title: Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review

text: INTRODUCTION: The spread of novel corona virus (COVID-19) across the globe and the associated morbidity and mortality challenged the nations by several means. One such underrecognized and unaddressed area is the mental health issues medical staff develop during the pandemic. MATERIALS AND METHODS: This review aimed to review the literature about mental health problems faced by health care workers (HCW) during the COVID-19 pandemic. Literature search was conducted in the following databases: PubMed, Google Scholar, Cochrane Library, Embase. All types of articles published in the last 4 months (January 2020-April 2020) which were relevant to the subject of the review were searched. A total of 23 articles were selected by initial screening and 6 articles were included in the final review. RESULTS: Review of all the 6 articles showed that current research focused on assessing several aspects of mental health affected in HCW due to COVID-19. Several sociodemographic variables like gender, profession, age, place of work, department of work and psychological variables like poor social support, self-efficacy were associated with increased stress, anxiety, depressive symptoms, insomnia in HCW. There is increasing evidence that suggests that COVID-19 can be an independent risk factor for stress in HCW. CONCLUSION: Regular screening of medical personnel involved in treating, diagnosing patients with COVID-19 should be done for evaluating stress, depression and anxiety by using multidisciplinary Psychiatry teams.


title: Deceiving SARS-CoV-2 molecular-tropism clues - A combinational contemporary strategy

text: Several attempts to control the dreadfulness of SARS-CoV-2 are still underway. Based on the literature evidences we have speculated a prospective contemporary remedy, which was categorized into Specificity, Remedy, and a Conveyor. In which, pros and cons were discussed and inferred the possible alternatives. (a) Specificity: Implicit to express the ACE2 receptors in conveyor cells to deceive SARS-CoV-2 frompreponetargets. (b) Remedy: As depletion of pulmonary surfactants causes strong acute respiratory distress syndrome, we propose an entity of a cost-effective artificialsurfactantsystem as a remedy to pulmonary complications. (c) Conveyor: We propose red blood cells (RBCs) as a conveyor with embedded artificial surfactant and protruding ACE2 receptors for the target-specific delivery. Overall we postulate focused insights by employing a combinational contemporary strategy to steer towards a prospective direction on combating SARS-CoV-2.


Pooling of samples for testing for SARS-CoV-2 in asymptomatic people


title: Neuroinvasive potential of a primary respiratory pathogen SARS- CoV2: Summarizing the evidences

text: BACKROUND AND AIMS: After the emergence of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the last two decades, the world is facing its new challenge in SARS-CoV-2 pandemic with unfathomable global responses. The characteristic clinical symptoms for Coronavirus (COVID-19) affected patients are high fever, dry-cough, dyspnoea, lethal pneumonia whereas some patients also show additional neurological signs such as headache, nausea, vomiting etc. The accumulative evidences suggest that SARS-CoV-2 is not only confined within the respiratory tract but may also invade the central nervous system (CNS) and peripheral nervous system (PNS) inducing some fatal neurological diseases. Here, we analyze the phylogenetic perspective of SARS-CoV-2 with other strains of ß-Coronaviridae from a standpoint of neurological spectrum disorders. METHODOLOGY: A Pubmed/Medline, NIH Lit Covid, Cochrane library and some open data bases (BioRxiv, MedRxiv,preprint.org and others) search were carried out by using keywords relevant to our topic of discussion. The extracted literatures are scrutinized by the authors. RESULTS: 58 literatures including original articles, case reports and case series were selected by the authors to analyze the differential distribution of neurological impairments in COVID-19 positive patients along with angiotensin-converting enzyme-2 (ACE2) expression dynamics in neuronal and non-neuronal tissue in CNS and PNS with neuroinvasive potential of SARS-CoV2. CONCLUSION: We discuss the need for modulations in clinical approach from a neurological point of view, as a measure towards reducing disease transmission, morbidity and mortality in SARS-CoV2 positive patients.


docid: tdqudifi

title: Interactive web-based graphs of novel coronavirus COVID-19 cases and deaths per population by country

text: An accurate grasp of COVID-19 situation is considered highly important. The website we launched provides graphs of COVID-19 cases and deaths per one million population over time including trajectory analysis, and one can easily grasp the COVID-19 trend and adequately compare the situation between countries through this interactive graph system.


Spontaneous echo contrast in venous ultrasound of severe COVID-19 patients


Mitigating mental health consequences during the COVID-19 outbreak: Lessons from China


title: Early use of tocilizumab in the prevention of adult respiratory failure in SARS-CoV-2 infections and the utilization of interleukin-6 levels in the management

text: BACKGROUND: Respiratory failure in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection appears related to cytokine release syndrome (CRS) that often results in mechanical ventilation (MV). We investigated the role of tocilizumab (TCZ) on interleukin-6 (IL-6) trends and MV in SARS-CoV-2 patients. METHODS: In this longitudinal observational study, 112 patients were evaluated from 2/1/2020 - 5/31/2020. TCZ was administered followed by methylprednisolone to patients with > 3L oxygen (O2) requirement and pneumonia severity index (PSI) score ≤ 130 with CT scan changes. IL-6, C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), D-dimer, and procalcitonin were monitored on days 0, 3, and 6 of therapy. Statistical analyses were performed with significance ≤ 0.05. RESULTS: 80/112 SARS-CoV-2-positive patients (45 males, 56.96%; 34 females, 43.04%) were included in this study. Seven patients expired (8.75%) and nine patients required MV (11.25%). Median IL-6 levels pre-administration of TCZ was 342.50 (78.25 - 666.25) pg/mL compared to post-administration on day 3 (563; 162 - 783) pg/mL (P < 0.00001). On day 6, the median dropped to 545 (333.50 - 678.50) pg/mL compared to day 3 (P = 0.709). CRP, ferritin, LDH, and D-dimer levels were reduced following TCZ therapy. CONCLUSIONS: Early use of TCZ may reduce the need for MV and decrease CRP, ferritin, LDH, and D-dimer levels. The sequential use of methylprednisolone for 72 hours seems to potentiate the effect and prolong the suppression of the cytokine storm. IL-6 levels may be helpful as a prognostic tool. This article is protected by copyright. All rights reserved.


Convalescent Plasma Therapy for Corona Virus Disease 2019: a Long Way to Go but Worth Trying


title: Development of a TaqMan-probe-based multiplex real-time PCR for the simultaneous detection of emerging and reemerging swine coronaviruses

text: With the outbreak of the recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, coronaviruses have become a global research hotspot in the field of virology. Coronaviruses mainly cause respiratory and digestive tract diseases, several coronaviruses are responsible for porcine diarrhea, such as porcine epidemic diarrhea virus (PEDV), porcine deltacoronavirus (PDCoV), and emerging swine acute diarrhea syndrome coronavirus (SADS-CoV). Those viruses have caused huge economic losses and are considered as potential public health threats. Porcine torovirus (PToV) and coronaviruses, sharing similar genomic structure and replication strategy, belong to the same order Nidovirales. Here, we developed a multiplex TaqMan-probe-based real-time PCR for the simultaneous detection of PEDV, PDCoV, PToV, and SADS-CoV for the first time. Specific primers and TaqMan fluorescent probes were designed targeting the ORF1a region of PDEV, PToV, and SADS-CoV and the ORF1b region of PDCoV. The method showed high sensitivity and specificity, with a detection limit of 1 × 102 copies/µL for each pathogen. A total of 101 clinical swine samples with signs of diarrhea were analyzed using this method, and the result showed good consistency with conventional reverse transcription PCR (RT-PCR). This method improves the efficiency for surveillance of these emerging and reemerging swine enteric viruses and can help reduce economic losses to the pig industry, which also benefits animal and public health.


title: Modeling of Viral Aerosol Transmission and Detection

text: In this paper, we propose studying the disease spread mechanism in the atmosphere as an engineering problem. Aerosol transmission is the most significant mode among the viral transmission mechanisms that do not include physical contact, where airflows carry virus-laden droplets over long distances. Throughout this work, we study the transport of these droplets as a molecular communication problem, where one has no control over the transmission source, but a robust receiver can be designed using bio-sensors. To this end, we present a complete system model and derive an end-to-end mathematical model for the transmission channel under certain constraints and boundary conditions. We derive the system response for both continuous sources such as breathing and jet or impulsive sources such as coughing and sneezing. In addition to transmitter and channel, we assumed a receiver architecture composed of air sampler and Silicon Nanowire field-effect transistor. Then, we formulate a detection problem to maximize the likelihood decision rule and minimize the corresponding missed detection probability. Finally, we present several numerical results to observe the impact of parameters that affect the performance and justify the feasibility of the proposed setup in related applications.


Mental health emergency department attendances


title: School Nurses on the Front Lines of Healthcare: The Approach to Maintaining Student Health and Wellness During COVID-19 School Closures

text: In response to the novel coronavirus disease 2019 (COVID-19) pandemic, most states in the United States enacted statewide school closures, ranging in duration from 1 month to the remainder of the academic year. The extended durations of these closures present unique challenges, as many families rely on the school as a source of physical activity, mental health services, psychosocial support, child care, and food security. While the school doors may be closed, the school nurse can still play a vital role in emergency management. This article discusses challenges and proposes solutions to maintaining student health and wellness during extended school closures due to the COVID-19 pandemic. Furthermore, it is inevitable that until a vaccine for coronavirus is developed and readily available, many schools will continue to see future closures, though likely for shorter periods of time, as they respond to local outbreaks.


Opportunities From the Coronavirus Disease 2019 Pandemic for Transforming Psychiatric Care With Telehealth


title: Modeling Super-spreading Events for Infectious Diseases: Case Study SARS

text: Super-spreading events for infectious diseases occur when some infected individuals infect more than the average number of secondary cases. Several super-spreading individuals have been identified for the 2003 outbreak of severe acute respiratory syndrome (SARS). We develop a model for super-spreading events of infectious diseases, which is based on the outbreak of SARS. Using this model we describe two methods for estimating the parameters of the model, which we demonstrate with the small-scale SARS outbreak at the Amoy Gardens, Hong Kong, and the large-scale outbreak in the entire Hong Kong Special Administrative Region. One method is based on parameters calculated for the classical susceptible - infected - removed (SIR) disease model. The second is based on parameter estimates found in the literature. Using the parameters calculated for the SIR model, our model predicts an outcome similar to that for the SIR model. On the other hand, using parameter estimates from SARS literature our model predicts a much more serious epidemic.


title: Variational Coupling Revisited: Simpler Models, Theoretical Connections, and Novel Applications

text: Variational models with coupling terms are becoming increasingly popular in image analysis. They involve auxiliary variables, such that their energy minimisation splits into multiple fractional steps that can be solved easier and more efficiently. In our paper we show that coupling models offer a number of interesting properties that go far beyond their obvious numerical benefits. We demonstrate that discontinuity-preserving denoising can be achieved even with quadratic data and smoothness terms, provided that the coupling term involves the $L^1$ norm. We show that such an $L^1$ coupling term provides additional information as a powerful edge detector that has remained unexplored so far. While coupling models in the literature approximate higher order regularisation, we argue that already first order coupling models can be useful. As a specific example, we present a first order coupling model that outperforms classical TV regularisation. It also establishes a theoretical connection between TV regularisation and the Mumford-Shah segmentation approach. Unlike other Mumford-Shah algorithms, it is a strictly convex approximation, for which we can guarantee convergence of a split Bregman algorithm.


COVID-19 and remote consulting strategies in managing trauma and orthopaedics


title: The Impact of Coronavirus Disease 2019 on Bariatric Surgery: Redefining Psychosocial Care

text: The global outbreak of the 2019 novel coronavirus disease has had a tremendous psychological impact on individuals around the world. Individuals with obesity are susceptible to distress and psychological sequalae secondary to this pandemic, which can have detrimental effects on obesity management. In particular, individuals undergoing bariatric surgery could experience increased emotional distress, resulting in increased eating psychopathology, mental health exacerbation, and difficulties with self-management. Addressing these challenges requires novel approaches to redefining psychosocial care before and after bariatric surgery. Emerging evidence suggests that the remote delivery of care using virtual care models, including mobile and online modalities, could extend the reach of psychosocial services to individuals after bariatric surgery and mitigate weight regain or impairment in quality of life. Because of this pandemic, the rapid integration of virtual psychosocial care in bariatric surgery programs to address patients' needs will create new opportunities for clinical and implementational scientific research.


Complications of Orbital Emphysema in a COVID-19 Patient


title: Histopathologic Evaluation and Scoring of Viral Lung Infection

text: Emergent coronaviruses such as MERS-CoV and SARS-CoV can cause significant morbidity and mortality in infected individuals. Lung infection is a common clinical feature and contributes to disease severity as well as viral transmission. Animal models are often required to study viral infections and therapies, especially during an initial outbreak. Histopathology studies allow for identification of lesions and affected cell types to better understand viral pathogenesis and clarify effective therapies. Use of immunostaining allows detection of presumed viral receptors and viral tropism for cells can be evaluated to correlate with lesions. In the lung, lesions and immunostaining can be qualitatively described to define the cell types, microanatomic location, and type of changes seen. These features are important and necessary, but this approach can have limitations when comparing treatment groups. Semiquantitative and quantitative tissue scores are more rigorous as these provide the ability to statistically compare groups and increase the reproducibility and rigor of the study. This review describes principles, approaches, and resources that can be useful to evaluate coronavirus lung infection, focusing on MER-CoV infection as the principal example.


title: Dark Sirens to Resolve the Hubble-Lema\^itre Tension

text: The planned sensitivity upgrades to the LIGO and Virgo facilities could uniquely identify host galaxies of dark sirens-compact binary coalescences without any electromagnetic counterparts-within a redshift of z = 0.1. This is aided by the higher order spherical harmonic modes present in the gravitational-wave signal, which also improve distance estimation. In conjunction, sensitivity upgrades and higher modes will facilitate an accurate, independent measurement of the host galaxy's redshift in addition to the luminosity distance from the gravitational wave observation to infer the Hubble-Lema\^itre constant H0 to better than a few percent in five years. A possible Voyager upgrade or third generation facilities would further solidify the role of dark sirens for precision cosmology in the future.


"Water, water, everywhere": a challenge to ventilators in the COVID-19 pandemic


title: Novel coronavirus 2019 (COVID-19): Emergence and implications for emergency care

text: A novel coronavirus (COVID-19) causing acute illness with severe symptoms has been isolated in Wuhan, Hubei Province, China. Since its emergence, cases have been found worldwide, reminiscent of severe acute respiratory syndrome and Middle East respiratory syndrome outbreaks over the past 2 decades. Current understanding of this epidemic remains limited due to its rapid development and available data. While occurrence outside mainland China remains low, the likelihood of increasing cases globally continues to rise. Given this potential, it is imperative that emergency clinicians understand the preliminary data behind the dynamics of this disease, recognize possible presentations of patients, and understand proposed treatment modalities.


title: Az elso száz minimálisan invazív tüdolebeny-eltávolítás eredményei osztályunk beteganyagában

text: PATIENTS AND METHODS: Between 1st November 2013 and 30th June 2019 we performed 112 VATS lobectomies with isolated intubation and anterior approach. In 98 cases lobectomies were performed for malignant lesions, while in 9 cases for benign changes. 78 men and 34 women were operated on. The average age was 60.5 years (42-63). In 5 cases the left upper lobes were resected, in cases 36 the left lower lobes, in 15 cases the right upper lobes, in 11 cases the mid lobes, in 44 cases the right lower lobes, and in one case pneumonectomy was performed. RESULTS: there was no postoperative mortality. Conversion was required in three 3 patients. The average time of surgery was 150 minutes (70-215). Re-operation was needed in two cases due to bleeding and air leakage. Out of the 112 operations, primary lung cancer was demonstrated on pathology in 88 cases, while benign lesions /inflammation in 9 cases. The stages of primary lung cancer were the following: I.a:57, I.b:22, II.a:6, II.b:3 patients. Tumour subtypes were the detailed as 52 adenocarcinoma, 23 squamous cell cc., 2 small cell cc., 5 large cell cc., and 6 carcinoid. 10 patients underwent VATS lobectomy for metastatic disease. CONCLUSION: As a result of an adequate learning period, VATS lobectomies have become a routine surgery in our unit. Currently 65% of the thoracotomies and more than 50 percent of the lobectomies are performed by the VATS method. Our results are comparable to national as well as international data.


title: Incidence of Adverse Drug Reactions in COVID-19 Patients in China: An Active Monitoring Study by Hospital Pharmacovigilance System

text: To evaluate the incidence, type, and risk factors associated with adverse drug reactions (ADRs) among patients with coronavirus disease 2019 (COVID-19) by Hospital Pharmacovigilance System (CHPS). A retrospective analysis was performed on 217 patients with COVID-19 admitted to the First Hospital of Changsha in China, from January 17, 2020, to February 29, 2020. The active monitoring model in CHPS was used to detect ADR signals of the hospital information system. The risk factors for the ADRs were classified using the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) system. Univariate and multivariate logistic regressions were carried out to analyze the risk factors of ADRs. Our results showed that the prevalence of ADRs was 37.8% in the patients, which was predominated by drug-induced gastrointestinal disorders and liver system disorders (23.0% vs. 13.8%). The ADR could be explained by the use of lopinavir/ ritonavir and umifenovir by 63.8% and 18.1%, respectively. There were 96.8% of ADRs that occurred within 14 days of hospitalization. Multivariable analysis showed that length of stay (odds ratio (OR): 2.02; 95% confidence interval (CI) 1.03-3.96; P = 0.04), number of drugs used in the hospital (OR: 3.17; 95% CI 1.60-6.27; P = 0.001) and underlying basic diseases (OR: 2.07; 95% CI 1.02-4.23; P = 0.04) were independent risk factor for ADRs in the patients. Together, the incidence of ADRs was significantly high during the treatment period. Moreover, the active monitoring of the CHPS system reflected ADRs during COVID-19 treatment in the real world, which provided reference for safe medication in the clinic.


title: [Analysis on pattern of prescriptions and syndromes of traditional Chinese medicine for prevention and treatment of COVID-19]

text: To investigate the regularity of prescription and clinical syndromes by analyzing the diagnosis and treatment protocols of traditional Chinese medicine(TCM) for coronavirus disease 2019(COVID-19), so as to provide references for syndrome differentiation and relevant researches. The diagnosis and treatment protocols of COVID-19 published by national and regional health authorities were searched, and information was extracted in regard to disease stages, type of syndromes, and prescriptions, etc. Frequency statistics and relative analysis were used to analyze the rule of syndrome differentiation and prescription with TCM, and further discussion on the pathogenesis and progress of the disease. A total of 26 diagnosis and treatment protocols of TCM for COVID-19 were retrieved after screening(including 1 national scheme and 25 regional ones), among which 16 contained aspects of both prevention and treatment, 7 only involved treatment contents and 3 were prevention schemes. The courses of COVID-19 can be divided into early stage, middle stage, severe stage and recovery stage. The pathogeny of COVID-19 in TCM is damp-toxin, with the core pathogenesis of damp-toxin retention in lung and Qi repression. Its pathological features can be summarized as "damp, toxin, obstruction, deficiency". The location of the disease is lung, always involving spleen and stomach, and may further affect heart and kidney in severe cases. The major treatments for each course are Fanghua Shizuo, Xuanfei Touxie(early stage); Qingre Jiedu, Xuanxie Feire(middle stage); Kaibi Gutuo, Huiyang Jiuni(severe stage); Qingjie Yure, Yiqi Yangyin(recovery stage). There were many diagnosis and treatment protocols for COVID-19 have been published, which generally followed the national edition, through with certain personalities in different regional protocols. There were common features with respect to the disease stage, syndrome differentiation, therapeutic principles and methods, as well as prescriptions; the treatment were generally carried out against the core pathogenesis and progress of the disease. Along with the deepening recognition of COVID-19, the diagnosis and treatment protocols are still need further concretization and standardization. We hope researchers and decision-makers can pay more attention to the treatment of Huayu Tongluo in severe and recovery period.


COVID-19 and Eye Problems


title: Representative Committees of Peers

text: A population of voters must elect representatives among themselves to decide on a sequence of possibly unforeseen binary issues. Voters care only about the final decision, not the elected representatives. The disutility of a voter is proportional to the fraction of issues, where his preferences disagree with the decision. While an issue-by-issue vote by all voters would maximize social welfare, we are interested in how well the preferences of the population can be approximated by a small committee. We show that a k-sortition (a random committee of k voters with the majority vote within the committee) leads to an outcome within the factor 1+O(1/k) of the optimal social cost for any number of voters n, any number of issues $m$, and any preference profile. For a small number of issues m, the social cost can be made even closer to optimal by delegation procedures that weigh committee members according to their number of followers. However, for large m, we demonstrate that the k-sortition is the worst-case optimal rule within a broad family of committee-based rules that take into account metric information about the preference profile of the whole population.


title: Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis

text: OBJECTIVE: To determine long-term clinical outcomes in survivors of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus infections after hospitalization or intensive care unit admission. DATA SOURCES: Ovid MEDLINE, EMBASE, CINAHL Plus, and PsycINFO were searched. STUDY SELECTION: Original studies reporting clinical outcomes of adult SARS and MERS survivors 3 months after admission or 2 months after discharge were included. DATA EXTRACTION: Studies were graded using the Oxford Centre for Evidence-Based Medicine 2009 Level of Evidence Tool. Meta-analysis was used to derive pooled estimates for prevalence/severity of outcomes up to 6 months after hospital discharge, and beyond 6 months after discharge. DATA SYNTHESIS: Of 1,169 identified studies, 28 were included in the analysis. Pooled analysis revealed that common complications up to 6 months after discharge were: impaired diffusing capacity for carbon monoxide (prevalence 27%, 95% confidence interval (CI) 1545%); and reduced exercise capacity (mean 6-min walking distance 461 m, CI 450473 m). The prevalences of post-traumatic stress disorder (39%, 95% CI 3147%), depression (33%, 95% CI 2050%) and anxiety (30%, 95% CI 1061) beyond 6 months after discharge were considerable. Low scores on Short-Form 36 were identified beyond 6 months after discharge. CONCLUSION: Lung function abnormalities, psychological impairment and reduced exercise capacity were common in SARS and MERS survivors. Clinicians should anticipate and investigate similar long-term outcomes in COVID-19 survivors.


title: [Pediatric impact of COVID-19]

text: Children infected with SARS-CoV-2 are underrepresented during the current COVID-19 outbreak Unlike other respiratory viruses, SARS-CoV-2 rather infects adults who subsequently infect their children From recent Chinese and Italian data, children commonly present mild to moderate disease, a large proportion of them being asymptomatic In particular, children present significantly less fever, cough and pneumonia compared to adults However, more cases of pneumonia were reported from children infected with SARS-CoV-2 compared to those infected with H1N1 No vertical transmission of SARS-CoV-2 has been described so far


docid: nftnjezn

title: Pandemics and social stigma: Who's next? Italy's experience with COVID-19


Coronavirus Disease 2019: Understanding Immunopathogenesis Is the "Holy Grail" to Explain Why Children Have Less Severe Acute Disease


A Closed Chamber ENT Examination Unit for Aerosol-Generating Endoscopic Examinations of COVID-19 Patients


title: The implications of preliminary screening and diagnosis: Clinical characteristics of 33 mild patients with SARS-CoV-2 infection in Hunan, China

text: BACKGROUND: In December 2019, coronavirus Disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China. The disease has rapidly spread from Wuhan to other regions. OBJECTIVES: To describe the clinical manifestations and epidemiological characteristics of patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in Hunan Province in 2020. STUDY DESIGN: From January 19 to February 7, 2020, 33 patients with positive in nucleic acid test of pharyngeal swab were retrospectively collected and analyzed. RESULTS: There are 33 COVID-19 patients (16 male, 17 female), and the median age was 46 years. Nineteen patients (48 %) were associated with a family cluster outbreak. Seventeen patients (52 %) had traveled or lived in Hubei Province. These patients are early mild cases, most common symptoms are fever [23 (70 %)] and cough [13 (39 %)]. Most patients' white blood cell counts are normal, while they manifest as significant reduction in lymphocytes [17/28 (61 %)]. The levels of c-reactive protein and erythrocyte sedimentation rate suggest a typical viral infection. Procalcitonin did not increase and D-dimer increased slightly. Lactate dehydrogenase (LDH) levels have elevated in most patients. CT images of these patients showed bilateral multiple plaques or nodular ground-glass opacities (68.4 %). Fecal nucleic acid results were positive in eight COVID-19 patients accompanied with diarrhea. Tear nucleic acid results were negative in six COVID-19 patients. And four asymptomatic patients were infected with SARS-CoV-2. CONCLUSIONS: The clinical symptoms, laboratory results and imaging reports of patients with COVID-19 in Hunan area are significantly different from those in Wuhan area. For non-Wuhan epidemic areas, more attention should be paid to nucleic acid test results of throat swabs and stools, and it is not easily to diagnose based on clinical symptoms and CT results. Reduced whole blood lymph count can be used as an adjuvant diagnosis of early SARS-CoV-2 infection. Attention should be paid to asymptomatic carriers, which is of great significance for the control of the global epidemic.


title: Australian and New Zealand consensus statement on the management of lymphoma, chronic lymphocytic leukaemia and myeloma during the COVID-19 pandemic

text: The COVID-19 pandemic poses a unique challenge to the care of patients with haematological malignancies. Viral pneumonia is known to cause disproportionately severe disease in patients with cancer, and patients with lymphoma, myeloma and chronic lymphocytic leukaemia are likely to be at particular risk of severe disease related to COVID-19. This statement has been developed by consensus among authors from Australia and New Zealand. We aim to provide supportive guidance to clinicians making individual patient decisions during the COVID-19 pandemic, in particular during periods that access to healthcare resources may be limited. General recommendations include those to minimise patient exposure to COVID-19, including the use of telehealth, avoidance of non-essential visits and minimisation of time spent by patients in infusion suites and other clinical areas. This statement also provides recommendations where appropriate in assessing indications for therapy, reducing therapy-associated immunosuppression and reducing healthcare utilisation in patients with specific haematological malignancies during the COVID-19 pandemic. Specific decisions regarding therapy of haematological malignancies will need to be individualised, based on disease risk, risks of immunosuppression, rates of community transmission of COVID-19 and available local healthcare resources.


Saving the frontline health workforce amidst the COVID-19 crisis: Challenges and recommendations


Papular-purpuric exanthem in a COVID-19 patient: clinical and dermoscopic description


title: Papular-Purpuric Exanthem in a COVID-19 Patient: Clinical and Dermoscopic Description

text: Acute Coronavirus disease 2019 (COVID-19) has become a global health concern associated with a broad spectrum of clinical presentations. Cutaneous lesions in COVID-19 are still under continuous study. We report a case of COVID-19 (+) patient with late-onset cutaneous rash associated with a systemic inflammatory response during the second hospitalization.


China is tightening its grip on coronavirus research


Helmet continuous positive airway pressure and prone positioning: A proposal for an early management of COVID-19 patients


title: Adaptive County Level COVID-19 Forecast Models: Analysis and Improvement

text: Accurately forecasting county level COVID-19 confirmed cases is crucial to optimizing medical resources. Forecasting emerging outbreaks pose a particular challenge because many existing forecasting techniques learn from historical seasons trends. Recurrent neural networks (RNNs) with LSTM-based cells are a logical choice of model due to their ability to learn temporal dynamics. In this paper, we adapt the state and county level influenza model, TDEFSI-LONLY, proposed in Wang et a. [l2020] to national and county level COVID-19 data. We show that this model poorly forecasts the current pandemic. We analyze the two week ahead forecasting capabilities of the TDEFSI-LONLY model with combinations of regularization techniques. Effective training of the TDEFSI-LONLY model requires data augmentation, to overcome this challenge we utilize an SEIR model and present an inter-county mixing extension to this model to simulate sufficient training data. Further, we propose an alternate forecast model, {\it County Level Epidemiological Inference Recurrent Network} (\alg{}) that trains an LSTM backbone on national confirmed cases to learn a low dimensional time pattern and utilizes a time distributed dense layer to learn individual county confirmed case changes each day for a two weeks forecast. We show that the best, worst, and median state forecasts made using CLEIR-Net model are respectively New York, South Carolina, and Montana.


Historical Lessons from Twentieth-Century Pandemics Due to Respiratory Viruses


title: Cholinergic modulation of corticotropin-releasing hormone (CRH) and non-CRH neurons in Barrington's nucleus of the mouse

text: Corticotropin-releasing hormone (CRH) is expressed in Barrington's nucleus (BarN), which plays an essential role in the regulation of micturition. To control the neural activities of BarN, glutamatergic and GABAergic inputs from multiple sources have been demonstrated; however, it is not clear how modulatory neurotransmitters affect the activity of BarN neurons. We have employed knock-in mice, CRH-expressing neurons of which are labeled with a modified yellow fluorescent protein (Venus). Using whole-cell patch-clamp recordings, we examined the responses of Venus-expressing (putative CRH-expressing) neurons in BarN (BarCRH), as well as non-CRH-expressing neurons (BarCRH-negative), following bath application of cholinergic agonists. According to the present study, the activity of BarCRH neurons could be modulated by dual cholinergic mechanisms. First, they are inhibited by a muscarinic receptor-mediated mechanism, most likely through the M2 subclass of muscarinic receptors. Second, BarCRH neurons are excited by a nicotinic receptor-mediated mechanism. BarCRH-negative neurons also responded to cholinergic agents. Choline transporter-immunoreactive nerve terminals were observed in close proximity to the neurites, as well as the somata of BarCRH. The present results suggest that BarN neurons are capable of responding to cholinergic input.


Ivermectin and COVID-19: Keeping Rigor in Times of Urgency


title: Cirugía de la pared abdominal después del SARS-CoV-2: ¿es hora de restablecer los procedimientos no esenciales pospuestos?/ Cirugía de la pared abdominal después del SARS-CoV-2: ¿es hora de restablecer los procedimientos no esenciales pospuestos?/ Abdominal Wall Surgery After SARS-CoV-2: Time to Reestablish Postponed Non-essential Procedures?

text: Pandemic by the COVID-19 has found us unprotected to provide an adequate and rapid sanitary response. The hospital network of our public health system has provided most of the resources for the treatment of patients affected by the infection. Non-essential (non-priority) surgeries have been postponed. The optimal and proportionate reestablishment of these non-priority surgeries can be a problem. This article offers a technical and non-technical view of reestablishment non-priority surgeries from the perspective of abdominal wall surgery.


title: [Be alert to superposed effect of seasonal influenza while fighting against COVID-19]

text: COVID-19 continues to spread throughout the country, and the prevention and control of the epidemic has entered a critical period. However, southern cities with severe outbreaks are about to enter the seasonal influenza season. We should strengthen the epidemiological investigation, optimize the laboratory testing strategy, take effective measures, strengthen the prevention and control of influenza epidemic, and minimize the interference to the COVID-19 epidemic.


title: Asymptomatic patients as a source of COVID-19 infections: A systematic review and meta-analysis

text: BACKGROUND: Coronavirus Disease 2019 (COVID-19) is characterised by an unpredictable disease course, ranging from asymptomatic infections to severe, life-threating manifestations. Asymptomatic COVID-19 infections have been described, and the aim of this systematic review was to summarise their presentation form. METHODS: We searched PubMed® and Google® (1 December 2019 to 29 March 2020) and extracted age, laboratory findings, and computed tomography (CT) investigations. Pooled incidence rates of clinical characteristics were analysed using random effects models. RESULTS: In total, 506 patients from 34 studies (68 single cases and 438 from case series) with an asymptomatic course were identified. Patients with normal radiology were younger (19.59 ± 17.17 years) than patients with abnormal radiology (39.14 ± 26.70 years) (p value = 0.013). Despite being asymptomatic, CT investigations revealed abnormalities in 62.2% of the cases and ground glass opacities were most frequently observed (43.09% by meta-analysis). Most studies reported normal laboratory findings (61.74% by meta-analysis). CONCLUSIONS: More than half of patients without any symptoms present with CT abnormalities. Asymptomatic patients may be contagious and thus a potential source of transmission of COVID-19.


title: The recent challenges of highly contagious COVID-19; causing respiratory infections: symptoms, diagnosis, transmission, possible vaccines, animal models and immunotherapy

text: COVID-19 is highly contagious pathogenic viral infection initiated from Wuhan seafood wholesale market of China on December 2019 and spread rapidly around the whole world due to onward transmission. This recent outbreak of novel coronavirus (CoV) was believed to be originated from bats and causing respiratory infections such as common cold, dry cough, fever, headache, dyspnea, pneumonia and finally Severe Acute Respiratory Syndrome (SARS) in humans. For this widespread zoonotic virus, human-to-human transmission has resulted in nearly 83 lakh cases in 213 countries and territories with 4,50,686 deaths as on 19th June 2020. This review presents a report on the origin, transmission, symptoms, diagnosis, possible vaccines, animal models and immunotherapy for this novel virus and will provide ample references for the researchers towards the ongoing development of therapeutic agents and vaccines and also preventing the spread of this disease.


Downregulation of ACE2 induces overstimulation of the renin-angiotensin system in COVID-19: should we block the renin-angiotensin system?


Origine de SARS-CoV-2 : le probable et le possible


Laboratories and Pandemic Preparedness: A Framework for Collaboration and Oversight


title: How average is average? Temporal patterns in human behaviour as measured by mobile phone data -- or why chose Thursdays

text: Mobile phone data -- with file sizes scaling into terabytes -- easily overwhelm the computational capacity available to some researchers. Moreover, for ethical reasons, data access is often granted only to particular subsets, restricting analyses to cover single days, weeks, or geographical areas. Consequently, it is frequently impossible to set a particular analysis or event in its context and know how typical it is, compared to other days, weeks or months. This is important for academic referees questioning research on mobile phone data and for the analysts in deciding how to sample, how much data to process, and which events are anomalous. All these issues require an understanding of variability in Big Data to answer the question of how average is average? This paper provides a method, using a large mobile phone dataset, to answer these basic but necessary questions. We show that file size is a robust proxy for the activity level of phone users by profiling the temporal variability of the data at an hourly, daily and monthly level. We then apply time-series analysis to isolate temporal periodicity. Finally, we discuss confidence limits to anomalous events in the data. We recommend an analytical approach to mobile phone data selection which suggests that ideally data should be sampled across days, across working weeks, and across the year, to obtain a representative average. However, where this is impossible, the temporal variability is such that specific weekdays' data can provide a fair picture of other days in their general structure.


COVID-19 contagion and contamination through hands of trauma patients: what risks and what precautions?


title: Ventilator Triage Policies During the COVID-19 Pandemic at U.S. Hospitals Associated With Members of the Association of Bioethics Program Directors

text: Background: The coronavirus disease 2019 pandemic has or threatens to overwhelm health care systems. Many institutions are developing ventilator triage policies. Objective: To characterize the development of ventilator triage policies and compare policy content. Design: Survey and mixed-methods content analysis. Setting: North American hospitals associated with members of the Association of Bioethics Program Directors. Participants: Program directors. Measurements: Characteristics of institutions and policies, including triage criteria and triage committee membership. Results: Sixty-seven program directors responded (response rate, 91.8%); 36 (53.7%) hospitals did not yet have a policy, and 7 (10.4%) hospitals' policies could not be shared. The 29 institutions providing policies were relatively evenly distributed among the 4 U.S. geographic regions (range, 5 to 9 policies per region). Among the 26 unique policies analyzed, 3 (11.3%) were produced by state health departments. The most frequently cited triage criteria were benefit (25 policies [96.2%]), need (14 [53.8%]), age (13 [50.0%]), conservation of resources (10 [38.5%]), and lottery (9 [34.6%]). Twenty-one (80.8%) policies use scoring systems, and 20 of these (95.2%) use a version of the Sequential Organ Failure Assessment score. Among the policies that specify the triage team's composition (23 [88.5%]), all require or recommend a physician member, 20 (87.0%) a nurse, 16 (69.6%) an ethicist, 8 (34.8%) a chaplain, and 8 (34.8%) a respiratory therapist. Thirteen (50.0% of all policies) require or recommend those making triage decisions not be involved in direct patient care, but only 2 (7.7%) require that their decisions be blinded to ethically irrelevant considerations. Limitation: The results may not be generalizable to institutions without academic bioethics programs. Conclusion: Over one half of respondents did not have ventilator triage policies. Policies have substantial heterogeneity, and many omit guidance on fair implementation.


title: Novel coronavirus and regular physical activity involvement: Opinion

text: The novel coronavirus (NCOVID-19) has quickly become a public health concern globally and needs urgent attention. While there is no current evidence of vaccines and specific drugs to prevent and treat the ailments emanating from NCOVID-19 infections, complementary and conventional medical treatments could prove beneficial in ameliorating some of the respiratory difficulties, especially in countries in sub-Saharan Africa. These treatments include specific breathing exercises, a diet that strengthens the immune system, as well as avoiding tobacco smoking and alcohol consumption. On the other hand, for those who have not contracted the virus, participation in indoor and within-the-yard physical activity could be beneficial in preventing unwanted weight gain as well as associated conditions such as anxiety and depression.


title: A different way of nursing

text: Sam Foster, Chief Nurse, Oxford University Hospitals, considers how different ways of working during the COVID-19 emergency have led nurses to reflect on and change the way they nurse.


COVID-19 outbreak: impact of the quarantine-induced stress on cardiovascular disease risk burden


Decline in the number of coronary angiography and percutaneous coronary intervention procedures in patients with acute myocardial infarction in Poland during the coronavirus disease 2019 pandemic


The harms of police frisking in times of a pandemic


title: Dentistry and coronavirus (COVID-19) - moral decision-making

text: The coronavirus (COVID-19) has challenged health professions and systems and has evoked different speeds of reaction and types of response around the world. The role of dental professionals in preventing the transmission of COVID-19 is critically important. While all routine dental care has been suspended in countries experiencing COVID-19 disease during the period of pandemic, the need for organised urgent care delivered by teams provided with appropriate personal protective equipment takes priority. Dental professionals can also contribute to medical care. Major and rapid reorganisation of both clinical and support services is not straightforward. Dental professionals felt a moral duty to reduce routine care for fear of spreading COVID-19 among their patients and beyond, but were understandably concerned about the financial consequences. Amidst the explosion of information available online and through social media, it is difficult to identify reliable research evidence and guidance, but moral decisions must be made.


Epidemiology of COVID-19 Outbreak in Japan, January-March 2020


title: Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period

text: It is urgent to understand the future of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) transmission. We used estimates of seasonality, immunity, and cross-immunity for human coronavirus OC43 (HCoV-OC43) and HCoV-HKU1 using time-series data from the United States to inform a model of SARS-CoV-2 transmission. We projected that recurrent wintertime outbreaks of SARS-CoV-2 will probably occur after the initial, most severe pandemic wave. Absent other interventions, a key metric for the success of social distancing is whether critical care capacities are exceeded. To avoid this, prolonged or intermittent social distancing may be necessary into 2022. Additional interventions, including expanded critical care capacity and an effective therapeutic, would improve the success of intermittent distancing and hasten the acquisition of herd immunity. Longitudinal serological studies are urgently needed to determine the extent and duration of immunity to SARS-CoV-2. Even in the event of apparent elimination, SARS-CoV-2 surveillance should be maintained because a resurgence in contagion could be possible as late as 2024.


title: Comparison of Hospitalized Patients with pneumonia caused by COVID-19 and influenza A in children under 5 years

text: BACKGROUND: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in Wuhan, considerable attention has been paid on its epidemiology and clinical characteristics in children patients. However, it is also crucial for clinicians to differentiate COVID-19 from other respiratory infectious diseases, such as influenza viruses. METHODS: This was a retrospective study. Two group of COVID-19 patients (n=57) and influenza A patients (n=59) were enrolled. We analyzed and compared their clinical manifestations, imaging characteristics and treatments. RESULTS: The proportions of cough (70.2%), fever (54.4%) and gastrointestinal symptoms (14.1%) in COVID-19 patients were lower than those of influenza A patients (98.3%, P<0.001; 84.7%, P<0.001; and 35.6%, P=0.007; respectively). In addition, COVID-19 patients showed significantly lower levels of leukocytes (7.87 vs. 9.89×109/L, P=0.027), neutrophils (2.43 vs. 5.16×109/L, P<0.001), C-reactive protein (CRP; 3.7 vs. 15.1mg/L, P=0.001) and procalcitonin (PCT; 0.09 vs. 0.68mm/h, P<0.001), while lymphocyte levels (4.58 vs. 3.56×109/L; P=0.006) were significantly higher compared with influenza A patients. In terms of CT imaging, ground-glass opacification in chest CT was more common in COVID-19 patients than in influenza A patients (42.1% vs. 15%, P=0.032). In contrast, consolidation was more common in influenza A patients (25%) than that in COVID-19 patients (5.2%, P=0.025). CONCLUSION: The clinical manifestations and laboratory tests of COVID-19 children are milder than those of influenza A children under 5 years. Additionally, imaging results more commonly presented as ground-glass opacities in COVID-19 patients.


title: Echocardiographic Findings in Patients With COVID-19 Pneumonia

text: The aim of this study was to characterize the echocardiographic phenotype of patients with COVID-19 pneumonia and its relation to biomarkers. Seventy-four patients (59 ± 13 years old, 78% male) admitted with COVID-19 were included after referral for transthoracic echocardiography as part of routine care. A level 1 British Society of Echocardiography transthoracic echocardiography was used to assess chamber size and function, valvular disease, and likelihood of pulmonary hypertension. The chief abnormalities were right ventricle (RV) dilatation (41%) and RV dysfunction (27%). RV impairment was associated with increased D-dimer and C-reactive protein levels. In contrast, left ventricular function was hyperdynamic or normal in most (89%) patients.


title: The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study

text: BACKGROUND: In the early stages of the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China, the local health-care system was overwhelmed. Physicians and nurses who had no infectious disease expertise were recruited to provide care to patients with COVID-19. To our knowledge, no studies on their experiences of combating COVID-19 have been published. We aimed to describe the experiences of these health-care providers in the early stages of the outbreak. METHODS: We did a qualitative study using an empirical phenomenological approach. Nurses and physicians were recruited from five COVID-19-designated hospitals in Hubei province using purposive and snowball sampling. They participated in semi-structured, in-depth interviews by telephone from Feb 10 to Feb 15, 2020. Interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method. FINDINGS: We recruited nine nurses and four physicians. Three theme categories emerged from data analysis. The first was "being fully responsible for patients' wellbeing-'this is my duty'". Health-care providers volunteered and tried their best to provide care for patients. Nurses had a crucial role in providing intensive care and assisting with activities of daily living. The second category was "challenges of working on COVID-19 wards". Health-care providers were challenged by working in a totally new context, exhaustion due to heavy workloads and protective gear, the fear of becoming infected and infecting others, feeling powerless to handle patients' conditions, and managing relationships in this stressful situation. The third category was "resilience amid challenges". Health-care providers identified many sources of social support and used self-management strategies to cope with the situation. They also achieved transcendence from this unique experience. INTERPRETATION: The intensive work drained health-care providers physically and emotionally. Health-care providers showed their resilience and the spirit of professional dedication to overcome difficulties. Comprehensive support should be provided to safeguard the wellbeing of health-care providers. Regular and intensive training for all health-care providers is necessary to promote preparedness and efficacy in crisis management. FUNDING: National Key R&D Program of China, Project of Humanities and Social Sciences of the Ministry of Education in China.


title: Efficacy of Serology Testing in Predicting Reinfection in Patients with SARS-CoV-2

text: In many parts of the United States, SARS-CoV-2 cases have reached peak infection rates, prompting administrators to create protocols to resume elective cases. As elective procedures and surgeries get scheduled, ASCs must implement some form of widespread testing in order to ensure the safety of both the ASC staff as well as the patients being seen. The CDC recently announced the approval of new serological testing for SARS-CoV-2, a test that can indicate the presence of IgM and IgG antibodies in the serum against viral particles. However, the possibility for reinfection raises questions about the utility of this new serological test, as the presence of IgG may not correspond to long-term immunity. The coronavirus has been known to form escape mutations, which may correspond to reduction in immunoglobulin binding capacity. Patients who develop more robust immune responses with formation of memory CD8+ T-cells and helper CD4+ T-cells will be the most equipped if exposed to the virus, but unfortunately the serology test will not help us in distinguishing those individuals. Given the inherent disadvantages of serological testing, antibody testing alone should not be used when deciding patient care and should be combined with PCR testing.


Interleukin 6-blockade treatment for severe COVID-19 in two patients with multiple myeloma


Vaccine designers take first shots at COVID-19


docid: izkwiqoa

title: Calculated decisions: COVID-19 calculators during extreme resource-limited situations

text: In the near future, clinicians may face scenarios in which there are not have enough resources (ventilators, ECMO machines, etc) available for the number of critically sick COVID-19 patients There may not be enough healthcare workers, as those who are positive for COVID-19 or those who have been exposed to the virus and need to be quarantined During these worst-case scenarios, new crisis standards of care and thresholds for intensive care unit (ICU) admissions will be needed Clinical decision scores may support the clinician's decision-making, especially if properly adapted for this unique pandemic and for the patient being treated This review discusses the use of clinical prediction scores for pneumonia severity at 3 main decision points to examine which scores may provide value in this unique situation Initial data from a cohort of over 44,000 COVID-19 patients in China, including risk factors for mortality, were compared with data from cohorts used to study the clinical scores, in order to estimate the potential appropriateness of each score and determine how to best adjust results at the bedside


title: Mental health stressors in Israel during the coronavirus pandemic

text: A survey of 503 Israelis, performed in April 2020, found high levels of anxiety and risk for depression; these mental health issues were associated with several stressors connected with the coronavirus and related policies. However, only a small percentage of the sample received mental health care from a professional, with native-born Israelis less likely than recent immigrants to receive such care. Some possible initiatives based on these findings are suggested. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Attenuation of antibody response to SARS-CoV-2 in a patient on ocrelizumab with hypogammaglobulinemia


Understanding the Dynamics of COVID-19


Perspective: SARS-CoV-2, COVID-19 and Haematologists


title: Making Sense of the Current Covid 19 Situation and Suggesting a tailored Release Strategy through Modeling And Simulation Case Study: Casablanca, Morocco

text: Since the very first days of announcing Covid 19 as a global pandemic, researchers around the world from different backgrounds and organizations including national governments and the World Health Organization (WHO) have extensively begun using Modeling and Simulation (M&S) techniques in deciding on the optimal strategies in order to mitigate the public health and economical effects of Covid-19. In this paper, we present our results from applying M&S on the city of Casablanca, Morocco to comprehend (i): How it can be relatively easy or difficult for such pandemic to penetrate to the studied region (country, city, district, etc.). (ii): How it can spread relatively fast or slow within that region. And finally (iii): What is the optimal strategy for containing and mitigating the propagation of the disease while still keeping the economy as near to normal as possible.


docid: spuhlmme

title: An up-to-date overview of computational polypharmacology in modern drug discovery

text: INTRODUCTION: In recent years, computational polypharmacology has gained significant attention to study the promiscuous nature of drugs. Despite tremendous challenges, community-wide efforts have led to a variety of novel approaches for predicting drug polypharmacology. In particular, some rapid advances using machine learning and artificial intelligence have been reported with great success. AREAS COVERED: In this article, the authors provide a comprehensive update on the current state-of-the-art polypharmacology approaches and their applications, focusing on those reports published after our 2017 review article. The authors particularly discuss some novel, groundbreaking concepts, and methods that have been developed recently and applied to drug polypharmacology studies. EXPERT OPINION: Polypharmacology is evolving and novel concepts are being introduced to counter the current challenges in the field. However, major hurdles remain including incompleteness of high-quality experimental data, lack of in vitro and in vivo assays to characterize multi-targeting agents, shortage of robust computational methods, and challenges to identify the best target combinations and design effective multi-targeting agents. Fortunately, numerous national/international efforts including multi-omics and artificial intelligence initiatives as well as most recent collaborations on addressing the COVID-19 pandemic have shown significant promise to propel the field of polypharmacology forward.


title: Luchtwegklachten in tijden van corona./ [Respiratory complaints in the time of COVID-19]

text: The current guidelines for diagnosis and treatment of primary respiratory infections are still useful during the COVID-19 epidemic.Telephone triage of patients with respiratory complaints aims to identify patients with complications or an increased risk of complications.There are no indications to test for SARS-CoV-2 virus in general practice.During this COVID-19 epidemic, protective clothing is recommended in all physical contacts with patients with respiratory complaints.There is no reason to be cautious about using NSAIDs in patients suspected of COVID-19.Amoxicillin is first choice treatment for respiratory infections during the COVID-19 epidemic; there is lack of evidence to support azithromycin as a first choice.Respiratory rate > 24 / min or saturation <92-94% indicate imminent respiratory decompensation and may be reasons for referral.


title: Early Comprehensive Testing for COVID-19 is Essential to Protect Trauma Centers

text: BACKGROUND: The SARS-CoV-2 pandemic presents a threat to healthcare systems worldwide. Trauma centers may be uniquely impacted, given the need for rapid invasive interventions in severely injured and the growing incidence of community infection. We discuss the impact that SARS-CoV-2 has had in our trauma center and our steps to limit the potential exposures. METHODS: We performed a retrospective evaluation of the trauma service, from March 16-30, following the appearance of SARS-CoV-2 in our state. We recorded the daily number of trauma patients diagnosed with SARS-CoV-2 infection, the presence of clinical symptoms or radiological signs of COVID-19, and the results of verbal symptom screen (for new admissions). The number of trauma activations, admissions, and census, as well as staff exposures and infections, was recorded daily. RESULTS: Over the 14-day evaluation period, we tested 85 trauma patients for SARS-CoV-2 infection, and 21 (25%) were found to be positive. Sixty percent of the patients in the trauma/burn ICU were infected with SARS-CoV-2. Positive verbal screen results, presence of ground glass opacities on admission chest CT, and presence of clinical symptoms were not significantly different in patients with or without SARS-CoV-2 infection (p > 0.05). Many infected patients were without clinical symptoms (9/21, 43%) or radiological signs on admission (18/21, 86%) of COVID-19. CONCLUSIONS: 45% of trauma patients are asymptomatic at the time of SARS-CoV-2 diagnosis. Respiratory symptoms as well as verbal screening (recent fevers, shortness of breath, cough, international travel, and close contact with known SARS-CoV-2 carriers) are inaccurate in the trauma population. These findings demonstrate the need for comprehensive rapid testing of all trauma patients upon presentation to the trauma bay. LEVEL OF EVIDENCE: Level III, Diagnostic Tests or Criteria.


title: Artificial intelligence-enabled rapid diagnosis of patients with COVID-19

text: For diagnosis of coronavirus disease 2019 (COVID-19), a SARS-CoV-2 virus-specific reverse transcriptase polymerase chain reaction (RT-PCR) test is routinely used. However, this test can take up to 2 d to complete, serial testing may be required to rule out the possibility of false negative results and there is currently a shortage of RT-PCR test kits, underscoring the urgent need for alternative methods for rapid and accurate diagnosis of patients with COVID-19. Chest computed tomography (CT) is a valuable component in the evaluation of patients with suspected SARS-CoV-2 infection. Nevertheless, CT alone may have limited negative predictive value for ruling out SARS-CoV-2 infection, as some patients may have normal radiological findings at early stages of the disease. In this study, we used artificial intelligence (AI) algorithms to integrate chest CT findings with clinical symptoms, exposure history and laboratory testing to rapidly diagnose patients who are positive for COVID-19. Among a total of 905 patients tested by real-time RT-PCR assay and next-generation sequencing RT-PCR, 419 (46.3%) tested positive for SARS-CoV-2. In a test set of 279 patients, the AI system achieved an area under the curve of 0.92 and had equal sensitivity as compared to a senior thoracic radiologist. The AI system also improved the detection of patients who were positive for COVID-19 via RT-PCR who presented with normal CT scans, correctly identifying 17 of 25 (68%) patients, whereas radiologists classified all of these patients as COVID-19 negative. When CT scans and associated clinical history are available, the proposed AI system can help to rapidly diagnose COVID-19 patients.


Diagnostic testing for SARS-CoV-2


title: Diabetes, Obesity and COVID-19: A Complex Interplay

text: With the accumulation of observational data showing association of metabolic comorbidities with adverse outcomes from COVID-19, there is a need to disentangle the contributions of pre-existing macro- and microvascular disease, obesity and glycaemia. This article outlines the complex mechanistic and clinical interplay between diabetes and COVID-19, the clinical and research questions that arise from these; and the types of studies needed to answer them. The authors are clinicians and academics working in diabetes and obesity medicine, but the article is pitched to an audience of generalists with clinical experience or interest in management of COVID-19. This article is protected by copyright. All rights reserved.


title: Telemedicine and the Interdisciplinary Clinic Model: During the COVID-19 Pandemic and Beyond

text: The emergence of the novel coronavirus disease 2019 (COVID-19) and the subsequent need for physical distancing have necessitated a swift change in health care delivery. Prior to the COVID-19 outbreak, many institutions utilized an interdisciplinary clinic model including both a laryngologist and a speech-language pathologist for the evaluation of patients with voice, swallowing, and upper airway disorders. To improve access, many providers are pursuing the use of interdisciplinary telemedicine to provide individualized patient-centered care while allowing for physical distancing. The purpose of this commentary is to review the current literature regarding telemedicine in laryngology and speech-language pathology as well as the current and future states of practice for interdisciplinary tele-evaluations.


title: Clinical features and dynamics of viral load in imported and non-imported patients with COVID-19

text: OBJECTIVES: To compare the clinical characteristics and the dynamics of viral load between imported and non-imported patients with COVID-19. DESIGN AND METHODS: Data from 51 laboratory-confirmed patients were retrospectively analyzed. RESULTS: The incubation period in the tertiary group was longer than that in the imported and secondary groups (both p < 0.05). Fever was the most common symptom at the onset of illness (73.33%, 58.82%, and 68.42%, respectively), and half of the patients had a low-grade temperature (<38.0 °C) with a short duration of fever (<7 days). CT scans showed that most patients in the three groups had bilateral pneumonia (80.00%, 76.47%, and 73.68%, respectively). Ct values detected in the tertiary patients were similar to those for the imported and secondary groups at the time of admission (both p > 0.05). For the tertiary group, the viral load was undetectable in half of the patients (52.63%) on day 7, and in all patients on day 14. For one third of the patients in the imported and secondary groups, the viral load remained positive on day 14 after the admission. CONCLUSIONS: COVID-19 can present as pneumonia with a low onset of symptoms, and the infectivity of SARS-CoV2 may gradually decrease in tertiary patients.


docid: tybhmypi

title: Practice change amidst the COVID-19 pandemic: Harnessing the momentum for expanding telehealth in transplant


title: Should RT-PCR be considered a gold standard in the diagnosis of Covid-19?

text: In reference to the comments by Dramé M., et al., 2020, that question the possibility of whether the reverse-transcriptase-polymerase-chain-reaction (RT-PCR) for viral load should be considered a gold standard in the diagnosis of Covid-19. They justify this doubt due to its sensitivity, which only reaches 38%, and is certainly no better than luck. However, in the cited publication by Liu K., et al., 2020, Hainan, China, it does not specify RT-PCR sensitivity. This article is protected by copyright. All rights reserved.


title: Genomic analysis and comparative multiple sequences of SARS-CoV2

text: BACKGROUND: China announced an outbreak of new coronavirus in the city of Wuhan on December 31, 2019; lash to now, the virus transmission has become pandemic worldwide. Severe cases from the Huanan Seafood Wholesale market in Wuhan were confirmed pneumonia with a novel coronavirus (2019-nCoV). Understanding the molecular mechanisms of genome selection and packaging is critical for developing antiviral strategies. Thus, we defined the correlation in 10 severe acute respiratory syndrome coronavirus (SARS-CoV2) sequences from different countries to analyze the genomic patterns of disease origin and evolution aiming for developing new control pandemic processes. METHODS: We apply genomic analysis to observe SARS-CoV2 sequences from GenBank (http://www.ncbi.nim.nih.gov/genebank/): MN 908947 (China, C1), MN985325 (USA: WA, UW), MN996527 (China, C2), MT007544 (Australia: Victoria, A1), MT027064 (USA: CA, UC), MT039890 (South Korea, K1), MT066175 (Taiwan, T1), MT066176 (Taiwan, T2), LC528232 (Japan, J1), and LC528233 (Japan, J2) for genomic sequence alignment analysis. Multiple Sequence Alignment by Clustalw (https://www.genome.jp/tools-bin/clustalw) web service is applied as our alignment tool. RESULTS: We analyzed 10 sequences from the National Center for Biotechnology Information (NCBI) database by genome alignment and found no difference in amino acid sequences within M and N proteins. There are two amino acid variances in the spike (S) protein region. One mutation found from the South Korea sequence is verified. Two possible "L" and "S" SNPs found in ORF1ab and ORF8 regions are detected. CONCLUSION: We performed genomic analysis and comparative multiple sequences of SARS-CoV2. Studies about the biological symptoms of SARS-CoV2 in clinic animals and humans will manipulate an understanding on the origin of pandemic crisis.


Covid-19: Racism may be linked to ethnic minorities' raised death risk, says PHE


The performance and professionalism of nurses in the fight against the new outbreak of COVID-19 epidemic is laudable


COVID-19 and Racial/Ethnic Disparities


title: A Sequence Homology and Bioinformatic Approach Can Predict Candidate Targets for Immune Responses to SARS-CoV-2

text: Effective countermeasures against the recent emergence and rapid expansion of the 2019 novel coronavirus (SARS-CoV-2) require the development of data and tools to understand and monitor its spread and immune responses to it. However, little information is available about the targets of immune responses to SARS-CoV-2. We used the Immune Epitope Database and Analysis Resource (IEDB) to catalog available data related to other coronaviruses. This includes SARS-CoV, which has high sequence similarity to SARS-CoV-2 and is the best-characterized coronavirus in terms of epitope responses. We identified multiple specific regions in SARS-CoV-2 that have high homology to the SARS-CoV virus. Parallel bioinformatic predictions identified a priori potential B and T cell epitopes for SARS-CoV-2. The independent identification of the same regions using two approaches reflects the high probability that these regions are promising targets for immune recognition of SARS-CoV-2. These predictions can facilitate effective vaccine design against this virus of high priority.


title: [Anesthesia management in cesarean section for patient with COVID-19: a case report]

text: Since the coronavirus disease 2019 (COVID-19) affects the cardio-pulmonary function of pregnant women, the anesthetic management and protection of medical staff in the cesarean section is significantly different from that in ordinary surgical operation. This paper reports a case of cesarean section for a woman with COVID-19, which was successfully performed in the First Affiliated Hospital of Zhejiang University School of Medicine on February 8, 2020. Anesthetic management, protection of medical staff and psychological intervention for the pregnant woman during the operation were discussed. Importance has been attached to the preoperative evaluation of pregnant women with COVID-19 and the implementation of anesthesia plan. For moderate patients, intraspinal anesthesia is preferred in cesarean section, and try to reduce its influence in respiration and circulation in both maternal and infant; general anesthesia with endotracheal intubation should be adopted for severe or critically ill patients. Ensure the safety of medical environment, and anesthetists should carry out level-â ¢ standard protection. Special attention and support should be paid to maternal psychology: fully explanation before operation to reduce anxiety; relieve the discomfort during operation, so as to reduce tension; avoid the bad mood due to pain after operation.


Coronavirus Disease 2019 (COVID-19) and healthcare-associated infections: Emerging and future challenges for public health in Brazil


title: COVID-19's Impact on Italian Urology

text: The COVID-19 pandemic has impacted our lives, our habits and our healthcare system. Italy is one of the countries affected first and more aggressively from the outbreak. Our rapidity has been guide for other healthcare systems from around the World. We describe the impact of COVID-19 on Urology, how the Urological scientific community responded to the emergency and our experience in a high-volume Roman University hospital. The aim of our work is to share our experience providing suggestions for other global hospitals on how to manage the COVID-19 emergency.


title: Predictive Analysis of COVID-19 Time-series Data from Johns Hopkins University

text: We provide a predictive analysis of the spread of COVID-19, also known as SARS-CoV-2, using the dataset made publicly available online by the Johns Hopkins University. Our main objective is to provide predictions of the number of infected people for different countries in the next 14 days. The predictive analysis is done using time-series data transformed on a logarithmic scale. We use two well-known methods for prediction: polynomial regression and neural network. As the number of training data for each country is limited, we use a single-layer neural network called the extreme learning machine (ELM) to avoid over-fitting. Due to the non-stationary nature of the time-series, a sliding window approach is used to provide a more accurate prediction.


title: CT characteristics of patients infected with 2019 novel coronavirus: association with clinical type

text: AIM: To summarise the features of chest computed tomography (CT) of a series of patients infected with 2019 novel coronavirus (2019-nCov) to speed up recognition and have a better understanding of COVID-19 disease. MATERIALS AND METHODS: The clinical information and chest CT images of 93 patients infected with 2019-nCov from multiple centres were reviewed. RESULTS: Of the 93 cases, abnormalities in 91 cases were located at the subpleural level, presenting with ground-glass opacity (GGO; n=69, 74.2%) and consolidation (n=56, 60.2%) in multiple lobes. Other CT features included vascular dilatation (n=83, 89.2%), interlobular septal thickening (n=29, 31.2%), bronchodilatation (n=44, 47.3%), the crazy-paving sign (n=34, 36.6%), the sieve-hole sign (n=12, 12.9%), pleural thickening (n=21, 22.6%), and pleural effusion (n=8, 8.6%). Multiple lobe involvement, including the presence of consolidation, the crazy-paving sign, interlobular septal thickening, pleural thickening and pleural effusion, was more common in critical patients with heavy/critical infection (p<0.05), whereas the presence of GGO, involvement of one or two lobes, and the halo sign were more common in patients with mild/common-type infections (p<0.05). Moreover, older age, higher body temperature, complaints of chest tightness and breathlessness, and lymphopenia was associated with heavy/critical infections. CONCLUSION: The CT and clinical appearances of COVID-19 are variable and reflect the severity of COVID-19 to some extent.


COVID-19, End-Stage Heart Failure and Outcome: A Word of Caution in Determining the Causal Link


Protracted ketonaemia in hyperglycaemic emergencies in COVID-19: a retrospective case series


A brewing storm: The neuropsychological sequelae of hyperinflammation due to COVID-19


title: Is nicotine exposure linked to cardiopulmonary vulnerability to COVID-19 in the general population?

text: The recent emergence of COVID-19 has resulted in a worldwide crisis, with large populations locked down and transportation links severed. While approximately 80% of infected individuals have minimal symptoms, around 15-20% need to be hospitalized, greatly stressing global healthcare systems. As of March 10, the death rate appears to be about 3.4%, although this number is highly stratified among different populations. Here, we focus on those individuals who have been exposed to nicotine prior to their exposure to the virus. We predict that these individuals are 'primed' to be at higher risk because nicotine can directly impact the putative receptor for the virus (ACE2) and lead to deleterious signaling in lung epithelial cells.


title: Thioredoxin System Protein Expression Is Associated with Poor Clinical Outcome in Adult and Paediatric Gliomas and Medulloblastomas

text: The thioredoxin (Trx) system is an important enzyme family that regulates cellular redox homeostasis. Protein expression of Trx system family members has been assessed in various cancers and linked to various clinicopathological variables, disease progression, treatment response and survival outcomes but information is lacking in brain tumours. Expression of the system was therefore examined, by immunohistochemistry in different brain tumour types, adult and paediatric cases, to determine if expression was of importance to clinical outcome. Trx system proteins were expressed, to variable levels, across all brain tumour types with significant variations in expression between different tumour types/grades/regions. High Trx reductase (TrxR) expression was linked to worse prognosis across all cohorts. High cytoplasmic TrxR expression was significantly associated with adverse overall survival (OS) in adult glioblastoma (P = 0.027) and paediatric low-grade glioma (LGG) patients (P = 0.012). High expression of nuclear TrxR, cytoplasmic and nuclear Trx and Trx-interacting protein (TxNIP) was associated with improved OS in paediatric LGGs (P = 0.031, P < 0.001, P = 0.044 and P = 0.018, respectively). For patients with high-grade gliomas, both high cytoplasmic TrxR and Trx expression were associated with poor OS (P = 0.002 and P = 0.007, respectively). In medulloblastoma, high expression of cytoplasmic TrxR and Trx and nuclear Trx was associated with worse prognosis (P = 0.013, P = 0.033 and P = 0.007, respectively); with cytoplasmic TrxR and nuclear Trx remaining so in multivariate analysis (P = 0.009 and P = 0.013, respectively). The consistent finding that high levels of cytoplasmic TrxR are associated with a worse prognosis across all cohorts suggests that TrxR is an important therapeutic target in brain cancers.


title: On airborne transmission and control of SARS-Cov-2

text: The COVID-19 pandemic is creating a havoc situation across the globe that modern society has ever seen. Despite of their paramount importance, the transmission routes of SARS-Cov-2 still remain debated among various sectors. Evidences compiled here strongly suggest that the COVID-19 could be transmitted via air in inadequately ventilated environments. Existing experimental data showed that coronavirus survival was negatively impacted by ozone, high temperature and low humidity. Here, regression analysis showed that the spread of SARS-Cov-2 was reduced by increasing ambient ozone concentration level from 48.83 to 94.67 µg/m3 (p-value = 0.039) and decreasing relative humidity from 23.33 to 82.67% (p-value = 0.002) and temperature from -13.17 to 19 °C) (p-value = 0.003) observed for Chinese cities during Jan-March 2020. Besides using these environmental implications, social distancing and wearing a mask are strongly encouraged to maximize the fight against the COVID-19 airborne transmission. At no other time than now are the scientists in various disciplines around the world badly needed by the society to collectively confront this disastrous pandemic.


Faced with 2019-nCoV outbreak, we have learned our lessons from SARS of 2003


Correlation between viral RNA shedding and serum antibodies in individuals with coronavirus disease 2019


title: COVID-19: lessons for junior doctors redeployed to critical care

text: Approximately 4% of patients with coronavirus disease 2019 (COVID-19) will require admission to an intensive care unit (ICU). Governments have cancelled elective procedures, ordered new ventilators and built new hospitals to meet this unprecedented challenge. However, intensive care ultimately relies on human resources. To enhance surge capacity, many junior doctors have been redeployed to ICU despite a relative lack of training and experience. The COVID-19 pandemic poses additional challenges to new ICU recruits, from the practicalities of using personal protective equipment to higher risks of burnout and moral injury. In this article, we describe lessons for junior doctors responsible for managing patients who are critically ill with COVID-19 based on our experiences at an urban teaching hospital.


COVID-19 vaccines for all?


title: Enfermería ante el COVID-19, un punto clave para la prevención, control y mitigación de la pandemia

text: The SARS-CoV-2 or COVID-19 outbreak originated in China has reached Mexico However, the scientific community, including nursing, has generated vertiginous evidence that can help make decisions in the care of the affected population The purpose of this study is to describe the nursing experience before COVID-19 as a key point for the prevention, control and mitigation of the pandemic Based on the recommendations issued by the Ministry of Health, the clinical evidence and the resources available in the health institutions, the disease prevention measures have been initiated and maintained both in the community and in the health institutions The reconversion of hospitals and care protocols adapted to our context are trying to strengthen the control and mitigation of the disease


Vascular Changes Detected With Thoracic CT in Coronavirus Disease (COVID-19) Might Be Significant Determinants for Accurate Diagnosis and Optimal Patient Management


Advancing scientific knowledge in times of pandemics


title: Social Capital in the Response to COVID-19

text: Social capital provides a number of benefits during crisis scenarios, and high social capital communities respond more efficaciously than those with low social capital. With this in mind, we argue that the response to and recovery from the COVID-19 pandemic may be hampered in many American communities by deficiencies or disruptions in social capital brought about by physical distancing. Drawing on evidence from past crises, we recommend individuals, communities, and government institutions work to strengthen and expand social networks. A failure to do so will exact a toll in terms of human morbidity and mortality and exacerbate the current disaster.


title: Fibrinolysis and COVID-19: a plasmin paradox

text: The COVID-19 pandemic has provided many challenges in the field of thrombosis and haemostasis. Among these is a novel form of coagulopathy that includes exceptionally high levels of D-dimer. D-dimer is a marker of poor prognosis, but does this also imply a causal relationship? These spectacularly raised D-dimer levels may actually signify the failing attempt of the fibrinolytic system to remove fibrin and necrotic tissue from the lung parenchyma, being consumed or overwhelmed in the process. Indeed, recent studies suggest that increasing fibrinolytic activity might offer hope for patients with critical disease and severe respiratory failure. However, the fibrinolytic system can also be harnessed by coronavirus to promote infectivity and where anti-fibrinolytic measures would also seem appropriate. Hence, there is a clinical paradox where plasmin formation can be either deleterious or beneficial in COVID-19, but not at the same time. Hence, it all comes down to timing.


The Impact of the COVID-19 Pandemic on Parkinson's Disease: Hidden Sorrows and Emerging Opportunities


title: Elevated Troponin in Patients With Coronavirus Disease 2019: Possible Mechanisms

text: Coronavirus disease 2019 (COVID-19) is a pandemic that has affected more than 1.8 million people worldwide, overwhelmed health care systems owing to the high proportion of critical presentations, and resulted in more than 100,000 deaths. Since the first data analyses in China, elevated cardiac troponin has been noted in a substantial proportion of patients, implicating myocardial injury as a possible pathogenic mechanism contributing to severe illness and mortality. Accordingly, high troponin levels are associated with increased mortality in patients with COVID-19. This brief review explores the available evidence regarding the association between COVID-19 and myocardial injury.


title: Phytochemistry and antibacterial activity of aqueous andhydroalcoholic extracts of three medicinal plants against foodpathogens/ Fitoquímica e atividade antibacteriana de extratos aquosos e hidroalcoólicos de trêsplantas medicinais contra patógenos de alimentos

text: This study aimed to characterize the phytochemical compositions of three medicinal Brazilian plants leaves and bast extracts, and to determine their antibacterial activity on three foodborne and waterborne bacterial pathogens. Parkia platycephala, Pouteria ramiflora and Lophanthera lactescens leaves and basts were collected and aqueous and hydroalcoholic extracts were prepared. Qualitative screening of the phytochemical extracts was performed with three replicates and in triplicate in order to identify the bioactive compounds. The Minimal Inhibitory Concentration and Minimal Bactericide Concentration were determined by microdilution in broth and Escherichia coli, Salmonella typhimurium and Staphylococcus aureus growth was observed on agar plates. Phytochemical composition analysis allowed for the identification of anthraquinones, catechins, saponins, tannins, sesquiterpenlactones and other lactones in the three plants leaves and bast aqueous and hydroalcoholic extracts. Eighty-three percent of the plant extracts showed antibacterial activity against S. aureus, and P. platycephala extracts were the only ones that inhibited E. coli and S. typhimurium growth. The present study contributes significantly to the phytochemical composition characterization of three plant species commonly used in Brazilian traditional medicine. The plant extracts in vitro antibacterial activity was demonstrated and catechins present in the extracts are, most likely, the bioactive compounds responsible for this action.(AU)


Infecciones emergentes, el gran reto de la salud global: Covid-19./ [Emerging infections, the great challenge of global health: Covid-19]


title: Use of pioglitazone in people with type 2 diabetes mellitus with coronavirus disease 2019 (COVID-19): Boon or bane?

text: BACKGROUND AND AIMS: People with type 2 diabetes mellitus (T2DM) have increased morbidity and mortality due to coronavirus disease-19(COVID-19). It has been speculated that use of pioglitazone might increase such risk. The aim of our brief commentary is to review the safety of pioglitazone in people with T2DM and mild/moderate COVID-19. METHODS: We searched PubMed database using specific keywords related to our aims till May 15, 2020. Full text of relevant articles published in English language were retrieved and reviewed. RESULTS: Medications, including pioglitazone, that upregulate tissue expression of angiotensin converting enzyme 2 (ACE2), might have a dual role in COVID-19; on the one hand they might increase risk of infection as SARS-CoV2 uses ACE2 as a coreceptor to enter alveolar cells, but on the other hand, by reducing angiotensin II levels, they can protect against acute lung injury. There is no evidence to date that pioglitazone upregulates ACE2 in the alveolar cells; rather, there is evidence from animal studies of upregulation of ACE2 in insulin sensitive tissues, which might have a protective effect on lung injury. Moreover by moderating the exaggerated host proinflammatory response, pioglitazone can potentially reduce SARS-CoV-2 driven hyperinflammation. CONCLUSIONS: Pioglitazone has more potential for benefit than harm, and can be continued in people with T2DM and mild/moderate COVID-19, unless there are specific contraindications for its use. There is an urgent need to assess clinically relevant outcomes in people with diabetes and COVID-19 based upon baseline antidiabetes therapy, in particular pioglitazone.


docid: aiidoegy

title: Factors associated with COVID-19 outbreak-related suicides in India


Fighting the Coronavirus Outbreak


The COVID-19 pandemonium pandemic


title: Association of diabetes and hypertension with disease severity in covid-19 patients: a systematic literature review and exploratory meta-analysis

text: AIM: The novel coronavirus infection (COVID-19), now a worldwide public health concern is associated with varied fatality. Patients with chronic underlying conditions like diabetes and hypertension have shown worst outcomes. The understanding of the association might be helpful in early vigilant monitoring and better management of COVID-19 patients at high risk. The aim of the meta-analysis was to assess the association of diabetes and hypertension with severity of disease. METHODS: A literature search was conducted using the databases PubMed and Cochrane until March 31, 2020. Seven studies were included in the meta- analysis, including 2018 CIVID-19 patients. RESULTS: Diabetes was lower in the survivors (OR: 0.56; 95%CI: 0.35-0.90; p=0.017; I2: 0.0%) and non-severe (OR: 1.66; 95%CI: 1.20-2.30; p=0.002; I2: 0.0%) patients. No association of diabetes was found with ICU care. Hypertension was positively associated with death (OR: 0.49; 95%CI: 0.34-0.73; p=0.000; I2: 0.0%), ICU care (OR: 0.42; 95%CI: 0.22-0.81; p=0.009; I2: 0.0%) and severity (OR: 2.69; 95%CI: 1.27-5.73; p=0.01; I2: 52.4%). CONCLUSIONS: Our findings suggest that diabetes and hypertension have a negative effect on health status of COVID-19 patients. However, large prevalence studies demonstrating the consequences of comorbid diabetes and hypertension are urgently needed to understand the magnitude of these vexatious comorbidities.


title: Endocrine vigilance in COVID-19

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus responsible for a pandemic that emerged in December 2019. Heterogeneous clinical forms are described from asymptomatic to severe hypoxaemic acute respiratory syndrome with multisystem organ failure. The impact of this coronavirus disease 2019 on the endocrine glands remains unknown. However, the results of previous studies on viruses from the same family allow us to write proposals for patients followed for chronic endocrine diseases. Currently, if these subjects are infected with SARS-CoV-2, they must not stop their treatment. In some cases, hormone replacement doses have to be increased. In case of worsening clinical signs, hormonal biological monitoring must be done. This article will be helpful for improving the management of chronic endocrine diseases that could affect thyroid, adrenals, gonads and pituitary gland functions. Proposals could be applied in COVID-19 infected subjects or in those who have been in contact with COVID-19 infected people.


Age matters for cardiac arrests? No meaningful interpretation of results is possible without understanding context


docid: gevqlael

title: Use of a novel adhesive suture retention wound closure device to prevent patient follow-up visits during COVID-19 pandemic


docid: swcmtbtu

title: COVID-19: A New Virus, but a Familiar Receptor and Cytokine Release Syndrome

text: Zhou et al. (Nature) and Hoffmann et al. (Cell) identify ACE2 as a SARS-CoV-2 receptor, and the latter show its entry mechanism depends on cellular serine protease TMPRSS2. These results may explain proinflammatory cytokine release via the associated angiotestin II pathway and a possible therapeutic target via the IL-6-STAT3 axis.


title: Intravenous Thrombolysis for Stroke in a COVID-19 Positive Filipino Patient, a Case Report

text: The 2019 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which was first reported in Wuhan, China last December 2019, has been declared an emergency by the World Health Organization but eventually progressed to become a Pandemic. To date, Coronavirus Disease 2019 (COVID-19) has affected at least 100,000 individuals worldwide, reaching thousands of mortalities (Zhou et al., 2020; World Health Organization, 2020). In the Philippines, the number of COVID-19 confirmed positive cases is over 636 and is expected to rise (Department of Health, 2020). Respiratory infections alongside their comorbidities can induce acute myocardial infarction and acute ischemic stroke (Warren-Gash et al., 2018) [3]. These may further bring challenges in the management and administration of Intravenous (IV) Alteplase in eligible patients. Currently, there are no case reports in the administration IV Altepase in ischemic stroke patients who are COVID-19 positive. We present a case of a 62-year old female who was admitted due to cough, colds and shortness of breath of 2 weeks duration and was tested to be COVD-19 positive. She suffered from an ischemic stroke while in the Medical Intensive Care Unit and was given Intravenous thrombolysis.


The importance of COVID-19 screening and testing in the obstetric patient population


title: Recommendations of protective measures for orthopedic surgeons during COVID-19 pandemic

text: PURPOSE: It was the primary purpose of the present systematic review to identify the optimal protection measures during COVID-19 pandemic and provide guidance of protective measures for orthopedic surgeons. The secondary purpose was to report the protection experience of an orthopedic trauma center in Wuhan, China during the pandemic. METHODS: A systematic search of the PubMed, Cochrane, Web of Science, Google Scholar was performed for studies about COVID-19, fracture, trauma, orthopedic, healthcare workers, protection, telemedicine. The appropriate protective measures for orthopedic surgeons and patients were reviewed (on-site first aid, emergency room, operating room, isolation wards, general ward, etc.) during the entire diagnosis and treatment process of traumatic patients. RESULTS: Eighteen studies were included, and most studies (13/18) emphasized that orthopedic surgeons should pay attention to prevent cross-infection. Only four studies have reported in detail how orthopedic surgeons should be protected during surgery in the operating room. No detailed studies on multidisciplinary cooperation, strict protection, protection training, indications of emergency surgery, first aid on-site and protection in orthopedic wards were found. CONCLUSION: Strict protection at every step in the patient pathway is important to reduce the risk of cross-infection. Lessons learnt from our experience provide some recommendations of protective measures during the entire diagnosis and treatment process of traumatic patients and help others to manage orthopedic patients with COVID-19, to reduce the risk of cross-infection between patients and to protect healthcare workers during work. LEVEL OF EVIDENCE: IV.


title: Continuous Learning and Inference of Individual Probability of SARS-CoV-2 Infection Based on Interaction Data

text: This study presents a new approach to determine the likelihood of asymptomatic carriers of the SARS-CoV-2 virus by using interaction-based continuous learning and inference of individual probability (CLIIP) for contagious ranking. This approach is developed based on an individual directed graph (IDG), using multi-layer bidirectional path tracking and inference searching. The IDG is determined by the appearance timeline and spatial data that can adapt over time. Additionally, the approach takes into consideration the incubation period and several features that can represent real-world circumstances, such as the number of asymptomatic carriers present. After each update of confirmed cases, the model collects the interaction features and infers the individual person's probability of getting infected using the status of the surrounding people. The CLIIP approach is validated using the individualized bidirectional SEIR model to simulate the contagion process. Compared to traditional contact tracing methods, our approach significantly reduces the screening and quarantine required to search for the potential asymptomatic virus carriers by as much as 94%.


title: Manifestaciones hepáticas y repercusión en el paciente cirrótico de COVID-19./ Manifestaciones hepáticas y repercusión en el paciente cirrótico de COVID-19./ Hepatic manifestations and impact of COVID-19 on the cirrhotic patient

text: The novel SARS-CoV-2 coronavirus is responsible for the infectious disease caused by coronavirus 19 (COVID-19). The current pandemic is growing worldwide and could affect 50-60% of the world population in the months to come. The most severe disease manifestations are atypical pneumonia and sepsis, but the gastrointestinal tract, particularly the liver, has recently been reported to be affected by SARS-CoV-2. Therefore, the aim of the present work was to review the literature available on the topic and provide information about COVID-19, in both healthy and diseased livers, and issue recommendations. The incidence of liver injury specifically associated with COVID-19 varies from 14.8-53%. The majority of case series have reported altered ALT and AST, elevated total bilirubin, and low serum albumin and liver compromise has been associated with the most severe cases of COVID-19. Cirrhosis of the liver has a recognized immune dysfunction status that includes immunodeficiency and systemic inflammation, making it reasonable for those patients to be more susceptible to SARS-CoV-2 infection. The recommendations for those patients, in addition to the general measures of physical distancing and handwashing for all persons, include social, medical, and psychologic support during the period of home quarantine to prevent lapses in treatment. Patients should be made aware that they need to keep abreast of changes in recommendations and social policies.


Postpartum exacerbation of antenatal COVID-19 pneumonia in 3 women