title: The effects of COVID-19 on the health and socio-economic security of sex workers in Nairobi, Kenya: Emerging intersections with HIV

text: The COVID-19 pandemic, and its attendant responses, has led to massive health, social, and economic challenges on a global scale. While, so far, having a relatively low burden of COVID-19 infection, it is the response in lower- and middle- income countries that has had particularly dire consequences for impoverished populations such as sex workers, many of whom rely on regular income in the informal economic sector to survive. This commentary captures the challenges in Kenya posed by daily curfews and lost economic income, coupled with further changes to sex work that increase potential exposure to infection, stigmatisation, violence, and various health concerns. It also highlights the ways in which communities and programmes have demonstrated resourcefulness in responding to this unprecedented disruption in order to emerge healthy when COVID-19, and the measures to contain it, subside.


Pandemic places pharmacist in unexpected role


Letter to the Editor. Utilization of health personnel in developing countries during the COVID-19 pandemic


COVID-19 Special Column: COVID-19 Hits Native Hawaiian and Pacific Islander Communities the Hardest


SARS-CoV-2 persisted in lung tissue despite disappearance in other clinical samples


title: Could COVID-19 have an impact on male fertility?

text: The pandemic caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to several hypotheses of functional alteration of different organs. The direct influence of this virus on the male urogenital organs is still to be evaluated. However some hypotheses can already be made, especially in the andrological field, for the biological similarity of the SARS-CoV and SARS-CoV2. As well as SARS-CoV, SARS CoV-2 uses the 'Angiotensin Converting Enzyme-2' (ACE2) as a receptor to enter human cells. It was found that ACE2, Angiotensin (1-7) and its MAS receptors are present, over in the lung, also in the testicles, in particular in Leydig and Sertoli cells. A first hypothesis is that the virus could enter the testicle and lead to alterations in testicular functionality. A second hypothesis is that the binding of the virus to the ACE2 receptor, could cause an excess of ACE2 and give rise to a typical inflammatory response. The inflammatory cells could interfere with the function of Leydig and Sertoli cells. Both hypotheses should be evaluated and confirmed, in order to possibly monitor fertility in patients COVID-19+.


title: Deployment of a computerized ward visitor registration system in coronavirus disease 2019 epidemic: Experiences of a large academic medical center in Taiwan

text: BACKGROUND: Visitors to hospitalized patients during an epidemic might themselves be carriers and are therefore likely to spread the disease in wards. Although measures were taken to restrict hospital visits, traditional paper-based registration is insufficient to screen and monitor the numbers of visitors to a large hospital. METHODS: Throughout March 2020, during the coronavirus disease 2019 crisis, a computer system was deployed in the 2800-bed Taipei Veterans General Hospital (Taipei, Taiwan) to register, screen, and monitor inpatient visitors. This system comprised three parts: online registration form, entrance check-in interface, and registration database. The early utilization of this newly deployed system was then analyzed. RESULTS: A total of 22,336 visits were recorded between March 11, 2020, and March 31, 2020, with 1064 a day on average. Out of these visits, 18.1% (n = 4049) had made online reservations within 48 hours. On the other hand, of all 4941 online reservations, 18.1% (n = 892) were no-shows. In the last 12 days of the study period, eight prospective visitors were identified as ineligible by the computer system, and so their visits were denied. CONCLUSION: Using a computer system, the hospital was able to enforce restrictions on hospital visits. Although the online registration system had not been fully used yet in the early phase of adoption, its superiority from the standpoint of disease control should enable hospital managers to consider abolishing on-site visitor registration.


COVID-19 in lung-transplanted and cystic fibrosis patients: Be careful


title: Coronavirus (COVID-19) Classification using Deep Features Fusion and Ranking Technique

text: Coronavirus (COVID-19) emerged towards the end of 2019. World Health Organization (WHO) was identified it as a global epidemic. Consensus occurred in the opinion that using Computerized Tomography (CT) techniques for early diagnosis of pandemic disease gives both fast and accurate results. It was stated by expert radiologists that COVID-19 displays different behaviours in CT images. In this study, a novel method was proposed as fusing and ranking deep features to detect COVID-19 in early phase. 16x16 (Subset-1) and 32x32 (Subset-2) patches were obtained from 150 CT images to generate sub-datasets. Within the scope of the proposed method, 3000 patch images have been labelled as CoVID-19 and No finding for using in training and testing phase. Feature fusion and ranking method have been applied in order to increase the performance of the proposed method. Then, the processed data was classified with a Support Vector Machine (SVM). According to other pre-trained Convolutional Neural Network (CNN) models used in transfer learning, the proposed method shows high performance on Subset-2 with 98.27% accuracy, 98.93% sensitivity, 97.60% specificity, 97.63% precision, 98.28% F1-score and 96.54% Matthews Correlation Coefficient (MCC) metrics.


title: EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic

text: The coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to healthcare worldwide. The infection can be life threatening and require intensive care treatment. The transmission of the disease poses a risk to both patients and healthcare workers. The number of patients requiring hospital admission and intensive care may overwhelm health systems and negatively affect standard care for patients presenting with conditions needing emergency interventions. This position statements aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. To that end, we assembled a panel of interventional cardiologists and acute cardiac care specialists appointed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and from the Acute Cardiovascular Care Association (ACVC) and included the experience from the first and worst affected areas in Europe. Modified diagnostic and treatment algorithms are proposed to adapt evidence-based protocols for this unprecedented challenge. Various clinical scenarios, as well as management algorithms for patients with a diagnosed or suspected COVID-19 infection, presenting with ST- and non-ST-segment elevation ACS are described. In addition, we address the need for re-organization of ACS networks, with redistribution of hub and spoke hospitals, as well as for in-hospital reorganization of emergency rooms and cardiac units, with examples coming from multiple European countries. Furthermore, we provide a guidance to reorganization of catheterization laboratories and, importantly, measures for protection of healthcare providers involved with invasive procedures.


Lessons learned from Korea: COVID-19 pandemic


title: Psychological impact of COVID-19 quarantine measures in northeastern Italy on mothers in the immediate postpartum period

text: OBJECTIVE: To explore whether quarantine measures and hospital containment policies among women giving birth in a COVID-19 "hotspot" area in northeastern Italy enhanced psycho-emotional distress in the immediate postpartum period. METHODS: We designed a non-concurrent case-control study of mothers who gave birth during a COVID-19 quarantine period between March 8 and May 3, 2020 (COVID-19 study group), with an antecedent group of matched postpartum women (control group) who delivered in the same period in 2019. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) on the second day postpartum. RESULTS: The COVID-19 study group (n=91) had significantly higher mean EPDS scores compared with the control group (n=101) (8.5 ± 4.6 vs 6.34 ± 4.1; P<0.001). Furthermore, 28.6% of women in the COVID-19 group had a global EPDS score above 12. Analysis of three EPDS subscales revealed significantly higher scores among the COVID-19 group compared with the control group for anhedonia (0.60 ± 0.61 vs 0.19 ± 0.36; P<0.001) and depression (0.58 ± 0.54 vs 0.35 ± 0.45; P=0.001). CONCLUSIONS: Concerns about risk of exposure to COVID-19, combined with quarantine measures adopted during the COVID-19 pandemic, adversely affected the thoughts and emotions of new mothers, worsening depressive symptoms.


title: Challenges of managing the asymptomatic carriers of SARS-CoV-2

text: After an outbreak in Wuhan, China, a growing number of countries are now suffering from an epidemic by SARS-CoV-2, which causes COVID-19. Undoubtedly, reports of the skyrocketing global spread of COVID-19 has shocked people globally, from Japan to the United States. Presently, the World Health Organization indicates that the fatality rate due to COVID-19 is about 2%, inferring that many positive subjects may potentially overcome the illness with mild influenza-like symptoms and no need for hospitalization at intensive-care units. Because COVID-19 is completely new to the human immune system, many throughout the world are likely vulnerable to becoming sick after their initial exposure to SARS-CoV-2. Besides hospitalized cases, many individuals are likely asymptomatic but potentially carry the virus. While our knowledge about carriers and their virus shedding is deficient, some studies modelling the viral transmission have considered the potential contribution of the asymptomatic carriers. Protocols for managing asymptomatic cases, for example for controlling them to restrict their contact with healthy people at public places or private residences, have not been established. In-house quarantine may as well be applicable to asymptomatic cases if they could be identified and diagnosed. Presumably now, the asymptomatic subjects potentially contribute to the transmission of COVID-19 without their knowledge, intention, or being diagnosed as carriers. Thus, managing the asymptomatic subjects, who can carry and likely transmit the virus, is a major healthcare challenge while the pandemic is looming.


Genomics of COVID-19: molecular mechanisms going from susceptibility to severity of the disease


title: Characterization of diketopiperazine heterodimers as potential chemical markers for discrimination of two dominant black aspergilli, Aspergillus niger and Aspergillus tubingensis

text: Black aspergilli are distributed worldwide and represent one of the most prolific sources of metabolites with biomedical and agrochemical interests. However, due to their similar morphological characteristics and insufficient molecular identification, the taxonomic classification of black aspergilli remains ill-defined. The production of specialised metabolites is often unique for species among black aspergilli and could be used as diagnostic chemical markers for species identification. In this study, chemical investigation of Aspergillus tubingensis OUCMBIII 143291 led to the discovery of the diagnostic chemical marker asperazine, a complex diketopiperazine heterodimer, as well as two previously undescribed analogues, asperazine B and C. In addition, an undescribed 2-benzylpyridin-4(1H)-one-containing amide, pestalamide D, along with four known related metabolites were isolated. Their chemical structures, including their absolute configurations, were established on the basis of comprehensive spectral analysis and chiral HPLC analysis of the acidic hydrolysates. Asperazines B and C can serve as potential chemical markers for distinguishing A. tubingensis from A. niger, two representative species of black aspergilli that are usually incorrectly identified. Moreover, the isolated compounds were evaluated for their antifungal activity against eight phytopathogenic fungi including Alternaria alternata, A. brassicae, Botrytis cinerea, Colletotrichum lagenarium, Fusarium oxysporum, Gaeumannomyces graminis, Penicillium digitatum, and Valsa mali. Pestalamide D exhibited significant activities against B. cinerea, C. lagenarium, and V. mali, with MIC values of 4, 8, and 8 µg/mL, respectively, compared with the positive controls carbendazim (MICs = 8, 4, and 4 µg/mL) and prochloraz (MICs = 8, 8, and 4 µg/mL). The results of this study reveal two additional chemical markers and provide a powerful tool for the rapid identification of black aspergilli.


title: COVID-19, Australia: Epidemiology Report 7 (Reporting week ending 19:00 AEDT 14 March 2020)

text: This is the seventh epidemiological report for coronavirus disease 2019 (COVID-19), reported in Australia as at 19:00 Australian Eastern Daylight Time [AEDT] 14 March 2020. It includes data on COVID-19 cases diagnosed in Australia, the international situation and a review of current evidence.


Transforming operating rooms into intensive care units and the versatility of the physician anesthesiologist during the COVID-19 crisis


docid: gbffkame

title: Isolation of potent SARS-CoV-2 neutralizing antibodies and protection from disease in a small animal model

text: Countermeasures to prevent and treat COVID-19 are a global health priority. We enrolled a cohort of SARS-CoV-2-recovered participants, developed neutralization assays to interrogate antibody responses, adapted our high-throughput antibody generation pipeline to rapidly screen over 1800 antibodies, and established an animal model to test protection. We isolated potent neutralizing antibodies (nAbs) to two epitopes on the receptor binding domain (RBD) and to distinct non-RBD epitopes on the spike (S) protein. We showed that passive transfer of a nAb provides protection against disease in high-dose SARS-CoV-2 challenge in Syrian hamsters, as revealed by maintained weight and low lung viral titers in treated animals. The study suggests a role for nAbs in prophylaxis, and potentially therapy, of COVID-19. The nAbs define protective epitopes to guide vaccine design.


Mental Health Response to the COVID-19 Outbreak in China


title: Projecting the Course of COVID-19 in Turkey: A Probabilistic Modeling Approach

text: BACKGROUND/AIM: The COVID-19 Pandemic originated in Wuhan, China, in December 2019 and became one of the worst global health crises ever. While struggling with the unknown nature of this novel coronavirus, many researchers and groups attempted to project the progress of the pandemic using empirical or mechanistic models, each one having its drawbacks. The first confirmed cases were announced early in March, and since then, serious containment measures have taken place in Turkey. MATERIALS AND METHODS: Here, we present a different approach, a Bayesian negative binomial multilevel model with mixed effects, for the projection of the COVID-19 pandemic and apply this model to the Turkish case. The model source code is available at https://github.com/kansil/covid-19. We predicted confirmed daily cases and cumulative numbers for June 6th to June 26th with 80%, 95% and 99% prediction intervals (PI). RESULTS: Our projections showed that if we continued to comply with measures and no drastic changes are seen in diagnosis or management protocols, the epidemic curve would tend to decrease in this time interval. Also, the predictive validity analysis suggests that proposed model projections should be in the 95% PI band for the first 12 days of the projections. CONCLUSION: We expect that drastic changes in the course of the COVID-19 in Turkey will cause the model to suffer in predictive validity, and this can be used to monitor the epidemic. We hope that the discussion on these projections and the limitations of the epidemiological forecasting will be beneficial to the medical community, and policy-makers.


Summary of the COVID-19 outbreak in Vietnam - Lessons and suggestions


title: Potential impact of SARS-CoV-2 infection on the thymus

text: Understanding the pathogenesis of certain viral agents is essential for developing new treatments and obtaining a clinical cure. With the onset of the new coronavirus (SARS-CoV-2) pandemic in the beginning of 2020, a rush to conduct studies and develop drugs has led to the publication of articles that seek to address knowledge gaps and contribute to the global scientific research community. There are still no reports on the infectivity or repercussions of SARS-CoV-2 infection on the central lymphoid organ, the thymus, neither on thymocytes or thymic epithelial cells. In this brief review, we present a hypothesis about lymphopenia observed in SARS patients and the probable pathological changes that the thymus may undergo due to this new virus. Key words: Thymus, coronavirus, lymphopenia.


Governance lessons from COVID-19


title: Is periodontal disease a risk factor for severe COVID-19 illness?

text: Periodontal disease (PD) comprises a group of diseases involving inflammatory aspects of the host and dysbiotic events that affect periodontal tissues and could have systemic implications. Diverse factors and comorbidities have been closely associated with PD such as diabetes, obesity, aging, hypertension, and so on; although, underlying mechanisms or causal associations have not been established completely. Interestingly, these same factors have been widely associated with progression or severe coronavirus disease 2019 (COVID-19), an illness caused by coronavirus SARS-CoV-2. Since inflammatory and dysbiotic factors as well as comorbidities affect systemic health, it is possible that periodontal status indicates the risk of complication of COVID-19. However, assessment of oral health history including periodontal status in COVID-19 patients has not been reported. Knowing PD is associated with severe COVID-19 could help identify risk groups and establish pertinent recommendations.


title: Approach to Acute Cardiovascular Complications in COVID-19 Infection

text: The novel coronavirus disease 2019, otherwise known as COVID-19, is a global pandemic with primary respiratory manifestations in those who are symptomatic. It has spread to >187 countries with a rapidly growing number of affected patients. Underlying cardiovascular disease is associated with more severe manifestations of COVID-19 and higher rates of mortality. COVID-19 can have both primary (arrhythmias, myocardial infarction, and myocarditis) and secondary (myocardial injury/biomarker elevation and heart failure) cardiac involvement. In severe cases, profound circulatory failure can result. This review discusses the presentation and management of patients with severe cardiac complications of COVID-19 disease, with an emphasis on a Heart-Lung team approach in patient management. Furthermore, it focuses on the use of and indications for acute mechanical circulatory support in cardiogenic and/or mixed shock.


text: The novel coronavirus disease 2019, otherwise known as COVID-19, is a global pandemic with primary respiratory manifestations in those who are symptomatic. It has spread to more than 187 countries with a rapidly growing number of affected patients. Underlying cardiovascular disease is associated with more severe manifestations of COVID-19 and higher rates of mortality. COVID-19 can have both primary (arrhythmias, myocardial infarction, myocarditis) and secondary (myocardial injury/biomarker elevation, heart failure) cardiac involvement. In severe cases, profound circulatory failure can result. This review discusses the presentation and management of patients with severe cardiac complications of COVID-19 disease, with an emphasis on a "Heart-Lung" team approach in patient management. Furthermore, it focuses on the use of and indications for acute mechanical circulatory support in cardiogenic and/or mixed shock.


title: Risk Factors of Severe Disease and Efficacy of Treatment in Patients Infected with COVID-19: A Systematic Review, Meta-Analysis and Meta-Regression Analysis

text: The coronavirus disease 2019 (COVID-19) pandemic spread globally in the beginning of 2020. At present, predictors of severe disease and the efficacy of different treatments are not well-understood. We conducted a systematic review and meta-analysis of all published studies up to March 15, 2020 which reported COVID-19 clinical features and/or treatment outcomes. 45 studies reporting 4203 patients were included. Pooled rates of intensive care unit (ICU) admission, mortality and acute respiratory distress syndrome (ARDS) were 10.9%, 4.3% and 18.4%, respectively. On meta-regression, ICU admission was predicted by raised leukocyte count (p<0.0001), raised alanine aminotransferase (p=0.024), raised aspartate transaminase (p=0.0040), elevated lactate dehydrogenase (LDH) (p<0.0001) and increased procalcitonin (p<0.0001). ARDS was predicted by elevated LDH (p<0.0001), while mortality was predicted by raised leukocyte count (p=0.0005) and elevated LDH (p<0.0001). Treatment with lopinavir-ritonavir showed no significant benefit in mortality and ARDS rates. Corticosteroids were associated with a higher rate of ARDS (p=0.0003).


DNACPR notices: campaigner for patients' right to be consulted says government has misunderstood her demands


title: The Prebiotic Provenance of Semi-Aqueous Solvents

text: The numerous and varied roles of phosphorylated organic molecules in biochemistry suggest they may have been important to the origin of life. The prominence of phosphorylated molecules presents a conundrum given that phosphorylation is a thermodynamically unfavorable, endergonic process in water, and most natural sources of phosphate are poorly soluble. We recently demonstrated that a semi-aqueous solvent consisting of urea, ammonium formate, and water (UAFW) supports the dissolution of phosphate and the phosphorylation of nucleosides. However, the prebiotic feasibility and robustness of the UAFW system are unclear. Here, we study the UAFW system as a medium in which phosphate minerals are potentially solubilized. Specifically, we conduct a series of chemical experiments alongside thermodynamic models that simulate the formation of ammonium formate from the hydrolysis of hydrogen cyanide, and demonstrate the stability of formamide in such solvents (as an aqueous mixture). The dissolution of hydroxylapatite requires a liquid medium, and we investigate whether a UAFW system is solid or liquid over varied conditions, finding that this characteristic is controlled by the molar ratios of the three components. For liquid UAFW mixtures, we also find the solubility of phosphate is higher when the quantity of ammonium formate is greater than urea. We suggest the urea within the system can lower the activity of water, help create a stable and persistent solution, and may act as a condensing agent/catalyst to improve nucleoside phosphorylation yields.


title: Enfermidades do sistema digestório de bovinos da região semiárida do Brasil/ Digestive diseases of cattle from the semiarid of Brazil

text: Os problemas digestivos são importantes causas de afecções em bovinos e estudos sobre a frequência de ocorrência destas na região semiárida do Brasil ainda não foram realizados. Objetivou-se com este trabalho obter informações sobre a ocorrência de doenças do sistema digestório em bovinos atendidos no Hospital Veterinário da Universidade Federal de Campina Grande no período de janeiro de 2000 a dezembro de 2014. No período do levantamento foram atendidos 1.202 bovinos, sendo 19,4% (233/1202) diagnosticados com enfermidades do sistema digestório. A taxa de letalidade das enfermidades foi 49,8% (116/233). As reticulites traumáticas e a indigestão vagal foram diagnosticadas, respectivamente, em 13,3%e 5,1% dos animais atendidos, sendo considerados distúrbios motores frequentes e de alta letalidade devido à gravidade das lesões, demora no atendimento clínico e imprecisão no diagnóstico. A obstrução ao fluxo da ingesta foi também uma condição identificada frequentemente, sendo ocasionada por obstruções esofágicas (4,3%), impactações no rúmen (11,7%), omaso e/ou abomaso (3,4%) e principalmente acidentes intestinais (26,2%), tendo a totalidade dos casos superado os distúrbios fermentativos da cavidade ruminorreticular. Actinobacilose (6,9%), actinomicose (3%) e paratuberculose (1,7%) foram as doenças infecciosas bacterianas diagnosticadas. As doenças infecciosas virais diagnosticadas foram a febre catarral maligna (4,3%), diarreia viral bovina e a doença das mucosas (3%). As doenças parasitárias foram também importantes causas de morbidade em bovinos jovens (9,4%) apesar dos sistemas de criação com baixa lotação e as condições climáticas da região não favorecerem a sobrevivência de parasitos gastrintestinais, demonstrando que não estão sendo implantadas medidas de controle adequadas para estas enfermidades. Os distúrbios motores da cavidade ruminorreticular, seguido das obstruções intestinais e das doenças infecciosas digestivas são os mais... (AU)


docid: vegfmupx

title: A glimpse into the eye of the COVID-19 cytokine storm


Extended US travel ban harms global science


title: Onsite telemedicine strategy for coronavirus (COVID-19) screening to limit exposure in ED

text: Coronavirus (severe acute respiratory syndrome coronavirus 2) outbreak is a public health emergency and a global pandemic. During the present coronavirus disease (COVID-19) crisis, telemedicine has been recommended to screen suspected patients to limit risk of exposure and maximise medical staff protection. We constructed the protective physical barrier with telemedicine technology to limit COVID-19 exposure in ED. Our hospital is an urban community hospital with annual ED volume of approximately 50 000 patients. We equipped our patient exam room with intercom and iPad for telecommunication. Based on our telemedicine screening protocol, physician can conduct a visual physical examination on stable patients via intercom or videoconference. Telemedicine was initially used to overcome the physical barrier between patients and physicians. However, our protocol is designed to create a protective physical barrier to protect healthcare workers and enhance efficiency in ED. The implementation can be a promising protocol in making ED care more cost-effective and efficient during the COVID-19 pandemic and beyond.


docid: lramtwmr

title: Covid-19: Deaths in Mexico triple since reopening began in June


Programmatic Responses to the Coronavirus Pandemic: A Survey of 502 Cardiac Surgeons


title: Isothermal evaporation rate of deposited liquid aerosols and the SARS-CoV-2 coronavirus survival

text: It is shown that the evaporation rate of a liquid sample containing the culture of coronavirus affects its survival on a substrate. Possible mechanisms of such influence can be due to the appearance of large, about 140 bar, non comprehensive capillary pressures and the associated dynamic forces during the movement of the evaporation front in a sample with the virus. A simulation of isothermal evaporation of a thin liquid sample based on the Stefan problem was performed. The comparison of simulation data and recent experiments on the coronavirus survival on various surfaces showed that the rate of isothermal evaporation of aqueous samples, which is higher for heat-conducting materials, correlates well with the lifetime of the coronavirus on these surfaces.


title: Virtual Visits for Care of Patients with Heart Failure in the Era of COVID-19: A Statement from the Heart Failure Society of America

text: In response to the COVID-19 pandemic, US federal and state governments have implemented wide-ranging stay-at-home recommendations as a means to reduce spread of infection. As a consequence, many US healthcare systems and practices have curtailed ambulatory clinic visits-pillars of care for patients with heart failure (HF). In this context, synchronous audio/video interactions, also known as virtual visits (VVs), have emerged as an innovative and necessary alternative. This scientific statement outlines the benefits and challenges of VVs, enumerates changes in policy and reimbursement that have increased the feasibility of VVs during the COVID-19 era, describes platforms and models of care for VVs, and provides a vision for the future of VVs.


Defending the front lines during the COVID-19 pandemic: Protecting our first responders and emergency medical service personnel


title: Confidential Computing for Privacy-Preserving Contact Tracing

text: Contact tracing is paramount to fighting the pandemic but it comes with legitimate privacy concerns. This paper proposes a system enabling both, contact tracing and data privacy. We propose the use of the Intel SGX trusted execution environment to build a privacy-preserving contact tracing backend. While the concept of a confidential computing backend proposed in this paper can be combined with any existing contact tracing smartphone application, we describe a full contact tracing system for demonstration purposes. A prototype of a privacy-preserving contact tracing system based on SGX has been implemented by the authors in a hackathon.


title: Complexity in human transportation networks: A comparative analysis of worldwide air transportation and global cargo ship movements

text: We present a comparative network theoretic analysis of the two largest global transportation networks: The worldwide air-transportation network (WAN) and the global cargoship network (GCSN). We show that both networks exhibit striking statistical similarities despite significant differences in topology and connectivity. Both networks exhibit a discontinuity in node and link betweenness distributions which implies that these networks naturally segragate in two different classes of nodes and links. We introduce a technique based on effective distances, shortest paths and shortest-path trees for strongly weighted symmetric networks and show that in a shortest-path-tree representation the most significant features of both networks can be readily seen. We show that effective shortest-path distance, unlike conventional geographic distance measures, strongly correlates with node centrality measures. Using the new technique we show that network resilience can be investigated more precisely than with contemporary techniques that are based on percolation theory. We extract a functional relationship between node characteristics and resilience to network disruption. Finally we discuss the results, their implications and conclude that dynamic processes that evolve on both networks are expected to share universal dynamic characteristics.


COVID-19-associated Pulmonary Aspergillosis


title: Evaluation of sex-related hormones and semen characteristics in reproductive-aged male COVID-19 patients

text: In the past several months, the outbreak of SARS-CoV-2-associated infection (coronavirus disease 2019, COVID-19) developed rapidly and has turned into a global pandemic. Although SARS-CoV-2 mainly attacks respiratory systems, manifestations of multiple organs have been observed. Great concern was raised about whether COVID-19 may affect male reproductive functions. In this study, we collected semen specimens from twelve male COVID-19 patients for virus detection and semen characteristics analysis. No SARS-CoV-2 was found in semen specimens. 8 out of 12 patients had normal semen quality. We also compared the sex-related hormone levels between 119 reproductive-aged men with SARS-CoV-2 infection and 273 age-matched control men. A higher serum luteinizing hormone (LH) and a lower ratio of testosterone (T) to LH were observed in the COVID-19 group. Multiple regression analysis indicated that serum T:LH ratio was negatively associated with white blood cell counts (WBC) and c-reactive protein (CRP) level in COVID-19 patients. It's the first report about semen assessment and sex-hormone evaluation in reproductive-aged male COVID-19 patients. Although further study is needed to clarify the reasons and underlying mechanisms, our study presents an abnormal sex hormone secretion among COVID-19 patients, suggesting that attention should be paid to reproductive function evaluation in the follow-up. This article is protected by copyright. All rights reserved.


Challenges to paediatric services during COVID-19 pandemic: A London, UK perspective


title: Pharmacy leadership during emergency preparedness: Insights from the Middle East and South Asia

text: Disclaimer: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.


title: Gastrointestinal Symptoms and outcomes in hospitalized COVID-19 patients

text: INTRODUCTION: Gastrointestinal (GI) symptoms are increasingly being recognized in coronavirus disease 2019 (COVID-19). It is unclear if the presence of GI symptoms is associated with poor outcomes in COVID-19. We aim to assess if GI symptoms could be used for prognostication in hospitalized patients with COVID-19. METHODS: We retrospectively analyzed patients admitted to a tertiary medical center in Brooklyn, NY, from March 18, 2020, to March 31, 2020, with COVID-19. The patients' medical charts were reviewed for the presence of GI symptoms at admission, including nausea, vomiting, diarrhea, and abdominal pain. COVID-19 patients with GI symptoms (cases) were compared with COVID-19 patients without GI symptoms (control). RESULTS: A total of 150 hospitalized COVID-19 patients were included, of which 31 (20.6%) patients had at least one or more of the GI symptoms (cases). They were compared with the 119 COVID-19 patients without GI symptoms (controls). The average age among cases was 57.6 years (SD 17.2) and, control was 63.3 years (SD 14.6). No statistically significant difference was noted in comorbidities and laboratory findings. The primary outcome was mortality, which did not differ between cases and controls (41.9% vs. 37.8%, p=0.68). No statistically significant differences were noted in secondary outcomes, including the length of stay (LOS, 7.8 days vs. 7.9 days, p=0.87) and need for mechanical ventilation (29% vs. 26.9%, p=0.82). DISCUSSION: In our study, the presence of GI manifestations in COVID-19 at the time of admission was not associated with increased mortality, LOS, or mechanical ventilation.


title: Erratum: Investigation of Turkish dentists' clinical attitudes and behaviors towards the COVID-19 pandemic: a survey study. Braz Oral Res. 2020;34:e054 DOI: 10.1590/1807-3107bor-2020.vol34.0054

text: [This corrects the article doi: 10.1590/1807-3107bor-2020.vol34.0054].


Roles and Responsibilities of the Orthopaedic Community and the Society During COVID-19 Pandemic


A Centrally Acting Antihypertensive, Clonidine, Sedates Patients Presenting With Acute Respiratory Distress Syndrome Evoked by Severe Acute Respiratory Syndrome-Coronavirus 2


title: Assessing nitrogen dioxide (NO2) levels as a contributing factor to coronavirus (COVID-19) fatality

text: Nitrogen dioxide (NO2) is an ambient trace-gas result of both natural and anthropogenic processes. Long-term exposure to NO2 may cause a wide spectrum of severe health problems such as hypertension, diabetes, heart and cardiovascular diseases and even death. The objective of this study is to examine the relationship between long-term exposure to NO2 and coronavirus fatality. The Sentinel-5P is used for mapping the tropospheric NO2 distribution and the NCEP/NCAR reanalysis for evaluating the atmospheric capability to disperse the pollution. The spatial analysis has been conducted on a regional scale and combined with the number of death cases taken from 66 administrative regions in Italy, Spain, France and Germany. Results show that out of the 4443 fatality cases, 3487 (78%) were in five regions located in north Italy and central Spain. Additionally, the same five regions show the highest NO2 concentrations combined with downwards airflow which prevent an efficient dispersion of air pollution. These results indicate that the long-term exposure to this pollutant may be one of the most important contributors to fatality caused by the COVID-19 virus in these regions and maybe across the whole world.


Stability and Viability of SARS-CoV-2


title: Pandemic Pulse: Unraveling and Modeling Social Signals during the COVID-19 Pandemic

text: We present and begin to explore a collection of social data that represents part of the COVID-19 pandemic's effects on the United States. This data is collected from a range of sources and includes longitudinal trends of news topics, social distancing behaviors, community mobility changes, web searches, and more. This multimodal effort enables new opportunities for analyzing the impacts such a pandemic has on the pulse of society. Our preliminary results show that the number of COVID-19-related news articles published immediately after the World Health Organization declared the pandemic on March 11, and that since that time have steadily decreased---regardless of changes in the number of cases or public policies. Additionally, we found that politically moderate and scientifically-grounded sources have, relative to baselines measured before the beginning of the pandemic, published a lower proportion of COVID-19 news than more politically extreme sources. We suggest that further analysis of these multimodal signals could produce meaningful social insights and present an interactive dashboard to aid further exploration.


docid: wjgjsipa

title: Salivary diagnostics in COVID-19: Future research implications


Coagulopathy associated with COVID-19


title: An Efficient COVID-19 Prediction Model Validated with the Cases of China, Italy and Spain: Total or Partial Lockdowns?

text: The present work develops an accurate prediction model of the COVID-19 pandemic, capable not only of fitting data with a high regression coefficient but also to predict the overall infections and the infection peak day as well. The model is based on the Verhulst equation, which has been used to fit the data of the COVID-19 spread in China, Italy, and Spain. This model has been used to predict both the infection peak day, and the total infected people in Italy and Spain. With this prediction model, the overall infections, the infection peak, and date can accurately be predicted one week before they occur. According to the study, the infection peak took place on 23 March in Italy, and on 29 March in Spain. Moreover, the influence of the total and partial lockdowns has been studied, without finding any meaningful difference in the disease spread. However, the infected population, and the rate of new infections at the start of the lockdown, seem to play an important role in the infection spread. The developed model is not only an important tool to predict the disease spread, but also gives some significant clues about the main factors that affect to the COVID-19 spread, and quantifies the effects of partial and total lockdowns as well.


title: Variation in volumes and characteristics of trauma patients admitted to a level one trauma centre during national level 4 lockdown for COVID-19 in New Zealand

text: AIM: The aims of this study were to describe the variation in volumes and types of injuries admitted to a level one trauma centre in New Zealand over two 14-day periods before and during the national level 4 lockdown for COVID-19;and highlight communities at risk of preventable injury that may impact negatively on hospital resources METHOD: A retrospective, descriptive study of prospectively collected data in the Midland Trauma Registry in New Zealand RESULTS: Overall there was a reduction of 43% in all injury-related admissions with significant reductions seen in major injury (50% reduction), males (50% reduction) and children aged 0-14 years (48% reduction) Results for ethnicity and persons aged over 14 years were within 3% deviation of this overall 43% reduction Injuries at home, particularly falls, predominate CONCLUSION: Despite the significant reduction in admissions during level 4 lockdown, hospitals should continue to provide full services until resource limitations are unavoidable Immediate messaging is recommended to reduce rates of injury on the farm and at home, specifically falls prevention Ongoing attention of road users to road safety is essential to reduce the incidence of preventable major injury These immediate measures can potentially reduce unnecessary pressure on hospital beds and resources during the pandemic


title: Weibo-COV: A Large-Scale COVID-19 Social Media Dataset from Weibo

text: With the rapid development of COVID-19, people are asked to maintain"social distance"and"stay at home". In this scenario, more and more social interactions move online, especially on social media like Twitter and Weibo. People post tweets to share information, express opinions and seek help during the pandemic, and these tweets on social media are valuable for studies against COVID19, such as early warning and outbreaks detection. Therefore, in this paper, we release a novel large-scale COVID-19 social media dataset from Weibo called Weibo-COV, covering more than 40 million tweets from 1 December 2019 to 30 April 2020. Moreover, the field information of the dataset is very rich, including basic tweets information, interactive information, location information and retweet network. We hope this dataset can promote studies of COVID-19 from multiple perspectives and enable better and faster researches to suppress the spread of this disease.


title: Neurological manifestations of COVID-19, SARS and MERS

text: Since December 2019, the world is affected by an outbreak of a new disease named COVID-19, which is an acronym of 'coronavirus disease 2019'. Coronaviruses (CoV) were assumed to be associated with mild upper respiratory tract infections, such as common cold. This perception changed in time due to occurrence of the Severe Acute Respiratory Syndrome (SARS) caused by SARS-CoV in 2002 and the Middle East Respiratory Syndrome (MERS) caused by MERS-CoV in 2012, both inducing an epidemic severe viral pneumonia with potentially respiratory failure and numerous extra-pulmonary manifestations. The novel coronavirus, SARS-CoV-2, is likewise a causative pathogen for severe viral pneumonia with the risk of progression to respiratory failure and systemic manifestations. In this review, we will give a summary of the neurological manifestations due to SARS and MERS, as those might predict the neurological outcome in the novel COVID-19. Additionally, we provide an overview of the current knowledge concerning neurological manifestations associated with COVID-19, to the extent that literature is already available as the pandemic is still ongoing.


title: How to Handle a COVID-19 Patient in the Angiographic Suite

text: This is a single-center report on coordination of staff and handling of patients during the outbreak of the COVID-19 (coronavirus disease 2019) in a region with high incidence and prevalence of disease. The selection of procedures for interventional radiology (IR), preparation of staff and interventional suite before the arrival of patients, the facility ventilation systems and intra- and post-procedural workflow optimization are described. The control measures described may increase the cost of the equipment, prolong procedural times and increase technical difficulties. However, these precautions may help control the spread of COVID-19 within the healthcare facility.


Community Obstetrical Units Less Likely than Academic Units to Have Universal COVID-19 Testing


title: Surge after the surge: Anticipating the increased volume and needs of patients with head and neck cancer after the peak in COVID-19

text: The novel coronavirus disease 2019 (COVID-19) pandemic continues to have extensive effects on public health as it spreads rapidly across the globe. Patients with head and neck cancer are a particularly susceptible population to these effects, and we expect there to be a potential surge in patients presenting with head and neck cancers after the surge in COVID-19. Furthermore, the impact of social distancing measures could result in a shift toward more advanced disease at presentation. With appropriate anticipation, multidisciplinary head and cancer teams could potentially minimize the impact of this surge and plan for strategies to provide optimal care for patients with head and neck cancer.


Quantitative evaluation of olfactory dysfunction in hospitalized patients with Coronavirus [2] (COVID-19)


title: Position statement of expert panel of the Polish Allergology Society on the management of patients with bronchial asthma and allergic diseases during SARS-Cov-2 pandemics

text: The document prepared by the expert panel of allergy/immunology specialists representing Polish Allergy Society intends to provide allergists with recommendations with respect to proper management of allergic patients during SARS-CoV-2 pandemics Allergist should aim at reducing patient’s social interactions by replacing face-to-face visits with communication via telephone or internet In parallel allergist is responsible for assuring that the patient is receiving proper care of underlying allergic disease The experts panel provides eighteen recommendations for management of patients with asthma and allergic diseases during pandemics, indicating that in majority of patients asthma treatment (including inhaled corticosteroids) and allergy treatment should be continued Specific recommendations for treatment with allergen immunotherapy and with biologics are discussed in details


title: A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors

text: The uncontrolled spread of the coronavirus disease 2019 (COVID-19) has called for unprecedented measures, to the extent that the Italian government has imposed a quarantine on the entire country. Quarantine has a huge impact and can cause considerable psychological strain. The present study aims to establish the prevalence of psychiatric symptoms and identify risk and protective factors for psychological distress in the general population. An online survey was administered from 18-22 March 2020 to 2766 participants. Multivariate ordinal logistic regression models were constructed to examine the associations between sociodemographic variables; personality traits; depression, anxiety, and stress. Female gender, negative affect, and detachment were associated with higher levels of depression, anxiety, and stress. Having an acquaintance infected was associated with increased levels of both depression and stress, whereas a history of stressful situations and medical problems was associated with higher levels of depression and anxiety. Finally, those with a family member infected and young person who had to work outside their domicile presented higher levels of anxiety and stress, respectively. This epidemiological picture is an important benchmark for identifying persons at greater risk of suffering from psychological distress and the results are useful for tailoring psychological interventions targeting the post-traumatic nature of the distress.


title: Single-Dose, Intranasal Immunization with Recombinant Parainfluenza Virus 5 Expressing Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Spike Protein Protects Mice from Fatal MERS-CoV Infection

text: Middle East respiratory syndrome coronavirus (MERS-CoV) can cause severe and fatal acute respiratory disease in humans and remains endemic in the Middle East since first being identified in 2012. There are currently no approved vaccines or therapies available for MERS-CoV. In this study, we evaluated parainfluenza virus 5 (PIV5)-based vaccine expressing the MERS-CoV envelope spike protein (PIV5/MERS-S) in a human DPP4 knockin C57BL/6 congenic mouse model (hDPP4 KI). Following a single-dose intranasal immunization, PIV5-MERS-S induced neutralizing antibody and robust T cell responses in hDPP4 KI mice. A single intranasal administration of 104 PFU PIV5-MERS-S provided complete protection against a lethal challenge with mouse-adapted MERS-CoV (MERSMA6.1.2) and improved virus clearance in the lung. In comparison, single-dose intramuscular immunization with 106 PFU UV-inactivated MERSMA6.1.2 mixed with Imject alum provided protection to only 25% of immunized mice. Intriguingly, an influx of eosinophils was observed only in the lungs of mice immunized with inactivated MERS-CoV, suggestive of a hypersensitivity-type response. Overall, our study indicated that PIV5-MERS-S is a promising effective vaccine candidate against MERS-CoV infection.IMPORTANCE MERS-CoV causes lethal infection in humans, and there is no vaccine. Our work demonstrates that PIV5 is a promising vector for developing a MERS vaccine. Furthermore, success of PIV5-based MERS vaccine can be employed to develop a vaccine for emerging CoVs such as SARS-CoV-2, which causes COVID-19.


title: Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial

text: BACKGROUND: There is no proven specific pharmacological treatment for patients with the acute respiratory distress syndrome (ARDS). The efficacy of corticosteroids in ARDS remains controversial. We aimed to assess the effects of dexamethasone in ARDS, which might change pulmonary and systemic inflammation and result in a decrease in duration of mechanical ventilation and mortality. METHODS: We did a multicentre, randomised controlled trial in a network of 17 intensive care units (ICUs) in teaching hospitals across Spain in patients with established moderate-to-severe ARDS (defined by a ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen of 200 mm Hg or less assessed with a positive end-expiratory pressure of 10 cm H2O or more and FiO2 of 0·5 or more at 24 h after ARDS onset). Patients with brain death, terminal-stage disease, or receiving corticosteroids or immunosuppressive drugs were excluded. Eligible patients were randomly assigned based on balanced treatment assignments with a computerised randomisation allocation sequence using blocks of 10 opaque, sealed envelopes to receive immediate treatment with dexamethasone or continued routine intensive care (control group). Patients in the dexamethasone group received an intravenous dose of 20 mg once daily from day 1 to day 5, which was reduced to 10 mg once daily from day 6 to day 10. Patients in both groups were ventilated with lung-protective mechanical ventilation. Allocation concealment was maintained at all sites during the trial. Primary outcome was the number of ventilator-free days at 28 days, defined as the number of days alive and free from mechanical ventilation from day of randomisation to day 28. Secondary outcome was all-cause mortality 60 days after randomisation. All analyses were done according to the intention-to-treat principle. This study is registered with ClinicalTrials.gov, NCT01731795. FINDINGS: Between March 28, 2013, and Dec 31, 2018, we enrolled 277 patients and randomly assigned 139 patients to the dexamethasone group and 138 to the control group. The trial was stopped by the data safety monitoring board due to low enrolment rate after enrolling more than 88% (277/314) of the planned sample size. The mean number of ventilator-free days was higher in the dexamethasone group than in the control group (between-group difference 4·8 days [95% CI 2·57 to 7·03]; p<0·0001). At 60 days, 29 (21%) patients in the dexamethasone group and 50 (36%) patients in the control group had died (between-group difference -15·3% [-25·9 to -4·9]; p=0·0047). The proportion of adverse events did not differ significantly between the dexamethasone group and control group. The most common adverse events were hyperglycaemia in the ICU (105 [76%] patients in the dexamethasone group vs 97 [70%] patients in the control group), new infections in the ICU (eg, pneumonia or sepsis; 33 [24%] vs 35 [25%]), and barotrauma (14 [10%] vs 10 [7%]). INTERPRETATION: Early administration of dexamethasone could reduce duration of mechanical ventilation and overall mortality in patients with established moderate-to-severe ARDS. FUNDING: Fundación Mutua Madrileña, Instituto de Salud Carlos III, The European Regional Development's Funds, Asociación Científica Pulmón y Ventilación Mecánica.


title: Clinical presentation and course of COVID-19

text: Information about the clinical presentation and course of COVID-19 is evolving rapidly. On presentation, cough and fever predominate, but extrapulmonary symptoms are also common; in some patients, loss of sense of smell may be an early but favorable sign. The mortality rate varies widely in different reports but should become clearer as more data are collected. Risk factors for severe disease and death include comorbid conditions such as hypertension, cardiovascular disease, diabetes mellitus, and chronic obstructive pulmonary disease. Other implicated factors include older age, obesity, end-stage renal disease, and a higher neutrophil-lymphocyte ratio.


The many mechanisms of action of Chloroquine: to use or not to use (in COVID-19) that is the question


Covid-19 is threatening the survival of US primary care


Symptomatology, assessment, and treatment of anxiety in older adults with cancer


Responding to COVID-19: Agile Use of Information Technology to Serve Patients With Diabetes


title: Impact of the COVID-19 pandemic on orthopedic trauma workload in a London level 1 trauma center: the "golden month"

text: Background and purpose - The COVID-19 pandemic has been recognized as an unprecedented global health crisis. This is the first observational study to evaluate its impact on the orthopedic workload in a London level 1 trauma center (i.e., a major trauma center [MTC]) before (2019) and during (2020) the "golden month" post-COVID-19 lockdown.Patients and methods - We performed a longitudinal observational prevalence study of both acute orthopedic trauma referrals, operative and anesthetic casemix for the first "golden" month from March 17, 2020. We compared the data with the same period in 2019. Statistical analyses included median (median absolute deviation), risk and odds ratios, as well as Fisher's exact test to calculate the statistical significance, set at p ≤ 0.05.Results - Acute trauma referrals in the post-COVID period were almost halved compared with 2019, with similar distribution between pediatric and adult patients, requiring a significant 19% more admissions (RR 1.3, OR 2.6, p = 0.003). Hip fractures and polytrauma cases accounted for an additional 11% of the modal number of injuries in 2020, but with 19% reduction in isolated limb injuries that were modal in 2019. Total operative cases fell by a third during the COVID-19 outbreak. There was a decrease of 14% (RR 0.85, OR 0.20, p = 0.006) in aerosol-generating anesthetic techniques used.Interpretation - The impact of the COVID-19 pandemic has led to a decline in the number of acute trauma referrals, admissions (but increased risk and odds ratio), operations, and aerosolizing anesthetic procedures since implementing social distancing and lockdown measures during the "golden month."


title: Facilitating Access to Multilingual COVID-19 Information via Neural Machine Translation

text: Every day, more people are becoming infected and dying from exposure to COVID-19. Some countries in Europe like Spain, France, the UK and Italy have suffered particularly badly from the virus. Others such as Germany appear to have coped extremely well. Both health professionals and the general public are keen to receive up-to-date information on the effects of the virus, as well as treatments that have proven to be effective. In cases where language is a barrier to access of pertinent information, machine translation (MT) may help people assimilate information published in different languages. Our MT systems trained on COVID-19 data are freely available for anyone to use to help translate information published in German, French, Italian, Spanish into English, as well as the reverse direction.


title: Delayed presentation of acute ischemic strokes during the COVID-19 crisis

text: BACKGROUND: The COVID-19 pandemic has disrupted established care paths worldwide. Patient awareness of the pandemic and executive limitations imposed on public life have changed the perception of when to seek care for acute conditions in some cases. We sought to study whether there is a delay in presentation for acute ischemic stroke patients in the first month of the pandemic in the US. METHODS: The interval between last-known-well (LKW) time and presentation of 710 consecutive patients presenting with acute ischemic strokes to 12 stroke centers across the US were extracted from a prospectively maintained quality database. We analyzed the timing and severity of the presentation in the baseline period from February to March 2019 and compared results with the timeframe of February and March 2020. RESULTS: There were 320 patients in the 2-month baseline period in 2019, there was a marked decrease in patients from February to March of 2020 (227 patients in February, and 163 patients in March). There was no difference in the severity of the presentation between groups and no difference in age between the baseline and the COVID period. The mean interval from LKW to the presentation was significantly longer in the COVID period (603±1035 min) compared with the baseline period (442±435 min, P<0.02). CONCLUSION: We present data supporting an association between public awareness and limitations imposed on public life during the COVID-19 pandemic in the US and a delay in presentation for acute ischemic stroke patients to a stroke center.


title: Effects of Micronutrients or Conditional Amino Acids on COVID-19-Related Outcomes: An Evidence Analysis Center Scoping Review

text: Recent narrative reviews have described the potential efficacy of providing individuals infected with coronavirus disease 2019 (COVID-19) with additional micronutrients to reduce disease severity. Although there are compelling reasons why providing additional micronutrients or conditional amino acids may affect COVID-19-related outcomes, evidence is lacking. The objective of this scoping review is to explore and describe the literature examining the effect of providing additional micronutrients or conditional amino acids (glutamine, arginine) in adults with conditions or infections similar to COVID-19 infection on COVID-19-related health outcomes. A literature search of the MEDLINE database and hand search of Cochrane Database of systematic reviews retrieved 1,423 unique studies, and 8 studies were included in this scoping review. Four studies examined a target population with ventilator-related pneumonia and acute respiratory distress syndrome, and the other 4 studies included patients who were at risk for ventilator-associated pneumonia. Interventions included intravenous ascorbic acid, intramuscular cholecalciferol, enteral and intramuscular vitamin E, enteral zinc sulfate, and oral and parenteral glutamine. In 6 of the 8 included studies, baseline status of the nutrient of interest was not reported and, thus, it is uncertain how outcomes may vary in the context of nutrient deficiency or insufficiency compared with sufficiency. In the absence of direct evidence examining efficacy of providing additional micronutrients or conditional amino acids to standard care, registered dietitian nutritionists must rely on clinical expertise and indirect evidence to guide medical nutrition therapy for patients infected with COVID-19.


title: Impact du SARS-CoV2 sur la structuration de la prise en charge du cancer : exemple de la tenue des RCP de cancérologie en Occitanie./ [COVID-19 impact on the cancer care structuration: example of the multidisciplinary team meeting dedicated to oncology in Occitanie]

text: This work examines the impact of the SARS-CoV2 epidemic and the organizational recommendations that have been issued since March 16 on tumor boards (TB) activity. The tumor board activity was measured from tumor board sheets extracted from the oncologic electronic file between January 7, 2019 and April 24, 2020. The pre-containment activity was compared to the activity of the containment periods but also to the equivalent periods in 2019. The number of meetings held, the average number of files reviewed per meeting including first presentations and the average number of physicians' attendance were the evaluation criteria. The study covered 191 TB that held 3,943 multidisciplinary team meetings (MTM) and reviewed 72070 files (including 30127 first submissions). There was a moderate decrease of 8 % in the number of meetings after March 16, 2020. The number of files examined decreased by 23 % in the following month and even more by 33 % in the third period. The physicians' number who attended MTM also decreased by 25 %. The negative impact was higher in the Mediterranean part of the region. This first study of tumor board activity, covering a large region but little affected by the pandemic, shows that its impact on the participation to the MTM has been moderate. In addition, tumor boards have followed the recommendations for optimizing quorum. However, the decrease in average MTM activity, particularly for first submissions, suggests a potential delay in patient management. Complementary qualitative and quantitative works are warranted to estimate the real impact on carcinologic outcomes.


title: Skull-base surgery during the COVID-19 pandemic: the Italian Skull Base Society recommendations

text: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is highly contagious with devastating impacts for healthcare systems worldwide. Medical staff are at high risk of viral contamination and it is imperative to know what personal protective equipment (PPE) is appropriate for each situation. Furthermore, elective clinics and operations have been reduced in order to mobilize manpower to the acute specialties combating the outbreak; appropriate differentiation between patients who require immediate care and those who can receive telephone consultation or whose treatment might viably be postponed is therefore crucial. Italy was 1 of the earliest and hardest-hit European countries and therefore the Italian Skull Base Society board has promulgated specific recommendations based on consensus best practices and the literature, where available. Only urgent surgical operations are recommended and all patients should be tested at least twice (on days 4 and 2 prior to surgery). For positive patients, procedures should be postponed until after swab test negativization. If the procedure is vital to the survival of the patient, filtering facepiece 3 (FFP3) and/or powered air purifying respirator (PAPR) devices, goggles, full-face visor, double gloves, water-resistant gowns, and protective caps are mandatory. For negative patients, use of at least an FFP2 mask is recommended. In all cases the use of drills, which promote the aerosolization of potentially infected mucous particles, should be avoided. Given the potential neurotropism of SARS-CoV-2, dura handling should be minimized. It is only through widely-agreed protocols and teamwork that we will be able to deal with the evolving and complex implications of this new pandemic.


title: Correction to: Venous thromboembolism and heparin use in COVID-19 patients: juggling between pragmatic choices, suggestions of medical societies and the lack of guidelines

text: In the original version of the article, the article title was processed incorrectly. The correct article title is "Venous Thromboembolism and Heparin Use in COVID-19 Patients: Juggling between Pragmatic Choices, Suggestions of Medical Societies and the Lack of Guidelines". This has been corrected with this erratum and the original article has also been updated to reflect the change in article title.


Venous thromboembolism and heparin use in COVID-19 patients: juggling between pragmatic choices, suggestions of medical societies and the lack of guidelines


COVID-19 is possibly a consequence of the anthropogenic biodiversity crisis and climate changes


Two for one with split- or co-ventilation at the peak of the COVID-19 tsunami: is there any role for communal care when the resources for personalised medicine are exhausted?


Non-evidenced based treatment: An unintended cause of morbidity and mortality related to COVID-19


Is aberrant CD8+ T cell activation by hypertension associated with cardiac injury in severe cases of COVID-19?


title: Assessment of immunodeficiency scoring index performance in enterovirus/rhinovirus respiratory infection after allogeneic hematopoietic stem cell transplantation

text: BACKGROUND: Enterovirus/rhinoviruses (EvRh) are the most common cause of respiratory virus infections in recipients of allogeneic stem cell transplantation (allo-HSCT). OBJECTIVE: We sought to analyze the value of the immunodeficiency scoring index (ISI) in predicting lower respiratory tract disease (LRTD) progression and mortality in a prospective cohort of consecutive adult (>16 years) allo-HSCT recipients with EvRh infection from December 1 2013 to December 1 2019 at two Spanish transplant centers. RESULTS: We included 234 allo-HSCT recipients with 383 EvRh episodes. Out of 383 EvRh episodes, 98 (25%) had LRTD. Multivariate logistic regression analysis identified three independent factors associated with LRTD progression: Ig G < 400 mg/dL, community-acquired respiratory virus (CARV) co-infection and high-risk ISI. Inclusion of Ig G levels and CARV co-infection in the ISI improved its performance by significantly increasing the area under the receiver operator characteristic curve (AUROC) from 0.643 to 0.734 (P = .03). Likewise, the two conditions identified by multivariate analyses as associated with higher probability of mortality were high-risk ISI and EvRh infection within 6 months after transplant. CONCLUSIONS: Our findings confirm the value of high-risk ISI in predicting both probability of EvRh LRTD and 3-month overall mortality. We also demonstrate that the original ISI could be adapted to other CARV types by including additional variables to improve its performance.


Surprise Billing in Surgical Care Episodes - Overview, Ethical Concerns, and Policy Solutions in Light of COVID-19


title: Managing childhood allergies and immunodeficiencies during respiratory virus epidemics - The 2020 COVID-19 pandemic: A statement from the EAACI-section on pediatrics

text: While the world is facing an unprecedented pandemic with COVID-19, patients with chronic diseases need special attention and if warranted adaptation of their regular treatment plan. In children, allergy and asthma are among the most prevalent non-communicable chronic diseases, and healthcare providers taking care of these patients need guidance. At the current stage of knowledge, children have less severe symptoms of COVID-19, and severe asthma and immunodeficiency are classified as risk factors. In addition, there is no evidence that currently available asthma and allergy treatments, including antihistamines, corticosteroids, and bronchodilators, increase the risk of severe disease from COVID-19. Most countries affected by COVID-19 have opted for nationwide confinement, which means that communication with the primary clinician is often performed by telemedicine. Optimal disease control of allergic, asthmatic, and immunodeficient children should be sought according to usual treatment guidelines. This statement of the EAACI Section on Pediatrics puts forward six recommendations for the management of childhood allergies and immunodeficiencies based on six underlying facts and existing evidence.


Much on early intervention, some thoughts on COVID-19 and a paradox to ponder on


title: Coupled effects of local movement and global interaction on contagion

text: By incorporating segregated spatial domain and individual-based linkage into the SIS (susceptible-infected-susceptible) model, we investigate the coupled effects of random walk and intragroup interaction on contagion. Compared with the situation where only local movement or individual-based linkage exists, the coexistence of them leads to a wider spread of infectious disease. The roles of narrowing segregated spatial domain and reducing mobility in epidemic control are checked, these two measures are found to be conducive to curbing the spread of infectious disease. Considering heterogeneous time scales between local movement and global interaction, a log-log relation between the change in the number of infected individuals and the timescale $\tau$ is found. A theoretical analysis indicates that the evolutionary dynamics in the present model is related to the encounter probability and the encounter time. A functional relation between the epidemic threshold and the ratio of shortcuts, and a functional relation between the encounter time and the timescale $\tau$ are found.


title: Individual risk management strategy and potential therapeutic options for the COVID-19 pandemic

text: It is an ugly fact that a significant amount of the world's population will contract SARS-CoV-II infection with the current spreading. While a specific treatment is not yet coming soon, individual risk assessment and management strategies are crucial. The individual preventive and protective measures drive the personal risk of getting the disease. Among the virus-contracted hosts, their different metabolic status, as determined by their diet, nutrition, age, sex, medical conditions, lifestyle, and environmental factors, govern the personal fate toward different clinical severity of COVID-19, from asymptomatic, mild, moderate, to death. The careful individual assessment for the possible dietary, nutritional, medical, lifestyle, and environmental risks, together with the proper relevant risk management strategies, is the sensible way to deal with the pandemic of SARS-CoV-II.


What use are words at a time like this?


Correction to Lancet Gastroenterol Hepatol 2020; 5: 667-68


title: COVID-19: A Revelation - A reply to Ian Mitroff

text: This is a rejoinder of Dr. Ian Mitroff's perspective titled "Corona Virus: A Prime Example of A Wicked Mess". While I agree with Dr. Mitroff on the complexity of the COVID-19 outbreak and the urgency to address it, I disagree with him on points related to the role of wet market in this specific outbreak and whether China had acknowledged the existence of the outbreak. I also consider key highlights of the outbreak are the importance of collaboration across national and state borders and a balance between privacy and public health under such situations.


title: Epidemiologic and clinical characteristics of heart transplant recipients during the 2019 coronavirus outbreak in Wuhan, China: A descriptive survey report

text: BACKGROUND: The epidemiologic and clinical characteristics of heart transplant (HTx) recipients during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic remains unclear. We studied the characteristics of HTx recipients from December 20, 2019, to February 25, 2020, in an effort to understand their risk and outcomes. METHODS: All accessible HTx recipients were included in this single-center retrospective study. We collected information on the recipients using a web-based questionnaire as well as the hospital database. RESULTS: We followed 87 HTx recipients (72.4% were men, and the average age was 51 years). A total of 79 recipients resided in Hubei, and 57 recipients had a Wuhan-related history of travel or contact. Most took precautionary measures while in contact with suspicious crowds, and 96.6% of the families and communities undertook prevention and quarantine procedures. Four upper airway infections were reported, and 3 of them tested negative for SARS-CoV-2 (the fourth recovered and was not tested). All cases were mild and successfully recovered after proper treatment. Laboratory results of 47 HTx cases within the last 2 months were extracted. Of these, 21.3% of recipients had pre-existing lymphopenia, and 87.2% of recipients had a therapeutic concentration of tacrolimus (5-12 ng/ml). Liver and kidney insufficiency was seen in 5 and 6 recipients, respectively. CONCLUSION: HTx recipients who practiced appropriate prevention measures had a low rate of infection with SARS-CoV-2 and transition to the associated disease COVID-19. These early data will require confirmation as the pandemic establishes around the world.


title: COVID-19-Associated Encephalitis Mimicking Glial Tumor

text: BACKGROUND: Reports on neurologic manifestations of coronavirus disease 2019 (COVID-19) have attracted broad attention. We present an unusual case of COVID-19-associated encephalitis mimicking a glial tumor. CASE DESCRIPTION: A 35-year-old woman presented with headache and seizures. T2 fluid-attenuated inverse recovery imaging showed hyperintensities in the left temporal lobe. Magnetic resonance spectroscopy showed an elevated choline peak. Imaging findings were suggestive of high-grade glioma. Antiepileptic medication failed to achieve seizure control. A left anterior temporal lobectomy was performed. The patient had no postoperative deficits, and her symptoms completely improved. Histologic examination revealed encephalitis. Postoperatively, our patient tested positive for COVID-19. CONCLUSIONS: Our case raises awareness of neurologic manifestations of the disease and their potential to mimic glial tumors. For prompt diagnosis and prevention of transmission, clinicians should consider COVID-19 in patients with similar presentation.


Testing COVID-19 therapies to prevent progression of mild disease


title: Mechanisms and evidence of vertical transmission of infections in pregnancy including SARS-CoV-2

text: There remain unanswered questions concerning mother-to-child-transmission (MTCT) of SARS-CoV-2. Despite reports of neonatal COVID-19, SARS-CoV-2 has not been consistently isolated in perinatal samples thus, definitive proof of transplacental infection is still lacking. To address these questions, we assessed investigative tools used to confirm maternal-fetal infection and known protective mechanisms of the placental barrier that prevent transplacental pathogen migration. Forty studies of COVID-19 pregnancies reviewed suggest a lack of consensus on diagnostic strategy for congenital infection. While RT-PCR of neonatal swabs was universally performed, a wide range of clinical samples was screened including vaginal secretions (22.5%), amniotic fluid (35%), breast milk (22.5%) and umbilical cord blood. Neonatal COVID-19 was reported in eight studies, two of which were based on the detection of SARS-CoV-2 IgM in neonatal blood. Histological examination demonstrated sparse viral particles, vascular malperfusion and inflammation in the placenta from pregnant women with COVID-19. The paucity of placental co-expression of ACE-2 and TMPRSS2, two receptors involved in cytoplasmic entry of SARS-CoV-2, may explain its relative insensitivity to transplacental infection. Viral interactions may utilise membrane receptors other than ACE-2 thus, tissue susceptibility may be broader than currently known. Further spatial-temporal studies are needed to determine the true potential for transplacental migration. This article is protected by copyright. All rights reserved.


title: Assessing groundwater quality for drinking water supply using hybrid fuzzy-GIS-based water quality index

text: Groundwater is a vital source of freshwater in both urban and rural regions of the world. However, its injudicious abstraction and rapidly increasing contamination are posing a severe threat for sustainable water supply worldwide. Geographical Information System (GIS)-based groundwater quality evaluation using Groundwater Quality Index (GQI) has been proved to be a cost-effective tool for assessing groundwater quality and its variability at a larger scale. However, the conventional GQI approach is unable to deal with uncertainties involved in the assessment of environmental problems. To overcome this limitation, a novel hybrid framework integrating Fuzzy Logic with the GIS-based GQI is proposed in this study for assessing groundwater quality and its spatial variability. The proposed hybrid framework is demonstrated through a case study in a hard-rock terrain of Southern India using ten prominent groundwater-quality parameters measured during pre-monsoon and post-monsoon seasons. Two conventional GIS-based GQI models GQI-10 (using all the ten groundwater-quality parameters) and GQI-7 (using seven 'concerned/critical' groundwater-quality parameters) as well as hybrid Fuzzy-GIS-based GQI (FGQI) models (using seven critical parameters) were developed for the two seasons and the results were compared. The Trapezoidal membership functions classified the model input parameters into 'desirable', 'acceptable' and 'unacceptable' classes based on the experts' knowledge and water quality standards for drinking purposes. The concentrations of Ca2+, Mg2+, and SO42- in groundwater were found within the WHO desirable limits for drinking water throughout the year, while the concentrations of seven parameters (TDS, NO3--N, Na+, Cl-, K+, F- and Hardness) exceed their permissible limits during pre-monsoon and post-monsoon seasons. A comparative evaluation of GQI models revealed that the FGQI model predicts groundwater quality better than the conventional GQI-10 and GQI-7 models. GQI modeling results suggest that the groundwater of most of eastern and southern parts (â¼60% in pre-monsoon season; â¼90% in post-monsoon season) of the study area is unsuitable for drinking. Further, the groundwater quality deteriorates during post-monsoon seasons compared to pre-monsoon seasons, which indicates an increased influx of contaminants from different industries, mining areas, waste disposal sites and agricultural fields during monsoon seasons. This finding calls for the strict enforcement of regulations for proper handling of effluents from various contamination sources in the study area. It is concluded that the fuzzy logic-based decision-making approach (FGQI) is more reliable and pragmatic for groundwater-quality assessment and analysis at a larger scale. It can serve as a useful tool for the water planners and decision makers in efficiently monitoring and managing groundwater quality at watershed or basin scales.


title: How Reliable is Smartphone-based Electronic Contact Tracing for COVID-19?

text: Smartphone-based electronic contact tracing is currently considered an essential tool towards easing lockdowns, curfews, and shelter-in-place orders issued by most governments around the world in response to the 2020 novel coronavirus (SARS-CoV-2) crisis. While the focus on developing smartphone-based contact tracing applications or apps has been on privacy concerns stemming from the use of such apps, an important question that has not received sufficient attention is: How reliable will such smartphone-based electronic contact tracing be? This is a technical question related to how two smartphones reliably register their mutual proximity. Here, we examine in detail the technical prerequisites required for effective smartphone-based contact tracing. The underlying mechanism that any contact tracing app relies on is called Neighbor Discovery (ND), which involves smartphones transmitting and scanning for Bluetooth signals to record their mutual presence whenever they are in close proximity. The hardware support and the software protocols used for ND in smartphones, however, were not designed for reliable contact tracing. In this paper, we quantitatively evaluate how reliably can smartphones do contact tracing. Our results point towards the design of a wearable solution for contact tracing that can overcome the shortcomings of a smartphone-based solution to provide more reliable and accurate contact tracing. To the best of our knowledge, this is the first study that quantifies, both, the suitability and also the drawbacks of smartphone-based contact tracing. Further, our results can be used to parameterize a ND protocol to maximize the reliability of any contact tracing app that uses it.


The Italian dermatologic community facing COVID-19 pandemic: recommendation from the Italian society of dermatology and venereology


docid: kocfjexu

title: Thoughts on COVID-19 and autoimmune diseases

text: Over the 2 months since coronavirus first appeared in China, cases have emerged on every continent, and it is clear that patients with autoimmune diseases might also be affected. Coronavirus disease 2019 (COVID-19) is a highly contagious viral illness with a mortality rate approaching 2%. Here we discuss the challenges that patients with autoimmune diseases might face and the information on using immunomodulatory therapies like chloroquine, tocilizumab and baricitinib to quench the cytokine storm in patients with very severe COVID-19 pneumonia.


title: A national UK audit for diagnostic accuracy of preoperative CT chest in emergency and elective surgery during COVID-19 pandemic

text: AIM: To report on a snap audit of all departments in the UK as to the value of preoperative thoracic imaging, preferably computed tomography (CT), of patients undergoing any surgery to assess for changes consistent with COVID-19 preoperatively. MATERIALS AND METHODS: All Imaging departments in the UK were contacted and asked to record the number of preoperative CT examinations performed in patients being considered for both emergency and elective surgical intervention over a 5-day period in May 2020. RESULTS: Forty-seven percent of departments replied with data provided on >820 patients. Nineteen percent of additional preoperative CT was in patients undergoing elective intervention and 81% in patients presenting with surgical abdominal pain. There was a high rate of false positives in patients who tested negative for COVID-19, producing a sensitivity for thoracic CT of 68.4%. CONCLUSION: This UK-wide audit demonstrates that a large number of additional thoracic imaging examinations over a 5-day period were performed with a low sensitivity for the identification of COVID-19 in this preoperative group of patients. Given these findings, it is difficult to justify this additional examination in this group of patients.


How to reorganize the access of children in a radiotherapy department in the era of COVID19, in order to protect themselves and elderly patients


title: Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain

text: The pandemic caused by Covid-19 has been an unprecedented social and health emergency worldwide. This is the first study in the scientific literature reporting the psychological impact of the Covid-19 outbreak in a sample of the Spanish population. A cross-sectional study was conducted through an online survey of 3480 people. The presence of depression, anxiety and post-traumatic stress disorder (PTSD) was evaluated with screening tests from 14 March. Sociodemographic and Covid-19-related data was collected. Additionally, spiritual well-being, loneliness, social support, discrimination and sense of belonging were assessed. Descriptive analyses were carried out and linear regression models compiled. The 18.7% of the sample revealed depressive, 21.6% anxiety and 15.8% PTSD symptoms. Being in the older age group, having economic stability and the belief that adequate information had been provided about the pandemic were negatively related to depression, anxiety and PTSD. However, female gender, previous diagnoses of mental health problems or neurological disorders, having symptoms associated with the virus, or those with a close relative infected were associated with greater symptomatology in all three variables. Predictive models revealed that the greatest protector for symptomatology was spiritual well-being, while loneliness was the strongest predictor of depression, anxiety and PTSD. The impact on our mental health caused by the pandemic and the measures adopted during the first weeks to deal with it are evident. In addition, it is possible to identify the need of greater psychological support in general and in certain particularly vulnerable groups.


title: Effects of non-pharmaceutical interventions on COVID-19 cases, deaths, and demand for hospital services in the UK: a modelling study

text: BACKGROUND: Non-pharmaceutical interventions have been implemented to reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the UK. Projecting the size of an unmitigated epidemic and the potential effect of different control measures has been crucial to support evidence-based policy making during the early stages of the epidemic. This study assesses the potential impact of different control measures for mitigating the burden of COVID-19 in the UK. METHODS: We used a stochastic age-structured transmission model to explore a range of intervention scenarios, tracking 66·4 million people aggregated to 186 county-level administrative units in England, Wales, Scotland, and Northern Ireland. The four base interventions modelled were school closures, physical distancing, shielding of people aged 70 years or older, and self-isolation of symptomatic cases. We also modelled the combination of these interventions, as well as a programme of intensive interventions with phased lockdown-type restrictions that substantially limited contacts outside of the home for repeated periods. We simulated different triggers for the introduction of interventions, and estimated the impact of varying adherence to interventions across counties. For each scenario, we projected estimated new cases over time, patients requiring inpatient and critical care (ie, admission to the intensive care units [ICU]) treatment, and deaths, and compared the effect of each intervention on the basic reproduction number, R0. FINDINGS: We projected a median unmitigated burden of 23 million (95% prediction interval 13-30) clinical cases and 350â000 deaths (170â000-480â000) due to COVID-19 in the UK by December, 2021. We found that the four base interventions were each likely to decrease R0, but not sufficiently to prevent ICU demand from exceeding health service capacity. The combined intervention was more effective at reducing R0, but only lockdown periods were sufficient to bring R0 near or below 1; the most stringent lockdown scenario resulted in a projected 120â000 cases (46â000-700â000) and 50â000 deaths (9300-160â000). Intensive interventions with lockdown periods would need to be in place for a large proportion of the coming year to prevent health-care demand exceeding availability. INTERPRETATION: The characteristics of SARS-CoV-2 mean that extreme measures are probably required to bring the epidemic under control and to prevent very large numbers of deaths and an excess of demand on hospital beds, especially those in ICUs. FUNDING: Medical Research Council.


title: The laboratory tests and host immunity of COVID-19 patients with different severity of illness

text: BACKGROUNDThe coronavirus disease 2019 (COVID-19), infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a severe outbreak throughout the world. The host immunity of COVID-19 patients is unknown.METHODSThe routine laboratory tests and host immunity in COVID-19 patients with different severity of illness were compared after patient admission.RESULTSA total of 65 SARS-CoV-2-positive patients were classified as having mild (n = 30), severe (n = 20), and extremely severe (n = 15) illness. Many routine laboratory tests, such as ferritin, lactate dehydrogenase, and D-dimer, were increased in severe and extremely severe patients. The absolute numbers of CD4+ T cells, CD8+ T cells, and B cells were gradually decreased with increased severity of illness. The activation markers such as HLA-DR and CD45RO expressed on CD4+ and CD8+ T cells were increased in severe and extremely severe patients compared with mild patients. The costimulatory molecule CD28 had opposite results. The percentage of natural Tregs was decreased in extremely severe patients. The percentage of IFN-Î³-producing CD8+ T cells was increased in both severe and extremely severe patients compared with mild patients. The percentage of IFN-Î³-producing CD4+ T cells was increased in extremely severe patients. IL-2R, IL-6, and IL-10 were all increased in extremely severe patients. The activation of DC and B cells was decreased in extremely severe patients.CONCLUSIONThe number and function of T cells are inconsistent in COVID-19 patients. The hyperfunction of CD4+ and CD8+ T cells is associated with the pathogenesis of extremely severe SARS-CoV-2 infection.FUNDINGThis work was funded by the National Mega Project on Major Infectious Disease Prevention (2017ZX10103005-007) and the Fundamental Research Funds for the Central Universities (2019kfyRCPY098).


SARS-CoV-2 Does Not Spread Through ECMO or Dialysis Membranes


Animal source of the coronavirus continues to elude scientists


Reply to: "A dermatologic manifestation of COVID-19: Transient livedo reticularis"


Practical tips for using masks in the COVID-19 pandemic


title: High prevalence of COVID-19-associated diabetic ketoacidosis in UK secondary care

text: We aim to describe the prevalence of diabetic ketoacidosis (DKA) in individuals admitted to a single centre with COVID-19. We identified 218 individuals hospitalised with COVID-19, of these four fulfilled criteria for DKA (4/218, 1.8%). We conclude DKA is common and severe in individuals hospitalised with COVID-19.


title: Clinical characteristics of 82 cases of death from COVID-19

text: A recently developed pneumonia caused by SARS-CoV-2 bursting in Wuhan, China, has quickly spread across the world. We report the clinical characteristics of 82 cases of death from COVID-19 in a single center. Clinical data on 82 death cases laboratory-confirmed as SARS-CoV-2 infection were obtained from a Wuhan local hospital's electronic medical records according to previously designed standardized data collection forms. All patients were local residents of Wuhan, and a large proportion of them were diagnosed with severe illness when admitted. Due to the overwhelming of our system, a total of 14 patients (17.1%) were treated in the ICU, 83% of deaths never received Critical Care Support, only 40% had mechanical ventilation support despite 100% needing oxygen and the leading cause of death being pulmonary. Most of the patients who died were male (65.9%). More than half of the patients who died were older than 60 years (80.5%), and the median age was 72.5 years. The bulk of the patients who died had comorbidities (76.8%), including hypertension (56.1%), heart disease (20.7%), diabetes (18.3%), cerebrovascular disease (12.2%), and cancer (7.3%). Respiratory failure remained the leading cause of death (69.5%), followed by sepsis/MOF (28.0%), cardiac failure (14.6%), hemorrhage (6.1%), and renal failure (3.7%). Furthermore, respiratory, cardiac, hemorrhagic, hepatic, and renal damage were found in 100%, 89%, 80.5%, 78.0%, and 31.7% of patients, respectively. On admission, lymphopenia (89.2%), neutrophilia (74.3%), and thrombocytopenia (24.3%) were usually observed. Most patients had a high neutrophil-to-lymphocyte ratio of >5 (94.5%), high systemic immune-inflammation index of >500 (89.2%), and increased C-reactive protein (100%), lactate dehydrogenase (93.2%), and D-dimer (97.1%) levels. A high level of IL-6 (>10 pg/ml) was observed in all detected patients. The median time from initial symptoms to death was 15 days (IQR 11-20), and a significant association between aspartate aminotransferase (p = 0.002), alanine aminotransferase (p = 0.037) and time from initial symptoms to death was remarkably observed. Older males with comorbidities are more likely to develop severe disease and even die from SARS-CoV-2 infection. Respiratory failure is the main cause of COVID-19, but the virus itself and cytokine release syndrome-mediated damage to other organs, including cardiac, renal, hepatic, and hemorrhagic damage, should be taken seriously as well.


Letter to the Editor: Importance of metabolic health in the era of COVID-19


title: Online Information Exchange and Anxiety Spread in the Early Stage of the Novel Coronavirus (COVID-19) Outbreak in South Korea: Structural Topic Model and Network Analysis

text: BACKGROUND: In case of a population-wide infectious disease outbreak, such as the novel coronavirus disease (COVID-19), people's online activities could significantly affect public concerns and health behaviors due to difficulty in accessing credible information from reliable sources, which in turn causes people to seek necessary information on the web. Therefore, measuring and analyzing online health communication and public sentiment is essential for establishing effective and efficient disease control policies, especially in the early stage of an outbreak. OBJECTIVE: This study aimed to investigate the trends of online health communication, analyze the focus of people's anxiety in the early stages of COVID-19, and evaluate the appropriateness of online information. METHODS: We collected 13,148 questions and 29,040 answers related to COVID-19 from Naver, the most popular Korean web portal (January 20, 2020, to March 2, 2020). Three main methods were used in this study: (1) the structural topic model was used to examine the topics in the online questions; (2) word network analysis was conducted to analyze the focus of people's anxiety and worry in the questions; and (3) two medical doctors assessed the appropriateness of the answers to the questions, which were primarily related to people's anxiety. RESULTS: A total of 50 topics and 6 cohesive topic communities were identified from the questions. Among them, topic community 4 (suspecting COVID-19 infection after developing a particular symptom) accounted for the largest portion of the questions. As the number of confirmed patients increased, the proportion of topics belonging to topic community 4 also increased. Additionally, the prolonged situation led to a slight increase in the proportion of topics related to job issues. People's anxieties and worries were closely related with physical symptoms and self-protection methods. Although relatively appropriate to suspect physical symptoms, a high proportion of answers related to self-protection methods were assessed as misinformation or advertisements. CONCLUSIONS: Search activity for online information regarding the COVID-19 outbreak has been active. Many of the online questions were related to people's anxieties and worries. A considerable portion of corresponding answers had false information or were advertisements. The study results could contribute reference information to various countries that need to monitor public anxiety and provide appropriate information in the early stage of an infectious disease outbreak, including COVID-19. Our research also contributes to developing methods for measuring public opinion and sentiment in an epidemic situation based on natural language data on the internet.


Radiology Department and Residency Program Response and Adaption to COVID 19


title: De Novo Status Epilepticus in patients with COVID-19

text: Neurological complications are increasingly recognized with SARS-CoV-2, the causative pathogen for COVID-19. We present a single-center retrospective case series reporting the EEG and outcome of de novo status epilepticus (SE) in two African-American women with laboratory-confirmed SARS-CoV-2 virus. SE was the initial presentation in one asymptomatic individual. Patient 2 had COVID-19 pneumonia, and fluctuating mental status that raised the suspicion of subclinical SE. The patient with older age and higher comorbidities failed to recover from the viral illness that has no definitive treatment.


Is povidone-iodine mouthwash effective against SARS-CoV-2? First in vivo tests


title: Project 1000 x 1000: Centrifugal melt spinning for distributed manufacturing of N95 filtering facepiece respirators

text: The COVID-19 pandemic has caused a global shortage of personal protective equipment. While existing supply chains are struggling to meet the surge in demand, the limited supply of N95 filtering facepiece respirators (FFRs) has placed healthcare workers at risk. This paper presents a method for scalable and distributed manufacturing of FFR filter material based on a combination of centrifugal melt spinning utilizing readily available cotton candy machines as an example. The proposed method produces nonwoven polypropylene fabric material with filtering efficiency of up to 96% for particles 0.30-0.49 {\mu}m in diameter. We additionally demonstrate a scalable means to test for filtration efficiency and pressure drop to ensure a standardized degree of quality in the output material. We perform preliminary optimization of relevant parameters for scale-up and propose that this is a viable method to rapidly produce up to one million N95 FFRs per day in distributed manner with just six machines per site operating across 200 locations. We share this work as a starting point for others to rapidly construct, replicate and develop their own affordable modular processes aimed at producing high quality filtration material to address the current FFR shortage globally.