title: COVID-19-Hospitalized Patients in Karnataka: Survival and Stay Characteristics

text: The information on the clinical course of coronavirus disease 2019 (COVID-19) and its correlates which are essential to assess the hospital care needs of the population are currently limited. We investigated the factors associated with hospital stay and death for COVID-19 patients for the entire state of Karnataka, India. A retrospective-cohort analysis was conducted on 445 COVID-19 patients that were reported in the publicly available media-bulletin from March 9, 2020, to April 23, 2020, for the Karnataka state. This fixed cohort was followed till 14 days (May 8, 2020) for definitive outcomes (death/discharge). The median length of hospital stay was 17 days (interquartile range: 15-20) for COVID-19 patients. Having severe disease at the time of admission (adjusted-hazard-ratio: 9.3 (3.2-27.3);P < 0.001) and being aged ≥ 60 years (adjusted-hazard-ratio: 11.9 (3.5-40.6);P < 0.001) were the significant predictors of COVID-19 mortality. By moving beyond descriptive (which provide only crude information) to survival analyses, information on the local hospital-related characteristics will be crucial to model bed-occupancy demands for contingency planning during COVID-19 pandemic.


Covid-19 and COPD: A Personal Reflection


docid: zeydlreg

title: COVID-19 sampling from the middle ear and mastoid: A case report


title: Chest CT imaging characteristics of COVID-19 pneumonia in preschool children: a retrospective study

text: BACKGROUND: Recently, the World Health Organization has declared the coronavirus disease 2019 (COVID-19) outbreak a public health emergency of international concern. So far, however, limited data are available for children. Therefore, we aimed to investigate the clinical and chest CT imaging characteristics of COVID-19 in preschool children. METHODS: From January 26, 2020 to February 20, 2020, the clinical and initial chest CT imaging data of eight preschool children with laboratory-confirmed COVID-19 from two hospitals were retrospectively collected. The chest CT imaging characteristics, including the distribution, shape, and density of lesions, and the pleural effusion, pleural changes, and enlarged lymph nodes were evaluated. RESULTS: Two cases (25%) were classified as mild type, and they showed no obvious abnormal CT findings or minimal pleural thickening on the right side. Five cases (62.5%) were classified as moderate type. Among these patients, one case showed consolidation located in the subpleural region of the right upper lobe, with thickening in the adjacent pleura; one case showed multiple consolidation and ground-glass opacities with blurry margins; one case displayed bronchial pneumonia-like changes in the left upper lobe; and two cases displayed asthmatic bronchitis-like changes. One case (12.5%) was classified as critical type and showed bronchial pneumonia-like changes in the bilateral lungs, presenting blurred and messy bilateral lung markings and multiple patchy shadows scattered along the lung markings with blurry margins. CONCLUSIONS: The chest CT findings of COVID-19 in preschool children are atypical and various. Accurate diagnosis requires a comprehensive evaluation of epidemiological, clinical, laboratory and CT imaging data.


title: Lopinavir/ritonavir is associated with pneumonia resolution in COVID-19 patients with influenza coinfection: a retrospective matched-pair cohort study

text: BACKGROUND: During the early stages of the pandemic, some coronavirus disease (COVID-19)patients were misdiagnosed as having influenza, which aroused the concern that some deaths attributed to influenza were actually COVID-19-related. Howerver, little is known about whether coinfection with influenza contributes to severity of COVID-19 pneumonia, and the optimal therapeutic strategy for these patients. METHODS: We retrospectively studied 128 hospitalized patients with COVID-19 pneumonia. All patients were positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)positive by nucleic acid detection. 64 cases were co-infected with influenza A/B and the other 64 were influenza negative, matched by age, sex, and days from onset of symptoms. RESULTS: Among the 64 co-infected patients, 54 (84.4%) were co-infected with influenza A, and 10 (15.6%) with influenza B. The median duration of viral shedding time from admission was longer for patients with influenza coinfection (17.0 days) than for those without influenza coinfection (12.0 days) (P<0.001). The multivariable Cox proportional hazards model showed that the hazard ratio HR of resolution in lung involvement was 1.878 (P=0.020) for patients administered lopinavir/ritonavir, compared with those not administered lopinavir/ritonavir (95% confidence interval (CI) 1.103, 3.196). Among influenza co-infected patients, those treated with lopinavir/ritonavir exhibited faster pneumonia resolution within two weeks after symptom onset (37% vs 1%, P=0.001). CONCLUSIONS: There was no difference in lung involvement between influenza co-infected and non-infected groups. Lopinavir/ritonavir eliminated the difference of lung involvement between influenza co-infected and non-infected groups, indicating that lopinavir/ritonavir is associated with pneumonia resolution in COVID-19. This article is protected by copyright. All rights reserved.


title: CB1 cannabinoid receptor-mediated plasticity of GABAergic synapses in the mouse insular cortex

text: The insular cortex plays pivotal roles in taste learning. As cellular mechanisms of taste learning, long-term potentiation (LTP) at glutamatergic synapses is well studied. However, little is known about long-term changes of synaptic efficacy at GABAergic synapses in the insular cortex. Here, we examined the synaptic mechanisms of long-term plasticity at GABAergic synapses in layer V pyramidal neurons of the mouse insular cortex. In response to a prolonged high-frequency stimulation (HFS), GABAergic synapses displayed endocannabinod (eCB)-mediated long-term depression (LTDGABA). When cannabinoid 1 receptors (CB1Rs) were blocked by a CB1R antagonist, the same stimuli caused LTP at GABAergic synapses (LTPGABA) which was mediated by production of nitric oxide (NO) via activation of NMDA receptors. Intriguingly, NO signaling was necessary for the induction of LTDGABA. In the presence of leptin which blocks CB1 signaling, the prolonged HFS caused LTPGABA which was mediated by NO signaling. These results indicate that long-term plasticity at GABAergic synapses in the insular cortex can be modulated by combined effects of eCB and NO signaling. These forms of GABAergic synaptic plasticity in the insular cortex may be crucial synaptic mechanisms in taste learning.


Covid-19: Simuleringsmodeller ved epidemier./ Covid-19: Simuleringsmodeller ved epidemier./ Covid-19: Simulation models for epidemics


title: Drug treatment of coronavirus disease 2019 (COVID-19) in China

text: Since December 2019, the coronavirus disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread throughout China as well as other countries. More than 8,700,000 confirmed COVID-19 cases have been recorded worldwide so far, with much more cases popping up overseas than those inside. As the initial epicenter in the world, China has been combating the epidemic for a relatively longer period and accumulated valuable experience in prevention and control of COVID-19. This article reviewed the clinical use, mechanism and efficacy of the clinically approved drugs recommended in the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (DTPNCP) released by National Health Commission of P.R.China, and the novel therapeutic agents now undergoing clinical trials approved by China National Medical Products Administration (NMPA) to evaluate experimental treatment for COVID-19. Reviewing the progress in drug development for the treatment against COVID-19 in China may provide insight into the epidemic control in other countries.


Keeping pace: An ED communications strategy for COVID-19


title: Psychophysical Olfactory Tests and Detection of COVID-19 in Patients With Sudden Onset Olfactory Dysfunction: A Prospective Study

text: OBJECTIVE: To investigate the coronavirus disease 2019 (COVID-19) status of patients with initial sudden olfactory anosmia (ISOA) through nasopharyngeal swabs for reverse transcription-polymerase chain reaction (RT-PCR) analysis and to explore their olfactory dysfunctions with psychophysical olfactory evaluation. METHODS: A total of 78 ISOA patients were recruited from April 6, 2020, to April 10, 2020, through a public call of University of Mons (Mons, Belgium). Patients benefited from nasopharyngeal swabs and fulfilled the patient-reported outcome questionnaire. Among them, 46 patients performed psychophysical olfactory evaluation using olfactory identification testing. Based on the duration of the ISOA, 2 groups of patients were compared: patients with olfactory dysfunction duration ≤12 days (group 1) and those with duration >12 days (group 2). RESULTS: In group 1, 42 patients (87.5%) had a positive viral load determined by RT-PCR and 6 patients (12.5%) were negative. In group 2, 7 patients (23%) had a positive viral load and 23 patients (77%) were negative. The psychophysical olfactory evaluation reported that anosmia and hyposmia occurred in 24 (52%) and 11 (24%) patients, respectively. Eleven patients were normosmic. The viral load was significantly higher in patients of group 1 compared with those of group 2. CONCLUSIONS: Coronavirus disease 2019 was detected in a high proportion of ISOA patients, especially over the first 12 days of olfactory dysfunction. Anosmia is an important symptom to consider in the detection of COVID-19 infection.


title: A logistic growth model for COVID-19 proliferation: experiences from China and international implications in infectious diseases

text: OBJECTIVE: As the COVID-19 global pandemic continues its proliferation globally, this paper shares the findings and experiences of modelling the outbreak in China and its provinces and proposes implications for the study of infectious diseases and the COVID-19 pandemic in other nations. METHODS: An NLS (non-linear least square) method estimated the parameters of a differentiated logistic growth function of new COVID-19 cases in multiple regions in China and nations with a large amount of cases based on training data from Feb. 20 to Mar. 13. A restriction test was subsequently employed to test whether a designated parameter was identical among regions or countries. We conducted diagnosis of the residuals and also its goodness of fit with testing data from Mar. 13 to Apr. 18. FINDINGS: We find that the model fits time series data exceedingly well in China, its provinces, and two other nations, and we provide estimates of key parameters. We reject the null hypothesis that the growth rate of the outbreak is the same among ten selected provinces as well as between South Korea and Iran. We also find that the model does not provide reliable estimates in countries that are in the early stages of outbreak. We further find that the R2 value be varied and misleading when compared among different curves of the same nonlinear model, as well as the existence of heteroskedasticity and positive serial correlation within residuals in some provinces and nations. CONCLUSION: We believe that there is potential for our model to contribute to better public health policy combatting COVID-19 by providing a simple logistical framework for retrospectively analyzing the outbreak in regions that have already experienced maximal proliferation in cases. However, based upon our statistical findings, we outline certain pitfalls in modelling and their implications on results.


title: Prediction of the Number of COVID-19 Confirmed Cases Based on K-Means-LSTM

text: COVID-19 is a pandemic disease that began to rapidly spread in the US with the first case detected on January 19, 2020, in Washington State. March 9, 2020, and then increased rapidly with total cases of 25,739 as of April 20, 2020. The Covid-19 pandemic is so unnerving that it is difficult to understand how any person is affected by the virus. Although most people with coronavirus 81%, according to the U.S. Centers for Disease Control and Prevention (CDC), will have little to mild symptoms, others may rely on a ventilator to breathe or not at all. SEIR models have broad applicability in predicting the outcome of the population with a variety of diseases. However, many researchers use these models without validating the necessary hypotheses. Far too many researchers often"overfit"the data by using too many predictor variables and small sample sizes to create models. Models thus developed are unlikely to stand validity check on a separate group of population and regions. The researcher remains unaware that overfitting has occurred, without attempting such validation. In the paper, we present a combination algorithm that combines similar days features selection based on the region using Xgboost, K Means, and long short-term memory (LSTM) neural networks to construct a prediction model (i.e., K-Means-LSTM) for short-term COVID-19 cases forecasting in Louisana state USA. The weighted k-means algorithm based on extreme gradient boosting is used to evaluate the similarity between the forecasts and past days. The results show that the method with K-Means-LSTM has a higher accuracy with an RMSE of 601.20 whereas the SEIR model with an RMSE of 3615.83.


Implementation of a non-invasive oxygenation support strategy during the COVID-19 pandemic in an ephemeral Respiratory Intermediate Care Unit


docid: utdpgyex

title: Combating COVID-19: health equity matters


title: Correction to: Heparin resistance in COVID19 patients in the intensive care unit

text: In the original publication of this article, one of the co-author name "D. de Monteverde-Robb" was inadvertently mentioned as "R. de Monteverde-Robb". The correct author name is "D. de Monteverde-Robb". This error has been corrected with this erratum.


title: Continuous Renal Replacement Therapy for a Patient with Severe COVID-19

text: The outbreak of coronavirus disease 2019 (COVID-19) is a global health threat. It is a respiratory disease, and acute kidney injury (AKI) is rare; however, if a patient develops severe AKI, renal replacement therapy (RRT) should be considered. Recently, we had a critically ill COVID-19 patient who developed severe AKI and needed continuous RRT (CRRT). To avoid the potential risk of infection from CRRT effluents, we measured severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genetic material in the effluents by qRT-PCR, and low copy numbers of the viral genome were detected. Due to unstable hemodynamic status in critically ill patients, CRRT should be the first choice for severe AKI in COVID-19 patients. We suggest prevention of clinical infection and control during administration of RRT in the acute phase of COVID-19 patients with AKI or multiple organ failure.


A Tribute to Frontline Health Care Professionals During the COVID-19 Pandemic


Management-supportive measures for managers of healthcare organizations during the COVID-19 epidemic


title: Acute complications and mortality in hospitalized patients with coronavirus disease 2019: a systematic review and meta-analysis

text: BACKGROUND: The incidence of acute complications and mortality associated with COVID-19 remains poorly characterized. The aims of this systematic review and meta-analysis were to summarize the evidence on clinically relevant outcomes in hospitalized patients with COVID-19. METHODS: MEDLINE, EMBASE, PubMed, and medRxiv were searched up to April 20, 2020, for studies including hospitalized symptomatic adult patients with laboratory-confirmed COVID-19. The primary outcomes were all-cause mortality and acute respiratory distress syndrome (ARDS). The secondary outcomes included acute cardiac or kidney injury, shock, coagulopathy, and venous thromboembolism. The main analysis was based on data from peer-reviewed studies. Summary estimates and the corresponding 95% prediction intervals (PIs) were obtained through meta-analyses. RESULTS: A total of 44 peer-reviewed studies with 14,866 COVID-19 patients were included. In general, risk of bias was high. All-cause mortality was 10% overall (95% PI, 2 to 39%; 1687/14203 patients; 43 studies), 34% in patients admitted to intensive care units (95% PI, 8 to 76%; 659/2368 patients; 10 studies), 83% in patients requiring invasive ventilation (95% PI, 1 to 100%; 180/220 patients; 6 studies), and 75% in patients who developed ARDS (95% PI, 35 to 94%; 339/455 patients; 11 studies). On average, ARDS occurred in 14% of patients (95% PI, 2 to 59%; 999/6322 patients; 23 studies), acute cardiac injury in 15% (95% PI, 5 to 38%; 452/2389 patients; 10 studies), venous thromboembolism in 15% (95% PI, 0 to 100%; patients; 3 studies), acute kidney injury in 6% (95% PI, 1 to 41%; 318/4682 patients; 15 studies), coagulopathy in 6% (95% PI, 1 to 39%; 223/3370 patients; 9 studies), and shock in 3% (95% PI, 0 to 61%; 203/4309 patients; 13 studies). CONCLUSIONS: Mortality was very high in critically ill patients based on very low-quality evidence due to striking heterogeneity and risk of bias. The incidence of clinically relevant outcomes was substantial, although reported by only one third of the studies suggesting considerable underreporting. TRIAL REGISTRATION: PROSPERO registration ID for this study is CRD42020177243 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=177243 ).


Perioperative Preparations for COVID-19: The Pediatric Cardiac Team Perspective


title: Amino acid 159 of the envelope protein affects viral replication and T-cell infiltration by West Nile virus in intracranial infection

text: West Nile virus (WNV) is an important cause of viral encephalitis in birds and animals, including humans. Amino acid 159 of the envelope (E) protein is reportedly implicated in the different levels of neurovirulence in mice infected with WNV NY99 or Eg101. We investigated the role of amino acid 159 of the E protein in the pathogenesis of WNV infection. We produced recombinant WNV with the structural proteins of the NY99 or Eg101 strain (NY-WT or EgCME-WT) and mutant viruses with substitutions of amino acid 159 of the E protein (NY-E-V159I or EgCME-E-I159V). The NY-WT and NY-E-V159I or EgCME-WT and EgCME-E-I159V titers in culture supernatant were similar. The mortality rate and viral titer in the brains of mice inoculated intraperitoneally with NY-WT or NY-E-V159I were also similar. In contrast, the mortality rate and viral titer in the brains of mice inoculated intracranially with EgCME-E-I159V were significantly higher than those of mice inoculated with EgCME-WT. The numbers of CD3-positive and CD8-positive T cells were greater in brains inoculated with EgCME-E-I159V than in those inoculated with EgCME-WT. Therefore, amino acid 159 of the E protein modulates the pathogenicity of WNV by affecting viral replication and T-cell infiltration in the brain.


title: Treating Leukemia in the Time of COVID-19

text: The coronavirus disease 2019 (COVID-19) pandemic poses several challenges to the management of patients with leukemia. The biology of each leukemia and its corresponding treatment with conventional intensive chemotherapy, with or without targeted therapies (venetoclax, FLT3 inhibitors, IDH1/2 inhibitors, Bruton's tyrosine kinase inhibitors), introduce additional layers of complexity during COVID-19 high-risk periods. The knowledge about COVID-19 is accumulating rapidly. An important distinction is the prevalence of "exposure" versus "clinical infectivity," which determine the risk versus benefit of modifying potentially highly curative therapies in leukemia. At present, the rate of clinical infection is <1-2% worldwide. With a mortality rate of 1-5% in CO-VID-19 patients in the general population and potentially of >30% in patients with cancer, careful consideration should be given to the risk of COVID-19 in leukemia. Instead of reducing patient access to specialized cancer centers and modifying therapies to ones with unproven curative benefit, there is more rationale for less intensive, yet effective therapies that may require fewer clinic visits or hospitalizations. Here, we offer recommendations on the optimization of leukemia management during high-risk COVID-19 periods.


docid: fzlsfkbb

title: Advances on Antiviral Activity of Morus spp. Plant Extracts: Human Coronavirus and Virus-Related Respiratory Tract Infections in the Spotlight

text: (1) Background: Viral respiratory infections cause life-threatening diseases in millions of people worldwide every year. Human coronavirus and several picornaviruses are responsible for worldwide epidemic outbreaks, thus representing a heavy burden to their hosts. In the absence of specific treatments for human viral infections, natural products offer an alternative in terms of innovative drug therapies. (2) Methods: We analyzed the antiviral properties of the leaves and stem bark of the mulberry tree (Morus spp.). We compared the antiviral activity of Morus spp. on enveloped and nonenveloped viral pathogens, such as human coronavirus (HCoV 229E) and different members of the Picornaviridae family-human poliovirus 1, human parechovirus 1 and 3, and human echovirus 11. The antiviral activity of 12 water and water-alcohol plant extracts of the leaves and stem bark of three different species of mulberry-Morus alba var. alba, Morus alba var. rosa, and Morus rubra-were evaluated. We also evaluated the antiviral activities of kuwanon G against HCoV-229E. (3) Results: Our results showed that several extracts reduced the viral titer and cytopathogenic effects (CPE). Leaves' water-alcohol extracts exhibited maximum antiviral activity on human coronavirus, while stem bark and leaves' water and water-alcohol extracts were the most effective on picornaviruses. (4) Conclusions: The analysis of the antiviral activities of Morus spp. offer promising applications in antiviral strategies.


The pandemic mixed up what scientists study - and some won't go back


The possibility of COVID-19 transmission from eye to nose


The response during a pandemic is a blurred vision of the future. Reflections on the Lombardy reorganization of the neurosurgical emergencies during the COVID-19


title: ERCP and SARS-COV-2: an urgent procedure that should be immune

text: BACKGROUND: Radical changes to clinical and endoscopy practice have been rapidly introduced following the spread of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Urgent endoscopies are, however, intended to proceed as normal with additional personal protective procedures. A perceived reduction in hospital attendances may suggest a number of urgently indicated endoscopic retrograde cholangio-pancreatographies (ERCPs) are being missed. Objectives and Methods: A review of all ERCPs carried out in a large tertiary referral endoscopy unit under healthcare restrictions was compared to the same time period in previous years. The intention was to determine if ERCPs are proceeding as normal or if there is a difference in referral characteristics. RESULTS: Under service restrictions (13 March to the end of April 2020), 55 ERCPs were performed compared with 87 ERCPs in 2019. Similar numbers to 2019 were also recorded in the preceding years. One case of coronavirus disease 2019 (COVID-19) was reported in a patient in the days following ERCP, with no cases notified among staff related to endoscopy. CONCLUSIONS: A reduction in ERCP referrals raises concern that a cohort of patients with significant biliary disease remain undetected. Whether this results in later, and more severe, presentation remains to be seen but a potential surge in such cases could significantly burden all future endoscopy planning services.


title: Supporting Adults Bereaved Through COVID-19: A Rapid Review of the Impact of Previous Pandemics on Grief and Bereavement

text: The global COVID-19 pandemic is likely to have a major impact on the experience of death, dying, and bereavement. This study aimed to review and synthesize learning from previous literature focused on the impact on grief and bereavement during other infectious disease outbreaks. We conducted a rapid scoping review according to the principles of the Joanna Briggs Institute and analyzed qualitative data using thematic synthesis. From the 218 identified articles, 6 were included in the analysis. They were four qualitative studies, one observational study, and a systematic review. Studies were conducted in West Africa, Haiti, and Singapore. No research studies have focused on outcomes and support for bereaved people during a pandemic. Studies have tended to focus on survivors who are those who had the illness and recovered, recognizing that some of these individuals will also be bereaved people. Previous pandemics appear to cause multiple losses both directly related to death itself and also in terms of disruption to social norms, rituals, and mourning practices. This affects the ability for an individual to connect with the deceased both before and after the death, potentially increasing the risk of complicated grief. In view of the limited research, specific learning from the current COVID-19 crisis and the impact on the bereaved would be pertinent. Current focus should include innovative ways to promote connection and adapt rituals while maintaining respect. Strong leadership and coordination between different bereavement organisations is essential to providing successful postbereavement support.


Reorganization of thoracic surgery activity in a national high-volume comprehensive cancer centre in the Italian epicentre of coronavirus disease 2019


title: Nutrition in times of Covid-19, how to trust the deluge of scientific information

text: PURPOSE OF REVIEW: The Covid-19 pandemic has daunted the world with its enormous impact on healthcare, economic recession, and psychological distress. Nutrition is an integral part of every person life care, and should also be mandatorily integrated to patient care under the Covid-19 pandemic. It is crucial to understand how the Covid-19 does develop and which risk factors are associated with negative outcomes and death. Therefore, it is of utmost importance to have studies that respect the basic tenets of the scientific method in order to be trusted. The goal of this review is to discuss the deluge of scientific data and how it might influence clinical reasoning and practice. RECENT FINDINGS: A large number of scientific manuscripts are daily published worldwide, and the Covid-19 makes no exception. Up to now, data on Covid-19 have come from countries initially affected by the disease and mostly pertain either epidemiological observations or opinion papers. Many of them do not fulfil the essential principles characterizing the adequate scientific method. SUMMARY: It is crucial to be able to critical appraise the scientific literature, in order to provide adequate nutrition therapy to patients, and in particular, to Covid-19 infected individuals.


title: Clinical and Radiographic Presentations of COVID-19 among Patients Receiving Radiation Therapy for Thoracic Malignancies

text: The 2019 novel coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a pandemic affecting healthcare centers across the globe. Patients with cancer have been reported to be particularly vulnerable to infection, morbidity, and severe events. Given the high proportion of asymptomatic carriers and concerns regarding speed and availability of laboratory testing, novel detection strategies are necessary to supplement traditional screening methods and facilitate mitigation of viral transmission. Recent data support the diagnostic consistency and potential value of computed tomography (CT) scans to aid early diagnosis of COVID-19. Volumetric CT image-guidance is commonly employed in patients undergoing radiotherapy and presents a unique opportunity to screen for COVID-specific lung changes. This case series describes the presentation of SARS-CoV-2 infections among three patients undergoing thoracic radiotherapy across multiple institutions. We highlight their clinical symptoms, imaging findings, potential confounders, and clinical workflow to triage these patients to the next level of care.


title: [Study on screening potential traditional Chinese medicines against 2019-nCoV based on Mpro and PLP]

text: With the rapid outbreak of COVID-19, traditional Chinese medicine(TCM) has been playing an active role against the epidemic. However, the screening of TCM is limited by the development cycle and laboratory conditions, which greatly limits the screening speed. This study established optimization docking models and virtual screening to discovery potential active herbs for the prevention and treatment of the novel coronavirus based on molecular docking technology. The crystal structures of 3 CL protease(Mpro) and papain-like protease(PLP) were obtained from PDB database and homologous modeling respectively, and were used to conduct virtual screening of TCMD 2009 database by CDOCKER program. The ingredients scored in the top 100 were selected respectively, and the candidate herbs were ranked by the numbers of hit molecules. Based on Mpro inhibitors screening, 12 322 potential active components were obtained, and the representative active components included aster pentapeptide A, ligustrazine, salvianolic acid B, etc., and Zingiberis Rhizoma Recens, Asteris Radix et Rhizoma, Notoginseng Radix et Rhizoma, Chuanxiong Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, Zingiberis Rhizoma, Dianthi Herba, Rhei Radix et Rhizoma, Cistanches Herba were obtained. While 11 294 potential active ingredients were obtained by PLP inhibitor screening, representative active ingredients included gingerketophenol, ginkgol alcohol, ferulic acid, etc., and Codonopsis Radix, Notopterygii Rhizoma et Radix, Zingiberis Rhizoma Recens, Ginkgo Semen, Chuanxiong Rhizoma, Trichosanthis Fructus, Paeoniae Radix Alba, Psoraleae Fructus, Sophorae Flavescentis Radix, Notoginseng Radix et Rhizoma, Angelicae Sinensis Radix were chosen. By combining the diagnosis and treatment scheme of Hunan province's and angiotensin converting enzyme 2(ACE2) inhibitors screening from literature, present study also discussed the rational application of candidate herbs to this epidemic situation. Trichosanthis Fructus obtained by PLP inhibitors screening and Fritillaria verticillata obtained by ACE2 inhibitors screening were parts of the Sangbei Zhisou Powder and Xiaoxianxiong Decoction, which might be applicable to the syndromes of cough and dyspnea. Rhei Radix et Rhizoma screened by Mpro and Trichosanthis Fructus screened by PLP were contained in Maxing Shigan Decoction and Xuanbai Chengqi Decoction, and could be applied to the syndromes of epidemic virus blocking lung. Mori Folium, Lonicerae Japonicae Flos and Forsythiae Fructus obtained by ACE2 inhibitors screening were included in the Sangju Decoction and Yinqiaosan, which might be applicable to the syndromes of warm pathogen attacking lung and cough and dyspnea. The results of this study are intended to provide a reference for the further development of traditional Chinese medicine to deal with the new epidemic.


title: Clinical characteristics and outcome of SARS-CoV-2 infection in Italian pediatric oncology patients: a study from the Infectious Diseases Working Group of the AIEOP

text: BACKGROUND: Little is known as yet about the outcome of SARS-CoV-2 infection in children being treated for cancer. METHODS: We collected information on the clinical characteristics and outcomes of a cohort of 29 children (16 females and 13 males, median age 7 years, range [0-16]) diagnosed with SARS-CoV-2 infection while on chemotherapy/immunotherapy (N=26), or after stem cell transplantation (N=3) during the peak of the epidemic in Italy. These patients suffered from leukemia (N=16), lymphoma (N=3), solid tumors (N=10), and Langerhans cell histiocytosis (N=1). RESULTS: The course of the disease was mild in all cases, with only 12 children developing symptoms (pneumonia in 3 cases), and none needing intensive care. Fifteen patients were hospitalized, including 7 asymptomatic patients. Nine patients (including 5 with no symptoms) were given hydroxychloroquine, and 3 of them were also given lopinavir/ritonavir. CONCLUSIONS: SARS-CoV-2 infection seems to take a milder clinical course in children than in adults with cancer. Specific SARS-CoV-2 treatment seems unnecessary for most children. In the light of our findings, and albeit with the necessary caution, we suggest avoiding major changes to planned anticancer treatments in pediatric patients acquiring COVID-19.


More on 'Association between ABO blood groups and risk of SARS-CoV-2 pneumonia'


Letter regarding "SARS-CoV-2 in the peritoneal waste in a patient treated with peritoneal dialysis"


Covid 19: death certification in England and Wales


docid: mmhrnxiy

title: Blocking of the CD80/86 axis as a therapeutic approach to prevent progression to more severe forms of COVID-19

text: In its more severe forms, COVID-19 progresses towards an excessive immune response, leading to the systemic overexpression of proinflammatory cytokines like IL6, mostly from the infected lungs. This cytokine storm can cause multiple organ damage and death. Consequently, there is a pressing need to identify therapies to treat and prevent severe symptoms during COVID-19. Based on previous clinical evidence, we hypothesized that inhibiting T cell co-stimulation by blocking CD80/86 could be an effective therapeutic strategy against progression to severe proinflammatory states. To support this hypothesis, we performed an analysis integrating blood transcriptional data we generated from rheumatoid arthritis patients treated with abatacept -- a CD80/86 co-stimulation inhibitor -- with the pathological features associated with COVID-19, particularly in its more severe forms. We have found that many of the biological processes that have been consistently associated with COVID-19 pathology are reversed by CD80/86 co-stimulation inhibition, including the downregulation of IL6 production. Also, analysis of previous transcriptional data from blood of SARS-CoV-infected patients showed that the response to abatacept has a very high level of antagonism to that elicited by COVID-19. Finally, analyzing a recent single cell RNA-seq dataset from bronchoalveolar lavage fluid cells from COVID-19 patients, we found a significant correlation along the main elements of the C80/86 axis: CD86+/80+ antigen presenting cells, activated CD4+ T cells and IL6 production. Our in-silico study provides additional support to the hypothesis that blocking of the CD80/CD86 signaling axis may be protective of the excessive proinflammatory state associated with COVID-19 in the lungs.


Hemodynamics, baroreflex index and blood biomarkers of a patient who died after being affected by COVID-19: case report


title: Recommendations for risk stratified use of cardiac computed tomography for congenital heart disease during the COVID-19 pandemic

text: The impact of the coronavirus disease (COVID-19) pandemic in the United States and around the world has required significant changes to medical practice. Amidst the rapidly evolving public health emergency, hospital centers have been required to postpone elective procedures, preserve personal protective equipment (PPE), practice social distancing and limit staff exposures. Patients with congenital heart disease (CHD) often need urgent evaluation, most commonly for preprocedural evaluation. We have stratified the most common indications for cardiac computed tomography (CCT) imaging in patients with CHD to help guide care for these patients during the COVID-19 pandemic including considerations for reopening.


The multifaceted long-term effects of the COVID-19 pandemic on urology


title: Surveillance to improve evidence for community control decisions during the COVID-19 pandemic - Opening the animal epidemic toolbox for public health

text: During the first few months of 2020, the COVID-19 pandemic has reached Europe. Health systems all over the world are trying to control the outbreak in the shortest possible time. Exotic disease outbreaks are not uncommon in animal health and randomised surveillance is frequently used as support for decision-making. This editorial discusses the possibilities of practicing One Health, by using methods from animal health to enhance surveillance for COVID-19 to provide an evidence base fort decision-making in communities and countries.


Cardiovascular and Logistic Issues Associated With COVID-19 Pandemic


A segregated-team model to maintain cancer care during the COVID-19 outbreak at an academic center in Singapore


title: How to Effectively Support Patients with Rheumatic Conditions Now and Beyond COVID-19

text: May 2020, the COVID-19 pandemic continues to unfold. Governments are investing in public health, clinical and research efforts to avoid the spread of the SARS-CoV-2 virus, reduce the number of deaths and prevent the collapse of health care systems. However, this pandemic will have unprecedented consequences for people who live with chronic conditions for the months and even years to come without coordinated actions.


title: Salivary detection of SARS-CoV-2 (COVID-19) and implications for oral health-care providers

text: The coronavirus disease 2019 (COVID-19) pandemic has become a major public health crisis. The diagnostic and containment efforts for the disease have presented significant challenges for the global health-care community. In this brief report, we provide perspective on the potential use of salivary specimens for detection and serial monitoring of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on current literature. Oral health-care providers are at an elevated risk of exposure to COVID-19 due to their proximity to nasopharynx of patients, and the practice involving the use of aerosol-generating equipment. Here, we summarize the general guidelines for oral health-care specialists for prevention of nosocomial transmission of COVID-19, and provide specific recommendations for clinical care management.


Temporal profiling of plasma cytokines, chemokines and growth factors from mild, severe and fatal COVID-19 patients


title: Propensity score-matched comparison between open and minimal invasive hybrid esophagectomy for esophageal adenocarcinoma

text: BACKGROUND: This study compared the outcome between patients who had an open and those who had a hybrid esophagectomy for T1 or T3 esophageal adenocarcinoma (eAC). No clear data are available concerning this question based on T-category. METHODS: Two groups of patients with esophagectomy and high intrathoracic esophagogastrostomy for eAC were analyzed: hybrid (laparoscopy + right thoracotomy) (n = 835) and open (laparotomy + right thoracotomy) (n = 188). Outcome criteria were 30- and 90-day mortality, R0-resection rate (R0), number of resected lymph nodes (rLNs), and 5-year survival rate (5y-SR). For each type of surgery, three patient groups were analyzed: pT1-carcinoma (group-1), cT3Nx and neoadjuvant chemoradiation (group-2), and pT3N0-3 without neoadjuvant therapy (group-3). The comparison was based on a propensity score matching in relation of 1:2 for open versus hybrid. RESULTS: In group-1 (38 open vs 76 hybrid) R0-resection (100%), 30-day mortality (0%), 90-day mortality (2.6% vs 0%), and rLNs (median 29.5 vs 28.5) were not significantly different. The pN0-rate was 76% in the open and 92% in the hybrid group (p = 0.036). Accordingly, the 5y-SR was 69% and 87% (p = 0.016), but the prognosis of the subgroups pT1pN0 or pT1pN+ was not significantly different between open or hybrid. In group-2 (68 open vs 135 hybrid) R0-resection (97%), 30-day (0% vs 0.7%) and 90-day (4%) mortality, rLNs (28.5 vs 26), and 5y-SR (36% vs 41%) were not significantly different. In group-3 (37 open vs 75 hybrid) R0, postoperative mortality, rLNs, and 5y-SR were not significantly different. CONCLUSION: In a propensity score-matched comparison of patients with an open or hybrid esophagectomy for esophageal adenocarcinoma the quality of oncologic resection, postoperative mortality and prognosis are not different.


title: Distinct clinical characteristics and risk factors for mortality in female COVID-19 inpatients: a sex-stratified large-scale cohort study in Wuhan, China

text: BACKGROUND: As the coronavirus disease 2019 (COVID-19) outbreak accelerates worldwide, it is highly significant to evaluate sex-specific clinical characteristics and outcomes, that may affect public health policies. METHODS: COVID-19 patients admitted to Tongji Hospital between January 18and March 27, 2020 were evaluated. Clinical features, laboratory data, complications and outcomes were compared between females and males. Risk factors for mortality in the whole population, females and males were determined respectively. RESULTS: There were 1667 (50.38%) females among the3309 patients included in this study. The mortality rate was only 5.9% in females but 12.7% in males. Compared with males, more females had no initial symptoms (11.1% vs 8.3%, p=0.008). Complications including acute respiratory distress syndrome, acute kidney injury, septic shock, cardiac injury and coagulation disorder were less common in females; critical illness was also significant less common in females (31.1% vs 39.4%, p<0.0001). Significantly fewer female patients received antibiotics treatment (p=0.001), antiviral therapy (p=0.025) glucocorticoids treatment (p<0.0001), mechanical ventilation (p<0.0001) and had Intensive Care Unit admission (p<0.0001). A lower risk of death was found in females (odds ratio 0.44, 95% confidence interval 0.34-0.58) after adjusting for age and coexisting diseases. Among females, age, malignancy, chronic kidney disease and days from onset to admission were significant associated with mortality, while chronic kidney disease was not risk factor in males. CONCLUSIONS: Significantly more mild illness and fewer deaths were found in female COVID-19 inpatients and risk factors associated with mortality varied among male and female population.


title: COVID 19 and Spanish flu pandemics: All it changes, nothing changes

text: The Corona Virus 19 (COVID 19) epidemic is an infectious disease which was declared as a pandemic and hit all the Countries, all over the world, from the beginning of the year 2020. There are many similarities between the COVID 19 epidemic and the Spanish flu epidemic. We considered some preventive measures which do not change in the two epidemics.


title: Impact of multi-professional simulation-based training on the perception of safety and preparedness among health workers caring for COVID-19 patients in Pakistan

text: It aimed to evaluate the perception of safety and preparedness among health workers caring for coronavirus disease 2019 (COVID-19) patients before and after a multi-professional simulation-based course in Pakistan. Health workers' perception of preparedness, safety, and their willingness to care for COVID-19 patients were measured before after attending a simulation-based training course to prepare them to care for COVID-19 patients, in Combined Military Hospital Landi Kotal Cantt, from 1st March 2020 to 30th April 2020. : The participants' perceived level of safety and preparedness to care for COVID-19 patients before the simulation-based course was low but increased after completing it (P<0.05). They felt confident and were willing to a significantly higher degree to care for patients of COVID-19 or other infections requiring high isolationSimulation-based training is an effective tool to improve the perception of risk and readiness to deal with COVID-19 among medical and non-medical health workers in Pakistan.


Erfordern besondere Zeiten besondere Maßnahmen?/ [Do desperate times call for desperate measures?]


Acute hemolysis by hydroxycloroquine was observed in G6PD-deficient patient with severe COVD-19 related lung injury


Pneumonia without Respiratory Symptoms


title: Modeling COVID-19 Latent Prevalence to Assess a Public Health Intervention at a State and Regional Scale: Retrospective Cohort Study

text: BACKGROUND: Emergence of the coronavirus disease (COVID-19) caught the world off guard and unprepared, initiating a global pandemic. In the absence of evidence, individual communities had to take timely action to reduce the rate of disease spread and avoid overburdening their health care systems. Although a few predictive models have been published to guide these decisions, most have not taken into account spatial differences and have included assumptions that do not match the local realities. Access to reliable information that is adapted to local context is critical for policy makers to make informed decisions during a rapidly evolving pandemic. OBJECTIVE: The goal of this study was to develop an adapted susceptible-infected-removed (SIR) model to predict the trajectory of the COVID-19 pandemic in North Carolina and the Charlotte Metropolitan Region, and to incorporate the effect of a public health intervention to reduce disease spread while accounting for unique regional features and imperfect detection. METHODS: Three SIR models were fit to infection prevalence data from North Carolina and the greater Charlotte Region and then rigorously compared. One of these models (SIR-int) accounted for a stay-at-home intervention and imperfect detection of COVID-19 cases. We computed longitudinal total estimates of the susceptible, infected, and removed compartments of both populations, along with other pandemic characteristics such as the basic reproduction number. RESULTS: Prior to March 26, disease spread was rapid at the pandemic onset with the Charlotte Region doubling time of 2.56 days (95% CI 2.11-3.25) and in North Carolina 2.94 days (95% CI 2.33-4.00). Subsequently, disease spread significantly slowed with doubling times increased in the Charlotte Region to 4.70 days (95% CI 3.77-6.22) and in North Carolina to 4.01 days (95% CI 3.43-4.83). Reflecting spatial differences, this deceleration favored the greater Charlotte Region compared to North Carolina as a whole. A comparison of the efficacy of intervention, defined as 1 - the hazard ratio of infection, gave 0.25 for North Carolina and 0.43 for the Charlotte Region. In addition, early in the pandemic, the initial basic SIR model had good fit to the data; however, as the pandemic and local conditions evolved, the SIR-int model emerged as the model with better fit. CONCLUSIONS: Using local data and continuous attention to model adaptation, our findings have enabled policy makers, public health officials, and health systems to proactively plan capacity and evaluate the impact of a public health intervention. Our SIR-int model for estimated latent prevalence was reasonably flexible, highly accurate, and demonstrated efficacy of a stay-at-home order at both the state and regional level. Our results highlight the importance of incorporating local context into pandemic forecast modeling, as well as the need to remain vigilant and informed by the data as we enter into a critical period of the outbreak.


Your COVID-19 Intubation Kit


title: The impact of covid-19 pandemic on urgent endoscopy in Italy: a nation-wide multicenter study

text: Objective: COVID-19 pandemic has seriously affected Italy. Radical changes occurred in the Italian NHS and thus in GI departments, as only urgent endoscopies were guaranteed. The study aimed to report how the demand for urgent endoscopy changed during the COVID-19 pandemic in Italy and to evaluate the appropriateness of urgent referrals in the Endoscopy Unit.Material and methods: Nation-wide, cross-sectional survey study in 54 Italian GI Units. Data were collected regarding urgent endoscopies (EGD, CS, ERCP) in two different time periods: March 2019 and March 2020.Results: Thirty-five (64.8%) GI endoscopy Units responded to the survey. The entity of reduction of overall urgent EGDs and CSs performed in March 2020 versus March 2019 was statistically significant: 541 versus 974 (-80%), p < .001 for EGD and 171 versus 265 (-55%), p < .008, for CS, respectively. No statistically significant reduction of urgent ERCP performed in March 2020 versus March 2019 was found. The increase in overall diagnostic yield for urgent EGD in March 2020 versus March 2019 was 7.3% (CI [0.028-0.117], p = .001). No statistically significant difference in diagnostic yield for CS between 2019 and 2020 was found.Conclusion: The study showed a statistically significant reduction of urgent EGD and CS performed during the SARS-CoV-2 pandemic, in March 2020, compared to March 2019. The diagnostic yield of urgent EGD performed in March 2020 was significantly higher than that of March 2019. No statistically significant difference was found in terms of diagnostic yield of urgent CS between March 2020 and March 2019.


title: Network pharmacology-based analysis of the role of traditional Chinese herbal medicines in the treatment of COVID-19

text: BACKGROUND: The novel coronavirus named COVID-19, which originated in Wuhan, China, has spread to many countries around the world. Currently, no effective medical treatment exists to combat this disease. Traditional Chinese herbal medicines (CHM) have unique roles in the treatment of viral infections. In this article we analyzed the effectiveness and possible molecular mechanisms of CHM formulas for the prevention of COVID-19. METHODS: The active ingredients and action targets of CHM formulas were obtained from the TCMSP database. Genes related to severe acute respiratory syndromes (SARS) and Middle East respiratory syndrome (MERS) were queried on the GeneCards database. The action mechanisms of these genes were predicted using a Gene Ontology (GO)-based functional enrichment and annotation tool and the Kyoto Encyclopedia of Genes and Genomes (KEGG). RESULTS: CHM formulas played a positive role in preventing COVID-19 and warrant further application. CONCLUSIONS: Our research provides new evidence to support the possible value of CHM formulas for the prevention of COVID-19. However, further clinical studies with large sample sizes are required to verify their effectiveness.


title: Potential role of incretins in diabetes and COVID-19 infection: a hypothesis worth exploring

text: Patients with diabetes mellitus have been reported to be at a high risk of complications from SARS-CoV2 virus infection (COVID-19). In type 2 diabetes, there is a change in immune system cells, which shift from an anti-inflammatory to a predominantly pro-inflammatory pattern. This altered immune profile may induce important clinical consequences, including increased susceptibility to lung infections; and enhanced local inflammatory response. Furthermore, dipeptidyl peptidase 4 (DPP4) enzyme is highly expressed in the lung, and that it may have additional actions besides its effects on glucose metabolism, which might exert profound pro-inflammatory effects. We briefly review the impact on the inflammatory system of DPP4 for its possible detrimental effect on COVID-19 syndrome, and of DPP4 inhibitors (gliptins), currently used as glucose lowering agents, which may have the potential to exert positive pleiotropic effect on inflammatory diseases, in addition to their effects on glucose metabolism. Thanks to these ancillary effects, gliptins could potentially be "repurposed" as salutary drugs against COVID-19 syndrome, even in non-diabetic subjects. Clinical studies should be designed to investigate this possibility.


Responding to COVID-19 in Hong Kong


title: Evolution of severe acute respiratory syndrome coronavirus 2 RNA test results in a patient with fatal coronavirus disease 2019: a case report

text: A 65-year-old man was hospitalized owing to fever (38.6 °C) and dry cough since 4 days. He visited Wuhan 8 days ago. At admission, nasopharyngeal swab samples were taken, and polymerase chain reaction analysis confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA positivity. On day 9, after admission, the chest computed tomography scan showed diffuse ground-glass shadows in the patient's bilateral lungs. On day 11, his respiratory symptoms worsened. Subsequently, type I respiratory failure was diagnosed, coinciding with kidney injury, and subsequently, type II respiratory failure occurred, coupled with multiorgan failure including the heart and liver. However, the patient's constitution worsened although SARS-CoV-2 tests were negative since day 13. He died on day 21. Lung biopsy showed areas of diffuse alveolar damage, characterized by extensive acute alveolitis with numerous intra-alveolar neutrophil, lymphocyte, and macrophage infiltrations. Microthrombi were seen in the dilated pulmonary capillaries. Immunohistochemistry staining for SARS-CoV-2 N protein was negative. Taken together, the patient died of multiorgan failure although the SARS-CoV-2 infection was cleared already, implicating that for disease worsening, no active SARS-CoV-2 infection is required.


Professional academic organizations on infectious disease Joint Statement on COVID-19


title: Possible therapeutic agents for COVID-19: a comprehensive review

text: INTRODUCTION: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has emerged in China. There are no available vaccines or antiviral drugs for COVID-19 patients. Herein, we represented possible therapeutic agents that may stand as a potential therapy against COVID-19. AREAS COVERED: We searched PubMed, Google Scholar, and clinicaltrials.gov for relevant papers. We showed some agents with potentially favorable efficacy, acceptable safety as well as good pharmacokinetic profiles. Several therapies are under assessment to evaluate their efficacy and safety for COVID-19. However, some drugs were withdrawn due to their side effects after demonstrating some clinical efficacy. Indeed, the most effective therapies could be organ function support, convalescent plasma, anticoagulants, and immune as well as antiviral therapies, especially anti-influenza drugs due to the similarities between respiratory viruses regarding viral entry, uncoating, and replication. We encourage giving more attention to favipiravir, remdesivir, and measles vaccine. EXPERT OPINION: A combination, at least dual or even triple therapy, of the aforementioned efficacious and safe therapies is greatly recommended for COVID-19. Further, patients should have a routine assessment for their coagulation and bleeding profiles as well as their inflammatory and cytokine concentrations.


title: Cold Plasma, a New Hope in the Field of Virus Inactivation

text: Viruses can infect all cell-based organisms, from bacteria to humans, animals, and plants. They are responsible for numerous cases of hospitalization, many deaths, and widespread crop destruction, all of which result in an enormous medical, economical, and biological burden. Each of the currently used decontamination methods has important drawbacks. Cold plasma (CP) has entered this field as a novel, efficient, and clean solution for virus inactivation. We present recent developments in this promising field of CP-mediated virus inactivation, and describe the applications and mechanisms of the inactivation. This is particularly relevant because viral pandemics, such as COVID-19, highlight the need for alternative virus inactivation methods to replace, complement, or upgrade existing procedures.


Mission command: applying principles of military leadership to the SARS-CoV-2 (COVID-19) crisis


title: Reorganization of the endoscopic activity of Cancer Institutes during phase II of the Covid-19 emergency

text: After the lockdown during the emergency phase of the Covid-19 pandemic, we have to deal with phase 2, a period of uncertain duration, with a controlled and progressive return to normalization, in which we need to reconcile our work and our movements with the presence of the virus on our territory. Digestive endoscopic activity is a high-risk transmission procedure for Covid-19. The measures put in place to protect healthcare personnel and patients are stressful and "time-consuming" and lead to a reduction in the number of endoscopic procedures that can be performed. In this scenario, the Oncological Institutes are forced to make a rigorous selection of patients to undergo endoscopic examinations and treatments, according to lists of exceptional priorities, in order to guarantee cancer patients and subjects at high risk of developing digestive tumors, a preferential diagnostic and therapeutic process, protected from contagion risks. For this purpose, cuts and postponing times of endoscopic performances are here proposed, which go beyond the guidelines of scientific societies and have little evidences in the literature. These changes should be applied limited to this exceptional period and in proportion to the capacity of each operating unit in order to meet the demands of the patients.


Aging in Times of the COVID-19 Pandemic: Avoiding Ageism and Fostering Intergenerational Solidarity


A view from UK public health registrars on the challenges of COVID-19


title: COVID-19 presenting as acute pancreatitis

text: The ongoing pandemic of Coronavirus disease-2019 (COVID-19) has spread over 200 countries worldwide, affecting >2 million people and >120,000 deaths. COVID-19 is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The most common symptoms include cough, shortness of breath, and fever. However, gastrointestinal manifestations of COVID-19 are increasingly being recognized. Herein, we report a case of COVID-19 who presented with acute pancreatitis (AP) without any other risk factors.


Implications for COVID-19 triage from the ICNARC report of 2204 COVID-19 cases managed in UK adult intensive care units


title: Group testing performance evaluation for SARS-CoV-2 massive scale screening and testing

text: BACKGROUND: The capacity of the current molecular testing convention does not allow high-throughput and community level scans of COVID-19 infections. The diameter in the current paradigm of shallow tracing is unlikely to reach the silent clusters that might be as important as the symptomatic cases in the spread of the disease. Group testing is a feasible and promising approach when the resources are scarce and when a relatively low prevalence regime is observed on the population. METHODS: We employed group testing with a sparse random pooling scheme and conventional group test decoding algorithms both for exact and inexact recovery. RESULTS: Our simulations showed that significant reduction in per case test numbers (or expansion in total test numbers preserving the number of actual tests conducted) for very sparse prevalence regimes is available. Currently proposed COVID-19 group testing schemes offer a gain up to 15X-20X scale-up. There is a good probability that the required scale up to achieve massive scale testing might be greater in certain scenarios. We investigated if further improvement is available, especially in sparse prevalence occurrence where outbreaks are needed to be avoided by population scans. CONCLUSION: Our simulations show that sparse random pooling can provide improved efficiency gains compared to conventional group testing or Reed-Solomon error correcting codes. Therefore, we propose that special designs for different scenarios could be available and it is possible to scale up testing capabilities significantly.


docid: wsleywry

title: Facts and reflections on COVID-19 and anti-hypertensives drugs

text: Based on some publications that associate SARS-CoV-2 infection with the use of anti-hypertensive drug groups such as angiotensin-converting-enzyme inhibitors (e.g. enalapril) or angiotensin II receptor blockers (e.g. losartan), many patients from South America, Central America or Spain, have stopped or intend to interrupt their treatments with these drugs. Hence, it may exist ominous consequences due to this drop out. For this reason, it is necessary to quickly warn about this situation and the risks associated with it.


title: Evaluation of commercial and automated SARS-CoV-2 IgG and IgA ELISAs using coronavirus disease (COVID-19) patient samples

text: Antibody-screening methods to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) need to be validated. We evaluated SARS-CoV-2 IgG and IgA ELISAs in conjunction with the EUROLabworkstation (Euroimmun, Lübeck, Germany). Overall specificities were 91.9% and 73.0% for IgG and IgA ELISAs, respectively. Of 39 coronavirus disease patients, 13 were IgG and IgA positive and 11 IgA alone at sampling. IgGs and IgAs were respectively detected at a median of 12 and 11 days after symptom onset.


docid: vvsfjoxh

title: Supporting the UK National Health Service during the COVID-19 crisis from an academic perspective


title: Preliminary Recommendations for Surgical Practice of Neurosurgery Department in the Central Epidemic Area of 2019 Coronavirus Infection

text: Since December 2019, an outbreak of coronavirus disease 2019 (COVID-19) has posed significant threats to the public health and life in China. Unlike the other 6 identified coronaviruses, the SARS-Cov-2 has a high infectious rate, a long incubation period and a variety of manifestations. In the absence of effective treatments for the virus, it becomes extremely urgent to develop scientific and standardized proposals for prevention and control of virus transmission. Hereby we focused on the surgical practice in Neurosurgery Department, Tongji Hospital, Wuhan, and drafted several recommendations based on the latest relevant guidelines and our experience. These recommendations have helped us until now to achieve 'zero infection' of doctors and nurses in our department, we would like to share them with other medical staff of neurosurgery to fight 2019-nCoV infection.


docid: xorfrxwj

title: Unrealistic Optimism in the Time of Coronavirus Pandemic: May It Help to Kill, If So-Whom: Disease or the Person?

text: Objective: The results of numerous empirical studies have showed the occurrence of so-called unrealistic optimism. Thus, we aimed to investigate whether in the situation of an imminent coronavirus pandemic, people would still perceive themselves as being less exposed to the disease than others. Methods: Survey studies were conducted to examine the level of unrealistic optimism. Participants (n = 171, 67.3% of women) in a subjective way judged the risk of their coronavirus infection and the likelihood that this would happen to an average student of the same sex from their class. The survey was conducted in three waves: prior to the announcement of the first case of coronavirus (2-3 March), immediately after that announcement (5-6 March), and a few days later (9-10 March). Results: We showed that women estimated the chances of being infected as significantly higher (M = 4.52, SD = 2.079; t = 2.387; p = 0.018; Cohen's d = 0.393) than men (M = 3.71, SD = 2.042). The phenomenon of unrealistic optimism was observed especially in men (as compared to other male participants) as it appeared in all three measures (M (you) = 3.95 vs. M (other male student) = 4.63; M = 3.71 vs. M = 4.68, and M = 4.46 vs. M = 5.38 in phase one, two, and three, respectively; p 0.006 for all comparison), but also in women in the last two measures (M(you) = 4.55 vs. M (other female student) = 4.95, and M = 4.99 vs. M = 5.38 in phase 2 and 3, respectively; p 0.012 for both comparisons). Conclusions: The study revealed a fairly general occurrence of unrealistic optimism, which was mainly observed in men as it appeared in all three measures, but also in women in the last two measures. This result is important for health experts who are responsible for making people comply with regulations concerning social distancing, putting masks on to stop infection, and staying at home. It is possible that unrealistically optimistic people will behave much less in line with the aforementioned recommendations, causing coronavirus to spread widely.


title: Looking after yourself and others

text: The global Covid-19 outbreak is having a profound impact on everyone, including people in the veterinary profession. Public health and government advice for some to self isolate and for all of us to increase social distancing poses huge challenges for the industry and its people, as well as clients and patients. Here, Vetlife Helpline manager.


Implications for cancer care in Iran during COVID-19 pandemic


SARS-CoV-2 in the Employees of a Large University Hospital


title: Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center

text: COVID-19 is rapidly spreading worldwide. Healthcare systems are struggling to properly allocate resources while ensuring cure for diseases outside of the infection. The aim of this study was to demonstrate how surgical activity was affected by the virus outbreak and show the changes in practice in a tertiary referral COVID-19 center. The official bulletins of the Italian National Institute for the Infectious Diseases "L. Spallanzani" were reviewed to retrieve the number of daily COVID-19 patients. Records of consecutive oncological and transplant procedures performed during the outbreak were reviewed. Patients with a high probability of postoperative intensive care unit (ICU) admission were considered as high risk and defined by an ASA score ≥ III and/or a Charlson Comorbidity Index (CCI) ≥ 6 and/or a Revised Cardiac Risk Index for Preoperative Risk (RCRI) ≥ 3. 72 patients were operated, including 12 (16.6%) liver and kidney transplantations. Patients had few comorbidities (26.3%), low ASA score (1.9 ± 0.5), CCI (3.7 ± 1.3), and RCRI (1.2 ± 0.6) and had overall a low risk of postoperative ICU admission. Few patients had liver cirrhosis (12.5%) or received preoperative systemic therapy (16.6%). 36 (50%) high-risk surgical procedures were performed, including major hepatectomies, pancreaticoduodenectomies, total gastrectomies, multivisceral resections, and transplantations. Despite this, only 15 patients (20.8%) were admitted to the ICU. Only oncologic cases and transplantations were performed during the COVID-19 outbreak. Careful selection of patients allowed to perform major cancer surgeries and transplantations without further stressing hospital resources, meanwhile minimizing collateral damage to patients.


Response to: 'Severe COVID-19 associated pneumonia in 3 patients with systemic sclerosis treated with rituximab' by Avouac et al


Targeting inflammation and cytokine storm in COVID-19


title: Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico

text: BACKGROUND: The SARS-CoV-2 outbreak poses a challenge to health care systems due to its high complication rates in patients with cardiometabolic diseases. Here, we identify risk factors and propose a clinical score to predict COVID-19 lethality, including specific factors for diabetes and obesity, and its role in improving risk prediction. METHODS: We obtained data of confirmed and negative COVID-19 cases and their demographic and health characteristics from the General Directorate of Epidemiology of the Mexican Ministry of Health. We investigated specific risk factors associated to COVID-19 positivity and mortality and explored the impact of diabetes and obesity on modifying COVID-19-related lethality. Finally, we built a clinical score to predict COVID-19 lethality. RESULTS: Among the 177â 133 subjects at the time of writing this report (May 18, 2020), we observed 51â 633 subjects with SARS-CoV-2 and 5,332 deaths. Risk factors for lethality in COVID-19 include early-onset diabetes, obesity, chronic obstructive pulmonary disease, advanced age, hypertension, immunosuppression, and chronic kidney disease (CKD); we observed that obesity mediates 49.5% of the effect of diabetes on COVID-19 lethality. Early-onset diabetes conferred an increased risk of hospitalization and obesity conferred an increased risk for intensive care unit admission and intubation. Our predictive score for COVID-19 lethality included ageâ ≥â 65 years, diabetes, early-onset diabetes, obesity, ageâ <â 40 years, CKD, hypertension, and immunosuppression and significantly discriminates lethal from non-lethal COVID-19 cases (C-statisticâ =â 0.823). CONCLUSIONS: Here, we propose a mechanistic approach to evaluate the risk for complications and lethality attributable to COVID-19, considering the effect of obesity and diabetes in Mexico. Our score offers a clinical tool for quick determination of high-risk susceptibility patients in a first-contact scenario.


The novel coronavirus (COVID-19) infection in Hangzhou: An experience to share


title: Medical Education Amid the COVID-19 Pandemic

text: The coronavirus pandemic has shaken the mankind to its core. Social distancing is the most important preventive strategy for the spread of this contagion, short of a vaccine. Implementation of the same has forced many countries in to a complete lock-down. Closure of schools and universities has made education uncertain at all levels. Medical education is no exception. In this pandemic, the need for uninterrupted generation of future doctors is felt more than ever in our living memory. Continuity of medical education is thus imperative. While "Live" patient contact is an irreplaceable tenet of clinical teaching, these extraordinary times demand exceptional measures. Pedagogical innovations involving technology and simulation based teaching (Online lectures, video vase vignettes, virtual simulators, webcasting, online chat-rooms) need to be brought to the forefront. Since the medical educators have been pushed inevitably to rely on technology-based learning, they should not only embrace it but also develop and evaluate its sustainability and application in preclinical and clinical setting. Meanwhile, the students, whose medical educations are stuck in this pandemic time, should realize that there is no bigger teacher than a first-hand experience, and they are eyewitnesses to the making of history.


A Follow-up Study of Recovered Patients with COVID-19 in Wuhan, China


Infection Control Measures for COVID-19 in the Labour Suite and Neonatal Unit


title: Potential scenarios for the progression of a COVID-19 epidemic in the European Union and the European Economic Area, March 2020

text: Two months after the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the possibility of established and widespread community transmission in the European Union and European Economic Area (EU/EEA) is becoming more likely. We provide scenarios for use in preparedness for a possible widespread epidemic. The EU/EEA is moving towards the 'limited sustained transmission' phase. We propose actions to prepare for potential mitigation phases and coordinate efforts to protect the health of citizens.


Commentary: COVID-19 and diabetes mellitus: What we know, how our patients should be treated now, and what should happen next


Effectiveness of CBCT imaging during radiotherapy for the detection of initial COVID-19 lung disease


The start of the Austrian response to the COVID-19 crisis: a personal account


High-flow nasal cannula may be no safer than non-invasive positive pressure ventilation for COVID-19 patients


title: The effect of social distance measures on COVID-19 epidemics in Europe: an interrupted time series analysis

text: Following the introduction of unprecedented "stay-at-home" national policies, the COVID-19 pandemic recently started declining in Europe. Our research aims were to characterize the changepoint in the flow of the COVID-19 epidemic in each European country and to evaluate the association of the level of social distancing with the observed decline in the national epidemics. Interrupted time series analyses were conducted in 28 European countries. Social distance index was calculated based on Google Community Mobility Reports. Changepoints were estimated by threshold regression, national findings were analyzed by Poisson regression, and the effect of social distancing in mixed effects Poisson regression model. Our findings identified the most probable changepoints in 28 European countries. Before changepoint, incidence of new COVID-19 cases grew by 24% per day on average. From the changepoint, this growth rate was reduced to 0.9%, 0.3% increase, and to 0.7% and 1.7% decrease by increasing social distancing quartiles. The beneficial effect of higher social distance quartiles (i.e., turning the increase into decline) was statistically significant for the fourth quartile. Notably, many countries in lower quartiles also achieved a flat epidemic curve. In these countries, other plausible COVID-19 containment measures could contribute to controlling the first wave of the disease. The association of social distance quartiles with viral spread could also be hindered by local bottlenecks in infection control. Our results allow for moderate optimism related to the gradual lifting of social distance measures in the general population, and call for specific attention to the protection of focal micro-societies enriching high-risk elderly subjects, including nursing homes and chronic care facilities.


Malta's healthcare escalation for COVID-19


Primum non nocere: Potential indirect adverse effects of COVID-19 containment strategies in the African region


title: In Silico Investigation of the SARS CoV2 Protease with Thymoquinone Major Constituent of Nigella Sativa

text: The COVID-19 caused by a new type of coronavirus has emerged from China and led to thousands of deaths globally. Despite many groups engaged in studying the newly emerged virus and searching for the treatment, the understanding of the SARS-CoV2 target ligand interactions represents a key challenge. Several studies are being conducted to identify potential treatment. Alternatively, the results of numerous studies have shown that protease inhibitors can be a genuine leader in research. The antiviral activity and beneficial effect against respiratory disorders of thymoquinone have been largely demonstrated. The aim of this study is to testing In Silico the inhibition of the replication of SARS CoV2 by thymoquinone. This is a molecular simulation study using SARS CoV2 protease and thymoquinone structures provided by Protein Data Bank. The preliminary results have shown that thymoquinone may have inhibitory activities against SARS CoV2 protease. Furthermore, given the demonstrated results of thymoquinone, we can conclude that it may be considered as an effective or adjuvant treatment for SARS CoV2 infection.


Potential negative effects of the free use of chloroquine to manage COVID-19 in Colombia


COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal


title: Statistical Decision Properties of Imprecise Trials Assessing COVID-19 Drugs

text: As the COVID-19 pandemic progresses, researchers are reporting findings of randomized trials comparing standard care with care augmented by experimental drugs. The trials have small sample sizes, so estimates of treatment effects are imprecise. Seeing imprecision, clinicians reading research articles may find it difficult to decide when to treat patients with experimental drugs. Whatever decision criterion one uses, there is always some probability that random variation in trial outcomes will lead to prescribing sub-optimal treatments. A conventional practice when comparing standard care and an innovation is to choose the innovation only if the estimated treatment effect is positive and statistically significant. This practice defers to standard care as the status quo. To evaluate decision criteria, we use the concept of near-optimality, which jointly considers the probability and magnitude of decision errors. An appealing decision criterion from this perspective is the empirical success rule, which chooses the treatment with the highest observed average patient outcome in the trial. Considering the design of recent and ongoing COVID-19 trials, we show that the empirical success rule yields treatment results that are much closer to optimal than those generated by prevailing decision criteria based on hypothesis tests.


Impact of COVID-19 as a vertical infection in late pregnancy


Mitigating and learning from the impact of COVID-19 infection on addictive disorders


title: Sexual and reproductive health (SRH): a key issue in the emergency response to the coronavirus disease (COVID- 19) outbreak

text: The novel coronavirus disease (COVID-19) outbreak was first declared in China in December 2019, and WHO declared the pandemic on 11 March 2020. A fast-rising number of confirmed cases has been observed in all continents, with Europe at the epicentre of the outbreak at this moment.Sexual and reproductive health (SRH) and rights is a significant public health issue during the epidemics. The novel coronavirus (SARS-CoV-2) is new to humans, and only limited scientific evidence is available to identify the impact of the disease COVID-19 on SRH, including clinical presentation and outcomes of the infection during pregnancy, or for persons with STI/HIV-related immunosuppression. Beyond the clinical scope of SRH, we should not neglect the impacts at the health system level and disruptions or interruptions in regular provision of SRH services, such as pre- and postnatal checks, safe abortion, contraception, HIV/AIDS and sexually transmitted infections. Furthermore, other aspects merit attention such as the potential increase of gender-based violence and domestic abuse, and effects of stigma and discrimination associated with COVID-19 and their effects on SRH clients and health care providers. Therefore, there is an urgent need for the scientific community to generate sound clinical, epidemiological, and psycho-social behavioral links between COVID-19 and SRH and rights outcomes.


title: "Stay Nearby or Get Checked": A Covid-19 Lockdown Exit Strategy

text: This paper repurposes the classic insight from network theory that long-distance connections drive disease propagation into a strategy for controlling a second wave of Covid-19. We simulate a scenario in which a lockdown is first imposed on a population and then partly lifted while long-range transmission is kept at a minimum. Simulated spreading patterns resemble contemporary distributions of Covid-19 across nations, regions, and provinces, providing some model validation. Results suggest that the proposed strategy may significantly flatten a second wave. We also find that post-lockdown flare-ups remain local longer, aiding geographical containment. Public policy may target long ties by heavily focusing medical testing and mobility tracking efforts on traffic and transport. This policy can be communicated to the general public as a simple and reasonable principle: Stay nearby or get checked.


title: Daily medical education for confined students during COVID-19 pandemic: A simple videoconference solution

text: The outbreak of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 infection has recently spread globally and is now a pandemic. As a result, university hospitals have had to take unprecedented measures of containment, including asking nonessential staff to stay at home. Medical students practicing in the surgical departments find themselves idle, as nonurgent surgical activity has been canceled, until further notice. Likewise, universities are closed and medical training for students is likely to suffer if teachers do not implement urgent measures to provide continuing education. Thus, we sought to set up a daily medical education procedure for surgical students confined to their homes. We report a simple and free teaching method intended to compensate for the disappearance of daily lessons performed in the surgery department using the Google Hangouts application. This video conference method can be applied to clinical as well as anatomy lessons.


title: Incidence of acute kidney injury and its association with mortality in patients with COVID-19: a meta-analysis

text: Acute kidney injury (AKI) is a complication of COVID-19. However, the incidence of AKI in COVID-19 varies among studies. Thus, we aimed to evaluate the pooled incidence of AKI and its association with mortality in patients with COVID-19 using a meta-analysis. We search Ovid MEDLINE, EMBASE, and the Cochrane Library for eligible publications reporting the clinical characteristics of patients with COVID-19 without language restriction. Incidence of AKI and mortality were reported. Meta-regression was used to describe the association between outcomes. From 26 studies (n=5497), the pooled incidence of AKI in patients with COVID-19 was 8.4% (95% CI 6.0% to 11.7%) with a pooled incidence of renal replacement therapy of 3.6% (95% CI 1.8% to 7.1%). The incidence of AKI was higher in critically ill patients (19.9%) compared with hospitalized patients (7.3%). The pooled estimated odds ratio for mortality from AKI was 13.33 (95% CI 4.05 to 43.91). No potential publication bias was detected. By using meta-regression analyses, the incidence of AKI was positively associated with mortality after adjusted for age and sex (Q=26.18; p=0.02). Moreover, age (p<0.01), diabetes (p=0.02), hypertension (p<0.01) and baseline serum creatinine levels (p=0.04) were positively associated with AKI incidence in adjusted models. In conclusion, AKI is present in 8.3% of overall patients with COVID-19 and in 19.9% of critically ill patients with COVID-19. Presence of AKI is associated with 13-fold increased risk of mortality. Age, diabetes, hypertension, and baseline serum creatinine levels are associated with increased AKI incidence.


Posterior reversible encephalopathy syndrome (PRES) as a neurological association in severe Covid-19


title: Very Long-acting Antivirals as Chemovaccines for Preventing Viral Infections

text: Following the advent of penicillin as first widely used antibiotic during World War II, viruses have steadily replaced bacteria as major agents of infections, particularly for microorganisms that can spread globally. Good examples are pandemics caused by HIV, hepatitis B, hepatitis C, and nowadays severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the coronavirus of coronavirus disease (COVID)-19.


title: Recomendações para realização de anestesia locoregional durante a pandemia de COVID19./ [Recommendations for local-regional anesthesia during the COVID-19 pandemic]

text: Since the beginning of the COVID-19 pandemic, many questions have come up regarding safe anesthesia management of patients with the disease. Regional anesthesia, whether peripheral nerve or neuraxial, is a safe alternative for managing patients with COVID-19, by choosing modalities that mitigate pulmonary function involvement. Adopting regional anesthesia mitigates adverse effects in the postoperative period and provides safety to pati ents and teams, as long as there is compliance with individual protection and interpersonal transmission care measures. Respecting contra-indications and judicial use of safety techniques and norms are essential. The present manuscript aims to review the evidence available on regional anesthesia for patients with COVID-19 and offer practical recommendations for safe and efficient performance.


Biophotonic telemedicine for disease diagnosis and monitoring during pandemics: overcoming COVID-19 and shaping the future of healthcare


COVID-19 and radiation induced pneumonitis: Overlapping clinical features of different diseases


In Response to Isolated Anosmia and Ageusia in COVID-19 With Spontaneous Recovery


title: Airborne transmission of SARS-CoV-2: The world should face the reality

text: Hand washing and maintaining social distance are the main measures recommended by the World Health Organization (WHO) to avoid contracting COVID-19. Unfortunately, these measured do not prevent infection by inhalation of small droplets exhaled by an infected person that can travel distance of meters or tens of meters in the air and carry their viral content. Science explains the mechanisms of such transport and there is evidence that this is a significant route of infection in indoor environments. Despite this, no countries or authorities consider airborne spread of COVID-19 in their regulations to prevent infections transmission indoors. It is therefore extremely important, that the national authorities acknowledge the reality that the virus spreads through air, and recommend that adequate control measures be implemented to prevent further spread of the SARS-CoV-2 virus, in particularly removal of the virus-laden droplets from indoor air by ventilation.


SARS-CoV-2 receptor ACE2 gene expression and RAAS inhibitors


title: Tocilizumab treatment in COVID-19: A single center experience

text: Tocilizumab (TCZ), a monoclonal antibody against interleukin-6 (IL-6), emerged as an alternative treatment for COVID-19 patients with a risk of cytokine storms recently. In the present study, we aimed to discuss the treatment response of TCZ therapy in COVID-19 infected patients. The demographic, treatment, laboratory parameters of C-reactive protein (CRP) and IL-6 before and after TCZ therapy and clinical outcome in the 15 COVID-19 patients were retrospectively assessed. Totally 15 patients with COVID-19 were included in this study. Two of them were moderately ill, six were seriously ill and seven were critically ill. The TCZ was used in combination with methylprednisolone in eight patients. Five patients received the TCZ administration twice or more. Although TCZ treatment ameliorated the increased CRP in all patients rapidly, for the four critically ill patients who received an only single dose of TCZ, three of them (No. 1, 2, and 3) still dead and the CRP level in the rest one patient (No. 7) failed to return to normal range with a clinical outcome of disease aggravation. Serum IL-6 level tended to further spiked firstly and then decreased after TCZ therapy in 10 patients. A persistent and dramatic increase of IL-6 was observed in these four patients who failed treatment. TCZ appears to be an effective treatment option in COVID-19 patients with a risk of cytokine storms. And for these critically ill patients with elevated IL-6, the repeated dose of the TCZ is recommended.


title: Personalized Cognitive Counseling Reduces Drinking Expectancy Among Men Who Have Sex with Men and Transgender Women in Lima, Peru: A Pilot Randomized Controlled Trial

text: Personalized cognitive counseling (PCC) is an evidence-based intervention designed to modify HIV-related risk behavior. We assessed the impact of PCC on sexual behavior, drinking expectancy, and incidence of sexually transmitted infections (STIs) in a 6-month randomized controlled trial among 153 HIV-uninfected men who have sex with men (MSM) and transgender women (TW) in Peru. Study retention was ≥ 90%, with three HIV infections (3 Control) and 19 cases of GC/CT (10 Control, 9 PCC) at 6 months. There was a decline in condomless receptive anal intercourse in the Control (0.74, 95% CI 0.60-0.91; p < 0.01) and PCC arms (0.72, 0.55-0.94; p = 0.02) at 6-month follow-up. There was a decrease in drinking expectancy at 6 months among participants endorsing alcohol use in the PCC arm (0.89, 0.83-0.96; p < 0.01), versus no change in the Control arm (0.98, 0.92-1.04; p = 0.54). PCC was efficacious in reducing drinking expectancy and HIV risk among MSM and TW in Peru.


title: Epidemic trend of corona virus disease 2019 (COVID-19) in mainland China/ 中华预防医学杂志

text: Objective@#In order to master the epidemic trend of corona virus disease 2019 (COVID-19) and evaluate the effect of prevention and control, we evaluate the epidemic dynamics of COVID-19 in mainland China, Hubei province, Wuhan city and other provinces outside Hubei from January 16 to February 14, 2020.@*Methods@#We collected the daily number of new confirmed COVID-19 cases by nucleic acid detection reported by the National Health Commission from January 16, 2020 to February 14, 2020. The analysis includes the epidemic curve of the new confirmed cases, multiple of the new confirmed cases for period-over-period, multiple of the new confirmed cases for fixed-base, and the period-over-period growth rate of the new confirmed cases.@*Results@#From January 16 to February 14, 2020, the cumulative number of new confirmed cases of COVID-19 in mainland China was 50 031, including 37 930 in Hubei province, 22 883 in Wuhan city and 12 101 in other provinces outside Hubei. The peak of the number of new confirmed cases in other provinces outside Hubei was from January 31 to February 4, 2020, and the peak of new confirmed cases in Wuhan city and Hubei province was from February 5 to February 9, 2020. The number of new confirmed cases in other provinces outside Hubei showed a significant decline (23% compared with the peak) from February 5 to February 9, 2020, while the number of new confirmed cases in Wuhan city (30% compared with the peak) and Hubei Province (37% compared with the peak) decreased significantly from February 10 to February 14, 2020.@*Conclusion@#The epidemic prevention and control measures taken by the state and governments at all levels have shown very significant effects, effectively curbing the spread of the COVID-19 epidemic in China.


docid: qrbiteyu

title: [Epidemic trend of corona virus disease 2019 (COVID-19) in mainland China]

text: Objective: In order to master the epidemic trend of corona virus disease 2019 (COVID-19) and evaluate the effect of prevention and control, we evaluate the epidemic dynamics of COVID-19 in mainland China, Hubei province, Wuhan city and other provinces outside Hubei from January 16 to February 14, 2020. Methods: We collected the daily number of new confirmed COVID-19 cases by nucleic acid detection reported by the National Health Commission from January 16, 2020 to February 14, 2020. The analysis includes the epidemic curve of the new confirmed cases, multiple of the new confirmed cases for period-over-period, multiple of the new confirmed cases for fixed-base, and the period-over-period growth rate of the new confirmed cases. Results: From January 16 to February 14, 2020, the cumulative number of new confirmed cases of COVID-19 in mainland China was 50 031, including 37 930 in Hubei province, 22 883 in Wuhan city and 12 101 in other provinces outside Hubei. The peak of the number of new confirmed cases in other provinces outside Hubei was from January 31 to February 4, 2020, and the peak of new confirmed cases in Wuhan city and Hubei province was from February 5 to February 9, 2020. The number of new confirmed cases in other provinces outside Hubei showed a significant decline (23% compared with the peak) from February 5 to February 9, 2020, while the number of new confirmed cases in Wuhan city (30% compared with the peak) and Hubei Province (37% compared with the peak) decreased significantly from February 10 to February 14, 2020. Conclusion: The epidemic prevention and control measures taken by the state and governments at all levels have shown very significant effects, effectively curbing the spread of the COVID-19 epidemic in China.


title: Feasibility and acceptability of a telephone-based chaplaincy intervention in a large, outpatient oncology center

text: PURPOSE: Telechaplaincy (the use of telecommunications and virtual technology to deliver spiritual and religious care by healthcare chaplains or other religious/spiritual leaders) is a relatively novel intervention that has increasingly been used in recent years, and especially during COVID-19. Telephone-based chaplaincy is one mode of telechaplaincy. The purpose of this study was to (1) describe telephone-based chaplaincy interventions delivered as the first point of contact to patients who screen positive for religious/spiritual concern(s) using an electronic data system, and (2) assess the feasibility and acceptability of delivering interventions in an outpatient cancer institute using this methodology. METHODS: Patients were screened for religious and spiritual (R/S) concern(s) using an electronic data system. Patients indicating R/S concern(s) were offered a telephone-based chaplaincy intervention and asked to complete a survey assessing acceptability of the intervention. Feasibility and acceptability data were collected. RESULTS: Thirty percent of screened patients indicated R/S concern(s). Telephone-based chaplaincy interventions were offered to 100% of eligible patients, establishing contact with 61% of eligible patients, and offering chaplaincy interventions to 48% of those patients. Survey participants report high acceptability of the offered intervention. CONCLUSION: This is the first study examining feasibility and acceptability of telephone-based chaplaincy with oncology patients. Telephone-based chaplaincy is feasible and acceptable within an outpatient oncology setting, supporting the promise of this interventional strategy. Further research is needed to refine practices.


title: Fake news and coronavirus: Detecting key players and trends through analysis of Twitter conversations

text: The global health crisis arising from the expansion of Covid-19 has led the WHO to coin the term infodemics to define a situation of fear and insecurity in which the dissemination of false information has become widespread These hoaxes take advantage of this type of emotion to spread faster than the coronavirus itself, generating fear and distrust in the population The spread of these lies, part of which circulates on social networks, is dangerous because it affects health and can make the contagion worse and cause people to die This research aims to analyse and visualise the network created around the false news circulating on Twitter about the coronavirus pandemic using the technique of social network analysis NodeXL Pro software has been used Several measures of network centrality have been used to generate the network of connections between users, to represent their interaction patterns and to identify the key actors within the network In addition, a semantic network has also been created to discover the differences in the way groups of people talk about the topic The results show that the situation in the USA dominates the conversation, despite the fact that at that time there were hardly any cases, and Europe had become the global epicentre of the Covid-19 Despite reports of inaction by journalists and critics of the Trump government, there are several weeks in which disinformation distracts from taking more effective action and actually preventing contagion Moreover, among the actors with the most prominent positions in the network, there is little presence of scientists and institutions that help to disprove the hoaxes and explain the hygiene measures


title: A Global lmmunological Observatory to meet a time of pandemics

text: SARS-CoV-2 presents an unprecedented international challenge, but it will not be the last such threat. Here, we argue that the world needs to be much better prepared to rapidly detect, define and defeat future pandemics. We propose that a Global Immunological Observatory and associated developments in systems immunology, therapeutics and vaccine design should be at the heart of this enterprise.


title: Considerations for Obesity, Vitamin D, and Physical Activity Amid the COVID-19 Pandemic

text: As the biomedical community races to disentangle the unknowns associated with severe acute respiratory syndrome coronavirus 2, the virus responsible for causing coronavirus disease, the link between diminished immune function and individuals with obesity raises important questions about the possibility for greater viral pathogenicity in this population. Increased adiposity may undermine the pulmonary microenvironment wherein viral pathogenesis and immune cell trafficking could contribute to a maladaptive cycle of local inflammation and secondary injury. A further challenge to those with obesity during the current pandemic may involve vitamin D deficiency or insufficiency. In the interest of personal and public health, we caution decision- and policy makers alike not to pin all hope on a proverbial "silver bullet." Until further breakthroughs emerge, we should remember that modifiable lifestyle factors such as diet and physical activity should not be marginalized. Decades of empirical evidence support both as key factors promoting health and wellness.


title: In Response to COVID-19: Configuration Model of the Epidemic Spreading

text: A configuration model for epidemic spread, based on a scale-free network, is introduced. We obtain the analytical solutions describing both unstable and stable dynamics of the epidemic spreading, and demonstrate how these regimes can interchange during the epidemic. We apply the model to the COVID-19 case and demonstrate the predictive features of our model.


title: A new Chapter for ACPGBI

text: The Coronavirus pandemic has significantly impacted on the practice of colorectal surgery and other branches of medicine. In addition to disrupting patient care at every level, it has also decimated the normal business and structures that maintain the high quality of care that our patients expect. These vary from local departmental audits to the function of learned societies such as the Association of Coloproctology of Great Britain and Ireland. During this challenging and rapidly evolving era, clinicians crave communication and being connected to their peers.


A new Chapter for the Association of Coloproctology of Great Britain and Ireland


title: Updated Approaches against SARS-CoV-2

text: Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lies behind the ongoing outbreak of coronavirus disease 2019 (COVID-19). There is a growing understanding of SARS-CoV-2 in virology, epidemiology, and clinical management strategies. However, no anti-SARS-CoV-2 drug or vaccine has been officially approved due to the absence of adequate evidence. Scientists are racing to develop a treatment for COVID-19. Recent studies have revealed many attractive therapeutic options, even if some of them remain to be further confirmed in rigorous preclinical models and clinical trials. In this minireview, we aim to summarize the updated potential approaches against SARS-CoV-2. We emphasize that further efforts are warranted to develop the safest and most effective approach.


India fights hard to neutralize the spread of COVID-19


title: Council business continues virtually despite Covid-19 lockdown

text: BVA Council met via online video conferencing to discuss BVA's ongoing response to the coronavirus pandemic and how veterinary work might need to change in the medium to long term as restrictions ease.


Asian Bioethics Review Enters a New Era


The puzzle of sharing bio-molecular targets between coronaviruses and mediators of the cardiovascular system in humans: Looking for plausible hypotheses