title: COVID-19 and gynecological cancer: a review of the published guidelines

text: On March 11, 2020 the COVID-19 outbreak was declared a 'pandemic' by the World Health Organization. COVID-19 is associated with higher surgical morbidity and mortality. An array of guidelines on the management of cancer during this pandemic have been published since the first reports of the outbreak. This narrative review brings all the relevant information from the guidelines together into one document, to support patient care. We present a detailed review of published guidelines, statements, comments from peer-reviewed journals, and nationally/internationally recognized professional bodies and societies' web pages (in English or with English translation available) between December 1, 2019 and May 27, 2020. Search terms included combinations of COVID, SARS-COV-2, guideline, gynecology, oncology, gynecological, cancer. Recommendations for surgical and oncological prioritization of gynecological cancers are discussed and summarized. The role of minimally invasive surgery, patient perspectives, medico-legal aspects, and clinical trials during the pandemic are also discussed. The consensus is that elective benign surgery should cease and cancer surgery, chemotherapy, and radiotherapy should continue based on prioritization. Patient and staff face-to-face interactions should be limited, and health resources used efficiently using prioritization strategies. This review and the guidelines on which it is based support the difficult decisions currently facing us in gynecological cancer. It is a balancing act: limited resources and a hostile environment pitted against the time-sensitive nature of cancer treatment. We can only hope to do our best for our patients with the resources available to us.


title: Who is going to pay the price of Covid-19? Reflections about an unequal Brazil

text: The COVID-19 pandemic has caused high mortality rates among older people, and in order to avoid a healthcare system crisis, almost all countries worldwide have adopted social isolation measures to prevent the spread of the disease. However, in Brazil, a country demarcated by economic inequalities, in which approximately 25% of the population live below the poverty line, these measures will cost severe economic losses and accentuated starvation. For this reason, the underprivileged population should be immediately prioritized and well informed through good practice to avoid the virus. Since, government discrepancies in dealing with the COVID-19 outbreak leaves the population without congruent guidelines on how to react or what to believe, allowing the spread of fake news and political crises. Here, we discuss who will pay the price of the Brazilian government denying the impact of COVID-19 pandemic and suggest some measures to ensure that clear information and protection reach this population.


MCAT Testing During the COVID-19 Pandemic


[ACE2 in the context of 2019-nCoV infection: friend or foe?]


title: Cerebrovascular disease in patients with COVID-19: neuroimaging, histological and clinical description

text: Since the appearance of the first case of coronavirus disease 2019 (COVID-19) a pandemic has emerged affecting millions of people worldwide. Although the main clinical manifestations are respiratory, an increase in neurological conditions, specifically acute cerebrovascular disease, has been detected. We present cerebrovascular disease case incidence in hospitalized patients with SARS-CoV-2 infection. Patients were confirmed by microbiological/serological testing, or on chest CT semiology. Available data on comorbidity, laboratory parameters, treatment administered, neuroimaging, neuropathological studies and clinical evolution during hospitalization, measured by the modified Rankin scale, were analysed. A bivariate study was also designed to identify differences between ischaemic and haemorrhagic subtypes. A statistical model of binary logistic regression and sensitivity analysis was designed to study the influence of independent variables over prognosis. In our centre, there were 1683 admissions of patients with COVID-19 over 50 days, of which 23 (1.4%) developed cerebrovascular disease. Within this group of patients, cerebral and chest CT scans were performed in all cases, and MRI in six (26.1%). Histological samples were obtained in 6/23 cases (two brain biopsies, and four arterial thrombi). Seventeen patients were classified as cerebral ischaemia (73.9%, with two arterial dissections), five as intracerebral haemorrhage (21.7%), and one leukoencephalopathy of posterior reversible encephalopathy type. Haemorrhagic patients had higher ferritin levels at the time of stroke (1554.3 versus 519.2, P = 0.004). Ischaemic strokes were unexpectedly frequent in the vertebrobasilar territory (6/17, 35.3%). In the haemorrhagic group, a characteristic radiological pattern was identified showing subarachnoid haemorrhage, parieto-occipital leukoencephalopathy, microbleeds and single or multiple focal haematomas. Brain biopsies performed showed signs of thrombotic microangiopathy and endothelial injury, with no evidence of vasculitis or necrotizing encephalitis. The functional prognosis during the hospital period was unfavourable in 73.9% (17/23 modified Rankin scale 4-6), and age was the main predictive variable (odds ratio = 1.5; 95% confidence interval 1.012-2.225; P = 0.043). Our series shows cerebrovascular disease incidence of 1.4% in patients with COVID-19 with high morbidity and mortality. We describe pathological and radiological data consistent with thrombotic microangiopathy caused by endotheliopathy with a haemorrhagic predisposition.


title: Fra cure intensive e cure palliative ai tempi di CoViD-19./ [Between intensive care and palliative care at the time of CoViD-19.]

text: The pandemic infection caused by the virus SARS-CoV-2 has determined a severe imbalance between demand and actual supply of intensive care. The shortage of intensive care units (ICU) beds and ventilators for the treatment of patients with severe respiratory failure produced angst in the clinicians/intensivists who have to decide which patients admit to ICU and in which patients to implement palliative care. They have to apply specific clinical and ethical criteria, in emergency conditions. Proportionality and appropriateness criteria should be integrated with equity, equality, utility criteria, widening the distributive justice concept from the right of the patient to receive all available therapies to a right resources allocation during shortage, guided by public health ethic. The clinical criteria should include the disease severity, the number and severity of comorbidities, frailty, the organ failures and their stage, the patient's age, the functional autonomy and cognitive status. Consequently the first come-first served rule to ICU admission should not be applied. The patients not admitted to ICU due to clinical reasons and advanced stage diseases should receive a high quality palliative care, to obtain a good symptoms control (mainly dyspnea, anxiety and delirium) and to implement palliative sedation at the end of life. Finally particular attention should be paid to the bereavement management of the family/caregivers and in the right approach of psychological problems and Post-Traumatic Stress Disorder of health workers involved in the pandemia.


Gastroenterological features of COVID-19 and the role of the United European Gastroenterology Journal


title: Nurse Staffing and Coronavirus Infections in California Nursing Homes

text: In the United States, 1.4 million nursing home residents have been severely impacted by the COVID-19 pandemic with at least 25,923 resident and 449 staff deaths reported from the virus by June 1, 2020. The majority of residents have chronic illnesses and conditions and are vulnerable to infections and many share rooms and have congregate meals. There was evidence of inadequate registered nurse (RN) staffing levels and infection control procedures in many nursing homes prior to the outbreak of the virus. The aim of this study was to examine the relationship of nurse staffing in California nursing homes and compare homes with and without COVID-19 residents. Study data were from both the California and Los Angeles Departments of Public Health and as well as news organizations on nursing homes reporting COVID-19 infections between March and May 4, 2020. Results indicate that nursing homes with total RN staffing levels under the recommended minimum standard (0.75 hours per resident day) had a two times greater probability of having COVID-19 resident infections. Nursing homes with lower Medicare five-star ratings on total nurse and RN staffing levels (adjusted for acuity), higher total health deficiencies, and more beds had a higher probability of having COVID-19 residents. Nursing homes with low RN and total staffing levels appear to leave residents vulnerable to COVID-19 infections. Establishing minimum staffing standards at the federal and state levels could prevent this in the future.


title: An Evaluation of Florida's Zika Response Using the WHO Health Systems Framework: Can We Apply These Lessons to COVID-19?

text: OBJECTIVES: From 2016 to 2018 Florida documented 1471 cases of Zika virus, 299 of which were pregnant women (Florida Department of Health, https://www.floridahealth.gov/diseases-and-conditions/mosquito-bornediseases/surveillance.html, 2019a). Florida's response required unprecedented rapid and continuous cross-sector communication, adaptation, and coordination. Zika tested public health systems in new ways, particularly for maternal child health populations. The systems are now being challenged again, as the Coronavirus COVID-19 pandemic spreads throughout Florida. This qualitative journey mapping evaluation of Florida's response focused on care for pregnant women and families with infants exposed to Zika virus. METHODS: Fifteen focus groups and interviews were conducted with 33 public health and healthcare workers who managed outbreak response, case investigations, and patient care in south Florida. Data were thematically analyzed, and the results were framed by the World Health Organization's (WHO) Healthcare Systems Framework of six building blocks: health service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership and governance (World Health Organization, https://www.who.int/healthsystems/strategy/everybodys_business.pdf, 2007, https://www.who.int/healthinfo/systems/monitoring/en/, 2010). RESULTS: Results highlighted coordination of resources, essential services and treatment, data collection, communication among public health and healthcare systems, and dissemination of information. Community education, testing accuracy and turnaround time, financing, and continuity of health services were areas of need, and there was room for improvement in all indicator areas. CONCLUSIONS: The WHO Framework encapsulated important infrastructure and process factors relevant to the Florida Zika response as well as future epidemics. In this context, similarities, differences, and implications for the Coronavirus COVID-19 pandemic response are discussed.


title: Protease Inhibitors: Candidate Drugs to Inhibit Severe Acute Respiratory Syndrome Coronavirus 2 Replication

text: The number of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly increased, although the WHO declared a pandemic. However, drugs that function against SARS-CoV-2 have not been established. SARS-CoV-2 has been suggested to bind angiotensin-converting enzyme 2, the receptor of the SARS coronavirus. SARS coronavirus and coronavirus 229E, the cause of the common cold, replicate through cell-surface and endosomal pathways using a protease, the type II transmembrane protease. To examine the effects of protease inhibitors on the replication of coronavirus 229E, we pretreated primary cultures of human nasal epithelial (HNE) cells with camostat or nafamostat, each of which has been used for the treatment of pancreatitis and/or disseminated intravascular coagulation. HNE cells were then infected with coronavirus 229E, and viral titers in the airway surface liquid of the cells were examined. Pretreatment with camostat (0.1-10 µg/mL) or nafamostat (0.01-1 µg/mL) reduced the titers of coronavirus 229E. Furthermore, a significant amount of type II transmembrane protease protein was detected in the airway surface liquid of HNE cells. Additionally, interferons have been reported to have antiviral effects against SARS coronavirus. The additive effects of interferons on the inhibitory effects of other candidate drugs to treat SARS-CoV-2 infection, such as lopinavir, ritonavir and favipiravir, have also been studied. These findings suggest that protease inhibitors of this type may inhibit coronavirus 229E replication in human airway epithelial cells at clinical concentrations. Protease inhibitors, interferons or the combination of these drugs may become candidate drugs to inhibit the replication of SARS-CoV-2.


title: Policy over- and under-design: an information quality perspective

text: This article seeks to improve our understanding of what policy over- and under-design mean; what are the consequences of these suboptimal designs; and how politics matters to these designs. Based on the review of the literature and a variety of examples that focus on the role of information quality in policy design, and drawing on two phenomena from the field of epidemiology (namely, over-adjustment and unnecessary adjustment), the article enhances the definitional clarity of the terms under investigation and allows us to address the difficulty in reconciling technical problem solving with politics. The article proposes new definitional statements of proportionate and disproportionate policy designs that vary according to the extent to which the main design properties are adjusted to low-quality information. It also explores distinct variations in a few policy characteristics resulting from over- and under-design. The policy characteristics examined here include economic efficiency, policy effectiveness, policy robustness; the space for making significant changes at a later stage when high-quality information becomes available; the potential consequences in terms of policy over- and under-reaction; and the political ramifications of these suboptimal designs for elected executives. With regard to the interaction between technical and political logics, the article posits that deliberate policy over- and under-design can be viewed as solutions to serious political problems faced by elected executives, especially in politically sensitive times. Therefore, it facilitates a more realistic understanding of the conditions under which a policy is under- or over-designed to respond to some objectives but entirely proportionate with regard to others.


Covid-19: US governors call for government help to secure more tests


COVID-19 patients for tracheostomy: Anesthetic and team considerations


Computed Tomographic Findings in COVID-19


title: Comment on"Landau equation and QCD sum rules for the tetraquark molecular states"[Phys. Rev. D 101, 074011 (2020)]

text: Recently, a QCD sum-rule analysis of tetraquark molecular states has been published, having the objective of demonstrating that our previously formulated tetraquark-adequate QCD sum rules are not correct. This comment brings to the attention of the reader inconsistencies in that article and explains some subtle details of QCD sum rules for exotic states.


title: Negligible risk of the COVID-19 resurgence caused by work resuming in China (outside Hubei): a statistical probability study

text: The COVID-19 outbreak in China appears to reach the late stage since late March 2020, and a stepwise restoration of economic operations is implemented. Risk assessment for such economic restoration is of significance. Here, we estimated the probability of COVID-19 resurgence caused by work resuming in typical provinces/cities and found that such probability is very limited (<5% for all the regions except Beijing). Our work may inform provincial governments to make risk level-based, differentiated control measures.


T cells found in coronavirus patients 'bode well' for long-term immunity


title: Evaluation of antiviral therapies for coronavirus disease 2019 pneumonia in Shanghai, China

text: The aim of our study was to evaluate the therapeutic effect of antiviral drugs on coronavirus disease 2019 (COVID-19) pneumonia. Patients confirmed with COVID-19 pneumonia were enrolled and divided into seven groups according to the treatment option. Information including age, sex, and duration from illness onset to admission, clinical manifestations, and laboratory data at admission, and length of hospital stay were evaluated. The chest computed tomography (CT) imaging obtained at admission and after a 5-day treatment cycle were assessed. The clinical symptoms and laboratory tests at discharge were also assessed. At admission, no significant differences were found among the groups, including the duration from illness onset to admission, clinical symptoms, and main laboratory results. No significant differences were found among the groups in terms of the proportion of patients with pneumonia resolution (P = .151) after treatment or the length of hospital stay (P = .116). At discharge, 7 of 184 (4%) patients had a mild cough while their other symptoms had disappeared, and the proportion of patients with abnormal liver function and with increased leukocytes, neutrophils or erythrocyte sedimentation rate among the 184 patients were close to those at admission. According to the results, the inclusion of antiviral drugs in therapeutic regimens based on symptomatic treatment had no significant additional impact on the improvement in COVID-19 patients. In addition, the results of chest CT imaging, clinical manifestations, and laboratory tests at discharge were not completely consistent.


Offline: A novel solution to live with coronavirus


title: Diagnostic accuracy of an automated chemiluminescent immunoassay for anti-SARS-CoV-2 IgM and IgG antibodies: an Italian experience

text: A pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been spreading throughout the world. Though molecular diagnostic tests are the gold standard for COVID-19, serological testing is emerging as a potential surveillance tool, in addition to its complementary role in COVID-19 diagnostics. Indubitably quantitative serological testing provides greater advantages than qualitative tests but today there is still little known about serological diagnostics and what the most appropriate role quantitative tests might play. Sixty-one COVID-19 patients and 64 patients from a control group were tested by iFlash1800 CLIA analyzer for anti-SARS CoV-2 antibodies IgM and IgG. All COVID-19 patients were hospitalized in San Giovanni di Dio Hospital (Florence, Italy) and had a positive oro/nasopharyngeal swab reverse-transcription polymerase chain reaction result. The highest sensitivity with a very good specificity performance was reached at a cutoff value of 10.0 AU/mL for IgM and of 7.1 for IgG antibodies, hence near to the manufacturer's cutoff values of 10 AU/mL for both isotypes. The receiver operating characteristic curves showed area under the curve values of 0.918 and 0.980 for anti-SARS CoV-2 antibodies IgM and IgG, respectively. iFlash1800 CLIA analyzer has shown highly accurate results for the anti-SARS-CoV-2 antibodies profile and can be considered an excellent tool for COVID-19 diagnostics.


Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic


title: Pollen likely seasonal factor in inhibiting flu-like epidemics. A Dutch study into the inverse relation between pollen counts, hay fever and flu-like incidence 2016-2019

text: There is uncertainty if current models for the Covid-19 pandemic should already take into account seasonality. That is because current environmental factors do not provide a powerful explanation of such seasonality, especially given climate differences between countries with moderate climates. It is hypothesized that one major factor is overlooked: pollen count. Pollen are documented to invoke strong immune responses and might create an environmental factor that makes it more difficult for flu-like viruses to survive outside a host. This Dutch study confirms that there is a (highly) significant inverse correlation between pollen count and weekly changes in medical flu consults, and that there is a highly significant inverse correlation between hay fever incidence, as measured by prescribed medication revenues, and weekly flu consults. This supports the idea that pollen are a direct or indirect factor in the seasonality of flu-like epidemics. If seasonality will be observed during the covid-19 spread as well, it is not unlikely that pollen play a role.


The challenge of laypeople cardio-pulmonary resuscitation training during and after COVID-19 pandemic


Causes of hypogeusia/hyposmia in SARS-CoV2 infected patients


title: The Spread of the Covid-19 Pandemic in Time and Space

text: As the COVID-19 pandemic has had a profound impact on public health and global economies in 2020; it is crucial to understand how it developed and spread in time and space. This paper contributes to the growing literature by considering the dynamics of country-wise growth rates of infection numbers. Low-order serial correlation of growth rates is predominantly negative with cycles of two to four days for most countries. The results of fitted spatial autoregressive models suggest that there is high degree of spillover between countries. Forecast variances of many countries, in particular those with a high absolute number of infections, can to a large extent be explained by structural innovations of other countries. A better understanding of the serial and spatial dynamics of the spread of the pandemic may contribute to an improved containment and risk management.


title: Combination of four clinical indicators predicts the severe/critical symptom of patients infected COVID-19

text: BACKGROUND: Despite the death rate of COVID-19 is less than 3%, the fatality rate of severe/critical cases is high, according to World Health Organization (WHO). Thus, screening the severe/critical cases before symptom occurs effectively saves medical resources. METHODS AND MATERIALS: In this study, all 336 cases of patients infected COVID-19 in Shanghai to March 12th, were retrospectively enrolled, and divided in to training and test datasets. In addition, 220 clinical and laboratory observations/records were also collected. Clinical indicators were associated with severe/critical symptoms were identified and a model for severe/critical symptom prediction was developed. RESULTS: Totally, 36 clinical indicators significantly associated with severe/critical symptom were identified. The clinical indicators are mainly thyroxine, immune related cells and products. Support Vector Machine (SVM) and optimized combination of age, GSH, CD3 ratio and total protein has a good performance in discriminating the mild and severe/critical cases. The area under receiving operating curve (AUROC) reached 0.9996 and 0.9757 in the training and testing dataset, respectively. When the using cut-off value as 0.0667, the recall rate was 93.33 % and 100 % in the training and testing datasets, separately. Cox multivariate regression and survival analyses revealed that the model significantly discriminated the severe/critical cases and used the information of the selected clinical indicators. CONCLUSION: The model was robust and effective in predicting the severe/critical COVID cases.


title: In response: Diabetes is a risk factor for the progression and prognosis of COVID-19

text: The article cited does not differentiate between Type I and Type II diabetes. More information is needed to properly assess risk.


title: COVID-19 TestNorm - A tool to normalize COVID-19 testing names to LOINC codes

text: Large observational data networks that leverage routine clinical practice data in electronic health records (EHRs) are critical resources for research on COVID-19. Data normalization is a key challenge for the secondary use of EHRs for COVID-19 research across institutions. In this study, we addressed the challenge of automating the normalization of COVID-19 diagnostic tests, which are critical data elements, but for which controlled terminology terms were published after clinical implementation. We developed a simple but effective rule-based tool called COVID-19 TestNorm to automatically normalize local COVID-19 testing names to standard LOINC codes. COVID-19 TestNorm was developed and evaluated using 568 test names collected from eight healthcare systems. Our results show that it could achieve an accuracy of 97.4% on an independent test set. COVID-19 TestNorm is available as an open-source package for developers and as an online web application for end-users (https://clamp.uth.edu/covid/loinc.php). We believe it will be a useful tool to support secondary use of EHRs for research on COVID-19.


Active Telephonic Follow-up During COVID-19 Lockdown: Initial Experience


title: Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China

text: OBJECTIVES: The purpose of this study was to observe the imaging characteristics of the novel coronavirus pneumonia. METHODS: Sixty-three confirmed patients were enrolled from December 30, 2019 to January 31, 2020. High-resolution CT (HRCT) of the chest was performed. The number of affected lobes, ground glass nodules (GGO), patchy/punctate ground glass opacities, patchy consolidation, fibrous stripes and irregular solid nodules in each patient's chest CT image were recorded. Additionally, we performed imaging follow-up of these patients. RESULTS: CT images of 63 confirmed patients were collected. M/F ratio: 33/30. The mean age was 44.9 ± 15.2 years. The mean number of affected lobes was 3.3 ± 1.8. Nineteen (30.2%) patients had one affected lobe, five (7.9%) patients had two affected lobes, four (6.3%) patients had three affected lobes, seven (11.1%) patients had four affected lobes while 28 (44.4%) patients had 5 affected lobes. Fifty-four (85.7%) patients had patchy/punctate ground glass opacities, 14 (22.2%) patients had GGO, 12 (19.0%) patients had patchy consolidation, 11 (17.5%) patients had fibrous stripes and 8 (12.7%) patients had irregular solid nodules. Fifty-four (85.7%) patients progressed, including single GGO increased, enlarged and consolidated; fibrous stripe enlarged, while solid nodules increased and enlarged. CONCLUSIONS: Imaging changes in novel viral pneumonia are rapid. The manifestations of the novel coronavirus pneumonia are diverse. Imaging changes of typical viral pneumonia and some specific imaging features were observed. Therefore, we need to strengthen the recognition of image changes to help clinicians to diagnose quickly and accurately. KEY POINTS: â¢ High-resolution CT (HRCT) of the chest is critical for early detection, evaluation of disease severity and follow-up of patients with the novel coronavirus pneumonia. â¢ The manifestations of the novel coronavirus pneumonia are diverse and change rapidly. â¢ Radiologists should be aware of the various features of the disease and temporal changes.


Telemedicine and technological devices for amyotrophic lateral sclerosis in the era of COVID-19


Physician Moms Group: the support network that's needed more than ever during the covid-19 pandemic


COVID-19 outbreak impact on neonatal emergency transport


title: Impaired cardiac function is associated with mortality in patients with acute COVID-19 infection

text: BACKGROUND: COVID-19 infection may cause severe respiratory distress and is associated with increased morbidity and mortality. Impaired cardiac function and/or pre-existing cardiovascular disease may be associated with poor prognosis. In the present study, we report a comprehensive cardiovascular characterization in the first consecutive collective of patients that was admitted and treated at the University Hospital of Tübingen, Germany. METHODS: 123 consecutive patients with COVID-19 were included. Routine blood sampling, transthoracic echocardiography and electrocardiography were performed at hospital admission. RESULTS: We found that impaired left-ventricular and right-ventricular function as well as tricuspid regurgitation > grade 1 were significantly associated with higher mortality. Furthermore, elevated levels of myocardial distress markers (troponin-I and NT pro-BNP) were associated with poor prognosis in this patient collective. CONCLUSION: Impaired cardiac function is associated with poor prognosis in COVID-19 positive patients. Consequently, treatment of these patients should include careful guideline-conform cardiovascular evaluation and treatment. Thus, formation of a competent Cardio-COVID-19 team may represent a major clinical measure to optimize therapy of cardiovascular patients during this pandemic.


Re: Low-dose corticosteroid therapy does not delay viral clearance in patients with COVID-19


title: Prediction for Progression Risk in Patients with COVID-19 Pneumonia: the CALL Score

text: BACKGROUND: We aimed to clarify the high-risk factors with multivariate analysis and establish a prediction of disease progression, so as to help clinicians to better choose therapeutic strategy. METHODS: All the consecutive patients with COVID-19 admitted to Fuyang second people's hospital or the fifth medical center of Chinese PLA general hospital between January 20 and February 22, 2020, were enrolled and their clinical data were retrospectively collected. Multivariate COX regression was used to identify the risk factors associated with progression, and then were incorporated into the nomogram to establish a novel prediction scoring model. ROC was used to assess the performance of the novel model. RESULTS: Overall, 208 patients were divided into stable group (n=168, 80.8%) and progressive group (n=40,19.2%) based on whether their conditions worsened during the hospitalization Univariate and multivariate analysis showed that comorbidity, older age, lower lymphocyte and higher lactate dehydrogenase at presentation were independent high-risk factors for COVID-19 progression. Incorporating these 4 factors, the nomogram achieved good concordance indexes of 0.86 (95%CI 0.81 - 0.91), and had well-fitted calibration curves. A novel scoring model, named as CALL, was established, and its area under ROC was 0.91 (95% CI 0.86 to 0.94). Using a cutoff value of 6 points, the positive and negative predictive values were 50.7% (38.9% - 62.4%) and 98.5% (94.7% - 99.8%), respectively. CONCLUSION: Using the CALL score model, clinicians can improve the therapeutic effect and reduce the mortality of COVID-19 with more accurate and reasonable resolutions on medical resources.


docid: tctfxzrc

title: SARS-CoV-2 infection in liver-Author's reply


title: Main Routes of Entry and Genomic Diversity of SARS-CoV-2, Uganda

text: We established rapid local viral sequencing to document the genomic diversity of severe acute respiratory syndrome coronavirus 2 entering Uganda. Virus lineages closely followed the travel origins of infected persons. Our sequence data provide an important baseline for tracking any further transmission of the virus throughout the country and region.


Why Choose Cyclosporin A as First-line Therapy in COVID-19 Pneumonia


First Case of Covid-19 in the United States


Baseline use of hydroxychloroquine in systemic lupus erythematosus does not preclude SARS-CoV-2 infection and severe COVID-19


title: The mental health of health care workers in Oman during the COVID-19 pandemic

text: BACKGROUND: COVID-19 disease is one of the most destructive events that humanity has witnessed in the 21st century. It has impacted all aspects of life and all segments of populations, including already vulnerable health care providers. AIMS: This study sought to detect the prevalence of mental health issues in sample of physicians and nurses working in several health facilities in Oman. METHOD: We gauged the mental health conditions of 509 physicians (38.1%) and nurses (61.9 %) using the Perceived Stress Scale, Generalized Anxiety Disorder Scale and World Health Organization Well-Being Index. RESULTS: The study revealed a high prevalence of stress, anxiety and poor psychological well-being, especially among females, young health care workers and those who interacted with known or suspected COVID-19 patients. CONCLUSION: The outcomes of this study support the handful of studies published during this global health crisis that have found that the mental health of health care workers has been harshly affected and predicted that it will continue, to various degrees, to be affected in the foreseeable future. The results of this study highlight the urgency of providing administrative and psychological support as well as current and accurate information on COVID-19 to health care workers.


title: Fortalezas y limitaciones de los modelos matemáticos en las pandemias: el caso de COVID-19 en Chile./ Fortalezas y limitaciones de los modelos matemáticos en las pandemias: el caso de COVID-19 en Chile./ Strengths and limitations of mathematical models in pandemicsthe case of COVID-19 in Chile

text: This short paper focuses on the role of mathematical models to analyze the impact of pandemics on health resources and the different trade-offs that may be included in them. There is a large body of literature suggesting that mathematical modeling may be helpful to estimate how much additional equipment and infrastructure are necessary to mitigate an increase in demand for health services during a large-scale outbreak of an infectious disease. I comment on the crucial role of these models with a special focus on their strengths and limitations.


Quelle conduite à tenir pour le suivi des patients glaucomateux en cette période d'épidémie de Covid-19 à virus SARS-CoV-2 ?/ [How to approach follow-up of glaucoma patients during COVID-19 pandemic]


title: The role of angiotensin-converting enzyme 2 in coronaviruses/influenza viruses and cardiovascular disease

text: Angiotensin-converting enzyme 2 (ACE2) has emerged as a key regulator of the renin-angiotensin system in cardiovascular (CV) disease and plays a pivotal role in infections by coronaviruses and influenza viruses. The present review is primarily focused on the findings to indicate the role of ACE2 in the relationship of coronaviruses and influenza viruses to CV disease. It is postulated that the risk of coronavirus or influenza virus infection is high, at least partly due to high ACE2 expression in populations with a high CV risk. Coronavirus and influenza virus vaccine usage in high CV risk populations could be a potential strategy to prevent both CV disease and coronavirus/influenza virus infections.


title: COVID-19 and ART: the view of the Italian Society of Fertility and Sterility and Reproductive Medicine

text: The COVID-19 pandemic is an unprecedented global situation. As assisted reproductive technology (ART) specialists, we should be cautious, carefully monitoring the situation while contributing by sharing novel evidence to counsel our patients, both pregnant women and would-be mothers. Time to egg collection and drop-out rates are critical parameters for scheduling treatments once the curve of infections has peaked and plateaued in each country. In order to reduce the values for these two parameters, infertile patients now require even more support from their IVF team: urgent oocyte collection for oncology patients must be guaranteed, and oocyte retrievals for women of advanced maternal age and/or reduced ovarian reserve cannot be postponed indefinitely. This document represents the position of the Italian Society of Fertility and Sterility and Reproductive Medicine (SIFES-MR) in outlining ART priorities during and after this emergency.


COVID-19 and cancer care in Bermuda


title: The impact of COVID-19 on neurosurgeons and the strategy for triaging non-emergent operations: a global neurosurgery study

text: OBJECT: The COVID-19 pandemic has disrupted all aspects of society globally. As healthcare resources had to be preserved for infected patients, and the risk of in-hospital procedures escalated for uninfected patients and staff, neurosurgeons around the world have had to postpone non-emergent procedures. Under these unprecedented conditions, the decision to defer cases became increasingly difficult as COVID-19 cases skyrocketed. METHODS: Data was collected by self-reporting surveys during two discrete periods: the principal survey accrued responses during 2 weeks at the peak of the global pandemic, and the supplemental survey accrued responses after that to detect changes in opinions and circumstances. Nine hypothetical surgical scenarios were used to query neurosurgeons' opinion on the risk of postponement and the urgency to re-schedule the procedures. An acuity index was generated for each scenario, and this was used to rank the nine cases. RESULTS: There were 494 respondents to the principal survey from 60 countries. 258 (52.5%) reported that all elective cases and clinics have been shut down by their main hospital. A total of 226 respondents (46.1%) reported that their operative volume had dropped more than 50%. For the countries most affected by COVID-19, this proportion was 54.7%. There was a high degree of agreement among our respondents that fast-evolving neuro-oncological cases are non-emergent cases that nonetheless have the highest risk in postponement, and selected vascular cases may have high acuity as well. CONCLUSION: We report on the impact of COVID-19 on neurosurgeons around the world. From their ranking of the nine case scenarios, we deduced a strategic scheme that can serve as a guideline to triage non-emergent neurosurgical procedures during the pandemic. With it, hopefully, neurosurgeons can continue to serve their patients without endangering them either neurologically or risking their exposure to the deadly virus.


Letter to editor: Severe brain haemorrhage and concomitant COVID-19 Infection: A neurovascular complication of COVID-19


title: A Case of Critically Ill Infant of Coronavirus Disease 2019 With Persistent Reduction of T Lymphocytes

text: BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) is becoming a global threat. However, our understanding of the clinical characteristics and treatment of critically ill pediatric patients and their ability of transmitting the coronavirus that causes COVID-19 still remains inadequate because only a handful pediatric cases of COVID-19 have been reported. METHODS: Epidemiology, clinical characteristics, treatment, laboratory data and follow-up information and the treatment of critically ill infant were recorded. RESULTS: The infant had life-threatening clinical features including high fever, septic shock, recurrent apnea, petechiae and acute kidney injury and persistent declined CD3+, CD4+ and CD8+ T cells. The duration of nasopharyngeal virus shedding lasted for 49 days even with the administration of lopinavir/ritonavir for 8 days. The CD3+, CD4+ and CD8+ T cells was partially recovered 68 days post onset of the disease. Accumulating of effector memory CD4+ T cells (CD4+TEM) was observed among T-cell compartment. The nucleic acid tests and serum antibody for the severe acute respiratory syndrome coronavirus 2 of the infant's mother who kept intimate contact with the infant were negative despite no strict personal protection. CONCLUSIONS: The persistent reduction of CD4+ and CD8+ T cells was the typical feature of critically ill infant with COVID-19. CD4+ and CD8+ T cells might play a key role in aggravating COVID-19 and predicts a more critical course in children. The prolonged nasopharyngeal virus shedding was related with the severity of respiratory injury. The transmission of SARS-CoV-2 from infant (even very critical cases) to adult might be unlikely.


title: Gestión Y Liderazgo De Los Servicios De Enfermería En El Plan De Emergencia De La Pandemia Covid-19: La Experiencia Del Hospital Clínic De Barcelona./ [management and Leadership of Nursing Services in the Emergency Plan for the Pandemic Covid-19: the Experience of the Clinic Hospital of Barcelona]

text: At the international level, the enormous demand to manage the COVID-19 pandemic has posed a challenge both in the provision of personnel and in supplies and sanitary material. There is no precedent or publication related to the management and leadership of nursing services in Spain within the emergency plan for the COVID-19 pandemic. This article describes the experience of the Hospital Clinico de Barcelona in the current extraordinary circumstances that undoubtedly constitute a nursing management of enormous magnitude and unprecedented due to the high number of people affected and the extraordinary risk of healthcare personnel. Following national and international guidelines to alleviate the pandemic, protect health and prevent the spread of the outbreak. The ability to work as a team, emotional management and respect for organizational decisions have made it possible to face the challenges that the pandemic has put in place and that the Nursing Department can lead in a calm and orderly manner the different actions to perform. Lastly, it will be necessary to continue with an in-depth analysis of the situation and of the actions carried out in order to identify the areas for improvement as well as to evaluate the overall nature of the process.


title: Clinical Characteristics of Elderly Patients with COVID-19 in Hunan Province, China: A Multicenter, Retrospective Study

text: BACKGROUND: The aim of this study was to analyze and summarize the clinical characteristics of elderly patients with coronavirus disease 2019 (COVID-19) and compare the differences of young-old patients (60-74 years old) and old-old patients (≥75 years old). METHODS: In thisretrospective, multicenter study, the medical records of elderly patients who were diagnosed with COVID-19 in Hunan province, China, from January 21 to February 19, 2020 were reviewed. The characteristics of young-old patients and old-old patients were compared. RESULTS: Of the 105 elderly patientsconfirmed withCOVID-19, 81.0% were young-old patients, and 19.0% were old-old patients; 54.3% of elderly patients were females. Overall, 69.5% of elderly patients had underlying diseases, and the most common comorbidities included hypertension (43.8%), diabetes (25.7%), and cardiac disease (16.2%). Of the elderly patients, 22.9% were severe and 10.5% were critical severe cases. On admission, the most frequent symptoms in elderly patients included fever (66.7%), cough (64.8%), and fatigue (33.3%). Lymphopenia (31.4%), increased D-dimer (38.1%), depressed albumin (36.2%), elevated lactate dehydrogenase (41.0%), and a high level of C-reactive protein (79.0%) were common among elderly patients with COVID-19. The median prothrombin time (PT) and the activated partial thromboplastin time (APTT) were longer in old-old patients than young-old patients (PT median 12.3 vs. 13.1 s, p = 0.007; APTT median 39.0 vs. 33.5 s, p = 0.045). Young-old patients showed fewer complications (14.1%) than old-old patients (40.0%; p = 0.0014) and fewer received invasive ventilator support (3.5 vs. 25.0%, p = 0.006). As of March 11, 2020, 85.7% of elderly patients had been discharged, 3 deaths had occurred, and 11.4% were still hospitalized. CONCLUSIONS: Elderly patients usually have chronic medical illness and are likely to have a severe or critically severe condition. They could show atypical symptoms without fever or cough and multiple organ dysfunction. Old-old patients tend to have more complications than young-old patients during hospitalization. Careful nursing, observation, and systemic treatment are very important in elderly patients.


Addressing Skilled Nursing Facilities' COVID-19 Psychosocial Needs Via Staff Training and a Process Group Intervention


title: Estimation of COVID-19 spread curves integrating global data and borrowing information

text: Currently, novel coronavirus disease 2019 (COVID-19) is a big threat to global health. The rapid spread of the virus has created pandemic, and countries all over the world are struggling with a surge in COVID-19 infected cases. There are no drugs or other therapeutics approved by the US Food and Drug Administration to prevent or treat COVID-19: information on the disease is very limited and scattered even if it exists. This motivates the use of data integration, combining data from diverse sources and eliciting useful information with a unified view of them. In this paper, we propose a Bayesian hierarchical model that integrates global data for real-time prediction of infection trajectory for multiple countries. Because the proposed model takes advantage of borrowing information across multiple countries, it outperforms an existing individual country-based model. As fully Bayesian way has been adopted, the model provides a powerful predictive tool endowed with uncertainty quantification. Additionally, a joint variable selection technique has been integrated into the proposed modeling scheme, which aimed to identify possible country-level risk factors for severe disease due to COVID-19.


title: Counter-COVID- 19 pandemic strategy in the Maghreb Central. Qualitative study of the perceptions of health professionals

text: CONTEXT: The Maghreb Central, like all the countries of the world, was strongly mobilized (governments, ministries of health, population, civil society) in the response against COVID-19, immediately after the registration of the first cases on its territory (end of February, beginning of March) and according to pre-established control strategies. OBJECTIVES: Describe the perceptions of health professionals in the Central Maghreb (Tunisia, Algeria and Morocco) as to the Strengths/Opportunities and Weaknesses/Threats of the national response plans against COVID-19, during the first weeks of their execution, and report their proposals for optimizing the performance of control strategies. METHODS: This is a qualitative study of the perceptions of health professionals in the Maghreb Central regarding their experience of the first six weeks of fighting the COVID-19 pandemic. The data was collected using the "Delphi" technique in one turn, based on an electronic form such as "Google Form", developed according to SWOT analysis. The respondents' verbatim was grouped into homogeneous groups of items, the occurrence of which was subsequently measured. RESULTS: A total of 382 health professionals from the Maghreb Central participated in this study, with a median age of 37 years and a median professional tenure of 10 years. The major force of the Maghreb response strategies, the most shared by the respondents, was the performance of the human resources mobilized (doctors, biologists, nurses, etc.) who succeeded in quickly learning from the international epidemiological expertise accumulated in Asia and in Europe. The fight against COVID-19 in the Central Maghreb was confronted with the general and chronic fragility of the national health systems and the low support of the general population for the recommendations of the steering committees of response, threatening the capacity of the Maghreb to confront new epidemics. CONCLUSION: The success of the national response plans against COVID-19 and of possible epidemics or pandemics in the Central Maghreb, is strongly attributed to the commitment of health professionals and to community participation, necessitating the launch of assistant motivation programs. and development of health personnel and mobilization and loyalty of civil society.


title: Diagnostic value and key features of computed tomography in Coronavirus Disease 2019

text: On 31 December 2019, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei province, China, and caused the outbreak of the Coronavirus Disease 2019 (COVID-19). To date, computed tomography (CT) findings have been recommended as major evidence for the clinical diagnosis of COVID-19 in Hubei, China. This review focuses on the imaging characteristics and changes throughout the disease course in patients with COVID-19 in order to provide some help for clinicians. Typical CT findings included bilateral ground-glass opacity, pulmonary consolidation, and prominent distribution in the posterior and peripheral parts of the lungs. This review also provides a comparison between COVID-19 and other diseases that have similar CT findings. Since most patients with COVID-19 infection share typical imaging features, radiological examinations have an irreplaceable role in screening, diagnosis and monitoring treatment effects in clinical practice.


title: COVID-19 pandemic: Impact caused by school closure and national lockdown on pediatric visits and admissions for viral and non-viral infections, a time series analysis

text: A time series analysis of 871,543 pediatric emergency visits revealed that the COVID-19 lockdown and school closure were associated with a significant decrease in infectious diseases disseminated through airborne or fecal-oral transmissions: common cold, gastro-enteritis, bronchiolitis, acute otitis. No change was found for urinary tract infections.


title: COVID-19 preclinical models: human angiotensin-converting enzyme 2 transgenic mice

text: Coronavirus disease 2019 (COVID-19) is a declared pandemic that is spreading all over the world at a dreadfully fast rate. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the pathogen of COVID-19, infects the human body using angiotensin-converting enzyme 2 (ACE2) as a receptor identical to the severe acute respiratory syndrome (SARS) pandemic that occurred in 2002-2003. SARS-CoV-2 has a higher binding affinity to human ACE2 than to that of other species. Animal models that mimic the human disease are highly essential to develop therapeutics and vaccines against COVID-19. Here, we review transgenic mice that express human ACE2 in the airway and other epithelia and have shown to develop a rapidly lethal infection after intranasal inoculation with SARS-CoV, the pathogen of SARS. This literature review aims to present the importance of utilizing the human ACE2 transgenic mouse model to better understand the pathogenesis of COVID-19 and develop both therapeutics and vaccines.


title: Role of focusing on the positive side during COVID-19 outbreak: Mental health perspective from positive psychology

text: This paper discusses how positive emotions can help maintain and improve mental health during the COVID-19 outbreak, taking into account examples of social interaction and positive psychology research efforts in Japanese context. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Pretreated household materials carry similar filtration protection against pathogens when compared with surgical masks

text: OBJECTIVE: The past 4 months, the emergence and spread of novel 2019 SARS-Cov-2 (COVID-19) has led to a global pandemic which is rapidly depleting supplies of personal protective equipment worldwide. There are currently over 1.6 million confirmed cases of COVID-19 worldwide which has resulted in more the 100,000 deaths. As these numbers grow daily, hospitals are being forced to reuse surgical masks in hopes of conserving their dwindling supply. Since COVID-19 will most likely have effects that last for many months, our nationwide shortage of masks poses a long term issue that must be addressed immediately. METHODS: Based on a previous study by Quan et al., a salt-based soaking strategy has been reported to enhance the filtration ability of surgical masks. We propose a similar soaking process which uses materials widely available in anyone's household. We tested this method of pretreating a variety of materials with a salt-based solution by a droplet test using fluorescently stained nanoparticles similar in size to the COVID-19 virus. RESULTS: In this study, we found that paper towels and surgical masks pretreated with the salt-based solution showed a noticeable increase in filtration of nanoparticles similar in size to the COVID-19 virus. We also show that the TWEEN20 used by Quan et al. is not a critical component for the solution, and using salt alone in solution still provides a dramatically increased level of protection. CONCLUSIONS: We believe this method will allow for healthcare workers to create a disposable added layer of protection to their surgical masks, N95s, or homemade masks by using household available products. Adoption of this method may play an essential role in ensuring the safety of healthcare workers during the COVID-19 pandemic and any pandemics that may arise in the future.


title: Strategic planning to augment the testing capacity for COVID-19 in India

text: Background & objectives: Nearly 5,500 tests for coronavirus disease 2019 (COVID-19) had been conducted on March 31, 2020 across the Indian Council of Medical Research (ICMR)-approved public and private laboratories in India. Given the need to rapidly increase testing coverage, we undertook an exercise to explore and quantify interventions to increase the daily real-time reverse transcription-polymerase chain reaction (qRT-PCR)-based testing capacity over the next few months. The objective of this exercise was to prepare a potential plan to scale-up COVID-19 testing in India in the public sector. Methods: Potential increase in daily testing capacity of the existing public laboratories was calculated across the three base scenarios of shifts (9, 16 and 24 h). Additional testing capacity was added for each shift scenario based on interventions ranging from procurement of additional qRT-PCR machines, leveraging spare capacity on available qRT-PCR machines not drafted into COVID-19 testing, to in-laboratory process optimization efforts. Results: Moving to a 24 h working model in the existing approved laboratories can enhance the daily testing capacity to 40,464 tests/day. The capacity can be further bolstered by leveraging qRT-PCR and nucleic acid amplification test (NAAT)-based machines available with the Multidisciplinary Research Units (MRUs), National AIDS Control Organisation (NACO) and National Tuberculosis Elimination Programme (NTEP). Using combination/multiplex kits, and provision of automated RNA extraction platforms at all laboratories could also optimize run time and contribute to capacity increase by 1.5-2 times. Interpretation & conclusions: Adopting these interventions could help increase public sector's daily testing capacity to nearly 100,000-120,000 tests/day. It is important to note that utilization of the scaled-up testing capacity will require deployment of additional workforce, procurement of corresponding commodities for testing and scale-up of sample collection and transportation efforts.


title: Sudden cardiac death in COVID-19 patients, a report of three cases

text: The mortality rate of coronavirus disease-19 (COVID-19) has been reported as 1-6% in most studies. The cause of most deaths has been acute pneumonia. Nevertheless, it has been noted that cardiovascular failure can also lead to death. Three COVID-19 patients were diagnosed based on reverse transcriptase-polymerase chain reaction of a nasopharyngeal swab test and radiological examinations in our hospital. The patients received medications at the discretion of the treating physician. In this case series, chest computed tomography scans and electrocardiograms, along with other diagnostic tests were used to evaluate these individuals. Sudden cardiac death in COVID-19 patients is not common, but it is a major concern. So, it is recommended to monitor cardiac condition in selected patients with COVID-19.


The broad spectrum of dermatological manifestations in COVID-19: clinical and histopathological features learned from a series of 34 cases


title: Comparison of Four Molecular In Vitro Diagnostic Assays for the Detection of SARS-CoV-2 in Nasopharyngeal Specimens

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel human coronavirus that causes coronavirus disease 2019 (COVID-19), was first discovered in December 2019 as the cause of an outbreak of pneumonia in the city of Wuhan, Hubei province, China. The clinical presentation of COVID-19 is fairly non-specific, and symptoms overlap with other seasonal respiratory infections concurrently circulating in the population. Furthermore, it is estimated that up to 80% of infected individuals experience mild symptoms or are asymptomatic, confounding efforts to reliably diagnose COVID-19 empirically. To support infection control measures, there is an urgent need for rapid and accurate molecular diagnostics to identify COVID-19 positive patients. In the present study, we have evaluated the analytical sensitivity and clinical performance of four SARS-CoV-2 molecular diagnostic assays granted Emergency Use Authorization by the FDA using nasopharyngeal swabs from symptomatic patients: the New York SARS-CoV-2 Real-time Reverse Transcriptase (RT)-PCR Diagnostic Panel (Modified CDC), the Simplexa COVID-19 Direct (Diasorin Molecular), GenMark ePlex SARS-CoV-2 assay (GenMark) and the Hologic Panther Fusion® SARS-CoV-2 assay (Hologic). This information is crucial for both laboratories and clinical teams, as decisions on which testing platform to implement are made.


Covid-19: Campaigner calls for national guidance to stop DNR orders being made without discussion with patients and families


title: The Unique Challenges Faced by Assisted Living Communities to Meet Federal Guidelines for COVID-19

text: This perspective addresses the challenges that assisted living (AL) providers face concerning federal guidelines to prevent increased spread of COVID-19. These challenges include restriction of family visitation, use of third-party providers as essential workers, staffing guidelines, transfer policies, and rural AL hospitalizations. To meet these challenges we recommend that AL providers incorporate digital technology to maintain family-resident communication. We also recommend that states adopt protocols that limit the number of AL communities visited by home health care workers in a 14-day period, appeal to the federal government for hazard pay for direct care workers, and to extend the personal care attendant program to AL. It is further recommended that states work with AL communities to implement COVID-19 comprehensive emergency management plans that are well-coordinated with local emergency operation centers to assist with transfers to COVID-19 specific locations and to assist in rural areas with hospital transfers. Together, these recommendations to AL providers and state and federal agencies address the unique structure and needs of AL and would enable AL communities to be better prepared to care for and reduce those infected with COVID-19.


title: Implementation of Continuous Glucose Monitoring in the Hospital: Emergent Considerations for Remote Glucose Monitoring During the COVID-19 Pandemic

text: Continuous glucose monitoring (CGM) has become a widely used tool in the ambulatory setting for monitoring glucose levels, as well as detecting uncontrolled hyperglycemia, hypoglycemia, and glycemic variability. The accuracy of some CGM systems has recently improved to the point of manufacture with factory calibration and Food and Drug Administration clearance for nonadjunctive use to dose insulin. In this commentary, we analyze the answers to six questions about what is needed to bring CGM into the hospital as a reliable, safe, and effective tool. The evidence to date indicates that CGM offers promise as an effective tool for monitoring hospitalized patients. During the current coronavirus disease 2019 crisis, we hope to provide guidance to healthcare professionals, who are seeking to reduce exposure to SARS-Cov-2, as well as preserve invaluable personal protective equipment. In this commentary, we address who, what, where, when, why, and how CGM can be adopted for inpatient use.


Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and COVID-19 infection during pregnancy


title: Covid-19 and pregnancy

text: Guideline: Coronavirus (COVID-19) Infection in pregnancyPublished by the Royal College of Obstetricians and Gynaecologists (RCOG), with input from the Royal College of Midwives, the Royal College of Paediatrics and Child Health (RCPH), the Royal College of Anaesthetists, and the Obstetric Anaesthetists' Association.This summary is based on version 8 of the guideline, published on 17 April 2020 (https://www.rcog.org.uk/globalassets/documents/guidelines/2020-04-17-coronavirus-covid-19-infection-in-pregnancy.pdf).


title: Modeling and Forecasting the COVID-19 Temporal Spread in Greece: An Exploratory Approach based on Complex Network Defined Splines

text: Within the complex framework of anti-COVID-19 health management, where the criteria of diagnostic testing, the availability of public-health resources and services, and the applied anti-COVID-19 policies vary between countries, the reliability and accuracy in the modeling of temporal spread can prove to be effective in the worldwide fight against the disease. This paper applies an exploratory time-series analysis to the evolution of the disease in Greece, which currently suggests a success story of COVID-19 management. The proposed method builds on a recent conceptualization of detecting connective communities in a time-series and develops a novel spline regression model where the knot vector is determined by the community detection in the complex network. Overall, the study contributes to the COVID-19 research by proposing a free of disconnected past-data and reliable framework of forecasting, which can facilitate decision-making and management of the available health resources.


title: Modeling and forecasting the COVID-19 temporal spread in Greece: an exploratory approach based on complex network defined splines

text: Within the complex framework of anti-COVID-19 health management, where the criteria of diagnostic testing, the availability of public-health resources and services, and the applied anti-COVID-19 policies vary between countries, the reliability and the accuracy in the modeling of temporal spread can be proven effective in the worldwide fight against the disease. This paper applies an exploratory time-series analysis to the evolution of the disease in Greece, which currently suggests a success story of COVID-19 management. The proposed method builds on a recent conceptualization of detecting connective communities in a time-series and develops a novel spline regression model where the knot vector is determined by the community detection in the complex network. Overall, the study contributes to the COVID-19 research by proposing a free of disconnected past-data and reliable framework of forecasting, which can facilitate decision-making and management of the available health resources.


title: Controlling epidemic diseases based only on social distancing level

text: The World Health Organization (WHO) made the assessment that COVID-19 can be characterized as a pandemic on March 11, 2020. To the COVID-19 outbreak, there is no vaccination and no treatment. The only way to control the COVID-19 outbreak is sustained physical distancing. In this work, a simple control law was proposed to keep the infected individuals during the COVID-19 outbreak below the desired number. The proposed control law keeps the value of infected individuals controlled only adjusting the social distancing level. The stability analysis of the proposed control law is done and the uncertainties in the parameters were considered. A version of the proposed controller to daily update was developed. This is a very simple approach to the developed control law and can be calculated in a spreadsheet. In the end, numerical simulations were done to show the behavior of the number of infected individuals during an epidemic disease when the proposed control law is used to adjust the social distancing level.


docid: idkyinjp

title: Headache and impaired consciousness level associated with SARS-CoV-2 in CSF: A case report


Rethinking the post-COVID-19 pandemic hospital: more ICU beds or smart monitoring on the wards?


Covid-19: Rest and PPE reassurance are needed before NHS services can restart, MPs hear


title: Lower bias, lower noise CMB lensing with foreground-hardened estimators

text: Extragalactic foregrounds in temperature maps of the Cosmic Microwave Background (CMB) severely limit the ability of standard estimators to reconstruct the weak lensing potential. These foregrounds are not fully removable by multi-frequency cleaning or masking and can lead to large biases if not properly accounted for. For foregrounds made of a number of unclustered point sources, an estimator for the source amplitude can be derived and deprojected, removing any bias to the lensing reconstruction. We show with simulations that all of the extragalactic foregrounds in temperature can be approximated by a collection of sources with identical profiles, and that a simple bias hardening technique is effective at reducing any bias to lensing, at a minimal noise cost. We compare the performance and bias to other methods such as"shear-only"reconstruction, and discuss how to jointly deproject any arbitrary number of foregrounds, each with an arbitrary profile. In particular, for a Simons Observatory-like experiment foreground-hardened estimators allow us to extend the maximum multipole used in the reconstruction, increasing the overall statistical power by $\sim 50\%$ over the standard quadratic estimator, both in auto and cross-correlation. We conclude that source hardening outperforms the standard lensing quadratic estimator both in auto and cross-correlation, and in terms of lensing signal-to-noise and foreground bias.


title: A deep learning approach to characterize 2019 coronavirus disease (COVID-19) pneumonia in chest CT images

text: OBJECTIVES: To utilize a deep learning model for automatic detection of abnormalities in chest CT images from COVID-19 patients and compare its quantitative determination performance with radiological residents. METHODS: A deep learning algorithm consisted of lesion detection, segmentation, and location was trained and validated in 14,435 participants with chest CT images and definite pathogen diagnosis. The algorithm was tested in a non-overlapping dataset of 96 confirmed COVID-19 patients in three hospitals across China during the outbreak. Quantitative detection performance of the model was compared with three radiological residents with two experienced radiologists' reading reports as reference standard by assessing the accuracy, sensitivity, specificity, and F1 score. RESULTS: Of 96 patients, 88 had pneumonia lesions on CT images and 8 had no abnormities on CT images. For per-patient basis, the algorithm showed superior sensitivity of 1.00 (95% confidence interval (CI) 0.95, 1.00) and F1 score of 0.97 in detecting lesions from CT images of COVID-19 pneumonia patients. While for per-lung lobe basis, the algorithm achieved a sensitivity of 0.96 (95% CI 0.94, 0.98) and a slightly inferior F1 score of 0.86. The median volume of lesions calculated by algorithm was 40.10 cm3. An average running speed of 20.3 s ± 5.8 per case demonstrated the algorithm was much faster than the residents in assessing CT images (all p < 0.017). The deep learning algorithm can also assist radiologists make quicker diagnosis (all p < 0.0001) with superior diagnostic performance. CONCLUSIONS: The algorithm showed excellent performance in detecting COVID-19 pneumonia on chest CT images compared with resident radiologists. KEY POINTS: â¢ The higher sensitivity of deep learning model in detecting COVID-19 pneumonia were found compared with radiological residents on a per-lobe and per-patient basis. â¢ The deep learning model improves diagnosis efficiency by shortening processing time. â¢ The deep learning model can automatically calculate the volume of the lesions and whole lung.


docid: cvpymljk

title: COVID-19: A primer for Neuroradiologists

text: The potential for central nervous system (CNS) involvement in coronavirus disease 2019 (COVID-19) is a matter of grave concern and there is a relevant body of evidence in the basic sciences to support this possibility. A neuroradiologist should be aware of the potential mechanisms involved in the neuropathogenesis of this virus, as we begin to see cases with abnormal brain scans emerging from all parts of the world.


docid: ovbfmwqy

title: Leaf Anatomy of Xylopia aromatica (Lam. ) Mart. (Annonaceae) occurring in a rocky savannah in the Brazilian Amazonian/ Anatomia foliar de Xylopia aromatica (Lam. ) Mart. (Annonaceae) ocorrente em uma savana rochosa na Amazônia Brasileira

text: Savannas of the Amazon Region of Mato Grosso State have an unique ecological identity due to the complexity of the Cerrado-Amazon transition region, their geographical isolation and the physical-chemical properties of the soil. This study aimed to characterize the leaf anatomy of Xylopia aromatica, and to identify potential adaptive traits to the xeric environment. We collected adult leaves from X. aromatica from a Amazonian savannah located in the Nova Canãa do Norte city, Mato Grosso. The leaves were fixed and stored in 70% ethanol. Cross sections were obtained by free hand with the aid of a razor blade, stained with astra blue and basic fuchsin, and mounted on histological slides. Charactersconsidered adaptive: thick cuticle, epidermal cells with thickened walls, the presence of silica in theepidermis, trichomes, hypostomatic leaves, stomata on the same level as the other epidermal cells, presenceof hypodermis, and dorsiventral mesophyll with palisade parenchyma occupying more than 50%. Theanatomical characters presented are of great importance for the establishment and development of X.aromatica in xeric environments. They contribute to the protection of the leaves from many biotic andabiotic factors to which they are subjected, thus ensuring the species survival in the savannic environment.(AU)


title: Mood, anxiety and olfactory dysfunction in COVID-19: evidence of central nervous system involvement?

text: INTRODUCTION: The objective of this study was to determine the burden of depressed mood and anxiety in COVID-19, and associated disease characteristics. MATERIALS AND METHODS: This is a prospective, cross-sectional study of 114 COVID-19 positive patients diagnosed using RT-PCR-based testing over a 6-week period. The 2-item Patient Health Questionnaire (PHQ-2) and the 2-item Generalized Anxiety Disorder questionnaire (GAD-2) were used to measure depressed mood and anxiety level, respectively, at enrollment and for participants' baseline, pre-COVID-19 state. Severity of smell loss, loss of taste, nasal obstruction, rhinorrhea/mucus production, fever, cough and shortness of breath (SOB) during COVID-19 were assessed. RESULTS: PHQ-2 and GAD-2 significantly (p<0.001) increased from baseline to enrollment. PHQ-2 was associated with smell loss (adjusted incidence rate ratio [aIRR]=1.40, 95%CI: 1.10-1.78, p=0.006), age (aIRR=1.02, 95%CI: 1.01-1.04, p=0.006), and baseline PHQ-2 score (aIRR=1.39, 95%CI: 1.09-1.76, p=0.007). GAD-2 score was associated with smell loss (aIRR=1.29, 95%CI: 1.02-1.62, p=0.035), age (aIRR=1.02, 95%CI: 1.01-1.04, p=0.025) and baseline GAD-2 score (aIRR=1.55, 95%CI: 1.24-1.93, p<0.001). Loss of taste also exhibited similar associations with PHQ-2 and GAD-2. PHQ-2 and GAD-2 scores were not associated with severities of any other symptoms during the COVID-19 course. CONCLUSIONS: Despite the occurrence of symptoms-such as SOB-associated with severe manifestations of COVID-19, only the severities of smell and taste loss were associated with depressed mood and anxiety. These results may raise the novel possibility of emotional disturbance as a CNS manifestation of COVID-19 given trans-olfactory tract penetration of the central nervous system (CNS) by coronaviruses.


Diagnostic Testing for the Novel Coronavirus


Covid-19: Oxford team begins vaccine trials in Brazil and South Africa to determine efficacy


docid: vhnhiwxo

title: Comparative physiological mechanisms of arbuscular mycorrhizal fungi in mitigating salt-induced adverse effects on leaves and roots of Zelkova serrata

text: Arbuscular mycorrhizal (AM) fungi enhance plant salt tolerance. However, physiological mechanisms of enhanced salt tolerance in leaves and roots of trees rarely have been compared. To reveal the different mechanisms, our study utilized comprehensive analyses of leaves and roots to examine the effects of Funneliformis mosseae on the salinity tolerance of Zelkova serrata. Seedlings of Z. serrata were exposed to four salt levels in a greenhouse with and without F. mosseae inoculation. Treatment comparisons revealed that following F. mosseae inoculation, (1) nutrient deficiency caused by osmotic stress was mitigated by the fungus enhancing nutrient contents (K, Ca, and Mg) in roots and (N, P, K, Ca, and Mg) in leaves, with Ca and K contents being higher in both leaves and roots; (2) mycorrhizas alleviated ion toxicity by maintaining a favorable ion balance (e.g., K+/Na+), and this regulatory effect was higher in leaves than that in roots; and (3) oxidative damage was reduced by an increase in the activities of antioxidant enzymes and accumulation of antioxidant compounds in mycorrhizal plants although the increase differed in leaves and roots. In particular, AM fungus-enhanced catalase activity and reduced glutathione content only occurred in leaves, whereas an enhanced content of reduced ascorbic acid was only noted in roots. Growth, root vitality, leaf photosynthetic pigments, net photosynthetic rate, and dry weight were higher in seedlings with AM fungus inoculation. These results suggest that AM fungus inoculation improved salinity tolerance of Z. serrata, but the physiological mechanisms differed between leaves and roots.


FR - Organización de un servicio de dermatología en la pandemia del COVID-19./ FR - Organización de un servicio de dermatología en la pandemia del COVID-19./ RF - Organisation of a Dermatology Department During the COVID-19 Pandemic


Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): Evidence from a meta-analysis


title: ESMO Management and treatment adapted recommendations in the COVID-19 era: Pancreatic Cancer

text: The COVID-19 pandemic is challenging the capacities of health systems in many countries. National healthcare services have to manage unexpected shortages of healthcare resources that have to be re-allocated according to the principles of fair and ethical prioritisation, in order to maintain the highest levels of care to all patients, ensure the safety of patients and healthcare workers, and save as many lives as possible. Also, cancer care services have to pursue restructuring, following the same evidence-based dispositions. In this article, we propose a guidance to the management of pancreatic cancer during the pandemic, prioritised according to a three-tiered framework, and based on expert clinical judgement and magnitude of benefit expected from specific interventions. Since the availability of resources for diagnostic procedures, surgery and postoperative care, systemic therapy and radiotherapy may differ, the authors have separated the prioritisation analyses. The impact of postponing or abrogating cancer interventions on outcomes according to a high, medium or low priority scale is outlined and discussed. The implementation of healthcare services using telemedicine is explored; it reveals itself as functional and effective for limiting patients' need to travel to centres and thereby has the potential to reduce diffusion of SARS-CoV-2. Pancreatic cancer demands a considerable amount of medical resources. Therefore, the redefinition of its diagnostic and therapeutic algorithms with a rigorous method is crucial in order to ensure the highest quality of continuum of care in the broader context of the pandemic and the challenged healthcare systems.


title: SARS-CoV-2 epidemic in India: epidemiological features and in silico analysis of the effect of interventions

text: Background: After SARS-CoV-2 set foot in India, the Government took a number of steps to limit the spread of the virus in the country. This included restricted testing, isolation, contact tracing and quarantine, and enforcement of a nation-wide lockdown starting 25 March 2020. The objectives of this study were to i) describe the age,gender distribution and mortality among COVID-19 patients identified till 14 April 2020 and predict the range of contact rate; and ii) predict the number of active COVID-19 patients after 40 days of lockdown. Methods: We used a cross-sectional descriptive design for first objective and a susceptible-infected-removed model for in silico predictions. We collected data from government-controlled and crowdsourced websites. Results: Studying age and gender parameters of 1161 Indian COVID-19 patients, the median age was 38 years (IQR, 27-52) with 20-39 year-old males being the most affected group. The number of affected patients were 854 (73.6%) men and 307 (26.4%) women. If the current contact rate continues (0.25-27), India may have 110460 to 220575 infected persons at the end of 40 days lockdown. Conclusion: The disease is majorly affecting a younger age group in India. Interventions have been helpful in preventing the worst-case scenario in India, but will be unable to prevent the spike in number of cases.


title: Smell and taste dysfunction in patients with SARS-CoV-2 infection: A review of epidemiology, pathogenesis, prognosis, and treatment options

text: During the initial pandemic wave of COVID-19, apart from common presenting symptoms (cough, fever, and fatigue), many countries have reported a sudden increase in the number of smell and taste dysfunction patients. Smell dysfunction has been reported in other viral infections (parainfluenza, rhinovirus, SARS, and others), but the incidence is much lower than SARS-CoV-2 infection. The pathophysiology of post-infectious olfactory loss was hypothesized that viruses may produce an inflammatory reaction of the nasal mucosa or damage the olfactory neuroepithelium directly. However, loss of smell could be presented in COVID-19 patients without other rhinologic symptoms or significant nasal inflammation. This review aims to provide a brief overview of recent evidence for epidemiology, pathological mechanisms for the smell, and taste dysfunction in SARS-CoV-2 infected patients. Furthermore, prognosis and treatments are reviewed with scanty evidence. We also discuss the possibility of using "smell and taste loss" as a screening tool for COVID-19 and treatment options in the post-SARS-CoV-2 infectious olfactory loss.


title: Infant Case of Co-infection with SARS-CoV-2 and Citrobacter koseri Urinary Infection

text: Since 2019 coronavirus disease (COVID-19) is highly contagious with a high mortality rate. France has taken strict infection control measures. According to the report by the Center for Disease Control and Prevention, children are less affected with COVID-19 and seem to have less severe disease than adults. We reported the first confirmed infant case of co-infection with SARS-CoV-2 and Citrobacter koseri urinary infection in 6-week-old child admitted on 25 March 2020 with mild symptoms in the Pediatric COVID Unit of Amiens University Hospital, France.


Simulation as a tool for learning surgical craft in Covid-19 era


Hydroxychloroquine shortages among patients with systemic lupus erythematosus during the COVID-19 pandemic: experience of the Systemic Lupus International Collaborating Clinics


title: Virtual Management of Patients With Cancer During the COVID-19 Pandemic: Web-Based Questionnaire Study

text: BACKGROUND: During the coronavirus disease (COVID-19) pandemic, patients with cancer in rural settings and distant geographical areas will be affected the most by curfews. Virtual management (telemedicine) has been shown to reduce health costs and improve access to care. OBJECTIVE: The aim of this survey is to understand oncologists' awareness of and views on virtual management, challenges, and preferences, as well as their priorities regarding the prescribing of anticancer treatments during the COVID-19 pandemic. METHODS: We created a self-administrated electronic survey about the virtual management of patients with cancer during the COVID-19 pandemic. We evaluated its clinical sensibility and pilot tested the instrument. We surveyed practicing oncologists in Gulf and Arab countries using snowball sampling via emails and social media networks. Reminders were sent 1 and 2 weeks later using SurveyMonkey. RESULTS: We received 222 responses from validated oncologists from April 2-22, 2020. An awareness of virtual clinics, virtual multidisciplinary teams, and virtual prescriptions was reported by 182 (82%), 175 (79%), and 166 (75%) respondents, respectively. Reported challenges associated with virtual management were the lack of physical exam (n=134, 60%), patients' awareness and access (n=131, 59%), the lack of physical attendance of patients (n=93, 42%), information technology (IT) support (n=82, 37%), and the safety of virtual management (n=78, 35%). Overall, 111 (50%) and 107 (48%) oncologists did not prefer the virtual prescription of chemotherapy and novel immunotherapy, respectively. However, 188 (85%), 165 (74%), and 127 (57%) oncologists preferred the virtual prescription of hormonal therapy, bone modifying agents, and targeted therapy, respectively. In total, 184 (83%), 183 (83%), and 176 (80%) oncologists preferred to continue neoadjuvant, adjuvant, and perioperative treatments, respectively. Overall, 118 (53%) respondents preferred to continue first-line palliative treatment, in contrast to 68 (30%) and 47 (21%) respondents indicating a preference to interrupt second- and third-line palliative treatment, respectively. For administration of virtual prescriptions, all respondents preferred the oral route and 118 (53%) preferred the subcutaneous route. In contrast, 193 (87%) did not prefer the intravenous route for virtual prescriptions. Overall, 102 (46%) oncologists responded that they would "definitely" prefer to manage patients with cancer virtually. CONCLUSIONS: Oncologists have a high level of awareness of virtual management. Although their survey responses indicated that second- and third-line palliative treatments should be interrupted, they stated that neoadjuvant, adjuvant, perioperative, and first-line palliative treatments should continue. Our results confirm that oncologists' views on the priority of anticancer treatments are consistent with the evolving literature during the COVID-19 pandemic. Challenges to virtual management should be addressed to improve the care of patients with cancer.


Protecting medical staff from skin injury/disease caused by personal protective equipment during epidemic period of COVID-19: experience from China


The consequences of the COVID-19 pandemic


Severe COVID-19-associated pneumonia in 3 patients with systemic sclerosis treated with rituximab


title: First case of focal epilepsy associated with SARS-coronavirus-2

text: A healthy patient presented to Klinikum Altmühlfranken Weißenburg Hospital, Germany, with two morning attacks of painful muscle spasm in the left upper and lower limbs, without altered consciousness. Full examinations, radiological imaging, electroencephalography, lumbar puncture, and autoimmune profile were either normal or not consistent with patient's complaint. Subsequent epileptic episodes were observed on admission day and the following days; thus, the patient was diagnosed with focal epilepsy. The patient started to develop a fever and severe cough on day 4, and SARS-coronavirus-2 was confirmed through a nasopharyngeal swap. She received anticonvulsants and symptomatic treatments and completely recovered. This report emphasizes the potential nervous system involvement in severe acute respiratory syndrome-coronavirus-2 pathogenesis.


Neurosurgeons in the Corona crisis: striving for remedy and redemption. A message from the president of the EANS


Digital tablets to improve quality of life of COVID-19 older inpatients during lockdown


Recommendations on cardiopulmonary resuscitation strategy and procedure for novel coronavirus pneumonia


The race for coronavirus vaccines: a graphical guide


docid: zscviypa

title: Covid-19: Lack of test and trace data are frustrating government scrutiny


title: St. Corona  eine Fürsprecherin gegen Seuchen? : Eine Miszelle aus der Medizin- und Urologiegeschichte./ [St. Corona-a patron saint against pandemics? : A short essay on the history of medicine and urology]

text: The knowledge of hagiography and hagiotherapy still plays an important role in the history of science, especially when focusing on specific aspects of history. While knowledge about St. Liborius persists in urology, knowledge about patron saints for pandemics, especially those who were called upon to treat venereal diseases, has diminished due to the association with nonappropriate sexual behavior.


Hospital infection and COVID-19: Do not put all your eggs on the "swab" tests


A Note to the JLD Community in Response to the Pandemic


Two patients with acute meningoencephalitis concomitant with SARS-CoV-2 infection


title: The SARS-CoV-2 outbreak from a one health perspective

text: The SARS-CoV-2 is a new human coronavirus candidate recently detected in China that is now reported in people on inhabited continents. The virus shares a high level of identity with some bat coronaviruses and is recognised as a potentially zoonotic virus. We are utilizing the One Health concept to understand the emergence of the virus, as well as to point to some possible control strategies that might reduce the spread of the virus across the globe; thus, containment of such virus would be possible.


title: Tension pneumothorax in a patient with COVID-19

text: A 36-year-old man was brought to the emergency department with suspected COVID-19, following a 3-week history of cough, fevers and shortness of breath, worsening suddenly in the preceding 4 hours. On presentation he was hypoxaemic, with an SpO2 of 88% on 15 L/min oxygen, tachycardic and had no audible breath sounds on auscultation of the left hemithorax. Local guidelines recommended that the patient should be initiated on continuous positive airway pressure while investigations were awaited, however given the examination findings an emergency portable chest radiograph was performed. The chest radiograph demonstrated a left-sided tension pneumothorax. This was treated with emergency needle decompression, with good effect, followed by chest drain insertion. A repeat chest radiograph demonstrated lung re-expansion, and the patient was admitted to a COVID-19 specific ward for further observation. This case demonstrates tension pneumothorax as a possible complication of suspected COVID-19 and emphasises the importance of thorough history-taking and clinical examination.


The accuracy of "Preliminary estimation of the novel coronavirus disease (COVID-19) cases in Iran: A modelling analysis based on overseas cases and air travel data"


Microbicidal actives with virucidal efficacy against SARS-CoV-2


Impact of Covid-19 on veterinary care


Remdesivir for the Treatment of Covid-19 - Preliminary Report


Coronavirus Disease 2019 (COVID-19) and Dialysis: The Experience in Singapore


Critical paediatric COVID-19: varied presentations but good outcomes


docid: sbcjyxhe

title: Probiotics and COVID-19: one size does not fit all


A Marker of Systemic Inflammation or Direct Cardiac Injury: Should Cardiac Troponin Levels be Monitored in COVID-19 Patients?


title: Neutrophil to CD4+ lymphocyte ratio as a potential biomarker in predicting virus negative conversion time in COVID-19

text: BACKGROUND: Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. Our study aimed to evaluate the robustness of neutrophil to CD4+ lymphocyte ratio (NCD4LR) in predicting the negative conversion time (NCT) of SARS-CoV-2 in COVID-19 patients. METHODS: Univariate and multivariate analysis were conducted to evaluate the independency of NCD4LR in predicting NCT. Receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) were used to assess the diagnostic accuracy. RESULTS: Compared with low NCD4LR patients, patients with high NCD4LR had an older age; higher incidence of fever, fatigue, chest distress/breath shortness, severer disease assessment on admission; higher levels of inflammatory indicators; low levels of lymphocyte subsets, and a longer NCT. Multivariate analysis also identified NCD4LR as an independent risk factor for delayed NCT. ROC analysis showed that NCD4LR had a better performance than neutrophil to lymphocyte ratio in predicting the virus negative conversion within 2 weeks (AUC = 0.772), 3 weeks (AUC = 0.710), 4 weeks (AUC = 0.728), or 5 weeks (AUC = 0.815). CONCLUSION: This study suggests that NCD4LR is a potential and useful biomarker for predicting the virus negative conversion time in COVID-19 patients. Furthermore, due to the NCDLR value is easily calculated, it can be widely used as a clinical biomarker for disease progression and clinical outcomes in COVID-19 patients.


A British Society of Thoracic Imaging statement: considerations in designing local imaging diagnostic algorithms for the COVID-19 pandemic. A reply


title: Beyond the Linguistic/Medical Anthropology Divide: Retooling Anthropology to Face COVID-19

text: Differing analytics and ethnographic practices impede conversations between linguistic and medical anthropologists. Here I juxtapose articles in this special issue that use diverse ethnographic sites to rethink anthropological concepts of health, disease, care, the body, language, and communication in the light of the 2020 COVID-19 pandemic. I track how anthropologists and their interlocutors envision relations between ideologies, embedded modeling (or metacommunication), and ordinary pragmatics, particularly by projecting their actual or ideal consonance versus exploring how sounds, bodies, technologies, and practices emerge from disjunctures. Comparing H1N1 in 2009 and COVID-19 prompts reflection on why anthropologists must transcend this foundational divide to tackle pandemic complexities.


title: Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults

text: PURPOSE: To discuss the different characteristics of clinical, laboratory, and chest computed tomography (CT) in pediatric patients from adults with 2019 novel coronavirus (COVID-19) infection. METHODS: The clinical, laboratory, and chest CT features of 20 pediatric inpatients with COVID-19 infection confirmed by pharyngeal swab COVID-19 nucleic acid test were retrospectively analyzed during 23 January and 8 February 2020. The clinical and laboratory information was obtained from inpatient records. All the patients were undergone chest CT in our hospital. RESULTS: Thirteen pediatric patients (13/20, 65%) had an identified history of close contact with COVID-19 diagnosed family members. Fever (12/20, 60%) and cough (13/20, 65%) were the most common symptoms. For laboratory findings, procalcitonin elevation (16/20, 80%) should be pay attention to, which is not common in adults. Coinfection (8/20, 40%) is common in pediatric patients. A total of 6 patients presented with unilateral pulmonary lesions (6/20, 30%), 10 with bilateral pulmonary lesions (10/20, 50%), and 4 cases showed no abnormality on chest CT (4/20, 20%). Consolidation with surrounding halo sign was observed in 10 patients (10/20, 50%), ground-glass opacities were observed in 12 patients (12/20, 60%), fine mesh shadow was observed in 4 patients (4/20, 20%), and tiny nodules were observed in 3 patients (3/20, 15%). CONCLUSION: Procalcitonin elevation and consolidation with surrounding halo signs were common in pediatric patients which were different from adults. It is suggested that underlying coinfection may be more common in pediatrics, and the consolidation with surrounding halo sign which is considered as a typical sign in pediatric patients.


title: Inhaled modified angiotensin converting enzyme 2 (ACE2) as a decoy to mitigate SARS-CoV-2 infection

text: COVID-19 is a new zoonotic disease caused by the SARS-CoV-2 virus Since its emergence in Wuhan City, China, the virus has rapidly spread across the globe causing calamitous health, economic and societal consequences It causes disproportionately severe disease in the elderly and those with co-morbidities, such as hypertension and diabetes There is currently no proven treatment for COVID-19 and a safe and effective vaccine is at least a year away The virus gains access to the respiratory epithelium through cell surface angiotensin converting enzyme 2 (ACE2) The receptor binding domain (RBD) of the virus is unlikely to mutate without loss of pathogenicity and thus represents an attractive target for antiviral treatment Inhaled modified recombinant human ACE2, may bind SARS-CoV-2 and mitigate lung damage This decoy strategy is unlikely to provoke an adverse immune response and may reduce morbidity and mortality in high-risk groups


COVID-19: implementing sustainable low cost physical distancing and enhanced hygiene


title: Transformation of a large multi-speciality hospital into a dedicated COVID-19 centre during the coronavirus pandemic

text: INTRODUCTION: The article describes the process of converting a large multi-specialized hospital into one dedicated to COVID-19 patients, and present established standards of work organization in all the wards and training system of the medical and supporting staff. The several weeks pandemic of the COVID-19 disease has forced the healthcare systems of numerous countries to adjust their resources to the care of the growing number of COVID-19 patients. Managers were presented with the challenge of protecting the healthcare workers from transmission of the disease within medical institutions, and issues concerning the physical and psychological depletion of personnel. MATERIAL AND METHODS: Based on analyses of the structure and work processes in Central Clinical Hospital (CCH) reconstructive strategic plan was developed. It included: division of existing wards into observation and isolation wards; installing locks; weekly plan for supplying personal protection equipment (PPE); designating new access to the hospital and communication routes; training of medical and supporting staff. The plan was implemented from the first days of conversion of the hospital. RESULTS: The wards of the CCH were converted for observation and isolation, and each one was fitted with sanitary locks. There was a big improvement in the supply of PPE for the medical staff. Separation of the 'dirty' and 'clean' parts of the CCH were attained, and widespread intensive training not only protected personnel against infections, but also diminished unrest which was discernable at the beginning of conversion. CONCLUSIONS: The transformation efforts will ultimately be appraised at the end of the epidemic, but the data looks encouraging. Two weeks after conversion, the testing of hospital Staff was started and by the end of April, 459 tests were had been conducted, of which only 11 were positive.


title: The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China

text: BACKGROUND Coronavirus disease 2019 (COVID-19), formerly known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 2019 novel coronavirus (2019-nCoV), was first identified in December 2019 in Wuhan City, China. Structural equation modeling (SEM) is a multivariate analysis method to determine the structural relationship between measured variables. This observational study aimed to use SEM to determine the effects of social support on sleep quality and function of medical staff who treated patients with COVID-19 in January and February 2020 in Wuhan, China. MATERIAL AND METHODS A one-month cross-sectional observational study included 180 medical staff who treated patients with COVID-19 infection. Levels of anxiety, self-efficacy, stress, sleep quality, and social support were measured using the and the Self-Rating Anxiety Scale (SAS), the General Self-Efficacy Scale (GSES), the Stanford Acute Stress Reaction (SASR) questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Social Support Rate Scale (SSRS), respectively. Pearson's correlation analysis and SEM identified the interactions between these factors. RESULTS Levels of social support for medical staff were significantly associated with self-efficacy and sleep quality and negatively associated with the degree of anxiety and stress. Levels of anxiety were significantly associated with the levels of stress, which negatively impacted self-efficacy and sleep quality. Anxiety, stress, and self-efficacy were mediating variables associated with social support and sleep quality. CONCLUSIONS SEM showed that medical staff in China who were treating patients with COVID-19 infection during January and February 2020 had levels of anxiety, stress, and self-efficacy that were dependent on sleep quality and social support.