title: Chinese herbal Huo-Gu Formula for treatment of steroid-associated osteonecrosis of femoral head: a 14-years follow-up of convalescent SARS patients

text: Purpose: The Coronavirus disease 2019 (COVID-19) reminds us of the SARS outbreak in 2003, and up to date, corticosteroid is commonly administrated to severe patients with COVID-19. Osteonecrosis of the femoral head (ONFH) is a common disabling complication among convalescent SARS patients who received corticosteroid therapy. In China, a considerable number of convalescent SARS patients with steroid-associated ONFH had undergone conservative treatment by Traditional Chinese Medicine (TCM), and this study aims to evaluate the long-term results of a spleen-invigorating Huo-Gu Formula (HGF) therapy in these patients. Participants: and methods: A total of 33 convalescent SARS patients (nine males and 24 females) with bilateral steroid-associated ONFH (66 hips) were enrolled in this study. All patients received oral HGF therapy for six months when they were confirmed the diagnosis of steroid-associated ONFH. They had been regularly followed up at an interval of one year. Harris hip score and medical imaging modalities, including plain radiography, computed tomography, and magnetic resonance imaging, were performed to evaluate the outcomes. Results: Based on average 14 years of follow-up of HGF therapy (ranging from six to 16 years), 38 hips (57%) among the 66 hips developed definite osteoarthritis, and 14 hips (26%) in 53 pre-collapse hips (ARCO stage I or II) progressed to femoral head collapse(ARCO stage III or IV). Only five patients (also five hips) underwent total hip arthroplasty, and the mean hip survival time was over 15 years by the Kaplan-Meier analysis. We observed a mean Harris hip score of 63 points, which represented the reserve of 55% in pain score and 70% in physical function score. The severity of groin pain was not correlated to the severity of osteoarthritis. Conclusion: Chinese herbal HGF therapy demonstrates beneficial effects on preventing femoral head collapse, delaying total hip arthroplasty (THA)surgery, and maintaining physical function in the treatment of steroid-associated ONFH. HGF therapy might be therefore a good alternative for the treatment of steroid-associated ONFH secondary to rheumatologic and infection diseases.


Tomar o no tomar «decisiones en caliente¼ respecto al tratamiento de la infección por SARS-CoV-2./ [Whether to make decisions "on the fly" regarding treatment for SARS-CoV-2 infection]


title: Differential mortality in COVID-19 patients from India and western countries

text: BACKGROUND AND AIMS: COVID-19 disease has been associated with disproportionate mortality amongst world population. We try to elucidate various reasons for lower mortality rate in the Indian subcontinent due to COVID-19 pandemic. METHOD: We carried out a comprehensive review of the literature using suitable keywords such as 'COVID-19', 'Pandemics', 'disease outbreaks' and 'India' on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the month of May 2020 during the current COVID-19 pandemic and assessed mortality data. RESULTS: The mortality observed in Indian and south Asian subcontinent is lower than in the west. Multifactorial reasons indicated for this differential mortality due to COVID-19 have been described in the current literature. CONCLUSIONS: The effects of COVID-19 on the health of racial and ethnic minority groups are still emerging with disproportionate burden of illness and death amongst some black and ethnic minority groups. Overall the current COVID-19 related mortality appears to be lower in the health and resource challenged populous Indian subcontinent. Further scientific studies would be helpful to understand this disparity in mortality due to COVID-19 in the world population.


Applications of 3D Printing Technology to Address COVID-19-Related Supply Shortages


Coronavirus Disease (COVID-19) With Relevance to Pediatrics


title: Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults

text: AIM: The coronavirus disease 2019 (COVID-19) pandemic has affected hundreds of thousands of people. Data on symptoms and prognosis in children are rare. METHODS: A systematic literature review was carried out to identify papers on COVID-19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), using the MEDLINE and Embase databases between January 1 and March 18, 2020. RESULTS: The search identified 45 relevant scientific papers and letters. The review showed that children have so far accounted for 1%-5% of diagnosed COVID-19 cases, they often have milder disease than adults and deaths have been extremely rare. Diagnostic findings have been similar to adults, with fever and respiratory symptoms being prevalent, but fewer children seem to have developed severe pneumonia. Elevated inflammatory markers were less common in children, and lymphocytopenia seemed rare. Newborn infants have developed symptomatic COVID-19, but evidence of vertical intrauterine transmission was scarce. Suggested treatment included providing oxygen, inhalations, nutritional support and maintaining fluids and electrolyte balances. CONCLUSIONS: The coronavirus disease 2019 has occurred in children, but they seemed to have a milder disease course and better prognosis than adults. Deaths were extremely rare.


docid: ddcdnhtr

title: How Should Rehabilitative Departments of Hospitals Prepare for Coronavirus Disease 2019?


title: SARS-CoV-2 and cardiovascular complications: From molecular mechanisms to pharmaceutical management

text: The coronavirus disease 2019 (COVID-19), elicited by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is a pandemic public health emergency of global concern. Other than the profound severe pulmonary damage, SARS-CoV-2 infection also leads to a series of cardiovascular abnormalities, including myocardial injury, myocarditis and pericarditis, arrhythmia and cardiac arrest, cardiomyopathy, heart failure, cardiogenic shock, and coagulation abnormalities. Meanwhile, COVID-19 patients with preexisting cardiovascular diseases are often at a much higher risk of increased morbidity and mortality. Up-to-date, a number of mechanisms have been postulated for COVID-19-associated cardiovascular damage including SARS-CoV-2 receptor angiotensin-converting enzyme 2 (ACE2) activation, cytokine storm, hypoxemia, stress and cardiotoxicity of antiviral drugs. In this context, special attention should be given towards COVID-19 patients with concurrent cardiovascular diseases, and special cardiovascular attention is warranted for treatment of COVID-19.


On Patient Safety: COVID-19 Exposes the Dangerous State of Drug and Device Supply Chains


An invited commentary on: Optimizing response in surgical systems during and after COVID-19 pandemic: Lessons from China and the UK - Perspective. Zheng Liu (IJS-D-20-00464)


title: How to Detect and Track Chronic Neurologic Sequelae of Covid-19? Use of Auditory Brainstem Responses and Neuroimaging for Long-term Patient Follow-up

text: This review intends to provide an overview of the current knowledge on neurologic sequelae of COVID-19 and their possible etiology, and, based on available data, proposes possible improvements in current medical care procedures. We conducted a thorough review of the scientific literature on neurologic manifestations of COVID-19, the neuroinvasive propensity of known coronaviruses (CoV) and their possible effects on brain structural and functional integrity. It appears that around one third of COVID-19 patients admitted to intensive care units (ICU) for respiratory difficulties exhibit neurologic symptoms. This may be due to progressive brain damage and dysfunction triggered by severe hypoxia and hypoxemia, heightened inflammation and SARS-CoV-2 dissemination into brain parenchyma, as suggested by current reports and analyses of previous CoV outbreaks. Viral invasion of the brain may particularly target and alter brainstem and thalamic functions and, consequently, result in sensorimotor dysfunctions and psychiatric disorders. Moreover, data collected from other structurally homologous CoV suggest that SARS-CoV-2 infection may lead to brain cell degeneration and demyelination similar to multiple sclerosis (MS). Hence, current evidence warrants further evaluation and long-term follow-up of possible neurologic sequelae in COVID-19 patients. It may be particularly relevant to evaluate brainstem integrity in recovered patients, as it is suspected that this cerebral area may particularly be dysfunctional following SARS-CoV-2 infection. Because CoV infection can potentially lead to chronic neuroinflammation and progressive demyelination, neuroimaging features and signs of MS may also be evaluated in the long term in recovered COVID-19 patients.


title: Medical Students Are Not Essential Workers: Examining Institutional Responsibility During the COVID-19 Pandemic

text: In light of the evolving COVID-19 pandemic, the Association of American Medical Colleges (AAMC) and Liaison Committee on Medical Education (LCME) released a joint statement in March 2020 recommending an immediate suspension of medical student participation in direct patient contact. As graduating medical students who will soon begin residency, the authors fully support this recommendation. Though paid health care workers, like residents, nurses, and environmental services staff, are essential to the management of COVID-19 patients, medical students are not. Students' continued involvement in direct patient care will contribute to SARS-CoV-2 exposures and transmissions and will waste already limited personal protective equipment. By decreasing non-essential personnel in health care settings, including medical students, medical schools will contribute to national and global efforts to "flatten the curve."The authors also assert that medical schools are responsible for ensuring medical student safety. Without the protections provided to paid health care workers, students are uniquely disadvantaged within the medical hierarchy; these inequalities must be addressed before medical students are safely reintegrated into clinical roles. Although graduating medical students and institutional leadership may worry that suspending clinical rotations might prevent students from completing graduation requirements, the authors argue the ethical obligation to "flatten the curve" supersedes usual teaching responsibilities. Therefore, the authors request further guidance from the LCME and AAMC regarding curricular exemptions/alternatives and adjusted graduation timelines. The pool of graduating medical students affected by this pause in direct patient contact represents a powerful reserve, which may soon need to be utilized as the COVID-19 pandemic continues to challenge the U.S. health care infrastructure.


title: A Generic Framework and Library for Exploration of Small Multiples through Interactive Piling

text: Small multiples are miniature representations of visual information used generically across many domains. Handling large numbers of small multiples imposes challenges on many analytic tasks like inspection, comparison, navigation, or annotation. To address these challenges, we developed a framework and implemented a library called Piling.js for designing interactive piling interfaces. Based on the piling metaphor, such interfaces afford flexible organization, exploration, and comparison of large numbers of small multiples by interactively aggregating visual objects into piles. Based on a systematic analysis of previous work, we present a structured design space to guide the design of visual piling interfaces. To enable designers to efficiently build their own visual piling interfaces, Piling.js provides a declarative interface to avoid having to write low-level code and implements common aspects of the design space. An accompanying GUI additionally supports the dynamic configuration of the piling interface. We demonstrate the expressiveness of Piling.js with examples from machine learning, immunofluorescence microscopy, genomics, and public health.


title: Suspension and resumption of kidney transplant programs during the COVID-19 pandemic: perspectives from patients, caregivers and potential living donors-a qualitative study

text: BACKGROUND: Many countries have suspended kidney transplantation programs during the COVID-19 pandemic because of concerns for patient safety and the shortage of healthcare resources. This study aimed to describe patient, family member and potential donor perspectives on the suspension and resumption of kidney transplant programs due to COVID-19. METHODS: We conducted seven online focus groups involving 31 adult kidney transplant candidates (n=22), caregivers (n=4) and potential donors (n=5). Transcripts were analyzed thematically. RESULTS: We identified five themes: cascading disappointments and devastation (with subthemes of shattering hope, succumbing to defeat, regret and guilt); helplessness and vulnerability (fear of declining health, confronted by the threat of and change in dialysis, disconnected from healthcare, susceptibility to infective complications); stress from uncertainty (confusion from conflicting information, unable to forward plan), exacerbating burdens (incurring extra financial costs, intensifying caregiver responsibilities), and sustaining health through the delay (protecting eligibility, relying on social support, adapting to emerging modalities of care). CONCLUSIONS: During the suspension of kidney transplantation programs, patients felt medically vulnerable because of declining health, susceptibility to infection and reduced access to care. There is a need to address health vulnerabilities, disappointment, uncertainty and additional burdens arising from the suspension of kidney transplantation programs.


title: COVID-19 outbreak: Migration, effects on society, global environment and prevention

text: The COVID-19 pandemic is considered as the most crucial global health calamity of the century and the greatest challenge that the humankind faced since the 2nd World War. In December 2019, a new infectious respiratory disease emerged in Wuhan, Hubei province, China and was named by the World Health Organization as COVID-19 (coronavirus disease 2019). A new class of corona virus, known as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has been found to be responsible for occurrence of this disease. As far as the history of human civilization is concerned there are instances of severe outbreaks of diseases caused by a number of viruses. According to the report of the World Health Organization (WHO as of April 18 2020), the current outbreak of COVID-19, has affected over 2164111 people and killed more than 146,198 people in more than 200 countries throughout the world. Till now there is no report of any clinically approved antiviral drugs or vaccines that are effective against COVID-19. It has rapidly spread around the world, posing enormous health, economic, environmental and social challenges to the entire human population. The coronavirus outbreak is severely disrupting the global economy. Almost all the nations are struggling to slow down the transmission of the disease by testing & treating patients, quarantining suspected persons through contact tracing, restricting large gatherings, maintaining complete or partial lock down etc. This paper describes the impact of COVID-19 on society and global environment, and the possible ways in which the disease can be controlled has also been discussed therein.


title: Recommendation to Optimize Safety of Elective Surgical Care While Limiting the Spread of COVID-19: Primum Non Nocere

text: COVID-19 has drastically altered our lives in an unprecedented manner, shuttering industries, and leaving most of the country in isolation as we adapt to the evolving crisis. Orthopedic surgery has not been spared from these effects, with the postponement of elective procedures in an attempt to mitigate disease transmission and preserve hospital resources as the pandemic continues to expand. During these turbulent times, it is crucial to understand that while patient and care-providers safety is paramount, canceling or postponing essential surgical care is not without consequences, and may be irreversibly detrimental to a patient's health and quality of life in some cases. The optimal solution of how to effectively balance the resumption of standard surgical care while doing everything possible to limit the spread of COVID-19 is undetermined, and could include strategies such as social distancing, screening forms and tests including temperature screening, segregation of inpatient and outpatient teams, proper use of protective gear, and the use of ambulatory surgery centers (ASCs) to provide elective, yet ultimately essential, surgical care while conserving resources and protecting the health of patients and health-care providers. Of importance, these recommendations do not and should not supersede evolving United States Centers for Disease Control and Prevention (CDC), and relevant federal, state and local public health guidelines. Level of Evidence: Level V.


Síndrome de Guillain-Barré tras infección por SARS-CoV-2. Comentarios tras la publicación de 16 nuevos casos./ Síndrome de Guillain-Barré tras infección por SARS-CoV-2. Comentarios tras la publicación de 16 nuevos casos./ Guillain-Barré syndrome associated with SARS-CoV-2 infection. Comments after 16 published cases


title: C1-INH and the contact system in COVID-19

text: COVID-19 is frequently associated with severe systemic consequences, including vasculitis, a hyperinflammatory state and hypercoagulation. The mechanisms leading to these life-threatening abnormalities are multifactorial. Based on the analysis of publicly available interactomes, we propose that SARS-CoV-2 infection directly causes a deficiency in C1 esterase inhibitor (C1-INH), a pathogen-specific mechanism that may help explain significant systemic abnormalities in COVID-19 patients.


title: Modeling COVID-19 in Cape Verde Islands -- An application of SIR model

text: The rapid and surprised emergence of COVID-19, having infected three million and killed two hundred thousand people worldwide in less than five months, has led many experts to focus on simulating its propagation dynamics in order to have an estimated outlook for the not too distante future and so supporting the local and national governments in making decisions. In this paper, we apply the SIR model to simulating the propagation dynamics of COVID-19 on the Cape Verde Islands. It will be done firstly for Santiago and Boavista Islands, ant then for Cape Verde in general. The choice of Santiago rests on the fact that it is the largest island, with more than 50% of the Population of the country, whereas Boavista was chosen because it is the island where the first case of COVID-19 in Cape Verde was diagnosed. Observations made after the date of the simulations were carried out corroborates our projections.


title: Author´s answer to: "Effect of adacolumn® in ulcerative colitis with COVID-19"

text: We have read with interest the article published by Pérez et al., we really appreciate their interesting comments and would like to qualify some points. With the except of the clinical practice, currently there is no recommendation based on scientific evidence about the use of apheresis in the treatment of ulcerative colitis (UC), and even less in Crohn's disease (CD). However, the results obtained in the case of Pérez et al. in relation to systemic inflammation and pulmonary clinical improvement are very interesting from a pathophysiological and clinical point of view.


Creating dermatology guidelines for COVID-19: The pitfalls of applying evidence-based medicine to an emerging infectious disease


title: Assessing the risk of seizures with chloroquine or hydroxychloroquine therapy for COVID-19 in persons with epilepsy

text: BACKGROUND: The goal of this systematic review is to assess the published literature for seizure risk with chloroquine or hydroxychloroquine therapy in persons with and without epilepsy. With the COVID-19 pandemic, there is a desperate need for treatment against the SARS CoV-2 virus. Chloroquine or hydroxychloroquine is one proposed medication that has received substantial public attention. However, the package insert states that these medications may provoke seizures in patients with epilepsy, and this has resulted in increased questions and anxiety in the epilepsy community. METHODS: PubMed (1970 to March 27, 2020) and the Embase (1970 to March 27, 2020) were searched with the terms chloroquine or hydroxychloroquine and seizure or epilepsy, convulsions, or status epilepticus. Selected studies were reviewed, and the adverse drug reaction was classified. RESULTS: Only eleven out of 31 studies were deemed eligible for systematic analysis. For chloroquine, eligible studies were- one prospective study(n = 109), two case series(n = 6), and six case reports. The dose of chloroquine ranged between 100-500 mg/day, except in one patient with a seizure, who was after taking 1000 mg. For hydroxychloroquine, there was one prospective observational study(n = 631) and one case report. The clinical trials failed to find any significant relation between seizures and chloroquine or hydroxychloroquine. CONCLUSION: Although the package insert describes an increased risk of seizure, the systematic review highlights that such a statement is not supported by class I evidence. Clinicians, therefore, need to understand that data regarding this specific topic is limited to case series and case reports. There is no substantial evidence to suggest that these medications can increase seizure risk.


Rhabdomyolysis and Acute Renal Failure in an Adolescent with COVID-19


[Glucocorticoid for coronavirus disease 2019: a dilemma]


Hazardous Postoperative Outcomes of Unexpected COVID-19 Infected Patients: A Call for Global Consideration of Sampling All Asymptomatic Patients Before Surgical Treatment


title: Role of Pharmacists in COVID-19 Disease: A Jordanian Perspective

text: OBJECTIVES: The novel 2019 coronavirus outbreak that first appeared in Wuhan has quickly gained global attention, due to its high transmissibility and devastating clinical and economic outcomes. The aim of this study was to assess the possible roles of Jordanian pharmacists in minimizing the stage of community transmission. METHODS: A cross-sectional survey using Google forms targeting Jordanian pharmacists was conducted during March 2020 and distributed electronically by means of social media. Using the survey tool, we measured the pharmacists' knowledge, the educative activities they perform, and their perceptions regarding undertaking traditional and untraditional roles during the COVID-19 outbreak, as specified by the International Pharmaceutical Federation (FIP). Collected data were analyzed using SPSS version-19. RESULTS: Jordanian pharmacists (n = 449) reported performing various educative activities, and in general, they were knowledgeable about various aspects of the COVID-19 disease (median knowledge score: 20 [range, 13-25]), but certain gaps in knowledge were detected that must be addressed. Pharmacists had positive perceptions about both their traditional and untraditional roles specified by the FIP, the median perceptions score was 4 (range, 1-5). CONCLUSIONS: Jordanian pharmacists can be used to reduce community transmission of the outbreak. However, more actions are required to keep pharmacists knowledgeable with recent disease updates to enable them to perform their tasks effectively during times of crisis.


ACE2 activators for the treatment of COVID 19 patients


Når covid-19 møter afrikansk helsevesen


Tocilizumab for refractory severe immune checkpoint inhibitor-associated myocarditis


title: The challenges facing indigenous communities in Latin America as they confront the COVID-19 pandemic

text: The coronavirus disease 2019 (COVID-2019) pandemic struck Latin America in late February and is now beginning to spread across the rural indigenous communities in the region, home to 42 million people. Eighty percent of this highly marginalized population is concentrated in Bolivia, Guatemala, Mexico and Peru. Health care services for these ethnic groups face distinct challenges in view of their high levels of marginalization and cultural differences from the majority. Drawing on 30 years of work on the responses of health systems in the indigenous communities of Latin America, our group of researchers believes that countries in the region must be prepared to combat the epidemic in indigenous settings marked by deprivation and social disparity. We discuss four main challenges that need to be addressed by governments to guarantee the health and lives of those at the bottom of the social structure: the indigenous peoples in the region. More than an analysis, our work provides a practical guide for designing and implementing a response to COVID-19 in indigenous communities.


title: European consensus recommendations for neonatal and paediatric retrievals of positive or suspected COVID-19 patients

text: BACKGROUND: The 2020 novel coronavirus (SARS-Cov-2) pandemic necessitates tailored recommendations addressing specific procedures for neonatal and paediatric transport of suspected or positive COVID-19 patients. The aim of this consensus statement is to define guidelines for safe clinical care for children needing inter-facility transport while making sure that the clinical teams involved are sufficiently protected from SARS-CoV-2. METHODS: A taskforce, composed of members of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Transport section and the European Society for Paediatric Research (ESPR), reviewed the published literature and used a rapid, two-step modified Delphi process to formulate recommendations regarding safety and clinical management during transport of COVID-19 patients. RESULTS: The joint taskforce consisted of a panel of 12 experts who reached an agreement on a set of 17 recommendations specifying pertinent aspects on neonatal and paediatric COVID-19 patient transport. These included: case definition, personal protective equipment, airway management, equipment and strategies for invasive and non-invasive ventilation, special considerations for incubator and open stretcher transports, parents on transport and decontamination of transport vehicles. CONCLUSIONS: Our consensus recommendations aim to define current best-practice and should help guide transport teams dealing with infants and children with COVID-19 to work safely and effectively. IMPACT: We present European consensus recommendations on pertinent measures for transporting infants and children in times of the coronavirus (SARS-Cov-2 /COVID-19) pandemic. A panel of experts reviewed the evidence around transporting infants and children with proven or suspected COVID-19. Specific guidance on aspects of personal protective equipment, airway management and considerations for incubator and open stretcher transports is presented. Based on scant evidence, best-practice recommendations for neonatal and paediatric transport teams are presented, aiming for the protection of teams and patients. We highlight gaps in knowledge and areas of future research.


COVID-19 Presenting as Acute Hepatitis


Maternal mortality from COVID-19 in Mexico


title: EPIC30M: An Epidemics Corpus Of Over 30 Million Relevant Tweets

text: Since the start of COVID-19, several relevant corpora from various sources are presented in the literature that contain millions of data points. While these corpora are valuable in supporting many analyses on this specific pandemic, researchers require additional benchmark corpora that contain other epidemics to facilitate cross-epidemic pattern recognition and trend analysis tasks. During our other efforts on COVID-19 related work, we discover very little disease related corpora in the literature that are sizable and rich enough to support such cross-epidemic analysis tasks. In this paper, we present EPIC30M, a large-scale epidemic corpus that contains 30 millions micro-blog posts, i.e., tweets crawled from Twitter, from year 2006 to 2020. EPIC30M contains a subset of 26.2 millions tweets related to three general diseases, namely Ebola, Cholera and Swine Flu, and another subset of 4.7 millions tweets of six global epidemic outbreaks, including 2009 H1N1 Swine Flu, 2010 Haiti Cholera, 2012 Middle-East Respiratory Syndrome (MERS), 2013 West African Ebola, 2016 Yemen Cholera and 2018 Kivu Ebola. Furthermore, we explore and discuss the properties of the corpus with statistics of key terms and hashtags and trends analysis for each subset. Finally, we demonstrate the value and impact that EPIC30M could create through a discussion of multiple use cases of cross-epidemic research topics that attract growing interest in recent years. These use cases span multiple research areas, such as epidemiological modeling, pattern recognition, natural language understanding and economical modeling.


title: French consensus regarding precautions during tracheostomy and post-tracheostomy care in the context of COVID-19 pandemic

text: Tracheostomy post-tracheostomy care are regarded as at high risk for contamination of health care professionals with the new coronavirus (SARS-CoV-2). Considering the rapid spread of the infection, all patients in France must be considered as potentially infected by the virus. Nevertheless, patients without clinical or radiological (CT scan) markers of COVID-19, and with negative nasopharyngeal sample within 24h of surgery, are at low risk of being infected. Instructions for personal protection include specific wound dressings and decontamination of all material used. The operating room should be ventilated after each tracheostomy and the pressure of the room should be neutral or negative. Percutaneous tracheostomy is to be preferred over surgical cervicotomy in order to reduce aerosolization and to avoid moving patients from the intensive care unit to the operating room. Ventilation must be optimized during the procedure, to limit patient oxygen desaturation. Drug assisted neuromuscular blockage is advised to reduce coughing during tracheostomy tube insertion. An experienced team is mandatory to secure and accelerate the procedure as well as to reduce risk of contamination.


title: COVID-19 related home confinement in adults: weight gain risks and opportunities

text: As the global COVID-19 pandemic unfolds, over 90% of U.S. adult residents are confined to their homes, with restaurants, shops, schools, and workplaces shut down to prevent disease spread. While it is a priority to mitigate the immediate impact, one area of great concern is the long-term effects of this pandemic on weight management in adults. As evident from previous research, small changes in body weight in relatively short time periods can become permanent and lead to substantial weight gain over time(1). Considering that the current situation could last a total of several months, this extended home confinement could exacerbate the problem of obesity in adults by substantially contributing to or exceeding annual weight gain.


Covert COVID-19 complications: Continuing the use of evidence-based drugs to minimize potentially lethal indirect effects of the pandemic in stroke patients


docid: vgoyplxo

title: Mobile phone data and COVID-19: Missing an opportunity?

text: This paper describes how mobile phone data can guide government and public health authorities in determining the best course of action to control the COVID-19 pandemic and in assessing the effectiveness of control measures such as physical distancing. It identifies key gaps and reasons why this kind of data is only scarcely used, although their value in similar epidemics has proven in a number of use cases. It presents ways to overcome these gaps and key recommendations for urgent action, most notably the establishment of mixed expert groups on national and regional level, and the inclusion and support of governments and public authorities early on. It is authored by a group of experienced data scientists, epidemiologists, demographers and representatives of mobile network operators who jointly put their work at the service of the global effort to combat the COVID-19 pandemic.


Die COVID-19-Pandemie: Arbeitsrecht im Krankenhaus in bewegten Zeiten


Peer mentoring for medical students during the COVID-19 pandemic via a social media platform


Does epicardial fat contribute to COVID-19 myocardial inflammation?


A spike with which to beat COVID-19?


Mortality surveillance during the COVID-19 pandemic


A framework to deal with uncertainty in the age of COVID-19


Covid-19: protecting patients in hospital for neurorehabilitation and their therapists


Response: Acute Hyperglycemic Crises with Coronavirus Disease-19: Case Reports (Diabetes Metab J 2020;44:349-53)


title: Ethical surgical triage of patients with head and neck cancer during the COVID-19 pandemic

text: BACKGROUND: Coronavirus has serially overtaken our metropolitan hospitals. At peak, patients with acute respiratory distress syndrome may outnumber mechanical ventilators. In our Miami Hospital System, COVID-19 cases have multiplied for 4 weeks and elective surgery has been suspended. METHODS: An Otolaryngologic Triage Committee was created to appropriately allocate resources to patients. Hospital ethicists provided support. Our tumor conference screened patients for nonsurgical options. Patients were tested twice for coronavirus before performing urgent contaminated operations. N95 masks and protective equipment were conserved when possible. Patients with low-grade cancers were advised to delay surgery, and other difficult decisions were made. RESULTS: Hundreds of surgeries were canceled. Sixty-five cases screened over 3 weeks are tabulated. Physicians and patients expressed discomfort regarding perceived deviations from standards, but risk of COVID-19 exposure tempered these discussions. CONCLUSIONS: We describe the use of actively managed surgical triage to fairly balance our patient's health with public health concerns.


title: How to reduce the potential risk of vertical transmission of SARS-CoV-2 during vaginal delivery?

text: The risk of vertical transmission during vaginal delivery in COVID-19 pregnant patients is currently a topic of debate. Obstetric norms on vaginal birth assistance to reduce the potential risk of perinatal infection should be promoted by ensuring that the risk of contamination from maternal anus and faecal material is reduced during vaginal delivery.


title: Clinical nursing and midwifery education in the pandemic age

text: The COVID-19 pandemic has disrupted clinical nursing and midwifery education. This disruption has long-term implications for the nursing and midwifery workforce and for future healthcare responses to pandemics. Solutions may include enhanced partnerships between schools of nursing and midwifery and health service providers and including schools of nursing and midwifery in preparedness planning. These suggestions notwithstanding, we call upon national and international nursing and midwifery bodies to study how to further the clinical education of nurses and midwives during pandemics and other times of crisis.


title: Angiotensin-converting enzyme 2, a SARS-CoV-2 receptor, is upregulated by interleukin-6 via STAT3 signaling in synovial tissues

text: The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has spread explosively worldwide and resulted in a pandemic of a new respiratory disease called coronavirus disease 2019 (COVID-19) in 2020. Symptoms of COVID-19 include fever, malaise, cough, and in severe cases, pneumonia and acute respiratory distress syndrome (1,2).


Cardiovascular risks of hydroxychloroquine in treatment and prophylaxis of COVID-19 patients: A scientific statement from the Indian Heart Rhythm Society


title: Favipiravir: Pharmacokinetics and Concerns About Clinical Trials for 2019-nCoV Infection

text: An outbreak of 2019-nCoV infection has spread across the world. No specific antiviral drugs have been approved for the treatment of COVID-2019. In addition to the recommended antiviral drugs, such as interferon-É, lopinavir/ritonavir, ribavirin, and chloroquine phosphate, some clinical trials focusing on virus RNA-dependent RNA polymerase (RdRp) inhibitors have been registered and initiated. Favipiravir, a purine nucleic acid analog and potent RdRp inhibitor approved for use in influenza, is also considered in several clinical trials. Herein, we summarized the pharmacokinetic characteristics of favipiravir and possible drug-drug interactions from the view of drug metabolism. We hope this will be helpful for the design of clinical trials for favipiravir in COVID-2019, as data regarding in vitro virus inhibition and efficacy in preclinical animal studies are still not available.


Is thromboprophylaxis with high-dose enoxaparin really necessary for COVID-19 patients? A new "prudent" randomised clinical trial


Activation of TLR7 and Innate Immunity as an Efficient Method Against COVID-19 Pandemic: Imiquimod as a Potential Therapy


Fever with rash in COVID-19: viral exanthema or secondary lesions?


title: Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: an experience from Hong Kong

text: PURPOSE: Coronavirus disease (COVID-19) has rapidly emerged as a global health threat. The purpose of this article is to share our local experience of stepping up infection control measures in ophthalmology to minimise COVID-19 infection of both healthcare workers and patients. METHODS: Infection control measures implemented in our ophthalmology clinic are discussed. The measures are based on detailed risk assessment by both local ophthalmologists and infection control experts. RESULTS: A three-level hierarchy of control measures was adopted. First, for administrative control, in order to lower patient attendance, text messages with an enquiry phone number were sent to patients to reschedule appointments or arrange drug refill. In order to minimise cross-infection of COVID-19, a triage system was set up to identify patients with fever, respiratory symptoms, acute conjunctivitis or recent travel to outbreak areas and to encourage these individuals to postpone their appointments for at least 14 days. Micro-aerosol generating procedures, such as non-contact tonometry and operations under general anaesthesia were avoided. Nasal endoscopy was avoided as it may provoke sneezing and cause generation of droplets. All elective clinical services were suspended. Infection control training was provided to all clinical staff. Second, for environmental control, to reduce droplet transmission of COVID-19, installation of protective shields on slit lamps, frequent disinfection of equipment, and provision of eye protection to staff were implemented. All staff were advised to measure their own body temperatures before work and promptly report any symptoms of upper respiratory tract infection, vomiting or diarrhoea. Third, universal masking, hand hygiene, and appropriate use of personal protective equipment (PPE) were promoted. CONCLUSION: We hope our initial experience in stepping up infection control measures for COVID-19 infection in ophthalmology can help ophthalmologists globally to prepare for the potential community outbreak or pandemic. In order to minimise transmission of COVID-19, ophthalmologists should work closely with local infection control teams to implement infection control measures that are appropriate for their own clinical settings.


title: Optimal step length for the Newton method near the minimum of a self-concordant function

text: The quadratic convergence region of the exact Newton method around the minimum of a self-concordant function makes up a fraction of the Dikin ellipsoid. Outside of this region, the Newton method has to be damped in order to ensure convergence. However, the available estimates of both the size of the convergence region and the step length to be used outside of it are based on conservative relations between the Hessians at different points and are hence sub-optimal. In this contribution we use methods of optimal control theory to compute the optimal step length of the Newton method on the class of self-concordant functions, as a function of the Newton decrement. With this step length quadratic convergence can be achieved on the whole Dikin ellipsoid. The exact bounds are expressed in terms of solutions of ordinary differential equations which cannot be integrated explicitly. As an application, the neighbourhood of the central path in which the iterates of short-step interior point methods for conic programming are required to stay can be enlarged, enabling faster progress along the central path during each iteration and hence fewer iterations to achieve a given accuracy.


title: [The virtual ward - the students' clinical education during the current pandemic]

text: On March 17, 2020, the Swedish Government recommended all higher education institutions to move to online and distance learning during the COVID-19 pandemic The integrated course in Infection, Microbiology, and Immunity at the Programme in Medicine at University of Gothenburg had to be completely transformed Creative solutions have now replaced the clinical training that normally takes place during the students' clinical education at the hospital We developed a digital concept entitled "the virtual ward", in which we interact with the students in real time Here, the students are able to follow their patients on a daily basis during teacher-guided sessions


title: Covid 19 pandemic and gynaecological laparoscopic surgery: knowns and unknowns

text: The worldwide impact of COVID 19 continues to be felt as hospitals in all countries reduce elective and non-urgent cases to allow staffing and resources to be deployed elsewhere Urgent gynaecological and cancer procedures are continuing, and it is imperative all theatre staff are protected and risks of SARS-CoV-2 viral transmission reduced when operating on asymptomatic, suspected or confirmed COVID 19 patients In particular, there are concerns relating to the transmission of COVID 19 during gynaecological laparoscopic surgery, arising from the potential generation of SARS-CoV-2 contaminated aerosols from CO2 leakage and the creation of smoke from the use of energy devices The aim of this paper is to review all the up to date evidence, including experiences from China and Italy, to guide the safe management of such patients when undergoing gynaecological procedures


Covid-19: undocumented migrants are probably at greatest risk


Coronavirus misinformation needs researchers to respond


title: Prediction and analysis of Coronavirus Disease 2019

text: In December 2019, a novel coronavirus was found in a seafood wholesale market in Wuhan, China. WHO officially named this coronavirus as COVID-19. Since the first patient was hospitalized on December 12, 2019, China has reported a total of 78,824 confirmed CONID-19 cases and 2,788 deaths as of February 28, 2020. Wuhan's cumulative confirmed cases and deaths accounted for 61.1% and 76.5% of the whole China mainland , making it the priority center for epidemic prevention and control. Meanwhile, 51 countries and regions outside China have reported 4,879 confirmed cases and 79 deaths as of February 28, 2020. COVID-19 epidemic does great harm to people's daily life and country's economic development. This paper adopts three kinds of mathematical models, i.e., Logistic model, Bertalanffy model and Gompertz model. The epidemic trends of SARS were first fitted and analyzed in order to prove the validity of the existing mathematical models. The results were then used to fit and analyze the situation of COVID-19. The prediction results of three different mathematical models are different for different parameters and in different regions. In general, the fitting effect of Logistic model may be the best among the three models studied in this paper, while the fitting effect of Gompertz model may be better than Bertalanffy model. According to the current trend, based on the three models, the total number of people expected to be infected is 49852-57447 in Wuhan,12972-13405 in non-Hubei areas and 80261-85140 in China respectively. The total death toll is 2502-5108 in Wuhan, 107-125 in Non-Hubei areas and 3150-6286 in China respetively. COVID-19 will be over p robably in late-April, 2020 in Wuhan and before late-March, 2020 in other areas respectively.


title: COVID-19 Disease in Children: What Dentists Should Know and Do to Prevent Viral Spread. The Italian Point of View

text: Coronavirus disease 2019 (COVID-19) has spread rapidly across the globe, becoming a major public health challenge not for China only, but also for countries around the world. Despite worldwide efforts to contain viral spread, the outbreak has not been stopped yet. Among healthcare personnel, dentists seem to be at elevated risk of exposure to COVID-19. This risk is even more serious in pediatric dentistry, since affected children, frequently, present an asymptomatic, mild or moderate clinical viral infection and, therefore, they may play a major role in community-based COVID-19 transmission. To date, despite no universal guidelines are available for dental procedures in pediatric dentistry during COVID-19 outbreak, routine dental practice should be postponed and only severe dental emergencies must be treated. In the case of a dental emergency, involving a pediatric patient, dentists should be aware of which recommended management protocol can be adopted during the practice to protect patient health, to safeguard their-self and to prevent viral transmission. The aim of this paper is to provide clinical recommendations, presenting a needed tool for dentists to allow a valid and safe how-to-do protocol. Pediatric dentists should keep a high level of awareness to help patients, minimize risk and prevent viral spread.


Further aspects of doxycycline therapy in COVID-19


docid: jhvllaoi

title: Rohingya refugees at high risk of COVID-19 in Bangladesh


title: Prior treatment with immunosuppressants among COVID-19 inpatients at one hospital in Spain

text: Vulnerability to coronavirus disease 2019 (COVID-19) in patients with cardiovascular risk factors is well known. However, the prognostic influence of immunosuppressive drugs or their ability to counteract the cytokine storm involving critically-ill patients are uncertain. The scarce related literature mainly involves transplantation.


title: A single-cell atlas of the peripheral immune response in patients with severe COVID-19

text: There is an urgent need to better understand the pathophysiology of Coronavirus disease 2019 (COVID-19), the global pandemic caused by SARS-CoV-2, which has infected more than three million people worldwide1. Approximately 20% of patients with COVID-19 develop severe disease and 5% of patients require intensive care2. Severe disease has been associated with changes in peripheral immune activity, including increased levels of pro-inflammatory cytokines3,4 that may be produced by a subset of inflammatory monocytes5,6, lymphopenia7,8 and T cell exhaustion9,10. To elucidate pathways in peripheral immune cells that might lead to immunopathology or protective immunity in severe COVID-19, we applied single-cell RNA sequencing (scRNA-seq) to profile peripheral blood mononuclear cells (PBMCs) from seven patients hospitalized for COVID-19, four of whom had acute respiratory distress syndrome, and six healthy controls. We identify reconfiguration of peripheral immune cell phenotype in COVID-19, including a heterogeneous interferon-stimulated gene signature, HLA class II downregulation and a developing neutrophil population that appears closely related to plasmablasts appearing in patients with acute respiratory failure requiring mechanical ventilation. Importantly, we found that peripheral monocytes and lymphocytes do not express substantial amounts of pro-inflammatory cytokines. Collectively, we provide a cell atlas of the peripheral immune response to severe COVID-19.


title: Recommendations for Surgery During the Novel Coronavirus (COVID-19) Epidemic

text: The whole world is going through an unprecedented period during the pandemic of COVID-19. This pandemic has affected all aspects of daily life with far-reaching implications, especially in most aspects of healthcare. Practice of surgery across the globe is in a standstill as of now. When we restart surgical practices across world, we have to bring new protocols and practices in place to combat the transmission. This article discusses the major changes in surgical practice, which need to be brought in. This article is based on scientific information about transmission of virus and experiences of some of the authors from China, a country which successfully dealt with and contained the virus outbreak.


COVID-19 Pandemic as a Driver for Spreading Virtual Care Globally: The Future Starts Now


Covid-19: Leading statistician welcomes UK government's move to improve testing data


Is it ethical to be a 'whistleblower' during COVID-19 pandemic? Ethical challenges confronted by health care workers in China


title: Exploring the genomic and proteomic variations of SARS-CoV-2 spike glycoprotein: A computational biology approach

text: The newly identified SARS-CoV-2 has now been reported from around 185 countries with more than a million confirmed human cases including more than 120,000 deaths. The genomes of SARS-COV-2 strains isolated from different parts of the world are now available and the unique features of constituent genes and proteins need to be explored to understand the biology of the virus. Spike glycoprotein is one of the major targets to be explored because of its role during the entry of coronaviruses into host cells. We analyzed 320 whole-genome sequences and 320 spike protein sequences of SARS-CoV-2 using multiple sequence alignment. In this study, 483 unique variations have been identified among the genomes of SARS-CoV-2 including 25 nonsynonymous mutations and one deletion in the spike (S) protein. Among the 26 variations detected in S, 12 variations were located at the N-terminal domain (NTD) and 6 variations at the receptor-binding domain (RBD) which might alter the interaction of S protein with the host receptor angiotensin-converting enzyme 2 (ACE2). Besides, 22 amino acid insertions were identified in the spike protein of SARS-CoV-2 in comparison with that of SARS-CoV. Phylogenetic analyses of spike protein revealed that Bat coronavirus have a close evolutionary relationship with circulating SARS-CoV-2. The genetic variation analysis data presented in this study can help a better understanding of SARS-CoV-2 pathogenesis. Based on results reported herein, potential inhibitors against S protein can be designed by considering these variations and their impact on protein structure.


title: Artificial Intelligence-Empowered Mobilization of Assessments in COVID-19-like Pandemics: A Case Study for Early Flattening of the Curve

text: The global outbreak of the Coronavirus Disease 2019 (COVID-19) pandemic has uncovered the fragility of healthcare and public health preparedness and planning against epidemics/pandemics. In addition to the medical practice for treatment and immunization, it is vital to have a thorough understanding of community spread phenomena as related research reports 17.9-30.8% confirmed cases to remain asymptomatic. Therefore, an effective assessment strategy is vital to maximize tested population in a short amount of time. This article proposes an Artificial Intelligence (AI)-driven mobilization strategy for mobile assessment agents for epidemics/pandemics. To this end, a self-organizing feature map (SOFM) is trained by using data acquired from past mobile crowdsensing (MCS) campaigns to model mobility patterns of individuals in multiple districts of a city so to maximize the assessed population with minimum agents in the shortest possible time. Through simulation results for a real street map on a mobile crowdsensing simulator and considering the worst case analysis, it is shown that on the 15th day following the first confirmed case in the city under the risk of community spread, AI-enabled mobilization of assessment centers can reduce the unassessed population size down to one fourth of the unassessed population under the case when assessment agents are randomly deployed over the entire city.


title: Practical approaches to pedagogically rich online tutorials in health professions education

text: Health professions education in tertiary, industrial and other contexts often entails face-to-face small group learning through tutorials. The current novel coronavirus, COVID-19, has reduced face-to-face contact, and this has challenged how health professionals and clinical students can access training, accreditation and development. Online and other remote mechanisms are available to tutors and course designers; however, they might not feel comfortable with such affordances, in light of expectations to so rapidly change familiar teaching and delivery styles. This may result in the loss of interaction and disruption of peer learning, which are hallmarks of the small group tutorial. Collaborative learning is essential to develop and refine an emerging sense of belonging to a professional community through formal studies, and interactive learning is a requirement for some registered health professions to satisfy ongoing professional accreditation. Online media has been used to promote social learning in regional, rural and remote communities for some time. Strategies for learning activity design and tutor training are proposed to equip course designers and educators to support health professions education remotely, through the synchronous, online small group. This may herald a new era of increased access to training and professional development for non-urban learners, beyond COVID-19.


Is Hydroxychloroquine a possible post-exposure prophylaxis drug to limit the transmission to health care workers exposed to COVID19?


title: Drug repositioning: a brief overview

text: OBJECTIVES: Drug repositioning, that is, the use of a drug in an indication other than the one for which it was initially marketed, is a growing trend. Its origins lie mainly in the attrition experienced in recent years in the field of new drug discovery. KEY FINDINGS: Despite some regulatory and economic challenges, drug repositioning offers many advantages, and a number of recent successes have confirmed both its public health benefits and its commercial value. The first examples of successful drug repositioning mainly came about through serendipity like acetylsalicylic acid, thalidomide, sildenafil or dimethylfumarate. CONCLUSION: The history of great-repositioned drugs has given some solutions to various pathologies. Serendipity is not yet useful to find repositioning drugs. Drug repositioning is of growing interest. Nowadays, a more rational approach to the identification of drug candidates for repositioning is possible, especially using data mining.


title: Mortality and Advanced Support Requirement for Patients With Cancer With COVID-19: A Mathematical Dynamic Model for Latin America

text: PURPOSE: In the midst of a global pandemic, evidence suggests that similar to other severe respiratory viral infections, patients with cancer are at higher risk of becoming infected by COVID-19 and have a poorer prognosis. METHODS: We have modeled the mortality and the intensive care unit (ICU) requirement for the care of patients with cancer infected with COVID-19 in Latin America. A dynamic multistate Markov model was constructed. Transition probabilities were estimated on the basis of published reports for cumulative probability of complications. Basic reproductive number (R0) values were modeled with R using the EpiEstim package. Estimations of days of ICU requirement and absolute mortality were calculated by imputing number of cumulative cases in the Markov model. RESULTS: Estimated median time of ICU requirement was 12.7 days, median time to mortality was 16.3 days after infection, and median time to severe event was 8.1 days. Peak ICU occupancy for patients with cancer was calculated at 16 days after infection. Deterministic sensitivity analysis revealed an interval for mortality between 18.5% and 30.4%. With the actual incidence tendency, Latin America would be expected to lose approximately 111,725 patients with cancer to SARS-CoV-2 (range, 87,116-143,154 patients) by the 60th day since the start of the outbreak. Losses calculated vary between < 1% to 17.6% of all patients with cancer in the region. CONCLUSION: Cancer-related cases and deaths attributable to SARS-CoV-2 will put a great strain on health care systems in Latin America. Early implementation of interventions on the basis of data given by disease modeling could mitigate both infections and deaths among patients with cancer.


title: Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents

text: Currently, the emergence of a novel human coronavirus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its spread via droplets, contaminated hands or surfaces. We therefore reviewed the literature on all available information about the persistence of human and veterinary coronaviruses on inanimate surfaces as well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare facilities. The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Other biocidal agents such as 0.05-0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective. As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.


The potential impact of COVID-19-related disruption on tuberculosis burden


title: Using effective hand hygiene practice to prevent and control infection

text: Decontamination using hand hygiene remains one of the most important and effective methods for reducing healthcare-associated infections and cross-infection between patients. In 1860, Florence Nightingale wrote that nurses should wash their hands frequently throughout the day, demonstrating an early awareness of the effectiveness of this simple procedure. The COVID-19 pandemic has demonstrated that effectively applied hand hygiene is a vital intervention that can be used to prevent the spread of disease. This article details the correct procedure required for effective hand hygiene and emphasises the need for nurses to keep up to date with evidence-based guidelines. The article also outlines the differences between hand decontamination using alcohol-based hand gels and soap and water, and the complex factors that can interfere with effective hand hygiene compliance.


Alert to Potential Contagiousness: A Case of Lung Cancer With Asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection


Invasive mechanical ventilation in COVID-19 patient management: the experience with 469 patients in Wuhan


docid: dhlquvjy

title: Causal Explanations of Image Misclassifications

text: The causal explanation of image misclassifications is an understudied niche, which can potentially provide valuable insights in model interpretability and increase prediction accuracy. This study trains CIFAR-10 on six modern CNN architectures, including VGG16, ResNet50, GoogLeNet, DenseNet161, MobileNet V2, and Inception V3, and explores the misclassification patterns using conditional confusion matrices and misclassification networks. Two causes are identified and qualitatively distinguished: morphological similarity and non-essential information interference. The former cause is not model dependent, whereas the latter is inconsistent across all six models. To reduce the misclassifications caused by non-essential information interference, this study erases the pixels within the bonding boxes anchored at the top 5% pixels of the saliency map. This method first verifies the cause; then by directly modifying the cause it reduces the misclassification. Future studies will focus on quantitatively differentiating the two causes of misclassifications, generalizing the anchor-box based inference modification method to reduce misclassification, exploring the interactions of the two causes in misclassifications.


COVID-19 in children: the link in the transmission chain


Emergence of Coronavirus (COVID-19) outbreak: Anthropological and social science perspectives


title: Chloroquine-induced QTc prolongation in COVID-19 patients

text: BACKGROUND: In the battle against the SARS-CoV2 pandemic, chloroquine has emerged as a new potential therapeutic option for the treatment of infected patients. A safety consideration for the application of chloroquine is its QTc-prolonging potential. Thus far, no data are available on the QTc-prolonging potential of chloroquine in COVID-19 patients. OBJECTIVE: To assess the degree of chloroquine-induced QTc prolongation in hospitalised COVID-19 patients. METHODS: A baseline electrocardiogram (ECG) and ECGs recorded during chloroquine treatment were retrospectively collected in patients suspected of having COVID-19. The QTc interval was calculated by computerised and manual interpretation. Baseline and follow-up QTc intervals were compared using the paired samples t-test. RESULTS: A total of 95 patients had a baseline ECG recording and at least one ECG recording during chloroquine therapy. Chloroquine treatment resulted in a mean QTc prolongation of 35â¯ms (95% CI 28-43â¯ms) using computerised interpretation and 34â¯ms (95% CI 25-43â¯ms) using manual interpretation. No torsade de pointes was observed during chloroquine treatment. After manual review, 22 patients (23%) had a QTc interval exceeding 500â¯ms during chloroquine treatment. None of these patients had a prolonged QTc interval prior to the initiation of chloroquine treatment. CONCLUSIONS: Chloroquine significantly prolongs the QTc interval in a clinically relevant matter. This highlights the need for ECG monitoring when prescribing chloroquine to COVID-19 patients.


Clinical features and outcomes of four HIV patients with COVID-19 in Wuhan, China


Risk factors for severe COVID-19: Evidence from 167 hospitalized patients in Anhui, China


Clinical Characteristics of Patients Who Died of Coronavirus Disease 2019 in China


Return to work guidelines for the COVID-19 pandemic


title: A Critic Evaluation of Methods for COVID-19 Automatic Detection from X-Ray Images

text: In this paper, we compare and evaluate different testing protocols used for automatic COVID-19 diagnosis from X-Ray images in the recent literature. We show that similar results can be obtained using X-Ray images that do not contain most of the lungs. We are able to remove the lungs from the images by turning to black the center of the X-Ray scan and training our classifiers only on the outer part of the images. Hence, we deduce that several testing protocols for the recognition are not fair and that the neural networks are learning patterns in the dataset that are not correlated to the presence of COVID-19. Finally, we show that creating a fair testing protocol is a challenging task, and we provide a method to measure how fair a specific testing protocol is. In the future research we suggest to check the fairness of a testing protocol using our tools and we encourage researchers to look for better techniques than the ones that we propose.


Can Ticagrelor be used to prevent sepsis-induced coagulopathy in COVID-19?


Hemophagocytic lymphohistiocytosis in SARS-CoV-2 infection


title: A high normal ankle-brachial index is associated with biopsy-proven severe renal small artery intimal thickening and impaired renal function in chronic kidney disease

text: A significant relationship has been established between central hemodynamics and renal microvascular damage. We hypothesized that the increase in the ankle-brachial index (ABI) with age is due to increased arterial stiffness and wave reflection and is thus associated with the pathogenesis of the renal small artery in patients with chronic kidney disease (CKD). We recruited 122 patients with CKD (stages 1-5) who underwent renal biopsy and ABI measurements between 2010 and 2013. Renal small artery intimal thickening (SA-IT) severity was assessed by semiquantitative grading. The median age was 47 years, with a range of 15-86 years (47% women). The median estimated glomerular filtration rate (eGFR) was 62 mL/min/1.73 m2. Compared with patients with the lowest 1-3 SA-IT index quartile, those with the highest quartile of the SA-IT index were older in age had higher mean arterial pressure, ABI, brachial-ankle pulse wave velocity, and lower eGFR. ABI was positively associated with SA-IT severity and inversely associated with eGFR. Multivariate logistic regression analyses showed that ABI was significantly associated with the highest quartile of the SA-IT index (odds ratio per SD increase in ABI, 1.83; 95% confidence interval, 1.08-3.26) and low eGFR (<60 mL/min/1.73 m2) (odds ratio per SD increase in ABI, 1.74; 95% confidence interval, 1.03-3.03). In conclusion, a high normal ABI was associated with severe renal small artery intimal thickening and low eGFR in patients with CKD.


title: The Neurobiology of Social Distance

text: Never before have we experienced social isolation on such a massive scale as we have in response to coronavirus disease 2019 (COVID-19). However, we know that the social environment has a dramatic impact on our sense of life satisfaction and well-being. In times of distress, crisis, or disaster, human resilience depends on the richness and strength of social connections, as well as on active engagement in groups and communities. Over recent years, evidence emerging from various disciplines has made it abundantly clear: perceived social isolation (i.e., loneliness) may be the most potent threat to survival and longevity. We highlight the benefits of social bonds, the choreographies of bond creation and maintenance, as well as the neurocognitive basis of social isolation and its deep consequences for mental and physical health.


title: Cardiopulmonary resuscitation in COVID-19 patients

text: COVID-19 is extremely transmissible. Cardiopulmonary resuscitation (CPR) is associated with multiple aerosol-generating procedures including chest compression, positive pressure ventilation, and airway manipulation. Healthcare providers who perform CPR are at high risk of contracting COVID-19. CPR in patients with suspected or proven COVID-19 must be performed without compromising the safety of healthcare providers. An overview of special considerations.


title: Tocilizumab for treatment of mechanically ventilated patients with COVID-19

text: BACKGROUND: Severe COVID-19 can manifest in rapid decompensation and respiratory failure with elevated inflammatory markers, consistent with cytokine release syndrome for which IL-6 blockade is approved treatment. METHODS: We assessed effectiveness and safety of IL-6 blockade with tocilizumab in a single-center cohort of patients with COVID-19 requiring mechanical ventilation. The primary endpoint was survival probability post-intubation; secondary analyses included an ordinal illness severity scale integrating superinfections. Outcomes in patients who received tocilizumab compared to tocilizumab-untreated controls were evaluated using multivariable Cox regression with propensity score inverse probability weighting (IPTW). RESULTS: 154 patients were included, of whom 78 received tocilizumab and 76 did not. Median follow-up was 47 days (range 28-67). Baseline characteristics were similar between groups, although tocilizumab-treated patients were younger (mean 55 vs. 60 years), less likely to have chronic pulmonary disease (10% vs. 28%), and had lower D-dimer values at time of intubation (median 2.4 vs. 6.5 mg/dL). In IPTW-adjusted models, tocilizumab was associated with a 45% reduction in hazard of death [hazard ratio 0.55 (95% CI 0.33, 0.90)] and improved status on the ordinal outcome scale [odds ratio per 1-level increase: 0.58 (0.36, 0.94)]. Though tocilizumab was associated with an increased proportion of patients with superinfections (54% vs. 26%; p<0.001), there was no difference in 28-day case fatality rate among tocilizumab-treated patients with versus without superinfection [22% vs. 15%; p=0.42]. Staphylococcus aureus accounted for ~50% of bacterial pneumonia. CONCLUSIONS: In this cohort of mechanically ventilated COVID-19 patients, tocilizumab was associated with lower mortality despite higher superinfection occurrence.


title: Influenza response planning for the centers of excellence for influenza research and surveillance: Science preparedness for enhancing global health security

text: BACKGROUND: The Centers of Excellence for Influenza Research and Surveillance (CEIRS) network, funded by the US National Institutes of Health, has been operational since 2007 and is tasked with conducting research to improve understanding of influenza viruses. Recently, CEIRS developed an Influenza Response Plan (IRP) to improve science preparedness for the network. METHODS: Development of the IRP involved a collaborative process between project staff, CEIRS center directors or their designees, and NIAID CEIRS leadership (referred to as the Pandemic Planning Advisory Committee [PPAC]). Project staff identified and summarized the response capabilities of each center and then worked with the PPAC to identify and rank research priorities for an emergency response using a modified Delphi method. RESULTS: Key elements of the response plan include tables of response capabilities for each CEIRS center, a framework that outlines and ranks research priorities for CEIRS during an emergency situation, and an operational strategy for executing the research priorities. CONCLUSIONS: The CEIRS IRP highlights the importance of enhancing science preparedness in advance of an influenza pandemic or other influenza-related zoonotic incident to ensure that research can be carried out expeditiously and effectively in emergency situations and to improve global health security.


COVID-19 - Implications on and of Surgical Practices: Where Do We Draw the Line?


COVID-19, Mental Health and Aging: A Need for New Knowledge to Bridge Science and Service


title: A Review of Early Experience in Lung Ultrasound in the Diagnosis and Management of COVID-19

text: A novel coronavirus (2019-nCoV) was identified as the cause of a cluster of pneumonia in Wuhan, China, at the end of 2019. Since then more than eight million confirmed cases of coronavirus disease 2019 (COVID-19) have been reported around the globe. The current gold standard for etiologic diagnosis is reverse transcription-polymerase chain reaction analysis of respiratory-tract specimens, but the test has a high false-negative rate owing to both nasopharyngeal swab sampling error and viral burden. Hence diagnostic imaging has emerged as a fundamental component of current management of COVID-19. Currently, high-resolution computed tomography is the main imaging tool for primary diagnosis and evaluation of disease severity in patients. Lung ultrasound (LUS) imaging has become a safe bedside imaging alternative that does not expose the patient to radiation and minimizes the risk of contamination. Although the number of studies to date is limited, LUS findings have demonstrated high diagnostic sensitivity and accuracy, comparable with those of chest computed tomography scans. In this note we review the current state of the art of LUS in evaluating pulmonary changes induced by COVID-19. The goal is to identify characteristic sonographic findings most suited for the diagnosis of COVID-19 pneumonia infections.


docid: eeqfetsb

title: COVID-19: Complexity and the Black Swan

text: In previous President's Columns (Valeras, 2019a, 2019b), the properties of complexity and complex adaptive systems have been discussed, in terms of the value of continual and iterative change, in order to nudge a system to emerge differently, rather than maintain the status quo. COVID-19 is not a nudge; it is a tidal wave. Engaging with and understanding complexity science allows us to examine the internal rules of our health care system and recognize our own role as agents that can systematically and deliberately disrupt the status quo. The intertwined and interdependent complex relationships that exist in health care between persons, business, academia, and government buffer the system from rapid and drastic change. COVID-19, however, swiftly disrupted many of the rules keeping the system in its previous state. Some would describe this sudden and dramatic systems change as a Black Swan. This column will examine the role of the Black Swan, as it relates to this pandemic. The Black Swan is a term coined in the 2nd century by Roman poet Juvenal's description of something being rara avis in terries nigroque simillima cygno, Latin for "a bird as rare as the black swan" (Taleb, 2007, p. xxxi). At this time, reference to a black swan was meant as a statement of impossibility, because all historical records of swans had been white. In 1697, Dutch explorers discovered black swans living in the wild in Western Australia (Taleb, 2007, p. xxi), and the black swan became a metaphor for events that come as a surprise, have major implications, and can often be understood only with the benefit of hindsight. This theory of the black swan was further articulated by Nassim Nicholas Taleb in his books Fooled by Randomness (Taleb, 2001) and The Black Swan (Taleb, 2007). (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Fetal Diagnosis and Therapy during the COVID-19 Pandemic: Guidance on Behalf of the International Fetal Medicine and Surgery Society

text: The COVID-19 pandemic has stressed patients and healthcare givers alike and challenged our practice of antenatal care, including fetal diagnosis and therapy. This document aims to review relevant recent information to allow us to optimize prenatal care delivery. We discuss potential modifications to obstetric management and fetal procedures in SARS-CoV2-negative and SARS-CoV2-positive patients with fetal anomalies or disorders. Most fetal therapies are time sensitive and cannot be delayed. If personnel and resources are available, we should continue to offer procedures of proven benefit, acknowledging any fetal and maternal risks, including those to health care workers. There is, to date, minimal, unconfirmed evidence of spontaneous vertical transmission, though it may theoretically be increased with some procedures. Knowing a mother's preoperative SARS-CoV-2 status would enable us to avoid or defer certain procedures while she is contagious and to protect health care workers appropriately. Some fetal conditions may alternatively be managed neonatally. Counseling regarding fetal interventions which have a possibility of additional intra- or postoperative morbidity must be performed in the context of local resource availability. Procedures of unproven benefit should not be offered. We encourage participation in registries and trials that may help us to understand the impact of COVID-19 on pregnant women, their fetuses, and neonates.


title: Analysis of free aniline in chrome-free leather accelerated aging

text: Under acidic conditions, aniline can react with nitrite diazotization, then diazotization can reaction products under the condition of alkaline naphthol coupled with armor and color. The product of this reaction has a maximum absorption at 495 nm. By using a series of optimized experiments, we obtained the optimum instrument operation parameters and reaction conditions to analyze aniline in leather extract solutions. Under optimal conditions, aniline concentration was within the range of 0.002-2.0 mg/L, and peak height (H, mV) and concentration (c, mg/L) had a linear relationship. The linear correlation coefficient was R2 = 0.9997, the detection limit was 1.62 µg/L, and the RSD was 0.71%. Aniline in leather extract after accelerated aging was calculated using our calculation method, and the range of standard addition recovery was recorded to be between 97.8% and 103.8%. Compared with the national standard anti-interference method, our result recorded more accurate results and the relative mean absolute error (RAAE) was smaller. Our flow injection analysis combined with ultraviolet visible spectrophotometry (FIA-UV) method can eliminate interference due to trace elements in the extraction solution, as well as effectively improving accuracy and reliability for the determination of aniline in chrome-free leather extraction solution.


Psychological crisis interventions in Sichuan Province during the 2019 novel coronavirus outbreak


title: Expert consensus on prevention and control of COVID-19 in the neurological intensive care unit (first edition)

text: During the COVID-19 epidemic, the treatment of critically ill patients has been increasingly difficult and challenging. During the epidemic, some patients with neurological diseases also have COVID-19, which could be misdiagnosed and cause silent transmission and nosocomial infection. Such risk is high in a neurological intensive care unit (NCU). Therefore, prevention and control of epidemic in critically ill patients is of utmost importance. The principle of NCU care should include comprehensive screening and risk assessment, weighing risk against benefits and reducing the risk of COVID-19 transmission while treating patients as promptly as possible.


title: Surfactant-based prophylaxis and therapy against COVID-19: A possibility

text: Hand hygiene by washing with soap and water is recommended for the prevention of COVID-19 spread. Soaps and detergents are explained to act by damaging viral spike glycoproteins (peplomers) or by washing out the virus through entrapment in the micelles. Technically, soaps come under a functional category of molecules known as surfactants. Surfactants are widely used in pharmaceutical formulations as excipients. We wonder why surfactants are still not tried for prophylaxis or therapy against COVID-19? That too when many of them have proven antiviral properties. Moreover, lung surfactants have already shown benefits in respiratory viral infections. Therefore, we postulate that surfactant-based prophylaxis and therapy would be promising. We believe that our hypothesis would stimulate debate or new research exploring the possibility of surfactant-based prophylaxis and therapy against COVID-19. The success of a surfactant-based technique would save the world from any such pandemic in the future too.


The Use of "Novel Pharmacology" in the Treatment of COVID-19 and Potential Psychiatric Risks


Dermatological manifestation of pediatrics multisystem inflammatory syndrome associated with COVID-19 in a 3-year-old girl


Dermatological Manifestation of Pediatrics Multisystem Inflammatory Syndrome Associated with COVID-19 in a 3-Year-Old Girl


title: Impact of intervention on the spread of COVID-19 in India: A model based study

text: The outbreak of corona virus disease 2019 (COVID-19), caused by the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already created emergency situations in almost every country of the world. The disease spreads all over the world within a very short period of time after its first identification in Wuhan, China in December, 2019. In India, the outbreaks starts on $2^{nd}$ March, 2020 and after that the cases are increasing exponentially. Very high population density, the unavailability of specific medicines or vaccines, insufficient evidences regarding the transmission mechanism of the disease also make it difficult to fight against the disease properly in India. Mathematical models have been used to predict the disease dynamics and also to assess the efficiency of the intervention strategies in reducing the disease burden. In this work, we propose a mathematical model to describe the disease transmission mechanism between the individuals. We consider the initial phase of the outbreak situation in India and our proposed model is fitted to the daily cumulative new reported cases during the period $2^{nd}$ March, 2020 to $24^{th}$ March, 2020. We estimate the basic reproduction number $(R_0)$, effective reproduction number (R(t)) and epidemic doubling time from the incidence data for the above-mentioned period. We further assess the effect of preventive measures such as spread of awareness, lock-down, proper hand sanitization, etc. in reducing the new cases. Two intervention scenarios are considered depending on the variability of the intervention strength over the period of implementation. Our study suggests that higher intervention effort is required to control the disease outbreak within a shorter period of time in India. Moreover, our analysis reveals that the strength of the intervention should be strengthened over the time to eradicate the disease effectively.


title: Structure-based screening of novel lichen compounds against SARS Coronavirus main protease (Mpro) as potentials inhibitors of COVID-19

text: The outbreak of SARS-CoV-2 and deaths caused by it all over the world have imposed great concern on the scientific community to develop potential drugs to combat Coronavirus disease-19 (COVID-19). In this regard, lichen metabolites may offer a vast reservoir for the discovery of antiviral drug candidates. Therefore, to find novel compounds against COVID-19, we created a library of 412 lichen compounds and subjected to virtual screening against the SARS-CoV-2 Main protease (Mpro). All the ligands were virtually screened, and 27 compounds were found to have high affinity with Mpro. These compounds were assessed for drug-likeness analysis where two compounds were found to fit well for redocking studies. Molecular docking, drug-likeness, X-Score, and toxicity analysis resulting in two lichen compounds, Calycin and Rhizocarpic acid with Mpro-inhibiting activity. These compounds were finally subjected to molecular dynamics simulation to compare the dynamics behavior and stability of the Mpro after ligand binding. The binding energy was calculated by MM-PBSA method to determine the intermolecular protein-ligand interactions. Our results showed that two compounds; Calycin and Rhizocarpic acid had the binding free energy of - 42.42 kJ mol/1 and - 57.85 kJ mol/1 respectively as compared to reference X77 (- 91.78 kJ mol/1). We concluded that Calycin and Rhizocarpic acid show considerable structural and pharmacological properties and they can be used as hit compounds to develop potential antiviral agents against SARS-CoV-2. These lichen compounds may be a suitable candidate for further experimental analysis.


Human rights protections are needed alongside PPE for health-care workers responding to COVID-19


What's Important: Redeployment of the Orthopaedic Surgeon During the COVID-19 Pandemic: Perspectives from the Trenches


title: Application of the PDCA cycle for standardized nursing management in a COVID-19 intensive care unit

text: BACKGROUND: Nursing quality is an integral part of health care quality and one of key performance indicators (KPIs) for health care management. The Plan-Do-Check-Act (PDCA) cycle is a management tool for continuous improvement of a business's products or processes. It can be applied to standardize nursing management and thus improve the nursing quality and increase the survival rate of patients. This study assessed the value of the PDCA cycle in standardizing nursing management in an intensive care unit (ICU) for patients with severe coronavirus disease 2019 (COVID-19). METHODS: The status quo of the ICU was analyzed, and the relevant issues and countermeasures were proposed. The PDCA cycle was applied to standardize the nursing management in the ICU. RESULTS: Nine measures were proposed and applied to improve the management of the COVID-19 ICU: defining the clean or contaminated areas, use of self-designed shoe storage cabinets, defining staff roles and responsibilities, establishing the staffing structure, staff training, placing items at fixed locations, improving shift handover, use of bulletin boards for listing key points, and use of reserved drugs cabinets. The virus contamination awareness, professional skills, awareness of duties and responsibilities, and quality and performance of nursing were remarkably improved 2 weeks after the implementation of the above countermeasures. CONCLUSIONS: The PDCA cycle helps to standardize nursing management in COVID-19 ICU by developing and applying effective nursing management approaches.


docid: rvutwvdt

title: Will Complement Inhibition Be the New Target in Treating COVID-19-Related Systemic Thrombosis?


title: Fact or Fiction: Verifying Scientific Claims

text: We introduce scientific claim verification, a new task to select abstracts from the research literature containing evidence that supports or refutes a given scientific claim, and to identify rationales justifying each decision. To study this task, we construct SciFact, a dataset of 1.4K expert-written scientific claims paired with evidence-containing abstracts annotated with labels and rationales. We develop baseline models for SciFact, and demonstrate that these models benefit from combined training on a large dataset of claims about Wikipedia articles, together with the new SciFact data. We show that our claim verification system is able to identify plausible evidence for 23 / 36 claims relevant to COVID-19 on the CORD-19 corpus. Our results and experiments strongly suggest that our new task and data will support significant future research efforts.


title: Natural products and their derivatives against coronavirus: A review of the non-clinical and pre-clinical data

text: Several corona viral infections have created serious threats in the last couple of decades claiming the death of thousands of human beings. Recently, corona viral epidemic raised the issue of developing effective antiviral agents at the earliest to prevent further losses. Natural products have always played a crucial role in drug development process against various diseases, which resulted in screening of such agents to combat emergent mutants of corona virus. This review focuses on those natural compounds that showed promising results against corona viruses. Although inhibition of viral replication is often considered as a general mechanism for antiviral activity of most of the natural products, studies have shown that some natural products can interact with key viral proteins that are associated with virulence. In this context, some of the natural products have antiviral activity in the nanomolar concentration (e.g., lycorine, homoharringtonine, silvestrol, ouabain, tylophorine, and 7-methoxycryptopleurine) and could be leads for further drug development on their own or as a template for drug design. In addition, a good number of natural products with anti-corona virus activity are the major constituents of some common dietary supplements, which can be exploited to improve the immunity of the general population in certain epidemics.


title: Coronavirus disease 19 in minority populations of Newark, New Jersey

text: BACKGROUND: The purpose of this study is to report the clinical features and outcomes of Black/African American (AA) and Latino Hispanic patients with Coronavirus disease 2019 (COVID-19) hospitalized in an inter-city hospital in the state of New Jersey. METHODS: This is a retrospective cohort study of AA and Latino Hispanic patients with COVID-19 admitted to a 665-bed quaternary care, teaching hospital located in Newark, New Jersey. The study included patients who had completed hospitalization between March 10, 2020, and April 10, 2020. We reviewed demographics, socioeconomic variables and incidence of in-hospital mortality and morbidity. Logistic regression was used to identify predictor of in-hospital death. RESULTS: Out of 416 patients, 251 (60%) had completed hospitalization as of April 10, 2020. The incidence of In-hospital mortality was 38.6% (n = 97). Most common symptoms at initial presentation were dyspnea 39% (n = 162) followed by cough 38%(n = 156) and fever 34% (n = 143). Patients were in the highest quartile for population's density, number of housing units and disproportionately fell into the lowest median income quartile for the state of New Jersey. The incidence of septic shock, acute kidney injury (AKI) requiring hemodialysis and admission to an intensive care unit (ICU) was 24% (n = 59), 21% (n = 52), 33% (n = 82) respectively. Independent predictors of in-hospital mortality were older age, lower serum Hemoglobin < 10 mg/dl, elevated serum Ferritin and Creatinine phosphokinase levels > 1200 U/L and > 1000 U/L. CONCLUSIONS: Findings from an inter-city hospital's experience with COVID-19 among underserved minority populations showed that, more than one of every three patients were at risk for in-hospital death or morbidity. Older age and elevated inflammatory markers at presentation were associated with in-hospital death.


title: Clinical Characteristics of Hospitalized Individuals Dying with COVID-19 by Age Group in Italy

text: BACKGROUND: aim of the present study is to describe characteristics of COVID-19 related deaths and to compare the clinical phenotype and course of COVID-19 related deaths occurring in adults (< 65 years) and older adults (≥ 65 years). METHODS: medical charts of 3,032 patients dying with COVID-19 in Italy (368 aged < 65 years and 2,664 aged ≥ 65 years) were revised to extract information on demographics, pre-existing comorbidities, and in-hospital complications leading to death. RESULTS: Older adults (≥ 65 years) presented with a higher number of comorbidities compared to those aged < 65 years (3.3 ± 1.9 vs. 2.5 ± 1.8, p<0.001). Prevalence of ischemic heart disease, atrial fibrillation, heart failure, stroke, hypertension, dementia, COPD, and chronic renal failure was higher in older patients (≥ 65 years), while obesity, chronic liver disease, and HIV infection were more common in younger adults (< 65 years); 10.9% of younger patients (< 65 years) had no comorbidities, compared to 3.2% of older patients (≥ 65 years). The younger adults had a higher rate of non-respiratory complications than older patients including acute renal failure (30.0% vs 20.6%), acute cardiac injury (13.5% vs 10.3%) and superinfections (30.9% vs. 9.8%). CONCLUSIONS: individuals dying with COVID-19 present with high levels of comorbidities, irrespective of age group, but a small proportion of deaths occurs in healthy adults with no pre-existing conditions. Non-respiratory complications are common, suggesting that the treatment of respiratory conditions needs to be combined with strategies to prevent and mitigate the effects of non-respiratory complications.


title: Spatial-Temporal Variations in Atmospheric Factors Contribute to SARS-CoV-2 Outbreak

text: The global outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causing coronavirus disease 2019 (COVID-19) has reached over five million confirmed cases worldwide, and numbers are still growing at a fast rate. Despite the wide outbreak of the infection, a remarkable asymmetry is observed in the number of cases and in the distribution of the severity of the COVID-19 symptoms in patients with respect to the countries/regions. In the early stages of a new pathogen outbreak, it is critical to understand the dynamics of the infection transmission, in order to follow contagion over time and project the epidemiological situation in the near future. While it is possible to reason that observed variation in the number and severity of cases stems from the initial number of infected individuals, the difference in the testing policies and social aspects of community transmissions, the factors that could explain high discrepancy in areas with a similar level of healthcare still remain unknown. Here, we introduce a binary classifier based on an artificial neural network that can help in explaining those differences and that can be used to support the design of containment policies. We found that SARS-CoV-2 infection frequency positively correlates with particulate air pollutants, and specifically with particulate matter 2.5 (PM2.5), while ozone gas is oppositely related with the number of infected individuals. We propose that atmospheric air pollutants could thus serve as surrogate markers to complement the infection outbreak anticipation.


COVID-19, Vascular Diseases, and Vascular Services


COVID-19: PCR screening of asymptomatic health-care workers at London hospital


title: Compassionate Use of Remdesivir for Patients with Severe Covid-19

text: BACKGROUND: Remdesivir, a nucleotide analogue prodrug that inhibits viral RNA polymerases, has shown in vitro activity against SARS-CoV-2. METHODS: We provided remdesivir on a compassionate-use basis to patients hospitalized with Covid-19, the illness caused by infection with SARS-CoV-2. Patients were those with confirmed SARS-CoV-2 infection who had an oxygen saturation of 94% or less while they were breathing ambient air or who were receiving oxygen support. Patients received a 10-day course of remdesivir, consisting of 200 mg administered intravenously on day 1, followed by 100 mg daily for the remaining 9 days of treatment. This report is based on data from patients who received remdesivir during the period from January 25, 2020, through March 7, 2020, and have clinical data for at least 1 subsequent day. RESULTS: Of the 61 patients who received at least one dose of remdesivir, data from 8 could not be analyzed (including 7 patients with no post-treatment data and 1 with a dosing error). Of the 53 patients whose data were analyzed, 22 were in the United States, 22 in Europe or Canada, and 9 in Japan. At baseline, 30 patients (57%) were receiving mechanical ventilation and 4 (8%) were receiving extracorporeal membrane oxygenation. During a median follow-up of 18 days, 36 patients (68%) had an improvement in oxygen-support class, including 17 of 30 patients (57%) receiving mechanical ventilation who were extubated. A total of 25 patients (47%) were discharged, and 7 patients (13%) died; mortality was 18% (6 of 34) among patients receiving invasive ventilation and 5% (1 of 19) among those not receiving invasive ventilation. CONCLUSIONS: In this cohort of patients hospitalized for severe Covid-19 who were treated with compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients (68%). Measurement of efficacy will require ongoing randomized, placebo-controlled trials of remdesivir therapy. (Funded by Gilead Sciences.).


Corrigendum to "N-alkyl-hydroxybenzoyl anilide hydroxamates as dual inhibitors of HDAC and HSP90, downregulating IFN-Î³ induced PD-L1 expression"[Eur. J. Med. Chem. 2020 Jan 1;185:111725]


ADAM17 inhibition may exert a protective effect on COVID-19


title: Abdominal pain in a patient with COVID-19 infection: A case of multiple thromboemboli

text: The novel coronavirus SARS-CoV-2 (COVID-19) pandemic has created diagnostic uncertainty with regards to distinguishing this infection from pulmonary embolism (PE). Although there appears to be an increased incidence of thromboembolic disease in patients with COVID-19 infection, recommendations regarding anticoagulation are lacking. We present the case of a 61-year-old woman with clinically significant venous and arterial thromboemboli in the setting of COVID-19 infection requiring tissue plasminogen activator (tPA).


The value of hospital personnel serological screening in an integrated COVID-19 infection prevention and control strategy


Covid-19: an Imperative to Bridge the Gap Between Medicine And Public Health


Covid-19: Experts urge strategies to prevent further outbreaks in care homes


Screening all pregnant women admitted to labor and delivery for the virus responsible for coronavirus disease 2019


title: COVID-19 (Novel Coronavirus 2019) - recent trends

text: The World Health Organization (WHO) has issued a warning that, although the 2019 novel coronavirus (COVID-19) from Wuhan City (China), is not pandemic, it should be contained to prevent the global spread. The COVID-19 virus was known earlier as 2019-nCoV. As of 12 February 2020, WHO reported 45,171 cases and 1115 deaths related to COVID-19. COVID-19 is similar to Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) virus in its pathogenicity, clinical spectrum, and epidemiology. Comparison of the genome sequences of COVID-19, SARS-CoV, and Middle East Respiratory Syndrome coronavirus (MERS-CoV) showed that COVID-19 has a better sequence identity with SARS-CoV compared to MERS CoV. However, the amino acid sequence of COVID-19 differs from other coronaviruses specifically in the regions of 1ab polyprotein and surface glycoprotein or S-protein. Although several animals have been speculated to be a reservoir for COVID-19, no animal reservoir has been already confirmed. COVID-19 causes COVID-19 disease that has similar symptoms as SARS-CoV. Studies suggest that the human receptor for COVID-19 may be angiotensin-converting enzyme 2 (ACE2) receptor similar to that of SARS-CoV. The nucleocapsid (N) protein of COVID-19 has nearly 90% amino acid sequence identity with SARS-CoV. The N protein antibodies of SARS-CoV may cross react with COVID-19 but may not provide cross-immunity. In a similar fashion to SARS-CoV, the N protein of COVID-19 may play an important role in suppressing the RNA interference (RNAi) to overcome the host defense. This mini-review aims at investigating the most recent trend of COVID-19.