title: Design and clinical validation of a 3D-printed nasopharyngeal swab for COVID-19 testing

text: We describe the development and validation of a novel 3D-printed nasopharyngeal swab for the identification of SARS-CoV-2. We subjected the novel swab to mechanical and fluid absorption testing ex-vivo, and confirmed its ability to retain and release murine coronavirus and SARS-CoV-2. Compared to the Copan FLOQSwab, the novel swab displayed excellent correlation of RT-PCR cycle threshold values on paired clinical testing in COVID-19 patients, at r = 0.918 and 0.943 for the SARS-CoV-2 ORF1/a and sarbecovirus E-gene respectively. Overall positive and negative percent agreement was 90.6% and 100% respectively on a dual-assay RT-PCR platform, with discordant samples observed only at high cycle thresholds. When carefully designed and tested, 3D-printed swabs are a viable alternative to traditional swabs and will help mitigate strained resources in the escalating COVID-19 pandemic.


title: Virus-Receptor Interactions of Glycosylated SARS-CoV-2 Spike and Human ACE2 Receptor

text: The current COVID-19 pandemic is caused by the SARS-CoV-2 betacoronavirus, which utilizes its highly glycosylated trimeric Spike protein to bind to the cell surface receptor ACE2 glycoprotein and facilitate host cell entry. We utilized glycomics-informed glycoproteomics to characterize site-specific microheterogeneity of glycosylation for a recombinant trimer spike mimetic immunogen and for a soluble version of human ACE2. We combined this information with bioinformatic analyses of natural variants and with existing 3D-structures of both glycoproteins to generate molecular dynamic simulations of each glycoprotein alone and interacting with one another. Our results highlight roles for glycans in sterically masking polypeptide epitopes and directly modulating Spike-ACE2 interactions. Furthermore, our results illustrate the impact of viral evolution and divergence on Spike glycosylation, as well as the influence of natural variants on ACE2 receptor glycosylation that, taken together, can facilitate immunogen design to achieve antibody neutralization and inform therapeutic strategies to inhibit viral infection.


docid: dieaqxmi

title: Remdesivir in treatment of COVID-19: A systematic benefit-risk assessment

text: Background: There is a need to identify effective, safe treatments for COVID-19 (coronavirus disease) rapidly, given the current, ongoing pandemic. A systematic benefit-risk assessment was designed and conducted to strengthen the ongoing understanding of the benefit-risk balance for remdesivir in COVID-19 treatment by using a structured method which uses all available data. Methods: The Benefit-Risk Action Team (BRAT) framework was used to assess the overall benefit-risk of the use of remdesivir as a treatment for COVID-19 compared to standard of care, placebo or other treatments. We searched PubMed,Google Scholar and government agency websites to identify literature reporting clinical outcomes in patients taking remdesivir for COVID-19. A value tree was constructed and key benefits and risks were ranked by two clinicians in order of considered importance. Results: Several key benefits and risks for use of remdesivir in COVID-19 compared to placebo have been identified. In one trial, the benefit of time to clinical improvement was not statistically significant (21 vs 23 days, HR=1.23, 95% CI: 0.87, 1.75), although the study was underpowered. In another trial, a shorter time to recovery in patients treated with remdesivir was observed (11 vs 15 days), with non-significant reduced mortality risk (8% vs 12%). Risk data were only available from one trial. This trial reported fewer serious adverse events in patients taking remdesivir (18%) comparted to the placebo group (26%), however more patients in the remdesivir group discontinued treatment as a result of an adverse event compared to those patients receiving placebo (12% vs 5%). Conclusions: Preliminary clinical trial results suggest a favourable benefit-risk profile for remdesivir compared to placebo, however there is limited safety data available at the current time. The current framework summarises the key anticipated benefits and risks for which further data are needed. Ongoing clinical trial data can be incorporated into the framework when available to provide an updated benefit-risk assessment.


title: A Counterfactual Graphical Model Reveals Economic and Sociodemographic Variables as Key Determinants of Country-Wise COVID-19 Burden

text: Importance: Insights into the country-wise differences in COVID-19 burden can impact the policies being developed to control disease spread. Objective: Present study evaluated the possible socio-economic and health related factors (and their temporal consistency) determining the disease burden of COVID-19. Design: A retrospective analysis for identifying associations of COVID-19 burden. Setting: Data on COVID-19 statistics (number of cases, tests and deaths per million) was extracted from the website https://www.worldometers.info/coronavirus/ on 10th April and 12th May. Variables obtained to estimate the possible determinants for COVID-19 burden included economic- gross domestic product; socio-demographic- Sustainable Development Goals, SDGs indicators related to health systems, percentage Chinese diaspora; and COVID-19 trajectory- date of first case in each country, days between first reported case and 10th April, days between 100th and 1000th case, and government response stringency index (GRSI). Main outcomes and Measures: COVID-19 burden was modeled using economic and socio-demographic determinants. Consistency of inferences for two time points at three levels of increasing statistical rigor using (i) Spearman correlations, (ii) Bayesian probabilistic graphical model, and (iii) counterfactual impact was evaluated. Results: Countries economy (reflected by GDP), mainly through the testing rates, was the major and temporally consistent determinant of COVID-19 burden in the model. Reproduction number of COVID-19 was lower where mortality due to water, sanitation, and hygiene (WaSH) was higher, thus strengthening the hygiene hypothesis. There was no association between vaccination status or tuberculosis incidence and COVID burden, refuting the claims over BCG vaccination as a possible factor against COVID-19 trajectory. Conclusion and Relevance: Countries economy, through testing power, was the major determinant of COVID-19 burden. There was weak evidence for hygiene hypothesis as a protective factor against COVID-19.


title: Scientometric Trends for Coronaviruses and Other Emerging Viral Infections

text: COVID-19 is the most rapidly expanding coronavirus outbreak in the past two decades. To provide a swift response to a novel outbreak, prior knowledge from similar outbreaks is essential. Here, we study the volume of research conducted on previous coronavirus outbreaks, specifically SARS and MERS, relative to other infectious diseases by analyzing over 35 million papers from the last 20 years. Our results demonstrate that previous coronavirus outbreaks have been understudied compared to other viruses. We also show that the research volume of emerging infectious diseases is very high after an outbreak and drops drastically upon the containment of the disease. This can yield inadequate research and limited investment in gaining a full understanding of novel coronavirus management and prevention. Independent of the outcome of the current COVID-19 outbreak, we believe that measures should be taken to encourage sustained research in the field.


title: Live Facial Recognition: Trust and Legitimacy as Predictors of Public Support for Police Use of New Technology

text: Facial recognition technology is just one of a suite of new digital tools police and other security providers around the world are adopting in an effort to function more safely and efficiently This paper reports results from a major new London-based study exploring public responses to Live Facial Recognition (LFR): a technology that enables police to carry out real-time automated identity checks in public spaces We find that public trust and legitimacy are important factors predicting the acceptance or rejection of LFR Crucially, trust and, particularly, legitimacy seem to serve to alleviate privacy concerns about police use of this technology In an era where police use of new technologies is only likely to increase, especially as the Covid-19 global pandemic develops, these findings have important implications for police–public relations and how the ‘public voice’ is fed into debates


title: COVID-19 and the Efficacy of Different Types of Respiratory Protective Equipment Used by Health Care Providers in a Health Care Setting

text: Coronavirus, the virus that caused the global pandemic at the beginning of 2020 and affected millions across the globe, presented as an enormous challenge to health care providers around the world. With increasing numbers of infected patients presenting daily, health care workers are struggling to take effective measures to protect themselves from transmission against the highly contagious coronavirus. This case helps us understand the implications of coronavirus-infected patients on the health care providers directly responsible for the management of these patients and the relative efficacy of different types of respiratory protective equipment mainly N95 masks and surgical masks in preventing the spread of infection among those at the front lines providing care.


title: Clustering method for spread pattern analysis of corona-virus (COVID-19) infection in Iran

text: The COVID-19 is outbreak from China and infected more than 131,652 people and caused 7,300 deaths in Iran. Unfortunately, the infection numbers and deaths are still increasing rapidly which has put the world on the catastrophic abyss edge. Application of data mining to perform pattern recognition of infection is mainly used for peparing the spread mapping which considred in this work for spatiotemporal distribution assessment and spread pattern analysis of corona-virus (COVID-19) infection in Iran.


Myalgia may not be associated with severity of coronavirus disease 2019 (COVID-19)


title: National Consumption of Antimalarial Drugs and COVID-19 Deaths Dynamics : an Ecological Study

text: COVID-19 (Coronavirus Disease-2019) is an international public health problem with a high rate of severe clinical cases. Several treatments are currently being tested worldwide. This paper focuses on anti-malarial drugs such as chloroquine or hydroxychloroquine, which have been currently reviewed by a systematic study as a good potential candidate and that has been reported as the most used treatment by a recent survey of physicians. We compare the dynamics of COVID-19 death rates in countries using anti-malaria drugs as a treatment from the start of the epidemic versus countries that do not, the day of the 3rd death and the following 10 days. We show that the first group have a much slower dynamic in death rates that the second group. This univariate analysis is of course only one additional piece of evidence in the debate regarding the efficiency of anti-malaria drugs, and it is also limited as the two groups certainly have other systemic differences in the way they responded to the pandemic, in the way they report death or in their population that better explain differences in dynamics (systematic differences that may also explain their choice to rely on anti-malaria drugs in the first place). Nevertheless, the difference in dynamics is so striking that we believe that the urgency context commands presenting the univariate analysis before delving into further analysis. In the end, this data might ultimately be either a piece of evidence in favor or anti-malaria drugs or a stepping stone in understanding further what other ecological aspects place a role in the dynamics of COVID-19 deaths.


title: Genetic analysis of the novel SARS-CoV-2 host receptor TMPRSS2 in different populations

text: The infection coronavirus disease 2019 (COVID-19) is caused by a virus classified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At cellular level, virus infection initiates with binding of viral particles to the host surface cellular receptor angiotensin converting enzyme 2 (ACE2). SARS-CoV-2 engages ACE2 as the entry receptor and employs the cellular serine protease 2 (TMPRSS2) for S protein priming. TMPRSS2 activity is essential for viral spread and pathogenesis in the infected host. Understanding how TMPRSS2 protein expression in the lung varies in the population could reveal important insights into differential susceptibility to influenza and coronavirus infections. Here, we systematically analyzed coding-region variants in TMPRSS2 and the eQTL variants, which may affect the gene expression, to compare the genomic characteristics of TMPRSS2 among different populations. Our findings suggest that the lung-specific eQTL variants may confer different susceptibility or response to SARS-CoV-2 infection from different populations under the similar conditions. In particular, we found that the eQTL variant rs35074065 is associated with high expression of TMPRSS2 but with a low expression of the interferon (IFN)-α/β-inducible gene, MX1, splicing isoform. Thus, these subjects could account for a more susceptibility either to viral infection or to a decrease in cellular antiviral response.


title: Change in outbreak epicenter and its impact on the importation risks of COVID-19 progression: a modelling study

text: The outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) that originated in the city of Wuhan, China has now spread to every inhabitable continent, but now theattention has shifted from China to other epicenters, especially Italy. This study explored the influence of spatial proximities and travel patterns from Italy on the further spread of SARS-CoV-2 around the globe. We showed that as the epicenter changes, the dynamics of SARS-CoV-2 spread change to reflect spatial proximities.


title: Human mobility and poverty as key factors in strategies against COVID-19

text: The unprecedented COVID-19 pandemic that swiped across the globe led many countries to apply 14 heavy nationwide restrictions and control measures. Analyzing aggregate and anonymized 15 mobility data from the cell-phone devices of >3 million users in Israel, we identified that poorer 16 regions exhibited lower and slower compliance with the restrictions. We integrated these mobility 17 patterns into age-, risk- and region-structured transmission model, and showed how we can explain 18 the spatiotemporal dynamics of 250 regions covering Israel. Model projections suggest that 19 applying localized and temporal interventions that focus on high-risk groups can substantially 20 reduce mortality, particularly in poorer regions, while enabling daily routine for a vast majority of 21 the population. These trends were consistent across vast ranges of epidemiological parameters, 22 possible seasonal forcing, and even when we assumed that vaccination would be commercially 23 available in 1-3 years. Our findings can help policymakers worldwide identify hotspots and apply 24 designated strategies against future COVID-19 outbreaks.


title: Beyond predicting the number of infections: predicting who is likely to be COVID negative or positive

text: This study provides the first attempt to identify people at greater risk of COVID-19 infection, enabling more targeted infectious disease prevention and control, which are especially important in the ongoing shortage of COVID-19 testing. We conducted a primary survey of 521 adults on April 1-10, 2020 in Iran, where the official infection rate was 0.08%. In our sample, 3% reported being COVID-19 positive and 15% were unsure of their status. This relatively high positive rate enabled us to conduct the analysis at the 5% significance level. At the time of the survey, 44% of the adults worked from home; 26% still went to work in their workplaces; 27% had stopped working due to the COVID-19 pandemic; and 3% were unemployed. Adults who exercised more were more likely to be COVID-19 negative. Each additional hour of exercise per day predicted a 78% increase in the likelihood of being COVID-19 negative. Adults with chronic medical illnesses were 48% more likely to be COVID-19 negative. In terms of work situation, those who worked from home were the most likely to be COVID-19 negative, and those who had stopped working were the most likely to be COVID-19 positive. Individuals in larger organizations were less likely to be COVID-19 positive. Given the testing shortage in many countries, we identify a novel approach to predict the likelihood of COVID-19 infection by a set of personal and work situation characteristics, in order to help to identify individuals with more or less risk of contracting the virus. We hope this research opens a new research avenue to identify the individual risk factors of COVID-19 infection to enable more targeted infectious disease prevention, communication, testing, and control to complement the effort to expand testing capacity.


title: Modelling and data-based analysis of COVID-19 outbreak in India : a study on impact of social distancing measures

text: In this manuscript, we model and visualize the region-wise trends of the evolution to COVID-19 infections employing a SIR epidemiological model. The SIR dynamics are expressed using stochastic differential equations. We first optimize the parameters of the model using RMSE as loss function on the available data using L-BFGS-B gradient descent optimisation to minimise this loss function. This helps to gain better approximation of the models parameter for specific country or region. The derived parameters are aggregated to project future trends for the Indian subcontinent for next 180 days, which is currently at an early stage within the infection cycle. The projections are meant to function a suggestion for strategies for the socio-political counter measures to mitigate COVID-19. This study considers the current data for India from various open sources. The SIR models prediction is found following the actual trends till date. The inflection point analysis is important to find out which countries have reached their inflection point of the number of infection. We found that if current restrictions like lockdown in India continues with same control till 20 May 2020 then,the number of infected patients will start decreasing after this date.


title: Highly sensitive and specific multiplex antibody assays to quantify immunoglobulins M, A and G against SARS-CoV-2 antigens

text: Reliable serological tests are required to determine the prevalence of antibodies against SARS-CoV-2 antigens and to characterise immunity to the disease in order to address key knowledge gaps in the context of the COVID-19 pandemic. Quantitative suspension array technology (qSAT) assays based on the xMAP Luminex platform overcome the limitations of rapid diagnostic tests and ELISA with their higher precision, dynamic range, throughput, miniaturization, cost-efficacy and multiplexing capacity. We developed three qSAT assays to detect IgM, IgA and IgG to a panel of eight SARS-CoV-2 antigens including spike (S), nucleoprotein (N) and membrane (M) protein constructs. The assays were optimized to minimize processing time and maximize signal to noise ratio. We evaluated the performance of the assays using 128 plasmas obtained before the COVID-19 pandemic (negative controls) and 115 plasmas from individuals with SARS-CoV-2 diagnosis (positive controls), of whom 8 were asymptomatic, 58 had mild symptoms and 49 were hospitalized. Pre-existing IgG antibodies recognizing N, M and S2 proteins were detected in negative controls suggestive of cross-reactive to common cold coronaviruses. The best performing antibody isotype/antigen signatures had specificities of 100% and sensitivities of 94.94% at ≥14 days since the onset of symptoms and 96.08% at ≥21 days since the onset of symptoms, with AUC of 0.992 and 0.999, respectively. Combining multiple antibody markers as assessed by qSAT assays has the highest efficiency, breadth and versatility to accurately detect low-level antibody responses for obtaining reliable data on prevalence of exposure to novel pathogens in a population. Our assays will allow gaining insights into antibody correlates of immunity required for vaccine development to combat pandemics like the COVID-19.


title: Analysis of TCM in prevention and treatment of post-traumatic stress disorder induced by COVID-19/ 中医药防治新型冠状病毒肺炎所致创伤后应激障碍用药探析

text: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, Hubei Province in December 2019, with severe acute respiratory syndrome (SARS) in 2002 and Middle East respiratory syndrome (MERS) in 2012 are all infectious diseases caused by coronavirus. According to the knowledge of infectious diseases such as SARS and MERS, many patients and health care workers suffered from depression and anxiety during and after the epidemic. In particular, post-epidemic survivors were more likely to suffer from post-traumatic stress disorder (PTSD). Similar conditions could be occurred during and after COVID-19. Therefore, it is also an important task to reduce the prevalence of PTSD after COVID-19 as much as possible and to relieve the tension of infected patients, first-line medical staff, quarantine personnel and so on. Traditional Chinese medicine has unique advantages in the treatment of emotional diseases. Understanding the etiology and pathogenesis of PTSD by theory of traditional Chinese medicine and looking for effective methods to treat PTSD will be helpful to treat PTSD of survivors after COVID-19. It is found that Sini Powder has potential value in the treatment of PTSD by the summary and comparison of the research on traditional Chinese medicine related to the treatment of PTSD. We hope to overcome this epidemic psychologically and spiritually. Therefore, it is considered that Sini Powder can be used as the first choice for relieving emotional diseases of related patients during COVID-19 and treating PTSD of survivors after COVID-19.


title: Prediction of COVID-19 Outbreak in China and Optimal Return Date for University Students Based on Propagation Dynamics

text: On 12 December 2019, a novel coronavirus disease, named COVID-19, began to spread around the world from Wuhan, China. It is useful and urgent to consider the future trend of this outbreak. We establish the 4+1 penta-group model to predict the development of the COVID-19 outbreak. In this model, we use the collected data to calibrate the parameters, and let the recovery rate and mortality change according to the actual situation. Furthermore, we propose the BAT model, which is composed of three parts: simulation of the return rush (Back), analytic hierarchy process (AHP) method, and technique for order preference by similarity to an ideal solution (TOPSIS) method, to figure out the best return date for university students. We also discuss the impacts of some factors that may occur in the future, such as secondary infection, emergence of effective drugs, and population flow from Korea to China.


title: Glossary

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title: Repeated population-based surveys of antibodies against SARS-CoV-2 in Southern Brazil

text: Population based data on COVID-19 are urgently needed for informing policy decisions, yet few such studies are available anywhere, as most surveys rely on self-selected volunteers. In the Brazilian State of Rio Grande do Sul (population 11.3 million), we are carrying out fortnightly household surveys in nine of the largest cities. Multi-stage probability sampling was used in each city to select 500 households, within which one resident was randomly chosen for testing. The Wondfo lateral flow rapid test for detecting antibodies against SARS-CoV-2 has been validated in four different settings, including our own, with pooled estimates of sensitivity (84.8%, 95% CI 81.4%;87.8%) and specificity (99.0%, 95% CI 97.8%;99.7%), which are within the acceptable range for epidemiological studies. In the first wave of the study (April 11-13), 4,188 subjects were tested, of whom two were positive (0.0477%; 95% confidence interval (CI) 0.0058%;0.1724%). In the second round (Apr 25-27) there were six positive subjects (0.1333%; 95% CI 0.0489%;0.2900%). We also tested family members of positive index cases, and nine out of 19 had positive results. Testing of reported COVID-19 cases according to RT-PCR confirmed that the test was highly sensitive under field conditions. The epidemic is at an early stage in the State, as the first case was reported on Feb 28, and by Apr 30, 50 deaths were registered. Strict lockdown measures were implemented in mid-March, and our results suggest that compliance was high, with full or near full compliance rates of 79.4% in the first and 71.7% in the second round. As far as we know, this is the only large population anywhere undergoing regular household serological surveys for COVID-19. The results show that the epidemic is at an early phase, and findings from the next rounds will allow us to document time trends and propose Public Health measures.


title: Prediction of New Coronavirus Infection Based on a Modified SEIR Model

text: BACKGROUND The outbreak of the new coronavirus infection in Wuhan City, Hubei Province in December 2019, poses a huge threat to China and even global public health security. Respiratory droplets and contact transmission are the main routes of transmission of new coronaviruses. Compared with SARS and Ebola viruses, new coronavirus infections are infectious during the incubation period. Traditional SEIR (susceptibility-exposure-infection-Removal) There are some differences in conditions for the prediction of the epidemic trend of new coronavirus infection. The outbreak of the new coronavirus infection coincided with the Spring Festival before and after the Chinese Spring Festival.It is necessary to make appropriate optimization and amendments to the traditional model to meet the actual evolution of the epidemic situation. METHODS The traditional SEIR model assumes that the virus-infected person is not infectious during the incubation period and that the infected person did not take isolation measures during the illness. The transmission of the new coronavirus no longer meets the basic assumptions of the classical kinetic system. Therefore, this article first establishes a modified SEIR model. Predict and analyze the changing trend of the epidemic situation, then estimate the parameters involved in the infection dynamics model, and then use Matlab to simulate the established dynamic equations based on public data and analyze the results. Recommendations for universal prevention and control of infectious diseases. RESULTS The first case of new coronavirus infection was confirmed in Wuhan on December 8, 2019. When Wuhan City took no action, assuming the average daily number of contacts per infected person k = 5, the number of infected persons will reach about 2,384,803 people; If wuhan adopts the measures of sealing the city on January 22, 2020, under the premise of k=2, the number of infected people decreases by 19,773 compared with that on January 23, and there is no significant change in the time when the number of infected people reaches the peak. Under the premise of k = 1, the number of infected persons was reduced by 14,330 compared with the closure on January 23, and the time to reach the peak of the number of infected persons was reduced by 2 days. If Wuhan City is closed for one day, the number of infected persons will increase from 106,145 to 130,626 under the premise of k = 2; the number of infected persons will increase from 74,369 to 92,010 under the premise of k = 1. CONCLUSIONS Comparing the number of confirmed diagnoses actually notified by the department with the number of infected people obtained from the simulation of the model, it can be seen that the city closure measures adopted by the Wuhan Municipal Government on January 23 and the first-level response measures adopted by the country are effective for the epidemic Prevention and control play a vital role. Wearing a mask when going out and avoiding close contact with people can effectively reduce the infection rate.


title: A simple microbiome in the European common cuttlefish, Sepia officinalis

text: The European common cuttlefish, Sepia officinalis, is used extensively in biological and biomedical research yet its microbiome remains poorly characterized. We analyzed the microbiota of the digestive tract, gills, and skin in mariculture-raised S. officinalis using a combination of 16S rRNA amplicon sequencing, qPCR and fluorescence spectral imaging. Sequencing revealed a highly simplified microbiota consisting largely of two single bacterial amplicon sequence variants (ASVs) of Vibrionaceae and Piscirickettsiaceae. The esophagus was dominated by a single ASV of the genus Vibrio. Imaging revealed bacteria in the family Vibrionaceae distributed in a discrete layer that lines the esophagus. This Vibrio was also the primary ASV found in the microbiota of the stomach, cecum, and intestine, but occurred at lower abundance as determined by qPCR and was found only scattered in the lumen rather than in a discrete layer via imaging analysis. Treatment of animals with the commonly-used antibiotic enrofloxacin led to a nearly 80% reduction of the dominant Vibrio ASV in the esophagus but did not significantly alter the relative abundance of bacteria overall between treated versus control animals. Data from the gills was dominated by a single ASV in the family Piscirickettsiaceae, which imaging visualized as small clusters of cells. We conclude that bacteria belonging to the Gammaproteobacteria are the major symbionts of the cuttlefish Sepia officinalis cultured from eggs in captivity, and that the esophagus and gills are major colonization sites. IMPORTANCE Microbes can play critical roles in the physiology of their animal hosts, as evidenced in cephalopods by the role of Vibrio (Aliivibrio) fischeri in the light organ of the bobtail squid and the role of Alpha- and Gammaproteobacteria in the reproductive system and egg defense in a variety of cephalopods. We sampled the cuttlefish microbiome throughout the digestive tract, gills, and skin and found dense colonization of an unexpected site, the esophagus, by a microbe of the genus Vibrio, as well as colonization of gills by Piscirickettsiaceae. This finding expands the range of organisms and body sites known to be associated with Vibrio and is of potential significance for understanding host-symbiont associations as well as for understanding and maintaining the health of cephalopods in mariculture.


docid: uskdzlzj

title: Cataract in the human lens: a systematic review of proteomic studiesID#008979

text: Purpose: The aim of this systematic review is to identify all the available data on human lens proteomics with a critical role to age-related cataract formation in order to elucidate the physiopathology of the aging lens. Materials and methods: We searched on Medline and Cochrane databases. The search generated 328 manuscripts. We included nine original proteomic studies that investigated human cataractous lenses. Results: Deamidation was the major age-related post-translational modification. There was a significant increase in the amount of A-crystallin D-isoAsp58 present at all ages, while an increase in the extent of Trp oxidation was apparent in cataract lenses when compared to aged normal lenses. During aging, enzymes with oxidized cysteine at critical sites included GAPDH, glutathione synthase, aldehyde dehydrogenase, sorbitol dehydrogenase, and PARK7. Conclusion: D-isoAsp in A crystallin could be associated with the development of age-related cataract in human, by contributing to the denaturation of a crystallin, and decreasing its ability to act as a chaperone. Oxidation of Trp may be associated with nuclear cataract formation in man, while the role of oxidant stress in age-related cataract formation is dominant.


docid: eqwxkwqa

title: Comparative Genomic Analysis of Rapidly Evolving SARS-CoV-2 Viruses Reveal Mosaic Pattern of Phylogeographical Distribution

text: The Coronavirus Disease-2019 (COVID-19) that started in Wuhan, China in December 2019 has spread worldwide emerging as a global pandemic. The severe respiratory pneumonia caused by the novel SARS-CoV-2 has so far claimed more than 60,000 lives and has impacted human lives worldwide. However, as the novel SARS-CoV-2 displays high transmission rates, their underlying genomic severity is required to be fully understood. We studied the complete genomes of 95 SARS-CoV-2 strains from different geographical regions worldwide to uncover the pattern of the spread of the virus. We show that there is no direct transmission pattern of the virus among neighboring countries suggesting that the outbreak is a result of travel of infected humans to different countries. We revealed unique single nucleotide polymorphisms (SNPs) in nsp13-16 (ORF1b polyprotein) and S-Protein within 10 viral isolates from the USA. These viral proteins are involved in RNA replication, indicating highly evolved viral strains circulating in the population of USA than other countries. Furthermore, we found an amino acid addition in nsp16 (mRNA cap-1 methyltransferase) of the USA isolate (MT188341) leading to shift in amino acid frame from position 2540 onwards. Through the construction of SARS-CoV-2-human interactome, we further revealed that multiple host proteins (PHB, PPP1CA, TGF-β, SOCS3, STAT3, JAK1/2, SMAD3, BCL2, CAV1 & SPECC1) are manipulated by the viral proteins (nsp2, PL-PRO, N-protein, ORF7a, M-S-ORF3a complex, nsp7-nsp8-nsp9-RdRp complex) for mediating host immune evasion. Thus, the replicative machinery of SARS-CoV-2 is fast evolving to evade host challenges which need to be considered for developing effective treatment strategies.


title: Alternatives for establishing a surgical airway during the COVID-19 pandemic Alternativas para o estabelecimento de via aérea cirúrgica durante a pandemia de COVID-19/ Alternatives for establishing a surgical airway during the COVID-19 pandemic

text: ABSTRACT Currently doctors and health professionals are facing a challenging pandemic caused by a new strain called 2019 Novel Coronavirus (COVID-19) Human infection with COVID-19 does not yet have the clinical spectrum fully described, and the pattern of lethality, mortality, infectivity and transmissibility is not known with precision There is no specific vaccine or medication available Treatment is supportive and nonspecific In Brazil, as in the rest of the world, the number of COVID-19 cases has grown alarmingly, leading to an increase in the number of hospitalizations as well as in mortality from the disease Currently, the states with the highest number of cases are, respectively, São Paulo, Rio de Janeiro, Distrito Federal and Ceará The objective of this work is to offer alternatives in order to guide surgeons regarding the surgical management of the airways in patients with suspicion and / or confirmation for COVID-19 infection


title: POOLING FOR SARS-CoV-2 CONTROL IN CARE INSTITUTIONS

text: Workers and residents in Care Homes are considered at special risk for the acquisition of SARS-CoV-2 infection, due to the infectivity and high mortality rate in the case of residents, compared to other containment areas. The aims of the present study, based in our local experience, were (a) to describe SARS-CoV-2 prevalence in institutionalized people in Galicia (Spain) during the Coronavirus pandemic and (b) to evaluate the expected performance of a pooling strategy using RT-PCR for the next rounds of screening of institutionalized people. Distribution of SARS-CoV-2 infection at Care Houses was uneven. As the virus circulation global rate was low in our area, the number of people at risk of acquiring the infection continues to be very high. In this work, we have successfully demonstrated that pooling of different groups of samples at low prevalence clusters, can be done with a small average delay on quantification cycle (Cq) values. A new surveillance system with guaranteed protection is required for small clusters, previously covered with individual testing. Our proposal for Care Houses, once prevalence zero is achieved, would include successive rounds of testing using a pooling solution for transmission control preserving testing resources. Scale-up of this method may be of utility to confront larger clusters to avoid the viral circulation and keeping them operative.


title: Evidence of Protective Role of Ultraviolet-B (UVB) Radiation in Reducing COVID-19 Deaths

text: Background: Research is ongoing to identify an effective way to prevent or treat COVID-19, but thus far these efforts have not yet identified a possible solution. Prior studies indicate the protective role of Ultraviolet-B (UVB) radiation in human health, mediated by vitamin D synthesis. In this study, we empirically outline a negative association of UVB radiation as measured by the ultraviolet index (UVI) with the number of deaths attributed to COVID-19 (COVID-19 deaths). Methods: We carry out an observational study, applying a fixed-effect log-linear regression model to a panel dataset of 64 countries over a period of 78 days (n=4992). We use the cumulative number of COVID-19 deaths and case-fatality rate (CFR) as the main dependent variables to test our hypothesis and isolate UVI effect from potential confounding factors such as underlying time trends, country-specific time-constant and time-varying factors such as weather. Findings: After controlling for time-constant and time-varying factors, we find that a permanent unit increase in UVI is associated with a 2.2 percentage points decline in daily growth rates of cumulative COVID-19 deaths [p < 0.01], as well as a 1.9 percentage points, decline in the daily growth rates of CFR [p < 0.05]. These results represent a significant percentage reduction in terms of the daily growth rates of cumulative COVID-19 deaths (-22.92%) and CFR (-73.08%). Our results are consistent across different model specifications. Interpretation: We find a significant negative association between UVI and COVID-19 deaths, indicating evidence of the protective role of UVB in mitigating COVID-19 deaths. If confirmed via clinical studies, then the possibility of mitigating COVID-19 deaths via sensible sunlight exposure or vitamin D intervention will be very attractive because it is cost-effective and widely available.


title: Therapeutic Anticoagulation Is Associated with Decreased Mortality in Mechanically Ventilated COVID-19 Patients

text: Objective: To evaluate differences in morbidity and mortality among mechanically ventilated patients with COVID-19 treated with therapeutic versus prophylactic anticoagulation. Methods: We performed a retrospective review of 245 COVID-19 positive patients admitted to the ICU requiring mechanical ventilation from March 1, 2020 through April 11, 2020 at Mount Sinai Hospital. Patients either received therapeutic anticoagulation for a minimum of 5 days or prophylactic dose anticoagulation. Morbidity and mortality data were analyzed. Results: Propensity score (PS) weighted Kaplan-Meier plot demonstrated a survival advantage (57% vs. 25%) at 35 days from admission to the ICU in patients who received therapeutic anticoagulation for a minimum of 5 days compared to those who received prophylactic anticoagulation during their hospital course. A multivariate Cox proportional hazard regression model with PS weights to adjust for baseline differences found a 79% reduction in death in patients who were therapeutically anticoagulated HR 0.209, [95% CI (0.10, 0.46), p <0.001]. Bleeding complications were similar between both groups. A 26.7% [95% CI (1.16, 1.39), p<0.001] excess mortality was found for each 1 mg/dL rise in serum creatinine over a 21-day period. Conclusions: Therapeutic anticoagulation is associated with a survival advantage among patients with COVID-19 who require mechanical ventilation in the ICU.


title: TMPRSS2 and furin are both essential for proteolytic activation and spread of SARS-CoV-2 in human airway epithelial cells and provide promising drug targets

text: In December 2019, a novel coronavirus named SARS-CoV-2 first reported in Wuhan, China, emerged and rapidly spread to numerous other countries globally, causing the current pandemic. SARS-CoV-2 causes acute infection of the respiratory tract (COVID-19) that can result in severe disease and lethality. Currently, there is no approved antiviral drug for treating COVID-19 patients and there is an urgent need for specific antiviral therapies and vaccines. In order for SARS-CoV-2 to enter cells, its surface glycoprotein spike (S) must be cleaved at two different sites by host cell proteases, which therefore represent potential drug targets. In the present study we investigated which host cell proteases activate the SARS-CoV-2 S protein in Calu-3 human airway epithelial cells. We show that S can be cleaved by both the proprotein convertase furin at the S1/S2 site and the transmembrane serine protease 2 (TMPRSS2) at the S2’ site. We demonstrate that TMPRSS2 is essential for activation of SARS-CoV-2 S in Calu-3 cells through antisense-mediated knockdown of TMPRSS2 expression. Further, we show that SARS-CoV-2 replication can be efficiently inhibited by two synthetic inhibitors of TMPRSS2 and also by the broad range serine protease inhibitor aprotinin. Additionally, SARS-CoV-2 replication was also strongly inhibited by the synthetic furin inhibitor MI-1851. Combining various TMPRSS2 inhibitors with MI-1851 produced more potent antiviral activity against SARS-CoV-2 than an equimolar amount of any single serine protease inhibitor. In contrast, inhibition of endosomal cathepsins by E64d did not affect virus replication. Our data demonstrate that both TMPRSS2 and furin are essential for SARS-CoV-2 activation in human airway cells and are promising drug targets for the treatment of COVID-19 either by targeting one of these proteases alone or by a combination of furin and TMPRSS2 inhibitors. Therefore, this approach has a high therapeutic potential for treatment of COVID-19.


title: Artificial intelligence predicts the immunogenic landscape of SARS-CoV-2: toward universal blueprints for vaccine designs

text: The global population is at present suffering from a pandemic of Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The goals of this study were to use artificial intelligence (AI) to predict blueprints for designing universal vaccines against SARS-CoV-2, that contain a sufficiently broad repertoire of T-cell epitopes capable of providing coverage and protection across the global population. To help achieve these aims, we profiled the entire SARS-CoV-2 proteome across the most frequent 100 HLA-A, HLA-B and HLA-DR alleles in the human population, using host-infected cell surface antigen presentation and immunogenicity predictors from the NEC Immune Profiler suite of tools, and generated comprehensive epitope maps. We then used these epitope maps as input for a Monte Carlo simulation designed to identify statistically significant “epitope hotspot” regions in the virus that are most likely to be immunogenic across a broad spectrum of HLA types. We then removed epitope hotspots that shared significant homology with proteins in the human proteome to reduce the chance of inducing off-target autoimmune responses. We also analyzed the antigen presentation and immunogenic landscape of all the nonsynonymous mutations across 3400 different sequences of the virus, to identify a trend whereby SARS-COV-2 mutations are predicted to have reduced potential to be presented by host-infected cells, and consequently detected by the host immune system. A sequence conservation analysis then removed epitope hotspots that occurred in less-conserved regions of the viral proteome. Finally, we used a database of the HLA genotypes of approximately 22 000 individuals to develop a “digital twin” type simulation to model how effective different combinations of hotspots would work in a diverse human population, and used the approach to identify an optimal constellation of epitopes hotspots that could provide maximum coverage in the global population. By combining the antigen presentation to the infected-host cell surface and immunogenicity predictions of the NEC Immune Profiler with a robust Monte Carlo and digital twin simulation, we have managed to profile the entire SARS-CoV-2 proteome and identify a subset of epitope hotspots that could be harnessed in a vaccine formulation to provide a broad coverage across the global population.


docid: sustpulo

title: A new challenge of unfractionated heparin anticoagulation treatment for moderate to severe COVID-19 in Japan


title: Memory-Dependent Model for the Dynamics of COVID-19 Pandemic

text: COVID-19 pandemic has impacted people all across the world. As a result, there has been a collective effort to monitor, predict, and control the spread of this disease. Among this effort is the development of mathematical models that could capture accurately the available data and simulate closely the futuristic scenarios. In this paper, a fractional-order memory-dependent model for simulating the spread of COVID-19 is proposed. In this model, the impact of governmental action and public perception are incorporated as part of the time-varying transmission rate. The model simulation is performed using the two-step generalized exponential time-differencing method and tested for data from Wuhan, China. The mean-square errors demonstrate the merit of the fractional-order model and provide a good estimate of the optimal order.


title: Knowledge and practice of preventive measures against COVID-19 infection among pregnant women in a low-resource African setting

text: Background: Coronavirus disease pandemic has resulted in death of thousands of people across several countries. Several preventive measures have been recommended to halt the spread of the disease and its associated mortality. However, the level knowledge and practice of these preventive measures against COVID-19 infection among pregnant women, which constitute vulnerable groups, are yet to be evaluated. Aim: To determine the knowledge and practice of preventive measures against COVID-19 infection among pregnant women in Abakaliki. Materials and Methods: This was a self-administered questionnaire-based cross-sectional study conducted from February 1, 2020 to March 31, 2020 among 284 antenatal clinic attendees at Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State. A pretested and validated questionnaire was used to collect the data. Data analysis was done using SPSS version 22. Results: Of 284 participants, 60.9% (n=173) had adequate knowledge of the preventive measures against COVID-19 infection. However, the overall practice of these preventive measures among the participants were poor as 69.7% of the participants were not practicing the preventive measures against the coronavirus. The determinants of poor practice of the preventive measures among the participants were being in age group 31-40 years (AOR=2.04, 95%CI: 1.26 - 5.37, p=0.022), married (AOR=2.99, 95%CI: 1.40 - 6.33, p=0.035) grandmultiparous (AOR=3.11, 95%CI: 1.32 - 6.56, p=0.021), residing in rural area (AOR=2.08, 95%CI: 1.32 - 4.05, p=0.031), and having no formal education (AOR=6.73, 95%CI: 2.66 - 18.34, p=0.002). Conclusion: The study showed that most of the participants had adequate knowledge of preventive measures against COVID-19 infection but the practice of these preventive measures were poor among the participants.


Animals and coronavirus, help for African labs and a short flu season


title: Pregnancy outcomes, Newborn complications and Maternal-Fetal Transmission of SARS-CoV-2 in women with COVID-19: A systematic review

text: Abstract Objective: The aim of this systematic review was to examine published and preprint reports for maternal and fetal outcomes in pregnant women with COVID-19 and also assess the incidence of maternal-fetal transmission of SARS CO-V-2 infection. Design : Systematic review Data sources:We searched PUMBED. Medline, Embase, MedRxiv and bioRxiv databases upto 31st March 2020 utilizing combinations of word variants for " coronavirus " or " COVID-19 " or " severe acute respiratory syndrome " or " SARS-COV-2 " and " pregnancy " . We also included data from preprint articles. Study selection : Original case reports and case series on pregnant women with a confirmed diagnosis of SARS-CoV-2 infection. Data extraction : We included 23 studies [China (20), USA (01), Republic of Korea (01) and Honduras, Central America (01) reporting the information on 172 pregnant women and 162 neonates. The primary outcome measures were maternal health characteristics and adverse pregnancy outcomes, neonatal outcomes and SARS-CoV-2 infection in neonates was extracted. Treatments given to pregnant women with COVID-19 were also recorded. Results: Out of 172 women affected by COVID-19 in pregnancy, 160 women had delivered 162 newborns (2 set of twins, 12 ongoing pregnancies). In pregnant women with COVID-19, the most common symptoms were fever (54%), cough (35%), myalgia (17%), dyspnea (12%) and diarrhea (4%). Pneumonia was diagnosed by CT scan imaging in 100 % of COVID-19 pregnant women. Pregnancy complications included delivery by cesarean section (89%), preterm labor (21%), fetal distress (9%) and premature rupture of membranes (8%). The most common co-morbidities associated with pregnant women with COVID-19 were diabetes (11%), hypertensive disorders (9%), placental disorders (5%), co-infections (6%), scarred uterus (5%), hypothyroidism (5%) and anemia (4%). Amongst the neonates of COVID-19 mothers, preterm birth (23%), respiratory distress syndrome (14%), pneumonia (14%) low birth weight (11%), small for gestational age (3%) were reported. There was one still birth and one neonatal death reported. Vertical transmission rate of SARS-CoV-2 is estimated to be 11%. Conclusion In pregnant women with COVID-19, diabetes and hypertensive disorders are common co-morbidities and there is a risk of preterm delivery. Amongst the neonates born to mothers with COVID-19, respiratory distress syndrome and pneumonia are common occurrence. There is an evidence of vertical transmission of SARS-CoV-2 infection in women with COVID-19.


title: ACE2-Variants Indicate Potential SARS-CoV-2-Susceptibility in Animals: An Extensive Molecular Dynamics Study

text: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in late 2019 and since evolved into a global threat with nearly 4.4 million infected people and over 290,000 confirmed deaths worldwide.1 SARS-CoV-2 is an enveloped virus presenting spike (S) glycoproteins on its outer surface. Binding of S to host cell angiotensin converting enzyme 2 (ACE2) is thought to be critical for cellular entry. The host range of the virus extends far beyond humans and non-human primates. Natural and experimental infections have confirmed high susceptibility of cats, ferrets, and hamsters, whereas dogs, mice, rats, pigs, and chickens seem refractory to SARS-CoV-2 infection. To investigate the reason for the variable susceptibility observed in different species, we have developed molecular descriptors to efficiently analyze our dynamic simulation models of complexes between SARS-CoV-2 S and ACE2. Based on our analyses we predict that: (i) the red squirrel is likely susceptible to SARS-CoV-2 infection and (ii) specific mutations in ACE2 of dogs, rats, and mice render them susceptible to SARS-CoV-2 infection.


title: Effects of Nozzle Geometries on 3D Printing of Clay Constructs: Quantifying Contour Deviation and Mechanical Properties

text: Abstract In this research, ready-to-print clay was employed to 3D print cylindrical constructs using two different nozzle geometries. The cylinders were printed using a direct ink writing (DIW) 3D printer with similar printing parameters such that the impacts of using different nozzle geometries in contour deviation and mechanical properties of the printed constructs can be quantified. Choosing the right nozzle geometry before printing is critical as it affects the surface finish as well as the mechanical properties of the constructs. This study utilizes point cloud data of the printed samples obtained from a scanning system to measure the contour deviation and surface roughness. According to the results from the point cloud analysis, for cylindrical constructs, circular nozzle imparts less surface roughness and contour deviation whereas square nozzle imparts higher compression strength but with comparatively higher contour deviation and surface roughness. The study provides framework to determine the deviations and mechanical properties of the free form constructs. The work has provided a guideline of nozzle selection in 3D printing of clay constructs for civil infrastructures.


title: Effectiveness of the strategies implemented in SriLanka for controlling the COVID-19 outbreak

text: In order to bring the new coronavirus pandemic in the country under control, the government of Sri Lanka implemented a set of control strategies including social distancing, quarantine, lockdowns, travel restrictions and isolation of villages. The aim of this study is to investigate the effectiveness of the overall control process with the aid of classical compartment models and network models. Our results indicate that the prevailing control strategies are effective with at least 50% contact rate reduction or with at least 40% isolation of the contact history of infected population.


title: Using past and current data to estimate potential crisis service use in mental healthcare after the COVID-19 lockdown: South London and Maudsley data

text: The lockdown policy response to the COVID-19 pandemic in the UK has a potentially important impact on provision of mental healthcare with uncertain consequences over the 12 months ahead. Past activity may provide a means to predict future demand. Taking advantage of the Clinical Record Interactive Search (CRIS) data resource at the South London and Maudsley NHS Trust (SLaM; a large mental health service provider for 1.2m residents in south London), we carried out a range of descriptive analyses to inform the Trust on patient groups who might be most likely to require inpatient and home treatment team (HTT) crisis care. We considered the 12 months following UK COVID-19 lockdown policy on 16th March, drawing on comparable findings from previous years, and quantified levels of change in service delivery to those most likely to receive crisis care. For 12-month crisis days from 16th March in 2015-19, we found that most (over 80%) were accounted for by inpatient care (rather than HTT), most (around 75%) were used by patients who were current or recent Trust patients at the commencement of follow-up, and highest numbers were used by patients with a previously recorded schizophreniform disorder diagnosis. For current/recent patients on 16th March there had been substantial reductions in use of inpatient care in the following 31 days in 2020, more than previous years; changes in total non-inpatient contact numbers did not differ in 2020 compared to previous years, although there had been a marked switch from face-to-face to virtual contacts.


title: Implications for tetraspanin-enriched microdomain assembly based on structures of CD9 with EWI-F

text: Tetraspanins are ubiquitous eukaryotic membrane proteins that contribute to a variety of signaling processes by spatially organizing partner-receptor molecules in the plasma membrane. How tetraspanins bind and cluster partner receptors into so-called tetraspanin-enriched microdomains is unknown. Here we present crystal structures of the large extracellular loop of CD9 in complex with nanobodies 4C8 and 4E8; and, the cryo-EM structure of 4C8-bound CD9 in complex with its prototypical partner EWI-F. The CD9 - EWI-F complex displays a tetrameric arrangement with two centrally positioned EWI-F molecules, dimerized through their ectodomains, and two CD9 molecules, one bound to each EWI-F single-pass transmembrane helix through CD9-helices h3 and h4. In the crystal structures, nanobodies 4C8 and 4E8 bind CD9 at the C and D loop, in agreement with 4C8 binding at the ends of the CD9 - EWI-F cryo-EM complex. Overall, the 4C8 - CD9 - EWI-F - EWI-F - CD9 - 4C8 complexes varied from nearly two-fold symmetric (i.e. with the two CD9 - 4C8 copies in nearly anti-parallel orientation) to ca. 50° bent arrangements. Since membrane helices h1 and h2 and the EC2 D-loop have been previously identified as sites for tetraspanin homo-dimerization, the observed linear but flexible arrangement of CD9 - EWI-F with potential CD9 - CD9 homo-dimerization at either end provides a new ‘concatenation model’ for forming short linear or circular assemblies, which may explain the occurrence of tetraspanin-enriched microdomains.


title: Susceptibility of tree shrew to SARS-CoV-2 infection

text: Since SARS-CoV-2 became a pandemic event in the world, it has not only caused huge economic losses, but also a serious threat to global public health. Many scientific questions about SARS-CoV-2 and COVID-19 were raised and urgently need to be answered, including the susceptibility of animals to SARS-CoV-2 infection. Here we tested whether tree shrew, an emerging experimental animal domesticated from wild animal, is susceptible to SARS-CoV-2 infection. No clinical signs were observed in SARS-CoV-2 inoculated tree shrews during this experiment except the increasing body temperature (above 39° C) particular in female animals during infection. Low levels of virus shedding and replication in tissues occurred in all three age groups, each of which showed his own characteristics. Histopathological examine revealed that pulmonary abnormalities were mild but the main changes although slight lesions were also observed in other tissues. In summary, tree shrew is not susceptible to SARS-CoV-2 infection and may not be a suitable animal for COVID-19 related researches.


title: Coronavirus hemagglutinin-esterase and spike proteins co-evolve for functional balance and optimal virion avidity

text: Human coronaviruses OC43 and HKU1 are respiratory pathogen of zoonotic origin that have gained worldwide distribution. OC43 apparently emerged from a bovine coronavirus (BCoV) spill-over. All three viruses attach to 9-O-acetylated sialoglycans via spike protein S with hemagglutinin-esterase HE acting as a receptor-destroying enzyme. In BCoV, an HE lectin domain promotes esterase activity towards clustered substrates. OC43 and HKU1, however, lost HE lectin function as an adaptation to humans. Replaying OC43 evolution, we knocked-out BCoV HE lectin function and performed forced evolution-population dynamics analysis. Loss of HE receptor-binding selected for second-site mutations in S, decreasing S binding affinity by orders of magnitude. Irreversible HE mutations selected for cooperativity in virus swarms with low-affinity S minority variants sustaining propagation of high-affinity majority phenotypes. Salvageable HE mutations induced successive second-site substitutions in both S and HE. Apparently, S and HE are functionally interdependent and co-evolve to optimize the balance between attachment and release. This mechanism of glycan-based receptor usage, entailing a concerted, fine-tuned activity of two envelope protein species, is unique among CoVs, but reminiscent of that of influenza A viruses (IAVs). Apparently, general principles fundamental to virion-sialoglycan interactions prompted convergent evolution of two important groups of human and animal pathogens.


title: The infection evidence of SARS-COV-2 in ocular surface： a single-center cross-sectional study

text: Purpose: The aim of this study was to identify whether SARS-COV-2 infected in ocular surface. Methods: Cross-sectional study of patients presenting for who received a COVID-19 diagnosis, from December 30, 2019 to February 7, 2020, at Tongji hospital, Tongji medical college, Huazhong University of Science and Technology. Demographics, temperature was recorded, blood routine test (Rt), chest Computed Tomography (CT) were took intermittently, and SARS-COV-2 real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay were arranged for the nasopharyngeal and conjunctival swab samples. Results: A total of 102 patients (48 Male [50%] and 54 Female [50%]) with clinical symptoms, Rt, and chest Computed Tomography (CT) abnormalities were identified with a clinical diagnosis of COVID-19. Patients had a mean [SD] gestational age of 57.63 [14.90] years. Of a total of 102 patients identified, 72 patients (36 men [50%] and 36 women [50%]; mean [SD] age, 58.68 [14.81] years) confirmed by laboratory diagnosis with SARS-COV-2 RT-PCR assay. Only two patients (2.78%) with conjunctivitis was identified from 72 patients with a laboratory confirmed COVID-19. However, SARS-COV-2 RNA fragments was found in ocular discharges by SARS-COV-2 RT-PCR only in one patient with conjunctivitis. Conclusions: Although we suspect the incidence of SARS-COV-2 infection through the ocular surface is extremely low, the nosocomial infection of SARS-CoV-2 through the eyes after occupational exposure is a potential route. The inefficient diagnostic method and the sampling time lag may contribute to the lower positive rate of conjunctival swab samples of SARS-COV-2. Therefore, to lower the SARS-COV-2 nosocomial infection, the protective goggles should be wore in all the health care workers.


title: Grad students on COVID-19’s impact

text: With COVID-19 causing university closures around the world, we wondered how graduate students are holding up Here are some of their stories, in their own words A disorienting orientation Aaron Perez, prospective grad student I finally did it! After 2 years of applying to different chemical engineering graduate programs, I was admitted to a university, and it invited me to attend its on-campus orientation Little did I know that COVID-19 would impact the entire trip Before accepting the invitation, I asked the graduate adviser if it was safe to travel to that state The response I got was “Yes, we don’t have any cases here ” Although I was worried, I decided to pack my bags and travel to the university I knew from the beginning that this trip would be chaotic First, my flight was delayed for more than 3 h for additional temperature screenings Second, several students canceled their


title: TrkB agonists prevent post-ischemic BDNF-TrkB mediated emergence of refractory neonatal seizures in CD-1 pups

text: Refractory neonatal seizures do not respond to first-line anti-seizure medications (ASMs) like phenobarbital (PB), a positive allosteric modulator for GABAA receptors, the most widely used ASM to treat neonatal seizures. GABAA receptor-mediated inhibition is dependent upon neuronal chloride regulation. The electroneutral cation-chloride transporter KCC2 mediates neuronal chloride extrusion; an age-dependent increase of KCC2 expression enables the shift of GABAergic signaling from depolarizing to hyperpolarizing. BDNF-TrkB activation following excitotoxic injury recruits downstream targets like PLCγ1, leading to KCC2 hypofunction. This study investigated the efficacy of partial and full TrkB agonists; LM22A-4 (LM), HIOC and Deoxygedunin (DG) respectively, on PB-refractory seizures, post-ischemic TrkB-pathway activation, and KCC2 membrane stability in a P7 CD-1 mouse model of refractory neonatal seizures. Anti-seizure efficacy was determined by quantifying seizure burdens with continuous video-EEG. LM rescued PB-refractory seizures in a sexually dimorphic manner. LM anti-seizure efficacy was associated with a significant reduction in the post-ischemic phosphorylation of TrkB at Y816, a site known to mediate post-ischemic KCC2 hypofunction via PLCγ1 activation. LM additionally rescued ischemia-induced pKCC2-S940 dephosphorylation preserving its membrane stability. HIOC and DG, two novel full TrkB agonists, also rescued PB-refractoriness and post-ischemic TrkB-PLCγ1 pathway activation. Additionally, chemogenetic inactivation of TrkB significantly reduced post-ischemic neonatal seizure burdens at P7. Developmental expression profiles of TrkB and KCC2 in naïve pups identified developmental differences that may underlie the sex-dependent variance in anti-seizure efficacy. These results support a novel role for the TrkB receptor in the emergence of age-dependent refractory neonatal seizures.


title: COVID-19 in-patient hospital mortality by ethnicity

text: There is debate about the extent to which COVID-19 affects ethnic groups differently. We explored if there was variation in hospital mortality in patients with COVID. Mortality rates in 1,276 inpatients in Bradford with test results for COVID-19 were analysed by ethnic group. The age-adjusted risk of dying from COVID-19 was slightly lower in South Asian compared to White British patients. (RR =0.87, 95% CI: 0.41 to 1.84).


title: Graduating in lockdown

text: Fabian Rivers, recent graduate rep on BVA Council, spares a thought for those graduating during the Covid-19 pandemic.


title: Asian Pacific Association of Gastroenterology (APAGE) Inflammatory Bowel Disease (IBD) Working Party guidelines on IBD management during the COVID‐19 pandemic

text: The COVID‐19 pandemic, secondary to SARS‐CoV‐2, has resulted in high mortality and morbidity worldwide. As inflammatory bowel disease (IBD) is a chronic disease, and most patients are on long‐term immunosuppressive agents, there is understandable concern, particularly in terms of therapy. In view of this, experts in IBD across the Asia Pacific region were invited to put together recommendations based on their experience and the currently available data. In general, most IBD therapies (with a few exceptions) can be continued safely, and the general consensus is that maintaining disease control should remain the main principle of management. In addition, social distancing measures and the appropriate use of personal protective equipment should be strictly adhered to. During the current pandemic, face‐to‐face clinic follow ups and non‐urgent procedures should be kept to a minimum.


title: Efficient and Practical Sample Pooling for High-Throughput PCR Diagnosis of COVID-19

text: Diagnostic assays using quantitative Polymerase Chain Reaction (qPCR) most commonly process patient samples one by one. While this is usually an effective and reliable method, the current efforts against the COVID-19 pandemic demand more efficient measures. Diagnostic assays can be scaled up by the method of High-Throughput qPCR via sample pooling. Pooling, the action of combining multiple samples into one tube, is most effective when the chance of positive detection of the target, SARS-CoV-2 RNA, is low. In such cases, large groups of samples can be conclusively classified as negative with a single test, with no need to individually test every sample. However, different frequencies of the target-product presence in the samples, require different pool/batch sizes for optimal results. Here, we present two possible optimized pooling strategies for diagnostic SARSCoV-2 testing on large scales, each one better suited for a different range of target frequency. In the first, we employ a simple information-theoretic heuristic to derive a highly efficient re-pooling protocol: an estimate of the target frequency determines the initial pool size, and any subsequent pools found positive are re-pooled at half-size and tested again. In the range of very rare target (<0.05), this approach can reduce the number of necessary tests dramatically. For example, this method achieves a reduction of a factor of 50 for a target frequency of 0.001. The second method is a simpler approach of optimized one-time pooling followed by individual tests on positive pools. We show that this approach is just as efficient for moderate target-product frequencies (0.05<0.2). For example, it reduces the number of tests needed by half if the frequency of positives samples is 0.07. We show that both methods are comparable to the absolute upper-bound efficiency given by Shannon's source coding theorem. Our strategies require no investment at all, and they offer a significant reduction in the amount of equipment and time needed to test large numbers of samples. Both approaches are dynamic; they can be easily implemented in different conditions with various infection rates and sample numbers. We compare our strategies to the naive way of testing and also to alternative matrix methods. Most importantly, we offer practical pooling instructions for laboratories that perform large scale qPCR assays to diagnose SARS-CoV-2 viral particles.


title: COVID-19 pandemic brings a sedentary lifestyle: a cross-sectional and longitudinal study

text: Objectives: The coronavirus disease 2019 (COVID-19) pandemic continues to pose profound challenges on society. Governments around the world have managed to mitigate its spread through strategies including social distancing; however, this may result in the adoption of sedentary lifestyle. This study aimed to investigate: 1) physical activity (PA) levels, sedentary behavior (SB) and sleep among young adults during COVID-19 epidemic, and 2) the change in these behaviors before and during the pandemic. Methods: A total of 631 young adults (38.8% males) participated in the cross-sectional study and completed an online survey that included five components: general information, COVID-19 related issues, PA, SB, and sleep. For longitudinal study, PA, SB, and sleep data collected from 70 participants before and during COVID-19 pandemic were analyzed. Results: Participants reported engaging in low PA, high SB and long sleep duration during COVID-19 pandemic. Females had greater concern for COVID-19 related issues and engaged in more prevention strategies than males. Moreover, a significant decline in PA while increase in both times spent in SB and sleep were determined after COVID-19 outbreak. Conclusion: The results of this study demonstrated a sedentary lifestyle in young adults in responses to social distancing during the COVID-19 pandemic, which will assist health policy makers and practitioners in the development of population specific health education and behavior interventions during this pandemic and for other future events.


title: The effect of non-pharmaceutical interventions (NPIs) on the spread of COVID-19 pandemic in Japan: A modeling study

text: Non-pharmaceutical interventions (NPIs) are founded to be effective to delay epidemic spread and to reduce the number of patients. Moderate NPIs took in Japan seemed to have reduced the COVID-19 patients and to lower death rates, thus, effects of those NPIs are worthy of investigation. We used open source data and divided the data into three periods: Jan 22 to Feb 25 (Period I), Feb 26 to Apr 6 (Period II), and Apr 7 to May 14 (Period III). We developed the SIRD model and applied the Monte Carlo Simulation to estimate a combination of optimal results, including the peak of infected cases, the peak date, and R0. For Period I, the estimated peak infected cases were smaller than the observed ones, the peak date was earlier than the observed one, and the R0 was about 4.66. For the other two periods, the estimated cases were more, and the peak dates were earlier than the observed ones. The R0 was 2.50 in Period II, and 1.79 in Period III. NPIs took in Japan might have reduced more than 50% of the daily contacts per people compared to that before COVID-19. Owing to the effects of NPIs, the Japanese society had avoided collapse of medical service. Nevertheless, the capacity of daily RT-PCR may have restricted the reported confirmed cases.


docid: loishurx

title: A Comprehensive Review of the COVID-19 Pandemic and the Role of IoT, Drones, AI, Blockchain, and 5G in Managing its Impact

text: The unprecedented outbreak of the 2019 novel coronavirus, termed as COVID-19 by the World Health Organization (WHO), has placed numerous governments around the world in a precarious position. The impact of the COVID-19 outbreak, earlier witnessed by the citizens of China alone, has now become a matter of grave concern for virtually every country in the world. The scarcity of resources to endure the COVID-19 outbreak combined with the fear of overburdened healthcare systems has forced a majority of these countries into a state of partial or complete lockdown. The number of laboratory-confirmed coronavirus cases has been increasing at an alarming rate throughout the world, with reportedly more than 3 million confirmed cases as of 30 April 2020. Adding to these woes, numerous false reports, misinformation, and unsolicited fears in regards to coronavirus, are being circulated regularly since the outbreak of the COVID-19. In response to such acts, we draw on various reliable sources to present a detailed review of all the major aspects associated with the COVID-19 pandemic. In addition to the direct health implications associated with the outbreak of COVID-19, this study highlights its impact on the global economy. In drawing things to a close, we explore the use of technologies such as the Internet of Things (IoT), Unmanned Aerial Vehicles (UAVs), blockchain, Artificial Intelligence (AI), and 5G, among others, to help mitigate the impact of COVID-19 outbreak.


title: tbiExtractor: A framework for extracting traumatic brain injury common data elements from radiology reports

text: Objective The manual extraction of valuable data from electronic medical records is cumbersome, error-prone, and inconsistent. By automating extraction in conjunction with standardized terminology, the quality and consistency of data utilized for research and clinical purposes would be substantially improved. Here, we set out to develop and validate a framework to extract pertinent clinical conditions for traumatic brain injury (TBI) from computed tomography (CT) reports. Materials and Methods We developed tbiExtractor, which extends pyConTextNLP, a regular expression algorithm using negation detection and contextual features, to create a framework for extracting TBI common data elements from radiology reports. The algorithm inputs radiology reports and outputs a structured summary containing 27 clinical findings with their respective annotations. Development and validation of the algorithm was completed using two physician annotators as the gold standard. Results tbiExtractor displayed high sensitivity (0.92-0.94) and specificity (0.99) when compared to the gold standard. The algorithm also demonstrated a high equivalence (94.6%) with the annotators. A majority of clinical findings (85%) had minimal errors (F1 Score ≥ 0.80). When compared to annotators, tbiExtractor extracted information in significantly less time (0.3 sec vs 1.7 min per report). Discussion and Conclusion tbiExtractor is a validated algorithm for extraction of TBI common data elements from radiology reports. This automation reduces the time spent to extract structured data and improves the consistency of data extracted. Lastly, tbiExtractor can be used to stratify subjects into groups based on visible damage by partitioning the annotations of the pertinent clinical conditions on a radiology report.


title: Optimization of SARS-CoV-2 detection by RT-QPCR without RNA extraction

text: Rapid and reliable screening of SARS-CoV-2 is fundamental to assess viral spread and limit the pandemic we are facing. In this study we evaluated the reliability and the efficiency of a direct RT-QPCR method (without RNA extraction) using SeeGene Allplex™ 2019-nCoV RT-QPCR and the influence of swab storage media composition on further viral detection. We show that SeeGene’s assay provides similar efficiency as the RealStar® SARS-CoV-2 RT-PCR kit (Altona Diagnostics), and that RNA extraction is not necessary nor advantageous if samples are stored in UTM or molecular water but is recommended if samples are stored in saline solution and in Hanks medium.


title: Human flourishing, tourism transformation and COVID-19: a conceptual touchstone

text: As the planet remains in the grips of COVID-19 and amidst enforced lockdowns and restrictions, and possibly the most profound economic downturn since the Great Depression, the resounding enquiry asks—what will the new normal look like? And, in much the same way, tourism aficionados, policy makers and communities are asking a similar question—what will the tourism landscape, and indeed the world, look like after the pandemic? As casualties from the crisis continue to fall by the wayside, the rethinking about what an emergent tourism industry might resemble is on in earnest. Many are hopeful that this wake-up call event is an opportunity to reshape tourism into a model that is more sustainable, inclusive and caring of the many stakeholders that rely on it. And some indicators, though not all, point in that direction. In line with this, the concept of ‘human flourishing’ offers merits as an alternative touchstone for evaluating the impacts of tourism on host communities. Human flourishing has a long genesis and its contemporary manifestation, pushed by COVID-19 and applied to travel and tourism, further expands the bounds of its application. Human flourishing has the potential to offer more nuanced sets of approaches by which the impact of tourism on host communities might be measured. The challenge remaining is how to develop robust indices to calibrate human flourishing policy successes.


title: Epidemiological characteristics of COVID-19 in medical staff members of neurosurgery departments in Hubei province: A multicentre descriptive study

text: Background The novel coronavirus (SARS-CoV-2) has infected a large number of healthcare workers in Hubei province, China. In addition to infectious and respiratory disease physicians, many doctors in other medical fields have been infected. Methods We prospectively collected epidemiological data on medical staff members who are working in neurosurgery departments in 107 hospitals in Hubei province through self-reported questionnaires or telephone interviews. Data of medical staff members with laboratory-confirmed coronavirus disease 2019 (COVID-19) were analysed. The final follow-up date was 1 March 2020. Findings A total of 5,442 neurosurgery department medical staff members were surveyed. One hundred and twenty cases, involving 54 doctors and 66 nurses, were found to have been infected with SARS-CoV-2. The overall incidence was 2.2%. These cases were concentrated in 26 centres, 16 of which had admitted a total of 59 patients with COVID-19 complicated by craniocerebral disease. Medical staff members in centres receiving COVID-19 patients had a higher risk of contracting infection than those in centres not receiving COVID-19 patients (relative risk: 19.6; 95% confidence interval: 12.6-30.6). Contact with either COVID-19 patients (62.5%, 75/120) or infected colleagues (30.8%, 37/120) was the most common mode of transmission. About 78.3% (94/120) of the infected cases wore surgical masks, whereas 20.8% (25/120) failed to use protection when exposed to the source of infection. Severe infections were observed in 11.7% (14/120) of the cases, with one death (0.8%, 1/120). All the infected medical staff members had been discharged from the hospital. A total of 1,287 medical staff members were dispatched to participate in the frontline response to COVID-19 under level 2 protection of whom one was infected. Medical staff members who took inadequate protection had a higher risk of contracting infection than those using level 2 protection (relative risk: 36.9; 95% confidence interval: 5.2-263.6). Interpretation Neurosurgical staff members in Hubei province were seriously affected by COVID-19. Level 2 protection and strengthening of protective measures are likely to be effective in preventing medical workers from being infected.


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title: Epidemiological description and analysis of RdRp, E and N genes dynamic by RT-PCR of SARS-CoV-2 in Moroccan population: Experience of the National Reference Laboratory (LNR)-UM6SS

text: The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a new infectious disease that first emerged in Hubei province, China, in December 2019. On 2 March 2020, the Moroccan Ministry of Health confirmed the first COVID-19 case in Morocco. The new virus SARS-CoV-2 was identified in the sample of a Moroccan expatriate residing in Italy. Without a therapeutic vaccine or specific antiviral drugs, early detection and isolation become essential against novel Coronavirus. This study aims to analyze the epidemiological profile of the SARS-CoV-2 in Moroccan cases and to investigate the dynamic of RdRp gene, N gene, and E gene in patients from diagnosis until the recovery. Among 859 Covid-19 RT-PCR tests realized for 285 patients, 133 cases had positive results Covid-19. 9 % of these cases present the 3 genes RdRp, N, and E, 47% only the RdRp gene, 2% with RdRp and N gene, 26% cases are positives with N gene, and 16 % with N and E gene. The analysis of the Covid-19 genes (RdRp, N, and E) dynamic reveal that more than 6% stay positive with detection of the N and E gene, and 14% with the N gene after 12 days of treatment. The median period from positive to the first negative Covid-19 RT-PCR tests was 6.8{+/-}2.24 days for 44% cases, 14.31 {+/-} 2.4 days for 30%, and 22.67 {+/-} 1.21 days for 4%. This a first description of the Moroccan COVID-19 cases and the analysis of the dynamic of the 3 genes RdRp, N, and E. The analysis of our population can help to involved in the care of patients.


title: Mobility-Guided Modeling of the COVID-19 Pandemic in Metro Manila

text: COVID-19 is a novel respiratory disease first identified in Wuhan, China, that is caused by the novel coronavirus, SARS-CoV-2. To better understand the dynamics of the COVID-19 pandemic in the Philippines, we have used real-time mobility data to modify the DELPHI Epidemiological Model recently developed at M.I.T., to simulate the pandemic in Metro Manila. We have chosen to focus on the National Capital Region, not only because it is the nation's demographic heart where over a tenth of the country's population live, but also because it has been the epidemiological epicenter of the Philippine pandemic. Our model suggests that the government-imposed enhanced community quarantine (ECQ) has successfully limited the spread of the pandemic. It is clear that the initial wave of the pandemic is flattening, though suppression of viral spread has been delayed by the local pandemics in the City of Manila and Quezon City. Our data also reveals that replacing the ECQ with a General Community Quarantine (GCQ) will increase the forecasted number of deaths in the nation's capital unless rigorous tracing and testing can be implemented to prevent a second wave of the pandemic.


title: A score-based risk model for predicting severe COVID-19 infection as a key component of lockdown exit strategy

text: Background: As many countries consider and employ various lockdown exit strategies, health authorities seek tools to provide differential targeted advice for social distancing based on personal risk for severe COVID-19. However, striking a balance between a scientifically precise multivariable risk prediction model, and a model which can easily be used by the general public, remains a challenge. A list of risk criteria, as defined by the CDC for example, provides a simple solution, but may be too inclusive by classifying a substantial portion of the population at high risk. Score-based risk classification tools may provide a good compromise between accuracy and simplicity. Objective: To create a score-based risk classification tool for severe COVID-19. Methods: The outcome was defined as a composite of being labeled severe during hospitalization or dying due to COVID-19. The risk classification tool was developed using retrospective data from all COVID-19 patients that were diagnosed until April 1st, 2020 in a large healthcare organization ("training set"). The developed tool combines 10 risk factors using simple summation, and defines three risk levels according to the patient's age and number of accumulated risk points - basic risk, high risk and very-high risk (the last two levels are also considered together as the elevated risk group). The tool's performance in accurately identifying individuals at risk was evaluated using a "temporal test set" of COVID-19 patients diagnosed between April 2nd and April 22nd, 2020, later than those used for model development. The tool's performance was also compared to that of the CDC's criteria. The healthcare organization's general population was used to evaluate the proportion of patients that would be classified to each of the model's risk levels and as elevated risk by the CDC criteria. Results: A total of 2,421, 2,624 and 4,631,168 individuals were included in the training, test, and general population cohorts, respectively. The outcome rate in the training and test sets was 5%. Overall, 18% of the general population would be classified at elevated risk by the model, with a resulting sensitivity of 92%, compared to 35% that would be defined as elevated risk by the CDC criteria, with a resulting sensitivity of 96%. Within the model's elevated risk groups, the high and very-high risk groups comprised 15% and 3% of the general population, with an incidence rate (PPV) of 15% and 33%, respectively. Discussion: A simple to communicate score-based risk classification tool classifies at elevated risk about half of the population that is considered to have an elevated risk by the CDC risk criteria, with only a 4% reduction in sensitivity. The model's ability to further divide the elevated risk population into two markedly different subgroups allows providing more refined recommendations to the general public and limiting the restrictions of social distancing to a smaller and more manageable subset of the population. This model was adopted by the Israeli ministry of health as its risk classification tool for COVID-19 lab tests prioritization and for targeting its instructions on risk management during the lockdown exit strategy.


title: Worldwide and Regional Forecasting of Coronavirus (Covid-19) Spread using a Deep Learning Model

text: In December 2019, Covid-19 epidemic was identified in Wuhan, China. Covid-19 may cause fatality especially among elderly, and people with chronic health problems. After human to human transmissions of the disease, it has rapidly spread throughout China, and then the outbreak has reached to neighboring countries in Asia. Now, the spread of the virus is accelerating in the world, and increasing number of new cases has been reported daily in Europe, Middle East, Africa and America regions. Recently, World Health Organization (WHO) also announced Covid-19 as a Pandemic. As of 3 April, worldwide around more than 1 million cases and around 60,000 fatalities are reported. Thus, forecasting regional and worldwide outbreak size of Covid-19 is important in order to take necessary actions regarding to preparedness plans and mitigation interventions. In this work, we design a deep learning model, which is an effective artificial intelligence method, to provide regional and worldwide forecasts. Particularly for worldwide, our approach predicts the cumulative number of cases, cumulative number of deaths and daily new cases. For Europe and Middle East regions, we predict the cumulative number of cases, and for Mainland China we predict daily new cases and the cumulative number of deaths. We predict the next 10 days based on the previously reported actual time series data of Covid-19. For worldwide forecasts, we use the data provided by Worldometers. For Europe and Middle East forecasts, we use the data provided by World Health Organization, and for China Mainland forecasts, the data is obtained from Chinese Centre for Disease Control and Prevention. This is the first time that a deep learning model has been employed for Covid-19 spread prediction, solely based on the known reported cases of Covid-19. The proposed deep learning architecture consists of Long Short Term Memory (LSTM) layer, dropout layer, and fully connected layers to predict regional and worldwide forecasts. We evaluate our approach with Root Mean Square Error (RMSE) metric. For forecasting, we use the network models that give the minimum RMSE on the last 3 days of actual data. Networks, which achieves the minimum RMSE on the last 3 days, are used to predict the next 10 days. Every day, the spread and situations are changing. Our approach can take into account these real-time changes; the deep learning model can be re-trained with new daily data and perform real-time forecasting. Results show that the proposed deep learning model is promising, it can predict possible scenarios regionally and globally for the spread of Covid-19.


title: Corona Virus Disease 2019 (COVID-19) Presenting as Acute ST Elevation Myocardial Infarction

text: Patients with Covid-19 disease commonly present with symptoms related to respiratory illness, and less commonly they develop cardiovascular complications either on presentation or during the course of the disease. The mortality/morbidity is high in these patients with cardiovascular involvement. Acute ST-elevation myocardial infarction (STEMI) is a medical emergency which needs immediate coronary re-perfusion for better patient outcomes. Here we present a patient who presented to the emergency room with acute STEMI and later tested positive for COVID-19. She was successfully treated with coronary revascularization and stent placement, and remains on the ventilator to date as she quickly developed acute respiratory distress syndrome. We need more research in Covid-19 patients with cardiovascular involvement for early diagnosis, prevention of exposure to health care workers and effective treatment.


title: Identifying the measurements required to estimate rates of COVID-19 transmission, infection, and detection, using variational data assimilation

text: We demonstrate the ability of statistical data assimilation to identify the measurements required for accurate state and parameter estimation in an epidemiological model for the novel coronavirus disease COVID-19. Our context is an effort to inform policy regarding social behavior, to mitigate strain on hospital capacity. The model unknowns are taken to be: the time-varying transmission rate, the fraction of exposed cases that require hospitalization, and the time-varying detection probabilities of new asymptomatic and symptomatic cases. In simulations, we obtain accurate estimates of undetected (that is, unmeasured) infectious populations, by measuring the detected cases together with the recovered and dead - and without assumed knowledge of the detection rates. These state estimates require a measurement of the recovered population, and are tolerant to low errors in that measurement. Further, excellent estimates of all quantities are obtained using a temporal baseline of 112 days, with the exception of the time-varying transmission rate at times prior to the implementation of social distancing. The estimation of this transmission rate is sensitive to contamination in the data, highlighting the need for accurate and uniform methods of reporting. Finally, we employ the procedure using real data from Italy reported by Johns Hopkins. The aim of this paper is not to assign extreme significance to the results of these specific experiments textit{per se}. Rather, we intend to exemplify the power of SDA to determine what properties of measurements will yield estimates of unknown model parameters to a desired precision - all set within the complex context of the COVID-19 pandemic.


title: Early viral clearance and antibody kinetics of COVID-19 among asymptomatic carriers

text: Background Asymptomatic carriers contribute to the spread of Coronavirus Disease 2019 (COVID-19), but their clinical characteristics, viral kinetics, and antibody responses remain unclear. Methods A total of 56 COVID-19 patients without symptoms at admission and 19 age-matched symptomatic patients were enrolled. RNA of SARS-CoV-2 was tested using transcriptase quantitative PCR, and the total antibodies (Ab), IgG, IgA and IgM against the SARS-CoV-2 were tested using Chemiluminescence Microparticle Immuno Assay. Results Among 56 patients without symptoms at admission, 33 cases displayed symptoms and 23 remained asymptomatic throughout the follow-up period. 43.8% of the asymptomatic carriers were children and none of the asymptomatic cases had recognizable changes in C-reactive protein or interleukin-6, except one 64-year-old patient. The initial threshold cycle value of nasopharyngeal SARS-CoV-2 in asymptomatic carriers was similar to that in pre-symptomatic and symptomatic patients, but the communicable period of asymptomatic carriers (9.63 days) was shorter than pre-symptomatic patients (13.6 days). There was no obvious differences of the seropositive conversion rate of total Ab, IgG, and IgA among the three groups, though the rates of IgM varied largely. The average peak IgG and IgM COI of asymptomatic cases was 3.5 and 0.8, respectively, which is also lower than those in symptomatic patients with peaked IgG and IgM COI of 4.5 and 2.4 (p <0.05). Conclusion Young COVID-19 patients seem to be asymptomatic cases with early clearance of SARS-CoV-2 and low levels of IgM generation but high total Ab, IgG and IgA. Our findings provide empirical information for viral clearance and antibody kinetics of asymptomatic COVID-19 patients.


title: Community responses during the early phase of the COVID-19 epidemic in Hong Kong: risk perception, information exposure and preventive measures

text: Background: Community responses are important for outbreak management during the early phase when non-pharmaceutical interventions are the major preventive options. Therefore, this study aims to examine the psychological and behavioral responses of the community during the early phase of the COVID-19 epidemic in Hong Kong. Method: A cross-sectional online survey was launched within 36 hours after confirmed COVID-19 cases were first reported. Councilors of all 452 district council constituency areas were approached for survey dissemination. Respondent demographics, anxiety level, risk perception, sources to retrieve COVID-19 information, actual adoption and perceived efficacy of precautionary measures were collected. Result: Analysis from 1715 complete responses indicated high perceived susceptibility (89%) and high perceived severity (97%). Most respondents were worried about COVID-19 (97%), and had their daily routines disrupted (slightly/greatly: 98%). The anxiety level, measured by the Hospital Anxiety and Depression Scale, was borderline abnormal (9.01). Nearly all respondents were alert to the disease progression (99.5%). The most trusted information sources were doctors (84%), followed by broadcast (57%) and newspaper (54%), but they were not common information sources (doctor: 5%; broadcast: 34%; newspaper: 40%). Only 16% respondents found official websites reliable. Enhanced personal hygiene practices and travel avoidance to China were frequently adopted (>77%) and considered effective (>90%). The adoption of social-distancing measures was lower (39%-88%), and their drivers for greater adoption include: being female (adjusted odds ratio [aOR]:1.27), living in the New Territories (aOR:1.32-1.55), perceived as having good understanding of COVID-19 (aOR:1.84) and being more anxious (aOR:1.07). Discussion: Risk perception towards COVID-19 in the community was high. Most respondents are alert to the disease progression, and adopt self-protective measures. This study contributes by examining the psycho-behavioral responses of hosts, in addition to the largely studied mechanistic aspects, during the early phase of the current COVID-19 epidemic. The timely psychological and behavioral assessment of the community is useful to inform subsequent interventions and risk communication strategies as the epidemic progresses.


title: Clinical presentation and evolution of COVID-19 in immunosuppressed patients. Preliminary evaluation in a North Italian cohort on calcineurin-inhibitors based therapy

text: The clinical course of COVID-19 in patients undergoing chronic immunosuppressive therapy is yet poorly known. We performed a monocentric cross-sectional study describing the clinical course of COVID-19 in a cohort of patients from northern Italy treated with calcineurin-inhibitors for organ transplantation or rheumatic diseases. Data were collected by phone call and clinical chart review between March 27th- 31st 2020. COVID-19 related symptoms, rynopharingeal swab, therapeutic changes and outcome were assessed in 384 consecutive patients (57% males; median age 61 years, IQR 48-69). 331 patients (86%) received solid organ transplantation (kidney n=140, 36%, heart n=100, 26%, lung n=91, 24%) and 53 (14%) had a rheumatic disease. Calcineurin inhibitors were the only immunosuppressant administered in 46 patients (12%). 14 patients developed a confirmed COVID-19 (swab positivity) and 14 a clinical COVID-19 (only typical symptoms). Fever (75%) and diarrhoea (50%) were the most common symptoms. Fourteen patients were hospitalized and 11 have already been dismissed. No patient required start/changes of the O2 therapy or developed superinfection. Only one patient, with metastatic lung cancer, died. In conclusion, COVID-19 showed a mild course in our cohort, with low mortality. Calcineurin inhibitor-based immunosuppressive regimens appear safe in this context and should not be discontinued.