title: Sinus and Anterior Skull Base Surgery during the COVID-19 pandemic: Systematic review, Synthesis and YO-IFOS position.

text: Purpose: The COVID-19 pandemic has caused significant confusion about healthcare providers and patients pandemic-specific risks related to surgery. The aim of this systematic review is to summarize recommendations for sinus and anterior skull base surgery during the COVID-19 pandemic. Methods: PubMed/MEDLINE, Google Scholar, Scopus and Embase were searched by two independent otolaryngologists from the Young Otolaryngologists of IFOS (YO-IFOS) for studies dealing with sinus and skull base surgery during COVID-19 pandemic. The review also included unpublished guidelines edited by Otolaryngology-Head and Neck Surgery or Neurosurgery societies. Perioperative factors were investigated including surgical indications, preoperative testing of patients, practical management in operating rooms, technical aspects of surgery and postoperative management. The literature review was performed according to PRISMA guidelines. The criteria for considering studies or guidelines for the review were based on the population, intervention, comparison, outcome, timing and setting (PICOTS) framework. Results: 15 international publications met inclusion criteria. Five references were guidelines from national societies. All guidelines recommended postponing elective surgeries. An algorithm is proposed that classifies endonasal surgical procedures into three groups based on the risk of postponing surgery. Patients COVID-19 status should be preoperatively assessed. Highest level of personal protective equipment (PPE) is recommended, and the use of high-speed powered devices should be avoided. Face-to-face postoperative visits must be limited. Conclusions: Sinus and skull base surgeries are high-risk procedures due to potential aerosolization of SARS-CoV-2 virus. Protection of health care workers by decreasing exposure and optimizing use of PPE is essential with sinus and anterior skull base surgery.


Security research on COVID-19


title: Identifying Influential Spreaders of Epidemics on Community Networks

text: An efficient strategy for the identification of influential spreaders that could be used to control epidemics within populations would be of considerable importance. Generally, populations are characterized by its community structures and by the heterogeneous distributions of weak ties among nodes bridging over communities. A strategy for community networks capable of identifying influential spreaders that accelerate the spread of disease is here proposed. In this strategy, influential spreaders serve as target nodes. This is based on the idea that, in k-shell decomposition, weak ties and strong ties are processed separately. The strategy was used on empirical networks constructed from online social networks, and results indicated that this strategy is more accurate than other strategies. Its effectiveness stems from the patterns of connectivity among neighbors, and it successfully identified the important nodes. In addition, the performance of the strategy remained robust even when there were errors in the structure of the network.


title: COVID-19 Epidemic in Switzerland: Growth Prediction and Containment Strategy Using Artificial Intelligence and Big Data

text: Using a previously developed agent-based artificial intelligence simulation platform (EnerPol) coupled with Big Data, the evolution and containment of COVID-19 in Switzerland is examined. The EnerPol platform has been used in a broad range of case studies in different sectors in all of Europe, USA, Japan, South Korea and sub Saharan Africa over the last 10 years. In the present study, the entire Swiss population (8.57 million people), including cross-border commuters, and the entire Swiss public and private transport network that is simulated to assess transmission of the COVID-19 virus. The individual contacts within the population, and possible transmission pathways, are established from a simulation of daily activities that are calibrated with micro-census data. Various governmental interventions with regards to closures and social distancing are also implemented. The epidemiology of the COVID-19 virus is based on publicly available statistical data and adapted to Swiss demographics. The predictions estimate that between 22 February and 11 April 2020, there will be 720 deaths from 83300 COVID-19 cases, and 73300 will have recovered; our preliminary variability in these estimates is about 21% over the aforementioned period. In the absence of governmental intervention, 42.7% of the Swiss population would have been infected by 25 April 2020 compared to our prediction of a 1% infection over this time period, saving thousands of lives. It is argued that future scenarios regarding relaxation of the lockdown should be carefully simulated, as by 19 April 2020, there will still remain a substantial number of infected individuals, who could retrigger a second spread of COVID-19. Through the use of a digital tool, such as Enerpol, to evaluate in a data-driven manner the impacts of various policy scenarios, the most effective measures to mitigate a spread of COVID-19 can be devised while we await the deployment of large-scale vaccination for the population globally. By tailoring the spatio-temporal characteristics of the spread to match the capacity of local healthcare facilities, appropriate logistic needs can be determined, in order not to overwhelm the health care services across the country.


title: SARS-CoV-2 detection in setting of viral swab scarcity: are MRSA swabs and viral swabs equivalent?

text: Abstract: Background: The global pandemic of Severe Acute Respiratory Syndrome-Related Coronavirus 2 (SARS-CoV2) has resulted in unprecedented challenges for healthcare systems. One barrier to widespread testing has been a paucity of traditional respiratory viral swab collection kits relative to the demand. Whether other sample collection kits, such as widely available MRSA nasal swabs can be used to detect SARS-CoV-2 is unknown. Methods: We compared simultaneous nasal MRSA swabs (COPAN ESwabs 480C flocked nasal swab in 1mL of liquid Amies medium) and virals wabs (BD H192(07) flexible mini-tip flocked nasopharyngeal swabs in 3mL Universal Transport Medium) for SARS-CoV-2 PCR testing using Simplexa COVID-19 Direct assay on patients over a 4-day period. When the results were discordant, the viral swab sample was run again on the Cepheid Xpert Xpress SARS-CoV-2 assay. Results: Of the 81 included samples, there were 19 positives and 62 negatives in viral media and 18 positives and 63 negative in the MRSA swabs. Amongst all included samples, there was concordance between the COPAN ESwabs 480C and the viral swabs in 78 (96.3%). Conclusion: We found a high rate of concordance in test results between COPAN ESwabs 480C in Amies solution and BD H192(07) nasopharyngeal swabs in in 3 mL of Universal Viral Transport medium viral media. Clinicians and laboratories should feel better informed and assured using COPAN ESwabs 480C to help in the diagnosis of COVID-19.


title: COVID-19 legislation in Belgium at the crossroads of a political and a health crisis*

text: This paper discusses the corona virus crisis legislation in Belgium, against the background of a political crisis. It raises the questions how a minority government could find legitimacy to take drastic measures that impact upon fundamental rights and how the political crisis impacted the position of Parliament. This is examined from the viewpoint of input, throughput and output legitimacy, and with a comparison to the position of Parliament in Belgium during earlier crises and in the federated entities. The conclusions point to the increased importance of expert advice, an over-use of ministerial police powers, but also to a more important role for Parliament than what we could have expected under the reign of a majority government. While the political crisis did not hinder firm intervention in an initial phase, it is, however, problematic to deal with the effects of the crisis over the longer term.


docid: kifqgskc

title: Computational simulations reveal the binding dynamics between human ACE2 and the receptor binding domain of SARS-CoV-2 spike protein

text: A novel coronavirus (the SARS-CoV-2) has been identified in January 2020 as the causal pathogen for COVID-19 pneumonia, an outbreak started near the end of 2019 in Wuhan, China. The SARS-CoV-2 was found to be closely related to the SARS-CoV, based on the genomic analysis. The Angiotensin converting enzyme 2 protein (ACE2) utilized by the SARS-CoV as a receptor was found to facilitate the infection of SARS-CoV-2 as well, initiated by the binding of the spike protein to the human ACE2. Using homology modeling and molecular dynamics (MD) simulation methods, we report here the detailed structure of the ACE2 in complex with the receptor binding domain (RBD) of the SARS-CoV-2 spike protein. The predicted model is highly consistent with the experimentally determined complex structures. Plausible binding modes between human ACE2 and the RBD were revealed from all-atom MD simulations. The simulation data further revealed critical residues at the complex interface and provided more details about the interactions between the SARS-CoV-2 RBD and human ACE2. Two mutants mimicking rat ACE2 were modeled to study the mutation effects on RBD binding to ACE2. The simulations showed that the N-terminal helix and the K353 of the human ACE2 alter the binding modes of the CoV2-RBD to the ACE2.


Protocolo de diagnóstico y tratamiento para COVID-19 mediante medicina tradicional china#*


title: Estimation of the incubation period of COVID-19 using viral load data

text: The incubation period, or the time from infection to symptom onset of COVID-19 has been usually estimated using data collected through interviews with cases and their contacts. However, this estimation is influenced by uncertainty in recalling effort of exposure time. We propose a novel method that uses viral load data collected over time since hospitalization, hindcasting the timing of infection with a mathematical model for viral dynamics. As an example, we used the reported viral load data from multiple countries (Singapore, China, Germany, France, and Korea) and estimated the incubation period. The median, 2.5, and 97.5 percentiles of the incubation period were 5.23 days (95% CI: 5.17, 5.25), 3.29 days (3.25, 3.37), and 8.22 days (8.02, 8.46), respectively, which are comparable to the values estimated in previous studies. Using viral load to estimate the incubation period might be a useful approach especially when impractical to directly observe the infection event.


title: Rethinking the role of blood pressure drugs in COVID-19

text: All it takes is a simple cough: a sharp intake of breath, the compression of air in the lungs, and the throat flying open to spew air, spit, and mucus If the person coughing is infected with the novel coronavirus, it comes along for the ride on droplets, which can travel up to 50 miles per hour When someone breathes those droplets in, the virus can get into the lungs Once inside, it uses a spike protein on its surface to target an enzyme—ACE2—scattered over the outsides of the airway’s cells If the spike protein connects with its target, the coronavirus uses ACE2 as a door to slip inside the cell Thus begins an infection During the early days of the coronavirus outbreak, researchers hypothesized that the likelihood of contracting COVID-19, the disease caused by the novel coronavirus, could be related to the amount of ACE2 on someone’s cells—the more doors for the virus to enter through, the higher the risk That idea prompted doctors around the world in March to warn the millions of people taking two classes of blood pressure medications, angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), of a potential danger: these medications appear to increase ACE2 levels in cells, at least in some studies, so the drugs may make their users more susceptible to the novel coronavirus, SARS-CoV-2


COVID-19 and the Elderly: Who Cares?


title: Estimation of seroprevalence of novel coronavirus disease (COVID-19) using preserved serum at an outpatient setting in Kobe, Japan: A cross-sectional study.

text: Summary Background Coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has been affecting many people on earth and our society. Japan is known to have relatively less number of infections as well as deaths among developed nations. However, accurate prevalence of COVID-19 in Japan remains unknown. Therefore, we conducted a cross-sectional study to estimate seroprevalence of SARS-CoV-2 infection. Methods We conducted a cross-sectional serologic testing for SARS-CoV-2 antibody using 1,000 samples from patients at outpatient settings who visited the clinic from March 31 to April 7, 2020, stratified by decade of age and sex. Results There were 33 positive IgG among 1,000 serum samples (3.3%, 95%CI: 2.3-4.6%). By applying this figure to the census of Kobe City (poplation: 1,518,870), it is estimated that the number of people with positive IgG be 50,123 (95%CI: 34,934-69,868). Age and sex adjusted prevalence of positivity was 2.7% (95%CI 1.8-3.9%), and the estimated number of people with positive IgG was 40,999 (95%CI: 27,333-59,221). These numbers were 396 to 858 fold more than confirmed cases with PCR testing in Kobe City. Conclusions Our cross-sectional serological study suggests that the number of people with seropositive for SARS-CoV-2 infection in Kobe, Japan is far more than the confirmed cases by PCR testing.


title: Whole-genome sequence analysis and homology modelling of the main protease and non-structural protein 3 of SARS-CoV-2 reveal an aza-peptide and a lead inhibitor with possible antiviral properties

text: Viruses belonging to the family Coronaviridae consist of virulent pathogens that have a zoonotic property. Severe acute respiratory syndrome coronaviruses (SARS-CoVs) and Middle East respiratory syndrome coronaviruses (MERS-CoVs) of this family have emerged before and SARS-CoV-2 has emerged now globally. The characterization of spike glycoproteins, polyproteins and other viral proteins from viruses is important for antiviral drug development. Homology modelling of these proteins with known templates offers the opportunity to discover ligand-binding sites and explore the possible antiviral properties of these protein-ligand complexes. In this study, we performed a complete bioinformatic analysis, sequence alignment, comparison of multiple sequences and modelling of the SARS-CoV-2 whole-genome sequences, the spike protein and the polyproteins for homology with known proteins. We also analysed binding sites in these models for possible binding with ligands that exhibit antiviral properties. Our results indicated that the sequence of the polyprotein isolate SARS-CoV-2_HKU-SZ-001_2020 showed 98.94 percent identity to SARS-coronavirus NSP12 bound to NSP7 and NSP8 co-factors. The results also indicated that a part of the viral genome (residues 3268-3573 in Frame 2 with 306 amino acids) of the SARS-CoV-2 isolate Wuhan-Hu-1 (GenBank Accession Number MN908947.3) when modelled with templateof the PDB database showed 96 percent identity to a 3C-like peptidase of SARS-CoVs, which has the ability to bind with an aza-peptide epoxide (APE) known for the irreversible inhibition of SARS-CoV main peptidase. A docking profile with 9 different conformations of the ligand with the protein model using Autodock Vina showed an affinity of −7.1 kcal mol−1. This region was conserved in 831 genomes of SARS-CoV-2. The part of the genome (residues 1568-1882 in Frame 2 with 315 amino acids) when modelled with template of the PDB database showed 82 percent identity to a papain-like protease/deubiquitinase, which when complexed with ligand GRL0617 acts as an inhibitor and can block SARS-CoV replication. A docking profile with 9 different conformations of the ligand with the protein model using Autodock Vina showed an affinity of −7.9 kcal mol−1. This region was conserved in 831 genomes of SARS-CoV-2. It is possible that these ligands can be used as antivirals of SARS-CoV-2.


Aktuelle Informationen zu COVID-19 auf einer Plattform – zeitschriftenübergreifend


title: Forecasting the spread of COVID-19 in Nigeria using Box-Jenkins Modeling Procedure

text: Abstract Objective: This study is focused on the analysis of the spread of Covid19 in Nigeria, applying statistical models and available data from the NCDC. We present an insight into the spread of Covid19 in Nigeria in order to establish a suitable prediction model, which can be applied as a decisionsupportive tool for assigning health interventions and mitigating the spread of the Covid19 infection. Methodology: Daily spread data from February 27 to April 26, 2020, were collected to construct the autoregressive integrated moving average (ARIMA) model using the R software. Stability analysis and stationarity test, parameter test, and model diagnostic were also carried out. Finally, the fitting, selection and prediction accuracy of the ARIMA model was evaluated using the AICc model selection criteria. Results: The ARIMA (1,1,0) model was finally selected among ARIMA models based upon the parameter test and Box Ljung test. A ten day forecast was also made from the model, which shows a steep upward trend of the spread of the COVID19 in Nigeria within the selected time frame. Conclusion: Federal Government of Nigeria through the presidential task force can apply the forecasted trend of much more spread to make more informed decisions on the additional measures in place to curb the spread of the virus. Application of the model can also assist in studying the effectiveness of the lockdown on the on the spread of Covid19 in Nigeria.


title: Enabling servitization by retrofitting legacy equipment for Industry 4.0 applications: benefits and barriers for OEMs

text: Abstract In the wake of industry 4.0, many industries have started to pivot towards digital, collaborative, and smart manufacturing systems by connecting their machinery as part of the Internet of Things (IoT). IoT has the potential to provide visibility and improve manufacturing systems through data collection, analysis, and subsequent actions based on insights generated from large amounts of manufacturing data. Even though comparatively newer equipment come readily equipped with embedded sensors and industrial connectivity necessary to connect to the IoT environment, there are many manufacturers (equipment users) who rely on long standing “legacy systems” that offer no or very limited connectivity. In this context, solutions mostly result in the development of low-cost retrofit or upgrade kits that allow integrating legacy equipment into Industry 4.0 environment and thus enable digital servitization. Servitization is a transformation journey that involves firms developing the capabilities they need to provide technical and data-driven services that supplement traditional product offerings. However, retrofitting solutions of legacy equipment rarely involve Original Equipment Manufacturers (OEMs) who may otherwise leverage the opportunity to create and capture unique value by retrofitting and then provisioning data-driven value-added services for the manufacturers. Hence, the primary objective of this paper is to identify and analyze the available literature on retrofitting and upgrading of the legacy equipment for Industry 4.0 integration. In doing so, this study also investigates the potential opportunities and challenges of OEMs in supporting the Industry 4.0 transition of legacy equipment in a servitization context.


title: Publish or perish: Reporting Characteristics of Peer-reviewed publications, pre-prints and registered studies on the COVID-19 pandemic

text: Background The COVID-19 pandemic has resulted in a mass of academic papers being published in a very brief span of time. Our aim was to compare the amount and reporting characteristics of COVID-19 related peer-reviewed and pre-prints publications. We also investigated the amount of ongoing trials and systematic reviews. Methods and findings A cross-sectional study of publications covering the COVID-19 pandemic time frame, up to May 20, 2020 was conducted. PubMed with appropriate combinations of Medical Subject Headings and COVID-19 section of MedRxiv and BioRxiv archives were searched. We examined Clinicaltrial.gov, Chinese Clinical Trial Registry, EU Register and 15 other trial registers as well as the international prospective register of systematic reviews (PROSPERO). Characteristics of each publication source were extracted. Regression analyses and Z tests were used to analyze publication trends over the weeks and compare their relative proportions. We found 3635 peer-reviewed publications and 3805 pre-prints, of which 8.6% (n=329) were published in indexed journals. Peer-reviewed and pre-print publications amount both increased significantly over time (p<0.001). Case reports (peer-reviewed: 6% vs pre-prints: 0.9%, p<0.001) and letters (17.4% vs 0.5%, p<0.001) accounted for a greater share of the peer-reviewed compared to pre-print publications. In turn, randomized controlled trials (0.22% vs 0.63% p<0.001) and systematic reviews (0.08% vs 5%) accounted for a significantly greater share of the pre-print publications. Clinicaltrials.gov, Chinese Clinical Trial Registry and EU register included 57.9%, 49.5 % and 98.9% trials mostly still 'recruiting'. PROSPERO amounted to 962 systematic review protocols. Conclusion Pre-prints were slightly more prevalent than peer-reviewed publications, yet both are growing. To fill the void given by the absence of published primary studies, immediate opinions (i.e., letters) has virulently been published in PubMed. However, preprints has been promoted as rapid responses to give direct and promptly access at scientific findings in this pandemic.


title: Environmental impact of the COVID-19 pandemic–a lesson for the future

text: The environment is an integral component of human and animal health. COVID-19 is a global health challenge in the twenty-first century. The emergence of SARS-CoV-2 in Wuhan, China in December 2019, and its spread to regional countries and nowadays affecting more than 210 countries worldwide represents the first pandemic in history to be caused by a coronavirus. The COVID-19 pandemic has huge impacts on most aspects of human activities, as well as on the economy and health care systems. Lock-downs, quarantines and border closures in the wake of the pandemic have led to reductions in air pollution through decreased travel and production. These positive environmental effects are likely mostly temporary, but may serve as an example that changes in our way of life can have prompt positive effects for the environment and demonstrate the usefulness of travel-reducing measures such as teleconferencing. Thus, acknowledging that COVID-19 is first and foremost a global disaster, the pandemic may inspire to future behavioral changes with positive environmental effects.


title: Dataset on the COVID-19 Pandemic Situation in Tunisia with application to SIR Model

text: April 9, 2020 marks 100 days since first cases of the Coronavirus Disease 2019 in China. In this crucial day with 1 436 198 confirmed infected cases in the world (New confirmed infected cases 82 837) and 85 521 deaths (6286 New daily deaths), the Global Level of the Covid-19 pandemic is evaluated at very high according to the World Health Organization (WHO) situation report. For most people, COVID-19 infection will cause mild illness (fever and at least one sign/symptom of respiratory disease), however for more than 3.4% of people, it can be fatal. Older people and those with pre-existing medical conditions (such as cardiovascular disease, chronic respiratory disease or diabetes) are at risk for severe disease and mortality. The incubation period of the virus is estimated to be between 2 and 14 days but longer incubation are reported. Furthermore, Data published by world authorities shows that statistics are different for different geographical regions and depends on many social and environmental factors. The sad reality of the COVID-19 is that there are currently no medications or vaccines proven to be effective for the treatment or prevention of the disease. The pandemic spread is consequenctly followed by a worldwide panic. Facing this dramatic uncertain situation, implementing a country wide strategy for social distancing and a general logistic policy for critical and life-saving supplies is an urgency for governomental and sanitaire authorities. Several mathematical models have been proposed for developed countries to predict the epidemic spread. However these models can't be adapted to developing countries due to the major differences in geographic, societal, economic and political adopted strategies. Here, we propose the application of the well known SIR model to the case study of Tunisia where Data are collected from three official databases showing differences in reporting methods. The proposed data could be useful to predict the spread of COVID-2019 and design a more reliable model that can estimate the finale size of the spread and help in monitoring infection control.


title: Nucleus translocation of tRNA synthetase mediates late integrated stress response

text: Various stress conditions are signaled through phosphorylation of translation initiation factor eIF2α to inhibit global translation while selectively activating transcription factor ATF4 to aid cell survival and recovery. However, this integrated stress response is acute and cannot resolve lasting stress. Here we report that TyrRS, a member of the aminoacyl-tRNA synthetase family capable of responding to diverse stress factors through cytosol-nucleus translocation and activating stress-response genes, also inhibits global translation, however at a later stage than eIF2α/ATF4 and mTOR responses. Excluding TyrRS from the nucleus over-activates protein synthesis and increases apoptosis in cells under prolonged oxidative stress. Nuclear TyrRS transcriptionally represses translation genes by recruiting TRIM28 and/or NuRD complex. We propose TyrRS, possibly along with other family members, can sense a variety of stress signals through intrinsic properties of this enzyme and its strategically located nuclear localization signal and integrate them by nucleus-translocation to effect protective responses against prolonged stress.


title: Changes in Subway Ridership in Response to COVID-19 in Seoul, South Korea: Implications for Social Distancing

text: Introduction While numerous episodes of Coronavirus disease 2019 (COVID-19) infection and subsequent government announcements in South Korea were accompanied by widespread social distancing efforts by the people, it is unclear whether these episodes and government announcements were actually influential in improving social distancing, or whether the level of response among different demographic groups varied. Methods Data were downloaded from Seoul Data Open Plaza, and changes in the number of passengers on the Seoul Metropolitan Subway network between January 1, 2020, and March 31, 2020, were used to assess the extent to which people in Seoul practiced social distancing. Five events regarding COVID-19 that received wide public attention between January and March 2020 were identified and the changes in the number of passengers before and after each event were analyzed. Also, similar analyses were performed for 16 stations that were specific in either the age or purpose of the visit of the passengers. Results Compared to the third week of January 2020 (January 13-19), the mean daily number of passengers in all stations decreased by 2,984,857.4 or 40.6% by the first week of March (March 2-8). The percentage decrease in individual stations between this period was not significantly different between “young” and “old” stations (46.3% vs. 49.2%; p = 0.551) but was significantly smaller in “work” stations than in “leisure” stations (36.2% vs. 51.6%; p = 0.021). Of the five events, the first reported death due to COVID-19 in South Korea and the identification of a mass infection cluster in Daegu on February 20 were accompanied by the greatest decrease of the mean daily number of passengers (1,352,153.3 or 20.8%), while the first mass infection in Seoul on March 10 and the announcement of aggressive social distancing campaign on March 22 were accompanied by an increase in the number of passengers. Conclusions The number of subway passengers in Seoul decreased markedly during late February but slowly increased afterward, suggesting decreasing levels of risk perception and adherence to social distancing. Understanding the differing patterns of subway use by age or purpose of the visit may guide policymakers and the general public in shaping their future response to the current pandemic.


docid: lmstdmyb

title: Scrutinizing the SARS-CoV-2 protein information for the designing an effective vaccine encompassing both the T-cell and B-cell epitopes

text: Novel SARS coronavirus (SARS-CoV-2) has caused a pandemic condition world-wide and has been declared as public health emergency of International concern by WHO in a very short span of time. The community transmission of this highly infectious virus has severely affected various parts of China, Italy, Spain and USA among others. The prophylactic solution against SARS-CoV-2 infection is challenging due to the high mutation rate of its RNA genome. Herein, we exploited a next generation vaccinology approach to construct a multi-epitope vaccine candidate against SARS-CoV-2 with high antigenicity, safety and efficacy to combat this deadly infectious agent. The whole proteome was scrutinized for the screening of highly conserved, antigenic, non-allergen and non-toxic epitopes having high population coverage that can elicit both humoral and cellular mediated immune response against COVID-19 infection. These epitopes along with four different adjuvants were utilized to construct a multi-epitope vaccine candidate that can generate strong immunological memory response having high efficacy in humans. Various physiochemical analyses revealed the formation of a stable vaccine product having a high propensity to form a protective solution against the detrimental SARS-CoV-2 strain with high efficacy. The vaccine candidate interacted with immunological receptor TLR3 with high affinity depicting the generation of innate immunity. Further, the codon optimization and in silico expression show the plausibility of the high expression and easy purification of the vaccine product. Thus, this present study provides an initial platform of the rapid generation of an efficacious protective vaccine for combating COVID-19.


title: The Hybrid Forecasting Method SVR-ESAR forCovid-19

text: We know that SARS-Cov2 produces the new COVID-19 disease, which is one of the most dangerous pandemics of modern times. This pandemic has critical health and economic consequences, and even the health services of the large, powerful nations may be saturated. Thus, forecasting the number of infected persons in any country is essential for controlling the situation. In the literature, different forecasting methods have been published attempting to solve the problem. However, a simple and accurate forecasting method is required for its implementation in any part of the world. This paper presents a precise and straightforward forecasting method named SVR-ESAR (Support Vector regression hybridized with the classical Exponential smoothing and ARIMA). We applied this method to the infected time series in four scenarios: the Whole World, China, the US, and Mexico. We compared our results with those of the literature showing the proposed method has the best accuracy.


Recommendations for the management of newborn with suspected or confirmed coronavirus disease-19


title: T cells found in COVID-19 patients ‘bode well’ for long-term immunity

text: SARS-CoV-2, the virus that causes COVID-19, has been unclear Now, two studies reveal that infected people harbor T cells that target the virus—and may help them recover Both studies also found that some people never infected with SARS-CoV-2 have these cellular defenses, most likely because they were previously infected with other coronaviruses “This is encouraging data,” says virologist Angela Rasmussen of Columbia University Although the studies don’t clarify whether people who clear a SARS-CoV-2 infection can ward off the virus in the future, both identified strong T cell responses to it, which “bodes well for the development of long-term protective immunity,” Rasmussen says The findings could also help researchers create better vaccines


title: Taking aim at a fast-moving target: Targets to watch for SARS-CoV-2 and COVID-19

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized as a betacoronavirus and recognized as the seventh discrete coronavirus species capable of causing human disease. This new coronavirus causes febrile respiratory illness and on March 11, 2020, was characterized as a global pandemic. Investigators have accelerated the search for a vaccine to prevent infection and for agents to treat it. This article presents those drug targets that (as of March 20, 2020) are currently under active investigation for the treatment of COVID-19, the disease caused by SARS-CoV-2 infection.


Simulated net‐benefit of polymerase chain reaction test for COVID‐19 among asymptomatic patients


title: Benefit-risk analysis of health benefits of routine childhood immunisation against the excess risk of SARS-CoV-2 infections during the Covid-19 pandemic in Africa

text: Background: National immunisation programmes globally are at risk of suspension due to the severe health system constraints and physical distancing measures in place to mitigate the ongoing COVID-19 pandemic. Our aim is to compare the health benefits of sustaining routine childhood immunisation in Africa against the risk of acquiring SARS-CoV-2 infections through visiting routine vaccination service delivery points. Methods: We used two scenarios to approximate the child deaths that may be caused by immunisation coverage reductions during COVID-19 outbreaks. First, we used previously reported country-specific child mortality impact estimates of childhood immunisation for diphtheria, tetanus, pertussis, hepatitis B, Haemophilus influenzae type b, pneumococcal, rotavirus, measles, meningitis A, rubella, and yellow fever (DTP3, HepB3, Hib3, PCV3, RotaC, MCV1, MCV2, MenA, RCV, YFV) to approximate the future deaths averted before completing five years of age by routine childhood vaccination during a 6-month Covid-19 risk period without catch-up campaigns. Second, we analysed an alternative scenario that approximates the health benefits of sustaining routine childhood immunisation to only the child deaths averted from measles outbreaks during the Covid-19 risk period. The excess number of infections due to additional SARS-CoV-2 exposure during immunisation visits assumes that contact reducing interventions flatten the outbreak curve during the Covid-19 risk period, that 60% of the population will have been infected by the end of that period, that children can be infected by either vaccinators or during transport and that upon child infection the whole household would be infected. Country specific household age structure estimates and age dependent infection fatality rates are then applied to calculate the number of deaths attributable to the vaccination clinic visits. We present benefit-risk ratios for routine childhood immunisation alongside 95% uncertainty range estimates from probabilistic sensitivity analysis. Findings: For every one excess Covid-19 death attributable to SARS-CoV-2 infections acquired during routine vaccination clinic visits, there could be 143 (38 - 576) deaths in children prevented by sustaining routine childhood immunisation in Africa. The benefit-risk ratio for the vaccinated children, siblings, parents or adult care-givers, and older adults in the households of vaccinated children are 58,000 (3,200 - 21,350,000), 52,000 (2,800 - 18,884,000), 2,000 (393 - 12,000), and 157 (41 - 652) respectively. In the alternative scenario that approximates the health benefits to only the child deaths averted from measles outbreaks, the benefit-risk ratio to the households of vaccinated children is 5 (1 - 21) under these highly conservative assumptions and if the risk to only the vaccinated children is considered, the benefit-risk ratio is 2,000 (131 - 839,000). Interpretation: Our analysis suggests that the health benefits of deaths prevented by sustaining routine childhood immunisation in Africa far outweighs the excess risk of Covid-19 deaths associated with vaccination clinic visits. However, there are other factors that must be considered for strategic decision making to sustain routine childhood immunisation in African countries during the Covid-19 pandemic. These include logistical constraints of vaccine supply chain problems caused by the Covid-19 pandemic, reallocation of immunisation providers to other prioritised health services, healthcare staff shortages caused by SARS-CoV-2 infections among the staff, decreased demand for vaccination arising from community reluctance to visit vaccination clinics for fear of contracting SARS-CoV-2 infections, and infection risk to healthcare staff providing immunisation services as well as to their households and onward SARS-CoV-2 transmission into the wider community.


title: Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review

text: Objectives: To examine the impact of providing healthcare during or after health emergencies caused by viral epidemic outbreaks on healthcare workers (HCWs) mental health, and to assess the available evidence base regarding interventions to reduce such impact. Design: Systematic rapid review and meta-analysis. Data sources: MEDLINE, Embase, and PsycINFO, searched up to 23 March 2020. Method: We selected observational and experimental studies examining the impact on mental health of epidemic outbreaks on HCWs. Titles and abstracts were screened by one reviewer, and full texts were evaluated by two reviewers independently. We extracted study characteristics, symptoms, prevalence of mental health problems, risk factors, mental health interventions, and its impact. We assessed risk of bias for each individual study. We conducted a narrative and tabulated synthesis of the results. We pooled data using random-effects meta-analyses to estimate the prevalence of specific mental health problems. We followed the GRADE approach to assess the certainty in the evidence. Results: We included 61 studies (56 examining impact on mental health and five about interventions to reduce such impact). Most were conducted in Asia (59%), examined the impact of the SARS epidemic (69%), and took place in the hospital setting (79%). The pooled prevalence was higher for anxiety (45%, 95% CI 21 to 69%; 6 studies, 3,373 participants), followed by depression (38%, 95% CI 15 to 60%; 7 studies, 3,636 participants), acute stress disorder (31%, 95% CI 0 to 82%, 3 studies , 2,587 participants), burnout (29%, 95% CI 25 to 32%; 3 studies; 1,168 participants) and post-traumatic stress disorder (19%, 95% CI 11 to 26%, 10 studies, 3,121 participants). Based on 37 studies, we identified a broad number of risk factors for these conditions, including sociodemographic: younger age and female gender; social factors: lack of social support, social rejection or isolation, stigmatization; and occupational: working in a high risk environment (frontline staff), specific occupational roles (e.g., nurse), and lower levels of specialized training, preparedness and job experience. Two out of five interventions identified were educational aimed to prevent mental health problems by increasing HCWs resilience. These interventions showed positive effects in confidence in support and training, pandemic self-efficacy and interpersonal problems solving (very low certainty). One multifaceted intervention (based on training and organisational changes) targeted at hospital nurses during the SARS epidemic produced statistically significant improvements in anxiety, depression, and sleep quality (very low certainty). The impact of the two remaining interventions (multifaceted and based on psychotherapy provision) was unreported. Conclusion: The prevalence of anxiety, depression, acute and post-traumatic stress disorder, and burnout, was high both during and after the outbreaks. These problems not only have a long-lasting effect on the mental health of HCWs, but also hinder the urgent response to the current COVID-19 pandemic, by jeopardising attention and decision-making. Governments and healthcare authorities should take urgent actions to protect the mental health of HCWs. In light of the limited evidence regarding the impact of interventions to tackle mental health problems in HCWs, the risk factors identified in this study represent important targets for future interventions.


docid: wdeahrff

title: Manifestations of mortality based global data of COVID-19; unifying global model through single parameter

text: Critical inspection of the world data of COVID-19 mortality rates per population number has been made and used to express extensive variations in mortality over the globe in terms of a powered parameter {lambda} varying from 0 to 1.2 expressed as a measure of strength of primary infection, originating from China source. The copying process is degenerating successively while infection is passed on to secondary subjects. We have been able to correlate global data through this parameter; any value close to or less than 1 shows significant impact of diluted multiple secondary effect. Further, the scatter diagram shows no effect of temperature of the geographical location and so is likely as the virus is only being spread from either contact or close proximity; the virus does not need to face highs and lows of temperatures of the environment. It stays only in the range of human body temperature and appears to be stable in 36 to 40C range. If it faces the environmental temperatures it is possible for its quicker deactivation but that situation never arises for this virus except when it spreads from surfaces.


title: Predicting Growth of COVID-19 Confirmed Cases in Each U.S. County with a Population of 50,000 or More

text: Models of local spread of COVID-19 are needed to assist local governments and health care providers to prepare for surges of clinical cases in their communities. National and state based models are inadequate because the virus is introduced and spreads at different rates in local areas. Models based on motor vehicle traffic measured by tracking cell phones movement in relation to daily numbers of confirmed cases are being developed but this study finds that indicator less effective in predicting future cases than time since the first case in a county. Each county has its own function of time since the first case that can be used to predict increases in reported cases two weeks in advance for each of 914 counties in the U.S. with populations of 50,000 or more inhabitants.


title: IgY antibodies against Ebola virus possess post-exposure protection and excellent thermostability

text: Ebola virus (EBOV) is the most virulent pathogens that cause hemorrhagic fever with high mortality rates in humans and nonhuman primates. The postexposure antibody therapies to prevent EBOV infection are considered efficient. However, due to the poor thermal stability of mammalian antibody, their application in the tropics has been limited. Here, we developed a thermostable therapeutic antibody against EBOV based on chicken immunoglobulin Y (IgY). The IgY antibodies demonstrated excellent thermal stability, which retained their neutralizing activity at 25°C for one year, in contrast to conventional polyclonal or monoclonal antibodies (MAbs). We immunized laying hens with a variety of EBOV vaccine candidates and confirmed that VSV Δ G/EBOVGP encoding the EBOV glycoprotein could induce high titer neutralizing antibodies against EBOV. The therapeutic efficacy of immune IgY antibodies in vivo was evaluated in the newborn Balb/c mice model. Lethal dose of virus challenged mice were treated 2 or 24 h post-infection with different doses of anti-EBOV IgY. The group receiving a high dose of 106 NAU/kg (neutralizing antibody units/kilogram) achieved complete protection with no signs of disease, while the low-dose group was only partially protected. In contrast, all mice receiving naïve IgY died within 10 days. In conclusion, the anti-EBOV IgY exhibits excellent thermostability and protective efficacy, and it is very promising to be developed as alternative therapeutic entities. Author Summary Although several Ebola virus therapeutic antibodies have been reported in recent years, however, due to the poor thermal stability of mammalian antibody, their application in tropical endemic areas has been limited. We developed a highly thermostable therapeutic antibody against EBOV based on chicken immunoglobulin Y (IgY). The IgY antibodies demonstrated excellent thermal stability, which retained their neutralizing activity at 25°C for one year. The newborn mice receiving passive transfer of IgY achieved complete protection against a lethal dose of virus challenge indicating that the anti-EBOV IgY provides a promising countermeasure to solve the current clinical application problems of Ebola antibody-based treatments in Africa.


title: Lack of Association Between Genetic Variants at ACE2 and TMPRSS2 Genes Involved in SARS-CoV-2 Infection and Human Quantitative Phenotypes

text: Coronavirus disease 2019 (COVID-19) shows a wide variation in expression and severity of symptoms, from very mild or no symptoms, to flu-like symptoms, and in more severe cases, to pneumonia, acute respiratory distress syndrome, and even death. Large differences in outcome have also been observed between males and females. The causes for this variability are likely to be multifactorial, and to include genetics. The SARS-CoV-2 virus responsible for the infection depends on two human genes: the human receptor angiotensin converting enzyme 2 (ACE2) for cell invasion, and the serine protease TMPRSS2 for S protein priming. Genetic variation in these two genes may thus modulate an individual's genetic predisposition to infection and virus clearance. While genetic data on COVID-19 patients is being gathered, we carried out a phenome-wide association scan (PheWAS) to investigate the role of these genes in other human phenotypes in the general population. We examined 178 quantitative phenotypes including cytokines and cardio-metabolic biomarkers, as well as usage of 58 medications in 36,339 volunteers from the Lifelines population cohort, in relation to 1,273 genetic variants located in or near ACE2 and TMPRSS2. While none reached our threshold for significance, we observed several interesting suggestive associations. For example, single nucleotide polymorphisms (SNPs) near the TMPRSS2 genes were associated with thrombocytes count (p = 1.8 × 10(−5)). SNPs within the ACE2 gene were associated with (1) the use of angiotensin II receptor blockers (ARBs) combination therapies (p = 5.7 × 10(−4)), an association that is significantly stronger in females (p(dif)(f) = 0.01), and (2) with the use of non-steroid anti-inflammatory and antirheumatic products (p = 5.5 × 10(−4)). While these associations need to be confirmed in larger sample sizes, they suggest that these variants could play a role in diseases such as thrombocytopenia, hypertension, and chronic inflammation that are often observed in the more severe COVID-19 cases. Further investigation of these genetic variants in the context of COVID-19 is thus promising for better understanding of disease variability. Full results are available at https://covid19research.nl.


title: Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study

text: COVID-19 has spread to most countries in the world. Puzzlingly, the impact of the disease is different in different countries. These differences are attributed to differences in cultural norms, mitigation efforts, and health infrastructure. Here we propose that national differences in COVID-19 impact could be partially explained by the different national policies respect to Bacillus Calmette-Guerin (BCG) childhood vaccination. BCG vaccination has been reported to offer broad protection to respiratory infections. We compared large number of countries BCG vaccination policies with the morbidity and mortality for COVID-19. We found that countries without universal policies of BCG vaccination (Italy, Nederland, USA) have been more severely affected compared to countries with universal and long-standing BCG policies. Countries that have a late start of universal BCG policy (Iran, 1984) had high mortality, consistent with the idea that BCG protects the vaccinated elderly population. We also found that BCG vaccination also reduced the number of reported COVID-19 cases in a country. The combination of reduced morbidity and mortality makes BCG vaccination a potential new tool in the fight against COVID-19.


title: Modeling the effect of COVID-19 disease on the cardiac function: a computational study

text: Background The effect of COVID-19 on the cardiac function and on the vascular system increases the morbidity and mortality of infected subjects with cardiovascular diseases. Objectives To provide preliminary results on cardiac global outcomes (such as cardiac output, ventricular pressures) obtained by means of computational models in plausible scenarios characterized by COVID-19. Methods We considered a lumped parameters computational model of the cardiovascular system, which models, from the mechanical point of view, the systemic and pulmonary circulations, the four cardiac valves and the four heart chambers, through mathematical equations of the underlying physical processes. To study the effect of COVID-19, we varied the heart rate, the contractility and the pulmonary resistances in suitable ranges. Results Our computations on individuals with both otherwise normal and impaired cardiac functions revealed that COVID-19 worsen cardiac function, as shown by a decrease of some cardiac biomarkers values such as cardiac output and ejection fraction. In the case of existing impaired cardiac function, the presence of COVID-19 lead to values outside the normal ranges. Conclusions Computational models revealed to be an effective tool to study the effect of COVID-19 on the cardiovascular system. Such effect could be significant for patients with impaired cardiac function. This is especially useful to perform a sensitivity analysis of the hemodynamics for different conditions. CONDENSED ABSTRACT Emerging studies address how COVID-19 infection might impact the cardiovascular system. This relates particularly to the development of myocardial injury, acute coronary syndrome, myocarditis, arrhythmia, and heart failure. Prospective treatment approach is advised for these patients. By the assessment of conventional important biomarkers obtained with new sources as a 0-dimentional computational model, we propose a new study protocol as an effective method to evaluate short-term prognosis. The clinical protocol proposed will help to rapidly identify which patients require intensive monitoring, diagnostic strategy and most adequate therapy.


title: Differentiating between 2019 novel coronavirus pneumonia and influenza using a non-specific laboratory marker-based dynamic nomogram

text: BACKGROUND: There is currently a lack of non-specific laboratory indicators as a quantitative standard to distinguish between the 2019 coronavirus disease (COVID-19) and an influenza A or B virus infection. Thus, the aim of this study was to establish a nomogram to detect COVID-19. METHODS: A nomogram was established using data collected from 457 patients (181 with COVID-19 and 276 with influenza A or B infection) at China. The nomogram used age, lymphocyte percentage, and monocyte count to differentiate COVID-19 from influenza. RESULTS: Our nomogram predicted probabilities of COVID-19 with an AUROC of 0.913 (95% confidence interval [CI], 0.883–0.937), greater than that of the lymphocyte-to-monocyte ratio (0.849, 95%CI, 0.812–0.880; p = 0.0007), lymphocyte percentage (0.808, 95%CI, 0.768–0.843; p < 0.0001), monocyte count (0.780, 95%CI, 0.739–0.817; p < 0.0001), or age (0.656, 95%CI, 0.610–0.699; p < 0.0001). The predicted probability conformed to the real observation outcomes of COVID-19, according to the calibration curves. CONCLUSIONS: We found that age, lymphocyte percentage, and monocyte count are risk factors for the early-stage prediction of patients infected with the 2019 novel coronavirus. As such, our research provides a useful test for doctors to differentiate COVID-19 from influenza.


title: Forecasting the Worldwide Spread of COVID-19 based on Logistic Model and SEIR Model

text: Background: With the outbreak of coronavirus disease 2019 (COVID-19), a sudden case increase in late February 2020 led to deep concern globally. Italy, South Korea, Iran, France, Germany, Spain, the US and Japan are probably the countries with the most severe outbreaks. Collecting epidemiological data and predicting epidemic trends are important for the development and measurement of public intervention strategies. Epidemic prediction results yielded by different mathematical models are inconsistent; therefore, we sought to compare different models and their prediction results to generate objective conclusions. Methods: We used the number of cases reported from January 23 to March 20, 2020, to estimate the possible spread size and peak time of COVID-19, especially in 8 high-risk countries. The logistic growth model, basic SEIR model and adjusted SEIR model were adopted for prediction. Given that different model inputs may infer different model outputs, we implemented three model predictions with three scenarios of epidemic development. Results: When comparing all 8 countries short-term prediction results and peak predictions, the differences among the models were relatively large. The logistic growth model estimated a smaller epidemic size than the basic SERI model did; however, once we added parameters that considered the effects of public health interventions and control measures, the adjusted SERI model results demonstrated a considerably rapid deceleration of epidemic development. Our results demonstrated that contact rate, quarantine scale, and the initial quarantine time and length are important factors in controlling epidemic size and length. Conclusions: We demonstrated a comparative assessment of the predictions of the COVID-19 outbreak in eight high-risk countries using multiple methods. By forecasting epidemic size and peak time as well as simulating the effects of public health interventions, the intent of this paper is to help clarify the transmission dynamics of COVID-19 and recommend operation suggestions to slow down the epidemic. It is suggested that the quick detection of cases, sufficient implementation of quarantine and public self-protection behaviors are critical to slow down the epidemic.


title: Brownian distance covariance

text: Distance correlation is a new class of multivariate dependence coefficients applicable to random vectors of arbitrary and not necessarily equal dimension. Distance covariance and distance correlation are analogous to product-moment covariance and correlation, but generalize and extend these classical bivariate measures of dependence. Distance correlation characterizes independence: it is zero if and only if the random vectors are independent. The notion of covariance with respect to a stochastic process is introduced, and it is shown that population distance covariance coincides with the covariance with respect to Brownian motion; thus, both can be called Brownian distance covariance. In the bivariate case, Brownian covariance is the natural extension of product-moment covariance, as we obtain Pearson product-moment covariance by replacing the Brownian motion in the definition with identity. The corresponding statistic has an elegantly simple computing formula. Advantages of applying Brownian covariance and correlation vs the classical Pearson covariance and correlation are discussed and illustrated.


title: Short k-mer Abundance Profiles Yield Robust Machine Learning Features and Accurate Classifiers for RNA Viruses

text: High throughout sequencing technologies have greatly enabled the study of genomics, transcriptomics and metagenomics. Automated annotation and classification of the vast amounts of generated sequence data has become paramount for facilitating biological sciences. Genomes of viruses can be radically different from all life, both in terms of molecular structure and primary sequence. Alignment-based and profile-based searches are commonly employed for characterization of assembled viral contigs from high-throughput sequencing data. Recent attempts have highlighted the use of machine learning models for the task but these models rely entirely on DNA genomes and owing to the intrinsic genomic complexity of viruses, RNA viruses have gone completely overlooked. Here, we present a novel short k-mer based sequence scoring method that generates robust sequence information for training machine learning classifiers. We trained 18 classifiers for the task of distinguishing viral RNA from human transcripts. We challenged our models with very stringent testing protocols across different species and evaluated performance against BLASTn, BLASTx and HMMER3 searches. For clean sequence data retrieved from curated databases, our models display near perfect accuracy, outperforming all similar attempts previously reported. On de-novo assemblies of raw RNA-Seq data from cells subjected to Ebola virus, the area under the ROC curve varied from 0.6 to 0.86 depending on the software used for assembly. Our classifier was able to properly classify the majority of the false hits generated by BLAST and HMMER3 searches on the same data. The outstanding performance metrics of our model lays the groundwork for robust machine learning methods for the automated annotation of sequence data. Author Summary In this age of high-throughput sequencing, proper classification of copious amounts of sequence data remains to be a daunting challenge. Presently, sequence alignment methods are immediately assigned to the task. Owing to the selection forces of nature, there is considerable homology even between the sequences of different species which draws ambiguity to the results of alignment-based searches. Machine Learning methods are becoming more reliable for characterizing sequence data, but virus genomes are more variable than all forms of life and viruses with RNA-based genomes have gone overlooked in previous machine learning attempts. We designed a novel short k-mer based scoring criteria whereby a large number of highly robust numerical feature sets can be derived from sequence data. These features were able to accurately distinguish virus RNA from human transcripts with performance scores better than all previous reports. Our models were able to generalize well to distant species of viruses and mouse transcripts. The model correctly classifies the majority of false hits generated by current standard alignment tools. These findings strongly imply that this k-mer score based computational pipeline forges a highly informative, rich set of numerical machine learning features and similar pipelines can greatly advance the field of computational biology.


The sac in times of COVID/ La sac en tiempos de COVID


title: Early Detection of Coronavirus Cases Using Chest X-ray Images Employing Machine Learning and Deep Learning Approaches

text: This study aims to investigate if applying machine learning and deep learning approaches on chest X-ray images can detect cases of coronavirus. The chest X-ray datasets were obtained from Kaggle and Github and pre-processed into a single dataset using random sampling. We applied several machine learning and deep learning methods including Convolutional Neural Networks (CNN) along with classical machine learners. In deep learning procedure, several pre-trained models were also employed transfer learning in this dataset. Our proposed CNN model showed the highest accuracy (94.03%), AUC (95.52%), f-measure (94.03%), sensitivity (94.03%) and specificity (97.01%) as well as the lowest fall out (4.48%) and miss rate (2.98%) respectively. We also evaluated specificity and fall out rate along with accuracy to identify non-COVID-19 individuals more accurately. As a result, our new models might help to early detect COVID-19 patients and prevent community transmission compared to traditional methods.


title: How far Covid19 virus spread can be curbed byrelaxing lockdown in different stages? -A study inIndian scenario

text: After the emergence of the first cases in Wuhan, China, the novel coronavirus (2019-nCoV) infection has rapidly spread out to other provinces , neighboring countries and finally has become a global terror. It is indeed a matter of serious concern to study the transmission dynamics of this virus. The potential and severity of an outbreak and providing critical information for identifying the type of disease interventions and intensity can be well understood by the unknown basic reproduction number. A stochastic model can be used to estimate this number with possible safeguard on uncertainties. It is essential to assess how the expensive, resource-intensive measures can contribute to the prevention and control of the 2019-nCoV infection and how long they should be maintained. A short-term forecast of incidences are often of high priority. The challenge is to forecast unseen future simulated data for three different scenarios at some time points. We estimate current levels of transmissibility, over variable time points under different levels of interventions and use that to forecast near-future incidence. The forecasted values of incidence can be used for determining the near future mortality also.


title: Forecasting COVID-19 impact on hospital bed-days, ICU-days, ventilator-days and deaths by US state in the next 4 months

text: Key Points Question: Assuming social distancing measures are maintained, what are the forecasted gaps in available health service resources and number of deaths from the COVID-19 pandemic for each state in the United States? Findings: Using a statistical model, we predict excess demand will be 64,175 (95% UI 7,977 to 251,059) total beds and 17,380 (95% UI 2,432 to 57,955) ICU beds at the peak of COVID-19. Peak ventilator use is predicted to be 19,481 (95% UI 9,767 to 39,674) ventilators. Peak demand will be in the second week of April. We estimate 81,114 (95% UI 38,242 to 162,106) deaths in the United States from COVID-19 over the next 4 months. Meaning: Even with social distancing measures enacted and sustained, the peak demand for hospital services due to the COVID-19 pandemic is likely going to exceed capacity substantially. Alongside the implementation and enforcement of social distancing measures, there is an urgent need to develop and implement plans to reduce non-COVID-19 demand for and temporarily increase capacity of health facilities. Abstract Importance: This study presents the first set of estimates of predicted health service utilization and deaths due to COVID-19 by day for the next 4 months for each state in the US. Objective: To determine the extent and timing of deaths and excess demand for hospital services due to COVID-19 in the US. Design, Setting, and Participants: This study used data on confirmed COVID-19 deaths by day from WHO websites and local and national governments; data on hospital capacity and utilization for US states; and observed COVID-19 utilization data from select locations to develop a statistical model forecasting deaths and hospital utilization against capacity by state for the US over the next 4 months. Exposure(s): COVID-19. Main outcome(s) and measure(s): Deaths, bed and ICU occupancy, and ventilator use. Results: Compared to licensed capacity and average annual occupancy rates, excess demand from COVID-19 at the peak of the pandemic in the second week of April is predicted to be 64,175 (95% UI 7,977 to 251,059) total beds and 17,380 (95% UI 2,432 to 57,955) ICU beds. At the peak of the pandemic, ventilator use is predicted to be 19,481 (95% UI 9,767 to 39,674). The date of peak excess demand by state varies from the second week of April through May. We estimate that there will a total of 81,114 (95% UI 38,242 to 162,106) deaths from COVID-19 over the next 4 months in the US. Deaths from COVID-19 are estimated to drop below 10 deaths per day between May 31 and June 6. Conclusions and Relevance: In addition to a large number of deaths from COVID-19, the epidemic in the US will place a load well beyond the current capacity of hospitals to manage, especially for ICU care. These estimates can help inform the development and implementation of strategies to mitigate this gap, including reducing non-COVID-19 demand for services and temporarily increasing system capacity. These are urgently needed given that peak volumes are estimated to be only three weeks away. The estimated excess demand on hospital systems is predicated on the enactment of social distancing measures in all states that have not done so already within the next week and maintenance of these measures throughout the epidemic, emphasizing the importance of implementing, enforcing, and maintaining these measures to mitigate hospital system overload and prevent deaths.


COVID-19 – Eine neue Herausforderung


title: Analysis of national and international guidelines on respiratory protection equipment for COVID-19 in healthcare settings.

text: Introduction Consistent guidelines on respiratory protection for healthcare professionals combined with improved global supply chains are critical to protect staff and patients from COVID-19. We summarized and compared the guidelines published by national and international societies/organizations on facemasks and respirators to prevent COVID-19 in healthcare settings. Methods From the 1st January to the 2nd April 2020, guidelines published in four countries (France, Germany, United States, United Kingdom), and two international organizations (US and European Center for Diseases Control, and World Health Organization) were reviewed to analyze the mask and respirators recommended as PPE for the care of patients during the COVID-19 outbreak. Guidelines were eligible for analysis if they (1) included specific guidelines, (2) were written for HCP protection, (3) targeting healthcare settings. The strategy recommended for optimizing supplies and overcoming shortages was collected. Observations The guidelines publication process on respiratory protections varied greatly across countries. Some referred to a unique guide whereas others saw the issue of multiple recommendations by various societies and organization. In term of chronology, most guidelines were published in March with either downgraded (US and European CDC), relatively stable (WHO, Germany, and UK), or a mixing of high and low level equipment (France). The recommendation of respirators was universally recommended for aerosol generating procedures (AGP) across countries, although the type of respirators and what constituted an AGP was variable. Some guidance maintained the use of N95/99 for all contact with confirmed COVID-19 cases (i.e. Germany) whereas others, recommended a surgical mask (i.e. WHO, UK, France). The strategies to overcome shortage of respiratory protection equipment were based on minimizing the need and rationalizing the use, but also prolonging their use, reusing them after cleaning/sterilization, or using cloth masks. Conclusions Stable and consistent guidelines inside and across countries, clearly detailing the respiratory protection type, and the circumstances in which they need to be used may prevent the confusion among frontline staff, and avoid shortage.


title: Military participation in health security: analysis of Joint External Evaluation mission reports and National Action Plans for Health Security

text: Militaries across the world play an important but at times poorly defined and underappreciated role in global health security. For example, they are often called upon to support civilian authorities in humanitarian crises and to provide routine healthcare for civilians. Furthermore, military personnel are a unique population in a health security context, as they are highly mobile and often deploy to austere settings domestically and internationally, which may increase exposure to infectious diseases. Despite the role of militaries, few studies have systematically evaluated the involvement of militaries in global health security activities, including the Global Health Security Agenda (GHSA). To address this shortcoming, we analyzed Joint External Evaluation (JEE) mission reports (n=91) and National Action Plans for Health Security (n=11) that had been completed as of October 2019 (n=91) to determine the extent to which military organizations have been involved in the evaluation process, country military contributions to health security are accounted for, and specific recommendations are provided for the country's military. For JEE reports, military involvement was highest for the "Respond" core area (73%) but much lower for the Prevent (36%) and Detect (30%) core areas. Similarly, 73% of NAPHS documents mentioned military involvement in the Respond core area, compared to 27% and 36% for Prevent and Detect, respectively. Additionally, only 26% of JEE reports provide recommendations for the military in any of the core areas. Our results indicate the need to more fully incorporate military roles and contributions into the GHSA framework and other health security activities in order to improve national capabilities to prevent, detect, and respond to infectious disease threats.


title: Glycosaminoglycan binding motif at S1/S2 proteolytic cleavage site on spike glycoprotein may facilitate novel coronavirus (SARS-CoV-2) host cell entry

text: Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) has resulted in a pandemic and continues to spread around the globe at an unprecedented rate. To date, no effective therapeutic is available to fight its associated disease, COVID-19. Our discovery of a novel insertion of glycosaminoglycan (GAG)-binding motif at S1/S2 proteolytic cleavage site (681-686 (PRRARS)) and two other GAG-binding-like motifs within SARS-CoV-2 spike glycoprotein (SGP) led us to hypothesize that host cell surface GAGs might be involved in host cell entry of SARS-CoV-2. Using a surface plasmon resonance direct binding assay, we found that both monomeric and trimeric SARS-CoV-2 spike more tightly bind to immobilized heparin (KD = 40 pM and 73 pM, respectively) than the SARS-CoV and MERS-CoV SGPs (500 nM and 1 nM, respectively). In competitive binding studies, the IC50 of heparin, tri-sulfated non-anticoagulant heparan sulfate, and non-anticoagulant low molecular weight heparin against SARS-CoV-2 SGP binding to immobilized heparin were 0.056 μM, 0.12 μM, and 26.4 μM, respectively. Finally, unbiased computational ligand docking indicates that heparan sulfate interacts with the GAG-binding motif at the S1/S2 site on each monomer interface in the trimeric SARS-CoV-2 SGP, and at another site (453-459 (YRLFRKS)) when the receptor-binding domain is in an open conformation. Our study augments our knowledge in SARS-CoV-2 pathogenesis and advances carbohydrate-based COVID-19 therapeutic development.


title: Transmission Dynamics and Control Methodology of COVID-19: a Modeling Study

text: The coronavirus disease 2019 (COVID-19) has grown up to be a pandemic within a short span of time. To investigate transmission dynamics and then determine control methodology, we took epidemic in Wuhan as a study case. Unfortunately, to our best knowledge, the existing models are based on the common assumption that the total population follows a homogeneous spatial distribution, which is not the case for the prevalence occurred both in the community and in hospital due to the difference in the contact rate. To solve this problem, we propose a novel epidemic model called SEIR-HC, which is a novel epidemic model with two different social circles. Using the model alongside the exclusive optimization algorithm, the spread process of COVID-19 epidemic in Wuhan city is reproduced and then the propagation characteristics and unknown data are estimated. Furthermore, the control measures implemented in Wuhan are assessed and the control methodology of COVID-19 is discussed to provide guidance for limiting the epidemic spread.


title: Quantitative modeling and analysis show country-specific quarantine measures can circumvent COVID19 infection spread post lockdown

text: The outbreak of COVID19 has been declared a global pandemic by WHO which started in Wuhan last November and now has spread to more than 200 countries with 4.5 million cases and a death toll of more than 300 thousand. In response, many countries have implemented lock down to ensure social distancing and started rigorously quarantining the infected subjects. Here we utilized the infection dynamics available from WHO and quantitatively calibrated the confirmed, recovered, and dead populations from 23 different countries. The chosen countries chosen are in three stages of infection 1. Where the first wave of infection is significantly diminished 2. Infection peak is reached but daily infection still persists significantly 3. The infection peak is not yet reached. The model successfully captured the daily trajectories of countries with both early and late phase of infection and determined incubation time, transmission rate, quarantine and recovery rates. Our analysis shows, the reduction in the estimated reproduction number with time is significantly correlated to the testing rate and medical facility of a country. Further, our model identifies that an increase in quarantine rate through more testing could be the most potent strategy to substantially reduce the undetected infection, accelerate the time to infection peak and facilitate faster recovery of a nation from the first infection wave, which could perhaps have direct social and economic implications. Our model also shows, that post lockdown infection spread towards a much larger second wave can be controlled via rigorous increase in the quarantine rates which could be tailored in a country specific manner; for instance, our simulations suggest that USA or Spain would require a 10 fold more increase in quarantine rates compared to India to control the second wave post lockdown. Our data driven modeling and analysis of the trajectories from multiple countries thus pave a way to understand the infection dynamics during and post lockdown phases in various countries and it can help strategize the testing and quarantine processes and influence the spread of the disease in future.


title: Health Care WorkersMental Health During the First Weeks of the SARS-CoV-2 Pandemic in Switzerland: A Cross-Sectional Study

text: Background: The current SARS-CoV-2 pandemic poses various challenges for health care workers (HCWs), which may impair their mental health. First evidence from China suggests that HCWs are at risk for anxiety and depression. However, generalizability to western countries is limited. The current study aimed at exploring HCWs mental health during the SARS-CoV-2 pandemic in Switzerland. In addition, we conducted a network analysis to investigate the independent effect of risk and protective factors on HCWs mental health and their interplay. Methods: In an exploratory, cross-sectional, nation-wide online survey, we assessed demographics, work characteristics, COVID-19 exposure, and anxiety, depression, and burnout in 857 physicians and 553 nurses during the pandemic in Switzerland. At the time of data collection, Switzerland had among the highest per capita rate of COVID-19 cases in the world. Results: Overall symptom levels of anxiety, depression, and burnout were elevated. Women, nurses, frontline staff and HCWs exposed to COVID-19 patients reported more symptoms than their peers. However, these effects were all small and, in the network analysis, most of them did not remain significant after controlling for the other factors. Whereas COVID-19 exposure was only partially associated with mental health, perceived support by the employer independently predicted anxiety and burnout. Conclusions: Our finding that HCWs had elevated levels of anxiety, depression, and burnout underscores the importance to systematically monitor HCWs mental health during this ongoing pandemic. Because perceived support and mental health impairments were negatively related, we encourage the implementation of supportive measures for HCWs well-being during this crisis.


title: Heavy hitters join for coronavirus treatments

text: A trio of heavy hitters is pitching in up to $125 million in seed funding to launch the COVID-19 Therapeutics Accelerator The Bill & Melinda Gates Foundation and Wellcome are committing up to $50 million each, and Mastercard has pledged up to $25 million


title: The origin of SARS-CoV-2 in Istanbul: Sequencing findings from the epicenter of the pandemic in Turkey

text: OBJECTIVE: Turkey is one of the latest countries that COVID-19 disease was reported, with the first case on March 11, 2020, and since then, Istanbul became the epicenter of the pandemic in Turkey. Here, we reveal sequences of the virus isolated from three different patients with various clinical presentations. METHODS: Nasopharyngeal swab specimens of the patients were tested positive for the COVID-19 by qRT-PCR. Viral RNA extraction was performed from the same swab samples. Amplicon based libraries were prepared and sequenced using the Illumina NextSeq platform. Raw sequencing data were processed for variant calling and generating near-complete genome sequences. All three genomes were evaluated and compared with other worldwide isolates. RESULTS: The patients showed various clinics (an asymptomatic patient, patient with mild disease, and with severe pulmonary infiltration). Amplicon-based next-generation sequencing approach successfully applied to generate near-complete genomes with an average depth of 2.616. All three viral genomes carried the D614G variant (G clade according to GISAID classification) with implications for the origin of a spread first through China to Europe then to Istanbul. CONCLUSION: Here, we report the viral genomes circulating in Istanbul for the first time. Further sequencing of the virus isolates may enable us to understand variations in disease presentation and association with viral factors if there is any. In addition, the sequencing of more viral genomes will delineate the spread of disease and will guide and ease the necessary measures taken to stem the spread of the novel coronavirus.


title: The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study

text: Background: The COVID-19 New Mum Study is recording maternal experiences and infant feeding during the period of UK lockdown. This report from week 1 of the survey aims to (1) provide information relevant for those supporting this population; (2) identify groups currently under-represented in the survey. Methods: Women living in the UK aged [≥]18 years with an infant [≤]12 months of age completed an anonymous online survey (https://is.gd/covid19newmumstudy). Information/links are shared via websites, social media and existing contacts. Results: Between May 27th and June 3rd 2020, 1365 women provided data (94% white, 95% married/with partner, 66% degree/higher qualification, 86% living in house; 1049 (77%) delivered before lockdown (BL) and 316 (23%) during lockdown (DL). Delivery mode, skin-to-skin contact and breastfeeding initiation did not differ between groups. DL women had shorter hospital stays (p<0.001) and 39% reported changes to their birth plan. Reflecting younger infant age, 59% of DL infants were exclusively breast-fed or mixed fed versus 39% of BL (p<0.05). Thirteen % reported a change in feeding; often related to lack of breastfeeding support, especially with practical problems. Important sources of feeding support were the partner (60%), health professional (50%) and online groups (47%). 45% of DL women reported insufficient support with feeding. Among BL women, 57% and 69% reported decreased feeding support and childcare, respectively. 40% BL/45% DL women reported insufficient support with their own health, 8%/9% contacted a mental health professional and 11% reported their mental health was affected. 9% highlighted lack of contact and support from family and distress that they had missed seeing the baby. Conclusion: Lockdown has had an impact on maternal experiences, resulting in distress for many women. Survey participants are currently not representative of the population; notably, groups at greater risk are under-represented. Increasing the diversity of participants is a priority.


docid: boakvomb

title: Electron Beam Welding of Inconel 718

text: Abstract This paper presents a study of Electron Beam Welding (EBW) of rolled Inconel 718 (IN718) plates. The experiment utilized nine different heat inputs at three different levels of welding speed and beam current. The weld quality was characterized and ranked based on weld geometry, microhardness and mechanical properties. Fusion area and weld penetration depth were found to be proportional to the heat input. Microhardness measurement showed a wider and softer weld zone at the beam entrance. Voids, found at weld bottoms when welding at the highest beam power of 3250 watt and scanning speed exceeding 0.78 m/min, can be removed by a suitable machining process. All samples but one had tensile strength exceeding the specification for rolled IN718 (837 MPa); ductility of welded specimens also met the specification (57%) when welding with heat input less than 225 J/mm. At low heat inputs, the welded samples fractured outside of the weld zone and indicated their exceptional weld strength. The samples welded at higher heat inputs cracked and fractured at the weld. These results provide a benchmark for comparison with future study on EBW of selective laser melted IN718.


title: Risk factors for adverse clinical outcomes in patients with COVID-19: A systematic review and meta-analysis

text: Importance: COVID-19 is a clinically heterogeneous disease of varying severity and prognosis. Clinical characteristics that impact disease course could offer guidance for clinical decision making and future research endeavors and unveil disease pathways. Objective: To examine risk factors associated with adverse clinical outcomes in patients with COVID-19. Data sources: We performed a systematic review in PubMed from January 1 until April 19, 2020. Study selection: Observational studies that examined the association of any clinical characteristic with an adverse clinical outcome were considered eligible. We scrutinized studies for potential overlap. Data extraction and synthesis: Information on the effect of clinical factors on clinical endpoints of patients with COVID-19 was independently extracted by two researchers. When an effect size was not reported, crude odds ratios were calculated based on the available information from the eligible articles. Study-specific effect sizes from non-overlapping studies were synthesized applying the random-effects model. Main outcome and measure: The examined outcomes were severity and progression of disease, admission to ICU, need for mechanical ventilation, mortality, or a composite outcome. Results: We identified 88 eligible articles, and we performed a total of 256 meta-analyses on the association of 98 unique risk factors with five clinical outcomes. Seven meta-analyses presented the strongest epidemiological evidence in terms of statistical significance (P-value <0.005), between-study heterogeneity (I2 <50%), sample size (more than 1000 COVID-19 patients), 95% prediction interval excluded the null value, and absence of small-study effects. Elevated C-reactive protein (OR, 6.46; 95% CI, 4.85 - 8.60), decreased lymphocyte count (OR, 4.16; 95% CI, 3.17 - 5.45), cerebrovascular disease (OR, 2.84; 95% CI, 1.55 - 5.20), chronic obstructive pulmonary disease (OR, 4.44; 95% CI, 2.46 - 8.02), diabetes mellitus (OR, 2.04; 95% CI, 1.54 - 2.70), hemoptysis (OR, 7.03; 95% CI, 4.57 - 10.81), and male sex (OR, 1.51; 95% CI, 1.30 - 1.75) were associated with risk of severe COVID-19. Conclusions and relevance: Our results highlight factors that could be useful for prognostic model building, help guide patients' selection for randomized clinical trials, as well as provide alternative treatment targets by shedding light to disease pathophysiology.


title: A note on COVID-19 seroprevalence studies: a meta-analysis using hierarchical modelling

text: In recent weeks, several seroprevalence studies have appeared which attempt to determine the prevalence of antibodies against SARS-CoV-2 in the population of certain European and American locations. Many of these studies find an antibody prevalence comparable to the false positive rate of their respective serology tests and the relatively low statistical power associated with each study has invited criticism. To determine the strength of the signal, we perform a meta-analysis on the publicly available seroprevalence data based on Bayesian hierarchical modelling with Markov Chain Monte Carlo and Generalized Linear Mixed Modelling with prediction sampling. We examine studies with results from Santa Clara County (CA), Los Angeles County (CA), San Miguel County (CO), Chelsea (MA), the comte de Geneve (Switzerland), and Gangelt (Germany). Our results are in broad agreement with the conclusions of the studies; we find that there is evidence for non-trivial levels of antibody prevalence across all study locations. However, we also find that a significant probability mass exists for antibody prevalence at levels lower than the reported figures. The results of our meta-analysis on the recent seroprevalence studies point to an important and strongly suggestive signal.


title: Understanding the impact of the COVID-19 pandemic on well-being and virtual care for people living with dementia and care partners living in the community

text: The COVID-19 pandemic has necessitated public health measures that have impacted the provision of care for people living with dementia and their families. Additionally, the isolation that results from social distancing may be harming well-being for families, as formal and informal supports become less accessible. For those with living with dementia and experiencing agitation, social distancing may be even harder to maintain, or social distancing could potentially aggravate dementia-related neuropsychiatric symptoms. To understand the lived experience of social and physical distancing during the COVID-19 pandemic in Canada we remotely interviewed 21 participants who normally attend a dementia specialty clinic in Calgary, Alberta, during a period where essential businesses were closed and healthcare had abruptly transitioned to telemedicine. The impacts of the public health measures in response to the pandemic emerged in three main categories of experience: 1) personal; 2) health services; and 3) health status (of both person living with dementia and care partner). This in-depth understanding of the needs and experiences of the pandemic for people living with dementia suggests that innovative means are urgently needed to facilitate provision of remote medicine and also social interaction and integration.


title: A simple method to quantify country-specific effects of COVID-19 containment measures

text: Most of the world is currently fighting to limit the impact of the COVID-19 pandemic. Italy, the Western country with most COVID-19 related deaths, was the first to implement drastic containment measures in early March, 2020. Since then most other European countries, the USA, Canada and Australia, have implemented similar restrictions, ranging from school closures, banning of recreational activities and large events, to complete lockdown. Such limitations, and softer promotion of social distancing, may be more effective in one society than in another due to cultural or political differences. It is therefore important to evaluate the effectiveness of these initiatives by analyzing country-specific COVID-19 data. We propose to model COVID-19 dynamics with a SIQR (susceptible - infectious - quarantined - recovered) model, since confirmed positive cases are isolated and do not transmit the disease. We provide an explicit formula that is easily implemented and permits us to fit official COVID-19 data in a series of Western countries. We found excellent agreement with data-driven estimation of the day-of-change in disease dynamics and the dates when official interventions were introduced. Our analysis predicts that for most countries only the more drastic restrictions have reduced virus spreading. Further, we predict that the number of unidentified COVID-19-positive individuals at the beginning of the epidemic is ∼10 times the number of confirmed cases. Our results provide important insight for future planning of non-pharmacological interventions aiming to contain spreading of COVID-19 and similar diseases.


title: Effect of Nanomaterial Shape on Fabrication of Conformal Circuits

text: Abstract This paper investigates how the change in nanomaterial (NM) shape influences resistance evolution during conformal interconnect fabrication via sequential Vacuum-forming and Flash Light Sintering (FLS) approach. The NM shape in the conformal circuit is tuned by mixing nanowires (NW) with nanoflakes (NF) or nanospheres (NS) at different mixing ratios. The change in line resistance post-forming and post-sintering for any given mixing ratio is studied in greater depth using SEM characterization, UV-Vis spectrophotometry and thermal measurements. For optimal NM mixing ratio and process parameters, the fabricated circuit achieves electrical resistivity of 55.4 µΩ-cm within 30 seconds on a wall inclined at 60⁰ to the horizontal with a width to height aspect ratio of 2.5:1.


docid: rnufhzqf

title: Characteristics and transmission dynamics of COVID-19 in healthcare workers at a London teaching hospital

text: Background Healthcare worker (HCW) associated COVID-19 is of global concern due to the potential for nosocomial spread and depletion of staff numbers. However, the literature on transmission routes and risk factors for COVID-19 in HCWs is limited. Aim To examine the characteristics and transmission dynamics of SARS-CoV-2 in HCWs in a university teaching hospital in London, UK. Methods Staff records and virology testing results were combined to identify staff sickness and COVID-19 rates from March to April 2020. Comparisons were made with staff professional groups, department of work and ethnicity. Analysis was performed using Microsoft ExcelTM. Findings COVID-19 rates in our HCWs largely rose and declined in parallel with the number of community cases. White and non-white ethnic groups among our HCWs had similar rates of infection. Clinical staff had a higher rate of laboratory-confirmed COVID-19 than non-clinical staff, but total sickness rates were similar. Doctors had the highest rate of infection, but took the fewest sickness days. Critical Care had lower rates than the Emergency Department (ED), but rates in the ED declined once all staff were advised to use Personal Protective Equipment (PPE). Conclusion These findings show that sustained transmission of SARS-CoV-2 among our hospital staff did not occur, beyond the community outbreak, even in the absence of strict infection control measures in non-clinical areas. The results also suggest that current PPE is effective when used appropriately. In addition, our findings emphasise the importance of testing both clinical and non-clinical staff groups during a pandemic. Keywords COVID-19, healthcare workers, testing, outbreak investigation, transmission dynamics


title: COVID-19 pandemic and health worker stress: The mediating effect of emotional regulation

text: Background/Introduction. Psychological and physical well-being of health personnel has been significantly affected by COVID-19. Work overload and continuous exposure to positive COVID-19 cases have caused them fatigue, stress, anxiety, insomnia and other detriments. This research aims: 1) to analyze whether the use of cognitive reevaluation and emotional suppression strategies decreases and increases, respectively, stress levels of health personnel, 2) to quantify the impact of contact with patients with COVID-19 on stress s level of medical staff. Method. Emotion regulation strategies and stress level were evaluated in 155 Dominican physicians by means of psychological tests with adequate levels of reliability. In addition, a questionnaire created by the researchers quantified the impact that contact with those infected had on their stress levels. Results. Contact with patients with COVID-19 predicts increased use of emotion suppression strategies, although is not associated with the use of cognitive reevaluation. These findings lead to an even greater increase in stress on health care providers. Conclusions. Contextual contingencies demand immediate responses and may not allow health personnel to use cognitive re-evaluation strategies, leaning more towards emotion suppression. However, findings regarding high levels of stress require the implementation of intervention programs focused on the promotion of more functional emotion regulation strategies. Such programs may reduce current stress and prevent post-traumatic symptoms.


title: DERIVATION OF A SCORE TO PREDICT ADMISSION TO INTENSIVE CARE UNIT IN PATIENTS WITH COVID-19: THE ABC-GOALS SCORE

text: Background. COVID-19 pandemic poses a burden on hospital resources and intensive care unit (ICU) occupation. The study aimed to derive a scoring system that, assessed upon patient first-contact evaluation, predicts the need for admission to ICU. Methods. All consecutive patients admitted to a COVID-19 reference center were prospectively assessed. Patients were segregated into a group that required admission to ICU during their hospitalization and a group that never required ICU admission and was already discharged from hospitalization. Three models including clinical, laboratory and imaging findings were derived by logistic regression analysis and internally validated. A score, defined as the ABC-GOALS score was created by assigning values based on the variables weighted odd ratios. Results. The study comprised 329 patients, 115 (35%) required ICU admission and 214 (65%) were hospitalized and discharged from general wards. The clinical prediction model (ABC-GOALSc) included sex, obesity, the Charlson comorbidity index, dyspnea, arterial pressure and respiratory rate at triage evaluation. The clinical plus laboratory model (ABC-GOALScl) added serum albumin, glucose, lactate dehydrogenase and S/F ratio to the clinical model. The model that included imaging (ABC-GOALSclx) added the CT scan finding of >50% lung involvement. All three models outperformed other pneumonia-specific scores with area under the curve of 0.79 (0.74-0.83), 0.86 (0.82-0.90) and 0.88 (0.84-0.92) for the clinical, laboratory and imaging model, respectively. Conclusion. The ABC-GOALS score is a tool to evaluate patients with COVID-19 at admission to the emergency department that allows to timely predict their risk of admission to an ICU and may help optimize healthcare capacities.


An den Rand gerückt


Fear, explanation and action – the psychosocial response to emerging infections


title: Synonymous mutations and the molecular evolution of SARS-Cov-2 origins

text: Human severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is most closely related, by average genetic distance, to two coronaviruses isolated from bats, RaTG13 and RmYN02. However, there is a segment of high amino acid similarity between human SARS-CoV-2 and a pangolin isolated strain, GD410721, in the receptor binding domain (RBD) of the spike protein, a pattern that can be caused by either recombination or by convergent amino acid evolution driven by natural selection. We perform a detailed analysis of the synonymous divergence, which is less likely to be affected by selection than amino acid divergence, between human SARS-CoV-2 and related strains. We show that the synonymous divergence between the bat derived viruses and SARS-CoV-2 is larger than between GD410721 and SARS-CoV-2 in the RBD, providing strong additional support for the recombination hypothesis. However, the synonymous divergence between pangolin strain and SARS-CoV-2 is also relatively high, which is not consistent with a recent recombination between them, instead it suggests a recombination into RaTG13. We also find a 14-fold increase in the dN/dS ratio from the lineage leading to SARS-CoV-2 to the strains of the current pandemic, suggesting that the vast majority of non-synonymous mutations currently segregating within the human strains have a negative impact on viral fitness. Finally, we estimate that the time to the most recent common ancestor of SARS-CoV-2 and RaTG13 or RmYN02 based on synonymous divergence, is 51.71 years (95% C.I., 28.11-75.31) and 37.02 years (95% C.I., 18.19-55.85), respectively.


Pandémie de covid-19 : un grand défi nutritionnel, une réponse massive et coordonnée


Stabilitäten von SARS-CoV-2 und SARS-CoV-1 verglichen


title: Glossary and Abbreviations

text: Unknown