title: Rapid Reorganization of an Academic Infectious Diseases Program During the COVID-19 Pandemic in Detroit: A Novel Unit-Based Group Rounding Model

text: The surge of coronavirus disease 2019 (COVID-19) hospitalizations at our 877-bed quaternary care hospital in Detroit led to an emergent demand for Infectious Diseases (ID) consultations. The traditional one-on-one consultation model was untenable. Therefore, we rapidly restructured our ID division to provide effective consultative services. We implemented a novel unit-based group rounds model that focused on delivering key updates to teams and providing unit-wide consultations simultaneously to all team members. Effectiveness of the program was studied using Likert-scale survey data. The survey captured data from the first month of the Detroit COVID-19 pandemic. During this period there were approximately 950 patients hospitalized for treatment of COVID-19. The survey of trainees and faculty reported an overall 95% positive response to delivery of information, new knowledge acquisition, and provider confidence in the care of COVID-19 patients. This showed that the unit-based consult model is a sustainable effort to provide care during epidemics.


title: Detection of cryptic CCND1 rearrangements in mantle cell lymphoma by next generation sequencing

text: The accurate detection of recurrent genetic abnormalities for most hematologic neoplasms is critical for diagnosis, prognosis and/or treatment. Rearrangements involving CCND1 are observed in a subset of mature B-cell neoplasms and can be reliably detected by fluorescence in situ hybridization (FISH) in most cases. However, cryptic and complex chromosomal rearrangements may pose a technical challenge for accurate diagnosis. Herein, we describe two patients with suspected mantle cell lymphoma that lacked obvious CCND1 rearrangements by FISH studies. A next generation sequencing (NGS) based assay, mate-pair sequencing (MPseq), was utilized in each case to investigate potential cryptic CCND1 rearrangements and revealed cryptic insertional events resulting in CCND1/IGH and CCND1/IGK rearrangements. These cases demonstrate that NGS-based assays, including MPseq, are a powerful approach to identify cryptic rearrangements of clinical importance that are not detected by current clinical genomics evaluation.


title: Doubt, Disorientation, and Death in the Plague Time

text: An account of an experience with contracting an illness that may well have been Covid-19 gives rise to reflections on doubt and on the art of dying well. The upshot: our mortality remains a fundamentally disorienting condition of our existence. If there's any wisdom to be had concerning our deaths, it likely lies in the direction of accepting their deranging character, rather than in searching for the philosophical insight that will reconcile us to our fate.


Fibrinolysis Shutdown and Thrombosis in Severe COVID-19


Is the HScore useful in COVID-19?


Societal considerations in host genome testing for COVID-19


Lower detection rates of SARS-COV2 antibodies in cancer patients versus health care workers after symptomatic COVID-19


title: Why lockdown : On the spread of SARS-CoV-2 in India, a network approach

text: We analyze the time series data of number of districts or cities in India that are affected by COVID-19 from March 01, 2020 to April 17, 2020. We study the data in the framework of time series network data. The networks are defined by using the geodesic distances of the districts or cities specified by the latitude and longitude coordinates. We particularly restrict our analysis to all but districts in the north-eastern part of India. Unlike recent studies on the projection of the number of people infected with SARS-CoV-2 in the near future, in this note, the emphasis is on understanding the dynamics of the spread of the virus across the districts of India. We perform spectral and structural analysis of the model networks by considering several measures, notably the spectral radius, the algebraic connectivity, the average clustering coefficient, the average path length and the structure of the communities. Furthermore, we study the overall expansion properties given by the number of districts or cities before and after lockdown. These studies show that lockdown has a significant impact on the spread of SARS-CoV-2 in districts or cities over long distances. However, this impact is only observed after approximately two weeks of lockdown. We speculate that this happened due to the insufficient number of tests for COVID-19 before the lockdown which could not stop the movement of people infected with the virus but not detected, over long distances.


Drug repurposing in the era of COVID-19: a call for leadership and government investment


docid: qluoacik

title: Study on the effect of nursing-technology integrated in the imaging examination of Novel coronavirus pneumonia/ 重庆医学

text: Currently, the outbreak of the new coronary pneumonia has entered a critical period of screening, prevention and control.In order to block the transmission of the virus in the radiology department, it is particularly important to effectively protect the medical servant while speeding up the flow of inspection.Based on the basis of notification of the bureau of disease control and prevention, the expert consensus of the CMA and CMDA, and the literature review, combined with the previous practical work experience,this article puts forward the recommendations on the important effect of nursing-technology integrated in the imaging examination of novel coronavirus pneumonia, in order to provide reference for the protection of medical servant in the radiology department at the front line of anti-epidemic.


title: Lessons to Europe from China for cancer treatment during the COVID-19 pandemic

text: During the COVID-19 era, Chinese hospitals have developed a system that enables vulnerable cancer patients to continue to receive high-quality medical care, optimising their survival whilst protecting them. This includes use of digital quick codes, fever clinics and optimal scheduling. We wish to share our experiences working with patients during the pandemic.


title: Half of Rural Residents at High Risk of Serious Illness Due to COVID-19, Creating Stress on Rural Hospitals

text: PURPOSE: During the COVID-19 epidemic, it is critical to understand how the need for hospital care in rural areas aligns with the capacity across states. METHODS: We analyzed data from the 2018 Behavioral Risk Factor Surveillance System to estimate the number of adults who have an elevated risk of serious illness if they are infected with coronavirus in metropolitan, micropolitan, and rural areas for each state. Study data included 430,949 survey responses representing over 255.2 million noninstitutionalized US adults. For data on hospital beds, aggregate survey data were linked to data from the 2017 Area Health Resource Files by state and metropolitan status. FINDINGS: About 50% of rural residents are at high risk for hospitalization and serious illness if they are infected with COVID-19, compared to 46.9% and 40.0% in micropolitan and metropolitan areas, respectively. In 19 states, more than 50% of rural populations are at high risk for serious illness if infected. Rural residents will generate an estimated 10% more hospitalizations for COVID-19 per capita than urban residents given equal infection rates. CONCLUSION: More than half of rural residents are at increased risk of hospitalization and death if infected with COVID-19. Experts expect COVID-19 burden to outpace hospital capacity across the country, and rural areas are no exception. Policy makers need to consider supply chain modifications, regulatory changes, and financial assistance policies to assist rural communities in caring for people affected by COVID-19.


title: Gender Analysis of COVID-19 Outbreak in South Korea: A Common Challenge and Call for Action

text: This study aims to analyze South Korea's experience during the COVID-19 outbreak through a gendered lens. We briefly introduce the COVID-19 outbreak in Korea, scrutinize gendered vulnerability in contracting the virus, and then analyze the gendered aspects of the pandemic response in two phases: quarantine policy and mitigation policy. The authors elicit four lessons from the analysis. First, gender needs to be mainstreamed at all stages of a public health emergency response. Second, in addition to medical care, all formal and informal care work should be considered as an essential component of health care systems. Third, a people-centered approach in health governance should be prioritized to make women's voices heard at every level. Fourth, medical technology and resources to cope with pandemic should be produced and distributed in an equitable manner, acknowledging differential vulnerability and susceptibility.


title: Decoding asymptomatic COVID-19 infection and transmission

text: Coronavirus disease 2019 (COVID-19) is a continuously devastating public health and the world economy. One of the major challenges in controlling the COVID-19 outbreak is its asymptomatic infection and transmission, which are elusive and defenseless in most situations. The pathogenicity and virulence of asymptomatic COVID-19 remain mysterious. Based on the genotyping of 20656 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) genome isolates, we reveal that asymptomatic infection is linked to SARS-CoV-2 11083G>T mutation, i.e., leucine (L) to phenylalanine (F) substitution at the residue 37 (L37F) of nonstructure protein 6 (NSP6). By analyzing the distribution of 11083G>T in various countries, we unveil that 11083G>T may correlate with the hypotoxicity of SARS-CoV-2. Moreover, we show a global decaying tendency of the 11083G>T mutation ratio indicating that 11083G>T hinders SARS-CoV-2 transmission capacity. Sequence alignment found both NSP6 and residue 37 neighborhoods are relatively conservative over a few coronaviral species, indicating their importance in regulating host cell autophagy to undermine innate cellular defense against viral infection. Using machine learning and topological data analysis, we demonstrate that mutation L37F has made NSP6 energetically less stable. The rigidity and flexibility index and several network models suggest that mutation L37F may have compromised the NSP6 function, leading to a relatively weak SARS-CoV subtype. This assessment is a good agreement with our genotyping of SARS-CoV-2 evolution and transmission across various countries and regions over the past few months.


Extubation of patients with COVID-19


Postnatally-Acquired COVID-19 in Central India


Covid-19 during pregnancy: A case series from an universally tested population from the north of Portugal


title: SARS-CoV-2 outbreak: How can pharmacists help?

text: Coronaviruses (CoVs) are a large family of viruses that cause disorders ranging from a mild cold to severe disease. Some of the CoVs are zoonotic, meaning they can be transmitted from animals to humans. In December 2019, the world awoke to a new zoonotic strain of CoV that was named SARS-CoV-2 (standing for severe acute respiratory syndrome coronavirus 2), which has been classified as a high-consequence infectious disease. In addition, serious complications related to COVID-19 have been reported in some patients. These include acute respiratory distress syndrome, acute renal failure, septic shock and ventilator-associated pneumonia. The pharmacist, as a healthcare practitioner, can play an important role in hindering the spread of COVID-19, and can be an active participant in national and community efforts to fight and contain this outbreak.


Strategies for Disseminating and Implementing COVID-19 Public Health Prevention Practices in Rural Areas


docid: vmtsfbjp

title: Rationale for universal face masks in public against COVID-19


Can Global Pharmaceutical Supply Chains Scale Up Sustainably for the COVID-19 Crisis?


docid: mobgbjqf

title: COVID-19: Avoiding a second tragedy in a tuberculosis burdened country

text: To the Editor Novel Coronavirus disease (COVID-19) was first notified in December 2019 from Wuhan, China. Now, it has spread rapidly and has been declared a pandemic affecting over 200 countries with widespread morbidity and mortality. It has been postulated that the most vulnerable population are the elderly, people living in crowded areas, children and immune-compromised individuals, such as people living with human immunodeficiency virus (HIV). The correlation of tuberculosis (TB), HIV and malnutrition are well documented and hence, people with tuberculosis should be considered as special population in this pandemic. TB is an ancient disease among humans recorded as far back as seventy thousand years which was declared a global public health emergency in 1993 by the World Health Organisation (WHO). India has the highest TB burden in the world.


Asymptomatic cases in a family cluster with SARS-CoV-2 infection


title: How we make choices and sacrifices in medical education during the COVID-19 pandemic

text: In this commentary, we highlight some of the pressing choices and sacrifices we must make in medical education during the COVID-19 pandemic.


title: Utilitarianism and the pandemic

text: There are no egalitarians in a pandemic. The scale of the challenge for health systems and public policy means that there is an ineluctable need to prioritize the needs of the many. It is impossible to treat all citizens equally, and a failure to carefully consider the consequences of actions could lead to massive preventable loss of life. In a pandemic there is a strong ethical need to consider how to do most good overall. Utilitarianism is an influential moral theory that states that the right action is the action that is expected to produce the greatest good. It offers clear operationalizable principles. In this paper we provide a summary of how utilitarianism could inform two challenging questions that have been important in the early phase of the pandemic: (a) Triage: which patients should receive access to a ventilator if there is overwhelming demand outstripping supply? (b) Lockdown: how should countries decide when to implement stringent social restrictions, balancing preventing deaths from COVID-19 with causing deaths and reductions in well-being from other causes? Our aim is not to argue that utilitarianism is the only relevant ethical theory, or in favour of a purely utilitarian approach. However, clearly considering which options will do the most good overall will help societies identify and consider the necessary cost of other values. Societies may choose either to embrace or not to embrace the utilitarian course, but with a clear understanding of the values involved and the price they are willing to pay.


COVID-19: A personal thank you to all perioperative practitioners and other key workers


docid: bxkbjnhh

title: Deep learning for classification and localization of COVID-19 markers in point-of-care lung ultrasound

text: Deep learning (DL) has proved successful in medical imaging and, in the wake of the recent COVID-19 pandemic, some works have started to investigate DLbased solutions for the assisted diagnosis of lung diseases. While existing works focus on CT scans, this paper studies the application of DL techniques for the analysis of lung ultrasonography (LUS) images. Specifically, we present a novel fully-annotated dataset of LUS images collected from several Italian hospitals, with labels indicating the degree of disease severity at a frame-level, videolevel, and pixel-level (segmentation masks). Leveraging these data, we introduce several deep models that address relevant tasks for the automatic analysis of LUS images. In particular, we present a novel deep network, derived from Spatial Transformer Networks, which simultaneously predicts the disease severity score associated to a input frame and provides localization of pathological artefacts in a weakly-supervised way. Furthermore, we introduce a new method based on uninorms for effective frame score aggregation at a video-level. Finally, we benchmark state of the art deep models for estimating pixel-level segmentations of COVID-19 imaging biomarkers. Experiments on the proposed dataset demonstrate satisfactory results on all the considered tasks, paving the way to future research on DL for the assisted diagnosis of COVID-19 from LUS data.


title: Understanding the Effects of Tennessee's Open Covid-19 Testing Policy: Bounding Policy Effects with Nonrandomly Missing Data

text: Increased testing for Covid-19 is seen as one of the most important steps to re-open the economy. The current paper considers Tennessee's"open-testing"policy where the state substantially increased testing while removing symptom requirements for individuals to be tested. To understand the effect of the policy, we combine standard identifying assumptions with additional weak assumptions to deal with non-random testing that lead to bounds on policy effects of interest. Our results suggest that Tennessee's open-testing policy has reduced total cases (which are not fully observed), confirmed cases, and trips to work among counties with a fast-growing number of confirmed cases.


title: Estimation of the basic reproduction number, average incubation time, asymptomatic infection rate, and case fatality rate for COVID-19: Meta-analysis and sensitivity analysis

text: The coronavirus disease-2019 (COVID-19) has been found to be caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, comprehensive knowledge of COVID-19 remains incomplete and many important features are still unknown. This manuscript conducts a meta-analysis and a sensitivity study to answer the questions: What is the basic reproduction number? How long is the incubation time of the disease on average? What portion of infections are asymptomatic? And ultimately, what is the case fatality rate? Our studies estimate the basic reproduction number to be 3.15 with the 95% CI (2.41-3.90), the average incubation time to be 5.08 days with the 95% CI (4.77-5.39) (in day), the asymptomatic infection rate to be 46% with the 95% CI (18.48%-73.60%), and the case fatality rate to be 2.72% with 95% CI (1.29%-4.16%) where asymptomatic infections are accounted for.


title: Mask wearing in pre-symptomatic patients prevents SARS-CoV-2 transmission: An epidemiological analysis

text: OBJECTIVES: Pandemic COVID-19 has become a seriously public health priority worldwide. Comprehensive strategies including travel restrictions and mask-wearing have been implemented to mitigate the virus circulation. However, detail information on community transmission is unavailable yet. METHODS: From January 23 to March 1, 2020, 127 patients (median age: 46 years; range: 11-80) with 71 male and 56 female, were confirmed to be infected with the SARS-CoV-2 in Taizhou, Zhejiang, China. Epidemiological trajectory and clinical features of these COVID-19 cases were retrospectively retrieved from electronic medical records and valid individual questionnaire. RESULTS: The disease onset was between January 9 to February 14, 2020. Among them, 64 patients are local residents, and 63 patients were back home from Wuhan from January 10 to 24, 2020 before travel restriction. 197 local residents had definite close-contact with 41 pre-symptomatic patients back from Wuhan. 123 and 74 of them contact with mask-wearing or with no mask-wearing pre-symptomatic patients back from Wuhan, respectively. Data showed that incidence of COVID-19 was significantly higher for local residents close-contact with no mask-wearing Wuhan returned pre-symptomatic patients (19.0% vs. 8.1%, pâ¯<â¯0.001). Among 57 close-contact individuals, 21 sequential local COVID-19 patients originated from a pre-symptomatic Wuhan returned couple, indicated dense gathering in congested spaces is a high risk for SARS-CoV-2 transmission. CONCLUSIONS: Our findings provided valuable details of pre-symptomatic patient mask-wearing and restriction of mass gathering in congested spaces particularly, are important interventions to mitigate the SARS-CoV-2 transmission.


title: Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic

text: AIMS: Analyze the relationship between obesity and influenza. METHODS: Basal hormone milieu, defective response of both innate and adaptive immune system and sedentariness are major determinants in the severity of influenza viral infection in obese patients. Being overweight not only increases the risk of infection and of complications for the single obese person, but a large prevalence of obese individuals within the population might increase the chance of appearance of more virulent viral strain, prolongs the virus shedding throughout the total population and eventually might increase overall mortality rate of an influenza pandemic. RESULTS: Waiting for the development of a vaccination against COVID-19, isolation of positive cases and social distancing are the primary interventions. Nonetheless, evidence from previous influenza pandemics suggests the following interventions aimed at improving immune response: (1) lose weight with a mild caloric restriction; (2) include AMPK activators and PPAR gamma activators in the drug treatment for obesity associated with diabetes; and (3) practice mild-to-moderate physical exercise. CONCLUSIONS: Due to prolonged viral shedding, quarantine in obese subjects should likely be longer than normal weight individuals.


Recommendations for personal protective equipment and smoke evacuation for dermatologic surgeries amid the COVID-19 crisis


title: Comparison of clinical characteristics and outcomes of patients with coronavirus disease 2019 at different ages

text: BACKGROUND: Information about the clinical characteristics and mortality of patients with coronavirus disease 2019 at different ages is limited. RESULTS: The older group had more patients with dyspnea and fewer patients with fever and muscle pain. Older patients had more underlying diseases, secondary infection, myocardial injury, renal dysfunction, coagulation dysfunction, and immune dysfunction on admission. More older patients received immunoglobulin therapy and mechanical ventilation. The proportions of patients with multiple organ injuries, critically ill patients and death increased significantly with age. The older groups had higher cumulative death risk than the younger group. Hypertension, cerebrovascular disease, comorbidities, acute cardiac injury, shock and complications are independent predictors of death. CONCLUSIONS: The symptoms of the elderly patients were more atypical, with more comorbidities, secondary infection, organ injuries, immune dysfunction and a higher risk of critical illness. Older age was an important risk factor for mortality. METHODS: 1000 patients diagnosed with coronavirus disease 2019 from January 1, 2020 to February 14, 2020 were enrolled. According to age, patients were divided into group 1 (<60 years old), group 2 (60-74 years old) and group 3 (≥75 years old). The clinical symptoms, first laboratory results, CT findings, organ injuries, disease severity and mortality were analyzed.


title: Frequency and severity of general surgical emergencies during the COVID-19 pandemic: single-centre experience from a large metropolitan teaching hospital

text: INTRODUCTION: The COVID-19 pandemic has put significant stress on healthcare systems globally. This study focuses on emergency general surgery services at a major trauma centre and teaching hospital. We aimed to identify whether the number of patients and the severity of their presentation has significantly changed since the implementation of a national lockdown. MATERIALS AND METHODS: This study is a retrospective review of acute referrals (from general practice and accident and emergency) to the emergency general surgery team over a 14-day period before (group 1) and during (group 2) lockdown. RESULTS: A total of 151 patients were reviewed by the general surgical team in group 1 and 75 in group 2 (a 50.3% reduction). The number of days with symptoms prior to presentation was significantly shorter in group 1 compared with group 2 (3 vs 4, p = 0.04). There was no significant difference in the National Early Warning Score, white blood cell count, lymphocytes and C-reactive protein on admission between the two groups of patients. There were significantly fewer patients admitted after lockdown compared with pre-lockdown (66% vs 48%, p = 0.01). Length of hospital stay was significantly shorter during lockdown compared with pre-lockdown (5 days vs 4 days, p = 0.04). CONCLUSION: Fewer patients were referred and admitted during lockdown compared with pre-lockdown, and the length of stay was also significantly reduced. There was also a delay in presentation to hospital, although these patients were not more unwell based on the scoring criteria used within this study.


title: COVID-19: Should We Test Everyone?

text: Since the beginning of 2020, the coronavirus disease 2019 (COVID-19) has spread rapidly in the city of Wuhan, P.R. China, and subsequently, across the world. The swift spread of the virus is largely attributed to its stealth transmissions in which infected patients may be asymptomatic. Undetected transmissions present a remarkable challenge for the containment of the virus and pose an appalling threat to the public. An urgent question that has been asked by the public is"Should I be tested for COVID-19 if I am sick?". While different regions established their own criteria for screening infected cases, the screening criteria have been modified based on new evidence and understanding of the virus as well as the availability of resources. The shortage of test kits and medical personnel has considerably limited our ability to do as many tests as possible. Public health officials and clinicians are facing a dilemma of balancing the limited resources and unlimited demands. On one hand, they are striving to achieve the best outcome by optimizing the usage of the scant resources. On the other hand, they are challenged by the patients' frustrations and anxieties, stemming from the concerns of not being tested for COVID-19 for not meeting the definition of PUI (person under investigation). In this paper, we evaluate the situation from the statistical viewpoint by factoring into the considerations of the uncertainty and inaccuracy of the test, an issue that is often overlooked by the general public. We aim to shed light on the tough situation by providing evidence-based reasoning from the statistical angle, and we expect this examination will help the general public understand and assess the situation rationally. Most importantly, the development offers recommendations for physicians to make sensible evaluations to optimally use the limited resources for the best medical outcome.


title: SARS-CoV-2 host diversity: An update of natural infections and experimental evidence

text: Coronavirus disease-19 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is now a pandemic threat. This virus is supposed to be spread by human to human transmission. Cellular angiotensin-converting enzyme 2 (ACE2) is the receptor of SARS-CoV-2 which is identical or similar in different species of animals such as pigs, ferrets, cats, orangutans, monkeys, and humans. Moreover, a recent study predicted that dogs might be secondary hosts during the evolution of SARS-CoV-2 from bat to human. Therefore, there is a possibility of spreading SARS-CoV-2 through domestic pets. There are now many reports of SARS-CoV-2 positive cases in dogs, cats, tigers, lion, and minks. Experimental data showed ferrets and cats are highly susceptible to SARS-CoV-2 as infected by virus inoculation and can transmit the virus directly or indirectly by droplets or airborne routes. Based on these natural infection reports and experimental data, whether the pets are responsible for SARS-CoV-2 spread to humans; needs to be deeply investigated. Humans showing clinical symptoms of respiratory infections have been undergoing for the COVID-19 diagnostic test but many infected people and few pets confirmed with SARS-CoV-2 remained asymptomatic. In this review, we summarize the natural cases of SARS-CoV-2 in animals with the latest researches conducted in this field. This review will be helpful to think insights of SARS-CoV-2 transmissions, spread, and demand for seroprevalence studies, especially in companion animals.


title: Use of Tocilizumab for COVID-19-Induced Cytokine Release Syndrome: A Cautionary Case Report

text: Novel coronavirus disease 2019 (COVID-19) emerged in late December 2019 in Wuhan, China. Since then, COVID-19 has become a pandemic affecting more than 4.1 million people worldwide. Patients with COVID-19 have a wide spectrum of manifestations, one being cytokine release syndrome (CRS) and its fatal correlate, secondary hemophagocytic lymphohistiocytosis (sHLH). Anti-cytokine therapy such as tocilizumab, an IL-6 receptor antagonist, is a potential treatment for COVID-19; however, data regarding the efficacy of this anti-IL-6 therapy are currently lacking. We report two cases of patients who received a diagnosis of COVID-19 complicated by CRS and were treated with tocilizumab. Both patients progressed to sHLH despite treatment with tocilizumab, and one developed viral myocarditis, challenging the safety and clinical usefulness of tocilizumab in the treatment of COVID-19-induced CRS. These cases highlight the need for clinical trials to determine optimal patient selection and timing for the use of tocilizumab during this disease process.


text: Novel coronavirus disease 2019 (COVID-19) emerged in late December 2019 in Wuhan, China. Since then, COVID-19 has become a pandemic affecting more than 1.5 million people worldwide. Patients with COVID-19 have a wide spectrum of manifestations, one being cytokine release syndrome (CRS) and its fatal correlate, secondary hemophagocytic lymphohistiocytosis (sHLH). Anti-cytokine therapy such as tocilizumab, an IL-6 receptor antagonist, is a potential treatment for COVID-19; however, data regarding the efficacy of this anti-IL-6 therapy are currently lacking. We report two cases of patients who received a diagnosis of COVID-19 complicated by CRS and were treated with tocilizumab. Both patients progressed to sHLH despite treatment with tocilizumab, and one developed viral myocarditis, challenging the safety and clinical usefulness of tocilizumab in the treatment of COVID-19-induced CRS. These cases highlight the need for clinical trials to determine optimal patient selection and timing for the use of tocilizumab during this disease process.


Complicated coronavirus disease 2019 (COVID-19) in a psoriatic patient treated with ixekizumab


title: Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19

text: As we write our editorial for a health literacy special issue in the midst of the international COVID-19 crisis, we take this opportunity to highlight the importance of individual, community, and population health literacy. We are not only in a "pandemic" but also an "infodemic". Health literacy is more important than ever in the face of these global health threats, which have impacted outcomes across the levels of the socio-ecological model (SEM), including individual health behaviors, family relationships, organizational behavior, state policy-making, national mortality statistics, and the international economy in the span of weeks. Our special issue sought to pull together interdisciplinary threads guided by two principles. The first was defining health literacy as essential skills and situational resources needed for people to find, understand, evaluate, communicate, and use information and services in a variety of forms across various settings throughout their life course to promote health and wellbeing. The second was the idea that enhancing health literacy in populations and systems is critical to achieving health equity. In this time of public health need across traditional borders, the inter-sectoral and international perspectives of special issue articles are more urgent than ever. A greater understanding, appreciation, and application of health literacy can support policy action on multiple levels to address major public health challenges. Health literacy should be built deliberately as a population-level resource and community asset. We have summarized the set of articles in this special issue across the levels of the SEM, hoping their thoughtful considerations and interesting findings will help to support global health and wellness and inspire future research, policy, and practice in this global public health emergency and beyond.


Covid-19 digestive system involvement and clinical outcomes in a large academic hospital in Milan, Italy


COVID-19 Digestive System Involvement and Clinical Outcomes in a Large Academic Hospital in Milan, Italy


Non-Invasive versus Invasive Ventilation in COVID-19: One Size Does Not Fit All!


Pulmonary intravascular coagulation in COVID-19: possible pathogenesis and recommendations on anticoagulant/thrombolytic therapy


Riesgo de reactivación de la hepatitis B asociado al tratamiento con corticoides frente a SARS-CoV-2 (COVID-19)./ [Risk of hepatitis B reactivation associated with treatment against SARS-CoV-2 (COVID-19) with corticosteroids]


COVID-19 patients with hypertension have more severity condition, and ACEI/ARB treatment have no infulence on the clinical severity and outcome


title: COVID-19 epidemic outcome predictions based on logistic fitting and estimation of its reliability

text: Since the first outbreak of the COVID-19 epidemic at the end of 2019, data has been made available on the number of infections, deaths and recoveries for all countries of the World, and that data can be used for statistical analysis. The primary interest of this paper is how well the logistic equation can predict the outcome of COVID-19 epidemic in any regions of the World assuming that the methodology of the testing process, namely the data collection method and social behavior is not changing over the course of time. Besides the social relevance, this study has two scientific purposes: we investigate if a simple saturation model can describe the trend of the COVID-19 epidemic and if so, we would like to determine, from which point during the epidemic the fitting parameters provide reliable predictions. We also give estimations for the outcome of this epidemic in several countries based on the logistic model and the data available on 27 March, 2020. Based on the saturated cases in China, we have managed to find some criteria to judge the reliability of the predictions.


title: Projecting and comparing non-pharmaceutical interventions to contain COVID-19 in major economies

text: Non-pharmaceutical interventions (NPIs) such as quarantine, self-isolation, social distancing, and virus-contact tracing can greatly reduce the spread of the virus during a pandemic. In the wave of the COVID-19 pandemic, many countries have implemented various NPIs for infection control and mitigation. However, the stringency of the NPIs and the resulting impact among different countries remain unclear due to the lack of quantitative factors. In this study we took a further step to incorporate the effect of the NPIs into the pandemic dynamics model using the concept of policy intensity factor (PIF). This idea enables us to characterize the transition rates as time varying quantities instead of constant values, and thus capturing the dynamical behavior of the basic reproduction number variation in the pandemic. By leveraging a great amount of data reported by the governments and the World Health Organization, we projected the dynamics of the pandemic for the major economies in the world, including the numbers of infected, susceptible, and recovered cases, as well as the pandemic durations. It is observed that the proposed variable-rate susceptible-exposed-infected-recovered (VR-SEIR) model fits and projects the pandemic dynamics very well. We further showed that the resulting PIFs correlate with the stringency of NPIs, which allows us to project the final affected numbers of people in those countries when their current NPIs have been imposed for 90, 180, 360 days. It provides a quantitative insight into the effectiveness of the implemented NPIs, and sheds a new light on minimizing both affected people from COVID-19 and the economic impact.


Low risk of SARS-CoV-2 transmission through the ocular surface


title: A Note on Early Epidemiological Analysis of Coronavirus Disease 2019 Outbreak using Crowdsourced Data

text: Crowdsourcing data can prove of paramount importance in monitoring and controlling the spread of infectious diseases. The recent paper by Sun, Chen and Viboud (2020) is important because it contributes to the understanding of the epidemiology and of the spreading of Covid-19 in a period when most of the epidemic characteristics are still unknown. However, the use of crowdsourcing data raises a number of problems from the statistical point of view which run the risk of invalidating the results and of biasing estimation and hypothesis testing. While the work by Sun, Chen and Viboud (2020) has to be commended, given the importance of the topic for worldwide health security, in this paper we deem important to remark the presence of the possible sources of statistical biases and to point out possible solutions to them


title: COVID-19 Crisis Creates Opportunities for Community-Centered Population Health: Community Health Workers at the Center

text: Dealing with the COVID-19 coronavirus requires a coordinated transnational effort. We propose a 2-stage state-led effort that utilizes community health workers (CHWs). We spell out what is beginning to occur in states to control and suppress COVID-19. In the second stage, we suggest working with these CHWs as a key element in the next evolution of our health care system: community-centered population health.


title: Glycosylated hemoglobin is associated with systemic inflammation, hypercoagulability, and prognosis of COVID-19 patients

text: BACKGROUND: Diabetes is a risk factor for the progression and prognosis of coronavirus disease (COVID-19), but the relationship between glycosylated hemoglobin (HbA1c) level, inflammation, and prognosis of COVID-19 patients has not been explored. METHODS: This was a retrospective study of COVID-19 patients who underwent an HbA1c test. Their demographic data, medical history, signs and symptoms of COVID-19, laboratory test results, and final outcomes of COVID-19 treatment were collected and analyzed. RESULTS: A total of 132 patients were included and divided into three groups based on their blood glucose status. There were significant differences in SaO2, serum ferritin level, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen (Fbg) level, and IL6 level among the three groups. A pairwise comparison of the groups showed that groups B and C were significantly different from group A in terms of CRP, ESR, and Fbg, IL6, and serum ferritin levels (P < 0.05). Correlation analysis showed that there was a linear negative correlation between SaO2 and HbA1c (r = -0.22, P = 0.01), while there was a linear positive correlation between serum ferritin, CRP, Fbg, and ESR levels and HbA1c (P < 0.05). CONCLUSIONS: High HbA1c level is associated with inflammation, hypercoagulability, and low SaO2 in COVID-19 patients, and the mortality rate (27.7%) is higher in patients with diabetes. Determining HbA1c level after hospital admission is thus helpful assessing inflammation, hypercoagulability, and prognosis of COVID-19 patients.


The traps of calling the public health response to COVID-19 "an unexpected war against an invisible enemy"


docid: qppfzqxa

title: Covid-19: Health and care workers will be "highest priority" for vaccination, says JCVI


title: Cardiac manifestations in COVID-19 patients-A systematic review

text: OBJECTIVES: The coronavirus disease-2019 (COVID-19) pandemic has resulted in the worst global pandemic of our generation, affecting 215 countries with nearly 5.5 million cases. The association between COVID-19 and the cardiovascular system has been well described. We sought to systematically review the current published literature on the different cardiac manifestations and the use of cardiac-specific biomarkers in terms of their prognostic value in determining clinical outcomes and correlation to disease severity. METHODS: A systematic literature review across PubMed, Cochrane database, Embase, Google Scholar, and Ovid was performed according to PRISMA guidelines to identify relevant articles that discussed risk factors for cardiovascular manifestations, cardiac manifestations in COVID-19 patients, and cardiac-specific biomarkers with their clinical implications on COVID-19. RESULTS: Sixty-one relevant articles were identified which described risk factors for cardiovascular manifestations, cardiac manifestations (including heart failure, cardiogenic shock, arrhythmia, and myocarditis among others) and cardiac-specific biomarkers (including CK-MB, CK, myoglobin, troponin, and NT-proBNP). Cardiovascular risk factors can play a crucial role in identifying patients vulnerable to developing cardiovascular manifestations of COVID-19 and thus help to save lives. A wide array of cardiac manifestations is associated with the interaction between COVID-19 and the cardiovascular system. Cardiac-specific biomarkers provide a useful prognostic tool in helping identify patients with the severe disease early and allowing for escalation of treatment in a timely fashion. CONCLUSION: COVID-19 is an evolving pandemic with predominate respiratory manifestations, however, due to the interaction with the cardiovascular system; cardiac manifestations/complications feature heavily in this disease, with cardiac biomarkers providing important prognostic information.


title: COVID-19, Australia: Epidemiology Report 12 (Reporting week to 23:59 AEST 19 April 2020)

text: Confirmed cases in Australia notified up to 19 April 2020: notifications = 6,606; deaths = 69. The reduction in international travel and domestic movement, social distancing measures and public health action have likely slowed the spread of the disease. Notifications in Australia remain predominantly among people with recent overseas travel, with some locally-acquired cases being detected. Most locally-acquired cases can be linked back to a confirmed case, with a small portion unable to be epidemiologically linked. The distribution of overseas-acquired cases to locally-acquired cases varies by jurisdiction. The crude case fatality rate (CFR) in Australia remains low (1.0%) compared to the World Health Organization's globally-reported rate (6.8%) and to other comparable high-income countries such as the United States of America (4.7%) and the United Kingdom (13.5%). The low CFR is likely reflective of high case ascertainment including detection of mild cases. High case ascertainment enables public health response and reduction of disease transmission. Internationally, cases continue to increase. The rates of increase have started to slow in several regions, although it is too soon to tell whether this trend will be sustained. Interpretation of international epidemiology should be conducted with caution as it differs from country to country depending not only on the disease dynamics, but also on differences in case detection, testing and implemented public health measures.


Priority plan for invasive cardiac electrophysiology procedures during the coronavirus disease 2019 (COVID-19) pandemic


Effect of the COVID-19 pandemic on cancer treatment and research


Risk of hospitalization and death from COVID-19 infection in patients with chronic plaque psoriasis receiving a biologic treatment and renal transplant recipients in maintenance immunosuppressive treatment


From the Desk of the Editor in Chief


COVID-19 Interference with Renin-Angiotensin System in the Context of Heart Failure


Risk factors for severe COVID-19 illness in healthcare workers: Too many unknowns


title: Telemedicine During the COVID-19 Pandemic: Experiences From Western China

text: Disasters and pandemics pose unique challenges to health care delivery. As health care resources continue to be stretched due to the increasing burden of the coronavirus disease (COVID-19) pandemic, telemedicine, including tele-education, may be an effective way to rationally allocate medical resources. During the COVID-19 pandemic, a multimodal telemedicine network in Sichuan Province in Western China was activated immediately after the first outbreak in January 2020. The network synergizes a newly established 5G service, a smartphone app, and an existing telemedicine system. Telemedicine was demonstrated to be feasible, acceptable, and effective in Western China, and allowed for significant improvements in health care outcomes. The success of telemedicine here may be a useful reference for other parts of the world.


title: Mobility restrictions for the control of epidemics: When do they work?

text: Mobility restrictions - travel advisories, trade and travel bans, border closures and, in extreme cases, area quarantines or cordons sanitaires - are among the most widely used measures to control infectious diseases. Restrictions of this kind were important in the response to epidemics of SARS (2003), H1N1 influenza (2009), and Ebola (2014). However, they do not always work as expected. The imposition of a cordon sanitaire to control the 2014 West African Ebola outbreak, for example, is argued to have led to a higher-than-expected number of cases in the quarantined area. To determine when mobility restrictions reduce the size of an epidemic, we use a model of disease transmission within and between economically heterogeneous locally connected communities. One community comprises a low-risk, resource-rich, low-density population with access to effective medical resources. The other comprises a high-risk, resource-poor, high-density population without access to effective medical resources. We find that the overall size of an epidemic centered in the high-risk community is sensitive to the stringency of mobility restrictions between the two communities. Unrestricted mobility between the two risk communities increases the number of secondary cases in the low-risk community but reduces the overall epidemic size. By contrast, the imposition of a cordon sanitaire around the high-risk community reduces the number of secondary infections in the low-risk community but increases the overall epidemic size. The degree to which mobility restrictions increase or decrease the overall epidemic size depends on the level of risk in each community and the characteristics of the disease.


text: BACKGROUND: Mobility restrictions-trade and travel bans, border closures and, in extreme cases, area quarantines or cordons sanitaires-are among the most widely used measures to control infectious diseases. Restrictions of this kind were important in the response to epidemics of SARS (2003), H1N1 influenza (2009), Ebola (2014) and, currently in the containment of the ongoing COVID-19 pandemic. However, they do not always work as expected. METHODS: To determine when mobility restrictions reduce the size of an epidemic, we use a model of disease transmission within and between economically heterogeneous locally connected communities. One community comprises a low-risk, low-density population with access to effective medical resources. The other comprises a high-risk, high-density population without access to effective medical resources. FINDINGS: Unrestricted mobility between the two risk communities increases the number of secondary cases in the low-risk community but reduces the overall epidemic size. By contrast, the imposition of a cordon sanitaire around the high-risk community reduces the number of secondary infections in the low-risk community but increases the overall epidemic size. INTERPRETATION: Mobility restrictions may not be an effective policy for controlling the spread of an infectious disease if it is assessed by the overall final epidemic size. Patterns of mobility established through the independent mobility and trade decisions of people in both communities may be sufficient to contain epidemics.


title: Re-analysis of SARS-CoV-2-infected host cell proteomics time-course data by impact pathway analysis and network analysis: a potential link with inflammatory response

text: Coronavirus disease 2019 (COVID-19), caused by an outbreak of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) in Wuhan, China, has led to an unprecedented health and economic crisis worldwide. To develop treatments that can stop or lessen the symptoms and severity of SARS-CoV-2 infection, it is critical to understand how the virus behaves inside human cells, and so far studies in this area remain scarce. A recent study investigated translatome and proteome host cell changes induced in vitro by SARS-CoV-2. Here, we use the publicly available proteomics data from this study to re-analyze the in vitro cellular consequences of SARS-CoV-2 infection by impact pathways analysis and network analysis. Notably, proteins linked to the inflammatory response, but also proteins related to chromosome segregation during mitosis, were found to be altered in response to viral infection. Upregulation of inflammatory response proteins is in line with the propagation of inflammatory reaction and lung injury that is observed in advanced stages of COVID-19 patients and which worsens with age.


title: Forecasting the Spread of Covid-19 Under Control Scenarios Using LSTM and Dynamic Behavioral Models

text: To accurately predict the regional spread of Covid-19 infection, this study proposes a novel hybrid model which combines a Long short-term memory (LSTM) artificial recurrent neural network with dynamic behavioral models. Several factors and control strategies affect the virus spread, and the uncertainty arisen from confounding variables underlying the spread of the Covid-19 infection is substantial. The proposed model considers the effect of multiple factors to enhance the accuracy in predicting the number of cases and deaths across the top ten most-affected countries and Australia. The results show that the proposed model closely replicates test data. It not only provides accurate predictions but also estimates the daily behavior of the system under uncertainty. The hybrid model outperforms the LSTM model accounting for limited available data. The parameters of the hybrid models were optimized using a genetic algorithm for each country to improve the prediction power while considering regional properties. Since the proposed model can accurately predict Covid-19 spread under consideration of containment policies, is capable of being used for policy assessment, planning and decision-making.


title: Gastrointestinal endoscopy in the era of the acute pandemic of coronavirus disease 2019: Recommendations by Japan Gastroenterological Endoscopy Society (Issued on April 9th, 2020)

text: All gastrointestinal endoscopic procedures have a high risk of aerosol contamination of the coronavirus disease 2019 (COVID-19) to endoscopists, nurses, and healthcare assistants. Given the current pandemic situation of COVID-19, the Japan Gastroenterological Endoscopy Society issued the recommendation for gastrointestinal (GI) endoscopy based on the status of COVID-19 as of April 9, 2020, in Japan: (i) indications for GI endoscopy in the pandemic of COVID-19; (ii) practical protective equipment for medical personnel depending on the risk for COVID-19; (iii) preprocedural management, such as pharyngeal local anesthesia using lidocaine spray which has a potential to generate the aerosols; (iv) ideal settings of the endoscopy room including the numbers of the staff and the patients; (v) postprocedural management, such as undressing and follow-up of the patients, as well as the involved staff, were documented to fit the practical scenarios in GI endoscopy, with the available data in Japan and the world. We believe that certain measures will prevent further spread of COVID-19.


title: Screen time for children and adolescents during the COVID-19 pandemic

text: The coronavirus 2019 (COVID-19) pandemic has led to laws and policies including national school closures, lockdown or shelter in place laws, and social distancing recommendations that may translate to higher overall screen time among children and adolescents for the duration of these laws and policies. These policies may need to be periodically re-instated to control future COVID-19 recurrences or other national emergencies. Excessive screen time is associated with cardiovascular disease risk factors such as obesity, high blood pressure, and insulin resistance because it increases sedentary time and is associated with snacking.


The COVID-19 pandemic and suicide by self-immolation: Is risk increasing?


How to help the free market fight coronavirus


A plague on both your houses: European and Asian responses to Coronavirus


title: Understanding SARS-CoV-2 endocytosis for COVID-19 drug repurposing

text: The quest for the effective treatment against coronavirus disease 2019 pneumonia caused by the severe acute respiratory syndrome (SARS)-coronavirus 2(CoV-2) coronavirus is hampered by the lack of knowledge concerning the basic cell biology of the infection. Given that most viruses use endocytosis to enter the host cell, mechanistic investigation of SARS-CoV-2 infection needs to consider the diversity of endocytic pathways available for SARS-CoV-2 entry in the human lung epithelium. Taking advantage of the well-established methodology of membrane trafficking studies, this research direction allows for the rapid characterisation of the key cell biological mechanism(s) responsible for SARS-CoV-2 infection. Furthermore, 11 clinically approved generic drugs are identified as potential candidates for repurposing as blockers of several potential routes for SARS-CoV-2 endocytosis. More broadly, the paradigm of targeting a fundamental aspect of human cell biology to protect against infection may be advantageous in the context of future pandemic outbreaks.


SARS-CoV-2 infection in two pediatric patients with immune cytopenias: A single institution experience during the pandemic


COVID-19 Cases and Deaths in Federal and State Prisons


title: Analyzing the Impact of Covid-19 Control Policies on Campus Occupancy and Mobility via Passive WiFi Sensing

text: The outbreak of virus has resulted in many different policies being enacted across the world to reduce the spread of the virus. These efforts range from increased social awareness and social distancing (Sweden) to full country-wide lockdowns (Singapore, most of Europe, many states in the US). The effectiveness of various policies in containing the spread of the disease is still being studied by researchers. In this paper, using WiFi data collected directly from the infrastructure, we present a detailed analysis of the impact of virus related policies on the staff and students of three different college campuses. Two of these campuses are in Singapore, while the third is in the Northeastern United States. Our study focuses on two different key metrics, 1) Occupancy, defined as the number of people in a building, on average, in a specific hour, and 2) Mobility, defined as the number of places visited by an individual, on average, in a specific hour. We use these two metrics since they provide a strong indicator of how likely it is for virus to spread if there is an outbreak. Our results show that online learning, split-team, and other space management policies are effective at lowering Occupancy. However, they do not change the Mobility patterns for individuals who are still moving around. Reducing Mobility requires introducing strict stay-at-home or lockdown orders, but doing so increases Occupancy in residential spaces. We present our results and then discuss the implications of the findings for policymakers.


title: Using Wavelets and Spectral Methods to Study Patterns in Image-Classification Datasets

text: Deep learning models extract, before a final classification layer, features or patterns which are key for their unprecedented advantageous performance. However, the process of complex nonlinear feature extraction is not well understood, a major reason why interpretation, adversarial robustness, and generalization of deep neural nets are all open research problems. In this paper, we use wavelet transformation and spectral methods to analyze the contents of image classification datasets, extract specific patterns from the datasets and find the associations between patterns and classes. We show that each image can be written as the summation of a finite number of rank-1 patterns in the wavelet space, providing a low rank approximation that captures the structures and patterns essential for learning. Regarding the studies on memorization vs learning, our results clearly reveal disassociation of patterns from classes, when images are randomly labeled. Our method can be used as a pattern recognition approach to understand and interpret learnability of these datasets. It may also be used for gaining insights about the features and patterns that deep classifiers learn from the datasets.


COVID-19 Therapeutic and Prevention


Without food, there can be no exit from the pandemic


Smoking is Associated with COVID-19 Progression: A Meta-Analysis


title: Obesity is Associated with Increased Risk for Mortality Among Hospitalized Patients with COVID-19

text: OBJECTIVE: Obesity has been identified as a risk factor for severe COVID-19 caused by the SARS-CoV2 virus, however a direct association with mortality has not been reported. We sought to determine whether obesity is a risk factor for mortality among COVID-19 patients. METHODS: The study was a retrospective cohort, including patients with COVID-19 between March 1 and April 18, 2020. The primary objective was to determine if obesity is a predictor of mortality. RESULTS: A total of 238 patients were included, 218 patients (91.6%) were African American, 113 (47.5%) were male, and the mean age was 58.5 years. Of the included patients, 146 (61.3%) were obese (BMI >30kg/m2 ), with 63 (26.5%), 29 (12.2%), and 54 (22.7%) with class 1, 2, and 3 obesity, respectively. Obesity was identified as a predictor for mortality (OR 1.7(1.1-2.8),p=0.016), as was male gender (OR 5.2(1.6-16.5),p=0.01) and older age (OR 3.6(2.0-6.3),p<0.0005). Obesity (OR 1.7(1.3-2.1),p<0.0005) and older age (OR 1.3(1.0-1.6),p=0.03) were also risk factors for hypoxemia. CONCLUSIONS: Obesity was found to be a significant predictor for mortality among inpatients with COVID-19 after adjusting for age, gender, and other comorbidities. Patients with obesity were also more likely to present with hypoxemia.


title: Community Responses during Early Phase of COVID-19 Epidemic, Hong Kong

text: During the early phase of the coronavirus disease epidemic in Hong Kong, 1,715 survey respondents reported high levels of perceived risk, mild anxiety, and adoption of personal-hygiene, travel-avoidance, and social-distancing measures. Widely adopted individual precautionary measures, coupled with early government actions, might slow transmission early in the outbreak.


docid: vywwnfyj

title: Identifying potential treatments of COVID-19 from Traditional Chinese Medicine (TCM) by using a data-driven approach

text: ETHNOPHARMACOLOGICAL RELEVANCE: Traditional Chinese Medicine (TCM) has been widely used as an approach worldwide. Chinese Medicines (CMs) had been used to treat and prevent viral infection pneumonia diseases for thousands of years and had accumulated a large number of clinical experiences and effective prescriptions. AIM OF THE STUDY: This research aimed to systematically excavate the classical prescriptions of Chinese Medicine (CM), which have been used to prevent and treat Pestilence (Wenbing, Wenyi, Shiyi or Yibing) for long history in China, to obtain the potential prescriptions and ingredients to alternatively treat COVID-19. MATERIALS AND METHODS: We developed the screening system based on data mining, molecular docking and network pharmacology. Data mining and association network were used to mine the high-frequency herbs and formulas from ancient prescriptions. Virtual screening for the effective components of high frequency CMs and compatibility Chinese Medicine was explored by a molecular docking approach. Furthermore, network pharmacology method was used to preliminarily uncover the molecule mechanism. RESULTS: 574 prescriptions were obtained from 96,606 classical prescriptions with the key words to treat "Warm diseases (Wenbing)", "Pestilence (Wenyi or Yibing)" or "Epidemic diseases (Shiyi)". Meanwhile, 40 kinds of CMs, 36 CMs-pairs, 6 triple-CMs-groups existed with high frequency among the 574 prescriptions. Additionally, the key targets of SARS-COV-2, namely 3CL hydrolase (Mpro) and angiotensin-converting enzyme 2(ACE2), were used to dock the main ingredients from the 40 kinds by the LigandFitDock method. A total of 66 compounds components with higher frequency were docked with the COVID-19 targets, which were distributed in 26 kinds of CMs, among which Gancao (Glycyrrhizae Radix Et Rhizoma), HuangQin (Scutellariae Radix), Dahuang (Rhei Radix Et Rhizome) and Chaihu (Bupleuri Radix) contain more potential compounds. Network pharmacology results showed that Gancao (Glycyrrhizae Radix Et Rhizoma) and HuangQin (Scutellariae Radix) CMs-pairs could also interact with the targets involving in immune and inflammation diseases. CONCLUSIONS: These results we obtained probably provided potential candidate CMs formulas or active ingredients to overcome COVID-19. Prospectively, animal experiment and rigorous clinic studies are needed to confirm the potential preventive and treat effect of these CMs and compounds.


title: Molecular-based Alternatives for Colorectal Cancer Screening during the COVID-19 Pandemic

text: Due to the COVID-19 pandemic, important elective procedures, such as screening colonoscopy, have been delayed or cancelled, and there may be a very long waitlist for rescheduling once the moratorium is lifted However, DNA-based stool sample tests may be useful for colorectal cancer screening when colonoscopy is not available The aim of this review is to demonstrate the potential utility of enhanced DNA-based stool testing for colorectal cancer screening and diagnosis during crises that strain available healthcare resources, such as the current COVID-19 pandemic This review shows that DNA-based stool sample tests have the potential to enable colorectal cancer screening to prioritize patients to elective colonoscopy procedures, the continued delay of which during the COVID-19 pandemic has already placed a burden on future elective procedures


Chest tube with air leaks is a potential "super spreader" of COVID-19


The coronavirus outbreak could make it quicker and easier to trial drugs


Hepatocellular Type II Fibrinogen Inclusions in a Patient with Severe COVID-19 and Hepatitis


title: Correlation between cytokines and coagulation-related parameters in patients with coronavirus disease 2019 admitted to ICU

text: BACKGROUND: The novel SARS-CoV-2 caused a large number of infections and deaths worldwide. Thus, new ideas for an appropriated assessment of patients' condition and clinical treatment are of utmost importance. Therefore, in this study, the laboratory parameters of patients with coronavirus disease 2019 (COVID-19) were evaluated to identify the correlation between cytokine expression and other laboratory parameters. METHODS: A retrospective and single-center study was performed in Wuhan, involving 83 severe or critical COVID-19 patients admitted to the intensive care unit (ICU). Laboratory parameters in ICU patients with laboratory-confirmed infection of SARS-CoV2 were collected. The association between parameters was assessed by Spearman's rank correlation. RESULTS: Patients' median age was 66 years (IQR, 57-73), and 55 (66%) were men. Among the 83 patients, 61 (73%) had 1 or more coexisting medical condition. The median concentration of IL-2R, IL-6, IL8, IL10, and TNFα were above the normal range, without IL-1ß. A significant negative correlation between IL-6 and platelet count was discovered (r2 = -0.448, P<0.001) as well as a significant correlation between IL-6 and other platelet parameters. Finally, a correlation between multiple cytokines and coagulation indicators was found, pro-inflammatory factors were found to be more associated to coagulation parameters, with the highest correlation between IL-6 and the International normalized ratio (INR) (r2=0.444, P<0.001). CONCLUSIONS: Our results suggested that cytokines play an important role in the pathogenesis of COVID-19. In addition, IL-6 seems more relevant in the evaluation of the condition of COVID-19 patients.


A word of caution and call for cross-society collaboration to develop surgical guidance about COVID-19


Web Exclusive. Annals On Call - Clinical Reasoning and Testing for COVID-19


Time to treatment still matters in ST-elevation myocardial infarction: a call to maintain treatment effectiveness during the COVID-19 pandemic


Covid-19: Highest risk patients are asked to stay at home for 12 weeks


Nursing and the novel coronavirus: Risks and responsibilities in a global outbreak


Letter to the editor: Headline stress disorder caused by Netnews during the outbreak of COVID-19


title: Large-scale national screening for Coronavirus Disease 2019 in China

text: Faced with the new challenges in the pandemic control, imported coronavirus disease (COVID-19) infections and asymptomatic infection, Chinese authorities have implemented new intervention measures-national large-scale nucleic acid testing. This article summarizes the population who needs the nucleic acid testing, analyzes the current data of COVID-19 testing capacity, concludes the timeline of coronavirus testing and suggests what needs to be done to facilitate the government large-scale screening measures.


docid: thmnmzun

title: COVID-19 and the Ocular Surface: A Review of Transmission and Manifestations

text: PURPOSE: The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reached pandemic proportions within an unprecedented span of time. It is controversial whether the virus can be transmitted via tears and its ocular implications have not been widely studied. In this article, the current evidence related to ocular transmission and ocular manifestations is reviewed. RESULTS: Several mechanisms for the ocular transmission of the virus are proposed with highlight on the nasolacrimal system as a conduit between the eye and the respiratory tract, and the role of the lacrimal gland in hematogenous spread. Ocular surface manifestations such as conjunctivitis are more commonly reported. CONCLUSION: The exact pathophysiology of ocular transmission of the virus remains incompletely understood, although there is preliminary evidence of SARS-CoV-2 being detected in ocular secretions. The ocular tropism of the virus and its potential to cause localized ocular disease are worth considering.


title: COVID-19 Science Policy, Experts, and Publics: Why Epistemic Democracy Matters in Ecological Crises

text: In times of planetary health crises such as the COVID-19 pandemic, a critically informed science and technology policy is crucial. In this overarching context, governments are faced with making rapid and high-stake decisions dictated by emergency that in a state of normalcy they would not, or could not pursue. Governments tend to gather, therefore, an incredible amount of unchecked power in times of fast-moving ecological crises that raises concerns about where the legitimacy of such excessive power comes from. Moreover, the elected politicians rely on the expert advice in a pandemic. This takes away democratic political authority from the sovereign people and instead places it on allegedly objective unelected experts. In contrast, experts have (1) a dubious reputation in predicting the future and (2) varying degrees of biases and self-interests, which make them susceptible, for instance, to "framing problems" in relation to the urgent public issues at stake. This article suggests new ways of thinking about COVID-19 technology policy, drawing from the field of political science and democratic theory. It examines the power-laden tensions between the political authority and the expert authority. Going forward, I highlight the brief history of epistemic democracy, taking into consideration that in advanced modern democracies, political decision making has to draw, in part, from expert knowledge, but without resulting in democratic deficits. The COVID-19 science and technology policy can usefully build on epistemic democracy while strengthening the science, society, and democracy nexus.


Predicting Severe Outcomes in COVID-19


title: The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study

text: BACKGROUND: The COVID-19 pandemic has placed unprecedented strain on health-care systems. Frailty is being used in clinical decision making for patients with COVID-19, yet the prevalence and effect of frailty in people with COVID-19 is not known. In the COVID-19 in Older PEople (COPE) study we aimed to establish the prevalence of frailty in patients with COVID-19 who were admitted to hospital and investigate its association with mortality and duration of hospital stay. METHODS: This was an observational cohort study conducted at ten hospitals in the UK and one in Italy. All adults (≥18 years) admitted to participating hospitals with COVID-19 were included. Patients with incomplete hospital records were excluded. The study analysed routinely generated hospital data for patients with COVID-19. Frailty was assessed by specialist COVID-19 teams using the clinical frailty scale (CFS) and patients were grouped according to their score (1-2=fit; 3-4=vulnerable, but not frail; 5-6=initial signs of frailty but with some degree of independence; and 7-9=severe or very severe frailty). The primary outcome was in-hospital mortality (time from hospital admission to mortality and day-7 mortality). FINDINGS: Between Feb 27, and April 28, 2020, we enrolled 1564 patients with COVID-19. The median age was 74 years (IQR 61-83); 903 (57·7%) were men and 661 (42·3%) were women; 425 (27·2%) had died at data cutoff (April 28, 2020). 772 (49·4%) were classed as frail (CFS 5-8) and 27 (1·7%) were classed as terminally ill (CFS 9). Compared with CFS 1-2, the adjusted hazard ratios for time from hospital admission to death were 1·55 (95% CI 1·00-2·41) for CFS 3-4, 1·83 (1·15-2·91) for CFS 5-6, and 2·39 (1·50-3·81) for CFS 7-9, and adjusted odds ratios for day-7 mortality were 1·22 (95% CI 0·63-2·38) for CFS 3-4, 1·62 (0·81-3·26) for CFS 5-6, and 3·12 (1·56-6·24) for CFS 7-9. INTERPRETATION: In a large population of patients admitted to hospital with COVID-19, disease outcomes were better predicted by frailty than either age or comorbidity. Our results support the use of CFS to inform decision making about medical care in adult patients admitted to hospital with COVID-19. FUNDING: None.


title: Achados clínico-patológicos e métodos de controle da intoxicação por Pteridium (aquilinum) arachnoideum em uma propriedade do Rio Grande do Sul/ Clinical and pathological findings and control methods of the poisoning by Pteridium (aquilinum) arachnoideum in a farm of Rio Grande do Sul, Brazil

text: A infestação de pastagens por Pteridium arachnoideum é um problema que afeta a pecuária em diversas partes do mundo, ocasionando perdas produtivas e mortalidades nos rebanhos, bem como a redução das áreas de pastagens. Devido aos prejuízos na bovinocultura, foi proposto o acompanhamento de uma propriedade no Rio Grande do Sul com perdas por Pteridium arachnoideum. Realizou-se um levantamento das mortes associadas à intoxicação por samambaia na propriedade durante o período de janeiro de 2007 a janeiro de 2015. Adicionalmente, testou-se a viabilidade de ovinos como ferramenta de controle biológico de samambaia e se acompanhou as tentativas de controle da planta através do uso dos herbicidas metilsulfuron-metil e picloram, os quais eram associados ou não à roçada prévia. Das mortes por intoxicação natural acompanhadas na propriedade, observou-se 22 casos de quadro agudo de diátese hemorrágica e seis de quadro crônico de carcinomas do trato digestório superior. Em cinco bovinos jovens com diátese hemorrágica, além de hemorragias disseminadas e infartos, observou-se acentuado edema laríngeo, que cursava, clinicamente, com dispneia e estertores respiratórios característicos. Os carcinomas do trato digestório superior, apesar de menos frequentes, causaram perdas expressivas, devido à mortalidade anual de reprodutoras. Notou-se que a introdução de bovinos jovens em áreas recentemente roçadas pode resultar no consumo de grandes quantidades de samambaia e na ocorrência de surtos da enfermidade aguda. O controle das populações de samambaia pelo pastejo por ovinos não foi eficiente, devido ao baixo consumo observado com a lotação de quatro ovinos por hectare, embora mortalidade de ovinos por consumo da planta não tenha sido registrada. Após a retirada do potreiro infestado por samambaia, ao final do experimento, oito dos ovinos foram acompanhados, clinicamente, por três anos e não apresentaram nenhuma alteração. A utilização dos herbicidas resultou em uma redução da cobertura de P. arachnoideum. No entanto, essa prática necessita de estudos adicionais, já que algumas áreas não tiveram recuperação satisfatória da pastagem e o seu uso pode causar impactos ambientais e aquisição de resistência de P. arachnoideum aos herbicidas.(AU)


docid: wcnyncld

title: Observation and analysis of 26 cases of asymptomatic SARS-COV2 infection


Simultaneous onset of COVID-19 and autoimmune haemolytic anaemia


title: Quantitative clarification of key questions about COVID-19 epidemiology

text: Modeling the spread of COVID-19 is crucial for informing public health policy. All models for COVID-19 epidemiology rely on parameters describing the dynamics of the infection process. The meanings of epidemiological parameters like R_0, R_t, the"serial interval"and"generation interval"can be challenging to understand, especially as these and other parameters are conceptually overlapping and sometimes confusingly named. Moreover, the procedures used to estimate these parameters make various assumptions and use different mathematical approaches that should be understood and accounted for when relying on parameter values and reporting them to the public. Here, we offer several insights regarding the derivation of commonly-reported epidemiological parameters, and describe how mitigation measures like lockdown are expected to affect their values. We aim to present these quantitative relationships in a manner that is accessible to the widest audience possible. We hope that better communicating the intricacies of epidemiological models will improve our collective understanding of their strengths and weaknesses, and will help avoid possible pitfalls when using them.


title: Negative Transmission of SARS-CoV-2 to Hand-Expressed Colostrum from SARS-CoV-2-Positive Mothers

text: Aim: The objective of our study was to determine whether the SARS-CoV-2-positive mothers transmit the virus to their hand-expressed colostrum. Methods: This is an observational prospective study that included pregnant women who tested positive for SARS-CoV-2 by PCR test on a nasopharyngeal swab at the moment of childbirth and who wanted to breastfeed their newborns. A colostrum sample was obtained from the mothers by manual self-extraction. To collect the samples, the mothers wore surgical masks, washed their hands with an 85% alcohol-based gel, and washed their breast with gauze that was saturated with soap and water. Results: We obtained seven colostrum samples from different mothers in the first hours postdelivery. SARS-CoV-2 was not detected in any of the colostrum samples obtained in our study. Conclusion: In our study, breast milk was not a source of SARS-CoV-2 transmission. Hand expression (assuring that a mask is used and that appropriate hygienic measures are used for the hands and the breast), when direct breastfeeding is not possible, appears to be a safe way of feeding newborns of mothers with COVID-19.


Safety first - assisted human reproduction second


Consequences of the coronavirus pandemic for global health research and practice


title: Pulmonary Arterial Thrombosis in COVID-19 With Fatal Outcome: Results From a Prospective, Single-Center, Clinicopathologic Case Series

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly become pandemic, with substantial mortality. OBJECTIVE: To evaluate the pathologic changes of organ systems and the clinicopathologic basis for severe and fatal outcomes. DESIGN: Prospective autopsy study. SETTING: Single pathology department. PARTICIPANTS: 11 deceased patients with COVID-19 (10 of whom were selected at random for autopsy). MEASUREMENTS: Systematic macroscopic, histopathologic, and viral analysis (SARS-CoV-2 on real-time polymerase chain reaction assay), with correlation of pathologic and clinical features, including comorbidities, comedication, and laboratory values. RESULTS: Patients' age ranged from 66 to 91 years (mean, 80.5 years; 8 men, 3 women). Ten of the 11 patients received prophylactic anticoagulant therapy; venous thromboembolism was not clinically suspected antemortem in any of the patients. Both lungs showed various stages of diffuse alveolar damage (DAD), including edema, hyaline membranes, and proliferation of pneumocytes and fibroblasts. Thrombosis of small and mid-sized pulmonary arteries was found in various degrees in all 11 patients and was associated with infarction in 8 patients and bronchopneumonia in 6 patients. Kupffer cell proliferation was seen in all patients, and chronic hepatic congestion in 8 patients. Other changes in the liver included hepatic steatosis, portal fibrosis, lymphocytic infiltrates and ductular proliferation, lobular cholestasis, and acute liver cell necrosis, together with central vein thrombosis. Additional frequent findings included renal proximal tubular injury, focal pancreatitis, adrenocortical hyperplasia, and lymphocyte depletion of spleen and lymph nodes. Viral RNA was detectable in pharyngeal, bronchial, and colonic mucosa but not bile. LIMITATION: The sample was small. CONCLUSION: COVID-19 predominantly involves the lungs, causing DAD and leading to acute respiratory insufficiency. Death may be caused by the thrombosis observed in segmental and subsegmental pulmonary arterial vessels despite the use of prophylactic anticoagulation. Studies are needed to further understand the thrombotic complications of COVID-19, together with the roles for strict thrombosis prophylaxis, laboratory, and imaging studies and early anticoagulant therapy for suspected pulmonary arterial thrombosis or thromboembolism. PRIMARY FUNDING SOURCE: None.


title: Cadaveric Simulation of Endoscopic Endonasal Procedures: Analysis of Droplet Splatter Patterns During the COVID-19 Pandemic

text: OBJECTIVE: The primary mode of viral transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is thought to occur through the spread of respiratory droplets. The objective of this study was to investigate droplet and splatter patterns resulting from common endoscopic endonasal procedures. STUDY DESIGN: Cadaver simulation series. SETTING: Dedicated surgical laboratory. SUBJECTS AND METHODS: After instilling cadaver head specimens (n = 2) with fluorescein solution, endoscopic endonasal procedures were systematically performed to evaluate the quantity, size, and distance of droplets and splatter following each experimental condition. RESULTS: There were no observable fluorescein droplets or splatter noted in the measured surgical field in any direction after nasal endoscopy, septoplasty with microdebrider-assisted turbinoplasty, cold-steel functional endoscopic sinus surgery (FESS), and all experimental conditions using an ultrasonic aspirator. Limited droplet spread was noted with microdebrider FESS (2 droplets, <1 mm in size, within 10 cm), drilling of the sphenoid rostrum with a diamond burr (8, <1 mm, 12 cm), and drilling of the frontal beak with a cutting burr (5, <1 mm, 9 cm); however, the use of concurrent suction while drilling resulted in no droplets or splatter. The control condition of external activation of the drill resulted in gross contamination (11, 2 cm, 13 cm). CONCLUSION: Our results indicate that there is very little droplet generation from routine rhinologic procedures. The droplet generation from drilling was mitigated with the use of concurrent suction. Extreme caution should be used to avoid activating powered instrumentation outside of the nasal cavity, which was found to cause droplet contamination.


title: A predictive model for Covid-19 spread applied to eight US states

text: A compartmental epidemic model is proposed to predict the Covid-19 virus spread. It considers: both detected and undetected infected populations, medical quarantine and social sequestration, release from sequestration, plus possible reinfection. The coefficients in the model are evaluated by fitting to empirical data for eight US states: Arizona, California, Florida, Illinois, Louisiana, New Jersey, New York State, and Texas. Together these states make up 43% of the US population; some of these states appear to have handled their initial outbreaks well, while others appear to be emerging hotspots. The evolution of Covid-19 is fairly similar among the states: variations in contact and recovery rates remain below 5%; however, not surprisingly, variations are larger in death rate, reinfection rate, stay-at-home effect, and release rate from sequestration. The results reveal that outbreaks may have been well underway in several states before first detected and that California might have seen more than one influx of the pandemic. Our projections based on the current situation indicate that Covid-19 will become endemic, spreading for more than two years. Should states fully relax stay-at-home orders, most states may experience a secondary peak in 2021. If lockdowns had been kept in place, the number of Covid-19 deaths so far could have been significantly lower in most states that opened up. Additionally, our model predicts that decreasing contact rate by 10%, or increasing testing by approximately 15%, or doubling lockdown compliance (from the current $\sim$ 15% to $\sim$ 30%) will eradicate infections in the state of Texas within a year. Extending our fits for all of the US states, we predict about 11 million total infections (including undetected), 8 million cumulative confirmed cases, and 630,000 cumulative deaths by November 1, 2020.


title: [Recommendations for general surgery clinical practice in novel coronavirus pneumonia situation]

text: Novel coronavirus pneumonia (NCP) is a highly infectious disease, has a long incubation period and a variety of clinical manifestations, which has a significant impact on public health and life. Afterwards, scientific and standardized work processing during the epidemic is of great significance for prevention and control. In order to implement the central government's decision-making deployment and defeat the NCP as soon as possible, we had focused on the key points in the clinical work of general surgery according to latest relevant guidelines, literature and experience in epidemic prevention. Finally, we drafted the prevention and control strategies and recommendations to make a reference for medical staff of general surgery to fight NCP.


title: Recommendations for general surgery clinical practice in novel coronavirus pneumonia situation/ 中华外科杂志


Covid-19: Surgeons embrace virtual consultations to meet patients' needs during pandemic


title: COVID-19 pandemic and cardiovascular disease: where do we stand?

text: INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease 2019 (COVID-19) which recently has been characterized as a pandemic by the World Health Organization (WHO) having killed almost 250,000 people worldwide as of May 4th 2020. Despite the fact that SARS-CoV-2 seems to predominantly affect the respiratory system leading to pneumonia and acute respiratory distress syndrome, it is now evident that it may also affect the cardiovascular system in multiple ways. EVIDENCE ACQUISITION: The current paper is a review of the most recent literature regarding SARS-CoV-2 infection and its associated main cardiovascular clinical manifestations. EVIDENCE SYNTHESIS: Cardiovascular disease represents a prevalent underlying comorbidity associated with increased mortality rates among COVID-19 affected individuals. In addition, various cardiovascular manifestations have been linked to the viral insult, including among others acute coronary syndromes, myocarditis, acute heart failure, cardiac injury, arrhythmias and acute pulmonary embolism. CONCLUSIONS: Further studies are required in order to establish the complicated association between SARS-CoV-2 infection and its effects on the cardiovascular system. Our knowledge regarding diagnostic approaches, therapeutic management and preventive measures is constantly enriched throughout an abundance of ongoing research in the respective fields.


The Clinical Microbiology Laboratory Response to COVID-19: a Micro-Comic Strip


Blood vessel injury may spur disease's fatal second phase


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title: Therapeutic and triage strategies for 2019 novel coronavirus disease in fever clinics


Breast cancer screening of mutation carriers in the era of COVID-19 pandemic


title: Private metropolitan telepsychiatry in Australia during Covid-19: current practice and future developments

text: OBJECTIVE: This paper discusses issues arising from the rapid implementation of metropolitan telepsychiatry in private practice during the Covid-19 public health emergency. CONCLUSIONS: The relatively rapid uptake of private practice metropolitan telepsychiatry may further increase flexibility of the options for appointments through ongoing broad telepsychiatry access after the Covid-19 crisis. Telepsychiatry can be used to facilitate the temporary provision of psychiatric care, and has benefits and risks, but is not a longer-term replacement for the interpersonal richness of face-to-face consultations.


title: Review of the present features and the infection control challenges of COVID-19 pandemic in dialysis facilities

text: The COVID-19 has swept the world causing suffering, death, loss, and massive economy damage. The dialysis population is vulnerable and the dialysis facility is critical in maintaining operations and avoiding disease transmission. The present information regarding the clinical features of COVID-19 infection in the dialysis population was collected, and the useful measures of COVID-19 infection prevention and infection control in the dialysis facilities were summarized. Leadership, education, preparedness, management, and recovery phase were determined to be the critical procedures. It is hoped this updated interim review might provide information for medical professionals to take proactive action to best prepare and mitigate damage when facing the COVID-19 pandemic challenge.


title: COVID-19 transforms health care through telemedicine: evidence from the field

text: This study provides data on the feasibility and impact of video-enabled telemedicine use among patients and providers and its impact on urgent and non-urgent health care delivery from one large health system (NYU Langone Health) at the epicenter of the COVID-19 outbreak in the United States. Between March 2nd and April 14th 2020, telemedicine visits increased from 369.1 daily to 866.8 daily (135% increase) in urgent care after the system-wide expansion of virtual health visits in response to COVID-19, and from 94.7 daily to 4209.3 (4345% increase) in non-urgent care post expansion. Of all virtual visits post expansion, 56.2% and 17.6% urgent and non-urgent visits, respectively, were COVID-19-related. Telemedicine usage was highest by patients aged 20-44, particularly for urgent care. The COVID-19 pandemic has driven rapid expansion of telemedicine use for urgent care and non-urgent care visits beyond baseline periods. This reflects an important change in telemedicine that other institutions facing the COVID-19 pandemic should anticipate.


A child confirmed COVID-19 with only symptoms of conjunctivitis and eyelid dermatitis


title: Anatomical study of the female reproductive system and bacteriome of Diaphorina citri Kuwayama, (Insecta: Hemiptera, Liviidae) using micro-computed tomography

text: Huanglongbing (HLB) (citrus greening disease) is one of the most serious bacterial diseases of citrus. It is caused by (1) Candidatus Liberibacter africanus, transmitted by Trioza erytreae and (2) C.L. asiaticus and C.L. americanus, transmitted by Diaphorina citri. As part of a multidisciplinary project on D. citri (www.citrusgreening.org), we made a detailed study, using micro-computed tomography, of the female abdominal terminalia, reproductive system (ovaries, accessory glands, spermatheca, colleterial (= cement) gland, connecting ducts, and ovipositor) and bacteriome, which we present here. New terms and structures are introduced and described, particularly concerning the spermatheca, ovipositor and bacteriome. The quality of images and bacteriome reconstructions are comparable, or clearer, than those previously published using a synchrotron or fluorescence in situ hybridisation (FISH). This study: reviews knowledge of the female reproductive system and bacteriome organ in D. citri; represents the first detailed morphological study of D. citri to use micro-CT; and extensively revises existing morphological information relevant to psylloids, hemipterans and insects in general. High quality images and supplementary videos represent a significant advance in knowledge of psylloid anatomy and are useful tools for future research and as educational aids.


Telemedicine Services During COVID-19: Considerations for Medically Underserved Populations


title: Stopping the SuperSpreader Epidemic: the lessons from SARS (with, perhaps, applications to MERS)

text: I discuss the so-called SuperSpreader epidemic, for which SARS is the canonical examples (and, perhaps, MERS will be another). I use simulation by an agent-based model as well as the mathematics of multi-type branching-processes to illustrate how the SS epidemic differs from the more familiar uniform epidemic (e.g., caused by influenza). The conclusions may surprise the reader: (a) The SS epidemic must be described by at least two numbers, such as the mean reproductive number (of"secondary"cases caused by a"primary case"), R0, and the variance of same, call it V0; (b) Even if R0>1, if V0>>R0 the probability that an infection-chain caused by one primary case goes extinct without intervention may be close to one (e.g., 0.97); (c) The SS epidemic may have a long"kindling period"in which sporadic cases appear (transmitted from some unknown host) and generate a cluster of cases, but the chains peter out, perhaps generating a false sense of security that a pandemic will not occur; (d) Interventions such as isolation (or contact-tracing and secondary case isolation) may prove efficacious even without driving R0 below one; (e) The efficacy of such interventions diminishes, but slowly, with increasing V0 at fixed R0. From these considerations, I argue that the SS epidemic has dynamics sufficiently distinct from the uniform case that efficacious public-health interventions can be designed even in the absence of a vaccine or other form of treatment.


Correction to Lancet Public Health 2020; 5; e261-70


title: Epidemiologic characteristics of early cases with 2019 novel coronavirus (2019-nCoV) disease in Korea

text: In about 20 days since the diagnosis of the first case of the 2019 novel coronavirus (2019-nCoV) in Korea on January 20, 2020, 28 cases have been confirmed. Fifteen patients (53.6%) of them were male and median age of was 42 years (range, 20-73). Of the confirmed cases, 16, 9, and 3 were index (57.2%), first-generation (32.1%), and second-generation (10.7%) cases, respectively. All first-generation and second-generation patients were family members or intimate acquaintances of the index cases with close contacts. Fifteen among 16 index patients had entered Korea from January 19 to 24, 2020 while 1 patient had entered Korea on January 31, 2020. The average incubation period was 3.9 days (median, 3.0), and the reproduction number was estimated as 0.48. Three of the confirmed patients were asymptomatic when they were diagnosed. Epidemiological indicators will be revised with the availability of additional data in the future. Sharing epidemiological information among researchers worldwide is essential for efficient preparation and response in tackling this new infectious disease.


Using air purifier as a supplementary protective measure in dental clinics during the COVID-19 pandemic


Équipements de protection individuelle (EPI) pour anesthésiologistes: la nécessité de directives nationales./ Personal protective equipment (PPE) for anesthesiologists: the need for national guidelines


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title: COVID-19 in Bangladesh: public awareness and insufficient health facilities remain key challenges


The COVID-19 Global Rheumatology Alliance: collecting data in a pandemic


COVID-19: 2020 a year in turmoil


Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line


Modifying Practices in GI Oncology in the Face of COVID-19: Recommendations From Expert Oncologists on Minimizing Patient Risk


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title: Facing challenges with the novel coronavirus SARS-CoV-2 outbreak./ Facing challenges with the novel coronavirus SARS-CoV-2 outbreak


COVID-19: Do not be phobic from fever


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title: Cardiac Surgery in Canada During the COVID-19 Pandemic: A Guidance Statement From the Canadian Society of Cardiac Surgeons

text: On March 11, 2020, the World Health Organization declared that COVID-19 was a pandemic.1 At that time, only 118,000 cases had been reported globally, 90% of which had occurred in 4 countries.1 Since then, the world landscape has changed dramatically. As of March 31, 2020, there are now nearly 800,000 cases, with truly global involvement.2 Countries that were previously unaffected are currently experiencing mounting rates of the novel coronavirus infection with associated increases in COVID-19-related deaths. At present, Canada has more than 8000 cases of COVID-19, with considerable variation in rates of infection among provinces and territories.3 Amid concerns over growing resource constraints, cardiac surgeons from across Canada have been forced to make drastic changes to their clinical practices. From prioritizing and delaying elective cases to altering therapeutic strategies in high-risk patients, cardiac surgeons, along with their heart teams, are having to reconsider how best to manage their patients. It is with this in mind that the Canadian Society of Cardiac Surgeons (CSCS) and its Board of Directors have come together to formulate a series of guiding statements. With strong representation from across the country and the support of the Canadian Cardiovascular Society, the authors have attempted to provide guidance to their colleagues on the subjects of leadership roles that cardiac surgeons may assume during this pandemic: patient assessment and triage, risk reduction, and real-time sharing of expertise and experiences.


title: Inequity and the disproportionate impact of COVID-19 on communities of color in the United States: The need for a trauma-informed social justice response

text: COVID-19 has had disproportionate contagion and fatality in Black, Latino, and Native American communities and among the poor in the United States. Toxic stress resulting from racial and social inequities have been magnified during the pandemic, with implications for poor physical and mental health and socioeconomic outcomes. It is imperative that our country focus and invest in addressing health inequities and work across sectors to build self-efficacy and long-term capacity within communities and systems of care serving the most disenfranchised, now and in the aftermath of the COVID-19 epidemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Mortality in Older Patients with COVID-19


title: Production networks and epidemic spreading: How to restart the UK economy?

text: We analyse the economics and epidemiology of different scenarios for a phased restart of the UK economy. Our economic model is designed to address the unique features of the COVID-19 pandemic. Social distancing measures affect both supply and demand, and input-output constraints play a key role in restricting economic output. Standard models for production functions are not adequate to model the short-term effects of lockdown. A survey of industry analysts conducted by IHS Markit allows us to evaluate which inputs for each industry are absolutely necessary for production over a two month period. Our model also includes inventory dynamics and feedback between unemployment and consumption. We demonstrate that economic outcomes are very sensitive to the choice of production function, show how supply constraints cause strong network effects, and find some counter-intuitive effects, such as that reopening only a few industries can actually lower aggregate output. Occupation-specific data and contact surveys allow us to estimate how different industries affect the transmission rate of the disease. We investigate six different re-opening scenarios, presenting our best estimates for the increase in R0 and the increase in GDP. Our results suggest that there is a reasonable compromise that yields a relatively small increase in R0 and delivers a substantial boost in economic output. This corresponds to a situation in which all non-consumer facing industries reopen, schools are open only for workers who need childcare, and everyone who can work from home continues to work from home.