title: DVT incidence and risk factors in critically ill patients with COVID-19

text: Few data are available on the incidence of deep vein thrombosis (DVT) in critically ill COVID-19 with thrombosis prophylaxis. This study retrospectively included 88 patients in the ICU with critically ill COVID-19 at Jinyintan Hospital in Wuhan, China. All patients underwent compression ultrasonography for identifying DVT. Firth logistic regression was used to examine the association of DVT with sex, age, hypoalbuminemia, D-dimer, and SOFA score. The median (interquartile range [IQR]) age and SOFA score of 88 patients were 63 (55-71) years old and 5 (4-6), respectively. Despite all patients receiving guideline-recommended low-molecular-weight heparin (LMWH) thromboprophylaxis, the incidence of DVT was 46% (95% CI 35-56%). Proximal DVT was recognized in 9% (95% CI 3-15%) of the patients, while 46% (95% CI 35-56%) of patients had distal DVT. All of the proximal DVT combined with distal DVT. Risk factors of DVT extension occurred in all distal DVT patients. As Padua score ≥ 4 or IMPROVE score ≥ 2, 53% and 46% of patients had DVT, respectively. Mortality was higher in patients with acute DVT (30%) compared with non-DVT (17%), but did not reach statistical significance. Hypoalbuminemia (odds ratio [OR], 0.17; 95% CI 0.06-0.05, P = 0.001), higher SOFA score (OR per IQR, 2.07; 95% CI 1.38-3.39, P = 0.001), and elevated D-dimer (OR per IQR, 1.04; 95% CI 1.03-1.84, P = 0.029) were significant DVT risk factors in multivariable analyses. High incidence of DVT was identified in patients with critically ill COVID-19, despite the use of guideline-recommended pharmacologic thromboprophylaxis. The presence of hypoalbuminemia, higher SOFA score, and elevated D-dimer were significantly independent risk factors of DVT. More effective VTE prevention and management strategies may need to be addressed.


title: Navigating Immunosuppression in a Pandemic: A Guide for the Dermatologist from the COVID Task Force of the Medical Dermatology Society and Society of Dermatology Hospitalists

text: Dermatologists treating immune-mediated skin disease must now contend with the uncertainties associated with immunosuppressive use in the context of the SARS-CoV-2 pandemic. Though the risk of infection with many commonly used immunosuppressive agents remains low, direct data evaluating the safety of such agents in COVID-19 are scarce. This article reviews and offers guidance based upon currently available safety data, and the most recent COVID-19 outcome data, in patients with immune-mediated dermatologic disease. The interdisciplinary panel of experts emphasize a stepwise, shared decision-making approach in the management of immunosuppressive therapy. The goal of this article is to help providers minimize the risk of disease flares while simultaneously minimizing the risk of iatrogenic harm during an evolving pandemic.


title: Innate Immune Signaling and Proteolytic Pathways in the Resolution or Exacerbation of SARS-CoV-2 in Covid-19: Key Therapeutic Targets?

text: COVID-19 is caused by the Severe Acute Respiratory Syndrome (SARS) coronavirus (Cov)-2, an enveloped virus with a positive-polarity, single-stranded RNA genome. The initial outbreak of the pandemic began in December 2019, and it is affecting the human health of the global community. In common with previous pandemics (Influenza H1N1 and SARS-CoV) and the epidemics of Middle east respiratory syndrome (MERS)-CoV, CoVs target bronchial and alveolar epithelial cells. Virus protein ligands (e.g., haemagglutinin or trimeric spike glycoprotein for Influenza and CoV, respectively) interact with cellular receptors, such as (depending on the virus) either sialic acids, Dipeptidyl peptidase 4 (DPP4), or angiotensin-converting enzyme 2 (ACE2). Host proteases, e.g., cathepsins, furin, or members of the type II transmembrane serine proteases (TTSP) family, such as Transmembrane protease serine 2 (TMPRSS2), are involved in virus entry by proteolytically activating virus ligands. Also involved are Toll Like Receptor (TLR) family members, which upregulate anti-viral and pro-inflammatory mediators [interleukin (IL)-6 and IL-8 and type I and type III Interferons among others], through the activation of Nuclear Factor (NF)-kB. When these events (virus cellular entry and innate immune responses) are uncontrolled, a deleterious systemic response is sometimes encountered in infected patients, leading to the well-described "cytokine storm" and an ensuing multiple organ failure promoted by a downregulation of dendritic cell, macrophage, and T-cell function. We aim to describe how the lung and systemic host innate immune responses affect survival either positively, through downregulating initial viral load, or negatively, by triggering uncontrolled inflammation. An emphasis will be put on host cellular signaling pathways and proteases involved with a view on tackling these therapeutically.


title: Agent-based Simulation of Pedestrian Dynamics for Exposure Time Estimation in Epidemic Risk Assessment

text: With the Corona Virus Disease 2019 (COVID-19) pandemic spreading across the world, protective measures for containing the virus are essential, especially as long as no vaccine or effective treatment is available. One important measure is the so-called physical distancing or social distancing. In this paper, we propose an agent-based numerical simulation of pedestrian dynamics in order to assess behaviour of pedestrians in public places in the context of contact-transmission of infectious diseases like COVID-19, and to gather insights about exposure times and the overall effectiveness of distancing measures. To abide the minimum distance of $1.5m$ stipulated by the German government at an infection rate of 2%, our simulation results suggest that a density of one person per $16m^2$ or below is sufficient. The results of this study give insight about how physical distancing as a protective measure can be carried out more efficiently to help reduce the spread of COVID-19.


COVID-19: the perspective of Italian embryologists managing the IVF laboratory in pandemic emergency


title: [Robotic and laparosocpic urological surgery during COVID-19 pandemia.]

text: OBJECTIVE: SARS-CoV-2 pandemic hashigh repercussion on urologic minimally invasive surgery (MIS) Controversy about safety of MIS procedures during COVID-19 pandemic has been published Nowadays, our priority should be create agreement in order to restart and organize MIS with safety conditions for patients and healthcare workers METHODS: Pubmed and web search was conducted with following terms: "SARS-CoV-2", "COVID19", "COVID19 Urology", COVID19 Surgery", "COVID19 transmission", "SARS-CoV-2 transmission", "COVID19 nd minimally invasive surgery", "SARS-CoV-2 and CO 2insuflation" A narrative review of available literature and scientific evidence summary was done A modify nominal group technique was used to achieve an expert consensus First draft was circulated amongst authors Definitive document was approved in May 26th RESULTS: Non evidence supports higher risk of SARSCoV-2 healthcare workers infection with MIS compared to open surgery MIS is associated with shorter hospital stay than open surgery Modify MIS indications to open surgery, with no scientific evidence, could spend valuable resources in detriment to COVID-19 patients MIS indications should be prioritized attending to available resources and pandemic intensity SARS-CoV-2screening 72 hours prior to surgery by clinical and epidemiological questionnaire and nasopharyngeal PCRis recommended, in order to prevent nosocomial transmission, professional infections and to minimize postoperative complications Intraoperative steps should be established to reduce professional exposure to surgical aerosols, including: surgical room reorganization, adequate personal protective equipment, surgical technique optimization and management of CO2 and surgical smoke CONCLUSIONS: In COVID-19 pandemic de-escalation, MIS carried out with optimal safety measurements, could contribute to reduce hospital resources utilization With current evidence, MIS should not be limited or reconverted to open surgery during COVID-19 pandemic


title: Robotic and laparosocpic urological surgery during COVID-19 pandemia./ Situacion de la cirugia laparoscopica y robotica urologica durante la pandemia COVID-19

text: OBJECTIVE: SARS-CoV-2 pandemic hashigh repercussion on urologic minimally invasive surgery (MIS) Controversy about safety of MIS procedures during COVID-19 pandemic has been published Nowadays, our priority should be create agreement in order to restart and organize MIS with safety conditions for patients and healthcare workers METHODS: Pubmed and web search was conducted with following terms: "SARS-CoV-2", "COVID19", "COVID19 Urology", COVID19 Surgery", "COVID19 transmission", "SARS-CoV-2 transmission", "COVID19 nd minimally invasive surgery", "SARS-CoV-2 and CO 2insuflation" A narrative review of available literature and scientific evidence summary was done A modify nominal group technique was used to achieve an expert consensus First draft was circulated amongst authors Definitive document was approved in May 26th RESULTS: Non evidence supports higher risk of SARSCoV-2 healthcare workers infection with MIS compared to open surgery MIS is associated with shorter hospital stay than open surgery Modify MIS indications to open surgery, with no scientific evidence, could spend valuable resources in detriment to COVID-19 patients MIS indications should be prioritized attending to available resources and pandemic intensity SARS-CoV-2screening 72 hours prior to surgery by clinical and epidemiological questionnaire and nasopharyngeal PCRis recommended, in order to prevent nosocomial transmission, professional infections and to minimize postoperative complications Intraoperative steps should be established to reduce professional exposure to surgical aerosols, including: surgical room reorganization, adequate personal protective equipment, surgical technique optimization and management of CO2 and surgical smoke CONCLUSIONS: In COVID-19 pandemic de-escalation, MIS carried out with optimal safety measurements, could contribute to reduce hospital resources utilization With current evidence, MIS should not be limited or reconverted to open surgery during COVID-19 pandemic OBJETIVO: La pandemia provocada por el nuevo coronavirus SARS-CoV-2 ha tenido una elevada repercusion sobre la cirugia minimamente invasiva (CMI) Ha surgido una importante controversia sobre la realizacion de CMI durante la pandemia COVID-19 Es prioritario, establecer un consenso sobre la organizacion y realizacion con seguridad de la CMI durante la pandemia MATERIAL Y METODOS: Se realizo una busqueda web y en PubMed con los terminos: SARS-CoV-2, COVID19,COVID19 Urology, COVID19 Surgery, COVID19 transmission, SARS-CoV-2 transmission, COVID19 and minimally invasive surgery, SARSCoV-2 and CO2 insuflation Se realizo una revision narrativa de la literatura y una sintesis de la evidencia disponible Se ha utilizado una tecnica de grupo nominal modificada, circulando un primer borrador a todos los autores y aprobandose la version definitiva el dia 26 de Mayo de 2020 RESULTADOS: No existe evidencia sobre una mayor exposicion a SARS-CoV-2 en CMI respecto a cirugia abierta La CMI se asocia a una menor estancia hospitalaria por lo que cambiar, sin justificacion, la indicacionde CMI puede retrotraer recursos que podrian ser utilizados para la pandemia COVID-19 Se debepriorizar la CMI segun los recursos disponibles y la intensidad de la pandemia en cada momento Se recomienda realizar despistaje de SARS-CoV-2 mediante cuestionario clinico-epidemiologico y PCR nasofaringea 72 horas antes de la CMI electiva, para minimizar las complicaciones postoperatorias, evitar la transmisioncruzada entre pacientes y la posible exposicion de los profesionales sanitarios Se recomienda establecer medidas de organizacion en quirofano, de proteccion personal, tecnica quirurgica y manejo del CO2 y aerosoles generados para reducir la exposicion y riesgos del personal sanitario CONCLUSIONES: La CMI realizada con las medidasd e seguridad adecuadas para el paciente y profesionales, puede contribuir durante la desescalada a una menor utilizacion de recursos sanitarios y por tanto, no debe limitarse su utilizacion o cambiar sus indicaciones


Letter to the Editor: COVID-19 and Perioperative Considerations


Reply to: Hedenstierna et al, Haouzi et al, Maley et al, Fowler et al, Bhatia and Mohammed, Bos, & Koumbourlis and Motoyama


title: Management of a delivery suite during the COVID-19 epidemic

text: BACKGROUND: Since the first report of the new coronavirus (COVID-19) infection in December of 2019, it has become rapidly prevalent and been declared as a Public Health Emergency of International Concern by the World Health Organization. There are quite a few cases reported involving delivery with COVID-19 infection, but little valuable suggestion was provided about what healthcare providers of obstetrics and neonatology should do in their clinic practice for unknown status or presumed negative women. Here, we summarized the current practice of delivery management in China that successfully prevented rapid increase in adverse pregnancy outcomes and nosocomial infection in departments of obstetrics and neonatology during the pandemic of COVID-19.


docid: pycngobf

title: SBDiEM: A new Mathematical model of Infectious Disease Dynamics

text: A worldwide multi-scale interplay among a plethora of factors, ranging from micro-pathogens and individual or population interactions to macro-scale environmental, socio-economic and demographic conditions, entails the development of highly sophisticated mathematical models for robust representation of the contagious disease dynamics that would lead to the improvement of current outbreak control strategies and vaccination and prevention policies. Due to the complexity of the underlying interactions, both deterministic and stochastic epidemiological models are built upon incomplete information regarding the infectious network. Hence, rigorous mathematical epidemiology models can be utilized to combat epidemic outbreaks. We introduce a new spatiotemporal approach (SBDiEM) for modeling, forecasting and nowcasting infectious dynamics, particularly in light of recent efforts to establish a global surveillance network for combating pandemics with the use of artificial intelligence. This model can be adjusted to describe past outbreaks as well as COVID-19. Our novel methodology may have important implications for national health systems, international stakeholders and policy makers.


Sanitization of glaucoma clinic instruments in COVID-19 era


title: Molecular basis of COVID-19 relationships in different species: a one health perspective

text: Outside the Hubei province, China, the mild form of infection and the progressive recover of the COVID-19 patients suggest the intervention of "unconventional" biological mechanisms worthy of attention. Based on the high-homology between the Spike protein epitopes of taxonomically-related coronaviruses, we hypothesized that past contact with infected dogs shield humans against the circulating SARS-CoV-2. Elseways, the recurrent virus exposure over a short time-lapse might result in the Antibody Dependent Enhancement, triggering the violent immune reaction responsible for the severe clinical outcomes observed in the Hubei province. Nevertheless, further experimental studies are desired for a confidential evaluation of the postulated hypotheses.


title: Clinical orthodontic management during the COVID-19 pandemic

text: OBJECTIVES: To provide a comprehensive summary of the implications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) on orthodontic treatment, contingency management, and provision of emergency orthodontic treatment, using currently available data and literature. MATERIALS AND METHODS: Orthodontically relevant sources of information were searched using electronic databases including PubMed and Google Scholar and current reports from major health bodies such as Centers of Disease Control and Prevention, World Health Organization, National Institutes of Health, and major national orthodontic associations. RESULTS: Where available, peer-reviewed and more recent publications were given priority. Due to the rapidly evolving nature of COVID-19 and limitations in quality of evidence, a narrative synthesis was undertaken. Relevant to orthodontics, human-to human transmission of SARS-CoV-2 occurs predominantly through the respiratory tract via droplets, secretions (cough, sneeze), and or direct contact, where the virus enters the mucous membrane of the mouth, nose, and eyes. The virus can remain stable for days on plastic and stainless steel. Most infected persons experience a mild form of disease, but those with advanced age or underlying comorbidities may suffer severe respiratory and multiorgan complications. CONCLUSIONS: During the spread of the COVID-19 pandemic, elective orthodontic treatment should be suspended and resumed only when permitted by federal, provincial, and local health regulatory authorities. Emergency orthodontic treatment can be provided by following a contingency plan founded on effective communication and triage. Treatment advice should be delivered remotely first when possible, and where necessary, in-person treatment can be performed in a well-prepared operatory following the necessary precautions and infection prevention and control (IPAC) protocol.


title: Coronavirus Outbreak in Nigeria: Burden and Socio-Medical Response during the First 100 Days

text: BACKGROUND: The coronavirus disease of 2019 (COVID-19) pandemic shocked the world, overwhelming the health systems of even high-income countries. Expectedly, the situation has elicited social and medical responses from the public and governments respectively. Nigeria recorded an imported case from Italy on February 27, 2020. Hence, this paper assesses the early socio-medical response to COVID-19 in Nigeria within the first 100 days after the index case. The paper employs analytical methods and collates data from various media reports and official sources. FINDINGS: The incidence of COVID-19 grows steadily in Nigeria, moving from an imported case and elitist pattern to community transmission. The case fatality stood at 2.8%. The country recorded an upsurge (52% of total cases) in the transmission of COVID-19 during the short period the lockdown was relaxed. The paper presents a concise response framework to highlight some specific multisectoral responses to the pandemic. A combination of social and medical responses help Nigeria to curtail the spread of the virus to a large extent. CONCLUSION: The potential of overwhelming COVID-19 is still imminent in Nigeria as the country is attempting to hurriedly open the economy, which could sacrifice public health gains for temporary economic gains.


title: Covid-19 impact on air quality in megacities

text: Air pollution is among the highest contributors to mortality worldwide, especially in urban areas. During spring 2020, many countries enacted social distancing measures in order to slow down the ongoing Covid-19 pandemic. A particularly drastic measure, the"lockdown", urged people to stay at home and thereby prevent new Covid-19 infections. In turn, it also reduced traffic and industrial activities. But how much did these lockdown measures improve air quality in large cities, and are there differences in how air quality was affected? Here, we analyse data from two megacities: London as an example for Europe and Delhi as an example for Asia. We consider data during and before the lockdown and compare these to a similar time period from 2019. Overall, we find a reduction in almost all air pollutants with intriguing differences between the two cities. In London, despite smaller average concentrations, we still observe high-pollutant states and an increased tendency towards extreme events (a higher kurtosis during lockdown). For Delhi, we observe a much stronger decrease of pollution concentrations, including high pollution states. These results could help to design rules to improve long-term air quality in megacities.


title: Characteristics and Clinical Outcomes of COVID-19 Patients in an Underserved-Inner City Population: A Single Tertiary Center Cohort

text: BACKGROUND: There is limited information describing the characteristics and clinical outcomes of patients infected with coronavirus disease 2019 (COVID-19) especially those in underserved urban area with minority population in the United States. METHODS: This is a retrospective single center study for patients who were admitted with COVID-19 infection. Data collection was from March 1 through April 24,2020. Demographic, clinical, laboratory, and treatment data were presented using descriptive statistics and frequencies. Chi-square test and multivariate logistic regression were used to determine association of risk factors and clinical outcomes. RESULTS: A total of 242 inpatients were included with a mean age of 66 ±14.75 (±SD). 50% were female and 70% were African American. Comorbidities included hypertension (74%), diabetes mellitus (49%), and 19% had either COPD or asthma. Older age was associated with higher risk of inpatient death OR 1.056 [95% CI 1.023 to 1.090; p=0.001]. Inpatient mortality occurred in 70% who needed mechanical ventilation (OR: 29.51; 95% CI: 13.28-65.60; p<0.0001), 58% who required continuous renal replacement therapy/hemodialysis (CRRT/HD) (OR: 6.63; 95% CI: 2.74-16.05; p<0.0001), and 69% who needed vasopressors (OR: 30.64; 95% CI: 13.56 to 69.20; p<0.0001). Amongst biomarkers of disease severity, only baseline CRP levels (145±116 mg/L) were associated with mortality OR 1.008 [95% CI 1.003 to 1.012; p=0.002]. CONCLUSION: Majority of hospitalized patients had hypertension and diabetes. Older age was an independent risk factor for inpatient mortality. Requirement of mechanical ventilation, vasopressor use, and CRRT/HD were associated significantly with inpatient mortality. Higher baseline CRP was significantly associated with inpatient death. This article is protected by copyright. All rights reserved.


title: Nasal Swab as Preferred Clinical Specimen for Covid-19 Testing in Children

text: The first pediatric study demonstrating significantly higher positivity rate of nasal (mid-turbinate) swab testing over oropharyngeal swab testing in detecting SARS-CoV-2 (Fisher exact test 0.046, Cohen K 0.43, confidence interval 95%, 0.014-0.855). Benefits might include lower collection-related hazard for healthcare workers. We recommend it as preferred choice for swab-based SARS-CoV-2 testing in children.


Keeping a cut above the coronavirus disease: surgical perspectives from a public health institution in Singapore during Covid-19


title: Children's Respiratory Infections in Tianjin Area, China: Associations with Home Environments and Lifestyles

text: Children spend most of their indoors time at home, which may have substantial influence on their health. We conducted a cross-sectional study in the Tianjin area, China to quantify the incidence of respiratory infections among children, and its association with home environments and lifestyles. The lifetime-ever incidences of croup, pneumonia and ear infection among children aged 0-8 in Tianjin area was 9.2%, 28.7% and 11.6%, respectively. The incidence of common cold infections more than twice per year was 31.3%. Home environments and lifestyles included strong risk factors for childhood respiratory infections. Perceived dry air had the greatest association with childhood common colds (population attributable fraction (PAF = 15.0%). Modern floor covering had the greatest association with croup (PAF = 14.7%) and ear infection (PAF = 34.5%), while infrequent bedding sun-curing had the greatest association with pneumonia (PAF = 18.7%). Condensation (a proxy of poor ventilation) accounted for 12.2% of the incidence of croup (PAF = 12.2%) and frequent common colds (PAF = 8.4%). Our findings indicate that factors related to "modern" home environments and lifestyles are risks for childhood respiratory infections. Modifying such factors might reduce the incidence of respiratory infections among children.


title: Clinical Characteristics and Outcome for Four SARS-CoV-2-infected Cancer Patients Treated with Immune Checkpoint Inhibitors

text: Preliminary data suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with higher mortality among cancer patients, particularly in those on systemic therapy. It is unclear whether this applies to patients receiving immune checkpoint inhibitors (ICIs). In this case series, 74 patients from a single institution with genitourinary (GU) cancer on ICI were followed up during a 12-wk period. During this period, 11 patients (15%) developed symptoms consistent with coronavirus disease 2019 (COVID-19) and four (5%) tested positive. Two patients had metastatic urothelial cancer (treated with atezolizumab) and two had metastatic renal cancer (treated with ipilimumab and nivolumab). All had additional risk factors associated with COVID-19 mortality and two received steroids within 1 mo of infection. Two patients developed symptoms requiring hospitalisation. All four are alive 32-45 d after their first symptoms and 28-38 d after testing positive. These patients all had multiple risk factors associated with severe COVID-19. These data suggest that the higher risk of COVID-19 death associated with systemic therapy in cancer may not apply to patients on ICIs. Assessment of COVID-19 severity in these patients can be complicated by the underlying cancer and its treatment.


title: COVID-19 Exposes the Cracks in Our Already Fragile Mental Health System

text: The coronavirus pandemic has caused enormous concern among many people. Every morning, we are met with an increasing deluge of dire news about the most recent number of people to contract COVID-19 and to die from it, decreases in the stock market, and countries implementing broad travel restrictions and stay-at-home orders.1,2 The current state of affairs is having a negative effect on the mental well-being of our country's residents. It also highlights the policy gaps in our current system that inhibit the vital conditions for well-being and resiliency.3 Although the primary focus has rightfully been on stopping the spread of COVID-19, we should also quickly prepare to address the mental toll the pandemic is taking on individuals and communities across the country. (Am J Public Health. Published online ahead of print May 21, 2020: e1-e2. doi:10.2105/AJPH.2020.305699).


The role of hysteroscopy during COVID-19 outbreak: Safeguarding lives and saving resources


title: Presence of viral RNA of SARS-CoV-2 in conjunctival swab specimens of COVID-19 patients

text: Purpose: To detect the presence of viral RNA of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in conjunctival swab specimens of coronavirus disease-19 (COVID-19) patients. Methods: Forty-five COVID-19 patients positive for real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 in nasopharyngeal swab with or without ocular manifestations were included in the study. The conjunctival swab of each patient was collected by an ophthalmologist posted for COVID duty. Results: Out of 45 patients, 35 (77.77%) were males and the rest were females. The mean age was 31.26 ± 12.81 years. None of the patients had any ocular manifestations. One (2.23%) out of 45 patients was positive for RT-PCR SARS-CoV-2 in the conjunctival swab. Conclusion: This study shows that SARS-CoV-2 can be detected in conjunctival swabs of confirmed cases of COVID-19 patients. Though the positivity rate of detecting SARS-CoV-2 in conjunctival swabs is very less, care should be exercised during the ocular examination of patients of COVID-19.


title: Assessment of the impact of media coverage in coronavirus-related Google Trends: Infodemiology study

text: BACKGROUND: The influence of media coverage in online searches may hamper the role of Google Trends (GT) for Covid-19 monitoring. OBJECTIVE: To assess whether Covid-19-related GT - particularly on ageusia and anosmia - were primarily related to media coverage or with epidemic trends. METHODS: We retrieved GT data for searches on "coronavirus", "cough", "anosmia" and "ageusia", plotting them for a period of 5 years. In addition, we analysed the trends of those queries for 17 countries throughout the year of 2020, particularly concerning rises and peaks of searches. For anosmia and ageusia, we assessed whether the respective GT correlated with Covid-19 cases and deaths both throughout 2020 and specifically before March 16, 2020 (i.e., the date when the media started reporting that those symptoms could be associated with Covid-19). RESULTS: Over the last five years, peaks of "coronavirus" GT were only observed during the Winter of 2020. Rises and peaks in "coronavirus" searches were similar in time in the 17 different assessed countries, irrespectively of their epidemic situation. In 15 of these countries, rises in "anosmia" and "ageusia" GT occurred in the same week or one week after they were identified in the media as symptoms of Covid-19. Analysing data prior to March 16, 2020, anosmia/ageusia GT were found to have variable correlation with Covid-19 cases and deaths in the different countries. CONCLUSIONS: Covid-19-related GT is more related to media coverage than with epidemic trends.


COVID-19: Immense necessity and challenges in meeting the needs of minorities, especially asylum seekers and undocumented migrants


Dental sleep medicine perspectives post-COVID-19: interprofessional adaptation and directions


RAAS inhibitors do not increase the risk of COVID-19


title: Practical exploration of paperless medical records for COVID-19 : Tongji Hospital as an example/ 中华医院管理杂志

text: December 2019 witnessed the outbreak of COVID-19 in Wuhan city and its rapid spread to other parts of China, and overseas as well. Tongji Hospital, as a designated hospital for treatment of critically ill patients, shoulders the diagnosis and treatment tasks of numerous critically ill patients of such a disease. For the purpose of handling their medical records and effectively preventing the nosocomial infection of the disease, the hospital puts in place both the electronic signature system of patients based on a Wechat applet and a paperless medical record total solution based on the data center. These measures overcome the challenges incurred by patients’ signature on paper-based records and medical records archiving during the epidemic. On the other hand, they can not only downsize the paper-based medical records, minimize the risk of infection caused by paper-based medical records via contacts, but also effectively save the hospital of its operating costs and improve its efficiency of clinical work.


title: COVID-19 Challenges Basic Researchers

text: As COVID-19 continues to surge, cancer scientists engaged in basic research face unique challenges. At centers throughout the United States, investigators are confronting difficult decisions about which experiments to continue, while securing supplies and creating contingency plans for a complete shutdown.


docid: nuobkpsx

title: The Early Natural History of SARS-CoV-2 Infection: Clinical Observations From an Urban, Ambulatory COVID-19 Clinic


title: Estimation of the actual disease occurrence based on official case numbers during a COVID outbreak in Germany 2020

text: Since the beginning of March 2020, the cumulative numbers of cases of infection with the novel coronavirus SARS-CoV-2 in Germany have been reported on a daily basis. The reports originate from national laws, according to which positive test findings must be submitted to the Federal Health Authorities, the Robert Koch Institute, via the local health authorities. Since an enormous number of unreported cases can be expected, the question of how widespread the disease has been in the population cannot be answered based on these administrative reports. Using mathematical modeling, however, estimates can be made. These estimates indicate that the small numbers of diagnostic tests carried out at the beginning of the outbreak overlooked considerable parts of the infection. In order to cover the initial phase of future waves of the disease, wide-spread and comprehensive tests are recommended.


title: ReCOVery: A Multimodal Repository for COVID-19 News Credibility Research

text: First identified in Wuhan, China, in December 2019, the outbreak of COVID-19 has been declared as a global emergency in January, and a pandemic in March 2020 by the World Health Organization (WHO). Along with this pandemic, we are also experiencing an"infodemic"of information with low credibility such as fake news and conspiracies. In this work, we present ReCOVery, a repository designed and constructed to facilitate the studies of combating such information regarding COVID-19. We first broadly search and investigate ~2,000 news publishers, from which 61 are identified with extreme [high or low] levels of credibility. By inheriting the credibility of the media on which they were published, a total of 2,029 news articles on coronavirus, published from January to May 2020, are collected in the repository, along with 140,820 tweets that reveal how these news articles are spread on the social network. The repository provides multimodal information of news articles on coronavirus, including textual, visual, temporal, and network information. The way that news credibility is obtained allows a trade-off between dataset scalability and label accuracy. Extensive experiments are conducted to present data statistics and distributions, as well as to provide baseline performances for predicting news credibility so that future methods can be directly compared. Our repository is available at http://coronavirus-fakenews.com, which will be timely updated.


title: Multi-Objective DNN-based Precoder for MIMO Communications

text: This paper introduces a unified deep neural network (DNN)-based precoder for two-user multiple-input multiple-output (MIMO) networks with five objectives: data transmission, energy harvesting, simultaneous wireless information and power transfer, physical layer (PHY) security, and multicasting. First, a rotation-based precoding is developed to solve the above problems independently. Rotation-based precoding is new precoding and power allocation that beats existing solutions in PHY security and multicasting and is reliable in different antenna settings. Next, a DNN-based precoder is designed to unify the solution for all objectives. The proposed DNN concurrently learns the solutions given by conventional methods, i.e., analytical or rotation-based solutions. A binary vector is designed as an input feature to distinguish the objectives. Numerical results demonstrate that, compared to the conventional solutions, the proposed DNN-based precoder reduces on-the-fly computational complexity more than an order of magnitude while reaching near-optimal performance (99.45\% of the averaged optimal solutions). The new precoder is also more robust to the variations of the numbers of antennas at the receivers.


docid: dgzsqbkd

title: Impact of COVID-19 pandemic on medical postgraduate training in the United States


title: Commentary: Could iron chelators prove to be useful as an adjunct to COVID-19 Treatment Regimens?

text: The pandemic of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a significant threat to global health. Currently, no specific prophylactic and therapeutic treatment is available. No evidence from randomized clinical trials (RCTs) that a treatment may ameliorate the clinical outcome of patients with COVID-19 exists with the only exception of preliminary evidence from remdesivir trials. Here, we present evidence from the literature and a compelling hypothesis on the potential immunomodulatory, iron chelating and anti-oxidant effects of iron chelators in the treatment of COVID-19 and its complications. Interestingly, iron chelation has been shown in vitro to suppress endothelial inflammation in viral infection, which is the main pathophysiologic mechanism behind systemic organ involvement induced by SARS-CoV-2, by inhibiting IL-6 synthesis through decreasing NF-kB. Iron chelators exhibit iron chelating, antiviral and immunomodulatory effects in vitro and in vivo, particularly against RNA viruses. These agents could attenuate ARDS and help control SARS-CoV-2 via multiple mechanisms including: 1) inhibition of viral replication; 2) decrease of iron availability; 3) upregulation of B cells; 4) improvement of the neutralizing anti-viral antibody titer; 5) inhibition of endothelial inflammation and 6) prevention of pulmonary fibrosis and lung decline via reduction of pulmonary iron accumulation. Both retrospective analyses of data in electronic health records, as well as proof of concept studies in humans and large RCTs are needed to fully elucidate the efficacy and safety of iron chelating agents in the therapeutic armamentarium of COVID-19, probably as an adjunctive treatment.


Surgical Stabilization of Rib Fractures during the COVID-19 Pandemic


title: Chinese medicine for COVID-19: A protocol for systematic review and meta-analysis

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus that was first identified during an investigation into an outbreak in Wuhan, China. The clinical spectrum of SARS-CoV-2 infection appears to be wide, encompassing asymptomatic infection, mild upper respiratory tract illness, and severe viral pneumonia with respiratory failure and even death, with many patients being hospitalised with pneumonia. In China and East Asia, Chinese medicine has been widely used to treat diverse diseases for thousands of years. As an important means of treatment now, Chinese medicine plays a significant role in the treatment of respiratory diseases in China. The aim of this study is to assess the efficacy and safety of Chinese medicine for COVID-19. METHODS: We will search the following sources for the identification of trials: The Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science and Technique Journals Database (VIP), and the Wanfang Database. All the above databases will be searched from the available date of inception until the latest issue. No language or publication restriction will be used. Randomized controlled trials will be included if they recruited participants with COVID-19 for assessing the effect of Chinese medicine vs control (placebo, no treatment, and other therapeutic agents). Primary outcomes will include chest CT and nucleic acid detection of respiratory samples. Two authors will independently scan the articles searched, extract the data from articles included, and assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by consensus or the involvement of a third party. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Dichotomous variables will be reported as risk ratio or odds ratio with 95% confidence intervals (CIs) and continuous variables will be summarized as mean difference or standard mean difference with 95% CIs. RESULTS AND CONCLUSION: The available evidence of the treatment of COVID-19 with traditional Chinese medicine will be summarized, and evaluation of the efficacy and the adverse effects of these treatments will be made. This review will be disseminated in print by peer-review.


title: Genome analysis of SARS-CoV-2 isolates occurring in India: Present scenario

text: Background: The origin of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is still a debatable topic. The association of the virus spread from the market is supported by the close relation of genome sequences of environmental surface samples with virus samples from earliest patients by phylogenetic analysis. Objectives: To have an insight into the SARS-CoV-2 genome sequences reported from India for better understanding on their epidemiology and virulence. Methods: Genome sequences of Indian isolates of SARS-CoV-2 were analyzed to understand their phylogeny and divergence with respect to other isolates reported from other countries. Amino acid sequences of individual open reading frames (ORFs) from SARS-CoV-2 Indian isolates were aligned with sequences of isolates reported from other countries to identify the mutations occurred in Indian isolates. Results: Our analysis suggests that Indian SARS-CoV-2 isolates are closely related to isolates reported from other parts of the world. Most ORFs are highly conserved; mutations were also detected in some ORFs. We found that most isolates reported from India have key mutations at 614th position of the S protein and 84th position of the ORF 8, which has been reported to be associated with high virulence and high transmission rate. Conclusion: An attempt was made to understand the SARS-CoV-2 virus reported from India. SARS-CoV-2 reported from India was closely similar to other SARS-CoV-2 reported from other parts of the world, which suggests that vaccines and other therapeutic methods generated from other countries might work well in India. In addition, available sequence data suggest that majority of Indian isolates are capable of high transmission and virulence.


Scientific and ethical basis for social-distancing interventions against COVID-19


How Community-Based Health Systems Embrace Research During the COVID-19 Pandemic


title: Proposed Changes to the 2021 Residency Application Process in the Wake of COVID-19

text: The COVID-19 pandemic has brought unique challenges to the delivery of undergraduate medical education, particularly for current third-year medical students who are preparing to apply to residency. In mid-March, medical schools suspended all clinical rotations for the remainder of the 2019-2020 academic year. As such, third-year medical students may not be able to complete sufficient clinical experiences to make important career choices before they have to submit their residency applications. While the decision to suspend clinical rotations was necessary to protect students, specialty organizations and residency programs must mitigate the deficits in students' clinical education caused by the COVID-19 pandemic.In this Perspective, the authors identify potential challenges for third-year medical students and advocate for solutions to improve the residency application process for students and programs. First, they propose delaying the date that programs can access applicant data through the Electronic Residency Application Service, thereby affording students more time to complete clinical experiences, solidify their specialty decision, and strengthen their residency application. Second, the authors recommend a restriction on the number of visiting rotations that students are expected to complete to allow for a more equitable distribution of these important experiences. Third, they suggest that program directors from each specialty agree on a maximum number of applications per applicant (based on historical data) to curb an upsurge in applications that may stem from the unique circumstances created by COVID-19 without causing applicants undue stress. Lastly, the authors advocate that residency programs develop infrastructure to conduct video-based interviews and engage students through virtual networking events.Amidst the unique environment created by COVID-19, the authors urge governing bodies, specialty organizations, and residency programs to consider these recommendations to improve the efficiency and reduce the stress surrounding the 2021 Match.


title: Coronavirus Disease Outbreak in Call Center, South Korea

text: We describe the epidemiology of a coronavirus disease (COVID-19) outbreak in a call center in South Korea. We obtained information on demographic characteristics by using standardized epidemiologic investigation forms. We performed descriptive analyses and reported the results as frequencies and proportions for categoric variables. Of 1,143 persons who were tested for COVID-19, a total of 97 (8.5%, 95% CI 7.0%-10.3%) had confirmed cases. Of these, 94 were working in an 11th-floor call center with 216 employees, translating to an attack rate of 43.5% (95% CI 36.9%-50.4%). The household secondary attack rate among symptomatic case-patients was 16.2% (95% CI 11.6%- 22.0%). Of the 97 persons with confirmed COVID-19, only 4 (1.9%) remained asymptomatic within 14 days of quarantine, and none of their household contacts acquired secondary infections. Extensive contact tracing, testing all contacts, and early quarantine blocked further transmission and might be effective for containing rapid outbreaks in crowded work settings.


title: [Clinical analysis of kidney injury in patients with COVID-19]

text: Objective: To investigate the relationship between novel coronavirus pneumonia (COVID-19) and kidney injury. Methods: A retrospective analysis was performed on COVID-19 confirmed patients in the Central Theater Command General Hospital of Chinese PLA on March 12, 2020. A total of 87 hospitalized COVID-19 confirmed patients were enrolled in the study, and they were hospitalized at least one week. The recorded information included clinical data and indicators of kidney-related laboratory tests. Results: The average age of patients was (65.2±17.1) years, and 34.5% (30/87) patients were ≥ 75 years old and 31.0% (27/87) patients were 60~74 years old. Male and female patients accounted for 59.8% (52/87) and 40.2% (35/87), respectively. There were 29.9% (26/87) and 12.6% (11/87) patients who had already showed mild elevation of blood urea nitrogen (BUN) and serum creatinine (SCr) at admission. Moreover, 25.3% (22/87) and 4.6% (4/87) patients still exhibited mild elevation of BUN and SCr one week after admission. However, 28.7% (25/87) patients showed an elevation of BUN one week later after admission, though their BUN levels were normal at admission. Likewise, 16.1% (14/87) patients showed an elevation of SCr one week later after admission, while their SCr levels were normal at admission. Only two patients had an increase of SCr ≥26.5 µmol/L, and both of them were over 75 years old. Conclusions: COVID-19 patients with severe acute kidney injury are uncommon. However, attention should be paid to acute kidney injury of the elderly patients in the diagnosis and treatment of COVID-19.


Comment on "Smooth or Risky Revisit of an Old Malaria Drug for COVID-19?"


COVID-19 stigma induced by press releases in Japan: It's time to reconsider risk communication learned from the Fukushima Daiichi Nuclear Disaster


Bolstering the surgical response to COVID-19: how virtual technology will save lives and safeguard surgical practice


Airborne precautions are needed against COVID-19


title: Clinical Trials for COVID-19: Can we Better Use the Short Window of Opportunity?

text: The scientific community has risen to the coronavirus disease 2019 (COVID-19) challenge, coming up with an impressive list of candidate drugs and vaccines targeting an array of pharmacological and immunological mechanisms. Yet, generating clinical evidence of efficacy and safety of these candidate treatments may be frustrated by the absence of comprehensive trial coordination mechanisms. Many small stand-alone trials and observational studies of single-agent interventions are currently running or in planning; many of these will likely not deliver robust results that could support regulatory and patient-level treatment decisions. In this paper, we discuss actions that all stakeholders in the clinical trial ecosystem need to take to ensure that the window of opportunity during this pandemic will not shut, both for patients in need of treatment and for researchers to conduct decision-relevant clinical trials.


title: [Az aneszteziológiai és intenzív ellátás kihívásai a COVID19-fertozéssel kapcsolatban. Gyakorlati ajánlás]/ Challenges of intensive care and anesthesiology related to COVID-19 pandemic. Practical considerations

text: Due to the coronavirus epidemic, healthcare systems face growing challenges all around the world nowadays. These challenges are the most critical in the field of intensive treatment and anesthesiology. One of the most important prerequisites of effective critical care treatment is preserving the involved healthcare workers from the infection, by providing them with detailed practical advices on the preventive measures and treatment strategies. The aim of the present review is to summarize the most important related knowledge available from previous experiences. Orv Hetil. 2020; 161(17): 652659.


title: Redefining Pathways into Acute Rehabilitation during the COVID-19 Crisis

text: The coronavirus disease 2019 (COVID-19) pandemic has necessitated drastic changes across the spectrum of health care, all of which have occurred with unprecedented rapidity. The need to accommodate change on such a large scale has required ingenuity and decisive thinking. The field of physical medicine and rehabilitation has been faced with many of these challenges. Healthcare practitioners in New York City, the epicenter of the pandemic in the United States, were among the first to encounter many of these challenges. One of the largest lessons included learning how to streamline admissions and transfer process into an acute rehabilitation hospital as part of a concerted effort to make acute care hospital beds available as quickly as possible.


title: The Brighton Collaboration standardized template for collection of key information for benefit-risk assessment of protein vaccines

text: Several protein vaccine candidates are among the COVID-19 vaccines in development. The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) has prepared a standardized template to describe the key considerations for the benefit-risk assessment of protein vaccines. This will help key stakeholders to assess potential safety issues and understand the benefit-risk of such a vaccine platform. The structured and standardized assessment provided by the template would also help contribute to improved public acceptance and communication of licensed protein vaccines.


title: A Framework for Evidence Synthesis Programs to Respond to a Pandemic

text: The coronavirus disease 2019 (COVID-19) pandemic requires making rapid decisions based on sparse and rapidly changing evidence. Evidence synthesis programs conduct systematic reviews for guideline developers, health systems clinicians, and decision-makers that usually take an average 6 to 8 months to complete. We present a framework for evidence synthesis programs to respond to pandemics that has proven feasible and practical during the COVID-19 response in a large multistate health system employing more than 78,000 people. The framework includes four components: an approach for conducting rapid reviews, a repository of rapid reviews, a registry for all original studies about COVID-19, and twice-weekly prioritized update of new evidence sent to key stakeholders. As COVID-19 will not be our last pandemic, we share the details of this framework to allow replication in other institutions and re-implementation in future pandemics.


Substance misuse during COVID-19: protecting people who use drugs


Impact of COVID-19 on pituitary surgery


The clinical observation of a patient with common variable immunodeficiency diagnosed as having coronavirus disease 2019


Are Gastrointestinal Symptoms Specific for COVID-19 Infection? A Prospective Case-Control Study from the United States


title: Dynamics of the COVID-19 pandemic in India

text: Understanding the dynamics of the COVID-19 pandemic is crucial for improved control and social distancing strategies. To that effect, we have employed the susceptible-exposed-infectious-recovered model, refined by contact tracing and hospitalization data from Indian provinces Kerala, Delhi, Maharashtra, and West Bengal, as well as from overall India. We have performed a sensitivity analysis to identify the most crucial input parameters, and we have calibrated the model to describe the data as best as possible. Short-term predictions reveal an increasing and worrying trend of COVID-19 cases for all four provinces and India as a whole, while long-term predictions also reveal the possibility of oscillatory dynamics. Our research thus leaves the option open that COVID-19 might become a seasonal occurrence. We also simulate and discuss the impact of media on the dynamics of the COVID-19 pandemic.


Four cases: Human immunodeficiency virus and novel coronavirus 2019 Co-infection in patients from Long Island, New York


title: Secondary Traumatization Outcomes and Associated Factors Among the Health Care Workers Exposed to the COVID-19

text: BACKGROUND: Secondary traumatization exposure and mental health conditions of health care workers gained importance during the coronavirus disease 2019 (COVID-19) epidemic period. AIMS: In our study, we aim to research the secondary traumatization and associated factors among health care workers. METHOD: This cross-sectional study was applied through an online questionnaire using the snowball sampling method. Two hundred fifty-one health care workers from different units/services and 312 non-medical worker adults attended to the research. Health care workers were divided into two groups based on working with COVID-19 patients at the frontline or not. The data were collected via Introductory Information Form, Secondary Traumatic Stress Scale (STSS) and Patient Health Questionnaire-4 (PHQ-4) between 22 May and 30 May 2020. RESULTS: Among the 563 participants, 251 (44.6%) were health care workers and 312 (55.4%) were non-medical workers. The anxiety, depression and secondary traumatization scores of the frontline health care workers for the COVID-19 were found to be significantly higher than those of the other health workers or non-medical workers (p < .001). Also, we found that being a woman, being in the first years of the work, living with a parent, having a chronic disease, having a trauma history and increased social media use are related to having higher scores from the secondary traumatization scale. CONCLUSION: The secondary traumatization exposure and the mental health conditions of the health care workers directly working with the COVID-19 patients should be taken into consideration. It is important to provide social support, examine and control riskier groups for mental health regularly during the pandemic.


title: Daily Situation Report on Coronavirus disease (COVID-19) in Iran;March 22, 2020

text: To forecast the COVID-19 epidemic trend in Iran, a set of dynamic models were created In these models, the effect of climate and community behavior change on the reproductive number is modeled A baseline scenario is also defined as letting the epidemic grow naturally, with no prevention/control interventions Different levels of intervention are also defined based on the extent of population isolation Outcomes of each scenario on the number of infected cases are computed Modeling results shows that if effective isolation occurs in 10% of the population, 307,000 individuals will be infected with COVID-19 in Iran by May 20, 2020 For an isolation rate of 25%, started since March 10, 2020, cumulative number of deaths will be 13,450 individuals by May 20, 2020 If preventive efforts can reach a 32% effective isolation rate, a considerable decrease in the number of new cases would be expected during April and May, and the total number of deaths would decrease to 8,630 If the isolation rate increases to 40%, the total number of infected individuals is expected to be 6,030 individuals It should be acknowledged that this model predicts the number of deaths of all COVID-19 cases, including those who will not be confirmed as COVID-19, because of non-testing or death prior to COVID-19 identification This serious health issue requires both long-term and short-term planning and arrangements Social distancing, and identification and isolation of suspected and confirmed cases are believed to be the most important and effective control measure, and should be strengthened soon For further details on the methodology and results of these models, please visit: http://corona behdasht gov ir/files/site1/files/Covid_Modeling_V14_26 12 98 pdf


title: Child protection in the time of COVID-19

text: As the number of cases of coronavirus disease 2019 (COVID-19) caused by the virus SARS-CoV-2 rises exponentially in Australia with consequences for the health system and society at large, we need to remember that during this pandemic that necessary social distancing measures, effective school closures and rising unemployment levels may lead to an increased risk for child abuse and neglect.


Acrylic window as physical barrier for Personal Protective Equipment (PPE) conservation


Preparing for COVID-19 Related Drug Shortages


Advancing care for bipolar disorder today and breakthroughs in access and treatments tomorrow with mobile health and smartphone apps


docid: ltdxgysz

title: Infection Control for CT Equipment and Radiographers' Personal Protection During the Coronavirus Disease (COVID-19) Outbreak in China

text: OBJECTIVE. Because CT plays an important role in diagnosis, isolation, treatment, and effective evaluation of coronavirus disease (COVID-19), infection prevention and control management of CT examination rooms is important. CONCLUSION. We describe modifications to the CT examination process, strict disinfection of examination rooms, arrangement of waiting areas, and efforts to increase radiographers' awareness of personal protection made at our institution during the COVID-19 outbreak. In addition, we discuss the potential of using artificial intelligence in imaging patients with contagious diseases.


Regional BCG vaccination policy in former East- and West Germany may impact on both severity of SARS-CoV-2 and incidence of childhood leukemia


title: Did COVID-19 infections decline before UK lockdown?

text: The number of new infections per day is a key quantity for effective epidemic management. It can be estimated by testing of random population samples. Without such direct epidemiological measurement, other approaches are required to infer whether the number of new cases is likely to be increasing or decreasing: for example, estimating the pathogen reproductive rate, R, using data gathered from the clinical response to the disease. For COVID-19 such R estimation is heavily dependent on modelling assumptions, because the available clinical case data are opportunistic observational data subject to severe temporal confounding. Given this difficulty it is useful to reconstruct the time course of infections from the least compromised available data, using minimal prior assumptions. A Bayesian inverse problem approach applied to UK data on COVID-19 deaths and the disease duration distribution suggests that infections were in decline before UK lockdown, and that infections in Sweden started to decline only a short time later.


title: ECMO use in COVID-19: lessons from past respiratory virus outbreaks-a narrative review

text: The spread of coronavirus disease 2019 (COVID-19) continues to grow exponentially in most countries, posing an unprecedented burden on the healthcare sector and the world economy. Previous respiratory virus outbreaks, such as severe acute respiratory syndrome (SARS), pandemic H1N1 and Middle East respiratory syndrome (MERS), have provided significant insights into preparation and provision of intensive care support including extracorporeal membrane oxygenation (ECMO). Many patients have already been supported with ECMO during the current COVID-19 pandemic, and it is likely that many more may receive ECMO support, although, at this point, the role of ECMO in COVID-19-related cardiopulmonary failure is unclear. Here, we review the experience with the use of ECMO in the past respiratory virus outbreaks and discuss potential role for ECMO in COVID-19.


title: The Clinical Features and Outcomes of Discharged Coronavirus Disease 2019 Patientsï¼A Prospective Cohort Study

text: BACKGROUND: COVID-19 is a global pandemic but the follow-up data of discharged patients was barely described. AIMS: To investigate clinical outcomes, distribution of quarantine locations, and the infection status of the contacts of COVID-19 patients after discharge. DESIGN: A prospective cohort study. METHODS: Demographics, baseline characteristics of 131 COVID-19 patients discharged from February 3 to 21, 2020 in Wuhan, China were collected and analyzed by reviewing the medical records retrospectively. Post-hospitalization data related to clinical outcomes, quarantine locations and close contact history were obtained by following up the patients every week up to 4 weeks. RESULTS: 53 (40.05%) patients on discharge had cough (29.01%), fatigue (7.63%), expectoration (6.11%), chest tightness (6.11%), dyspnea (3.82%), chest pain (3.05%), and palpitation (1.53%). These symptoms constantly declined in 4 weeks post discharge. Transient fever recurred in 11 (8.4%) patients. 78 (59.5%) discharged patients underwent chest CT and 2 (1.53%) showed deterioration. 94 (71.8%) patients received SARS-CoV-2 retest and 8 (6.10%) reported positive. 7 (2.29%) patients were re-admitted because of fever or positive SARS-CoV-2 retest. 121 (92.37%) and 4 (3.05%) patients were self-quarantined at home or community spots following discharge, with totally 167 closely contacted persons free of COVID-19 at the endpoint of study. CONCLUSIONS: The majority of COVID-19 patients after discharge were in the course of recovery. Readmission was required in rare cases due to suspected recurrence of COVID-19. Although no contacted infection observed, appropriate self-quarantine and regular reexamination are necessary, particularly for those who have recurred symptoms.


Lung perfusion [99mTc]-MAA SPECT/CT to rule out pulmonary embolism in COVID-19 patients with contraindications for iodine contrast


SARS-CoV-2 Testing, Prevalence, and Predictors of COVID-19 in Patients with Inflammatory Bowel Disease in Northern California


title: Agricultural policy reforms: Roles of markets and states in China and India

text: Market reforms have been given much of the credit for China's spectacular growth performance. This paper looks at China's reform process systematically with India's and argues that the Chinese state has played a key role in transforming China into a modern economic state, deploying unlimited supplies of labor and combining it with a variety of initiatives in a pragmatic, nonideological way to promote public and private investment and create productive employment in agricultural, manufacturing, and service sectors. India's reforms have been sporadic and are still a work in progress. The record-breaking expansion of China's financial system in fostering investments was overlooked, but has attracted considerable attention in recent years. Is China unique, or are lessons from the Chinese experience for public policy and its sequencing transferrable for agricultural and structural transformation in countries lagging behind, including India?


title: Prevalence and Impact of Myocardial Injury in Patients Hospitalized with COVID-19 Infection

text: BACKGROUND: The degree of myocardial injury, as reflected by troponin elevation, and associated outcomes among US hospitalized patients with Coronavirus Disease 2019 (COVID-19) are unknown. OBJECTIVES: To describe the degree of myocardial injury and associated outcomes in a large hospitalized cohort with laboratory-confirmed COVID-19. METHODS: Patients with COVID-19 admitted to one of five Mount Sinai Health System hospitals in New York City between February 27th and April 12th, 2020 with troponin-I (normal value <0.03ng/mL) measured within 24 hours of admission were included (n=2,736). Demographics, medical history, admission labs, and outcomes were captured from the hospitals' EHR. RESULTS: The median age was 66.4 years, with 59.6% men. Cardiovascular disease (CVD) including coronary artery disease, atrial fibrillation, and heart failure, was more prevalent in patients with higher troponin concentrations, as were hypertension and diabetes. A total of 506 (18.5%) patients died during hospitalization. In all, 985 (36%) patients had elevated troponin concentrations. After adjusting for disease severity and relevant clinical factors, even small amounts of myocardial injury (e.g. troponin I 0.03-0.09ng/mL, n=455, 16.6%) were significantly associated with death (adjusted HR: 1.75, 95% CI 1.37-2.24; P<0.001) while greater amounts (e.g. troponin I>0.09 ng/dL, n=530, 19.4%) were significantly associated with higher risk (adjusted HR 3.03, 95% CI 2.42-3.80; P<0.001). CONCLUSIONS: Myocardial injury is prevalent among patients hospitalized with COVID-19 however troponin concentrations were generally present at low levels. Patients with CVD are more likely to have myocardial injury than patients without CVD. Troponin elevation among patients hospitalized with COVID-19 is associated with higher risk of mortality.


title: Post-discharge surveillance and positive virus detection in two medical staff recovered from coronavirus disease 2019 (COVID-19), China, January to February 2020

text: Since December 2019, 62 medical staff of Zhongnan Hospital in Wuhan, China have been hospitalised with coronavirus disease 2019. During the post-discharge surveillance after clinical recovery, swabs were positive in two asymptomatic cases (3.23%). Case 1 had presented typical clinical and radiological manifestations on admission, while manifestation in Case 2 was very mild. In conclusion, a small proportion of recovered patients may test positive after discharge, and post-discharge surveillance and isolation need to be strengthened.


Editorial - COVID-19


Clinical uncertainty and Covid-19: Embrace the questions and find solutions


docid: knsgpese

title: Ethics of instantaneous contact tracing using mobile phone apps in the control of the COVID-19 pandemic

text: In this paper we discuss ethical implications of the use of mobile phone apps in the control of the COVID-19 pandemic. Contact tracing is a well-established feature of public health practice during infectious disease outbreaks and epidemics. However, the high proportion of pre-symptomatic transmission in COVID-19 means that standard contact tracing methods are too slow to stop the progression of infection through the population. To address this problem, many countries around the world have deployed or are developing mobile phone apps capable of supporting instantaneous contact tracing. Informed by the on-going mapping of 'proximity events' these apps are intended both to inform public health policy and to provide alerts to individuals who have been in contact with a person with the infection. The proposed use of mobile phone data for 'intelligent physical distancing' in such contexts raises a number of important ethical questions. In our paper, we outline some ethical considerations that need to be addressed in any deployment of this kind of approach as part of a multidimensional public health response. We also, briefly, explore the implications for its use in future infectious disease outbreaks.


title: The early impact of the Covid-19 pandemic on the global and Turkish economy

text: Background/aim: Individuals infected by the Covid-19 potentially are at risk of health and economic well-being. Today, the Covid-19 is a global issue, and the world economy can be interpreted as almost at the standstill. In this context, this study aims to discuss the potential first reactions of short and long term global economic impacts of the pandemic through sectors by assessing its costs according to the data announced for both the world and Turkey. In addition, this study tries to put forth possible economic and political scenarios for the post-pandemic world. Materials and methods: This is a review article that summarizes the current reports and discussions about the economic consequences of this historical event, and tries to make some inferences considering them. Results: This pandemic has severe adverse effects on the employees, customers, supply chains and financial markets, in brief, most probably it will cause a global economic recession. Nevertheless, due to the uncertainty of the end of this pandemic, both the length and scale of this contraction are not predictable. Conclusion: It takes a while for the world economy to recover from the contraction. It seems that this pandemic will lead to a permanent shift in the world and its politics, especially in health, security, trade, employment, agriculture, manufacturing goods production and science policies. Since this new world might provide great opportunities for some countries that did not dominate world production before, governments should develop new strategies to adjust the new world order without much delay.


title: Bonnet-Myers sharp graphs of diameter three

text: Regular graphs which are Bonnet-Myers sharp (in the sense of Ollivier Ricci curvature) and self-centered have been completely classified, and it is a natural question whether the condition of self-centeredness can be removed in the classification. We prove that this condition is indeed not necessary in the special case of Bonnet-Myers sharp graphs of diameter 3.


docid: yvqkpezp

title: The parent drugs chloroquine and hydroxychloroquine do not inhibit human CYP3A activity in vitro


Balancing public health and private wealth: lessons on climate inaction from the COVID-19 pandemic - a report from the International Society of Dermatology Climate Change Committee


title: Clinical features of 109 cases of novel coronavirus pneumonia/ 中华传染病杂志

text: Objective@#To observe theepidemiology, clinical manifestations, laboratory tests, imaging findings, treatment and prognosis of patients with novel coronavirus pneumonia.@*Methods@#Clinical data of 109 patients with suspected and definite novel coronavirus pneumonia admitted to Wuhan Sixth Hospital from December 24, 2019 to January 28, 2020 were retrospectively analyzed. Statistical analysiswas performed by using t test or chi-square test.@*Results@#Among the 109 patients, 48 (44%) were male and 61 (56%) were female, with the average age of (52.5±10.8) years. Fifty-four patients (49.5%) had definite contact history. Among the 109 patients, 104 (95.5%) presentedwith fever, 37(33.7%) with headache, 78 (71.9%) with general pain, 88 (80.8%) with fatigue and poor appetite, 23 (21.3%) with diarrhea, 94 (86.5%) withcoughing, 23 (21.3%) with shortness of breath, 57 (52.8%) withpalpitation, 45 (41.5%) with chest distress, 4 (3.3%) with chest pain, 40 (37.0%) with lung rales. Forty-two cases (38.5%) had leukocyte count <4×109/L, 58 cases (53.2%) had lymphocyte count <1.5×109/L, 7 cases (24.8%) had hemoglobin <120g/L, 37 cases(33.9%) had LDH >230 mmol/L, 29 cases (26.6%) had brain natriuretic peptide precursor>300 ng/mL, 87 cases (79.8%) had hypersensitive C-reactive protein >10mg/L, 26 cases (23.9%) had D-dimer >0.5 mg/L, 35 cases (32.1%) had coagulation disorder. The leukocyte counts, LDH, brain natriuretic peptide precursor and D-dimer of severe/critical cases[(11.33±4.87)×109/L, (527.51±260.87) mmol/L, (722.88±189.56) ng/mL, (1.89±4.24) mg/L, respectively] were all significantly higher than those of common cases [(4.02±1.49)×109/L, (159.75±30.31)mmol/L, (428.22±124.76)ng/mLand (0.41±0.22)mg/L, respectively], while the lymphocyte count of severe/critical cases [(0.60±0.17)×109/L] was significantly lower than common cases [(1.13±0.43)×109/L] (t=11.36, 11.33,9.81,2.81 and 7.77,all P<0.05). On admission, chest CT showed that 27 cases (24.8%) of pneumonia were unilateral, 82 cases (75.2%) werebilateral, and most of them were ground glass. The pneumonia progressed in a short time and reached the peak within 10 days. The comprehensive treatment included antiviral drugs, prevention ofbacterialinfection and supportive treatment, and glucocorticoid and respiratory support treatment wereadministrated when necessary.@*Conclusions@#The novel coronavirus pneumonia is characterized by highly infectious, rapid progress, and diverse clinical and imaging features. Early diagnosis and active comprehensive treatment could improve theprognosis and reduce themortality.


Myositis as a manifestation of SARS-CoV-2


title: Epidemiological and Clinical Characteristics of Patients With Coronavirus Disease-2019 in Shiyan City, China

text: To investigate the early epidemic of COVID-19, a total of 176 confirmed COVID-19 cases in Shiyan city, Hubei province, China were surveyed. Our data indicated that the rate of emergence of early confirmed COVID-19 cases in Hubei province outside Wuhan was dependent on migration population, and the second-generation of patients were family clusters originating from Wuhan travelers. Epidemiological investigation indicated that the reproductive number (R0) under containment strategies was 1.81, and asymptomatic SARS-CoV-2 carriers were contagious with a transmission rate of 10.7%. Among the 176 patients, 53 were admitted to the Renmin Hospital of Hubei University of Medicine. The clinical characteristics of these 53 patients were collected and compared based on a positive RT-PCR test and presence of pneumonia. Clinical data showed that 47.2% (25/53) of COVID-19 patients were co-infected with Mycoplasma pneumoniae, and COVID-19 patients coinfected with M. pneumoniae had a higher percentage of monocytes (P < 0.0044) and a lower neutrophils percentage (P < 0.0264). Therefore, it is important to assess the transmissibility of infected asymptomatic individuals for SARS-CoV-2 transmission; moreover, clinicians should be alert to the high incidence of co-infection with M. pneumoniae in COVID-19 patients.


title: The modified NUTRIC score can be used for nutritional risk assessment as well as prognosis prediction in critically ill COVID-19 patients

text: BACKGROUND & AIMS: In the newly emerged Coronavirus Disease 2019 (COVID-19) disaster, little is known about the nutritional risks for critically ill patients. It is also unknown whether the modified Nutrition Risk in the Critically ill (mNUTRIC) score is applicable for nutritional risk assessment in intensive care unit (ICU) COVID-19 patients. We set out to investigate the applicability of the mNUTRIC score for assessing nutritional risks and predicting outcomes for these critically ill COVID-19 patients. METHODS: This retrospective observational study was conducted in three ICUs which had been specially established and equipped for COVID-19 in Wuhan, China. The study population was critically ill COVID-19 patients who had been admitted to these ICUs between January 28 and February 21, 2020. Exclusion criteria were as follows: 1) patients of ï¼18 years; 2) patients who were pregnant; 3) length of ICU stay of ï¼24 h; 4) insufficient medical information available. Patients' characteristics and clinical information were obtained from electronic medical and nursing records. The nutritional risk for each patient was assessed at their ICU admission using the mNUTRIC score. A score of ≥5 indicated high nutritional risk. Mortality was calculated according to patients' outcomes following 28 days of hospitalization in ICU. RESULTS: A total of 136 critically ill COVID-19 patients with a median age of 69 years (IQR: 57-77), 86 (63%) males and 50 (37%) females, were included in the study. Based on the mNUTRIC score at ICU admission, a high nutritional risk (≥5 points) was observed in 61% of the critically ill COVID-19 patients, while a low nutritional risk (<5 points) was observed in 39%. The mortality of ICU 28-day was significantly higher in the high nutritional risk group than in the low nutritional risk group (87% vs 49%, P ï¼0.001). Patients in the high nutritional risk group exhibited significantly higher incidences of acute respiratory distress syndrome, acute myocardial injury, secondary infection, shock and use of vasopressors. Additionally, use of a multivariate Cox analysis showed that patients with high nutritional risk had a higher probability of death at ICU 28-day than those with low nutritional risk (adjusted HR = 2.01, 95% CI: 1.22-3.32, P = 0.006). CONCLUSIONS: A large proportion of critically ill COVID-19 patients had a high nutritional risk, as revealed by their mNUTRIC score. Patients with high nutritional risk at ICU admission exhibited significantly higher mortality of ICU 28-day, as well as twice the probability of death at ICU 28-day than those with low nutritional risk. Therefore, the mNUTRIC score may be an appropriate tool for nutritional risk assessment and prognosis prediction for critically ill COVID-19 patients.


title: How to obtain evidence of vertical transmission in viral infected pregnant women: Reflection on COVID-19 epidemic/ 中华围产医学杂志

text: During the COVID-19 epidemic, there have been many misconceptions concerning vertical transmission between the mother and fetus/baby, which has caused much discussion and controversy. However, there is no strong evidence to indicate that this novel coronavirus could be vertically transmitted from infected mothers to their fetuses/infants. Several easily confused concepts are clarified in this paper, including vertical transmission, intrauterine transmission, mother-to-infant transmission, intrapartum or postpartum transmission. Well-designed protocols and a disciplined research team are essential for both basic and clinical research, in order to contribute to obtaining more scientific evidence for better understanding of the characteristics of this novel coronavirus. Proper handling and disposal of the body fluids and tissue are critical for safety. We highlight the significant value of relevant research, and suggest future research directions, such as investigating the impact of COVID-19 in different trimesters. Furthermore, China has the most experience of treating pregnant women exposed to the COVID-19 virus, and it would be a great service to the rest of the world, for all centers in China to collaborate to report this collective experience.


title: Comparison of Citations Trends between the COVID-19 Pandemic and SARS-CoV, MERS-CoV, Ebola, Zika, Avian and Swine Influenza Epidemics

text: Objective: The novel coronavirus COVID-19 outbreak rapidly evolved into pandemic. Global research efforts focus on this topic and with the collaboration of the scientific journals publication industry produced more than 16,000 related published articles in PubMed within five months from the onset of the outbreak. Herein, a comparison of the COVID-19 citations in PubMed and Web of Science was performed with SARS-CoV, MERS-CoV, Ebola, Zika, avian and swine influenza epidemics. Methods: The citations were searched and collected using the disease terms and the date of publication restriction. The total number of PubMed citations and the HIV associated papers during the same chronological periods were examined in parallel. The journal category and country information of the publications were gathered from Web of Science. The collected data were statistically analyzed and compared. Results: Significant correlations were found between COVID-19 and MERS (CC=0.988; p=0.003; q=0.006), Ebola (CC=0.987; p=0.003; q=0.011), and SARS (CC=0.964; p=0.015; q=0.028) epidemics five-month pick of novel citations in PubMed. However, COVID-19 publications were accumulated earlier and in larger numbers than any other 21st century major communicable disease outbreak. Conclusion: The acceleration and the total number of COVID-19 publications represent an unprecedented landmark event in the medical library history. The immediate adoption of the fast-track peer-reviewing and publishing as well as the open access publication policies by the journal publishers are significant contributors to this bibliographic phenomenon.


ARIA-EAACI statement on Asthma and COVID-19 (June 2, 2020)


Utility of nasopharyngeal swabs in series before hospitalization during SARS-CoV-2 outbreak


title: Telemedicina con telemonitorización en el seguimiento de pacientes con COVID-19./ Telemedicina con telemonitorización en el seguimiento de pacientes con COVID-19./ Tracing of COVID-19 patients by telemedicine with telemonitoring

text: AIM: To asses if telemedicine with telemonitoring is a clinically useful and secure tool in the tracking of patients with COVID-19. METHODS: A prospective observational study of patients with COVID-19 diagnosis by positive PCR considered high-risk tracked with telemedicine and telemonitoring was conducted in the sanitary area of Lugo between March 17th and April 17th, 2020. Two groups of patients were included: Outpatient Tracing from the beginning and after discharge. Every patient sent a daily clinical questionnaire with temperature and oxygen saturation 3 times a day. Proactive monitoring was done by getting in touch with every patient at least 11a day. RESULTS: 313 patients (52.4% female) with a total average age of 60.9 (DE 15.9) years were included. Additionally, 2 patients refused to join the program. Since the beginning, 224 were traced outpatient and 89 after being discharged. Among the first category, 38 (16.90%) were referred to Emergency department on 43 occasions; 18 were hospitalized (8.03%), and 2 deceased. Neither deaths nor a matter of vital emergency occurred at home. When including patients after admissions monitoring was done in 304 cases. One patient re-entered (0.32%) to the hospital, and another one left the program (0.32%). The average time of monitoring was 11.64 (SD 3.58) days, and 224 (73.68%) patients were discharged during the 30 days of study. CONCLUSIONS: Our study suggests that telemedicine with home telemonitoring, used proactively, allows for monitoring high-risk patients with COVID-19 in a clinically useful and secure way.


Prise en charge des cancers du sein pendant la pandémie de COVID 19 : le CNGOF se mobilise./ [Breast cancer management during the COVID 19 pandemic: The CNGOF takes action]


Prise en charge des cancers du sein pendant la pandémie de COVID 19 : le CNGOF se mobilise./ [Breast cancer management during the COVID 19 pandemic: the CNGOF takes action]


title: Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey

text: Unprecedented measures have been adopted to control the rapid spread of the ongoing COVID-19 epidemic in China. People's adherence to control measures is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. In this study, we investigated Chinese residents' KAP towards COVID-19 during the rapid rise period of the outbreak. An online sample of Chinese residents was successfully recruited via the authors' networks with residents and popular media in Hubei, China. A self-developed online KAP questionnaire was completed by the participants. The knowledge questionnaire consisted of 12 questions regarding the clinical characteristics and prevention of COVID-19. Assessments on residents' attitudes and practices towards COVID-19 included questions on confidence in winning the battle against COVID-19 and wearing masks when going out in recent days. Among the survey completers (n=6910), 65.7% were women, 63.5% held a bachelor degree or above, and 56.2% engaged in mental labor. The overall correct rate of the knowledge questionnaire was 90%. The majority of the respondents (97.1%) had confidence that China can win the battle against COVID-19. Nearly all of the participants (98.0%) wore masks when going out in recent days. In multiple logistic regression analyses, the COVID-19 knowledge score (OR: 0.75-0.90, P<0.001) was significantly associated with a lower likelihood of negative attitudes and preventive practices towards COVID-2019. Most Chinese residents of a relatively high socioeconomic status, in particular women, are knowledgeable about COVID-19, hold optimistic attitudes, and have appropriate practices towards COVID-19. Health education programs aimed at improving COVID-19 knowledge are helpful for Chinese residents to hold optimistic attitudes and maintain appropriate practices. Due to the limited sample representativeness, we must be cautious when generalizing these findings to populations of a low socioeconomic status.


Arterial hypertension and risk of death in patients with COVID-19 infection: Systematic review and meta-analysis


Shut down and reboot-preparing to minimise infection in a post-COVID-19 era


AHPBA Webinar about Covid-19: lessons learned responding to a pandemic


title: Mutations can reveal how the coronavirus moves—but they’re easy to overinterpret ;Science ;AAAS

text: mmediately after Christian Drosten published a genetic sequence of the novel coronavirus online on 28 February, he took to Twitter to issue a warning As the virus has raced around the world, more than 350 genome sequences have been shared on the online platform GISAID They hold clues to how the new virus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading and evolving But because the sequences represent a tiny fraction of cases and show few telltale differences, they are easy to overinterpret, as Drosten realized A virologist at the Charité University Hospital in Berlin, he had sequenced the virus from a German patient infected with COVID-19 in Italy The genome looked similar to that of a virus found in a patient in Munich, the capital of Bavaria, more than 1 month earlier;both shared three mutations not seen in early sequences from China Drosten realized this could give rise to the idea that the Italian outbreak was “seeded” by the one in Bavaria, which state public health officials said had been quashed by tracing and quarantining all contacts of the 14 confirmed cases But he thought it was just as likely that a Chinese variant carrying the three mutations had taken independent routes to both countries The newly sequenced genome “is not sufficient to claim a link between Munich and Italy,” Drosten tweeted


title: Electrical probing of COVID-19 spike protein receptor binding domain via a graphene field-effect transistor

text: Here, in an effort towards facile and fast screening/diagnosis of novel coronavirus disease 2019 (COVID-19), we combined the unprecedently sensitive graphene field-effect transistor (Gr-FET) with highly selective antibody-antigen interaction to develop a coronavirus immunosensor. The Gr-FET immunosensors can rapidly identify (about 2 mins) and accurately capture the COVID-19 spike protein S1 (which contains a receptor binding domain, RBD) at a limit of detection down to 0.2 pM, in a real-time and label-free manner. Further results ensure that the Gr-FET immunosensors can be promisingly applied to screen for high-affinity antibodies (with binding constant up to 2*10^11 M^-1 against the RBD) at concentrations down to 0.1 pM. Thus, our developed electrical Gr-FET immunosensors provide an appealing alternative to address the early screening/diagnosis as well as the analysis and rational design of neutralizing-antibody locking methods of this ongoing public health crisis.


title: The sensitivity and specificity analyses of ambient temperature and population size on the transmission rate of the novel coronavirus (COVID-19) in different provinces of Iran

text: On 10 April 2020, Iran reported 68,192 COVID-19 cumulative cases including 4232 death and 35,465 recovery cases. Numerous factors could influence the transmission rate and survival of coronavirus. On this basis and according to the latest epidemiological researches, both ambient temperature (AT) and population size (PS) can be considered as significant transmissibility factors for coronavirus. The analysis of receiver operating characteristics (ROC) allows measuring the performance of a classification model using the confusion matrix. This study intends to investigate the sensitivity of AT and PS on the transmission rate of the novel coronavirus in different provinces of Iran. For this purpose, the information of each province of Iran including the annual average of AT and the number of healthy and diseased cases are categorized. Subsequently, the sensitivity and specificity analyses of both AT and PS factors are performed. The obtained results confirm that AT and PS have low sensibility and high sensitivity, respectively. Thus, there is no scientific reason to confirm that the number of COVID-19 cases in warmer climates is less than that of moderate or cold climates. Therefore, it is recommended that the cities/provinces with a population of over 1.7 million people have stricter inspections and more precise controls as their management policy.


Covid-19: Why Germany's case fatality rate seems so low


title: Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19

text: Previously, we showed that 3% (31/1032)of asymptomatic healthcare workers (HCWs) from a large teaching hospital in Cambridge, UK, tested positive for SARS-CoV-2 in April 2020. About 15% (26/169) HCWs with symptoms of coronavirus disease 2019 (COVID-19) also tested positive for SARS-CoV-2 (Rivett et al., 2020). Here, we show that the proportion of both asymptomatic and symptomatic HCWs testing positive for SARS-CoV-2 rapidly declined to near-zero between 25th April and 24th May 2020, corresponding to a decline in patient admissions with COVID-19 during the ongoing UK 'lockdown'. These data demonstrate how infection prevention and control measures including staff testing may help prevent hospitals from becoming independent 'hubs' of SARS-CoV-2 transmission, and illustrate how, with appropriate precautions, organizations in other sectors may be able to resume on-site work safely.


text: Previously we showed that 31/1,032 (3%) asymptomatic healthcare workers (HCW) from a large teaching hospital in Cambridge UK tested positive for SARS-CoV-2 in April 2020. 26/169 (15%) HCWs with symptoms of coronavirus disease 2019 (COVID-19) also tested positive (Rivett et al., 2020). Here we show that the proportion of both asymptomatic and symptomatic HCWs testing positive rapidly declined to near-zero between 25th April and 24th May 2020, corresponding with a decline in patient admissions with COVID-19 during the ongoing UK 'lockdown'. These data demonstrate how infection prevention and control measures including staff testing may help prevent hospitals from becoming independent 'hubs' of SARS-CoV-2 transmission, and illustrate how, with appropriate precautions, organisations in other sectors may be able to resume on-site work safely.


Management of surgery in the era of COVID-19: preliminary data from 11 medical centres in Beijing


Kawasaki disease linked to COVID-19 in children


title: No Participant Left Behind: Conducting Science During COVID-19

text: Cognitive scientists have ramped up online testing in response to the COVID-19 pandemic. Although research conducted online solves the problem of data collection, the paucity of internet access among low-income and minority communities may reduce the diversity of study samples, and thus have an impact on the generalizability of scientific findings.


title: Predicting potential drug targets and repurposable drugs for COVID-19 via a deep generative model for graphs

text: Coronavirus Disease 2019 (COVID-19) has been creating a worldwide pandemic situation. Repurposing drugs, already shown to be free of harmful side effects, for the treatment of COVID-19 patients is an important option in launching novel therapeutic strategies. Therefore, reliable molecule interaction data are a crucial basis, where drug-/protein-protein interaction networks establish invaluable, year-long carefully curated data resources. However, these resources have not yet been systematically exploited using high-performance artificial intelligence approaches. Here, we combine three networks, two of which are year-long curated, and one of which, on SARS-CoV-2-human host-virus protein interactions, was published only most recently (30th of April 2020), raising a novel network that puts drugs, human and virus proteins into mutual context. We apply Variational Graph AutoEncoders (VGAEs), representing most advanced deep learning based methodology for the analysis of data that are subject to network constraints. Reliable simulations confirm that we operate at utmost accuracy in terms of predicting missing links. We then predict hitherto unknown links between drugs and human proteins against which virus proteins preferably bind. The corresponding therapeutic agents present splendid starting points for exploring novel host-directed therapy (HDT) options.


Amiodarone as a possible therapy for coronavirus infection


Ways of Protecting Religious Older Adults from the Consequences of COVID-19


COVID-19 positive test result from a private hospital laboratory: Neglecting to report and problems with national infection control


title: Emerging Adults and COVID-19: The Role of Individualism-Collectivism on Perceived Risks and Psychological Maladjustment

text: The outbreak of the coronavirus disease 2019 (COVID-19) has dramatically changed our habits and routines. Uncertainty, insecurity, instability for the present and future, and reduced autonomy and self-directedness, are common feelings at the time of COVID-19. These aspects are very important during emerging adulthood. In spite of the fact that medical reports suggest that youth are less prone to experience COVID-19 infections, emerging adults might be at higher risk for their psychological adjustment. Emerging adults showed higher concerns about their role as a possible asymptomatic carrier than being positive with COVID-19 themselves. Both worries and concerns about COVID-19 and psychological maladjustment may be related to cultural factors. Individualism, collectivism, equality, and hierarchy seem to be meaningful perspectives to take into account. A total of 1183 Italian emerging adults were asked to fill out an online survey during the second week of the national lockdown in Italy. Results showed they reported an accurate perceived knowledge about COVID-19. At the same time, they showed higher worries and concerns about COVID-19 for their relatives, followed by more general/social worries. The lowest score included worries about COVID-19 related to themselves. State anxiety and stress levels were above the normal cutoff, confirming the challenges that emerging adults are facing during the pandemic. On one hand, emerging adults' collectivistic orientation was related to higher perceived risks of infection; on the other hand, it predicted lower psychological maladjustment, controlling for socio-demographic variables. The study suggests that to fight the COVID-19 pandemic and decrease levels of psychological maladjustment in emerging adulthood, individuals' cultural orientation such as the wish of sharing common goals with others, interdependence, and sociability, have to be emphasized and promoted as protective factors.


title: Might renin-angiotensin system blockers play a role in the COVID-19 pandemic?

text: Since December 2019, a new coronavirus, named SARS-CoV-2, has spread globally, affecting >200 000 people worldwide with the so-called COVID-19 disease. The scientific community is actively and constantly working to identify the mechanisms involved in the diffusion of this virus and the pathogenesis of the infection, with its most frequent and severe complication, namely interstitial pneumonia. To date, SARS-CoV-2 is known to enter the host cells via the angiotensin-converting enzyme 2 protein. For this reason, the hypothesis that drugs capable of increasing the expression of this protein may have a role in the spread of the virus and in the symptomatology of affected patients has taken hold. The purpose of this Editorial is to briefly show the evidence currently available in this regard and to provide ideas for future research.


title: Estimation of COVID-19-induced depletion of hospital resources in Ontario, Canada

text: BACKGROUND: The global spread of coronavirus disease 2019 (COVID-19) continues in several jurisdictions, causing substantial strain to health care systems. The purpose of our study was to predict the effect of the COVID-19 pandemic on patient outcomes and use of hospital resources in Ontario, Canada. METHODS: We developed an individual-level simulation to model the flow of patients with COVID-19 through the hospital system in Ontario. We simulated different combined scenarios of epidemic trajectory and hospital health care capacity. Our outcomes included the number of patients who needed admission to the ward or to the intensive care unit (ICU) with or without the need for mechanical ventilation, number of days to resource depletion, number of patients awaiting resources and number of deaths. RESULTS: We found that with effective early public health measures, hospital system resources would not be depleted. For scenarios with late or ineffective implementation of physical distancing, hospital resources would be depleted within 14-26 days, and in the worst case scenario, 13 321 patients would die while waiting for needed resources. Resource depletion would be avoided or delayed with aggressive measures to increase ICU, ventilator and acute care hospital capacities. INTERPRETATION: We found that without aggressive physical distancing measures, the Ontario hospital system would have been inadequately equipped to manage the expected number of patients with COVID-19 despite a rapid increase in capacity. This lack of hospital resources would have led to an increase in mortality. By slowing the spread of the disease using public health measures and by increasing hospital capacity, Ontario may have avoided catastrophic stresses to its hospitals.