title: Medical mask versus cotton mask for preventing respiratory droplet transmission in micro environments

text: The objective of this study was to investigate whether cotton mask worn by respiratory infection person could suppress respiratory droplet levels compared to medical mask. We recruited adult volunteers with confirmed influenza and suspected cases of coronavirus disease 2019 (COVID-19) to wear medical masks and self-designed triple-layer cotton masks in a regular bedroom and a car with air conditioning. Four 1-hour repeated measurements (two measurements for bedroom the others for car) of particles with a size range of 20-1000 nm measured by number concentrations (NC0.02-1), temperature and relatively humidity, and cough/sneeze counts per hour were conducted for each volunteer. The paired t-tests were used for within-group comparisons in a bedroom and in a car. The results showed that there was no significant difference in NC0.02-1 or cough/sneeze counts between volunteers with medical masks and cotton masks in a bedroom or a car. We concluded that the cotton mask could be a potential substitute for medical mask for respiratory infection person in microenvironment with air conditioning. Healthy people may daily use cotton mask in the community since cotton mask is washable and reusable.


Necessity is the mother of innovation-the time to collaborate is now


title: Beyond the fear: Nurses' experiences caring for patients with Middle East respiratory syndrome: A phenomenological study

text: AIM AND OBJECTIVES: To explore the experiences of Korean nurses who had directly cared for patients with Middle East respiratory syndrome (MERS) and to derive the structure and meaning of these experiences. BACKGROUND: In 2015, the MERS epidemic struck Korea, and ill-prepared nurses had to care for patients with MERS. Nurses experienced conflict between their fear of the disease and their work and professional ethic. DESIGN: We employed a phenomenological qualitative approach. METHODS: Inductive, qualitative, in-depth interviews were performed with 17 nurses. The study process followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS: The qualitative inductive content analysis generated seven theme clusters and 18 themes. The theme clusters were "Fear of Uncertainty," "Beyond Hesitation," "A Scene Like a Battlefield," "Chaotic Nursing Identity," "Buttresses for Sustainability," "Lingering Trauma" and "Expanded Horizon of Nursing." The final analysis revealed that the core theme was "Beyond the fear of uncertainty." CONCLUSIONS: This study contrives a more in-depth, holistic understanding by describing the experiences of nurses who directly cared for patients with MERS-the first large-scale infectious disease in Korea. Although nurses saw themselves as vital caregivers, they were frightened of the disease, had to work in a harsh environment, experienced various internal conflicts and had to deal with varying forms of uncertainty. RELEVANCE TO CLINICAL PRACTICE: This study sheds light on the nursing situation during crises involving serious infectious diseases; to combat these, more medical facilities are needed, and staff should be proactively guided on how to care for patients. It can serve as part of a good foundation for further study of medical staff during recurring epidemics.


title: Implications for Neuromodulation Therapy to Control Inflammation and Related Organ Dysfunction in COVID-19

text: COVID-19 is a syndrome that includes more than just isolated respiratory disease, as severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2) also interacts with the cardiovascular, nervous, renal, and immune system at multiple levels, increasing morbidity in patients with underlying cardiometabolic conditions and inducing myocardial injury or dysfunction. Emerging evidence suggests that patients with the highest rate of morbidity and mortality following SARS-CoV2 infection have also developed a hyperinflammatory syndrome (also termed cytokine release syndrome). We lay out the potential contribution of a dysfunction in autonomic tone to the cytokine release syndrome and related multiorgan damage in COVID-19. We hypothesize that a cholinergic anti-inflammatory pathway could be targeted as a therapeutic avenue. Graphical Abstract .


Confronting COVID-19: Issues in Hemophilia and Congenital Bleeding Disorders


docid: joabbbvf

title: A cross-sectional comparison of epidemiological and clinical features of patients with coronavirus disease (COVID-19) in Wuhan and outside Wuhan, China

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread outside the initial epicenter of Wuhan. We compared cases in Guangzhou and Wuhan to illustrate potential changes in pathogenicity and epidemiological characteristics as the epidemic has progressed. METHODS: We studied 20 patients admitted to the Third Affiliated Hospital of Sun Yat-Sen University in Guangzhou, China from January 22 to February 12, 2020. Data were extracted from medical records. These cases were compared with the 99 cases, previously published in Lancet, from Wuhan Jinyintan Hospital from January 1 to January 20, 2020. RESULTS: Guangzhou patients were younger and had better prognosis than Wuhan patients. The Wuhan patients were more likely to be admitted to the ICU (23% vs 5%) and had a higher mortality rate (11% vs 0%). Cases in Guangzhou tended to be more community clustered. Diarrhea and vomiting were more common among Guangzhou patients and SARS-CoV-2 RNA was found in feces. Fecal SARA-CoV-2 RNA remained positive when nasopharyngeal swabs turned negative in some patients. CONCLUSIONS: This study indicates possible diminishing virulence of the virus in the process of transmission. Yet persistent positive RNA in feces after negative nasopharyngeal swabs suggests a possible prolonged transmission period that challenges current quarantine practices.


Why covid-19 antibody tests are not the game changer the UK government claims


title: Safe and effective management of tracheostomy in COVID-19 patients

text: BACKGROUND: An increasing number of COVID-19 patients worldwide will probably need tracheostomy in an emergency or at the recovering stage of COVID-19. We explored the safe and effective management of tracheostomy in COVID-19 patients, to benefit patients and protect health care workers at the same time. METHODS: We retrospectively analyzed 11 hospitalized COVID-19 patients undergoing tracheostomy. Clinical features of patients, ventilator withdrawal after tracheostomy, surgical complications, and nosocomial infection of the health care workers associated with the tracheostomy were analyzed. RESULTS: The tracheostomy of all the 11 cases (100%) was performed successfully, including percutaneous tracheostomy of 6 cases (54.5%) and conventional open tracheostomy of 5 cases (45.5%). No severe postoperative complications occurred, and no health care workers associated with the tracheostomy are confirmed to be infected by SARS-CoV-2. CONCLUSION: Comprehensive evaluation before tracheostomy, optimized procedures during tracheostomy, and special care after tracheostomy can make the tracheostomy safe and beneficial in COVID-19 patients.


Oxygen: under or over a surgical facemask for COVID-19 patients?


title: Clinical characteristics and outcomes of cancer patients with COVID-19

text: This retrospective study aimed to analysis clinical characteristics and outcomes of cancer patients with novel coronavirus disease-19 (COVID-19). Medical records, laboratory results and radiologic findings of 52 cancer patients with COVID-19 were collected, clinical characteristics and outcomes were summarized. A total of 52 cancer patients with COVID-19 were included. Median age of 52 cancer patients with COVID-19 was 63 years (34-98). Thirty-three (63.5%) patients were mild and 19 (36.5%) were severe/critical. Lung cancer was the most frequent cancer type (10, 19.2%). The common symptoms were as follows: fever (25%), dry cough (17.3%), chest distress (11.5%), and fatigue (9.6%). There were 33 (63.5%) patients had comorbidities, the most common symptom was hypertension (17, 51.5%). Twenty-six (78.8%) patients developed pneumonia on admission. Lymphocytes (0.6 × 109/L) decreased in both mild and severe/critical patients. Median levels of D-dimer, C-reactive protein, procalcitonin, and lactate dehydrogenase were 2.8 mg/L, 70.5 mg/L, 0.3 ng/mL, and 318 U/L, respectively, which increased significantly in severe/critical patients compared with the mild patients. Interleukin-6 (12.6 pg/mL) increased in both mild and severe/critical patients, there was a significant difference between them. Complications were observed in 29 (55.8%) patients, such as liver injury (19, 36.5%), acute respiratory distress syndrome (9, 17.3%), sepsis (8, 15.4%), myocardial injury (8, 15.4%), renal insufficiency (4, 7.7%), and multiple organ dysfunction syndrome (3, 5.8%). Eleven (21.2%) patients with cancer died. The infection rate of severe acute respiratory syndrome coronavirus 2 in patients with cancer was higher than the general population, cancer patients with COVID-19 showed deteriorating conditions and poor outcomes.


title: [Relationship between D-dimer concentration and inflammatory factors or organ function in patients with coronavirus disease 2019]

text: OBJECTIVE: To explore the relationship between D-dimer concentration and inflammatory factors or organ function in patients with coronavirus disease 2019 (COVID-19). METHODS: A retrospective study was conducted. The clinical data of 72 patients with COVID-19 admitted to intensive unit of Tongji Guanggu Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology in Wuhan, Hubei Province from February 10th to 29th in 2020 were collected, including their general information, routine blood test, coagulation function, inflammatory parameters, cytokines, and organ function related laboratory parameters at admission. The patients were divided into two groups, namely D-dimer normal group (< 0.5 mg/L) and D-dimer elevated group (≥ 0.5 mg/L). The differences of general data, inflammatory parameters and cytokines between the two groups were compared. Besides, the correlation between D-dimer and organ function was analyzed by linear regression. The change in sequential organ failure assessment (SOFA) between the first visit after the onset of the disease and admission to intensive unit ≥ 2 was defined as being combined with organ damage. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of D-dimer on organ damage in patients with COVID-19. RESULTS: 65.3% of the 72 patients had abnormal coagulation. The D-dimer level of COVID-19 patients gradually increased with the aggravation of the disease, and the levels of ordinary type (n = 14), severe type (n = 49), and critical type (n = 9) were 0.43 (0.22, 0.89), 0.66 (0.26, 1.36), and 2.65 (0.68, 15.45) mg/L, respectively, with statistically significant difference (P < 0.05). Thirty-two patients (44.4%) had normal D-dimer, and 40 (55.6%) had elevated D-dimer. Compared with the normal D-dimer group, the patients in the D-dimer elevated group were older (years old: 67.7±11.6 vs. 54.0±13.1), and the levels of white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), interleukins (IL-6, IL-8, IL-10), IL-2 receptor (IL-2R) and tumor necrosis factor-α (TNF-α) at admission were significantly higher [WBC (×109/L): 7.16 (5.55, 9.75) vs. 5.25 (4.59, 6.98), NEU (×109/L): 7.11±5.46 vs. 3.33±1.58, PCT (µg/L): 0.08 (0.06, 0.21) vs. 0.05 (0.04, 0.06), hs-CRP (mg/L): 27.9 (3.4, 58.8) vs. 1.3 (0.8, 6.6), IL-6 (ng/L): 11.80 (2.97, 30.61) vs. 1.98 (1.50, 4.73), IL-8 (ng/L): 19.90 (13.33, 42.28) vs. 9.40 (12.35, 15.30), IL-10 (ng/L): 5.00 (5.00, 8.38) vs. 5.00 (5.00, 5.00), IL-2R (kU/L): 907.90±458.42 vs. 572.13±274.55, TNF-α (ng/L): 10.94±5.95 vs. 7.77±3.67], while lymphocyte (LYM) and monocyte (MON) counts were lower [LYM (×109/L): 1.14±0.49 vs. 1.46±0.42, MON (×109/L): 0.63±0.25 vs. 0.87±0.21], with significant differences (all P < 0.05). Linear regression analysis showed that D-dimer level was negatively related with pulse oxygen saturation (SpO2), oxygenation index (PaO2/FiO2) and platelet count (PLT) with ß values of -0.493, -11.615, and -0.018, respectively (all P < 0.05). However, D-dimer level was positively related with respiratory rate (RR), aspartate aminotransferase (AST), total bilirubin (TBil) and direct bilirubin (DBil) with ß values of 0.485, 0.107, 0.291, and 0.404 (all P < 0.05). ROC curve analysis showed that the area under ROC curve (AUC) of D-dimer for predicting organ injury in COVID-19 patients was 0.889, and the 95% confidence interval (95%CI) was 0.753-1.000. When the optimal cut-off value was 2.36 mg/L, the sensitivity was 85.7%, and the specificity was 78.1%. CONCLUSIONS: D-dimer levels in COVID-19 patients are correlated with inflammatory factors and organ function, and it can be used to predict organ injury.


Are Patients With Alcohol Use Disorders at Increased Risk for Covid-19 Infection?


Hospital Emergency Management Plan During the COVID-19 Epidemic


title: Increasing the Signal-to-Noise Ratio: COVID-19 Clinical Synopsis for Outpatient Providers

text: The novel coronavirus (SARS-CoV-2), which is the cause of coronavirus disease (COVID-19 formally 2019-nCoV), has received widespread attention from the medical community. Despite the rapid publication of research on the virus and the disease it causes, there is a lack of concise and relevant material to help busy medical providers navigate recognition and management of the disease in the ambulatory setting. This review article aims to bridge this gap by briefly reviewing the key points of the evaluation and treatment of patients with COVID-19 in the ambulatory clinic environment.


Reply: "Biologics for psoriasis during COVID-19 outbreak"


title: Preparing maternity for COVID-19: A translational simulation approach

text: COVID-19 has posed major challenges for health care. Hospitals around the world have needed to rapidly prepare for the emerging pandemic. Translational simulation - simulation that is integrated and focused on emerging clinical priorities - offers numerous opportunities to aid in pandemic preparation. We describe our approach to preparing our institution's maternity services for the COVID-19 pandemic using translational simulation. We suggest lessons for providers of maternity services, and for those who support them through simulation activities.


docid: dzccwoqo

title: Otolaryngologists and the Doctor-Patient Relationship during a Pandemic

text: The COVID-19 pandemic has forced otolaryngologists and their patients to confront issues that they have rarely if ever previously faced. Prominent among these is the need to put the collective good ahead of the interests of individual patients with otolaryngologic disorders. We argue that the individual doctor-patient relationship remains paramount even at a time when public health principles mandate systems-level thinking.


docid: yidauzwo

title: Time for a Change: Personal Experiences With COVID-19 and Diabetes


Clinical Characteristics of Covid-19 in New York City


title: Correction to: Practical indications for the prevention and management of SARS-CoV-2 in ambulatory dialysis patients: lessons from the first phase of the epidemics in Lombardy

text: The originally published article the co-author name Marco Heidempergher incorrectly spelled as Marco Hedemperger. The correct name given below.


Strategy of using personal protective equipment during aerosol generating medical procedures with COVID-19


How coronavirus dashed Ethiopia's dream of hosting Africa's first major AI conference


COVID-19: Leave politics out of practicing medicine


Pre- and post-operative screening in limited-term elective cancer surgery patients during the COVID-19 pandemic


title: Neutralizing Antibodies Responses to SARS-CoV-2 in COVID-19 Inpatients and Convalescent Patients

text: BACKGROUND: COVID-19 is a pandemic with no specific antiviral treatments or vaccines. The urgent needs for exploring the neutralizing antibodies from patients with different clinical characteristics are emerging. METHODS: A total of 117 blood samples were collected from 70 COVID-19 inpatients and convalescent patients. Antibodies were determined with a modified cytopathogenic neutralization assay (NA) based on live SARS-CoV-2 and enzyme linked immunosorbent assay (ELISA). The dynamics of neutralizing antibody levels at different time points with different clinical characteristics were analyzed. RESULTS: The seropositivity rate reached up to 100.0% within 20 days since onset, and remained 100.0% till day 41-53. The total GMT was 1:163.7 (95% CI, 128.5 to 208.6) by NA and 1:12441.7 (95% CI, 9754.5 to 15869.2) by ELISA. The antibody level by NA and ELISA peaked on day 31-40 since onset, and then decreased slightly. In multivariate GEE analysis, patients at age of 31-45, 46-60, and 61-84 had a higher neutralizing antibody level than those at age of 16-30 (ß=1.0470, P=0.0125; ß=1.0613, P=0.0307; ß=1.3713, P=0.0020). Patients with a worse clinical classification had a higher neutralizing antibody titer (ß=0.4639, P=0.0227). CONCLUSIONS: The neutralizing antibodies were detected even at the early stage of disease, and a significant response showed in convalescent patients.


title: Repositioning of pentoxifylline as an immunomodulator and regulator of the renin-angiotensin system in the treatment of COVID-19

text: Pentoxifylline (PTX) is a phosphodiesterase inhibitor that increases cyclic adenosine monophosphate levels, which in turn activate protein kinase, leading to a reduction in the synthesis of proinflammatory cytokines to ultimately influence the renin-angiotensin system (RAS) in vitro by inhibiting angiotensin 1 receptor (AT1R) expression. The rheological, anti-inflammatory, and renin-angiotensin axis properties of PTX highlight this drug as a therapeutic treatment alternative for patients with COVID-19 by helping reduce the production of the inflammatory cytokines without deleterious effects on the immune system to delay viral clearance. Moreover, PTX can restore the balance of the immune response, reduce damage to the endothelium and alveolar epithelial cells, improve circulation, and prevent microvascular thrombosis. There is further evidence that PTX can improve ventilatory parameters. Therefore, we propose repositioning PTX in the treatment of COVID-19. The main advantage of repositioning PTX is that it is an affordable drug that is already available worldwide with an established safety profile, further offering the possibility of immediately analysing the result of its use and associated success rates. Another advantage is that PTX selectively reduces the concentration of TNF-α mRNA in cells, which, in the case of an acute infectious state such as COVID-19, would seem to offer a more strategic approach.


title: Emergence of Kawasaki disease related to SARS-CoV-2 infection in an epicentre of the French COVID-19 epidemic: a time-series analysis

text: BACKGROUND: Kawasaki disease is an acute febrile systemic childhood vasculitis, which is suspected to be triggered by respiratory viral infections. We aimed to examine whether the ongoing COVID-19 epidemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with an increase in the incidence of Kawasaki disease. METHODS: We did a quasi-experimental interrupted time series analysis over the past 15 years in a tertiary paediatric centre in the Paris region, a French epicentre of the COVID-19 outbreak. The main outcome was the number of Kawasaki disease cases over time, estimated by quasi-Poisson regression. In the same centre, we recorded the number of hospital admissions from the emergency department (2005-2020) and the results of nasopharyngeal multiplex PCR to identify respiratory pathogens (2017-2020). These data were compared with daily hospital admissions due to confirmed COVID-19 in the same region, recorded by Public Health France. FINDINGS: Between Dec 1, 2005, and May 20, 2020, we included 230 patients with Kawasaki disease. The median number of Kawasaki disease hospitalisations estimated by the quasi-Poisson model was 1·2 per month (IQR 1·1-1·3). In April, 2020, we identified a rapid increase of Kawasaki disease that was related to SARS-CoV-2 (six cases per month; 497% increase [95% CI 72-1082]; p=0·0011), starting 2 weeks after the peak of the COVID-19 epidemic. SARS-CoV-2 was the only virus circulating intensely during this period, and was found in eight (80%) of ten patients with Kawasaki disease since April 15 (SARS-CoV-2-positive PCR or serology). A second peak of hospital admissions due to Kawasaki disease was observed in December, 2009 (six cases per month; 365% increase ([31-719]; p=0.0053), concomitant with the influenza A H1N1 pandemic. INTERPRETATION: Our study further suggests that viral respiratory infections, including SAR-CoV-2, could be triggers for Kawasaki disease and indicates the potential timing of an increase in incidence of the disease in COVID-19 epidemics. Health-care providers should be prepared to manage an influx of patients with severe Kawasaki disease, particularly in countries where the peak of COVID-19 has recently been reached. FUNDING: French National Research Agency.


title: Preparedness and response to Pediatric CoVID-19 in European Emergency Departments: a survey of the REPEM and PERUKI networks

text: Study objective: We aimed to describe the variability and identify gaps in preparedness and response to the COVID-19 pandemic in European EDs caring for children. Methods: A cross-sectional point prevalence survey, was developed and disseminated through the pediatric emergency medicine research networks for Europe (REPEM) and the United Kingdom and Ireland (PERUKI). We aimed to include ten EDs for countries with > 20 million inhabitants and five EDs for less populated countries, unless the number of eligible EDs was below five. ED directors or their delegates completed the survey between March 20th and 21st to report practice at that time. We used descriptive statistics to analyse data. Results: Overall 102 centers from 18 countries (86% response rate) completed the survey: 34% did not have an ED contingency plan for pandemics and 36% had never had simulations for such events. Wide variation on PPE items was shown for recommended PPE use at pre-triage and for patient assessment, with 62% of centers experiencing shortage in one or more PPE items, most frequently FFP2/N95 masks. Only 17% of EDs had negative pressure isolation rooms. COVID-19 positive ED staff was reported in 25% of centers. Conclusion: We found variation and identified gaps in preparedness and response to the COVID-19 epidemic across European referral EDs for children. A lack in early availability of a documented contingency plan, provision of simulation training, appropriate use of PPE, and appropriate isolation facilities emerged as gaps that should be optimized to improve preparedness and inform responses to future pandemics.


docid: fgdmoccb

title: Postoperative Adjuvant Transarterial Infusion Chemotherapy with FOLFOX Could Improve Outcomes of Hepatocellular Carcinoma Patients with Microvascular Invasion: A Preliminary Report of a Phase III, Randomized Controlled Clinical Trial

text: BACKGROUND: Microvascular invasion (MVI) is a risk factor for tumor recurrence after hepatectomy in hepatocellular carcinoma (HCC) patients. OBJECTIVE: This study aimed to investigate the efficacy and safety of postoperative adjuvant transarterial infusion chemotherapy (TAI) with the FOLFOX regimen for HCC patients with MVI. METHODS: In this prospective, phase III, randomized, open-label, controlled clinical trial, HCC patients with histologically confirmed MVI were randomly assigned (1:1) after hepatectomy to receive either one to two cycles of adjuvant TAI (AT group) or follow-up without any adjuvant treatment (FU group). The primary endpoint was disease-free survival (DFS), while secondary endpoints were overall survival (OS) and safety. RESULTS: Between June 2016 and April 2019, 127 patients were randomly assigned to the AT group (n = 63) or FU group (n = 64). Clinicopathological characteristics of the two groups were well-balanced. The 6-, 12-, and 18-month OS rates for the AT group were 100.0%, 97.7%, and 97.7%, respectively, and 94.5%, 89.6%, and 78.5% for the FU group, respectively. The 6-, 12-, and 18-month DFS rates for the AT and FU groups were 84.7%, 61.8%, and 58.7%, and 62.9%, 48.1%, and 38.6%, respectively. OS and DFS were significantly better in the AT group than in the FU group (p = 0.037 and 0.023, respectively). No patients in the AT group experienced grade 3 or more severe adverse events. CONCLUSIONS: Adjuvant TAI after hepatectomy may bring survival benefits to HCC patients with MVI. TRIAL REGISTRATION: Trial number: NCT03192618.


Cerebral Infarction in an Elderly Patient with Coronavirus Disease


title: Heat inactivation of serum interferes with the immunoanalysis of antibodies to SARS-CoV-2

text: BACKGROUND: The detection of serum antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is emerging as a new tool for the coronavirus disease 2019 (COVID-19) diagnosis. Since many coronaviruses are sensitive to heat, heating inactivation of samples at 56°C prior to testing is considered a possible method to reduce the risk of transmission, but the effect of heating on the measurement of SARS-CoV-2 antibodies is still unclear. METHODS: By comparing the levels of SARS-CoV-2 antibodies before and after heat inactivation of serum at 56°C for 30 minutes using a quantitative fluorescence immunochromatographic assay RESULTS: We showed that heat inactivation significantly interferes with the levels of antibodies to SARS-CoV-2. The IgM levels of all the 34 serum samples (100%) from COVID-19 patients decreased by an average level of 53.56%. The IgG levels were decreased in 22 of 34 samples (64.71%) by an average level of 49.54%. Similar changes can also be observed in the non-COVID-19 disease group (n = 9). Of note, 44.12% of the detected IgM levels were dropped below the cutoff value after heating, suggesting heat inactivation can lead to false-negative results of these samples. CONCLUSION: Our results indicate that heat inactivation of serum at 56°C for 30 minutes interferes with the immunoanalysis of antibodies to SARS-CoV-2. Heat inactivation prior to immunoanalysis is not recommended, and the possibility of false-negative results should be considered if the sample was pre-inactivated by heating.


docid: uxdkgdwy

title: Social isolation in Covid-19: The impact of loneliness


COVID-19: home poisoning throughout the containment period (vol 5, pg e314, 2020)


COVID-19: home poisoning throughout the containment period


Asthma prolongs intubation in COVID-19


title: User Concerns&Tradeoffs in Technology-Facilitated Contact Tracing

text: Contact tracing apps are one of the primary technology-facilitated Coronavirus (COVID) responses currently proposed. In the majority of Western nations there is the expectation that citizens will have the autonomy to decide whether or not to install a COVID-related app. Yet, the more users who install a COVID app, the greater the impact on public health. As explained by Chan et al. the value of users installing a contact-tracing app grows quadratically with the number of users who install. How can we get users to install COVID apps? By understanding and mitigating user concerns and tradeoffs. This document provides a framework for considering the user-relevant components of COVID apps and corresponding user tradeoffs related to these apps. Specifically, we enumerate user tradeoffs related to data collection, data quality, identifier/data encryption, privacy invasion, mobile costs, user agency, benefits from app use, and app transparency. We break down which tradeoffs are relevant for which contact tracing implementations (centralized vs. decentralized, location- vs. proximity-based). Additionally, we compare contact tracing to an alternative technology-facilitated COVID solution: narrowcasts. Narrowcasts are location-personalized broadcasts about COVID hotspots in your vicinity.


title: Chloroquine als mogelijke behandeling van COVID-19./ [Chloroquine as a possible treatment for COVID-19]

text: Since the outbreak of COVID-19, chloroquine has been mentioned as a possible treatment. In vitro studies have shown anti-viral activity of chloroquine against SARS-CoV-2. Recently, the Dutch National Institute for Public Health and the Environment published treatment options for antiviral treatment for COVID-19 where chloroquine was suggested as first choice for off-label treatment, beside remdesivir en lopinavir/ritonavir. In this commentary, we provide a background and history of chloroquine, the evidence for antiviral efficacy of chloroquine and the arguments for off-label use of chloroquine in COVID-19.


Modelling the pandemic


The Author's Response: A Lesson from Temporary Closing of a Single University-affiliated Hospital owing to In-Hospital Transmission of Coronavirus Disease 2019


title: Radiological findings and clinical characteristics of pregnant women with COVID-19 pneumonia

text: OBJECTIVE: To study chest CT images and clinical characteristics of COVID-19 pneumonia in pregnant patients to examine any correlation. METHODS: Between December 31, 2019 and March 7, 2020, 23 hospitalized pregnant patients with confirmed COVID-19 were enrolled in the study. Clinical presentations were collected retrospectively from records, including laboratory testing, chest CT imaging, and symptoms. Descriptive analysis and correlation of patients' clinical and CT characteristics were performed. Laboratory results from time of first admission and CT absorption (defined as reduction in lesion area, decrease in density, and absorption of some solid components) were compared between symptomatic and asymptomatic patients. RESULTS: Fifteen (65.2%) patients were asymptomatic with patchy ground-glass opacity in a single lung lobe. Eight (34.8%) patients were symptomatic with multiple patchy ground-glass shadows, consolidation, and fibrous stripes. Differences in lymphocyte percentage and neutrophil granulocyte rate between first admission and CT absorption were significant (P<0.001). Median absorption time was shorter in the asymptomatic group compared with the symptomatic group (5 vs 10 days; P<0.001). Median hospitalization time between asymptomatic and symptomatic patients was 14 vs 25.5 days; P>0.001. Median absorption time and length of hospitalization for all patients was 6 days (IQR 5-8) and 17 days (IQR 13-25), respectively. CONCLUSION: Radiological findings and clinical characteristics in pregnant women with COVID-19 were similar to those of non-pregnant women with COVID-19. Median absorption time and length of hospitalization in asymptomatic patients were significantly shorter than in symptomatic patients. Lymphocyte percentage and neutrophil granulocyte rate may be used as laboratory indicators of CT absorption.


docid: xzhldjnb

title: Resumption of daily services in a gastroenterology department in Guangzhou, China, in the wake of COVID-19


Severe neutropenia in infants with severe acute respiratory syndrome caused by the novel coronavirus 2019 infection


COVID-19: Is a paradigm change to be expected in health care and transfusion medicine?


docid: opvkurid

title: In-ICU COVID-19 patients' characteristics for an estimation in post-ICU rehabilitation care requirement


title: Evidence from two cases of asymptomatic infection with SARS-CoV-2: Are 14 days of isolation sufficient?

text: Among 78 laboratory-confirmed cases, we found two asymptomatic infections. One patient was discharged within 14 days after treatment. Another patient was discharged 25 days after treatment, and his RT-PCR test was still positive on the 15th day. We found that there may be virus carriers in the asymptomatic population with an epidemiological contact history. After 14 days of isolation, those with asymptomatic infection may still carry the virus, which means a risk of transmission, presenting a new challenge for the management of home isolation.


Dermatology residents and the care of patients with coronavirus disease 2019 (COVID-19)


Should we try the antiinflammatory natural product, celastrol, for COVID-19?


title: Factor VIII and Functional Protein C Activity in Critically Ill Patients With Coronavirus Disease 2019: A Case Series

text: Critically ill patients with coronavirus disease 2019 (COVID-19) have been observed to be hypercoagulable, but the mechanisms for this remain poorly described. Factor VIII is a procoagulant factor that increases during inflammation and is cleaved by activated protein C. To our knowledge, there is only 1 prior study of factor VIII and functional protein C activity in critically ill patients with COVID-19. Here, we present a case series of 10 critically ill patients with COVID-19 who had severe elevations in factor VIII activity and low normal functional protein C activity, which may have contributed to hypercoagulability.


Prevalence of anxiety and depression among the healthcare workers in Nepal during the COVID-19 pandemic


title: Dynamic adaptation to COVID-19 in a Singapore paediatric emergency department

text: Singapore was one of the earliest countries affected by the coronavirus disease 2019 (COVID-19) pandemic, with more laboratory-confirmed COVID-19 cases in early February 2020 than any other country outside China. This short report is a narrative review of our tertiary paediatric emergency department (ED) perspective and experience managing the evolving outbreak situation. Logistic considerations included the segregation of the ED into physically separate high-risk, intermediate-risk and low-risk areas, with risk-adapted use of personal protective equipment (PPE) for healthcare personnel in each ED area. Workflow considerations included the progressive introduction of outpatient COVID-19 testing in the ED for enhanced surveillance; adapting the admissions process particularly for high-risk and intermediate-risk cases; and the management of unwell accompanying adult caregivers. Manpower considerations included the reorganisation of medical manpower into modular teams to mitigate the risk of hospital transmission of COVID-19. Future plans for a tiered isolation facility should include structural modifications for the permanent isolation facility such as anterooms for PPE donning/doffing; replication of key ED functions in the tent facility such as a separate resuscitation room and portable X-ray room; and refresher PPE training. Dynamic reassessment of ED workflow processes, in conjunction with the hospital and national public health response, may help in managing this novel disease entity.


[Ethical decision-making framework for the allocation of scarce mechanical ventilators during the COVID-19 crisis]


title: Association of smoking habits with TXNIP DNA methylation levels in leukocytes among general Japanese population

text: Thioredoxin-interacting protein (TXNIP) inhibits the activity of thioredoxin (TXN), leading to increased oxidative stress. Expression of the TXNIP gene is regulated by DNA methylation. However, no study has reported the influence of lifestyle factors on TXNIP DNA methylation. Our goal was to determine the association between smoking habits and TXNIP DNA methylation levels in a Japanese population. We conducted a cross-sectional study of 417 subjects (180 males and 237 females) participating in a health examination. We used a pyrosequencing assay to determine TXNIP DNA methylation levels in leukocytes. The mean TXNIP DNA methylation level in current smokers (75.3%) was significantly lower than that in never and ex-smokers (never: 78.1%, p < 0.001; ex: 76.9%, p = 0.013). Multivariable logistic regression analyses showed that the OR for TXNIP DNA hypomethylation was significantly higher in current smokers than that in never smokers, and significantly higher in current smokers with years of smoking ≥ 35 and Brinkman Index ≥ 600 compared to that in non-smokers. In conclusion, we found that current smokers had TXNIP DNA hypomethylation compared to never and ex-smokers. Moreover, long-term smoking and high smoking exposure also were associated with TXNIP DNA hypomethylation.


title: Matrix metalloproteinase 3 as a valuable marker for patients with COVID-19

text: The situation of the coronavirus disease 2019 (COVID-19) continues to evolve, our study explored the significance of serum levels of matrix metalloproteinase 3 (MMP3) as a marker for patients with COVID-19. Sixty-two COVID-19 patients in the First Hospital of Hunan University of Chinese Medicine and Loudi Center for Diseases Prevention and Control, from January to March 2020, were sampled as the novel coronavirus pneumonia infected group. One hundred and thirty-one cases from the First Hospital of Hunan University of Chinese Medicine, including 67 healthy individuals and 64 non-COVID-19 inpatients, served as the noninfected group. Approximately every 5 days, sera from 20 cases were collected and analyzed three times, using an automatic biochemical analyzer, to detect serum MMP3 concentrations. Correlation was analyzed between MMP3 and other proinflammatory cytokines. Following normality tests, differences in serum MMP3 levels between the infected and noninfected group were analyzed via SPSS (version 25.0) software, using the Wilcoxon rank sum test. The MMP3 concentration was 44.44 (23.46 ~ 72.12) ng/mL in the infected group and 32.42 (28.16 ~ 41.21) ng/mL in the noninfected group. The difference between the two groups was statistically significant (Z = -2.799, P = .005 < .05). A positive correlation was found between MMP3 and interleukin 1ß (IL-1ß; r = .681, P = .000 < .05), and IL-6 (r = .529, P = .002 < .05). Serum MMP3 concentration, measured over three separate time points, were 55.98 (30.80 ~ 75.97) ng/mL, 34.84 (0.00 ~ 51.84) ng/mL, and 5.71 (0.00 ~ 40.46) ng/mL, respectively. Detection of serum MMP3 levels may play an important role in the development of therapeutic approaches for COVID-19 and may indicate the severity of disease.


title: Perinatal aspects on the covid-19 pandemic: a practical resource for perinatal-neonatal specialists

text: BACKGROUND: Little is known about the perinatal aspects of COVID-19. OBJECTIVE: To summarize available evidence and provide perinatologists/neonatologists with tools for managing their patients. METHODS: Analysis of available literature on COVID-19 using Medline and Google scholar. RESULTS: From scant data: vertical transmission from maternal infection during the third trimester probably does not occur or likely it occurs very rarely. Consequences of COVID-19 infection among women during early pregnancy remain unknown. We cannot conclude if pregnancy is a risk factor for more severe disease in women with COVID-19. Little is known about disease severity in neonates, and from very few samples, the presence of SARS-CoV-2 has not been documented in human milk. Links to websites of organizations with updated COVID-19 information are provided. Infographics summarize an approach to the pregnant woman or neonate with suspected or confirmed COVID-19. CONCLUSIONS: As the pandemic continues, more data will be available that could lead to changes in current knowledge and recommendations.


COVID-19-associated mild encephalitis/encephalopathy with a reversible splenial lesion


Will COVID-19 be evidence-based medicine's nemesis?


title: Deep learning the atmospheric boundary layer height

text: A question of global concern regarding the sustainable future of humankind stems from the effect due to aerosols on the global climate. The quantification of atmospheric aerosols and their relationship to climatic impacts are key to understanding the dynamics of climate forcing and to improve our knowledge about climate change. Due to its response to precipitation, temperature, topography and human activity, one of the most dynamical atmospheric regions is the atmospheric boundary layer (ABL): ABL aerosols have a sizable impact on the evolution of the radiative forcing of climate change, human health, food security, and, ultimately, on the local and global economy. The identification of ABL pattern behaviour requires constant monitoring and the application of instrumental and computational methods for its detection and analysis. Here, we show a new method for the retrieval of ABL top arising from light detection and ranging (LiDAR) signals, by training a convolutional neural network in a supervised manner; forcing it to learn how to retrieve such a dynamical parameter on real, non-ideal conditions and in a fully automated, unsupervised way. Our findings pave the way for a full integration of LiDAR elastic, inelastic, and depolarisation signal processing, and provide a novel approach for real-time quantitative sensing of aerosols.


docid: zmsocgfs

title: Uganda's First 100 COVID-19 Cases: Trends and Lessons


title: COVID-19 infection and mental disorders: a call for action to enhance protection and break down barriers

text: No abstract available


title: Clinical Manifestation of Severe Cases with COVID-19

text: Objective】To explore the clinical manifestation of COVID- 19 severe cases 【Methods】Clinical data of one severe case with COVID-19 including the clinical characteristic ，laboratory testing results，radiography，treatment，complication and outcome of the patient were retrospectively collected and analyzed 【Results】The patient with COVID-19 was a 61-year old male，He suffered with underlying disease His symptoms included fever，cough，myalgia，fatigue，and dyspnea Laboratory testing results included normal WBC count，decreased lymphocyte cells，elevated LDH and hypoxemia Radiography findings showed bilateral lung infiltration His condition deteriorated after intensive treatment for one week He was intubated and treated with mechanical ventilation because of complicating with severe acute respiratory distress syndrome（ARDS） 【Conclusion】COVID-19 is an emerging acute communicable disease，which lack specific and effective treatment Most patients have a good prognosis but mortality in severe cases is high More attention should be paid on the high risk of progression in COVID-19 cases


title: Travel/Tropical Medicine and Pandemic Considerations for the Global Surgeon

text: International travel goes hand in hand with medical delivery to underserved communities. The global health care worker can be exposed to a wide range of infectious diseases during their global experiences. A pretravel risk assessment visit and all appropriate vaccinations and education must be performed. Universal practices of water safety, food safety, and insect avoidance will prevent most travel-related infections and complications. Region-specific vaccinations will further reduce illness risk. An understanding of common travel-related illness signs and symptoms is helpful. Emerging pathogens that can cause a pandemic should be understood to avoid health care worker infection and spread.


[My treatment strategies for severe and critical coronavirus disease 2019]


title: Preferred practice guidelines for glaucoma management during COVID-19 pandemic

text: The COVID-19 pandemic has threatened the humanity at a global level to a large extent by the burden of the disease with significant mortality and to a certain extent as a byproduct of the necessary efforts to contain the same. There is a significant impact on the health care system, as we not only have to contain pandemic, but continue to treat our non-COVID-19 patients in a safe and responsible manner. Ophthalmology practice in general and glaucoma in particular needs certain modifications and additional precautions while examining as well as managing these patients keeping their and our safety in mind. As the lockdown relaxations are in vogue we need to learn how to deal with our regular patients as well in addition to emergency care. This paper presents the consensus-based guidelines by an expert panel on how to restart glaucoma practice during this COVID-19 time. These guidelines will be applicable across the country and should help ophthalmologists and glaucoma specialist to restart their practices while safeguarding the patients and their own selves from getting infected.


title: Bladder Cancer at the time of COVID-19 Outbreak

text: The COVID-19 outbreak has led to the deferral of a great number of surgeries in an attempt to reduce transmission of infection, free up hospital beds, intensive care and anaesthetists, and limit aerosol-generating procedures. Guidelines and suggestions have been provided to categorize Urological diseases into risk groups and recommendations are available on procedures that can be or cannot be deferred. We aim to summarise updates on diagnosis, treatment and follow up of bladder cancer during the COVID-19 outbreaks.


title: Early decrease in blood platelet count is associated with poor prognosis in COVID-19 patients-indications for predictive, preventive, and personalized medical approach

text: Background: Changes in platelet count are common in COVID-19 patients. The platelet count reflects the thrombocyte turnover, acting as a sensitive indicator of illness severity that is of great clinical utility to monitor a quickly changing health condition of patients affected by aggressive viral infections. This study aims to investigate the significance of platelet count during the progression of the disease in COVID-19 patients. Methods: A total of 532 COVID-19 patients were involved in the cohort study from the First People's Hospital of Jiangxia District in Wuhan from January 7, 2020, to February 28, 2020. We collected the clinical characteristics and laboratory data of patients. Patients still hospitalized before February 29, 2020, died on admission, with malignant tumors, previous gastrointestinal surgery, missing baseline platelet count, or platelet count detected only once, were excluded. We used a generalized additive model and generalized additive mixed model to compare trends in platelet count over time among survivors and non-survivors, with an adjustment for potential confounders. Results: During the follow-up, twenty-nine subjects died (mortality rate, 5.45%). The platelets among non-survivors decreased and among survivors increased gradually within 1 week after admission. In addition, the difference between the two groups showed an increasing trend during 1 week after admission. This difference increased by an average of 5.3 × 10^9/L daily. Conclusions: In the early stage, platelet count can dynamically reflect the pathophysiological changes in COVID-19 patients. Early decrease in platelet count was associated with mortality in patients with COVID-19. Causality, however, cannot be deduced from our data.


Effective Chemicals against Novel Coronavirus (COVID-19) in China


title: Lopinavir/ritonavir did not shorten the duration of SARS CoV-2 shedding in patients with mild pneumonia in Taiwan

text: An increase of Ct values was 0.9 per day in 2 cases of COVID-19 treated with lopinavir/ritonavir (LPV/r), an increase was 1.0 per day in 3 cases without LPV/r through illness day 1-10, indicating that LPV/r did not shorten the duration of SARS CoV-2 shedding.


Voice from China: nomenclature of the novel coronavirus and related diseases


docid: utjqhsar

title: Patterns of liver injury in COVID-19 - a German case series

text: BACKGROUND: Reports of liver injury in patients with novel coronavirus disease 2019 (COVID-19) are emerging from China and the USA. A wide variety of liver function test abnormalities and few cases of severe liver failure have been reported. No data on the hepatic phenotype from Europe are available at current. METHODS: We report a case series of 44 consecutive patients hospitalized for COVID-19 in Germany. RESULTS: At the time of admission, aspartate aminotransferase greater than the upper limit of normal was present in 70%, while alanine aminotransferase was elevated in 15.8%. Markers of cholestatic liver injury were altered only in a minority of patients. During hospitalization, 31% and 22% experienced increasing aspartate aminotransferase and alanine aminotransferase, respectively, when transaminases were normal at admission. Severe liver injury defined by 3×> upper limit of normal was observed in 9.1% over a mean time of 10.5 days. Importantly, patients exhibited cytotoxicity including lactate dehydrogenase and creatinine kinase elevations, but no signs of relevant liver function impairment. CONCLUSION: In summary, in a case series of hospitalized patients in Germany, cytotoxicity in the absence of severe liver dysfunction at admission and only few cases suggestive of severe liver injury during hospital were observed.


Impact of the COVID-19 Pandemic on HIV Testing and Assisted Partner Notification Services, Western Kenya


docid: hjeiegje

title: The psycho-emotional impact of COVID-19 on surgical staff working in emergency departments


Characteristics and clinical course of Covid-19 patients admitted with acute stroke


Matt Morgan: Covid-19 and the need for bold decisions


docid: ugcanukp

title: Practical Bioethics during the Exceptional Circumstances of a Pandemic


docid: jyapvsqw

title: Emerging technologies to combat COVID-19 pandemic


title: Shortlisting SARS-CoV-2 Peptides for Targeted Studies from Experimental Data-Dependent Acquisition Tandem Mass Spectrometry Data

text: Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a crucial tool for fighting the COVID-19 pandemic. This dataset brief presents the exploration of a shotgun proteomics dataset acquired on SARS-CoV-2 infected Vero cells. Proteins from inactivated virus samples were extracted, digested with trypsin, and the resulting peptides were identified by data-dependent acquisition tandem mass spectrometry. The 101 peptides reporting for six viral proteins were specifically analyzed in terms of their analytical characteristics, species specificity and conservation, and their proneness to structural modifications. Based on these results, a shortlist of 14 peptides from the N, S, and M main structural proteins that could be used for targeted mass-spectrometry method development and diagnostic of the new SARS-CoV-2 is proposed and the best candidates are commented.


Critical Infection Control Adaptations to Survive COVID-19 in Retirement Communities


title: Real-Time Real Economic Activity: Exiting the Great Recession and Entering the Pandemic Recession

text: We study the real-time signals provided by the Aruoba-Diebold-Scotti Index of Business conditions (ADS) for tracking economic activity at high frequency. We start with exit from the Great Recession, comparing the evolution of real-time vintage beliefs to a"final"late-vintage chronology. We then consider entry into the Pandemic Recession, again tracking the evolution of real-time vintage beliefs. ADS swings widely as its underlying economic indicators swing widely, but the emerging ADS path as of this writing (late June) indicates a return to growth in May. The trajectory of the nascent recovery, however, is highly uncertain -- particularly as COVID-19 spreads in the South and West -- and could be revised or eliminated as new data arrive.


Alcohol use and misuse during the COVID-19 pandemic: a potential public health crisis?


title: Initial data from an experiment to implement a safe procedure to perform PA erect chest radiographs for COVID-19 patients with a mobile radiographic system in a "clean" zone of the hospital ward

text: INTRODUCTION: With the current Covid-19 pandemic, general wards have been converted into cohort wards for Covid-19 patients who are stable and ambulant. A 2-radiographer mobile radiography team is required to perform bedside Chest X-rays (CXR) for these patients. Hospital guidelines require both radiographers to be in full Personal Protective Equipment (PPE) throughout the image acquisition process and the mobile radiographic unit needs to be disinfected twice after each case. This affects the efficiency of the procedure and an increase usage of limited PPE resources. This study aims to explore the feasibility of performing mobile chest radiography with the mobile radiographic unit in a "clean" zone of the hospital ward. METHODS: An anthropomorphic body phantom was used during the test. With the mobile radiographic unit placed in a "clean" zone, the phantom and the mobile radiographic unit was segregated by the room door with a clear glass panel. The test was carried out with the room door open and closed. Integrated radiation level and patient dose were measured. A consultant radiologist was invited to review and score all the images acquired using a Barco Medical Grade workstation. The Absolute Visual Grading Analysis (VGA) scoring system was used to score these images. RESULTS: A VGA score of 4 was given to all the 40 test images, suggesting that there is no significant differences in the image quality of the images acquired using the 2 different methods. Radiation exposure received by the patient at the highest kV setting through the glass is comparable to the regular CXR on patient without glass panel at 90 kV, suggesting that there is no significant increase in patient dose. CONCLUSION: The result suggests that acquiring CXR with the X-ray beam attenuating through a glass panel is a safe and feasible way of performing CXR for COVID-19 patients in the newly converted COVID wards. This will allow the mobile radiographic unit as well as one radiographer to be completely segregated from the patient. IMPLICATIONS FOR PRACTICE: This new method of acquiring CXR in an isolation facility set up requires a 2-Radiographer mobile radiography team, and is applicable only for patients who are generally well and not presented with any mobility issues. It is also important to note that a clear glass panel must be present in the barriers set up for segregation between the "clean" zone and patient zone in order to use this new method of acquiring CXR.


docid: bzhkpiaj

title: Exploring Automatic Diagnosis of COVID-19 from Crowdsourced Respiratory Sound Data

text: Audio signals generated by the human body (e.g., sighs, breathing, heart, digestion, vibration sounds) have routinely been used by clinicians as diagnostic or progression indicators for diseases and disease onset. However, until recently, such signals were usually collected through manual auscultation at scheduled visits. Research has now started to use digital technology to gather bodily sounds (e.g., from digital stethoscopes) for cardiovascular or respiratory examination, which could then be used for automatic analysis. Some initial work shows promise in detecting diagnostic signals of COVID-19 from voice and coughs. In this paper we describe our data analysis over a large-scale crowdsourced dataset of respiratory sounds collected to aid diagnosis of COVID-19. We use coughs and breathing to understand how discernible COVID-19 sounds are from those in asthma or healthy controls. Our results show that even a simple binary machine learning classifier is able to classify correctly healthy and COVID-19 sounds. We also show how we distinguish a user who tested positive for COVID-19 and has a cough from a healthy user with cough, and users who tested positive for COVID-19 and have a cough from users with asthma and a cough. Our models achieve an AUC above 70% across all tasks. Clearly these results are preliminary and only scratch the surface of the possibilities of the exploitation of this type of data and audio-based machine learning. This work opens the door to further investigation of how automatically analysed respiratory patterns could be used as pre-screening signals to aid COVID-19 diagnosis.


Anticancer drugs and COVID-19 antiviral treatments in patients with cancer: What can we safely use?


title: Temperature dependence of COVID-19 transmission

text: The recent coronavirus pandemic follows in its early stages an almost exponential growth, with the number of cases quite well fit in time by $N(t)\propto e^{\alpha t}$, in many countries. We analyze the rate $\alpha$ for each country, starting from a threshold of 30 total cases and using the next 12 days, capturing thus the early growth homogeneously. We look for a link between $\alpha$ and the average temperature $T$ of each country, in the month of the epidemic growth. We analyze a {\it base} set of 42 countries, which developed the epidemic earlier, an {\it intermediate} set of 88 countries and an {\it extended} set of 125 countries, which developed the epidemic more recently. Applying a linear fit $\alpha(T)$, we find increasing evidence for a decreasing $\alpha$ as a function of $T$, at $99.66\%$C.L., $99.86\%$C.L. and $99.99995 \%$ C.L. ($p$-value $5 \cdot 10^{-7}$, or 5$\sigma$ detection) in the {\it base}, {\it intermediate} and {\it extended} dataset, respectively. The doubling time is expected to increase by $40\%\sim 50\%$, going from $5^\circ$ C to $25^\circ$ C. In the {\it base} set, going beyond a linear model, a peak at $(7.7\pm 3.6)^\circ C$ seems to be present, but its evidence disappears for the larger datasets. We also analyzed a possible bias: poor countries, often located in warm regions, might have less intense testing. By excluding countries below a given GDP per capita, we find that our conclusions are only slightly affected and only for the {\it extended} dataset. The significance remains high, with a $p$-value of $10^{-3}-10^{-4}$ or less. Our findings give hope that, for northern hemisphere countries, the growth rate should significantly decrease as a result of both warmer weather and lockdown policies. In general the propagation should be hopefully stopped by strong lockdown, testing and tracking policies, before the arrival of the cold season.


New coronavirus threat galvanizes scientists


Monitoring behavioural insights related to COVID-19


title: Coronavirus (SARS-CoV-2)  Ausbruch in Nordrhein-Westfalen (Kreis Heinsberg)  Erstdiagnose einer COVID-19-Infektion bei einem Ehepaar./ [Coronavirus (SARS-CoV-2) - Outbreak in North Rhine-Westphalia (District of Heinsberg) - First diagnosis of a COVID-19 manifestation in a couple]

text: HISTORY AND CLINICAL FINDINGS: Up to February 24th 2020 occasionally occuring SARS-CoV-2 infections in Germany without severe course. Emergency presentation of a couple in the emergency room. For seven days now, the man has fever, dry cough und physical weakness and the wife has similar symptoms of a milder form. The clinical examination shows fine crackles over both lungs and a respiratory failure of the husband. INVESTIGATIONS AND DIAGNOSIS: Laboratory increase in inflammation parameters as well as transaminases and lactate dehydrogenase. Radiologically lung infiltrates of different severity. Further on diagnosis of a SARS-CoV-2-infection of both patients with a severe course of the male. TREATMENT AND COURSE: Intubation and mechanical ventilation of the male patient with prolonged intenive care treatment. Recovery of the female patient under conventional oxygen therapy. DISCUSSION: These two cases show the starting point of an endemic spread of SARS-CoV-2 in the district of Heinsberg (North Rhine-Westphalia) and up to this point the first case of a life-threatenning course in Germany.


New virus in China requires international control effort


Transparency and Trust During the Coronavirus Disease 2019 (COVID-19) Pandemic


Transparency and Trust During the Coronavirus Disease 2019 COVID-19 Pandemic


title: Ictus como complicación y como factor pronóstico de COVID-19./ Ictus como complicación y como factor pronóstico de COVID-19./ Stroke as a complication and prognostic factor of COVID-19

text: INTRODUCTION: Contradictory data have been reported on the incidence of stroke in patients with COVID-19 and the risk of SARS-CoV-2 infection among patients with history of stroke. METHODS: This study systematically reviews case series reporting stroke as a complication of COVID-19, and analyses the prognosis of patients with COVID-19 and history of stroke. The pathophysiological mechanisms of stroke in patients with COVID-19 are also reviewed. CONCLUSIONS: History of stroke increases the risk of death due to COVID-19 by 3 times. Stroke currently seems not to be one of the main complications of COVID-19.


After COVID-19: Thinking Differently About Running the Health Care System


Chilblains-like dermatologic manifestation of COVID-19 diagnosed by serology via multidisciplinary virtual care


Resident Education in the Time of a Global Pandemic: Development of the Collaborative OMS Virtual Interinstitutional Didactic (COVID) Program


title: Treating Covid-19 at the Inflection Point

text: We appreciate the interest by Moura and colleague in our editorial regarding the role of the rheumatologist during the Covid-19 pandemic (1). The letter by Drs. Carlos Antonio Moura and Ana Luísa Cerqueira de Sant'Ana Costa emphasizes the need to understand mechanisms of disease underlying the more serious complications of Covid-19 infection as well as provide the best treatment possible to large numbers of seriously ill patients during a global pandemic (2).


Caring for Newborns Born to Mothers with COVID-19: More Questions than Answers


Clinical outcomes and prognosis of patients with HIV and SARS-CoV-2 coinfection


title: Clinical Outcomes and Prognosis of Patients with HIV and SARS-CoV-2 Co-infection

text: Dear Editor, I read with interest the review, "Living with HIV in the time of COVID-19: a glimpse of hope" by Adadi et al. published in the Journal of Medical Virology. However, I believe that the conclusions made within this article should be taken with caution as the outcomes of patients co-infected with HIV and SARS-CoV-2 are not definitive and evidence regarding this matter is constantly evolving. This article is protected by copyright. All rights reserved.


No Benefit for Lopinavir-Ritonavir in Severe COVID-19


Covid-19: schools set to close across UK except for children of health and social care workers


Covid-19: Time for a paradigm change


title: Human T leukaemia Type 1 and COVID-19

text: In the absence of clinical data on Human T leukaemia Type 1 and COVID-19 infection, we are providing guidance to clinicians who look after people living with HTLV-1.


The Wakley-Wu Lien Teh Prize Essay 2020: Chinese health workers' experiences during the COVID-19 pandemic


title: SARS-CoV-2 and DPP4 inhibition: Is it time to pray for Janus Bifrons?

text: Diabetes could be a risk factor for severity and mortality in patients with coronavirus disease 2019 COVID-19. It has been hypothesized that DPP4 inhibition, a therapy currently available for type 2 diabetes, might represent a target for decreasing the risk of the acute respiratory complications of the COVID-19 infection but (1) lack of demonstration of SARS-CoV2 binding to DPP4 (2) possible protective role of sDPP4 in Middle East respiratory Syndrome (MERS-CoV) (3) demonstrated inhibition and downregulation of DPP4 by HIV1 and MERS-CoV and (4) not exclusive role of the receptor binding in tropism of the Coronavirus family, support that DPP4 inhibition at present doesn't represent a plausible approach to mitigate COVID-19.


title: Nurses need support during Covid-19 pandemic

text: Stress in mental health nursing has long been recognised as impacting on individual performance, sickness and employment retention (see Edwards, D. & Burnard, 2003). Schwartz Rounds (SR) are interdisciplinary fora designed for staff to come together to reflect on the emotional and challenges associated with working in healthcare. They are utilised to promote compassion and to prevent burnout among caregivers across care services (Pepper et al, 2012), including mental health services (Farr & Barker, 2017).


Secure communication conduits during COVID-19 lockdown


docid: mgrqqhlj

title: COVID-19 Infection Unmasking Brugada Syndrome


Veterinary oncologists adapting to COVID-19 pandemic


title: Effects of ambient temperature and humidity on droplet lifetime - A perspective of exhalation sneeze droplets with COVID-19 virus transmission

text: A one-dimensional droplet evaporation model is used to estimate the droplet lifetime from evaporation in air. The mathematical model invokes assumptions of spherical symmetry, ideal gas mixture, binary diffusion, no re-condensation on droplet surface, and constant properties. Four initial droplet diameters (0.001, 0.01, 0.1, and 1â¯mm), two ambient temperatures (20 and 30â¯oC) and a range of ambient relative humidity are considered. For the conditions studied, the results show that the ambient relative humidity plays an important role in the droplet lifetime calculation. Increasing the ambient temperature does not necessarily decrease the droplet lifetime; it occurs only when the ambient relative humidity is set below 37%. When the ambient relative humidity is higher than 37%, the higher ambient temperature (30â¯oC) results in a longer droplet lifetime for the same initial droplet diameter considered. The results also suggest that there may exist a critical ambient relative humidity; beyond which, the droplet lifetime will increase exponentially. For ambient temperature at 30â¯oC, the critical ambient relative humidity is around 55.7%. It must be mentioned that the results of this study do not imply that the COVID-19 virus will be deactivated at the end of the droplet lifetime. The study simply shows the potential effects resulting from the ambient temperature and ambient relative humidity on virus carrying drops.


Cardiovascular Disease in the Post-COVID-19 Era - the Impending Tsunami?


title: Inside the Mind of Investors During the COVID-19 Pandemic: Evidence from the StockTwits Data

text: We study the investor beliefs, sentiment and disagreement, about stock market returns during the COVID-19 pandemic using a large number of messages of investors on a social media investing platform, \textit{StockTwits}. The rich and multimodal features of StockTwits data allow us to explore the evolution of sentiment and disagreement within and across investors, sectors, and even industries. We find that the sentiment (disagreement) has a sharp decrease (increase) across all investors with any investment philosophy, horizon, and experience between February 19, 2020, and March 23, 2020, where a historical market high followed by a record drop. Surprisingly, these measures have a sharp reverse toward the end of March. However, the performance of these measures across various sectors is heterogeneous. Financial and healthcare sectors are the most pessimistic and optimistic divisions, respectively.


Impaired Breakdown of Bradykinin and Its Metabolites as a Possible Cause for Pulmonary Edema in COVID-19 Infection


title: Comment on "Cutaneous manifestations in COVID-19: a first perspective " by Recalcati S

text: Since the coronavirus disease 2019 (COVID 19) outbreak was first reported in the Chinese city of Wuhan on December 31, 2019, it has stricken more than 1,000,000 persons worldwide, of whom over 50,000 have died (1). Having been infected by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), patients with COVID-19 mainly present with fever and respiratory symptoms (2). Isolated sudden onset anosmia has also frequently been reported (3). Less frequently, rhinorrhea, diarrhoea and dysgeusia may be associated. While only a few reports have evoked cutaneous manifestations (4), we read with interest an initial study on the topic entitled "Cutaneous manifestations in COVID-19: a first perspective " by Recalcati S. (5).


COVID-19 Highlights the Need for Trained Social Workers in Nursing Homes


title: Covid-19: avaliação remota em Atenção Primária à Saúde

text: O que você precisa saber? A maioria dos pacientes com Covid-19 podem ser manejados remotamente com aconselhamento de manejo de sintomas e autoisolamento;Apesar da maioria das consultas poderem ser feitas por telefone, a imagem de vídeo fornece pistas adicionais visuais e a presença terapêutica do profissional de saúde para o paciente;Falta de ar é um sintoma preocupante, embora, hoje, não há ferramenta validada para avaliá-la remotamente;Aconselhamento sobre rede de segurança para o paciente é crucial, uma vez que, alguns pacientes deterioram muito a sua condição de saúde em 2 semanas, mais comumente por pneumonia


title: SARS-CoV-2 infection in healthcare personnel with high-risk occupational exposure: evaluation of seven-day exclusion from work policy

text: BACKGROUND: Starting in late February 2020, Greece is experiencing a coronavirus disease 2019 (COVID-19) epidemic. Healthcare personnel (HCP) were disproportionately affected, accounting for approximately 10% of notified cases. Exclusion from work for 7 days was recommended for HCP with high-risk occupational exposure. Our aim was to evaluate the 7-day exclusion from work policy for HCP with high-risk exposure. METHODS: HCP with a history of occupational exposure to COVID-19 were notified to the Hellenic National Public Health Organization, regardless of their exposure risk category. Exposed HCP were followed for 14 days after last exposure. RESULTS: We prospectively studied 3398 occupationally exposed HCP; nursing personnel accounted for most exposures (n=1705; 50.2%). Of the 3398 exposed HCP, 1599 (47.1%) were classified as low-risk, 765 (22.5%) as moderate-risk, and 1031 (30.4%) as high-risk exposures. Sixty-six (1.9%) HCP developed COVID-19 at a mean of 3.65 days (range: 0-17 days) post-exposure. Of the 66 HCP with COVID-19, 46, 7, and 13 had a history of high-, moderate- or low-risk exposure (4.5%, 0.9%, and 0.8% of all high-, moderate-, and low-risk exposures, respectively). Hospitalization and absenteeism were more prevalent among HCP with high-risk exposure. A logistic regression analysis showed that the following variables were significantly associated with an increased risk for the onset of COVID-19: male, administrative personnel, underlying disease and high-risk exposure. CONCLUSION: HCP with high-risk occupational exposure to COVID-19 had increased probability of serious morbidity, healthcare seeking, hospitalization and absenteeism. Our findings justify the 7-day exclusion from work policy for HCP with high-risk exposure.


title: COVID-19, Australia: Epidemiology Report 2 (Reporting week ending 19:00 AEDT 8 February 2020)

text: This is the second epidemiological report for coronavirus disease (COVID-19), previously known as novel coronavirus (2019-nCoV), reported in Australia as at 19:00 Australian Eastern Daylight Time [AEDT] 8 February 2020. It includes data on Australian cases notified during the week ending 19:00 AEDT 8 February 2020, the international situation and current information on the severity, transmission and spread of the COVID-19 infection.


New FDA Guidance on General Clinical Trial Conduct in the Era of COVID-19


title: Clinical features of pediatric patients with COVID-19: a report of two family cluster cases

text: BACKGROUND: Coronovirus disease 2019 (COVID-19) has spread rapidly across the globe. People of all ages are susceptible to COVID-19. However, literature reports on pediatric patients are limited. METHODS: To improve the recognition of COVID-19 infection in children, we retrospectively reviewed two confirmed pediatric cases from two family clusters. Both clinical features and laboratory examination results of the children and their family members were described. RESULTS: The two confirmed children only presented with mild respiratory or gastrointestinal symptoms. Both of them had normal chest CT images. After general and symptomatic treatments, both children recovered quickly. Both families had travel histories to Hubei Province. CONCLUSIONS: Pediatric patients with COVID-19 are mostly owing to family cluster or with a close contact history. Infected children have relatively milder clinical symptoms than infected adults. We should attach importance to early recognition, early diagnosis, and early treatment of infected children.


The important role of serology for COVID-19 control


Corticosteroid use in selected patients with severe acute respiratory distress syndrome related to COVID-19


title: Pervasive Communications Technologies For Managing Pandemics

text: Pandemics always have had serious consequences unless they were effectively contained. Recent experiences with COVID-19 show that by using a smart and swift approach to deal with pandemics, avoids overwhelming of healthcare systems, and reduces the loss of precious life. This paper is about using smart technologies such as Mobile Edge Clouds (MEC), Internet of Things (IoT), and Artificial Intelligence (AI), as an approach to effectively manage pandemics. IoT provides pervasive connectivity among various devices and can be used for collecting information such as location and symptoms of potentially infected individuals. MECs provide cloud services on the edge, integrating IoT infrastructure and execution of sophisticated AI algorithms in the Cloud. In this paper, we develop a prototype to demonstrate the convergence of pervasive technologies to support research in managing pandemics. Low-cost Single Board Computers (SBC) based clusters are integrated within MEC to support remote medical teams in the field. The prototype implements a lightweight Docker container orchestrated by Kubernetes eco-system which is deployed on the clusters. The prototype successfully demonstrates that mobile medical facilities can utilize the proposed solution to collect information and execute AI algorithms while on the go. Finally, we present a discussion on the role of converging pervasive technologies on managing pandemics.


COVID-19 and parasitology


Household infection: The predominant risk factor for close contacts of patients with COVID-19


title: Experiences and perceptions risk of health-care workers from coronavirus: A protocol for systematic review

text: BACKGROUND: Healthcare workers (HCWs) were at the frontline during the battle against coronavirus. Understanding and managing their fears and anxieties may hold lessons for handling future outbreaks. However, the experiences and perceptions risk of HCWs from coronavirus still remains to be controversial. Thus, the objective of this review is to identify, appraise, and synthesize available evidence related to the experiences and perceptions of risk of HCWs from coronavirus. METHODS: The studies were gathered from PubMed, Cochrane Library, EMBASE, CBMdisc, CNKI, WKSP, CSJFT, Google Scholar, and PsycINFO, along with several sources of gray literature. The retrieval of full-text studies, data extraction, and quality assessment of the included studies will be independently conducted by 2 reviewers. The meta-aggregative will be used for findings pooling and a summary of ConQual findings tables will be presented in future. RESULTS: This study will be submitted to a peer-reviewed journal for publication. CONCLUSION: The literature will provide a high-quality analysis of the current evidence to assess the experiences and perceptions risk of health-care workers from coronavirus. REGISTRATION INFORMATION: CRD42020170388.


title: Performance Characteristics of the Abbott Architect SARS-CoV-2 IgG Assay and Seroprevalence in Boise, Idaho

text: Coronavirus disease-19 (COVID19), the novel respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with severe morbidity and mortality. The rollout of diagnostic testing in the United States was slow, leading to numerous cases that were not tested for SARS-CoV-2 in February and March 2020, necessitating the use of serological testing to determine past infections. Here, we evaluated the Abbott SARS-CoV-2 IgG test for detection of anti-SARS-CoV-2 IgG antibodies by testing 3 distinct patient populations. We tested 1,020 serum specimens collected prior to SARS-CoV-2 circulation in the United States and found one false positive, indicating a specificity of 99.90%. We tested 125 patients who tested RT-PCR positive for SARS-CoV-2 for which 689 excess serum specimens were available and found sensitivity reached 100% at day 17 after symptom onset and day 13 after PCR positivity. Alternative index value thresholds for positivity resulted in 100% sensitivity and 100% specificity in this cohort. We tested 4,856 individuals from Boise, Idaho collected over one week in April 2020 as part of the Crush the Curve initiative and detected 87 positives for a positivity rate of 1.79%. These data demonstrate excellent analytical performance of the Abbott SARS-CoV-2 IgG test as well as the limited circulation of the virus in the western United States. We expect the availability of high-quality serological testing will be a key tool in the fight against SARS-CoV-2.


title: Why Are Lopinavir and Ritonavir Effective against the Newly Emerged Coronavirus 2019? Atomistic Insights into the Inhibitory Mechanisms

text: Since the emergence of a novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported from Wuhan, China, neither a specific vaccine nor an antiviral drug against SARS-CoV-2 has become available. However, a combination of two HIV-1 protease inhibitors, lopinavir and ritonavir, has been found to be effective against SARS-CoV, and both drugs could bind well to the SARS-CoV 3C-like protease (SARS-CoV 3CLpro). In this work, molecular complexation between each inhibitor and SARS-CoV-2 3CLpro was studied using all-atom molecular dynamics simulations, free energy calculations, and pair interaction energy analyses based on MM/PB(GB)SA and FMO-MP2/PCM/6-31G* methods. Both anti-HIV drugs interacted well with the residues at the active site of SARS-CoV-2 3CLpro. Ritonavir showed a somewhat higher number atomic contacts, a somewhat higher binding efficiency, and a somewhat higher number of key binding residues compared to lopinavir, which correspond with the slightly lower water accessibility at the 3CLpro active site. In addition, only ritonavir could interact with the oxyanion hole residues N142 and G143 via the formation of two hydrogen bonds. The interactions in terms of electrostatics, dispersion, and charge transfer played an important role in the drug binding. The obtained results demonstrated how repurposed anti-HIV drugs could be used to combat COVID-19.


title: In silico study the inhibition of angiotensin converting enzyme 2 receptor of COVID-19 by Ammoides verticillata components harvested from Western Algeria

text: The objective of this present study is to focus on the in silico study to screen for an alternative drug that can block the activity of the angiotensin converting enzyme 2 (ACE2) as a receptor for SARS-CoV-2, potential therapeutic target of the COVID-19 virus using natural compounds (Isothymol, Thymol, Limonene, P-cymene and Î³-terpinene) derived from the essential oil of the antiviral and antimicrobial plant Ammoides verticillata (Desf.) Briq. which is located in the occidental Algeria areas. This study reveals that Isothymol, a major component of this plant, gives the best docking scores, compared to, the co-crystallized inhibitor ß-D-mannose of the enzyme ACE2, to Captropil drug as good ACE2 inhibitor and to Chloroquine antiviral drug also involved in other mechanisms as inhibition of ACE2 cellular receptor. In silico (ADME), drug-likeness, PASS & P450 site of metabolism prediction, pharmacophore Mapper showed that the compound Isothymol has given a good tests results compared to the ß-D-mannose co-crystallized inhibitor, to Captopril and Chloroquine drugs. Also the other natural compounds gave good results. The Molecular Dynamics Simulation study showed good result for the Isotymol- ACE2 docked complex. This study revealed for the first time that Isothymol is a functional inhibitor of angiotensin converting enzyme 2 activity and the components of essential oils Ammoides verticillata can be used as potential inhibitors to the ACE2 receptor of SARS-CoV-2.Communicated by Ramaswamy H. Sarma.


docid: vlioqbxu

title: Narrative Medicine: Thinking With Stories During The Plague


title: Just the Facts: Protected code blue - Cardiopulmonary resuscitation in the emergency department during the coronavirus disease 2019 pandemic

text: Emergency medical services (EMS) is called for a 65-year-old man with a 1-week history of cough, fever, and mild shortness of breath now reporting chest pain. Vitals on scene were HR 110, BP 135/90, SpO2 88% on room air. EMS arrives at the emergency department (ED). As the patient is moved to a negative pressure room, he becomes unresponsive with no palpable pulse. What next steps should be discussed in order to protect the team and achieve the best possible patient outcome?


David Oliver: Covid-19 will make us stop some activities for good


title: Potential Applications of Plant Biotechnology against SARS-CoV-2

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus responsible for an ongoing human pandemic (COVID-19). There is a massive international effort underway to develop diagnostic reagents, vaccines, and antiviral drugs in a bid to slow down the spread of the disease and save lives. One part of that international effort involves the research community working with plants, bringing researchers from all over the world together with commercial enterprises to achieve the rapid supply of protein antigens and antibodies for diagnostic kits, and scalable production systems for the emergency manufacturing of vaccines and antiviral drugs. Here, we look at some of the ways in which plants can and are being used in the fight against COVID-19.


Palliative care in advanced coronavirus disease in intensive care units


Systematic review of simulated airway management whilst wearing personal protective equipment


title: A multi-region variant of the SIR model and its extensions

text: In this note, we describe simple generalizations of the basic SIR model for epidemic, in case of a multi-region scenario, to be used for predicting the COVID-19 epidemic spread in Italy.


Rapidly scalable mechanical ventilator for the COVID-19 pandemic


title: Chloroquine in COVID-19: the evidence

text: To the Editor The Coronavirus disease 2019 (COVID-19) has been declared as a pandemic by World Health Organisation (WHO). The global mortality has increased, especially in countries like Italy and Iran. With the increasing morbidity and mortality, search for a cure has been the global demand.


title: Globalisation in the time of COVID-19: repositioning Africa to meet the immediate and remote challenges

text: The COVID-19 pandemic has ushered in a new climate of uncertainty which is fuelling protectionism and playing into nationalist narratives. Globalisation is under significant threat as governments scramble to reduce their vulnerability to the virus by limiting global trade and flows of people. With the imposition of border closures and strict migration measures, there have been major disruptions in Africa's global supply chains with adverse impacts on employment and poverty. The African economies overly reliant on single export-orientated industries, such as oil and gas, are expected to be severely hit. This situation is further aggravated by tumbling oil prices and a lowered global demand for African non-oil products. The agricultural sector, which should buffer these shocks, is also being affected by the enforcement of lockdowns which threaten people's livelihoods and food security. Lockdowns may not be the answer in Africa and the issue of public health pandemic response will need to be addressed by enacting context-specific policies which should be implemented in a humane way. In addressing the socioeconomic impact of COVID-19 on African nations, we argue that governments should prioritize social protection programmes to provide people with resources to maintain economic productivity while limiting job losses. International funders are committing assistance to Africa for this purpose, but generally as loans (adding to debt burdens) rather than as grants. G20 agreement so suspend debt payments for a year will help, but is insufficient to fiscal need. Maintaining cross-border trade and cooperation to continue generating public revenues is desirable. New strategies for diversifying African economies and limiting their dependence on external funding by promoting trade with a more regionalised (continental) focus as promoted by the African Continental Free Trade Agreement, while not without limitations, should be explored. While it is premature to judge the final economic and death toll of COVID-19, African leaders' response to the pandemic, and the support they receive from wealthier nations, will determine its eventual outcomes.


Type 1 diabetes onset triggered by COVID-19


title: COVID-19: Generate and apply local modelled transmission and morbidity effects to provide an estimate of the variation in overall relative healthcare resource impact at general practice granularity

text: INTRODUCTION: Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is the name given to the 2019 novel coronavirus. COVID-19 is the name given to the disease associated with the virus. SARS-CoV-2 is a new strain of coronavirus not been previously identified in humans. METHODS: Two key factors, case incidence and case morbidity, were analysed for England. When taken together they give an estimate of relative demand on healthcare utilisation. To analyse case incidence, the latest values for indicators that could be associated with infection transmission rates were collected from the Office of National Statistics (ONS) and Quality Outcome Framework (QOF) sources. These included population density, %age >16, at fulltime work/education, %age over 60, %BME ethnicity, social deprivation as IMD2019, location as latitude/longitude, and patient engagement as %self-confident in their own long-term condition management. Average case morbidity was calculated. To provide a comparative measure of overall healthcare resource impact, individual GP practice impact scores were compared against the median practice. RESULTS: The case incidence regression is a dynamic situation but it currently shows that Urban, %Working, and age >60 were the strongest determinants of case incidence. The local population comorbidity remains unchanged. The range of relative healthcare impact was wide with 80% of practices falling at 20%-250% of the national median. Once practice population numbers were included we found that the top 33% of GP practices supporting 45% of the patient population would require 68% of COVID-19 healthcare resources. The model provides useful information about the relative impact of Covid-19 on healthcare workload at GP practice granularity in all parts of England. CONCLUSION: Covid-19 is impacting on the utilisation of health/social care resources across the world. This model provides a way of predicting relative local levels of disease burden based on defined criteria, thereby providing a method for targeting limited care resources to optimise national/regional/local responses to the COVID-19 outbreak.


Covid-19 in care homes: the many determinants of this perfect storm


docid: hechmemo

title: SARS-CoV-2 will continue to circulate in the human population: an opinion from the point of view of the virus-host relationship

text: At the population level, the virus-host relationship is not set up to end with the complete elimination of either or both. Pathogen-resistant individuals will always remain in the host population. In turn, the virus can never completely eliminate the host population, because evolutionarily such an event is a dead end for the virus as an obligate intracellular parasite. A certain existential balance exists in the virus-host relationship. Against this backdrop, viral epidemics and pandemics only become manifest and egregious to human beings when tens and hundreds of thousands of people die and the question emerges what caused the high mortality peaks on the death chart. The answer seems clear; the emerging strain of the virus is new to the host population, and new mutations of the virus and natural selection will lead to a survival of only genetically resistant individuals in a host population. The dangers inherent to a novel virus are due to new features generally inthe molecular structure of proteins, which enable the virus to infect the cells of the host organism more intensively, dramatically challenging host immunity, and thus be transmitted more readily in the host population. In this article, we will concentrate on the facts currently available about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has caused COVID-19 (coronavirus disease 2019) pandemic and try to predict its development and consequences based on the virus-host relationship. In fact, only two scenarios will occur simultaneously in the very near future: people who are genetically resistant to the virus will get sick, recover, and develop immunity, while people who are sensitive to the virus will need drugs and vaccines, which will have to be researched and developed if they are to recover. If the pandemic does not stop, in a few decades it is anticipated that SARS-CoV-2 will become as safe as the four non-severe acute respiratory syndrome human coronaviruses (HCoV-NL63, HCoV-HKU1, HCoV-OC43, and HCoV-229E) currently circulating but causing low mortality in the human population.


title: From plague to coronavirus: On the value of ship traffic data for epidemic modeling

text: In addition to moving people and goods, ships can spread disease. Ship traffic may complement air traffic as a source of import risk, and cruise ships - with large passenger volumes and multiple stops - are potential hotspots, in particular for diseases with long incubation periods. Vessel trajectory data from ship Automatic Identification Systems (AIS) is available online and it is possible to extract and analyze this data. We illustrate this in the case of the current coronavirus epidemic, in which hundreds of infected individuals have traveled in ships captured in the AIS dataset. This real time and historical data should be included in epidemiological models of disease to inform the corresponding operational response.


title: Beyond just"flattening the curve": Optimal control of epidemics with purely non-pharmaceutical interventions

text: When effective medical treatment and vaccination are not available, non-pharmaceutical interventions such as social distancing, home quarantine and far-reaching shutdown of public life are the only available strategies to prevent the spread of epidemics. Based on an extended SEIR (susceptible-exposed-infectious-recovered) model and continuous-time optimal control theory, we compute the optimal non-pharmaceutical intervention strategy for the case that a vaccine is never found and complete containment (eradication of the epidemic) is impossible. In this case, the optimal control must meet competing requirements: First, the minimization of disease-related deaths, and, second, the establishment of a sufficient degree of natural immunity at the end of the measures, in order to exclude a second wave. Moreover, the socio-economic costs of the intervention shall be kept at a minimum. The numerically computed optimal control strategy is a single-intervention scenario that goes beyond heuristically motivated interventions and simple"flattening of the curve."Careful analysis of the computed control strategy reveals, however, that the obtained solution is in fact a tightrope walk close to the stability boundary of the system, where socio-economic costs and the risk of a new outbreak must be constantly balanced against one another. The model system is calibrated to reproduce the initial exponential growth phase of the COVID-19 pandemic in Germany.


title: Psychological Support for Medical Rescue Teams in Emergencies/ 中山大学学报(医学科学版)

text: @# Emergencies refer to those events that cause serious social harm, including natural disasters and public health events, and require emergency response. Medical rescue team is the main emergency rescue team. While carrying out the rescue mission, they are under great pressure both physically and mentally due to the unadaptability of the rescue environment, the lack of protective materials, overwork and other reasons, often resulting in fear, tension, anxiety, pessimism, self-blame and even acute stress disorder. Without timely and effective psychological support, long-term psychological problems such as post-traumatic stress disorder will remain after the event. Comprehensive psychological support includes psychological measurement of the whole rescue process, team formation before rescue and detailed psychological support intervention training, self-relaxation during rescue, basic life and safety guarantee, drug treatment, online psychological assistance, withdrawal of stressors after rescue and lifestyle reconstruction.


title: An Empirical Methodology for Detecting and Prioritizing Needs during Crisis Events

text: In times of crisis, identifying the essential needs is a crucial step to providing appropriate resources and services to affected entities. Social media platforms such as Twitter contain vast amount of information about the general public's needs. However, the sparsity of the information as well as the amount of noisy content present a challenge to practitioners to effectively identify shared information on these platforms. In this study, we propose two novel methods for two distinct but related needs detection tasks: the identification of 1) a list of resources needed ranked by priority, and 2) sentences that specify who-needs-what resources. We evaluated our methods on a set of tweets about the COVID-19 crisis. For task 1 (detecting top needs), we compared our results against two given lists of resources and achieved 64% precision. For task 2 (detecting who-needs-what), we compared our results on a set of 1,000 annotated tweets and achieved a 68% F1-score.


Does Cigarette Smoking Protect Against SARS-CoV-2 Infection?


A 5-point strategy for improved connection with relatives of critically ill patients with COVID-19


Can Covid Catalyze an Educational Transformation? Competency-Based Advancement in a Crisis


title: GPU-Accelerated Drug Discovery with Docking on the Summit Supercomputer: Porting, Optimization, and Application to COVID-19 Research

text: Protein-ligand docking is an in silico tool used to screen potential drug compounds for their ability to bind to a given protein receptor within a drug-discovery campaign. Experimental drug screening is expensive and time consuming, and it is desirable to carry out large scale docking calculations in a high-throughput manner to narrow the experimental search space. Few of the existing computational docking tools were designed with high performance computing in mind. Therefore, optimizations to maximize use of high-performance computational resources available at leadership-class computing facilities enables these facilities to be leveraged for drug discovery. Here we present the porting, optimization, and validation of the AutoDock-GPU program for the Summit supercomputer, and its application to initial compound screening efforts to target proteins of the SARS-CoV-2 virus responsible for the current COVID-19 pandemic.


Severe COVID-19 in a pregnant patient admitted to hospital in Wuhan


Critical Care During the Coronavirus Crisis-Reflections on the Roles of Anesthesiologists in Meeting the Challenges of the Pandemic


Producing Independent, Systematic Review Evidence: Cochrane's Response to COVID-19


HMGB1: A Possible Crucial Therapeutic Target for COVID-19?


title: Correction to: The COVID-19 Pandemic and its Impact on the Cardio-Oncology Population

text: In light of the recent retraction of the New England Journal of Medicine article entitled "Cardiovascular Disease, Drug Therapy, and Mortality in COVID-19" (Mehra et al., full citation provided below), the authors would like to remove the following statement, which appeared on page 2, under the heading Cardiovascular Disease and COVID-19.


Coronavirus puts drug repurposing on the fast track


Walter Gusmini : patients COVID ou non COVID, telle est la question


patients COVID ou non COVID, telle est la question


title: Coronavirus just caused the American Physical Society to cancel its biggest meeting of the year ;Science ;AAAS

text: Citing the growing threat of the coronavirus, the American Physical Society (APS), the 55,000 member professional society for physicists and researchers in associated fields, cancelled its largest meeting of the year just 34 hours before it was supposed to begin APS’s March Meeting was to be held this week at the Colorado Convention Center in Denver, and the society anticipated more than 10,000 people from all over the world would attend However, late yesterday, APS issued a statement abruptly calling off the meeting “The decision to cancel was based on the latest scientific data being reported, and the fact that a large number of attendees at this meeting are coming from outside the U S ,” including countries where the virus is circulating and for which the U S Centers for Disease Control and Prevention have advised people to avoid non-essential travel, the APS statement says “[T]his decision was made out of deep concern for the health and well-being of our registrants, staff, vendors, and the Denver community ”


Residency and Fellowship Program Accreditation: Effects of the Novel Coronavirus (COVID-19) Pandemic


Preventing stroke in symptomatic carotid artery disease during the COVID-19 pandemic


title: Hyperinflammation and derangement of renin-angiotensin-aldosterone system in COVID-19: A novel hypothesis for clinically suspected hypercoagulopathy and microvascular immunothrombosis

text: Early clinical evidence suggests that severe cases of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are frequently characterized by hyperinflammation, imbalance of renin-angiotensin-aldosterone system, and a particular form of vasculopathy, thrombotic microangiopathy, and intravascular coagulopathy. In this paper, we present an immunothrombosis model of COVID-19. We discuss the underlying pathogenesis and the interaction between multiple systems, resulting in propagation of immunothrombosis, which through investigation in the coming weeks, may lead to both an improved understanding of COVID-19 pathophysiology and identification of innovative and efficient therapeutic targets to reverse the otherwise unfavorable clinical outcome of many of these patients.


Dermatologic surgery in the COVID-19 era: Observations and practical suggestions


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