title: Comparative study of four SARS-CoV-2 Nucleic Acid Amplification Test (NAAT) platforms demonstrates that ID NOW performance is impaired substantially by patient and specimen type

text: The advent of the COVID-19 pandemic in the United States created a unique situation where multiple molecular diagnostic assays with various indications for use in the detection of SARS-CoV-2 rapidly received Emergency Use Authorization by the FDA, were validated by laboratories and utilized clinically, all within a period of a few weeks. We compared the performance of four of these assays that were being evaluated for use at our institution: Abbott RealTime m2000 SARS-CoV-2 Assay, DiaSorin Simplexa COVID-19 Direct, Cepheid Xpert Xpress SARS-CoV-2 and Abbott ID NOW COVID-19. Nasopharyngeal and nasal specimens were collected from 88 ED and hospital-admitted patients and tested by the four methods in parallel to compare performance. ID NOW performance stood out as significantly worse than the other three assays despite demonstrating comparable analytic sensitivity. Further study determined that the use of a foam nasal swab compared to a nylon flocked nasopharyngeal swab, as well as use in a population chronically vs. acutely positive for SARS-CoV-2, were significant factors in the poor comparable performance.


title: Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting

text: Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has presented health-care systems worldwide with novel challenges and experiences and evidence is emerging during the pandemic. Patients requiring hospitalization frequently suffer from respiratory failure of different severities. Aim: The aim of this guideline is the treatment of patients with SARS CoV-2 (COVID-19) in hospital; in particular, it addresses the treatment of respiratory failure treated in general Internal Medical- and Pulmonary Medical wards. Results: Elderly patients and patients with chronic disease are particularly vulnerable to COVID-19. Target oxygen saturation should be between 92% and 96% in patients without chronic lung diseases. Treatment with >5 L oxygen/min should be in close collaboration with intensive care colleagues and >15 l/min preferably in intensive care units. High-flow nasal canula (HFNC) and long-term Continuous Positive Airway Pressure (CPAP) are recommended for patients not responding to conventional oxygen therapy. Non-invasive ventilation (NIV) is only recommended for selected patients, such as those with a ceiling of treatment or patients presenting with hypercapnic failure. With the use of humidification protective equipment as FFP2-3 masks should be used. Nebulized medication should be avoided, and spacers should be used instead. Conclusion: Respiratory failure is frequently the cause of hospitalization in patients with COVID-19 and should be monitored closely.


title: ACE2-expressing endothelial cells in aging mouse brain

text: Angiotensin-converting enzyme 2 (ACE2) is a key receptor mediating the entry of SARS-CoV-2 into the host cell. Through a systematic analysis of publicly available mouse brain sc/snRNA-seq data, we found that ACE2 is specifically expressed in small sub-populations of endothelial cells and mural cells, namely pericytes and vascular smooth muscle cells. Further, functional changes in viral mRNA transcription and replication, and impaired blood-brain barrier regulation were most prominently implicated in the aged, ACE2-expressing endothelial cells, when compared to the young adult mouse brains. Concordant EC transcriptomic changes were further found in normal aged human brains. Overall, this work reveals an outline of ACE2 distribution in the mouse brain and identify putative brain host cells that may underlie the selective susceptibility of the aging brain to viral infection.


title: Erratum: Multisite Inhibitors for Enteric Coronavirus: Antiviral Cationic Carbon Dots Based on Curcumin (ACS Applied Nano Materials (2018) 1: 10 (5451−5459) DOI: 10.1021/acsanm.8b00779)

text: Metrics & More. Article Recommendations Page 5457. Two images of the lane in the "&veta;-actin" group (Figures 10d and S9) were chosen by mistake when submitting pictures. To verify the accuracy of the experimental results, we repeated these experiments, and the revised Figures 10d and S9 support the results reported in the original paper. This change does not affect the conclusion of this paper. The authors apologize for any inconvenience that this may have caused. (Figure Presented). The revised Figure S9 is as follows: (Figure Presented).


title: Anxiety, worry and perceived stress in the world due to the COVID-19 pandemic, March 2020. Preliminary results.

text: Introduction: Since the beginning of the outbreak in China, ending 2019, the Novel Coronavirus (COVID-19) has spread subsequently to the rest of the world causing an on-going pandemic. The World Health Organisation (WHO) declared COVID-19: a public health emergency of international concern. Having into consideration the lockdown and quarantine situation, we decided to do evaluate the current emotional state on the general population with a web-based survey in English and in Spanish, which was considered a useful and fast method that could help us determine how people perceived stress and worry due to the COVID-19. Methods: The survey included a 22 items, gathering information in 3 sections: Sociodemographic data, the Perceived Stress Scale (PSS-10) by Cohen and additional queries that assessed the current worry and change of behaviours due to this pandemic. Results: The survey received 891 respondents from 25 countries, from March 17 to 23rd, 2020. The mean age of the respondents was 43.8 (14.2) years old, and more than two thirds were women. 12.8% were health personnel.The mean of the PSS-10 score was 17.4 (6.4). Significantly higher scores were observed among women, youth, students, and among those who expressed concern and those who perceived increased susceptibility to the COVID-19. In contrast, no significant differences were observed between the health professionals and the general population. A good correlation was observed between mean relative volume (RSV) of the las 14 days and the number of cases reported (rho = 0.68, p <0.001) and deaths (rho = 0.51, p <0.001). Discussion: With these results we describe an increase of affective symptoms due to the COVID-19. This pandemic is raising the anxiety levels. The findings of our study show the affective and cognitive alterations people are going through. This survey is the first attempt to measure the psychological consequences this pandemic is having, in order to be able to later be able to provide the support to confront this global issue, addressing the mental health care that will be needed.


title: Analyzing the impact of SARS CoV-2 on the human proteome

text: The COVID-19 respiratory disease is caused by the novel coronavirus SARS-CoV-2, which uses the enzyme ACE2 to entry human cells. This disease is characterized by important damages at multi-organ level, partially due to the abundant expression of ACE2 in practically all human tissues. However, not every organ in which ACE2 is abundant is affected by SARS CoV-2, which suggests the existence of other multi-organ routes for transmitting the perturbations produced by the virus. We consider here diffusive processes through the protein-protein interaction (PPI) network of proteins targeted by SARS CoV-2 as such alternative route. We found a subdiffusive regime that allows the propagation of virus perturbations through the PPI network at a significant rate. By following the main subdiffusive routes across the PPI network we identify proteins mainly expressed in the heart, cerebral cortex, thymus, testis, lymph node, kidney, among others of the organs reported to be affected by COVID-19.


title: Mögliche Therapiestrategien bei Covid-19-Erkrankungen mit chinesischen Arzneimitteln

text: In view of the severe corona virus pandemic and the not yet foreseeable availability of causal therapy approaches (vaccination, antiviral drugs), it is of great importance to know what Chinese medicine can contribute to the treatment of Covid 19. According to a WHO report published in 2004, concerning the 2003 SARS epidemic caused by SARS-CoV-1, Chinese medicine was used in China both preventively and therapeutically in addition to Western medicine. In both these preventive and curative roles, treatment proved to be significantly effective. During the current outbreak of SARS-CoV-2, about 60,000 Covid 19 patients were treated with Chinese medicine in the Wuhan region alone by the end of February 2020. The first part of this paper provides a summarizing overview of a number of sources with treatment recommendations and experiences of different clinics, working groups and official bodies. In the second part - based on currently known information — the author voices his own considerations on pathophysiology and important therapeutic principles. Finally, he presents preliminary treatment proposals using Chinese medicinal remedies for what appear to be the central pattern of the disorder - a blockage of pulmonary qi and the transformation of fluids in the context of an accumulation of dampness /humor with toxicity and, in severe cases, development into pneumonia.


title: Belief in Conspiracy Theory about COVID-19 Predicts Mental Health and Well-being -- A Study of Healthcare Staff in Ecuador

text: Abstract Objective: We aim to provide the first evidence of belief in conspiracy theory regarding the COVID-19 virus as a predictor of the mental health and well-being of healthcare workers. Methods: We conducted a survey of 252 healthcare workers in Ecuador from April 10 to May 2, 2020. Results: In Ecuador, 32.54% of the sampled healthcare workers experienced distress disorder, and 28.17% had anxiety disorder. Compared to healthcare workers who were not sure where the virus originated, those who believed the virus was developed intentionally in a lab reported higher levels of distress and anxiety, and lower levels of job satisfaction and life satisfaction. Older healthcare workers and those who exercise more reported higher job satisfaction. Married healthcare workers, those who exercise more, and those not infected reported higher life satisfaction. Conclusion: This paper identifies belief in a COVID-19 conspiracy theory as an important predictor of distress, anxiety, and job and life satisfaction of healthcare workers. It enables mental health services to better target and help mentally vulnerable healthcare workers during the ongoing COVID-19 pandemic.


Does the Clinical Spectrum of Coronavirus Disease 2019 (COVID-19) Show Regional Differences?


title: PERSONAL PROTECTIVE EQUIPMENT (PPE) USING IN ANTALYA 112 EMERGENCY AMBULANCE SERVICES DURING OUTBREAK

text: A new type of Coronavirus (SARS CoV2) which was identified on January 7th, 2020; which caused disease named COVID 19 caused by this virus. The first confirmed COVID 19 (+) case in Turkey was detected on March 11th, 2020. The first COVID-19 case in Antalya was detected on March 14th, 2020 and transferred by an Antalya 112 emergency ambulance to hospital. The aim of this descriptive, retrospective and cross-sectional study which is conducted between the dates of March 14th, 2020 and May 31st, 2020, is to evaluate the level of Personal Protective Equipment (PPE) usage, the risk analysis results and follow up measures of Antalya 112 ambulance teams during COVID-19 outbreak. There were 5344 possible and 787 confirmed COVID-19 (+) positive ambulance cases between the dates of study conducted. The majority of these cases were male (62%) and over the age of 65 (47%). The majority of cases were result in transferred to healthcare facilities (75.48%). The total 2361 ambulance team workers were taken to risk analysis measurements and then followed-up procedures. The majority of ambulance team members were assessed with no risk available. The Level 4 PPE (N95/FPP, Goggle/face protection, Gloves, Apron/coverall) were used most commonly (84.50%). The HCWs who use Level-4 PPE for confirmed COVID-19 (+) cases, were assessed no risk exposed. The using mask on patient and the level of PPE usage showed negative correlation with risk level of HCWs. There are only 2 HCWs diagnosed with COVID 19 by CT scan. The follow up procedures of two HCWs has been finalized, and both of them cured, follow ups ended. The studies about easy use, hightech PPE with maximum protection, are recommended for further investigations. Keywords: COVID 19, Ambulance Services, Personal Protective Equipment


title: Clinical characterization and chest CT findings in laboratory-confirmed COVID-19: a systematic review and meta-analysis

text: Background: Imagery techniques have been used as essential parts of diagnostic workup for patients suspected for 2019-nCoV infection, Multiple studies have reported the features of chest computed tomography (CT) scans among a number of 2019-nCoV patients. Method: Study Identification was carried out in databases (PubMed, Embase and Cochrane Library) to identify published studies examining the diagnosis, the 2019 novel coronavirus (2019-nCoV). Heterogeneity among reported prevalence was assessed by computing p-values of Cochrane Q-test and I2-statics. The pooled prevalence of treatment failure was carried out with a fixed effects meta-analysis model, generating the pooled 95% confidence interval. A random-effect model was used to pool the results since this model could incorporate the heterogeneity of the studies and therefore proved a more generalized result. Results: According to the combined results of meta-analysis, the total 55% of corona patients were males. The mean age of the patients was 41.31 (34.14, 48.47). Two prevalent clinical symptoms between patients were fever, cough with prevalence of 85%, and 62%, respectively. Either Ground Glass Opacity GGO or consolidation was seen in 86% but 14% had NO GGO or consolidation. The other rare CT symptoms were pericardial effusion, and pleural effusion with 4, 5, 7% prevalence, respectively. The most prevalent event was Either GGO or consolidation in 85% of patients. Conclusion: The most CT-scan abnormality is Either Ground Glass Opacity GGO or consolidation however in few patients none of them might be observed, so trusting in just CT findings will lead to miss some patients.


title: D936Y and Other Mutations in the Fusion Core of the SARS-Cov-2 Spike Protein Heptad Repeat 1 Undermine the Post-Fusion Assembly

text: The iconic “red crown” of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is made of its spike (S) glycoprotein. The S protein is the Trojan horse of coronaviruses, mediating their entry into the host cells. While SARS-CoV-2 was becoming a global threat, scientists have been accumulating data on the virus at an impressive pace, both in terms of genomic sequences and of three-dimensional structures. On April 21st, the GISAID resource had collected 10,823 SARS-CoV-2 genomic sequences. We extracted from them all the complete S protein sequences and identified point mutations thereof. Six mutations were located on a 14-residue segment (929-943) in the “fusion core” of the heptad repeat 1 (HR1). Our modeling in the pre- and post-fusion S protein conformations revealed, for three of them, the loss of interactions stabilizing the post-fusion assembly. On May 29th, the SARS-CoV-2 genomic sequences in GISAID were 34,805. An analysis of the occurrences of the HR1 mutations in this updated dataset revealed a significant increase for the S929I and S939F mutations and a dramatic increase for the D936Y mutation, which was particularly widespread in Sweden and Wales/England. We notice that this is also the mutation causing the loss of a strong inter-monomer interaction, the D936-R1185 salt bridge, thus clearly weakening the post-fusion assembly.


title: Assessing the nationwide impact of COVID-19 mitigation policies on the transmission rate of SARS-CoV-2 in Brazil

text: COVID-19 is now identified in almost all countries in the world, with poorer regions being particularly more disadvantaged to efficiently mitigate the impacts of the pandemic. In the absence of efficient therapeutics or vaccines, control strategies are currently based on non-pharmaceutical interventions, comprising changes in population behavior and governmental interventions, among which the prohibition of mass gatherings, closure of non-essential establishments, quarantine and movement restrictions. In this work we analyzed the effects of 547 published governmental interventions, and population adherence thereof, on the dynamics of COVID-19 cases across all 27 Brazilian states, with emphasis on state capitals and remaining inland cities. A generalized SEIR model with a time-varying transmission rate (TR), that considers transmission by asymptomatic individuals, is presented. Confirmed COVID-19 cases were used to calibrate the model parameters using non-linear least squares methods. We analyze the changes on the TR and effective reproduction number as a function of both the extent of enforced measures across Brazilian states as well as population movement. The social mobility reduction index, a measure of population movement, together with the stringency index, adapted to incorporate the degree of restrictions imposed by governmental regulations, were used in conjunction to quantify and compare the effects of varying degrees of policy strictness across Brazilian states. Our results show that population adherence to social distance recommendations plays an important role for the effectiveness of interventions, and represents a major challenge to the control of COVID-19 in low- and middle-income countries.


title: ASSESSMENT OF WORKERS PERSONAL VULNERABILITY TO COVID-19 USING COVID-AGE

text: Decisions on fitness for employment that entails a risk of contracting Covid-19 require an assessment of the workers personal vulnerability should infection occur. Using recently published UK data, we have developed a risk model that provides estimates of personal vulnerability to Covid-19 according to sex, age, ethnicity, and various comorbidities. Vulnerability from each risk factor is quantified in terms of its equivalence to added years of age. Addition of the impact from each risk factor to an individuals true age generates their Covid-age, a summary measure representing the age of a healthy UK white male with equivalent vulnerability. We discuss important limitations of the model, including current scientific uncertainties and limitations on generalisability beyond the UK setting and its use beyond informing assessments of individual vulnerability in the workplace. As new evidence becomes available, some of these limitations can be addressed. The model does not remove the need for clinical judgement or for other important considerations when managing occupational risks from Covid-19.


title: Spatiotemporal patterns of COVID-19 impact on human activities and environment in Mainland China using nighttime light and air quality data

text: The sudden outbreak of the COVID-19 pandemic has brought drastic changes to people's daily lives, work, and the surrounding environment. Investigations into these changes are very important for decision makers to implement policies on economic loss assessments and stimulation packages, city reopening, resilience of the environment, and arrangement of medical resources. In order to analyze the impact of COVID-19 on people's lives, activities, and the natural environment, this paper investigates the spatial and temporal characteristics of Nighttime Light (NTL) radiance and Air Quality Index (AQI) before and during the pandemic in mainland China. The monthly mean NTL radiance, and daily and monthly mean AQI are calculated over mainland China and compared before and during the pandemic. Our results show that the monthly average NTL brightness is much lower during the quarantine period than before. This study categorizes NTL into three classes: residential area, transportation, and public facilities and commercial centers, with NTL radiance ranges of 5-20, 20-40 and greater than 40 (nWcm -2. sr -1), respectively. We found that the Number of Pixels (NOP) with NTL detection increased in the residential area and decreased in the commercial centers for most of the provinces after the shutdown, while transportation and public facilities generally stayed the same. More specifically, we examined these factors in Wuhan, where the first confirmed cases were reported, and where the earliest quarantine measures were taken. Observations and analysis of pixels associated with commercial centers were observed to have lower NTL radiance values, indicating a dimming behavior, while residential area pixels recorded increased levels of brightness after the beginning of the lockdown. The study also discovered a significant decreasing trend in the daily average AQI for mainland China from January to March 2020, with cleaner air in most provinces during February and March, compared to January 2020. In conclusion, the outbreak and spread of COVID-19 has had a crucial impact on people's daily lives and activity ranges through the increased implementation of lockdown and quarantine policies. On the other hand, the air quality of mainland China has improved with the reduction in non-essential industries and motor vehicle usage. This evidence demonstrates that the Chinese government has executed very stringent quarantine policies to deal with the pandemic. The decisive response to control the spread of COVID-19 provides a reference for other parts of the world.


title: An Age and Space Structured SIR Model Describing the Covid-19 Pandemic

text: We present an epidemic model capable of describing key features of the present Covid-19 pandemic. While capturing several qualitative properties of the virus spreading, it allows to compute the basic reproduction number, the number of deaths due to the virus and various other statistics. Numerical integrations are used to illustrate the relevance of quarantine and the role of care houses.


title: Interleukin-6 blockade for severe COVID-19

text: In the context of COVID-19 pandemic and growing tensions worldwide regarding healthcare facilities, there is an urgent need for effective treatments likely to reduce the crunch of ICU beds. Following the assumption by Mehta and colleagues who exhorted physicians to screen patients with severe COVID-19 for hyperinflammation and investigate immunomodulatory drugs in this setting, we relate our short-term - yet promising - experience regarding IL6 blockade with tocilizumab in 30 selected patients of less than 80 years of age, >5 days of prior disease duration, severe (i.e. requiring strictly over 6L/min of oxygen therapy) rapidly deteriorating (i.e. increase by more than 3L/min of oxygen flow within the previous 12 hours) COVID-19-related pneumonia. By comparison with a control group of patients (matched for age, gender and disease severity using the inverse probability of treatment weighted methodology) that did not receive tocilizumab. We demonstrate that, in highly selected patients, IL6 blockade could curb the "cytokine storm", prevent ICU admission and the requirement for mechanical ventilation. Notwithstanding the shortcomings of this retrospective small sample-size study, we believe that these preliminary findings support the fostering of research efforts in the fight against COVID-19-induced inflammation, especially before patients require admission to the ICU.


title: Tapestry: A Single-Round Smart Pooling Technique for COVID-19 Testing

text: The COVID-19 pandemic has strained testing capabilities worldwide. There is an urgent need to find economical and scalable ways to test more people. We present Tapestry, a novel quantitative nonadaptive pooling scheme to test many samples using only a few tests. The underlying molecular diagnostic test is any real-time RT-PCR diagnostic panel approved for the detection of the SARS-CoV-2 virus. In cases where most samples are negative for the virus, Tapestry accurately identifies the status of each individual sample with a single round of testing in fewer tests than simple two-round pooling. We also present a companion Android application BYOM Smart Testing which guides users through the pipetting steps required to perform the combinatorial pooling. The results of the pooled tests can be fed into the application to recover the status and estimated viral load for each individual sample.


title: Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections

text: Background SARS-CoV-2 is the cause of an ongoing pandemic with a projected 100,000 to 240,000 U.S. deaths. To date, documentation of histopathologic features in fatal cases of COVID-19 has been limited due to small sample size and incomplete organ sampling. Methods Post-mortem examinations were performed on 12 fatal COVID-19 cases in Washington State during February-March 2020. Clinical and laboratory data were reviewed. Tissue examination of all major organs was performed by light microscopy and electron microscopy. The presence of viral RNA in sampled tissues was tested by RT-PCR. Results All 12 patients were older with significant preexisting comorbidities. The major pulmonary finding was diffuse alveolar damage in the acute and/or organizing phases with virus identified in type I and II pneumocytes by electron microscopy. The kidney demonstrated viral particles in the tubular epithelium, endothelium, and podocytes without significant inflammation. Viral particles were also observed in the trachea and large intestines. SARS-CoV-2 RNA was detected in the cardiac tissue of a patient with lymphocytic myocarditis. RT-PCR also detected viral RNA in the subcarinal lymph nodes, liver, spleen, and large intestines. Conclusion SARS-CoV-2 represents the third novel coronavirus to cause widespread human disease since 2002. Similar to SARS and MERS, the primary pathology was diffuse alveolar damage with virus located in the pneumocytes. However, other major organs including the heart and kidneys may be susceptible to viral replication and damage leading to increased mortality in those with disseminated disease. Understanding the pathology of SARS-CoV-2 will be essential to design effective therapies.


docid: bezpprrk

title: Urine Proteome of COVID-19 Patients

text: The atypical pneumonia (COVID-19) caused by SARS-CoV-2 is an ongoing pandemic and a serious threat to global public health. The COVID-19 patients with severe symptoms account for a majority of mortality of this disease. However, early detection and effective prediction of patients with mild to severe symptoms remains challenging. In this study, we performed proteomic profiling of urine samples from 32 healthy control individuals and 6 COVID-19 positive patients (3 mild and 3 severe). We found that urine proteome samples from the mild and severe COVID-19 patients with comorbidities can be clearly differentiated from healthy proteome samples based on the clustering analysis. Multiple pathways have been compromised after the COVID-19 infection, including the dysregulation of immune response, complement activation, platelet degranulation, lipoprotein metabolic process and response to hypoxia. We further validated our finding by directly comparing the same patients' urine proteome after recovery. This study demonstrates the COVID-19 pathophysiology related molecular alterations could be detected in the urine and the potential application of urinary proteome in auxiliary diagnosis, severity determination and therapy development of COVID-19.


title: Intense bitterness of molecules: machine learning for expediting drug discovery

text: Drug development is a long, expensive and multistage process geared to achieving safe drugs with high efficacy. A crucial prerequisite for completing the medication regimen for oral drugs, particularly for pediatric and geriatric populations, is achieving taste that does not hinder compliance. Currently, the aversive taste of drugs is tested in late stages of clinical trials. This can result in the need to reformulate, potentially resulting in the use of more animals for additional toxicity trials, increased financial costs and a delay in release to the market. Here we present BitterIntense, a machine learning tool that classifies molecules into “very bitter” or “not very bitter”, based on their chemical structure. The model, trained on chemically diverse compounds, has above 80% accuracy on several test sets. BitterIntense suggests that intense bitterness does not correlate with toxicity and hepatotoxicity of drugs and that the prevalence of very bitter compounds among drugs is lower than among microbial compounds. BitterIntense allows quick and easy prediction of strong bitterness of compounds of interest for food and pharma industries. We estimate that implementation of BitterIntense or similar tools early in drug discovery and development process may lead to reduction in delays, in animal use and in overall financial burden. Significance Statement Drug development integrates increasingly sophisticated technologies, but extreme bitterness of drugs remains a poorly addressed cause of medicine regimen incompletion. Reformulating the drug can result in delays in the development of a potential medicine, increasing the lead time to the patients. It might also require the use of extra animals in toxicity trials and lead to increased costs for pharma companies. We have developed a computational predictor for intense bitterness, that has above 80% accuracy. Applying the classifier to annotated datasets suggests that intense bitterness does not correlate with toxicity and hepatotoxicity of drugs. BitterIntense can be used in the early stages of drug development to identify drug candidates that require bitterness masking, and thus reduce animal use, time and monetary loss.


docid: pqpzbmlu

title: Regressing SARS-CoV-2 sewage measurements onto COVID-19 burden in the population: a proof-of-concept for quantitative environmental surveillance

text: SARS-CoV-2 is an RNA virus, a member of the coronavirus family of respiratory viruses that includes SARS-CoV-1 and MERS. COVID-19, the clinical syndrome caused by SARS-CoV-2, has evolved into a global pandemic with more than 2,900,000 people infected. It has had an acute and dramatic impact on health care systems, economies, and societies of affected countries within these few months. Widespread testing and tracing efforts are employed in many countries in order to contain and mitigate this pandemic. Recent data has indicated that fecal shedding of SARS-CoV-2 is common, and that the virus can be detected in wastewater. This indicates that wastewater monitoring is a potentially efficient tool for epidemiological surveillance of SARS-CoV-2 infection in large populations at relevant scales. Collecting raw sewage data, representing specific districts, and crosslinking this data with the number of infected people from each location, will enable us to derive and provide quantitative surveillance tools. In particular, this will provide important means to (i) estimate the extent of outbreaks and their spatial distributions, based primarily on in-sewer measurements (ii) manage the early-warning system quantitatively and efficiently (and similarly, verify disease elimination). Here we report the development of a virus concentration method using PEG or alum, providing an important a tool for detection of SARS-CoV-2 RNA in sewage and relating it to the local populations and geographic information. This will provide a proof of concept for the use of sewage associated virus data as a reliable epidemiological tool.


title: Clear plastic drapes may be effective at limiting aerosolization and droplet spray during extubation: implications for COVID-19

text: Protection of frontline HCPs is paramount. However, PPE is a limited resource and often requires providers to be adaptive and resourceful in a crisis. The inexpensive and simple method of using clear drapes during extubation (and possibly intubation) of COVID-19 patients may be considered by frontline HCPs and infection control specialists as an additional precaution. Modifications of the clear plastics can be adapted for surgical procedures that may be AGMPs.


docid: vjofhmec

title: COVID-19 and privacy in the European Union: A legal perspective on contact tracing


docid: vytmwmoj

title: Control Strategies to Curtail Transmission of COVID-19

text: Recently, the World Health Organization has declared the outbreak of a severe acute respiratory syndrome coronavirius as a pandemic, and declared it as Public Health Emergency of International Concern. More than 6,83,536 positive cases and 32,139 deaths caused by coronavirus 2019 affecting 199 countries and territories. This pandemic can transform into an extremely destructive form if we still do not take it seriously. In this present study, we propose a generalized SEIR model of COVID-2019 to study the behavior of its transmission under different control strategies.


title: The Clinical Manifestations and Chest Computed Tomography Findings of Coronavirus Disease 2019 (COVID-19) Patients in China: A Proportion Meta-Analysis

text: OBJECTIVES: The objectives of this study were to identify the clinical features and chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) patients and to compare the characteristics of patients diagnosed in Wuhan and in other areas of China by integrating the findings reported in previous studies. METHODS: We conducted a proportion meta-analysis to integrate the results of previous studies identified in online databases, and subsequently compared the overlapping of 95% confidence intervals (CIs) between locations of diagnosis. The heterogeneity of the results of the included studies was also demonstrated. RESULTS: Nine studies with level IV evidence were considered to be eligible for the meta-analysis, and a comparative analysis was only possible between patients diagnosed in Wuhan and outside of Wuhan in China. Fever (84.8%; 95% CI, 78.5% to 90.1%) was identified as the most common clinical manifestation in all COVID-19 patients, and signs of respiratory infection were also frequently present in these patients. When comparing the clinical features according to the location of diagnosis, fever and dyspnea were less frequent in patients diagnosed outside of Wuhan (fever: 78.1%; 95% CI, 73.2% to 82.7%; dyspnea: 3.80%; 95% CI, 0.13% to 12.22%) than in patients diagnosed in Wuhan (fever: 91.7%; 95% CI, 88.0% to 94.8%; dyspnea: 21.1%; 95% CI, 13.2% to 30.3%). The chest CT findings exhibited no significant differences between the groups. CONCLUSION: Fever was found to be the most common symptom in COVID-19, and respiratory infection signs were also commonly present. Fever and dyspnea were less frequently observed in the patients diagnosed outside of Wuhan, which should be considered in COVID-19 screening programs. These results may be attributable to the earlier diagnosis of the disease and the younger age of patients outside of Wuhan although further analysis is needed. The role of chest CT in COVID-19 diagnosis is inconclusive based on this study.


docid: lcozlzdu

title: Fabrication and Characterization of In Situ Zn-TiB2 Nanocomposite

text: Abstract Zinc (Zn) matrix composite has been newly discovered categories of biodegradable materials. With a combination of chemical stability, thermal stability and biocompatibility, ceramic nanoparticles outperformed intermetallics of zinc alloys with inherent advantages of retaining a proper corrosion rate and an exceptional ductility. Compared with Zn alloys, Zn matrix nanocomposites showed an unprecedented strengthening without sacrifices of corrosion rate, which were introduced by intermetallics. In this work, in situ titanium diboride (TiB2) reinforced Zn nanocomposite was prepared via a few cost-effective and economical methods: flux-assisted synthesis (FAS), ultrasound-assisted nanoparticle homogenization and hot rolling. 3 vol.% of TiB2 nanoparticles were synthesized with an average size of 454nm, followed by molten salt assisted ultrasound homogenization and hot rolling. Hot-rolled (HR) Zn-TiB2 performed high strength and high ductility, mostly due to precipitation strengthening (Orowan strengthening). Yield stress (YS) and ultimate tensile stress (UTS) increased by 90% and 45%, respectively, while the elongation to failure retained 23%. The mechanical performance of Zn-TiB2 made it promise to serve as an innovative biodegradable material for load-bearing applications.


docid: gpvxudjl

title: Coronavirus Disease 2019 (COVID-19) Can Masquerade as Acute Postoperative Periprosthetic Joint Infection

text: Fever etiology during the first postoperative days following total knee arthroplasty (TKA) may be challenging to solve. Early periprosthetic joint infection is the main reason; however, other equally important causes must be excluded such as thrombosis, deep venous thrombosis, and chest or urinary tract infections. We report the case of a 70-year-old Caucasian female patient presented with high fever reaching 39°C, fatigue, and myalgia lasting for a week after a fully cemented primary TKA. Symptoms were falsely attributed to the surgical procedure, leading to erroneous early management and a complicated postoperative course. In the era of the severe acute respiratory syndrome coronavirus 2 (SARs-CoV-2) pandemic, a high index of suspicion for coronavirus disease 2019 (COVID-19) symptoms and viral chest infection must be raised, primarily in vulnerable patients.


Coronavirus Disease (COVID-19) Outbreak: Hypofractionated Radiotherapy in Soft Tissue Sarcomas as a Valuable Option in the Environment of Limited Medical Resources and Demands for Increased Protection of Patients


title: A deterministic epidemic model for the emergence of COVID-19 in China

text: Coronavirus disease (COVID-19) broke out in Wuhan, Hubei province,China, in December 2019 and soon after Chinese health authorities tookunprecedented prevention and control measures to curb the spreading ofthe novel coronavirus-related pneumonia. We develop a mathematicalmodel based on daily updates of reported cases to study the evolutionof the epidemic. With the model, on 95% confidence level, we estimatethe basic reproduction number, R0 = 2.82 ± 0.11, time between March19 and March 21 when the effective reproduction number becoming lessthan one, the epidemic ending after April 2 and the total number ofconfirmed cases approaching 14408 ± 429 on the Chinese mainlandexcluding Hubei province.


title: Towards the next phase: evaluation of serological assays for diagnostics and exposure assessment.

text: The world is entering a new era of the COVID-19 pandemic in which there is an increasing call for reliable antibody testing. To support decision making on the deployment of serology for either population screening or diagnostics, we present a comprehensive comparison of serological COVID-19 assays. We show that the assay detecting total immunoglobulins against the receptor binding domain of SARS CoV-2, had optimal characteristics for antibody detection in different stages of disease.


title: Making antibodies to treat coronavirus, and why planting trees won’t save the planet

text: Staff Writer Jon Cohen joins host Sarah Crespi to talk about using monoclonal antibodies to treat or prevent infection by SARS-CoV-2 Many companies and researchers are rushing to design and test this type of treatment, which proved effective in combating Ebola last year See all of our News coverage of the pandemic here, and all of our Research and Editorials here And Karen Holl, a professor of environmental studies at the University of California, Santa Cruz, joins Sarah to discuss the proper planning of tree-planting campaigns It turns out that just putting a tree in the ground is not enough to stop climate change and reforest the planet


docid: naebdelz

title: A genome epidemiological study of SARS-CoV-2 introduction into Japan

text: Background: After the first case of COVID-19 in Japan on 15 January 2020, multiple nationwide COVID-19 clusters were identified by the end of February. The Japanese government focused on mitigating emerging COVID-19 clusters by conducting active nationwide epidemiological surveillance. However, an increasing number of cases appeared until early April, many with unclear infection routes exhibiting no recent history of travel outside Japan. We aimed to evaluate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome sequences from COVID-19 cases until early April and characterise the genealogical networks to demonstrate possible routes of spread in Japan. Methods: Nasopharyngeal specimens were collected from patients and a quantitative reverse transcription polymerase chain reaction testing for SARS-CoV-2 was performed. Positive RNA samples were subjected whole genome sequencing and a haplotype network analysis was performed. Findings: Some of the primary clusters identified during January and February in Japan directly descended from Wuhan-Hu-1-related isolates in China and other distinct clusters. Clusters were almost contained until mid-March; the haplotype network analysis demonstrated that COVID-19 cases from late March through early April may have caused an additional large cluster related to the outbreak in Europe, leading to additional spread within Japan. National self-restraint during February was effective in mitigating the COVID-19 spread, but late action on stopping immigration and declaring national emergency in Japan might be involved in the later increase in cases. Interpretation: Genome surveillance suggested that at least two distinct SARS-CoV-2 introductions from China and other countries occurred. Funding: Japan Agency for Medical Research and Development.


title: A brief review of antiviral drugs evaluated in registered clinical trials for COVID-19

text: Background: Although a number of antiviral agents have been evaluated for coronaviruses there are no approved drugs available. To provide an overview of the landscape of therapeutic research for COVID-19, we conducted a review of registered clinical trials. Methods: A review of currently registered clinical trials was performed on registries, including the Chinese (chictr.org.cn) and US (clinicaltrials.gov) databases to identify relevant studies up to March, 7th 2020. The search was conducted using the search terms “2019-nCoV”, “COVID-19”, “SARS-CoV-2”, “Hcov-19”, “new coronavirus”, “novel coronavirus”. We included interventional clinical trials focusing on patients with COVID-19 and assessing antiviral drugs or agents. Findings: Out of the 353 studies identified, 115 clinical trials were selected for data extraction. Phase IV trials were the most commonly reported study type (n=27, 23%). However, 62 trials (54%) did not describe the phase of the study. Eighty percent (n=92) of the trials were randomized with parallel assignment and the median number of planned inclusions was 63 (IQR, 36-120). Open-label studies were the most frequent (46%) followed by double-blind (13%) and single blind studies (10%). The most frequently assessed therapies were: stem cells therapy (n=23 trials), lopinavir/ritonavir (n=15), chloroquine (n=11), umifenovir (n=9), hydroxychloroquine (n=7), plasma treatment (n=7), favipiravir (n=7), methylprednisolone (n=5), and remdesivir (n=5). Remdesivir was tested in 5 trials with a median of 400 (IQR, 394-453) planned inclusions per trial, while stem cells therapy was tested in 23 trials, but had a median of 40 (IQR, 23-60) planned inclusions per trial. Lopinavir/ritonavir was associated with the highest total number of planned inclusions (2606) followed by remdesivir (2155). Only 52% of the clinical trials reported the treatment dose (n=60) and only 34% (n=39) the duration. The primary outcome was clinical in 76 studies (66%), virological in 27 (23%); radiological in 9 (8%) or immunological in three studies (3%). Interpretation: Numerous clinical trials have been registered since the beginning of the COVID-19 outbreak, however, a number of information regarding drugs or trial design were lacking. Funding: None


Africa’s critical care capacity before COVID-19


title: Morphological and intracellular alterations induced by cytotoxin VT2y produced by Escherichia coli isolated from chickens with swollen head syndrome

text: Abstract Recently, a novel verocytotoxin named VT2y was described which belongs to the STx family and is produced by Escherichia coli isolated from domestic poultry with swollen head syndrome (SHS). The VT2y toxin induced apoptosis in Vero, HeLa, CHO, CEF (primary chicken embryo fibroblast) and PCK (primary chicken kidney) cell lines. Morphological evidence (nuclear shrinkage, chromatin condensation and blebbing of the plasma membrane) of apoptosis could be distinguished in 15 min and was maximal at 1 h after treatment with VT2y. This was confirmed by the terminal dUTP nick-end-labeling (TUNEL) method.


title: Lessons from movement ecology for the return to work: modeling contacts and the spread of COVID-19

text: Human behavior (movement, social contacts) plays a central role in the spread of pathogens like SARS-CoV-2. The rapid spread of SARS-CoV-2 was driven by global human movement, and recent lockdown measures aim to localize movement and contact in order to slow spread. Thus, movement and contact patterns need to be explicitly considered when making reopening decisions, especially regarding return to work. Here, as a case study, we consider the initial stages of resuming research at a large research university, using approaches from movement ecology and contact network epidemiology. First, we develop a dynamical pathogen model describing movement between home and work; we show that limiting social contact, via reduced people or reduced time in the workplace are fairly equivalent strategies to slow pathogen spread. Second, we develop a model based on spatial contact patterns within a specific office and lab building on campus; we show that restricting on-campus activities to labs (rather than labs and offices) could dramatically alter (modularize) contact network structure and thus, potentially reduce relative risk of pathogen spread. Here we argue that explicitly accounting for human movement and contact behavior in the workplace can provide additional insights to be used in conjunction with ongoing public health efforts.


title: Feasibility of non-invasive nitric oxide inhalation in acute hypoxic respiratory failure: potential role during the COVID-19 pandemic

text: Acute hypoxemic respiratory failure (ARF) is characterized by both lower arterial oxygen and carbon dioxide tensions in the blood. First line treatment for ARF includes oxygen therapy,intially admininstered non invasively using nasal prongs, high flow nasal cannulae or masks. Invasive mechancial ventilation (IMV) is usually reserved for patients who are unable to maintain their airway, those with worsening hypoxemia, or those who develop respiratory muscle fatigue and consequent hypercapnia. Inhaled nitric oxide (iNO) gas is known to improve oxygenation in patients with ARF by manipulating ventilation-perfusion matching. Addition of iNO may potentially alleviate the need for IMV in selected patients. This article demonstrates the feasibility of this technique based on our experience of patients with hypoxemic ARF. This technique may also be considered for patients with hypoxic ARF in setting of COVID-19.


docid: wolrseqc

title: Social interventions can lower COVID-19 deaths in middle-income countries

text: A novel pandemic coronavirus disease (COVID-19) was first detected in late 2019 in Wuhan (China)1,2. COVID-19 has caused 77 national governments worldwide to impose a lockdown in part or all their countries, as of April 4, 20203. The United States and the United Kingdom estimated the effectiveness of non-pharmaceutical interventions to reduce COVID-19 deaths, but there is less evidence to support choice of control measures in middle-income countries4. We used Colombia, an upper-middle income country, as a case-study to assess the effect of social interventions to suppress or mitigate the COVID-19 pandemic. Here we show that a combination of social distancing interventions, triggered by critical care admissions, can suppress and mitigate the peak of COVID-19, resulting in less critical care use, hospitalizations, and deaths. We found, through a mathematical simulation model, that a one-time social intervention may delay the number of critical care admissions and deaths related to the COVID-19 pandemic. However, a series of social interventions (social and work distance and school closures) over a period of a year can reduce the expected burden of COVID-19, however, these interventions imply long periods of lockdown. Colombia would prevent up to 97% of COVID-19 deaths using these triggered series of interventions during the first year. Our analyses could be used by decision-makers from other middle-income countries with similar demographics and contact patterns to Colombia to reduce COVID-19 critical care admissions and deaths in their jurisdictions.


title: Estimating the risk of COVID-19 death during the course of the outbreak in Korea, February-March, 2020

text: Background: In Korea, a total of 8,799 confirmed cases of COVID-19 including 102 deaths have been recorded as of Mar 21, 2020. The time-delay adjusted case fatality risk of COVID-19 in Korea is yet to be estimated. Methods: We obtained the daily series of confirmed cases and deaths in Korea reported prior to March 21,2020. Using statistical methods, we estimated the time-delay adjusted risk for death from COVID-19 in the city of Daegu, Gyeongsangbuk-do, other regions in Korea, as well as for the entire country. Results: Our model-based crude CFR fitted the observed data well throughout the course of the epidemic except for the very early stage in Gyeongsangbuk-do, partially due to the reporting delay. Our estimates of the risk for death in Gyeongsangbuk-do reached 2.4% (95% CrI: 1.6-3.4%), 1.3% (95% CrI: 1.0-1.6%) in Daegu and 0.7% (95% CrI: 0.3-1.4%) in other regions, whereas the national estimate of the risk for death was estimated at 1.4% (95% CrI: 1.2-1.7%) in Korea. Conclusions: The relatively low CFRs are associated with the early implementation of public health interventions including widespread testing, social distancing, and delayed school openings in Korea. Geographic differences in CFR are likely influenced by clusters of nosocomial transmission.


title: Accurate Prediction of COVID-19 using Chest X-Ray Images through Deep Feature Learning model with SMOTE and Machine Learning Classifiers

text: According to the World Health Organization (WHO), the coronavirus (COVID-19) pandemic is putting even the best healthcare systems across the world under tremendous pressure. The early detection of this type of virus will help in relieving the pressure of the healthcare systems. Chest X-rays has been playing a crucial role in the diagnosis of diseases like Pneumonia. As COVID-19 is a type of influenza, it is possible to diagnose using this imaging technique. With rapid development in the area of Machine Learning (ML) and Deep learning, there had been intelligent systems to classify between Pneumonia and Normal patients. This paper proposes the machine learning-based classification of the extracted deep feature using ResNet152 with COVID-19 and Pneumonia patients on chest X-ray images. SMOTE is used for balancing the imbalanced data points of COVID-19 and Normal patients. This non-invasive and early prediction of novel coronavirus (COVID-19) by analyzing chest X-rays can further be used to predict the spread of the virus in asymptomatic patients. The model is achieving an accuracy of 0.973 on Random Forest and 0.977 using XGBoost predictive classifiers. The establishment of such an approach will be useful to predict the outbreak early, which in turn can aid to control it effectively.


title: Applying the unified models of ecology to forecast epidemics, with application to Covid-19

text: During a burgeoning outbreak of a novel disease, public attention will ordinarily expand as the severity of the outbreak expands--as infections multiply and news reports accumulate. Such public attention will in turn reinforce tactics to control the outbreak. In classical epidemiological models, effects of such tactics can be incorporated in standard parameters of transmission, recovery, and mortality. Unfortunately, early in an outbreak those individual parameters may be poorly known, hence corresponding models can get lost in uncertainty. This makes it difficult to determine whether the disease is spreading exponentially or logistically, or along another path. Examining cases over time is also problematic, as a logistically growing infection that is leveling off appears exponential in early phases. Here we report on the most basic mechanistic, ecological model we can imagine, which can help distinguish growth that is and is not under control. This approach did a satisfactory job predicting the final outcome of the Ebola outbreak of 2014-15. The model's two parameters were computable in real time, well before the outcome was actually known. The first parameter is an intrinsic rate of increase in cumulative deaths or reported cases. The second parameter is related to the human social system and represents all tactics that combine to control the outbreak. That parameter is coupled to the number of cumulative deaths or cases. We examine the basic mechanisms operating in this model and show the predictions made during the Ebola outbreak. We also consider how this basic model is performing for the Covid-19 pandemic and highlight ecological models that align with popularly discussed concepts such as flatten-the-curve, exponential growth, and inflection points of curves.


title: SEIR and Regression Model based COVID-19 outbreak predictions in India

text: COVID-19 pandemic has become a major threat to the country. Till date, well tested medication or antidote is not available to cure this disease. According to WHO reports, COVID-19 is a severe acute respiratory syndrome which is transmitted through respiratory droplets and contact routes. Analysis of this disease requires major attention by the Government to take necessary steps in reducing the effect of this global pandemic. In this study, outbreak of this disease has been analysed for India till 30th March 2020 and predictions have been made for the number of cases for the next 2 weeks. SEIR model and Regression model have been used for predictions based on the data collected from John Hopkins University repository in the time period of 30th January 2020 to 30th March 2020. The performance of the models was evaluated using RMSLE and achieved 1.52 for SEIR model and 1.75 for the regression model. The RMSLE error rate between SEIR model and Regression model was found to be 2.01. Also, the value of R0 which is the spread of the disease was calculated to be 2.02. Expected cases may rise between 5000-6000 in the next two weeks of time. This study will help the Government and doctors in preparing their plans for the next two weeks. Based on the predictions for short-term interval, these models can be tuned for forecasting in long-term intervals.


title: Identification of a common deletion in the spike protein of SARS-CoV-2

text: Two notable features have been identified in the SARS-CoV-2 genome: (1) the receptor binding domain of SARS-CoV-2; (2) a unique insertion of twelve nucleotide or four amino acids (PRRA) at the S1 and S2 boundary. For the first feature, the similar RBD identified in SARs-like virus from pangolin suggests the RBD in SARS-CoV-2 may already exist in animal host(s) before it transmitted into human. The left puzzle is the history and function of the insertion at S1/S2 boundary, which is uniquely identified in SARS-CoV-2. In this study, we identified two variants from the first Guangdong SARS-CoV-2 cell strain, with deletion mutations on polybasic cleavage site (PRRAR) and its flank sites. More extensive screening indicates the deletion at the flank sites of PRRAR could be detected in 3 of 68 clinical samples and half of 22 in vitro isolated viral strains. These data indicate (1) the deletion of QTQTN, at the flank of polybasic cleavage site, is likely benefit the SARS-CoV-2 replication or infection in vitro but under strong purification selection in vivo since it is rarely identified in clinical samples; (2) there could be a very efficient mechanism for deleting this region from viral genome as the variants losing 23585-23599 is commonly detected after two rounds of cell passage. The mechanistic explanation for this in vitro adaptation and in vivo purification processes (or reverse) that led to such genomic changes in SARS-CoV-2 requires further work. Nonetheless, this study has provided valuable clues to aid further investigation of spike protein function and virus evolution. The deletion mutation identified in vitro isolation should be also noted for current vaccine development.


title: Eco-Virological Preliminary Study of Potentially Emerging Pathogens in Hedgehogs (Erinaceus europaeus) Recovered at a Wildlife Treatment and Rehabilitation Center in Northern Italy

text: SIMPLE SUMMARY: Most of the newly emerging infections arise from animal reservoirs, frequently represented by wildlife species. Western European hedgehogs (Erinaceus europaeus) are mammalian hibernators, mainly nocturnal and insectivorous, living in natural open and green spaces as well as artificial, rural and urban, areas. They are generalist predators of macro-invertebrates, but they may also eat meat, bird eggs and on occasion pet food. These ecological and feeding habits, along with their high population densities, notable synanthropic attitudes, frequent contacts with sympatric wild and domestic species, including humans, implicate the possibility of intra- and interspecies interactions accounting for the possible involvement of E. europaeus in the ecology of several potentially emerging pathogens, including coronaviruses. Using PCR-based and virus isolation methods, we found that 58.3% of 24 hedgehogs’ fecal samples were PCR-positive for Erinaceus coronaviruses (EriCoVs). We did not observe any clinical disease related to the EriCoV infection in hedgehogs. However, the high mutation rates characterizing members of the Coronaviridae family and their potential successful interspecies host jumps—as that likely occurred in the Novel coronavirus (2019-nCoV) emergence—should be considered in the management of hedgehogs admitted to multi-species wildlife rehabilitation centers, recommending their return back to the original recovery areas. ABSTRACT: The Western European Hedgehog (Erinaceus europaeus) is one of the four hedgehog species belonging to the genus Erinaceus. Among them, E. amurensis is extant in East Asia’s areas only, whereas E. europaeus, E. roumanicus and E. concolor are mainly found in Europe. E. europaeus is endemically distributed from western to central and southern Europe, including Italy. Western European hedgehogs’ ecological and feeding habits, along with their high population densities, notable synanthropic attitudes, frequent contacts with sympatric wild and domestic species, including humans, implicate the possible involvement of E. europaeus in the ecology of potentially emerging viruses, such as coronaviruses, influenza A and influenza D viruses, canine distemper virus, pestiviruses and Aujeszky’s disease virus. We examined 24 E. europaeus individuals found injured in urban and rural areas of Northern Italy. Of the 24 fecal samples collected and tested for the above-mentioned pathogens by both PCR-based and virus isolation methods, 14 were found PCR-positive for betacoronaviruses belonging to lineage C and related to the known Erinaceus coronaviruses (EriCoVs), as determined by partial sequencing of the virus genome. Our findings suggest that hedgehogs could be considered natural reservoirs of CoVs, and also act as chronic shedding carriers of these potentially emerging RNA viruses.


title: International Electronic Health Record-Derived COVID-19 Clinical Course Profiles: The 4CE Consortium

text: We leveraged the largely untapped resource of electronic health record data to address critical clinical and epidemiological questions about Coronavirus Disease 2019 (COVID-19). To do this, we formed an international consortium (4CE) of 96 hospitals across 5 countries (www.covidclinical.net). Contributors utilized the Informatics for Integrating Biology and the Bedside (i2b2) or Observational Medical Outcomes Partnership (OMOP) platforms to map to a common data model. The group focused on comorbidities and temporal changes in key laboratory test values. Harmonized data were analyzed locally and converted to a shared aggregate form for rapid analysis and visualization of regional differences and global commonalities. Data covered 27,584 COVID-19 cases with 187,802 laboratory tests. Case counts and laboratory trajectories were concordant with existing literature. Laboratory tests at the time of diagnosis showed hospital-level differences equivalent to country-level variation across the consortium partners. Despite the limitations of decentralized data generation, we established a framework to capture the trajectory of COVID-19 disease in patients and their response to interventions.


COVID-19 bei thorakalen Tumorerkrankungen


title: Coding variants in ACE2 and TMPRSS2 are not major drivers of COVID-19 severity in UK Biobank subjects.

text: There is wide individual variation in response to infection with SARS-CoV-2 and this may be influenced by ethnicity. It is plausible that coding variants in the ACE2 and TMPRSS2 genes might contribute to this variation. Exome sequence data was obtained for 49,953 UK Biobank subjects of whom 74 had tested positive for SARS-CoV-2 and could be presumed to have severe disease because mildly affected subjects were not tested in the relevant period. A weighted burden analysis was carried out using SCOREASSOC to determine whether there were differences between these cases and the other sequenced subjects in the overall burden of rare, damaging variants in ACE2 or TMPRSS2. There were no significant differences in weighted burden scores between cases and controls for either gene. There were no individual DNA sequence variants with a markedly different frequency between cases and controls. Genetic variants affecting the structure and function of the ACE2 and TMPRSS2 proteins are not a major determinant of whether infection with SARS-CoV-2 results in severe symptoms. This research has been conducted using the UK Biobank Resource.


title: COVID 19 healthcare facility demand forecasts for rural residents

text: One of the main challenges in dealing with the current COVID 19 pandemic is how to fulfill the healthcare facility demands especially for the residents living in the rural areas that have restricted healthcare access. Correspondingly, this study aims to record the daily COVID 19 cases and continue with the forecasting of the average daily demand (ADD) of healthcare facilities including beds, ICUs, and ventilators using ARIMA model. The forecasts were made for 3 rural populations located in the southern Amazon. The model shows that the healthcare ADD was different in each population. Likewise, the model forecasts that in a rural population that has the highest daily case with projected average cases equal to 67 cases/day (95%CI: 24, 110), that population has to fulfill healthcare ADD consisting of 57 beds/day (95%CI: 21, 93), 8 ICUs/day (95%CI: 2, 14), and 2 ventilators/day (95%CI: 2, 3). To conclude, the ARIMA model has addressed critical questions about ADD for beds, ICUs, and ventilators for rural residents. This ARIMA model based healthcare plan will hopefully provide versatile tool to improve healthcare resource allocations.


title: Mental Health of Clinical Staff Working in High-Risk Epidemic and Pandemic Health Emergencies: A Rapid Review of the Evidence and Meta-Analysis

text: The global pandemic of SARS-CoV-2 / COVID-19 has raised concerns about the potential mental health impact on frontline clinical staff. However, given that poor mental health is common in staff working in acute medicine, we aimed to estimate the additional burden of working directly with infected patients during epidemic and pandemic health emergencies. We completed a rapid review of the evidence and identified 74 relevant studies from outbreaks of COVID-19, Ebola, H1N1 influenza, Middle East respiratory syndrome (MERS), and severe acute respiratory syndrome (SARS). Due to varying caseness criteria, a meta-analysis of prevalence was not possible. However, it was clear that levels of self-reported depression, anxiety and posttraumatic stress disorder (PTSD) related symptoms were high, and somewhat higher in clinical staff working in high exposure roles. To assess the impact of high- versus low-exposure healthcare work more formally, we estimated the standardised mean difference (SMD) of scale means using a random effects meta-analysis. High exposure work was associated with only a small additional burden of acute mental health problems compared to low exposure work (anxiety: SMD=0.22, 95% CI 0.06 - 0.38; PTSD symptoms: SMD=0.21, 95% CI 0.01 - 0.4; depression: SMD=0.20, -0.07 - 0.47). This effect was potentially inflated by publication bias and there was a moderate risk of bias in the studies in the meta-analysis. A narrative review of candidate risk factors identified being a nurse, seeing colleagues infected, experiencing quarantine, non-voluntary role assignment, and experiencing stigma, as associated with particularly poor mental health outcomes. Protective factors included team and institutional support, use and faith in infection prevention measures, and a sense of professional duty and altruistic acceptance of risk. Notably, formal psychological support services were valued by frontline staff, although those with the highest burden of mental health difficulties were the least likely to request or receive support.


title: COVID-19 in Children with Brain-Based Developmental Disabilities: A Rapid Review

text: Background. The prevalence of symptomatic COVID-19 in children remains low to date. In just a few months, COVID-19 has affected millions of people worldwide, and as of the date of this publication, the pandemic continues. Based on the current available evidence, children do not appear to be at higher risk of contracting COVID-19 than adults. However, children with neurological and neuromuscular conditions are vulnerable to the respiratory complications of other viral infections. Objectives. To assess whether children with brain-based developmental disabilities were more likely to develop COVID-19 and have complications or poorer outcomes following infection. Methods. We conducted a two-week rapid review on studies with primary data regarding children aged between zero and 18 years old with brain-based developmental disabilities, or who were at risk of developing such disabilities, with confirmed or suspected COVID-19. We performed our literature searches on April 18, 2020. Results. Our search strategy identified 538 individual records, of which four were included in our review. Of the 50 COVID-19 pediatric patients reported in the included studies, a total of seven children were at risk of developing brain-based disabilities. Symptoms ranged in severity. However, generally, patients were discharged or saw improvements in their symptoms by the end of the study period. No deaths were reported. Discussion. Our study highlights a knowledge gap regarding the impact of COVID-19 in children with brain-based developmental disabilities.


title: Towards a taxonomically unbiased EU Biodiversity Strategy for 2030

text: Through the Habitats Directive (92/43/EEC) and the LIFE projects financial investments, Europe has been the world’s experimental arena for biological conservation. With an estimated budget of €20 billion/year, the EU Biodiversity Strategy for 2030 has set an ambitious goal of reaching 30% Protected Areas and ensure no deterioration in conservation trends and status of all protected species. We analyzed LIFE projects focused on animals from 1992 to 2018 and we found that investment towards vertebrates has been six times higher than that for invertebrates (€970 vs €150 million), with birds and mammals alone accounting for 72% species and 75% total budget. Budget allocation is primarily explained by species’ popularity. We propose a roadmap to achieve unbiased conservation targets for 2030 and beyond.


title: COVIDep platform for real-time reporting of vaccine target recommendations for SARS-CoV-2: Description and connections with COVID-19 immune responses and preclinical vaccine trials

text: We introduce COVIDep (https://COVIDep.ust.hk), a web-based platform that provides immune target recommendations for guiding SARS-CoV-2 vaccine development. COVIDep implements a protocol that pools together publicly-available genetic data for SARS-CoV-2 and epitope data for SARS-CoV to identify B cell and T cell epitopes that present potential immune targets for SARS-CoV-2. Correspondences between outputs of COVIDep and immune responses recorded in COVID-19 patients and preclinical vaccine trials are also indicated. The platform is user-friendly, flexible, and based on up-to-date data. It may help guide vaccine designs and associated experimental studies for SARS-CoV-2.


title: High Incidence of Venous Thrombosis in Patients with Moderate to Severe COVID-19

text: COVID-19 predisposes to venous thromboembolism and there are multiple data regarding high incidence of venous thrombosis in critical COVID-19 patients, however reports on this complication in less severe patients are not widely available. The aim of this study was to investigate the incidence of deep-vein thrombosis (DVT) in patients with moderate to severe COVID-19 and to assess the prevalence of DVT with lung computerized tomography (lung CT) exams, clinical information and lab data. This study examined 75 consecutive patients with moderate to severe COVID-19, with specific exclusions. METHODS Almost all patients (pts) admitted to our hospital in the first half of May underwent comprehensive vein ultrasonography. 75 pts (aged 27-92 y, median - 63 y, 36 males and 39 females) with moderate to severe COVID-19 were included in our study. RESULTS Spontaneous echo contrast (decreased blood velocity and blood stasis) was detected in common femoral veins in 53 pts (70.7%). DVT was found in 15 pts (20%). The vast majority of those with DVT (13 pts, 86.7%) had thrombi only in calf veins and ileofemoral thrombosis was detected in 2 pts with DVT (13.3%). There was no significant observed difference between DVT and non-DVT patients with respect to age, underlying diseases, lung CT scores and SpaO2 at admission. There was also no significant observed difference between DVT and non-DVT patients with respect to both "time from symptoms onset to admission" and with respect to the majority of lab data. However, a significant difference was observed in D-dimer level (1.87 +/- 1.62 vs 0.51 +/- 0,4 mcg/mL p<0.0001) and C-reactive protein (116.9 +/- 83,6 and 65.1 +/- 64.98 mg/L, p = 0.014) for patients with DVT and patients without DVT respectably (Receiver operating characteristics (ROC) curve analysis revealed that the level of D-dimer >/= 0.69 mcg/mL is the predictor of DVT with a sensitivity of 76.9%, a specificity of 77.6%, p < 0.001 (AUC area under curve = 0.7944). Logistic regression confirmed that D-dimer is an independent predictor of DVT and patients with D-dimer >/= 0.69 mcg/mL have odds ratio (OR) of developing DVT = 5.1 (confidence interval [CI] 1.9 - 13.5)). CONCLUSION Patients with moderate to severe COVID-19 show high incidence of DVT, indicating that moderate to severe COVID-19 patients may require an early administration of anticoagulation therapy as part of their treatment. Such therapy may be continued after hospital discharge. Based on these findings, these patients may also require a follow-up with vein ultrasonography after recovery to rule out DVT.


title: Understanding the spreading patterns of COVID-19 in UK and its impact on exit strategies

text: Prior to lockdown the spread of COVID-19 in UK is found to be exponential, with an exponent 0.207. In case of COVID-19 this spreading behaviour is quantitatively better described with a mobility-driven SIR-SEIR model [2] rather than the homogenous mixing models. Lockdown has dramatically slowed down the spread of COVID-19 in UK, and even more significantly, has changed the growth in the total number of infected from exponential to quadratic. This significant change is due to a transition from a mobility-driven epidemic spreading to a spatial epidemic which is dominated by slow growth of spatially isolated clusters of infected population. Our results strongly indicate that, to avoid a return to exponential growth of COVID-19 (also known as second wave), mobility restrictions should not be prematurely lifted. Instead mobility should be kept restricted while new measures, such as wearing of masks and contact tracing, get implemented in order to prevent health services becoming overwhelmed due to a resurgence of exponential growth.


title: ALeRT-COVID: Attentive Lockdown-awaRe Transfer Learning for Predicting COVID-19 Pandemics in Different Countries

text: Countries across the world are in different stages of COVID-19 trajectory, among which many have implemented the lockdown measures to prevent its spread. Although the lockdown is effective in such prevention, it may put the economy into a depression. Predicting the epidemic progression with government switching the lockdown on or off is critical. We propose a transfer learning approach called ALeRT-COVID using attention-based recurrent neural network (RNN) architecture to predict the epidemic trends for different countries. A source model was trained on the pre-defined source countries and then transferred to each target country. The lockdown measure was introduced to our model as a predictor and the attention mechanism was utilized to learn the different contributions of the confirmed cases in the past days to the future trend. Results demonstrated that the transfer learning strategy is helpful especially for early-stage countries. By introducing the lockdown predictor and the attention mechanism, ALeRT-COVID showed a significant improvement on the prediction performance. We predicted the confirmed cases in one week when extending and easing lockdown separately. Results showed the lockdown measures is still necessary for a number of countries. We expect our research can help different countries to make better decisions on the lockdown measures.


title: Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China

text: This study investigated psychiatric symptoms (depression, anxiety, and traumatic stress) during state-enforced quarantine among university students in China. We conducted a cross-sectional survey with 1,912 university students during March and April 2020. Psychiatric symptoms in the mild or higher range based on clinical cut-offs were alarmingly prevalent: 67.05% reported traumatic stress symptoms, 46.55% had depressive symptoms, and 34.73% reported anxiety symptoms. Further, 19.56% endorsed some degree of suicidal ideation. We explored factors that may contribute to poor psychological health as well as those that may function as protective factors. Risk and protective factors examined included demographic variables, two known protective factors for mental health (mindfulness, perceived social support), four COVID-specific factors (COVID-19 related efficacy, perceived COVID-19 threat, perceived COVID-19 societal stigma, COVID-19 prosocial behavior) and screen media usage. Across psychiatric symptom domains, mindfulness was associated with lower symptom severity, while COVID-19 related financial stress, perceived COVID-19 societal stigma, and perceived COVID-19 threat were associated with higher symptom severity. COVID-19 threat and COVID-19 stigma showed main and interactive effects in predicting all mental health outcomes, with their combination associated with highest symptom severity. Average screen media device usage was 6 hours and usage was positively associated with depression. Female gender and COVID-19 prosocial behavior were associated with higher anxiety, while COVID-19 self-efficacy associated with lower anxiety symptoms. Study limitations and implications for treatment and prevention of affective disorders during crisis are discussed.


Will the COVID-19 pandemic have a silver lining? An Indian perspective


title: Using heparin molecules to manage COVID‐2019

text: The COVID‐19 (coronavirus disease 2019) pandemic is becoming one of the largest global public health crises in modern history. The race for an effective drug to prevent or treat the infection is the highest priority among healthcare providers, government officials and the pharmaceutical industry. Recent evidence reports that the use of low‐molecular weight heparin reduces mortality in severe coronavirus patients with coagulopathy. Although the full scope of the benefits from heparin for COVID‐19 patients is unfolding, encouraging clinical data suggest that heparin‐like molecules may represent a useful approach to treat or prevent SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2) infection. This article intends to offer our opinions on the mechanism(s) by which heparin may attenuate the course of SARS‐CoV‐2 infection. Furthermore, we propose a novel strategy to treat or prevent SARS‐CoV‐2 infection using ‘designer’ heparin molecules that are fabricated using a synthetic biology approach.


title: A Letter to the Future AWWA

text: Dear Future AWWA Members, I'm writing to you on the 139th birthday of the American Water Works Association, and what a strange time it is We are in the midst of a global pandemic A disease called COVID‐19 is spreading so quickly that we are running short on hospital beds and people are hoarding toilet paper At this moment, the United States has more confirmed cases than any other country and Canada is ranked 15th But I am not writing to tell you about the tragedy of COVID‐19;I imagine the history books will capture that This is a letter about how today's water professionals are rising to the challenge through their selfless and often uncelebrated acts of courage They are building on the legacy of water professionals throughout AWWA's history, and I wish you were here to witness it As you—the future AWWA—look back on spring 2020, you will clearly see how access to safe, reliable water was critical in halting the spread of COVID‐19 The simplest example I can provide is handwashing The practice of handwashing for at least 20 seconds, with plenty of soap, has never seemed so important Now, we are a society uniformly obsessed with washing our hands Because tap water is critical to personal hygiene and protecting the public's health, the US Environmental Protection Agency this week sent a letter to all governors, reminding them that water utility workers and water sector businesses that support water utilities should be considered “essential” as communities impose orders to keep people at home And in another sign of the essential nature of water service in a public health crisis, utilities are suspending water shutoffs and, in many cases, restoring service to customers who had previously been shut off But it isn't these policy decisions I hope you'll remember It's the exemplary—and yes, courageous—commitment of your predecessors in the water profession Each day, water professionals are delivering safe water to their communities and then cleaning the wastewater before returning it to the environment Never has this daily routine seemed more extraordinary These days, we are all being asked to participate in “social distancing,” a term that most had never heard of before COVID‐19 As schools and restaurants close and citizens are ordered to stay at home, your predecessors in the water profession continue to do what it takes to keep the water flowing, whether that is repairing mains, unclogging sewer lines (you can't imagine what some people do in the absence of toilet paper!), or ensuring treatment equipment is functioning properly Many water professionals are stationed 24/7 at treatment plants They are living apart from their own families so they can protect all of our families The ongoing pandemic has given our society new appreciation for the work of health professionals, police, and other first responders I would say that water professionals are not only first responders, but “everyday” responders They are the super‐heroes we don't need to summon because they are already on the scene I am certain that in time we will be able to return to a more normal state, where a handshake is a handshake and not an elbow bump And when we do, I hope that we—and the people who live in the communities we serve—remember that water is critical to everything we care about and that it played a crucial role in eliminating COVID‐19 It is not an overstatement to say that others’ lives were in the hands of water professionals during the pandemic Poet and philosopher George Santayana is known for saying, “Those who cannot remember the past are condemned to repeat it ” In this case, however, it would be wise to remember and repeat selfless acts like those of water professionals facing COVID‐19 in the spring of 2020 In closing, Happy Birthday, AWWA, and my thanks to all who are members today and in the future Your commitment to the legacy of safe and reliable water service is, quite literally, life‐saving Sincerely, David B LaFrance Chief Executive Officer, American Water orks Association


title: Re-emergence of TIVA in COVID times

text: Total intravenous anaesthesia (TIVA) is a technique of general anaesthesia (GA) given via intravenous route exclusively. In perspective of COVID-19, TIVA is far more advantageous than inhalational anaesthesia. It avoids the deleterious effects of immunosuppression and lacks any respiratory irritation, thus providing an edge in the current situation. Many peripheral surgeries can be done with the patient breathing spontaneously without any airway device, thus avoiding airway instrumentation leading to droplet and aerosol generation. Intravenous agents can be utilized to provide sedation during regional anaesthesia (RA), which can easily be escalated to contain pain due to sparing of blocks or receding neuraxial anaesthesia. The present narrative review focuses on the merits of adopting TIVA technique during this pandemic so as to decrease the risk and morbidity arising from anaesthetizing COVID-19 patients.


Transmission via aerosols: Plausible differences among emerging coronaviruses


title: Ruxolitinib to be tested in fight against COVID-19

text: Drugmakers Incyte and Novartis are gearing up for a Phase III clinical trial of their drug ruxolitinib to see if it can help patients with severe COVID-19, the respiratory disease caused by the new coronavirus Doctors think the compound might dampen the out-of-control immune response—known as a cytokine storm—seen in people with severe COVID-19 If the cytokine storm can be tempered before there is significant damage to the lungs, patients might not require ventilators or might need them for less time and have a better chance of surviving the disease Plans for the randomized trial were announced April 2 The trial will compare the outcomes of about 350 hospitalized patients who get either ruxolitinib or the current best standard of care without the drug Severe COVID-19 patients unable to enroll in a trial can still get the drug through a so-called open-label study, in which both the doctor and patient


Tragic Intersection: Where the Back Pain Crisis and the COVID-19 Pandemic MeetTriaging Telehealth in Wound Care: Embracing the Regulations within Your Workflows


title: Multi-Antigenic Virus-like Particle of SARS CoV-2 produced in Saccharomyces cerevisiae as a vaccine candidate

text: Spike, Envelope and Membrane proteins from the SARS CoV-2 virus surface coat are important vaccine targets. We hereby report recombinant co-expression of the three proteins (Spike, Envelope and Membrane) in a engineered Saccharomyces cerevisiae platform (D-Crypt™) and their self-assembly as Virus-like particle (VLP). This design as a multi-antigenic VLP for SARS CoV-2 has the potential to be a scalable vaccine candidate. The VLP is confirmed by transmission electron microscopy (TEM) images of the SARS CoV-2, along with supportive HPLC, Dynamic Light Scattering (DLS) and allied analytical data. The images clearly outline the presence of a “Corona” like morphology, and uniform size distribution.


title: Analysis of SARS-CoV-2 specific T-cell receptors in ImmuneCode reveals cross-reactivity to immunodominant Influenza M1 epitope

text: Adaptive Biotechnologies and Microsoft have recently partnered to release ImmuneCode, a database containing SARS-CoV-2 specific T-cell receptors derived through MIRA, a T-cell receptor (TCR) sequencing based sequencing approach to identify antigen-specific TCRs. Herein, we query the extent of cross reactivity between these derived SARS-CoV-2 specific TCRs and other known antigens present in McPas-TCR, a manually curated catalogue of pathology-associated TCRs. We reveal cross reactivity between SARS-CoV-2 specific TCRs and the immunodominant Influenza GILGFVFTL M1 epitope, suggesting the importance of further work in characterizing the implications of prior Influenza exposure or co-exposure to the pathology of SARS-CoV-2 illness.


title: Diagnosis and Prediction Model for COVID19 Patients Response to Treatment based on Convolutional Neural Networks and Whale Optimization Algorithm Using CT Images

text: The outbreak of coronavirus diseases (COVID-19) has rabidly spread all over the world. The World Health Organization (WHO) has announced that coronavirus COVID19 is an international pandemic. The Real-Time Reverse transcription polymerase Chain Reaction (RTPCR) has a low positive and sensitivity rate in the early stage of COVID19. As a result, the Computed Tomography (CT) imaging is used for diagnosing. COVID19 has different key signs on a CT scan differ from other viral pneumonia. These signs include ground glass opacities, consolidations, and crazy paving. In this paper, an Artificial Intelligence-inspired Model for COVID19 Diagnosis and Prediction for Patient Response to Treatment (AIMDP) is proposed. AIMDP model has two main functions reflected in two proposed modules, namely, the Diagnosis Module (DM) and Prediction Module (PM). The Diagnosis Module (DM) is proposed for early and accurately detecting the patients with COVID 19 and distinguish it from other viral pneumonias using COVID19 signs obtained from CT scans. The DM model, uses Convolutional Neural Networks (CNNs) as a Deep learning technique for segmentation, can process hundreds of CT images in seconds to speed up diagnosis of COVID19 and contribute in its containment. In addition, some countries have no ability to provide all patients with the treatment and intensive care services, so it will be mandatory to give treatment to only responding patients. In this context, the Prediction Module (PM) is proposed for predicting the ability of the patient to respond to treatment based on different factors e.g. age, infection stage, respiratory failure, multi-organ failure and the treatment regimens. PM implement the Whale Optimization Algorithm for selecting the most relevant patients features. The experimental results show promising performance for the proposed diagnosing and prediction modules, using a dataset with hundreds of real data and CT images.


Primary Care Practitioners' Response to 2019 Novel Coronavirus Outbreak in China


docid: umqowine

title: Clinical features, Diagnosis, and Treatment of COVID-19: A systematic review of case reports and case series

text: Objectives: The 2019 novel coronavirus (COVID-19) has been declared a public health emergency worldwide. The objective of this systematic review was to characterize the clinical, diagnostic, and treatment characteristics of patients presenting with COVID-19. Methods: We conducted a structured search using PubMed/Medline, Embase, Web of Science and the Cochrane Library to collect both case reports and case series on COVID-19 published up to February 30, 2020. Results: Thirty-four articles were included analyzing a total of 99 patients with a mean age of 46.2 years. The most common presenting symptom in patients who tested positive for COVID-19 was fever, reported in up to 83% of patients from 76.4% of the analyzed studies. Other symptoms including rhinorrhea, dizziness, and chills were less frequently reported. Additionally, in studies which reported C-reactive protein (CRP) measurements (44%), a large majority of patients displayed an elevated CRP (73%). Progression to acute respiratory distress syndrome (ARDS) was the most common complication of patients testing positive for COVID-19 (33%). CT images displayed ground-glass opacification (GGO) patterns (80%) as well as bilateral lung involvement (71.0%). The most commonly used antiviral treatment modalities included, lopinavir (HIV protease inhibitor), arbidiol hydrochloride (influenza fusion inhibitor), and oseltamivir (neuraminidase inhibitor). Conclusions: Development of ARDS may play a role in estimating disease progression and mortality risk. Early detection of elevations in serum CRP, combined with a clinical COVID-19 symptom presentation may be used as a surrogate marker for presence and severity of disease. There is a paucity of data surrounding the efficacy of treatments. There is currently not a well-established gold standard therapy for the treatment of diagnosed COVID-19. Further prospective investigations are necessary.


title: Hypertension and Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Covid-19

text: Introduction: COVID-19 disproportionately affects those with comorbidities and the elderly. Hypertension is the most common pre-existing condition amongst COVID-19 patients. Upregulation of the renin-angiotensin-aldosterone system (RAAS) is common in hypertensive patients and may promote inflammation and ensuing cytokine storm in COVID-19. It is unknown whether RAAS inhibition with ACE1 inhibitors or angiotensin-receptor blockers (ARB) can be harmful or beneficial. Methods: Within Hackensack Meridian Health network, the largest healthcare provider in New Jersey, we performed a retrospective, multicenter, convenience sampling study of hospitalized COVID-19 patients. Demographics, clinical characteristics, treatments, and outcomes were manually abstracted. Fishers exact tests, and logistic regression were performed. Results: Among 3017 hospitalized COVID-19 patients, 1584 (52.5%) carried a diagnosis of hypertension. In the discharged or deceased cohort, the overall mortality was significantly increased at 35% vs 13% among COVID-19 patients with hypertension. However, when adjusted for age, the effect of hypertension on mortality was greatly diminished, with a reduction in odds-ratio by over half; and completely disappeared when adjusted for other major covariates. The mortality rates were lower for hypertensive patients prescribed ACE1 (27%, p=0.001) or ARBs (33%, p=0.12) compared to other anti-hypertensive agents (39%) in the unadjusted analyses. RAAS inhibitor therapy appeared protective compared to other anti-hypertensive agents (p=0.001). Conclusions: While our results are limited by the retrospective nature of our study and by potential confounders, our data argue against a harmful effect of RAAS inhibition and support the HFSA/AHA/ACC joint statement recommending continuing ACE1 and ARB therapy in hypertensive COVID-19 patients.


title: Predicting COVID-19 Pandemic in Saudi Arabia Using Modified Singular Spectrum Analysis

text: This research presents a modified Singular Spectrum Analysis (SSA) approach for the analysis of COVID-19 in Saudi Arabia. We have proposed this approach and developed it in [1,2,3] for separability and grouping step in SSA, which plays an important role for reconstruction and forecasting in the SSA. The modified SSA mainly enables us to identify the number of the interpretable components required for separability, signal extraction and noise reduction. The approach was examined using different number of simulated and real data with different structures and signal to noise ratio. In this study we examine its capability in analysing COVID-19 data. Then, we use Vector SSA for predicting new data points and the peak of this pandemic. The results shows that the approach can be used as a promising one in decomposing and forecasting the daily cases of COVID-19 in Saudi Arabia.


docid: hxeijsmu

title: IN-UTERO MOTHER-TO-CHILD SARS-CoV-2 TRANSMISSION: viral detection and fetal immune response

text: Pregnancy is known to increase the risk of severe illnesses in response to viral infections. Therefore, the impact of SARS-CoV-2 infection during gestational ages might be detrimental and the potential vertical transmission should be thoroughly studied. Herein, we investigated whether SARS-CoV-2 vertical transmission is possible and, in case, whether this results in a fetal involvement. Additionally, we analyzed the role of the antibody and the inflammatory responses in placenta and plasma from SARS-CoV-2-positive pregnant women and fetuses. 31 SARS-CoV-2 pregnant women were enrolled. Real-time PCR was performed to detect the virus on maternal and newborns nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma, placenta and umbilical cord biopsies, amniotic fluids and milk. Maternal and umbilical cord plasma, and milk were tested for specific anti-SARS-CoV-2 antibodies. RNA expression quantification of genes involved in the inflammatory response was performed on four selected placentas. On maternal and umbilical cord plasma of the same subjects, secreted cytokines/chemokines were quantified. SARS-CoV-2 is found in at-term placentae and in the umbilical cord blood, in the vaginal mucosa of pregnant women and in milk. Furthermore, we report the presence of specific anti-SARS-CoV-2 IgM and IgG antibodies in the umbilical cord blood of pregnant women, as well as in milk specimens. Finally, a specific inflammatory response is triggered by SARS-CoV-2 infection in pregnant women at both systemic and placental level, and in umbilical cord blood plasma. Our data strongly support the hypothesis that in-utero vertical transmission is possible in SARS-CoV-2 positive pregnant women. This is essential for defining proper obstetric management of COVID-19 pregnant women, or putative indications for mode and timing of delivery.


title: Detecting Robust Patterns in the Spread of Epidemics: A Case Study of Influenza in the United States and France

text: In this paper, the authors develop a method of detecting correlations between epidemic patterns in different regions that are due to human movement and introduce a null model in which the travel-induced correlations are cancelled. They apply this method to the well-documented cases of seasonal influenza outbreaks in the United States and France. In the United States (using data for 1972-2002), the authors observed strong short-range correlations between several states and their immediate neighbors, as well as robust long-range spreading patterns resulting from large domestic air-traffic flows. The stability of these results over time allowed the authors to draw conclusions about the possible impact of travel restrictions on epidemic spread. The authors also applied this method to the case of France (1984-2004) and found that on the regional scale, there was no transportation mode that clearly dominated disease spread. The simplicity and robustness of this method suggest that it could be a useful tool for detecting transmission channels in the spread of epidemics.


title: Knowledge, attitude and practice of secondary school students toward COVID-19 epidemic in Italy: a cross selectional study

text: The coronavirus disease (COVID-19) is a highly transmittable and pathogenic viral infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which emerges in December 2019 in Wuhan, China and spreads around the world at the beginning of 2020. The World Health Organization declares the outbreak a Public Health Emergency of International Concern on the 30th of January, and a pandemic on the 11th of March. On the 4th of March, the Italian government orders the full closure of all schools and universities nationwide. The aim of this study is to investigate the knowledge, practice and attitudes (KAP) of secondary school at the time of COVID-19 pandemic in Italy. In this cross-sectional, web-based survey, conducted among the high school student population with age ranging from 14 to 19 years old, a questionnaire with 19 items regarding the KAP toward COVID-19 is asked. Study participants are recruited from several secondary schools of different areas. Frequencies and histograms are computed for descriptive purposes. Statistical analysis is computed with Chi square test, utilized to depict relevant difference between geender. Among a total of 2380 students who answers the questionnaire, 40.7% are male and 59.3% are female. Level of knowledge about generical characteristics of COVID-19 is quite similar among gender. Students present a good level of knowledge about the clinical presentation of the disease, the basic hygiene principles, the modes of transmission and the method of protection against virus transmission. The knowledge about number of this pandemia and easy scientific correlation with COVID-19 is quite confused. The most frequently reported source of knowledge about COVID-19 is television, whereas the less is the school. Our findings suggest that student population shows appropriate practice, and positive attitude towards COVID-19 at the time of its outbreak. More emphasis should be placed on education of the student partecipants about biological meaning of this infection and relative preventive or future measures.


title: Physician Burnout, Interrupted

text: The burnout problem won’t be solved without addressing the issues of autonomy, competence, and relatedness During the Covid-19 pandemic, a sense of altruism and urgency has catalyzed restoration of these pillars of intrinsic motivation Can these changes be sustained?


title: Appendix

text: Unknown