Paediatric treatment trials for COVID-19 are an ethical imperative


title: Majorana Zero Modes in Nanowires with Combined Triangular and Hexagonal Geometry

text: The effects of geometry on the hosting of Majorana zero modes are explored in core-shell nanowires with a hexagonal core and a triangular shell, and vice versa. The energy interval separating electronic states localized in the corners from states localized on the sides of the shell is shown to be larger for a triangular nanowire with a hexagonal core, than a triangular one. We build the topological phase diagram for both cases and compare them to earlier work on prismatic nanowires with the same core and shell geometry. We suggest that a dual core nanowire is needed to allow for braiding operation of Majorana zero modes at the nanowire end plane.


title: Current Resources for Evidence-Based Practice, May 2020

text: An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of a new National Academy of Medicine report on planned place of birth and implications during the SARS-CoV-2 pandemic and commentaries on reviews focused on anorectal sexually transmitted infections and feeding methods following cleft lip repair in infants.


title: The Influence of COVID-19 on Air Quality in India: A Boon or Inutile

text: Corona virus diseases-2019 (COVID-19), an infectious disease identified in late December, 2019, in Wuhan city of China, was declared a pandemic by the World Health Organization. Most countries including India have announced some sort of lockdown to reduce the effects of COVID-19 and discontinue the transmission of novel coronavirus. Major negative effects on the social and surrounding environment have been reported due to COVID-19, however positive effects have also been observed with respect to air quality. Secondary results have been taken from National Aeronautics and Space Administration (NASA), indicating significant reduction (50%) in air quality of Indian region. This perspective highlights the effects of the lockdown due to COVID-19 on aerosol optical thickness specifically in India.


docid: tdjdlnrk

title: Guidance for Health Care Providers on Management of Cardiovascular Complications in Patients Suspected or Confirmed with COVID 19 Virus Infection


title: Bibliometric analysis of PubMed literature on Coronavirus Disease 2019/ 中华医学科研管理杂志

text: Objective@#To systematically analyze the distribution of research hotspots related to the COVID, provide reference for future scientific research.@*Methods@#Relevant literatures collected by PubMed database since December 1, 2019 were retrieved, the key information related to literatures was extracted and analyzed, and the wordcloud2 package of R software was used for word frequency analysis.@*Results@#A total number of 194 valid papers were obtained, which published in 81 journals. Most papers was published in early February 2020, and a maximum of 24 papers were published in a single day. 167 papers (86.08%) were written in English. These papers included case reports, expert opinions, guidelines, articles, reviews, communications and other forms, and the subjects included epidemiology, prevention and control, virology, diagnosis and treatment, pathology and etiology, vaccines and drugs, epidemic prediction models, and bioinformatics analysis. The proportion of article in English literatures was higher than that in Chinese literatures (P=0.005). Among them, 91 papers (46.9%) were independently completed by the Chinese researchers, 15 papers (7.7%) were completed by the Chinese and foreign researchers, and 88 papers (45.4%) were completed by foreign researchers.@*Conclusions@#At present, the researches on the new coronavirus pneumonia mainly focus on virology and epidemiology, but lack of relevant research results such as treatment and prognosis.


title: Consideraciones para la Atención de Urgencia Odontológica y Medidas Preventivas para COVID-19 (SARS-CoV 2)

text: El siguiente artículo busca presentar diversas consideraciones para la atención odontológica a fin de disminuir riesgo de exposición al virus «Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)¼ para el profesional odontólogo La higiene y el lavado de manos tanto de profesionales como de pacientes, es considerado uno de los puntos más críticos para reducir el contagio Los odontólogos también deben preferir procedimientos electivos, en caso de atención de urgencias tomar medidas estrictas de bioseguridad para la protección de la piel y mucosas y considerar diferir en lo posible la atención odontológica en pacientes con signos y síntomas de Coronavirus (COVID-19)


title: What if the worst consequences of COVID-19 concerned non-COVID patients?

text: We highlight in this short article the side-effects of COVID-19 pandemic on the management of non-COVID patients, with potential detrimental and irreversible complications. We thus propose adjusted strategies to deal with both COVID and non-COVID patients.


title: Neonatal Resuscitation Where the Mother Has a Suspected or Confirmed Novel Coronavirus (SARS-CoV-2) Infection: Suggestion for a Pragmatic Action Plan

text: Coronavirus disease 2019 (COVID-19), caused by the novel SARS-CoV-2 virus, is rapidly spreading across the world. As the number of infections increases, those of infected pregnant women and children will rise as well. Controversy exists whether COVID-19 can be transmitted in utero and lead to disease in the newborn. As this chance cannot be ruled out, strict instructions for the management of mothers and newborn infants are mandatory. This perspective aims to be a practical support tool for the planning of delivery and neonatal resuscitation of infants born by mothers with suspected or confirmed COVID-19 infection.


The COVID-19 crisis: reflections on cardiothoracic surgery training


Coming back to the normal clinic: how has COVID-19 changed us?


title: Predicting Mortality Risk in Viral and Unspecified Pneumonia to Assist Clinicians with COVID-19 ECMO Planning

text: Respiratory complications due to coronavirus disease COVID-19 have claimed tens of thousands of lives in 2020. Many cases of COVID-19 escalate from Severe Acute Respiratory Syndrome (SARS-CoV-2) to viral pneumonia to acute respiratory distress syndrome (ARDS) to death. Extracorporeal membranous oxygenation (ECMO) is a life-sustaining oxygenation and ventilation therapy that may be used for patients with severe ARDS when mechanical ventilation is insufficient to sustain life. While early planning and surgical cannulation for ECMO can increase survival, clinicians report the lack of a risk score hinders these efforts. In this work, we leverage machine learning techniques to develop the PEER score, used to highlight critically ill patients with viral or unspecified pneumonia at high risk of mortality or decompensation in a subpopulation eligible for ECMO. The PEER score is validated on two large, publicly available critical care databases and predicts mortality at least as well as other existing risk scores. Stratifying our cohorts into low-risk and high-risk groups, we find that the high-risk group also has a higher proportion of decompensation indicators such as vasopressor and ventilator use. Finally, the PEER score is provided in the form of a nomogram for direct calculation of patient risk, and can be used to highlight at-risk patients among critical care patients eligible for ECMO.


title: Importance of SARs-Cov-2 anosmia: From phenomenology to neurobiology

text: Anosmia and hypogeusia, the inability or decreased ability to smell and taste, have been reported as common complaints in SARS-CoV-2 patients who were still in an asymptomatic phase. These impairments affect the ability to sense odors in foods and the environment, obviously affecting quality of life, related to social interactions and general well-being. The British Association of Otorhinolaryngology (ENT-UK) considers loss of sense of smell in their list of COVID-19's markers of infection. Here we present two cases in which early manifestations of anosmia and hypogeusia were experienced with psycho-sensorial and atmospheric phenomena. Psychiatrists, neurologists and physicians in general should be aware of this symptom presentation in order to avoid mistreatment, given that persistent olfactory dysfunction might increase the risks of nutritional deficit and lead to development of adjustment disorders. All clinicians should be aware that the presentation of SARS-CoV-2's symptoms goes far beyond respiratory and sensorial dimensions and involves psychosensorial and neurological dimensions; these clinical observations could shed light on the neurobiological substrates involved in COVID-19 disease.


title: Disruption of joint arthroplasty services in Europe during the COVID-19 pandemic: an online survey within the European Hip Society (EHS) and the European Knee Associates (EKA)

text: PURPOSE: The aim of the present study was to evaluate the impact of the coronavirus (COVID-19) pandemic on joint arthroplasty service in Europe by conducting an online survey of arthroplasty surgeons. METHODS: The survey was conducted in the European Hip Society (EHS) and the European Knee Associates (EKA). The survey consisted of 20 questions (single, multiple choice, ranked). Four topics were addressed: (1) origin and surgical experience of the participant (four questions); (2) potential disruption of arthroplasty surgeries (12 questions); (3) influence of the COVID-19 pandemic on the particular arthroplasty surgeon (four questions); (4) a matrix provided 14 different arthroplasty surgeries and the participant was asked to state whether dedicated surgery was stopped, delayed or cancelled. RESULTS: Two-hundred and seventy-two surgeons (217 EHS, 55 EKA) from 40 different countries participated. Of the respondents, 25.7% stated that all surgeries were cancelled in their departments, while 68.4% responded that elective inpatient procedures were no longer being performed. With regard to the specific surgical procedures, nearly all primary TJA were cancelled (92.6%) as well as aseptic revisions (94.7%). In most hospitals, periprosthetic fractures (87.2%), hip arthroplasty for femoral neck fractures and septic revisions for acute infections (75.8%) were still being performed. CONCLUSION: During the current 2020 COVID-19 pandemic, we are experiencing a near-total shutdown of TJA. A massive cutback was observed for primary TJA and revision TJA, even in massively failed TJA with collapse, dislocation, component failure or imminent dislocation. Only life-threatening pathologies like periprosthetic fractures and acute septic TJA are currently undergoing surgical treatment. LEVEL OF EVIDENCE: V.


title: Hypoalbuminemia predicts the outcome of COVID-19 independent of age and co-morbidity

text: The coronavirus disease 2019 (COVID-19) has evolved into a pandemic rapidly. Most of the literature show that the elevated liver enzymes in COVID-19 are of little clinical significance. Lower albumin level is seen in severe COVID-19 and is not parallel to the changes in alanine aminotransferase and aspartate aminotransferase levels. We aimed to explore the impact of hypoalbuminemia in COVID-19. This retrospective cohort study included adult patients with confirmed COVID-19. The relationship between hypoalbuminemia and death was studied using binary logistic analysis. A total of 299 adult patients were included, 160 (53.5%) were males and the average age was 53.4 ± 16.7 years. The median time from the onset of illness to admission was 3 days (interquartile ranges, 2-5). Approximately one-third of the patients had comorbidities. Hypoalbuminemia (<35 g/L) was found in 106 (35.5%) patients. The difference in albumin was considerable between survivors and non-survivors (37.6 ± 6.2 vs 30.5 ± 4.0, P < .001). Serum albumin level was inversely correlated to white blood cell (r = -.149, P = .01) and neutrophil to lymphocyte ratio (r = -.298, P < .001). Multivariate analysis showed the presence of comorbidities (OR, 6.816; 95% CI, 1.361-34.133), lymphopenia (OR, 13.130; 95% CI, 1.632-105.658) and hypoalbuminemia (OR, 6.394; 95% CI, 1.315-31.092) were independent predictive factors for mortality. In conclusion, hypoalbuminemia is associated with the outcome of COVID-19. The potential therapeutic value of albumin infusion in COVID-19 should be further explored at the earliest.


Questions raised by COVID-19 case descriptions


title: A highly conserved cryptic epitope in the receptor binding domains of SARS-CoV-2 and SARS-CoV

text: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has now become a pandemic, but there is currently very little understanding of the antigenicity of the virus. We therefore determined the crystal structure of CR3022, a neutralizing antibody previously isolated from a convalescent SARS patient, in complex with the receptor binding domain (RBD) of the SARS-CoV-2 spike (S) protein at 3.1-angstrom resolution. CR3022 targets a highly conserved epitope, distal from the receptor binding site, that enables cross-reactive binding between SARS-CoV-2 and SARS-CoV. Structural modeling further demonstrates that the binding epitope can only be accessed by CR3022 when at least two RBDs on the trimeric S protein are in the "up" conformation and slightly rotated. These results provide molecular insights into antibody recognition of SARS-CoV-2.


title: Analysis of vaginal delivery outcomes among pregnant women in Wuhan, China during the COVID-19 pandemic

text: OBJECTIVE: To study vaginal delivery outcomes and neonatal prognosis and summarize the management of vaginal delivery during the COVID-19 pandemic. METHODS: A retrospective analysis of medical records and comparison of vaginal delivery outcomes between 10 pregnant women with clinical diagnosis of COVID-19 and 53 pregnant women without COVID-19 admitted to Zhongnan Hospital of Wuhan University between January 20 and March 2, 2020. Results of laboratory tests, imaging tests, and SARS-CoV-2 nucleic acid tests were also analyzed in neonates delivered by pregnant women with clinical diagnosis of COVID-19. RESULTS: There were no significant differences in gestational age, postpartum hemorrhage, and perineal resection rates between the two groups. There were no significant differences in birth weight of neonates and neonatal asphyxia rates between the two groups. Neonates delivered by pregnant women with clinical diagnosis of COVID-19 tested negative for SARS-CoV-2 infection. CONCLUSIONS: Under the premise of full evaluation of vaginal delivery conditions and strict protection measures, pregnant women with ordinary type COVID-19 can try vaginal delivery without exacerbation of COVID-19 and without increasing the risk of SARS-CoV-2 infection in neonates.


Is there enough evidence to discontinue the renin-angiotensin system inhibitors in patients with COVID-19?


Science in the fight against the novel coronavirus disease 2019 (COVID-19)


China's new public health constitution: a cause for hope?


title: Absence of nosocomial transmission of coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in the prepandemic phase in Hong Kong

text: BACKGROUND: To describe the infection control strategy to achieve zero nosocomial transmission of symptomatic coronavirus disease (COVID-19) due to SARS-CoV-2 during the prepandemic phase (the first 72 days after announcement of pneumonia cases in Wuhan) in Hong Kong. METHODS: Administrative support with the aim of zero nosocomial transmission by reducing elective clinical services, decanting wards, mobilizing isolation facilities, providing adequate personal protective equipment, coordinating laboratory network for rapid molecular diagnosis under 4-tier active surveillance for hospitalized patients and outpatients, and organizing staff forum and training was implemented under the framework of preparedness plan in Hospital Authority. The trend of SARS-CoV-2 in the first 72 days was compared with that of SARS-CoV 2003. RESULTS: Up to day 72 of the epidemic, 130 (0.40%) of 32,443 patients being screened confirmed to have SARS-CoV-2 by reverse transcription polymerase chain reaction. Compared with SARS outbreak in 2003, the SARS-CoV-2 case load constituted 8.9% (130 SARS-CoV-2/1458 SARS-CoV) of SARS-CoV infected cases at day 72 of the outbreak. The incidences of nosocomial acquisition of SARS-CoV per 1,000 SARS-patient-day and per 100 SARS-patient-admission were 7.9 and 16.9, respectively, which were significantly higher than the corresponding incidences of SARS-CoV-2 (zero infection, P <.001). CONCLUSIONS: Administrative support to infection control could minimize the risk of nosocomial transmission of SARS-CoV-2.


Neurological Manifestation of COVID-19 and the Enhanced Role of Physiatrists


title: Organization of biologic therapy during the COVID-19 pandemic based on example of Dermatology Clinic Centre of Postgraduate Medical Education in Warsaw

text: The COVID-19 pandemic spread to almost all countries in the world within a few months, necessitating changes in medical care for patients with SARS-CoV-2 infections as well as patients with various chronic diseases. Ensuring the safety of medical staff and patients in hospitals specializing in infectious diseases is a major logistical challenge. Psoriasis patients treated with immunosuppressive medications, including those under biologic therapy, are a special group. Many scientific societies do not recommend discontinuing therapy in patients without symptoms or confirmation of SARS-CoV-2 infection despite the potentially higher risk of respiratory tract infections in this patient population. Based on our own experience, we present the organization of the biologic therapy within the unit of a Single Specialty Infectious Hospital.


title: Discussing Serious News Remotely: Navigating Difficult Conversations During a Pandemic

text: The 2020 severe acute respiratory syndrome coronavirus 2 pandemic has led to an increasing number of telemedicine clinician-patient encounters through telephone or videoconference. This provides a particular challenge in cancer care, where discussions frequently pertain to serious topics and are preferably performed in person. In this review, we use the SPIKES (Setting, Perception, Invitation, Knowledge, Empathy/Emotion, and Strategy/Summarize) protocol as a framework for how to approach the discussion of serious news through telemedicine. We discuss the practical and technical aspects of preparation for a remote conversation and review some differences, limitations, and advantages of these discussions. The greatest challenge with the medium is the loss of the ability to read and display nonverbal cues. Vigilant attention to proven communication strategies and solicitation of patient involvement with the discussion can allow the care provider to display empathy at a distance. Having serious discussions through telemedicine is likely unavoidable for many providers in this unprecedented time. This summary provides some strategies to help to maintain the high standard of care that we all seek for our patients who are receiving serious news.


title: Continues renal replacement therapy (CRRT) with disposable hemoperfusion cartridge: A promising option for severe COVID-19

text: Cytokine release syndrome is prevalent in severe cases of COVID-19. In this syndrome, an uncontrolled response of immune system occurs. Extracorporeal blood purification has been proven to effectively remove the released inflammatory cytokines. Here, we reported a successful case to represent our experience of extracorporeal blood purification in a patient with severe COVID-19.


A missing link between SARS-CoV-2 and the eye?: ACE2 expression on the ocular surface


Serial CT features in discharged COVID-19 patients with positive RT-PCR re-test


The impact of COVID-19 on critical cardiac care and what is to come postpandemic


title: Delayed Diagnosis of Postintubation Tracheal Stenosis due to the Coronavirus Disease 2019 Pandemic: A Case Report

text: Tracheal stenosis is an uncommon but severe problem after long-term intubation. Here, we report a patient who came from a containment zone of coronavirus disease 2019 (COVID-19) and presented with complaints of breathlessness and cough. She was suspected to have an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Later, she developed type 2 respiratory failure and carbon dioxide narcosis because of delay in diagnosis of severe, near-complete postintubation tracheal stenosis due to over suspicion of COVID-19 during the current pandemic.


title: Biological plausibility for interactions between dietary fat, resveratrol, ACE2, and SARS-CoV illness severity

text: The angiotensin converting enzyme-2 (ACE2) cellular receptor is responsible for the pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), thus impacting the entrance and clearance of the virus. Studies demonstrate that upregulation of ACE2 has a protective effect on SARS-CoV-2 illness severity. Moreover, animal studies demonstrate that dietary intake can modulate ACE2 gene expression and function. A high intake of resveratrol may have a protective role, upregulating ACE2, whereas a high intake of dietary fat may have a detrimental role, downregulating ACE2. As such, we postulate on the biological plausibility of interactions between dietary fat and/or resveratrol and ACE2 gene variations in the modulation of SARS-CoV-2 illness severity. We call to action the research community to test this plausible interaction in a sample of human subjects.


title: Can steroids reverse the severe COVID-19 induced "cytokine storm"?

text: Severe coronavirus disease (COVID-19) is characterized by an excessive proinflammatory cytokine storm, resulting in acute lung injury and development of acute respiratory distress syndrome (ARDS). The role of corticosteroids is controversial in severe COVID-19 pneumonia and associated hyper-inflammatory syndrome. We reported a case series of six consecutive COVID-19 patients with severe pneumonia, ARDS and laboratory indices of hyper-inflammatory syndrome. All patients were treated early with a short course of corticosteroids, and clinical outcomes were compared before and after corticosteroids administration. All patients evaded intubation and intensive care admission, ARDS resolved within 11.8 days (median), viral clearance was achieved in four patients within 17.2 days (median), and all patients were discharged from the hospital in 16.8 days (median). Early administration of short course corticosteroids improves clinical outcome of patients with severe COVID-19 pneumonia and evidence of immune hyperreactivity.


title: Can steroids reverse the severe COVID-19 induced 'cytokine storm'?

text: Severe COVID-19 is characterized by an excessive pro-inflammatory cytokine storm, resulting in acute lung injury and development of ARDS. The role of corticosteroids is controversial in severe COVID-19 pneumonia and associated hyper-inflammatory syndrome. We reported a case series of six consecutive COVID-19 patients with severe pneumonia, ARDS and laboratory indices of hyper-inflammatory syndrome. All patients were treated early with a short course of corticosteroids, and clinical outcomes were compared before and after corticosteroids administration. All patients evaded intubation and intensive care admission, ARDS resolved within 11.8 days (median), viral clearance was achieved in 4 patients within 17.2 days (median), and all patients were discharged from the hospital in 16.8 days (median). Early administration of short course corticosteroids improves clinical outcome of patients with severe COVID-19 pneumonia and evidence of immune hyper-reactivity. This article is protected by copyright. All rights reserved.


Effective strategies to prevent coronavirus disease-2019 (COVID-19) outbreak in hospital


title: Clinical characteristics of four cancer patients with SARS-CoV-2 infection in Wuhan, China

text: BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the outbreak of pneumonia in Wuhan. The virus is highly infectious. Patients with cancer might be susceptible to the viral infection because of the immunosuppressive state cause by therapies on tumors. CASE PRESENTATION: We present the clinical features of four cancer patients who were infected with SARS-CoV-2 in late January of 2020 in our hospital. Cases 1 and 3 were diagnosed as mild and common type of coronavirus disease 2019 (COVID-2019) and survived from the viral infection. They acquired SARS-CoV-2 infection during their staying in hospital under radiotherapy and surgery of the tumors. Cases 2 and 4 suffered from severe type of COVID-19, and Case 2 was dead owning to the advanced age, uncontrolled chronic B cell lymphocytic leukemia and many other underlying diseases. The immunosuppressive state induced by liver transplantation and anti-rejection therapy might contribute to the severity of COVID-19 in Case 4, who suffered from hepatitis B related hepatocellular carcinoma. However, Case 4 was recovered from COVID-19 after a combination therapy against virus, bacteria and fungi, and also respiratory support. Nearly all patients showed a decrease in lymphocytes including total CD3+ T cells, B cells, and natural killer cells after infection of the virus. CONCLUSIONS: The severity of COVID-19 might be influenced by immune system state and underlying diseases in cancer patients. And the treatment of SARS-CoV-2 infection in cancer patients is challenged by the immunosuppressive state of these patients under chemotherapy or surgery.


title: Follow-up and management of head and neck cancer patients during the 2019 novel coronavirus (SARS-CoV-2) disease pandemic

text: The SARS-CoV-2 pandemic has significantly impacted healthcare delivery around the world. Elective procedures and routine follow-ups have been cancelled and/or converted to tele-health visits by many systems. In this article, we focus on recommendations for the surveillance of head and neck cancer patients during and following radiotherapy treatment. We synthesized information from clinical evidence, existing recommendations from the NCCN, and variations in practice between multiple academic tertiary cancer centers to develop the proposed guidance.


title: Biochemical indicators of coronavirus disease 2019 exacerbation and the clinical implications

text: Coronavirus Disease 2019 (COVID-19) has sparked a global pandemic, affecting more than 4 million people worldwide. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause acute lung injury (ALI) and even acute respiratory distress syndrome (ARDS); with a fatality of 7.0 %. Accumulating evidence suggested that the progression of COVID-19 is associated with lymphopenia and excessive inflammation, and a subset of severe cases might exhibit cytokine storm triggered by secondary hemophagocytic lymphohistiocytosis (sHLH). Furthermore, secondary bacterial infection may contribute to the exacerbation of COVID-19. We recommend using both IL-10 and IL-6 as the indicators of cytokine storm, and monitoring the elevation of procalcitonin (PCT) as an alert for initiating antibacterial agents. Understanding the dynamic progression of SARS-CoV-2 infection is crucial to determine an effective treatment strategy to reduce the rising mortality of this global pandemic.


docid: ujyizoka

title: Obesity and COVID-19: Oro-Naso-Sensory Perception

text: Through a recent upsurge of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, the clinical assessment of most of the coronavirus disease 19 (COVID-19) patients clearly presents a health condition with the loss of oro-naso-sensory (ONS) perception, responsible for the detection of flavor and savor. These changes include anosmia and dysgeusia. In some cases, these clinical manifestations appear even before the general flu-like symptoms, e.g., sore throat, thoracic oppression and fever. There is no direct report available on the loss of these chemical senses in obese COVID-19 patients. Interestingly, obesity has been shown to be associated with low ONS cues. These alterations in obese subjects are due to obesity-induced altered expression of olfacto-taste receptors. Besides, obesity may further aggravate the SARS-CoV-2 infection, as this pathology is associated with a high degree of inflammation/immunosuppression and reduced protection against viral infections. Hence, obesity represents a great risk factor for SARS-CoV-2 infection, as it may hide the viral-associated altered ONS symptoms, thus leading to a high mortality rate in these subjects.


title: COVID-19: Learning from Lessons To Guide Treatment and Prevention Interventions

text: Coronavirus disease 2019 (COVID-19) is caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and first emerged in December 2019 in Wuhan, Hubei province, China. Since then, the virus has rapidly spread to many countries. While the outbreak in China appears to be in decline, the disease has spread across the world, with a daily increase in the number of confirmed cases and infection-related deaths. Here, we highlight (i) the lessons that have been learnt so far and how they will benefit reducing the impact of COVID-19 disease and (ii) an update on the status of drug treatment and vaccine development to prevent COVID-19 and potential future related pandemics. Although the mortality rate is clearly higher than for influenza, the rate does seem to vary from country to country, possibly reflecting differences in how rapidly local health authorities respond to isolate and effectively care for the affected population. Drugs are urgently needed for both prophylaxis and the treatment of severely ill patients; however, no proven effective therapies for SARS-CoV-2 currently exist. A number of drugs that have been approved for other diseases are being tested for the treatment of COVID-19 patients, but there is an absence of data from appropriately designed clinical trials showing that these drugs, either alone or in combination, will prove effective. There is also a global urgency to develop a vaccine against COVID-19, but development and appropriate testing will take at least a year before such a vaccine will be globally available. This review summarizes the lessons learnt so far from the COVID-19 pandemic, examines the evidence regarding the drugs that are being tested for the treatment of COVID19, and describes the progress made in efforts to develop an effective vaccine.


title: How Shenzhen, China avoided widespread community transmission: a potential model for successful prevention and control of COVID-19

text: Shenzhen is a city of 22 million people in south China that serves as a financial and trade center for East Asia. The city has extensive ties to Hubei Province, the first reported epicenter of the coronavirus disease 2019 (COVID-19) outbreak in the world. Initial predictions suggested Shenzhen would experience a high number of COVID-19 cases. These predictions have not materialized. As of 31 March 2020 Shenzhen had only 451 confirmed cases of COVID-19. Contact tracing has shown that no cases were the result of community transmission within the city. While Shenzhen did not implement a citywide lockdown like Wuhan, it did put into place a rapid response system first developed after the severe acute respiratory syndrome (SARS) epidemic in 2003. In the wake of the 2003 SARS outbreak, Shenzhen health authority created a network for surveillance and responding to novel respiratory infections, including pneumonia of unknown causes (PUC). The network rapidly detected mass discussion about PUC and immediately deployed emergency preparedness, quarantine for close contacts of PUC. Five early actions (early detection, early reporting, early diagnosis, early isolation, and early treatment) and four centralized responses (centralized coordination by experts, centralized allocation of resources, centralized placement of patients, and centralized provision of treatment) ensured effective prevention and control. Tripartite working teams comprising community cadres, medical personnel and police were formulated to conduct contact tracing at each neighborhood and residential community. Incorporation of mobile technology, big data, and artificial intelligence into COVID-19 response increased accessibility to health services, reduced misinformation and minimized the impact of fake news. Shenzhen's unique experience in successfully controlling the COVID-19 outbreak may be a useful model for countries and regions currently experiencing rapid spread of the virus.


title: Is the Rigidity of SARS-CoV-2 Spike Receptor-Binding Motif the Hallmark for Its Enhanced Infectivity? Insights from All-Atom Simulations

text: The severe acute respiratory syndrome coronavirus (SARS-CoV-2) pandemic is setting the global health crisis of our time, causing a devastating societal and economic burden. An idiosyncratic trait of coronaviruses is the presence of spike glycoproteins on the viral envelope, which mediate the virus binding to specific host receptor, enabling its entry into the human cells. In spite of the high sequence identity of SARS-CoV-2 with its closely related SARS-CoV emerged in 2002, the atomic-level determinants underlining the molecular recognition of SARS-CoV-2 to the angiotensin-converting enzyme 2 (ACE2) receptor and, thus, the rapid virus spread into human body, remain unresolved. Here, multi-microsecond-long molecular dynamics simulations enabled us to unprecedentedly dissect the key molecular traits liable of the higher affinity/specificity of SARS-CoV-2 toward ACE2 as compared to SARS-CoV. This supplies a minute per-residue contact map underlining its stunningly high infectivity. Harnessing this knowledge is pivotal for urgently developing effective medical countermeasures to face the ongoing global health crisis.


title: Considerations for Bedside Urologic Procedures in Patients With Severe Acute Respiratory Syndrome Coronavirus-2

text: OBJECTIVE: To provide guidance when performing bedside urologic procedures on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positive patients and offer considerations to maximize the safety of the patients and providers, conserve supplies, and provide optimal management of urologic issues. METHODS: Urologic trainees and attending physicians at our institution, who are familiar with existing safety recommendations and guidelines regarding the care of infected patients, were queried regarding their experiences to determine an expert consensus on best practices for bedside procedures for SARS-CoV-2 positive patients. RESULTS: Our team developed the following general recommendations for urologic interventions on SARS-CoV-2 positive patients: maximize use of telehealth (even for inpatient consults), minimize in-room time, use personal protective equipment appropriately, enlist a colleague to assist, and acquire all supplies that may be needed and maintain them outside the room. Detailed recommendations were also developed for difficult urethral catheterization, bedside cystoscopy, incision and drainage of abscesses, and gross hematuria/clot irrigations. CONCLUSION: As patients hospitalized with SARS-CoV-2 infection are predominantly men over 50 years old, there are significant urologic challenges common in this population that have emerged with this pandemic. While there is tremendous variation in how different regions have been affected, the demographics of SARS-CoV-2 mean that urologists will continue to have a unique role in helping to manage these patients. Here, we summarize recommendations for bedside urologic interventions specific to SARS-CoV-2 positive patients based on experiences from a large metropolitan hospital system. Regulations and requirements may differ on an institutional basis, so these guidelines are intended to augment specific local protocols.


title: Forecasting the cumulative number of COVID-19 deaths in China: a Boltzmann function-based modeling study

text: The COVID-19 outbreak is ongoing in China. Here, Boltzmann function-based analyses reveal the potential total numbers of COVID-19 deaths: 3,260 (95% confidence interval [CI], 3187-3394) in China; 110 (95% CI, 109-112) in Hubei Province; 3,174 (95% CI, 3095-3270) outside Hubei; 2,550 (95% CI, 2494-2621) in Wuhan City; and 617 (95% CI, 607-632) outside Wuhan.


title: Immunoinformatics-aided identification of T cell and B cell epitopes in the surface glycoprotein of 2019-nCoV

text: The 2019 novel coronavirus (2019-nCoV) outbreak has caused a large number of deaths with thousands of confirmed cases worldwide, especially in East Asia. This study took an immunoinformatics approach to identify significant cytotoxic T lymphocyte (CTL) and B cell epitopes in the 2019-nCoV surface glycoprotein. Also, interactions between identified CTL epitopes and their corresponding major histocompatibility complex (MHC) class I supertype representatives prevalent in China were studied by molecular dynamics simulations. We identified five CTL epitopes, three sequential B cell epitopes and five discontinuous B cell epitopes in the viral surface glycoprotein. Also, during simulations, the CTL epitopes were observed to be binding MHC class I peptide-binding grooves via multiple contacts, with continuous hydrogen bonds and salt bridge anchors, indicating their potential in generating immune responses. Some of these identified epitopes can be potential candidates for the development of 2019-nCoV vaccines.


title: Debate: #Together despite the distance

text: The pandemic COVID-19 (SARS-CoV-2) has had a major global impact on the healthcare systems worldwide as they deal with the surge of critically ill persons. Additionally, the preventative measure of stay-at-home orders and closure of nonessential businesses has caused the disruption of entire communities. The child/youth mental health workforce bears the additional burden of the disruption of the systems-based practice crucial to the successful provision of mental health services. Major sources of stress for the workforce include: (a) a threat to the worker's personal/family health and life (traumatic injury), (b) a loss of colleagues or threat to professional mastery and identity (grief injury), (c) an inner conflict between ones' values and aspirations and what they are able to accomplish in their work (moral injury), and (d) fatigue, simply feeling worn out by the relentless work and need, without time for rest and recovery (fatigue injury). The rapid transformation of the in-person to virtual practice by the implementation of telehealth/telephonic sessions has eroded the boundary between personal/professional life and created a new Zoom fatigue.


Reply to Suri et al.: COVID-19 Real-Time RT-PCR: Does Positivity on Follow-up RT-PCR Always Imply Infectivity?


Reply to: COVID-19 Real-time RTPCR: Does Positivity on Follow up RTPCR Always Imply Infectivity?


title: A focused review on the genital and sexual affection of COVID-19 patients

text: The pandemic of coronavirus disease-2019 (COVID-19) could harm the reproductive and sexual health of both males and females. This could be through psychological, immunological, or systemic effects. In this article, we tried to elucidate the mechanisms that could explain the current and future genital affection of COVID-19 patients.


SECURE-Psoriasis: a de-identified registry of psoriasis patients diagnosed with COVID-19


Can spironolactone be used to prevent COVID-19-induced acute respiratory distress syndrome in patients with hypertension?


COVID-19: una pandemia de valores y algo más./ COVID-19: una pandemia de valores y algo más./ COVID-19: A pandemic of values and more


title: Clinical and radiological features of novel coronavirus pneumonia

text: Recently, COVID-19 has spread in more than 100 countries and regions around the world, raising grave global concerns. COVID-19 transmits mainly through respiratory droplets and close contacts, causing cluster infections. The symptoms are dominantly fever, fatigue, and dry cough, and can be complicated with tiredness, sore throat, and headache. A few patients have symptoms such as stuffy nose, runny nose, and diarrhea. The severe disease can progress rapidly into the acute respiratory distress syndrome (ARDS). Reverse transcription polymerase chain reaction (RT-PCR) and Next-generation sequencing (NGS) are the gold standard for diagnosing COVID-19. Chest imaging is used for cross validation. Chest CT is highly recommended as the preferred imaging diagnosis method for COVID-19 due to its high density and high spatial resolution. The common CT manifestation of COVID-19 includes multiple segmental ground glass opacities (GGOs) distributed dominantly in extrapulmonary/subpleural zones and along bronchovascular bundles with crazy paving sign and interlobular septal thickening and consolidation. Pleural effusion or mediastinal lymphadenopathy is rarely seen. In CT imaging, COVID-19 manifests differently in its various stages including the early stage, the progression (consolidation) stage, and the absorption stage. In its early stage, it manifests as scattered flaky GGOs in various sizes, dominated by peripheral pulmonary zone/subpleural distributions. In the progression state, GGOs increase in number and/or size, and lung consolidations may become visible. The main manifestation in the absorption stage is interstitial change of both lungs, such as fibrous cords and reticular opacities. Differentiation between COVID-19 pneumonia and other viral pneumonias are also analyzed. Thus, CT examination can help reduce false negatives of nucleic acid tests.


title: [The Effects and Management of Viral Pneumonia on Lung Cancer Patients]

text: The worldwide epidemic of three coronaviruses and one influenza virus in 21st century have seriously threatened human health. Infection with these viruses can cause respiratory symptoms. The patients with lung cancer are more susceptible to viral infection and have a worse prognosis due to the advanced age and the systemic immunosuppressive state caused by malignancy itself and the anticancer treatments. In addition, without sufficient clinical awareness, a missed diagnosis of viral pneumonia may occur due to the fever and respiratory symptoms caused by lung cancer and its secondary diseases. Furthermore, control measures against viral outbreaks may interfere with routine diagnosis and treatment of lung cancer patients. Therefore, scientific protection and individualized management of lung cancer patients are particularly important during virus epidemic prevention and control. Here, we systematically reviewed the epidemiological and clinical characteristics of viral pneumonia, its impact on patients with lung cancer and the differential diagnosis of lung cancer-related respiratory manifestations, aiming to provide guidance for the individual management of lung cancer patients during the prevention and control of viral pneumonia epidemic.


title: Thyroid Function Analysis in 50 Patients with COVID-19: A Retrospective Study

text: Background: Since the outbreak of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, it has affected >200 countries, areas, or territories in 6 continents. At present, whether COVID-19 has an effect on thyroid function is unclear. The aim of this study was to evaluate thyroid function in patients with COVID-19. Methods: Clinical manifestations, laboratory results, and chest computed tomography scans were retrospectively reviewed for 50 patients with laboratory-confirmed COVID-19 without a history of thyroid disease who underwent thyroid function testing during their course of COVID-19 infection and after recovery. They were admitted to the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China, between January and March 2020. Healthy participants who underwent routine physical checkups and non-COVID-19 pneumonia patients with a similar degree of severity during the same period were included in the study as the control group. Thyroid hormone and thyrotropin (TSH) levels were analyzed and compared between the COVID-19 and control groups. Results: TSH lower than the normal range was present in 56% (28/50) of the patients with COVID-19. The levels of TSH and serum total triiodothyronine (TT3) of the patients with COVID-19 were significantly lower than those of the healthy control group and non-COVID-19 pneumonia patients. The more severe the COVID-19, the lower the TSH and TT3 levels were, with statistical significance (p < 0.001). The degree of the decreases in TSH and TT3 levels was positively correlated with the severity of the disease. The total thyroxine (TT4) level of the patients with COVID-19 was not significantly different from the control group. All the patients did not receive thyroid hormone replacement therapy. After recovery, no significant differences in TSH, TT3, TT4, free triiodothyronine (fT3), and free thyroxine (fT4) levels were found between the COVID-19 and control groups. Conclusions: The changes in serum TSH and TT3 levels may be important manifestations of the courses of COVID-19.


title: A review of the systematic biology of fossil and living bony-tongue fishes, Osteoglossomorpha (Actinopterygii: Teleostei)

text: The bony-tongue fishes, Osteoglossomorpha, have been the focus of a great deal of morphological, systematic, and evolutionary study, due in part to their basal position among extant teleostean fishes. This group includes the mooneyes (Hiodontidae), knifefishes (Notopteridae), the abu (Gymnarchidae), elephantfishes (Mormyridae), arawanas and pirarucu (Osteoglossidae), and the African butterfly fish (Pantodontidae). This morphologically heterogeneous group also has a long and diverse fossil record, including taxa from all continents and both freshwater and marine deposits. The phylogenetic relationships among most extant osteoglossomorph families are widely agreed upon. However, there is still much to discover about the systematic biology of these fishes, particularly with regard to the phylogenetic affinities of several fossil taxa, within Mormyridae, and the position of Pantodon. In this paper we review the state of knowledge for osteoglossomorph fishes. We first provide an overview of the diversity of Osteoglossomorpha, and then discuss studies of the phylogeny of Osteoglossomorpha from both morphological and molecular perspectives, as well as biogeographic analyses of the group. Finally, we offer our perspectives on future needs for research on the systematic biology of Osteoglossomorpha.(AU)


title: Evaluating the efficacy and safety of human anti-SARS-CoV-2 convalescent plasma in severely ill adults with COVID-19: A structured summary of a study protocol for a randomized controlled trial

text: OBJECTIVES: The aim of this study is to evaluate the efficacy and safety of human anti-SARS-CoV-2 convalescent plasma in hospitalized adults with severe SARS-CoV-2 infection. TRIAL DESIGN: This is a prospective, single-center, phase 2, randomized, controlled trial that is blinded to participants and clinical outcome assessor. PARTICIPANTS: Eligible participants include adults (≥ 18 years) with evidence of SARS-CoV-2 infection by PCR test of nasopharyngeal or oropharyngeal swab within 14 days of randomization, evidence of infiltrates on chest radiography, peripheral capillary oxygen saturation (SpO2) ≤ 94% on room air, and/or need for supplemental oxygen, non-invasive mechanical ventilation, or invasive mechanical ventilation, who are willing and able to provide written informed consent prior to performing study procedures or who have a legally authorized representative available to do so. Exclusion criteria include participation in another clinical trial of anti-viral agent(s)* for coronavirus disease-2019 (COVID-19), receipt of any anti-viral agent(s)* with possible activity against SARS-CoV-2 <24 hours prior to plasma infusion, mechanical ventilation (including extracorporeal membrane oxygenation [ECMO]) for ≥ 5 days, severe multi-organ failure, history of allergic reactions to transfused blood products per NHSN/CDC criteria, known IgA deficiency, and pregnancy. Included participants will be hospitalized at the time of randomization and plasma infusion. *Use of remdesivir as treatment for COVID-19 is permitted. The study will be undertaken at Columbia University Irving Medical Center in New York, USA. INTERVENTION AND COMPARATOR: The investigational treatment is anti-SARS-CoV-2 human convalescent plasma. To procure the investigational treatment, volunteers who recovered from COVID-19 will undergo testing to confirm the presence of anti-SARS-CoV-2 antibody to the spike trimer at a 1:400 dilution. Donors will also be screened for transfusion-transmitted infections (e.g. HIV, HBV, HCV, WNV, HTLV-I/II, T. cruzi, ZIKV). If donors have experienced COVID-19 symptoms within 28 days, they will be screened with a nasopharyngeal swab to confirm they are SARS-CoV-2 PCR-negative. Plasma will be collected using standard apheresis technology by the New York Blood Center. Study participants will be randomized in a 2:1 ratio to receive one unit (200 - 250 mL) of anti-SARS-CoV-2 plasma versus one unit (200 - 250 mL) of the earliest available control plasma. The control plasma cannot be tested for presence of anti-SARS-CoV-2 antibody prior to the transfusion, but will be tested for anti- SARS-CoV-2 antibody after the transfusion to allow for a retrospective per-protocol analysis. MAIN OUTCOMES: The primary endpoint is time to clinical improvement. This is defined as time from randomization to either discharge from the hospital or improvement by one point on the following seven-point ordinal scale, whichever occurs first. 1. Not hospitalized with resumption of normal activities 2. Not hospitalized, but unable to resume normal activities 3. Hospitalized, not requiring supplemental oxygen 4. Hospitalized, requiring supplemental oxygen 5. Hospitalized, requiring high-flow oxygen therapy or non-invasive mechanical ventilation 6. Hospitalized, requiring ECMO, invasive mechanical ventilation, or both 7. Death This scale, designed to assess clinical status over time, was based on that recommended by the World Health Organization for use in determining efficacy end-points in clinical trials in hospitalized patients with COVID-19. A recent clinical trial evaluating the efficacy and safety of lopinavir- ritonavir for patients hospitalized with severe COVID-19 used a similar ordinal scale, as have recent clinical trials of novel therapeutics for severe influenza, including a post-hoc analysis of a trial evaluating immune plasma. The primary safety endpoints are cumulative incidence of grade 3 and 4 adverse events and cumulative incidence of serious adverse events during the study period. RANDOMIZATION: Study participants will be randomized in a 2:1 ratio to receive anti-SARS-CoV-2 plasma versus control plasma using a web-based randomization platform. Treatment assignments will be generated using randomly permuted blocks of different sizes to minimize imbalance while also minimizing predictability. BLINDING (MASKING): The study participants and the clinicians who will evaluate post-treatment outcomes will be blinded to group assignment. The blood bank and the clinical research team will not be blinded to group assignment. NUMBERS TO BE RANDOMIZED (SAMPLE SIZE): We plan to enroll 129 participants, with 86 in the anti-SARS-CoV-2 arm, and 43 in the control arm. Among the participants, we expect ~70% or n = 72 will achieve clinical improvement. This will yield an 80% power for a one-sided Wald test at 0.15 level of significance under the proportional hazards model with a hazard ratio of 1.5. TRIAL STATUS: Protocol AAAS9924, Version 17APR2020, 4/17/2020 Start of recruitment: April 20, 2020 Recruitment is ongoing. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04359810 Date of trial registration: April 24, 2020 Retrospectively registered FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


docid: xpbcoipf

title: Comparing the binding interactions in the receptor binding domains of SARS-CoV-2 and SARS-CoV

text: COVID-19, since emerged in Wuhan, China, has been a major concern due to its high infection rate, leaving more than one million infected people around the world. Huge number of studies tried to reveal the structure of the SARS-CoV-2 compared to the SARS-CoV-1, in order to suppress this high infection rate. Some of these studies showed that the mutations in the SARS-CoV-1 Spike protein might be responsible for its higher affinity to the ACE2 human cell receptor. In this work, we used molecular dynamics simulations and Monte Carlo sampling to compare the binding affinities of the spike proteins of SARS-CoV and SARS-CoV-2 to the ACE2. We found that the SARS-CoV-2 binds to ACE2 stronger than SARS-CoV by 7 kcal/mol, due to enhanced electrostatic interactions. The major contributions to the electrostatic binding energies are resulting from the salt-bridges formed between R426 and ACE2-E329 in case of SARS-CoV and K417 and ACE2-D30 for SARS-CoV2. In addition, there is no significant contribution from a single mutant to the binding energies. However, these mutations induce sophisticated structural changes that enhance the binding energies. Our results also indicate that the SARS-CoV-2 is unlikely a lab engineered virus.


title: Comparing the Binding Interactions in the Receptor Binding Domains of SARS-CoV-2 and SARS-CoV

text: SARS-CoV-2, since emerging in Wuhan, China, has been a major concern because of its high infection rate and has left more than six million infected people around the world. Many studies endeavored to reveal the structure of the SARS-CoV-2 compared to the SARS-CoV, in order to find solutions to suppress this high infection rate. Some of these studies showed that the mutations in the SARS-CoV spike (S) protein might be responsible for its higher affinity to the ACE2 human cell receptor. In this work, we used molecular dynamics simulations and Monte Carlo sampling to compare the binding affinities of the S proteins of SARS-CoV and SARS-CoV-2 to the ACE2. Our results show that the protein surface of the ACE2 at the receptor binding domain (RBD) exhibits negative electrostatic potential, while a positive potential is observed for the S proteins of SARS-CoV/SARS-CoV-2. In addition, the binding energies at the interface are slightly higher for SARS-CoV-2 because of enhanced electrostatic interactions. The major contributions to the electrostatic binding energies result from the salt bridges forming between R426 and ACE-2-E329 in the case of SARS-CoV and K417 and ACE2-D30 in the SARS-CoV-2. In addition, our results indicate that the enhancement in the binding energy is not due to a single mutant but rather because of the sophisticated structural changes induced by all these mutations together. This finding suggests that it is implausible for the SARS-CoV-2 to be a lab-engineered virus.


"Social Media Misinformation"-An Epidemic within the COVID-19 Pandemic.


title: Role of electronic media in mitigating the psychological impacts of novel coronavirus (COVID-19)

text: The current research initiative focuses on the role of Pakistani media in eliminating panic and depression among health practitioners and the general public due to the outbreak of novel coronavirus (COVID-19). In Pakistan, electronic media is the most common source of information due to the higher rural population and the lower literacy rate and media's handling of COVID-19 coverage so far creates panic and depression. We suggest that special televised transmissions featuring psychologists and physiatrists should be aired to reduce the panic. Media also mitigates the stress of frontline medical staff by paying special attributes to them.


The Strategy for Return to Work after the COVID-19 Pandemic on Small and Medium-sized Enterprises


Reflection on SARS-CoV-2 infection of container ship seafarers


docid: sxaxrlfj

title: Immune Checkpoint Inhibitors for Cancer Therapy in the COVID-19 Era

text: The potential immune intersection between COVID-19 disease and cancer therapy raises important practical clinical questions and highlights multiple scientific gaps to be filled. Among available therapeutic approaches to be considered, immune checkpoint inhibitors (ICI) seem to require major attention as they may act at the crossroads between cancer treatment and COVID-19 disease, due to their profound immunomodulatory activity. On the basis of available literature evidence, we suggest guidance to consider for treating physicians, and propose areas of clinical and preclinical investigation. Comprehensively, although with the necessary caution, ICI therapy seems to remain a suitable therapeutic option for patients with cancer during the COVID-19 pandemic.


title: Mind the GAP: Security&Privacy Risks of Contact Tracing Apps

text: Contact tracing apps running on mobile devices promise to reduce the manual effort required for identifying infection chains and to increase the tracing accuracy in the presence of COVID-19. Several contract tracing apps have been proposed or deployed in practice. Also Google and Apple have announced their joint effort of providing an API for exposure notification in order to implement decentralized contract tracing apps using Bluetooth Low Energy, the so-called"Google/Apple Proposal", which we abbreviate by"GAP". Some countries have already decided or are planning to base their contact tracing apps on GAP. Several researchers have pointed out potential privacy and security risks related to most of the contact tracing approaches proposed until now, including those that claim privacy protection and are based on GAP. This report makes a first attempt towards providing empirical evidence in real-world scenarios for two such risks discussed in the literature: one concerning privacy, and the other one concerning security. In particular, we focus on a practical analysis of GAP, given that it is the foundation of several tracing apps. We demonstrate that in real-world scenarios the current GAP design is vulnerable to (i) profiling and possibly de-anonymizing infected persons, and (ii) relay-based wormhole attacks that principally can generate fake contacts with the potential of significantly affecting the accuracy of an app-based contact tracing system. For both types of attack, we have built tools that can be easily used on mobile phones or Raspberry Pis (e.g., Bluetooth sniffers). We hope that our findings provide valuable input in the process of testing and certifying contact tracing apps, e.g., as planned for the German Corona-Warn-App, ultimately guiding improvements for secure and privacy-preserving design and implementation of digital contact tracing systems.


title: Clinical evaluation of an immunochromatographic IgM/IgG antibody assay and chest computed tomography for the diagnosis of COVID-19

text: BACKGROUND: We evaluated the clinical performance of an immunochromatographic (IC) IgM/IgG antibody assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) and chest computed tomography (CT) for the diagnosis of Coronavirus disease 2019 (COVID-19). METHODS: We examined 139 serum specimens collected from 112 patients with COVID-19 and 48 serum specimens collected from 48 non-COVID-19 patients. The presence of IgM/IgG antibody for SARS-COV2 was determined using the One Step Novel Coronavirus (COVID-19) IgM/IgG Antibody Test. Chest CT was performed in COVID-19 patients on admission. FINDINGS: Of the139 COVID-19 serum specimens, IgM was detected in 27.8 %, 48.0 %, and 95.8 % of the specimens collected within 1 week, 1-2 weeks, and >2 weeks after symptom onset and IgG was detected in 3.3 %, 8.0 %, and 62.5 %, respectively. Among the 48 non-COVID-19 serum specimens, 1 generated a false-positive result for IgM. Thirty-eight of the 112 COVID-19 patients were asymptomatic, of whom 15 were positive for IgM, and 74 were symptomatic, of whom 22 were positive for IgM and 7 were positive for IgG. The diagnostic sensitivity of CT scan alone and in combination with the IC assay was 57.9 % (22/38) and 68.4 % (26/38) for the asymptomatic patients and 74.3 % (55/74) and 82.4 % (61/74) for the symptomatic patients, respectively. CONCLUSION: The IC assay had low sensitivity during the early phase of infection, and thus IC assay alone is not recommended for initial diagnostic testing for COVID-19. If RT-qPCR is not available, the combination of chest CT and IC assay may be useful for diagnosing COVID-19.


Lupus anticoagulant is frequent in patients with Covid-19


Psychosomatic Medicine and Covid-19 Pandemic


COVID-19: Not a Simple Public Health Emergency


Advanced respiratory monitoring in COVID-19 patients: use less PEEP!


title: Clinical characteristics of COVID-19 patients in three consecutive generations of spread in Zhejiang, China

text: OBJECTIVE: To determine the clinical characteristics of COVID-19 patients as the SARS-CoV-2 virus continues to circulate in the population. METHODS: This is a retrospective, multi-center cohort study. Adult COVID-19 cases from four hospitals in Zhejiang were enrolled and clustered into 3 groups based on epidemiological history. First-generation patients had a travel history to Hubei within 14 days before disease onset; second generation patients had a contact history with first-generation patients; third-generation patients had a contact history with second-generation patients. Demographic, clinical characteristics, clinical outcomes, and duration of viral shedding were analyzed. RESULTS: 171 patients were enrolled, with 83, 44, and 44 patients in the first, second, and third generation, respectively. Compared to first and second generation, third generation patients were older (61.3 vs. 48.3 and 44.0 y, P<0.001), had more coexisting conditions (56.8% vs. 36.1% and 27.3%, P=0.013). At 7±1 days from illness onset, third generation patients had lower lymphocyte (0.6 vs. 0.8 and 0.8×109/L, P=0.007), higher C-reactive protein (29.7 vs. 17.1 and 13.8mg/L, P=0.018) and D-dimer (1066 vs. 412.5 and 549µg/L, P=0.002) and more lesions involving the pulmonary lobes (lobes≥5, 81.8% vs. 53.0% and 34.1%, P<0.001). The proportions of third-generation patients developing severe illness (72.7% vs. 32.5% and 27.3%, P<0.001), critical illness (38.6% vs. 10.8% and 6.8%, P<0.001) and receiving endotracheal intubation (20.5% vs. 3.6% and 2.3%, P=0.002) were higher than the other two groups. CONCLUSION: The third generation patients were older, had more underlying comorbidities and had a higher proportion of severe or critical illness compared to first and second-generation.


title: A Model for COVID-19 Prediction in Iran Based on China Parameters

text: BACKGROUND: The rapid spread of COVID-19 virus from China to other countries and outbreaks of disease require an epidemiological analysis of the disease in the shortest time and an increased awareness of effective interventions. The purpose of this study was to estimate the COVID-19 epidemic in Iran based on the SIR model. The results of the analysis of the epidemiological data of Iran from January 22 to March 24, 2020 were investigated and prediction was made until April 15, 2020. METHODS: By estimating the three parameters of time-dependent transmission rate, time-dependent recovery rate, and timedependent death rate from Covid-19 outbreak in China, and using the number of Covid-19 infections in Iran, we predicted the number of patients for the next month in Iran. Each of these parameters was estimated using GAM models. All analyses were conducted in R software using the mgcv package. RESULTS: Based on our predictions of Iran about 29000 people will be infected from March 25 to April 15, 2020. On average, 1292 people with COVID-19 are expected to be infected daily in Iran. The epidemic peaks within 3 days (March 25 to March 27, 2020) and reaches its highest point on March 25, 2020 with 1715 infected cases. CONCLUSION: The most important point is to emphasize the timing of the epidemic peak, hospital readiness, government measures and public readiness to reduce social contact.


docid: fheedtjb

title: COVID-19 in the pediatric population


Sex hormones signal why virus hits men harder


The possible impact of COVID-19 on colorectal surgery in Italy


title: Natural Products as Potential Leads Against Coronaviruses: Could They be Encouraging Structural Models Against SARS-CoV-2?

text: New coronavirus referred to SARS-CoV-2 has caused a worldwide pandemic (COVID-19) declared by WHO. Coronavirus disease 2019 (COVID-19) is an infectious disease with severe acute respiratory syndrome caused by coronavirus-2 (SARS-CoV-2). SARS-CoV-2 is akin to SARS-CoV, which was the causative agent of severe acute respiratory syndrome (SARS) in 2002 as well as to that of Middle East respiratory syndrome (MERS) in 2012. SARS-CoV-2 has been revealed to belong to Coronaviridiae family as a member of ß-coronaviruses. It has a positive-sense single-stranded RNA with the largest RNA genome. Since its genomic sequence has a notable similarity to that of SARS-CoV, antiviral drugs used to treat SARS and MERS are now being also applied for COVID-19 treatment. In order to combat SARS-CoV-2, many drug and vaccine development studies at experimental and clinical levels are currently conducted worldwide. In this sense, medicinal plants and the pure natural molecules isolated from plants have been reported to exhibit significant inhibitory antiviral activity against SARS-CoV and other types of coronaviruses. In the present review, plant extracts and natural molecules with the mentioned activity are discussed in order to give inspiration to researchers to take these molecules into consideration against SARS-CoV-2.


COVID-19 with abdominal symptoms and acute abdominal pain: a guide to identification for general practice


Covid-19: now is not the time to judge the UK's response


title: Inhibition of cytokine signaling by ruxolitinib and implications for COVID-19 treatment

text: Approximately 15% of patients with coronavirus disease 2019 (COVID-19) experience severe disease, and 5% progress to critical stage that can result in rapid death. No vaccines or antiviral treatments have yet proven effective against COVID-19. Patients with severe COVID-19 experience elevated plasma levels of pro-inflammatory cytokines, which can result in cytokine storm, followed by massive immune cell infiltration into the lungs leading to alveolar damage, decreased lung function, and rapid progression to death. As many of the elevated cytokines signal through Janus kinase (JAK)1/JAK2, inhibition of these pathways with ruxolitinib has the potential to mitigate the COVID-19-associated cytokine storm and reduce mortality. This is supported by preclinical and clinical data from other diseases with hyperinflammatory states, where ruxolitinib has been shown to reduce cytokine levels and improve outcomes. The urgent need for treatments for patients with severe disease support expedited investigation of ruxolitinib for patients with COVID-19.


What is the role of a dermatologist in the battle against COVID-19? The experience from a hospital on the frontline in Milan


title: Impact of temperature on the dynamics of the COVID-19 outbreak in China

text: A COVID-19 outbreak emerged in Wuhan, China at the end of 2019 and developed into a global pandemic during March 2020. The effects of temperature on the dynamics of the COVID-19 epidemic in China are unknown. Data on COVID-19 daily confirmed cases and daily mean temperatures were collected from 31 provincial-level regions in mainland China between Jan. 20 and Feb. 29, 2020. Locally weighted regression and smoothing scatterplot (LOESS), distributed lag nonlinear models (DLNMs), and random-effects meta-analysis were used to examine the relationship between daily confirmed cases rate of COVID-19 and temperature conditions. The daily number of new cases peaked on Feb. 12, and then decreased. The daily confirmed cases rate of COVID-19 had a biphasic relationship with temperature (with a peak at 10 °C), and the daily incidence of COVID-19 decreased at values below and above these values. The overall epidemic intensity of COVID-19 reduced slightly following days with higher temperatures with a relative risk (RR) was 0.96 (95% CI: 0.93, 0.99). A random-effect meta-analysis including 28 provinces in mainland China, we confirmed the statistically significant association between temperature and RR during the study period (Coefficient = -0.0100, 95% CI: -0.0125, -0.0074). The DLNMs in Hubei Province (outside of Wuhan) and Wuhan showed similar patterns of temperature. Additionally, a modified susceptible-exposed-infectious-recovered (M-SEIR) model, with adjustment for climatic factors, was used to provide a complete characterization of the impact of climate on the dynamics of the COVID-19 epidemic.


High SARS-CoV-2 infection rates in respiratory staff nurses and correlation of COVID-19 symptom patterns with PCR positivity and relative viral loads


SARS-CoV-2: March toward adaptation


docid: asgjavxf

title: COVID-19 Pandemic: Negative-pressure tent during atomization of local anesthetic for awake fibreoptic intubation


title: Elective tracheostomy during COVID-19 outbreak: to whom, when, how? Early experience from Venice, Italy

text: PURPOSE: The need for prolonged invasive mechanical ventilation in COVID-19 patients is placing the otorhinolaryngologist in front of an increasing request for tracheostomy. Nowadays, there is uncertainty regarding the timing of tracheostomy, the prognosis of these patients and the safety of healthcare workers. The aim of this study is to evaluate the efficacy and safety of tracheostomy placement in patients with COVID-19. METHODS: A retrospective cohort study on 23 COVID 19 patients, to analyse the timing of tracheostomy, the risk factors associated with in-hospital death and the infection of the involved health care workers. Early tracheostomy was defined as ≤ 10 days and late ones > 10 days. RESULTS: The mortality rate of COVID-19 patients admitted to ICU that underwent tracheostomy was 18%. The overall mortality of patients admitted to ICU was 53%. The univariate analysis revealed that early tracheostomy, SOFA score > 6, and D-dimer level > 4 were significantly associated with a greater risk of death. At the multivariate analysis SOFA score > 6 and D-dimer level > 4 resulted as significant factors for a higher risk of death. No health care workers associated with tracheostomy are confirmed to be infected by SARS-CoV2. CONCLUSION: We suggest to wait at least 14 days to perform tracheostomy. In patients with SOFA score > 6 and D dimer > 4, tracheostomy should not be performed or should be postponed. Optimized procedures and enhanced personal protective equipment can make the tracheostomy safe and beneficial in COVID-19 patients.


Convalescent plasma for patients with COVID-19


Vitreoretinal surgery tip and tricks in the era of COVID-19


Seven tips to manage your mental health and well-being during the COVID-19 outbreak


docid: wukoaovw

title: Prioritizing systemic therapies for genitourinary malignancies: Canadian recommendations during the COVID-19 pandemic


title: Are coinfections with COVID-19 and influenza low or underreported? An observational study examining current published literature including three new unpublished cases

text: As the coronavirus disease-2019 (COVID-19) pandemic continues, one major point of uncertainty is the impact this novel pathogen will have during the upcoming 2020 to 2021 flu season. While the influenza virus is a known contributor to human morbidity and mortality, the question of how a coinfection between COVID-19 and influenza might manifest is of utmost concern. The aim of this study was to review the limited cases of COVID-19/influenza coinfection currently available in the literature, along with cases in the community of El Paso, TX, to determine whether any patterns of clinical presentation and morbidity emerged. An international review of the literature was conducted. Six published articles describing COVID-19/influenza coinfection were identified, with a total of 13 patients described therein. Three additional patients were identified from the El Paso, TX data. The most common presenting symptoms were fever and cough. The most common laboratory findings were elevated C-reactive protein and lymphocytopenia. Thirteen patients presented with viral pneumonia findings on CT, and nine had findings of ground-glass opacity. Finally, complications were reported in six patients, with most common complication being acute respiratory distress syndrome. The results of the review indicate that, due to the similarity in presentation between COVID-19 and influenza, further analysis will be required to understand the effects of coinfection on morbidity and mortality. However, the limited number of coinfection cases in the literature indicates that the implementation of COVID-19 control measures may continue to play a role in limiting the spread of these human respiratory pathogens.


title: Are co-infections with COVID-19 and Influenza low or underreported? An observational study examining current published literature including three new unpublished cases

text: As the COVID-19 pandemic continues, one major point of uncertainty is the impact this novel pathogen will have during the upcoming 2020-2021 flu season. While the influenza virus is a known contributor to human morbidity and mortality, the question of how a coinfection between COVID-19 and influenza might manifest is of utmost concern. The aim of this study was to review the limited cases of COVID-19/influenza coinfection currently available in the literature, along with cases in the community of El Paso, Texas, to determine whether any patterns of clinical presentation and morbidity emerged. An international review of the literature was conducted. Six published articles describing COVID-19/influenza coinfection were identified, with a total of thirteen patients described therein. Three additional patients were identified from the El Paso, Texas data. The most common presenting symptoms were fever and cough. The most common laboratory findings were elevated C-reactive protein and lymphocytopenia. Thirteen patients presented with viral pneumonia findings on CT, and nine had findings of ground-glass opacity. Finally, complications were reported in six patients, with most common complication being acute respiratory distress syndrome (ARDS). The results of the review indicate that, due to the similarity in presentation between COVID-19 and influenza, further analysis will be required to understand the effects of coinfection on morbidity and mortality. However, the limited number of coinfection cases in the literature indicates that the implementation of COVID-19 control measures may continue to play a role in limiting the spread of these human respiratory pathogens. This article is protected by copyright. All rights reserved.


title: "Not Wars, Water pumps" - From emotive to rational language in managing the Covid-19 pandemic

text: At the date of writing this editorial, there is now agreement amongst experts that the first wave of the United Kingdom's (UK) COVID-19 pandemic is in decline (1). The number of deaths reported each day is now around 1% of the cumulative total and falling. In general, the approach to predicting pandemic policy has been through a comparison of inter-country performance in managing this crisis. While all countries are paying a high price in economic slowdown and lives lost, the health consequences in terms of cases and deaths have varied considerably. Countries with lower relative mortality and infection numbers have shown a more structured logical approach to pandemic management.


title: Guillain-Barré Syndrome as a Neurological Complication of Novel COVID-19 Infection: A Case Report and Review of the Literature

text: INTRODUCTION: The novel coronavirus (COVID-19) is a global pandemic. Although the main clinical manifestation of COVID-19 is respiratory involvement, there is evidence suggesting the neuroinvasive potential of COVID-19. There are limited reports of neurological complications of COVID-19 infection in the literature. Herein, we aim to describe 2 members of a family affected by COVID-19, presenting with ascending paresthesia with the final diagnosis of Guillain-Barré syndrome. CASE REPORT: A 38-year-old man presented with a history of ascending paresthesia and bilateral facial droop since 5 days before admission. The medical history was positive for flu-like symptoms affecting all the members of his family. The neurological examination was notable for bilateral peripheral facial paralysis, generalized areflexia, and derceased sensation in distal limbs. The cerebrospinal fluid analysis revealed an albuminocytologic dissociation. In addition, the electromyography-nerve conduction study findings were suggestive of acute axonal-demyelinating polyneuropathy. Meanwhile the patient was treated with a diagnosis of Guillain-Barré syndrome, his 14-year-old daughter presented with a history of progressive paresthesia and weakness. Similar to her father, the paraclinical evaluations were consistent with Guillain-Barré syndrome. Taking into account clinical findings and the outbreak of COVID-19, the suspicion of COVID-19 was proposed. Eventually, on the basis of throat swab samples stand on polymerase chain reaction, the patients were diagnosed with COVID-19. CONCLUSION: Our cases revealed the familial occurrence of Guillain-Barré syndrome after COVID-19 infection. The authors emphasize neurological complications of COVID-19.


title: Preparedness for Coronavirus Disease in Hospitals of Nepal: A Nationwide Survey

text: INTRODUCTION: Coronavirus disease pandemic has affected large number of people globally and has continued to spread. Preparedness of individual nations and the hospitals is important to effectively deal with the surge of cases. We aimed to obtain nation wide data from Nepal, about hospital preparedness for COVID-19. METHODS: Online questionnaire was prepared in accordance with the Center for Disease Control recommendations to assess preparedness of hospitals for COVID-19. The questionnaire was circulated to the over 800 doctors across the nation, who are the life members of six medical societies. RESULTS: We obtained 131 completed responses from all seven provinces. Majority of respondents had anaesthesiology as the primary specialty. Only 52 (39.7%) participants mentioned that their hospital had policy to receive suspected or proven cases with COVID-19. Presence of isolation ward was mentioned by 83 (63.4%) respondents, with only 9 (6.9%)mentioning the presence of airborne isolation. Supply of personal protective equipment (PPE) was inadequate as per 124 (94.7%) respondents. Critical care services for COVID-19 patients were possible only in hospitals of 42 (32.1%)respondents. RT-polymerase chain reaction could be performed only in the hospital of 6 (4.6%) respondents. CONCLUSIONS: It is apparent that most of the hospitals are not well prepared for management of patients with COVID-19. Resource allocation and policy making should be aimed to enhance national preparedness for the pandemic.


習近平とコロナウイルス : トップダウン型危機管理の弊害 (新型ウイルスの封じ込め・管理はできるのか)


title: The Performance of the Iranian Red Crescent by Launching Testing Centers for the Coronavirus Disease

text: The coronavirus disease (COVID-19) screening project has been conducted by the Red Crescent Society for 17 days with the aim of identifying and treating people with COVID-19, reducing road trips, and sensitizing people to the problem. Due to the shortage of testing devices, passengers were screened by measuring skin temperature. In 851 screening posts, 95 371 volunteers of Red Crescent monitored 21 640 866 people.Besides screening people, the stations have had other functions, including urging people to stay at home, restricting road trips, especially during the Iranian New Year holidays, reassuring the people that all relevant organizations are doing their best to respond to COVID-19, and the like. However, future research is still needed to analyze the cost-benefit of this plan and other possible options.


title: Fulminant Acute Kidney Injury in a Young Patient with Novel Coronavirus 2019

text: Coronavirus disease 2019 (COVID-19) is a global pandemic affecting more than 200 countries and 180,000 cases in the United States. While the outbreak began in China, the number of cases outside of China exceeded those in China on March 15, 2020 and are currently rising at an exponential rate. The number of fatalities in the United States are expected to exceed more than Italy and China. The disease is characterized predominantly as an acute respiratory illness. However, preliminary data suggests that kidney is a target for the virus and deterioration of renal function was associated with poor outcomes including in-hospital mortality. We pre-sent a report of a patient with COVID-19 who presented with acute onset of symptoms and normal renal function at baseline but rapidly deteriorated resulting in death. The timing of decline in renal function correlated with his worsening clinical status. He was started on continuous veno-venous hemofiltration without signs of clinical benefit. We also present the possible mechanisms for acute kidney injury in these patients. We performed a review of the emerging literature by searching PubMed, Google Scholar, and EMBASE for studies and/or case series published on this topic. Acute kidney injury might help risk stratify critically ill patients on a fatal course of COVID-19.


title: Pulmonary Thromboembolism as a Potential Cause of Clinical Deterioration in COVID-19 Patients;a Commentary

text: Although the findings of some studies have been indicative of the direct relationship between the severity of clinical findings and imaging, reports have been published regarding inconsistency of clinical findings with imaging and laboratory evidence Physicians treating these patients frequently report cases in which patients, sometimes in the recovery phase and despite improvements in imaging indices, suddenly deteriorate and in some instances suddenly expire This letter aimed to draw attention to the role of pulmonary thromboembolism as a potential and possible cause of clinical deterioration in covid-19 patients


COVID-19-associated nephritis: early warning for disease severity and complications?


title: A structural model for the Coronavirus Nucleocapsid

text: We propose a mesoscale model structure for the coronavirus nucleocapsid, assembled from the high resolution structures of the basic building blocks of the N-protein, CryoEM imaging and mathematical constraints for an overall quasi-spherical particle. The structure is a truncated octahedron that accommodates two layers: an outer shell composed of triangular and quadrangular lattices of the N-terminal domain and an inner shell of equivalent lattices of coiled parallel helices of the C-terminal domain. The model is consistent with the dimensions expected for packaging large viral genomes and provides a rationale to interpret the apparent pleomorphic nature of coronaviruses.


docid: wfaqzdsa

title: COVID-19 infection and glucocorticoids: update from the Italian Society of Endocrinology Expert Opinion on steroid replacement in adrenal insufficiency


docid: lgunckur

title: Tuberculosis, COVID-19 and migrants: Preliminary analysis of deaths occurring in 69 patients from two cohorts

text: Little is known about the relationship between the COVID-19 and tuberculosis (TB). The aim of this study is to describe a group of patients who died with TB (active disease or sequelae) and COVID-19 in two cohorts. Data from 49 consecutive cases in 8 countries (cohort A) and 20 hospitalised patients with TB and COVID-19 (cohort B) were analysed and patients who died were described. Demographic and clinical variables were retrospectively collected, including co-morbidities and risk factors for TB and COVID-19 mortality. Overall, 8 out of 69 (11.6%) patients died, 7 from cohort A (14.3%) and one from cohort B (5%). Out of 69 patients 43 were migrants, 26/49 (53.1%) in cohort A and 17/20 (85.0%) in cohort B. Migrants: (1) were younger than natives; in cohort A the median (IQR) age was 40 (27-49) VS. 66 (46-70) years, whereas in cohort B 37 (27-46) VS. 48 (47-60) years; (2) had a lower mortality rate than natives (1/43, 2.3% versus 7/26, 26.9%; p-value: 0.002); (3) had fewer co-morbidities than natives (23/43, 53.5% versus 5/26-19.2%) natives; p-value: 0.005). The study findings show that: (1) mortality is likely to occur in elderly patients with co-morbidities; (2) TB might not be a major determinant of mortality and (3) migrants had lower mortality, probably because of their younger age and lower number of co-morbidities. However, in settings where advanced forms of TB frequently occur and are caused by drug-resistant strains of M. tuberculosis, higher mortality rates can be expected in young individuals.


docid: uswksoie

title: Exercise-related Mental Health Problems and Solutions during the COVID-19 Pandemic


title: Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic for outpatient and hospital practices

text: Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic constitute the guidance to outpatient and hospital practices in all cases where contact with a patient whose status of COVID-19 is unknown. They have been created based on world publications and recommendations due to the current state of the COVID-19 pandemic. Justification for suspension of planned provision of services in the first phase of a pandemic was presented. The indication of the best medical practices for the time of stabilization, but with the persistence of the risk of COVID-19 infection in the population are discussed. The possibility of providing services in the following months of the pandemic is important. We provide the rationale for launching medical activities and indicate optimal practices until the consolidation of SARS COV-2 prevention and treatment methods.


docid: kwekboyl

title: Letter to the Editor. COVID-19 and chronic pain


Co-infection with COVID-19 and influenza A virus in two died patients with acute respiratory syndrome, Bojnurd, Iran


Droplet nuclei aerosol and Covid 19 - a risk to healthcare staff


title: Factors associated with duration of viral shedding in adults with COVID-19 outside of Wuhan, China: A retrospective cohort study

text: Objectives: To investigate factors associated with the duration of viral shedding in patients with COVID-19 outside of Wuhan. Methods: In this retrospective cohort study, patients with laboratory-confirmed COVID-19 in Changsha, China were included. Clinical characteristics, laboratory findings, treatment and outcome were retrieved. Univariable and multivariable analysis were performed to explore potential factors. Results: Totally 147 patients with COVID-19 were included. The median duration of viral shedding (the number of days from symptoms onset till the successive negative detection of SARS-CoV-2 RNA) was 17 days (interquartile range [IQR], 12 to 21). Multivariable Logistic regression analysis indicated that the highest temperature at admission (odds ratio [OR], 5.200; 95% confidence interval [CI]: 1.190-22.726; p = 0.028) and time from symptom onset to admission (OR, 1.740; 95% CI: 1.296-2.337; p < 0.001) and hospital length of stay (OR, 1.604; 95% CI: 1.262-2.040; p < 0.001) were risk factors for prolonged duration of viral shedding. Conclusions: This is the study with relatively large sample size that mainly focused on the duration of viral shedding and relevant factors in patients with COVID-19 outside of Wuhan, China. Potential risk factors were identified and should be taken into consideration for the strategy of quarantine of infected patients.


title: COVID-19 e coronaropatia: uso selettivo e collaborativo delle risorse durante le crisi sanitarie./ [COVID-19 and coronary artery disease: selective and collaborative use of resources during public health crisis]

text: The COVID-19 epidemic is one of the most demanding challenges for the public health organizations. The Lombardy region faced firstly this outbreak in Italy and recorded rapidly a saturation of intensive care and internal medicine beds. Consequently, this lack of technical and human resources, together with people mobility restriction to contain virus spreading, determined the interruption of elective surgical and interventional cardiovascular procedures. In addition, the emergency track of acute patients has been rewritten due to limited resources and viral co-infection (pre- or in-hospital). Herein, we describe two cases of acute coronary syndrome with severe coronary artery disease and an indication for coronary artery bypass grafting. The first patient, COVID-19 positive, was treated with transcatheter technique due to symptom instability and underwent temporary circulatory support without intubation. The second patient received an intra-aortic balloon pump and was then transferred, in accordance with government emergency provisions, to a hub hospital to undergo off-pump coronary artery bypass grafting and short intensive care unit stay. These two apparently similar cases were treated differently according to the moving epidemiological and organizational conditions.


The Role of Oral and Maxillofacial Surgeons in COVID-19 Response


title: Amplifying the role of knowledge translation platforms in the COVID-19 pandemic response

text: The COVID-19 pandemic presents the worst public health crisis in recent history. The response to the COVID-19 pandemic has been challenged by many factors, including scientific uncertainties, scarcity of relevant research, proliferation of misinformation and fake news, poor access to actionable evidence, time constraints, and weak collaborations among relevant stakeholders. Knowledge translation (KT) platforms, composed of organisations, initiatives and networks supporting evidence-informed policy-making, can play an important role in providing relevant and timely evidence to inform pandemic responses and bridge the gap between science, policy, practice and politics. In this Commentary, we highlight the emerging roles of KT platforms in light of the COVID-19 pandemic. We also reflect on the lessons learned from the efforts of a KT platform in a middle-income country to inform decision-making and practice during the COVID-19 pandemic. The lessons learned can be integrated into strengthening the role, structures and mandates of KT platforms as hubs for trustworthy evidence that can inform policies and practice during public health crises and in promoting their integration and institutionalisation within the policy-making processes.


title: Case reports study of the first five patients COVID-19 treated with remdesivir in France

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified as responsible for the COVID-19 outbreak worldwide. Data on treatment are scare and parallels are made between SARS-CoV-2 and other coronavirus. Remdesivir is a broad spectrum antiviral with efficient in vitro activity against SARS-CoV-2 and controversial evidence of clinical improvement in severe COVID-19 patients. We aimed to describe the clinical outcome and virological monitoring of the first five COVID-19 patients admitted in ICU for severe pneumonia related to SARS-CoV-2 and treated with remdesivir in the University hospital of Bichat, Paris, France. SARS-CoV-2 RT-qPCR in blood plasma, lower and upper respiratory tract were monitored. Among the five treated patients, two needed mechanical ventilation and one high flow cannula oxygen. A significant decrease in SARS-CoV-2 viral load from upper respiratory tract was observed in most cases but two died with active SARS-CoV-2 replication in the lower respiratory tract. Plasma samples were positive for SARS-CoV-2 in only one patient. Remdesivir was interrupted for side effects among four patients, including 2 ALT elevations (3 to 5 N) and 2 renal failures requiring renal replacement. This case series of five COVID-19 patients requiring ICU for a respiratory distress and treated with remdesivir, highlights the complexity of remdesivir use in such critically ill patients.


Sudden olfactory and gustatory dysfunctions: Important red flags in COVID-19


title: Separating NOM from salts in ion exchange brine with ceramic nanofiltration

text: In drinking water treatment, natural organic matter (NOM) is effectively removed from surface water using ion exchange (IEX). A main drawback of using IEX for NOM removal is the production of spent IEX regeneration brine, a polluting waste that is expensive to discharge. In this work, we studied ceramic nanofiltration as a treatment for the spent NOM-rich brine, with the aim to reduce the volume of this waste and to recycle salt. Compared to polymeric nanofiltration, the fouling was limited. When NOM is rejected and concentrated, a clean permeate with the regeneration salt (NaCl) could be produced and reused in the IEX regeneration process. Bench scale studies revealed that NOM could be effectively separated from the NaCl solution by steric effects. However, the separation of NaCl from other salts present in the brine, such as Na2SO4, was not sufficient for reuse purposes. The low sulphate rejection was mainly due to the low zeta potential of the membrane at the high ionic strength of the brine. The permeate of the ceramic nanofiltration should be treated further to obtain a sodium chloride quality that can be recycled as a regenerant solution for ion exchange. Further treatment steps will benefit from the removal of NOM from the brine.


title: How Support of Early Career Researchers Can Reset Science in the Post-COVID19 World

text: The COVID19 crisis has magnified the issues plaguing academic science, but it has also provided the scientific establishment with an unprecedented opportunity to reset. Shoring up the foundation of academic science will require a concerted effort between funding agencies, universities, and the public to rethink how we support scientists, with a special emphasis on early career researchers.


Protect Indigenous peoples from COVID-19


COVID-19 infection in patients following hepato-pancreatico-biliary intervention: An early experience


title: Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020

text: Fear is an adaptive response in the presence of danger. However, when threat is uncertain and continuous, as in the current coronavirus disease (COVID-19) pandemic, fear can become chronic and burdensome. To identify predictors of fear of the coronavirus, we conducted an online survey (N = 439) three days after the World Health Organization declared the coronavirus outbreak a pandemic (i.e., between March 14 and 17, 2020). Fear of the coronavirus was assessed with the newly developed Fear of the Coronavirus Questionnaire (FCQ) consisting of eight questions pertaining to different dimensions of fear (e.g., subjective worry, safety behaviors, preferential attention), and an open-ended question. The predictors included psychological vulnerability factors (i.e., intolerance of uncertainty, worry, and health anxiety), media exposure, and personal relevance (i.e., personal health, risk for loved ones, and risk control). We found four predictors for the FCQ in a simultaneous regression analysis: health anxiety, regular media use, social media use, and risks for loved ones (R2 = .37). Furthermore, 16 different topics of concern were identified based participants' open-ended responses, including the health of loved ones, health care systems overload, and economic consequences. We discuss the relevance of our findings for managing people's fear of the coronavirus.


title: Care of Asymptomatic SARS-CoV-2 positive Kidney Transplant Recipients

text: Sharing of experience amongst transplant community through various platforms and rapid publications has proven invaluable during the COVID-19 pandemic (1-3). The general consensus seemed to be that most kidney transplant recipients would have a moderate or mild course, although some may progress to a more severe disease. It was recommended to stop or decrease the dose of anti-proliferative agents and continue with calcineurin inhibitors (CNIs) and maintenance steroids (4).


Comfort and compliance with the use of facemasks during COVID -19 infection


title: A multi-region discrete time mathematical modeling of the dynamics of Covid-19 virus propagation using optimal control

text: We study in this work a discrete mathematical model that describes the dynamics of transmission of the Corona virus between humans on the one hand and animals on the other hand in a region or in different regions. Also, we propose an optimal strategy to implement the optimal campaigns through the use of awareness campaigns in region j that aims at protecting individuals from being infected by the virus, security campaigns and health measures to prevent the movement of individuals from one region to another, encouraging the individuals to join quarantine centers and the disposal of infected animals. The aim is to maximize the number of individuals subjected to quarantine and trying to reduce the number of the infected individuals and the infected animals. Pontryagin's maximum principle in discrete time is used to characterize the optimal controls and the optimality system is solved by an iterative method. The numerical simulation is carried out using Matlab. The Incremental Cost-Effectiveness Ratio was calculated to investigate the cost-effectiveness of all possible combinations of the four control measures. Using cost-effectiveness analysis, we show that control of protecting susceptible individuals, preventing their contact with the infected individuals and encouraging the exposed individuals to join quarantine centers provides the most cost-effective strategy to control the disease.