypoparathyroidism", "management", "treatment" and "guidelines" with interposition of the Boolean operator "AND". RESULTS: We have summarized the most feasible strategies for the management of diabetes mellitus, thyroid disorders, primary adrenal insufficiency (including congenital adrenal hyperplasia), Cushing's syndrome, pituitary tumors, osteoporosis, primary hyperparathyroidism and hypoparathyroidism amid the constraints laid down by the raging pandemic. In general, medical management should be encouraged and surgical interventions should be deferred whenever possible. Ongoing medications should be continued. Sick-day rules should be sincerely adhered to. Regular contact with physicians can be maintained through teleconsultations and virtual clinics. CONCLUSIONS: Considering the burden of endocrine disorders in the general population, their management needs to be prioritized amid the ongoing COVID-19 pandemic.


title: Achieving a Covid-19 Free Country: Citizens Preventive Measures and Communication Pathways

text: The Coronavirus Disease 2019 (COVID-19) has spread on a global scale in an extremely short time, causing hundreds of thousands of deaths, and, at the same time, triggering extreme panic. Prevention in medicine is considered the best protection action for individuals in order to avoid infections. This study investigates whether Greek citizens (N = 3359) take the necessary precautions to prevent developing the COVID-19 disease, and it segments them based on homogenous behavior groups. Lastly, it provides communication techniques that should be implemented, targeting each citizen segment for a long-term COVID-19 free country. Data analysis revealed the extent of the applied precaution measures. The ones most applied by citizens were to avoid non-mandatory transportation, contact with individuals with respiratory symptoms, and individuals of high risk for severe illness (vulnerable groups). On the other hand, the least applied measures are daily checks of body temperature, monitoring for fever, cough, or dyspnea, use of a face mask when in public places, or when using public transportation. Additionally, cluster analysis revealed five groups of citizens based on self-reported behavior, namely, the Meticulous Proactive Citizens, the Self-isolated Citizens, the Cautious Citizens, the Occasionally Cautious Citizens, and the Unconcerned Citizens. Communication strategies targeting each segment are also discussed.


title: Coronavirus disease (COVID-19) and neonate: What neonatologist need to know

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause china epidemics with high morbidity and mortality, the infection has been transmitted to other countries. About three neonates and more than 230 children cases are reported. The disease condition of the main children was mild. There is currently no evidence that SARS-CoV-2 can be transmitted transplacentally from mother to the newborn. The treatment strategy for children with Coronavirus disease (COVID-19) is based on adult experience. Thus far, no deaths have been reported in the pediatric age group. This review describes the current understanding of COVID-19 infection in newborns and children.


title: SARS-CoV-2 testing and outcomes in the first 30 days after the first case of COVID-19 at an Australian children's hospital

text: OBJECTIVE: International studies describing COVID-19 in children have shown low proportions of paediatric cases and generally a mild clinical course. We aimed to present early data on children tested for SARS-CoV-2 at a large Australian tertiary children's hospital according to the state health department guidelines, which varied over time. METHODS: We conducted a retrospective cohort study at The Royal Children's Hospital, Melbourne, Australia. It included all paediatric patients (aged 0-18 years) who presented to the ED or the Respiratory Infection Clinic (RIC) and were tested for SARS-CoV-2. The 30-day study period commenced after the first confirmed positive case was detected at the hospital on 21 March 2020, until 19 April 2020. We recorded epidemiological and clinical data. RESULTS: There were 433 patients in whom SARS-CoV-2 testing was performed in ED (331 [76%]) or RIC (102 [24%]). There were four (0.9%) who had positive SARS-CoV-2 detected, none of whom were admitted to hospital or developed severe disease. Of these SARS-CoV-2 positive patients, 1/4 (25%) had a comorbidity, which was asthma. Of the SARS-CoV-2 negative patients, 196/429 (46%) had comorbidities. Risk factors for COVID-19 were identified in 4/4 SARS-CoV-2 positive patients and 47/429 (11%) SARS-CoV-2 negative patients. CONCLUSION: Our study identified a very low rate of SARS-CoV-2 positive cases in children presenting to a tertiary ED or RIC, none of whom were admitted to hospital. A high proportion of patients who were SARS-CoV-2 negative had comorbidities.


CORONA-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management


title: Cirugía durante la pandemia del SARS-COV-2 / COVID-19: el efecto de la generación de aerosoles de partículas en escenarios quirúrgicos

text: Hasta el momento no se ha publicado información conclusiva que respalde la teoría de que los virus respiratorios se transmitan a través del humo quirúrgico o el neumoperitoneo Por lo tanto, las alertas sobre los riesgos de la laparoscopia emitidas durante las primeras semanas de la pandemia deben ser analizadas con precaución y a la luz de la evidencia cambiante sobre el tema Tanto la cirugía abierta como la laparoscópica tienen el potencial de generar aerosoles de partículas y por lo tanto, en ambos escenarios es fundamental la protección de todo el equipo de trabajo dentro del quirófano En todos los procedimientos durante la época de pandemia, se deben buscar las estrategias más efectivas para controlar las potenciales fuentes de trasmisión y minimizar la exposición del personal en los momentos de mayor riesgo, relacionados con el manejo de la vía aérea y las cavidades del paciente La siguiente es una revisión narrativa de literatura sobre las cirugías durante la pandemia del SARS-CoV-2 / COVID-19 y el efecto de los aerosoles durante estos procedimientos, con el fin de integrar y dar a conocer las principales medidas que se han propuesto a nivel global, para manejar este nuevo grupo de pacientesTo date no conclusive information has been published to support the theory that respiratory viruses are transmitted through surgical smoke or pneumoperitoneum Therefore, alerts about the risks of laparoscopy issued during the first weeks of the pandemic should be viewed with caution and in light of changing evidence on the subject Both open and laparoscopic surgery have the potential to generate aerosols of particles and therefore, in both scenarios, the protection of all the surgical team within the operating room is essential In all procedures during the pandemic season, the most effective strategies should be sought to control potential sources of transmission and minimize staff exposure at times of greatest risk related to the management of the patient's airway and cavities The following is a narrative review of the literature on surgeries during the SARS-CoV-2 / COVID-19 pandemic and the effect of aerosols during these procedures, in order to integrate and publicize the main measures that have been proposed globally, to manage this new group of patients


title: Modeling the Dynamics of the COVID-19 Population in Australia: A Probabilistic Analysis

text: The novel Corona Virus COVID-19 arrived on Australian shores around 25 January 2020. This paper presents a novel method of dynamically modeling and forecasting the COVID-19 pandemic in Australia with a high degree of accuracy and in a timely manner using limited data; a valuable resource that can be used to guide government decision-making on societal restrictions on a daily and/or weekly basis. The"partially-observable stochastic process"used in this study predicts not only the future actual values with extremely low error, but also the percentage of unobserved COVID-19 cases in the population. The model can further assist policy makers to assess the effectiveness of several possible alternative scenarios in their decision-making processes.


title: The impact of negative lymph nodes in the survival outcomes of pN+ patients following radical gastrectomy: the inverse lymph node ratio as a better score to study negative lymph nodes

text: The impact of negative lymph nodes (LNs) on survival of pN+ patients has been recognized. The weight of negative LNs in an inverse lymph node ratio (nR) should be related to its prognostic impact. Five hundred and two consecutive gastric cancer patients, who underwent radical gastrectomy, were included. Patients were split into groups according to the number of harvested nodes and a cross-tabulation with pTNM stages was performed to test differences in the tumor burden. pN+ patients (n = 296) were split into groups of negative LNs harvested. We tested an alternative formula for computing a lymph node ratio: nR = total number of harvested nodes/total number of positive nodes. The median number of negative LNs was significantly different (p < 0.01) between dissection groups, but not the median of positive nodes (p > 0.05). No difference in pTNM percentage distribution was found between these groups (p > 0.05). When tested, the overall survival improved significantly for groups with larger numbers of negative LNs (p < 0.001). A cutoff of nR ≥ 6 was an independent prognostic factor for survival (p = 0.001), and the survival of pN+ patients with nR ≥ 6 was not different from pN0 patients. The impact of the number of negative LNs on the survival of the pN+ patients was demonstrated. The higher numbers in the numerator of the nR was due to the disproportion between harvested negative LNs and metastatic LNs. Larger ratios imply more negative lymph nodes in relation to positive lymph nodes, which was significantly associated with survival. We believe that the proposed nR is a friendlier to use format because of its intuitive interpretation.


title: COVID-19 and Long-Term Care Policy for Older People in Canada

text: Older people are especially vulnerable to COVID-19, including and especially people living in long-term care facilities. In this Perspective, we discuss the impact of the COVID-19 pandemic on long-term care policy in Canada. More specifically, we use the example of recent developments in Quebec, where a tragedy in a specific facility is acting as a dramatic "focusing event". It draws attention to the problems facing long-term care facilities, considering existing policy legacies and the opening of a "policy window" that may facilitate comprehensive reforms in the wake of the COVID-19 pandemic.


title: The epidemiology, diagnosis and treatment of COVID-19

text: In December 2019, the outbreak of the novel coronavirus disease (COVID-19) in China spread worldwide, becoming an emergency of major international concern. SARS-CoV-2 infection causes clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus. Human-to-human transmission via droplets, contaminated hands or surfaces has been described, with incubation times of 2-14 days. Early diagnosis, quarantine, and supportive treatments are essential to cure patients. This paper reviews the literature on all available information about the epidemiology, diagnosis, isolation and treatments of COVID-19. Treatments, including antiviral agents, chloroquine and hydroxychloroquine, corticosteroids, antibodies, convalescent plasma transfusion and vaccines, are discussed in this article. In addition, registered trials investigating treatment options for COVID-19 infection are listed.


title: Usefulness of echocardiography to detect cardiac involvement in COVID-19 patients

text: Coronavirus disease 2019 (COVID-19) outbreak is a current global healthcare burden, leading to the life-threatening severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, evidence showed that, even if the prevalence of COVID-19 damage consists in pulmonary lesions and symptoms, it could also affect other organs, such as heart, liver, and spleen. Particularly, some infected patients refer to the emergency department for cardiovascular symptoms, and around 10% of COVID-19 victims had finally developed heart injury. Therefore, the use of echocardiography, according to the safety local protocols and ensuring the use of personal protective equipment, could be useful firstly to discriminate between primary cardiac disease or COVID-19-related myocardial damage, and then for assessing and monitoring COVID-19 cardiovascular complications: acute myocarditis and arrhythmias, acute heart failure, sepsis-induced myocardial impairment, and right ventricular failure derived from treatment with high-pressure mechanical ventilation. The present review aims to enlighten the applications of transthoracic echocardiography for the diagnostic and therapeutic management of myocardial damage in COVID-19 patients.


title: Intraoperative Diagnosis of Coronavirus Disease 2019 in an Asymptomatic Patient: A Case Report

text: Patients with coronavirus disease 2019 (COVID-19) with variable clinical presentations are encountered in the perioperative setting. While some have already been diagnosed and are symptomatic, others have undiagnosed, asymptomatic COVID-19. The latter group poses the greatest risk of transmission. Given limited capacities in most health care systems, diagnostic testing is mainly performed in symptomatic patients or those with relevant exposure. We report an intraoperative diagnosis of COVID-19 in an asymptomatic patient, prompted by clinical signs. To control a pandemic such as COVID-19, a high index of suspicion is pivotal when caring for asymptomatic patients in the perioperative setting.


title: Process-Oriented In Situ Simulation Is a Valuable Tool to Rapidly Ensure Operating Room Preparedness for COVID-19 Outbreak

text: STATEMENT: Process-oriented in situ simulation has been gaining widespread acceptance in the evaluation of the safety of new healthcare teams and facilities. In this article, we highlight learning points from our proactive use of in situ simulation as part of plan-do-study-act cycles to ensure operating room facility preparedness for COVID-19 outbreak. We found in situ simulation to be a valuable tool in disease outbreak preparedness, allowing us to ensure proper use of personal protective equipment and protocol adherence, and to identify latent safety threats and novel problems that were not apparent in the initial planning stage. Through this, we could refine our workflow and operating room setup to provide timely surgical interventions for potential COVID-19 patients in our hospital while keeping our staff and patients safe. Running a simulation may be time and resource intensive, but it is a small price to pay if it can help prevent disease spread in an outbreak.


title: Guillain-Barré syndrome during SARS-CoV-2 pandemic: A case report and review of recent literature

text: Acute demyelinating inflammatory polyneuropathy (AIDP) is the most common type of Guillain-Barré syndrome (GBS) in Europe, following several viral and bacterial infections. Data on AIDP-patients associated with SARS-CoV-2 (coronavirus-2) infection are scarce. We describe the case of a 54-years-old Caucasian female patient with typical clinical and electrophysiological manifestations of AIDP, who was reported positive with PCR for SARS-CoV-2, 3 weeks prior to onset of the neurological symptoms. She did not experience a preceding fever or respiratory symptoms, but a transient loss of smell and taste. At the admission to our neurological department, a progressive proximally pronounced paraparesis, areflexia, and sensory loss with tingling of all extremities were found, which began 10 days before. The modified Erasmus Giullain-Barré Syndrome outcome score (mEGOS) was 3/9 at admission and 1/12 at day 7 of hospitalization. The electrophysiological assessment proved a segmental demyelinating polyneuropathy and cerebrospinal fluid examination showed an albuminocytologic dissociation. The neurological symptoms improved significantly during treatment with immunoglobulins. Our case draws attention to the occurrence of GBS also in patients with COVID-19 (coronavirus disease 2019), who did not experience respiratory or general symptoms. It emphasizes that SARS-CoV-2 induces immunological processes, regardless from the lack of prodromic symptoms. However, it is likely that there is a connection between the severity of the respiratory syndrome and further neurological consequences.


What's the way out? Potential exit strategies from the COVID-19 lockdown


ACEing COVID-19: A Role for Angiotensin Axis Inhibition in SARS-CoV-2 Infection?


title: Novel biosensor platforms for the detection of coronavirus infection and SARS-CoV-2

text: The recent outbreak of the SARS-CoV-2 pandemic has been causing respiratory diseases globally, damaging wide-ranges of social-economical activities. This virus is transmitted through personal contact and possibly also through ambient air. Effective biosensor platforms for the detection of this virus and the related host response are in urgent demand. These platforms can facilitate routine diagnostic assays in certified clinical labs. They can also be integrated into point-of-care products. Furthermore, environmental biosensors can be designed to detect SARS-CoV-2 in the ambient air or in the intensive care ventilators. Here, we evaluate technical components of biosensors, including the biological targets of recognition, the recognition methods and the signal amplification and transduction systems. Effective SARS-CoV-2 detectors can be designed by adequate combination of these technologies.


title: Surveillance and taxonomic analysis of the coronavirus dominant in pigeons in China

text: Coronaviruses (CoVs) are found in humans and a wide variety of wild and domestic animals, and of substantial impact on human and animal health. In poultry, the genetic diversity, evolution, distribution and taxonomy of CoVs dominant in birds other than chickens remain enigmatic. In our previous study, we proposed that the CoVs dominant (i.e. mainly circulating) in ducks (DdCoVs) should represent a novel species, which was different from the one represented by the CoVs dominant in chickens (CdCoVs). In this study, we conducted a large-scale surveillance of CoVs in chickens, ducks, geese, pigeons and other birds (quails, sparrows and partridges) using a conserved RT-PCR assay. The surveillance demonstrated that CdCoVs, DdCoVs and the CoVs dominant in pigeons (PdCoVs) belong to different lineages, and they are all prevalent in live poultry markets and the backyard flocks in some regions of China. We further sequenced seven Coronaviridae-wide conserved domains in their replicase polyprotein pp1ab of seven PdCoVs and found that the genetic distances in these domains between PdCoVs and DdCoVs or CdCoVs are large enough to separate PdCoVs into a novel species, which were different from the ones represented by DdCoVs or CdCoVs within the genus Gammacoronavirus, per the species demarcation criterion of International Committee on Taxonomy of Viruses. This report shed novel insight into the genetic diversity, distribution, evolution and taxonomy of avian CoVs.


title: Did the lockdown curb the spread of COVID-19 infection rate in India: A data-driven analysis

text: In order to analyze the effectiveness of three successive nationwide lockdown enforced in India, we present a data-driven analysis of four key parameters, reducing the transmission rate, restraining the growth rate, flattening the epidemic curve and improving the health care system. These were quantified by the consideration of four different metrics, namely, reproduction rate, growth rate, doubling time and death to recovery ratio. The incidence data of the COVID-19 (during the period of 2nd March 2020 to 31st May 2020) outbreak in India was analyzed for the best fit to the epidemic curve, making use of the exponential growth, the maximum likelihood estimation, sequential Bayesian method and estimation of time-dependent reproduction. The best fit (based on the data considered) was for the time-dependent approach. Accordingly, this approach was used to assess the impact on the effective reproduction rate. The period of pre-lockdown to the end of lockdown 3, saw a $45\%$ reduction in the rate of effective reproduction rate. During the same period the growth rate reduced from $393\%$ during the pre-lockdown to $33\%$ after lockdown 3, accompanied by the average doubling time increasing form $4$-$6$ days to $12$-$14$ days. Finally, the death-to-recovery ratio dropped from $0.28$ (pre-lockdown) to $0.08$ after lockdown 3. In conclusion, all the four metrics considered to assess the effectiveness of the lockdown, exhibited significant favourable changes, from the pre-lockdown period to the end of lockdown 3. Analysis of the data in the post-lockdown period with these metrics will provide greater clarity with regards to the extent of the success of the lockdown.


title: Epidemic model on a network: analysis and applications to COVID-19

text: We analyze an epidemic model on a network consisting of susceptible-infected-recovered equations at the nodes coupled by diffusion using a graph Laplacian. We introduce an epidemic criterion and examine different vaccination/containment strategies: we prove that it is most effective to vaccinate a node of highest degree. The model is also useful to evaluate deconfinement scenarios and prevent a so-called second wave. The model has few parameters enabling fitting to the data and the essential ingredient of importation of infected; these features are particularly important for the current COVID-19 epidemic.


title: Caution in the management of SARS-CoV-2 infection in males

text: The coronavirus 2 (SARS-CoV-2) pandemic carries clinical, economic and social burdens that are currently being disclosed. The key steps of virus life cycle have been recently clarified, highlighting the role of host type 2 angiotensin converting enzyme (ACE2) and TMPRSS2 serine protease in virus-cell binding and entry, respectively. Importantly, major concerns derive from the androgen-dependent tissue-expression of both TMPRSS2 and ACE2, suggesting a differential clinical course of the infection between genders. In agreement with this model, available epidemiological data show that the disease in males has an higher risk to display an heavier pattern and associates with both an increased access to critical care unit and higher mortality rate. In this opinion article, available evidence linking the androgen activity with the gender differences observed in SARS-CoV-2 infection are discussed, hypothesizing possible therapeutic approaches in male based on the disruption of androgen signaling. On these bases, gender-specific recommendations for the management of male patients affected by SARS-CoV-2 infection are warmly suggested, in order to improve the clinical course of the disease.


Psychosis and Infodemic Isolation Resulting in First Inpatient Hospitalization During the COVID-19 Pandemic A Case Series


Of mice and men: COVID-19 challenges translational neuroscience


Fatal outcome of COVID-19 disease in a 5-month infant with comorbidities


title: Management of Female and Functional Urology Patients During the COVID Pandemic

text: CONTEXT: Coronavirus disease 19 (COVID-19) has changed standard urology practice around the world. The situation is affecting not only uro-oncological patients but also patients with benign and disabling conditions who are suffering delays in medical attention that impact their quality of life. OBJECTIVE: To propose, based on expert advice and current evidence where available, a strategy to reorganize female and functional urological (FFU) activity (diagnosis and treatment). EVIDENCE ACQUISITION: The present document is based on a narrative review of the limited data available in the urological literature on SARS-Cov-2 and the experience of FFU experts from several countries around the world. EVIDENCE SYNTHESIS: In all the treatment schemes proposed in the literature on the COVID-19 pandemic, FFU surgery is not adequately covered and usually grouped into the category that is not urgent or can be delayed, but in a sustained pandemic scenario there are cases that cannot be delayed that should be considered for surgery as a priority. The aim of this document is to provide a detailed management plan for noninvasive and invasive FFU consultations, investigations, and operations. A classification of FFU surgical activity by indication and urgency is proposed, as well as recommendations adopted from the literature for good surgical practice and by surgical approach in FFU in the COVID-19 era. CONCLUSIONS: Functional, benign, and pelvic floor conditions have often been considered suitable for delay in challenging times. The long-term implications of this reduction in functional urology clinical activity are currently unknown. This document will help functional urology departments to reorganize their activity to best serve their patients. PATIENT SUMMARY: Many patients will suffer delays in urology treatment because of COVID-19, with consequent impairment of their physical and psychological health and deterioration of their quality of life. Efforts should be made to minimize the burden for this patient group, without endangering patients and health care workers.


Letter: Covid-19, and vitamin D


title: Filling in the gaps

text: The COVID-19 pandemic, and our response to it, has created many voids in our lives, with no-one spared of its effects. As a result, we have all looked for, and found ways to fill in the gaps. In the midst of the epidemic, with healthcare providers in New York City pushed to the extremes of what can be asked of them, they have found ways to bridge the gulf between how they were trained to practice medicine, and what they are being asked to do now.


title: Can oral rinses play a role in preventing transmission of Covid 19 infection?

text: This narrative review describes the existing body of evidence supporting the potential role of oral rinses in preventing the transmission of SARS-CoV2. Multiple sources were searched for evidence including PubMed, Researchgate and Google Scholar. References that were identified were then investigated further to find additional source material and the original primary research. Academic and clinical experts were consulted for additional input on virology, immunology, lipid biochemistry, microbicides as well as dental and clinical practice. The authors also collaborated with a number of commercial companies to acquire information on the specific formulations of oral rinses, information not available within the public domain. There were no restrictions on language for the search strategy.


Reply to "Segmental Pulmonary Vascular Changes in COVID-19 Pneumonia"


title: Psychotic symptoms in COVID-19 patients. A retrospective descriptive study

text: Psychotic symptoms have been related to other coronavirus infections. We conducted a single-centre retrospective and observational study to describe new-onset psychotic episodes in COVID-19 patients. Ten patients infected by the novel coronavirus with psychotic symptoms and no previous history of psychosis were identified by the emergency and liaison psychiatry departments. Nine of the cases presented with psychotic symptoms at least two weeks after the first somatic manifestations attributed to COVID-19 and receiving pharmacological treatment. Structured delusions mixed with confusional features were the most frequent clinical presentations. Hence, COVID-19 patients can develop psychotic symptoms as a consequence of multiple concurrent factors.


title: CT findings in lung parenchyma in COVID-19 - pictorial review

text: Those are typical findings in COVID-19 lung involvement: Ground glass opacities with peripheral distribution, some very soft;sign of the dissolving sugar - peripherally escaping infiltration;often contact with tiny thickened visceral pleura (including interlobium);increasing number of the infiltrates in caudal direction


title: Retweeting for COVID-19: Consensus building, information sharing, dissent, and lockdown life

text: Purpose: Public attitudes towards COVID-19 and social distancing are critical in reducing its spread. It is therefore important to understand public reactions, information dissemination and consensus building in all major forms, including social media. This article investigates important issues reflected on Twitter. Design/methodology/approach: A thematic analysis of the most retweeted English-language tweets on Twitter mentioning COVID-19 during March 10-29, 2020. Findings: The main themes identified for the 87 qualifying tweets accounting for 14 million retweets were: lockdown life; attitude towards social restrictions; politics; safety messages; people with COVID-19; support for key workers; work; and COVID-19 facts/news. Research limitations/implications: Twitter played many positive roles, mainly through unofficial tweets. Users shared social distancing information, helped build support for social distancing, criticised government responses, expressed support for key workers, and helped each other to cope with social isolation. A few popular tweets not supporting social distancing show that government messages sometimes failed. Practical implications: Public health campaigns in future may consider encouraging grass roots social web activity to support campaign goals. At a methodological level, analysing retweet counts emphasised politics and ignored practical implementation issues. Originality/value: This is the first qualitative analysis of general COVID-19-related retweeting.


title: Fibromyalgia 2016 criteria and assessments: comprehensive validation in a Norwegian population

text: Background and aims The ACR1990 criteria of fibromyalgia (FM) have been criticized due to poor reliability of tender points counting (TPC), inconsistent definitions of the widespread pain, and by not considering other symptoms than pain in the FM phenotype. Therefore, several newer self-report measures for FM criteria have emerged. The aim of this study was to translate the fibromyalgia survey questionnaire (FSQ) to Norwegian and validate both the 2011 and the 2016 fibromyalgia survey diagnostic criteria (FSDC) against the ACR1990 criteria. Methods One hundred and twenty chronic pain patients formerly diagnosed with fibromyalgia according to the ACR1990 criteria, and 62 controls not diagnosed or where fibromyalgia was not suspected, were enrolled in this study. All responded to a Norwegian version of the FSQ. Also, they had a clinical examination according to ACR1990 fibromyalgia criteria including a counting of significant tender points with an algometer (TPC). The FSQ with the Widespread Pain Index (WPI) and Symptom Severity scale (SSS) subscales, Fibromyalgia Severity (FS) sum score, was examined for correlations with the fibromyalgia impact questionnaire (FIQ) and TPCs. Face-validity, internal consistence, test-retest reliability and construct validity with convergent and divergent approaches were examined and a Receiver Operating Characteristics (ROC) analysis was performed. Results The internal consistency of FS measured by Cronbach's alfa was good (=0.904). The test-retest reliability measures using intra class correlation were respectable for the FS, including WPI and SSS subscales (0.86, 0.84 and 0.87). FS, WPI and SSS correlated significantly with FIQ (0.74, 0.59 and 0.85) and TPC indicating an adequate construct, convergent validity. The medians of FS, WPI and SSS in the fibromyalgia-group were significantly different from the non-fibromyalgia-group indicating good construct, divergent validity. Using the 2011 and 2016 FSDC vs. ACR 1990 as a reference, sensitivity, specificity, positive likelihood ratio (LR +) and negative likelihood ratio (LR-) were identified. The accuracy rate for both 2011 and 2016 FSDC were respectable (84%). ROC analysis using FS revealed a very good Area Under the Curve (AUC) = 0.860. Conclusion The current study revealed that the Norwegian versions of FSQ is a valid tool for assessment of fibromyalgia according to the 2011 and 2016 (FSDC).


Is climate change the next pandemic for dermatology? Lessons from COVID-19


title: Persistence of Bacteriophage Phi 6 on Porous and Non-Porous Surfaces; Potential for use as Ebola or Coronavirus Surrogate

text: The infection of healthcare workers during the 2013 -2016 Ebola outbreak raised concerns about fomite transmission. In the wake of the Coronavirus Disease 2019 (COVID-19) pandemic, investigations are ongoing to determine the role of fomites in coronavirus transmission as well. The bacteriophage Phi 6 has a phospholipid envelope and is commonly used in environmental studies as a surrogate for human enveloped viruses. The persistence of Phi 6 was evaluated as a surrogate for EBOV and coronaviruses on porous and nonporous hospital surfaces. Phi 6 was suspended in a body fluid simulant and inoculated onto 1 cm2 coupons of steel, plastic, and two fabric curtain types. The coupons were placed at two controlled absolute humidity (AH) levels; a low AH of 3.0 g/m3 and a high AH of 14.4 g/m3 Phi 6 declined at a slower rate on all materials under low AH conditions with a decay rate of 0.06 log10PFU/d to 0.11 log10PFU/d, as compared to the higher AH conditions with a decay rate of 0.65 log10PFU/h to 1.42 log10PFU/d. There was a significant difference in decay rates between porous and non-porous surfaces at both low AH (P < 0.0001) and high AH (P < 0.0001). Under these laboratory-simulated conditions, Phi 6 was found to be a conservative surrogate for EBOV under low AH conditions, in that it persisted longer than Ebola virus in similar AH conditions. Additionally, some coronaviruses persist longer than phi6 under similar conditions, therefore Phi6 may not be a suitable surrogate for coronaviruses.IMPORTANCE Understanding the persistence of enveloped viruses helps inform infection control practices and procedures in healthcare facilities and community settings. These data convey to public health investigators that enveloped viruses can persist and remain infective on surfaces, thus demonstrating a potential risk for transmission. Under these laboratory-simulated western indoor hospital conditions, Phi 6 was used to assess suitability as a surrogate for environmental persistence research related to enveloped viruses, including EBOV and coronaviruses.


title: Divide and Conquer: Strategies in Singapore to Manage a Nuclear Medicine Department During COVID-19

text: The COVID-19 outbreak was declared a public health emergency of international concern by the World Health Organization on January 30, 2020. Since then, the virus has spread to affect more countries worldwide. During this period, our nuclear medicine department at Singapore General Hospital segregated our staff and patients by time, by space, or both, to minimize contact and prevent spread of the virus. Necessary changes to our clinical practices and stricter infection control measures were also enforced. We share our personal experience in managing a nuclear medicine department during this epidemic.


COVID-19 and molecular mimicry: The Columbus' egg?


docid: npgxwduy

title: An Online Educational Platform in the COVID-19 Pandemic


title: Design of a Multiepitope-Based Peptide Vaccine against the E Protein of Human COVID-19: An Immunoinformatics Approach

text: Background: A new endemic disease has spread across Wuhan City, China, in December 2019. Within few weeks, the World Health Organization (WHO) announced a novel coronavirus designated as coronavirus disease 2019 (COVID-19). In late January 2020, WHO declared the outbreak of a "public-health emergency of international concern" due to the rapid and increasing spread of the disease worldwide. Currently, there is no vaccine or approved treatment for this emerging infection; thus, the objective of this study is to design a multiepitope peptide vaccine against COVID-19 using an immunoinformatics approach. Method: Several techniques facilitating the combination of the immunoinformatics approach and comparative genomic approach were used in order to determine the potential peptides for designing the T-cell epitope-based peptide vaccine using the envelope protein of 2019-nCoV as a target. Results: Extensive mutations, insertion, and deletion were discovered with comparative sequencing in the COVID-19 strain. Additionally, ten peptides binding to MHC class I and MHC class II were found to be promising candidates for vaccine design with adequate world population coverage of 88.5% and 99.99%, respectively. Conclusion: The T-cell epitope-based peptide vaccine was designed for COVID-19 using the envelope protein as an immunogenic target. Nevertheless, the proposed vaccine rapidly needs to be validated clinically in order to ensure its safety and immunogenic profile to help stop this epidemic before it leads to devastating global outbreaks.


What Other Countries Can Learn From Italy During the COVID-19 Pandemic


docid: uvnnctdh

title: Promoting platelets is a therapeutic option to combat severe viral infection of the lung


Coronavirus disease 2019 and men's reproductive health


docid: cleximpf

title: Should SARS-CoV-2 influence immunosuppressive therapy for autoimmune blistering diseases?

text: In this dramatic period where the whole world is affected by the outbreak of coronavirus disease 19 (COVID-19), scientific data relating to the causative virus SARS-CoV-2 as well as the subsequent therapeutic repercussions on the management of other diseases should be divulged in order to share as much information as possible among experts in a timely manner.


title: The Impact of COVID-19 on HIV Treatment and Research: A Call to Action

text: The impact of the COVID-19 pandemic is far reaching, with devastating effects on individuals, communities, and societies across the world. People with chronic health conditions may be at greater risk of contracting or experiencing complications from COVID-19. In addition to illness or death for those who contract the virus, the physical distancing required to flatten the curve of new cases is having a negative impact on the economy, the effects of which intersect with mental health and other existing health concerns, thus affecting marginalized communities. Given that HIV also has a disproportionate impact on marginalized communities, COVID-19 is affecting people with HIV (PWH) in unique ways and will continue to have an impact on HIV research and treatment after the COVID-19 crisis passes. Using the biopsychosocial framework to contextualize the impact of COVID-19 on PWH, the purpose of this review article is to: (1) outline the similarities and differences between the COVID-19 and HIV pandemics; (2) describe the current and future impact of COVID-19 on PWH; and (3) outline a call to action for scientists and practitioners to respond to the impact of COVID-19 on HIV prevention and treatment.


title: [Venous thromboembolism in patients with COVID-19]

text: The importance of venous thromboembolism (VTE) as a major complication in patients with severe corona virus disease 2019 (COVID-19) is becoming increasingly evident. In this review, we describe the proposed pathophysiology of the prothrombotic coagulation changes observed in patients with COVID-19. Further, based on a review of the currently available evidence on VTE prevalence in patients with COVID-19, we present and discuss the recommendations from the Danish Society of Thrombosis and Haemostasis on the use of thromboprophylaxis in patients with COVID-19.


title: Thrombotic microangiopathy, DIC-syndrome and COVID-19: link with pregnancy prothrombotic state

text: For last months, humanity has faced a formidable unknown enemy, which is presented as a new coronavirus infection. Despite the fact that the causative agents of new diseases appear at a certain frequency and that the virus SARS-CoV-2 has certain common properties with its predecessors, at the moment we are dealing with a new unknown pathogenesis of the development of severe complications in patients with risk factors. A final understanding of pathological process mechanisms is the goal of the scientific community. Summarizing research data from different countries, it became obvious that in severe cases of viral infection, we are dealing with a combination of the systemic inflammatory response syndrome, disseminated intravascular coagulation and thrombotic microangiopathy (TMA). Thrombotic microangiopathy is represented by a group of different conditions in which thrombocytopenia, hemolytic anemia, and multiple organ failure occur. The article reflects the main types of TMA, pathogenesis and principles of therapy. The main participants in the process are described in detail, including the von Willebrand factor and ADAMTS-13. Based on the knowledge available, as well as new data obtained from patients with COVID-19, we proposed possible models for the implementation of conditions such as sepsis, TMA, and DIC in patients with severe new coronavirus infection. Through a deeper understanding of pathogenesis, it will be possible to develop more effective diagnosis and therapy.


Letter: Using Continuous Intracranial Electroencephalography Monitoring to Manage Epilepsy Patients During COVID-19


title: Letter: Using Continuous Intracranial Electroencephalography Monitoring to Manage Epilepsy Patients During COVID-19 ;Neurosurgery ;Oxford Academic

text: The COVID-19 healthcare crisis and the resulting “stay-at-home” orders have created many obstacles for physicians across disciplines who are trying to maintain the standard of care This is particularly true for epilepsy patients with uncontrolled seizures who often require frequent ambulatory visits, ancillary testing, and even inpatient monitoring The American Epilepsy Society statement on COVID-19 advises epilepsy centers to utilize remote care options such as telephone, telehealth, and electronic health record messaging to manage their patients, a treatment model that is largely new to epilepsy care The urgent move to a remote care model is underscored by the International League Against Epilepsy, which advised physicians to counsel patients that they could experience an increase in seizures due to decreased access to antiepileptic medications (AEDs) and increased stress during COVID-19 Indeed, viral infection has been hypothesized to be one of the important causative factors of febrile seizures,1 though the risk of seizures due to COVID-19 and its related fevers remain debated 2 Novel remote-care options are thus needed during a crisis like this to ensure the best care possible for epilepsy patients [truncated]


title: Managing Diabetes in Pregnancy Before, During, and After COVID-19

text: Background: Pregnant women with diabetes are identified as being more vulnerable to the severe effects of COVID-19 and advised to stringently follow social distancing measures. Here, we review the management of diabetes in pregnancy before and during the lockdown. Methods: Majority of antenatal diabetes and obstetric visits are provided remotely, with pregnant women attending hospital clinics only for essential ultrasound scans and labor and delivery. Online resources for supporting women planning pregnancy and for self-management of pregnant women with type 1 diabetes (T1D) using intermittent or continuous glucose monitoring are provided. Retinal screening procedures, intrapartum care, and the varying impact of lockdown on maternal glycemic control are considered. Alternative screening procedures for diagnosing hyperglycemia during pregnancy and gestational diabetes mellitus (GDM) are discussed. Case histories describe the remote initiation of insulin pump therapy and automated insulin delivery in T1D pregnancy. Results: Initial feedback suggests that video consultations are well received and that the patient experiences for women requiring face-to-face visits are greatly improved. As the pandemic eases, formal evaluation of remote models of diabetes education and technology implementation, including women's views, will be important. Conclusions: Research and audit activities will resume and we will find new ways for supporting pregnant women with diabetes to choose their preferred glucose monitoring and insulin delivery.


Response by Cohen et al to Letter Regarding Article, "Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19"


Covid-19: Trump says risk to Americans is "very low"


COVID-19 and experiences of moral injury in front-line key workers


Response to: 'Emergency arising from patients' fear of taking antimalarials during these COVID-19 times: are antimalarials as unsafe for cardiovascular health as recent reports suggest?' by Santos-Mareno et al


title: Neurological Insights of COVID-19 Pandemic

text: The novel coronavirus SARS-CoV-2, which was identified after a recent outbreak in Wuhan, China, in December 2019, has kept the whole world in tenterhooks due to its severe life-threatening nature of the infection. The virus is unlike its previous counterparts, SARS-CoV and MERS-CoV, or anything the world has encountered before both in terms of virulence and severity of the infection. If scientific reports relevant to the SARS-CoV-2 virus are noted, it can be seen that the virus owes much of its killer properties to its unique structure that has a stronger binding affinity with the human angiotensin-converting enzyme 2 (hACE2) protein, which the viruses utilize as an entry point to gain accesses to its hosts. Recent reports suggest that it is not just the lung that the virus may be targeting; the human brain may soon emerge as the new abode of the virus. Already instances of patients with COVID-19 have been reported with mild (anosmia and ageusia) to severe (encephalopathy) neurological manifestations, and if that is so, then it gives us more reasons to be frightened of this killer virus. Keeping in mind that the situation does not worsen from here, immediate awareness and more thorough research regarding the neuroinvasive nature of the virus is the immediate need of the hour. Scientists globally also need to up their game to design more specific therapeutic strategies with the available information to counteract the pandemic. In this Viewpoint, we provide a brief outline of the currently known neurological manifestations of COVID-19 and discuss some probable ways to design therapeutic strategies to overcome the present global crisis.


Silent COVID-19: what your skin can reveal


title: What Are People Asking About COVID-19? A Question Classification Dataset

text: We present COVID-Q, a set of 1,690 questions about COVID-19 from 13 sources, which we annotate into 15 question categories and 207 question classes. The most common questions in our dataset asked about transmission, prevention, and societal effects of COVID, and we found that many questions that appeared in multiple sources were not answered by any FAQ websites of reputable organizations such as the CDC and FDA. We post our dataset publicly at https://github.com/JerryWei03/COVID-Q . For classifying questions into 15 categories, a BERT baseline scored 58.1% accuracy when trained on 20 examples per class, and for classifying questions into 89 question classes, the baseline achieved 54.6% accuracy. We hope COVID-Q can be helpful either for direct use in developing applied systems or as a domain-specific resource for model evaluation.


title: Associations among state-level physical distancing measures and suicidal thoughts and behaviors among U.S. adults during the early COVID-19 pandemic

text: PURPOSE: The purpose of this study was to identify leading sources of stress, describe rates of mental health outcomes, and examine their associations among U.S. adults during the first months of the COVID-19 pandemic. METHOD: In a cross-sectional, general population survey conducted from March 18 to April 4, 2020, U.S. adults (n=10,625) were recruited through Qualtrics Panels using quota sampling methods. RESULTS: Life stressors, probable depression, past-month suicide ideation, and past-month suicide attempts were not elevated among participants subject to state-level stay-at-home orders and/or large gatherings bans. Multiple life stressors were associated with increased rates of probable depression. Past-month suicide ideation was significantly higher among participants reporting ongoing arguments with a partner and serious legal problems. Past-month suicide attempt was significantly higher among participants reporting concerns about a life-threatening illness or injury, but was significantly lower among participants reporting an unexpected bill or expense. CONCLUSIONS: Results failed to support the conclusion that physical distancing measures are correlated with worse mental health outcomes. Concerns about life-threatening illness or injury was uniquely associated with increased risk of suicide attempt.


Impact of COVID-19 on tuberculosis control in China


Patients with COVID-19 present with low plasma citrulline concentrations that associate with systemic inflammation and gastrointestinal symptoms


title: Using X-ray images and deep learning for automated detection of coronavirus disease

text: Coronavirus is still the leading cause of death worldwide. There are a set number of COVID-19 test units accessible in emergency clinics because of the expanding cases daily. Therefore, it is important to implement an automatic detection and classification system as a speedy elective finding choice to forestall COVID-19 spreading among individuals. Medical images analysis is one of the most promising research areas, it provides facilities for diagnosis and making decisions of a number of diseases such as Coronavirus. This paper conducts a comparative study of the use of the recent deep learning models (VGG16, VGG19, DenseNet201, Inception_ResNet_V2, Inception_V3, Resnet50, and MobileNet_V2) to deal with detection and classification of coronavirus pneumonia. The experiments were conducted using chest X-ray & CT dataset of 6087 images (2780 images of bacterial pneumonia, 1493 of coronavirus, 231 of Covid19, and 1583 normal) and confusion matrices are used to evaluate model performances. Results found out that the use of inception_Resnet_V2 and Densnet201 provide better results compared to other models used in this work (92.18% accuracy for Inception-ResNetV2 and 88.09% accuracy for Densnet201).Communicated by Ramaswamy H. Sarma.


title: nirS-type denitrifying bacterial communities in relation to soil physicochemical conditions and soil depths of two montane riparian meadows in North China

text: Mountain riparian zones are excellent buffers for protecting aquatic ecosystems from nutrient runoff in nitrogen deposition processes due to fertilization and manure. Denitrification is a critical process for transferring soil N to the atmosphere. Denitrifying bacterial communities in soil are indicative of the soil quality of a functional ecosystem. We investigated the effects of physicochemical properties of soil on the diversity and activity of denitrifiers in the top-soil and sub-soil of two typical montane riparian meadows: a multi-colored and a flood-plain meadow. Illumina MiSeq 2500 sequencing of nirS showed that the multi-colored meadow had greater diversity and abundance of nirS-type denitrifiers than the flood-plain meadow and that the total N content, ammonium content, and denitrification enzyme activity (DEA) in soil differed significantly between the two types of meadows. The abundances of dominant denitrifiers at phylum and genus levels showed different responses to the two soil layers of the two meadow types. In top-soils, the highest abundance of Firmicutes was recorded in the multi-colored meadow, while in the flood-plain meadow, there was the highest abundance of Proteobacteria. The Actinobacteria abundance was the highest in top-soil and sub-soil of the flood-plain meadow. The abundance of Chloroflexi was the highest in top-soil of the flood-plain meadow and in sub-soil of the multi-colored meadow. The diversity of denitrifying bacteria was strongly influenced by variations of soil properties down the soil profile. Spearman's rank correlation analyses showed that the diversity and community composition of denitrifying bacteria were strongly associated with most of the soil properties. Therefore, physicochemical soil properties, and particularly the organic carbon, nitrate, and ammonium contents, influence the diversity and abundance of denitrifiers in soil.


title: Hypercoagulability of COVID-19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis

text: BACKGROUND: The severe inflammatory state secondary to COVID-19 leads to a severe derangement of hemostasis that has been recently described as a state of disseminated intravascular coagulation (DIC) and consumption coagulopathy, defined as decreased platelet count, increased fibrin(ogen) degradation products such as D-dimer, as well as low fibrinogen. AIMS: Whole blood from 24 patients admitted at the intensive care unit because of COVID-19 was collected and evaluated with thromboelastography by the TEG point-of-care device on a single occasion and six underwent repeated measurements on two consecutive days for a total of 30 observations. Plasma was evaluated for the other parameters of hemostasis. RESULTS: TEG parameters are consistent with a state of hypercoagulability as shown by decreased values, and increased values of K angle and MA. Platelet count was normal or increased, prothrombin time and activated partial thromboplastin time were near(normal). Fibrinogen was increased and D-dimer was dramatically increased. C-reactive protein was increased. Factor VIII and von Willebrand factor (n = 11) were increased. Antithrombin (n = 11) was marginally decreased and protein C (n = 11) was increased. CONCLUSION: The results of this cohort of patients with COVID-19 are not consistent with acute DIC, rather they support hypercoagulability together with a severe inflammatory state. These findings may explain the events of venous thromboembolism observed in some of these patients and support antithrombotic prophylaxis/treatment. Clinical trials are urgently needed to establish the type of drug, dosage, and optimal duration of prophylaxis.


title: PrivyTRAC: Privacy and Security Preserving Contact Tracing System

text: Smartphone location-based methods have been proposed and implemented as an effective alternative to traditional labor intensive contact tracing methods. However, there are serious privacy and security concerns that may impede wide-spread adoption in many societies. Furthermore, these methods rely solely on proximity to patients, based on Bluetooth or GPS signal for example, ignoring lingering effects of virus, including COVID-19, present in the environment. This results in inaccurate risk assessment and incomplete contact tracing. A new system concept, called PrivyTRAC, preserves user privacy, increases security and improves accuracy of smartphone contact tracing. PrivyTRAC enhances users' and patients' privacy by letting users conduct self-evaluation based on the risk maps download to their smartphones. No user information is transmitted to external locations or devices, and no personally identifiable patient information is embedded in the risk maps as they are processed anonymized and aggregated locations of confirmed patients. The risk maps consider both spatial proximity and temporal effects to improve the accuracy of the infection risk estimation. Experiments conducted in the paper illustrate improvement of PrivyTRAC over proximity based methods in terms of true and false positives. An approach to further improve infection risk estimation by incorporating both positive and negative local test results from contacts of confirmed cases is also described.


docid: ddisdsof

title: Stochastic approach to study control strategies of Covid-19 pandemic in India

text: India is one of the worst affected countries by the Covid-19 pandemic at present. We studied publicly available data of the Covid-19 patients in India and analyzed possible impacts of quarantine and social distancing within the stochastic framework of the SEQIR model to illustrate the controlling strategy of the pandemic. Our simulation results clearly show that proper quarantine and social distancing should be maintained from an early time just at the start of the pandemic and should be continued till its end to effectively control the pandemic. This calls for a more socially disciplined lifestyle in this perspective in future. The demographic stochasticity, which is quite visible in the system dynamics, has a critical role in regulating and controlling the pandemic.


docid: qxbpxdmr

title: Covid-19, chronicles of a forecasted pandemic


COVID-19: an unexpected indication for anti-rheumatic therapies?


Retraction and republication: cardiac toxicity of hydroxychloroquine in COVID-19


title: Soft matter science and the COVID-19 pandemic

text: Much of the science underpinning the global response to the COVID-19 pandemic lies in the soft matter domain. Coronaviruses are composite particles with a core of nucleic acids complexed to proteins surrounded by a protein-studded lipid bilayer shell. A dominant route for transmission is via air-borne aerosols and droplets. Viral interaction with polymeric body fluids, particularly mucus, and cell membranes control their infectivity, while their interaction with skin and artificial surfaces underpins cleaning and disinfection and the efficacy of masks and other personal protective equipment. The global response to COVID-19 has highlighted gaps in the soft matter knowledge base. We survey these gaps and suggest questions that can (and need to) be tackled, both in response to COVID-19 and to better prepare for future viral pandemics.


title: COVID-2019: update on epidemiology, disease spread and management

text: With each passing day, more cases of Coronavirus disease (COVID-2019) are being detected and unfortunately the fear of novel corona virus 2019 (2019-nCoV) becoming a pandemic disease has come true. Constant efforts at individual, national, and international level are being made in order to understand the genomics, hosts, modes of transmission and epidemiological link of nCoV-2019. As of now, whole genome sequence of the newly discovered coronavirus has already been decoded. Genomic characterization nCoV-2019 have shown close homology with bat-derived severe acute respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21. Structural analysis of the receptor binding site has confirmed that 2019-nCoV binds with the same ACE 2 receptor protein as human SARS virus. Compared to the previous coronavirus outbreaks, the overall mortality rate is relatively low for COVID-2019 (2-3%). Suspected cases must be quarantined till their test comes positive or they clear infection. At present, treatment of COVID-2019 is mostly based on the knowledge gained from the SARS and MERS outbreaks. Remdesivir, originally develop as a treatment for Ebola virus disease and Marburg virus infections, is being studied for it effectiveness against 2019-nCoV infection. Many other antiviral agents and vaccines are being tested but most of them are in phase I or II and hence unlikely to be of any benefit immediately with regards to current outbreak. Hence, the standard infection control techniques and preventive steps for healthy individuals and supportive care for the confirmed cases is the best available strategy to deal with current viral outbreak. .


A 9-year-old girl with Kawasaki disease and pulmonary nodules


title: Association Between Clinical Manifestations and Prognosis in Patients with COVID-19

text: PURPOSE: The purpose of this study was to determine the risk factors associated with pneumonia, acute respiratory distress syndrome (ARDS), and clinical outcome among patients with novel coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional multicenter clinical study. A total of 95 patients infected with COVID-19 were enrolled. The COVID-19 diagnostic standard was polymerase chain reaction detection of target genes of 2019 novel coronavirus (2019-nCoV). Clinical, laboratory, and radiologic results, as well as treatment outcome data, were obtained. ARDS was defined as an oxygenation index (arterial partial pressure of oxygen/fraction of inspired oxygen) ≤300 mm Hg. FINDINGS: Multivariate analysis showed that older age (odds ratio [OR], 1.078; p = 0.008) and high body mass index (OR, 1.327; p = 0.024) were independent risk factors associated with patients with pneumonia. For patients with ARDS, multivariate analysis showed that only high systolic blood pressure (OR, 1.046; p = 0.025) and high lactate dehydrogenase level (OR, 1.010; p = 0.021) were independent risk factors associated with ARDS. A total of 70 patients underwent CT imaging repeatedly after treatment. Patients were divided in a disease exacerbation group (n = 19) and a disease relief group (n = 51). High body mass index (OR, 1.285; p = 0.017) and tobacco smoking (OR, 16.13; p = 0.032) were independent risk factors associated with disease exacerbation after treatment. IMPLICATIONS: These study results help in the risk stratification of patients with 2019-nCoV infection. Patients with risk factors should be given timely intervention to avoid disease progression.


The Vascular Surgery COVID-19 Collaborative (VASCC)


title: Two Randomized Controlled Trials of Bacillus Calmette-Guérin Vaccination to reduce absenteeism among health care workers and hospital admission by elderly persons during the COVID-19 pandemic: A structured summary of the study protocols for two randomised controlled trials

text: OBJECTIVES: The objectives of these two separate trials are: (1) to reduce health care workers (HCWs) absenteeism; and (2) to reduce hospital admission among the elderly during the COVID-19 pandemic through BCG vaccination. TRIAL DESIGN: Two separate multi-centre placebo-controlled parallel group randomized trials PARTICIPANTS: (1) Health care personnel working in the hospital or ambulance service where they will take care of patients with the COVID-19 infection and (2) elderly ≥60 years. The HCW trial is being undertaken in 9 hospitals. The elderly trial is being undertaken in locations in the community in Nijmegen, Utrecht, and Veghel, in the Netherlands, using senior citizen organisations to facilitate recruitment. INTERVENTION AND COMPARATOR: For both trials the intervention group will be randomized to vaccination with 0.1 ml of the licensed BCG vaccine (Danish strain 1331, SSI, Denmark, equivalent to 0.075 mg attenuated M. bovis). The placebo group consists of 0.1 ml 0.9% NaCl, which is the same amount, and has the same colour and appearance as the suspended BCG vaccine. MAIN OUTCOMES: (1) Number of days of unplanned work absenteeism in HCWs for any reason which can be continuously measured on a bi-weekly basis, and (2) the cumulative incidence of hospital admission due to documented COVID-19. RANDOMISATION: Participants will be randomized to BCG vaccine or placebo (1;1) centrally using a computer- based system, stratified by study centre. BLINDING (MASKING): Subjects, investigators, physicians and outcome assessors are blinded for the intervention. Only the pharmacist assistant that prepares- and research personnel that administers- study medicines are unblinded. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): (1) The sample size for the first trial is N=1500 HCWs randomised 1:1 to either BCG vaccine (n=750) and placebo (n=750) and (2) The sample size for the second trial is N=1600 elderly persons randomised to BCG vaccine (n=800) and the placebo group (n=800). TRIAL STATUS: HCW: version 4.0, 24-04-2020. Recruitment began 25-03-2020 and was completed on the 23-04-2020. Elderly: version 3.0, 04-04-2020. Recruitment began 16-04- 2020 and is ongoing. TRIAL REGISTRATION: The HCWs trial was registered 31-03-2020 at clinicaltrials.gov (identifier: NCT04328441) and registered 20-03-2020 at the Dutch Trial Registry (trialregister.nl, identifier Trial NL8477). The elderly trial was registered 22-04-2020 at the Dutch trial registry with number NL8547. FULL PROTOCOL: The full protocols will be attached as additional files, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


docid: fuuosbdv

title: SARS-COV-2, o novo Coronavírus: uma reflexão sobre a Saúde Única (One Health) e a importância da medicina de viagem na emergência de novos patógenos


title: Covid-19 pandemic impact on mental health: a web-based cross-sectional survey on a sample of Italian general practitioners

text: BACKGROUND: Since the World Health Organization declared the new 2019 coronavirus disease (Covid-19) outbreak first a Public Health Emergency of International Concern and then a pandemic, Italy held more than 195.350 cases and 26.380 deaths. Working in the frontline with suspected Covid-19 infection patients, general practitioners (GPs) are daily under both physical and psychological pressure. Methods: A web-based cross-sectional survey was carried out on italian GPs working in Genoa (Italy), to assess the impact of Covid-19 pandemic on mental health. The survey was anonymous and a free Google Forms® software was used. RESULTS: One hundred thirty-one GPs completed the survey. Compared to GPs with absent or mild depressive symptoms (PHQ-9 < 10), GPs reporting moderate to severe depressive symptoms (N=30, 22.9%; PHQ-9 ≥ 10) reported more helplessness (96.7% vs. 79.2%, p=.025), spent more than three hours searching for COVID-19 information (43.3% vs. 19.8%, p=.024), perceived less adequate personal protective equipment (PPE) (6.7% vs. 23.8%, p=.049) and visited more COVID-19 infected patients (16.63 ± 27.30 vs. 9.52 ± 11.75, p=.041). Moreover, PHQ-9 ≥ 10 GPs reported a significant higher severity for both anxiety and insomnia (13.43 ± 4.96 vs. 4.88 ± 3.53 and 11.60 ± 5.53 vs. 4.84 ± 3.81, respectively; p<.001), and a worse quality of life in both mental (34.60 ± 7.45 vs. 46.01 ± 7.83, p<.001) and physical (43.50 ± 9.37 vs. 52.94 ± 4.78, p<.001) component summary. CONCLUSIONS: Our results give early insight into the urgent need to provide continuity of care for patients at the community-level, adequate PPE to GPs and a clear guidance from public health institutions. A precarious healthcare system both at a national and regional level might have triggered negative mental health outcomes in Italian GPs.


title: "Impact of the COVID-19 pandemic on Gastroenterology Divisions in Italy: a national survey"

text: Background: In Italy, the spread of the COVID-19 pandemic has stressed the entire healthcare system and required a huge re-organization of many Divisions, including those of Gastroenterology. Aims: to assess the impact of COVID-19 pandemic on Gastroenterology Divisions across Italy. Methods: All members of the Italian Society of Gastroenterology (SIGE) were invited to answer a web-based survey. Results: Data of 121 hospitals from all 20 Italian regions were analyzed. Overall, 10.7% Gastroenterology Divisions have been converted to Covid Units. Outpatients consultations, endoscopic and ultrasound procedures were limited to urgencies and oncology indications in 85.1%, 96.2% and 72.2% of Units, respectively, and 46.7% of them suspended the screening for colorectal cancer.Moreover, 72.2% of the staff received a training for use of personal protective equipment, although 45.5% did not have sufficient devices for adequate replacement. Overall, 132 healthcare workers in 41 Gastroenterology Divisions were found to be infected. Conclusion: This is the first study to evaluate, at a country level, the impact of COVID-19 outbreak on Gastroenterology Divisions. Substantial changes of practice and reduction of procedures have been recorded in the entire country. The long-term impact of such modifications is difficult to estimate but potentially very risky for many digestive diseases.


title: The impact of COVID-19 on patients with neuromyelitis optica spectrum disorder; a pilot study

text: Neuromyelitis optica spectrum disorder (NMOSD) is a CNS neuroinflammatory disorder, mediated by the pathogenic autoantibody aquaporin-4 (AQP4-IgG). Current treatment includes long-term use of immunomodulatory therapies, leading to increased rates of infections among this population. It is of interest therefore, to study how the COVID-19 pandemic affects NMOSD patients in terms of their disease activity. A 15-point questionnaire was administered to 33 participants living in Northern California with NMOSD, MS and other related disorders. Although none of the participants were diagnosed with COVID-19, our results show that 2 participants with NMOSD experienced new onset of neurological symptoms and 2 experienced worsening of previous neurological symptoms - suggesting a possible effect of pandemic-related stress on this CNS autoimmune disorder.


docid: qxluekyl

title: Treat all COVID 19-positive patients, but do not forget those negative with chronic diseases

text: The outbreak of coronavirus disease 2019 (COVID-19) has distressed our working practice. Infectious disease specialists, pneumologists and intensivists were not enough to face the enormous amount of patients that needed hospital care; therefore, many doctors have been recruited from other medical specialties trying to take care of as many patients as possible. The 'call to duty' of such doctors for urgent COVID-19 cases, however, diverted the attention from the care of patients with chronic conditions, which might have been neglected or undervalued. In this extremely difficult time, the standard of care of chronic patients has been reduced and this might have determined an increased rate of complications secondary to undermanagement. Thousands of patients with acute and chronic non-COVID-19 conditions have not accessed specialist care in the last weeks in Italy. Moreover, even those patients who have had scheduled an outpatient visit did not attend it for fear of leaving their home or due to the inability to go. During the pandemic, there was a drastic reduction in the number of hospital admissions for any medical conditions different from COVID-19. Self-presentation to the emergency department (ED) has been discouraged and the patients' own fear of being infected by going to the hospital led to also a significant decrease in ED access. During the lockdown, in San Giuseppe Hospital MultiMedica IRCCS, Milan, the ED admissions dropped from the mean of 2361/month in December 2019-February 2020 to 1102 (- 53%) and 861 (- 63%) in March and April 2020, respectively. For all the above-mentioned reasons, it is possible that some clinical conditions will further progress with a significant increase in morbidity and mortality. To prevent this, it is essential that patients with chronic conditions should be at least monitored and managed with telephone or online health consultation, identifying those who need urgent access to care, prioritizing outpatient visits based on disease severity. Patients with mild conditions could be managed outside the hospital by implementing telemedicine and creating networks of general practitioners who can consult with in-hospital specialists.


COVID-19 swab collection and serological screening in lipoprotein apheresis unit


docid: nwrzxwxv

title: The right to health must guide responses to COVID-19


title: Organisation d'un service de radiothérapie pendant l'épidémie de COVID-19 : expérience du centre hospitalier de Mulhouse./ [Management of a radiotherapy center during the COVID-19 outbreak: The experience of the Mulhouse hospital centre (France)]

text: The COVID-19 outbreak grows exponentially in our country. Despite most of patients develops benign symptoms, cancer patients are at risk of a severe form of the disease. Radiotherapy centres are a potential contamination place due to the number of patients treated and staff present. Their organization during the outbreak period aims to ensure continuity of care while limiting the risk of death from COVID-19. In the radiotherapy department of Mulhouse hospital (France), we pointed five points out: protection of medical and paramedical staff, protection of patients undergoing treatment, detection of patients suspected of being infected by SARS-CoV-2 and their management, reorganization of the patient circuit and measures regarding the quality management. This reflection, which began at the beginning of the outbreak in our city, allows us to preserve the access to radiotherapy treatments by anticipating the risk of spreading the virus. Through biweekly meetings, we continue to adapt to the epidemic in our department, considering our material resources. The ability to perform diagnostic tests in all suspect patients would also allow us to refine our procedures.


docid: mpfqexxx

title: Dual antiplatelet therapy in patients with acute coronary syndrome during the coronavirus disease of 2019 pandemia: the right choice at the right time


Delayed pulmonary abscess following COVID-19 pneumonia: A case report


title: Courage, Fortitude, and Effective Leadership of Surgical Teams During COVID-19

text: The world as we once knew it has been drastically altered secondary to coronavirus disease 2019 (COVID-19). The impact of these changes, particularly for those practicing in the medical profession, extends beyond the physical to the psychological, emotional, and spiritual. We discuss the factors that contribute to these stresses, way to manage them, and how we as leaders of our teams can inspire resilience and help our colleagues endure these most difficult times.


Ultraschall in der Schwangerschaft während der Corona-Virus Pandemie: Ein praktisches Vorgehen


title: Potential new treatment strategies for COVID-19: is there a role for bromhexine as add-on therapy?

text: Of huge importance now is to provide a fast, cost-effective, safe, and immediately available pharmaceutical solution to curb the rapid global spread of SARS-CoV-2. Recent publications on SARS-CoV-2 have brought attention to the possible benefit of chloroquine in the treatment of patients infected by SARS-CoV-2. Whether chloroquine can treat SARS-CoV-2 alone and also work as a prophylactic is doubtful. An effective prophylactic medication to prevent viral entry has to contain, at least, either a protease inhibitor or a competitive virus ACE2-binding inhibitor. Using bromhexine at a dosage that selectively inhibits TMPRSS2 and, in so doing, inhibits TMPRSS2-specific viral entry is likely to be effective against SARS-CoV-2. We propose the use of bromhexine as a prophylactic and treatment. We encourage the scientific community to assess bromhexine clinically as a prophylactic and curative treatment. If proven to be effective, this would allow a rapid, accessible, and cost-effective application worldwide.


title: The Role of Pharmacists in the Fight Against COVID-19

text: Pharmacists across various practice settings are joining the fight against COVID-19, empowered by the resources available through national, governmental and professional organizations. Long-term care pharmacists are instrumental in optimizing medication management and developing policies to reduce the risk of COVID-19 transmission among vulnerable residents.


Covid-19: Care home deaths in England and Wales double in four weeks


title: Open Data Resources for Fighting COVID-19

text: We provide an insight into the open data resources pertinent to the study of the spread of Covid-19 pandemic and its control. We identify the variables required to analyze fundamental aspects like seasonal behaviour, regional mortality rates, and effectiveness of government measures. Open data resources, along with data-driven methodologies, provide many opportunities to improve the response of the different administrations to the virus. We describe the present limitations and difficulties encountered in most of the open-data resources. To facilitate the access to the main open-data portals and resources, we identify the most relevant institutions, at a world scale, providing Covid-19 information and/or auxiliary variables (demographics, mobility, etc.). We also describe several open resources to access Covid-19 data-sets at a country-wide level (i.e. China, Italy, Spain, France, Germany, U.S., etc.). In an attempt to facilitate the rapid response to the study of the seasonal behaviour of Covid-19, we enumerate the main open resources in terms of weather and climate variables. CONCO-Team: The authors of this paper belong to the CONtrol COvid-19 Team, which is composed of different researches from universities of Spain, Italy, France, Germany, United Kingdom and Argentina. The main goal of CONCO-Team is to develop data-driven methods for the better understanding and control of the pandemic.


Life/Style : MOVIES 新型コロナを予言したウイルス映画が語ること : インタビュー


Lung ultrasound findings in patients with COVID-19 pneumonia


title: Procedures for Flow Cytometry-Based Sorting of Unfixed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infected Cells and Other Infectious Agents

text: In response to the recent COVID-19 pandemic, many laboratories are involved in research supporting SARS-CoV-2 vaccine development and clinical trials. Flow cytometry laboratories will be responsible for a large part of this effort by sorting unfixed antigen-specific lymphocytes. Therefore, it is critical and timely that we have an understanding of risk assessment and established procedures of infectious cell sorting. Here we present procedures covering the biosafety aspects of sorting unfixed SARS-CoV-2-infected cells and other infectious agents of similar risk level. These procedures follow the ISAC Biosafety Committee guidelines and were recently approved by the National Institutes of Health Institutional Biosafety Committee for sorting SARS-CoV-2-infected cells. © 2020 International Society for Advancement of Cytometry.


title: Eccentric grazing envelope evolution towards type IIb supernova progenitors

text: We simulate the evolution of eccentric binary systems in the frame of the grazing envelope evolution (GEE) channel for the formation of Type IIb supernovae (SNe IIb), and find that extra mass removal by jets increases the parameter space for the formation of SNe IIb in this channel. To explore the role of eccentricity and the extra mass removal by jets we use the stellar evolutionary code MESA binary. The initial primary and secondary masses are M1i=15Mo and M2i=2.5Mo. We examine initial semi-major axes of 600-1000Ro, and eccentricities of e=0-0.9. Both Roche lobe overflow (RLOF) and mass removal by jets, followed by a wind, leave a hydrogen mass in the exploding star of M(H,f)=0.05Mo, compatible with a SN IIb progenitor. When the initial orbit is not circular the final orbit might have a very high eccentricity. In many cases, with and without the extra mass removal by jets, the system can enter a common envelope evolution (CEE) phase, and then gets out from it. For some ranges of eccentricities the jets are more efficient in preventing the CEE. Despite the large uncertainties, extra mass removal by jets substantially increases the likelihood of the system to get out from a CEE. This strengthens earlier conclusions for circular orbits. In some cases RLOF alone, without mass removal by jets, can form SN IIb progenitors. We estimate that the extra mass removal by jets in the GEE channel increases the number of progenitors relative to that by RLOF alone by about a factor of two.


title: CoroNet: A deep neural network for detection and diagnosis of COVID-19 from chest x-ray images

text: BACKGROUND AND OBJECTIVE: The novel Coronavirus also called COVID-19 originated in Wuhan, China in December 2019 and has now spread across the world. It has so far infected around 1.8 million people and claimed approximately 114,698 lives overall. As the number of cases are rapidly increasing, most of the countries are facing shortage of testing kits and resources. The limited quantity of testing kits and increasing number of daily cases encouraged us to come up with a Deep Learning model that can aid radiologists and clinicians in detecting COVID-19 cases using chest X-rays. METHODS: In this study, we propose CoroNet, a Deep Convolutional Neural Network model to automatically detect COVID-19 infection from chest X-ray images. The proposed model is based on Xception architecture pre-trained on ImageNet dataset and trained end-to-end on a dataset prepared by collecting COVID-19 and other chest pneumonia X-ray images from two different publically available databases. RESULTS: CoroNet has been trained and tested on the prepared dataset and the experimental results show that our proposed model achieved an overall accuracy of 89.6%, and more importantly the precision and recall rate for COVID-19 cases are 93% and 98.2% for 4-class cases (COVID vs Pneumonia bacterial vs pneumonia viral vs normal). For 3-class classification (COVID vs Pneumonia vs normal), the proposed model produced a classification accuracy of 95%. The preliminary results of this study look promising which can be further improved as more training data becomes available. CONCLUSION: CoroNet achieved promising results on a small prepared dataset which indicates that given more data, the proposed model can achieve better results with minimum pre-processing of data. Overall, the proposed model substantially advances the current radiology based methodology and during COVID-19 pandemic, it can be very helpful tool for clinical practitioners and radiologists to aid them in diagnosis, quantification and follow-up of COVID-19 cases.


title: Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia

text: BACKGROUND: Some patients with COVID-19 pneumonia also present with kidney injury, and autopsy findings of patients who died from the illness sometimes show renal damage. However, little is known about the clinical characteristics of kidney-related complications, including hematuria, proteinuria, and AKI. METHODS: In this retrospective, single-center study in China, we analyzed data from electronic medical records of 333 hospitalized patients with COVID-19 pneumonia, including information about clinical, laboratory, radiologic, and other characteristics, as well as information about renal outcomes. RESULTS: We found that 251 of the 333 patients (75.4%) had abnormal urine dipstick tests or AKI. Of 198 patients with renal involvement for the median duration of 12 days, 118 (59.6%) experienced remission of pneumonia during this period, and 111 of 162 (68.5%) patients experienced remission of proteinuria. Among 35 patients who developed AKI (with AKI identified by criteria expanded somewhat beyond the 2012 Kidney Disease: Improving Global Outcomes definition), 16 (45.7%) experienced complete recovery of kidney function. We suspect that most AKI cases were intrinsic AKI. Patients with renal involvement had higher overall mortality compared with those without renal involvement (28 of 251 [11.2%] versus one of 82 [1.2%], respectively). Stepwise multivariate binary logistic regression analyses showed that severity of pneumonia was the risk factor most commonly associated with lower odds of proteinuric or hematuric remission and recovery from AKI. CONCLUSIONS: Renal abnormalities occurred in the majority of patients with COVID-19 pneumonia. Although proteinuria, hematuria, and AKI often resolved in such patients within 3 weeks after the onset of symptoms, renal complications in COVID-19 were associated with higher mortality.