title: Coronavirus Disease 2019 Treatment: A Review of Early and Emerging Options

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has spread across the globe resulting in a pandemic. At the time of this review, COVID-19 has been diagnosed in more than 200 000 patients and associated with over 8000 deaths (Centers for Disease Control and Prevention, World Health Organization). On behalf of the Society of Infectious Diseases Pharmacists, we herein summarize the current evidence as of March 18, 2020 to provide guidance on potential COVID-19 treatment options. It is important to caution readers that new data emerges daily regarding clinical characteristics, treatment options, and outcomes for COVID-19. Optimized supportive care remains the mainstay of therapy, and the clinical efficacy for the subsequent agents is still under investigation. Antimicrobial stewardship programs, including infectious diseases pharmacists and physicians, are at the forefront of COVID-19 emergency preparedness. We encourage all readers to continue to assess clinical data as it emerges and share their experience within our community in a well-controlled, adequately powered fashion.


title: Using the LIST model to Estimate the Effects of Contact Tracing on COVID-19 Endemic Equilibria in England and its Regions

text: Governments across Europe are preparing for the emergence from lockdown, in phases, to prevent a resurgence in cases of COVID-19. Along with social distancing (SD) measures, contact tracing comprising find, track, trace and isolate (FTTI) policies are also being implemented. Here, we investigate FTTI policies in terms of their impact on the endemic equilibrium. We used a generative model, the dynamic causal 'Location', 'Infection', 'Symptom' and 'Testing' (LIST) model to identify testing, tracing, and quarantine requirements. We optimised LIST model parameters based on time series of daily reported cases and deaths of COVID-19 in England and based upon reported cases in the nine regions of England and in all 150 upper tier local authorities. Using these optimised parameters, we forecasted infection rates and the impact of FTTI for each area; national, regional, and local. Predicting data from early June 2020, we find that under conditions of medium-term immunity, a '40%' FTTI policy (or greater), could reach a distinct endemic equilibrium that produces a significantly lower death rate and a decrease in ICU occupancy. Considering regions of England in isolation, some regions could substantially reduce death rates with 20% efficacy. We characterise the accompanying endemic equilibria in terms of dynamical stability, observing bifurcation patterns whereby relatively small increases in FTTI efficacy result in stable states with reduced overall morbidity and mortality. These analyses suggest that FTTI will not only save lives, even if only partially effective, and could underwrite the stability of any endemic steady-state we manage to attain.


COVID-19: Private Practice Neurology Hit by Pay Cuts, Furloughs, and Loss of Job Benefits


title: Evaluation of recombinant nucleocapsid and spike proteins for serological diagnosis of novel coronavirus disease 2019 (COVID-19)

text: Background: The colloidal gold immunochromatography assay (GICA) is a rapid diagnostic tool for novel coronavirus disease 2019 (COVID-19) infections. However, with significant numbers of false negatives, improvements to GICA are needed. Methods: Six recombinant HCoV-19 nucleocapsid and spike proteins were prepared and evaluated. The optimal proteins were employed to develop a sandwich-format GICA strip to detect total antibodies (IgM and IgG) against HCoV-19. GICA performance was assessed with comparison of viral RNA detection. Results: Recombinant HCoV-19 proteins were obtained, including three prokaryotically expressed rN, rN1, rN2 nucleocapsid proteins, and three eukaryotically expressed rS1, rS-RBD, rS-RBD-mFc spike proteins. The recombinant proteins with the highest ELISA titers (rS1 and rS-RBD-mFc) against coronavirus-specific IgM and IgG were chosen for GICA development. The GICA has a sensitivity and specificity of 86.89% (106/122) and 99.39% (656/660), respectively. Furthermore, 65.63% (21/32) of the clinically confirmed but RT-PCR negative samples were GICA positive. Conclusions: The eukaryotically-expressed spike proteins (rS1and rS-RBD-mFc) are more suitable than the prokaryotically expressed nucleocapsid proteins for HCoV-19 serological diagnosis. The GICA sandwich used to detect total antibodies is a powerful complement to the current standard RNA-based tests.


title: Susceptibility to and transmission of COVID-19 amongst children and adolescents compared with adults: a systematic review and meta-analysis

text: Background The degree to which children and young people are infected by and transmit the SARS-CoV-2 virus is unclear. Clinical series and testing cohorts based upon screening of symptomatic cases provide biased estimates of susceptibility in children. The role of children and young people in transmission of SARS-CoV-2 is dependent on susceptibility, symptoms, viral load, social contact patterns and behaviour. Methods We undertook a rapid systematic review of contact-tracing studies and population-screening studies to address the question What is the susceptibility to and transmission of SARS-CoV-2 by children and adolescents compared with adults? We searched PubMed and medRxiv on 16 May 2020 and identified 6327 studies, with additional studies identified through handsearching of cited references (2) and professional contacts (4). We assessed quality, summarized findings and undertook a random effects meta-analysis of contact-tracing studies. Results 18 studies met inclusion criteria; 9 contact-tracing, 8 population-screening and 1 systematic-review. Meta-analysis of contact tracing studies showed that the pooled odds ratio of being an infected contact in children compared with adults for all contact tracing studies was 0.44 (0.29, 0.69) with substantial heterogeneity (63%). Findings from a systematic review of household clusters of COVID-19 found 3/31 (10%) were due to a child index case and a population-based school contact tracing study found minimal transmission by child or teacher index cases. Findings from population-screening studies were heterogenous and not suitable for meta-analysis. Large studies from Iceland, the Netherlands and Spain and an Italian municipal study showed markedly lower SARS-CoV-2 prevalence amongst children and young people, however studies from Stockholm, England and municipalities in Switzerland and Germany showed showed no difference in infection prevalence between adults and children. Conclusions There is preliminary evidence that children and young people have lower susceptibility to SARS-CoV-2, with a 56% lower odds of being an infected contact. There is weak evidence that children and young people play a lesser role in transmission of SARS-CoV-2 at a population level. Our study provides no information on the infectivity of children.


Regional lymph node irradiation in breast cancer may worsen lung damage in COVID-19 positive patients


title: Covid-19 in Chile. The experience of a Regional reference Center. Preliminary report

text: During the first pandemic wave Covid-19 reached Latin America cities. Aim: To report clinical features and outcomes associated to Covid-19 in a group of patients admitted during the first wave in a regional reference Center in southern Chile designated to severe and critical cases. Methods: Cases were identified by a compatible clinical picture associated to positive RT-PCR or serological testing. A standard protocol was applied. Results: 21 adult patients (20 diagnosed by PCR, one by serology) were admitted between epidemiological weeks 13 to 20, involving 8.8% of total regional cases. Hospitalization occurred at a median of 11 days after symptoms onset. Patients [≥]60 years old predominated (57.1%). Hypertension (61.9%), obesity (57.1%) and diabetes mellitus 2 (38.1%) were prevalent but 19% had no comorbid conditions nor were elderly. Two cases involved second-trimester pregnant women. Positive IgM or IgM/IgG results obtained by rapid serological testing were limited (19% at 1st week; 42.9% at 2nd week). Nine patients (42.9%, critical group) were transferred to ICU and connected to mechanical ventilation due to respiratory failure. By univariate analysis admission to ICU was significantly associated to tachypnea and higher plasmatic LDH values. One pregnant woman required urgent cesarean section given birth to a premature neonate without vertical transmission. Two patients died (in-hospital mortality 9.5%) and length of stay was equal or higher than 14 days in 57.9% of patients. Conclusion: In our regional Center, Covid 19 was associated to known risk factors, had a prolonged stay and in-hospital mortality. Tachypnea [≥]30/min is predictive of transfer to ICU.


docid: ucwuptgg

title: Human Mobility Restrictions and the Spread of the Novel Coronavirus (2019-nCoV) in China

text: We quantify the causal impact of human mobility restrictions, particularly the lockdown of the city of Wuhan on January 23, 2020, on the containment and delay of the spread of the Novel Coronavirus (2019-nCoV). We employ a set of difference-in-differences (DID) estimations to disentangle the lockdown effect on human mobility reductions from other confounding effects including panic effect, virus effect, and the Spring Festival effect. We find that the lockdown of Wuhan reduced inflow into Wuhan by 76.64%, outflows from Wuhan by 56.35%, and within-Wuhan movements by 54.15%. We also estimate the dynamic effects of up to 22 lagged population inflows from Wuhan and other Hubei cities, the epicenter of the 2019-nCoV outbreak, on the destination cities' new infection cases. We find, using simulations with these estimates, that the lockdown of the city of Wuhan on January 23, 2020 contributed significantly to reducing the total infection cases outside of Wuhan, even with the social distancing measures later imposed by other cities. We find that the COVID-19 cases would be 64.81% higher in the 347 Chinese cities outside Hubei province, and 52.64% higher in the 16 non-Wuhan cities inside Hubei, in the counterfactual world in which the city of Wuhan were not locked down from January 23, 2020. We also find that there were substantial undocumented infection cases in the early days of the 2019-nCoV outbreak in Wuhan and other cities of Hubei province, but over time, the gap between the officially reported cases and our estimated "actual" cases narrows significantly. We also find evidence that enhanced social distancing policies in the 63 Chinese cities outside Hubei province are effective in reducing the impact of population inflows from the epicenter cities in Hubei province on the spread of 2019-nCoV virus in the destination cities elsewhere.


title: An evolutionary perspective of virus propagation

text: This paper presents an evolutionary algorithm that simulates simplified scenarios of the diffusion of an infectious disease within a given population. The proposed evolutionary epidemic diffusion (EED) computational model has a limited number of variables and parameters, but is still able to simulate a variety of configurations that have a good adherence to real-world cases. The use of two space distances and the calculation of spatial 2-dimensional entropy are also examined. Several simulations demonstrate the feasibility of the EED for testing distinct social, logistic and economy risks. The performance of the system dynamics is assessed by several variables and indices. The global information is efficiently condensed and visualized by means of multidimensional scaling.


title: Chest Computed Tomography Findings in COVID-19 and Influenza: A Narrative Review

text: OBJECTIVE: The COVID-19 pandemic and annual influenza epidemic are responsible for thousands of deaths globally. With a similarity in clinical as well as laboratory findings, there is a need to differentiate these two conditions on chest CT scan. This paper attempts to use existing literature to draw out differences in chest CT findings in COVID-19 and influenza. METHODS: A search was conducted using PubMed. 17 original studies on chest CT findings in COVID-19 and influenza were identified for full-text review and data analysis. Findings. COVID-19 and influenza share similar chest CT findings. The differences found show that COVID-19 ground-glass opacities are usually peripherally located with the lower lobes being commonly involved, while influenza has a central, peripheral, or random distribution usually affecting the five lobes. Vascular engorgement, pleural thickening, and subpleural lines were reported in COVID-19 patients. In contrast, pneumomediastinum and pneumothorax were reported only in studies on influenza. Conclusion and Relevance. COVID-19 and influenza have overlapping chest CT features with few differences which can assist in telling apart the two pathologies. Additional studies are needed to further define the differences and degree between COVID-19 and influenza.


title: Basic estimation-prediction techniques for Covid-19, and a prediction for Stockholm

text: An important task during the current Covid-19 pandemic is to predict the remainder of the epidemic, both without preventive measures and with. In the current paper we address this question using a simple estimation-prediction method. The input is the observed initial doubling time and a known value of R0. The simple General epidemic model is then fitted, and time calibration to calendar time is done using the observed number of case fatalities, together with estimates of the time between infection to death and the infection fatality risk. Finally, predictions are made assuming no change of behaviour, as well as for the situation where preventive measures are put in place at one specific time-point. The overall effect of the preventive measures is assumed to be known, or else estimated from the observed increased doubling time after preventive measures are put in place. The predictions are highly sensitive to the doubling times without and with preventive measures, sensitive to R0, but less sensitive to the estimates used for time-calibration: observed number of case fatalities, typical time between infection and death, and the infection fatality risk. The method is applied to the urban area of Stockholm, and predictions show that the peak of infections appear in mid-April and infections start settling in May.


title: Signature of N-terminal domain (NTD) structural re-orientation in NPC1 for proper alignment of cholesterol transport: Molecular dynamics study with mutation

text: The lysosomal membrane protein NPC1 (Niemann-Pick type C1) and NPC2 (Niemann-Pick type C2) are main players of cholesterol control in lysosome and it is known that mutation on these proteins leads to cholesterol trafficking related disease, called Niemann-Pick disease type C (NPC) disease. The mutation R518W or R518Q on NPC1 is one of such disease-related mutations, causing reduced cholesterol transport by half, resulting in accumulation of cholesterol and lipids in late endosomal/lysosomal region of the cell. Even though there has been significant progress in understanding cholesterol transport by NPC1 in combination with NPC2, especially after the structural determination of full length NPC1 in 2016, many details such as interaction of full length NPC1 with NPC2, molecular motions responsible for cholesterol transport during and after this interaction, and structure and function relations of many mutations are still not well understood. We report the extensive molecular dynamics simulations to gain insight into the structure and motions of NPC1 lumenal domain for cholesterol transport and disease behind the mutation (R518W). It is found that the mutation induces structural shift of NTD (N-terminal domain), toward the loop region in MLD (middle lumenal domain), which is believed to play central role in interaction with NPC2 protein, such that the interaction with NPC2 protein might be less favorable compare to wild NPC1. Also, the simulation indicates the possible re-orientation of the NTD, aligning to form an internal tunnel, after receiving the cholesterol from NPC2 with wild NPC1 unlike the mutated one, a possible pose for further action in cholesterol trafficking. We believe the current study can provide better understanding on the cholesterol transport by NPC1, especially the role of NTD of NPC1, in combination with NPC2 interaction. Synopsis modeling study of cholesterol binding protein NPC1


Delivery in Asymptomatic Italian Woman with SARS-CoV-2 Infection


title: ‘Finally, a virus got me.’ Scientist who fought Ebola and HIV reflects on facing death from COVID-19

text: Virologist Peter Piot, director of the London School of Hygiene & Tropical Medicine, fell ill with COVID-19 in mid-March He spent a week in a hospital and has been recovering at his home in London since Climbing a flight of stairs still leaves him breathless Piot, who grew up in Belgium, was one of the discoverers of the Ebola virus in 1976 and spent his career fighting infectious diseases He headed the Joint United Nations Programme on HIV/AIDS between 1995 and 2008 and is currently a coronavirus adviser to European Commission President Ursula von der Leyen But his personal confrontation with the new coronavirus was a life-changing experience, Piot says


title: Coronavirus disease 2019 (COVID-19): research progress and clinical practice

text: Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by SARS-CoV-2 As of March 30, 2020, there have been 693,224 reported patients with COVID-19 worldwide, with 1,446 in Japan Currently, although aspects of the route of transmission are unclear, infection by contact and by inhaling droplets is considered to be the dominant transmission route Inflammatory symptoms in the upper respiratory tract persist for several days to 1 week after onset, and in some patients symptoms of pneumonia worsen and become severe The presence of underlying diseases and advanced age are risk factors for increased severity Diagnosis is based on detection of SARS-CoV-2 by polymerase chain reaction (PCR) testing of nasopharyngeal swabs or sputum Symptomatic management is the main treatment for this disease Although the efficacy of several agents is currently being tested, at present there is no effective therapeutic agent To prevent infection, in addition to standard preventive measures, measures that counteract infection by contact and droplet inhalation are important In addition, if procedures that cause aerosolization of virus are used, then measures that prevent airborne infection should be implemented


title: Does Lockdown Decrease the Protective Role of ultraviolet-B (UVB) Radiation in Reducing COVID-19 Deaths?

text: Background: Nations are imposing unprecedented measures at large-scale to contain the spread of COVID-19 pandemic. Recent studies indicate that measures such as lockdowns may have slowed down the growth of COVID-19. However, in addition to substantial economic and social costs, these measures also limit the exposure to Ultraviolet-B radiation (UVB). Emerging observational evidence indicate the protective role of UVB and vitamin D in reducing the severity and mortality of COVID-19 deaths. In this observational study, we empirically outline the independent protective roles of lockdown and UVB exposure as measured by ultraviolet index (UVI), whilst also examining whether the severity of lockdown is associated with a reduction in the protective role. Methods. We apply a log-linear fixed-effects model to a panel dataset of 162 countries over a period of 108 days (n=6049). We use the cumulative number of COVID-19 deaths as the dependent variable and isolate the mitigating influence of lockdown severity on the association between UVI and growth-rates of COVID-19 deaths from time-constant country-specific and time-varying country-specific potentially confounding factors. Findings: After controlling for time-constant and time-varying factors, we find that a unit increase in UVI and lockdown severity are independently associated with 17% [-1.8 percentage points] and 77% [-7.9 percentage points] decline in COVID-19 deaths growth rate, indicating their respective protective roles. However, the widely utilized and least severe lockdown (recommendation to not leave the house) already fully mitigates the protective role of UVI by 95% [1.8 percentage points] indicating its downside. Interpretation: We find that lockdown severity and UVI are independently associated with a slowdown in the daily growth rates of cumulative COVID-19 deaths. However, we find consistent evidence that increase in lockdown severity is associated with a significant reduction in the protective role of UVI in reducing COVID-19 deaths. Our results suggest that lockdowns in conjunction with adequate exposure to UVB radiation might have provided even more substantial health benefits, than lockdowns alone. For example, we estimate that there would be 21% fewer deaths on average with sufficient UVB exposure while people were recommended not to leave their house. Therefore, our study outlines the importance of considering UVB exposure, especially while implementing lockdowns and may support policy decision making in countries imposing such measures.


title: Uncertainty quantification for polymer micromilling force models using Bayesian inference

text: Abstract In the current work, we describe and evaluate the application of Bayesian inference to estimate and/or refine the mechanistic model force coefficients, as well as to quantify the uncertainties associated with the force coefficients in force models for polymer micromilling. Proper modeling of forces is important to optimize process accuracy and productivity, including characterizing stability of micromachining process. Although the precision of mechanistic models depends on the uncertainty of the force coefficients, these models are deterministic and do not take into account the uncertainty in the model parameters. Bayesian inference provides a formal framework to incorporate uncertainty into the model formulation. In this study, the posterior probabilities in each Bayesian update are estimated using a numerical Markov Chain Monte Carlo (MCMC) scheme, known as Metropolis-Hastings (MH) algorithm. To determine the starting point of Markov Chain, two different calibration approaches are first used to obtain the deterministic coefficients of the mechanistic model: genetic algorithm (GA) and nonlinear regression. The uncertainties in these coefficients are then evaluated using the Bayesian inference approach. For both of the cases, a uniform prior distribution is used. Finally, the uncertainty in coefficients is propagated into predicted micromilling forces to obtain the uncertainties in predicted forces. It is concluded that the presented approach is successful in uncertainty quantification of the force model coefficients for polymer micromilling and assessing their effect on forces with different calibration approaches.


title: COVID-19 in Uganda: Predicting the impact of the disease and public health response on disease burden

text: Objective COVID-19 transmission and the lock-down response are now established in sub-Saharan Africa, including Uganda. Population age distributions and prior morbidities differ markedly in these countries from those where large outbreaks have become established previously. We determined to predict likely impact of COVID-19 and the response on the Ugandan population, measure and compare these appropriately, to understand whether the benefits of the response could be outweighed by the costs. Design and setting We applied age-based COVID-19 mortality data from China to the population structures of Uganda and countries with previously established outbreaks, comparing theoretical mortality and disability-adjusted life years (DALYs) lost. Based on recent Uganda health system data and on theoretical scenarios of program deterioration, we predicted potential mortality and DALYs lost for HIV/AIDS, malaria and maternal. Main outcome measures Disability-adjusted life years (DALYs) lost, mortality. Results Based on population age structure alone, Uganda is predicted to have a relatively low COVID-19 burden, with 12% of the mortality and 19% of the lost DALYs predicted for equivalent transmission in the Italian population. Scenarios of lockdown impact predict comparable or higher burdens from HIV or malaria alone to that of an extensive COVID-19 outbreak. Emerging disease data presented from Uganda, including HIV case finding and maternal mortality, suggest early signs that such deterioration could be occurring. Conclusions The results indicate that COVID-19 impact on Uganda may be relatively light, while there is a high risk of a significant negative impact on other disease burden if the lockdown response to COVID-19 is prolonged. The results are likely to extend to other sub-Saharan populations, underlining the importance of tailoring COVID-19 responses according to population structure and potential disease vulnerabilities.


title: A novel high specificity COVID-19 screening method based on simple blood exams and artificial intelligence

text: Background: The SARS-CoV-2 virus responsible for COVID-19 poses a significant challenge to healthcare systems worldwide. Despite governmental initiatives aimed at containing the spread of the disease, several countries are experiencing unmanageable increases in the demand for ICU beds, medical equipment, and larger testing capacity. Efficient COVID-19 diagnosis enables healthcare systems to provide better care for patients while protecting caregivers from the disease. However, many countries are constrained by the limited amount of test kits available, the lack of equipment and trained professionals. In the case of patients visiting emergency rooms (ERs) with a suspect of COVID-19, a prompt diagnosis can improve the outcome and even provide information for efficient hospital management. In this context, a quick, inexpensive and readily available test to perform an initial triage at ER could help to smooth patient flow, provide better patient care, and reduce the backlog of exams. Methods: In this Case-control quantitative study, we developed a strategy backed by artificial intelligence to perform an initial screening of suspect COVID-19 cases. We developed a machine learning classifier that takes widely available simple blood exams as input and predicts if that suspect case is likely to be positive (having SARS-CoV-2) or negative(not having SARS-CoV-2). Based on this initial classification, positive cases can be referred for further highly sensitive testing (e.g. CT scan, or specific antibodies). We used publicly available data from the Albert Einstein Hospital in Brazil from 5,644 patients. Focussing on using simple blood exams, a sample of 599 subjects that had the fewest missing values for 16 common exams were selected. From these 599 patients, only 81 were positive for SARS-CoV-2 (determined by RT-PCR). Based on this data, we built an artificial intelligence classification framework, ER-CoV, aiming at determining which patients were more likely to be negative for SARS-CoV-2 when visiting an ER and that were categorized as a suspect case by medical professionals. The primary goal of this investigation is to develop a classifier with high specificity and high negative predictive values, with reasonable sensitivity. Findings: We identified that our framework achieved an average specificity of 92.16% [95% CI 91.73 - 92.59] and negative predictive value (NPV) of 95.29% [95% CI 94.65% - 95.90%]. Those values are completely aligned with our goal of providing an effective low-cost system to triage suspected patients at ERs. As for sensitivity, our model achieved an average of 63.98% [95% CI 59.82% - 67.50%] and positive predictive value (PPV) of 48.00% [95% CI 44.88% - 51.56%]. An error analysis identified that, on average, 45% of the false negative results would have been hospitalized anyway, thus the model is making mistakes for severe cases that would not be overlooked, partially mitigating the fact that the test is not high-sensitive. All code for our AI model, called ER-CoV is publicly available at https://github.com/soares-f/ER-CoV. Interpretation: Based on the capacity of our model to accurately predict which cases are negative from suspected patients arriving at emergency rooms, we envision that this framework can play an important role in patient triage. Probably the most important outcome is related to testing availability, which at this point is extremely low in many countries. Considering the achieved specificity, we would reduce by at least 90% the number of SARS-CoV-2 tests performed at emergency rooms, with the chance of getting a false negative at around 5%. The second important outcome is related to patient management in hospitals. Patients predicted as positive by our framework could be immediately separated from the other patients while waiting for the results of confirmatory tests. This could reduce the spread rate inside hospitals since in many hospitals all suspected cases are kept in the same ward. In Brazil, where the data was collected, rate infection is starting to quickly spread, the lead time of a SARS-CoV-2 can be up to 2 weeks. Funding: University of Sheffield provided financial support for the Ph.D scholarship for Felipe Soares.


title: Can India stay immune enough to combat COVID‐19 pandemic? An economic query

text: The COVID‐19 pandemic has affected different sectors of the economy in an unprecedented way, and this article is an attempt to analyze the economic effect of the outbreak in India. However, before we assess the economic cost associated with the pandemic, we economists fully consider the outbreak as a human tragedy. There has not been any econometric technique that can account the countless human sufferings that the crisis has brought. Through this article, we address several important research questions and demonstrate India's strength to stay immune to combat COVID‐19 pandemic. The research questions are as follows. First, what will be the effect of COVID‐19 on the Indian economy and how does it affect the different sectors of the economy? Second, how does the pandemic affect the bilateral trade relation between India and China? Third, we question the role of the public health system in dealing with the outbreak of the virus in India. This article also presents the growth projection of the Indian economy by different economic agents. We finally conclude the article by mentioning a few policy recommendations for the Indian economy.


title: The association between treatment with heparin and survival in patients with Covid-19

text: Objectives: This study investigates the association between the treatment with heparin and mortality in patients admitted with Covid-19. Methods: Routinely recorded, clinical data, up to the 24th of April 2020, from the 2075 patients with Covid-19, admitted in 17 hospitals in Spain between the 1st of March and the 20th of April 2020 were used. The following variables were extracted for this study: age, gender, temperature, and saturation of oxygen on admission, treatment with heparin, hydroxychloroquine, azithromycin, steroids, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir, together with data on mortality. Multivariable logistic regression models were used to investigate the associations. Results: At the time of collecting the data, 301 patients had died, 1447 had been discharged home from the hospitals, 201 were still admitted, and 126 had been transferred to hospitals not included in the study. Median follow up time was 8 (IQR:5-12) days. Heparin had been used in 1734 patients. Heparin was associated with lower mortality when the model was adjusted for age and gender, with OR (95%CI): 0.55 (0.37-0.82) p=0.003. This association remained significant when saturation of oxygen <90%, and temperature >37C were added to de model with OR: 0.54(0.36-0.82) p=0.003, and also when all the other drugs were included as covariates OR: 0.42 (0.26-0.66) p<0.001. Conclusions: The association between heparin and lower mortality observed in this study can be acknowledged by clinicians in hospitals and in the community. Randomized controlled trials to assess the causal effects of heparin in different therapeutic regimes are required.


title: AAEDM: Theoretical Dynamic Epidemic Diffusion Model and Covid-19 Korea Pandemic Cases

text: This paper deals with an advanced analytical epidemic diffusion model which is capable to predict the status of epidemic impacts. This newly propose model well describes an epidemic growth and it could be widely applied into various topics including pathology, epidemiology, business and data sciences. The Advanced Analytical Epidemic Diffusion Model (AAEDM) is a dynamic diffusion prediction model which is theoretically intuitive and its tractable closed formula could be easily adapted into versatile Bigdata driven analytics including the machine learning system. This dynamic model is still an analytical model but the periods of prediction are segmented for adapting the values from the dataset when the data is available. The epidemiologically vital parameters which effect on the AAEDM are also introduced in this paper. The evaluation of this theoretical model based on the Covid-19 data in Korea has been accomplished with relative fair future prediction accuracies. Although this analytical model has been designed from a basic exponential growth model, the performance of the AAEDM is competitive with other Bigdata based simulation models. Since the AAEDM is relatively simple and handy, anyone can use this model into analyzing outbreak situations in his daily life.


Navigating the COVID-19 Pandemic as an Oncology Nurse


SPECIAL COVID-19 COVERAGE: Breaking News: Should ED Staff Move Out of Their Homes?


title: A first study on the impact of containment measure on COVID-19 spread in Morocco

text: Background: Since the appearance of the first case of COVID-19 in Morocco, the cumulative number of reported infectious cases continues to increase and, consequently, the government imposed the containment measure within the country. Our aim is to predict the impact of the compulsory containment on COVID-19 spread. Earlier knowledge of the epidemic characteristics of COVID-19 transmission related to Morocco will be of great interest to establish an optimal plan-of-action to control the epidemic. Method: Using a Susceptible-Asymptomatic-Infectious model and the data of reported cumulative confirmed cases in Morocco from March 2nd to April 9, 2020, we determined the basic and control reproduction numbers and we estimated the model parameter values. Furthermore, simulations of different scenarios of containment are performed. Results: Epidemic characteristics are predicted according to different rates of containment. The basic reproduction number is estimated to be 2.9949, with CI(2.6729-3.1485). Furthermore, a threshold value of containment rate, below which the epidemic duration is postponed, is determined. Conclusion: Our findings show that the basic reproduction number reflects a high speed of spread of the epidemic. Furthermore, the compulsory containment can be efficient if more than 73% of population are confined. However, even with 90% of containment, the end-time is estimated to happen on July 4th which can be harmful and lead to consequent social-economic damages. Thus, containment need to be accompanied by other measures such as mass testing to reduce the size of asymptomatic population. Indeed, our sensitivity analysis investigation shows that the COVID-19 dynamics depends strongly on the asymptomatic duration as well as the contact and containment rates. Our results can help the Moroccan government to anticipate the spread of COVID-19 and avoid human loses and consequent social-economic damages as well.


title: Upregulation of Human Endogenous Retroviruses in Bronchoalveolar Lavage Fluid of COVID-19 Patients

text: Background: Severe COVID-19 pneumonia has been associated with the development of intense inflammatory responses during the course of infections with SARS-CoV-2. Given that Human Endogenous Retroviruses (HERVs) are known to be activated during and participate in inflammatory processes, we examined whether HERV dysregulation signatures are present in COVID-19 patients. Results: By comparing transcriptomes of Peripheral Blood Monocytes (PBMCs) and Bronchoalveolar Lavage Fluid (BALF) from patients and normal controls we have shown that HERVs are intensely dysregulated in BALF, but not in PBMCs. In particular, upregulation in the expression of multiple HERV families was detected in BALF samples of COVID-19 patients, with HERV-W being the most highly upregulated family among the families analysed. In addition, we compared the expression of HERVs in Human Bronchial Epithelial Cells (HBECs) without and after senescence induction in an oncogene-induced senescence model, in order to quantitatively measure changes in the expression of HERVs in bronchial cells during the processes of cellular senescence. Conclusions: This apparent difference of HERV dysregulation between PBMCs and BALF warrants further studies in involvement of HERVs in inflammatory pathogenetic mechanisms as well as exploration of HERVs as potential biomarkers for disease progression. Furthermore, the increase in the expression of HERVs in senescent HBECs in comparison to non-induced HBECs provides a potential link for increased COVID-19 severity and mortality in aged populations.


title: Response strategies for COVID-19 epidemics in African settings: a mathematical modelling study

text: Background The health impact of COVID-19 may differ in African settings as compared to countries in Europe or China due to demographic, epidemiological, environmental and socio-economic factors. We evaluated strategies to reduce SARS-CoV-2 burden in African countries, so as to support decisions that balance minimising mortality, protecting health services and safeguarding livelihoods. Methods We used a Susceptible-Exposed-Infectious-Recovered mathematical model, stratified by age, to predict the evolution of COVID-19 epidemics in three countries representing a range of age distributions in Africa (from oldest to youngest average age: Mauritius, Nigeria and Niger), under various effectiveness assumptions for combinations of different non-pharmaceutical interventions: self-isolation of symptomatic people, physical distancing, and shielding (physical isolation) of the high-risk population. We adapted model parameters to better represent uncertainty about what might be expected in African populations, in particular by shifting the distribution of severity risk towards younger ages and increasing the case-fatality ratio. Results We predicted median clinical attack rates over the first 12 months of 17% (Niger) to 39% (Mauritius), peaking at 2-4 months, if epidemics were unmitigated. Self-isolation while symptomatic had a maximum impact of about 30% on reducing severe cases, while the impact of physical distancing varied widely depending on percent contact reduction and R 0 . The effect of shielding high-risk people, e.g. by rehousing them in physical isolation, was sensitive mainly to residual contact with low-risk people, and to a lesser extent to contact among shielded individuals. Response strategies incorporating self-isolation of symptomatic individuals, moderate physical distancing and high uptake of shielding reduced predicted peak bed demand by 46% to 54% and mortality by 60% to 75%. Lockdowns delayed epidemics by about 3 months. Estimates were sensitive to differences in age-specific social mixing patterns, as published in the literature. Discussion In African settings, as elsewhere, current evidence suggests large COVID-19 epidemics are expected. However, African countries have fewer means to suppress transmission and manage cases. We found that self-isolation of symptomatic persons and general physical distancing are unlikely to avert very large epidemics, unless distancing takes the form of stringent lockdown measures. However, both interventions help to mitigate the epidemic. Shielding of high-risk individuals can reduce health service demand and, even more markedly, mortality if it features high uptake and low contact of shielded and unshielded people, with no increase in contact among shielded people. Strategies combining self-isolation, moderate physical distancing and shielding will probably achieve substantial reductions in mortality in African countries. Temporary lockdowns, where socioeconomically acceptable, can help gain crucial time for planning and expanding health service capacity.


title: Effect of various decontamination procedures on disposable N95 mask integrity and SARS-CoV-2 infectivity

text: The COVID-19 pandemic has created a high demand on personal protective equipment, including disposable N95 masks. Given the need for mask reuse, we tested the feasibility of vaporized hydrogen peroxide (VHP), ultraviolet light (UV), and ethanol decontamination strategies on N95 mask integrity and the ability to remove the infectious potential of SARS-CoV-2. FIT test data showed functional degradation by both ethanol and UV decontamination to different degrees. VHP treated masks showed no significant change in function after two treatments. We also report a single SARS-CoV-2 virucidal experiment using Vero E6 cell infection. We hope our data will guide further research for evidenced-based decisions for disposable N95 mask reuse and help protect caregivers from SARS-CoV-2 and other pathogens.


title: A statistical forecast of LOW mortality and morbidity due to COVID-19, in ARGENTINA and other Southern Hemisphere countries.

text: A set of open source programs in Python is devised to fit a parametric integrated Gaussian equation to cumulative deaths due to COVID-19 in Southern Hemisphere countries. The programs were successfully tested using data from advanced outbreak trajectories (Italy and Spain). The procedure was applied to data reported by Argentina. The projected total death toll will be 182 (277-182) with a peak of deaths (6(+/-2)) the 14 of April. The outbreak begins the 9th of March and end completely the 20th of May. However, already on 1st of May, 2 s (95.45%) of the deaths have occurred. The death toll arises from a number of infected individuals between 36412 and 2275. Then, they were to use to process data from several Southern Hemisphere countries: Argentina, Brazil, Mexico, Peru, Colombia, Ecuador, Cuba, Chile, Panama, Australia, Bolivia, Honduras, New Zealand, Paraguay, Guatemala, Venezuela, Uruguay, El Salvador, Jamaica, Haiti, Costa Rica and Nicaragua. The trend is to show low number of total deaths compared with other disease outbreaks. A total projected number of deaths between 15148 and 9939 deaths for a total population of ca. 664 M inhabitants. The projected death toll is much lower (5-10 times) than those forecasted by the Imperial College Group (ICG) even considering the best scenario of total suppression of virus transmission. Using actual mortality rates it is possible to back calculate which number of infected individuals would produce such mortality. The calculated number of infected individuals (worst case scenario) is below 2.5 million. This is significantly lower than that calculated by ICG (> 45 millions). In most countries the outbreak will end in May or early June. The dynamics of the outbreaks seems to do not saturate the health services (hospital beds) but only Peru, Ecuador and Panama should have not enough ICU beds for grave COVID-19 patients


title: Safety and Efficacy of Avaren-Fc Lectibody Targeting HCV High-Mannose Glycans in a Human Liver Chimeric Mouse Model

text: Infection with hepatitis C virus (HCV) remains to be a major cause of morbidity and mortality worldwide despite the recent advent of highly effective direct-acting antivirals. The envelope glycoproteins of HCV are heavily glycosylated with a high proportion of high-mannose glycans (HMGs), which serve as a shield against neutralizing antibodies and assist in the interaction with cell-entry receptors. However, currently there is no approved therapeutic targeting this potentially druggable biomarker. Here, we investigated the therapeutic potential of the lectibody Avaren-Fc (AvFc), a HMG-binding lectin-Fc fusion protein. In vitro assays showed AvFc’s capacity to neutralize cell culture-derived HCV in a genotype independent manner with IC50 values in the low nanomolar range. A histidine buffer-based AvFc formulation was developed for in vivo studies using the PXB human liver chimeric mouse model. Systemic administration of AvFc was well tolerated; after 11 consecutive doses every other day at 25 mg/kg, there were no significant changes in body or liver weights, nor any impact noted in blood human albumin levels or serum alanine aminotransferase activity. Gross necropsy and liver pathology further confirmed the lack of discernible toxicity. This treatment regimen successfully prevented genotype 1a HCV infection in all animals, while an AvFc mutant lacking HMG binding activity failed to block the infection. These results suggest that targeting envelope HMGs is a promising therapeutic approach against HCV infection. In particular, AvFc may provide a safe and efficacious means to prevent recurrent infection upon liver transplantation in HCV-related end-stage liver disease patients.


title: EFFECTIVENESS OF BASELINE AND POST-PROCESSED CHEST X-RAY IN NONEARLY COVID-19 PATIENTS

text: Background CT is a very sensitive technique to detect pneumonia in COVID-19 patients. However, it is impaired by high costs, logistic issues and high risk of exposure. Chest x-ray (CXR) is a low-cost, low-risk, not time consuming technique and is emerging as the recommended imaging modality to use in COVID-19 pandemic. This technique, although less sensitive than CT-scan, can provide useful information about pulmonary involvement. Purpose To describe chest x-ray features of COVID-19 pneumonia and to evaluate the sensitivity of this technique in detecting pneumonia. A further scope is to assess the effectiveness of a post-processing algorithm in improving lung lesions detectability. Materials and Methods 72 patients with laboratory-confirmed COVID-19 underwent bedside chest X-ray. Two radiologists were asked to express their opinion about: (i) presence of pneumonia (negative or positive); (ii) localization (unilateral or bilateral); (iii) topography (according to pulmonary fields); (iv) density (non consolidative ground-glass or inhomogeneous opacities; consolidative nodulartype or triangular; mixed consolidative e non-consolidative); and (v) presence of pleural effusion. The point (i) was evaluated separately, while the other points in consensus. A quality assessment of post-processed x-ray images was performed by two different readers. Results The agreement about presence of pneumonia was almost perfect with K value of 0.933 and p < 0.001. Sensitivity was 69%. The following findings were seen: unilateral lung involvement in 50%; lower lung lesions in 54%; peripheral distribution in 48%; and non-consolidative pattern in 44%. Post-processed images improved the detection of lesions in 7 out 72 patients ({cong}10%) Conclusion CXR owns a good sensitivity in detecting COVID-19 lung involvement. Use of post-processing algorithm can improve detection of lesions. Our data support recommendations of the Radiological Society of North America (RSNA) to consider chest x-ray as first step imaging examination in Covid-19 patients.


title: Ultra brief psychological interventions for covid-19 pandemic: Introduction of a locally-adapted brief intervention for mental health and psychosocial support service

text: The ultra-brief psychological interventions (UBPI) was created in 2018 to empower healthcare providers with psychological skills that can be delivered within a short period. Techniques used within UBPI were adopted from a variety of well established psychotherapies and distilled into its core essentials. This enabled practitioners of UBPI to deliver specific psychological skills in the appropriate context to the client within a period of 15–20 min. UBPI was also manualised to standardised training of practitioners. During the novel coronavirus disease of 2019 (COVID-19) pandemic, UBPI was modified to suit the unique psychological demands of the pandemic. This article presents how UBPI was adapted and used with healthcare providers dealing with COVID-19 and also with the public who required psychological first aid (PFA).


title: Inflammatory markers in Covid-19 Patients: a systematic review and meta-analysis.

text: Introduction Diagnosis of COVID-19 is based on clinical manifestation, history of exposure, positive findings on chest CT and laboratory tests. It has been shown that inflammation plays a role in pathogenesis of COVID-19. Method We used the necessary transformations to convert the median and IQR to mean and SD Random-effect model using Der Simonian, and Laird methods was used if heterogeneity between studies was significant, the homogeneity among studies was assessed with I2 Statistic, values above 50%, and for the chi-square test, P-values <0.1 was supposed statistically significant Results Twelve studies were included in the analysis that all of which were conducted in China in the year 2020. The result of combining 12 articles with 772 participants showed that the pooled estimate of the mean of lymphocyte with 95% CI was (Mean: 1.01; 95% CI (0.76-1.26); p-value<0.001). About WBC the pooled result of 9 studies with 402 participants was (Mean: 5.11; 95% CI (3.90-6.32); p-value<0.001) Also the pooled mean estimate of 9 studies with 513 patients for the ratio of Neutrophil/lymphocyte was (Mean: 3.62; 95% CI (1.48-5.77); p-value=0.001). The pooled mean from the combination of 7 studies with 521 patients on CRP was (Mean: 28.75; 95% CI (8.04-49.46). Conclusion Inflammatory Markers increase in patients with Covid-19, which can be a good indicator to find patients.


title: Analysis of Effectiveness of Quarantine Measures in Controlling COVID-19

text: COVID-19 has created an interesting discourse among the people of the world particularly regarding preventive measures of infectious diseases. In this paper, the authors forecast the spread of the Corona virus outbreak and study how the reduction of transmission rates influences its decline. The paper makes use of the SIR (Susceptible Infected Recovered) Model which is a deterministic model used in the field of epidemiology-based on differential equations derived from sections of the population. The Basic Reproduction Number (Ro) represents the criticality of the epidemic in numeric terms. Forecasting an epidemic provides insights about the geographic spreading of the disease and the case incidences required to better inform intervention strategists about situations that may occur during the outbreak. Through this research paper, the authors wish to provide an insight into the impact of control measures on the pandemic. By drawing a comparison of three countries and their quarantine measures, observations on the decline of the outbreak are made. Authors intend to guide the intervention strategies of under-resourced countries like India and aid in the overall containment of the outbreak.


title: A rapid, low cost, and highly sensitive SARS-CoV-2 diagnostic based on whole genome sequencing

text: Early detection of infection with SARS-CoV-2 is key to managing the current global pandemic, as evidence shows the virus is most contagious on or before symptom onset. Here, we introduce a low-cost, high-throughput method for diagnosis of SARS-CoV-2 infection, dubbed Pathogen-Oriented Low-Cost Assembly & Re-Sequencing (POLAR), that enhances sensitivity by aiming to amplify the entire SARS-CoV-2 genome rather than targeting particular viral loci, as in typical RT-PCR assays. To achieve this goal, we combine a SARS-CoV-2 enrichment method developed by the ARTIC Network (https://artic.network/) with short-read DNA sequencing and de novo genome assembly. We are able to reliably (>95% accuracy) detect SARS-CoV-2 at concentrations of 84 genome equivalents per milliliter, better than the reported limits of detection of almost all diagnostic methods currently approved by the US Food and Drug Administration. At higher concentrations, we are able to reliably assemble the SARS-CoV-2 genome in the sample, often with no gaps and perfect accuracy. Such genome assemblies enable the spread of the disease to be analyzed much more effectively than would be possible with an ordinary yes/no diagnostic, and can help identify vaccine and drug targets. Finally, we show that POLAR diagnoses on 10 of 10 clinical nasopharyngeal swab samples (half positive, half negative) match those obtained in a CLIA-certified lab using the Center for Disease Control’s 2019-Novel Coronavirus test. Using POLAR, a single person can process 192 samples over the course of an 8-hour experiment, at a cost of ∼$30/patient, enabling a 24-hour turnaround with sequencing and data analysis time included. Further testing and refinement will likely enable greater enhancements in the sensitivity of the above approach.


The relevance of COVID-19 pandemic to psychiatry


docid: tyhtdawb

title: COVID-19: Effects of weather conditions on the propagation of respiratory droplets

text: As the number of confirmed cases of Coronavirus disease 2019 (COVID-19) continues to increase, there has been a rising concern regarding the effect of weather conditions, especially over the upcoming summer, on the transmission of this disease. In this study, we assess the transmission of COVID-19 under different weather conditions by investigating the propagation of infectious respiratory droplets. A comprehensive mathematical model is established to explore their evaporation, heat transfer and kinematics under different temperature, humidity and ventilation conditions. The transmitting pathway of COVID-19 through respiratory droplets is divided into short-range droplet contacts and long-range aerosol exposure. We show that the effect of weather conditions is not monotonic: low temperature and high humidity facilitate droplet contact transmission, while high temperature and low humidity promote the formation of aerosol particles and accumulation of particles with a diameter of 2.5 m or less (PM2.5). Our model suggests that the 6 ft of social distance recommended by the Center for Disease Control and Prevention (CDC) may be insufficient in certain environmental conditions, as the droplet spreading distance can be as long as 6 m (19.7 ft) in cold and humid weather. The results of this study suggest that the current pandemic may not ebb in the summer of the northern hemisphere without proper intervention, as there is an increasing chance of aerosol transmission. We also emphasize that the meticulous design of building ventilation systems is critical in containing both the droplet contact infections and aerosol exposures.


title: Utah-Stanford Ventilator (Vent4US): Developing a rapidlyscalable ventilator for COVID-19 patients with ARDS

text: We describe a minimum, rapidly scalable ventilator designed for COVID-19 patients with ARDS. Our design philosophy is not only to try to address potential ventilator shortages, but also to account for uncertainties in the supply chains of parts commonly used in traditional ventilators. To do so we employ a modular design approach and broadly explore taking advantage of parts from non-traditional supply chains. In our current prototype, we demonstrate volume control with assist control on a test lung and present a linear actuator-driven pinch valve-based implementation for both pressure control and volume control with decelerating inspiratory flow. We estimate the component cost of the system to be around $500. We publish our draft design documents and current implementation which is open and accessible in the hope that broadening the community globally will accelerate arriving at a solution and that peer review will improve the final design.


title: Changing trends of excess self-protective behavior, and association with belief in prevention myths during the COVID-19 epidemic in China: A panel study

text: Abstract Objective This prospective observational study examined changing trends of excess self-protective behavior (EPB), and its association with perceived risk, severity and belief in prevention myths during the Chinese COVID-19 epidemic. Methods The study employed a longitudinal design. Participants were recruited for an online panel survey from chat groups on social media platforms. Descriptive statistics and the CATMOD program were used for data analysis. Findings Participants numbered 150 for the linkable baseline survey and 102 for the final survey. There were 5 waves of interviews. The prevalence of participants perceiving a personal risk of contracting COVID-19, and severe consequences of the disease, was 18.6% and 25.5%, respectively. Their prevalence had declined to 4.9% and 17.6%, respectively, by the last observation point. The 5 selected EPBs also manifested a decreasing trend. Belief in COVID-19 prevention myths trended upwards. Perceived risk was positively associated with each EPB, and perceived severity with disinfection of clothes and hoarding of products. Myth adherence was positively associated with disinfection of clothes and both hand washing and sanitization. Conclusion This study yielded new information about EPB among the public during the COVID-19 epidemic. Policy and health education modifications are essential for minimizing the adverse health effects of subscribing to prevention myths.


title: Elementary spatial structures and dispersion of COVID-19: health geography directing responses to public health emergency in Sao Paulo State, Brazil

text: Public health policies to contain the spread of COVID-19 rely mainly on non-pharmacological measures. Those measures, especially social distancing, are a challenge for developing countries, such as Brazil. In Sao Paulo, the most populous state in Brazil (45 million inhabitants), most COVID-19 cases up to April 18th were reported in the Capital and metropolitan area. However, the inner municipalities, where 20 million people live, are also at risk. As governmental authorities discuss the loosening of measures for restricting population mobility, it is urgent to analyze the routes of dispersion of COVID-19 in those municipalities. In this ecological study, we use geographical models of population mobility as patterns for spread of SARS-Cov-2 infection. Based on surveillance data, we identify two patterns: one by contiguous diffusion from the capital metropolitan area and other that is hierarchical, with long-distance spread through major highways to cities of regional relevance. We also modelled the impact of social distancing strategies in the most relevant cities, and estimated a beneficial effect in each and every setting studied. This acknowledgement can provide real-time responses to support public health strategies.


title: Estimation of the Time-Varying Reproduction Number of COVID-19 Outbreak in China

text: Background: The 2019-nCoV outbreak in Wuhan, China has attracted world-wide attention. As of February 11, 2020, a total of 44730 cases of novel coronavirus-infected pneumonia associated with COVID-19 were confirmed by the National Health Commission of China. Methods: Three approaches, namely Poisson likelihood-based method (ML), exponential growth rate-based method (EGR) and stochastic Susceptible-Infected-Removed dynamic model-based method (SIR), were implemented to estimate the basic and controlled reproduction numbers. Results: A total of 71 chains of transmission together with dates of symptoms onset and 67 dates of infections were identified among 5405 confirmed cases outside Hubei as reported by February 2, 2020. Based on this information, we find the serial interval having an average of 4.41 days with a standard deviation of 3.17 days and the infectious period having an average of 10.91 days with a standard deviation of 3.95 days. Conclusions: The controlled reproduction number is declining. It is lower than one in most regions of China, but is still larger than one in Hubei Province. Sustained efforts are needed to further reduce the Rc to below one in order to end the current epidemic.


title: Preparation of alcohol-based handrub in COVID-19 Alsatian cluster

text: Alsace, in particular Haut-Rhin, is one of the main clusters of COVID-19 in France There has been a shortage of essential supplies in the area, especially alcohol-based hand sanitizer In this context, and in accordance with the decree dated March 6, 2020, our hospital management team asked us to start local production of alcohol-based handrub This was a real challenge: In one week, we had to implement the production of handrub to meet the needs of a 1,400-bed hospital The production had to comply with the French preparation guidelines and take place on specific premises, with qualified and calibrated equipment, by qualified staff, under the supervision of a pharmacist The other big challenge we faced was the supply of pharmaceutical raw and packaging materials During this particular critical period, all suppliers were out of stock Here, we describe the organizational set-up and the decisions made, e g , to use technical-grade ethanol before the publication of the decrees dated March 13 and March 23, 2020


title: D614G mutation of SARS-CoV-2 spike protein enhances viral infectivity

text: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The spike (S) protein that mediates SARS-CoV-2 entry into host cells is a major target for vaccines and therapeutics. Thus, insights into its sequence variations are key to understanding the infection and antigenicity of SARS-CoV-2. A dominant mutational variant at position 614 of the S protein (aspartate to glycine, D614G mutation) was observed in the SARS-CoV-2 genome sequence obtained from the Nextstrain database. Using a pseudovirus-based assay, we identified that S-D614 and S-G614 protein pseudotyped viruses share a common receptor, human angiotensin-converting enzyme 2 (ACE2), which could be blocked by recombinant ACE2 with the fused Fc region of human IgG1. However, S-D614 and S-G614 protein demonstrated functional differences. First, S-G614 protein could be cleaved by serine protease elastase-2 more efficiently. Second, S-G614 pseudovirus infected 293T-ACE2 cells significantly more efficiently than did the S-D614 pseudovirus, especially in the presence of elastase-2. Third, an elastase inhibitor approved for clinical use blocked elastase-enhanced S-G614 pseudovirus infection. Moreover, 93% (65/70) convalescent sera from patients with COVID-19 could neutralize both S-D614 and S-G614 pseudoviruses with comparable efficiencies, but about 7% (5/70) convalescent sera showed reduced neutralizing activity against the S-G614 pseudovirus. These findings have important implications for SARS-CoV-2 transmission and immune interventions.


title: Statistical analysis of the impact of environmental temperature on the exponential growth rate of cases infected by COVID-19

text: We perform a statistical analysis for understanding the effect of the environmental temperature on the exponential growth rate of the cases infected by COVID-19 for US and Italian regions. In particular, we analyze the datasets of regional infected cases, derive the growth rates for regions characterized by readable exponential growth phase in their evolution spread curve and plot them against the environmental temperatures averaged within the same regions, derive the relationship between temperature and growth rate, and evaluate its statistical confidence. The results clearly support the first reported statistically significant relationship of negative correlation between the average environmental temperature and exponential growth rates of the infected cases. The critical temperature, which eliminates the exponential growth, and thus the COVID-19 spread in US regions, is estimated to be Tc = 86.1 ± 4.3 F.


title: Cohen's kappa statistics as a convenient means to identify accurate SARS-CoV-2 rapid antibody tests

text: There are many available rapid antibody tests, but the performance of such tests remains unclear. Moreover, it is difficult to compare among the various devices regarding their sensitivity & specificity. In order to compare the performance of such devices, we used Cohen's kappa statistics to assess the level of agreement between RT-PCR and rapid antibody tests. In doing this study, we considered the term of validity after symptom-onset to compare two tests. It takes more than a week to produce antibodies in the body, and RT-PCR thus gives negative result in the convalescent period. On ELISA data from the literature kappa statistics was calculated as 1.0 beyond 10 days after symptom-onset. By taking these factors into consideration, we evaluated agreement with samples collected beyond 10 days of symptom-onset during the active period. We calculated the data from 9 devices, and the kappa statistics for English data were calculated as 0.64 on average. The same finding was 0.75 for Chinese data. These results corresponded with the values from sensitivity & specificity of their reports. Both reports had no details about the collection procedures. Kappa statistics might become even more accurate, if samples could be restricted to ones collected beyond 10 days. Regarding the data from our hospital', the kappa statistics was 0.97 when restricted to samples collected beyond 10 days, which thus showed excellent agreement. By using kappa statistics, the performances of rapid antibody tests can be shown as one figure, so that their comparison becomes easy to carry out.


title: Radiological Findings in COVID-19 and Adaptive Approaches for Radiology Departments: Literature Review and Experience Sharing

text: Radiological investigations play an important role in the treatment course of patients with coronavirus disease 2019 (COVID-19) and radiologists should be familiar with the imaging characteristics Being an integral component of the healthcare system, radiology departments have made adaptations to enhance infection control and strengthen the service In this article, we review the radiological features of COVID-19 on chest radiography and computed tomography, and share experiences on the adaptive approach of radiology departments amidst the COVID-19 pandemic


title: Real-time estimation of R_0 for supporting public-health policies against COVID-19

text: Background: In the absence of a consensus protocol to slow down the current SARS- CoV2 spread, policy makers are in need of real-time indicators to support decisions in public health matters. The Basic Reproduction Number (R_0) represents viral spread rate and can be dramatically modified by the application of effective public control measures. However, current methodologies to calculate R_0 from data remain cumbersome and unusable during an outbreak. Objective: To provide a simple mathematical formulation for obtaining R_0 in Real-Time, and apply it to assess the effectiveness of public-health policies in different iconic countries. Study design: By modifying the equations describing the spread of the virus, we derived a real-time $R_0$ estimator that can be readily calculated from daily official case reports. Results: We show the application of a time trend analysis of the R_0 estimator to assess the efficacy and promptness of public health measures that impacted on the development of the COVID-19 epidemic in iconic countries. Conclusions: We propose our simple estimator and method as useful tools to follow and assess in real time the effectiveness of public health policies on COVID-19 evolution.


title: Epidemic Landscape and Forecasting of SARS-CoV-2 in India

text: BACKGROUND India was one of the countries to institute strict measures for SARS-CoV-2 control in early phase. Since, then, the epidemic growth trajectory was slow before registering an explosion of cases due to local cluster transmissions. METHODS We estimated growth rate and doubling time of SARS-CoV-2 for India and high burden states using crowd sourced time series data. Further, we also estimated Basic Reproductive Number (R0) and time dependent reproductive number (Rt) using serial intervals from the data. We compared the R0 estimated from five different methods and R0 from SB was further used in analysis. We modified standard SIR models to SIRD model to accommodate deaths using R0 with the Sequential Bayesian method (SBM) for simulation in SIRD models. RESULTS On an average, 2.8 individuals were infected by an index case. The mean serial interval was 3.9 days. The R0 estimated from different methods ranged from 1.43 to 1.85. The mean time to recovery was 14, SD 5.3 days. Daily epidemic growth rate of India was 0.16 [95%CI; 0.14, 0.17] with a doubling time of 4.30 days [95%CI; 3.96, 4.70]. From the SIRD model, it can be deduced that the peak of SARS-CoV-2 in India will be around mid-July to early August 2020 with around 12.5% likely to be infected at peak time of incidence. CONCLUSIONS The pattern of spread of SARS-CoV-2 in India is suggestive of community transmission. There is a need to increase fund for infectious disease research and epidemiologic studies. All the current gains may be reversed rapidly if air travel and social mixing resumes rapidly. For the time being, these must be resumed only in a phased manner, and should be back to normal levels only after we are prepared to deal with the disease with efficient tools like vaccine or a medicine.


title: A mathematical model for the spatiotemporal epidemic spreading of COVID19

text: An outbreak of a novel coronavirus, named SARS-CoV-2, that provokes the COVID-19 disease, was first reported in Hubei, mainland China on 31 December 2019. As of 20 March 2020, cases have been reported in 166 countries/regions, including cases of human-to-human transmission around the world. The proportions of this epidemics is probably one of the largest challenges faced by our interconnected modern societies. According to the current epidemiological reports, the large basic reproduction number, R_0 ~ 2.3, number of secondary cases produced by an infected individual in a population of susceptible individuals, as well as an asymptomatic period (up to 14 days) in which infectious individuals are undetectable without further analysis, pave the way for a major crisis of the national health capacity systems. Recent scientific reports have pointed out that the detected cases of COVID19 at young ages is strikingly short and that lethality is concentrated at large ages. Here we adapt a Microscopic Markov Chain Approach (MMCA) metapopulation mobility model to capture the spread of COVID-19. We propose a model that stratifies the population by ages, and account for the different incidences of the disease at each strata. The model is used to predict the incidence of the epidemics in a spatial population through time, permitting investigation of control measures. The model is applied to the current epidemic in Spain, using the estimates of the epidemiological parameters and the mobility and demographic census data of the national institute of statistics (INE). The results indicate that the peak of incidence will happen in the first half of April 2020 in absence of mobility restrictions. These results can be refined with improved estimates of epidemiological parameters, and can be adapted to precise mobility restrictions at the level of municipalities. The current estimates largely compromises the Spanish health capacity system, in particular that for intensive care units, from the end of March. However, the model allows for the scrutiny of containment measures that can be used for health authorities to forecast with accuracy their impact in prevalence of COVID--19. Here we show by testing different epidemic containment scenarios that we urge to enforce total lockdown to avoid a massive collapse of the Spanish national health system.


title: The potential SARS-CoV-2 entry inhibitor

text: Outbreak of coronavirus disease 2019 (COVID-19) occurred in Wuhan and has rapidly spread to almost all parts of world. In coronaviruses, the receptor binding domain (RBD) in the distal part of S1 subunit of SARS-CoV-2 spike protein can directly bind to angiotensin converting enzyme 2 (ACE2). RBD promote viral entry into the host cells and is an important therapeutic target. In this study, we discovered that theaflavin showed the lower idock score (idock score: −7.95 kcal/mol). To confirm the result, we discovered that theaflavin showed FullFitness score of −991.21 kcal/mol and estimated ΔG of −8.53 kcal/mol for the most favorable interaction with contact area of SARS-CoV-2 RBD by SwissDock service. Regarding contact modes, hydrophobic interactions contribute significantly in binding and additional hydrogen bonds were formed between theaflavin and Arg454, Phe456, Asn460, Cys480, Gln493, Asn501 and Val503 of SARS-CoV-2 RBD, near the direct contact area with ACE2. Our results suggest that theaflavin could be the candidate of SARS-CoV-2 entry inhibitor for further study.


title: Factors associated with prolonged viral shedding and impact of Lopinavir/Ritonavir treatment in patients with SARS-CoV-2 infection

text: Background: The duration of viral shedding is central to guide decisions around isolation precautions and antiviral treatment. However, studies about risk factors associated with prolonged SARS-CoV-2 shedding and the potential impact of Lopinavir/Ritonavir (LPV/r) treatment remain scarce. Methods: In this retrospective study, data were collected from all SARS-CoV-2 infected patients who were admitted to isolation wards and had RT-PCR conversion at the NO.3 People's hospital of Hubei province between 31 January and 09 March 2020. We compared clinical features and SARS-CoV-2 RNA shedding between patients with LPV/r treatment and those without. Logistic regression analysis was employed to evaluate risk factors associated with prolonged viral shedding. Results: Of 120 patients, the median age was 52 years, 54 (45%) were male and 78 (65%) received LPV/r treatment. The median duration of SARS-CoV-2 RNA detection from symptom onset was 23 days (IQR, 18-32 days). Older age (odd ratio [OR] 1.03, 95% confidence interval [CI] 1.00-1.05, p=0.03) and lack of LPV/r treatment (OR 2.42, 95% CI 1.10-5.36, p=0.029) were independent risk factors for prolonged SARS-CoV-2 RNA shedding in multivariate logistic regression analysis. The median duration of viral shedding was shorter in the LPV/r treatment group (n=78) than that in no LPV/r treatment group (n=42) (median, 22 days vs. 28.5 days, p=0.02). Only earlier administration of LPV/r treatment (≤10 days from symptom onset) could shorten the duration of viral shedding. Conclusions: Older age and lack of LPV/r treatment were independently associated with prolonged SARS-CoV-2 RNA shedding in patients with COVID-19. Earlier administration of LPV/r treatment could shorten viral shedding.


title: CoViD--19: An Automatic, Semiparametric Estimation Method for the Population Infected in Italy

text: To date, official data on the number of people infected with the SARS-CoV-2 , responsible for the CoViD19 , have been released by the Italian Government just on the basis of a non representative sample of population which tested positive for the swab. However a reliable estimation of the number of infected, including asymptomatic people, turns out to be crucial in the preparation of operational schemes and to estimate the future number of people, who will require, to different extents, medical attentions. In order to overcome the current data shortcoming, this paper proposes a bootstrap driven, estimation procedure for the number of people infected with the SARSCoV2. This method is designed to be robust, automatic and suitable to generate estimations at regional level. Obtained results show that, while official data at March the 12th report 12.839 cases in Italy, people infected wiyh the SARSCoV2 could be as high as 105.789.


title: Using different epidemiological models to modeling the epidemic dynamics in Brazil

text: In this paper we provide forecasts of the cumulative number of confirmed reported cases in Brazil, specifically in Pernambuco and Ceara, by using the generalized logistic growth model, the Richards growth model and Susceptible, Un-quanrantined infected, Quarantined infected, Confirmed infected (SUQC) phenomenological model. We rely on the Nash-Sutcliffe efficiency (NSE), root-mean-square error (RMSE) and mean absolute relative error (MARE) to quantify the quality of the models fits during the calibrationAll of these analyzes have been valid until the present date, April 14, 2020. The different models provide insights of our scenario predictions.


title: Estimating the Size of High-risk Populations for COVID-19 Mortality across 442 US Cities

text: A variety of predisposing factors have been associated with serious illness and death from COVID-19. Understanding the distribution of risks associated with these factors by local communities can provide important opportunities for targeting interventions. We characterize the distribution of risk for COVID-19 mortality for populations at large across 442 US cities, by utilizing recently published estimates of risk associated with age, gender, ethnicity, social deprivation and 12 health conditions from a very large UK-based study, combined with the information available on prevalence and co-occurrence of these factors in the US through a variety of population-based public databases. We estimate that across all the cities, an underlying weighted risk-score can identify a total of approximately 12.65 million, 4.09 million and 1.34 million individuals who are at 2-, 5- and 10-fold higher risk, respectively, compared to the average risk for the US population. The percentage of population which exceed the respective risk thresholds varies across the cities in the range (1st-99th percentile), 3.6%-20.1%, 0.7%-8.0% and 0.1%-3.2%, respectively. The percentage of deaths within a city that are expected to occur above these risk-thresholds varies in the range of 20.1%-53.5%, 8.5%-38.2% and 2.9%-25.4%, respectively. Our analysis can provide guidance to national and local policy makers regarding resources needed to protect the most vulnerable populations in these communities, and how much utility such interventions may have in reducing the total population burden of death.


title: Protocol for a multicentre study of nosocomial SARS-CoV2 transmission The NOSO-COR Project

text: Introduction: The newly identified SARS-CoV2 can cause serious acute respiratory infections such as pneumonia with a mortality rate of approximately 2% to 4%. In the current context of high incidence rates of SARS-CoV2 in the community, a significant increase in the rate of nosocomial transmission is expected. The risk of nosocomial transmission could even be higher in low-income countries that have fragile healthcare systems. This protocol is intended to study and document suspected or confirmed cases of nosocomial SARS-CoV2 infection, the clinical spectrum and the determinants (risk factors/protective) at participating hospitals. Methods and analysis: This will be an international multicentre prospective, observational, hospital-based study in adults and children. It will include volunteer patients, care givers and healthcare professionals in France and hospitals affiliated with the GABRIEL network. Demographic and clinical data will be collected using case-report forms designed especially for the purpose of the project. A nasopharyngeal swab will be collected and tested for SARS-CoV2 by RT-PCR. Characteristics of the study participants, the proportion of confirmed nosocomial SARS-CoV2 infections relative to all patients with syndromes suggestive of 2019-nCoV infection will be analysed. Appropriate multivariate modelling will be used to identify the determinants associated with nosocomial onset. Ethics and dissemination: This study was approved by the clinical research and committee of Ile de France V on March 8, 2020. Registration details: The trial was registered in ClinicalTrials (NCT04290780).


title: The Impact of COVID-19 Pandemic on Cardiology Services

text: Objective: COVID-19 pandemic resulted in prioritisation of NHS resources to cope with the surge in infected patients. However, there have been no studies in the UK looking at the effect of COVID-19 work pattern on the provision of cardiology services. We aim to assess the impact of the pandemic on the cardiology services and clinical activity. Methods: We analysed key performance indicators in cardiology services in a single centre in the UK in the intervals prior and during the lockdown to assess for reduction or changes to service provisions. Results: There has been more than 50% drop in patients presenting to cardiology and those diagnosed with myocardial infarction. All cardiology service provisions sustained significant reductions which included outpatient clinics, investigations, procedures and cardiology community services such as heart failure and cardiac rehabilitation. Conclusion: As ischaemic heart disease continues to be the leading cause of death nationally and globally, cardiology services need to prepare for a significant increase in workload in the recovery phase and develop new pathways to urgently help those adversely affected by the changes in service provisions.


title: NAATP members work to support staff during changes of pandemic

text: Members of the National Association of Addiction Treatment Providers (NAATP) ? treatment programs both inpatient and outpatient ? are still open for business In fact, business is booming, NAATP told ADAW last week This is good for patients, and good for providers, but at the same time, it's stressful for staff Employers are working to combat this stress by helping to obtain personal protective equipment (PPE) ? masks and gloves ? for staff In addition, they are trying to ramp up with telehealth, provide supports for staff and keep paying attention to the needs of patients Demand for treatment is increasing, as drinking is going up as well


title: Deciphering complex mechanisms of resistance and loss of potency through coupled molecular dynamics and machine learning

text: Drug resistance threatens many critical therapeutics through mutations in the drug target. The molecular mechanisms by which combinations of mutations, especially involving those distal from the active site, alter drug binding to confer resistance are poorly understood and thus difficult to counteract. A strategy coupling parallel molecular dynamics simulations and machine learning to identify conserved mechanisms underlying resistance was developed. A series of 28 HIV-1 protease variants with up to 24 varied substitutions were used as a rigorous model of this strategy. Many of the mutations were distal from the active site and the potency to darunavir varied from low pM to near μM. With features extracted from molecular dynamics simulations, elastic network machine learning was applied to correlate physical interactions at the molecular level with potency loss. This fit to within 1 kcal/mol of experimental potency for both the training and test sets, outperforming MM/GBSA calculations. Feature reduction resulted in a model with 4 specific features that correspond to interactions critical for potency regardless of enzyme variant. These predictive features throughout the enzyme would not have been identified without dynamics and machine learning and specifically varied with potency. This approach enables capturing the conserved dynamic molecular mechanisms by which complex combinations of mutations confer resistance and identifying critical interactions which serve as bellwethers over a wide range of inhibitor potency. Machine learning models leveraging molecular dynamics can thus elucidate mechanisms that confer loss of affinity due to variations distal from the active site, such as in drug resistance.


title: How COVID-19 has put accessibility front and center

text: As I prepared to put the finishing touches on the American Chemical Society Committee on Chemists with Disabilities (CWD) agenda in late February this year, it became apparent that the ACS national meeting in Philadelphia would not be held in the fashion we are accustomed to because of growing concerns over the spread of the novel coronavirus When the decision was made to cancel the national meeting, CWD, along with our ACS colleagues and committee teams, needed to pivot to virtual program options to facilitate our committee meeting Fortunately, our group had already been exploring several platforms for holding a virtual committee meeting As chemists with disabilities, overcoming accessibility challenges is always front and center For example, having the ability to access a videoconference with a hearing impairment requires real-time captioning Additionally, to fully engage members who are visually impaired, it is important to verbally describe all the features of the graphic content or pictures that are being shared in the visual format With these challenges in mind, the committee evaluated which program features were most important and which platforms could deliver content with a high degree of accessibility for our committee members [truncated]


title: Non-communicable diseases and inequalities increase risk of death among COVID-19 patients in Mexico

text: Background Current SARS-CoV-2 pandemic is confronting Mexico with pre-existing challenges: epidemic of non-communicable diseases (NCD) and high social inequity. Those challenges may worsen burden of COVID-19. Methods and findings Using data from national reporting of SARS-CoV-2 tested individuals, we analyzed those with a positive result to estimated odds of hospitalization, intubation and death based on pre-existing non-communicable diseases and socioeconomic indicators. We found that obesity, diabetes and hypertension increase the odds of the 3 outcomes, as well as indicators of social vulnerability. Conclusions Mexico's response to COVID-19 is stymied by a synergistic double challenge: raging NCDs and extreme social inequity. The response to the current pandemic must take both of them into account both to be effective and to ensure that the burden of COVID-19 not fall disproportionately on those who are already disadvantaged.


The role of telemedicine to control COVID-19


title: Dynamical model for social distancing in the U.S. during the COVID-19 epidemic

text: Background Social distancing has led to a flattening of the curve in many states across the U.S. This is part of a novel, massive, global social experiment which has served to mitigate the pandemic in the absence of a vaccine or effective anti-viral drugs. Hence it is important to be able to forecast hospitalizations reasonably accurately. Methods We propose on phenomenological grounds a generalized diffusion equation which in- corporates the effect of social distancing to forecast the temporal evolution of the probability of having a given number of hospitalizations. The probability density function is log-normal in the number of hospitalizations, which is useful in describing pandemics where the number of hospital- izations is very high. Findings We used this insight and data to make forecasts for states using Monte Carlo methods. Back testing validates our approach, which yields good results about a week into the future. States are beginning to reopen at the time of publication and our forecasts indicate possible precursors of increased hospitalizations. Additionally we studied the reproducibility Ro in New York (Italian strain) and California (Wuhan strain). We find that even if there is a difference in the transmission of the two strains, social distancing has been able to control the progression of COVID 19. Funding None.


title: A SARS-CoV-2 vaccine candidate would likely match all currently circulating strains

text: The magnitude of the COVID-19 pandemic underscores the urgency for a safe and effective vaccine. Here we analyzed SARS-CoV-2 sequence diversity across 5,700 sequences sampled since December 2019. The Spike protein, which is the target immunogen of most vaccine candidates, showed 93 sites with shared polymorphisms; only one of these mutations was found in more than 1% of currently circulating sequences. The minimal diversity found among SARS-CoV-2 sequences can be explained by drift and bottleneck events as the virus spread away from its original epicenter in Wuhan, China. Importantly, there is little evidence that the virus has adapted to its human host since December 2019. Our findings suggest that a single vaccine should be efficacious against current global strains. One Sentence Summary The limited diversification of SARS-CoV-2 reflects drift and bottleneck events rather than adaptation to humans as the virus spread.


docid: aezihlpd

title: Hypoxia in acute cardiac injury of coronavirus disease 2019: lesson learned from pathological studies


title: Estimating the Fraction of Unreported Infections in Epidemics with a Known Epicenter: an Application to COVID-19

text: We develop a simple analytical method to estimate the fraction of unreported infections in epidemics with a known epicenter and estimate the number of unreported COVID-19 infections in the US during the first half of March 2020. Our method utilizes the covariation in initial reported infections across US regions and the number of travelers to these regions from the epicenter, along with the results of a randomized testing study in Iceland. We estimate that 4%-14% (1.5%-10%) of actual infections had been reported in US up to March 16, accounting for an assumed reporting lag of 8 (5) days.


title: Full lockdown policies in Western Europe countries have no evident impacts on the COVID-19 epidemic.

text: This phenomenological study assesses the impacts of full lockdown strategies applied in Italy, France, Spain and United Kingdom, on the slowdown of the 2020 COVID-19 outbreak. Comparing the trajectory of the epidemic before and after the lockdown, we find no evidence of any discontinuity in the growth rate, doubling time, and reproduction number trends. Extrapolating pre-lockdown growth rate trends, we provide estimates of the death toll in the absence of any lockdown policies, and show that these strategies might not have saved any life in western Europe. We also show that neighboring countries applying less restrictive social distancing measures (as opposed to police-enforced home containment) experience a very similar time evolution of the epidemic.


AI in Medicine, Covid-19 and Springer Nature's Open Access Agreement


title: An ACE therapy for COVID-19

text: Recombinant human soluble ACE2 inhibits SARS-CoV-2 viral infection in human organoids in vitro


title: Updates on coronavirus (COVID-19) and kidney

text: The severe acute respiratory syndrome (SARS) is an infectious disease developed in Wuhan, China, at first. It involves the respiratory system and other organs like kidney, gastrointestinal tract and nervous system as well. The recent reports indicated that renal disorder is prevalent in coronavirus patients. The aim of this study was to provide a review of nephropathy caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and its mechanisms. The Web of Science, Scopus, and PubMed databases were systematically searched. Articles reporting nephropathy, coronavirus disease (COVID-19), coronavirus and the renal injury were included for assessment. Study designs, contrast agents, case reports and results were assessed. Of the assessed studies, suggested mechanisms include sepsis which caused cytokine storm syndrome or perhaps direct cellular injury due to the virus. In patients who were studied, albuminuria, proteinuria, and hematuria as well as an elevation in blood urea nitrogen and serum creatinine were observed. Additionally CT scan of the kidneys showed a decrease in tissue density suggestive of inflammation and interstitial edema. On the other hand, dialysis patients are a high-risk group than the general population. The current treatment for COVID-19 in acute kidney injury includes supportive management or kidney replacement therapy. All patients need to be quarantined. An N95 fit-tested mask and protective clothing and proper equipment are necessary. Some drugs can be effective to inhibit the outcome of this infection such as lopinavir/ritonavir, remdesvir, Chloroquine phosphate, convalescent plasma, tocilizumab, ACEi/ ARBs (angiotensin-converting enzyme inhibitor/angiotensin receptor blockers), and hrsACE2 (human recombinant soluble angiotensin-converting-enzyme 2).


title: Professors must support the mental health of trainees during the COVID-19 crisis

text: Even before COVID-19 hit, there was a mental health crisis in academia A 2018 study, for instance, found that rates of anxiety and depression in graduate students were nearly six times greater than what’s seen in the general population Now, the pressures that may lead to mental health challenges in academia are even more extreme Many scientists are worried about their own health as well as that of their families Some are anxious about their future job prospects And nearly everyone has been adjusting to a new work situation—one that revolves around digital communication rather than face-to-face contact


title: Burden of respiratory viral infection in persons with human immunodeficiency virus

text: This study was conducted to determine the prevalence of respiratory viral infections (RVI) in persons living with HIV (PLH) admitted with a respiratory complaint using real‐time reverse transcription polymerase chain reaction and primer‐independent next‐generation sequencing (NGS). Of 82 subjects, respiratory viruses were the most common pathogen identified in 27 (33%), followed by fungus and bacteria in 8 (10%) and 4 (5%) subjects, respectively. Among subjects with RVI, 11 (41%) required ICU admission and 16 (59%) required mechanical ventilation. The proportion of respiratory viruses identified, and the associated complicated hospital course highlights the significant role that RVIs play in the lung health of PLH.


title: Electronic Transport in DNA

text: We study the electronic properties of DNA by way of a tight-binding model applied to four particular DNA sequences. The charge transfer properties are presented in terms of localisation lengths, crudely speaking the length over which electrons travel. Various types of disorder, including random potentials, are employed to account for different real environments. We have performed calculations on poly(dG)-poly(dC), telomeric-DNA, random-ATGC DNA and lambda-DNA. We find that random and lambda-DNA have localisation lengths allowing for electron motion among a few dozen base pairs only. A novel enhancement of localisation lengths is observed at particular energies for an increasing binary backbone disorder. We comment on the possible biological relevance of sequence dependent charge transfer in DNA.


title: Abkürzungen

text: Unknown


title: Pathogen Infection Recovery Probability (PIRP) Versus Proinflammatory Anti-Pathogen Species (PIAPS) Levels: Modelling and Therapeutic Strategies

text: Current CoVID-19 pandemic is spreading rapidly worldwide, and it may become one of the largest pandemic events in modern history if out of control. It appears most of the SARS-CoV2 virus infection resulted deaths are mainly due to dysfunctions or failures of the lung or multiple organs that could be attributed to hosts immunodysfunctions particularly hyperinflammatory type disorders. In this brief review and study, a math model is proposed to correlate the Pathogen Infection Recovery Probability (PIRP) versus Proinflammatory Anti-Pathogen Species (PIAPS) levels within a host unit, where a maximum PIRP is exhibited when the PIAPS levels are equal to or around PIAPS equilibrium levels at the pathogen elimination or clearance onset. Based on this model, rational or effective therapeutic strategies at right stages or timing, with right type of agents (immuno-stimulators or immuno-suppressors), and right dosages, may be designed and implemented that are expected to effectively achieve maximum PIRP or reduce the mortality.


title: Modifying reusable elastomeric respirators to utilise breathing system filters with 3D printed adapters, a safe alternative to N95 during COVID-19

text: The COVID-19 pandemic has caused a worldwide shortage of personal protective equipment including N95 and FFP3 respirators. Reusable elastomeric respirators are suitable alternatives when used with compatible filters. These filters may be difficult to source and elastomeric respirators are not recommended for surgical use as the exhaled air is not filtered. Breathing system filters are routinely used in anaesthetic circuits to filter virus and bacteria. In this study, we designed 3D printed adapters that allowed elastomeric respirators to utilise breathing system filters and made simple modifications to the respirators to filter exhaled breaths. We then evaluated the performance and safety of our modified elastomeric respirators with quantitative fit tests. We recruited 8 volunteers to perform quantitative fit tests. Fit factors, respiratory rate and end-tidal carbon dioxide were recorded before and after wearing the modified respirators for 1 hour. All 8 volunteers obtained fit factors of 200+, the maximum achievable, for all tests exercises in all fit tests. The mean (range) end-tidal carbon dioxide was 4.5 (3.9-5.5) kPa and 4.6 (range 4.1-5.3) kPa before and after 1 hour of usage. The mean (range) respiratory rate was 16.5 (11-24) min-1 and 17.4 (15-22) min-1 before and after 1 hour of usage. Four (50%) did not experience any subjective discomfort while 2 (25%) reported pressure on the face, 1 (12.5%) reported exhalation resistance and 1 (12.5%) reported transient dizziness with exertion. Breathing system filters combined with properly fitted reusable elastomeric respirators is a safe alternative to N95 during the COVID-19 pandemic.